bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk factor analysis of axial symptoms after single-segment anterior cervical discectomy and fusion: A retrospective study of 113 patients
Authors: Wang Lin-Feng , Dong Zhen , Miao De-Chao , Shen Yong , Wang Feng
Published: November 2019

Objective

This retrospective study was performed to investigate the risk factors for axial symptoms (AS) after single-segment anterior cervical discectomy and fusion (ACDF).

Methods

One hundred thirteen patients with cervical spondylosis who had undergone single-segment ACDF from January 2012 to December 2015 were divided into those with and without AS (n = 34 and n = 79, respectively). Clinical data and radiological evaluation results were recorded.

Results

The occurrence rate of AS was 30.1% (34/113), and the average visual analog scale score was 4.5 points. Bony fusion was achieved in all cases during follow-up. There were no differences in age, sex, disease duration, diagnostic categories, operative segment, Japanese Orthopaedic Association score, or adjacent segment degeneration. However, cervical range of motion (CROM), cervical curvature, and disc space enlargement significantly differed between the groups. Logistic regression analysis revealed that CROM, cervical curvature, and disc space enlargement were independently associated with AS.

Conclusions

AS after single-segment ACDF is not rare. Disc space enlargement is a risk factor for AS, while higher CROM and lordotic cervical curvature are protective factors. Excessive or insufficient disc space enlargement could increase the incidence of AS. Maintaining CROM within the normal range and restoring cervical lordosis might help to prevent AS.
An empirical study on waste generation rates at different stages of construction projects in China
Authors: Wang Qiankun , Chen Lei , Hu Ruibo , Ren Zhigang , He Yanting , Liu Daoru , Zhou Ziqi
Published: November 2019

Estimation of construction waste generation is critical to construction waste management decisions. However, current construction waste estimation methods have various limitations (e.g. small samples). To address those limitations, this research conducts an empirical study to evaluate the waste generation rate of different types of waste at different construction stages. In this study, construction waste from 148 new-built residential construction sites in China were sorted and weighted on site and their waste generation rates were estimated separately. The results indicated that the amount of inorganic nonmetallic waste with a generation rate of 16.59 kg m−2 was the highest among the five types of waste (i.e. inorganic nonmetallic waste, organic waste, metallic waste, composite waste, hazardous waste), while the waste generation rate for the underground construction stage, which was 27.57 kg m−2, was the highest among the three stages (i.e. underground stage, superstructure stage, finishing stage). Compared with previous data, the new waste generation rate proposed in this research can better estimate the actual waste generation situation in construction sites, which provides reliable information for proper decision-making. Furthermore, based on the result of the empirical study, some recommendations for construction waste reduction are proposed.
Breaking the Mirror of the Spectacle: Mass Murder/Suicide as the Ecstasy of Simulated Experience
Authors: Simpson Oliver
Published: November 2019

This article develops a sociological understanding of the lone mass shooter and the ways in which his affectual constellation is produced within and mirrors the social space. It begins by outlining the contemporary political context of terrorism. The article then explores the affectual constellation of an isolated mass murderer, by asking the question ‘what is a loser?’. Following this, it links the emergence of the radical loser to modernity through an exploration of the genealogy of nihilism. Then, taking the mass murderer Elliot Rodger as a paradigmatic case, it explores the ways in which his affectual constellation can be understood as produced within the capitalist social formation. Finally, it argues that mass murder can be understood as the ecstasy of simulated experience, its violent countertransference, constituting a zone of indistinction between the spectacle and the real, killing and being killed.
Healthcare-related factors affecting the management of HIV infected patients: a systematic review of qualitative evidence
Authors: Cheema Ejaz , Abbas Asraa , Al-Hamid Abdullah
Published: November 2019

Human immunodeficiency virus (HIV) infection is a major health concern that is associated with high mortality and socioeconomic burden on both patients and healthcare authorities. This systematic review aimed to qualitatively explore the healthcare-related factors influencing the management of HIV in adult patients. Seven online databases (PubMed, Embase, Google Scholar, CINAHL, PsycInfo, PsycExtra, and International Pharmaceutical Abstract) were searched. Articles published in English language between September 2000 and September 2018 were eligible for inclusion. Quality assessment tool developed by the EPPI-Centre was used to assess the quality of the included studies. A cross-case thematic analysis was conducted using NVivo 10. A total of 30 studies were included in the review. The qualitative analysis identified four major themes influencing the management of HIV: awareness of healthcare professionals (HCPs), attitudes of HCPs, lack of healthcare infrastructure, and stigma associated with HIV. The findings of this review suggest that people living with HIV are at an increased risk of experiencing poor disease management due to various healthcare-related factors. HCPs and policy makers should acknowledge the presence of these factors with the aim of providing quality care to people living with HIV.
Implications of shocks in energy consumption for energy policy in sub-Saharan Africa
Authors: Omoju Oluwasola E , Li Jinkai , Zhang Jin , Rauf Abdul , Sosoo Victor Edem
Published: November 2019

Sub-Saharan Africa has the lowest energy consumption per capita in the world, and this has undermined socioeconomic development in the region. The stationarity of energy consumption in the region has important implications for energy policy, forecasting and macroeconomic developments. This paper investigates the stationarity properties of energy consumption in 48 sub-Saharan Africa countries using the Augment Dickey–Fuller, Zivot–Andrews, Clemente–Montanes–Reyes and Lee–Strazicich LM tests. Using the Lee-Strazicich LM test as a benchmark, the study shows that energy consumption is stationary in 41 countries. This implies that energy policy makers should not be concerned about shocks in energy consumption in these countries because the shocks will be temporary and not transmitted to the macroeconomy. Also, energy policies will not have long-term effects. Policies that exert one-time temporary shocks on energy consumption would be more effective in these countries.
The paleoecology and extinction of endemic tortoises in the Bahamian Archipelago
Authors: Steadman David W , Albury Nancy A , Carlson Lizabeth A , Franz Richard , LeFebvre Michelle J , Kakuk Brian , Keegan William F
Published: November 2019

No native species of tortoises ( Chelonoidis spp.) live today in the Bahamian (Lucayan) Archipelago (= The Bahamas + The Turks and Caicos Islands), although a number of species inhabited these islands at the first human contact in the late-Holocene. Until their extinction, tortoises were the largest terrestrial herbivores in the island group. We report 16 accelerator mass spectrometer (AMS) radiocarbon (14C) dates determined directly on individual bones of indigenous, extinct tortoises from the six Bahamian islands (Abaco, Eleuthera, Flamingo Cay, Crooked, Middle Caicos, Grand Turk) on five different carbonate banks. These 16 specimens probably represent six or seven species of tortoises, although only one ( Chelonoidis alburyorum on Abaco) has been described thus far. Tortoises seem to have survived on most Bahamian islands for only one or two centuries after initial human settlement, which took place no earlier than AD ~700–1000. The exception is Grand Turk, where we have evidence from the Coralie archeological site that tortoises survived for approximately three centuries after human arrival, based on stratigraphically associated 14C dates from both tortoise bones and wood charcoal. The stable isotope values of carbon (σ13C) and nitrogen (σ15N) of dated tortoise fossils show a NW-to-SE trend in the archipelago that may reflect increasing aridity and more consumption of cactus.
High-resolution climatic (monsoonal) variability reconstructed from a continuous ~2700-year sediment record from Northwest Himalaya (Ladakh)
Authors: Sharma Choudhurimayum Pankaj , Rawat Suman Lata , Srivastava Pradeep , Meena Narendra K , Agnihotri Rajesh , Kumar Anil , Chahal Poonam , Gahlaud SKS , Shukla UK
Published: November 2019

A chronologically well-constrained sedimentary archive from Upshi (Ladakh) was studied using a multi-proxy approach namely palynology, environmental magnetism, total organic carbon (TOC), total nitrogen (TN), stable isotopes of carbon and nitrogen providing a continuous vegetation, and paleoenvironmental history spanning the last ~2700 years with a temporal resolution of ~43 years. Pollen assemblage shows non-arboreal pollen (NAP) and non-pollen palynomorph (NPP) were dominant around the Upshi from ~2646 to 2431 cal. yr BP, indicating warmer conditions. Arboreal pollen (AP) and NAP gradually increased from 2431 to 1860 cal. yr BP in the study area, under warm and wet conditions, corresponding to the Roman Warm Period (RWP). This phase also witnessed enhanced sediment δ15N and χlf values. From ~1860 to ~1154 cal. yr BP increased Chenopodiaceae/Amaranthaceae and substantial spread of NPP suggest decreased temperature and prevalence of cold-dry climate. This period also records declining trends of χlf, δ15N, δ13Corg, TOC, and TN contents. From ~1154 to 293 cal. yr BP, the vegetation type reversed to mixed conifer and broad-leaved forest with significant increase in herbaceous taxa, rising δ15N, δ13Corg, TOC, and TN suggesting warm and wet conditions in the study area. This period broadly corresponds to the ‘Medieval Warm Period’ (MWP). Among all the proxies employed, depth profiles of TOC and TN (wt%) appear to respond best against external climate forcing showing remarkable correlation(s) with residual Δ14C in atmosphere, indicating dominance of intrinsic solar variability on regional climate/environment. The reconstructed recorded is well connected with established historical events and cultural activities of the Eurasian region.
Susceptibility of small boreal lakes to environmental changes as inferred from organic sediments of Lake Talvilampi (Finland)
Authors: Milecka Krystyna , Mirosław-Grabowska Joanna , Zawisza Edyta , Kowalewski Grzegorz
Published: November 2019

During the Holocene, multiple thermal changes commonly occurred in the northern hemisphere. They are well-recorded in lakes with minimum human impact from the Arctic Circle area. The development of these lakes reflects ecological and climatic changes occurring from the formation of the lakes until present-day times. All environmental fluctuations affect biodiversity and are reflected in the number and composition of species. The goals of this study were to detect the ecological changes in a small Finnish lake using pollen, Cladocera and geochemical analyses. The research area is located within the northern zone of boreal coniferous forest and is the most sparsely populated region of Finland. The lake is located in Kuusamo uplands, E Finland, near the polar circle and over 20 km from the Russian border. Indicators of cold water were found only during the initial stage, after the 8.2 ka event and then the temperature was higher. Trophy was high at the beginning of the lake development and then a significant increase in trophy was found after 2600 BP. The impact of human activity is hardly traceable in Arctic Circle Finland throughout the Holocene Thermal Maximum. During the late-Holocene (after 4200 yr cal. BP), this impact is still weak and, even as late as the 20th century, only a few traces of human activity are recorded. General conclusion is that long-term climatic shift has been the most important factor driving changes in the limnology of Lake Talvilampi.
Fatigue–oxidation–creep damage model under axial-torsional thermo-mechanical loading
Authors: Li Dao-Hang , Shang De-Guang , Cui Jin , Li Luo-Jin , Wang Ling-Wan , Zhang Cheng-Cheng , Chen Bo
Published: November 2019

A fatigue–oxidation–creep damage model that can take into account the effect of multiaxial cyclic feature on the damage mechanism is proposed under axial-torsional thermo-mechanical fatigue loading. In the proposed model, the effects of non-proportional additional hardening on fatigue, oxidation, and creep damages are considered, and the variation of oxidation damage under different high temperature loading conditions is also described. Moreover, the intergranular creep damage needs to be equivalent to the transgranular damage before accumulating with the fatigue and oxidation damages. The fatigue, oxidation, and creep damages can be expressed as the fractions of fatigue life, critical crack length, and creep rupture time, respectively, which allows the linear accumulation of different types of damages on the basis of life fraction rule. In addition, the proposed model is validated by various fatigue experimental results, including uniaxial thermo-mechanical fatigue, axial-torsional thermo-mechanical fatigue, and isothermal axial-torsional fatigue under proportional and non-proportional loadings. The results showed that the errors are within a factor of 2.
Characterizing HPV Vaccine Sentiments and Content on Instagram
Authors: Kearney Matthew D. , Selvan Preethi , Hauer Michael K. , Leader Amy E. , Massey Philip M.
Published: November 2019

Background. With its growing popularity, inclusion of image and text, and user-friendly interface, Instagram is uniquely positioned for exploring health behaviors and sources and types of informational exposure related to the human papillomavirus (HPV) vaccine. Aims. To characterize public Instagram posts about the HPV vaccine and quantify the impact of sentiment and context on engagement via likes. Method. Using Netlytic, 3,378 publicly available English-language posts were collected using the search terms “#HPV,” “#HPVVaccine,” and “#Gardasil.” We randomly selected 1,200 posts to content analyze. Our final analytic sample included 360 posts after excluding posts whose links were no longer active ( n = 221) or that were not relevant ( n = 619). Results. A higher proportion of posts were pro-vaccine (55.8%) than anti-vaccine (42.2%). Pro-HPV vaccination posts were liked significantly less than anti-vaccination posts (24 vs. 86 likes; p < .001). More posts contained actionable information/resources (63.9%) than personal narrative elements (36.1%). Less than one in three posts (30.0%) came from health-related sources. Discussion. Pro-vaccine posts were more prevalent on Instagram, and anti-vaccine posts had higher engagement and typically included misleading information about the HPV vaccine. Personal narratives skewed toward anti-vaccine sentiments and most were produced by individual users. Pro-vaccine narratives portrayed individuals who received the vaccine, but provided limited details on vaccine experiences, starkly contrasting with the depth of details in anti-vaccine personal narrative posts. Conclusion. On Instagram, individuals and organizations have an opportunity to promote HPV vaccination by continuing to provide informational resources in addition to creating more narrative-style posts.
National Institutes of Health Support of Digital Health Behavior Research
Authors: Riley William T. , Oh April , Aklin Will M. , Wolff-Hughes Dana L.
Published: November 2019

The National Institutes of Health (NIH) has increasingly supported research in digital health technologies to advance research and deliver behavior change interventions. We highlight some of the research supported by the NIH in eHealth, mHealth, and social media as well as research resources supported by the NIH to accelerate research in this area. We also describe some of the challenges and opportunities in the digital health field and the need to balance the promise of these technologies with rigorous scientific evidence.
Intimate Partner Violence on Instagram: Visualizing a Public Health Approach to Prevention
Authors: Carlyle Kellie E. , Guidry Jeanine P. D. , Dougherty Sharyn A. , Burton Candace W.
Published: November 2019

Social media platforms like Instagram are often used as venues for discussing relationships, making them ideal channels for promoting healthy relationships and preventing intimate partner violence (IPV). This is particularly relevant for IPV, which has been historically understood as a personal issue and lacked support for consideration as a significant public health issue. To explore a potential platform for IPV prevention, this study examines the ways in which IPV messages on Instagram reflect public health understandings of, and approaches to, prevention and how Instagram users engage with these posts. We analyzed 700 Instagram posts about IPV using the social ecological model as the theoretical framework for conceptualizing framing devices. Posts that mentioned individual causal attribution and individual solution responsibility were both present in the majority of posts and elicited more engagement than posts that did not. Encouragingly, the Instagram sample was more reflective of a range of different types of IPV experiences than previous analyses of traditional media content, possibly indicating that a public health approach to this issue is gaining traction.
Advancing the Promise of Digital Technology and Social Media to Promote Population Health
Authors: Allegrante John P. , Auld M. Elaine
Published: November 2019

In June of 2018, the Society for Public Health Education partnered with The George Washington University Milken Institute School of Public Health, University of Maryland School of Public Health at College Park, and the Public Good Projects to convene the inaugural Digital Health Promotion Executive Leadership Summit in Washington, D.C. We launched the 2018 Summit for several reasons. First, because of the ubiquity of digital technology and reach of social media, it had become apparent to us that the time was right to bring greater focus to the promise that digital technology and social media hold for improving the public’s health. Second, while other forums were discussing uses of mHealth and eHealth, it was clear the public and private sectors were talking within siloes; thus we believed that more needed to be done to catalyze a dialogue among the academic, industry, and government sectors to share their efforts and to examine the opportunities—and challenges—of forging collaborative partnerships in developing and evaluating the next generation of digital information and health communication technologies. And third, we hoped to facilitate a conversation among leaders from each of these sectors that would result in a consensus on a “Common Agenda” for future actions to advance digital health promotion efforts.
Optimizing Retrieval of Biospecimens Using the Curated Cancer Clinical Outcomes Database (C3OD)
Authors: Mudaranthakam Dinesh Pal , Shergina Elena , Park Michele , Thompson Jeffrey , Streeter David , Hu Jinxiang , Wick Jo , Gajewski Byron , Koestler Devin C , Godwin Andrew K , Jensen Roy A , Mayo Matthew S
Published: November 2019

To fully support their role in translational and personalized medicine, biorepositories and biobanks must continue to advance the annotation of their biospecimens with robust clinical and laboratory data. Translational research and personalized medicine require well-documented and up-to-date information, but the infrastructure used to support biorepositories and biobanks can easily be out of sync with the host institution. To assist researchers and provide them with accurate pathological, epidemiological, and bio-molecular data, the Biospecimen Repository Core Facility (BRCF) at the University of Kansas Medical Center (KUMC) merges data from medical records, the tumor registry, and pathology reports using the Curated Cancer Clinical Outcomes Database (C3OD). In this report, we describe the utilization of C3OD to optimally retrieve and dispense biospecimen samples using these 3 data sources and demonstrate how C3OD greatly increases the efficiency of obtaining biospecimen samples for the researchers.
Word-finding difficulty is a prevalent disease-related deficit in early multiple sclerosis
Authors: Brandstadter Rachel , Fabian Michelle , Leavitt Victoria M , Krieger Stephen , Yeshokumar Anusha , Katz Sand Ilana , Klineova Sylvia , Riley Claire S , Lewis Christina , Pelle Gabrielle , Lublin Fred D , Miller Aaron E , Sumowski James F
Published: November 2019

Background:

Persons with multiple sclerosis (MS) commonly report word-finding difficulty clinically, yet this language deficit remains underexplored.

Objective:

To investigate the prevalence and nature of word-finding difficulty in persons with early MS on three levels: patient report, cognitive substrates, and neuroimaging.

Methods:

Two samples of early MS patients ( n = 185 and n = 55; ⩽5 years diagnosed) and healthy controls ( n = 50) reported frequency/severity of cognitive deficits and underwent objective assessment with tasks of rapid automatized naming (RAN), measuring lexical access speed, memory, word generation, and cognitive efficiency. High-resolution brain magnetic resonance imaging (MRI) derived measurements of regional cortical thickness, global and deep gray matter volume, and T2 lesion volume. Relationships among patient-reported word-finding difficulty, cognitive performance, and neural correlates were examined.

Results:

Word-finding difficulty was the most common cognitive complaint of MS patients and the only complaint reported more by patients than healthy controls. Only RAN performance discriminated MS patients with subjective word-finding deficits from those without subjective complaints and from healthy controls. Thinner left parietal cortical gray matter independently predicted impaired RAN performance, driven primarily by the left precuneus.

Conclusion:

Three levels of evidence (patient-report, objective behavior, regional gray matter) support word-finding difficulty as a prevalent, measurable, disease-related deficit in early MS linked to left parietal cortical thinning.
The fundamental role of storytelling and practical wisdom in facilitating the ethics education of junior doctors
Authors: Paton Alexis , Kotzee Ben
Published: November 2019

Practical wisdom is a key concept in the field of virtue ethics, and it has played a significant role in the thinking of those who make use of virtue when theorising medical practice and ethics. In this article, we examine how storytelling and practical wisdom play integral roles in the medical ethics education of junior doctors. Using a qualitative approach, we conducted 46 interviews with a cohort of junior doctors to explore the role doctors feel phronesis has in their medical ethics practice and how they acquire practical wisdom through storytelling as an essential part of their medical ethics education. Through thematic analysis of the interviews, we discuss the key role storytelling about moral exemplars and role models plays in developing medical ethics education, and how telling stories about role models is considered to be one of the most useful ways to learn medical ethics. We finish by developing an argument for why practical wisdom should be an important part of medical ethics training, focusing on the important role that phronesis narratives should have in teaching medical ethics.
Safety-state evaluation model based on structural entropy weight–matter element extension method for ancient timber architecture
Authors: Huan Junhong , Ma Donghui , Wang Wei , Guo Xiaodong , Wang Ziyi , Wu Linchao
Published: November 2019

This article investigates various factors that may influence the safety state of ancient timber architecture, to improve the accuracy of safety-state evaluation results for ancient timber architecture. During the process, a safety-state evaluation system for ancient timber architecture is developed. This safety-state evaluation system includes five parts: foundation, plinth, timber frame, enclosing wall, and roof. Based on the system, a safety-assessment model for ancient timber architecture based on structural entropy weight–matter element extension model is also introduced. In this model, the structural entropy weight method is applied to calculating the weight of each index and takes the influence of subjective and objective weights into consideration comprehensively. This model has the following three detailed steps. First, correlation function and correlation degree of extension set are used to quantify the relationship between the evaluation indexes of the components, joints, and evaluation interval of each safety state. Second, the safety states of units are determined according to the distribution of safety state of the components. Third, the safety degree of the entire structure is determined via the minimum safety state of units. This study also uses the Niaoqiangsanchu in Forbidden City as a study case and found that the evaluation results are consistent with the results of the practical damage survey and the actual situation of the architecture. The model thus minimizes the uncertainty of qualitative and quantitative factors in the process of evaluating the safety degree of ancient timber architecture, to finally obtain the objective evaluation results.
Healing environment correlated with patients’ psychological comfort: Post-occupancy evaluation of general hospitals
Authors: Mahmood Fouad Jalal , Tayib Abdullah Yosif
Published: November 2019

Modern hospital indoor environment aims at fulfilling the psychological needs and preferences of the people who use it. Nowadays, physical and non-physical and healing environments are perceived as potential contributors to recovery processes. Unlike curing, healing relates to aspects of health that are psychological and spiritual. This study aims at tracing the relationship between the qualitative level of the healing environment and patients’ psychological comfort. Therefore, a 43-item questionnaire was distributed among 148 respondents to obtain patients’ opinion; a total of 117 valid questionnaires were received. The results showed that the quality of the healing environment can be considerably related to the fulfilment of patients’ satisfaction. The patients at tested hospitals were generally satisfied with their healing environments. The findings revealed four crucial factors, Interior appearance, Comfort and control, Views and Privacy, to create a satisfying healing environment. A negative correlation between demographic information, such as age and education, and patient satisfaction was revealed. Additionally, this study suggests that post-occupancy evaluation is a relevant tool for evaluating the quality of indoor environment and a useful technique to inform designers that variations in the indoor physical design may positively influence the patients’ level of satisfaction.
Social media prosumption and online political participation: An examination of online communication processes
Authors: Yamamoto Masahiro , Nah Seungahn , Bae Soo Young
Published: November 2019

This study examines the extent to which social media prosumption, an integrated act of consumption and production, is associated with online political participation. Data from an online panel survey of American adults reveal that social media prosumption has a positive relationship with online political participation indirectly through online political information seeking. Social media prosumption is also positively related to online political participation through online political information and online discussion heterogeneity in serial. Implications are discussed for the role of prosumptive use of social media in online political participation.
Taggle: Combining overview and details in tabular data visualizations
Authors: Furmanova Katarina , Gratzl Samuel , Stitz Holger , Zichner Thomas , Jaresova Miroslava , Lex Alexander , Streit Marc
Published: November 2019

Most tabular data visualization techniques focus on overviews, yet many practical analysis tasks are concerned with investigating individual items of interest. At the same time, relating an item to the rest of a potentially large table is important. In this work, we present Taggle, a tabular visualization technique for exploring and presenting large and complex tables. Taggle takes an item-centric, spreadsheet-like approach, visualizing each row in the source data individually using visual encodings for the cells. At the same time, Taggle introduces data-driven aggregation of data subsets. The aggregation strategy is complemented by interaction methods tailored to answer specific analysis questions, such as sorting based on multiple columns and rich data selection and filtering capabilities. We demonstrate Taggle by a case study conducted by a domain expert on complex genomics data analysis for the purpose of drug discovery.
Do the reactive attitudes justify public reason?
Authors: Tahzib Collis
Published: November 2019

According to public reason liberalism, the laws and institutions of society must be in some sense justifiable to all reasonable citizens. But why care about justifiability to reasonable citizens? Recently, Gerald Gaus has developed a novel and sophisticated defence of public justification. Gaus argues that our everyday reactive attitudes of resentment and indignation presuppose public justification and that these reactive attitudes are essential to social life. In this article, I challenge the first premise by considering cases in which agents are liable to the reactive attitudes for violating moral rules that they had no sufficient reason to endorse, and I challenge the second premise by drawing on recent work on moral responsibility that suggests that social life would still be possible, and perhaps even improved, in the absence of the reactive attitudes. Finally, I question whether the reactive attitudes are even the kind of thing that could justify public reason.
‘Diving for dope’: Identity in submarine drug policing at the ‘maritime gateway to Europe’
Authors: Eski Yarin
Published: November 2019

This article offers an ethnographic account of everyday identity (re)configuration in submarine policing by the Dutch Customs Diving Team (CDT) officers of illegal underwater drug trafficking in the Port of Rotterdam (PoR). In so doing, it explores what it means to perform drug inspections that depend on international collaboration and intelligence sharing, and also depend on the cooperation of ships’ crews, enabling the CDT to deal with challenging submarine circumstances. The findings emerge from a qualitative analysis, using an Othering framework, of data collected during fieldwork in 2011 in the PoR. The main argument of this contribution is that to prevent drug trafficking from entering in the port (and its European hinterland) and by legitimately interrupting the trade flow, the CDT must become a justifiable intervention itself. However, given the low number of drug seizures since the CDT’s inception, its legitimacy and efficacy are called into question at a time of hypersecuritization on the one hand and austere policing on the other; a bifurcating context in which CDT officers feel the need to (re)configure a superior policing Self through an inferior policed Other for which (discriminating) stigmas that exist about drug trafficking, maritime shipping and (counter-narcotics) policing are (unwillingly) used and amplified.
Vigilante rituals theory: A cultural explanation of vigilante violence
Authors: Asif Muhammad , Weenink Don
Published: November 2019

This contribution offers a new theory of vigilante violence: vigilante rituals theory. We argue that vigilante violence originates from fear, righteous anger, and retaliatory punitive desire that stems from violations of moral imperatives, which are Durkheimian sacred values. We argue that morally outraged people transform their fear and anger into violent action through mobilization and bodily alignment in vigilante rituals. These rituals can restore the integrity of moral imperatives and generate the unity of the in-group. Further, we propose the following variable socio-legal conditions that affect the likelihood for vigilante rituals to occur: legal legitimacy, an exposure to violence, and authorities’ encouragement of (violent) self-help. We conclude by noting how the theory advances prevailing explanations and how it can be used in future empirical research.
Epileptic Spikes in EEG and Migraine Attacks in the Course of Cannabis Withdrawal: A Case Report
Authors: Adorjan Kristina , Chrobok Agnieszka I. , Koller Gabi , Karch Susanne , Pogarell Oliver
Published: November 2019

In psychiatry, routine EEGs are often abnormal and not very specific, raising questions about the clinical relevance and consequences of potential anomalies. One such question is whether the administration of anticonvulsants would be useful if epileptic discharges are detected in patients without any clinical correlates. With regard to this question, we present a case study in which abnormal EEG patterns were observed in a patient with chronic migraine and cannabis addiction. The patient was a 34-year-old woman with a 14-year history of cannabis abuse who, during withdrawal, showed epileptic spikes, without any corresponding clinical symptoms, and migraine attacks of increasing intensity and frequency. This case study is in line with the new DSM-5 diagnostic tool that for the first time includes the diagnosis of cannabis withdrawal.
Port Strategies for Robot-Assisted Lobectomy by High-Volume Thoracic Surgeons: A Nationwide Survey
Authors: Oh Daniel S. , Tisol William B. , Cesnik Larry , Crosby Anna , Cerfolio Robert J.
Published: November 2019

Objective

Robot-assisted lobectomy is the fastest growing technique for pulmonary lobectomy, but the diversity of approaches has led to apprehension about port placement among learning surgeons. The aim of this study was to survey high-volume thoracic surgeons who perform robot-assisted lobectomy to understand and consolidate common themes of port placement.

Methods

An electronic online survey was created, and the link was emailed to the 100 highest volume robotic thoracic surgeons in the United States. The survey included an interactive graphical interface, which allowed each respondent to mark the preferential robotic port placement in the chest wall for each of the 5 pulmonary lobectomies. Results were analyzed individually and in aggregate. A heat map was generated to show trends.

Results

One hundred surgeons were surveyed (response rate: 62%). Most (90%) respondents utilized a 4-arm approach and 79% used a completely 4-arm portal approach with CO2 insufflation. Exact locations for each robotic port were reported by 60% of the surveyed surgeons and the results varied; however, most surgeons generally used the seventh to ninth interspaces for the camera and instruments. The use of multiple different interspace levels was common. Ninety-four percent of respondents used an additional nonrobotic assistant port.

Conclusions

There is not a universal port strategy for robot-assisted lobectomy. However, placement of the camera and robotic ports low in the seventh to ninth interspaces is the most common approach. There are some nuances of stapling port strategies and sequence of port placement, which are identified.
Vitamin C and Turmeric Attenuate Bax and Bcl-2 Proteins’ Expressions and DNA Damage in Lead Acetate-Induced Liver Injury
Authors: Alhusaini Ahlam M. , Faddah Laila M. , Hasan Iman H. , Jarallah Somayah J. , Alghamdi Shrouq H. , Alhadab Norah M. , Badr Amira , Elorabi Najlaa , Zakaria Enas , Al-anazi Abeer
Published: November 2019

Background:

Lead is a common environmental and occupational pollutant which induced multiorgans dysfunction. The present study was designed to investigate the hepatoprotective effects of turmeric (TUR) and/or vitamin C (Vit-C) alone or together against lead acetate toxicity and to explore novel molecular pathways.

Method:

Acute hepatotoxicity was induced by lead acetate (100 mg/kg/day, i.p.) in male rats, and the effect of TUR (200 mg/kg/day, orally) and/or Vit-C (250 mg/kg/day, orally) along with lead acetate for 7 days was studied.

Results:

Lead acetate increased serum alanine transaminase, aspartate transaminase, lactate dehydrogenase, hepatic lipid peroxidation and nitric oxide; while, hepatic superoxide dismutase and glutathione activities were downregulated. Hepatic Bcl-2-associated X (Bax) and B-cell lymphoma-2 (Bcl-2) proteins expressions were altered and hepatic DNA damaged was increased as well. Liver/body weight ratio was decreased. Hematoxylin and eosin demonstrated that lead acetate induced focal areas of massive hepatic degeneration of the hepatocytes. Treatment with both antioxidants ameliorated all the altered parameters and induced marked improvement of liver architecture.

Conclusion:

The combination of TUR and Vit-C has shown the most protective effects against lead acetate-induced hepatotoxicity.
Three-dimensional walking of a simulated muscle-driven quadruped robot with neuromorphic two-level central pattern generators
Authors: Habu Yasushi , Uta Keiichiro , Fukuoka Yasuhiro
Published: November 2019

We aim to design a neuromorphic controller for the locomotion of a quadruped robot with muscle-driven leg mechanisms. To this end, we use a simulated cat model; each leg of the model is equipped with three joints driven by six muscle models incorporating two-joint muscles. For each leg, we use a two-level central pattern generator consisting of a rhythm generation part to produce basic rhythms and a pattern formation part to synergistically activate a different set of muscles in each of the four sequential phases (swing, touchdown, stance, and liftoff). Conventionally, it was difficult for a quadruped model with such realistic neural systems and muscle-driven leg mechanisms to walk even on flat terrain, but because of our improved neural and mechanical components, our quadruped model succeeds in reproducing motoneuron activations and leg trajectories similar to those in cats and achieves stable three-dimensional locomotion at a variety of speeds. Moreover, the quadruped is capable of walking upslope and over irregular terrains and adapting to perturbations, even without adjusting the parameters.
Incidence and operations of median, ulnar and radial entrapment neuropathies in Finland: a nationwide register study
Authors: Hulkkonen Sina , Lampainen Kaisa , Auvinen Juha , Miettunen Jouko , Karppinen Jaro , Ryhänen Jorma
Published: November 2019

The aim of this study was to investigate the incidence rates and operations for carpal tunnel syndrome and ulnar and radial neuropathies in specialist care in Finland. Patients diagnosed with entrapment neuropathies of the upper extremity were identified from the Care Register for Health Care, 2007–2016. There were 81,911 cases in 54,095,070 person-years. The total crude incidence rates per 100,000 person-years among women and men were 197 and 105 for carpal tunnel syndrome, 26 and 36 for ulnar neuropathies, and 5.7 and 8.5 for radial neuropathies, respectively. Of these, carpal tunnel syndrome was operated on in 63% of women and 61% of men, ulnar neuropathy in 43% of women and 47% of men, and radial neuropathy in 11% of women and 8% of men. Incidence of carpal tunnel syndrome and ulnar neuropathies increased up to late middle age, while radial neuropathies were less common.

Level of evidence: III
Feeling Like an Imposter: The Effect of Perceived Classroom Competition on the Daily Psychological Experiences of First-Generation College Students
Authors: Canning Elizabeth A. , LaCosse Jennifer , Kroeper Kathryn M. , Murphy Mary C.
Published: November 2019

Many college students intend to pursue science, technology, engineering, and math (STEM) careers but quickly abandon these goals when confronted with notoriously competitive STEM courses that often pit students against each other. This emphasis on interpersonal competition could be especially detrimental for first-generation (FG) college students, an underrepresented group in STEM fields which more strongly values communality and collaboration relative to their continuing-generation peers. Thus, FG students may experience more imposter feelings in STEM courses perceived as having a competitive culture. A longitudinal study (with 818 students and 2,638 experience-sampling observations) found that perceived classroom competition was associated with greater daily in-class imposter feelings among all students—but especially among FG students. Imposter feelings in turn predicted students’ end-of-term course engagement, attendance, dropout intentions, and course grades. Classroom competition and the imposter feelings it engenders may be an overlooked barrier for promoting the engagement, performance, and retention of FG students in STEM.
Hospitalizations for cardiovascular diseases attributable to tobacco smoking in France in 2015
Authors: Bonaldi Christophe , Pasquereau Anne , Hill Catherine , Thomas Daniel , Moutengou Elodie , Thanh Viêt Nguyen , Olié Valérie
Published: November 2019

Aims

Tobacco smoking is a major risk factor for many cardiovascular diseases. In France, the daily smoking prevalence is among the highest in high-income European countries. This study estimated the number of hospitalizations for cardiovascular diseases attributable to smoking in France in 2015, and the number of stays that could have been avoided if there had been 10% less current smokers or if the prevalence of current smokers had been 20%.

Methods

Age- and sex-specific attributable fractions were calculated by combining relative risks extracted from the literature with the prevalence of smoking estimated in the 2014 Health Barometer, a national representative survey. These fractions were applied to hospitalization stays with a primary diagnosis for a cardiovascular disease whose risk is known to increase with smoking.

Results

In France in 2015, 250,813 hospital stays (95% uncertainty interval=234,869–269,807) related to a cardiovascular condition were estimated as attributable to smoking. This represented 21% of all stays for a cardiovascular condition. Ischemic heart disease accounted for the largest share of smoking-related stays (39%). If the number of current smokers had been 10% lower or if the prevalence of smoking in the population had dropped to below 20%, 5867 stays and 25,911 stays, respectively, would have been prevented.

Conclusions

In France, a large number of hospital stays for cardiovascular disease are attributable to tobacco smoking. A 10% reduction in smoking would avoid nearly 6000 hospital stays per year; more than 25,000 annual hospital stays if only 20% of the French population smoked.
Provider Attitudes and Support of Patients’ Autonomy for Phosphate Binder Medication Adherence in ESRD
Authors: Umeukeje Ebele M , Osman Rabia , Nettles Arie L , Wallston Kenneth A , Cavanaugh Kerri L
Published: November 2019

This cross-sectional study of 56 dialysis providers from 3 dialysis clinics examined providers’ attitudes and perception of autonomy support for patients’ medication adherence behaviors. Respondents completed surveys assessing attitudes and perception of autonomy support. Compared to all other provider types, physicians and nurse practitioners (MD/NP) thought it was “less true” that phosphate binder medications are very important for dialysis patients (MD/NP vs others: 5.1 [1.4] vs 6.1 [1.1]; P = 0.02). More dialysis technicians (19%) offered the highest level of support. Attitudes and perception of autonomy support for medication adherence are suboptimal, vary by dialysis provider type, and are targets for quality improvement in dialysis care. This study addresses critical gap in existing knowledge about these two novel provider-based psychosocial factors and their potential impact on phosphate binder medication adherence.
Use of sugammadex in patients with neuromuscular disorders: a systematic review of case reports
Authors: Gurunathan Usha , Kunju Shakeel Meeran , Stanton Lisa May Lin
Published: November 2019

Background

Sugammadex is a modified gamma-cyclodextrin that acts by selectively encapsulating free amino-steroidal neuromuscular relaxants. Several case reports have been published on the use of sugammadex in patients with neuromuscular disorders that include neuromuscular junction diseases, myopathies, neuropathies, and motor neurone disorders. The primary aim of this review is to systematically review the evidence on the use of sugammadex in patients with this heterogeneous group of diseases and provide recommendations for clinical practice.

Methods

A systematic electronic search of Medline, Embase and CINAHL databases was done until June 2019, to identify case reports describing the use of sugammadex in adult surgical patients with neuromuscular disorders.

Results

Of the 578 records identified through database searches, 43 articles were finally included for the systematic review. Of these, 17 reports were on patients with myopathy, 15 reports on myasthenia gravis, 9 reports on motor neuron diseases and 2 reports on neuropathies.

Conclusions

Majority of the articles reviewed report successful use of sugammadex to reverse steroidal muscle relaxants, especially rocuronium, in patients with neuromuscular diseases. However, with sugammadex, unpredictability in response and uncertainty regarding optimum dose still remain issues. Quantitative neuromuscular monitoring to ensure complete reversal and adequate postoperative monitoring is strongly recommended in these patients, despite the use of sugammadex.
Neurology practice and stroke services across East China: a multi-site, county-level hospital-based survey
Authors: Zhang Jun-Fang , Qiu Meng-Yao , Zhang Yu-Lei , Wang Xi-Xi , Wang Guo-Ping , Geng Yu , Zhang Ke-Zhong , Fang Kan , Wu Yun-Cheng
Published: November 2019

Background

Neurological disorders are an economic and public health burden which requires efficient and adequate medical resources. Currently, little is known about the status of the quality of neurological care services available in China. As neurological primary care is mostly provided at the county hospital level, investigation of this geographical level is required. The aim of this study is to evaluate currently available neurology care services in Yangtze River Delta Urban Agglomerations in east China.

Methods

A multi-site, county-level hospital-based observational survey was conducted in east China from January 2017 to December 2017. A questionnaire was made to assess hospital and the departmental patient care capabilities, human resources and technical capacity in neurology departments.

Results

Of 228 hospitals across the Yangtze River Delta Urban Agglomerations, 217 documents were returned. Of these, 22 were excluded due to invalid hospital information or duplicate submission. Overall, most hospitals have neurology departments (162, 83.1%) while less than half of the hospitals have a stroke center (80, 41.0%) and neurology emergency department (46, 23.6%). Among 162 hospitals with neurology department, 5 were excluded due to inadequate sharing, leaving 157 hospitals for analysis. About 84.1% of these neurology departments can administer intravenous thrombolysis while about one third of them has the ability to perform arterial thrombectomy (36.9%). In addition, 46.2% of hospitals can carry out computed tomography angiography (CTA) in emergency room. Tertiary care hospitals are much more equipped with modern medical resources compared to the secondary hospitals. In four administrative regions, the neurology services are better in more economically advanced regions.

Conclusions

Neurological care services need to be enhanced at the county-level hospitals to improve health care delivery.