bluuebunny/crossref_metadata_2025 huggingface dataset:
Neural shutdown under stress: an evolutionary perspective on spreading depolarization
Authors: Robertson R. Meldrum , Dawson-Scully Ken D. , Andrew R. David
Published: February 2020

Neural function depends on maintaining cellular membrane potentials as the basis for electrical signaling. Yet, in mammals and insects, neuronal and glial membrane potentials can reversibly depolarize to zero, shutting down neural function by the process of spreading depolarization (SD) that collapses the ion gradients across membranes. SD is not evident in all metazoan taxa with centralized nervous systems. We consider the occurrence and similarities of SD in different animals and suggest that it is an emergent property of nervous systems that have evolved to control complex behaviors requiring energetically expensive, rapid information processing in a tightly regulated extracellular environment. Whether SD is beneficial or not in mammals remains an open question. However, in insects, it is associated with the response to harsh environments and may provide an energetic advantage that improves the chances of survival. The remarkable similarity of SD in diverse taxa supports a model systems approach to understanding the mechanistic underpinning of human neuropathology associated with migraine, stroke, and traumatic brain injury.
Upregulated Expression of Intestinal Antimicrobial Peptide HD5 Associated with Renal Function in IgA Nephropathy
Authors: Feng Shaozhen , Zhong Zhong , Fan Jinjin , Li Xiaoyan , Shi Dianchun , Jiang Lanping
Published: February 2020

Purpose. It was reported that gut-kidney axis may play an important role in IgA nephropathy (IgAN). Previous five GWASs of different populations for IgAN have discovered several genes related to intestinal immunity, including DEFA gene. However, the roles of the encoded proteins of DEFA5/6 which were called intestinal antimicrobial peptides HD5 and HD6 were not clear in kidney disease, such as IgAN. The purpose of this study was to clarify the association of HD5 and HD6 with IgAN. Methods. We measured HD5 and HD6 in serum, urine, and kidney of IgAN patients and normal controls by ELISA, Western blot, and immunofluorescence. The association of HD5 or HD6 levels with clinical and pathologic phenotypes was analyzed. Results. Serum levels of HD5 and HD6 were significantly higher in IgAN patients than those in normal controls. Baseline serum HD5 levels were significantly associated with eGFR (P=0.002) and tubular atrophy/interstitial fibrosis (P=0.004) by stepwise multivariate regression analysis. Compared to the patients with serum HD5 below the median level, patients with elevated serum HD5 above the median level had a significantly worse renal outcome (log-rank test, P=0.009) by Kaplan-Meier analysis. A Cox regression model showed that serum HD5 was an independent prognostic factor (HR=1.239, P=0.029) after adjusting for the well-known predictors of outcome in IgAN patients. In renal biopsies of IgAN patients, HD5 was significantly expressed in the damaged proximal tubules, while no immunoreactive HD6 was found. Interestingly, the serum HD6 level of IgAN patients was significantly associated with gender. Conclusions. In IgAN patients, an elevated serum HD5 level at the time of renal biopsy was associated with poor renal outcomes. HD5 rather than HD6 was probably associated with renal function of IgAN patients.
The Existence of Normalized Solutions for a Nonlocal Problem in ℝ3
Authors: Yang Jing
Published: February 2020

In this paper, we study the following fractional Schrödinger equation in ℝ3−Δσu−λu=up−2u, in ℝ3 with σ∈0,1,λ∈ℝ and p∈2+σ,2+4/3σ. By using the constrained variational method, we show the existence of solutions with prescribed L2 norm for this problem.
Primary Cardiac Lymphoma Manifesting as Complete Heart Block
Authors: Usry Courtney R. , Wilson Andrew S. , Bush Kelvin N. V.
Published: February 2020

Primary cardiac tumors are exceedingly rare with variable clinical manifestations. This case involves a patient presentation of symptomatic complete heart block and cardiac imaging revealing a right atrial mass invading the myocardium consistent with Burkitt lymphoma on histopathology. The patient received definitive bradytherapy with a pacemaker and chemotherapy for the primary cardiac lymphoma. After three cycles of chemotherapy, the right atrial mass regressed significantly with restoration of atrioventricular conduction and no pacing burden. Primary cardiac lymphomas infrequently manifest as atrioventricular block and this case highlights cardiac masses as a potential etiology when evaluating new conduction disturbances and bradyarrhythmias.
Data Analysis of Step-Stress Accelerated Life Test with Random Group Effects under Weibull Distribution
Authors: Wang Juan
Published: February 2020

Step-stress accelerating life test (SSALT), aiming to predict the failure behavior under use condition by the data collected from elevated test setting, is implemented to specimen with time-varying stress levels. Typical testing protocols in SSALT, such as subsampling, cannot guarantee complete randomization and thus result in correlated observations among groups. To consider the random effects from the group-to-group variation, we build a nonlinear mixed effect model (NLMM) with the assumption of Weibull distribution for life time data analysis from SSALT. Both maximum likelihood estimation (MLE) and Bayesian inference are introduced for the estimation and prediction of model parameters as well as other statistics of interest. Gauss–Hermite (G-H) quadrature is used to obtain an accurate approximation of the likelihood for observations, and different priors of model parameters are applied in Bayesian analysis. A comprehensive simulation study and an analysis for a real data set are conducted to justify the proposed method, suggesting that the incorporation of the random effect from the underlying experimental routine ensures a more solid and practical conclusion when the heterogeneous group effect is statistically significant.
Role of Chemokine (C–X–C Motif) Ligand 10 (CXCL10) in Renal Diseases
Authors: Gao Jie , Wu Lingling , Wang Siyang , Chen Xiangmei
Published: February 2020

Chemokine C–X–C ligand 10 (CXCL10), also known as interferon-γ-inducible protein 10 (IP-10), exerts biological function mainly through binding to its specific receptor, CXCR3. Studies have shown that renal resident mesangial cells, renal tubular epithelial cells, podocytes, endothelial cells, and infiltrating inflammatory cells express CXCL10 and CXCR3 under inflammatory conditions. In the last few years, strong experimental and clinical evidence has indicated that CXCL10 is involved in the development of renal diseases through the chemoattraction of inflammatory cells and facilitation of cell growth and angiostatic effects. In addition, CXCL10 has been shown to be a significant biomarker of disease severity, and it can be used as a prognostic indicator for a variety of renal diseases, such as renal allograft dysfunction and lupus nephritis. In this review, we summarize the structures and biological functions of CXCL10 and CXCR3, focusing on the important role of CXCL10 in the pathogenesis of kidney disease, and provide a theoretical basis for CXCL10 as a potential biomarker and therapeutic target in human kidney disease.
Implications of Oxidative Stress and Cellular Senescence in Age-Related Thymus Involution
Authors: Barbouti Alexandra , Vasileiou Panagiotis V. S. , Evangelou Konstantinos , Vlasis Konstantinos G. , Papoudou-Bai Alexandra , Gorgoulis Vassilis G. , Kanavaros Panagiotis
Published: February 2020

The human thymus is a primary lymphoepithelial organ which supports the production of self-tolerant T cells with competent and regulatory functions. Paradoxically, despite the crucial role that it exerts in T cell-mediated immunity and prevention of systemic autoimmunity, the thymus is the first organ of the body that exhibits age-associated degeneration/regression, termed “thymic involution.” A hallmark of this early phenomenon is a progressive decline of thymic mass as well as a decreased output of naïve T cells, thus resulting in impaired immune response. Importantly, thymic involution has been recently linked with cellular senescence which is a stress response induced by various stimuli. Accumulation of senescent cells in tissues has been implicated in aging and a plethora of age-related diseases. In addition, several lines of evidence indicate that oxidative stress, a well-established trigger of senescence, is also involved in thymic involution, thus highlighting a possible interplay between oxidative stress, senescence, and thymic involution.
On the Flux Linkage between Pancake Coils in Resonance-Type Wireless Power Transfer Systems
Authors: Parise Mauro , Antonini Giulio , Romano Daniele
Published: February 2020

This work presents a series representation for the mutual inductance of two coaxial pancake coils which remains accurate in non-quasi-static regime under the hypothesis that the current in the source coil is uniformly distributed. Making use of Gegenbauer’s addition theorem and a term-by-term analytical integration, the mutual inductance between two generic turns belonging to distinct coils is expressed as a sum of spherical Hankel functions with algebraic coefficients. The accuracy and efficiency of the resulting expression is proved through pertinent numerical examples.
Effect of Modulating FcRn Binding on Direct and Pretargeted Tumor Uptake of Full-length Antibodies
Authors: Nazarova Lidia , Rafidi Hanine , Mandikian Danielle , Ferl Gregory Z. , Koerber James T. , Davies Christopher W. , Ulufatu Sheila , Ho Jason , Lau Jeffrey , Yu Shang-Fan , Ernst James , Sadowsky Jack D. , Boswell C. Andrew
Published: February 2020

Full-length antibodies lack ideal pharmacokinetic properties for rapid targeted imaging, prompting the pursuit of smaller peptides and fragments. Nevertheless, studying the disposition properties of antibody-based imaging agents can provide critical insight into the pharmacology of their therapeutic counterparts, particularly for those coupled with potent payloads. Here, we evaluate modulation of binding to the neonatal Fc receptor (FcRn) as a protein engineering-based pharmacologic strategy to minimize the overall blood pool background with directly labeled antibodies and undesirable systemic click reaction of radiolabeled tetrazine with circulating pretargeted trans-cyclooctene (TCO)-modified antibodies. Noninvasive SPECT imaging of mice bearing HER2-expressing xenografts was performed both directly (111In-labeled antibody) and indirectly (pretargeted TCO-modified antibody followed by 111In-labeled tetrazine). Pharmacokinetic modulation of antibodies was achieved by two distinct methods: Fc engineering to reduce binding affinity to FcRn, and delayed administration of an antibody that competes with binding to FcRn. Tumor imaging with directly labeled antibodies was feasible in the absence of FcRn binding, rapidly attaining high tumor-to-blood ratios, but accompanied by moderate liver and spleen uptake. Pretargeted imaging of tumors with non-FcRn-binding antibody was also feasible, but systemic click reaction still occurred, albeit at lower levels than with parental antibody. Our findings demonstrate that FcRn binding impairment of full-length IgG antibodies moderately lowers tumor accumulation of radioactivity, and shifts background activity from blood pool to liver and spleen. Furthermore, reduction of FcRn binding did not eliminate systemic click reaction, but yielded greater improvements in tumor-to-blood ratio when imaging with directly labeled antibodies than with pretargeting.
Weather Fluctuations May Have an Impact on Stroke Occurrence in a Society: A Population-Based Cohort Study
Authors: Matsumaru Naoki , Okada Hideshi , Suzuki Kodai , Nachi Sho , Yoshida Takahiro , Tsukamoto Katsura , Ogura Shinji
Published: February 2020

Background: Stroke has been found to have a seasonally varying incidence; blood pressure, one of its risk factors, is influenced by humidity and temperature. The relationship between the incidence of stroke and meteorological parameters remains controversial. Objective: We investigated whether meteorological conditions are significant risk factors for stroke, focusing on the fluctuation of weather elements that triggers the onset of stroke. Methods: We collected ambulance transportation data recorded by emergency personnel from Gifu Prefecture. We included cases where the cause of the transportation was stroke and excluded cases of trauma. We combined these data with meteorological data as well as data on average temperature, average air pressure, and humidity provided publicly by the Japan Meteorological Agency. Our target period was from January 2012 to December 2016. Results: In the 5-year target period, there were 5,501 occurrences of ambulance transportation due to stroke. A seasonal tendency was confirmed, since ambulance transportation for stroke occurred more frequently at low temperatures (p < 0.001). Temperature (odds ratio: 0.91; p < 0.001) and humidity change (odds ratio: 1.50; p = 0.016) were identified as risk factors for ambulance transportation due to stroke. An increase in temperature incurs a lower risk than a decrease (odds ratio: 0.58; p = 0.09), although there is no statistically significant difference. Conclusions: Meteorological effects on the frequency of ambulance transportation due to stroke were studied. A lower temperature and radical humidity change were identified as risk factors for ambulance transportation due to stroke, and a decrease in temperature was also associated. We speculate on the possibilities of using meteorological data to optimize the assignment of limited medical resources in medical economics.
Perforation of the Small Intestine after Introduction of Lenvatinib in a Patient with Advanced Hepatocellular Carcinoma
Authors: Suzuki Naomi , Tajiri Kazuto , Futsukaichi Yuka , Tanaka Shinichi , Murayama Aiko , Entani Toshiki , Kobayashi Saito , Takahashi Kosuke , Fujii Tsutomu , Imura Johji , Yasuda Ichiro
Published: February 2020

Lenvatinib is a first-line standard treatment for advanced hepatocellular carcinoma (HCC) with better anti-tumor effects than sorafenib, as shown by greater inhibition of the kinases of fibroblast growth factor receptor and vascular endothelial growth factor (VEGF) receptor. This report describes a patient with advanced HCC who experienced perforation of the small intestine 1 month after starting the treatment with lenvatinib. This patient likely had partial necrosis of a metastasis to the small intestine before starting lenvatinib treatment, with subsequent ischemic changes leading to perforation of the small intestine. Although metastasis of HCC to the small intestine is rare, patients with these metastases should be regarded as being at risk for perforation during lenvatinib treatment.
IL (Interleukin)-15 Bridges Astrocyte-Microglia Crosstalk and Exacerbates Brain Injury Following Intracerebral Hemorrhage
Authors: Shi Samuel X. , Li Yu-Jing , Shi Kaibin , Wood Kristofer , Ducruet Andrew F. , Liu Qiang
Published: February 2020

Background and Purpose—

Microglia are among the first cells to respond to intracerebral hemorrhage (ICH), but the mechanisms that underlie their activity following ICH remain unclear. IL (interleukin)-15 is a proinflammatory cytokine that orchestrates homeostasis and the intensity of the immune response following central nervous system inflammatory events. The goal of this study was to investigate the role of IL-15 in ICH injury.

Methods—

Using brain slices of patients with ICH, we determined the presence and cellular source of IL-15. A transgenic mouse line with targeted expression of IL-15 in astrocytes was generated to determine the role of astrocytic IL-15 in ICH. The expression of IL-15 was controlled by a glial fibrillary acidic protein promoter (GFAP-IL-15
tg
). ICH was induced by intraparenchymal injection of collagenase or autologous blood.

Results—

In patients with ICH and wild-type mice subjected to experimental ICH, we found a significant upregulation of IL-15 in astrocytes. In GFAP-IL-15
tg
mice, we found that astrocyte-targeted expression of IL-15 exacerbated brain edema and neurological deficits following ICH. This aggravated ICH injury in GFAP-IL-15
tg
mice is accompanied by increased microglial accumulation in close proximity to astrocytes in perihematomal tissues. Additionally, microglial expression of CD86, IL-1β, and TNF-α is markedly increased in GFAP-IL-15
tg
mice following ICH. Furthermore, depletion of microglia using a colony stimulating factor 1 receptor inhibitor diminishes the exacerbation of ICH injury in GFAP-IL-15
tg
mice.

Conclusions—

Our findings identify IL-15 as a mediator of the crosstalk between astrocytes and microglia that exacerbates brain injury following ICH.
The Strange Case of Henry Bergh’s “Declaration of the Rights of Animals”
Authors: Ingram Darcy
Published: February 2020

A growing number of texts that address the history of the animal protection movement in the United States point to the importance of a document written in 1866 by ASPCA founder Henry Bergh and signed by dozens of influential supporters entitled the “Declaration of the Rights of Animals.” This article pursues the discussions and the bibliographical matter found in these texts along with other likely sources in which the “Declaration” or discussion of it might appear, and comes to the conclusion that no such document exists. In lieu of the “Declaration,” the article locates its origins in a very different document, traces the trajectory that led to that document being viewed in the terms currently ascribed to it, and emphasizes the impact that the presence or absence of such a groundbreaking document as the “Declaration” has on our understanding of the history and evolution of the animal protection movement.
Being Councillor and Prophet?
Authors: Perona Blandine
Published: February 2020

By studying three letters of Erasmus to princes (to Charles, Archduke of Austria in 1516, to the same, became Charles the 5th in 1523 and to Francis the 1st in 1524), this present article intends to show that Erasmus constantly tries to resolve a puzzle which is central in Utopia’s first book. Erasmus does not really choose between the answers which the fictitious More and Hythlodaeus give to the readers. He uses rhetorical accommodation as a way to be at the same time councillor and prophet, at the same time deferential and irreverent. In 1535, his last work, the Ecclesiastes, shows that during all his life he recommended the same solution. Accommodation is the way to be heard and to make words effective for princes’ councillors and for preachers too.
Metaphysical Time in Rūmī’s Mathnawī: Sufi Terminology of Metaphysical Time
Authors: Lewisohn Leonard
Published: February 2020

This article explores the idea of Metaphysical Time in the poetry of Jalāl al-Dīn Rūmī against more general understandings of time and temporality in Sufi thought and Persian poetry. Various attitudes toward serial time and the subjective experience of past, present, and future are reflected in the poetry of not only Rūmī, but also ʽUmar Khayyām and Ḥāfiẓ. The philosophical approaches toward human temporality discussed here include sentient carpe diem, spiritual carpe diem, and pursuit of the Metaphysical Moment, or Time’s Currency (naqd-i waqt). To understand this, we must examine Rūmī’s understanding of the notion of the Sufi as ‘the son of time’ (Ibn al-waqt), along with the concomitant or related ideas in Rūmī’s poetry of ‘the Father of Time’ (abū ‘l-waqt) and ‘the Brethren of Time’ (ikhwān al-waqt), and the Prophet’s Hadith, ‘I have a time with God….’. The article elaborates on some remarkable homologies between the concepts of time and the ‘Industrious Man’ in the poetry of Mawlānā Rūmī and William Blake, and how the attraction of divine love pulls the lover out of Time into the realm of Eternity, and how love subverts rational categories of time and space, which become illusory and vanish in the mystical experience of unity. Aldous Huxley’s distinction between the Philosophers of Time and the Philosophers of Eternity is also explored in relation to Rūmī’s thinking.
The Seven Avatars of Love: Deliberations on Rūmī’s Mathnawī
Authors: Zekrgoo Amir H. , Tajer Leyla H.
Published: February 2020

An ‘avatar’ is a technical Sanskrit term used in Indian mythology, referring to a divine manifestation on earth. The ultimate goal of an avatar is to save the earth and guide its occupants to salvation. Similarly, Rūmī equates true love with God and introduces seven different personifications of love on earth as divine agents who are there to lead mankind to the ultimate joy of liberation – liberation from their own egos and from their surroundings. The typical stories of love revolve around the lovers’ fears, pains, joys, and other emotional states, and the path they follow in order to experience the ultimate ecstasy of union with the beloved. In the Mathnawī the issue of love has been discussed in various passages and stages. A detailed analytical study of the magnum opus shows an effort by Rūmī to represent various stages of love in bodily forms. That is to say the lover, in his mystical journey, faces individuals who are in fact personifications of love. In his journey of self-discovery, the lover encounters seven mysterious individuals, whom we have termed the Seven Avatars of Love. These seven avatars appear at various stages of the journey in order to test, help, and provide guidance to the lover. They are in fact manifestations of a single reality disguised in seven forms: the Blood-shedder, the Spiritual Guide (Pīr), the Constable, the King, the Caliph, the Angel Gabriel, and finally, the Musician. Together they display various intellectual, mental, and emotional challenges that are experienced by true lovers on the path of love.
Curcuma papilionacea (Zingiberaceae), an unusual new species from southern Thailand

Authors: SOONTHORNKALUMP SUTTHINUT , ONGSAKUL ANNOP , DOLAJI AUMDAH , LEONG-ŠKORNIČKOVÁ JANA
Published: February 2020

Curcuma papilionacea, an unusual new species of Curcuma subgenus Hitcheniopsis (Zingiberaceae) is described and illustrated here. It is known only from Satun province in southern Thailand, and is easily distinguishable among all species of subgenus Hitcheniopsis by its inflorescence of green bracts and pea-like flowers with a small labellum and very prominent lateral staminodes. It also has prominently developed anther spurs, a character not yet recorded in this subgenus. It is compared to the four morphologically closest species which are Curcuma alismatifolia, C. harmandii, C. rhabdota and C. saraburiensis. A preliminary IUCN conservation assessment of Critically Endangered (CR), and notes on its distribution and ecology are also provided.
A new species of the genus Omaliopsis Jeannel, 1940 (Coleoptera: Staphylinidae: Omaliinae: Omaliini) from northern Sichuan, China
Authors: SHAVRIN ALEXEY V.
Published: February 2020

The omaliine genus Omaliopsis Jeannel, 1940 includes twelve species distributed in the Ethiopian, Madagascan, Palaearctic and Nearctic regions (Herman 2001, Shavrin 2019). The present paper is a supplement to my previous study (Shavrin 2019) and presents an additional description of a new species from the northern Sichuan, China.
Agathidium mexicanum Hendrichs, 1979: Types rediscovered
Authors: NAVARRETE-HEREDIA JOSÉ L. , SANDOVAL LILIANA P. , ZARAGOZA-CABALLERO SANTIAGO
Published: February 2020

Agathidium mexicanum Hendrichs, 1979: 106 is the single Mexican species of Leiodidae described by a Mexican entomologist: Chemical Engineer Jorge Hendrichs. As an amateur coleopterist he made a beetle collection of 18,400 specimens, adequately labeled by his wife and daughter. Most of the specimens are now in the entomological collection of the Instituto de Biología, UNAM. He published 12 papers, one of them devoted to the description of one leiodid species: Agathidium mexicanum Hendrichs, 1979. Type specimens of A. mexicanum were collected in Estado de Mexico and Distrito Federal (now Ciudad de México) localities (type locality: Cerro Tlaloc, Estado de México). The type series as described in the original description was constituted by 13 specimens: Holotype (male), allotype (female) and, 11 paratypes (6 males and 5 females). For specific details, data of the material examined is fully included (Hendrichs 1979: 110):
Description of the Adult Male of Stylops nubeculae Pierce (Strepsiptera: Stylopidae), a New Record for Canada
Authors: BALZER ZACHARY S. , DAVIS ARTHUR R.
Published: February 2020

The morphology of the adult male of Stylops nubeculae Pierce, encountered in stylopized gasters of two adult bees of Andrena peckhami, is described for the first time. This species was previously known only from the endoparasitic adult female found in Colorado, USA. We report a new locality for this species in Alberta, Canada.
Potential Impact of Preceding Aleutian Low Variation on El Niño–Southern Oscillation during the Following Winter
Authors: Chen Shangfeng , Chen Wen , Wu Renguang , Yu Bin , Graf Hans-F.
Published: February 2020

The present study reveals a close relation between the interannual variation of Aleutian low intensity (ALI) in March and the subsequent winter El Niño–Southern Oscillation (ENSO). When March ALI is weaker (stronger) than normal, an El Niño (a La Niña)–like sea surface temperature (SST) warming (cooling) tends to appear in the equatorial central-eastern Pacific during the subsequent winter. The physical process linking March ALI to the following winter ENSO is as follows. When March ALI is below normal, a notable atmospheric dipole pattern develops over the North Pacific, with an anticyclonic anomaly over the Aleutian region and a cyclonic anomaly over the subtropical west-central Pacific. The formation of the anomalous cyclone is attributed to feedback of the synoptic-scale eddy-to-mean-flow energy flux and associated vorticity transportation. Specifically, easterly wind anomalies over the midlatitudes related to the weakened ALI are accompanied by a decrease in synoptic-scale eddy activity, which forces an anomalous cyclone to its southern flank. The accompanying westerly wind anomalies over the tropical west-central Pacific induce SST warming in the equatorial central-eastern Pacific during the following summer–autumn via triggering eastward-propagating warm Kelvin waves, which may sustain and develop into an El Niño event during the following winter via positive air–sea feedback. The relation of March ALI with the following winter ENSO is independent of the preceding tropical Pacific SST, the preceding-winter North Pacific Oscillation, and the spring Arctic Oscillation. The results of this analysis may provide an additional source for the prediction of ENSO.
Testicular Loss in Children Due to Incorrect Early Diagnosis of Torsion
Authors: Kumar Vijay , Matai Pallavi , Prabhu Santosh Padubidri , Sundeep P. T.
Published: February 2020

Background. Testicular torsion is a common surgical emergency in children that requires a high index of suspicion, early diagnosis, and exploration. Most children present early to their primary pediatricians or physicians. The aim of this retrospective study is to determine the surgical outcome of testicular torsion with early as well as delayed presentation or referral at our pediatric surgical unit. Methods. Records of 50 patients who presented with testicular torsion at our pediatric surgical unit over the span of 10 years (2007-2017) were reviewed retrospectively. The duration and characteristics of symptoms, initial consultation with primary care health professional, time duration between the initial consultation and referral to a tertiary care center, clinical findings prior to surgery, and operative findings were noted. Results. Fifty patients were in the age group ranging from 38 days to 18 years. All the patients consulted the primary care health professionals within 3 to 6 hours after the onset of testicular pain. The patients presented to our hospital within the range of 3.5 hours to 10 days of onset of initial symptoms. Out of 50 patients who presented to our hospital with torsion testis, 45 (90%) patients underwent orchidectomy as the testicle was gangrenous and 5 patients underwent orchiopexy as the testicle was viable. Conclusion. The risk of testicular loss is very high if there is delay in the initial diagnosis of testicular torsion. Greater effort in educating the primary health care professionals may reduce this delay. Primary objective of treating the acute scrotum should be prevention of testicular loss than treating symptoms.
A Critical Discourse Analysis of Intellectual Property Rights Within NAFTA 1.0: Implications for NAFTA 2.0 and for Democratic (Health) Governance in Canada
Authors: Mohamed Faisal Ali , Chaufan Claudia
Published: February 2020

In 1993, the Canadian federal government ratified the North American Free Trade Agreement (NAFTA). Prior to ratification, compulsory licensing was eliminated from Canada’s Patent Act and intellectual property rights (IPRs) were strengthened. Compulsory licensing allows competitors to produce drugs under patent without the consent of the patent holder, challenging drug monopolies and lowering prices, whereas IPRs lengthen patent protections, shielding patent holders from competition and increasing prices. We perform a critical discourse analysis of key provisions in Chapter 17 of NAFTA in light of industry claims that pharmaceutical innovation requires important investments in research and development, justifying high drug prices. We note that since NAFTA, spending in research and development in Canada has decreased and drug prices have increased, becoming a major barrier to equitable access to critically necessary medications. We argue that by modifying the law, the federal government has wronged the Canadian people by discursively appropriating the language of protecting the public good while in practice legitimizing and consolidating private drug development and production, legalizing exorbitant profits, and excluding well-tested publicly financed alternatives. While NAFTA has now been superseded by the Canada–United States–Mexico Agreement, our analysis offers important lessons moving forward.
Unbanked in India: A qualitative analysis of 24 years of financial inclusion policies
Authors: Sinha Gaurav R , Piedra Lissette M
Published: February 2020

Social work has historically engaged in pioneering interventions to improve the financial well-being of people. India is an interesting case as it has the highest number of unbanked people on one side and numerous policy interventions on the other. Using systematic review and Gioia methodology, we analyzed 24 years of financial inclusion policies. Our analysis revealed that the efficacy of policies was impeded by flawed designs, as the policymakers preferred ‘quick fixes’ over long-term solutions. Our study highlights the need for learning from the past and organizing complex information in a way that helps policymakers in taking informed policy design decisions.
Patterns of Suffering in Palliative Care: A Descriptive Study
Authors: Seng Beng Tan , Ting Ting Tan , Karupiah Malathi , Xin Ni Cheah , Li Li Hong , Chong Guan Ng , Ee Chin Loh , Chee Loong Lam , Maw Pin Tan
Published: February 2020

Suffering experiences are common phenomena in palliative care. In this study, we aim to explore the different patterns of suffering in palliative care. Adult palliative care patients were recruited from the University of Malaya Medical Centre. Suffering scores were charted 3 times a day for a week. The characteristics of the suffering charts were analyzed using SPSS. The patterns of suffering were analyzed using structural pattern recognition. A total of 53 patients participated. The overall trends of suffering were downward (64%), upward (19%), and stable (17%). Median minimum and maximum suffering scores were 2/10 and 6/10, with an average of 3.6/10. Nine patterns of suffering were recognized from categorizing two key characteristics of suffering (intensity and fluctuation)—named S1 to S9. Understanding the different patterns of suffering may lead to better suffering management.
Legitimacy in the ‘secular church’ of the United Nations
Authors: Troy Jodok
Published: February 2020

This article argues that how the United Nations (UN) conceptualizes legitimacy is not only a matter of legalism or power politics. The UN’s conception of legitimacy also utilizes concepts, language and symbolism from the religious realm. Understanding the entanglement between political and religious concepts and the ways of their verbalization at the agential level sheds light on how legitimacy became to be acknowledged as an integral part of the UN and how it changes. At the constitutional level, the article examines phrases and ‘verbal symbols’, enshrined in the Charter of the ‘secular church’ UN. They evoke intrinsic legitimacy claims based on religious concepts and discourse such as hope and salvation. At the agential level, the article illustrates how the Secretary-General verbalizes those abstract constitutional principles of legitimacy. Religious language and symbolism in the constitutional framework and agential practice of the UN does not necessarily produce an exclusive form of legitimacy. This article shows, however, that legitimacy as nested in the UN’s constitutional setting cannot exist without religious templates because they remain a matter of a ‘cultural frame’.
Interpreting Vietnam’s China policy from the perspective of role theory: independent role versus interactive role
Authors: Huang Chiung-Chiu
Published: February 2020

Literature of small state’s foreign policy-making has mostly focused on the structural factors and less on the perceptions of the weak state. This article adopts a cross-level analysis framed by role theory to investigate Vietnam’s China policy. Two role conceptions are provided to illustrate Vietnam’s management of bilateral relations with China. The main demarcation of these two roles lies in their perceptions of hierarchy embedded in the asymmetric relations. The independent role is ego-driven and identity based that it views hierarchy as mainly the discrepancy of material power. By contrast, the interactive role is relational oriented and interprets hierarchy from the angle of distribution of responsibilities; the higher role expectation of the other actor and the pursuit of relational security are especially emphasized by this interactive role. Finally, this article utilizes the case of South China Sea dispute to explain how and why inter-role conflict and domestic role contestation occurred.
Neurological complications during treatment of liver abscess: think of metronidazole toxicity
Authors: Arora Navneet , Wasti Kushal P , Babbar Navida , Saroch Atul , Pannu Ashok K , Sharma Navneet
Published: February 2020

Related neurological adverse effects to metronidazole are rarely encountered in clinical practice despite its wide use as an antibacterial or antiparasitic agent. The neurotoxicity is not dose-dependent and is fully reversible with discontinuation of the drug. We describe a young man who was receiving metronidazole for an amoebic liver abscess and developed encephalopathy and seizures. Brain magnetic resonance imaging showed characteristic bilateral symmetrical cerebellar dentate hyperintensities.
Once bitten, twice shy: Dissatisfaction with previous therapy and its implication for future help-seeking among men
Authors: Seidler Zac E , Rice Simon M , Kealy David , Oliffe John L , Ogrodniczuk John S
Published: February 2020

Objective

Men can be reluctant to disclose distress and many men have ambivalence toward seeking help for depression, leading to poor uptake of and engagement in psychotherapy. The present study sought to explore whether a previously dissatisfying therapy experience leads to greater doubts about the effectiveness of treatment, in turn impacting on a man’s willingness to disclose their distress in future.

Method

An online survey of 133 Canadian men was conducted to investigate their current depressive symptoms, previous experience of, and belief in, the effectiveness of psychotherapy and likelihood of disclosing distress to their physician. A regression model with mediation was employed to analyze the relationship between these responses.

Results

The regression model highlighted a significant negative association between satisfaction with previous therapy and doubt about the effectiveness of therapy (t = −7.299, 99% confidence interval [−.537, −.254], p < .001). There was also a significant indirect effect, such that doubt about the effectiveness of therapy mediated the association between previous satisfaction and willingness to disclose distress to a physician (t = 3.748, 99% confidence interval [.123, .690], p < .001).

Conclusions

Providing treatment for depression that men find engaging and satisfying may improve their confidence that psychotherapy can help, make them more likely to reach out for assistance in the future and in turn, benefit their long-term mental health outcomes.
Early tracheostomy after initiation of venovenous extracorporeal membrane oxygenation is associated with decreased duration of extracorporeal membrane oxygenation support
Authors: DiChiacchio Laura , Boulos Francesca M , Brigante Francis , Raithel Maxwell , Shah Aakash , Pasrija Chetan , Mackowick Kristen , Menaker Jay , Mazzeffi Michael , Herr Daniel , Kon Zachary N , Deatrick Kristopher B
Published: February 2020

Timing of tracheostomy placement for patients with respiratory failure requiring venovenous extracorporeal membrane oxygenation support is variable and continues to depend on surgeon preference. We retrospectively reviewed all consecutive adult patients supported with peripheral venovenous extracorporeal membrane oxygenation for acute respiratory distress syndrome at a single institution with the hypothesis that early tracheostomy (within 7 days of extracorporeal membrane oxygenation initiation) decreases the duration of extracorporeal membrane oxygenation support. The primary endpoint was duration of extracorporeal membrane oxygenation support. Secondary endpoints included mortality, overall and intensive care unit length of stay, duration of mechanical ventilation, and time from extracorporeal membrane oxygenation initiation to liberation from ventilator, intensive care unit discharge, and hospital discharge. Overall and extracorporeal membrane oxygenation–associated hospital costs were compared. A total of 50 patients were identified for inclusion (early n = 21; late n = 29). Baseline characteristics including indices of disease severity were similar between groups. Duration of extracorporeal membrane oxygenation support was significantly shorter in the early tracheostomy group (12 vs. 21 days; p = 0.005). Median extracorporeal membrane oxygenation–related costs were significantly decreased in the early tracheostomy group ($3,624 vs. $5,603, p = 0.03). Early tracheostomy placement is associated with decreased time on extracorporeal membrane oxygenation support and reduced extracorporeal membrane oxygenation–related costs in this cohort. Validation in a prospective cohort or a clinical trial is indicated.
Healthcare providers’ views and experiences of non-specialist palliative care in hospitals: A qualitative systematic review and thematic synthesis
Authors: Nevin Mary , Hynes Geralyn , Smith Valerie
Published: February 2020

Background:

Healthcare providers working in hospitals are frequently exposed to patients with palliative care needs. For most patients, these reflect non-specialist rather than specialist palliative care needs. Embedding palliative care principles early in patients’ disease trajectories within acute care delivery in hospitals, however, is a challenge. How to best understand the experiences of those providing non-specialist palliative care in hospitals has not been systematically assessed.

Aim:

To synthesise the evidence on healthcare providers’ views and experiences of non-specialist palliative care in hospitals.

Design:

A qualitative systematic review and thematic synthesis using Thomas and Harden’s thematic synthesis framework.

Data sources:

Databases of MEDLINE, CINAHL, PsycINFO and EMBASE were searched from date of inception to March 2018. Studies were eligible for inclusion if they reported on healthcare providers’ views and experiences of non-specialist palliative care in hospitals. Studies were appraised for quality but not excluded on that basis. The review was prospectively registered with the International Prospective Register of Systematic Reviews.

Results:

Thirty-nine papers of 37 studies were included, representing 985 hospital healthcare providers’ views and experiences. Four major analytical themes emerged; ‘Understanding of Palliative Care’, ‘Complexities of Communication’, ‘Hospital Ecosystem’ and ‘Doctors and Nurses – a Different Lens’.

Conclusions:

Non-specialist palliative care in hospitals is operationalised as care in the last weeks and days of life. The organisation of acute care, inter-disciplinary working practices, clinician attitudes, poor communication structures and lack of education and training in palliative care principles exacerbates poor implementation of this care earlier for patients in hospitals.
The effects of a dance intervention on somatic symptoms and emotional distress in adolescent girls: A randomized controlled trial
Authors: Duberg Anna , Jutengren Göran , Hagberg Lars , Möller Margareta
Published: February 2020

Objective

To investigate whether a dance intervention for adolescent girls reduces stress-related symptoms.

Methods

This was a randomized controlled trial of an after-school intervention. Participants were 112 girls aged 13 to 18 years with stress-related somatic symptoms and emotional distress. The intervention comprised twice-weekly dance sessions for 8 months with a focus on enjoyment and socialization. A questionnaire was administered at baseline and after 8, 12 and 20 months. Participants rated the frequency with which they had experienced somatic symptoms and emotional distress during the previous 3 months.

Results

After the intervention, there was a significantly greater reduction in somatic symptoms and emotional distress in the dance intervention group than in the control group. The difference in the mean score change on a 5-point scale was 0.26 (95% confidence interval [CI]: 0.04 to 0.47) for somatic symptoms and 0.30 (95% CI: 0.04 to 0.58) for emotional distress.

Conclusion

Dance interventions may reduce somatic symptoms and emotional distress in adolescent girls, and may constitute a nonpharmacological complement to school health services. However, continued participation is needed for long-term sustainable results. Additional randomized studies are required to further evaluate the effect of this type of intervention in different settings.  This study was registered with ClinicalTrials.gov. Study name: ‘Influencing Adolescent Girls With Creative Dance Twice Weekly’.  URL: http: //clinicaltrials.gov/ct2/show/study/NCT01523561 .  Trial registration number: NCT01523561.
A Prospective Longitudinal Investigation of Cortical Thickness and Gyrification in Schizophrenia
Authors: Nelson Eric A. , Kraguljac Nina V. , White David M. , Jindal Ripu D. , Shin Ah L. , Lahti Adrienne C.
Published: February 2020

Background:

Cortical thickness (CT) and gyrification are complementary indices that assess different aspects of gray matter structural integrity. Both neurodevelopment insults and acute tissue response to antipsychotic medication could underlie the known heterogeneity of treatment response and are well-suited for interrogation into the relationship between gray matter morphometry and clinical outcomes in schizophrenia (SZ).

Methods:

Using a prospective design, we enrolled 34 unmedicated patients with SZ and 23 healthy controls. Patients were scanned at baseline and after a 6-week trial with risperidone. CT and local gyrification index (LGI) values were quantified from structural MRI scans using FreeSurfer 5.3.

Results:

We found reduced CT and LGI in patients compared to controls. Vertex-wise analyses demonstrated that hypogyrification was most prominent in the inferior frontal cortex, temporal cortex, insula, pre/postcentral gyri, temporoparietal junction, and the supramarginal gyrus. Baseline CT was predictive of subsequent response to antipsychotic treatment, and increase in CT after 6 weeks was correlated with greater symptom reductions.

Conclusions:

In summary, we report evidence of reduced CT and LGI in unmedicated patients compared to controls, suggesting involvement of different aspects of gray matter morphometry in the pathophysiology of SZ. Importantly, we found that lower CT at baseline and greater increase of CT following 6 weeks of treatment with risperidone were associated with better clinical response. Our results suggest that cortical thinning may normalize as a result of a good response to antipsychotic medication, possibly by alleviating potential neurotoxic processes underlying gray matter deterioration.
La valeur retirée d’une pratique : une application au cas des économies d’électricité
Authors: Innocent Morgane , François-Lecompte Agnès
Published: February 2020

Cette recherche propose un cadre d’analyse de la valeur retirée d’une pratique. Nous établissons tout d’abord un lien avec le concept de valeur de consommation en marketing. L’approche retenue pour la valeur retirée d’une pratique est celle d’une conception bivalente, incluant les différents motifs de valorisation et dévalorisation de l’activité. Nous proposons ensuite un modèle construit sur l’hypothèse que la valeur retirée d’une pratique évolue en fonction de l’intensité de celle-ci. L’étude empirique porte sur la pratique d’écogestes électriques. Les résultats montrent que plus la pratique s’intensifie, plus sa valorisation est forte alors que sa dévalorisation est minorée. Une analyse multigroupes permet, en complément, d’observer la diversification de la valeur lorsque l’intensité de la pratique s’accroît. Les résultats révèlent notamment l’importance de la valeur eudémonique, ce qui offre une nouvelle piste pour la compréhension des mécanismes d’appropriation des pratiques à enjeu sociétal.
The Utility of Short-Interval Follow-Up for Baseline High-Risk Screening Breast MRI
Authors: Shergill Ravi , Osman Heba , Al-Douri Faten , Ramonas Milita , Al Duwaiki Suad , Alabousi Abdullah
Published: February 2020

Objective:

Patients with a high lifetime risk of developing breast cancer undergo annual screening magnetic resonance imaging (MRI) starting at age 30. A proportion of these patients are subsequently required to undergo short-interval follow-up MRI 6 months after their baseline examination. The purpose of this study was to evaluate the utility and outcome of these short-interval follow-up examinations in this population.

Methods:

A retrospective review was performed of 523 patients who received their baseline high-risk breast screening MRI at our institution between 2013 and 2017. The proportion of patients who received a short-interval follow-up MRI at 6 months was recorded. The findings at baseline and follow-up MRI were recorded, as well as the outcomes and results of any interventions performed.

Results:

Ninety-six (17.6%) patients (age range: 25-67, mean age: 41) received a short-interval follow-up MRI following their baseline screening examination. Indications for follow-up included moderate to marked background parenchymal enhancement, nonmass enhancement, and likely benign enhancing mass. Of the 92 patients, 5 (5.4%) went on to have a biopsy, with none revealing a malignant pathology. The remainder either returned to routine screening (91.3%) or received further imaging in the form of ultrasound or additional follow-up MRI (3.3%).

Conclusion:

Short-interval follow-up breast MRI in high-risk patients after a baseline screening study with likely benign findings is unlikely to yield clinically significant findings. This retrospective study can be considered a starting point for additional future work looking at the rate, indications, and yield of short-interval follow-up following baseline high-risk screening breast MRI studies.