bluuebunny/crossref_metadata_2025 huggingface dataset:
Stepfamily Policies and Laws in the United States: Lessons from the West
Authors: Stewart Susan D. , Timothy Elcy E.
Published: May 2020

Although stepfamilies exist in some form in nearly every country in the world, they are most common in Western countries. This paper provides a summary of laws, policies, and programs pertaining to stepfamilies in a selection of Western countries, with a special focus on the United States. Although stepfamilies have been prevalent throughout the West for decades, they remain “incompletely institutionalized,” and governments have been slow to address their needs and concerns. There is large variation across Western countries with respect to how stepfamilies are treated under the law, with some countries employing more liberal definitions of “parents,” “children,” and “families,” than others. In contrast, stepfamilies in the United States must contend with a complex and conflicting set of federal laws, state laws, and court precedents. Their legal status is uncertain and the way stepfamilies are treated is inconsistent across social programs and policies. Overall, there is clear bias against stepfamilies within most U.S. institutions. The review includes recommendations for change that would enhance stepfamily stability and quality of life in both Western and non-Western contexts.
Advice Padded With Encouragement: A Preliminary Assessment of an Extended Integrated Model of Advice Giving in Supportive Interactions
Authors: Malloch Yining Zhou , Feng Bo , Wang Bingqing , Kim Chelsea
Published: May 2020

The integrated model of advice giving (IMA) proposes that advising in supportive interactions should be carried out in three sequential moves: emotional support—problem inquiry and analysis—advice (EPA). Prior research indicates the utility of this framework for effective advising in supportive interactions. The current project proposed and tested an extended integrated model of advice giving, adding eSteem support (S) as a fourth move in the sequence. Two experiments were conducted. Study 1 included 371 participants recruited from Amazon Mechanical Turk. Results showed that the emotional support—problem inquiry and analysis—advice—eSteem support (EPAS) sequence did not elicit significantly higher evaluations of advice quality compared with the EPA or emotional support—problem inquiry and analysis—eSteem support—advice (EPSA) sequence. Study 2 replicated Study 1 with 364 college students and found that, compared with the other two sequences, the EPAS sequence did not produce significantly higher evaluations of advice quality or intention to follow advice. Theoretical implications and directions for future research are discussed.
Evaluation of risk factors for adverse outcome in extracorporeal membrane oxygenation–supported elderly postcardiotomy patients
Authors: Samalavicius Robertas , Norkiene Ieva , Scupakova Nadezda , Sabliauskas Jurij , Urbonas Karolis , Andrijauskas Povilas , Jankuviene Agne , Puodziukaite Lina , Zorinas Aleksejus , Janusauskas Vilius , Rucinskas Kestutis , Laurusonis Kestutis , Serpytis Pranas
Published: May 2020

Background:

Recently extracorporeal membrane oxygenation is becoming the commonly used mechanical assist device for the treatment of severe cardiogenic shock in postcardiotomy patients. Evaluation of risk factors of negative outcome would be beneficial in decision-making in the elderly patient population.

Methods:

This was a retrospective single-centre analysis of elderly patients who underwent extracorporeal membrane oxygenation treatment for refractory cardiogenic shock in a tertiary care centre. Demographic data, comorbidities and perioperative parameters were collected to evaluate their impact on the outcome of extracorporeal membrane oxygenation treatment in this patient group. Logistic regression analysis of the variables was performed to identify factors predicting an adverse outcome.

Results:

Forty consecutive elderly patients underwent extracorporeal membrane oxygenation treatment during the study period. The mean age was 76.7 ± 3.8 years, 27 (68%) were male. The mean Survival after Veno–Arterial extracorporeal membrane oxygenation score before initiating extracorporeal membrane oxygenation support was − 11 ± 6. Intra-aortic counterpulsation was used as the first-line mechanical support in 31 (77%) patients. The mean duration of extracorporeal membrane oxygenation support was 172 ± 128 hours. Twenty-four patients (56%) were successfully weaned from extracorporeal membrane oxygenation, and 8 (20%) survived to hospital discharge. Lactate level before extracorporeal membrane oxygenation initiation was the only predictor of unfavourable outcome in multivariate analysis (p < 0.05).

Conclusion:

High lactate level before initiation of extracorporeal membrane oxygenation was the most important prognostic values of an unfavourable outcome.
Extracorporeal life support for phaeochromocytoma-induced cardiogenic shock: a systematic review
Authors: Matteucci Matteo , Kowalewski Mariusz , Fina Dario , Jiritano Federica , Meani Paolo , Raffa Giuseppe M , Aldobayyan Ibrahim , Beghi Cesare , Maessen Jos , Lorusso Roberto
Published: May 2020

Introduction:

Phaeochromocytoma is a catecholamine-secreting tumour associated with clinical presentation ranging from paroxysmal hypertension to intractable cardiogenic shock. Extracorporeal life support, in veno-arterial mode, application in refractory acute heart dysfunction is sharply increasing worldwide. However, its clinical utility in phaeochromocytoma-induced cardiogenic shock remains still unclear.

Methods:

A systematic review of published reports was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Statement. Searches were accomplished on PubMed, Embase and Google Scholar to identify articles describing the use of extracorporeal life support in the setting of phaeochromocytoma-induced cardiogenic shock (PROSPERO: CRD42019125225).

Results:

Thirty-five reports, including 62 patients supported with extracorporeal life support because of intractable phaeochromocytoma crisis, were included for the analysis. Almost all the subjects underwent peripheral cannulation for extracorporeal life support. The median duration of the mechanical circulatory support was 5 days, and most of the patients recovered normal myocardial function (left ventricular ejection fraction ⩾50%). In-hospital survival was 87%. Phaeochromocytoma was removed surgically during extracorporeal life support in 10 patients (16%), while in the remaining after haemodynamic stabilization and weaning from the mechanical support.

Conclusion:

Successful management of phaeochromocytoma-induced cardiogenic shock depends on prompt recognition and immediate treatment of shock. In this scenario, extracorporeal life support may play a significant role allowing cardiac and end-organ recovery and giving time for accurate diagnosis and specific treatment.
Benefits of a Self-Management Program for the Couple Living With Parkinson’s Disease: A Pilot Study
Authors: Lyons Karen S. , Zajack Alex , Greer Melissa , Chaimov Holly , Dieckmann Nathan F. , Carter Julie H.
Published: May 2020

The goal of this pilot study was to explore health benefits for couples participating together in an existing community-based self-management workshop for Parkinson’s disease (PD). A quasi-experimental two-wave design explored the effects of the Strive to Thrive program in comparison to a wait-list control condition. Preliminary data ( n = 39 couples) showed that spouses in the intervention group had greater engagement in mental relaxation techniques at 7 weeks than those in the control condition (large effect size). Small effects were observed for increases in aerobic activity and mental relaxation for the adult with PD, increases in strength-based activities and self-efficacy for spouses, declines in depressive symptoms for spouses, and decreases in protective buffering for both adults with PD and spouses. The program showed potential for existing community-based programs to benefit couples living with chronic illness.
Functional studies of flaked and ground stone artefacts reveal starchy tree nut and root exploitation in mid-Holocene highland New Guinea
Authors: Field JH , Summerhayes GR , Luu S , Coster ACF , Ford A , Mandui H , Fullagar R , Hayes E , Leavesley M , Lovave M , Kealhofer L
Published: May 2020

Ground stone technology for processing starchy plant foods has its origins in the late Pleistocene, with subsequent intensification and transformation of this technology coinciding with the global emergence of agriculture in the early Holocene. On the island of New Guinea, agriculture first emerges in the highland Wahgi Valley, potentially from c. 9 kya, and clearly evident by 6.5 kya. Approximately 400 km further east in the highland Ivane Valley, long-term occupation sequences span the Holocene and late Pleistocene, but there is currently no direct evidence for wetland agriculture. Here, we report rare evidence for ground stone implements from a secure mid-Holocene archaeological context in the Ivane Valley. The Joe’s Garden site has flaked and ground stone artefacts with significant starch assemblages dating to approximately 4.4 kya. We present the first empirical evidence for the function of stone bowls from a New Guinea highland setting. Usewear and residues indicate the grinding and pounding of endemic starch-rich plant foods. Geometric morphometric analysis of starch grains shows that at least two taxa were processed: Castanopsis acuminatissima (nut) and Pueraria lobata (tuber). This regional example adds to our understanding of the trajectories of diverse plant food exploitation and ground stone technology development witnessed globally in the Holocene.
Rushing Gunshot Victims to Trauma Care: The Influence of First Responders and the Challenge of the Geography
Authors: Hatten David N. , Wolff Kevin T.
Published: May 2020

Past research exploring correlates to gunshot wound fatality have focused on the distance between the victim/incident location and trauma care facilities. Far less is known regarding the role of first responders in linking individuals to trauma care services. This study introduces a new method for measuring proximity to trauma care services and first responder locations, using the STATA OSRMTIME package to assess this relationship. A positive and significant relationship was found between travel time, measured in minutes, from first responder locations and the likelihood of gunshot fatality, controlling for age, race, sex, and, injury severity.
Placental Pathology in Covid-19 Positive Mothers: Preliminary Findings
Authors: Baergen Rebecca N , Heller Debra S
Published: May 2020

This study describes the pathology and clinical information on 20 placentas whose mother tested positive for the novel Coronovirus (2019-nCoV) cases. Ten of the 20 cases showed some evidence of fetal vascular malperfusion or fetal vascular thrombosis. The significance of these findings is unclear and needs further study.
When Do Police Stressors Particularly Predict Organizational Commitment? The Moderating Role of Social Resources
Authors: Choi Jaeyong , Kruis Nathan E. , Yun Ilhong
Published: May 2020

This study uses data from 570 male police officers working in 16 substations in South Korea to examine the impact of job stressors (e.g., victimization, authoritative organizational culture, and perceptions of unfair work assignments) on organizational commitment. Furthermore, we examine the conditioning effect of social resources on organizational commitment. The results show that organizational characteristics (e.g., authoritative organizational culture, unfair work assignments, and conflict with coworkers) influence officers’ organizational commitment more so than victimization experiences. The results also show that social resources spill over into the workplace and condition the effects of organizational culture on predicting organizational commitment. Potential policy implications are discussed.
Presence of Hepatic Steatosis Does Not Increase the Risk of Hepatocellular Carcinoma in Patients With Chronic Hepatitis B Over Long Follow-Up
Authors: Lim Chong Teik , Goh George Boon Bee , Li Huihua , Lim Tony Kiat-Hon , Leow Wei Qiang , Wan Wei Keat , Azhar Rafay , Chow Wan Cheng , Kumar Rajneesh
Published: May 2020

Background:

Chronic hepatitis B (CHB) infection and nonalcoholic fatty liver disease (NAFLD) are liver diseases which may lead to hepatocellular carcinoma (HCC) formation. Both disease entities have been attributed independently to increase risk of HCC development. While concomitant hepatic steatosis in patients with CHB are becoming more frequent in view of increasing NAFLD prevalence, there is no conclusive evidence linking presence of hepatic steatosis and increased HCC risk in patients with CHB infection. This study explores the association of hepatic steatosis among CHB-infected individuals in HCC development.

Methods:

This is a retrospective study on a cohort of patients with CHB who underwent liver biopsy between January 2000 and December 2014. They were stratified according to presence and severity of histologically proven hepatic steatosis and subsequently followed up to evaluate the association between hepatic steatosis and HCC development.

Results:

Among 289 patients with a median follow-up of 111.1 months, hepatic steatosis was present in 185 patients (64.0%). In all, 27 patients developed HCC on follow-up and 21 of them had hepatic steatosis. Univariate Cox analysis showed that age (hazard ratio [HR] = 1.08, 95% CI = 1.042-1.12), type 2 diabetes mellitus (T2DM) (HR = 4.00, 95% CI = 1.622-9.863), and Ishak score (HR = 1.221, 95% CI = 1.014-1.472) were associated with HCC development, whereas multivariate Cox analysis demonstrated that age and T2DM (HR = 2.69, 95% CI = 1.072-6.759) were significant risk factors for development of HCC.

Conclusions:

Concurrent hepatic steatosis in patients with CHB infection is not a risk factor for hepatocellular carcinoma formation.
Dual-Method Contraception Use Among Young Women Pre- and Post-ACA Implementation
Authors: Montgomery Tiffany M. , Stephens-Shields Alisa J. , Schapira Marilyn M. , Akers Aletha Y.
Published: May 2020

The 2012 implementation of the Patient Protection and Affordable Care Act (ACA) contraceptive coverage mandate removed financial barriers to contraception access for many insured women. Since that time, increases in sexually transmitted disease (STD) rates have been noted, particularly among Black adolescent and young adult women aged 15 to 24 years. It is unclear whether changes in dual-method contraception use (simultaneous use of nonbarrier contraceptive methods and condoms) are associated with the increase in STD rates. A repeated cross-sectional analysis was conducted among adolescent and young adult women to compare pre-ACA data from the 2006–2010 cohort and post-ACA data from the 2013–2015 cohort of the National Survey for Family Growth. A significant decrease in short-acting reversible contraception use (SARC; 78.2% vs. 67.5%; p <  .01) and a significant increase in long-acting reversible contraception use (LARC; 8.9% vs. 21.8%; p <  .01) were found, but no significant change in dual-method contraception use was found among pre- versus post-ACA SARC users and SARC nonusers (odds ratio [OR]: 1.88, 95% confidence interval [CI]: 0.64–5.46, p =  .25), LARC users and LARC nonusers (adjusted odds ratio [AOR]: 1.62, 95% CI: 0.42–6.18, p =  .48), or White and Black women (AOR: 1.45, 95% CI: 0.66–3.18, p =  .35). There was no direct association between changes in contraception use and decreased condom use and therefore no indirect association between changes in contraception use and increased STD rates. Health care providers should continue promoting consistent condom use. Additional research is needed to understand recent increases in STD rates among Black women in the post-ACA era.
COVID-19 global pandemic planning: Decontamination and reuse processes for N95 respirators
Authors: Perkins Douglas J , Villescas Steven , Wu Terry H , Muller Timothy , Bradfute Steven , Hurwitz Ivy , Cheng Qiuying , Wilcox Hannah , Weiss Myissa , Bartlett Chris , Langsjoen Jens , Seidenberg Phil
Published: May 2020

Coronavirus disease 2019 (COVID-19) is an illness caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease was first identified as a cluster of respiratory illness in Wuhan City, Hubei Province, China, in December 2019, and has rapidly spread across the globe to greater than 200 countries. Healthcare providers are at an increased risk for contracting the disease due to occupational exposure and require appropriate personal protective equipment (PPE), including N95 respirators. The rapid worldwide spread of high numbers of COVID-19 cases has facilitated the need for a substantial supply of PPE that is largely unavailable in many settings, thereby creating critical shortages. Creative solutions for the decontamination and safe reuse of PPE to protect our frontline healthcare personnel are essential. Here, we describe the development of a process that began in late February 2020 for selecting and implementing the use of hydrogen peroxide vapor (HPV) as viable method to reprocess N95 respirators. Since pre-existing HPV decontamination chambers were not available, we optimized the sterilization process in an operating room after experiencing initial challenges in other environments. Details are provided about the prioritization and implementation of processes for collection and storage, pre-processing, HPV decontamination, and post-processing of filtering facepiece respirators. Important lessons learned from this experience include, developing an adequate reserve of PPE for effective reprocessing and distribution, and identifying a suitable location with optimal environmental controls (i.e. operating room). Collectively, information presented here provides a framework for other institutions considering decontamination procedures for N95 respirators.

Impact statement

There is a critical shortage of personal protective equipment (PPE) around the globe. This article describes the safe collection, storage, and decontamination of N95 respirators using hydrogen peroxide vapor (HPV). This article is unique because it describes the HPV process in an operating room, and is therefore, a deployable method for many healthcare settings. Results presented here offer creative solutions to the current PPE shortage.
Radio environment map construction by adaptive ordinary Kriging algorithm based on affinity propagation clustering
Authors: Xia Haiyang , Zha Song , Huang Jijun , Liu Jibin
Published: May 2020

In the era of 5G mobile communication, radio environment maps are increasingly viewed as a powerful weapon for the optimization of spectrum resources, especially in the field of autonomous vehicles. However, due to the constraint of limited resources when it comes to sensor networks, it is crucial to select a suitable scale of sensor measurements for radio environment map construction. This article proposes an adaptive ordinary Kriging algorithm based on affinity propagation clustering as a novel spatial interpolation method for the construction of the radio environment map, which can provide precise awareness of signal strength at locations where no measurements are available. Initially, a semivariogram is obtained from all the sensor measurements. Then, in order to select the minimum scale of measurements and at the same time guarantee accuracy, the affinity propagation clustering is introduced in the selection of sensors. Moreover, the sensor estimation groups are created based on the clustering result, and estimation results are obtained by ordinary Kriging. In the end, the simulation of the proposed algorithm is analyzed through comparisons with three conventional algorithms: inverse distance weighting, nearest neighbor, and ordinary Kriging. As a result, the conclusion can be drawn that the proposed algorithm is superior to others in accuracy as well as in efficiency.
Aspiration thrombectomy as the first-line treatment of M2 occlusions
Authors: Harsany Jan , Haring Jozef , Hoferica Matus , Mako Miroslav , Janega Pavol , Krastev Georgi , Klepanec Andrej
Published: May 2020

Purpose

The aim of the present study was (i) to evaluate the safety and efficacy of aspiration thrombectomy in patients with M2 occlusions and (ii) to compare outcome of treatment of occlusion of different M2 segments.

Materials and methods

Between March 2016 and June 2019, 82 patients with acute ischemic stroke and isolated M2 occlusions were treated in cerebrovascular stroke center with aspiration thrombectomy as the first-line treatment. Functional outcomes of patients with different types of M2 occlusions were statistically compared. Multivariable logistic regression analysis was performed to determine the factors associated with good clinical outcome.

Results

The mean age was 71.9 ± 13.4 years, 47.6% were men. Aspiration thrombectomy alone was utilized in 72.5% of patients, with 27.5% of patients being treated with a combination of aspiration thrombectomy and stent retriever. At the three-month follow-up, there was no statistically significant difference in functional outcome between different types of M2 occlusions (p = 0.662), however in the underpowered analysis because of the small sample size of patients, with good clinical outcome mRS 0–2 in 50% of all treated patients. Symptomatic intracranial hemorrhage was found in 6.1% of patients. Lower age (OR 0.932, 95% CI 0.878–0.988) and lower NIHSS score upon admission (OR 0.893, 95% CI 0.805–0.991) were independent predictors of good clinical outcome.

Conclusion

Aspiration thrombectomy appeared to be a safe and effective first-line treatment option for patients with M2 occlusion, being the first-line option for almost three-quarters of patients.
Impact of sex-specific target dose in chronic heart failure patients with reduced ejection fraction
Authors: Veenis Jesse F , Rocca Hans-Peter Brunner-La , Linssen Gerard C M , Erol-Yilmaz Ayten , Pronk Arjen C B , Engelen Domien J M , van Tooren Rob M , Koornstra-Wortel Hetty J J , de Boer Rudolf A , van der Meer Peter , Hoes Arno W , Brugts Jasper J ,   for the CHECK-HF investigators
Published: May 2020

Aims

A recent study suggested that women with heart failure and heart failure reduced ejection fraction might hypothetically need lower doses of angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers ( = renin-angiotensin-system inhibitors) and β-blockers than men to achieve the best outcome. We assessed the current medical treatment of heart failure reduced ejection fraction in men and women in a large contemporary cohort and address the hypothetical impact of changing treatment levels in women.

Methods

This analysis is part of a large contemporary quality of heart failure care project which includes 5320 (64%) men and 3003 (36%) women with heart failure reduced ejection fraction. Detailed information on heart failure therapy prescription and dosage were collected.

Results

Women less often received renin-angiotensin-system inhibitors (79% vs 83%, p < 0.01), but more often β-blockers (82% vs 79%, p < 0.01) than men. Differences in guideline-recommended target doses between sexes were relatively small. Implementing a hypothetical sex-specific dosing schedule (at 50% of the current recommended dose in the European Society of Cardiology guidelines in women only) would lead to significantly higher levels of women receiving appropriate dosing (β-blocker 87% vs 54%, p < 0.01; renin-angiotensin-system inhibitor 96% vs 75%, p < 0.01). Most interestingly, the total number of women with >100% of the new hypothetical target dose would be 24% for β-blockers and 52% for renin-angiotensin-system inhibitors, which can be considered as relatively overdosed.

Conclusion

In this large contemporary heart failure registry, there were significant but relatively small differences in drug dose between men and women with heart failure reduced ejection fraction. Implementation of the hypothetical sex-specific target dosing schedule would lead to considerably more women adequately treated. In contrast, we identified a group of women who might have been relatively overdosed with increased risk of side-effects and intolerance.
Multicentric Italian survey on daily practice for autoimmune pancreatitis: Clinical data, diagnosis, treatment, and evolution toward pancreatic insufficiency
Authors: Barresi Luca , Tacelli Matteo , Crinò Stefano Francesco , Attili Fabia , Petrone Maria Chiara , De Nucci Germana , Carrara Silvia , Manfredi Guido , Capurso Gabriele , De Angelis Claudio Giovanni , Crocellà Lucia , Fantin Alberto , Dore Maria Francesca , Garribba Alessandra Tina , Tarantino Ilaria , De Pretis Nicolò , Pagliari Danilo , Rossi Gemma , Manes Gianpiero , Preatoni Paoletta , Barbuscio Ilenia , Tuzzolino Fabio , Traina Mario , Frulloni Luca , Costamagna Guido , Arcidiacono Paolo Giorgio , Buscarini Elisabetta , Pezzilli Raffaele ,   Italian Association of Hospital Gastroenterologists and Endoscopists (AIGO), Italian Association for the Study of the Pancreas (AISP)
Published: May 2020

Background

Autoimmune pancreatitis (AIP) is a rare, and relatively new, form of chronic pancreatitis. The management of AIP can vary considerably among different centres in daily clinical practice.

Objectives

The aim of this study is to present a picture of epidemiological, clinical characteristics, outcomes, and the real‐life practice in terms of management in several academic and non‐academic centres in Italy.

Methods

Data on the clinical presentation, diagnostic work‐up, treatments, frequency of relapses, and long‐term outcomes were retrospectively collected in a cohort of AIP patients diagnosed at 14 centres in Italy.

Results

One hundred and six patients were classified as type 1 AIP, 48 as type 2 AIP, and 19 as not otherwise specified. Epidemiological, clinical, radiological, and serological characteristics, and relapses were similar to those previously reported for different types of AIP. Endoscopic cytohistology was available in 46.2% of cases, and diagnostic for AIP in only 35.2%. Steroid trial to aid diagnosis was administered in 43.3% cases, and effective in 93.3%. Steroid therapy was used in 70.5% of cases, and effective in 92.6% of patients. Maintenance therapy with low dose of steroid (MST) was prescribed in 25.4% of cases at a mean dose of 5 (±1.4) mg/die, and median time of MST was 60 days. Immunosuppressive drugs were rarely used (10.9%), and rituximab in 1.7%. Faecal elastase‐1 was evaluated in only 31.2% of patients, and was pathological in 59.2%.

Conclusions

In this cohort of AIP patients, diagnosis and classification for subtype was frequently possible, confirming the different characteristics of AIP1 and AIP2 previously reported. Nevertheless, we observed a low use of histology and steroid trial for a diagnosis of AIP. Steroid treatment was the most used therapy in our cohort. Immunosuppressants and rituximab were rarely used. The evaluation of exocrine pancreatic insufficiency is underemployed considering its high prevalence.
Population Health Intervention Implementation Among Migrants With Precarious Status in Montreal: Underlying Theory and Key Challenges
Authors: Belaid Loubna , Benoit Magalie , Kaur Navdeep , Lili Azari , Ridde Valery
Published: May 2020

The purpose of this study is to describe the underlying theory and the challenges involved in implementing an intervention to access health care services for migrants with precarious status (MPS) in Montreal. The description of the underlying theory of the intervention was based on a documentary analysis and a workshop with clinicians ( n = 9). The challenges were identified through concept mapping ( n = 28) and in-depth interviews ( n = 13). The results of the study indicated that the aims of the intervention were to provide access to health care to MPS primarily to avoid any further health status deterioration. The most significant challenges identified were sustainable funding resources and improved access to care and protection for MPS. The interviews indicated that MPS are difficult to reach out; public health care system rules are unclear; resource constraints make it difficult to provide adequate and continuing care; and advocacy activities are difficult to organize.
Synergistic Use of Bourdieu’s Theory of Practice, Queer Theories, and Employment Relation Theories: A Perspective for Sustainable Transgender Inclusion at the Workplace
Authors: Krishna Mehta Nikhil Kewal
Published: May 2020

Many transgender employees leave their employment even before they settle themselves in their workplace. Their inclusion in mainstream employment is a sensitive and emerging issue. As Bourdieu’s theory of practice promises to work at both the agency and structure level, I see great potential in integrating it with queer perspectives and employment relations theory. This integration can play a significant role in transgender inclusion in the workplace. Therefore, a potential model has been proposed to build a theoretical model using underpinnings from these theories. Based on the deductive approach, integration of queer theories and employment relation theory may enable one to understand queer habitus, capitals, and practices in the social field. I suggest that in the pursuance of taking forward queer habitus, capital in the social field (employment), Unitarian, Pluralist, and Marxist views from the premise of employment theories can add empathy and sensitivity. Therefore, in this study, I intend to present a perspective through an integrated model derived from concepts from these theories. In the future, this model can be explored for observational confrontation and synergistic use to check workplace reality and to seek sustainable transgender inclusion at the workplace.
Medical Malpractice Trends in Thyroidectomies among General Surgeons and Otolaryngologists
Authors: Swonke Megan L. , Shakibai Nasim , Chaaban Mohamad R.
Published: May 2020

Objectives

This study aims to examine litigation trends with thyroidectomies in the United States from 1984 to 2018.

Methods

We used the Westlaw legal database to collect data on the defendant, plaintiff, case demographics, alleged reasons for malpractice, additional complications, and case outcomes.

Results

The most common reason for litigation was vocal cord paralysis (51%, n = 28), with the majority ruling in favor of the defendant (64%, P =. 042). Of those, 43% of cases (n = 12) were due to unilateral recurrent laryngeal nerve (RLN) injury, and 39% (n = 11) were due to bilateral RLN injury. Of the claims due to vocal cord paralysis that resulted in indemnity payment (36%), the majority included additional damages, such as lack of informed consent (30%) or subsequent damages from permanent tracheostomy (40%), which is usually a result of bilateral nerve paralysis.

Conclusion

RLN injury was the most common complication leading to trial, with most cases ruling in favor of the defense. However, most verdicts that favored the plaintiff or those that settled were due to subsequent damages from bilateral nerve paralysis, such as permanent tracheostomy. We encourage surgeons to consider a staged procedure in high‐risk cases or cases with signal loss. There needs to be a bigger emphasis on informed consent in the training of surgeons. Surgeons should educate patients at high risk on potential surgical complications that may drastically affect their quality of life.
Overexpression of RPN2 suppresses radiosensitivity of glioma cells by activating STAT3 signal transduction
Authors: Li Changyu , Ran Haonan , Song Shaojun , Liu Weisong , Zou Wenhui , Jiang Bei , Zhao Hongmei , Shao Bin
Published: May 2020

Background

Radiation therapy is the primary method of treatment for glioblastoma (GBM). Therefore, the suppression of radioresistance in GBM cells is of enormous significance. Ribophorin II (RPN2), a protein component of an N-oligosaccharyl transferase complex, has been associated with chemotherapy drug resistance in multiple cancers, including GBM. However, it remains unclear whether this also plays a role in radiation therapy resistance in GBM.

Methods

We conducted a bioinformatic analysis of RPN2 expression using the UCSC Cancer Genomics Browser and GEPIA database and performed an immunohistochemical assessment of RPN2 expression in biopsy specimens from 34 GBM patients who had received radiation-based therapy. We also studied the expression and function of RPN2 in radiation-resistant GBM cells.

Results

We found that RPN2 expression was upregulated in GBM tumors and correlated with poor survival. The expression of RPN2 was also higher in GBM patients with tumor recurrence, who were classified to be resistant to radiation therapy. In the radiation-resistant GBM cells, the expression of RPN2 was also higher than in the parental cells. Depletion of RPN2 in resistant cells can sensitize these cells to radiation-induced apoptosis, and overexpression of RPN2 had the reverse effect. Myeloid cell leukemia 1 (MCL1) was found to be the downstream target of RPN2, and contributed to radiation resistance in GBM cells. Furthermore, STAT3 was found to be the regulator of MCL1, which can be activated by RPN2 dysregulation.

Conclusion

Our study has revealed a novel function of RPN2 in radiation-resistant GBM, and has shown that MCL1 depletion or suppression could be a promising method of therapy to overcome the resistance promoted by RPN2 dysregulation.
Improved Stiffness Modeling for An Exechon-Like Parallel Kinematic Machine (PKM) and Its Application
Authors: Shen Nanyan , Geng Liang , Li Jing , Ye Fei , Yu Zhuang , Wang Zirui
Published: May 2020

Hole drilling or contour milling for the large and complex workpieces such as automobile panels and aircraft fuselages makes a high combined demand on machining accuracy, stiffness and workspace of machining equipment. Therefore, a 5-DOF (degrees of freedom) parallel kinematic machine (PKM) with redundant constraints is proposed. Based on the kinematics analysis of the parallel mechanism using intermediate variables, the kinematics problems of the PKM are solved through equivalent kinematics model. The structural stiffness matrix method is adopted to model the stiffness of the parallel mechanism of the PKM, where the stiffness of each joint and branch component is obtained by stiffness formula and finite element analysis. And the stiffness model of the parallel mechanism is improved by correction coefficient matrix, each element of which is constructed as a polynomial function of three independent end variables of the parallel mechanism. The terminal stiffness matrices obtained by simulation result are used to determine the coefficients of polynomial function by least square fitting to describe the correction coefficient over the workspace of the parallel mechanism quantitatively. The experiment results prove that the modification method can greatly improve the stiffness model of the parallel mechanism. To enhance the machining accuracy of the PKM, the proposed kinematics model and the improved stiffness model are utilized to optimize the working stiffness of parallel machine by searching the best relative position of parallel machine and workpiece. A plate workpiece taken as example is examined in the case study section, which demonstrates the effectiveness of optimization method.
Controllable Two-dimensional Perovskite Crystallization via Water Additive for High-performance Solar Cells
Authors: Liu Ziji , Zheng Hualin , Liu Detao , Liang Zhiqing , Yang Wenyao , Chen Hao , Ji Long , Yuan Shihao , Gu Yiding , Li Shibin
Published: May 2020

Steering the crystallization of two-dimensional (2D) perovskite film is an important strategy to improve the power conversion efficiency (PCE) of 2D perovskite solar cells (PVSCs). In this paper, the deionized water (H2O) additive is introduced into the perovskite precursor solution to prepare high-quality 2D perovskite films. The 2D perovskite film treated with 3% H2O shows a good surface morphology, increased crystal size, enhanced crystallinity, preferred orientation, and low defect density. The fabricated 2D PVSC with 3% H2O exhibits a higher PCE compared with that without H2O (12.15% vs 2.29%). Furthermore, the shelf stability of unsealed devices with 3% H2O under ambient environment is significantly improved. This work provides a simple method to prepare high-quality 2D perovskite films for efficient and stable 2D PVSCs.
Identification and analysis of CYP450 and UGT supergene family members from the transcriptome of Aralia elata (Miq.) seem reveal candidate genes for triterpenoid saponin biosynthesis
Authors: Cheng Yao , Liu Hanbing , Tong Xuejiao , Liu Zaimin , Zhang Xin , Li Dalong , Jiang Xinmei , Yu Xihong
Published: May 2020

Background

Members of the cytochrome P450 (CYP450) and UDP-glycosyltransferase (UGT) gene superfamily have been shown to play essential roles in regulating secondary metabolite biosynthesis. However, the systematic identification of CYP450s and UGTs has not been reported in Aralia elata (Miq.) Seem, a highly valued medicinal plant.

Results

In the present study, we conducted the RNA-sequencing (RNA-seq) analysis of the leaves, stems, and roots of A. elata, yielding 66,713 total unigenes. Following annotation and KEGG pathway analysis, we were able to identify 64 unigenes related to triterpenoid skeleton biosynthesis, 254 CYP450s and 122 UGTs, respectively. A total of 150 CYP450s and 92 UGTs encoding > 300 amino acid proteins were utilized for phylogenetic and tissue-specific expression analyses. This allowed us to cluster 150 CYP450s into 9 clans and 40 families, and then these CYP450 proteins were further grouped into two primary branches: A-type (53%) and non-A-type (47%). A phylogenetic analysis of 92 UGTs and other plant UGTs led to clustering into 16 groups (A-P). We further assessed the expression patterns of these CYP450 and UGT genes across A. elata tissues, with 23 CYP450 and 16 UGT members being selected for qRT-PCR validation, respectively. From these data, we identified CYP716A295 and CYP716A296 as the candidate genes most likely to be associated with oleanolic acid synthesis, while CYP72A763 and CYP72A776 were identified as being the most likely to play roles in hederagenin biosynthesis. We also selected five unigenes as the best candidates for oleanolic acid 3-O-glucosyltransferase. Finally, we assessed the subcellular localization of three CYP450 proteins within Arabidopsis protoplasts, highlighting the fact that they localize to the endoplasmic reticulum.

Conclusions

This study presents a systematic analysis of the CYP450 and UGT gene family in A. elata and provides a foundation for further functional characterization of these two multigene families.
Social media as a recruitment platform for a nationwide online survey of COVID-19 knowledge, beliefs, and practices in the United States: methodology and feasibility analysis
Authors: Ali Shahmir H. , Foreman Joshua , Capasso Ariadna , Jones Abbey M. , Tozan Yesim , DiClemente Ralph J.
Published: May 2020

Background

The COVID-19 pandemic has evolved into one of the most impactful health crises in modern history, compelling researchers to explore innovative ways to efficiently collect public health data in a timely manner. Social media platforms have been explored as a research recruitment tool in other settings; however, their feasibility for collecting representative survey data during infectious disease epidemics remain unexplored.

Objectives

This study has two aims 1) describe the methodology used to recruit a nationwide sample of adults residing in the United States (U.S.) to participate in a survey on COVID-19 knowledge, beliefs, and practices, and 2) outline the preliminary findings related to recruitment, challenges using social media as a recruitment platform, and strategies used to address these challenges.

Methods

An original web-based survey informed by evidence from past literature and validated scales was developed. A Facebook advertisement campaign was used to disseminate the link to an online Qualtrics survey between March 20–30, 2020. Two supplementary male-only and racial minority- targeted advertisements were created on the sixth and tenth day of recruitment, respectively, to address issues of disproportionate female- and White-oriented gender- and ethnic-skewing observed in the advertisement’s reach and response trends.

Results

In total, 6602 participant responses were recorded with representation from all U.S. 50 states, the District of Columbia, and Puerto Rico. The advertisements cumulatively reached 236,017 individuals and resulted in 9609 clicks (4.07% reach). Total cost of the advertisement was $906, resulting in costs of $0.09 per click and $0.18 per full response (completed surveys). Implementation of the male-only advertisement improved the cumulative percentage of male respondents from approximately 20 to 40%.

Conclusions

The social media advertisement campaign was an effective and efficient strategy to collect large scale, nationwide data on COVID-19 within a short time period. Although the proportion of men who completed the survey was lower than those who didn’t, interventions to increase male responses and enhance representativeness were successful. These findings can inform future research on the use of social media recruitment for the rapid collection of survey data related to rapidly evolving health crises, such as COVID-19.
Molecular epidemiology of drug resistant Mycobacterium tuberculosis in Africa: a systematic review
Authors: Chisompola Namaunga Kasumu , Streicher Elizabeth Maria , Muchemwa Chishala Miriam Kapambwe , Warren Robin Mark , Sampson Samantha Leigh
Published: May 2020

Background

The burden of drug resistant tuberculosis in Africa is largely driven by the emergence and spread of multidrug resistant (MDR) and extensively drug resistant (XDR) Mycobacterium tuberculosis strains. MDR-TB is defined as resistance to isoniazid and rifampicin, while XDR-TB is defined as MDR-TB with added resistance to any of the second line injectable drugs and any fluoroquinolone.

The highest burden of drug resistant TB is seen in countries further experiencing an HIV epidemic. The molecular mechanisms of drug resistance as well as the evolution of drug resistant TB strains have been widely studied using various genotyping tools. The study aimed to analyse the drug resistant lineages in circulation and transmission dynamics of these lineages in Africa by describing outbreaks, nosocomial transmission and migration. Viewed as a whole, this can give a better insight into the transmission dynamics of drug resistant TB in Africa.

Methods

A systematic review was performed on peer reviewed original research extracted from PubMed reporting on the lineages associated with drug resistant TB from African countries, and their association with outbreaks, nosocomial transmission and migration. The search terms “Tuberculosis AND drug resistance AND Africa AND (spoligotyping OR molecular epidemiology OR IS6110 OR MIRU OR DNA fingerprinting OR RFLP OR VNTR OR WGS)” were used to identify relevant articles reporting the molecular epidemiology of drug resistant TB in Africa.

Results

Diverse genotypes are associated with drug resistant TB in Africa, with variations in strain predominance within the continent. Lineage 4 predominates across Africa demonstrating the ability of “modern strains” to adapt and spread easily. Most studies under review reported primary drug resistance as the predominant type of transmission. Drug resistant TB strains are associated with community and nosocomial outbreaks involving MDR- and XDR-TB strains. The under-use of molecular epidemiological tools is of concern, resulting in gaps in knowledge of the transmission dynamics of drug resistant TB on the continent.

Conclusions

Genetic diversity of M. tuberculosis strains has been demonstrated across Africa implying that diverse genotypes are driving the epidemiology of drug resistant TB across the continent.
Kidney triplication with ectopic ureterocele: a case report
Authors: Osipov I. B. , Lebedev D. A. , Lifanova M. V.
Published: May 2020

Background

Kidney triplication is a rare urological abnormality. Association of triplex kidney and ureterocele is out of ordinary. Treatment of such patients usually implies heminephrureterectomy of the upper moiety. We report a case of a saved function of the upper moiety after minimal invasive surgical procedure.

Case presentations

5-year old girl complained for continuous wetting. Examination revealed 3 - segmented left kidney with pelvi-ureteric dilation of the upper moiety, IV grade vesicoureteral reflux in the upper moiety, cervical ectopic ureteral orifice of the upper moiety and a commune ureteral orifice of the lower segments.

An endoscopic laser dissection of ureterocele was performed. Drainage of the upper moiety of triplex kidney was restored. Examination 18 months later showed no wetting and infection symptoms. Pelvi-ureteric dilation of the upper moiety and cavity of ureterocele decreased to minimal. Grade of vesicoureteral reflux decreased to I.

Conclusion

Minimal invasive elimination of obstruction of the upper moiety of triplex kidney was successful and led to regress of vesicoureteral reflux, urinary incontinence and let to avoid heminephrectomy.
Deep learning-based dental plaque detection on primary teeth: a comparison with clinical assessments
Authors: You Wenzhe , Hao Aimin , Li Shuai , Wang Yong , Xia Bin
Published: May 2020

Background

Dental plaque causes many common oral diseases (e.g., caries, gingivitis, and periodontitis). Therefore, plaque detection and control are extremely important for children’s oral health. The objectives of this study were to design a deep learning-based artificial intelligence (AI) model to detect plaque on primary teeth and to evaluate the diagnostic accuracy of the model.

Methods

A conventional neural network (CNN) framework was adopted, and 886 intraoral photos of primary teeth were used for training. To validate clinical feasibility, 98 intraoral photos of primary teeth were assessed by the AI model. Additionally, tooth photos were acquired using a digital camera. One experienced pediatric dentist examined the photos and marked the regions containing plaque. Then, a plaque-disclosing agent was applied, and the areas with plaque were identified. After 1 week, the dentist drew the plaque area on the 98 photos taken by the digital camera again to evaluate the consistency of manual diagnosis. Additionally, 102 intraoral photos of primary teeth were marked to denote the plaque areas obtained by the AI model and the dentist to evaluate the diagnostic capacity of each approach based on lower-resolution photos. The mean intersection-over-union (MIoU) metric was employed to indicate detection accuracy.

Results

The MIoU for detecting plaque on the tested tooth photos was 0.726 ± 0.165.

The dentist’s MIoU was 0.695 ± 0.269 when first diagnosing the 98 photos taken by the digital camera and 0.689 ± 0.253 after 1 week. Compared to the dentist, the AI model demonstrated a higher MIoU (0.736 ± 0.174), and the results did not change after 1 week. When the dentist and the AI model assessed the 102 intraoral photos, the MIoU was 0.652 ± 0.195 for the dentist and 0.724 ± 0.159 for the model. The results of a paired t-test found no significant difference between the AI model and human specialist (P > .05) in diagnosing dental plaque on primary teeth.

Conclusions

The AI model showed clinically acceptable performance in detecting dental plaque on primary teeth compared with an experienced pediatric dentist. This finding illustrates the potential of such AI technology to help improve pediatric oral health.