bluuebunny/crossref_metadata_2025 huggingface dataset:
Zweijährige Analyse dermatologischer Konsultationen außerhalb der Sprechzeiten am Universitätsklinikum Frankfurt
Authors: Osowski Sebastian A. , Wagner Niklas , Osowski Andreas C. , Ochsendorf Falk , Kaufmann Roland , Weberschock Tobias
Published: June 2019

Hintergrund

In den letzten Jahren ist die Anzahl der der Notdienstpatienten fächerübergreifend angestiegen. In Deutschland werden dermatologische Vorstellungen außerhalb der Sprechzeiten durch den ärztlichen Bereitschaftsdienst, Notaufnahmen und tertiäre Gesundheitsdienstleister wahrgenommen. Es liegen nur wenige Informationen über die Gründe dieser dermatologischen Konsultationen vor.

Ziele

Ziel der Studie war es, die Patientencharakteristika und die Diagnosen zu analysieren sowie die sich aus den Konsultationen ergebende Aufnahmerate. Die Aufnahmeraten zu bestimmen, die aus diesen Konsultationen resultieren.

Methoden

Wir führten eine retrospektive Analyse durch, die die dermatologischen Konsultationen außerhalb der Sprechzeiten in einem tertiären Referenzzentrum über einen Zeitraum von zwei Jahren erfasste.

Ergebnisse

Insgesamt stellten sich 3635 Patienten im Referenzzentrum vor. Die häufigsten ambulanten Diagnosen waren akute Urtikaria (13,8 %) und bakterielle Infektionen (12,3 %). Gemäß dem „Nationalen Kompetenzbasierten Lernzielkatologs Medizin“ (NKLM) wurden 83 % der ambulanten Diagnosen die höchste Kompetenzebene zugewiesen. 405 Patienten (11,01 %) benötigten keine dermatologische Behandlung, während 430 Patienten (13,6 %) stationär aufgenommen wurden. Die meisten Aufnahmen waren die Folge von bakteriellen Infektionen und Herpes Zoster. Fortgeschrittenes Alter, Schmerz und Fieber waren mit einer hohen Wahrscheinlichkeit einer Aufnahme assoziiert.

Schlussfolgerungen

Die Aufnahmeraten in einem tertiären dermatologischen Referenzzentrum waren wesentlich geringer als in interdisziplinären Notaufnahmen. Einige wenige Diagnosen waren für mehr als die Hälfte aller Konsultationen verantwortlich. Diese Diagnosen sind im NKLM gut abgebildet.
Can Consumers Use Online Reviews to Avoid Unsuitable Doctors? Evidence From RateMDs.com and the Federation of State Medical Boards
Authors: Lantzy Shannon , Anderson David
Published: June 2019

It is difficult to assess a doctor's quality. According to theory, doctors provide a classic credence service, in which the quality of the service is difficult or impossible to determine even after its consumption. We challenge the notion that doctors are pure credence goods by analyzing the power of online reviews to predict whether a doctor is unsuitable for medical practice. We use doctor ratings as inputs to our model despite strong debate regarding their informational value in healthcare. We use state medical board sanctions as a signal of doctors’ suitability to practice. We find predictive power in our models: there is indeed a signal of underlying doctor suitability in online ratings. Implications for consumer choice, regulatory surveillance, economic theory, and the usefulness of predictive modeling are discussed.
Guidelines for standardizing cleansing and disinfection of gastrointestinal endoscopes
Authors: Iwakiri Ryuichi , Tanaka Kiyohito , Gotoda Takuji , Oka Shiro , Ohtsuka Takao , Sakata Yasuhisa , Chiba Toshimi , Higuchi Kazuhide , Masuyama Hironori , Nozaki Ryoichi , Matsuda Koji , Shimono Nobuyuki , Fujimoto Kazuma , Tajiri Hisao
Published: June 2019

As part of the activities toward standardizing endoscopy procedures, the Japan Gastroenterological Endoscopy Society has prepared guidelines for cleansing and disinfection of gastrointestinal endoscopes. The environment of gastrointestinal endoscopy differs between Japan and advanced Western countries. In advanced Western countries, gastrointestinal endoscopy is performed almost exclusively at specialized facilities, where strict provisions are observed for cleansing and disinfecting endoscopes. In Japan, however, gastrointestinal endoscopy is performed even in small clinics, and the annual number of gastrointestinal endoscopy cases is enormous. In addition, the method for cleansing and disinfecting endoscopes differs among hospitals. Although there is a distinct lack of evidence for how gastrointestinal endoscopes are cleaned and disinfected, it is necessary to standardize the method for doing so to advance the field of endoscopic medicine.
Negative feedback processes following drainage slow down permafrost degradation
Authors: Göckede Mathias , Kwon Min Jung , Kittler Fanny , Heimann Martin , Zimov Nikita , Zimov Sergey
Published: June 2019

The sustainability of the vast Arctic permafrost carbon pool under climate change is of paramount importance for global climate trajectories. Accurate climate change forecasts, therefore, depend on a reliable representation of mechanisms governing Arctic carbon cycle processes, but this task is complicated by the complex interaction of multiple controls on Arctic ecosystem changes, linked through both positive and negative feedbacks. As a primary example, predicted Arctic warming can be substantially influenced by shifts in hydrologic regimes, linked to, for example, altered precipitation patterns or changes in topography following permafrost degradation. This study presents observational evidence how severe drainage, a scenario that may affect large Arctic areas with ice‐rich permafrost soils under future climate change, affects biogeochemical and biogeophysical processes within an Arctic floodplain. Our in situ data demonstrate reduced carbon losses and transfer of sensible heat to the atmosphere, and effects linked to drainage‐induced long‐term shifts in vegetation communities and soil thermal regimes largely counterbalanced the immediate drainage impact. Moreover, higher surface albedo in combination with low thermal conductivity cooled the permafrost soils. Accordingly, long‐term drainage effects linked to warming‐induced permafrost degradation hold the potential to alleviate positive feedbacks between permafrost carbon and Arctic warming, and to slow down permafrost degradation. Self‐stabilizing effects associated with ecosystem disturbance such as these drainage impacts are a key factor for predicting future feedbacks between Arctic permafrost and climate change, and, thus, neglect of these mechanisms will exaggerate the impacts of Arctic change on future global climate projections.
Impact of infected and noninfected human dentine debris on bone healing in rats
Authors: Pappen F. G. , Xavier S. R. , Pilownic K. J. , Santos L. G. P. , Gomes A. P. N. , Felix A. C. , Demarco F. F. , Souza E. M.
Published: June 2019

Aim

To evaluate in vivo the bone tissue response of rats to varying amounts of infected and noninfected dentine debris.

Methodology

Bone tissue reactions were evaluated histologically in 42 Wistar rats after 7, 30 and 60 days. For each animal, three surgical cavities were prepared on the femur and filled with varying amounts (5, 10 or 20 mg) of infected or noninfected dentine debris pellets. In the negative control group, the surgical cavities were not filled. At the end of each experimental period, the animals were euthanized. The samples were processed histologically and analysed using a light microscope. The presence and the severity of inflammatory reaction, as well as hard tissue deposition were evaluated. Data were subjected to statistical analysis and the effects of the dependent variables calculated using nonparametric tests Kruskal–Wallis and Mann–Whitney U with due Bonferroni corrections at P = 0.05.

Results

At 7 days, the presence of infected debris significantly increased the histopathological scores for neutrophils (P < 0.05), and abscess formation (P < 0.05). Noninfected debris scored significantly higher for lymphocyte infiltrate compared with the control group and infected debris (P < 0.05). Both infected and noninfected debris equally triggered eosinophil cells compared with no‐dentine (P < 0.05). As for giant cells and macrophages, no difference was detected amongst the dentine groups (P > 0.05). Hard tissue deposition was similar regardless of the presence or the bacteriological status of the dentine (P = 1.00). None of the above histopathological parameters was significantly influenced by the amount of debris (P > 0.05). For all parameters evaluated, at 7 days of analysis, the inflammatory response was significantly more intense compared with 30 and 60 days (P < 0.05). Inflammatory parameters were scored similarly for the evaluated groups after 30 and 60 days (P > 0.05). However, hard tissue deposition has significantly increased after 30 days (P < 0.05). No difference was seen between 30 and 60 days of analysis (P = 1.00) for all histological parameters evaluated.

Conclusion

The assumption that the amount of extruded debris may negatively affect the inflammatory response of bone tissue was not validated in the present in vivo animal study. Infected dentine may trigger acute inflammatory parameters especially during the first 7 days of contact with the tissue; however, in the long term, these negative effects are mitigated.
Adapting nurse‐led cystoscopy experience to the United States: Tele‐cystoscopy a possible compromise?
Authors: Beller Haerin , Lobo Jennifer M. , Horton Bethany J. , Sims Terran , Corey Thomas , Tyson Teresa , Schenkman Noah S. , Krupski Tracey L. , Jones Randy A.
Published: June 2019

Urology workforce shortages in rural areas limit access to diagnostic cystoscopy for hematuria or surveillance cystoscopy for patients with bladder cancer. To address this, we developed a tele‐cystoscopy model in which urologic advanced practice professionals (APPs) perform cystoscopies that are interpreted in real‐time by board‐certified urologists at their home institution. This collaborative model allows the cystoscopic interpretation to be performed by a board‐certified urologist. This model may both improve access for patients in remote locations and may lead to greater acceptance of nurse‐led cystoscopy in the medical legal environment found in the United States.
Sequential, within‐season infection with influenza A (H3N2) in a usually healthy vaccinated child
Authors: Temte Jonathan L. , Uzicanin Amra , Goss Maureen , Comp Lily , Temte Emily , Barlow Shari , Reisdorf Erik , Shult Peter , Wedig Mary , Florek Kelsey
Published: June 2019

Cocirculation of varying influenza types, strains, and lineages allows coinfection and intra‐season sequential infection, although a same‐strain sequential infection has not been previously described. This case report describes the first known case of sequential laboratory‐confirmed influenza A (H3N2) infections in a child within one season.
A randomized controlled trial of a mobile application‐assisted nurse‐led model used to improve treatment outcomes in children with asthma
Authors: Lv Shaoxia , Ye Xiaohong , Wang Zhijiang , Xia Wenfen , Qi Yajuan , Wang Weihan , Chen Yuehua , Cai Xiaohong , Qian Xubo
Published: June 2019

Aim

To evaluate the effectiveness of a mobile application‐assisted nurse‐led management model in childhood asthma.

Background

Studies have shown that a nurse‐led asthma management model can improve asthma outcomes. However, the role of a mobile application‐assisted nurse‐led model in paediatric asthma management has not been studied well.

Design

A multi‐centre randomized clinical trial.

Methods

The trial was conducted between March 2017–March 2018. A total of 152 children (6 to 11.9 years old) were enrolled, with 77 children in the experimental group and 75 in the control group. All children received nurse‐led asthma management and other routine treatment measures, including inhaled corticosteroids. Meanwhile, a mobile application was used to manage asthma only for children in the experimental group. Primary outcome was frequency of asthma exacerbations. All outcomes were evaluated twice a month for 12 months.

Results

Compared with the pre‐enrollment period, frequency of asthma exacerbations decreased in the post‐enrollment period in the two groups, with a greater decrease in the experimental group. Compared with children in the control group, children in the experimental group had better secondary outcomes, such as improved adherence, higher Childhood Asthma Control Test scores, decreased respiratory tract infections, days of antibiotic use, days of school absence, parental work loss, and medical expenses.

Conclusion

A mobile application‐assisted nurse‐led management model decreased asthma exacerbations and improved secondary outcomes in children with asthma. Further research is needed to verify its validity in larger population samples.

Impact

Children with asthma benefited from a nurse‐led asthma management model when combined with mobile application. This trial suggested that computer and Internet technologies should be incorporated into nurse‐led asthma strategy in paediatric asthma management.

Trial registration: The current trial was registered online with the Chinese Clinical Trial Registry (registration number: ChiCTR1800016726).
MiR‐629 regulates hypoxic pulmonary vascular remodelling by targeting FOXO3 and PERP
Authors: Zhao Mei , Chen Ni , Li Xuelian , Lin Ling
Published: June 2019

Pulmonary arterial hypertension (PAH) is featured by the increase in pulmonary vascular resistance and pulmonary arterial pressure. Despite that abnormal proliferation and phenotypic changes in human pulmonary artery smooth muscle cells (HPASMCs) contributing to the pathophysiology of PAH, the underlying molecular mechanisms remain unclear. In the present study, we detected the expression of miR‐629 in hypoxia‐treated HPASMCs and explored the mechanistic role of miR‐629 in regulating HPASMC proliferation, migration and apoptosis. Hypoxia time‐dependently induced up‐regulation of miR‐629 and promoted cell viability and proliferation in HPASMCs. Treatment with miR‐629 mimics promoted HPASMCs proliferation and migration, but inhibited cell apoptosis; while knockdown of miR‐629 suppressed the cell proliferation and migration but promoted cell apoptosis in HPASMCs. The bioinformatics prediction revealed FOXO3 and PERP as downstream targets of miR‐629, and miR‐629 negatively regulated the expression of FOXO3 and PERP via targeting the 3’ untranslated regions. Enforced expression of FOXO3 or PERP attenuated the miR‐629 overexpression or hypoxia‐induced enhanced effects on HPASMC proliferation and proliferation, and the suppressive effects on HPASMC apoptosis. Furthermore, the expression of miR‐629 was up‐regulated, and the expression of FOXO3 and PERP mRNA was down‐regulated in the plasma from PAH patients when compared to healthy controls. In conclusion, the present study provided evidence regarding the novel role of miR‐629 in regulating cell proliferation, migration and apoptosis of HPASMCs during hypoxia.
Long non‐coding RNA LINC00526 represses glioma progression via forming a double negative feedback loop with AXL
Authors: Yan Jian , Xu Chunhua , Li Youping , Tang Bin , Xie Shenhao , Hong Tao , Zeng Erming
Published: June 2019

Glioma is the most common primary intracranial carcinoma with extremely poor prognosis. The significances of long non‐coding RNA (lncRNA) involved in glioma have been started revealed. However, the expression, roles and molecular mechanisms of most lncRNAs in glioma are still unknown. In this study, we identified a novel lncRNA LINC00526, which is significantly low expressed in glioma. Low expression of LINC00526 is correlated with aggravation and poor survival in glioma. Functional assays revealed that ectopic expression of LINC00526 inhibits glioma cell proliferation, migration, and invasion. LINC00526 silencing promotes glioma cell proliferation, migration and invasion. Mechanistically, we found that LINC00526 directly interacts with EZH2, represses the binding of EZH2 to AXL promoter, attenuates the transcriptional activating roles of EZH2 on AXL, and therefore represses AXL expression. Via repressing AXL, LINC00526 further represses PI3K/Akt/NF‐κB signalling. Intriguingly, we identified that NFKB1 and NFKB2 directly binds LINC00526 promoter and represses LINC00526 transcription. We further found that via activating NF‐κB signalling, AXL represses LINC00526 transcription. Therefore, LINC00526/EZH2/AXL/PI3K/Akt/NF‐κB form a feedback loop in glioma. Analysis of the TCGA data revealed that the expression of LINC00526 is inversely correlated with that of AXL in glioma tissues. In addition, functional rescue assays revealed that the tumour suppressive roles of LINC00526 are dependent on the negative regulation of AXL. Collectively, our data identified LINC00526 as a tumour suppressor in glioma via forming a double negative feedback loop with AXL. Our data also suggested LINC00526 as a potential prognostic biomarker and therapeutic candidate for glioma.
miR‐1, miR‐499 and miR‐208 are sensitive markers to diagnose sudden death due to early acute myocardial infarction
Authors: Pinchi Enrica , Frati Paola , Aromatario Mariarosaria , Cipolloni Luigi , Fabbri Matteo , La Russa Raffaele , Maiese Aniello , Neri Margherita , Santurro Alessandro , Scopetti Matteo , Viola Rocco Valerio , Turillazzi Emanuela , Fineschi Vittorio
Published: June 2019

MicroRNAs (miRNAs) are strongly up‐regulated under pathological stress and in a wide range of diseases. In recent years, miRNAs are under investigation for their potential use as biomarkers in cardiovascular diseases. We investigate whether specific cardio‐miRNAs are overexpressed in heart samples from subjects deceased for acute myocardial infarction (AMI) or sudden cardiac death (SCD), and whether miRNA could help differentiate between them. Forty four cases of death due to cardiovascular disease were selected, respectively, 19 cases categorized as AMI and 25 as SCD. Eighteen cases of traumatic death without pathological cardiac involvement were selected as control. Immunohistochemical investigation was performed for CD15, IL‐15, Cx43, MCP‐1, tryptase, troponin C and troponin I. Reverse transcription and quantitative real‐time PCR were performed for miR‐1, miR‐133, miR‐208 and miR‐499. In AMI group, stronger immunoreaction for the CD15, IL‐15 and MCP‐1 antibodies was detectable compared with SCD and control. Cx43 showed a negative reaction with respect to the other groups. Real‐time PCR results showed a down‐regulation of all miRNAs in the AMI group compared with SCD and control. The selected miRNAs presented high accuracy in discriminating SCD from AMI (miR‐1 and miR‐499) and AMI from control (miR‐208) representing a potential aid for both clinicians and pathologists for differential diagnosis.
Butyrate rather than LPS subverts gingival epithelial homeostasis by downregulation of intercellular junctions and triggering pyroptosis
Authors: Liu Juan , Wang Yixiang , Meng Huanxin , Yu Jingting , Lu Hongye , Li Wenjing , Lu Ruifang , Zhao Yibing , Li Qiqiang , Su Li
Published: June 2019

Aim

To investigate the effects of sodium butyrate (NaB) and lipopolysaccharide (LPS) on gingival epithelial barrier.

Material and methods

We cultured human primary gingival epithelial cells and investigated the effects of NaB and LPS on gingival epithelial barrier and involved mechanisms at in vitro and in vivo levels by immunostaining, confocal microscopy, field emission scanning electron microscopy (FE‐SEM), transmission electronic microscopy (TEM), transepithelial electrical resistance (TEER), FTIC‐dextran flux, flow cytometry, real‐time PCR and Western blot assays.

Results

Our results showed that NaB, rather than LPS, destroyed the epithelial barrier by breaking down cell–cell junctions and triggering gingival epithelial cell pyroptosis with characteristic morphological changes, including swollen cells, large bubbles, pore formation in the plasma membrane and subcellular organelles changes. The upregulated expression of pyroptosis‐related markers, caspase‐3 and gasdermin‐E (GSDME) contributed to this effect. Pyroptosis aroused by NaB is a pro‐inflammatory cell death. Pyroptotic cell death provoked inflammatory responses by upregulation of IL‐8 and MCP‐1, and releasing intracellular contents into the extracellular microenvironment after pyroptotic rupture of the plasma membrane.

Conclusions

Our new findings indicate that butyrate is a potent destructive factor of gingival epithelial barrier and pro‐inflammatory mediator, which shed a new light on our understanding of periodontitis initiation.
Using ultrasound for improving hydration and debittering of Andean lupin grains
Authors: Miano Alberto C. , Rojas Meliza L. , Augusto Pedro E. D.
Published: June 2019

This article presents results about the potential use of ultrasound technology on the hydration and debittering process of Andean lupin grains (Lupinus albusSweet). The hydration process was conducted conventionally and also assisted by ultrasound technology (ultrasonic water bath, 25 kHz, 41 W/L). Further than the hydration kinetics, the alkaloid content was evaluated. As results, the hydration kinetics of this grain showed a sigmoidal behavior, which was accelerated almost 40% using ultrasound. The lag phase was reduced about 13%, and the equilibrium moisture content was increased about 14%. Finally, by using ultrasound during hydration process, the alkaloid extraction was also improved, extracting 21% more compared to the conventional process. It was concluded that ultrasound technology accelerates not only the hydration process but also the extraction of alkaloids.

Practical Applications

Andean lupin is a pulse with potential importance for human and animal alimentation due to its high quantity of proteins. However, this pulse has a considerable quantity of undesirable alkaloids that are bitter and toxic. Therefore, a debittering process is required. Further, before debittering, hydration of the grains is required, which is a long and batch process. This work demonstrated that both the hydration and the debittering processes can be enhanced by ultrasound. Consequently, ultrasound technology would have a double application during hydration process of Andean lupin grains.
Examining Antecedents of Health Insurance Literacy: The Role of Locus of Control, Cognitive Style, and Financial Knowledge
Authors: O'Connor Genevieve Elizabeth , Kabadayi Sertan
Published: June 2019

Today's consumer is expected to make health‐care decisions that have serious implications for their welfare. However, a major barrier to these decisions is a basic lack of understanding of health insurance. A critical first step is to examine drivers of health insurance literacy and in turn offer interventions that can have a positive impact on consumer welfare. This article explores the relationship between relevant consumer psychographics, financial knowledge, and demographics with health insurance literacy. Results indicate that while demographics play a role, the degree to which consumers believe a situation or event is under their own control (i.e., locus of control), how they process information (i.e., cognitive style), and consumer's financial confidence (i.e., subjective knowledge) is a critical indicator of their health insurance literacy. Cluster analysis reveals three “faces” of health insurance literacy.
“Never in my mind to give up!” A qualitative study of long‐term intensive care patients’ inner strength and willpower—Promoting and challenging aspects
Authors: Alexandersen Ingeborg , Stjern Berit , Eide Regina , Haugdahl Hege Selnes , Engan Paulsby Tove , Borgen Lund Stine , Haugan Gørill
Published: June 2019

Aims and objectives

To explore aspects that promote and challenge long‐term ICU patients’ inner strength and willpower.

Background

Considerable research has been devoted to ICU patients’ experiences; however, research on long‐term ICU patients is limited. Studies in a health‐promoting perspective focusing on long‐term ICU patients’ inner strength and willpower are scarce.

Design

A qualitative, hermeneutic‐phenomenological approach, using in‐depth interviews.

Methods

Seventeen long‐term Norwegian ICU patients were interviewed once, at 6–18 months after ICU discharge. The consolidated criteria for reporting qualitative research was used (Data S1).

Results

The lived experience of the phenomenon “inner strength and willpower” and what promotes and challenges this phenomenon in long‐term ICU patients were represented by four main themes and nine subthemes. Promoting aspects comprised of two main themes and five subthemes: (a) “No doubt about coming back to life” with subthemes; “Strong connectedness to life; feeling alive and present,” “Meaning and purpose; feeling valuable to somebody.” (b) “How to ignite and maintain the spark of life,” with the subthemes: “Practical solutions, coping skills from previous life experiences,” “Provocative and inspiring experiences” and “Vivid dream experiences that ignite the willpower.” Two main categories and four subcategories represented challenging aspects: (a) Exhaustion, weakness and discomfort; subthemes; “Physical challenges” and “Mental discomfort” and (b) “Tiring delusions,” subthemes; “Living in the worst horror movie” and “Feeling trapped.”

Conclusion

This study expands on previous studies by providing insights about what promotes and challenges long‐term ICU patients’ inner strength and willpower during their recovery trajectory.

Relevance to clinical practice

Insights into the variety of long‐term ICU patients’ experiences during the recovery trajectory are important for ICU nurses to support and facilitate ICU patients’ inner strength and willpower.
Application of Mössbauer spectroscopy, multidimensional discriminant analysis, and Mahalanobis distance for classification of equilibrated ordinary chondrites
Authors: Woźniak Marek , Gałązka‐Friedman Jolanta , Duda Przemysław , Jakubowska Martyna , Rzepecka Patrycja , Karwowski Łukasz
Published: June 2019

Mössbauer spectra of equilibrated ordinary chondrites consist of two doublets due to paramagnetic iron present in olivines and pyroxenes and two sextets due to magnetically ordered iron present in metallic phases and troilite. The spectral areas of the different mineralogical phases found by Mössbauer spectroscopy in meteorites are proportional to the number of iron atoms in this mineralogical phase. This property of Mössbauer spectra can be the basis for constructing a method for the classification of ordinary chondrites. This idea was first explored at the Mössbauer Laboratory in Kanpur. This group suggested a qualitative method based on 2‐dimensional plots of Mössbauer spectral areas and thus classified properly some meteorites. We constructed a quantitative method using Mössbauer spectral areas, multidimensional discriminant analysis, and Mahalanobis distance (4M method) to determine the probability of a meteorite to be of type H, L, orLL. Based on 59 Mössbauer spectra, we calculated by the 4M method,Scluster, thelevel of similarityof the Goronyo meteorite to the clusters. On the plot of ferrosilite versus fayalite, the point representing Goronyo is located on the border between H and L areas. Calculated by the 4M method, the meteorite Goronyo is 32% similar to type H, 75% to type L, and 11% to typeLL. Additional mineralogical analyses suggested that the Goronyo meteorite would be classified as type L, although it was originally reported as type H in the Meteoritical Bulletin Database.
On the shock of civil war: cultural trauma and national identity in Finland and Ireland
Authors: Kissane Bill
Published: June 2019

What role does national identity play after civil war? Is reconstruction possible on the basis of an existing identity, or does a new identity have to be found? Much depends on whether narratives of conflict are unifying. I use the tools of cultural sociology to explain why the Finnish Civil War of 1918 has become a unifying ‘cultural trauma’ for the Finns, whereas the Irish Civil War of 1922–23 never became the dominant referent in Irish national identity. The difference is explained by the greater shock civil war posed to Finnish national identity.
Ethno‐political subordination and patient dissatisfaction: The Kurdish case inHakkâriduring the AKP period in Turkey, 2003–2013
Authors: Corut Ilker
Published: June 2019

This article revolves around a puzzle: the persistence of patient dissatisfaction with the health services as a mass phenomenon in a Kurdish province,Hakkâri, through the 2000s, despite the striking and tangible improvements enacted by the Turkish state. This is, I argue, related to the deeply entrenched conviction on the part of Hakkârians that their lives count for little in the eyes of the Turkish state. Rooted in the history of state‐Kurds relations, this conviction manifests itself in Hakkârians' deep distrust of the very basis of health services received, like the skills and intentions of health staff, causing many Hakkârians to underestimate service improvement. Thus, it is concluded, patient satisfaction among an ethnically subordinated group with health services provided by a dominant ethnic group may be unavoidably informed and perhaps overwhelmingly determined by an awareness of the wider ethno‐power context and its history, irrespective, that is, of material improvements.
The ‘values journey’ of nursing and midwifery students selected using multiple mini interviews: Evaluations from a longitudinal study
Authors: Groothuizen Johanna Elise , Callwood Alison , Allan Helen Therese
Published: June 2019

Values‐based practice is deemed essential for healthcare provision worldwide. In England, values‐based recruitment methods, such as multiple mini interviews (MMIs), are employed to ensure that healthcare students’ personal values align with the values of the National Health Service (NHS), which focus on compassion and patient‐centeredness. However, values cannot be seen as static constructs. They can be positively and negatively influenced by learning and socialisation. We have conceptualised students’ perceptions of their values over the duration of their education programme as a ‘values journey’. The aim of this hermeneutic longitudinal focus group study was to explore the ‘values journey’ of student nurses and midwives, recruited through MMIs, across the 3 years of their education programme. The study commenced in 2016, with 42 nursing and midwifery students, originally recruited onto their programmes through multiple mini interviews. At the third and final point of data collection, 25 participants remained. Findings indicate that students' confidence, courage and sense of accountability increased over the 3 years. However, their values were also shaped by time constraints, emotional experiences and racial discrimination. We argue that adequate psychological support is necessary as healthcare students embark on and progress through their values journey, and propose a framework for this.
Healthcare transition in pediatric liver transplantation: The perspectives of pediatric and adult healthcare professionals
Authors: Wright Jessica , Elwell Laura , McDonagh Janet , Kelly Deirdre , McClean Patricia , Ferguson James , Wray Jo
Published: June 2019

Introduction

Transition from pediatric to adult services of young people with a liver transplant is an important priority due to increasing numbers of young people surviving into adulthood. There is increased incidence of graft loss and non‐adherence following transfer to adult services. Although studies have considered the views and perceptions of young people who have undergone liver transplantation and their parents about transition, there is currently no qualitative research with healthcare professionals working in the field of liver transplantation. The aim of this study was to elicit the views of this group of stakeholders about barriers and facilitators of an effective transition process.

Methods

Semi‐structured interviews were carried out with 11 HCPs from pediatric and adult liver transplant programs and from a range of professional backgrounds. Interviews were transcribed verbatim and analyzed using thematic analysis.

Results

Four themes were identified: “non‐adherence and psychosocial issues,” “need for better psychological support,” “the role of parents,” and “the emotional impact of transition on healthcare professionals.” Within these themes, professionals described factors which hindered or promoted an effective transition process.

Conclusions

Screening tools which address psychological and social aspects of the lives of young people should be used in routine practice to identify patients requiring psychosocial support and to identify those at risk of non‐adherence. All staff involved with transition should be trained in the use of psychosocial screening strategies. The development of a formal referral pathway so that young people can access psychological support in adult services is recommended.
Venous thromboemboli associated with acute aerobic exercise: A review of case report commonalities
Authors: Taylor Beth A. , Parducci Paul M. , Zaleski Amanda L. , Panza Gregory A. , Pescatello Linda S. , Thompson Paul D.
Published: June 2019

Venous thromboembolic (VTE) events such as deep vein thrombosis (DVT) and pulmonary embolism (PE) have been reported in otherwise low‐risk healthy athletes following acute bouts of aerobic exercise.

Purpose

To review case reports and assess the commonalities of athletic individuals with VTE, as well as return‐to‐play (RTP) recommendations.

Methods

We reviewed 47 reports (20 DVTs, 15 PEs, and 12 DVTs/PEs, 19 women) of trained individuals who were diagnosed with DVT and/or PE following aerobic exercise. We assessed frequency of VTE risk factors, presenting symptoms, and RTP recommendations.

Results

The age of women (24.6 ± 7.0 years) was lower (P < .01) than of men (40.6 ± 13.6 years). Of the 19 women, 14 (73.7%) used oral contraceptives. Thirteen cases (27.7%) reported a recent period of prolonged inactivity (>1 hour), and another 12 cases were found to have an antithrombin disorder following testing after diagnosis. The most frequently reported symptoms were muscle pain in 26 of 32 (81.3%) DVT or DVT/PE cases, and dyspnea in 21 of 27 (77.8%) PE or DVT/PE cases. Despite these common symptoms, the estimated time from first report of symptoms to confirmed diagnosis was 56.3 ± 118.7 days and 25 cases (53.2%) were initially misdiagnosed. Twenty‐three cases (48.9%) did not report RTP recommendations, and those which did varied widely.

Conclusions

Thirty‐two cases (~70%) had at least one of three major risk factors, suggesting that many cases of VTE in athletes may be preventable with better education and awareness. The wide variety of RTP recommendations highlights the need for standardized guidelines in this population.
Identification of the novel HLA‐C*07:02:107 allele in a volunteer donor from the China Marrow Donor Program
Authors: Zhang Li‐Qun , Xiao Yao , Zhou Xiao‐Yang , Li Jin , Cai Jian‐Ping
Published: June 2019

HLA‐C*07:02:107 differs from HLA‐C*07:02:01:01 by one nucleotide substitution at position 978.
Immunosuppression reduction in liver and kidney transplant recipients with suspected bacterial infection: A multinational survey
Authors: Shepshelovich Daniel , Tau Noam , Green Hefziba , Rozen‐Zvi Benaya , Issaschar Assaf , Falcone Marco , Coussement Julien , Zusman Oren , Manuel Oriol , Mor Eytan , Torre‐Cisneros Julian , Yahav Dafna
Published: June 2019

Background

There is no consensus on the optimal management of immunosuppression during bacterial infections among solid organ transplant recipients.

Methods

A multicenter, cross‐sectional survey, of high‐volume kidney and liver transplant centers across US and Europe. Structured questionnaires including six multiple‐choice questions concerning the management of immunosuppression during infection were distributed among 381 centers.

Results

A total of 124 (33%) centers fully completed the questionnaire: 67 liver, 57 kidney centers. Participating centers reported heterogenous approaches to immunosuppression management for all types of immunosuppressive drugs. Notably, kidney centers reported similar frequencies of either discontinuation (19%), continuation (19%), or dose reduction (17.5%) of antimetabolites; discontinuation only for life‐threatening infection (17.5%) or case by case decisions (27%). Calcineurin inhibitors (CNI) management was heterogenous mostly among liver centers, with 8% discontinuing the CNI, 18% continuing, and 22% reducing dose. Heterogenous approaches to management of steroids and inhibitors of the mammalian target of rapamycin were also demonstrated.

Conclusions

Immunosuppression management during bacterial infection is heterogenous in US and European centers. Immunosupression reduction (ISR) during infection is a common practice, though supported by limited evidence. Demonstrating high heterogeneity in the approach to ISR, together with the equivocal results of clinical studies, support consideration of an interventional clinical trial.
CLIMATOLOGICAL CALIBRATION OF Z-R RELATIONSHIP FOR PAHANG RIVER BASIN
Authors: Tahir Wardah , Azad Wan Hazdy , Husaif Nurul , Osman Sazali , Ibrahim Zaidah , Ramli Suzana
Published: June 2019

Flood disaster due to prolonged heavy rainfall had caused millions ringgit of property losses, infrastructure damages and numerous deaths in the east coast region of Peninsular Malaysia. One of the efforts taken to improve disaster preparedness in this region is by enhancing the flood forecasting and warning system (FFWS) using rainfall input from weather radar. Weather radar has the advantage of its ability to provide good spatial and temporal resolution of rainfall estimates but comes with inherent associated errors. In this study, the radar rainfall estimates were improved by climatological calibration of reflectivity-rain (Z-R) relationships for Pahang river basin. The reflectivity data for period of one year from Kuantan radar station and the hourly rainfall depths at 67 rainfall stations located in the basin for the same periods were used. Correlation analysis between radar and gauged rainfall indicates that the further the distance from the radar, the weaker the R2 coefficient value. Two Z-R equations were derived using optimization method for distance (1) 0-100 km and (2) above 100 km from Kuantan radar. The results in the form of Z = 24R1.7 and Z =5R1.6 represents the average relationship for Kuantan radar for distance (1) and (2). The radar rainfall estimates using the newly derived climatological Z-R equations enhanced the FFWS for Pahang river basin.
Unsur al-Badī ͨ dalam Puisi al-Munfarijah Karya Ibn al-Naḥwī (Al-Badī ͨ Elements in the Poetry of al-Munfarijah by Ibn al-Naḥwī)
Authors: Zakaria Muhammad Zulfadhli , Abdullah Md Nor
Published: June 2019

The poetry of al-Munfarijah by Ibn al-Naḥwī is an Islamic poem-themed; sufism. This medieval poem received an encouraging response from the sufis and litterateurs. Besides quality content, the benefits of an Arabic poem are judged based on the usage of good language, high imagination, unique phonetics and alphabetical sound, and aesthetics. This values are based on the Arabic rhetoric. Hence, this article aims to examine the application of al-Badī elements which is a part of the Arabic rhetoric in al-Munfarijah poetry. This is a qualitative study that involves content analysis. General meaning was given to the selected verse. Thematic and deductive approaches are applied in data analysis. The study found that the application of al-Badī elements involved both al-Muḥassināt al-Ma ͨnawiyyah and al-Muḥassināt al-Lafẓiyyah. This article focuses only on three elements from each parts. The application of six elements is sufficient to illustrate the holistic semantics and aesthetics of poetry. This research reveals that the writer has an excellent level of al-Tharwah al-Lughawiyyah in his poetry. Despite the language aspect mentioned, a significant influence of tasawuf is also deployed. This proves the privilege and uniqueness that adds value to al-Munfarijah poetry
Maternal resveratrol administration protects against gestational diabetes‐induced glucose intolerance and islet dysfunction in the rat offspring
Authors: Brawerman Gabriel M. , Kereliuk Stephanie M. , Brar Navdeep , Cole Laura K. , Seshadri Nivedita , Pereira Troy J. , Xiang Bo , Hunt Kristin L. , Fonseca Mario A. , Hatch Grant M. , Doucette Christine A. , Dolinsky Vernon W.
Published: June 2019

Key points

Maternal resveratrol (RESV) administration in gestational diabetes (GDM) restored normoglycaemia and insulin secretion.

GDM‐induced obesity was prevented in male GDM+RESV offspring but not in females.

GDM+RESV offspring exhibited improved glucose tolerance and insulin sensitivity.

GDM+RESV restored hepatic glucose homeostasis in offspring.

Glucose‐stimulated insulin secretion was enhanced in GDM+RESV offspring.

Gestational diabetes (GDM), the most common complication of pregnancy, is associated with adverse metabolic health outcomes in offspring. Using a rat model of diet‐induced GDM, we investigated whether maternal resveratrol (RESV) supplementation (147 mg kg–1 day–1) in the third week of pregnancy could improve maternal glycaemia and protect the offspring from developing metabolic dysfunction. Female Sprague–Dawley rats consumed a high‐fat and sucrose (HFS) diet to induce GDM. Lean controls consumed a low‐fat (LF) diet. In the third trimester, when maternal hyperglycaemia was observed, the HFS diet was supplemented with RESV. At weaning, offspring were randomly assigned a LF or HFS diet until 15 weeks of age. In pregnant dams, RESV restored glucose tolerance, normoglycaemia and improved insulin secretion. At 15 weeks of age, GDM+RESV‐HFS male offspring were less obese than the GDM‐HFS offspring. By contrast, the female GDM+RESV‐HFS offspring were similarly as obese as the GDM‐HFS group. Hepatic steatosis, insulin resistance, glucose intolerance and dysregulated gluconeogenesis were observed in the male GDM offspring and were attenuated in the offspring of GDM+RESV dams. The dysregulation of several metabolic genes (e.g. ppara, lpl, pepck and g6p) in the livers of GDM offspring was attenuated in the GDM+RESV offspring group. Glucose stimulated insulin secretion was also improved in the islets from offspring of GDM+RESV dams. Thus, maternal RESV supplementation during the third trimester of pregnancy and lactation induced several beneficial metabolic health outcomes for both mothers and offspring. Therefore, RESV could be an alternative to current GDM treatments.
Investigating the Self-Healing of Dynamic Covalent Thermoset Polyimine and Its Nanocomposites
Authors: Shi Chuanqian , Zou Zhanan , Lei Zepeng , Wu Xingli , Liu Zhengwei , Lu Haiqing , Zhang Wei , Xiao Jianliang
Published: June 2019

Self-healable and recyclable materials and electronics can improve the reliability and repairability and can reduce environmental pollution; therefore, they promise very broad applications. In this study, we investigated the self-healing performance of dynamic covalent thermoset polyimine and its nanocomposites based on the dynamic covalent chemistry. Heat press was applied to two laminating films of polyimine and its nanocomposites to induce self-healing. The effects of heat press time, temperature, and load on the interfacial shear strength of the rehealed films were investigated. The results showed that increasing the heat press time, temperature, and load can significantly improve the interfacial shear strength and thus the self-healing effect. For polyimine nanocomposites, increasing the heat press time, temperature, and load led to the improved electrical conductivity of the rehealed films.
On Incompressibility Constraint and Crack Direction in Soft Solids
Authors: Mythravaruni P. , Volokh K. Y.
Published: June 2019

Most soft materials resist volumetric changes much more than shape distortions. This experimental observation led to the introduction of the incompressibility constraint in the constitutive description of soft materials. The incompressibility constraint provides analytical solutions for problems which, otherwise, could be solved numerically only. However, in the present work, we show that the enforcement of the incompressibility constraint in the analysis of the failure of soft materials can lead to somewhat nonphysical results. We use hyperelasticity with energy limiters to describe the material failure, which starts via the violation of the condition of strong ellipticity. This mathematical condition physically means inability of the material to propagate superimposed waves because cracks nucleate perpendicular to the direction of a possible wave propagation. By enforcing the incompressibility constraint, we sort out longitudinal waves, and consequently, we can miss cracks perpendicular to longitudinal waves. In the present work, we show that such scenario, indeed, occurs in the problems of uniaxial tension and pure shear of natural rubber. We also find that the suppression of longitudinal waves via the incompressibility constraint does not affect the consideration of the material failure in equibiaxial tension and the practically relevant problem of the failure of rubber bearings under combined shear and compression.
A Coupling Approach Combining Computational Fluid Dynamics and Finite Element Method to Predict Cutting Fluid Effects on the Tool Temperature in Cutting Processes
Authors: Helmig Thorsten , Peng Bingxiao , Ehrenpreis Claas , Augspurger Thorsten , Frekers Yona , Kneer Reinhold , Bergs Thomas
Published: June 2019

In metal cutting processes, the use of cutting fluids shows significant effects on workpiece surface quality by reducing thermomechanical loads on cutting tool and workpiece. Many efforts are made to model these thermomechanical processes, however without considering detailed heat transfer between cutting fluid, tool, and workpiece. To account for heat transfer effects, a coupling approach is developed, which combines computational fluid dynamics (CFD) and finite element method (FEM) chip formation simulation. Prior to the simulation, experimental investigations in orthogonal cutting in dry and wet cutting conditions with two different workpiece materials (AISI 1045 and DA 718) are conducted. To measure the tool temperature in dry as well as in wet cutting conditions, a two color pyrometer is placed inside an electrical discharge machining (EDM) drilled cutting tool hole. Besides tool temperature, the cutting force is recorded during the experiments and later used to calculate heat source terms for the CFD simulation. After the experiments, FEM chip formation simulations are performed and provide the chip forms for the CFD mesh generation. In general, CFD simulation and experiment are in reasonable agreement, as for each workpiece setup the measured temperature data are located between the simulation results from the two different tool geometries. Furthermore, numerical and experimental results both show a decrease of tool temperature in wet cutting conditions, however revealing a more significant cooling effect in a AISI 1045 workpiece setup. The results suggest that the placement of drilling holes has a major influence on the local tool temperature distribution, as the drilling hole equals a thermal resistance and hence leads to elevated temperatures at the tool front.
A Relative Adequacy Framework for Multi-Model Management in Design Optimization
Authors: Bayoumy Ahmed H. , Kokkolaras Michael
Published: June 2019

We consider the problem of selecting among different physics-based computational models of varying, and oftentimes not assessed, fidelity for evaluating the objective and constraint functions in numerical design optimization. Typically, higher-fidelity models are associated with higher computational cost. Therefore, it is desirable to employ them only when necessary. We introduce a relative adequacy framework that aims at determining whether lower-fidelity models (that are typically associated with lower computational cost) can be used in certain areas of the design space as the latter is being explored during the optimization process. We implement our approach by means of a trust-region management framework that utilizes the mesh adaptive direct search derivative-free optimization algorithm. We demonstrate the link between feasibility and fidelity and the key features of the proposed approach using two design optimization examples: a cantilever flexible beam subject to high accelerations and an airfoil in transonic flow conditions.