bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficient coverage greedy packet stateless routing in wireless sensor networks
Authors: Sivaram M , Rohini R , Rajanarayanan S , Maseleno Andino , Mohammed Amin Salih , Fareed Ibrahim Banar , Goel Pallavi M
Published: July 2020

Wireless sensor network is a collection of sensor nodes designed with different routing capabilities to operate on real-world applications. In extreme environments, real-time applications of wireless sensor network ensure exchange of data, a difficult one between the sensor nodes, when less resources are consumed. Therefore, researchers are developing a routing protocol including optimal routing procedures to increase the longevity of the networks. In this paper, an improved route extension architecture is developed in wireless sensor network environment. This Improved Greedy Perimeter Stateless Routing is proposed to offer an improved transmission coverage and reduced power consumption capability. It deploys a periodic broadcast of hello message (or control messages) including the positional information between the sensor nodes. The experimental result concludes that the Improved Greedy Perimeter Stateless Routing method achieves improved routing capabilities than the traditional hybrid protocols like LEACH and Greedy Perimeter Stateless Routing.
Bereaved College Students: Social Support, Coping Style, Continuing Bonds, and Social Media Use as Predictors of Complicated Grief and Posttraumatic Growth
Authors: S. Lipp Natania , O’Brien Karen M.
Published: July 2020

Many college students experience the death of someone close to them and could be at risk for complicated grieving. Their primary sources of support may be unavailable as family members may live far away and their peers may be unprepared to respond to their grief. In addition, college students are exposed to a variety of stressors that could result in maladaptive coping. Furthermore, although most college-aged students use social media, little is known about its impact on grieving. The purpose of this study was to examine the degree to which social support, coping, continuing bonds, and social media use predicted complicated grief and posttraumatic growth in a sample of college students who had experienced an interpersonal loss. Participants (N = 258; 77.5% female, M age = 19.98, SD = 1.41) completed an online survey assessing the aforementioned constructs using Likert-type scales. Findings from two hierarchical regressions indicated that coping variables accounted for the greatest percentage of variance in grieving outcomes with avoidant-emotional coping being the most robust predictor of complicated grief and problem-focused coping accounting for considerable variance in posttraumatic growth (both were associated positively with the outcomes). As hypothesized, continuing bonds explained variance in both grieving outcomes with externalized continuing bonds and maintaining continuing bonds on social media predicting complicated grief and internalized continuing bonds contributing to posttraumatic growth (also all positively associated). Social support from family also was predictive of posttraumatic growth in the positive direction. Future research directions and implications for practice are discussed with the hope that this research might inform the development of interventions to assist college students who are grieving.
Contributing and Relieving Factors of Suffering in Palliative Care Cancer Patients: A Descriptive Study
Authors: Tan Seng Beng , Tan Ting Ting , Tan Maw Pin , Loo Kim Kee , Lim Poh Khuen , Ng Chong Guan , Loh Ee Chin , Lam Chee Loong
Published: July 2020

To palliate suffering, understanding the circumstances leading to suffering and its amelioration could be helpful. Our study aimed to explore contributing and relieving factors of suffering in palliative care. Adult palliative care stage III or IV cancer in-patients were recruited from University of Malaya Medical Centre. Participants recorded their overall suffering score from 0 to 10 three times daily, followed by descriptions of their contributing and relieving factors. Factors of suffering were thematically analysed with NVIVO. Descriptive data were analysed with SPSS. 108 patients participated. The most common contributing factor of suffering was health factor (96.3%), followed by healthcare factor (78.7%), psychological factor (63.0%) and community factor (20.4%). The most common relieving factor was health factor (88.9%), followed by psychological factor (78.7%), community factor (75.9%) and healthcare factor (70.4%). Self-reported assessment of suffering offers a rapid approach to detect bothering issues that require immediate attention and further in-depth exploration.
Femoral shaft fracture following oil massage in neonates: a single-centre experience
Authors: Siddiqui Shahid Akhtar , Singh Mukesh Vir , Shrivastava Anubha , Maurya Manisha , Gaur Vinay K , Kumar Durgesh
Published: July 2020

Femoral shaft fractures following oil massage in newborns are very rare. We describe our observations at a tertiary centre in northern India. Three such cases encountered during the study period from July 2014 to June 2019 were evaluated. Sociocultural details, neonatal illnesses, mode of delivery, history of child abuse, type of fracture and management were recorded and analysed. All patients had a mid-shaft fracture after forceful oil massage by caring grandmothers. They all had complete union of fractures by the end of four weeks. This case series shows that mid-shaft fracture femur in neonates has excellent long-term prognosis, but the practice of oil massage needs to be modulated.
On being moderate and peaceful: Why Islamic political moderateness promotes outgroup tolerance and reconciliation
Authors: Zaduqisti Esti , Mashuri Ali , Zuhri Amat , Haryati Tri Astutik , Ula Miftahul
Published: July 2020

Islamic moderateness is said to be one of the key factors that contribute to the promotion of peace in Muslim societies. We present an empirical study conducted in Indonesia ( N = 299) that assessed Islamic political moderateness and examined its role in explaining Muslims’ tolerance towards non-Muslims, as well as the first group’s support for making reconciliation with the latter group. We found as hypothesised that Islamic political moderateness was a positive predictor of outgroup tolerance, because of the role it had in positively predicting the sense of national identity as a higher order identity vis-à-vis Islamic identity (i.e. higher order nested identity). Outgroup tolerance positively predicted and, in turn, fully mediated the positive association between Islamic political moderateness and Muslims’ reconciliatory tendencies, including feelings of collective guilt and shame, intergroup trust and perspective-taking, intergroup cooperation, willingness to apologise, as well as support for intergroup empowerment and reparative actions. These findings suggest the benefit of Islamic political moderateness to drive Muslims to appreciate the existence of non-Muslims. We discuss these empirical findings in terms of theoretical implications, research limitations and practical implications.
Romantic attachment, unforgiveness and relationship satisfaction in couples: A dyadic mediation analysis
Authors: Guzmán-González Mónica , Contreras Paula , Casu Giulia
Published: July 2020

Adult romantic attachment is strongly associated with couple relationship functioning, and many efforts have been made to identify the mechanisms underlying this link. Nevertheless, no previous study considered unforgiveness when investigating the relationship of romantic attachment with relationship satisfaction in couples. We used the actor–partner interdependence mediation model to explore the associations between romantic attachment and relationship satisfaction as mediated by unforgiveness (i.e., avoidance and revenge motivations) in a convenience sample of 104 Chilean couples. The couples completed self-report measures of romantic attachment, unforgiveness, and relationship satisfaction. Actor insecure attachment was associated with lower relationship satisfaction directly and indirectly. Indirectly, higher actor levels of attachment anxiety and avoidance were linked, respectively, to greater revenge and avoidance motivations, and thus to lower relationship satisfaction. Partner attachment avoidance was associated with lower relationship satisfaction only directly. Higher partner levels of attachment anxiety were associated with lower avoidance motivation, and thus with higher relationship satisfaction. These dyadic findings further attest to the detrimental role of attachment avoidance and unforgiveness against the couple’s functioning. The novel finding that attachment anxiety may indirectly promote a couple’s relationship satisfaction deserves further investigation. The implications for couple counseling and therapy are discussed.
Perioperative management of COVID-19 patients undergoing cardiac surgery with cardiopulmonary bypass
Authors: Gunaydin Serdar , Stammers Alfred H
Published: July 2020

Coronavirus disease 2019 (COVID-19) is a serious health concern which affects all healthcare professionals worldwide. The pandemic puts health services, including cardiac surgery units, under escalating pressure. There are significant challenges caused by this novel virus and ensuing disease that leads to great uncertainty. While it has been advocated to delay elective surgeries, most cardiac surgical patients present in a more urgent manner which elevates the critical nature for intervention, which may make the surgical decision inevitable. To date, no definitive treatments to the pandemic have been promoted. Cardiac surgical centers may experience an increasing number of COVID-19 patients in clinical practice. Preparation for managing these patients will require a change in the current modalities for perioperative care. Therefore, the goal of this report is to share our own experiences, combined with a review of the emerging literature, by highlighting principles for the adult cardiac surgery community regarding treatment of patients scheduled for surgery. The following report will recommend perioperative guidance in patient management to include safety precautions for the heart team, the conduct of extracorporeal circulation and related equipment, and covering the early period in intensive care in the context of the current pandemic.
Trump, COVID-19, and the War on Expertise
Authors: Rutledge Paul E.
Published: July 2020

In times of crisis, the American public looks to the president for leadership that will usher the country successfully to the other side of troubled times. There is a long history of presidential actions to lead the nation successfully through times of crisis. Abraham Lincoln’s leadership during the Civil War preserved the Union, just as Franklin Roosevelt’s leadership during both the Great Depression and World War II restored the nation toward a future of peace and prosperity defeating threats to both the economy and security at home and abroad. Currently, the public looks to President Donald Trump for leadership through the COVID-19 global pandemic, which is presenting a direct threat to the health and economic security of the nation. This article will examine the leadership of Donald Trump throughout the COVID-19 pandemic. Specifically, the focus will be on Donald Trump’s relationship with advisors and the extent to which he is using their shared expertise both for informing the public and in crafting policy responses to COVID-19.
What Is the Remedy for State and Local Fiscal Squeeze During the COVID-19 Recession? More Debt, and That Is Okay
Authors: Douglas James W. , Raudla Ringa
Published: July 2020

The COVID-19 crisis is placing a tremendous fiscal squeeze on state and local governments in the United States. We argue that the federal government should increase its deficit to fill in the fiscal gap. In the absence of sufficient federal assistance, we recommend that states suspend their balanced budget rules and norms and run deficits in their operating budgets to maintain services and meet additional obligations due to the pandemic. A comparison with Eurozone countries shows that states have more than enough debt capacity to run short-term deficits to respond to the crisis.
Crisis Coordination and the Role of Social Media in Response to COVID-19 in Wuhan, China
Authors: Li Yiran , Chandra Yanto , Kapucu Naim
Published: July 2020

The commentary addresses the government’s role in mitigating information asymmetry problems during pandemic crisis response. We use the outbreak of COVID-19 in Wuhan, China, as a case to show the use of social media as a key mechanism in shaping the actions of the central government in its coordination with the local governments during the pandemic response. The Chinese government effectively collaborated with a social media platform to not only create a dedicated channel to allow citizens to post information about the pandemic to accelerate the speed of relief but also mobilize citizens and nonprofit organizations to support government response and recovery efforts. This suggests that social media can provide a venue for the government to not only tackle the information overload but also mitigate the friction among levels of governments.
Singapore’s Responses to the COVID-19 Outbreak: A Critical Assessment
Authors: Abdullah Walid Jumblatt , Kim Soojin
Published: July 2020

This article reviews how Singapore has responded to the COVID-19 pandemic, from late-January to early May, 2020, through the three-phase approach to “learning”: in-between learning, trial-and-error learning, and contingency learning. Given its unique political system dominated by the People’s Action Party (PAP) and bureaucratic culture, the Singapore government has progressively implemented numerous control measures including strict travel bans, contact tracing, “Circuit Breaker,” compulsory mask-wearing, and social distancing policies, along with financial relief to businesses and workers, in a very top-down fashion. Although the health and treatment issues of foreign migrant workers in dormitories continue to be the subject of ongoing debate among many scholars, it should be noted that the mortality rate in Singapore still remains very low compared to that of many other countries. Singapore’s case points to an important lesson that learning-driven coordinated strategic approaches matter for effective crisis management in the long term.
Aging affects responsiveness of peripheral blood mononuclear cells to immunosuppression of periodontal ligament stem cells
Authors: Li Xiaoyu , Zhang Bowen , Wang Hong , Zhao Xiaolu , Zhang Zijie , Ding Gang , Wei Fulan
Published: July 2020

Objectives

The effect of age on the response of peripheral blood mononuclear cells (PBMCs) to immunosuppression induced by human periodontal ligament stem cells (hPDLSCs) is unclear. The identity of the cytokines most effective in inducing the PBMC immune response remains unknown. This study investigated the effects of age on immunophenotype, proliferation, activation, and cytokine secretion capacities of PBMCs following co-culture with hPDLSCs.

Methods

PBMCs were collected from younger (16–19 years) and older (45–55 years) donors, then co-cultured with confirmed hPDLSCs for various lengths of time. T lymphocyte proliferation and cell surface marker expression were analyzed by flow cytometry. Cytokine expression levels were measured by quantitative polymerase chain reaction assays and enzyme-linked immunosorbent assays.

Results

CD28 expression by T lymphocytes decreased with age, indicating reduced proliferation; CD95 expression increased with age, indicating enhanced apoptosis. Moreover, hPDLSCs inhibited T lymphocyte proliferation in both age groups; this inhibition was stronger in cells from older donors than in cells from younger donors. Age reduced the secretion of interleukin-2 and interferon-γ, whereas it increased the secretion of tumor necrosis factor-β by PBMCs cultured with hPDLSCs.

Conclusions

Aging may have a robust effect on the response of PBMCs towards hPDLSC-induced immunosuppression.
Carceral economies of migration control
Authors: Martin Lauren L
Published: July 2020

This article conceptualizes carceral economies of migration control. First, I argue that ‘privatization’ signals a reorganization of authority, rather than a relocation of ownership from public to private domains. Second, I argue for greater attention to the socio-technical practices of valuation specific to migration control through which commodification becomes possible. Third, this reorganization of authority has produced (1) status value, a form of value specific to immigration policing’s juridico-political position; and (2) valuation practices that translate, commensurate and circulate migrant life as a marketizable entity.
Patellar Malalignment Is Associated With Patellofemoral Lesions and Cartilage Relaxation Times After Hamstring Autograft Anterior Cruciate Ligament Reconstruction
Authors: Liao Tzu-Chieh , Martinez Alejandro G. Morales , Pedoia Valentina , Ma Benjamin C. , Li Xiaojuan , Link Thomas M. , Majumdar Sharmila , Souza Richard B.
Published: July 2020

Background:

There is growing evidence suggesting a link between patellofemoral joint (PFJ) osteoarthritis in anterior cruciate ligament (ACL)–reconstructed knees and altered joint alignment.

Purpose:

To determine whether patellar alignment differs between participants with and without ACL reconstruction (ACLR) and to identify possible associations between patellar alignment and PFJ osteoarthritis features over 3 years.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

A total of 37 participants with ACLR (sex, 23 male; mean ± SD age, 28.1 ± 7.4 years) and 20 healthy controls (13 male; 30.4 ± 4.8 years) participated. Patients underwent magnetic resonance imaging: (1) sagittal T2-weighted fat-saturated fast spin echo images to calculate patellar alignment, (2) sagittal 3-dimensional intermediate-weighted fast spin echo Cube sequence for clinical morphological grading (modified Whole-Organ Magnetic Resonance Imaging Score [WORMS]), and (3) sagittal combined T1ρ/T2 mapping sequence for performing voxel-based relaxometry. Patellar alignment of the ACLR knees were assessed at 6 months (baseline). One-way analysis of variance was used to compare patellar alignment among the ACLR (at 6 months), contralateral, and control knees. Within the ACLR group, a logistic regression model was used to identify if patellar alignment measures at baseline were risk factors for worsening of PFJ structural changes over 3 years. Statistical parametric mapping was used to evaluate the longitudinal associations between patellar alignment and cartilage relaxation times at 3 years.

Results:

When compared with control knees, ACLR knees exhibited a laterally and anteriorly displaced patella ( P = .045 and P = .041), less flexion ( P = .031), and less lateral spin ( P = .012). Furthermore, excessive lateral displacement was a significant predictor of worsening of WORMS ( P = .050). Lateral displacement was positively correlated with increased T1ρ and T2 in the patellar and trochlear cartilage at 3 years. Patellar lateral spin revealed similar negative findings.

Conclusion:

Participants with ACLR exhibited a laterally and anteriorly displaced patella, less flexion, and less lateral spin when compared with healthy controls. Excessive patellar lateral displacement was the strongest predictor to the development of PFJ osteoarthritis features longitudinally.
An In-Depth Analysis of Graft Rupture and Contralateral Anterior Cruciate Ligament Rupture Rates After Pediatric Anterior Cruciate Ligament Reconstruction
Authors: DeFrancesco Christopher J. , Striano Brendan M. , Bram Joshua T. , Baldwin Keith D. , Ganley Theodore J.
Published: July 2020

Background:

Reported rates of graft rupture and contralateral anterior cruciate ligament (ACL) rupture after ACL reconstruction (ACLR) are higher among pediatric patients than adults. Previous series may have underestimated postoperative event risk because of small sample sizes and high proportions of dropouts.

Purpose:

To calculate rates of graft rupture and contralateral ACL rupture after ACLR in a large pediatric series.

Study Design:

Case series; Level of evidence, 4.

Methods:

ACLRs performed in our tertiary care children’s hospital system over a period of >7 years were identified through billing review. Cases were sorted based on operative technique, with all-epiphyseal ACLRs considered separately. Transphyseal ACLRs were divided into 2 groups based on patient age, with a cutoff of 16 years. Clinic follow-up data as well as prospectively collected survey data were used to note graft rupture and contralateral ACL rupture events. Rates of graft rupture and contralateral ACL rupture were calculated using Kaplan-Meier survival analysis.

Results:

The final data set included 996 patients. A total of 161 patients underwent all-epiphyseal ACLR. Of the remaining transphyseal surgeries, 504 patients were <16 years of age at the time of surgery and 331 were ≥16 years. The 4-year cumulative rate of graft rupture via Kaplan-Meier survival analysis was 19.7% among all patients. The rate was 18.2% among all-epiphyseal ACLRs, 21.6% among transphyseal ACLRs in patients <16 years, and 16.4% among transphyseal ACLRs in patients ≥16 years ( P = .855). Survival analysis estimated the 4-year cumulative rate of contralateral ACL rupture at 12.0% among all patients: 6.63% among all-epiphyseal ACLRs, 15.7% among transphyseal ACLRs in patients <16 years, and 8.05% among transphyseal ACLRs in patients ≥16 years ( P = .093).

Conclusion:

This is the largest series of pediatric ACLRs yet reported, and it shows that the risks of another ACL injury after first-time ACLR are higher than previously reported. The risk of contralateral ACL rupture was lower than that for graft rupture. Our methods, including prospective follow-up surveys and survival analysis to generate cumulative rate estimates, provide a best-practice example for future case series calculations. Our results provide insight into the postoperative course of pediatric patients undergoing ACLR and are crucial for preoperative patient and family counseling. Understanding these risks may also influence return-to-play decisions.
Hip Arthroscopy in the High-Level Athlete: Does Capsular Closure Make a Difference?
Authors: Hassebrock Jeffrey D. , Makovicka Justin L. , Chhabra Anikar , Anastasi Matthew B. , Menzer Heather M. , Wilcox Justin G. , Economopoulos Kostas J.
Published: July 2020

Background:

Hip arthroscopy has been shown to be effective in athletes who have femoral acetabular impingement and labral tearing. The effect of complete capsular closure versus nonclosure on return to play is unknown.

Hypothesis:

Complete capsular closure after hip arthroscopy would lead to a higher rate and faster return to sports in high-level athletes.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

A nonrandomized retrospective review was performed of high school, collegiate, and professional athletes undergoing hip arthroscopy by a single high-volume hip arthroscopic surgeon. Athletes were divided into those undergoing complete capsular closure (CC group) and non–capsular closure (NC group) after hip arthroscopy. Rate and time to return to play were determined between the 2 groups. Patient-reported outcomes including modified Harris Hip Score (mHHS), Hip Outcome Score Activities of Daily Living (HOS-ADL), and Hip Outcome Score Sport-Specific Subscale (HOS-SSS) were obtained at a minimum of 2 years.

Results:

A total of 111 athletes with a minimum 2-year follow-up were included in the study. There were 62 in the CC group and 49 in the NC group. A higher percentage of athletes in the CC group returned to play compared with that in the NC group (90.3% vs 75.5%, respectively; P = .03). The CC group returned to play at a mean ± SD of 4.7 ± 1.9 months compared with 5.8 ± 2.6 months in the NC group ( P < .001). Patients in the CC group met the minimal clinically important difference for the mHHS, HOS-ADL, and HOS-SSS patient-reported outcomes at higher percentages: mHHS, 98.3% vs 87.7% for CC vs NC, respectively ( P = .02); HOS-ADL, 98.3% vs 87.7% ( P = .02); and HOS-SSS, 96.7% vs 89.7% ( P = .13). The difference between groups was statistically significant for mHHS and HOS-ADL.

Conclusion:

Complete capsular closure after hip arthroscopy was associated with faster return to play and a higher rate of return compared with that of nonclosure of the capsule in this sample population of high-level athletes. At a minimum 2-year follow-up, complete capsular closure was associated with significantly higher patient-reported outcomes compared with those of nonclosure in athletes who underwent hip arthroscopy.
The Stigma of ADHD: Teacher Ratings of Labeled Students
Authors: Metzger Ashley N. , Hamilton Laura T.
Published: July 2020

Despite the increasing prevalence of Attention-Deficit Hyperactivity Disorder (ADHD), little sociological research has focused on effects of diagnosis in schools. This study, which is grounded in the modified labeling approach, relies on three waves of Early Childhood Longitudinal Study (ECLS-K:2011) data to determine if teachers evaluate the academic performance of ADHD students as less promising than non-diagnosed peers. Results indicate that teachers are more likely to rate ADHD students as performing below grade level and are less likely to acknowledge these students as performing above grade level—regardless of demonstrated ability on subject-specific tests. The latter finding is, in part, a function of real and/or perceived behaviors in the classroom that inform teachers’ grade-level performance ratings. We argue that diagnosis may be a double-edged sword for children and their families, as it can provide access to special resources in the school but may activate teachers’ negative stereotypes about diagnosed students.
Shifting traditional healthcare paradoxes—The case for true system transformation
Authors: Monavvari Alan A. , Brady Lori , Harper Lisa , Mehrfar Parisa
Published: July 2020

Although national spending on healthcare has progressed on an upward trend over several decades, issues regarding performance remain. Challenges such as access to specialist care and maternal and infant mortality rates contributed to Canada’s recent ranking of ninth among 11 Organisation for Economic Co-operation and Development countries for overall health system performance. Although disruptive transformation is required to resolve our chronic performance issues, effective change cannot be realized without addressing the foundational elements of patient-centred care, interprofessional care, and system integration. Inspired by examples of innovative disruption in other jurisdictions and industries, these three concepts are outlined as the core ingredients for healthcare transformation and describe how they currently function in a paradoxical manner—as self-contradictory statements which in reality are not executed to their true meaning. This article illustrates how improvements in health system performance are hinged to the need to rectify and fuse these three mutually inclusive and inseparable concepts.
Ethical Coffee Room: An international collaboration in learning ethics digitally
Authors: Manninen Katri , Björling Gunilla , Kuznecova Jelena , Lakanmaa Riitta-Liisa
Published: July 2020

Background:

Ethics is a fundamental part of health care professionals’ competence and one of the major quality factors in good nursing care. Research shows challenges in learning and applying ethics. Ethical Coffee Room (ECR) is an electronic platform, where the students, nurses and teachers discuss anonymously ethical issues during students’ clinical practice. ECR offers 1 credit (27 working hours) for the students. This work included reading theoretical material, contributions for discussion of ethical dilemmas and reflection of one’s own learning. Every user – student, nurse supervisor or teacher – could choose her or his own pseudonym.

Aim:

The aim of this study was to describe how nursing students experience learning ethics with digital learning activity during clinical practice, how usable the Ethical Coffee Room platform is and how this learning activity should be developed further.

Research design, participants and context:

The study employed a qualitative descriptive design and was an EU project between Finland, Sweden and Latvia. In total, 34 second-year nursing students participated in the study. The data collection methods were semi-structured interviews and written comments in the discussion forum Ethical Coffee Room. The data were analysed using content analysis.

Ethical considerations:

Ethical approval and research permission were obtained from each partner organization, according to their national standards.

Findings:

The results are presented under three themes: positive learning experiences of Ethical Coffee Room, challenges in learning during Ethical Coffee Room and practical suggestions for future development of Ethical Coffee Room. The results showed that the Ethical Coffee Room was experienced as a novel type of learning activity and an interesting way to learn ethics.

Discussion and conclusion:

Ethical Coffee Room seems to be a promising learning activity enhancing students’ ethical competence in clinical practice. However, active participation of the mentor nurses and teachers is essential. Therefore, mentor nurses and teachers need in-depth knowledge of ethical theories and concepts and how to apply them in clinical context.
Possible Pharmacodynamic Interaction of Azelnidipine with Citicoline Against Ischemic Brain Injury: Behavioral, Biochemical and Histological Alterations
Authors: Gupta Varun , Bader Zein Eddin , Aakriti  , Kumar Anil
Published: July 2020

Background: Currently, no drug has been approved for the management of postischemic neuronal damage. Existing studies show that calcium channel blockers have neuroprotective properties, while citicoline is involved in maintaining neuronal integrity.

Purpose: This study was envisaged to investigate the effect of azelnidipine (novel calcium channel blocker) alone and in combination with citicoline (phosphatidyl-choline analogue) against ischemic brain damage in Wistar rats.

Methods: Previously standardized bilateral common carotid artery occlusion model was used to induce cerebral ischemic injury in Wistar rats. Pretreatment with azelnidipine (1.5 mg/Kg and 3 mg/Kg; p.o.) or citicoline (250 mg/Kg; i.p.) was done every 24 h starting 7 days before the bilateral common carotid artery occlusion surgery. Pharmacological assessments (behavioral, biochemical, mitochondrial, molecular, and histological) were done after 48 h of the reperfusion period.

Results: Azelnidipine and citicoline were found to protect the brain from progressive neuronal damage as seen by improved sensorimotor behavior (locomotion, rota rod, and beam balance performance) and reduced oxidative stress (decreased malondialdehyde (MDA), nitrite, increased glutathione (GSH), superoxide dismutase (SOD)). Impairment of mitochondrial enzyme system and increase in the infarct area were found to be arrested by individual treatments with azelnidipine and citicoline. These effects were further potentiated synergistically as the combination of citicoline and azelnidipine was found to decrease glutamate levels, caspase-3 activity and histological alterations as compared to their individual effects.

Conclusion: Azelnidipine and citicoline synergistically decrease excitotoxic and oxidative damage against ischemic brain injury in Wistar rats and, therefore, propose a clinically relevant combination for the prevention of postischemic neuronal damage.
Social Distancing and Outdoor Physical Activity During the COVID-19 Outbreak in South Korea: Implications for Physical Distancing Strategies
Authors: Park Sunhee , Kim Beomsoo , Lee Jaeil
Published: July 2020

The novel coronavirus disease (COVID-19) outbreak has put the entire world in a pandemic situation. In response, strict screening, quarantine protocols, and contact tracing have been conducted in South Korea. The purpose of this study was to examine effects of social distancing on the Public Bicycle Sharing System (PBSS) during the COVID-19 outbreak. We used the PBSS public dataset of Seoul, South Korea. Difference-in-differences (DID) analysis was used. In the DID approach, the 2 groups are distinguished based on designated year. Cases of PBSS use were observed in 2 time periods: pre- and post-strict social distancing in Seoul, Korea. Average PBSS usage per day doubled during 2019-2020 (30 697 vs 77 996, P < .001). Commuters and weekend users increased during the social distancing period in 2020 compared with the same period in 2019. DID analysis showed statistically significant positive effects of high levels of social distancing on PBSS usage, commuters, weekend users, and new subscribers. In conclusion, social distancing during the COVID-19 outbreak increased outdoor physical activity. Meaningful outdoor physical activity during the COVID-19 pandemic can be safe from infection and psychologically stabilized as long as keeping meticulous physical distancing, such as hand hygiene, wearing facial masks, and surface cleaning of public resources.
Measuring Cultural Awareness Among Slovene Nursing Student: A Cross-Sectional Study
Authors: Ličen Sabina , Karnjuš Igor , Prosen Mirko
Published: July 2020

Background: Measurements of nursing students’ cultural awareness are needed to evaluate education that intends to improve nurses’ cultural competency skills. The purpose of this study was to assess the level of cultural awareness held by undergraduate nursing students. Method: A nonexperimental, cross-sectional design was applied to a purposive sample of 149 undergraduate nursing students. Data were collected based on the Cultural Awareness Scale (CAS). Results: The results show that the nursing students had a moderately high level of cultural awareness for all CAS subscales ( M = 194.0). However, no statistically significant differences were seen between the students’ demographic (gender and age) and other data (year of study and religion) related to the overall CAS score ( p > .05). Discussion: Building on the satisfactory results obtained from this study, in the future, both the transcultural nursing contents as well as various strategies for teaching cultural competencies should be carefully evaluated.
Diabetes Mellitus and Noncardiac Atherosclerotic Vascular Disease—Pathogenesis and Pharmacological Treatment Options
Authors: Muzurović Emir M. , Mikhailidis Dimitri P.
Published: July 2020

Diabetes mellitus (DM) is also a cause of cardiovascular (CV) disease (CVD). Addressing the atherosclerotic CVD (ASCVD) burden in DM should reduce premature death and improve quality of life. Diabetes mellitus–associated ASCVD can lead to complications in all vascular beds (carotids as well as coronary, lower extremity, and renal arteries). This narrative review considers the diagnosis and pharmacological treatment of noncardiac atherosclerotic vascular disease (mainly in patients with DM). Based on current knowledge and the fact that modern DM treatment guidelines are based on CV outcome trials, it should be noted that patients with noncardiac CVD may not have the same benefits from certain drugs compared with patients who predominantly have cardiac complications. This leads to the conclusion that in the future, consideration should be given to conducting well-designed trials that will answer which pharmacological treatment modalities will be of greatest benefit to patients with noncardiac ASCVD.
Simulation training to improve aseptic non-touch technique and success during intravenous cannulation—effect on hospital-acquired blood stream infection and knowledge retention after 6 months: The snowball effect theory
Authors: Balachander Bharathi , Rajesh Deepa , Pinto Bonita Viona , Stevens Sofia , Rao PN Suman
Published: July 2020

Background:

Intravenous cannulation is a common procedure and a valuable skill in the neonatal intensive care unit. Standardized procedure and personnel training are needed in the unit to prevent hospital-acquired blood stream infections. Hence, we evaluated the effect of training using a low-fidelity simulation on the improvement of the aseptic non-touch technique during intravenous cannulation and knowledge retention after 6 months.

Methods:

The study was conducted in a tertiary care neonatal unit from June 2017 to July 2018. All the staff nurses and junior resident doctors posted in the neonatal intensive care were included in the study. A protocol and checklist score sheet was developed. The score sheet consisted of 23 items with a total score of 46. Participants were expected to obtain a minimum of 80%. A pre-test was conducted initially, followed by a formal training and then a post-test. The NITA newborn venous access mannequin was used to facilitate the training. A re-training for new nurses was conducted after 6 months. Data were analyzed using paired t-test.

Results:

A total of 29 doctors and nurses were enrolled in the training. The mean pre-test score was 29.93 compared to 42.66 in the post-test scores (mean difference 12.24(95% confidence interval: 9.39–16.05), p < 0.01. The mean scores were higher when the simulation was conducted after 6 months. There was a significant decline in blood stream infection rates from 5.5 to 1.65 per 1000 patient days (p = 0.05).

Conclusion:

Simulation-based training of health care personnel is a good modality to improve aseptic non-touch technique during intravenous cannulation in the neonatal intensive care unit. Simulation-based training also helps in knowledge retention and standardization of training procedures.
Interpretation of peripheral arterial and venous Doppler waveforms: A consensus statement from the Society for Vascular Medicine and Society for Vascular Ultrasound
Authors: Kim Esther SH , Sharma Aditya M , Scissons Robert , Dawson David , Eberhardt Robert T , Gerhard-Herman Marie , Hughes Joseph P , Knight Steve , Marie Kupinski Ann , Mahe Guillaume , Neumyer Marsha , Poe Patricia , Shugart Rita , Wennberg Paul , Williams David M , Zierler R Eugene
Published: July 2020

This expert consensus statement on the interpretation of peripheral arterial and venous spectral Doppler waveforms was jointly commissioned by the Society for Vascular Medicine (SVM) and the Society for Vascular Ultrasound (SVU). The consensus statement proposes a standardized nomenclature for arterial and venous spectral Doppler waveforms using a framework of key major descriptors and additional modifier terms. These key major descriptors and additional modifier terms are presented alongside representative Doppler waveforms, and nomenclature tables provide context by listing previous alternate terms to be replaced by the new major descriptors and modifiers. Finally, the document reviews Doppler waveform alterations with physiologic changes and disease states, provides optimization techniques for waveform acquisition and display, and provides practical guidance for incorporating the proposed nomenclature into the final interpretation report.
Permission, obedience, and continuities: A contribution to the sociological theory of genocidal processes
Authors: Ribes Alberto J
Published: July 2020

This article presents a theoretical reflection on genocidal processes. In the first place, we will propose the compatibility of the paradigm of permission with the paradigm of obedience, which would allow us to talk about tolerated genocidal acts, encouraged genocidal acts, and actively pursued genocidal acts. As we open up to the paradigm of permission this would lead us to challenge the explanations which regard genocidal processes as ruptures from civilization, from the moral order, and from the logic in everyday life in modern societies. It will be argued, in second place, that a paradigm of continuities would allow us to explore genocidal processes in a more accurate way. We will go on, then, in our third section, to the details of three processes which operate both in genocidal processes and in everyday life in modern societies: the categorization and construction of ‘others’, the construction of weakness, and the construction of superfluity.
Social workers’ views about children’s and parents’ competence in child protection decision-making
Authors: Korpinen Johanna , Pösö Tarja
Published: July 2020

Competence is an essential part of any decision-making process. In child protection, it is challenged by the controversial nature of child removals and the vulnerable situations which children and parents experience therein. This article examines how and on what grounds social workers view parents and children to be competent to give their informed view in care order proceedings and what they do if doubts about competence arise. The analysis is based on 30 interviews with social workers in Finland.

Findings

The professional ethos and ethics of social work were embedded in the social workers’ descriptions of children’s and parents’ competence. The social workers were confident that the parents and children (of certain age) were competent to give their informed view about whether to consent to the care order proposal and the proposed substitute home. When they spoke about competence ascribed with hesitation, they described the vulnerability of service users, as well as their attitudes and withdrawal from contact. In the cases, social workers emphasized a strength-based view of children and parents and aimed to ‘talk more’ with them and to ‘give them more time’ to support their right to give an informed view.

Applications

Social vulnerability and competence should be explored reflectively in relation to decision-making in child protection. A better understanding of their interrelation makes social workers more competent to support the service users’ right to be included in decision-making. Critical awareness is needed to recognize when ‘more talk’ is not enough to realize children’s and parents’ rights.
Establishing a Reading Mindset Measure: A Validation Study
Authors: Tock Jamie L. , Quinn Jamie M. , Otaiba Stephanie Al , Petscher Yaacov , Wanzek Jeanne
Published: July 2020

Much attention has been given to the development and validation of measures of growth mindset and its impact on learning, but the previous work has largely been focused on general measures of growth mindset. This research was focused on establishing the psychometric properties of a reading mindset (RM) measure among a sample of upper elementary school students and validating the measure through its relations with standardized measures of word reading and comprehension. The RM measure was developed to capture student’s beliefs about their ability, learning goals, and effort during reading. Item response theory was used to select items that optimally measured the RM measure from a pool of existing items from previous research. The final five-item RM measure predicted reading comprehension outcomes above and beyond the effects of word reading, indicating that this measure may be an important tool for diagnosing noncognitive areas of improvement for developing readers. The implications, limitations, and future directions for expanding upon the measure were discussed.
Do Surgical Site Infections in Open Aortoiliac Surgery Differ Between Occlusive and Aneurysmal Arterial Disease?
Authors: Langenberg Jasper C. M. , Roijers Joost , Kluytmans Jan A. J. W. , de Groot Hans G. W. , Ho Gwan H. , Veen Eelco J. , Buimer Thijs G. , der Laan Lijckle van
Published: July 2020

Background:

Surgical site infections (SSI) are frequently seen after aortoiliac vascular surgery (2%-14%). Deep SSIs are associated with graft infection, sepsis, and mortality. This study evaluates the difference in incidence and nature of SSI following open aortoiliac surgery for aneurysmal disease compared to occlusive arterial disease.

Methods:

A retrospective cohort study was conducted, including all consecutive patients who underwent open aortoiliac vascular surgery between January 2005 and December 2016 in the Amphia Hospital, Breda, the Netherlands. Patients were grouped by disease type, either aneurysmal or occlusive arterial disease. Data were gathered, including patient characteristics, potential risk factors, and development of SSI. Surgical site infections were defined in accordance with the criteria of the Centers for Disease Control.

Results:

Between January 2005 and December 2016, a total of 756 patients underwent open aortoiliac surgery of which 517 had aortoiliac aneurysms and 225 had aortoiliac occlusive disease. The group with occlusive disease was younger, predominantly male, and had more smokers. After exclusion of 228 patients undergoing acute surgery, the SSI rate after elective surgery was 6.2%, with 10 of 301 SSIs in the aneurysmal group (3.0%) and 22 of 213 SSIs in the group with occlusive disease (10.3%, P < .001). Also, infection-related readmission and reintervention were higher after occlusive surgery, 6.6% versus 0.9% ( P < .001) and 4.2% versus 0.9% ( P = .003), respectively. Staphylococcus aureus was found as the most common pathogen, causing 64% of SSI in occlusive disease versus 10% in aneurysmal disease ( P = .005). Logistic regression showed occlusive arterial disease and chronic renal disease were associated with SSI.

Conclusion:

Our study presents evidence for a higher rate of SSI in patients with aortoiliac occlusive disease compared to aortoiliac aneurysmal disease, in part due to inherent use of inguinal incision in patients with occlusive disease. All precautions to prevent SSI should be taken in patients undergoing vascular surgery for arterial occlusive disease.
João Allen: Collecting the World: An Exhibition and Case Study of the First Private Museum in Portugal
Authors: Castro Laura
Published: July 2020

João Allen (1781–1848) was a business man who collected antiques, curiosities, natural history, numismatics, archeological pieces, and fine arts. A trip to Italy in 1826–1827 was fundamental to his collection building, to the opening of the first private museum in Portugal, the Allen Museum in Porto (1837), and to the identity of one of Portugal’s most important museums, the Museu Nacional de Soares dos Reis created in 1833 under a different designation. Allen’s Grand Tour of Italy and his eclecticism were the cornerstone of the exhibition that took place in this museum in 2018. This article addresses the way in which the exhibition reflects the museum itself and recalls the formation of collections which are of great importance for the history of European museums due to what they reveal about the political and cultural circumstances of their times. Finally, we point out some possible developments concerning the permanent exhibition of the museum.
Multiomic Analysis of Methylation and Transcriptome Reveals a Novel Signature in Esophageal Cancer
Authors: Jin Yi-qi , Miao Dong-liu
Published: July 2020

Background:

Epigenetic alterations have been shown to lead to human carcinogenesis. The aim of this study was to perform an integrative analysis to develop an epigenetic signature to predict overall survival (OS) of esophageal cancer.

Methods:

DNA methylation and messenger RNA expression data of esophageal cancer samples were downloaded from The Cancer Genome Atlas database and were incorporated and analyzed using an R package MethylMix. Functional enrichment analysis of the methylation-related differentially expressed genes (DEGs) was performed. Epigenetic signature and nomogram associated with the OS of esophageal cancer were established by the multivariate Cox model.

Results:

A total of 71 methylation-related DEGs were identified. Kyoto Encyclopedia of Genes and Genomes pathway analysis revealed that these genes were involved in the biological process related to the initiation and progression of esophageal cancer. Two-gene (FAM24B and FAM200A) risk signature for OS was developed by multivariate Cox analysis, of which had high accuracy. The signature is independent of clinicopathological variables and indicated better predictive power than other clinicopathological variables. Moreover, we developed a novel prognostic nomogram based on risk score and 3 clinicopathological factors.

Conclusions:

Our study indicated possible methylation-related DEGs and established an epigenetic signature, which may provide novel insights for understanding the pathogenesis of esophageal cancer.