bluuebunny/crossref_metadata_2025 huggingface dataset:
jornada de emergências
Authors: Cardoso Ercio do Carmo Sena , Gusman Juliana
Published: June 2020

O presente artigo propõe reflexões sobre experiências representativas da produção acadêmica “Jornada das utopias”, realizada pelos cursos de comunicação da Pontifícia Universidade Católica de Minas Gerais. Mediante a problematização de certos embates culturais que ocorreram nesse contexto, será realizada uma análise sobre processos de tradução intercultural estabelecidos entre o grupo cultural Lá da Favelinha, convidado da jornada, e a organização do evento. Objetiva-se compreender formas enunciativas operadas por esse grupo que desafiam perspectivas hegemônicas de comunicação.
Association Between Blood Lead Level and Uncontrolled Hypertension in the US Population (NHANES 1999–2016)
Authors: Miao Hui , Liu Yan , Tsai Thomas C. , Schwartz Joel , Ji John S.
Published: June 2020

Background

This study aims to explore whether higher blood lead levels (
BLL
) may be associated with failure to control blood pressure and subsequent uncontrolled hypertension.

Methods and Results

We used serial cross‐sectional waves of the
US
National Health and Nutrition Examination Survey (NHANES) from 1999 to 2016. 30 762 subjects aged 20 years and above were included. Uncontrolled hypertension was defined as systolic blood pressure ≥130 mm Hg or diastolic blood pressure ≥80 mm Hg. We estimated odds ratios (
OR
s) of quartiles of
BLL
for any hypertension and uncontrolled hypertension by sex using logistic regression, adjusted for demographics, smoking status, serum cotinine, alcohol intake, body mass index, and menopause status in women. The weighted prevalence of hypertension was 46.7%, of which 80.1% were uncontrolled. Men, younger ages, ethnic minorities, people with lower income, never and current smokers, and people with higher
BLL
were less likely to have their hypertension controlled. In men, compared with the lowest quartile of
BLL
(<0.94 μg/dL), the highest 2 quartiles (0.94–1.50 μg/dL, 1.50–2.30 μg/dL) were associated with hypertension (Q2:
OR
, 1.12; 95%
CI
, 0.96–1.30; Q3:
OR
, 1.16; 95%
CI
, 1.01–1.34; Q4:
OR
, 1.25; 95%
CI
, 1.08–1.45), but not in women. In hypertensive men, higher
BLL
was related to uncontrolled hypertension compared with the lowest quartile (Q2:
OR
, 1.34; 95%
CI
, 0.98–1.85; Q3:
OR
, 1.70; 95%
CI
, 1.26–2.30; Q4:
OR
, 1.96; 95%
CI
, 1.45–2.65). In women, the relationship was similar (Q2:
OR
, 1.26; 95%
CI
, 0.95–1.67; Q3:
OR
, 1.48; 95%
CI
, 1.10–2.00; Q4: 1.70; 95%
CI
, 1.26–2.30).

Conclusions

BLL
is associated with higher prevalence of hypertension and uncontrolled hypertension, with more pronounced association in men.
Objective Identification of Intermediate Lesions Inducing Myocardial Ischemia Using Sequential Intracoronary Pressure and Flow Measurements
Authors: Stegehuis Valérie E. , Wijntjens Gilbert W. M. , Nijjer Sukhjinder S. , de Waard Guus A. , van de Hoef Tim P. , Sen Sayan , Petraco Ricardo , Echavarría‐Pinto Mauro , Meuwissen Martijn , Danad Ibrahim , Knaapen Paul , Escaned Javier , Davies Justin E. , van Royen Niels , Piek Jan J.
Published: June 2020

Background

Although ischemic heart disease has a complex and multilevel origin, the diagnostic approach is mainly focused on focal obstructive disease as assessed by pressure‐derived indexes. The prognostic relevance of coronary flow over coronary pressure has been suggested and implies that identification of relevant perfusion abnormalities by invasive physiology techniques is critical for the correct identification of patients who benefit from coronary revascularization. The purpose of this study was to evaluate the diagnostic potential of a sequential approach using pressure‐derived indexes instantaneous wave‐free ratio (
iFR
), fractional flow reserve (
FFR
), and coronary flow reserve (
CFR
) measurements to determine the number of intermediate lesions associated with flow abnormalities after initial pressure measurements.

Methods and Results

A total of 366 intermediate lesions were assessed with simultaneous intracoronary pressure and flow velocity measurements. Contemporary clinical
iFR
,
FFR,
and
CFR
cut points for myocardial ischemia were applied. A total of 118 (32%) lesions were
FFR
+ and 136 (37%) lesions were
iFR
+. Subsequent
CFR
assessment resulted for
FFR
in a total of 91 (25%)
FFR
+/
CFR
+ and for
iFR
a total of 111 (30%)
iFR
+/
CFR
+ lesions. An
iFR
,
FFR
, and invasive flow velocity assessment approach would have yielded 20% of lesions (74 of 366) as ischemic.

Conclusions

Ultimately, 20% of intermediate lesions are associated with flow abnormalities after applying a pressure and flow velocity sequential approach. If
iFR
is borderline,
FFR
has limited additional value, in contrast with
CFR
. These results emphasize the use of coronary physiology in assessing stenosis severity but may also further question the contemporary reputation of a pressure‐based approach as a gold standard for the detection of myocardial ischemia in ischemic heart disease.
Utilization and Complications of Catheter Ablation for Atrial Fibrillation in Patients With Hypertrophic Cardiomyopathy
Authors: Rozen Guy , Elbaz‐Greener Gabby , Marai Ibrahim , Andria Nizar , Hosseini Seyed Mohammadreza , Biton Yitschak , Heist E. Kevin , Ruskin Jeremy N. , Gavrilov Yulia , Carasso Shemy , Ghanim Diab , Amir Offer
Published: June 2020

Background

Atrial fibrillation (AF) is common and bears a major clinical impact in patients with hypertrophic cardiomyopathy (HCM). We aimed to investigate the use and real‐world safety of catheter ablation for AF in patients with HCM.

Methods and Results

We drew data from the US National Inpatient Sample to identify cases of AF ablation in HCM patients between 2003 and 2015. Sociodemographic and clinical data were collected, and incidence of catheter ablation complications, mortality, and length of stay were analyzed, including trends between the early (2003–2008) and later (2009–2015) study years. Among a weighted total of 1563 catheter ablation cases in patients with HCM, the median age was 62 (interquartile range, 52–72), 832 (53.2%) were male, and 1150 (73.6%) were white. The average annual volume of AF ablations in patients with HCM doubled between the early and the later study period (79–156). At least 1 complication occurred in 16.1% of cases, and the in‐hospital mortality rate was 1%. Cardiac and pericardial complications declined from 8.8% to 2.3% and from 2.8% to 0.9%, respectively, between the early and the later study years (
P
<0.01). Independent predictors of complications included female sex (odds ratio [OR], 4.81; 95% CI, 2.72–8.51), diabetes mellitus (OR, 6.57; 95% CI, 2.68–16.09) and obesity (OR, 3.82; 95% CI, 1.61–9.06).

Conclusions

Despite some decline in procedural complications over the years, catheter ablation for AF is still associated with a relatively high periprocedural morbidity and even mortality in patients with HCM. This emphasizes the importance of careful clinical consideration, by an experienced electrophysiologist, in referring patients with HCM for an AF ablation.
Improving Model-Based Genetic Programming for Symbolic Regression of
Small Expressions
Authors: Virgolin M. , Alderliesten T. , Witteveen C. , Bosman P. A. N.
Published: June 2020

The Gene-pool Optimal Mixing Evolutionary Algorithm (GOMEA) is a model-based EA framework that has been shown to perform well in several domains, including Genetic Programming (GP). Differently from traditional EAs where variation acts blindly, GOMEA learns a model of interdependencies within the genotype, that is, the linkage, to estimate what patterns to propagate. In this article, we study the role of Linkage Learning (LL) performed by GOMEA in Symbolic Regression (SR). We show that the non-uniformity in the distribution of the genotype in GP populations negatively biases LL, and propose a method to correct for this. We also propose approaches to improve LL when ephemeral random constants are used. Furthermore, we adapt a scheme of interleaving runs to alleviate the burden of tuning the population size, a crucial parameter for LL, to SR. We run experiments on 10 real-world datasets, enforcing a strict limitation on solution size, to enable interpretability. We find that the new LL method outperforms the standard one, and that GOMEA outperforms both traditional and semantic GP. We also find that the small solutions evolved by GOMEA are competitive with tuned decision trees, making GOMEA a promising new approach to SR.
Stop Signal Task Training Strengthens GABA-mediated Neurotransmission within the Primary Motor Cortex
Authors: Chowdhury Nahian S. , Livesey Evan J. , Harris Justin A.
Published: June 2020

We have recently shown that the efficiency in stopping a response, measured using the stop signal task, is related to GABAA-mediated short-interval intracortical inhibition (SICI) in the primary motor cortex. In this study, we conducted two experiments on humans to determine whether training participants in the stop signal task within one session (Experiment 1) and across multiple sessions (Experiment 2) would increase SICI strength. For each experiment, we obtained premeasures and postmeasures of stopping efficiency and resting-state SICI, that is, during relaxed muscle activity (Experiment 1, n = 45, 15 male participants) and SICI during the stop signal task (Experiment 2, n = 44, 21 male participants). In the middle blocks of Experiment 1 and the middle sessions of Experiment 2, participants in the experimental group completed stop signal task training, whereas control participants completed a similar task without the requirement to stop a response. After training, the experimental group showed increased resting-state SICI strength (Experiment 1) and increased SICI strength during the stop signal task (Experiment 2). Although there were no overall behavioral improvements in stopping efficiency, improvements at an individual level were correlated with increases in SICI strength at rest (Experiment 1) and during successful stopping (Experiment 2). These results provide evidence of neuroplasticity in resting-state and task-related GABAA-mediated SICI in the primary motor cortex after response inhibition training. These results also suggest that SICI and stopping efficiency are temporally linked, such that a change in SICI between time points is correlated with a change in stopping efficiency between time points.
Task-specific Disruptions in Theta Oscillations during Working Memory for Temporal Order in People with Schizophrenia
Authors: Liu Xiaonan L. , Ranganath Charan , Hsieh Liang-Tien , Hurtado Mitzi , Niendam Tara A. , Lesh Tyler A. , Carter Cameron S. , Ragland J. Daniel
Published: June 2020

Prior studies demonstrated that neural oscillations are enhanced during working memory (WM) maintenance and that this activity can predict behavioral performance in healthy individuals. However, it is unclear whether the relationship holds for people with WM deficits. People with schizophrenia have marked WM deficits, and such deficits are most prominent when patients are required to process relationships between items, such as temporal order. Here, we used EEG to compare the relationship between oscillatory activity and WM performance in patients and controls. EEG was recorded as participants performed tasks requiring maintenance of complex objects (“Item”) or the temporal order of objects (“Order”). In addition to testing for group differences, we examined individual differences in EEG power and WM performance across groups. Behavioral results demonstrated that patients showed impaired performance on both Item and Order trials. EEG analyses revealed that patients showed an overall reduction in alpha power, but the relationship between alpha activity and performance was preserved. In contrast, patients showed a reduction in theta power specific to Order trials, and theta power could predict performance on Order trials in controls, but not in patients. These findings demonstrate that WM impairments in patients may reflect two different processes: a general deficit in alpha oscillations and a specific deficit in theta oscillations when temporal order information must be maintained. At a broader level, the results highlight the value of characterizing brain–behavior relationships, by demonstrating that the relationship between neural oscillations and WM performance can be fundamentally disrupted in those with WM deficits.
Nonlinear response characteristics of neural networks and single neurons undergoing optogenetic excitation
Authors: Luboeinski Jannik , Tchumatchenko Tatjana
Published: June 2020

Optogenetic stimulation has become the method of choice for investigating neural computation in populations of neurons. Optogenetic experiments often aim to elicit a network response by stimulating specific groups of neurons. However, this is complicated by the fact that optogenetic stimulation is nonlinear, more light does not always equal to more spikes, and neurons that are not directly but indirectly stimulated could have a major impact on how networks respond to optogenetic stimulation. To clarify how optogenetic excitation of some neurons alters the network dynamics, we studied the temporal and spatial response of individual neurons and recurrent neural networks. In individual neurons, we find that neurons show a monotonic, saturating rate response to increasing light intensity and a nonmonotonic rate response to increasing pulse frequency. At the network level, we find that Gaussian light beams elicit spatial firing rate responses that are substantially broader than the stimulus profile. In summary, our analysis and our network simulation code allow us to predict the outcome of an optogenetic experiment and to assess whether the observed effects can be attributed to direct or indirect stimulation of neurons.
Beckett, Music, Intermediality
Authors: Laws Catherine
Published: June 2020

The topic of ‘Beckett and music’ has gained considerable attention in recent years. In previous work I have argued that music in Beckett’s plays does not, as some have suggested, exist beyond or exceed the ambiguities of body, knowledge and subjectivity that are apparent in other aspects of his work, but rather that its use parallels and reinforces these processes. If this kind of intermediality, involving music, operates already in some of Beckett’s work, how does it manifest when musicians work with or in relation to it? This question is addressed through a discussion of John Tilbury’s version of Worstward Ho, for piano, recorded voice and electronics.
Description of a new water mite of the genus Arrenurus (Acari, Hydrachnidia: Arrenuridae) from Chukotka
Authors: TUZOVSKIJ PETR V.
Published: June 2020

This paper describes a new water mite species of the family Arrenuridae. Specimens were collected by the author in standing waters of the Asian part of Russia with a common hand net with 250 μm. Most specimens were not dissected, thus preserving natural shape of the body. For several larvae, males and females the gnathosoma was mounted in a position that allowed examnation of the pedipalps in lateral view. To obtain larvae, water mites were maintained in laboratory (room temperature, natural day-night conditions). Eggs and larvae obtained from single female in glass with diameters 10 mm, and a height 15 mm.
Two new species in the mycophagous genus Pocadius Erichson, 1843 from China (Coleoptera: Nitidulidae: Nitidulinae)
Authors: CHEN XIAOXIAO , HUANG MIN
Published: June 2020

Two new Pocadius species, P. tenebrosus sp. nov. and P. zhangjiajieensis sp. nov., are described and illustrated from southwestern and south-central China. Diagnostic characters of the new species and related species are discussed.
Participatory video as a novel recovery-oriented intervention in early psychosis: A pilot study
Authors: MacDougall Arlene G , Kukan Sahana , Price Elizabeth , Glen Sarah , Bird Richelle , Powe Laura , Wiener Joshua C , Lysaker Paul H , Anderson Kelly K , Norman Ross MG
Published: June 2020

Background:

Personal narrative plays an important role in the process of recovery from psychotic illnesses. Participatory video is a novel, active intervention that can be used as a tool for fostering narrative development among people with psychosis.

Aim:

To assess the feasibility, acceptability and potential clinical utility of participatory video as an innovative tool for promoting recovery in early psychosis.

Methods:

Ten outpatients of an early psychosis intervention programme were recruited to participate in 13 biweekly workshops to plan, film and produce documentary-style videos of their experiences. Feasibility was measured through recruitment and retention. Acceptability was measured through workshop attendance and client satisfaction. Clinical outcomes were assessed at baseline, post intervention and 3 months post intervention.

Results:

The participatory video intervention was feasible and associated with a high degree of satisfaction for participants who completed the workshops ( n = 6). At 3-month follow-up, participants exhibited significant reductions ( p < .05) in tension, self-stigma and negative perceptions of hoped-for selves.

Conclusions:

The findings of this pilot study suggest that participatory video is feasible and acceptable for individuals with early psychosis. This study also provides important pilot data supporting a larger trial investigating the effectiveness of participatory video as a recovery-oriented intervention.
A micromechanical unit cell model with an octagonal fiber for continuous fiber reinforced composites
Authors: Huang Yuanchen , Cimini Carlos Alberto , Ha Sung Kyu
Published: June 2020

This paper presents a novel micromechanical unit cell model for continuous fiber reinforced composites, which features a fiber with an octagonal cross-section embedded in surrounding matrix, and was named as octagonal fiber model. The cross-section of octagonal fiber model was subdivided into five by five sub-regions, and the conditions of equilibrium and deformation compatibility were applied to derive expression of effective ply properties, and stress amplification factors, which correlate microstresses in sub-regions with ply stresses. For E-glass/epoxy and carbon/epoxy material systems with different fiber volume fractions, effective ply properties and stress amplification factors in sub-regions were evaluated using derived formulae. Results from octagonal fiber model were then compared with those from multiple analytical methods and finite element unit cell model. It was shown that effective ply properties predicted by octagonal fiber model were generally in good agreement with those from finite element model, and octagonal fiber model outperformed other analytical counterparts in estimating stress amplification factors, demonstrating the potential of octagonal fiber model.
Intravenous dexmedetomidine versus intravenous clonidine for post spinal anesthesia shivering: a meta-analysis of randomized controlled trials
Authors: Wang Na , Wang Zaitang , Song Xuesong , Wang Jinguo
Published: June 2020

Background

Dexmedetomidine and clonidine are the most extensively studied drugs for shivering treatment, because α2-adrenergic agonists can reduce the shivering threshold. The objective of this meta-analysis was to compare the efficacy and complications of dexmedetomidine with those of clonidine, when used for control of post spinal anesthesia shivering.

Methods

Electronic databases were searched for randomized controlled trials (RCT) comparing the effect of dexmedetomidine versus clonidine for control of post spinal anesthesia shivering. The endpoints were effective rate of shivering treatment, time to cease shivering, recurrent rate of shivering and complications.

Results

Six studies comprising 340 adult patients were included in this meta-analysis. Dexmedetomidine had higher effective rate of shivering treatment (odds ratio [OR]: 4.11, 95% confidence interval (CI): [1.53, 11.07], P = 0.005), shorter time to cease shivering (Mean differences (MD)=–1.91; 95% CI [–3.66, –0.15], P = 0.03), lower recurrent rate of shivering (OR = 0.30; 95% CI [0.12, 0.75], P = 0.01), compared to clonidine. Dexmedetomidine had a lower rate of hypotension and higher incidence of sedation than clonidine.

Conclusions

Dexmedetomidine is superior to clonidine when used for shivering treatment after spinal anesthesia, because of higher incidence of effective rate and sedation, faster control of shivering, lower incidence of recurrent rate and hypotention.
Randomized Controlled Trial of Balloon Dilation in Treatment of Subglottic Stenosis With a Rabbit Model
Authors: Wistermayer Paul , McIlwain Wesley , Escalante Derek , Rogers Derek J.
Published: June 2020

Objectives

Identify the effects of balloon dilation duration and topical ciprofloxacin‐dexamethasone application in treatment of subglottic stenosis.

Study Design

Randomized controlled trial.

Setting

Animal research facility.

Subjects and Methods

Forty‐four rabbits underwent subglottic injury in an Institutional Animal Care and Use Committee–approved study. One week after injury, the subglottis of each rabbit was measured and treated with endoscopic balloon dilation for 2 rounds of short duration (SBD; 3 seconds), long duration (LBD; 30 seconds), or LBD with topical ciprofloxacin‐dexamethasone application (LBD+C). The subglottis of each rabbit was remeasured at the study endpoint: 1 month postdilation or following development of life‐threatening respiratory distress.

Results

Of 44 rabbits, 35 (80%) survived to endoscopic balloon dilation, with 21 rabbits developing a grade III Cotton‐Myer stenosis. Prior to dilation, there was no difference in stenosis rates among groups (all subjects, P =. 99; grade III stenosis only, P =. 52). Among grade III subjects, improvement in stenosis after dilation was –1% (SD, 21%) for SBD, 27% (SD, 38%) for LBD, and 58% (SD, 29%) for LBD+C (P =. 01). Early euthanasia/death rates among grade III subjects were 85% for SBD, 63% for LBD, and 17% for LBD+C (P =. 03). Time to early euthanasia/death was 5.0 days for the SBD group and 8.4 days for the LBD group (P =. 04).

Conclusion

SBD was inferior to LBD or LBD+C in multiple metrics. LBD+C offered significant improvements in stenosis size and mortality over the SBD group and had the lowest rate of early mortality. Further research is needed to identify optimal balloon dilation treatment duration.
Subjective Visual Vertical Testing in Patients With Chronic Suppurative Otitis Media
Authors: da Costa Monsanto Rafael , Kasemodel Ana Luiza Papi , Tomaz Andreza , de Oliveira Penido Norma
Published: June 2020

Objective

To analyze the results of the subjective visual vertical test using the “bucket method” in patients with chronic suppurative otitis media (CSOM).

Study Design

Cross‐sectional, controlled study.

Setting

Outpatient otology clinic in a tertiary care hospital.

Subjects and Methods

Patients had CSOM, defined as the presence of chronic infection or inflammation of the middle ear cleft, associated with a perforation of the tympanic membrane, frequent or intractable middle ear suppuration, with or without cholesteatoma. Controls were selected using a nonprobability, purposive sampling method. We excluded patients with neurologic or metabolic diseases, cognitive deficits, otosclerosis, vestibular migraine, Ménière’s disease, past use of ototoxic medication, or head and neck cancer. The volunteers were subjected to the subjective visual vertical test using the “bucket method.” The results obtained in our study and control groups were analyzed using nonparametric tests.

Results

Our study comprised 51 patients with CSOM and 50 controls. In the CSOM group, we observed that 72.5% of the patients had vestibular symptoms in the past year, and 70.5% had abnormalities identified in at least 1 vestibular function test. The subjective visual vertical test revealed that patients with CSOM (with and without cholesteatoma) had significantly higher deviations of the true vertical as compared with controls (CSOM, 3.66°; controls, 0.76°; P <. 001).

Conclusion

Our results revealed that CSOM was associated with high rates of vestibular symptoms, abnormal vestibular function tests, and abnormal subjective vertical visual results.
Identification of 11 Different HPV Subtypes in Adult Patients With Recurrent Respiratory Papillomatosis
Authors: Hoesli Rebecca C. , Wingo Melissa L. , Richardson Brent E. , Bastian Robert W.
Published: June 2020

Objective

To define the human papillomavirus (HPV) subtypes seen in a large adult population with traditionally defined recurrent respiratory papillomatosis.

Study Design

Retrospective review.

Setting

Tertiary care laryngology practice.

Subjects and Methods

All patients had a firm diagnosis of recurrent respiratory papillomatosis defined by (1) visually obvious papillomas, (2) recurrence requiring multiple surgeries, and (3) pathology diagnosis of “papilloma.” Each patient had also undergone HPV subtyping. Age, sex, presence of malignancy, and HPV subtypes were tabulated and correlated with long‐term patient outcomes.

Results

A total of 184 patients were identified who fulfilled the above criteria. In total, 87.0% (160) had a low risk subtype; 9.2% had an alternative subtype. These consisted of subtypes 16, 18, 31, 44, 45, 55, and 70. Four patients (2.2%) had combinations of subtypes, with 1 patient with HPV 11 and 16, 1 patient with HPV 11 and 76, 1 patient with 11 and 84, and 1 patient with 18 and 45. Finally, 3.8% of patients were HPV negative, despite fulfilling all 3 criteria listed above.

Conclusion

In the patient population above, almost 10% of patients had an HPV subtype other than 6 and 11. This suggests that traditionally defined recurrent respiratory papillomatosis (RRP) can be caused by HPV subtypes other than 6 and/or 11. In addition, the clinical course of persons with this definition of RRP appears to vary by subtype, and this information may offer the ability to nuance follow‐up instructions, reducing in particular the burden placed upon patients who have RRP caused by subtypes 6 and 11.
Prevalence of Eustachian Tube Dysfunction in the US Elderly Population
Authors: Fischer Jakob L. , Riley Charles A. , Hsieh Mei‐Chin , Marino Michael J. , Wu Xiao‐Cheng , McCoul Edward D.
Published: June 2020

Objective

To investigate the prevalence of eustachian tube dysfunction (ETD) in elderly adults in the United States and its association with other upper aerodigestive inflammatory processes.

Study Design

Cross‐sectional study.

Setting

Population based.

Subjects and Methods

In total, 147,805 patients without malignancy were compared to 13,804 demographically matched patients with malignancy of the upper aerodigestive tract (UADT) by querying the Surveillance, Epidemiology, and End Results (SEER)–Medicare linked database for patients aged 66 to 99 years between 2003 and 2011. The prevalence of ETD and inflammatory diseases among these patients was compared. Association between ETD, other upper aerodigestive inflammatory processes, and UADT malignancies was evaluated.

Results

The prevalence of ETD was 5.44% among patients without malignancy and 9.08% in those with cancer (odds ratio [OR], 1.73; 95% CI, 1.63‐1.84). Patients with ETD in the control population were more likely (OR, 95% CI) to be diagnosed with chronic rhinitis (5.00, 4.70‐5.33), chronic sinusitis (4.20, 3.98‐4.43), allergic rhinitis (4.27, 4.08‐4.47), and gastroesophageal reflux disease (GERD) (2.42, 2.31‐2.53). Patients with ETD and chronic rhinitis (1.43, 1.24‐1.65), chronic sinusitis (1.57, 1.38‐1.78), and acute otitis media (1.33, 1.08‐1.65) were associated with higher rates of UADT malignancy.

Conclusion

Over 5% of patients older than 65 in the United States are diagnosed with ETD in the absence of UADT malignancy. Associations between ETD and chronic rhinitis, chronic sinusitis, allergic rhinitis, and GERD in the absence of UADT malignancy suggest that some patients may benefit from treatment of inflammatory disease as a cause of ETD.
Optimization of Delivery of Pediatric Otolaryngology Surgical Antibiotic Prophylaxis
Authors: Yalamanchi Pratyusha , Parent Ashley , Thorne Marc
Published: June 2020

Objectives

There is limited evidence regarding use of routine perioperative antibiotics for pediatric otolaryngologic procedures. The objectives of this quality improvement study were (1) to characterize the otolaryngology case mix for which antibiotics were delivered and (2) determine the percentage of surgical encounters with appropriate timing of antibiotic administration.

Methods

Pediatric otolaryngology procedures meeting criteria from 2015 to 2019 were evaluated as a component of an institution‐wide pediatric surgical antibiotic prophylaxis study using A3 problem solving to identify and roll out interventions for appropriate antibiotic administration. Descriptive statistical analysis of the interrupted time‐series data was used to describe the otolaryngology case mix for which antibiotics were delivered. The primary outcome measure was percentage of surgical encounters with appropriate timing of antibiotic administration in minutes relative to incision.

Results

In total, 1520 pediatric otolaryngology procedures with perioperative antibiotic delivery were performed from July 2015 to September 2019. While surgical site infection number (n = 2/year) was stable, administration of timely prophylactic antibiotics significantly improved: 27.5% of cases per month at baseline and 86.9% at the conclusion of the rollout of the sequential interventions (P <. 001).

Discussion

Given the exceedingly low infection rate of clean otolaryngology surgery, there is limited evidence in favor of perioperative antibiotics for the majority of procedures. Prophylactic antibiotics were most commonly used in otologic surgery involving cochlear implantation or in the setting of draining ears or cholesteatoma and in clean‐contaminated head and neck surgery cases.

Implications for Practice

Iterative continuous performance improvement can optimize evidence‐based delivery of preoperative prophylactic antibiotics. Additional interventions to ensure antimicrobial stewardship in pediatric otolaryngology are indicated.
Clinical outcomes and financial impacts of malnutrition in sepsis
Authors: McLaughlin Jessica , Chowdhury Nibras , Djurkovic Svetolik , Shahab Omer , Sayiner Mehmet , Fang Yun , Kennedy Ruth
Published: June 2020

Background:

In the United States in 2014 approximately 1.7 million adults were hospitalized with sepsis, resulting in about 270,000 deaths. Malnutrition in hospitalized patients contributes to increased morbidity, mortality, and costs, especially in the critically ill population.

Aim:

Our goal was to investigate the prevalence of malnutrition in sepsis and the impact it has on clinical and financial outcomes in our most critically ill patients.

Methods:

We implemented nutritional screening by a registered dietitian of 1000 patients admitted with sepsis to specialized care units. We calculated the prevalence of malnutrition, and compared outcomes including mortality, length of stay, and financial costs.

Results:

About 10% of patients with sepsis admitted to our specialized care units were diagnosed with malnutrition on admission after implementation of mandatory assessment.

Conclusions:

Although mortality did not reach statistical significance, these patients had more comorbidities, longer hospital stays, and higher total costs.
Effects of two different types of ankle–foot orthoses on gait outcomes in patients with subacute stroke: a randomized crossover trial
Authors: Karakkattil Priya Sibi , Trudelle-Jackson Elaine , Medley Ann , Swank Chad
Published: June 2020

Objective:

To identify whether patients in the subacute stage of stroke, with foot drop, would have better gait outcomes when using a double-adjustable AFO (DA AFO) or a posterior leaf spring AFO (PLS AFO) at baseline without practice and to determine whether one week of practice would significantly change gait outcomes with either of the AFOs.

Design:

Within-subject 2 × 2 repeated measures design.

Setting:

Postacute and outpatient rehabilitation center.

Participants:

Twenty individuals with mean age of 57 years (SD: 12.0 years) with subacute stroke.

Interventions:

Participants were measured using DA AFO and PLS AFO at baseline. Follow-up measurements were taken after one week of practice with each type of AFO in randomly assigned order.

Outcome Measures:

Gait endurance (6-Minute Walk Test (6MWT)), gait symmetry, and gait velocity at self-selected and fast-paced velocity measured using GAITRite gait analysis system and patient report of AFO preference.

Results:

At baseline, no significant differences were found between the 2 AFOs ( P > 0.05). There was no significant interaction ( P > 0.05) of AFO and practice for gait endurance, symmetry, and velocity. Main effect of practice was significant for gait endurance ( P < 0.001), self-selected velocity ( P = 0.001), and fast-paced velocity ( P < 0.001). In all, 16 participants preferred using DA AFO for walking.

Conclusions:

No difference between DA AFO and PLS AFO was found on measures of gait endurance, symmetry, and velocity at baseline or after practice. With practice over time, participants improved in gait endurance and velocity regardless of AFO type.
HIV and systemic lupus erythematosus: where immunodeficiency meets autoimmunity
Authors: O’Kelly Brendan , McNally Cora , McConkey Sam , Durcan Laura
Published: June 2020

We report a case of a new diagnosis of systemic lupus erythematosus (SLE) in a patient with HIV who presented to the outpatient department with a fever, headache and lymphadenopathy. Cerebrospinal fluid analysis showed lymphocytic pleocytosis. Initial concerns were for an infectious process, and investigations for systemic and central nervous system infection were negative. Serum testing for ANA, dsDNA, nucleosome, anti-histone and ribosomal-P antibodies was positive. A magnetic brain imaging scan of the brain showed a well-circumscribed lesion in the right cerebellar peduncle on T2/FLAIR. The patient was commenced on prednisolone and rituximab, and had a good clinical response. The cerebellar lesion resolved and has not recurred with sequential imaging. SLE and HIV are both multi-systemic diseases which rarely co-occur. Autoimmune processes should be considered in HIV patients with multi-systemic symptoms and signs.
Step Out of Line: Modeling Nonlinear Effects and Dynamics in Close-Relationships Research
Authors: Girme Yuthika U.
Published: June 2020

Despite widespread acknowledgment that close relationships frequently involve tumultuous and dynamic experiences, most models in relationship psychology focus on linear relationship processes. Modeling nonlinear patterns can, however, be an important way to assess and better understand the complexities inherent in close relationships. In this article, I draw on one of the most widely studied theories in relationship science—attachment theory—to illustrate how modeling nonlinear effects between variables (i.e., curvilinear effects) and nonlinear dynamics across time (i.e., within-person variation and within-dyad flexibility) can reconcile inconsistencies in the literature, reveal unique relationship experiences, and broaden our understanding of complex relationship processes.
Financialization at work: Shareholder primacy and stagnant wages in the United States
Authors: Palladino Lenore
Published: June 2020

Financialization has been ‘at work’ in the United States for nearly half of a century, as corporate executives have increasingly prioritized shareholder payments over other productive uses of corporate resources. Over the same period, employee bargaining power has fallen and wages for non-executive workers have stagnated across sectors. This article examines the effects of shareholder primacy on labour compensation in the United States in the neoliberal era at the aggregate, sectoral and firm level. Specifically, the article analyses changes in the relationships between rising profits, shareholder payments, and wages over the past four decades, finding evidence that shareholders’ gains come at the expense of employees in publicly traded corporations. The growing power of shareholders has been neglected compared to traditional arguments for wage stagnation, including globalization, de-unionization, rising market power and changes in industry composition. To disincentivize corporate behavior that prioritizes shareholders, a policy agenda is proposed that ends the practice of stock buybacks and institutes a stakeholder approach to corporate governance.
Attachment Styles and the Family Systems of Individuals Affected by Substance Abuse
Authors: Coffman Everette , Swank Jacqueline
Published: June 2020

This article focuses on the association between attachment styles within the family system and substance abuse. The authors describe attachment theory and the ways insecure attachments adversely affect the families of individuals with substance abuse concerns. Additionally, they discuss the need for attachment-informed approaches to treat these families and key components of this treatment approach.
Depressive symptoms among children attending community based support in South Africa – pathways for disrupting risk factors
Authors: Sherr Lorraine , Yakubovich Alexa R , Skeen Sarah , Tomlinson Mark , Cluver Lucie D , Roberts Kathryn J , Macedo Ana
Published: June 2020

Children in Southern Africa are exposed to high rates of structural and family adversities. This study tests whether services from Community Based Organisations (CBOs) in South Africa can promote children’s resilience against depression exposed to such adversities. Two linked longitudinal studies were conducted, comprising n = 1848 children aged 9 to 13 years. One group received CBO services, whilst the other (quasi-control) did not. Analyses used interaction terms in regression models to test for potential moderation effects of CBO attendance, and marginal effects models to interpret significant interactions. Two interaction effects were shown, demonstrating moderation effects of CBO attendance on common structural disadvantages. First, children exposed to community violence showed increased depression (contrast = 0.62 [95%CI 0.43, 0.82], p < .001), but this association was removed by CBO access (contrast = 0.07 [95%CI −0.28, 0.43], p = .682). Second, children living in informal housing showed increased depression (contrast = 0.63 [95%CI 0.42, 0.85], p < .001), however, this association was removed by CBO access (contrast = 0.01 [95%CI −0.55, 0.56], p = .977). CBO attendance is associated with fewer depressive symptoms, and can buffer against important structural adversities of poor housing and violence that are common in high HIV-prevalence areas. However, CBO attendance was not able to remove the increased psychosocial distress associated with some family-level vulnerabilities such as orphanhood and abuse. These findings highlight the centrality of CBO-provided psychosocial support for children in Southern Africa, and suggest areas for bolstering provision.
A dynamic structure-adaptive symbolic approach for slewing bearings’ life prediction under variable working conditions
Authors: Ding Peng , Jia Minping , Wang Hua
Published: June 2020

Data-driven technologies, especially artificial intelligence ones, are widely used in residual useful life (RUL) prediction of machinery. They are flexible in predicting RUL without grasping prior knowledge of physical mechanisms. However, interpretability is generally absent, which makes them like “black boxes.” This shortcoming directly raises considerable uncertainty of high-reliability applications, questions on the trustworthiness of decision-making results, and even results in poor generalization under cross-domain RUL predictions. Therefore, the idea of exploring explainable life prediction models with desired cross-domain prediction performances is motivated. The above dilemmas are tackled through the in-depth research of symbolic life models: an evolving symbolic regression approach, namely, dynamic structure–adaptive symbolic approach (DSASA). DSASA, visually displaying internal model structures, gives considerations to historical samples and dynamically accommodates real-time degradation of service parts. In brief, multi-signal-based health indicators are first entered into three genetic programming algorithms for initial life modeling. Afterward, DSASA reconstructs initial life expressions and tracks the real-time degradation of machinery via dynamic coupling terms. Finally, cross-validations are conducted through slewing bearings’ accelerated run-to-failed experiments under variable working conditions. Encouraging prediction results deliver that DSASA has reliable generalizations and significantly reduces prediction error by 82.5%, 45.5%, and 79.8% compared with initial models before reconstruction.
Wuity as a Philosophical Lens for Qualitative Data Analysis
Authors: Williamson Charmaine , Van Rooyen Annelien , Shuttleworth Christina , Binnekade Carol , Scott Deon
Published: June 2020

Qualitative researchers place value on taking a closer, insider look at data as well as the subsequent data analysis and interpretation. On one end of the interpretive spectrum, researchers should be fully imbued with the coding-to-theorizing process by attending closely to the coding that leads to their analysis. On the opposite end, are those researchers positioned in the positivist paradigm, who vividly question the “researcher-as-data” analysis and its explicit subjectivity. As a middle ground, qualitative researchers have worked collectively in broader teams and/or used independent, practiced coders to add rigor to the coding process. These approaches clearly reflect the philosophical positions researchers adopt in following a research process. For the current study, the authors used the framework of Wuity thinking, which prompts exploratory learning and draws on Eastern-based wisdom. By using Wuity as both a method and a theory, an independent coder with prior knowledge of the coding process oriented a team into the epistemic practices of qualitative coding. The study found that the subtleties of a Wuity lens show delicate and enabling thresholds for expanding mindsets and practices within epistemic communities. The authors concluded that a coding team, working in a different manner, may well advance novel points of departure for qualitative analysis.
Effect of computed tomography perfusion post-processing algorithms on optimal threshold selection for final infarct volume prediction
Authors: Rava Ryan A , Snyder Kenneth V , Mokin Maxim , Waqas Muhammad , Allman Ariana B , Senko Jillian L , Podgorsak Alexander R , Bhurwani Mohammad Mahdi Shiraz , Davies Jason M , Levy Elad I , Siddiqui Adnan H , Ionita Ciprian N
Published: June 2020

In acute ischemic stroke (AIS) patients, eligibility for endovascular intervention is commonly determined through computed tomography perfusion (CTP) analysis by quantifying ischemic tissue using perfusion parameter thresholds. However, thresholds are not uniform across all analysis methods due to dependencies on patient demographics and computational algorithms. This study aimed to investigate optimal perfusion thresholds for quantifying infarct and penumbra volumes using two post-processing CTP algorithms: Vitrea Bayesian and singular value decomposition plus (SVD+). We utilized 107 AIS patients (67 non-intervention patients and 40 successful reperfusion of thrombolysis in cerebral infarction (2b/3) patients). Infarct volumes were predicted for both post-processing algorithms through contralateral hemisphere comparisons using absolute time-to-peak (TTP) and relative regional cerebral blood volume (rCBV) thresholds ranging from +2.8 seconds to +9.3 seconds and –0.23 to –0.56 respectively. Optimal thresholds were determined by minimizing differences between predicted CTP and 24-hour fluid-attenuation inversion recovery magnetic resonance imaging infarct. Optimal thresholds were tested on 60 validation patients (30 intervention and 30 non-intervention) and compared using RAPID CTP software. Among the 67 non-intervention and 40 intervention patients, the following optimal thresholds were determined: intervention Bayesian: TTP = +4.8 seconds, rCBV = –0.29; intervention SVD+: TTP = +5.8 seconds, rCBV = –0.29; non-intervention Bayesian: TTP = +5.3 seconds, rCBV = –0.32; non-intervention SVD+: TTP = +6.3 seconds, rCBV = –0.26. When comparing SVD+ and Bayesian post-processing algorithms, optimal thresholds for TTP were significantly different for intervention and non-intervention patients. rCBV optimal thresholds were equal for intervention patients and significantly different for non-intervention patients. Comparison with commercially utilized software indicated similar performance.
Digital Ecosystems of Ideology: Linked Media as Rhetoric in Spanish Political Tweets
Authors: Ceia Vanessa
Published: June 2020

That Twitter is a major form of political mobilization and influence has been well documented. But what is the role of linked media—references to newspapers, photos, videos, and other external sources via URLs—in political Twitter messaging? How are linked references employed as campaign tools and rhetorical devices in messages published by political parties on Twitter? Is there a quantifiable relationship between a party’s ideology and linked media in tweets? With the spread of fake news, threats to a free press, and questioning of the legitimacy of political messaging on the rise globally, the sources on which parties draw to convince voters of their online messaging deserve critical attention. To explore the above questions, this article examines uses of linked media in tweets generated by the official accounts of Spain’s top five political parties during, in the lead-up, and in the immediate aftermath of the Spanish General Elections held on April 28, 2019. Grounded in a corpus of 10,038 tweets collected between March 1 and May 15, 2019, this study quantifies, compares, and critiques how linked media are integrated and remixed into tweets published by the left-leaning Spanish Workers’ Socialist Party (@PSOE), right-wing Popular Party (@populares), left-wing Podemos (@ahorapodemos), neoliberal Citizens (@CiudadanosCs), and far-right Vox (@vox_es) parties. Evidence reveals that each party links to media from somewhat homophilic groups of news outlets, journalists, and public figures, an analysis of which can shed light on how parties construct their digital self-representations, ideological networks of information, and attempt to sway voters.
Role of microRNA 4717, its effects on programmed cell death protein-1 in hepatitis B infection, and interaction between PDCD1 and miR-4717
Authors: Li Junhua , Li Andong
Published: June 2020

It is suggested that programmed cell death protein-1 (PD-1) is involved in hepatitis B virus (HBV) infection, the leading cause of hepatocellular carcinoma globally. This study was multi-aimed, that is, to investigate the role of microRNA (miR) 4717 and its target, PD-1 and to determine how the rs10204525 polymorphism in the 3′ untranslated region (3′UTR) of PD-1 affects its interaction with miR-4717. The expression levels of miR-4717 with various single-nucleotide polymorphisms were measured by reverse transcription–quantitative polymerase chain reaction (RT-qPCR). A total of 54 tissue samples from HBV-infected individuals were collected, genotyped, and categorized into three groups; AA (n = 32), AG (n = 18), and GG (n = 4). The expression levels of gene PDCD1 and its corresponding PD-1 protein were significantly declined in the AA group as compared to AG and GG groups. There was a negative linear association between PDCD1 and miR-4717 in the tissue samples. HEPG2 cells transfected with an miR-4717 mimic or PD-1 small interfering (si)RNA exhibited significantly reduced expression levels of PDCD1 and PD-1, whereas cells transfected with an inhibitor of miR-4717 demonstrated greater expression levels of PDCD1 and PD-1 compared with the scramble control. In addition, cell viability and apoptosis were assessed in cells transfected with an miR-4717 mimic, PD-1 siRNA, or an miR-4717 inhibitor. Results revealed that treatment with the miR-4717 mimic or PD-1 siRNA enhanced viability of cells and reduced apoptosis. The results of this study suggest that rs10204525 polymorphism interferes with the interaction between PD-1 and miR-4717 and therefore induces apoptosis in liver cancer cells.