bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of Mental Disorders in Abakaliki, Ebonyi State, Southeastern Nigeria
Authors: Stanley Njaka , Chinwe Ezeruigbo S.
Published: August 2020

Background:

Increasing psychological stressors have posed challenges to the well-being of the people across the globe and greatly affected the functionality and economic output of the individuals and the society. Nigeria has no existing mental health registry. Data on the prevalence of mental disorders are not readily available owing to lack of mental health registry. Hence, this study assessed the prevalence of mental disorders in Abakaliki metropolis, Ebonyi State.

Aim:

To determine the prevalence of mental disorders and associated factors among the residents of Abakaliki metropolis, Ebonyi State.

Method:

This cross-sectional descriptive research study involved 400 participants. Questionnaires adapted from world mental health diagnostic interview and General Health Questionnaire 12 were used for data collection. Data were analyzed using descriptive statistics and hypotheses tested using chi-square test at significance level of .05.

Results:

The prevalence of mental disorders among the respondents was 70% depressive disorders and 52.3% substance use disorders—tranquilizers (34.9%) and stimulants (15.8%) were the commonly used, while 85.3% suffered anxiety disorders. These were common among age range of 19 to 28 years—those with higher education and the unemployed. More females had mental disorders except substance use disorders, which was higher in males (53.4%). There was no significant relationship between mental disorders and the demographic variables, but significant relationship was found to exist between individuals’ age and anxiety disorder.

Conclusion:

Mental disorders, such as depression, anxiety, and substance use disorders, are common among the respondents and, therefore, calls for urgent attention of the government to improve the mental health of the people.
Cold smoking of Lebranche mullet (Mugil liza): Physicochemical, sensory, and microbiological evaluation
Authors: Jimenez Lugo Rolando , Paola Agustinelli Silvina , Isabel Yeannes María , Czerner Marina
Published: August 2020

The suitability of Mugil liza for cold smoking was evaluated and the effect of four different salting treatments on physicochemical, microbiological, and sensory characteristics was assessed. The addition of sucrose (3%) and acetic acid (0.5%) to the brine lead to fillet dehydration with lower NaCl penetration, combined with higher reduction of pH. Brining at refrigerated temperature (5 ± 1 ℃) instead of room temperature (16 ± 2 ℃) was more effective in preventing microbial growth. Loads of bacterial groups assessed in all smoked samples were below 100 CFU/g and the aw, moisture, NaCl, and pH values achieved were within the typical stability range of smoked fish products. The obtained products were characterized by the smoked aroma and salty taste, differing in 7 of the 21 evaluated descriptors. The use of acetic acid in brine formulation showed an effect over color and texture descriptors. The affective test indicated the overall acceptability of products, being preferred the samples treated in the lowest NaCl concentration (5%).
Use of alcohol containing caps for preventing bloodstream infections: A randomized controlled trial
Authors: Taşdelen Öğülmen Deniz , Ateş Sebahat
Published: August 2020

Background:

A majority of bloodstream infections seen in intensive care units stem from intravascular catheters used on patients. Catheter hubs are the entrance for pathogenic microorganisms into the inner surfaces of the catheters. The pathogenic microorganisms colonization in the mentioned areas can cause central line-associated bloodstream infection (CLABSI).

Methods:

This study was conducted as a randomized controlled trial to investigate the effect of alcohol-containing caps on the prevention of CLABSI. Total of 95 patients participated in the study. Isopropyl alcohol-containing caps were used for protecting the needle-free connectors closing the hubs of the central venous catheters in the intervention group. However, the control group patient received standard catheter caps.

Result:

There was a statistically significant difference between groups in terms of infection distribution (X2 = 13.058; p < 0.001). The risk of infection in the control group was 13.7 times higher than the risk of infection in the intervention group.

Discussion:

Our results suggest that alcohol-containing caps are effective or in preventing CLABSI.

Conclusion:

These findings suggest that alcohol-containing caps on ports are effective in preventing CLABSI.
Radial artery cannulation in intensive care unit patients: Does distance from wrist joint increase catheter durability and functionality?
Authors: Imbriaco Guglielmo , Monesi Alessandro , Giugni Aimone , Cilloni Nicola
Published: August 2020

Introduction:

Radial artery cannulation (RAC) is a common procedure in Intensive Care Units (ICU); radial catheters for ICU patients require increased durability to collect blood samples and to guarantee continuous hemodynamic monitoring. Failure in catheter functionality needs catheter replacement, impacting on staff workload, costs, and patient safety and discomfort.

Methods:

prospective non-randomised cohort study on adult ICU patients describing intensivists and critical care nurses’ approach in radial artery catheterization.

Results:

A sample of 103 radial artery cannulations was observed. Catheterization was performed blind in 71 patients (68.9%) and with ultrasound guidance (USG) in 32 (31.1%); majority of blind inserted RAC were at a distance between 0 and 3.9 cm from wrist joint (77.5%) while catheters inserted from 4 to 10 cm were mainly positioned with USG (84.4%). Radial catheters inserted with USG at a distance of 4 to 10 cm from wrist joint had an in-situ time double than those inserted blind (8.2 ± 7.5 vs 4.8 ± 7.3, p < 0.038).

Conclusions:

As recommended by current evidence and guidelines, USG represents a valuable support during arterial catheterization and is recommended in adult patients with clinical signs of shock, obese, swelling, and in the paediatric population. RAC in the forearm proximally, at a distance of at least 4 cm from wrist, could increase catheter durability and functionality for ICU patients. USG for cannulation in this forearm area is mandatory because of the deeper course of the radial artery.
Formation, Migration, and Morphodynamic Alteration of 50 Channel Bars in Darjeeling Himalayan Piedmont Zone, India
Authors: Dhali Md Kutubuddin , Mukhopadhyay Sutapa
Published: August 2020

Channel bars are common, striking fluvio-geomorphic depositional features of alluvial rivers. The study of this article has aimed to investigate the formation, migration, and morphodynamic alteration of channel bars (n = 50) in gravel braided alluvial rivers in Darjeeling Himalayan Piedmont zone. Dynamics of micro to meso bar deposition is mainly accomplished by the channel gradient, huge upstream landslide, and variation of discharge. Multi-criteria analysis method has been used to explain the variation of principal component analysis (PCA1, PCA2, and PCA3), both monsoon to post-monsoon. Bridge scouring, empirical aggradation, and degradation values are 0.1 to 1.05 m and [Formula: see text]. Migration, re-generation, and degradation of the micro bars with their optimum morphology show changes during the rainy season. In the upper ([Formula: see text]), middle ([Formula: see text]), and lower ([Formula: see text]) piedmont region, the bar dynamic area are 0.12 to 0.71, 0.12 to 2.83, and 0.10 to 5.43 km2, respectively. In total, 58% to 72% stability of the channel bars is observed in the upper piedmont region. The coefficient of determination ( R²) of channel bar area and width shows positive (0.63) relation.
Anemia among School Adolescents in Haramaya Town, Eastern Ethiopia: Cross-Sectional Study
Authors: Fage Sagni Girma , Egata Gudina , Dessie Yadeta , Kumsa Fekede Asefa , Mizana Biru Abdissa
Published: August 2020

Background:

Anemia is a condition characterized by reduction in the number of red blood cells and/or hemoglobin concentration. It affects 24.8% of the world population. There is little evidence on burden of anemia among adolescents in low income countries like Ethiopia. Thus, this study aimed to assess the magnitude of anemia and factors associated with anemia among school adolescents in eastern Ethiopia.

Methods:

School based cross-sectional study was conducted among 493 school adolescents in Haramaya town during February 1 to 28, 2017. Multi stage cluster sampling technique was used. We collected anthropometric data (weight and height) and hemoglobin level of all study participants. The hemoglobin level was adjusted for altitude. Data were entered into EpiData and exported to SPSS version 20 for analysis. Logistic regression model was fitted to identify factors associated with anemia. Level of statistical significance was declared at P < .05.

Results:

In this study, the prevalence of anemia was 29.4% [95% CI: (25.6, 33.5)]. Being female adolescent (AOR = 2.31, 95 % CI: [1.51, 3.54]), adolescents attending grades 9th to 10th (AOR = 1.66, 95% CI: [1.004, 2.77]), adolescents born to illiterate mothers [AOR = 2.23, 95% CI: (1.02, 4.89)], and low dietary diversity score (AOR = 2.33, 95% CI: [1.12, 4.86]) were factors that increased the likelihood of getting anemia.

Conclusion:

Anemia among school adolescents was a moderate public health problem in the study area. Being female, lower grade levels (9th to 10th), low dietary diversity score and illiterate maternal educational status increased the likelihood of getting anemia. School based Iron/Folic acid supplementation, nutrition education and promotion of diversified foods consumption should be given attention with particular focus on female adolescents.
COVID-19, 5G conspiracies and infrastructural futures
Authors: Meese James , Frith Jordan , Wilken Rowan
Published: August 2020

This article examines the emergence of conspiracy theories linking COVID-19 with 5G, with a focus on Australia, the United States and United Kingdom. The article is in two parts. The first details long-standing concerns around mobile technologies and infrastructures before showing how they translate to specific worries about 5G technology. The second shows how these fears have fuelled specific conspiracies connecting 5G with COVID-19, how they have animated protests and acts of vandalism that have occurred during the pandemic, and the ongoing engagement of conspiracists with official inquiries into 5G. Finally, we argue that a productive way to understand what is happening with 5G is to look beyond conspiracy theories to a larger set of concerns. We argue that the battle for control of 5G infrastructure can be productively understood in geopolitical terms, as forms of economic statecraft, which partly explains why governments are increasingly concerned about countering misinformation and disinformation around 5G.
From wartime loudspeakers to digital networks: communist persuasion and pandemic politics in Vietnam
Authors: Nguyen-Thu Giang
Published: August 2020

This commentary discusses the overall propaganda win of the Vietnamese government for its COVID-19 success and reveals the underlying logics of communist legitimacy in the wake of digital and biological virality.
Tribological behaviour of natural fibre 3D braided woven fabric reinforced PLA composites
Authors: Kanakannavar Sateeshkumar , Pitchaimani Jeyaraj , Ramesh MR
Published: August 2020

This study aims to investigate the potential of natural fibre 3D braided woven fabric (NFBF) reinforced PLA (poly lactic acid) composites for tribological applications. Composites with different fibre contents are prepared using film stacking process and hot press methods. Friction co-efficient and wear rate of the composites are analysed using pin-on-disc tribometer under dry contact sliding condition and various operating conditions (velocity and load) for a fixed sliding distance of 3000 m. The morphology of the worn surfaces is studied using scanning electron microscope (SEM). The reinforcement of fibre with the PLA reduced the polymer film generation and improved the surface roughness significantly. Wear rate of the composites are decreased drastically compared to pure PLA. Composite with 35 wt.% of NFBF reinforcement showed better wear characteristics.
Effects of being watched on eye gaze and facial displays of typical and autistic individuals during conversation
Authors: Cañigueral Roser , Ward Jamie A , Hamilton Antonia F de C
Published: August 2020

Communication with others relies on coordinated exchanges of social signals, such as eye gaze and facial displays. However, this can only happen when partners are able to see each other. Although previous studies report that autistic individuals have difficulties in planning eye gaze and making facial displays during conversation, evidence from real-life dyadic tasks is scarce and mixed. Across two studies, here we investigate how eye gaze and facial displays of typical and high-functioning autistic individuals are modulated by the belief in being seen and potential to show true gaze direction. Participants were recorded with an eye-tracking and video-camera system while they completed a structured Q&A task with a confederate under three social contexts: pre-recorded video, video-call and face-to-face. Typical participants gazed less to the confederate and produced more facial displays when they were being watched and when they were speaking. Contrary to our hypotheses, eye gaze and facial motion patterns in autistic participants were overall similar to the typical group. This suggests that high-functioning autistic participants are able to use eye gaze and facial displays as social signals. Future studies will need to investigate to what extent this reflects spontaneous behaviour or the use of compensation strategies.

Lay abstract

When we are communicating with other people, we exchange a variety of social signals through eye gaze and facial expressions. However, coordinated exchanges of these social signals can only happen when people involved in the interaction are able to see each other. Although previous studies report that autistic individuals have difficulties in using eye gaze and facial expressions during social interactions, evidence from tasks that involve real face-to-face conversations is scarce and mixed. Here, we investigate how eye gaze and facial expressions of typical and high-functioning autistic individuals are modulated by the belief in being seen by another person, and by being in a face-to-face interaction. Participants were recorded with an eye-tracking and video-camera system while they completed a structured Q&A task with a confederate under three social contexts: pre-recorded video (no belief in being seen, no face-to-face), video-call (belief in being seen, no face-to-face) and face-to-face (belief in being seen and face-to-face). Typical participants gazed less to the confederate and made more facial expressions when they were being watched and when they were speaking. Contrary to our hypotheses, eye gaze and facial expression patterns in autistic participants were overall similar to the typical group. This suggests that high-functioning autistic participants are able to use eye gaze and facial expressions as social signals. Future studies will need to investigate to what extent this reflects spontaneous behaviour or the use of compensation strategies.
The return of society
Authors: Dubet François
Published: August 2020

This article is a plea for the idea of society in sociological theory. Even though the industrial national societies no longer exist, the successive crises that we have encountered show that we need a general concept to account for social life. Thus sociology should be enabled to remain a moral and political philosophy.
Can Humble Leaders Get Results? The Indirect and Contextual Influences of Skip-Level Leaders
Authors: Peng Ann C. , Wang Biying , Schaubroeck John M. , Gao Riguang
Published: August 2020

We draw from social learning theory to propose a model in which humble behaviors displayed by higher-level leaders trickle down to lower-level team leaders and thereby indirectly promote team performance. We also propose that skip-level leader humility enhances the positive effect of team leader humility on team performance. Results based on time-lagged, multisource data from a sample of 128 work teams supported our model. Also, the trickle-down effect of leader humility is stronger in organizations with relatively high authority centralization. Our study thus links humble leadership of both direct and distant leaders to team performance and highlights the role of higher-level leaders in fostering humble behaviors of lower-level leaders.
Performance evaluation of Al2O3 nanofluid as an enhanced heat transfer fluid
Authors: Kong Minsuk , Lee Seungro
Published: August 2020

Thermal performance of Al2O3 nanoparticles dispersed in water was evaluated experimentally in a fully instrumented circular tube under turbulent flow conditions. Thermophysical properties of Al2O3 nanofluids at three different volumetric concentrations (0.38%, 0.81%, and 1.30%) were determined as a function of temperature. Pressure drop and heat transfer experiments were carried out at different volumetric concentrations and inlet fluid temperatures (10°C–30°C). The overall performance of the Al2O3 nanofluids was evaluated by considering both their hydraulic and heat transfer characteristics. The experimental results showed that the use of Al2O3 nanofluids increases the pressure drop by up to about 13% due to the greater viscosity. In addition, the heat transfer coefficient of nanofluids increased with the volumetric concentration by up to approximately 19% induced by the enhanced thermal conductivity. Furthermore, the experimental results indicated that the nanofluid with a volume fraction of 0.81% at the highest inlet fluid temperature increases the overall performance by up to around 8% and performs better than the other volume fractions. Enhancement in the overall performance increases with increasing inlet fluid temperature because of both the enhanced effective thermal conductivity and the decreased viscosity, which increases the energy exchange and decreases the pressure loss, respectively.
“We get double slammed!”: Healthcare experiences of perceived discrimination among low-income African-American women
Authors: Okoro Olihe N , Hillman Lisa A , Cernasev Alina
Published: August 2020

Background:

On account of their racial/ethnic minority status, class, and gender, African-American women of low socioeconomic status are among the least privileged, underserved, and most marginalized groups in the United States. Generally, African Americans continue to experience poorer health outcomes, in which disparities have been attributed to socioeconomic inequities and structural racism. This objective of this study was to explore the lived experiences of low-income African-American women in interacting with the healthcare system and healthcare providers.

Methods:

Twenty-two in-depth one-on-one interviews were conducted with low-income African-American women. The audio-recorded interviews were transcribed verbatim. An inductive content analysis was performed, using an analytical software, Dedoose® to enabled hierarchical coding. Codes were grouped into categories which were further analyzed for similarities that led to the emergence of themes.

Results:

A key finding was the experience of discriminatory treatment. The three themes that emerged relevant to this category were (1) perceived discrimination based on race/ethnicity, (2) perceived discrimination based on socioeconomic status, and (3) stereotypical assumptions such as drug-seeking and having sexually transmitted diseases.

Conclusion and Recommendations:

Low-income African-American women experience less than satisfactory patient care, where participants attribute to their experience of being stereotyped and their perception of discrimination in the healthcare system and from providers. Patients’ experiences within the healthcare system have implications for their healthcare-seeking behaviors and treatment outcomes. Healthcare personnel and providers need to be more aware of the potential for implicit bias toward this population. Healthcare workforce training on culturally responsive patient care approaches and more community engagement will help providers better understand the context of patients from this population and more effectively meet their healthcare needs.
Ethical challenges in researching and telling the stories of recently deceased people
Authors: Caswell Glenys , Turner Nicola
Published: August 2020

This paper explores ethical challenges encountered when conducting research about, and telling, the stories of individuals who had died before the research began. Cases were explored where individuals who lived alone had died alone at home and where their bodies had been undiscovered for an extended period. The ethical review process had not had anything significant to say about the deceased ‘participants’. As social researchers we considered whether it was ethical to involve deceased people in research when they had no opportunity to decline, and we were concerned about how to report such research. The idea that the dead can be harmed did not help our decision-making processes, but the notion of the dead having limited human rights conferred upon them was useful and aided us in clarifying how to conduct our research and disseminate our findings.
Look closer: The multidimensional patterns of post-stroke burden behind the modified Rankin Scale
Authors: Rethnam Venesha , Bernhardt Julie , Johns Hannah , Hayward Kathryn S , Collier Janice M , Ellery Fiona , Gao Lan , Moodie Marj , Dewey Helen , Donnan Geoffrey A , Churilov Leonid
Published: August 2020

Background

The utility-weighted modified Rankin Scale, representing patient perspectives of quality of life, is a newly proposed measure to improve the interpretability of the modified Rankin Scale. Despite obvious advantages, such weighting imperfectly reflects the multidimensional patterns of post-stroke burden.

Aims

To investigate multidimensional patterns of post-stroke burden formed by individual domains of Assessment of Quality of Life and Barthel Index for each modified Rankin Scale category.

Methods

In the A Very Early Rehabilitation Trial (n = 2104), modified Rankin Scale scores and modified Rankin Scale-stratified Barthel Index scores of Self-care and Mobility, and Assessment of Quality of Life scores of Independent Living, Senses, Mental Health and Relationships were collected at three months. The multivariate relationship between individual Assessment of Quality of Life and Barthel Index domains, and modified Rankin Scale was investigated using random effects linear regression models with respective interaction terms.

Results

Of 2104 patients, simultaneously collected Assessment of Quality of Life, Barthel Index and modified Rankin Scale scores at three months were available in 1870 patients. While individual Assessment of Quality of Life and Barthel Index domain scores decreased significantly as modified Rankin Scale increased (p < 0.0001), the patterns of decrease differed by domains (p < 0.0001). Patients with modified Rankin Scale 0–1 had the largest post-stroke burden in the Mental Health and Relationship domains, while patients with modified Rankin Scale >3 showed the greatest burden in Independent Living, Mobility and Self-care domains.

Conclusions

Across the modified Rankin Scale, individual domains are varyingly impacted demonstrating unique patterns of post-stroke burden, which facilitates appropriate assessment, articulation and interpretation of the modified Rankin Scale and utility-weighted modified Rankin Scale.
Should team coaches care about justice? Perceived justice mediates the relation between coaches’ autonomy support and athletes’ satisfaction and self-rated progression
Authors: De Backer Maarten , Boen Filip , Van Puyenbroeck Stef , Reynders Bart , Van Meervelt Koen , Vande Broek Gert
Published: August 2020

In contrast to the many studies in the business setting, few sport scientists have studied the predictors of athletes’ perception of justice. The present research aimed to determine the role of the interpersonal style of coaches (autonomy support) in enhancing perceived justice and its impact on satisfaction and performance. More precisely, two independent studies examined whether perceived justice mediated the relation between autonomy support on the one hand and athletes’ satisfaction and their self-rated progression on the other hand. In Study 1, female team dancers ( N = 145) completed questionnaires assessing autonomy support, justice, and satisfaction. In Study 2, male handball players ( N = 102) completed the same questionnaire extended with self-rated progression. Structural equation modeling revealed a positive link between athletes’ perceived autonomy support of the coach and perceived justice. Subsequently, procedural-interactional justice predicted higher levels of satisfaction and self-rated progression, while a significant indirect effect was found from autonomy support to satisfaction. Measurement and path invariance tests showed that the measurement scales and structural models were invariant across both samples. These findings signify the importance of autonomy support and perceived justice to optimize team athletes’ satisfaction and consequently their progression.
Challenges in the delivery of critical care in India during the COVID-19 pandemic
Authors: Tirupakuzhi Vijayaraghavan Bharath Kumar , Nainan Myatra Sheila , Mathew Meghena , Lodh Nirmalyo , Vasishtha Divatia Jigeeshu , Hammond Naomi , Jha Vivekanand , Venkatesh Balasubramanian
Published: August 2020

Coronavirus disease 2019 cases in India continue to increase and are expected to peak over the next few weeks. Based on some projection models, India is expected to have more than 10 million cases by September 2020. The spectrum of disease can vary from mild upper respiratory tract symptoms to life-threatening acute respiratory distress syndrome and multi-organ failure requiring intensive care. Even if less than 5% of patients require critical care services, this will still rapidly overwhelm the healthcare system in a country, where intensive care services and resources are scarce and unevenly distributed. In this perspective article, we highlight the critical care preparedness of India for the pandemic and the associated challenges.
A review of phenomenological spray penetration modeling for diesel engines with advanced injection strategy
Authors: Liu Long , Peng Yan , Liu Dai , Han Changfu , Zhao Ningbo , Ma Xiuzhen
Published: August 2020

Driven by the increasingly remarkable problems of environmental pollution and energy crisis, the combustion optimization of diesel engine seems to be more urgent than ever, therefore, advanced injection strategies are gradually proposed and employed in modern diesel engines. Phenomenological model, which serves as an effective tool to conduct the parametric study on the spray penetration, needs to be improved to fit the intensified injection condition. Since that there are no attempts to review the spray penetration model developments, in order to help to build a comprehensive understanding of diesel spray propagation, this article briefly summarized the early history and introduced the widely used classical and improved phenomenological spray penetration models. Besides, to provide a helpful reference for selection of suitable models, the modeling methods were analyzed and features and simulation of various models were discussed and compared. After that, the trend of modeling methods and promising directions for future spray modeling were suggested.
Longitudinal Assessment of Depressive Symptoms After Sport-Related Concussion in a Cohort of High School Athletes
Authors: Hammer Erin , Hetzel Scott , Pfaller Adam , McGuine Tim
Published: August 2020

Background:

The long-term effect of sport-related concussion on mood in adolescent athletes is largely unknown.

Hypothesis:

Longitudinal measures of depression will worsen acutely after sport-related concussion and improve with concussion symptom resolution.

Study Design:

Prospective cohort study.

Level of Evidence:

Level 3.

Methods:

A population-based sample of 2160 high school athletes from 31 urban, suburban, and rural high schools completed preseason baseline concussion symptom evaluation and Patient Health Questionnaire–9 (PHQ-9) assessments over 2 years. Athletic trainers recorded onset of sport-related concussion, and concussed athletes completed the PHQ-9 assessment within 24 to 72 hours, 7 days, date of return to sport, 3 months, 6 months, and 12 months after sport-related concussion. Scores at each time point were compared to baseline with mixed-effects models and repeated-measures analysis of variance. Sex-based differences were assessed using mixed-effect models.

Results:

Of the 2160 athletes enrolled in the study, 125 (5.8%; 80 males, 45 females) sustained a sport-related concussion. PHQ-9 scores worsened from baseline at 24 to 72 hours (+1.05; 95% CI, 0.26-1.84; P = 0.003) and 7 days (+0.91; 95% CI, 0.23-1.60; P = 0.006). However, PHQ-9 scores improved from baseline to date of return to sport (−1.38; 95% CI, −2.20 to −0.55; P < 0.001), 3 months (−1.08; 95% CI, −1.88 to −0.28; P = 0.003), 6 months (−1.19; 95% CI, −2.04 to −0.34; P = 0.001), and 12 months after sport-related concussion (−0.76; 95% CI, −1.43 to −0.08; P = 0.028). Female athletes reported more severe concussion symptoms 24 to 72 hours after sport-related concussion compared with male athletes (female, 20.5 [interquartile range (IQR), 10.0-36.2]; male, 9.0 [IQR, 4.0-19.5]; P = 0.003). Neither PHQ-9 scores nor change in PHQ-9 scores differed between male and female athletes at any time point.

Conclusion:

Sport-related concussion did not worsen longitudinal measures of depressed mood in this cohort of high school athletes.

Clinical Relevance:

Emotional symptoms are common after sport-related concussion, but typically resolve by return to sport.
Biomechanical In Vitro Study on the Stability of Patient-Specific CAD/CAM Mandibular Reconstruction Plates: A Comparison Between Selective Laser Melted, Milled, and Hand-Bent Plates
Authors: Kasper Robin , Winter Karsten , Pietzka Sebastian , Schramm Alexander , Wilde Frank
Published: August 2020

Study Design:

An experimental in vitro study.

Objective:

Plate fractures are a recurrent problem in alloplastic mandibular reconstruction. Hypothetically it can be assumed that computer-aided design (CAD)/computer-aided manufacturing (CAM) reconstruction plates have a higher stability than conventional hand-bent plates. The aim of the study was to compare additive and subtractive fabricated CAD/CAM mandibular reconstruction plates as well as conventional plates with regard to their biomechanical properties.

Methods:

In a chewing simulator, plates of 2 conventional locking plate systems and 2 CAD/CAM-fabricated plate systems were compared. The plates were loaded in a fatigue test. The maximum number of cycles until plate fracture and the plate stiffness were compared.

Results:

While all conventional plates fractured at a maximum load between 150 and 210 N (Newton) after a number of cycles between 40 000 and 643 000, none of the CAD/CAM plates broke despite a nearly doubled load of 330 N and 2 million cycles. Both CAD/CAM systems proved to be significantly superior to the hand-bent plates. There was no difference between the 2 CAD/CAM systems.

Conclusions:

Concerning the risk of plate fracture, patient-specific CAD/CAM reconstruction plates appear to have a significant advantage over conventional hand-bent plates in alloplastic mandibular reconstruction.
Carotid intima–media thickness relative to cognitive impairment in dialysis patients, and their relationship with brain volume and cerebral small vessel disease
Authors: Zheng Ke , Qian Yujun , Lin Tiaye , Han Fei , You Hui , Tao Xixi , Hou Bo , Yuan Jing , Wang Haiyun , Zhang Dingding , Lv Ke , Feng Feng , Zhu Yicheng , Li Xuemei
Published: August 2020

Background:

Carotid intima–media thickness (cIMT) is considered a risk factor for and predictor of cerebrovascular disease. In this study, we explored the contribution of cIMT to cognitive impairment (CI) in dialysis patients and the role of cerebral small vascular disease (CSVD) and brain atrophy in this process.

Methods:

Cognitive function was assessed using a comprehensive cognitive test battery. CSVD and brain volume were assessed by magnetic resonance imaging, and cIMT was measured by ultrasonography. Multivariable analysis and mediation were used to explore the relevant relationships among cIMT, CI, CSVD and brain volume.

Results:

Seventy-three dialysis patients were enrolled. Approximately 54.8% were diagnosed with increased cIMT. The increased cIMT group was older and had lower serum albumin and creatinine levels than the normal cIMT group. There was no difference in the CSVD prevalence between the different cIMT groups. Patients in the normal, unilaterally and bilaterally increased cIMT subgroups demonstrated a gradual decrease in brain-matter volume and degenerate cognitive function. cIMT was related to cognitive function and gray-/white-matter volume. Increased cIMT was associated with a significantly increased risk of a reduced Mini Mental State Examination/Montreal Cognitive Assessment score and Trail A/B time delay. Mediation analysis showed that CI was mediated by brain-matter volume but not by CSVD.

Conclusion:

Increased cIMT was an independent risk factor for impairment of global cognitive function, memory, and executive function. The impact of cIMT on cognition was not induced by CSVD but by brain atrophy. cIMT may be a useful tool for screening patients at high risk of CI in the dialysis population.
Dopamine-receptor blocking agent-associated akathisia: a summary of current understanding and proposal for a rational approach to treatment
Authors: Musco Shaina , McAllister Vivian , Caudle Ian
Published: August 2020

Dopamine-receptor blocking agent-associated akathisia (DRBA-A) is an adverse effect that can significantly limit the use of these important medications for the treatment of a variety of psychiatric diseases, yet there is no unifying theory regarding its pathophysiology. This knowledge gap limits clinicians’ ability to effectively manage DRBA-A and mitigate negative outcomes in an already vulnerable patient population. Based on a review of the current literature on the subject, it is hypothesized that dopaminergic and noradrenergic signaling is perturbed in DRBA-A. Accordingly, it is proposed that the optimal agent to manage this extrapyramidal symptom should increase dopamine signaling in the affected areas of the brain and counteract compensatory noradrenergic signaling via antagonism of adrenergic or serotonergic receptors.
Evaluation of a tertiary and district general hospital menopause service
Authors: Manley Kristyn M , Hillard T , Holloway D , Bruce D , Rymer J
Published: August 2020

Objective

Requests for management of menopausal symptoms and hormone replacement are increasing in the UK. Referrals to specialist clinics have to be balanced with increasing recommendations within the NHS to improve efficiency and patient care.

Study design

Retrospective evaluation of clinic records over two months at a district general (Poole Hospital) and tertiary (Guy’s Hospital) menopause service. Data on referral origin, reason for referral, interval from referral to review and outcome were collected and compared between trusts.

Main outcome measures

To evaluate and compare referrals and outcomes in a tertiary and district general menopause service and provide recommendations for improving efficiency.

Results

Most referrals are from primary care but up to 25% are from other specialties. Half of the appointments are new referrals and 95% of women attend. Of the new referrals, 50% have multiple medical comorbidities, 25% a personal or family history of cancer and 25% treatment resistance; 30% have premature ovarian insufficiency. At Guy’s Hospital, 30% are reviewed more than 18 weeks after referral, at Poole Hospital this is 6%. Treatment resistance is reported in half of the women reviewed at follow-up.

Conclusions

Menopause services review a complex patient population and the majority of referred women have more than one co-morbidity; they require time, specialist knowledge of current treatment options and a multidisciplinary approach. The main barrier to service efficiency is capacity, particularly in population dense areas; cognitive behavioural therapy and non-hormonal methods appear under-utilised in primary care, as do alternative methods of follow-up within the clinics such as telephone and patient-initiated appointments.
Nigerian healthcare workers’ perception of transdisciplinary approach to older adults’ care: A qualitative case study
Authors: Okoh Augustine E , Akinrolie Olayinka , Bell-Gam Hope Ilanye , Adandom Isreal , Ibekaku Michael C , Kalu Michael Ebe
Published: August 2020

Introduction

There is a growing interest in collaborative care for older adults in Nigeria; however, little is known about the application of a transdisciplinary approach to care in a typical Nigerian geriatric unit. Therefore, we described healthcare professionals’ (HCPs’) perception of a transdisciplinary approach to older adults’ care in Southern Nigeria.

Methods

Using Stakian’s approach to a qualitative case study, we purposively invited 16 HCPs working in the geriatric unit of a teaching hospital in Nigeria to a single, in-depth, semi-structured interview. We analysed data using Stakian’s approach of categorical aggregation and direct interpretation.

Results

Our participants identified five-key features of a transdisciplinary approach to care: consolidated consultation, consolidated care documentation, care files accessibility, shared care decision and a designated care manager. HCPs stated that transdisciplinary approach to care allowed for a consolidated consultation of patients, with all the HCPs (in the same room or via telehealth/telemedicine) and care decisions should be shared between all stakeholders and documented in an accessible unified electronic care document that is managed by a care manager. Factors ranging from lack of consensus on time for a consolidation consultation to inter-professional conflicts were perceived as possible hindrances to a transdisciplinary approach to older adults’ care.

Discussion

The features of transdisciplinary care described in this study partly aligned with the WHO’s integrated care for older people (ICOPE). Additional components not captured in ICOPE were found. While the description of transdisciplinary was from the perceptive of our study participant, caution should be applied when interpreting these findings.
Allogenic blood patch pleurodesis for continuous pneumothorax in three cats
Authors: Bersenas Alexa M , Hoddinott Katie L
Published: August 2020

Case series summary

Following diaphragmatic herniorrhaphy, three cats developed a continuous pneumothorax. All three cats required continuous suction to evacuate air from the thoracic cavity. Despite continuous suction, the pneumothorax persisted for all cats and blood patch pleurodesis (BPP) was performed using blood donor cats. All three cats had resolution of their pneumothorax within 24 h of BPP.

Relevance and novel information

This is the first report of BPP used in feline patients. More recently autologous BPP has been reported for use in dogs and humans, with a reportedly high success rate. BPP may allow timely resolution of continuous pneumothorax in cats and provide an alternative treatment option to prolonged medical management or surgical intervention. Allogenic blood from a donor cat may be necessitated in feline BPP when cardiovascular instability is appreciated in these small patients.
Examining the Role of Social Factors and Mooring Effects as Moderators on Consumers’ Shopping Intentions in Social Commerce Environments
Authors: Rashid Rao Muhammad , Rashid Qurat ul Ain , Pitafi Abdul Hameed
Published: August 2020

Consumers on social commerce platforms can easily access product information, but these platforms have not attracted potential consumers in emerging economies. Studying the social factors (social support, social presence, and relationship quality) and mooring effects (conformity and personal experience) in social commerce environments is essential for understanding consumers’ intentions. This study examines the role of social factors by integrating mooring effects as moderators in the Chinese model, where fear for the reliability of consumers’ comments is a concern. Quantitative data are collected from Chinese cities ( N = 303) and analyzed through partial least squares–structural equation modeling. The findings demonstrate the validity of social factors and enjoyment. Mooring effects positively influence shopping intentions, and system and service quality positively influences relationship quality and shopping intentions. Finally, mooring effects positively moderate the relationship between social presence, social support, and consumers’ intentions. The findings have theoretical understanding and practical implications.
Vertical and Horizontal Transmission of Streptococcus Mutans and Effective Factors: An In Vivo Study
Authors: Esra Kizilci , Nurhan Ozalp , Yilmaz Ayca Dilara , Berrin Ozcelik
Published: August 2020

Aim:

The degree of vertical (intrafamilial) and horizontal (extrafamilial) transfer of Streptococcus mutans ( S. mutans) to a child shows differences according to cultures. The wrong care habits may result in transfer of S. mutans. The aim of this study was to determine the vertical and horizontal transmission of S. mutans to a child and effective factors.

Materials and Methods:

Mothers and kindergarten staff of 37 children aged between 4 and 5 years who initially started in two kindergartens (Group 1, n = 19; Group 2, n = 18) were included in this in vivo study according to 95% reliability and 80% theoretical power. Intraoral examination of mothers and children made according to the World Health Organization criteria (dmf-t/DMF-T) was done, following which mothers were asked to fill questionnaire forms including knowledge and attitudes of them about oral/dental health care. 1 mL saliva samples received from children/mothers/staff were examined microbiologically in order to isolate and quantify S. mutans. Arbitrarily primed polymerase chain reaction analysis was done to determine the genetic characteristics of S. mutans. All examinations were repeated to evaluate the horizontal transmission in the fifth month. Parametric tests ( t-test and two-way analysis of variance) were employed for comparison of the variables that meet the normality assumption and nonparametric tests (Mann–Whitney) were also used.

Results:

It was observed that there is a statistically significant correlation between mother DMF-T values and mother–child S. mutans similarity level ( P < .05). There is a statistically positive correlation between the habits of using a common fork, spoon, glass, and mother–child similarity level.

Conclusion:

Vertical and horizontal transfers occurred in Turkish families in order to prevent the transfer of S. mutans; wrong baby care habits that may lead to the transfer of S. mutans, which is the main factor in case of tooth decay, should be avoided.
Immediate PrEP after PEP: Results from an Observational Nurse-Led PEP2PrEP Study
Authors: O’Byrne Patrick , Orser Lauren , Vandyk Amanda
Published: August 2020

Patients who use post-exposure prophylaxis (PEP) are at ongoing risk for HIV acquisition after completing PEP. While the Centers for Disease Control and Prevention recommends pre-exposure prophylaxis (PrEP) use immediately after PEP, some practitioners are hesitant to offer PEP-to-PrEP (PEP2PrEP). We began offering PEP2PrEP in the sexually transmitted infection clinic in Ottawa, Canada on August 5, 2018. During the first 16 months of PEP2PrEP, 61 patients requested PEP and 46 were initiated; 30 of these patients agreed to PEP2PrEP and 26 followed through. None of our PEP patients had confirmed HIV exposures; all fulfilled the initiation criterion of condomless anal sex with a male partner of unknown HIV-status. During the study, the number of PEP requests and initiations was statistical unchanged, yet the seroconversion rate among patients who used PEP decreased from 1.7% pre-PEP2PrEP to 0% post-PEP2PrEP. Regarding follow-up, most discontinuations occurred between the PrEP intake and 1-month follow-up visit.
Proposal for a Clinical Analysis of Patellar Tendon Pathologies: In Search of Efficient Therapeutic Indications
Authors: Fernandez-Jaén Tomas , Sanz-Zapata Fernando , Cortés Jesus Manuel , Balius-Mata Ramon , Alvarez-Rey Guillermo , Garrido-Gonzalez Jose Ignacio , Colmenero-Rolon Carlos , Recio-Alvarez Isabel , Guillen-Garcia Pedro
Published: August 2020

Development and advances in our understanding of basic sciences such as anatomy, biochemistry, histology, and biomechanics have led to a better knowledge of tendon injuries. Likewise, technological advances in available therapies have conditioned the rise of new therapeutic techniques, turning both diagnosis and therapeutic indications into the foundation of treatment for patellar tendon disorders. Furthermore, we often find no correlation between patellar tendon function and structure, as studied and diagnosed from images taken and referred symptoms. This statement proposes an analytic procedure that ensures a specific therapeutic goal instead of applying a specific drug or therapeutic technique, with the aim of establishing parameters that define the kind of tendinopathy clinicians see, taking into account all conditioning factors that may affect a patellar tendinopathy. These include etiological factors, systemic illnesses affecting tendons, local mechanical causes and clinical presentation, range of clinical presentations, symptom persistence, and pain location, as well as those factors described by echography, with or without the presence of neoangiogenesis and location of the pathology, and magnetic resonance imaging. Diagnosing patellar tendinopathies requires deployment of a complex and thorough assessment process for each individual case and should include all variables that basic sciences have provided. Once a diagnosis has been made, a therapeutic strategy that includes all existing variables should be established. The more precise a diagnosis is, the more selective the treatment options become.
Parallel Distributed Compensation /H∞ Control of Lane-keeping System Based on the Takagi-Sugeno Fuzzy Model
Authors: Chen Wuwei , Zhao Linfeng , Wang Huiran , Huang Yangcheng
Published: August 2020

Current research on lane-keeping systems ignores the effect of the driver and external resistance on the accuracy of tracking the lane centerline. To reduce the lateral deviation of the vehicle, a lane-keeping control method based on the fuzzy Takagi-Sugeno (T-S) model is proposed. The method adopts a driver model based on near and far visual angles, and a driver-road-vehicle closed-loop model based on longitudinal nonlinear velocity variation, obtaining the expected assist torque with a robust H∞controller which is designed based on parallel distributed compensation and linear matrix inequality. Considering the external influences of tire adhesion and aligning torque when the vehicle is steering, a feedforward compensation control is designed. The electric power steering system is adopted as the actuator for lane-keeping, and active steering redressing is realized by a control motor. Simulation results based on Carsim/Simulink and real vehicle test results demonstrate that the method helps to maintain the vehicle in the lane centerline and ensures driving safety.