bluuebunny/crossref_metadata_2025 huggingface dataset:
‘These chicks go just as hard as us!’ (Un)doing gender in a Dutch CrossFit gym
Authors: Schrijnder Suzanne , van Amsterdam Noortje , McLachlan Fiona
Published: April 2020

CrossFit is a relatively new fitness movement/sport, where women and men train together in the same space, performing the same athletic movements and gender equality is celebrated in CrossFit marketing, promoting equal opportunities for men and women. This paper explores how the much emphasized gender-equality narrative in CrossFit unfolds in gender performativity in a Dutch CrossFit gym. To this end, we draw from an ethnographic case study through which we examine the gendered narratives and bodily gestures of CrossFitters. Using Butler’s heterosexual matrix, we found that gender ideologies emerge in explicit and implicit narratives, materials and organizational structure, and embodied performances in the CrossFit gym. CrossFitters, on the one hand, explicitly challenge gender norms and create a space where women can undertake behaviour that is traditionally considered masculine. However, traditional gender norms, including heterosexual desire, are nonetheless implicitly reproduced through performances, narratives and organizational structures present in CrossFit.
Proteins Involved in the Induction of Procoagulant Activity and Autoimmune Response in Patients With Primary Antiphospholipid Syndrome
Authors: Araújo Débora Medeiros , Rodrigues Carlos Ewerton Maia , Gonçalves Nidyedja Goyanna Gomes , Rabelo-Júnior Carlos Nobre , Lobo Marina Duarte Pinto , Moreira Renato de Azevedo , Monteiro-Moreira Ana Cristina de Oliveira
Published: April 2020

The aim of this study was to determine the plasma protein profile of patients with primary antiphospholipid syndrome (PAPS) compared to healthy controls and identify proteins that might be used in the evaluation, diagnosis, and prognosis of this condition. The sample consisted of 14 patients with PAPS and 17 sex- and age-matched controls. Plasma samples were submitted to proteomic analysis (albumin and immunoglobulin G depletion, concentration, digestion, and label-free data-independent mass spectrometry). The software ExpressionE was used to quantify intergroup differences in protein expression. The analysis yielded 65 plasma proteins of which 11 were differentially expressed (9 upregulated and 2 downregulated) in relation to controls. Four of these are known to play a role in pathophysiological mechanisms of thrombosis: fibrinogen α chain, fibrinogen α chain, apolipoprotein C-III, and α-1-glycoprotein-1. Our analysis revealed autoimmune response and the presence of proteins believed to be functionally involved in the induction of procoagulant activity in patients with PAPS. Further studies are necessary to confirm our findings and may eventually lead to the development of significantly more accurate diagnostic tools.
Supernormal Antithrombin Activity Is an Independent Predictor of In-Hospital Mortality in Patients With Sepsis: A Retrospective Observational Study
Authors: Azuhata Takeo , Hayakwa Mineji , Maekawa Kunihiko , Komatsu Tomohide , Kuwana Tsukasa , Kawano Daisuke , Nakamura Kazuhiro , Kinoshita Kosaku , Wada Takeshi , Tanjoh Katsuhisa
Published: April 2020

Supernormal antithrombin (AT) activity is rare in patients with sepsis. This study compared mortality rate of patients with sepsis and supernormal AT activity with that of other patients. This retrospective study included patients with sepsis from 42 intensive care units (ICUs) in Japan. Patients were included if their AT activity was measured on ICU admission, and if they did not receive AT concentrate. They were categorized into low, normal, and supernormal with respective AT activity of ≤70%, >70% to ≤100%, and >100%. The primary outcome was hospital in-patient mortality. Nonlinear regression analysis showed that mortality risk gradually increased with AT activity in the supernormal range, but without statistical significance. Survival rate was significantly lower in low (67%) and supernormal (57%) AT groups than in the normal AT group (79%; P < .001 and P = .008, respectively). After adjusting for disease severity and AT activity on day 2, supernormal AT activity was the only independent predictor of mortality. Sepsis with supernormal AT activity associated with high mortality, independent of disease severity, might be a predictor of in-hospital mortality.
An evaluation of ultrasonic arrays for the static and dynamic measurement of wheel–rail contact pressure and area
Authors: Brunskill Henry , Hunter Andy , Zhou Lu , Dwyer Joyce Rob , Lewis Roger
Published: April 2020

The interfacial contact conditions between a railway vehicle wheel and the rail are paramount to the lifespan, safety and smooth operation of any rail network. The wheel–rail interface contact pressure and area conditions have been estimated, calculated and simulated by industry and academia for many years, but a method of accurately measuring dynamic contact conditions has yet to be realised. Methods using pressure-sensitive films and controlled air flow have been employed, but both are limited. Ultrasonic reflectometry is the term given to active ultrasonics in which an ultrasonic transducer is mounted on the outer surface of a component and a sound wave is generated. This ultrasonic wave packet propagates through the host medium and reflects off the contacting interface of interest. The reflected waveform is then detected and contact area and interfacial stiffness information can be extracted from the signal using the quasi-static spring model. Stiffness can be related to contact pressure by performing a simple calibration procedure. Previous contact pressure measurement work has relied on using a focusing transducer and a two-dimensional scanning arrangement which results in a high-resolution image of the wheel–rail contact, but is limited to static loading of a specimen cut from a wheel and rail. The work described in this paper has assessed the feasibility of measuring a dynamic wheel–rail contact patch using an array of 64 ultrasonic elements mounted in the rail. Each element is individually pulsed in sequence to build up a linear cross-sectional pressure profile measurement of the interface. These cross-sectional, line measurements are then processed and collated resulting in a two-dimensional contact pressure profile. Measurements have been taken at different speeds and loads.
Experimental research on micro-cutting wear of 38CrSi steel caused by TiAlN- and TiCrAlN-coated tools
Authors: Hou Yanjun , Shi Wentian , Li Qiangqiang , Liu Yude , Han Guoliang
Published: April 2020

A comparative study was carried out on the wear of 38CrSi high-alloy steel using TiCrAlN- and TiAlN-coated tools. The presence of elemental Cr in the TiCrAlN coating resulted in formation of a Cr–O film on the tool, which provided a lower friction coefficient. This also mitigated transfer of cutting heat to the tool substrate and inhibited elemental diffusion between the tool and the workpiece. Simultaneously, the hard Cr–O film, which formed outside the Al–O film, provided excellent wear resistance and protected the Al–O film. Thus, elemental Cr played an active role in enhancing the wear resistance of the tool, prolonging its life. A workpiece cut using a TiCrAlN-coated tool had a surface roughness of 0.79 µm, which was about 62% lower than that obtained using a TiAlN-coated tool. Although wear of the TiCrAlN-coated tool was reduced, reaching 0.2 mm over the standard test time of 8 min, this time was 300% longer than that observed with the TiAlN-coated tool. Furthermore, the cutting force components were smaller, at up to 8 N, and the cutting force was 50% lower than with the TiAlN-coated tool. The wear and failure mechanisms of micro-milling 38CrSi alloy were the product of a combination of forms of wear and followed the wear law in terms of tool tip breakage, coating damage, abrasive wear, and adhesive wear; coating damage had the most important effect on tool life.
Eating pathology and depressive symptoms as predictors of excessive weight gain during pregnancy
Authors: Hecht Leah M , Schwartz Natalie , Miller-Matero Lisa R , Braciszewski Jordan M , Haedt-Matt Alissa
Published: April 2020

Excessive gestational weight gain is associated with negative outcomes and the identification of contributing psychosocial factors may be useful in prevention and intervention. Pregnant women ( N = 70) completed self-report measures of eating pathology, depressive symptomatology, and gestational weight gain. Global eating pathology was positively associated with overvaluation of shape and weight, dietary restraint, frequency of binge eating, and depressive symptoms. Depressive symptoms significantly predicted excessive gestational weight gain, while global eating pathology predicted excessive gestational weight gain at a trend level. Results suggest that depressive symptoms more strongly predict excessive gestational weight gain than eating pathology.
Psychological assistance during the coronavirus disease 2019 outbreak in China
Authors: Wang Yanbo , Zhao Xudong , Feng Qiang , Liu Liang , Yao Yuhong , Shi Jingyu
Published: April 2020

Disaster psychological assistance has become an important part of the disaster relief system, playing a crucial role in restoring and maintaining emotional stability and security of people and reducing trauma-related stress. As the first country to experience the outbreak of the coronavirus disease 2019 (COVID-19), China actively adopted psychological assistance measures in response to the panic caused by the epidemic. These measures are expected to help the Chinese government and governments in other parts of the world to better respond to the outbreaks of COVID-19.
Concealment of nonreligious identity: Exploring social identity threat among atheists and other nonreligious individuals
Authors: Mackey Cameron D. , Silver Christopher F. , Rios Kimberly , Cowgill Colleen M. , Hood Ralph W.
Published: April 2020

Negative attitudes toward the nonreligious persist in America. This may compel some nonreligious individuals to conceal their identity to manage feelings of social identity threat. In one correlational study and one experiment, we found evidence of social identity threat and concealment behavior among nonreligious Americans. Our first study showed that Southern nonreligious individuals reported higher levels of stigma consciousness and self-reported concealment of nonreligious identity, which in turn predicted lower likelihood of self-identifying as “atheist” in public settings than in private settings. Our second study successfully manipulated feelings of social identity threat by showing that atheists who read an article about negative stereotypes of their group subsequently exhibited higher concealment scores than did atheists who read one of two control articles. Implications for how nonreligious individuals negotiate social identity threat and future directions for nonreligion research are discussed.
Deciphering posthumanism: Why and how it matters to urban planning in the Anthropocene
Authors: Jon Ihnji
Published: April 2020

This article responds to the call for planning theorists to develop a posthumanist approach to planning, especially in the context of the Anthropocene or planetary environmental degradation. In the wake of often unexpected and brutal feedback from nature – frequent flooding, heat waves, tornadoes or cyclones – the positioning or conceptualisation of ‘the environment’ in planning has changed; rather than being discounted as an inanimate background that merely hosts human affairs, it is now considered an active agent that influences how we design and plan for a city. The posthumanist framing of the planning agenda is closely related to the previous ‘material turn’ in planning, which initially introduced ‘distributive agency’, where human agency or our willingness to act is activated only via our relation with non-human surroundings. ‘More-than-human’ approaches to planning, inspired by the new ecology movement that debunks the idea of human exceptionalism, attempt to extend that logic even further by proclaiming how we can critically reframe planning to develop more inclusive and ethical relationships with non-human species. As a continuation of this dialogue, I provide the philosophical background behind the recent rise of posthumanist or ‘new materialist’ ecopolitics and argue why and how they can offer important insights for planning theory and practice. I lay out specifically how planners would execute this ‘posthumanist normativity’ in their everyday planning practices, focusing on three lessons that could be directly applicable: (1) understanding environment politics as a mundane politics of representation – which eventually allows us to consider non-human species as social minorities, (2) learning to ‘stay with the trouble’ – recognising the webs of our material dependency on non-human critters that encourage us to cultivate ‘response-ability’ and (3) activating political mobilisation based on empirical experiences – thinking of immediate physical experiences and sensory values as major sources of environmental activism.
“Their needs are higher than what I can do”: Moral distress in providers working with Latino immigrant families
Authors: Olcoń Katarzyna , Gulbas Lauren E
Published: April 2020

Social service providers tasked with alleviating the problems of the most marginalized and vulnerable populations are at particular risk for work-related stress and subsequent burnout. This article aims to move beyond individualized understandings of provider burnout and render visible the structural barriers that limit providers’ capacity to authentically help their clients. Guided by the concept of moral distress, we examined the experiences of 17 service providers who deliver behavioral and mental health services to Latino immigrants in a metropolitan area in Texas. An applied thematic analysis of individual interviews collected in 2015 revealed providers’ frustration with the countless systemic issues and helplessness in their inability to make substantial changes in their clients’ lives. This emotional toll, in turn, created a cycle where providers’ capacity to envision authentic, systemic change became limited. Our findings suggest that social work needs to go beyond the recommendations for self-care to prevent provider burnout and to address the inherent paradoxes in service provision to oppressed and vulnerable groups. We urge a shift toward a social action model to show an authentic commitment to social justice and to empower both providers and the marginalized populations they serve.
In situ wavenumber–frequency modal decomposition of acoustic emissions
Authors: Rajic Nik , Rosalie Cedric , Vien Benjamin Steven , van der Velden Stephen , Rose LR Francis , Smithard Joel , Chiu Wing Kong
Published: April 2020

A new acoustic sensing capability, consisting of a flexible high-density linear piezoelectric sensor array coupled to a high-bandwidth interrogation device, is developed and applied to in situ wavenumber–frequency modal decomposition of acoustic emissions in plates. An experimental assessment of the capability is undertaken using acoustic emissions generated by a ball-drop impact on aluminium and composite panels. A new method for acoustic source localisation based on this new sensor array is described, and it is shown to be more accurate than a conventional multilateration technique using single-point piezoelectric receivers. The potential of this new capability for acoustic emission detection, location and possible quantification is discussed.
Effect of sodium hydroxide treatment on dry sliding wear behavior of Phoenix sp. fiber reinforced polymer composites
Authors: Rajeshkumar G
Published: April 2020

In this work, the effect of various concentrations of sodium hydroxide treatment (5, 10, 15 and 20%) on tribological properties of Phoenix sp. fiber reinforced epoxy composites was investigated for the first time and reported. The composites were fabricated by using compression molding technique with optimized fiber length (20 mm) and fiber volume fraction (40%). The shore D hardness of the untreated and treated fiber reinforced composites was determined. The dry sliding wear test was conducted using pin-on-disk wear testing machine at different loads (10, 20 and 30 N), sliding speeds (1, 2 and 3 m/s) and sliding distances (1, 2 and 3 km). The arithmetic mean surface roughness of the samples was measured before and after the wear test. The outcomes revealed that the concentration of sodium hydroxide treatment significantly influenced the hardness and tribological properties and surface roughness value of the fabricated composites. In particular, the composites reinforced with 15% treated fiber composites showed higher wear resistance at all operating conditions and was suggested for fabricating the friction composites for automobile and machine tool applications. The morphology of the worn surfaces of the samples was examined using a scanning electron microscope to study the wear mechanisms.
International students’ motivations for studying in Indian universities: Implications for value proposition and positioning strategies
Authors: Pawar Sanjay Krishnapratap , Vispute Swati , Islam Tajamul , Chanda Ruby
Published: April 2020

Universities today devote serious effort to attract international students. The purpose of this research is to understand the motivation factors that impact international student choices in selecting Indian higher education as a study-abroad destination. This quantitative study examines the choice criteria of 249 full-time international students from the countries of Asia and Africa. A number of choice factors were identified. Results indicate that international students at Indian universities consider ‘university characteristics’ and ‘influence of social networks’ as the most important motivation factors that determine destination choice. The study findings suggest a value proposition canvas consisting of teaching quality, university rankings, safety and availability of academic courses as its foremost constituents. The paper notes decision-making influences and identifies implications for marketing actions of a developing host country operating in a competitive international student market.
International translation of Fever, Sugar, Swallow Protocols: The Quality in Acute Stroke Care Europe Project
Authors: Middleton S , Pfeilschifter W
Published: April 2020

The Quality in Acute Stroke (QASC) trial demonstrated a significant reduction in death and disability when clinicians were assisted to introduce protocols to manage fever, hyperglycaemia (sugar) and swallowing (FeSS) following stroke. We describe a unique international collaboration between the Nursing Research Institute at Australian Catholic University; the European Stroke Organisation; and the Angels Initiative, working collaboratively to support implementation of the nurse-led FeSS Protocols in 20 European countries. We currently have 71 hospitals from 16 countries participating (hospitals from four countries are in the preparation phase) with 49 hospitals currently entering data (n=2819 patients to-date). Baseline data have been received from 39 hospitals, with FeSS Protocol implementation commenced at 16 hospitals. Five hospitals have completed the Project. 'Upscale and spread' of these evidence-based, nursing protocols into countries with vastly different healthcare systems, many of whom also have no access to the latest stroke therapies, is likely to make a significant impact in reducing death and disability after stroke.
Perioperative care of the adult diabetic patient
Authors: Lloyd Helen
Published: April 2020

The prevalence of diabetes mellitus is rapidly increasing in the UK, presenting greater complexity in its management when in the presence of other comorbidities. In the care of the adult perioperative patient with diabetes mellitus not only can symptoms can be difficult to attribute to one specific cause but also the onset of complications can be rapid. This article discusses the aetiology and key concerns during the perioperative pathway of care for successful management of the adult diabetic patient.
Screw in Lisfranc Ligament
Authors: Sierra Stephen , Panchbhavi Vinod K.
Published: April 2020

Background. Injury to the Lisfranc interosseous ligament is currently managed with a screw. However, this can potentially further disrupt the ligament. The objective of this study was to observe the proximity of the screw or disruption it can cause at the ligament attachment sites. Methods. Twenty-three feet were studied. A 40-mm, 4.0, partially threaded, cannulated screw was inserted from the base of the second metatarsal into the medial cuneiform. The relationship of the ligament attachment sites to the screw hole were measured. Results. The screw hole contacted at least 1 of the ligament attachment sites in 20 of the 23 feet. The screw hole fully penetrated it in 7 feet, partially disrupted it in 4 feet, and had less than or equal to 1 mm of contact in 9 feet. There was no contact with either of the attachment sites in 3 feet, with an average distance of 1.5 mm separating them. Conclusion. Our results show the proximity of the ligament to the screw and the disruption that can result from its insertion. This is clinically relevant as some amount ligamentous disruption is likely to occur with insertion of the “Lisfranc screw,” which may interfere with its healing process.

Levels of Evidence: Level V: Expert opinion includes case reports and technique tips
Novel dose–response analyses of treprostinil in pulmonary arterial hypertension and its effects on six‐minute walk distance and hospitalizations
Authors: Ramani Gautam , Cassady Steven , Shen Eric , Broderick Meredith , Wasik Allie , Sui Qun , Nelsen Andrew
Published: April 2020

Treprostinil is a prostacyclin analogue approved for the treatment of pulmonary arterial hypertension. Apart from the inhaled formulation, there is neither a target dose nor a ceiling dose to guide clinicians using treprostinil; doses are individualized for each patient based upon tolerability and clinical improvement. Using combined data from the pivotal subcutaneous and oral treprostinil studies, we evaluated the effect of treprostinil dose on hospitalization and exercise capacity to better define the treprostinil dose–response relationship. Data from the pivotal subcutaneous and oral treprostinil studies were combined by converting oral doses to weight‐based continuous doses (ng/kg/min) accounting for patient weight and bioavailability. Patients were divided into dose tertiles (lowest, middle, highest 33%) and retrospectively analyzed. Analysis 1 assessed the effect of dose on pulmonary arterial hypertension‐related and all‐cause hospitalizations. Analysis 2 evaluated the effects of dose on six‐minute walk distance, Borg dyspnea score, and World Health Organization functional class. Results showed that, in Analysis 1, higher doses of treprostinil were associated with significantly longer times to first pulmonary arterial hypertension‐related and all‐cause hospitalization. In Analysis 2, there was a trend toward improvements in six‐minute walk distance with higher doses. In patients with pulmonary arterial hypertension on systemic treprostinil therapy, higher doses were associated with significantly longer time to first pulmonary arterial hypertension‐related and all‐cause hospitalization. There was a trend toward improvements in six‐minute walk distance. Collectively, these results underscore the importance of managing prostacyclin adverse events in order to achieve appropriate dose titration. Further studies are required to confirm these findings and to better characterize the dose–response relationship of treprostinil.
Pulmonary Arterial Hypertension—Symptoms and Impact Questionnaire: feasibility of utilizing one‐day versus seven‐day symptom reporting
Authors: Frantz Robert P. , Chin Kelly M. , Zhao Carol , Flynn Megan , Badesch David
Published: April 2020

Patient‐reported outcomes are important measures to include in pulmonary arterial hypertension clinical trials but are not widely utilized in clinical practice. Pulmonary Arterial Hypertension—Symptoms and Impact Questionnaire (PAH‐SYMPACT) is the only pulmonary arterial hypertension‐specific patient‐reported outcomes instrument developed and validated in accordance with the US Food and Drug Administration guidance on patient‐reported outcomes development. The PAH‐SYMPACT tool measures pulmonary arterial hypertension‐related symptoms and impact of pulmonary arterial hypertension on daily life. Symptoms are reported each day for seven consecutive days, and the impact of pulmonary arterial hypertension over one week is recalled and reported on day 7; however, daily symptom reporting may overburden patients and healthcare resources, limiting the practicality of PAH‐SYMPACT outside of clinical trials. To determine the practicability of an abridged version of PAH‐SYMPACT for which all reporting is completed on one day, symptom data from the SYMPHONY trial (NCT01841762; PAH‐SYMPACT validation study) were retrospectively analyzed to assess whether symptoms reported on each day correlated with the weekly average and whether one‐day symptom scores were sensitive to disease severity. Correlation coefficients comparing the weekly average and individual day symptom scores were mostly high or very high regardless of the day they were measured. Findings were similar when using either Spearman's rank correlation or weighted kappa method. One‐day symptom scores differentiated well between World Health Organization functional classes II and III/IV pulmonary arterial hypertension and were sensitive to change in disease severity as measured by the Patient Global Assessment of Disease Severity. These data suggest that the one‐day PAH‐SYMPACT is feasible and appropriate for routine implementation in clinical practice.
Management of complications of cardiac amyloidosis: 10 questions and answers
Authors: Aimo Alberto , Rapezzi Claudio , Vergaro Giuseppe , Giannoni Alberto , Spini Valentina , Passino Claudio , Emdin Michele
Published: April 2020

Amyloidosis is a systemic disorder characterized by extracellular deposition of insoluble fibrils. The most common forms are amyloid light chain and amyloid transthyretin (ATTR) amyloidoses. Cardiac involvement may be found in both these forms, and is an important cause of morbidity and mortality. The clinical presentation of cardiac amyloidosis (CA) may be represented by congestive heart failure (HF), possibly progressing to end-stage HF, as well as atrial fibrillation with possible thromboembolic events, and also conduction disturbances related to amyloid infiltration of conduction fibres. Beyond therapies targeting the blood dyscrasia or the ATTR amyloidogenic cascade, a careful choice of drug therapies, need for device implantation, and possibly treatments for advanced HF is then warranted. In the present review, we try to provide a useful guide to clinicians treating patients with CA by enucleating 10 main questions and answering them based on the evidence available as well as expert opinion and our clinical experience.
Novel Coronavirus (COVID-19): What You Need to Know
Authors: Carver Pamela E. , Phillips Jennan
Published: April 2020

Much remains unknown about COVID-19. Occupational health nurses must use reliable sources to control misinformation and prevent widespread panic.
Antibody development for preventing the human respiratory syncytial virus pathology
Authors: Soto Jorge A. , Gálvez Nicolás M. S. , Pacheco Gaspar A. , Bueno Susan M. , Kalergis Alexis M.
Published: April 2020

Human respiratory syncytial virus (hRSV) is the most important etiological agent causing hospitalizations associated with respiratory diseases in children under 5 years of age as well as the elderly, newborns and premature children are the most affected populations. This viral infection can be associated with various symptoms, such as fever, coughing, wheezing, and even pneumonia and bronchiolitis. Due to its severe symptoms, the need for mechanical ventilation is not uncommon in clinical practice. Additionally, alterations in the central nervous system -such as seizures, encephalopathy and encephalitis- have been associated with cases of hRSV-infections. Furthermore, the absence of effective vaccines or therapies against hRSV leads to elevated expenditures by the public health system and increased mortality rates for the high-risk population. Along these lines, vaccines and therapies can elicit different responses to this virus. While hRSV vaccine candidates seek to promote an active immune response associated with the achievement of immunological memory, other therapies -such as the administration of antibodies- provide a protective environment, although they do not trigger the activation of the immune system and therefore do not promote an immunological memory. An interesting approach to vaccination is the use of virus-neutralizing antibodies, which inhibit the entry of the pathogen into the host cells, therefore impairing the capacity of the virus to replicate. Currently, the most common molecule targeted for antibody design against hRSV is the F protein of this virus. However, other molecular components of the virus -such as the G or the N hRSV proteins- have also been explored as potential targets for the control of this disease. Currently, palivizumab is the only monoclonal antibody approved for human use. However, studies in humans have shown a protective effect only after the administration of at least 3 to 5 doses, due to the stability of this vaccine. Furthermore, other studies suggest that palivizumab only has an effectiveness close to 50% in high-risk infants. In this work, we will review different strategies addressed for the use of antibodies in a prophylactic or therapeutic context and their ability to prevent the symptoms caused by hRSV infection of the airways, as well as in other tissues such as the CNS.
Assessing repeatability and reproducibility of Anterior Active Rhinomanometry (AAR) in children
Authors: Cilluffo Giovanna , Zicari Anna Maria , Ferrante Giuliana , Malizia Velia , Fasola Salvatore , Duse Marzia , De Castro Giovanna , De Vittori Valentina , Schiavi Laura , Brindisi Giulia , Petrelli Paolo , La Grutta Stefania
Published: April 2020

Background

Repeatability and reproducibility are essential for clinicians for several purposes. Although discouraged, use of the Coefficient of Variation (CV) for assessing repeatability and reproducibility, rather than the Intraclass Correlation Coefficient (ICC), is still widespread. The aim of the present study was to highlight how using inappropriate indices may lead to misleading results, and this is done by simulation study and using real data on Anterior Active Rhinomanometry (AAR) in both healthy children and ones with rhinitis.

Methods

A simulation study was carried out to highlight how using inappropriate indices could be misleading. Then a comparison was made between CV and ICC to assess repeatability and reproducibility of AAR, for which previous studies have given underestimated results. AAR is recommended as the gold standard tool for measuring nasal resistance in clinical practice.

Results

A simulation study showed that the ICCs estimated from data generated assuming a true CV yielded results in agreement with estimated CVs; by contrast, if data were generated assuming a true ICC, CVs yielded conflicting results. For AAR, ICCs showed good repeatability, whereas CVs showed unacceptable repeatability. AUC and 95% CI for AAR showed good performance in predicting current symptoms of rhinitis in the overall study population.

Conclusions

The present study focused on the importance of the choice of appropriate indices of repeatability and reproducibility, demonstrating the repeatability of AAR in both healthy children and ones with rhinitis.

Trial registration

ClinicalTrials.gov(ID:NCT03286049; Registration Date: September 15, 2017; Actual Study Start Date: January 10, 2018).
Social, economic and family factors associated with binge drinking in Spanish adolescents
Authors: Vargas-Martínez Ana Magdalena , Trapero-Bertran Marta , Mora Toni , Lima-Serrano Marta
Published: April 2020

Background

The main aim of this study was to determine the socioeconomic and family factors associated with binge drinking (BD) in Spanish adolescents who participated in a web-based computer intervention for the prevention of binge drinking known asAlerta Alcohol.

Methods

Longitudinal analyses were carried out in a sample of Andalusian adolescents aged 15 to 19 enrolled in public schools, which was part of a two-arm cluster randomized controlled trial with an intervention group (IG) who received theAlerta Alcoholprogramme and a control group (CG) who did not receive any active intervention. Panel count data and the following econometric procedures were used: negative binomial, a two-part model and a finite mixture model. The endogenous variable in all models was the number of BD occasions in the last 30 days. A total of 1247 subjects in the pre-intervention period, with an average age of 16.8 years, plus 612 adolescents in the follow-up period (4 months later), were included in the analysis.

Results

In relation to findings, being older (≥17 years old), having more pocket money and higher family alcohol consumption were associated with greater BD. By contrast, subjects who completed the questionnaire on Wednesday, Thursday or Friday, further from the previous weekend, indicated a lower number of BD occasions.

Conclusions

Our results suggest the need to include families, especially parents and siblings, in interventions aimed at preventing alcohol use among adolescents, given the association shown between BD and both family alcohol consumption and weekly pocket money or availability of money to adolescents. Given the findings with regard to age, future research aimed at intervening in early adolescence to prevent BD would be justified.

Trial registration

(ClinicalTrials.gov):NCT03288896. Registration date: September 20, 2017. “Retrospectively registered”.
The association between sialolithiasis and smoking, alcohol drinking and obesity in Korea: a nested case-control study
Authors: Jin Young Ju , Han Young Eun , Choi Hyo Geun
Published: April 2020

Background

Smoking and alcohol consumption are the most common social habits in patients with sialolithiasis. Moreover, obesity has been reported to have a significant association with poor oral hygiene, one of the causes of sialolithiasis. The purpose of this study was to evaluate the relationships among tobacco smoking, drinking alcohol, obesity and sialolithiasis in a Korean population.

Methods

The Korean National Health Insurance Service-Health Screening Cohort, which includes patients ≥40 years old, was assessed from 2002 to 2013. A total of 947 sialolithiasis participants were matched with 3788 control subjects at a ratio of 1:4 with respect to age group, sex, income group, region of residence, hypertension, diabetes, and dyslipidemia. We analyzed the participants’ previous histories of smoking (current or past smokers compared to nonsmokers) and alcohol consumption (≥ 1 time per week compared to < 1 time per week) in the sialolithiasis and control groups. Obesity was measured using body mass index (BMI, kg/m2), which was categorized as < 18.5 (underweight), ≥ 18.5 and < 23 (normal), ≥ 23 and < 25 (overweight), ≥ 25 and < 30 (obese I), and ≥ 30 (obese II). Crude and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using conditional logistic regression analyses.

Results

The rate of smoking was higher in the sialolithiasis group (32.4% [307/947]) than in the control group (29.1% [1103/3788], P = 0.047). The adjusted OR of smoking for the sialolithiasis group was 1.31 (95% CI = 1.08–1.59, P = 0.006). Alcohol consumption and obesity were not statistically significantly related to sialolithiasis.

Conclusion

The odds of smoking were increased in sialolithiasis patients compared with control subjects in the population ≥ 40 years of age.
Resources utilisation and economic burden of percutaneous vertebroplasty or percutaneous kyphoplasty for treatment of osteoporotic vertebral compression fractures in China: a retrospective claim database study
Authors: Yang Dehong , Zhang Yanlei , Ma Xiao , Huo Li , Li Liran , Gao Yue
Published: April 2020

Background

Osteoporotic vertebral compression fractures (OVCF) is a common and often debilitating complication of osteoporosis, leading to significant morbidity and increased mortality. Percutaneous vertebroplasty (PVP) and Percutaneous kyphoplasty (PKP) are recommendable surgical treatments for OVCF.

Objective

To evaluate PVP/PKP utilisation and their related direct medical costs for OVCF treatment in China from the payer perspective.

Methods

A population-based medical claims database of a metropolitan city in China was analysed from the payer perspective, which included all inpatient claims from 01/01/2015 to 31/12/2017. All vertebral fractures patients that met the eligibility criteria (aged ≥50 years old, having vertebral fracture diagnosis, without unrelated diseases diagnoses such as tumour and scoliosis, received PVP/PKP) were deemed as OVCF patients. Baseline characteristics, surgery rate, length of stay in hospital, time to re-surgery, and costs (including costs per hospitalisation and annual costs) were described. Survival analysis function was used to estimate the re-surgery rate.

Results

Of the 50,686 patients with OVCF identified, 14,527 (28.66%) received a total number of 15,599 records of PVP/PKP surgeries from 2015 to 2017. Mean age was 75 at the first surgery captured in the database analysis period; females accounted for 79.54% of all cases. The median length of surgery stay was 9 days. Cumulative re-surgery rates were 1.22% in 30 days, 2.58% in 90 days, 3.61% in 183 days, 5.42% in 1 year, and 7.95% in 2 years. There was no significant difference in re-surgery rate between PVP and PKP (p = 0.3897). The median time to the re-surgery was 139 days. Mean costs per PVP/PKP-related hospitalisation were 35,906 CNY/5122 USD (34,195 CNY/4878USD for PVP, 44,414 CNY/6336 USD for PKP, p < 0.01). The overall costs of hospitalisation averaged 186.61 million CNY (26.62 million USD) per year in this metropolitan city.

Conclusion

From 2015 to 2017, nearly one-third of OVCF inpatients received PVP/PKP and the re-surgery rate was 7.95%. PVP/PKP procedures for OVCF place a high economic burden for both the healthcare system and patients. Early detection and treatment of patients with osteoporosis are critical in China.
The effects of oral administration of the novel muscarinic receptor antagonist DA-8010 on overactive bladder in rat with bladder outlet obstruction
Authors: Choi Jin Bong , Jeon Seung Hwan , Kwon Eun Bi , Bae Woong Jin , Cho Hyuk Jin , Ha U-Syn , Hong Sung-Hoo , Lee Ji Youl , Kim Sae Woong
Published: April 2020

Background

DA-8010 is a novel compound developed for the treatment of overactive bladder (OAB) and urinary incontinence. The aims of this study were to investigate the effects of DA-8010 on OAB in a rat model.

Methods

Study animals were divided into the following five groups of seven animals each: a sham-operated control group, a control group with partial bladder outlet obstruction (BOO) (OAB group), and three DA-8010 (doses of 0.3 mg/kg/day, 1 mg/kg/day, and 3 mg/kg/day, respectively) with partial BOO groups. Oral administration of the drugs was continued for 14 days after 2 weeks of partial BOO. After 4 weeks of partial BOO, cystometrography was performed in all groups. Additionally, pro-inflammatory cytokines, Rho-kinases, and histology of the bladder were analyzed.

Results

There was a significant increase in the contraction interval and a decrease in contraction pressure in the 3 mg/kg/day DA-8010 group versus those in the OAB group. Rho kinase was also significantly decreased in the DA-8010 3 mg/kg/day dosage treatment group. The increased ratio of collagen to smooth muscle after partial BOO was significantly attenuated in the DA-8010 3 mg/kg/day dosage group.

Conclusions

Oral administration of DA-8010 at 3 mg/kg/day improved findings in an OAB rat model induced by partial BOO. Our results suggest that the novel muscarinic receptor antagonist DA-8010 may be a promising drug for treating patients with OAB.
Associations of emotional intelligence and gratitude with empathy in medical students
Authors: Shi Meng , Du Tianjiao
Published: April 2020

Background

Empathy is an essential quality for physicians and medical trainees. This study aimed to examine the associations of emotional intelligence (EI) and gratitude with empathy in medical students.

Methods

We conducted this cross-sectional study at three medical schools in China. A pack of self-reported questionnaires, consisting of the Interpersonal Reactivity Index (IRI), the Trait Emotional Intelligence Questionnaire-Short Form (TEIQue-SF), the Gratitude Questionnaire-6 (GQ-6), and demographic section were distributed to the students.

Results

A pool of 1392 students became the final participants. After adjustment for the demographics, trait EI and gratitude were positively related to Perspective Taking and Empathic Concern, accounting for 33.1 and 22.7% of their variance, respectively. While trait EI was strongly and negatively associated with Personal Distress, gratitude was modestly and positively associated with it, and they collectively explained 29.1% of its variance.

Conclusions

Trait EI and gratitude could be vital psychological constructs for understanding empathy in medical students. The positive roles they may play could be considered when intervention strategies and programs are designed to enhance the professional competencies in medical students.
Report from the 5th cardiovascular outcome trial (CVOT) summit
Authors: Schnell Oliver , Standl Eberhard , Cos Xavier , Heerspink Hiddo JL , Itzhak Baruch , Lalic Nebojsa , Nauck Michael , Ceriello Antonio
Published: April 2020

The 5th Cardiovascular Outcome Trial (CVOT) Summit was held in Munich on October 24th–25th, 2019. As in previous years, this summit served as a reference meeting for in-depth discussions on the topic of recently completed and presented CVOTs. This year, focus was placed on the CVOTs CAROLINA, CREDENCE, DAPA-HF, REWIND, and PIONEER-6. Trial implications for diabetes management and the impact on new treatment algorithms were highlighted for diabetologists, cardiologists, endocrinologists, nephrologists, and general practitioners. Discussions evolved from CVOTs to additional therapy options for heart failure (ARNI), knowledge gained for the treatment and prevention of heart failure and diabetic kidney disease in populations with and without diabetes, particularly using SGLT-2 inhibitors and GLP-1 receptor agonists. Furthermore, the ever increasing impact of CVOTs and substances tested for primary prevention and primary care was discussed. The 6th Cardiovascular Outcome Trial Summit will be held in Munich on October 29th–30th, 2020 (https://www.cvot.org).
Sustaining LLIN coverage with continuous distribution: the school net programme in Tanzania
Authors: Yukich Joshua , Stuck Logan , Scates Sara , Wisniewski Janna , Chacky Frank , Festo Charles , Kabulika George , Dimoso Kanuth , Mandike Renata , Greer George , Serbantez Naomi , Elisaria Ester , Nyoni Waziri , Dadi David , Akim Ikupa , Lengeler Christian , Brown Nick , Koenker Hannah
Published: April 2020

Most malaria-endemic countries have struggled in the past decade to establish effective national-scale continuous distribution mechanisms for long-lasting insecticidal nets (LLINs). Since the implementation of the Tanzania National Voucher Scheme in 2004 and mass-distribution campaigns in 2009–2011 and 2015–2016, Tanzania has been committed to finding new and innovative ways of achieving and maintaining universal bed net coverage. Planning for the School Net Programme (SNP) began in 2011 and in 2013, the country piloted a SNP in three regions. Nets were distributed annually to children attending schools in selected primary and secondary grades. Intra-family re-distribution was assumed, and hence the family as a whole, rather than just the children themselves, were the targeted beneficiaries. The programme has since expanded to 14 regions and has seen six rounds of annual distribution. In its fifth year, 3 million nets were distributed at a cost of USD 3.64 per net and USD 0.60 per person-year of protection (including the net). ITN access and use were maintained at a high level (~ 50–75%) over the first 4 years of distribution within selected evaluation areas, even in the absence of a mass distribution event. Net distribution through primary schools has proven to be a feasible and effective strategy for maintaining consistently high coverage in Tanzania.
The C18:3n6/C22:4n6 ratio is a good lipid marker of chronic kidney disease (CKD) progression
Authors: Szczuko Małgorzata , Kaczkan Małgorzata , Małgorzewicz Sylwia , Rutkowski Przemysław , Dębska-Ślizień Alicja , Stachowska Ewa
Published: April 2020

Background

Chronic kidney disease (CKD) is a major challenge for public health due to increased risk of cardiovascular diseases (CVD) and premature death. The aim of this study was to determine the clinical picture of FA and the course of the pathophysiological mechanisms of CKD.

Methods

The study involved 149 patients with CKD and a control group including 43 people. Fatty acid profiles were investigated using gas chromatography. A total of 30 fatty acids and their derivatives were identified and quantified. The omega3, omega6, SFA, MUFA, and PUFA fatty acid contents were calculated. The correlation matrix was obtained for parameters relating to patients with CKD vs. FA, taking patients’ sex into consideration. The index C18:3n6/C22:4n6 was calculated according to the length of the treatment. Statistica 12.0 software (Tulsa, Oklahoma, USA) was used for the statistical analyses.

Results

The results showed decreased levels of total PUFA and increased concentrations of MUFA, including the activation of the palmitic and oleic acid pathway. An increase in the levels of n-6 9C22: 4n6 family fatty acids in all the patients and a reduction in the n-3 family (EPA, DHA) were observed. C18:3n6 was negatively correlated and C22:4n6 was positively correlated with the duration of the treatment. The index C18:3n6/C22:4n6 was defined as a new marker in the progression of the disease. Moreover, the index C18:3n6/ C22:4n6 was drastically decreased in later period. Nervonic acid was higher in the CKD group. In the group of men with CKD, there was a negative correlation between the excretion of K+, anthropometric measurements, and the levels of EPA and DHA.

Conclusions

The course of inflammation in CKD occurs through the decrease in PUFA and the synthesis of MUFA. The dominating cascade of changes is the elongation of GLA-C18:3n6 into DGLA-C20:3n6 and AA-C20:4n6. As CKD progresses, along with worsening anthropometrical parameters and increased secretion of potassium, the activity of Ʌ6-desaturase decreases, reducing the synthesis of EPA and DHA. The synthesis of AdA-C22:4n6 increases and the ratio C18:3n6/C22:4n6 drastically decreases after 5 years. This parameter can be used to diagnose disease progression.