bluuebunny/crossref_metadata_2025 huggingface dataset:
Revealing the Impact of Structural Variants in Multiple Myeloma
Authors: Rustad Even H. , Yellapantula Venkata D. , Glodzik Dominik , Maclachlan Kylee H. , Diamond Benjamin , Boyle Eileen M. , Ashby Cody , Blaney Patrick , Gundem Gunes , Hultcrantz Malin , Leongamornlert Daniel , Angelopoulos Nicos , Agnelli Luca , Auclair Daniel , Zhang Yanming , Dogan Ahmet , Bolli Niccolò , Papaemmanuil Elli , Anderson Kenneth C. , Moreau Philippe , Avet-Loiseau Hervé , Munshi Nikhil C. , Keats Jonathan J. , Campbell Peter J. , Morgan Gareth J. , Landgren Ola , Maura Francesco
Published: September 2020

The landscape of structural variants (SV) in multiple myeloma remains poorly understood. Here, we performed comprehensive analysis of SVs in a large cohort of 752 patients with multiple myeloma by low-coverage long-insert whole-genome sequencing. We identified 68 SV hotspots involving 17 new candidate driver genes, including the therapeutic targets BCMA (TNFRSF17), SLAM7, and MCL1. Catastrophic complex rearrangements termed chromothripsis were present in 24% of patients and independently associated with poor clinical outcomes. Templated insertions were the second most frequent complex event (19%), mostly involved in super-enhancer hijacking and activation of oncogenes such as CCND1 and MYC. Importantly, in 31% of patients, two or more seemingly independent putative driver events were caused by a single structural event, demonstrating that the complex genomic landscape of multiple myeloma can be acquired through few key events during tumor evolutionary history. Overall, this study reveals the critical role of SVs in multiple myeloma pathogenesis.

Significance:

Previous genomic studies in multiple myeloma have largely focused on single-nucleotide variants, recurrent copy-number alterations, and recurrent translocations. Here, we demonstrate the crucial role of SVs and complex events in the development of multiple myeloma and highlight the importance of whole-genome sequencing to decipher its genomic complexity.

See related commentary by Bergsagel and Kuehl, p. 221.

This article is highlighted in the In This Issue feature, p. 215
Dexamethasone in Patients with Spontaneous Intracerebral Hemorrhage: An Updated Meta-Analysis
Authors: Wintzer Stephanie , Heckmann Josef Georg , Huttner Hagen B. , Schwab Stefan
Published: September 2020

Background: Spontaneous intracerebral hemorrhage (ICH) is a frequent cerebrovascular disorder and still associated with high mortality and poor clinical outcomes. The purpose of this review was to update a 15-year-old former meta-analysis on randomized clinical trials (RCTs) addressing the question of whether ICH patients treated with dexamethasone have better outcomes than controls. Methods: The electronic databases PubMed, SCOPUS, and Cochrane as well as web platforms on current clinical trials were searched for the years 1970–2020 without constriction on language. Data were extracted and outcomes were pooled for conventional and cumulative meta-analysis using a commercial software program (www.Meta-Analysis.com). Results: Finally, 7 RCTs were identified and analyzed including 248 participants in the dexamethasone groups and 242 in the control groups. Five studies showed a high risk of bias. The overall relative risk (RR) for death was 1.32 (95% confidence interval [CI] 0.99–1.76; p = 0.06) and did not differ significantly between the 2 groups. After exclusion of studies with high risk of bias, the RR for death was 1.37 (95% CI 0.54–3.42; p = 0.51). The RR for poor outcome did not differ significantly between the 2 groups analyzed for all included studies (RR = 0.69; 95% CI 0.47–1; p = 0.05) and after exclusion of studies with high risk of bias (RR = 0.7; 95% CI 0.45–1.08; p = 0.11). The RR for complications did not differ significantly including all studies (RR = 1.29; 95% CI 0.77–2.17; p = 0.34) and after exclusion of studies with high risk of bias (RR = 1.27; 95% CI 0.18–8.89; p = 0.81). The cumulative statistics delivered no other results; however, it pointed out fewer complications over time in the dexamethasone group. Conclusion: Clear evidence of a beneficial or negative effect of dexamethasone is still lacking. Modern RCTs or observational studies with propensity design are necessary to evaluate the efficacy and safety of treatment with dexamethasone in patients with ICH.
COVID-19 in Patients with Hematologic Disorders Undergoing Therapy: Perspective of a Large Referral Hematology Center in Rome
Authors: Girmenia Corrado , Gentile Giuseppe , Micozzi Alessandra , Petrucci Luigi , Malaspina Francesco , Di Prima Alessio , Baldacci Erminia , Bianchi Simona , Pugliese Pellegrina , Turriziani Ombretta , Antonelli Guido , Tombolini Vincenzo , Foà Robin , Martelli Maurizio
Published: September 2020

Introduction: Patients with cancer may be more susceptible to and have higher morbidity and mortality rates from COVID-19 than the general population, while epidemiologic data specifically addressed to hematologic patients are limited. To investigate whether patients with hematologic diseases undergoing therapy are at increased risk for acquiring SARS CoV-2 infection compared to the general population, a retrospective study was carried out at a referral hematologic center in Rome, Italy, during the period of the greatest epidemic spread (March 8 to May 14, 2020). Methods: All adult and pediatric patients with a diagnosis of a neoplastic or a nonneoplastic hematologic disease who underwent treatment (chemotherapy or immunosuppressive or supportive therapy) during the study period or in the previous 6 months were considered. The prevalence of COVID-19 in the overall outpatient and inpatient population undergoing hematologic treatment compared to that of the general population was analyzed. The measures taken to manage patients during the epidemic period are described. Results: Overall, 2,513 patients with hematological diseases were considered. Out of 243 (9.7%) patients who were screened for SARS CoV-2, three of 119 (2.5%) outpatients with fever or respiratory symptoms and none of 124 asymptomatic patients were diagnosed with COVID-19. Three further patients were diagnosed with COVID-19 and managed in other hospitals in Rome. As of May 14, 2020, the prevalence of COVID-19 in our hematologic population accounted for 0.24% (95% CI 0.23–0.25; 6 of 2,513 patients: 1 case in every 419 patients) as compared to 0.12% (7,280 of 5,879,082 residents; 1 case in every 807 residents) in the general population (p = 0.14). Three of 6 patients diagnosed with COVID-19 required critical care and 2 died while still positive for SARS CoV-2. Out of 225 healthcare providers on duty at our Institution during the study period, 2 (0.9%) symptomatic cases were diagnosed with COVID-19. Conclusion: In our experience, the prevalence of COVID-19 in hematologic patients, mainly affected by malignancies, was not significantly higher compared to that of the general population. Definition of adapted strategies for healthcare services, while continuing to administer the standard hematologic treatments, represents the crucial challenge for the management of hematologic diseases in the COVID-19 era.
Longitudinal Retinal Changes Induced by Hydroxychloroquine in Eyes without Retinal Toxicity
Authors: Godinho Gonçalo , Madeira Carolina , Falcão Manuel , Penas Susana , Dinah-Bragança Teresa , Brandão Elisete , Carneiro Ângela , Santos-Silva Renato , Falcão-Reis Fernando , Beato João
Published: September 2020

Introduction: This study aimed to evaluate the longitudinal changes in retinal layer thickness in patients treated with hydroxychloroquine without retinal toxicity. Methods: This is a longitudinal retrospective study of patients taking hydroxychloroquine followed in a hydroxychloroquine retinal toxicity screening program of a tertiary hospital between January 2010 and April 2019. Patients who performed 2 optical coherence tomography (OCT) scans at least 1 year apart were included. All subjects with hydroxychloroquine suspected or confirmed retinal toxicity, glaucoma, retinal pathology, or poor segmented images were excluded. Spectral-domain optical coherence tomography (Spectralis HRA-OCT, Heidelberg) was used to evaluate the macular area. Automatically segmented ETDRS retinal thickness maps were compared between the first and the last OCT evaluation available. Full retina (FR), inner retina (IRL), ganglion cells (GCL), inner nuclear (INL), and outer retina (ORL) layer thicknesses were measured in the foveolar, paracentral, and peripheral area. Results: The population included 144 eyes of 144 patients. The mean interval between OCT scans was 38.1 ± 18.4 months, and the mean cumulative dose was 406.9 ± 223.9 g. Foveolar (p = 0.040, p = 0.006, and p = 0.001, respectively) and paracentral (p = 0.006, p = 0.001, and p = 0.005, respectively) FR, IRL, and GCL decreased overtime. No differences were found in INL or ORL. A very weak correlation was found between age and foveal IRL change overtime (p = 0.037; R = 0.175), as well as between the hydroxychloroquine time of use and foveal GCL variation (p = 0.032; R = 0.179). Conclusion: Hydroxychloroquine was found to cause progressive thinning of the inner retinal layers, specifically in the GCL of the foveolar and paracentral areas, but no changes were observed in the outer retina.
High‐Sensitivity Cardiac Troponin I and T Response Following Strenuous Activity is Attenuated by Smokeless Tobacco: NEEDED (North Sea Race Endurance Exercise Study) 2014
Authors: Skranes Julia Brox , Kleiven Øyunn , Aakre Kristin Moberg , Skadberg Øyvind , Melberg Tor H. , Omland Torbjørn , Ørn Stein
Published: September 2020

Background

Use of snus, a smokeless tobacco product, is increasing in Scandinavia. Strenuous physical activity is associated with an acute increase in high‐sensitivity cardiac troponin (swhs‐cTn) concentrations. Current smoking is associated with lower hs‐cTn, but whether this also holds true for smokeless tobacco and whether tobacco affects the hs‐cTn response to exercise remain unknown.

Methods and Results

We measured hs‐cTnI and hs‐cTnT concentrations in 914 recreational athletes before and 3 and 24 hours after a 91‐km bicycle race. Self‐reported snus tobacco habits were reported as noncurrent (n=796) and current (n=118). The association between snus use and change in log‐transformed hs‐cTnI and hs‐cTnT concentrations (ie, the differences between concentrations at baseline and 3 hours and 24 hours ) were assessed by multivariable linear regression analysis. Concentrations of hs‐cTn at baseline were lower in current than in noncurrent snus users (hs‐cTnI median, 1.7 ng/L; Q1 to Q3: 1.6–2.3 versus 2.0 ng/L; Q1 to Q3: 1.6–3.2 [
P
=0.020]; and hs‐cTnT: median, 2.9 ng/L, Q1 to Q3: 2.9–3.5 versus 2.9 ng/L, Q1 to Q3: 2.9–4.3 [
P
=0.021]). In fully adjusted multivariable models, use of snus was associated with lower change in hs‐cTn concentrations from baseline to 3 hours (hs‐cTnI: −29% [
P
=0.002], hs‐cTnT: −18% [
P
=0.010]) and 24 hours (hscTnI: −30% [
P
=0.010], hs‐cTnT −19%, [
P
=0.013]).

Conclusions

Resting hs‐cTn concentrations are lower and the exercise‐induced cardiac troponin response is attenuated in current users of smokeless tobacco compared with nonusers. Further insight into the pathophysiological processes underlying the attenuated cardiac troponin response to exercise in tobacco users is needed.

Registration

URL:
https://www.clini​caltr​ials.gov
; Unique identifier: NCT02166216.
Contemporary Pagan Pilgrimage: Ritual and Re-Storying in the Irish Landscape
Authors: Butler Jenny
Published: September 2020

In an examination of contemporary Pagan pilgrimage in Ireland, based on longitudinal ethnographic research, this article identifies and analyzes different cultural processes at work, focusing on the sacralization of the landscape through ritualization and re-storying. Correlations and differences between modern Pagan pilgrimage and the popular Roman Catholic pilgrimage tradition are identified since the way in which modern Pagan pilgrimage manifests is most similar to traditional Catholic site-specific pilgrimage. Contemporary Pagan activities and discourses are contextualized within Irish history and within other meaningful layers constructed over time in relation to Ireland’s sacred landscape. Counterheritagization processes and the contestation of meanings connected to pilgrimage sites is discussed as regards the process of Celticization in how a Celtic past is reactivated in the present by journeying to, and engaging with, significantly reclaimed and “re-storied” sites. For this new religious movement, the land itself plays a vital role as a dynamic and active space.
New Liodessus species from the high Andes of Peru (Coleoptera: Dytiscidae, Bidessini)
Authors: BALKE MICHAEL , MEGNA YOANDRI S. , ZENTENO NILVER , FIGUEROA LUIS , HENDRICH LARS
Published: September 2020

We describe four new species of the diving beetle genus Liodessus Guignot from the high Andean regions of Peru: Liodessus alpinus sp. nov. from Junín, L. hauthi sp. nov. from Huánuco and Churubamba, L. rhigos sp. nov. from Junín, and L. thespesios sp. nov. from Cusco. We delineate the species using morphological structures and provide a 5’ mitochondrial cytochrome c oxidase 1 database on the Barcode of Life Data System (BOLD). We also provide taxonomic notes on Liodessus acollensis Guignot, 1955 and L. andinus Guignot, 1957, described from the high Andes of Peru and Bolivia. These species occur at higher altitudes above 3,400 m and up to 4,900 m, and were collected in shallow, exposed peatland pools and puddles, mostly in steppes and high Andean Puna. The known distribution and habitat preferences of each species are outlined briefly.
Impossible Ethics
Authors: Ackerman Sarah
Published: September 2020

The proper practice of psychoanalysis repudiates a rule-based code of ethical conduct. A conflict exists, however, between Freud’s rejection of the Biblical commandment to love one’s neighbor as oneself and his development of psychoanalytic techniques that demand something very much of this ilk. Other essential conflicts in analytic practice include the impossibility of removing the analyst’s desire from the analytic relationship, the unruly nature of unconscious processes in both analyst and analysand, and the après-coup nature of ethical recognition. A discourse of ethics is recommended in which analysts are called on to consider the ethical demands of each clinical moment. Ethical demands on the analysand, as well as the analyst, bring to light the way in which analysis rests on the foundational ethical situation into which humankind is born.
Opioid Prescribing and Use After Pediatric Umbilical Hernia Repair
Authors: L. Lee Matthew , B. Camp Lauren , V. Raval Mehul , Y. Huang Eunice
Published: September 2020

Background

Opioid overuse is a concern in adult and pediatric populations. Physician education may improve appropriate opioid prescribing and patient instruction for use. Prescribing and use of opioids for pain control after pediatric umbilical hernia (UH) repair before and after surgeon education was evaluated. This is a substudy of a multi-institutional study assessing prescribing practice before and after surgeon education. This study further assessed patient prescription filling patterns and parent report of pain control.

Methods

A retrospective study was performed evaluating children who underwent UH 6 months before and after an educational presentation on opioid use. Prescriptions, prescription fills, patient medication use, and pain control effectiveness were assessed. Adverse events were collected.

Results

There were 78 subjects in the pre-education and 99 in the post-education group. Opioid prescribed changed from 98.7% to 61.6% ( P < .0001), and nonopioid prescriptions increased following education ( P = .0063). The number of opioid prescriptions filled decreased ( P = .0296). There were limited data on opioid doses used and quality of pain control, but the post-education group showed good pain control. There was no difference in adverse events.

Discussion

Surgeon education on the current opioid epidemic and strategies for opioid stewardship improves opioid prescribing and use without adversely impacting pain control or clinical outcome.
Analysis of the American College of Surgeons Clinical Congress Twitter Hashtags and Its Impact on Online Engagement and Attendance Rates
Authors: Elkbuli Adel , Santarone Kristen , Boneva Dessy , Hai Shaikh , McKenney Mark
Published: September 2020

Background

Twitter at conferences facilitates remote interaction and spread of ideas. Through the use of hashtags, conference information can be gathered, referenced, disseminated, and discussed in 1 electronic location by attendees and nonattendees from remote locations. The aim of this study is to analyze the American College of Surgeons Clinical Congress (ACSCC) Twitter hashtag activities and evaluate its impact on meeting participation and engagement for the last 5 annual meetings.

Methods

Twitter hashtags #ACSCC15, #ACSCC16, #ACSCC17, #ACSCC18, and #ACSCC19 were studied to determine tweets, retweets, users, and impressions. Data regarding top influencers and the most tweeted links were analyzed. Symplur Signals, a software that specializes in hashtags, was utilized for the analyses.

Results

Between 2015 and 2017, there was a consistent increase in tweets from 12 800 to 18 300 to 24 700, respectively. However, in 2018 and 2019, tweets dropped significantly to 19 700 and 19 300, respectively ( P < .05). Additionally, impressions dropped significantly by 24 million impressions from 2017 to 2019 (115.1M to 91.1M, P < .05) despite the growth of users from 2700 in 2015 to 4100 in 2016 and ~6500 in 2017-2019. This change occurred despite no change in meeting attendance rates, regardless of specialty ( P > .05). The most influential organizations in hashtag use were the American College of Surgeons (ACS) and Association of Women Surgeons (AWS).

Conclusion

Despite the significant reduction in views and online engagement activities in the past 2 years, the use of Twitter at the ACS CC has greatly increased the potential dissemination of information but not meeting attendance rates.
What Is the Utility of Restaging Imaging for Patients With Clinical Stage II/III Rectal Cancer After Completion of Neoadjuvant Chemoradiation and Prior to Proctectomy?
Authors: Hendrick Leah E. , Buckner Jacob D. , Guerrero Whitney M. , Shibata David , Hinkle Nathan M. , Monroe Justin J. , Glazer Evan S. , Deneve Jeremiah L. , Dickson Paxton V.
Published: September 2020

Background

In the United States, patients with clinical stage II or III rectal cancer typically receive neoadjuvant chemoradiation therapy (chemo/XRT) over a 5-6 week period followed by a 6-10 week break prior to proctectomy. In the current study, we evaluate the utilization of restaging studies performed and detection of disease progression during this window.

Methods

A retrospective review of patients with clinical stage II/III rectal cancer was performed. Medical records were analyzed to collect clinicopathologic data and the performance and results of preoperative, early postoperative, and first surveillance CT and/or PET/CT in patients completing long course neoadjuvant chemo/XRT and undergoing proctectomy.

Results

Between 2005 and 2017, 176 patients with clinical stage II or III rectal adenocarcinoma completed neoadjuvant chemo/XRT and underwent proctectomy. Preoperative restaging with CT CAP and/or CT/PET was performed in 72 (40.9%) patients with no detection of disease progression. Of the 104 patients without preoperative restaging, 1 had intraoperative detection of liver metastases and 31 had early postoperative reimaging (within 30 days of proctectomy) of which 2 had detection of new pulmonary metastases. Among 72 patients with no preoperative or early postoperative reimaging, first surveillance imaging was available in 47 and detected new metastases in 8 (17%).

Discussion

In patients with clinical stage II/III rectal cancer who undergo long course neoadjuvant chemo/XRT, perioperative reimaging with CT CAP and/or PET/CT detects new metastases in a small percentage of patients. A multi-institutional, prospective analysis using standardized staging protocols is warranted to better determine the value of preoperative restaging in these patients.
Alveolar Soft-Part Sarcoma in Olfactory Cleft: A Case Report and Clinicopathological Review
Authors: Alromaih Saud , Alqaryan Saleh , Alabood Saleh , Alabaishi Somaya , Ajlan Abdulrazag , Alsuhaibani Abdullah , Sumaily Ibrahim , Alsolami Afaf
Published: September 2020

Sinonasal alveolar soft-part sarcoma (ASPS) is a rare malignant disease that comprises 0.4% to 1.2% of all soft-tissue sarcomas. Alveolar soft-part sarcoma is usually difficult to diagnose because it has many clinical and pathological mimickers. In this case study, ASPS occurred in the olfactory cleft, representing the second case in this location in the literature. This article presents the clinical presentation, radiologic, and histopathological case, and reviews the literature regarding the differentials.
National interests and coalition positions on climate change: A text-based analysis
Authors: Castro Paula
Published: September 2020

Coalitions play a central role in the international negotiations under the United Nations Framework Convention on Climate Change. By getting together, countries join resources in defending their interests and positions. But building coalitions may come at a cost. Coalition positions are a result of compromise between their members, and thus the increase in bargaining power may come at a price if the preferences of their members are heterogeneous. Relying on automatic text analysis of written position papers submitted to the negotiations, I analyze the extent to which coalitions represent the preferences of their members and discuss whether this contributes to disproportionate policy responses at the international level. I focus on a recently formed coalition: the Like-Minded Developing Countries, a large and heterogeneous group that brings together emerging, oil-dependent and poor developing countries.
Correlates of Symptom Burden of Hemodialysis Patients
Authors: Song Yuan-yuan , Chen Lin , Yu Wen-wen , Wang Wen-xiu , Yang Dong-ju , Jiang Xiao-lian
Published: September 2020

This cross-sectional study assessed the overall symptom burden, including the prevalence, frequency, severity, and distress of symptoms among hemodialysis patients, and explored the relationship between demographic characteristics, clinical variables, self-management, sense of coherence, social support, and symptom burden in these patients. Herein, a regression analysis was performed to determine associations with symptom burden. The mean score of symptom burden among the participants (n = 382) was 74.12, with an average number of 12 symptoms. The analysis revealed that self-management, sense of coherence, and social support were negatively associated with the overall symptom burden. The multiple regression model showed that 48.6% of the variance in symptom burden was explained by meaningfulness, emotional management, daily urine output, subjective support, gender, and manageability. These findings contribute to the knowledge of symptom burden among hemodialysis patients and some new predictors (self-management, sense of coherence, and social support) of their symptom burden.
Timing the First Pediatric Tracheostomy Tube Change: A Randomized Controlled Trial
Authors: Chorney Stephen R. , Patel Rosemary C. , Boyd Allison E. , Stow Joanne , Schmitt Mary M. , Lipman Deborah , Dailey Julia F. , Nhan Carol , Giordano Terri , Sobol Steven E.
Published: September 2020

Objective

The first pediatric tracheostomy tube change often occurs within 7 days after placement; however, the optimal timing is not known. The primary objective was to determine the rate of adverse events of an early tube change. Secondary objectives compared rates of significant peristomal wounds, sedation requirements, and expedited intensive care discharges.

Study Design

Prospective randomized controlled trial.

Setting

Tertiary children’s hospital between October 2018 and April 2020.

Methods

A randomized controlled trial enrolled children under 24 months to early (day 4) or late (day 7) first tracheostomy tube changes.

Results

Sixteen children were enrolled with 10 randomized to an early change. Median age was 5.9 months (interquartile range, 5.4‐8.3), and 86.7% required tracheostomy for respiratory failure. All tracheostomy tube changes were performed without adverse events. There were no accidental decannulations. Significant wounds developed in 10% of children with early tracheostomy tube changes and 83.3% of children with late tracheostomy tube changes (odds ratio [OR], 45.0; 95% CI, 2.3‐885.6; P =. 01). This significant reduction in wound complications justified concluding trial enrollment. Hours of dexmedetomidine sedation (P =. 11) and boluses of midazolam during the first 7 days (P =. 08) were no different between groups. After the first change, 90% of the early group were discharged from intensive care within 5 weeks compared to 33.3% of patients in the late group (OR, 18.0; 95% CI, 1.2‐260.9; P =. 03).

Conclusion

The first tracheostomy tube change in children can occur without adverse events on day 4, resulting in fewer significant peristomal wounds and earlier intensive care discharge.
Risk Factors for Post–acute care Following Free Flap Reconstruction of the Oral Cavity
Authors: Lepse Jason , Sykes Kevin J. , Kakarala Kiran
Published: September 2020

Objective

Identify previously unreported factors that predict the need for post–acute care after free flap reconstruction of the oral cavity.

Study Design

Retrospective cohort study.

Setting

Single academic medical center.

Methods

A total of 134 patients with head and neck disease involving the oral cavity underwent free tissue transfer for reconstruction between August 2012 and October 2015. All patients had a tracheostomy placed at the time of surgery. Data were collected, including demographics, perioperative risk factors, and social variables. Univariate and multivariate logistic regression were used to identify risk factors for needing post–acute care.

Results

Of 134 patients, 37 (28%) required post–acute care upon discharge, and 97 of 134 (72%) were discharged home with assistance. Multivariate logistic regression revealed that lack of family support (adjusted odds ratio [AOR], 32.12; 95% CI, 13.75‐274.90; P =. 002), tracheostomy tube at discharge (AOR, 13.70; 95% CI, 3.20‐58.44; P <. 001), government insurance (AOR, 3.85; 95% CI, 1.13‐13.11; P =. 031), hospital stay >10 days (AOR, 3.52; 95% CI, 1.25‐9.90; P =. 017), and increasing age (AOR, 1.11; 95% CI, 1.04‐1.18; P =. 003) were significantly associated with post–acute care need.

Conclusion:

Lack of family support, tracheostomy tube at discharge, government insurance, hospital stay >10 days, and increasing age are independently associated with the need for post–acute care following free flap reconstruction of the oral cavity. Physicians, social workers, and nurse case managers are positioned to identify patients at high risk for needing post–acute care and to reduce the duration of hospitalizations.
Microstructural investigation and hole quality evaluation in S2/FM94 glass-fibre composites under dry and cryogenic conditions
Authors: Giasin Khaled , Barouni Antigoni , Dhakal Hom Nath , Featherson Carol , Redouane Zitoune , Morkavuk Sezer , Koklu Ugur
Published: September 2020

S2/FM94 glass fibre reinforced epoxy is an aerospace-grade composite currently bonded with aluminium alloys and installed in parts of the Airbus A380 fuselage. In addition to its abrasive and hard nature, S2/FM94 glass fibre is sensitive to thermal effects developed during the drilling process, and therefore using coolants becomes necessary. However, conventional oil and water-based coolants are not suitable for drilling of composites. Cryogenic coolants on the other hand are an attractive choice for machining composites and are environmentally friendly. In this study, a new environmentally friendly cryogenic cooling technique in a liquid nitrogen bath was used for the drilling of S2/FM94 glass fibre reinforced epoxy composite. The aim was to investigate the effect of drilling parameters and cryogenic cooling on cutting forces, surface roughness, hardness and delamination factor at hole entry and exit sides. The workpiece was drilled within a cryogenic bath. In this way, both cryogenic workpiece cooling and tool cooling were obtained. In addition, the drill geometry is fixed and only the cutting parameters (i.e. spindle speed and the feed rate) are varied under dry and cryogenic conditions. The results indicate that the spindle speed and cryogenic cooling had the most significant influence on the cutting forces and surface roughness parameters (Ra and Rz), while the use of cryogenic cooling had the most significant influence on increasing the hardness and size of delamination at entry and exit sides of the holes.
The Relationship Between Family Socioeconomic Status and Career Outcomes: A Life History Perspective
Authors: Hu Shi , Hood Michelle , Creed Peter A. , Shen Xueping
Published: September 2020

Based on the life history perspective, this study tested a serial mediation model in which family socioeconomic status (SES) related to person–job fit via resource scarcity, career exploration, and goal persistence. We expected that when seeking employment, higher SES students would perceive lower resource scarcity, and, in turn, adopt more adaptive career behaviors (i.e., career exploration and goal persistence) to maximize career success, which would then lead to better person–job fit upon graduation. Using a sample of 224 final-year students (mean age 21 years, 77% male), we found, as expected, that higher SES was related to more career exploration and goal persistence via lower perceived scarcity and that exploration and persistence were related to better person–job fit. In addition, higher SES was indirectly related to person–job fit via scarcity and the two career behaviors. The findings highlight the importance of family SES in young people’s career development.
An even-handed debate? The sexed/gendered controversy over laterality genes in British psychology, 1970s–1990s
Authors: Cornel Tabea
Published: September 2020

This article provides insight into the entwinement of the allegedly neutral category of handedness with questions of sex/gender, reproduction, dis/ability, and scientific authority. In the 1860s, Paul Broca suggested that the speech centre sat in the left brain hemisphere in most humans, and that right-handedness stemmed from this asymmetry. One century later, British psychologists Marian Annett and Chris McManus proposed biologically unconfirmed theories of how handedness and brain asymmetry were passed on in families. Their idea to integrate chance into genetic models of handedness was novel, and so was their use of computerized statistics to parse out the incidence of handedness genotypes and phenotypes. Notwithstanding significant conceptual and methodological overlaps, McManus and Annett did not collaborate and proposed competing theories. I analyse the sexed/gendered dimensions of their controversy by drawing on published literature, unpublished documents, and oral history interviews. I first attend to the epistemological importance of sex/gender. Both psychologists published several iterations of their models, which increasingly relied on questions of sex/gender and reproduction. Annett additionally linked handedness with stereotypically gendered cognitive abilities. Second, I argue that using masculine-coded computer technologies contributed to Annett’s professional marginalization whereas similar methods endowed McManus with surplus authority. Finally, I show that Annett’s complicity in stabilizing sociocultural hierarchies within her theory mirrored her personal experience of marginalization based on sex/gender, age, education, and lack of institutional affiliation. This analysis exemplifies the entanglement of cognitive and social factors in scientific controversies and adds to the literature on 20th-century British women psychologists.
An engineering perspective of vacuum assisted delivery devices in obstetrics: A review
Authors: Goordyal Dushyant , Anderson John , Alazmani Ali , Culmer Peter
Published: September 2020

Complications during childbirth result in the need for clinicians to use ‘assisted delivery’ in over 12% of cases (UK). After more than 50 years in clinical practice, vacuum assisted delivery (VAD) devices remain a mainstay in physically assisting child delivery; sometimes preferred over forceps due to their ease of use and reduced maternal morbidity. Despite their popularity and enduring track-record, VAD devices have shown little evidence of innovation or design change since their inception. In addition, evidence on the safety and functionality of VAD devices remains limited but does present opportunities for improvements to reduce adverse clinical outcomes. Consequently in this review we examine the literature and patent landscape surrounding VAD biomechanics, design evolution and performance from an engineering perspective, aiming to collate the limited but valuable information from a disparate field and provide a series of recommendations to inform future research into improved, safer, VAD systems.
Two subdivision methods based on the regular octahedron for single- and double-layer spherical geodesic domes
Authors: Pilarska Dominika
Published: September 2020

The paper presents the topological–geometric analysis of a selected number of space frames configurations for geodesic domes which are generated from the regular octahedron. Two subdivision methods for spherical triangles, proposed by Fuliński, were used to create two families of structures. The first family consists of six single-layer and six double-layer geodesic domes shaped on the basis of the first method of subdivision, while the second family contains six single-layer and six double-layer geodesic domes shaped on the basis of the second method of subdivision. The calculated results of the geometric parameters of the analyzed structures were used to create original formulas that allow for more advanced structures to be achieved, that is, with a larger number of nodes and struts. The geometric results were also used to create nomograms showing the range of struts of the same length for double-layer geodesic domes. In both single-layer and double-layer domes, the number of groups of struts of equal lengths and the number of faces with different areas are smaller for structures created according to the first method of subdivision. The comparison of the resulting element quantities of two methods shows that the largest differences appear between the domes with a larger number of struts (up to 67%). Here, the analysis might help the designer reach a final decision on the better choice of topology, in particular, when this aspect is combined with other design goals, such as efficiency, economy, utility, and elegance in the design of the structure and the cover of large areas.
Concurrent varicella and herpes simplex virus reactivation in the same trigeminal dermatome in a person living with HIV
Authors: Lindegger Daniel Josef , Rossi Daniele Claudio , Guex-Crosier Yan
Published: September 2020

We report a case of a concurrent reactivation of varicella zoster virus and herpes simplex virus in an immunocompromised patient unaware of her longstanding human immunodeficiency virus (HIV) infection. Despite being a rare event, concurrent reactivation of the two alphaherpesvirinae has been reported in various conditions, either in immunocompetent or immunocompromised patients. However, a reactivation in the same anatomical location in a person living with HIV seems to be an extremely rare event.
Hearing loss in individuals at risk for neurosyphilis
Authors: Marra Christina M , Maxwell Clare L , Ramchandani Meena , Tantalo Lauren C , Sahi Sharon K , Dunaway Shelia B , Litvack Jamie R
Published: September 2020

Otosyphilis is a serious complication of syphilis.

329 participants enrolled in a study of cerebrospinal fluid (CSF) abnormalities in syphilis underwent portable audiometry (250 Hz to 8000 Hz at 5–75 dB); it was repeated in 33 after otosyphilis treatment. Treponema pallidum spp pallidum ( T. pallidum) DNA in blood was quantitated by polymerase chain reaction. Odds ratios (ORs) or hazard ratios (HRs) with 95% confidence intervals (CIs) were determined by logistic, ordinal or Cox regression.

166 (50.5%) had normal hearing; 15 (4.6%) had low frequency (LF) loss alone, 93 (28.3%) had high frequency (HF) loss alone, and 55 (16.7%) had both. Adjusted odds of any hearing loss were higher with detectable blood T. pallidum DNA (3.00 [1.58–5.69], p = 0.001), CSF pleocytosis (2.02 [1.12–3.66], p = 0.02), and older age (2.22 per 10-year increase, [1.70–2.91], p < 0.001). HRs of normalization of LF and HF loss were lower for older individuals (0.20 [0.07–0.63, p = 0.005] and 0.22 [0.05–0.94, p = 0.04]), and HRs for normalization of HF loss were lower for those with more severe loss (0.09 [0.02–0.43], p = 0.002), and in those with CSF pleocytosis (0.32 [0.11–0.96], p = 0.04).

Older age and CSF pleocytosis increase the likelihood of otosyphilis and impair hearing recovery after otosyphilis treatment.
Exploring associations between place of sex work and HIV vulnerabilities among sex workers in Jamaica
Authors: Logie Carmen H , Wang Ying , Lalor Patrick , Williams Davina , Levermore Kandasi , Sherman Susan G
Published: September 2020

Sex workers’ work environment shapes HIV transmission dynamics. We applied the Structural HIV Determinants Framework to examine associations between the work environment of public spaces and HIV infection risks among sex workers in Jamaica, considering macro-structural (police harassment) and intrapersonal (depression) pathways. We implemented a cross-sectional survey with sex workers in Kingston, Ocho Rios, Montego Bay, and nearby towns in Jamaica. We conducted structural equation modeling to examine direct and indirect associations between place of sex work on HIV serostatus via mediators of police harassment and depression. Results indicate that public place of sex work had a significant indirect effect on self-reported HIV-positive serostatus; depression and police harassment mediated this relationship. Findings suggest that in contexts of criminalization, the sex work environment can elevate exposure to police violence and depression, in turn increasing HIV vulnerabilities.
Book review: Altaf Hussain Para. 2019. The Making of Modern Kashmir: Sheikh Abdullah and the Politics of the State
Authors: Mehdi Syed Eesar
Published: September 2020

Altaf Hussain Para. 2019. The Making of Modern Kashmir: Sheikh Abdullah and the Politics of the State. London: Routledge, 457 pp., ₹3,200. ISBN: 9780367322076
Improving Health Service Quality in the Kingdom of Cambodia: A Policy Perspective
Authors: Pheakdey Sambo , Chan Narith , Kolesar Robert John , Chak Chantha
Published: September 2020

The achievement of Universal Health Coverage, including quality services, is high on the international agenda. Cambodia aims to expand social health protection and is committed to improving the healthcare service quality. We review the country context and propose five policy approaches to accelerate progress on healthcare quality improvement in Cambodia. These approaches aim to augment the profile and continued focus on quality while leveraging and optimizing existing systems to incentivize improvements and increase value for money.
Autonomous camber morphing of a helicopter rotor blade with temperature change using integrated shape memory alloys
Authors: DiPalma Matthew , Gandhi Farhan
Published: September 2020

The present study proposes and explores a new autonomous morphing concept, where a 12–13° increase in camber is realized over a spanwise section of a helicopter rotor blade with increase in ambient temperature. The camber change is achieved through integration of Shape Memory Alloys (SMAs) on the lower surface of the blade, aft of the leading-edge spar. For a reference rotor of a utility-class helicopter generating 21,000 lbs thrust, a loss in lift of 2590 lb was observed due to operation in hot conditions. With the SMA camber morphing section extending from the blade root to 25%, 50%, and 75% span, the rotor recovered up to 11%, 43%, and 82% of the lift loss at high temperature (compared to a no-SMA blade). If the morphing section instead spans the outboard 25% of the blade (from 75% span to the blade tip), up to a 66% lift recovery is achieved due to the higher dynamic pressures over this region. While these results are achieved with existing SMA properties, idealized target values are also presented. For the SMA considered in the study, while a 40–115°F temperature change was required to achieve the full 12–13° design camber change, partial camber is achieved over a smaller temperature range. The paper identifies desired SMA properties that would produce a 12–13° camber change over an 80–100°F temperature change.
Active vibration control in human forearm model using paired piezoelectric sensor and actuator
Authors: Hosseini Seyedeh Marzieh , Kalhori Hamed , Al-Jumaily Adel
Published: September 2020

An active vibration control system to monitor and suppress the human forearm tremor is proposed in this article. The forearm is modelled as a uniform flexible continuous beam supported by a pin joint and a rotational spring at one end, whereas the other end is free. The beam is covered with a layer of piezoelectric sensor on its top surface and a layer of piezoelectric actuator on its bottom surface to form a control system, through which a closed-loop active control paradigm is implemented for tremor suppression. The governing equation of motion is derived using the Hamilton principle as well as the Galerkin procedure, leading to a second-order ordinary differential equation in time. The vibration response of the structure to an external harmonic excitation, analogous to tremor, is obtained analytically, enabling parametric study of the control system for tremor reduction. Using the obtained analytical expression, the effects of various parameters such as the control gain, the piezoelectric coefficient and the dielectric constant on the vibration response are studied. The results indicated that the proposed active vibration control system is an effective tool for active vibration control. Increasing the control gain of the control system as well as the magnitude of the piezoelectric constant decreased the amplitude of vibration, whereas the dielectric constant of the piezoelectric material did not show to have a significant effect on the beam vibration. The obtained results will pave the way for further experimental exploration to take and fabricate the most appropriate piezoelectric material and to design an effective active vibration control system for tremor suppression in people with Parkinson’s disease.
Fitness evaluation reuse for accelerating GPU-based evolutionary induction of decision trees
Authors: Jurczuk Krzysztof , Czajkowski Marcin , Kretowski Marek
Published: September 2020

Decision trees (DTs) are one of the most popular white-box machine-learning techniques. Traditionally, DTs are induced using a top-down greedy search that may lead to sub-optimal solutions. One of the emerging alternatives is an evolutionary induction inspired by the biological evolution. It searches for the tree structure and tests simultaneously, which results in less complex DTs with at least comparable prediction performance. However, the evolutionary search is computationally expensive, and its effective application to big data mining needs algorithmic and technological progress. In this paper, noting that many trees or their parts reappear during the evolution, we propose a reuse strategy. A fixed number of recently processed individuals (DTs) is stored in a so-called repository. A part of the repository entry (related to fitness calculations) is maintained on a CPU side to limit CPU/GPU memory transactions. The rest of the repository entry (tree structures) is located on a GPU side to speed up searching for similar DTs. As the most time-demanding task of the induction is the DTs’ evaluation, the GPU first searches similar DTs in the repository for reuse. If it fails, the GPU has to evaluate DT from the ground up. Large artificial and real-life datasets and various repository strategies are tested. Results show that the concept of reusing information from previous generations can accelerate the original GPU-based solution further. It is especially visible for large-scale data. To give an idea of the overall acceleration scale, the proposed solution can process even billions of objects in a few hours on a single GPU workstation.
A systematic review of orbital apex syndrome of odontogenic origin: Proposed algorithm for treatment
Authors: Leferman Carmen Ecaterina , Ciubotaru Alin Dumitru , Ghiciuc Cristina Mihaela , Stoica Bogdan Alexandru , Gradinaru Irina
Published: September 2020

Orbital apex syndrome (OAS) can be a rare, but severe complication of an odontogenic infection and has high morbidity and mortality. Antibacterial drugs are typically an appropriate treatment choice, but the most severe cases are fungal in nature and pose a tough challenge to the clinician. The aim of this study was to determine the predisposing factors, specific aspects in its management and the appropriate treatment strategy in order to improve patient outcome. A systematic review was conducted using PubMed, PubMed Central, Web of Science, and Scopus up to February 2020, based on the associations between dental extraction or infections and OAS. Of 721 papers found, 18 articles were considered eligible and presented in total 21 cases (13 fungal and eight bacterial infections). The information was organized into a diagnostic and treatment algorithm which included data extracted both from the included cases and updated literature of treatment efficacy studies. Immunosuppression (uncontrolled diabetes mellitus and chemotherapy) was found as an important predisposing factor particularly for fungal infections. In these cases, we suggest that early simultaneous approaches, including aggressive surgical procedures and systemic administration of amphotericin B, result in a better outcome. In conclusion, medical intervention success depends on aggressive treatment and multidisciplinary teamwork.
The Commonwealth Games 2018 and Event WIL: Inclusive Action for Journalism Education
Authors: Valencia-Forrester Faith
Published: September 2020

Journalism in higher education must find new ways of producing work-ready graduates who are prepared for the rapidly changing news media environment. Traditional internships are under increasing scrutiny over their quality and equitability. The past few years have seen a number of innovative models of work-integrated learning (WIL) emerging in journalism education. This article considers Event WIL as a model of university-led WIL in journalism education that brings academia and industry together in partnership to build the capacity of all student journalists to work in a dynamic media landscape. This article makes an argument for Event WIL as a model of WIL in journalism education by drawing on a case study of the Griffith University Commonwealth Games Media Centre at the Gold Coast Commonwealth Games in 2018. This case study provides insights into the key tenets of Event WIL: long-term preparation, harnessing pre-event WIL experiences, providing in-depth induction, establishing a hybrid space for a partnership between industry and academia and creating authentic opportunities for student publication are detailed. Notably, the WIL case study not only resulted in quality outcomes for students, but it also resulted in benefits for academics and industry representatives.