bluuebunny/crossref_metadata_2025 huggingface dataset:
How does it ‘sound’? Audiences, broadcasters, and managers on visual radio in Israel
Authors: Laor Tal
Published: August 2020

In recent years, radio broadcasts on social media have extended to visual radio broadcasts (e.g. Facebook Live) that support a continuous display of viewer comments in real time. Based on 65 semi-structured in-depth interviews, this study presents for the first time the perspectives of the main actors in the visual radio scene: viewers, broadcasters, and radio executives. Findings show that broadcasters generally believe that the recent visual changes to radio, forced by the changing media environment, have an adverse impact on the radiophonic medium. In contrast, radio executives, who set policies, believe that radio must maintain a presence in the visual, viral interactive online space. For viewers, visual radio meets diverse needs, generates enjoyment, and offers the added value of interactivity and enhanced sense of activity resulting from new access to ‘behind the scenes’ of radio broadcasts. This study demonstrates how the theory of technological determinism is reflected in practice, in the radiophonic medium’s adjustments to the features of the new era – visibility, lost anonymity through increased exposure, potential for viral dissemination, and real-time responsivity – despite the fact that these features are contrary to radio’s unique fundamental features. Despite this innovative turn, all actors – executives, broadcasters, and viewers – believe that radio broadcast consumption remains dominated by the traditional in-car audio format.
Experimental study on friction performance of damaged interface in steel-concrete composite beam connected by high-strength bolt
Authors: Xing Ying , Xu Ya-ning , Guo Qi , Jiao Jin-feng , Chen Qing-wei
Published: August 2020

Although traditional steel-concrete composite beam has excellent structural characteristics, it cannot meet the requirement of quick disassembly and repair in the bridge. This article presents an experimental study on friction performance of damaged steel-concrete interface in recoverable composite beam connected by high-strength frictional bolts. A total of 21 specific split tests were carried out using different concrete strength, steel strength, and surface treatment of steel. The experimental results showed that the demountable high-strength frictional bolt used in composite beam has similar performance as in the bare steel structures. The initial friction coefficient and slip stiffness were measured to be 0.34–0.47 and 52.3–116.1 kN/mm, respectively. Friction performance of damaged interface was obtained, proving that friction coefficient and slip stiffness will not decrease after the first slip damage. It is also confirmed that shot blasted steel and concrete with higher strength were more suitable in the demountable composite beam.
Feasibility of studying 460 MPa high-strength steel affected by strain aging with acoustic emission method
Authors: Yang Yiting , Wang Yan , Li Kehao
Published: August 2020

Strain aging significantly influences the behavior of partially damaged structural steel. The effects of strain aging can be determined based on mechanical experiments, but the sampling process causes further damage to the structures. To explore the possibility of using nondestructive testing (NDT) technology to distinguish the strain aging effects on steel materials, this study investigates the characteristics of acoustic emission (AE) signals for high-strength steel (HSS) affected by strain aging. First, different strain aging effects were applied to 460 MPa HSS specimens. Second, pencil lead break (PLB) tests were performed on the specimens with strain aging, and the generated AE signals were recorded. Finally, tensile tests were conducted, that the strain aging effects on mechanical behavior were determined. The obtained AE signals were compared by extracting the AE parameters and analyzed in the frequency and time-frequency domains with a fast Fourier transform (FFT) and a wavelet transform (WT), respectively. The study shows that the strain aging effects change the characteristics of the AE signals. Compared to the prestrain, the aging time has a more pronounced impact on the AE behaviors. This research proposes a possible NDT method to determine the effects of strain aging on steel materials. Experimental data are provided to detect the degree of partial damage to 460 MPa HSS owing to strain aging using the AE method.
Control of temperature and fume generation by cooking in a residential kitchen by ceiling radiative cooling and fume hood extraction
Authors: Li Wang , Wang Hanqing , Li Chengjun , Yu Chuck Wah
Published: August 2020

The heat radiation in a residential kitchen was simulated by CFD (Computational-fluid-dynamics) to evaluate the cooling by a radiant cooling ceiling panel and pollution dispersion by the range hood and the air extraction system. The kitchen has a 2-hobs stove and a fume hood for removing waste heat and fumes. The simulation was validated by measurements in a domestic kitchen in a home in Changsha, China, where summer temperature is generally about 33 °C and often over 35–42°C. The simulation results show that the pollutant concentration in the kitchen during cooking was much lower than the Chinese standard criteria of GB/T18883-2002. A standard turbulence model was used, which indicated satisfactory distribution of temperature and airflow in the kitchen. The indoor airflow velocity was low. The airflow temperature when both hobs were used was slightly higher by 3–4°C than when a single hob was used. The temperature in the kitchen during cooking was about 28 °C, which was a degree lower than the living-room temperature, thus maintaining a comfortable thermal and healthy environment. The radiant cooling in the ceiling was shown to be a significant contributing factor. The ring suction type range hood has a sufficient capacity to remove the kitchen fume contaminants.
Police ethics and integrity: Keeping the ‘blue code’ of silence
Authors: Westmarland Louise , Conway Steve
Published: August 2020

This paper examines attitudes towards police ethics and integrity using the responses of police officers and support staff to some ethical dilemmas via an online questionnaire. The aim of the study was to explore potential connections between respondents’ beliefs about the seriousness or type of misdemeanour and their likelihood of reporting the behaviour. Using a series of scenarios, we explore professional ethics and integrity by analysing the evidence from our survey of around 1,500 police officers, police community support officers (PCSOs) and police support staff. Throughout, we aim to show which of the scenarios were considered the most ‘serious’, which are more likely to be reported, and offer some suggestions as to why the ‘blue code’ is significant. The findings suggest the persistence of a reluctance to report some misdemeanours; of the 10 scenarios created for the survey, there was a great deal of certainty around the reporting theft of cash, but respondents were less likely to report a colleague keeping a ‘found’ watch. Accessing the Police National Computer without due authority was seen as relatively ‘serious’ and covering up for a drink-driving colleague and use of excessive force were both likely to be reported. We discovered ambiguities in responses around sexual touching of a colleague in an office setting, but a lower level of concern regarding an officer who forms a romantic relationship with a victim of crime who he met in a professional setting. Respondents expressed distrust in the force’s anonymous messenger system, set up for reporting a colleague’s behaviour without revealing their own identity and said they could treat a whistle-blower with respect or caution, depending on the circumstances of the individual case.
Numerical and experimental investigation of turbocharger compressor low-end performance improvement using a variable geometry inlet orifice
Authors: Zhao Ben , Zhao Qingjun , Zhao Wei , Xiang Xiaorong , Zhou Xiaoyong
Published: August 2020

Variable geometry orifice located upstream of a centrifugal impeller has been proposed to improve compressor low-end performance, by reducing compressor inlet flow area. The inlet flow area reduction is achieved by actuating the orifice flow area. The effects of the flow area reduction on compressor performance and the physical mechanisms controlling performance were investigated in the current work using numerical simulations and physical experiments. At the investigated compressor speed, with reduced inlet flow area, compressor efficiency at high flow rates is decreased by 2.01 percentage points based on the numerical predictions and by 6.47 percentage points based on the physical data. At low flow rate, however, compressor efficiency can be improved by 2.26 percentage points based on the numerical predictions and by 2.88 percentage points based on the physical data. Besides the efficiency, the inlet flow area reduction shifts the compressor stability limit toward the lower flow rate by 9.09% based on the numerical results and 41.13% based on the physical experiment and improves the compressor peak pressure ratio by 0.55% based on both the numerical and experimental data. At the flow rates lower than the peak efficiency point, it is beneficial to actuate the orifice to improve the compressor low-end performance. At flow rates higher than the peak efficiency point, it is necessary to deactivate the orifice to avoid the inlet flow area reduction that induces flow loss and degrades compressor performance.
CoBuilt 4.0: Investigating the potential of collaborative robotics for subject matter experts
Authors: Reinhardt Dagmar , Haeusler Matthias Hank , London Kerry , Loke Lian , Feng Yingbin , De Oliveira Barata Eduardo , Firth Charlotte , Dunn Kate , Khean Nariddh , Fabbri Alessandra , Wozniak-O’Connor Dylan , Masuda Rin
Published: August 2020

Human-robot interactions can offer alternatives and new pathways for construction industries, industrial growth and skilled labour, particularly in a context of industry 4.0. This research investigates the potential of collaborative robots (CoBots) for the construction industry and subject matter experts; by surveying industry requirements and assessments of CoBot acceptance; by investing processes and sequences of work protocols for standard architecture robots; and by exploring motion capture and tracking systems for a collaborative framework between human and robot co-workers. The research investigates CoBots as a labour and collaborative resource for construction processes that require precision, adaptability and variability.

Thus, this paper reports on a joint industry, government and academic research investigation in an Australian construction context. In section 1, we introduce background data to architecture robotics in the context of construction industries and reports on three sections. Section 2 reports on current industry applications and survey results from industry and trade feedback for the adoption of robots specifically to task complexity, perceived safety, and risk awareness. Section 3, as a result of research conducted in Section 2, introduces a pilot study for carpentry task sequences with capture of computable actions. Section 4 provides a discussion of results and preliminary findings. Section 5 concludes with an outlook on how the capture of computable actions provide the foundation to future research for capturing motion and machine learning.
Deliberation against Participation? Yellow Vests and Grand Débat: A Perspective from Deliberative Theory
Authors: Ehs Tamara , Mokre Monika
Published: August 2020

The yellow vest movement started in November 2018 and has formed the longest protest movement in France since 1945. The movement provoked different reactions of the French government—on the one hand, violence and repression; on the other hand, concessions. One of them was to provide a possibility for citizens’ participation by organizing the so-called “Grand Débat.” It was clear to all observers that this was less an attempt to further democracy in France than to calm down the protests of the yellow vests. Thus, it seemed doubtful from the beginning whether this form of participatory democracy could be understood as a real form of citizens’ deliberation, and in fact, several shortcomings with regard to procedure and participation were pointed out by theorists of deliberative democracy. The aim of this article is to analyze the Grand Débat with regard to its deliberative qualities and shortcomings.
Recent trend in developing advanced fiber metal laminates reinforced with nanoparticles: A review study
Authors: Eslami-Farsani Reza , Aghamohammadi Hamed , Khalili S Mohammad Reza , Ebrahimnezhad-Khaljiri Hossein , Jalali Hamid
Published: August 2020

Recently, fiber metal laminates (FMLs) have attracted considerable application in many industries due to their outstanding properties. FMLs are hybrid materials that are fabricated by adhesion of thin layers of metals and fiber-reinforced composites. It should be noted that the reinforcing mechanisms of nanoparticles on the polymeric composites have been well-established, but there is limited literature regarding the influence of nanoparticles on the mechanical behavior of FMLs and adhesively bonded joints (ABJs) between metal sheets and polymeric composites. To date, various nanofillers including carbon nanotubes, graphene nanoplatelets, clay nanoparticles and oxide nanoparticles have been used for improving the mechanical properties of FMLs, and ABJs. The performed studies revealed that the efficiency of nanoparticles in improving the properties of FMLs and ABJs mainly dependent on various factors such as surface treatment of metal sheets, type of nanoparticles, the morphology of nanoparticles, the size of samples, fabrication parameters, etc. However, the effects of parameters on the properties of FMLs and ABJs reinforced with nanoparticles have not considerably discussed in the literature. This review paper aims to review the existing related papers regarding the effects of nanoparticles on the mechanical properties of FMLs and ABJs in the term of adhesion between metal sheets and polymers.
Communities and Clinical Trials: A Case Study from the RTS,S Malaria Vaccine Trials in Eastern Africa
Authors: Wyss-van den Berg Machteld , Ogutu Bernhards , Sewankambo Nelson K. , Merten Sonja , Biller-Andorno Nikola , Tanner Marcel
Published: August 2020

When clinical trials enter human communities, two complex systems merge—creating challenges for the clinical trial team and the local human community. This is of particular relevance for clinical trials in low-resource settings where the resource scarcity can intensify existing inequities. Here we present a case study of a phase III malaria vaccine clinical trial. Through qualitative interviews with researchers and caregivers of pediatric participants we elucidate themes that shape the clinical trial system. These themes can be a useful complementary planning tool to existing research guidelines for clinical trial researchers. Respondents from both groups reported financial and social contextual realities to be major drivers in the system. We found a strong historical path dependency in the community that was closely tied to the relationships with researchers and indicative of the structural inequities. We elaborate on these findings and offer recommendations to improve trial design.
College Student Involvement in Hunting and Shooting Sports: What Drives Participation?
Authors: Wallace Lacey N.
Published: August 2020

Little is known about college students’ participation in shooting sports or hunting with firearms. It is also unknown how participation in these activities during the college years differs from childhood participation and why. This study investigated these questions with a survey of 298 college students in the Northeastern United States in 2017 and 2018. Results indicated that characteristics of the area where respondents grew up influenced their hunting participation during college, but this was not the case for shooting sports. Across activities, having fun was the topmost reported motivation for participation. For hunting with firearms, obtaining locally sourced meat was the second most commonly reported rationale. Participation in hunting and shooting sports was lower in college than in childhood; this trend was not explained by demographic characteristics.
Early experience utilizing artificial intelligence shows significant reduction in transfer times and length of stay in a hub and spoke model
Authors: Hassan Ameer E , Ringheanu Victor M , Rabah Rani R , Preston Laurie , Tekle Wondwossen G , Qureshi Adnan I
Published: August 2020

Background

Recently approved artificial intelligence (AI) software utilizes AI powered large vessel occlusion (LVO) detection technology which automatically identifies suspected LVO through CT angiogram (CTA) imaging and alerts on-call stroke teams. We performed this analysis to determine if utilization of AI software and workflow platform can reduce the transfer time (time interval between CTA at a primary stroke center (PSC) to door-in at a comprehensive stroke center (CSC)).

Methods

We compared the transfer time for all LVO transfer patients from a single spoke PSC to our CSC prior to and after incorporating AI Software (Viz.ai LVO). Using a prospectively collected stroke database at a CSC, demographics, mRS at discharge, mortality rate at discharge, length of stay (LOS) in hospital and neurological-ICU were examined.

Results

There were a total of 43 patients during the study period (median age 72.0 ± 12.54 yrs., 51.16% women). Analysis of 28 patients from the pre-AI software (median age 73.5 ± 12.28 yrs., 46.4% women), and 15 patients from the post-AI software (median age 70.0 ± 13.29 yrs., 60.00% women). Following implementation of AI software, median CTA time at PSC to door-in at CSC was significantly reduced by an average of 22.5 min. (132.5 min versus 110 min; p = 0.0470).

Conclusions

The incorporation of AI software was associated with an improvement in transfer times for LVO patients as well as a reduction in the overall hospital LOS and LOS in the neurological-ICU. More extensive studies are warranted to expand on the ability of AI technology to improve transfer times and outcomes for LVO patients.
Strengthening effect of laser shock peening on 7075-T6 aviation aluminum alloy
Authors: Zhang Junhao , Cheng Xiuquan , Xia Qinxiang , Yan Chang
Published: August 2020

The strengthening effect and uniformity of residual stress and strain of 7075-T6 aviation aluminum after laser shock peening were investigated. The finite element simulation model of laser shot peening on 7075-T6 aviation aluminum alloy was established and verified. On this basis and combined with experiment, the microstructure, residual stress distribution and equivalent strain distribution of 7075-T6 aviation aluminum alloy after laser shock peening were studied. An index U for evaluating the strain uniformity in the peened area was proposed based on the statistical processing of the equivalent strain distribution in the peened area. The results show that the average grain size on the peened surface of the specimen was refined to 20–30 μm after LSP, and a residual compressive stress layer with thickness of about 0.5 mm was induced on the surface. Grain refinement and residual compressive stress can promote the strength and fatigue properties of 7075-T6 aviation aluminum alloy. The minimum value of U is obtained in the 6 × 6 spot array (the corresponding overlap ratio is 58%), which suggest that the most uniform deformation peened area can be obtained by using 58% overlap ratio in the laser shot peening process, which can avoid stress concentration and improve fatigue life.
Multi-attribute self-attention guided vehicle local region detection based on convolutional neural network architecture
Authors: Chen Jingbo , Chen Shengyong , Bian Linjie
Published: August 2020

Many pieces of information are included in the front region of a vehicle, especially in windshield and bumper regions. Thus, windshield or bumper region detection is making sense to extract useful information. But the existing windshield and bumper detection methods based on traditional artificial features are not robust enough. Those features may become invalid in many real situations (e.g. occlude, illumination change, viewpoint change.). In this article, we propose a multi-attribute-guided vehicle discriminately region detection method based on convolutional neural network and not rely on bounding box regression. We separate the net into two branches, respectively, for identification (ID) and Model attributes training. Therefore, the feature spaces of different attributes become more independent. Additionally, we embed a self-attention block into our framework to improve the performance of local region detection. We train our model on PKU_VD data set which has a huge number of images inside. Furthermore, we labeled the handcrafted bounding boxes on 5000 randomly picked testing images, and 1020 of them are used for evaluation and 3980 as the training data for YOLOv3. We use Intersection over Union for quantitative evaluation. Experiments were conducted in three different latest convolutional neural network trunks to illustrate the detection performance of the proposed method. Simultaneously, in terms of quantitative evaluation, the performance of our method is close to YOLOv3 even without handcrafted bounding boxes.
Cerebrovascular events and outcomes in hospitalized patients with COVID-19: The SVIN COVID-19 Multinational Registry
Authors: Siegler James E , Cardona Pere , Arenillas Juan F , Talavera Blanca , Guillen Ana N , Chavarría-Miranda Alba , de Lera Mercedes , Khandelwal Priyank , Bach Ivo , Patel Pratit , Singla Amit , Requena Manuel , Ribo Marc , Jillella Dinesh V , Rangaraju Srikant , Nogueira Raul G , Haussen Diogo C , Vazquez Alejandro R , Urra Xabier , Chamorro Ángel , Román Luis S , Thon Jesse M , Then Ryna , Sanborn Emma , de la Ossa Natalia P , Millàn Mònica , Ruiz Isaac N , Mansour Ossama Y , Megahed Mohammed , Tiu Cristina , Terecoasa Elena O , Radu Răzvan A , Nguyen Thanh N , Curiale Gioacchino , Kaliaev Artem , Czap Alexandra L , Sebaugh Jacob , Zha Alicia M , Liebeskind David S , Ortega-Gutierrez Santiago , Farooqui Mudassir , Hassan Ameer E , Preston Laurie , Patterson Mary S , Bushnaq Saif , Zaidat Osama , Jovin Tudor G
Published: August 2020

Background

Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) has been associated with a significant risk of thrombotic events in critically ill patients.

Aim

To summarize the findings of a multinational observational cohort of patients with SARS-CoV-2 and cerebrovascular disease.

Methods

Retrospective observational cohort of consecutive adults evaluated in the emergency department and/or admitted with coronavirus disease 2019 (COVID-19) across 31 hospitals in four countries (1 February 2020–16 June 2020). The primary outcome was the incidence rate of cerebrovascular events, inclusive of acute ischemic stroke, intracranial hemorrhages (ICH), and cortical vein and/or sinus thrombosis (CVST).

Results

Of the 14,483 patients with laboratory-confirmed SARS-CoV-2, 172 were diagnosed with an acute cerebrovascular event (1.13% of cohort; 1130/100,000 patients, 95%CI 970–1320/100,000), 68/171 (40.5%) were female and 96/172 (55.8%) were between the ages 60 and 79 years. Of these, 156 had acute ischemic stroke (1.08%; 1080/100,000 95%CI 920–1260/100,000), 28 ICH (0.19%; 190/100,000 95%CI 130–280/100,000), and 3 with CVST (0.02%; 20/100,000, 95%CI 4–60/100,000). The in-hospital mortality rate for SARS-CoV-2-associated stroke was 38.1% and for ICH 58.3%. After adjusting for clustering by site and age, baseline stroke severity, and all predictors of in-hospital mortality found in univariate regression (p < 0.1: male sex, tobacco use, arrival by emergency medical services, lower platelet and lymphocyte counts, and intracranial occlusion), cryptogenic stroke mechanism (aOR 5.01, 95%CI 1.63–15.44, p < 0.01), older age (aOR 1.78, 95%CI 1.07–2.94, p = 0.03), and lower lymphocyte count on admission (aOR 0.58, 95%CI 0.34–0.98, p = 0.04) were the only independent predictors of mortality among patients with stroke and COVID-19.

Conclusions

COVID-19 is associated with a small but significant risk of clinically relevant cerebrovascular events, particularly ischemic stroke. The mortality rate is high for COVID-19-associated cerebrovascular complications; therefore, aggressive monitoring and early intervention should be pursued to mitigate poor outcomes.
Peptidoglycan derived from Lactobacillus rhamnosus MLGA up-regulates the expression of chicken β-defensin 9 without triggering an inflammatory response
Authors: Huang Juan , Li Junhui , Li Qiufen , Li Lin , Zhu Nianhua , Xiong Xiaowen , Li Guanhong
Published: August 2020

Defensins are critical components of the innate immune system and play an important role in the integration of innate and adaptive immune responses. Although information on the immunomodulatory properties of peptidoglycan from bacteria is abundant, little is known about the β-defensin induction effect of peptidoglycan from the probiotic Lactobacillus. This study investigated the effect of intact peptidoglycan from L. rhamnosus MLGA on the induction of avian β-defensin 9 in chicken immune cells and intestinal explants. Peptidoglycan from Lactobacillus rhamnosus MLGA dose dependently promoted avian β-defensin 9 mRNA expression in chicken PBMCs, splenocytes, thymocytes, hepatocytes, and chicken embryo jejunum, ileum, and cecum explants and increased the capacity of PBMC or splenocyte lysates to inhibit the growth of Salmonella Enteritidis. In contrast to the effect of L. rhamnosus MLGA-derived peptidoglycan, peptidoglycan derived from pathogenic Staphylococcus aureus reduced avian β-defensin 9 mRNA expression in chicken PBMCs and splenocytes. The inducible effect of peptidoglycan from L. rhamnosus MLGA on avian β-defensin 9 expression in PBMCs and splenocytes was observed without activation of the expression of associated pro-inflammatory cytokines IL-1β, IL-8, and IL-12p40, whereas these cytokine expressions were suppressed by peptidoglycan hydrolysate obtained by lysozyme digestion. The results of the present study show the capability of peptidoglycan derived from L. rhamnosus MLGA to induce the antimicrobial peptide defensin while simultaneously avoiding the deleterious risks of an inflammatory response.
Participatory visual arts activities for people with dementia: a review
Authors: Cavalcanti Barroso A , Rai Harleen Kaur , Sousa Lidia , Orrell Martin , Schneider Justine
Published: August 2020

Aims:

To report and summarise the effects of interventions using participatory visual arts activities in dementia research through a narrative synthesis systematic review.

Methods:

We searched four databases MEDLINE, EMBASE, PsycINFO and Applied Social Sciences Index & Abstracts (ASSIA). Of the 3263 records retrieved, 20 were included in this review. Quality was assessed with the Critical Appraisal Skills Programme (CASP) and the Downs and Black checklist.

Results:

The use of participatory visual arts has positive effects on cognition, social and psychological functioning of people with dementia, although the diversity of the studies provided inconsistent evidence of an overall positive effect. Participants evaluated the interventions as enjoyable and engaging.

Conclusions:

This review adds to previous work done by Deshmukh et al. and Windle et al. with a focus on studies that had participatory visual art-making activities made by people with dementia. The use of participatory arts may bring benefits for people with dementia. The heterogeneity of the interventions prevented generalisation of the results. Criteria associated with positive outcomes of the intervention are reported to aid on the design of participatory visual arts interventions for people with dementia. Future research in participatory arts should have a more detailed description of the methods and art interventions.
Peroneal Sheath Volumes Are Greater in Patients With Peroneal Pathology Compared With Controls
Authors: Miller Christopher P. , Smith Stacy E. , Goodman Eric M. , Fisk Erica , Smith Jeremy T. , Chiodo Christopher P. , Bluman Eric M.
Published: August 2020

Background

Peroneal tendon pathology is common. Several factors have been implicated, including low-lying muscles and accessory tendons. Studies have reported on the presence and length measurements of these structures. This study evaluates volume measurements within the sheath using magnetic resonance images for patients with operatively treated peroneal tendon pathology and control patients without peroneal disease.

Methods

Fifty-one patients with peroneal tendon pathology and 15 controls were included. The volumes of the peroneal sheath, peroneal tendons, peroneal muscle, and accessory peroneus tendons were measured. The distal extent of the peroneus brevis (PB) muscle was measured. Volume and length measurements were then compared.

Results

The mean PB muscle length from the tip of the fibula was 5.55 ± 2.5 mm (peroneal group) and 11.79 ± 4.07 mm (control) ( P = .017). The mean peroneal sheath volume was 7.06 versus 5.12 mL, respectively ( P = .001). The major contributors to this increased volume was the tenosynovitis (3.58 vs 2.56 mL, respectively; P = .019), the peroneal tendons (2.17 vs 1.7 mL, P = .004), and the accessory peroneus tendon + PB muscle (1.31 vs 0.86 mL, P = .023).

Conclusion

The current study supports that the PB muscle belly is more distal in patients with peroneal tendon pathology. The study also demonstrates increased total volume within the peroneal sheath among the same patients. We propose that increased volume within the sheath, regardless of what structure is enlarged, is associated with peroneal tendon pathology. Further studies are needed to determine if debridement and decompression of the sheath will result in improved functional outcomes for these patients.

Levels of Evidence

Level III: Case control imaging study
An Endonasal Incision Adds a Second Vector of Manipulation During Percutaneous Reduction of Fractures Involving the Frontonasal Region
Authors: Govind Akshay , Jelmini Jonathan
Published: August 2020

Study Design:

A case report.

Objective:

To describe a modification of percutaneous reduction of frontal sinus and/or naso-orbito-ethmoid (NOE) fractures, adding an endonasal intercartilaginous incision to provide a second vector of manipulation.

Methods:

Case report with particular attention paid to surgical technique, followed by a brief review of relevant literature.

Results:

Technique: A Carroll-Girard screw is used to engage the thickest part of the anterior wall of the frontal bone through a stab incision just superior to the frontonasal junction. An endonasal intercartilaginous incision is then made and a Cottle elevator is introduced to manipulate the fracture from the inferior aspect of the frontonasal junction. The percutaneous screw and the endonasal elevator provide perpendicular vectors for manipulation, thereby improving ability to reduce fractures when percutaneous traction alone is not successful. The technique is described here in a patient with anterior table frontal sinus fractures combined with posteriorly displaced Markowitz type 1 NOE fractures.

Conclusion:

While percutaneous reduction of frontal sinus fractures has been previously described, this report adds a subtle but important modification both in indication and technique for optimizing reduction while maintaining surgical simplicity and minimizing morbidity.
Renal transplant surgery – Then and now
Authors: Gan Valerie Huei Li
Published: August 2020

This year, Singapore General Hospital celebrates 50 years of renal transplantation. As we commemorate this historic milestone, we look back at the surgical journey and remember the pioneers, local as well as international, who have overcome myriad hurdles in performing kidney transplantations. These visionary surgeons have worked hand in hand with our nephrologists to establish renal transplantation as the renal replacement therapy of choice and our hospital as the oldest transplant program in Singapore.
A survey of UK general practitioners about depression, antidepressants and withdrawal: implementing the 2019 Public Health England report
Authors: Read John , Renton Julia , Harrop Christopher , Geekie Jim , Dowrick Christopher
Published: August 2020

Background:

In 2019, a literature review indicated that more than half of people who try to come off antidepressants experience withdrawal effects. Both the National Institute of Health and Care Excellence and the Royal College of Psychiatrists updated their positions in line with that review, and Public Health England published a 152-page report called Dependence and withdrawal associated with some prescribed medicines: an evidence review. The report made several recommendations relevant to general practice.

Method:

In order to facilitate implementation of these recommendations, an online survey was designed to explore United Kingdom general practitioner (GP) experiences, opinions, knowledge and needs in relation to depression, ADs and withdrawal. A total of 66 GPs had completed the survey when COVID-19 occurred.

Results:

In keeping with previous findings, this small sample of GPs had a predominantly psycho-social perspective on the causes of, and treatments for, depression. They broadly considered ADs effective for moderate/severe depression and ineffective for minimal/mild depression, for which they preferred psychological therapies and social prescribing. There was a marked lack of consistency in GPs’ knowledge about the incidence and duration of withdrawal effects. Only a minority (29%) felt their knowledge about withdrawal was ‘adequate’ and fewer (17%) believed this about their ‘Ability to distinguish between withdrawal effects and return of the original problem (e.g. depression)’. Two-thirds (68%) would like more training on these matters.

Conclusion:

It is hoped that even this small sample will be helpful when designing, and seeking funding for, GP training programmes, and when implementing the PHE recommendations for support services, based in the primary care system, for the millions of people contemplating or initiating withdrawal from ADs every year in the UK.
Prevalence of mental disorders is higher in patients with multiple sclerosis than in the general population or in patients with rheumatoid arthritis in France
Authors: Guilleux Alice , Roux Jonathan , Travers David , Leray Emmanuelle
Published: August 2020

Background

Mental disorders (MDs) in multiple sclerosis (MS) patients decreases treatment adherence and quality of life, and increases the risk of disability progression and care consumption.

Objective

This study was to assess the prevalence of MDs in MS patients compared with healthy controls (HC) of the French general population and rheumatoid arthritis (RA) patients.

Methods

The 2015 prevalence of MDs for MS patients, RA patients and general population was estimated using a random population-based data sample from ‘National Inter-Scheme Information System on Health Insurance’ in the 2011–2015 period. Two control groups (1:5 ratio for the HC and 1:1 for the RA group) were matched to the MS group for year of birth, gender, area of residence and health insurance scheme.

Results

A total of 1145 MS patients were identified (sex ratio of 2.5 (F/M); median age 50 years). The prevalence of MDs was higher in the population of patients with MS (37.3%) than in the French general population (13.6%), and to a lesser extent in the RA group (21.1%) leading to the prevalence ratios of 2.8 (95% confidence intervals (CIs) 2.5–3.0) and 1.9 (95% CI 1.7–2.3), respectively.

Conclusions

This study confirmed that MS patients are at a higher risk of MDs than the French general population or RA patients.
Education [Bildung]–Literality–Competence: On Competing Tasks of Public Schools and the Need for New Links Between Teaching and Educational Research
Authors: Benner Dietrich
Published: August 2020

Purpose:

The article distinguishes between the three concepts of standardization of the tasks of pedagogical action in modern educational systems: - the traditional concept of standardizing educational goals through curricula, - the literacy concept of psychometric standardization, - and the concept of competence, which can be developed in different ways.

Design/Approach/Methods:

I examine these concepts and show - that traditional curricular orientations suffer from the fact that they have not developed controls over the achievement of objectives, - that literacy concept allows for psychometric measurement, but this is not coordinated with the actual teaching and its goals, - and that competence models only offer further possibilities if their subject-specific requirements are aligned with the educational theoretical and didactic teaching objectives.

Findings:

Instead of replacing traditional input control with output measurements, it is important to link teaching and educational research in such a way that competence measurements not only measure the levels of demands achieved by learners but also the quality and effectiveness of teaching.

Originality/Value:

The train of thought overcomes the juxtaposition of philosophy of education and empirical research and shows how the two can cooperate theoretically and empirically.
Palestinian Health Care Workers’ Stress and Stressors During COVID-19 Pandemic: A Cross-Sectional Study
Authors: Maraqa Beesan , Nazzal Zaher , Zink Therese
Published: August 2020

Background:

COVID-19 is thought to be the most significant public health threat the modern world has encountered. Health care workers (HCWs) face enormous pressure due to work overload, negative emotions, exhaustion, lack of contact with their families, and risk of catching the infection and death.

Aim:

This study aims to assess the level of stress perceived by HCWs and possible associated factors during the COVID-19 outbreak in Palestine.

Methods:

A cross-sectional sample of 430 frontlines HCWs was conducted using an online self-reported questionnaire. HCWs’ stress from the COVID-19 outbreak, factors that increase stress, and the activities that reduced stress were assessed. Chi-square test was used to compare between a categorical variable and the study outcome; associations are presented as odds ratios (OR) and confidence intervals (95% CI) with 0.05 significance level. Al-Najah National University institutional review board granted ethics approval.

Results:

Most respondents (74.0%) reported high-stress levels during the outbreak. Fear of transmitting the virus to family was the most stressful factor (91.6%). HCWs who did not have training on the outbreak response were more likely to have high-stress levels (OR = 2.7 [95% CI = 1.7-4.4], P < .001). Those with high stress reported being disappointed (OR = 2.4 [95% CI = 1.5-3.6], P < .001), and strongly considered taking sick leave (OR = 3.9 [95% CI = 1.9-7.9], P < .001).

Conclusion:

HCWs are under tremendous stress, given the ongoing COVID-19 pandemic. Understanding the psychological impact of the outbreak on HCWs and the activities that mitigate the stress is crucial to guide policies and interventions that can maintain psychological well-being.
Aortopulmonary Collateral Artery from the Proximal Ascending Aorta: A Rare Anatomical Finding
Authors: Careddu Lucio , Angeli Emanuela , Assenza Gabriele Egidy , Hasan Tammam , Quarti Andrea , Petridis Francesco Dimitri , Donti Andrea , Gargiulo Gaetano Domenico
Published: August 2020

Tetralogy of Fallot with pulmonary atresia and major aortopulmonary collateral arteries is a rare congenital heart lesion in which pulmonary blood supply may arise from different segments of the aorta. We report an unusual case of a newborn with a major collateral artery originating from the proximal ascending aorta. Successful reparative surgery was undertaken.
Pulmonary Venoatrial Connection Using a Ringed Tube Graft to Repair Partial Anomalous Pulmonary Venous Return
Authors: Ong Chin Siang , D’Alessandro David A. , Cameron Duke E. , Melnitchouk Serguei
Published: August 2020

Left-sided partial anomalous pulmonary venous return (left pulmonary veins to left vertical vein) was repaired in a 70-year-old patient by ligation of the vertical vein and connection of the pulmonary veins to the left atrial appendage using a ringed polytetrafluoroethylene tube graft. The graft made the connection technically easier and facilitated a torque-free and tension-free anastomosis that was “stented” open by the rings.
Off-Pump “Clamp and Sew” Extracardiac Fontan With Inverted Bifurcated Graft for Dextrocardia With Heterotaxy Syndrome
Authors: Said Sameh M. , Marey Gamal , Joy Brian , Griselli Massimo
Published: August 2020

Avoiding cardiopulmonary bypass during palliation of single ventricle has the advantages of minimizing transfusions, pulmonary vascular resistance, and avoiding the inflammatory response from cardiopulmonary bypass. It is however not always straightforward, and the technique may be faced with challenges.
Sickle Cell-Related Complications in Patients Undergoing Cardiopulmonary Bypass
Authors: Chacon-Portillo Martin A. , Mossad Emad B. , Zea-Vera Rodrigo , Beckerman Ziv , Binsalamah Ziyad M. , Adachi Iki , Mery Carlos M. , Imamura Michiaki , Heinle Jeffrey S. , Fraser Charles D.
Published: August 2020

Background:

We aimed to describe our experience with patients with sickle cell trait (SCT) and undergoing surgery on cardiopulmonary bypass (CPB).

Methods:

Data on all patients with SCT or sickle-α thalassemia who underwent surgery on CPB were collected (1996-2017).

Results:

Overall, 46 patients were included, 37 (80%) had SCT and 9 (20%) had sickle-α thalassemia. A total of 4 (9%) developed a potential sickle cell–related complication. Patients with sickle cell-related complications were significantly older (median 14 years vs 14 months, P = .037) and heavier (median 54 kg vs 9 kg, P = .041). Complications occurred, although without statistical significance, in patients who underwent longer median CPB times (249 minutes vs 137 minutes, P = .069), lower median temperature (31.7 °C vs 33.3 °C, P = .094), and a higher percentage underwent deep hypothermic circulatory arrest (50% vs 7%, P = .053). A total of 30 (65%) patients underwent exchange transfusion (ET) pre-bypass. Patients who underwent ET were significantly older (median 4 years vs 7 months, P = .003) and heavier (median 16 kg vs 6 kg, P = .015) than patients who did not undergo ET. The incidence of complications was comparable between patients who underwent ET (10%) and those who did not (6%).

Conclusions:

In this retrospective, single-center study, it has been shown that cardiac surgery requiring CPB in patients with SCT and sickle-α thalassemia had a low risk for sickle cell-associated complications. In this cohort of patients, older age, longer CPB times, lower median temperature, and the utilization of deep hypothermic circulatory arrest appear to play an important role in the development of complications.
Type C Esophageal Atresia and d-Transposition of the Great Arteries in a Newborn
Authors: Heneghan Julia A. , Ramakrishnan Karthik , Wernovsky Gil
Published: August 2020

A newborn was diagnosed with type C esophageal atresia and d-transposition of the great arteries (d-TGA). In this report, we discuss the management implications of the co-occurrence of two rare congenital abnormalities, including extracorporeal membrane oxygenation support prior to surgical intervention for d-TGA.
Giant Right Atrial Abscess in a Premature Infant With Fungal Endocarditis in a Developing Country
Authors: Pradegan Nicola , Muñoz Ysailis Mariñez , Reyes Marcos , Toribio Janet , Herrera Cesar J. , Leon-Wyss Juan R.
Published: August 2020

Although infective endocarditis rarely appears during infancy, fungal infections remain a concern in the preterm neonatal population as the result of compromised immunity, prolonged hospitalization, and invasive procedures. The increased awareness of fungal colonization and improvements in medical therapy have not reduced the high mortality rate of mycotic infections in premature newborns, especially in developing countries, and there is no consensus on the surgical timing to treat neonatal fungal endocarditis. We present the case of a two-month-old boy with a history of three weeks of hospitalization for prematurity. After being discharged, the patient developed symptomatic candidemia resulting from a large right atrial abscess obstructing the tricuspid valve; despite antifungal therapy, urgent surgical resection was required.
Mid-Term Follow-Up of Neonatal Neochordal Reconstruction of Tricuspid Valve for Perinatal Chordal Rupture Causing Severe Tricuspid Valve Regurgitation
Authors: Roy Chowdhuri Kuntal , Dutta Nilanjan , Raja Nayem , Girotra Sumir , Radhakrishnan Sitaraman , Iyer Parvathi Unninayar , Iyer Krishna Subramony
Published: August 2020

Background:

Papillary muscle rupture in the perinatal period is a rare event that leads to severe mitral or tricuspid insufficiency due to a flail leaflet. Neonatal tricuspid chordal reconstruction for this condition is rarely reported. Early recognition and treatment have the potential to be lifesaving. We present our surgical experience with five such patients, along with their midterm follow-up.

Methods:

Between August 2010 and November 2012, five neonates (aged 1-30 days) underwent surgery for severe atrioventricular valve regurgitation. All neonates had severe tricuspid regurgitation due to ruptured chordae. In addition, two had moderate mitral regurgitation; one due to ruptured chordae of the posterior mitral leaflet and the other due to prolapse of the anterior mitral leaflet. All underwent emergent surgery where the ruptured chordae to the anterior tricuspid leaflet were replaced with neochordae made with expanded polytetrafluoroethylene (ePTFE) suture. The mitral valve was repaired in two patients.

Results:

All patients survived surgery without the need for postoperative mechanical circulatory assist. Predischarge echocardiograms showed good coaptation of tricuspid and mitral leaflets with minimal regurgitation in all. At follow-up between 75 months to 102 months, four patients had excellent outcomes with less than mild tricuspid regurgitation. One child with flail tricuspid and mitral leaflets developed progressive tricuspid and mitral regurgitation requiring surgical re-repair at 20 months following the initial surgery.

Conclusion:

Repair of chordal rupture of the tricuspid valve in neonates using e PTFE neo-chordae can provide acute salvage and gratifying midterm results in the management of this potentially fatal condition.