bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of rectangular hybrid-stiffened-plate structural system with fibre-reinforced polymer fabric composite in tension zone
Authors: Dhindsa Inderpreet Kaur , Rai Hardeep Singh , Singh Harvinder
Published: August 2020

Reinforced concrete plates stiffened by the beams in the orthogonal directions are widely used in bridges and buildings. Local failure occurs due to stiff beams whereas shallow beams cause global collapse failure in the plate. A theoretical model using inelastic analysis (yield line analysis) has been formulated to predict the behaviour of the rectangular hybrid-reinforced concrete-stiffened-plate system which recognized the benefits of different types of fibre-reinforced polymer fabric and ferrocement in tension side. Parametric study was also conducted to capture the influence of different parameters such as number of panels, plate aspect ratio and beam strength parameter on the flexural capacity of plate system. Designer can select the proportionate hybrid-stiffened-plate system which fails globally to avoid negative yield lines through design chart. In the experimental study, four rectangular hybrid-stiffened-plate structural systems were developed with two internal beams in each perpendicular direction incorporating ferrocement and unidirectional carbon fibre–reinforced polymer fabric, unidirectional basalt fibre–reinforced polymer fabric and bidirectional glass fibre–reinforced polymer fabric sheet on the bottom side. The experimental ultimate load was recorded maximum in unidirectional carbon hybrid–stiffened-plate system, however, unidirectional basalt hybrid–stiffened-plate system gave the best performance with respect to the cost analysis. The numerical analysis had a reasonable consistency with experimental and analytical results.
Mental health and the risk of negative social life events: A prospective cohort study among the adult Danish population
Authors: Christensen Anne Illemann , Davidsen Michael , Koushede Vibeke , Juel Knud
Published: August 2020

Background: The consequences of poor mental health on morbidity and mortality are well established. However, studies prospectively examining the consequences on social life events are lacking. This study prospectively examines the risk of various social life events (educational attainment, employment status, marital status and parenthood) defined in administrative registers by mental health status at baseline defined by the MCS-12 in the Danish adult population. Methods: The analysis is based on data from the Danish National Health Survey 2010. A total of 177,639 individuals completed the questionnaire (59.5% of the sample). MCS-12 was used to categorise participants according to mental health status (poor, moderate and good). Survey data were linked to administrative registers at the individual level and followed for a minimum of 4 years. Cox proportional hazards models were used to prospectively examine the risk of various social life events according to mental health status at baseline. Results: Individuals with poor mental health and, to a certain degree, individuals with moderate mental health were less likely to experience positive life events such as progression in educational level, getting married, being employed and becoming a parent and were more likely to experience negative life events such as becoming unemployed and divorced/widowed. Conclusions: Mental health status is associated with educational attainment, employment status, marital status and parenthood. These results add to a growing body of evidence indicating that poor mental health is associated with substantial societal-level impairments that should be taken into consideration when making decisions regarding allocation of treatment and research resources.
Gender gaps in preschool age: A study of behavior, neurodevelopment and pre-academic skills
Authors: Brandlistuen Ragnhild E. , Flatø Martin , Stoltenberg Camilla , Helland Siri S. , Wang Mari V.
Published: August 2020

Background: Female educational advantage is evident from elementary school and throughout the education system. Understanding the gender differences that precede school entry might provide important insight as to why girls outperform boys later in their educational careers. Aims: The aim of this study was to explore gender differences in early literacy and numeracy skills, as well as a range of neurodevelopmental and behavioral domains between the age of five and six years. Methods: We used questionnaire data from preschool teachers in the Norwegian Mother, Father and Child Cohort Study reported for 7467 children attending the final year in preschool, to explore gender differences and age patterns by fitting flexible regression models predicting pre-academic, behavioral and neurodevelopmental outcomes. Results: We found gender differences favoring girls for all outcomes except internalizing behavior. For neurodevelopment and behavior, differences in adjusted standardized scores ranged from 46% of a standard deviation (95% confidence interval (CI) 0.41, 0.50) in overall school readiness to 31% of a standard deviation difference in externalizing behavior problems (CI 0.21, 0.41). We found gender differences for all literacy skills in favor of girls. The gender gap in naming and adding numbers was small, but in favor of girls. Increasing age was associated with improved pre-academic skills and school readiness, as well as reduction of attention problems and language difficulties, the latter especially for boys. Conclusions: We conclude that gender differences favoring girls exist prior to school entry for a broad range of pre-academic, behavioral and neurodevelopmental skills relevant to school functioning.
Blower-door estimates of PM2.5 deposition rates and penetration factors in an idealized room
Authors: Lai Yonghang , Ridley Ian , Brimblecombe Peter
Published: August 2020

Particle deposition and penetration in buildings has been widely studied, but the effect of indoor characteristics merits further investigation, so improved experimental methods may be needed. The present study measured indoor and outdoor concentrations of PM2.5 and estimated PM2.5 deposition rates and penetration factors under a variety of different indoor situations, with a novel method (blower-door method). The blower-door method is compared with the standard decay and rebound method for an idealized room (a portable building test cell; 6.08 m [Formula: see text] 2.40 m [Formula: see text] 2.60 m) under eight testing scenarios (empty, cardboard boxes in three arrangements, terry cloth wall covering, and three sets of window holes); run three times to establish the coefficient of variation representing precision. Results show that higher induced indoor–outdoor pressure differences cause a larger variation of estimated effective deposition rate on different indoor surfaces. The deposition rate and penetration factor may be influenced by indoor surface materials. The blower-door method gives higher precision for the estimates, and detects subtle differences in penetration factors, which may be difficult using the decay and rebound method.
Predicting problematic smartphone use over time in adolescence: A latent class regression analysis of online and offline activities
Authors: Camerini Anne-Linda , Gerosa Tiziano , Marciano Laura
Published: August 2020

Despite today’s ubiquitous nature of smartphones among adolescents, little is known about behavioural online and offline longitudinal predictors of problematic smartphone use (PSU). Guided by Uses and Gratifications Theory, we applied latent class analysis on survey data collected in 2017 from a cohort of 1096 adolescents ( Mage = 12.4, SDage = 0.56) and regressed PSU measured 1 year later on class membership, controlling for socio-demographic characteristics, social desirability and autoregressive effects. We extracted four distinct classes: social-recreational onliners ( n = 228), weekend onliners ( n = 331), balanced ( n = 404) and noninvolved ( n = 153). Characterised by significantly more time spent online for recreational and social networking activities, both during weekdays and weekend days, as well as less time for sleep, the social-recreational onliners class showed significantly higher levels of PSU over time. Future studies should assess not only duration but also the frequency of daily online activities to provide further insights into behavioural predictors of PSU.
A brief history of news making in Russia
Authors: Yablokov Ilya , Schimpfössl Elisabeth
Published: August 2020

In this introductory article to our special issue on newsmaking in Russia, we provide a context for how the study of journalism evolved in Russia in contrast to Europe and the US. This brief historical overview helps make sense of the specific trajectory of journalism studies: from normative Cold War perspectives to a highly diverse and vibrant field that considers journalistic agency, the interplay of commercialisation and media control and the complexities of a rapidly changing media environment. The contributions to this special issue present nuanced approaches to self-censorship, the impact of digital technologies and political intervention.
A predictive combustion model for one-dimensional gasoline engine simulation
Authors: Nomura Yoshihiro , Yamamoto Seiji , Nagaoka Makoto , Diel Stephan , Kurihara Kenta , Shimizu Rio , Murase Eiji
Published: August 2020

A new predictive combustion model for a one-dimensional computational fluid dynamics tool in the multibody dynamics processes of gasoline engines was developed and validated. The model consists of (1) a turbulent burning velocity model featuring a flame radius–based transitional function, steady burning velocity that considers local quenching using the Karlovitz number and laminarization by turbulent Reynolds number, as well as turbulent flame thickness and its quenching model near the liner wall, and (2) a knock model featuring auto-ignition by the Livengood–Wu integration and ignition delay time obtained using a full-kinetic model. The proposed model and previous models were verified under a wide range of operating conditions using engines with widely different specifications. Good agreement was only obtained for combustion characteristics by the proposed model without requiring individual calibration of model constants. The model was also evaluated for utilization after prototyping. Improved accuracy, especially of ignition timing, was obtained after further calibration using a small amount of engine data. It was confirmed that the proposed model is highly accurate at the early stage of the engine development process, and is also applicable for engine calibration models that require higher accuracy.
Consumption logistics and the ordering of market systems
Authors: Smaniotto Cristiano , Emontspool Julie , Askegaard Søren
Published: August 2020

This article argues that consumption logistics are fundamental modes of ordering markets. Constructivist Market Studies (CMS) and Market System Dynamics (MSD) approaches improved our understanding of, respectively, the practical and symbolic processes of market organization. On this backdrop, previous research has predominantly framed logistics as a practical performance of this organization. Conversely, we argue that logistical performances are as much practical as they are symbolic. Drawing on both CMS and MSD research, we therefore conceptualize consumption logistics as the system of interrelated practices ordering the heterogeneous entities of consumption in space and time. Put differently, by integrating market and consumption practices, consumption logistics recursively (per)form the context of markets, that is, the situated conditions affording subjects the possibility to consume and objects to be consumed within specific markets. Our theorization brings forward the complex practical-symbolic ordering of markets, with implications for discussions of spaces, subjects and meanings of market phenomena.
Lurking in the bushes: informality, illicit activity and transitional green space in Berlin and Detroit
Authors: Draus Paul , Haase Dagmar , Napieralski Jacob , Qureshi Salman , Roddy Juliette
Published: August 2020

This paper offers an exploratory overview of different research literatures examining the relationship between urban nature or green space on the one hand, and marginalized, stigmatized, and illicit activities on the other. We situate this discussion within the geographic literature concerning assemblage theory and informality, and apply these concepts to urban green space. We offer some comparative examples from Detroit and Berlin, two cities known for their green space and illicit activity, but with very different histories and cultural contexts. For this purpose, we draw on our own primary research in both Detroit and Berlin, examining how the dynamics of these interactions produce diverse and distinctive urban places in some cases and associations of danger or insecurity in others, sometimes both simultaneously. We utilize diverse methodologies, including qualitative interviews and focus groups, mobile explorations, photography, and sketching to provide examples of spaces as complex assemblages of actors with diverse, emergent potentials. We conclude by contending that green spaces and urban nature belong on the same map as studies of informal and illicit activities, adopting a more fluid conception of the shifting relationship between people and green space in the evolving city.
Applicability and limitations of time domain reflectometry bridge scour monitoring system in general field conditions
Authors: Wang Kai , Lin Chih-Ping
Published: August 2020

A real-time and durable system for scour process monitoring with sufficient spatial precision is in pressing need for bridge safety management. In light of this, an innovative bundled time domain reflectometry sensing cable was recently proposed to enhance the time domain reflectometry technique for scour monitoring. However, current development only dealt with the construction of bundled sensing cable and the corresponding new data reduction method. Before it can be put into practical use, issues related to the effect of hydrological conditions, long-distance measurement, and actual field implementation are yet to be investigated. This study used both numerical simulations and laboratory experiments to examine the time domain reflectometry signals in response to both scour and deposition in different water-level conditions. As a result, the first guideline of waveform classification and interpretation is newly proposed to validly determine scour depth under various field conditions. Since field measurements often come with significant signal attenuation from resistance loss of long cable and dielectric and conductive loss in the sensing section, numerical simulations and a series of full-scale experiments were also conducted to assess the time domain reflectometry scour measurement range. The maximum measurement range of the latest time domain reflectometry scour sensing cable was found to be about 6 m. Within this range, the maximum error of scour estimation is within 0.2 m. Considering the new findings, a field time domain reflectometry scour monitoring system using the bundled time domain reflectometry sensing cable was designed accordingly and implemented at a bridge for the first time. The monitoring system successfully captured the scour process during a storm event and revealed some practical issues for future improvement as well.
Trust and the Coronavirus Pandemic: What are the Consequences of and for Trust? An Early Review of the Literature
Authors: Devine Daniel , Gaskell Jennifer , Jennings Will , Stoker Gerry
Published: August 2020

Trust between governors and the governed is seen as essential to facilitating good governance. This claim has become a prominent contention during the coronavirus pandemic. The crisis also presents a unique test of key hypotheses in the trust literature. Moreover, understanding the dynamics of trust, how it facilitates and hinders policy responses, and also the likely effects of these responses on trust are going to be fundamental questions in policy and trust research in the future. In this article, we review the early literature on the coronavirus pandemic and political and social trust, summarise their findings and highlight key challenges for future research. We show how the studies shed light on trust’s association with implementation of government measures, public compliance with them, mortality rates and the effect of government action on levels of trust. We also urge caution given the varying ways of measuring trust and operationalising the impact of the pandemic, the existence of common issues with quantitative studies and the relatively limited geographical scope of studies to date. We argue that it is going to be important to have a holistic understanding of these dynamics, using mixed-methods research as well as the quantitative studies we review here.
Developing a Primary Care–Focused Intervention to Engage Patients With Osteoarthritis in Physical Activity: A Stakeholder Engagement Qualitative Study
Authors: Griesemer Ida , Vu Maihan B. , Callahan Leigh F. , Cleveland Rebecca , Golightly Yvonne M. , Grimm Kimberlea , Huffman Katie , Nelson Amanda E. , Rees Jennifer , Allen Kelli
Published: August 2020

Physical activity (PA) is important for managing osteoarthritis (OA), but many patients are inactive. Research is needed on strategies to leverage clinical encounters to engage patients in PA. Guided by the socioecological model of health behavior, this study aimed to engage stakeholders in the process of refining an Osteoarthritis Physical Activity Care Pathway (OA-PCP). Six focus groups and seven individual interviews were conducted with key stakeholders. Focus groups were specific to stakeholder roles and included patients with OA, support partners, and clinic personnel ( n = 6 focus groups). Interview participants were local and national PA program representatives ( n = 7 interviews). Data were analyzed by thematic analysis. Themes identified in the data included ways the OA-PCP can help patients with OA address challenges to PA engagement, strategies for connecting patients with PA resources, methods for implementing OA-PCP into clinical settings and potential use of PA trackers in the OA-PCP program. Stakeholders’ comments were summarized into key recommendations for OA-PCP. Some recommendations reinforced and led to refinements in planned aspects of OA-PCP, including tailoring to individual patients, involvement of a support partner, and addressing pain with PA. Other recommendations resulted in larger changes for OA-PCP, including the addition of three email- or mail-based contacts and not requiring use of a PA tracker. The refined OA-PCP program is being evaluated in an exploratory trial, with the ultimate goal of establishing a PA program for OA that can be successfully implemented in clinical settings.
Using Online Communication Skills Training to Increase Organ Donation Authorization
Authors: Siminoff Laura A. , Gardiner Heather M. , Alolod Gerard P. , Wilson-Genderson Maureen
Published: August 2020

Introduction:

Family denial of organ donation from deceased donor-eligible patients is a major contributor to the deficit of transplantable organs in the United States.

Research Question:

Does an evidence-based communication intervention improve deceased organ donor authorization rates from family decision-makers?

Design:

This implementation and dissemination study used Communicating Effectively about Donation on Organ Procurement Organization professionals responsible for discussing donation and obtaining authorization from family decision-makers. A 14-month, nationwide social marketing campaign generated a sample of 682 requesters, yielding a final analyzable sample of 253 participants. Serving as their own controls, participants spent the first 3 months in a preintervention period, completed the web-based intervention, and progressed to a 3-month postintervention period. Participants completed brief online weekly surveys to assess the intervention’s impact on their communication skills.

Results:

Authorization rates did not improve overall between the pre- and postintervention periods. A differential effect of the intervention on 3 distinct groups of requesters was found: one group exhibited high and stable authorization rates pre–post (78%-74%); a second group had low initial authorization rates that increased after exposure to the intervention (46%-73%); the third had low and variable rates of authorization that failed to improve after the intervention (45%-36%).

Conclusion:

This study underscores the value of evidence-based communication training. Training targeted to requesters’ skill levels is needed to realize overall improvements in individual performance, the quality of donation discussions, and rates of family decision-maker authorization to solid organ donation.
Guns and Butter
Authors: Finley Susan
Published: August 2020

The buzz about violence in schools has lightened during the COVID-19 pandemic, but without a plan or resolution to the problems of gun availability, pervasive gun culture and other issues of violence in U.S. schools and society. In recent, pre-COVID conversation with preservice teachers and school administrators (separate conversations), I was surprised by the support that was expressed for a highly-policed school environment that includes armed teachers, principals and other school personnel. At an intellectual level, I cannot grasp how increased policing in schools can promote any result other than the possibilities of increased racism and further inculcation of a police-state mentality in schools and society. As I mulled the issues around gun violence in particular, I realized that my objections go beyond a philosophy or an intellectual point of view, but are instead rooted in visceral, long-held feelings based in experience. In this autoethnographic essay, I recount my personal experiences in an attempt to illustrate through personal experience the folly of wide-spread gun ownership and to underscore the canard that guns can protect us in our homes and schools.
Study of the Radiosensitizing and Radioprotective Efficacy of Bromelain (a Pineapple Extract): In Vitro and In Vivo
Authors: Mekkawy Mai H. , Fahmy Hanan A. , Nada Ahmed S. , Ali Ola S.
Published: August 2020

This study hypothesizes that, bromelain (BL) acts as radiosensitizer of tumor cells and that it protects normal cells from radiation effects. In vitro and in vivo studies have been carried out to prove that assumption. In vitro MTT cell proliferation assay has shown that the irradiated Ehrlich ascites carcinoma (EAC) cell line could be sensitized by BL pretreatment. In vivo: animals were randomly divided into 5 groups, Group 1: control (PBS i.p for 10 days), Group 2: Ehrlich solid tumor (EST) bearing mice, Group 3: EST + γ-radiation (fractionated dose, 1 Gy × 5), Group 4: EST + BL (6 mg/kg, i.p), daily for 10 days, Group 5: EST + BL for 10 days followed by γ-irradiation (1 Gy × 5). The size and weight of tumors in gamma-irradiated EST bearing mice treated with BL decreased significantly with a significant amelioration in the histopathological examination. Besides, BL mitigated the effect of γ-irradiation on the liver relative gene expression of poly ADP ribose polymerase-1 (PARP1), nuclear factor kappa activated B cells (NF-κB), and peroxisome proliferator-activated receptor α (PPAR-α), and it restored liver function via amelioration of paraoxonase1 (PON1) activity, reactive oxygen species (ROS) content, lipid peroxidation (LPO) and serum aspartate transaminase (AST), alanine transaminase (ALT), and albumin (ALB). It is concluded that BL can be considered as a radio-sensitizer and radio-protector, suggesting a possible role in reducing radiation exposure dose during radiotherapy.
Thigh Compartment Syndrome After Thrombolytic Therapy of an Occluded Lower Extremity Bypass Graft
Authors: Singh Kuldeep , Ruan Qing Zhao , Schor Jonathan , Lachhar Garry , Saha Sumit , Deitch Jonathan
Published: August 2020

Compartment syndrome is caused by increased pressure within fascial compartment. We present a unique case of a thigh compartment syndrome that occurred after overnight catheter delivered Tissue plasminogen activator (tPA) thrombolysis of an acutely thrombosis femoral-to above knee popliteal artery Propaten® PTFE (WL Gore & Associates, Flagstaff, AZ) bypass graft. The condition was treated by emergency fasciotomy and the patient recovered uneventfully.
A scoping review of problems and challenges faced by school leaders (2003–2019)
Authors: Tintoré Mireia , Cunha Rosário Serrão , Cabral Ilídia , Alves José Joaquim Matias
Published: August 2020

The purpose of this scoping review is to analyse the literature concerning principals’ problems and challenges, beginning in 2003 and ending in 2019. The research team conducted an extensive search to locate relevant academic literature, comprising 17 years of research, and a total of 153 documents were analysed. According to the findings, most of the documents (71%) correspond to the last six years (2014–2019), and most are studies from Anglo-Saxon countries (55%). The results point to eight main categories related to the complex nature of the job (the management challenge, the complexity challenge and the learning challenge), and interactions with different stakeholders (problems with educational authorities and educational policy; the staff and teaching process; the students; the families and the school community; and the society). Although the importance given to each category varies from one context to another, problems concerning the complex nature of the job and with the educational authorities and the educational policy are the most recurrent. A significant increase in the number and complexity of problems and challenges throughout the times was noticed, which seems to enhance the need for changes in educational policies and the careful design and implementation of leadership training programmes.
Optimal allocation of multi-state elements in a sliding window system with phased missions
Authors: Yi Kunxiang , Kou Gang , Gao Kaiye , Xiao Hui
Published: August 2020

Many real-world engineering systems such as aerospace systems, intelligent transportation systems and high-performance computing systems are designed to complete missions in multiple phases. These types of systems are known as phased-mission systems. Inspired by an industrial heating system, this research proposes a generalized linear sliding window system with phased missions. The proposed system consists of N nodes with M multi-state elements that are subject to degradation. The linear sliding window system fails if the cumulative performance of any r consecutive nodes is less than the pre-determined demand in any phase. The degradation process of each element is modeled by a continuous-time Markov chain. A novel reliability evaluation algorithm is proposed for the linear sliding window system with phased missions by extending the universal generating function technique. Furthermore, the optimal element allocation strategy is determined using the particle swarm optimization. The effectiveness of the proposed algorithm is confirmed by a set of numerical experiments.
Urinary stone management during the COVID-19 pandemic: a suggested approach and review of literature
Authors: Fakhr Yasseri Alimohammad , Aghamir Seyed Mohammad Kazem
Published: August 2020

COVID-19 is now the major health concern of the century in many countries. Prolonged homestay has various undesirable consequences for people, such as physical inactivity and weight gain, which potentially could put people at risk of urinary stone formation. With regard to the prevention and treatment strategy for urinary stones during this COVID-19 pandemic period, patients can be divided into two groups. The first group comprises those for whom urological intervention is not indicated and where general dietary and lifestyle recommendations are helpful. The second group comprises those patients where urological intervention is indicated. This group can be divided into emergent and nonemergent subgroups. Patients with urinary stones and concomitant uremia, sepsis, anuria, or refractory pain and vomiting make up the emergent group, where intervention is necessary. The preferred option during the novel coronavirus crisis for these patients is percutaneous nephrostomy tube insertion under local anesthesia. The second subgroup is made up of those patients with asymptomatic and noncomplicated renal and ureteral stones where urologic intervention is indicated in the usual time scale. However, we suggest conservative treatment for 3 months during the COVID-19 outbreak after which re-evaluation of the patient should be carried out. Thus the operation could be chosen carefully based on the patient’s and urologist’s preference and the rate of infection in that center.
Developing leadership in dentists and schoolteachers to improve oral health inequalities
Authors: Wordley Valerie , Bedi Raman
Published: August 2020

With oral diseases affecting people of all ages in every country of the world, new approaches are necessary to remove inequalities in oral health and increase access to oral health education. With over 1 billion children attending school, developing dental leadership skills not only in dental professionals but also in schoolteachers will help to spread oral health prevention messages effectively, implement healthy habits at a young age and impact a greater proportion of the global population to improve their oral health.
The impact of AMO-HR systems on proactive employee behavior: The mediating contribution of leader-member and team-member exchange
Authors: Al-Tit Ahmad Adnan
Published: August 2020

The aim of this study is to examine the impact of AMO-HR Systems (i.e., ability-enhancing HR practices, motivation-enhancing HR practices and opportunity-enhancing HR practices) on proactive employee behavior through the effect of leader-member and team-member exchange. A questionnaire was developed based on prior related works to collect the required data from a sample of 230 employees from 13 small companies in the service industry in the Jordanian capital, Amman. The results showed that nine HR practices are significant predictors of employee proactivity behavior. The impact was significantly mediated by leader-member and team-member exchange. On the ground of the results, the study concluded that proactivity is a function of three categories of HR practices. First, an employee should be supported to enhance his or her ability. Second, an employee should be motivated and granted the opportunity to share knowledge. Third, employees should be encouraged to participate in problem solving, in the presence of leader-member coordination, to improve relationship quality and team-member recognition, support, and effective communications. Accordingly, recommendations, social and managerial implications were reported.
Hospital Diabetes Meeting 2020
Authors: Umpierrez Guillermo , Rushakoff Robert , Seley Jane Jeffrie , Zhang Jennifer Y. , Shang Trisha , Han Julia , Spanakis Elias K. , Alexanian Sara , Drincic Andjela , Kulasa Kristen , Mendez Carlos E. , Tanton Damon , Wallia Amisha , Zilbermint Mihail , Klonoff David C.
Published: August 2020

Patients with diabetes may experience adverse outcomes related to their glycemic control when hospitalized. Continuous glucose monitoring systems, insulin-dosing software, enhancements to the electronic health record, and other medical technologies are now available to improve hospital care. Because of these developments, new approaches are needed to incorporate evolving treatments into routine care. With the goal of educating healthcare professionals on the most recent practices and research for managing diabetes in the hospital, Diabetes Technology Society hosted the Virtual Hospital Diabetes Meeting on April 24-25, 2020. Because of the coronavirus disease 2019 (COVID-19) pandemic, the meeting was restructured to be held virtually during the national lockdown to ensure the safety of the participants and allow them to remain at their posts treating COVID-19 patients. The meeting focused on (1) inpatient management and perioperative care, (2) diabetic ketoacidosis and hyperglycemic hyperosmolar state, (3) computer-guided insulin dosing, (4) Coronavirus Disease 2019 and diabetes, (5) technology, (6) hypoglycemia, (7) data and cybersecurity, (8) special situations, (9) glucometrics and insulinometrics, and (10) quality and safety. This meeting report contains summaries of each of the ten sessions. A virtual poster session will be presented within two months of the meeting.
Proof of Concept for a New Raman-Based Prototype for Noninvasive Glucose Monitoring
Authors: Pleus Stefan , Schauer Sebastian , Jendrike Nina , Zschornack Eva , Link Manuela , Hepp Karl Dietrich , Haug Cornelia , Freckmann Guido
Published: August 2020

Background:

Noninvasive glucose monitoring (NIGM) in diabetes is a long-sought-for technology. Among the many attempts Raman spectroscopy was considered as the most promising because of its glucose specificity. In this study, a recently developed prototype (GlucoBeam, RSP Systems A/S, Denmark) was tested in patients with type 1 diabetes to establish calibration models and to demonstrate proof of concept for this device in real use.

Methods:

The NIGM table-top prototype was used by 15 adult subjects with type 1 diabetes for up to 25 days at home and in an in-clinic setting. On each day, the subjects performed at least six measurement units throughout the day. Each measurement unit comprised two capillary blood glucose measurements, two scans with an intermittent scanning continuous glucose monitoring (CGM) system, and two NIGM measurements using the thenar of the subject’s right hand.

Results:

Calibration models were established using data from 19 to 24 days. The remaining 3-8 days were used for independent validation. The mean absolute relative difference of the NIGM prototype was 23.6% ± 13.1% for the outpatient days, 28.2% ± 9.9% for the in-clinic day, and 26.3% ± 10.8% for the complete study. Consensus error grid analysis of the NIGM prototype for the complete study showed 93.6% of values in clinically acceptable zones A and B.

Conclusions:

This proof of concept study demonstrated a practical realization of a Raman-based NIGM device, with performance on par with early-generation CGM systems. The findings will assist in further performance improvements of the device.
Automated Self-Adjusting Subcutaneous Insulin Algorithm for Patients NPO or on TPN or Enteral Feedings
Authors: Patzek Sophie , MacMaster Heidemarie W. , Rov-Ikpah Esther , San Luis Craig , Johnson Craig , Juttukonda Venkateswarlu , Rushakoff Robert J.
Published: August 2020

Background:

Perioperative diabetes patients are often treated with sliding-scale insulin, despite a lack of evidence to support therapeutic effectiveness. We introduced an automated subcutaneous insulin algorithm (SQIA) to improve glycemic control in these patients while maintaining the simplicity of a q4 hour adjustable sliding-scale insulin order set.

Methods:

In this pilot study, we implemented a fully programmed, self-adjusting SQIA as part of a structured order set in the electronic medical record for adult patients who are nil per os, or on continuous enteral tube feedings or total parenteral nutrition. The nurse only enters the current glucose in the Medication Administration Record, and then the calculated dose is shown. The new dose is based on previous dose, and current and previous glucoses. The SQIA titrates the glucose to 120-180 mg/dL. For this pilot, this order set was utilized for complex perioperative oncologic patients.

Results:

The median duration on the SQIA was 58 hours. Glucoses at titration initiation were highest at 206 ± 63 mg/dL, and came down to 156 ± 29 mg/dL by 72 hours. The majority of measured glucoses (66.8%, n = 647) were maintained between 80 and 180 mg/dL. There were no glucoses lower than 60 mg/dL, and only 0.3% (n = 3) were below 70 mg/dL. There was a low rate of errors (1%).

Conclusions:

A simple automated SQIA can be used to titrate insulin to meet the changing metabolic requirements of individuals perioperatively and maintain glucose within the target range for these hospitalized patients.
Lighting Control in Patient Rooms: Understanding Nurses’ Perceptions of Hospital Lighting Using Qualitative Methods
Authors: McCunn Lindsay J. , Safranek Sarah , Wilkerson Andrea , Davis Robert G.
Published: August 2020

Purpose:

This study differs in its methodological approach from previously published research by interpreting qualitative results against existing literature to understand how nurses conceptualize medical–surgical patient rooms as productive settings in relation to lighting, as well as the ways in which nurses believe these spaces could be enhanced for patient satisfaction.

Methods:

Content analysis was used to interpret themes emerging from nurses’ subjective responses to open-ended items. Three of the facilities had older, traditional lighting systems; one had a contemporary framework.

Results:

A theme of environmental control over both overhead and task lighting emerged from data from all items. Although controllability was among the “best” lighting attributes, more refinement is necessary for optimal staff productivity and patient satisfaction. Daylighting was also considered to be among the best attributes. Control over light level via additional dimming capability for patients, as well as additional light sources, was prominent across the four hospitals. Unique to the more modern facility, trespassing of light was problematic for nurses considering the experiences of patients—even where modern models exist, more attention can be paid to the ways in which window shades, and light sources outside of rooms, penetrate spaces and affect users.

Conclusion:

The finding that nurses and patients desire greater control over the lighting in patient rooms is consistent with Ulrich’s theory of supportive design for healthcare and coincides with advances in lighting technology. Despite differences in the level of sophistication in lighting among the four facilities, control continues to be a primary concern for nurses.
Political Authenticity: Conceptualization of a Popular Term
Authors: Luebke Simon M.
Published: August 2020

Authenticity is a prominent concept in current political discourse. Its popularity in political communication has also inspired a growing but still fragmented body of research in communication science. Since this field lacks an integrative conceptualization, this article aims to clarify political authenticity for academic discourse and as a research object for communication science. The article provides a narrative review of research on authenticity in political communication and proposes an understanding of political authenticity as a social construction which is created and negotiated in complex communication processes among politicians, the media, and the audience. I propose performed, mediated, and perceived political authenticity as three analytic perspectives to deconstruct these complex processes and to link political authenticity with media and communication literature. Finally, I derive four dimensions of political authenticity (consistency, intimacy, ordinariness, and immediacy) and corresponding indicators that will help to operationalize it as a strategy by politicians, a product from mediation processes, and as an audience perception.
Prevalence and Clinical Significance of Radiographic Sinus Disease on Preoperative Computed Tomography Imaging in the Endoscopic Skull Base Surgery Population
Authors: Shah Janki , Cappello Zachary J. , Roxbury Christopher , Tang Dennis , Woodard Troy D. , Kshettry Varun R. , Recinos Pablo F. , Sindwani Raj
Published: August 2020

Introduction

Endoscopic skull base surgery (ESBS) provides a safe, minimally invasive approach to treat benign and malignant skull base lesions. The significance of concomitant sinonasal pathology on imaging in patients undergoing ESBS and its effect on perioperative management is not well described. We sought to identify the prevalence and clinical significance of incidentally found radiographic sinus disease on preoperative imaging in patients undergoing ESBS and provide a protocol for management of these patients.

Design

A retrospective chart review was performed of consecutive patients who underwent ESBS from January 1, 2016 to June 30, 2018. Preoperative computed tomography (CT) scans were reviewed and scored using the Lund-Mackay (LM) staging system. Preoperative nasal endoscopy findings were analyzed. Any preoperative treatment based on these findings and changes in intraoperative management were examined.

Results

A total of 156 patients (81 women, 74 men) who underwent ESBS were reviewed. The average LM score was 2 ± 2.7 (range: 0–12). A total of 94 patients (60.3%) had evidence of radiographic sinus disease (LM score > 0) and 23 patients (14.7%) had presence of sphenoid sinus disease. Seven patients (4.5%) were treated preoperatively based on CT and/or nasal endoscopy findings. All patients who received preoperative treatment had evidence of sinus disease on imaging with an average score of 4.7 and were evaluated and treated within 1-2 weeks prior to ESBS. One patient had ESBS postponed until endoscopic sinus surgery was performed for extensive chronic rhinosinusitis (CRS) findings on imaging.

Conclusion

A review of preoperative imaging in patients undergoing ESBS can help identify concurrent sinonasal disease, which has the potential to alter preoperative as well as intraoperative management in these patients. We report a diligent but conservative approach for the treatment of concomitant CRS in the ESBS population with decision for preoperative treatment guided by various factors.
Resisting a European Arrest Warrant: A social rights perspective
Authors: Šubic Neža
Published: August 2020

This article starts from the premise that social rights should be taken seriously in the context of the European Arrest Warrant (EAW). Historically neglected, social rights have slowly gained recognition as legal entitlements. The article focuses on the protection of social rights – understood here as the rights to an adequate standard of living, healthcare and education – in regard to one aspect of the EAW: resisting its execution due to a real risk of a breach of social rights in detention in the issuing Member State. The social rights–based argument for resisting an EAW is premised on the Court of Justice of the European Union’s jurisprudence on ‘exceptional circumstances’ in which mutual trust can be rebutted, in particular Aranyosi and LM. The article identifies three ways for protecting social rights in the context of resisting an EAW. First, elements of social rights can be protected through resisting an EAW on the basis of a real risk of a breach of the prohibition of inhuman and degrading treatment. Second, social rights could be protected by resisting an EAW on the grounds of those non-absolute civil rights that indirectly protect elements of social rights. Third, the option of resisting an EAW by relying directly on social rights is also examined. Taking a social rights perspective expands the type of cases in which an individual can resist surrender due to a risk of facing poor detention conditions; this includes certain situations where the potential breach does not reach the high threshold of the prohibition of inhuman and degrading treatment. However, the article concludes that the rigid framework for balancing mutual trust and fundamental rights established by Aranyosi and LM ultimately creates a ceiling for the protection of social rights and prevents them from being fully respected and protected in the context of resisting an EAW.
Teriflunomide preserves peripheral nerve mitochondria from oxidative stress-mediated alterations
Authors: Malla Bimala , Cotten Samuel , Ulshoefer Rebecca , Paul Friedemann , Hauser Anja E. , Niesner Raluca , Bros Helena , Infante-Duarte Carmen
Published: August 2020

Mitochondrial dysfunction is a common pathological hallmark in various inflammatory and degenerative diseases of the central nervous system, including multiple sclerosis (MS). We previously showed that oxidative stress alters axonal mitochondria, limiting their transport and inducing conformational changes that lead to axonal damage. Teriflunomide (TFN), an oral immunomodulatory drug approved for the treatment of relapsing forms of MS, reversibly inhibits dihydroorotate dehydrogenase (DHODH). DHODH is crucial for de novo pyrimidine biosynthesis and is the only mitochondrial enzyme in this pathway, thus conferring a link between inflammation, mitochondrial activity and axonal integrity.

Here, we investigated how DHODH inhibition may affect mitochondrial behavior in the context of oxidative stress. We employed a model of transected murine spinal roots, previously developed in our laboratory. Using confocal live imaging of axonal mitochondria, we showed that in unmanipulated axons, TFN increased significantly the mitochondria length without altering their transport features. In mitochondria challenged with 50 µM hydrogen peroxide (H2O2) to induce oxidative stress, the presence of TFN at 1 µM concentration was able to restore mitochondrial shape, motility, as well as mitochondrial oxidation potential to control levels. No effects were observed at 5 µM TFN, while some shape and motility parameters were restored to control levels at 50 µM TFN.

Thus, our data demonstrate an undescribed link between DHODH and mitochondrial dynamics and point to a potential neuroprotective effect of DHODH inhibition in the context of oxidative stress-induced damage of axonal mitochondria.
Nonbacterial thrombotic endocarditis as an initial presentation of advanced cholangiocarcinoma in a young patient: A case report
Authors: Al-Ghamdi Bandar , Alkaf Fahmi A , Al-Anazi Menwar M , Al Hebaishi Yahya , Al Othimeen Normeen A , Robert Asirvatham Alwin , Ahmed Osman , Alkhushail Abdullah
Published: August 2020

Nonbacterial thrombotic endocarditis, a form of noninfectious thrombotic endocarditis, is mainly characterized by deposition of sterile platelet thrombi on heart valves. Usually, it is observed in advanced malignancy. Herein, we report a case of a previously healthy male with recent unprovoked deep vein thrombosis presented with acute ischemic stroke. The echocardiogram revealed aortic and mitral valve masses. Eventually, he was discovered to have advanced cholangiocarcinoma. The present case, apart from being the youngest reported case, is among the few reported cases which manifest the association between cholangiocarcinoma and nonbacterial thrombotic endocarditis.
Acyclovir-induced neurotoxicity in an immunocompromised patient
Authors: Marks Daniel , De La Paz Andrew , Walston Bobbi Jo
Published: August 2020

This is a case report of a 75-year-old immunocompromised male who developed encephalopathy while undergoing treatment for disseminated herpes zoster with peripheral nerve involvement. While his initial presentation involved primarily profound lower extremity weakness, he developed progressive confusion to the point of obtundation only after initiation of standard therapy with intravenous acyclovir. The evaluation of his altered mental status was largely unremarkable. It was only after his acyclovir was discontinued that his symptoms resolved and he returned to his baseline mental status. His presentation was most consistent with acyclovir-induced neurotoxicity, which can present in patients with renal impairment and those who are immunocompromised.