bluuebunny/crossref_metadata_2025 huggingface dataset:
Politicization and Polarization in Climate Change News Content, 1985-2017
Authors: Chinn Sedona , Hart P. Sol , Soroka Stuart
Published: January 2020

Despite concerns about politicization and polarization in climate change news, previous work has not been able to offer evidence concerning long-term trends. Using computer-assisted content analyses of all climate change articles from major newspapers in the United States between 1985 and 2017, we find that media representations of climate change have become (a) increasingly politicized, whereby political actors are increasingly featured and scientific actors less so and (b) increasingly polarized, in that Democratic and Republican discourses are markedly different. These findings parallel trends in U.S. public opinion, pointing to these features of news coverage as polarizing influences on climate attitudes.
Shell design from planar pre-stressed structures
Authors: Danescu Alexandre , Ionescu Ioan R.
Published: January 2020

The interplay between mechanics and geometry is used to construct a theoretical framework able to describe the class of three-dimensional objects that can be fabricated from suitable planar designs by using relaxation of pre-strains/stress in ultra-thin films. Small deformations and large rotations are used here to model the elastic relaxation into various three-dimensional shapes. Over the kinematics associated with the designed mid-surface, a small perturbation of Love–Kirchhoff type is considered in order to deduce the design plate-to-shell equations for orthotropic materials with an important pre-stress/strain heterogeneity. The resulting equations for the efforts average and efforts moments provide the supplementary equations to compute the in-plane pre-strain/stress. In particular, for materials with a weak material transversal heterogeneity the moments equations involve only the thickness, the curvature tensor, and the pre-strain/stress moments. Special attention is devoted to materials that can be obtained by layer-by-layer crystal growth (molecular beam epitaxy), which posses an in-plane isotropic pre-strain. We have found that a rectangular plate could relax both into a cylindrical surface or on a part of a sphere in which case it should have a small diameter with respect to the sphere radius. In both cases, the theoretical estimates have been compared with the experimental realizations and finite-element numerical computations and we found very good agreement among all of them. In addition, for the cone geometry we found that the design is not possible from an isotropic pre-stress with an in-plane homogeneity. However, the 3D finite-element computation of the relaxed surface with a (necessary) non-isotropic pre-stress obtained from the theoretical estimates matches remarkably well the designed conical surface.
Employee Inclusion During Change: The Stories of Middle Managers in Non-Profit Home Care Organizations
Authors: Yahaya Zurika Saku
Published: January 2020

Although extensive studies have provided valuable information to establish a strong relationship between the success of change and variables like communication, employee commitment, and leadership, it is important to understand the experiences of workers during a change process. The research problem exists because there is a minimal exploration of the experiences of middle management in the process of corporate decision-making during organizational change adoption in the home care industry. The purpose of this study was to explore the experience of middle managers related to employee inclusion during an organizational restructuring in non-profit home care organizations. The researcher interviewed six middle managers from two non-profit home healthcare organizations in New York City using purposive sampling. The results reflected the experiences of middle managers in non-profit home care organizations and may be transferable to other organizations. The findings were categorized under the following themes: Stress and Fear, Task-Oriented Leadership Behavior, Employee Exclusion, and Job Dissatisfaction. Employers should recognize and engage middle managers in corporate decision-making that target middle managers. As change is inevitable, understanding the experience of middle managers is crucial for leaders in home care organizations undergoing organizational restructuring because of the top-down management structure in these organizations. The information may be relevant for leaders to incorporate attitudes and steps that promote a good relationship and engage middle managers in the processes of organizational change.
Effects of Delayed Video-Based Feedback and Observing Feedback on Paraprofessional Implementation of Evidence-Based Practices for Students With Severe Disabilities
Authors: Brock Matthew E. , Barczak Mary A. , Dueker Scott A.
Published: January 2020

Coaching with live observation and immediate performance feedback is an effective means to train paraprofessionals, but might not always be feasible. We used a multiple baseline across participants design with six paraprofessionals who taught elementary students with severe disabilities to test the efficacy of two innovations designed to improve the feasibility of delivering feedback. We found a functional relation between delayed, video-based performance feedback and paraprofessional implementation fidelity of two systematic prompting strategies. Observing a colleague receive feedback did result in some improvement, but did not enable all paraprofessionals to meet the training criterion. These findings suggest that delayed, video-based feedback is an effective and feasible training tool, but only observing a colleague receive feedback might be insufficient.
Intravenous Fluid Management Practices in Kidney Transplant Patients: A Multicenter Observational Cohort Pilot Study
Authors: Efune Guy E. , Zerillo Jeron , Zhou George , Mazzeffi Michael A. , Demaria Samuel , Wang Cynthia ,   the Society for the Advancement of Transplant Anesthesia Research Committee Writing Group
Published: January 2020

Background

Limited evidence exists with regard to best practices in fluid management during kidney transplantation, which may directly affect the incidence of DGF. The authors of this study embarked on a collaborative observational multicenter pilot study to evaluate fluid administration practices in different transplant centers, with a focus on the relationship between total administered crystalloid volume and its association with DGF.

Methods

Twenty consecutive kidney transplant patients were included from 9 academic medical centers in the United States. One hundred eighty patients were included in the final cohort and variables were compared between patients with and without DGF. Administered crystalloid volume was the primary variable of interest; however, additional patient and surgical variables were compared between patients with and without DGF. Variation in crystalloid administration was explored between centers by comparing median administered crystalloid volumes per kilogram of body weight. Also, unadjusted and adjusted logistic regression analyses were performed to determine which variables were independently associated with DGF.

Results

Multivariable regression modeling demonstrated that cold ischemic time and ephedrine use during surgery were independently associated with DGF. There was no independent association between administered crystalloid volume and DGF.

Conclusion

In this study of patients having kidney transplantation, we did not find an independent association between administered crystalloid volume and DGF, although there was significant variability in crystalloid administration between centers. Our data suggest that DGF was driven mainly by surgical factors such as cold ischemic time. Ephedrine was also independently associated with DGF, which should be explored in future studies.
Social Conventions and Boundary Work in an Online Q&A: The Example of Vegetarianism and Veganism
Authors: Neuman Nicklas
Published: January 2020

The aim of this article is to explore the regulation of social conventions (more or less arbitrary norms of how one ought to act that are based on joint commitments) in online interaction. As the empirical case, the article scrutinises discussions about what it means to exercise vegetarianism or veganism. Drawing on ‘naturally occurring’ data from the question-and-answer platform Yahoo! Answers, conventions of vegetarianism and veganism are argued to be protected and upheld through symbolic boundaries, primarily in three forms: incompatibility, inauthenticity and noncommitment. Moreover, by utilising the platform’s system of thumbs-up and thumbs-down, it is argued that we are provided evidence of social approvals and sanctions in real time. The findings are suggested to have implications for continued theorising on conventions, studies of boundaries in the social sciences and analyses of social media as an arena for re-orientations of established sociological problems.
Latent variable evidence on the interplay between language switching frequency and executive control in Spanish-Catalan bilinguals
Authors: Sanchez-Azanza Victor A. , López-Penadés Raúl , Aguilar-Mediavilla Eva , Adrover-Roig Daniel
Published: January 2020

Aims and objectives/purpose/research questions:

We characterized the impact of several bilingualism-related factors on the executive control of Spanish-Catalan bilinguals.

Design/methodology/approach:

Participants self-reported information regarding their age of acquisition, second language proficiency and frequency of natural language switching, and performed non-linguistic tasks tapping into specific executive control subcomponents, including inhibition, switching and updating.

Data and analysis:

Data were analyzed by means of a structural equation model (SEM) approach.

Findings/conclusions:

Results revealed that the frequency of natural language switching positively modulated the executive control performance of Spanish-Catalan bilinguals, while neither age of acquisition nor second language proficiency had an effect. Moreover, we found that the impact of natural language switching exerted general-processing influences, affecting all subcomponents of executive control. Findings are discussed in relation to context-specific effects on the cognitive system of a particular bilingual population.

Originality:

The current study applied an SEM approach to provide new evidence on the previously ambiguous relation between bilingualism-related factors and executive control.

Significance/implications:

Our findings suggest that the frequency of natural language switching does globally influence the executive control of Spanish-Catalan bilinguals.
Outcomes of health information technology utilization in nursing homes: Do implementation processes matter?
Authors: Hamann Darla J , Bezboruah Karabi C
Published: January 2020

We examined several outcomes of health information technology utilization in nursing homes and how the processes used to implement health information technology affected these outcomes. We hypothesized that one type of health information technology, electronic medical records, will improve efficiency and quality-related outcomes, and that the use of effective implementation processes and change leadership strategies will improve these outcomes. We tested these hypotheses by creating an original survey based on the case study literature, which we sent to the top executives of nursing homes in seven US states. The administrators reported that electronic medical record adoption led to moderately positive efficiency and quality outcomes, but its adoption was unrelated to objective quality indicators obtained from regulatory agencies. Improved electronic medical record implementation processes, however, were positively related to administrator-reported efficiency and quality outcomes and to decreased deficiency citations at the next regulatory visit to the nursing home. Change leadership processes did not matter as much as technological implementation processes.
The popularity of eating broadcast: Content analysis of “mukbang” YouTube videos, media coverage, and the health impact of “mukbang” on public
Authors: Kang EunKyo , Lee Jihye , Kim Kyae Hyung , Yun Young Ho
Published: January 2020

As “mukbang” (eating broadcast) becomes increasingly widespread, there is growing interest about the impact of mukbang on public health. This study aimed to analyze the content of mukbang YouTube videos, as well as news articles related to mukbang and the association between watching mukbang videos and health habits. We analyzed 5952 YouTube mukbang videos, 5265 news articles, and a survey of 1200 people in Korea. In this study, we confirmed that the provocative content of mukbang YouTube videos, such as overeating, was related to video popularity (p < 0.001). In addition, more exposure to mukbang was associated with greater effects on dietary health due to mukbang (p < 0.001). The prevalence of news articles on the negative effects of mukbang showed an increasing trend over time, while the articles on “Mukbang is funny” were most common in all the years evaluated. To cope with public health problems such as obesity, it will be necessary to continue to investigate the content and effects of mukbang on public health.
Book review: Fletcher, G. 2019: Engendering Transformative Change in International Development
Authors: Rodríguez Diana Jiménez Thomas
Published: January 2020

Fletcher, G. 2019: Engendering Transformative Change in International Development. New York, NY: Routledge. xiv + 185 pp. £115 (Hardback). ISBN: 978-1-138-57533-2.
Book review: Sahoo, Sarbeswar. 2017: Pentecostalism and Politics of Conversion in India and Bauman, Chad M. 2015. Pentecostals, Proselytization and Anti-Christian Violence in Contemporary India
Authors: Kapadia Karin
Published: January 2020

Sahoo, Sarbeswar. 2017: Pentecostalism and Politics of Conversion in India. Cambridge and New York: Cambridge University Press. xviii + 205 pp. £75.00. ISBN: 978-1-108-41612-2 (hardback).

Bauman, Chad M. 2015. Pentecostals, Proselytization and Anti-Christian Violence in Contemporary India. Oxford and New York: Oxford University Press. xvi + 208 pp. £20.49. ISBN: 978-0-19-020210-1 (paperback).
HGF/c-Met Promote Renal Carcinoma Cancer Stem Cells Enrichment Through Upregulation of Cir-CCDC66
Authors: Yang Juhong , Yang Lei , Li Shen , Hu Ning
Published: January 2020

Increasing studies have suggested that circular RNAs play an important function in the process of numerous cancers. We aimed to investigate the possible role of cir-CCDC66 in renal carcinoma cancer. As cancer stem cells are responsible for the renal carcinoma cancer tumor growth and resistance to conventional therapy, we focus on the cir-CCDC66 influence on renal carcinoma cancer stem cells. In this study, we performed experiments in human renal tubular epithelial cell HK2 cells and several renal carcinoma cancer cancer cell lines. The results showed that cir-CCDC66 was upregulated not only in renal carcinoma cancer cancer cell lines but also in cancer stem cell spheres. What’s more, the results showed that cir-CCDC66 enhanced the cancer stem cell enrichment. Further mechanistic studies showed that hepatocyte growth factor/c-Met pathway was activated in cancer stem cell enrichment and responsible for the cir-CCDC66 upregulation. Inhibition of hepatocyte growth factor/c-Met could block cir-CCDC66-induced cancer stem cell enrichment. In conclusion, our research revealed a novel mechanism between hepatocyte growth factor/c-Met/cir-CCDC66 and cancer stem cell enrichment. We verified that cir-CCDC66 could be a promising biomarker and therapy target for renal carcinoma cancer treatment.
Losing STEAM: A Case Study of Failure in School Reform
Authors: Johnson Olivia A.
Published: January 2020

This study examines issues encountered during a school’s first year implementing science, technology, engineering, arts, and math (STEAM) curriculum. The school year began with multiple changes in leadership, including the appointment of a School Operations Manager and Teacher on Special Assignment, who took on respective roles of principal and assistant principal. Tension between school and district leadership, a teacher’s arrest, and lack of adequate training for the school’s teachers contributed to the failure of the eighth-grade level’s first-quarter STEAM unit. This study delves into events leading up to—and tensions surrounding—the team’s decision to begin a new unit in the second quarter.
Probability model of sensitive similarity measures in information retrieval
Authors: Gu Xiaolong , Zhang Jie
Published: January 2020

In today’s Internet age, a lot of data is stored and used, which is very important. In people’s daily life, if these data are sorted, information retrieval technology will be used, and in information retrieval, some information retrieval inaccuracies often appear. Information retrieval model is an important framework and method for fast, complete, and accurate user information retrieval. With the rapid development of information technology, great changes have taken place in people’s production and life. Various information network technologies are widely used in people’s lives. The resulting flow of information shows explosive growth, information retrieval. User requirements are getting higher and higher. How to complete personalized information retrieval in a large amount of mixed information, so that retrieval technology can help us obtain effective retrieval results, has become a realistic problem worth exploring. In this article, the application of probability model based on sensitive similarity measure in information retrieval model is analyzed, and a similarity measure algorithm based on spectral clustering is proposed. By improving the similarity measure, the sensitivity problem of scale parameters is overcome and the retrieval precision is improved. In order to better reflect the superiority of the proposed algorithm, this article compares with ng-jordan-weiss (NJW) and deep sparse subspace clustering (DSSC) algorithms. The experimental results show that the proposed algorithm is superior to NJW and DSSC algorithms for different data sets in different evaluation indicators (Rand and F-measure).
Case of ventricular septal rupture following acute myocardial infarction
Authors: Amorosi Natasha M , White Alison
Published: January 2020

Ventricular septal rupture is a rare and potentially fatal complication of transmural myocardial infarction. Early identification utilising transthoracic echocardiography significantly improves long term outcomes in these patients. We report on a case of a 77-year-old male who presented with signs and symptoms of cardiac failure and a loud systolic murmur. The patient underwent an initial point-of-care ultrasound which revealed evidence of a transmural myocardial infarction and a high suspicion of an apical ventricular septal rupture. A complete transthoracic echocardiogram confirmed the septal rupture diagnosis and the patient subsequently underwent surgical repair of the ventricular rupture. This case highlights the role of echocardiography in decreasing adverse outcomes in patients with ventricular septal rupture.
Acid and inflammatory sensitisation of naked mole-rat colonic afferent nerves
Authors: Hockley James RF , Barker Katie H , Taylor Toni S , Callejo Gerard , Husson Zoe M , Bulmer David C , Smith Ewan St. J
Published: January 2020

Acid sensing in the gastrointestinal tract is required for gut homeostasis and the detection of tissue acidosis caused by ischaemia, inflammation and infection. In the colorectum, activation of colonic afferents by low pH contributes to visceral hypersensitivity and abdominal pain in human disease including during inflammatory bowel disease. The naked mole-rat ( Heterocephalus glaber) shows no pain-related behaviour to subcutaneous acid injection and cutaneous afferents are insensitive to acid, an adaptation thought to be a consequence of the subterranean, likely hypercapnic, environment in which it lives. As such we sought to investigate naked mole-rat interoception within the gastrointestinal tract and how this differed from the mouse ( Mus Musculus). Here, we show the presence of calcitonin gene-related peptide expressing extrinsic nerve fibres innervating both mesenteric blood vessels and the myenteric plexi of the smooth muscle layers of the naked mole-rat colorectum. Using ex vivo colonic-nerve electrophysiological recordings, we show differential sensitivity of naked mole-rat, compared to mouse, colonic afferents to acid and the prototypic inflammatory mediator bradykinin, but not direct mechanical stimuli. In naked mole-rat, but not mouse, we observed mechanical hypersensitivity to acid, whilst both species sensitised to bradykinin. Collectively, these findings suggest that naked mole-rat colonic afferents are capable of detecting acidic stimuli; however, their intracellular coupling to downstream molecular effectors of neuronal excitability and mechanotransduction likely differs between species.
Hematoma Hounsfield units and expansion of intracerebral hemorrhage: A potential marker of hemostatic clot contraction
Authors: Jeong Han-Gil , Bang Jae Seung , Kim Beom Joon , Bae Hee-Joon , Han Moon-Ku
Published: January 2020

Background

Clot contraction reinforces hemostasis by providing an impermeable barrier and contractile force. Since computed tomography attenuation of intracerebral hemorrhage is largely determined by the density of red blood cells, clot contraction can be reflected in an increase of Hounsfield unit (HU) of hematoma.

Aims

We hypothesized that hematoma expansion is inversely associated with mean HU of intracerebral hemorrhage at presentation.

Methods

Eighty-nine consecutive spontaneous intracerebral hemorrhage patients with onset to first computed tomography within 24 h were included. Hematomas were segmented using semiautomated planimetry to measure the volume and mean HU. Hematoma expansion was defined as an increase in hematoma volume by over 33% or 6 mL. Multivariable logistic regression was performed for hematoma expansion. The discrimination power of mean HU for hematoma expansion was assessed using C-statistic.

Results

The computed tomography attenuation of hematoma at presentation was 57.5 ± 3.3 HU and the volume was 16.9 ± 23.2 mL. Hematoma expansion occurred in 37.1% of patients. The computed tomography attenuation of hematoma was lower in patients with hematoma expansion than with no expansion (55.7 ± 2.9 HU vs. 58.6 ± 3.1 HU, p-value < 0.01). Multivariable logistic regression revealed that the mean HU of hematoma was inversely associated with hematoma expansion (adjusted odds ratio, 0.64; 95% confidence interval, 0.51–0.80). The C-statistic of the model with four known predictors increased from 0.66 to 0.84 after incorporating mean HU (p-value < 0.01).

Conclusions

Intracerebral hemorrhage with lower mean HU of hematoma at presentation is more likely to undergo hematoma expansion. This finding suggests the potential presence of clot contraction process that reinforces hemostasis in intracerebral hemorrhage.
Insulin Storage: A Critical Reappraisal
Authors: Heinemann Lutz , Braune Katarina , Carter Alan , Zayani Amin , Krämer Laura A.
Published: January 2020

Insulin, as a peptide hormone drug, is susceptible to changes in stability when exposed to environmental factors under storage. Proper storage according to the manufacturer’s recommendations is important to maintain its potency and enable precise dosing for people with diabetes (PwD). While it is reasonable to assume that transport conditions and temperature are well controlled during the supply chain, little is known about insulin storage after dispensing and insulin potency at the moment of administration. Insulin is exposed to various environmental factors when carried by PwD and storage recommendations are often not met when it is stored in household refrigerators. It is difficult to assess changes in insulin potency in clinical practice, and there is a gap in the current scientific literature on insulin stability. Package leaflet recommendations only give limited information on the impact of improper storage conditions on insulin stability and guidelines by health organizations are inconsistent. Given the importance of precise dosing in diabetes care, there is a need for more transparency on insulin stability, awareness for proper storage among health care professionals and PwD as well as clear guidelines and practical storage recommendations from manufacturers and health organizations.
Application of Theory in Studies of Healthcare Built Environment Research
Authors: Shannon Michelle M. , Nordin S. , Bernhardt J. , Elf M.
Published: January 2020

We aimed to examine the nature and extent of theory application in studies of built environment attributes and impact on adults in healthcare facilities. Many varied theories are described when providing the rationale for research into built environments in healthcare. Uncertainty exists around the right theory to frame a research question, alignment with measurement tools, and whether healthcare setting makes a difference. This poses challenges to researchers seeking to build the evidence base for built environment design that benefits patients and staff. Our multidisciplinary review team scoped the literature to determine how theories are used to inform research investigating the impact of the built environment of healthcare on adults. When researchers recorded theory at development of the study question, in data collection, and in data analysis/interpretation, we called this explicitly theory-based application. Synthesis occurred using a narrative approach. Overall, we found 17 diverse theories named in studies. Explicitly theory-based use occurred with eight theories, comprising 47% of all theories used. Five theories were named more frequently in studies out of all theories identified. In 20% of studies, theory was not used explicitly during the research inquiry. We argue that researchers must continue to strive toward explicit use of theories, similar to development of other health interventions that employ multifactorial components.
A Social Constructivist Grounded Theory of School Principal Legal Learning
Authors: Schneider Tracey L.
Published: January 2020

This article presents a social constructivist grounded theory of school principal legal learning. The author analyzed 10 interviews with K-12 school principals and 10 school law faculty documents to investigate how principals develop the knowledge and skills to address legal issues in schools. Two themes emerged. The first theme was source of legal learning, with categories that included theoretical legal learning and practical/reality-based learning. The second theme was supports for legal learning, with categories that included supports of school law faculty, attorneys, policies, building level–specific content, professional development, and a combined practice of reflection to develop a common-sense approach.
A legitimacy-based approach to EU criminal law: Maybe we are getting there, after all
Authors: Nuotio Kimmo
Published: January 2020

European Union (EU) law is known for its strong emphasis on effectivity and more generally for its instrumental character. This is not foreign even to European criminal law, a feature which creates some tension between the EU criminal law and criminal law in the national setting. EU Framework Decisions and Directives often require the Member States to criminalize certain forms of conduct with sanctions that are ‘Effective, Dissuasive and Proportionate’. In this article, I try to show that it would be timely to look at EU criminal law from an alternative point of view, as a more mature law. I call this a legitimacy-based approach. Such a reading would ease some of these tensions. It would also be helpful in developing a criminal policy for the EU, a policy which would be realistic and pragmatic. And it would be easier to look at EU criminal law from the point of view of justice. In order to get there, we need to see where the (current) narrow deterrence argument gets is wrong or one-sided. Some social theory is needed in order to make the point.
Th17 cells increase in RRMS as well as in SPMS, whereas various other phenotypes of Th17 increase in RRMS only
Authors: Kalra S , Lowndes C , Durant L , Strange RC , Al-Araji A , Hawkins Clive P , Curnow S John
Published: January 2020

Background

The nature and extent of inflammation seen in multiple sclerosis (MS) varies throughout the course of the disease. Changes seen in CD4+ T-helper cells in relapsing–remitting (RR) MS and secondary progressive (SP) MS might differ qualitatively and/or quantitatively.

Objective

The objective of this paper is to study the frequencies of all major CD4+ T-helper subtypes – Th17, Th22 and Th1 lineage cells – in relapse, remission and secondary progression alongside CCR6 status, a chemokine receptor involved in migration of these cells into the central nervous system.

Methods

We compared 100 patients (50 RRMS and 50 SPMS) and 50 healthy volunteers and performed flow cytometric analysis of lymphocytes in blood samples.

Results

We demonstrated raised frequencies of various cell types along the Th17 axis; Th17, Th17.1 (IL-17+ interferon gamma+) and dual IL-17+ IL-22+ cells in RRMS. Th22 and CCR6+ Th1 cells (nonclassical Th1) were also increased in RRMS. All these cells were CCR6+. Only Th17 frequencies were elevated in SPMS.

Conclusions

Increased frequencies of Th17 cells are implicated both in RRMS and SPMS. The CCR6 pathway includes Th17, Th22 and Th1 nonclassical cells, of which Th22 and Th1 cells represent the greatest subsets in MS.
Patient-Centered Medical Home With Colocation: Observations and Insights From an Academic Family Medicine Clinic
Authors: Pujalte George G. A. , Pantin Sally Ann , Waller Thomas A. , Maruoka Nishi Livia Y. , Willis Floyd B. , Jethwa Tarang P. , Presutti Richard J.
Published: January 2020

There is a movement in the United States to transform family medicine practices from single physician–based patient care to team-based care. These teams are usually composed of multiple disciplines, including social workers, pharmacists, registered nurses, physician assistants, nurse practitioners, and physicians. The teams support patients and their families, provide holistic care to patients of all ages, and allow their members to work to the highest level of their training in an integrated fashion. Grouping care team members together within visual and auditory distance of each other is likely to enhance communication and teamwork, resulting in more efficient care for patients. This grouping is termed colocation. The authors describe how the use of colocation can lead to clearer, faster communication between care team members. This practice style has the potential to be expanded into various clinical settings in any given health system and to almost all clinical specialties and practices.
Forever-Fit Summer Camp: The Impact of a 6-Week Summer Healthy Lifestyle Day Camp on Anthropometric, Cardiovascular, and Physical Fitness Measures in Youth With Obesity
Authors: El Mikati Hala K. , Boateng Anthony O. , McKinney Brett M. , Haberlin-Pittz Katie , Pike Julie , Perry Patrick , Hannon Tamara S. , Yazel-Smith Lisa
Published: January 2020

Pediatric obesity is a public health concern with lifestyle intervention as the first-line treatment. Forever-Fit Summer Camp (FFSC) is a 6-week summer day program offering physical activity, nutrition education, and well-balanced meals to youth at low cost. The aim of the study was to assess the efficacy of this program that does not emphasize weight loss rather emphasizes healthy behaviors on body mass index, cardiovascular and physical fitness. Methods: The inclusion criteria were adolescents between 8 and 12 years and body mass index (BMI) ≥85th percentile. The data were collected at baseline and week 6 (wk-6) and was analyzed for 2013-2018 using paired-sample t tests. Results: The participants’ (N = 179) average age was 10.6 ± 1.6 years with a majority of females (71%) and black race/ethnicity (70%). At wk-6, BMI and waist circumference decreased by 0.8 ± 0.7 kg/m2 and 1.0 ± 1.3 in, respectively. Resting heart rate, diastolic and systolic blood pressure decreased by 8.5 ± 11.0 bpm, 6.3 ± 8.8 mmHg, and 6.4 ± 10.1 mmHg, respectively. The number of pushups, curl-ups, and chair squats were higher by 5.8 ± 7.5, 6.7 ± 9.1, and 7.7 ± 8.5, respectively. Conclusion: The FFSC is efficacious for improving BMI, cardiovascular, and physical fitness in the short term. The effect of similar episodic efforts that implement healthy lifestyle modifications throughout the school year should be investigated.
Cerumen Management: An Updated Clinical Review and Evidence-Based Approach for Primary Care Physicians
Authors: Horton Garret A. , Simpson Matthew T. W. , Beyea Michael M. , Beyea Jason A.
Published: January 2020

Objective: To provide family physicians with a practical, evidence-based approach to managing patients with cerumen impaction. Methods: MEDLINE, The Cochrane Library, and the Turning Research Into Practice (TRIP) database were searched for English-language cerumen impaction guidelines and reviews. All such articles published between 1992 and 2018 were reviewed, with most providing level II and III evidence. Results: Cerumen impaction is a common presentation seen in primary care and cerumen removal is one of the most common otolaryngologic procedures performed in general practice. Cerumen impaction is often harmless but can be accompanied by more serious symptoms. Cerumenolytics and irrigation of the ear canal are reasonable first-line therapies and can be used in conjunction or isolation. If irrigation and cerumenolytics are contraindicated, manual removal is appropriate, but the tools necessary are not commonplace in primary care clinics and specialized training may be required to prevent adverse outcomes. Conclusion: Family physicians play a key role in the assessment and management of cerumen impaction and are well equipped to do so. Knowledge of the available techniques for cerumen removal as well as their contraindications ensures that cerumen is removed safely and effectively. When cerumen removal cannot be removed safely in a primary care setting, referral to Otolaryngology-Head and Neck Surgery is appropriate.
Perceived Needs for Mental Health Care Among Emerging Adults With Cancer
Authors: Tang Jennie , Perlman Christopher , Leatherdale Scott T. , Ferro Mark A.
Published: January 2020

The challenges of living with cancer can compound the normative stresses of navigating emerging adulthood and have long-term psychiatric consequences. However, there is a lack of information on the mental health services required by this potentially vulnerable group of young people. This study estimated the prevalence of mental disorder among emerging adults (EAs) with cancer and examined their perceived needs for mental health care. Data from 5,590 individuals (15–29 years) who participated in the Canadian Community Health Survey—Mental Health were used in the analyses. The prevalence of mood or substance use disorder among those with cancer ( n = 42) was 42.9% compared to 32.2% among controls. EAs with cancer had higher odds of reporting unmet perceived needs for mental health care, OR = 7.72, 95% CI [1.85, 28.57]. This suggests an opportunity to improve future health services aimed at addressing the mental health care needs for EAs with cancer and potentially, other long-term chronic conditions.
Assessment of the Accuracy of the AO Spine-TL Classification for Thoracolumbar Spine Fractures Using the AO Surgery Reference Mobile App
Authors: Ono Allan Hiroshi de Araujo , Chang Verônica Yulin Prieto , Rodenbeck Erico Myung , de Araujo Alex Oliveira , de Oliveira Rafael Garcia , Marcon Raphael Martus , Cristante Alexandre Fogaça , Filho Tarcisio Eloy Pessoa Barros
Published: January 2020

Study Design:

Cohort study.

Objectives:

This study aimed to evaluate the accuracy of the AO Surgery Reference mobile app in the diagnosis of thoracolumbar fractures of the spine according to the AO TL classification, and to discuss the usefulness of this app in the teaching and training of the resident physicians in orthopedics and traumatology area.

Methods:

The 24 residents of Orthopedic and Traumatology program assessed 20 cases of thoracolumbar fractures selected from the hospital database on 2 different occasions, with a 30-day interval, and they classified these cases with and without using the AO Surgery Reference app. A group of spine experts previously established the gold standard and the answers were statistically compared, with the inter- and intraobserver reliability evaluated by the kappa index.

Results:

The use of the AO Surgery Reference app increased the classification success rate of the fracture morphology (from 53.4% to 72.5%), of the comorbidity modifier (from 61.4% to 77.9%) and of the neurological status modifier (from 55.1% to 72.9%). In addition, the mobile app raised the classification agreement and accuracy. The kappa index increased from 0.30 to 0.53 regarding the morphological classification of fractures.

Conclusions:

The residents improved their ability to recognize and classify thoracolumbar spine fractures, which reinforces the importance of this tool in medical education and clinical practice.
The efficacy of intra-articular fentanyl supplementation for knee arthroscopy: A meta-analysis of randomized controlled studies
Authors: Lu Jian-Zuo , Fu Jia-Xing , Wang Da-feng , Su Zhong-Liang , Zheng Yuan-Bo
Published: January 2020

Introduction:

The efficacy of intra-articular fentanyl supplementation for pain control after knee arthroscopy remains controversial. We conduct a systematic review and meta-analysis to explore the influence of intra-articular fentanyl supplementation for pain intensity after arthroscopic knee surgery.

Methods:

We searched PubMed, EMbase, Web of Science, EBSCO, and Cochrane Library databases through May 2019 for randomized controlled trials (RCTs) assessing the efficacy and safety of intra-articular fentanyl supplementation for arthroscopic knee surgery. This meta-analysis is performed using the random-effects model.

Results:

Four RCTs are included in the meta-analysis. Overall, compared with control group after knee arthroscopy, intra-articular fentanyl supplementation is associated with reduced pain scores at 1 h (standard mean difference (Std MD) = −3.50; 95% confidence interval (CI) = −5.68 to −1.32; p = 0.002), 2 h (Std MD = −4.73; 95% CI = −8.75 to −0.71; p = 0.02), and 8 h (Std MD = −5.02; 95% CI = −9.73 to −0.30; p = 0.04) but shows no substantial impact on pain scores at 4 h (Std MD = −3.94; 95% CI = −7.93 to 0.05; p = 0.05) or the supplementary analgesia (risk ratio = 0.56; 95% CI = 0.09–3.59; p = 0.54).

Conclusions:

Intra-articular fentanyl supplementation does benefit in pain control after knee arthroscopy.
Evaluation of the effectiveness of expandable cages for reconstruction of the anterior column of the spine
Authors: Cappelletto Barbara , Giorgiutti Fabrizia , Balsano Massimo
Published: January 2020

Purpose:

For anterior spine column reconstruction after corpectomy, expandable cages offer solid anterior support and allow correction of deformity, providing excellent primary stability. To provide a larger body of clinical observations concerning the effectiveness of the approach, this retrospective study examines patients treated by corpectomy and reconstruction with an expandable cage for different pathologies.

Methods:

Across 5 years, 39 patients underwent vertebral reconstruction with expandable cages after single ( n = 34), double ( n = 4), or triple ( n = 1) corpectomy. Pathologies were tumors ( n = 21), fractures, or deformities in traumatic injuries ( n = 14), degenerative pathology ( n = 2), and infection ( n = 2). Levels were cervical ( n = 10), thoracic ( n = 14), and lumbar ( n = 15). All patients were evaluated clinically and radiographically.

Results:

There were no cases of neurologic deterioration. Nurick grade showed significant improvement at 3 months postoperative versus preoperative ( p < 0.01). Visual analog scale significantly improved preoperatively versus 3 and 12 months postoperatively (both p = 0). Regional angulation was significantly corrected, from preoperative to 3 and 12 months postoperative, at cervical, thoracic, and lumbar levels. We achieved reconstruction of the normal local anatomy with full recovery of the height of the vertebral body. Six patients (15.4%) had complications and two (5.1%) underwent revision surgery.

Conclusions:

In our experience, expandable cages confer stable anterior support, providing significant improvement of the segmental kyphosis angle and restoration of the original somatic height. Our clinical results are favorable, and the low rate of complications and revision accentuates the expandable cage as a valuable tool to replace the vertebral body in diverse pathologies and different spine levels.
Treatment of Acute Proximal Anterior Cruciate Ligament Tears—Part 1: Gap Formation and Stabilization Potential of Repair Techniques
Authors: Bachmaier Samuel , DiFelice Gregory S. , Sonnery-Cottet Bertrand , Douoguih Wiemi A. , Smith Patrick A. , Pace Lee J. , Ritter Daniel , Wijdicks Coen A.
Published: January 2020

Background:

Recently, there has been a resurgence of interest in primary repair of the anterior cruciate ligament (ACL), with fixation techniques evolving. However, to date, there have been no biomechanical studies comparing fixed to adjustable fixation repair techniques.

Hypothesis:

Adjustable ACL repair provides for improved stabilization compared with fixed techniques with respect to both gap formation and residual load-bearing capability.

Study Design:

Controlled laboratory study.

Methods:

A total of 4 different ACL repair techniques (n = 5 per group), including single– and double–cinch loop (CL) cortical button fixation as well as knotless single–suture anchor fixation, were tested using a porcine model. For adjustable single-CL loop fixation, additional preconditioning (10 cycles at 0.5 Hz) was performed. The force after fixation and the actuator displacement to achieve a time-zero preload of 10 N were measured for fixed techniques. Incrementally increasing cycling (1 mm/500 cycles) from 1 to 8 mm was performed for 4000 cycles at 0.75 Hz before pull to failure (50 mm/min). The final residual peak load and gap formation for each test block were analyzed as well as ultimate strength.

Results:

Knot tying of a single-CL over a button (mean ± SD, 0.66 ± 0.23 mm) and knotless anchor fixation (0.20 ± 0.12 mm) resulted in significant time-zero gaps ( P < .001) and significantly higher overall gap formation at reduced residual loading (analysis of covariance, P < .001) compared with both the double-CL loop and adjustable fixation techniques. The adjustable group showed the highest failure load and stiffness, at 305.7 N and 117.1 N/mm, respectively. The failure load of the knotted single-CL group was significantly reduced compared with all other groups ( P < .001).

Conclusion:

Adjustable single-CL cortical button fixation with intraoperative preconditioning optimized time-zero ACL tension and led to significantly improved stabilization and reduced gap formation, with the highest ultimate strength. Single-CL loop knot tying over the button and knotless anchor fixation resulted in time-zero gaps to achieve slight tension on the ACL and significantly higher gap formation at reduced load-bearing capability.

Clinical Relevance:

Although the clinical relevance of gap formation is uncertain, a biomechanical understanding of the stabilization potential of current ACL repair techniques is pertinent to the continued evolution of surgical approaches to enable better clinical outcomes.
Artificial Intelligence in Health Care: Insights From an Educational Forum
Authors: Barbour Andrew B , Frush Jennifer M , Gatta Luke A , McManigle William C , Keah Niobra M , Bejarano-Pineda Lorena , Guerrero Evan M
Published: January 2020

Discussions surrounding the future of artificial intelligenc (AI) in healthcare often cause consternation among healthcare professionals. These feelings may stem from a lack of formal education on AI and how to be a leader of AI implementation in medical systems. To address this, our academic medical center hosted an educational summit exploring how to become a leader of AI in healthcare. This article presents three lessons learned from hosting this summit, thus providing guidance for developing medical curriculum on the topic of AI in healthcare.
Analysis of the causes of the formation of the special writing position of the month in oracle bone inscriptions
Authors: Tang Tao , Deng Fei
Published: January 2020

In oracle bone inscriptions of the Shang dynasty, the writing position of the numeral month is relatively fixed, but there are also special writing positions. The formation of the special writing position of the numeral month in an oracle bone inscription is mainly influenced by five factors: zhaowen 兆文, the writing position of inscriptions, the format of line in an oracle bone inscription, the nature of the numeral month, and the writing materials of an oracle bone inscription. The influence of zhaowen on the writing position of the month is mainly manifested in fanzhao 犯兆. The influence of the writing position of inscriptions on the writing position of months includes two situations: the influence of the writing positions of inscriptions themselves and the influence of the writing position of the adjacent inscriptions. The influence of the format of line in oracle bone inscriptions on the writing position of months is mainly manifested in the direction of lines in oracle bone inscriptions. The influence of the nature of the month on the writing position of the month includes the independence and randomness of the month. The influence of the writing materials of an oracle bone inscription on the writing position of the month includes the scapula and the tortoise plastrons.
Nature-based solutions as discursive tools and contested practices in urban nature’s neoliberalisation processes
Authors: Kotsila Panagiota , Anguelovski Isabelle , Baró Francesc , Langemeyer Johannes , Sekulova Filka , JT Connolly James
Published: January 2020

‘Nature-based solutions’ is the new jargon used to promote ideas of urban sustainability, which is gaining traction in both academic and policy circles, especially in the European Union. Through an analysis of the definitions and discourse around nature-based solutions, we discern a number of assumptions stemming from positivist science that are embedded in the term, and which we find create an inviting space for nature’s neoliberalisation processes. We provide empirical analysis of how these assumptions realise in two city-initiated projects in Barcelona, Spain, that have been identified as nature-based solutions: the green corridor of Passeig de Sant Joan and the community garden of Espai Germanetes supported under the municipal Pla Buits scheme. Both projects were born in a neoliberal political climate, but their outcomes in terms of neoliberalism and its contestation were very distinct – not least because of the different forms of governance and socio-natural interaction that these two projects foster. Urban nature can serve elite economic players at the expense of widespread socio-ecological benefits. But it can also serve as a ground for the articulation of demands for open and participatory green spaces that go beyond precarious and controlled stewardship for, or market-mediated interactions with, urban nature. We urge for future research and practice on nature-based solutions to be more critical of the term itself, and to guide its instrumentalisation in urban planning away from neoliberal agendas and towards more emancipatory and just socio-ecological futures.