bluuebunny/crossref_metadata_2025 huggingface dataset:
Ocular Complications in the Prone Position in the Critical Care Setting: The COVID-19 Pandemic
Authors: Sanghi Priyanka , Malik Mohsan , Hossain Ibtesham T. , Manzouri Bita
Published: September 2020

Purpose:

Ocular complications are common in the critical care setting but are frequently missed due to the focus on life-saving organ support. The SARS-CoV-2 (COVID-19) pandemic has led to a surge in critical care capacity and prone positioning practices which may increase the risk of ocular complications. This article aims to review all ocular complications associated with prone positioning, with a focus on challenges posed by COVID-19.

Materials and Methods:

A literature review using keywords of “intensive care”, “critical care”, “eye care”, “ocular disorders”, “ophthalmic complications,” “coronavirus”, “COVID-19,” “prone” and “proning” was performed using the electronic databases of PUBMED, EMBASE and CINAHL.

Results:

The effects of prone positioning on improving respiratory outcomes in critically unwell patients are well established; however, there is a lack of literature regarding the effects of prone positioning on ocular complications in the critical care setting. Sight-threatening ophthalmic disorders potentiated by proning include ocular surface disease, acute angle closure, ischemic optic neuropathy, orbital compartment syndrome and vascular occlusions.

Conclusions:

COVID-19 patients may be more susceptible to ocular complications with increased proning practices and increasing demand on critical care staff. This review outlines these ocular complications with a focus on preventative and treatment measures to avoid devastating visual outcomes for the patient.
Effect of immidazolium-based green solvents on the moisture absorption and thickness swelling behavior of wood flour/polyethylene composites
Authors: Kord Behzad , Ghalehno Mohammad Dahmardeh , Movahedi Farnaz
Published: September 2020

The water transport kinetics and moisture-induced thickness swelling behavior of wood-plastic composites (WPCs) in the presence of two imidazolium-based ionic liquids (ILs) were studied. The wood flour chemically treated with ILs were compounded through melt mixing of high-density polyethylene and coupling agent, and finally, the test specimens were produced by compression molding. Hygroscopic rates of the composites were evaluated by immersing them in the water at room temperature and monitoring moisture sorption and thickness changes for several weeks. Besides, the water diffusion coefficients and swelling rate parameters were measured for all composites. It was found that the water absorption and thickness swelling of the WPC specimens reduced as a result of ILs treatment. The SEM analysis revealed that the presence of ILs can improve the quality of adhesion between the polymer matrix and the cellulosic materials, to decrease the gaps in the interfacial region and block the hydrophilic groups. Studying the water sorption process in the specimens showed that the process follows kinetics and mechanisms described by Fick’s law. The highest water diffusion coefficients and swelling rate parameters were found in composites with untreated wood.
Refractory Dabigatran-Induced Hemorrhage Despite Multiple Idarucizumab Administration and Renal Replacement Therapy
Authors: Flynn Francis , Richard Guillaume , Dobrescu Marc A. , Bouchard Josée , Williamson David , Brindamour Dave , Charbonney Emmanuel , Dupuis Sébastien
Published: September 2020

Purpose:

This case report describes a patient with dabigatran accumulation due to acute kidney injury on chronic kidney disease, requiring multiple administration of idarucizumab along with renal replacement therapy because of rebound effect causing numerous episodes of bleeding.

An 86-year-old man on dabigatran etexilate 110 mg twice daily for stroke prevention with atrial fibrillation was admitted to the hospital for bowel obstruction and severe acute kidney injury on chronic kidney disease. The patient had an abnormal coagulation profile and no history of bleeding. Initial laboratory values revealed a hemoglobin concentration of 10.7 g/dL, a platelet count of 115 × 103 platelets/μL, an activated partial thromboplastin time of 150.4 seconds, an international normalized ratio of 10.28, a thrombin time greater than 100 seconds and a serum creatinine of 5.54 mg/dL (490 μmol/L). An initial dose of idarucizumab was administered 1 hour prior to surgery to prevent bleeding. Significant bleeding and hemodynamic instability occurred following surgery. Three additional doses of idarucizumab, 2 sessions of intermittent hemodialysis, continuous venovenous hemofiltration and blood products were required to achieve normalization of coagulation parameters and hemodynamic stability due to rebound coagulopathy after each dose of idarucizumab.

Conclusion:

Acute kidney injury on chronic kidney disease and third-space redistribution could have led to important dabigatran accumulation and favored rebound coagulopathy. Multiple therapeutic approaches may be required in the management of complex dabigatran intoxication.
Peppermint Essential Oil for Nausea and Vomiting in Hospitalized Patients: Incorporating Holistic Patient Decision Making Into the Research Design
Authors: Mohr Carla , Jensen Cassandra , Padden Nicole , Besel Jamie M. , Brant Jeannine M.
Published: September 2020

Aims

This study examined nausea and vomiting (N/V) in hospitalized patients following the use of inhaled peppermint essential oil (aromatherapy) compared to combined aromatherapy/antiemetics or antiemetics alone.

Method and Materials

A total of 103 hospitalized patients were offered one of three options to control N/V. Patient choice was considered in the holistic trial design so that patients were not denied either the essential oil or antiemetics. Patients rated nausea 0 to 10 on the Edmonton Symptom Assessment Scale at symptom onset and within 60 minutes of the intervention.

Results

Only three subjects enrolled in the antiemetic arm; thus this arm was eliminated from analysis, resulting in 100 evaluable patients. Mean nausea score improved significantly for the entire sample following the aromatherapy or aromatherapy/antiemetic intervention ( p < .0001). Patients in the aromatherapy arm had significant improvement in nausea compared to the combined aromatherapy/antiemetic arm ( p < .0001). Patient perception that peppermint oil relieves N/V significantly improved for the entire sample. Notable is that 65% of patients used peppermint essential oil alone.

Conclusions

Peppermint essential oil is an effective independent or complementary modality for relief of N/V in hospitalized patients. Research designs that incorporate patient decision making should be considered for studies in which placebos do not contribute to holistic care.
Factors Affecting Nurses’ Impact on Social Justice in the Health System
Authors: Hosseinzadegan Fariba , Jasemi Madineh , Habibzadeh Hosein
Published: September 2020

Background:

Social inequities in health systems are threats to global health. Considering the important role of nurses in establishing social justice, identification of factors affecting nurses’ participation in this area can contribute to the development of social justice.

Objective:

This study aimed to identify factors affecting nurses’ participation in establishing social justice in the health system.

Research design and methods:

The study was conducted using conventional qualitative content analysis approach. Purposive sampling was used to select 14 participants in 2019. The data were collected through semi-structured interviews and analyzed concurrently with data gathering.

Participants and research context:

In total, six faculty members, five nursing managers, and three clinical nurses from three different universities were interviewed.

Ethical considerations:

The research was approved by the Ethics Committee of Urmia University of Medical Sciences in Iran.

Findings:

Four main themes were found, including inadequate professional authority, insufficient attention to social justice in the area of education, clinical concerns as barriers to professional presence in society, and reflection of personality traits in the profession. These are the main factors affecting nurses’ participation in establishing social justice in the health system.

Discussion:

Authorities need to take effective steps to establish social justice through reforming the health system’s policy-making and power-acquisition domains, promoting nurses’ involvement in social factors in health issues, and adding professional values as a part of nursing curriculum. The clinical practice environment can also be helpful through providing quality, safe, and cost-effective services. In addition, fair and efficient recruitment process for new nurses can contribute to the establishment of social justice in the health system.

Conclusion:

Macro-level managerial factors such as policy, education, and clinical environment, along with personal factors, play a significant role in the participation of nursing profession in establishing social justice.
Engagement in Emotional News on Social Media: Intensity and Type of Emotions
Authors: Choi Jihyang , Lee Sang Yup , Ji Sung Wook
Published: September 2020

This study sheds new light on the relationship between emotion and engagement. Specifically, we investigate how the six discrete emotions that news visuals deliver, as well as the positiveness of news text, are associated with three engagement activities: sharing, commenting, and reacting. The findings show that users are less likely to share or comment on news posts that convey positive emotions, although they tend to react to such news frequently. The most prominent kind of emotion associated with user engagement activities was “sadness.” We analyzed 12,179 news stories posted on the four major U.S. newspapers’ Facebook pages.
Online Information Seeking and Disease Prevention Intent During COVID-19 Outbreak
Authors: Li Jinhui , Zheng Han
Published: September 2020

Guided by the risk information seeking and processing (RISP) model, this study aims to examine the key determinants that predispose individuals’ online information seeking behavior and prevention intent during the COVID-19 outbreak. Through an online survey with 741 respondents in China, results indicate that affective responses, informational subjective norms, and information insufficiency are positively related to online information seeking about COVID-19. Furthermore, online information seeking is positively associated with prevention intent, and attitude toward prevention partially mediates this association. Finally, theoretical and practical implications of this study are discussed in the context of COVID-19.
Community-based (rooted) research for regeneration: understanding benefits, barriers, and resources for Indigenous education and research
Authors: David-Chavez Dominique M , Valdez Shelly , Estevez Jorge Baracutei , Meléndez Martínez Carlalynne , Garcia Angel A , Josephs Keisha , Troncoso Abril
Published: September 2020

For researchers and educators working to engage Indigenous knowledges, colonial legacies, including assimilation-driven education curriculum, form challenging and complex pathways to navigate. To address such legacies and support Indigenous education efforts, we developed a participatory research model exploring benefits, barriers, and resources for engaging Indigenous knowledges in science education and research. This article details methods and findings from an inter-island knowledge exchange describing the experiences of seven Indigenous scholars and practitioners working in the Caribbean. We drew from Indigenous research methodologies, participatory action research, and constructivist grounded theory. Our research findings describe how individual experiences weave into a larger collective, intergenerational story of survival, adaptation, resilience, and regeneration. Findings from this study deepen understandings regarding how underlying socio-political challenges manifest at different scales of space and time, from immediate to intergenerational, and practitioner-identified resources to overcome them, such as Indigenous language, community action, and creating support systems.
Proteins and Amino Acids Treated with Atmospheric Plasma Show Significantly Increased Bioavailability in Humans
Authors: Sharp Matthew H , Stefan Matthew W , Gheith Raad H , Reber Dallen D , Ottinger Charlie R , Wilson Jacob M , Lowery Ryan P
Published: September 2020

Background:

Muscle mass is an important determinant of metabolic health and physical function. It has previously been demonstrated that the postprandial rise in circulating essential amino acids acts as the main stimulus for muscle protein synthesis (MPS). The current study investigated the postprandial plasma essential amino acid (EAA) and branched-chain amino acid (BCAA) responses of (1) Hydrolyzed whey protein isolate (HWPI) compared to plasma treated non-hydrolyzed whey protein isolate (PT-NHWPI), (2) standard branch-chain amino acids (S-BCAA) compared to plasma treated branch-chained amino acids (PT-BCAA), (3) standard pea protein (S-PP), compared to plasma treated pea protein (PT-PP), and (4) HWPI compared to PT-PP.

Methods:

Ten subjects (24.6 ± 5.3 years; 178.8 ± 8.1 cm; 78.6 ± 10.1 kg) participated in a double-blind, randomized, crossover trial comparing four separate protein conditions (HWPI, PT-NHWPI, S-PP, PT-PP). A separate cohort of ten subjects (26.4 ± 7.4 years; 178.8 ± 5.9 cm; 85 ± 12.3 kg) participated in a double-blind randomized, crossover trial comparing two branch-chain amino acid conditions: S-BCAA and PT-BCAA. All conditions were administered following a 7-day washout. Plasma EAA and BCAA concentrations were assessed from blood donated by subjects at pre-consumption, 30-, 60-, 90-, 120-, and 180 minutes post-consumption.

Results:

Blood plasma levels of total EAA and BCAA concentration were significantly greater in all treated conditions at 30-, 60-, 90-, and 120 minutes post consumption ( P < .05). There were no differences between PT-PP and HWPI.

Discussion:

All proteins significantly elevated EAAs, and BCAAs from basal levels. However, we conclude that the consumption of the treated proteins significantly raises blood levels of EAAs, and BCAAs to a greater extent across multiple dairy, vegan, and isolated BCAA conditions. Moreover, atmospheric plasma treatment of a vegan protein source makes its amino acid response similar to whey. Thus, protein supplementation with that has undergone Ingredient Optimized® atmospheric plasma treatment technology may be highly beneficial for improving the blood plasma amino acid response.
Bad influence: social networks, elite brokerage, and the construction of alliances
Authors: Sazak Selim Can
Published: September 2020

If all states want to survive, why do some of them enter unpropitious alliances? International Relations (IR) theory’s conventional answer is that imperfect information and systemic complexity result in miscalculation. This explanation begs the question: any alliance that fails is a miscalculated one, so the puzzle is not whether but why such mistakes are made. This article imports from recent scholarship on network theory and interpersonal trust to offer an alternative explanation. Alliances are not entities ethereally formed out of strategic imperatives, but products of interactions within transnational social networks of political, military, and business elites in the prospective allies. Such interactions enable alliances because people who are connected to each other through mutual association or previous exchanges develop mutual trust and gain subjective certainty about each other’s intentions and capabilities, which points at a previously ignored mechanism in alliance behavior: brokerage. In a case study that combines theory-based archival research and social network analysis, this article uses historical evidence on the Turco-German alliance to empirically demonstrate the brokerage role Colmar von der Goltz, the head of the German military mission to the Ottoman Empire, played in the two countries’ relations at the turn of the century and their eventual alliance in the First World War. The analysis points at a potential means of bridging IR, history, and sociology while expanding our understanding of alliance behavior and providing policy-relevant insights on geo-economic competition and the weaponization of interdependence at a time of growing strategic rivalry on the world stage.
CCPP’s contribution to the maturing of the DMM
Authors: Crittenden Patricia M
Published: September 2020

Over a decade, CCPP published many articles, a special issue and two special sections that enabled the DMM to become established as an alternative to both attachment disorganization and psychiatric diagnoses. New clinical authors from many countries contributed to an empirical set of assessment validity studies and findings regarding troubled and highrisk children and families. The outcome was a validated life-span series of assessments of attachment, a coherent body of important clinical findings, especially regarding school-aged children, and family functional formulations as laying the basis for DMM Integrative Treatment.
Profits of deceit: Performing populism in polarised times
Authors: Murdock Graham
Published: September 2020

The article is an invited contribution to the special issue to mark the anniversary of the publication of Jim McGuigan’s ‘Cultural Populism’. Drawing on work on authoritarian populism produced by the scholars grouped around the Frankfurt Institute of Research during their war-time exile in the Unites States, this article explores the right-wing populist platforms developed by Donald Trump during and after his presidential campaign and by the two Leave campaigns in the British referendum on European Union membership. It argues that understanding their popular appeal requires us to pay particular attention to the performative styles employed and the ways they mobilise motifs from popular media and direct forms of communicative address to connect with lived experiences, articulate anxieties and present policies that benefit the already privileged as true expressions of the popular interest.
How to report on elections? The effects of game, issue and negative coverage on reader engagement and incivility
Authors: Gonçalves João , Pereira Sara , Torres da Silva Marisa
Published: September 2020

This study investigates to what extent specific features of news articles about election campaigns impact reader engagement and civility in news comments. Using content analysis of articles ( N = 830) and comments ( N = 29,421) published during the 2015 Portuguese Legislative elections, we test the impact of negative coverage, issue coverage and game coverage (politics as a game) on the number of comments that an article receives and the level of civility thereof. Additionally, we explore how affective polarisation of a commenter may moderate the effects on incivility. Findings show that negativity towards political actors in an article is tied to both an increase in the number of comments and their level of incivility. Game coverage only led to a significant increase in the number of comments, while actor-related positivity was also related to an increase in incivility. Issue coverage had neither positive nor negative effects. The results inform newsrooms and academics about the implications of different types of election reporting, while accounting for features of news articles that are typically not integrated in a single study.
Human permanent tooth sizes are associated with genes encoding oestrogen receptors
Authors: Cunha Arthur S , Vertuan dos Santos Luiza , Schaffer Pugsley Baratto Samantha , Abbasoglu Zerrin , Gerber Jennifer Tsi , Paza Aleysson , Matsumoto Mírian Aiko Nakane , Scariot Rafaela , Stuani Maria Bernadete , Küchler Erika Calvano
Published: September 2020

Objective:

To evaluate if genetic polymorphisms in the oestrogen receptor 1 ( ESR1) and oestrogen receptor 2 ( ESR2) genes encoded for oestrogen receptors alpha (ERα) and beta (ERβ) are involved in permanent tooth size.

Design:

Cross-sectional study.

Setting:

Orthodontic Clinic at School of Dentistry of Ribeirão Preto, University of São Paulo.

Participants:

A total of 108 orthodontic patients.

Materials and Methods:

Pre-treatment orthodontic records were evaluated. Dental casts were used to determine the maximum crown measurements of fully erupted permanent teeth in the mesiodistal dimensions. Second and third molars were not included in the analysis. Genomic DNA samples were used for the genotyping of four genetic polymorphisms: ESR1 (rs9340799 and rs2234693) and ESR2 (rs1256049 and rs4986938). The associations between tooth size and sex were evaluated using t test. The associations between tooth size and genotype were analysed with linear regression and adjusted by sex at an alpha of P⩽0.05.

Results:

Female patients presented smaller tooth size than male patients. A statistically significant difference was observed in almost all teeth ( P<0.05). The genetic polymorphisms in rs9340799, rs2234693, rs1256049 and rs4986938 were associated with some tooth sizes in both the maxilla and mandible ( P<0.05).

Conclusion:

This study provides evidence that genetic polymorphisms in ESR1 and ESR2 could be associated with tooth size in permanent teeth.
Drawing lessons from early school leavers in a social justice context: Introductory comments
Authors: Macedo Eunice , Nairz-Wirth Erna , Araújo Helena C , Szalai Julia
Published: September 2020

This special issue focuses on the trajectories of early school leavers and includes corresponding papers from six countries in Europe. It presents a cross-national view on interrelated issues that facilitate understanding of the lessons that can be learned from these trajectories to promote a more socially just approach to education. In this introductory article, the authors present early school leaving (ESL) as a key issue in Europe, discuss relevant good practices and set the scene for an analysis of education as a matter of social justice and human rights – one which requires, above all, the prevention of educational poverty.
A postprocessing and path optimization based on nonlinear error for multijoint industrial robot-based 3D printing
Authors: Fu Guoqiang , Gu Tengda , Gao Hongli , Lu Caijiang
Published: September 2020

Multijoint industrial robots can be used for 3D printing to manufacture the complex freeform surfaces. The postprocessing is the basis of the precise printing. Due to the nonlinear motion of the rotational joint, nonlinear error is inevitable in multijoint industrial robots. In this article, the postprocessing and the path optimization based on the nonlinear errors are proposed to improve the accuracy of the multijoint industrial robots-based 3D printing. Firstly, the kinematics of the multijoint industrial robot for 3D printing is analyzed briefly based on product of exponential (POE) theory by considering the structure parameters. All possible groups of joint angles for one tool pose in the joint range are obtained in the inverse kinematics. Secondly, the nonlinear error evaluation based on the interpolation is derived according to the kinematics. The nonlinear error of one numerical control (NC) code or one tool pose is obtained. The principle of minimum nonlinear error of joint angle is proposed to select the appropriate solution of joint angle for the postprocessing. Thirdly, a path smoothing method by inserting new tool poses adaptively is proposed to reduce the nonlinear error of the whole printing path. The smooth level in the smoothing is proposed to avoid the endless insertion near the singular area. Finally, simulation and experiments are carried out to testify the effectiveness of the proposed postprocessing and path optimization method.
Assessing the validity of a linear inflation method in noninvasive blood pressure monitoring during the induction period of general anaesthesia
Authors: Kikuchi Ken-ichiro , Hirata Naoyuki , Yoshikawa Yusuke , Yamakage Michiaki
Published: September 2020

Inflationary noninvasive blood pressure (iNIBP) monitoring can determine BP in a shorter time compared to conventional deflationary NIBP (dNIBP) monitoring. We assessed the efficacy of iNIBP monitoring during induction of general anaesthesia and tracheal intubation, which can cause rapid changes in haemodynamics. Our study included 14 surgery patients receiving tracheal intubation under general anaesthesia. Blood pressure was continuously measured using iNIBP monitoring. We recorded the percentage of successful iNIBP monitoring (measurements made without switching to dNIBP mode) during anaesthesia induction. We obtained 326 BP-measurements from 14 patients. The iNIPB mode was able to perform 90.9% of the measurements during the induction of general anaesthesia. iNIBP could determine BP even during periods of high blood pressure variability (31.6% [interquartile range; 22–40]). Our results validate the utility of iNIBP monitoring during the induction period of general anaesthesia, despite the rapid haemodynamic changes.
Real-world evidence of the impact of adalimumab on work productivity and sleep measures in patients with rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis
Authors: Tektonidou Maria G. , Katsifis Gkikas , Georgountzos Athanasios , Theodoridou Athina , Koukli Eftychia-Maria , Kandili Anna , Giokic-Kakavouli Giasna , Karatsourakis Theofilos-Diamantis
Published: September 2020

Objective:

Our aim was to evaluate the effect of adalimumab on work productivity measures, overall activity impairment, and sleep quality in patients with active moderate to severe rheumatoid arthritis (RA), psoriatic arthritis (PsA), or ankylosing spondylitis (AS) treated in routine care settings in Greece and determine factors associated with work impairment and sleep disturbance.

Methods:

Patients with active moderate to severe RA ( n = 184), PsA ( n = 166), and AS ( n = 150) were enrolled in this 24-month, prospective, observational study at 80 hospital outpatient clinics and private practices throughout Greece. Patients received adalimumab alone or in combination with standard antirheumatic therapies according to routine care. Work productivity and sleep were assessed through two patient-reported outcome measures: the Work Productivity and Activity Impairment–General Health questionnaire and the Medical Outcomes Study Sleep Scale (MOS-SS). Pearson correlation coefficients were estimated to assess the association of work impairment and sleep disturbances with disease activity scores.

Results:

In the overall population, adalimumab significantly lowered absenteeism [mean (95% confidence interval) reduction, 18.9% (13.3–24.5%); n = 100]; presenteeism [40.0% (33.8–46.3%); n = 98], overall work productivity impairment [46.8% (40.4–53.2%); n = 94], activity impairment [47.0% (44.3–49.6); n = 421], and the MOS-SS sleep problems index [31.6 (29.5–34.1); n = 421] after 24-month treatment ( p < 0.001). Significant improvements were also noted across the RA, PsA, and AS subpopulations ( p < 0.05). Improvements in overall work impairment and sleep disturbance positively correlated with improvements in disease activity measures.

Conclusion:

Adalimumab improves work productivity and sleep problems while lowering disease activity in patients with moderate to severe RA, PsA, and AS managed in real-world settings.
Diterpenoid Constituents of Teucrium scordium L. Subsp. scordioides (Shreb.) Maire Et Petitmengin
Authors: Bozov Petko I. , Penchev Plamen N. , Girova Tania D. , Gochev Velizar K.
Published: September 2020

A new scordidesin А (1) and 2 known furo-clerodane diterpenoids, teucrin A (2) and 6-ketoteuscordin (3), were isolated by the phytochemical investigation of the acetone extract from the aerial parts of Teucrium scordium L. subsp. scordioides (Lamiaceae). The structure and stereochemistry of the compounds were established by high-resolution electrospray ionization mass spectrometry, infrared spectroscopy, and various 1H nuclear magnetic resonance (NMR) and 2-dimensional-NMR techniques. Additionally, we report 13C NMR spectral data of 3 that were not published before. Antimicrobial activity of the compounds was tested against Gram-positive and Gram-negative bacteria belonging to 5 different species and against 2 strains of yeast belonging to 2 different species of the genus Candida.
AO CMF International Task Force Recommendations on Best Practices for Maxillofacial Procedures During COVID-19 Pandemic
Authors: Grant Michael , Buchbinder Daniel , Dodson Thomas B. , Fusetti Stefano , Leung Mike Yiu Yan , Aniceto Gregorio Sánchez , Schramm Alexander , Strong Edward Bradley , Wolvius Eppo
Published: September 2020

The COVID-19 pandemic is a global problem that has adversely and significantly impacted the safe practice of maxillofacial surgery. The risk lies in the heavy viral load in the oral/nasal/upper respiratory mucosal surfaces. Surgical procedures performed in this anatomic regional produce aerosalized viral particles which are highly infectious. Best practices and recommendations are outlined to mitigate the risk to the provider.
Convalescent plasma appears efficacious and safe in COVID-19
Authors: Khulood Daulat , Adil Mir Shoebulla , Sultana Ruqiya , Nimra
Published: September 2020

A cluster of pneumonia cases of unknown etiology associated with pyrexia and acute respiratory distress was identified in Southern China. Links between the previous severe acute respiratory syndrome (SARS) cases and the region’s seafood market were noted with the possibility of a new zoonosis and SARS-CoV-2 was identified as the responsible agent. Currently, there are no effective prophylactic or therapeutic options to deal with coronavirus disease-19 (COVID-19) or any other human coronavirus (HCoV) infections. Convalescent plasma (CP) therapy is a classic adaptive immunotherapy which has been in use for more a century to prevent and treat infections including SARS, Middle East respiratory syndrome (MERS), and H1N1 pandemic. Moreover, the World Health Organization regarded CP transfusion as the most promising therapy to treat MERS-CoV. This review was undertaken to demonstrate the potential of CP in the treatment of the pandemic COVID-19 disease. A total of eight studies conducted on CP therapy in patients with COVID-19 were reviewed wherein 25,028 patients above 18 years of age were involved. The vast majority of patients reported favorable outcomes when treated with CP with <1% serious adverse events. Despite its promising beneficial effects in patients severely ill with COVID-19, CP therapy requires further evaluation in randomized clinical trials (RCTs) as a lack of satisfactory efficacy data from this area certainly enhances the hesitancy with regard to employing this treatment. In the present circumstances of unsatisfactory pharmacological therapy and the urgent need for a successful curative remedy, considering the use of CP therapy is reasonable provided RCTs confirm its safety, efficacy, and tolerability.
Study of three novel biomarkers, MR-proADM, midkine, and stromelysin2, and peripheral atherosclerosis in a Chinese Han population: A case-control study
Authors: Chen Zhong , Zhu Yawen , Zhang Lili
Published: September 2020

Midregional pro-adrenomedullin (MR-proADM), midkine, and stromelysin2 (ST2) are novel cardiac biomarkers associated with heart failure and atherosclerotic diseases like stable ischemic disease and acute coronary syndrome. The potential association between these three biomarkers and peripheral artery disease (PAD) remains unclear. The aim of this study was to assess the correlation between these three biomarkers and their association with PAD in the Chinese Han population. This study included 224 patients suspected of having coronary artery disease (CAD). All subjects underwent coronary angiography and carotid and subclavian ultrasound assessment for detection of coronary and peripheral atherosclerosis and were divided into two groups according to whether they had PAD or not. Pearson’s correlation coefficient r was calculated, and multivariable logistic regression analysis was conducted to represent the associations of these biomarkers and PAD. The study included 133 patients with PAD and 91 non-PAD controls and these two groups had similar values for age, ST2, hematocrit, hemoglobin, red blood cell counts, creatinine and CAD ratio, smoking, and type 2 diabetes (all p > 0.05). Compared with non-PAD controls, patients with PAD had lower levels of MR-proADM and midkine and higher levels of TC, LDL-C, and fasting blood sugar (FBS) (all p < 0.05). MR-proADM was positively and ST2 negatively correlated with midkine (all p < 0.05). Compared with females, male patients had higher values of MR-proADM ( p < 0.05) and similar levels of ST2 and midkine (all p > 0.05). Multivariable regression analysis identified FBS as a risk predictor (OR: 1.163, 95% CI: 1.108–1.401, p = 0.014) and MR-proADM as a protective factor (OR: 0.720, 95% CI: 0.529–0.920, p = 0.037) of PAD. Three novel biomarkers, MR-proADM, midkine, and ST2, are internally related, and MR-proADM is gender-specific and a protective factor of peripheral atherosclerosis in the Chinese Han population studied. Clinical Trial: ChiCTR-DDD-17013908
Therapeutic Strategy of Percutaneous Transforaminal Endoscopic Decompression for Stenosis Associated With Adult Degenerative Scoliosis
Authors: Jin Lin-Yu , Wang Kun , Lv Zhen-Dong , Su Xin-Jin , Liu Hai-Ying , Shen Hong-Xing , Li Xin-Feng
Published: September 2020

Study Design:

A retrospective study.

Objective:

To investigate the effects of percutaneous transforaminal endoscopic decompression (PTED) for lumbar stenosis associated with adult degenerative scoliosis and to analyze the correlation between preoperative radiological parameters and postoperative surgical outcomes.

Methods:

Two years of retrospective data was collected from 46 patients with lumbar stenosis associated with adult degenerative scoliosis who underwent PTED. The visual analog scale (VAS), Oswestry Disability Index, and modified MacNab criteria were used to evaluate the clinical outcomes. Multiple linear regression analysis was used to analyze the correlation between radiological parameters and surgical outcomes.

Results:

The mean age of the 33 female and 13 male patients was 73.5 ± 8.1 years. The mean follow-up was 27.6 ± 3.5 months (range from 24 to 36). The average coronal Cobb angle was 24.5 ± 8.2°. There were better outcomes of the VAS for leg pain and Oswestry Disability Index after surgery. Based on the MacNab criteria, excellent or good outcomes were noted in 84.78% of patients. Multiple linear regression analysis showed that Cobb angle and lateral olisthy may be the predictors for low back pain.

Conclusion:

Transforaminal endoscopic surgery may be an effective and safe method for geriatric patients with lumbar stenosis associated with degenerative scoliosis. The predictive factors of clinical outcomes were severe Cobb angle and high degree lateral subluxation. Transforaminal endoscopic surgery may not be recommended for patients with Cobb angle larger than 30° combined with lateral subluxation.
‘Preparation’ and ‘Readiness’: The Education Paradigm for the Organisation Development Certificate Programme
Authors: Sankarasubramanyan R.
Published: September 2020

The organisation development certificate programme (ODCP) offered by the Indian Society for Applied Behavioural Science—ISABS ( www.isabs.org ) is a unique blend of learning about organisations, the process of OD with deep awareness about self as an instrument of change.

ISABS as an institution has been engaged with T-groups for the past 50 years, having learnt the same from National Training Laboratories (NTL) Institute for Applied Behavioural Science ( www.ntl.org ). The focus of ISABS has been on discovering oneself through the process of engagement in small groups. ISABS pedagogy has evolved over years after initial learning from NTL This pedagogy distinguishes itself from any typical university education by stressing on experiencing and reflection of the learning process held together by a process facilitator. The expectation is that the participants will conceptualise and apply their learning through their own volition. However, this needed to change for the ODCP programme. This article unfolds the process for the reader.

The process of OD is based on the quality of the interaction/engagement between the client system and the OD practitioner. Hence, the quality of the ‘preparedness’ and ‘readiness’ of the OD practitioner plays a big role in the ‘process of OD’.

ISABS addresses the twin issues of ‘preparedness’ and ‘readiness’ of participants to enter the field of OD through a pedagogy that is a combination of experiential, cognitive, reflective and peer learning. In addition, OD competencies and values are internalised through a learner-centred approach to teaching, classroom as organisation simulations and support systems provided through coaching and learning facilitation.
Pedagogical Contextualisation and Integration Challenges for Organisation Development in India: Cultural Wisdom and Rational Modernity in Organisations
Authors: Ananthanarayanan Raghu
Published: September 2020

Since the 1970s, Indian organisations adopted the new and imported thrust of management knowledge, orientations, practices and systems. But much of what was imported did not take root, as it did not take into account the latent level of emotional and social universe of Indian managers in which their manifest behaviour is grounded. The role design is based on a picture of the organisation that is drawn from the West, and worse still, its models were colonial. It is dysfunctional for the individual, untenable for society and disempowering for the organisation. Indic wisdom has venerated the quintessential Arjuna. In reawakening and valuing this cultural heritage of ours lies our ability to shape a future free of colonial hangovers and envy of Western ways of being. It is only by awakening the Arjuna power and fostering a deep dialogue that we are going to be able to find creative and regenerative ways of living.
iTRAQ-based comparative proteomic analysis of differences in the protein profiles of stems and leaves from two alfalfa genotypes
Authors: Sun Hao , Yu Jie , Zhang Fan , Kang Junmei , Li Mingna , Wang Zhen , Liu Wenwen , Zhang Jiaju , Yang Qingchuan , Long Ruicai
Published: September 2020

Background

To explore the molecular regulatory mechanisms of early stem and leaf development, proteomic analysis was performed on leaves and stems of F genotype alfalfa, with thin stems and small leaves, and M genotype alfalfa, with thick stems and large leaves.

Results

Based on fold-change thresholds of > 1.20 or < 0.83 (p < 0.05), a large number of proteins were identified as being differentially enriched between the M and F genotypes: 249 downregulated and 139 upregulated in stems and 164 downregulated and 134 upregulated in leaves. The differentially enriched proteins in stems were mainly involved in amino acid biosynthesis, phenylpropanoid biosynthesis, carbon fixation, and phenylalanine metabolism. The differentially enriched proteins in leaves were mainly involved in porphyrin and chlorophyll metabolism, phenylpropanoid biosynthesis, starch and sucrose metabolism, and carbon fixation in photosynthetic organisms. Six differentially enriched proteins were mapped onto the porphyrin and chlorophyll metabolism pathway in leaves of the M genotype, including five upregulated proteins involved in chlorophyll biosynthesis and one downregulated protein involved in chlorophyll degradation. Eleven differentially enriched proteins were mapped onto the phenylpropanoid pathway in stems of the M genotype, including two upregulated proteins and nine downregulated proteins.

Conclusion

Enhanced chlorophyll synthesis and decreased lignin synthesis provided a reasonable explanation for the larger leaves and lower levels of stem lignification in M genotype alfalfa. This proteomic study aimed to classify the functions of differentially enriched proteins and to provide information on the molecular regulatory networks involved in stem and leaf development.
The role of accreditation in 21st century health professions education: report of an International Consensus Group
Authors: Frank Jason R. , Taber Sarah , van Zanten Marta , Scheele Fedde , Blouin Danielle ,   on behalf of the International Health Professions Accreditation Outcomes Consortium
Published: September 2020

Background

Accreditation is considered an essential ingredient for an effective system of health professions education (HPE) globally. While accreditation systems exist in various forms worldwide, there has been little written about the contemporary enterprise of accreditation and even less about its role in improving health care outcomes.

We set out to 1) identify a global, contemporary definition of accreditation in the health professions, 2) describe the relationship of educational accreditation to health care outcomes, 3) identify important questions and recurring issues in twenty-first century HPE accreditation, and 4) propose a framework of essential ingredients in present-day HPE accreditation.

Methods

We identified health professions accreditation leaders via a literature search and a Google search of HPE institutions, as well as by accessing the networks of other leaders. These leaders were invited to join an international consensus consortium to advance the scholarship and thinking about HPE accreditation. We describe the consensus findings from the International Health Professions Accreditation Outcomes Consortium (IHPAOC).

Results

We define accreditation asthe process of formal evaluation of an educational program, institution, or system against defined standards by an external body for the purposes of quality assurance and enhancement.In the context of HPE, accreditation is distinct from other forms of program evaluation or research. Accreditation can enhance health care outcomes because of its ability to influence and standardize the quality of training programs, continuously enhance curriculum to align with population needs, and improve learning environments. We describe ten fundamental and recurring elements of accreditation systems commonly found in HPE and provide an overview of five emerging developments in accreditation in the health professions based on the consensus findings.

Conclusions

Accreditation has taken on greater importance in contemporary HPE. These consensus findings provide frameworks of core elements of accreditation systems and both recurring and emerging design issues. HPE scholars, educators, and leaders can build on these frameworks to advance research, development, and operation of high-quality accreditation systems worldwide.
A “fit for purpose” framework for medical education accreditation system design
Authors: Taber Sarah , Akdemir Nesibe , Gorman Lisa , van Zanten Marta , Frank Jason R.
Published: September 2020

Background

Accreditation is a key feature of many medical education systems, helping to ensure that programs teach and assess learners according to applicable standards, provide optimal learning environments, and produce professionals who are competent to practise in challenging and evolving health care systems. Although most medical education accreditation systems apply similar standards domains and process elements, there can be substantial variation among accreditation systems at the level of design and implementation. A discussion group at the 2013 World Summit on Outcomes-Based Accreditation examined best practices in health professional education accreditation systems and identified that the literature examining the effectiveness of different approaches to accreditation is scant. Although some frameworks for accreditation design do exist, they are often specific to one phase of the medical education continuum.

Main text

This paper attempts to define a framework for the operational design of medical education accreditation that articulates design options as well as their contextual and practical implications. It assumes there is no single set of best practices in accreditation system development but, rather, an underlying set of design decisions. A “fit for purpose” approach aims to ensure that a system, policy, or program is designed and operationalized in a manner best suited to local needs and contexts. This approach is aligned with emerging models for education and international development that espouse decentralization.

Conclusion

The framework highlights that, rather than a single best practice, variation among accreditation systems is appropriate provided that is it tailored to the needs of local contexts. Our framework is intended to provide guidance to administrators, policy-makers, and educators regarding different approaches to medical education accreditation and their applicability and appropriateness in local contexts.
Analyzing medical device connectivity and its effect on cyber security in german hospitals
Authors: Willing Markus , Dresen Christian , Haverkamp Uwe , Schinzel Sebastian
Published: September 2020

Background

Modern healthcare devices can be connected to computer networks and many western healthcare institutions run those devices in networks. At the same time, cyber attacks are on the rise and there is evidence that cybercriminals do not spare critical infrastructure such as major hospitals, even if they endanger patients. Intuitively, the more and closer connected healthcare devices are to public networks, the higher the risk of getting attacked.

Methods

To asses the current connectivity status of healthcare devices, we surveyed the field of German hospitals and especially University Medical Center UMCs.

Results

The results show a strong correlation between the networking degree and the number of medical devices. The average number of medical devices is 25.150, with a median of networked medical devices of 3.600. Actual key users of networked medical devices are the departments Radiology, Intensive Care, Radio-Oncology RO, Nuclear Medicine NUC, and Anaesthesiology in the group of UMCs. In the next five years, the usage of networked medical devices will increase significantly in the departments of Surgery, Intensive Care, and Radiology. We detected a strong correlation between the degree of connectivity and the likelihood of being attacked.The survey answers regarding the cyber security status reveal a lack of security basics in some of the inquired hospitals. We did discover successful attacks in hospitals with separated or subsidiary departments. A fusion of competencies on an organizational level facilitates the right behavior here. Most hospitals rated themselves predominantly positively in the self-assessment but also stated the usefulness of IT security insurance.

Conclusions

Concluding our results, hospitals are already facing the consequences of omitted measures within their growing pool of medical devices. Continuously relying on historically grown structures without adaption and trusting manufactures to solve vectors is a critical behavior that could seriously endanger patients.