bluuebunny/crossref_metadata_2025 huggingface dataset:
Association of Probiotic Clostridium butyricum Therapy with Survival and Response to Immune Checkpoint Blockade in Patients with Lung Cancer
Authors: Tomita Yusuke , Ikeda Tokunori , Sakata Shinya , Saruwatari Koichi , Sato Ryo , Iyama Shinji , Jodai Takayuki , Akaike Kimitaka , Ishizuka Shiho , Saeki Sho , Sakagami Takuro
Published: July 2020

Gut dysbiosis caused by antibiotics impairs response to immune checkpoint blockade (ICB). Gut microbiota is becoming an attractive therapeutic target for cancer. The Clostridium butyricum MIYAIRI 588 strain is a probiotic therapy used to improve symptoms related to antibiotic-induced dysbiosis in Japan. We hypothesized that probiotic Clostridium butyricum therapy (CBT) may affect the therapeutic efficacy of ICBs. We retrospectively evaluated 118 patients with advanced non–small cell lung cancer treated with ICBs at Kumamoto University Hospital (Kumamoto-shi, Kumamoto, Japan). Survival analysis comparing patients given CBT before and/or after ICB was conducted using univariate analyses and Cox proportional hazards regression models using propensity score. Propensity score analyses confirmed that probiotic CBT significantly prolonged progression-free survival (PFS) and overall survival (OS). Probiotic CBT significantly associated with longer PFS and OS even in patients who received antibiotic therapy. This study suggests that probiotic CBT may have a positive impact on therapeutic efficacy of ICB in patients with cancer.

See articles by Hakozaki et al., p. 1243, and Peng et al., p. 1251
Tenascin-C Orchestrates an Immune-Suppressive Tumor Microenvironment in Oral Squamous Cell Carcinoma
Authors: Spenlé Caroline , Loustau Thomas , Murdamoothoo Devadarssen , Erne William , Beghelli-de la Forest Divonne Stephanie , Veber Romain , Petti Luciana , Bourdely Pierre , Mörgelin Matthias , Brauchle Eva-Maria , Cremel Gérard , Randrianarisoa Vony , Camara Abdouramane , Rekima Samah , Schaub Sebastian , Nouhen Kelly , Imhof Thomas , Hansen Uwe , Paul Nicodème , Carapito Raphael , Pythoud Nicolas , Hirschler Aurélie , Carapito Christine , Dumortier Hélène , Mueller Christopher G. , Koch Manuel , Schenke-Layland Katja , Kon Shigeyuki , Sudaka Anne , Anjuère Fabienne , Van Obberghen-Schilling Ellen , Orend Gertraud
Published: July 2020

Inherent immune suppression represents a major challenge in the treatment of human cancer. The extracellular matrix molecule tenascin-C promotes cancer by multiple mechanisms, yet the roles of tenascin-C in tumor immunity are incompletely understood. Using a 4NQO-induced oral squamous cell carcinoma (OSCC) model with abundant and absent tenascin-C, we demonstrated that tenascin-C enforced an immune-suppressive lymphoid stroma via CCL21/CCR7 signaling, leading to increased metastatic tumors. Through TLR4, tenascin-C increased expression of CCR7 in CD11c+ myeloid cells. By inducing CCL21 in lymphatic endothelial cells via integrin α9β1 and binding to CCL21, tenascin-C immobilized CD11c+ cells in the stroma. Inversion of the lymph node-to-tumor CCL21 gradient, recruitment of T regulatory cells, high expression of anti-inflammatory cytokines, and matrisomal components were hallmarks of the tenascin-C–instructed lymphoid stroma. Ablation of tenascin-C or CCR7 blockade inhibited the lymphoid immune-suppressive stromal properties, reducing tumor growth, progression, and metastasis. Thus, targeting CCR7 could be relevant in human head and neck tumors, as high tenascin-C expression and an immune-suppressive stroma correlate to poor patient survival.
Spherophakia and Ectopia Lentis in a Sturge-Weber Patient: A Case Report
Authors: Avalos-Lara Samuel Josue , Antonio-Aguirre Bani , Perez-Ortiz Andric C. , Mendoza Velásquez Cristina , Camacho-Ordoñez Azyadeh , Palacio Pastrana Claudia
Published: July 2020

Sturge-Weber syndrome (SWS) is a rare, sporadic neurocutaneous disorder, primarily characterized by port-wine stain (PWS) over the ophthalmic division of the trigeminal nerve (V1) territory (hallmark feature) and glaucoma (in 30–60% of cases). Other ocular manifestations include episcleral involvement of the PWS, choroidal vascular malformations, and iris heterochromia. Two previous reports also associated ectopia lentis concomitantly among these cases. However, here we report spherophakia as a novel ophthalmological finding in SWS. A 56-year-old female previously diagnosed with SWS presented to the outpatient clinic complaining of right-sided decreased visual acuity and pain after a fall. Phenotypically, the patient had a PWS around V1 territory and involvement of both eyelids. Previous relevant ocular history included retinal detachment without macular involvement, ocular hypertension, and phacodonesis. The slit-lamp examination showed anterior lens luxation and elevated intraocular pressure (IOP) of 40 mm Hg by tonometry. Prior to the surgical approach, the patient received hypotensive treatment for elevated IOP. After intracapsular lens extraction, measurements were consistent with spherophakia. Postoperatively, the patient underwent optical coherence tomography (OCT). There was cystic macular edema (CME) by OCT and a detached posterior hyaloid membrane. The patient fully recovered with topical treatment of bromfenac for CME. To the best of our knowledge, this is the first report of concomitant anterior lens luxation and spherophakia (novel association) in a SWS patient. Our findings supplement the differential ocular diagnoses in SWS and should be considered in the routine ocular exam, specifically of the anterior segment. CME occurred similar to otherwise healthy eyes. However, in this case, topical anti-inflammatory medications had a good response and were well-tolerated.
Activation and Blockade of Serotonin-4 Receptors in the Lateral Habenula Produce Antidepressant Effects in the Hemiparkinsonian Rat
Authors: Guo Yuan , Zhang Li , Zhang Jin , Lv Shu-Xuan , Du Cheng-Xue , Wang Tao , Wang Hui-Sheng , Xie Wen , Liu Jian
Published: July 2020

Background: The 5-hydroxytryptamine (5-HT) neurotransmitter system and lateral habenula (LHb) are involved in the regulation of depression, while the mechanisms remain to be clarified. Objectives: The effects and possible mecha-nism underlying activation or blockade of 5-HT4 receptors (5-HT4Rs) in the LHb in depression were investigated by behavioral and neurochemical methods based on a Parkinson’s disease (PD) rat model. Method: 6-Hydroxydopamine (6-OHDA) was injected unilaterally into the substantia nigra pars compacta to establish the PD rat model. The depressive-like behaviors were measured by the forced swimming test (FST) and sucrose preference test (SPT). The concentrations of dopamine (DA), noradrenaline (NA) and 5-HT in the related brain regions were measured by a neurochemical method. Results: The 6-OHDA lesions increased the immobility time in the FST and decreased the sucrose consumption in the SPT, suggesting the induction of depressive-like behaviors. Intra-LHb injection of BIMU-8 (5-HT4R agonist) or GR113808 (5-HT4R antagonist) produced antidepressant effects in the lesioned rats. Intra-LHb injection of BIMU-8 significantly increased the DA levels in the medial prefrontal cortex (mPFC) and ventral hippocampus (vHip), increased the 5-HT level in the mPFC and decreased the NA level in the vHip only in the lesioned rats, while intra-LHb injection of GR113808 changed DA, NA and 5-HT levels in the mPFC, LHb and vHip in both sham and the lesioned rats. Conclusions: All these results suggest that activation or blockade of the LHb 5-HT4Rs produce antidepressant effects in the 6-OHDA-lesioned rats, which are related to the changes of monoamines in the limbic and limbic-related regions.
Design and Baseline Characteristics of the Chlorthalidone in Chronic Kidney Disease (CLICK) Trial
Authors: Agarwal Rajiv , Cramer Andrew E. , Balmes-Fenwick Mary , Sinha Arjun D. , Ouyang Fangqian , Tu Wanzhu
Published: July 2020

Background: Hypertension often accompanies chronic kidney disease (CKD), and diuretics are widely prescribed to reduce blood pressure (BP). Chlorthalidone (CTD) is a thiazide-like diuretic and an effective antihypertensive drug, yet little data exist to support its use in treating hypertension in individuals with advanced CKD. Methods: Chlorthalidone in Chronic Kidney Disease (CLICK) is a phase II, single-institution, multicenter, double-blind randomized control trial to test the hypothesis that CTD improves BP, through reduction of extracellular fluid volume, and results in target organ protection in patients with stage 4 CKD and poorly controlled hypertension. After a single-blind placebo run-in for 2 weeks and confirmation of hypertension by 24-h ambulatory blood pressure (ABP), patients are randomized to either placebo or CTD 12.5 mg once daily (QD) followed by dose escalation. Randomization is stratified by prior loop diuretic use, and the double-blind phase lasts 12 weeks. With a total of 160 patients, the study will have ≥80% power to detect a 6 mm Hg difference in systolic 24-h ABP between the 2 treatment groups. Results: Between June 2016 and October 2019, 131 patients have been randomized. The baseline characteristics are as follows: average age 65.8 years, 79% men, 36% Black, 79% with diabetes, mean eGFR 23.2 mL/min/1.73 m2, median urine albumin/creatinine ratio 923 mg/g, average number of BP medications 3.4, 60% on loop diuretics, and 24-h ABP averaged 141.7/73.8 mm Hg. Conclusion: Among patients with stage 4 CKD and uncontrolled hypertension, CLICK should answer the question whether CTD is safe and effective.
Erfolgreiche Behandlung multipler Melanommetastasen mit einer Kombinationstherapie aus Nivolumab, Ipilimumab und Denosumab
Authors: Yoshida Saaya , Fujimura Taku , Kambayashi Yumi , Amagai Ryo , Hashimoto Akira , Aiba Setsuya
Published: July 2020

Die Kombination aus Nivolumab und Ipilimumab ist einer der vielversprechenden Therapieansätze zur Steigerung der antitumoralen Immunreaktion bei Patienten mit fortgeschrittenem Melanom. Ein Hauptaugenmerk der Dermatologen liegt auf der Optimierung des Ansprechens. Aktuelle Berichte deuten darauf hin, dass – vor dem Hintergrund, dass CD8+-T-Zellen nach Anwendung von Immuncheckpoint-Inhibitoren beim Melanom die RANKL-Expression steigern und so ein immunsuppressives Tumormikromilieu schaffen – Denosumab die antitumorale Wirkung dieser Immuncheckpoint-Inhibitoren, z.B. Nivolumab und Ipilimumab, zusätzlich steigern könnte. Wir stellen hier den Fall eines Patienten mit multipel metastasierendem Melanom vor, der mit einer Kombinationstherapie aus Nivolumab, Ipilimumab und Denosumab behandelt wurde.
ОСОБЛИВОСТI РОЗВИТКУ МЕДIАТОРСЬКОЇ КОМПЕТЕНТНОСТI МАЙБУТНЬОГО ФАХIВЦЯ В ГАЛУЗІ МЕДИЦИНИ
Authors: Nevinska L. M. , Kulchytskyi V. Y. , Yastremska S. O.
Published: July 2020

У статті проаналізовано особливості розвитку медіаторської компетентності майбутнього фахівця в галузі медицини; розглянуто компоненти, критерії, показники та рiвнi медіаторської компетентності.
ФАКТОРИ ТА НАСЛІДКИ РОЗВИТКУ ПРОФЕСІЙНОГО СТРЕСУ МЕДИЧНОГО ПЕРСОНАЛУ ОНКОЛОГІЧНОГО ВІДДІЛЕННЯ
Authors: Kаrshunova А. S. , Lymar L. Ye.
Published: July 2020

У статті розглянуто фактори та причини, що впливають на появу професійного стресу. Зосереджено увагу на розвитку синдрому емоційного вигорання, його суті та складових.
ПРОФІЛАКТИКА ТА КОРЕКЦІЯ ПОРУШЕНЬ ПОСТАВИ РІЗНИМИ МЕТОДАМИ ФІЗИЧНОЇ РЕАБІЛІТАЦІЇ
Authors: Davybida N. O. , Kulyk T. Ya.
Published: July 2020

Порушення постави займають одне з перших місць серед захворювань опорно-рухового апарату. Відомо, що між станом опорно-рухового апарату і здоров᾽ям людини існує дуже тісний зв᾽язок. Відсутність відхилень у стані опорно-рухового апарату є обов᾽язковою умовою нормального функціонування органів і систем, підтримання доброго фізичного стану та працездатності. Незважаючи на значні успіхи, досягнуті протягом останнього десятиліття, в діагностиці та лікуванні цієї патології, проблема залишається актуальною.
Arrangements for the Care of Elderly in Shanghai
Authors: Nundy Madhurima , Baru Rama V.
Published: July 2020

This article looks at the arrangements for the care of elderly in Shanghai through the conceptual framework of the ‘care diamond’ and ‘continuum of care’. The findings, that are based on fieldwork conducted by the authors in Shanghai, delineate what constitutes care diamond in the city for the elderly population. This is mapped through the levels of care from home-based to tertiary-level end-of-life services that are needed by the elderly population. It also looks at the emerging markets of care in this sector and discusses whether multiple actors providing a range of services achieve continuum of care for Shanghai’s elderly population.
Examining COVID-19 and HIV: The impact of intersectional stigma on short- and long-term health outcomes among African Americans
Authors: Nydegger Liesl A , Hill Mandy J
Published: July 2020

The COVID-19 pandemic has exacerbated the health disparities and structural racism among African Americans. We examined overlaps between the COVID-19 pandemic and HIV epidemic using an intersectional stigma framework through the lens of Critical Race Theory. Intersectional stigma, medical mistrust, and decreased likelihood of referral for HIV and COVID-19 testing leads to decreased engagement in the healthcare system. Social inequities increase health disparities and lead to increased rates of chronic diseases, which increases the risk and severity of COVID-19. Solutions to mitigate impact among African Americans include increasing engagement regarding African American health, funding, and providers of color.
Effects of Transcranial Direct Current Stimulation Over the Dorsolateral Prefrontal Cortex (PFC) on Cognitive-Motor Dual Control Skills
Authors: Lee JaeHyuk , Dong SungHee , Jeong JiChai , Yoon BumChul
Published: July 2020

This randomized crossover study investigated whether anodal transcranial direct current stimulation (tDCS) over the dorsolateral prefontal cortex (dlPFC) modulates memory-guided finger isometric maintenance during single motor and dual cognitive-motor tasks, based on electroencephalogram (EEG) signals. Twenty-three healthy participants (14 female; M age = 29.130 years, SD = 10.918) underwent both sham and 2-mA stimulation sessions over the dlPFC for 20 minutes, with a minimum washout period of seven days. We analyzed finger-force isometric maintenance and event-related spectral perturbation (ERSP) of the EEG during early and later phases of both tasks. We observed a significant motor accuracy improvement ( p = .014) and significant variation of force output ( p = .027) with significant decrease in ERSP on the dorsomedial prefrontal cortex (dmPFC) (early phase, p = .027; later phase, p = .023) only after 2 mA stimulation. Thus, anodal tDCS over the dlPFC may improve memory-guided force control during cognitive-motor dual tasks.
Three-dimensional discrete element simulation of the runaway vehicle deceleration process on the arrester bed of truck escape ramps
Authors: Qin Pinpin , Wu Fengmin , Wu Da , Zhang Shunfeng , Huang Daming
Published: July 2020

Due to imperfect design norms and guidelines for China’s truck escape ramp, previous studies have not been able to reflect the effect of wheel subsidence process on the deceleration of runaway vehicles. A discrete element method was used to establish an aggregate discrete element and a wheel discrete element. The three-dimensional discrete element model for an aggregate-wheel combination was established based on a particle flow code in three dimensions on a software platform using the “FISH” language. The microscopic parameters of the aggregate discrete element particles and wheel discrete element particles were calibrated using a simulated static triaxial compression test and real vehicle test data, respectively. Four sets of numerical simulation tests were designed for analyzing the influence of the aggregate diameter, grade of the arrester bed, truckload, and entry speed on the wheel subsidence depth and stopping distance of runaway vehicles. The results indicate that the smaller the aggregate diameter and entry speed and the greater the truckload and grade of the arrester bed, the more easily the wheel falls into the gravel aggregate, the better the deceleration effect, and the smaller the stopping distance. As the wheel subsidence depth increases, the speed at the unit stopping distance decreases more quickly. The maximum subsidence depth mainly depends on the truckload. The research results can provide a theoretical basis for the design of the arrester bed length and the thickness of the aggregate pavement in a truck escape ramp.
Adverse Events Associated With Laser Use in the Upper Airway
Authors: Tong Jane Y. , Pasick Luke J. , Benito Daniel A. , Sataloff Robert T.
Published: July 2020

Objective

Surgical lasers are used extensively in head and neck surgery. Laser use in the upper airway offers many advantages but also presents risks to patients and operators that are not reported comprehensively. This study aims to summarize device malfunctions, patient complications, and subsequent interventions related to laser use in the upper airway.

Methods

The US Food and Drug Administration’s Manufacturer and User Facility Device Experience database was queried for reports of surgical laser adverse events from January 2010 to March 2020. Data were extracted from reports pertaining to the upper airway.

Results

Sixty‐two reports involving upper airway laser use in an operating room were identified, from which 95 events were extracted. Of these, 40 (42.1%) were adverse events to patients, 2 (2.1%) adverse events to operators, and 53 (55.8%) device malfunctions. Dislodgement of laser fiber in the airway (23 [57.5%]), burn (8 [20%]), and scar (5 [12.5%]) were the most common adverse events to patients. Two incidents of eye exposure through unfiltered microscope lenses were the only adverse events to operators. Fiber break (26 [49.1%]) and flare (12 [22.6%]) were the most common device malfunctions.

Discussion

Surgical lasers have demonstrated utility in head and neck surgery but are associated with risks. This study discusses adverse events and device malfunctions associated with airway laser surgery and emphasizes shortcomings in current reporting.

Implications for Practice

Standardized reporting and multi‐institutional research are needed to better understand adverse events related to surgical laser use and to allow accurate estimation of their prevalence.
Gender-Specific Correlates of Alcohol Use Among College Students in Kerala, India
Authors: Raveendranathan Dhanya , Jaisoorya T. S. , Nair B. Sivasankaran , Menon Priya G. , Rani Anjana , Thennarasu K. , Murthy Pratima
Published: July 2020

Background:

Studies of alcohol use among college students in India have reported a male preponderance, but a recent large study suggested that alcohol use is increasing in young females. This increase in use among the young females is of concern as they experience poorer outcomes and a higher risk for addiction. Hence, we aimed to examine the gender-specific correlates of alcohol use among college students in the district of Ernakulum, Kerala.

Methods:

From 58 colleges, 5,784 students completed a self-administered questionnaire that assessed use of alcohol, use of tobacco and illicit drugs, psychological distress, suicidality, symptoms of attention deficit hyperactivity disorder, and history of sexual abuse.

Results:

Of the questionnaires, 342 had incomplete responses and had to be discarded, and the rest (n = 5,442, 94.1%) were analyzed. lifetime alcohol use was reported by 39% males and 12.6% females. In the multivariable logistic regression analysis using a full model, male students using alcohol compared to male non-users were older, non-Muslim, had poor academic performance, and used other substances. Female users, compared to female non-users, were non-Muslim, had urban residence, used tobacco, and had higher psychological distress, higher suicidal thoughts, and higher lifetime exposure to sexual abuse.

Conclusion:

Gender-specific differences extend across sociodemographic and psychological domains. Incorporation of these may improve the effectiveness of public health strategies addressing alcohol use.
Factors Affecting the Psychological Well-being of Health Care Workers During an Epidemic: A Thematic Review
Authors: Philip Joel , Cherian Vinu
Published: July 2020

Background:

Health care workers (HCWs) constitute a vulnerable group in terms of physical, mental, and emotional health setbacks during an epidemic. An in-depth understanding of the effects of epidemics on HCWs is of utmost importance, in order to put in place measures for their well-being. The purpose of the review was to compile, compare, and contrast the available information so as to produce a lucid picture of how HCWs are impacted during an epidemic, and the factors that affect their mental health.

Methods:

A literature search of MEDLINE and Google Scholar databases was conducted to uncover research pertaining to four major epidemic outbreaks over the last two decades. The search was carried out at three levels using pertinent key words. The records thus identified were narrowed down at three further levels, that is, by screening of the title, abstract, and full text, to obtain articles most relevant to the subject matter. Data extraction was done using a spreadsheet to compile the relevant data. Data synthesis was done by studying those factors found to affect psychological well-being of HCWs and separating them into suitable sub-groups. Recommendations to mitigate the psychological impact were proposed.

Results:

Thirteen factors were identified, which were grouped under the broad categories of socio-demographic variables, individual characteristics, social characteristics, and psychological constructs.

Conclusion:

Epidemics have a profound impact on psychological well-being of HCWs. There is a pressing need to address the issue of the psychological health of this vulnerable group.
Pravastatin attenuates atherosclerosis after myocardial infarction by inhibiting inflammatory Ly6Chigh monocytosis in apolipoprotein E knockout mice
Authors: Chen Yufei , Zhang Hongqi , Hu Liang , Shi Haiming , Liu Xiaojin , Jia Jianguo , Sun Shengjia , Ou Yang , Luo Xinping , Zhou Guomin , Shen Wei
Published: July 2020

Objective

To evaluate the protective effect of pravastatin on atherosclerotic development and inflammatory monocyte subset in atherosclerotic apolipoprotein E (ApoE)−/− mice after myocardial infarction (MI).

Methods

Male ApoE−/− mice (8 weeks old) were fed a high-fat diet for 14 weeks throughout the experiment. A MI model was produced using 18-week-old ApoE−/− mice. They were randomly divided into three groups: sham group, MI group, and MI+Pra group (40 mg/kg/day pravastatin). After 4 weeks (at the end of the study period), the mice were sacrificed and cardiac function was evaluated by echocardiography. Aortic lesion areas were evaluated using oil red O staining. Plaque macrophage in aortic sinus was analyzed by immunofluorescence staining. Flow cytometry was used to explore the proportions of monocyte subsets in the blood, spleen, and bone marrow．

Results

Pravastatin improved cardiac function and reduced lesion areas. It also attenuated the supply of monocytes in spleen, especially the inflammatory Ly6Chigh monocyte subset. Pravastatin also subsequently reduced macrophage accumulation in atherosclerotic lesions.

Conclusions

MI accelerated chronic atherosclerosis progress. Pravastatin suppressed atherosclerotic development and inhibited inflammatory monocytosis after MI in ApoE−/− mice.
Impact of increased serum 8-hydroxy-2′-deoxyguanosine levels on extent of coronary artery lesions in elderly patients with type 2 diabetes
Authors: Zhao Yajie , Liang Wei , Tian Shuya , Shen Linhui , Yang Hui
Published: July 2020

Objective

Patients with type 2 diabetes (T2DM) are prone to cardiovascular disease, and both conditions are linked to oxidative DNA damage, which produces 8-hydroxy-2′-deoxyguanosine (8-OHdG). We investigated the impact of 8-OHdG on coronary heart disease (CHD) in elderly patients with T2DM.

Methods

We assessed the demographic, clinical, and biochemical characteristics of 147 patients with T2DM (mean age 73.29 ± 8.19 years) with or without CHD. Serum 8-OHdG was detected by enzyme-linked immunosorbent assay. CHD was diagnosed as ≥50% stenosis in at least one main branch of the coronary arteries determined by coronarography, evaluated by Gensini score.

Results

Serum 8-OHdG, number of stenotic branches, and Gensini score were all significantly increased in the CHD group. After adjustment for various factors, the number of stenotic branches and Gensini score remained positively correlated with 8-OHdG levels in the CHD group. Coronary artery lesions were significantly more severe in the CHD compared with the non-CHD group when 8-OHdG levels were >0.523 ng/mL. The number of stenotic branches and Gensini score were significantly independently associated with 8-OHdG levels in patients with T2DM.

Conclusions

8-OHdG is a marker of oxidative DNA damage, and is highly associated with the extent of coronary artery lesions in ageing patients with T2DM. Trial registration: Registration number: 1.0/20170720; date of registration 26/07/2016 (retrospectively registered).
Using Artificial Potential Field Theory for a Cooperative Control Model in a Connected and Automated Vehicles Environment
Authors: Yi Ziwei , Li Linheng , Qu Xu , Hong Yang , Mao Peipei , Ran Bin
Published: July 2020

Artificial potential field (APF) theory has been extensively applied in traffic path planning as an efficient method to avoid collision. However, studies in collision avoidance based on APF theory only considered the movement of single vehicle. In this paper, a vehicle cooperative control model for avoiding collision in the connected and autonomous vehicles (CAVs) environment is presented, using APF theory. The proposed model not merely guarantees the travel safety of vehicles in avoiding collision, but also promotes driving comfort and improves traffic efficiency. To verify the cooperative control model, simulations of four scenarios are designed and compared with the human driving environment. Five indicators are selected to evaluate the results, that is, time–space diagram, time mean speed (TMS), the rate of large deceleration time (large deceleration is that deceleration larger than –2 m/s2), the inverse time-to-collision ([Formula: see text]), and lane-changing times. According to the simulation results, the cooperative control model could alleviate the capacity drop and increase the TMS to improve traffic efficiency, reduce the rate of the large deceleration time to promote driving comfort, and decrease [Formula: see text] to promote safety in small and large input flow rates. The results reveal the proposed model is significantly superior to the human driving environment whether in free or congested situations, except for the lane-change times, which are slightly larger.
Application of a geographic information system-based fuzzy analytic hierarchy process model to locate potential municipal solid waste incineration plant sites: A case study of Izmir Metropolitan Municipality
Authors: Yalcinkaya Sedat , Kirtiloglu Osman Sami
Published: July 2020

Locating candidate sites for municipal solid waste management facilities is a multi-criteria decision and involves spatial consideration that all municipalities have to deal with. This study aims to develop a holistic model for locating the most suitable facility sites in municipal solid waste management considering environmental and economic factors, and its application to an incineration facility in Izmir as a case study. A fuzzy analytic hierarchy process model was developed by integrating multi-criteria decision analysis methods and a geographic information system. A stepwise methodology was conducted, including generating a spatial database, exclusion analysis, preference analysis to determine spatial membership degrees and weights for each preference factor and generating the final land suitability map. A high-resolution land suitability map and the point vector format data of potential incineration plant sites were created as the model outputs. The case study results demonstrated that an incineration facility with a total capacity of 117 MWe could be established for energy recovery from 5649 tonnes day–1 municipal solid waste. Four locations were determined as potential incineration facility sites in the case study area. The model can be utilized for different study areas to aid decision-makers in the process of site selection for not only incineration facilities but also for other municipal solid waste management facilities.
Making the best interests of the child a substantive human right at the centre of national level expulsion decisions
Authors: Collinson Jonathan
Published: July 2020

The best interests of the child has become an central facet of the jurisprudence of the European Court of Human Rights (ECtHR) in expulsion cases. This article argues that the indirect application of the best interests of the child as an interpretive benchmark for Article 8 ECHR is not the end point of State’s responsibilities under Article 3 UN Convention on the Rights of the Child (UNCRC). This article argues that the ECtHR’s case law presents significant limitations in the subject matter scope of the best interests of the child, and limitations to the way in which it incorporates them into the Article 8 ECHR balancing exercise. This article acts as a thought experiment by modelling an alternative mode of decision-making. It asks what the best interests of the child might look like as the substantive human right at the centre of decisions about the expulsion of foreign nationals.
Giving nurses a voice during ethical conflict in the Intensive Care Unit
Authors: McAndrew Natalie S , Hardin Joshua B
Published: July 2020

Background:

Ethical conflict and subsequent nurse moral distress and burnout are common in the intensive care unit (ICU). There is a gap in our understanding of nurses’ perceptions of how organizational resources support them in addressing ethical conflict in the intensive care unit.

Research question/objectives/methods:

The aim of this qualitative, descriptive study was to explore how nurses experience ethical conflict and use organizational resources to support them as they address ethical conflict in their practice.

Participants and research context:

Responses to two open-ended questions were collected from critical care nurses working in five intensive care units at a large, academic medical center in the Midwestern region of the United States.

Ethical considerations:

This study was approved by the Institutional Review Board at the organization where the study took place.

Findings:

Three main interwoven themes emerged: nurses perceive (1) intensive care unit culture, practices, and organizational priorities contribute to patient suffering; (2) nurses are marginalized during ethical conflict in the intensive care unit; and (3) organizational resources have the potential to reduce nurse moral distress. Nurses identified ethics education, interprofessional dialogue, and greater involvement of nurses as important strategies to improve the management of ethical conflict.

Discussion:

Ethical conflict related to healthcare system challenges is intrinsic in the daily practice of critical care nurses. Nurses want to be engaged in discussions about their perspectives on ethical conflict and play an active role in addressing ethical conflict in their practice. Organizational resources that support nurses are vital to the resolution of ethical conflict.

Conclusion:

These findings can inform the development of interventions that aim to proactively and comprehensively address ethical conflict in the intensive care unit to reduce nurse moral distress and improve the delivery of patient and family care.
Pre‐hospital emergency response to terrorist attacks: A scoping review
Authors: Amiresmaili Mohammadreza , Talebian Ali , Miraki Sadegh
Published: July 2020

Background:

Terrorist incidents are on the rise in the world, and many countries have been involved so far. Unfortunately, many innocent people fall victim to such incidents every year. The pre‐hospital emergency, as one of the most important organs in the management and service of the victims, plays a vital role in these events.

Objectives:

This scoping review aimed to evaluate the performance and preparedness of the pre‐hospital emergency in the world for such Terrorist incidents.

Methods:

In order to access the documents and scientific evidence relevant to the purpose of our research, selected keywords were searched in PubMed, Scopus, and Web of Science databases. Finally, we collected the required information through a pre‐designed data extraction form that designed based on the purpose of this study.

Results:

The initial search, with the specified search strategies, resulted into 794 documents (263, 488, and 43 documents from PubMed, Scopus, and Web of Science databases, respectively). Finally, eight papers were selected through the full text of the selected articles, three of which were qualitative and three were quantitative, and two were mix‐methods (qualitative/quantitative). Our findings show that published papers have so far emphasized four main axes, namely, preparation, training and practice, effective communication, and the proper triage and transmission of these four axes.

Conclusion:

A few studies have been done in this area and more studies should be done in different areas and sectors, and given that terrorist incidents are on rise and the pre‐hospital emergency organization as one of the most important organizations is not well prepared to respond these events although it has a vital role to play, they need to be more prepared to effectively manage these incidents.
Specialist Palliative Care Activity at an Acute Care Tertiary Hospital and Its Representation in Administrative Data
Authors: Stubbs Joanne M. , Assareh Hassan , Achat Helen M. , Greenaway Sally , Muruganantham Poorani
Published: July 2020

Objective:

To quantify and examine specialist palliative care (SPC) in-hospital activity and compare it to routinely collected administrative data on palliative care (PC).

Methods:

All patients discharged from a large acute care tertiary hospital in New South Wales, Australia, between July 1 and December 31, 2017, were identified from the hospital’s data warehouse. Administrative data were supplemented with information from the electronic medical record for hospital stays which were assigned the PC additional diagnosis code (Z51.5); had a “palliative care” care type; or included SPC consultation.

Results:

Of 34 653 hospital stays, 524 were coded as receiving PC—based on care type (43%) and/or diagnosis code Z51.5 (100%). Specialist palliative care provided 1717 consultations over 507 hospital stays. Patients had 2 (median; interquartile range: 1-4) consultations during an average stay of 15.3 days (SD 15.78; median 10); the first occurred 7.0 days (SD 12.13; median 3) after admission. Of patient stays with an SPC consultation, 70% were assigned the PC Z51.5 code; 60% were referred for symptom management; 68% had cancer. One hundred forty-one patients were under a palliative specialist—either from initial hospital admission (49.6%) or later in their stay.

Conclusions:

Palliative care specialists provide expert input into patient management, benefitting patients and other clinicians. Administrative data inadequately capture their involvement in patient care, especially consultations, and are therefore inappropriate for reporting SPC activity. Exclusion of information related to SPC activity results in an incomplete and distorted representation of PC services and fails to acknowledge the valuable contribution made by SPC.
Long-term outcomes of intrathecal baclofen in ambulatory multiple sclerosis patients: A single-center experience
Authors: Abbatemarco Justin R , Griffin Austin , Jones Noble G , Hartman Jennifer , McKee Keith , Wang Zhini , Nagel Sean J , Machado Andre G , Bethoux Francois
Published: July 2020

Background:

Intrathecal baclofen (ITB) is traditionally reserved for non-ambulatory patients.

Objective:

To investigate outcomes of ITB in ambulatory multiple sclerosis (MS) patients.

Methods:

Changes in outcome measures were estimated by a mixed effect model, while the complication rate was calculated using a logistic regression. Predictors of non-ambulatory status were identified by Cox model.

Results:

In all, 256 patients received an ITB test injection and 170 underwent ITB surgery. Aggregate Modified Ashworth Scale (MAS) scores for the ambulatory ITB cohort decreased from 13.5 ± 6.96 to 4.54 ± 4.18 at 5 years ( p < 0.001). There was no significant change in walking speed 1 year post ITB surgery (0.45 m/second ± 0.30 vs 0.38 m/second ± 0.39, p = 0.80) with 77.8% of patients remaining ambulatory which decreased to 41.7% at year 5. Longer MS disease duration (hazard ratio (HR): 1.04; 95% confidence interval (CI): 1.01–1.07; p = 0.018) and lower hip flexor strength (HR: 0.40; 95% CI: 0.27–0.57; p < 0.001) predicted non-ambulatory status after surgery. Complications were more likely in the ambulatory cohort (odds ratio (OR): 3.30, 95% CI: 2.17–5.02; p = 0.017).

Conclusion:

ITB is effective for ambulatory MS patients without compromising short-term walking speed, although a higher complication rate was observed in this cohort.
COVID-19 in multiple sclerosis: The Dutch experience
Authors: Loonstra Floor C , Hoitsma Elske , van Kempen Zoé LE , Killestein Joep , Mostert Jop P
Published: July 2020

Here, we provide an extensive overview of all reported COVID-19 cases in multiple sclerosis (MS) patients in the Netherlands between 27 February and 9 June 2020, gathered by the Dutch MS Taskforce of the Netherlands Society of Neurology. A total of 86 MS patients were reported, 43 of whom tested positive for COVID-19. Of 43 patients who tested positive, 22 patients were hospitalized. Three intensive care unit (ICU) admissions and four deaths were reported. Our findings show no apparent difference in disease-modifying treatment (DMT) use and COVID-19 disease course in Dutch MS patients. In addition, a clear link between low lymphocyte count and severe disease was not observed.
Challenging discourses of deficit: Understanding the vibrancy and complexity of multilingualism through language trajectory grids
Authors: Choi Julie , Slaughter Yvette
Published: July 2020

The ‘multilingual turn’ has opened up a variety of creative, participatory methods for researchers and educators to explore language learners’ linguistic repertoires, language practices and resources, and linguistic experiences. In this article, we draw on data from the English as an additional language (EAL) secondary school classroom context where we use what we call ‘language trajectory grids’ to make visible EAL students’ English language learning experiences. The grid activity involves plotting learners’ emotions, practices, relationships, and life circumstances with their resources, practices and historical events onto a chronological grid. Using a narrative structure to make sense of learners’ grids and the ‘small stories’ (Barkhuizen, 2009) participants shared during the activity, we discuss the affordances of such devices in opening up space for teachers and learners to critically reflect on the complexities and vibrancy of contemporary multilingual language journeys; to recognize situational factors that influence dispositions towards language, language learning and identity; and as a powerful starting point for students and teachers to engage in ‘collaborative relations of power’.
Using phecode analysis to characterize co-occurring medical conditions in autism spectrum disorder
Authors: Failla Michelle D , Schwartz Kyle L , Chaganti Shikha , Cutting Laurie E , Landman Bennett A , Cascio Carissa J
Published: July 2020

Individuals with autism spectrum disorder experience a significant number of co-occurring medical conditions, yet little is known about these conditions beyond prevalence. Using large-scale de-identified medical records, we can use a novel phecode-based tool to characterize co-occurring conditions in autism spectrum disorder. We hypothesized that individuals with autism spectrum disorder experience an increased burden of co-occurring conditions as measured by presence, frequency, and duration of visits related to co-occurring conditions. Secondarily, we hypothesized that age at first encounter for autism spectrum disorder (early, <5; late, >5) would be associated with different co-occurring conditions. The International Classification of Diseases, Ninth Revision, codes were extracted from a large anonymized electronic medical center database for 3097 individuals with autism spectrum disorder and 3097 matched controls. Co-occurring conditions were characterized using a novel tool (pyPheWAS) to examine presence, frequency, and duration of each condition. We identified several categories of co-occurring conditions in autism spectrum disorder: neurological (convulsions, sleep disorders); psychiatric (anxiety disorders, adjustment/conduct disorders), as well as constipation, hearing loss, and developmental delays. Our work confirms individuals with autism spectrum disorder are under a significant medical burden, with increased duration and frequency of visits associated with co-occurring conditions. Adequate management of these conditions could improve quality of life for individuals with autism spectrum disorder.

Lay abstract

People with autism spectrum disorder often have a number of other medical conditions in addition to autism. These can range from constipation to epilepsy. This study uses medical record data to understand how frequently and how long people with autism have to be seen by a medical professional for these other medical conditions. This study confirmed that people with autism often have a number of other medical conditions and that they have to go see a medical professional about those conditions often. We also looked to see if children diagnosed with autism after age 5 years might have different medical conditions compared to children diagnosed earlier. Children diagnosed later had more conditions like asthma, hearing loss, and mood disorders. This work describes how much medical care people with autism get for different medical conditions and the burden of seeking additional medical care for people with autism and their families.
By any memes necessary? Small political acts, incidental exposure and memes during the 2017 UK general election
Authors: McLoughlin Liam , Southern Rosalynd
Published: July 2020

Following the 2017 UK general election, there was much debate about the so-called ‘youthquake’, or increase in youth turnout (YouGov). Some journalists claimed it was the ‘. . . memes wot won it’. This article seeks to understand the role of memes during political campaigns. Combining meta-data and content analysis, this article aims to answer three questions. First, who creates political memes? Second, what is the level of engagement with political memes and who engages with them? Finally, can any meaningful political information be derived from memes? The findings here suggest that by far the most common producers of memes were citizens suggesting that memes may be a form of citizen-initiated political participation. There was a high level of engagement with memes with almost half a million shares in our sample. However, the level of policy information in memes was low suggesting they are unlikely to increase political knowledge.
Glenohumeral osteoarthritis: an overview of etiology and diagnostics
Authors: Ibounig Thomas , Simons Thomas , Launonen Antti , Paavola Mika
Published: July 2020

Background and Aims:

Osteoarthritis (OA) is the world’s most common joint disease and there is currently no cure. Glenohumeral osteoarthritis (GHOA) accounts for an estimated 5%–17% of patients with shoulder complaints. The etiology of GHOA is multifactorial, and we review the various non-specific and specific risk factors and further sub-classify them into local and systemic factors.

Materials and Methods:

Data for this review article were identified by searches of MEDLINE, PubMed, and references from relevant articles using search terms such as “glenohumeral,” “osteoarthritis,” “epidemiology,” “etiology,” “imaging,” and “pathophysiology.” Only articles published in English, German, and Finnish between 1957 and 2017 were included.

Results:

The prevalence of radiological shoulder OA has been estimated to be as high as 16%–20% in the middle-aged and elderly population, but the concordance between structural findings and symptoms seems to be weak, as many of these individuals are asymptomatic. The vast majority of GHOA is related to non-specific factors, namely advancing age, while specific risk factors are commonly found in young patients. Diagnosis of GHOA is made when typical clinical features and defined radiological findings overlap in an individual.

Conclusion:

Conclusion: Ultimately the determinants of shoulder pain in GHOA remain incompletely understood. Improved understanding of the etiology and diagnosis of GHOA will enable clinicians to better determine which patients will benefit from different treatment modalities, as well as provide new avenues to potential treatments.
Women’s Experiences of the Intersections of Work and Intimate Partner Violence: A Review of Qualitative Research
Authors: MacGregor Jennifer C. D. , Naeemzadah Najibullah , Oliver Casey L. , Javan Tanaz , MacQuarrie Barbara J. , Wathen C. Nadine
Published: July 2020

The impacts of intimate partner violence (IPV) on work, workplaces, and employment are receiving increasing attention from researchers, employers, and policy makers, but research synthesis is needed to develop evidence-based strategies to address the problem. The purpose of this review of qualitative research is to explore abused women’s experiences of the intersections of work and IPV, including the range of benefits and drawbacks of work. Multiple search strategies, including systematic database searches by a professional librarian, resulted in 2,306 unique articles that were independently screened for eligibility by two team members. Qualitative research articles were eligible for inclusion and were also required to (1) sample women with past and/or current IPV experience and (2) report results regarding women’s experiences or views of the benefits and/or drawbacks of work. Ultimately, 32 qualitative research articles involving 757 women were included and analyzed using thematic synthesis. Results revealed the potential of work to offer survivors a great range of benefits and drawbacks, many of which have received little research attention. The importance of work for women survivors has been emphasized in the literature, often with respect to financial independence facilitating the leaving process. However, our research underscores how the impact of work for many women survivors is not straightforward and, for some, involves a “trade-off” of benefits and drawbacks. Those developing work-related interventions, services (e.g., career counseling), or policies for women who experience IPV should consider the range of benefits and drawbacks in their planning, as “one-size-fits-all” solutions are unlikely to be effective.