bluuebunny/crossref_metadata_2025 huggingface dataset:
Disruption of mitochondrial membrane potential coupled with alterations in cardiac biomarker expression as early cardiotoxic signatures in human ES cell–derived cardiac cells
Authors: Jyoti Saras , Tandon Simran
Published: June 2019

Cardiotoxicity is one of the most significant reasons of attrition in drug development. The present study assessed the sensitivity of various endpoints for early monitoring of drug-induced cardiotoxicity using human embryonic stem cell–derived cardiac cells, including precursors as well as mature cardiomyocytes, by correlating changes in cardiac biomarker expression. Directed differentiation was induced and cardiac progenitor cell (CPC) population were treated with cardiotoxic drugs, namely, doxorubicin (Dox) and paclitaxel (Pac), and with noncardiotoxic drug, namely penicillin G. To assess cardiac-specific toxicity, the changes in the expression of key markers of cardiac lineage, such as Nkx2.5, Tbx5, α-myosin heavy chain α-MHC, and cardiac troponin T, were studied using quantitative real-time polymerase chain reaction (qRT-PCR) and flow cytometry (FC). The half-maximal inhibition in the expression of these cardiac markers was analyzed from the dose–response curves. We also assessed the half-maximal inhibition (IC50) in cardiac cells using propidium iodide dye (IC50 PI) and by measuring disruption in the mitochondrial membrane potential (IC50 MMP). We observed that the most sensitive marker was α-MHC in the case of both Dox and Pac, and the order of sensitivity of the various prediction assays was MMP > protein expression by FC > gene expression by qRT-PCR > cell viability by PI staining. The results could enrich the screening of drug-induced cardiotoxicity in vitro and propose disruption in MMP along with downregulation of α-MHC protein as a potential biomarker of predicting cardiotoxicity earlier during drug safety evaluation.
A rubber-modified epoxy composite with very high toughness and heat resistance
Authors: Li Binghai , Zhang Xiaohong , Qi Guicun , Wang Xiang , Zhang Jiangru , Han Peng , Ru Yue , Qiao Jinliang
Published: June 2019

A high performance epoxy composite with very high toughness and heat resistance had been designed and prepared. Epoxy resin TDE-85 with an impact strength of 10.2 kJ m−2, a heat distortion temperature (HDT) of 121°C, and a glass transition temperature of 127°C was chosen as the matrix of the composite, while carboxylic nitrile-butadiene elastomeric nanoparticles (CNB-ENPs) coated with triethanolamine on the surface with a diameter of about 100 nm was selected as the modifier. Surprisingly, the rubber-modified epoxy resin exhibited not only very high toughness but also very high heat resistance. The HDT of epoxy resin TDE-85 after modification increased 57°C, reaching 178°C, while the impact strength increased by 107%, increasing to 21.1 kJ m−2. The relationship between the microstructure and performance had been evaluated by transmission electron microscopy, mechanical testing, and dynamic mechanical analysis. The results showed that the CNB-ENP/TDE-85 composite resulted in large interface and a special morphology after modification.
Field-testing the Euro-MCD Instrument: Experienced outcomes of moral case deliberation
Authors: de Snoo-Trimp Janine C , Molewijk Bert , Ursin Gøril , Brinchmann Berit Støre , Widdershoven Guy AM , de Vet Henrica CW , Svantesson Mia
Published: June 2019

Background:

Moral case deliberation is a form of clinical ethics support to help healthcare professionals in dealing with ethically difficult situations. There is a lack of evidence about what outcomes healthcare professionals experience in daily practice after moral case deliberations. The Euro-MCD Instrument was developed to measure outcomes, based on the literature, a Delphi panel, and content validity testing. To examine relevance of items and adequateness of domains, a field study is needed.

Aim:

To describe experienced outcomes after participating in a series of moral case deliberations, both during sessions and in daily practice, and to explore correlations between items to further validate the Euro-MCD Instrument.

Methods:

In Sweden, the Netherlands, and Norway, healthcare institutions that planned a series of moral case deliberations were invited. Closed responses were quantitatively analyzed. The factor structure of the instrument was tested using exploratory factor analyses.

Ethical considerations:

The study was approved in Sweden by a review board. In Norway and the Netherlands, data services and review boards were informed about the study.

Results:

The Euro-MCD Instrument was completed by 443 and 247 healthcare professionals after four and eight moral case deliberations, respectively. They experienced especially outcomes related to a better collaboration with co-workers and outcomes about individual moral reflexivity and attitude, both during sessions and in daily practice. Outcomes were experienced to a higher extent during sessions than in daily practice. The factor structure revealed four domains of outcomes, which did not confirm the six Euro-MCD domains.

Conclusion:

Field-testing the Euro-MCD Instrument showed the most frequently experienced outcomes and which outcomes correlated with each other. When revising the instrument, domains should be reconsidered, combined with theory about underlying concepts. In the future, a feasible and valid instrument will be presented to get insight into how moral case deliberation supports and improves healthcare.
Is it time to include people with intellectual disabilities in Royal Australian and New Zealand College of Psychiatrists’ treatment guidelines?
Authors: Hill Harry
Published: June 2019

Objective:

The Royal Australian and New Zealand College of Psychiatrists’ (RANZCP) treatment guidelines set the zeitgeist for psychiatric practice in Australasia. This review conceptualises the current approach to treatment of individuals with an intellectual disability and co-occurring mental illness in RANZCP guidelines, and its potential impact.

Conclusions:

The enduring omission of people with an intellectual disability and co-occurring mental illness from RANZCP clinical guidelines is a missed opportunity in normalising care and optimising outcomes for people with an intellectual disability. There are substantial cultural, political and historical overlays contributing to the ongoing divide between health and disability. In developing psychiatric guidelines, authors should consider including people with co-occurring intellectual disability as a specific population, that requires distinctive consideration.
The impact of substance use on treatment as a compulsory patient
Authors: Vine Ruth , Tibble Holly , Pirkis Jane , Spittal Matthew , Judd Fiona
Published: June 2019

Objectives:

This paper considers the impact of having a diagnosis of substance use disorder on the utilisation of compulsory orders under the Victorian Mental Health Act (2014).

Methods:

We analysed the subsequent treatment episodes over 2 years of people who had been on a community treatment order for at least 3 months and determined the odds of a further treatment order if there was a diagnosis of substance use at or about the time the index community treatment order ended.

Results:

An additional diagnosis of a substance use disorder was coded in 47.7% and was associated with significantly increased odds of a subsequent treatment order in the following 2 years for those with a main diagnosis of schizophrenia (AOR = 3.03, p<0.001) and ‘other’ disorders (AOR = 11.60, p=0.002). Those with a main diagnosis of mood disorder had a significant increase in odds for an inpatient treatment order if there was an additional substance use disorder diagnosis (AOR = 3.81, p=0.006).

Conclusions:

Having an additional diagnosis of substance use disorder was associated with increased likelihood of being placed on an order. This study supports greater emphasis being given to treatment of substance use concurrently with that of mental illness.
Fatal Sarcocystis cruzi–induced eosinophilic myocarditis in a heifer in Uruguay
Authors: Aráoz Virginia , da Silva Silveira Caroline , Moré Gastón , Banchero Georgget , Riet-Correa Franklin , Giannitti Federico
Published: June 2019

Sarcocystis spp. are causative agents of bovine eosinophilic myositis and/or myocarditis, which are chronic subclinical myopathies that are occasionally responsible for condemnation at slaughterhouses. Sarcocystis cruzi is a protozoan parasite of worldwide distribution transmitted by canids, most commonly associated with subclinical infection in cattle. Although S. cruzi infections can rarely lead to fatal systemic disease, fatal cardiac cases with confirmation of the etiologic diagnosis have not been reported, to our knowledge. We describe herein an unusual case of S. cruzi–induced fatal bovine eosinophilic myocarditis. A 22-mo-old, Holstein–Hereford heifer, in a group of 110 cattle on pasture, manifested growth retardation and died in February 2017. Autopsy revealed myriad yellow-green 1–3-mm coalescing foci, surrounded by fibrosis, affecting ~75% of the ventricular myocardium. Pulmonary edema, ascites, and hydrothorax were consistent with chronic congestive heart failure. Histology revealed severe eosinophilic, granulomatous, necrotizing myocarditis, with multinucleate giant cells, fibrosis, and mineralization. Numerous thin-walled protozoan cysts resembling Sarcocystis spp. were present in the necrotic foci and within the sarcoplasm of adjacent cardiomyocytes. PCR and sequencing of the 18S rRNA gene revealed 99.9–100% homology with S. cruzi. Sarcocystosis can be a rare cause of fatal myocarditis in cattle.
From metaphor to theory: the role of resonance in perceptual learning
Authors: Raja Vicente
Published: June 2019

Unlike dominant cognitivist theories that take perceptual learning to be a process of enriching sensory stimulation with previous knowledge, ecological psychologists take it to be an enhancement in the detection of already rich perceptual information. The difference between beginners and experts is that the latter detect better information to support their task goals. While the study of perceptual learning in terms of perceptual information and perceiver–environment interactions is common in the ecological literature, ecological psychology still lacks a story regarding the way perceptual information is detected by perceptual systems and the plasticity of such detection in learning events. In this article, I propose the ecological notion of resonance—along with biophysical resonance, non-linear resonance, and metastability—as a plausible foundation to account for the process of detection of perceptual information both in perceptual events and in events of perceptual learning.
What Is the Evidence for Co-trimoxazole, Clindamycin, Doxycycline, and Minocycline in the Treatment of Methicillin-Resistant Staphylococcus aureus (MRSA) Pneumonia?
Authors: Hong Jenny , Ensom Mary H. H. , Lau Tim T. Y.
Published: June 2019

Objective: To review the evidence for trimethoprim-sulfamethoxazole (TMP-SMX), clindamycin, doxycycline, and minocycline in the treatment of methicillin-resistant Staphylococcus aureus (MRSA) pneumonia. Data Source: MEDLINE, PubMed, EMBASE, Google, Google Scholar, Cochrane Central Register of Controlled Trials from 1946 to May 20, 2019. The search was performed with the keywords methicillin-resistant Staphylococcus aureus, MRSA, Staphylococcus aureus, pneumonia, trimethoprim, sulfamethoxazole drug combination, trimethoprim, sulfamethoxazole, TMP-SMX, co-trimoxazole, clindamycin, doxycycline, and minocycline. Data Extraction: Studies reporting the use of the above antibiotics for MRSA pneumonia treatment with clinical outcomes were included. Search parameters were limited to English language and human studies only. Data Synthesis: The search yielded 16 relevant articles: 6 TMP-SMX, 8 clindamycin, zero doxycycline, and 2 minocycline. For TMP-SMX, prospective randomized trials showed variable results; however, these studies were not specifically designed to assess MRSA pneumonia treatment. Retrospective studies with clindamycin suggested that it could be used as monotherapy or in combination with other anti-MRSA antibiotics. There was no evidence for doxycycline use, but 2 small retrospective reviews appeared to support minocycline as a treatment option. Relevance to Patient Care and Clinical Practice: These antibiotics are often used in clinical practice as potential treatment options for MRSA pneumonia. This article reviews the evidence for the clinical efficacy and safety of these agents. Conclusions: There are limited data to support use of TMP-SMX, clindamycin, doxycycline, or minocycline in MRSA pneumonia treatment. Randomized controlled trials are required to determine the effectiveness of these antibiotics. Clinicians should base their decision to use these agents on a case-by-case basis depending on clinical status and susceptibility results.
Developing and Validating a Pediatric Potentially Avoidable Transfer Quality Metric
Authors: Rosenthal Jennifer L. , Atolagbe Oluseun , Hamline Michelle Y. , Li Su-Ting T. , Toney Alexis , Witkowski Jessica , McKnight Heather , Tancredi Daniel J. , Romano Patrick S.
Published: June 2019

This study aimed to evaluate a quality metric that identifies pediatric potentially avoidable transfers from diagnosis and procedure codes. Using physician medical record review as the gold standard, the following steps were used: (1) develop the initial metric definition, (2) estimate initial metric definition operating characteristics, (3) refine this definition to optimize the c-statistic, and (4) validate this optimized metric definition using a separate sample. The initial metric using Sample A patient transfers had a c-statistic of 0.63 (95% confidence interval = 0.53-0.73). Following 22 revisions, the optimized metric definition was a transfer discharged within 24 hours that did not receive any of a select list of 60 268 specialized diagnoses or procedures. The optimized metric on Sample B demonstrated a sensitivity of 80.6%, specificity of 85.7%, and c-statistic of 0.83 (95% confidence interval = 0.75-0.91). The quality metric developed and validated in this study demonstrated satisfactory operating characteristics, providing a feasible means to measure this important outcome.
Global injectivity in second-gradient nonlinear elasticity and its approximation with penalty terms
Authors: Krömer Stefan , Valdman Jan
Published: June 2019

We present a new penalty term approximating the Ciarlet–Nečas condition (global invertibility of deformations) as a soft constraint for hyperelastic materials. For non-simple materials including a suitable higher-order term in the elastic energy, we prove that the penalized functionals converge to the original functional subject to the Ciarlet–Nečas condition. Moreover, the penalization can be chosen in such a way that for all low-energy deformations, self-interpenetration is avoided completely already at all sufficiently small finite values of the penalization parameter. We also present numerical experiments in two dimensions illustrating our theoretical results and provide own MATLAB code available for download and testing.
Introduction to the Special Issue on “Social Movements and Private Environmental Governance”
Authors: Lyon Thomas P.
Published: June 2019

This special issue presents five articles that explore the linkages between social movements and private environmental standards that are not promulgated by governments. They draw on disciplines ranging from economics to political science to sociology to law. This introduction places the articles in context and explains their origins and intent.
A comparative study of lens management in the United Kingdom and India with regard to rhegmatogenous retinal detachment surgery
Authors: Brent Alexander J , Bedi Sahiba , Wakefield Matthew , Banerjee Somnath
Published: June 2019

Introduction:

Lens management in phakic patients with rhegmatogenous retinal detachments undergoing para plana vitrectomy surgery remains controversial among vitreoretinal surgeons. When combined phacovitrectomy is performed, the biometry decisions can be challenging both in the face of macula-off rhegmatogenous retinal detachments and previous refractive surgery. This study analyses current trends in practise.

Methods:

A scenario-related survey was sent to all members of the British and Eire Association of Vitreoretinal Surgeons and to vitreoretinal surgeons in the northern Indian state of Punjab.

Results:

In post-laser-assisted in situ keratomileusis patients with a visually significant cataract and a macula-on rhegmatogenous retinal detachment, the majority of British and Eire Association of Vitreoretinal Surgeons members (67.3%) and surgeons in Punjab (91.4%) would perform a stand-alone para plana vitrectomy and defer cataract surgery. When a combined phacovitrectomy is performed in this scenario, the majority of British and Eire Association of Vitreoretinal Surgeons (68%) would implant an intraocular lens (using either Haigis-L or European Society of Cataract and Refractive Surgeons/American Society of Cataract and Refractive Surgeons calculators), whereas the majority of Punjab surgeons (79.3%) would leave the patient aphakic. In a patient with a cataract and macula-off rhegmatogenous retinal detachment undergoing combined phacovitrectomy surgery, without any previous refractive surgery, the majority of British and Eire Association of Vitreoretinal Surgeons members (47.3%) would use the opposite eye biometry, whereas most Punjab surgeons (62.7%) would leave the patient aphakic.

Discussion:

Vitreoretinal surgeons in both the United Kingdom and Punjab predominantly avoid combined surgery in rhegmatogenous retinal detachment cases, even when faced with a visually significant cataract. When combined phacovitrectomy is performed, most vitreoretinal surgeons preference using the opposite eye biometry for macula-off cases and Haigis-L (myope) or online calculators for post-laser-assisted in situ keratomileusis cases.
Undersizing the Exeter stem in hip hemiarthroplasty increases the risk of periprosthetic fracture
Authors: Korsnes Lars , Gottvall Andreas , Buttazzoni Christian , Mints Michael
Published: June 2019

Introduction:

Whether under- or oversizing of the femoral component of cemented hip hemiarthroplasties impacts the risk of periprosthetic fractures (PPF) has only been examined experimentally. This study was carried out to add more knowledge about the risks of PPF in cemented polished tapered hemiarthroplasties.

Methods:

20 patients with PPF following hip hemiarthroplasty with cemented Exeter V40 stems were compared to 50 controls who never suffered PPF having received the same type of Exeter hemiprosthesis for the same indication. The difference between stem size and post-hoc radiographic ideal templated size was investigated as a predictor of PPF.

Results:

Cases had a median size difference to post-hoc templating of –2, while controls had a median size difference of –1 ( p = 0.09). An ROC curve constructed to find an optimal cutoff point in size difference between cases and controls arrived at an area under curve of 63%, with –1.5 as the cutoff. Patients with size differences exceeding –1.5 had a statistically significant increased PPF risk (odds ratio = 3.8, 95% confidence interval, 1.1–13.3, p < 0.05). This group covered 55% of all cases.

Conclusion:

An implanted femoral component that is 2 or more sizes smaller than the template that is shown to be appropriate will increase the risk of PPF in Exeter hip hemiarthroplasties.
Peripherally inserted central catheter–related thrombosis rate in modern vascular access era—when insertion technique matters: A systematic review and meta-analysis
Authors: Balsorano Paolo , Virgili Gianni , Villa Gianluca , Pittiruti Mauro , Romagnoli Stefano , De Gaudio Angelo Raffaele , Pinelli Fulvio
Published: June 2019

Background:

Technical factors at the moment of catheter insertion might have a role in peripherally inserted central catheter–related thrombotic risk. We performed a systematic review and meta-analysis to define the actual rate of peripherally inserted central catheter–related symptomatic deep vein thrombosis in patients in whom catheter insertion was performed according to ultrasound guidance, appropriate catheter size choice, and proper verification of tip location.

Methods:

We searched Medline, Embase, and Cochrane Library. Only prospective observational studies published in peer-reviewed journals after 2010 up to November 2018 reporting peripherally inserted central catheter–related deep vein thrombosis rate were included. All studies were of adult patients who underwent peripherally inserted central catheter insertion. Results were restricted to those studies which included in their methods ultrasound guidance for venipuncture, catheter tip location, and a catheter size selection strategy. Random-effect meta-analyses and arcsine transformation for binomial data were performed to pool deep vein thrombosis weighted frequencies.

Results:

Of the 1441 studies identified, 15 studies involving 5420 patients and 5914 peripherally inserted central catheters fulfilled our inclusion criteria. The weighted frequency of peripherally inserted central catheter–related deep vein thrombosis was 2.4% (95% confidence interval = 1.5–3.3) and remained low in oncologic patients (2.2%, 95% confidence interval = 0.6–3.9). Thrombotic rate was higher in onco-hematologic patients (5.9%, 95% confidence interval = 1.2–10). Considerable heterogeneity (I2 = 74.9) was observed and all studies were considered at high risk of attrition bias.

Conclusions:

A proper technique is crucial at the moment of peripherally inserted central catheter insertion. Peripherally inserted central catheter–related deep vein thrombosis rate appears to be low when evidence-based technical factors are taken into consideration during the insertion procedure.
From contempt of court to fake news: public legitimisation and governance in mediated Singapore
Authors: Lee Howard , Lee Terence
Published: June 2019

Common perceptions and literature on media in Singapore suggest an authoritarian government that either silences or co-opts public media, using repressive laws that are passed unopposed, given the People’s Action Party (PAP) government’s super majority in Parliament. In practice, laws in Singapore are not simply crafted to maximise their effects in silencing political criticism but are also carefully debated – at times with the PAP’s strongest opponents – in public, to rationalise their implementation even before such laws are applied. In studying public discourse surrounding four recent pieces of media legislation, this article argues that the Singapore government strives not just for its right to pass laws at will but is equally concerned with building its legitimacy to govern using these laws. This sophisticated practice, in line with Foucault’s concept of governmentality, seeks to govern by convincing the citizenry to consent the suppression of their own socio-cultural and political freedom.
Calibration of the ISO tapping machine for finite-element prediction tool on a wooden-base floor
Authors: Qian Cheng , Ménard Sylvain , Bard-Hagberg Delphine , Kouyoumji Jean-Luc , Negreira Juan
Published: June 2019

One important challenge of the wooden constructions is to achieve a high quality of acoustic insulation, especially decreasing the impact noise in the low-frequency range. In order to avoid over-designed solutions and expensive experimental tests in the design phase, reliable prediction tools are called for. This article is an initial investigation of modeling the ISO standardized tapping machine on a cross-laminated timber floor, using finite element method. The wooden-based floor was first calibrated in terms of its dynamic properties. The influence of the material properties of the cross-laminated timber floor was discussed. The force generated by the tapping machine was then introduced in the established cross-laminated timber model. The model was finally validated by comparing the simulation results with the measured accelerations.
Evaluating unintended consequences: New insights into solving practical, ethical and political challenges of evaluation
Authors: Oliver Kathryn , Lorenc Theo , Tinkler Jane
Published: June 2019

Evaluating complex interventions and policies is challenging. This is particularly true for the identification of unintended consequences, whether negative or positive. This article uses data from a workshop with policymakers and evaluators to explore the evaluation of unintended consequences. We identify three main challenges for policymakers and evaluators: being able to identify and evaluate unintended effects, to avoid creating unintended effects and being able to explain these effects. We discuss practical, political and ethical issues for each of these challenges and identify recommendations for evaluators who want to consider unintended consequences. First, use a broader range of methods to explore how policies play out; second, use theory to plan evaluations; and third, discuss both methods and theory with relevant stakeholders to make these as useful as possible. We offer novel insights into recent debates about theory-led and co-produced interventions and policies.
Collective identity, social adversity and college student sympathy for violent radicalization
Authors: Rousseau Cécile , Oulhote Youssef , Lecompte Vanessa , Mekki-Berrada Abdelwahed , Hassan Ghayda , El Hage Habib
Published: June 2019

Identity issues have been at the forefront in studies on determinants of youth violent radicalization. Identity uncertainty and identity fusion appear to be associated with quests for meaning, which may find some answers in extremist discourses and radical engagements. This process has been considered to be particularly important for second-generation migrants who have to negotiate multiple identities, sometimes in situations of social adversity. This paper aims to understand the relations between collective identity, social adversity (discrimination and exposure to violence), and sympathy for violent radicalization in College students in Quebec. This mixed-method study consisted of a large online survey conducted at eight colleges in Quebec. Multilevel analysis accounted for the clustered nature of data while generalized additive mixed models were used to study nonlinear relations. Results highlight the complex associations between collective identity and youth sympathy for violent radicalization. They confirm that negative public representations of minority communities may lead to more sympathy for violent radicalization. Although results suggest that strong enough identities can act as protective anchorages for youth, they also indicate that when collective identity becomes too central in personal identity this may accentuate othering processes and legitimize violence toward the out-group. These results have implications for prevention programs. They indicate that improving the public image of minority communities through mainstream media or the social media may increase youth public self-esteem and decrease their sympathy for violent radicalization. They also invite the education field to foster the development of strong plural identities.
Noise-canceling spike between pilot and main-pressure-rise peaks of multiple-injection diesel combustion
Authors: Fuyuto Takayuki , Taki Masahiro
Published: June 2019

A previous study addressed combustion-noise reduction by optimizing the interval between two peaks in the pressure-rise rate (dP/dθ) of premixed charge combustion ignition with the split injection of fuel in diesel engines. Noise canceling occurs between two dP/dθ peaks, which reduces the overall combustion noise by lowering the maximum frequency component of the noise spectrum. The period of this frequency is twice the interval between the two dP/dθ peaks. We named this noise-reduction technique “noise-canceling spike” because it relies on the interference between a spike in the pressure rise and the preceding peak in the pressure rise. The time interval between the dP/dθ peaks must be controlled precisely to enable the utilization of the noise-canceling spike. In this article, the theory of the noise-canceling spike between the dP/dθ peak of the pilot injection and a single dP/dθ peak of the main injection is explained relatively simply, using experimental data analysis and zero-dimensional cycle simulations to prove that the noise-canceling spike is a universal phenomenon which occurs between the two dP/dθ peaks independently of the combustion (injection) strategy. Then, the theory of the noise-canceling spike is extended to those cases with three or more dP/dθ peaks, in which the noise-canceling spike can occur between every pair of dP/dθ peaks. Finally, we prove that the noise-canceling spike can occur between the dP/dθ peak of the pilot heat release and the multiple dP/dθ peaks of the main heat release in diesel combustion. The noise-canceling spike between the dP/dθ peak of the pilot combustion and the first dP/dθ peak of the main combustion becomes the dominating factor which reduces the overall combustion noise. In addition, the reasons why there have previously been no reports of the canceling and amplifying between the two dP/dθ peaks are discussed.
Setting up home noninvasive ventilation
Authors: Arnal Jean-Michel , Thevenin Charles-Philippe , Couzinou Benoit , Texereau Joelle , Garnero Aude
Published: June 2019

Home noninvasive ventilation (NIV) is widely used to correct nocturnal alveolar hypoventilation in patients with chronic respiratory failure of various etiologies. The most commonly used ventilation mode is pressure support with a backup respiratory rate. This mode requires six main settings, as well as some additional settings that should be adjusted according to the individual patient. This review details the effect of each setting, how the settings should be adjusted according to each patient, and the risks if they are not adjusted correctly. The examples described here are based on real patient cases and bench simulations. Optimizing the settings for home NIV may improve the quality and tolerance of the treatment.
A Theoretical Literature Review on Adaptive Structuration Theory as Its Relevance to Human Resource Development
Authors: Turner John R. , Morris Mark , Atamenwan Imonitie
Published: June 2019

The Problem

Adaptive structuration theory (AST) has had little to no attention within the human resource development (HRD) literature. It is important for HRD scholars and scholar-practitioners to be concerned with how new technology initiatives impact both the individual and the organization, equally. Unfortunately, new technologies are often introduced with no consideration of its utility to the agents expected to use these new technologies, causing incompatibilities and productivity losses.

The Solution

AST views the duality of structure between an organization’s structural features and its human agents. This perspective enables human agents when implementing new technologies and organizational change initiatives. Also, AST provides HRD scholars and scholar-practitioners with new insight into the interactions that take place during these change initiatives, providing support for current and future research efforts.

The Stakeholders

It would be beneficial for HRD scholars and scholar-practitioners involved with designing, evaluating, implementing, or managing technology in the workplace.
Endovascular Therapy for Below-the-Elbow Arterial Disease: An Initial Single-Center Experience
Authors: Chen James X. , Levin L. Scott , Mantell Mark P. , Redmond Jonas W. , Clark Timothy W. I.
Published: June 2019

Purpose: To evaluate the technical success, clinical success, and complication rates of endovascular revascularization for below-the-elbow (BTE) peripheral artery disease. Materials and Methods: A retrospective review was performed of 19 patients (mean age 63 years; 12 men) with critical hand ischemia (CHI) who underwent 25 interventions in 19 arms between October 2010 and June 2017. Access was attained using 4-F or 5-F sheaths via antegrade brachial, retrograde radial, or fistula/graft access routes depending on the target vessel. A 0.018-inch hydrophilic microwire was used for intimal or subintimal recanalization. Angioplasty was performed over a 0.014-inch guidewire using low-profile balloons. The primary endpoint of the study was technical success, defined as successful lesion crossing/dilation, with residual stenosis <30%. Clinical success referred to improvement in pain and/or steal symptoms. Results: Technical success was achieved in 88% (22 of 25 procedures), with no significant difference in outcome associated with indications or baseline vessel disease. Complications occurred in 6 cases, of which 5 were minor and 1 was major. Clinical success was achieved in 12 of 14 patients with available follow-up; 5 of 7 patients with ulcers experienced wound healing. Conclusion: Endovascular revascularization for BTE occlusive disease is an effective and safe strategy for treating CHI.
A Pilot Randomized Controlled Trial Comparing Levothyroxine to Placebo in Neurologically Deceased Donors
Authors: Frenette Anne Julie , Williamson David , Williams Virginie , Lagacé Anne-Marie , Charbonney Emmanuel , Serri Karim
Published: June 2019

Background:

Although commonly prescribed, the efficacy of levothyroxine to improve heart function in neurologically deceased donors is unclear. We evaluated the feasibility of a randomized controlled trial to compare levothyroxine to placebo on the variation of left ventricular ejection fraction, in hemodynamically unstable donors.

Methods:

We conducted a pilot, double-blinded, randomized controlled trial. Deceased donors with reduced left ventricular ejection fraction or needing vasopressors were included. We randomized participants to a 20 μg bolus followed by a 20 μg/h infusion of levothyroxine or an identically appearing placebo. We report the proportion of recruited participants, the time to the administration of the study drug, and protocol violations.

Results:

Twenty-four participants (N = 24/104; 23.1%) were eligible. Five of them (N = 5/24; 20.8%) were excluded by the attending physician. Four others were not included, due to family refusal for research (n = 2/24;8.3%) and unavailability of research staff (n = 2/24; 8.3%). Fifteen participants were randomized (N = 15/104; 14.4%). Mean time between the echocardiography and the initiation of the drug was 1.73 hours, and14 (93.3%) of 15 of the participants received the drug within 2 hours after the echocardiography. We report no study violation. The study was stopped prematurely because of low recruitment.

Conclusion:

This pilot trial suggests that the success of a definitive randomized control trial to assess the efficacy of levothyroxine in deceased donors could benefit from a multicenter recruitment and education on the evidence surrounding the pharmacological management of organ donors. The need for consent to research interventions in deceased donors should also be clarified.
“We Are Aiming for Quality and Good Music”: The Hebrew Orphan Asylum Harmonica band (NYC) and Music Education, 1924–1930
Authors: Shansky Carol L.
Published: June 2019

Once referred to as “the most maligned musical instrument on earth,” the harmonica holds an important historical place in music education as an instrument around which bands were formed, solo and ensemble competitions were held, and in some cases, careers were born. Much of this activity centered itself on city recreation programs as well as public schools. The instrument’s size, low price, and relative ease of sound production were appealing for these organizations. The boys and girls that lived and studied at the Hebrew Orphan Asylum of New York City were engaged participants in these contests as well as performing in radio broadcasts of harmonica band playing. This paper examines the history of this ensemble as a representative of the incredible activity in this underresearched area of music education.
An Evaluation of Complications Following Ultrasound-Guided Regional Block Anesthesia in Outpatient Hand Surgery
Authors: Voskeridjian Armen C. , Calem Daniel , Rivlin Michael , Beredjiklian Pedro K. , Wang Mark L.
Published: June 2019

Background: Ultrasound-guided (USG) assistance has contributed to the acceptance of regional anesthesia as a safe and efficient alternative to traditional general anesthesia. However, limited data exist regarding the safety of supraclavicular blocks used in common hand surgery procedures. The purpose of this retrospective study was to evaluate a large sample of cases to determine the effectiveness and complication rate of supraclavicular nerve blocks and confirm the safety of its use within the ambulatory surgery center (ASC) setting. Methods: Nerve blocks for the upper extremity were performed via the supraclavicular approach using the USG technique. Records were analyzed for all patients monitored during the immediate postoperative recovery and step-down phases at the ASC and contacted by phone or evaluated within 2 weeks at their first postoperative visit. Adverse outcomes related to the regional block anesthesia were identified via phone interview or postoperative surgical visit and documented. Results: In all, 713 records were reviewed with 56% female (n = 398) and 44% male (n = 315) patients. Of the 713 cases, 4 adverse events were identified (0.6%, 95% confidence interval [%]), including 2 abnormal reactions to the nerve block and 2 incomplete blocks with inadequate pain control. Conclusions: This study is the first report to evaluate a large sample of outpatient hand procedures at a high-volume ASC. We can report no clinically significant pulmonary or neurovascular complications with the use of USG supraclavicular nerve block techniques, further supporting its establishment as a safe and efficient procedure, yielding a low complication rate.
Top 10 global educational topics in stroke: A survey by the World Stroke Organization
Authors: Saini Monica , Belson Sarah , Lahiff-Jenkins Carmen , Sandercock Peter
Published: June 2019

Aim

As part of a program of work to develop an educational strategy and implementation plan for the World Stroke Organization, we conducted a survey of World Stroke Organization members (health professionals, laypersons (Stroke Support Organizations)) to identify their potential educational needs.

Methods

We developed a questionnaire to identify priority educational needs in consultation with the World Stroke Organization Education Committee. The World Stroke Organization invited all individual members and associated Stroke Support Organizations to complete the questionnaire via a web-based survey. Survey responses were supplemented by questionnaires emailed directly to key persons in Stroke Support Organizations and information from semi-structured telephone interviews, where necessary. The questionnaire asked respondents to prioritize topics in diagnosis, management of acute stroke, stroke care services, stroke rehabilitation, and stroke prevention. Free-text responses were assessed with word cloud.

Results

The online survey was completed by 264 respondents from 60 countries; 19.1% were from low- and middle-income countries, 59% were stroke specialist physicians, 28% allied health professionals or nurses, 9% Stroke Support Organizations, 4% general physicians. Fifteen Stroke Support Organizations from 11 countries responded to the emailed survey. Seven Stroke Support Organizations' members were interviewed by telephone; one was interviewed in-person. We highlight the two highest priority topics in each of the five questionnaire domains.

Conclusion

The 10 priority topics were all applicable in a low- or middle-income setting: setting up and delivering stroke diagnosis, treatment, rehabilitation and prevention services, and emphasized the most basic elements of care. The survey participants have identified a number of key topics that merit inclusion in stroke teaching materials and courses, especially those aimed at practitioners working in resource-limited settings.
Functional Movement Screening and injury risk in elite adolescent rugby league players
Authors: Dyer Cameron S , Callister Robin , Sanctuary Colin E , Snodgrass Suzanne J
Published: June 2019

Research is limited as to whether Functional Movement Screen scores relate to non-contact injury risk in rugby league players. This cohort study investigates whether the Functional Movement Screen score predicts non-contact injuries in elite adolescent rugby league players. Australian adolescent rugby league players ( n = 52; mean age 16.0 ± 1.0 years) from one club participated in this study. Functional Movement Screen scores, height, and mass were collected at the beginning of the preseason. Training, match exposure, and injury incidence data (non-contact match and training injuries with three levels of severity) were recorded for each individual athlete throughout the season. Linear and logistic regression analyses were conducted to investigate the association between Functional Movement Screen score (continuous score, ≤ 14 or > 14, and three subscores) and injury risk, whilst controlling for exposure time. The mean Functional Movement Screen score for the sample was 13.4 (95% CI: 11.0–14.0). A total of 72 non-contact injuries were recorded (incidence rate: 18.7 per 1000 exposure hours; 95% CI: 11.6–24.8). There were no statistically significant associations between non-contact injury and Functional Movement Screen score for any of the analyses conducted. Our results suggest that the Functional Movement Screen does not reflect non-contact injury risk in elite adolescent rugby league players. Further research should investigate whether a more sport-specific movement screen in the preseason can more effectively predict injury risk in this population.
Mobile extracorporeal membrane oxygenation service for severe acute respiratory failure – A review of five years of experience
Authors: Krzak Ada M , Fowles Jo-Anne , Vuylsteke Alain
Published: June 2019

Provision of extracorporeal membrane oxygenation as part of support escalation in severe refractory acute respiratory failure in England is provided by five specialist centres that operate within a well-defined quality and safety framework. We conducted a qualitative study of the extracorporeal membrane oxygenation retrieval service provided by one of the five centres. We analysed 176 consecutive debrief reports written between October 2013 and April 2018 by the consultant. Main identified issues were short delays in retrieval predominantly due to insufficient communication or equipment failure. All issues were addressed in subsequent practice. Our results suggest a need for improved communication between the referring intensive care unit and retrieving team. Our findings highlight the value of regular reflection-based evaluation to ensure continued provision of safe and efficient service.
Lipids that directly regulate innate immune signal transduction
Authors: Barnett Katherine C , Kagan Jonathan C
Published: June 2019

Pattern Recognition Receptors (PRRs) detect evidence of infection and tissue damage. The activation of these receptors and their downstream signal transduction pathways initiate a protective immune response. These signaling pathways are influenced by their spatial context, and precise subcellular positioning of proteins and protein complexes in these pathways is essential for effective immune responses in vivo. This organization is not limited to transmembrane proteins that reside in specific organelles, but also to proteins that engage membrane lipid head groups for proper positioning. In this review, we focus on the role of cell membranes and protein–lipid interactions in innate immune signal transduction and how their mechanisms of localization regulate the immune response. We will discuss how lipids spatially regulate the sensing of damage or infection, mediate effector activity, and serve as messengers of cell death and tissue damage.
Exercise and the gastrointestinal system
Authors: Stachow Ela
Published: June 2019

Physical exercise can have both acute and enduring effects on the gastrointestinal system. Physiological changes occur during exercise and as a result of repetitive physical activity. As a lifestyle measure, routine exercise has been associated with a reduced risk of developing certain gastrointestinal diseases. Exercise can also be beneficial for patients with gastrointestinal disease. Unpleasant gastrointestinal symptoms during vigorous exercise may limit athletes in competition and conversely, competitive sport can have adverse effects on the gastrointestinal tract. This article aims to explore the relationship between exercise and the gastrointestinal system and to prepare clinicians for discussion of pertinent aspects of this relationship with patients.
The incidence and relative risk of adverse events in patients treated with bisphosphonate therapy for breast cancer: a systematic review and meta-analysis
Authors: Yang Yan-Li , Xiang Zi-Jian , Yang Jing-Hua , Wang Wen-Jie , Xiang Ruo-Lan
Published: June 2019

Background:

Adjuvant bisphosphonates reduce the rate of breast cancer recurrence in the bone and improve breast cancer survival. However, the risk of adverse events associated with bisphosphonate therapy for breast cancer remains poorly defined.

Methods:

A literature search was conducted using the PubMed, EMBASE, Cochrane and Web of Science libraries. Risk ratio (RR) was calculated to evaluate the adverse events of the meta-analytic results. Osteonecrosis of the jaw (ONJ) incidence was calculated using the random effect model (D+L pooled) for meta-analysis.

Results:

A total of 47 studies comprising 20,607 patients were included; 23 randomized controlled studies (RCTs) provided data of adverse events for bisphosphonate therapy versus without bisphosphonates. Bisphosphonates were significantly associated with influenza-like illness (RR = 4.52), fatigue (RR = 1.08), fever (RR = 1.82), dyspepsia (RR = 1.25), anorexia (RR = 1.29), and urinary tract infection (RR = 1.32). No differences were observed in other adverse events. We combined the incidence of ONJ in 24 retrospective studies to analyze the incidence of ONJ using bisphosphonates. The pooled probability of ONJ toxicity in the bisphosphonates group was 2%.

Conclusions:

Bisphosphonates were significantly associated with influenza-like illness, fatigue, fever, dyspepsia, anorexia, and urinary tract infection. Furthermore, bisphosphonates increase the risk of ONJ toxicity.
Social media platforms and content exposure: How to restore users’ control
Authors: Stasi Maria Luisa
Published: June 2019

Social media platforms have become the main channel for people to communicate, access information and share content. A handful of giant platforms dominate the markets and, through a complex typology of conducts, are able to strongly affect users’ exposure to content, violating their privacy, as well as their freedom of expression and information. Regulators have at disposal a toolbox to fix the problem. This article analyses possible instruments and makes suggestions to contribute to the debate.
Chemical Compositions of Crassocephalum crepidioides Essential Oils and Larvicidal Activities Against Aedes aegypti, Aedes albopictus, and Culex quinquefasciatus
Authors: Hung Nguyen Huy , Satyal Prabodh , Dai Do Ngoc , Tai Thieu Anh , Huong Le Thi , Hong Chuong Nguyen Thị , Hieu Ho Viet , Tuan Pham Anh , Vuong Pham Van , Setzer William N.
Published: June 2019

The leaf, stem, and floral essential oils of Crassocephalum crepidioides growing wild in central Vietnam were obtained by hydrodistillation and analyzed by gas chromatography-mass spectrometry. The major component in all 3 oils was myrcene (59.3%, 26.1%, and 43.3%, respectively). The 24-hour mosquito larvicidal activities of the oil of the aerial parts (stems and leaves) were determined against wild-caught Aedes albopictus (IC50 = 14.3 μg/mL), laboratory-reared Aedes aegypti (IC50 = 4.95 μg/mL), and wild-caught Culex quinquefasciatus (IC50 = 18.4 μg/mL). The high concentration of myrcene in the essential oil likely accounts for the mosquito larvicidal activity observed.