bluuebunny/crossref_metadata_2025 huggingface dataset:
Vegetation changes and plant wax biomarkers from an ombrotrophic bog define hydroclimate trends and human-environment interactions during the Holocene in northern Norway
Authors: Balascio Nicholas L , Anderson R Scott , D’Andrea William J , Wickler Stephen , D’Andrea Robert M , Bakke Jostein
Published: August 2020

Holocene climate records from northern Europe improve our understanding of important North Atlantic ocean and atmospheric circulation systems to long-term insolation-driven changes, as well as more rapid forcing and feedback mechanisms. Here we assess Holocene climate and environmental changes in northern Norway based on the analysis of pollen, non-pollen palynomorphs, plant macrofossils, and plant wax biomarkers from a high latitude ombrotrophic bog. We define the extent and thickness of Hollabåttjønnen Bog (0.16 km2), which is located 10 km north of Tromsø. Several cores were analyzed, including a 5.16-m core that spans the last 9.5 cal ka BP. Vegetation changes from several sites were reconstructed and the distribution and hydrogen isotopic composition (δD) of n-alkanes (C21–C33) were analyzed. Our data show several distinct climate intervals that primarily indicate changes in bog surface moisture. In the early Holocene (c. 9.5–7.7 cal ka BP), wetter conditions are defined by the presence of wetland sedges and grasses, higher concentrations of mid-chain length n-alkanes, and a similarity in δD values among homologs. A dry mid-Holocene (c. 7.7–3.8 cal ka BP) is inferred from the presence of a heath shrubland, low peat accumulations rates, and significant differences between δD values of mid- and long-chain length n-alkanes. The late Holocene (c. 3.8 cal ka BP-present) is marked by the onset of wetter conditions, lateral bog expansion, and an increase in sedges and grasses. The Hollabåttjønnen Bog record is also significant because its margins were an important location for human settlement. We correlate early Holocene environmental conditions with changes in Stone Age structures recently excavated, and we identify the occurrence of coprophilous fungi, such as Sporormiella and Sordaria, likely associated with reindeer grazing activity beginning c. 1 cal ka BP. This site therefore provides important regional paleoclimate information as well as context for evaluating local prehistoric human-environment interactions.
Visiting and observing: reflections on clinical observer visits to Neuropsychiatry, Royal Melbourne Hospital
Authors: Looi Jeffrey , Velakoulis Dennis
Published: August 2020

Objectives:

To describe and provide experiential reflections on a model of continuing professional development in psychiatry for development and maintenance of specialised skills.

Conclusions:

For clinical psychiatrists working in smaller population centres, clinical observer visits with peers may be a useful method to develop, improve and calibrate knowledge and skills. Such potential benefits may be even more marked for specialised fields of psychiatry, such as neuropsychiatry.
Assessment of the New L Pharyngeal Flap for Velopharyngeal Insufficiency
Authors: El-Anwar Mohammad Waheed , Elsheikh Ezzeddin , Alnemr Mohamed Abdelmohsen , Quriba Amal Saed , Hassan Elham , Bahgat Ahmed Yassin
Published: August 2020

Objective:

To assess the results of the new L pharyngeal flap for treatment of velopharyngeal insufficiency (VPI).

Methods:

This study included 60 patients who were diagnosed as persistent VPI (for > 1 year without response to speech therapy for 6 months at least). L-shaped superiorly based pharyngeal flap was tailored from oropharynx and inserted into the soft palate through a transverse full-thickness palatal incision 1 cm from the hard palate, then the distal horizontal part of the flap was spread 1 cm anteroposterior direction and 1 cm horizontally into the soft palate. Prior to and after surgery, patients were assessed by oral examination, video nasoendoscopy, and speech evaluation.

Results:

Postoperative speech assessment showed significant improvement in nasoendoscopic closure, speech assessment, and nasometric assessments. Grade 4 velopharyngeal valve closure (complete closure) could be achieved in 59 (98.3%) patients at 6 months postoperatively. No patients showed dehiscence (partial or total) of the flap and no obstructive sleep apnea was reported.

Conclusion:

The newly designed L pharyngeal flap was proved to be highly effective, reliable, and safe in treating patients with persistent VPI with easy applicability and without significant complication.
Incidence and Hematological Biomarkers Associated With Preoperative Deep Venous Thrombosis Following Foot Fractures
Authors: Ma Jiangtao , Qin Jin , Hu Jinglve , Shang Meishuang , Zhou Yali , Liang Ningxi , Zhang Yingze , Zhu Yanbin
Published: August 2020

Background:

This study was designed to investigate the incidence and hematological biomarker levels that are associated with deep venous thrombosis (DVT) following closed foot fractures (except calcaneal fractures).

Methods:

A retrospective analysis of data on patients presenting with closed foot fractures (excluding the calcaneus) between October 2014 and December 2018 was conducted. Duplex ultrasonography was used to screen preoperative DVT of bilateral lower extremities. Data on demographics, comorbidities, types of fracture, and laboratory biomarkers at admission were collected. Univariate analyses and multivariate logistic regression analyses were carried out to determine the independent risk factors associated with DVT.

Results:

A total of 537 patients were included, among whom 28 patients had preoperative DVTs, indicating a crude incidence rate of 5.2%. In isolated closed foot fractures, DVT occurred in 12 (2.9%) out of 410 patients, while in patients with concurrent fracture in other locations, 16 (12.6%) out of 127 patients developed DVT. The average interval between fracture occurrence and diagnosis of DVT was 4.2 days (median, 2 days), ranging from 0 to 17 days. Twenty-four patients (85.7%) developed DVT in the injured extremity, 3 (10.7%) in the uninjured extremity, and 1 (3.5%) in bilateral extremities. Seven risk factors were identified to be associated with DVT, including alcohol consumption, concomitant other fractures, platelet distribution width (PDW) <12%, high-density lipoprotein cholesterol (HDL-C) <1.1mmol/L, serum alkaline phosphatase (ALP) >100 U/L, serum sodium concentration (Na+) <135 mmol/L, and D-dimer >0.5 mg/L.

Conclusion:

Being aware of the prevalence of DVT in closed foot fractures can help physicians to carry out the overall assessment, risk stratification, and individual prevention programs.

Level of Evidence:

Level III, a prospective cohort study.
Power and Promise of Next-Generation Sequencing in Liquid Biopsies and Cancer Control
Authors: Wu Ting-Miao , Liu Ji-Bin , Liu Yu , Shi Yi , Li Wen , Wang Gao-Ren , Ma Yu-Shui , Fu Da
Published: August 2020

Traditional methods of cancer treatment are usually based on the morphological and histological diagnosis of tumors, and they are not optimized according to the specific situation. Precision medicine adjusts the existing treatment regimen based on the patient’s genomic information to make it most suitable for patients. Detection of genetic mutations in tumors is the basis of precise cancer medicine. Through the analysis of genetic mutations in patients with cancer, we can tailor the treatment plan for each patient with cancer to maximize the curative effect, minimize damage to healthy tissues, and optimize resources. In recent years, next-generation sequencing technology has developed rapidly and has become the core technology of precise targeted therapy and immunotherapy for cancer. From early cancer screening to treatment guidance for patients with advanced cancer, liquid biopsy is increasingly used in cancer management. This is as a result of the development of better noninvasive, repeatable, sensitive, and accurate tools used in early screening, diagnosis, evaluation, and monitoring of patients. Cell-free DNA, which is a new noninvasive molecular pathological detection method, often carries tumor-specific gene changes. It plays an important role in optimizing treatment and evaluating the efficacy of different treatment options in clinical trials, and it has broad clinical applications.
Evaluation of intraoperative lagophthalmos formula for levator resection in congenital ptosis in Egyptian patients
Authors: Rakha Tarek M , El Saadani Abd El Khalik I , Awara Amr M , Mandour Sameh S
Published: August 2020

Purpose:

To evaluate the recent intraoperative lagophthalmos formula method for levator resection in determining postoperative lid height in congenital ptosis on Egyptian patients.

Methods:

This is a prospective case series which included 20 eyelids of 17 Egyptian children with congenital ptosis whose levator function is 4 mm or better. They underwent levator muscle resection guided by the recently presented intraoperative lagophthalmos formula. Preoperative Margin-to-Reflex Distance 1 (MRD1) and levator function were measured then intraoperative palpebral fissure opening was determined from formula: Intraoperative lagophthalmos = 9.08 − (0.48 × Preoperative MRD1) − (0.26 × Levator function). Success was defined as postoperative MRD1 ⩾ 3 mm and difference between both eyelid height ⩽1 mm at 6 months.

Results:

From 20 eyelids, there were five cases with mild (25%), 11 with moderate (55%), and four with severe (20%) ptosis. They showed success in four cases (80%), eight cases (73%), and three cases (75%) in each degree respectively with an overall success of 15 cases (75%).

Conclusion:

Proposed intraoperative lagophthalmos formula showed relatively good results in predicting postoperative eyelid level in Egyptian children with simple congenital ptosis with fair to good levator function.
‘Even if you don’t care…you do care after all’: ‘Othering’ and physical education in Norway
Authors: Røset Linda , Green Ken , Thurston Miranda
Published: August 2020

In the past decade or more, improving young people’s mental health has been identified as a priority for policy-makers in many countries, including Norway. Physical education, as a setting for physical activity, is increasingly viewed as having a potentially significant role to play in addressing mental health among the young. This paper reports the findings from a study of 148 Norwegian youngsters (68 girls and 80 boys) from the 10th grade (15–16 years old) in eight secondary schools in Norway in 2017. It explores Norwegian youngsters’ experiences of physical education in relation to aspects of their mental health – specifically, being judged and, by extension, ‘othered’. The findings suggest that physical education may undoubtedly serve to generate positive feelings associated with physical activity and games and, in doing so, bolster some youngsters’ self-esteem and self-identities. On the other hand, however, for those less competent in sporting terms, and whose bodily self-image is not particularly positive, the public nature of physical education and the nature of the activities that constitute the subject can give rise to unplanned and unintended harm to some youngsters’ mental health – especially in countries, such as Norway, where sport is a significant aspect of the group habitus and collective ‘we-group’ identity.
Dual adaptive robust control for uncertain nonlinear active suspension systems actuated by asymmetric electrohydraulic actuators
Authors: Zhao Dingxuan , Du Miaomiao , Ni Tao , Gong Mingde , Ma Lizhe
Published: August 2020

This study investigates the vibration control issue of active suspension systems. Unlike previous results that neglect the actuator dynamics or consider the impractical symmetrical hydraulic cylinder model, this paper incorporates more reasonable asymmetric electrohydraulic actuator into active suspension system and derives its dynamic model. However, whether active suspension or electrohydraulic actuator suffers from nonlinearities (e.g. nonlinear spring, nonlinear damper and nonlinear actuator dynamics) and parameters uncertainties (e.g. the variations of sprung mass and hydraulic fluid’s bulk modulus as well as hydraulic cylinder original control volumes) , which were rarely synthetically considered in the existing researches.To address these issues, we develop a novel dual adaptive robust controller (ARC). An ARC is firstly designed for main-loop system for stabilizing the car body and improving ride comfort in the presence of nonlinearities and parameter uncertainties as well as road disturbances. In order to meet the constraints requirements of suspension system, the tunable parameters in main-loop control law are optimized by solving linear matrix inequality with kidney-inspired algorithm. Another ARC is further synthesized for sub-loop system to deal with the nonlinear and uncertain dynamics in electrohydraulic actuator for ensuring the force tracking performance. Meanwhile, the uncertain parameters are estimated online to compensate the model deviation. The terminal control law is able to guarantee the asymptotic stability of close-loop system within Lyapunov framework. Finally, the effectiveness and robustness of the proposed controller are demonstrated via excessive simulation experiments over different road conditions.
Data journalism uptake in South Africa’s mainstream quotidian business news reporting practices
Authors: Munoriyarwa Allen
Published: August 2020

Drawing from the sociology of news production theory, this study examines the uptake of data-driven practices in business news reporting. It examines the extent to which journalists have adopted data journalism in business news and how this has altered their news reporting practices. It is based on a textual analysis of business news stories from two selected prominent business newspapers – Business Day and The Financial Mail and qualitative interviews with business news reporters. The study finds that there is a (gradually) increasing uptake of data-driven business news reporting practices, tempered by journalists’ concerns regarding their own individual professional capabilities. Furthermore, the practice has increasingly created a new narrative of corporate accountability in the press and inculcated collaboration in newsrooms. It argues that data-driven business news practices have upended the ‘rhythimised’ and ‘routinised’ news production processes by, among other aspects, empowering non-elite news sources, fostering newsroom collaborations and agentive the newsrooms. However, there is need for a recalibration of journalism education if data-driven reporting practices are to be more sustainable.
Philosophies of integration? Elite views on citizenship policies in Scandinavia
Authors: Brochmann Grete , Midtbøen Arnfinn H
Published: August 2020

Research on the ‘civic turn’ in European citizenship policies suggests that concerns over immigrant integration have fueled the restrictive development of citizenship policies in recent decades. However, few efforts have been made to explore the normative ideas underlying this development. Departing from Favell’s (1998) influential concept of ‘philosophies of integration’, this article draws on elite-interviews with top-level bureaucrats, politicians and citizenship experts in the Scandinavian countries and explores how ideas about nationhood and integration have influenced the divergence in citizenship policies in the region, and what overall purpose the policy-changes reflect. We find that, especially in Denmark, the gradual introduction of ever more demanding civic integration requirements appears to be a part of the broader aim of controlling the inflow of migrants and not to enhance the integration of those already present in the country. Conversely, the Swedish liberal approach to citizenship, which regularly has been analyzed as a steppingstone to societal integration, might in reality have been a reflection of benign neglect. In Norway, immigrant integration has clearly been part of the underlying rationale for changes in naturalization requirements, yet the control dimension have played an increasingly important role. These findings suggests that, although the citizenship institution remains important in nation states’ efforts to solve their ‘ethnic dilemmas’, the underlying rationale behind policy-change is more multifaceted than previously understood.
Life-History Factors Influence Teenagers’ Suicidal Ideation: A Model Selection Analysis of the Canadian National Longitudinal Survey of Children and Youth
Authors: Ziker John P. , Snopkowski Kristin
Published: August 2020

Suicidality is an important contributor to disease burden worldwide. We examine the developmental and environmental correlates of reported suicidal ideation at age 15 and develop a new evolutionary model of suicidality based on life history trade-offs and hypothesized accompanying modulations of cognition. Data were derived from the National Longitudinal Survey of Children and Youth (Statistics Canada) which collected information on children’s social, emotional, and behavioral development in eight cycles between 1994 and 2009. We take a model selection approach to understand thoughts of suicide at age 15 ( N ≈ 1,700). The most highly ranked models include social support, early life psychosocial stressors, prenatal stress, and mortality cues. Those reporting consistent early life stress had 2.66 greater odds of reporting thoughts of suicide at age 15 than those who reported no childhood stress. Social support of the primary caregiver, neighborhood cohesion, nonkin social support of the adolescent, and the number of social support sources are all associated with suicidal thoughts, where greater neighborhood cohesion and social support sources are associated with a reduction in experiencing suicidal thoughts. Mother’s prenatal smoking throughout pregnancy is associated with a 1.5 greater odds of suicidal thoughts for adolescents compared to children whose mother’s reported not smoking during pregnancy. We discuss these findings in light of evolutionary models of suicidality. This study identifies both positive and negative associations on suicidal thoughts at age 15 and considers these in light of adaptive response models of human development. Findings are relevant for mental health policy.
Relationship Between Psychological Factors and Wound Occurrence in Patients With Peripheral Arterial Disease in the Leg
Authors: Onoyama Ayaka , Hoshiyama Minoru , Yabe Hiroki
Published: August 2020

This prospective study investigated psychological factors affecting wound healing in patients with peripheral arterial disease (PAD). Fifty patients with PAD in a local hospital were enrolled. The Geriatric Depression Scale short version, Type-D scale 14, Medical Outcome Study 36-Item Short-Form Health Survey (SF-36), Functional Independence Measure, Self-efficacy for Managing Chronic Disease Scale, Barriers Self-Efficacy Scale, and Mini Nutritional Assessment were applied to assess physical and psychological factors. Wound occurrence and healing were evaluated at 6 months after discharge, and 34 and 30 patients could be followed, respectively. The patient group with wound occurrence showed poorer mental component score (MCS) and better role/social component score (RCS) category scores of SF-36, and a higher stage in the Fontaine classification, than those without wound occurrence. On comparing Fontaine classification–matched subgroups, patients with wound occurrence showed poorer general health factor and MCS and better RCS of SF-36 than those without wound occurrence. Logistic analysis showed that MCS and RCS predicted wound occurrence and needs for local medical treatment, respectively. Among the psychological factors tested, MCS was a major factor associated with wound occurrence in the present study, with wide variation in clinical conditions and factors associated with PAD. Psychological factors were important as biological, physical, and social factors for patients with PAD during the long-term follow-up period, and an appropriate battery to evaluate psychological factors focused on patients with PAD should be developed.
Improving Analytic Reasoning via Crowdsourcing and Structured Analytic Techniques
Authors: van Gelder Tim , Kruger Ariel , Thomman Sujai , de Rozario Richard , Silver Elizabeth , Saletta Morgan , Barnett Ashley , Sinnott Richard O. , Jayaputera Glenn Tesla , Burgman Mark
Published: August 2020

How might analytic reasoning in intelligence reports be substantially improved? One conjecture is that this can be achieved through a combination of crowdsourcing and structured analytic techniques (SATs). To explore this conjecture, we developed a new crowdsourcing platform supporting groups in collaborative reasoning and intelligence report drafting using a novel SAT we call “Contending Analyses.” In this paper we present findings from a large study designed to assess whether groups of professional analysts working on the platform produce better-reasoned reports than those analysts produce when using methods and tools normally used in their organizations. Secondary questions were whether professional analysts working on the platform produce better reasoning than the general public working on the platform; and how usable the platform is. Our main finding is a large effect size (Cohen’s d = 1.37) in favor of working on platform. This provides early support for the general conjecture. We discuss limitations of our study, implications for intelligence organizations, and future directions for the work as a whole.
When and how to include vulnerable subjects in clinical trials
Authors: Wendler David
Published: August 2020

There has been a good deal of discussion in the literature regarding which subjects are vulnerable in the context of clinical trials. There has been significantly less discussion regarding when and how to include vulnerable subjects in clinical trials. This lack of guidance is a particular problem for trials covered by the US regulations, which mandate strict requirements on the inclusion of three groups: pregnant women/fetuses, prisoners, and children. For the past 30 years, funders, investigators, and institutional review boards have frequently responded to these regulations by excluding pregnant women/fetuses, prisoners, and children from clinical trials. More recent work has emphasized the extent to which a default of exclusion can undermine the value of clinical trials, especially pragmatic trials. A default of exclusion also has the potential to undermine the interests of vulnerable groups, in both the short and the long term. These concerns raise the need for guidance on how to satisfy existing US regulations, while minimizing their negative impact on the value of clinical trials and the interests of vulnerable groups. The present manuscript thus describes a six-step decision procedure that institutional review boards can use to determine when and how to include vulnerable subjects in clinical trials, including pragmatic trials, that are covered by US regulations.
Antialcohol Effects of Dihydromyricetin in Combination With Other Flavonoids
Authors: Silva Joshua , Yu Xin , Qi Luqing , Davies Daryl L. , Liang Jing
Published: August 2020

Herbal remedies are consumed by approximately 50% of the population in the United States for health and wellness, including products promoted for liver health and alcohol (ethanol [EtOH]). Previously, we have shown that dihydromyricetin (DHM), a bioflavonoid, can counteract EtOH intoxication and withdrawal via GABAA receptor (GABAAR) activity. Through evaluation of GABAAR potentiation using DHM, resveratrol, genistein, daidzein, and turmeric, we found that the activity of DHM is unique. Furthermore, using the loss of right reflex induced by EtOH in rats, we discovered that DHM was superior in reducing EtOH intoxication and EtOH actions on GABAARs. However, the combination of DHM with turmeric, daidzein, or resveratrol diminished the DHM effects. Here, we report that combinations of DHM should be evaluated, as we have found that combining DHM with other flavonoids diminished efficacy. Collectively, these data support the utility of DHM as a unique antialcohol intoxication therapy.
Participatory Design, Project Clients, and Healthcare User Groups
Authors: Carthey Jane
Published: August 2020

Aim:

This study is the third in a series of investigations that explored the role of project user groups and how they impact on the design of a healthcare facility. Previous studies focused on a wide range of users, whereas this study sought the views of project clients.

Background:

The “project client” represents the organization responsible for the procurement of a healthcare facility. “Users” will work in or “use” that building. With the input of project clients, this research focused on the user group process required for Australian and New Zealand publicly funded healthcare projects. It sought lessons to improve the process for future projects.

Methods:

Previous research findings, and an expanded literature review examining participatory design, were used to develop questions for semistructured interviews with selected project clients. Responses were transcribed and analyzed in terms of themes and subthemes using reflexive thematic analysis to develop a narrative that reports and discusses the findings.

Results:

Although not all are recognized, many stakeholders influence design decisions. No history, rationale, terms of reference, or evaluations of the user group process were found, suggesting that although it is a “given,” the process could be enhanced. Useful suggestions for improving the user group process are offered.

Conclusions:

Evaluating the user group process, and learning from alternative approaches, may improve its outcomes. A project charter and terms of reference would support more effective decision making, while best practice guidelines and education for user group participants should be considered.
Ecological Environments of Tropical and Subtropical Regions in China
Authors: Sun Jiasen , Li Guo , Wang Qunwei , Zhang Bin
Published: August 2020

China’s tropical and subtropical zones have high levels of economic development and are densely populated. However, the economic development and population growth have exacerbated ecological problems. This special issue provides a platform for sharing the latest studies on the ecological environments in the tropical and subtropical regions of China. The studies in this issue can be divided into three categories: (a) energy-saving and emission reduction, environmental efficiency, and carbon emissions; (b) relationship between economic development and the ecological environment; and (c) environmental protection services, public satisfaction, and corporate environmental obligations. In this special issue, some studies have adopted and expanded new methods in the field of ecological environment, and some studies have provided empirical evidence for meteorological disaster theory and household consumption behavior theory. In addition, the conclusions of some studies provide important recommendations to the government for policy formulation regarding the ecological environment, improvement of environmental protection services, and economic development.
The Seven Forms of Challenges in the Wildlife Trade
Authors: Roberts David L. , Hinsley Amy
Published: August 2020

Initiatives that aim to regulate the international wildlife trade must take into account its multiple and often complex dimensions in order to be effective. To do this, it is essential to understand the interactions between three of the key dimensions of the wildlife trade: (1) taxonomic unit, (2) geographic origin, and (3) product form and transformation. We propose a framework to provide a structured approach to defining the complexities of the wildlife trade, based on Rabinowitz’s seven forms of rarity. We demonstrate the complexities and how they apply to our framework using two contrasting examples: the trade in elephant ivory, and the horticultural orchid trade. Further we use the framework to map different traceability solutions. To be as efficient as possible, efforts to tackle the illegal and unsustainable utilisation of wildlife should take a more structured approach. This framework identifies challenges that current initiatives may face, how they may interact and provides a structure for designing future interventions.
Attachment to place and territoriality in Nandigram land struggle, India
Authors: Bose Sayoni
Published: August 2020

The Nandigram peasant struggle against land acquisition for special economic zones (SEZs) in West Bengal, India, in 2006–2007, highlights the importance of attachment to place and territorialization in resistance. Analyzing the Nandigram land struggle, I underscore the importance of place-based attachment. I argue that land is a social relation. The land acquisition was a threat of breakage in that place-based relation, which led to negative perceptions of industrialization. This threat pronounced the existing attachment to place, which led to the spatialization of the muktanchal or liberated zone. I conceptualize the muktanchal as an act of territoriality, where militant peasant identities emerged that facilitated their claim-making. This paper uses content analysis of existing primary data from heterogeneous sources, to illuminate how the peasants strategically created the muktanchal to contest top-down attempts by the state to create a SEZ enclave.
Rhinomanometry Versus Computational Fluid Dynamics: Correlated, but Different Techniques
Authors: Cherobin Giancarlo B. , Voegels Richard L. , Pinna Fábio R. , Gebrim Eloisa M. M. S. , Bailey Ryan S. , Garcia Guilherme J. M.
Published: August 2020

Background

Past studies reported a low correlation between rhinomanometry and computational fluid dynamics (CFD), but the source of the discrepancy was unclear. Low correlation or lack of correlation has also been reported between subjective and objective measures of nasal patency.

Objective:

This study investigates (1) the correlation and agreement between nasal resistance derived from CFD (RCFD) and rhinomanometry (RRMN), and (2) the correlation between objective and subjective measures of nasal patency.

Methods

Twenty-five patients with nasal obstruction underwent anterior rhinomanometry before and after mucosal decongestion with oxymetazoline. Subjective nasal patency was assessed with a 0-10 visual analog scale (VAS). CFD simulations were performed based on computed tomography scans obtained after mucosal decongestion. To validate the CFD methods, nasal resistance was measured in vitro (REXPERIMENT) by performing pressure-flow experiments in anatomically accurate plastic nasal replicas from 6 individuals.

Results

Mucosal decongestion was associated with a reduction in bilateral nasal resistance (0.34 ± 0.23 Pa.s/ml to 0.19 ± 0.24 Pa.s/ml, p = 0.003) and improved sensation of nasal airflow (bilateral VAS decreased from 5.2 ± 1.9 to 2.6 ± 1.9, p < 0.001). A statistically significant correlation was found between VAS in the most obstructed cavity and unilateral airflow before and after mucosal decongestion (r = −0.42, p = 0.003). Excellent correlation was found between RCFD and REXPERIMENT (r = 0.96, p < 0.001) with good agreement between the numerical and in vitro values (RCFD/REXPERIMENT = 0.93 ± 0.08). A weak correlation was found between RCFD and RRMN (r = 0.41, p = 0.003) with CFD underpredicting nasal resistance derived from rhinomanometry (RCFD/RRMN = 0.65 ± 0.63). A stronger correlation was found when unilateral airflow at a pressure drop of 75 Pa was used to compare CFD with rhinomanometry (r = 0.76, p < 0.001).

Conclusion

CFD and rhinomanometry are moderately correlated, but CFD underpredicts nasal resistance measured in vivo due in part to the assumption of rigid nasal walls. Our results confirm previous reports that subjective nasal patency correlates better with unilateral than with bilateral measurements and in the context of an intervention.
Low-grade fibromyxoid sarcoma: A rare case in an unusual location
Authors: Perez Diandra , El-Zammar Ola , Cobanov Brando , Naous Rana
Published: August 2020

Low-grade fibromyxoid sarcoma, also known as Evans tumor, is a low-grade sarcoma that most commonly arises in the deep soft tissue of the proximal extremities or trunk in young adults. It is very rare in the viscera as a primary site, with only a few cases reported in the literature. Here, we present a case of Evans tumor occurring in an unusual and rarely reported location; an intrathoracic mass arising from the diaphragmatic pleura.
Home health nurses’ views on participating in pre-ambulance emergency treatment: A qualitative descriptive study
Authors: Fjällman Carina , Hilli Yvonne , Jonasson Lise-Lotte
Published: August 2020

As part of the Health Care Interaction project that was rolled out in western Sweden, home health nurses (HHNs) were called on as first responders to provide emergency treatment to patients, while waiting for the ambulance to arrive. The aim of this study was to evaluate the Health Care Interaction project in terms of the training and preparation of HHNs and the competencies that the nurses felt they needed to develop to feel confident in these assignments. In this qualitative descriptive study, 11 home health nurses from six municipalities that implemented the project were interviewed, and the data were analysed using content analysis. The COREQ guidelines were followed in the reporting of this study. The findings show that some municipalities did not have a training or preparation course in place, and guided the HHNs to refer to self-education material. The HHNs emphasised the importance of continuously updating their knowledge and skills through regular training. Further, feedback and reflection were considered important as reinforcement of learning.
Study on the effect ofPeriplaneta americanaon ulcerative colitis in rats induced by 2,4,6-trinitrobenzene sulfonic acid
Authors: Che Yi-Hao , Yang Zhi-Bin , Zhang Han-Chao , Wu Xiu-Mei , Sun Min-Zhe , Tang Miao , Wang Peng-Chuan , Geng Fu-Neng , Wan Ping , Liu Heng , He Miao , Zhao Yu , Zhang Cheng-Gui
Published: August 2020

Ulcerative colitis (UC) is a chronic inflammatory disease of intestinal tract, and Periplaneta americana has been found to be effective in the treatment for UC. The purpose of the study was to investigate the therapeutic effect of Periplaneta americana extract Ento-A on UC in rats induced by 2,4,6-trinitrobenzene sulfonic acid (TNBS) and to explore its mechanism. The Sprague-Dawley (SD) rats were randomly divided into normal control group; TNBS-treated group; sulfasalazine (SASP) treated group; Ento-A low- (50 mg/kg), medium- (100 mg/kg), and high-dose (200 mg/kg) groups, respectively. The UC model of rats was induced via TNBS. Disease activity index (DAI) was used to evaluate the severity of UC in rats. The macroscopic and microscopic damages of colon were accessed by colon mucosa damage index (CMDI) and histopathological score (HS), respectively. The levels of interleukin-4 (IL-4), interleukin-17 (IL-17), tumor necrosis factor-α (TNF-α), and interferon-γ (IFN-γ) in serum and the contents of myeloperoxidase (MPO), transforming growth factor-β1 (TGF-β1), and epidermal growth factor (EGF) in colonic mucosa were measured by enzyme-linked immunosorbent assay (ELISA). Compared with the normal control group, the TNBS-treated group showed increase in DAI, CMDI, HS, IL-17, TNF-α, IFN-γ as well as MPO and decrease in the levels of IL-4, EGF, and TGF-β1. However, Ento-A-administrated groups reversed the changes in the DAI, CMDI, HS, and the cytokines caused by TNBS. The study indicates that Periplaneta americana extract Ento-A can effectively alleviate the inflammation in TNBS-induced UC of rats, and the mechanism of that may be related to restoring the balance of T helper 1 (Th1)/Th2/Th17/T regulatory (Treg) cytokines.
The Same and the Different: On Semantization and Instrumentalization Practices in the (Maths) Classroom
Authors: Janík Tomáš , Slavík Jan , Najvar Petr , Jirotková Darina
Published: August 2020

There is no education without content. Teaching and learning in schools is devoted to “something,” not to “nothing” or “anything.” The more heterogeneous, multicultural, and multilingual the classroom, the more semantization of educational content within teaching and learning is needed. Therefore, the role of various languages in the classroom is revisited. In this article, we elaborate on the theory of language-sensitive content transformation and introduce the concept of operational isomorphism and its potential in the field of didactics, research on teaching, and learning and teacher education. Using a case study of mathematics teaching, we illustrate, how students can benefit from semantization and instrumentalization practices in the classroom and how these processes take the form of extensional deconstruction and intensional expansion or intensional condensation.
Lower Tibial Tunnel Placement in Isolated Posterior Cruciate Ligament Reconstruction: Clinical Outcomes and Quantitative Radiological Analysis of the Killer Turn
Authors: Lin Yipeng , Huang Zeyuan , Zhang Kaibo , Pan Xuelin , Huang Xihao , Li Jian , Li Qi
Published: August 2020

Background:

The “killer turn” effect after posterior cruciate ligament (PCL) reconstruction is a problem that can lead to graft laxity or failure. Solutions for this situation are currently lacking.

Purpose:

To evaluate the clinical outcomes of a modified procedure for PCL reconstruction and quantify the killer turn using 3-dimensional (3D) computed tomography (CT).

Study design:

Case series; Level of evidence, 4.

Methods:

A total of 15 patients underwent modified PCL reconstruction with the tibial aperture below the center of the PCL footprint. Next, 2 virtual tibial tunnels with anatomic and proximal tibial apertures were created on 3D CT. All patients were assessed according to the Lysholm score, International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form, Tegner score, side-to-side difference (SSD) in tibial posterior translation using stress radiography, and 3D gait analysis.

Results:

The modified tibial tunnel showed 2 significantly gentler turns (superior, 109.87° ± 10.12°; inferior, 151.25° ± 9.07°) compared with those reconstructed with anatomic (91.33° ± 7.28°; P < .001 for both comparisons) and proximal (99° ± 7.92°; P = .023 and P < .001, respectively) tibial apertures. The distance from the footprint to the tibial aperture was 16.49 ± 3.73 mm. All patient-reported outcome scores (mean ± SD) improved from pre- to postoperatively: Lysholm score, from 46.4 ± 18.87 to 83.47 ± 10.54 ( P < .001); Tegner score, from 2.47 ± 1.85 to 6.07 ± 1.58 ( P < .001); IKDC sports activities score, from 19 ± 9.90 to 33.07 ± 5.35 ( P < .001); and IKDC knee symptoms score, from 17.87 ± 6.31 to 25.67 ± 3.66 ( P < .001). The mean SSD improved from 9.15 ± 2.27 mm preoperatively to 4.20 ± 2.31 mm postoperatively ( P < .001). The reconstructed knee showed significantly more adduction (by 1.642°), less flexion (by 1.285°), and more lateral translation (by 0.279 mm) than that of the intact knee ( P < .001 for all).

Conclusion:

Lowering the tibial aperture during PCL reconstruction reduced the killer turn, and the clinical outcomes remained satisfactory. However, SSD and clinical outcomes were similar to those of previously described techniques using an anatomic tibial tunnel.
Degree of Adaptation of Jerusalem Palestinian Students at Israeli Academic Colleges
Authors: Mizel Omar
Published: August 2020

Several international and local studies have indicated that Arab students face specific difficulties in adapting to and integrating into Israeli colleges. This research aims to identify and analyze the adaptation difficulties faced by Palestinian students in academic colleges in Israel. The research sample consists of Palestinian freshmen from different schools and neighborhoods in East Jerusalem who are studying at a college in West Jerusalem. In-depth interviews were used to document and analyze the experiences and challenges of these students on campus. The interviews revealed a number of factors that impede students’ adaptation and their academic success, and they can be grouped under the concepts of culture shock, language barriers, isolation, and transportation. To deal with these difficulties, students used different strategies such as piety, withdrawal, dependency, and distancing. Implementing specific programs to consider and address specific social and cultural aspects of Palestinian students’ difficulties may contribute to reducing the alienation and culture shock they face in college, such as introducing programs on life skills and treatment of others, hiring faculty who are capable of understanding the Palestinian cultural context and introducing qualified Arab staff in the administrative and service departments.
Olfaction in Primary Atrophic Rhinitis and Effect of Treatment
Authors: Mishra Anupam , Mishra Shukla Nimisha , Verma Veerendra , Mishra Subhash Chandra
Published: August 2020

Objective

To assess olfactory and clinical morbidity in primary (idiopathic)–type atrophic rhinitis and its course following treatment.

Study Design

Prospective nonrandomized controlled cohort study with follow‐up.

Setting

Department of Otorhinolaryngology and Head and Neck Surgery of a university hospital (tertiary heath care center).

Methods

Sixty‐one patients with atrophic rhinitis underwent assessment of clinical severity with baseline olfaction with the Brief Smell Identification test, while the improvement of their status following surgical versus nonsurgical treatment was further assessed.

Results

Olfaction was universally deranged with bimodal age presentation and female predominance (61%). Clinical improvement was significantly associated with surgical treatment but did not reveal any relation with up‐front severity of disease. A near‐significant association of age with severity did not reveal significance when stratified by age group. Baseline olfaction or its change following treatment did not reveal any significance with severity of disease or clinical improvement. Radiologic atrophy also did not reveal any significant relation with severity criteria.

Conclusions

Olfactory functions as compared with clinical parameters provided better reflection of underlying (systemic) pathology with environmental interaction, while later it mainly signified localized condition. Accordingly, olfaction was affected early and recovered slowly (or not at all), independent of clinical morbidity, which in turn is affected rather late but recovers early. Olfactory dysfunction at the initial stage may be a surrogate marker of potential worsening clinical condition, since bacteria often superinfect underlying susceptible nasal environment. While surgery mainly improved clinical parameters without affecting olfaction directly, a true improvement would include recovery of both.
Anxiety and Depression in Patients With Retinitis Pigmentosa
Authors: Le Patrick , Nguyen Michelle , Vu Thoai , Dao Diem-Phuong , Olson Daniel , Zhang Alice Yang
Published: August 2020

Purpose:

Retinitis pigmentosa (RP) is a chronic progressive disease with no curative treatments. Understanding the variables involved with improving patients’ quality of life is important in managing this population. The literature investigating the relationship of anxiety and depression with RP relies on the analysis of smaller subset populations of patients with RP, and no study has quantified the effect size of the potential association. This study aims to elucidate and quantify the association between RP, anxiety, and depression.

Methods:

A retrospective case-control study was conducted of 6 093 833 medical records within the University of North Carolina Hospital and outpatient clinic system from July 1, 2004, to August 30, 2019. Patients with a diagnosis of RP, anxiety, and depression were identified within the Carolina Data Warehouse for Health by International Classification of Diseases, Ninth and Tenth Revision codes.

Results:

From the base population of 6 093 833 patients' medical records, 690 patients were diagnosed with RP, 253 065 with anxiety, and 232 541 with depression. Patients with RP have an odds ratio, adjusted for sex and age, of 4.915 (95% CI, 4.035-5.987) for having comorbid anxiety, 5.609 (95% CI, 4.622-6.807) for comorbid depression, and 4.130 (95% CI, 3.187-5.353) for comorbid anxiety and depression.

Conclusions:

Patients with RP have a higher prevalence of anxiety and depression, with increased odds of approximately 5 to 6 times for also carrying a diagnosis of anxiety or depression and about 4 times for carrying diagnoses of anxiety and depression compared with the general population.
Evaluation of an Expert Guided Integrative Therapy Concept in Patients With Breast or Gynecological Cancer During Systemic Therapy
Authors: Schmidt Georg , Mathes Sofia , Klein Evelyn , Kiechle Marion , Paepke Daniela
Published: August 2020

Purpose.

Breast and gynecological cancer patients undergoing systemic therapy frequently request integrative therapy concepts. The potential of integrative therapy (IM) lies in minimizing side effects of conventional cancer treatments and therefore decreasing treatment delays. IM can help to improve patients’ physical and emotional well-being, optimizing health and quality of life as IM involves patients in their own treatment. A counseling service for integrative medicine concepts as an outpatient program was implemented in our cancer center in 2013.

Methods.

In 2016 and 2017 144 breast and gynecological cancer patients were included into our specific IM program. The program comprises biological based complementary and alternative medicines (BB-CAM), a structured exercise therapy, manipulative and body-based practices, nutritional counseling, psycho-oncological and relaxing therapies. Therapists with additional specialization for IM, guide the treatment units. The program was evaluated via self-administered questionnaire.

Results.

78% of the participating patients noticed an improvement by using BB-CAMs. 86% stated to feel better through participation in the structured exercise program. 74% profited from nutritional counseling and 91% from manual therapy. 93% of the patients treated with body compresses considered the application as soothing. The Bio-Frequency Sound Color Bed led to a relaxation in 96%. Psychological therapy improved coping with the disease in 70% of the patients.

Conclusion.

Integrative oncology combines the best practices of conventional and complementary therapy, uniting them in a holistic concept. Data show that our integrative therapy concept is well accepted by the patients and that therapy- and disease-related side effects can be reduced.
Development of BIMSTEC Free Trade Area for Thailand in Indo-Pacific
Authors: Srisangnam Piti , Sabhasri Chayodom , Horachaikul Surat , Sinthuphan4and Jirayudh , Rudjanakanoknad Jittichai
Published: August 2020

To develop a policy for creation of economic value and utilise the development of Bay of Bengal Initiative for Multi-Sectoral Technical and Economic Cooperation (BIMSTEC) free trade area for Thailand, two research tools are adopted in this article. The first one is based on the Global Trade Analysis Project (GTAP) model, adopted as a tool to explore quantitative impacts from the implementation of free trade area. Due to the limitations of the model, however, we have adopted a complementing qualitative analytical framework to ensure that the research must be as comprehensive as possible in every aspect. The qualitative analytical framework chosen in this article is called PEST analysis. Having completed field research, in-depth interviews, focus group meetings and model studies, this article concludes that BIMSTEC is a large-scale market with high purchasing power and growth rate as well as a great source of vast natural and human resources. It is situated not far from Thailand, and at the same time, its social and cultural conditions are very close to those of Thailand’s. It concludes that a stronger BIMSTEC is an essential foundation of Indo-Pacific.

JEL Codes: F13, F 15