bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effect of MicroRNA-331-3p on Preadipocytes Proliferation and Differentiation and Fatty Acid Accumulation in Laiwu Pigs
Authors: Chen Tao , Cui Jingxiang , Ma Lixia , Zeng Yongqing , Chen Wei
Published: December 2019

Objective. The proliferation and differentiation of preadipocytes are regulated by microRNAs (miRNAs), hormones, and other factors. This study aimed to investigate the effects of miR-331-3p on the proliferation and differentiation of preadipocytes in addition to fatty acid metabolism. Methods. Preadipocytes were transfected with miR-331-3p mimics, miR-NC, or miR-331-3p inhibitor to explore its effect on cell proliferation and fatty acid accumulation. Furthermore, preadipocytes were transfected with pre-miR-331-3p, pcDNA3.1(+), or miR-331-3p inhibitor to explore its effect on differentiation. Results. It was observed that miR-331-3p could inhibit preadipocytes proliferation. Furthermore, miR-331-3p was highly expressed during cellular differentiation and appeared to promote the process. In addition, dual fluorescein analysis showed that dihydrolipoamide S-succinyltransferase (DLST) is a target gene of miR-331-3p, and overexpression of miR-331-3p could regulate the metabolism of fatty acids in the citrate pyruvate cycle by targeting DLST expression. Conclusion. In summary, these findings indicated that miR-331-3p exerts contrasting effects on the processes of fat deposition.
Effectiveness of Cherries in Reducing Uric Acid and Gout: A Systematic Review
Authors: Chen Pei-En , Liu Chia-Yu , Chien Wu-Hsiung , Chien Ching-Wen , Tung Tao-Hsin
Published: December 2019

Background. Previous studies have reported the use of complementary therapies to reduce the risk of gout attacks. In this study, we assessed the effectiveness of cherries in reducing uric acid levels associated with gout. Methods. We searched for relevant studies on PubMed, Embase, and the Cochrane Library without restrictions on language from inception until August 15, 2019. The risk of bias was evaluated using the PRISMA statement and checklist, and the methodological quality was assessed using the Cochrane Collaboration tool. Results. The six studies included in this systematic review reported decreases in the incidence and severity of gout following the ingestion of cherries. Gout patients regularly ingesting cherry extract/juice reported fewer gout flare ups than those patients who did not supplement their diets with cherry products. Overall, we observed a positive correlation between the consumption of tart cherry juice and a decrease in serum uric acid concentration. Conclusions. Current evidence supports an association between cherry intake and a reduced risk of gout attacks. Note however that we were unable to conduct effective meta-analysis due to a lack of relevant studies and a high degree of variation in the methodologies and metrics used in previous studies. Further comprehensive trials or long-term follow-up studies will be required to evaluate the efficacy of cherry intake in treating patients with gout or hyperuricemia.
Free Tube Graft Urethroplasty for Repair of Hypospadias
Authors: Obara Kenji , Hoshii Tatsuhiko  , Hoshino Sayaka , Yamana Kazutoshi  , Anraku Tsutomu , Maruyama Ryo , Kuroki Hiroo , Ishizaki Fumio  , Yamazaki  Hiroyuki  , Tomita Yoshihiko
Published: December 2019

Introduction: We aimed to assess the outcome of free tube graft urethroplasty for single-stage repair of hypospadias with chordee in children. Materials and Methods: We retrospectively evaluated a series of 56 patients (16 months to 9 years old, median 24 months) who underwent free graft urethroplasty for repair of hypospadias with chordee between May 2005 and November 2017. The median follow-up was 7 years (range 1–11). Results: After releasing the chordee, the hypospadiac orifice was retracted to become penile in 32 patients (57%), penoscrotal in 18 patients (32%), and scrotal in 6 patients (11%). Single-stage repair was achieved without complications in 42 patients (75%). Of the remaining 14 patients with postoperative complications requiring surgical intervention, 2 had meatal stenosis, 9 had urethrocutaneous fistula, 1 had urethral diverticulum without meatal stenosis, and 1 had meatal regression. One patient who complained the urine stream went upwards in an arc underwent cutback meatoplasty to correct the stream. In all patients, a neomeatus with a vertically oriented slit-like appearance was eventually achieved at the tip of the glans. Conclusion: A free graft is an appropriate choice for repairing hypospadias with chordee. Our procedure achieved favorable functional and cosmetic outcomes with a low postoperative morbidity rate.
Longitudinal Effects of Cigarette Smoking and Smoking Cessation on Aortic Wave Reflections, Pulse Wave Velocity, and Carotid Artery Distensibility
Authors: Schmidt Kelly M. T. , Hansen Kristin M. , Johnson Adrienne L. , Gepner Adam D. , Korcarz Claudia E. , Fiore Michael C. , Baker Timothy B. , Piper Megan E. , Stein James H.
Published: December 2019

Background

We evaluated the effects of smoking and smoking cessation on aortic wave reflections (augmentation index), aortic pulse wave velocity, and carotid artery distensibility and stiffness (distensibility coefficient, Young's elastic modulus).

Methods and Results

Current smokers underwent carotid, radial, and femoral artery tonometry and carotid ultrasound at baseline and 3 years after a quit attempt. Baseline associations of smoking heaviness markers (exhaled carbon monoxide and cigarettes smoked/d) and effects of smoking cessation at year 3 on changes in arterial measures were assessed using multivariable linear regression models. The 1417 smokers (54% female) were mean (SD) 49.3 (11.6) years old and smoked 17.2 (8.3) cigarettes/d (exhaled carbon monoxide 14.7 [8.2] parts per million). Arterial measures were associated more strongly with age, blood pressure (BP), and waist circumference than with smoking heaviness markers. Augmentation index was associated independently with carbon monoxide (
P
=0.004). Pulse wave velocity, distensibility coefficient, and Young's elastic modulus had small, inconsistent associations with smoking heaviness markers. At year 3, augmentation index improved with smoking cessation (
P
=0.006) despite more weight gain (2.54 vs 0.36 kg,
P
<0.001) and insulin resistance (
P
=0.001) among abstainers, but distensibility coefficient decreased (
P
=0.004). Changes in arterial measures were related more strongly to changes in BP than smoking cessation.

Conclusions

Arterial wave reflection and stiffness measures were associated more strongly with age, BP, and waist circumference than smoking heaviness. Smoking cessation was associated with weight gain and increased insulin resistance. Changes in arterial measures were predicted by changes in BP, highlighting the need to address weight gain and BP changes during a quit attempt.
Tissue Protrusion With Attenuation Is Associated With Ischemic Brain Lesions After Carotid Artery Stenting
Authors: Funatsu Naoko , Enomoto Yukiko , Egashira Yusuke , Yamauchi Keita , Nakayama Noriyuki , Kawasaki Masanori , Iwama Toru
Published: December 2019

Background and Purpose—

Tissue protrusion between stent struts is frequently observed on optical frequency domain imaging evaluation after carotid artery stenting, but its clinical relevance is unclear. We aimed to investigate the association between the characteristics of tissue protrusion assessed by optical frequency domain imaging and brain lesions identified by diffusion-weighted imaging after carotid artery stenting.

Methods—

Sixty-five consecutive patients who underwent optical frequency domain imaging after protected carotid artery stenting were enrolled in the study. Cross-sectional optical frequency domain images within the stented segments were evaluated at 0.125-mm intervals. Magnetic resonance imaging was performed 1 to 10 days after treatment. The characteristics of tissue protrusion were compared between patients with and without new ipsilateral brain lesions on posttreatment magnetic resonance imaging.

Results—

Tissue protrusion was observed in 62 patients (95%). New brain lesions were observed in 24 patients (37%). In the multivariate analysis, the presence of protrusion with attenuation (odds ratio, 2.94 [95% CI, 1.05–8.68]
P
=0.04) was associated with new brain lesions after carotid artery stenting.

Conclusions—

The presence of protrusion with attenuation assessed by optical frequency domain imaging was associated with ipsilateral brain lesions after carotid artery stenting. Prevention or treatment of protrusions with attenuation may reduce ischemic brain lesions after carotid artery stenting.
What Is It Like to Self-Rescue from a Building Collapse as a Firefighter: a Phenomenological Inquiry
Authors: Broomé Rodger E. , Russell Eric J.
Published: December 2019

This descriptive scientific-phenomenological study set forth to discover what is like to survive a building collapse as a firefighter. The participants of the study were 3 uniformed and sworn professional firefighters performing interior operations at a commercial building structure fire. The 3 participants all become trapped and had to self-rescue as a result of a structural collapse. The data collected from the participant interviews was analyzed and transformed so as to form the structure of the study.
Parzival auf dem Zauberberg?
Authors: Friedrich Kathrin
Published: December 2019

Medieval German literature had a deeper impact on Thomas Mann than is typically assumed. The comparison between Wolfram’s von Eschenbach Parzival and Thomas Mann’s The Magic Mountain illustrates this influence. Nearly 700 years separate both novels, nevertheless, they show amazing parallels. Especially as their narrators are very much alike. Both appear exposed in their stories, utilise Wolfram’s Bogengleichnis, and are unreliable. In addition, they both reflect on their narrations as literary constructs. While Wolfram’s narrator defends his protagonist Parzival for his misdeeds Mann does not bother to do so for Hans Castorp. The heroes and other characters are comparable, but develop differently. Parzival gains knowledge and his identity, whereas Hans Castorp loses both. Parzival fails his first encounter with the grail. Castorp, in contrast, wins a deep insight into life in his Schneetraum; but forgets it immediately. Castorp is as foolish as Parzival when he begins his journey. He is, however, not a grail-quester although Howard Nemerov concludes this in his 1939 dissertation. Yet, the Magic Mountain seems strongly influenced by Parzival. But while the characters in Parzival seek to help the central protagonist, egoism is predominant in the Magic Mountain, the hero stagnates and fails to successfully finish the hero’s journey.
Phylogeny of two new pheronematid sponges from the Caroline Seamount and South China Sea
Authors: Lin Gong , Xinzheng Li , Kwen-Shen Lee
Published: December 2019

Two new species of genus Pheronemoides are described in this study. The Specimens were collected from the South China sea and the Caroline seamount in the northwestern Pacific Ocean. Pheronemoides crustiformis sp. nov. differs from its congeners in exhibiting large microamphidiscs, whip-like and slightly bent microuncinates and small spiny microdiactins. Pheronemoides curvipentactin sp. nov. possesses special pentactine atrialia with round terminal or tapering terminal curved pinular rays and crooked pentactins, making it easily distinguishable from its congeners. Partial sequences of the 28S rDNA and 16S rDNA genes were also amplified to confirm the family assignment of the two new species and to explore the systematic status of Pheronemoides.
Konrad Lange on ‘the Illusion of Materials’ in Painting and Visual Arts: Revisiting a Psychoaesthetic Theory of the Perception of Material Properties
Authors: Romand David
Published: December 2019

In the present article, I discuss the concept of ‘the illusion of materials’ (die Stoffillusion) as it was elaborated in the late 19th and early 20th centuries by the German aesthetician and art historian Konrad Lange (1855–1921). Here I intend to revisit a remarkable theory of the psychological mechanisms that underlie the aesthetic experience of mimesis in painting and, more generally speaking, in visual arts. First, I deal with the historical background of Lange’s contribution by saying a word about the German-speaking psychoaesthetic paradigm as it developed between the mid-19th century and WWI. Second, I discuss the basic tenets of Lange’s ‘illusionistic aesthetics’ (Illusionsästhetik), the view according to which the experience of the beautiful lies in a process of ‘conscious self-delusion’ (bewusste Selbsttäuschung) by which means the contemplating subject mentally oscillates between ‘semblance’ and ‘reality’. Third, I analyze Lange’s theoretical way of conceiving the illusion of materials by showing that he identified it as one of the seven chief categories of aesthetic illusions and by insisting on his distinction between the ‘subjective’ non-aesthetic illusion and the ‘objective’ aesthetic illusion of materials. Fourth, I show how Lange conceived the place of the illusion of materials in aesthetic experience in general and in the contemplation of painting and sculpture in particular. In a fifth, concluding part, I deal with the significance of Lange’s ideas on the illusion of materials today by highlighting their close relation to Daniel Arasse’s conception of painting contemplation as a dialectics of ‘the pictorial’ and ‘the iconic’, while also suggesting that they may be very fruitful within the context of current experimental psycho- and neuroaesthetic research.
Flesh and Blood
Authors: Beit-Hallahmi Benjamin
Published: December 2019

Fears and stories about an underground religion devoted to Satan, which demands and carries out child sacrifice, appeared in the United States in the late twentieth century and became the subject of media reports supported by some mental health professionals. Looking at these modern fantasies leads us back to ancient stories which in some cases believers consider the height of religious devotion. Horrifying ideas about human sacrifice, child sacrifice, and the offering to the gods of a beloved only son by his father appear repeatedly in Western traditions, starting with the Greeks and the Hebrews. This publication focuses on rituals of violence tied to religion, both imagined and real. The main question of this work is the meaning of blood and ritual killing in the history of religion. The publication examines the encounter with the idea of child sacrifice in the context of human hopes for salvation.
The lefteye flounder family Bothidae (Order Pleuronectiformes) of Taiwan
Authors: AMAOKA KUNIO , HO HSUAN-CHING
Published: December 2019

The family Bothidae in Taiwan is reviewed. A total of 15 genera and 42 species are recognized. Historical records are re-evaluated and five species are recorded in Taiwan for the first time: Arnoglossus yamanakai Fukui & Ozawa, 1988, Crossorhombus valderostratus (Alcock, 1890), Parabothus polylepis (Alcock, 1889), Parabothus coarctatus (Gilbert, 1905), and Psettina variegata (Fowler, 1933). Laeops tongkongensis Chen & Weng, 1965 is recognized as a junior synonym of Laeops kitaharae Smith & Pope, 1906. Keys to genera and species, diagnostic characters, distribution and photographs are provided.
Tracking Mesoscale Convective Systems that are Potential Candidates for Tropical Cyclogenesis
Authors: Núñez Ocasio Kelly M. , Evans Jenni L. , Young George S.
Published: December 2019

This study introduces the development of the Tracking Algorithm for Mesoscale Convective Systems (TAMS), an algorithm that allows for the identifying, tracking, classifying, and assigning of rainfall to mesoscale convective systems (MCSs). TAMS combines area-overlapping and projected-cloud-edge tracking techniques to maximize the probability of detecting the progression of a convective system through time, accounting for splits and mergers. The combination of projection on area overlapping is equivalent to setting the background flow in which MCSs are moving on. Sensitivity tests show that area-overlapping technique with no projection (thus, no background flow) underestimates the real propagation speed of MCSs over Africa. The MCS life cycles and propagation derived using TAMS are consistent with climatology. The rainfall assignment is also more reliable than with previous methods as it utilizes a combination of regridding through linear interpolation with high temporal and spatial resolution data. This makes possible the identification of extreme rainfall events associated with intense MCSs more effectively. TAMS will be utilized in future work to build an AEW–MCS dataset to study tropical cyclogenesis.
Quality of life: A universal or a disability specific concept?
Authors: Erez Asnat Bar-Haim , Gal Eynat
Published: December 2019

Background.

Quality of life (QoL) is an important outcome of occupational therapy practice. Autism spectrum disorder (ASD) is a neurodevelopmental disorder that impacts the individual throughout their lifespan and may substantially affect QoL. Measuring QoL of people with ASD presents a challenge and a debate whether to use general versus disability-specific adapted measures.

Purpose.

This paper aims to (a) revisit the construct of QoL and discuss specific dilemmas pertaining to its measurement, and (b) discuss implications to the assessment of QoL in individuals with ASD while highlighting the potential contribution of occupational therapy to the development of measures.

Key Issues.

We suggest adding the domain of accessibility into QoL assessments, including, physical, sensory, social, and cognitive aspects, and to use disability-specific QoL measures.

Implications.

The paper presents a call for occupational therapists to be involved in developing specific ASD disability-oriented measures that consider the unique characteristics of the disorder and environmental supports.
Accounting for Differential Item Functioning Using Bayesian Approximate Measurement Invariance
Authors: Sideridis Georgios D. , Tsaousis Ioannis , Alamri Abeer A.
Published: December 2019

The main thesis of the present study is to use the Bayesian structural equation modeling (BSEM) methodology of establishing approximate measurement invariance (A-MI) using data from a national examination in Saudi Arabia as an alternative to not meeting strong invariance criteria. Instead, we illustrate how to account for the absence of measurement invariance using relative compared to exact criteria. A secondary goal was to compare latent means across groups using invariant parameters only and through utilizing exact and relative evaluative-MI protocol suggested equivalence of the thresholds using prior variances equal to 0.10. Subsequent differences between groups were evaluated using effect size criteria and the prior-posterior predictive p-value (PPPP), which proved to be invaluable in attesting for differences that are beyond zero, some meaningless nonzero estimate, and the three commonly used indices of effect sizes described by Cohen in 1988 (i.e., .20, .50, and .80). Results substantiated the use of the PPPP for evaluating mean differences across groups when utilizing nonexact evaluative criteria.
Flexural, pull-out, and fractured surface characterization for multi-material 3D printed functionally graded prototype
Authors: Kumar Sudhir , Singh Rupinder , Singh TP , Batish Ajay
Published: December 2019

This paper reports the flexural, pull-out, and fractured surface characterization for multi-material three-dimensional printed functionally graded prototypes, which is prepared on fused deposition modeling setup. The work is an extension of previously reported study in which different thermoplastic matrices of polylactic acid blended with polyvinyl chloride, wood dust, and Fe3O4 powder (as multiple blended feedstock filaments) have been prepared separately with twin screw extrusion for possible three-dimensional printing. Finally, functionally graded prototypes with alternative layers of polylactic acid (01 layer), polylactic acid + polyvinyl chloride (01 layer), polylactic acid + wood dust (02 layers), and polylactic acid + Fe3O4 (02 layers) were three-dimensional printed on fused deposition modeling for flexural samples as per ASTM D790. With regard to process parameters of fused deposition modeling (in this case study), infill density of 100%, infill angle of 45°, and infill speed of 50 mm/s were the optimized processing conditions. The results of study suggest that maximum flexural strength 26.92 MPa and pull-out strength 18.11 MPa were observed for functionally graded multi-material three-dimensional printed prototypes. From fractured surface analysis and hardness result, it has been ascertained that higher infill density and lower infill angle lead to better diffusion of material in layer-by-layer fashion resulting into less void formation and better flexural and pull-out performances. The novelty of this work lies in accessing the behavior of three-dimensional printed prototypes having different functional ability for each layer, with a potential to replace hybrid blend-based prototypes.
Evaluating the Effectiveness of Mindfulness-Based Interventions in Incarcerated Populations: A Meta-Analysis
Authors: Per Megan , Spinelli Christina , Sadowski Isabel , Schmelefske Emma , Anand Leena , Khoury Bassam
Published: December 2019

A growing body of research supports the use of mindfulness-based interventions (MBIs) in incarcerated populations; however, treatment effectiveness remains unclear. This meta-analysis of 22 studies ( N = 2,265, 75% male) quantified the effectiveness of MBIs in incarcerated populations on key psychological outcomes and criminogenic needs. Results from pre–post studies indicated MBIs had a small to moderate effect on all outcomes, but this was not supported by controlled studies. Studies with older participants, more females, and longer treatment length demonstrated slightly greater effects. Results from pre–post analyses demonstrated significant reductions in psychological outcomes (depression, anxiety, and stress) and criminogenic needs (impulsivity, self-dysregulation, anger, substance use behavior, and attitude). However, only depression and anxiety were significantly reduced in controlled studies. Although findings offer preliminary support of the efficacy of MBIs in targeting psychological health in incarcerated populations, further controlled studies are required to examine criminogenic outcomes and recidivism rates after treatment.
A Seat at the Table and a Room of Their Own: Interconnected processes of social media use at the intersection of gender and occupation
Authors: Vaast Emmanuelle
Published: December 2019

Social media have enabled people to connect with others in unprecedented ways. Existing scholarship has so far provided conflicting insights regarding what people do with these connections. Here I propose that to make sense of what people accomplish with social media-enabled connections, one needs to examine more closely their foundations. Specifically, one key way to understand social media-enabled connections is to consider how social media enable people to come together on the basis of joint social identities. This study focuses on how people use social media in ways that connect them to one another at the intersection of gender and occupational identities, i.e. two social identities that have been central to many organization studies and are critical in today’s societies. The study relies upon the qualitative investigation of how women and gender non-binaries data scientists used social media. The study reveals that, at the intersection of gender and occupation, people use social media to engage in three interconnected processes of promoting inclusion, co-producing equalizing resources, and fostering exclusive enclaves. It brings light to new ambivalence reflected in people’s uses of social media as they seek, simultaneously, to reshape gender dynamics in their occupation and to protect their reputation as competent workers. It unpacks why and how, with social media, the professional and the political have become intertwined.
Unique New York? Theorizing the Impact of Resources on the Quality of Defense Representation in a Deviant State
Authors: Davies Andrew L. B. , Lopes Giza , Clark Alyssa
Published: December 2019

Litigation in New York State has resulted in the allocation of substantial new funding to limit indigent defense caseloads and improve representation provided to criminal defendants. Funding injections have rarely been studied in defense, however, so it is not clear what will be the effects of the new resources. Defense critics expect their impact to be transformative, but empirical scholarship is more pessimistic. We sort between these perspectives using exploratory interviews with the individuals most critical to the planned reforms: executive-level chief public defenders. Conceptualizing defense service quality in terms of “public value,” we find points of deviation from both the optimistic and pessimistic accounts. New York is a “deviant case,” we argue, which can be used to break new theoretical and empirical ground around the question of how resources impact defense service quality.
Freedom and Humanbecoming
Authors: Bunkers Sandra Schmidt
Published: December 2019

Freedom, one of the four postulates of the humanbecoming paradigm, is the focus of this article. Freedom is explored from a humanbecoming perspective and from the existential/phenomenological perspectives of Heidegger and Sartre.
Patient-Centered Medical (Health) Home: Nursing Theory-Guided Policy Perspectives
Authors: Ortiz Mario R.
Published: December 2019

Nurses have provided care to individuals, families, and communities, since its “official” founding by Nightingale. Over time, nurses have carved out their unique contributions to serving others by articulating the knowledge needed to practice in a variety of settings so that the “work” of nurses is differentiated from other healthcare professionals. One broad area of practice where nurses serve diverse populations is the Patient-Centered Medical or health Home. The purpose of this paper is to examine patient-centered health (medical) homes (PCHH) and the ways in which nursing theory may guide the principles and policies of PCCHs.
Patients’ Perceptions of Nursing Care in a University Hospital
Authors: Ozturk Hülya , Demirsoy Nilufer , Sayligil Omur , Florczak Kristine L.
Published: December 2019

Patient satisfaction with nursing is an important indicator of the quality of the nursing services. This study used The Patient Perception of Hospital Experience With Nursing (PPHEN) scale (Dozier, Kitzman, Ingersol, Holmberg, & Schultz, 2001) to determine the nursing care perception of patients in a Turkish tertiary care hospital. The study design was descriptive comparative and used convenience sampling. In total, 566 patients volunteered to take part in the study. The patient satisfaction level with nursing was found to be below average; patient satisfaction showed no meaningful differences between genders, marital status, or the clinics where the patient was hospitalized, but significantly higher levels of satisfaction were found with higher levels of education, younger age, higher incomes, and being employed. Overall, the patients considered that nursing care needs improvement, especially in terms of the provision of information and psychosocial support.
Music and Teaching-Learning in Nursing: Harmony and Rhythm in Co-Constructing New Knowings
Authors: Yancey Nan Russell
Published: December 2019

Drawing on a passion for music and teaching-learning, the author explored possibilities in using music creatively in the teaching-learning of nursing. Considering what was found in the literature, further insights were gleaned from interviewing two professional musicians and considering two relevant movies. From these insights, implications are offered for nurse teachers seeking innovative ways to engage students in teaching-learning on their journey of becoming nurses.
Numerical and experimental investigations on the flow and noise characteristics in a centrifugal fan with step tongue volutes
Authors: Wei Yikun , Zhu Lingling , Zhang Wei , Wang Zhengdao
Published: December 2019

This paper presents numerical and experimental investigations on the flow and noise characteristics in a forward multi-blade centrifugal fan with step tongue volutes. Numerical simulations are performed by large eddy simulation, and the experiments are conducted to test the effects of the cut-off arrangements on the noise characteristics of the fan. The objective of this work is to explore the effect of the double-stepped tongue and single-stepped tongue on the internal complex flow and the noise generation within the fan. The comparison of the results of numerical calculation demonstrates that the internal complex flow of centrifugal fan can be controlled by the stepped tongue, the flow loss in meridian plane for the double-stepped tongue (HLHL, L stands for low and H for high) model is obviously lower than that of the original model, the Q-criterion value of HLHL model is lower than that of the original model, and the noise of the HLHL model produces an obvious decrease of 1.90 dB compared to that of the reference model. The comparison of the test results further shows that the HLHL model produces a decrease about 1.97 dB compared to that of the reference model, which mainly indicates the double-stepped tongue HLHL model more effectively controls the tonal noise comparing to the single-stepped tongue (HL) model. Meanwhile, the stepped arrangements possess comparable performance characteristics to the reference model. The double-stepped tongue HLHL model makes a positive contribution to the pressure rise of the centrifugal fan.
Male circumcision and the risk of gonorrhoea, syphilis, HIV and human papillomavirus among men in Tanzania
Authors: Olesen Tina B , Munk Christian , Mwaiselage Julius , Kahesa Crispin , Rasch Vibeke , Frederiksen Kirsten , Iftner Thomas , Kjaer Susanne K
Published: December 2019

To examine the association between male circumcision and the risk of gonorrhoea, syphilis, HIV and high-risk (hr) human papillomavirus (HPV). We used data from a cross-sectional study conducted among 1902 men in Tanzania. Circumcision status was assessed at a clinical examination and history of gonorrhoea and syphilis was obtained from questionnaire data. Penile samples were tested for HPV using Hybrid Capture 2 and genotyped by the INNO-LiPA HPV Genotyping Extra test. Blood samples were tested for HIV. Using logistic regression the association between male circumcision and gonorrhoea, syphilis, HIV and hr HPV was assessed estimating odds ratios (ORs) and 95% confidence intervals (CIs). All analyses were adjusted for age and lifetime number of sexual partners. In the multivariable analysis, the odds of gonorrhoea were lower in circumcised men compared with uncircumcised men (OR = 0.52; 95% CI: 0.37–0.74). Likewise, the odds of HIV were considerably lower in circumcised men (OR = 0.42; 95% CI: 0.26–0.67). Furthermore, lower odds of hr HPV were seen in circumcised men compared with uncircumcised men, although not statistically significant (OR = 0.81; 95% CI: 0.56–1.17). Finally, the odds of HPV16 (OR = 0.48; 95% CI: 0.23–0.98) and multiple (≥2) hr HPV types (OR = 0.71; 95% CI: 0.44–1.12) were lower in circumcised men than in uncircumcised men. Circumcised men have a significantly lower risk of gonorrhoea, HIV and HPV16, compared with uncircumcised men.
Tunable metamaterial beam using negative capacitor for local resonators coupling
Authors: Hu Guobiao , Xu Jiawen , Tang Lihua , Lan Chunbo , Das Raj
Published: December 2019

This article presents a theoretical study of a tunable metamaterial beam for low-frequency broadband vibration suppression. First, the mechanism of employing the shunt circuit technique to realize the internal coupling between two adjacent local resonators is introduced. The working principle of the proposed metamaterial beam by integrating the shunt circuit technique is demonstrated. The stability of the proposed metamaterial beam is then analysed, and the corresponding criterion is proposed. Subsequently, analytical models of the proposed metamaterial beam are developed. The band structures and the transmittances are calculated. The analytical study demonstrates the generation of multiple band gaps using a shunt negative capacitance circuit, which is equivalent to a coupling spring. A parametric study is conducted to investigate the effect of the equivalent coupling stiffness on the band gaps and the corresponding suppression regions. It is found that the band gaps are controllable by varying the equivalent coupling stiffness. Finally, to verify the analytical solutions, a finite-element model of the proposed metamaterial beam is developed. The simulation results confirm the existence of multiple band gaps, which are tunable through modification of the negative capacitance. The broadband vibration-suppression ability of the proposed metamaterial beam is thus confirmed.
Using Facial Electromyography to Test the Peak–End Rule in Tourism Advertising
Authors: Li Shanshi , Walters Gabby , Packer Jan , Scott Noel
Published: December 2019

This article examines how real-time emotions elicited by advertisements affect post-viewing judgments, with the goal of determining whether the key moments of real-time emotions lead to enhanced global retrospective judgments. Facial electromyography (EMG) was used to measure objective and unbiased moment-to-moment emotions. One hundred and one participants watched three destination advertisements while their real-time facial EMG data and self-report ratings were collected. The results demonstrate that tourism consumers’ average, peak, and end emotional experiences are correlated with their post-viewing attitude toward the advertisement. However, this study does not provide additional support for superiority of the peak and end moments in driving global retrospective evaluations in tourism advertising. The study advances our understanding of how consumers evaluate tourism advertisements based on more objective physiological data and extends the literature on key moments and retrospective evaluations. Implications and recommendations for future research are discussed.
An Exploratory Analysis of Factors Associated With Interest in Postpartum Intrauterine Device Uptake Among Pregnant Women and Couples in Kigali, Rwanda
Authors: Da Costa Vanessa , Ingabire Rosine , Sinabamenye Robertine , Karita Etienne , Umutoni Victoria , Hoagland Alexandra , Allen Susan , Mork Ellen , Parker Rachel , Mukamuyango Jeannine , Haddad Lisa , Nyombayire Julien , Wall Kristin M
Published: December 2019

Background:

The desire to space or prevent future pregnancies is high among postpartum women in Rwanda. However, the use of long-acting reversible contraception (LARC), especially the highly effective and cost-effective copper intrauterine device (IUD), is very low, whereas the rates of unintended pregnancy are high. This study aims to identify factors associated with pregnant women’s and couple’s interest in receiving a postpartum intrauterine device (PPIUD) within 6 weeks after delivery.

Methods:

A total of 150 pregnant women or couples attending antenatal care (ANC) in Kigali, Rwanda participated in this cross-sectional study. After participating in a postpartum LARC counseling session, surveys assessed participants’ demographics, pregnancy experiences and desires, and PPIUD knowledge, attitudes, practices, and interest. Multivariable logistic regression was used to model factors associated PPIUD interest within 6 weeks postpartum.

Results:

Although only 3% of women had ever used an IUD previously, 124 (83%) women were interested in receiving a PPIUD after counseling. Self-reporting physical side effects (adjusted odds ratio [aOR], 0.21; 95% confidence interval [CI], 0.06-0.75) and infection (aOR, 0.19; 95% CI, 0.04-0.85) as disadvantages to the IUD were significantly associated with no interest in receiving a PPIUD. Interest did not differ by male involvement.

Conclusion:

Recommendations to increase PPIUD uptake include educating pregnant women and couples about the method during ANC and addressing client myths and misconceptions about the IUD. This strategy allows pregnant women and couples to make informed decisions about their future contraception use, reduce unmet need for family planning, and reduce unintended pregnancy.
An examination of the self-presentation of the top five franchised English buxibans in Taiwan
Authors: Chang Feng-Ru
Published: December 2019

This study aims to uncover the connection of shadow education with other discourses in society through exploring the self-presentation of the top five leading franchised English buxibans in Taiwan by adopting a multimodal discourse analysis to examine their homepage and brand story webpage. The findings suggest that these top five leading franchised English buxibans present themselves as ‘a trustworthy, reliable, professional and caring edu-business’, ‘an expert in English language teaching’, ‘a bridge to the world’ and ‘an independent system growing out of mainstream education’. The multiple self-presentations reveal shadow education does not operate in isolation, but acts like an assemblage in which several discourses are entangled and interact with each other to make sense of it. The findings reflect the implicit socio-cultural values or beliefs, show its connection with other discourses in the society and further suggest research on shadow education should be rooted in the local discourse.
‘Get me the airway there’: Negotiating leadership in obstetric emergencies
Authors: Mesinioti Polina , Angouri Jo , O’Brien Stephen , Bristowe Katherine , Siassakos Dimitrios
Published: December 2019

The article discusses leadership enactment in medical emergencies. We draw on video recordings of simulated obstetric emergencies and investigate how senior clinicians ‘do being’ the leader discursively in the spatiomaterial context of the emergency room. We take an interactional analysis approach, combining conversation analysis and interactional sociolinguistics and look specifically into the ways in which professional roles do interactional control using directives and questions in the material space of the obstetric room. We discuss this interactional performance in relation to the clinical performance of the teams. Our analysis shows that leadership in medical emergencies is multimodally achieved; professionals draw on discursive strategies, the affordances of material space, body and gaze orientation, which build on each other and converge in indexing leadership. Our findings highlight the situated nature of negotiating responsibility, illustrating that leadership in our context is claimed, projected and resisted discursively. We provide a typology of the functions of questions in the emergency encounter, and close the article by foregrounding the implications of our study and providing directions for further research.
Effectiveness of stereotactic ablative radiotherapy in patients with advanced hepatocellular carcinoma unsuitable for transarterial chemoembolization
Authors: Lee Hsin-Lun , Tsai Jo-Ting , Chen Chun-You , Lin Ying-Chun , Ho Chin-Beng , Ting Lai-Lei , Kuo Chia-Chun , Lai I-Chun , Lin Chun-Yu , Tang Jui-Hsiang , Huang Yu-Min , Kao Wei-Yu , Cheng Sheng-Wei , Shen Chia-Ning , Chen Shang-Wen , Chiou Jeng-Fong
Published: December 2019

Background:

Stereotactic ablative radiotherapy (SABR) can deliver tumoricidal doses and achieve long-term control in early hepatocellular carcinoma (HCC). However, limited studies have investigated the safety and effectiveness of SABR in patients with advanced diseases that is unsuitable for transarterial chemoembolization (TACE).

Methods:

In this observational study, we reviewed the medical records of patients with Barcelona Clinic Liver Cancer (BCLC) stage C disease treated with linear accelerator-based SABR between 2008 and 2016. Their tumors were either refractory to TACE or TACE was contraindicated. Overall survival (OS), in-field progression-free survival (IFPFS), and out-field progression-free survival were calculated using Kaplan–Meier analysis. The Cox regression model was used to examine the effects of variables. Treatment-related toxicities were scored according to the Common Terminology Criteria for Adverse Events (version 4.03) and whether patients developed radiation-induced liver disease (RILD) after SABR.

Results:

This study included 32 patients. The mean maximal tumor diameter and tumor volumes were 4.7 cm and 135.9 ml, respectively. Patients received linear accelerator-based SABR with a median prescribed dose of 48 Gy (30–60 Gy) in three to six fractions. Based on the assessment of treatment response by using the Response Evaluation Criteria in Solid Tumors (version 1.1), 19% of patients achieved a complete response and 53% achieved a partial response. After a median follow-up of 18.1 months (4.0–65.9 months), 10, 19, and 9 patients experienced in-field failure, out-field hepatic recurrence, and extrahepatic metastases, respectively. The estimated 2-year OS and IFPFS rates were 54.4% and 62.7%, respectively. In a multivariate analysis, a pretreatment Cancer of the Liver Italian Program (CLIP) score of ⩾2 ( p = 0.01) was a prognostic factor for shorter OS, and a biologically effective dose (BED) of < 85 Gy10 ( p = 0.011) and a Child–Pugh score of ⩾6 ( p = 0.014) were prognostic factors for inferior IFPFS. In this study five and eight patients developed classic and nonclassic RILD, respectively.

Conclusions:

SABR can serve as a salvage treatment for patients with HCC with BCLC stage C disease unsuitable for TACE, in particular, in those with a baseline CLIP score of ⩽1. A BED10 of ⩾85 Gy is an appropriate prescribed dose for tumor control. Because out-field relapse is the major cause of treatment failure, SABR in combination with novel systemic modalities should be investigated in future studies.
The Influence of Visibility on Medical Teamwork in Emergency Departments: A Mixed-Methods Study
Authors: Gharaveis Arsalan , Pati Debajyoti , Hamilton D. Kirk , Shepley Mardelle , Rodiek Susan , Najarian Mohammad
Published: December 2019

Aim:

This mixed-methods study delivers empirical evidence on the influence of visibility on healthcare teamwork in Emergency Departments (EDs). This study researchers hypothesized that with changes of visibility in EDs, teamwork among medical staff members will be impacted.

Background:

Prior research results suggest that visibility can influence health-setting efficacy. Teamwork is one of the components of each healthcare system that can be supported by environmental design.

Method:

Visibility in four subject sites from the same healthcare system was objectively measured by morphology plan analyses. Teamwork among medical staff members was the behavioral variable of interest and explored through field observations, interviews, and surveys.

Results:

The qualitative outcomes demonstrated that teamwork can be enhanced by improved visibility, while the quantitative findings supported the idea that some specific measures of visibility were correlated with teamwork.

Conclusion:

This study provides a model for future research on the association between healthcare staff behavior and ED plan configuration. The enhancement of ED design, considering the significance of visibility, enhances the perceptions of nurses and physicians in terms of teamwork.
Addressing cost and time barriers in chronic disease management through telemedicine: an exploratory research in select low- and middle-income countries
Authors: Sayani Saleem , Muzammil Momina , Saleh Karima , Muqeet Abdul , Zaidi Fabiha , Shaikh Tehniat
Published: December 2019

Background:

Despite evidence supporting telehealth provision in developed countries, there is limited evidence regarding its economic benefits for patients living in areas where access and cost present major barriers to health care, particularly in low- and middle-income countries (LMICs). This study explores the economic benefits of telemedicine for patients, in terms of cost and times savings, and its potential role in improving chronic disease outcomes.

Methods:

This retrospective cross-sectional study compared telemedicine services with hypothetical in-person consultations, with a focus on patient travel time and travel cost savings. A database containing teleconsultation visits ( N = 25,182) conducted at health facilities in remote regions of Afghanistan, Pakistan, Tajikistan, and the Kyrgyz Republic, was analyzed. A two-sample homoscedastic t test was used to determine differences between the two groups. A one-way sensitivity analysis was also conducted, presuming in-person teleconsultations at 90%, 75%, and 50%.

Results:

The study extracted data from 25,182 teleconsultation visits (12,814 males; 12,368 females). The cumulative patient savings through the program amounted to USD 9,175,132, and 1,876,146 h, or 213.1 years. A significant difference was seen between the two groups in terms of mean time savings ( p-value <0.05), and a nearly significant difference was observed in terms of mean cost savings ( p-value = 0.05).

Conclusions:

This study suggests that considerable economic benefits imparted to patients in low-resource settings of LMICs via accessing telemedicine. Telemedicine has great potential to improve chronic disease outcomes in low-resource areas by reducing socioeconomic barriers related to cost and access, and increasing uptake of services, thereby enabling early intervention and long-term management.
Comparison of optical coherence tomography angiography results of adult patients with Familial Mediterranean fever and healthy individuals
Authors: Karaca Emine Esra , Ozek Dilay , Omma Ahmet , Evren Kemer Ozlem
Published: December 2019

Purpose:

The aim of this study is to assess the macular ultrastructure measuring by optical coherence tomography angiography in adult patients with Familial Mediterranean fever.

Methods:

Participants were 62 Familial Mediterranean fever patients and 54 healthy individuals in control group with similar age and sex. The superficial and deep vascular plexus structures covering the central fovea in an area of 6 mm × 6 mm were measured using AngioVue images taken with optical coherence tomography angiography. Vasculature structure, foveal avascular zone, acircularity index of foveal avascular zone (the ratio of the perimeter of foveal avascular zone and the perimeter of a circle with the equal area), and superficial and deep retinal plexus densities were measured.

Results:

The inferior deep vascular density was measured: 49.17% ± 8.59% in Familial Mediterranean fever patients, 55.56% ± 5.92% in the control group. The deep inferior-hemi vascular density was measured: 48.59% ± 10.34% in Familial Mediterranean fever patients, 56.54% ± 8.05% in the control group. Deep inferior and deep inferior-hemi vascular density was significantly reduced in Familial Mediterranean fever patients compared with healthy controls ( p = 0.04 and p = 0.03, respectively).

Conclusion:

The vascular abnormalities in optical coherence tomography angiography show subclinical signs of microangiopathy in Familial Mediterranean fever patients. This observation, which can be obtained only through optical coherence tomography angiography, may be an ocular hallmark for Familial Mediterranean fever disease.