bluuebunny/crossref_metadata_2025 huggingface dataset:
The Value of CT and MRI Examination in the Diagnosis of Diffuse Axonal Injury
Authors: Chen Haosheng , Liu Junjie , Lei Zhen , Gretrhen Gibton
Published: June 2020

Objective: To compare the number of detections of diffuse axonal injury (DAI) lesions between CT and MRI routine sequences (T1WI, T2WI, FLAIR) and special sequences (DWI, SWI). There is no difference in the detection rate of hemorrhagic lesions and non-hemorrhagic lesions with
diffuse axonal injury, and more clinically valuable diagnostic methods are obtained to improve the clinical understanding of the detection and disease of diffuse axonal injury. Methods: The paper collected 37 cases of clinical data and imaging data of patients with diffuse axonal injury
clinically diagnosed from March 2017 to January 2019 in our hospital. The patients underwent CT scan of the Department of Radiology in our hospital within 72 hours after the injury, and MRI was performed one week after admission according to the stable condition. The imaging data was obtained
from the radiology consciousness readings. Results: A total of 37 patients underwent imaging studies. The number of missed CT scans in the brainstem was relatively small compared with other locations, and the number of missed diagnosis of lesions in the cerebellum was higher. In the
conventional MRI sequence, FLAIR detected the most lesions, and the difference between the number of lesions detected by T1WI and T2WI was statistically significant (χ2 = 22.930, P = 0.011 < 0.05). Among the special sequences, the number of SWI lesions was the
highest, and the difference between DWI and SWI was statistically significant (χ2 = 13.090, P = 0.002 < 0.05). The number of detected CT, FLAIR and SWI was compared. The number of SWI detected was the most, and the difference was statistically significant (χ2
= 19.634, P = 0.033 < 0.05). DWI had the highest detection rate for hemorrhagic lesions, followed by FLAIR (χ2 = 188.168, P < 0.001). SWI had the highest detection rate for hemorrhagic lesions, followed by DWI (χ2 = 1363.452,
P < 0.001). Conclusion: The most common number of lesions detected in patients with DAI is the SWI sequence. For the detection of hemorrhagic lesions, SWI has obvious advantages. In non-hemorrhagic lesions, the detection rate of DWI is significantly higher than other sequences.
Therefore, it can be said that the DWI and SWI sequences provide an important imaging basis for the definitive diagnosis of DAI, and have high application value.
Brain Image Enhancement Approach Based on Singular Value Decomposition in Nonsubsampled Shearlet Transform Domain
Authors: Li Liangliang , Si Yujuan , Wang Linli , Jia Zhenhong , Ma Hongbing
Published: June 2020

In this work, a novel image enhancement algorithm using NSST and SVD is proposed to improve the definition of the acquired brain images. The input brain image is computed by CLAHE, then the processed brain image and input brain image are decomposed into low- and high-frequency components
by NSST, the singular value matrix of the low-frequency component is estimated. The final enhancement image is obtained by inverse NSST. Results of this experiment demonstrate that the proposed technique has good performance in terms of brain image enhancement when compared to other methods.
Application of Back Propagation Neural Network Model in Prediction and Diagnosis of Osteoporosis
Authors: Lu Tong , Xue Yi , Kong Wenbin , Shen Yingchao , Cao Xi , Wang Qiang , Ferran Malafarina
Published: June 2020

The classification model of osteoporosis was established, the diagnostic index system of osteoporosis was analyzed, and the BP neural network system was designed. The data of 1261 people from 402 nuclear families were collected, including age, gender and medical history. The actual
data were sampled and tested by using the computational function of ANN, so that the model error could be controlled within a set range. The results of neural network analysis suggested that among the 12 factors influencing bone mineral density, gender had the most obvious effect, followed
by height, weight and age. The polymorphism of estrogen receptor PvuII had the greatest impact on bone mineral density (ER PvuII) of all candidate genes, and the factor that had the most serious effect was BGP gene. A large number of BP network training test results were within the expected
error range, and the same conclusion was drawn using the same sample and traditional statistical methods.Therisk factors application has certain feasibility and accuracy.
Application of Enhanced CT and Enhanced MRI Fusion Image in the Treatment of Primary Liver Cancer
Authors: Zhang Hong , Wang Hongchun , Chai Ruiping , Ma Hongcan , Marcela Alida
Published: June 2020

Objective: To provide a decision-making opinion for the clinical selection of treatment options by comparing the preoperative enhanced CT and enhanced MRI scan images of liver transplantation for primary liver cancer with the tumor diameter measurement of postoperative gross
specimens. Methods: Nine patients with primary liver cancer who underwent liver transplantation from January 2017 to January 2018 were enrolled. The patients were not treated with local treatment before surgery. Previous imaging studies showed nodular liver cancer. 64-slice spiral CT
plain scan+three-stage enhanced scan, 3.0T superconducting MRI scan conventional plain scan, postoperative gross specimen anatomy, record tumor location, number, maximum diameter, compare different imaging techniques and postoperative gross specimens The coincidence rate of the maximum diameter
of the same tumor (according to the standard is the maximum diameter difference between the imaging and the gross specimen of the postoperative specimen ≤5 mm), the difference between the groups, and the correlation between the groups. Results: The maximum diameter of the same tumor
was measured. The coincidence rate between CT and postoperative gross specimens was 22%. The difference was statistically significant (P = −0.017), the correlation coefficient was 0.928, and the coincidence rate between MRI and postoperative gross specimen was 44%. The difference
was statistically significant (P = −0.010) and the correlation coefficient was 0.979. Conclusion: Image fusion technology with enhanced CT and enhanced MRI has changed the treatment decision of some patients with liver cancer, and it has certain value for optimizing treatment.
Assessment of the Relationship Between C-Reactive Protein-to-Albumin Ratio and the Presence and Severity of Isolated Coronary Artery Ectasia
Authors: Dereli Seçkin , Çerik İdris Buğra , Kaya Ahmet , Bektaş Osman
Published: June 2020

We investigated the relationship between C-reactive protein-to-albumin ratio (CAR) and coronary artery ectasia (CAE). The retrospective study population included 150 patients with isolated CAE, 150 with obstructive coronary artery disease (CAD), and 150 with a normal coronary artery angiogram (NCA). The severity of isolated CAE was determined according to the Markis classification. C-reactive protein-to-albumin ratio was significantly higher in patients with isolated CAE than in those with obstructive CAD and NCA (10.5 [5.9-30.9], 5.7 [1.8-13.2] and 3.0 [0.9-8.9], respectively). Logistic regression analysis showed that CAR (odds ratio [OR]: 3.054, 95% CI: 1.021-9.165, P = .001), platelet-to-lymphocyte ratio (PLR; OR: 1.330, 95% CI: 1.025-1.694, P = .044), and monocyte-to-high density cholesterol ratio (MHR; OR: 1.031, 95% CI: 1.009-1.054, P = .006) were independently associated with the presence of isolated CAE. Receiver operating characteristic curve analysis showed that CAR (area under the curve [AUC] ± standard error [SE] = 0.838 ± 0.016; P < .001) had a stronger diagnostic value for detecting significant CAE than PLR (AUC ± SE = 0.632 ± 0.023) and MHR (AUC ± SE = 0.726 ± 0.022). C-reactive protein-to-albumin ratio had a significantly strong correlation with the severity of isolated CAE (r = 0.536, P < .001). To the best of our knowledge, this study showed for the first time that CAR was significantly associated with CAE presence and severity.
Use of a Cervicofacial Flap in Closing Large Defects Following Wide Local Excision of Complicated Preauricular Lesions
Authors: Akakpo Kenneth , Luck Kaylee , Chun Robert H.
Published: June 2020

Purpose:

To describe innovative surgical technique for closure of large defect following complicated preauricular cyst excision secondary to prior failed excision attempts, infections, and drainage procedures. Preauricular cysts must be widely excised including any fistulous tracts in order to reduce recurrence rates; however, the resultant large local excision poses cosmetic challenges.

Methods:

Retrospective chart review of 3 patient cases who underwent excision of recurrent preauricular lesions involving cervical parotid flap closure. All three cases demonstrate complicated preauricular congenital cysts which were infected and had prior drainage, excision attempts, or sclerotherapy. A cervicoparotid flap was used to close all defects cosmetically with no facial nerve weakness and without distortion to the oral commissure or lateral canthus.

Results/conclusions:

There is a high recurrence rate seen with wide local congenital cyst excisions that have been previously excised, infected, and drained; as well as, cosmetically unfavorable outcomes utilizing traditional repair. Utilizing our closure technique which involves reconstructive local regional flap with cervicoparotid approach our 3 patients have had no reoccurance of cyst or infection. Our approach also maximizes cosmetic outcomes, with reduced scar visibility. Pre and postoperative photos will be shown.
More and Better Jobs, But Not for Everyone: Effects of Innovation in French Firms
Authors: Duhautois Richard , Erhel Christine , Guergoat-Larivière Mathilde , Mofakhami Malo
Published: June 2020

The authors analyze the effect of technological innovation on employment and job quality using a difference-in-differences matching model and a unique matched data set of French firms (the Community Innovation Survey with administrative and fiscal data). Overall, they find evidence that product innovation increases employment and certain dimensions of job quality, such as the number of permanent contracts and working hours. The authors consider this virtuous circle between innovation, employment, and job quality to be nuanced, however, for two reasons. First, not all social groups benefit from firm innovation, as lower-skilled workers are less positively affected in terms of employment and are sometimes negatively affected in terms of wages. Second, the positive effects of innovation appear mainly in manufacturing and not in services. Public policy should pay attention, then, to the consequences of innovation across individuals and sectors to ensure that innovation is beneficial to all.
Does Health Insurance Lead to Improvement of Health Status Among Chinese Rural Adults? Evidence From the China Family Panel Studies
Authors: Sun Jian , Lyu Shoujun
Published: June 2020

The purpose of this study is to examine the causal relationship between the New Rural Cooperative Medical Scheme (NRCMS) and health status among Chinese rural adults. The data were drawn from China Family Panel Studies performed in 2016, involving 2,093 rural adults. Furthermore, this study employed k-nearest neighbor matching out of propensity score matching (PSM) to investigate the impact of NRCMS on health status among rural adults. Moreover, radius matching, kernel matching, and nearest-neighbor matching within caliper out of PSM were adopted to conduct sensitivity analyses. This study demonstrates that NRCMS enrollment has had a significant and positive effect on the self-assessed and mental health of rural adults, and the health effect shows significant age and income disparities. Moreover, the positive health effect may result from 2 channels, including the increase of health services utilization and the fact that adults with NRCMS are more likely to seek health care in lower-level medical institutions.
Existential–Humanistic Therapy and Disaster Response: Lessons From the COVID-19 Pandemic
Authors: Hoffman Louis
Published: June 2020

The COVID-19 pandemic has dramatically affected the mental health field. The unique distress caused by the pandemic along with the need for many to transition their therapy practices to TeleHealth/Telepsychology modalities caught many therapists, including existential–humanistic therapists, unprepared to make the necessary adjustments to treat clients in a manner that is safe and effective. Existential–humanistic therapy often is neglected with trauma and disaster relief work, despite its relevancy and important contributions. All therapies must adjust in crisis situations, particularly when adjustments to how services are offered are disrupted; however, the impact of these changes varies by therapeutic orientation. As an approach that values genuineness, empathy, and presence, existential–humanistic therapy faces unique challenges when employed with disaster response. However, when these challenges are faced, existential–humanistic therapy has much to offer disaster response, including consideration of existential guilt, existential shattering, existential anxiety, and existential perspectives on self-care.
Food security issues in the former Yugoslav countries
Authors: Kovljenić Mina , Raletić-Jotanović Saša
Published: June 2020

Food insecurity creates serious ethical, economic, and stability problems in all countries of the world, resulting in a need for its research. Each country seeks to ensure the highest degree of self-sufficiency in meeting the food needs by its own food production. However, the production of a sufficient quantity of food, and in particular its adequate structure, is not always fully realized. Therefore, ensuring food security has become an issue of primary strategic importance. Given that all the countries of the former Yugoslavia are relatively new countries undergoing a difficult period of transition, and that there are no local studies on food security, it remains to be examined how food- secure these countries are today and what factors affect their food security. The survey covered all countries of the former Yugoslavia: Republic of Serbia, Federation of Bosnia and Herzegovina, Republic of Montenegro, Republic of Croatia, Republic of Slovenia and Northern Macedonia. The survey data were taken from the FAOSTAT database, World Bank, as well as the national statistics of the countries of the former Yugoslavia, and hierarchical regression analysis was used. The results of the research showed that there is a statistically significant influence on the level of food security of all independent factors: general level of economic development, population growth, foreign trade, investments in agriculture. Of all the countries of the former Yugoslavia, Slovenia has emerged as the most nutritionally secure country, while the lowest level of food security has been observed in Bosnia and Herzegovina.
Parameterization of energy cycles between the hemispheres
Authors: Swedan Nabil H
Published: June 2020

Seasonal variations in the temperatures of the hemispheres induce seasonal energy cycles between the hemispheres that drive tropical cyclones. Because the northern hemisphere has warmed more than the southern hemisphere, climate energy cycles develop between the hemispheres as well. The seasonal and climate energy cycles appear to interact among themselves, and tropical cyclone counts are affected by these interactions. Furthermore, the total number of tropical cyclones appears to have an increasing trend. The annual energy of tropical cyclones is nearly 1.46 × 1022 J yr−1, and climate cycle energy is between 4.0 and 6.6 × 1021 J per cycle. The magnitude of the climate energy cycles is thus large enough to alter the energy and frequency of the tropical cyclones. Given that the climate is changing, the energy and frequency of tropical cyclones may be changing as well. The subject is broad and this work is limited to parameterization of the physics of energy oscillations between the hemispheres, demonstrating the existence of climate energy cycles, and revealing interactions between climate and seasonal energy cycles. Also, this parameterization may assist researchers in obtaining more and coordinated data relative to these cycles.
Teacher Wage Penalty and Decrease in Teacher Quality: Evidence from Career-Changers
Authors: Han Eunice S.
Published: June 2020

This paper examines the relation between teacher pay and teacher quality through the career dynamics of teachers and non-teachers. I find that public school teachers earn considerably less than their comparable college graduates in the non-teaching sector. By tracking wage differentials before and after career changes, I find evidence of positive selection, in which high-paid teachers are more likely to move to non-teaching occupations, and of negative selection, in which low-paid non-teachers tend to move to the teaching sector. These selection patterns, which ultimately contribute to a decrease in teacher quality, are more significant in union-unfriendly states.
Gas transport properties of cellular hollow fiber membranes based on LLDPE/LDPE blends
Authors: Razzaz Zahir , Mohebbi Abolfazl , Rodrigue Denis
Published: June 2020

The production of foamed hollow fiber membranes (HFMs) is presented based on polymer blends using various concentrations of linear low-density polyethylene (LLDPE) and low-density polyethylene (LPDE) combined with azodicarbonamide (chemical blowing agent) to prepare samples via twin-screw extrusion. In particular, the blowing agent concentration as well as the stretching speed were found to be the most important parameters to achieve a good cellular structure for membrane application. From the samples obtained, a complete set of morphological, thermal, and gas transport characterization was performed. The results show that LLDPE/LDPE blends compared to neat LLDPE lead to higher cell density at high stretching speed, which is appropriate for membranes having higher gas permeability and selectivity due to lower cell wall thickness. The results also show that the developed cellular structure has high potential for the continuous production of HFMs for different gas separation, especially for hydrogen recovery.
The effects of a dialogue-based intervention to promote psychosocial well-being after stroke: a randomized controlled trial
Authors: Bragstad Line Kildal , Hjelle Ellen Gabrielsen , Zucknick Manuela , Sveen Unni , Thommessen Bente , Bronken Berit Arnesveen , Martinsen Randi , Kitzmüller Gabriele , Mangset Margrete , Kvigne Kari Johanne , Hilari Katerina , Lightbody C Elizabeth , Kirkevold Marit
Published: June 2020

Objective:

To evaluate the effect of a dialogue-based intervention targeting psychosocial well-being at 12 months post-stroke.

Design:

Multicenter, prospective, randomized, assessor-blinded, controlled trial with two parallel groups.

Setting:

Community.

Subjects:

Three-hundred and twenty-two adults (⩾18 years) with stroke within the last four weeks were randomly allocated into intervention group ( n = 166) or control group ( n = 156).

Interventions:

The intervention group received a dialogue-based intervention to promote psychosocial well-being, comprising eight individual 1–1½ hour sessions delivered during the first six months post-stroke.

Main measures:

The primary outcome measure was the General Health Questionnaire-28 (GHQ-28). Secondary outcome measures included the Stroke and Aphasia Quality of Life Scale-39g, the Sense of Coherence scale, and the Yale Brown single-item questionnaire.

Results:

The mean (SD) age of the participants was 66.8 (12.1) years in the intervention group and 65.7 (13.3) years in the control group. At 12 months post-stroke, the mean (SE) GHQ-28 score was 20.6 (0.84) in the intervention group and 19.9 (0.85) in the control group. There were no between-group differences in psychosocial well-being at 12 months post-stroke (mean difference: −0.74, 95% confidence interval (CI): −3.08, 1.60). The secondary outcomes showed no statistically significant between-group difference in health-related quality of life, sense of coherence, or depression at 12 months.

Conclusion:

The results of this trial did not demonstrate lower levels of emotional distress and anxiety or higher levels of health-related quality of life in the intervention group (dialogue-based intervention) as compared to the control group (usual care) at 12 months post-stroke.
Building organizational compassion among teams delivering end-of-life care in the intensive care unit: The 3 Wishes Project
Authors: Vanstone Meredith , Sadik Marina , Smith Orla , Neville Thanh H , LeBlanc Allana , Boyle Anne , Clarke France J , Swinton Marilyn E , Takaoka Alyson , Toledo Feli , Baker Andrew J , Phung Peter , Cook Deborah J
Published: June 2020

Background:

The 3 Wishes Project is a semistructured program that improves the quality of care for patients dying in the intensive care unit by eliciting and implementing wishes. This simple intervention honors the legacy of patients and eases family grief, forging human connections between family members and clinicians.

Aim:

To examine how the 3 Wishes Project enables collective patterns of compassion between patients, families, clinicians, and managerial leaders in the intensive care unit.

Design:

Using a qualitative descriptive approach, interviews and focus groups were used to collect data from family members of dying patients, clinicians, and institutional leaders. Unconstrained directed qualitative content analysis was performed using Organizational Compassion as the analytic framework.

Setting/participants:

Four North American intensive care units, participants were 74 family members of dying patients, 72 frontline clinicians, and 20 managerial leaders.

Results:

The policies and processes of the 3 Wishes Project exemplify organizational compassion by supporting individuals in the intensive care unit to collectively notice, feel, and respond to suffering. As an intervention that enables and empowers clinicians to engage in acts of kindness to enhance end-of-life care, the 3 Wishes Project is particularly well situated to encourage collective responses to suffering and promote compassion between patients, family members, and clinicians.

Conclusions:

Examining the 3 Wishes Project through the lens of organizational compassion reveals the potential of this program to cultivate the capacity for people to collectively notice, feel, and respond to suffering. Our data document multidirectional demonstrations of compassion between clinicians and family members, forging the type of human connections that may foster resilience.
FSMI: Fast computation of Shannon mutual information for information-theoretic mapping
Authors: Zhang Zhengdong , Henderson Theia , Karaman Sertac , Sze Vivienne
Published: June 2020

Exploration tasks are embedded in many robotics applications, such as search and rescue and space exploration. Information-based exploration algorithms aim to find the most informative trajectories by maximizing an information-theoretic metric, such as the mutual information between the map and potential future measurements. Unfortunately, most existing information-based exploration algorithms are plagued by the computational difficulty of evaluating the Shannon mutual information metric. In this article, we consider the fundamental problem of evaluating Shannon mutual information between the map and a range measurement. First, we consider 2D environments. We propose a novel algorithm, called the fast Shannon mutual information (FSMI). The key insight behind the algorithm is that a certain integral can be computed analytically, leading to substantial computational savings. Second, we consider 3D environments, represented by efficient data structures, e.g., an OctoMap, such that the measurements are compressed by run-length encoding (RLE). We propose a novel algorithm, called FSMI-RLE, that efficiently evaluates the Shannon mutual information when the measurements are compressed using RLE. For both the FSMI and the FSMI-RLE, we also propose variants that make different assumptions on the sensor noise distribution for the purpose of further computational savings. We evaluate the proposed algorithms in extensive experiments. In particular, we show that the proposed algorithms outperform existing algorithms that compute Shannon mutual information as well as other algorithms that compute the Cauchy–Schwarz quadratic mutual information (CSQMI). In addition, we demonstrate the computation of Shannon mutual information on a 3D map for the first time.
Assessment of liver metastases radiomic feature reproducibility with deep-learning-based semi-automatic segmentation software
Authors: Wang Lan , Tan Jingwen , Ge Yingqian , Tao Xinwei , Cui Zheng , Fei Zhenyu , Lu Jing , Zhang Huan , Pan Zilai
Published: June 2020

Background

Good feature reproducibility enhances model reliability. The manual segmentation of gastric cancer with liver metastasis (GCLM) can be time-consuming and unstable.

Purpose

To assess the value of a semi-automatic segmentation tool in improving the reproducibility of the radiomic features of GCLM.

Material and Methods

Patients who underwent dual-source computed tomography were retrospectively reviewed. As an intra-observer analysis, one radiologist segmented metastatic liver lesions manually and semi-automatically twice. Another radiologist re-segmented the lesions once as an inter-observer analysis. A total of 1691 features were extracted. Spearman rank correlation was used for feature reproducibility analysis. The times for manual and semi-automatic segmentation were recorded and analyzed.

Results

Seventy-two patients with 168 lesions were included. Most of the GCLM radiomic features became more reliable with the tool than the manual method. For the intra-observer feature reproducibility analysis of manual and semi-automatic segmentation, the rates of features with good reliability were 45.5% and 62.3% ( P < 0.02), respectively; for the inter-observer analysis, the rates were 29.3% and 46.0% ( P < 0.05), respectively. For feature types, the semi-automatic method increased reliability in 6/7 types in the intra-observer analysis and 5/7 types in the inter-observer analysis. For image types, the reliability of the square and exponential types was significantly increased. The mean time of semi-automatic segmentation was significantly shorter than that of the manual method ( P < 0.05).

Conclusion

The application of semi-automated software increased feature reliability in the intra- and inter-observer analyses. The semi-automatic process took less time than the manual process.
Lessons from a Large-Scale Experiment on the Use of Smartphone Apps to Collect Travel Diary Data: The “City Logger” for the Greater Golden Horseshoe Area
Authors: Faghih Imani Ahmadreza , Harding Chris , Srikukenthiran Siva , Miller Eric J. , Nurul Habib Khandker
Published: June 2020

Smartphones offer a potential alternative to collect high-quality information on the travel patterns of individuals without burdening the respondents with reporting every detail of their travel. Smartphone apps have recently become a common tool for travel survey data collection around the world, especially for multiday surveys. However, there still exists a lack of systematic assessment of issues related to smartphone app-based surveys, such as the impact of app design or the recruitment method on the collected data. Through a large-scale experiment (named the City Logger), this paper assesses the data produced by the City Logger app, to better understand recruitment avenues (targeted invitation versus crowdsourcing), and examine differences in respondents’ travel behavior recruited through crowdsourcing methods. The paper also examines how app design, and particularly the user input method for trip validation, influences participants’ responses. The results indicate that, while crowdsourcing recruitment is promising, it might not yet be the best way to capture a true representation of the population. For app design, a combination of real-time and travel diary approaches is recommended. An ideal app would prompt users real-time and create a travel diary, so users can validate, edit, or delete the recorded information.
A Father against his Daughter on Marriage Choice: A 1823 Rapto Trial in Chile
Authors: Parodi Karime
Published: June 2020

Studies of rapto—commonly known as the theft of a woman by a man—in scholarship on Chile are extremely scarce. While research into the judicial–legal culture of colonial nineteenth-century Chile from a sociohistorical framework includes judicial files on rapto, scholars have neglected the specific rhetorical and judicial strategies deployed by individual elite legal actors in cases of rapto as an opportunity to explore women’s agency and to understand rapto as an avenue for intergenerational conflict about free will in marriage choice. In this article, I look into the judicial file of a trial of rapto by seduction and its appeal, which took place during the years 1823–1824 in Santiago. I examine the judicial and rhetorical strategies used by a father, his daughter, and her suitor’s public defender to make their claims in court through the lens of gender, honor, and class. Although the father uses rapto by seduction as a tool to hide his daughter’s consent from the judges, her willingness to elope with her suitor eventually comes to the fore and disrupts the trial. In this case, the parties turn to several judicial and rhetorical strategies not only to bolster their cases but also to argue about larger social issues and conflicts specific to the early nineteenth century, such as autonomy in marriage choice and honor.
Management of used personal protective equipment and wastes related to COVID-19 in South Korea
Authors: Rhee Seung-Whee
Published: June 2020

With the rapid spread of coronavirus disease 2019 (COVID-19), the amount of used personal protective equipment (PPE) including face masks and protective clothes has significantly increased. This used PPE in a hospital can lead to the indirect infection by COVID-19. Accordingly, it has been recognized that the management of used PPE is very important to prevent the spread of COVID-19. Through the experience of spreading some infectious diseases such as severe acute respiratory syndrome, Middle East respiratory syndrome and Ebola virus in South Korea (Republic of Korea), a safe management method of waste related to infectious diseases has been developed. In addition, regarding waste related to COVID-19, the Ministry of Environment, SK, proposed special measures to strengthen the management process of waste related to COVID-19 based on principles such as sustainability, transparency and safety.
“I Want My Mum to Know That I Am a Good Guy …”: A Thematic Analysis of the Accounts of Adolescents Who Exhibit Child-to-Parent Violence in the United Kingdom
Authors: Papamichail Alexandra , Bates Elizabeth A.
Published: June 2020

This qualitative study explores child-to-parent violence (CPV) in the United Kingdom based on the accounts of adolescents who exhibit this type of family violence. The key areas of interest concern the familial relationships and contexts within which adolescents are embedded, and their perceptions about their emotional states and how these interplay with CPV. Eight participants were recruited in total from a community sample from two different intervention programs aiming to tackle CPV in England. Methods included participant-observation, face-to-face interviews, and handwritten interviews; all data were analyzed thematically. Results suggest that CPV is linked with adverse childhood experiences (ACEs), unsatisfactory relationships with parents, perceived emotional rejection from parents, and emotional dysregulation in young people. In this study, violent behavior was directed not only against mothers but in all cases against siblings and stepfathers. The findings address the complexity of the subject and the need for tailored, evidence-based interventions in the field of CPV.
Midwives Perceiving and Dealing With Violence Against Women: Is It Mostly About Midwives Actively Protecting Women? A Modified Grounded Theory Study
Authors: Siller Heidi , König-Bachmann Martina , Perkhofer Susanne , Hochleitner Margarethe
Published: June 2020

Violence against women (VAW) affects pregnancy, birthing, and puerperium. In this sense, domestic violence (DV) or intimate partner violence (IPV) may increase during pregnancy, sexual child abuse may affect the birthing process, and obstetric violence may occur during birthing. Thus, consideration of violence during pregnancy and puerperium is essential to providing optimal care for women. This implies that midwives should be able to identify women affected by VAW. Therefore, this study explored VAW as perceived by midwives in one region of Austria. Interviews with 15 midwives (mean age 38.7 years) were conducted in Tyrol, Austria, between December 2014 and December 2015. Data were analyzed with a modified version of Grounded Theory. The core category “protecting but walking on eggshells” showed the caution with which midwives approached VAW and in particular DV or IPV. Including VAW in midwifery was connected to midwives being active protectors of women in their care. This meant being an intuitive, sensible, guiding, and empowering midwife to the woman. Staying active was necessary to fulfill the protective role also with regard to DV. However, this was influenced by the visibility of the connection between VAW, pregnancy, childbirth, and puerperium. The key to including VAW and particularly DV was midwives’ professional role of actively protecting women. Neglecting DV during pregnancy, labor, and puerperium meant further silencing DV, and keeping it hidden. Considering these aspects in planning and implementing actions to prevent VAW is expected to support sustainability and motivation to ask women about all forms of violence during and after pregnancy.
Alteration of gene expression profile in mouse embryonic stem cells and neural differentiation deficits by ethephon
Authors: Nejad S Mohammadi , Hodjat M , Mousavi SA , Baeeri M , Rezvanfar MA , Rahimifard M , Sabuncuoglu S , Abdollahi M
Published: June 2020

Ethephon, a member of the organophosphorus compounds, is one of the most widely used plant growth regulators for artificial ripening. Although million pounds of this chemical is being used annually, the knowledge regarding its molecular toxicity is yet not sufficient. The purpose of this study was to evaluate the potential developmental toxicity of ethephon using embryonic stem cell model. The mouse embryonic stem cells (mESCs) were exposed to various concentrations of ethephon and the viability, cell cycle alteration and changes in the gene expression profile were evaluated using high-throughput RNA sequencing. Further, the effect of ethephon on neural differentiation potential was examined. The results showed that ethephon at noncytotoxic doses induced cell cycle arrest in mESCs. Gene ontology enrichment analysis showed that terms related to cell fate and organismal development, including neuron fate commitment, embryo development and cardiac cell differentiation, were markedly enriched in ethephon-treated cells. Neural induction of mESCs in the presence of ethephon was inhibited and the expression of neural genes was decreased in differentiated cells. Results obtained from this work clearly demonstrate that ethephon affects the gene expression profile of undifferentiated mESCs and prevents neural differentiation. Therefore, more caution against the frequent application of ethephon is advised.
Systematic reviews as a “lens of evidence”: Determinants of participation in breast cancer screening
Authors: Mandrik O , Tolma E , Zielonke N , Meheus F , Ordóñez-Reyes C , Severens JL , Murillo R
Published: June 2020

Objective

To assess the determinants of the participation rate in breast cancer screening programs by conducting a systematic review of reviews.

Methods

We conducted a systematic search in PubMed via Medline, Scopus, Embase, and Cochrane identifying the literature up to April 2019. Out of 2258 revealed unique abstracts, we included 31 reviews, from which 25 were considered as systematic. We applied the Walsh & McPhee Systems Model of Clinical Preventive Care to systematize the determinants of screening participation.

Results

The reviews, mainly in high-income settings, reported a wide range for breast cancer screening participation rate: 16–90%. The determinants of breast cancer screening participation were simple low-cost interventions such as invitation letters, basic information on screening, multiple reminders, fixed appointments, prompts from healthcare professionals, and healthcare organizational factors (e.g. close proximity to screening facility). More complex interventions (such as face-to-face counselling or home visits), mass media or improved access to transport should not be encouraged by policy makers unless other information appears. The repeated participation in mammography screening was consistently high, above 62%. Previous positive experience with screening influenced the repeated participation in screening programs. The reviews were inconsistent in the use of terminology related to breast cancer screening participation, which may have contributed to the heterogeneity in the reported outcomes.

Conclusions

This study shows that consistent findings of systematic reviews bring more certainty into the conclusions on the effects of simple invitation techniques, fixed appointments and prompts, as well as healthcare organizational factors on promoting participation rate in screening mammography.
Doing More With Less: Review of Dolutegravir-Lamivudine, a Novel Single-Tablet Regimen for Antiretroviral-Naïve Adults With HIV-1 Infection
Authors: Santevecchi Barbara A. , Miller Stacy , Childs-Kean Lindsey M.
Published: June 2020

Objective:

To review data on efficacy and safety of dolutegravir (DTG) and lamivudine (3TC) in treatment-naïve adults with HIV-1 infection.

Data Sources:

Phase III clinical trials and review articles were identified through PubMed (1996 to March 2020) and ClinicalTrials.gov (2000 to May 2020) using the keywords dolutegravir, lamivudine, and HIV.

Study Selection and Data Extraction:

Relevant clinical trials and review articles available in English evaluating efficacy and safety of DTG and 3TC were included.

Data Synthesis:

The once-daily, single-tablet regimen of DTG/3TC is the first dual antiretroviral therapy (ART) recommended for initial therapy in treatment-naïve adults with HIV-1 infection. DTG and 3TC were compared with a regimen of DTG and tenofovir disoproxil fumarate/emtricitabine in the GEMINI studies and demonstrated noninferiority for the primary end point of virological suppression at up to 96 weeks. No treatment-emergent resistance mutations were identified in a small group of participants who did not reach virological suppression. The regimen is well tolerated, and the most common adverse events reported in trials include headache, diarrhea, nausea, insomnia, and fatigue.

Relevance to Patient Care and Clinical Practice:

This dual-ART regimen is a favorable treatment option for ART-naïve patients with HIV-1 RNA <500 000 copies/mL, absence of hepatitis B virus, and no resistance to DTG or 3TC. Benefits of dual ART include reduction in treatment-related adverse events and toxicities, drug interactions, and cost. In addition, the once-daily, single-tablet formulation promotes adherence.

Conclusions:

DTG/3TC has demonstrated efficacy in maintaining virological suppression in ART-naïve patients at up to 96 weeks while minimizing treatment-related adverse events and toxicities.
Marital Satisfaction During Retirement
Authors: Fye Marissa A. , Chasek Christine Tina , Mims Grace A. , Sandman Jacob , Hinrichsen Alex
Published: June 2020

Marriage/commitment and retirement are two common experiences in an adult’s life. Marital satisfaction and retirement have been researched in multiple disciplines. The relationship between these two constructs has not been as widely researched. The purpose of this study was to determine whether retirement has an impact on marital satisfaction. Quantitative methods and analyses were used. The variables used accounted for 83% of the variance of satisfaction. Limitations and implications are provided to inform marriage and family pedagogy and practice.
Radiographic Impact of Lapidus, Proximal Lateral Closing Wedge Osteotomy, and Suture Button Procedures on First Ray Length and Dorsiflexion for Hallux Valgus
Authors: Foran Ian M. , Mehraban Nasima , Jacobsen Stephen K. , Bohl Daniel D. , Lin Johnny , Lee Simon , Holmes George B. , Hamid Kamran S.
Published: June 2020

Background:

Shortening and dorsiflexion of the first metatarsal are known potential side effects of metatarsal osteotomies for hallux valgus (HV) with the potential to cause transfer metatarsalgia. We compared the effect of the first tarsometatarsal joint arthrodesis (Lapidus procedure), proximal lateral closing wedge osteotomy (PLCWO), and intermetatarsal suture button fixation procedures on the length and dorsiflexion of the first ray.

Methods:

We retrospectively evaluated 105 feet in 99 patients with 30 weeks of follow-up. The average age was 54 years. Seventy-four feet had a Lapidus procedure, 12 had a PLCWO, and 19 had intermetatarsal suture button fixation. Digital radiographic measurements were made for the pre- and postoperative hallux valgus angle (HVA) and intermetatarsal angle (IMA), absolute and relative shortening of the first ray, and dorsiflexion.

Results:

Preoperative HVA and IMA did not differ between treatment groups ( P > .05 for each). Similar corrections of HVA (30.5-13.5 degrees) were achieved between all groups ( P > .05). The IMA was improved more in the Lapidus group (14.3-6.5 degrees) compared with the suture button fixation group (14.2-8.1 degrees) ( P = .045). There were significant differences in the change in absolute first cuneiform–metatarsal length (FCML) between the Lapidus (–1.6 mm), PLCWO (–2.3 mm), and intermetatarsal suture button fixation (+1.9 mm) procedure ( P = .004). There were also significant differences in relative first metatarsal shortening between the Lapidus (0.1 mm relative shortening), PLCWO (1.1 mm relative shortening), and intermetatarsal suture button fixation (1.3 mm lengthening) procedure ( P < .001). The average dorsiflexion differed between the Lapidus (1.8 degrees) and suture button fixation (0.4 degrees) groups ( P = .004).

Conclusion:

Intermetatarsal suture button fixation relatively lengthened the first ray, the Lapidus procedure maintained length, and the PLCWO relatively and absolutely shortened it. Dorsiflexion may be higher with the Lapidus and osteotomy procedures.

Level of Evidence:

Level III, retrospective comparative series.
Intraoperative Effect of 2D vs 3D Fluoroscopy on Quality of Reduction and Patient-Related Outcome in Calcaneal Fracture Surgery
Authors: Halm Jens A. , Beerekamp M. Suzan H. , de Muinck-Keijzer Robert Jan , Beenen Ludo F. M. , Maas Mario , Goslings J. Carel , Schepers Tim
Published: June 2020

Background:

Three-dimensional (3D) fluoroscopy is thought to be advantageous in the open reduction and internal fixation (ORIF) of calcaneal fractures. The goal of this multicenter randomized controlled trial was to investigate the clinical effect of additional intraoperative 3D fluoroscopy on postoperative quality of reduction and fixation and patient-reported outcome as compared to conventional 2-dimensional (2D) fluoroscopy in patients with intra-articular fractures of the calcaneus.

Methods:

Patients were randomized to 3D or conventional 2D fluoroscopy during operative treatment of calcaneal fractures. Primary outcome was the difference in quality of fracture reduction and implant position on postoperative computed tomography (CT). Secondary endpoints included intraoperative corrections (prior to wound closure), complications, and revision surgery (after wound closure). Function and patient-reported outcome were evaluated after surgery and included range of motion, Foot and Ankle Outcome Score (FAOS), American Orthopaedic Foot & Ankle Society (AOFAS) score, Short-Form 36 (SF-36) questionnaires, and Kellgren-Lawrence posttraumatic osteoarthritis classification. A total of 102 calcaneal fractures were included in the study in 100 patients. Fifty fractures were randomized to the 3D group and 52 to the 2D group.

Results:

There was a statistically significant difference in duration of surgery between the groups (2D 125 min vs 3D 147 min; P < .001). After 3D fluoroscopy, a total of 57 intraoperative corrections were performed in 28 patients (56%). The postoperative CT scan revealed an indication for additional revision of reduction or implant position in 69% of the 3D group vs 60% in the 2D fluoroscopy group. At 2 years, there was no difference in number of revision surgery, complications, FAOS, AOFAS score, SF-36 score, or posttraumatic osteoarthritis.

Conclusion:

The use of intraoperative 3D fluoroscopy in the treatment of intra-articular calcaneal fractures prolongs the operative procedures without improving the quality of reduction and fixation. There was no benefit of intraoperative 3D fluoroscopy with regard to postoperative complications, quality of life, functional outcome, or posttraumatic osteoarthritis. Level of Evidence: Level I, prospective randomized controlled study.
Prescriber and pharmacist understanding of revised Rhode Island pain management regulations
Authors: Rogala Britny G , Jarvais Alexandria , Ng Taylor , Bratberg Jeffrey
Published: June 2020

Introduction

Federal agencies and national associations have implemented action plans in response to the opioid crisis. Furthermore, over 30 states have enacted legislation with opioid-related restrictions, guidance, or requirements. Following recommendations from the governor-appointed Overdose Prevention and Intervention Task Force, the Rhode Island Department of Health developed an original and updated version of Pain Management Regulations in March 2017 and July 2018, respectively. Our study aimed to identify disparities in interpretation and misconceptions of the updated Rhode Island Department of Health new Pain Management Regulations.

Methods

Our 29-question survey evaluated pharmacist and prescriber knowledge of regulations, with special attention given to pain management in patients with cancer.

Results

Thirty-two prescribers and 33 pharmacists completed the survey. The survey identified significant variance in regulation knowledge. Pharmacists correctly identified diagnosis exclusions 13–84% of the time, with a much greater understanding when diagnosis language was used instead of ICD-10 codes. Prescribers correctly identified exclusions 24–46% of the time, with little difference noted when using diagnosis language versus ICD-10 codes. The majority (59.3%) of pharmacists misclassified patients with no prescription dispensed in 30 days as patients who would be considered opioid-naïve. Both prescribers and pharmacists commonly misidentified the frequency with which the prescription drug monitoring program needs to be checked, although in both scenarios were stricter than the regulations themselves. In addition, there were significant differences in interpretation regarding naloxone co-prescribing requirements and patient awareness of naloxone co-prescribing between prescribers and pharmacists.

Conclusion

Our findings outline several misinterpretations that affect access to chronic and cancer-related pain opioid prescriptions, despite several Rhode Island Department of Health-initiated interventions. When adopting regulations, states should proactively develop educational initiatives to avoid access challenges for patients with diagnoses of exclusion.