bluuebunny/crossref_metadata_2025 huggingface dataset:
Clonidine as an Adjuvant to Bupivacaine for Suprazygomatic Maxillary Nerve Blocks in Cleft lip and Palate Repair: A Randomized, Prospective, Double-Blind Study
Authors: Barbero Gaston Echaniz , de Miguel Marcos , Sierra Plinio , Merritt Glenn , Bora Pranjal , Borah Nabamallika , Ciarallo Christopher , Ing Richard , Bosenberg Adrian , de Nadal Miriam
Published: October 2020

Objectives:

Does clonidine, as adjuvant to bupivacaine for suprazygomatic maxillary nerve blocks, reduce emergence agitation in patients undergoing cleft lip and cleft palate surgery?

Design:

Randomized, controlled, and double-blind study.

Setting:

Guwahati Comprehensive Cleft Care Center, Guwahati (Assam, India).

Participants:

A total of 124 patients; with a median age of 5 years in the clonidine group (CLG) and 7 years in the control group (CG), who underwent cleft lip or cleft palate surgery were included. Exclusion criteria included lack of consent from patients or their guardians, allergy to local anesthetics, coagulation disorders, local infection at the puncture site before performing the block, and language difficulties or cognitive disorders.

Interventions:

Patients were randomized into 2 groups to receive bilateral suprazygomatic maxillary nerve blocks with either a bupivacaine/clonidine mixture for the CLG or bupivacaine alone in the CG.

Main Outcome Measure:

The primary end point was the incidence of emergence agitation.

Results:

There was a statistically significant difference in the incidence of emergence agitation (30.2% in the CG compared to 15.2% in the CLG; difference of incidences: 15%, 95% CI: 0.1-30.1). The percentage of patients requiring intraoperative Fentanyl was lower in the CLG (10.6% compared to 26.4%; difference of incidences: 15.8%, 95% CI: 1.8-29). No other differences were observed. Further research in a more typically aged children population undergoing cleft surgery is needed.

Conclusions:

The use of clonidine as an adjuvant to bupivacaine in maxillary nerve block reduces the incidence of emergence agitation and intraoperative opioid consumption without hemodynamic or sedative side effects in patients undergoing cleft lip and palate surgery.
Interstitial nephritis with pembrolizumab: A case report and review
Authors: Peláez Bejarano A , Montero Pérez O , Inoriza Rueda A , Garrido Martínez MT
Published: October 2020

Introduction

Pembrolizumab is a monoclonal antibody approved for adult patients with advanced non–small-cell lung cancer (NSCLC). Although immune related adverse events are considered to be well tolerated, complications may occur and discontinuation of the treatment could be required.

Case report

A 62-year old patient diagnosed with advanced non-small cell lung cancer experienced a decline in the renal function after seven cycles with pembrolizumab. Management & outcome: After ruling out other common causes of interstitial nephritis, pembrolizumab was attributed as a cause of interstitial nephritis. At first, toxicity was managed with corticosteroids and closely monitoring the patient, but finally pembrolizumab had to be discontinued due to the kidney function did not recover.

Discussion

Renal and urinary disorders were reported in <3% of patients treated with pembrolizumab, being interstitial nephritis the most reported toxicity. The kidney damage can be a complication to consider in patients receiving pembrolizumab. Early identification of an increase in serum creatinine levels may help with prevention by establishing an effective treatment, although it may not mean a total recovery of kidney function.
An exploration of mercaptopurine/methotrexate tolerance during maintenance therapy in children with acute lymphoblastic leukemia
Authors: Whiley AC , Price V , MacDonald T
Published: October 2020

Purpose

Mercaptopurine (6MP) and methotrexate (MTX) cause myelosuppression and interruptions in therapy in children with lymphoblastic leukemia (ALL). Length of time off of therapy is related to poorer outcomes. To date the dose at which most children tolerate these agents without drops in blood counts has not been identified. This study attempts to determine the maximum tolerated dose of both 6MP/MTX.

Methods

A retrospective chart review of 77 ALL children, median age 4.5 years. Time to first interruption and dose, along with total number of interruptions were collected. Absolute neutrophil and platelet counts recorded at time of interruption. Subgroup analysis of age, sex, diagnosis and risk stratification were also completed. REB approval was gained.

Results

Of the 77 patients that were studied, 9 of them had no treatment interruptions. Descriptive statistics are reported using Strata software. The mean number of interruptions during maintenance was 3.2, the mean time to first interruption was 149.8 days. The mean dose percent of MTX and 6MP at first interruption was 94.4% and 106% respectively. Maintenance therapy was interrupted independent of age, sex, diagnosis or disease risk stratification.

Conclusion

Few patients complete maintenance therapy without interruptions at the current dose escalation schedules outlined by the Children’s Oncology Group protocols. The interruptions are due in part to intolerance of dose escalations of MTX and 6 MP above 100%. Future research should investigate doses of 6MP and MTX in maintenance therapy in relation to leukemia outcomes.
Programmed death-1 or programmed death ligand-1 inhibitors? A meta-analysis of differential efficacy as compared to chemotherapy in advanced non-small cell lung cancer
Authors: Bozcuk Hakan , Artaç Mehmet , Mutlu Hasan , Sever Özlem , Yıldırım Mustafa
Published: October 2020

Background

Programmed Death-1 (PD-1) and Programmed Death Ligand-1 (PDL-1) inhibitors have improved survival over chemotherapy in advanced Non- Small Cell Lung Cancer (NSCLC). However, it is unclear if there are class specific differences in the efficacy of Checkpoint Inhibitors (CPIs) in NSCLC, and this paper is designed to answer these clinical questions.

Methods

For this Meta-analysis, we searched PubMed, Science of Web, “Clinicaltrials.gov” and online sources for trials comparing PD-1 and PDL-1 CPIs in advanced NSCLC. The data for Hazard Ratio (HR) and their Confidence Intervals (CI) for Overall Survival (OS) was extracted.

Results

A sum of 9739 patients from 16 trials were included in the efficacy evaluation. For the OS endpoint, both PD-1 inhibitors (HR = 0.76, 95%CI = 0.69–0.83, P < 0.001) and PDL-1 inhibitors (HR = 0.84, 95%CI = 0.74–0.95, P < 0.001) were superior to chemotherapy in treatment naïve (upfront) patients, the results were similar in treatment refractory patients (PD-1 inhibitors (HR = 0.67, 95%CI = 0.60–0.75, P < 0.001) and PDL-1 inhibitors (HR = 0.78, 95%CI = 0.69–0.88, P < 0.001) were superior to chemotherapy). There was no difference in the effect of PD-1 and PDL-1 classes of CPIs over chemotherapy in treatment naïve and treatment refractory settings (Q = 1.88, df = 1, P = 0.017, and, Q = 3.27, df = 1, P = 0.070, respectively).

Conclusion

Efficacy of PD-1 and PDL-1 class of CPIs was not different, although differences among individual CPIs or their combinations cannot be excluded. We were also able to compute pooled efficacy data, as compared to chemotherapy alone, for trials where these groups of CPIs were utilized.
Stabilisation of betalains and phenolic compounds extracted from red cactus pear (Opuntia ficus-indica) by spray and freeze-drying using oca (Oxalis tuberosa) starch as drying aid
Authors: Morales Noelia X. Cruz , Gómez Katherine Ysabel Villa , Schweiggert Ralf Martin , Delgado Grethel Teresa Choque
Published: October 2020

The objective of this work was to evaluate the stabilisation of betalains and phenolic compounds extracted from red cactus pear by spray and freeze-drying. After hydroethanolic extraction and partial solvent removal under reduced pressure, the highly coloured extracts were enriched with oca starch and maltodextrin as drying aids in different ratios (100:0, 70:30, and 50:50, oca starch: maltodextrin) prior to spray and freeze-drying. The obtained microencapsulated extract powders were characterised by moisture content, hygroscopicity, solubility and morphology. In addition, the stability of the encapsulated betalains and phenolics was evaluated during storage at room temperature for 105 days. All microcapsules showed high retentions of betacyanins (69.9–86.5% after 105 days), betaxanthins (72.2–81.9%), phenolic compounds (46.5–63.5%) and antioxidant capacity (60.1–64.9%, FRAP method; 49.7–57.5%, ABTS method). The system with 70:30 starch:maltodextrin ratio as drying aids showed the highest values of retention regarding the polyphenol content (63.5%), antioxidant capacity (64.9% to FRAP method) and betacyanin content (86.5%), as well as a low degradation rate constant of betacyanins (1.23 × 10−3 days−1) and a long half-life (563 days). Oca starch used alone or in combination with maltodextrin has been shown to work adequately as a microencapsulating agent and stabilizer of pigments and antioxidants derived from red cactus pear.
A CUDA fast multipole method with highly efficient M2L far field evaluation
Authors: Kohnke Bartosz , Kutzner Carsten , Beckmann Andreas , Lube Gert , Kabadshow Ivo , Dachsel Holger , Grubmüller Helmut
Published: October 2020

Solving an N-body problem, electrostatic or gravitational, is a crucial task and the main computational bottleneck in many scientific applications. Its direct solution is an ubiquitous showcase example for the compute power of graphics processing units (GPUs). However, the naïve pairwise summation has [Formula: see text] computational complexity. The fast multipole method (FMM) can reduce runtime and complexity to [Formula: see text] for any specified precision. Here, we present a CUDA-accelerated, C++ FMM implementation for multi particle systems with [Formula: see text] potential that are found, e.g. in biomolecular simulations. The algorithm involves several operators to exchange information in an octree data structure. We focus on the Multipole-to-Local (M2L) operator, as its runtime is limiting for the overall performance. We propose, implement and benchmark three different M2L parallelization approaches. Approach (1) utilizes Unified Memory to minimize programming and porting efforts. It achieves decent speedups for only little implementation work. Approach (2) employs CUDA Dynamic Parallelism to significantly improve performance for high approximation accuracies. The presorted list-based approach (3) fits periodic boundary conditions particularly well. It exploits FMM operator symmetries to minimize both memory access and the number of complex multiplications. The result is a compute-bound implementation, i.e. performance is limited by arithmetic operations rather than by memory accesses. The complete CUDA parallelized FMM is incorporated within the GROMACS molecular dynamics package as an alternative Coulomb solver.
Sedative effects of acepromazine in combination with nalbuphine or butorphanol, intramuscularly or intravenously, in healthy cats: a randomized, blinded clinical trial
Authors: Costa Gabriela P , Monteiro Eduardo R , Marques Éder J , Beck Rafael C , Carneiro Rafael K , da Costa Fernanda VA , Valle Stella F
Published: October 2020

Objectives

The aim of this study was to compare the sedative effects in cats administered acepromazine–nalbuphine and acepromazine–butorphanol, intramuscularly (IM) and intravenously (IV), and the occurrence of adverse cardiorespiratory effects.

Methods

Forty-six cats were randomly divided into four groups and administered acepromazine (0.05 mg/kg) combined with nalbuphine (0.5 mg/kg) or butorphanol (0.4 mg/kg), IV (ACP-NALIV and ACP-BUTIV groups, respectively) or IM (ACP-NALIM and ACP-BUTIM groups, respectively). Sedation scores, ease of intravenous catheter placement (simple descriptive scale [SDS] scores), physiologic variables, venous blood gases and the propofol dose required for anesthetic induction were recorded.

Results

Mild sedation was observed in all groups approximately 30 mins after treatment administration (timepoint T1, prior to propofol administration). Sedation scores at T1 increased above baseline in all groups ( P <0.05), but no significant difference was observed among groups. Dynamic interactive visual analogue scale sedation scores (range 0–100 mm) recorded at T1 were (median [interquartile range]): ACP-NALIM, 12 (10–12); ACP-NALIV, 11 (6–16); ACP-BUTIM, 11 (7–14); and ACP-BUTIV, 12 (7–19). Overall, SDS scores did not change from baseline at T1 and there was no significant difference among groups. The propofol dose did not differ among groups. Blood gases remained within the reference intervals for cats. Significant decreases from baseline were detected for all groups in systolic arterial pressure (SAP). Mean ± SD values at T1 were (mmHg): ACP-NALIM, 108 ± 13; ACP-NALIV, 102 ± 10; ACP-BUTIM, 97 ± 13; and ACP-BUTIV, 98 ± 21. Arterial hypotension (SAP <90 mmHg) was recorded at T1 in 0/11, 1/13, 4/11 and 5/11 cats in groups ACP-NALIM, ACP-NALIV, ACP-BUTIM and ACP-BUTIV, respectively, and was further exacerbated after the induction of anesthesia with propofol.

Conclusions and relevance

In healthy cats administered acepromazine–nalbuphine and acepromazine–butorphanol, IM and IV, the degree of sedation was mild regardless of the protocol and the route of administration. The main adverse effect observed was a reduction in arterial blood pressure.
Deep gluteal space anatomy and its relationship with deep gluteal pain syndromes
Authors: Leite Maria J , Pinho André R , Silva Miguel R , Lixa João C , Madeira Maria D , Pereira Pedro G
Published: October 2020

Introduction:

Increasing interest has been seen in understanding the anatomy and biomechanics involved in the Deep Gluteal Syndrome, therefore the main objective of our paper was to define the anatomy of the deep gluteal space concerning the important osseous, muscular and neurological structures.

Methods:

12 cadaveric models (24 hemipelvises) were used. We proceeded with classical anatomic dissection and evaluated numerous osseous, musculotendinous and neurologic structures and their relationships. We also determined the femoral anteversion and neck-shaft angles.

Results:

We found that 15.4% of lower limbs examined presented variations in the sciatic nerve (SN) emergence, and this was significantly longer in men. The distance from the SN to the trochanteric region was also significantly lower in males. The average ischiofemoral distance (IFD) was 2.5 ± 1.3 cm, at the same time that the structures comprised in that space showed superior areas, such as the quadratus femoris (QF) with 5.0 ± 1.1 cm and the SN with 1.4 ± 0.3 cm widths. Besides that, we also evaluated the distance from the SN to the lesser trochanter (LT) and the ischial tuberosity (IT), in the ischiofemoral space, reaching average values of 1.1 ± 0.7 cm and 1.5 ± 0.6 cm respectively. Regarding the relationship between the proximal hamstring insertion, we verified that the LT was at an average distance of 1.6 ± 1.1 cm, that the SN was only 0.2 ± 0.3 cm lateral to it, and the PN is just 2.6 ± 1.2 cm proximal to it.

Conclusions:

Our study confirmed the extreme variation in the SN origin that can contribute to the Piriformis syndrome. The IFD obtained in our study showed that this distance was small for the structures contained in this space. The proximal hamstring insertion showed a significantly more extended footprint in males, which puts the pudendal nerve (PN) at higher risk of iatrogenic injury.
China’s human rights foreign policy in the Xi Jinping era: Normative revisionism shrouded in discursive moderation
Authors: Chen Titus C , Hsu Chiahao
Published: October 2020

This article applies mixed methods to examine if PRC leadership change in 2012 – from the Hu Jintao government to the Xi Jinping administration – has led to significant changes in China’s international human rights policy. Empirical analyses characterise a discursively moderate China whose international human rights statements in the Xi-era are no more contentious than during Hu Jintao’s time. Despite its communicative moderation, Xi’s China is found to have pursued an agenda of international human rights policy that is more ambitious and revisionist than before. China under Xi’s rule is no longer content with passively defending its human rights governance model but has actively promoted this model internationally. The Xi Jinping administration has undertaken to market its illiberal model of national development as the new universal framework for the international human rights system. By doing so, Xi’s China is bound to undermine the liberal foundation of international human rights norms.
An ontology of off-task behavior in a number activity: The body, space-time, and mathematics
Authors: Chen Lin
Published: October 2020

This article aims to interrogate the Cartesian rationality determining current early childhood mathematics by highlighting the irrational aspect of mathematics learning, which is usually underemphasized and even devalued by the dominant discourse. Using Deleuze and Guattari’s concept of refrain as the method, the article explores the unfolding emergence of a child’s off-task behavior in a number activity as it conceptualizes the child’s body in relation to its surroundings. The article also explores how this conceptualization of off-task behavior helps to rethink mathematical ability and conceptual construction in responding to and elaborating on research on embodied mathematics. Based on these explorations, the article hopes to contribute a strategy for the vision of adopting a more democratic manner in mathematics learning.
Effective elastic modulus of foamed long glass fiber reinforced polypropylene: Experiment and computation
Authors: Cai Liya , Zhao Kegang , Huang Xiangdong , Ye Jie , Zhao Yong
Published: October 2020

The cross-section of an injection-molded plate of foamed long glass fiber reinforced polypropylene was analyzed using scanning electron microscopy. The distribution of the glass fiber orientations and the microcellular structure in the thickness direction were also studied. A multilayer representative volume element was constructed based on the fiber orientation tensors and the cell distribution. Nested and two-step homogenization methods based on the Mori–Tanaka and Voigt models were used to homogenize each layer of the representative volume element. Finally, classic laminate theory was used to obtain the effective elastic modulus of the material. The computed elastic moduli of the single-layer and multilayer representative volume element models with different loading directions predicted by the homogenization and finite element methods were compared with the experimental results. We found that the constructed multilayer representative volume element model can predict the elastic moduli of the foamed glass fiber reinforced polypropylene effectively and that the predicted results were accurate and stable.
Tourists’ perceptions of green building design and their intention of staying in green hotel
Authors: Hou Huiying (Cynthia) , Wu Hao
Published: October 2020

Hotel developers incorporate green building design to save on capital and operation cost. Hotel operators adopt green practice to affect tourists’ intention of staying (IoS). This paper recognises the important contribution of green building design and eco-service provision to green hotels. It investigates the internal relationships of tourists’ environmental concern (EC), their perceived importance of green building design (PIGBD) and their IoS in green hotels. A moderating regression analysis was adopted to validate the proposed tourists behavioural pattern based on a survey sample of 161 tourists from Hong Kong. The results reveal tourists’ EC positively affects their IoS, and their PIGBD is proved to be a moderating factor of the EC-IoS relation. It implies that tourists’ IoS in green hotels is influenced by the level of their awareness and perceptions of green building design attributes. Given that green building design is often an omitted element in the previous hospitality literature, this paper highlights its potential role and implications in facilitating sustainable practices in the hospitality industry. Identifying the potential moderating factors of tourists’ EC-IoS relation can assist the development of green marketing strategy, which adds value to the tourism and hospitality industry. From a social interest perspective, it is crucial to raise tourists’ eco-literacy in all the ‘green ends’ including green building design of hotels.
Developing a framework for international students’ rationales for studying abroad, beyond economic factors
Authors: Fakunle Omolabake
Published: October 2020

Underpinned by neoliberalism and spurred by growing international student mobility (ISM), global trends and policymaking on internationalisation are geared towards the maximisation of efforts by countries and institutions to recruit fee-paying international students. For international students, previous studies on their decision-making processes and motivations for studying abroad emphasise the benefit of acquiring a quality education and employability, tending to human capital development. The dominant framing of internationalisation around economic imperatives, which has been criticised by several scholars, limits our understanding of non-economic dimensions of ISM. A review of Sen’s capability approach encompassing both intrinsic and instrumental values supports the framework presented in this article. The framework, illustrated by qualitative data, captures how international students’ rationales for studying abroad include the following four dimensions: educational; experiential; aspirational; and economic. This article raises a critical question about how an internationalisation policy that does not represent a broad range of students’ rationales for studying abroad can be expected to provide a transformative experience for students. The concluding section details recommendations for a re-imagining of policy towards enhancing the international student experience. It briefly points to the timeliness of the proposed framework in the light the possible impact of Covid-19 on the future of ISM.
Heparin-Bonded Stent-Graft for the Treatment of TASC II C and D Femoropopliteal Lesions: 36-Month Results of the Viabahn 25 cm Trial
Authors: Böhme Tanja , Noory Elias , Brechtel Klaus , Scheinert Dierk , Bosiers Marc , Beschorner Ulrich , Zeller Thomas
Published: October 2020

Purpose:

To evaluate the 36-month technical and clinical outcome after implantation of the 25-cm Viabahn endoprosthesis with Propaten bioactive surface in TransAtlantic Inter-Society Consensus II C and D lesions of the superficial femoral and proximal popliteal arteries.

Materials and Methods:

This prospective, multicenter, single-arm trial ( ClinicalTrials.gov; identifier NCT01263665) enrolled 71 patients (mean age 66.7±8.3 years; 50 men) with lifestyle-limiting claudication or rest pain (Rutherford category 2–4) and long (>20-cm) lesions of the superficial femoral and proximal popliteal arteries. Primary endpoint was primary patency at 36 months. Secondary endpoints included primary assisted patency; secondary patency; freedom from target lesion revascularization (TLR); freedom from a composite of death, target vessel revascularization (TVR), and amputation; clinical success; and freedom from device fracture.

Results:

Primary patency estimated by Kaplan-Meier analysis was 40.6% at 36 months. Primary assisted patency and secondary patency estimates were 53.0% and 96.9%, respectively. Within 36 months, 27 patients had to undergo a TLR. Twenty-five patients (35.2%) had a TVR. Freedom from the composite of death, TVR, and amputation endpoint was 44.5%. The estimate of the sustained clinical success with stable or improved Rutherford category was 58.5%. No stent fracture was detected during follow-up.

Conclusion:

The primary patency rate without reintervention after treatment of long femoropopliteal lesions is low. However, secondary patency after implantation of a Viabahn endoprosthesis is high and seems to be superior to the use of other revascularization techniques, resulting in persistent clinical improvement.
Enhancing biocompatibility of PCL/PU nano-structures to control the water wettability by NaOH hydrolysis treatment for tissue engineering applications
Authors: Jirofti Nafiseh , Mohebbi-Kalhori Davod , Masoumi Ramin
Published: October 2020

Nano-structures due to their unique properties can provide a biomimetic structure for cell attachment and proliferation in tissue engineering (TE) applications. But sometimes, their surface properties are not particularly suitable for directed tissue growth. In this regard, present study has focused on fabrication and hydrolysis of Poly ( ε-caprolactone) (PCL)/Polyurethane (PU) by aqueous sodium hydroxide (NaOH) with a view to modify the surface and hydrophilicity of the structures. The characterizations and mechanical properties of non-hydrolyzed and hydrolyzed nano-structures were evaluated by SEM, FESEM, FTIR, water contact angle and tensile stress. The all hydrolyzed nano-structures showed improvement in contact angle after 2h at all concentrations of NaOH. The PCL, PU, PCL75%:PU25%, and PCL25%:PU75% structures have shown 3.8%, 12.5%, 4.1% and 7%, respectively, of shrinkage at hydrolysis at 3 M NaOH and 3 h. The PCL25%:PU75% structure indicated the greatest reduction in stress and strain at 3 M NaOH and 3 h (1.1 ± 0.06 MPa with 52% decreases) and (156 ± 5% with 49% decreases), respectively. Also, the structure with 75% of PCL showed 28% reduction in Young's Modulus (4.33 ± 0.45 MPa) at 3 M NaOH after 2 h. It is noted that the hydrolysis treatment with 3 M of NaOH concentration at 2 h is optimum condition for hydrolysis hybrid nan-structures for TE applications. Also, the results of this study proposed that hydrolyzed PCL75%:PU25% hybrid nano-structures due to its unique mechanical properties and optimum surface modification could be promising candidate for TE applications.
Aphasia in Alzheimer’s Disease and Other Dementias (ADOD): Evidence From Chinese
Authors: Weekes Brendan Stuart Hackett
Published: October 2020

Speech and language impairments (aphasia) are typical of patients with Alzheimer’s Disease and other dementias (ADOD) and in some pathologies are diagnostic e.g. Primary Progressive Aphasia (PPA). One question concerns the reliability and validity of symptomatology across typologically different languages. A review of aphasia in ADOD across languages suggests a similar pattern of word comprehension, naming and word finding difficulties but also evidence of language specific features in symptomatology e.g. processing of tone in Chinese languages. Given differences in linguistic impairments across languages, it is recommended that screening for aphasia in community and epidemiological studies use a Short ScreeningTest (SST) that can be delivered across dialects and languages in indigenous languages and also multilingual populations.
Getting Excited Through Cyclin: A Role for Endothelial Cdk5 Signaling in Hippocampal Hyperexcitability
Authors: Aroor Alisha , Brewster Amy L.
Published: October 2020

[Box: see text]
Prediction of Depression Severity Scores Based on Functional Connectivity and Complexity of the EEG Signal
Authors: Mohammadi Yousef , Moradi Mohammad Hassan
Published: October 2020

Background

Depression is one of the most common mental disorders and the leading cause of functional disabilities. This study aims to specify whether functional connectivity and complexity of brain activity can predict the severity of depression (Beck Depression Inventory–II scores).

Methods

Resting-state, eyes-closed EEG data were recorded from 60 depressed patients. A phase synchronization measure was used to estimate functional connectivity between all pairs of the EEG channels in the delta (1-4 Hz), theta (4-8 Hz), alpha (8-13 Hz), and beta (13-30 Hz) frequency bands. To quantify the local value of functional connectivity, 2 graph theory metrics, degree, and clustering coefficient (CC), were measured. Moreover, Lempel-Ziv complexity (LZC) and fuzzy entropy (FuzzyEn) were used to measure the complexity of the EEG signal.

Results

Through correlation analysis, a significant negative relationship was found between graph metrics and depression severity in the alpha band. This association was strongly positive for the complexity measures in alpha and delta bands. Also, the linear regression model represented a substantial performance of depression severity prediction based on EEG features of the alpha band ( r = 0.839; P < .0001, root mean square error score of 7.69).

Conclusion

We found that the brain activity of patients with depression was related to depression severity. Abnormal brain activity reflects an increase in the severity of depression. The presented regression model provides a quantitative depression severity prediction, which can inform the development of EEG state and exhibit potential desirable application for the medical treatment of the depressive disorder.
Hybrid endografts in ‘wide neck’ abdominal aortic aneurysm in patients unfit for open surgery: The Funnel Technique – Case report and review of the literature
Authors: Amico Alessio , Russo David , Franciosi Francesco Benassi , Musio Debora , de Prisco Roberta , Celoria Giovanni
Published: October 2020

Objectives

Abdominal aortic aneurysms with a wide proximal neck (>32 mm) are a contraindication for the use of conventional abdominal endovascular stent grafts because of their limited maximum proximal diameter (36 mm). In these cases, it is customary to resort to sophisticated techniques such as parallel or fenestrated grafts. In very selected cases, such as symptomatic wide neck aneurysm or patient with limited life expectancy, Funnel Technique may find an indication.

Methods

It consists in placing a bifurcated endograft in the abdominal aorta embricated with a thoracic endograft as a proximal cuff in an infrarenal position.

Results

In the literature review, we found 32 cases of this technique, whose characteristics are collected in a table.

Conclusion

The Funnel Technique, taking advantage of the larger diameters of the thoracic prostheses, may easily treat abdominal aortic aneurysm cases with a wide neck.
An improved A-Star based path planning algorithm for autonomous land vehicles
Authors: Erke Shang , Bin Dai , Yiming Nie , Qi Zhu , Liang Xiao , Dawei Zhao
Published: October 2020

This article presents a novel path planning algorithm for autonomous land vehicles. There are four main contributions: Firstly, an evaluation standard is introduced to measure the performance of different algorithms and to select appropriate parameters for the proposed algorithm. Secondly, a guideline generated by human or global planning is employed to develop the heuristic function to overcome the shortcoming of traditional A-Star algorithms. Thirdly, for improving the obstacle avoidance performance, key points around the obstacle are employed, which would guide the planning path to avoid the obstacle much earlier than the traditional one. Fourth, a novel variable-step based A-Star algorithm is also introduced to reduce the computing time of the proposed algorithm. Compared with the state-of-the-art techniques, experimental results show that the performance of the proposed algorithm is robust and stable.
Development, factor structure, and reliability of the Shared Instructional Leadership Scale in public secondary schools
Authors: Zhan Xi , Anthony Anika B , Goddard Roger , Beard Karen Stansberry
Published: October 2020

Shared instructional leadership may support informed decision making on matters of curriculum, instruction, and assessment. Given the various organizational processes and outcomes associated with this construct, it is important to be able to measure the degree to which it exists in schools. In this article we propose the Shared Instructional Leadership Scale and report its reliability and the validity of its factor structure. The scale was designed to assess the extent to which faculty perceive that principals, teachers, and school staff collaborate on instructional leadership practices. Drawing from a sample of 422 teachers nested in 107 schools, we generated four sub-samples to examine its psychometric properties. Next, using exploratory factor analysis techniques, we found the Shared Instructional Leadership Scale factor structure to be stable across all four sub-samples. Finally, we conducted confirmatory factor analysis on a second school-level sample ( n = 103) and the results confirmed the Shared Instructional Leadership Scale had a unidimensional structure. We conclude with a discussion of the potential of the Shared Instructional Leadership Scale to inform practice and implications for future research, including directions for further scale validation.
The effectiveness of empathy training on the empathy skills of nurses working in intensive care units
Authors: Mirzaei Maghsud Azam , Abazari Farrokh , Miri Sakineh , Sadat Nematollahi Monir
Published: October 2020

Background

Empathy is an essential condition for effective nursing care. An empathetic relationship between the nurse and the patient leads to positive therapeutic outcomes, increases nurses' adjustment in educational and therapeutic environments and influences their ethical sensitivities.

Aims

The current study aimed to determine the effectiveness of empathy training on the empathy skills of nurses working in intensive care units of Shahid Bahonar Hospital in Kerman, Iran.

Methods

This experimental study was conducted on nurses working in intensive care units of Shahid Bahonar Hospital affiliated to Kerman University of Medical Sciences in Iran. All nurses working in intensive care units of Shahid Bahonar Hospital were selected by randomised sampling. Data were collected by the Davis Empathy Scale (possible range 0–105) and analysed using descriptive statistics and analysis of variance.

Results

Comparison of the mean empathy scores showed the mean scores of empathy skills in the control group were 63.45 ± 8.102 and 63.54 ± 8.05 in the pre- and post-test, respectively, which was not significantly different. But the mean scores of empathy skills in the Experimental group were 63.40 ± 8.136 and 67.7 ± 9.027 in the pre- and post-test, respectively, which showed a significant increase ( p < 0.05).

Conclusions

The present intervention showed the effectiveness of empathy training on the empathy skills of nurses. Empathy can be acquired and learned.
Public health counselling following an HIV diagnosis among men who have sex with men: tensions between individual needs and health protection mandates
Authors: Orser Lauren , O'Byrne Patrick
Published: October 2020

Background

In Ontario, provincial regulations stipulate that public health units must complete post-test counselling with all persons newly diagnosed with human immunodeficiency virus. Public health nurses conduct this follow-up and are responsible for ensuring appropriate surveillance and management of human immunodeficiency virus with the primary objective of reducing ongoing human immunodeficiency virus transmission in their health jurisdiction. To date, little research has explored the effectiveness of this mandatory public health counselling from the perspective of patients – the majority of whom are men who have sex with men.

Aims

To address gaps in public health nursing practice, a pilot study was conducted with men who have sex with men in Ottawa to explore their attitudes and experiences of receiving mandatory human immunodeficiency virus follow-up after their diagnosis.

Methods

Qualitative interviews were conducted and interpreted using thematic analysis.

Results

This analysis revealed a contrariety between the needs of individuals and of public health units, with patients' perceiving their personal wishes to be secondary to public health mandates – and led patients to simultaneously want to evade, and be assisted by, public health nurses.

Conclusions

Public health units and nurses should consider adopting a more patient-centered approach to HIV case management, which incorporates patients’ experiences of receiving an HIV diagnosis.
Healthcare-seeking behaviours in college students and young adults: a review
Authors: Tran Dieu-My T , Silvestri-Elmore Angela
Published: October 2020

Background/aims

To review the literature on college students’ healthcare-seeking behaviours to uncover the current evidence and promote better healthcare-seeking behaviours and essentially better health outcomes in young adults.

Methods

The researchers conducted an extensive literature review using CINAHL, Cochrane, PubMed, EBSCOhost and Google Scholar in the years 2018 and 2019. The search was limited to the past 18 years (2000–2018) and to studies reported in the English language focused on the general healthcare-seeking behaviour of college students. The search was also extended to young adults (aged 18–39 years).

Results

A total of 56 articles were identified for abstract review and only 28 articles met the inclusion criteria for the final review. The following themes emerged to organise our findings: healthcare-seeking behaviour among college students, health information resource utilisation and its influence on healthcare-seeking behaviours and barriers to accessing care among college students.

Conclusions

This review summarises the current body of knowledge related to healthcare-seeking behaviour among college students, health information resource utilisation and its influence on healthcare-seeking behaviour and barriers to accessing care among this population. Important measures further to address the health needs and interventions for addressing these needs among the college student population are discussed.
Natural history of nonbacterial thrombotic endocarditis treated with warfarin
Authors: Slivka Andrew P , Agriesti Julie E , Orsinelli David A
Published: October 2020

We report on the natural history of a cohort of patients presenting with transient ischemic attack or stroke and nonbacterial thrombotic endocarditis treated with warfarin.

Patients with valvular vegetations on echocardiography, stroke, or transient ischemic attack presenting to a single neurologist were included. All patients were treated with warfarin until the vegetation resolved or for two years, then were switched to aspirin and had at least one clinical and echocardiographic follow-up.

Twenty-nine patients were included and followed for a median of 27 months. Average age was 42 years and 72% were female. Two patients had vegetations on two valves. Five patients (17%) had recurrent strokes, three had systemic lupus erythematosus and antiphospholipid antibodies, one had antiphospholipid antibodies alone and one had neither condition. Three of the five patients did not have resolution of the vegetation at the time of the event. The valvular vegetations resolved in 23 of the 31 affected valves (74%) after a median of 11 months (range 4.5–157.5). Eleven patients had at least one follow-up echocardiogram after resolution of the vegetation and none had recurrent vegetations after warfarin was stopped.

This study should serve to provide general recommendations regarding treatment of patients with TIA/stroke with nonbacterial thrombotic endocarditis. Valvular vegetations resolve in most patients and the risk of recurrent stroke is low. Warfarin can safely be switched to aspirin in most patients when the vegetation resolves or after two years if it does not resolve. Prolonged warfarin may be warranted in patients with systemic lupus erythematosus, positive antiphospholipid antibodies, and a persistent vegetation.
The importance of health security in post-Brexit EU–UK relations
Authors: Glencross Andrew
Published: October 2020

This article examines the possibilities for negotiating the UK–EU health-security relationship after 2020. Health security, in the sense of measures to prevent and mitigate health emergencies, had played a marginal role in the UK–EU negotiations, but COVID-19 has greatly amplified this policy area’s significance. At the beginning of the pandemic, Brussels introduced significant measures to promote public health sovereignty, notably joint procurement and stockpiling of personal protective equipment. The UK went against the grain by limiting its involvement in joint procurement at a time when other countries were rushing to participate. UK participation in some EU health measures is possible on existing terms, but not joint procurement. This leaves the UK facing an uncertain future because of the potential risks associated with not participating in EU programmes, notably in terms of access to personal protective equipment supplies and possible market distortion resulting from new EU policies promoting stockpiling and reshoring. The politicisation of health security thus adds another complication to the post-Brexit EU–UK relationship.
Ureteroscopy in the day case setting: it’s worth it! Retrospective single surgeon outcomes analysis during service relocation (inpatient to daycase) in a DGH
Authors: Kremel Darja , Siatos Dimitrios , Al Jaafari Feras
Published: October 2020

Objective:

Due to advances in surgical techniques and anaesthesia, day surgery is now becoming the standard care pathway for many complex procedures traditionally treated through inpatient pathways. Our aim was to study outcomes for patients undergoing rigid and flexible ureteroscopy before and after moving this service from a district general hospital to a day surgery unit.

Methods:

This was a retrospective observational study of 136 consecutive patients undergoing elective ureteroscopy for stone treatment. Half of the patients ( n=68, inpatient group) underwent treatment according to the standard inpatient pathway, while the other half underwent treatment following relocation of this service to a day case unit ( n=68, day case group). Outcomes were length of stay, readmission rate and complications.

Results:

In the inpatient group, 12 patients (17.6%) were discharged home the day of surgery (day 0), 42 patients (61.8%) stayed in hospital for one night. In the day case group, 58 patients (85.3%) were discharged on day 0, nine patients (13.2%) stayed for one night. Length of stay in the day case group was significantly shorter ( P<0.001). Rates of postoperative complications and readmissions were not significantly different.

Conclusion:

Day case ureteroscopy for stone treatment is feasible and safe. It is associated with a significantly reduced length of stay without an increase in postoperative complications or readmission.
Mental imagery: A lever for valuing an intangible offer
Authors: Abaidi Ibtissame , Agrebi Sinda , Ben Nasr Imed , Cottet Patrice
Published: October 2020

In a context of growth of smart offers, studying the process of valuing an intangible offer by highlighting the role of consumer’s mental self-imagery is a promising avenue. An experimental study involving a representative sample of 836 individuals finds that mental imagery reduces the perception of intangibility. Thus, perceived value can be positively affected by the mediation of perceived benefits. This research enriches the literature on the perceived value of innovative offers by identifying fundamental determinants, namely, mental self-imagery and perceived intangibility.
A comparative study of tolerability and effects on immunoglobulin levels and CD19 cell counts with ocrelizumab vs low dose of rituximab in multiple sclerosis
Authors: Evertsson Björn , Hoyt Tammy , Christensen Angel , Nimer Faiez AL , Foley John , Piehl Fredrik
Published: October 2020

Background

Rituximab (RTX) and ocrelizumab (OCR) are two anti-CD20 biologics used in MS; however, comparisons on safety and efficacy are rare.

Objective

To compare treatment outcomes over the first year with RTX and OCR.

Methods

Retrospective cohort study comprising MS patients initiating RTX at the Karolinska University Hospital (Sweden; n = 311) and OCR at Rocky Mountain MS Clinic (Utah, USA; n = 161), respectively.

Results

Levels of immunoglobulin G measured in blood dropped 0.16 g/L (95% confidence interval 0.01 to 0.31) with each OCR infusion, but remained stable with RTX. In contrast, levels of immunoglobulin M decreased to a similar extent with both drugs. Ten and 15% of patients discontinued treatment with RTX and OCR, respectively (n.s), however, adverse events leading to treatment discontinuation were more common with OCR (6.8% vs 2.6%; p = 0.026). Only 3.1 and 1.6% discontinued OCR and RTX, respectively, due to lack of effect (n.s). The degree of B cell depletion was superior with OCR.

Conclusion

Overall, differences between the two treatments were small. Although the study design precludes robust conclusions regarding the risk-benefit with the studied therapies, our findings indicate that the tolerability and safety with RTX is not inferior to OCR.
Making enemies with media
Authors: Packer Jeremy , Reeves Joshua
Published: October 2020

This article examines the role of media technology in determining preconstitutive enemies of the political order. To do so, it analyzes how discipline-specific methods of enemy detection, analysis, and neutralization correspond to different media environments. Media have a diagnostic and prescriptive significance: not only do they locate enemies that conform to their own unique standards of measurement, they also offer reprogramming resources that accentuate their own peculiar biases and capacities. Episodes in the history of biology and psychology are examined for evidence of this media logic.
Born to do science? A case study of family factors in the academic lives of the Chinese scientific elite
Authors: Wang Huibin
Published: October 2020

Primarily based on data collected by the Project for Collecting Historic Data of Scientists’ Academic Life, this paper sets out to analyse the cultural and social role of family factors in the academic lives of three prominent scientists: He Zehui, Wang Shouwu and Wang Shoujue. It was found that, while providing economic support, in the cultural dimension, their family conveyed the idea of saving the nation through science and industry, offered guidance on research career planning and cultivated the concept of feminism; in the social dimension, the three scientists clearly benefited from the academic power and social networks of their family members. This case study of a Chinese scientific family reveals an integration between Western scientific culture and Chinese family culture, and extracts some family factors that have great influence on the academic lives of the scientific elite.