bluuebunny/crossref_metadata_2025 huggingface dataset:
Collaborative patterns, authorship practices and scientific success in biomedical research: a network analysis
Authors: Patel Vanash M , Panzarasa Pietro , Ashrafian Hutan , Evans Tim S , Kirresh Ali , Sevdalis Nick , Darzi Ara , Athanasiou Thanos
Published: June 2019

Summary

Objective

To investigate the relationship between biomedical researchers' collaborative and authorship practices and scientific success.

Design

Longitudinal quantitative analysis of individual researchers' careers over a nine-year period.

Setting

A leading biomedical research institution in the United Kingdom.

Participants

Five hundred and twenty-five biomedical researchers who were in employment on 31 December 2009.

Main outcome measures

We constructed the co-authorship network in which nodes are the researchers, and links are established between any two researchers if they co-authored one or more articles. For each researcher, we recorded the position held in the co-authorship network and in the bylines of all articles published in each three-year interval and calculated the number of citations these articles accrued until January 2013. We estimated maximum likelihood negative binomial panel regression models.

Results

Our analysis suggests that collaboration sustained success, yet excessive co-authorship did not. Last positions in non-alphabetised bylines were beneficial for higher academic ranks but not for junior ones. A professor could witness a 20.57% increase in the expected citation count if last-listed non-alphabetically in one additional publication; yet, a lecturer suffered from a 13.04% reduction. First positions in alphabetised bylines were positively associated with performance for junior academics only. A lecturer could experience a 8.78% increase in the expected citation count if first-listed alphabetically in one additional publication. While junior researchers amplified success when brokering among otherwise disconnected collaborators, senior researchers prospered from socially cohesive networks, rich in third-party relationships.

Conclusions

These results help biomedical scientists shape successful careers and research institutions develop effective assessment and recruitment policies that will ultimately sustain the quality of biomedical research and patient care.
Correlational analysis of heart rate variability band power and respiratory frequency to identify an optimal frequency band
Authors: Narang Mahak , Singh Mandeep
Published: June 2019

In this paper, we have analysed correlational studies between high frequency-heart rate variability (HF-HRV) band power and respiration frequency (RF) to identify an optimal narrower HF-HRV band capturing maximum information related to respiration-based heart rate variability. To get exclusive respiration related information, prospective narrower high frequency (HF) band of HRV has been defined with HF band centred around the RF. The RF and HF-HRV band power using fast Fourier transform (FFT) has been computed for all the subjects. The prospective narrower HF bands of HRV defined as [Respiration Frequency (RF) ±δ], with δ as bandwidth taken to be 0.04, 0.05, 0.06, 0.07, 0.08, 0.10 and 0.12 Hz, has been analysed in this research. Average negative correlation between RF and HF-HRV band power for standard HF band (0.12Hz to 0.4 Hz) with the prospective narrower HF bands has been compared. The results show that average negative correlation for HF band defined by (RF±0.10) comes out to be -0.459278665 and for the standard HF band it comes out to be -0.315965889. This suggests that the narrower HF band defined by (RF±0.10) captures maximum information related to respiration-based heart rate variability. This study may be used for detecting stress and anxiety conditions. The study may be further used to distinguish between normal sinus arrythmia (NSA) and non-NSA. It may further be used to extract respiration rate from electrocardiography (ECG) signal alone.
Predictive Factors for Perinatal Outcomes of Infants Diagnosed With Micrognathia Antenatally
Authors: Tay Sok Yan , Krishnasarma Rekha , Mehta Deepak , Mehollin-Ray Amy , Chandy Binoy
Published: June 2019

Introduction:

Advances in fetal imaging have allowed us to identify abnormalities previously not appreciated. With this study, we hope to identify factors predicting a difficult airway at birth and review the perinatal outcomes of these patients.

Methods:

Sixteen patients with antenatally diagnosed micrognathia were reviewed from a tertiary care hospital database from 2011 to 2016. Jaw index (JI), amniotic fluid index (AFI), glossoptosis, gastric size, and oropharynx obliteration were assessed. The airway support required at birth, specialist team involvement, and outcomes were evaluated.

Results:

Nine (56.3%) of 16 patients had JI <5th percentile, 3 (33.3%) of 9 had difficult intubation, 2 (22.2%) of 9 needed an emergency tracheostomy, and 1 (11.1%) of 9 died. Seven patients had polyhydramnios, 2 (28.6%) of 7 had difficult intubation, 2 (28.6%) of 7 required tracheostomy, and 1 (14.3%) of 7 died. Twelve patients had either JI <5th percentile or abnormal AFI, 5 (41.7%) of 12 had difficult intubation, 2 (16.7%) of 12 required tracheostomy, and 1 (8.33%) of 12 died. For the group without otolaryngology consultation, 8 (50%) of 16, 1 (12.5%) of 8 had difficult intubation and 1 (12.5%) of 8 died because airway was not secured after 45 minutes of resuscitation.

Conclusion:

Jaw index <5th percentile or abnormal AFI predicts a difficult airway. A multidisciplinary approach with otolaryngology involvement for airway intervention may be required at birth.
Expression Profile of Survivin and p16 in Laryngeal Squamous Cell Carcinoma: Contribution of Tunisian Patients
Authors: Ben Elhadj Mariem , Amine Olfa E. L. , Mokni Baizig Nehla , Ben Ayoub Wided , Goucha Aida , El May Michèle-Veronique , Fourati Asma
Published: June 2019

The objective of this study was to evaluate the expression of survivin and p16 in laryngeal squamous cell carcinoma (LSCC) in order to analyze their pathogenesis and prognostic significance in Tunisian patients. A total of 70 patients with LSCC collected at the Salah Azaiez Cancer Institute of Tunis were retrospectively evaluated. Expression of survivin and p16 was examined using immunohistochemistry, and the correlations with clinicopathological parameters, overall survival (OS), and disease-free survival (DFS) were statistically evaluated. The positive expression of survivin and p16 were found in 58.6% and 51.43% of LSCC cases, respectively. The p16 expression was not associated with either clinical parameters or patient survival, whereas there was a strong correlation of survivin expression and lymph node metastases ( P = .002), alcohol consumption ( P = .024), and therapeutic protocol (with or without chemotherapy; P = .001). Kaplan-Meier survival curves showed that patients with LSCC having positive survivin expression have shorter OS ( P = .026) and shorter DFS ( P = .01) than those with negative expression. Positive survivin expression was also correlated with high recurrence rate ( P = .014). Therefore, survivin is a poor prognostic marker for LSCC but the therapeutic protocol remains, in multivariate study, the most decisive for the OS and DFS of our patients with P < .01. Our data indicated that, in Tunisian laryngeal squamous cell carcinoma, survivin expression is associated with unfavorable outcomes and represents a predictor marker of recurrence and chemoresistance. However, p16 expression has no prognosis value.
Endoscopic‐Assisted Cochlear Implantation in Children with Malformed Ears
Authors: Carner Marco , Sacchetto Andrea , Bianconi Luca , Soloperto Davide , Sacchetto Luca , Presutti Livio , Marchioni Daniele
Published: June 2019

Objective

Complex middle and inner ear malformations are considered an important limitation for cochlear implant (CI) with traditional microscopic techniques. The aim of the present study is to describe the results of the endoscopic‐assisted CI procedure in children with malformed ears.

Study Design

Case series with chart review of consecutive patients.

Setting

Two tertiary referral centers: University Hospital of Verona and University Hospital of Modena, Italy.

Subjects and Methods

In total, 25 children underwent endoscopic‐assisted cochlear implantation between January 2013 and January 2018. The audiologic and neuroradiologic assessment showed profound hearing loss and malformation of the middle and inner ear in all children. A complete review of anatomic features, surgical results, and audiologic outcomes was performed. The surgical technique is described step‐by‐step, and the outcomes are detailed.

Results

All patients (mean age, 3.6 years; range, 2.8‐9 years) underwent a transattical/endoscopic‐assisted CI procedure. All children showed varying degrees of auditory benefit, as measured by routine audiometry, speech perception tests, and Categories of Auditory Performance scores (mean, 6). No immediate or late postoperative complications were noted.

Conclusion

The endoscopic‐assisted approach proved to be successful in cochlear implantation. The direct visualization and magnification allow (1) exploration of the tympanic cavity; (2) confirmation of all anatomic features, with strict control of the course of the facial nerve, round window area, and inner ear; and (3) performance of the cochleostomy with adequate insertion of the array.
Clinical Consensus Statement: Balloon Dilation of the Eustachian Tube
Authors: Tucci Debara L. , McCoul Edward D. , Rosenfeld Richard M. , Tunkel David E. , Batra Pete S. , Chandrasekhar Sujana S. , Cordes Susan R. , Eshraghi Adrien A. , Kaylie David , Lal Devyani , Lee Jivianne , Setzen Michael , Sindwani Raj , Syms Charles A. , Bishop Charles , Poe Dennis S. , Corrigan Maureen , Lambie Erin
Published: June 2019

Objective

To develop a clinical consensus statement on the use of balloon dilation of the eustachian tube (BDET).

Methods

An expert panel of otolaryngologists was assembled with nominated representatives of general otolaryngology and relevant subspecialty societies. The target population was adults 18 years or older who are candidates for BDET because of obstructive eustachian tube dysfunction (OETD) in 1 or both ears for 3 months or longer that significantly affects quality of life or functional health status. A modified Delphi method was used to distill expert opinion into clinical statements that met a standardized definition of consensus.

Results

After 3 iterative Delphi method surveys, 28 statements met the predefined criteria for consensus, while 28 statements did not. The clinical statements were grouped into 3 categories for the purposes of presentation and discussion: (1) patient criteria, (2) perioperative considerations, and (3) outcomes.

Conclusion

This panel reached consensus on several statements that clarify diagnosis and perioperative management of OETD. Lack of consensus on other statements likely reflects knowledge gaps regarding the role of BDET in managing OETD. Expert panel consensus may provide helpful information for the otolaryngologist considering the use of BDET for the management of patients with OETD.
Expanding intimacy theory: Vulnerable disclosures and partner responding
Authors: Khalifian Chandra E. , Barry Robin A.
Published: June 2019

Intimacy—a sense of closeness between individuals—is a fundamental component of healthy relationships and promotes mental and physical health. Theorists agree that intimacy increases when individuals’ vulnerable disclosures are met with partners’ supportive responses. The present research expands theory by examining two qualities of vulnerable disclosures that may alter their function within intimacy processes: (1) the extent to which the disclosure includes/implicates the partner and (2) the extent to which the disclosure describes specific, rather than general, vulnerable experiences. We hypothesized that specific, partner-exclusive vulnerable disclosures (i.e., disclosures that do not implicate the partner) would support proximal outcomes of intimacy processes (i.e., higher responsiveness and reinforcement and lower punishment). In contrast, specific partner-inclusive vulnerable disclosures (i.e., disclosures that implicate the partner in feelings of vulnerability) would be associated with lower perceived partner responsiveness and reinforcement and higher perceived punishment. Eighty-two cohabiting couples participated in two randomly assigned video-recorded vulnerability discussions (either partner-inclusive or -exclusive). Trained coders rated the extent to which the disclosing individual described their vulnerability specifically rather than generally. Couples then rated how responsive, reinforcing, and punishing their partner was during each discussion. Hypotheses were tested with multilevel modeling. Individuals perceived lower responsiveness and reinforcement and higher punishment when disclosing specific, partner-inclusive vulnerabilities compared to partner-exclusive vulnerabilities. Vulnerable disclosures function differently and can either support or hinder the intimacy process. To enhance relationship functioning, a more complete understanding of the intimacy process is imperative.
Assessment of the effects of Kinesiotaping on musical motor performance in musicians suffering from focal hand dystonia: a pilot study
Authors: Bravi Riccardo , Ioannou Christos I , Minciacchi Diego , Altenmüller Eckart
Published: June 2019

Objective:

The aim of this study was to explore the immediate and short-term effects of a Correction Kinesiotaping intervention on fine motor control in musicians with focal hand dystonia.

Design:

A single-blinded, single-arm repeated measures, pilot study.

Setting:

Medical outpatient clinic.

Subjects:

Seven musicians diagnosed with focal hand dystonia.

Interventions:

Musicians performed musical exercises under the following conditions: without Kinesiotape (baseline), during a Correction Kinesiotaping intervention and immediately after tape removal (block 1) and during a Sham Kinesiotaping intervention and immediately after tape removal (block 2). Blocks were randomly presented across participants. A tailored Correction Kinesiotaping intervention on affected fingers was provided based on the dystonic pattern that each patient manifested while playing.

Main measures:

Motor performance was video-documented and independent experts blindly assessed the general performance and fingers’ posture on visual analogue scales. Also, musicians’ self-reports of the musical abilities were evaluated. Finally, electromyographic activity and coactivation index of wrist antagonist muscles were analyzed.

Results:

No significant differences in effects between Correction Kinesiotaping and Sham Kinesiotaping were reported by the experts, either for general performance ( P > 0.05) or for fingers’ posture ( P > 0.05); any subtle benefits observed during Correction Kinesiotaping were lost after the tape was removed. Musicians estimated that Correction Kinesiotaping was ineffective in improving their musical abilities. Also, no significant changes with respect to the coactivation index ( P > 0.05) were found among the conditions.

Conclusion:

Correction Kinesiotaping intervention may not be useful to reduce dystonic patterns, nor to improve playing ability, in musicians with focal hand dystonia.
Regulation of adenosine A2A receptor gene expression in a model of binge eating in the amygdaloid complex of female rats
Authors: Micioni Di Bonaventura Maria Vittoria , Pucci Mariangela , Giusepponi Maria Elena , Romano Adele , Lambertucci Catia , Volpini Rosaria , Micioni Di Bonaventura Emanuela , Gaetani Silvana , Maccarrone Mauro , D’Addario Claudio , Cifani Carlo
Published: June 2019

Background:

Pharmacological treatment approaches for eating disorders, such as binge eating disorder and bulimia nervosa, are currently limited.

Methods and aims:

Using a well-characterized animal model of binge eating, we investigated the epigenetic regulation of the A2A Adenosine Receptor (A2AAR) and dopaminergic D2 receptor (D2R) genes.

Results:

Gene expression analysis revealed a selective increase of both receptor mRNAs in the amygdaloid complex of stressed and restricted rats, which exhibited binge-like eating, when compared to non-stressed and non-restricted rats. Consistently, pyrosequencing analysis revealed a significant reduction of the percentage of DNA methylation but only at the A2AAR promoter region in rats showing binge-like behaviour compared to the control animals. Focusing thus on A2AAR agonist (VT 7) administration (which inhibited the episode of binge systemically at 0.1 mg/kg or intra-central amygdala (CeA) injection at 900 ng/side) induced a significant increase of A2AAR mRNA levels in restricted and stressed rats when compared to the control group. In addition, we observed a significant decrease in A2AAR mRNA levels in rats treated with the A2AAR antagonist (ANR 94) at 1 mg/kg. Consistent changes in the DNA methylation status of the A2AAR promoter were found in restricted and stressed rats after administration of VT 7 or ANR 94.

Conclusion:

We confirm the role of A2AAR in binge eating behaviours, and we underline the importance of epigenetic regulation of the A2AAR gene, possibly due to a compensatory mechanism to counteract the effect of binge eating. We suggest that A2AAR activation, inducing receptor gene up-regulation, could be relevant to reduction of food consumption.
Manipulating the 5 Dimensions of the EuroQol Instrument: The Effects on Self-Reporting Actual Health and Valuing Hypothetical Health States
Authors: Tsuchiya Aki , Bansback Nick , Hole Arne Risa , Mulhern Brendan
Published: June 2019

Background. The EQ-5D instrument has 5 dimensions. This article reports on the effects of manipulating a) the order in which the 5 dimensions are presented (appearing first v. last), b) splitting of the composite dimensions (“pain or discomfort” and “anxiety or depression”), and c) removing or “bolting off” 1 of the 5 EQ-5D dimensions at a time. The effects were examined in 2 contexts: 1) self-reporting health and 2) health state valuations. Methods. Three different types of discrete choice experiments (DCE) including a duration attribute were designed. An online survey with 12 subtypes, each with 10 DCE tasks, was designed and completed by 2494 members of the UK general public. Results. Of the 3 manipulations in the self-reporting context, only b) splitting anxiety or depression had a significant effect. In the health state valuation context, b) splitting level 5 pain or discomfort (relative to pain) and splitting level 5 anxiety or depression (relative to anxiety) had significant effects as did c) bolting off dimensions. Conclusions. We find that the values given to certain health dimensions are sensitive to the way in which it is described and the other health dimensions presented. Of particular interest is the effect of splitting composite dimensions: a given EQ-5D(-5L) profile may mean different things depending on whether the profile is used to self-report one’s health or to value hypothetical states, so that the health state values of EQ-5D(-5L) in population tariffs may not correspond to the states that patients self-report themselves in.
Commercial Vehicle Parking in Downtown Seattle: Insights on the Battle for the Curb
Authors: Girón-Valderrama Gabriela del Carmen , Machado-León José Luis , Goodchild Anne
Published: June 2019

Rapid urban growth puts pressure on local governments to rethink how they manage street curb parking. Competition for space among road users and lack of adequate infrastructure force delivery drivers either to search for vacant spaces or to park in unsuitable areas, which negatively impacts road capacity and causes inconvenience to other users of the road. The purpose of this paper is to advance research by providing data-based insight into what is actually happening at the curb. To achieve this objective, the research team developed and implemented a data collection method to quantify the usage of curb space in the densest urban area of Seattle, Center City. This study captures the parking behavior of commercial vehicles everywhere along the block face as well as the parking activities of all vehicles (including passenger vehicles) in commercial vehicle loading zones. Based on the empirical findings, important characteristics of Seattle’s urban freight parking operations are described, including a detailed classification of vehicle types, dwell time distribution, and choice of curb use for parking (e.g., authorized and unauthorized spaces). The relationship between land use and commercial vehicle parking operations at the curb is discussed. Seattle’s parking management initiatives will benefit from the insights into current behavior gained from this research.
Efficacy of Platelet-Rich Plasma for the Treatment of Interstitial Supraspinatus Tears: A Double-Blinded, Randomized Controlled Trial
Authors: Schwitzguebel Adrien J. , Kolo Frank C. , Tirefort Jérôme , Kourhani Abed , Nowak Alexandra , Gremeaux Vincent , Saffarini Mo , Lädermann Alexandre
Published: June 2019

Background:

The benefits of platelet-rich plasma (PRP) for the treatment of rotator cuff tears remain inconclusive, as it is administered either as an adjuvant to surgical repair or as a primary infiltration without targeting the index lesion, which could dilute its effect.

Purpose:

To determine whether PRP infiltrations are superior to saline solution infiltrations (placebo) at improving healing, pain, and function when injected under ultrasound guidance within isolated interstitial supraspinatus tears.

Study Design:

Randomized controlled trial; Level of evidence, 1.

Methods:

In this single-center, double-blinded, randomized controlled trial, 80 adults with symptomatic isolated interstitial tears of the supraspinatus, confirmed by magnetic resonance arthrography, were randomized to PRP or saline injections. Each patient received 2 injections with a 1-month interval. The primary outcome was the change in lesion volume, calculated on magnetic resonance arthrography, at 7 months. The secondary outcomes were improvements in shoulder pain and the Single Assessment Numerical Evaluation (SANE) score at >12 months.

Results:

Preoperative patient characteristics did not differ between the 2 groups. At 7 months, there were no significant differences between the PRP and control groups in terms of a decrease in lesion size (–0.3 ± 23.6 mm3 vs –8.1 ± 84.7 mm3, respectively; P = .175); reduction of pain on a visual analog scale (VAS) (–2.3 ± 3.0 vs –2.0 ± 3.0, respectively; P = .586); and improvement in SANE (16.7 ± 20.0 vs 14.9 ± 29.0, respectively; P = .650), Constant (8.6 ± 13.0 vs 10.7 ± 19.0, respectively; P = .596), and American Shoulder and Elbow Surgeons (19.5 ± 20.0 vs 21.9 ± 28.0, respectively; P = .665) scores. At >12 months, there were no significant differences between the PRP and control groups in terms of a reduction of pain on a VAS (–3.3 ± 2.6 vs –2.3 ± 3.2, respectively; P = .087) or improvement in the SANE score (24.4 ± 27.5 vs 23.4 ± 24.9, respectively; P = .846). At 19.5 ± 5.3 months, the incidence of adverse effects (pain >48 hours, frozen shoulder, extension of lesion) was significantly higher in the PRP group than the control group (54% vs 26%, respectively; P = .020).

Conclusion:

PRP injections within interstitial supraspinatus tears did not improve tendon healing or clinical scores compared with saline injections and were associated with more adverse events.

Registration:

NCT02672085 (ClinicalTrials.gov identifier).
Fidelity of Implementation in the Field of Learning Disabilities
Authors: Sanetti Lisa M. Hagermoser , Luh Hao-Jan
Published: June 2019

Decades of research and billions of dollars have been spent to develop and evaluate evidence-based interventions and develop multitiered systems of support (MTSS) toward the goal of more effectively delivering interventions and improving student outcomes. Available evidence, however, suggests interventions are often adopted slowly and delivered with poor fidelity, resulting in uninspiring outcomes for students. The field of implementation science has emerged to address the science-to-practice gap in human service sectors (e.g., education) as a way of improving service recipient (e.g., student) outcomes. For the considerable investment in school-based intervention development and evaluation to have a significant public health impact for students, educators must integrate key findings from implementation science into their practice and research. Toward this end, the purpose of this article is four-fold. First, it overviews implementation science and implementation theories, models, and frameworks. Second, it discusses the relevance of implementation science and fidelity to both the systems-level implementation of MTSS and individual-level implementation of interventions to students with learning disability (LD). Third, it reviews the unique legal aspects related to service implementation for students with LD and the gap between state-level mandates and available science. Finally, it provides additional resources and recommendations for readers.
Whining noise computation of a planetary gear set induced by the multi-mesh excitations
Authors: Neufond Jessica , Denimal Enora , Rigaud Emmanuel , Perret-Liaudet Jöel , Carbonelli Alexandre
Published: June 2019

A complete procedure for the whining noise computation of a planetary gear set induced by the multi-mesh excitations is presented. This procedure is divided into three main steps. First, the parametrical internal excitations are simultaneously characterized by considering all contacts at the multiple gear meshes. Secondly, a finite element model of the planetary gear set is built. Finally, the coupled equations of motion are projected onto the modal basis and the stationary dynamic response is computed using an iterative spectral method.
Prevalence and correlates of cervical abnormalities among female sex workers in Tijuana, Mexico
Authors: Bristow Claire C , Brown Brandon , Marg Logan , Iñiguez Raquel I , Meckel-Parker Kristen , Silverman Jay G , Magis-Rodriguez Carlos , Gaines Tommi L , Brouwer Kimberly C
Published: June 2019

In Tijuana, Mexico, sex work is regulated by the municipal health department and includes regular testing for HIV and other sexually transmitted infections (STIs) for registered female sex workers (FSWs). However, Papanicolaou (Pap) testing is missing from current sexual health assessments. We aimed to answer the following research questions: (1) What is the prevalence of cervical abnormalities among a sample of FSWs in Tijuana, Mexico? (2) What are the correlates of cervical abnormalities among a sample of FSWs in Tijuana, Mexico? From 2013 to 2014, a cohort of 300 FSWs in Tijuana, Mexico were recruited using modified time–location sampling. Participants were given Pap, HIV, and STI tests. The prevalence of an abnormal Pap was 11.7% (35/300). FSWs ever registered with municipal health services were less likely to have an abnormal Pap result (4.8% versus 14.4%, p = 0.03), were more likely to report a previous Pap test (88.1% versus 70.4%, p = .001), and were more likely to report a sexual health checkup in the last year (60.7% versus 37.0%, p < 0.001) than those who had never been registered. FSWs, including those who registered with the municipality, remain at risk for cervical abnormalities.
Immune reconstitution inflammatory syndrome in an HIV-infected patient with disseminated coccidioidomycosis
Authors: Lin Andrew Y , Chun Victor , Dhamija Anish , Bordin-Wosk Talya , Kadakia Ankita
Published: June 2019

Immune reconstitution inflammatory syndrome (IRIS) is a condition characterized by excessive inflammatory response to an underlying pathogen following immune recovery. IRIS associated with coccidioidomycosis infection is rare, with only a few cases reported to date. Unfortunately, the mortality rate for disseminated coccidioidomycosis-related IRIS in the available literature is extremely high. We present a case of paradoxical IRIS associated with disseminated coccidioidomycosis in an HIV-infected patient following initiation of antiretroviral therapy, who was successfully treated with steroid therapy.
Challenges and motivators for male partner involvement in prenatal care for HIV testing in a tertiary setting in Brazil
Authors: Yeganeh Nava , Kerin Tara , Simon Mariana , Nielsen-Saines Karin , Klausner Jeffrey D , Santos Breno , Melo Marineide , Fitter Samantha , Gorbach Pamina M.
Published: June 2019

Male partner involvement in prenatal care has been shown to improve outcomes for the entire family in low- and middle income countries. In Brazil, partners of pregnant women are encouraged to attend prenatal care for HIV testing. From November 2016 to July 2017, male partners of women delivering at Hospital Conceiçao were interviewed using computer-assisted telephone interviews regarding individual, relationship and system-wide facilitators and barriers to attending prenatal care. Of 403 men interviewed, 202 attended prenatal care and 201 did not. Individual factors that predicted prenatal care attendance included over-estimating the risk of mother to child transmission (AOR 2.13, 95% CI: 1.35–3.4), and endorsing that HIV-infected individuals can live satisfying lives (AOR 7.24, 95% CI: 1.9–47.5). Partnership factors associated with attendance included invitation by partner (AOR 5.6, 95% CI: 2.4–15.6). Systemic factors negatively associated with prenatal care attendance included a history of not being able to afford medical care (AOR 0.3, 95% CI: 0.15–0.6) and identifying work as a barrier to prenatal care attendance (AOR 0.19 95% CI: 0.11–0.31). Partners should be actively invited to prenatal care during flexible flexible hours. Once involved, almost all would accept HIV and sexually transmitted infection (STI) testing to protect partners and unborn infants during this vulnerable period.
Hemorrhagic brain lesions in a newly diagnosed HIV-1 infected patient
Authors: Pellegrino D , de Lima Patricia Picciarelli , de Oliveira Augusto César Penalva , Vidal José E
Published: June 2019

We report the case of a previously healthy 29-year-old man who has sex with men who was admitted with sub-acute onset of headache, seizures and altered mental status. Physical examination revealed oral thrush, mental confusion and right hemiparesis. An unenhanced computed tomography of the brain revealed multiple rounded hemorrhages associated with perilesional edema and no enhancement was seen after contrast infusion. A rapid test for HIV-1 was positive and the CD4 T-lymphocyte count was 120 cells/mm3. Pyrimethamine, sulfadiazine plus folinic acid and dexamethasome were started. After two weeks of treatment, the clinical condition and neuroimaging of the patient remained unaltered. A stereotactic brain biopsy was performed and the histopathologic examination confirmed the diagnosis of hemorrhagic toxoplasmosis. After a longer course of anti-Toxoplasma treatment due to an incomplete clinical and radiological response, the patient was discharged home. Hemorrhagic toxoplasmosis is a rare presentation of cerebral toxoplasmosis and should be considered in the differential diagnosis of hemorrhagic cerebral lesions in HIV-infected patients in order to initiate specific treatment promptly.
Numerical investigation of deep surge in a centrifugal compressor with vaned diffuser and large plenum
Authors: Yang Zhao , Guang Xi , Zhiheng Wang , Pengfei Zhang
Published: June 2019

As the flow rate decreases from stable point to surge point, the complex unsteady flow phenomenon of surge occurs in a centrifugal compressor, which has a significant influence on vast aspects of a compressor. To advance deep understanding of the feature of the deep surge phenomenon, the RANS/URANS numerical simulation is conducted on a centrifugal compressor with a large plenum to analyze the detailed internal flow field in the compressor together with the macroscopic characteristics of the deep surge cycle. The anticlockwise limit cycle obtained from the simulation is firstly analyzed to show the transient characteristics of the stage. Then the variation of blade torque and axial force is presented to show the transient feature in surge cycle together with the proposed prediction of blade torque versus mass flow rate. Meanwhile, there exist different characteristics of the pressure fluctuation along the streamwise direction of the impeller blade, especially the large variation of blade loading near the trailing edge. And the fluctuation of flow field can respectively suppress or promote the hub-corner separation at the process of acceleration or deceleration region, affecting the development of diffuser stall in the surge cycle. The detailed analysis can be helpful to develop the surge model of lumped parameters and determine the effect of surge on impeller blades or downstream components.
Suppression of hump characteristic for a pump-turbine using leading-edge protuberance
Authors: Zhiwei Guo , Chihang Wang , Zhongdong Qian , Xianwu Luo , Weipeng Xia
Published: June 2019

The application of wave guide vanes with bio-inspired leading-edge protuberances to the hump characteristic of a pump-turbine is examined in this study. Numerical simulation with a shear-stress transport turbulence model is used to calculate the three-dimensional flow in a pump-turbine in pumping mode. Three tubercle amplitudes of 0.02c, 0.04c, and 0.08c (c is chord length), and three spanwise wavenumbers (2/s, 4/s and 8/s, s is the length of span) for guide vanes are especially considered. The results obtained show that the simulated performances of original guide vanes are found to be in good qualitative agreement with experimental data, supporting the validation of the computational fluid dynamics method. For different wave guide vanes with leading-edge protuberances, it is shown that the hump characteristic of the pump-turbine in pumping mode is effectively improved. This is due to improved flow fields below the tongue in view of entropy production and vector field. The energy loss can be clearly compared through the entropy distribution for different locations of the guide vanes, and it is improved for the wave guide vanes with bio-inspired leading-edge protuberances. For current pump-turbine, the optimal amplitude and wavenumber are found to be around 0.04c and 4/s.
Prevalence of cognitive impairment using the Montreal Cognitive Assessment questionnaire among patients with systemic lupus erythematosus: a cross-sectional study at two tertiary centres in Malaysia
Authors: Kanapathy A , Nik Jaafar N R , Shaharir S S , Chan L F , Rozita M , Ch’ng S S
Published: June 2019

Introduction

Cognitive impairment is a common neuropsychiatric manifestation of systemic lupus erythematosus (SLE). However, it is not routinely assessed for despite its high prevalence and significant disease burden.

Aims

This study aimed to determine the prevalence of mild cognitive impairment (MCI) using the Montreal Cognitive Assessment (MoCA) and its associated factors among patients diagnosed with SLE in Malaysia.

Methods

A total of 200 SLE patients were recruited prospectively from the outpatient clinics of two tertiary hospitals in Malaysia. Standardized clinical interview was utilized to obtain information on socio-demographic characteristics. All patients were then assessed using the MoCA questionnaire for presence of cognitive impairment; the Patient Health Questionnaire 9 (PHQ-9) for presence of depressive symptoms; and the Wong–Baker Faces Pain Scale (WBFPS) for severity of pain. The evaluation of disease activity and severity were performed by the treating rheumatologists and nephrologists using the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and Systemic Lupus International Collaborating Clinics Damage Index (SLICC DI).

Results

The prevalence of MCI was 35%. The significant associated factors from the bivariate analysis were male gender ( p = 0.04), educational level ( p = 0.00), WBFPS score ( p = 0.035) and anticardiolipin IgM ( p = 0.01). Further analysis using logistic regression model found that male gender (OR = 7.43, 95% confidence interval 1.06–52.06, p = 0.04), lower educational level (OR = 4.4, 95% confidence interval 1.47–13.21, p = 0.01) and presence of anticardiolipin IgM (OR = 6.81, 95% confidence interval 1.45–32.01, p = 0.031) were associated with impaired MoCA scores. Also, increasing pain scores increased the risk of patients being affected by cognitive impairment.

Conclusion

Over one-third of patients with SLE in our cohort were found to have MCI. Risk factors included male gender, lower educational level, higher pain score and presence of anticardiolipin IgM. Physicians are encouraged to perform routine screening to detect cognitive dysfunction in patients with SLE in their clinical practice as part of a more comprehensive management.
Changing hospitalization trends for systemic lupus erythematosus and rheumatoid arthritis in England
Authors: Hannah J , Galloway J , Kaul A
Published: June 2019

Objectives

Systemic lupus erythematosus (SLE) is a chronic, multisystemic, immune-mediated disorder associated with a substantial hospitalization risk. As a comparatively rare disease, there is a sparsity of research examining the burden of hospital admission in the contemporary era. We aim to describe national trends in hospitalization rates in England between 1998 and 2015 for SLE, using rheumatoid arthritis (RA) and general population rates as comparison cohorts for benchmarking.

Methods

Hospital admission rates, emergency and day-case admission rates, length of stay and bed days used were calculated using finished consultant episodes from Hospital Episode Statistics data. Cochran-Armitage tests and linear regression quantified the significance and magnitude of change over time.

Results

SLE admissions increased from 8.97 to 9.04 per 100,000 ( p < 0.001) between 1998 and 2015. By comparison, RA admissions rose from 71.0 to 171.6 per 100,000 ( p < 0.001) and all-cause admissions rose from 24,500 to 34,500 per 100,000 ( p < 0.001). Emergency admissions decreased both for SLE (2.6 to 1.2 per 100,000) and RA (12.8 to 4.4 per 100,000) despite all-cause emergency admissions increasing from 9400 to 10,300 per 100,000. SLE and RA day cases increased, whilst median length of stay decreased. Despite increasing admissions, total bed days for SLE and RA fell by 60% and 90%, respectively.

Conclusions

Whilst all-cause emergency admissions rose in the general population, those for SLE fell. Length of stay and bed days reduced and day cases increased, probably reflecting changing therapeutic strategies. This potentially large reduction in resource utilization warrants consideration when assessing the impact of new therapies.
Moisture sorption isotherm of cross-linked wheat gluten and epoxydized oil using GAB and BET
Authors: Mohamed AA , Alamri MS , Hussain S , Ibraheem MA , Abdo Qasem Akram A
Published: June 2019

The moisture sorption isotherm of wheat gluten/epoxydized sesame or sunflower oil resin was determined at 25, 40, and 55°C. The resin was prepared by cross-linking epoxydized oil and wheat gluten using 1, 2, and 3% zinc chloride as the catalyst. The experiment was carried out over 0.1–0.9 water activity ( a w) range using gravimetric sorption analyzer (Q 2000, TA Instruments, New Castle, PA, USA). The resin isotherms were found to be type III shape where the equilibrium moisture content (EMC) was higher at lower temperatures. The EMC of gluten epoxy resin was dependent on the degree of cross-linking because more cross-linking decreased EMC. The Guggenheim Anderson-de Boer (GAB) parameters support the theory of the free volume as it relates to monolayer absorption. This could be attributed to the decrease in the number of water binding sites due to the development of dense areas during cross-linking and increase in the free volume. The GAB and Brunauer–Emmett–Teller were found to be suitable for predicting the water sorption isotherm for gluten protein resin because it provided low root mean square error. The heat of sorption based on the Clausius–Clapeyron equation (qst) increased with decrease in moisture content.
Evolution of Indigenous Rights Under International Law: Analysis from TWAIL Perspective
Authors: Shrinkhal Rashwet
Published: June 2019

Indigenous people are the most socially, politically, and economically marginalized groups in the world. They are the most oppressed on account of the fact that the values sustaining the moral roots of their culture are considered incompatible with the values of modern culture. This article traces the evolution of rights of indigenous people in international law. It argues that discrimination against indigenous people was maintained under international law based on differences on scale of civilization. It will demonstrate how ‘universal standards’ may be applied not as an agent of liberation but dominance. In doing so, Third World Approaches to International Law (TWAIL) perspective is adopted to deconstruct international law.
Magnetorheological elastomer peristaltic fluid conveying system for non-Newtonian fluids with an analogic moisture loss process
Authors: Wu Chenjun , Zhang Qingxu , Fan Xinpeng , Song Yihu , Zheng Qiang
Published: June 2019

A magnetorheological elastomer peristaltic fluid conveying system consisting of a magnetorheological elastomer tube and two electromagnets implements controlled movements via an external magnetic field with varying periods of driving voltages to convey non-Newtonian fluids over a certain time period. The effects of backpressure at the outlet of the magnetorheological elastomer peristaltic fluid conveying system, the viscosity of fluids at zero shear rate, and moisture loss along the longitudinal direction on net pumped volume are investigated systematically. The results demonstrate that the net pumped volume declines linearly with backpressure under all driving voltage periods. An improvement of the viscosity of fluids at zero shear rate allows at first the decrease, then the increase, and finally the decrease of the net pumped volume. Moisture loss plays a second role in the net pumped volume and the change of the fluid viscosity profile. The compression of the magnetorheological elastomer tube, the maximum shear stress, and the maximum von Mises stress in the magnetorheological elastomer peristaltic fluid conveying system are investigated to evaluate the magneto-fluid-structure interaction. This research offers a new approach to biological fluid conveying with an analogic moisture loss process.
Craniofacial Cleft: A Case of Tessier 10 Cleft With a Novel Method to Repair Large Bilateral Colobomas
Authors: Barnett Joshua M. , Pang John H. Y. , Herman Sean , Lee Jonathan , Stefko S. Tonya , Losee Joseph E. , Goldstein Jesse
Published: June 2019

Objective:

To describe a reliable method utilizing large, rotation flaps to reconstruct a number 10 Tessier cleft.

Design:

This is a descriptive clinical case report.

Setting:

Pediatric teaching hospital affiliated with a university.

Patients, Participants:

One participant in this clinical case report.

Interventions:

Full-thickness excision of the clefted eyelid, brow, and forehead tissue was performed bilaterally to develop medial and lateral eyebrow and forehead flaps. Right: the forehead/brow flap was rotated caudally to reapproximate the eyebrow and an eyelid rotation flap was also used to reapproximate the lid margin. Left: forehead/brow rotation flap allowed realignment of the eyebrow and a series of Z-plasties were used in the eyelid to reapproximate the lid margin and to lengthen the eyelid.

Main Outcome Measure(s):

Develop and construct a reliable reconstruction with full-eyelid closure and minimal donor site morbidity.

Results:

Complete eyelid closure bilaterally was achieved intraoperatively, and was maintained at 6-month follow-up with no evidence of ocular pathology.

Conclusions:

Large, bilateral upper eyelid colobomas require repair to prevent blindness. Although free tarsomarginal grafts and lid-sharing procedures have been described, we demonstrate that large rotation flaps designed along the cleft margin can provide a reliable reconstruction and minimize donor-site morbidity.
It’s Complicated: Patient and Informal Caregiver Performance of Outpatient Parenteral Antimicrobial Therapy-Related Tasks
Authors: Keller Sara C. , Cosgrove Sara E. , Arbaje Alicia I. , Chang Rachel H. , Krosche Amanda , Williams Deborah , Gurses Ayse P.
Published: June 2019

Outpatient parenteral antimicrobial therapy (OPAT) requires patients and caregivers to infuse antimicrobials through venous catheters (VCs) in the home. The objective of this study was to perform a patient-centered goal-directed task analysis to identify what is required for successful completion of OPAT. The authors performed 40 semi-structured patient interviews and 20 observations of patients and caregivers performing OPAT-related tasks. Six overall goals were identified: (1) understanding and developing skills in OPAT, (2) receiving supplies, (3) medication administration and VC maintenance, (4) preventing VC harm while performing activities of daily living, (5) managing when hazards lead to failures, and (6) monitoring status. The authors suggest that patients and caregivers use teach-back, take formal OPAT classes, receive visual and verbal instructions, use cognitive aids, learn how to troubleshoot, and receive clear instructions to address areas of uncertainty. Addressing these goals is essential to ensuring the safety of and positive experiences for our patients.
In-Situ Adaptation and Coastal Vulnerabilities in Ghana and Tanzania
Authors: Yang Jeasurk , Owusu Victor , Andriesse Edo , Dziwornu Ablo Austin
Published: June 2019

Coastal fisheries communities in sub-Saharan Africa are under high socioeconomic vulnerability in the face of environmental pressures. This article contributes to the current adaptation debate by revisiting the benefits of in-situ adaptation. We assess possible in-situ adaptation strategies amid ongoing vulnerabilities by comparing Ghana and Tanzania. A total of 441 household surveys were conducted in four study sites. The major findings of the study are as follows: First, the three major in-situ adaptation strategies are regular changes of nondestructive fisheries techniques, alternative occupations, and collective action. Second, all three strategies have a significant relationship with income change. Finally, the communities in Tanzania utilized all three strategies more and performed better economically than those in Ghana. On the basis of these insights, we suggest implications of in-situ adaptation for future coastal development in sub-Saharan Africa.