bluuebunny/crossref_metadata_2025 huggingface dataset:
Sleeping soldiers: On sleep and war
Authors: Kinsella Helen M
Published: February 2020

In this article, I explore sleep specifically as a weapon of war, as a logistic of war, and as a metaphor for conscience in war. In proposing the capacity to sleep as a measure of the effects of strategies of war, and to recalibrate understandings of intimacy and vulnerability in war, I highlight the distinct effects of war on all its denizens. I make no claim for sameness among their experiences – far from it. And yet, at the same time, I wish to draw attention to what this exploratory essay also conveys, namely, the possibility for a sort of what Judith Butler terms ‘sensate democracy’ in the experience of sleeplessness, exposing a counterintuitive commonality among those deemed friends and enemies. Such a focus brings to the fore that which Simone Weil so powerfully articulated – that violence and force destroy those who wield them and those who are subject to them, potentially reducing each to something less than human, rendering them ‘brothers in the same misery’. Far from facilitating or structuring a relativistic moral equivalence, this potential solidarity provides a form and a measure that, in turn, make way for an analysis of distinct relations of power.
Advanced Stage of Disease and Systemic Inflammation as Factors Associated With Referral of Patients With Colorectal Cancer to a Palliative Care Unit
Authors: Silva Thiago Huaytalla , Peres Wilza Arantes Ferreira , Rosa Karla Santos da Costa , Schilithz Arthur Orlando Correa , de Oliveira Livia Costa , Murad Leonardo Borges
Published: February 2020

Objective:

To identify factors associated with referral to an exclusive palliative care unit (PCU) in patients with colorectal cancer (CRC).

Methods:

Retrospective cohort study with patients having CRC of both sexes treated at a hospital unit, aged ≥20 years. Data were extracted from the medical records of pretreatment patients between January 2008 and August 2014. The outcome was referral to the PCU within 5 years. Logistic regression analyses were performed to assess whether sociodemographic, clinical, nutritional, and biochemistry data were associated to referral, generating odds ratios (OR), and 95% confidence intervals (CI).

Results:

Four hundred fifteen patients were evaluated. The Patient-Generated Subjective Global Assessment demonstrated a prevalence of malnutrition of 57.3%. One hundred one (24.3%) patients were referred to the PCU after 16.3 months (interquartile range: 7.2-33.5). These patients were more likely to be at an advanced stage of the disease and have malnutrition and exacerbated systemic inflammation. Tumor stage III and IV (OR: 2.05; 95% CI: 1.12-3.76) and neutrophil-to-lymphocyte ratio (NLR) ≥3 (OR: 1.89; 95% CI: 1.12-3.17) were predictors of an increased chance of referral to the PCU.

Conclusion:

Advanced disease stage and NLR were associated with referral of patients with CCR to a PCU.
Sleight of Hand: The Expropriation of Balinese Culture
Authors: Suartika Gusti Ayu Made , Cuthbert Alexander R.
Published: February 2020

In a prior paper (Suartika, Zerby, & Cuthbert, 2018), cultural space and its social meaning were examined in detail. While the three main gateways into culture were analyzed, the actual processes through which culture is abstracted by capital were not discussed. Below we seek to advance on our initial model. Hence the dominant processes by which culture is both politicized and commodified by capital are explored using political economy as a reference point. Historically, appropriation and exploitation have dominated the development process universally. But while they remain functional, they have lost much of their relevance. We maintain that expropriation is now on the ascendant, a process we call sleight of hand due to the closeted nature of expropriation processes. Since all three principles are frequently used in isolation or conflated to each other in error, the paper first clarifies terminology before exploring their relevance for Bali. We then outline the nature of resultant conflicts, with examples from nature, economy and ideology using the littoral zone as exemplary of tourism impacts. In conclusion, we suggest that processes of expropriation establish a baseline for understanding how culture is used to further political and economic agendas in Bali.
The effect of viewing idealised smile images versus nature images via social media on immediate facial satisfaction in young adults: A randomised controlled trial
Authors: Sampson Ariane , Jeremiah Huw G , Andiappan Manoharan , Newton J Tim
Published: February 2020

Introduction:

The objective of this randomised controlled trial (RCT) is to investigate the effect of a social networking site (SNS) on body dissatisfaction, facial and smile dissatisfaction, and face-related discrepancy, and whether these effects differ from the use of appearance-neutral Instagram images. We also aimed to investigate whether there are trends in increased self-reported use of social media and increased body dissatisfaction, facial and smile dissatisfaction, and face-related discrepancy.

Methods:

Undergraduate students were randomly allocated to an experimental group with idealised smile images or to a control group with neutral nature images. They completed pre-exposure questionnaires, then perused for 5 min their allocated images on individual Apple iPads via the Instagram application. Participants then completed the post-exposure surveys. The main outcome was facial dissatisfaction. Body dissatisfaction and total facial and body dissatisfaction were secondary outcomes. Simple randomisation was achieved with a computerised random number generator. Data were analysed using repeated measures ANOVA and multivariate regression analyses.

Results:

A total of 132 participants (mean age = 20.50 ± 2.21 years) were randomised to either the experimental group with idealised smile images (n=71) or the control group with neutral nature images (n=61). Baseline characteristics were similar between groups and no participants were lost. Exposure to ‘ideal’ facial images on social media decreases facial satisfaction (95% confidence interval [CI] = 0.85–1.05; P < 0.0001). Individuals with high baseline self-discrepancy scores are less satisfied with their facial features and body appearance (95% CI = 0.04–1.16; P = 0.036).

Conclusion:

This study shows that viewing SNSs with high visual media reduces satisfaction with facial appearance in the short term in men and women. This effect is greater in those with high self-discrepancy scores. Increased media usage was not correlated with increased dissatisfaction. Wearing braces or having had braces was shown not to influence post-exposure dissatisfaction.
Patient experience of preheated and room temperature skin disinfection prior to cardiac device implantation: A randomised controlled trial
Authors: Wistrand Camilla , Nilsson Ulrica , Sundqvist Ann-Sofie
Published: February 2020

Background:

Clinically, patients often comment on the coolness of the skin disinfectant. However, scarce evidence is available regarding patients’ experience during intraoperative skin disinfection.

Aims:

The aim of this study was to describe and compare intraoperative patient experiences with preheated and room temperature skin disinfectant.

Method:

This randomised controlled trial included 220 patients undergoing cardiac device implantation. Patients allocated to preheated (36°C) or room temperature (20°C) chlorhexidine in 70% ethanol verbally answered an open-ended question regarding their experience with the skin disinfection. Results were assessed using a qualitative approach with comparative quantification.

Results:

The analysis resulted in nine categories describing the patients’ experiences with preheated and room temperature skin disinfection. Most of the patients described the skin disinfection process as a negative experience, which consisted of six categories: cold, smell, change in temperature, unpleasant, wet and painful. In addition, two neutral categories of response (nothing in particular and neither pleasant nor unpleasant) and one positive response (pleasant) emerged through the analysis. Preheated skin disinfection yielded significantly fewer negative experiences in the category cold (85% vs. 15%, P<0.0001) and significantly more positive experiences (66% vs. 34%, P<0.002). Neutral categories (neither pleasant nor unpleasant 65% vs. 35%, P=0.01, nothing in particular 74% vs. 26%, P<0.001) dominated after preheated skin disinfection.

Conclusion:

The use of preheated skin disinfection promotes a positive patient experience with skin disinfection.

Trial registration:

ClinicalTrials.gov registration number NCT02260479 ( https://clinicaltrials.gov/ct2/results?cond=preheated+skin+disinfection ).
A motion planning method for unmanned surface vehicle in restricted waters
Authors: Gu Shangding , Zhou Chunhui , Wen Yuanqiao , Zhong Xi , Zhu Man , Xiao Changshi , Du Zhe
Published: February 2020

The maneuvering characteristics of the unmanned surface vehicle itself are very important to motion planning due to the limited water scale area. If the size, motion state, and maneuvering characteristics of the unmanned surface vehicle are not considered, the shortest path obtained is actually not feasible in the restricted waters. In this article, the widely used A* algorithm is improved by accounting for the maneuvering characteristics of the unmanned surface vehicle, named as the Label-A* Algorithm, which is further employed to fix the problem related to the motion planning for the unmanned surface vehicle in restricted waters. The solution to the motion planning mainly contains three stages. First, the unmanned surface vehicle trajectory unit library is established based on its maneuvering characteristics; second, an improved label-A* Algorithm is constructed, and the unmanned surface vehicle motion planning method is proposed with the trajectory unit, which is suitable for the restricted waters; Finally, numerical simulations and filed tests are designed to verify the formulated model and proposed algorithm. The motion planning method can simultaneously meet the state constraints, maneuvering characteristics constraints, and water scale constraints of unmanned surface vehicle.
Immigration detention and juxtaposed border controls on the French north coast
Authors: Bosworth Mary
Published: February 2020

In this article, I build on criminological accounts of immigration detention by examining British short-term holding facilities located on French territory in the ports of Calais and Dunkerque and the policies and treaties that govern them. For a number of reasons, including barriers to research access, their legal complexity, and their modest size and nature, these institutions have received little empirical or theoretical scrutiny. Yet, as I shall demonstrate through an analysis of a range of published material from Parliamentary debates, government and non-governmental agencies, the media and the Internet, as well as observations of the sites themselves and figures about them, these banal, bureaucratic sites of temporary custody play an important role in upholding the more familiar border spectacle of the region.
Rethinking self-control and crime: Are all forms of impulsivity criminogenic?
Authors: Wendel Brynn E. , Rocque Michael , Posick Chad
Published: February 2020

Traditionally, criminological research on impulsivity and crime assumes impulsivity is a uniform construct that is positively related to deviant behavior. However, psychological research on impulsivity indicates that the construct may have multiple forms, which vary in their relationship to antisocial behavior. One possibility that few studies have examined is whether some forms of impulsivity are unrelated, or negatively related, to antisocial behavior. This study uses Dickman’s (1990) functional and dysfunctional impulsivity scales and finds that dysfunctional impulsivity is a better predictor of crime than functional impulsivity, but does not differ for substance use or school deviance. These results highlight ways that impulsivity measures can be refined in the future.
Emerging approaches to support dynamic mission planning: survey and recommendations for future research
Authors: Henchey Matthew , Rosen Scott
Published: February 2020

In the Department of Defense, unmanned aerial vehicle (UAV) mission planning is typically in the form of a set of pre-defined waypoints and tasks, and results in optimized plans being implemented prior to the beginning of the mission. These include the order of waypoints, assignment of tasks, and assignment of trajectories. One emerging area that has been recently identified in the literature involves frameworks, simulations, and supporting algorithms for dynamic mission planning, which entail re-planning mid-mission based on new information. These frameworks require algorithmic support for flight path and flight time approximations, which can be computationally complex in nature. This article seeks to identify the leading academic algorithms that could support dynamic mission planning and recommendations for future research for how they could be adopted and used in current applications. A survey of emerging UAV mission planning algorithms and academic UAV flight path algorithms is presented, beginning with a taxonomy of the problem space. Next, areas of future research related to current applications are presented.
A systematic review and meta-analysis of Woven EndoBridge single layer for treatment of intracranial aneurysms
Authors: van Rooij SBT , Sprengers ME , Peluso JP , Daams J , Verbaan D , van Rooij WJ , Majoie CB
Published: February 2020

Background and purpose

The Woven EndoBridge is an intrasaccular device for the treatment of intracranial aneurysms. The first generation consisted of a high-profile double-layer braid. This review aims to evaluate the outcomes of the new generation low-profile Woven EndoBridge single layer device for intracranial aneurysm treatment.

Methods

A systematic review was conducted with Medline, Embase, and Web of Science Conference Proceedings databases. The search strategy provided 589 articles, 15 articles were included.

Results

Fifteen articles were identified reporting the use of Woven EndoBridge single-layer devices in 963 aneurysms, mostly wide-necked bifurcation aneurysms. Procedural aneurysm rupture was reported in 8 of 963 patients (0.83%; 95%CI 0.39–1.66%) and thromboembolic events in 54 of 963 patients (5.61%, 95CI 4.31–7.26%). Cumulative morbidity was 2.85% (27/949, 95%CI 1.95–4.12%) and mortality 0.93% (9/963, 95%CI 0.46–1.80%). The overall rate of adequate aneurysm occlusion at last follow-up was 83.3% (613/736; 95%CI 80.4–85.8%). Retreatment was reported in 38 aneurysms in eight studies with 450 aneurysms with follow-up (38/450; 8.4%, 95CI 6.2–11.4%). In 12 studies comprising 644 aneurysms with follow-up, rebleeds occurred in three patients in three studies with mean follow-up between 3.3 and 14.4 months (0.47%, 95%CI 0.09–1.43%)

Conclusion

Woven EndoBridge single-layer is a promising new low-profile device especially for wide-neck bifurcation aneurysms, both ruptured and unruptured. No antiplatelet medication is needed which is a great advantage, especially in ruptured aneurysms. Efficacy and safety compare favorably with (stent-assisted) coiling. However, no direct comparison with other treatments is available as yet.
Detection of organic amines using a ratiometric chromophoric fluorescent probe with a significant emission shift
Authors: Wu Dan , Liu Yi , Zheng Fei , Rong Shi-Qi , Yang Tao , Zhao Yan-Kun , Yang Rui-Wu , Zou Ping , Wang Guang-Tu
Published: February 2020

Taking advantages of both the well-known α,β-unsaturated structure and the special nucleophilicity of organic amines toward its acceptor moieties, intramolecular charge transfer as a signaling mechanism is used to design and synthesize a new ratiometric chromophoric fluorescent probe (BI-CA-ID) with large emission shifts toward organic amines. This probe is employed for the detection of organic amines with high selectivity and sensitivity and a “naked-eye” color change (from red to colorless). Ultraviolet–visible and fluorescence spectrometric measurements are used to determine detection limits as low as 0.024 and 0.43 μM. Furthermore, nucleophilic addition of the amine on the α,β-unsaturated of BI-CA-ID indicated that the sensing mechanism occurs via interruption of the π-conjugation.
First-time mothers’ perceptions of social support: Recommendations for best practice
Authors: De Sousa Machado Tiffany , Chur-Hansen Anna , Due Clemence
Published: February 2020

Research indicates social support is imperative for postpartum well-being. The types of social support and access to preferred supports are less understood. This article considers first-time mothers’ perceptions of the effectiveness of social supports and perceived barriers to accessing support and provides recommendations for best practice. A search of the literature for terms related to postpartum social support was conducted. Major themes were identified and synthesised. A critique and analysis of the literature is presented with recommendations for best practice. Much of the research around postnatal support fails to distinguish the specific type of support, meaning creating support solutions for the postpartum period may not be effectively targeted. Recommendations for individualised support are made.
Beyond Words: Understanding Grit in Survivors of Stroke and Caregivers
Authors: Klappa Susan G , Quach Brian , Steele Jorden , Harper Chelsea
Published: February 2020

Grit is defined as perseverance and long-term focus on goals. Grit may be helpful in surviving stroke for both survivors and caregivers. The purpose of this study was to investigate the level of grit among survivors of stroke and caregivers using health humanities to gain a deeper understanding of the lived experience of stroke survivors. A sample of convenience was used. Phase I (n = 22) utilized the Grit Scale survey. Phase II (n = 6) utilized phenomenological interviews. The Grit Scale survey data were analyzed with SPSS 25. Qualitative data were analyzed with the whole-parts-whole method of Giorgi, Dahlberg, Drew, and Nyström. Grit scores were high for both survivors of stroke (3.77 ± 0.50) and caregivers (3.89 ± 0.51). Themes emerging from the phenomenological interviews included: (a) gritty toughness, (b) challenges, (3) accomplishments, and (4) advice for health-care providers. Survivors of stroke and caregivers embodied high grit levels. Participants articulated the importance of long-term goals despite challenges. Understanding grit among survivors and caregivers may help clinicians develop best practices to better support these individuals.
Tampering With the Autonomous Self? Student Reactions to a Course on Critical Perspectives of Social Entrepreneurship
Authors: Wettermark Anna
Published: February 2020

This article analyzes student reactions to a course on critical perspectives of social entrepreneurship. Conceptualizing student reactions not merely as resistance but as a breaking up of ‘illusions” that students nurture about their selves make these reactions both more graspable for teachers and possible to influence. First, the article suggests that student reactions need to be acknowledged and comprehended in their complexity, and that teachers adjust pedagogical approaches to students’ abilities and the level of awareness. Second, the article examines processual and relational aspects of critical pedagogy and identifies in student reactions a sense of ambivalence that makes students alternate between resistance/rejection and curiosity/attraction. This ambivalence implies that reconstructive, or hopeful, aspects of entrepreneurship are important in critical curricula in order to complement more deconstructive or skeptical aspects. From a relational point of view, it is desirable that teachers support students in their learning processes by creating a safe and trusting space for learning. The article also discusses the responsibility and sensitivity of teachers and suggests that teachers’ acceptance of own feelings of insufficiency, shame, or vulnerability plays an important role in creating spaces that favor learning and mutual trust between teachers and students.
The distribution of oxytocin and the oxytocin receptor in rat brain: relation to regions active in migraine
Authors: Warfvinge Karin , Krause Diana , Edvinsson Lars
Published: February 2020

Background

Recent work, both clinical and experimental, suggests that the hypothalamic hormone oxytocin (OT) and its receptor (OTR) may be involved in migraine pathophysiology.

In order to better understand possible central actions of OT in migraine/headache pathogenesis, we mapped the distribution of OT and OTR in nerve cells and fibers in rat brain with a focus on areas related to migraine attacks and/or shown previously to contain calcitonin gene related peptide (CGRP), another neuropeptide involved in migraine.

Methods

Distribution of OT and OTR in the adult, rat brain was qualitatively examined with immunohistochemistry using a series of well characterized specific antibodies.

Results

As expected, OT was extensively localized in the cell somas of two hypothalamic nuclei, the supraoptic (SO or SON) and paraventricular nuclei (Pa or PVN). OT also was found in many other regions of the brain where it was localized mainly in nerve fibers. In contrast, OTR staining in the brain was mainly observed in cell somas with very little expression in fibers. The most distinct OTR expression was found in the hippocampus, the pons and the substantia nigra. In some regions of the brain (e.g. the amygdala and the hypothalamus), both OT and OTR were expressed (match). Mismatch between the peptide and its receptor was primarily observed in the cerebral and cerebellar cortex (OT expression) and hippocampus (OTR expression).

Conclusions

We compared OT/OTR distribution in the CNS with that of CGRP and identified regions related to migraine. In particular, regions suggested as “migraine generators”, showed correspondence among the three mappings. These findings suggest central OT pathways may contribute to the role of the hypothalamus in migraine attacks.
Correction to: The peptide transporter 1a of the zebrafish Danio rerio, an emerging model in nutrigenomics and nutrition research: molecular characterization, functional properties, and expression analysis
Authors: Vacca Francesca , Barca Amilcare , Gomes Ana S. , Mazzei Aurora , Piccinni Barbara , Cinquetti Raffaella , Del Vecchio Gianmarco , Romano Alessandro , Rønnestad Ivar , Bossi Elena , Verri Tiziano
Published: February 2020

Following publication of the original article [1], the authors flagged that the ‘Availability of data and materials’ declaration is incomplete.
Microplastics in surface water and sediments of Chongming Island in the Yangtze Estuary, China
Authors: Li Yubo , Lu Zhibo , Zheng Hongyuan , Wang Juan , Chen Cheng
Published: February 2020

Background

The Yangtze Estuary acts as gateways where microplastics transport from freshwater into marine environments, with one of the largest discharge volumes in the world. The occurrence of microplastics in surface water and sediments of the Yangtze Estuary has been reported. However, little is known about microplastics in and around Chongming Island in the estuary. In this study, the distribution of microplastics in surface water and sediments of Chongming Island was investigated and compared in different environmental medium.

Results

Abundances of microplastics in surface water and sediments were in the ranges of 0–259 items m− 3 and 10–60 items kg− 1 dry weight, respectively. Microplastics were more abundant in the surface water of the Yangtze River shores than in the inland rivers (p < 0.01). Proportions in fiber form in surface water and sediment were 33% and 67%; and those in fragment form were 39% and 24%. Most particles (> 72%) were < 1 mm in the longest dimension; 65% were white and 30% were transparent. Of the 11 compositions identified, polyethylene, polypropylene, and α-cellulose predominated in both phases.

Conclusion

This is the first study to focus on microplastics in inland watercourses on Chongming Island and along the Yangtze River’s shores in both phases. There were differences between the island and estuary in composition and density due to the distinct vertical mixing processes. The in situ filtration of surface water (100 L) sampling method was well employed in various freshwater environments and free of plastic materials in front of the filter, analysis results of which provided an important baseline reference for evaluating microplastic pollution in the Yangtze Estuary.
RNA-Seq reveals differential expression profiles and functional annotation of genes involved in retinal degeneration in Pde6c mutant Danio rerio
Authors: Saddala Madhu Sudhana , Lennikov Anton , Bouras Adam , Huang Hu
Published: February 2020

Background

Retinal degenerative diseases affect millions of people and represent the leading cause of vision loss around the world. Retinal degeneration has been attributed to a wide variety of causes, such as disruption of genes involved in phototransduction, biosynthesis, folding of the rhodopsin molecule, and the structural support of the retina. The molecular pathogenesis of the biological events in retinal degeneration is unclear; however, the molecular basis of the retinal pathological defect can be potentially determined by gene-expression profiling of the whole retina. In the present study, we analyzed the differential gene expression profile of the retina from a wild-type zebrafish and phosphodiesterase 6c (pde6c) mutant.

Results

The datasets were downloaded from the Sequence Read Archive (SRA), and adaptors and unbiased bases were removed, and sequences were checked to ensure the quality. The reads were further aligned to the reference genome of zebrafish, and the gene expression was calculated. The differentially expressed genes (DEGs) were filtered based on the log fold change (logFC) (±4) and p-values (p < 0.001). We performed gene annotation (molecular function [MF], biological process [BP], cellular component [CC]), and determined the functional pathways Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway for the DEGs. Our result showed 216 upregulated and 3527 downregulated genes between normal and pde6c mutant zebrafish. These DEGs are involved in various KEGG pathways, such as the phototransduction (12 genes), mRNA surveillance (17 genes), phagosome (25 genes), glycolysis/gluconeogenesis (15 genes), adrenergic signaling in cardiomyocytes (29 genes), ribosome (20 genes), the citrate cycle (TCA cycle; 8 genes), insulin signaling (24 genes), oxidative phosphorylation (20 genes), and RNA transport (22 genes) pathways. Many more of all the pathway genes were down-regulated, while fewer were up-regulated in the retina of pde6c mutant zebrafish.

Conclusions

Our data strongly indicate that, among these genes, the above-mentioned pathways’ genes as well as calcium-binding, neural damage, peptidase, immunological, and apoptosis proteins are mostly involved in the retinal and neural degeneration that cause abnormalities in photoreceptors or retinal pigment epithelium (RPE) cells.
Prognostic value of peripheral blood natural killer cells in colorectal cancer
Authors: Tang Yan-ping , Xie Ming-zhi , Li Ke-zhi , Li Ji-lin , Cai Zheng-min , Hu Bang-li
Published: February 2020

Background

The association between natural killer (NK) cells and survival in colorectal cancer (CRC) patients remains controversial. This study aimed to clarify the prognostic value of peripheral blood NK cells in CRC patients.

Methods

A total of 447 CRC patients who underwent radical surgery and chemotherapy were retrospectively analyzed. Cox regression analyses were used to identify independent prognostic indicators. Correlation between NK cell percentage and other clinicopathological features (gender, age, histological grade, tumor stage, immune cells, and inflammatory indicators) was analyzed. The prognostic values of the combinations of NK cell percentage and other clinicopathological features were also determined.

Results

Multivariate Cox regression analysis revealed that NK cell percentage in the peripheral blood was an independent prognostic indicator in CRC patients. A higher percentage of NK cells indicated a longer survival time than a lower percentage. NK cell percentage was positively correlated to the T and B lymphocyte counts and negatively correlated to the patients’ age and albumin levels. With an area of 0.741 under a receiver operating characteristic curve, NK cells have a moderate predictive value for 3rd-year survival in CRC. This area increased to 0.851 by combining NK cell percentage with the B lymphocyte count. Elderly patients and those at an advanced clinical stage presented a lower percentage of NK cells than younger patients and those at an early clinical stage.

Conclusions

This study demonstrated that NK cells in the blood were an independent predictor of survival in CRC patients, and the combined count of NK cells and B lymphocytes could increase the prognostic value.
Augmented exercise in hospital improves physical performance and reduces negative post hospitalization events: a randomized controlled trial
Authors: McCullagh Ruth , O’Connell Eimear , O’Meara Sarah , Dahly Darren , O’Reilly Eilis , O’Connor Kieran , Horgan N. Frances , Timmons Suzanne
Published: February 2020

Background

To measure the effects of an augmented prescribed exercise programme versus usual care, on physical performance, quality of life and healthcare utilisation for frail older medical patients in the acute setting.

Methods

This was a parallel single-blinded randomised controlled trial. Within 2 days of admission, older medical inpatients with an anticipated length of stay ≥3 days, needing assistance/aid to walk, were blindly randomly allocated to the intervention or control group. Until discharge, both groups received twice daily, Monday-to-Friday half-hour assisted exercises, assisted by a staff physiotherapist. The intervention group completed tailored strengthening and balance exercises; the control group performed stretching and relaxation exercises. Length of stay was the primary outcome measure. Blindly assessed secondary measures included readmissions within 3 months, and physical performance (Short Physical Performance Battery) and quality of life (EuroQOL-5D-5 L) at discharge and at 3 months. Time-to-event analysis was used to measure differences in length of stay, and regression models were used to measure differences in physical performance, quality of life, adverse events (falls, deaths) and negative events (prolonged hospitalisation, institutionalisation).

Results

Of the 199 patients allocated, 190 patients’ (aged 80 ± 7.5 years) data were analysed. Groups were comparable at baseline. In intention-to-treat analysis, length of stay did not differ between groups (HR 1.09 (95% CI, 0.77–1.56) p = 0.6). Physical performance was better in the intervention group at discharge (difference 0.88 (95% CI, 0.20–1.57) p = 0.01), but lost at follow-up (difference 0.45 (95% CI, − 0.43 – 1.33) p = 0.3). An improvement in quality of life was detected at follow-up in the intervention group (difference 0.28 (95% CI, 0.9–0.47) p = 0.004). Overall, fewer negative events occurred in the intervention group (OR 0.46 (95% CI 0.23–0.92) p = 0.03).

Conclusion

Improvements in physical performance, quality of life and fewer negative events suggest that this intervention is of value to frail medical inpatients. Its effect on length of stay remains unclear.

Trial registration

ClinicalTrials.gov Identifier: NCT02463864, registered prospectively 26.05.2015.
Association between non-high-density lipoprotein cholesterol and haemorrhagic transformation in patients with acute ischaemic stroke
Authors: Wang Yanan , Song Quhong , Cheng Yajun , Wei Chenchen , Ye Chen , Liu Junfeng , Wu Bo , Liu Ming
Published: February 2020

Background

It is unclear whether non-high-density lipoprotein cholesterol (Non-HDL-C) is associated with haemorrhagic transformation (HT) after acute ischaemic stroke (AIS). We aimed to explore the association between Non-HDL-C and HT, as well as compare the predictive values of Non-HDL-C and low-density lipoprotein cholesterol (LDL-C) for HT.

Methods

We consecutively enrolled AIS patients within 7 days of stroke onset. Participants were divided into four categories according to quartiles of Non-HDL-C. HT was assessed by follow-up brain imaging. We assessed the association between Non-HDL-C, LDL-C and HT in multivariate logistic regression analysis.

Results

A total of 2043 patients were included, among whom 232 were identified as HT. Compared with the highest quartiles, the first, second and third quartiles of Non-HDL-C were associated with increased risk of HT (adjusted odds ratios [ORs] 1.74 [95% confidence interval [CI] 1.09–2.78], 2.01[95% CI 1.26–3.20], and 1.76 [95% CI 1.10–2.83], respectively, P for trend = 0.024). Similar results were found for LDL-C. There was significant interaction between Non-HDL-C and age (P for interaction = 0.021). The addition of Non-HDL-C and LDL-C to conventional factors significantly improved predictive values [Non-HDL-C, net reclassification index (NRI) 0.24, 95%CI 0.17–0.31, P < 0.001; LDL-C, NRI 0.15, 95%CI 0.08–0.22, P = 0.03].

Conclusions

Low Non-HDL-C was associated with increased risks of HT. In addition, Non-HDL-C has similar effects as LDL-C for predicting HT.
Healthcare worker knowledge and skills following coaching in WHO early essential newborn care program in the Solomon Islands: a prospective multi-site cohort study
Authors: Tosif Shidan , Jatobatu Anna , Maepioh Anita , Gray Amy , Sobel Howard , Mannava Priya , Duke Trevor
Published: February 2020

Background

Newborn mortality in Oceania declined slower than other regions in the past 25 years. The World Health Organization (WHO) introduced the Early Essential Newborn Care program (EENC) in 2015 in Solomon Islands, a Small Island Developing State, to address high newborn mortality. We explored knowledge and skills retention among healthcare workers following EENC coaching.

Methods

Between March 2015 and December 2017, healthcare workers in five hospitals were assessed: pre- and post-clinical coaching and at a later evaluation. Standardised written and clinical skills assessments for breathing and non-breathing baby scenarios were used. Additionally, written surveys were completed during evaluation for feedback on the EENC experience.

Results

Fifty-three healthcare workers were included in the evaluation. Median time between initial coaching and evaluation was 21 months (IQR 18–26). Median written score increased from 44% at baseline to 89% post-coaching (p < 0.001), and was 61% at evaluation (p < 0.001). Skills assessment score was 20% at baseline and 95% post-coaching in the Breathing Baby scenario (p < 0.001). In the Non-Breathing Baby scenario, score was 63% at baseline and 86% post-coaching (p < 0.001). At evaluation, median score in the Breathing Baby scenario was 82% a reduction of 13% from post-coaching (p < 0.001) and 72% for the Non-Breathing Baby, a reduction of 14% post-coaching (p < 0.001). Nurse aides had least reduction in evaluation scores of − 2% for the Breathing Baby and midwives − 10% for the Non-Breathing Baby respectively from post-coaching to evaluation.

Conclusions

EENC coaching resulted in immediate improvements in knowledge and skills but declined over time. Healthcare workers who used the skills in regular practice had higher scores. Complementary quality improvement strategies are needed to sustain resuscitation skills following training over time.

Trial registration

Australia New Zealand Trial Registry, Retrospective Registration (12/2/2019), registration number ACTRN12619000201178.
Negotiating support from relationships and resources: a longitudinal study examining the role of personal support networks in the management of severe and enduring mental health problems
Authors: Brooks Helen Louise , Bee Penny , Lovell Karina , Rogers Anne
Published: February 2020

Background

Personal communities or personal support networks comprise a variety of social ties considered important to individuals in their everyday lives. This set of active and significant ties influence the capacity to manage mental health problems because of the potential to access social support. However, little is known in the context of people’s everyday management of mental health about how relationships with people, places, objects and activities are navigated and negotiated. This study aimed to explore the nature and negotiation of support from personal communities in the everyday management of severe and enduring mental health problems.

Methods

A longitudinal qualitative study undertaken in the UK incorporating 79 interviews with 29 participants based on personal network mapping. 29 users of mental health services with a diagnosis of severe and enduring mental illness were interviewed at three time points. Data was analysed using an inductive thematic approach underpinned by the Network Episode Model.

Results

The presence and maintenance of interpersonal trust was a fundamental condition of the relational work required to develop, undertake and sustain relationships with others. Whilst relationships with spouses, family members and friends were generally viewed positively, the work required to engage human others was contingent, vicarious and overlain with felt and enacted stigma. Developing relationships with others was hindered by a lack of confidence fuelled by the experience of mental illness and a fear of rejection or failure. By contrast, weaker ties and inanimate objects and places offered and provided a sense of reliability and security. Strategies employed by participants in order to garner sufficient support for condition management in the light of these particular challenges are illuminated by the discussion of who and what is relevant and valued in personal support networks.

Conclusions

Access to valued activities, hobbies and things should be considered alongside human relationships in providing a means of ongoing support and resource for the everyday management of life for those experiencing severe and enduring mental health problems.
Post-traumatic stress disorder, psychiatric comorbidities and associated factors among refugees in Nakivale camp in southwestern Uganda
Authors: Bapolisi Achille Mwira , Song Suzan J. , Kesande Claire , Rukundo Godfrey Zari , Ashaba Scholastic
Published: February 2020

Background

Armed conflict in Africa has led to displacement of over 24.2 million people, more than 1.4 million of whom are living in Uganda. Studies show that refugees living in Ugandan refugee settlements are at increased risk for post-traumatic stress disorder. However data on the prevalence of other mental health problems among refugees including depression, anxiety and substance use disorder among refugees in Uganda is lacking. Our aim was to determine the prevalence of post-traumatic stress disorder, its main psychiatric comorbidities and perceived psychosocial needs among refugees in Nakivale refugee camp.

Methods

We conducted a cross-sectional survey of refugee camp residents (n = 387) from nine different countries of origin. Psychiatric disorders were assessed using the MINI International Neuropsychiatric Interview (MINI) and perceived needs by the Humanitarian Emerging Settings Perceived Needs Scale (HESPER).

Results

The prevalence of psychiatric disorders was high among refugees as was the level of perceived needs. The most prevalent psychiatric disorders were generalized anxiety disorders (73%), post-traumatic stress disorder (PTSD) (67%), major depressive disorder (58%) and substance use disorders (30%). There was a higher level of comorbidity between PTSD and substance use disorder (OR = 5.13), major depressive disorder (OR = 4.04) and generalized anxiety disorder (OR = 3.27).

In multivariate analysis, PTSD was positively associated with the perception of stress as a serious problem (OR = 6.52; P-value = 0.003), safety and protection for women in the community (OR = 2.35; P-value = 0.011), care for family (OR = 2.00; P-value = 0.035) and Place to live in (OR = 1.83; P-value = 0.04). After applying the Bonferroni correction, the perception of stress remained significantly associated with PTSD.

Conclusion

Our findings suggest a strong association between PTSD, its main comorbidities and basic needs in Nakivale refugee camps. Mental health support should include psychological interventions as well as social assistance to improve the health of refugees.
How men receive and utilise partner support when trying to change their diet and physical activity within a men’s weight management programme
Authors: Tripathee Sheela , Sweeting Helen , Chambers Stephanie , Maclean Alice
Published: February 2020

Background

The impacts of interventions designed to change health behaviours are potentially affected by the complex social systems in which they are embedded. This study uses Scottish data to explore how men receive and utilise partner support when attempting to change dietary practices and physical activity within the context of Football Fans in Training (FFIT), a gender-sensitised weight management and healthy living programme for men who are overweight/obese.

Methods

Separate semi-structured face-to-face interviews were conducted with 20 men and their cohabiting female partners (total n = 40), 3–12 months after the men had completed FFIT. Data were thematically analysed and individual interviews were combined for dyadic analysis.

Results

Men’s and women’s accounts suggested variations in men’s need for, and utilisation of, partner support in order to make changes to dietary practices and physical activity. There were also differences in descriptions of women’s involvement in men’s behaviour changes. Typologies were developed categorising men as ‘resolute’, ‘reliant’/‘receptive’ and ‘non-responsive’ and women as ‘very involved’, ‘partially involved’ and ‘not involved’. Men were more reliant, and women more involved, in changes to dietary practices compared to physical activity. The role of partner involvement in promoting men’s behaviour change seemed contingent on men’s resoluteness, or their reliance on the partner support.

Conclusions

These results highlight how interactions between men’s resoluteness/reliance on cohabiting female partners and the partners’ involvement impact the extent to which female partners influence men’s changes to dietary practices and physical activity following a weight loss intervention. Understanding this interaction could increase the impact of health interventions aimed at one individual’s behaviour by considering other family members’ roles in facilitating those changes. The typologies developed for this study might contribute towards the development of behaviour change theories within the cohabiting couple context.
Evidence of avian influenza virus in seabirds breeding on a Norwegian high-Arctic archipelago
Authors: Lee Megan Marie , Jaspers Veerle L. B. , Gabrielsen Geir Wing , Jenssen Bjørn Munro , Ciesielski Tomasz Maciej , Mortensen Åse-Karen , Lundgren Silje Strand , Waugh Courtney A.
Published: February 2020

Background

Wild aquatic birds serve as the natural reservoir for avian influenza virus (AIV), a disease with significant implications for avian and mammalian health. Climate change is predicted to impact the dynamics of AIV, particularly in areas such as the Arctic, but the baseline data needed to detect these shifts is often unavailable. In this study, plasma from two species of gulls breeding on the high-Arctic Svalbard archipelago were screened for antibodies to AIV.

Results

AIV antibodies were found in black-legged kittiwake (Rissa tridactyla) samples from multiple years, as well as in glaucous gulls (Larus hyperboreous) samples.

Conclusions

Despite small sample sizes, evidence of exposure to AIV was found among Svalbard gulls. A wider survey of Svalbard avian species is warranted to establish knowledge on the extent of AIV exposure on Svalbard and to determine whether active infections are present.
Mechanical behavior of a titanium alloy scaffold mimicking trabecular structure
Authors: Zhang Chunqiu , Zhang Lan , Liu Lu , Lv Linwei , Gao Lilan , Liu Nian , Wang Xin , Ye Jinduo
Published: February 2020

Background

Additively manufactured porous metallic structures have recently received great attention for bone implant applications. The morphological characteristics and mechanical behavior of 3D printed titanium alloy trabecular structure will affect the effects of artificial prosthesis replacement. However, the mechanical behavior of titanium alloy trabecular structure at present clinical usage still is lack of in-depth study from design to manufacture as well as from structure to mechanical function.

Methods

A unit cell of titanium alloy was designed to mimick trabecular structure. The controlled microarchitecture refers to a repeating array of unit-cells, composed of titanium alloy, which make up the scaffold structure. Five kinds of unit cell mimicking trabecular structure with different pore sizes and porosity were obtained by modifying the strut sizes of the cell and scaling the cell as a whole. The titanium alloy trabecular structure was fabricated by 3D printing based on Electron Beam Melting (EBM). The paper characterized the difference between the designs and fabrication of trabecular structures, as well as mechanical properties and the progressive collapse behavior and failure mechanism of the scaffold.

Results

The actual porosities of the EBM-produced bone trabeculae are lower than the designed, and the load capacity of a bearing is related to the porosity of the structure. The larger the porosity of the structure, the smaller the stiffness and the worse the load capacity is. The fracture interface of the trabecular structure under compression is at an angle of 45o with respect to the compressive axis direction, which conforms to Tresca yield criterion. The trabeculae-mimicked unit cell is anisotropy. Under quasi-static loading, loading speed has no effect on mechanical performance of bone trabecular specimens. There is no difference of the mechanical performance at various orientations and sites in metallic workspace. The elastic modulus of the scaffold decreases by 96%–93% and strength reduction 96%–91%, compared with titanium alloy dense metals structure. The apparent elastic modulus of the unit-cell-repeated scaffold is 0.39–0.618 GPa, which is close to that of natural bone and stress shielding can be reduced.

Conclusion

We have systematically studied the structural design, fabrication and mechanical behavior of a 3D printed titanium alloy scaffold mimicking trabecula bone. This study will be benefit of the application of prostheses with proper structures and functions.