bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of ultrasonographic, radiographic and intra-operative findings in severe hip osteoarthritis
Authors: Nevalainen Mika T. , Kauppinen Kyösti V. , Niinimäki Tuukka , Saarakkala Simo S.
Published: December 2020

Aim of this study was to assess the US findings of patients with late-stage hip OA undergoing total hip arthroplasty (THA), and to associate the US findings with conventional radiography (CR) and intraoperative findings. Moreover, the inter-rater reliability of hip US, and association between the US and Oxford Hip Score (OHS) were evaluated. Sixty-eight hips were included, and intraoperative findings were available on 48 hips. Mean patient age was 67.6 years and 38% were males. OA findings—osteophytes at femoral collum and anterosuperior acetabulum, femoral head deformity and effusion—were assessed on US, CR and THA. The diagnostic performance of US and CR was compared by applying the THA findings as the gold standard. Osteoarthritic US findings were very common, but no association between the US findings and OHS was observed. The pooled inter-rater reliability (n = 65) varied from moderate to excellent (k = 0.538–0.815). When THA findings were used as the gold standard, US detected femoral collum osteophytes with 95% sensitivity, 0% specificity, 81% accuracy, and 85% positive predictive value. Concerning acetabular osteophytes, the respective values were 96%, 0%, 88% and 91%. For the femoral head deformity, they were 92%, 36%, 38% and 83%, and for the effusion 49%, 85%, 58% and 90%, respectively. US provides similar detection of osteophytes as does CR. On femoral head deformity, performance of the US is superior to CR. The inter-rater reliability of the US evaluation varies from moderate to excellent, and no association between US and OHS was observed in this patient cohort.
Education and stroke: evidence from epidemiology and Mendelian randomization study
Authors: Xiuyun Wen , Qian Wu , Minjun Xie , Weidong Li , Lizhen Liao
Published: December 2020

We aim to characterize the association between education and incident stroke (including total stroke, ischemic stroke, and hemorrhagic stroke) and assess whether there is a causal relationship between them. The final sample size was 11,509 in this study from the Atherosclerosis Risk in Communities (ARIC) study. Cox hazard regression models were used to explore the association between education level and incident stroke. Two-sample Mendelian randomization (MR) was used to estimate the causality. During a median follow-up of 25.3 years, 915 cases (8.0%) of stroke occurred. Participants with advanced education level were associated with 25% (HR 0.75; 95% CI 0.62, 0.91) decreased the rate of incident total stroke. Hazard ratio of intermediate and advanced education level for ischemic stroke were 0.82 (0.69, 0.98) and 0.73 (0.60, 0.90) separately. In the MR analysis, we observed evidence that education was likely a negetive causal risk factor for ischemic stroke (OR 0.764, 95% CI 0.585–0.998, P = 0.048). Higher education level was associated with a decreased rate of total stroke and ischemic stroke incident, but not hemorrhagic stroke incident. There might be a protective causal association between education and ischemic stroke (but not total stroke nor hemorrhagic stroke).
Clinical features and KRAS mutation in colorectal cancer with bone metastasis
Authors: Park Hyung Soon , Chun You Jin , Kim Han Sang , Kim Jee Hung , Lee Choong-kun , Beom Seung-Hoon , Shin Sang Joon , Ahn Joong Bae
Published: December 2020

Bone metastasis is known as a poor prognostic factor in colorectal cancer (CRC), but its clinical manifestations and outcomes are uncertain. CRC with bone metastasis was searched from January 2006 to April 2016. Of 11,551 CRC patients, 321 (2.7%) patients had bone metastasis. Bone-only metastasis was found in only 8.7% of patients. Synchronous bone metastasis was present in 147 (45.8%) patients. In patients with metachronous bone metastasis, the median time from CRC diagnosis to bone metastasis (TTB) was 27.2 months. KRAS mutation status was a marginally significant factor affecting TTB (median TTB, KRAS wild-type or mutation: 29 or 25.8 months, respectively, P = 0.068). Skeletal-related events (SREs) were noted in 200 (62.3%) patients. Median overall survival (OS) from diagnosis of bone metastasis was 8.0 months. On multivariate analysis, multi-organ metastasis, peritoneal metastasis, neutrophil-to-lymphocyte ratio (NLR) ≥ 2.7, and alkaline phosphatase (ALP) ≥ 123 were independent factors for OS. Palliative chemotherapy prolonged survival in CRC patients with bone metastasis (HR 0.25, 95% CI 0.2–0.33). In conclusion, bone metastasis of CRC is rare, but it is related to SREs. Most patients have other organ metastasis and survival is 8.0 months. Attention should be paid to bone metastasis in CRC patients.
Higher evolutionary rates in life-history traits in insular than in mainland palms
Authors: Cássia-Silva Cibele , Freitas Cíntia G. , Lemes Larissa Pereira , Paterno Gustavo Brant , Dias Priscila A. , Bacon Christine D. , Collevatti Rosane G.
Published: December 2020

Isolated islands, due to the reduced interspecific competition compared to mainland habitats, present ecological opportunities for colonizing lineages. As a consequence, island lineages may be expected to experience higher rates of trait evolution than mainland lineages. However, island effects on key life-history traits of vascular plants remain underexplored at broad spatiotemporal scales, even for emblematic island clades such as palms. Here, we used phylogenetic comparative methods to evaluate potential differences in size and macroevolutionary patterns of height and fruit diameter among mainland, continental, and volcanic island palms. Further, phylogenetic beta-diversity was used to determine if lineage turnover supported an adaptive radiation scenario on volcanic islands. Volcanic island palms were taller than their continental island and mainland counterparts, whereas continental island palms exhibited smaller fruit size. Height and fruit size of palms evolved under evolutionary constraints towards an optimal value. However, scenarios of adaptive radiation and niche conservatism were not supported for the height and fruit size of volcanic and mainland palm clades, respectively, as expected. Instead, continental island palms exhibited higher evolutionary rates for height and fruit size. Insular palm assemblages (continental and volcanic) are composed of unique lineages. Beyond representing evolutionary sources of new palm lineages, our results demonstrate that insular habitats are important in shaping palm trait diversity. Also, the higher phenotypic evolutionary rates of continental island palms suggest disparate selection pressures on this habitat type, which can be an important driver of trait diversification over time. Taken together, these results stress the importance of insular habitats for conservation of functional, phylogenetic, and taxonomic diversity of palms.
Impact of tobacco-related chronic obstructive pulmonary disease on developmental trajectories of comorbidities in the Taiwan population
Authors: Ho Te-Wei , Tsai Yi-Ju , Huang Chun-Ta , Lien Angela Shin-Yu , Lai Feipei
Published: December 2020

Comorbidities adversely affect the quality of life and survival of patients with chronic obstructive pulmonary disease (COPD), and timely identification and management of comorbidities are important in caring for COPD patients. This study aimed to investigate the impact of COPD on long-term developmental trajectories of its comorbidities. From 2010 to 2013, all spirometry-confirmed COPD patients with a 5-year follow-up period were identified as the cases. The prevalence of comorbidities and their trajectories in COPD cases were obtained and compared with those in non-COPD controls matched for age, sex, smoking status and Charlson comorbidity index (CCI). Over the study period, a total of 682 patients, 341 each in COPD and control groups were included, with a mean age of 69.1 years and 89% male. The baseline mean CCI was 1.9 for both groups of patients and significantly increased to 3.4 and 2.7 in COPD and control groups after 5 years, respectively (both P < 0.001). Through the 5-year follow-up, a significant increase in the prevalence of all comorbidities of interest was observed in the COPD cohort and the incidence was remarkably higher for hypertension [incidence rate ratio (IRR) 1.495; 95% confidence interval (CI) 1.017–2.198], malignancy (IRR 2.397; 95% CI 1.408–4.081), diabetes mellitus (IRR 2.927; 95% CI 1.612–5.318), heart failure (IRR 2.531; 95% CI 1.502–4.265) and peptic ulcer disease (IRR 2.073; 95% CI 1.176–3.654) as compared to the non-COPD matched controls. In conclusion, our findings suggest that the presence of COPD may be considered a pathogenic factor involved in the development of certain comorbidities.
A C21-steroidal derivative suppresses T-cell lymphoma in mice by inhibiting SIRT3 via SAP18-SIN3
Authors: Gajendran Babu , Varier Krishnapriya M. , Liu Wuling , Wang Chunlin , Sample Klarke M. , Zacksenhaus Eldad , Juiwei Cui , Huang LieJun , Hao XiaoJiang , Ben-David Yaacov
Published: December 2020

The SIN3 repressor complex and the NAD-dependent deacetylase SIRT3 control cell growth, and development as well as malignant transformation. Even then, a little known about cross-talks between these two chromatin modifiers or whether their interaction explored therapeutically. Here we describe the identification of a C21-steroidal derivative compound, 3-O-chloroacetyl-gagamine, A671, which potently suppresses the growth of mouse and human T-cell lymphoma and erythroleukemia in vitro and preclinical models. A671 exerts its anti-neoplastic effects by direct interaction with Histone deacetylase complex subunit SAP18, a component of the SIN3 suppressor complex. This interaction stabilizes and activates SAP18, leading to transcriptional suppression of SIRT3, consequently to inhibition of proliferation and cell death. The resistance of cancer cells to A671 correlated with diminished SAP18 activation and sustained SIRT3 expression. These results uncover the SAP18-SIN3-SIRT3 axis that can be pharmacologically targeted by a C21-steroidal agent to suppress T-cell lymphoma and other malignancies.
First principles calculation of topological invariants of non-Hermitian photonic crystals
Authors: Prudêncio Filipa R. , Silveirinha Mário G.
Published: December 2020

Topological photonic systems have recently emerged as an exciting new paradigm to guide light without back-reflections. The Chern topological numbers of a photonic platform are usually written in terms of the Berry curvature, which depends on the normal modes of the system. Here, we use a gauge invariant Green’s function method to determine from first principles the topological invariants of photonic crystals. The proposed formalism does not require the calculation of the photonic band-structure, and can be easily implemented using the operators obtained with a standard plane-wave expansion. Furthermore, it is shown that the theory can be readily applied to the classification of topological phases of non-Hermitian photonic crystals with lossy or gainy materials, e.g., parity-time symmetric photonic crystals.
Large mobility modulation in ultrathin amorphous titanium oxide transistors
Authors: Tiwale Nikhil , Subramanian Ashwanth , Dai Zhongwei , Sikder Sayantani , Sadowski Jerzy T. , Nam Chang-Yong
Published: December 2020

Recently, ultrathin metal-oxide thin film transistors (TFTs) have shown very high on-off ratio and ultra-sharp subthreshold swing, making them promising candidates for applications beyond conventional large-area electronics. While the on-off operation in typical TFTs results primarily from the modulation of charge carrier density by gate voltage, the high on-off ratio in ultrathin oxide TFTs can be associated with a large carrier mobility modulation, whose origin remains unknown. We investigate 3.5 nm-thick TiOx-based ultrathin TFTs exhibiting on-off ratio of ~106, predominantly driven by ~6-decade gate-induced mobility modulation. The power law behavior of the mobility features two regimes, with a very high exponent at low gate voltages, unprecedented for oxide TFTs. We find that this phenomenon is well explained by the presence of high-density tail states near the conduction band edge, which supports carrier transport via variable range hopping. The observed two-exponent regimes reflect the bi-exponential distribution of the density of band-tail states. This improved understanding would be significant in fabricating high-performance ultrathin oxide devices.
Ocean warming and acidification uncouple calcification from calcifier biomass which accelerates coral reef decline
Authors: Dove Sophie Gwendoline , Brown Kristen Taylor , Van Den Heuvel Annamieke , Chai Aaron , Hoegh-Guldberg Ove
Published: December 2020

Global climate change will drive declines in coral reefs over coming decades. Yet, the relative role of temperature versus acidification, and the ability of resultant ecosystems to retain core services such as coastal protection, are less clear. Here, we investigate changes to the net chemical balances of calcium carbonate within complex experimental coral reefs over 18 months under conditions projected for 2100 if CO2 emissions continue unmitigated. We reveal a decoupling of calcifier biomass and calcification under the synergistic impact of warming and acidification, that combined with increased night-time dissolution, leads to an accelerated loss of carbonate frameworks. Climate change induced degradation will limit the ability of coral reefs to keep-up with sea level rise, possibly for thousands of years. We conclude that instead of simply transitioning to alternate states that are capable of buffering coastlines, reefs are at risk of drowning leading to critical losses in ecosystem functions.
Gold nanomaterials in the management of lung cancer
Authors: Guinart Ainoa , Perry Hannah L. , Wilton-Ely James D. E. T. , Tetley Teresa D.
Published: December 2020

Lung cancer (LC) is one of the most deadly cancers worldwide, with very low survival rates, mainly due to poor management, which has barely changed in recent years. Nanomedicines, especially gold nanomaterials, with their unique and size-dependent properties offer a potential solution to many challenges in the field. The versatility afforded by the shape, size, charge and surface chemistry of gold nanostructures allows them to be adapted for many applications in the diagnosis, treatment and imaging of LC. In this review, a survey of the most recent advances in the field is presented with an emphasis on the optical properties of gold nanoscale materials and their use in cancer management. Gold nanoparticle toxicology has also been a focus of interest for many years but the studies have also sometimes arrived at contradictory conclusions. To enable extrapolation and facilitate the development of medicines based on gold nanomaterials, it must be assumed that each design will have its own unique characteristics that require evaluation before translation to the clinic. Advances in the understanding and recognition of the molecular signatures of LC have aided the development of personalised medicines. Tailoring the treatment to each case should, ideally increase the survival outcomes as well as reduce medical costs. This review seeks to present the potential of gold nanomaterials in LC management and to provide a unified view, which will be of interest to those in the field as well as researchers considering entering this highly important area of research.
Designing Courses in Communication Sciences and Disorders Using Backward Design
Authors: Slavych Bonnie K.
Published: December 2020

Purpose

To ensure that students are learning the most important information and developing the most important skills and to make certain that any externally mandated standards are met, professors need to intentionally plan their courses. This tutorial will provide a description and comparison of three classes of course design (forward, central, and backward) and two well-regarded frameworks for facilitating efficient and effective backward design (Integrated Design and Understanding by Design). Explanations of key terminology and examples from the redesign of a graduate voice disorders course will be provided.

Conclusions

Following the Understanding by Design framework for backward course design not only resulted in a well-organized course that facilitated achievement of a learner-centered, knowledge and skill–centered, and assessment-centered environment but also greatly increased the confidence of the instructor and the participation of the students. Intentional course planning can facilitate more efficient and effective learning sessions, resulting in both instructor and student satisfaction. The information provided in this tutorial can be adapted for any communication sciences and disorders course and with any level of faculty experience.
The Effect of Dental and Occlusal Anomalies on Articulation in Individuals With Cleft Lip and/or Cleft Palate
Authors: Mason Kazlin N.
Published: December 2020

Purpose

Dental and occlusal anomalies are common in individuals with cleft lip and palate, placing them at risk for speech sound distortions. Speech-language pathologists and dental practitioners frequently interact when presented with clinical problems secondary to dental and occlusal anomalies. This is especially true when treating a child with a cleft lip and palate. The speech sound error types must be identified and their etiologies evaluated to develop appropriate management plans. The purpose of this review article is to describe the types of dental and occlusal anomalies that are common in individuals with cleft lip and/or palate and discuss the impact these anomalies have on articulation.

Method

A review of the literature was completed with a focus on prevalence, definitions, and descriptions of dental and occlusal anomalies in individuals with cleft lip and palate. The impact of dental/occlusal anomalies on speech production is described.

Results and Conclusions

There is sufficient evidence that dental and occlusal anomalies have an impact on articulation, but the relationship of dental or occlusal status is not always a direct one. The phonemes most affected by aberrant oral conditions are sibilants, though other phonemes may be impacted as well. These speech errors are considered to be obligatory oral distortions in that they are made in response to an oral structural defect. These speech errors are not typically amenable to speech therapy, but rather require orthodontic and/or surgical correction. Such treatment can be effective in improving these errors, often spontaneously, however, speech therapy may be necessary (and most effective) following correction of the dental and/or occlusal anomalies if errors persist.
Using Solution-Focused Principles With Older Children Who Stutter and Their Parents to Elicit Perspectives of Therapeutic Change
Authors: Rodgers Naomi H. , Berquez Ali , Hollister Julia , Zebrowski Patricia M.
Published: December 2020

Purpose

We previously presented findings from pretherapy solution-focused interviews regarding the therapeutic best hopes of older children who stutter (CWS) and their parents. The current follow-up study explored the same clients' solution-focused reflections 1 year later with respect to their perspectives of what changes had occurred over the course of therapy.

Method

Seven CWS (11–14 years old) and 12 of their parents, who were interviewed in the original Berquez et al. (2015) study, were interviewed again 1 year after they started therapy. These clients responded to open-ended, solution-focused brief therapy (SFBT)–style questions and rating scales. Their responses were qualitatively and quantitatively analyzed to identify what clients noticed had changed over the course of therapy.

Result

CWS and their parents reported changes spanning social communication abilities, cognitive-emotional skills, and speech management strategies. While these were consistent with their pretherapy best hopes, CWS and their parents identified additional, unexpected gains beyond the scope of what they originally hoped for at the beginning of therapy, including improvements in adaptive coping, academic experience, parent–child interactions, thoughts and feelings about stuttering, and personal growth.

Conclusion

SFBT can provide speech-language pathologists a framework for facilitating client reflections on positive signs of change that occur over the therapeutic process.
Estimating Hamiltonian fluctuations from quantum time averages
Authors: Sharma Navneet , Gautam Kumar , Parthasarathy Harish
Published: December 2020

This study presents a framework for the enhancement of parameter estimation issues by computing the time average of several quantum observables measured under the evolution of the Hamiltonian system. These time‐cum‐quantum averages are expressed as a quadratic function of the orthogonal projections on the eigen subspaces of the system. Estimation of the parameters is done using the approximate time‐independent perturbation theory assuming the other parameters to be small with respect to one of the parameters that is normalised to unity in the presence of noise. The study also proves that the derived expression for the mean square parameter estimation error attains the quantum limit. When the measurement noise is classical and for general positive operator‐valued measure successive time, the authors derive an expression for the quantum Cramèr–Rao lower bound.
Smart load scheduling strategy utilising optimal charging of electric vehicles in power grids based on an optimisation algorithm
Authors: Lu Maxim , Abedinia Oveis , Bagheri Mehdi , Ghadimi Noradin , Shafie‐khah Miadreza , Catalão João P.S.
Published: December 2020

One of the main goals of any power grid is sustainability. The given study proposes a new method, which aims to reduce users’ anxiety especially at slow charging stations and improve the smart charging model to increase the benefits for the electric vehicles’ owners, which in turn will increase the grid stability. The issue under consideration is modelled as an optimisation problem to minimise the cost of charging. This approach levels the load effectively throughout the day by providing power to charge EVs’ batteries during the off‐peak hours and drawing it from the EVs’ batteries during peak‐demand hours of the day. In order to minimise the costs associated with EVs’ charging in the given optimisation problem, an improved version of an intelligent algorithm is developed. In order to evaluate the effectiveness of the proposed technique, it is implemented on several standard models with various loads, as well as compared with other optimisation methods. The superiority and efficiency of the proposed method are demonstrated, by analysing the obtained results and comparing them with the ones produced by the competitor techniques.
Constraining the age of young stellar clusters via the amplitude of photometric variability
Authors: Messina S.
Published: December 2020

Context. The determination of stellar age is a crucial task in astrophysics research. At present, the various methods employed in such studies are either model-dependent or based on calibrated empirical relations. The most reliable results are generally obtained when different methods are applied in a complementary manner.

Aims. We propose a new method for the age determination of young stellar associations and open clusters (ages ≲ 125 Myr), which may allow for the placement of further constraints on the age when used in tandem with other methods.

Methods. We explore the amplitude of the photometric variability in bins of color and rotation period of five young associations and clusters spanning an interval of ages from ∼1−3 Myr to ∼ 625 Myr (Taurus, ρ Ophiuchi, Upper Scorpius, Pleiades, and Praesepe), which all have high-quality time-series photometry from Kepler K2 campaigns.

Results. In the low-mass regime, we find that stars with similar color and rotation periods but different ages exhibit a range of amplitudes for their photometric variability, with younger stars showing a larger photometric variability than older stars.

Conclusions. The decline of photometric variability amplitude versus age in stars with similar color and rotation period may, in principle, be calibrated and adopted as an additional empirical relation for constraining the age of young associations and open clusters, provided that time-series photometry is available for their low-mass members.
GaiaEarly Data Release 3
Authors: Riello M. , De Angeli F. , Evans D. W. , Montegriffo P. , Carrasco J. M. , Busso G. , Palaversa L. , Burgess P. W. , Diener C. , Davidson M. , Rowell N. , Fabricius C. , Jordi C. , Bellazzini M. , Pancino E. , Harrison D. L. , Cacciari C. , van Leeuwen F. , Hambly N. C. , Hodgkin S. T. , Osborne P. J. , Altavilla G. , Barstow M. A. , Brown A. G. A. , Castellani M. , Cowell S. , De Luise F. , Gilmore G. , Giuffrida G. , Hidalgo S. , Holland G. , Marinoni S. , Pagani C. , Piersimoni A. M. , Pulone L. , Ragaini S. , Rainer M. , Richards P. J. , Sanna N. , Walton N. A. , Weiler M. , Yoldas A.
Published: December 2020

Context. GaiaEarly Data Release 3 (GaiaEDR3) contains astrometry and photometry results for about 1.8 billion sources based on observations collected by the European Space AgencyGaiasatellite during the first 34 months of its operational phase.

Aims.In this paper, we focus on the photometric content, describing the input data, the algorithms, the processing, and the validation of the results. Particular attention is given to the quality of the data and to a number of features that users may need to take into account to make the best use of theGaiaEDR3 catalogue.

Methods.The processing broadly followed the same procedure as forGaiaDR2, but with significant improvements in several aspects of the blue and red photometer (BP and RP) preprocessing and in the photometric calibration process. In particular, the treatment of the BP and RP background has been updated to include a better estimation of the local background, and the detection of crowding effects has been used to exclude affected data from the calibrations. The photometric calibration models have also been updated to account for flux loss over the whole magnitude range. Significant improvements in the modelling and calibration of theGaiapoint and line spread functions have also helped to reduce a number of instrumental effects that were still present in DR2.Results. GaiaEDR3 contains 1.806 billion sources withG-band photometry and 1.540 billion sources withGBPandGRPphotometry. The median uncertainty in theG-band photometry, as measured from the standard deviation of the internally calibrated mean photometry for a given source, is 0.2 mmag at magnitudeG= 10–14, 0.8 mmag atG≈ 17, and 2.6 mmag atG≈ 19. The significant magnitude term found in theGaiaDR2 photometry is no longer visible, and overall there are no trends larger than 1 mmag mag−1. Using one passband over the whole colour and magnitude range leaves no systematics above the 1% level in magnitude in any of the bands, and a larger systematic is present for a very small sample of bright and blue sources. A detailed description of the residual systematic effects is provided. Overall the quality of the calibrated mean photometry inGaiaEDR3 is superior with respect to DR2 for all bands.
GaiaEarly Data Release 3
Authors: Torra F. , Castañeda J. , Fabricius C. , Lindegren L. , Clotet M. , González-Vidal J. J. , Bartolomé S. , Bastian U. , Bernet M. , Biermann M. , Garralda N. , Gúrpide A. , Lammers U. , Portell J. , Torra J.
Published: December 2020

Context.TheGaiaEarly Data Release 3 (GaiaEDR3) contains results derived from 78 billion individual field-of-view transits of 2.5 billion sources collected by the European Space Agency’sGaiamission during its first 34 months of continuous scanning of the sky.

Aims.We describe the input data, which have the form of onboard detections, and the modeling and processing that is involved in cross-matching these detections to sources. For the cross-match, we formed clusters of detections that were all linked to the same physical light source on the sky.

Methods.As a first step, onboard detections that were deemed spurious were discarded. The remaining detections were then preliminarily associated with one or more sources in the existing source list in an observation-to-source match. All candidate matches that directly or indirectly were associated with the same source form a match candidate group. The detections from the same group were then subject to a cluster analysis. Each cluster was assigned a source identifier that normally was the same as the identifiers fromGaiaDR2. Because the number of individual detections is very high, we also describe the efficient organising of the processing.

Results.We present results and statistics for the final cross-match with particular emphasis on the more complicated cases that are relevant for the users of theGaiacatalogue. We describe the improvements over the earlierGaiadata releases, in particular for stars of high proper motion, for the brightest sources, for variable sources, and for close source pairs.
La participation à un stage en communauté, obligatoire et encadré change-t-elle l’attitude des externes en médecine à l’égard des personnes en situation d’itinérance ? Une étude pré et post
Authors: Lavallée Marc-André , Thommeret-Carrière Anne-Sophie , Authier Marie , Binta Diallo Fatoumata
Published: December 2020

Contexte : Les personnes en situation d’itinérance sont souvent victimes des effets d’inégalités sociales de santé, qui peuvent être renforcées par une attitude négative des professionnels de la santé. Cette recherche évalue si la participation obligatoire des externes en médecine de l’Université de Montréal à un stage encadré d’une semaine en communauté apporte des changements positifs à leur à l’égard des individus en situation d’itinérance. Méthode : Il s’agit d’une étude pré-post comparant les scores au Health Professionals’ Attitudes Towards the Homeless Inventory (HPATHI) avant (T0) et après (T1) le stage. 271 externes en médecine ont participé au stage. De ce nombre, 139 (51 %) d’entre eux ont répondu au questionnaire autant en T0 qu’en T1 et ont été inclus dans les analyses. L’issue primaire est un changement du score total au questionnaire entre T0 et T1, mesuré par un test T apparié. Le maintien de l’effet à un troisième temps de mesure (T2) et l’effet des caractéristiques sociodémographiques ont également été mesurés dans les issues secondaires. Résultats : Le score total moyen au test d’attitude est significativement plus élevé après le stage en comparaison à celui au début du stage, avec une amélioration moyenne de 0,15 sur une échelle de Likert de 5 (3,91 vs. 3,76, p < 0,001 ; d de Cohen 0,54) En répétant ce test sur trois groupes de participants selon leur score initial, le groupe ayant le score initial le plus élevé ne montrait pas d’amélioration significative (4,24 vs. 4,33, p = 0,017) et le groupe avec le score initial le plus bas présentait le plus grand changement (3,34 vs. 3,55, p < 0,001). Conclusion : Cette recherche suggère que ce stage en communauté, encadré et obligatoire permet une amélioration statistiquement significative de l’attitude des externes en médecine envers les personnes en situation d’itinérance. Cette amélioration est plus importante pour les externes qui présentent une attitude initiale plus négative.
PluriPASS, première année commune aux études de santé (PACES) adaptée de l’Université d’Angers : caractérisation et suivi de la population étudiante sur les trois semestres du dispositif
Authors: Amand Marion , Richard Isabelle , Lerolle Nicolas , Alves de Sousa Adeline , Mallet Sabine , Saint-André Jean-Paul , Passirani Catherine
Published: December 2020

Contexte : En France, les assises de l’enseignement supérieur et de la recherche en 2013 ont permis de mettre en lumière les carences de la première année commune aux études de santé (PACES). L’Université d’Angers a souhaité expérimenter un nouveau mode d’admission dans les études de santé, dénommé PluriPASS. Ce parcours pluridisciplinaire, en tant qu’alternative à la PACES classique, a pour volonté d’une part de garantir un recrutement efficace dans six filières contingentées de santé et d’autre part de favoriser une orientation progressive vers une quinzaine de licences des Universités d’Angers et du Mans pour ceux qui n’auraient pas été recrutés dans la filière de santé souhaitée. But : Cet article vise à identifier les caractéristiques des étudiants admis ou non admis en filière de santé, en fonction des choix qu’ils ont faits au fur et à mesure de leur parcours. Méthodes : Les données mobilisées pour répondre à cet objectif sont celles relatives aux inscriptions et aux examens, issues des bases de données administratives des deux universités, auxquelles on applique des traitements statistiques afin de dégager les caractéristiques les plus significatives. Résultats : Dans le cas d’une non admission en filière santé, trois fois plus d’étudiants en moyenne, par rapport à la PACES classique, poursuivent et réussissent leurs études de licence. Conclusion : À travers une voie d’accès pluridisciplinaire commune à un ensemble de formations et par une orientation progressive, PluriPASS offre la possibilité à une majorité d’étudiants de poursuivre des études longues, y compris hors santé.
Formation à la relation médecin-malade dans le cadre d’une pathologie chronique. Un dispositif original basé sur l’intervention d’une psychologue clinicienne et d’un professeur de communication
Authors: Chambellan Sylvie , Wable Thierry , Freger Pierre , Veber Benoit , Vittecoq Olivier
Published: December 2020

Contexte et problématique :À l’ère de la médecine basée sur les preuves, les critères d’évaluation utilisés par les médecins tendent à s’écarter des attentes des patients atteints de pathologies chroniques dont la douleur est difficile à estimer. La relation médecin-malade s’en trouve altérée du fait d’un manque de formation dans la gestion de situations complexes par les médecins mais également du fait de l’utilisation de critères d’évaluation parfois inadaptés. Ces situations, comme celle que représente l’annonce d’un diagnostic ou de la prise en charge de la douleur, sont difficiles à appréhender sans formation préalable adaptée.Objectif :Rapporter l’expérience du service de rhumatologie du Centre hospitalier universitaire (CHU) de Rouen relative à l’implantation d’ateliers de formation à la relation médecin-patient pour les stagiaires du second cycle des études médicales. Exposer notamment les démarches didactique et pédagogique suivies par les promoteurs et en documenter certains impacts.Méthodes :Les ateliers sont organisés en petits groupes, animés par une psychologue clinicienne et un professeur de communication, encadrés par un médecin. Lors de cette séance qui dure deux heures, les deux animateurs, qui jouent le rôle de médiateur, offrent un espace de parole permettant aux étudiants de s’exprimer autour de leur relation au patient et éclairent les problématiques soulevées par l’apport d’éléments théoriques dans les champs de la psychologie et de la communication. Ces ateliers comprennent deux temps : l’un basé sur l’apprentissage en situation (en lien direct avec les patients pris en charge), l’autre consistant en la mise en application par des jeux de rôle.Résultats :L’enquête d’évaluation menée auprès des stagiaires a permis de documenter des résultats très encourageants pour cette nouvelle forme d’apprentissage qui s’inscrit en complément de l’enseignement académique.Conclusion :Les ateliers apportent aux étudiants une expérience d’apprentissage complémentaire par rapport aux autres activités organisées sous l’égide des soignants lors du stage, en mettant l’accent sur les différentes dimensions de la relation médecin-patient, en lien avec les champs de la psychologie et de la communication.
70 Jahre PPmP … und immer ein bisschen
weiser?
Authors: Strauß Bernhard
Published: December 2020

Mit dem vorliegenden Heft wird der 70. Jahrgang der PPmP komplettiert, eine
Gelegenheit den 70. Geburtstag unserer Zeitschrift nun auch offiziell zu begehen.
Ursprünglich „Zeitschrift für Psychotherapie und
medizinische Psychologie“ genannt, erschien diese 1951 erstmalig als Organ
der „Allgemeinen Ärztlichen Gesellschaft für
Psychotherapie“ (AÄGP, zugleich auch der Österreichischen
Ärztegesellschaft für Psychotherapie, vgl. 1).
Kropfbildende Naturstoffe
Authors: Bielenberg Jens
Published: December 2020

Studien zeigen, dass die Jodversorgung in Deutschland, trotz der Anreicherung von Salz und dessen Anwendung in der Lebensmittelindustrie, unterhalb der Bedarfswerte liegt. Goitrogene Substanzen in Lebensmitteln können zusätzlich die Schilddrüse an der Jodaufnahme hindern und eine Kropfbildung begünstigen. Insbesondere Kohlsorten, eine soja- oder hirsereiche Ernährung, verschiedene Nusssorten wie Wal- oder Erdnüsse, aber auch eine zu hohe Jodaufnahme können die Schilddrüsenfunktion beeinträchtigen und strumigen wirken.
Ionisierende Strahlung: Gesundheitsrisiken im Katastrophenfall
Authors: Weiss Wolfgang
Published: December 2020

Die nukleare Katastrophe in Fukushima hat mehr Todesfälle durch Evakuierungsmaßnahmen gefordert als durch die ionisierende Strahlung selbst. Die Erkenntnisse haben u. a. dazu geführt, folgendes Gebot in das Strahlenschutzkonzept aufzunehmen: Bei der Rechtfertigung einschneidender Schutzmaßnahmen sind sowohl die strahlenbedingten gesundheitlichen Risiken als auch die mit der Maßnahme verbundenen gesundheitlichen und gesellschaftlichen Risiken zu berücksichtigen.

Die erfolgreiche Umsetzung von Schutzkonzepten in Ausnahmesituationen ist nur dann möglich, wenn sie fachlich und organisatorisch gut vorbereitet, regelmäßig in realistischen Übungen erprobt und auf Basis aktueller wissenschaftlicher Erkenntnisse fortentwickelt werden. Die Wissensbasis in der Bevölkerung und bei zentralen Berufsgruppen in der Medizin ist dazu erforderlich und sollte z. B. in Ausbildungskurrikula aufgenommen werden.
Steroidhormone und Schilddrüse
Authors: Krug Marianne
Published: December 2020

In der Allgemeinpraxis müssen Sexualhormone und Schilddrüsenfunktion häufig im Zusammenhang betrachtet werden. Symptomüberlappungen können eine differenzierte Anamnese erfordern, beide Hormonachsen betroffen sein, beide Hormonsysteme einander beeinflussen bzw. die Substitution der einen Achse die andere.

Die enge Verzahnung dieser beiden Hormonsysteme zeigt sich z. B. daran, dass der Häufigkeitsgipfel von Schilddrüsenerkrankungen in die Lebensphase hormoneller Umbrüche wie Pubertät, Schwangerschaft, Postpartalzeit oder Wechseljahre fällt. Schilddrüsendysfunktionen können Symptome aus dem Bereich der Sexualfunktion entfalten wie Zyklusstörungen, In- und Subfertilität, Komplikationen im Schwangerschaftsverlauf, Prämenstruelles Syndrom, Ovarialzysten, Libidoverlust oder Erektionsstörungen.

Dieser Artikel stellt die wichtigsten wechselseitigen Einflüsse der gonadalen und der Schilddrüsenachse dar.
Physical Activity to Stay Fit
Authors: Shadap Arkierupaia
Published: December 2020

Physical activity is any bodily movement produced by skeletal muscles that require energy expenditure. According to World Health Organization, regular physical activities such as walking, cycling, doing the household work, etc., make an individual feel good and it has significant benefits for health. One of the vital elements for healthy bones at every age is exercise. Exercise lowers the blood pressure, slightly decreases the levels of total- and low-density lipoprotein—the bad cholesterol, and increases the levels of high-density lipoprotein—the good cholesterol. Regular physical activity and exercise help in maintaining the healthy body weight, decreasing stress, apprehension, and preventing depression. Exercising can also possibly help in delaying the effects of Alzheimer’s disease and other forms of dementia. Strong evidence shows that physical activity has a wide range of beneficial effects for both physical and mental well-being.
Pediatric Pneumococcal Hemolytic Uremic Syndrome Treated with Sequence Tandem Therapeutic Plasma Exchange and Continuous Venovenous Hemodiafiltration: A Case Report
Authors: Markic Josko , Polic Branka , Kovacevic Tanja , Rogulj Marijana , Ardalic Tatjana Catipovic
Published: December 2020

Hemolytic uremic syndrome (HUS) is characterized by microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury. Approximately 5% of HUS cases are associated with Streptococcus pneumoniae infections (pHUS). Treatment includes supportive care with appropriate antimicrobial therapy, fluid and blood product resuscitation, and renal replacement therapy. We presented a case of a 22-month-old previously healthy girl, who was hospitalized at University Hospital of Split. Left-sided pneumonia and sepsis caused by S. pneumoniae were confirmed. The course of illness was complicated with development of pHUS. Since the pathogenesis of pHUS is only partially understood, the treatment remains controversial. Our patient was successfully treated with daily sequence tandem continuous venovenous hemodiafiltration and therapeutic plasma exchange with albumins, along with other supportive measures. Therefore, in our opinion, plasmapheresis should be considered as a part of standard treatment of children with pHUS. Additionally, the incidence of pHUS appears to be increasing. S. pneumoniae is a particularly important among pediatric pathogens and it can cause wide spectrum of illnesses. Therefore, due to the significant burden of invasive pneumococcal disease, pneumococcal vaccination should be encouraged.
Reassessment of Pediatric Tension-Type Headaches
Authors: Vaiman Michael , Mametov Kadri , Roitblat Yulia , Abba Michael , Nehuliaieva Liliia , Foonberg Maya , Frank Charles , Kaliberdenko Vitalii B. , Shterenshis Michael
Published: December 2020

A retrospective multicenter chart review was conducted with the objective of evaluating the hypothesis that certain cases diagnosed as tension-type headache (TTH) in pediatric neurology are not stress-related or central sensitization-related conditions but may mimic an autoimmune disorder of the dura mater. Of the 29,642 patient charts reviewed, 12,424 charts (42%) were excluded because of incomplete data and 17,218 cases were analyzed. For all the 29,642 charts, TTH or chronic daily headaches were diagnosed in 29.2% of cases. Among the 17,218 cases subjected to detailed diagnostic procedures, TTH was diagnosed in only 5%. In 7,044 cases, the initial diagnosis of TTH was changed to headache attributed to infection (87.4%), which was supported by the presence of meningeal signs, high antistreptolysin-O titers, and, in 46% of cases, magnetic resonance imaging (MRI)-detected thickening of the cranial dura mater. The initial diagnosis of migraine was confirmed in 87.7% of cases (8,034/9,162). In some cases of treatment-resistant pediatric recurrent headaches, which are initially diagnosed as TTH, a secondary type of headache may be suspected as the underlying cause. Usually this type of headache has streptococcal infection-related laboratory findings, the meninges as the site of the lesion, and meningism as the clinical presentation.
Management of Chronic Total Occlusion of Coronary Artery
Authors: Mares Adriana , Mukherjee Debabrata
Published: December 2020

Chronic total occlusion (CTO) of a coronary artery is typically defined as a completely occluded artery without any antegrade flow and a duration of at least 3 months. We reviewed the current literature describing the optimal management of CTO including the role of revascularization and choice of modality, i.e., percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery. Databases (PubMed, the Cochrane Library, Embase, EBSCO, Web of Science, and CINAHL) were searched and relevant studies of patients with CTO were selected for review. The prevalence of coronary artery CTOs is approximately 25% among patients undergoing coronary angiography for angina. Available data suggests that PCI of CTO can be a technically complex procedure with relatively lower success rates compared with non-CTO PCI and typically associated with a higher complication rate especially at nonspecialized centers. Furthermore, successful CTO-PCI is associated with symptomatic improvement but does not appear to improve mortality, myocardial infarction, stroke, and repeat revascularization rates. Based on contemporary data, PCI of CTO lesions may be considered in patients with incapacitating angina despite treatment with optimal guideline-directed medical therapy and in whom based on coronary anatomy there is a reasonable chance of technical success with an acceptable risk.
Achalasia Cardia: A Mimicker of Pulmonary Tuberculosis in a High-Burden Setting
Authors: Sharma Pratibha , Ganga Ranganath T.
Published: December 2020

BRICS (Brazil, Russia, India, China, and South Africa) countries account for more than two-thirds of the global tuberculosis burden. Tuberculosis is a common diagnosis in patients presenting with chronic respiratory symptoms in these high-burden countries, which results in other diseases being missed easily. The national tuberculosis elimination program encourages to start antitubercular treatment on a clinical basis even without any confirmatory evidence. This has resulted in missing many nontuberculosis cases and unnecessarily exposing to adverse effects of antitubercular drugs. Here we report one such instance where achalasia cardia was missed for a long time.
Back to basics: Behavioral theory and internationalization
Authors: Surdu Irina , Greve Henrich R. , Benito Gabriel R. G.
Published: December 2020

International business (IB) scholars’ over-reliance on a select few theories leaves our understanding of firm internationalization incomplete. The behavioral theory of the firm (BTF) can offer new insights and can be used to model a broad range of firm actions. We focus on the three basic BTF components: problemistic search, learning by doing, and vicarious learning. These components help us understand why firm behaviors are more dynamic and heterogeneous than other theories allow. BTF, with its emphasis on how firms assess performance according to aspiration levels, selectively learn and update routines, and selectively incorporate the learning of others, is better suited to examine the diversity and change increasingly observed in internationalization decisions. We explain why scholars should move beyond “dynamizing” static theories and show BTF’s applicability to behaviors involving change such as multi-mode market entries and market re-entries. BTF also helps examine the decision to internationalize in the first place, nascent firm internationalization, location choices, international market adaptation, and headquarter–subsidiary relationships. We encourage IB scholars to use theories that can handle the complexity increasingly associated with modern firm growth, and propose BTF as a promising starting point.
Quantum oscillation measurements of a type-II Weyl semimetal
Authors: Kim Meeri
Published: December 2020

Results reveal that LaAlGe has smaller effective masses and larger Fermi velocities compared to other type-II Weyl semimetals.