bluuebunny/crossref_metadata_2025 huggingface dataset:
Pazopanib-related secondary polycythemia in metastatic myxofibrosarcoma: A case report and review of the literature
Authors: Fanelli Martina , Caputo Francesco , Cerma Krisida , Gelsomino Fabio , Bari Alessia , Dominici Massimo , Pozzi Samantha
Published: August 2020

Introduction

Pazopanib, a tyrosine kinase inhibitor (TKI), is a standard treatment for various tumours, including metastatic non-adipocytic soft-tissue sarcomas. In literature, erythrocytosis has been described as a TKI-related condition.

Case report

A 59-year-old man underwent surgical removal of a sub-scapular mass consistent with myxofibrosarcoma. After distant relapse, he first started chemotherapy, and then Pazopanib. He was found to have increased levels of hemoglobin (Hb) and hematocrit (Hct). He was asymphtomatic, with no history of pulmonary disease nor smoking habit. Erythropoietin (EPO) level was higher than normal. A polycythemia vera was ruled out. Management & outcome: The patient started a prophylactic therapy with lysine acetylsalicylate, and we observed a reduction of Hb, but not Hct. Due to disease progression, we interrupted Pazopanib. After a week from drug discontinuation, Hb levels got back to the normal range, Hct was lowering. We decided not to perform phlebotomy, considering the declining trend in Hb and Hct values and the absence of symptoms.

Discussion

We postulated a Pazopanib-related secondary erythrocytosis, since Hb and Hct levels increased from baseline during treatment, then normalized when Pazopanib was discontinued. We used the Naranjo Nomogram to assess the correlation between the adverse effect and Pazopanib, the correlation was “Probable”, a score of 5. To the best of our knowledge, this is the first case report of Pazopanib-related secondary polycythemia in a patient with sarcoma. It is important to pay attention to blood count and to any symptoms potentially related to erythrocytosis in patients treated with TKIs.
The role of ado-trastuzumab emtansine in current clinical practice
Authors: Turshudzhyan Alla
Published: August 2020

Objective

This review reflects the literature from 2019 to 2020 on ado-trastuzumab emtansine’s (T-DM1) therapeutic use, clinical controversies, and newest perspectives on use. Data sources: PubMed was used as a database. Search “ado-trastuzumab emtansine” on June 11th, 2020 resulted in 57 publications: 20 clinical trials, two metanalysis, six randomized controlled studies, 13 reviews, and two systematic reviews. Of the 57 publications, 34 were descriptive of the topic in question and were used for this review. Data summary: T-DM1 is now used for patients with HER2 breast cancer who have residual disease post surgery after neoadjuvant chemotherapy (KATHERINE trial). Initial success prompted KRISTINE trial, which investigated whether T-DM1 can be used as a neoadjuvant therapy. While it did have fewer adverse events, T-DM1 was inferior to chemotherapy in treating early breast cancer. Noted shortcomings of the drug were toxicity limited Cmax, slow rate of internalization, lack of payload bystander effects, and number of resistance mechanisms. Proposed solutions were pre-treatment with metformin to augment drug internalization by the cell, use of second generation anti-HER2 antibody-drug conjugates to overcome developing resistance, payload swapping to increase bystander effect.

Conclusions

While T-DM1 has fewer side-effects, it is inferior to chemotherapy in early breast cancer treatment. More research should be done to overcome resistance pathways, identify rate-limiting intracellular processing pathways, improve bystander, and enhance internalization of the drug. Until more research is done, T-DM1 will continue to be used in HER2 positive breast cancer as well as a few other HER2 expressing tumors that fail to respond to neoadjuvant therapy.
Cardiac Specialists’ Perspectives on Barriers to Cardiac Rehabilitation Referral and Participation in a Low-Resource Setting
Authors: Ghanbari-Firoozabadi Mahdieh , Mirzaei Masoud , Nasiriani Khadijeh , Hemati Mozhgan , Entezari Jamal , Vafaeinasab Mohammadreza , Grace Sherry L , Jafary Hasan , Sadrbafghi Seyed Mahmood
Published: August 2020

Background:

Cardiac specialists are arguably the most influential providers in ensuring patients access cardiac rehabilitation (CR). Physician barriers to referral have been scantly investigated outside of high-income settings, and not qualitatively.

Aim:

This study investigated cardiac specialists’ perceptions of barriers and facilitators to patient CR participation in a low-resource setting, with a focus on referral.

Methods:

In this qualitative study, focus groups were conducted with conventional content analysis. Thirteen of 14 eligible cardiac specialists working in Yazd, Iran, participated in 1 or both focus groups (n = 9 and n = 10, respectively). The recording of the first focus group was transcribed into a word file verbatim, and the accuracy of the content of all field notes and the transcripts was approved by the research team, which was then analyzed inductively. Following a similar process, saturation was achieved with the second focus group.

Results:

Four themes emerged: “physician factors,” “center factors,” “patient factors,” and “cultural factors.” Regarding “physician factors,” most participants mentioned shortage of time. Regarding “center factors,” most participants mentioned poor physician-patient-center coordination. In “patient factors,” the subcategories that arose were socioeconomic challenges and clinical condition of the patients. “Cultural factors” related to lack of belief in behavioral/preventive medicine.

Conclusions:

Barriers to CR referral and participation were multilevel, as in high-resource settings. However, relative recency of the introduction of CR in these settings seemed to cause great lack of awareness. Cultural beliefs may differ, and communication from CR programs to referring providers was a particular challenge in this setting.
Systematic Review of Interventions Designed to Maintain or Increase Physical Activity Post-Cardiac Rehabilitation Phase II
Authors: Graham Helen , Prue-Owens Kathy , Kirby Jess , Ramesh Mythreyi
Published: August 2020

Background:

Cardiovascular disease (CVD) continues to be the No. 1 cause of death in the United States and globally, and individuals with a history of a cardiac event are at increased risk for a repeat event. Physical inactivity creates health problems for individuals with chronic heart disease. Evidence shows that physical activity (PA), as a central component of cardiac rehabilitation phase II (CRII), decreases hospital readmission and mortality. Yet, individual adherence to PA tends to decline several months following CRII completion.

Objective:

The purpose of this review was to evaluate current literature for interventions designed to assist individuals diagnosed with myocardial infarction (MI), coronary artery bypass graft (CABG), coronary artery disease (CAD), and percutaneous coronary intervention (PCI) to maintain or increase PA post-CRII.

Methods:

A systematic search of 5 electronic databases including hand-searched articles between 2000 and 2019. Key Medical Subject Headings (MeSH) search terms included cardiac rehabilitation, intervention, exercise or PA, outcomes, compliance, adherence, or maintenance. Only interventions implemented following CRII program completion were included for review.

Results:

Based on the inclusion criteria, the search yielded 19 randomized control trials retained for descriptive analysis. Interventions were categorized into 3 domains. The intervention designs varied widely in terms of duration of the intervention and the length of time to outcome measurement. Most interventions were short-term with only 2 studies offering a long-term intervention of greater than 1 year. Interventions using a theoretical approach most often included a cognitive-behavioral model.

Conclusions:

Interventions offered shortly after completion of CRII may help cardiac patients maintain PA and reduce the risk of experiencing additional cardiac events; however, more quality research is needed. Additional research to examine PA maintenance in older adults (70 years and older) would be valuable based on the increase in average lifespan. Studies with larger and more diverse samples, and less variation in methods and outcomes would greatly increase the ability to conduct a high-quality meta-analysis.
‘Turn up the volume and listen to my voice’: Students’ perceptions of Music in school
Authors: Stavrou Natassa Economidou , Papageorgi Ioulia
Published: August 2020

Music teachers are often faced with students’ negative attitudes towards Music as a school subject, and dilemmas of what would be most important to teach and at the same time interesting, useful and relevant to students. Looking at music teaching and learning through the eyes of students can play a key role in re-shaping the condition of learning and promoting a positive and motivating musical learning environment. The aim of this study was to ‘turn up the volume’ of secondary students’ views of their music lessons in secondary school, including what they value and how they would have liked lessons to be if they had the opportunity to change things. A self-report questionnaire was devised for the purposes of the study and was administered to 749 secondary school students in schools in Cyprus. Our findings reveal that participants enjoyed Μusic, ranking it as their second favourite out of 15 secondary school subjects. However, there was a reported discrepancy between the activities students are engaged with and what they would like to be engaged with. Students called for more focus on singing, to play a greater variety of instruments besides the recorder (i.e., drums, guitar and piano) and to play the music they like. Building on students’ perspectives, recommendations are made for music teachers and policy makers.
Troubling the Southern turn in feminisms
Authors: Desai Manisha
Published: August 2020

In this article, I focus on the work of the South Asian Network for Gender Transformation (SANGAT) to show how it goes beyond the current turn to the Global South in much contemporary transnational feminisms. It does so in two ways. One, as evident in the name, it defines a regional imaginary, which is place-based and informed by the long history of interactions in the area beyond the colonial, postcolonial, and recent global forces, as well as in conversation with discourses and practices from the North. Second, its praxis connects activists across borders in a process of mutual learning that acknowledges power inequalities and draws upon local as well as transnational feminist theories and methodologies to enable sustainable collaborations for social and gender justice in the region. Thus, rather than reproducing the North/South binaries with its attendant erasures SANGAT seeks to go beyond them to develop place-based yet connected ‘solidarities of epistemologies’ and praxis.
De-escalating rituximab dose results in stability of clinical, radiological, and serum neurofilament levels in multiple sclerosis
Authors: Disanto Giulio , Ripellino Paolo , Riccitelli Gianna C , Sacco Rosaria , Scotti Barbara , Fucili Anita , Pravatà Emanuele , Kuhle Jens , Gobbi Claudio , Zecca Chiara
Published: August 2020

Background:

Phase II and observational studies support the use of rituximab in multiple sclerosis. Standard protocols are lacking, but studies suggest comparable efficacy between low- and high-dose regimens.

Objective:

To evaluate effectiveness and safety of de-escalating rituximab dose from 1000 to 500 mg/6 months in multiple sclerosis.

Methods:

Patients were switched from rituximab 1000 to 500 mg/6 months and prospectively followed for 12 months. Relapses, disability, occurrence of brain/spinal magnetic resonance imaging (MRI) lesions, serum neurofilament light chain (NfL), CD19+ B cell, and IgG concentrations were analyzed.

Results:

Fifty-nine patients were included (37 relapsing-remitting, 22 secondary progressive). No relapses occurred, with no difference in expanded disability status scale (EDSS) between baseline (4 (2.5–4.5) and 12 months (3.5 (2.5–5.5) p = 0.284). Overall, three new T2 lesions appeared during follow-up. NfL concentration was stable between baseline (7.9 (5.9–45.2) pg/mL) and 12 months (9.1 (5.9–21.3) pg/mL, p = 0.120). IgG concentrations decreased with greater rituximab load (coefficient = −0.439, p = 0.041). IgG deficient patients had greater risk of infections (OR = 6.27, 95% CI = 1.71–22.9, p = 0.005).

Conclusion:

De-escalating rituximab dose from 1000 to 500 mg/6 months is safe, results in clinical and radiological stability, and does not affect serum NfL over 12 months. Rituximab load negatively influences IgG concentrations, and IgG deficient patients are at higher risk of infections.
Policy preferences and party switching: Evidence from the 2012 Japanese election
Authors: Hamzawi Jordan
Published: August 2020

In 2012, despite controlling more than 60% of all seats in Japan’s lower house, the Democratic Party of Japan had roughly 100 legislators switch parties. The break-up proved so disastrous that the DPJ collapsed and Japan’s steadily developing two-party system utterly collapsed, marking one of the most momentous events in recent Japanese political history. However, there is little systematic understanding of what produced this outcome. I leverage a dataset of candidate policy preferences in order to pinpoint what led politicians to take the dramatic step of leaving the ruling party. Through factor analysis and logistic regression, I find that DPJ incumbents with policy preferences significantly different from their party were especially likely to switch and that those preferences predict the party they ultimately chose.
Systematic Review: Effectiveness of psychosocial interventions on wellbeing outcomes for adolescent or adult victim/survivors of recent rape or sexual assault
Authors: Lomax Jane , Meyrick Jane
Published: August 2020

Sexual assault and rape are common forms of sexual violence/abuse. The psychological/health consequences represent significant and ongoing harm. It seems imperative that victim/survivors receive evidence-based support within first response settings. To assess what psychosocial interventions work for victim/survivors of a recent sexual assault. Twenty-seven electronic databases were systematically searched. Narrative data synthesis was used to read across studies. Reporting format follows PRISMA checklist. Ten studies were identifed including range of interventions. The evidence is sparse and scientifically weak, common flaws are reviewed. There is some weak evidence for the impact of video and cognitive behavioural therapy (CBT) based interventions, especially trauma processing. There is a gap in the evidence base on psychosocial interventions for victim/survivors of sexual assault and higher quality research is required.
Production and comprehension of pronouns in individuals with autism: A meta-analysis and systematic review
Authors: Finnegan Elizabeth G , Asaro-Saddler Kristie , Zajic Matthew C
Published: August 2020

This study compared pronoun use in individuals with autism to their typically developing peers via meta-analysis and systematic review of 20 selected articles to examine differences in overall pronoun usage as well as in personal, ambiguous, possessive, reflexive, and clitic pronoun usage. Summary effects indicated significant differences between individuals with autism and their typically developing peers in the use of pronouns overall as well as in ambiguous, clitic, and reflexive pronoun usage, but not in personal and possessive pronoun usage. Results indicate wide variation in the way individuals with autism use pronouns, and individual outcomes appeared to be moderated by multiple factors, including cognitive ability, first language, and overall language development. Implications and recommendations for assessment and intervention practices are discussed.

Lay abstract

This research compared pronoun use in individuals with autism and typically developing peers. Meta-analysis and systematic review of 20 selected articles were used to determine whether significant differences existed in the use of pronouns overall as well as in personal, ambiguous, possessive, reflexive, and clitic pronoun usage. Summary effects indicated significant differences between individuals with autism and their typically developing peers in the use of pronouns overall as well as in ambiguous, clitic, and reflexive pronoun usage, but not in personal and possessive pronoun usage. Results indicate wide variation in the way individuals with autism use pronouns. Since individual outcomes appear to be moderated by multiple factors, including cognitive ability, first language, and overall language development, it is recommended these be considered in assessment and treatment.
The Cultural Formulation Interview since DSM-5: Prospects for training, research, and clinical practice
Authors: Aggarwal Neil Krishan , Jarvis G. Eric , Gómez-Carrillo Ana , Kirmayer Laurence J. , Lewis-Fernández Roberto
Published: August 2020

While social science research has demonstrated the importance of culture in shaping psychiatric illness, clinical methods for assessing the cultural dimensions of illness have not been adopted as part of routine care. Reasons for limited integration include the impression that attention to culture requires specialized skills, is only relevant to a subset of patients from unfamiliar backgrounds, and takes too much time to be useful. The DSM-5 Cultural Formulation Interview (CFI), published in 2013, was developed to provide a simplified approach to collecting information needed for cultural assessment. It offers a 16-question interview protocol that has been field tested at sites around the world. However, little is known about how CFI implementation has affected training, health services, and clinical outcomes. This article offers a comprehensive narrative review that synthesizes peer-reviewed, published studies on CFI use. A total of 25 studies were identified, with sample sizes ranging from 1 to 460 participants. In all pilot CFI studies 960 unique subjects were enrolled, and in final CFI studies 739 were enrolled. Studies focused on how the CFI affects clinical practice; explored the CFI through research paradigms in medical communication, implementation science, and family psychiatry; and examined clinician training. In most studies, patients and clinicians reported that using the CFI improved clinical rapport. This evidence base offers an opportunity to consider implications for training, research, and clinical practice and to identify crucial areas for further research.
An experimental study on the flexural behavior of local prestressed steel–concrete composite continuous box beams
Authors: Zhang Xuebing , Zhang Zhanwei , Cao Guohui , Mo Dongshan
Published: August 2020

The flexural bearing capacities of three composite continuous box beams with different prestressing degrees were tested and studied to investigate the influences of local prestressing bundles on the deflection, relative slip of interface, strain, and redistribution of the internal force of the steel–concrete composite continuous box beam. Results show that the arrangement of local prestress can not only improve the bending stiffness at the mid-span of the composite continuous box beam, but also significantly enhance the ductility. In the design process of the local prestressed composite continuous box beam, the influence of the slip at the middle support should be fully considered, and the deflection could not be taken as a control factor. The internal force redistribution of the local prestressed continuous box beam is lower than that of the ordinary continuous box beam, but it still has good plastic internal force redistribution. The number of prestressing bundles in the negative moment region is the main factor that affects the internal force redistribution of the middle support.
Fatigue behavior improvement of hardened parts using sequential hard turning, grinding, and ball burnishing operations
Authors: Arsalani Moosa , Razfar Mohammad Reza , Abdullah Amir , Khajehzadeh Mohsen
Published: August 2020

One of the major problems encountered in hardened components such as roller bearings, which work under fatigue loading conditions, is that the requirement of higher surface finishes (≈0.15 µm Ra) cannot be achieved by the sequential hard turning and ball burnishing processes. Such high surface qualities can be generated by additional finishing operations such as grinding. However, despite the improvement in the surface roughness, the grinding process increases both the tensile surface residual stresses and crack initiation sites on the ground surface; therefore, the fatigue behavior of the component may deteriorate. In this study, the effects of adding a grinding operation before the ball burnishing process on the fatigue behavior of AISI 4130 steel were experimentally studied. According to the achieved results, the burnished pre-ground samples show a considerable reduction in the final surface roughness and, at the same time, higher microhardness, higher endurance limit, and smaller area of the fatigue cracking zone. The burnished pre-turned and burnished pre-ground samples showed 4.24% and 10.95% improvements in the endurance limit compared to that of the turned samples, respectively.
Student engagement: The impact of positive psychology interventions on students
Authors: Hammill Jackie , Nguyen Thinh , Henderson Fiona
Published: August 2020

Positive psychology interventions are widely used in primary and secondary education to enhance student engagement and well-being. When used in the higher education sector, interventions tend to be used in psychology, psychotherapy and mindfulness programmes with successful outcomes in terms of student engagement, learning and well-being. However, there is little evidence to support the effectiveness of such interventions in disciplines outside of psychology. This triangulated action research study utilised student self-reported feedback to explore the link between positive psychology interventions and student engagement in a non-psychology related classroom. The study involved two intervention and one control group. In contrast to results obtained from psychology students, findings in this study showed a lack of student engagement in both intervention groups and a significant increase in student engagement in the control group compared to one of the intervention groups. The findings suggest that further consideration needs to be given to identify positive psychology interventions that might achieve a better fit with non-psychology students.
Poisson–Tweedie mixed-effects model: A flexible approach for the analysis of longitudinal RNA-seq data
Authors: Signorelli Mirko , Spitali Pietro , Tsonaka Roula
Published: August 2020

We present a new modelling approach for longitudinal overdispersed counts that is motivated by the increasing availability of longitudinal RNA-sequencing experiments. The distribution of RNA-seq counts typically exhibits overdispersion, zero-inflation and heavy tails; moreover, in longitudinal designs repeated measurements from the same subject are typically (positively) correlated. We propose a generalized linear mixed model based on the Poisson–Tweedie distribution that can flexibly handle each of the aforementioned features of longitudinal overdispersed counts. We develop a computational approach to accurately evaluate the likelihood of the proposed model and to perform maximum likelihood estimation. Our approach is implemented in the R package ptmixed, which can be freely downloaded from CRAN. We assess the performance of ptmixed on simulated data, and we present an application to a dataset with longitudinal RNA-sequencing measurements from healthy and dystrophic mice. The applicability of the Poisson–Tweedie mixed-effects model is not restricted to longitudinal RNA-seq data, but it extends to any scenario where non-independent measurements of a discrete overdispersed response variable are available.
Preliminary Efficacy and Safety of Reishi & Privet Formula on Quality of Life Among Non–Small Cell Lung Cancer Patients Undergoing Chemotherapy: A Randomized Placebo-Controlled Trial
Authors: Liu Jie , Mao Jun J. , Li Susan Qing , Lin Hongsheng
Published: August 2020

Background:

Cancer patients often experience decreased quality of life during chemotherapy. This study aimed to determine the preliminary efficacy and safety of Reishi & Privet Formula (RPF) for maintaining quality of life among patients with non–small cell lung cancer (NSCLC) undergoing chemotherapy.

Methods:

We conducted a phase II randomized, double-blind, placebo-controlled clinical trial in China. Adults with NSCLC scheduled to receive chemotherapy were randomly assigned (3:1 ratio) to receive oral RPF (3.36 g/day) or placebo daily for 6 weeks. The main outcome was the Functional Assessment of Cancer Therapy–Lung (FACT-L). We evaluated RPF’s safety profile using the Common Terminology Criteria for Adverse Events and assessed changes in outcome measures from baseline to weeks 3 and 6 using a linear mixed effects model.

Results:

We enrolled 82 participants across 8 cancer centers in China. The median age was 59 years, 56 (68%) had advanced cancer. Compared with the placebo group, the RPF group had nonstatistically significant higher quality of life as measured by the FACT-L total score ( P = .086) over 2 cycles of chemotherapy. The RPF group was associated with a nonsignificant better general health ( P = .050) and emotional well-being ( P = .090) than the placebo group. Adverse events rates did not differ between groups.

Conclusions:

This study demonstrated preliminary safety and suggests a promising trend in RPF’s effect on maintaining quality of life and emotional well-being among NSCLC patients undergoing chemotherapy. Future adequately powered randomized-controlled trials are needed to verify the efficacy and safety of RPF in cancer patients undergoing chemotherapy.
Is periodontal disease a risk factor for developing severe Covid-19 infection? The potential role of Galectin-3
Authors: Kara Cankat , Çelen Kübra , Dede Figen Öngöz , Gökmenoğlu Ceren , Kara Nihal Beldüz
Published: August 2020

Impact statement

There could be a close relationship between periodontal diseases (PDs) severity and Covid-19 infections. This relationship could be caused by Galectin-3-mediated increased immune response and increased viral attachment. Keeping PDs under control and maintaining rigorous oral hygiene during this troubled Covid-19 pandemic period is very important.

Patients with older age and pre-existing conditions like cardiovascular disease, hypertension, diabetes, and obesity are in the higher risk group for developing severe Covid-19 infections. The inflammatory pathways that are involved in these conditions are the same pathways that we see in periodontal diseases (PDs). This raises a significant question: Is PD a pre-existing condition that can increase the risk of developing severe Covid-19 infection? Several studies have shown that Galectins play a key role in the homeostasis of immune cells, and recently, a relationship was found between Covid-19 and Galectin-3 (Gal-3).It has been determined that an important area in the spike protein of Coronavirus-19 is almost exactly the same as the morphology of Gal-3, and these spike proteins are critical for the entry of the virus into host cells. We suspect that there is enough evidence to support a close relationship between PDs severity and Covid-19 infections. There is accumulating evidence to suggest a relationship between the severity of PD and the risk of infection with Covid-19, which requires further investigation. This relationship could be caused by Gal-3-mediated increased immune response and increased viral attachment. In this context, we want to emphasize the importance of keeping PD under control by maintaining rigorous oral hygiene during this troubled Covid-19 pandemic period. We would also like to point out the possibility that having PD may be a pre-disposition toward developing a severe Covid-19 infection.
Septal Signaling Suppresses Seizures Through Stimulating Somatostatin Cells
Authors: Forcelli Patrick A.
Published: August 2020

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Surface or Depth: A Paradigm Shift in Invasive Epilepsy Monitoring
Authors: Englot Dario J.
Published: August 2020

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A Late Post-EVAR Rupture in a 102-Year-Old Patient Related to a Type II Endoleak
Authors: Gonzalez-Urquijo Mauricio , Reijnen Michel M. P. J. , Lozano-Balderas Gerardo , Fabiani Mario Alejandro
Published: August 2020

Purpose:

Endovascular abdominal aortic aneurysm repair (EVAR) is progressively being applied in the elderly population. Type II endoleaks are common and mostly benign, but they are related to more aneurysm sac expansion after EVAR. They may lead to rupture in <1% of cases. We present a case of a centenarian with a post-EVAR rupture, related to type II endoleak, and discuss the use of EVAR on the management of this type of endoleak in an extremely old patient.

Case Presentation:

A 102-year-old man with a history of EVAR 12 years earlier, presented to the emergency department with a drop of consciousness. A computed tomography revealed a ruptured abdominal aortic aneurysm. Angiography showed a type II endoleak related to patent lumbar arteries deriving from collateral branches of the right internal iliac artery. Embolization was not successful and subsequently the ostium of the iliolumbar artery was overstented, obliterating the feeding branch. The postoperative course was complicated by a deterioration of chronic obstructive pulmonary disease and patient was discharged home on the seventh postprocedural day; nonetheless, he died on postoperative day sixteenth due to respiratory complications.

Conclusion:

Complications following EVAR are a real threat and emphasize the need for follow-up. The current case report shows that age per se should not be a contraindication for EVAR nor for follow-up. Also, late ruptures due to type II endoleaks could be treated in the very elderly population although larger series are required for robust conclusions.
Hypergraph-based resource allocation for Device-to-Device underlay H-CRAN network
Authors: Zhao Pan , Guo Wenlei , Xu Datong , Jiang Zhiliang , Chai Jie , Sun Lijun , Li He , Han Weiliang
Published: August 2020

In the hybrid communication scenario of the Heterogeneous Cloud Radio Access Network and Device-to-Device in 5G, spectrum efficiency promotion and the interference controlling caused by spectrum reuse are still challenges. In this article, a novel resource management method, consisting of power and channel allocation, is proposed to solve this problem. An optimization model to maximum the system throughput and spectrum efficiency of the system, which is constrained by Signal to Interference plus Noise Ratio requirements of all users in diverse layers, is established. To solve the non-convex mixed integer nonlinear optimization problem, the optimization model is decomposed into two sub-problems, which are all solvable quasi-convex power allocation and non-convex channel allocation. The first step is to solve a power allocation problem based on solid geometric programming with the vertex search method. Then, a channel allocation constructed by three-dimensional hypergraph matching is established, and the best result of this problem is obtained by a heuristic greed algorithm based on the bipartite conflict graph and µ-claw search. Finally, the simulation results show that the proposed scheme improves the throughput performance at least 6% over other algorithms.
Potential Value of Haptic Feedback in Minimally Invasive Surgery for Deep Endometriosis
Authors: Vlek Stijn L. , Burm Rens , Govers Tim M. , Vleugels Michel P. H. , Tuynman Jurriaan B. , Mijatovic Velja
Published: August 2020

Introduction. Laparoscopic treatment of deep endometriosis (DE) is associated with intra- and post-operative morbidity. New technological developments, such as haptic feedback in laparoscopic instruments, could reduce the rate of complications. The aim of this study was to assess the room for improvement and potential cost-effectiveness of haptic feedback instruments in laparoscopic surgery. Methods. To assess the potential value of haptic feedback, a decision analytical model was constructed. Complications that could be related to the absence of haptic feedback were included in the model. Costs of complications were based on the additional length of hospital stay, operating time, outpatient visits, reinterventions, and/or conversions to laparotomy. The target population consists of women who are treated for DE in the Netherlands. A headroom analysis was performed to estimate the maximum value of haptic feedback in case it would be able to prevent all selected intra- and post-operative complications. Results. A total of 9.7 intraoperative and 47.0 post-operative complications are expected in the cohort of 636 patients annually treated for DE in the Netherlands. Together, these complications cause an additional length of hospital stay of 432.1 days, 10.2 additional outpatient visits, 73.9 reinterventions, and 4.2 conversions. Most consequences are related to post-operative complications. The total additional annual costs due to complications were €436 623, amounting to €687 additional costs per patient. Discussion. This study demonstrated that the potential value for improvement in DE laparoscopic surgery by using haptic feedback instruments is considerable, mostly caused by the potential prevention of major post-operative complications.
Culturally Responsive Health Promotion to Address Health Disparities in African American Men: A Program Impact Evaluation
Authors: Okoro Olihe N. , Nelson Chantele S. , Witherspoon Stephan P. , Witherspoon Salaam F. , Simmons Glenn E.
Published: August 2020

African American (AA) men continue to experience worse health outcomes compared to men of other races/ethnicities. Community-based interventions are known to be effective in health promotion and disease prevention. The program objectives were to (a) increase knowledge and risk awareness of targeted conditions, (b) change health-care-seeking attitudes toward regular primary care among AA men, and (c) improve their lifestyle-related health behaviors by leveraging the influence of women in their lives. The community-engaged educational intervention targeted both men and women and included eight 90-min sessions per cohort. Topics included prostate cancer, cardiovascular disease, diabetes, mental health, health-care access, and healthy lifestyle. Sessions were both didactic and interactive. A pre-/post-intervention questionnaire assessed knowledge. Interviews were conducted with male participants and a focus group discussion (FGD) with women to assess program impact. Interview and FGD transcripts were analyzed for themes and recommendations. Major themes were—increased knowledge/awareness of risk associated with chronic conditions, change in health-care-seeking attitudes, increased self-efficacy to engage the health-care system, and lifestyle changes. Other impacts reported were building community/social support, a safe and enabling learning environment, and enhanced community health status overall. Recommendations included having extended, more in-depth sessions, targeting the younger generation, smaller cohort sizes, and more community-based health programming. Community-engaged health promotion using a cohort model as well as including women can be effective in increasing knowledge, enhancing self-efficacy, and providing the much-needed social support. These can influence health-related behaviors and thus contribute to improving health outcomes for AA men.
Open abdominal aortic aneurysm repair with incidental finding of an extra-adrenal pheochromocytoma of the organ of Zuckerkandl
Authors: Gonzalez Kathy , Singh Michael J
Published: August 2020

Objectives

Pheochromocytomas are rare catecholamine-secreting neuroendocrine tumors that arise from chromaffin cells of the adrenal medulla or extra-adrenal paraganglia. The most common location of these tumors is within the adrenal medulla. Extra-adrenal pheochromocytomas (EAPs) may occur in any portion of the paraganglion system. The most common location of EAPs is at the organ of Zuckerkandl, which is a collection of chromaffin cells near the origin of the inferior mesenteric artery.

Methods

We present a case of an EAP of the organ of Zuckerkandl incidentally discovered and resected during urgent open repair of a symptomatic 6.7-cm juxtarenal abdominal aortic aneurysm (AAA).

Results

The patient underwent successful open surgical repair of a juxtarenal AAA and resection of the pheochromocytoma.

Conclusions

Concomitant pheochromocytomas and abdominal aortic aneurysms are rare, with a small number described in the literature. We describe the case of a simultaneous EAP of the organ of Zuckerkandl and AAA repair. This case demonstrates that these lesions can be safely resected in the same setting as AAA repair.
Family violence screening and disclosure in a large metropolitan hospital: A health service users’ survey
Authors: Fisher Caroline A , Galbraith Georgina , Hocking Alison , May Amanda , O’Brien Emma , Willis Karen
Published: August 2020

Objectives:

Assisting patients who are experiencing family violence is an important issue for health services. Rates of screening for family violence in general hospital settings in Australia are unclear. This study was conducted to obtain data on hospital family violence screening rates and health service users’ perceptions of the screening process, in a large metropolitan hospital in Australia.

Methods:

Clients from the clinical caseloads of social work and psychology staff were invited to participate in a tablet administered, online survey of their family violence screening experiences, within the health service.

Results:

A total of 59 surveys were completed by hospital users, who had been treated in areas including the emergency department, acute inpatient wards, sub-acute and rehabilitation units, and outpatient clinics. Less than half the sample reported being screened for family violence at the health service. One-quarter of the respondents reported disclosing family violence concerns, with one-fifth wanting to disclose, but not feeling comfortable to do so. The majority of respondents who disclosed family violence felt supported by the response of the staff member and were provided with information they found helpful. However, further work could be done to improve screening rates, environmental and organizational factors to promote users feeling comfortable to disclose, and staff responses to disclosures.

Conclusion:

The results of the survey will be used to inform the development of a hospital-wide family violence training initiative aimed to improve staff knowledge, confidence, rates of screening, and clinical responses to family violence.
Does comprehension (sometimes) go wrong for noncanonical sentences?
Authors: Meng Michael , Bader Markus
Published: August 2020

This article addresses the question of whether the human parsing mechanism (HPM) derives sentence meaning always from representations that are computed algorithmically or whether the HPM sometimes resorts to non-algorithmic strategies that may result in misinterpretations. Misinterpretation effects for noncanonical sentences, such as passives, constitute important evidence in favour of models allowing for nonveridical representations. However, it is unclear whether these effects reflect errors in the mapping of form to meaning, or difficulties specific to the procedure used to test comprehension. We report two experiments combining two different comprehension tasks to address these alternative possibilities. In Experiment 1, participants first judged the plausibility of canonical and noncanonical sentences and then named the agent or patient of the sentence. In Experiment 2, the order of the two tasks was reversed. Both tasks require the correct identification of agent or patient/theme, but differ regarding the complexity of operations required to complete the task successfully. In both experiments, participants made a substantial number of errors with agent/patient naming, even when they had correctly assessed sentence plausibility. We conclude that misinterpretation effects do not indicate parsing errors and therefore cannot serve as evidence for non-algorithmic processing. Our results support models of the HPM that assume algorithmic processing only.
An adaptive Cahn-Hilliard equation for enhanced edges in binary image inpainting
Authors: Theljani Anis , Houichet Hamdi , Mohamed Anis
Published: August 2020

We consider the Cahn-Hilliard equation for solving the binary image inpainting problem with emphasis on the recovery of low-order sets (edges, corners) and enhanced edges. The model consists in solving a modified Cahn-Hilliard equation by weighting the diffusion operator with a function which will be selected locally and adaptively. The diffusivity selection is dynamically adopted at the discrete level using the residual error indicator. We combine the adaptive approach with a standard mesh adaptation technique in order to well approximate and recover the singular set of the solution. We give some numerical examples and comparisons with the classical Cahn-Hillard equation for different scenarios. The numerical results illustrate the effectiveness of the proposed model.
Pulmonary sarcomatoid carcinoma: progress, treatment and expectations
Authors: Li Xin , Wu Di , Liu Hongyu , Chen Jun
Published: August 2020

Pulmonary sarcomatoid carcinoma (PSC) is a unique, highly invasive pulmonary malignancy with a poor prognosis, representing 0.1–0.4% of all malignant lung tumors. Because of its highly aggressive character and propensity for frequent metastasis, PSC shows low response rates to traditional treatments such as chemotherapy, radiotherapy, and neoadjuvant therapy. In recent years, considerable progress has been made in gene sequencing, targeted therapies, and immunotherapies. One of the most promising treatment approaches is the selection of mono-targeted or multi-targeted drugs according to tumor gene-mutation sites, such as epidermal growth factor receptor or vascular endothelial growth factor receptor 2 ( EGFR/VEGFR2), anaplastic lymphoma kinase ( ALK), and others. Another approach is the activation of therapeutic anti-tumor immunity via pathways including programmed cell-death protein-1/programmed cell-death ligand-1 ( PD-1/PD-L1), which has been used in individual cases. In this review, we will introduce the clinicopathologic features, molecular typing, and traditional treatments. We will also review the biological characteristics and the latest therapies for PSC. These novel therapies show promise in the management of PSC, and the outcomes of investigative trials will hopefully reveal a variety of treatment options for patients with PSC.
Limonoids From Choerospondias axillaris
Authors: Phan Nguyen Huu Toan , Thuan Nguyen Thi Dieu , Hien Nguyen Thi Thu , Huyen Pham Van , Hanh Tran Thi Hong , Vien Le Thi , Hong Quang Tran , Cuong Nguyen Xuan , Nam Nguyen Hoai , Van Kiem Phan , Van Minh Chau
Published: August 2020

Eight limonoids (1-8), including 1 new compound named as axillariol A (1), were isolated from the dichloromethane extract of Choerospondias axillaris branches and leaves using various chromatographic separations. Their structures were confirmed by detailed analysis of the 1-dimensional (1D), 2D nuclear magnetic resonance, and high-resolution electrospray ionization quadrupole time-of-flight mass spectra. In addition, toonaciliatins N (6) and toonaciliatins O (7) showed selective and significant cytotoxicity on the rhabdomyosarcoma human cancer cell line with half-maximal inhibitory concentration values of 9.12 and 7.79 µM, respectively.
Adverse Events Following Minimally Invasive Achilles Tendon Repair
Authors: Idarraga Alexander J. , Bohl Daniel D. , Barnard Eric , Movassaghi Kamran , Hamid Kamran S. , Schiff Adam P.
Published: August 2020

Background

The rate of wound complications following traditional open Achilles tendon repair is reported at 7.6%. The purpose of this study is to characterize the rate of wound and other early complications following a specific minimally invasive Achilles tendon repair technique, and to identify any factors associated with increased risk.

Methods

The postoperative courses of 99 patients who underwent minimally invasive Achilles tendon repair by 2 surgeons at separate academic medical centers were retrospectively reviewed. Mean follow-up was 8.1 months (range 3.0-24.6 months). Repair technique was similar in all cases with the exception that 71 procedures used a longitudinal incision and a tourniquet, while 28 procedures used a transverse incision and no tourniquet (surgeon preference). The rates of complications were compared between patients with differing baseline and procedural characteristics.

Results

Of the 99 patients included in the study, 2 (2.0%) developed wound complications. There was no statistical difference in the rate of wound complications between patients in the longitudinal incision/tourniquet group and patients in the transverse incision/no tourniquet group (2.8% vs 0%; P = 1.000). Four patients (4.0%) developed sural neuropraxia. One patient developed deep venous thrombosis. There were no cases of rerupture. At final follow-up, all 99 patients had intact Thompson tests and well-healed wounds.

Conclusions

The rate of wound complications following minimally invasive Achilles tendon repair is low at 2.0%. Patients should be counseled that although risk for wound complications may be lower with this minimally invasive technique, there are risks for sural neuropraxia and deep suture reaction.

Levels of Evidence:

Level III, Retrospective study
Genetic or Autoimmune: POLG-Related Epilepsy Initially Treated as an Autoimmune Encephalitis, a Case Report
Authors: Shah Suma , Berezoski Abigail , Rahman Shareena , Eckstein Christopher , Luedke Matthew
Published: August 2020

Hospital neurologists participate at the forefront of managing fulminant acute and subacute onset epilepsy, frequently attributed to autoimmune encephalitis (AE). As the recognition of antibody-mediated AE grows, there is a growing number of patients who are treated as antibody-negative AE. While antibody-negative autoimmune processes should be considered in the setting of acute and subacute onset of fulminant epilepsy, other causes must be considered before subjecting patients to long-term immunomodulatory treatments and other potential therapeutic toxicities. We present the case of a previously healthy young man who presented with new-onset refractory seizures treated with escalating doses of anti-epileptic drugs as well as immunosuppression for presumed autoimmune epilepsy. He developed valproic acid induced hepatotoxicity requiring liver transplantation and was later found to have a POLG mutation. We discuss the presentation of POLG mutations as well as the diagnosis of seronegative autoimmune encephalitis. We highlight the need for a broad differential when evaluating new onset refractory seizures in an otherwise healthy person.