bluuebunny/crossref_metadata_2025 huggingface dataset:
Glomangioma of Uncertain Malignant Potential: A Case Report
Authors: McCullough Meghan , Balzer Bonnie , Kuschner Stuart H.
Published: January 2020

Glomus tumors are rare benign tumors which commonly affect the hand but are seldom seen extradigitally. Less commonly seen is the glomangioma, a variant of benign glomus tumor, and even rarer is the glomangiosarcoma, a malignant variant. Determining malignancy can be difficult and an intermediate diagnosis, glomus tumor of uncertain malignant potential, has been proposed. We present a case of a 56-year-old male with a recurrent forearm mass diagnosed as a glomangioma of uncertain malignant potential. Although the characteristics and behavior of malignant cases are still incompletely understood, it is important that a high index of suspicion be maintained when approaching these tumors, especially when large or recurrent. Glomangiomas should be included in the differential diagnosis when evaluating soft tissue masses in the forearm and should be evaluated for malignant features.
Association between Dietary Vitamin A and HPV Infection in American Women: Data from NHANES 2003–2016
Authors: Huang Xian , Chen Chi , Zhu Fangfang , Zhang Yingxuan , Feng Qiuting , Li Jingwei , Yu Qingying , Zhong Yanlan , Luo Songping , Gao Jie
Published: January 2020

Objective. Evidence regarding the relationship between vitamin A and HPV infection was limited. Therefore, this study is designed to investigate whether vitamin A was independently related to HPV infection in 13412 American women from NHANES for seven cycles. Methods. The present study is a cross‐sectional study. A total of 13412 eligible participants who had available HPV tests and vitamin A intake data were registered in the NHANE database from 2003 to 2016. The targeted independent variable and the dependent variable were vitamin A measured at baseline and HPV infection, respectively. We analyzed the association between dietary vitamin A intake and the prevalence of HPV infection. Besides, GAM and smooth curve fittings were used to address the nonlinear relationship between vitamin A and HPV infection to determine the effect of HPV infection. Results. The result of fully adjusted binary logistic regression showed vitamin A was not associated with the risk of HPV infection after adjusting confounders (odds ratio = 0.97, 95% confidence interval: 0.97–1.02). A nonlinear relationship was detected between vitamin A and HPV infection, whose inflection point was 10.5 of log2 vitamin A (by the recursive algorithm). One unit increase of log2 vitamin A is associated with the 10% reduced risk of HPV infection when dietary vitamin A is < 1448.155mcg. Conversely, when the dietary vitamin A intake is ≧1448.155 mcg, for each additional log2 of vitamin A, the risk of HPV infection increased by 70%. Conclusions. We found that dietary vitamin A was quite different from the trend of HPV infection in different confidence intervals. The results suggested that an appropriate amount (95% CI: 0.9–1.0, <10.5 of log2 transformer, i.e., 1448.155 mcg) of dietary vitamin A may be beneficial to prevent HPV infection. However, excessive intake of dietary vitamin A (95% CI: 1.1–2.8, ≧10.5 of log2 transformer, i.e., 1448.155 mcg) may increase the risk of HPV infection.
Secure Communication Scheme Based on a New 5D Multistable Four-Wing Memristive Hyperchaotic System with Disturbance Inputs
Authors: Yu Fei , Zhang Zinan , Liu Li , Shen Hui , Huang Yuanyuan , Shi Changqiong , Cai Shuo , Song Yun , Du Sichun , Xu Quan
Published: January 2020

By introducing a flux-controlled memristor model with absolute value function, a 5D multistable four-wing memristive hyperchaotic system (FWMHS) with linear equilibrium points is proposed in this paper. The dynamic characteristics of the system are studied in terms of equilibrium point, perpetual point, bifurcation diagram, Lyapunov exponential spectrum, phase portraits, and spectral entropy. This system is of the group of systems that have coexisting attractors. In addition, the circuit implementation scheme is also proposed. Then, a secure communication scheme based on the proposed 5D multistable FWMHS with disturbance inputs is designed. Based on parametric modulation theory and Lyapunov stability theory, synchronization and secure communication between the transmitter and receiver are realized and two message signals are recovered by a convenient robust high-order sliding mode adaptive controller. Through the proposed adaptive controller, the unknown parameters can be identified accurately, the gain of the receiver system can be adjusted continuously, and the disturbance inputs of the transmitter and receiver can be suppressed effectively. Thereafter, the convergence of the proposed scheme is proven by means of an appropriate Lyapunov functional and the effectiveness of the theoretical results is testified via numerical simulations.
Glycemic Index, Starch, and Protein Digestibility in Tempeh Gembus Cookies
Authors: Manullang Valentina A. , Rahadiyanti Ayu , Pratiwi Syafira N. , Afifah Diana N.
Published: January 2020

Diabetes mellitus is directly related to diet and lifestyle. Control of blood glucose levels is needed to reduce the risk of complications, and one way is to choose foods with a low glycemic index. Cookies made from tempeh gembus/tempeh gembus flour are expected to be eaten as a snack and are safe for people with diabetes. The aim of this research was to analyze glycemic index (GI), glycemic load (GL), dietary fiber, in vitro starch, and protein digestibility of cookies with tempeh gembus flour substitution. Completely randomized design research with one primary factor used cookies with variations of 0%, 25%, and 50% tempeh gembus flour substitution. GI was calculated using the Incremental Area Under the Blood Glucose Response Curve (IAUC) method. Dietary fiber concentration analysis was done by enzymatic methods. The starch and protein digestion rates were calculated using the in vitro method. GI, GL, dietary fiber, starch digestion rate, and protein digestion rate data were analyzed with descriptive methods. Cookies with lowest GI (47.01 ± 11.08%) and GL (6.90 ± 1.63) were found in cookies with 50% tempeh gembus flour substitution. The highest dietary fiber content (24.61 ± 0.41%), digestibility of starch (48.07 ± 0.01%), and protein (20.27 ± 0.43%) cookies were found in cookies with 50% tempeh gembus flour substitution. The higher tempeh gembus flour substitution produced low GI and GL while its dietary fiber, in vitro starch, and protein digestibility were highest.
Erratic Behavioral Attitude Leads to Noncommunicable Diseases: A Cross‐Sectional Study
Authors: Habib Arif , Alam Mohammad Mahtab , Hussain Izhar , Nasir Nazim , Almuthebi Musa
Published: January 2020

Background. The burden of noncommunicable diseases (NCDs) in the Arab world has reached an alarming level. Behavioral risk factors including consumption of fast food, inadequate sleep, and skipping meals are pervasive. This study aims at establishing the association between NCDs and modernized behavioral risk factors among populations. Methods. A cross‐sectional study was carried out with 1070 respondents who were 18 years old. The data were collected using a structured questionnaire with the help of the WHO STEPS approach with some modifications regarding NCD risk factors. Results. 30% of respondents had cardiovascular diseases (CVD) followed by respiratory diseases (23%) and diabetes (3%) while the habit of smoking was found among 52% of respondents followed by physical inactivity (49%), skipping meals (24%), and inadequate sleep (30%). Consumption of fast food was found to be a significant risk factor for obesity (odds ratio (OR) = 2.72, 95% confidence interval (CI) [1.50, 4.92]), CVD (OR = 1.52, 95% CI [1.20, 1.94]), and respiratory disease (OR = 2.13, 95% CI [1.58, 2.86]). Significant linkages were found between CVD and smoking (OR = 0.69, 95% CI [0.54, 0.88]), diet pattern (OR = 1.86, 95% CI [1.44, 2.39]), fast food (OR = 1.52, 95% CI [1.20, 1.94]), and sleep hours (OR = 0.57, 95% CI [0.42, 0.79]). Conclusions. Undesirable behavioral risk factors pose a considerable threat to public health with a high prevalence rate of NCDs. Reducing the NCD burden and promoting healthy lifestyle formation of suitable strategies and their smooth implementation is the need of the hour.
Online State of Charge Estimation of Lithium-Ion Cells Using Particle Filter-Based Hybrid Filtering Approach
Authors: Zhang Ming , Wang Kai , Zhou Yan-ting
Published: January 2020

Filtering based state of charge (SOC) estimation with an equivalent circuit model is commonly extended to Lithium-ion (Li-ion) batteries for electric vehicle (EV) or similar energy storage applications. During the last several decades, different implementations of online parameter identification such as Kalman filters have been presented in literature. However, if the system is a moving EV during rapid acceleration or regenerative braking or when using heating or air conditioning, most of the existing works suffer from poor prediction of state and state estimation error covariance, leading to the problem of accuracy degeneracy of the algorithm. On this account, this paper presents a particle filter-based hybrid filtering method particularly for SOC estimation of Li-ion cells in EVs. A sampling importance resampling particle filter is used in combination with a standard Kalman filter and an unscented Kalman filter as a proposal distribution for the particle filter to be made much faster and more accurate. Test results show that the error on the state estimate is less than 0.8% despite additive current measurement noise with 0.05 A deviation.
The Key Role of VEGF in the Cross Talk between Pterygium and Dry Eye and Its Clinical Significance
Authors: Liu Chang , Song Yiyue , Wang Xiaoran , Lai Zhaoguang , Li Chaoyang , Wan Pengxia , Xu Nuo , Huang Danping , Liu Yizhi , Wang Zhichong
Published: January 2020

Purpose: To examine whether dry eye severity is a risk factor for pterygium activity and whether vascular endothelial growth factor (VEGF) is crucial in the cross talk between pterygium and dry eye. Methods: A total of 103 patients with primary pterygium (Pteg) were included in the study group; they were divided into 2 groups according to the complication of dry eye (DE) (Pteg + DE group, Pteg – DE group). Further, 60 patients with just dry eye (DE group) and 60 normal individuals (normal) were included as 2 control groups. DE severity and pterygium activity were measured, and unstimulated tear samples and pterygium tissues were collected for cytokine detection. Results: (1) Tear detection: VEGF expression increased in the Pteg + DE group compared to the Pteg – DE, DE, and normal control groups; VEGF was especially increased in the active Pteg + DE group. VEGF concentration was positively correlated with pterygium activity. (2) Tissue detection: the mRNA expression of VEGF was upregulated in the active pterygium group. Conclusions: Inflammation played an important role in the development of dry eye and pterygium. VEGF was the core molecule in the cross talk, which might explain the high incidence of the coexistence of these 2 diseases.
Oct-4 Enhanced the Therapeutic Effects of Mesenchymal Stem Cell-Derived Extracellular Vesicles in Acute Kidney Injury
Authors: Zhang Zhi-Yuan  , Hou Yan-Ping , Zou Xiang-Yu , Xing Xiao-Yu , Ju Guan-Qun , Zhong Liang , Sun Jie
Published: January 2020

Background/Aims: Acute kidney injury (AKI) is a common clinical condition that can lead to chronic kidney failure. Although mesenchymal stem cell-derived extracellular vesicles (MSC EVs) are regarded as a potent AKI treatment, the mechanisms underlying their beneficial effects remain unclear. Oct-4 may play an important role in tissue injury repair. We thus hypothesized that oct-4 overexpression might enhance the therapeutic effects of MSC EVs in AKI treatment. Methods: Renal tubular epithelial cells were cultured in a low oxygen environment, then cocultured with MSC EVs or control medium for 48 h. BrdU and transferase-mediated dUTP nick-end labeling (TUNEL) staining were used to assess cell proliferation and apoptosis. Mice subjected to ischemia reperfusion were randomly divided into 4 groups, then injected with either phosphate-buffered saline (vehicle), EVs, EVs overexpressing oct-4 (EVs+Oct-4), and EVs not expressing Oct-4 (EVs–Oct-4). Blood creatinine (CREA) and urine nitrone levels were assessed 48 h and 2 weeks after injection. After ischemia reperfusion, renal tissues from each group were stained with TUNEL and proliferating cell nuclear antigen (PCNA) to determine the degree of apoptosis and proliferation. Masson trichrome staining was used to evaluate renal fibrosis progression. Snail gene expression was assessed using polymerase chain reaction (PCR). Results: At 48 h after hypoxic treatment, TUNEL and BrdU staining indicated that the EVs+Oct-4 group had the least apoptosis and the most proliferation, respectively. Treatment with EVs overexpressing Oct-4 significantly decreased serum Crea and blood urea nitrogen levels and rescued kidney fibrosis, as indicated by the low proportion of Masson staining, high number of PCNA-positive cells, and low number of TUNEL-positive cells. PCR analysis indicated that Snail was most upregulated in the vehicle group and least upregulated in the EVs+Oct-4 group. Conclusions: MSC EVs had a pronounced therapeutic effect on ischemic reperfusion injury-related AKI, and Oct-4 overexpression enhanced these therapeutic effects. Our results may inspire a new direction for AKI treatment with MSC EVs.
Long-Term Efficacy of Deep Brain Stimulation of Bilateral Globus Pallidus Internus in Primary Meige Syndrome
Authors: Tian Hong , Yu Yanbing , Zhen Xueke , Zhang Li , Yuan Yue , Zhang Bo , Wang Liang
Published: January 2020

Objective: Deep brain stimulation (DBS) of the internal segment of the globus pallidus (GPi) is an alternative therapy in ameliorating the clinical symptoms of primary Meige syndrome. Nevertheless, proof of its efficacy and safety is insufficient due to several case reports and small-sample clinical studies. This study aims to investigate postoperative long-term efficacy in patients undergoing DBS of the GPi for primary Meige syndrome. Methods: We performed a retrospective study to assess the efficacy and safety of bilateral GPi stimulation in 40 patients with primary Meige syndrome who responded poorly to medical treatments or botulinum toxin injections. All participants were postoperatively followed up at the outpatient clinic, and their motor functions were assessed using the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS). The severity of patients’ dystonia was evaluated before surgery and at follow-up neurostimu­lation. Results: The implanted stimulator was turned on 1 month after surgery. All 40 patients received monopolar stimulation using the following parameters: voltage 2.5–3.5 V (average: 2.6 ± 0.8 V), frequency 60–160 Hz (average: 88.0 ± 21.3 Hz), and pulse width 60–185 μS (average: 90.0 ± 21.1 μS). In 28 of 40 patients, the symptoms had signifi­cantly improved within 1 week of stimulation. Most of the patients had been followed up for 6–24 months (average: 15.0 ± 7.8 months). The clinical symptoms of all patients had significantly improved. At 6, 12, and 24 months after surgery, the BFMDRS subscores of eyes, mouth, speech, and swallowing were significantly lower, and subscores of mouth movement showed progressively decreased with prolonged stimulation time. The overall improvement rate was 83%. Five adverse events occurred in the 40 patients; all of these events resolved without permanent sequelae. Conclusions: Bilateral GPi-DBS demonstrated satisfactory long-term efficacy in the treatment of primary Meige syndrome and could serve as an effective and safe option.
Portuguese Consensus on Diagnosis, Treatment, and Management of Anemia in Pediatric Inflammatory Bowel Disease
Authors: Lopes Ana Isabel , Azevedo Sara , Cabral José , Ferreira Maria Gomes , Sande-Lemos Piedade , Ferreira Ricardo , Trindade Eunice , Lima Rosa , Antunes Henedina ,   on behalf of the Portuguese Society of Pediatric Gastroenterology, Hepatology and Nutrition (SPGP) – Anemia-IBD Working Group
Published: January 2020

Anemia is a common extraintestinal manifestation of inflammatory bowel disease (IBD), both in pediatric and in adult patients. Iron deficiency is the main cause of anemia in patients with IBD. Anemia is a clinically relevant comorbidity, with impact on patients’ quality of life and it should be timely diagnosed and adequately treated. Currently, an active treatment approach is the recommended strategy, with evidence showing efficacy and safety of intravenous iron formulations. However, evidence in pediatric age remains scarce and no clinical recommendations exist for the diagnosis and treatment of this particular age group. The present document represents the first national consensus on the management of anemia in pediatric IBD and is therefore particularly relevant. The authors anticipate that the proposed recommendations will be useful in daily clinical practice for diagnosing and managing iron deficiency and iron-deficiency anemia in the pediatric population with IBD.
Single-Injection Ultrasound-Guided Thoracic Paravertebral Block versus Local Anesthetic Infiltration in Peritoneal Dialysis Catheter Surgeries: A Randomized Controlled Trial
Authors: Zhang Hai-yan , Jiang Xiao-juan , Li Qi , Tang Xiao-hong , Zhu Tao
Published: January 2020

Introduction: Ultrasound-guided thoracic paravertebral block (US-TPVB) is generally used for postoperative analgesia. We hypothesized that single-injection US-TPVB could be used as the principal anesthetic technique for a peritoneal dialysis catheter (PDC) procedure (implantation or removal). The anesthetic effect and venous ropivacaine level after a TPVB would be compared with that after local anesthetic infiltration (LAI). Methods: Patients undergoing PDC procedures were randomized into Group LAI or TPVB. In Group LAI, 40 mL of 0.25% ropivacaine were used. In Group TPVB, single-injection of US-TPVB at T10–T11 level was performed with 20 mL of 0.25% ropivacaine. The quality of anesthesia, visual analogue scale of pain, and venous total plasma ropivacaine level were compared between the 2 groups. Results: Seventy-four eligible patients were enrolled and 38 in Group TPVB. Thirty patients in Group TPVB and 26 patients in Group LAI underwent PDC procedures successfully. Higher satisfaction rates by nephrologists and patients (76.3 and 78.9%) were reported in Group TPVB (44.4 and 44.4% in Group LAI, respectively). The peak venous total plasma ropivacaine concentrations were below the reported toxic threshold in the 2 groups. Conclusions: A single-injection US-TPVB with 20 mL of 0.25% ropivacaine at T10–T11 could be the principal anesthetic technique for PDC procedures, which provided a comparable anesthetic effect to that of LAI with 40 mL ropivacaine. Higher satisfaction rates by nephrologists and patients were observed in Group TPVB. The 20 mL dose of 0.25% ropivacaine used for an US-TPVB was safe in end-stage renal diseases patients.
Hospital Utilization and Costs in Older Patients with Advanced Chronic Kidney Disease Choosing Conservative Care or Dialysis: A Retrospective Cohort Study
Authors: Verberne Wouter R. , Ocak Gurbey , van Gils-Verrij Liesbeth A. , van Delden Johannes J.M. , Bos Willem Jan W.
Published: January 2020

Background: Nondialytic conservative care has been recognized as a viable alternative to chronic dialysis in older patients with end-stage kidney disease, but little is known about its consequences on hospital utilization and costs. Methods: We performed a retrospective cohort study to compare outpatient and inpatient hospital utilization, place of death, and hospital costs in patients aged ≥70 years old who chose conservative care (n = 100) or dialysis (n = 162) after shared decision making in a nonacademic teaching hospital between 2008 and 2016. Results: Patients who chose conservative care were older than patients who chose dialysis (82.5 vs. 76.3 years). Comorbidity did not differ between the 2 patient groups. The incidence rates of outpatient visits per year were 7.1 in patients who chose conservative care and 10.7 in patients who chose dialysis (incidence rate ratio 0.67, 95% CI 0.55–0.81). The incidence rates of in-hospital days per year were, respectively, 6.0 and 9.8 (incidence rate ratio 0.50, 95% CI 0.29–0.88). Also in the final month of life, patients on conservative care had less outpatient visits, were less frequently hospitalized, and died less frequently in hospital than the dialysis patient group. The cost rates per year, measured from original treatment decision, were EUR 5,859 in conservative care patients and EUR 28,354 in patients who chose dialysis comprising both the predialysis and dialysis period (cost rate ratio 0.42, 95% CI 0.27–0.65). Patients who chose dialysis had higher costs on dialysis sessions, outpatient care, inpatient care, laboratory tests, and medical imaging. Conclusions: Patients who decided to forego dialysis and chose conservative care had less outpatient and inpatient hospital utilization than patients who chose dialysis, including less intensive hospital utilization near the end of life. Both overall and nondialysis-related costs were lower in patients on a conservative care pathway.
Adolescentes e o livro
Authors: Machiavelli Marina , Brignol Liliane Dutra
Published: January 2020

Este artigo analisa usos e apropriações do livro por adolescentes, de modo a entender os impactos dos suportes digitais nas formas de leitura. Para tanto, reflete a partir da perspectiva das mediações de Martín-Barbero, especificamente no que se refere à tecnicidade. Com base na discussão teórica e em pesquisa empírica (com destaque para a análise de entrevistas), é possível compreender hábitos e preferências de adolescentes leitores, de modo a identificar novos usos que se concretizam na trama entre o livro e a internet. Mantém-se a importância do livro enquanto produto cultural e simbólico para os adolescentes pesquisados, em práticas que transitam entre o impresso, o on-line e as diferentes telas, combinando leitura silenciosa, íntima e compartilhada, expandindo as narrativas ao dividir recomendações e produzir novos conteúdos associados ao livro em redes sociais digitais.
Saint Genet ou “l’enfer, c’est les Adultes”: algumas considerações
Authors: Fujiwara Gustavo
Published: January 2020

Este artigo pretende elucidar alguns aspectos da biografia existencial de Sartre sobre o poeta e romancista Jean Genet. Elucidando a estrutura (dialética) da obra, veremos que a presente biografia faz emergir o sentido e o peso do social nas análises sartreanas acerca da liberdade.
Why Wittgenstein Doesn’t Refute Skepticism
Authors: Krempel Raquel Albieri
Published: January 2020

In On Certainty, Wittgenstein formulates several criticisms against skepticism about our knowledge of the external world. My goal is to show that Wittgenstein does not here offer a convincing answer to the skeptical problem. First, I will present a strong version of the problem, understanding it as a paradoxical argument. In the second part, I will introduce and raise problems for two pragmatic responses against skepticism that appear in On Certainty. Finally, I will present some of Wittgenstein’s logical criticisms against skepticism, which may initially be considered strong, because they seem to refute some skeptical assumptions. They concern Wittgenstein’s ideas that it is logically impossible to doubt and to be mistaken about Moorean propositions, and that these propositions don’t have a truth-value. But even these, I intend to show, do not really challenge skepticism, for they are not well grounded.
A morte do poeta: Benjamin leitor de Hölderlin
Authors: Vaccari Ulisses Razzante
Published: January 2020

O artigo, num primeiro momento, busca contextualizar as condições de surgimento do ensaio Dois poemas de Friedrich Hölderlin, de Benjamin, recorrendo a alguns fatos históricos, como a morte de seu amigo Fritz Heinle e Nobert von Hellingrath. Ligadas ao estopim da Primeira Guerra Mundial, tais mortes representam para Benjamin a morte de toda uma geração de jovens, na qual ele havia depositado toda a esperança de renascimento da cultura alemã. A leitura que faz de Hölderlin, nesse sentido, tem um fim político, ao procurar combater uma interpretação esteticizante de seus poemas, influenciada pelo círculo de Stefan George. Num segundo momento, o artigo aprofunda a leitura do ensaio de Benjamin sobre Hölderlin, buscando definir o conceito de “poetificado” como conceito central de sua crítica de arte, evidenciando em que medida esse conceito lhe serve como contraposição às leituras provenientes do círculo de George, entre elas, a do próprio Hellingrath.
Risk of Osteoporosis in Patients With Atrial Fibrillation Using Non–Vitamin K Antagonist Oral Anticoagulants or Warfarin
Authors: Huang Huei‐Kai , Liu Peter Pin‐Sung , Hsu Jin‐Yi , Lin Shu‐Man , Peng Carol Chiung‐Hui , Wang Jen‐Hung , Yeh Jih‐I , Loh Ching‐Hui
Published: January 2020

Background

Warfarin, a vitamin K antagonist, has been shown to affect bone mineral density and cause osteoporosis. However, studies investigating the relationship between non–vitamin K antagonist oral anticoagulants (
NOAC
s) and osteoporosis are limited. We thus compared the risk of osteoporosis in patients with atrial fibrillation treated with either
NOAC
s or warfarin.

Methods and Results

This nationwide, retrospective cohort study used Taiwan's National Health Insurance Research Database. All adult patients in Taiwan who were newly diagnosed with atrial fibrillation and treated with
NOAC
s or warfarin between January 2012 and December 2015 were included and classified into their respective cohorts. Patients who received
NOAC
s were subcategorized into the rivaroxaban, dabigatran, and apixaban subgroups. Propensity score matching was performed for each head‐to‐head comparison. Adjusted hazard ratios (
aHR
s) for the risk of osteoporosis were calculated using Cox proportional hazards regression models, with adjustment for confounders. Overall, 17 008 patients were included, with 8504 in each cohort.
NOAC
s were associated with a lower osteoporosis risk than warfarin (
aHR
=0.82; 95% CI=0.68–0.97). A subgroup effect of treatment duration was identified (namely, the lower osteoporosis risk with
NOAC
compared with warfarin became stronger in those with longer treatment duration [
P
for interaction <0.001]). Furthermore, significantly lower risks of osteoporosis were observed in the rivaroxaban (
aHR
=0.68; 95%
CI
=0.55–0.83) and apixaban (
aHR
=0.38; 95%
CI
=0.22–0.66) subgroups, but not in the dabigatran subgroup (
aHR
=1.04; 95%
CI
=0.85–1.27).

Conclusions

Compared with warfarin, rivaroxaban and apixaban were associated with a significantly lower risk of osteoporosis in patients with atrial fibrillation.
Becoming Blind
Authors: Janfada Mahtab
Published: January 2020

Medicine has always been regarded as one of the most significant disciplines, grounded in a humanistic approach, due to its ultimate exposure and connection with people as ‘patients’ and hence a holistic understanding of the patient as ‘human’ is fundamental. In our potentially dangerous times, the instrumental, technical and fragmented ways of seeing knowledge tend to permeate most disciplines, including medicine. This may result in individuals becoming alienated with the ‘self’ as potential doctors, with the discipline and with patients through the monologic discourse of academia or clinics. This article examines this (in)visible global issue in the specific context of Iran, where bilingual medical education adds another level of complexity in dialogic ‘seeing’ of self, knowledge and patients. Grounded in Bakhtin’s theory of dialogue and critical literacy approach to language and literacy, this article explores the affordances of a pedagogical intervention at an Iranian university. This offers diverse avenues for constructing a holistic medical knowledge in the process of becoming a professional through narrative medicine, clinical scenarios, evidence-based medicine and personal experiences. Selected stories of participants’ ontological and epistemological transformations, in their process of ideological becoming, are offered to argue for the urgency of dialogic ways of ‘seeing’ in potentially dangerous times.
Impact of Ocean–Atmosphere Current Feedback on Ocean Mesoscale Activity: Regional Variations and Sensitivity to Model Resolution
Authors: Jullien Swen , Masson Sébastien , Oerder Véra , Samson Guillaume , Colas François , Renault Lionel
Published: January 2020

Ocean mesoscale eddies are characterized by rotating-like and meandering currents that imprint the low-level atmosphere. Such a current feedback (CFB) has been shown to induce a sink of energy from the ocean to the atmosphere, and consequently to damp the eddy kinetic energy (EKE), with an apparent regional disparity. In a context of increasing model resolution, the importance of this feedback and its dependence on oceanic and atmospheric model resolution arise. Using a hierarchy of quasi-global coupled models with spatial resolutions varying from 1/4° to 1/12°, the present study shows that the CFB induces a negative wind work at scales ranging from 100 to 1000 km, and a subsequent damping of the mesoscale activity by ~30% on average, independently of the model resolution. Regional variations of this damping range from ~20% in very rich eddying regions to ~40% in poor eddying regions. This regional modulation is associated with a different balance between the sink of energy by eddy wind work and the source of EKE by ocean intrinsic instabilities. The efficiency of the CFB is also shown to be a function of the surface wind magnitude: the larger the wind, the larger the sink of energy. The CFB impact is thus related to both wind and EKE. Its correct representation requires both an ocean model that resolves the mesoscale field adequately and an atmospheric model resolution that matches the ocean effective resolution and allows a realistic representation of wind patterns. These results are crucial for including adequately mesoscale ocean–atmosphere interactions in coupled general circulation models and have strong implications in climate research.
Outcomes Assessment of Multi-Level Sleep Surgery in Syndromic Versus Non-Syndromic Children
Authors: Munawar Suqrat , Marston Alexander P. , Patel Terral , Nguyen Shaun A. , White David R.
Published: January 2020

Objectives:

Analyze the differences in length of stay, cost, disposition, and demographics between syndromic and non-syndromic children undergoing multi-level sleep surgery.

Methods:

Children with sleep disordered breathing or obstructive sleep apnea that had undergone sleep surgeries were isolated from the 1997 to 2012 editions of the Kids’ Inpatient Database, Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality. Children were then classified as syndromic or non-syndromic and stratified by level of sleep surgery (tonsillectomy & adenoidectomy, tonsillectomy & adenoidectomy plus other site surgery, other site surgery). Length of stay and cost were reported with Kruskal–Wallis one-way analysis of variance, disposition with binomial logistic regression, and demographics with chi-square.

Results:

Syndromic children compared to non-syndromic children were more likely to have surgery beyond just tonsillectomy & adenoidectomy and also had a longer length of stay, higher total cost and non-routine disposition (all P < .001). Syndromic children undergoing tonsillectomy and adenoidectomy plus other site surgery had a longer length of stay compared to syndromic children undergoing tonsillectomy & adenoidectomy (6.00 days vs 3.63 days, P < .001). However, no similar statistically significant difference in length of stay was found in non-syndromic children (2.01 days vs 2.87 days, P > .05).

Conclusion:

The potential risks/benefits need to be weighed carefully before undertaking sleep surgery in syndromic children. They experience a longer length of stay, higher cost, and non-routine disposition when compared to non-syndromic children. This is especially true when considering the transition from tonsillectomy & adenoidectomy to tonsillectomy & adenoidectomy plus other site surgery, as syndromic children experience a longer length of stay and non-syndromic children do not.
Utilization of rapid prototyping technology for the fabrication of an orthopedic shoe inserts for foot pain reprieve using thermo-softening viscoelastic polymers: A novel experimental approach
Authors: Sharma Shubham , Singh Jujhar , Kumar Harish , Sharma Abhinav , Aggarwal Vivek , Gill Amoljit Singh , Jayarambabu N , Kailasa Saraswathi , Rao K Venkateswara
Published: January 2020

This research work has been completed by concentrating on the structure of inserts for foot orthosis fabricated by utilizing rapid prototyping technology. Thermoplastic elastomer and thermoplastic polyurethane are the most commonly used materials that are being used in customized three-dimensional printed orthotic insoles, which are comfortable and prevent the user in many foot disorders. Thermo-softening viscoelastic polymers, explicitly Filaflex and Ninjaflex, have been printed by utilizing Flash Forge three-dimensional printers to evaluate the mechanical properties of specimens with alterations of the percentage rate fill-up design replicas. The results are compared on the basis of hardness test, flexural/bending test, and tensile test using Durometer and Universal Testing Machine (UTM). It has also been observed that the most significant effecting factor is infill density.
Mechanical modeling of textile composites using fiber-reinforced voxel models
Authors: Xie Jun-bo , Liu Chong , Yang Zhi , Jiao Wei , Zhang Yi-fan , Chen Xiao-ming , Chen Li
Published: January 2020

The fiber-reinforced voxel modeling technique is proposed to analyze the stress field and predict stiffness properties of textile composites. The textile reinforcements and matrix materials are modeled by virtual fibers and 3D voxel elements separately. Then the virtual fibers are “inserted” into the background voxel elements to construct the fiber-reinforced voxel elements. Stiffness properties of each fiber-reinforced voxel element are determined using volume average method based on the volume fraction and orientation of the virtual fibers it occupies. Geometry modeling and meshing of the complex reinforcements and matrix regions are avoided. As the reinforcements are generated in quasi-fiber scale, contact interactions and compaction deformations of the yarns can be modeled with high fidelity. A composite model containing one crimped yarn is used to verify the proposed method by comparing the calculating results of the fiber-reinforced voxel and traditional meso-scale models. The effect of voxel meshing density and virtual fiber radius on the simulation accuracy is also analyzed. Mechanical modeling of a multiply plain weave composite is performed by this model. Influence of nesting and compaction of the plies on the stress field can be fully characterized.
“I Keep it Together at Work but Fall Apart at Home”: The Experience of Israeli Homeroom Teachers Coping With the Death of a Student in their Class
Authors: Levkovich Inbar , Duvshan Ronny
Published: January 2020

This qualitative study examines the experiences of 16 Israeli high school homeroom teachers coping with the death of a student from their class. We used in-depth, semistructured, face-to-face interviews. Analysis of the findings revealed three key themes: (a) After their initial sense of shock and pain upon learning of the death of one of their students, the homeroom teachers were immediately asked to convey the bad news to their class. (b) The teachers experienced profound grief, had difficulty dealing with the student’s absence, and invested resources in preserving the student’s memory through various activities. (c) The teachers claimed that the experience affected their personal lives and stated that memories of it continued to surface long afterwards. Some found it difficult to function and even chose to leave the profession. The discussion raises the need for early assessment and planning in schools to address loss-related issues and provide support for teachers.
Identifying well-being challenges and solutions in the police service: A World Café approach
Authors: Clements Andrew James , Sharples Adrienne , Kinman Gail
Published: January 2020

Police work presents risks to mental and physical health for officers and civilian staff. We report a project using an innovative method that involved police employees in identifying well-being challenges and potential solutions. We facilitated ‘World Café’ events in which approximately 180 officers and civilian staff participated. Qualitative data were collected and thematically analysed drawing upon the Job Demands-Resources model. We developed themes relating to workload, management practices, occupational health processes, and continuing mental health stigma. Our analyses suggest an environment in which resources are insufficient to meet demands and the resulting pressures may contribute to management behaviours that can impair subordinate well-being.
Movement intellectuals engaging the grassroots: A strategy perspective on the Black Consciousness Movement
Authors: Morgan Marcus
Published: January 2020

Drawing upon activist interviews and framing theory this article proposes that the Black Consciousness Movement (BCM) is better understood not by focusing on the objective status of its leadership as middle-class intellectuals, but by instead looking at what these ‘movement intellectuals’ subjectively did to link their philosophy of liberation to the lifeworlds of those they sought to engage. It argues that this shift reveals three important features of social movements and movement intellectuals more generally. Firstly, it uncovers the meaningful, value-driven, emotional and collective-identity bases for action, alongside the more familiar instrumental motivations. Secondly, given the inevitable clash between movement intent and the contingent constraints under which movements invariably operate, it argues that movement success is better judged not by external criteria that are assumed to hold universally, but instead by reference to the unique strategic intentions articulated by movements themselves. Finally, it shows how, given heterogeneous audiences, the deployment of a diversity of grounded intellectual strategies can help augment the resonance of a movement’s core political message.
Comparing Capitalisms: Debates, Controversies and Future Directions
Authors: Wood Geoffrey T , Allen Matthew MC
Published: January 2020

Various strands of the comparative capitalisms (CC) literature agree that the advanced economies have liberalized in recent years, bringing with it rising income and wealth inequality and job insecurity; although these perspectives differ in important ways, there is much common ground between them to explain this heightened level of inequality and insecurity. Through reviewing contributions to three key CC perspectives since 2007/2008, we argue that they have tended to focus on developments in co-ordinated market economies, leading to a neglect of growing structural crises in liberal market economies, which have contributed to the UK and the USA entering uncharted socio-political waters. We extend recent work that emphasizes how variation between countries in labour-market institutions, different corporate forms and states’ fiscal policies help to explain income and wealth inequality to highlight future research agendas that seek to combine more systematically these institutional areas to explain social inequalities, workers’ experiences and socio-political crises within capitalist systems.
New approach for the prediction of compression pressure using the cut strip method
Authors: Faisal Siddique Hafiz , Mazari Adnan , Havelka Antonin , Kus Zdenek , Cirkl David , Hes Lubos
Published: January 2020

The main objective of the current research is the development of a new mathematical model for the prediction of compression pressure based on the incorporation of some new parameters. These new parameters include deformed width (wf), true stress ([Formula: see text]), true/logarithm strain ([Formula: see text]), true modulus of elasticity ([Formula: see text]), along with measurement of engineering stress ([Formula: see text]), engineering strain ([Formula: see text]) and engineering modulus of elasticity ([Formula: see text]) at ankle position. Various brands of compression socks comprising similar fibrous combinations, as well as knit type, were purchased. Initially they were hand washed, put on the leg for marking, marked in a square, sliced, and cut into rectangular strips. The rectangular cut strips were evaluated for force–elongation characterization at different strain values considering the requisite practical elongation values (circumferential difference between leg and sock at ankle portion). For pressure measurement, a Salzmann MST MK IV pressure measuring device using a standard-sized wooden leg (circumference = 240 mm) was used. For tensile evaluation, a Testometric tensile tester was used. In this research we developed the two mathematical models based on true Young’s modulus and engineering Young’s modulus were compared with Hooke’s law and Laplace’s law. The developed models were also compared with previously existing models statistically.
The strategic use of normative arguments in international negotiations
Authors: Heimann Gadi , Herman Lior
Published: January 2020

This article claims that normative arguments play a greater role in negotiations than existing scholarship implies. While the approaches of communicative and rhetorical action limit the use of arguments to environments that meet certain conditions, in fact normative arguments are widely used and can be found in almost every example of negotiations. This article seeks to explain this phenomenon. Negotiating parties that feel obligated to tackle normative arguments raised by the opposing side – either because of the presence of an audience or to maintain its reputation – have a number of tools at their disposal. Negotiators who are unsuccessful in tackling these arguments will tend to offer a proposal that is more attractive to the other side. Although normative arguments do not generally have a sweeping influence on the outcome of negotiations, they are still likely to play a significant role. The article applies this theoretical framework to the case of the lengthy negotiations between the EEC and Israel, in which the former had no material motivation and desire to cede to Israel’s demands and nevertheless did so.
Social Policy since Rousseff: Misrepresentation and Marginalization
Authors: Lavinas Lena , Gentil Denise
Published: January 2020

The objectives of this article are (1) to characterize the Brazilian social context in the pre- and postimpeachment periods of President Dilma Rousseff and to interpret the direction of the so-called Temer reforms and their impact on the deepening and generalization of the financialization process of the Brazilian economy; (2) to highlight the low complementarity of macroeconomic policy with regards to social policy in these two periods; (3) to envision potential scenarios with the election of an ultraliberal right-wing government regarding the economy and an ultraconservative government regarding values and morals, pointing out redistribution challenges.

Este artigo tem por objetivo (1) caracterizar o contexto social brasileiro no pré e pós-impeachment da Presidente Dilma Rousseff e interpretar a direção das chamadas reformas da gestão Temer e seu impacto no aprofundamento e generalização do processo de financeirização da economia brasileira, alterando a função da política social; (2) traduzir a baixa complementariedade da política macroeconômica para com a política social nesses dois períodos; (3) sinalizar cenários prováveis do enfrentamento redistributivo com a eleição de um governo de direita de perfil ultraliberal na economia e ultraconservador nos valores e costumes, apontando os desafios para redistribuição.
Introduction: Urban History, Arnold Hirsch, and the Second Ghetto Thesis Redux
Authors: Gilfoyle Timothy J.
Published: January 2020

The death of American historian Arnold Hirsch, in 2018, generated multiple reexaminations of his profoundly influential “second ghetto thesis.” Hirsch’s landmark Making the Second Ghetto: Race and Housing in Chicago, 1940 - 1960 (1983) is considered among the most important books on twentieth-century American history published in the past half century. In 2003, contributors to a special issue of the Journal of Urban History reflected on the twentieth anniversary of Hirsch’s second ghetto thesis. More recently, a new generation of urbanists have emerged who build upon and challenge Hirsch’s work. This forum highlights this new generation.
Can plants be considered a building service?
Authors: Gubb Curtis , Blanusa Tijana , Griffiths Alistair , Pfrang Christian
Published: January 2020

Plants are utilised in many forms within indoor environments, from simple houseplants to complex and species-rich green walls. Plants offer multi-faceted services indoors including pollutant removal and reductions in building energy consumption. This review firstly identifies – by critical assessment of the literature – pollutants which are currently measured at harmful concentrations indoors – classifying them as ‘2019’s priority pollutants’ and providing thorough health assessments of each. Secondly, the authors present which indoor plants have been shown to effectively remove ‘2019’s priority pollutants’ and direct future research onto any that have not been investigated. Thirdly, the authors consolidate the current research presenting why plants should be considered a building service.

Practical application: Plants are commonly used inside indoor environments. However, the benefits they bring are often overstated. This review paper looks to consolidate the current academic research on the various services plants can provide indoors including pollutant removal and relative humidity regulation. The authors hope that the paper can be used to inform and educate building service engineers and alike on the current state of play concerning indoor plants.
Catheter-directed foam sclerotherapy, an alternative to ultrasound-guided foam sclerotherapy for varicose vein treatment: A systematic review and meta-analysis
Authors: Lim Sheng Y , Tan Joshua XD , D’Cruz Reuban T , Syn Nicholas , Chong Tze T , Tang Tjun Y
Published: January 2020

Purpose

Catheter-directed foam sclerotherapy is a new addition to the treatment modalities available for varicose veins. As a modification of ultrasound-guided foam sclerotherapy, catheter-directed foam sclerotherapy has been purported to offer higher complete ablation rates and an improved safety profile. The aim of this study is to appraise the current literature on the outcomes of catheter-directed foam sclerotherapy compared to ultrasound-guided foam sclerotherapy in chronic venous insufficiency.

Methods

The review of the literature was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data from studies that reported the outcomes of catheter-directed foam sclerotherapy and ultrasound-guided foam sclerotherapy were extracted, to determine the pooled proportion of complete ablation rates, using a random effect meta-analysis model.

Results

A total of 62 studies, involving 3689 patients, were included in the systematic review. Higher rates of complete ablation were reported in catheter-directed foam sclerotherapy compared to ultrasound-guided foam sclerotherapy during the short- and medium-term follow-ups (Relative Risk = 1.06, Relative Risk = 1.15, Relative Risk = 1.19, p < 0.05). Fewer major and minor complications were also reported in patients who underwent catheter-directed foam sclerotherapy (Relative Risk = 0.23, Relative Risk= 0.43–0.76, p < 0.05).

Conclusion

Catheter-directed foam sclerotherapy has been demonstrated to have many advantages over ultrasound-guided foam sclerotherapy, offering superior complete ablation rates in the short-, medium- and long-term follow-ups. It also has a better safety profile, conferring a lower risk of major and minor complications. The conclusions should however be viewed in the context of significant limitations imposed by limited study data.