bluuebunny/crossref_metadata_2025 huggingface dataset:
Racial and Insurance Inequalities in Access to Early Pediatric Cochlear Implantation
Authors: Liu Xinliang , Rosa‐Lugo Linda I. , Cosby Janel L. , Pritchett Cedric V.
Published: September 2020

Objective

To evaluate the association between race/ethnicity and insurance status on the access to early cochlear implantation.

Study Design

Population‐based retrospective analysis of pediatric cochlear implantation procedures.

Setting

State Ambulatory Surgery and Services Databases of Florida from 2005 to 2017.

Methods

All children aged 18 years or younger in the state of Florida undergoing cochlear implantation were identified. The outcome measures were access to early cochlear implantation (before 1 and 2 years of age). Descriptive and multivariate logistic regression analyses were conducted.

Results

Among 1511 pediatric cochlear implantation procedures with complete data, 65 (4.3%) procedures were performed by 1 year of age and 348 (23.0%) by 2 years of age. Black children (odds ratio [OR], 0.44; 95% CI, 0.28‐0.70), Hispanic children (OR, 0.70; 95% CI, 0.52‐0.94), and children with Medicaid (OR, 0.64; 95% CI, 0.48‐0.84) were significantly less likely to be implanted before 2 years of age. Even when insured by private insurance, black and Hispanic children were still less likely to be implanted before 2 years of age compared to white children with private insurance. Greater racial and insurance disparities existed in access to cochlear implantation before 1 year of age compared to implantation before 2 years of age.

Conclusion

Racial/ethnic and insurance disparities in pediatric cochlear implantation can be observed at the population level. To address these racial and insurance inequalities, a multidisciplinary care team is needed and priorities should be given to research endeavors and policy interventions that target these disparities.
Lawn Lake, a high montane hunting camp in the Colorado (USA) rocky mountains: Insights into early Holocene Late Paleoindian hunter-gatherer adaptations and paleo-landscapes
Authors: Brunswig Robert H , Doerner James P
Published: September 2020

The Lawn Lake site is a stratified hunting camp situated on a glacial lake outlet river terrace in Rocky Mountain National Park’s upper subalpine forest zone. Its archaeological assemblage represents 9,000 years of hunter-gatherer use as a summer game and plant processing camp for subalpine forest and nearby alpine tundra resource areas. This article’s focus is on the site’s earliest camp levels which contain artifacts and AMS radiocarbon dated hearth charcoal between 8,900 and 7,900 cal yr BP, placing them among the region’s earliest high montane (3,353 m ASL) Paleoindian hunting camps, once part of a network of such sites designed to support systematic high altitude procurement of summer migratory game animals and plant foods in Southern Rocky Mountain subalpine forest and tundra ecosystems. Lawn Lake paleoclimate and paleoecology studies produced long-term pollen records and climate-proxy sediment data for modeling the site’s prehistoric climate and ecology history, useful for interpreting its high-altitude Late Paleoindian hunter-gatherer adaptations.
Are family carers part of the care team providing end-of-life care? A qualitative interview study on the collaboration between family and professional carers
Authors: Vermorgen Maarten , Vandenbogaerde Isabel , Van Audenhove Chantal , Hudson Peter , Deliens Luc , Cohen Joachim , De Vleminck Aline
Published: September 2020

Background:

The attention of healthcare professionals is directed mainly towards the recipients of care and often insufficiently towards family carers. However, an effective collaboration between professionals and family carers is vital to provide quality palliative and end-of-life care. Such collaboration is under-studied in a palliative care context.

Aim:

This study aimed to investigate how family carers of people who live at home with a life-limiting chronic illness experience and perceive collaboration with different healthcare professionals in the last phase of life.

Design:

Face-to-face semi-structured interviews were conducted with the primary family carers of people with a life-limiting chronic illness. Interpretative phenomenological analysis was used to analyse the data.

Setting/participants:

A heterogeneous sample of 30 family carers of people with cancer, heart failure or dementia was recruited through a variety of care providers and services, in order to reflect the heterogeneity of caregiving in serious illness.

Results:

Five main themes emerged from interpretative phenomenological analysis that describe the quality of the collaboration between family carers and professionals: respecting family carers both as someone with care needs and as a member of the care team; the continuous availability and accessibility of healthcare professionals; the provision of information and communication including family carer issues; the coordination of care between all parties and contextual factors. The dominant experience by family carers was one of missed opportunities across these themes.

Conclusions:

This qualitative study about the experiences and perceptions of family carers of people with a chronic life-limiting illness living at home regarding the collaboration with different healthcare providers in the last phase life, showed that family carers experience a lot of possibilities, but perceive missed opportunities as well, for healthcare professionals to effectively collaborate with them for palliative care.
Network Autocorrelation of Perceived Physical Activity Skill Competence Among Adolescents at a Summer Care Program: A Pilot Study
Authors: Prochnow Tyler , Patterson Megan S. , Bridges Hamilton Christina N. , Delgado Haley , Craig Sam , Umstattd Meyer M. Renee
Published: September 2020

Purpose:

This study investigates the possible association between adolescent friendship networks and perceived physical activity skill competence in a summer care program.

Design:

Adolescents participated in researcher-administered surveys at the start (T1) and end (T2) of summer.

Setting:

Adolescents at a Boys & Girls Club were sampled.

Sample:

Adolescents (age 8-12) completed researcher-administered surveys at T1 (n = 100; µ age = 9.9 years; 47% male; 55% Black) and T2 (n = 77; µ age = 9.8 years; 51% male; 49% Black).

Measures:

Perceived skill competence was measured by asking adolescents to rate how good they felt they were at physical activity at the club. Adolescents were also asked to provide names of up to 5 peers whom they hung around with, talked to, and did things with the most while at the club.

Analysis:

Linear network autocorrelation models were used to determine network effects or clustering of perceived physical activity skill competence within the club.

Results:

There were significant network effects for adolescent perceived skill competency scores at T1 (β = 0.05, p < 0.01) and T2 (β = 0.05, p = 0.02), indicating adolescent perceived skill competence scores were associated with those of their friends.

Conclusions:

Practitioners may wish to encourage the use of group or collaborative skill competency improvement activities as well as possibly pairing adolescents with differing skill competencies to foster improvement and possible diffusion of perceived skill competency.
Should I stay or should I go? British voter you got to let me know! Prime Ministers, intra-party conflict, and membership referendums in the British Westminster model
Authors: König Thomas , Lu Xiao
Published: September 2020

We explain the referendums on British membership of the European Communities and European Union from a principal–agent perspective between the Prime Minister and the rank-and-file. We show that announcing a referendum on the Prime Minister’s membership proposal helps the incumbent party to win the general election when the rank-and-file is divided on the terms of membership. When the Prime Minister overcomes the rank-and-file’s mistrust of her effectiveness in negotiating new membership terms with other member states, the voters are more likely to follow her proposal. However, when intra-party controversies reveal principal–agent problems, the initially uninformed voters can learn about the dysfunctionality of the terms and are more likely to reject the Prime Minister’s proposal.
Comparative study of Box–Behnken and central composite designs to investigate the effective parameters of ammonia–water absorption refrigerant system
Authors: Kazemian ME , Gandjalikhan Nassab SA , Jahanshahi Javaran E
Published: September 2020

In this paper, the statistical analyses of the ammonia-water absorption refrigerant system (ARS) are presented. For this purpose, different surface response methods, including the Central composite design (CCD) and Box- Behnken design (BBD), have been studied and compared first to obtain the best response. An attempt is made to study the effect of some factors (mass flow rate, isentropic efficiency of pump, pressure ratio, maximum pressure of cycle, concentration difference of strong and weak solution, concentration of strong solution and effectiveness factor of heat exchanger and pure ammonia concentration) on the system’s response. Based on the design of experiment analysis, regression models are presented to quantify the effects of these parameters on coefficient of performance (COP) and cooling load of the ammonia-water absorption refrigerant cycle. The proposed correlations obtained by the analysis have remarkably satisfactory performance for all simulation data. The error analysis is applied to find the maximum error of 0.482% in numerical computations for ARS by CCD method in midpoint values of parameters.
Development and control of an intelligent assistive exo-glove via fuzzy controller and emotional learning system
Authors: Abarghooei Arash , Salarieh Hassan , Boroushaki Mehrdad
Published: September 2020

The aim of this article is design, fabricate, and control a conceptual prototype of a flexible wearable robot to increase fingers’ force using a novel cable mechanism. In this robot, force and position are controlled in separate phases by a fuzzy system equipped with emotional learning. A Flexible structure has been chosen for this robot, because flexible gloves are lighter and much more suitable for use in daily tasks compared to rigid structures. Since this system is supposed to be substituted for weak or damaged limb, it should have a behavior similar to the body organs as much as possible. Therefore, a novel mechanism, inspired by the natural movement mechanism of the human hand, has been designed and tried to use a control method similar to the human brain. In order to control the glove, a proportional linear and a fuzzy controller were selected and designed. Then they were implemented through the Simulink environment of MATLAB software and applied to the glove using a real-time interface system. Finally, through some experiments, the performance of the glove and controllers have been evaluated and compared in the case of using linear and emotional learning fuzzy controllers. As expected, using the fuzzy controller with an emotional learning system makes low tracking errors result and represents appropriate performance. Compared to the linear controller, the overshoot decreased up to the one-third, and the settling time declined to one-fifth.
Statistical and experimental investigation using a novel multi-objective optimization algorithm on a novel titanium hybrid composite developed by lens process
Authors: Bose Soutrik , Nandi Titas
Published: September 2020

The machining of titanium based hybrid composite by conventional method is very complicated because of its enhanced strength-to-weight ratio, resistance to corrosion, abrasion and fatigue and this hybrid composite is extensively necessary for automobile, aerospace, sports, spacecrafts, marine and bio-medical industries. In this paper, an investigation is presented based on a novel optimization algorithm named as desirable grey relational analysis (DGRA) where desirability function is coupled with grey relational analysis for multi-objective optimization (MOO). A novel titanium hybrid composite is developed by laser engineered net shaping (LENS) process. Experimental investigation is carried on wire electro-discharge machining (WEDM) process varying power, time off and peak current as the most important input process parameters. Fuzzy technique for order preference by similarity to ideal solution (FTOPSIS) is proposed along with fuzzy analytical hierarchy process (FAHP) for criteria weights for the comparison of the experimental and the predicted results. Statistical investigation on response surface methodology (RSM) is carried on the Box-Behnken design (BBD) model using 3 factors and 3 levels design of experiments (DOE) on output responses like material removal rate (MRR), surface roughness (SR), kerf width (KW) and over cut (OC) to obtain satisfactory outcomes and then authenticated by confirmatory test. Analysis of variance (ANOVA) is used for significance of the models. Optimal condition and solution is attained by method of desirability to accomplish the best output response. This optimized result is further enhanced by 3.09%, 2.05% and 1.02% when compared with desirability to FTOPSIS, FTOPSIS to DGRA, and desirability to DGRA.
Prominence of occurrence accorded to climate change information in Tanzanian newspapers
Authors: Siyao Peter Onauphoo , Sife Alfred Said
Published: September 2020

Study was conducted to analyse degree of prominence that Tanzanian newspapers accorded to climate change information. We argue that the level of prominence accorded to climate change information by Tanzanian newspapers is inadequate. Prioritising the coverage of climate change information in newspapers is important for facilitating its access, promotion and dissemination for awareness creation. Triangulation of quantitative content analysis and in-depth interview method approaches and a sample size of 1600 newspaper editions drawn from six Tanzanian newspapers for a span of 10 years were used. Newspaper editions were quantitatively content analysed and the frequencies at which climate change information articles were placed at the various parts of the newspapers were analysed. Findings indicate that a total of 81,162 articles were published. Of this total, only 684 (0.84%) articles covered climate change information. Furthermore, findings indicate that, of the total 684 climate change information articles, only 53 (7.6%) were placed in the front pages of the six Tanzanian newspapers for all 10 years, giving a yearly average of 5.3 articles for all newspapers and only 1 article for each newspaper per year, whereas the majority (631, 92.25%) of articles in climate change were randomly placed in the inside pages. The Chi-square test ( χ 2 = 10.000; df = 1; p value < 0.002) shows that significant differences exist between the locations of number of articles in front pages and inside pages. The findings suggest that climate change information in Tanzanian newspapers was not given the necessary level of prominence. Study recommends that newspaper media houses should have editorial policy that will ensure that they have a social responsibility of reporting climate change information prominently in their newspapers for wide public access and dissemination. This paper also recommends the need for the provision of specialised trainings such as climate change journalism to news editors, journalists and reporters for equipping them with the good writing styles and skills that will enable them to produce more appealing climate change stories that will attract its front page placement status for setting an agenda in the direction of climate change adaptation, coping and mitigation mechanisms in Tanzania
Sliding mode control of an ozone generator based on dual AC/DC/AC power converters
Authors: Alsmadi Yazan M , Chairez Isaac , Utkin Vadim
Published: September 2020

The aim of this study was to design a first-order sliding mode controller for dual AC/DC/AC power converters to regulate the production of a corona discharge ozone generator. The design is presented in the two following parts: (a) The first part regulates a three-branch (phase) AC/DC converter to control the DC intermedium voltage that is required to produce the desired ozone concentration, while (b) the second part regulates a one-phase DC/AC power conversion circuit that regulates amplitude of the AC voltage that must be injected into the reaction chamber of the ozone generator. For the first section, the controller regulates the switching sequence yielding the control of the input currents, which defines the amplitude of the DC voltage. In the second, the switching control regulates the amplitude of the expected output AC signal, which depends on the obtained DC voltage from the AC/DC section. This structure represents a novel form to adjust the functioning of the AC/DC/AC power device, which has not been used before in the context of ozone production. Lyapunov’s second method was the main tool for confirming the existence of an asymptotical equilibrium state point for the trajectory tracking deviation for both sections of the power converter. The voltage amplitude was tested on a previously validated mathematical model of a corona-effect ozone generator performance. Several numerical evaluations illustrated the efficient performance of the suggested discontinuous controller and considering the proposed switching sequence that realizes the control action. The proposed controller was contrasted with a usual proportional/integral/derivative (extended state) design, which is a common technique to regulate the ozone generation system.
Rethinking border walls as fluid meshworks
Authors: Ozguc Umut
Published: September 2020

We tend to see border walls as stable concrete fortifications. This article seeks to offer an alternative understanding of walls by suggesting a shift in border studies from network thinking to meshwork thinking. Despite references to multiplicity, concepts of networks and assemblages in border studies continue to provide neat narratives of walls. This article reimagines the border beyond sovereign–disciplinary–biopolitical networks and assemblages. It argues that border walls are constituted by and constitutive of the ever-shifting transformative movements of lines: colonizing lines, crack lines and lines of flight. By tracing the lines of the Separation Wall in the West Bank, this article reveals that, on the border, all these lines coexist, entangle with one another, and in their entanglements, they alter each other to form a fluid meshwork. Meshwork thinking shows the constant mobility of the border and shifts our attention to the power of molecular movements beneath the state in creating, sustaining and disrupting power politics. By presenting a less state-centric, more complex picture of the Separation Wall, this article aims to highlight the movement of the lines that transform the border into a meshwork.
The Defence of Aachaaram, Femininity, and Neo-Savarna Power in Kerala
Authors: Devika J.
Published: September 2020

This paper examines the discourse of the Ready to Wait (RTW) campaign, led by highly-educated professional neo-savarna women in Kerala, against litigation to open the doors of Kerala’s Sabarimala shrine to women of menstruating ages, hitherto barred from the pilgrimage. The term savarna refers to the privileged caste-communities that, from pre-colonial times, controlled land and other material resources and ritual practices, and continued to do so to a large extent even later. Avarna refers to those oppressed groups that laboured for the savarna and were subjected to degradation through such practices as untouchability and unseeability, and whose exclusion from social power continues in different ways despite these groups having achieved economic presence and education. Following a Supreme Court verdict in September 2018, which struck down the Sabarimala taboo, Kerala was shaken by violent protests led by neo-savarna and SanghParivar organisations. Through a close reading of the Facebook engagement of a Right to Wait campaigner, I seek to make sense of the particular sorts of ‘dissonance’ these organisations seem to be creating within the male-defined space of Hindutva, the specific caste politics they represent, as well as their articulation and disarticulation with a discourse on women’s empowerment and feminism. I argue that it is time that we seriously theorise the power relations between the savarna and avarna women under brahminical patriarchy, instead of focusing singularly on the subordination of upper-caste women by the male brahminical elite.
Hand-Print CARE: Towards Ethics-led Action Learning for ESD in School Subject Disciplines
Authors: O’Donoghue Rob , Henze Christa , Shimray Chong , Sarabhai Kartikeya V. , Rivera Juan Carlos A. Sandoval
Published: September 2020

The Hand-Print concept emerged as a proposition for learner-led action learning in the Centre for Environment Education, Ahmedabad, Gujarat, India. Hand-Print CARE as an ethics-led action learning proposition was developed at a Local Culture for Understanding Mathematics and Science (LOCUMS) research group meeting with some educators in Alta, Norway. Here ‘CARE’ emerged as an acronym reflecting an ethic of inclusive respect through Concern for others, being Attentive to needs, showing Respect for each other and being Engaged in learning actions for the common good. Hand-Print CARE was thus activated as a co-engaged mediation process towards ‘Learning to look after others to best care for ourselves and the surroundings we all share’. Conceptual tools towards a Hand-Print CARE rationale were clarified in subsequent ESD workshops in Malaysia and Mexico and the challenge of developing a schema for ESD in school subject disciplines emerged at an ESD training workshop with National Council for Education Research and Training (NCERT) in Delhi, India.

This article explores the emergence of Hand-Print CARE and the framing of an open-ended schema for mediating better-situated and ethics-led action learning in school subject disciplines. A formative perspective towards more locally situated and co-engaged processes for mediating learning was refined through an ESD Expert-Net collaboration to clarify ESD learning progressions in school subject disciplines. Some start-up materials were developed with partnering NGOs in the small town of Howick in KwaZulu-Natal, South Africa, and in an expanding collaboration involving partners in India, Mexico, Germany and South Africa. Each of us worked to refine Hand-Print CARE learning progressions for ESD processes of action learning in diverse subject discipline and school-in-community settings.
Anxiety sensitivity and acculturative stress: Concurrent relations to mental health among Spanish-speaking Latinx in primary care
Authors: Zvolensky Michael J. , Bakhshaie Jafar , Shepherd Justin M. , Peraza Natalia , Viana Andres G. , Walker Rheeda L. , Garza Monica , Ochoa-Perez Melissa , Lemaire Chad
Published: September 2020

The Latinx population suffers from mental health inequalities. Although past work has implicated acculturative stress and anxiety sensitivity as important individual difference factors for anxiety and depression in this group, it is presently unclear how they work together to influence more severe anxiety and depressive symptom expression among Latinx. To help address this gap in the existing literature, the current study evaluated the role of concurrent anxiety sensitivity and acculturative stress, in terms of anxiety and depressive symptoms and disorders, in a Latinx population in a primary care setting. Participants included 142 Latinx individuals (86.7% female; Mage = 39.66, SD = 11.34). After accounting for shared variance, the results indicated that both anxiety sensitivity and acculturative stress were significantly associated with anxious arousal symptoms, social anxiety, and depressive symptoms. However, anxiety sensitivity, but not acculturative stress, was significantly related to a number of mood and anxiety disorders. These findings suggest the importance of assessing both anxiety sensitivity and acculturative stress in routine mental health screening, as both factors may be related to poorer psychological health among this group.
Using big data and social network analysis for cultural tourism planning in Hakka villages
Authors: Hu In-Lin , Chang Chen-Chi , Lin Yu-Hsun
Published: September 2020

Traveling in a Hakka village, the tourist can feel the culture of the Hakka in Taiwan and see traditional drama, artwork, handicrafts, and foods. The current trend in tourism planning is to incorporate online word of mouth into route design. This paper aims to examine common characteristics of Hakka village tourism development, identifying the need for planning and offering a model of the directions planning might take. It begins with big data collection of the online service and combines that with social network analysis. The results indicated that tourism planning with user's online search strategy will provide a better and more precise tour service. It is suggested that the government should set up the tour service center at the location identified as being in the structural hole of the tourism network. As cultural tourism continues to expand, big data applications will offer new opportunities and challenges to tourism planning.
Stakeholder perspectives of the dementia-friendly hospital: A qualitative descriptive focus group study
Authors: Toubøl Annemarie , Moestrup Lene , Ryg Jesper , Thomsen Katja , Nielsen Dorthe S
Published: September 2020

The term dementia-friendly hospital is increasingly used to describe a variety of initiatives and strategies that are implemented to meet the challenges faced by patients with dementia during hospitalization. However, no definition of the dementia-friendly hospital currently exists. This qualitative focus group study aimed to describe stakeholders’ perspectives of the dementia-friendly hospital. Four stakeholder groups were included: people with dementia, relatives, hospital staff, and representatives from the Danish Alzheimer Association. The thematic analysis suggests that a person-centered approach is a key feature. This approach is described as a continuously reflexive awareness of how to see the person behind the dementia diagnosis. We discuss possible revision of the current dementia discourse and the implications of the findings for future practice and research.
A Retrospective Cohort Study of Risk Factors for Surgical Site Infection Following Lung Transplant
Authors: Moraes Josiane Luzia Sibioni , Oliveira Ramon Antonio , Samano Marcos Naoyuki , Poveda Vanessa de Brito
Published: September 2020

Background:

Surgical site infections (SSIs) are among the leading health care–associated infections as well as a major problem in the postoperative period of lung transplant recipients. Little is known about the risk factors in this specific population. The objective of this study was to identify the incidence, risk factors, and outcomes of SSI following lung transplant.

Methods:

Digital medical records of adult recipients subjected to lung transplant from July 2011 and June 2016 in a large Brazilian referral teaching public center were analyzed in this retrospective cohort follow-up.

Results:

Among the 121 recipients analyzed, 19 (15.7%) had SSI; of these, 11 (57.8%) had superficial incisional infections, 1 (5.2%) had a deep incisional infection, and 7 (36.8%) had organ/space infection. Recipient-related risk factors for SSI were high body mass index ( P = .041), prolonged surgery time ( P = .043), and prolonged duration of chest drain placement ( P = .009). At the multiple logistic regression was found that each hour elapsed in the surgical time increased the odds of SSI by around 2 times (odds ratio 2.34; 95% CI, 1.46-4.53; P = .002). Donor-related risk factors included smoking status ( P = .05) and positive bronchoalveolar lavage ( P < .001). Having an SSI was associated with an increased length of stay in intensive care units ( P = .003), reoperation ( P = .014), and a higher 1-year mortality rate ( P = .02).

Conclusions:

The identified incidence rate was higher to that observed in the previous studies. The risk factors duration of chest tube placement and donor smoking status are different from those reported in the scientific literature.
Mediating the opponent’s news: A study of inter-media citations in the Israeli–Palestinian conflict
Authors: Gonen Yonatan , Tenenboim-Weinblatt Keren , Kampf Zohar
Published: September 2020

By using information sources from the opponent’s side, the media can introduce alternative viewpoints and broaden the discussion on the conflict. One important information source that has received little attention in research is the other side’s media reports. This study explores the practice of inter-media citations by analyzing Israeli and Palestinian news reports published over a span of 10 years. Based on a computerized quantitative analysis of 235,340 media texts, the authors show how the weaker (Palestinian) side relies more heavily on the media of the stronger side (Israel) than vice versa. During escalations or negotiations, the rate of use of inter-media citations is significantly higher than during routine periods. Furthermore, two main characteristics of a media source make it more likely to be cited: political agenda and accessibility. The authors discuss the factors shaping the phenomenon of inter-media citations and the implications of this practice for conflict coverage.
Pheochromocytoma Multisystem Crisis and Masquerading Disseminated Histoplasmosis in a Neurofibromatosis Type 1 Patient With Bilateral Adrenal Tumors
Authors: Broadfoot Brannon G. , Kumarapeli Asangi R.
Published: September 2020

Pheochromocytomas are rare catecholamine-secreting neuroendocrine tumors that can occasionally progress to life-threatening disease, including a multisystem crisis. Patients with Neurofibromatosis type 1 (NF1) may develop pheochromocytomas, and the consequent chronic elevation of plasma catecholamine levels could further complicate various cardiovascular and pulmonary manifestations they may have. A 37-year-old African American female with NF1 presented with severe dyspnea, chills, myalgia, vomiting, and abdominal pain. Within several hours of hospital admission, she developed progressive agitation and died from circulatory collapse. An autopsy revealed disseminated histoplasmosis with necrotizing granulomatosis in her lungs, mediastinum, liver, and spleen, as well as bilateral pheochromocytomas with one tumor showing marked hemorrhage. Additionally, she had cardiac hypertrophy, myocarditis, pulmonary edema, apical bullae, features of pulmonary hypertension and interstitial fibrosis. Disseminated histoplasmosis caused by the fungal organism Histoplasma capsulatum is rarely described in immunocompetent individuals. This case is presented to illustrate that chronic hypercatecholaminemia caused by pheochromocytomas may potentially mask disseminated fungal infections which in turn could induce pheochromocytoma multisystem crisis in susceptible patients with neurofibromatosis.
Chemical Composition and Antimicrobial Activity of the Essential Oil From Euphorbia helioscopia L.
Authors: Zhu Qing , Jiang Mei-Lin , Shao Feng , Ma Guang-Qiang , Shi Qiang , Liu Rong-Hua
Published: September 2020

The chemical composition and antimicrobial activity of the essential oil from the aerial parts of Euphorbia helioscopia L. were investigated by gas chromatography-mass spectrometry (GC-MS), GC, and microdilution methods. Thirty-five compounds, representing 83.51% of the total oil, were identified. 1,6-Dihydrocarveol (31.39%), carvone (16.79%), menthol (8.23%), and trans-dihydrocarvone (5.53%) were the principal constituents of the oil. The essential oil exhibited strong antimicrobial activity against strains of the bacteria, Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Shigella dysenteriae, and a strain of the fungus Candida albicans with a minimal inhibitory concentration value of 31.25 μg/mL and minimum bactericidal concentration values of 31.25 μg/mL ( S. aureus), 62.50 μg/mL ( E. faecalis), >62.50 μg/mL ( E. coli), >62.50 μg/mL ( S. dysenteriae), and >62.50 μg/mL ( C. albicans). These results indicated that the essential oil from the aerial parts of E. helioscopia could be used to control diseases caused by these microbes.
“Let the Atrocious Images Haunt Us”—Encounters with Conflict and Connection in Visual Art-Making
Authors: Rouse Alison
Published: September 2020

In the relative comfort of my UK living room, a passive spectator of TV news, I watch fleeting images of appalling suffering and devastation emanating from the war in Syria. The coverage of the bombing of Aleppo (2015) is heart-rending. I turn to art in response, to slow the disappearance of visual images and to counter my sense of remove. This begins as self-activism, drawing/painting-as-inquiry, in combination with journal writing. As the work progresses, portraits burst out of the sketchbook and claim space to speak for themselves, demanding a place in the wider world, their own artivism. What they communicate to each viewer will vary—a commentary on war, on a country’s response to migration, or a call to action for what might be different? The inquiry moves through personal and cultural layers of a creative process to question what art does, and what it fails to do, in the context of this project and activism. Art’s potential, through the acts of looking and making, to affect is central to the sequence of encounters (connections and disconnections), which are examined here.
Fish oil supplementation and repeated macular hemorrhage without choroidal neovascularization: A case report
Authors: Li Shi-Ying , Fujinami Kaoru , Crewther Sheila G , Long Yan-Ling , Lie Hong-Xuan , Yin Zheng-Qin
Published: September 2020

Macular hemorrhage can occur spontaneously and repeatedly without choroidal neovascularization or other known lesions associated with myopia. We report a case of repeated myopic macular hemorrhage following fish oil supplementation. A 32-year-old male was referred with newly acquired paracentral scotoma in the left eye. Serial retinal imaging, including fundus photography, fluorescein angiography, and spectral-domain optical coherence tomography were performed. Fundus photography and fluorescein angiography showed a subtle red-colored lesion nasal to the fovea. Optical coherence tomography showed a dome shaped elevation in the ellipsoid zone and interdigitation zone in the left eye. No known ocular risk factors for macular hemorrhage, such as choroidal neovascularization, lacquer cracks, Fuch’s spot or choroid thinning or keratoconus were observed. After 2 months without any treatment, the left eye lesion disappeared. However 2 weeks later, another newly developed red-colored lesion close to the left fovea was observed. At that moment, the detailed medical history revealed that the patient had been regularly taking a high dose of commercially available fish oil supplement beginning one month before the first macular hemorrhage. After discontinuation of the fish oil, the second left hemorrhage resolved gradually over the following 8 weeks. No recurrent hemorrhages have been detected at the 12 months follow-up visits. Our observations suggest that the relative value of nutritional supplementation with high doses of fish oil should be cautioned in patients with repetitive retinal hemorrhage.
Time-Driven Activity-Based Costing: A Better Way to Understand the Cost of Caring for Hip Fractures
Authors: Blaschke Breanna L. , Parikh Harsh R. , Vang Sandy X. , Cunningham Brian P.
Published: September 2020

Geriatric hip fractures are a common and costly injury. They are expected to surge in incidence and economic burden as the population ages. With an increasing financial strain on the healthcare system, payors and providers are looking toward alternative, value-based models to contain costs. Value in healthcare is the ratio of outcomes achieved over costs incurred, and can be improved by reducing cost while maintaining or improving outcomes, or by improving outcomes while maintaining or reducing costs. Therefore, an understanding of cost, the denominator of the value equation, is essential to value-based healthcare. Because traditional hospital accounting methods do not link costs to conditions, there has been little research to date on the costs of treating geriatric hip fractures over the entire cycle of care. The aim of this article is to summarize existing costing methodologies, and in particular, to review the strengths and limitations of Time-Driven Activity-Based Costing (TDABC) in orthopaedic trauma, especially as it pertains to the needs and challenges unique to hip fracture care. TDABC determines costs at the patient-level over the entire care cycle, allowing for population variability, while simultaneously identifying cost drivers that might inform risk-stratification for future alternative payment models. Through process mapping, TDABC also reveals areas of variation or inefficiency that can be targeted for optimization, and empowers physicians by focusing on costs in the control of the provider. Although barriers remain, TDABC is well-positioned to provide transparent costing and targets to improve the value of hip fracture care
Communication Perspectives on Organizational Culture and Organizational Identification
Authors: Walker Robyn
Published: September 2020

Introduction to special issue on organizational culture and organizational identification.
The dangers of déjà vu: memory B cells as the cells of origin of ABC-DLBCLs
Authors: Venturutti Leandro , Melnick Ari M.
Published: September 2020

Activated B-cell (ABC)-diffuse large B-cell lymphomas (DLBCLs) are clinically aggressive and phenotypically complex malignancies, whose transformation mechanisms remain unclear. Partially differentiated antigen-secreting cells (plasmablasts) have long been regarded as cells-of-origin for these tumors, despite lack of definitive experimental evidence. Recent DLBCL reclassification based on mutational landscapes identified MCD/C5 tumors as specific ABC-DLBCLs with unfavorable clinical outcome, activating mutations in the signaling adaptors MYD88 and CD79B, and immune evasion through mutation of antigen-presenting genes. MCD/C5s manifest prominent extranodal dissemination and similarities with primary extranodal lymphomas (PENLs). In this regard, recent studies on TBL1XR1, a gene recurrently mutated in MCD/C5s and PENLs, suggest that aberrant memory B cells (MBs), and not plasmablasts, are the true cells-of-origin for these tumors. Moreover, transcriptional and phenotypic profiling suggests that MCD/C5s, as a class, represent bona fide MB tumors. Based on emerging findings we propose herein a generalized stepwise model for MCD/C5 and PENLs pathogenesis, whereby acquisition of founder mutations in activated B cells favors the development of aberrant MBs prone to avoid plasmacytic differentiation on recall and undergo systemic dissemination. Cyclic reactivation of these MBs through persistent antigen exposure favors their clonal expansion and accumulation of mutations, which further facilitate their activation. As a result, MB-like clonal precursors become trapped in an oscillatory state of semipermanent activation and phenotypic sway that facilitates ulterior transformation and accounts for the extranodal clinical presentation and biology of these tumors. In addition, we discuss diagnostic and therapeutic implications of a MB cell-of-origin for these lymphomas.
Deficiency in Aim2 affects viability and calcification of vascular smooth muscle cells from murine aortas and angiotensin-II induced aortic aneurysms
Authors: Wortmann Markus , Arshad Muhammad , Hakimi Maani , Böckler Dittmar , Dihlmann Susanne
Published: September 2020

Background

Phenotypic transformation of vascular smooth muscle cells is a key element in vascular remodeling and aortic aneurysm growth. Previously, deletion of several inflammasome components decreased formation of aortic aneurysm (AA) in the Angiotensin II (AngII) -induced mouse model. We hypothesized that the inflammasome sensor Absent in melanoma 2 (Aim2) might affect the phenotype of vascular smooth muscle cells (VSMC), thereby reducing AA formation.

Methods

Aim2−/− mice and wild-type (WT) C57Bl/6 J mice were used as an animal model. VSMC were isolated from 6 months old mice and grown in vitro. Young (passage 3–5) and senescent (passage 7–12) cells were analyzed in vitro for calcification in mineralization medium by Alizarin Red S staining. Expression of calcification and inflammatory markers were studied by real-time RT-PCR and Western blotting, release of cytokines was determined by ELISA. To induce AA, osmotic mini-pumps loaded with AngII (1500 ng/kg bodyweight/min) were implanted for 28 days in male mice at 6 months of age.

Results

Compared with VSMC from WT mice, VSMC isolated from Aim2−/− mice were larger, less viable, and underwent stronger calcification in mineralization medium, along with induction of Bmp4 and repression of Tnfsf11/Rankl gene expression. In addition, Aim2 deficiency was associated with reduced inflammasome gene expression and release of Interleukin-6. Using the mouse model of AngII induced AA, Aim2 deficiency reduced AA incidence to 48.4% (15/31) in Aim2−/− mice versus 76.5% (13/17) in WT mice. In contrast to Aim2−/− mice, AA from WT mice expressed significantly increased levels of alpha-smooth muscle actin/Acta2, indicating tissue remodeling. Reduced cell proliferation in Aim2−/− mice was indicated by significantly increased p16ink4a/Cdkn2a expression in untreated and AngII-infused aortas, and by significantly lower amounts of proliferating (Ki67 positive) VSMC in AngII-infused Aim2−/− mice.

Conclusions

Our results suggest a role for Aim2 in regulating VSMC proliferation and transition to an osteoblast-like or osteoclast-like phenotype, thereby modulating the response of VSMC in aortic remodeling and AA formation.
The digitalization and public crisis responses of small and medium enterprises: Implications from a COVID-19 survey
Authors: Guo Hai , Yang Zhuen , Huang Ran , Guo Anqi
Published: September 2020

The COVID-19 outbreak is a global crisis that has placed small and medium enterprises (SMEs) under huge pressure to survive, requiring them to respond effectively to the crisis. SMEs have adopted various digital technologies to cope with this crisis. Using a data set from a survey with 518 Chinese SMEs, the study examines the relationship between SMEs’ digitalization and their public crisis responses. The empirical results show that digitalization has enabled SMEs to respond effectively to the public crisis by making use of their dynamic capabilities. In addition, digitalization can help improve SMEs’ performance. We propose a theoretical framework of digitalization and crisis responses for SMEs and present three avenues for future research.
Seagull: lasso, group lasso and sparse-group lasso regularization for linear regression models via proximal gradient descent
Authors: Klosa Jan , Simon Noah , Westermark Pål Olof , Liebscher Volkmar , Wittenburg Dörte
Published: September 2020

Background

Statistical analyses of biological problems in life sciences often lead to high-dimensional linear models. To solve the corresponding system of equations, penalization approaches are often the methods of choice. They are especially useful in case of multicollinearity, which appears if the number of explanatory variables exceeds the number of observations or for some biological reason. Then, the model goodness of fit is penalized by some suitable function of interest. Prominent examples are the lasso, group lasso and sparse-group lasso. Here, we offer a fast and numerically cheap implementation of these operators via proximal gradient descent. The grid search for the penalty parameter is realized by warm starts. The step size between consecutive iterations is determined with backtracking line search. Finally, seagull -the R package presented here- produces complete regularization paths.

Results

Publicly available high-dimensional methylation data are used to compare seagull to the established R package SGL. The results of both packages enabled a precise prediction of biological age from DNA methylation status. But even though the results of seagull and SGL were very similar (R2 > 0.99), seagull computed the solution in a fraction of the time needed by SGL. Additionally, seagull enables the incorporation of weights for each penalized feature.

Conclusions

The following operators for linear regression models are available in seagull: lasso, group lasso, sparse-group lasso and Integrative LASSO with Penalty Factors (IPF-lasso). Thus, seagull is a convenient envelope of lasso variants.
Gametophyte and embryonic ontogeny: understanding the reproductive calendar of Cypripedium japonicum Thunb. (Cypripedoideae, Orchidaceae), a lady’s slipper orchid endemic to East Asia
Authors: Ghimire Balkrishna , Son Sungwon , Kim Jae Hyeun , Jeong Mi Jin
Published: September 2020

Background

The genusCypripediumL. is one of the five genera of the subfamily Cypripedioideae, members of which are commonly known as lady’s slipper orchids.Cypripedium japonicumis a perennial herb native to East Asia, specifically China, Japan, and Korea. Due to its limited distribution, the species is included in the Endangered category of the IUCN Red List.

Results

We investigated gametophyte development, including complete embryogenesis, inC. japonicum. The complete reproductive cycle is presented based on our observations. Anther development begins under the soil, and meiosis of pollen mother cells begins 3 weeks before anthesis, possibly during early April. The megaspore mother cells develop just after pollination in early May and mature in mid–late June. The pattern of embryo sac formation is bisporic, and there are six nuclei: three forming the egg apparatus, two polar nuclei, and an antipodal cell in the mature embryo sac. Triple fertilization results in the endosperm nucleus, which degenerates when the proembryo reaches the eight-to-sixteen-cell stage.

Conclusion

Our overall comparisons of the features of gametophyte and embryo development inC. japonicumsuggest that previous reports on the embryology ofCypripediumare not sufficient for characterization of the entire genus. Based on the available information, a reproductive calendar showing the key reproductive events leading to embryo formation has been prepared.