bluuebunny/crossref_metadata_2025 huggingface dataset:
Is a virtual clinic model a safe and effective way for assessing patients referred with suspiciously blurred optic discs? The blurred disc clinic
Authors: Jefferis Joanna M , Griffith Nigel , Blackwell Daniel , Batty Ruth , Hickman Simon J , Pepper Irene M
Published: November 2020

Background:

There are increasing numbers of referrals to ophthalmology departments due to blurred optic disc margins. In light of this and the COVID-19 pandemic we aimed to assess whether these patients could be safely assessed without direct contact between the clinician and patient.

Methods:

We retrospectively reviewed the records of consecutive patients seen in our ‘blurred disc clinic’ between August 2018 and October 2019. We then presented anonymous information from their referral letter, their visual fields and optic nerve images to two consultant neuro-ophthalmologists blinded to the outcome of the face-to-face consultation. In the simulated virtual clinic, the two consultants were asked to choose an outcome for each patient from discharge, investigate or bring in for a face-to-face assessment.

Results:

Out of 133 patients seen in the blurred disc clinic, six (4.5%) were found to have papilloedema. All six were identified by both neuro-ophthalmologists as needing a face-to-face clinic consultation from the simulated virtual clinic. One hundred and twenty (90%) patients were discharged from the face-to-face clinic at the first consultation. The two neuro-ophthalmologists chose to discharge 114 (95%) and 99 (83%) of these respectively from the simulated virtual clinic. The virtual clinic would have potentially missed serious pathology in only one patient who had normal optic discs but reported diplopia at the previous face-to-face consultation.

Conclusions:

A virtual clinic model is an effective way of screening for papilloedema in patients referred to the eye clinic with suspicious optic discs. Unrelated or incidental pathology may be missed in a virtual clinic.
How does the commissioning process hinder the uptake of complexity-appropriate evaluation?
Authors: Cox Jayne , Barbrook-Johnson Pete
Published: November 2020

This paper investigates the role of evaluation commissioning in hindering the take-up of complexity-appropriate evaluation methods, using findings from interviews with 19 UK evaluation commissioners and contractors. We find, against a backdrop of a need to ‘do more with less’ and frustration with some traditional approaches, the commissioning process is perceived to hinder adoption of complexity-appropriate methods because of its inherent lack of time and flexibility, and assessment processes which struggle to compare methods fairly. Participants suggested a range of ways forward, including more scoping and dialogue in commissioning processes, more accommodation of uncertainty, fostering of demand from policy users, more robust business cases, and more radical overhauls of the commissioning process. Findings also emphasised the need to understand how the commissioning process interacts with the wider policy making environment and evidence culture, and how this manifests itself in different attitudes to risk in commissioning from different actors.
Social cognition in first episode adolescent depression and its correlation with clinical features and quality of life
Authors: Tekin Uğur , Erermiş Hatice Serpil , Satar Ayşegül , Aydın Ayşe Nur , Köse Sezen , Bildik Tezan
Published: November 2020

Research has suggested that patients with depression have deficits in social cognition, however they provide limited data regarding adolescent depression. Moreover, the relationship of social cognition with clinical features and quality of life is less studied. This study investigated social cognition in depressive adolescents and the correlations of social cognition with clinical features and quality of life. Thirty-five depressed adolescents and 37 healthy controls were assessed. Emotion perception and decoding ToM, quality of life and clinical variables were evaluated. No significant differences were found between depression and control groups regarding social cognitive tests. The results indicated that examined clinical features were not correlated significantly with social cognitive tests. Results suggest that social cognitive abilities are not disturbed in adolescents with first depressive episode.
The effects of three different storytelling approaches on the vocabulary acquisition and response patterns of young EFL students
Authors: Gao Ya-Ling , Wang Fei-Yu , Lee Sy-Ying
Published: November 2020

Storytelling is a well-established literary practice in language classrooms. However, approaches influencing its effectiveness and efficiency have rarely been investigated. This study compared the effects of three storytelling approaches on the vocabulary acquisition and response patterns of third-grade students of English as a foreign language (EFL). The storytelling approaches we considered are commonly used in schools, including storytelling alone (S), storytelling with word focus (S+W), and storytelling with activities (S+A). Our research comprised a three-week pilot study and a nine-week main study. For both studies, a pretest–posttest design involving a delayed test was used. Video recordings were also captured to facilitate the categorization of in-class response patterns. Results indicated that storytelling alone achieved the best performance. Vocabulary improvement with word focus or follow-up activities faded over the long term. The groups (S and S+W) which heard more stories generated more responses based on their own knowledge and life experience (as opposed to simply recalling facts) than did the group which completed more supplementary activities (S+A). This article provides both pedagogical implications and invitations for future empirical research.
Difference in default mode network subsystems in autism across childhood and adolescence
Authors: Bathelt Joe , Geurts Hilde M
Published: November 2020

Differences in the default mode network are among the most replicated brain-level findings in autistic individuals. Furthermore, subregions within the default mode network are associated with cognitive functions such as mentalising that are immediately relevant to cognitive theories of autism. Recent evidence suggests that the default mode network comprises partially independent subsystems that are tied to dissociable cognitive processes, specifically a medial temporal lobe subsystem involved in memory retrieval, a dorsal medial prefrontal cortex subsystem involved in social processing and a posterior cingulate cortex – anterior medial prefrontal cortex system that ties the other subsystems together. This modular organisation is thought to arise in childhood development. The current analysis investigated differences in default mode network subsystems in 193 autistic boys and young men (5–18 years) and in a group of 208 age-matched boys and young men without a diagnosis using resting-state functional magnetic resonance imaging from the data repository of the Autism Brain Imaging Data Exchange. The results indicated a developmental trend towards greater modularisation of the default mode network across childhood and adolescence in autism, mostly driven by reduced between-subnetwork connection strength. In contrast, default mode network subnetwork organisation was relatively stable in the comparison group. We suggest that these differences reflect delayed maturation of the default mode network in autism.

Lay abstract

Neuroimaging research has identified a network of brain regions that are more active when we daydream compared to when we are engaged in a task. This network has been named the default mode network. Furthermore, differences in the default mode network are the most consistent findings in neuroimaging research in autism. Recent studies suggest that the default mode network is composed of subnetworks that are tied to different functions, namely memory and understanding others’ minds. In this study, we investigated if default mode network differences in autism are related to specific subnetworks of the default mode network and if these differences change across childhood and adolescence. Our results suggest that the subnetworks of the default mode network are less differentiated in autism in middle childhood compared to neurotypicals. By late adolescence, the default mode network subnetwork organisation was similar in the autistic and neurotypical groups. These findings provide a foundation for future studies to investigate if this developmental pattern relates to improvements in the integration of memory and social understanding as autistic children grow up.
Queering consent: Negotiating critical consent in les-bi-trans-queer BDSM contexts
Authors: Bauer Robin
Published: November 2020

In BDSM community discourse as well as research on BDSM, consent has been treated as an uncomplicated given, often relying on liberal or post-feminist notions of consent as a rational contract between equals until recently. The results of a qualitative study on the les-bi-trans-queer BDSM communities in contrast highlight that on the one hand, queer BDSM technologies of negotiating consent are valuable tools in moving away from heteronormative and liberal notions of consent towards a culture of sexual consent as communicative. On the other hand, limits to BDSM consent technologies are discussed and it is argued that consent needs to be critical and developed collectively.
Marriage, aging, and women’s pursuit of commercial sex in Japan
Authors: Takeyama Akiko
Published: November 2020

A number of scholarly works have observed Western and Japanese women travelers who seek romance and adventure with local “beach boys” in the Global South. Despite the important criticism of geopolitical inequality contained in these works, what is missing is how those involved in such commodified sexual relationships make sense of what they do. This essay focuses on how well-heeled Japanese married women, who are concerned with the meaning and effects of aging, pursue a commodified form of sexual intimacy as a means to rediscover their sense of sexual subjectivity. How do they perceive their own involvement in sexual commerce? What kinds of sexual power dynamics do these women and their younger, precarious male partners shape at the intersection of gender, age, and class? How do these women make sense of the apparently masculine act of paying for sex, which requires them to transgress cultural norms of feminine passivity in sexual matters? By posing these questions, this article provides a fine-grained portrayal of a particular kind of feminist agency.
Flexural capacity and bending stiffness of welded hollow spherical joints with H-beams
Authors: Yan Xiangyu , Zhang Yuxuan , Chen Zhihua , Liu Hongbo , Zhang Qiwu
Published: November 2020

Eight specimens were designed, and pure bending tests were completed to study the mechanical properties of welded hollow spherical joints (WHS joints) with an H-beam subjected to pure bending. Parametric analyses of the joints under pure bending were conducted in consideration of the diameter(D) and wall thickness (t) of the welded hollow sphere(WHS), and height (h) and width (b) of the H-beam to validate the numerical model. Calculation methods for the flexural capacity and bending stiffness of the H-beam WHS joints were proposed. Results revealed two failure modes of the joints under pure bending, namely, (1) concave at the connection between the WHS and upper flange and external heave at the connection between the WHS and lower flange and (2) small concave at the connection between the WHS and upper flange and tensile fracture of the welding seam at the connection between the WHS and lower flange. The joints demonstrated good ductility under pure bending. The flexural capacity and bending stiffness of the joints were positively related to the wall thickness of the WHS and to the height and width of H-beam but were negatively correlated with the diameter of the WHS. The errors between proposed formulas and FEA for calculating flexural capacity and bending stiffness are very small, indicating the formulas can be employed in structural calculation instead of FEA.
Flexural behavior of corroded reinforced concrete beam strengthened with jute fiber reinforced polymer
Authors: Akid Abu Sayed Mohammad , Wasiew Qudrati Al , Sobuz Md. Habibur Rahman , Rahman Touhidur , Tam Vivian WY
Published: November 2020

Fiber-reinforced polymer (FRP) is a revolutionary breakthrough in the history of structural engineering innovation due to its unique characteristics to strengthen and repair the deficient reinforced concrete structures. This paper aimed at evaluating the flexural characteristics of jute fiber reinforced polymer (JFRP) bonded reinforced concrete beams. The influence of the test variables comprised of strengthening scheme and corrosion rate for reinforced concrete (RC) beams. The experimental study comprised of casting six RC beams and testing them in flexure loading. To determine the flexural response of RC beams, three beams were fabricated with JFRP laminate having a level of corrosion of 0%, 7.5%, and 15%, whereas three beams were designated as control beams having same corrosion levels with no JFRP. Test results indicated that all JFRP strengthened beams exhibited increased ultimate load, yield load, first cracking load, and lower ductility index compared to control beams. The results also revealed that JFRP strengthening technique improved the flexural strength of the corroded beams efficiently, albeit the ultimate load of the beams diminished with higher corrosion level. Analytical calculations were carried out for quantifying the flexural characteristics and mass loss of beams which provided a good agreement with the test results.
More than a class act? dilemmas in researching elite school girls’ feminist politics
Authors: Charles Claire , Allan Alexandra
Published: November 2020

Feminist scholars have long been concerned with privileged women’s activism and engagement with feminist politics and how acts of resistance from privileged subjects might best be understood. In the current moment, we are seeing a reinvigoration of interest in feminist activism particularly from young women, but not necessarily focusing on young women who are positioned as privileged. Simultaneously, there is attention in the sociology of elite schooling to the question of social justice politics in privileged spaces. In this article, we contribute to both of these scholarly conversations by reporting on the feminist activism of three young women attending an elite school in Australia. We argue that these young women’s activism/feminist politics need to be understood as a complex entanglement of resistance and reproduction with regard to gender, race and class, and that drawing on recent theorisations influenced by post-humanism in feminist educational research produces fresh insights into researching gender/race/class reproduction by young women in elite educational settings.
Refusing abjection: transphobia and trans youth survivance
Authors: James Julie
Published: November 2020

This article argues that Julia Kristeva’s Powers of Horror: an Essay on Abjection lays out a theory that is not universal in its application, but rather details the violent emergence and defence of Eurocentric, colonial and orientalist subjectivities and related hierarchical social orders. The Eurocentrism found in Kristeva’s political and theoretical stances are referenced, with detailed attention paid to explicating how her theory of abjection describes a brutal, colonising, psychological and social mechanism. This framework is applied to transphobia and its manifestations. It is centrally argued that gender diversity, trans rights and trans inclusivity may be the targets of multiple and compounding abjection processes. The essay concludes with looking at how young trans people are starting to refuse transphobic abjection to survive, to thrive and to revitalise gender diversity.
Old Detroit, New Detroit: “Makers” and the impasse of place change
Authors: Marotta Steve
Published: November 2020

In Cruel Optimism, Lauren Berlant describes an impasse as “what it feels like to be in the middle of a shift.” This paper mobilizes that notion of impasse to critically analyze the position of Detroit’s “maker” community against the background of a rapidly changing city. Makers, who might crudely be described as small craft-manufacturers, have found themselves entangled in an emergent narrative of place transition captured by the juxtapositional monikers of “Old Detroit” and “New Detroit.” The goal of this paper is to think through what gets taken up by these Old/New representations of Detroit – and what the shift between the two feels like – as described by makers. I interpret Old and New Detroit to be unique-but-inseparable place imaginaries; they are the representational bracketing around a transitional lifeworld in which the optimism makers brought to Old Detroit has largely come unraveled in New Detroit. This unraveling, I suggest, is not only a collective melancholy associated with feelings of eroding creativity and autonomy, but also a percolating confrontation with the privileged fantasies of Old Detroit. For makers, New Detroit meant professionalization and gentrification: on one hand, the exigencies of New Detroit have occluded the creative and egalitarian form of change they envisioned for the city; on the other, it opened new financial benefits for their small businesses. The resulting impasse tasked makers with adjusting to the economic and moral uncertainties posed by still-unfolding circumstances in a changing Detroit.
Specific EF-Related Tasks and Reading in Adolescents With Typical Hearing or a Cochlear Implant
Authors: Figueroa Mario , Silvestre Núria , Darbra Sònia
Published: November 2020

The acquisition of effective reading comprehension for adolescents with a cochlear implant (CI) in inclusive settings is crucial for ensuring the benefit of current traditional reading curricula and instructional practices. Executive functions (EF) are recognized as important cognitive processes during reading by students with typical hearing (TH). This study compared the relationship between EF and reading comprehension in adolescents with TH and a CI. Three tests sessions were performed on two groups of adolescents between 12 and 16 years old (36 with CI and 54 with TH). Reading comprehension was assessed by a standardized reading battery and EF by computerized tests. The results indicated that adolescents with CI perform EF tasks with a similar efficiency as the TH group, but the performance of CI group on expository texts was lower than in TH students. Reading comprehension of expository texts was related to inhibition and shifting in adolescents with CI.
Quick laboratory methodology for determining the particle filtration efficiency of face masks/respirators in the wake of COVID-19 pandemic
Authors: Joshi Manish , Khan Arshad , Sapra BK
Published: November 2020

Recent crisis in the form of COVID-19 has rendered wearing of mask mandatory for patients, health care workers and members of public worldwide. This has caused a sudden shift of focus on availability, effectiveness, re-use and development of face masks/respirators. In the current pandemic situation, the shortage of masks has also led to rethinking on strategies of reuse of masks after due sterilization. This work discusses a quick laboratory methodology to test/determine the particle filtration efficiency of face masks/respirators. The testing parameters include the particle capture efficiency of the mask material/full mask, pressure drop and the fit factor. Two different, simple, make-shift set-ups have been adopted for the present context. The first is used to measure the intrinsic particle capture efficiency and pressure drop of the filter material and the second as a ‘full mask sampler’ to assess the leakages through seams and joints of the mask. Experiments conducted with atomized NaCl test particles on three types of mask viz. commercial N-95 respirator, surgical mask and cloth mask have been used for evolving the methodology. The differences in terms of capture efficiency of aerosol particles for the filter material and for the full mask in face fix/sealed fixture have been linked to improvement of the mask design in development phase. This paper hopes to provide a crucial laboratory link between the mask developers and the certification agencies in the times of urgency. Needless to mention that commercialization of the same is subject to certification from authorized agencies, following standard procedures.
Cooling discourses, agnosis and environmental harm
Authors: Monod de Froideville Sarah
Published: November 2020

Critical scholars consider a lack of action around issues of environmental harm a ‘product of persuasion’ by way of various forms of denial, downplay and spin on behalf of elite parties invested in maintaining a neo-liberal social and economic status quo. This paper introduces to this body of work the concept of ‘cooling discourses’ in relation to two cases of environmental harm in the New Zealand (NZ) context. Cooling discourses are employed to settle concerns about harmful activity that are gathering momentum through acknowledging the harm and appearing to address the activity in some manner. Cooling discourses are temporary stupefying discourses that facilitate a state of ignorance, or agnosis so that harmful activity can continue or resume unopposed.
Collegiate coach attitudes towards lesbians and gay men
Authors: Mullin Elizabeth M , Cook Sarah
Published: November 2020

The purpose of the current study was to examine attitudes towards lesbians and gay men among National Collegiate Athletic Association (NCAA) Division I, II, and III coaches. Coaches ( N = 290) from NCAA Division I (21%), II (22%), and III (56%) member institutions representing 31 different sports completed the Attitudes towards Lesbians and Gay Men scale and a demographic questionnaire. Overall, coaches reported generally positive attitudes towards lesbians and gay men. No significant gender x division interaction was found with respect towards attitudes towards lesbians and gay men, Pillai’s Trace = .023, F(4, 494) = 1.419, p = .227, ηp 2  = .011. Male coaches reported significantly more negative attitudes than female coaches, Pillai’s Trace = .046, F(2, 247) = 5.92, p = .003, ηp 2  = .046. When examining differences in age, older coaches (50 and older) reported significantly more negative attitudes than 30-39 and 40-49-year-old coaches ( ps < .05). These findings add to the limited understanding of coach attitudes towards individuals who identify as lesbian or gay men. An understanding of attitudes provides the basis for positive change that can be translated into more inclusive behaviors to provide a better experience for lesbian and gay male athletes.
Variation in the clinical commissioning of surgery for three common hand conditions in England
Authors: Coffey Duncan , Redgrave Natalie , Hudson-Phillips Sarah , Clark Calum , Tahmassebi Ramon , Vig Stella
Published: November 2020

The surgical referral policies for patients with trigger finger, ganglion removal and Dupuytren’s disease were collected for all Clinical Commissioning Groups in England. The aim was to assess whether there was variation in the policies across England, resulting in inequality in patients’ access to surgery. Data were collected between October 2018 and January 2019 and compared with national guidelines. Analysis of the results showed that for all three conditions, surgical commissioning policies varied depending on the locality. The results also show that despite the existence of national guidelines, they are not implemented. This has the potential to lead to variation in surgical referral and access to services for patients in different localities in England.

Level of evidence: III
Conventional disease-modifying antirheumatic drugs therapy may not slow spinal radiographic progression in ankylosing spondylitis: results from an 18-year longitudinal dataset
Authors: Lee Tae-Han , Koo Bon San , Nam Bora , Oh Ji Seon , Park Seo Young , Lee Seunghun , Joo Kyung Bin , Kim Tae-Hwan
Published: November 2020

Objectives:

The clinical benefit of conventional disease-modifying antirheumatic drugs (cDMARDs) for treating ankylosing spondylitis (AS) is generally limited to improvements in peripheral arthritis. However, cDMARDs could be conditionally considered as alternatives to established drugs for improving axial manifestations in exceptional circumstances. However, there are few studies of the impact of cDMARDs on radiographic progression outcomes. Therefore, we investigated the effectiveness of cDMARDs on radiographic progression in AS.

Methods:

Among 1280 AS patients at a single hospital from 2000 to 2018, 301 who had been treated with sulfasalazine (SSZ) or methotrexate (MTX) were enrolled. For each patient, the entire follow-up period was split into 1-year intervals. Each interval was classified as either an “on-cDMARD” interval, which was a period of treatment with SSZ alone, MTX alone, or a combination of SSZ and MTX, or an “off-cDMARD” interval, which was a period without cDMARD treatment. Radiographic progression was scored using the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). The relationship between cDMARD use and radiographic progression within the intervals, defined as the rate of mSASSS progression, was investigated using linear models with adjustment for potential confounding covariates and for clustering among observations from the same patient.

Results:

The 732 on-cDMARD intervals and 1027 off-cDMARD intervals were obtained from enrolled patients. In multivariable regression analysis, there was no significant association between cDMARDs and the rate of mSASSS progression (β = −0.081, p = 0.418). The mean adjusted mSASSS change per year was 0.610 from on-cDMARD intervals and 0.691 from off-cDMARD intervals.

Conclusion:

Treatment with cDMARDs may not reduce radiographic progression in AS patients.
A 30-year-old male with COVID-19 presenting with seizures and leukoencephalopathy
Authors: Khan Zohaib , Singh Sukhdev , Foster Allison , Mazo Jahinover , Graciano-Mireles Gira , Kikkeri Vinaya
Published: November 2020

First reported in Wuhan, China, Novel Coronavirus Disease-19 rapidly spread causing an outbreak of viral pneumonia and became a pandemic in early 2020. It was later discovered to be caused by Severe Acute Respiratory Syndrome Coronavirus 2, a novel coronavirus. Although the vast majority of cases have primarily involved the respiratory system, some serious cases have started to emerge with central and peripheral nervous system complications. We present the case of a 30-year-old morbidly obese male who initially presented to the emergency department with seizures, altered mental status, and COVID-19 pneumonia. After a 21-day hospital course including 14 days of intensive care unit management, he was stabilized and discharged to a rehabilitation facility. He returned 1 day later with worsening respiratory distress and was found to have acute pulmonary embolism requiring placement of an inferior vena cava filter. After an additional 6 days in the hospital, he was discharged back to the outpatient facility. He returned for a third time with altered mental status, visual and auditory hallucinations, and confabulation. This report provides critical information in revealing a peculiar neurological sequela of COVID-19 induced leukoencephalopathy and its disease course. We hope to shed light on this sequence of events by providing possible mechanisms to aid clinicians in the identification and management of this complication.
Inflammatory polyradiculoneuropathies: Clinical and immunological aspects, current therapies, and future perspectives
Authors: Di Stefano Vincenzo , Barbone Filomena , Ferrante Camilla , Telese Roberta , Vitale Michela , Onofrj Marco , Di Muzio Antonio
Published: November 2020

Inflammatory polyradiculoneuropathies are heterogeneous disorders characterized by immune-mediated leukocyte infiltration of peripheral nerves and nerve roots leading to demyelination or axonal degeneration or both. Inflammatory polyradiculoneuropathies can be divided into acute and chronic: Guillain–Barré syndrome and chronic inflammatory demyelinating polyneuropathy and their variants. Despite major advances in immunology and molecular biology have been made in the last years, the pathogenesis of these disorders is not completely understood. This review summarizes the current literature of the clinical features and pathogenic mechanisms of inflammatory polyradiculoneuropathies and focuses on current therapies and new potential treatment for the future.
A Mixed-method Study of the Effects of Post-migration Economic Stressors on the Mental Health of Recently Resettled Refugees
Authors: Goodkind Jessica , Ferrera Julieta , Lardier David , Hess Julia Meredith , Greene R. Neil
Published: November 2020

After years of emphasis on pre-migration trauma as the major determinant of refugee mental health, researchers have begun to explore the effects of post-migration stressors on refugees’ distress. However, few studies have brought together refugees’ emic understandings of the effects of economic stressors on their mental health with quantitative data sets to further explore the salience of stress processes as an explanatory mechanism. In qualitative interviews, 41 percent of 290 recently resettled adult refugees noted that economic stressors were a major source of distress and described pathways through which these stressors negatively influenced their mental health by limiting their ability to learn English, obtain meaningful employment, access health care, maintain contact with their families, and integrate into their communities. In structural equation modeling of quantitative data, we tested several possible hypotheses that emerged from the qualitative findings. We find that post-migration economic stressors mediated the relationship between migration-related trauma and post-migration emotional distress and post-traumatic stress disorder (PTSD) symptoms. These findings provide empirical support for stress proliferation as a mechanism through which trauma exposure contributes to distress.
Provocations for Boundary Spanning from Mohammad Nagar’s Community Toilet
Authors: Singh Vanshika
Published: November 2020

Collaborative research endeavours, such as the ‘Boundary Spanning and Intermediation for Urban Regeneration’ project, can help unpack boundary spanning from the viewpoint of communities in informal settlements who engage with the state through certain actors operating as their citizen–state interface. This article builds on the story of a community toilet in Mohammad Nagar settlement in Bholakpur, a neighbourhood in the southern Indian city of Hyderabad, where solid consumer waste is processed, recycled and regenerated with value. Tracing the struggles to build a functional community toilet from 2012 to 2017 amidst a gentrifying real estate landscape, this article asks: what does the process of working through a fragmented community to claim a community toilet from the state say to the idea of boundary spanning? By describing the boundary-spanning activities of three different actors invested in working through a divided settlement to co-produce an effective claim, it seeks to enquire about the different knowledge types these actors hone. How are these knowledge types generated? How do different actors deploy them in the neighbourhood? Through its analysis of the post-2017 scenario, when the toilet stood built but unmaintained and unused, the article argues for studying boundary spanning over time and spatial change, especially in places like Mohammad Nagar, where securing basic and usable civic infrastructure relies on multiple iterations of boundary-spanning activities.
State-society Interactions and Bordering Practices in Gurugram’s Pandemic Response
Authors: Naik Mukta
Published: November 2020

Civil society has played a key role in responding to the COVID-19 crisis in Indian cities. This article uses the conceptualisation of boundaries and borders to reflect on the role of local state and civil society actors in Gurugram’s pandemic response. It examines the state’s bordering practices, state-society relations as well as processes of negotiation that enabled disease management as well as relief efforts-especially for migrant workers-during the crisis.
Hemiscrotal agenesis: a novel phenotype of a rare malformation
Authors: Mansy Mohamed , Kotb Mostafa , Abdelmeguid Yasmine , Raafat Shaymaa , Abdelaziz Marwa
Published: November 2020

Background

Hemiscrotal agenesis (HSA) is an exceedingly rare congenital anomaly in scrotal development. It is characterized by unilateral absence of scrotal skin with intact midline raphe. In the English literature, only seven patients were diagnosed with HSA. Herein, we report a 14-month-old boy with HSA, unilateral cryptorchidism and a perineal skin tag. Additionally, the patient had a monodactylous limb, unilateral cerebellar hypoplasia, and a cardiac septal defect.

Case presentation

A 14-month-old boy presented with right HSA and ectopic scrotal skin in the right perineal region. Extra-genital examination showed right monodactylous lower limb, without dysmorphic facial features or any other skeletal anomalies. His karyotype was 46, XY, while his hormonal profile showed prepubertal LH and FSH. Skeletal survey showed right monodactylous lower limb (with only a big toe which had 2 phalanges) and normal spine alignment. A previous echocardiography was done and showed a small muscular ventricular septal defect (VSD) that closed on follow-up. Magnetic resonance imaging of the brain showed posterior fossa malformation. The patient had his right testis fixed in the right scrotum. The pathological examination of the perineal lesion showed fibro-epithelial polyp (skin tag), with no testicular tissue or atypia.

Conclusion

We believe that this is the first case to be reported with hemiscrotal agenesis and ipsilateral cryptorchidism, associated with a perineal skin tag, unilateral monodactylous lower limb on the same side, unilateral cerebellar hypoplasia, and VSD. Interestingly, further genetic analysis is required to reach a final diagnosis. However, regrettably, advanced molecular diagnostic studies for this patient is not available in our country.
Cardiac resynchronization therapy and its effects in patients with type 2 DIAbetes mellitus OPTimized in automatic vs. echo guided approach. Data from the DIA-OPTA investigators
Authors: Sardu Celestino , Paolisso Pasquale , Ducceschi Valentino , Santamaria Matteo , Sacra Cosimo , Massetti Massimo , Ruocco Antonio , Marfella Raffaele
Published: November 2020

Objectives

To evaluate the effects of cardiac resynchronization therapy (CRTd) in patients with type 2 diabetes mellitus (T2DM) optimized via automatic vs. echocardiography-guided approach.

Background

The suboptimal atrio-ventricular (AV) and inter-ventricular (VV) delays optimization reduces CRTd response. Therefore, we hypothesized that automatic CRTd optimization might improve clinical outcomes in T2DM patients.

Methods

We designed a prospective, multicenter study to recruit, from October 2016 to June 2019, 191 consecutive failing heart patients with T2DM, and candidate to receive a CRTd. Study outcomes were CRTd responders rate, hospitalizations for heart failure (HF) worsening, cardiac deaths and all cause of deaths in T2DM patients treated with CRTd and randomly optimized via automatic (n 93) vs. echocardiography-guided (n 98) approach at 12 months of follow-up.

Results

We had a significant difference in the rate of CRTd responders (68 (73.1%) vs. 58 (59.2%), p 0.038), and hospitalizations for HF worsening (12 (16.1%) vs. 22 (22.4%), p 0.030) in automatic vs. echocardiography-guided group of patients. At multivariate Cox regression analysis, the automatic guided approach (3.636 [1.271–10.399], CI 95%, p 0.016) and baseline highest values of atrium pressure (automatic SonR values, 2.863 [1.537–6.231], CI 95%, p 0.006) predicted rate of CRTd responders. In automatic group, we had significant difference in SonR values comparing the rate of CRTd responders vs. non responders (1.24 ± 0.72 g vs. 0.58 ± 0.46 g (follow-up), p 0.001), the rate of hospitalizations for HF worsening events (0.48 ± 0.29 g vs. 1.18 ± 0.43 g, p 0.001), and the rate of cardiac deaths ( 1.13 ± 0.72 g vs. 0.65 ± 0.69 g, p 0.047).

Conclusions

Automatic optimization increased CRTd responders rate, and reduced hospitalizations for HF worsening. Intriguingly, automatic CRTd and highest baseline values of SonR could be predictive of CRTd responders. Notably, there was a significant difference in SonR values for CRTd responders vs. non responders, and about hospitalizations for HF worsening and cardiac deaths.

Clinical trial ClinicalTrials.gov Identifier NCT04547244.
Long noncoding RNAs: functions and mechanisms in colon cancer
Authors: Chen Sian , Shen Xian
Published: November 2020

Evidence indicates that long non-coding RNAs (lncRNAs) play a crucial role in the carcinogenesis and progression of a wide variety of human malignancies including colon cancer. In this review, we describe the functions and mechanisms of lncRNAs involved in colon oncogenesis, such as HOTAIR, PVT1, H19, MALAT1, SNHG1, SNHG7, SNHG15, TUG1, XIST, ROR and ZEB1-AS1. We summarize the roles of lncRNAs in regulating cell proliferation, cell apoptotic death, the cell cycle, cell migrative and invasive ability, epithelial-mesenchymal transition (EMT), cancer stem cells and drug resistance in colon cancer. In addition, we briefly highlight the functions of circRNAs in colon tumorigenesis and progression, including circPPP1R12A, circPIP5K1A, circCTIC1, circ_0001313, circRNA_104916 and circRNA-ACAP2. This review provides the rationale for anticancer therapy via modulation of lncRNAs and circular RNAs (circRNAs) in colon carcinoma.
Nonparametric estimation of a primary care production function in urban Brazil
Authors: Wichmann Bruno , Wichmann Roberta
Published: November 2020

Background

The Brazilian public health system is one of the largest health systems in the world, with a mandate to deliver medical care to more than 200 million Brazilians. The objective of this study is to estimate a production function for primary care in urban Brazil. Our goal is to use flexible estimates to identify heterogeneous returns and complementarities between medical capital and labor.

Methods

We use a large dataset from 2012 to 2016 (with more than 400 million consultations, 270 thousand physicians, and 11 thousand clinics) to nonparametrically estimate a primary care production function and calculate the elasticity of doctors’ visits (output) to two inputs: capital stock (number of clinics) and labor (number of physicians). We benchmark our nonparametric estimates against estimates of a Cobb-Douglas (CD) production function. The CD model was chosen as a baseline because it is arguably the most popular parametric production function model. By comparing our nonparametric results with those from the CD model, our paper shed some light on the limitations of the parametric approach, and on the novelty of nonparametric insights.

Results

The nonparametric results show significantly heterogeneity of returns to both capital and labor, depending on the scale of operation. We find that diseconomies of scale, diminishing returns to scale, and increasing returns to scale are possible, depending on the input range.

Conclusions

The nonparametric model identifies complementarities between capital and labor, which is essential in designing efficient policy interventions. For example, we find that the response of primary care consultations to labor is steeper when capital level is high. This means that, if the goal is to allocate labor to maximize increases in consultations, adding physicians in cities with a high number of clinics is preferred to allocating physicians to low medical infrastructure municipalities. The results highlight how the CD model hides useful policy information by not accounting for the heterogeneity in the data.
Inoculation of native symbiotic effective Sinorhizobium spp. enhanced soybean [Glycine max (L.) Merr.] grain yield in Ethiopia
Authors: Temesgen Diriba , Assefa Fassil
Published: November 2020

Background

Soybean [Glycine max(L) Merr.] is an annual leguminous crop serving as a source of food and feed, green manure, biodiesel and fiber. It is nodulated by diverse slow growing and fast growing rhizobia belonging to the genusBradyrhizobiumandSinorhizobium, respectively. In Ethiopia, it has been cultivated since 1950s with lower grain yield history. Yield improvement efforts have been more concentrated on agronomic studies, inoculation of exoticBradyrhizobium japonicumincluding TAL379 and/or fertilizer application. The results have usually been unsatisfactory and inconsistent. This study was initiated to identify promising indigenous soybean rhizobial inoculant that can enhance yield of the crop in the country.

Methods

Native soybean rhizobia, designated GMR forGlycine maxrhizobia, were trapped using soybean (cv. Ethio-Yugoslavia) from soils collected across agro-ecologies of Ethiopia. They were screened for in vitro tolerance against physico-chemical stresses, plant growth promoting (PGP) traits and symbiotic performances at greenhouse and field levels. A referenceB. japonicum(TAL379) was included in all experiments. A soybean plant growth promotingAchromobactersp. was also included in field trials for co-inoculation. Quantitative data were assessed by analysis of variance (ANOVA) employing SAS computer software package version 9.3. Mean separations were undertaken using Duncan’s Multiple Range Test at p ≤ 0.05. Phenotypic variability of the test bacteria was undertaken using PAST4.03 Computer Software.

Result

GMR that produced acid and grew faster with larger colonies were identified asSinorhizobiumspp. and those which produced alkali and grew slowly with smaller colonies were identified asBradyrhizobiumspp. though further genetic analysis should be performed for verification and identification of their genus and species, respectively. TwoSinorhizobiumspp. (GMR120C and GMR125B) profoundly nodulated different soybean cultivars under greenhouse conditions and significantly improved grain yield (p ≤ 0.05; maximum 3.98 tons ha−1) compared to 2.41, 2.82 and 2.69 recorded as maximum grain yield (tons ha−1) for TAL379 inoculation, positive control and negative control, respectively in field trials. Higher yield was recorded when GMR125B was co-inoculated withAchromobactersp., but when GMR120C was inoculated singly. These GMR also showed efficient utilization of numerous substrates, some PGP traits and potential adaptation to various ecological stresses.

Conclusion

The twoSinorhizobiumspp. (GMR120C and GMR125B) are promising soybean inoculants that can be used to enhance the productivity of the crop in the country.
Correction to: The chemodiversity of paddy soil dissolved organic matter correlates with microbial community at continental scales
Authors: Li Hong-Yi , Wang Hang , Wang Hai-Tao , Xin Pei-Yong , Xu Xin-Hua , Ma Yun , Liu Wei-Ping , Teng Chang-Yun , Jiang Cheng-Liang , Lou Li-Ping , Arnold Wyatt , Cralle Lauren , Zhu Yong-Guan , Chu Jin-Fang , Gilbert Jack A. , Zhang Zhi-Jian
Published: November 2020

An amendment to this paper has been published and can be accessed via the original article.
Building a rapid autopsy program – a step-by-step logistics guide
Authors: Bacon Eliza R. , Ihle Kena , Lee Peter P. , Waisman James R.
Published: November 2020

Background

Rapid Autopsy Programs offer an opportunity to collect tissue from patients immediately after death, providing critical biological material necessary to develop more effective therapies and improve patient outcomes. Here, we present a step-by-step guide to build a cancer-focused Rapid Autopsy Program, based on our own experiences building “The Legacy Project” at the City of Hope Comprehensive Cancer Center.

Methods

The linear timeline of events is separated into four phases: 1) Building the Infrastructure, 2) Recruiting and Consenting, 3) Preparing for Death, and 4) Tissue Collection and Follow up. Important considerations and methods for adaptation are discussed throughout the protocol.

Discussion

Using these methods, we successfully collected a total of 533 specimens from 9 subjects. The average time from death to last specimen acquisition was 6.1 h (range: 4.03–7.66 h; median: 5.71 h). A diverse team with various areas of expertise is critical for successful program implementation. Our goal herein this protocol is to provide a comprehensive framework and foundation for other institutions to use as a model.
Mechanical thrombectomy for pulmonary embolism in patients with patent foramen Ovale
Authors: Nezami Nariman , Chockalingam Arun , Cornman-Homonoff Joshua , Marino Angelo , Pollak Jeffrey , Mojibian Hamid
Published: November 2020

Background

The current level of evidence for mechanical thrombectomy (MT) of pulmonary embolism (PE) in patients with patent foramen ovale (PFO) is limited.

Results

This was a retrospective analysis of 9 patients with PFO and acute high-risk or intermediate-high-risk PE, 6 with intermediate-high risk and 3 with high-risk PE. All underwent MT using the Inari FlowTriever System from Dec 2018 to November 2019. Six of these patients had confirmed deep venous thrombosis. The technical and clinical success rate for MT in all patients was 100% and 77.8%, respectively. Right-heart strain improved in 6/8 patients on follow-up echocardiography. Mean main pulmonary artery (MPA) pressure significantly decreased after MT (p < 0.012). One patient presented with altered mental status (somnolence and disorientation) prior to coronary artery angiogram and thrombectomy, developed a middle cerebral artery embolic stroke 1 day after MT, and recovered with minor sequalae and later was discharged. There was no in-hospital mortality.

Conclusions

MT using FlowTriever was feasible and safe, successfully improving MPA pressure in patients presenting with concurrent PFO and PE.
Aldosterone Induces Vasoconstriction in Individuals with Type 2 Diabetes: Effect of Acute Antioxidant Administration
Authors: Finsen Stine Høyer , Hansen Mie Rytz , Hansen Pernille B Lærkegaard , Mortensen Stefan P
Published: November 2020

Context

Individuals with type 2 diabetes have an increased risk of endothelial dysfunction and cardiovascular disease. Plasma aldosterone could contribute by reactive oxygen species–dependent mechanisms by inducing a shift in the balance between a vasoconstrictor and vasodilator response to aldosterone.

Objective

We aimed to investigate the acute vascular effects of aldosterone in individuals with type 2 diabetes compared with healthy controls and if infusion of an antioxidant (n-acetylcysteine [NAC]) would alter the vascular response.

Methods

In a case–control design, 12 participants with type 2 diabetes and 14 healthy controls, recruited from the general community, were studied. Leg hemodynamics were measured before and during aldosterone infusion (0.2 and 5 ng min–1 [L leg volume]–1) for 10 minutes into the femoral artery with and without coinfusion of NAC (125 mg kg–1 hour–1 followed by 25 mg kg–1 hour–1). Leg blood flow and arterial blood pressure was measured, and femoral arterial and venous blood samples were collected.

Results

Compared with the control group, leg blood flow and vascular conductance decreased during infusion of aldosterone at the high dose in individuals with type 2 diabetes, whereas coinfusion of NAC attenuated this response. Plasma aldosterone increased in both groups during aldosterone infusion and there was no difference between groups at baseline or during the infusions.

Conclusion

These results suggests that type 2 diabetes is associated with a vasoconstrictor response to physiological levels of infused aldosterone and that the antioxidant NAC diminishes this response.