bluuebunny/crossref_metadata_2025 huggingface dataset:
Multidimensional Prognostic Index Predicts Clinical Outcome and Mortality in Hospitalised Older Patients with Diverticular Disease
Authors: Lenti Marco Vincenzo , Aronico Nicola , Giuffrida Paolo , Costa Stefania , Costetti Martina , Musacchio Clarissa , Pastorelli Luca , Mengoli Caterina , Borrelli de Andreis Federica , Cococcia Sara , Tinelli Carmine , Klersy Catherine , Vecchi Maurizio , Pilotto Alberto , Di Sabatino Antonio
Published: April 2021

Introduction: The Multidimensional Prognostic Index (MPI) is a validated tool for assessing mortality risk in hospitalised patients. We aimed to evaluate whether the MPI predicted mortality and the risk of developing diverticular disease (DD) complications in older patients. Methods: This is a multicentre study conducted in January 2016-March 2018. All patients with DD aged 65 years and older were included. Patients were stratified into three groups according to MPI groups (1, low risk; 2, moderate risk; 3, high risk). Risk of developing DD complications and mortality rate were assessed. Bivariate models were fitted. Results: One hundred hospitalised patients with DD (mean age 77.9 ± 10.6 years, 53 female patients) were included. Patients with higher MPI groups were more likely to develop DD complications. In particular, 12 (46.2%), 21 (52.5%), and 28 (82.4%) patients with complicated DD were distributed to the MPI 1, MPI 2, and MPI 3 groups (p = 0.0063), respectively. Two patients died in the MPI 1, 4 in the MPI 2, and 29 in the MPI 3 group, with mortality rates of 4.0 per 100 person-year (95% confidence interval [CI] 1.0–15.9), 5.6 (95% CI 2.1–15.0), and 89.2 (95% CI 62–130), respectively (log-rank test p < 0.001). In bivariate analysis, after adjustment for age >80 years, Charlson Comorbidity Index >4, DD complications, and the presence of thromboembolism, higher MPI group was independently associated with higher mortality. Those in the MPI 3 group experienced a greater risk of 1-year hospital readmission (p < 0.001). Conclusion: MPI predicted mortality in patients with DD and also correlated with the risk of developing DD complications. Studies focussing on possible pathophysiological mechanisms between DD complications and MPI are needed.
Concurrence of 1- and 3-Min Sit-to-Stand Tests with the 6-Min Walk Test in Idiopathic Pulmonary Fibrosis
Authors: Fedi Arnaud , Keddache Sophia , Quétant Sébastien , Guillien Alicia , Antoniadis Anestis , Soumagne Thibaud , Ritter Ophélie , Glérant Jean-Charles , Cottin Vincent , Degano Bruno , Aguilaniu Bernard
Published: April 2021

Background: In idiopathic pulmonary fibrosis (IPF), some physiological parameters measured during a 6-min walk test (6-MWT) impart reliable prognostic information. Sit-to-stand tests (STSTs) are field exercise tests that are easier to implement than the 6-MWT in daily practice. Objectives: The aims of the study were to test the reproducibility and compare 2 STSTs (the 1-min STST [1-STST] and the semi-paced 3-min chair rise test [3-CRT]) in IPF, and to determine if selected physiological parameters (speed of displacement and changes in pulse oxygen saturation [SpO2]) are interchangeable between the STSTs and the 6-MWT. Methods: Thirty-three patients with stable IPF were studied in 3 French expert centers. To test reproducibility, intra-class correlations (ICCs) of parameters measured during tests performed 7–14 days apart were calculated. To test interchangeability, the agreement and correlation of physiological responses measured during STSTs and during 6-MWT were studied. Results: Vertical displacements and changes in SpO2 during both STSTs were reproducible, with ICCs ranging from 0.78 [0.63–0.87] to 0.95 [0.92–0.97]. Vertical displacements during 1-STST and 3-CRT were correlated with 6-MWT distance (correlation coefficients (r) of 0.72 and 0.77, respectively; p < 0.001). Similarly, correlations were found between changes in SpO2 measured during the 2 STSTs and the 6-MWT, with coefficients ranging from 0.73 to 0.91 (p < 0.001). Distance walked and SpO2 during 6-MWT were well estimated from vertical displacement and SpO2 during the 2 STSTs, respectively. Conclusion: The correlations found between the 2 STSTs and the 6-MWT suggest that STSTs may be of interest to assess displacement and exercise-induced changes in SpO2 in IPF patients.
Utility of Caudal Angulation for Venous Access under Fluoroscopic Guidance during Cardiovascular Implantable Electronic Device Implantation
Authors: Deepti Siddharthan , Singh Dhara , Ghati Nirmal , Shaw Manish , Naik Nitish , Singh Sandeep
Published: April 2021

Background: Axillary venous access is preferred for CIED implantation. The procedure is usually performed under fluoroscopic guidance in anteroposterior (A-P) view. However, there is a lack of perception of depth in this view with a fear of creating complications. Caudal fluoroscopy (adding 30°–35° caudal angulation to A-P projection) has been proposed to circumvent this problem. Objective: The aim of this study was to elucidate the advantages of caudal fluoroscopy using fluoroscopic images, contrast venograms, and CT angiography images of axillary vein. Methods: The fluoroscopic images and contrast venograms obtained in the A-P view were compared with caudal fluoroscopy in patients undergoing CIED implantation at our centre. Also, the CT angiography images of axillary vein were reconstructed to understand the relative anatomy of the vein and the underlying lung parenchyma, simulating these 2 projections. Results: The CT angiography images, contrast venograms, and fluoroscopic images confirmed that caudal fluoroscopy allows better visualization of the vein in relation to the lung parenchyma and rib cage. Analysis of fluoroscopic images revealed that the bend of the first rib formed a conical prominence in caudal fluoroscopy. This served as an important bony landmark for successful venous access, which was usually obtained while the needle was being directed towards this prominence in caudal fluoroscopy. Conclusions: The proposed advantages of caudal fluoroscopy for CIED implantation have been elucidated by analysis of CT angiography images, contrast venograms, and fluoroscopic images.
Serum PR3-ANCA Is a Predictor of Primary Nonresponse to Anti-TNF-α Agents in Patients with Ulcerative Colitis
Authors: Yoshida Atsushi , Matsuoka Katsuyoshi , Ueno Fumiaki , Morizane Toshio , Endo Yutaka , Hibi Toshifumi
Published: April 2021

Background: Anti-tumor necrosis factor-α (TNF-α) agents are effective for moderately to severely active ulcerative colitis (UC). Nonetheless, a proportion of patients fail to respond to these agents as therapy for induction of remission. Recent studies indicated that perinuclear anti-neutrophil cytoplasmic antibody (p-ANCA) may predict response to anti-TNF-α agents in UC patients. However, whether PR3-ANCA can predict primary nonresponse (PNR) to anti-TNF-α agents has not yet been evaluated. The aim of this study was to examine whether PR3-ANCA can predict PNR to anti-TNF-α in UC patients. Methods: This was a single-center retrospective study. Data were extracted from 50 patients with UC who had measurements of PR3-ANCA and received anti-TNF-α agents for the first time as induction therapy. The primary endpoint of this study was a proportion of patients with PNR stratified by PR3-ANCA positivity. PNR to anti-TNF-α agents was defined as failure to achieve reduction in partial Mayo score by 2 or more points and change to other therapeutics within 6 weeks. Results: Fourteen (28%) of the 50 patients were PR3-ANCA positive. Seventeen (34%) of the 50 patients demonstrated PNR. Eleven (78.6%) of the 14 PR3-ANCA-positive patients demonstrated PNR, while 6 (16.7%) of the 36 PR3-ANCA-negative patients demonstrated PNR. Multivariate analysis demonstrated that PR3-ANCA positivity was associated with PNR to anti-TNF-α agents (odds ratio 19.29, 95% CI: 3.30–172.67; p = 0.002). Conclusion: PR3-ANCA positivity can predict PNR to anti-TNF-α agents in UC patients.
Current Reality of Treating Advanced Soft Tissue Sarcoma as Illustrated by Case Studies
Authors: Broto Javier Martín , Jones Robin L.
Published: April 2021

In the first-line setting of advanced soft tissue sarcomas (STS), the treatment aim generally drives decision-making. Anthracycline combinations with ifosfamide or dacarbazine are more appropriate when the aim is tumour shrinkage, and doxorubicin monotherapy is suitable for tumour control. In patients who progress on anthracycline-based regimens, scope exists for tumour shrinkage with trabectedin and concurrent low-dose radiotherapy. Selecting systemic treatment for patients with advanced STS unsuited to receive standard anthracycline-based therapy often involves complex decision-making as clinical trial evidence comparing alternative options is lacking. Key factors to consider are patient characteristics (e.g., age, medical history, performance status), disease characteristics (e.g., stage, histology), and treatment requirements such as the drug’s safety profile, evidence of efficacy by subtype, and approved indication as an alternative first-line treatment option. Real-world data for elderly STS patients derived from retrospective studies and post hoc analyses of clinical trials have particular value in guiding treatment selection and improving the management of this populous but undertreated segment of the STS population.
Age-Stratified Outcome in Treatment of Left Main Coronary Artery Stenosis: A NOBLE Trial Substudy
Authors: Steigen Terje , Holm Niels Ramsing , Myrmel Truls , Endresen Petter C. , Trovik Thor , Mäkikallio Timo , Lindsay Mitchell , Spence Mark S. , Erglis Andrejs , Menown Ian B.A. , Kumsars Indulis , Kellerth Thomas , Davidavičius Giedrius , Linder Rikard , Anttila Vesa , Juul Hune Mogensen Lone , Hostrup Nielsen Per , Graham Alastair N.J. , Hildick-Smith David , Thuesen Leif , Christiansen Evald Høj ,   NOBLE Study Investigators
Published: April 2021

Background: In the treatment of left main coronary artery (LMCA) disease, patients’ age may affect the clinical outcome after percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). This study stratified the clinical outcome according to the age of patients treated for LMCA stenosis with PCI or CABG in the Nordic-Baltic-British Left Main Revascularization (NOBLE) study. Methods: Patients with LMCA disease were enrolled in 36 centers in northern Europe and randomized 1:1 to treatment by PCI or CABG. Eligible patients had stable angina pectoris, unstable angina pectoris, or non-ST elevation myocardial infarction. The primary endpoint was major adverse cardiac or cerebrovascular events (MACCEs), a composite of all-cause mortality, nonprocedural myocardial infarction, any repeat coronary revascularization, and stroke. Age-stratified analysis was performed for the groups younger and older than 67 years and for patients older than 80 years. Results: For patients ≥67 years, the 5-year MACCEs were 35.7 versus 22.3% (hazard ratio [HR] 1.72 [95% confidence interval [CI] 1.27–2.33], p = 0.0004) for PCI versus CABG. The difference in MACCEs was driven by more myocardial infarctions (10.8 vs. 3.8% HR 3.01 [95% CI 1.52–5.96], p = 0.0009) and more repeat revascularizations (19.5 vs. 10.0% HR 2.01 [95% CI 1.29–3.12], p = 0.002). In patients younger than 67 years, MACCE was 20.5 versus 15.3% (HR 1.38 [95% CI 0.93–2.06], p = 0.11 for PCI versus CABG. All-cause mortality was similar after PCI and CABG in both age-groups. On multivariate analysis, age was a predictor of MACCE, along with PCI, diabetes, and SYNTAX score. Conclusions: As the overall NOBLE results show revascularization of LMCA disease, age of 67 years or older was associated with lower 5-year MACCE after CABG compared to PCI. Clinical outcomes were not significantly different in the subgroup younger than 67 years, although no significant interaction was present between age and treatment. Mortality was similar for all subgroups (ClinicalTrials.gov identifier: NCT01496651).
Excess Body Weight and Metabolic (Dysfunction)-Associated Fatty Liver Disease (MAFLD)
Authors: Roeb Elke
Published: April 2021

Background: Nonalcoholic fatty liver disease (NAFLD) describes a continuum of liver abnormalities from simple nonalcoholic fatty liver (NAFL) to nonalcoholic fatty liver hepatitis or steatohepatitis (NASH) to NASH fibrosis. It has a variable course, but just like alcoholic fatty liver disease, it can lead to liver cirrhosis and cancer (hepatocellular carcinoma). Summary: NAFLD is a clinical entity characterized by the presence of liver steatosis, which affects at least 5% of hepatocytes. Affected are people who consume little or no alcohol and who have no secondary cause of liver steatosis such as viral hepatitis, drug intake (e.g., tamoxifen, amiodarone, methotrexate, etc.), or lipodystrophy. NAFLD is, nowadays, the most common liver disease in Europe, with an estimated prevalence of 25%. The currently widely recognized recommendation for the therapy of NAFLD is a lifestyle modification with the goal of weight loss. Although no drugs are currently approved for the treatment of NAFLD, several candidates are in clinical trials. Besides weight loss and physical activity, corresponding single active ingredients or combination therapies are intended to stop the progression of the disease and, in the best case, reverse it. The newly propagated name MAFLD (metabolic-associated fatty liver disease) should indicate that the disease is associated with metabolic disorders. The term MAFLD also implies multiple overlapping causes and drivers of this soaring disease. Key Messages: The prevalence of NAFLD continues to rise worldwide. NAFLD, NASH, and fibrosis in NAFLD occur predominantly in patients with obesity and type 2 diabetes (T2DM) or else precede these conditions. The progression of NAFLD is highly dependent on changes in glucose, lipid metabolism, and fibrogenesis. A new definition and nomenclature of fatty liver disease, “metabolic associated fatty liver disease” (MAFLD), should be discussed carefully, since around 40% of the global population with NAFLD are classified as non-obese and almost 1/5 as lean. Since the pathogenesis of fatty liver disease, obesity, and glucose and lipid metabolism diseases are very closely related, it is important to continue to look for mechanisms that these diseases have in common and develop new therapeutic approaches.
Current Status and Quality of Machine Learning-Based Radiomics Studies for Glioma Grading: A Systematic Review
Authors: Tabatabaei Mohsen , Razaei Ali , Sarrami Amir Hossein , Saadatpour Zahra , Singhal Aparna , Sotoudeh Houman
Published: April 2021

Introduction: Radiomics now has significant momentum in the era of precision medicine. Glioma is one of the pathologies that has been extensively evaluated by radiomics. However, this technique has not been incorporated into clinical practice. In this systematic review, we selected and reviewed the published studies about glioma grading by radiomics to evaluate this technique’s feasibility and its challenges. Material and Methods: Using seven different search strings, we considered all published English manuscripts from 2015 to September 2020 in PubMed, Embase, and Scopus databases. After implementing the exclusion and inclusion criteria, the final papers were selected for the methodological quality assessment based on our in-house Modified Radiomics Standard Scoring (RQS) containing 43 items (minimum score of 0, maximum score of 44). Finally, we offered our opinion about the challenges and weaknesses of the selected papers. Results: By our search, 1,177 manuscripts were found (485 in PubMed, 343 in Embase, and 349 in Scopus). After the implementation of inclusion and exclusion criteria, 18 papers remained for the final analysis by RQS. The total RQS score ranged from 26 (59% of maximum possible score) to 43 (97% of maximum possible score) with a mean of 33.5 (76% of maximum possible score). Conclusion: The current studies are promising but very heterogeneous in design with high variation in the radiomics software, the number of extracted features, the number of selected features, and machine learning models. All of the studies were retrospective in design; many are based on small datasets and/or suffer from class imbalance and lack of external validation data­sets.
ОПТИМІЗАЦІЯ ПРОТИЕПІДЕМІЧНОГО ЗАБЕЗПЕЧЕННЯ У ДИНАМІЦІ ПАНДЕМІЇ COVID-19
Authors: Vynohrad N. O. , Vasylyshyn Z. P. , Kozak L. P. , Shul U. A. , Yurchenko O. O. , Dubyna D. O.
Published: April 2021

Новий коронавірус SARS-Cov-2, який виявили в м. Ухань у грудні 2019 р., спричинив пандемію COVID-19. Протиепідемічний захист у різних уражених країнах відрізняється за обсягами режимно-обмежувальних заходів і регламентами реагування. Найефективнішим виявився комплекс карантинних заходів у поєднанні з раннім виявленням епідемічних осередків та їх блокуванням.

Масовість ураження населення в більшості країнах світу зумовила неефективність діяльності усіх трьох основних медичних ланок системи реагування на біологічні загрози: клінічної, епідеміологічної та лабораторної, – які є визначальними у ліквідації пандемії. Відсутність засобів лікування і профілактики вимагає постійного моніторингу епідемічної ситуації та своєчасної корекції заходів стримання її негативних тенденцій розвитку. Медичні заклади стали об’єктами високого ризику зараження як медичного персоналу, так і усіх, хто звертається за медичною допомогою, що вимагає тотального запровадження специфічних заходів інфекційного контролю щодо COVID-19 на всіх рівнях надання медичної допомоги, включно на етапах евакуації та сортування хворих.

Швидке прогресування розвитку епідемічного процесу COVID-19 на планеті на фоні даних про низьке репродуктивне число свідчить про недостатність знань з основних проявів і закономірностей епідемічного процесу цього особливо небезпечного інфекційного захворювання, що може бути основною причиною неефективності протиепідемічних заходів.

Еволюція SARS-Cov-2 з формуванням трьох підтипів і п’яти генотипів збудника, особливо поява варіанту вірусу D614G з підвищеною контагіозністю і вірулентністю, вимагає ефективного вірусологічного моніторингу для створення валідних діагностичних тест-систем і оцінювання перспективності застосування специфічної активної імунопрофілактики на момент появи вакцин проти COVID-19.

Відсутність даних про інфікувальну дозу SARS-Cov-2 із врахуванням механізмів передачі збудника інфекції, наявність високої частки асимптомних форм хвороби, обмежені дані щодо «суперрозповсюджувачів» патогена, великі втрати серед медичного персоналу, відмінності в системах реагування на біологічні небезпеки на уражених територіях та низка інших обставин ускладнюють можливості ефективного протиепідемічного реагування на COVID-19. Відсутність контролю дотримання рекомендованого обсягу протиепідемічних заходів інтенсифікує розвиток епідемічного процесу в період запровадження адаптивного карантину.
COVID-19: ЕПІДЕМІОЛОГІЯ, КЛІНІКА, ДІАГНОСТИКА, ЛІКУВАННЯ ТА ПРОФІЛАКТИКА
Authors: Andreychyn M. A. , Nychyk N. A. , Zavidniuk N. H. , Iosyk Ia. I. , Ischuk I. S. , Ivakhiv O. L.
Published: April 2021

На підставі огляду наукової літератури наведено основні дані про історію коронавірусних інфекцій людини, зокрема епідемії тяжкого гострого респіраторного синдрому (SARS) і близько-східного респіраторного синдрому (MERS) та теперішню пандемію COVID-19. Послідовно описано етіологію COVID-19, її епідеміологію, патогенез, основні клінічні варіанти та їх прояви, класифікацію за ступенем тяжкості, можливі ускладнення та обтяжливі чинники. Подано визначення різних випадків цієї інфекції за епідеміологічними та клінічними критеріями. Перечислено лабораторні та апаратні методи діагностики з клінічним тлумаченням. Виокремлено методи специфічної та диференційної діагностики. Наведено показання до госпіталізації хворих на COVID-19 і сучасні підходи до лікування за відсутності специфічних противірусних засобів. У лікуванні акцент зроблено на застосуванні патогенетичної терапії. Стисло наведено основні заходи неспецифічної індивідуальної та колективної профілактики із запровадженням карантину. Стаття призначена головно для лікарів, які працюють з хворими на COVID-19 і контактними особами.
An updated Checklist of the Mediterranean fishes of Israel, with illustrations of recently recorded species and delineation of Lessepsian migrants
Authors: GOLANI DANIEL
Published: April 2021

This checklist of the Mediterranean fishes of Israel enumerates 469 species which is an addition of 62 species since the previous checklist of 2005. This new checklist includes 58 Condrichthys and 411 Osteicthys species. Most newly-recorded species are of Red Sea origin (Lessepsian migrants)—38 species, 25 species are from previously poorly investigated habitats, mainly deep water, while two species reached the Mediterranean most likely by ballast water and two are aquaculture escapees.                The dramatic increase in the number of Lessepsian migrants (an average of 2.5 species per year) is most likely due to the increased water influx between the Red Sea and the Mediterranean, following the recent opening of the new parallel, 72 km, “new canal” and the enlargement of other parts of the Suez Canal.
Toward a Theory of the Evolution of Drop Morphology and Splintering by Freezing
Authors: Staroselsky Alexander , Acharya Ranadip , Khain Alexander
Published: April 2021

The drop freezing process is described by a phase-field model. Two cases are considered: when the freezing is triggered by central nucleation and when nucleation occurs on the drop surface. Depending on the environmental temperature and drop size, different morphological structures develop. Detailed dendritic growth was simulated at the first stage of drop freezing. Independent of the nucleation location, a decrease in temperature within the range from ~−5° to −25°C led to an increase in the number of dendrites and a decrease in their width and the interdendritic space. At temperatures lower than about −25°C, a planar front developed following surface nucleation, while dendrites formed a granular-like structure with small interdendritic distances following bulk nucleation. An ice shell grew in at the same time (but slower) as dendrites following surface nucleation, while it started forming once the dendrites have reached the drop surface in the case of central nucleation. The formed ice morphology at the first freezing stage predefined the splintering probability. We assume that stresses needed to break the ice shell arose from freezing of the water in the interdendritic spaces. Under this assumption, the number of possible splinters/fragments was proportional to the number of dendrites, and the maximum rate of splintering/fragmentation occurred within a temperature range of about −10° to −20°C, is in agreement with available laboratory and in situ measurements. At temperatures < −25°C, freezing did not lead to the formation of significant stresses, making splintering unlikely. The number of dendrites increased with drop size, causing a corresponding increase in the number of splinters. Examples of morphology that favors drop cracking are presented, and the duration of the freezing stages is evaluated. Sensitivity of the freezing process to the surface fluxes is discussed.
A Neural Network-Based Observation Operator for Coupled Ocean-Acoustic Variational Data Assimilation
Authors: Storto Andrea , De Magistris Giovanni , Falchetti Silvia , Oddo Paolo
Published: April 2021

Variational data assimilation requires implementing the tangent-linear and adjoint (TA/AD) version of any operator. This intrinsically hampers the use of complicated observations. Here, we assess a new data-driven approach to assimilate acoustic underwater propagation measurements (Transmission Loss, TL) into a regional ocean forecasting system. TL measurements depend on the underlying sound speed fields, mostly temperature, and their inversion would require heavy coding of the TA/AD of an acoustic underwater propagation model. In this study, the non-linear version of the acoustic model is applied to an ensemble of perturbed oceanic conditions. TL outputs are used to formulate both a statistical linear operator based on canonical correlation analysis (CCA), and a neural network-based (NN) operator. For the latter, two linearization strategies are compared, the best-performing one relying on reverse-mode automatic differentiation. The new observation operator is applied in data assimilation experiments over the Ligurian Sea (Mediterranean Sea), using the Observing System Simulation Experiments (OSSE) methodology to assess the impact of TL observations onto oceanic fields. TL observations are extracted from a nature run with perturbed surface boundary conditions and stochastic ocean physics. Sensitivity analyses indicate that the NN reconstruction of TL is significantly better than CCA. Both CCA and NN are able to improve the upper ocean skill scores in forecast experiments, with NN outperforming CCA on the average. The use of the NN observation operator is computationally affordable, and its general formulation appears promising for the adjoint-free assimilation of any remote sensing observing network.
Winnicott’s Idea OF The False Self: Theory as Autobiography
Authors: Ehrlich Robert
Published: April 2021

One of the most important concepts developed by D. W. Winnicott was his idea of the false self. In the course of his work, he was often preoccupied with the need to maintain a sense of psychological vitality, which could be threatened in various ways. Threats occur throughout the life cycle as parents, siblings, friends, teachers, and other people impact the individual and contribute to the creation of the inner world of fantasy, which is also self-generated. These elements can work together or separately to undermine one’s sense of vitality by the pressure to comply with a variety of demands, which can give rise to a false self. Winnicott’s principal method of exploring this issue was through his clinical work, which was informed by personal struggles instrumental in shaping his thinking about the concept.
A Body of One’s Own: From Self-Cutting to the Cuts of Separation in an Adolescent Suffering From Traumatic Early Abandonments
Authors: Balottin Laura , Quagelli Luca , Costantini Maria Vittoria
Published: April 2021

The treatment of adolescents suffering from early traumatic experiences inescapably involves the encounter with patients’ concrete use of their bodies and actions. The clinical history of an adolescent girl reveals the relationship between traumatic transgenerational abandonments and self-cutting in the transference-countertransference relationship. Initially the patient’s body and actions were the only way to communicate experiences that could not be conveyed in words and represented: the “skin for two” of the original psychosomatic envelope needed to be wounded, cut, broken concretely. The establishment of a boundary between internal and external, self and other, is the result of a complex process with roots in the quality of the encounter with the object. Gradually, in the encounter with the analyst, the young patient may construct a tenuous possibility of differentiation and begin to access the first outline of a representation of loss.
Mother-Infant Observations: A View into the Wordless Social Instincts that Form the Foundation of Human Psychodynamics
Authors: Benveniste Daniel S.
Published: April 2021

Mother-infant observations attune the psychotherapist to the nonverbal interactions that shape the child’s experience of the world. The origins of our interest in psychoanalytic mother-infant observations can be traced back to clinical work with adults, child analyses, ethology (the study of animal behavior), and theoretical questions about the development of the symbolic function in infancy. More recently, seminars and direct experience in mother-infant observation have been gaining popularity as components of psychoanalytic training. Indeed, mother-infant observations are a kind of human ethological investigation that offer a rare peek into the wordless social instincts that find their origins in the ancient evolution of our species.
Government choice between contract termination and contract expiration in re-municipalization: a case of historical recurrence?
Authors: Albalate Daniel , Bel Germà , Reeves Eoin
Published: April 2021

Since the early 2000s, the terms ‘re-municipalization’ and ‘reverse privatization’ entered the lexicon as several examples emerged of governments taking ownership of assets and services that had previously been privatized or outsourced. Various methods are used to implement re-municipalization decisions and differences are observed across countries and sectors. The approaches most frequently adopted are re-municipalization through contract termination and contract expiration. We utilize a wide database of re-municipalizations worldwide to analyse the factors that influence governments’ choice between these two approaches. The results from our multivariate analysis find a pattern of historical recurrence in the characteristics of the current re-municipalization process.

Points for practitioners

Most governments wait for contracts to expire but the number of contract terminations is sizeable. Re-municipalization in larger cities, network sectors (particularly water) and implemented by municipal governments have a positive association with termination. Re-municipalization of energy utilities and conducted in countries of French legal origin is positively associated with contract expiration. Patterns of contemporary re-municipalization closely resemble those witnessed in the ‘Progressive Era’.
Delamination and hole wall roughness evaluation in air-cooled drilling of carbon fiber-reinforced polymer
Authors: Hoffmann Nícholas , Souza Gabriel SC , Souza André J , Tita Volnei
Published: April 2021

Drilling of carbon fiber-reinforced polymer (CFRP) is widely employed in manufacturing processes in the aeronautical, automobile, and energy industries. The evaluation of the hole region focusing on wall roughness and delamination phenomena is extremely important to predict bolted joints' performance, where at least one of the adherent is a composite material. Thus, this work performed a statistical analysis on the delamination (entrance and exit of the plate) and wall roughness of drilling holes in an 8.6 mm thick CFRP plate carried out by an uncoated carbide drill under compressed air-cooling, varying the cutting speeds and feed rates. Since air-cooling usage combines positive aspects, such as low-cost implementation and shorter process time compared to ultrasonic-assisted drilling, it turns out to be an excellent alternative for aeronautical industry. Thus, the main contribution of the present work consists on analyzing the variation of the delamination in the entrance and exit of the first and tenth holes of a CFRP plate after dry and air-cooled drilling. This variation of the delamination between the cold drill (first hole) and the heated drill due to the drilling holes' sequence (after ten holes) is investigated for 18 different combinations of parameters (runs). For instance, it is shown that if the combination of parameters values is suitable, then it is possible to reduce the mean value of adjusted delamination factor for the entrance of the tenth hole around 11% when comparing cooled-air with dry cutting.
Motivators for Cannabis Use Among Young Adults in Outpatient Psychiatric Care: A Qualitative Study
Authors: Whiteley Laura , Haubrick Kayla K. , Arnold Trisha , Craker Lacey , Olsen Elizabeth , Hershkowitz Dylan , Maj Shannon , Brown Larry K.
Published: April 2021

Cannabis use is prevalent among youth with mental illness, despite the increased risk of exacerbating psychiatric symptoms. The rapidly changing legality of cannabis has contributed to its normalization and decreased perceived risks. This study qualitatively gathered young adult psychiatric patients’ ( n=15) perspectives on cannabis to inform a use reduction intervention. NVivo12 was used to organize coded data and facilitate analysis. Motivations to use included viewing cannabis utilization as normalized, supported, and a safer alternative to psychiatric medications. Facilitators for decreasing use were cannabis’ inadequacy at long-term symptom relief, the negative psychiatric sequelae seen in other users, and moderation of intake. Recommendations for the intervention included avoiding overly critical content and providing behavioral skills to aid reduction while improving psychiatric symptoms. Young adults in psychiatric care have unique motivations for cannabis consumption and decreasing use, which should be targeted in future interventions.
Archiving genetically altered animals: a review of cryopreservation and recovery methods for genome edited animals
Authors: Hart-Johnson Sarah , Mankelow Katharine
Published: April 2021

With the ever-expanding numbers of genetically altered (GA) animals created in this new age of CRISPR/Cas, tools for helping the management of this vast and valuable resource are essential. Cryopreservation of embryos and germplasm of GA animals has been a widely used tool for many years now, allowing for the archiving, distribution and colony management of stock. However, each year brings an array of advances, improving survival rates of embryos, success rates of in-vitro fertilisation and the ability to better share lines and refine the methods to preserve them. This article will focus on the mouse field, referencing the latest developments and assessing their efficacy and ease of implementation, with a brief note on other common genetically altered species (rat, zebrafish, Xenopus, avian species and non-human Primates).
Relating Competitive Golfers’ Perceived Emotions and Performance
Authors: Lundkvist Erik , Gustafsson Henrik , Björklund Gunilla , Davis Paul , Ivarsson Andreas
Published: April 2021

The present study examined relationships between golfers’ self-perceived emotions (e.g., irritability, nervousness, tension), task-oriented coping, perceived control, and performance during a golf competition. We implemented a process-oriented golf analysis in which competitors rated these variables hole-by-hole in a competitive golf round. Within a two-level Bayesian multivariate autoregressive model, we showed that (a) within persons, emotions and task-oriented coping were reactions that stemmed from performance on the previous hole; and (b) between persons, player skill level predicted both better scores and the ability to limit the influence of negative affect on performance. These findings highlight the complex nature of the relationship between emotions and performance. Future studies might use a similarly ecologically valid research design to more precisely measure aspects of time and potentially moderating effects of player skill level and personality. An increased understanding of the dynamic relationship between emotions and performance can promote the development of effective psychological interventions for optimal performance outcomes.
Release or Denial: Evaluating the Roles of Emotion and Risk in Parole Decisions
Authors: Yelderman Logan A. , Estrada-Reynolds Victoria , Lawrence Timothy I.
Published: April 2021

Parole boards often incorporate numerous factors when making release decisions. These factors are typically related to the inmates’ case files. However, in some instances, parole boards’ decisions are influenced by factors outside of the case files, sometimes referred to as extra-legal factors. According to the emotion as social information model, emotion can communicate specific messages to others, and in this case, parole board members might unknowingly incorporate their own emotions and inmates’ emotional displays into their decisions. The current study examines the role of parole board member and inmate emotional expressions as predictors of parole release decisions. Parole hearings were coded for emotion, parole board and inmate gender, supporter presence, and risk scores. Overall, risk scores and parole board members’ emotions predicted release decisions. Higher risk scores were associated with a lower likelihood of release, and inmates’ negative emotion was related to a lower likelihood of release. Implications are discussed.
The role of radiotherapy in neuroendocrine cervical cancer: SEER-based study
Authors: Dong Meilian , Gu Xiaobin , Ma Taoran , Mi Yin , Shi Yonggang , Fan Ruitai
Published: April 2021

Background:

There are few randomised prospective data or guidelines for the treatment of neuroendocrine cervical cancer (NECC). In addition, the role of radiotherapy (RT) in NECC remains controversial. We used the Surveillance Epidemiology and End Results (SEER) database to investigate the role of RT for the treatment of NECC. Particular attention was paid to the different role of RT in patients with or without a metastasis (M1 or M0).

Methods:

The SEER database was queried for studies on NECC. We limited the year of diagnosis to the years 2000 to 2015. A Pearson’s two-sided Chi-squared test, the Kaplan–Meier method and Cox regression analysis models were used for statistical analyses. The overall survival (OS) was studied for the overall group and between-subgroup groups.

Results:

NECC was an aggressive disease with a mean OS of only 46.3 months (range of 0–196 months, median of 23 months). No significant differences were shown between the surgery (S) and S + RT groups ( p = 0.146) in the M0 (without metastasis) arm. However, there was a statistically significant difference in OS between the S and S + RT groups in the M1 (with metastasis) arm (median of 44.6 months for the S group and 80.9 months for the S + RT group), p = 0.004. The mean survival was significantly longer for M0 patients than for M1 patients when treated with S only (S arm), that is, 82.1 months versus 44.6 months, respectively (log-rank p = 0.000). We also noted that when patients received adjuvant RT (S + RT arm), there were no significant differences between the M0 and M1 groups (median of 90.6 and 81.0 months, p = 0.704, respectively). Age at diagnosis, chemotherapy, T stage and N stage were significant factors for OS in the M0 arm. Interestingly, radiotherapy was the only significant factor for OS with a multivariate HR for death of 0.502 (95% CI 0.206–0.750, p = 0.006) in the M1 arm.

Conclusions:

RT may be carefully used in patients who are negative for metastases. Using SEER data, we identified a significant survival advantage with the combination of radiotherapy and surgery in NECC with metastases. This suggests that active local treatment should be conducted and has a significant impact on OS, even if a distant metastasis has occurred.
Capturing the non-technical skills of a technical skills trainer (NTS-TeST) during simulation
Authors: Pears Matthew , Biyani Chandra Shekhar , Joyce Adrian D , Spearpoint Ken , Yiasemidou Marina , Cleynenbreugel Ben Van , Patterson Jake , Mushtaq Faisal
Published: April 2021

Objective

To develop an assessment instrument that can be used as a comprehensive feedback record to convey to a trainer the non-technical aspects of skill acquisition and training.

Methods

The instrument was developed across three rounds. In Round 1, 6 endourological consultants undertook a modified Delphi process. Round 2 included 10 trainers who assessed each question’s relevance and practicability. Round 3 involved a pilot study with fifteen urology residents who participated in a technical skills simulation session with the incorporation of the instrument. We report the content, face, and construct validity, and the internal consistency of an NTS instrument for trainers.

Results

The instrument had a consistent and a high positive average for each of the 4 sections of the instrument, regardless of the type of user. Positive Spearman’s correlation coefficients (0.02 to .64) for content validity and Cronbach’s alpha (a = 0.70) indicated good validity and moderate reliability of the instrument.

Conclusion

We propose a novel NTS instrument for trainers during a simulation. This instrument can be used for benchmarking the quality of technical skills simulation training.
Facile thermoplastic polyurethane-based multi-walled carbon nanotube ink for fabrication of screen-printed fabric electrodes of wearable e-textiles with high adhesion and resistance stability under large deformation
Authors: Jiang Lihong , Hong Hong , Hu Jiyong
Published: April 2021

Carbon nanotubes have been widely used to formulate printed conductive ink in recent years due to their excellent conductivity, chemical stability and mechanical properties. However, the common problems of this ink, such as poor adhesion and low resistance stability under large deformation, hinder its application in the fabric electrodes (FEs) of wearable and stretchable e-textiles. Herein, conductive inks with a simple preparation process, high adhesion and conductive stability were formulated by mixing the conductive filler, multi-walled carbon nanotubes (MWCNTs), into a thermoplastic polyurethane matrix with a reversible cross-linked structure. Then it is evaluated whether the MWCNT-based conductive ink is suitable for the screen-printing fabrication of highly durable and washable FEs. The experimental results showed that the screen-printed fabric electrode exhibited remarkable resistance stability under bending and folding deformation. In particular, after 1000 bending cycles and 100 folding–unfolding cycles under additional pressure, the sheet resistance of FEs only increased by 0.8% and 5.0%, respectively. Moreover, the screen-printed conductive pattern has strong adhesion to polyamide fabric substrate by the Scotch tape and washing tests, and there are no significant changes in resistance and surface morphology. High-performance conductive inks with facile and large-scale production potential are developed, and show great prospect in the development of wearable printing e-textiles.
Investigation of Clostridium difficile in elderly people: A preliminary study in Iran
Authors: Ghasemi Ahmad , Mohabati Mobarez Ashraf , Mostafavi Ehsan
Published: April 2021

Elderly people are at increased risk for infections such as with Clostridium difficile. This can colonize their gut and cause various gastro-intestinal manifestations. Our survey investigated its prevalence in a nursing home in Iran. Faecal samples were collected and tested by polymerase chain reaction for identification of A, B and binary toxin genes. From 289 samples, 42(14.5%) isolates were found. Toxin genes were positive in 19 isolates (17 AþBþ and 2 isolates ABþ). The elderly are especially at risk and great attention should be paid to contamination within their nursing homes. This is not an isolated regional problem.
Opioids, Race, Context, and Journeys to Crime: Analyzing Black–White Differences in Travel Associated With Opioid Possession Offenses
Authors: Donnelly Ellen A. , Wagner Jascha , Hughes Cresean , Gray Andrew C. , Anderson Tammy L. , O’connell Daniel J.
Published: April 2021

Journeys to crime, or distances traveled from residences to places of alleged crimes, describe how people enter into the criminal justice system. Race, as an ascribed characteristic of individuals and a determinant of community conditions, introduces disparities in journeys to crime. Use of opioids among nonurban, White populations and changing law enforcement responses prompt inquiry into how race affects journeys to crime associated with opioid possession. This study evaluates Black–White differences in travel among persons arrested for opioid possession in Delaware. It applies race and rationality theory to assess the effects of race and racialized context on travel patterns. Multilevel models reveal travel to possess opioids is greater for White relative to Black Delawareans. Community conditions such as marijuana possession arrest rates and concentrated disadvantage have varying impacts on travel from various geographic areas. Racial–spatial differences in travel show persistent disparities in drug law enforcement amid efforts to curb opioid misuse.
Küme mongen on the Coast: Contexts and Course Changes in Intercultural Health in the South of Chile
Authors: Picaroni Sobrado Natalia , Gay Sebastián Medina , Vásquez Reyes José Osvaldo
Published: April 2021

The current entanglement of intercultural health and küme mongen (good health or good life) in the Williche territory of Chile is an unstable and contradictory construction that emerged as an ideological and utopian response to three simultaneous processes: the neoliberal acceleration of dispossession and eco-social degradation, the neoliberal implementation of a special health care policy for indigenous peoples, and various forms of lack of access to health care.

El entrelazamiento actual de la salud intercultural y el küme mongen (buena salud o buena vida) en el territorio williche de Chile es una construcción inestable y contradictoria que surgió como una respuesta ideológica y utópica a tres procesos simultáneos: la aceleración neoliberal del despojo y la degradación ecosocial, la implementación neoliberal de una política especial de atención de la salud para los pueblos indígenas, y diversas manifestaciones de falta de acceso a la atención médica.
Three Synchronous Head and Neck Cancers: A Multidisciplinary and Surgical Challenge
Authors: Bertone Fabio , Robiolio Emanuele , Robiolio Luca , Liscia Daniele , Gervasio Carmine F.
Published: April 2021

Second primary cancer (SPC) is a term used to describe a new primary cancer occurring in patients who had formerly been diagnosed with tumor. Even though SPCs appear to be related to primary cancers, they are actually entities that have arisen independently and not as a result of recurrence. This report is of the first case in literature of a patient hospitalized for the surgical treatment of 3 synchronous Head and Neck Cancers. A 66-year-old male was admitted to our hospital (Ospedale Degli Infermi—Biella, Italy) complaining about pharyngodynia. Three different lesions were identified through endoscopic examination and narrow band imaging: the first one on left tonsil, the second one on epiglottis, and the third one on right aryepiglottic fold. The case was subject to a multidisciplinary team analysis due to its complexity, then the surgery consisted in (1) CO2 laser left tonsillectomy, associated with (2) CO2 laser excision of the lesion on epiglottis free edge, and (3) CO2 laser excision of right aryepiglottic fold lesion. Synchronous tumors are among the most defiant challenges for surgeons since no international guideline specifies differentiated strategies to be adopted in patients affected by synchronous Head and Neck Cancers, therefore surgical planning must be tailored differently from patient to patient, and many unsolved questions still concern clinical treatments to be adopted.
Lobular Capillary Hemangioma Originating From the Posterior End of the Inferior Turbinate: A Very Rare Occurrence
Authors: Lee Jae Hoon
Published: April 2021

Lobular capillary hemangioma mostly occurs in the anterior portion of the nasal cavity, rarely occurring in the posterior end of the inferior turbinate, as in this case. We report a case of lobular capillary hemangioma originating from the posterior end of the right inferior turbinate, which was successfully removed via an endoscopic endonasal approach.