bluuebunny/crossref_metadata_2025 huggingface dataset:
Replication of Top Loci From COL4A1/2 Associated With White Matter Hyperintensity Burden in Patients With Ischemic Stroke
Authors: Li Jiang , Abedi Vida ,   on behalf of Regeneron Genetic Center, Zand Ramin , Griessenauer Christoph J.
Published: November 2020

Background and Purpose:

The purpose of this study was to replicate the top loci associated with white matter hyperintensity (WMH) phenotypes identified by large genome-wide association studies and the loci identified from the previous candidate gene studies.

Methods:

A total of 946 Geisinger MyCode patients with acute ischemic stroke with validated European ancestry and magnetic resonance imaging data were included in this study. Log-transformed WMH volume, as a quantitative trait, was calculated by a fully automated quantification process. The genome-wide association studies was carried out by a linear mixed regression model (GEMMA). A candidate-single nucleotide polymorphism analysis by including known single nucleotide polymorphisms, reported from a meta-analysis and several large GWAS for WMH, was conducted in all cases and binary converted extreme cases.

Results:

No genome-wide significantly associated variants were identified. In a candidate-single nucleotide polymorphism study, rs9515201 (
COL4A2
) and rs3744028 (
TRIM65
), 2 known genetic loci, showed nominal or trend of association with the WMH volume (β=0.13 and
P
=0.001 for rs9515201; β=0.094 and
P
=0.094 for rs3744028), and replicated in a subset of extreme cases versus controls (odds ratio=1.78,
P
=7.74×10
−
4
for rs9515201; odds ratio=1.53,
P
=0.047 for rs3744028, respectively). MTHFR677 cytosine/thymine (rs1801133) also showed an association with the binary WMH with odds ratio=1.47 for T allele (
P
=0.019).

Conclusions:

Replication of COL4A1/2 associated with WMH reassures that the genetic risk factors for monogenic and polygenic ischemic stroke are shared at gene level.
Implementing the Law of khulʿ in Egypt
Authors: Lindbekk Monika
Published: November 2020

This article aims to contribute to the growing scholarly literature on the implementation of shariʿa-based family law codes by describing and analyzing the gender implications of religiously inspired judicial activism in relation to judicial divorce through khulʿ. The article highlights two functions played by family court judges and other legal professionals. First, I argue that Egyptian family court judges and other court personnel, such as court experts and court-appointed arbiters from al-Azhar, enjoy considerable discretion in interpreting and implementing the personal status codes. Second, the article argues that legal professionals sometimes use the court and other legal spaces as a platform to articulate alternative visions of family and marriage, as well as to voice anxieties over a perceived increase in female-initiated divorce. The article situates these contradictory practices against the background of the contestation of early twenty-first-century reforms, which challenged male authority in the family, in particular the 2000 law of judicial khulʿ.
Intimacy Under Surveillance: Illicit Sexuality, Moral Policing, and the State in Contemporary Malaysia
Authors: Mohd. Razif Nurul Huda
Published: November 2020

Malaysia’s Malay-Muslim majority adheres to heteronormative forms of sexuality that recognise marriage as the only means of securing access to lawful sexual intimacy. Islam, Malay customs (adat), and the Malaysian state impose strict sanctions on pre- and extramarital intimacy in its Syariah criminal laws. A Vice Prevention Unit responsible for moral policing is legally authorised to arrest couples who violate Islamic rules of behaviour, including sexual offences such as khalwat (illicit proximity)—a crime of passion punishable by a fine and/or imprisonment. This article compares two khalwat trials in Kota Bharu and Kuala Lumpur’s Syariah court to illustrate what Peletz (2002) calls the judges’ “cultural logic of judicial reasoning”. In these trials, Syariah judges extend beyond a narrowed focus on gender to also consider cultural understandings of age, profession, family circumstances, and marital status, thus reproducing Malay adat understandings of intimacy, marriage, and personhood. In an effort to steer young couples away from forbidden sexual temptations, the Malaysian state liberalises access to marriage by recognising cross-border marriages contracted in Southern Thailand, offering financial incentives to young couples intending to marry and defending existing legal provisions allowing the marriage of minors. The Malaysian state’s mix of punitive, preventative, and pro-marriage policies, I suggest, are various ways of surveilling sexuality by bringing uncontrolled desires under the purview of matrimony, where it may find its lawful expression.
A Practical Screening Tool to Predict Early Childhood Obesity Risk: Examining a Birth Cohort
Authors: Gannon James , Pollock Allison J. , Allen David B. , Kling Pamela J.
Published: November 2020

Children obese at the age of 5 years are at greater risk of lifelong obesity. Because certain risks of obesity can be identified in early infancy, a tool for obesity risk prediction in early life would be clinically useful. We investigated predictors of obesity risk in a novel, prospectively collected healthy birth cohort recruited for demographic risks to develop iron deficiency at 1 year, a cohort leveraged because risk factors for iron deficiency and obesity overlap. Obesity at the age of 5 years was defined as age- and sex-specific body mass index Z-score ( zBMI) >2SD. For each child, obesity risk factors were summed. Of 10 total risk factors, the following 4 key risks were identified: maternal obesity, maternal diabetes, large for gestational age, or breastfeeding <6 months. Childhood obesity was predicted by either ≥3 total number of risks ( P < .033), any key risk ( P < .002), or summing key risks ( P < .0001). In clinical practice, summing early life risk factors may be a useful strategy for preemptive counseling.
An Empirical Analysis of the Environmental Kuznets Curve for River Water Pollution in Uttar Pradesh
Authors: Sheikh Aisha , Hassan Owais Ibni
Published: November 2020

This article attempts to test the environmental Kuznets curve (EKC) hypothesis for river water pollution for a panel dataset of 15 districts of Uttar Pradesh. There are sharp socio-economic and demographic variations within India; therefore, a regional study can give a better insight into the pollution income relationship of a specific region compared to a national study. Panel unit root tests, Pedroni cointegration test and fully modified ordinary least square (FMOLS) method have been employed to investigate EKC for two water pollutants—biochemcial oxygen demand (BOD) and total coliform (TC). Findings suggest that there is no evidence of an EKC for BOD, but results validate the existence of an EKC for TC. The Swachha Bharat Mission launched in 2014 aimed at eliminating open defecation and increasing toilet access in rural India can be a credited for the reduction in TC levels since 2014. The success of NAMAMI Gange so far seems to be localised to regions where political thrust has expedited the completion of projects.
Distrust in government and its relationship with mental health after the Fukushima nuclear power plant accident
Authors: Fukasawa Maiko , Kawakami Norito , Umeda Maki , Akiyama Tsuyoshi , Horikoshi Naoko , Yasumura Seiji , Yabe Hirooki , Suzuki Yuriko , Bromet Evelyn J
Published: November 2020

Background:

Distrust in authorities has negative effects on mental health.

Aims:

In this study, we aimed to explore whether the impact of distrust in government on mental health became stronger in the area heavily affected by the 2011 Fukushima nuclear power plant accident.

Methods:

We examined the effects of distrust in the national government on depressive symptoms three years after the accident among community residents in Fukushima prefecture using those in the Kanto area (the area surrounding Tokyo) as a control. A questionnaire survey was administered to a random sample of 1000 residents in Fukushima prefecture and 1650 residents in the Kanto area. Distrust in the national government was assessed using a four-point single-item scale. Depressive symptoms were measured using the Patient Health Questionnaire-9. The associations of residential area (i.e. living in Fukushima prefecture or in the Kanto area) and distrust in the national government with depressive symptoms were examined, controlling for socio-demographic characteristics and disaster-related experiences using multivariate linear regression analyses. We used the interaction term of residential area and distrust in the government to explore the difference in the association between the respondents in Fukushima prefecture and those in the Kanto area.

Results:

Valid responses were obtained from 976 (36.8%) residents. Distrust in the government was associated with depressive symptoms and the association was stronger in Fukushima prefecture than in the Kanto area.

Conclusion:

The deleterious effects of distrust in the government on mental health may become more serious after a nuclear power plant accident and require careful attention during support activities in an affected area.
Femtosecond laser polishing of SiC/SiC composites: Effect of incident angle on surface topography and oxidation
Authors: Yan Zhaoxuan , Lin Qingyan , Li Guoji , Zhang Yong , Wang Wenjun , Mei Xuesong
Published: November 2020

In this article, a new ultrafast laser polishing method for SiC/SiC composites was reported and the effects of different incident angles were discussed in detail. The results indicated that the incident angle had a great influence on the polishing of SiC/SiC composites. Under the normal incident condition, the surface roughness was barely improved and the laser-induced defects even degraded the process quality. With the increasing incident angle, surface oxidation and defects dramatically decreased. At 80 degrees, the surface convex structure is almost eliminated and the protruding fiber was neatly cut off. Furthermore, a theoretical model of laser polishing for SiC/SiC composites is used to analyze the laser propagation and power density distribution in different incident angles. The model successfully predicted the laser energy resonance enhancement and illustrated the formation mechanism of laser-induced defects and nanoripples. Meanwhile, the result shows that the laser energy concentrated on the convex fiber of composites as the incident angle increased, which explained that the SiC/SiC composites polishing quality was significantly improved under the inclined incident condition.
Research on compression properties of unidirectional carbon fiber reinforced epoxy resin composite (UCFREP)
Authors: Changfang Zhao , Zhitan Zhou , Changxing Zhao , Hongwei Zhu , Kebin Zhang , Jianlin Zhong , Jie Ren , Guigao Le
Published: November 2020

To research the axial compression properties of unidirectional carbon fiber reinforced epoxy resin composite (UCFREP), the compression experiments at different strain rates were carried out by using the MTS universal electronic testing machine and the equipment of split Hopkinson pressure bar (SHPB). Furthermore, the finite element analysis (FEA) was also used to study the compression properties of UCFREP with different conditions. The true stress-strain curves in quasi-static and dynamic compression were obtained, and the relationship between yield limit and strain rate was coupled. The microstructure of the failure area was observed by scanning electron microscope (SEM). A formula for predicting compression strength of combined buckling under the quasi-static condition was presented. The application range of Chang-Chang failure criterion was discussed by FEA, and the compression failure of UCFREP with different fiber directions was predicted. The results show that UCFREP has the obvious strain rate effect, the mechanical properties at dynamic compression are nonlinear. Shear is the main compression failure mode, which includes the shear cracking of matrix between fibers and the shear buckling of fiber. The direction of the fiber is the main factor that causes the shear cracking, such as the shear cracking shows the feature of 45° when the direction of the fiber is 45°. As a conclusion, increasing the shear strength of matrix and fiber will be a way to increase the compression strength of UCFREP. This paper could be used as a reference to develop the new constitutive model, especially considering the nonlinear effect.
Developing and Establishing Content Validity of Vignettes for Health Care Education and Research
Authors: St. Marie Barbara , Jimmerson Andrea , Perkhounkova Yelena , Herr Keela
Published: November 2020

The use of vignettes in research and education is well documented. Documentation of how vignettes are developed and content validity is established, however, are rare. The purpose of this paper is to describe a method for development and establishing content validity of vignettes that can be used to assess student performance and research participant outcomes. This three-phase method was designed to validate seven vignettes for a future research project. Content validity index survey and expert panel interviews were used to inform improvements in validity. Findings showed that clinical vignettes were improved with respect to content relevance (from 0.93 to 0.96) and importance (from 0.68 to 0.93). Developing validated vignettes is essential when used to measure outcomes in education and in research. This three-phase method of vignette development and validation is feasible and effective in improving content validity of vignettes and can be used in other education and research projects.
Police–school partnerships and the war on black youth
Authors: Nijjar Jasbinder S.
Published: November 2020

This article discusses the growing presence of police officers in British schools, under a resurgent police–school partnerships policy agenda in the ‘war on gangs’ and serious youth violence. It argues that while efforts to coordinate law enforcement and education implicate schools in general, evidence on race and policing raises concerns about the disproportionate impact of such strategies on black students. Police–school partnerships enhance existing and escalating forms of multi-agency police surveillance and profiling, while also giving officers a greater role in everyday schooling matters. Thus, grassroots anti-racist movements face a developing and dynamic challenge to resist not only the militarised policing of black youth, but also the corresponding weaponization of schools and the wider welfare state.
Lived experiences in daily life with myalgic encephalomyelitis
Authors: Sandhu Reeti KK , Sundby Maj , Ørneborg Sidsel , Nielsen Svetlana Solgaard , Christensen Jeanette Reffstrup , Larsen Anette Enemark
Published: November 2020

Introduction

Myalgic encephalomyelitis is a complex systemic condition, causing severe symptoms that limit the quality of life of the people living with it. This study examined changes in life, coping strategies, and the ability to obtain a successful occupational adaptation in people with myalgic encephalomyelitis in Denmark, viewed from the perspective of the model of human occupation.

Method

In-depth qualitative interviews with seven persons with myalgic encephalomyelitis aged 31–61 years were analysed with qualitative content analysis.

Results

The participants experienced severe changes in their lives leading to impaired occupational competences which affected their occupational identity and made them lonely. Pacing and environmental changes were the preferred coping strategies in their attempt to adapt to the new circumstances.

Conclusion

The participants experienced major changes in everyday life with the onset of myalgic encephalomyelitis. Pacing and environmental changes were not sufficient strategies to secure a successful occupational adaptation. Thus, people living with myalgic encephalomyelitis need assistance to enable a successful occupational adaptation and preserve hope. Access to occupational therapy within the Danish programme for people living with myalgic encephalomyelitis may support more effective occupational adaptation in the population.
Validation of Prognostic Radiomic Features From Resectable Pancreatic Ductal Adenocarcinoma in Patients With Advanced Disease Undergoing Chemotherapy
Authors: Salinas-Miranda Emmanuel , Khalvati Farzad , Namdar Kashayar , Deniffel Dominik , Dong Xin , Abbas Engy , Wilson Julie M. , O’Kane Grainne M. , Knox Jennifer , Gallinger Steven , Haider Masoom A.
Published: November 2020

Background:

Radiomic features in pancreatic ductal adenocarcinoma (PDAC) often lack validation in independent test sets or are limited to early or late stage disease. Given the lethal nature of PDAC it is possible that there are similarities in radiomic features of both early and advanced disease reflective of aggressive biology.

Purpose:

To assess the performance of prognostic radiomic features previously published in patients with resectable PDAC in a test set of patients with unresectable PDAC undergoing chemotherapy.

Methods:

The pre-treatment CT of 108 patients enrolled in a prospective chemotherapy trial were used as a test cohort for 2 previously published prognostic radiomic features in resectable PDAC (Sum Entropy and Cluster Tendency with square-root filter[Sqrt]). We assessed the performance of these 2 radiomic features for the prediction of overall survival (OS) and time to progression (TTP) using Cox proportional-hazard models.

Results:

Sqrt Cluster Tendency was significantly associated with outcome with a hazard ratio (HR) of 1.27(for primary pancreatic tumor plus local nodes), (Confidence Interval(CI):1.01 -1.6, P-value = 0.039) for OS and a HR of 1.25(CI:1.00 -1.55, P-value = 0.047) for TTP. Sum entropy was not associated with outcomes. Sqrt Cluster Tendency remained significant in multivariate analysis.

Conclusion:

The CT radiomic feature Sqrt Cluster Tendency, previously demonstrated to be prognostic in resectable PDAC, remained a significant prognostic factor for OS and TTP in a test set of unresectable PDAC patients. This radiomic feature warrants further investigation to understand its biologic correlates and CT applicability in PDAC patients.
Biocompatibility study of modified injectable hyaluronic acid hydrogel with mannitol/BSA to alveolar bone cells
Authors: Areevijit Kwanhatai , Dhanesuan Nirada , Luckanagul Jittima Amie , Rungsiyanont Sorasun
Published: November 2020

The quality and quantity of bone are crucial to the success of dental implant treatment. Recently, bone grafting materials have reached some limitations. This study aimed to evaluate the biocompatibility of novel drug delivery material, injectable methacrylated hyaluronic acid hydrogel incorporated with different ratios of mannitol and BSA (Man/BSA MeHA), to human alveolar bone cells. The three-dimensionally encapsulated cell culture was evaluated with the resazurin cell viability test, alkaline phosphatase activity assay, immunohistochemistry test for collagen type-I synthesis, and cell morphology. The results showed that the encapsulated cells were viable in all four ratios of Man/BSA MeHA hydrogel and the average metabolic rate was not less than the control group. The morphology test showed round shape cells at the upper portion of the hydrogel and fibroblast-like or polygonal shape at the lower portion of hydrogel next to the culture plate. All four groups could express enzyme alkaline phosphatase and collagen type-I. In conclusion, four ratios of Man/BSA MeHA hydrogel were biocompatible with primary human alveolar bone cells.
The notion of ‘a person of unsound mind’ under Article 5 § 1(e) of the European Convention on Human Rights
Authors: Szwed Marcin
Published: November 2020

This article presents a critical analysis of the case-law of the ECtHR with regards to the interpretation of the notion of ‘a person of unsound mind’ under Article 5 § 1(e) of the Convention. According to the Court, only a person who has been reliably diagnosed with a mental disorder and who poses a danger to himself or others can be legally detained as ‘a person of unsound mind’. However, the notion of ‘unsoundness of mind’ is not limited to such mental disorders which are treatable or which deprive the persons affected of their ability to self-control and so in the past the Court applied the said provision of the Convention to, among others, persons diagnosed with personality disorders or paedophilia who commited crimes acting with full criminal responsibility. The article argues that such a definition of the notion ‘a person of unsound mind’ is not sufficiently clear, what is dangerous from the perspective of protection of personal liberty. For this reason, the article proposes to limit the scope of the analysed notion to persons affected by such mental disorders that exclude or significantly reduce their ability to make informed decisions about their own health and/or to control their own behaviour and recognise the meaning of their own actions. Only then, provided that other criteria developed in the Court’s case law, such as dangerousness for self or others and lack of less restrictive alternatives, have been satisfied, detention of person with mental disorder may be consistent with the object and purpose of the Convention.
Cultural and Practical Implications for Psychiatric Telehealth Services: A Response to COVID-19
Authors: Goldin Deana , Maltseva Tatayana , Scaccianoce Monica , Brenes Francisco
Published: November 2020

In the midst of the current COVID-19 pandemic, telehealth or the remote delivery of mental health services via videoconferencing technology is experiencing exponential growth in utilization. Telehealth services provide mental healthcare providers the ability to deliver timely assessments, facilitate and leverage scarce resources, and maintain client connections in a time where social distancing is endorsed. The delivery of culturally appropriate psychiatric telehealth services is particularly relevant for diverse ethnic populations along with best practices to promote client-provider engagement and client satisfaction. The aim of this article is to provide an overview of psychiatric telehealth services and its functions and deliver insights into culturally appropriate practice strategies.
Patients’ Experiences of Comorbid HIV/AIDS and Diabetes Care and Management in Soweto, South Africa
Authors: Bosire Edna N.
Published: November 2020

More people with HIV live in South Africa than anywhere else in the world. As people with HIV increasingly confront comorbid conditions, such as Type 2 diabetes, the need for integrated chronic care continues to grow. However, chronic care for patients with multimorbidities is limited in many public hospitals in South Africa. This ethnographic study describes patients’ experiences seeking care for comorbid HIV and diabetes at a public tertiary hospital in Soweto, South Africa, and self-management at home. Findings illustrate how fragmented care, multiple clinic appointments, conflicting information, and poor patient–provider communication impeded patients’ access to care for their multimorbidities. Socio-economic factors such as poverty, costly transport to the hospital, and food insecurity impeded management of multimorbidities. Integrated care for patients with multimorbidities in Soweto is imperative and must recognize the critical role social and economic conditions play in shaping the experiences of living with HIV, diabetes, and their overlap.
Clinical Outcomes and Complications Following Limited Open Achilles Repair Without an Instrumented Guide
Authors: Akoh Craig C. , Fletcher Amanda , Sharma Akhil , Parekh Selene G.
Published: November 2020

Background:

We report the clinical outcomes and complications following our limited open incision Achilles tendon repair technique without instrument guides.

Methods:

A total of 33 patients were included in this study. We recorded pre- and postoperative scores on the Foot and Ankle Disability Index (FADI), visual analog scale (VAS), and the Foot and Ankle Outcome Score (FAOS). Subgroup analyses were performed for acute (<2 weeks) and subacute (2-6 weeks) Achilles tendon repairs. A P value <.05 was considered significant for all statistical analyses.

Results:

The median time from injury to surgery was 10.0 days (range, 1-45 days). At a median follow-up of 3.7 years (range, 1.0-9.8 years), the average pre- and postoperative outcome scores improved significantly for the following: FADI index (49.1-98.4, P < .001), VAS (4.8-0.2, P < .001), FAOS Pain (54.8-99.2, P < .001), FAOS Symptoms (84.6-97.0, P < .001), FAOS activities of daily living (61.4-97.2, P < .001), FAOS Sports and Recreational Activity (39.5-98.5, P < .001), and FAOS quality of life (39.7-88.7, P < .001). There were no significant differences between pre- and postoperative outcome scores between the acute and subacute Achilles repair groups. There were no wound complication, reruptures, or reoperations in the entire cohort.

Conclusion:

Patients showed improvements in postoperative patient-reported outcome scores with minimal complications. There was no significant difference in outcomes for acute vs subacute repairs. Our limited open incision Achilles tendon repair, which required no additional targeting instrumentation, had favorable midterm results.

Level of Evidence:

Level IV, retrospective case series.
Atglistatin Pretreatment Preserves Remote Myocardium Function Following Myocardial Infarction
Authors: Bottermann Katharina , Granade Mitchell E. , Oenarto Vici , Fischer Jens W. , Harris Thurl E.
Published: November 2020

The pathological role of adipose derived fatty acids following myocardial infarction has long been hypothesized. However, most methods for reducing adipocyte lipolysis have significant non-adipose effects. Atglistatin, a direct inhibitor of the initial lipase in the lipolysis cascade, has been recently shown to inhibit adipose tissue lipolysis after oral administration. To explore the ability of Atglistatin to impact the pathophysiology of cardiac ischemia we performed prophylactic treatment of mice with Atglistatin for 2 days before 1-hour cardiac ischemia. After 7 days of reperfusion, hearts of Atglistatin treated mice showed significantly improved systolic pump function while infarct and scar size were unaffected. Strain analysis of echocardiographic data revealed an enhanced performance of the remote myocardium as cause for overall improved systolic function. The present study provides evidence that inhibition of adipocyte adipose triglyceride lipase (ATGL) using Atglistatin is able to improve cardiac function after MI by targeting the remote myocardium.
Localized muscle spasm as a manifestation of pembrolizumab-induced infusion reaction
Authors: White Christopher , Borlagdan Jared , Wing Jason , Lopez Charles D
Published: November 2020

Introduction

As immune checkpoint inhibitors increasingly gain oncological utility, the incidence of unique adverse events may rise as well. The description and management of localized, recurrent muscle spasms secondary to pembrolizumab infusions has not previously been reported.

Case report

A 64-year-old male receiving pembrolizumab infusions experienced acute-onset, isolated spasms and pain occurring in cycles 2 through 5. Management and outcome: Pretreatment with intravenous lorazepam, diphenhydramine, famotidine, ondansetron, and fluids have led to spasm-free pembrolizumab infusions.

Discussion

The purpose of this report is to provide the first known incidence and successful corrective measures taken for localized muscle spasms secondary to pembrolizumab infusion.
Depressive Disorders Are Associated With Risk of Falls in People With Chronic Kidney Disease
Authors: Kistler Brandon M. , Khubchandani Jagdish , Bennett Paul , Wilund Kenneth R. , Sosnoff Jacob
Published: November 2020

OBJECTIVES

People with chronic kidney disease (CKD) are at increased risk for falls and fall-related injuries. Depressive disorders (DEP) are common in individuals with CKD and may increase the risk of falls and fall-related injuries. However, not much is known about the relationship between DEP and falls in people with CKD. The purpose of this study was to determine the influence of DEP on the relationship between CKD, falls, and fall-related injuries.

METHOD

Using the Behavioral Risk Factor Surveillance System, we identified 16,574 adults with CKD. Patients with CKD were stratified by history of self-reported DEP (SRDEP), and multivariate logistic regression was conducted to determine the odds for falls and fall-related injuries among those with and without SRDEP.

RESULTS

In unadjusted regression analysis, falls (OR = 2.40, 95% CI = 2.08-2.76) and fall-related injuries (OR = 2.12, 95% CI = 1.72-2.59) were higher in individuals with CKD and history of SRDEP compared to those with CKD and no history of SRDEP. Adjustment for confounders had little effect on the relationship between a history of SRDEP and either falls (AOR = 1.87, 95% CI = 1.60-2.19) or fall-related injuries (AOR = 1.58, 95% CI = 1.26-1.97).

CONCLUSIONS

People with CKD and DEP are at increased odds for falls and fall-related injuries even after adjustment for sociodemographic, lifestyle factors, and comorbidities. Prospective studies are warranted to further understand this relationship, but it may be prudent for clinicians, in particular nurses, to consider fall risk when treating DEP in patients with CKD.
Structural Adjustment and Community Resilience: The Case of Postdisaster Housing Recovery After the Canterbury Earthquakes of 2010 and 2011
Authors: Rivera-Muñoz Graciela , Howden-Chapman Philippa
Published: November 2020

Background

This project is a case study of postdisaster housing recovery in Christchurch, New Zealand, after the Canterbury earthquakes of 2010 and 2011.

Aims

In this qualitative study, we analyzed the statutory framework governing the process of postdisaster housing recovery and its impact on local democracy. We also explored the role of communities and the third sector in housing and urban renewal. This aim was to contribute to the development of a critical theoretical understanding of community resilience as an inherently political concept. Community resilience is influenced by causal factors or generative mechanisms that affect the relations between people in a particular social context.

Method

We completed a narrative synthesis of textual data from the thematic analysis of in-depth interviews with key informants, related policies, media, and fieldwork.

Results

A centralization of government authority over housing recovery resulted in an erosion of democracy and representative government at a local level. This centralization had major impacts on communities and their voice in the process of postdisaster housing recovery. Communities, however, never relented and worked tirelessly among themselves and with other social sectors to make a positive impact on postdisaster housing and urban recovery against difficult odds and stretched resources. This immense social capital and inspiring sense of community must be fostered and given the opportunity to democratically participate in the development of recovery policy as a key element of community resilience.
Efficacy and safety of Nd:YAG laser vitreolysis for symptomatic vitreous floaters: A randomized controlled trial
Authors: Ludwig Gustavo D , Gemelli Henrique , Nunes Guilherme M , Serracarbassa Pedro D , Zanotele Márgara
Published: November 2020

Background:

Vitreous floaters are a common and inconvenient phenomena. This study aims to examine the efficacy and safety in treating vitreous floaters using Nd:YAG laser vitreolysis.

Methods:

In this prospective double-blinded randomized clinical trial 24 eyes of twenty-four patients were randomized into intervention with YAG laser vitreolysis and control groups. Primary outcomes were visual disturbance on a 10-point scale, qualitative changes in a 4-level scale, contrast sensitivity measured with the Pelli-Robson table and the National Eye Institute Visual Functioning Questionnaire 25 (NEI VFQ-25). Secondary results included objective change in vitreous opacities, best-corrected visual acuity (BCVA), variation in intraocular pressure (IOP) and other adverse events.

Results:

Twenty-one patients (21 eyes; 5 male, 16 female) were enrolled in this study (mean age 62 ± 7.9 years), three were lost during follow-up. In the YAG laser group, the 10-point visual disturbance score improved a mean of 4.7 points ( p < 0.001) compared to the control group that improved 2.1 ( p = 0.09). The YAG laser group reported greater subjectively symptomatic improvement (77%) than controls (25%). NEI VFQ-25 revealed improved general vision (75.8 versus 59.2; p = 0.037) and in mental health at 6 months (84.3 versus 70.3; p = 0.048). There was no significant difference in contrast sensitivity ( p = 0.848) and in IOP ( p = 0.505). No differences in adverse events between groups were identified.

Conclusion:

Vitreolysis with Nd:YAG laser improves visual results in patients with symptomatic vitreous floaters, without adverse events considered clinically relevant. Other trials with a larger number of participants are required to corroborate these results.
A novel surgical technique for the treatment of a filtration bleb extending over 180° after Xen gel stent implantation
Authors: Välimäki Juha
Published: November 2020

Purpose:

To describe a novel surgical treatment option for managing a symptomatic filtration bleb extending into the three quadrants with adequate IOP control after Xen gel stent implantation.

Methods:

A 62-year-old female with pseudoexfoliative glaucoma with an IOP of 34 mmHg underwent implantation of a Xen to reduce the IOP in her right eye. The IOP responded well to the procedure, but the patient developed a persistent giant filtration bleb with foreign body sensation and pain. A huge filtering bleb of over 180° after Xen implant surgery was managed by splitting the giant bleb into two parts, posterior dissection into the intermuscular space, a biodegradable collagen device implantation, and suturing the conjunctiva in two parts with absorbable and nonabsorbable sutures.

Results:

Before the operation for treatment of a giant bleb, the patient had an IOP of 12 mmHg, a best-corrected visual acuity (BCVA) of 20/40, corneal dellen, and no antiglaucoma medication. Following the bleb recession procedure, the IOP was 16 mmHg, BCVA improved to 20/20, there were no corneal dellen and the patient reported resolution of her bleb discomfort. The IOP and BCVA remained stable through 18 months of follow-up and no antiglaucoma medications or additional surgical procedures were required.

Conclusion:

The novel technique described here can be one option to treat this rare (over 180°) bleb formation after Xen Gel Stent implantation without adversely affecting IOP control.
A retrospective analysis of the clinical effectiveness of subcutaneously tunneled femoral vein cannulations at the bedside: A low risk central venous access approach in the neonatal intensive care unit
Authors: Ostroff Matthew , Zauk Adel , Chowdhury Sara , Moureau Nancy , Mobley Carly
Published: November 2020

Objective:

The purpose of this retrospective analysis was to evaluate the clinical efficacy and safety of ultrasound (US)-guided, subcutaneously tunneled, femoral inserted central catheters (ST-FICCs) in the neonatal intensive care unit (NICU).

Methods:

Following clinical success with ST-FICCs in adults, we expanded this practice to the neonatal population. In an 18-month retrospective cohort analysis (2018–2020) of 82 neonates, we evaluated the clinical outcome for procedural success, completion of therapy, and incidence of early and late complications for insertion of US-guided ST-FICCs in the NICU.

Results:

Placement of ST-FICCs were successful in 100% of neonates ( n = 82/82) with 94% to the right ( n = 77/82) and 6% to the left common femoral veins ( n = 5/82). Gestational age ranged 23-39 weeks with median age of 29 weeks. Birthweight ranged from 450 g to >2000 g. Weight at insertion ranged 570 to 3345 g and day of life 1 to 137, with median at day 5. Ultrasound guided femoral vein puncture was recorded on 74 patients, first attempt 63/74 (85%), second attempt 8/74 (11%) and third attempt 3/74 (4%). Catheter french used: 1.9Fr ( n = 80/82), 2.6Fr ( n = 1/82), and 3-Fr ( n = 1/82). Catheter lengths were 8 to 20 cm, average 12cm. Catheter termination confirmed with posterior/anterior and lateral abdominal radiographs with inferior vena cava (IVC) ( n = 33/82), IVC/right atrial junction ( n = 31/82), or right atrium ( n = 18/82). Atrial placements were retracted; no cases of malposition to the lumbar/renal/hepatic veins ( n = 0/82). 1528 catheter days ranging 5 to 72 days (average 18). No insertion-related or post-insertion complications. All patients completed prescribed therapy with one catheter.

Conclusion:

Bedside placement of an ST-FICC is a safe route for central venous access in the NICU, preserving upper extremity vasculature, eliminates risks associated with sedation, fluoroscopy, tunneled and non-tunneled supra-diaphragmatic central venous insertion.
How a catchy bass line might someday resonate beyond my business ethics classroom: Rock music in management learning
Authors: Michaelson Christopher
Published: November 2020

Business ethics is one of the “unsettled humanities” in a management curriculum that tends to value instrumental and measurable goods. However, the value of business ethics may not be apparent to students until they experience unpredictable challenges to their ethical values at work long after they have left the management classroom. This essay traces my journey to using music – particularly, British rock songs – to reinforce learning and retention of the essential feelings and ideas in my students’ learning experience. It draws upon contrasting theories of ethical and economic value, the role of narrative in ethical theory and pedagogy, and the associative powers of music to show how the lyrics and music of songs might help classroom learning resonate later in life. In doing so, the essay shows how the songs of rebellious rock musicians might unsettle stereotypical conceptions of business and resettle appreciation for the value of the arts and humanities in life and work.
GDP volatility implication of tourism volatility in South Africa: A time-varying approach
Authors: Lee Chien-Chiang , Olasehinde-Williams Godwin O , Olanipekun Ifedolapo Olabisi
Published: November 2020

The importance of tourism as one of the bedrocks of economic growth in South Africa suggests that volatility in the sector may have dire consequences. We therefore empirically analyse the impact of tourism volatility (TV) on the gross domestic product (GDP) volatility of the country, using time-varying approaches that treat the parameter estimations as functions of time, thereby overcoming the challenge posed by parameter instabilities, non-linearities, non-stationarity, regime shifts and time variations. We find that TV significantly aggravates GDP volatility (GDPV) in South Africa. The impact varies from year to year and is greatest during the periods characterized by economic turbulence and crime and violence against foreigners. The size of the coefficients has been on a steady increase over time, reflecting the growing importance of tourism and TV to the South African economy. We also find that TV is a significant predictor of GDPV in the country. We strongly recommend that policymakers pay serious attention to economic happenings around the world since TV is one of the channels through which global economic crises affect the South African economy. We also recommend that the minimization of crime and social disorder should form an essential component of tourism development and promotion strategy in South Africa.
Leveraging the Photovoice Methodology for Critical Realist Theorizing
Authors: Mukumbang Ferdinand C. , van Wyk Brian
Published: November 2020

Photovoice is a visual research methodology that integrates images and words to encourage the exploration of the experiences, perceptions, and meaning-making processes of individuals on various social phenomena. As a participatory qualitative methodology, Photovoice has been used within the interpretivist paradigm to explore various [public] health and social phenomena to enhance participants’ (co-investigators’) engagement and to lobby for policy. Despite its exponential growth and extensive application in the last two decades, its potential usefulness in critical realist-informed studies is unexplored. Herein, we highlight the epistemological and methodological alignment of the Photovoice methodology with the critical realist philosophy of science regarding the understanding of social phenomena through meaning-making. Drawing on the authors’ work on adolescents’ (non)adherence behavior on antiretroviral therapy, we illustrate the application of Photovoice methods in a critical realist-informed qualitative study. The emancipatory potential of the Photovoice methodology aligns with that of critical realist epistemology as they privilege participants’ (co-investigators’) knowledge generation and learning to better understand and take control of their situation - “integrated” knowledge translation. Methodologically, Photovoice provides a useful dialogue strategy for promoting discussions between the researcher and the co-investigators to obtain value-impregnated accounts to inform critical realist theorizing. The Photovoice methodology is appropriate for theorizing in critical realist research and especially suitable when engaging with suppressed or marginalized populations.
Smart wetting of permeable pavements as an evaporative-cooling measure for improving the urban climate during heat waves
Authors: Kubilay Aytaç , Ferrari Andrea , Derome Dominique , Carmeliet Jan
Published: November 2020

An urban microclimate model is used to design a smart wetting protocol for multilayer street pavements in order to maximize the evaporative cooling effect as a mitigation measure for thermal discomfort during heat waves. The microclimate model is built upon a computational fluid dynamics (CFD) model for solving the turbulent air, heat and moisture flow in the air domain of a street canyon. The CFD model is coupled to a model for heat and moisture transport in porous urban materials and to a radiative exchange model, determining the net solar and thermal radiation on each urban surface. A two-layer pavement system, previously optimized for maximal evaporative cooling applying the principles of capillary pumping and capillary break, is considered to design a smart wetting protocol answering the questions “when,” “how much,” and “how long” a pavement should be artificially wetted. It was found for the current optimized pavement solutions that a daily amount of 6 mm wetting over 10 min in the morning, preferentially between 8:00 and 10:00, guarantees a maximal evaporative cooling for 24 h during a heat wave.
Competence of medical and obstetric registrars in the management of systemic lupus erythematosus in pregnancy
Authors: Zamparini Jarrod , Pattinson Stuart , Makan Kavita
Published: November 2020

Introduction

Systemic lupus erythematosus has a predilection for women of childbearing age. Globally a shortage of rheumatologists exists resulting in general physicians and obstetricians treating systemic lupus erythematosus in pregnancy.

Methods

We conducted a survey amongst medical and obstetric registrars in South Africa to assess their subjective and objective competence in managing pregnant women with systemic lupus erythematosus.

Results

The pass rate for the objective section was 70.8% with no statistically significant difference in the pass rate between medical and obstetric registrars. Participants felt unprepared to manage pregnant women with systemic lupus erythematosus, with a mean overall score of 3.4 out of 7 for the subjective section, based on four Likert scale type questions.

Conclusion

Trainees are not able to accurately assess their own levels of competence in order to identify their learning needs. Due to the shortage of rheumatologists and lack of obstetric physicians in South Africa, general physicians and obstetricians must be equipped to provide adequate care to pregnant women with systemic lupus erythematosus.
Clinical and molecular distinctions in patients with refractory colon cancer who benefit from regorafenib treatment
Authors: Lee Min-Sang , Cho Hee Jin , Hong Jung Yong , Lee Jeeyun , Park Se Hoon , Park Joon Oh , Park Young Suk , Lim Ho Yeong , Kang Won Ki , Cho Yong Beom , Kim Seung Tae
Published: November 2020

Regorafenib (Stivarga, BAY 73-4506; Bayer Pharma AG, Berlin, Germany) is a novel oral multikinase inhibitor that blocks the activity of several protein kinases. However, few guidelines exist for novel biomarkers to select patients who will likely benefit from regorafenib treatment. Metastatic colorectal cancer (mCRC) patients treated with regorafenib were evaluated in this study. Tumor tissues of these patients were subjected to next-generation sequencing-based cancer panel tests. The relationship between molecular profiling and efficacy of regorafenib was analyzed. Among the 76 mCRC patients, the median age was 58 years (range 22–79 years), and 73.7% received regorafenib as a third-line therapy. The primary tumor locations were the right side ( n = 15, 19.8%) and the left side ( n = 61, 80.2%). Most patients (97.4%) had received prior anti-angiogenetic agents, and a prior anti-Epidermal Growth Factor Receptor (EGFR) agent had been administered to 32.9%. Of these 76 patients, 65 were evaluated to determine the efficacy of treatment. We observed zero complete responses, seven confirmed partial responses (PR 9.2%), 26 stable disease states (34.2%), and 32 disease progressions (42.1%). The overall confirmed response rate and the disease control rate were 9.2% and 43.4%, respectively. Genomic analysis revealed that APC mutations were significant in patients who demonstrated a tumor response to regorafenib ( p < 0.05). Interestingly, FGFR1 amplification was detected in only three of 76 patients (3.9%), and these three patients achieved a PR to regorafenib. The median progression-free survival time was 2.8 months (95% Confidence Interval [CI] 1.6–4.0). Patients with BRAF mutation and/or SMAD4 mutation had significantly worse progression-free survival (PFS) than those without such a mutation. On pathway analysis, Tumor Growth Factor (TGF)-beta pathways were significantly associated with worse PFS. We found that efficacy of regorafenib might be correlated with specific genetic aberrations, such as APC mutation and FGFR1 amplification. In addition, SMAD4 mutation and TGF-beta pathway were associated with worse PFS after regorafenib. We found that efficacy of regorafenib might be correlated with specific genetic aberrations, such as APC mutation and FGFR1 amplification. In addition, SMAD4 mutation and the TGF-beta pathway were associated with worse PFS after regorafenib.