bluuebunny/crossref_metadata_2025 huggingface dataset:
Multicenter phase III randomized trial comparing laparoscopy and laparotomy for colon cancer surgery in patients older than 75 years: the CELL study, a Fédération de Recherche en Chirurgie (FRENCH) trial
Authors: Manceau Gilles , Brouquet Antoine , Chaibi Pascal , Passot Guillaume , Bouché Olivier , Mathonnet Murielle , Regimbeau Jean-Marc , Lo Dico Rea , Lefèvre Jérémie H. , Peschaud Frédérique , Facy Olivier , Volpin Enrico , Chouillard Elie , Beyert-Berjot Laura , Verny Marc , Karoui Mehdi , Benoist Stéphane
Published: December 2019

Background

Several multicenter randomized controlled trials comparing laparoscopy and conventional open surgery for colon cancer have demonstrated that laparoscopic approach achieved the same oncological results while improving significantly early postoperative outcomes. These trials included few elderly patients, with a median age not exceeding 71 years. However, colon cancer is a disease of the elderly. More than 65% of patients operated on for colon cancer belong to this age group, and this proportion may become more pronounced in the coming years. In current practice, laparoscopy is underused in this population.

Methods

The CELL (Colectomy for cancer in the Elderly by Laparoscopy or Laparotomy) trial is a multicenter, open-label randomized, 2-arm phase III superiority trial. Patients aged 75 years or older with uncomplicated colonic adenocarcinoma or endoscopically unresectable colonic polyp will be randomized to either colectomy by laparoscopy or laparotomy. The primary endpoint of the study is overall postoperative morbidity, defined as any complication classification occurring up to 30 days after surgery. The secondary endpoints are: 30-day and 90-day postoperative mortality, 30-day readmission rate, quality of surgical resection, health-related quality of life and evolution of geriatric assessment. A 35 to 20% overall postoperative morbidity rate reduction is expected for patients operated on by laparoscopy compared with those who underwent surgery by laparotomy. With a two-sided α risk of 5% and a power of 80% (β = 0.20), 276 patients will be required in total.

Discussion

To date, no dedicated randomized controlled trial has been conducted to evaluate morbidity after colon cancer surgery by laparoscopy or laparotomy in the elderly and the benefits of laparoscopy is still debated in this context. Thus, a prospective multicenter randomized trial evaluating postoperative outcomes specifically in elderly patients operated on for colon cancer by laparoscopy or laparotomy with curative intent is warranted. If significant, such a study might change the current surgical practices and allow a significant improvement in the surgical management of this population, which will be the vast majority of patients treated for colon cancer in the coming years.

Trial registration

ClinicalTrials.gov NCT03033719 (January 27, 2017).
Awareness of HIV/AIDS and its routes of transmission as well as access to health knowledge among rural residents in Western China: a cross-sectional study
Authors: Zhang Tianqi , Miao Yang , Li Lingui , Bian Ying
Published: December 2019

Background

The purpose of this study was to evaluate the coverage of HIV health education among rural residents in western China by ascertaining their awareness of HIV/AIDS and its transmission routes, and to investigate how these residents receive health information.

Methods

A survey was conducted through stratified clustered sampling at 99 county hospitals in 11 provinces in western China. Information was collected on awareness of HIV/AIDS and its transmission routes, as well as residents’ access to health knowledge. Chi-square analysis was used to analyse the differences in HIV/AIDS awareness (knowing of the existence of HIV/AIDS, hereinafter referred to as “HIV awareness rate”) between different subgroups categorized by demographic status, regional factors, and different methods of access to health knowledge. To further analyse the effects of access to health knowledge on HIV awareness, a logistic regression model was established. The relationship between access to health knowledge and transmission routes was also examined using chi-square analysis.

Results

The HIV awareness rate of the total 9274 participants was 80.9%. There were statistically significant differences between subgroups classified by age (χ2 = 482.118, p<0.001), education (χ2 = 853.465, p<0.001), occupation (χ2 = 340.553, p<0.001), income (χ2 = 186.448, p<0.001), cumulative HIV cases according to province (χ2 = 59.513, p<0.001), per capita annual net income of rural households according to province (χ2 = 64.676, p<0.001), proportion of minority population according to province (χ2 = 94.898, p<0.001), direct access to health knowledge (medical staff: χ2 = 419.775, p<0.001; mass media: χ2 = 740.238, p<0.001; family members: χ2 = 12.189, p<0.001; socializing: χ2 = 48.780, p<0.001; health education activities: χ2 = 154.400, p<0.001), and indirect access to health knowledge (having a non-communicable disease with medical instructions χ2 = 78.709, p<0.001; physical examinations: χ2 = 135.679, p<0.001). The logistic regression model showed that education and mass media had the strongest impacts on HIV awareness among all methods of access. Participants had the least awareness of HIV’s mother-to-child transmission route.

Conclusion

The HIV awareness rate indicated that previous HIV health education covered 80% of the rural population in western China. Mass media should take greater responsibility in HIV health education for the general population, and special attention should be paid to the elderly, the most impoverished population, minority community as well as the mother-to-child transmission route.
Association between dietary selenium intake and the prevalence of osteoporosis: a cross-sectional study
Authors: Wang Yuqing , Xie Dongxing , Li Jiatian , Long Huizhong , Wu Jing , Wu Ziying , He Hongyi , Wang Haochen , Yang Tuo , Wang Yilun
Published: December 2019

Objective

To examine the correlation between dietary selenium (Se) intake and the prevalence of osteoporosis (OP) in the general middle-aged and older population in China.

Methods

Data for analyses were collected from a population based cross-sectional study performed at the Xiangya Hospital Health Management Centre. Dietary Se intake was evaluated using a validated semi-quantitative food frequency questionnaire. OP was diagnosed on the basis of bone mineral density scans using a compact radiographic absorptiometry system. The correlation between dietary Se intake and the prevalence of OP was primarily examined by multivariable logistic regression.

Results

This cross-sectional study included a total of 6267 subjects (mean age: 52.2 ± 7.4 years; 42% women), and the prevalence of OP among the included subjects was 9.6% (2.3% in men and 19.7% in women). Compared with the lowest quartile, the energy intake, age, gender and body mass index (BMI)-adjusted odds ratios of OP were 0.72 (95% confidence interval [CI] 0.55–0.94), 0.72 (95% CI 0.51–1.01) and 0.47 (95% CI 0.31–0.73) for the second, third and fourth quartiles of dietary Se intake, respectively (Pfor trend = 0.001). The results remained consistent in male and female subjects. Adjustment for additional potential confounders (i.e., smoking status, drinking status, physical activity level, nutritional supplements, diabetes, hypertension, fibre intake, and calcium intake) did not cause substantial changes to the results.

Conclusions

In the middle-aged and older humans, participants with lower levels of dietary Se intake have a higher prevalence of OP in a dose-response manner.
Learning and coping through reflection: exploring patient death experiences of medical students
Authors: Trivate Travuth , Dennis Ashley A , Sholl Sarah , Wilkinson Tracey
Published: December 2019

Background

Existing studies have explored many aspects of medical students’ experiences of patient death and propose the importance of faculty support for coping. However, UK-based literature on this subject and research concerning learning through reflection as part of coping are relatively limited. This study, through the lens of reflection, aims to explore students' experiences with patient death in a UK context. These include coping strategies, support from faculty following patient death and the relationship between these experiences and learning. Our research questions were:

How do medical students cope with and learn from their experiences?

How does support from ward staff and the medical school help them cope with and learn from these experiences?

How can students best be supported following patient death?

Methods

We employed narrative inquiry to explore how medical students made sense of their experiences of patient death. Twelve students participated in our study via an online narrative questionnaire. Thematic analysis and complementary narrative analysis of an exemplar were applied to address our research aim.

Results

Coping strategies comprised internal and external strategies. Internal strategies included (1) re-interpretation of the death into a meaningful experience including lessons learned; (2) normalization; (3) staying busy and (4) enduring negative emotions. External strategies included speaking to someone, which was found to influence normalization, and lessons learned. Both satisfactory and unsatisfactory support from ward staff was identified. Satisfactory support was characterized by the inclusion of emotional and professional support. Unsatisfactory support was often characterized by a lack of emotional support. Narrative analysis further demonstrated how the experience with patient death was re-interpreted meaningfully. Students suggested that support should be structured, active, sensitive, and include peers and near-peers.

Conclusion

Many coping strategies, internal and external, were employed in students’ experiences with patient death. Student reflections, enhanced by support from ward staff, were shown to be important for learning from patient death. We encourage faculty to have regular sessions in which medical students can reflect on the death incident and discuss appropriately with others, including peers and near-peers.
The timing of testing influences skill retention after basic life support training: a prospective quasi-experimental study
Authors: Kovács Enikő , Jenei Zsigmond Máté , Csordás Katalin , Fritúz Gábor , Hauser Balázs , Gyarmathy V. Anna , Zima Endre , Gál János
Published: December 2019

Background

Proper basic life support (BLS) is key in improving the survival of out-of-hospital cardiac arrest. BLS skills deteriorate in three to 6 months after training. One method to improve skill retention may be using the “testing effect” to test skills at the end of a BLS course. The aim of our study was to investigate whether either testing or the timing of such testing after BLS training have any influence on skill retention.

Methods

This was a post-test only, partial coverage, prospective quasi-experimental study designed to evaluate a BLS training course among 464 fifth year medical students at Semmelweis University in the first semester of 2013/2014. Groups were systematically but non-randomly assigned to either a control group that took no exam or one of two experimental groups that took an exam (N = 179, NoExam group; N = 165, EndExam group – exam at the end of the BLS training; N = 120, 3mExam group – exam 3 months after the BLS training). The ability to perform ten prescribed essential BLS steps was evaluated during a skill retention assessment 2 months after the course in the NoExam, 2 months after the course (and the exam) in the EndExam and 5 months after the course (2 months after the exam) in the 3mExam group to measure skill retention and the effect of our intervention. Scores were calculated for each BLS step, and also summed up as a total score. We used Kruskal-Wallis test to assess differences in skill retention.

Results

Overall, NoExam and EndExam groups showed similar skill retention. The mean total score (and many of the sub-scores) of students was significantly higher in the 3mExam group compared to both the NoExam and the EndExam groups, and there was no difference in the total score (and many of the sub-scores) of the latter two groups. The 3mExam group had less variability in total scores (and many of the sub-scores) than the other two groups.

Conclusion

Our study provides evidence that testing these skills 3 months after BLS training may be more effective than either testing immediately at the end of the course or no testing at all.
Deterrence approach on the compliance with electronic medical records privacy policy: the moderating role of computer monitoring
Authors: Kuo Kuang-Ming , Talley Paul C. , Cheng Tain-Junn
Published: December 2019

Background

This study explored the possible antecedents that will motivate hospital employees’ compliance with privacy policy related to electronic medical records (EMR) from a deterrence perspective. Further, we also investigated the moderating effect of computer monitoring on relationships among the antecedents and the level of hospital employees’ compliance intention.

Methods

Data was collected from a large Taiwanese medical center using survey methodology. A total of 303 responses was analyzed via hierarchical regression analysis.

Results

The results revealed that sanction severity and sanction certainty significantly predict hospital employees’ compliance intention, respectively. Further, our study found external computer monitoring significantly moderates the relationship between sanction certainty and compliance intention.

Conclusions

Based on our findings, the study suggests that healthcare facilities should take proactive countermeasures, such as computer monitoring, to better protect the privacy of EMR in addition to stated privacy policy. However, the extent of computer monitoring should be kept to minimum requirements as stated by relevant regulations.
Proof-of-concept study: Homomorphically encrypted data can support real-time learning in personalized cancer medicine
Authors: Paddock Silvia , Abedtash Hamed , Zummo Jacqueline , Thomas Samuel
Published: December 2019

Background

The successful introduction of homomorphic encryption (HE) in clinical research holds promise for improving acceptance of data-sharing protocols, increasing sample sizes, and accelerating learning from real-world data (RWD). A well-scoped use case for HE would pave the way for more widespread adoption in healthcare applications. Determining the efficacy of targeted cancer treatments used off-label for a variety of genetically defined conditions is an excellent candidate for introduction of HE-based learning systems because of a significant unmet need to share and combine confidential data, the use of relatively simple algorithms, and an opportunity to reach large numbers of willing study participants.

Methods

We used published literature to estimate the numbers of patients who might be eligible to receive treatments approved for other indications based on molecular profiles. We then estimated the sample size and number of variables that would be required for a successful system to detect exceptional responses with sufficient power. We generated an appropriately sized, simulated dataset (n = 5000) and used an established HE algorithm to detect exceptional responses and calculate total drug exposure, while the data remained encrypted.

Results

Our results demonstrated the feasibility of using an HE-based system to identify exceptional responders and perform calculations on patient data during a hypothetical 3-year study. Although homomorphically encrypted computations are time consuming, the required basic computations (i.e., addition) do not pose a critical bottleneck to the analysis.

Conclusion

In this proof-of-concept study, based on simulated data, we demonstrate that identifying exceptional responders to targeted cancer treatments represents a valuable and feasible use case.

Past solutions to either completely anonymize data or restrict access through stringent data use agreements have limited the utility of abundant and valuable data. Because of its privacy protections, we believe that an HE-based learning system for real-world cancer treatment would entice thousands more patients to voluntarily contribute data through participation in research studies beyond the currently available secondary data populated from hospital electronic health records and administrative claims. Forming collaborations between technical experts, physicians, patient advocates, payers, and researchers, and testing the system on existing RWD are critical next steps to making HE-based learning a reality in healthcare.
Innate immunity activation in the early brain injury period following subarachnoid hemorrhage
Authors:   on behalf of the Canadian Critical Care Translational Biology Group, Gris Typhaine , Laplante Patrick , Thebault Paméla , Cayrol Romain , Najjar Ahmed , Joannette-Pilon Benjamin , Brillant-Marquis Frédéric , Magro Elsa , English Shane W. , Lapointe Réjean , Bojanowski Michel , Francoeur Charles L. , Cailhier Jean-François
Published: December 2019

Background

Aneurysmal subarachnoid hemorrhage (SAH) is a catastrophic disease with devastating consequences, including a high mortality rate and severe disabilities among survivors. Inflammation is induced following SAH, but the exact role and phenotype of innate immune cells remain poorly characterized. We investigated the inflammatory components of the early brain injury in an animal model and in SAH patients.

Method

SAH was induced through injection of blood in the subarachnoid space of C57Bl/6 J wild-type mice. Prospective blood collections were obtained at 12 h, days 1, 2, and 7 to evaluate the systemic inflammatory consequences of SAH by flow cytometry and enzyme-linked immunosorbent-assay (ELISA). Brains were collected, enzymatically digested, or fixed to characterize infiltrating inflammatory cells and neuronal death using flow cytometry and immunofluorescence. Phenotypic evaluation was performed at day 7 using the holding time and footprint tests. We then compared the identified inflammatory proteins to the profiles obtained from the plasma of 13 human SAH patients.

Results

Following SAH, systemic IL-6 levels increased rapidly, whereas IL-10 levels were reduced. Neutrophils were increased both in the brain and in the blood reflecting local and peripheral inflammation following SAH. More intracerebral pro-inflammatory monocytes were found at early time points. Astrocyte and microglia activation were also increased, and mice had severe motor deficits, which were associated with an increase in the percentage of caspase-3-positive apoptotic neurons. Similarly, we found that IL-6 levels in patients were rapidly increased following SAH. ICAM-1, bFGF, IL-7, IL-12p40, and MCP-4 variations over time were different between SAH patients with good versus bad outcomes. Moreover, high levels of Flt-1 and VEGF at admission were associated with worse outcomes.

Conclusion

SAH induces an early intracerebral infiltration and peripheral activation of innate immune cells. Furthermore, microglia and astrocytic activation are present at later time points. Our human and mouse data illustrate that SAH is a systemic inflammatory disease and that immune cells represent potential therapeutic targets to help this population of patients in need of new treatments.
A maple syrup extract alters lipid metabolism in obese type 2 diabetic model mice
Authors: Toyoda Tsudoi , Kamei Asuka , Ishijima Tomoko , Abe Keiko , Okada Shinji
Published: December 2019

Background

Some polyphenols are known to improve the symptoms of diabetes. In the present study, we investigated the effects of a polyphenol-rich extract of maple syrup (MSx) on a diabetic mouse model.

Methods

KK-Aymice were fed a normal or 0.05% MSx-supplemented diet for 42 days. Body weight, food intake, serum biochemical parameters, and fecal total bile acid were measured. Gene expression of liver and epididymal white adipose tissue (WAT) and cecal microbiota were analyzed. Data were analyzed with an unpaired two-tailed Student’sttest or Welch’sttest according to the results of theFtest.

Results

Serum low-density lipoprotein cholesterol levels were significantly reduced in mice that consumed MSx. Hepatic genes related to fatty acid degradation and cholesterol catabolism were upregulated in mice that consumed MSx. In contrast, the expression of genes related to lipid metabolism in WAT was unaffected by the intake of MSx. There were no significant differences between the two groups in terms of total bile acid level in the feces and the relative abundance of bacteria in the cecum.

Conclusion

Our results primarily indicate that MSx can help alleviate one of the symptoms of dyslipidemia.
Concordance between sequential transbronchial lung cryobiopsy and surgical lung biopsy in patients with diffuse interstitial lung disease
Authors: Zaizen Yoshiaki , Kohashi Yasuo , Kuroda Kishio , Tabata Kazuhiro , Kitamura Yuka , Hebisawa Akira , Saito Yuji , Fukuoka Junya
Published: December 2019

Background

Increasing evidence indicates the utility of transbronchial lung cryobiopsy (TBLC) for the diagnosis of interstitial lung disease (ILD). However, only one study has compared TBLC and surgical lung biopsy (SLB) performed on the same patients.

Methods

We identified seven patients with ILD with TBLC and SLB. We evaluated the clinical characteristics and made a pathological diagnosis based on the official ATS/ERS/JRS/ALAT clinical practice guideline of idiopathic pulmonary fibrosis with both TBLC and SLB.

Results

Six cases were diagnosed as Usual interstitial pneumonia (UIP) in both TBLC and SLB. One case was diagnosed as indeterminate for UIP with TBLC and probable UIP with SLB. Etiological diagnosis with TBLC and SLB were concordant in 2 cases of idiopathic pulmonary fibrosis (IPF) but discordant for other diagnoses. Major histological findings of UIP including dense fibrosis, peripheral distribution, and fibroblastic foci showed high concordance between TBLC and SLB, which implies that TBLC can reliably detect these features. In contrast, loose fibrosis, cellular infiltration, and airway disease showed poor concordance between the two methods.

Conclusion

Our study showed that TBLC is useful for UIP diagnosis but not for other ILD. With a multidisciplinary approach, diagnosis of IPF may be determined by TBLC, whereas ILD other than IPF may require SLB.
Shisa3 brakes resistance to EGFR-TKIs in lung adenocarcinoma by suppressing cancer stem cell properties
Authors: Si Jiahui , Ma Yuanyuan , Bi Ji Wang , Xiong Ying , Lv Chao , Li Shaolei , Wu Nan , Yang Yue
Published: December 2019

Background

Although EGFR tyrosine kinase inhibitors (EGFR-TKIs) are beneficial to lung adenocarcinoma patients with sensitive EGFR mutations, resistance to these inhibitors induces a cancer stem cell (CSC) phenotype. Here, we clarify the function and molecular mechanism of shisa3 as a suppressor that can reverse EGFR-TKI resistance and inhibit CSC properties.

Methods

The suppresser genes involved in EGFR-TKI resistance were identified and validated by transcriptome sequencing, quantitative real-time PCR (qRT-PCR) and immunohistochemistry. Biological function analyses, cell half maximal inhibitory concentration (IC50), self-renewal, and migration and invasion capacities, were detected by CCK8, sphere formation and Transwell assays. Tumorigenesis and therapeutic effects were investigated in nonobese diabetic/severe combined immunodeficiency (nod-scid) mice. The underlying mechanisms were explored by Western blot and immunoprecipitation analyses.

Results

We found that low expression of shisa3 was related to EGFR-TKI resistance in lung adenocarcinoma patients. Ectopic overexpression of shisa3 inhibited CSC properties and the cell cycle in the lung adenocarcinoma cells resistant to gefitinib/osimertinib. In contrast, suppression of shisa3 promoted CSC phenotypes and the cell cycle in the cells sensitive to EGFR-TKIs. For TKI-resistant PC9/ER tumors in nod-scid mice, overexpressed shisa3 had a significant inhibitory effect. In addition, we verified that shisa3 inhibited EGFR-TKI resistance by interacting with FGFR1/3 to regulate AKT/mTOR signaling. Furthermore, combinational administration of inhibitors of FGFR/AKT/mTOR and cell cycle signaling could overcome EGFR-TKI resistance associated with shisa3-mediated CSC capacities in vivo.

Conclusion

Taken together, shisa3 was identified as a brake to EGFR-TKI resistance and CSC characteristics, probably through the FGFR/AKT/mTOR and cell cycle pathways, indicating that shisa3 and concomitant inhibition of its regulated signaling may be a promising therapeutic strategy for reversing EGFR-TKI resistance.
Effect of tobacco smoking on the epigenetic age of human respiratory organs
Authors: Wu Xiaohui , Huang Qingsheng , Javed Ruheena , Zhong Jiayong , Gao Huan , Liang Huiying
Published: December 2019

Background

Smoking leads to the aging of organs. However, no studies have been conducted to quantify the effect of smoking on the aging of respiratory organs and the aging-reversing ability of smoking cessation.

Results

We collected genome-wide methylation datasets of buccal cells, airway cells, esophagus tissue, and lung tissue from non-smokers, smokers, and ex-smokers. We used the “epigenetic clock” method to quantify the epigenetic age acceleration in the four organs. The statistical analyses showed the following: (1) Smoking increased the epigenetic age of airway cells by an average of 4.9 years and lung tissue by 4.3 years. (2) After smoking ceased, the epigenetic age acceleration in airway cells (but not in lung tissue) slowed to a level that non-smokers had. (3) The epigenetic age acceleration in airway cells and lung tissue showed no gender difference.

Conclusions

Smoking can accelerate the epigenetic age of human respiratory organs, but the effect varies among organs and can be reversed by smoking cessation. Our study provides a powerful incentive to reduce tobacco consumption autonomously.
Diagnosis of Vespa affinis venom allergy: use of immunochemical methods and a passive basophil activation test
Authors: Gunasekara Peshala , Handunnetti S. M. , Premawansa Sunil , Kaluarachchi Pradeep , Karunatilake Chandima , Ratnayake Indra P. , Dias R. K. S. , Premakumara G. A. S. , Dasanayake W. M. D. K. , Seneviratne Suranjith L. , de Silva Rajiva
Published: December 2019

Background

Allergy toVespa affinisvenom is common in the Asia Pacific region. Venom preparations for diagnosis are not commercially available for this species.

Methods

The prominent allergens inV. affinisvenom were identifiedusing immunochemical methods. Use of ImmunoCAP ofVespula vulgariscrude venom/its components and a passive basophil activation test (BAT) in the diagnosis of patients who had anaphylaxis toV. affinisvenom (n = 30) were also accessed. The IgE double-positivity rates (positive to both hornet and honeybee) in ImmunoCAP and the passive BAT were determined.

Results

High IgE reactivity was seen with the five allergens inV. affinisvenom; 96% (29/30) for 34 and 24 kDa, 93% (28/30) for 45 kDa and 90% (27/30) reactivity for the 100 and 80 kDa respectively. IgE cross-reactivity was low with ImmunoCAP usingV. vulgarisvenom (43%; 13/30) and Ves v1 (3%; 1/30), but relatively high with Ves v5 (73%; 22/30). All patients (100%) were positive toV. affinisvenom in passive BAT. In ImmunoCAP, a high double-positivity rate (76%; 23/30) was detected while no double-positivity was detected in passive BAT.

Conclusions

High IgE reactivity for five allergens ofV. affinispoints to the potential of using these allergens in component resolved diagnosis (CRD). The passive BAT has shown its importance as a promising diagnostic tool with high accuracy. It would be particularly useful in cases with doubtful double-positive results of other diagnostic tests.
The validity and applicability of CAD-RADS in the management of patients with coronary artery disease
Authors: Basha Mohammad Abd Alkhalik , Aly Sameh Abdelaziz , Ismail Ahmad Abdel Azim , Bahaaeldin Hanan A. , Shehata Samar Mohamad
Published: December 2019

Background

The coronary artery disease reporting and data system (CAD-RADS) is designed for a uniform standardization of coronary computed tomography angiography (CCTA) reporting and further management recommendations of coronary artery disease (CAD). This study aimed to assess clinical validity, applicability, and reproducibility of CAD-RADS in the management of patients with CAD.

Methods and results

A single-center prospective study included 287 patients with clinically suspected or operated CAD who underwent CCTA. Four reviewers evaluated the CCTA images independently and assigned a CAD-RADS category to each patient. The invasive coronary angiography (ICA) was used as the reference standard for calculating diagnostic performance of CAD-RADS for categorizing the degree of coronary artery stenosis. The intra-class correlation (ICC) was used to test the inter-reviewer agreement (IRA). Reporting was provided to referring consultants according to the CAD-RADS. Based on ICA results, we have 156 patients with non-significant CAD and 131 patients with significant CAD. On a patient-based analysis, regarding those patients classified as CAD-RADS 4 and CAD-RADS 5 for predicting significant CAD, the CAD-RADS had a sensitivity, specificity, and an accuracy of 100%, 96.8 to 98.7%, and 98.3 to 99.3%, respectively, depending on the reviewer. There was an excellent IRA for CAD-RADS categories (ICC = 0.9862). The best cutoff value for predicting significant CAD was > CAD-RADS 3. Eighty-seven percentage of referring consultants considered CAD-RADS reporting system to be “quite helpful” or “completely helpful” for clinical decision-making in CAD.

Conclusion

CAD-RADS is valuable for improving CCTA structural reports and facilitating decision-making with high diagnostic accuracy and high reproducibility.
Height estimation from head dimensions in South-South Nigeria
Authors: Eboh Dennis E. O. , Ohaju-Obodo John O.
Published: December 2019

Background

Height estimation is an important stage of forensic investigation to identify an unknown person. The problem of unidentified human remains in the study area, due to local militia activities, kidnapping, and murder, necessitated this study to assess the correlation between the body height and head dimensions and to formulate regression models for estimation of height that are population and gender-specific.

Materials and methods

The study involved 952 subjects (464 males and 488 females), aged 18–30 years, from five ethnic groups and sampled from six universities in South-South Nigeria. Stature, head circumference, head length, and head width were measured using a standard anthropometric method. The data collected were analyzed using IBM SPSS Statistics 20. Statistical significance was pegged at p < 0.05.

Results

There was a significantly greater head dimension in males compared to females. There was a significant relationship between height and head dimensions in the majority of data. The relationship of the head circumference with stature was strongest in male data among the Bekwara and combined data among the Esan and Urhobo. Regarding the head length, the strongest relationship was in females and combined data among Bekwara, and males and combined data among the Ogbia had the strongest relationship. The relationship of stature with the head width was strongest in males and combined data among the Bekwara, and female data among the Ogbia.

Conclusion

This study showed that head dimensions can be used as tools in the height reconstruction of an individual using simple and multiple regression models, and this has medico-legal implication.
Insect fauna of pests and their natural enemies inhabiting sorghum-panicles in Egypt
Authors: El-Gepaly Hosam M. K. H.
Published: December 2019

Sorghum panicles offer a very rich microenvironment for many insect pest species and their natural enemies. Thirty arthropod species belonging to 28 families, pertaining to 9 orders were obtained from sorghum panicles planted in Sohag Governorate, Egypt, during the 3 successive seasons of 2016–2018. Out of these species were 14 pests, 16 predators, and 3 parasitoids. Lepidopteran and hemipteran pests were the most dominant species-infested sorghum-panicles during the mature stages of the panicles. Three microlepidopteran pests, the noctuid,Eublemma(Autoba)gayneri(Roth.); the pyralid,Cryptoblabes gnidiellaMillière, and the cosmopterigid,Pyroderces simplexWalsingham, were recorded as major pest species infesting sorghum panicles in Sohag Governorate. The dipteran parasitoid species,Nemorilla floralis(Fallen) (Tachinidae) emerged from the pupae of theE. gayneriandC. gnidiella, while the hymenopteran parasitoid,Brachymeria aegyptiaca(Chalcididae) was obtained from the pupae of all the studied microlepidopteran pests. Spiders, coccinellids, andOriusspp. were the dominant predators collected form panicles. Post-harvest, larvae, and pupae of lepidopteran pests, especiallyP. simplexrecorded (147, 96, and 79 larvae) and (47, 30, and 73 pupae)/10 panicles in 2016, 2017, and 2018 seasons, respectively.
Interpersonal violence and mental health outcomes following disaster
Authors: Molyneaux Robyn , Gibbs Lisa , Bryant Richard A. , Humphreys Cathy , Hegarty Kelsey , Kellett Connie , Gallagher H. Colin , Block Karen , Harms Louise , Richardson John F. , Alkemade Nathan , Forbes David
Published: December 2019

Background

Disasters pose a documented risk to mental health, with a range of peri- and post-disaster factors (both pre-existing and disaster-precipitated) linked to adverse outcomes. Among these, increasing empirical attention is being paid to the relation between disasters and violence.

Aims

This study examined self-reported experiences of assault or violence victimisation among communities affected by high, medium, and low disaster severity following the 2009 bushfires in Victoria, Australia. The association between violence, mental health outcomes and alcohol misuse was also investigated.

Method

Participants were 1016 adults from high-, medium- and low-affected communities, 3–4 years after an Australian bushfire disaster. Rates of reported violence were compared by areas of bushfire-affectedness. Logistic regression models were applied separately to men and women to assess the experience of violence in predicting general and fire-related post-traumatic stress disorder, depression and alcohol misuse.

Results

Reports of experiencing violence were significantly higher among high bushfire-affected compared with low bushfire-affected regions. Analyses indicated the significant relationship between disaster-affectedness and violence was observed for women only, with rates of 1.0, 0 and 7.4% in low, medium and high bushfire-affected areas, respectively. Among women living in high bushfire-affected areas, negative change to income was associated with an increased likelihood of experiencing violence (odds ratio, 4.68). For women, post-disaster violence was associated with more severe post-traumatic stress disorder and depression symptoms.

Conclusions

Women residing within high bushfire-affected communities experienced the highest levels of violence. These post-disaster experiences of violence are associated with post-disaster changes to income and with post-traumatic stress disorder and depression symptoms among women. These findings have critical implications for the assessment of, and interventions for, women experiencing or at risk of violence post-disaster.
Choosing Death: The Making of Martyrs in Early American Criminal Narratives
Authors: Eyring Mary Kathleen
Published: December 2019

In 1701 Puritan minister John Rogers published the criminal narrative of Esther Rodgers, who had been convicted of infanticide and executed. Esther Rodgers appears in Rogers’s Death the Certain Wages of Sin not as a depraved criminal or even a repentant sinner but as a courageous Christian martyr. Much of the productive recent scholarship on Rodgers studies the way her criminal status operated in the public sphere generally or print culture specifically, but the literary construction of her legal criminal status reveals a larger negotiation over marginalized individuals’ ability to consent and dissent in early New England and an unexpected orientation toward choice in early American literature. Rogers and his contemporaries engaged the conventions of the early modern criminal narrative to organize the chaos of maternal tragedy according to fictions of choice and the conventions of ancient and antique scripture to recast execution as a prelude to salvation. But in the ill-fitting spaces between the criminal’s story and the forms to which these authors suited it, readers could see a character who was something more—or less—than murderer or martyr: a sympathetic victim granted the ability to consent only in order to certify her legal culpability, religious conversion, and complicity in the macabre spectacle of her own public execution.
Reconstructing Revenge: Race and Justice after the Civil War
Authors: Laski Gregory
Published: December 2019

This essay reconsiders the politics of African American literature after the Civil War by focusing on revenge as a response to the wrong of slavery. Though forgiveness dominates literary and historical scholarship, I assemble an archive of real and imagined instances of vengeance in black-authored texts from the period following formal emancipation to the dawn of the twentieth century: the petitions of the freedmen of Edisto Island, South Carolina; the minutes of the 1865 Virginia State Convention of Colored People; the narrative of the ex-slave Samuel Hall; and the Colored American Magazine’s coverage of the lynching of Louis Wright. Reading these works alongside Pauline E. Hopkins’s Winona (1902), I show how her novel develops a philosophy of righteous revenge that reclaims the true meaning of justice in a democracy. Ultimately, this archive can help us not only to examine anew a neglected literary period but also to reimagine racial justice, then and now.
Exporting Manhood: Adaptation and the Post-NAFTA Latinx Novel
Authors: Varon Alberto
Published: December 2019

This essay examines the figure of the vanishing male in a trio of novels—Cristina Rivera Garza’s La muerte me da, Luis Alberto Urrea’s Into the Beautiful North, and James Cañon’s Tales from the Town of Widows—whose circa-2007 publication speaks to the fifteen-year legacy of the North American Free Trade Agreement. The essay argues for a notion of “adaptive belonging” as a formal and political strategy for coping with neoliberal policies’ hemispheric shift.
Beyond Protest: Voice and Exit in Contemporary American Poetry
Authors: McKelvey Seth
Published: December 2019

In liberal political economy, voice (voting, complaining, etc.) and exit (dissociating, boycotting, etc.) are the two primary feedback mechanisms for improving large organizations. When it comes to the political state, however, exit is off the table: no one leaves the state, so dissenters must articulate their dissatisfaction within systems of representation. For any politics opposed to the state, voice is all one has. This essay reads Juliana Spahr’s This Connection of Everyone with Lungs (2005) and Well Then There Now (2011) and Nathaniel Mackey’s Splay Anthem (2006) as exemplars of an impetus in contemporary American poetry to enable exit from the state. However, this project inevitably fails, and the poetics of exit resorts to a renewed voice. Rather than a complaint addressed to authority, these poets’ voiced demand for exit now forms the potential basis of new political collectivities, people joined by a shared desire to leave the state.
Intervention, Encroachment
Authors: Fenves Peter
Published: December 2019

This article shows that Walter Benjamin's initial characterization of the “sphere of moral relations” as divided by two mutually exclusive poles, law and justice, without a mediating third term such as “ethical life” or “moral education,” generates the basis for his critique of violence. After describing how this characterization of moral relations both reproduces and inverts the underlying schema of Kant's Metaphysics of Morals, the article outlines the procedure whereby Benjamin's initial definition of violence as an “intervention” into moral relations is supplemented by a corresponding definition of legal “encroachment”: law presents itself as a resolution or “expiation” of morally ambiguous relations; but insofar as the “sphere of moral relations” is split between the two poles of law and justice, such expiation conceals and thus intensifies the moral ambiguity of the situation on which law encroaches. The article concludes by suggesting that contemporary encroachments of law constitute a danger, akin to the growth of nihilism (in Nietzsche's sense), to which Benjamin's essay seeks to alert its readers.
Rechtsphilosophie after the War
Authors: Ng Julia
Published: December 2019

What resources does philosophy have at its disposal for a critical analysis of the role of violence in a war of all against all? Faced with this question, Walter Benjamin discovers that legal positivism, which believes in the capacity to derive how law ought to be from the sheer concept of a “correct” law, is constitutively blind to the possibility that values may be misaligned with law, and that the basic structures of law and consensus might come after the fact of power. Drawing on the work of contemporaneous legal theorist Leonard Nelson, this article argues that Benjamin developed a potent critique of the dialectic of recognition at work in the legitimation of violence, making way instead for an analysis of what remains unrecognizable to the normative order: power, loitering as a “nonvalue” in the gap between values and legal ends.
Conscription and Critique
Authors: Ertür Başak
Published: December 2019

This article focuses on the discussion of general conscription in Walter Benjamin's 1921 essay “Toward the Critique of Violence.” In the essay, Benjamin presents conscription or compulsory military service alongside his discussions of police violence and capital punishment, and as one manifestation of legal violence in which law-preserving and law-positing forms of violence coincide and mix. This article proposes that Benjamin's discussion of conscription should be read as a formal model for understanding how legal subjectification in the modern state works more generally, and how it circumscribes critique. This reading is offered through a series of snapshots of various veins and elements in Benjamin's essay, while also connecting this interpretation to the work of a number of contemporary scholars of colonialism, namely Talal Asad, David Scott, and Samera Esmeir, who all invoke conscription as a particularly powerful metaphor for modern law's tendency to colonize critique.
Benjamin on the Border
Authors: Ty Michelle
Published: December 2019

This essay offers a critique of contemporary regimes of migrant repression in light of Walter Benjamin's reflections on borders and their constitutive relation to legal violence. In paragraphs 15–17 of “Toward the Critique of Violence,” Benjamin evokes the legend of Niobe, who, in a fatal stroke of retaliation by the gods, is turned into stone—transformed at once into the grief-stricken precipitate of mythic violence and into an enduring marker of the boundary between two separate and unequal worlds. From this tale, Benjamin unfolds an understanding of the border, not as the mere backdrop for the use of force nor as a territorial demarcation that states may justifiably defend, but as the very instantiation of legal violence (in its originary form). He contends, further, that establishing borders is a technic of ambiguity, designed to represent inequality as a single line that may not be transgressed, and produces, too, a nexus of guilt in relation to which one who “steps over” becomes fated to illegality and to the violence that the latter ostensibly warrants. In drawing attention to the inextricability of borders and the violence that they instantiate, and in exposing the identity between mythic retribution and Grenzsetzung (border-positing), Benjamin offers insight into current practices of criminalizing border crossers and militarizing borderlands. Some promise for the negation of the order that secures those who traverse the border as fatalities of law is found in the essay's final moments, when Benjamin imagines extralegal justice, or divine violence, as a de-creative force that annihilates the borders that confer the sentence of life-destroying guilt.
Accessing financial reports and corporate events with GetDFPData
Authors: Perlin Marcelo S. , Kirch Guilherme , Vancin Daniel
Published: December 2019

This paper presents and discusses the contributions and usage of GetDFPData, which is an open and free software for accessing corporate data from the Brazilian financial exchange, B3. The distribution and popularization of an open-source algorithm for gathering and managing financial data can improve finance research and practice in two ways. First, it increases the number and quality of research in accounting and corporate finance. Secondly, it provides retail investors with reliable data that may help their allocation decisions. Initially, we analyze the use of this kind of data in a list of recent publications to show the relevance of financial reports and corporate events data for research in the fields of accounting and finance. Finally, we illustrate the use of GetDFPData in large-scale research, an empirical and reproducible example of a corporate finance study.
Investigating gateway effects using the PATH study
Authors: Lee Peter , Fry John
Published: December 2019

Background: A recent meta-analysis of nine cohort studies in youths reported that baseline ever e-cigarette use strongly predicted cigarette smoking initiation in the next 6-18 months, with an adjusted odds ratio (OR) of 3.62 (95% confidence interval 2.42-5.41). A recent e-cigarette review agreed there was substantial evidence for this “gateway effect”. As the number of confounders considered in the studies was limited we investigated whether the effect might have resulted from inadequate adjustment, using Waves 1 and 2 of the US PATH study.

Methods: Our main analyses considered Wave 1 never cigarette smokers who, at Wave 2, had data on smoking initiation.We constructed a propensity score for ever e-cigarette use from Wave 1 variables, using this to predict ever cigarette smoking. Sensitivity analyses accounted for other tobacco product use, linked current e-cigarette use to subsequent current smoking, or used propensity scores for ever smoking or ever tobacco product use as predictors. We also considered predictors using data from both waves, attempting to reduce residual confounding from misclassified responses.

Results: Adjustment for propensity dramatically reduced the unadjusted OR of 5.70 (4.33-7.50) to 2.48 (1.85-3.31), 2.47 (1.79-3.42) or 1.85 (1.35-2.53), whether adjustment was made as quintiles, as a continuous variable or for the individual variables. Additional adjustment for other tobacco products reduced this last OR to 1.59 (1.14-2.20). Sensitivity analyses confirmed adjustment removed most of the gateway effect. Control for residual confounding also reduced the association.

Conclusions: We found that confounding is a major factor, explaining most of the observed gateway effect. However, our analyses are limited by small numbers of new smokers considered and the possibility of over-adjustment if taking up e-cigarettes affects some predictor variables. Further analyses are intended using Wave 3 data to try to minimize these problems, and clarify the extent of any true gateway effect.