bluuebunny/crossref_metadata_2025 huggingface dataset:
Screening for Bacteremia in Trauma Patients: Traditional Markers Fall Short
Authors: Stutsrim Ashlee E. , Griffin Caitlin M. , Palavecino Elizabeth L. , Hildreth Amy N. , Avery Martin D. , Chang Michael C. , Miller Preston R. , Nunn Andrew M.
Published: November 2020

Background

Deranged physiology in trauma complicates the clinical identification of sepsis, resulting in overscreening for bacteremia. No clinical signs or biomarkers accurately diagnose sepsis in this population. Our objective was to evaluate the accuracy of the current criteria used to prompt screening for bacteremia in trauma patients and determine independent predictors of bacteremia.

Materials and Methods

Adult trauma patients admitted to our level I academic trauma center who had blood cultures (BCs) drawn were identified. Those with positive BCs were compared to those with negative or false positive BCs. False positive was defined as a BC deemed contaminated and not treated at the discretion of the attending physician.

Results

Over a 2-year period, 366 trauma patients had BCs drawn. After excluding surveillance cultures (those drawn to demonstrate bacteremia clearance), 492 unique BC sets were evaluated; 104 (21.1%) BC sets were positive; 30 (28.8%) of these were falsely positive, resulting in a true-positive rate of 15% in the screened population. Univariate analysis suggested temperature and heart rate were associated with positive BC, while multivariable analysis found only the presence of a central line and lactic acid to be predictive. Procalcitonin (PCT) was poorly predictive, with a positive predictive value of 18% and a negative predictive value of 91%.

Conclusion

Current tools for identifying bacteremia in trauma patients result in overscreening. PCT may have a limited role as a negative predictor for bacteremia. Given that false-positive BCs have negative patient and economic consequences, future study should focus on development of alternative screening modalities.
Shared Decision-Making in the Context of Uncertain Care Goals and Outcomes: Dissecting a Penetrating Abdominal Trauma Case Complicated by Enterocutaneous Fistulae
Authors: Marterre Buddy , Shin Jaewook , Terzian William T. Hillman
Published: November 2020

Surgeons care deeply about their patients, their patient’s surgical outcomes, and their fund of knowledge as it relates to disease, treatment options, and risk is remarkable. Unfortunately, surgical patients’ values, hopes, fears, and unacceptable levels of suffering are rarely elicited and addressed while constructing surgical treatment plans, even when the stakes are high. How can surgeons bring all their experience, education, and expertise to bear in a patient-centered manner amidst uncertainty? Surgeons typically emulate mentors who either employed a solely informative, facilitative, or directive/paternalistic approach to decision-making. These 3 styles fail to simultaneously address: (1) what matters most to patients and (2) the surgeon’s expertise. Since communication in each of these 3 approaches is unidirectional, and the decisional power locus is imbalanced, they are unshared, nonpartnering, and—perhaps surprisingly—not patient-centered. Patient-centered, collaborative shared decision-making (SDM) approaches align with palliative care principles and are rarely employed, taught, or modeled. Furthermore, nonpartnering approaches to surgical decision-making are often laden with unintended consequences, such as patient and family suffering and the suffering of surgeons. We present the high-risk case of an abdominal gunshot wound in a morbidly obese man, which was complicated by 3 enterocutaneous fistulae and a loss of abdominal wall integrity, where ongoing empathic, partnering SDM dialogue is enabling a patient-centered and value‐concordant care plan. The authors invite you to virtually journey with us as this case unfolds, as the impending surgical decisions are substantial and weighty. Uncertainty and risks appear at every turn—providing additional challenges to overcome.
Sport and academic performance in Australian Indigenous children
Authors: Dumuid Dorothea , Wilson Rachel , Olds Timothy , Evans John Robert
Published: November 2020

Objective

Sport may promote academic performance through physiological and psychosocial mechanisms. We aimed to examine the association between sports participation and academic performance in Aboriginal and Torres Strait Islander children.

Methods

Participants were from four successive waves of Australia’s Longitudinal Study of Indigenous Children ( n = 303, baseline age 5–6 y). Cumulative sports participation was regressed against academic performance from two standardised tests.

Results

Children participating in sport at all four waves performed significantly better than children participating in sport in 0, 2 or 3 waves in Progressive Achievement Test (PAT) Maths (110 vs. 103, 105 and 105, p = 0.007, 0.02 and 0.02, respectively), and better than children participating at two waves in National Assessment Program – Literacy and Numeracy (NAPLAN) numeracy (438 vs. 409, p = 0.006). There were no significant differences in PAT reading or NAPLAN literacy.

Conclusion

Sports participation appears to be associated with subsequent better numeracy (2–7 months of learning) in a sample of Australian indigenous children. Fostering sports participation among indigenous children may be an avenue for reducing disadvantage.
Economic Evaluation of a Pharmacist-Led 5-Day Therapeutic Hold of IV Levothyroxine at an Academic Medical Center
Authors: Barlow Blake T. , Roberts Russel J. , Newman Kelly , Harrison Sarah K. , Sin Jonathan H.
Published: November 2020

Objective: Providers often admit patients with active outpatient prescriptions for levothyroxine. During an inpatient admission, providers may instruct critically ill patients to take nothing by mouth, or nil per os (NPO). Thus, they may prescribe the intravenous (IV) formulation of levothyroxine during this period. However, levothyroxine possesses a prolonged half-life of up to 7 days; therefore, immediate transition to IV levothyroxine may not be clinically necessary in the acute NPO setting. Intravenous levothyroxine is significantly more expensive than equivalent oral doses and may prove to be a financial burden for an institution. By understanding the pharmacokinetic properties of levothyroxine, we implemented a cost-saving initiative involving a 5-day therapeutic hold of IV levothyroxine. Methods: This was a retrospective evaluation in 2 intensive care units (ICU): a 20-bed surgical/trauma ICU and an 18-bed mixed medical/surgical ICU. Patient data, utilization data, and documented pharmacist interventions were collected for 6 months prior to implementation of the 5-day IV levothyroxine therapeutic hold and for 6 months post-implementation. All patients prescribed IV levothyroxine during these timeframes were included. Results: During the 6-month pre-implementation phase, 674 doses (691 vials) of IV levothyroxine for 77 unique patients were dispensed from the 2 ICUs. During the 6-month post-implementation phase, 168 doses (188 vials) of IV levothyroxine were dispensed for 44 unique patients. Of the 44 patients (48 orders) who still received IV levothyroxine, 22.9% of orders were deemed clinically necessary by the pharmacist and were not recommended to be held under the protocol, 64.6% were due to the verifying pharmacist being unaware of the protocol, 8.3% of orders were due to protocol non-compliance, and 4.2% were verified after the 5-day hold was complete as the patient remained NPO. This pharmacy-led initiative resulted in a 75% decrease in usage post-implementation and an estimated annualized savings of $80,000. Conclusion: A pharmacy-led initiative comprised of a 5-day therapeutic hold of IV levothyroxine was feasible and led to a 75% reduction in usage and cost over a 6-month period in 2 ICU’s. Future steps include additional staff education for improved protocol adherence and expanding the protocol institution-wide for an even greater cost-savings potential.
Impact of Pharmacist Intervention on Medication Adherence and Patient-Reported Outcomes among Depressed Patients in a Private Psychiatric Hospital of Nepal: a randomised controlled trial
Authors: Marasine Nirmal Raj , Sankhi Sabina , Lamichhane Rajendra
Published: November 2020

Aim: We aimed to evaluate the impact of pharmaceutical service intervention on medication adherence and patient-reported outcomes among patients diagnosed with depression in a private psychiatric hospital in Nepal. Methods: A single-center, open trial with a parallel design was conducted among 18 to 65 years aged patients, diagnosed with depression and under antidepressant medication(s) for ≥2 months. Patients were randomised into either the intervention or control group. The control group (n = 98) received the usual care, while the intervention group (n = 98) received a pharmaceutical service intervention. The two groups were compared using the Mann-Whitney U test, independent t-test, or chi-square test at 2 and 4 months for changes in medication adherence and patient-reported [severity of depression and health-related quality of life (HRQoL)] outcomes. Results: One hundred ninety adult patients were enrolled in the study. At baseline, there were no significant differences in any of the outcome measures between the intervention and control groups. At 2 and 4 months, the intervention group had a significant improvement only in medication adherence ( P < .001) compared with the control group [MGL score: 1 (2) vs 2 (2) and 1 (1) vs 2 (1), P < .001, respectively]. Conclusion: Our study suggests that a brief pharmaceutical service intervention in the hospital setting can have a significant impact on patients’ adherence to antidepressants but does not improve their severity of depression and HRQoL.
Sustainable low liquor ratio dyeing of cotton with C.I. Reactive Blue 21 using dioctyl sodium sulfosuccinate
Authors: Mamun Kabir Shekh Md. , Sk Salauddin , Koh Joonseok
Published: November 2020

Low liquor ratio (material to liquor ratio = 1:5) dyeing of cotton fabric with C.I. Reactive Blue 21 using dioctyl sodium sulfosuccinate as a surfactant was thoroughly analyzed. The dye–surfactant interactions in the micelles during low liquor ratio dyeing were investigated by ultraviolet-visible spectroscopy and the chemical mechanism of the process was evaluated by Fourier-transform infrared spectroscopy analysis. Cotton fabric was subjected to low liquor ratio dyeing and conventional dyeing by varying the temperature, pH, treatment time, and non-identical chemical concentration. The effectiveness of the process was assessed based on the color strength ( K/ S), exhaustion (%), fixation (%), and levelness. Low liquor ratio dyeing afforded superior dyeing compared to conventional dyeing, attributed to the anti-agglomeration effects of the former, which also had no adverse impact on the fastness of the dye. The lower environmental impact due to the lower effluent footprint (biological oxygen demand, chemical oxygen demand, total dissolved solids, and dissolved oxygen) is another benefit of low liquor ratio dyeing. High-pressure liquid chromatography and gas chromatography-mass spectrometry analyses revealed that the low liquor ratio dyed fabric is free of toxic substances (alkylphenol ethoxylates and formaldehyde). Moreover, low liquor ratio dyeing is more cost-effective and outperformed conventional dyeing in all aspects, while being a sustainable process.
Effects of Criminogenic Risk–Needs Assessment Feedback During Prerelease Correctional Rehabilitation
Authors: King Christopher M. , Heilbrun Kirk
Published: November 2020

This pre–post follow-up randomized trial investigated the receptiveness and responsiveness of 82 incarcerated men undergoing reentry to feedback (discussion-based, form-based, or none–minimal) regarding their criminogenic risk–needs assessment results. Both short-term outcomes (self-perceived risk–needs, motivation for change, treatment readiness, and feedback satisfaction) and longer-term outcomes (intuitional conduct, rearrest, or halfway house return) were examined. As hypothesized, among study completers ( n = 67), motivation for change was significantly higher following discussion feedback, and both feedback formats were rated favorably by participants. Contrary to hypotheses, feedback recipients, including those who showed gains at post, did not appear reliably distinct from others on longer-term outcomes; nor were most outcomes significantly associated with baseline risk scores. Feedback about risk and needs may be useful in correctional treatment for motivation enhancement and treatment orienting, but special attention to measurement, contextual, and intensity factors is warranted.
The Relationship Between Gastroesophageal Reflux Disease and Laryngopharyngeal Reflux Based on pH Monitoring
Authors: Wu Yun , Wang Junyao , Huang Qing , Peng Tao , Zhao Lili , Feng Guijian , Liu Yulan
Published: November 2020

Objectives:

Many studies on the relationship between gastroesophageal reflux disease (GERD) and laryngopharyngeal reflux (LPR) were based on symptoms, but there are few research on it using reflux monitoring. This study was designed to investigate the relationship between GERD and LPR based on pH monitoring.

Methods:

All patients were scheduled for esophageal manometry and pH monitoring sequentially. They were stratified into 4 groups as no reflux disease, isolated GERD, isolated LPR (iLPR), and GERD combined with LPR (GERD&LPR) according to pH monitoring.

Results:

The incidence of LPR in GERD was 46.3%, while the probability of combining GERD in LPR was 52.7%. The reflux profile in the laryngopharynx showed a significant difference in the total reflux time (17.82 ± 18.4 vs 9.62 ± 9.58, P = .023) and the percentage of total reflux time (1.31% ± 1.37% vs 0.71% ± .0.73%, P = .023) between the GERD&LPR and iLPR groups.

Conclusion:

Laryngopharyngeal reflux can be combined with GERD or it can exist as an independent diagnosis. In patients with GERD&LPR, the total reflux time and the percentage of reflux time in the laryngopharynx are higher than those in the iLPR group. Reflux episodes in the laryngopharynx of patients with GERD&LPR may be derived from GERD.
What Is the Impact of Prior Authorization on the Incidence of Pediatric Tonsillectomy?
Authors: Torrecillas Vanessa F. , Neuberger Kaden , Ramirez Alexander , Krakovitz Paul , Meier Jeremy D.
Published: November 2020

Objective

Third‐party payers advocate for prior authorization (PA) to reduce overutilization of health care resources. The impact of PA in elective surgery is understudied, especially in cases where evidence‐based clinical practice guidelines define operative candidacy. The objective of this study is to investigate the impact of PA on the incidence of pediatric tonsillectomy.

Study Design

Cross‐sectional study.

Setting

Health claims database from a third‐party payer.

Methods

Any pediatric patient who had evaluation for tonsillectomy from 2016 to 2019 was eligible for inclusion. A time series analysis was used to evaluate the change in incidence of tonsillectomy before and after PA. Lag time from consultation to surgery before and after PA was compared with segmented regression.

Results

A total of 10,047 tonsillectomy claims met inclusion and exclusion criteria. Female patients made up 51% of claims, and the mean age was 7.9 years. Just 1.5% of claims were denied after PA implementation. There was no change in the incidence of tonsillectomy for all plan types (P =. 1). Increased lag time from consultation to surgery was noted immediately after PA implementation by 2.38 days (95% CI, 0.23‐4.54; P =. 030); otherwise, there was no significant change over time (P =. 98).

Conclusion

A modest number of tonsillectomy claims were denied approval after implementation of PA. The value of PA for pediatric tonsillectomy is questionable, as it did not result in decreased incidence of tonsillectomy in this cohort.
Organizational Transformation to Improve Breast Cancer Screening Behaviors in Iranian Women: A Qualitative Study
Authors: Safizadeh Hossein , Mangolian Shahrbabaki Parvin , Hafezpour Sara
Published: November 2020

Breast cancer is the most common cause of premature mortality among women, and screening is one of the most important means of early diagnosis of breast cancer. This qualitative study was conducted to explore strategies for promoting breast cancer screening behaviors from the perspective of health volunteers in south-east Iran. Data collection was performed through focus groups. Using the purposive sampling method, 35 participants were selected and data were analyzed using a specific qualitative content analysis framework. By analyzing the data to provide strategies for promoting breast cancer screening behaviors, the main theme of “organizational transformation” with five subthemes including the promotion of health-centered beliefs in society, the development of culture-based training, the media revolution, financial support, and the provision of efficient health-care providers were extracted. According to the results of the study, the development of organizational transformation plays an important role in planning for the promotion of breast cancer screening.
Metachronous double primary neuroendocrine tumors in larynx and lung: a case report
Authors: Song In Hye , Lee Youn Soo , Sun Dong-Il , Hong Yong-Kil , Lee Kyo-Young
Published: November 2020

When a patient harbors two or more neuroendocrine tumors (NETs), it can be difficult to determine whether they are double primary tumors or metastases. A 60-year-old man complained of voice change lasting 1 month. On physical examination and imaging, a 1.8-cm mass was observed in his epiglottis, and a laser epiglottectomy was performed. Upon microscopic examination, the tumor consisted of medium-sized ovoid or short spindle cells. Immunohistochemical staining of the tumor cells was positive for synaptophysin, chromogranin, and calcitonin but negative for CD56; the Ki-67 proliferation index was approximately 5%. The patient was diagnosed with atypical carcinoid tumor. In 2015, a hypermetabolic endobronchial tumor was identified in the left lower lobe by positron emission tomography-computed tomography. Bronchoscopic biopsy revealed palisading large tumor cells with high nuclear-cytoplasmic ratio, frequent mitoses, and necrosis. The tumor cells were positive for CD56 and negative for cytokeratin-7, thyroid transcription factor-1, P40, synaptophysin, chromogranin, and calcitonin; the Ki-67 proliferation index was approximately 90%. Overall histologic findings were consistent with large cell neuroendocrine carcinoma rather than metastatic atypical carcinoid tumor. Detailed clinical and pathological review are essential to differentiate between metastatic NET and double primary NETs and, therefore, to provide the best management of the patient.
Perioperative shared decision-making in the Bay of Plenty, New Zealand: Audit results from a complex decision pathway quality improvement initiative using a structured communication tool
Authors: Omundsen Heidi C , Franklin Renee L , Higson Vicki L , Omundsen Mark S , Rossaak Jeremy I
Published: November 2020

Patients presenting for elective surgery in the Bay of Plenty area in New Zealand are increasingly elderly with significant medical comorbidities. For these patients the risk–benefit balance of undergoing surgery can be complex. We recognised the need for a robust shared decision-making pathway within our perioperative medicine service. We describe the setup of a complex decision pathway within our district health board and report on the audit data from our first 49 patients. The complex decision pathway encourages surgeons to identify high-risk patients who will benefit from shared decision-making, manages input from multiple specialists as needed with excellent communication between those specialists, and provides a patient-centred approach to decision-making using a structured communication tool.
Prevalence and characteristics of Alice in Wonderland Syndrome in adult migraineurs: Perspectives from a tertiary referral headache unit
Authors: Mastria Giulio , Mancini Valentina , Cesare Marco Di , Puma Marta , Alessiani Michele , Petolicchio Barbara , Viganò Alessandro , Piero Vittorio Di
Published: November 2020

Background

Migraine affects how the brain processes sensory information at multiple levels. The aberrant integration of visual and somatosensory stimuli is thought to underlie Alice in Wonderland Syndrome, a disorder often reported as being associated with migraine. However, there is still a lack of knowledge about the epidemiology of this syndrome in migraineurs and the association between Alice in Wonderland Syndrome episodes and migraine attacks. Therefore, we conducted a prospective cohort study to systematically evaluate the prevalence and the clinical features of Alice in Wonderland Syndrome in a large sample of patients with migraine.

Methods

All the patients attending for the first time a tertiary-level headache clinic were consecutively screened for Alice in Wonderland Syndrome symptoms by means of an ad hoc questionnaire and detailed clinical interview, over a period of 1.5 years. Patients experiencing Alice in Wonderland Syndrome symptoms were contacted for a follow-up after 8–12 months.

Results

Two hundred and ten patients were recruited: 40 patients (19%) reported lifetime occurrence of Alice in Wonderland Syndrome, 90% of whom (38/40) had migraine with aura. Thirty-one patients experienced episodes of Alice in Wonderland Syndrome within 1 h from the start of migraine headache. Patients reported either visual or visual and somatosensory symptoms (i.e. somatosensory symptoms never presented alone). We collected the follow-up details of 30 patients with Alice in Wonderland Syndrome, 18 of whom had been prescribed a preventive treatment for migraine. After 8–12 months, 5 of the treated patients reported a decrease, while 13 reported no episodes of Alice in Wonderland Syndrome.

Conclusion

Alice in Wonderland Syndrome prevalence in migraineurs was found to be higher than expected. Alice in Wonderland Syndrome was mostly associated with migraine with aura and tended to occur close to the migraine attack, suggesting the existence of a common pathophysiological mechanism. Patients treated with migraine preventive treatments had a higher chance of decreasing or even resolving Alice in Wonderland Syndrome episodes.
Epileptic Spasms in a Large Hypothalamic Hamartoma Cohort
Authors: Karakas Cemal , Wilfong Angus A. , Riviello James J. , Curry Daniel J. , Ali Irfan
Published: November 2020

Introduction:

Hypothalamic hamartoma is rarely associated with epileptic spasms. We describe epileptic spasms in a large cohort of hypothalamic hamartoma patients.

Methods:

We performed a retrospective chart review between March 2011 and March 2020 to identify patients with hypothalamic hamartoma and epilepsy.

Results:

We identified 114 patients with hypothalamic hamartoma and epilepsy, only 3 male patients (2.6%) also had epileptic spasms. The epileptic spasms developed between 6 and 18 months of age. Epileptic spasms resolved with oral prednisolone in 1 and with vigabatrin in the second patient. The third patient continued epileptic spasms despite multiple antiepileptic drugs and partial resection of hypothalamic hamartoma. All 3 patients underwent laser-ablation of hypothalamic hamartoma at the age of 14, 29, and 63 months. The seizure burden decreased by 100%, 84%, and 93% at follow-up (3-47 months).

Conclusions:

Epileptic spasms are rare in hypothalamic hamartoma patients and early laser-ablation could potentially treat epileptic spasms and all other seizure types associated with hypothalamic hamartoma.
Organizational Ambidexterity in Family-Managed Firms: The Role of Family Involvement in Top Management
Authors: Kammerlander Nadine , Patzelt Holger , Behrens Judith , Röhm Christian
Published: November 2020

Organizational ambidexterity is vital for family firms’ long-term success, yet we still lack sufficient insights into the role of family involvement in top management in this context. Building on research on family firm innovation and diversity, we argue there are curvilinear relationships between family involvement in top management and exploration, exploitation, and organizational ambidexterity. We further propose that these (inverse) U-shaped relationships are affected by family CEOs’ family-centered noneconomic goals. Multisource data on 109 family-managed firms support most of our hypotheses and provide a nuanced understanding of how diversity within top management affects family firms’ innovative behavior.
Biological Behavior of Canine Acanthomatous Ameloblastoma Assessed With Computed Tomography and Histopathology: A Comparative Study
Authors: Goldschmidt Stephanie , Bell Cynthia , Waller Kenneth , Hetzel Scott , Soukup Jason W.
Published: November 2020

Canine acanthomatous ameloblastoma (CAA) appears to have variable biological behavior with some tumors presenting with slow growth and minimal bone loss while others grow rapidly and cause severe cancellous and cortical bone destruction. The primary aim of the study is to elucidate if variations (grades) of CAA can be identified based on both histological and diagnostic imaging indices, and to compare markers of more aggressive behavior between these 2 commonly used diagnostic tools. This study evaluated 45 cases of CAA and confirmed that there is high degree of variability in tumor invasiveness as measured with computed tomography, with predominantly intraosseous tumors being significantly associated with more invasive behavior. However, the analysis also identified that there was very little correlation between computed tomographic and histological appearance of the tumor. CAA tends to have a highly uniform and predictable histological pattern, with tumors that aggressively invade bone (as seen on CT) not showing features of atypia that might be helpful in predicting the biological behavior of the neoplastic cells. Thus, reliance on diagnostic imaging as a measure of biological behavior is recommended for treatment planning as well as possible creation of a variant/grading scheme. Prospective studies are required to evaluate if differing variants of CAA as based on diagnostic imaging should be treated differently, and how this would affect long term clinical outcome.
Layered control of forklift lateral stability based on Takagi–Sugenofuzzy neural network
Authors: Xia Guang , Li Jiacheng , Tang Xiwen , Zhao Linfeng , Sun Baoqun
Published: November 2020

An anti-roll hydraulic cylinder is designed as an executive mechanism of the lateral stability control to provide lateral support force on the basis of an analysis of the structure of the forklift and the mechanism of lateral instability. A lateral stability layered control method based on Takagi–Sugeno (T–S) fuzzy neural network is proposed, divides the forklift lateral stability control into the upper identification layer, the middle control layer and the lower executive layer. Simulation and real vehicle test results indicate that the forklift lateral stability control method based on the T–S fuzzy neural network can effectively identify the forklift driving state, reduce the forklift rollover possibility and improve forklift safety under limited working conditions.
Numerical investigation of wave interactions in an experimental wave-energy converter using OpenFOAM
Authors: Sangtarash Ali , Roohi Ehsan
Published: November 2020

In this paper, OpenFOAM wave generation and active wave absorption boundary conditions were used to simulate wave interaction of a specific experimental wave energy converter (WEC) with equilibrium buoys and two power take-off systems that work in parallel, over a broad range of wave conditions. Two solitary and cnoidal wave generation boundary conditions for three different wave heights were implemented at the inlet to generate waves. The validation phase included a comparison of free-surface with numerical results of solitary and cnoidal waves generation at the flume. To investigate the impact of equilibrium buoys, wave flow around the wave energy converter was simulated for two cases. In the first case, WEC was considered as a single box, and in the second, two equilibrium buoys were added to the WEC. By comparison of these two cases, we discovered that although equilibrium buoys decrease the horizontal force on the main box, they cause the production of two efficient vertical forces. One of these forces moves the front equilibrium buoy generating electricity individually from the main box mechanism, and the other vertical force is applied to the back equilibrium buoy accelerating the rotation of the main box. Overall, wave energy absorption is enhanced by using the equilibrium buoys.
The International Criminal Trial as a Site for Contesting Historical and Political Narratives: The Case of Dominic Ongwen
Authors: Hassellind Filip Strandberg
Published: November 2020

This paper considers how the international criminal trial emerges as a site for contesting historical and political narratives, and how the proceedings against Dominic Ongwen in the International Criminal Court gives us yet another opportunity to do so. It focuses on how the criminal trial appears to reinforce the hegemony of some contested historical narratives over others in attempting to deal with the past. It is suggested that the conflict in Uganda as well as what is currently happening in the Ongwen trial cannot be understood in isolation from, on the one hand, interregional and factional struggles within the Ugandan territory and, on the other hand, a postcolonial logic. Departing from this nexus, the paper introduces, discusses, and analyzes the strategy of rupture as developed by Jacques Vergès. By scrutinizing the legal strategies employed by Ongwen and his defense team, the paper argues that their strategies demonstrate the ways in which historical and political narratives are susceptible to ‘rupture’ by counternarratives put forth by defendants who refuse to play their part in the global justice drama by pointing to the struggle for larger contextual issues. In the setting of the Ongwen trial, this paper argues that by tapping into the victim-perpetrator narrative, Ongwen’s defense team are, wittingly or unwittingly, ‘rupturing’ the binaries in international criminal law. The paper concludes by arguing that the Court may need to find a new approach to ‘courtroom historiography’ if it is going to survive, either with or without the Global South.
Hindered phenolic antioxidants as heat-oxygen stabilizers for HDPE
Authors: Wang Yuru , Ren He , Yan Yibin , He Shuyan , Wu Shuang , Zhao Qian
Published: November 2020

The effects of four hindered phenolic antioxidants in the short-term heat-oxygen stability of High-Density Polyethylene (HDPE) was evaluated by the Melt Flow Rate (MFR) and Oxidation Induction Time (OIT) analyses. The results showed that Irganox 1330 and Irganox 1010 had more excellent processing property and oxidation resistance behavior in HDPE than Irganox 1024 and Irganox 3114. The OIT values of HDPE with Irganox 1330 and Irganox 1010 were up to 97.25 min and 89.73 min respectively. The long-term accelerated heat-oxygen stability tests of HDPE containing hindered phenolic antioxidants were carried out at 110°C in deionized water pressurized with pure oxygen at a pressure of 10 MPa. The characterization of the long-term heat-oxygen stability was performed by Fourier Transform Infrared (FTIR), Differential Scanning Calorimetry (DSC) and tensile testing. However, the results exhibited that the aging resistance of HDPE containing Irganox 1010 was inferior to that of HDPE containing Irganox 1024 and Irganox 3114, which is quite contrary to their short-term effect on HDPE stabilization. It may be speculated that the ester groups of Irganox 1010 undergo hydrolysis during the long-term heat-oxygen stability tests, leading to the formation of 3-(3,5-ditert-butyl-4-hydroxy-phenyl) propanoic acid and pentaerythritol.
Mapping the entertainment ecosystem of Wattpad: Platforms, publishing and adaptation
Authors: Parnell Claire
Published: November 2020

Digital platforms have reshaped the creative industries and restructured relationships between media sectors. Creative writing and reading social media platforms like Wattpad are challenging what it means to publish fiction in the early 21st century, and digital streaming platforms like Netflix, Hulu and others have begun looking to these platforms to source creative content for adaptation. Praxis on creative writing social media platforms is shaped by a complex and ongoing interplay between the technocultural and socio-economic conditions of platforms and their users. This article argues for an integration of publishing studies and platform studies by applying a media ecology framework to map behaviour on Wattpad, one of the largest creative writing social media platforms, and the relationships it has developed with other media companies. Specifically, it draws on and extends José van Dijck’s ((2013) The Culture of Connectivity: A Critical History of Social Media. New York, NY: Oxford University Press.) microsystem/ecosystem connective media model and proposes a broader conceptualisation of the entertainment ecosystem that incorporates adaptation of content across the book publishing and entertainment media sectors. Mapping these platforms alongside legacy media and publishing companies offers a productive framework for theorising contemporary entertainment media production within the platform media landscape.
An EU minimum wage target for adequate in-work incomes?
Authors: Marchal Sarah
Published: November 2020

This article summarises the arguments in favour of an EU initiative on minimum wages and highlights the steps that have been taken so far, focusing, in particular, on the First Stage consultation document prepared by the European Commission. Based on this consultation document and previous proposals, this article assesses some of the issues related to promoting an EU target minimum wage as a percentage of a national reference wage. Focusing on the adequacy of minimum wages for workers and their families, this article highlights first, the impact rather technical issues relating to the definition of the reference wage may have, and second, the importance of considering the interaction of the minimum wage with the broader tax benefit system in ensuring adequate in-work incomes. Whereas an EU initiative on minimum wages certainly has merit, these two caveats illustrate the need for a clear definition of what one wants to achieve by this initiative, and indicate that specific goals will require additional accompanying measures, such as a further monitoring of the net incomes of minimum wage earners
He's frequency–amplitude formulation for nonlinear oscillators using Jacobi elliptic functions
Authors: Elías-Zúñiga Alex , Palacios-Pineda Luis Manuel , Jiménez-Cedeño Isaac H , Martínez-Romero Oscar , Trejo Daniel Olvera
Published: November 2020

In this work, the Duffing’s type analytical frequency–amplitude relationship for nonlinear oscillators is derived by using Hés formulation and Jacobi elliptic functions. Comparison of the numerical results obtained from the derived analytical expression using Jacobi elliptic functions with respect to the exact ones is performed by considering weak and strong Duffing’s nonlinear oscillators.
College disability support offices as advertisements: A multimodal discourse analysis
Authors: Kim So Yoon
Published: November 2020

This study examined the disability support offices (DSOs) websites of twelve US higher education institutions (HEIs) anchored in multimodal discourse analysis and genre analysis to examine how semiotic resources are deployed to describe DSO services on their websites and to determine the discursive functions of advertisement they perform. The DSO websites were within four clicks from HEI homepages but had inconsistent navigation paths, making it difficult to reach DSO websites. DSO websites were foregrounding promoting and branding the institutions rather than presenting the information about the services offered. This is achieved by using multimodal promotional rhetoric such as: (a) situating accessibility as central commodifiable attribute, (b) promoting the value of accessibility, (c) establishing the superiority of the institution, (d) constructing images of students with disabilities as empowered but dependent upon the DSO, and (e) situating students within a college community. Implications for DSO websites functioning as advertisements are also discussed.
Countermeasure and therapeutic: A(1–7) to treat acute respiratory distress syndrome due to COVID-19 infection
Authors: Soto Maira , diZerega Gere , Rodgers Kathleen E
Published: November 2020

In the wake of the COVID-19 pandemic it has become clear that there is a need for therapies that are capable of reducing damage caused to patients from infections. Infections that induce Acute Respiratory Distress Syndrome (ARDS) are especially devastating because lung damage is so critical and difficult to manage. Angiotensin (1–7) [A(1–7)] has already been shown to protect pulmonary health and architecture in various models of disease. There is also evidence that A(1–7) can modulate immune function and protect various organs (lung, kidney, and heart) from oxidative damage and inflammation. Here we focus on making a case for the development of novel therapies that target the protective arm of the Renin Angiotensin System (RAS).
Thermo-catalytic degradation of different consumer plastic wastes by zeolite a catalyst: A kinetic approach
Authors: Patnaik Sthitapragyan , Barick Aruna Kumar , Panda Achyut K
Published: November 2020

This research work includes the effect of Zeolite-A catalyst on the thermal degradation behavior of six different consumer plastic wastes like high density polyethylene (HDPE), polypropylene (PP), polyethylene terephthalate (PET), polymethylene methacralate (PMMA), polystyrene (PS) and polytetrafluoro ethylene (PTFE) through kinetic approach by using thermogravimetric analysis (TGA) data. Kinetic parameters such as reaction order, activation energy, and Arrhenius constant for the degradation of different waste plastics is determined using model fitting Coats–Redfern method. All the plastics show one-step degradation in the temperature range of 300–600°C. There is a significant decrease in activation energy (Ea) for the thermo-catalytic decomposition of the plastics in presence of Zeolite A catalyst. The extent of catalytic effect is found different for different plastics in the order of HDPE < PP < PS < PET < PMMA < PTFE. The order of the thermal degradation reaction is also found different for different types of plastics. The order of the reaction is altered in case of PET, PS and PTFE in presence of the catalyst but it is unaffected in case of remaining plastics. This treatment would reduce the energy consumption of pyrolysis process and also make the process economical viable.
Evaluation of Cognitive Skill Degradation in Flight Planning
Authors: Volz Katherine M. , Dorneich Michael C.
Published: November 2020

This work aimed to identify cognitive skills associated with flight planning, suggest which skills might be susceptible to skill degradation, and investigate the effects of cognitive skill degradation over time. Information automation systems offload cognitive tasks to reduce workload and error. However, the same phenomena seen with physical skill degradation in highly automated aircrafts may also occur when automating cognitive tasks. Two studies were conducted. An applied cognitive task analysis identified cognitive skills in flight planning. An empirical evaluation examined whether some of those skills were susceptible to cognitive skill degradation over time when using automation. Participants were placed into three groups. After conducting a flight planning task manually, groups differed in the next three practice trials: manual, alternating between manual and automation, or only with automation. Finally, all groups conducted the task manually again. Trials were separated by 2 weeks. The automation group showed the most performance degradation and highest workload, while the manual group showed the least performance degradation and least workload. Automation use did not provide the practice needed to mitigate cognitive skill degradation. Analysis of the impacts of information automation on cognitive performance is a first step in understanding the root causes of errors and developing mitigations.
Rotational atherectomy with adjunctive balloon angioplasty in calcified chronic total occlusions of superficial femoral artery
Authors: Engin Aysen Y , Saydam Onur
Published: November 2020

Objectives

The aim was to report the mid-term outcomes of Jetstream™ rotational atherectomy device in complex femoropopliteal lesions.

Methods

Between November 2016 and April 2018, 55 patients who were treated with rotational atherectomy and adjunctive balloon angioplasty due to complex femoropopliteal lesions were retrospectively scanned.

Results

Fifty-five patients who underwent endovascular treatment with rotational atherectomy for chronic total occlusive femoropopliteal lesions were included in the study. Technical success rate was 100%. The mean age was 63 (±10.5) years. The cohort included 25 (45.4%) diabetics and 45 (81.8%) current smokers. The mean length of the lesions was 20.8 ± 11.2 cm. Chronic total occlusive lesions were detected in 35 (63.6%) patients, and mixed-type steno-occlusive lesions were detected in 20 patients (36.4%). Thirty-three (60%) lesions were moderate or severely calcified. Adjunctive balloon angioplasty was performed with plain old balloon angioplasty (POBA) on 31 (56.4%) patients and with drug-coated balloon angioplasty on 24 (43.6%) patients. After adjunctive balloon angioplasty, flow limiting dissection was observed in 20 (36.3%) patients, and 17 (30.9%) patients needed stent implantation. The Kaplan–Meier analysis method estimated that the overall primary patency rates at 12 and 24 months were 81.8% and 70.9%, respectively. Overall, secondary patency rates at 12 and 24 months were 94.5% and 80%. No statistically significant differences of 24-month primary patency and secondary patency rates were found between patients treated with drug-coated balloon angioplasty and POBA as an adjunctive therapy, even though primary patency (83.3% vs. 61.3%, p = .06) and secondary patency (91.7% vs. 71%, p = .56) rates of drug-coated balloon angioplasty were slightly higher than POBA. Patients with claudication had better primary patency (90.5% vs. 58.8%, p = .001) and secondary patency (100% vs. 67.6%, p = .004) rates than patients with critical limb ischemia at 24 months. Significant differences between patients who did and did not stop smoking were found in 24-month primary patency (57% vs. 88%, p = .007) and secondary patency (67% vs. 96%, p = .007). Six patients underwent unplanned amputation. There were eight (14.5%) mortalities during follow-up.

Conclusions

Rotational atherectomy with adjunctive balloon angioplasty has satisfactory technical success rates and mid-term outcomes. As an adjunctive method, there was no difference between drug-coated balloon angioplasty s and POBAs. Smoking cessation is always the first-step treatment to improve mid-term patency results. Patients with critical limb ischemia have worse patency results compared to the patients with claudication.
The use of nebulized pharmacotherapies during the COVID-19 pandemic
Authors: Sethi Sanjay , Barjaktarevic Igor Z. , Tashkin Donald P.
Published: November 2020

Coronavirus disease 2019 (COVID-19), caused by the highly contagious novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has resulted in a worldwide pandemic and currently represents a major public health issue. COVID-19 has highlighted the need for clear and accurate guidance on the use of aerosol-generating procedures, such as nebulization, for the treatment of patients with respiratory diseases with or without COVID-19. Despite the lack of evidence, there is heightened concern about the potential risk of transmission of SARS-CoV-2 in the form of aerosolized respiratory droplets during the nebulized treatment of patients with COVID-19. Consequently, the use of metered-dose inhalers (MDIs) has risen considerably as an alternative to nebulized therapy, which has led to inadequate supplies of MDIs in some parts of the United States. In this article, we review and discuss the role of nebulization in patients with SARS-CoV-2 and the treatment of noninfected patients with chronic respiratory diseases. The following two important questions are addressed: (1) should nebulized therapy be used in hospital or home settings by patients infected with SARS-CoV-2; and (2) should nebulized therapy be continued in patients already using it for chronic respiratory disease management in hospital or home settings?

The reviews of this paper are available via the supplemental material section.
Morphological and immunohistochemical approaches to the diagnosis of Hashimoto thyroiditis and mucosa associated lymphoid tissue lymphomas: An audit
Authors: Rency Koshy , Santha Sadasivan , Dain Chacko Pearl
Published: November 2020

Most cases of autoimmune hypothyroidism are due to Hashimoto thyroiditis (HT). It is sometimes difficult to distinguish HT from mucosa associated lymphoid tissue (MALT) lymphoma using cytology or histology alone. This has necessitated the use of immunohistochemistry and other molecular techniques. A descriptive study was undertaken to determine the prevalence of MALT lymphoma and other associations of HT using histopathological and immunohistochemical methods. For testing of kappa and lambda antibodies, paraffin sections were prepared for immunohistochemical staining using a peroxidase-antiperoxidase immune complex method. Immunostaining in HT, demonstrated a polyclonal lymphoid population, as evidenced by dual positivity for kappa and lambda staining cells, whereas MALT lymphoma revealed a monoclonal lymphoid population, with strong positivity for kappa immunostaining and lack of lambda light chain expression. The proportion of MALT lymphoma in surgically treated cases of HT in the present study was 3.5% (95% CI: 0%–8.3%). The common malignancy associated with HT was papillary carcinoma of the thyroid (8.8%). Among the benign conditions, nodular colloid goiter (7%) was more commonly associated. Although modern molecular techniques are available for the confirmation of lymphomas, they are more expensive, time consuming and are available only in a few centers. Strict morphological criteria can differentiate HT from MALT lymphoma, but in suspicious cases, paraffin section immunohistochemistry using light chain restriction can offer comparable and reliable results. Since papillary carcinoma and MALT lymphoma have been associated with HT, these patients require careful surveillance.
Cultivating hope in the Christian university classroom
Authors: Kits Gerda J , Berkenbosch Roy , Moyer Joanne M
Published: November 2020

Today’s postsecondary students struggle with increasing depression and anxiety, in part influenced by the troubling state of the world. Our students desperately need hope; yet, too often, their university classes diminish rather than increase hope. A key role of the Christian educator is to teach students to live in biblical hope, rooted in the transformational work of God in human history. Drawing on the work of diverse scholars and educators, this article lays out a theological framework for hope and uses it to outline orientations and practices for the classroom that equip students to live faithfully into that hope.