bluuebunny/crossref_metadata_2025 huggingface dataset:
Living the Art and Science of Nursing: Flow and Transitioning
Authors: Carroll Karen
Published: December 2019

Nurses, based on their unique disciplinary knowledge and role, serve as key members of interdisciplinary teams to guide assessments and interventions addressing patient’s goals in flow and transitions of care. This introductory column represents selected thoughts on bridging theory and practice with patient flow and transitions.
Conceptual Foreknowings: An Integrative Review of Hope
Authors: Doe Mi Jin
Published: December 2019

Hope is a universal humanuniverse living experience. To advance nursing knowledge of hope as a universal humanuniverse living experience, the scholar dwelled with printed material on hope and explored with pattern preferences. The purpose of this paper is to set forth the conceptual foreknowings arising from the integrative review of literature from diverse disciplines. Four themes arose from the review, which are elaborated here.
The Prismatic Midparadigm of Nursing
Authors: Littzen Chloe O. R. , Langley Carrie A. , Grant Consuelo A.
Published: December 2019

The disciplinary perspective of nursing is guided in part by its metaparadigm, which includes the concepts of human beings, environment, health, and nursing. While relevant to the discipline as a whole, these abstract concepts are not meant for operationalization into the practice environment. The authors in this paper introduce a midparadigm of nursing—namely, the prismatic midparadigm—for applications in research, practice, policy, and education. It is a framework of concepts that are less abstract, but congruent with, the metaparadigm and more specific to the practice environment with the context of vulnerability as central.
End of Life Decision-Making: Watson’s Theory of Human Caring
Authors: Murali Komal Patel
Published: December 2019

The phenomenon of end-of-life (EOL) decision-making is a lived experience by which individuals or families make decisions about care they will receive prior to death. A postmodern philosophical approach suggests EOL decision-making is a varied contextual phenomenon that is highly influenced by subjectivity. Thus, there is no specific definition for the phenomenon of EOL decision-making. Watson’s theory of human caring complements a postmodern approach in guiding the nursing process of caring for individuals as they experience EOL decision-making.
Biomechanical assessment of the stability of osteochondral grafts implanted in porcine and bovine femoral condyles
Authors: Bowland Philippa , Cowie Raelene M , Ingham Eileen , Fisher John , Jennings Louise M
Published: December 2019

Osteochondral grafts are used clinically to repair cartilage and bone defects and to restore the congruent articulating surfaces of the knee joint following cartilage damage or injury. The clinical success of such osteochondral grafts is heavily reliant on the biomechanical and tribological properties of the surgical repair; however, a limited number of studies have investigated these factors. The aim of this study was to evaluate the influence of graft harvesting and implantation technique as well as bone properties on the primary stability of press-fit implanted osteochondral grafts using a series of uniaxial experimental push-in and push-out tests. Animal (porcine and bovine) knees were used to deliver models of different bone properties (elastic modulus and yield stress). The study showed the graft harvesting method using either a chisel or drill-aided trephine to have no influence on primary graft stability; however, the preparation technique for the graft recipient site was shown to influence the force required to push the graft into the host tissue. For example, when the length of the graft was equal to the recipient site (bottomed), the graft was more stable and dilation of the recipient site was shown to reduce short-term graft stability especially in immature or less dense bone tissue. The push-out tests which compared tissue of different skeletal maturities demonstrated that the maturity of both the graft and host bone tissue to influence the stability of the graft. A higher force was required to push out more skeletally mature grafts from mature bone tissue. The study demonstrates the importance of surgical technique and bone quality/properties on the primary stability and ultimately, the success of osteochondral grafts in the knee.
Barriers to condom use among key populations in Namibia
Authors: Russell Colin , Tahlil Kadija , Davis Margaret , Winston Anna , Amaambo Taimi , Hamunime Ndapewa , Pietersen Ismelda , Jordan Michael R , Tang Alice M , Hong Steven Y
Published: December 2019

Key populations (KPs), particularly female sex workers (FSWs) and men who have sex with men (MSM), are at increased risk for HIV. Namibia is a global priority for HIV prevention interventions. Marginalized communities must be provided effective and culturally appropriate means to prevent HIV, namely condom use. This cross-sectional analysis of data collected by The Society for Family Health was conducted from 2016 to 2017 in Namibia. Demographics and consistent condom use (CCU) barriers were analyzed among 621 FSWs, MSM, and Other KPs. From the data, 37% FSWs, 24% MSM, and 28% Other KPs were HIV-positive. One-quarter of FSWs and Other KPs reported CCU, while 46% MSM reported CCU. Consistent condom users were more likely to be HIV-negative, have achieved a higher education and use condom-compatible lubricant (CCL). In a multivariate model, higher education, being HIV-negative, and always using CCL remained independent correlates of CCU. Substance use and condom unavailability were the most commonly identified barriers to CCU. FSWs reported client-focused reasons for not using condoms. To the best of our knowledge, this is the first peer-reviewed study assessing condom use behavior and associated factors among FSWs and MSM in Namibia.
Audit of patient retention in pre-exposure prophylaxis (PrEP) services in an integrated sexual reproductive health service setting
Authors: Cochrane Eleanor , Knapper Carys
Published: December 2019

Pre-exposure prophylaxis (PrEP) for HIV in Wales was launched in July 2017. We set up a PrEP service delivered via our integrated sexual reproductive health service in Aneurin Bevan University Health Board (ABUHB), south east Wales. Public Health Wales (PHW) data show a 22% ‘lost to follow-up’ rate amongst Welsh PrEP patients. Over 18 months, 278 patients booked into ABUHB PrEP clinics. Of these, 275 were men who have sex with men (MSM). One hundred and ninety-three patients commenced PrEP, 5 were diagnosed with HIV at baseline, 42 did not attend their first appointment. The remainder declined PrEP. Of those commenced on PrEP, 51.7% had reduced clinic attendances; all were MSM. Patients with reduced attendances were more likely to be younger (mean age 33 vs. 37 years), reside outside ABUHB catchment area (56.4% vs. 49.6%) and have mental health issues (28.6% vs. 18.8%), but were less likely to disclose substance misuse (24.2% vs. 27.1%) than those attending in line with operational guidance. Of the 63 patients who stopped attending the PrEP clinic, 32.3% (21) had documented reasons, the most common being reduced self-perceived risk. This is the first evaluation of reasons why patients stop attending as well as risk factors associated with those lost to follow-up in PrEP services in Wales.
Off-design performance improvement of twin-shaft gas turbine by variable geometry turbine and compressor besides fuel control
Authors: Sanaye Sepehr , Hosseini Salahadin
Published: December 2019

A novel procedure for finding the optimum values of design parameters of industrial twin-shaft gas turbines at various ambient temperatures is presented here. This paper focuses on being off design due to various ambient temperatures. The gas turbine modeling is performed by applying compressor and turbine characteristic maps and using thermodynamic matching method. The gas turbine power output is selected as an objective function in optimization procedure with genetic algorithm. Design parameters are compressor inlet guide vane angle, turbine exit temperature, and power turbine inlet nozzle guide vane angle. The novel constrains in optimization are compressor surge margin and turbine blade life cycle. A trained neural network is used for life cycle estimation of high pressure (gas generator) turbine blades. Results for optimum values for nozzle guide vane/inlet guide vane (23°/27°–27°/6°) in ambient temperature range of 25–45 ℃ provided higher net power output (3–4.3%) and more secured compressor surge margin in comparison with that for gas turbines control by turbine exit temperature. Gas turbines thermal efficiency also increased from 0.09 to 0.34% (while the gas generator turbine first rotor blade creep life cycle was kept almost constant about 40,000 h). Meanwhile, the averaged values for turbine exit temperature/turbine inlet temperature changed from 831.2/1475 to 823/1471°K, respectively, which shows about 1% decrease in turbine exit temperature and 0.3% decrease in turbine inlet temperature.
Investigation into the outlying swirl instability in the hydro-turbine draft tube under part-load operation
Authors: Muhirwa Alexis , Cai Wei-Hua , Li Feng-Chen , Su Wen-Tao , Binama Maxime , Li Biao , Li Xiao-Bin
Published: December 2019

The swirling trajectory of the draft tube flow improves the pressure recovery. Resultant flow instabilities are still problematic for an optimized hydropower generation. Engineering solutions are getting increasing importance. However; the depth of wall-mounted countermeasures is a challenging parameter. Performance assessment of countermeasures would rate dampened pressure pulsations in terms of their sources so as to place them at a proper location. A method for evaluating the instability in the outlying domain of the draft tube cone is herein suggested. Two part-load operating points with opposite polarity in pressure pulsations have been investigated. The numerical approach of Shear Stress Transport has been used, and experimental agreement of measurements for the pressure spectra is verified at the wall. Inlet flow conditions and the growth of the core instability are described. The outlying domain of the draft tube has been found to be composed of three distinct zones of influence: the shortest upper cone with upstream travelling influences, the longest middle cone with core excitation, and the lowermost cone dominated by the backward elbow influence. The wall response lies within a definite high-frequency range proper to the operating point. During admission, the frequency range becomes even wider due to high kinetic energy and the highest pressure amplitude of the draft tube is developed by the impact of blade passing frequency. The excitation from the vortex rope precession in the outlying domain strongly depends on the operating condition. Thus, further works should extend this study over a wider operation range, and mount pressure sensors on countermeasures in order to identify their own instability contribution.
Investigating the effect of using nanofluids on the performance of a double-effect absorption refrigeration cycle combined with a solar collector
Authors: Aramesh Mohamad , Pourfayaz Fathollah , Haghir Mehdi , Kasaeian Alibakhsh , Ahmadi Mohammad H
Published: December 2019

In this article, the performance of a double-effect LiBr-H2O absorption refrigeration cycle is studied and is improved by applying solar energy and utilizing nanofluids. A trough collector is used to preheat the working fluid before entering the generator of the cycle. In addition, four different nanofluids are considered as the heat transfer fluid of the collector: Al2O3, Ag, Cu, and CuO. The effects of using nanofluids on the outlet temperature of the heat transfer fluid, the temperature of the working fluid entering the generator, the heat produced by the generator, and COP of the cycle are studied. Different concentrations of the nanoparticles from 0 to 2.5% are considered for the nanofluids. The results indicate that in all the concentrations, Ag nanoparticles will have a better performance comparing to the other types. Furthermore, it was concluded that the higher concentrations of the nanoparticles and along with it the higher inlet temperature of the generator will decrease the generator heat production rate up to 4%. Moreover, considering the constant cooling capacity of the cycle, usage of the Ag nanoparticles in the concentration of 2.5% increases the value of COP up to 3.9%, with respect to the pure water.
The association between heavy metal and serum cholesterol levels in the US population: National Health and Nutrition Examination Survey 2009–2012
Authors: Buhari O , Dayyab FM , Igbinoba O , Atanda A , Medhane F , Faillace RT
Published: December 2019

Background:

Few studies have examined the relationship between heavy metal and serum cholesterol levels, and no recent study has examined this relationship in the US population.

Methods and Results:

A total of 19,591 individuals aged 0–80 years were included in the National Health and Nutrition Examination Survey 2009–2012; the current study was composed of survey participants for whom some or all low-density lipoprotein cholesterol (LDL-C), serum triglyceride, high-density lipoprotein cholesterol, total cholesterol, blood lead (Pb), total blood mercury (Hg), and blood cadmium (Cd) levels had been measured. Three tertiles (T1–T3) of heavy metals were used to explore dose–response association between heavy metal exposure and serum cholesterol level. Logistic regression was used to explore the relationship between tertiles of blood heavy metal levels and serum cholesterol levels after adjusting for age, sex, and socioeconomic status. We have shown that the groups with the highest levels of Pb, Hg, and Cd had a 56%, 73%, and 41% chance, respectively, of having a high total cholesterol level. In study subjects with the highest Pb levels, there was also a 22% chance of being in the group with the highest LDL-C level. An increase in total cholesterol and LDL-C levels was observed from the first to the third tertiles of the heavy metals studied.

Conclusion:

Increasing blood Pb, Hg, and Cd levels were associated with significantly increased odds of high total cholesterol after adjusting for age, sex, and socioeconomic status.
Enhancing Rigor in Quantitative Entrepreneurship Research
Authors: Maula Markku , Stam Wouter
Published: December 2019

Reflecting on common empirical concerns in quantitative entrepreneurship research, recent calls for improved rigor and reproducibility in social science research, and recent methodological developments, we discuss new opportunities for further enhancing rigor in quantitative entrepreneurship research. In addition to highlighting common key concerns of editors and reviewers, we review recent methodological guidelines in the social sciences that offer more in-depth discussions of particular empirical issues and approaches. We conclude by offering a set of best practice recommendations for further enhancing rigor in quantitative entrepreneurship research.
Modeling of strain kinetics of damping viscoelastic magnetically controlled materials in creep mode
Authors: Korobko Evguenia V , Zhurauski Mikalai A , Bateer Buhe , Novikova Zoya A , Kuzmin Vladimir A
Published: December 2019

The results of experimental studies of strain kinetics of composite magnetically controlled materials in the creep mode with preliminary exposure and without exposure are described by the Burgers model with two elastic and two viscous parameters, which is a combination of viscoelastic Kelvin–Voigt and Maxwell models connected in series. The dependence of the model parameters on the magnetic field induction is determined. The values of elastic and viscous parameters increase with increasing magnetic field induction in the range up to 500 mT by one or two orders of magnitude. It was determined that the value of the viscous Maxwell parameter does not change after preliminary exposure in the field. The values of the other two elastic and viscous Kelvin–Voigt parameters increase with exposure in a magnetic field.
Line-patterned hybrid magnetorheological elastomer developed by 3D printing
Authors: Bastola AK , Paudel M , Li L
Published: December 2019

This article presents the development of line-patterned magnetorheological elastomers via 3D printing and their magnetorheological characterization. Herein, we consider five different patterns of magnetorheological fluid filaments that are printed and encapsulated within the elastomer matrix. The 3D-printed magnetorheological elastomers could represent the conventional isotropic and anisotropic magnetorheological elastomers. First, the effect of patterning the magnetorheological fluid filaments and the effect of change in the direction of the magnetic field is studied for all five patterns. Thereafter, the dynamic properties of 3D-printed magnetorheological elastomers under uniaxial deformation are presented. Magnetorheological effect shown by 3D-printed magnetorheological elastomers was found to be depended on the printed patterns as well as the direction of the applied magnetic field. This result showed that the 3D printing method has the potential to produce anisotropic magnetorheological elastomers or unique configuration of magnetic particles within the elastomer matrix. The dynamic testing showed that the storage modulus of 3D-printed magnetorheological elastomers is increased with increasing frequency and decreased with increasing strain amplitude, which signifies that the 3D-printed hybrid magnetorheological elastomers are also viscoelastic materials and the properties are magnetic field dependent as that of current magnetorheological elastomers.
OrthoAligner “NAM”: A Case Series of Presurgical Infant Orthopedics (PSIO) Using Clear Aligners
Authors: Batra Puneet , Gribel Bruno Frazāo , Abhinav B. A. , Arora Anika , Raghavan Sreevatsan
Published: December 2019

Presurgical infant orthopedics (PSIO) is done to reduce the size of the cleft defect along with improving the arch alignment and nasolabial aesthetics in patients with cleft lip and palate, leading to an improvement of nasolabial aesthetics allowing for a tidier and more aesthetic reparative procedure and postsurgical scar. Since the 2000s, clear aligners have slowly and steadily treaded their way as an acceptable orthodontic modality, with their usage and acceptability increasing considerably over the past decade. Thus, from the knowledge gathered in its 10 years working with 3-dimensional (3-D) diagnosis, treatment planning, and 3-D Printing services, Compass 3D (Belo Horizonte, Brazil) developed the OrthoAligner NAM system. This case series highlights one of the world’s first documented cases of PSIO treated with a series of clear aligners.
Energy Transition in Europe and the United States: Policy Entrepreneurs and Veto Players in Federalist Systems
Authors: Balthasar Andreas , Schreurs Miranda A. , Varone Frédéric
Published: December 2019

The focus of this special issue is on the energy transformations taking place in several European countries (Austria, Belgium, Germany, and Switzerland) and at the federal and subnational (state) levels in the United States with special attention given to California. The cases examined all have federalist structures, and with the exception of the federal level of the United States, all have relatively ambitious climate and renewable energy targets. We compare these states out of an interest in better understanding how federalism interacts with energy transitions. The comparison is also intriguing as at the federal level the United States presents a stark contrast with the federalist European countries considered in this special issue but at the subnational level many similarities can be found.
Prevalence and Capacity of Cancer Diagnostics and Treatment: A Demand and Supply Survey of Health-Care Facilities in Kenya
Authors: Wambalaba Francis W. , Son Barbara , Wambalaba Akosa E. , Nyong’o Dorothy , Nyong’o Anyang’
Published: December 2019

The cancer incidence burden is expected to rise to over 85% in sub-Saharan Africa by 2030.1 This alarming trend underscores the need to develop evidence-based interventions that can effectively handle this volatile epidemic. The evidence generation entails the collection of adequate information on burden, pattern, and prevalence of cancer relative to capacity to promote effective decision-making. Accordingly, this study documents the prevalence and types of cancer in Kenya (demand side) and to determine the diagnostic and treatment capacity of the various health facilities to handle cancer cases (supply side). To investigate demand and supply factors for cancer control, the study surveyed 7 of the 47 counties in Kenya during 2013 to 2014. It sampled 1048 patients with cancer records and 12 health-care facilities. The study found that the most frequent age for female patients was at age 52, while for men was at age 62. The most prevalent cancer in women was breast cancer and cancer of the cervix, while for men was cancer of the esophagus and prostate. It was also found that children and rural populations were more vulnerable than it was thought, hence defying the local perception that cancer inflicts only adults and those in urban areas. Accessing cancer screening and treatment was one of the major hurdles as most cancer care services in Kenya were concentrated within a 5-km radius of each other in Nairobi. The limited capacity with respect to diagnosis and treatment has implications to issues of access, proximity, and availability. It is critical that policy makers and practitioners closely review the current public and individual perceptions about the cancer problems and mitigation strategies.
Taxpayer Service Provision and Tax Compliance: Evidence for Large Taxpayers in Jamaica
Authors: Small Oronde , Brown Leanora
Published: December 2019

This research examines the effect of the provision of taxpayer services on filing and payment compliance for the corporate income tax (CIT) and general consumption tax (GCT) for large taxpayers in Jamaica. We focus on taxpayer’s decision to file and pay taxes conditional on reporting positive tax liabilities. The empirical strategy adopts a regression discontinuity design that exploits an exogenous jump in the intensity of taxpayer service delivery that occurs at an arbitrary gross receipts threshold. The results indicate null effects for the CIT where enforcement is relatively weak but positive filing and payment compliance effects for the GCT where enforcement is stronger. This is suggestive of a complementarity between the enforcement strength of the tax regime and service delivery.
Identification of AcrAB-TolC Efflux Pump Genes and Detection of Mutation in Efflux Repressor AcrR from Omeprazole Responsive Multidrug-Resistant Escherichia coli Isolates Causing Urinary Tract Infections
Authors: Chowdhury Nandan , Suhani Sabrina , Purkaystha Auditi , Begum Musammat Kulsuma , Raihan Topu , Alam Md. Jahangir , Islam Kamrul , Azad Abul Kalam
Published: December 2019

Antimicrobial resistance poses a threat in the treatment of infectious diseases in Bangladesh as well as in the world. Multidrug-resistant (MDR) Enterobacteriaceae, the most common cause of one such infectious disease, urinary tract infection (UTI), has contributed to the escalating problem of selecting empiric antibiotics against UTIs. The aim of this study was to investigate the presence of the efflux pump in MDR Escherichia coli isolates from UTI in the North-East region of Bangladesh, to isolate and characterize the AcrAB-TolC efflux pump genes of these locally isolated strains and to do mutation analysis of the efflux pump repressor AcrR gene to understand the AcrAB-TolC efflux pump mechanism. In the presence of omeprazole, an efflux pump inhibitor, every MDR E. coli isolate showed increased susceptibility to at least 1 of the 7 antibiotics investigated, indicating that efflux pump might be involved in their antibiotic resistance. Omeprazole decreased the minimum inhibitory concentration of every antibiotics being investigated by 2- to 8-fold. DNA and the deduced amino acid sequences of the polymerase chain reaction (PCR) products analyzed by bioinformatics tools revealed that the chromosomal AcrAB-TolC and AcrR genes were present in all MDR and antibiotic-susceptible E. coli isolates. However, the deduced amino acid sequences of the amplification refractory mutation system (ARMS) PCR product of the AcrR gene revealed that the substitution of arginine to cysteine at position 45 of AcrR was observed only in the MDR E. coli whose antibiotic susceptibility increased in the presence of omeprazole. Data reported herein support the notion that the increased antibiotic susceptibility of the MDR E. coli isolates in the presence of omeprazole might be due to efflux pump(s) inhibition and the AcrAB-TolC efflux pump might be a contributor to antibiotic resistance when the mutation of arginine to cysteine occurs at position 45 of AcrR.
The influence of heat source distribution on the space cooling load oriented to local thermal requirements
Authors: Liang Chao , Melikov Arsen Krikor , Li Xianting
Published: December 2019

Existing studies have shown that the space cooling load oriented to local thermal requirements is significantly influenced by different heat source distributions. However, numerical methods have been mainly used in the analysis based on a fixed airflow field and ignoring the thermal plume. Here, an experiment in a chamber with mixing ventilation was conducted. The heat sources were simulated by metal barrels and an oil-filled radiator, 13 types of heat source distributions were designed and the local cooling load (LCL) was used as the evaluation index. The results show that (1) the LCL is equal to the total amount of heat sources at the steady state in a room with mixing ventilation only if the heat sources are also distributed uniformly; (2) the LCL decreases with a decrease in the intensity of heat sources, achieving a decrease rate of 47.4%–70.8% in the experiment with different intensities; (3) the LCL is 9.2%–22.3% lower than the total amount of heat sources when these are located near the exhaust diffuser or far away from the target zone; (4) owing to its smaller surface area, the LCL with an oil-filled radiator is 7% lower than that with five metal barrels.
Understanding consumer perceptions of luxury brands
Authors: Romaniuk Jenni , Huang Ava
Published: December 2019

Continuing the stream of luxury brand research that seeks to identify how luxury brands differ from non-luxury brands, we test whether the brand usage and attribute prototypicality influences on consumers’ perceptual responses about non-luxury brands extend to luxury brands. Drawing on data from individuals who qualify in the top 25% income tier in their country, in the United States ( n = 300) and China ( n = 366), across three luxury categories of Fashion, Jewelry, and Watches, we find that brand usage and attribute prototypicality patterns drive baseline response levels for brands on luxury attributes. Furthermore, a calculation from Romaniuk and Sharp is able to accurately estimate scores (±2pp) for over 90% of luxury brands of the 580 brand–luxury attribute combinations tested. The ability to benchmark scores for brands on luxury attributes will enable practitioners to separate real differences in the positioning of luxury brands from those that simply reflect the current size of the brand’s customer base, and over time more effectively detect the effect of luxury brand marketing activities on consumers.
Survivor-Defined Advocacy in the Civil Protection Order Process
Authors: Costello John , Durfee Alesha
Published: December 2019

This study examines how lay legal advocates meet petitioners’ extralegal and legal needs during the protection order process using survivor-defined advocacy. We conducted interviews with 20 lay legal advocates and identified four ways in which advocates provided services consistent with survivor-defined advocacy, including court accompaniment, safety planning, meeting petitioners’ extralegal needs, and centering the survivor as the decision-maker. We discuss our results in light of previous research on survivor-defined advocacy and describe the implications in the context of current domestic violence law and policy, including the need to enhance lay legal advocates’ ability to provide survivor-defined approaches in their services.
Relationship Between Cannabis Use and Erectile Dysfunction: A Systematic Review and Meta-Analysis
Authors: Pizzol Damiano , Demurtas Jacopo , Stubbs Brendon , Soysal Pinar , Mason Corina , Isik Ahmet Turan , Solmi Marco , Smith Lee , Veronese Nicola
Published: December 2019

Globally, there is increasing usage and legalization of cannabis. In addition to its reported therapeutic effects, cannabis has several health risks which are not clearly defined. Erectile dysfunction (ED) is the most common male sexual disorder and there are plausible mechanisms linking cannabis use to ED. No attempt has been made to collate the literature on this topic. The aim of this review was to summarize the prevalence and risk of ED in cannabis users compared to controls.

A systematic review of major databases from inception to January 1, 2019, without language restriction, was undertaken to identify studies investigating cannabis use and presence of ED. The analysis compared the prevalence of ED in cannabis users versus controls. Consequently, the odds ratio (OR) with 95% confidence intervals (CI) was calculated, applying a random-effect model.

Five case–control studies were included with data from 3,395 healthy men, 1,035 using cannabis (smoking) and 2,360 nonusers. The overall prevalence of ED in cannabis users was 69.1% (95% CI: 38.0–89.1), whilst the correspondent figure in controls was 34.7% (95% CI: 20.3–52.7). The OR of ED in cannabis users was almost four times that of controls (OR = 3.83; 95% CI: 1.30–11.28; p = .02), even if characterized by high heterogeneity ( I2 = 90%) and the prediction intervals overlapped 1.00 (95% CI: 0.35–7.26).

Data suggest that ED is twice as high in cannabis users compared to controls. Future longitudinal research is needed to confirm/refute this and explore if a dose–response relationship between cannabis and ED may be evident.
The Anesthetic Effectiveness of J-Tip Needle-Free Injection System Prior to Trigger Finger Injection: A Double-Blind Randomized Clinical Trial
Authors: Patel Kushal R. , Fralinger David , MacGillis Kyle J. , Wright-Chisem Joshua , Mejia Alfonso
Published: December 2019

Background: The aim of this preliminary study was to evaluate the effectiveness of a J-tip needle-free injection system (JNFS) to reduce pain associated with corticosteroid injection of the tendon sheath for treatment of trigger finger. Methods: Thirty-four consecutive trigger fingers occurring in 28 unique patients who met inclusion/exclusion criteria were consented and enrolled into this double-blind randomized controlled study. Patients were randomly assigned to the control (JNFS loaded with sterile normal saline) or treatment group (JNFS loaded with buffered 1% lidocaine). Both the fellowship-trained hand surgeon and patient were blinded to the allocation group. Prior to each trigger finger injection, each patient rated pain associated with stubbing toe and papercut on the visual analog scale (VAS), in addition to a postprocedure VAS pain score. Results: A total of 28 patients and 34 digits were enrolled in this study. There was no difference in patient demographics or preintervention pain perception between the control and treatment groups. The use of JNFS demonstrated lower mean pain VAS score when comparing the control group (n = 17) with the treatment group (n = 17), with VAS pain scores of 49 (SD = 31) and 39 (SD = 36), respectively. However, this difference was not statistically significant ( P = .389). Conclusions: The use of JNFS loaded with 1% buffered lidocaine may reduce pain associated with trigger finger injections, although our results did not find a statistically significant difference. We hypothesize that the pain caused by the acidity of lidocaine is the primary driver of pain and discomfort during injection, and the pain from the needle stick is secondary. As a result, any pain reduction from JNFS is masked by the most painful part of injection—the delivery of injectate. Based on the findings and experience obtained from this study, we hypothesize that a follow-up study using buffered lidocaine may be able to better reveal the benefits of JNFS.
Technological Heterogeneity and Hotel Efficiency: A Bayesian Approach
Authors: Arbelo-Pérez Marta , Arbelo Antonio , Pérez-Gómez Pilar
Published: December 2019

Hotel efficiency has traditionally been estimated assuming that all hotels use the same production technology. However, in practice, hotels have different technologies, and ignoring this reality can lead to an overestimation of inefficiency in the sector. This article relaxes this assumption and estimates efficiency in the hotel industry using a stochastic frontier model with random coefficients. This methodology allows us to separate firm-specific inefficiencies from potential technological heterogeneity across hotels. The empirical results indicate that the estimated efficiencies differ between the random coefficients model and the fixed coefficients model. These findings support our thesis of technological heterogeneity across hotels.
Examining the Step-Up Brand Extensions of Budget Hotels: The Reciprocal Spillover Effects
Authors: Ye Shun , Wu Linfeng (Zenny) , Paek Soyon
Published: December 2019

This study investigates and validates the reciprocal spillover effects model in the upward extensions of budget hotel brands to the midscale market. In particular, the relationships among the components of extended brand performance (i.e., quality, innovativeness, and involvement) and their effects on customer attitude toward parent budget brands are modeled and tested through an empirical study of three leading budget hotel brands in China and their mid-end extensions. Data were collected through an online survey of 790 customers and then analyzed using structural equation modeling. Results confirmed that the three extension performance components can directly or indirectly affect attitude toward parent brands. The findings of this study will assure budget hotel groups that step-up brand extension can be beneficial to their original brands.
Renal artery injury during inferior vena cava filter removal with endobronchial forceps
Authors: Padula Carlos A , Lewis Andrew R , Frey Gregory T , McKinney J Mark , Paz-Fumagalli Ricardo , Ritchie Charles A , Devcic Zlatko , Toskich Beau B
Published: December 2019

Retrieval of tip-embedded inferior vena cava filters using endobronchial forceps is a well-described technique. The tip of dorsally tilted filters may be in proximity to the right renal artery, increasing the risk of arterial injury during retrieval. We present one case that illustrates renal artery injury requiring emergent stent graft repair. The three subsequent cases illustrate techniques that avoid renal artery injury using a femoral and jugular approach with the assistance of an arterial fiducial wire. Renal artery injury is a potential complication during retrieval of filters using endobronchial forceps that can be prevented with careful planning.
Carotid plaque and lumbar bone mineral density status in post-menopausal women: An age-matched, analytical cross-sectional study
Authors: Sitthisombat Patraporn , Soontrapa Sukree , Kaewrudee Srinaree , Sothornwit Jen , Eamudomkarn Nuntasiri , Promsorn Julaluck , Takong Wittawat , Somboonporn Woraluk
Published: December 2019

Objective

To explore the association between carotid plaque and lumbar spine osteoporosis in post-menopausal women.

Study design

Age-matched, cross-sectional study.

Main outcome measures

Carotid plaque and carotid intima media thickness were measured with B-mode ultrasound. Lumbar spine bone mineral density was measured with dual-energy X-ray absorptiometry. Prevalence odds ratios and the respective 95% confidence intervals (95%CI) were calculated to determine the association.

Results

Seventy-two post-menopausal women with lumbar spine osteoporosis and 72 post-menopausal women with normal lumbar spine bone mineral density were enrolled. The adjusted prevalence odds ratio of carotid plaque presence in post-menopausal women with lumbar spine osteoporosis was 1.73 (95%CI; 0.60 to 4.94) when compared to post-menopausal women with normal lumbar spine bone mineral density. The presence of vulnerable plaque was greater in post-menopausal women with lumbar spine osteoporosis; however, the difference was not statistically significant after adjusting for other risk factors of cardiovascular disease (odds ratio 1.31; 95%CI; 0.39 to 4.43). There was no significant difference in carotid intima media thickness between the two groups. Multiple logistic regression analysis with backward elimination in assessment of potential risk factors for the presence of carotid plaque showed that the year since menopause, family history of cardiovascular disease and systolic blood pressure were nominally significant associated factors with a respective adjusted odds ratio of 1.06 (95%CI; 1.01 to 1.12), 6.23 (95%CI; 1.65 to 23.46) and 1.03 (95%CI; 1.01 to 1.06).

Conclusions

The current study indicates that lumbar spine osteoporosis is not associated with the presence of carotid plaque, whereas year since menopause, family history of cardiovascular disease and systolic blood pressure are associated factors.
Lemierre’s Syndrome Due to Methicillin-Resistant Staphylococcus aureus
Authors: Zamora Gonzalez Rolando A. , Sarria Juan C. , Christians Nicole A. , Baliss Michelle
Published: December 2019

Lemierre’s syndrome is an uncommon and potentially fatal complication of oropharyngeal and facial infections. It involves an associated septic thrombophlebitis, bacteremia, and septic emboli. Traditionally, compromise of the internal jugular vein has been described in conjunction with an infection caused by anaerobes, especially, Fusobacterium necrophorum. In recent years, however, variant forms have been appearing, including other vessel compromise and other etiologic agents. We present the case of Lemierre’s syndrome in a 31-year-old male with facial vein thrombosis, septic emboli to the lungs, and bacteremia caused by methicillin-resistant Staphylococcus aureus. We hope that this case will raise awareness about variant presentations and promote a timely diagnosis and appropriate treatment of this potentially fatal infection.
The Vastus Medialis Insertion Is More Proximal and Medial in Patients With Patellar Instability: A Magnetic Resonance Imaging Case-Control Study
Authors: Gobbi Riccardo Gomes , Hinckel Betina Bremer , Teixeira Paulo Renan Lima , Giglio Pedro Nogueira , Lucarini Bruno Romano , Pécora José Ricardo , Camanho Gilberto Luis , Demange Marco Kawamura
Published: December 2019

Background:

The anatomy and function of the quadriceps muscle play a role in patellofemoral stability. Few studies have evaluated anatomic differences in the vastus medialis between patients with and without patellar instability.

Purpose:

To compare the anatomy of the vastus medialis using magnetic resonance imaging in patients with patellar instability to a control group.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

A group of patients with patellar instability were sex-matched with a control group with anterior cruciate ligament tears, meniscal injuries, or sprains; patients younger than 15 years were excluded. The anatomy of the vastus medialis was examined by the distance between the distal origin of the vastus medialis in the femur and the medial femoral condyle, the distance from the proximal pole of the patella to the most distal insertion of the muscle and its ratio to the length of the articular surface of the patella, and a qualitative description of the insertion position of the muscle fibers (directly in the patella or the medial retinaculum).

Results:

Both groups comprised 78 knees (48 female; 61.5%). The mean age in the control and patellar instability groups was 30.2 ± 7.8 years and 25.6 ± 7.5 years, respectively ( P = .001). The distance from the vastus origin to the condyle was 27.52 ± 3.49 mm and 26.59 ± 3.43 mm, respectively ( P = .041); the distance from the proximal pole of the patella to the most distal muscle insertion was 17.59 ± 5.54 mm and 15.02 ± 4.18 mm, respectively ( P < .001); and the ratio of this distance to the joint surface was 0.586 ± 0.180 and 0.481 ± 0.130, respectively ( P < .001). In 75.6% of knees in the patellar instability group, the insertion of the vastus was into the medial retinaculum and not into the patella compared with 52.6% in the control group ( P = .003; odds ratio, 2.8).

Conclusion:

The distal insertion of the vastus medialis differed in knees with patellar instability, with a more proximal insertion and less patellar coverage relative to controls, and was more frequently found in the retinaculum instead of directly in the patella.
“He Explained It to Me and I Also Did It Myself”: How Older Adults Get Support with Their Technology Uses
Authors: Hunsaker Amanda , Nguyen Minh Hao , Fuchs Jaelle , Djukaric Teodora , Hugentobler Larissa , Hargittai Eszter
Published: December 2019

Given that older adults constitute a highly heterogeneous group that engages with digital media in varying ways, there is likely to be large variation in technology support needs, something heretofore unaddressed in the literature. Drawing on in-depth qualitative interviews with a multinational sample of older adults, the authors explore the support needs of older adults for using digital media, including their perceptions of whether the support they receive meets their needs. Participants obtained assistance from both informal (e.g., adult children) and formal (e.g., computer classes) sources. However, the support given can lack immediacy, leaving older adults dependent on others’ availability to provide it. Educational approaches that emphasize individualized support and wide availability might allow an improved experience for a population that is increasingly online with an interest in a wide range of activities.
Mental health in adolescents with a history of developmental language disorder: The moderating effect of bullying victimisation
Authors: Kilpatrick Tina , Leitão Suze , Boyes Mark
Published: December 2019

Background

Children and adolescents with a history of developmental language disorder are at elevated risk of experiencing internalising and externalising symptoms. The existing literature suggests a link between developmental language disorder, bullying victimisation and low self-esteem, both of which are negatively associated with child and adolescent mental health more generally.

Aim

We examined the relationship between having a history of developmental language disorder and internalising and externalising symptoms in adolescence. We also tested whether bullying victimisation and self-esteem were associated with mental health outcomes, and whether they moderated the association between a history of developmental language disorder and psychological symptoms. Methods and procedures: Adolescents with a history of developmental language disorder ( n = 20, 10–16 years, 10% female, 90% male) were compared to a group of typically developing peers ( n =  22, 10–16 years, 36.4% female, 63.6% male). Receptive and expressive language, internalising and externalising symptoms, bullying victimisation and self-esteem were assessed with well-validated measures. Outcomes and results: Contrary to our predictions, a history of developmental language disorder was not directly associated with internalising or externalising symptoms. However, in terms of internalising symptoms, there was a significant interaction between a history of developmental language disorder and bullying victimisation ( β = 1.01, p =  .02). Specifically, there was a significant association between a history of developmental language disorder and internalising symptoms at high levels of bullying victimisation [ t(41) = 2.52, p =  .02] but not at low levels of bullying victimisation [ t(41) = –.67, p =  .51). Conclusions and implications: Bullying victimisation appears to increase the risk of internalising symptoms in adolescents with a history of developmental language disorder. Future research should examine whether anti-bullying interventions can help prevent the development of internalising problems for children with developmental language disorder. These findings may aid clinicians in developing their understanding of developmental language disorder and reinforces the importance of holistic client management in speech language therapy.
MiR-214 prevents the progression of diffuse large B-cell lymphoma by targeting PD-L1
Authors: Sun Jing-Ran , Zhang Xiao , Zhang Ya
Published: December 2019

Objective

We explored the role and mechanism of miR-214 involvement in the progression of diffuse large B-cell lymphoma (DLBCL).

Methods

The expression levels of miR-214 and PD-L1 in human DLBCL cell lines and in tissue samples from patients with DLBCL were determined using quantitative RT-PCR. The dual-luciferase reporter assay was employed to determine the correlation between the expressions of miR-214 and PD-L1. Cell viability, invasiveness and apoptosis were respectively examined in cells of the DLBCL line OCI-Ly3 using CCK-8, transwell and flow cytometry assays. The expression level of PD-L1 was determined via immunoblotting. Inflammatory cytokine secretion was determined via enzyme-linked immune sorbent assay (ELISA).

Results

miR-214 was downregulated and PD-L1 was upregulated in DLBCL tissues and cell lines in comparison to normal adjacent tissues or normal B-cell. This indicates a negative correlation in the expression levels. Overexpression of miR-214 inhibited cell viability and invasion and induced apoptosis of OCI-Ly3 cells. Moreover, miR-214 was shown to target PD-L1 mRNA by binding to its 3′-untranslated region (UTR). Knockdown of PD-L1 attenuated the malignant phenotype of OCI-Ly3 cells. Overexpression of miR-214 inhibited tumor growth by targeting PD-L1 in vivo.

Conclusion

By targeting PD-L1, miR-214 regulates the progression of DLBCL in vitro and in vivo.