bluuebunny/crossref_metadata_2025 huggingface dataset:
Smart properties of carbon nanotube-epoxy composites
Authors: Tian Changjin , Wang Youzhi , Yang Qilin , Ge Zhi , Du Yefeng
Published: July 2020

Intelligent smart materials can not only monitor the damage and degradation of architectural structures in real time but also the health structure. In recent years, carbon nanotubes materials have emerged to possess both excellent mechanical and electrical properties. Moreover, when carbon nanotubes are added to epoxy resin, intelligent composite materials with significant sensitivity are created. In this study, the stress–strain curves and anelasticity of carbon nanotube/epoxy resin composites with different carbon nanotube concentrations is analyzed. Through changing the level of carbon nanotubes using the two-pole method, the percolation threshold of carbon nanotube/epoxy composites was determined. Thereafter, the effect of temperature on the composites’ conductive properties was investigated. Moreover, using the stepwise cyclic loading method, the piezoresistivity of the carbon nanotube/epoxy composites was investigated. The test results show that the elastic limit, the yield point, and the elastic modulus range of the carbon nanotube/epoxy composites is approximately 45 MPa, 50 MPa, and 1–2 GPa, respectively. The anelasticity of the carbon nanotube/epoxy composites increases with the gradual increase of the stress level. The percolation threshold interval of carbon nanotube/epoxy composites ranges from 0.5 to 1.0 wt%. The rate of change of resistance for the different concentrations on carbon nanotube/epoxy specimens corresponds to the temperature. Notably, the carbon nanotube/epoxy composites have better discrimination and pressure sensitivity for different grades of load. When the carbon nanotube content is 0.5 wt%, the sensitivity of the carbon nanotube/epoxy composites pressure-sensitive property is the largest, which is in agreement with the threshold curve. The results of this investigation have implications for the application of carbon nanotube/epoxy composites in structural health monitoring.
Negotiating partnership models in the humanities: The possibility of collaboration within undergraduate English courses
Authors: Symonds Eloise
Published: July 2020

Recognising the popularity of partnership models, this article questions the current literature on partnership within the humanities and explores the possibility of effectively implementing partnership within the English discipline, through exploration of the traditional modes of learning associated with specific disciplines and the barriers that exist through the traditional teacher-learner dynamic. It considers the difficulty of breaking down both the conventional learning methods of reading English and traditional hierarchies in universities in order to foster more collaborative processes. In this article, I use Fairclough’s three-dimensional model of critical discourse analysis to explore 32 interviews, 12 observations and 12 policy documents from two post-1992 English universities. Negotiating partnership models in the humanities requires further exploration, with attention given to conventional methods of learning associated with disciplines, traditional learner-teacher hierarchies and the structural barriers these associations create for establishing collaborative learning relationships between academics and undergraduates.
Leading with/in emotion states: The criticality of political subjects and policy debates in educational leadership on emotions
Authors: Grosland Tanetha , Roberts LaSonja
Published: July 2020

One of the many facets of educational leadership is the emotional aspects of educational leadership itself. Leaders are regularly immersed in emotionally charged broad-based policy debates and political subjects like protests and voting policies. These are policy subjects that politically occur not only in schools where educational leaders practice but also in their interactions with school boards, media, and community members. Such interactions are stressful and contribute to leadership burnout, especially among critical educational leaders. As such, educational leadership needs to address not only the emotionality of their practice but the emotions that result from the interactions they regularly encounter in their practice about societal political subjects and policy debates. Simply, emotions are the reason educators politically advocate for policy subjects in the first place—it’s because of how they “feel” about racial segregation or that they are “pissed” about police brutality. Using textual analysis, this article contends that the scholarship within educational leadership lacks attentiveness to addressing how emotions interact with the societal political subjects that permeate leadership, therefore stifling innovative practices for addressing “controversial” policy debates and political subjects that are, ipso facto, inherently emotional. This view of emotions in educational leadership has the power to change how the field conceptualizes politics and policy subjects. Accordingly, educational leadership that focuses on emotional interactions with political subjects is apt to advance the field of educational politics and policy.
The Impact of National Anthem Protests on National Football League Television Ratings
Authors: Brown Judah , Sheridan Brandon J.
Published: July 2020

The National Football League’s (NFL) television ratings decreased by approximately 8% during the 2016 season, then a further 10% the following season. These declines coincided with league-wide national anthem protests initiated by Colin Kaepernick at the beginning of the 2016 season. Existing research identifies many determinants of demand for sporting events, but athletes’ protests are seldom considered. We use detailed data on players’ protests and television ratings to construct a new, game-level panel for the four NFL seasons between 2014 and 2017. Our results show protests are statistically significantly associated with lower TV ratings, but the economic magnitude is relatively muted.
In situ deposition of nickel nano particles on polyester fabric and its application as a flexible electrode in supercapacitor
Authors: Shahidi Sheila , Kalaoglu Fatma
Published: July 2020

In this research work, Nickel was in situ synthesized on polyester fabric using facile method. For this purpose, electroless plating method was used. In the first step, samples were sensitized using copper acetate. Hydrazine were used as reducing agent. In the same bath, Nickle acetate was added and in presence of hydrazine, the Nickle nano particles were deposited on the surface of polyester fibers. The morphological properties of nano particles on the surface were investigated using Scanning Electron Microscope (SEM). The electrical resistance of samples after metal plating were measured by two-point probe. The rubbing and wash fastness of samples through electrical resistance were also studied. The results show that, Ni plated sample has very high resistance to rubbing. Even after 8000 cycles of rubbing using Martindale system, the electrical resistance of rubbed samples reaches to 40 Ω/sq. But it should be mentioned that, the wash fastness of prepared samples is not satisfactory. The main purpose of this research was, investigating on the storage properties of Ni plated polyester fabric. The electrochemical properties of samples were investigated using cyclic voltammetry (CV) and galvanostatic charging–discharging (GCD) measurements (Autolab PGSTAT 302 N). The Ni plated polyester in this work, showed, a specific capacitance of 450 mF/cm2 by GCD test at the current density of 7.5 mA/cm2. Also the integrated area for the CV curves related to rubbed samples, is large enough. The resultant Ni plated fabric provides a promising substrate to prepare textile-based electrodes for flexile supercapacitors.
Routine Placement of Temporary Epicardial Pacing Leads Is Not Required After Minimally Invasive Aortic Valve Replacement
Authors: Amirjamshidi Hossein , Vidovich Courtney , Knight Peter A.
Published: July 2020

Objective

Our objective is to identify the incidence of urgent transvenous (TV) pacing wire placement following minimally invasive aortic valve replacement (mini-AVR).

Methods

This is a single-center, retrospective, observational study including 359 individuals who underwent isolated mini-AVR through right anterior mini-thoracotomy between January 2015 and September 2019. Patients were grouped according to avoidance or insertion of epicardial pacing wires, and further subdivided based on the requirement for postoperative emergent temporary TV pacing or permanent pacemaker (PPM) placement during the index admission.

Results

Two hundred forty-two (67.4%) had acceptable rate and no high-degree atrioventricular (AV) block prior to chest closure and did not have insertion of epicardial pacing wires. Of those patients, only 3 (1.2%) required emergent TV pacing and 6 (2.5%) required nonemergent TV pacing with or without PPM placement during the index admission. Sixty-two (17.3%) patients received only atrial epicardial pacing leads secondary to sinus bradycardia or junctional rhythm and 3 (4.8%) of those patients required PPM placement due to sick sinus syndrome and 1 (1.6%) patient required nonemergent TV pacing and PPM due to high-grade AV heart block. Fifty-five (15.3%) patients received ventricular leads due to high-grade AV heart block and 7 (12.7%) of those patients required PPM placement during the index admission.

Conclusions

Temporary epicardial lead insertion is not routinely required in mini-AVR in patients with normal rate and acceptable AV conduction prior to chest closure. In the absence of epicardial ventricular lead insertion, the chance of requiring urgent TV pacing wire placement during the index admission is 0.99%.
Beyond Correlation: Acoustic Transformation Methods for the Experimental Study of Emotional Voice and Speech
Authors: Arias Pablo , Rachman Laura , Liuni Marco , Aucouturier Jean-Julien
Published: July 2020

While acoustic analysis methods have become a commodity in voice emotion research, experiments that attempt not only to describe but to computationally manipulate expressive cues in emotional voice and speech have remained relatively rare. We give here a nontechnical overview of voice-transformation techniques from the audio signal-processing community that we believe are ripe for adoption in this context. We provide sound examples of what they can achieve, examples of experimental questions for which they can be used, and links to open-source implementations. We point at a number of methodological properties of these algorithms, such as being specific, parametric, exhaustive, and real-time, and describe the new possibilities that these open for the experimental study of the emotional voice.
The Latarjet procedure in competitive athletes younger than 20 years old with a significant glenoid bone loss
Authors: Rossi Luciano A , Tanoira Ignacio , Bruchmann María G , Pasqualini Ignacio , Ranalletta Maximiliano
Published: July 2020

Purpose

To analyze return to sports, functional outcomes, and complications following the Latarjet procedure in competitive athletes younger than 20 years old with a significant glenoid bone loss.

Methods

Between 2010 and 2017, 60 competitive athletes younger than 20 years old with a significant glenoid bone loss were operated with the Latarjet procedure. Return to sports, range of motion, and the Rowe and the Athletic Shoulder Outcome Scoring System score were used to assess functional outcomes. Complications and bone consolidation were also evaluated.

Results

The mean follow-up was 58 months and the mean age was 16.3 years. Overall, 93% were able to return to sports and 84% returned at the same level. The Rowe and Athletic Shoulder Outcome Scoring System scores showed statistical improvement after operation ( P <  .001). The total complication rate was 22% and the revision rate was 1.6%. The recurrence rate was 3.3%. The bone block healed in 93% of the cases.

Conclusions

In competitive athletes younger than 20 years old with a significant glenoid bone loss, the Latarjet procedure resulted in excellent functional outcomes, with most of the patients returning to sports and at the same level they had before injury with a low rate of recurrences. However, this procedure is associated with a significant rate of complications and should preferably be performed by experienced surgeons.
Pressurized intraperitoneal aerosol chemotherapy with cisplatin and doxorubicin or oxaliplatin for peritoneal metastasis from pancreatic adenocarcinoma and cholangiocarcinoma
Authors: Di Giorgio Andrea , Sgarbura Olivia , Rotolo Stefano , Schena Carlo Alberto , Bagalà Cinzia , Inzani Frediano , Russo Andrea , Chiantera Vito , Pacelli Fabio
Published: July 2020

Background:

Systemic chemotherapy for pancreatic adenocarcinoma (PDAC) and cholangiocarcinoma (CC) with peritoneal metastases (PM) is affected by several pharmacological shortcomings and low clinical efficacy. Pressurized intraperitoneal aerosol chemotherapy (PIPAC) is expected to maximize exposure of peritoneal nodules to antiblastic agents. This study aims to evaluate safety and efficacy of PIPAC for PM of PDAC and CC origin.

Methods:

This is a retrospective analysis of consecutive PDAC and CC cases with PM treated with PIPAC at two European referral centers for peritoneal disease. We prospectively recorded from August 2016 to May 2019 demographic, clinical, surgical, and oncological data. We performed a feasibility and safety assessment and an efficacy analysis based on clinical and pathological regression.

Results:

Twenty patients with PM from PDAC (14) and CC (six) underwent 45 PIPAC administrations. Cisplatin–doxorubicin or oxaliplatin were administered to eight and 12 patients, respectively. We experienced one intraoperative complication (small bowel perforation) and 18 grade 1–2 postoperative adverse events according to Common Terminology Criteria for Adverse Events version 4.0. A pathological regression was recorded in 50% of patients (62% in the cisplatin–doxorubicin cohort and 42% in the oxaliplatin one). Median survival from the first PIPAC was 9.7 and 10.9 months for PDAC and CC, respectively.

Conclusion:

PIPAC resulted feasible and safe without relevant toxicity issues, with both cisplatin–doxorubicin and oxaliplatin. The pathological response observed supports the evidence of antitumoral activity. Despite the study limitations, these outcomes are encouraging, recommending PIPAC in prospective, controlled trials in the palliative setting or the first line chemotherapy for PM from PDAC and CC.
PARP inhibition and immune modulation: scientific rationale and perspectives for the treatment of gynecologic cancers
Authors: Lee Elizabeth K. , Konstantinopoulos Panagiotis A.
Published: July 2020

Poly[adenosine diphosphate (ADP) ribose]polymerase (PARP) has multifaceted roles in the maintenance of genomic integrity, deoxyribonucleic acid (DNA) repair and replication, and the maintenance of immune-system homeostasis. PARP inhibitors are an attractive oncologic therapy, causing direct cancer cell cytotoxicity by propagating DNA damage and indirectly, by various mechanisms of immunostimulation, including activation of the cGAS/STING pathway, paracrine stimulation of dendritic cells, increased T-cell infiltration, and upregulation of death-ligand receptors to increase susceptibility to natural-killer-cell killing. However, these immunostimulatory effects are counterbalanced by PARPi-mediated upregulation of programmed cell-death-ligand 1 (PD-L1), which leads to immunosuppression. Combining PARP inhibition with immune-checkpoint blockade seeks to exploit the immune stimulatory effects of PARP inhibition while negating the immunosuppressive effects of PD-L1 upregulation.
Theory Amid Policy and Practice: A Typology of Theory Use in Educational Leadership Scholarship
Authors: Modeste Marsha E. , Pavlakis Alexandra E. , Nguyen Chi
Published: July 2020

In the field of educational leadership, there is some work around the preferred theories of scholars, but little to no research on how the chosen theories are subsequently applied. Better understanding the purpose, role, and depth of how theory is used in educational leadership can help inform the teaching and mentorship of aspiring leaders and scholars. To examine the nature of theory use in educational leadership, we applied Dressman’s typology of theory use in literacy (2007), to 47 policy and practice-oriented articles in Educational Administration Quarterly. We found similar patterns to Dressman’s typology, but also important differences. Implications are discussed.
Religion and the Development of Character: Personality Changes Before and After Religious Conversion and Deconversion
Authors: Stronge Samantha , Bulbulia Joseph , Davis Don E. , Sibley Chris G.
Published: July 2020

Previous longitudinal research indicates that although religion may affect how personality traits are expressed, religion does not affect people's underlying personalities. However, such research has drawn from small North American samples and relatively short time intervals that do not include data from individuals prior to conversion. Here, we use a representative national sample of New Zealand adults over 9 years (2009–2017, N = 31,604) and piecewise latent growth models to assess longitudinal change in Big Five personality and Honesty-Humility before and after conversion to/deconversion from Christianity ( N = 540 converts, N = 886 deconverts). We observed no personality changes before conversion or after deconversion. However, we observed increases in Honesty-Humility, Conscientiousness, and Neuroticism following conversion. We also observed increases in Honesty-Humility and decreases in Agreeableness preceding deconversion. These findings indicate that religious conversion initiates specific changes in character, the most pronounced of which relate to increases in modesty and greed-avoidance.
Meaning-Making, Psychological Distress, and the Experience of Meaning in Life Following a Natural Disaster
Authors: Maffly-Kipp Joseph , Flanagan Patricia , Kim Jinhyung , Rivera Grace , Friedman Matthew D. , Vess Matthew , Hicks Joshua A.
Published: July 2020

The purpose of this study was to examine the role of meaning-making in response to collective trauma. In the aftermath of Hurricane Harvey, we recruited participants ( N = 570) to test the hypothesis that searching for meaning (vs. finding meaning) in the event would be associated with greater (vs. lower) levels of acute and post-traumatic stress symptoms. We further hypothesized that searching for (and finding) meaning in the event would predict global search for (and presence of) meaning in life (MIL). Consistent with our hypotheses, we found that searching for meaning in the event was associated with greater psychological distress at both time points and predicted global search for MIL at one of the time points. Finding meaning in the event was unexpectedly not consistently associated with lower levels of stress; however, across analyses, finding meaning in Hurricane Harvey was associated with greater levels of MIL. Implications and possible explanations for these unexpected results are discussed.
Hydrogel and neural progenitor cell delivery supports organotypic fetal spinal cord development in an ex vivo model of prenatal spina bifida repair
Authors: Biancotti Juan C , Walker Kendal A , Jiang Guihua , Di Bernardo Julie , Shea Lonnie D , Kunisaki Shaun M
Published: July 2020

Studying how the fetal spinal cord regenerates in an ex vivo model of spina bifida repair may provide insights into the development of new tissue engineering treatment strategies to better optimize neurologic function in affected patients. Here, we developed hydrogel surgical patches designed for prenatal repair of myelomeningocele defects and demonstrated viability of both human and rat neural progenitor donor cells within this three-dimensional scaffold microenvironment. We then established an organotypic slice culture model using transverse lumbar spinal cord slices harvested from retinoic acid–exposed fetal rats to study the effect of fibrin hydrogel patches ex vivo. Based on histology, immunohistochemistry, gene expression, and enzyme-linked immunoabsorbent assays, these experiments demonstrate the biocompatibility of fibrin hydrogel patches on the fetal spinal cord and suggest this organotypic slice culture system as a useful platform for evaluating mechanisms of damage and repair in children with neural tube defects.
The Influence of Social Media on Employee’s Knowledge Sharing Motivation: A Two-Factor Theory Perspective
Authors: Zhang XiaoJuan , Jinpeng Xiang , Khan Farhan
Published: July 2020

This study aims to investigate social media (hygiene factor), motivators (allow employees to share knowledge), and employee’s knowledge sharing motivation (KSM). For this purpose, the author introduces two-factor theory as its research framework to propose research hypotheses and construct the theoretical model. Then the model is tested and validated based on a survey of 278 enterprise employees in China, utilizing structural equation modeling through SPSS statistics and AMOS. It is found that first, the three states of knowledge sharing (lack of motivation, intermediate state, and with motivation) constitute two continuums. The satisfaction of motivators and hygiene factors respectively lead to changes in the state of motivation to share, and second, social media affects the staff’s motivation to share through both a direct and an indirect pathway. Directly, as the hygiene factor, the absence of social media will weaken the staff’s motivation to share. However, its usage doesn’t directly increase employees’ sharing motivation. Indirectly, through the mediating effect of self-efficacy social media can influence knowledge sharing motivation of employees.
Toward an Instructional WTC-Mediated Model for L2 Classroom Interaction
Authors: Wang Chaochang , Tseng Wen-Ta
Published: July 2020

This study examined the mediating roles of two forms of willingness to communicate (WTC) in the relationship between teachers’ attitudes toward classroom interaction and L2 classroom teaching behaviors. Classroom interaction is held to be pivotal in the acquisition of a second language, and the attitudes of L2 teachers toward it may play a critical role in determining their instructional willingness to integrate it into their teaching and the extent to which it features in their teaching behavior. However, few studies advance this line of research. To address the research gap on this issue, the purpose of this study is to establish an empirical model to examine the causal relationships between the attitudes of L2 teachers toward classroom interaction, their instructional willingness, and their teaching behavior. The empirical data consist of survey responses from 410 Taiwanese high school teachers of English. The structural equation modeling (SEM) results showed that both the general form and the instructional form of WTC significantly mediated the causal relationships between teachers’ attitudes toward classroom interaction and teachers’ L2 teaching behaviors. A multi-group analysis further showed that the two forms of WTC played a more salient mediating role in the practice of senior teachers, defined as those with more than 10 years of teaching experience, than in the practice of junior teachers, defined as those with 10 years or less teaching experience. The research and pedagogical implications are presented in light of the research findings.
Hybrid Anterior Cervical Discectomy and Fusion and Cervical Disc Arthroplasty: An Analysis of Short-Term Complications, Reoperations, and Readmissions
Authors: Boddapati Venkat , Lee Nathan J. , Mathew Justin , Vulapalli Meghana M. , Lombardi Joseph M. , Dyrszka Marc D. , Sardar Zeeshan M. , Lehman Ronald A. , Riew K. Daniel
Published: July 2020

Study Design:

Retrospective cohort study.

Objectives:

Although cervical disc arthroplasty (CDA) has become a well-established and effective treatment for symptomatic cervical degeneration, many patients with multilevel disease are not good candidates for CDA at all levels. For such patients, hybrid surgery (HS)—a combination of adjacent anterior cervical discectomy and fusion (ACDF) and CDA—may be more appropriate. Given the novelty of HS and the relative dearth of studies adequately assessing short-term perioperative complications, this current study sought to assess the short-term morbidity profile of HS, differences in operative duration, length of stay (LOS), and readmission and reoperation rates and reasons relative to a 2-level ACDF cohort.

Methods:

All patients who underwent HS and 2-level ACDF were identified between 2011 and 2018 using a large, prospectively collected registry. Baseline patient characteristics and postoperative complications were compared using bivariate and/or multivariate analysis.

Results:

A total of 390 patients undergoing HS were identified. Two-level procedures were the most common (74.9%). Patients undergoing HS were more likely to be younger, male, and have fewer comorbidities. There were no differences between HS and 2-level ACDF in rates of any postoperative complication, transfusion, readmissions, and operative duration. However, HS had a decreased LOS (0.5 days), relative to a 2-level ACDF. HS patients had low rates of reoperation (1.28%) with 1 case for hematoma evacuation and another for revision CDA.

Conclusions:

This study represents one of the largest cohorts of patients undergoing HS reported to date. Patients undergoing HS are not at increased risk of perioperative complications relative to a 2-level ACDF and may benefit from shorter LOS.
Biomechanical Comparison of Graft Preparation Techniques for All-Inside Anterior Cruciate Ligament Reconstruction
Authors: Bowes Julia , Mohamed Nada , Baptiste Jonelle Jn , Westover Lindsey , Hui Catherine , Sommerfeldt Mark
Published: July 2020

Background:

All-inside anterior cruciate ligament reconstruction (ACLR) is an emerging technique used to treat ACL injuries. The all-inside technique uses a 4-stranded graft made from a single tendon that is looped on itself. The 4 strands of the graft must be secured to each other to become a closed-loop structure. Various suture configurations exist to secure the graft to adjustable loop devices, and there is a lack of data to support one technique over another. In addition to the primary sutures used to fasten the graft together, accessory sutures can be tied over the button as secondary fixation.

Purpose:

To evaluate biomechanical properties of 4-stranded grafts prepared in 5 different configurations.

Study Design:

Controlled laboratory study.

Methods:

Porcine flexor tendons (N = 25) were prepared in 5 different configurations (n = 5 tendons per group): simple-interrupted sutures (unsecured fixation), side-to-side fixation with and without secondary fixation, and end-to-end fixation with and without secondary fixation. The grafts were put through the same mechanical testing protocol (cyclic loading, pull to failure) to measure average load at graft failure, average displacement at failure, average stiffness, and average elongation rate. Differences between graft preparation techniques were investigated using 1-way analyses of variance (ANOVAs) with post hoc t tests ( P < .05).

Results:

Significant 1-way ANOVAs for each biomechanical property were found. Unsecured fixation was the weakest graft preparation with the lowest stiffness (167 ± 12 N/mm), lowest ultimate failure load (637 ± 99 N), and highest elongation rate (0.0033 ± 0.0007 mm/s). End-to-end fixation without secondary fixation showed the highest ultimate failure load (846 ± 26 N), highest stiffness (212 ± 10 N/mm), and lowest rate of elongation (0.0025 ± 0.0001 mm/s). End-to-end fixation, both with and without secondary fixation, as well as side-to-side fixation with secondary fixation showed significantly higher ultimate failure loads than grafts with unsecured fixation. End-to-end fixation performed better than side-to-side fixation; however, for most variables, the difference was not statistically significant. Secondary fixation did not provide significant improvement.

Conclusion:

The all-inside ACL graft with simple-interrupted sutures is biomechanically inferior to a graft that has its free ends secured to the adjustable tibial loop. Adding secondary fixation to the tibial button does not significantly change the biomechanical properties. Further clinical studies are required to determine whether these findings translate into differences in clinical outcome.

Clinical Relevance:

All-inside ACLR is gaining popularity in hamstring ACL reconstructive techniques. These results provide surgeons with guidance on the best graft preparation method when using a single quadrupled hamstring tendon graft.
Preterm Nutrition and Clinical Outcomes
Authors: Gidi Netsanet Workneh , Mekasha Amha , Nigussie Assaye K. , Goldenberg Robert L. , McClure Elizabeth M. , Worku Bogale , Amaru Gesit M. , Tazu Bonger Zelalem , Demtse Asrat G. , Kebede Zemene T. , Siebeck Matthias , Genzel-Boroviczény Orsolya , Muhe Lulu M.
Published: July 2020

Background. In low-income countries, preterm nutrition is often inadequately addressed. The aim of the study was to assess the patterns of feeding and associated clinical outcomes of preterm neonates admitted to neonatal intensive care units in Ethiopia. Method. This was a multicenter, prospective study. Infants’ clinical characteristics at birth, daily monitoring of feeding history, and weight measurements were collected. An outcome assessment was completed at 28 days. Result. For this analysis, 2560 infants (53% male) were eligible. The mean (SD) gestational age was 33.1 (2.2) weeks. During the hospital stay the proportion of infants on breast milk only, preterm formula, term formula, and mixed feeding was 58%, 27.4%, 1.6%, and 34.1%, respectively. Delay in enteral feeding was associated with increased risk of death (odds ratio [OR] = 1.92, 95% confidence interval [CI] = 1.33-2.78; P < .001) and (OR = 5.06, 95% CI = 3.23-7.87; P < .001) for 1 to 3 and 4 to 6 days of delay in enteral feeding, respectively, after adjusting for possible confounders. The length of delay in enteral feeding was associated with increased risk of hypoglycemia (OR = 1.2, 95% CI = 1.1-1.2; P = .005). The mortality rate was lower in hospitals providing preterm formula more often ( P = .04). Half of the infants continued losing weight at the time of discharge. Conclusion. Delayed enteral feeding significantly increases the risk of mortality before discharge and hypoglycemia in preterm infants in resource-limited settings. Ensuring adequate nutritional support of preterm infants is highly needed.
Influence of Neonatal Resuscitation Training on Practice of Community Health Extension Workers in Managing Asphyxiated Newborns in Rural Nigeria: A Qualitative Study
Authors: Olaniyi Adenike Adebola O. , Ncama Busisiwe P.
Published: July 2020

Birth asphyxia is a global health burden, and effective neonatal resuscitation could reduce the burden of deaths. Providing a suitable newborn resuscitation care will depend on the availability of an effective skilled health worker, who is competent in neonatal resuscitation. The study explores and assesses the effect of neonatal resuscitation training and retention of knowledge and skills in the management of asphyxiated newborns in rural Nigeria. This study used a narrative analysis technique to analyze data from a semistructured, individual interview. Data were analyzed using ATLAS.ti 8 qualitative software and applying the principle of thematic analysis. There was a considerable retention of knowledge and ability to practice the procedure even though some equipment was not available. Proficiency in neonatal resuscitation is an essential intervention for the survival of newborns and infants. Therefore, execution of neonatal resuscitation training program in rural communities can further improve knowledge and skills of community birth attendants in Nigeria.
National Board of Medical Examiners and Curriculum Change: What Do Scores Tell Us? A Case Study at the University of Balamand Medical School
Authors: Al Ojaimi Mode , Khairallah Megan , Younes Rayya , Salloum Sara , Zgheib Ghania
Published: July 2020

Objectives:

This study describes the results of NBME (National Board of Medical Examiners) implementation in Balamand Medical School (BMS) from 2015 to 2019, after major curricular changes were introduced as of 2012. BMS students’ performance was compared with the international USMLE step 1 (United States Medical Licensing Examination, herein referred to as step 1) cohorts’ performances. The BMS students’ NBME results were analyzed over the successive academic years to assess the impact of the serial curricular changes that were implemented.

Methods:

This longitudinal study describes the performance of BMS preclinical second year medicine (Med II) students on all their NBME exams over 4 academic years starting 2015-2016 to 2018-2019. These scores were compared with the step 1 comparison group scores using item difficulty. The t test was computed for each of the NBME exams to check whether the scores’ differences were significant.

Results:

Results revealed that all BMS cohorts scored lower than the international USMLE step 1 comparison cohorts in all disciplines across the 4 academic years except Psychiatry. However, the results were progressively approaching step 1 results, and the difference between step 1 scores and BMS students’ NBME scores became closer and not significant as of year 4.

Conclusions:

The results of the study are promising. They show that the serial curricular changes enabled BMS Med II students’ scores to reach the international cohorts’ scores after 4 academic years. Moreover, the absence of statistical difference between cohort 4 scores and step 1 cohorts is not module dependent and applies to all clinical modules. Further studies should be conducted to assess whether the results obtained for cohort 4 can be maintained.
Krukenberg tumor secondary to gall bladder carcinoma masquerading C3 glomerulopathy
Authors: Meena Priti , Bhargava Vinant , Rana Devinder Singh , Bhalla Anil Kumar , Gupta Ashwani , Gupta Pallav
Published: July 2020

Background:

C3 glomerulopathy is caused by dysregulation of the alternative complement pathway. Association with solid organ tumors is rare. However, there have been a few case reports of membranoproliferative glomerulonephritis secondary to gastrointestinal neoplasms.

Case:

A 38-year-old female presented with abdominal distension, loss of appetite, amenorrhea, and easy fatigability. She had been diagnosed 8 months back with C3 glomerulopathy and had received immunosuppression. On evaluation, she was incidentally detected to have Krukenberg tumor. The primary site of malignancy was gall bladder.

Conclusion:

Our case report highlights a possible association between C3 glomerulopathy and Krukenberg tumor secondary to gall bladder carcinoma and emphasizes the fact that even in cases of C3 glomerulopathy, occult malignancy should be considered as an underlying pathology.
Making India’s cleanest city: Sanitation, intersectionality, and infrastructural violence
Authors: Truelove Yaffa , O’Reilly Kathleen
Published: July 2020

Inaugurated in 2014, India’s Swachh Bharat Mission (SBM) intends to eradicate open defecation in urban and rural areas by 2019. In cities, the scheme ranks municipalities for achieving open defecation-free status and other measures of cleanliness. In 2017, Indore was first nationally recognized with the national Cleanest City award. In the weeks before the city was evaluated, it sponsored a number of activities that demolished housing and sanitation infrastructures, singled out the female body for humiliation, and forced residents to revert back to the very sanitation practices the city was allegedly trying to eradicate.

This paper traces the differing articulations of power at work between the extension and demolition of the city’s infrastructure. It focuses particularly on latrines, the metrics, and the urban vision to make Indore the Cleanest City, but also gives attention to the additional infrastructures connected to latrine-making and unmaking, including housing. We specifically explore two dimensions of what we call the “infrastructural intersectionality” of the Clean City Mission, which discloses differing forms of compounding infrastructural violence that include the dissolution of both material and social infrastructures. Firstly, the intersectionality of gender/caste/class/race social identities and power relations that are embedded and reified through infrastructures and, secondly, the intersectionality of multiple infrastructures that are inter-connected and co-constituted through each other. We argue that bringing the lens of intersectionality is critical for recognizing the socially differentiated and gendered dimensions of sanitation infrastructure, the SBM, and its situated infrastructural violence. By exploring two themes related to infrastructure and intersectionality, we show the criticality of embodied and gendered approaches to analyzing the power of infrastructure in the everyday.
“The Untold Side of COVID-19”: Struggle and Perspectives of the Sexual Minorities
Authors: Banerjee Debanjan , Nair Vasundharaa S.
Published: July 2020

The coronavirus disease 2019 (COVID-19) pandemic has threatened global public health. Travel has been restricted, economies slashed, borders sealed, and billions quarantined at their residences, in an attempt to contain the outbreak. Social distancing and lockdown measures have disrupted human lives in terms of social relationships and emotional bonds. Every individual is facing unique challenges to cope with these unprecedented times. However, certain sections of the population, like the Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ) community, are particularly vulnerable to not only the infective risks of the virus, but also the psycho-social offshoots of the global lockdown and the pandemic aftermath. The various factors range from the immunocompromised state, increased comorbidities of sexually transmitted diseases, other chronic medical disorders and substance abuse, as well as reduced access to health care, to stigma and social discrimination, administrative apathy, economic constraints, and uncertainty of social rituals like the Pride Celebrations. These can lead to the underdetection of the viral load, increased physiological risks to COVID-19, decreased help-seeking, and inequality in health and legal care. Their emotional and psychosexual well-being also gets impaired, with increased risks for psychiatric disorders and suicidality.

Keeping these factors in the background, this article glances at the disproportionate risk related to the COVID-19 pandemic in the sexual minorities, explores the psycho-social factors behind the same, and highlights specific ways to mitigate these risks for better care. Adopting a rights-based perspective for the LGBTQ community through public health measures during such crises can help reduce stigma and promote their social inclusion.
Deciphering the mode of action and position of genetic variants impacting on egg number in broiler breeders
Authors: Tarsani Eirini , Kranis Andreas , Maniatis Gerasimos , Avendano Santiago , Hager-Theodorides Ariadne L. , Kominakis Antonios
Published: July 2020

Background

Aim of the present study was first to identify genetic variants associated with egg number (EN) in female broilers, second to describe the mode of their gene action (additive and/or dominant) and third to provide a list with implicated candidate genes for the trait. A number of 2586 female broilers genotyped with the high density (~ 600 k) SNP array and with records on EN (mean = 132.4 eggs, SD = 29.8 eggs) were used. Data were analyzed with application of additive and dominant multi-locus mixed models.

Results

A number of 7 additive, 4 dominant and 6 additive plus dominant marker-trait significant associations were detected. A total number of 57 positional candidate genes were detected within 50 kb downstream and upstream flanking regions of the 17 significant markers. Functional enrichment analysis pinpointed two genes (BHLHE40 and CRTC1) to be involved in the ‘entrainment of circadian clock by photoperiod’ biological process. Gene prioritization analysis of the positional candidate genes identified 10 top ranked genes (GDF15, BHLHE40, JUND, GDF3, COMP, ITPR1, ELF3, ELL, CRLF1 and IFI30). Seven prioritized genes (GDF15, BHLHE40, JUND, GDF3, COMP, ELF3, CRTC1) have documented functional relevance to reproduction, while two more prioritized genes (ITPR1 and ELL) are reported to be related to egg quality in chickens.

Conclusions

Present results have shown that detailed exploration of phenotype-marker associations can disclose the mode of action of genetic variants and help in identifying causative genes associated with reproductive traits in the species.
Effect of diabetes mellitus on survival in patients with gallbladder Cancer: a systematic review and meta-analysis
Authors: Jing Chen , Wang Zhengyi , Fu Xue
Published: July 2020

Background

Increasing evidences indicated that diabetes might increase the incidence of gallbladder cancer. However, no sufficient data has ever clarified the impact of diabetes on the survival of patients with gallbladder cancer.

Methods

We comprehensively searched PubMed, Embase, and the Cochrane Library databases through July 2019 in order to find sufficient eligible researches. The pooled hazard risks (HRs) and relative risks (RRs) with 95% confidence intervals (CIs) were calculated with either fix-effects or random-effects model. Due to the low gallbladder cancer mortality in general population, the RRs and standard mortality ratios (SMRs) were considered the similar estimates of the HRs.

Results

Ten eligible studies were included in this meta-analysis. Analysis of eight cohorts found that diabetes was closely associated with the mortality of gallbladder cancer (HR = 1.10; 95% CI: 1.06–1.14; P < 0.00001). However, the mortality in male diabetes patients was not higher than female patients (RR = 1.08, 95%CI = 0.57–2.04, P = 0.80).

Conclusions

These findings indicated that diabetes patients had a higher mortality of gallbladder cancer compared with non-diabetes.
Engaging male students with mental health support: a qualitative focus group study
Authors: Sagar-Ouriaghli I. , Brown J. S. L. , Tailor V. , Godfrey E.
Published: July 2020

Background

Males are less likely to seek help for mental health difficulties compared to females. Despite considerable interest, a paucity of evidence-based solutions exists to address this. Concerns about students’ mental health has led to the United Kingdom’s Department of Education to make this a priority. Studies have shown that male students hold more negative attitudes towards the use of psychological services compared to female students and are less likely to seek help. A major concern is that male students make up 69% of university suicides, which is often associated with lower rates of help-seeking. This focus group study therefore sought to identify potential approaches that would be relevant to improving mental health help-seeking in male students.

Methods

Three focus groups comprising of 24 male students at a London University were conducted. Participants were asked questions exploring: the barriers to seeking help, what would encourage help-seeking, how an appropriate intervention should be designed, and how to publicise this intervention to male students. Thematic analysis was conducted to evaluate participants responses.

Results

Five distinct themes were identified. These were: 1) protecting male vulnerability, 2) providing a masculine narrative of help-seeking, 3) differences over intervention format, 4) difficulty knowing when and how to seek help, and 5) strategies to sensitively engage male students.

Conclusions

These themes represent important considerations that can be used, together with the existing literature about male help-seeking, to develop more male friendly interventions that are suitable for male students. This could help improve help-seeking attitudes and the uptake of mental health interventions for male students experiencing emotional distress.
Development and evaluation of a bladder Cancer specific survivorship care plan by patients and clinical care providers: a multi-methods approach
Authors: Lee Cheryl T. , Mohamed Nihal E. , Pisipati Sailaja , Shah Qainat N. , Agarwal Piyush K. , Downs Tracy M. , Droller Michael , Gilbert Scott M. , Goltz Heather H. , Hall Simon J. , Hendawi Mohamed , Hoffman-Censits Jean , O’Donnell Michael , Kaag Matthew , Karsh Lawrence I. , Kassouf Wassim , Quale Diane Z. , Sagalowsky Arthur , Steinberg Gary D. , Latini David M.
Published: July 2020

Background, context and purpose

In spite of the mixed evidence for their impact, survivorship Care Plans (SCPs) are recommended to enhance quality of care for cancer survivors. Data on the feasibility of SCPs in bladder cancer (BC) is sparse. Using a mixed-methods approach, this study describes the iterative development, acceptability and feasibility of BC specific SCP (BC-SCP) in clinical settings.

Methods

In Phase I, we developed the BC-SCP. In Phase II, we conducted four focus groups with 19 patients and 15 providers to examine its acceptability and usability challenges. Data analyses using the Atlas.ti program, informed refinement of the BC-SCP. In Phase III, we conducted feasibility testing of the refined BC-SCP with 18 providers from 12 health-centers. An encounter survey was completed after each assessment to examine the feasibility of the BC-SCP. Chi-square and Fisher Exact tests were used for comparative analyses.

Results

During phase I, we observed high patient and provider acceptability of the BC-SCP and substantial engagement in improving its content, design, and structure. In Phase II, providers completed 59 BC-SCPs. Mean time for BC-SCP completion was 12.3 min. Providers reported that BC-SCP content was clear, did not hamper clinic flow and was readily completed with easy-to-access information. Comparative analyses to examine differences in SCP completion time by patient clinico-demographic characteristics and provider type revealed no significant differences.

Conclusions

Our BC-SCP has clinical relevance, and can be used in an active practice setting. However, considerable progress will be necessary to achieve implementation of and sharing the BC-SCP with patients and care providers, particularly within the electronic medical record. In summary, BC-SCPs are essential to improve the follow up care of BC survivors. Clinical resources are required to ensure appropriate implementation of BC-SCPs.

Trial registration

Study HUM00056082.