bluuebunny/crossref_metadata_2025 huggingface dataset:
The Research-Practice Gap in Music Education: Applying Brokerage Structures to Guide Future Inquiry
Authors: Alsop Michael A.
Published: July 2020

The research-practice gap in music education has been discussed for decades. Many attempts have been made to explain the gap and offer recommendations for bridging it. However, few systematic examinations of the gap have been undertaken. The purpose of this article is to demonstrate how a model of brokerage structures can be applied to guide future inquiry into the gap. Context around the research-practice gap in music education is provided, the concept of brokerage models in social settings is explained, and then four brokerage structures are elaborated on and applied.
Behind the Eight Ball: The Effects of Race and Number of Infractions on the Severity of Exclusionary Discipline Sanctions Issued in Secondary School
Authors: Blake Jamilia J. , Smith Danielle M. , Unni Asha , Marchbanks Miner P. , Wood Steve , Eason John M.
Published: July 2020

African American and Hispanic students receive more punitive school discipline than White students even when students of color commit similar infractions as Whites. Similarly, students with a disability status are more likely to experience harsher discipline in schools compared to their counterparts without a disability label. This study examines whether these discrepancies are a result of a difference in the number of infractions students of different racial/ethnic groups and disability categories commit. Using secondary educational data from a state educational agency in the United States, we demonstrate that African American and Hispanic students and students with an emotional behavioral disorder status receive more severe sanctions than White students and students without a disability label at their first discipline encounter. This racial disparity in discipline severity continues through six sanctions and is eliminated at the 13th sanction. The disability disparity in discipline severity dissipates after 10 sanctions for students with emotional behavioral disorder and intellectual disability. Implications for school personnel and future directions are discussed.
Matrix-Induced Autologous Chondrocyte Implantation (MACI) Grafting for Osteochondral Lesions of the Talus
Authors: Lenz Christopher G. , Tan Shu , Carey Andrew L. , Ang Kaenson , Schneider Timothy
Published: July 2020

Background:

Matrix-induced autologous chondrocyte implantation (MACI) is an established treatment method for larger joints and has shown promising results in the ankle as well. We present a series of patients after ankle MACI with long-term follow-up of clinical and radiological outcomes.

Methods:

We present the follow-up of 15 patients who underwent MACI grafting from August 2003 to February 2006. The mean follow-up was 12.9 years. Clinical evaluations were conducted using the American Orthopaedic Foot & Ankle Society (AOFAS), Foot and Ankle Activity Measurement (FAAM), and visual analog scale (VAS) scoring systems and the magnetic resonance observation of cartilage repair tissue (MOCART) scoring system for radiological evaluation.

Results:

The mean size of the talar osteochondral defects was 204 mm2. We found a significant improvement in mean AOFAS score from 60 preoperatively to a mean of 84 at 12 years postoperatively. The 12-year FAAM score for Activities of Daily Living was 89% (range, 62%-99%). The mean 12-year MOCART score was 65 points (range, 30-100 points) with significant agreement between assessors ( P < .001). However, the MOCART scores did not correlate with the FAAM scores ( P = .86).

Conclusion:

Considering our long-term follow-up, we believe MACI is a reliable treatment method for talar osteochondral defects providing lasting pain relief and satisfying clinical results. However, with an equivalent outcome, but at higher costs, and the requirement for 2 operative procedures, the results do not seem to be superior to other established methods. The clinical utility of the MOCART score requires further scrutiny since we were not able to show any correlation between the score and clinical outcome.

Level of Evidence:

Level IV, case series.
The Virtual Foot and Ankle Physical Examination
Authors: Eble Stephanie K. , Hansen Oliver B. , Ellis Scott J. , Drakos Mark C.
Published: July 2020

The COVID-19 pandemic has necessitated a rapid and drastic shift for clinicians and patients away from traditional in-person visits and toward internet-based virtual visits. The adoption of telehealth services is likely to persist in some capacity even as in-person visits resume, given the convenience and efficiency of telehealth consultations for patients and perhaps surgeons. A primary challenge of virtual visits, particularly in the field of orthopedic surgery, is the physical examination. However, for the foot and ankle, routine physical examination maneuvers can be completed virtually with little modification given proper patient instruction. We present a comprehensive virtual foot and ankle examination for telehealth visits, including instructions that can be provided to patients verbatim and a corresponding checklist for provider documentation.

Level of Evidence: Level V, expert opinion.
Communicative Daily Life Stories: Raising Awareness About the Link Between Desire and Violence
Authors: Ruiz-Eugenio Laura , Puigvert Lídia , Ríos Oriol , Cisneros Rosa Maria
Published: July 2020

Gender violence poses a serious risk for women, girls, and children worldwide. Despite all efforts put forth to curtail it, few successful results have emerged. Narratives have been used to denounce the reality lived by survivors. However, scarcely any literature has explored how they get to question their own reality and, if they do, how these survivors are able to break the circle of gender violence by making room for nonviolent and egalitarian relationships. This article is a step in this direction: It explores how some girls, after participating in an initiative based on the language of desire, known as “Dialogic Feminist Gatherings,” encourage one another to question the dominant model of socialization in relationships in which attraction is linked to violent behaviors. The analysis focuses on communicative daily life stories (hereafter CDLS) performed in a Spanish high school with female teens after their participation in the gatherings. Drawing from these stories, the article illustrates how this methodological tool allows one to assess the impact of these gatherings on identifying the existence of this dominant model while also pushing to question it. This article also contributes to a better understanding of the relationship between attraction and violence, a risk factor for gender violence previously noted in the scientific literature. The knowledge obtained through this inquiry reinforces an evidence-based approach to having an effective social impact on the struggle against gender violence.
Successful oxaliplatin desensitization protocol in a patient with colorectal metastatic cancer
Authors: de Lira-Quezada Cindy E. , Villarreal-Gonzalez Rosalaura V. , Gonzalez-Diaz Sandra N. , Carrasco-Diaz Ligia L.
Published: July 2020

Introduction

Platinum compounds are frequently used for the treatment of colorectal cancer as initial chemotherapy. Oxaliplatin is a third-generation platinum used for the treatment of stage III colorectal cancer and is associated with hypersensitivity reactions. The incidence of hypersensitivity reaction is approximately 12%, with 1–2% of patients developing moderate to severe reactions.

Case report

A 54-year-old male patient with stage III B colon cancer was diagnosed and chemotherapy with oxaliplatin was indicated by the oncology service. Within 20 min of the first cycle of oxaliplatin, he developed dyspnea, laryngeal spam, foreign body sensation in the throat, nausea, and diarrhea; therefore, the infusion of oxaliplatin was suspended, and intramuscular epinephrine was administered and intravenous hydrocortisone along with chlorpheniramine with adequate resolution of symptoms. Management and outcome: Intradermal skin test performed at the concentration of 5 mg/ml (dilution 1:100) was positive. Due to the symptoms presented we decided to perform desensitization to oxaliplatin (total dose: 250 mg) with three bags–12 steps protocol with an initial concentration dose of 1/100 of the total dose in a course of 5.56 h with no hypersensitivity reactions.

Discussion

Approximately 50% of patients who are exposed to oxaliplatin may have hypersensitivity despite premedication. Desensitization protocol induces tolerance to a drug temporarily and is dependent on continuous exposure.
Resuming hip and knee arthroplasty after COVID-19: ethical implications for wellbeing, safety and the economy
Authors: Kort Nanne P , Zagra Luigi , Barrena Enrique Gomez , Tandogan Reha N , Thaler Martin , Berstock James R , Karachalios Theofilos
Published: July 2020

Reinstating elective hip and knee arthroplasty services presents significant challenges. We need to be honest about the scale of the obstacles ahead and realise that the health challenges and economic consequences of the COVID-19 pandemic are potentially devastating.

We must also prepare to make difficult ethical decisions about restarting elective hip and knee arthroplasty. These decisions should be based on the existing evidence-base, reliable data, the recommendations of experts, and regional circumstances.
Physical Exercise as Kynurenine Pathway Modulator in Chronic Diseases: Implications for Immune and Energy Homeostasis
Authors: Joisten Niklas , Walzik David , Metcalfe Alan J , Bloch Wilhelm , Zimmer Philipp
Published: July 2020

Emerging evidence highlights the substantial role of the kynurenine pathway in various physiological systems and pathological conditions. Physical exercise has been shown to impact the kynurenine pathway in response to both single (acute) and multiple (chronic) exercise training stimuli. In this perspective article, we briefly outline the current knowledge concerning exercise-induced modulations of the kynurenine pathway and discuss underlying mechanisms. Furthermore, we expose the potential involvement of exercise-induced kynurenine pathway modulations on energy homeostasis (eg, through de novo synthesis of NAD+) and finally suggest how these modulations may contribute to exercise-induced benefits in the prevention and treatment of chronic diseases.
Expenditure and price elasticities for tourism sub-industries from the Fourier flexible form
Authors: Fleissig Adrian R
Published: July 2020

Tourism studies holding expenditure and price elasticities constant can produce misleading results. The Fourier flexible form provides estimates of expenditure and price elasticities over the business cycle. Results typically show considerable evidence of increased variation in expenditure and price elasticities over the business cycle and during the decline in overall tourism expenditure from 2001 to 2003 and from 2009 to 2011. Estimated own-price elasticities show that air transportation has the most elastic demand while food and beverage have an inelastic demand. Air transportation, shopping, and accommodation often have expenditure elasticities exceeding unity making them luxury goods during those periods. Results show that food and beverages are necessary goods. Estimated Morishima elasticities find air transportation and other transportation-related commodities are substitutes with the degree of substitution changing over time but are complementary in use with the remaining sub-industries. Marketing strategies from tourism agencies and governments should be flexible and respond to how consumers change expenditure over the business cycle.
EU coordination of social security from the point of view of EU integration theory
Authors: Golynker Oxana
Published: July 2020

This article comprises a study of the negotiation of the Commission’s proposal for amending Regulation (EC) No 883/2004 on the coordination of social security systems and Regulation (EC) No 987/2009 in the context of EU integration theories. This analysis is used to argue that the current integration stage in the coordination of social security is a complex phenomenon which displays elements of intergovernmentalism, neo-functionalism and post-functionalism. The negotiation process highlights the disagreements between the key players which may have important consequences for the future of EU regulation in the area of coordination of social security. The article concludes that the signs of intergovernmentalism are prevalent, as evident in the attention the Commission has given to the concerns of the Member States, the negotiating position of the Council, and the vote of the European Parliament which failed to approve the proposal at the first reading. This prevalence has led to a pause in the reform of the coordination regulations and may eventually lead to compromises that will weaken the progress of integration in the future. At the same time, the article argues that the theory of post-functionalism is important in explaining the phenomenon of Brexit with regard to the UK’s position in the negotiation of the Commission’s proposal and its future relevance for UK and EU citizens affected by the UK’s departure from the EU. The article concludes that disintegration along the lines of post-functionalism should not prevent the reintegration of the UK into the EU coordination of social security schemes, but may reinforce the prevalence of intergovernmentalism.
Surgical Strategy for Contralateral Groin Management in Patients Scheduled for Unilateral Inguinal Hernia Repair: An International Web-Based Surveymonkey® Questionnaire: Strategy for Contralateral Groin Management during Inguinal Hernia Repair
Authors: Johansen Niels , Miserez Marc , de Beaux Andrew , Montgomery Agneta , Faylona Jose Macario , Carbonell Alfredo , Bisgaard Thue
Published: July 2020

Background:

A contralateral occult inguinal hernia is frequently observed in patients planned for a unilateral laparoscopic inguinal hernia repair. Surgical strategy for contralateral groin management in patients scheduled for an endo-laparoscopic unilateral inguinal hernia repair is controversial and based on questionable evidence. This study aimed to gather international opinion concerning the surgical strategy for the contralateral asymptomatic side when no hernia or lipoma is clinically evident at the preoperative examination or anamnesis.

Methods:

An international Internet-based questionnaire was sent to all the members of the European Hernia Society, the Americas Hernia Society, and the Asia Pacific Hernia Society. The clinical scenario for responders was a patient with a unilateral symptomatic inguinal hernia planned for endo-laparoscopic repair with no preoperative symptoms/lump on the contralateral side.

Results:

A total of 640 surgeons replied (response rate = 26%), of whom 506 were included for analysis. Most surgeons had performed > 300 repairs. The preferred surgical technique was evenly distributed between laparoscopic total extraperitoneal repair and laparoscopic transabdominal preperitoneal repair. In total, 54% preferred to implant a prophylactic mesh on the contralateral side when an occult hernia was found, 47% when a lipoma was found, and 6% when no occult hernia/lipoma was identified.

Conclusions:

Mesh implementation was preferred by half of the endo-laparoscopic hernia surgeons for a contralateral occult hernia and/or lipoma. Although not supported by strong evidence, mesh implantation on the asymptomatic contralateral side might be cost-effective and perhaps beneficial in the long term but could be offset by increased risk of chronic pain and sexual dysfunction.
A typology of masspersonal information seeking repertoires (MISR): Global implications for political participation and subjective well-being
Authors: Liu James H , Zhang Robert Jiqi , Vilar Roosevelt , Milojev Petar , Hakim Moh. Abdul , de Zúñiga Homero Gil , Schumann Sandy , Páez Dario
Published: July 2020

Masspersonal information seeking repertoires are a person-centered method of gaining insight into the relationship between Internet use, subjective well-being, and political participation. Through latent profile analysis, three person types were identified in two waves of stratified samples in 18 countries ( N = 8352). In accord with the “augmentation hypothesis,” high levels of interpersonal contact and traditional mass media usage covaried with high Internet use for the highly engaged type, that had highest political participation and life satisfaction, political knowledge, low depressive symptoms and also high anxiety. The other two types fit the “displacement hypothesis,” where Internet-based media displaces traditional media and face-to-face communication. Compared with the digitally immersed, the traditional repertoire was more knowledgeable and politically engaged, and had better well-being. Latent transition analysis showed these repertoires were stable over 6 months. Identifying different types of people with different information seeking styles clarifies mixed results on effects of online mass media use.
We are what we click: Understanding time and content-based habits of online news readers
Authors: Makhortykh Mykola , de Vreese Claes , Helberger Natali , Harambam Jaron , Bountouridis Dimitrios
Published: July 2020

The article contributes both conceptually and methodologically to the study of online news consumption by introducing new approaches to measuring user information behaviour and proposing a typology of users based on their click behaviour. Using as a case study two online outlets of large national newspapers, it employs computational approaches to detect patterns in time- and content-based user interactions with news content based on clickstream data. The analysis of interactions detects several distinct timelines of news consumption and scrutinises how users switch between news topics during reading sessions. Using clustering analysis, the article then identifies several types of news readers (e.g. samplers, gourmets) and examines their news diets. The results point out the limited variation in topical composition of the news diets between different types of readers and the tendency of these diets to align with the news supply patterns (i.e. the average distribution of topics covered by the outlet).
‘What I’m not gonna buy’: Algorithmic culture jamming and anti-consumer politics on YouTube
Authors: Wood Rachel
Published: July 2020

This article is based on an analysis of ‘anti-haul’ videos on YouTube, where a vlogger explains which beauty products they plan not to buy. Anti-haul vloggers have much in common with ‘culture jamming’ movements, which use the communicative practices and materials of promotional culture against itself to spread an anti-consumerist agenda. The article argues that anti-hauls should be understood as the reinvention of ‘culture jamming’ techniques for a contemporary promotional culture that is platform based, algorithmically governed, and mobilised through the affective, authentic performance of the ‘influencer’. I refer to this manipulation of the platform’s visibility mechanisms to spread anti-consumer messages as ‘algorithmic culture jamming’. The anti-consumer politics of anti-hauls are contradictory and ambivalent. At the same time, I argue that anti-hauls also offer important possibilities for political learning, personal and collective transformation, and alternative creative pleasures outside of continual consumer accumulation.
Seeing the forest for the trees: Visualizing platformization and its governance
Authors: Van Dijck José
Published: July 2020

The complexities of platforms are increasingly at odds with the narrow legal and economic concepts in which their governance is grounded. This article aims to analyze platformization through the metaphorical lens of a tree to make sense of information ecosystems as hierarchical and interdependent structures. The layered shape of the tree draws attention to the dynamics of power concentration: vertical integration, infrastructuralization, and cross-sectorization. Next, the metaphor helps to revision the current patchwork of European regulatory frameworks, addressing the power asymmetry between citizens and the data-driven systems through which their daily practices are governed. Finally, the platformization tree serves to identify points of intervention that may inform European regulatory bodies and policy-makers to act as agents of change. Taking a holistic approach to platformization, this visual metaphor may inspire a set of principles that reshapes the platform ecosystem in the interest of society and the common good.
Do Spitzenkandidaten really make a difference? An experiment on the effectiveness of personalized European Parliament election campaigns
Authors: Gattermann Katjana , Marquart Franziska
Published: July 2020

This article investigates the impact of pan-European candidates in European Parliament election campaigns. It focusses on the two 2019 nominees for the European Greens, who were Dutch and German, respectively. We conducted a pre-registered experiment in the Netherlands and Germany in early April 2019 to test the effects of (non-)personalized campaign posters on (a) turnout intention and (b) vote intention for the Greens alongside possible mediating effects of campaign and candidate evaluations. Our results suggest that while personalized campaigns as opposed to non-personalized campaigns may not matter per se for turnout and vote intention, individual candidates can make a difference in European elections, particularly with respect to vote intention. As such, the results have important implications for our understanding of European Parliament election campaigns.
Deep neural networks–based damage detection using vibration signals of finite element model and real intact state: An evaluation via a lab-scale offshore jacket structure
Authors: Mousavi Zohreh , Varahram Sina , Ettefagh Mir Mohammad , Sadeghi Morteza H , Razavi Seyed Naser
Published: July 2020

Structural health monitoring of mechanical systems is essential to avoid their catastrophic failure. In this article, an effective deep neural network is developed for extracting the damage-sensitive features from frequency data of vibration signals to damage detection of mechanical systems in the presence of the uncertainties such as modeling errors, measurement errors, and environmental noises. For this purpose, the finite element method is used to analyze a mechanical system (finite element model). Then, vibration experiments are carried out on the laboratory-scale model. Vibration signals of real intact system are used to updating the finite element model and minimizing the disparities between the natural frequencies of the finite element model and real system. Some parts of the signals that are not related to the nature of the system are removed using the complete ensemble empirical mode decomposition technique. Frequency domain decomposition method is used to extract frequency data. The proposed deep neural network is trained using frequency data of the finite element model and real intact state and then is tested using frequency data of the real system. The proposed network is designed in two stages, namely, the pre-training classification based on deep auto-encoder and Softmax layer (first stage), and the re-training classification based on backpropagation algorithm for fine tuning of the network (second stage). The proposed method is validated using a lab-scale offshore jacket structure. The results show that the proposed method can learn features from the frequency data and achieve higher accuracy than other comparative methods.
Unsupervised deep learning approach using a deep auto-encoder with a one-class support vector machine to detect damage
Authors: Wang Zilong , Cha Young-Jin
Published: July 2020

This article proposes an unsupervised deep learning–based approach to detect structural damage. Supervised deep learning methods have been proposed in recent years, but they require data from an intact structure and various damage scenarios of monitored structures for their training processes. However, the labeling work on the training data is typically time-consuming and costly, and sometimes collecting sufficient training data from various damage scenarios of infrastructures in service is impractical. In this article, the proposed unsupervised deep learning method based on a deep auto-encoder with an one-class support vector machine only uses the measured acceleration response data acquired from intact or baseline structures as training data, which enables future structural damage to be detected. The major contributions and novelties of the proposed method are as follows. First, an appropriate deep auto-encoder is carefully designed through comparative studies on the depth of neural networks. Second, the designed deep auto-encoder is taken as an extractor to obtain damage-sensitive features from the measured acceleration response data, and an one-class support vector machine is used as a damage detector. Third, experimental and numerical studies validate the high accuracy of the proposed method for damage detection: a 97.4% mean average for a 12-story numerical building model and a 91.0% accuracy for a laboratory-scaled steel bridge. Fourth, the proposed method also detects light damage (i.e. a 10% reduction in stiffness) with 96.9% to 99.0% accuracy, which shows its superior performance compared with the current state of the art. Fifth, it provides stable and more robust damage detection performance with reduced tuning parameters.
Nurse Staffing and Coronavirus Infections in California Nursing Homes
Authors: Harrington Charlene , Ross Leslie , Chapman Susan , Halifax Elizabeth , Spurlock Bruce , Bakerjian Debra
Published: July 2020

In the United States, 1.4 million nursing home residents have been severely impacted by the COVID-19 pandemic with at least 25,923 resident and 449 staff deaths reported from the virus by June 1, 2020. The majority of residents have chronic illnesses and conditions and are vulnerable to infections and many share rooms and have congregate meals. There was evidence of inadequate registered nurse (RN) staffing levels and infection control procedures in many nursing homes prior to the outbreak of the virus. The aim of this study was to examine the relationship of nurse staffing in California nursing homes and compare homes with and without COVID-19 residents. Study data were from both the California and Los Angeles Departments of Public Health and as well as news organizations on nursing homes reporting COVID-19 infections between March and May 4, 2020. Results indicate that nursing homes with total RN staffing levels under the recommended minimum standard (0.75 hours per resident day) had a two times greater probability of having COVID-19 resident infections. Nursing homes with lower Medicare five-star ratings on total nurse and RN staffing levels (adjusted for acuity), higher total health deficiencies, and more beds had a higher probability of having COVID-19 residents. Nursing homes with low RN and total staffing levels appear to leave residents vulnerable to COVID-19 infections. Establishing minimum staffing standards at the federal and state levels could prevent this in the future.
Behavior Support Coaching for a Paraprofessional Working With First-Grade Students Exhibiting Disruptive Behavior Problems in an Urban High-Poverty Elementary School
Authors: Alperin Alexander , Reddy Linda A. , Glover Todd A. , Breeden Nicole , Dudek Christopher , Regan Patrick
Published: July 2020

Despite receiving little to no training in behavior management, paraprofessionals often support young students with or at risk of disruptive behavior disorders in elementary schools. The Behavior Support Coaching for Paraprofessionals (BSC-P) is a new evidence-based data-driven approach for enhancing paraprofessionals’ skills in identifying behavior needs, setting goals, and selecting and implementing evidence-based interventions for improving student disruptive behaviors. The current case study presents the application of the BSC-P (eight sessions over 3 months) with a paraprofessional and teacher who support two first-grade students exhibiting disruptive behaviors in an urban high-poverty elementary school. Implemented evidence-based interventions include say, show, check, a token economy, and antecedent modification. Findings revealed increased paraprofessional intervention fidelity, improved student classroom engagement (effect sizes of 3.77 and 2.10), and decreased student inappropriate verbal and physical behavior (effect sizes of 1.34 and 1.88, respectively).
“Inflammatory Bowel Disease—Not Just the Bowel’s Bane”: Peripheral Arterial and Venous Thrombosis in a Patient With Crohn Disease
Authors: Boussi Leora , Safaya Aditya , Goyal Arun , Mateo Romeo , Laskowski Igor , Babu Sateesh
Published: July 2020

Introduction:

Inflammatory bowel disease (IBD) is a chronic multisystem inflammatory condition with associated endothelial dysfunction and dysregulated coagulation. Although deep venous thrombosis (DVT) in IBD has been well described, arterial thrombosis and thromboembolism are less commonly appreciated.

Methods:

A 63-year-old male with a known history of Crohn disease presented with acute-onset right arm pain. His past vascular history was significant for left lower extremity DVT with an existing inferior vena cava filter and acute ischemia of the right lower extremity requiring a below-knee amputation a year ago. Imaging revealed acute brachial, ulnar, and radial artery thrombosis.

Results:

Patient underwent an open right brachial, radial, and ulnar thrombectomy to restore vascular flow. He required multiple exploration and thrombectomy for reocclusion of the vessels in the early postoperative period. He later developed a rapidly deteriorating clinical status, flank ecchymosis and swelling concerning for soft tissue ischemia, and compartment syndrome heralding an eventual hemodynamic collapse. On exploration, he was found to have chronic fibrosis of his left femoral vein and femoral artery occlusion. Clinically, the patient deteriorated rapidly, which resulted in his demise.

Conclusion:

The inflammatory reaction in IBD leads to arterial stiffening and hypercoagulability, which should theoretically increase the risk for vascular disease. Although the link between IBD and DVT is well established, arterial thrombosis and thromboembolism remain widely debated, with some implications for therapeutic intervention. The link between vascular thrombosis and IBD must be examined further, as the treatment and prevention of vascular complications in IBD depends on our understanding of this relationship.
Horseshoe Kidney Blunt Trauma With Double Laceration: Endovascular Management
Authors: Boninsegna Enrico , Simonini Emilio , Crosara Stefano , Sozzi Carlo , Colopi Stefano
Published: July 2020

A 78-year-old male patient was admitted to our hospital after abdominal trauma. Contrast-enhanced computed tomography (CT) scan demonstrated a horseshoe kidney with a perinephric hematoma and evidence of arterial hemorrhage. An anomalous renal arterial anatomy was noted as well, with a renal artery originating from the left common iliac artery. He was successfully treated via an endovascular approach. Varying forms of vascularization may complicate angiographic treatment of patients with abdominal trauma in a setting of kidney anomalies. Obtaining and evaluating contrast-enhanced CT angiography can identify anomalous vessels and can be invaluable when deciding on the most appropriate interventional approach.
Development of a control law to improve the handling qualities for short-range air-to-air combat maneuvers
Authors: Kim Chong-Sup , Ji Chang-Ho , Kim Byoung Soo
Published: July 2020

Modern fighter aircraft have been designed to have high maneuverability in order to preoccupy strategic superiority in short-range air-to-air combat between fighter aircraft in warfare. Digital fly-by-wire flight control system design is aimed at providing good handling qualities for all mission task elements over the entire flight envelope. To provide both excellent gross acquisition and fine tracking compatibility, simultaneously for air-to-air combat maneuvers, this article presents a common longitudinal control law design of a task-dependent self-adjusting command-path pilot prefilter gain scheduler within the same control law design architecture and response type based on nonlinear dynamic inversion control. We perform the frequency- and time-domain analyses based on the mathematical model of T-50 advanced trainer aircraft to evaluate the basic flying qualities of the proposed control method. Furthermore, the pilot evaluation is performed to evaluate the gross acquisition and fine tracking capability for air-to-air tracking maneuvers in a handling quality simulator. The evaluation results reveal that the proposed control method improves the fine tracking capability without the degradation of gross acquisition.
Dynamic modeling of the Stewart platform for the NanShan Radio Telescope
Authors: Kazezkhan Guljaina , Xiang Binbin , Wang Na , Yusup Aili
Published: July 2020

The NanShan Radio Telescope is a 26-m fully steerable radio telescope, and it adopts a 6-UPU Stewart platform with electric motors to adjust and align the position of the subreflector. In order to analyze the actual dynamic performance and control the Stewart platform of the NanShan Radio Telescope, this article models the inverse dynamic of the Stewart platform using the virtual work approach. The model improves the accuracy of the dynamic equations and considered the pitching motion of the base platform in the practical application of the radio telescope. Dynamic simulations of the Stewart platform are implemented, the conditions of the passive rotation of the piston of actuators are considered, and the results show that the effect of the passive rotation of the pistons of the actuators is important to obtain more accurate result. The conditions of the system under the different elevation angles of the radio telescope are also considered, and the results show that the change of the elevation angles of the radio telescope has a great impact on the driving forces of the Stewart platform. It is known from the analysis that the passive rotation of pistons of actuators and the elevation movement of the primary reflector of the radio telescope are not ignorable for the precise analysis and control of the Stewart platform of the NanShan Radio Telescope.
Peripheral artery disease in outpatients with a recent history of acute coronary syndrome or at high atherothrombotic risk
Authors: Cantú-Brito Carlos , Chiquete Erwin , Antezana-Castro Javier F , Toapanta-Yanchapaxi Liz , Ochoa-Guzmán Ana , Ruiz-Sandoval José Luis ,   INDAGA Cardiologists Investigators
Published: July 2020

Objectives

The frequency and implications of peripheral artery disease (PAD) in some risk groups are not entirely characterized in Latin America. We studied PAD prevalence, risk factors, and six-month outcomes in stable outpatients with a history of a recent acute coronary syndrome (ACS), or at high coronary risk.

Methods

We recruited 830 outpatients in 43 Mexican sites (median age: 64.8 years; 57.8% men). Inclusion criteria were age >18 years, and ACS within 30 days, or age <55 years plus ≥2 major vascular risk factors, or age ≥55 years plus ≥1 vascular risk factors. Patients received standardized assessments at baseline and six-month follow-up for medical history, ankle-brachial index (ABI), and the Edinburgh Claudication Questionnaire (ECQ).

Results

ABI <0.8 was found in 10.5%, <0.9 in 22.5%, >1.3 in 4.8%, and >1.4 in 3.6%, without differences according to sex or selection criteria. Positive ECQ was found in 7.6%. ABI <0.9 was directly associated with age, diabetes, ACS, and chronic kidney disease, but inversely associated with BMI >27. The six-month case-fatality and atherothrombotic events rates were 1.6% and 3.6%, respectively. In patients with ABI <0.9 and ABI <0.8, the six-month case-fatality rates were 2.5% ( p =  0.27) and 5.4% ( p =  0.03), respectively. In a Cox proportional-hazards model, baseline factors associated with death were age ≥65, ABI <0.8, and ACS.

Conclusions

Subclinical PAD is more common than symptomatic claudication in high-risk coronary outpatients. Low ABI is associated with reduced short-term survival in patients with recent ACS or at high coronary risk.
Psychosocial Vulnerabilities to Upper Respiratory Infectious Illness: Implications for Susceptibility to Coronavirus Disease 2019 (COVID-19)
Authors: Cohen Sheldon
Published: July 2020

For 35 years, our laboratory has been involved in identifying psychosocial factors that predict who becomes ill when they are exposed to a virus affecting the upper respiratory tract. To pursue this question, we used a unique viral-challenge design in which we assessed behavioral, social, and psychological factors in healthy adults. We subsequently exposed these adults to a cold or influenza virus and then monitored them in quarantine for 5 to 6 days for onset of respiratory illness. Factors we found to be associated with greater risk of respiratory illnesses after virus exposure included smoking, ingesting an inadequate level of vitamin C, and chronic psychological stress. Those associated with decreased risk included social integration, social support, physical activity, adequate and efficient sleep, and moderate alcohol intake. We cautiously suggest that our findings could have implications for identifying who becomes ill when exposed to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for coronavirus disease 2019 (COVID-19). This argument is based on evidence that the associations we report are replicable across multiple respiratory viruses and that the pathways found to link psychosocial factors to colds and influenza may play similar roles in COVID-19.
Improving the photocatalytic activity of nitrogen-doped surface defect TiO2-x nanobelts for degradation of organic pollutants
Authors: Zhang Zhen , Qin Shao-dong , Chen Jing-yun , Li Jing , Xing Ai-hua
Published: July 2020

The synthesis of surface defect TiO2-x nanobelts with excellent visible light absorption is important to reduce costs, increase stability, and improve photocatalytic activity. In this work, we report that nitrogen-doped surface defect TiO2-x nanobelts are synthesized by annealing pristine TiO2 nanobelts in Ar/H2 (95%/5%) atmosphere followed by subsequent heat treatment in NH3 at various temperatures. The aim is to study the effect of the extent of the N-doping amount in the lattice of TiO2-x nanobelts on light absorption and photocatalytic activity. Considering the increase in organic pollutants in wastewater, the photocatalytic activity is measured by degrading rhodamine B (RhB) dye in water. The results demonstrate that the calcination temperature affects the doping level of N, and the b-TiO2-N550 sample exhibits higher photocatalytic performance than that of other samples under visible-light irradiation for the degradation of rhodamine B, which is up to 96.11%. The enhancement is ascribed to the synergistic effect of N-doping and self-doping oxygen vacancy (which extend the visible light absorption) and the separation efficiency of photogenerated carriers, which improves the photocatalytic activity.
Sustainable and recyclable palladium nanoparticles–catalyzed reduction of nitroaromatics in water/glycerol at room temperature
Authors: Dai Bencai , Zhou Yang , Liu Changchun , Chen Jin , Shen Zhihao , Zhao Yongde
Published: July 2020

Palladium nanoparticles with unique catalytic activity and high stability are synthesized. These nanoparticles exhibit excellent catalytic reduction activity for nitroaromatics in green solvents in the presence of H2 at ambient pressure and temperature. The prominent advantages of this nanotechnology include low consumption of catalyst, excellent chemoselectivity, high reusability of the catalyst, and environmentally green solvents.
Treatment outcomes of acute appendicitis and associated factors among admitted patients with a diagnosis of acute abdomen in Debre Markos Referral Hospital, Amhara Region, North West Ethiopia
Authors: Afenigus Abebe Dilie , Bayieh Agumas Mossie , Kassahun Berhanu
Published: July 2020

Introduction

Appendicitis is an inflammation of the vermiform appendix and is one of the most common causes of an acute abdomen in young adults. If left untreated, it can lead to appendiceal abscess, perforation and peritonitis.

Objective

To assess treatment outcomes of acute appendicitis and associated factors among admitted patients with a diagnosis of acute abdomen. Methods and materials: A cross sectional study was employed among 169 patients using a census. Data were collected from patient medical records by using a checklist. Data were entered using Epi-data and analysed by statistical product and service solution. Logistic regression analysis was employed.

Results

Among 303 patients with a diagnosis of acute abdomen, 169 (55.7%) developed acute appendicitis; of whom, 45 (26.6%) developed unfavourable treatment outcomes. Patients who had elevated white blood cell count at the time of presentation (adjusted odds ratio = 4.7; 95% confidence interval (1.95, 11.35)) and intraoperative appendiceal abscess (adjusted odds ratio = 3.8; 95% confidence interval (1.61, 9.07)) were significantly associated with an unfavourable appendicitis treatment outcome. Conclusion and recommendation: Nearly a quarter of the patients developed unfavourable treatment outcomes. Elevated white blood cell count and intraoperative appendiceal abscess were significantly associated with unfavourable appendicitis treatment outcome. Therefore, early detection and treatment of appendiceal abscess is crucial for a better outcome.
Rationale and design of an evidence-based tool to guide preoperative evaluation and management
Authors: Campbell Alex R , Ingham David P , Shepherd Michele F , Mueller Joshua J , Henry Timothy D , Sharkey Scott W , Cummings Michael K
Published: July 2020

Background

In the United States, over-testing and over-treatment are recognised causes of excess cost and patient harm. Healthcare value, defined as health outcomes achieved relative to the costs of care, has become a focus to improve the quality and affordability of healthcare.

Aim

To describe the rationale for, and development of a standardised clinical preoperative decision-support tool. Program description: An evidence-based, preoperative clinical decision tool was developed to guide preoperative testing and management of high-risk medications. Program evaluation: Patient data before and after implementation of the tool will be analysed to determine its effectiveness in reducing preoperative testing.

Discussion

Preoperative testing is an area that presents an opportunity to increase healthcare value and decrease healthcare spending. Guidelines are available to standardise preoperative assessment but their adoption and acceptance into practice has been slow. To systematise preoperative assessment within our healthcare system, we reviewed current published literature and guidelines and synthesised them into an electronic, evidence-based, decision-support tool. After distribution of the tool to clinicians in our healthcare system, we will assess its impact on healthcare value, costs and outcomes. We believe that an evidence-based preoperative tool, seamlessly and efficiently integrated into clinician workflow, can improve preoperative patient care.
In justified anger
Authors: O’Keefe Phil , O’Keefe Paul
Published: July 2020

There were certain assumptions underlying the (early) government response to the pandemic in Britain. The first one was to try and preserve capital accumulation for the very rich by making the rest of the population suffer, a population that had experienced austerity for years. The second assumption signifying thinly disguised racism was to deny that what originated in China had any relevance to the United Kingdom. A corollary of this was: if other countries wished to shut down, the United Kingdom would reap the benefits. These assumptions which led to relative inactivity in the early stage of the pandemic prompt us to ask: what human value system puts the preservation of the capitalist market economy above saving human lives?
Pilot implementation of Bukhali: A preconception health trial in South Africa
Authors: Draper CE , Prioreschi A , Ware LJ , Lye S , Norris SA
Published: July 2020

Objectives:

This article describes the learnings from the pilot phase of the Healthy Life Trajectories Initiative, a preconception health trial for 18- to 25-year-old women in Soweto, South Africa.

Methods:

The study compares two arms focussed on either physical and mental health (intervention; delivered by community health workers – ‘Health Helpers’) or standard of care plus (control; standard access to healthcare plus additional telephonic input on ‘life skills’; delivered by call centre assistants). These are collectively referred to as Bukhali. Data on the pilot implementation of the Bukhali trial (n = 1655) were collected from (1) weekly team meetings, (2) two focus groups (one with the intervention team Health Helpers, n = 7; one with intervention participants, n = 8) and one paired interview with control call centre assistants (n = 2), (3) notes from eight debrief sessions with Health Helpers and (4) quantitative trial monitoring data. Qualitative data were thematically analysed.

Results:

The findings clustered within three themes: (1) challenges for young women in Soweto, (2) priorities for young women in Soweto and (3) implementation challenges and perceptions of the intervention. Challenges were mostly related to tough socioeconomic circumstances and less prioritisation of living a healthier life. The priorities of employment and educational opportunities reflected the socioeconomic challenges, where health was not recognised as priority. The main challenge to participation and compliance with the trial was that young women in Soweto generally wanted a tangible and preferably financial and immediate benefit. Community peer sessions, despite being recommended by young women as part of the intervention development, were not successful. Many women also moved between multiple households within Soweto, which flagged concerns for a cluster trial and risk of contamination.

Conclusion:

Preconception health trials should consider socioeconomic challenges present in urban poor contexts. Learnings from the pilot phase significantly affected the design and implementation of the main Bukhali trial.
Rectal perforations caused by cleansing enemas in chronically constipated patients: Two case reports
Authors: Lee Seokyoun , Kwon Jungnam , Lee Junhee
Published: July 2020

Constipation is a common disease that is frequently treated with cleansing enemas. Enemas are considered as effective and in some cases may cause serious adverse events. Iatrogenic perforations due to enemas lead to adverse outcomes in elderly patients with a poor general condition. Perforation remains an infrequent and rarely reported complication. In this work, we describe the cases of two patients with rectal perforation caused by a cleansing enema. The first patient had rectal perforation that led to a para-rectal abscess and the second patient had generalized peritonitis caused by rectal perforation.
Royal Society of Medicine Surgical Innovation Day Adrian Tanner Prize Winner 2019: Multidisciplinary care and surgical innovation for the benefit of the patient with head and neck cancer of unknown primary
Authors: Mistry Rakesh , Walker Abigail , Walker Nathan , Ofo Enyinnaya
Published: July 2020

Head and neck carcinoma of unknown primary accounts for approximately 1–5% of all head and neck cancers and presents a genuine diagnostic and therapeutic dilemma. Despite advanced investigations, the primary tumour location remains unknown in up to 40% of these cases. Transoral robotic surgery presents a viable diagnostic and therapeutic option in these patients. This surgical innovation alongside advances in the understanding of head and neck cancer biology means that a multidisciplinary approach in the management of these complex patients is of utmost importance to ensure optimal therapeutic outcomes.