bluuebunny/crossref_metadata_2025 huggingface dataset:
Challenges and facilitators to evidence-based decision-making for maternal and child health in Mozambique: district, municipal and national case studies
Authors: Inguane Celso , Sawadogo-Lewis Talata , Chaquisse Eusébio , Roberton Timothy , Ngale Kátia , Fernandes Quinhas , Dinis Aneth , Augusto Orvalho , Covele Alfredo , Hicks Leecreesha , Gremu Artur , Sherr Kenneth
Published: June 2020

Background

The need for evidence-based decision-making in the health sector is well understood in the global health community. Yet, gaps persist between the availability of evidence and the use of that evidence. Most research on evidence-based decision-making has been carried out in higher-income countries, and most studies look at policy-making rather than decision-making more broadly. We conducted this study to address these gaps and to identify challenges and facilitators to evidence-based decision-making in Maternal, Newborn and Child Health and Nutrition (MNCH&N) at the municipality, district, and national levels in Mozambique.

Methods

We used a case study design to capture the experiences of decision-makers and analysts (n = 24) who participated in evidence-based decision-making processes related to health policies and interventions to improve MNCH&N in diverse decision-making contexts (district, municipality, and national levels) in 2014–2017, in Mozambique. We examined six case studies, at the national level, in Maputo City and in two districts of Sofala Province and two of Zambézia Province, using individual in-depth interviews with key informants and a document review, for three weeks, in July 2018.

Results

Our analysis highlighted various challenges for evidence-based decision-making for MNCH&N, at national, district, and municipality levels in Mozambique, including limited demand for evidence, limited capacity to use evidence, and lack of trust in the available evidence. By contrast, access to evidence, and availability of evidence were viewed positively and seen as potential facilitators. Organizational capacity for the demand and use of evidence appears to be the greatest challenge; while individual capacity is also a barrier.

Conclusion

Evidence-based decision-making requires that actors have access to evidence and are empowered to act on that evidence. This, in turn, requires alignment between those who collect data, those who analyze and interpret data, and those who make and implement decisions. Investments in individual, organizational, and systems capacity to use evidence are needed to foster practices of evidence-based decision-making for improved maternal and child health in Mozambique.
Evaluation of SARS-CoV-2 viral RNA in fecal samples
Authors: Mesoraca Alvaro , Margiotti Katia , Viola Antonella , Cima Antonella , Sparacino Davide , Giorlandino Claudio
Published: June 2020

The need for timely establishment of a complete diagnostic protocol of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is demanded worldwide. We selected 15 positive novel coronavirus disease 19 (COVID-19) patients with mild or no symptom. Initially, fecal samples were negative in the 67% (10/15) of the cases, while 33% (5/10) of the cases were positive. After serial virus RNA testing, 73% (11/15) of the cases resulted positive to fecal specimens. In particular, 15 days after the first positive respiratory specimens test, 6 fecal specimens became positive for SARS-CoV-2 RNA, while 13 respiratory test returned negative result. In conclusion, qRT-PCR assays of fecal specimens, is an important step to control infection, suggesting that samples remained positive for SARS-CoV-2 RNA longer time then respiratory tract samples. Our results enhance the recent knowledge on this emerging infectious disease and offer suggestions for a more complete diagnostic strategy.
Human myoma tissue-based extracellular matrix models for testing the effects of irradiation on the HPV positive cells
Authors: Tuominen Heidi , Al-Samadi Ahmed , Salo Tuula , Rautava Jaana
Published: June 2020

Background

This study was designed to investigate the invasion of human papillomavirus (HPV) positive human cervical carcinoma cell lines in human leiomyoma-based extracellular matrices in vitro, and to test the suitability of the model for studying the irradiation effects on the cancer cell invasion.

Methods

HPV positive cervical carcinoma cell lines SiHa and CaSki, and HPV negative squamous cell carcinoma cell line HSC-3 were used. CaSki cells contain around 600 copies of HPV 16 virus in the genome, whereas SiHa have only 1–2 copies per cell. Cells were analyzed using two different human tumor derived extracellular matrix methods (3D myoma disc model, and Myogel Transwell invasion assay). Cultures were irradiated with 4 Gy. Myoma invasion area and the depth of invasion were measured with ImageJ 1.51j8 software. Statistical analyses were performed with SPSS Statistics (IBM SPSS® Statistics 25).

Results

All cells invaded through Myogel coated Transwell membranes and within myoma discs. In myoma discs, a difference in the invasion depth (p = 0.0001) but not in invasion area (p = 0.310) between the HPV positive cell lines was seen, since SiHa (less HPV) invaded slightly better than CaSki (more HPV). HSC-3 cells (HPV negative) invaded deepest (p = 0.048) than either of the HPV positive cell line cells. No difference was detected in the invasion area (p = 0.892) between HPV positive and HPV negative cells. The ionized radiation significantly reduced the invasion depth of HSC-3 (p = 0.008), SiHa (p = 0.0001) and CaSki (p = 0.005). No significant effect on the invasion area was detected in any of the cell lines. However, a significant difference was observed between SiHa and CaSki in the reduction of the invasion depth after radiation (p = 0.013) as the reduction was greater with SiHa than CaSki.

Conclusions

Both solid and gelatinous human leiomyoma-based extracellular matrix models were suitable platforms to study the invasion of HPV positive cervical carcinoma cells in vitro. SiHa cells with less HPV copy number cells invaded slightly better and were slightly more sensitive to irradiation than CaSki cells with high HPV copy number. However, there was no drastic differences between the invasion properties of these carcinoma cells.
Bone marrow-derived from the human femoral shaft as a new source of mesenchymal stem/stromal cells: an alternative cell material for banking and clinical transplantation
Authors: Drela Katarzyna , Stanaszek Luiza , Snioch Konrad , Kuczynska Zuzanna , Wrobel Mikolaj , Sarzynska Sylwia , Legosz Pawel , Maldyk Pawel , Lukomska Barbara
Published: June 2020

Background

Mesenchymal stem/stromal cells (MSC) are commonly used in regenerative medicine. Among different tissues, iliac crest bone marrow (BM) represents the most exploited source, but its disadvantages are a painful aspiration procedure and low cell number. An alternative, readily available source of MSC for research would be beneficial for regenerative medicine development. This work aimed to propose a new source of bone marrow isolation in which the femoral shaft is taken during total hip arthroplasty (THA).

Methods

In preliminary experiments, three different gradient methods for cell separation (Ficoll-Paque 1.078 g/mL, 17% sucrose gradient, BM seeding fraction) were tested with regard to the time of primary culture, initial cell number, the phenotype, and morphology of MSC. Then human bone marrow MSC derived from two different sources, iliac crest aspirate (BM-MSCi) or femoral shaft (BM-MSCt), were analyzed in terms of cell number and colony-forming ability followed by differentiation potential of MSC into osteo-, chondro-, and adipogenic lineages as well as mRNA expression of a variety of cytokines and growth factors.

Results

Our studies showed that MSC isolated from the bone marrow of two different sources and cultured under appropriate conditions had similar characteristics and comparable propensity to differentiate into mesodermal cells. MSC derived from BM-MSCi or BM-MSCt expressed various growth factors. Interestingly, the expression of EGF, FGF, IGF, and PDGF-A was much higher in BM-MSCt than BM-MSCi.

Conclusions

The results of our study demonstrate that human MSC isolated from the BM of the femoral shaft have similar biological characteristics as MSC derived from the iliac crest, suggesting the femoral shaft as a possible alternative source for mesenchymal stem/stromal cells.
Simultaneous in vivo PET/MRI using fluorine-18 labeled Fe3O4@Al(OH)3 nanoparticles: comparison of nanoparticle and nanoparticle-labeled stem cell distribution
Authors: Belderbos Sarah , González-Gómez Manuel Antonio , Cleeren Frederik , Wouters Jens , Piñeiro Yolanda , Deroose Christophe M. , Coosemans An , Gsell Willy , Bormans Guy , Rivas Jose , Himmelreich Uwe
Published: June 2020

Background

Mesenchymal stem cells (MSCs) have shown potential for treatment of different diseases. However, their working mechanism is still unknown. To elucidate this, the non-invasive and longitudinal tracking of MSCs would be beneficial. Both iron oxide-based nanoparticles (Fe3O4 NPs) for magnetic resonance imaging (MRI) and radiotracers for positron emission tomography (PET) have shown potential as in vivo cell imaging agents. However, they are limited by their negative contrast and lack of spatial information as well as short half-life, respectively. In this proof-of-principle study, we evaluated the potential of Fe3O4@Al(OH)3 NPs as dual PET/MRI contrast agents, as they allow stable binding of [18F]F− ions to the NPs and thus, NP visualization and quantification with both imaging modalities.

Results

18F-labeled Fe3O4@Al(OH)3 NPs (radiolabeled NPs) or mouse MSCs (mMSCs) labeled with these radiolabeled NPs were intravenously injected in healthy C57Bl/6 mice, and their biodistribution was studied using simultaneous PET/MRI acquisition. While liver uptake of radiolabeled NPs was seen with both PET and MRI, mMSCs uptake in the lungs could only be observed with PET. Even some initial loss of fluoride label did not impair NPs/mMSCs visualization. Furthermore, no negative effects on blood cell populations were seen after injection of either the NPs or mMSCs, indicating good biocompatibility.

Conclusion

We present the application of novel 18F-labeled Fe3O4@Al(OH)3 NPs as safe cell tracking agents for simultaneous PET/MRI. Combining both modalities allows fast and easy NP and mMSC localization and quantification using PET at early time points, while MRI provides high-resolution, anatomic background information and long-term NP follow-up, hereby overcoming limitations of the individual imaging modalities.
The nature and drivers of contracts in cattle herding and management: The case of Ghana
Authors: Ameleke Godwin Yao , Haagsma Rein , Karbo Naaminong , Mensah-Bonsu Akwasi
Published: June 2020

We study the characteristics of contracts in cattle production in Ghana and explain variations in contract type using agency and transaction cost theory. In their study of pastoral groups, especially those in West Africa, anthropologists have distinguished between two categories of contracts in cattle production: cattle owner–herd manager contracts and herd manager–herdsman contracts. However, few studies have analysed the variations in contract type within each category. Using survey data from 342 cattle kraal owners, we explored the contract types under the two contract categories and analysed their drivers using crosstabulations. Contract types in each category can be explicit, with the reward given by the principal explicitly specified, or implicit and unspecified. Environmental uncertainty was associated with implicit contracts while for explicit contracts, kraal owners’ outside options or opportunity cost for monitoring was associated with fixed-wage contracts, subsidy-only contracts, and input contribution by kraal owners. The combination of moral hazard and measurement costs explained whether herdsmen were familial and not paid with milk or hired and paid with milk. Our findings provide further insights into the drivers of contract type.
Hair loss due to scalp ringworm irradiation in childhood: health and psychosocial risks for women
Authors: Hoffer Liat , Shvarts Shifra , Segal-Engelchin Dorit
Published: June 2020

Background

Until 1960, hundreds of thousands of children worldwide had been treated for scalp ringworm by epilation via irradiation. The discovery of late health effects in adulthood prompted investigation of the medical aspects of irradiation in childhood and led to the establishment of strict protocols for the use of X-ray irradiation. These studies ignored alopecia, which affects some individuals who underwent irradiation for scalp ringworm as children. This study examined the impact of alopecia due to irradiation for scalp ringworm on the health and psychosocial status of affected women.

Methods

We analysed a random sample of 130 medical files of women recognised by Israel’s state committees as suffering from permanent hair loss as a result of scalp ringworm irradiation in childhood. The coded medical data included demographic variables, self-reported mental health conditions, self-reported physical health conditions, self-reported social conditions, and spousal relationship.

Results

Compared with the general population of women in Israel, research participants reported significantly higher rates of depression, anti-depressant and/or anti-anxiety drug use, psychotherapy or psychiatric hospitalisation, attempted suicide, migraines, cancer, and divorce. Many described humiliating social experiences due to their appearance, both in childhood and adulthood, that led them to curtail their social interactions. The participants also reported that alopecia negatively affected their spousal relationships.

Conclusions

Life with hair loss from scalp ringworm irradiation in childhood has a negative impact on women’s health status and psychosocial state. Health policy-makers must broaden their approach to women who underwent scalp ringworm irradiation by addressing the effects of their hair loss in addition to the effects of the radiation treatment per se. This may be achieved by guiding physicians who provide medical services to these women to take into account the psychosocial and health risks related to hair loss in their diagnosis and treatment as well as by creating a cadre of specially trained mental health professionals who can address their unique psychosocial needs. They must also consider including the specialized mental health services tailored for these women’s unique needs in the Healthcare Basket.
Major birth defects in the Brazilian side of the triple border: a population-based cross-sectional study
Authors: de Souza Suzana , Nampo Fernando Kenji , Pestana Cezar Rangel
Published: June 2020

Background

Major birth defects increase the risk of fetal death and pediatric hospitalization, which also impact on healthcare costs. Sociodemographic factors can drastically affect reproductive health and be used to discriminate the exposure to hidden risk factors. Foz do Iguassu is a Brazilian city located in the triple-border region of Brazil / Paraguay / Argentina with high rates of birth defects. However no study aimed to verify factors associated with this incidence or preventive care is reported. The current work investigated the prevalence of major birth defects and its association with maternal sociodemographic factors in Foz do Iguassu.

Methods

In this population-based cross-sectional study we used data of all live births occurred in Foz do Iguassu from 2012 to 2017. The associated sociodemographic variables such as maternal age, maternal education, maternal race, country of residence, maternal parity and onset of prenatal care were analyzed. Each major birth defect was described according to absolute and relative frequencies, Kruskal-Wallis and logistic regression models were used to evaluate variables associated with selected birth defects.

Results

The most prevalent major birth defects were Cleft Lip and/or Palate (9.5/10,000), gastroschisis (6.93/10,000), spina bifida (5.53/10,000), hydrocephalus (5.53/10,000), hypospadias (4.55/10,000), Down syndrome (4.23/10,000), anencephaly (2.93/10,000), anorectal atresia / stenosis (1.95/10,000), undetermined sex (1.95/10,000), esophageal atresia / stenosis with or without fistula (1.63/10,000) and limb reduction defects (1.30/10,000). Maternal age was associated with gastroschisis and Down syndrome. Only maternal education up to 7 years was statistically associated with major birth defects considering all other sociodemographic variables.

Conclusion

Cleft Lip and/or Palate and Gastroschisis prevalence were higher than those found in the literature. This findings may suggest a distinct epidemiological behavior regarding major birth defects in the region. The work opens new perspectives for birth defects risk factors in the triple-border.
Brown adipose tissue activity is modulated in olanzapine-treated young rats by simvastatin
Authors: Liu Xuemei , Feng Xiyu , Deng Chao , Liu Lu , Zeng Yanping , Hu Chang-Hua
Published: June 2020

Background

Prescription of second-generation antipsychotic drugs (SGAs) to childhood/adolescent has exponentially increased in recent years, which was associated with the greater risk of significant weight gain and dyslipidemia. Statin is considered a potential preventive and treatment approach for reducing SGA-induced weight gain and dyslipidemia in schizophrenia patients. However, the effect of statin treatment in children and adolescents with SGA-induced dyslipidemia is not clearly demonstrated.

Methods

To investigate the efficacy of statin interventions for reversing SGA-induced dyslipidemia, young Sprague Dawley rats were treated orally with either olanzapine (1.0 mg/kg,t.i.d.), simvastatin (3.0 mg/kg,t.i.d.), olanzapine plus simvastatin (O + S), or vehicle (control) for 5 weeks.

Results

Olanzapine treatment increased weight gain, food intake and feeding efficiency compared to the control, while O + S co-treatment significantly reversed body weight gain but without significant effects on food intake. Moreover, olanzapine treatment induced a slight but significant reduction in body temperature, with a decrease in locomotor activity. Fasting plasma glucose, triglycerides (TG), and total cholesterol (TC) levels were markedly elevated in the olanzapine-only group, whereas O + S co-treatment significantly ameliorated these changes. Pronounced activation of lipogenic gene expression in the liver and down-regulated expression of uncoupling protein-1 (UCP1) and peroxisome-proliferator-activated receptor-γ co-activator-1α (PGC-1α) in brown adipose tissue (BAT) was observed in the olanzapine-only group. Interestingly, these protein changes could be reversed by co-treatment with O + B.

Conclusions

Simvastatin is effective in ameliorating TC and TG elevated by olanzapine. Modulation of BAT activity by statins could be a partial mechanism in reducing metabolic side effects caused by SGAs in child and adolescent patients.

Graphical abstract
The de-implementation and persistence of low-value HIV prevention interventions in the United States: a cross-sectional study
Authors: McKay Virginia R. , Combs Todd B. , Dolcini M. Margaret , Brownson Ross C.
Published: June 2020

Background

As more effective or efficient interventions emerge out of scientific advancement to address a particular public health issue, it may be appropriate to de-implement low-value interventions, or interventions that are less effective or efficient. Furthermore, factors that contribute to appropriate de-implementation are not well identified. We examined the extent to which low-value interventions were de-implemented among public health organizations providing HIV prevention services, as well as explored socio-economic, organizational, and intervention characteristics associated with de-implementation.

Methods

We conducted an online cross-sectional survey from the fall of 2017 to the spring of 2019 with organizations (N = 188) providing HIV prevention services in the USA. Organizations were recruited from the Center for Disease Control and Prevention’s (CDC) website gettested.org from 20 metropolitan statistical areas with the highest HIV incidence. An organization was eligible to participate if the organization had provided at least one of the HIV prevention interventions identified as inefficient by the CDC in the last ten years, and one administrator familiar with HIV prevention programming at the organization was recruited to respond. Complete responses were analyzed to describe intervention de-implementation and identify organizational and intervention characteristics associated with de-implementation using logistic regression.

Results

Organizations reported 359 instances of implementing low-value interventions. Out of the low-value interventions implemented, approximately 57% were group, 34% were individual, and 5% were community interventions. Of interventions implemented, 46% had been de-implemented. Although we examined a number of intervention and organizational factors thought to be associated with de-implementation, the only factor statistically associated with de-implementation was organization size, with larger organizations—those with 50+ FTEs—being 3.1 times more likely to de-implement than smaller organizations (95% CI 1.3–7.5).

Conclusions

While low-value interventions are frequently de-implemented among HIV prevention organizations, many persisted representing substantial inefficiency in HIV prevention service delivery. Further exploration is needed to understand why organizations may opt to continue low-value interventions and the factors that lead to de-implementation.
Metasurface holographic image projection based on mathematical properties of Fourier transform
Authors: Ding Xumin , Wang Zhuochao , Hu Guangwei , Liu Jian , Zhang Kuang , Li Haoyu , Ratni Badreddine , Burokur Shah Nawaz , Wu Qun , Tan Jiubin , Qiu Cheng-Wei
Published: June 2020

Fourier transform, mapping the information in one domain to its reciprocal space, is of fundamental significance in real-time and parallel processing of massive data for sound and image manipulation. As a powerful platform of high-efficiency wave control, Huygens’ metasurface may offer to bridge the electromagnetic signal processing and analog Fourier transform at the hardware level and with remarkably improved performance. We here demonstrate a Huygens’ metasurface hologram, where the image pattern can be self-rotated or projected in free space by modulating the phase distribution based on the rotational invariance, time-shifting and scaling properties of Fourier transform. Our proof-of-concept experiment shows high-efficiency imaging operation in accordance with theoretical predictions, validating the proposed scheme as an ideal way to perform largely parallel spatial-domain mathematical operations in the analog domain using electromagnetic fields.
Design and Implementation of a Distant-Learning Clinical Research Mentorship Program: The Accra-Toronto Collaboration
Authors: Vulpe Horia , Vanderpuyne Verna , Yarney Joel , Tosoni Sarah , Ringash Jolie , Kassam Zahra , Wong Rebecca K.S.
Published: June 2020

PURPOSE

For many oncology training programs in low- and middle-income countries, dedicated time for research education and mentorship of trainees is limited. Here, we report a 1-year–long collaboration between a cancer center in Canada and one in Ghana with the aim of imparting clinical research skills and mentoring the research of radiation oncology residents.

METHODS

On the basis of a needs assessment conducted in Ghana, we designed a curriculum consisting of 13 weekly seminars delivered via videoconference, followed by a 1-year–long mentorship program to support research projects. The primary outcome was the feasibility of the program from seminars to manuscript preparation. We used multiple secondary outcomes to capture the learning experience with study-specific questionnaires. We evaluated critical thinking ability using the Berlin questionnaire. Funding was made available for research and travel to international conferences.

RESULTS

Five Ghanaian trainees submitted research proposals. Nine Canadian faculty members delivered the seminars and two served as methodology mentors, and two Ghanaian faculty acted as local supervisors. Feedback questionnaires from all participants showed that they agreed strongly that they would recommend the sessions to another resident (75%), that the objectives were clear (71%), and that the topics were useful for their training (73%). At the end of the program, two Ghanaian trainees finalized their manuscripts and one was published.

CONCLUSION

Here, we report on the implementation of a mentorship program focused on research methods and evidence-based medicine in sub-Saharan Africa. The program was successful in the drafting and publication of abstracts and manuscripts by local trainees.
Psychology Staffing at Cancer Centers: Data From National Comprehensive Cancer Network Member Institutions
Authors: Melton Laura , Krause Diana , Sugalski Jessica
Published: June 2020

PURPOSE:

The field of psycho-oncology is relatively undeveloped, with little information existing regarding the use of psychologists at cancer centers. Comprising 30 leading cancer centers across the United States, the National Comprehensive Cancer Network (NCCN) set out to understand the trends in its Member Institutions.

METHODS:

The NCCN Best Practices Committee surveyed NCCN Member Institutions regarding their use of psychologists. The survey was administered electronically in the spring/summer of 2017.

RESULTS:

The survey was completed by 18 cancer centers. Across institutions, 94% have psychologists appointed to provide direct care to their cancer center patients. The number of licensed psychologist full-time equivalents (FTEs) on staff who provide direct patient care ranged from < 1.0 FTE (17%) to 17.0-17.9 FTEs (6%). Regarding psychologist appointments, 41% have both faculty and staff appointments, 41% have all faculty appointments, and 18% have all staff appointments. Forty-three percent of institutions indicated that some licensed psychologists at their centers (ranging from 1%-65%) do not provide any direct clinical care, and 57% indicated that all licensed psychologist on staff devote some amount of time to direct clinical care. The percent of clinical care time that is spent on direct clinical care ranged from 15%-90%.

CONCLUSION:

There is great variability in psychology staffing, academic appointments, and the amount of direct patient care provided by on-staff psychologists at cancer centers.
Metabolic Syndrome and COVID 19: Endocrine-Immune-Vascular Interactions Shapes Clinical Course
Authors: Bansal Rashika , Gubbi Sriram , Muniyappa Ranganath
Published: June 2020

The ongoing coronavirus disease 2019 (COVID-19) pandemic is caused by the novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Individuals with metabolic syndrome are at increased risk for poor disease outcomes and mortality from COVID-19. The pathophysiologic mechanisms for these observations have not been fully elucidated. A critical interaction between SARS-CoV-2 and the angiotensin-converting enzyme 2 (ACE2) facilitates viral entry into the host cell. ACE2 is expressed in pancreatic islets, vascular endothelium, and adipose tissue, and the SARS-CoV-2 -ACE2 interaction in these tissues, along with other factors, governs the spectrum and the severity of clinical manifestations among COVID-19 patients with metabolic syndrome. Moreover, the pro-inflammatory milieu observed in patients with metabolic syndrome may contribute toward COVID-19-mediated host immune dysregulation, including suboptimal immune responses, hyperinflammation, microvascular dysfunction, and thrombosis. This review describes the spectrum of clinical features, the likely pathophysiologic mechanisms, and potential implications for the management of metabolic syndrome in COVID-19 patients.
Mademoiselle from Malibu: Eighteenth-Century Pastoral Romance, H-Bombs, and the Collaborative, Intertextual Gidget
Authors: Engle John
Published: June 2020

Mostly dismissed as a trivial entertainment, Frederick Kohner’s Gidget: The Little Girl with Big Ideas (1957) is in fact a telling aesthetic and cultural document. University of Vienna PhD, Jewish exile from Nazi Germany, and successful Hollywood screenwriter Kohner empathetically fictionalized his teenage daughter’s adventures with the original Malibu surf crew and in the process vividly signaled the emergence of a rebellious postwar youth culture. Just as interesting is the way Kohner’s entertaining comic drama of feminist awakening plays out through an intriguingly complex narrative voice, one blurring distinctions between its California teen daughter-protagonist-narrator and the father-author, both learned European exile and savvy Tinseltown operator. In subtly decisive ways, Kohner intervenes allusively and intertextually in the central narrative to anchor buoyant personal history in larger philosophical and political questions, in a cosmopolitan resistance to American puritanical norms, and in knowing reflection on contemporary discussions of representation and image. Gidget is a surprisingly postmodern textual space of disruption and juxtaposition that compellingly addresses its stealth core subject, a postwar America with its Western philosophical baggage and political and historical burden fumbling awkwardly forward toward new social and gender models.
Exile, Borders, and Poetry: A Study of Fang Xiaobiao's “Miscellaneous Poems on the Eastern Journey”
Authors: Yim Lawrence
Published: June 2020

Exile to Manchuria in the early Qing (1644–1912) is a peculiar historical, political, and cultural phenomenon whose scale and scope are unprecedented in premodern Chinese history. Among the exiles were some very accomplished writers who continued to write in the places of banishment, and their treatment of the trope of exile and exilic experiences in poems and prose writings is worthy of serious study. This article is a study of the exilic writings of the especially important yet understudied poet Fang Xiaobiao (1618–?), who in the wake of the examination scandal of 1657 was exiled to Ningguta 寧古塔, a remote town close to the borders of then Chosŏn Korea. The author conducts close readings of a series of poems titled “Miscellaneous Poems on the Eastern Journey” (Dongzheng zayong), written by Fang on his journey to Ningguta. The author studies not the historicity and historization of the actual exile event per se but, rather, the literary, aesthetic, and psychological representations of the exilic condition, to address the following questions: How is the uncanny psychic condition of the exile embedded in, and therefore reflected by, the literary and aesthetic configurations of the texts? How does the liminality of the exilic world interact with the liminality of exilic language? How do we understand and describe this “inbetweenness” historically, philosophically, and literarily? From these perspectives the author situates and fathoms the figure and voice of the exile turned poet, or poet turned exile. We can also see from these perspectives that the exiles are bound to encounter the “other” in the foreign landscapes, in the cultural and linguistic differences, and no less in the humbling experiences of themselves and their body and in the troubled subjectivity of the self.
Case Report: Renal potassium wasting in SARS-CoV-2 infection
Authors: Mabillard Holly , Tedd Hilary , Speight Ally , Duncan Christopher , Price David A. , Sayer John A.
Published: June 2020

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with many potentially fatal complications. Renal involvement in various forms is common in addition to serum electrolyte disturbances. Early reports suggest that hypokalaemia may frequent those with SARS-CoV-2 infection and various aetiological factors may cause this electrolyte disturbance. A Chinese retrospective study has demonstrated renal potassium wasting in patients infected with SARS-CoV-2, however, it is not known if these patients were receiving diuretic therapy which may be a contributing factor. This case report illustrates an example of renal potassium wasting in SARS-CoV-2 infection in the absence of diuretics and extra-renal mechanisms with important lessons learned.
Preliminary evidence for seasonality of Covid-19 due to ultraviolet radiation
Authors: Karapiperis Christos , Kouklis Panos , Papastratos Stelios , Chasapi Anastasia , Danchin Antoine , Ouzounis Christos A.
Published: June 2020

The Covid-19 pandemic has spread across the world during early 2020, with unforeseen consequences. Beyond social measures and biomedical research, it is important to assess the seasonality of the epidemic to inform strategies, with limited available data in the short period of time between the March equinox and the June solstice. While the effect of multiple factors is being investigated, little attention has been paid to ultraviolet (UV) radiation, a key parameter of seasonal forcing. We review the effects of UV radiation, proposing it as a potential element of seasonality, and provide evidence from the current literature and scant, yet revealing, observations. Explicit consideration should be given to UV radiation for the seasonality of Covid-19 at high latitudes and altitudes, based on the SARS and MERS epidemics and coronavirus diseases, and not just the ‘warmer days’ of summer.
Bird Swarm Optimization-based Stacked Autoencoder Deep Learning for Umpire Detection and Classification
Authors: Nandyal Suvarna , Kattimani Suvarna Laxmikant
Published: June 2020

One of the most watched and a played sport is cricket, especially in South Asian countries. In cricket, umpire has the power for making significant decisions about events in the field. With the growing increase of the utilization of technology in sports, this paper presents the umpire detection and classification by proposing an optimization algorithm. The overall procedure of the proposed approach involves three steps, like segmentation, feature extraction, and the classification. At first, the video frames are extracted from input cricket video, and the segmentation is performed based on Viola-Jones algorithm. Once the segmentation is done, the feature extraction is carried out using Histogram of Oriented Gradients (HOG), and Fuzzy Local Gradient Patterns (Fuzzy LGP). Finally, the extracted features are given to the classification step. Here, the classification is done using the proposed Bird Swarm Optimization-based stacked auto encoder deep learning classifier (BSO-Stacked Autoencoders), that categories into umpire or others. The performance of the umpire detection and classification based on BSO-Stacked Autoencoders is evaluated based on sensitivity, specificity, and accuracy. The proposed BSO-Stacked Autoencoder method achieves the maximal accuracy of 96.562%, the maximal sensitivity of 91.884%, and the maximal specificity of 99%, that indicates its superiority.
Integrating biosemiotics: From a semiological point of view
Authors: Pablé Adrian
Published: June 2020

This paper is a study in the ‘philosophy of semiotics’. It is centred on a critical approach to the Peircean sign conception, which underlies biosemiotics and the global perspective on signs. The present discussion tackles questions of ontological and epistemological interest, which it does by taking a distinctly semiological point of reference. The semiology which the present critique draws inspiration from is Roy Harris’ integrationism, an approach to human communication which rejects Saussurean semiology – the common target of Peircean semiotics. Integrationism explains signs in relation to human activities. It shares with biosemiotics a view of reality as speciesspecific, but takes a skeptical position towards the investigation of non-human signs on the grounds that it implies a metalanguage impervious to the radical indeterminacy of the sign. Integrationists take this indeterminacy as the starting point for their reflections on human communication.
Intermodal Hinterland Network Design Games
Authors: Bouchery Yann , Slikker Marco , Fransoo Jan C.
Published: June 2020

Intermodal hinterland transportation is becoming increasingly critical for global container supply chains. Managing intermodal hinterland networks is challenging because multiple actors often interact in practice. The intermodal hinterland network design games that we propose enable assessing the impact of having noncooperative users in intermodal networks. The games fall into the class of network design games but have key distinctive features. We provide some general results as well as an instance without a pure Nash equilibrium for the general case. Subsequently, we focus on the special case with a single intermodal connection available. We show that a pure Nash equilibrium always exists but that this one is not always unique. We additionally identify key structural properties for this single-hub game. These properties enable us to identify all pure Nash equilibria and a system-optimal solution in polynomial time. We illustrate our results with an application related to the development of an extended gate in the Netherlands and derive a series of insights. Overall, the results show that the multiple user feature of intermodal hinterland networks is critical and needs to be accounted for at the network design stage. We believe that this latter statement holds for general network design problems with multiple users.
Impact of a nurse-led same day admission pathway on hospital length of stay for transcatheter aortic valve implantation
Authors: McCalmont Gemma , Arshad Muhammad , Bawamia Bilal , Muir Douglas F , Vijayan Sethumadhavan , Williams Paul
Published: June 2020

Background/Aims

Patients undergoing transcatheter aortic valve intervention are commonly admitted the day before their procedure. Same-day admission offers a potential approach to reduce length of stay and procedural costs but there are little data on the feasibility and safety of this approach. This study aimed to explore the feasibility and safety of a same-day admission programme facilitated by a specialist nurse for patients undergoing elective transfemoral transcatheter aortic valve implantation.

Methods

Consecutive patients undergoing transcatheter aortic valve implantation through a standard care pathway (admission to hospital before the day of procedure) from July 2015 to July 2016 were retrospectively compared to those going through a same-day admission pathway from April 2017 to December 2018 at the James Cook University Hospital. Baseline and procedural characteristics, length of stay and clinical outcomes were analysed using chi square, Student's t-test and Mann–Whitney U tests.

Results

Overall, 121 of 135 (90%) patients were eligible for same-day admission and all underwent successful same-day transcatheter aortic valve implantation. There were 77 patients in the standard care group. Average length of stay in the same-day group was lower than the standard care group (1.5 vs 3.9 days; P<0.01) with no differences in mortality, procedural complications or readmission within 30 days between the two groups.

Conclusions

Routine same-day admission for transfemoral transcatheter aortic valve implantation facilitated by a specialist nurse can be safely implemented, leading to a shorter length of stay with no detrimental effect on clinical outcomes. This represents a highly effective method of reducing the procedural cost of transcatheter aortic valve implantation.
[RETRACTED] Negative pressure wound therapy versus conventional dressing for open fractures in lower extremity trauma
Authors: Tahir Muhammad , Chaudhry Ejaz A. , Zimri Faridullah K. , Ahmed Nadeem , Shaikh Saeed A. , Khan Shoaib , Choudry Usama K. , Aziz Amer , Jamali Allah R.
Published: June 2020

Aims

It has been generally accepted that open fractures require early skeletal stabilization and soft-tissue reconstruction. Traditionally, a standard gauze dressing was applied to open wounds. There has been a recent shift in this paradigm towards negative pressure wound therapy (NPWT). The aim of this study was to compare the clinical outcomes in patients with open tibial fractures receiving standard dressing versus NPWT.

Methods

This multicentre randomized controlled trial was approved by the ethical review board of a public sector tertiary care institute. Wounds were graded using Gustilo-Anderson (GA) classification, and patients with GA-II to III-C were included in the study. To be eligible, the patient had to present within 72 hours of the injury. The primary outcome of the study was patient-reported Disability Rating Index (DRI) at 12 months. Secondary outcomes included quality of life assessment using 12-Item Short-Form Health Survey questionnaire (SF-12), wound infection rates at six weeks and nonunion rates at 12 months. Logistic regression analysis and independent-samples t-test were applied for secondary outcomes. Analyses of primary and secondary outcomes were performed using SPSS v. 22.0.1 and p-values of < 0.05 were considered significant.

Results

A total of 486 patients were randomized between January 2016 and December 2018. Overall 206 (49.04%) patients underwent NPWT, while 214 (50.95%) patients were allocated to the standard dressing group. There was no statistically significant difference in DRI at 12 months between NPWT and standard dressing groups (mean difference 0.5; 95% confidence interval (CI) -0.08 to 1.1; p = 0.581). Regarding SF-12 scores at 12 months follow-up, there was no significant difference at any point from injury until 12 months (mean difference 1.4; 95% CI 0.7 to 1.9; p = 0.781). The 30-day deep infection rate was slightly higher in the standard gauze dressing group. The non-union odds were also comparable (odds ratio (OR) 0.90, 95% CI 0.56 to 1.45; p = 0.685).

Conclusion

Our study concludes that NPWT therapy does not confer benefit over standard dressing technique for open fractures. The DRI, SF-12 scores, wound infection, and nonunion rates were analogous in both study groups. We suggest surgeons continue to use cheaper and more readily available standard dressings. Cite this article: Bone Joint J 2020;102-B(7):912–917.
Standardization of lateral pelvic radiograph is necessary to predict spinopelvic mobility accurately
Authors: Ransone Michael , Fehring Keith , Fehring Thomas
Published: June 2020

Aims

Patients with abnormal spinopelvic mobility are at increased risk for instability. Measuring the change in sacral slope (ΔSS) can help determine spinopelvic mobility preoperatively. Sacral slope (SS) should decrease at least 10° to demonstrate adequate posterior pelvic tilt. There is potential for different ΔSS measurements in the same patient based on sitting posture. The purpose of this study was to determine the effect of sitting posture on the ΔSS in patients undergoing total hip arthroplasty (THA).

Methods

In total, 51 patients undergoing THA were reviewed to quantify the variability in preoperative spinopelvic mobility when measuring two different sitting positions using SS for planning.

Results

A total of 32 patients had standardized relaxed sitting radiographs, while 35 patients had standardized flexed sitting images. Of the 32 patients with relaxed sitting views, the mean ΔSS was 20.7° (SD 8.9°). No patients exhibited an increase in SS during relaxed sitting (i.e. anterior pelvic tilt or so-called reverse accommodation). Of the 35 patients with flexed sitting radiographs, the mean ΔSS was only 2.1° (SD 9.7°) with 16/35 (45.71%) showing anterior pelvic tilt, or so-called reverse accommodation, unexpectedly increasing the sitting SS compared to the standing SS. Overall, 18 patients had both relaxed sitting and flexed sitting radiographs. In patients with both types of sitting radiographs, the mean relaxed sit to stand ΔSS was 18.06° (SD 6.07°), while only a 3.00° (SD 10.53°) ΔSS was noted when flexed sitting. There was a mean ΔSS difference of 15.06° (SD 7.67°) noted in the same patient cohort depending on sitting posture (p < 0.001).

Conclusion

A 15° mean difference was noted depending on the sitting posture of the patient. Since decisions on component position can be made on preoperative lateral sit-stand radiographs, postural standardization is crucial. If using ΔSS for preoperative planning, the relaxed sitting radiograph is preferred. Cite this article: Bone Joint J 2020;102-B(7 Supple B):41–46.
Multimodal prophylaxis in patients with a history of venous thromboembolism undergoing primary elective hip arthroplasty
Authors: Gonzalez Della Valle Alejandro , Shanaghan Kate A. , Nguyen Joseph , Liu Jiabin , Memtsoudis Stavros , Sharrock Nigel E. , Salvati Eduardo A.
Published: June 2020

Aims

We studied the safety and efficacy of multimodal thromboprophylaxis in patients with a history of venous thromboembolism (VTE) who undergo total hip arthroplasty (THA) within the first 120 postoperative days, and the mortality during the first year. Multimodal prophylaxis includes discontinuation of procoagulant medications, VTE risk stratification, regional anaesthesia, an intravenous bolus of unfractionated heparin prior to femoral preparation, rapid mobilization, the use of pneumatic compression devices, and chemoprophylaxis tailored to the patient’s risk of VTE.

Methods

Between 2004 to 2018, 257 patients with a proven history of VTE underwent 277 primary elective THA procedures by two surgeons at a single institution. The patients had a history of deep vein thrombosis (DVT) (186, 67%), pulmonary embolism (PE) (43, 15.5%), or both (48, 17.5%). Chemoprophylaxis included aspirin (38 patients), anticoagulation (215 patients), or a combination of aspirin and anticoagulation (24 patients). A total of 50 patients (18%) had a vena cava filter in situ at the time of surgery. Patients were followed for 120 days to record complications, and for one year to record mortality.

Results

Postoperative VTE was diagnosed in seven patients (2.5%): DVT in five, and PE with and without DVT in one patient each. After hospitalization, three patients required readmiss-ion for evacuation of a haematoma, one for wound drainage, and one for monitoring of an elevated international normalized ratio (INR). Seven patients died (2.5%). One patient died five months postoperatively of a PE during open thrombectomy. She had discontinued anticoagulation. One patient died of a haemorrhagic stroke while receiving Coumadin. PE or bleeding was not suspected in the remaining five fatalities.

Conclusion

Multimodal prophylaxis is safe and effective in patients with a history of VTE. Postoperative anticoagulation should be prudent as very few patients developed VTE (2.5%) or died of suspected or confirmed PE. Mortality during the first year was mostly unrelated to either VTE or bleeding. Cite this article: Bone Joint J 2020;102-B(7 Supple B):71–77.