bluuebunny/crossref_metadata_2025 huggingface dataset:
Revisiting Third Nerve Palsy
Authors: Grover Smita Kapoor
Published: November 2020

Third nerve palsy is frequently encountered in a clinical setting and is tough to manage. This article explains the course of the nerve and the etiology at various levels. The associated clinical features and imaging techniques have been discussed. Medical and surgical management of complete and partial third nerve palsy have been dealt with in detail with photographs and illustrations.
Pattern of Viteoretinal Diseases in Patients of Kangra Valley
Authors: Parashar Aditi , Tuli Rajeev , Sharma Rattan K. , Sharma Mukta , Gupta Shalu
Published: November 2020

Background:

This study may be the foundation pillar for future planning and need for set up of vitreoretinal care services in Dr. Rajendra Prasad Government Medical College, Kangra at Tanda, India.

Aims and Objectives:

To determine the pattern of vitreoretinal diseases in patients attending the retina clinic of Dr. Rajendra Prasad Government Medical College, Kangra, Tanda, India.

Materials and Methods :

A retrospective analysis of the patients attending the retina clinic over a period of one year 2015 to 2016 was carried out from the out patient register. The patients with a very hazy media and posterior uveitis were excluded from the study.

Statistical Analysis:

The significance was determined using percentage.

Results :

In our study out of 424 cases, 237 (55.96%) were males and 187 (44.10%) were females. In our first age group less than equal to 40 years, out of 122 patients there were 72 males (59.01%) and 50 (40.98%) females and diabetic retinopathy was the commonest disorder in them followed by retinal detachment. In the second age group more than 40 years there were 302 patients including, 165 (54.63%) males and 137 (45.36%) females. Age related macular degeneration (ARMD) was the commonest disorder in them followed by diabetic retinopathy.

Conclusion:

With increase in age there in increase in number of retinal disorders. Out of the total diseases Diabetic retinopathy was the commonest retinal disorder (27.59%) and there was a male preponderance to it. The second most common retinal disorder was ARMD (20.04%), followed by retinal detachment (11.55%).
Measurement of Orbital Dimensions (Orbital Height, Breadth and Length of Superior Orbital Fissure) using Dry Skull's
Authors: Shukla Aakanksha , Bokariya Pradeep , Kothari Ruchi , Singh Smita
Published: November 2020

Introduction

Anthropometry is the scientific study of the measurements and proportions of the human body. Anthropometric studies are an integral part of craniofacial surgery and syndromology. Each orbital cavity is essentially intended as a socket for the eyeball. Assessment of orbital dimensions is important for knowing the anatomy of orbital structures and surgical management of orbital pathologies.

Aim

To estimate the orbital index and length of superior orbital fissure using dry skulls.

Methods

The study was conducted in the Anatomy department after ethics clearance. Forty dried skulls were utilised for study. The measurements for the dimensions of the orbital cavities were taken directly using a digital Vernier Calliper calibrated in millimetres except inter distance between lateral walls which was estimated by spreading calliper. The parameters investigated in our study were Orbital height, Orbital breadth, Length of superior Orbital fissure, Inter-distance between medial wall and Inter - distance between lateral walls of Orbit. Orbital index was calculated using formula: OI = orbital height/orbital breadth×100.

Result:

Mean orbital height of right orbit of the dry skulls was 31.94±2.91mm and Left orbit was 31.85±3.34mm. Mean Orbital breadth of right orbit was 39.6±1.88mm and Left orbit was 39.91±2.65mm. The mean inter-distance between medial walls of orbits was 21.62±1.08mm. The mean inter-distance between lateral walls of orbits was 94.28±4.45mm. Mean length of right superior orbital fissure of the dry skulls was 1.39±0.21cm and Left orbital fissure was 1.4 ±0.24cm. The mean Orbital index of Right orbit was 80.9 and Left Orbit was 80.2. Paired t test demonstrated no significant statistical difference between the right and left orbits (p>0.05).

Conclusion:

Normative Data for Indian skulls was reported. No significant difference was reported in the right and left orbits.
Knowledge, Attitude, and Practices of Emergency Management of Ocular Chemical Injury Among Primary Responders
Authors: Harakuni Umesh U. , Kumar Nilesh , Niharika
Published: November 2020

Introduction:

Chemical injuries are considered as one of the true ocular emergencies where timely management can save vision and years of visual rehabilitation. Thus, knowledge of the injury and its management is very important for medical professionals as well as the general population.

Aim:

This study aims to assess the knowledge, attitude, and practices of respondents from across the population about ocular chemical injuries.

Settings and Design:

A cross-sectional, questionnaire-based study was conducted over 1 month in a tertiary care hospital in Northern Karnataka.

Methods and Material:

60 respondents were divided into 2 groups. Respondents with various levels of medical training such as residents, casualty medical officers, and paramedical staff formed group 1, while group 2 constituted of site supervisors from workplace and family members of patients. Respondents were asked to answer a pre-formed multiple-choice questionnaire and the responses were noted and tabulated into an MS-Excel spreadsheet and were expressed in terms of percentage.

Results:

Knowledge about the etiological agents was better in group 1, while both groups had a similar attitude towards the signs and symptoms of injury and the practice pattern of emergency management was better in group 1.

Conclusions:

While better knowledge and practice of emergency management was shown by group 1, the attitude towards the signs and symptoms was similar in both groups. Variability among the group 1 respondents indicate a need for the formation of standard guidelines for the institutions dealing with ocular chemical injuries.
Autosomal Dominant Optic Atrophy Plus Syndrome
Authors: Prabu V. Rajesh , Ranjini H. , Wasnik Rajlaxmi B. , Priyambada Parul
Published: November 2020

A 9-year-old boy of Indian origin presented with defective vision and nystagmus. The parents also complained of hearing loss. On examination he had bilateral optic atrophy. The condition was running in family with his mother and uncle having similar visual and hearing disturbances, clinodactyly and intellectual disability at later age. Targeted gene sequencing revealed one copy of c.1058G>T (p.S3531) variant of unknown significance in exon 11 of OPA1 gene that was pathogenic of Autosomal Dominant Optic atrophy plus syndrome. This case highlights the clinical spectrum associated with OPA1 mutations.
Bilateral Asteroid Cornea due to Occupational Firecracker Burst
Authors: Agarwal Rinky , Bafna Rahul Kumar , Chetan  , Sharma Namrata
Published: November 2020

Firecrackers are largely used by people during festivals for their sound, spark, shine, and explosion while lighting up the celebration mood. Ocular injuries caused by these commodities are usually severe and devastating. Most of these are recreational, occur due to unpredictable explosion and involve individuals actively igniting the crackers or passive bystanders. However, occupational injuries due to these manmade devices has rarely been reported. Presently reported is a case of spontaneous bursting of firecracker, an occupational trauma in a young male, resulting in multiple orange corneal foreign bodies giving the appearance of asteroid cornea.
A Rare Case of Traumatic Superior Orbital Fissure Syndrome Following an Unusual Mode of Penetrating Injury
Authors: Patidar Narendra , Phadnis Prerana , Mohan Amit , Piush Parimal
Published: November 2020

Traumatic superior orbital fissure syndrome (SOFS) is a rare presentation with a low incidence of <1% associated with severe morbidity and mortality. We report a case following an unusual mode of orbital penetrating injury with wire to an eight-year-old male child whose clinical features and CT scan findings were suggestive of SOFS. Surgical decompression with steroid therapy under antibiotic coverage showed excellent results with complete recovery after 2 ½ months without any complications till 1 year of follow up.
Surprise Beneath The Bleb
Authors: Menon Meena Gopinath , Alle Vijaya L.
Published: November 2020

Bleb revision for hypot onous maculopat hy following trabeculectomy is an effective technique for raising intraocular pressure and limiting visual loss. Reinforcing materials such as donor sclera may play an important role if over-filt ration is the cause. Meticulous revision of the bleb can lead to resolution of bleb-related complications in most cases leaving a good quality of vision.
Attitudes and Practices of Pharmacists and Physicians towards Bush Medicine in Guyana
Authors: Tyrell Ede , Jeeboo Karishma , Carter Jewel Edmonson- , Thomas Troy , Kurup Rajini
Published: November 2020

Aims: To examine the attitudes and practices of physicians and pharmacists towards bush medicine, and explore the factors influencing their attitudes. Also, to determine whether a video educational intervention impacted attitudes.

Study Design: This was a cross-sectional study of registered physicians and pharmacists.

Place and Duration of Study: A total of 274 persons participated: 134 pharmacists attending their first Continuing Pharmacy Education (CPE) of 2015 and 140 physicians attending their annual Medical Scientific Conference.

Methodology: A pre-tested, self-administered questionnaire was distributed and collected, a video intervention was shown, and a post-intervention questionnaire was administered. Data were analysed using latent class cluster analysis, and the best-fitting model was determined using mainly the Bayesian Information Criterion (BIC). Logistic and multinomial regression and Fisher's exact test were also employed to investigate associations with demographic variables and the impact of the intervention.

Results: Most of the participants (56.4%) were 20-30 years old, and the majority (52%) had five years or less professional experience. Pharmacists displayed a more positive attitude to bush medicine than physicians. Most (99%) believed that patients should inform their physician/pharmacist about their bush medicine use, but only 53% routinely requested this information. More than half (52%) had personally used bush medicine, but only 38% had ever recommended its use. More than 90% believed that clinical trials should be conducted with bush medicine before it is used, and 88% were interested in further training. Ethnicity, years of professional experience and type of profession influenced attitudes and the intervention led to an improved outlook regarding bush medicine.

Conclusion: Overall, most participants had some misgivings about bush medicine but were willing to learn more and were interested in clinical trials. Evidence-based clinical research and training at the tertiary level or future continuing education sessions should be implemented using the content in the video as a template.
Evaluation of the Ameliorative Effects of Spirulina in PropylthiouracilInduced Hyperlipidaemia, Liver and Kidney Toxicity in Rats
Authors: Ragheb Eman M. , Aljehany Buthaina M.
Published: November 2020

Background: Propylthiouracil (PTU) is a drug widely used in the management of hyperthyroidism. The drug was observed to cause hepatitis and fulminant liver failure.Spirulinais documented to exhibit several therapeutic effectsincluding hepatoprotective, nephroprotective, and antioxidant activities.

Objective: This study aimed to assess the nutritional value of Spirulina,and to examine its  ameliorative effects against PTU-induced hypothyroidism associated with hyperlipidemia, liver, and kidney toxicity in rats.

Materials and Methods: This experiment was carried out on 50 rats (5 groups, n = 10). Hypothyroidism was induced in 40 ratsvia injecting 10 mg/kg/day PTUfor 6 weeks.

Results: The results of this study showed that Spirulina contains 57.30 % of its dry weight proteins while it contains only 8.2% of its dry weight fats. It contains several minerals and vitamins (E and β-carotene).Spirulina increases the final body weight, food intake, and body weight gain % values compared to PTU rats. The Alga increased FT3 and FT4 levels, while decrease TSH level compared to PTU rats. Spirulina significantly decreased serum liver enzymes (ALT, AST, and ALP) and serum kidney function markers (creatinine and urea) compared to PTU rats. Besides, it reduced serum lipid profile markers (TC, TG, and LDL-C) and increased HDL-C. The Alga reduced the lipid peroxidation product and increased glutathione peroxidase concentrations.

Conclusion: The results of this study confirmed the protective role of Spirulina versus PTU associated hypothyroidism, hyperlipidemia, hepatic, and nephrotoxicity. The antioxidant impact of Spirulina may elucidate its defensive effect against various PTU toxicities.
Sustainable Agriculture: Nutrition of Indigenous American 3 Sisters Garden Compared to Monoculture Corn Production and a Cool Old Squash
Authors: Terry Patricia A. , Pearson Debra , Holder Gregory
Published: November 2020

Balancing productivity, profitability, human health, and environmental health is a key challenge for agricultural sustainability. After WW2, however, U.S. government agricultural subsidies have created cheap corn that the processed food industry has infused into virtually every aspect of the American diet. As a result, rates of diabetes, heart disease, hypertension, kidney disease, obesity, and metabolic syndrome have increased significantly in the past forty years, especially among low socio-economic groups and non-Western peoples, due to the low cost of processed foods. Additionally, industrial monoculture corn production depletes soil nutrients and increases weeds and insects, requiring fertilizer and pesticide inputs that contaminant water, reduce biodiversity, and contribute to eutrophication. Multi-cropping, in particular growing corn, squash, and legumes in an Indigenous American Three Sisters garden provides significantly improved nutrition per mass of plant compared to corn. Squash is very high in carotenoids that have been shown to reduce rates of chronic diseases, such as cancers, diabetes, hypertension, and cardiovascular disease. It also promotes eye health and improves immune function. Agricultural practices of multi-cropping also replenish soil nutrients and suppress weeds and insects, requiring fewer fertilizer and pesticide inputs. Finally, in an exciting opportunity, the ancient Indigenous American squash Gete Okosomin, “Cool old squash,” was grown and a complete nutritional analysis was obtained and compared to common modern squashes. Different stories of its origin are also discussed.
Screening of preservatives and evaluation of sterilized cellulose nanofibers for toxicity studies
Authors: Sai Takafumi , Maru Junko , Obara Sawae , Endoh Shigehisa , Kajihara Hideo , Fujita Katsuhide
Published: November 2020

Objectives

The aim of this study is to establish a sterilization method for cellulose nanofibers (CNFs) dispersions that uses multiple preservatives with different hydrophilicities without affecting the physical and chemical properties of CNFs, and to provide useful information for sample preparation in future toxicity study of CNFs.

Methods

Various preservatives were added to the phosphorylated CNF dispersions, endotoxin level and the numbers of bacteria and fungi in the CNF dispersion were analyzed. The pH values and viscosity of sterilized CNF dispersions were compared with those of control and autoclaved CNF dispersions.

Results

Phosphorylated CNF dispersions at a concentration of 2.0 mg/mL or lower and the addition of 10 µg/mL benzalkonium chloride alone or 250 µg/mL methyl parahydroxybenzoate and 250 µg/mL propyl parahydroxybenzoate in combination can sterilize CNF dispersions without changing the physical and chemical properties of CNFs.

Conclusions

We developed sterilization method for CNF dispersions that uses multiple preservatives with different hydrophilicities without affecting the physical and chemical properties of CNFs. This sterilization method for CNFs dispersions can be applied to the safety assessment of CNF with different physicochemical properties in the future.
The North American Helpline initiative in Bangladesh for garment workers
Authors: Alamgir Hasnat
Published: November 2020

Introduction

After a series of garment factory disasters that had taken place in Bangladesh, the Alliance for Bangladesh Worker Safety (Alliance) was formed by 29 large North American retail companies to improve worker safety in Bangladesh- the second largest ready-made garments producing country in the world.

Aims

This report focuses on Alliance’s Worker Empowerment initiative—Worker Helpline and examines the types, contents and volume of calls received by it.

Methods

All published reports of Alliance that are available online were retrieved. Data from each quarter (Q) in 2017, 2018, and 2019 were extracted in terms of (1) Total calls (2) Substantive calls, and (3) Safety calls (Urgent and Non-urgent).

Results

By 2019, Q3 Helpline covered 1.5 million workers in 1091 factories. In Q1 2017, there was 1 call made per 73 workers and 20 calls made per a factory whereas in Q3 2019 there was 1 call per 171 workers and 8 calls coming from a factory. In terms of safety calls, there was 0.59 calls/factory in Q1 2017 but went down to 0.17 calls/factory in Q3 2019. Helpline in 2019 Q3 received 1283 substantive calls; of that 189 were safety calls which included 18 urgent and 171 non-urgent calls. In Q1 of 2017, 32% factories did not make any calls and in Q3 2019, 62% of factories did not make any calls at all.

Conclusions

The worker empowerment initiative- Helpline-in Bangladesh initiated by the North American companies remained underutilized.
Creation of the first monoclonal antibody recognizing an extracellular epitope of hABCC6
Authors: Kozák Eszter , Szikora Bence , Iliás Attila , Jani Péter K. , Hegyi Zoltán , Matula Zsolt , Dedinszki Dóra , Tőkési Natália , Fülöp Krisztina , Pomozi Viola , Várady György , Bakos Éva , Tusnády Gabor E. , Kacskovics Imre , Váradi Andras
Published: November 2020

Mutations in the ABCC6 gene result in calcification diseases such as pseudoxanthoma elasticum or Generalized Arterial Calcification of Infancy. Generation of antibodies recognizing an extracellular (EC) epitope of ABCC6 has been hampered by the short EC segments of the protein. To overcome this limitation, we immunized bovine FcRn transgenic mice exhibiting an augmented humoral immune response with Human Embryonic Kidney 293 cells cells expressing human ABCC6 (hABCC6). We obtained a monoclonal antibody recognizing an EC epitope of hABCC6 that we named mEChC6. Limited proteolysis revealed that the epitope is within a loop in the N‐terminal half of ABCC6 and probably spans amino acids 338–347. mEChC6 recognizes hABCC6 in the liver of hABCC6 transgenic mice, verifying both specificity and EC binding to intact hepatocytes.
Addressing selective attrition in the enhanced response time‐based concealed information test: A within‐subject replication
Authors: Lukács Gáspár
Published: November 2020

The response time‐based concealed information test can reveal when a person recognizes a relevant item among other, irrelevant items, based on comparatively slower responding. Thereby, if a person is concealing the knowledge about the relevance of this item (e.g., recognizing it as a murder weapon), this deception can be revealed. A recent study, conducted online and using a between‐subject design, introduced a significantly enhanced version by including additional items in the task. While this modified version outperformed the original version, it also resulted in a much higher rate of participant dropouts (i.e., participants leaving the experiment's website without completing the task). The grave implication is that the perceived enhancement is perhaps merely due to selective attrition. Therefore, the current experiment replicates the original one, but using a within‐subject design. The results show that there is a large enhancement even when selective attrition is prevented.
Controllable Assembly of Upconversion Nanoparticles Enhanced Tumor Cell Penetration and Killing Efficiency
Authors: Zhang Zhen , Rahmat Juwita Norasmara , Mahendran Ratha , Zhang Yong
Published: November 2020

The use of upconversion nanoparticles (UCNPs) for treating deep‐seated cancers and large tumors has recently been gaining momentum. Conventional approaches for loading photosensitizers (PS) to UCNPs using noncovalent physical adsorption and covalent conjugation had been previously described. However, these methods are time‐consuming and require extra modification steps. Incorporating PS loading during the controlled UCNPs assembly process is seldom reported. In this study, an amphiphilic copolymer, poly(styrene‐co‐maleic anhydride), is used to instruct UCNPs assembly formations into well‐controlled UCNPs clusters of various sizes, and the gap zones formed between individual UCNPs can be used to encapsulate PS. This nanostructure production process results in a considerably simpler and reliable method to load PS and other compounds. Also, after considering factors such as PS loading quantity, penetration in 3D bladder tumor organoids, and singlet oxygen production, the small UCNPs clusters displayed superior cell killing efficacy compared to single and big sized clusters. Therefore, these UCNPs clusters with different sizes could facilitate a clear and deep understanding of nanoparticle‐based delivery platform systems for cell killing and may pave a new way for other fields of UCNPs based applications.
Very Low Residual Dystrophin Quantity Is Associated with Milder Dystrophinopathy
Authors: de Feraudy Yvan , Ben Yaou Rabah , Wahbi Karim , Stalens Caroline , Stantzou Amalia , Laugel Vincent , Desguerre Isabelle ,   for the FILNEMUS Network, Servais Laurent , Leturcq France , Amthor Helge
Published: November 2020

Objective

This study was undertaken to determine whether a low residual quantity of dystrophin protein is associated with delayed clinical milestones in patients with DMD mutations.

Methods

We performed a retrospective multicentric cohort study by using molecular and clinical data from patients with DMD mutations registered in the Universal Mutation Database–DMD France database. Patients with intronic, splice site, or nonsense DMD mutations, with available muscle biopsy Western blot data, were included irrespective of whether they presented with severe Duchenne muscular dystrophy (DMD) or milder Becker muscular dystrophy (BMD). Patients were separated into 3 groups based on dystrophin protein levels. Clinical outcomes were ages at appearance of first symptoms; loss of ambulation; fall in vital capacity and left ventricular ejection fraction; interventions such as spinal fusion, tracheostomy, and noninvasive ventilation; and death.

Results

Of 3,880 patients with DMD mutations, 90 with mutations of interest were included. Forty‐two patients expressed no dystrophin (group A), and 31 of 42 (74%) developed DMD. Thirty‐four patients had dystrophin quantities < 5% (group B), and 21 of 34 (61%) developed BMD. Fourteen patients had dystrophin quantities ≥ 5% (group C), and all but 4 who lost ambulation beyond 24 years of age were ambulant. Dystrophin quantities of <5%, as low as <0.5%, were associated with milder phenotype for most of the evaluated clinical outcomes, including age at loss of ambulation (p < 0.001).

Interpretation

Very low residual dystrophin protein quantity can cause a shift in disease phenotype from DMD toward BMD. ANN NEUROL 2021;89:280–292
Role of in‐situ polymethyl‐methacrylate in addition type silicone rubber with specific reference to adhesion and damping properties
Authors: Huang Bin , Dai Lina , Chen Ziqi , Zhao Yan , Gao Xiyin , Wang Qian , Xie Zemin , Zhang Zhijie
Published: November 2020

Herein, a strategy of embedding in‐situ polymethyl‐methacrylate (PMMA) domains in polydimethylsiloxane (PDMS) networks is proposed to enhance adhesive and damping properties of addition type silicone rubber (SR). PMMA domains improve the modulus of SR (at room temperature), which is stronger correlated to its adhesive performance, according to the Griffith criterion. Besides, the damping performance at high temperature is provided by the glass transition of thermoplastic PMMA. The PMMA/SR blends are obtained by the crosslink of PMMA and vinyl‐terminated polydimethylsiloxane (vi‐PDMS) liquid blends with polymethylhydrosiloxane, and the PMMA/vi‐PDMS liquid blends are prepared by in‐situ radical polymerization of methyl‐methacrylate (MMA) in vi‐PDMS with toluene as compatibilizer. Effects of disperse speed, compatibilizer content, and PMMA proportion on the morphologies and properties of PMMA/SR blends are studied. Small PMMA domains (around 800 nm) in PMMA/vi‐PDMS blends with narrow size distribution and well dispersion are formed at appropriate disperse speed (100–300 rpm) and abundant compatibilizer content (~100 wt% refers to vi‐PDMS). The blends with 20 wt% PMMA possess tensile strength over 8 MPa and lap shear strength over 5 MPa to stainless steel. And the blends with 50 wt% PMMA show good damping properties with tan δ over 0.15 at temperature range from −50 to 150°C. Tg‐PMMA moves slightly to lower temperature with less PMMA embedded, but Tg‐PDMS remained stable relatively.
Intentions
Authors: Morwitz Vicki G. , Munz Kurt P.
Published: November 2020

Intentions are one of the most widely used constructs in consumer research. We review over 50 years of research that has helped us understand what intentions are, their antecedents and consequences, and how best to measure and use them as a proxy for or predictor of behavior. We define intentions and differentiate them from other closely relatedly psychological constructs. We review several psychological theories where intentions play a central role and highlight what is known about the strength of the intention–behavior relationship, and factors that moderate the strength of that relationship. We also review more methodological research and discuss what is known about how to best measure intentions and use them to predict behavior. Finally, we suggest opportunities for continued research on intentions and discuss their continued relevance in a world of big data.
Cognitive frailty as a predictor of adverse outcomes among older adults: A systematic review and meta‐analysis
Authors: Bu ZiHan , Huang AnLe , Xue MengTing , Li QingYun , Bai YaMei , Xu GuiHua
Published: November 2020

Objective

A systematic review and meta‐analysis basing on the prospective cohort studies were conducted to explore the risk of all‐cause mortality and dementia in cognitively frail older adults compared to robust older adults and to determine whether it was a predictor of adverse outcomes.

Methods

Pubmed, Web of Science, The Cochrane Library, EMBASE, and CINAHL databases were searched to retrieve studies on adverse outcomes of cognitive frailty. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Stata 15.0 Software was used to perform the meta‐analysis. The all‐cause mortality and dementia were observed to be the primary outcomes, while the other data were considered as the secondary outcome.

Results

A total of 14 studies were included in qualitative analysis and 12 studies were included in the meta‐analysis, with low risk of bias and moderate to good methodological quality. The results showed that cognitive frailty in older people had a higher risk of all‐cause mortality [HR = 1.93, 95%CI (1.67, 2.23), p < .001] and dementia [HR = 3.66, 95%CI (2.86, 4.70) as compared with robust. The subgroup analysis showed that the assessment tools were the main source of heterogeneity.

Conclusion

In older adults living in communities, the cognitive frailty was found to be a significant predictor of all‐cause mortality and dementia. Nonetheless, cognitive frailty was found to be a better predictor of all‐cause mortality and dementia than just frailty.
Mixing qualitative methods versus methodologies: A critical reflection on communication and power in inpatient care
Authors: O'Reilly Michelle , Kiyimba Nikki , Drewett Alison
Published: November 2020

This paper offers an illustrative example to demonstrate one way of combining qualitative methods. The context for the study was a UK inpatient psychiatric hospital. Data set one was collected from weekly ward rounds where inpatient staff met with autistic patients to review medication, listen to patient concerns and make plans or adjustments in light of this. Data set two was reflective discursive interviews with patients and staff. The research objective was to critically consider the potential reasons for discrepancies in dissatisfaction reports from patients in the interviews, compared to relative compliance exhibited by patients in the ward rounds. Utilising a video‐reflexive design and critical discursive psychology approach, both data sets were analysed together. It is possible to simultaneously analyse two different data sets, one naturally occurring and one researcher generated because of the epistemological congruence in the overall design. We have presented an argument for the benefits of mixing two qualitative methods, thereby extending the mixed‐methods evidence base beyond the traditional discussions of quantitative and qualitative paradigms.
The Role of Para Social Workers in Rural Communities in Uganda: Strengthening Community Resilience for the Protection of Children
Authors: Driscoll Jennifer J.
Published: November 2020

Para social workers (PSWs) are widely used in African nations to address inadequate capacity in the professional workforce, but there is to date very little academic commentary on the effectiveness of their role. This article considers the potential efficacy of the PSW model in strengthening child protection at community level in Uganda. Twenty interviews were conducted with local government officers, civil society organisation staff and PSWs (10 in each of 2 rural areas), together with four supplementary expert interviews. The data were analysed using a framework of community resilience. The findings suggest that the model has considerable potential to strengthen community‐level protection of children in circumstances in which the operation of formal systems is limited by resource constraints and outside interventions may struggle to gain understanding and acceptance within communities. Challenges include the potential for conflicts of interest to arise and the implications of increased reporting of child maltreatment for the response of the formal child protection system, including alternative care arrangements. Given its widespread and developing usage, further research to understand the conditions under which the PSW model is most effective and sustainable in different social, economic, political and cultural contexts is essential.

‘This article considers the potential efficacy of the PSW [para social worker] model in strengthening child protection at community level in Uganda’

Key Practitioner Messages

PSWs can provide significant additional capacity to community‐level child protection arrangements at little cost in a culturally appropriate fashion.

A key strength of the PSW model lies in its potential to regenerate community resources through the engagement of community members.

Developing sustainable community‐based child protection arrangements requires that attention is paid to balancing fiscal considerations against community ownership and also the response of the formal child protection system to increased reporting of child maltreatment.
Coronary thrombosis due to heparin‐induced thrombocytopenia after percutaneous coronary intervention: Easy to miss, uneasy to prevent
Authors: Mele Marco , Iacoviello Massimo , Casavecchia Grazia , Tricarico Lucia , Brunetti Natale Daniele
Published: November 2020

In case of unexplained post‐PCI coronary thrombosis, a HIT should be always considered. A pragmatic approach with bivalirudin may be reasonable, even in absence of confirmed laboratory diagnosis.
Active Edge Site Exposed β‐Ni(OH)2 Nanosheets on Stainless Steel Mesh as a Versatile Electrocatalyst for the Oxidation of Urea, Hydrazine, and Water
Authors: Kashale Anil A. , Ghule Anil V. , Chen I‐Wen Peter
Published: November 2020

Energy generation through electrochemical conversion while addressing the environmental concerns has always been the topic of interest to the scientific community. Particularly, the development of low‐cost and efficient electrocatalyst gained attention for large‐scale energy and clean‐energy production. But now the emphasis is on developing low‐cost and efficient electrocatalyst materials that show more than one electrocatalytic reactions. Hence, we have developed a highly porous and active edge plane exposed β‐Ni(OH)2 nanosheet on low‐cost and flexible stainless‐steel mesh (SSM) and investigated its catalytic activity for oxidation of urea, hydrazine, and water. The as‐prepared β‐Ni(OH)2/SSM demonstrates the excellent catalytic activity towards the urea oxidation reaction (UOR), hydrazine oxidation reaction (HzOR), and oxygen evolution reaction (OER) with potential lower than the 1.45 V vs. RHE, 1.34 V vs. RHE, and 1.51 V vs. RHE at 50 mA/cm2 current density, respectively. Furthermore, the as‐prepared electrocatalyst demonstrates excellent stability in UOR, HzOR, and OER for long time. The promising electrocatalytic activity of as‐prepared β‐Ni(OH)2/SSM electrocatalyst is attributed to the highly porous, and edge plane exposed binder‐free thin nanosheets grown on SSM, which also adds to the mechanical structure stability and a large amount of mass transportation during electrocatalytic activity.
Multinational enterprises and strategic actions in emerging economy contexts: From conformity to institutional entrepreneurship
Authors: Seifzadeh Pouya , Derayati Ehsan , Radnejad Amir Bahman
Published: November 2020

This research explores the broader set of strategic actions of multinational enterprises (MNEs) in emerging markets in response to institutional forces. We re‐examine the effect of MNEs on changing institutions in host countries and conceptualize a theoretical model of institutionalization and institutional change initiated by MNEs in emerging economy contexts. In our two‐stage approach, we build on an inductive study to explore MNEs' strategic actions and their institutional settings. We then conduct repertory grid analysis to analyze face‐to‐face interviews with mid‐level and senior managers of subsidiaries of eight major MNEs. We identify distinctive categories of strategic action taken by MNEs to respond to facets of their institutional environment, depending on the restrictiveness/openness of their institutional environment, and their self‐perceived organizational strength.
Mortality differences among patients with in‐hospital ST‐elevation myocardial infarction
Authors: Shahandeh Negeen , Dai Xuming , Jaski Brian , Dave Ravi , Jacobs Alice , Denktas Ali , Levine Glenn , Markovic Daniela , Smith Sidney C. , Press Marcella Calfon
Published: November 2020

Background

In‐hospital ST‐elevation myocardial infarction (STEMI) is associated with a higher mortality rate than out‐of‐hospital STEMI. Quality measures and universal protocols for treatment of in‐hospital STEMI do not exist, likely contributing to delays in recognition and treatment.

Hypothesis

To analyze differences in mortality among three subsets of patients who develop in‐hospital STEMI.

Methods

This was a multicenter, retrospective observational study of patients who developed in‐hospital STEMI at six United States medical centers between 2008 and 2017. Patients were stratified into three groups: (1) cardiac, (2) periprocedure, or (3) noncardiac/nonpostprocedure. Outcomes examined include time from electrocardiogram (ECG) acquisition to cardiac catheterization lab arrival (ECG‐to‐CCL) and survival to discharge.

Results

We identified 184 patients with in‐hospital STEMI (mean age 68.7 years, 58.7% male). Group 1 (cardiac) patients had a shorter average ECG‐to‐CCL time (69 minutes) than group 2 (periprocedure, 215 minutes) and group 3 (noncardiac/nonpostprocedure, 199 minutes). Compared to group 1, survival to discharge was lower for group 2 (OR 0.33, P = .102) and group 3 (OR 0.20, P = .016). After adjusting for prespecified covariates, the relationship between group and survival showed a similar trend but did not reach statistical significance.

Conclusions

Patients who develop in‐hospital STEMI in the context of a preceding procedure or noncardiac illness appear to have longer reperfusion times and higher in‐hospital mortality than patients admitted with cardiac diagnoses. Larger studies are warranted to further investigate these observations. Health systems should place an increased emphasis on developing quality metrics and implementing quality improvement initiatives to improve outcomes for in‐hospital STEMI.
Code generation for energy‐efficient execution of dynamic streaming task graphs on parallel and heterogeneous platforms
Authors: Litzinger Sebastian , Keller Jörg
Published: November 2020

Streaming task graphs are high‐level specifications for parallel applications operating on streams of data. For a static task graph structure, static schedulers can be used to map the tasks onto a parallel platform to minimize energy consumption for given throughput. We introduce dynamic elements into the task graph structure, thus specifying applications which adapt behavior at runtime, for example, switching from check‐only to active mode. This in turn necessitates a runtime system that can remap tasks and potentially adapt their degree of parallelism in case of a dynamic change of the task structure. We provide a toolchain and evaluate our prototype with streaming task graphs both synthetic and from a real application. We find that we meet throughput requirements with <3.5% energy overhead on average compared with an optimal static scheduler based on integer linear programming. Runtime overhead for remapping is negligible and application runtime and energy are accurately predicted. We also outline how to extend our system to a heterogeneous platform.
Participatory selection of CWR‐derived salt‐tolerant rice lines adapted to the coastal zone of the Mekong Delta
Authors: Tin Huynh Quang , Loi Nguyen Huu , Bjornstad Åsmund , Kilian Benjamin
Published: November 2020

Climate change is affecting agricultural production in the coastal areas of the Mekong Delta through the intrusion of salinity into the rice (Oryzaspp.) fields, where farmers cultivate photoperiod‐sensitive rice varieties with long growth duration and low grain yields. A set of 12 stable crop wild relative (CWR)‐derived rice lines with introgressions from wild riceOryza rufipogonGriffiths andO. nivaraS.D. Sharma & Shastry was evaluated for their phenotypic response to salinity tolerance by a participatory selection approach on farm in the Phuoc Long and Gia Rai districts, Bac Lieu province. The evaluation of the results showed that four lines derived from CWR are well adapted to the local environmental conditions, with high grain yield (>6.5 t ha−1), early maturity, and short plant height. These CWR‐derived lines were adopted by farmers and proposed for testing on a larger scale in different areas of the coastal zone.
Spatially explicit removal strategies increase the efficiency of invasive plant species control
Authors: Eppinga Maarten B. , Baudena Mara , Haber Elizabeth A. , Rietkerk Max , Wassen Martin J. , Santos Maria J.
Published: November 2020

Effective management strategies are needed to control expansion of invasive alien plant species and attenuate economic and ecological impacts. While previous theoretical studies have assessed optimal control strategies that balance economic costs and ecological benefits, less attention has been paid to the ways in which the spatial characteristics of individual patches may mediate the effectiveness of management strategies. We developed a spatially explicit cellular automaton model for invasive species spread, and compared the effectiveness of seven control strategies. These control strategies used different criteria to prioritize the removal of invasive species patches from the landscape. The different criteria were related to patch size, patch geometry, and patch position within the landscape. Effectiveness of strategies was assessed for both seed dispersing and clonally expanding plant species. We found that, for seed‐dispersing species, removal of small patches and removal of patches that are isolated within the landscape comprised relatively effective control strategies. For clonally expanding species, removal of patches based on their degree of isolation and their geometrical properties comprised relatively effective control strategies. Subsequently, we parameterized the model to mimic the observed spatial distribution of the invasive species Antigonon leptopus on St. Eustatius (northern Caribbean). This species expands clonally and also disperses via seeds, and model simulations showed that removal strategies focusing on smaller patches that are more isolated in the landscape would be most effective and could increase the effectiveness of a 10‐yr control strategy by 30–90%, as compared to random removal of patches. Our study emphasizes the potential for invasive plant species management to utilize recent advances in remote sensing, which enable mapping of invasive species at the high spatial resolution needed to quantify patch geometries. The presented results highlight how this spatial information can be used in the design of more effective invasive species control strategies.
The association of traumatic events and posttraumatic stress disorder with greater eating disorder and comorbid symptom severity in residential eating disorder treatment centers
Authors: Brewerton Timothy D. , Perlman Molly M. , Gavidia Ismael , Suro Giulia , Genet Jessica , Bunnell Douglas W.
Published: November 2020

Objective

Traumatic events, posttraumatic stress disorder (PTSD) and related symptoms are commonly associated with eating disorders (ED). Several clinical features indicative of a more severe and complex course have been associated with traumatized ED patients, especially those with PTSD, who may be more likely admitted to residential treatment (RT). Research in this population is sparse but of increasing interest.

Method

Adult participants (96.7% female) with EDs entering RT (n = 642) at seven sites in the U.S. completed validated self‐report assessments of ED, PTSD, major depression, state–trait anxiety, and quality of life. Presumptive diagnoses of DSM‐5 PTSD (PTSD+) were made via the Life Events Checklist‐5 and the PTSD Symptom Checklist for DSM‐5.

Results

PTSD+ occurred in 49.3% of patients. PTSD+ patients had significantly higher scores on all assessment measures (p ≤ .001), including measures of ED psychopathology, depression, state–trait anxiety, and quality of life. Those with PTSD+ had significantly higher numbers of lifetime traumatic event types, higher rates of almost all lifetime traumatic events, and a greater propensity toward binge‐type EDs.

Discussion

Results confirm that ED‐PTSD+ patients in RT are more symptomatic and have worse quality of life than ED patients without PTSD+. Integrated treatment approaches that effectively address ED‐PTSD+ are greatly needed.
Outcomes of a higher calorie inpatient refeeding protocol in Asian adolescents with anorexia nervosa
Authors: Davis Courtney , Hong Wei Jie Nicholas , Zhang Stella Letian , Quek Wei Ern Grace , Lim Jie Kai Ethel , Oh Jean Yin , Rajasegaran Kumudhini , Chew Chu Shan Elaine
Published: November 2020

Objective

This study aims to compare the outcomes of higher calorie refeeding (HCR) and a lower calorie refeeding (LCR) methods among a diverse sample of young Asian adolescents admitted to a tertiary institution in Asia for management of anorexia nervosa (AN).

Method

This is a retrospective case control study of Asian adolescents who were managed using an inpatient HCR protocol (2016–2017) and an LCR protocol (2010–2014). Baseline characteristics, daily change in percent median body mass index (%mBMI), and rates of refeeding hypophosphatemia were analyzed between groups.

Results

A total of 125 adolescents with AN were analyzed with 61 (52%) patients in the HCR group. Mean age was 14.0 years (SD =1.5) and mean presenting %mBMI was 73.2 (SD =6.9) with mean length of stay of 11.9 days (SD = 6.6). Patients in the HCR group had significantly increased rate of change of %mBMI (M = 0.39, SD = 0.31) than patients in the LCR group (M = 0.12, SD = 0.43) (p < .001). There was an increased rate of mild hypophosphatemia in the HCR group (HCR: 46%, LCR: 22%, p = .007) but no difference in rates of moderate hypophosphatemia and no cases of severe hypophosphataemia. Lower presenting %mBMI significantly predicted the phosphate levels (p = .004).

Discussion

In a sample of Asian adolescents with AN, use of an HCR protocol was associated with improved rate of inpatient weight gain. There was increased risk of mild hypophosphataemia, but not moderate to severe hypophosphataemia, suggesting that an HCR protocol can be used safely with close monitoring of phosphate levels.
Plant phylogeny drives arboreal caterpillar assemblages across the Holarctic
Authors: Seifert Carlo L. , Volf Martin , Jorge Leonardo R. , Abe Tomokazu , Carscallen Grace , Drozd Pavel , Kumar Rajesh , Lamarre Greg P.A. , Libra Martin , Losada Maria E. , Miller Scott E. , Murakami Masashi , Nichols Geoffrey , Pyszko Petr , Šigut Martin , Wagner David L. , Novotný Vojtěch
Published: November 2020

Assemblages of insect herbivores are structured by plant traits such as nutrient content, secondary metabolites, physical traits, and phenology. Many of these traits are phylogenetically conserved, implying a decrease in trait similarity with increasing phylogenetic distance of the host plant taxa. Thus, a metric of phylogenetic distances and relationships can be considered a proxy for phylogenetically conserved plant traits and used to predict variation in herbivorous insect assemblages among co‐occurring plant species.

Using a Holarctic dataset of exposed‐feeding and shelter‐building caterpillars, we aimed at showing how phylogenetic relationships among host plants explain compositional changes and characteristics of herbivore assemblages.

Our plant–caterpillar network data derived from plot‐based samplings at three different continents included >28,000 individual caterpillar–plant interactions. We tested whether increasing phylogenetic distance of the host plants leads to a decrease in caterpillar assemblage overlap. We further investigated to what degree phylogenetic isolation of a host tree species within the local community explains abundance, density, richness, and mean specialization of its associated caterpillar assemblage.

The overlap of caterpillar assemblages decreased with increasing phylogenetic distance among the host tree species. Phylogenetic isolation of a host plant within the local plant community was correlated with lower richness and mean specialization of the associated caterpillar assemblages. Phylogenetic isolation had no effect on caterpillar abundance or density. The effects of plant phylogeny were consistent across exposed‐feeding and shelter‐building caterpillars.

Our study reveals that distance metrics obtained from host plant phylogeny are useful predictors to explain compositional turnover among hosts and host‐specific variations in richness and mean specialization of associated insect herbivore assemblages in temperate broadleaf forests. As phylogenetic information of plant communities is becoming increasingly available, further large‐scale studies are needed to investigate to what degree plant phylogeny structures herbivore assemblages in other biomes and ecosystems.