bluuebunny/crossref_metadata_2025 huggingface dataset:
Bilateral Lung Metastases From a Phalangeal Giant Cell Tumor of Bone
Authors: Orr Annie , Liu Huifei , Mariani Rachel , Aldrink Jennifer H , Setty Bhuvana A , Koo Selene
Published: October 2020

We describe a rare pediatric case of a phalangeal giant cell tumor of bone with extensive bilateral lung metastases following curettage, wide resection, and amputation. Concurrent peripheral blood eosinophilia and pleural effusion with marked eosinophilia (47%) were present. To discover genetic changes driving tumor metastasis, genomic and transcriptome profiling of the metastatic lung mass as well as germline analysis were performed. Whole exome sequencing detected a histone H3F3A p.G35V missense mutation in tumor cells. RNA sequencing revealed overexpression of receptor activator of nuclear factor kappa-B ligand (RANKL). The patient is alive with no residual disease and uncompromised respiratory function 29 months after amputation of primary tumor and 19 months after surgical resection of his metastatic lung disease.
Structuring Evaluation Partnerships: Exploring Contrasts in Researcher–Practitioner Roles and Responsibilities When Implementing Randomized Experiments in Real-World Settings
Authors: Demby Hilary , Jenner Lynne , Gregory Alethia , Jenner Eric
Published: October 2020

Despite the increase in federal tiered evidence initiatives that require the use of rigorous evaluation designs, such as randomized experiments, there has been limited guidance in the evaluation literature on practical strategies to implement such studies successfully. This paper provides lessons learned in executing experiments in applied settings, such as schools, juvenile justice agencies, mental health clinics, reproductive health clinics, and job centers. To promote successful study implementation, evaluators must understand study roles, select suitable partners, and employ appropriate partnership models. In this article, we describe partner types and study roles, concretely illustrate how partnerships might be structured, discuss specific strategies to assess implementation partner capacity and maintain partner engagement, and consider how an evaluator can leverage the skills and resources of study partners to improve participant recruitment, enrollment, and retention. While the lessons are drawn from our experiences conducting 10 experimental studies, some may also apply to non-experimental evaluations.
Decreased antithrombin activity and inflammation in cats
Authors: Sun Prudence , Jeffery Unity
Published: October 2020

Objectives

The objective of this study was to determine if inflammatory markers are associated with antithrombin activity in cats.

Methods

For a retrospective population of 231 cats admitted to a referral hospital, antithrombin activity was classified as decreased (n = 77), intermediate (n = 97) or in the upper quartile (n = 57). Odds ratios (ORs) were calculated for an association between decreased or upper quartile activity and hypoalbuminemia, hyperfibrinogenemia, band neutrophilia and toxic change. Multiple logistic regression was performed to determine if an association between band neutrophilia and decreased antithrombin activity was independent of decreased hepatic synthesis, consumptive coagulopathy or protein loss.

Results

Cats with decreased antithrombin activity were more likely than cats with intermediate-to-upper quartile activity to have band neutrophilia (OR 2.85, P = 0.0050), hypoalbuminemia (OR 12.1, P <0.0001) or toxic neutrophils (OR 4.47, P <0.0001). Cats with antithrombin activity in the upper quartile were less likely than those with intermediate-to-low activity to have hypoalbuminemia (OR 0.31, P = 0.0023) or toxic neutrophils (OR 0.44, P = 0.033). In a regression model that included other mechanisms for decreased antithrombin, band neutrophilia remained associated with decreased antithrombin activity (adjusted OR 2.62, P = 0.013).

Conclusions and relevance

Contrary to previous studies suggesting antithrombin is a feline positive acute phase protein, this study demonstrates an association between decreased antithrombin activity and inflammation. Further studies are needed to determine the mechanistic basis of this association.
Assessment of copper accumulation in archived liver specimens from cats
Authors: Yamkate Punyamanee , Gold Randi M , Xenoulis Panagiotis G , Steiger Katja , Twedt David C , Suchodolski Jan S , Steiner Joerg M , Lidbury Jonathan A
Published: October 2020

Objectives

The aim of this study was to assess hepatic copper concentrations and zonal distribution in cat liver specimens.

Methods

For this study, 121 archived, formalin-fixed, paraffin-embedded liver specimens from cats were used. Tissue sections were stained for copper with rhodanine and scored from 0 (no copper accumulation) to 5 (panlobular copper accumulation). The tissue specimens were then deparaffinized and hepatic copper concentrations were measured using flame atomic absorption spectroscopy.

Results

Tissue samples were categorized into four groups based on histopathologic findings: (1) no significant histopathologic hepatic changes (n = 66); (2) hepatic steatosis (n = 18); (3) inflammatory or infectious disease (n = 24); and (4) neoplasia (n = 13). Of the 121 specimens, 13 (11%) stained positive for copper, with three having a score ⩾3. Thirty-seven specimens (31%) had copper concentrations above the reference interval ([RI] <180 µg/g dry weight liver). Copper concentrations in cats with hepatic inflammatory or infectious disease were significantly higher than cats with hepatic steatosis ( P = 0.03). Copper-staining score and concentration were positively correlated (rs = 0.46, P <0.001).

Conclusions and relevance

Despite the fact that 31% of specimens had copper concentrations above the RI, only 11% showed positive copper staining and only 2.5% had a score ⩾3. Our findings suggest that hepatic copper concentrations greater than the upper limit of the RI are relatively common in cats. Further studies to determine the factors that influence hepatic copper staining in cats and to establish contemporary RIs for hepatic copper in healthy cats are warranted.
A semi-analytical approach for rapid detection of roller-flange contacts in roller element bearings
Authors: Wolf Marius , Sanner Antoine , Fatemi Arshia
Published: October 2020

For axially loaded cylindrical and tapered roller bearings, the dynamic behaviour of individual rollers, wear and friction losses are strongly influenced by roller-flange contact forces. For a realistic modelling of normal and friction forces of the roller-flange contact, it is essential to determine location and theoretical penetration of this contact. The rapid contact detection is particularly significant for rolling element bearing dynamic modelling in multibody systems. In this paper a semi-analytical algorithm for contact detection is introduced and compared to state of the art methods. The new approach adopts piecewise functions of spheres, cones and tori for modelling of roller end and flange geometry. The location of the contact and its theoretical penetration is calculated using analytical and combined analytical-numerical schemes. The semi-analytical approach proves to be significantly faster and numerically more stable than current contact detection algorithms without compromising precision.
Postcrisis REIT performance using financial ratios: A DEA approach
Authors: Ampountolas Apostolos
Published: October 2020

This study examines the performance of public lodging real estate investment trusts (REITs) following the financial crisis period from 2013 to 2017. We employed data envelopment analysis, a nonparametric technique based on linear programming, to measure performance. Determinants of efficiency were assessed by a set of financial ratios predicting each REIT’s efficiency against its peers. Consequently, a Malmquist productivity index (MPI) evaluated the efficiency change in several periods. The empirical results revealed that the REITs generally performed well despite the moderate degree of volatility in the financial ratios. Results showed a wide variation in performance consistency, with a limited number of REITs—that is, 5 out of 20—consistently performing well during the study period. Additionally, the MPI indicated a decline in efficiency, while the productivity change showed a mixture of reflections. The decomposition components of the productivity index and efficiency changes are also provided. This study sheds light on understanding inefficient REITs and provides some guidance on the critical indicators that would help such REITs restructure their operational strategies to improve efficiency.
Brexit barbarization? The UK leaving the EU as de-civilizing trend
Authors: Inglis David
Published: October 2020

Social scientists have begun to offer varied diagnoses of why Brexit has happened, and what its consequences have been and will likely be. This article does so by drawing upon Elias-inspired notions of longer-term de-civilizing processes, shorter-term de-civilizing spurts, and short-term de-civilizing offensives. Brexit is conceived of as involving a set of interlocking phenomena and tendencies which are de-civilizing in nature, and therefore de-cosmopolit(an)izing too. Diverse empirical phenomena in the UK are made sense of through the unifying conceptual apparatus of ‘de-civilization’, allowing analysis to start to relate them to each other systematically. The article also uses this sociological approach to look ahead tentatively to what the post-Brexit socio-political landscape may look like in the future.
The influence of dyadic congruence and satisfaction with dyadic type on patient self-care in heart failure
Authors: Bugajski Andrew , Buck Harleah , Zeffiro Valentina , Morgan Hailey , Szalacha Laura , Alvaro Rosaria , Vellone Ercole
Published: October 2020

Background

Chronic illness management is increasingly carried out at home by individuals and their informal caregivers (dyads). Although synergistic in concept, the nuances of dyadic congruence in caring for patients with heart failure are largely unexamined.

Aims

The purpose of this study was to examine the role of dyadic-type congruence on patient self-care (maintenance, symptom perception, and management) while controlling for actor and partner effects.

Methods

This secondary data analysis of 277 dyads consisted of a series of multilevel models to examine the impact of dyadic congruence on a patient’s self-care maintenance, symptom perception, and self-care management. Patient-level and caregiver-level data were input into each model simultaneously to account differential appraisals of factors related to the dyad.

Results

Bivariate analyses yielded dyad congruence which was associated with better patient self-care maintenance, symptom perception and management. However, after multilevel models were constructed, dyad congruence was found to be a significant predictor of patient’s symptom perception scores, but not self-care maintenance or management scores. Caregiver’s satisfaction with the dyad was differentially and significantly associated with self-care – it was inversely associated with patient self-care maintenance and positively associated with patient self-care management.

Conclusion

This is the first study, to our knowledge, reporting that congruence in heart failure dyads is associated with better patient symptom perception and this advances our prior hypothesis that dyad typologies could be used to predict patient self-care performance. Since symptom perception is the key to preventing heart failure exacerbation, screening heart failure patient and caregiver dyads for congruence is important in clinical settings.
Whose life is it anyway? The life course as an observational medium in the education system
Authors: Corsi Giancarlo
Published: October 2020

System theory defines the life course ( Lebenslauf) as the medium of education. It is a medium, because the educator sees it as a potential for intervention, impressing pedagogically acceptable forms onto it. Yet the single individuals who are educated are autonomous observers who are exposed to an immense quantity of possible configurations of their lives. This raises a first question: how can education legitimate intentions and motivate pupils to accept the forms with which they collaborate, but which they have not chosen for themselves? A further question is raised by the fact that the life course does not coincide with the ‘career’ that each individual constructs for himself during his lifetime, when he is oriented towards roles in organisational terms (such as jobs) or that are in any case external to the system of education. This paper proposes the hypothesis that the life course and the career are coupled to each other by means of educational selection (certificates and qualifications). While this increases the potential available to the individual, it also increases uncertainty, the burden of decision-making and related risks. One skill that could be developed during education is the ability to manage this potential for combinations.
Ethical conflicts in patient-centred care
Authors: Hansson Sven Ove , Fröding Barbro
Published: October 2020

It could hardly be denied that healthcare should be patient-centred. However, some of the practices commonly described as patient-centred care may have ethically problematic consequences. This article identifies and discusses twelve ethical conflicts that may arise in the application of (some variants of) person-centred care. The conflicts concern e.g. privacy, autonomous decision-making, safeguarding medical quality, and maintaining professional egalitarianism as well as equality in care. Awareness of these potential conflicts can be helpful in finding the best way to ensure that healthcare has its focus on the needs and interests of the patients. Patient-centred care may have to take different forms, depending of the nature of the disease, the patient’s life situation, and the economic, organizational and technological resources available to the healthcare unit.
Introduction: Democratic Deliberation and Under-Represented Groups
Authors: Gherghina Sergiu , Mokre Monika , Miscoiu Sergiu
Published: October 2020

The key principles of democratic deliberation are the considered judgement and inclusion. However, research shows that not all categories are involved in this process. In particular, the groups that are under-represented in day-to-day politics are also less likely to make their voice heard in deliberation. So far, we know little about if and how deliberation fosters the involvement of under-represented groups. This symposium aims to address this gap in the literature and seeks to generate new ideas on the topic. It brings two contributions to the debate about the involvement of under-represented groups in deliberation: it identifies the means through which various deliberative practices can involve members of under-represented groups and explains how and why members of under-represented groups participate or refuse/are refused participation in deliberation.
Predicting Dropout for Nontraditional Undergraduate Students: A Machine Learning Approach
Authors: Huo Huade , Cui Jiashan , Hein Sarah , Padgett Zoe , Ossolinski Mark , Raim Ruth , Zhang Jijun
Published: October 2020

Student attrition represents one of the greatest challenges facing U.S. postsecondary institutions. Approximately 40 percent of students seeking a bachelor’s degree do not graduate within 6 years; among nontraditional students, who make up half of the undergraduate population, dropout rates are even higher. In this study, we developed a machine learning classifier using the XGBoost model and data from the National Center for Education Statistics (NCES) Beginning Postsecondary Students (BPS) Longitudinal Study: 2012/14 to predict nontraditional student dropout. In comparison with baseline models, the XGBoost model and logistic regression model with features identified by the XGBoost model displayed superior performance in predicting dropout. The predictive ability of the model and the features it identified as being most important in predicting nontraditional student dropout can inform discussion among educators seeking ways to identify and support at-risk students early in their postsecondary careers.
Impact of Thoracic Endografting on the Hemodynamics of the Native Aorta: Pre- and Postoperative Assessments of Wall Shear Stress and Vorticity Using Computational Fluid Dynamics
Authors: Midulla Marco , Moreno Ramiro , Negre-Salvayre Anne , Beregi Jean-Paul , Haulon Stéphan , Loffroy Romaric , Dake Michael , Rousseau Hervé
Published: October 2020

Purpose

To quantify the hemodynamic consequences of thoracic endovascular aortic repair (TEVAR) by comparing the preoperative and postoperative wall shear stress (WSS) and vorticity profiles on computational fluid dynamics (CFD) simulations.

Materials and Methods

The pre- and postoperative computed tomography (CT) scans from 20 consecutive patients (median age 69 years, range 20–87) treated for different thoracic aortic pathologies (11 aneurysms, 5 false aneurysms, 3 penetrating ulcers, and 1 traumatic aortic rupture) were segmented to construct patient-specific CFD models using a meshless code. The simulations were run over the cardiac cycle, and the WSS and vorticity values measured at the proximal and distal landing zones were compared.

Results

The CFD runs provided 4-dimensional simulations of blood flow in all patients. WSS and vorticity profiles at the proximal landing zone (located in zones 0–3 in 15 patients) varied in 18 and 20 of the cases, respectively; WSS was increased in 11 cases and the vorticity in 9. Pre- and postoperative WSS median values were 4.19 and 4.90 Pa, respectively. Vorticity median values were 40.38 and 39.17 Hz, respectively.

Conclusion

TEVAR induces functional alterations in the native thoracic aorta, though the prognostic significance of these changes is still unknown. CFD appears to be a valuable tool to explore aortic hemodynamics, and its application in a larger series would help define a predictive role for these hemodynamic assessments.
Aneurysm Volumes After Endovascular Repair of Ruptured vs Intact Aortic Aneurysms: A Retrospective Observational Study
Authors: Oliveira-Pinto José , Soares-Ferreira Rita , Oliveira Nelson F. G. , Bouwens Elke , Bastos Gonçalves Frederico M. , Hoeks Sanne , Van Rijn Marie Josee , Ten Raa Sander , Mansilha Armando , Verhagen Hence J. M.
Published: October 2020

Purpose

To compare changes in abdominal aortic aneurysm (AAA) sac volume between endovascular aneurysm repairs (EVAR) performed for ruptured (rEVAR) vs intact (iEVAR) AAAs and to determine the impact of early volume shrinkage on future complications.

Materials and Methods

A retrospective analysis was performed of all patients undergoing standard infrarenal EVAR from 2002 to 2016 at a tertiary referral institution. Only patients with degenerative AAAs and with 30-day and 1-year computed tomography angiography (CTA) imaging were included. Early sac shrinkage was defined as a volume sac reduction >10% between the first (<30-day) and the 1-year CTA. The primary endpoint was to compare AAA sac volume changes between patients undergoing rEVAR (n=51; mean age 71.0±8.5 years; 46 men) vs iEVAR (n=393; mean age 72.3±7.5 years; 350 men). Results are reported as the mean difference with the interquartile range (IQR Q1, Q3). The secondary endpoint was freedom from aneurysm-related complications after 1 year as determined by regression analysis; the results are presented as the hazard ratio (HR) and 95% confidence interval (CI).

Results

At baseline, the rEVAR group had larger aneurysms (p<0.001) and shorter (p<0.001) and more angulated (p=0.028) necks. Aneurysm sac volume decreased more in the rEVAR group during the first year [−26.3% (IQR −38.8%, −12.5%)] vs the iEVAR group [−11.9% (IQR −27.5%, 0); p<0.001]. However, after the first year, the change in sac volume was similar between the groups [−3.8% (IQR −32.9%, 31.9%) for rEVAR and −1.5% (IQR −20.9%, 13.6%) for iEVAR, p=0.74]. Endoleak occurrence during follow-up was similar between the groups. In the overall population, patients with early sac shrinkage had a lower incidence of complications after the 1-year examination (adjusted HR 0.59, 95% CI 0.39 to 0.89, p=0.01).

Conclusion

EVAR patients treated for rupture have more pronounced aneurysm sac shrinkage compared with iEVAR patients during the first year after EVAR. Patients presenting with early shrinkage are less likely to encounter late complications. These parameters may be considered when tailoring surveillance protocols.
Long non-coding RNA CCAT1 promotes non-small cell lung cancer progression by regulating the miR-216a-5p/RAP2B axis
Authors: Pang Lingling , Zhang Qianqian , Wu Yanmin , Yang Qingru , Zhang Jinghao , Liu Yuanyuan , Li Ruoran
Published: October 2020

The long non-coding RNA colon cancer-associated transcript 1 (CCAT1) has been investigated to involve in the progression of non-small cell lung cancer (NSCLC). Thus, this study aims to explore the detailed molecular mechanisms of CCAT1 in NSCLC. The expression of CCAT1, miR-216a-5p, RAP2B, Bax, Bcl-2, and cleaved caspase 3 was detected by qRT-PCR or Western blot. Cell proliferation, apoptosis, migration, and invasion were analyzed using cell counting kit-8, flow cytometry or Transwell assays, respectively. The interaction between miR-216a-5p and CCAT1 or RAP2B was analyzed by luciferase reporter, RNA immunoprecipitation, and pull-down assays. The expression of CCAT1 was elevated in NSCLC, and CCAT1 deletion could inhibit NSCLC cell proliferation, migration, and invasion but induce apoptosis in vitro as well as imped tumor growth in vivo. MiR-216a-5p was confirmed to be a target of CCAT1, and silencing miR-216a-5p could reverse CCAT1 depletion-mediated inhibitory effects on cell tumorigenesis in NSCLC. Besides that, miR-216a-5p was decreased in NSCLC, and miR-216a-5p restoration inhibited cell tumorigenesis by regulating RAP2B, which was verified to be a target of miR-216a-5p. Additionally, co-expression analysis suggested that CCAT1 indirectly regulated RAP2B level by targeting miR-216a-5p in NSCLC cells. Taken together, CCAT1 deletion could inhibit cell progression in NSCLC through miR-216a-5p/RAP2B axis, indicating a novel pathway underlying NSCLC cell progression and providing new potential targets for NSCLC treatment.
The effect of undergraduate nursing students’ e-Health literacy on healthy lifestyle behaviour
Authors: Turan Nuray , Güven Özdemir Nur , Çulha Yeliz , Özdemir Aydın Gülsün , Kaya Hatice , Aştı Türkinaz
Published: October 2020

e-Health literacy has become more important in promoting healthy lifestyles in recent years. The purpose of this study was to determine the effect of undergraduate nursing students’ e-Health literacy on healthy lifestyle behaviours. This cross-sectional study was conducted during the 2016–2017 academic year at a Nursing Department in the Faculty of Health Sciences in Istanbul. The study population consisted of 232 undergraduate nursing students. The study sample was 205 students who volunteered to participate in the research. The data were collected using the Structured Questionnaire Form, the e-Health Literacy Scale in Adolescent and the Adolescent Lifestyle Profile Scale. The mean score of the e-Health Literacy Scale in Adolescent was 29.50 ± 5.02. The mean total score of the Adolescent Lifestyle Profile was 112.11 ± 14.66. There was a positive correlation between students’ Internet attitudes and general health-promoting lifestyle ( r = 0.273; p < 0.01), indicating the higher the students’ e-Health literacy, the higher their levels of healthy lifestyle behaviours. The result showed that e-Health literacy is an important parameter in promoting healthy lifestyle behaviours of nursing students.
The energy-mobility system in transition: The case of the Swiss Federal Railways
Authors: van Baal Paul Adrianus , Finger Matthias
Published: October 2020

A convergence of the electricity and the transportation sectors can be observed, with private and public transport being increasingly electrified and with aggregated electricity demand and storage being increasingly operated as flexible assets. At the same time, sustainability concerns are driving systemic changes in both systems. This article introduces the concept of the energy-mobility system, which is a result of this convergence, and proposes an integrated framework for policy and governance of the energy-mobility system. The framework focuses on cross-sectoral policy ambitions related to climate change mitigation, namely reducing energy consumption, electrifying fossil fueled transport, decarbonizing electricity generation, promoting resilience, and integrating green infrastructure management. Public policy and the corresponding regulation are no longer conceptualized and executed in each sector separately. An integrated policy framework is indeed needed for the energy-mobility system, so that the institutions remain relatively aligned with the technological developments. The requirements for effective governance of the energy-mobility system are then discussed, which include an energy-mobility system operator. The potential for the policy and governance framework is addressed through a case study of the Swiss Federal Railways, which as the owner and operator of a fully electrified rail network and associated electricity infrastructure is already close to taking up such a role. While the Swiss case is unique, it can offer insight for other countries developing their regulatory approach to the convergence of the energy and mobility systems.
“Someone has to be the First”: Tracing Uruguay’s Marijuana Legalisation Through Counterfactuals
Authors: von Hoffmann Jonas
Published: October 2020

Why did Uruguay become the first country in the world to legalise marijuana in 2013? Based on extensive original research and unprecedented review of secondary sources, the article assesses alternative explanatory accounts through a unique combination of process tracing and counterfactual analysis. By tracing cannabis reform in Uruguay both as it was and was not but could have been in the absence of hypothesised explanatory factors, the article assesses the role of these factors in the causal story. Specifically, the article shows how and why political will and social mobilisation influenced both the reform process and outcome. In doing so, the article cuts through the haze of rival explanations to present the clearest picture of drug policy reform in Uruguay to date.
Targeted therapy with phosphodiesterase 5 inhibitors in patients with pulmonary hypertension due to heart failure and elevated pulmonary vascular resistance: a systematic review
Authors: Sanchez Palacios Galo M. , Schmidt Cindy , Wichman Tammy
Published: October 2020

Pulmonary Hypertension due to left heart disease is the most common type of Pulmonary Hypertension. Morbidity and mortality significantly increase once Pulmonary Hypertension is present. Treatment is aimed toward optimizing the underlying condition. Targeted therapy has been evaluated in small studies with mixed results. The goal of this systematic review is to identify the possible benefit and safety of Phosphodiesterase 5 inhibitors in Pulmonary Hypertension due to left heart disease with elevated pulmonary vascular resistance, diagnosed by right heart catheterization. Electronic searches using MEDLINE/PREMEDLINE, EMBASE, and The Cochrane Library were searched on 21 October 2018. Randomized clinical trials comparing Phosphodiesterase 5 inhibitors versus placebo in patients with proven Pulmonary Hypertension by right heart catheterization secondary to left heart disease (both heart failure with reduced ejection fraction and with preserved ejection fraction) and reported pulmonary vascular resistance were included. We identified 436 potentially relevant studies. After reviewing the titles and abstracts to exclude irrelevant articles, five randomized clinical trials were considered for the study. Sildenafil was well tolerated among all studies. Sildenafil was found to improve hemodynamics, exercise capacity, and quality of life in patients with elevated pulmonary vascular resistance. Phosphodiesterase 5 inhibitors therapy in patients with proven Pulmonary Hypertension due to left heart disease and elevated pulmonary vascular resistance by right heart catheterization may improve the quality of life, exercise capacity, and pulmonary hemodynamics. Further prospective randomized controlled studies are needed to confirm.
Chronic thromboembolic pulmonary hypertension mimicking coronary artery disease
Authors: Correale Michele , Fortunato Martino , Magnesa Michele , Varricchione Giuseppe , Campanale Giulio , Gravina Matteo , Di Biase Matteo , Daniele Brunetti Natale
Published: October 2020

We report the case of 63‐year‐old man, complaining of dyspnea and with abnormal systolic motion of the interventricular septum at echocardiography, referred for coronary angiography and suspect coronary artery disease. In the presence of normal coronary angio, a specific work‐up showed chronic thromboembolic pulmonary hypertension requiring pulmonary endarterectomy. The case highlights the need for a global cardiovascular and imaging approach in presence of poorly specific symptoms and signs of coronary artery disease.
Comparative effectiveness of endothelin receptor antagonists on mortality in patients with pulmonary arterial hypertension in a US Medicare population: a retrospective database analysis
Authors: Benza Raymond L. , Lickert Cassandra A. , Xie Lin , Drake William , Ogbomo Adesuwa , Yuce Huseyin , Cole Michele R.
Published: October 2020

Limited evidence is available on outcomes associated with currently available medications from the endothelin receptor antagonist drug class (bosentan, ambrisentan, and macitentan) in elderly patients with pulmonary arterial hypertension. We evaluated mortality in predominantly elderly patients with pulmonary arterial hypertension in the US taking endothelin receptor antagonists. A retrospective administrative claims study was conducted using the Centers for Medicare and Medicaid Services national Medicare database. Patients with pulmonary arterial hypertension were identified using diagnostic codes. Cohort inclusion required age ≥18 years; ≥1 claim for macitentan, ambrisentan, or bosentan between 1 January 2014 and 31 December 2015 (index date and index endothelin receptor antagonist defined by first such claim); continuous enrollment for ≥12 months before and after the index date; and ≥80% of days covered for the index endothelin receptor antagonist. Follow‐up was from index date until the earliest of Medicare disenrollment, death, or 31 December 2016. Multivariable Cox proportional hazards regression models were used to estimate mortality hazard ratios with 95% confidence intervals for macitentan vs. ambrisentan or bosentan, adjusting for potential confounders. The study cohort included 1628 patients on index macitentan, 2852 on ambrisentan, and 1972 on bosentan. Overall, 69% of patients were aged ≥65 years and most were females (76%). Macitentan was associated with an 18% lower risk for mortality than ambrisentan (hazard ratio: 0.82, 95% confidence interval: 0.72–0.93; P = 0.0026) and a 39% lower risk than bosentan (hazard ratio: 0.61, 95% confidence interval: 0.53–0.71; P < 0.0001). Variables that independently increased the risk of mortality included higher comorbidity index, increasing age, and inpatient hospitalizations at baseline.
Revisiting the mechanism of hypoxic pulmonary vasoconstriction using isolated perfused/ventilated mouse lung
Authors: Jain Pritesh P. , Hosokawa Susumu , Xiong Mingmei , Babicheva Aleksandra , Zhao Tengteng , Rodriguez Marisela , Rahimi Shamin , Pourhashemi Kiana , Balistrieri Francesca , Lai Ning , Malhotra Atul , Shyy John Y.‐J. , Valdez‐Jasso Daniela , Thistlethwaite Patricia A. , Makino Ayako , Yuan Jason X.‐J.
Published: October 2020

Hypoxic Pulmonary Vasoconstriction (HPV) is an important physiological mechanism of the lungs that matches perfusion to ventilation thus maximizing O2 saturation of the venous blood within the lungs. This study emphasizes on principal pathways in the initiation and modulation of hypoxic pulmonary vasoconstriction with a primary focus on the role of Ca2+ signaling and Ca2+ influx pathways in hypoxic pulmonary vasoconstriction. We used an ex vivo model, isolated perfused/ventilated mouse lung to evaluate hypoxic pulmonary vasoconstriction. Alveolar hypoxia (utilizing a mini ventilator) rapidly and reversibly increased pulmonary arterial pressure due to hypoxic pulmonary vasoconstriction in the isolated perfused/ventilated lung. By applying specific inhibitors for different membrane receptors and ion channels through intrapulmonary perfusion solution in isolated lung, we were able to define the targeted receptors and channels that regulate hypoxic pulmonary vasoconstriction. We show that extracellular Ca2+ or Ca2+ influx through various Ca2+‐permeable channels in the plasma membrane is required for hypoxic pulmonary vasoconstriction. Removal of extracellular Ca2+ abolished hypoxic pulmonary vasoconstriction, while blockade of L‐type voltage‐dependent Ca2+ channels (with nifedipine), non‐selective cation channels (with 30 µM SKF‐96365), and TRPC6/TRPV1 channels (with 1 µM SAR‐7334 and 30 µM capsazepine, respectively) significantly and reversibly inhibited hypoxic pulmonary vasoconstriction. Furthermore, blockers of Ca2+‐sensing receptors (by 30 µM NPS2143, an allosteric Ca2+‐sensing receptors inhibitor) and Notch (by 30 µM DAPT, a γ‐secretase inhibitor) also attenuated hypoxic pulmonary vasoconstriction. These data indicate that Ca2+ influx in pulmonary arterial smooth muscle cells through voltage‐dependent, receptor‐operated, and store‐operated Ca2+ entry pathways all contribute to initiation of hypoxic pulmonary vasoconstriction. The extracellular Ca2+‐mediated activation of Ca2+‐sensing receptors and the cell–cell interaction via Notch ligands and receptors contribute to the regulation of hypoxic pulmonary vasoconstriction.
Advanced risk stratification of intermediate risk group in pulmonary arterial hypertension
Authors: Yogeswaran Athiththan , Richter Manuel J. , Sommer Natascha , Ghofrani Hossein A. , Seeger Werner , Tello Khodr , Gall Henning
Published: October 2020

In 301 treatment‐naïve patients with pulmonary arterial hypertension stratified by the European Society of Cardiology/European Respiratory Society risk score, further stratification of intermediate‐risk patients based on six‐minute walk distance and the tricuspid annular plane systolic excursion/systolic pulmonary artery pressure ratio identified a subset with mortality rates comparable to low‐risk patients.
The economic lives of American-trained Chinese scientists after they returned to China in the 1950s: A case study of Huang Pao-tung and Feng Zhiliu
Authors: Wang Xin
Published: October 2020

This article is a case study of Huang Pao-tung (1921–2005), who was a polymer chemist and academician of the Chinese Academy of Sciences, and his wife, Feng Zhiliu (1921–2015), who was a polymer physicist. The couple studied in America and returned to China in the 1950s. Based on an analysis of first-hand data from the two scientists’ archives, diaries and memoirs, which recorded their economic lives after they returned, I found as follows: (1) their income after returning to China was about one-fifth of their income in the United States; (2) their income channel was narrow (there was no mechanism for wage increases, and their wages were unchanged for 25 years); (3) the main expenditure of their family was on food, and that proportion increased year by year; and (4) no taxes, low rents, free medical care and other benefits helped to reduce their cost of living in China. The importance of their profession as scientists and the government’s advocacy of scholars returning home brought them relatively good treatment, and their economic benefits and living standard were several times better than those of other ordinary social classes. However, this kind of preferential treatment was dependent on many other things, which caused them to lose independence and autonomy.
Collecting and compiling the oral accounts of Chinese scientists trained in the Soviet Union in the 1950s and 1960s: Practice and reflection
Authors: Wang Liyuan
Published: October 2020

In recent years, the recovery and compilation of the oral histories of scientists has attracted increasing attention. The focus of the research has also expanded from individual experiences to collective experience. As part of the Project on Collecting the Historical Data of Chinese Scientists’ Academic Life, and following the norms of historiography, I and other team members compiled oral interviews and accounts of Chinese scientists trained in the Soviet Union in the 1950s and 1960s. Through the procedures of data collection, candidate selection, framework construction and detailed presentation, I compiled the oral accounts of 16 Soviet-educated Chinese scientists, supplemented by photos, annotations and other information. These materials describe the lived circumstances and feelings of those scientists in the early days of the People’s Republic of China and recreate the collective experience of this generation of scientists from multiple angles.
Science and national defence: Special editions on the National Defence Science Movement during the Anti-Japanese War
Authors: Zhang Jiajing
Published: October 2020

In 1941, Chiang Kai-shek put forward the proposition that ‘National defence is built upon science and technology, and the strength of a country is secured by national defence’, marking the official start of the National Defence Science Movement (国防科学运动). Attempting to answer the call, a number of journals and newspapers published special issues dedicated to the movement, including many contributions from senior political officials and technological influencers. The papers explored the meaning and role of science, scientific research, science popularization, science-related awards and similar topics. The writers underscored the value of science, publicized the idea of ‘saving the country by means of science’ (科学救国), highlighted the value of basic science and social science, and explained how different disciplines could play their part in national defence. They envisaged postwar reconstruction plans in fields as diverse as telecommunications and forestry and called on young people to study science and take the initiative by devoting themselves to scientific research. The publication of these special issues raised the status of science, especially the basic and social sciences, while playing a positive role in encouraging young people to engage in scientific research.
Health Equity Lens Embedded in the Public Health Policies of Saudi Arabia: A Qualitative Document Analysis
Authors: Eklund Karlsson Leena , Ikonen Anne Leena , Alqahtani Kothar Mohammed , Tanggaard Andersen Pernille , Thapa Subash
Published: October 2020

In the Kingdom of Saudi Arabia (KSA), no studies have been documented to analyze the equity aspects of public health policies. The aims of the study were to identify policy documents in the KSA relevant to public health and to explore whether these include an equity approach. Twenty health-related documents were identified from various ministries’ websites and analyzed through directed content analysis. The results showed that the term “equity” was neither defined nor explained in the documents and suggestions on how to tackle health inequities were lacking. None of the suggested measures communicated an explicit focus on promoting health equity or the social gradient. Several upstream, midstream, and downstream measures were suggested to improve justice and public health for the people. The study reveals that there is a need for an in-depth assessment of the policy measures across sectors and their influence on health equity to inform future health policy development and action in the KSA.
Health and Social Care Educators’ Competence in Digital Collaborative Learning: A Cross-Sectional Survey
Authors: Männistö Merja , Mikkonen Kristina , Kuivila Heli-Maria , Koskinen Camilla , Koivula Meeri , Sjögren Tuulikki , Salminen Leena , Saaranen Terhi , Kyngäs Helvi , Kääriäinen Maria
Published: October 2020

The ongoing change from traditional pedagogy to digital collaborative learning requires a new mode of teaching, learning, and educators’ responsibilities. For competence in digitally mediated teaching, educators need understanding of how to provide appropriate digital environment to learn collectively and individually. The aim of this study was to describe and explore health and social care educators’ perceptions of their current level of competence in digital collaborative learning and identify distinct educators’ profiles. Data were collected via cross-sectional survey from educators in 21 universities of applied science and eight vocational colleges in Finland using an instrument covering two subdimensions: educators’ competence in fostering construction of knowledge in digital collaborative learning, and supporting students in individualized collaborative learning. The data were analyzed by statistical methods. Three significantly differing clusters of educators’ profiles were identified, and a significant association between type of current work organization and their self-reported competence in digital collaborative learning was found. The vocational college educators rated their competence in fostering construction of knowledge in digital collaborative learning as significantly lower than higher education educators. There were also remarkable differences in competence in supporting students’ individual collaborative learning. To provide such support, sufficient competence in teaching in digital learning environment is essential, and our study highlights clear needs to enhance this competence.
Successful sterilization and immediate reimplantation of extruded femoral diaphyseal segment: A case report and review of literature
Authors: Sodhai Vivek , Pradhan Chetan , Sancheti Parag , Shyam Ashok
Published: October 2020

Extrusion of bone is a rare situation in open fractures due to high energy trauma. There are few studies, reporting successful reimplantation of the extruded bone segment using various sterilization and fixation protocols. However, there are no definitive treatment strategies for this challenging situation. We report a case of 30-year-old male patient with grade IIIB compound right distal femur fracture with an extruded long bone segment, who was treated with successful sterilization and immediate reimplantation of an extruded long diaphyseal segment of distal femur following extensive cleaning with sterile normal saline, removal of debris with scrubbing by sterile brush, soakage in the broad-spectrum antimicrobial solution for 30 min, sterilization by autoclaving at 121°C for 45 min, and reimplantation during stable internal fixation with lateral distal femur locking plate using Arbeitsgemeinschaft für Osteosynthesefragen techniques. At 3 months, iliac crest bone grafting, osteoperiosteal flaps, and augmented fixation with a medial locking plate were performed through a subvastus approach for a void in the medial supracondylar femur region. Intraoperatively, punctate bleeding was observed from the reimplanted fragment. Infection was ruled out with normal leukocyte count, C-reactive protein marker, no evidence of unhealthy granulation tissue, and a sterile culture report from the fracture site. The fracture healed in 12 months and the patient had good functional outcome with a lower extremity functional score of 80% and knee range of motion of 110° at short-term follow up of 2 years without any complication. Decision of reimplantation is individualized depending on the time of presentation, contamination, and comminution of extruded fragment with scarce literature on standard treatment strategies. In our case, early presentation, meticulous debridement, unique sterilization technique, immediate reimplantation, and augmented dual distal femur plating with bone grafting aided in achieving successful union with good functional outcome and knee range of motion, avoiding any complications.
Tubo-ovarian abscess: Exploring optimal treatment options based on current evidence
Authors: Gkrozou Fani , Tsonis Orestis , Daniilidis Aggelos , Navrozoglou I , Paschopoulos Minas
Published: October 2020

Purpose:

Tubo-ovarian abscess (TOA) and pelvic abscess are characterized by an inflammatory pelvic mass. In the majority of cases, this condition involves the ovaries, the fallopian tubes and/or any other adjacent tissue. TOA is considered a severe complication of PID and can cause severe sepsis. The main risk factors for women’s health are the size of the abscess, the initial amount of white blood cells (WBC), patients’ age as well as, any co-existing comorbidities.

Methods:

This study provides a review of the current literature regarding the management of TOA and the different criteria used in order to establish the optimal therapeutic approach or to predict outcome by individualizing cases. Four major search engines, MEDLINE, Google Scholar, PubMed and EMBASE, up to February 2020 were explored, focusing in epidemiology and risk factors, pathogenesis, diagnosis and treatment.

Results:

Our review suggests that there are no clear guidelines for best practice, in case of TOA, but it appears that intravenous antibiotics combined with interventional radiology have good results for TOA <5 cm. When TOA is >5 cm, laparoscopic approach is indicated. Further studies are needed in order to evaluate the best treatment for women with TOA.

Conclusions:

More prospective studies on large-series of patients are in need, in order to determine a clear pathway and to suggest specific criteria, which can guide clinicians to choose optimal approach in a timely manner.
Applying Petitmengin’s Explicitation Interview Method to Elicit the Lived Experience of Breathing Upon Waking by an Individual With Cystic Fibrosis
Authors: Ladores Sigrid
Published: October 2020

Breathing is an act that most people do not consciously evoke unless there is a presence of illness that affects the respiratory system. Adults generally take in 12 to 15 breaths per minute without even a thought about the body’s mechanics that allow for proper oxygenation and ventilation. However, for those with pulmonary compromise, breathing becomes a very conscious, deliberate, and sometimes laborious act. The purpose of this paper is to demonstrate the use of the explicitation method by Petitmengin by interviewing a subject to elicit the lived experience of breathing by an individual with end-stage cystic fibrosis (CF). To apply the interview method, the following phenomenological question guided the interviewer’s approach: What is the lived experience of breathing upon waking for an individual with CF? This paper includes a transcription of the interview followed by a self-critique, textual analysis, and discussion of the implications to health care.
Job Offer Negotiations: Helping Students Negotiate Their Job Offers
Authors: Risavy Stephen D.
Published: October 2020

Students who do not negotiate their job offers often leave value on the table, which will compound over time and perhaps throughout an entire career. The purpose of this article is to present a process that has been successfully used to instruct management students regarding what to communicate during their job offer negotiations. Sample statements are provided so that students can communicate with prospective employers in a way that will allow them to maximize the value of their job offers while maintaining the relationship with the prospective employer. The connections between this teaching practice and the extant research literature as well as research questions that emanate specifically from these connections are also discussed.