bluuebunny/crossref_metadata_2025 huggingface dataset:
Temporality and timework: Danish endometrial cancer patients’ experiences of an accelerated cancer patient pathway
Authors: Sidenius Anne , Hansen Helle Ploug , Mogensen Ole , Rudnicki Martin , Tjørnhøj-Thomsen Tine
Published: March 2020

Early diagnosis and rapid treatment are deemed essential in relation to cancer. In 2007, Denmark implemented accelerated cancer patient pathways with predetermined time frames to reduce waiting time. In this article, based on fieldwork with observations at two hospitals and ethnographic interviews, we examine temporal experiences of the cancer patient pathway for endometrial cancer of the uterus at stage I. Results show that while the cancer patient pathway helps suspend thoughts of death it also brings a sense of timely confusion and concerns about whether disease has spread. This ambivalence is linked to a political discourse of cancer in general as acute and a clinical, biomedical framing of endometrial cancer in particular as “good” due to its slow growth. We demonstrate how women customize their temporal experiences to accelerate or decelerate time and argue that waiting is not necessarily a passive state. We emphasize the need for professionals to be aware that the cancer patient pathway time and subjective patient time are not always synchronized.
Delays, cancellations and compensation: Why are air passengers still finding it difficult to enforce their EU rights under Regulation 261/2004?
Authors: Drake Sara
Published: March 2020

The aim of this article is to identify why air passengers travelling in the European Union, endowed with the highest standard of consumer protection in the world under EU law, are still being denied their rights and finding it difficult to seek effective legal redress. This article argues that the principal cause of airlines’ non-compliance is the poor regulatory design of Regulation 261/2004, which has been compounded by inadequate application by the Member States and regulatory resistance by the airlines. This contribution will then demonstrate how the European Commission (‘Commission’) has responded through the adoption of both deterrence and compliance-based enforcement strategies, and maps out the mechanisms, tools and actors harnessed by the Commission to create a complex hybrid, multi-layered system of enforcement. The article reveals that enforcement gaps persist and argues that the effectiveness of the regime is unlikely to improve without legislative reform.
Cross-border litigation: Evaluating the Brexit impact – a socio-legal model for data analysis
Authors: Danov Mihail
Published: March 2020

The UK decision to leave the European Union could directly impact on the application of the EU private international law (‘PIL’) instruments in the UK. Any fresh legal uncertainty driven by such a change in the legal landscape in relation to PIL could have significant impact on private parties’ access to remedies. This article proposes a socio-legal model for measuring the Brexit impact on litigants’ access to legal remedies. In order to systematically identify the important issues (which need to be considered by policy-makers as priority in this context), the proposed theoretical model is developed around the litigants’ strategies. The advanced model has two major features. First, it is set to analyse the triangular relationship between: 1) jurisdiction (procedural rules); 2) choice of law (applicable substantive laws); 3) outcome of a cross-border case. Secondly, the relevant claimants’ and defendants’ strategies in cross-border cases are thoroughly considered by taking a game theoretic perspective.
Let’s talk about tax, baby
Authors: Bulman Anna
Published: March 2020

This Brief introduces Picture Human Rights, an initiative which seeks to explain international human rights law concepts through illustration. The inaugural series for this initiative was tax and human rights, based on the author’s interpretations of editors Philip Alston and Nikki Reisch’s 2019 book, Tax, Human Rights, and Inequality. The Brief selects some highlights from this series and explains the relevance of Picture Human Rights to modern human rights practice and advocacy.
Survival, Outcomes, and Use of Acuity Scoring Systems Following Tracheotomy in Veteran Patients
Authors: Bier-Laning Carol M. , Hotaling Jeffrey , Canar W. Jeffrey , Ansari Aziz A.
Published: March 2020

Objectives:

To determine whether established prognosis tools used in the general population of critically ill patients will accurately predict tracheotomy-related outcomes and survival outcomes in critically ill patients undergoing tracheotomy.

Methods:

Retrospective chart review of 94 consecutive critically ill patients undergoing isolated tracheotomy.

Results:

Logistic Organ Dysfunction System (LODS) and sepsis-related organ failure assessment (SOFA) scores, 2 validated measures of acuity in critically ill patients, were calculated for all patients. The only tracheotomy-related outcome of significance was the finding that patients with an LODS score ≤6 were more likely to become ventilator independent ( P < .015). Higher LODS or SOFA scores were associated with in-house death (LODS, P = .001, SOFA, P = .008) and death within 90 days (LODS, P = .009, SOFA, P = .031), while death within 180 days was associated only with a higher LODS score (LODS, P = .018). When controlling for age, there was an association between both LODS ( P = .015) and SOFA ( P = .019) scores and death within 90 days of tracheotomy.

Conclusions:

The survival outcome for critically ill patients undergoing tracheotomy seems accurately predicted based on scoring systems designed for use in the general population of critically ill patients. Logistic Organ Dysfunction System may also be useful to predict the likelihood of the tracheotomy-related outcome of ventilator independence. This suggests that LODS scores may be helpful to palliative care clinicians as part of a shared decision-making aid in critically ill, ventilated patients for whom tracheotomy is being considered.
The Effects of a Citywide Bike Share System on Active Transportation Among College Students: A Randomized Controlled Pilot Study
Authors: Grimes Amanda , Baker Michele
Published: March 2020

Introduction. Despite the known health benefits of biking, within the last year, 46% of college students reported not riding a bike. This trend indicates a need to explore interventions to increase bicycling. The purpose of this study was to examine how a free membership to a citywide bike share system, with a campus docking station, affected bicycling and physical activity. Method. Undergraduate students were recruited from a Midwest University to participate in this research study in spring 2018. Each participant wore an activity-tracking device for 3 weeks and was randomly assigned to either an intervention group ( n = 29) or a control group ( n = 27). Participants in the intervention group received a free 1-month membership to Kansas City’s bike share system, B-cycle. Data on the type of activity (e.g., biking), the frequency, duration, and overall steps were collected. A pre- and posttest survey was developed and distributed to assess perceptions and use of bicycles and the bike share system. T tests were performed to identify differences between the two groups. Results. Data analyses reveal no significant differences in overall steps or increased biking behavior between the two groups. Furthermore, only two of participants who received a free bike share membership redeemed their membership. Among other barriers, risk of overage fees or not wanting to enter credit/debit card information emerged as major themes that deterred participants. Conclusions. Results from this study will inform future interventions to decrease barriers, increase physical activity, and increase the proportions of trips taken by bike among college students. More specifically, alternative payment methods should be explored to decrease the barriers observed.
Beliefs about sleep paralysis in Turkey: Karabasan attack
Authors: Jalal Baland , Sevde Eskici H. , Acarturk Ceren , Hinton Devon E.
Published: March 2020

The present study examined explanations of sleep paralysis (SP) in Turkey. The participants were 59 college students recruited in İstanbul, Turkey, who had experienced SP at least once in their lifetime. Participants were administered the Sleep Paralysis Experiences and Phenomenology Questionnaire (SP-EPQ) in an interview. When asked whether they had heard of a name for SP, the vast majority (88%) mentioned the “ Karabasan”—a spirit-like creature rooted in Turkish folk tradition. Seventeen percent of the participants believed that their SP might have been caused by this supernatural creature. Thirty-seven percent of participants applied various supernatural and religious methods to prevent future SP attacks such as dua (supplicating to God), reciting the Quran, and wearing a musqa (a type of talisman inscribed with Quranic verses). Case studies are presented to illustrate these findings. The Karabasan constitutes a culturally specific, supernatural interpretation of the phenomenology of SP in Turkey.
The politics of embedding and the right to remain in post-Brexit Britain
Authors: Sotkasiira Tiina , Gawlewicz Anna
Published: March 2020

The European Union membership referendum (i.e. the Brexit referendum) in the United Kingdom in 2016 triggered a process of introspection among non-British European Union citizens with respect to their right to remain in the United Kingdom, including their right to entry, permanent residence, and access to work and social welfare. Drawing on interview data collected from 42 European Union nationals, namely Finnish and Polish migrants living in Scotland, we explore how European Union migrants’ decision-making and strategies for extending their stay in the United Kingdom, or returning to their country of origin, are shaped by and, in turn, shape their belonging and ties to their current place of residence and across state borders. In particular, we draw on the concept of embedding, which is used in migration studies to explain migration trajectories and decision-making. Our key argument is that more attention needs to be paid to the socio-political context within which migrants negotiate their embedding. To this end, we employ the term ‘politics of embedding’ to highlight the ways in which the embedding of non-British European Union citizens has been politicized and hierarchically structured in the United Kingdom after the Brexit referendum. By illustrating how the context of Brexit has changed how people evaluate their social and other attachments, and how their embedding is differentiated into ‘ties that bind’ and ‘ties that count’, we contribute to the emerging work on migration and Brexit, and specifically to the debate on how the politicization of migration shapes the sense of security on the one hand, and belonging, on the other.
Processing of waste carbon and polyamide fibers for high-performance thermoplastic composites: Modifications to the auto-leveling system to enhance the quality of hybrid drawn sliver
Authors: Khurshid Muhammad F , Hillerbrand Markus , Abdkader Anwar , Cherif Chokri
Published: March 2020

The auto-leveling system of a modern draw frame is widely used for conventional fibers to develop homogeneous, uniform, and defect free drawn slivers. This auto-leveling system also improves the quality of tapes and hybrid yarn structures by eliminating mass irregularities in hybrid sliver. However, the existing auto-leveling system exerts very high loads on feedstock, thus diminishing the quality of waste carbon in the delivered sliver. The aim of the present study was to process hybrid sliver based on waste carbon and polyamide fibers on a modern draw frame and modify the auto-leveling system to enable the damage-free processing of carbon fiber. For this purpose, hybrid card slivers were processed on an industrial draw frame with auto-leveling system. The different auto-leveling parameters, e.g., scan roller width and scan roller load, were modified and optimized for the uniform and damage-free processing of hybrid sliver. Results revealed that the scan roller load has a significant influence on the quality of waste carbon fiber in hybrid sliver. A uniform hybrid sliver ensures the reproducibility of unidirectional tapes and hybrid yarn at industrial scale, while simultaneously maintaining the quality of recycled carbon fiber-reinforced thermoplastics.
Prediction of ovarian aging using ovarian expression of BMP15, GDF9, and C-KIT
Authors: Park Min Jung , Ahn Jun-Woo , Kim Ki Hyung , Bang Junghee , Kim Seung Chul , Jeong Jae Yi , Choi Ye Eun , Kim Chang-Woon , Joo Bo Sun
Published: March 2020

This study investigated ovarian expressions of bone morphogenetic protein 15 (BMP15), growth differentiation factor 9 (GDF9), and C-KIT according to age in female mice to determine whether these factors can be served as new potential biomarkers of ovarian aging. Ovaries were collected from mice aged 10, 20, 30, and 40 weeks, and ovarian expressions of BMP15, GDF9, and C-KIT were examined by real-time PCR, Western blot, and immunohistochemistry. Follicle counts were measured on histological hematoxylin and eosin staining. In the second experiment to evaluate ovarian function, after superovulation with PMSG and hCG, the numbers of zygotes retrieved and embryo development rate were examined. Ovarian expressions of BMP15, GDF9, and C-KIT decreased with age. Follicle counts, numbers of retrieved zygotes, and embryo development rate were also significantly reduced in old mice over 30 weeks compared with young mice. These results indicate that these factors could be served as new potential biomarkers of ovarian aging.

Impact statement

Ovarian aging is becoming a more important issue in terms of fertility preservation and infertility treatment. Serum anti-Mullerian hormone (AMH) level and antral follicle count (AFC) are being practically used as markers of ovarian aging as well as ovarian reserve in human. However, these factors have some drawbacks in assessing ovarian aging and reserve. Therefore, the identification of ovarian expressions of BMP15, GDF9, and C-KIT according to female could be applied as a potent predictor of ovarian aging. This work provides new information on the development of diagnosis and treatment strategy of age-related fertility decline and premature ovarian insufficiency.
Does the presence of an opponent affect object projection accuracy in elite athletes? A study of the landing location of the short serve in elite badminton players
Authors: Vial Shayne , Croft James L , Schroeder Ryan T , Blazevich Anthony J , Wilkie Jodie Cochrane
Published: March 2020

The ability to accurately project (e.g. throw, kick, hit) an object at high speed is a uniquely human skill, and this ability has become a critical feature of many competitive sports. Nonetheless, in some sports, the target or end-point for a projected object is often not reached because an opponent intercepts or returns the object; thus, a player cannot use object landing location information to inform accuracy outcome. By comparing the landing location of serves performed without an opponent by elite badminton players to predicted landing points of serves delivered with an opponent, we aimed to determine whether object projection accuracy is affected by the presence of an opponent. Landing locations of serves to an opponent were predicted using a model developed through analysis of serves without an opponent present. The model predicted that 69% of serves to an opponent would have landed on or short (i.e. outside the permitted area) of the service line. Thus, serve trajectory in elite badminton players was considerably altered by the presence of an opponent, despite their aim to serve to a specific point on the court.
The significance of urgent ultrasound scan for shoulder dislocation in patients above the age of 40: A prospective British Elbow and Shoulder Society pathway implementation study
Authors: Zhou R , Prasad G , Robinson S , Shahane S , Sinha A
Published: March 2020

Background

The highlight of the British Elbow and Shoulder Society pathway for the management of traumatic anterior shoulder instability is early imaging in patients aged over 40 years to assess rotator cuff integrity and early repair, if indicated to optimise function. The senior author set up a protocol in our institute to streamline the diagnostic process for this cohort of patients. This was a retrospective analysis from a prospectively collected database to highlight the importance of early specialist imaging.

Methods

Our protocol is to perform urgent ultrasound scans for all suitable patients above 40 years after first-time traumatic shoulder dislocation. Demographics, associated injuries, ultrasound scan results, operations and functional outcomes were collated.

Results

One year following the introduction of our protocol, 40 patients with a mean age of 67 (range, 42–89; SD = 13.1) had ultrasound. The incidence of full-thickness rotator cuff tears was 57.5% (n = 23). Eleven patients with confirmed full-thickness rotator cuff tears underwent surgery. The mean age of surgical patients was significantly younger than the non-surgical group (p = 0.004).

Discussion

The use of early diagnostic imaging demonstrated a high incidence of full-thickness rotator cuff tears in this cohort of patients. This allowed early surgical repair to optimise function.
The likelihood of requiring a diagnostic test: Classifying emergency department patients with logistic regression
Authors: Sarıyer Görkem , Ataman Mustafa Gökalp
Published: March 2020

Background:

Emergency departments (EDs) play an important role in health systems since they are the front line for patients with emergency medical conditions who frequently require diagnostic tests and timely treatment.

Objective:

To improve decision-making and accelerate processes in EDs, this study proposes predictive models for classifying patients according to whether or not they are likely to require a diagnostic test based on referral diagnosis, age, gender, triage category and type of arrival.

Method:

Retrospective data were categorised into four output patient groups: not requiring any diagnostic test (group A); requiring a radiology test (group B); requiring a laboratory test (group C); requiring both tests (group D). Multivariable logistic regression models were used, with the outcome classifications represented as a series of binary variables: test (1) or no test (0); in the case of group A, no test (1) or test (0).

Results:

For all models, age, triage category, type of arrival and referral diagnosis were significant predictors whereas gender was not. The main referral diagnosis with high model coefficients varied by designed output groups (groups A, B, C and D). The overall accuracies of the logistic regression models for groups A, B, C and D were, respectively, 74.11%, 73.07%, 82.47% and 85.79%. Specificity metrics were higher than the sensitivities for groups B, C and D, meaning that these models were better able to predict negative outcomes.

Implications:

These results provide guidance for ED triage staff, researchers and practitioners in making rapid decisions regarding patients’ diagnostic test requirements based on specified variables in the predictive models. This is critical in ED operations planning as it potentially decreases waiting times, while increasing patient satisfaction and operational performance.
Lesser Metatarsophalangeal Instability: Diagnosis and Conservative Management of a Common Cause of Metatarsalgia
Authors: Kinter Christopher W. , Hodgkins Christopher W.
Published: March 2020

Context:

Lesser metatarsophalangeal (MTP) instability is a common condition that can become debilitating and require surgery.

Evidence Acquisition:

An extensive literature review was performed through MEDLINE and Google Scholar for publications relating to the etiology, diagnosis, and treatment of lesser MTP instability using the keywords metatarsophalangeal instability, athlete, forefoot pain, and metatarsalgia from database inception to 2019.

Study Design:

Clinical review.

Level of Evidence:

Level 4.

Results:

Lesser MTP instability is a common condition, especially in the active and aging populations. It is frequently misdiagnosed, causing delays in treatment that allow for progressive pain and deformity, which prevents an active lifestyle. Fortunately, MTP instability can be diagnosed easily with the drawer test. Magnetic resonance imaging is helpful when still in doubt. Conservative treatment entails joint immobilization and gradual return to play with taping and offloading metatarsal pads.

Conclusion:

Lesser MTP instability is a common diagnosis. Its early detection and conservative treatment can help the patient regain their previous level of activity and avoid surgery.
Echocardiographic markers of pulmonary hemodynamics and right ventricular hypertrophy in rat models of pulmonary hypertension
Authors: Spyropoulos Fotios , Vitali Sally H. , Touma Marlin , Rose Chase D. , Petty Carter R. , Levy Philip , Kourembanas Stella , Christou Helen
Published: March 2020

Echocardiography is the gold standard non‐invasive technique to diagnose pulmonary hypertension. It is also an important modality used to monitor disease progression and response to treatment in patients with pulmonary hypertension. Surprisingly, only few studies have been conducted to validate and standardize echocardiographic parameters in experimental animal models of pulmonary hypertension. We sought to define cut‐off values for both invasive and non‐invasive measures of pulmonary hemodynamics and right ventricular hypertrophy that would reliably diagnose pulmonary hypertension in three different rat models. The study was designed in two phases: (1) a derivation phase to establish the cut‐off values for invasive measures of right ventricular systolic pressure, Fulton's index (right ventricular weight/left ventricle + septum weight), right ventricular to body weight ratio, and non‐invasive echocardiographic measures of pulmonary arterial acceleration time, pulmonary arterial acceleration time to ejection time ratio and right ventricular wall thickness in diastole in the hypoxic and monocrotaline rat models of pulmonary hypertension and (2) a validation phase to test the performance of the cut‐off values in predicting pulmonary hypertension in an independent cohort of rats with Sugen/hypoxia‐induced pulmonary hypertension. Our study demonstrates that right ventricular systolic pressure ≥35.5 mmHg and Fulton's Index ≥0.34 are highly sensitive (>94%) and specific (>91%) cut‐offs to distinguish animals with pulmonary hypertension from controls. When pulmonary arterial acceleration time/ejection time and right ventricular wall thickness in diastole were both measured, a result of either pulmonary arterial acceleration time/ejection time ≤0.25 or right ventricular wall thickness in diastole ≥1.03 mm detected right ventricular systolic pressure ≥35.5 mmHg or Fulton's Index ≥0.34 with a sensitivity of 88% and specificity of 100%. With properly validated non‐invasive echocardiography measures of right ventricular performance in rats that accurately predict invasive measures of pulmonary hemodynamics, future studies can now utilize these markers to test the efficacy of different treatments with preclinical therapeutic modeling.
Acute type A aortic dissection: Aortic Dissection Detection Risk Score in emergency care – surgical delay because of initial misdiagnosis
Authors: Zaschke Lisa , Habazettl Helmut , Thurau Jana , Matschilles Christian , Göhlich Amélie , Montagner Matteo , Falk Volkmar , Kurz Stephan D
Published: March 2020

Background:

Acute type A aortic dissection requires immediate surgical treatment, but the correct diagnosis is often delayed. This study aimed to analyse how initial misdiagnosis affected the time intervals before surgical treatment, symptoms associated with correct or incorrect initial diagnosis and the potential of the Aortic Dissection Detection Risk Score to improve the sensitivity of initial diagnosis.

Methods:

We conducted a retrospective analysis of 350 patients with acute type A aortic dissection. Patients were divided into two groups: initial misdiagnosis (group 0) and correct initial diagnosis of acute type A aortic dissection (group 1). Symptoms were analysed as predictors for the correct or incorrect initial diagnosis by multivariate analysis. Based on these findings, the Aortic Dissection Detection Risk Score was calculated retrospectively; a result ⩾2 was defined as a positive score.

Results:

The early suspicion of aortic dissection significantly shortened the median time from pain to surgical correction from 8.6 h in patients with an initial misdiagnosis to 5.5 h in patients with the correct initial diagnosis (p<0.001). Of all acute type A aortic dissection patients, 49% had a positive Aortic Dissection Detection Risk Score. Of all initial misdiagnosed patients, 41% had a positive score (⩾2). The presence of lumbar pain (p<0.001), any paresis (p=0.037) and sweating (p=0.042) was more likely to lead to the correct initial diagnosis.

Conclusion:

An early consideration of acute aortic dissection may reduce the delay of surgical care. The suggested Aortic Dissection Detection Risk Score may be a useful tool to improve the preclinical assessment.
Their Hands Communicate and Their Eyes Listen: Perceptions of Small Group Messages Amongst Deaf College Basketball Players
Authors: Dix Andrew
Published: March 2020

This study concentrated on small group communication amongst Deaf basketball players. The central aim of the current research was to explore how outsiders perceive the communication of Deaf athletes who communicate via American Sign Language (ASL) in the sport of college basketball. Cultural identity theory (CIT) provided a theoretical foundation for the current research, while the extant literature on small groups was discussed to provide insight on intrateam messages. The participants in this study completed a pretest that centered on sports communication, partook in a distraction exercise, were informed they were analyzing Deaf athletes who communicate in ASL, and then completed a post-test that centered on sports communication. One of the main findings was that Deaf basketball players were perceived to share messages of acceptance with one another. Additional results revealed that Deaf basketball players were perceived to resolve conflict in a positive manner and were less likely to engage in negative conflict while communicating with teammates. Implications for CIT were a focal point in the study discussion as were practical implications tied to effective communication in team sports.
Radiostereometric Analysis Of Biceps Tenodesis: A Comparison Of Techniques
Authors: Okoroha Kelechi , Manderle Brandon J. , Beletsky Alexander , Yanke Adam Blair , Cole Brian J. , Forsythe Brian , Verma Nikhil N.
Published: March 2020

Objectives:

Arthroscopic biceps tenodesis (BT) is a common surgical procedure for treatment of anterior shoulder pain due to long head of the biceps pathology. BT can be accomplished via several different techniques. There continues to be a paucity of literature comparing the different techniques and fixation devices. The purpose of this study was to compare 4 different techniques for accomplishing a BT utilizing radiostereometric analysis.

Methods:

This study was a prospectively enrolled non-randomized trial of patients undergoing BT. All patients were treated at a single institution by 1 of 4 surgeons. Four different techniques were analyzed, 1) open BT with screw fixation, 2) open BT with single anchor fixation, 3) arthroscopic BT with screw fixation, and 4) arthroscopic BT with two suture anchor fixation. After the BT was completed a tantalum bead was sewn to the long head of the biceps tendon. This bead acted as a marker of the position of the biceps tendon. X-rays were taken during surgery while the patient remained sedated to establish time zero bead position. Follow up x-rays were completed at the patients 1st post-operative visit and 12 week post-operative visit. Position of the bead was measured at each time point in mm from the proximal most point of the humerus to its position distally.

Results:

A total of 60 patients were included in the analysis, with 15 patients in each of the 4 groups. Final bead position differed significantly for the open and arthroscopic techniques (107.35±20.39mm, 65.64±23.69mm, p<0.001), but did not differ significantly between the two open techniques and the two arthroscopic technique (p>0.05). The open technique resulted in 7.69±5.98mm of distal migration while the arthroscopic technique resulted in a similar amount of distal migration, 8.93±2.71mm.

Conclusion:

Short-term radiographic outcomes following open and arthroscopic biceps tenodesis revealed that each technique results in stable fixation of the tendon with minimal migration. Although a statistically significant migration occurred, this is likely clinically insignificant. This initial migration observed could be due to increased tensioning of the tendon when the patient is awake versus sedated.
Exploring links between early adversities and later outcomes for children adopted from care: Implications for planning post adoption support
Authors: Neil Elsbeth , Morciano Marcello , Young Julie , Hartley Louise
Published: March 2020

This study explored how child maltreatment, alongside a range of other variables, predicted adverse outcomes for children adopted from the foster care system in England. The participants were 319 adoptive parents who completed an in-depth online survey about their most recently adopted child. The mean age of children at placement for adoption was 28 months (range 0–11 years) and their ages at the time of the survey ranged from 0 years to 17 years (mean = 7 years). Detailed information was collected about children’s backgrounds, including their experiences in the birth family and the care system before adoption. Adoptive parents also reported on how well children were getting on in a range of areas of functioning and how well they felt the adoption was going overall. Child maltreatment and child adverse outcomes were modeled as two factors in a latent factor structural equation model. The relationship between these two factors was explored alongside a range of covariates. Associated with worse outcomes for children were potentially heritable factors (parental learning disability), the pre-birth environment (exposure to drugs or alcohol in utero) and the period between birth and moving to the adoptive family (higher levels of maltreatment, spending more than a year in care, having two or more foster placements). The child’s distress on moving from the foster home to the adoptive family was also highly significant in linking to poorer outcomes, suggesting the detrimental effect of poorly managed transitions. Implications for child welfare practices before and after adoption are discussed.
Bouncing of Hydroxylated Silica Nanoparticles: an Atomistic Study Based on REAX Potentials
Authors: Nietiadi Maureen L. , Rosandi Yudi , Urbassek Herbert M.
Published: March 2020

Clean silica surfaces have a high surface energy. In consequence, colliding silica nanoparticles will stick rather than bounce over a wide range of collision velocities. Often, however, silica surfaces are passivated by adsorbates, in particular water, which considerably reduce the surface energy. We study the effect of surface hydroxylation on silica nanoparticle collisions by atomistic simulation, using the REAX potential that allows for bond breaking and formation. We find that the bouncing velocity is reduced by more than an order of magnitude compared to clean nanoparticle collisions.
Ultrasensitive Wearable Pressure Sensors Based on Silver Nanowire-Coated Fabrics
Authors: Lian Yunlu , Yu He , Wang Mingyuan , Yang Xiaonan , Zhang Hefei
Published: March 2020

Flexible pressure sensors have attracted increasing attention due to their potential applications in wearable human health monitoring and care systems. Herein, we present a facile approach for fabricating all-textile-based piezoresistive pressure sensor with integrated Ag nanowire-coated fabrics. It fully takes advantage of the synergistic effect of the fiber/yarn/fabric multi-level contacts, leading to the ultrahigh sensitivity of 3.24 × 105 kPa−1 at 0–10 kPa and 2.16 × 104 kPa−1 at 10–100 kPa, respectively. Furthermore, the device achieved a fast response/relaxation time (32/24 ms) and a high stability (> 1000 loading/unloading cycles). Thus, such all-textile pressure sensor with high performance is expected to be applicable in the fields of smart cloths, activity monitoring, and healthcare device.
Identification and evolutionary analysis of the nucleolar proteome of Giardia lamblia
Authors: Feng Jin-Mei , Yang Chun-Lin , Tian Hai-Feng , Wang Jiang-Xin , Wen Jian-Fan
Published: March 2020

Background

The nucleoli, including their proteomes, of higher eukaryotes have been extensively studied, while few studies about the nucleoli of the lower eukaryotes – protists were reported. Giardia lamblia, a protist with the controversy of whether it is an extreme primitive eukaryote or just a highly evolved parasite, might be an interesting object for carrying out the nucleolar proteome study of protists and for further examining the controversy.

Results

Using bioinformatics methods, we reconstructed G. lamblia nucleolar proteome (GiNuP) and the common nucleolar proteome of the three representative higher eukaryotes (human, Arabidopsis, yeast) (HEBNuP). Comparisons of the two proteomes revealed that: 1) GiNuP is much smaller than HEBNuP, but 78.4% of its proteins have orthologs in the latter; 2) More than 68% of the GiNuP proteins are involved in the “Ribosome related” function, and the others participate in the other functions, and these two groups of proteins are much larger and much smaller than those in HEBNuP, respectively; 3) Both GiNuP and HEBNuP have their own specific proteins, but HEBNuP has a much higher proportion of such proteins to participate in more categories of nucleolar functions.

Conclusion

For the first time the nucleolar proteome of a protist - Giardia was reconstructed. The results of comparison of it with the common proteome of three representative higher eukaryotes -- HEBNuP indicated that the simplicity of GiNuP is most probably a reflection of primitiveness but not just parasitic reduction of Giardia, and simultaneously revealed some interesting evolutionary phenomena about the nucleolus and even the eukaryotic cell, compositionally and functionally.
Transcriptomic analysis of marine endophytic fungi extract identifies highly enriched anti-fungal fractions targeting cancer pathways in HepG2 cell lines
Authors: Blessie Ethel Juliet , Wruck Wasco , Abbey Benaiah Annertey , Ncube Audrey , Graffmann Nina , Amarh Vincent , Arthur Patrick Kobina , Adjaye James
Published: March 2020

Background

Marine endophytic fungi (MEF) are good sources of structurally unique and biologically active secondary metabolites. Due to the increase in antimicrobial resistance, the secondary metabolites from MEF ought to be fully explored to identify candidates which could serve as lead compounds for novel drug development. These secondary metabolites might also be useful for development of new cancer drugs. In this study, ethyl acetate extracts from marine endophytic fungal cultures were tested for their antifungal activity and anticancer properties against C. albicans and the human liver cancer cell line HepG2, respectively. The highly enriched fractions were also analyzed by high performance liquid chromatography coupled with high resolution mass spectrometry (HPLC-HRMS) and their effect on the HepG2 cells was assessed via transcriptomics and with a proliferation assay.

Results

We demonstrated that the fractions could reduce proliferation in HepG2 cells. The detailed transcriptome analysis revealed regulation of several cancer- and metabolism-related pathways and gene ontologies. The down-regulated pathways included, cell cycle, p53 signaling, DNA replication, sphingolipid metabolism and drug metabolism by cytochrome P450. The upregulated pathways included HIF-1 signaling, focal adhesion, necroptosis and transcriptional mis-regulation of cancer. Furthermore, a protein interaction network was constructed based on the 26 proteins distinguishing the three treatment conditions from the untreated cells. This network was composed of central functional components associated with metabolism and cancer such as TNF, MAPK, TRIM21 and one component contained APP.

Conclusions

The purified fractions from MEF investigated in this study showed antifungal activity against C. albicans and S. cerevisiae alone or both and reduced proliferation of the human liver cancer cell line HepG2 implicating regulation of several cancer- and metabolism-related pathways. The data from this study could be instrumental in identifying new pathways associated with liver cancer anti-proliferative processes which can be used for the development of novel antifungal and anti-cancer drugs.
Awareness of, attitude toward, and willingness to participate in pay for performance programs among family physicians: a cross-sectional study
Authors: Jan Chyi-Feng , Lee Meng-Chih , Chiu Ching-Ming , Huang Cheng-Kuo , Hwang Shinn-Jang , Chang Che-Jui , Chiu Tai-Yuan
Published: March 2020

Background

The National Health Insurance Administration of Taiwan has introduced several pay-for-performance programs to improve the quality of healthcare. This study aimed to provide government with evidence-based research findings to help primary care physicians to actively engage in pay-for-performance programs.

Methods

We conducted a questionnaire survey among family physicians with age-stratified sampling from September 2016 to December 2017. The structured questionnaire consisted of items including the basic demographics of the surveyee and their awareness of and attitudes toward the strengths and/or weaknesses of the pay-for-performance programs, as well as their subjective norms, and the willingness to participate in the pay-for-performance programs. Univariate analysis and multivariate logistic regression analysis were performed to compare the differences between family physicians who participate in the pay-for-performance programs versus those who did not.

Results

A total of 543 family physicians completed the questionnaire. Among family physicians who participated in the pay-for-performance programs, more had joined the Family Practice Integrated Care Project [Odds ratio (OR): 2.70; 95% Confidence interval (CI): 1.78 ~ 4.09], had a greater awareness of pay-for-performance programs (OR: 2.37; 95% CI: 1.50 ~ 3.83), and a less negative attitude to pay-for-performance programs (OR: 0.50; 95% CI: 0.31 ~ 0.80) after adjusting for age and gender. The major reasons for family physicians who decided to join the pay-for-performance programs included believing the programs help enhance the quality of healthcare (80.8%) and recognizing the benefit of saving health expenditure (63.4%). The causes of unwillingness to join in a pay-for-performance program among non-participants were increased load of administrative works (79.6%) and inadequate understanding of the contents of the pay-for-performance programs (62.9%).

Conclusions

To better motivate family physicians into P4P participation, hosting effective training programs, developing a more transparent formula for assessing financial risk, providing sufficient budget for healthcare quality improvement, and designing a reasonable profit-sharing plan to promote collaboration between different levels of medical institutions are all imperative.
Conservative recovery and replacement of a ruptured percutaneous endoscopic gastrostomy tube; a case report
Authors: Al Halabi Maan , Wakim Wakim , Moukaddam Hicham , Husari Ahmad
Published: March 2020

Background

Percutaneous Endoscopic Gastrostomy (PEG) feeding tubes are frequently placed in patients to provide enteral nutrition. We report a case of a complete rupture of a PEG tube intra-abdominally with associated peritonitis after more than a month of PEG placement and utilization. To our knowledge, this is a very rare case of a complete PEG rupture with the succeeding replacement and recovery of the fractured segments conservatively.

Case presentation

A 69-year-old female with a PEG in position and in use for more than a month started complaining of severe abdominal pain. Digital subtraction angiography (DSA) tubogram revealed rupture and separation of the PEG tube into two fragments.

Interventional radiology (IR) team was successful with their conservative approach. Both fragments were removed conservatively without the need for laparotomy. The distal fragment was utilized to place a guide wire, and a new PEG was placed in position with no intraabdominal leak.

Conclusion

Ruptured PEG tube should be considered in the differential of patients complaining of sudden abdominal pain, especially after chronic PEG utilization. Conservative approach by IR is a viable option in correcting this mishap.
The independent indicators for differentiating renal cell carcinoma from renal angiomyolipoma by contrast-enhanced ultrasound
Authors: Cao Hongli , Fang Liang , Chen Lin , Zhan Jia , Diao Xuehong , Liu Yingchun , Lu Chen , Zhang Zhengwang , Chen Yue
Published: March 2020

Background

The value of contrast-enhanced ultrasound (CEUS) in differentiating between renal cell carcinoma (RCC) and angiomyolipoma (AML) was analyzed. The purpose of this study was to identify the independent indicators of CEUS for predicting RCC.

Methods

A total of 172 renal tumors (150 RCCs, 22 AMLs) in 165 patients underwent conventional ultrasound (CUS) and CEUS examinations before radical or partial nephrectomy, and the features on CUS and CEUS were analyzed.

Results

There were significant differences in echogenicity, blood flow signals in color Doppler flow imaging (CDFI), peak intensity, homogeneity of enhancement, wash in, wash out, and perilesional rim-like enhancement between RCC and AML (P < 0.05 for all). Multivariate analysis indicated that perilesional rim-like enhancement (P = 0.035, odds ratio [OR] = 9.907, 95% confidence interval [CI]: 1.169–83.971) and fast wash out (P = 0.001, OR = 9.755, 95%[CI]: 2.497–38.115) were independent indicators for predicting RCC. The area under the receiver operating characteristic (ROC) curve (AUC) for perilesional rim-like enhancement was 0.838 (95% CI: 0.774–0.890) with 76.7% sensitivity and 90.9% specificity, while the AUC of fast wash out was 0.833 (95% CI:0.768–0.885) with 74.7% sensitivity and 81.8% specificity.

Conclusions

This study indicated that CEUS has value in differentiating RCC and AML. Present perilesional rim-like enhancement and fast wash out may be important indicators for predicting RCC.
Identification of a novel DDB2 mutation in a Chinese Han family with Xeroderma pigmentosum group E:a case report and literature review
Authors: Yang Rui , Kong Qingtao , Duan Yuanyuan , Li Weiwei , Sang Hong
Published: March 2020

Background

Xeroderma pigmentosum (XP) is a rare autosomal recessive genodermatosis. There are eight complementation groups of XP (XP-A to G and a variant form). XP-E is one of the least common forms, and XP-E patients are generally not diagnosed until they are adults due to a later onset of skin alterations.

Case presentation

We report a case of a 28-year-old Chinese woman with freckle-like hyperpigmented macules in a sun-exposed area who is prone to develop basal cell carcinomas. A genetic study revealed a novel homozygous c.111_112del deletion in exon 1 of the DDB2 gene. Western blotting analysis revealed that the patient lacked the expression of the wild-type mature DDB2 protein. The proband was first diagnosed with XPE on the basis of clinical findings and genetic testing. Sun protection was recommended, and the patient did not develop any skin cancers during the one-year follow-up.

Conclusions

We identified a novel homozygous deletion in DDB2 gene in Chinese XP-E patients having unique clinical features.
Idiopathic brain calcification in a patient with hereditary hemochromatosis
Authors: Scarlini Stefania , Cavallieri Francesco , Fiorini Massimo , Menozzi Elisa , Ferrara Francesca , Cavalleri Francesca , Reale Chiara , Garavaglia Barbara , Pietrangelo Antonello , Valzania Franco , Corradini Elena
Published: March 2020

Background

Detection of brain-MRI T2/T2* gradient echo images (T2*GRE)-hypointensity can be compatible with iron accumulation and leads to a differential diagnosis work-up including neurodegeneration with brain iron accumulation (NBIA) and Wilson Disease. Idiopathic or secondary brain calcification can be also associated with neurological involvement and brain-MRI T2/T2*GRE-hypointensity. Hereditary hemochromatosis (HH), characterized by systemic iron loading, usually does not involve the CNS, and only sporadic cases of neurological abnormalities or brain-MRI T2/T2*GRE-hypointensity have been reported.

Case presentation

A 59-year-old man came to our observation after a diagnosis of HH carried out in another hospital 2 years before. First-level genetic test had revealed a homozygous HFE p.Cys282Tyr (C282Y) mutation compatible with the diagnosis of HFE-related HH, thus phlebotomy treatment was started. The patient had a history of metabolic syndrome, type-2 diabetes, autoimmune thyroiditis and severe chondrocalcinosis. Brain-MRI showed the presence of bilateral T2*GRE hypointensities within globus pallidus, substantia nigra, dentate nucleus and left pulvinar that were considered expression of cerebral siderosis. No neurological symptoms or family history of neurological disease were reported. Neurological examination revealed only mild right-sided hypokinetic-rigid syndrome. Vitamin D–PTH axis, measurements of serum ceruloplasmin and copper, and urinary copper were within the normal range. A brain computed tomography (CT) was performed to better characterize the suspected and unexplained brain iron accumulation. On the CT images, the hypointense regions in the brain MRI were hyperdense. DNA sequence analysis of genes associated with primary familial brain calcification and NBIA was negative.

Conclusions

This report highlights the importance of brain CT-scan in ambiguous cases of suspected cerebral siderosis, and suggests that HH patients with a severe phenotype, and likely associated with chondrocalcinosis, may display also brain calcifications. Further studies are needed to confirm this hypothesis. So far, we can speculate that iron and calcium homeostasis could be reciprocally connected within the basal ganglia.