bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Thromboelastography and Conventional Coagulation Tests in Patients With Severe Liver Disease
Authors: Lloyd-Donald Patryck , Vasudevan Abhinav , Angus Peter , Gow Paul , Mårtensson Johan , Glassford Neil , Eastwood Glenn M. , Hart Graeme K. , Jones Daryl , Weinberg Laurence , Bellomo Rinaldo
Published: June 2020

Objective:

Thromboelastography (TEG) may provide rapid and clinically important coagulation information in acutely ill patients with chronic liver disease (CLD). Our objective was to describe the relationship between TEG and conventional coagulation tests (CCTs), which has not been previously explored in this population.

Methods:

In acutely ill patients with severe CLD (Child-Pugh score > 9, category C), we conducted a prospective observational study investigating coagulation assessment as measured by both CCTs and TEG. We used quantile regression to explore 30 associations between TEG parameters and corresponding CCTs. We compared TEG and CCT measures of coagulation initiation, clot formation, clot strength, and fibrinolysis.

Results:

We studied 34 patients on a total of 109 occasions. We observed inconsistent associations between TEG and CCT measures of coagulation initiation: TEG (citrated kaolin [CK] assay) standard reaction time and international normalized ratio: R 2 = 0.117 ( P = .044). Conversely, there were strong and consistent associations between tests of clot formation: TEG (CK) kinetics time and fibrinogen: R 2 = 0.202 ( P < .0001) and TEG (CK) α angle and fibrinogen 0.263 ( P < .0001). We also observed strong associations between tests of clot strength, specifically TEG MA and conventional fibrinogen levels, across all TEG assays: MA (CK) and fibrinogen: R 2 = 0.485 ( P < .0001). There were no associations between TEG and D-dimer levels.

Conclusions:

In acutely ill patients with CLD, there are strong and consistent associations between TEG measures of clot formation and clot strength and conventional fibrinogen levels. There are weak and/or inconsistent associations between TEG and all other conventional measures of coagulation.
Coincident remission of ankylosing spondylitis after autologous stem cell transplantation for multiple myeloma
Authors: Shaikh Hira , Bakalov Veli , Shaikh Soorih , Khattab Ahmed , Sadashiv Santhosh
Published: June 2020

Introduction

Ankylosing spondylitis is an autoimmune disease with chronic inflammation of the spine and sacroiliac joints that is commonly treated with immunosuppressants including disease-modifying antirheumatic drugs and anti-tumor necrosis factor alpha therapy.

Case report

A 75-year-old female with active ankylosing spondylitis on treatment with etanercept was referred to us for newly diagnosed IgG kappa free light chain multiple myeloma. After failing induction with revlimid, bortezomib, and dexamethasone, she was initiated on carfilzomib. Following the achievement of adequate response to induction, she underwent an autologous hematopoietic stem cell transplant selected for CD34+ cells with melphalan 200mg/m2 conditioning regimen. Given high-risk cytogenetics, i.e. monosomy 17 (17p) and hypodiploidy, she received two cycles of carfilzomib consolidation post-transplant. The patient tolerated the transplant well with successful engraftment and achieved complete remission of multiple myeloma with no detectable M spike, negative immunofixation study, and normalization of light chain ratio. While being off etanercept since the transplant, she noticed complete relief from joint pains related to her ankylosing spondylitis without a need to use the pain-relieving medications. Management and outcome: The patient has sustained remission of ankylosing spondylitis for two years post-transplant without flares or symptoms. She continues to remain off immunosuppressants.

Discussion

Although our patient had a coincident and unprecedented resolution of ankylosing spondylitis after receiving the hematopoietic stem cell transplant, this case consolidates the idea of transplant as a potential treatment option for ankylosing spondylitis and other rheumatological conditions.
Dependent Stress Mediates the Relation Between ADHD Symptoms and Depression
Authors: Rychik Natali , Fassett-Carman Alyssa , Snyder Hannah R.
Published: June 2020

Objective: Depression and attention-deficit hyperactivity disorder (ADHD) are prevalent and highly comorbid. ADHD symptoms are associated with specific dependent (i.e., self-generated) stressors in children, and there is a strong link between dependent stress and depression. Despite continued comorbidity of ADHD and depressive symptoms into adulthood, it is unknown whether stress generation mediates the relation between ADHD and subsequent depressive symptoms in emerging adulthood, a period of heightened stress. Method: We tested this mediation model in a semester-long longitudinal study of 224 college students (aged 18–23 years). We additionally tested whether this model differed between inattentive versus hyperactive/impulsive ADHD symptoms given evidence that they vary in their relations to stress and depression. Results: Dependent stress mediated the association between total ADHD symptoms at baseline and later depressive symptoms; these effects were equivalent for inattentive versus hyperactive/impulsive ADHD symptoms. Conclusion: These findings suggest stress generation as a mechanism for increased depression in individuals with ADHD symptoms.
Scenario Forecasting for Global Tourism
Authors: Wu Doris Chenguang , Cao Zheng , Wen Long , Song Haiyan
Published: June 2020

This study provides innovative forecasts of the probabilities of certain scenarios of tourism demand. The scenarios of interest are constructed in relation to tourism growth and economic growth. The probability forecasts based on these scenarios provide valuable information for destination policy makers. The time-varying parameter panel vector autoregressive (TVP-PVAR) model is adopted for scenario forecasting. Both the accuracy rate and the Brier score are used to evaluate the forecasting performance. A global set of 25 tourism destinations is empirically examined, and the results confirm that the TVP-PVAR model with a time-varying error covariance matrix is generally a promising tool for forecasting. Our study contributes to tourism forecasting literature in advocating the use of scenario forecasting to facilitate industry decision making in situations wherein forecasts are defined by two or more dimensions simultaneously. In addition, it is the first study to introduce the TVP-PVAR model to tourism demand forecasting.
Orbital plasmacytoma as the presenting feature in multiple myeloma
Authors: Mani Malavika , Kasturi Nirupama , Sravya Rekha , Kaliaperumal Subashini , Gochhait Debasis
Published: June 2020

A 50-year-old female patient presented with protrusion of the left eye for 1 month. Examination showed abaxial proptosis, restriction of extraocular movements, and elevated intraocular pressure. Computed tomography of the orbits showed soft tissue enhancing lesion in the superolateral aspect of the left orbit with lytic lesions in calvarium. Fine needle aspiration cytology of the lesion revealed a diagnosis of plasmacytoma with positive CD138 and CD38 immunohistochemical stains. Erythrocyte sedimentation rate, C-reactive protein and serum lactate dehydrogenase were elevated. Serum protein electrophoresis revealed hypergammaglobulinemia, and bone marrow biopsy revealed 6% plasma cells. The patient was started on chemotherapy with bortezomib, dexamethasone and lenalidomide by the medical oncologist. Significant improvement in proptosis and extraocular movements noted on follow-up. Orbital myeloma may be the first manifestation of systemic disease.
Nicotinamide N-Methyltransferase: Genomic Connection to Disease
Authors: Ramsden David B , Waring Rosemary H , Parsons Richard B , Barlow David J , Williams Adrian C
Published: June 2020

Single-nucleotide polymorphisms (SNPs) in and around the nicotinamide N-methyltransferase (NNMT) gene are associated with a range of cancers and other diseases and conditions. The data on these associations have been assembled, and their strength discussed. There is no evidence that the presence of either the major or minor base in any SNP affects the expression of nicotinamide N-methyltransferase. Nevertheless, suggestions have been put forward that some of these SNPs do affect NNMT expression and thus homocysteine metabolism. An alternative idea involving non-coding messenger RNAs (mRNAs) is suggested as a possible mechanism whereby health is influenced. It is postulated that these long, non-coding NNMT mRNAs may exert deleterious effects by interfering with the expression of other genes. Neither hypothesis, however, has experimental proof, and further work is necessary to elucidate NNMT genetic interactions.
A large population-based study of the mental health and wellbeing of children and young people in the North of England
Authors: Wright Barry , Garside Megan , Allgar Victoria , Hodkinson Rachel , Thorpe Helen
Published: June 2020

Background:

There has been a recent reported rise in prevalence of mental health problems among children in the United Kingdom, alongside increased referrals into specialist services. There is a need for up-to-date information regarding changing trends of young people’s mental health to allow for improved understanding and service planning.

Objectives:

This article aims to provide an overview of the current mental health and well-being of years 8, 9 and 11 secondary school–aged pupils from two large regions in the North of England.

Method:

This was a cohort cross-sectional study. Measures including the Strengths and Difficulties questionnaire, the EQ-5D-Y, social media use questions, and a mental health service use questionnaire were completed by participants.

Results:

In total, 6328 questionnaires were returned from 21 secondary schools. One in 10 participating pupils scored ‘very high’ for total mental health difficulties. Significant differences on well-being scores were found between both gender and year groups.

Conclusion:

In recent years, the proportion of children facing mental health problems has increased. In particular, high levels of female pupils and year 11 pupils report facing difficulties. It is important to develop targeted, accessible interventions, and to continue to collect up-to-date measures for this population.
Inadequate for democracy: How (not) to distribute education
Authors: Oprea Alexandra
Published: June 2020

There is widespread agreement among philosophers and legal scholars that the distribution of educational resources in the US is unjust, but little agreement about why. An increasingly prominent view posits a sufficientarian standard based on the requirements of democratic citizenship. This view, which I refer to as democratic sufficientarianism, argues that inequalities in educational resources or opportunities above the threshold required for democratic citizenship are morally unobjectionable if and only if all children are provided with an education sufficient to meet those demands. In the article, I argue that democratic sufficientarianism faces a democratic education dilemma. Either the philosopher specifies a precise and demanding threshold with antidemocratic implications, or she insists upon democratic equality irrespective of educational achievements, thereby undercutting the search for anything but a minimal educational threshold. As an alternative, I defend a new sufficientarian standard that is reflexive, education-specific, and democracy-compatible. This reflexive sufficientarian standard can act as a guide to democratic deliberation about education policy. The article also sketches possibilities for litigation on behalf of children who have received insufficient primary education.
Keys to unlocking service provider engagement in constrained co-production partnerships
Authors: Larsen Tone , Karlsen Jan E , Sagvaag Hildegunn
Published: June 2020

The article reports on research conducted in a public, specialised mental health and substance abuse service unit in Norway. The inquiry followed an action research framework, with patients, leaders and staff as co-researchers. Power sharing within such constrained institutions suggests that service providers risk engaging in paternalistic or avoidance approaches. Despite the inherent challenges of attempting a participative approach on an equal footing, facilitating service co-production may be served by mediation and support. Here, developing meeting spaces for dialogue between patients, staff and leaders appears vital. We argue that focussing on service providers’ own professional development may be benefiting to co-production. We propose steps to unlock the potential of genuine co-production partnerships in constrained organisational settings when staff and leaders have no prior experience involving patients systematically in service development.
Do moral development levels of the nurses affect their ethical decision making? A descriptive correlational study
Authors: Arslan Sümeyye , Türer Öztik Sinem , Kuzu Kurban Nevin
Published: June 2020

Background

In the globalizing world, nurses often meet humans from different cultures and values. This fact has led them to make ethical decisions, which do not comply with their own moral jurisdictions at care setting.

Objectives

The objective of the study was to investigate the relationships between moral development levels of the nurses and their scores of nursing principled thinking and practical consideration during decision making for ethical dilemmas.

Methods

This was a descriptive correlational study. Nursing Dilemma Test, Moral Development Scale for Professionals and socio-demographic form were used. Study was conducted with 227 nurses. Ethical considerations: An institutional authorization, an ethics approval from non-interventional ethics committee of the respective university, permission from the authors of the scales used and informed consents from the nurses were obtained in order to conduct the study.

Results

In this study, nurses were found to be at post-conventional level according to Kohlberg’s moral development theory. Sociodemographic and working characteristics of the nurses have not affected their scores of moral development level and their scores of nursing principled thinking, practical consideration and familiarity (p > 0.05). Nurses take attention for moral principles during decision making although not at a desirable level, and they are relatively affected by environmental factors

Conclusion

Although nurses are familiar with ethical problems at scenarios including ethical dilemmas, they cannot make decisions in accordance with their moral development levels during decision making for ethical dilemmas. Nurses should be instructed and supported for ethical decision making by recognizing factors that may be effective on their decision making.
The Sociology of Diplomats and Foreign Policy Sector: The Role of Cliques on the Policy-Making Process
Authors: Süleymanoğlu-Kürüm Rahime
Published: June 2020

This paper studies the sociology of elites and the role of cliques on the foreign policy-making process through an exploratory case study of Turkish Ministry for Foreign Affairs. It identifies elite sociology as the independent variable triggering a policy-making process in the Turkish Ministry for Foreign Affairs in line with organisational process or governmental politic approaches. It shows that until the 1980s, the Turkish Ministry for Foreign Affairs was marked by strong hierarchical tradition triggered by a certain career path and cliqueism leading to the homogeneity in the sociology of elites. This in turn triggered a foreign policy-making process based on organisational process. The role of cliqueism weakened along with the incremental circulation of elites in the post-1980s and particularly in the post-2005 period as the elite structure in the Turkish Ministry for Foreign Affairs became even more heterogeneous, foreign policy-making process moved towards governmental politics which allowed taking into account diverse schools of thought. Nevertheless, newly emerging programmatic elites employed deliberate efforts for elite circulation by altering the dominant career path and relying on political appointments. The resulting outcome was the emergence of a new clique of ruling elites subordinate to political elites which led to the politicisation of the foreign policy decision-making process in the post-2011 period.
Aortic Arch Anatomy Pattern in Patients Treated Using Double Homemade Fenestrated Stent-Grafts for Total Endovascular Aortic Arch Repair
Authors: Chassin-Trubert Lucien , Gandet Thomas , Ozdemir Baris Ata , Lounes Youcef , Alric Pierre , Canaud Ludovic
Published: June 2020

Purpose: To analyze the structural variation of the aortic arch and the supra-aortic arteries and establish an average spatial configuration that would be a pattern for a “universal double fenestration” design for physician-modified endovascular grafts (PMEGs) used in total thoracic endovascular aortic repair (TEVAR). Materials and Methods: Aortic arch morphology was retrospectively analyzed by reviewing the preoperative thoracic computed tomography angiography scans in 33 consecutive patients (mean age 68 years; 27 men) treated between January 2017 and March 2019 using double-fenestrated PMEGs for zone 0 TEVAR. Image analysis was completed according to a standardized technique on a vascular workstation with center lumen line reconstruction for all measurements. Variations in branching pattern of the aortic arch were classified into 8 types. Results: The arch trunk configuration was type I in 26 patients (79%), type II in 5 (15%), type III in 1, and type IV in 1. Mean aortic diameters at the level of mid ascending aorta, innominate artery (IA), left common carotid artery (LCCA), and left subclavian artery (LSA) were 35.7±3.7, 34.2±4.5, 33.3±6.7, and 33.7±4.7 mm, respectively. Mean diameters of the trunk were 12.2±1.7, 7.5±1.4, and 8.0±0.8 mm, respectively. Mean longitudinal center to center lengths were 15.9±2.5 mm between the LSA and LCCA and 12.1±3.0 mm between the LCCA and IA. Mean clock positions using the LSA as reference were 12:50 for the IA and 12:05 for the LCCA. In 32 patients (97%) all the supra-aortic branch vessels fit perfectly inside two delimited areas defined by a proximal common square area of 30×30 mm for the IA and LCCA and a second distal 8-mm-diameter circle for the LSA. Conclusion: Variations of the aortic arch anatomy are numerous and common. A general morphological pattern is described that delimits the aortic area where these variations occur. This information can be utilized for the design of an off-the-shelf double-fenestrated stent-graft for zone 0 TEVAR.
A Randomized, Placebo-Controlled Trial Evaluating Changes in Peripheral Neuropathy and Quality of Life by Using Low-Frequency Electrostimulation on Breast Cancer Patients Treated With Chemotherapy
Authors: Song Si-Yeon , Park Ji-Hye , Lee Jin Sun , Kim Je Ryong , Sohn Eun Hee , Jung Mi Sook , Yoo Hwa-Seung
Published: June 2020

Background: This study examined the effect of a portable low-frequency electrostimulation (ES) device on patients diagnosed with chemotherapy-induced peripheral neuropathy (CIPN) immediately after chemotherapy for breast cancer. Methods: A single-center, randomized, placebo-controlled trial was conducted. A total of 72 patients newly diagnosed with CIPN were enrolled and randomly placed into the ES (n = 36) or the sham ES group (SES; n = 36). Duloxetine or pregabalin was prescribed to all participants from the initial assessment. The devices for 14 days, at least twice a day, for at least 120 minutes. The primary outcomes were the overall intensities of the CIPN symptoms as assessed using Numerical Rating Scale (NRS). Secondary outcomes included Total Neuropathy Score (TNS), European Organization for Research and Treatment of Cancer Quality of Life (EORTC-QLQ), Chemotherapy-Induced Peripheral Neuropathy 20 (CIPN20), Functional Assessment of Cancer Therapy-Breast (FACT-B), and Instrument on Pattern Identification and Evaluation for CIPN (IPIE-CIPN). Results: No differences in NRS scores were found between the patients in the ES and the SES group ( P = 0.267). Patients in both groups showed significantly reduced CIPN intensities (ES P < .001; SES P < .001). No significant differences between the groups were found in TNS, EORTC-QLQ, CIPN20, and FACT-B. The general symptoms of CIPN diagnosed as cold arthralgia showed significance only in the ES group ( P = .006). Conclusion: Compared with a placebo, the effectiveness of the low-frequency ES device with pharmacological intervention was not significantly different, but a therapeutic effect was possible.
“Slowed Down but Not Stopped”: A Spiritual Life Review Intervention in Patients with Neurodegenerative Disease
Authors: Sytsma Terin T. , Bjork Lori B. , Jenkins Sarah M. , Chatterjee Krishanu , Piderman Katherine M.
Published: June 2020

Spiritual health is important in managing and coping with chronic and debilitating illnesses, such as neurodegenerative diseases. However, few spiritual interventions have addressed this population. This article quantitatively and qualitatively evaluates outcomes of a spiritual life review in neurodegenerative diseases patients. The majority of participants improved or maintained quality of life and spiritual/emotional well-being following the intervention. Spiritual life review may be an important intervention in the comprehensive care of patients with neurodegenerative diseases.
Improving Long-Term Care through Abuse Prevention and Ethics Training
Authors: Menio Diane A.
Published: June 2020

This article presents a solution for a critical issue, that is, elder abuse, and is focused on prevention through education and training for staff. Pastoral care and mental health professionals can benefit by using this film and curriculum for professional development when providing counseling, or when caring for elder clients on a long-term basis.
Synchronous versus staged carotid artery stenting and coronary artery bypass graft for patients with concomitant severe coronary and carotid artery stenosis: A systematic review and meta-analysis
Authors: Tzoumas Andreas , Giannopoulos Stefanos , Charisis Nektarios , Texakalidis Pavlos , Kokkinidis Damianos G , Zisis Sokratis N , Machinis Theofilos , Koullias George J
Published: June 2020

Background

Coronary artery disease requiring coronary artery bypass graft (CABG) frequently coexists with critical carotid stenosis. The most optimized strategy for treating concomitant carotid and coronary artery disease remains debatable.

Objective

The aim of this meta-analysis was to compare synchronous CAS and CABG versus staged CAS and CABG for patients with concomitant coronary artery disease and carotid artery stenosis in terms of peri-operative (30-day) and long-term clinical outcomes.

Methods

This study was performed according to the PRISMA guidelines. Eligible studies were identified through a search of PubMed, Scopus and Cochrane database until December 2019. A meta-analysis was conducted with the use of a random effects model. The I-square statistic was used to assess heterogeneity.

Results

Four studies comprising 357 patients were included in this meta-analysis. Patients who were treated with the synchronous approach had a statistically significant higher risk for peri-operative stoke (OR: 3.71; 95% CI: 1.00–13.69; I2 = 0%) compared tο the staged group. Peri-operative mortality (OR: 4.50; 95% CI: 0.88–23.01; I2 = 0%), myocardial infarction (MI) (OR: 1.54; 95% CI: 0.18– 13.09; I2 = 0%), postoperative bleeding (OR: 0.27;95% CI: 0.02–3.12; I2 = 0%), transient ischemic attacks (TIA) (OR: 0.60; 95% CI: 0.04– 9.20; I2 = 0.0%), acute kidney injury (AKI) (OR: 0.34; 95% CI: 0.03–4.03; I2 = 0.0%) and atrial fibrillation rates (OR:0.27; 95% CI: 0.02–3.12; I2 = 0.0%) were similar between the two groups. Synchronous CAS-CABG and staged CAS followed by CABG were associated with similar rates of late mortality (OR: 3.75; 95% CI: 0.50–27.94; I2 = 0.0%), MI (OR: 0.33; 95% CI: 0.01–12.03; I2 = 0.0%) and stroke (OR:3.58; 95% CI:0.84–15.20; I2 = 0.0%) after a mean follow-up of 47 months.

Conclusion

The simultaneous approach was associated with an increased risk of 30-day stroke compared to staged CAS and CABG. However, no statistically significant difference was found in long-term results of mortality, MI and stroke between the two approaches. Future studies are warranted to validate our results.
Completion imaging techniques and their clinical role after carotid endarterectomy: Systematic review of the literature
Authors: Spanos Konstantinos , Nana Petroula , Kouvelos George , Batzalexis Konstantinos , Matsagkas Miltiadis M , Giannoukas Athanasios D
Published: June 2020

Background

Completion imaging has been suggested for the intraoperative quality control assessment of the carotid endarterectomy technical success, in order to immediately resolve pathologic findings and accordingly improve patients’ outcome. The aim of this study was to present existing evidence of different completion imaging techniques after carotid endarterectomy and their role on clinical outcome.

Material and methods

A systematic review was performed searching in MEDLINE, CENTRAL, and Cochrane databases including studies reporting on completion imaging techniques after carotid endarterectomy.

Results

A total of 12,378 patients in 35 studies (20 retrospective and 15 prospective) underwent a completion imaging technique after carotid endarterectomy: in 19 studies, 5340 patients underwent arteriography; in 5 studies, 2095 angioscopy; in 21 studies, 5722 DUS; and in 2 studies, 150 patients underwent transcranial Doppler. Ten studies assessed > 1 imaging technique. The mean age was 67 ± 7 years old (69% males) with common co-morbidities to be hypertension (74%), smoking (64%), and hyperlipidemia (54%). Almost half of the patients (4949; 44%) were treated for symptomatic disease. In 1104 (9.7%) patients, a major defect was identified intra-operatively, while in 329 patients (2.9%), a minor defect. Common pathological findings were the presence of mural thrombus, carotid dissection, residual stenosis, and intimal flaps. An immediate re-intervention was undertaken in 75% (790/1053) of the patients to treat a major intra-operative imaging finding. In patients with re-intervention, only 2.3% (14/609) had an intra-operative stroke and 0.8% (5/609), a transient ischemic attack, while only 1.4% (8/575) had a stroke and 0.2% a transient ischemic attack (1/575) during 30-day post-operative period. No intra-operative death was reported. In the same period, the restenosis rate of internal and common carotid artery was 0.5% (3/575) and 0.2% (1/575), respectively.

Conclusion

Completion imaging techniques can detect defects in almost 10% of patients that may lead to immediate intra-operative surgical revision with low intra-operative stroke/transient ischemic attack rate and low early carotid restenosis. During the 30-day follow-up period, in those patients, the incidence of stroke/transient ischemic attack may be low but present. This review cannot provide any evidence on which completion imaging technique is better, and the clinical impact conferred by each technique in the absence of a randomized control studies.
Dorsal fracture-dislocation of the radiocarpal joint: a new classification and implications in surgical treatment
Authors: Biondi Marco , Lauri Giulio
Published: June 2020

Dorsal dislocations and fracture-dislocations of the radiocarpal joint are a spectrum of pathology involving both the bony and ligamentous structures that stabilize the radiocarpal joint. We retrospectively reviewed 63 dorsal radiocarpal dislocations treated in our Institute in order to propose a new classification and define surgical treatment. Preoperative CT-scan findings together with clinical and radiological outcomes were recorded. We identified four main types of lesions: Type I, pure dorsal radiocarpal dislocation; Type IIA, dorsal wall impaction and radial styloid avulsion; Type IIB, as IIA with additional intra-articular die punch; Type III, volar and dorsal marginal fragments; Type IV, larger volar and dorsal fragments. For each type of lesion, we propose specific options for treatment that are progressively more invasive. We believe that this classification adequately addresses the whole spectrum of bony and soft tissue injuries that occurs in dorsal radiocarpal fracture-dislocations giving a practical guide for surgical treatment.

Level of evidence: IV
Integrated planning of production and maintenance for imperfect system with subcontracting strategies
Authors: Hafidi Nouhayla , El Barkany Abdellah , El Mhamedi Abderrahman , Mahmoudi Morad
Published: June 2020

The purpose of this article is to deal with subcontracting strategies in the context of production, maintenance and quality integration. We study the multi-item capacitated lot-sizing problem for a production system composed of a single machine. The production system is considered imperfect, producing both conforming and non-conforming items. However, the deterioration of the system is a function of the time and production rate, which affects the quality of the manufactured items. Consequently, a quality control strategy is established, the aim is to inspect, adjust and control the manufactured items. To solve our problem, an evolutive optimization approach is proposed, namely the genetic algorithm (GA). Then, in order to adjust the parameters of GA, we use the Taguchi method. This article is one of the few documents dealing with integrated production management, maintenance and quality under subcontracting constraints that takes into account the complex aspect of the multi-item manufacturing industry. Then, a sensitivity analysis is also carried out to illustrate the robustness of the proposed control policy. Finally, we compare our results with the literature to validate our approach and highlight the advantage of subcontracting in minimizing costs.
Culturally Responsive Assessment of Life Science Skills and Abilities: Development, Field Testing, Implementation, and Results
Authors: Zimmerman Robert H. , Maker C. June , Alfaiz Fahad
Published: June 2020

A research team consisting of educators of gifted students, a scientist, and experts in measurement developed a performance-based assessment of life science skills and abilities. Four high schools in the Southwestern United States were the settings for field testing and implementation. Five levels of ratings were given: unknown, maybe, probably, definitely, and wow. The majority of student scores were in the maybe and probably categories. Using six new measures (concept maps in life and physical science, math problem solving, spatial analytical performance assessment, life science performance assessment and physical science performance assessment), 23 students (M2) were selected for participation in science laboratories at an R1 university along with 20 students (M1) selected by conventional means. When the nine attribute scores of the performance-based assessment were compared, no significant difference was found t(41), p > .38, between M1 and M2 students. Performance-based assessments in science, technology, engineering, and mathematics (STEM) will provide an alternative and a complement to standard achievement tests. They have the potential to identify and nurture exceptionally talented high school students across all demographic groups.
Structural Characterization of Pectic Polysaccharides From Bupleurum chinense DC
Authors: Yao Gang , Xu Jialei , Wang Xiang , Lu Jiaojaio , Chan Mi K. , Zhou Yifa , Sun Lin
Published: June 2020

Bupleurum chinense DC, a traditional medicinal plant in China that has many pharmacological effects, contains polysaccharide as one of its active components. In this study, we isolated and structurally characterized the polysaccharide from B. chinense. Water-soluble polysaccharides (termed WBCP) were extracted from the plant and fractionated by anion-exchange and size exclusion chromatographies. From this procedure, we obtained a homogeneous acidic polysaccharide (WBCP-A2) and determined its monosaccharide composition. Analysis by FT infrared and 13C NMR spectroscopies, along with enzymatic hydrolysis, indicated that WBCP-A2 is a pectic polysaccharide, composed of rhamnogalacturonan I, rhamnogalacturonan II, highly methyl-esterified homogalacturonan (HG), and either non- or low methyl-esterified HG domains. These different fractions may be covalently linked through HG segments to form the complex pectin molecules.
Rosai-Dorfman Disease: A Less Common Cause of Leptomeningeal and Nerve Root Enhancement
Authors: Petraglia Adam F. , Davick Jonathan J. , Mandell James W. , Lapides David A.
Published: June 2020

A 46-year-old male experienced progressive neurocognitive decline, weight loss, intermittent headaches, and weakness over 6 months. Magnetic resonance imaging of the brain revealed hydrocephalus and the spinal cord imaging showed diffuse leptomeningeal enhancement with prominent nerve root involvement. Intradural biopsy of lumbar arachnoid tissue found mixed inflammatory infiltrate consisting predominantly of histiocytes, S100 and CD68 positivity, and lymphocytophagocytosis (emperipolesis) consistent with extranodal Rosai-Dorfman disease. Rosai-Dorfman disease, a non-Langerhans cell histocytic disorder, can mimic the appearance of neurosarcoidosis and leptomeningeal carcinomatosis and should remain on the differential of a patient presenting with diffuse leptomeningeal enhancement, a common occurrence on a neurohospitalist service.
MR Target Sign in Cerebral Aspergillosis
Authors: Finelli Pasquale F.
Published: June 2020

Magnetic resonance (MR) is an effective imaging modality in the evaluation of infectious brain disease, yet findings are often nonspecific. The presence of a diagnostic feature can facilitate early treatment, particularly where mortality is high. We highlight MR apparent diffusion coefficient/T2-weighted target sign in the diagnosis of cerebral aspergillosis.
Chondral and Osteochondral Femoral Cartilage Lesions Treated with GelrinC: Significant Improvement of Radiological Outcome Over Time and Zonal Variation of the Repair Tissue Based on T2 Mapping at 24 Months
Authors: Schreiner Markus M. , Raudner Marcus , Szomolanyi Pavol , Ohel Kitty , Ben-Zur Livnat , Juras Vladimir , Mlynarik Vladimir , Windhager Reinhard , Trattnig Siegfried
Published: June 2020

Objective

To prospectively assess the efficacy of GelrinC in the treatment of chondral and osteochondral femoral cartilage lesions using morphological (Magnetic Resonance Observation of Cartilage Repair Tissue [MOCART]) and quantitative (T2-mapping) magnetic resonance imaging (MRI).

Design

This study was designed as a prospective single-arm, open label, multicenter study. Morphological magnetic resonance imaging (MRI) for MOCART assessment and T2 mapping was performed 1 week and 6, 12, 18, and 24 months after GelrinC implantation. Evaluation of T2 mapping was based on the assessment of global T2 indices (T2 of the repair tissue [RT] divided by T2 of healthy reference cartilage) and zonal variation.

Results

Fifty-six (20 female) patients were prospectively enrolled. The mean MOCART score significantly increased from baseline to the 24-month follow-up with 88.8 (95% CI, 85.8-91.9; P < 0.001) for all lesions combined as well as 86.8 (95% CI, 83.0-90.6) for chondral lesions and 94.1 (95% CI, 68.55-100) for osteochondral lesions. Furthermore, based on T2 mapping, significant zonal variation of the RT was observed at 24 months ( P = 0.039), which did not differ significantly from healthy reference cartilage ( P = 0.6).

Conclusion

Increasing MOCART scores were observed throughout the follow-up period, indicative of maturation of the cartilage repair. Significant zonal variation of the RT at 24 months might indicate the transformation into hyaline cartilage–like RT. Slightly differing morphological outcome between chondral and osteochondral lesions, but similar global and zonal T2 indices at 24 months, support the potential of GelrinC as a treatment option for both lesion types.
Mesenchymal Stromal Cell Transplantation Induces Regeneration of Large and Full-Thickness Cartilage Defect of the Temporomandibular Joint
Authors: Gomez Marcos , Wittig Olga , Diaz-Solano Dylana , Cardier José E.
Published: June 2020

Objective

Cartilage damage (CD) in the temporomandibular joint (TMJ) continues being a major problem in maxillofacial field. Evidence suggests that cellular therapy may be used for repairing CD in the TMJ.

Design

A murine model of condyle CD (CCD) was generated in the TMJ to evaluate the capacity of mesenchymal stromal cells (MSCs) to induce cartilage regeneration in CCD. A large CCD was surgically created in a condyle head of the TMJ of C57BL/6 mice. Human MSC embedded into preclotted platelet-rich plasma (PRP) were placed on the surface of CCD. As controls, untreated CCD and exposed TMJ condyle (sham) were used. After 6 weeks, animals were sacrificed, and each mandibular condyle was removed and CCD healing was assessed macroscopically and histologically.

Results

Macroscopic observation of CCD treated with MSC showed the presence of cartilage-like tissue in the CCD site. Histological analysis showed a complete repair of the articular surface with the presence of cartilage-like tissue and subchondral bone filling the CCD area. Chondrocytes were observed into collagen and glycosaminoglycans extracellular matrix filling the repaired tissue. There was no evidence of subchondral bone sclerosis. Untreated CCD showed denudated osteochondral lesions without signs of cartilage repair. Histological analysis showed the absence of tissue formation over the CCD.

Conclusions

Transplantation of MSC induces regeneration of TMJ-CCD. These results provide strong evidence to use MSC as potential treatment in patients with cartilage lesions in the TMJ.
Targeting translational read‐through of premature termination mutations in BMPR2 with PTC124 for pulmonary arterial hypertension
Authors: Long Lu , Yang Xudong , Southwood Mark , Moore Stephen , Crosby Alexi , Upton Paul D. , Dunmore Benjamin J. , Morrell Nicholas W.
Published: June 2020

Pulmonary arterial hypertension is a fatal disorder of the lung circulation in which accumulation of vascular cells progressively obliterates the pulmonary arterioles. This results in sustained elevation in pulmonary artery pressure leading eventually to right heart failure. Approximately, 80% of familial and 20% of sporadic idiopathic pulmonary arterial hypertension cases are caused by mutations in the bone morphogenetic protein receptor type 2 (BMPR2). Nonsense mutations in BMPR2 are amongst the most common mutations found, where the insertion of a premature termination codon causes mRNA degradation via activation of the nonsense‐mediated decay pathway leading to a state of haploinsufficiency. Ataluren (PTC124), a compound that permits ribosomal read‐through of premature stop codons, has been previously reported to increase BMPR2 protein expression in cells derived from pulmonary arterial hypertension patients harbouring nonsense mutations. In this study, we characterised the effects of PTC124 on a range of nonsense BMPR2 mutations, focusing on the R584X mutation both in vitro and in vivo. Treatment with PTC124 partially restored BMPR2 protein expression in blood outgrowth endothelial cells isolated from a patient harbouring the R584X mutation. Furthermore, a downstream bone morphogenetic protein signalling target, Id1, was rescued by PTC124 treatment. Mutant cells also exhibited increased lipopolysaccharide‐induced permeability, which was reversed by PTC124 treatment. Increased proliferation and apoptosis in R584X blood outgrowth endothelial cells were also significantly reduced by PTC124. Moreover, oral PTC124 increased lung BMPR2 protein expression in mice harbouring the R584X mutation (Bmpr2+/R584X). Our findings provide support for future experimental medicine studies of PTC124 in pulmonary arterial hypertension patients with specific nonsense BMPR2 mutations.
Preliminary investigation of the associations between psychological flexibility, symptoms and daily functioning in people with chronic abdominal pain
Authors: Yu Lin , Inspector Yoram , McCracken Lance M
Published: June 2020

Objective:

Acceptance and commitment therapy (ACT), based in the psychological flexibility model, may benefit people with chronic abdominal pain. The current study preliminarily investigates associations between psychological flexibility processes and daily general, social and emotional functioning in chronic abdominal pain.

Methods:

An online survey comprising measures of psychological flexibility processes and daily functioning was distributed through social media.

Subjects:

In total, 89 participants with chronic abdominal pain were included in the analyses.

Results:

All investigated psychological flexibility processes significantly correlated with pain interference, work and social adjustment, and depression, in the expected directions (|r| = .35–.68). Only pain acceptance significantly correlated with gastrointestinal (GI) symptoms, r = -.25. After adjusting for pain in the analyses, pain acceptance remained significantly associated with all outcomes, |β| = .28–.56, but depression. After adjusting for pain and pain acceptance, only cognitive fusion remained significantly associated with anxiety, β = -.27, and depression, β = .43. When contrasting GI-specific anxiety with psychological flexibility processes, pain acceptance was uniquely associated with pain-related interference and work and social adjustment, and cognitive fusion and committed action were uniquely associated with depression.

Conclusions:

Psychological flexibility processes were positively associated with daily functioning in people with chronic abdominal pain. ACT may provide benefit for these people. Further studies with experimental designs are needed to examine the utility of ACT for people with abdominal pain.
A case of systemic precursor T-cell lymphoblastic lymphoma presenting with single tooth mobility
Authors: Goutzanis Lampros , Apostolidis John , Giatra Chara , Chrysomali Evanthia , Deskos Dimitrios
Published: June 2020

Lymphoblastic lymphoma, seen primarily in children or young adults, is a type of non-Hodgkin lymphoma that originates from B or T lymphocyte precursors and rarely occurs in the oral cavity. A case of systemic precursor T-cell lymphoblastic lymphoma mimicking periodontitis of a lower second molar in a 20-year-old adult is currently presented. The case was initially misdiagnosed as periodontal disease and treated with tooth extraction by a dentist. Re-evaluation of the patient due to worsening of symptoms lead to cone beam computed tomography scanning that thoroughly revealed an extended osteolytic lesion of the right mandible. Afterward, a biopsy was performed, thus reaching the diagnosis of precursor T-cell lymphoblastic lymphoma. This report discusses differences in epidemiology of T-cell and B-cell lymphoblastic lymphomas, as well as their various intraoral manifestations that are mimicking a large family of oral pathology. It also focuses on conventional imaging findings that imply malignancy, which are often neglected during routine radiology interpretation.
Emotions and agency in prison research
Authors: Garrihy Joe , Watters Aoife
Published: June 2020

The emotionality of prison research has received much justified attention in recent years. However, this aspect of undertaking qualitative research is often not considered by early career researchers until they are confronted with the impact of both researching emotionally laden subjects and employing their emotional agency as the researcher. Emerging from this, the authors argue for the development of a methodology that conceives researchers as emotional agents. This methodology incorporates harnessing emotional experiences as a tool for data collection. In this way, researchers are encouraged and trained to shift from passive to active emotional agents. Thus, far from inhibiting the research, the inherent emotionality of conducting research enhances its rigour, integrity and validity. Emotionality is intrinsic to conducting research in the prison milieu. As such, it warrants constructive employment and integration into existing research methodologies. This article draws on the authors’ respective experiences conducting mixed methods research in prison settings. The authors’ research methodologies incorporated emotional reflexivity as a core constituent throughout their data collection, analysis and the writing of their doctoral studies. The argument will be illustrated by detailing experiences of emotional charge during the fieldwork. To reflect this, the authors advocate for the emergence of an integrative methodology. The development of such a methodology would be of value to prison researchers but particularly to novice and/or doctoral researchers. Furthermore, it would be similarly applicable to researchers throughout the field of criminal justice and beyond.
An Isolated Island Economy Analysis on the Effectiveness of Foreign Aid: TRNC
Authors: Tosun Ertan , Kirikkaleli Dervis , Safakli Okan Veli
Published: June 2020

Foreign aid is an important opportunity for developing countries to financing for development. As a result of this theory-based acceptance, foreign aid has long been granted to the Turkish Republic of Northern Cyprus (TRNC). However, the country’s level of development shows that the expected output from foreign aid has not been achieved. Yet, the continuation of foreign aid is only possible if it works. Identifying the barriers to the effective use of foreign aid will provide both the expected benefit and continuity of foreign aid for the TRNC. When we investigate the factors that cause this situation, we find that the literature does not provide a scattered, contradictory, and concise description of the causes. After an intensive literature review, we identify the factors that affect foreign aid. Through field surveys and other surveys, we confirm that these factors also apply to the impact of foreign aid to the TRNC. To quantify these factors, we have scored them for TRNC using different approaches. After this scoring, we reveal the factors that are open to improvement in TRNC. In other words, by applying this model to foreign aid to TRNC, we uncover the efficiency climate of foreign aid. As a result, for foreign aid to be effective, we conclude that it may be important to look at whether the conditions of the country are appropriate and to improve the noneligible ones to be more effective.