bluuebunny/crossref_metadata_2025 huggingface dataset:
Rivaroxaban Versus Warfarin for Stroke Prevention and Venous Thromboembolism Treatment in Extreme Obesity and High Body Weight
Authors: Perales Isaac J. , San Agustin Kimberly , DeAngelo Jessica , Campbell Ashley M.
Published: November 2019

Background: Limited clinical data exist describing the use of direct-acting oral anticoagulants (DOACs) in patients with body mass index (BMI) >40 kg/m2 or body weight >120 kg. Thus, DOAC therapy in this population remains controversial. Objectives: To investigate rivaroxaban as a safe and effective alternative to warfarin for venous thromboembolism (VTE) treatment and prevention of stroke in patients with atrial fibrillation identified as extremely obese or of high body weight. Methods: A retrospective chart review was performed at 2 academic medical centers in patients ≥18 years old and BMI >40 kg/m2 or weight >120 kg, newly initiated on warfarin or rivaroxaban for atrial fibrillation or VTE treatment. The primary end point was incidence of clinical failure, defined as VTE recurrence, stroke incidence, and mortality, within 12 months of initiation. Secondary end points included length of stay (LOS) and bleeding complications. Results: A total of 176 patients were included, with 84 and 92 patients in the rivaroxaban and warfarin arms, respectively. Clinical failure was lower in the rivaroxaban group but did not reach statistical significance when compared with warfarin (5% vs 13%; P = 0.06). LOS was significantly shorter in the rivaroxaban arm (2 days [1-3] vs 4 days [2-7], P < 0.0001). Percentage of bleeding complications was higher in the rivaroxaban arm but not statistically significant (8% vs 2%, P = 0.06). Conclusion and Relevance: Although not statistically significant, rivaroxaban trended toward a lower incidence of clinical failure while demonstrating a significantly shorter LOS when compared with warfarin for VTE treatment or atrial fibrillation in morbidly obese or high-body-weight patients.
Atypical Lipomatous Tumor/Well-Differentiated Liposarcoma With Features Mimicking Spindle Cell Lipoma
Authors: Jebastin Judith A. S. , Perry Kyle D. , Chitale Dhananjay A. , Mott Michael P. , Sanchez Jessica , Fritchie Karen J. , Palanisamy Nallasivam , Williamson Sean R.
Published: November 2019

Atypical lipomatous tumor/well-differentiated liposarcoma (ALT/WDL) and spindle cell lipoma are lipomatous tumors with distinct clinical, molecular, and prognostic features. Although histological and immunophenotypic features can overlap between ALT/WDL and spindle cell lipoma, the oncogenesis and clinical behavior are markedly different. In borderline cases, molecular analysis for MDM2 or CDK4 amplification can aid in distinguishing ALT/WDL from spindle cell lipoma. Although dedifferentiated liposarcoma has been reported to harbor both MDM2 amplification and loss of the RB1 region, we are not aware of a reported RB1 loss in well-differentiated ALT/WDL. In this article, we present a 69-year-old woman with a lipomatous tumor in the gluteal region that histologically, immunohistochemically, and molecularly mimicked spindle cell lipoma (with positive immunohistochemical staining for CD34 and loss of the RB1 gene region), yet harbored amplification of MDM2 and CDK4 confirmed by fluorescence in situ hybridization, supporting classification as ALT/WDL. This case strengthens the argument that in atypical clinical contexts, molecular studies for MDM2/CDK4 should be considered in tumors resembling spindle cell lipoma.
Thirty years of (in)visible disability in Australian television: Home and Away’s experiments with representation and inclusion
Authors: Mantilla Stephanie , Goggin Gerard
Published: November 2019

Disability is an increasingly dominant aspect of television representation, audiences, industries and policy internationally and offers many insights into issues of exclusion and inclusion. In this article, we reflect upon disability and the histories of Australian television through a case study of a much loved and long-running soap – Home and Away. In particular, we explore issues of inclusion via an analysis of the representation of overlooked disabilities, such as mental health, chronic illness and other ‘invisible’ disabilities, contrasting a key moment in the programme in the late 1990s with developments in the 2002–2019 period.
The devaluation of female labour in fruit and vegetable packaging plants in Spanish Mediterranean agriculture
Authors: de Castro Carlos , Reigada Alicia , Gadea Elena
Published: November 2019

Based on the evidence found in two case studies of intensive agriculture in Southern Spain, this article analyses the impact of business strategies aimed at devaluing packaging plant work in the competitive integration processes currently taking place in the global agri-food value chain. The article explores three business strategies: the feminisation, segmentation and deskilling of labour, along with ethnic substitution and labour recruitment outsourcing mechanisms. Although it acknowledges the importance of the dynamics of global competition, the article focuses mainly on how firms articulate their strategies in packaging plants within the political, family and sociocultural frameworks of specific local contexts. The analysis uses a qualitative methodology based on in-depth interviews and participant observations.
The Responsibility to Protect norm cluster and the challenge of atrocity prevention: an analysis of the European Union’s strategy in Myanmar
Authors: Staunton Eglantine , Ralph Jason
Published: November 2019

This article investigates the complex relationship between atrocity prevention and other related – yet distinct – norms of the Responsibility to Protect (R2P) norm cluster. It analyses how this cluster operates to help states, and other actors, properly discharge their responsibility. Central to the analysis is the realisation that abstractly aligned norms can clash in practice. Based on an extensive analysis of the 67 European Union (EU) documents and statements referring to R2P, and drawing on elite interviews with EU diplomats, we find that atrocity prevention has been ‘grafted’ onto the EU’s other normative commitments – including conflict resolution and democracy promotion – without sufficient acknowledgement of the cluster’s complexity and the need to prioritise atrocity prevention vis-à-vis these other linked norms. We ask whether this framing not only filtered but also diluted the normative power of atrocity prevention, leading to policies that manifestly failed to prevent the genocide that occurred in Myanmar from 2017. We find that the grafting of atrocity prevention onto related yet distinct norms contributed to an underestimation of the threat of genocide and a misplaced faith in the ability of democratic transition to prevent atrocity. However, we also find that factors unrelated to the normative framing of R2P influenced the EU’s willingness and ability to respond to atrocity crimes that occurred in the lead up to the genocide that began in 2017. The article contributes to our understanding of the as yet unstated normative implication of clustering norms and the EU’s implementation of R2P.
Reformative translation model for probability density functions of amplitude processes of crosswind-excited super-tall buildings
Authors: Hao Wei , Yang Qingshan
Published: November 2019

At the vicinity of vortex lock-in wind speed, the nonlinear aerodynamic damping effect of super-tall buildings is significant, which can greatly promote the surge of vortex-induced vibration in the crosswind direction, where the crosswind response characterized by harmonic amplitude shows narrow-band hardening non-Gaussian characteristic with the kurtosis well below 3, and the corresponding probability distribution of amplitude process distinctly differs from that of typical random buffeting response. Although the moment-based Hermite translation model has been widely used for estimating the extreme value distribution of non-Gaussian process, it fails to represent the probability distribution of hardening non-Gaussian amplitude process, notably for the response with a kurtosis close to 1.5. In this study, a new translation model based on orthogonal expansion of random processes is developed for obtaining the non-Gaussian amplitude process from an underlying Gaussian amplitude process, and the probability density function of the non-Gaussian amplitude process is derived by mapping the cumulative distribution function. The coefficients of translation model are determined by minimizing the errors between the estimated probability density functions and target values through nonlinear optimization, and the closed-form semi-empirical formulations, which connect the model coefficients with response kurtosis, are also proposed using least-square curve fitting. Moreover, the effectiveness and monotonicity of the proposed translation model are examined. This model can be readily incorporated into the extreme value analysis of crosswind response and facilitate the evaluation of wind-induced fatigue of super-tall buildings.
Multimodal mental models: Understanding users’ design expectations for mHealth apps
Authors: Brennen J Scott , Lazard Allison J , Adams Elizabeth Troutman
Published: November 2019

Employing qualitative structured interviews with mobile health app users, this research describes shared mental models for mHealth and reveals their complexity. The findings uncover prototypical design components common to mental models beyond health apps and suggest that users’ mental models are multimodal, containing distinct and often contradictory dimensions for evaluations of aesthetics and for craftsmanship. The findings also indicate that users’ mental models are informed by experiences with apps from across the mobile landscape. This research suggests that designers of consumer mobile health apps and mobile health interventions should incorporate prototypical or salient features. In doing so, they should index designs to trends across the larger app landscape and innovate the means to balance between multidimensional and conflicting mental models.
Effects of motion and structural vibration–induced loadings on the coupled dynamic response of a mono-column tension-leg-platform floating wind turbine
Authors: Imani Hasan , Abbaspour Madjid , Tabeshpour Mohammad Reza , Karimirad Madjid
Published: November 2019

Floating wind turbines are subjected to highly dynamic and complicated environmental conditions leading to significant platform motions and structural vibrations during operation and survival conditions. These motions and vibrations alter the induced loading characteristics; and consequently, affect the dynamic behavior of the system. In order to better understand the influence of such motions and structural vibrations, herein elastic structural disturbance of tower, on the system behavior, the spectral and statistical characteristics of a floating wind turbine dynamic responses under operational and survival conditions are fully explored using a fully coupled aero-hydro-servo-multi-rigid-flexible-body model. The spectral comparison results showed the important role of aerodynamic damping in reducing the high-frequency resonant responses in operational conditions. These analyses also revealed the effects of tower elasticity in shifting and amplifying high-frequency resonant responses. The statistical comparison results showed that the mean values of the responses are dominated by wind loads and the maximum and standard deviations of the responses are mainly induced by the combination of support platform motions and wave loads. It was also shown that elastic structural deformation of tower enlarges the statistical characteristics of the responses, especially when the system is subjected to both wind and wave loadings.
Penal populism: Negotiating the feminist agenda. Evidence from Spain and Poland
Authors: Grzyb Magdalena
Published: November 2019

It is interesting to observe how penal populism intersects with feminism when it comes to gender-based violence, as regards both anti-rape and domestic abuse reforms. There is a vast scholarship (Bumiller, 2008; Gottschalk, 2006; Gruber, 2007) in the US explaining how feminist activism turned to state power to demand more protection and more criminalization, and little focus on the European context.

This article aims to analyse the development of what might be called feminist penal populist discourse in Spain and Poland. Whereas penal populist discourse has been conspicuous in Spain, and the authorities there ally themselves with domestic feminist groups and scholars to combat gender-based violence, Poland has never embraced the feminist agenda, despite the widespread influence and effectiveness of penal populism in that country. The article attempts to answer the general question: Why are feminist demands likely to be addressed in some countries where penal populism discourse has emerged in the political and public sphere, but not in others? The analysis demonstrates that the proclivity for penal populism and selection of topics are strongly related not only to some structural factors or political culture, but also to the historical and social context of each country. In Spain, the feminist movement was incorporated and politicized by left-wing parties into mainstream politics, whereas in Poland there was no grass-roots movement for women’s liberation for a long time, and the emancipatory politics during the communist era was superficial.
Aging, Community-Based Employment, Mobility Impairment, and Retirement: National Core Indicators–Adult Consumer Survey Data
Authors: Stancliffe Roger J. , Nye-Lengerman Kelly M. , Kramme Julie E. D.
Published: November 2019

Little is known about how, when, or why individuals with intellectual and developmental disabilities (IDD) retire. Recognizing the changing needs of older adults with IDD is critical to support person-driven services and development of best practices in aging transitions. Using secondary analysis of the 2016 to 2017 National Core Indicators–Adult Consumer Survey (NCI-ACS) data for adults with IDD, we examined the relation between independent mobility (i.e., without aids), age group, level of intellectual disability, and type of employment/activity program, with a focus on mobility and community-based employment in older age groups. There was an overall age-related decline in mobility, but the prevalence of mobility impairment by age group was related to employment type. The percentage who were independently mobile was highest for community employment in every age group. The percentage of individuals by age group in community employment fell significantly from middle age onward, suggesting some former community-based workers had retired. There was no significant age-related difference in the percentage in facility-based employment across these age groups. Mobility limitations may be a barrier to obtaining or retaining community-based employment. Age-related mobility impairment may be associated with premature retirement, and could affect travel to and from work, undertaking work tasks, or both. Closer examination is needed of aging, community employment, and age-related mobility limitations to understand the specific causes of these effects on employment and identify supports and accommodations.
A case-controlled study on AngioJet rheolytic thrombectomy and catheter-directed thrombolysis in the treatment of acute lower extremity deep venous thrombosis
Authors: Zhu Jun , Ni Cai-Fang , Dai Zhen-Yu , Yao Li-Zheng , Li Wen-Hui
Published: November 2019

Objective

This study aims to compare the efficacy and safety of AngioJet rheolytic thrombectomy vs. catheter-directed thrombolysis in patients with acute lower extremity deep vein thrombosis.

Methods

Between the period of February 2015 and October 2016, 65 patients with documented acute lower extremity deep vein thrombosis were treated with catheter-directed intervention. These patients were divided into two groups: AngioJet group and catheter-directed thrombolysis group. Comparisons were made with regard to efficacy and safety between these two groups.

Results

In the AngioJet group, complete or partial thrombus removal was accomplished in 23 (72%) and 3 (9%) patients, respectively. In the catheter-directed thrombolysis group, complete or partial thrombus removal was accomplished in 27 (82%) patients and 1 (3%) patient, respectively. In the AngioJet group, the perimeter difference between the suffered limb and healthy one declined from 5.1 ± 2.3 cm to 1.4 ± 1.2 cm ( P <  0.05). In the catheter-directed thrombolysis group, the perimeter difference declined from 4.7 ± 1.6 cm to 1.5 ± 0.9 cm ( P <  0.05). The mean urokinase dose was 0.264 ± 0.135 million units in the AngioJet group and 1.869 ± 0.528 million units in the catheter-directed thrombolysis group ( P <  0.05). The duration of thrombolysis was 4.2 ± 1.7 h in the AngioJet group and 73.6 ± 18.3 h in the catheter-directed thrombolysis group ( P <  0.05). The occurrence of complications in these two groups was 19% and 18%, respectively (not significant).

Conclusion

AngioJet rheolytic thrombectomy is a new, safe and effective approach for treating acute lower extremity deep vein thrombosis. When compared to catheter-directed thrombolysis, this treatment provides similar success with lower urokinase dosage and shorter duration of thrombolysis.
Expression of PD-1/PD-L1 in head and neck squamous cell carcinoma and its clinical significance
Authors: Chen Shu-Wei , Li Si-Hao , Shi Ding-Bo , Jiang Wen-Mei , Song Ming , Yang An-Kui , Li Yu-Dong , Bei Jin-Xin , Chen Wen-Kuan , Zhang Quan
Published: November 2019

Objective:

To investigate the role of programmed death-1 (PD-1), programmed death-ligand 1 (PD-L1), and P16 in patients with head and neck squamous cell carcinoma (HNSCC).

Methods:

A total of 95 paraffin-embedded samples of tumorous tissue of HNSCC were collected. Expression levels of PD-1, PD-L1, and P16 were determined by immunohistochemistry.

Results:

A significantly higher proportion of PD-1 among patients infected with the human papillomavirus was found. PD-L1 expression is closely associated with the primary site of the tumor, postoperative recurrence, survival, PD-1 expression and P16 expression. Univariable analysis indicated that T stage, N stage, tumor node metastasis stage, tumor differentiation, and PD-L1 expression were all shown to be prognostic variables for overall survival in patients with HNSCC. In the multivariate analysis, only N stage ( P = 0.010) and PD-L1 expression ( P = 0.001) were found to be independent prognostic variables for overall survival. In addition, for disease recurrence, multivariate analysis showed that only PD-L1 expression was the associated independent risk factor. For the patients with negative PD-L1 expression, Kaplan-Meier analysis revealed that they had significantly worse outcomes in terms of overall survival ( P = 0.001). Similarly, compared with the patients with positive PD-L1 expression, those with negative PD-L1 expression had a higher probability of recurrence ( P = 0.026).

Conclusions:

The expression of PD-L1, PD-1, and P16 in HNSCC is significantly correlated. Human papillomavirus infection (P16 positive) is negatively related to postoperative recurrence. HNSCC patients with positive PD-L1/PD-1 expression tend to have better overall survival outcomes and lower probability of recurrence, providing more evidence for the PD-l-targeted immunotherapy of HNSCC.
When and How Video Games Can Be Good: A Review of the Positive Effects of Video Games on Well-Being
Authors: Halbrook Yemaya J. , O’Donnell Aisling T. , Msetfi Rachel M.
Published: November 2019

Video games are a source of entertainment for a wide population and have varied effects on well-being. The purpose of this article is to comprehensively examine game-play research to identify the factors that contribute to these disparate well-being outcomes and to highlight the potential positive effects. On the basis of existing literature, we argue that the effects of gaming on well-being are moderated by other variables, such as motivations for gaming and video-game characteristics. Specifically, the inclusion of social activity can benefit prosocial behaviors and affect the relationship between violent video games and aggression that some studies have demonstrated. Moreover, the research on the relationship between violent video games and aggression depends greatly on individual and sociocontextual variables outside of game play. The inclusion of physical activity in games can provide an improvement in physical health with high levels of enjoyment, potentially increasing adherence rates. Overall, following our review, we determined that the effects of gaming on well-being are moderated by and depend on the motivation for gaming, outside variables, the presence of violence, social interaction, and physical activity. Thus, we argue that there is potential for an “optimal gaming profile” that can be used in the future for both academic- and industry-related research.
Effect of acute antagonist static stretching on upper-body agonist power
Authors: Elliott Dave , Massey Dayne
Published: November 2019

There are many studies showing acute static stretching to be detrimental to power generation. However, the majority have focused upon the impact of stretching the agonist musculature. To date, few have examined the potential benefits of acute antagonist static stretching; none have focused on upper-body power. Utilising a repeated-measures design, 30 male participants were randomly assigned to one of two groups whereupon they performed four bench-throw tests; two control (NO-STRETCH) and two experimental (STRETCH), in a counter-balanced manner. Prior to the experimental measures, participants undertook a series of static antagonist stretches. Mean Pmax (SD) in the NO-STRETCH trials was 862.76 (146)W and 898.50 (144)W, respectively. For STRETCH trial 1, Pmax = 930.10 (146)W and trial 2, Pmax = 953.36 (136)W. When compared to the respective NO-STRETCH trials, antagonist static stretching did have a significant effect on Pmax for both the initial ( P < 0.01, d = 1.33) and the re-stretching procedures ( P < 0.01, d = 1.35). A significant difference was also found between the STRETCH trials ( P < 0.01, d = 0.46). The results have practical implications for those involved in upper-body power activities. Specifically, incorporating upper-body antagonist static stretching into pre-performance routines might offer a simple and effective means of enhancing agonist power.
New neighbours or a security threat? The role of local stories in anti-asylum seeker centre mobilization in the Netherlands
Authors: Segers Iris B
Published: November 2019

This article addresses the underexplored role of local storytelling in informing mobilization against asylum seeker centres in the Netherlands. In doing so, it summarizes the preliminary results of an in-depth qualitative study of an anti-asylum seeker centre protest movement in the neighbourhood Beverwaard in the city of Rotterdam. Based on 28 interviews with different stakeholders (citizens, local politicians, civil servants and social workers), a story-based thematic qualitative analysis inductively identified three important storylines (identity, voice and materiality) that played a key role in mobilization against the AZC in the local space. This article will discuss two concrete examples of how stories about voice and identity informed mobilization against a local asylum seeker centre based on grievances, as well as political opportunity structures. As such, this article expands currently dominant perspectives on anti-immigration mobilization that largely focus on broader macro factors such as radical right party politics and socio-economic deprivation by drawing attention to the ways in which bottom-up storytelling practices inform processes of anti-asylum seeker centre mobilization.
Clinical Efficacy and Safety of Omalizumab in the Treatment of Allergic Rhinitis: A Systematic Review and Meta-analysis of Randomized Clinical Trials
Authors: Yu Chenjie , Wang Kaijian , Cui Xinyan , Lu Ling , Dong Jianfei , Wang Maohua , Gao Xia
Published: November 2019

Background

Patients with moderate to severe allergic rhinitis (AR) who are treated according to the current rhinitis management guidelines may be inadequately controlled. These patients are at risk of serious comorbidities, such as asthma and chronic sinusitis. These symptoms, sneezing and an itchy, runny, stuffy nose, may have a negative impact on patients’ daily functioning. Omalizumab is being developed as a new choice for the treatment of AR. We therefore undertook a meta-analysis to assess the efficacy and safety of omalizumab in the treatment of AR.

Methods

We systematically searched PubMed, Cochrane Library, and MEDLINE databases for randomized controlled studies on the treatment of AR with omalizumab. Our evaluation outcomes were symptom scores, medication efficacy, combined symptom and medication scores, and adverse events. We descriptively summarized and quantitatively synthesized original data to evaluate the efficacy and safety of omalizumab in the treatment of AR by using Stata12.0 software for meta-analyses.

Results

The results of our meta-analysis showed that there were statistically significant differences between the omalizumab group and the control group in the following aspects: daily nasal symptom score (standardized mean difference [SMD] = –0.443, 95% confidence interval [CI]: –0.538 to –0.347, P < .001); daily ocular symptom score (SMD = –0.385, 95% CI: –0.5 to –0.269, P < .001); daily nasal medication symptom scores (SMD = –0.421, 95% CI: –0.591 to –0.251, P < .001); proportion of days of emergency drug use (risk ratio [RR] = 0.488, 95% CI: 0.307 to 0.788, P < .005); rhinoconjunctivitis-specific quality of life questionnaire (SMD = –0.286, 95% CI: –0.418 to –0.154, P < .001); and overall evaluation (RR = 1.435, 95% CI: 1.303–1.582, P < .001). There was no statistically significant difference in safety indicator: adverse events (RR = 1.026, 95% CI: 0.916–1.150, P = .655).

Conclusion

Omalizumab is effective and relatively safe in patients with AR; omalizumab used in conjunction with special immunotherapy has shown promising results, especially in reducing adverse events.
Allogeneic transplant for FLT3-ITD mutated AML: a focus on FLT3 inhibitors before, during, and after transplant
Authors: Bazarbachi Abdul Hamid , Al Hamed Rama , Malard Florent , Mohty Mohamad , Bazarbachi Ali
Published: November 2019

FMS-like tyrosine kinase 3 ( FLT3) mutations are one of the most frequently encountered genetic alterations in acute myeloid leukemia (AML), and are generally associated with unfavorable outcomes. Several tools are currently available to provide an accurate prognosis for patients with these mutations, including FLT3 mutation type (internal tandem duplication versus tyrosine kinase domain), mutation allelic ratio (high versus low), and concurrent nucleophosmin-1 ( NPM1) mutation, to help decide on optimal treatment. Recent advances in targeted therapies have paved the way for modern treatment strategies, such as the development of FLT3 kinase inhibitors. These novel drugs can be incorporated into any treatment component, including induction and consolidation, the relapse/refractory setting, bridging for transplant, salvage post-transplant, and as prophylactic long-term post-transplant maintenance. Many challenges remain though, such as their intolerability with high-dose chemotherapy in frail patients; whether their optimal use involves watchful waiting for molecular or hematologic relapse compared with prophylactic use as maintenance; and the exact role and indication for allogeneic stem cell transplantation, which arguably remains the only curative option for these high-risk patients.
Investigation of persuasive system design predictors of competitive behavior in fitness application: A mixed-method approach
Authors: Oyibo Kiemute , Vassileva Julita
Published: November 2019

Fitness applications aimed at behavior change are becoming increasingly popular due to the global prevalence of sedentary lifestyles and physical inactivity, causing countless non-communicable diseases. Competition is one of the most common persuasive strategies employed in such applications to motivate users to engage in physical activity in a social context. However, there is limited research on the persuasive system design predictors of users’ susceptibility to competition as a persuasive strategy for motivating behavior change in a social context. To bridge this gap, we designed storyboards illustrating four of the commonly employed persuasive strategies (reward, social learning, social comparison, and competition) in fitness applications and asked potential users to evaluate their perceived persuasiveness. The result of our path analysis showed that, overall, users’ susceptibilities to social comparison (βT = 0.48, p < 0.001), reward (βT = 0.42, p < 0.001), and social learning (βT = 0.29, p < 0.01) predicted their susceptibility to competition, with our model accounting for 41% of its variance. Social comparison partially mediated the relationship between reward and competition, while social learning partially mediated the relationship between social comparison and competition. Comparatively, the relationship between reward and social learning was stronger for females than for males, whereas the relationship between reward and competition was stronger for males than for females. Overall, our findings underscore the compatibility of all four persuasive strategies in a one-size-fits-all fitness application. We discuss our findings, drawing insight from the comments provided by participants.
A pilot study of diffusion tensor imaging metrics and cognitive performance pre and post repetitive, intentional sub-concussive heading in soccer practice
Authors: Kenny Rebecca A , Mayo Chantel D , Kennedy Samantha , Varga Aaron A , Stuart-Hill Lynneth , Garcia-Barrera Mauricio A , McQuarrie Amanda , Christie Brian R , Gawryluk Jodie R
Published: November 2019

Background

Although soccer players routinely head the ball in practice and games, recent research has suggested that cumulative effects of repetitive heading may cause sub-concussive injury with accompanying effects on brain and behavior. The current study aimed to prospectively investigate the effects of repetitive, intentional heading in soccer practice on brain structure and cognitive function, using a within-subjects design.

Methods

Participants included 10 soccer players (mean age 20.09 years ± 2.88) who were examined immediately pre- and post-heading practice. An accelerometer was used to measure the force of the impact during soccer heading. Magnetic resonance imaging data were acquired on a 3 T GE Scanner with diffusion tensor imaging. Diffusion tensor imaging analyses were completed using functional magnetic resonance imaging of the brain software library’s Tract-Based Spatial Statistics to examine changes in both fractional anisotropy and mean diffusivity due to heading the soccer ball. Behavioral measures were also completed pre- and post-soccer heading and included the Sport Concussion Assessment Tool and three short-computerized executive function tasks; R studio was used to compare behavioral data within subjects.

Results

Accelerometer data revealed that none of the heading impacts were >10 g. At this level of impact, there were no significant pre–post heading differences in either fractional anisotropy or mean diffusivity. Additionally, aside from minimal practice effects, there were no significant differences in Sport Concussion Assessment Tool scores and no significant differences in the performance of the three executive function tasks pre–post heading.

Conclusions

The results provide initial evidence that repetitive heading in soccer practice, at a g force of 10, does not cause changes in brain structure or executive function. Future research should investigate heading in the context of games and with a greater sample size that would allow for sex-based comparisons.
A Quasi-Experimental Study Examining the Impact and Challenges of Implementing a Fitness-Based Health Risk Assessment and a Physical Activity Counseling Intervention in the Workplace Setting
Authors: Hamm Naomi C. , Kehler D. Scott , Hay Jacqueline L. , Stammers Andrew N. , Strachan Shaelyn M. , Bouchard Danielle R. , Duhamel Todd A.
Published: November 2019

Objectives:

Few adults participate in enough physical activity for health benefits. The workplace provides a unique environment to deliver heath interventions and can be beneficial to the employee and the employer. The purpose of the study was to explore the use of a physical activity counseling (PAC) program and a fitness-based health risk assessment (fHRA) in the hospital workplace.

Methods:

A workplace-based intervention was developed utilizing a PAC program and an fHRA to improve physical activity levels of employees. Hospital employees were enrolled in a 4-month PAC program and given the option to also enroll in an fHRA program (PAC + fHRA). Physical activity was assessed by accelerometry and measured at baseline, 2 months, and 4 months. Changes in musculoskeletal fitness for those in the fHRA program were assessed at baseline and 2 months.

Results:

For both groups (PAC n = 22; PAC + fHRA n = 16), total and moderate to vigorous physical activity in bouts of 10 minutes or more increased significantly by 18.8 ( P = .004) and 10.2 ( P = .048) minutes per week at each data collection point, respectively. Only participants with gym memberships demonstrated increases in light physical activity over time. Those in the fHRA group significantly increased their overall musculoskeletal fitness levels from baseline levels (18.2 vs 21.7, P < .001). There was no difference in the change in physical activity levels between the groups.

Conclusions:

A PAC program in the workplace may increase physical activity levels within 4 months. The addition of an fHRA does not appear to further increase physical activity levels; however, it may improve overall employee musculoskeletal fitness levels.
A Review of CommunityWorks Canada®: Toward Employability Among High School–Age Youth With Autism Spectrum Disorder
Authors: Nicholas David B. , Mitchell Wendy , Zulla Rosslynn , Solomatin Evgeny , Qi Siwei
Published: November 2019

CommunityWorks Canada® is a 12-week (30-hour) program that provides social, communication, and job skill–building activities as well as peer mentorship to youth with autism spectrum disorder. Administration of a pre- and postprogram employment readiness measure (n = 76 participants) demonstrated positive changes as reflected by the participants’ decreased concerns about their responsibility, flexibility, job skills, communication, self-view, and health and safety. Postprogram qualitative interviews and survey data collected from a range of program stakeholders (participants, parents, peer mentors, and community partners/employers) corroborated identified gains in personal development, employment exposure, work proficiency, and comfort in work settings. For community partners/employers and peer mentors, greater understanding about autism spectrum disorder and commitment to inclusive hiring reportedly resulted from program engagement. Implications and recommendations are offered.
Book review: Jatin Bala, Trans., Stories of Social Awakening: Reflections of Dalit Refugee Lives of Bengal
Authors: Dattaray Debashree
Published: November 2019

Jatin Bala, Trans., Stories of Social Awakening: Reflections of Dalit Refugee Lives of Bengal. New Delhi: Authorspress, 2017, ₹350, 183 pp. ISBN: 9789352075430.
Does ophthalmic-grade silicone oil possess antimicrobial properties?
Authors: Dave Vivek Pravin , Joseph Joveeta , Jayabhasker Priyanka , Pappuru Rajeev Reddy , Pathengay Avinash , Das Taraprasad
Published: November 2019

Purpose

To test the antimicrobial properties of silicon oil (Aurosil 1000 cSt, Aurosil Plus 5000 cSt) on in vitro growth of common microorganisms causing endophthalmitis.

Materials and methods

Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa, multi-drug resistant (MDR) strain of Klebsiella pneumoniae, Escherichia coli, Candida albicans, and Aspergillus flavus were prepared to 0.5 McFarland turbidity. The bacteria and fungi were inoculated into the silicone oils, brain heart infusion (BHI) broth for bacteria and Sabouraud dextrose agar (SDA) broth for fungi, respectively, and cultured aerobically for 30 days. From each sample, 10 μl was plated onto nutrient agar and potato dextrose agar (PDA) for testing growth of bacteria and fungi respectively. Cultures from specimens, overnight incubation, and CFU counting were repeated on days 1, 3, 5, 7, 14, 21, 24, and 30. Negative controls were brain heart infusion and physiologic saline as well as silicone oils without any inoculations.

Results

All bacteria showed a decrease in CFUs by the fifth day and eliminated between 21 and 30 days in silicone oil. The silicon oil, irrespective of its viscosity, had only fungistatic effect up to 30 days. Colony-forming units of microorganisms remained stable in physiologic saline during the study. In BHI and Sabouraud broth, both bacteria and fungi showed a growth pattern that was compatible with the growth curve of microorganisms.

Conclusion

Medical-grade silicone oil used in ophthalmology exhibited in vitro bactericidal and fungistatic activity over 30 days. Insertion of silicone oil in vitrectomy for endophthalmitis, when required, could supplement the antimicrobial activities of intravitreal antibiotics in management of endophthalmitis.
E-learning as valuable caregivers’ support for people with dementia – A systematic review
Authors: Klimova Blanka , Valis Martin , Kuca Kamil , Masopust Jiri
Published: November 2019

Background

Present demographic trends show a considerable rise in elderly populations with aging disorders, such as dementia. The current article focused on the exploitation of e-learning as an informal support for caregivers of people with dementia and considered its benefits and limitations to provide proper and relevant care for this target group of people as well as maintain the quality of life of their caregivers.

Methods

The methodology of this study is based on a literature review of accessible peer-review articles from three recognized databases: Web of Science, Scopus, and PubMed. The findings of the selected studies were compared and evaluated.

Results

The findings showed that e-learning educational programs/courses helped caregivers feel more confident about dementia care, reduced their perceived stress and enhanced their feelings of empathy, understanding and concern.

Conclusions

The findings of this study reveal that the exploitation of e-learning as a support tool, especially for informal caregivers, in the management of dementia may be a promising method, but its implementation requires professional training of informal caregivers in the use of this technology. More evidence-based studies are needed on this topic.
Optimising the performance of frontline implementers engaged in the NTD programme in Nigeria: lessons for strengthening community health systems for universal health coverage
Authors: Oluwole Akinola , Dean Laura , Lar Luret , Salami Kabiru , Okoko Okefu , Isiyaku Sunday , Dixon Ruth , Elhassan Elizabeth , Schmidt Elena , Thomson Rachael , Theobald Sally , Ozano Kim
Published: November 2019

Background

The control and elimination of Neglected Tropical Diseases (NTDs) is dependent on mass administration of medicines (MAM) in communities and schools by community drug distributers (CDDs) who are supported and supervised by health facility staff (FLHF) and teachers. Understanding how to motivate, retain and optimise their performance is essential to ensure communities accept medicines. This study aimed to capture and translate knowledge, problems and solutions, identified by implementers, to enhance NTD programme delivery at the community level in Nigeria.

Methods

Qualitative data was collected through participatory stakeholder workshops organised around two themes: (i) identification of problems and (ii) finding solutions. Eighteen problem-focused workshops and 20 solution-focussed workshops were held with FLHF, CDDs and teachers in 12 purposively selected local government areas (LGA) across two states in Nigeria, Ogun and Kaduna States.

Result

The problems and solutions identified by frontline implementers were organised into three broad themes: technical support, social support and incentives. Areas identified for technical support included training, supervision, human resource management and workload, equipment and resources and timing of MAM implementation. Social support needs were for more equitable drug distributor selection processes, effective community sensitisation mechanisms and being associated with the health system. Incentives identified were both non-financial and financial including receiving positive community feedback and recognition and monetary remuneration. The results led to the development of the ‘NTD frontline implementer’s framework’ which was adapted from the Community Health Worker (CHW) Generic Logic Model by Naimoli et al. (Hum Resour Health 12:56, 2014).

Conclusion

Maximising performance of frontline implementers is key to successful attainment of NTD goals and other health interventions. As NTDs are viewed as a ‘litmus test’ for universal health coverage, the lessons shared here could cut across programmes aiming to achieve equitable coverage. It is critical to strengthen the collaboration between health systems and communities so that together they can jointly provide the necessary support for frontline implementers to deliver health for all. This research presents additional evidence that involving frontline implementers in the planning and implementation of health interventions through regular feedback before, during and after implementation has the potential to strengthen health outcomes.
Community-based maternal and child health project on 4+ antenatal care in the Democratic Republic of Congo: a difference-in-differences analysis
Authors: Lee Hocheol , Park Sung Jong , Ndombi Grace O. , Nam Eun Woo
Published: November 2019

Background

Despite efforts to achieve the Millennium Development Goals, the maternal mortality ratio in the Democratic Republic of Congo was 693 per 100,000 in 2015—the 6th highest in the world and higher than the average (547 per 100,000) in sub-Saharan Africa. Antenatal care (ANC) service is a cost-effective intervention for reducing the maternal mortality ratio in low-income countries. This study aimed to identify the intervention effect of the maternal and child health care (MCH) project on the use of four or more (4+) ANC services.

Methods

The MCH project was implemented using the three delays model in Kenge city by the Ministry of Public Health (MoPH) of the DRC with technical assistance from Korea International Cooperation Agency (KOICA) and the Yonsei Global Health Center from 2014 to 2017. Furthermore, Boko city was selected as the control group. A baseline and an endline survey were conducted in order to evaluate the effectiveness of this project. We interviewed 602 and 719 participants in Kenge, and 150 and 614 participants in Boko in the baseline and endline surveys, respectively. We interviewed married reproductive-aged women (19–45 years old) in both cities annually. The study instruments were developed based on the UNICEF Multiple Indicator Cluster Surveys. This study used the homogeneity test and the binary logistic regression difference-in-differences method of analysis.

Results

The odds of reproductive-aged women’s 4+ ANC service utilization at the intervention site increased 2.280 times from the baseline (OR: 2.280, 95% CI: 1.332–3.902,p = .003) as compared to the control site.

Conclusions

This study showed that the KOICA MCH project effectively increased the 4+ANC utilization by reproductive-aged women in Kenge. As the 4+ ANC services are expected to reduce maternal deaths, this project might have contributed to reducing maternal mortality in Kenge. In the future, we expect these findings to inform MCH policies of the MoPH in the DRC.
Individual variation of the masticatory system dominates 3D skull shape in the herbivory-adapted marsupial wombats
Authors: Weisbecker Vera , Guillerme Thomas , Speck Cruise , Sherratt Emma , Abraha Hyab Mehari , Sharp Alana C. , Terhune Claire E. , Collins Simon , Johnston Stephen , Panagiotopoulou Olga
Published: November 2019

Background

Within-species skull shape variation of marsupial mammals is widely considered low and strongly size-dependent (allometric), possibly due to developmental constraints arising from the altricial birth of marsupials. However, species whose skulls are impacted by strong muscular stresses – particularly those produced through mastication of tough food items – may not display such intrinsic patterns very clearly because of the known plastic response of bone to muscle activity of the individual. In such cases, allometry may not dominate within-species shape variation, even if it is a driver of evolutionary shape divergence; ordination of shape in a geometric morphometric context through principal component analysis (PCA) should reveal main variation in areas under masticatory stress (incisor region/zygomatic arches/mandibular ramus); but this main variation should emerge from high individual variability and thus have low eigenvalues.

Results

We assessed the evidence for high individual variation through 3D geometric morphometric shape analysis of crania and mandibles of three species of grazing-specialized wombats, whose diet of tough grasses puts considerable strain on their masticatory system. As expected, we found little allometry and low Principal Component 1 (PC1) eigenvalues within crania and mandibles of all three species. Also as expected, the main variation was in the muzzle, zygomatic arches, and masticatory muscle attachments of the mandibular ramus. We then implemented a new test to ask if the landmark variation reflected on PC1 was reflected in individuals with opposite PC1 scores and with opposite shapes in Procrustes space. This showed that correspondence between individual and ordinated shape variation was limited, indicating high levels of individual variability in the masticatory apparatus.

Discussion

Our results are inconsistent with hypotheses that skull shape variation within marsupial species reflects a constraint pattern. Rather, they support suggestions that individual plasticity can be an important determinant of within-species shape variation in marsupials (and possibly other mammals) with high masticatory stresses, making it difficult to understand the degree to which intrinsic constraints act on shape variation at the within-species level. We conclude that studies that link micro- and macroevolutionary patterns of shape variation might benefit from a focus on species with low-impact mastication, such as carnivorous or frugivorous species.