bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of fibrinogen concentrate administration on early mortality in traumatic hemorrhagic shock: A propensity score analysis
Authors: Hamada Sophie Rym , Pirracchio Romain , Beauchesne Jocelyn , Benlaldj Mohammed Nadjib , Meaudre Eric , Leone Marc , Pottecher Julien , Abback Paer Selim , Gauss Tobias , Boutonnet Mathieu , Cook Fabrice , Garrigue Delphine , Lesache Frédéric , Julie Josse , Rouquette Alexandra , Duranteau Jacques
Published: February 2020

BACKGROUND

Fibrinogen concentrate is widely used in traumatic hemorrhagic shock despite weak evidence in the literature. The aim of the study was to evaluate the effect of fibrinogen concentrate administration within the first 6 hours on 24-hour all-cause mortality in traumatic hemorrhagic shock using a causal inference approach.

METHODS

Observational study from a French multicenter prospective trauma registry was performed. Hemorrhagic shock was defined as transfusion of four or more red blood cell units within the first 6 hours after admission. The confounding variables for the outcome (24-hour all-cause mortality) and treatment allocation (fibrinogen concentrate administration within the first 6 hours) were chosen by a Delphi method. The propensity score was specified with a data-adaptive algorithm and a doubly-robust approach with inverse proportionality of treatment weighting allowed to compute the average treatment effect. Sensitivity analyses were performed.

RESULTS

Of 14,336 patients in the registry during the study period, 1,027 in hemorrhagic shock were analyzed (758 receiving fibrinogen concentrate within 6 hours and 269 not receiving fibrinogen concentrate). The average treatment effect, expressed as a risk difference, was −0.031 (95% confidence interval, −0.084 to 0.021). All sensitivity analysis confirmed the results.

CONCLUSIONS

Fibrinogen concentrate administration within the first 6 hours of a traumatic hemorrhagic shock did not decrease 24-hour all-cause mortality.

LEVEL OF EVIDENCE

Prognostic, level III.
Developing the implicit association test to uncover hidden preferences for sustainable drainage systems
Authors: O'Donnell Emily , Maskrey Shaun , Everett Glyn , Lamond Jessica
Published: February 2020

Understanding public perceptions of Sustainable Drainage Systems (SuDS) is critical for addressing barriers to their implementation. Perceptions are typically evaluated using explicit measures (e.g. questionnaires) that are subject to biases and may not fully capture attitudes towards SuDS. A novel image-based application of the Implicit Association Test is developed to investigate unconscious perceptions of SuDS in public greenspace and combined with explicit tests to evaluate perceptions of greenspace with and without SuDS, focusing on a sample population in Newcastle-upon-Tyne. Greenspace with or without SuDS is perceived positively by the sample population. Overall, respondents implicitly and explicitly prefer greenspace without SuDS and perceive greenspace without SuDS as more attractive, tidier and safer. The wide distribution of scores for SuDS, nonetheless, suggests a range of opinions and illustrates the complex nature of preferences for the use of greenspace. That the strongly negative explicit scores were not reflected in the implicit tests may suggest that explicit attitudes towards tidiness and safety may not be deep-rooted and are subject to social bias. Combined explicit and implicit tests may help us to understand any disconnect between expressed positive attitudes to natural spaces and behaviours around them and inform SuDS design to increase public acceptance.

This article is part of the theme issue ‘Urban flood resilience’.
Politics, water management and infrastructure
Authors: Trowsdale Sam , Boyle Kelly , Baker Tom
Published: February 2020

While modern water management has been central to the achievement of a range of beneficial social outcomes, it has increasingly drawn criticism for its disconnection from democratic decision-making, hindering efforts to develop more resilient systems. This paper examines how an experiment with more resilient water infrastructure politicized centralized water management focusing, in particular, on a stormwater re-use ‘third-pipe’ system at a large residential development in Auckland, New Zealand. Through analysis of resident and expert views on safety, cost and security, the paper attends (1) to the ways in which techno-managerial water management was contested and, thus, politicized through the implementation of the third pipe, and (2) how the mobilization of techno-managerial discourses by water management authorities delegitimized the third-pipe system, rendering it ultimately inoperable. While our case study was thwarted by the de-politicizing apparatus of water management authorities, such experiments offer precedents, resources and hope for more democratic systems of water management.

This article is part of the theme issue ‘Urban flood resilience’.
Challenges in developing urban flood resilience in India
Authors: Gupta Kapil
Published: February 2020

This note presents a short commentary on the recurring urban flooding in India and the challenges the country faces in implementing sustainable drainage practices and developing urban flood resilience. The major incidences of heavy rainfall and the consequent urban flooding and their causes are briefly described. The recent flood disaster management and mitigation measures carried out by the Central, State and Local Government are highlighted. The flood resilience initiatives and challenges are then discussed. The effects of climate change on increased rainfall in shorter durations are now being felt in many Indian cities. The planners are now taking cognizance of this and future flood resilience measures are being planned to incorporate an integrated approach to stormwater management by recommending best management practices in the stormwater manuals. However, a lot still needs to be done to make the cities in India flood resilient.

This article is part of the theme issue ‘Urban flood resilience'.
Interpretation and application of Sponge City guidelines in China
Authors: Griffiths James , Chan Faith Ka Shun , Shao Michelle , Zhu Fangfang , Higgitt David Laurence
Published: February 2020

‘Sponge City’ is the term used to describe the Chinese government's approach to urban surface water management. The concept was conceived in 2014 in response to an increasing incidence of urban flooding or water-logging in Chinese cities. While ambitious and far-reaching in its aim (of decreasing national flood risk, increasing water supply and improving water quality), the initiative must be implemented by individual subprovincial or municipal-level government entities. Thus, while the concept is similar to sustainable drainage systems (SuDS) in the UK (or low-impact development (LID) in the USA), it is developing with different regional characteristics, and during continuing rapid urbanization. Indeed, the increasing use of national rather than international examples of best practice reflects a growing body of knowledge that has evolved since the start of the Sponge City initiative. In this paper, interpretation and development of the national Sponge City guidelines are assessed for the Ningbo Municipality, an affluent and rapidly expanding city on China's low-lying east coast. While climate, geology and socio-economic factors can all be seen to influence the way that national guidelines are implemented, project financing, integration and assessment are found to be of increasing influence.

This article is part of the theme issue ‘Urban flood resilience’.
Paramesonia marina gen. nov., sp. nov., isolated from deep-sea water of the Indian Ocean
Authors: Wang Lei , Lai Qiliang , Liu Xiupian , Shao Zongze
Published: February 2020

A taxonomic study was carried out of strain K7T, which was isolated from deep-sea water collected from the Indian Ocean. The bacterium was Gram-stain-negative, aerobic, oxidase-negative, catalase-positive, rod-shaped and non-motile. Growth was observed at salinities of 0.5–10 % (optimum, 3 %), at a pH range of pH 6.0–10.0 (optimum, pH 7.0) and at temperatures of 10–40 °C (optimum, 28 °C). Results of phylogenetic analysis based on 16S rRNA gene sequences indicated that strain K7T belonged to the family

Flavobacteriaceae

, with the high sequence similarities to the genera

Mesonia

(92.2 %–94.4 %),

Salinimicrobium

(91.9 %–93.2 %),

Salegentibacter

(92.1 %–92.6 %),

Leeuwenhoekiella

(92.1 %–92.3 %),

Gramella

(91.9 %–92.1 %) and

Zunongwangia

(91.8 %–92.1 %). The principal fatty acids were iso-C15 : 0 (28.4 %), iso-C15 : 1G (14.2 %), summed feature 9 (iso-C17 : 1
 ω9c and/or C16 : 0 10-methyl; 11.6 %), iso-C17 : 0 3-OH (10.0 %) and summed feature 3 (C16 : 1
ω7c and/or C16 : 1
ω6c; 9.6 %). The G+C content of the chromosomal DNA was 35.8 mol%. The respiratory quinone was determined to be MK-6 (100 %). Phosphatidylethanolamine, two unidentified aminolipids, two unidentified phospholipid and four unidentified lipids were detected. The combined genotypic and phenotypic data show that strain K7T represents a novel species of a novel genus, for which the name Paramesonia marina gen. nov., sp. nov. is proposed, with the type strain K7T (=MCCC 1A01093T=KCTC 52325T).
Reduced levels of membrane-bound alkaline phosphatase in Vip3Aa-resistantHeliothis virescens
Authors: Pinos Daniel , Chakroun Maissa , Millán-Leiva Anabel , Jurat-Fuentes Juan Luis , Wright Denis J. , Hernández-Martínez Patricia , Ferré Juan
Published: February 2020

The Vip3Aa insecticidal protein fromBacillus thuringiensis(Bt) is produced by specific transgenic corn and cotton varieties for efficient control of target lepidopteran pests. The main threat to this technology is the evolution of resistance in targeted insect pests, thus understanding the mechanistic basis of resistance is crucial to deploy the most appropriate strategies for resistance management. In this work, a laboratory-selected colony ofHeliothis virescens(Vip-Sel) highly resistant to the Vip3Aa protein was used to test whether an alteration of membrane receptors in the insect midgut might explain the resistance phenotype. Binding of125I-labeled Vip3Aa to brush border membrane vesicles (BBMV) from 3rd instar larvae from Vip-Sel was not significantly different from binding in the reference susceptible colony. Interestingly, BBMV from Vip-Sel larvae show dramatically reduced levels of alkaline phosphatase activity, which was further confirmed by a strong down-regulation of the membrane-bound alkaline phosphatase 1 (HvmALP1) gene. However, its involvement as a receptor for the Vip3Aa protein was not supported by ligand blotting and viability assays with insect cells expressingHvmALP1. These data support that reduced alkaline phosphatase, previously observed in insect colonies resistant to Cry proteins from Bt, may also serve as an indirect marker that is not mechanistically involved in resistance to Vip3Aa.

IMPORTANCE

The Vip3Aa insecticidal protein remains the only lepidopteran-specific trait in transgenic Bt crops with no cases of field-evolved resistance. While laboratory-selected resistance to Vip3A has been reported elsewhere, the mechanism for resistance is unknown. Results in this work show lack of significant Vip3Aa binding alterations in resistant and reference colonies ofH. virescens.These observations are in contrast to most cases of high levels of resistance to insecticidal Bt proteins for which decreased binding is commonly detected. In addition, this study provides the first evidence of down-regulation of membrane bound alkaline phosphatase (mALP) associated with Vip3Aa resistance, a phenomenon commonly associated with resistance to Cry proteins from Bt. Results from this work suggest that mALP down-regulation may be a useful biomarker yet reject its direct participation in resistance to Vip3Aa.
Defensive forwards: stress-responsive proteins in cell walls of crop plants
Authors: Niu Liangjie , Wang Wei
Published: February 2020

As the vital component of plant cell wall, proteins play important roles in stress response through modifying wall structure and involving in wall integrity signaling. However, the potential of cell wall proteins (CWPs) in improvement of crop stress tolerance has probably been underestimated. Recently, we have critically reviewed the predictors, databases and cross-referencing of subcellular locations of possible CWPs in plants (Briefings in Bioinformatics2018;19:1130-1140). In this study, taking maize (Zea mays) as an example, we retrieved 1873 entries of probable maize CWPs recorded in UniProtKB. As a result, 863 maize CWPs are curated and classified as 59 kinds of protein families. By referring to GO annotation and gene differential expression in Expression Atlas, we highlight the potential of CWPs as defensive forwards in abiotic and biotic stress responses. In particular, several CWPs are found to play key roles in adaptation to many stresses. String analysis also reveals possibly strong interactions among many CWPs, especially those stress-responsive enzymes. The results allow us to narrow down the list of CWPs to a few specific proteins that could be candidates to enhance maize resistance.
The environmental impacts of palm oil and its alternatives
Authors: Beyer Robert M. , Durán América P. , Rademacher Tim T. , Martin Philip , Tayleur Catherine , Brooks Sharon E. , Coomes David , Donald Paul F. , Sanderson Fiona J.
Published: February 2020

The destruction of ecosystems for vegetable oil production represents a major cause of global biodiversity loss and greenhouse gas emissions1. Over the last two decades, oil palm, in particular, has caused societal concern due to its high impacts on biodiverse and carbon-dense tropical rainforests2–8, leading to calls to source vegetable oils from alternative oil-producing crops. However, given the high yields of oil palm, how does that damage compare with other oil crops that require more land? Here, we estimate the carbon and biodiversity footprints, per unit of oil produced, of the world’s five major vegetable oil crops. We find that oil palm has the lowest carbon loss and species richness loss per-tonne-oil, but has a larger impact on range-restricted species than sunflower and rapeseed. We go on to identify global areas for oil crop expansion that will minimise future carbon and biodiversity impacts, and argue that closing current yield gaps and optimising the location of future growing areas will be much more effective at reducing future environmental impacts of global vegetable oil production than substituting any one crop for another.
Immunoinformatic design of multi epitopes peptide-based universal cancer vaccine using matrix metalloproteinase-9 protein as a target
Authors: Abdelmoneim Abdelrahman H. , Mustafa Mujahed I. , Abdelmageed Miyssa I. , Murshed Naseem S. , Dawoud Enas A. , Ahmed Enas M. , Kamal eldin Rahma M. , Elfadol Nafisa M. , Sati Anfal Osama M. , Makhawi Abdelrafie M.
Published: February 2020

Background

Cancer remains a major public health hazard despite the extensive research over the years on cancer diagnostic and treatment, this is mainly due to the complex pathophysiology and genetic makeup of cancer. A new approach toward cancer treatment is the use of cancer vaccine, yet the different molecular bases of cancers reduce the effectiveness of this approach. In this work we aim to use matrix metalloproteinase-9 protein (MMP9) which is essential molecule in the survival and metastasis of all type of cancer as a target for universal cancer vaccine design.

Method

reference sequence of matrix metalloproteinase-9 protein was obtained from NCBI databases along with the related sequence, which is then checked for conservation using BioEdit, furthermore the B cell and T cell related peptide were analyzed using IEDB website. The best candidate peptide were then visualized using chimera software.

Result

Three Peptides found to be good candidate for interactions with B cells (SLPE, RLYT, and PALPR), while ten peptides found as a good target for interactions with MHC1 (YRYGYTRVA, YGYTRVAEM, YLYRYGYTR, WRFDVKAQM, ALWSAVTPL, LLLQKQLSL, LIADKWPAL, KLFGFCPTR, MYPMYRFTE, FLIADKWPA) with world combined coverage of 94.77%. In addition, ten peptides were also found as a good candidates for interactions with MHC2 (KMLLFSGRRLWRFDV, GRGKMLLFSGRRLWR, RGKMLLFSGRRLWRF, GKMLLFSGRRLWRFD, TFTRVYSRDADIVIQ, AVIDDAFARAFALWS, FARAFALWSAVTPLT, MLLFSGRRLWRFDVK, GNQLYLFKDGKYWRF, NQLYLFKDGKYWRFS), with world combined coverage of 90.67%.

CONCLUSION

23 peptide-based vaccine was designed for use as a universal cancer vaccine which has a high world population coverage for MHC1(94.77%) and MHC2 (90.67%) related alleles.
Roles of the ClC Chloride Channel CLH-1 in Food-associated Salt Chemotaxis Behavior ofC. elegans
Authors: Park Chanhyun , Sakurai Yuki , Sato Hirofumi , Kanda Shinji , Iino Yuichi , Kunitomo Hirofumi
Published: February 2020

The ability of animals to process dynamic sensory information facilitates foraging in an ever changing environment. However, molecular and neural mechanisms underlying such ability remain elusive. The ClC anion channels/transporters play a pivotal role in cellular ion homeostasis across all phlya. Here we find a ClC chloride channel is involved in salt concentration chemotaxis ofC. elegans. Genetic screening identified two altered-function mutations ofclh-1that disrupt experience-dependent salt chemotaxis. Using genetically encoded fluorescent sensors, we demonstrate that CLH-1 contributes to regulation of chloride and calcium dynamics of salt-sensing neuron, ASER. The mutant CLH-1 reduced responsiveness of ASER to salt stimuli in terms of both temporal resolution and intensity, which could disrupt navigation strategies for approaching preferred salt concentration. Furthermore, other ClC genes appeared to act redundantly in salt chemotaxis. These findings provide insights into the regulatory mechanism of neuronal responsivity by ClCs that contribute to modulation of navigation behavior.
Kwality Ltd.: the banker’s dilemma
Authors: Mathur Sachin
Published: February 2020

Learning outcomes

The case provides an opportunity to the students to learn some of the analytical processes in making a credit decision, including interpretation of financial ratios for credit analysis, forecasting a stress scenario, analysing cash flow adequacy, assessment of financial flexibility and, finally, recommend a credit decision.

Case overview/synopsis

The case discusses the analytical challenges facing a bank credit officer while assessing the credit quality of Kwality Ltd., an India-based dairy product manufacturer. Kwality Ltd. had undertaken a significant capacity expansion and business transformation to strengthen its market position in value-added dairy products business and improve its profit margins. The capacity expansion had recently been completed and the management, credit rating agency, equity analysts and investors appear to be optimistic regarding the company’s prospects. However, the capital investment had been almost entirely debt-funded and large long-term debt repayments would have become due shortly. The company had also built up large trade receivables. The banker had to assess if Kwality would be in a position to repay its debt and should his bank increase working capital disbursement to the company.

Complexity academic level

Complexity: Academic level. Applicability: MBA, Executive MBA.

Supplementary materials

Teaching Notes are available for educators only.

Subject code

CSS1: Accounting and Finance.
Trouble on the shop floor
Authors: Jordaan Barney , Cillié Gawie
Published: February 2020

Supplementary materials

The case is supported with a teaching note, discussion questions and suggested responses to those as well as verbatim transcripts from interviews conducted with managers and others for purposes of a research project after the strike had ended. Teaching Notes are available for educators only.

Learning outcomes

The learning outcomes are as follows: students will be able to critique the approach to collective bargaining of both the company and the union in the case and suggest alternative approaches; identify the steps the company could take to both deal with the aftermath of the strike and develop preventive measures for the future; and advise the company on a series of questions it needs advice on.

Case overview/synopsis

A violent strike erupted after failed wage negotiations. It laid bare deep divisions between African and non-African employees and between permanent employees and those appointed as temporary employees only. It also revealed the mindsets of people on both sides of the conflict, as well as several errors made by management in the manner in which they viewed the role of the union and failed to build strong relations with employees on the shop floor.

Complexity academic level

The case is suitable for students at honours or masters level in conflict studies, dispute resolution, employment relations, human resource management and negotiation.

Subject code

CSS 6: Human resource management.
Assessment of post-heat behavior of cement mortar incorporating silica fume and granulated blast-furnace slag
Authors: Pachideh Ghasem , Gholhaki Majid
Published: February 2020

Purpose

With respect to the studies conducted so far and lack of researches on the post-heat behavior of cement mortars containing pozzolanic materials, the purpose of this paper is to investigate the post-heat mechanical characteristics (i.e. compressive, tensile and flexural strength) of cement mortars containing granulated blast-furnace slag (GBFS) and silica fume (SF). In doing so, selected temperatures include 25, 100, 250, 500, 700 and 9000c. Last, the X-ray diffraction test was conducted to study the microstructure of mixtures and subsequently, the results were presented as power-one mathematical relations.

Design/methodology/approach

Totally, 378 specimens were built to conduct flexural, compressive and tensile strength tests. Accordingly, these specimens include cubic and prismatic specimens with dimensions of 5 × 5 × 5 cm and 16 × 4 × 4 cm, respectively, to conduct compressive and flexural strength tests together with briquette specimen used for tensile strength test in which cement was replaced by 7, 14 and 21 per cent of SF and GBFS. To study the effect of temperature, the specimens were heated. In this respect, they were heated with a rate of 5°C/min and exposed to temperatures of 25 (ordinary temperature), 100, 250, 500, 700 and 900°C.

Findings

On the basis of the results, the most profound effect of using GBFS and SF, respectively, takes place in low (up to 250°C) and high (500°C and greater degrees) temperatures. Quantitatively, the compressive, tensile and flexural strengths were enhanced by 73 and 180 per cent, 45 and 100 per cent, 106 and 112 per cent, respectively, in low and high temperatures. In addition, as the temperature elevates, the particles of specimens containing SF and GBFS shrink less in size compared to the reference specimen.

Originality/value

The specimens were cured according to ASTMC192 after 28 days placement in the water basin. First, in compliance with what has been specified by the mix design, the mortar, including pozzolanic materials and superplasticizer, was prepared and then, the sampling procedure was conducted on cubic specimens with dimension of 5 × 5 × 5 mm for compressive strength test, prismatic specimens with dimensions of 16 × 4 × 4 mm for flexural strength test and last, briquette specimens were provided to conduct tensile strength tests (for each temperature and every test, three specimens were built).
Intraocular tumour necrosis factor ligand related molecule 1 A links disease progression of proliferative diabetic retinopathy after primary vitrectomy
Authors: Wang Tian , Li Jianan , Xie Ruotian , Wang Jiaxing , Zhang Wei , Jiang Feng , Du Mei , Wang Xiaohong , Huang Bo , Brant Rodrigo , Zhang Cheng , Yan Hua
Published: February 2020

Tumour necrosis factor ligand related molecule 1 A (TL1A), a member of tumour necrosis factor superfamily, has been identified as a crucial regulator for vascular homeostasis and inflammation. However, the function of TL1A in diabetic retinopathy (DR) is largely unknown. This study aims to examine levels of TL1A in serum and intraocular fluid in patients with proliferative diabetic retinopathy (PDR), and to explore the correlation of intraocular TL1A with the prognosis of PDR progression after primary vitrectomy. Seventy‐five patients (75 eyes) with PDR who underwent pars plana vitrectomy (PPV) and 19 patients (19 eyes) who received vitrectomy for idiopathic macular holes (IMH) as non‐diabetic control group were enrolled in this prospective study. Serum, aqueous and vitreous fluid samples were collected during cataract and PPV surgery. Protein expressions of TL1A as well as other angiogenic and inflammatory cytokines in serum and intraocular fluid were measured. Correlations of intraocular TL1A concentrations with inflammatory cytokines were analyzed. We found both aqueous and vitreous TL1A levels were significantly higher in the PDR group than in control group (Paqueous = 0.026;Pvitreous<0.001). Angiogenic and inflammatory cytokines such as VEGF, IL‐6, IL‐8, MCP‐1, MIP‐1α, and MIP‐1β were significantly higher in intraocular fluid in PDR group than in controls, which MCP‐1 and MIP‐1α showed positive correlation with intraocular TL1A levels. There is no significant difference in the levels of serum TL1A as well as other inflammatory cytokines between PDR patients and controls. Intraocular levels of TL1A were significantly lower in PDR progression group than in the stable group (Paqueous<0.001;Pvitreous<0.001). Multivariate logistic regression analyses revealed that lower levels of intraocular TL1A was an important risk factor for predicting PDR progression after primary PPV (ORaqueous = 0.717,Paqueous = 0.001; ORvitreous = 0.684;Pvitreous = 0.002). In conclusion, TL1A and multiple inflammatory cytokines were highly enriched in the intraocular fluid of PDR patients compared with the controls. Lower levels of intraocular TL1A were associated with development of PDR complications after primary PPV and might be used as prognostic factor in predicting the vitrectomy outcome in PDR patients.
The Invisible Man of Indecency: Profanity and the Letters of the Late Ignatius Sancho, an African (1782)
Authors: Saillant John
Published: February 2020

This essay analyses vulgarities in Ignatius Sancho's letters, which were collected and published posthumously (in 1782) by one of his correspondents to provide revenue for Sancho's widow and children. It proposes a role for Sancho in English letters never previously suggested: that he used sexual innuendo in the manner of Swift, Sterne and London playwrights to spur a number of patrons and benefactors to provide gifts of money, food and other necessities when he had difficulty feeding his children. The posthumous collection continued that effort but elided some of his frankness, possibly because Sancho's widow was involved in its publication.
Functional Health in Korean Middle‐Aged Women with Poor Sleep Quality
Authors: Kim Go‐Un , Park Suin , Kim Sunah
Published: February 2020

PURPOSE

To develop and test a structural model of functional health in middle‐aged women based on the theory of unpleasant symptoms.

METHODS

The direct and indirect effects of menopause status, childhood trauma, post‐traumatic stress, social support, and sleep quality on functional health of 264 Korean women were examined.

FINDINGS

Menopause status and poor sleep quality had a negative direct effect and social support had a positive direct effect on functional health. Menopause status had a negative indirect effect on functional health through poor sleep quality.

CONCLUSIONS

Biopsychosocial nursing intervention programs need to be developed to improve functional health in middle‐aged women.

IMPLICATIONS FOR NURSING PRACTICE

It is important to mediate quality of sleep to improve functional health in middle‐aged women.

목적

불쾌증상 이론을 바탕으로 중년 여성의 건강기능을 평가하기 위함이다.

방법

264명의 한국 여성을 대상으로 건강기능에 영향을 미치는 폐경, 아동기 외상, 외상 후 스트레스, 사회적 지지의 직ㆍ간접적 영향을 확인하였다.

결과

폐경과 낮은 수면의 질은 건강기능에 부적 영향을 미쳤으며, 사회적 지지는 건강기능에 정적 영향을 미쳤다. 폐경은 건강기능에 간접적 영향을 미쳤다.

결론

중년여성의 건강기능을 증진하기 위해 신체ㆍ심리ㆍ사회적 요인을 고려한 통합적 중재가 필요하다.

간호실무 적용점: 중년여성의 건강기능을 유지하기 위해 수면의 질을 중재하는 것이 중요하다.
Measuring Agreement Among Prehospital Providers and Physicians in Patient Capacity Determination
Authors: O'Connor Laurel , Porter Liam , Dugas Julianne , Robinson Conor , Carrillo Eli , Knowles Kenneth , Nelson Kerrie P. , Gigliotti Ronald , Tennyson Joseph , Weisberg Stacy , Rebesco Matthew
Published: February 2020

Objectives

If a patient wishes to refuse treatment in the prehospital setting, prehospital providers and consulting emergency physicians must establish that the patient possesses the capacity to do so. The objective of this study is to assess agreement among prehospital providers and emergency physicians in performing patient capacity assessments.

Methods

This study involved 139 prehospital providers and 28 emergency medicine physicians. Study participants listened to 30 medical control calls pertaining to patient capacity and were asked to interpret whether the patients in the scenarios had the capacity to refuse treatment. Participants also reported their comfort level using modified Likert scales. Inter‐rater reliability was calculated utilizing Fleiss' and Model B kappa statistics. Fisher's exact tests were used to calculate p‐values comparing the proportion in each cohort that responded “no capacity.” Primary outcomes included inter‐rater reliability in the physician and prehospital provider cohorts.

Results

The inter‐rater agreement between the physicians was low (Fleiss' kappa = 0.31, standard error [SE] =0.06; model‐based kappa = 0.18, SE = 0.04). Agreement was similarly low for the 135 prehospital providers (Fleiss' kappa = 0.30, SE = 0.06; model‐based kappa = 0.28, SE = 0.04). The difference between the proportion of physicians and prehospital providers who responded “no capacity” was statistically significant in five of 30 scenarios. Median prehospital provider and physician confidence, on a 1 to 4 scale, was 2.00 (Q1–Q3 = 1.00–3.00 for prehospital providers and Q1–Q3 =1.0–2.0 for physicians).

Conclusions

There was poor inter‐rater reliability in capacity determination between and among the prehospital provider and physician cohorts. This suggests that there is need for additional study and standardization of this task.
Ageing as part of the curriculum for health‐care professionals: A Queensland Survey
Authors: Liddle Jacki , Beattie Elizabeth , Gannon Brenda , Bennett Sally , Pachana Nancy A.
Published: February 2020

Objectives

Education affects the attitudes and abilities of health professionals regarding older people. This study examines the nature and amount of ageing‐related content in programs at universities and in continuing education in Queensland for disciplines involved in the direct care of older people.

Methods

Surveys developed for the different settings were sent to universities and health professional representative bodies.

Results

Representatives from thirty (of 71) programs and 12 (of 22) professional bodies responded. Many program representatives (62%) reported ageing content was at an appropriate level. The remainder indicated it was too low. Representatives from professional bodies identified ageing was a priority (81%) and offered ageing‐related education (72%). Time spent on ageing in university programs varied widely (median of 67 hours [interquartile range: 222.5]). Qualitative feedback indicated tensions existed about accreditation standards and perceptions of ageing as a specialty versus a core practice area.

Conclusion

Ageing‐related education for health professionals requires attention to address shortcomings.
Correlation between percutaneous biopsy and final histopathology for retroperitoneal sarcoma: a single‐centre study
Authors: Young Rebekah , Snow Hayden , Hendry Shona , Mitchell Catherine , Slavin John , Schlicht Stephen , Na Lumine , Hofman Michael S. , Gyorki David E.
Published: February 2020

Background

Retroperitoneal sarcomas are rare soft tissue tumours accounting for 10–15% of soft tissue sarcomas. Patient prognosis and treatment recommendations (including extent of surgery and neoadjuvant strategies) are determined by the pre‐operative histopathological subtype and grade obtained from biopsy and thus it is important to understand the accuracy of biopsy in retroperitoneal masses.

Methods

This study presents a case series of primary retroperitoneal sarcomas managed at Peter MacCallum Cancer Centre (PMCC) between 2008 and 2019. Statistical analyses were performed to determine correlation between histopathology from percutaneous biopsy and surgical excision.

Results

A total of 117 patients who underwent percutaneous core biopsy and surgical excision of retroperitoneal sarcoma were included. Diagnostic accuracy varied with histopathological diagnosis, but overall precise concordance between biopsy and final histopathology was seen in 61% (κ = 0.57). Biopsy was most sensitive for identifying well‐differentiated liposarcoma (WDLPS) (sensitivity 85%, 95% CI 0.06–0.96) and leiomyosarcoma (sensitivity 81%, 95% CI 0.54–0.96) and was least sensitive for identifying de‐differentiated liposarcoma (DDLPS) (sensitivity 40%, 95% CI 0.25–0.56). Overall agreement between biopsy and final histopathology increased with use of PET/CT scan pre‐biopsy and with use of fluorescence in situ hybridisation testing on biopsy, however, neither test improved recognition of de‐differentiated components within WD/DDLPS on core biopsy.

Conclusions

Pre‐operative biopsy is important for clinical decision making in the treatment of retroperitoneal sarcoma. A significant portion of patients with a WDLPS will have a de‐differentiated component identified at the time of resection that was not identified on initial biopsy.
Sustaining livelihoods in a palm oil enclave: Differentiated gendered responses in East Kalimantan, Indonesia
Authors: Toumbourou Tessa D. , Dressler Wolfram H.
Published: February 2020

With large tracts of forested land planned for, or already converted to, industrial palm oil concessions, there is a need to better understand the gendered implications for, and responses by, communities affected by such landscape change. This paper examines the differentiated gendered responses and livelihood strategies of Dayak Modang women and men in a hamlet in East Kalimantan, Indonesia, surrounded by industrial palm oil plantations. Informed by feminist political ecology, we investigate how the compounding impact of industrial oil palm – the basis and outcome of enclavement – curtails livelihood options and reinforces gender differentiation in terms of access to and use of customary resources. Gendered inequalities and food insecurity dynamics emerge as a result. We show how, however, that despite gendered exclusions, Dayak Modang women use their own knowledge and practices to diversify livelihoods to negotiate emerging constraints over resource access and use. Our paper demonstrates that ways in which Dayak women ‘sustain livelihoods’ reflects forms of everyday negotiations and resistance to intensifying constraints over life and livelihood.
Criminal History, Sex, and Employment: Sex Differences in Ex‐Offender Hiring Stigma
Authors: Holloway Colin P. , Wiener Richard L.
Published: February 2020

Communities across the United States integrate thousands of men and women coming out of jail or prison each year and studies suggest that over 75% of this population will reoffend within a decade of release. According to research, positive employment outcomes are linked to preventing recidivism; however, employers routinely check or inquire about criminal histories and discriminate against ex‐offender applicants. The current research focused on employer stigma against applicants with a criminal history with an online sample of adults (N = 296). The analogue experiment examined hiring decisions for Black versus White applicants with or without a criminal history in order to explore the effect of race and criminal history on hiring outcomes. As expected, participants were less likely to recommend applicants with a criminal history for employment, but the sex of the respondent moderated the differences in racial bias. Male hiring decision makers did not differentiate between applicants with or without a criminal history when presented with a White applicant but did show a stigma against Black ex‐offenders versus Black applicants with a clean criminal history. Female hiring decision makers showed the opposite pattern demonstrating no preference between Black applicants with or without a criminal history but preferring White applicants without a criminal record versus White ex‐offenders. These findings suggest that male and female hiring managers are differently affected by the presence of a criminal history depending on the race of the applicant and these differences if replicated have interesting policy implications.
Game learning analytics for understanding reading skills in transparent writing system
Authors: Niemelä Marko , Kärkkäinen Tommi , Äyrämö Sami , Ronimus Miia , Richardson Ulla , Lyytinen Heikki
Published: February 2020

Serious games are designed to improve learning instead of providing only entertainment. Serious games analytics can be used for understanding and enhancing the quality of learning with serious games. One challenge in developing the computerized support for learning is that learning of skills varies between players. Appropriate algorithms are needed for analyzing the performance of individual players. This paper presents a novel clustering‐based profiling method for analyzing serious games learners. GraphoLearn, a game for training connections between the speech sounds and letters, serves as the game‐based learning environment. The proposed clustering method was designed to group the learners into profiles based on game log data. The obtained profiles were statistically analyzed. For instance, the results revealed one profile consisting of 136 players who had difficulties with connecting most of the target sounds and letters, whereas learners in the other profiles typically had difficulties with specific sound‐letter pairs. The results suggest that this profiling method can be useful for identifying children with a risk of reading disability and the proposed approach is a promising new method for analyzing serious game log data.

Practitioner Notes

What is already known about this topic

Serious games are used to improve learning and to tailor learning environments for people with various difficulties in learning.

Learning analytics and serious games analytics are growing research fields, applying and developing data analysis methods to analyze, profile and understand learning using serious games.

GraphoLearn is a learning game for training reading skills. The game provides preventive support for learners with varying skill levels including individuals who are struggling with reading.

What this paper adds

The paper develops and presents a novel approach for serious games analytics to analyze GraphoLearn players.

The proposed data analysis approach produces an interpretable set of error profiles, which characterize the learning difficulties in a unique way.

The profiling method can be used for longitudinal studies and applied to analyzing logs of other serious games.

Implications for practice and/or policy

It is possible to reveal and understand profiles of serious game players.

The proposed data analysis method can be used to identify players who have a potential risk for reading difficulties or disabilities.

Even though the proposed method provides only limited information about players' future skills, it offers a good starting point for other studies in which players' development can be monitored more accurately.
Advances in knowledge of inhibitor formation in severe haemophilia A
Authors: Cormier Matthew , Batty Paul , Tarrant Julie , Lillicrap David
Published: February 2020

Anti‐drug antibody formation following factor VIII (FVIII) replacement therapy is the most important treatment‐related complication in patients with severe haemophilia A. A significant number of these antibodies show neutralising activity against FVIII and are referred to as FVIII inhibitors. Alloimmunity to FVIII, given the absence of endogenous circulating FVIII protein, may be predictable to some extent; however, only 30% of patients develop inhibitors. Genetic and environmental risk factors have been identified, contributing to the likelihood of inhibitor development. Multiple immunological theories have been proposed which in part explain the outcomes of many epidemiological studies. Significant differences exist among replacement therapies, including the source, FVIII sequence, glycosylation, formulation components, impurities and aggregation potential, which significantly complicate interpretation of the results from these studies. In this review, we present recent advances in the understanding of the cellular mechanisms of inhibitor formation and highlight some areas of uncertainty requiring further investigation.
Pregnancy in sickle cell trait: what we do and don’t know
Authors: Wilson Samuel , Ellsworth Patrick , Key Nigel S.
Published: February 2020

Sickle cell trait (SCT) is the carrier state for sickle cell disease that results from the HBB rs334 missense mutation (p.Glu6Val) in the β‐globin chain of haemoglobin. While not associated with any impact on life expectancy, it has been established that SCT is associated with an increased risk of both venous thromboembolism (and in particular, pulmonary embolism) and chronic kidney disease. It is largely unknown what short‐ or long‐term effect, if any, pregnancy has upon the risk or outcomes of these disorders. In addition, SCT has been linked with various adverse outcomes in pregnancy, ranging from maternal complications such as elevated risk of bacteriuria to potentially life‐threatening entities such as pre‐eclampsia and prematurity. In these scenarios also, no clear association with SCT has been established. Given the high worldwide prevalence of SCT, further studies addressing these issues are warranted.
Haematological features, transfusion management and outcomes of massive obstetric haemorrhage: findings from the Australian and New Zealand Massive Transfusion Registry
Authors: Lasica Masa , Sparrow Rosemary L. , Tacey Mark , Pollock Wendy E. , Wood Erica M. , McQuilten Zoe K. ,   the members of the Australian and New Zealand Massive Transfusion Registry Steering Committee
Published: February 2020

Massive obstetric haemorrhage (MOH) is a leading cause of maternal morbidity and mortality world‐wide. Using the Australian and New Zealand Massive Transfusion Registry, we performed a bi‐national cohort study of MOH defined as bleeding at ≥20 weeks’ gestation or postpartum requiring ≥5 red blood cells (RBC) units within 4 h. Between 2008 and 2015, we identified 249 cases of MOH cases from 19 sites. Predominant causes of MOH were uterine atony (22%), placenta praevia (20%) and obstetric trauma (19%). Intensive care unit admission and/or hysterectomy occurred in 44% and 29% of cases, respectively. There were three deaths. Hypofibrinogenaemia (<2 g/l) occurred in 52% of cases in the first 24 h after massive transfusion commenced; of these cases, 74% received cryoprecipitate. Median values of other haemostatic tests were within accepted limits. Plasma, platelets or cryoprecipitate were transfused in 88%, 66% and 57% of cases, respectively. By multivariate regression, transfusion of ≥6 RBC units before the first cryoprecipitate (odds ratio [OR] 3·5, 95% CI: 1·7–7·2), placenta praevia (OR 7·2, 95% CI: 2·0–26·4) and emergency caesarean section (OR 4·9, 95% CI: 2·0–11·7) were independently associated with increased risk of hysterectomy. These findings confirm MOH as a major cause of maternal morbidity and mortality and indicate areas for practice improvement.
Psychosocial markers of pre‐hospital decision delay and psychological distress in acute coronary syndrome patients
Authors: Arrebola‐Moreno Mercedes , Petrova Dafina , Garrido Dunia , Ramírez‐Hernández José Antonio , Catena Andrés , Garcia‐Retamero Rocio
Published: February 2020

Objectives

Both pre‐hospital decision delay – the time patients wait before seeking medical attention after symptoms have started – and high psychological distress after the cardiac episode predict poor prognosis of patients with acute coronary syndromes (ACS). We aimed to identify psychosocial markers of these prognostic factors.

Design

A cross‐sectional study of 102 consecutive, clinically stable ACS survivors.

Methods

Participants completed a questionnaire measuring pre‐hospital decision delay, psychological distress, and several known psychosocial factors related to cardiovascular health: type D personality, resilience, social support, and concerns during the cardiac event. Multiple linear regression and mediation analyses were conducted.

Results

Type D personality and fewer concerns about the serious consequences of delaying help‐seeking were related to more psychological distress post‐ACS, and these relationships were mediated by longer pre‐hospital decision delay. In contrast, resilience was related to lower psychological distress. Social support and social concerns about help‐seeking were not related to the outcome variables.

Conclusions

Type D personality may be a risk factor for more delayed help‐seeking for an ACS and higher psychological distress after the cardiac event. Resilience, in contrast, emerged as a potential protective factor of patients’ mental health after the cardiac event. Pre‐hospital decision delay was related to thinking about serious consequences (e.g., complications, protecting one’s family) but not about social concerns (e.g., wasting other people’s time) during the cardiac episode.

Statement of Contribution

What is already known on this subject?

Longer pre‐hospital decision delay, that is waiting longer to seek medical attention after symptoms have started, predicts poor prognosis of acute coronary syndrome patients.

High psychological distress post‐ACS, such as the development of anxiety and/or depression, also predicts poor prognosis of these patients.

What does this study adds?

This study identifies several psychosocial markers of longer prehospital decision delay and high psychological distress post‐ACS.

Prehospital decision delay was related to thinking about serious consequences (e.g., complications, protecting one’s family) but not about social concerns (e.g., wasting other people’s time) during the cardiac episode.

Type D personality and fewer concerns about the serious consequences of delaying help‐seeking were related to more psychological distress, and these relationships were mediated by longer prehospital decision delay.

Resilience was related to lower psychological distress post‐ACS.
Potential microglia‐based interventions for stroke
Authors: Li Ling‐Zhi , Huang Yu‐You , Yang Zhen‐Hong , Zhang Si‐Jia , Han Zi‐Ping , Luo Yu‐Min
Published: February 2020

A large number of families worldwide suffer from the physical and mental burden posed by stroke. An increasing number of studies aimed at the prevention and treatment of stroke have been conducted. Specifically, manipulating the immune response to stroke is under intense investigation. Microglia are the principal immune cells in the brain and are the first line of defense against the pathophysiology induced by stroke. Increasing evidence has suggested that microglia play diverse roles that depend on dynamic interactions with neurons, astrocytes, and other neighboring cells both in the normal brain and under pathological conditions, including stroke. Moreover, there are dynamic alterations in microglial functions with respect to aging and sex differences in the human brain, which offer a deep understanding of the conditions of stroke patients of different ages and sex. Hence, we review the dynamic microglial reactions caused by aging, sex, and crosstalk with neighboring cells both in normal conditions and after stroke and relevant potential interventions.