bluuebunny/crossref_metadata_2025 huggingface dataset:
Attitude control of nanosatellite with single thruster using relative displacements of movable unit
Authors: Doroshin Anton V , Eremenko Alexander V
Published: September 2020

The attitude dynamics of a nanosatellite (NS) with one movable unit changing its angular position relative to a main body of the nanosatellite is considered. This relative movability of the unit can be implemented with the help of flexible rods of variable length connecting the unit with the main body. Change of the relative position of the movable unit shifts the center of mass of the entire mechanical system. The NS has a single jet engine rigidly mounted into the NS main body. The shift of the mass center creates an arm of the jet-engine thrust and a corresponding control torque. Schemes to control the attitude dynamics of the satellite using the movability of its unit are developed, using both the torque from the engine and inertia change.
Morroniside suppresses hydrogen peroxide-stimulated autophagy and apoptosis in rat ovarian granulosa cells through the PI3K/AKT/mTOR pathway
Authors: Deng D , Yan J , Wu Y , Wu K , Li W
Published: September 2020

Previous evidences have indicated that granulosa cells play a critical role in follicular growth. Hydrogen peroxide (H2O2)-induced oxidative stress has been associated with ovarian granulosa cell apoptosis and ovarian function. Recently, a study highlighted the protective role of morroniside against H2O2-induced damage. In this study, we aimed to investigate the effects of morroniside on H2O2-stimulated rat ovarian granulosa cells and its underlying molecular mechanisms. Our results showed that H2O2 treatment suppressed cell survival and increased apoptosis in rat granulosa cells, while treatment with morroniside markedly increased H2O2-induced granulosa cell survival in a dose-dependent manner (0, 10, 50 and 100 µM). Moreover, treatment with 50 µM morroniside impeded H2O2-induced cell apoptosis. An elevation in intracellular ROS, MDA, SOD, GSH-Px, and CAT level was observed in H2O2-induced granulosa cells; however, this effect was abrogated by morroniside treatment. Further studies suggested that administration of morroniside inhibited H2O2-induced granulosa cell apoptosis and caspase-3 activity. In addition, after morroniside treatment of H2O2-stimulated granulosa cells, autophagy-related protein (LC3-II/LC3-I ratio) and beclin-1 expression was decreased and p62 level was increased. Interestingly, we found that morroniside treatment activated the PI3K/AKT/mTOR pathway in H2O2-stimulated granulosa cells. Finally, we showed that treatment with PI3K and mTOR inhibitors reversed the protective effects of morroniside on H2O2-induced granulosa cells. Taken together, our data suggest that treatment with morroniside decreased apoptosis, autophagy, and oxidative stress in rat granulosa cells through the PI3K/AKT/mTOR pathway.
Morbidity and mortality following major large bowel resection for colorectal cancer detected by a population-based screening program
Authors: Paszat Lawrence F , Sutradhar Rinku , Corn Elyse , Luo Jin , Baxter Nancy N , Tinmouth Jill , Rabeneck Linda
Published: September 2020

Background and aims

In 2008, Ontario initiated a population-based colorectal screening program using guaiac fecal occult blood testing. This work was undertaken to fill a major gap in knowledge by estimating serious post-operative complications and mortality following major large bowel resection of colorectal cancer detected by a population-based screening program.

Methods

We identified persons with a first positive fecal occult blood result between 2008 and 2016, at the age of 50–74 years, who underwent a colonoscopy within 6 months, and proceeded to major large bowel resection for colon cancer within 6 months or rectosigmoid/rectal cancer within 12 months, and identified an unscreened cohort of resected cases diagnosed during the same years at the age of 50–74 years. We identified serious postoperative complications and readmissions ≤30 days following resection, and postoperative mortality ≤30 days, and between 31 and 90 days among the screen-detected and the unscreened cohorts.

Results

Serious post-operative complications or readmissions within 30 days were observed among 1476/4999 (29.5%) cases in the screen-detected cohort, and among 3060/8848 (34.6%) unscreened cases. Mortality within 30 days was 43/4999 (0.9%) among the screen-detected cohort, and 208/8848 (2.4%) among the unscreened cohort. Among 30 day survivors, mortality between 31 and 90 days was 28/4956 (0.6%) and 111/8640 (1.3%), respectively.

Conclusion

Serious post-operative complications, readmissions, and mortality may be more common following major large bowel resection for colorectal cancer between the ages of 50 and 74 among unscreened compared to screen-detected cases.
Lived Experiences for Supportive Care Needs of Women with Breast Cancer-Related Lymphedema: A Phenomenological Study
Authors: Arikan Dönmez Ayşe , Kuru Alici Nilgün , Borman Pınar
Published: September 2020

This descriptive phenomenological study was conducted to explore the lived experiences for supportive care needs of women with breast cancer-related lymphedema. Purposive sampling was used to recruit participants. In-depth, semi-structured interviews were conducted to collect data. Thematic analysis method was used for data analysis. Data saturation was achieved after interviewing 19 participants. The study was divided into four main themes and nine subthemes: physical (caused by difficulties in performing household chores, limitations in performing self-care activities, and challenges in shopping), psychosocial (being addicted to someone else in daily life, uncertainty about the future, social, and religious support), healthcare systems and information (attention from healthcare professionals, education and lifestyle advices, and access to healthcare sources), and financial supportive care needs. Women experience various SCNs in their daily lives. Provision of supportive care from both family members or others and healthcare professionals could ease the daily lives, improve physical, and psychosocial well-being.
Sequential Versus Concurrent Thoracic Radiotherapy in Combination With Cisplatin and Etoposide for N3 Limited-Stage Small-Cell Lung Cancer
Authors: Wang Zhenbo , Wan Jinliang , Liu Changmin , Li Lei , Dong Xinjun , Geng Haitao
Published: September 2020

At present, concurrent chemoradiotherapy (CRT) is considered the standard treatment of limited-stage small cell lung cancer (LS-SCLC). However, LS-SCLC is highly heterogeneous in the T stage, N stage, and prognosis. Increasing evidence has shown that individual treatment should be considered when treating LS-SCLC patients. The aim of the present study was to explore the optimal combination model of thoracic radiotherapy (TRT) and chemotherapy in N3 LS-SCLC. We retrospectively analyzed 93 N3 LS-SCLC patients treated in the Department of Oncology of Binzhou Medical University Hospital (Shandong, China) between March 2010 and October 2015. A total of 52 (52/93; 55.9%) patients received sequential CRT, and 41 (41/93; 44.1%) patients received concurrent CRT. All patients received 4-6 cycles of chemotherapy and TRT (50-60 Gy). The median follow-up time was 25.4 months (range was 6-65 months).The overall response rate was 88.5% in the sequential CRT group (9.6% complete response rate and 78.8% partial response rate) and 90.2% in the concurrent CRT group (14.6% complete response rate and 75.6% partial response rate). The PFS and OS were 15.4 months and 19.1 months in sequential CRT group, and 16.9 months and 20.5 months in concurrent CRT group. There was no significant difference in treatment response rate, PFS, and OS between sequential and concurrent CRT patients. The most common treatment-related toxicities were nausea/vomiting, neutropenia, and esophagitis. In conclusion, when concurrent CRT is performed in N3 LS-SCLC patients, tolerance to treatment should be fully considered. In our study, sequential CRT and concurrent CRT showed the same efficacy, and sequential CRT demonstrated better tolerance. However, these results require confirmation in future follow-up studies.
A Persistent Gender Bias in Chilean Press: The Influence of Journalist’s Gender and Editor’s Gender
Authors: Leiva Ricardo , Kimber David
Published: September 2020

There is a lot of evidence about gender bias in the media, but not clear evidence about its causes. In this article, we study the influence of journalist’s gender and editor’s gender on gender bias in the Chilean press through time. Based on content analysis of 2,645 news articles from Chilean leading newspapers and logistic regression, results confirm the relevance of gender of both journalists and editors on the presence of gender bias in the Chilean press, being a permanent behavior through time. Our research suggests that the more women in the newsrooms, the greater women’s representation by the news media.
Diffuse Subamniotic Calcification: A Novel Pattern of Placental Calcification
Authors: Nohr Erik W , Wright James R
Published: September 2020

Two primary patterns of placental calcification have been described, each with distinctive pathophysiology and clinical relevance. We report a novel pattern of diffuse subamniotic calcification. It occurred in a 25-week placenta involved by recurrent chronic histiocytic intervillositis (CHI) associated with severe intrauterine growth restriction (IUGR) and intrauterine fetal demise (IUFD). This was the mother’s third stillbirth related to CHI, despite treatment with intravenous immunoglobulin (IVIG), prednisone, low-molecular-weight heparin, and acetylsalicylic acid (ASA). On placental examination, the majority of the fetal surface was calcified. This variably formed a continuous band or dispersed calcium microparticles. Electron microscopy demonstrated associated electron dense deposits highly suggestive of immune complex deposition. CHI explains recurrent IUGR and stillbirth, but has not been associated with calcification or immune complex deposition. We hypothesize IVIG therapy may have caused immune complex deposition and subsequent dystrophic calcification, supported by its rare association with immune complex deposition disorders in the kidney. Identification of additional cases with this pattern of calcification, with additional studies on fresh tissue including immunofluorescence, electron microscopy and mass spectrometry, may aid in elucidating the underlying pathophysiology and clinical significance of this unusual lesion.
First Approach of Abiotic Drivers of Soil CO2 Efflux in Barro Colorado Island, Panama
Authors: Sugasti Lourdes , Pinzón Reinhardt
Published: September 2020

Soil CO2 fluxes from tropical forests into the atmosphere are expected to increase due to global warming. Studies of environmental conditions that contribute to carbon flux are now an important focus for climate change research. However, carbon flux in tropical areas such as Panama has received less attention. In Panama, water sources, rainforests, and soil conditions are vital natural resources, particularly within the Panama Canal watershed. Mature and secondary forests represent around 60% of Panama land cover. Secondary forests are considered potential carbon sinks and they are of economic interest as a means of mitigating increasing anthropogenic CO2 emissions; however, the dynamics of carbon fluxes in the soil of secondary forests remain poorly understood. This research investigated which environmental factors influence soil CO2 efflux. We used a closed chamber method to measure soil CO2 in the tropical forest of Barro Colorado Island, Panama. During 2016 to 2017, humidity had a significant effect on CO2 flux (average: 4.36 μmol/m2s), which was substantially lower than expected for this type of tropical forest. These findings will contribute to a better understanding of the complex and dynamic interrelationships between the water and carbon cycle, as well as abiotic drivers of soil CO2 fluxes. Our use of soil respiration chambers and infrared gas analyzer systems represents an innovative contribution to the water-carbon nexus of Panama and potentially of other countries.
Socioeconomic Status and Melanoma in Canada: A Systematic Review
Authors: Li Heidi Oi-Yee , Bailey Adrian Joseph-Michel , Grose Elysia , McDonald James Ted , Quimby Alexandra , Johnson-Obaseki Stephanie , Nessim Carolyn
Published: September 2020

As melanoma is one of the leading cancers in average years of life lost per death from disease, screening and early diagnosis are imperative to decrease morbidity and mortality. Socioeconomic status (SES) has been shown to be associated with melanoma incidence. However, it is unclear if this association holds true in universal healthcare systems where screening, diagnostic, and treatment services are available to all patients. The objective of this systematic review was to evaluate the evidence on the association of SES and melanoma incidence in Canada. A comprehensive search of PubMed and EMBASE yielded 7 studies reporting on melanoma incidence or outcomes with respect to SES in Canada. High SES was associated with increased melanoma incidence across all studies, which encompassed all Canadian provinces, and time periods spanning from 1979 to 2012. Studies also reported an increasing incidence of melanoma over time. There were substantial discrepancies in melanoma incidence across Canadian provinces, after controlling for SES and demographic characteristics. Populations of lower SES and living within certain healthcare regions had increased risks of advanced melanoma at diagnosis. This review highlights the potential for inequities in access to care even within a universal healthcare system. Future research is needed to characterize specific risk factors within different patient groups and within the universal health system context in order to implement targeted strategies to lower melanoma incidence, morbidity, and mortality.
Discourses of Choice in Australian Pay TV
Authors: Rizzo Teresa
Published: September 2020

This essay examines discourses of viewer choice in Australian pay TV and how central to them is the illusion of an all-powerful viewer in control of programming, who can watch what they want when they want. Drawing on the work of Karen Lury, it theorises programming and scheduling practices in the industry, focusing on the importance of this idea of viewing. It then considers how the introduction of a personal digital recorder (PDR) type device — specifically Foxtel's iQ — encourages practices linked to choice such as times/lifting, co-participation and customisation, and looks at how the use of such a device has more in common with a download culture where users search for media rather than tune in at a particular time. The essay explores how the iQ extends the discourse of viewer choice.
Freedom to Work: The Impact off Wireless on Labour Politics
Authors: Gregg Melissa
Published: September 2020

As the use of wireless communication technologies begins to settle into particular patterns, this essay considers the impact of such devices on workplace culture — particularly that of the professional middle class engaged in information work. While the study of workplace culture is usually the domain of sociology, management theory or organisational behaviour, media and cultural studies methods such as semiotic and discourse analysis, media consumption and theories of everyday life have a useful role to play in understanding how technology is marketed and subsequently used in and outside work contexts. As a starting point for this kind of approach, the paper combines an account of recent wireless advertising in Australia with research that is developing in ‘production-side cultural studies’ (Liu, 2004; Du Gay, 1997). In recognising the significance of new media technologies in contemporary labour practice and politics, it aims to move discussions beyond the notion of ‘work-life balance’ as a research endpoint to allow more variegated notions of freedom and flexibility for the workplaces of the present and near future.
An Australian Wireless Commons?
Authors: Goggin Gerard
Published: September 2020

In this paper, 1 reflect upon the Australian experience of wireless technologies and cultures, especially focusing on Wi-Fi, WiMax and broadband wireless. It is arguable that the development of these new wireless technologies has taken quite different forms in Australia than it has done in other countries. To approach this question, I consider the concept of a wireless commons and what it signifies, and look at how it could serve to open up Australian debates.
Tourists’ willingness to pay for holiday trip characteristics: A Discrete Choice Experiment
Authors: Boto-García David , Mariel Petr , Pino José Baños , Alvarez Antonio
Published: September 2020

This article studies the marginal rates of substitution and Willingness to Pay for holiday trip characteristics. Using a Discrete Choice Experiment, we examine how much individuals from four cities in Northern Spain are willing to pay for accommodation, mode of transport, travel time and length of stay. We estimate a Latent Class Model that accounts for taste heterogeneity based on sociodemographic characteristics. The welfare loss due to a tourism daily tax is also examined. Our results show that respondents place positive utility to travelling by plane, high-quality accommodation and longer stays. Specifically, they are willing to pay €170 more for plane travelling with respect to the use of car, €120 for staying at a four-star hotel relative to an apartment and €760 for a 10-day trip relative to a 3-day one. A daily tax of €1 per person would produce a larger welfare loss in coastal destinations.
Evaluation of real-time video from the digital indirect ophthalmoscope for telemedicine consultations in retinopathy of prematurity
Authors: Ho Tiffany , Lee Thomas C , Choe Ja-Yoon , Nallasamy Sudha
Published: September 2020

Introduction

This study aimed to evaluate the validity of using real-time video indirect ophthalmoscopy for telemedicine consultations for paediatric retinal findings, using retinopathy of prematurity (ROP) as a model disease.

Methods

An ophthalmologist simultaneously performed and recorded routine ROP screenings on enrolled premature infants (aged ≤30 weeks and weighing <1500 g) using the Keeler digital indirect ophthalmoscope. Examinations were graded as no ROP, mild, type 1 or type 2. Masked to clinical findings, another ophthalmologist reviewed and graded streamed video feed transmitted at 4096 kbps. We compared the sensitivity and specificity of diagnosing ROP via streamed and stored-and-forwarded video clips to the gold-standard in-person examination.

Results

A total of 150 examinations of individual eyes from 34 babies were included. The median postmenstrual age (PMA) at delivery was 24 weeks (range 23–34 weeks), the median birth weight was 630 g (range 455–1530 g) and the median PMA at examination was 37 weeks (range 31–54 weeks). Of those infants with any ROP, the sensitivity and specificity of streamed examinations were 100% and 70.6%, respectively. For type 2 or worse ROP, the sensitivity and specificity were 92.5% and 86.1%, respectively. For type 1 ROP, the sensitivity and specificity were 100% and 99.3%, respectively. Sensitivities (unless already 100%) and specificities were slightly higher for store-and-forward evaluations.

Discussion

Streamed video feed from the digital indirect ophthalmoscope can be utilised to diagnose clinically significant ROP accurately, though store-and-forward video review yielded slightly better results.
Indigeneity and ‘authenticity’ in African trans* activism
Authors: Kolanyane-Kesupile Katlego , McAllister John
Published: September 2020

Most efforts to promote gender equity in sub-Saharan Africa have been rooted in a Western heteronormative framework inherited from colonialism that aims at ‘balancing’ gender rather than deconstructing it. Dismantling this entrenched, though exogenous, binary is a daunting task, especially since, over time, it has become widely accepted as ‘authentically’ African, while the more radical initiatives of African trans* activists are seen as foreign. African trans* activism is theoretically sophisticated, deeply committed, and highly skilled, but its impact has been confined largely to an ‘Afropolitan’ elite. Based on interviews with leading trans* activists, this paper examines some of the key challenges to deconstructing the imported binary at grassroots levels. It looks at how linguistic and cultural particularities affect trans* activism in Africa and proposes new strategies, using lived cultures as a basis, that will be more appropriate and effective in a postcolonial context in which both indigenous and exogenous elements legitimately interact.
A systematic literature review on disinformation: Toward a unified taxonomical framework
Authors: Kapantai Eleni , Christopoulou Androniki , Berberidis Christos , Peristeras Vassilios
Published: September 2020

The scale, volume, and distribution speed of disinformation raise concerns in governments, businesses, and citizens. To respond effectively to this problem, we first need to disambiguate, understand, and clearly define the phenomenon. Our online information landscape is characterized by a variety of different types of false information. There is no commonly agreed typology framework, specific categorization criteria, and explicit definitions as a basis to assist the further investigation of the area. Our work is focused on filling this need. Our contribution is twofold. First, we collect the various implicit and explicit disinformation typologies proposed by scholars. We consolidate the findings following certain design principles to articulate an all-inclusive disinformation typology. Second, we propose three independent dimensions with controlled values per dimension as categorization criteria for all types of disinformation. The taxonomy can promote and support further multidisciplinary research to analyze the special characteristics of the identified disinformation types.
Deformation-assisted joining of tubes to sheets made from dissimilar materials
Authors: Alves Luis M , Afonso Rafael M , Martins Paulo AF
Published: September 2020

Following previous developments of the authors on deformation-assisted joining of metal tube-sheet connections by annular sheet squeezing, it is the aim and objective of this paper to extend the process applicability domain to polymers and composites. The presentation includes an overview of the main operative parameters, typical plastic deformation modes and process workability limits. Experiments and finite element simulations allowed comparing the results obtained with dissimilar materials against those earlier obtained with metal tubes and sheets. Results confirm the possibility of combining dissimilar materials in form-fit and force-fit tube-sheet connections for applications in flexible lightweight structures.
Synthesis, design and operation optimization of a combined cycle integrated energy system including optimization of the seasonal speed of a VLCC
Authors: Sakalis George N , Tzortzis George J , Frangopoulos Christos A
Published: September 2020

The study of an integrated energy system is presented in this article that will cover all types of energy loads (mechanical, electrical, thermal) on a Very Large Crude Carrier (VLCC) with the maximum technically possible and economically feasible exploitation of fuel energy, thus reducing the operating cost and environmental footprint of the ship. There may be a large variety of configurations, design specifications and operating states that can cover the loads, making it necessary to apply synthesis, design and operation optimization of the system. The net present value of the system is selected as the objective function. For this purpose, a superconfiguration of the system is considered, which includes a number of Diesel engines adapted for possible operation in a combined Diesel and Rankine cycle, heat recovery steam generators producing high and low pressure steam, steam turbines that can contribute to propulsion and/or to the electricity production, an exhaust gas boiler and auxiliary boilers, as well as Diesel-generator sets. The synthesis of the system, that is, the components that will finally exist in the system, and their interconnections, the design specification of the components and the operating properties at characteristic operating states of the ship are not predetermined, but they are the result of formal, mathematical optimization. In addition, the speed of the vessel in each state, an important operational variable that has a crucial effect on the propulsion power and thus on the fuel consumption, is also determined by the optimization. The hull characteristics, the loading condition and the weather state are taken into account for the calculation of the propulsion power. For the optimization, proper models of the various components have been developed and the optimization problem is solved by addressing the three levels (synthesis, design, and operation) at a single computational step. The benefits of optimization, as well as the conditions that make the combined cycle economically justified, are demonstrated through an application example. The numerical solution is obtained for various values of fuel price and freight rate, so that the effects of these two crucial parameters on the optimal solution are assessed.
An International Study on Ventricular Assist Device Program Models
Authors: Meehan Karen A. , Suresh Anupama , Combs Pamela S. , Jeevanandam Valluvan
Published: September 2020

Background:

Advanced technology and improved outcomes have led to rapid growth of ventricular assist devices (VADs) throughout the world, but little exists regarding their structure. We sought to study trends in VAD programs on a global level.

Methods:

We distributed a 26-question online survey to 321 individuals who work within those programs. Four categories of questions were formed: patient management, coordinator role, multidisciplinary support, and leadership.

Results:

Fifty-eight surveys (47 United States, 11 international) were analyzed. The majority of programs cared for 26 to 100 device-assisted patients (62%), 26% cared for ≤25 patients, and 12% cared for ≥100 patients. Advanced practice providers (APPs) were used in 69% of programs as a device coordinator. In-hospital rounding was performed equally among the APPs and registered nurses. Most programs used a social worker (90%), nutritionist (74%), pharmacist (72%), palliative care (66%), and finance coordinator (64%). Less than half (43%) included a case manager and only 33% used a pharmacist. The program leader was identified as a cardiologist (31%) or surgeon (26%) or both equally (43%).

Conclusion:

This study demonstrates differences and similarities between VAD program structures. Additional research is warranted to evaluate the effect of program structure on outcomes, job satisfaction, and retention regions.
Probation Officer Assessments of Risk when the Youth Look Different: Contributions of Structured Professional Judgment to Concerns About Racial Bias
Authors: Munoz Carla G. , Perrault Rachael T. , Vincent Gina M.
Published: September 2020

Various groups have expressed considerable concern about the potential for actuarial risk assessments to exacerbate racial disparities in justice settings. This study examined that potential when using a different approach to risk assessment, structured professional judgment (SPJ), by comparing risk decisions made by evaluators when the examinee’s race was different versus the same as theirs. A large sample of youth (N = 1,308) evaluated on the Structured Assessment of Violence Risk in Youth (SAVRY) by 137 juvenile probation officers (JPOs) in five states indicated the only moderation effect for the match or mismatch between JPOs’ and youths’ race/ethnicity was in the weight JPOs placed on five (out of 24) risk factors in their overall risk opinions. The match between JPOs' and youths' race had no bearing on JPOs’ final determination of youths’ risk levels. This study lends support for investigating the use of SPJ instruments as a method for minimizing racial bias.
Blending the Principles of Participatory Action Research Approach and Elements of Grounded Theory in a Disaster Risk Reduction Education Case Study
Authors: Canlas Ian Phil , Karpudewan Mageswary
Published: September 2020

This paper presents an exemplar of blending the principles of participatory action research and elements of grounded theory in a disaster risk reduction education case study. It illustrates and describes a modified methodological approach that was used during the needs’ assessment and analysis phase of a multiphase study on teaching of disaster risk reduction in science among public schools in Biliran Province, the Philippines. The approach was conceived upon considering the overarching aim of the study which is the effective, efficient, inclusive, and proactive teaching of disaster risk reduction in science, the complex nature of the disaster risk reduction education, and the multiple stakeholders involved in disaster risk reduction among public schools. Results revealed that the modified methodological approach provided a co-learning environment for both participants and researchers, created an opportunity to maximize participation toward generating knowledge, prioritizing problems, and conceptualizing solutions, strengthened the data collection and analysis process, hence ensuring quality in the entire research process, and addressed the participation issues pointed out in grounded theory studies. The modified methodological approach may be relevant and applicable to similar studies that are complex and emerging like the teaching of disaster risk reduction in science.
Treatment of Sinonasal Teratocarcinosarcoma: A Systematic Review and Survival Analysis
Authors: Chapurin Nikita , Totten Douglas J. , Morse Justin C. , Khurram Mohammad S. , Louis Peter C. , Sinard Robert J. , Chowdhury Naweed I.
Published: September 2020

Background

Sinonasal teratocarcinosarcoma (SNTCS) is a rare malignancy of the anterior skull base with only 127 cases described in the English literature. Given the rarity of this tumor, new cases and analysis of published reports may assist in future management of SNTCS.

Objectives

1) Describe findings from a systematic review of all available literature for malignant SNTCS including the clinical presentation, treatment modalities and outcomes. 2) Present two new cases of this rare anterior skull base tumor. 3) Compare treatment outcomes with respect to recurrence and mortality.

Methods

A systematic review of all English literature available in 2 comprehensive databases was conducted by two independent reviewers using PRISMA guidelines. 85 publications were identified. Each case was reviewed for demographics, treatment and survival, and aggregate treatment outcomes were compared using Kaplan-Meier analysis.

Results

A total of 64 articles meeting inclusion criteria were reported in the literature between 1977-2018. This represented a total of 127 patients, with a strong male predominance (83%) and mean age of 50 years (range 10–82). Mean follow-up was 21 months. Recurrence rate was 38%, with mean survival at 2 years of 55%. Almost all patients underwent surgery as a primary treatment modality (90%). The majority of cases were treated with multimodal therapy, with 55% receiving surgery and radiation and 20% receiving surgery with adjuvant chemoradiation. Kaplan-Meier analysis demonstrated a significant survival advantage for patients treated with combined therapy compared to surgery alone (p < 0.001) but did not show differences in recurrence (p = 0.085).

Conclusion

Two-year survival rates for SNTCS are 55%. Multimodality treatment outcomes appear to be superior to surgery alone based on the published data of this rare skull base tumor, although heterogeneity of treatment methods and reporting bias limits the generalizability of these findings.
Jumpy and Jerky: When Peripheral Vision Faces Reverse-Phi
Authors: Lorenceau Jean , Cavanagh Patrick
Published: September 2020

When an annulus in fast apparent motion reverses its contrast over time, the foveal and peripheral percepts are strikingly different. In central vision, the annulus appears to follow the same path as an annulus without flicker, whereas in the periphery, the stimulus seems to randomly jump across the screen. The illusion strength depends on motion speed and reversal rate. Our observations suggest that it results from a balance between conflicting phi and reverse-phi motion, positional uncertainty, and attention. In addition to illustrating the differences between central and peripheral motion processing, this illusion shows that both discrete positional sampling and motion energy combine to generate motion percepts, although with eccentricity dependent weights that are themselves affected by attention.
Virologic suppression in patients with a documented M184V/I mutation based on the number of active agents in the antiretroviral regimen
Authors: Mouradjian Mallory T , Heil Emily L , Sueng Hyunuk , Pandit Neha Sheth
Published: September 2020

Objectives:

The optimal antiretroviral therapy for patients with the M184V/I mutation is not known. The primary objective of this study was to determine the efficacy of various antiretroviral therapies in patients with HIV and the M184V/I mutation based on the number of active antiretroviral agents.

Methods:

A retrospective chart review was conducted of 100 treatment-experienced patients harboring the M184V/I mutation seen at an urban HIV clinic. Efficacy was classified as percentage of patients with viral suppression defined as HIV RNA viral load <200 copies/mL at last measurement on current antiretroviral therapy, stratified by the number of active antiretroviral agents.

Results:

The primary outcome of viral suppression occurred in 70.6% (12/17) of patients on <2 active agents, 77.2% (44/57) on 2–2.5 active agents, and 69.2% (18/26) on 3 active agents. No significant difference was found between viral suppression and patients on <2 and 2–2.5 antiretroviral agents (odds ratio = 0.71, 95% confidence interval = (0.21, 2.39), p = 0.8) or between patients on 3 and 2–2.5 active agents (odds ratio = 0.66, 95% confidence interval = (0.23, 1.88), p = 0.7). The most commonly prescribed regimen consisted of a boosted protease inhibitor with an integrase strand transfer inhibitor and two nucleoside reverse transcriptase inhibitors, one of which being lamivudine or emtricitabine.

Conclusion:

Similar rates of viral suppression were observed in patients regardless of the number of active antiretroviral agents prescribed. Regimens containing less than 3 active agents may maintain virologic suppression in patients with the M184V/I mutation. Further studies are needed to determine optimal antiretroviral therapy for patients with the M184V/I mutation.
Maintaining a safe uro-oncological surgical service in the face of the COVID-19 pandemic
Authors: Shillito Samuel , O’Flynn Kieran , Clarke Noel , Maddineni Satish
Published: September 2020

Objective:

The COVID-19 pandemic has had a profound impact on the provision of surgery across the NHS. Despite the challenges, the uro-oncology surgical provision at our centre in the northwest of England, a COVID-19 hotspot, has continued throughout.

Patients and methods:

We report a 26-patient case series performed following national lockdown. Patients were initially screened for COVID-19 symptoms and later all patients required a negative swab pre-operatively. Personal protective equipment using aerosol precautions was used for all cases. A post-operative ‘cold’ COVID-19 critical-care ward was created. Patients who developed possible symptoms of COVID-19 were isolated and swabbed. A telephone questionnaire was completed two weeks following discharge.

Results:

Three out of 26 patients developed post-operative pyrexia, but all tested negative for COVID-19. Non-COVID-19-related complication rates were consistent with our previous results. Telephone follow-up confirmed that none had experienced symptoms suggestive of COVID-19 infection. Overall, patient satisfaction with hospital COVID-19 precautions was high. All patients were satisfied with their decision to undergo surgery during the pandemic.

Conclusions:

Our results indicate that during the peak of the COVID-19 pandemic, with appropriate precautions, a safe surgical service can be continued.

Level of evidence

Level 3
A Preliminary Exploration of the Stability of Music- and Photo-Evoked Autobiographical Memories in People with Alzheimer’s and Behavioral Variant Frontotemporal Dementia
Authors: Baird Amee , Gelding Rebecca , Brancatisano Olivia , Thompson William Forde
Published: September 2020

Music evoked autobiographical memories (MEAMs) occur in people with Alzheimer’s dementia (AD), but there is limited study of such memories in people with other dementia types such as behavioral variant frontotemporal dementia (Bv-FTD). Furthermore, there has been no study of the integrity of such memories over time, and scarce comparison with other memory cues such as photos. Our aim was to address this current gap in our knowledge and to characterize MEAMs and photo-evoked autobiographical memories (PEAMs) in healthy elderly people and people with AD and Bv-FTD on two occasions, 6 months apart. Twenty-two participants (7 with AD, 6 with Bv-FTD, and 9 healthy elderly people) reported memories following exposure to two famous songs and two famous event photographs from each decade from 1930–2010 on two occasions. All people with AD and all healthy elderly controls reported at least one MEAM or PEAM at both times. In contrast, two people with Bv-FTD reported no memories at either time. The percentage of memories over time for songs and photos remained stable for the Healthy Elderly and AD groups, whilst the percentage of memories to songs increased over time for people with Bv-FTD. Songs elicited more positive memories than photos. The specific music and photo stimuli that triggered memories, and the topic of the memories that were evoked, remained stable over a 6-month period across all groups. Our results suggest that music and photos are efficient memory cues in people with AD and Bv-FTD. Future large-scale studies of people with different dementia types over a longer time period will provide insights into the integrity of music- and photo-evoked autobiographical memories as dementia progresses.
Spinal Surgery Site Infection Leading to Implant Loosening Is Influenced by the Number of Prior Operations
Authors: Bratschitsch Gerhard , Puchwein Paul , Zollner-Schwetz Ines , Sadoghi Patrick , Radl Roman , Leithner Andreas , Leitner Lukas
Published: September 2020

Study Design:

Retrospective Cohort Study.

Objectives:

Spinal surgery site infection and chronic implant infection are possible causes for ongoing pain, implant loosening, and failed back surgery syndrome. Evidence of chronic infection was found in 29.1% of revision cases but is also found in a considerable number of degenerative cases without prior surgery. Infection mechanisms and possible clinical correlations are unclear.

Methods:

Retrospective analysis of standardized surgery site screening (swab, tissue samples, implant sonication) in 181 cases without clinical evidence of preoperative surgery site infection.

Results:

Screening results of cases without prior spinal surgery (n = 49, 10.2% positive) were compared to cases with prior spine surgery without implant placement (e.g. micro discectomy) (n = 21, 23.8% positive), revision cases following singular spinal fusion (n = 73, 23.2% positive), and cases with multiple revisions (n = 38, 50.0% positive). Propionibacterium spp. detection rate increased to 80% in positive cases with multiple revisions. Implants in place during revision surgery had a significantly higher infection rate (32.4%) compared to no implant (14.2%, p = 0.007). Positive cases had a significantly higher pain level prior to surgery compared to negative cases ( p = 0.019). Laboratory parameters had no predictive value. Logistic regression revealed that previous spinal surgeries (odds ratio [OR] 1.38 per operation, p < 0.001) and male sex (OR 1.15, p = 0.028) were independent predictive factors for infection.

Conclusions:

Previous spinal surgery is a risk factor for chronic surgery site infection, leading to chronic pain, implant loosening, and revision. The presence of Propionibacterium spp. was correlated with chronic implant loosening and was more likely with cumulative surgeries.
Comparison between epsilon-aminocaproic acid and tranexamic acid for total hip and knee arthroplasty: A meta-analysis
Authors: Liu Wen-bin , Li Gui-Shi , Shen Peng , Zhang Fu-jiang
Published: September 2020

Background:

The aim was to compare the efficacy and safety of epsilon-aminocaproic acid (EACA) and tranexamic acid (TXA) in total hip arthroplasty (THA) and total knee arthroplasty (TKA).

Methods:

Potential academic articles were identified from the Cochrane Library, Springer, PubMed, and ScienceDirect databases from inception to December 2019. Randomized controlled trials (RCTs) and non-RCTs involving EACA and TXA in THA or TKA were included. Pooled data were analyzed using RevMan 5.1.

Results:

Three RCTs and three non-RCTs met the inclusion criteria. The present meta-analysis reveals that EACA is associated with significantly more blood loss than TXA. No significant differences were identified in terms of blood transfusion rate, transfusion units, hemoglobin (Hb) level at discharge, operation time, length of hospital stay, deep venous thrombosis (DVT), or 30-day readmission.

Conclusions:

Compared with TXA, EACA led to more blood loss in patients undergoing THA or TKA. However, there was no significant difference in the blood transfusion rate, transfusion units, Hb level at discharge, operation time, length of hospital stay, DVT, or 30-day readmission between groups.
What can co-creation do for the citizens? Applying co-creation for the promotion of participation in cities
Authors: Leino Helena , Puumala Eeva
Published: September 2020

Co-creation has become a globally popular concept in different sectors of the society. Its promise lies in breaking down hierarchies between local government, business life, universities, citizens and other stakeholders. Instead of being a top-down or bottom-up process, co-creation involves a multi-directional approach to problem solving. In this article, we scrutinize the capacity of co-creation to transform the practices of public sector in the context of urban development. In this way, we discuss both the potential and limitations of applying co-creation to the enhancement of citizen participation in cities. While new ways of acting can create novel spaces for opportunity, they also bring new winners and losers to the fore. After all, citizens are not all the same: they fall in several categories and some of them have more resources to participate in co-creative processes than others. Thus, it is relevant to know who participate in and whose voices get heard through these processes. We claim that to realise the participatory potential of co-creation, it is crucial to scrutinize actual practices through and networks within which it takes place. Through three co-creative processes from Finland, we illustrate that the promotion of participation through co-creation necessitates acknowledging the heterogeneity of citizens and taking seriously issues of urban social justice and inclusion. In conclusion, we identify issues regarding the sustainability and accessibility of participation that must be unpacked, if co-creative processes are to be used in the context of urban development.
Fovea Morphology After Vitrectomy in Eyes With Full-Thickness Macular Hole Coexisting With Diabetic Retinopathy
Authors: Michalewska Zofia , Nawrocki Jerzy
Published: September 2020

Purpose:

This work presents the effects of vitrectomy with an inverted internal limiting membrane flap in full-thickness macular holes (FTMHs) in eyes with diabetic retinopathy (DR).

Methods:

Vitrectomy with the inverted and temporal inverted internal limiting membrane flap technique was performed in all cases. Inclusion criteria were FTMH, diabetes treated with oral drugs or with insulin for at least 5 years, spectral–domain or swept–source optical coherence tomography performed before surgery then 1 week, 1, 3, 6, 12, and 18 to 36 months after surgery.

Results:

FTMH with nonproliferative DR (NPDR) was noted in 20 eyes and with proliferative DR (PDR) in 5 eyes. In PDR the margins of the macular holes (MHs) were always detached, and the MHs tended to be larger than in NPDR. The minimum diameter–to–base diameter ratio was 1:2 in NPDR and 1:10 in PDR. Postoperatively central retinal thickness and visual acuity (VA) were significantly lower for PDR. Twenty–one of 25 FTMHs were closed after the first surgery, and all were closed after the second surgery. VA improved, final results did not depend on FTMH diameter. Photoreceptor defects decreased in size but were present in all cases 12 months after surgery.

Conclusions:

Morphology of MHs in NPDR and PDR was varied. FTMH in NPDR resembled idiopathic cases; morphology of FTMH with PDR was different. In PDR, FTMHs were larger and the fovea was usually detached; retina thinning was also observed. Final VA depended on initial VA and the severity of the disease (NPDR vs PDR).
Comparison of anti-inflammatory effects of eye drops formulations after uncomplicated cataract surgery
Authors: Cagini Carlo , Pellegrino Adriana , Iannone Alessia , Cerquaglia Alessio , Modugno Antonella , Fiore Tito , Messina Marco
Published: September 2020

Aim:

The aim of this study is to compare the efficacy of different dexamethasone eye drops formulations in controlling postoperative inflammation.

Methods:

Cataract surgery was carried out in 72 patients (35 males) divided into two groups: group A (36 patients, mean age = 78.0 ± 5.6) received four times daily for 2 weeks a suspension containing tobramycin 0.3% mg/ml + dexamethasone 0.1% mg/ml, and group B (36 patients, mean age = 76.2 ± 6.8) a solution containing tobramycin 0.3% mg/ml + dexamethasone 0.1% mg/ml. Both groups received ofloxacin 0.5% four times daily for 7 days, and nepafenac 0.1% three times daily for 3 weeks. Best-corrected visual acuity, intraocular pressure, corneal thickness, endothelial cells count, aqueous flare and macular thickness were evaluated preoperatively and at 1 day, 15 days, 1 and 2 months.

Results:

In group A, intraocular pressure, corneal thickness and aqueous humour flare values preoperatively and at the end of follow-up were 14.3 ± 1.8 and 13.2 ± 1.8 mmHg, 546.4 ± 34.6 and 539.6 ± 36.1 µm, 11.84 ± 4.44 and 13.52 ± 5.54 ph/ms, respectively, with no statistically significant difference. In group B, intraocular pressure, corneal thickness and aqueous humour flare values preoperatively and at the end of follow-up were 14.3 ± 1.5 and 13.1 ± 1.7 mmHg, 552.9 ± 37.4 and 548.1 ± 39.3 µm, 11.45 ± 4.06 and 13.73 ± 4.99 ph/ms, respectively, with no statistically significant difference. No difference was detected in the macular thickness values in the parafoveal area preoperatively and at 2 months follow-up in group A (332.18 ± 16.19 and 337.71 ± 16.33 µm) and group B (329.11 ± 18.28 and 334.37 ± 20.86 µm), respectively.

Conclusion:

The two different formulations of dexamethasone eye drops reached the same anti-inflammatory effects.