bluuebunny/crossref_metadata_2025 huggingface dataset:
Teachers as intercultural bridge‐builders: Rethinking the metaphor of bridge‐building
Authors: Skrefsrud Thor‐André
Published: September 2020

The idea that intercultural understanding should be based on in‐depth knowledge about the other continues to capture the imagination of policy makers, practitioners, and researchers. According to this line of thinking, intercultural understanding is about creating a secure way of reducing cultural complexity, aiming to overcome what is perceived as the strangeness of the other. While this approach to intercultural understanding has been highly influential, a growing body of work has raised fundamental questions about its adequacy. This article contributes to this discussion by exploring the metaphorical expression, bridge‐building, as a way to describe teachers' work with intercultural understanding. The article relates the bridge‐building metaphor to the ability to develop and integrate targeted knowledge, skills, and attitudes. It also explores how the bridge‐building metaphor allows us to use our cultural and social experiences to facilitate an understanding of others.
Submucosal enteric neurons of the cavine distal colon are sensitive to hypoosmolar stimuli
Authors: Kollmann Patrick , Elfers Kristin , Maurer Stefanie , Klingenspor Martin , Schemann Michael , Mazzuoli‐Weber Gemma
Published: September 2020

Key points

Neurons of the enteric submucous plexus are challenged by osmolar fluctuations during digestion and absorption of nutrients.

Central neurons are very sensitive to changes in osmolality but knowledge on that issue related to enteric neurons is sparse.

The present study focuses on investigation of osmosensitivity of submucosal neurons including potential molecular mediating mechanisms.

Results show that submucosal neurons respond to hypoosmolar stimuli with increased activity which is partially mediated by the transient receptor potential vanilloid 4 channel.

We provided important information on osmosensitive properties of enteric neurons. These data are fundamental to better explain the nerve‐mediated control of the gastrointestinal functions during physiological and pathophysiological (diarrhoea) conditions.

Enteric neurons are located inside the gut wall, where they are confronted with changes in osmolality during (inter‐) digestive periods. In particular, neurons of the submucous plexus (SMP), located between epithelial cells and blood vessels may sense and respond to osmotic shifts. The present study was conducted to investigate osmosensitivity of enteric submucosal neurons and the potential role of the transient receptor potential vanilloid 4 channel (TRPV4) as a mediator of enteric neuronal osmosensitivity. Therefore, freshly dissected submucosal preparations from guinea pig colon were investigated for osmosensitivity using voltage‐sensitive dye and Ca2+imaging. Acute hypoosmolar stimuli (final osmolality reached at ganglia of 94, 144 and 194 mOsm kg‐1) were applied to single ganglia using a local perfusion system. Expression of TRPV4 in the SMP was quantified using qRT‐PCR, and GSK1016790A and HC‐067047 were used to activate or block the receptor, respectively, revealing its relevance in enteric osmosensitivity. On average, 11.0 [7.0/17.0] % of submucosal neurons per ganglion responded to the hypoosmolar stimulus. The Ca2+imaging experiments showed that glia responded to the hypoosmolar stimulus, but with a delay in comparison with neurons. mRNA expression of TRPV4 could be shown in the SMP and blockade of the receptor by HC‐067047 significantly decreased the number of responding neurons (0.0 [0.0/6.3] %) while the TRPV4 agonist GSK1016790A caused action potential discharge in a subpopulation of osmosensitive enteric neurons. The results of the present study provide insight into the osmosensitivity of submucosal enteric neurons and strongly indicate the involvement of TRPV4 as an osmotransducer.
Hydrate-Based Carbon Capture Process: Assessment of Various Packed Bed Systems for Boosted Kinetics of Hydrate Formation
Authors: Arora Amit , Kumar Asheesh , Bhattacharjee Gaurav , Balomajumder Chandrajit , Kumar Pushpendra
Published: September 2020

The case for developing novel technologies for carbon dioxide (CO2) capture is fast gaining traction owing to increasing levels of anthropogenic CO2 being emitted into the atmosphere. Here, we have studied the hydrate-based carbon dioxide capture and separation process from a fundamental viewpoint by exploring the use of various packed bed media to enhance the kinetics of hydrate formation using pure CO2 as the hydrate former. We established the fixed bed reactor (FBR) configuration as a superior option over the commonly used stirred tank reactor (STR) setups typically used for hydrate formation studies by showing enhanced hydrate formation kinetics using the former. For the various packing material studied, we have observed silica gel with 100 nm pore size to return the best kinetic performance, corresponding to a water to hydrate conversion of 28 mol% for 3 h of hydrate growth. The fundamental results obtained in the present study set up a solid foundation for follow-up works with a more applied perspective and should be of interest to researchers working in the carbon dioxide capture and storage and gas hydrate fields alike.
Field-Testing of Biodiesel (B100) and Diesel-Fueled Vehicles: Part 4—Piston Rating, and Fuel Injection Equipment Issues
Authors: Agarwal Avinash Kumar , Agarwal Deepak
Published: September 2020

This study investigated the use of biodiesel (B100) and baseline diesel in two identical unmodified vehicles to realistically assess different aspects of biodiesel's compatibility with modern common rail direct injection (CRDI) fuel injection equipment (FIE) and evaluate biodiesel's long-term durability/compatibility with engine components. Two identical vehicles were fueled with biodiesel (B100) and baseline mineral diesel for 30,000 km field-trials on highway under identical operating conditions. Exhaustive experimental results from this series of tests are divided into four segments. The fourth and the last paper of this series compares the effects of long-term usage of biodiesel on piston deposits and FIE components compared to baseline mineral diesel. A key challenge for improving engine performance and fuel economy is the reduction of frictional losses, primarily at the piston ring–liner interface, which accounts for majority of frictional losses. Piston rating was done for the two vehicles after the conclusion of field-trials and it revealed that rating of different piston sections was ∼5–15% superior in case of biodiesel-fueled vehicle compared to that of diesel-fueled vehicle. Performance of FIE components such as fuel filter, fuel injectors, and fuel pump was assessed after the conclusion of field-trials. Pressure drop at different fuel flow-rates across the fuel filter was measured for assessing the fuel filter blockage. Pressure drop across biodiesel filter was ∼30% higher than diesel filter after 10,000 km usage but almost twice after 15,000 km usage. These experimental results indicated that some additional technical measures should be taken by automotive manufacturers to offset these technical challenges before biodiesel is adapted on a large-scale in modern CRDI vehicles.
Coupled Heat Transfer and Hydraulic Modeling of an Experimental Printed Circuit Heat Exchanger Using Finite Element Methods
Authors: Jentz Ian W. , Anderson Mark H.
Published: September 2020

The Homogenized Heat Exchanger Thermohydraulic (HHXT) modeling environment has been developed to provide thermodynamic modeling of printed circuit heat exchangers (PCHEs). This finite element approach solves solid conduction and fluid thermohydraulics simultaneously, without the need to mesh the minuscule micro-channels of a PCHE. The model handles PCHE features such as headers, solid side walls, and channel inlet and outlet regions, in addition to the micro-channel core. The HHXT model resolves PCHE thermohydraulics using simple model definitions and minimum computational overhead, making it an ideal design tool. This work introduces the thermohydraulic model at the core of HHXT. The homogenization approach used in the model occupies a medium between simplified linear analyses of heat transfer within a PCHE and the brute force of a fully resolved finite element, or computational fluid dynamics, model. An example problem modeling an experimental PCHE is presented. The ability of the HHXT model to simulate fluid flow through a directional varying micro-channel core of two heat-exchanging streams is demonstrated. The HHXT model is being distributed for free within the research community.
A Theoretical Model for the Normal Contact Force of Two Elastoplastic Ellipsoidal Bodies
Authors: Becker Verena , Kamlah Marc
Published: September 2020

To model the mechanical behavior of granular materials, a reliable description of the material properties is indispensable. Individual grains are usually not perfectly spherical. In batteries, for instance, lithium nickel manganese cobalt oxide (NMC) is a frequently used material, consisting out of particles with possibly ellipsoidal like shapes. As particles may plastically deform under increasing stresses, the paper presents a theoretical model for the normal contact force of elastoplastic ellipsoidal bodies for the use in the context of mechanical discrete element method (DEM). The model can be considered as extension of the elastic, elastic-plastic, fully plastic Thornton model by using a more general description to incorporate elliptical contact areas. The focus is on a normal contact force description as continuous function of time for all regimes, elastic, elastoplastic, and fully plastic loading, as well as unloading from elastoplastic loading, while the evolution of the plastic contact area is not considered here. All underlying formulae to describe the force-displacement relationship for the static contact problem are derived, partly based on finite element analysis (FEA). To verify the new model, FEAs are performed and their results compared with the model predictions.
A Registration Method for Three-Dimensional Analysis of Bone Mineral Density in the Proximal Tibia
Authors: Babel Hugo , Wägeli Loïc , Sonmez Berke , Thiran Jean-Philippe , Omoumi Patrick , Jolles Brigitte M. , Favre Julien
Published: September 2020

Although alterations in bone mineral density (BMD) at the proximal tibia have been suggested to play a role in various musculoskeletal conditions, their pathophysiological implications and their value as markers for diagnosis remain unclear. Improving our understanding of proximal tibial BMD requires novel tools for three-dimensional (3D) analysis of BMD distribution. Three-dimensional imaging is possible with computed tomography (CT), but computational anatomy algorithms are missing to standardize the quantification of 3D proximal tibial BMD, preventing distribution analyses. The objectives of this study were to develop and assess a registration method, suitable with routine knee CT scans, to allow the standardized quantification of 3D BMD distribution in the proximal tibia. Second, as an example of application, the study aimed to characterize the distribution of BMD below the tibial cartilages in healthy knees. A method was proposed to register both the surface (vertices) and the content (voxels) of proximal tibias. The method combines rigid transformations to account for differences in bone size and position in the scanner's field of view and to address inconsistencies in the portion of the tibial shaft included in routine CT scan, with a nonrigid transformation locally matching the proximal tibias. The method proved to be highly reproducible and provided a comprehensive description of the relationship between bone depth and BMD. Specifically it reported significantly higher BMD in the first 6 mm of bone than deeper in the proximal tibia. In conclusion, the proposed method offers promising possibilities to analyze BMD and other properties of the tibia in 3D.
Real-time monitoring of photocatalytic methanol decomposition over Cu2O-loaded TiO2 nanotube arrays in high vacuum
Authors: Masegi Hikaru , Goto Hayato , Sadale Shivaji B. , Noda Kei
Published: September 2020

We report a real-time investigation on the photocatalytic decomposition of methanol over Cu2O-loaded TiO2 nanotube arrays (TNAs) in high vacuum. Cu2O-loaded TNAs were fabricated using all-electrochemical processes. TNAs were prepared by anodizing Ti foils, and Cu2O nanoparticles (CNPs) were pulse-electrodeposited onto anodized TNA surfaces. The photocatalytic decomposition of methanol was monitored using a quadrupole mass analyzer in high vacuum, where the partial pressures of intermediate and final reaction products were measured. Switching phenomena in the partial pressures of hydrogen (H2), formaldehyde (CH2O), water (H2O), and carbon monoxide (CO) were observed simultaneously according to the ON/OFF sequence of ultraviolet irradiations over TNA/CNP composites, thereby revealing that Cu2O can facilitate proton reduction like noble-metal-based cocatalysts such as platinum, even in a high vacuum environment. The intermediate reaction products suggest that the photocatalytic oxidation of gaseous methanol over TNA/CNP proceeds under the coexistence of direct and indirect hole transfer mechanisms.
REVIEWS OF ACOUSTICAL PATENTS
Authors: Fulop Sean A.
Published: September 2020

The purpose of these acoustical patent reviews is to provide enough information for a Journal reader to decide whether to seek more information from the patent itself. Any opinions expressed here are those of the reviewers as individuals and are not legal opinions. Patents are available via the internet at the USPTO website and using Google Patents.
Reconstitution of autophagosome nucleation defines Atg9 vesicles as seeds for membrane formation
Authors: Sawa-Makarska Justyna , Baumann Verena , Coudevylle Nicolas , von Bülow Sören , Nogellova Veronika , Abert Christine , Schuschnig Martina , Graef Martin , Hummer Gerhard , Martens Sascha
Published: September 2020

Reconstituting autophagosome nucleation

To stay healthy, our cells must constantly dispose of harmful material. Autophagy, or self-eating, is an important mechanism to ensure the clearance of bulky material. Such material is enwrapped by cellular membranes to form autophagosomes, the contents of which are then degraded. The formation of autophagosomes is a complicated process involving a large number of factors. How they act together in this process is still enigmatic. Sawa-Makarska
et al.
recapitulated the initial steps of autophagosome formation using purified autophagy factors from yeast. This approach elucidated some of the organizational principles of the autophagy machinery during the assembly of autophagosomes.

Science
, this issue p.
eaaz7714
A defined structural unit enables de novo design of small-molecule–binding proteins
Authors: Polizzi Nicholas F. , DeGrado William F.
Published: September 2020

A new tool in the protein design toolbox

Protein design can compute protein folds from first principles. However, designing new proteins that are functional remains challenging, in part because designing binding interactions requires simultaneous optimization of protein sequence and protein-ligand conformation. Polizzi and DeGrado designed proteins from scratch that bind a small-molecule drug (see the Perspective by Peacock). They introduced a new structural element called a van der Mer (vdM), which tracks the orientation of a chemical group relative to the backbone of a contacting residue. Assuming proteins bind ligands using interactions similar to intraprotein packing, they determined statistically preferred vdMs from a large set of structures in the Protein Data Bank. By including weighted vdMs in their computations, they designed two of six de novo proteins that bind the drug apixaban. A drug-protein x-ray crystal structure confirmed the designed model.

Science
, this issue p.
1227
; see also p.
1166
Dynamics of death by heat
Authors: Huey Raymond B. , Kearney Michael R.
Published: September 2020

Time at high temperature modulates fly mortality in nature
An ethical framework for global vaccine allocation
Authors: Emanuel Ezekiel J. , Persad Govind , Kern Adam , Buchanan Allen , Fabre Cécile , Halliday Daniel , Heath Joseph , Herzog Lisa , Leland R. J. , Lemango Ephrem T. , Luna Florencia , McCoy Matthew S. , Norheim Ole F. , Ottersen Trygve , Schaefer G. Owen , Tan Kok-Chor , Wellman Christopher Heath , Wolff Jonathan , Richardson Henry S.
Published: September 2020

The Fair Priority Model offers a practical way to fulfill pledges to distribute vaccines fairly and equitably
Serological Screening of Influenza A Virus Antibodies in Cats and Dogs Indicates Frequent Infection with Different Subtypes
Authors: Zhao Shan , Schuurman Nancy , Tieke Malte , Quist Berit , Zwinkels Steven , van Kuppeveld Frank J. M. , de Haan Cornelis A. M. , Egberink Herman
Published: September 2020

Influenza A viruses (IAVs) infect humans and a variety of other animal species. Infections with some subtypes of IAV were also reported in domestic cats and dogs. In addition to animal health implications, close contact between companion animals and humans also poses a potential risk of zoonotic IAV infections. In this study, serum samples from different cat and dog cohorts were analyzed for IAV antibodies against seven IAV subtypes, using three distinctive IAV-specific assays differing in IAV subtype-specific discriminatory power and sensitivity.
Thiamine-responsive acute severe pulmonary hypertension in exclusively breastfeeding infants: a prospective observational study
Authors: Sastry Usha M K , M Jayranganath , Kumar Raman Krishna , Ghosh Santu , A P Bharath , Subramanian Anand , Managuli Ameetkumar , Gangadhara Madhu , Manjunath Cholenahally Nanjappa
Published: September 2020

Objectives

Severe pulmonary hypertension (PH) causing right heart failure can occur due to thiamine deficiency in exclusively breastfeeding infants. This study describes the clinical profile and management of thiamine-responsive acute pulmonary hypertension.

Methods

A prospective observational study of infants presenting with severe PH without any other significant heart or lung disease. History of symptoms, clinical examination, echocardiography and basic investigations were performed. Dietary patterns of mothers were recorded. Thiamine was administered and serial echocardiography was performed.

Results

A total of 250 infants had severe PH and 231 infants responded to thiamine. The mean age was 3.2±1.2 months. Fast breathing, poor feeding, vomiting and aphonia were the main symptoms. Tachypnoea, tachycardia and hepatomegaly were found on examination. Echocardiogram revealed grossly dilated right heart with severe PH. Intravenous thiamine was administered to all the babies based on clinical suspicion. Clinical improvement with complete resolution of PH was noticed within 24–48 hours. Babies were followed up to a maximum of 60 months with no recurrence of PH. All the mothers consumed polished rice and followed postpartum food restriction.

Conclusion

Thiamine deficiency is still prevalent in selected parts of India. It can cause life-threatening PH in exclusively breastfeeding infants of mothers who are on a restricted diet predominantly consisting of polished rice. It can contribute to infant mortality. Thiamine administration based on clinical suspicion leads to remarkable recovery. High degree of awareness and thiamine supplementation in relevant geographical areas is required to tackle this fatal disease.
Exacerbated mini-puberty of infancy in an ex-extreme preterm girl
Authors: Santos Mafalda Casinhas , Limão Sara , Ferreira Patrícia
Published: September 2020

Vaginal bleeding can occur shortly after delivery in 3%–5% of newborns as a consequence of placental hormone withdrawal . Although usually benign, its differential diagnosis includes central precocious puberty, tumours and other pathological conditions. A girl born at 26 weeks of gestation presented with five episodes of vaginal bleeding, each lasting less than a week, initiated at 4 months of age. Luteinising hormone and oestradiol levels were in the pubertal range. Later, she exhibited breast development, with no other pubertal signs. An ultrasonography test revealed an impregnated endometrium and a right ovarian cyst with 43 mm of diameter. A cranioencephalic MRI was unremarkable. Clinicians adopted expectant management and there was clinical, hormonal and radiological resolution in 3 months. The spontaneous resolution suggested mini-puberty of infancy. This is usually an asymptomatic condition, but to date, four cases of an exacerbated form in extremepremature infants have been reported. Long-term follow-up data are missing.

A girl born at 26 weeks of gestation presented with five episodes of vaginal bleeding, each lasting less than a week, initiated at 4 months of age. Luteinising hormone and oestradiol levels were in the pubertal range. Later, she exhibited breast development, with no other pubertal signs. An ultrasonography test revealed an impregnated endometrium and a right ovarian cyst with 43 mm of diameter. A cranioencephalic MRI was unremarkable. Clinicians adopted expectant management and there was clinical, hormonal and radiological resolution in 3 months. The spontaneous resolution suggested mini-puberty of infancy. This is usually an asymptomatic condition, but to date, four cases of an exacerbated form in extremepremature infants have been reported. Long-term follow-up data are missing.
Work related sexual harassment and risk of suicide and suicide attempts: prospective cohort study
Authors: Magnusson Hanson Linda L , Nyberg Anna , Mittendorfer-Rutz Ellenor , Bondestam Fredrik , Madsen Ida E H
Published: September 2020

Objective

To analyse the relation between exposure to workplace sexual harassment and suicide, as well as suicide attempts.

Design

Prospective cohort study.

Setting

Sweden.

Participants

86 451 men and women of working age in paid work across different occupations responded to a self-report questionnaire including exposure to work related sexual harassment between 1995 and 2013. The analytical sample included 85 205 people with valid data on sexual harassment, follow-up time, and age.

Main outcome measures

Suicide and suicide attempts ascertained from administrative registers (mean follow-up time 13 years).

Results

Among the people included in the respective analyses of suicide and suicide attempts, 125 (0.1%) died from suicide and 816 (1%) had a suicide attempt during follow-up (rate 0.1 and 0.8 cases per 1000 person years). Overall, 11 of 4095 participants exposed to workplace sexual harassment and 114 of 81 110 unexposed participants committed suicide, and 61/4043 exposed and 755/80 513 unexposed participants had a record of suicide attempt. In Cox regression analyses adjusted for a range of sociodemographic characteristics, workplace sexual harassment was associated with an excess risk of both suicide (hazard ratio 2.82, 95% confidence interval 1.49 to 5.34) and suicide attempts (1.59, 1.21 to 2.08), and risk estimates remained significantly increased after adjustment for baseline health and certain work characteristics. No obvious differences between men and women were found.

Conclusions

The results support the hypothesis that workplace sexual harassment is prospectively associated with suicidal behaviour. This suggests that suicide prevention considering the social work environment may be useful. More research is, however, needed to determine causality, risk factors for workplace sexual harassment, and explanations for an association between work related sexual harassment and suicidal behaviour.
Investigating the characteristics and needs of frequently admitting hospital patients: a cross-sectional study in the UK
Authors: Kayyali Reem , Funnell Gill , Odeh Bassel , Sharma Anuj , Katsaros Yannis , Nabhani-Gebara Shereen , Pierscionek Barbara , Wells Joshua Sterling , Chang John
Published: September 2020

Objectives

This study forms the user requirements phase of the OPTIMAL project, which, through a predictive model and supportive intervention, aims to decrease early hospital readmissions. This phase aims to investigate the needs and characteristics of patients who had been admitted to hospital ≥2 times in the past 12 months.

Setting

This was a cross-sectional study involving patients from Croydon University Hospital (CUH), London, UK.

Participants

A total of 347 patients responded to a postal questionnaire, a response rate of 12.7%. To meet the inclusion criteria, participants needed to be aged ≥18 and have been admitted ≥2 times in the previous 12 months (August 2014–July 2015) to CUH.

Primary and secondary outcomes

To profile patients identified as frequent admitters to assess gaps in care at discharge or post-discharge. Additionally, to understand the patients’ experience of admission, discharge and post-discharge care.

Results

The range of admissions in the past 12 months was 2–30, with a mean of 2.8. At discharge 72.4% (n=231/347) were not given a contact for out-of-hours help. Regression analysis identified patient factors that were significantly associated with frequent admissions (>2 in 12 months), which included age (p=0.008), being in receipt of care (p=0.005) and admission due to a fall (p=0.01), but not receiving polypharmacy. Post-discharge, 41.8% (n=145/347) were concerned about being readmitted to the hospital. In the first 30 days after discharge, over half of patients (54.5% n=189/347) had no contact from a healthcare professional.

Conclusion

Considering that social care needs were more of a determinant of admission risk than medical needs, rectifying the lack of integration, communication and the under-utilisation of existing patient services could prevent avoidable problems during the transition of care and help decrease the likelihood of hospital readmission.
Impact of the abolition of copayments on the GP-centred coordination of care in Bavaria, Germany: analysis of routinely collected claims data
Authors: Olm Michaela , Donnachie Ewan , Tauscher Martin , Gerlach Roman , Linde Klaus , Maier Werner , Schwettmann Lars , Schneider Antonius
Published: September 2020

Objectives

In 2012, Germany abolished copayment for consultations in ambulatory care. This study investigated the effect of the abolition on general practitioner (GP)-centred coordination of care. We assessed how the proportion of patients with coordinated specialist care changed over time when copayment to all specialist services were removed. Furthermore, we studied how the number of ambulatory emergency cases and apparent ‘doctor shopping’ changed after the abolition.

Design

A retrospective routine data analysis of the Bavarian Association of Statutory Health Insurance Physicians, comparing the years 2011 and 2012 (with copayment), with the period from 2013 to 2016 (without copayment). Therefore, time series analyses covering 24 quarters were performed.

Setting

Primary care in Bavaria, Germany.

Participants

All statutorily insured patients in Bavaria, aged ≥18 years, with at least one ambulatory specialist contact between 2011 and 2016.

Primary and secondary outcome measures

Primary outcome was the percentage of patients with GP-coordinated care (every regular specialist consultation within a quarter was preceded by a GP referral). Secondary outcomes were the number of ambulatory emergency cases and apparent ‘doctor shopping’.

Results

After the abolition, the proportion of coordinated patients decreased from 49.6% (2011) to 15.5% (2016). Overall, younger patients and those living in areas with lower levels of deprivation showed the lowest proportions of coordination, which further decreased after abolition. Additionally, there were concomitant increases in the number of ambulatory emergency contacts and to a lesser extent in the number of patients with apparent ‘doctor shopping’.

Conclusions

The abolition of copayment in Germany was associated with a substantial decrease in GP coordination of specialist care. This suggests that the copayment was a partly effective tool to support coordinated care. Future studies are required to investigate how the gatekeeping function of GPs in Germany can best be strengthened while minimising the associated administrative overhead.
American and Australian family experiences while receiving a diagnosis or having treatment for idiopathic toe walking: a qualitative study
Authors: Williams Cylie , Robson Kristy , Pacey Verity , Gray Kelly
Published: September 2020

Objective

To understand parent journeys while navigating diagnosis, assessment or treatment of their children with idiopathic toe walking (ITW).

Design

Mixed methods qualitative study: analyses of survey data from the measure of processes of care-20 (MPOC-20) and semistructured interviews were analysed with an interpretative phenomenological analysis approach. Trustworthiness of data was achieved through member checking, researcher triangulation, reflexivity and transferability and comparison with the MPOC-20 results.

Setting

USA and Australia.

Participants

Parents of children diagnosed with ITW who had seen more than one health professional during their care and lived in Australia or the USA.

Results

Ten parents of children aged between 3 and 13 years and diagnosed with ITW participated. Parents described complex themes relating to their journeys. The themes relating to their journeys were: (1) riding the rollercoaster of diagnosis; (2) navigating the treatment options and (3) supporting parents in the journey. Each theme was supported by parent quotes about their experiences. Challenges were not localised to one country, in spite of vastly different healthcare systems.

Conclusions

These findings create opportunities for an international approach to education, treatment recommendations and outcome measures to improve patient and parent experiences. Health professionals should consider the impact on parents in navigating between health professionals when provided with a diagnosis which can have variable outcomes and varied treatment options.
Sick leave and disability pension in patients with chronic hepatitis C compared with a matched general population: a nationwide register study
Authors: Büsch Katharina , Hansson Fredrik , Holton Michelle , Lagging Martin , Westin Johan , Kövamees Jan , Sällberg Matti , Söderholm Jonas
Published: September 2020

Objective

The objective of this study was to evaluate sick leave and disability pension in patients with chronic hepatitis C virus (HCV) infection as compared with a matched general population cohort.

Design

Retrospective register study.

Setting

Nationwide in Sweden.

Participants

This register-based study used the Swedish National Patient Register to identify working-age patients with HCV in 2012 (n=32 021) who were diagnosed between 1999 and 2007 (n=19 362). Sick leave and disability pension data were retrieved from Statistics Sweden (1994–2012), with up to five matched individuals from the general population.

Primary and secondary outcome measures

The primary outcome was workdays lost due to sick leave episodes (>14 days) and disability pension overall. The secondary outcome was workdays lost per subgroup of patients with chronic HCV.

Results

In 2012, 14% of the HCV patients had ≥1 registered sick leave episode compared with 10% in the matched comparator cohort. For disability pension benefits, results were 30% versus 8%, respectively. Overall, in 2012, 57% of patients with HCV did not have any registered workdays lost, whereas 30% were absent ≥360 days compared with 83% and 9% in the matched cohort, respectively. The mean total number of annual workdays lost in 2012 was 126 days in the HCV patient cohort compared with 40 days in the matched general population comparator cohort. Annual days lost increased from a mean of 86 days 5 years before diagnosis to 136 days during the year of diagnosis.

Conclusions

These results show that Swedish HCV patients used more sick days and have a higher frequency of disability pension compared with a comparator cohort from the general Swedish population. Whether earlier diagnosis of HCV and treatment might impact work absence in Sweden warrants further investigation.
Exploring trust in religious leaders and institutions as a mechanism for improving retention in child malnutrition interventions in the Philippines: a retrospective cohort study
Authors: Lau Lincoln Leehang , Dodd Warren , Qu Han Lily , Cole Donald C
Published: September 2020

Objectives

In the context of persistent child malnutrition in the Philippines, the objective of this study was to examine how different dimensions of trust affected programme retention and physiological outcomes when a faith-based organisation (FBO) addressed moderate and severe acute malnutrition among children from households experiencing extreme poverty.

Setting

We retrospectively analysed survey data collected by International Care Ministries (ICM) in 2012–2013 across 150 communities in eight provinces (Negros Oriental, Negros Occidental, Bohol, Palawan, Sarangani, South Cotabato, Sultan Kudarat and Zamboanga del Norte) of the Philippines.

Study participants

Caregivers of 1192 children experiencing moderate acute malnutrition and severe acute malnutrition between the ages of 6 and 60 months.

Intervention

A 16-week child malnutrition treatment programme called Malnourished Child Outreach offered by ICM in partnership with local religious leaders and institutions.

Primary and secondary outcome measures

Programme dropout and weight-for-height z-score (WHZ) at the end of the programme for enrolled children were the two outcomes of interest. A logistic mixed-effects model was built to assess factors associated with programme dropout and a linear mixed-effects model for factors associated with WHZ at the end of the programme.

Results

Trust in religious leaders or institutions (−0.87 (95% CI: −1.43,–0.26)) was negatively associated with programme dropout, suggesting that with increasing levels of trust, decreasing proportions of children dropped out of treatment. Retention in the programme led to improved WHZ among participating children (−0.38 (95% CI: −1.43, 0.26)). Various measures of social capital, including trust in religious and public institutions, were not associated with WHZ at the end of the programme.

Conclusions

Leveraging pre-existing trust in religious leaders and institutions among households experiencing extreme poverty is one way that ICM, and potentially other FBOs, can promote retention in child nutrition interventions among vulnerable populations.
Are there social gradients in the occurrence of lung cancer and in the survival of lung cancer patients? Findings from an observational study using German claims data of Lower Saxony
Authors: Schröder Sebastian , Beller Johannes , Golpon Heiko , Geyer Siegfried
Published: September 2020

Objectives

Only a few studies on health inequalities in terms of lung cancer are available. We examined whether social inequalities are present for the occurrence of lung cancer. Confining the analyses to patients, it was also examined whether survival over the observation period and over a standardised period of 18 months differed by occupational position and income.

Methods

Our findings are based on claims data from a German statutory health insurance covering 2005–2016. The database comprised N=3 163 211 women (50.7%) and men (49.3%) aged 18 years and older. Diagnoses (International Statistical Classification of Diseases and Related Health Problems 10th Revision: C34.0 to C34.9) were hospital-based, and income and occupational position were used as indicators of socioeconomic position. Analyses on social gradients were performed for employed and retired insured, but only for employed insured information on occupation and on income were available, for retired women and men only income was available. Analyses were performed by means of proportional hazard regression.

Results

In employed women, social gradients for the occurrence emerged for occupational position, but not for income. In men, social differences were found for both indicators. For retired insured, income gradients were found in men. Looking at overall survival, neither in women nor in men social gradients emerged.

Conclusions

The reported social inequalities in the occurrence of lung cancer are pointing towards social differences in smoking behaviour, exposition to hazardous occupation-related substances and differences in preventive strategies. The absence of social inequalities in survival after lung cancer suggests equality in medical treatment of the disease.
Facing a blind alley - Experiences of stress-related exhaustion: a qualitative study
Authors: Alsén Sara , Ali Lilas , Ekman Inger , Fors Andreas
Published: September 2020

Introduction

Mental illness is a major concern in many countries. In Sweden, stress-related mental illness is currently the most frequent reason for sick leave.

Objective

This study aimed to explore patients’ experiences of stress-related exhaustion.

Design

A qualitative study with interview data analysed using a phenomenological hermeneutic method.

Setting

Participants were selected from public primary healthcare centres in a larger city in western Sweden.

Participants

Seven women and five men on sick leave from work due to stress-related exhaustion were included in the study.

Findings

Stress-related exhaustion was experienced as a loss of access to oneself and one’s context and feelings of being trapped and lost in life. The condition had a significant impact on personal identity, raised existential issues and was interpreted as facing a blind alley. Participants described a mistaken direction in life, being forced to stop, change direction and act differently.

Conclusion

Stress-related exhaustion is a challenging, life-changing existential experience that involves a crisis with an opportunity for new insights. Careful consideration of patients’ narratives together with the expertise of healthcare professionals can be combined to improve health and optimise recovery based on individual’s situation.
Patient education materials for non-specific low back pain and sciatica: a protocol for a systematic review and meta-analysis
Authors: Furlong Bradley , Aubrey-Bassler Kris , Etchegary Holly , Pike Andrea , Darmonkow Georgia , Swab Michelle , Hall Amanda
Published: September 2020

Introduction

Low back pain accounts for more disability than any other musculoskeletal condition and is associated with severe economic burden. Patients commonly present with negative beliefs about low back pain and this can have detrimental effects on their health outcomes. Providing evidence-based, patient-centred education that meets patient needs could help address these negative beliefs and alleviate the substantial low back pain burden. The primary aim of this review is to investigate the effectiveness of patient education materials on immediate process, clinical and health system outcomes.

Methods and analysis

The search strategy was developed in collaboration with a librarian and systematic searches will be performed in MEDLINE, EMBASE, CINAHL, PsycINFO and SPORTDiscus. We will also search trial registries and grey literature through the OpenGrey database. Study selection will include a title and abstract scan and full-text review by two authors. Only randomised controlled trials will be included in this review. Trials must include patients with low back pain or sciatica and investigate educational interventions with at least one of the following contrasts: (1) education alone versus no intervention; (2) education alone versus another intervention; (3) education in addition to another intervention versus the same intervention with no education. Data extraction, risk of bias and grading of the quality of evidence will be performed independently by two reviewers. Risk of bias will be assessed using the PEDro scale, and the quality of evidence will be assessed with the Grades of Recommendation, Assessment, Development and Evaluation approach. A random-effects model will be used for each contrast, and results will be pooled if the participants, interventions, and outcomes are homogeneous. If heterogeneity is high (I2>75%), we will evaluate the magnitude and direction of the differences in effect sizes across studies to determine if it remains reasonable to pool the results. Analyses of acute and subacute low back pain (less than 12 weeks duration) will be performed separately from chronic low back pain (12 weeks or greater duration). Likewise, analyses of short-term (less than 6 months) and long-term (6 months or greater) follow-up will be performed separately. Subgroup analyses will be performed on non-specific low back pain, sciatica and mixed populations.

Ethics and dissemination

Ethical approval is not required for this review. This study, along with its results, will be published in a peer-reviewed journal.
Care-pathways for patients presenting to emergency ambulance services with self-harm: national survey
Authors: Zayed Mohammed Gaber , Williams Victoria , Glendenning Alexander Charles , Bulger Jenna Katherine , Hewes Tom , Porter Alison , Snooks Helen , John A
Published: September 2020

Background

Self-harm is among the top five causes of acute hospital admissions and ambulance clinicians are often the first point of contact. However, the Emergency Department (ED) may not be the most appropriate place of care and little is known about the existence or nature of alternative pathways available to UK ambulance services. This survey describes the current management pathways used by ambulance services for patients who have self-harmed.

Methods

A structured questionnaire was sent to all UK ambulance services by email and followed up by telephone in 2018. Three independent researchers (two clinical) coded responses which were analysed thematically.

Results

All 13 UK ambulance services responded to the survey: nine by email and four by telephone interview. Two services reported a service-wide protocol for managing people presenting with self-harm, with referral to mental health crisis team available as an alternative to conveyance to ED, following on-scene psychosocial assessment. Four services reported local pathways for managing mental health patients which included care of patients who had self-harmed. Four services reported being in the process of developing pathways for managing mental health patients. Six services reported no service-wide nor local pathways for managing self-harm patients. No robust evaluation of new care models was reported.

Conclusion

Practice in ambulance services in the UK is variable, with a minority having a specific clinical pathway for managing self-harm, with an option to avoid ED. New pathways for patients who have self-harmed must be evaluated in terms of safety, clinical and cost-effectiveness.
Compression asphyxia and other clinicopathological findings from the Hillsborough Stadium disaster
Authors: Nolan Jerry P , Soar Jasmeet , Cary Nathaniel , Cooper Nigel , Crane Jack , Fegan-Earl Ashley , Lawler William , Lumb Philip , Rutty Guy
Published: September 2020

Ninety-six people died following a crowd crush at the Hillsborough Football Stadium, Sheffield, UK in 1989. The cause of death in nearly all cases was compression asphyxia. The clinical and pathological features of deaths encountered in crowds are discussed with a particular focus on the Hillsborough disaster.
Using a new socioepidemiological questionnaire to analyse associations between intergenerational upward social mobility and body fat distribution: a pilot study with the Oxford BioBank cohort
Authors: Eli K , Karpe F , Ulijaszek S
Published: September 2020

Background

As measured through body mass index (BMI), obesity is more prevalent among upwardly mobile adults than among adults born into middle-class families. Although BMI reflects general adiposity, health risks are more strongly associated with abdominal adiposity. It is therefore important to investigate associations between upward mobility and fat distribution.

Methods

A socioepidemiological questionnaire was developed, qualitatively validated and piloted with Oxford BioBank participants. Sex-specific analyses of variance (ANOVA) investigated associations between participant occupational class and adiposity, paternal occupational class and adiposity, and upward occupational mobility and adiposity. The main aim was to observe whether the expected directional effect of adiposity in relation to paternal occupational class would emerge.

Results

280 participants (166 women, 114 men; age 32–67 years) completed the questionnaire. Men with fathers of occupational class 2 or 3 had higher mean BMI, total body fat percentage, android fat mass and android-to-gynoid fat mass ratio than men with fathers of occupational class 1. Women with fathers of occupational class 2 or 3 had higher mean BMI, total body fat percentage, android fat mass and gynoid fat mass than women with fathers of occupational class 1. Among men, upward mobility was not associated with adiposity. Among women, upward mobility was associated with higher total body fat percentage, android fat mass and gynoid fat mass.

Conclusion

The expected directional effect was found, thereby supporting the questionnaire’s use. Upward mobility did not appear to change associations between paternal occupational class and participant adiposity. Future research using the socioepidemiological questionnaire should investigate associations between gender, educational mobility, adiposity and health.
The Landau problem and nonclassicality
Authors: Petronilo G. X. A. , Ulhoa S. C. , Araújo K. V. S. , Paiva R. A. S. , Amorim R. G. G. , Santana A. E.
Published: September 2020

Exploring the concept of the extended Galilei group [Formula: see text]. Representations for field theories in a symplectic manifold have been derived in association with the method of the Wigner function. The representation is written in the light-cone of a de Sitter space–time in five dimensions. A Hilbert space is constructed, endowed with a symplectic structure, which is used as a representation space for the Lie algebra of [Formula: see text]. This representation gives rise to the spin-0 Schrödinger (Klein–Gordon-like) equation for the wave functions in phase space, such that the dependent variables have the content of position and linear momentum. This is a particular example of a conformal theory, such that the wave functions are associated with the Wigner function through the Moyal product. We construct the Pauli–Schrödinger (Dirac-like) equation in phase space in its explicitly covariant form. In addition, we analyze the gauge symmetry for spin-1/2 particles in phase space and show how implement the minimal coupling in this case. We applied to the problem of an electron in an external field, and we recovered the nonrelativistic Landau levels. Finally, we study the parameter of negativity associated with the nonclassicality of the system.
Comment on: “Some quantum aspects of a particle with electric quadrupole moment interacting with an electric field subject to confining potentials”
Authors: Fernández Francisco M.
Published: September 2020

We analyze the results obtained from a model consisting of the interaction between the electric quadrupole moment of a moving particle and an electric field. We argue that the system does not support bound states because the motion along the [Formula: see text] axis is unbounded. It is shown that the author obtains a wrong bound-state spectrum for the motion in the [Formula: see text] plane and that the existence of allowed cyclotron frequencies is an artifact of the approach.