bluuebunny/crossref_metadata_2025 huggingface dataset:
Writing Genocide
Authors: Becker Heike
Published: March 2020

In this article I read several recently published novels that attempt to write the early 20th century Namibian experience of colonial war and genocide. Mari Serebrov’s Mama Namibia, Lauri Kubuitsile’s The Scattering and Jaspar Utley’s The Lie of the Land set out to write the genocide and its aftermath. Serebrov and Kubuitsile do so expressly from the perspective of survivors; their main characters are young Herero women who live through war and genocide. This sets Mama Namibia and The Scattering apart from the earlier literature, which—despite an enormous divergence of political and aesthetic outlooks—tended to be written from the perspective of German male protagonists. The Lie of the Land, too, scores new territory in postcolonial literature. I read these recent works of fiction against an oral history-based biography, in which a Namibian author, Uazuvara Katjivena, narrates the story of his grandmother who survived the genocide.
Namibian Life Stories from the ‘Struggle Days’
Authors: Malaba Mbongeni Zikhethele
Published: March 2020

This article analyses representative life stories that reflect the experiences of people who participated in the Namibian liberation struggle, as well as one narrative that reflects the traumatic effect of the brutal murder of her mother witnessed by a five year old girl. The stories detail the vicious nature of settler colonialism in South West Africa and the motive that drove youths to abscond from school to join SWAPO camps in neighbouring countries. Two of the male authored texts focus on the political dimensions of the struggle, with minimal personal details; the two accounts penned by women who obtained secondary and tertiary education in exile and underwent military training foreground the personal dimension that is understated in the male accounts. The human side of war, suffering and discrimination is captured in all the accounts, in differing degrees. The strong Christian beliefs of the selected authors are a striking feature in most of the life stories.
Erdogan’s Train to Authoritarianism
Authors: Gunter Michael M.
Published: March 2020

Recep Tayyip Erdogan — Turkey’s current president (elected 2014) and former prime minister (2003–2014) — infamously once declared that “democracy is like a train; you get off once you have reached your [real] destination.” In other words, one can use democratic means to achieve authoritarian goals. Analyzing Erdogan’s imaginary train journey, one must conclude that the Turkish leader never had the intention of reaching democracy. Indeed, now that he has achieved his actual authoritarian goal, he has jumped off the train. However, his journey did not always seem to be destined for such a terminus. Indeed, in his first decade in power, Erdogan won three parliamentary elections by ever-larger shares of the popular vote because he had helped to build Turkey into a burgeoning economic powerhouse and a moderate Islamic democracy. In the past decade, however, despite winning Turkey’s first popular election for president in August 2014, presiding over another great parliamentary victory in November 2015, and then winning re-election as president as well as retaining control of parliament in June 2018, Erdogan’s increasing authoritarianism has helped precipitate an accelerating crisis both domestically and externally for Turkey. His actions have also negatively affected the Kurds. Although his partial setback in the local elections held in March and June 2019 did seem to affect his hold on power, his seemingly successful creation of a Turkish safety zone in Northern (Syrian) Kurdistan in October 2019 revived his flailing domestic fortunes.
Resolving the taxonomic puzzle of Boana cinerascens (Spix, 1824), with resurrection of Hyla granosa gracilis Melin, 1941 (Anura: Hylidae)
Authors: STURARO MARCELO JOSÉ , COSTA JOÃO CARLOS LOPES , MACIEL ADRIANO O. , LIMA-FILHO GERALDO R. , ROJAS-RUNJAIC FERNANDO J. M. , MEJIA DANIELA PAREJA , RON SANTIAGO R. , PELOSO PEDRO L. V.
Published: March 2020

Expeditions to unexplored or little explored places are important for discovering new species and also for collecting new samples (including specimens and tissues for DNA sequencing ) that may help resolve a plethora of taxonomic problems. In the 19th century, several naturalists explored a number of localities in Amazonia, describing species for which type material was deposited, mostly, in European museums of natural history. Some of these types were lost or destroyed in World War II and recent expeditions have focused on sampling new material from the type localities. material from Boana cinerascens, which allowed us to infer phylogenetic relationships of the Boana punctata group (i.e., green Boana), based on DNA sequence data, and to revaluate the status of B. cinerascens and its synonyms. We designate, redescribe and illustrate a neotype for B. cinerascens, which was described by Spix in 1824, from the Municipality of Tefé, State of Amazonas, Brazil. We revalidate, redescribe, and illustrate Hyla granosa gracilis Melin, 1941(= Boana gracilis). Corroborating previous studies, the green Boana were not recovered as a monophyletic group. Boana cinerascens is sister of B. gracilis plus a clade containing B. atlantica + B. punctata (both species not recovered as monophyletic).
New species of Pycnogonum (Pycnogonida: Pycnogonidae) from Green Island, Taiwan, with an additional note on the holotype of P. spatium
Authors: LEE DAMIN , KIM WON
Published: March 2020

We report the discovery of a new species of the genus Pycnogonum Brünnich, 1764 found in the shallow waters of Green Island, Taiwan. Pycnogonum (Nulloviger) granulatum sp. nov. is characterized by the presence of the granular integument, a dorsal tubercle on the proboscis, the transverse ridges on the dorsal surface of the trunk, and the spines on the ventral surface of the tibia, tarsus, and propodus having cleft tips. Because the male gonopores are present and ovigers are absent, the present species belongs to the subgenus Nulloviger. The present species has been compared with P. (N.) moolenbeeki Stock, 1992, P. (N.) lobipes Stock, 1991, P. (N.) tuberculatum Clark, 1963, P. nodulosum Döhrn, 1881, and P. spatium Takahashi, Dick & Mawatari, 2007. Among the congeners, P. spatium is geographically the closest congener, of which type locality is Amami Island, Japan. The holotype of P. spatium was loaned from Hokkaido University Museum (ICHUM) and re–examined. To determine the exact gender of the holotype of P. spatium, additional investigations of the coxal pellicula and gonopores are required.
One new genus and species of the tribe Meconematini (Orthoptera: Tettigoniidae: Meconematinae) from China
Authors: WANG TAO , HUANG JIANHUA , SHI FUMING
Published: March 2020

In this paper, one new genus Paradoxitettigia gen. nov. is established and one new species Paradoxitettigia longicaudica sp. nov. is described. Furthermore, the morphological images of the new species are provided.
Cacoplistes (Laminogryllus) brevisparamerus Wang, Zhang, Wei & Liu, 2017: A junior synonym of Cacoplistes (Laminogryllus) choui Liu & Shi, 2012 (Orthoptera: Grylloidea: Phalangopsidae: Cachoplistinae)
Authors: WU XUE , SHEN CHU-ZE , LIU YUN-FENG , ZHANG TAO , LI KAI , HE ZHU-QING
Published: March 2020

Cacoplistes (Laminogryllus) spp. from Guangxi were compared by morphology and molecular studies. Morphology results showed that differences of genitalia were caused by movable epiphallus. Molecular result showed that only 0.3% substitution sites of COI gene were detected. Thus, C. (L.) brevisparamerus syn. is the junior synonym of C. (L.) choui.
Extremely Early Summer Monsoon Onset in the South China Sea in 2019 Following an El Niño Event
Authors: Hu Peng , Chen Wen , Chen Shangfeng , Liu Yuyun , Huang Ruping
Published: March 2020

The El Niño–Southern Oscillation (ENSO) is regarded as one of the most important factors for onset of the South China Sea summer monsoon (SCSSM). Previous studies generally indicated that an El Niño event tends to result in a late onset of the SCSSM monsoon. However, this relationship has not been true in recent years, particularly when an extremely early SCSSM onset (1 May 2019) occurred following the 2018/19 El Niño event in the preceding winter. The processes of the second earliest SCSSM onset in the past 41 years were investigated using NCEP–DOE reanalysis, OLR data, and ERSST. A negative sea surface temperature and associated anticyclonic anomalies were absent over the western North Pacific in the late spring of 2019 following an El Niño event in the preceding winter. Thus, the mean circulation in the late spring of 2019 does not prevent SCSSM onset, which is in sharp contrast to the composited spring of the El Niño decaying years. The convective active and westerly phases of a 30–60-day oscillation originating from the Indian Ocean provided a favorable background for the SCSSM onset in 2019. In addition, the monsoon onset vortex over the Bay of Bengal and the cold front associated with a midlatitude trough over East Asia also played important roles in triggering the early onset of the SCSSM in 2019. No tropical cyclone appeared over the western North Pacific during April and May, and the enhancement of quasi-biweekly oscillation mainly occurs after the SCSSM onset; thus, these two factors contribute little to the SCSSM onset in 2019.
Can Germany Become a Major Ally of Ukraine? Counterintuitive Deliberations on a Coming Partnership between Kyiv and Berlin
Authors: Umland Andreas
Published: March 2020

Over the last few years, intergovernmental affairs and the roles of individual countries within the West have started to shift. In response, Kyiv (Kiev) should reorder the priorities and emphases of its foreign political, economic, and cultural policies. The central focus of this re‐orientation should be more resolute than the hitherto deepening of Ukrainian relations has been, not only with the German government but also with the broader political elite, industrial companies, and the civil society of the Federal Republic. A recent systematic study of German perceptions of Ukraine can help develop new approaches, initiatives, and policies to reach a new level of German–Ukrainian partnership.
How and When are We Right to Prioritize the Interests of Residents and Citizens?
Authors: Camacho Beltrán Enrique
Published: March 2020

This article assesses an assumption pervasive in one strain of arguments in favor of stringent immigration controls. The assumption affirms that—for the case of regular admissions—to a certain extent states are permitted to prioritize the interests of their citizens and residents by issuing exclusionary immigration policies (call this the priority assumption). Using the normative methodology of applied international ethics, I suggest some broad constraints to this priority assumption that have a bearing on justifications for current practical immigration policy in Europe, North America, and beyond. I do so by redefining borders as domestic‐international institutions that open up borders not only to (internal) standards of justice but also to standards of international legitimacy.
Patient Perception and Duration of Pain after Microdirect Laryngoscopy
Authors: Tsang Trylon Matthew , Brett Oliver , Hu Amanda
Published: March 2020

Objective

Postoperative pain is an important part of the patient’s surgical experience. The objective was to evaluate patient perception and duration of pain after microdirect laryngoscopy (MDL).

Study Design

Case series with planned data collection.

Setting

Tertiary care, academic center.

Subjects and Methods

Adult patients undergoing MDL were administered the short‐form McGill Pain Questionnaire (SF‐MPQ) before surgery and on postoperative days (PODs) 1, 3, and 7. Demographic and clinical data were collected.

Results

In total, 130 patients (mean age 52.6 years, 84 male) participated in the study. About 46.2% required analgesia on POD 1, but only 23.1% required opioids. Overall, mild levels of pain were reported on the SF‐MPQ: sensory score, affective score, total score, present pain intensity (PPI), and visual analog scale (VAS). Patients reported a significant increase in pain on POD 1, with decreases in pain on PODs 3 and 7. Pain score returned to preoperative values for total score and affective score on POD 7 but remained significantly elevated for PPI, VAS, and sensory score. None of the following factors were associated with increased pain: age, sex, body mass index, Mallampati score, Cormack score, laryngoscope used, type of MDL, time under anesthesia, employment status, intubation, Voice Handicap Index 10, and chronic pain history.

Conclusion

Although mild levels of pain were reported after MDL, the pain persisted for up to 7 days. No demographic or clinical factors were found to be associated with increased pain. This study was one of the few prospective studies evaluating pain after MDL.
Hearing Loss, Loneliness, and Social Isolation: A Systematic Review
Authors: Shukla Aishwarya , Harper Michael , Pedersen Emily , Goman Adele , Suen Jonathan J. , Price Carrie , Applebaum Jeremy , Hoyer Matthew , Lin Frank R. , Reed Nicholas S.
Published: March 2020

Objective

Social isolation and loneliness are associated with increased mortality and higher health care spending in older adults. Hearing loss is a common condition in older adults and impairs communication and social interactions. The objective of this review is to summarize the current state of the literature exploring the association between hearing loss and social isolation and/or loneliness.

Data Sources

PubMed, Embase, CINAHL Plus, PsycINFO, and the Cochrane Library.

Review Methods

Articles were screened for inclusion by 2 independent reviewers, with a third reviewer for adjudication. English‐language studies of older adults with hearing loss that used a validated measure of social isolation or loneliness were included. A modified Newcastle‐Ottawa Scale was used to assess the quality of the studies included in the review.

Results

Of the 2495 identified studies, 14 were included in the review. Most of the studies (12/14) were cross‐sectional. Despite the heterogeneity of assessment methods for hearing status (self‐report or objective audiometry), loneliness, and social isolation, most multivariable‐adjusted studies found that hearing loss was associated with higher risk of loneliness and social isolation. Several studies found an effect modification of gender such that among women, hearing loss was more strongly associated with loneliness and social isolation than among men.

Conclusions

Our findings that hearing loss is associated with loneliness and social isolation have important implications for the cognitive and psychosocial health of older adults. Future studies should investigate whether treating hearing loss can decrease loneliness and social isolation in older adults.
Clinical vs Microscopic Extranodal Extension and Survival in Oropharyngeal Carcinoma in the Human Papillomavirus Era
Authors: Gal Thomas J. , O’Brien Kaitlin July , Chen Quan , Huang Bin
Published: March 2020

Objective

Extranodal extension (ENE) is known to be associated with poor outcomes in head and neck squamous cell carcinoma. The objective of this study is to examine the impact of extent of ENE on survival in oropharyngeal carcinoma in the human papillomavirus (HPV) era.

Study Design

Retrospective database review.

Setting

Review of the National Cancer Database.

Subjects and Methods

The National Cancer Database was used to examine surgically treated head and neck squamous cell carcinoma of the tonsil and base of tongue from 2010 to 2015. Nodes available for pathologic examination were classified as ENE negative (–), ENE clinically (+), or ENE (+) on pathology only. The primary outcome was overall survival. Cox regression modeling was used to examine the effect of ENE on survival while controlling for patient demographics, HPV status, stage, adjuvant radiation, and chemotherapy.

Results

Of the 66,106 patients identified, 16,845 were treated with surgery ± adjuvant therapy, 8780 of whom were known HPV+. Overall 5‐year survival for this group was 86%. Documented ENE was associated with over a 60% decrease in survival for clinical (hazard ratio [HR], 1.63) and pathologic (HR, 1.62) ENE compared to negative ENE, after adjustment for stage, adjuvant radiation ± chemotherapy, HPV, and other variables. No significant differences were found between clinical and pathologic ENE (HR, 1.001).

Conclusion

While both surgically resected clinical and pathologic ENE are associated with decreased survival, no significant differences are observed between the two. The impact of these observations on potential de‐escalation therapeutic strategies requires further study.
Palliative care and infection management at end of life in nursing homes: A descriptive survey
Authors: Tark Aluem , Estrada Leah V , Tresgallo Mary E , Quigley Denise D , Stone Patricia W , Agarwal Mansi
Published: March 2020

Background:

Infections are common occurrences at end of life that are associated with high rates of morbidity and mortality among frail elderly individuals. The problem of infections in nursing homes has led to a subsequent overuse and misuse of antibiotics in this already-frail population. Improving palliative care in nursing homes has been proposed as a key strategy to reduce the use of antibiotics.

Aim:

The aim of this study was to describe the current status of how nursing homes integrates palliative care and infection management at end of life across the nation.

Design:

This is a cross-sectional survey of nationally representative US nursing homes.

Setting/participants:

Between November 2017 and October 2018, a survey was conducted with a nationally representative random sample of nursing homes and 892 surveys were completed (49% response rate). The weighted study sample represented 15,381 nursing homes across the nation.

Results:

Most nursing homes engaged in care plan documentation on what is important to residents (90.43%) and discussed spiritual needs of terminally ill residents (89.50%). In the event of aspiration pneumonia in terminally ill residents, 59.43% of nursing homes responded that resident would be transferred to the hospital. In suspected urinary tract infection among terminally ill residents, 66.62% of nursing homes responded that the resident will be treated with antibiotics.

Conclusion:

The study found wide variations in nursing home palliative care practices, particularly for timing of end-of-life care discussions, and suboptimal care reported for antibiotic usage. Further education for nursing home staff on appropriate antibiotic usage and best practices to integrate infection management in palliative care at the end of life is needed.
Poly(acrylamide-co-acrylic acid) gel polymer electrolyte incorporating with water-soluble sodium sulfide salt for quasi-solid-state quantum dot-sensitized solar cell
Authors: Lee YC , Buraidah MH , Woo HJ
Published: March 2020

Rapid decay of photoanode, leakage from sealant, and evaporation of electrolyte are always the major concerns of quantum dot-sensitized solar cells (QDSCs) based on liquid electrolyte. Subsequently, gel polymer electrolyte (GPE) appears as an attractive solution in addition to lower cost, lighter weight, and flexibility. Poly(acrylamide- co-acrylic acid) (PAAm-PAA) is of special interest to act as a polymer host to entrap liquid electrolyte because it provides high transparency, good gelatinizing properties, and excellent compatibility with the liquid electrolyte. In this work, the electrical and transport properties of PAAm-PAA GPE incorporating with water-soluble sodium sulfide were characterized by impedance spectroscopy. An increment of ionic conductivity was observed with the incorporation of ethylene carbonate (EC) and potassium chloride (KCl). The highest room temperature ionic conductivity of PAAm-PAA GPE is 70.82 mS·cm−1. QDSC based on PAAm-PAA GPE with the composition of 1.3 wt% of KCl, 0.9 wt% of EC, 55.3 wt% of PAAm-PAA, 38.5 wt% of sodium sulfide, and 4.0 wt% of sulfur can present up to 1.80% of light-to-electricity conversion efficiency.
Experimental study on critical heat flux during flow boiling of R134a in a vertical helically coiled tube
Authors: Niu Xiaojuan , Yuan Huaijie , Zhao Liang
Published: March 2020

This paper carried out an experimental study on the critical heat flux during flow boiling of R134a in a vertical helically coiled tube. The length, inner diameter, coil diameter, and pitch of the test tube were 1.85 m, 8 mm, 205 mm, and 25 mm, respectively. Experiments cover the mass flux range of 190–400 kg·m−2·s−1, heat flux of 15–55 kW·m−2, inlet pressure of 0.8–1.1 MPa, and inlet vapor quality of 0.01–0.35. The effects of critical heat flux identification method, mass flux, system pressure, and inlet vapor quality on critical heat flux were presented. The critical heat flux obtained by the wall temperature rise method was larger than that obtained by the wall temperature oscillation method. The deviation of the critical heat flux corresponding to two methods, including wall temperature rises sharply above 10 ℃ and wall temperature drastic oscillation, was about 20% under the present experimental conditions. The critical heat flux increased with mass flux while it decreased with the inlet vapor quality and pressure. The experiment data were compared with four existing empirical correlations. A new correlation is proposed for critical heat flux prediction in vertical helical tubes.
Intercostal vessel screening prior to pleural interventions by the respiratory physician: a prospective study of real world practice
Authors: Bedawi Eihab O. , Talwar Ambika , Hassan Maged , McCracken David J. , Asciak Rachelle , Mercer Rachel M. , Kanellakis Nikolaos I. , Gleeson Fergus V. , Hallifax Rob J. , Wrightson John M. , Rahman Najib M.
Published: March 2020

Introduction

The rising incidence of pleural disease is seeing an international growth of pleural services, with physicians performing an ever-increasing volume of pleural interventions. These are frequently conducted at sites without immediate access to thoracic surgery or interventional radiology and serious complications such as pleural bleeding are likely to be under-reported.

Aim

To assess whether intercostal vessel screening can be performed by respiratory physicians at the time of pleural intervention, as an additional step that could potentially enhance safe practice.

Methods

This was a prospective, observational study of 596 ultrasound-guided pleural procedures conducted by respiratory physicians and trainees in a tertiary centre. Operators did not have additional formal radiology training. Intercostal vessel screening was performed using a low frequency probe and the colour Doppler feature.

Results

The intercostal vessels were screened in 95% of procedures and the intercostal artery (ICA) was successfully identified in 53% of cases. Screening resulted in an overall site alteration rate of 16% in all procedures, which increased to 30% when the ICA was successfully identified. This resulted in procedure abandonment in 2% of cases due to absence of a suitable entry site. Intercostal vessel screening was shown to be of particular value in the context of image-guided pleural biopsy.

Conclusion

Intercostal vessel screening is a simple and potentially important additional step that can be performed by respiratory physicians at the time of pleural intervention without advanced ultrasound expertise. Whether the widespread use of this technique can improve safety requires further evaluation in a multi-centre setting with a robust prospective study.
Mepolizumab effectiveness and identification of super-responders in severe asthma
Authors: Harvey Erin S. , Langton David , Katelaris Constance , Stevens Sean , Farah Claude S. , Gillman Andrew , Harrington John , Hew Mark , Kritikos Vicky , Radhakrishna Naghmeh , Bardin Philip , Peters Matthew , Reynolds Paul N. , Upham John W. , Baraket Melissa , Bowler Simon , Bowden Jeffrey , Chien Jimmy , Chung Li Ping , Grainge Christopher , Jenkins Christine , Katsoulotos Gregory P. , Lee Joy , McDonald Vanessa M. , Reddel Helen K. , Rimmer Janet , Wark Peter A.B. , Gibson Peter G.
Published: March 2020

Severe asthma is a high-burden disease. Real-world data on mepolizumab in patients with severe eosinophilic asthma is needed to assess whether the data from randomised controlled trials are applicable in a broader population.

The Australian Mepolizumab Registry (AMR) was established with an aim to assess the use, effectiveness and safety of mepolizumab for severe eosinophilic asthma in Australia.

Patients (n=309) with severe eosinophilic asthma (median age 60 years, 58% female) commenced mepolizumab. They had poor symptom control (median Asthma Control Questionnaire (ACQ)-5 score of 3.4), frequent exacerbations (median three courses of oral corticosteroids (OCS) in the previous 12 months), and 47% required daily OCS. Median baseline peripheral blood eosinophil level was 590 cells·µL−1. Comorbidities were common: allergic rhinitis 63%, gastro-oesophageal reflux disease 52%, obesity 46%, nasal polyps 34%.

Mepolizumab treatment reduced exacerbations requiring OCS compared with the previous year (annualised rate ratio 0.34 (95% CI 0.29–0.41); p<0.001) and hospitalisations (rate ratio 0.46 (95% CI 0.33–0.63); p<0.001). Treatment improved symptom control (median ACQ-5 reduced by 2.0 at 6 months), quality of life and lung function. Higher blood eosinophil levels (p=0.003) and later age of asthma onset (p=0.028) predicted a better ACQ-5 response to mepolizumab, whilst being male (p=0.031) or having body mass index ≥30 (p=0.043) predicted a lesser response. Super-responders (upper 25% of ACQ-5 responders, n=61, 24%) had a higher T2 disease burden and fewer comorbidities at baseline.

Mepolizumab therapy effectively reduces the significant and long-standing disease burden faced by patients with severe eosinophilic asthma in a real-world setting.
Comparison of spinal anesthesia and general anesthesia in inguinal hernia repair in adult: a systematic review and meta-analysis
Authors: Li Lin , Pang Yi , Wang Yongchao , Li Qi , Meng Xiangchao
Published: March 2020

Background

Inguinal hernia repair is one of the most commonly performed surgical procedures. To date, there is no consensus on which anesthesia should be used. The objective of this meta-analysis was to assess the efficacy of spinal anesthesia (SA) vs. general anesthesia (GA) in inguinal hernia repair in adults.

Methods

Eligible studies were identified before January 2020 from PubMed, Embase, ScienceDirect, Cochrane Library, Scopus database as well as reference lists. Outcomes included surgery time, the time in the operation room, the length of hospital stay, pain scores, patient satisfaction, and postoperative complications. Subgroup analysis based on surgical approaches was conducted.

Results

Six randomized controlled trials (RCT) and five cohort studies were included. A total of 2593 patients were analyzed. Compared to GA, SA was associated with a longer surgery time (weighted mean difference [WMD]: − 3.28, 95%confident interval [CI]: − 5.76, − 0.81), particularly in laparoscopic repair. Postoperative pain at 4 h and 12 h were in favor of SA following either open or laparoscopic repairs (standard mean difference [SMD]: 1.58; 95%CI: 0.55, 2.61, SMD: 0.99, 95%CI: 0.37, 1.60, respectively); and considering borderline significance, patients receiving SA might be more satisfied with the anesthesia they used for herniorrhaphy (SMD: -0.32, 95%CI: − 0.70, 0.06). Some major complications of scrotal edema, seroma, wound infection, recurrence, shoulder pain were comparable between the two groups. However, patients receiving SA had an increased risk of postoperative urinary retention and headache when compared with GA (relative ratio [RR]: 0.44, 95% CI: 0.23, 0.86, RR: 0.33, 95% CI: 0.12, 0.92, respectively). There was a tendency that the incidence of postoperative nausea and vomiting was lower in SA than GA (RR: 2.12, 95%CI: 0.95, 4.73), especially in open herniorrhaphy.

Conclusions

SA can be another good choice for pain relief no matter in open or laparoscopic hernia repairs, but it can’t be confirmed that SA is better than GA.
Global diastolic strain rate for the assessment of left ventricular diastolic dysfunction in young peritoneal dialysis patients: a case control study
Authors: Zhu Jing , Shi Fei , You Tao , Tang Chao , Chen Jianchang
Published: March 2020

Background

Left ventricular (LV) myocardial longitudinal diastolic strain rate measured by two-dimensional speckle tracking imaging (2D-STI) was proved to have a better correlation with the LV diastolic function. We aimed to use this sensitive tool to predict LV myocardial diastolic dysfunction in young peritoneal dialysis (PD) patients with preserved LV ejection fraction (LVEF).

Methods

We enrolled 30 PD patients aged ≤60 with LVEF ≥54% and classified as normal LV diastolic function by conventional echocardiography, and 30 age- and sex-matched healthy people as the control group. The left atrial maximum volume index (LAVI), LV mass index (LVMI), LVEF, LV posterior wall thickness (LVPWT), interventricular septal thickness (IVST), peak velocity of tricuspid regurgitation (TR), peak early diastolic velocity/late diastolic velocity (by Pulsed Doppler) (E/A) and E/peak velocity of the early diastolic wave (by Pulsed-wave tissue Doppler) (E/e’) were recorded by conventional echocardiographic. Next, the average LV global longitudinal systolic strain (GLS avg) and the average LV global longitudinal diastolic strain rate (DSr avg) during early diastole (DSrE avg), late diastole (DSrA avg) and isovolumic relaxation period (DSrIVR avg) were obtained from 2D-STI. Combined them with E, the new noninvasive indexes (E/DSrE avg., E/DSrA avg. and E/DSrIVR avg) were derived.

Results

The PD group ‘s LVEF, E/e′, TR and LAVI were in the normal range compared with the controls, and only e′ (p < 0.001) was decreased. The LVMI (p < 0.001), LVPWT (p < 0.001), IVST (p < 0.001) increased while E/A (p < 0.001) decreased. The GLS avg. (p = 0.008) was significantly decreased in PD patients compared with the controls. DSrA avg. (p = 0.006) and E/DSrE avg. (p = 0.006) were increased, while DSrE avg. (p < 0.001), DSrIVR avg. (p = 0.017) and E/DSrA avg. (p < 0.001) decreased. After the multivariable regression analysis, the correlation between DSrE and the conventional parameters including LVPWT (p < 0.001), E/A (p < 0.001) still remained significant.

Conclusions

Young PD patients with preserved LVEF already exhibited myocardial diastolic dysfunction. Global diastolic strain rate indexes were valuable parameters to evaluate diastolic dysfunction. Additionally, LVPWT was highly correlated with DSrE, such parameter should be taken into account for predicting the early LV diastolic dysfunction in clinical practice.
Stress on local and international psychotherapists in the crisis region of Iraq
Authors: Kizilhan Jan Ilhan
Published: March 2020

Background

Local and international Psychotherapists working with war survivors are confronted with a whole variety of burdens. The close contact to their clients and the conversations about terror, flight and genocides, they are frequently subject to vicarious traumatization resulting from these events and reveal a risk of developing secondary traumatization.

Methods

We interviewed 54 local psychotherapists and 28 psychotherapists originating from abroad who were treating survivors of ISIS terror in refugee camps organised by non-government organisations (NGOs).

Results

The results show that local and non-local psychotherapists who work in a context of humanitarian crises reveal a risk of developing secondary traumatization. The results of this present study would also indicate that the secondary traumatization depends both on individual characteristics such as bonding styles and personal experiences and also on the ambient characteristics such as the degree of traumatization of the patients.

Conclusion

The study revealed that the local and non-local psychotherapists had a range of different pressure factors and helpful resources which indicated that better caring/support, supervision and organization are needed to enable psychotherapists to perform more effectively in war regions from the point of view of preventive healthcare.
The relationship between living in urban and rural areas of Scotland and children’s physical activity and sedentary levels: a country-wide cross-sectional analysis
Authors: McCrorie Paul , Mitchell Rich , Macdonald Laura , Jones Andrew , Coombes Emma , Schipperijn Jasper , Ellaway Anne
Published: March 2020

Background

Living in urban or rural environments may influence children’s levels of physical activity and sedentary behaviours. We know little about variations in device-measured physical activity and sedentary levels of urban and rural children using nationally representative samples, or if these differences are moderated by socioeconomic factors or seasonal variation. Moreover, little is known about the influence of ‘walkability’ in the UK context. A greater understanding of these can better inform intervention strategies or policy initiatives at the population level.

Methods

Country-wide cross-sectional study in Scotland in which 774 children (427 girls, 357 boys), aged 10/11 years, wore an accelerometer on one occasion for at least four weekdays and one weekend day. Mean total physical activity, time spent in sedentary, light, and moderate-to-vigorous physical activity (MVPA), per day were extracted for weekdays, weekend days, and all days combined. Regression analyses explored associations between physical activity outcomes, urban/rural residence, and a modified walkability index (dwelling density and intersection density); with interactions fitted for household equivalised income and season of data collection. Sensitivity analyses assessed variation in findings by socioeconomic factors and urbanicity.

Results

Rural children spent an average of 14 min less sedentary (95% CI of difference: 2.23, 26.32) and 13 min more in light intensity activity (95% CI of difference, 2.81, 24.09) per day than those from urban settlements. No urban-rural differences were found for time spent in MVPA or in total levels of activity. Our walkability index was not associated with any outcome measure. We found no interactions with household equivalised income, but there were urban/rural differences in seasonal variation; urban children engaged in higher levels of MVPA in the spring months (difference: 10 mins, p = 0.06, n.s) and significantly lower levels in winter (difference: 8.7 mins, p = 0.036).

Conclusions

Extrapolated across one-year, rural children would accumulate approximately 79 h (or just over 3 days) less sedentary time than urban children, replacing this for light intensity activity. With both outcomes having known implications for health, this finding is particularly important. Future work should prioritise exploring the patterns and context in which these differences occur to allow for more targeted intervention/policy strategies.
Statin prescription among patients with type 2 diabetes in Botswana: findings and implications
Authors: Mwita Julius Chacha , Godman Brian , Esterhuizen Tonya M.
Published: March 2020

Background

There is evidence of statin benefit among patients with diabetes regardless of cholesterol levels or prior cardiovascular disease history. Despite the evidence, there is under-prescription of statins in clinical practice. This study aimed to assess statin prescriptions and associated factors among patients with type 2 diabetes in Botswana.

Methods

The study was a secondary data analysis of 500 randomly selected type 2 diabetes patients at a specialised diabetes clinic at Gaborone, Botswana. We assessed the proportion of statin-eligible patients who are prescribed statins and evaluated the adjusted associations between various factors and statin prescriptions.

Results

Overall, 477 (95.4%) participants were eligible for a statin prescription. Clinicians prescribed statins in 217 (45.5%) of eligible participants, and only one (4.4%) ineligible participant. The probability of a statin prescription was higher in participants with high baseline low-density lipoprotein cholesterol (risk ratio [RR]: 1.49; 95%CI: 1.17–1.89), increasing duration of diabetes (RR: 1.01; 95%CI 1.00–1.03) and the presence of chronic kidney disease (RR: 1.35; 95%CI: 1.06–1.74).

Conclusion

A large proportion with type 2 diabetes in Gaborone is not receiving statins. Clinicians did not consider most guideline-recommended indications for statin prescriptions. The findings call for improvement in diabetes quality of care by implementing evidence-based guideline recommendations.
A decision tree to improve identification of pathogenic mutations in clinical practice
Authors: do Nascimento Priscilla Machado , Medeiros Inácio Gomes , Falcão Raul Maia , Stransky Beatriz , de Souza Jorge Estefano Santana
Published: March 2020

Background

A variant of unknown significance (VUS) is a variant form of a gene that has been identified through genetic testing, but whose significance to the organism function is not known. An actual challenge in precision medicine is to precisely identify which detected mutations from a sequencing process have a suitable role in the treatment or diagnosis of a disease. The average accuracy of pathogenicity predictors is 85%. However, there is a significant discordance about the identification of mutational impact and pathogenicity among them. Therefore, manual verification is necessary for confirming the real effect of a mutation in its casuistic.

Methods

In this work, we use variables categorization and selection for building a decision tree model, and later we measure and compare its accuracy with four known mutation predictors and seventeen supervised machine-learning (ML) algorithms.

Results

The results showed that the proposed tree reached the highest precision among all tested variables: 91% for True Neutrals, 8% for False Neutrals, 9% for False Pathogenic, and 92% for True Pathogenic.

Conclusions

The decision tree exceptionally demonstrated high classification precision with cancer data, producing consistently relevant forecasts for the sample tests with an accuracy close to the best ones achieved from supervised ML algorithms. Besides, the decision tree algorithm is easier to apply in clinical practice by non-IT experts. From the cancer research community perspective, this approach can be successfully applied as an alternative for the determination of potential pathogenicity of VOUS.
Gene co-expression networks are associated with obesity-related traits in kidney transplant recipients
Authors: Jaime-Lara Rosario B. , Roy Abhrarup , Wang Yupeng , Stanfill Ansley , Cashion Ann K. , Joseph Paule V.
Published: March 2020

Background

Obesity is common among kidney transplant recipients; However biological mediators of obesity are not well understood in this population. Because subcutaneous adipose tissue can be easily obtained during kidney transplant surgery, it provides a unique avenue for studying the mechanisms of obesity for this group. Although differential gene expression patterns were previously profiled for kidney transplant patients, gene co-expression patterns can shed light on gene modules not yet explored on the coordinative behaviors of gene transcription in biological and disease processes from a systems perspective.

Methods

In this study, we collected 29 demographic and clinical variables and matching microarray expression data for 26 kidney transplant patients. We conducted Weighted Gene Correlation Network Analysis (WGCNA) for 5758 genes with the highest average expression levels and related gene co-expression to clinical traits.

Results

A total of 35 co-expression modules were detected, two of which showed associations with obesity-related traits, mainly at baseline. Gene Ontology (GO) enrichment was found for these two clinical trait-associated modules. One module consisting of 129 genes was enriched for a variety of processes, including cellular homeostasis and immune responses. The other module consisting of 36 genes was enriched for tissue development processes.

Conclusions

Our study generated gene co-expression modules associated with obesity-related traits in kidney transplant patients and provided new insights regarding the cellular biological processes underlying obesity in this population.
Overproduction of the Flv3B flavodiiron, enhances the photobiological hydrogen production by the nitrogen-fixing cyanobacterium Nostoc PCC 7120
Authors: Roumezi Baptiste , Avilan Luisana , Risoul Véronique , Brugna Myriam , Rabouille Sophie , Latifi Amel
Published: March 2020

Background

The ability of some photosynthetic microorganisms, particularly cyanobacteria and microalgae, to produce hydrogen (H2) is a promising alternative for renewable, clean-energy production. However, the most recent, related studies point out that much improvement is needed for sustainable cyanobacterial-based H2 production to become economically viable. In this study, we investigated the impact of induced O2-consumption on H2 photoproduction yields in the heterocyte-forming, N2-fixing cyanobacterium Nostoc PCC7120.

Results

The flv3B gene, encoding a flavodiiron protein naturally expressed in Nostoc heterocytes, was overexpressed. Under aerobic and phototrophic growth conditions, the recombinant strain displayed a significantly higher H2 production than the wild type. Nitrogenase activity assays indicated that flv3B overexpression did not enhance the nitrogen fixation rates. Interestingly, the transcription of the hox genes, encoding the NiFe Hox hydrogenase, was significantly elevated, as shown by the quantitative RT-PCR analyses.

Conclusion

We conclude that the overproduced Flv3B protein might have enhanced O2-consumption, thus creating conditions inducing hox genes and facilitating H2 production. The present study clearly demonstrates the potential to use metabolic engineered cyanobacteria for photosynthesis driven H2 production.
Creating mosquito-free outdoor spaces using transfluthrin-treated chairs and ribbons
Authors: Masalu John P. , Finda Marceline , Killeen Gerry F. , Ngowo Halfan S. , Pinda Polius G. , Okumu Fredros O.
Published: March 2020

Background

Residents of malaria-endemic communities spend several hours outdoors performing different activities, e.g. cooking, story-telling or eating, thereby exposing themselves to potentially-infectious mosquitoes. This compromises effectiveness of indoor interventions, notably long-lasting insecticide-treated nets (LLINs) and indoor residual spraying (IRS). This study characterized common peri-domestic spaces in rural south-eastern Tanzania, and assessed protective efficacy against mosquitoes of hessian fabric mats and ribbons treated with the spatial repellent, transfluthrin, and fitted to chairs and outdoor kitchens, respectively.

Methods

Two hundred households were surveyed, and their most-used peri-domestic spaces physically characterized. Protective efficacies of locally-made transfluthrin-emanating chairs and hessian ribbons were tested in outdoor environments of 28 households in dry and wet seasons, using volunteer-occupied exposure-free double net traps. CDC light traps were used to estimate host-seeking mosquito densities within open-structure outdoor kitchens. Field-collected Anopheles arabiensis and Anopheles funestus mosquitoes were exposed underneath the chairs to estimate 24 h-mortality. Finally, The World Health Organization insecticide susceptibility tests were conducted on wild-caught Anopheles from the villages.

Results

Approximately half (52%) of houses had verandas. Aside from these verandas, most houses also had peri-domestic spaces where residents stayed most times (67% of houses with verandas and 94% of non-veranda houses). Two-thirds of these spaces were sited under trees, and only one third (34.4%) were built-up. The outdoor structures were usually makeshift kitchens having roofs and partial walls. Transfluthrin-treated chairs reduced outdoor-biting An. arabiensis densities by 70–85%, while transfluthrin-treated hessian ribbons fitted to the outdoor kitchens caused 77–81% reduction in the general peri-domestic area. Almost all the field-collected An. arabiensis (99.4%) and An. funestus (100%) exposed under transfluthrin-treated chairs died. The An. arabiensis were susceptible to non-pyrethroids (pirimiphos methyl and bendiocarb), but resistant to pyrethroids commonly used on LLINs (deltamethrin and permethrin).

Conclusion

Most houses had actively-used peri-domestic outdoor spaces where exposure to mosquitoes occurred. The transfluthrin-treated chairs and ribbons reduced outdoor-biting malaria vectors in these peri-domestic spaces, and also elicited significant mortality among pyrethroid-resistant field-caught malaria vectors. These two new prototype formats for transfluthrin emanators, if developed further, may constitute new options for complementing LLINs and IRS with outdoor protection against malaria and other mosquito-borne pathogens in areas where peri-domestic human activities are common.
Health-related quality of life and associated factors among patients with diabetes mellitus at the University of Gondar referral hospital
Authors: Aschalew Andualem Yalew , Yitayal Mezgebu , Minyihun Amare
Published: March 2020

Background

Diabetes mellitus, which has a wide range of effects on the physical, social and psychological aspects of the well-being of a person, is a common and challenging chronic disease that causes a significant rate of morbidity and mortality. However, studies in our country, by and large, focused on the impact of the disease in terms of mortality and morbidity alone. Therefore, the objective of this study was to assess the health-related quality of life (HRQOL) and associated factors of diabetic patients at the University of Gondar referral hospital, Ethiopia.

Methods

A facility-based cross-sectional study was conducted at the University of Gondar referral hospital from April to May 2017. A generic World Health Organization Quality of Life (WHOQOL-BREF) questionnaire was used to measure the HRQOL. The data were analyzed by Stata version 12. Multiple Linear Regression analysis withP-value 0.05 was used to measure the degree of association between HRQOL and independent variables.

Results

A total of 408 patients with Diabetes Mellitus were included in the study. The HRQOL scores for physical, psychological, social and environmental domains were 50.9, 54.5, 55.8 and 47.3, respectively. Diabetes-related complications had a significant association with all except the psychological domain. Higher HRQOL was associated with exercising, following the recommended diet, foot care, sensible drinking and the absence of co-morbidities. However, old age, unemployment and being single and widower had a significant association with lower HRQOL.

Conclusion

The environmental and physical domains of HRQOL scores were the lowest compared to the social and psychological domains. Old age and living in rural area had a significant association with a lower HRQOL, whereas the absence of diabetes-related complications, exercising, general diet and foot care had a significant association with better HRQOL of patients. Therefore, strong advice on the recommended lifestyle is important, and old patients and rural dwellers should get due attention. In addition, the prevention of diabetes-related complications is important to improve the patient HRQOL which is an important outcome measurement from the patient’s perspective related to the impact of the disease. Therefore, including HRQOL assessment as part of routine management is necessary.