bluuebunny/crossref_metadata_2025 huggingface dataset:
Prognostic and Predictive Value of Circulating and Disseminated Tumor Cells in Breast Cancer: A National Cancer Database (NCDB) Analysis
Authors: Bilani Nadeem , Elson Leah , Liang Hong , Elimimian Elizabeth Blessing , Arteta-Bulos Rafael , Nahleh Zeina
Published: December 2020

Importance:

Our understanding of the utility of circulating tumor cells (CTCs) and disseminated tumor cells (DTCs) as clinical biomarkers continues to evolve.

Objective:

This study evaluated (1) clinicopathologic factors associated with the presence of CTCs or DTCs, (2) the prognostic value of CTCs or DTCs by disease stage, 3), the value of these biomarkers in predicting the benefit of chemotherapy.

Design:

This is a retrospective analysis of patients with breast cancer (BC) diagnosed between 2004 and 2016 using the National Cancer Database (NCDB). To evaluate variables associated with the presence of CTCs or DTCs at the univariate level, we used chi-squared and Wilcoxon rank-sum tests. Multivariate logistic regression models were then constructed using significant variables. Consequently, we included CTC or DTC status (i.e. positive or negative) in multivariate, stage-by-stage Cox regression analyses for overall survival (OS). After stratifying by receptor status and staging, we used the Kaplan-Meier method to explore chemotherapy efficacy in CTC- or DTC-positive vs. CTC- or DTC-negative subsets.

Results:

Factors significantly associated with CTCs were race, progesterone receptor status, HER2 status, histology and AJCC N- and M-staging. Factors associated with DTCs were race, HER2 status, histology and AJCC N-staging. CTCs were associated with poor OS in late-stage (III and IV) but not early-stage (0-II) BC. DTCs were not significantly associated with OS in either context. In hormone receptor (HR)-positive disease, chemotherapy was associated with better OS when CTC status was positive, both in early-stage and late-stage disease. In a subset of patients without CTCs, however, chemotherapy conferred no survival benefit. DTC status was not a significant predictor of chemotherapy efficacy in early or late-stage, HR+ disease.

Conclusions:

This study suggests that CTC-status is a significant prognostic factor at later stages of BC; yet it can also help guide management of early-stage disease as it appears predictive for chemotherapy benefit.
Trauma―Focused Treatment for PTSD With Comorbid Psychosis: A Case Report
Authors: Cherestal Stephanie , Herts Kate L.
Published: December 2020

Post-traumatic stress disorder is often a condition left untreated in patients also meeting criteria for psychotic disorders. While many clinicians who treat patients with these co-occurring conditions choose to avoid treatment targeting symptoms of PTSD for fear of de-stabilizing these individuals or exacerbating psychotic symptomatology, little is currently known about how patients respond to treatment for PTSD in the context of ongoing psychotic symptoms. Additionally, research is scarce regarding the clinical profile of individuals who develop psychotic symptoms secondary to a traumatic stressor, in the absence of any premorbid symptomatology. The purpose of this case report is to outline the case of an individual, “Mary” who developed psychotic symptoms secondary to a traumatic stressor in her middle age and to describe her response to treatment targeting her symptoms of PTSD. Mary presented with core symptoms of PTSD that emerged following a traumatic car crash. She developed psychotic symptoms (auditory and visual hallucinations) several weeks later. Mary underwent a treatment course of Prolonged Exposure targeting her symptoms of PTSD, with careful work done to monitor any changes in psychotic symptomatology while engaging in this treatment. Standardized measures such as the Post-traumatic Stress Disorder Checklist-5 (PCL-5) and the Psychotic Symptom Rating Scales were administered to assess Mary’s progress throughout treatment. This case report provides a comprehensive summary of Mary’s 16-week course of Prolonged Exposure therapy, which resulted in a significant reduction in PTSD symptomatology as demonstrated by a 72% decrease in scores on the PCL-5 from the initiation to the conclusion of treatment.
Beyond Liberal Peace in Sri Lanka: Victory, Politics, and State Formation
Authors: Åkebo Malin , Bastian Sunil
Published: December 2020

In 2009, the war between the Sri Lankan government and the Liberation Tigers of Tamil Eelam ended through a military victory for the government. Features of the post-war peace—including persistent militarization, strengthened nationalism, and communal violence—have commonly been attributed to a failed attempt at liberal peacebuilding followed by an authoritarian backlash. In contrast, this study shows how the post-war peace has been shaped by historical processes of state formation aimed at consolidating the Sri Lankan state. The article takes a long-term approach to analysing peace in Sri Lanka through the lens of state formation. The analysis centres on four key aspects: (1) post-war security, (2) state–minority relations, (3) socio-economic aspects, and (4) electoral politics. We conclude that there are currently few signs of any substantial state reform that would accommodate the continuous demand for social justice and minority rights that has spurred violent conflicts in Sri Lanka.
Quantitative EEG During Critical Illness Correlates with Patterns of Long-Term Cognitive Impairment
Authors: Williams Roberson Shawniqua , Azeez Naureen Abdul , Taneja Randip , Pun Brenda T. , Pandharipande Pratik P. , Jackson James C. , Ely E. Wesley
Published: December 2020

Objective

Many intensive care unit (ICU) survivors suffer disabling long-term cognitive impairment (LTCI) after critical illness. We compared EEG characteristics during critical illness with patients’ 1-year neuropsychological outcomes.

Methods

We performed a post hoc analysis of patients in the BRAIN-ICU study who had undergone EEG for clinical purposes during admission (n = 10). All survivors underwent formal cognitive assessments at 12-month follow-up. We evaluated EEGs by conventional visual inspection and computed 10 quantitative features. We explored associations between EEG and patterns of LTCI using Wilcoxon rank-sum tests and Spearman’s rank correlations.

Results

Of 521 Vanderbilt patients enrolled in the parent study, 24 had EEG recordings during admission. Ten survivors had EEG tracings available and completed follow-up cognitive testing. All but one inpatient EEG showed generalized background slowing. All patients demonstrated cognitive impairment in at least one domain at follow-up. The most common deficits occurred in delayed memory (DM—median index 62) and visuospatial/constructional (VC—median index 69) domains. Relative alpha power correlated with VC score (ρ = 0.78, P = .008). Peak interhemispheric coherence correlated negatively with DM (ρ = −0.81, P = .018).

Conclusions

Quantitative EEG features during critical illness correlated with domain-specific cognitive performance in our small cohort of ICU survivors. Further study in larger prospective cohorts is required to determine whether these relationships hold.

Significance

EEG may serve as a prognostic biomarker predicting patterns of long-term cognitive impairment.
Uniportal VATS Lobectomy and Decortication: Not an Everyday Occurrence
Authors: Newman Joshua S. , Renzi Alexandra S. , Glassman Lawrence , Lee Paul C. , Jurado Julissa , Hyman Kevin , Zeltsman David
Published: December 2020

Management of trapped lung with an underlying lung lesion and hydropneumothorax remains controversial. Furthermore, Aspergillus empyema and aspergilloma are rare pathologies for which uniportal video-assisted thoracoscopic (VATS) surgical management remains controversial. We present a young patient referred to our service after recent hospitalization for pneumonia. The patient was found to have a chronic effusion with a right lower lobe cystic parenchymal lesion and was taken to the operating room. The patient underwent right uniportal VATS surgery with evacuation of empyema, total pulmonary decortication, and right lower lobectomy. His postoperative course was unremarkable, and he was discharged home. Postoperative workup demonstrated lymphocyte variant hypereosinophilia. He continues to follow with thoracic surgery at the time of this report and remains asymptomatic. We conclude that uniportal VATS is a most minimally invasive, safe, and efficient approach for management of complex intrathoracic pathology including total pulmonary decortication and lobectomy.
Acute Systemic Response Of BDNF, Lactate and Cortisol to Strenuous Exercise Modalities in Healthy Untrained Women
Authors: García-Suárez Patricia C. , Rentería Iván , Moncada-Jiménez José , Fry Andrew C. , Jiménez-Maldonado Alberto
Published: December 2020

Acute bouts of intense exercise increase lactate concentration, which in turn stimulates brain-derived neurotrophic factor (BDNF) production. Cortisol released during intense exercise might inhibit BDNF synthesis. This study examined the acute effects of 2 protocols of strenuous exercise on serum BDNF. Seventeen physically-active healthy females (Age = 20.0 ± 0.9 yr., BMI = 23.0 ± 2.6 kg/m2) performed a strenuous cycle-ergometer graded exercise test (GXT) and a high-intensity interval training session (HIIT). Serum BDNF, serum cortisol, cortisol: BDNF ratio and blood lactate (BLa) were recorded at baseline and immediately following exercise. Although non-statistically significant, the HIIT session elicited a higher magnitude of change from baseline for BDNF ( d = 0.17) and cortisol ( d = 1.18) than after the GXT ( d = -0.26, and d = 0.82, respectively). An interaction was found between GXT and HIIT trials and measurements on BLa levels, with higher post-exertion values after HIIT than after GXT (p < 0.0001, η2 = 0.650, 95%CI = 2.2, 5.2). The higher BLa levels did not raise circulating BDNF. The elevated cortisol levels may have overcome the effects of lactate on BDNF. However, the higher BLa induced by HIIT suggest that interval exercise modality on the long-term could be a feasible intervention to increase circulating peripheral BDNF, at least in untrained healthy women.
Eat to Beat Stress
Authors: Naidoo Uma
Published: December 2020

There is a tendency to accept anxiety as an inevitable part of living in a stressful modern world. However, simple dietary changes can help attenuate the stress response. While there are several approaches to treating anxiety, research by Peter Roy-Byrne in 2015 has shown that only 50% to 60% of people respond to medication and psychotherapy, and only a quarter of patients have complete resolution of their symptoms. According to statistics from the National Institute of Mental health, prior to the COVID-19 pandemic, anxiety disorders were the most common mental health disorder in the United States, about 3 times more common than depression (18.1% vs 6.7%). A recent Express Scripts survey showed the percent increase in the number of new prescriptions for antianxiety medications by the middle March 2020 for antianxiety medications was 37.7%, underscoring the likely rise in anxiety associated with the pandemic. While traditional medications and therapies are well needed, to beat stress during times of a pandemic, it is important to think more broadly about how we can best affect our mental well-being. One of those ways is through our nutrition and dietary habits, and research by Opie et al in 2015 demonstrates that our dietary choices are more crucial than ever. This column reviews foods and substances that are important to consider in managing anxiety.
Interpreting Health Events in Big Data Using Qualitative Traditions
Authors: Fritz Roschelle L. , Dermody Gordana
Published: December 2020

The training of artificial intelligence requires integrating real-world context and mathematical computations. To achieve efficacious smart health artificial intelligence, contextual clinical knowledge serving as ground truth is required. Qualitative methods are well-suited to lend consistent and valid ground truth. In this methods article, we illustrate the use of qualitative descriptive methods for providing ground truth when training an intelligent agent to detect Restless Leg Syndrome. We show how one interdisciplinary, inter-methodological research team used both sensor-based data and the participant’s description of their experience with an episode of Restless Leg Syndrome for training the intelligent agent. We make the case for clinicians with qualitative research expertise to be included at the design table to ensure optimal efficacy of smart health artificial intelligence and a positive end-user experience.
Ricochet of steel spheres on sand with varying water content
Authors: Kim Yoon Keon , Choi Woo Chun
Published: December 2020

The explosion of a building generates plenty of debris that flies far away. The flying debris is hazardous because it contains large amounts of kinetic energy. Therefore, determining the safety distance from the debris is essential. However, debris ricochet that collides onto the ground affects the safety distance because the ricochet phenomenon is influenced by the condition of the medium. In this study, experiments and finite element analysis were performed to investigate the ricochet based on the water content of sand. From a direct shear test, the internal friction angle and cohesion of sand were obtained based on the water content. The effects of internal friction angle and adhesion on the yield stress and ricochet were investigated. The results indicated that as the water content increased, the internal friction angle increased and then decreased, and the cohesion continued to decrease. The yield stress was proportional to the internal friction angle and inversely proportional to adhesion. Therefore, lower yield stress resulted in deeper penetration of debris, leading to higher energy loss, which increased the kinetic energy loss factor. Thus, the condition of the medium should be considered for setting a proper safety distance suitable for the surrounding environment of the building.
Optimal predictive steering control for autonomous runway exits
Authors: Huang Zexin , Best Matthew , Knowles James
Published: December 2020

In this paper, we present a real-time optimal controller, Predictive Steering Control (PSC), to perform high-speed runway exit manoeuvres. PSC is developed based on a time-varying LQR with look-ahead. The aircraft’s ground dynamics are described by a high-fidelity nonlinear model. The proposed controller is compared with an Expert Pilot Model (EPM), which represents a pilot, in several different speed runway exit manoeuvres. With an improved road preview mechanism and optimal feedback gain, the predictive steering controller outperforms the expert pilot’s manual operations by executing the runway exit manoeuvre with a lower track error. To investigate the optimality of PSC, its solution is further optimised using a numerical optimal controller Generalized Optimal Control (GOC). PSC is shown to be close to the final optimal solution. To study robustness, PSC is tested with various aircraft configurations, road conditions and disturbances. The simulation results show that PSC is robust to disturbances within a normal range of operational parameters.
Short-term outcomes of inner branches for endovascular repair of complex abdominal and thoracoabdominal aortic aneurysms
Authors: Silverberg Daniel , Bar-Dayan Avner , Hater Haitam , Khaitovich Boris , Halak Moshe
Published: December 2020

Objectives

To report our early experience using endografts with inner branches for the treatment of complex abdominal aortic aneurysms and thoracoabdominal aortic aneurysms (TAAAs).

Methods

A retrospective analysis of all patients treated in our institution for complex abdominal aortic aneurysms and TAAAs with custom-made stent grafts consisting of one or more inner branches. Data collected included patients demographics, aortic aneurysm morphology, stent grafts features, perioperative morbidity and mortality and short-term reintervention and mortality rates.

Results

Twenty-seven patients (18 males, mean age 70 ± 7.1) were included. Indications for surgery included TAAAs (12, 41%) juxtarenal abdominal aortic aneurysms (10, 37%), type 1A endoleaks (4, 15%) and paraanastamotic aneurysms (1, 4%). A total of 90 inner branches were used. Twenty-one (78%) of the stent grafts consisted only of inner branches and six (22%) had a combination of inner branches with either fenestrations or outer branches. Technical success was achieved in 26/27 (96%) of the patients. There was one perioperative mortality. Six patients suffered from major perioperative adverse events. Mean follow-up was seven months (range 1–23). During the follow-up period, four patients (15%) required reinterventions. Branch-related reinterventions were performed in two (7%) patients. No occlusions of inner branches occurred during the follow-up.

Conclusions

Inner branches in branched endovascular aneurysm repairs offer a feasible option for the treatment of complex abdominal aortic aneurysms and TAAAs. The procedures can be completed with high technical success and with acceptable short-term branch-related reintervention rates. Further follow-up is required to determine the long-term durability of this technology.
The role of deputy principals: Perspectives of South African primary school principals and their deputies
Authors: Jansen Christa , du Plessis André
Published: December 2020

Education leadership literature indicates that relatively little attention has been given to the specific duties and responsibilities of South African deputy principals in comparison with other leadership and management positions in schools. As a result, their roles and responsibilities remain vague. The purpose of this study was, therefore, to explore the roles of deputy principals in selected well-resourced fee-paying primary schools. Semi-structured interviews were conducted with the principal and two deputy principals of each of the five participating schools. The participating schools were selected for having a reputation of being high-performing schools and being most likely to provide rich data. The findings suggest that the sub-context of a school is an important factor influencing the role of a deputy principal. In addition, principals play a key role in determining the job description of individual deputy principals. This is often accompanied by purposeful leadership distribution and a reconfiguration of conventional management structures. In addition, deputy principals were generally viewed as ‘principals-in-training’ and their relationship with their principals characterised by shared leadership practices.
Encoding and referent event influence on retrospective memory
Authors: O’Rear Andrea E , Radvansky Gabriel A
Published: December 2020

Previous work from our lab has shown that event structure can influence memory performance. Our work in prospective memory has shown that, consistent with an event model view, performance is better when multiple encoding events refer to a common retrieval event. The aim of this study was to assess the generality of this influence of event model structure on memory by using two retrospective memory tasks. This was done using lists of sentences (Experiment 1) and narrative texts (Experiment 2). The results of these retrospective memory tasks replicated that of the prospective memory task and are most consistent with an event cognition account. These results also suggest that encoding and referent event structures may affect some levels of representation (e.g., the surface form) more than others (e.g., the textbase and event model). Overall, we demonstrate that event structure has principled influences on memory apart from the nature of the materials or the task. Moreover, we discuss how these findings are inconsistent with more traditional theories of memory processing, such as associative interference and spreading activation accounts.
Malandragem and Ginga: Socio-cultural constraints on the development of expertise and skills in Brazilian football
Authors: Uehara Luiz , Button Chris , Saunders John , Araújo Duarte , Falcous Mark , Davids Keith
Published: December 2020

In an ecological dynamics rationale, the development of expertise in sports is shaped by interactions of personal, task and environmental constraints. A notable outcome of this process is the distinctive performance styles of athletes shaped by socio-cultural-historical constraints. To understand this process, we examined the role of socio-cultural constraints shaping the development of skill in Brazilian football players at the macrosystem level. A range of data sources were inductively generated and analysed through the qualitative interpretative paradigm, including historical contextual analysis, participant observation, and unstructured interviews. Malandragem (i.e., cunning) emerged as a major focus and our findings suggested that behavioural characteristics, such as mischief and deception, are common attributes valued by many elite Brazilian footballers. Our analysis suggests how the value system of Malandragem is a product of the socio-cultural constraints primarily influenced by the Mulattos’ cultural traditions, historically interacting with particular socio-economic conditions. In Brazil, Malandragem can manifest itself through the Ginga (i.e., body sway) playing style in which footballers move deceptively to gain competitive advantages over opponents. Whilst the theatrical antics of contemporary Malandros (i.e., tricksters and/or streetwise persons), such as Neymar Junior, are frowned upon by many football critics, we argue that some aspects of being Malandro may be contributing to the development of a high level of perceptual-motor and cognitive functioning that has underpinned the Ginga playing style in Brazilian football for many decades.
A failure prediction model for corrosion in gas transmission pipelines
Authors: Zakikhani Kimiya , Nasiri Fuzhan , Zayed Tarek
Published: December 2020

Transmission pipelines comprise a major part of a gas network, conveying natural gas within jurisdictions, and across international boundaries. In the United States, more than 10,000 failure incidents have been reported in gas transmission pipelines in a 20-year period from 1996 to 2016 leading to a cumulative property damage of more than $748 million. Among different failure sources, corrosion is ranked as the most frequent one, corresponding to approximately a quarter of total failures. Though in-line inspection is counted as the most frequently applied corrosion monitoring technique for oil and gas pipelines, it imposes considerable costs due to the necessity of implementing frequent inspections using smart devices. For this reason, several failure prediction models have been developed to estimate the corrosion failure. However, the majorities of these prediction models rely solely on experimental tests or limited historical records which undermine the extent of their applicability and ignore pipeline environmental and geographical circumstances. The objective of this research is to develop failure prediction models for external corrosion in underground gas transmission pipelines by considering both conventional and environmental/geographical variables. For this objective, multiple regression analysis was performed on the accessible historical data reported for gas transmission pipelines. Two main climate regions of Great Plains and South East in the US were selected, and their corresponding failure prediction models were developed. Such development was based on a step by step procedure analyzing different scenarios. Considering diagnostic measures, null hypothesis and residual analysis, scenario 3 was selected as satisfactory. The validation tests of the developed models present a root mean square error (RMSE) of 0.04 and 0.07 and R-Sq of 0.93 and 0.75, respectively. The results of this research can be applied in maintenance planning of gas transmission pipeline to estimate the critical time in which a pipeline may encounter external corrosion failure, and to accordingly schedule the maintenance activities.
White Women, White Men, and Intra-Racial Diversity: A Data-Led Analysis of Gender Representation in the UK Film Industry
Authors: Nwonka Clive James
Published: December 2020

This article addresses the role of data in measuring diversity in the UK film industry and its mediation of underrepresented identities excluded from the sector. Through a data-led analysis of gender representation across 235 British films made from 2016, this study assesses the impact and success of the interventions made by the BFI Diversity Standards within the film industry, analysing the response data collected by the BFI for film productions that have adhered to the standards as a condition for production support. What empirical evidence do the Diversity Standards’ data offer for a link between gender representation and key roles, genres, and regional locations? The article then identifies some of the key drivers influencing the primacy of particular identities across the standards. I want to argue that gender-positive diversity, whilst representing a slender challenge to exclusion via the structural decrees of the BFI policy, can also be understood as the result of intra-race homophily, one that sustains a culture of whiteness and racial exclusion. The article concludes by considering the position of senior white men as the structuring agents upon whom rest the power to permit women entry, and the implications of both an absence of intersectional data and the rigid identity categories of the standards for the inclusion of BAME women in the film industry workforce.
Comparison of time taken to obtain an arterial blood gas result at the bedside using the ProximaTM point of care machine vs. a standard remote arterial blood gas analyser: A randomized controlled trial
Authors: Mitchell Kay , Salmon Karen E , Egbosimba David , Troughton Gavin , Grocott Mike PW
Published: December 2020

Introduction

The ProximaTM point of care (POC) device enables arterial blood gas (ABG) samples to be analysed without the nurse leaving the patient. The benefits of this for work efficiency have not been evaluated.

Methods

We compared the time taken to obtain an ABG result using ProximaTM versus a standard ABG sampling system. Twenty patients were randomized to ABG sampling using ProximaTM, or a standard ABG system. Nurses were observed performing all ABG sampling episodes for a minimum of 24 hours and no more than 72 hours.

Results

The mean time taken to obtain a result using ProximaTM was 4:56 (SD = 1:40) minutes compared to 6:31 (SD = 1:53) minutes for the standard ABG technique (p < 0.001). Mean time away from the patient's bedside was 3.07 (SD = 1:17) minutes using the standard system and 0 minutes using ProximaTM (p < 0.001).

Conclusions

Reduced time for blood gas sampling and avoidance of time away from patients may have significant patient safety and resource management implications, but the clinical and financial significance were not evaluated.
Factors affecting return to work after surgical treatment of trapeziometacarpal joint osteoarthritis
Authors: van der Oest Mark J. W. , Teunissen Joris S. , Poelstra Ralph , Feitz Reinier , Burdorf Alex , Selles Ruud W ,   the Hand-Wrist Study Group
Published: December 2020

This study aimed to identify factors contributing to the timing of return to work after surgical treatment of trapeziometacarpal joint osteoarthritis and to calculate the costs of lost productivity. We included 627 patients with paid employment who underwent trapeziectomy and ligament reconstruction with tendon interposition. Time to return to work was measured through filling online questionnaires and analysed using survival analysis at 6 weeks and 3, 6 and 12 months after the surgery. Patients also filled in the Michigan Hand Outcomes Questionnaire. Costs of lost productivity were calculated using the human capital method. After 1 year, 78% of the patients returned to work. The median time to return to work was 12 weeks. Factors that significantly affected the time to return to work were occupational intensity (light, moderate or heavy physical labour), whether the dominant hand was treated and the Michigan Hand Outcomes Questionnaire work score and hand function score of the unoperated side at baseline. The costs of lost productivity were estimated at €11,000 on the patient level, resulting in €16.8 million on the Dutch population level per year.

Level of evidence: II
Indoor-related microbe damage induces complement system activation in building users
Authors: Atosuo Janne , Karhuvaara Outi , Suominen Eetu , Vilén Liisa , Nuutila Jari , Putus Tuula
Published: December 2020

In this comparative study, serum complement system antimicrobial activity was measured from 159 serum samples, taken from individuals from microbe-damaged (70 samples) and from reference buildings (89 samples). Antimicrobial activity was assessed using a probe-based bacterial Escherichia coli-lux bioluminescence system and comparison was made at a group level between the experimental and reference group. The complement activity was higher in users of microbe-damaged buildings compared with the reference group and the significant ( P < 0.001) increase in activity was found in the classical reaction pathway. This study strengthens our notion that exposure to indoor-related microbe damage increases the risk for systemic subclinical inflammation and creates a health risk for building users.
Finite element validation of 3D American football faceguard structural stiffness models
Authors: Ferriell William Davis , Batt Gregory S , DesJardins John D
Published: December 2020

Despite continued efforts to improve American football headgear technology, minimal structural changes have been made to faceguard design in the past 20 years. Although each new helmet system has its own compatible faceguard series, the primary design components have changed little between helmet systems. Additionally, little is known about specific parameters that influence faceguard performance, largely due to the variation inherent in laboratory impact testing. The goal of this study was two-fold: to validate a reverse engineering method for developing a library of faceguard models; and to validate the finite element simulation of three common American football faceguards subject to a quasi-static structural stiffness test. Three common Riddell® Speedflex™ (Des Plaines, IL) faceguard styles were modeled using a novel reverse engineering approach. Within ANSYS® Mechanical™ (ANSYS, Inc., Canonsburg, PA), the faceguards were modeled as stainless steel (elastic modulus = 193 GPa, Poisson’s ratio = 0.31). A displacement of 5 mm was prescribed in the posterior (z) direction. Boundary conditions were applied to accommodate the coronal plane (x, y) translation at clip attachment locations. The computational results correlated to the experimental results with statistical significance ( p value = 0.001). The Nose location was the most reliable with an average percent difference from experimental results of 2.7%, compared to 10.8% and 9.9% at the Mouth and Chin locations, respectively. Many studies utilizing computational models of protective headgear lack reported validation of headgear components. This study has validated the structural stiffness of three common faceguards to be used in future computational analyses. Furthermore, advancements in additive manufacturing technologies have opened the door to increasingly complex faceguard design capabilities; however, little is known about specific parameters that influence faceguard performance. With the models validated in this study, parameterized faceguard models should be used to iterate between design variables and assess the contribution of each variable on faceguard structural stiffness.
A systematic review of the association between fibromyalgia and functional gastrointestinal disorders
Authors: Erdrich Sharon , Hawrelak Jason A. , Myers Stephen P. , Harnett Joanna E.
Published: December 2020

Background:

Fibromyalgia and functional gastrointestinal disorders (FGID) including irritable bowel syndrome (IBS) are common conditions presenting in clinical settings and are more prevalent in women. While the relationship between IBS and fibromyalgia has been demonstrated, a review of the prevalence of the broader group of FGID in adults with fibromyalgia has not been undertaken. The aim of this review was to systematically review the published literature, identifying the comorbidity of FGID in people with fibromyalgia, and to discuss the clinical implications, limitations of current research and areas of interest for future research

Methods:

Medline, Embase, CINAHL and Web of Science were searched during June 2019. Results were screened for original research articles meeting established criteria for identification of FGID in adults diagnosed with fibromyalgia.

Results:

A total of 14 studies involving 1340 adults with fibromyalgia, 363 healthy controls and 441 adults with other pathologies were included in this review. Only 1 of the 14 studies included surveyed the full range of FGID . Functional gut disorders were matched to Rome II criteria for reporting and comparison. In addition to increased abdominal pain and functional bloating or gas, IBS of mixed-pattern and constipation-types appear to be more prevalent than diarrhoea-predominant IBS in adults with fibromyalgia.

Conclusion:

This review confirms previous reports that IBS is common in people living with fibromyalgia and suggests that IBS-mixed and constipation types predominate. An association with a range of FGID other than IBS is suggested, but data are limited. Research exploring the association between fibromyalgia and functional gastrointestinal dysfunction beyond IBS are warranted.
Clinical features and surgical outcomes of major urological interventions during cytoreductive surgery and hyperthermic intraperitoneal chemotheraphy
Authors: Düzgün Özgül , Kalın Murat , Sobay Resul , Özkan Ömer Faruk
Published: December 2020

Background:

Urinary system resections and reconstructions are needed in peritoneal carcinomatosis due to abdominal malignancies. The effect of hyperthermic intraperitoneal chemotherapy on these urological procedures after reconstruction remains uncertain. The aim of the study is to evaluate major urological interventions during cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in complex abdominal malignancies with peritoneal carcinomatosis.

Methods:

Forty-four cases underwent surgical intervention related to the urinary system among 208 cases who underwent cytoreductive surgery and hyperthermic intraperitoneal chemotherapy because of peritoneal carcinomatosis. Urinary system procedures performed in these patients (radical-partial cystectomy, partial ureter resection ureteroneocystostomy, ureteroureterostomy, nephrectomy) were evaluated in terms of postoperative morbidity–mortality and survival.

Results:

Urinary system resections were performed during cytoreductive surgery in a total of 44 cases. The mean age was 54 years (20–73). Patients were diagnosed with peritoneal carcinomatosis due to colorectal cancer in 21 (47.8%), ovarian cancer in nine (20.4%), sarcomatosis in five (11.4%), cervical cancer in four (9%) and other cancers (mesothelioma, uterus, breast, gastric) in five (11.4%) cases. Total nephrectomy was performed in three cases and partial nephrectomy in one case. Cystectomy was performed in 21 cases; 16 of these were partial and five were total cystectomies. Ureteroureterocystostomy with double J was performed in four cases and ureteroneocystostomy in 12 cases. While Clavian–Dindo grade 3–4 complications were seen in nine cases (20.4%), three cases (6.8%) became exitus during the first 30-day follow-up.

Conclusions:

Although urinary system involvements have been regarded as inoperable in the past, we think that with adequate experience radical urinary interventions performed in suitable patients can be carried out with acceptable morbidity and mortality as seen in our series.
Re-appraising the potential of naringin for natural, novel orthopedic biotherapies
Authors: Yu Kristin E. , Alder Kareme D. , Morris Montana T. , Munger Alana M. , Lee Inkyu , Cahill Sean V. , Kwon Hyuk-Kwon , Back JungHo , Lee Francis Y.
Published: December 2020

Naringin is a naturally occurring flavonoid found in plants of the Citrus genus that has historically been used in traditional Chinese medical regimens for the treatment of osteoporosis. Naringin modulates signaling through numerous molecular pathways critical to musculoskeletal development, cellular differentiation, and inflammation. Administration of naringin increases in vitro expression of bone morphogenetic proteins (BMPs) and activation of the Wnt/β-catenin and extracellular signal-related kinase (Erk) pathways, thereby promoting osteoblastic proliferation and differentiation from stem cell precursors for bone formation. Naringin also inhibits osteoclastogenesis by both modifying RANK/RANKL interactions and inducing apoptosis in osteoclasts in vitro. In addition, naringin acts on the estrogen receptor in bone to mimic the native bone-preserving effects of estrogen, with few systemic side effects on other estrogen-sensitive tissues. The efficacy of naringin therapy in reducing the osteolysis characteristic of common musculoskeletal pathologies such as osteoporosis, degenerative joint disease, and osteomyelitis, as well as inflammatory conditions affecting bone such as diabetes mellitus, has been extensively demonstrated in vitro and in animal models. Naringin thus represents a naturally abundant, cost-efficient agent whose potential for use in novel musculoskeletal biotherapies warrants re-visiting and further exploration through human studies. Here, we review the cellular mechanisms of action that have been elucidated regarding the action of naringin on bone resident cells and the bone microenvironment, in vivo evidence of naringin’s osteostimulative and chondroprotective properties in the setting of osteolytic bone disease, and current limitations in the development of naringin-containing translational therapies for common musculoskeletal conditions.
Time to use to European power again
Authors: Walshe Garvan
Published: December 2020

The decline of Russia and rise of China have shifted the security focus of the US towards China, leaving a security vacuum in Europe’s neighbourhood that the EU has so far been unwilling to fill. The vacuum has been exploited by hostile external powers, and nationalist anti-Europeans within, threatening the survival of the EU itself. A stronger European security role, anchored in a unified strategic culture, could turn the EU into a producer of regional security, and provide a new conservative narrative for European integration. While this will eventually need a treaty change, the centre–right should not wait until then to relegitimise the use of European power in Europe’s own neighbourhood.
Network Pharmacology Integrated Molecular Docking Reveals the Anti-COVID-19 Mechanism of Xingnaojing Injection
Authors: Yu Bing , Ke Xin-Ge , Yuan Chong , Chen Peng-Yu , Zhang Ying , Lin Ning , Yang Yan-Fang , Wu He-Zhen
Published: December 2020

In the process of fighting against COVID-19 in China, Xingnaojing injection has been recommended for its clinical treatment, but the information about its active components and mechanism is still lacking. Therefore, in this work, using network pharmacology and molecular docking, we studied the active components of Xingnaojing injection having anti-COVID-19 properties. Using the DL parameter, TCMSP and CNKI databases were used to screen the active components of the Xingnaojing injection. Then, the SwissTargetPrediction webserver was used to collect the corresponding gene targets, and the gene targets related to COVID-19 were searched in the Genecards database. The DAVID database was used to enrich the function of gene targets, and the KOBAS3.0 database for the annotation of related KEGG pathways. The “components–targets–pathways” network of Xingnaojing injection was constructed with Cytoscape 3.6.1 software. The protein–protein interaction networks were analyzed using the String database. Specific proteins, SARS-COV-2 3 Cl, ACE2, and the active components were imported into Discovery Studio 2016 Client for molecular docking studies. From the Xingnaojing injection, a total of 58 active components, including Divanillalaceton and Q27139023, were screened. These were linked to 53 gene targets including mitogen-activated protein kinase 1 (MAPK1), tumor necrosis factorTNF, epidermal growth factor receptor, MAPK3, and 196 signaling pathways related to COVID-19, such as apoptosis, C-type lectin receptor signaling pathway, and hypoxia-inducible factor 1 signaling pathway. Furthermore, molecular docking studies were performed to study potential binding between the key targets and selected active components. Xingnaojing injection exhibits anti-COVID-19 effects via multiple components, multiple targets, and multiple pathways. These results set a scientific basis for further elucidation of the anti-COVID-19 mechanism of Xingnaojing injection.
Patient Perceptions of Landscape and Abstract Art in Inpatient Cardiac Units: A Cross-Sectional Survey
Authors: Finkel Jennifer , Printz Bellamy , Gallagher Lisa M. , Au Adrian , Shibuya Kelly , Bethoux Francois
Published: December 2020

Purpose:

The purpose of this exploratory study was to capture the influence of artwork in the hospital corridors within cardiothoracic inpatients.

Background:

This study builds on previous research to determine the preferred types of artwork (landscape vs. abstract) in the hospital setting as well as the influence of the art itself.

Methods:

Participants engaged in surveys with predefined single-choice responses and semistructured one-on-one interviews.

Results:

Data were obtained from 45 participants, 15 from each of the units (Landscape, Abstract, or Mixed). A higher percentage of participants reported a positive impact on the Landscape Unit; however, the positive responses on the Abstract and Mixed Units were also notable. Eighty-two percent of responses from patients on the Abstract Unit were positive, as were 82% from the Landscape Unit and the Mixed Unit.

Conclusions:

Although landscape was preferred, abstract and mixed art also had positive responses and abstract did not have a negative effect. All genres of art have a place in a hospital; however, strategies should be developed that include more education, engagement, and interpretation of the artwork.
Seed Rain in a Tropical Dry Forest and Adjacent Home Gardens in the Yucatan
Authors: Villicaña-Hernández G. Jashui , Martínez-Natarén Daniela A. , Alvarez-Espino Ricardo X. , Munguía-Rosas Miguel A.
Published: December 2020

Tropical home gardens are widely recognized as reservoirs of biodiversity. Typically, Maya home gardens have an area of intensive management and one of extensive management. In the latter, some wild plant species may find safe sites for establishment, since they exhibit a high degree of similarity (in terms in plant species composition) to the surrounding forest and are dominated by plants with fleshy fruit. Therefore, this may attract frugivorous animals, which in turn may generate some seed rain. The objective of our study was to compare seed rain in the extensively managed areas of home gardens and in the surrounding forest during the fruiting peak in a rural landscape in the Yucatan. We assessed seed rain using seed traps in two habitats: the extensively managed areas of home gardens and an adjacent tropical forest. Seed rain was more abundant, denser and more diverse in the home gardens than in the adjacent forest. Approximately one quarter of the seeds recorded are from species shared between the forest and home gardens, suggesting there is notable seed exchange between these habitats. Also 50% of the seed species exclusively found in home gardens are allochthonous, likely rare species from the forest. In general, our results suggest that home gardens—particularly their extensively managed areas—are effective seed traps for forest species.
What is Feminism in Troubling Times? To Stay Standing Together
Authors: Mendus Alys , Kirkpatrick Davina , Murray Fiona
Published: December 2020

This performative piece, an enactment of lived feminism, acknowledges the privileges and explores the similarities and differences between three cis-gendered white women in different parts of the United Kingdom and how these aid and hinder collaboratively writing together. The piece was shared at the Autoethnography Special Interest Group at International Congress of Qualitative Inquiry (ICQI) in 2018. We had never written together before but had presented on the same Shame? panel at ICQI in 2017 convened by Alys Mendus that also included papers by Stacy Holman Jones and Anne Harris and a memorial to Sue Porter. There were similarities in terms of themes explored including sexuality and taboo. This was our starting point but it was not easy. We realized that difficulty within collaborative inquiry is rarely written about and published but is often the topic of conversation between academics. Perhaps feminism is our ability to stand together curious and alive to our nonshared experience with a commitment to not creating a shared perspective? To stay standing together, we could be stronger in these troubling times.
Prospection: Methodological Complexities of Imagining Academia
Authors: Pilotti Maura A. E. , El Alaoui Khadija , Salameh Muamar Hasan
Published: December 2020

Simulations can be considered a particular act of thinking that entails imagining oneself in a hypothetical scenario (as either the doer or the observer) to explore potential outcomes. Imagining the structure and functioning of institutions of higher education in the future is a complex task that may involve a blend of known and estimated facts along with desired outcomes. In the present paper, we discuss the merits of mental simulation along with a straightforward paradigm that may be useful in the study of prospection applied to this specific task. It is based on the assumption that prospection is a natural outcome of an intelligent cognitive system, which envisions the future to both anticipate and shape forthcoming events. We then discuss the benefits of prospection when the object to imagine is the university.