bluuebunny/crossref_metadata_2025 huggingface dataset:
Platelet Electron Microscopy: Utilizing LEAN Methodology to Optimize Laboratory Workflow
Authors: Asher Lucas , Hata Jessica
Published: May 2020

Background

Platelet electron microscopy (PEM) is the gold standard methodology for diagnosing storage pool disorder, defined as a paucity of delta granules, alpha granules, or both. PEM literature is limited with few published resources and without well-developed interlaboratory standardization for the preparation and examination of platelet samples.

Methods

Whole mount (WM) dense body (DB) counts for 300 pediatric cases were reviewed to determine whether counting fewer platelets could yield the same results. For 6 cases, DB average was determined on the day of WM preparation and on 2 consecutive days. Both WM and thin section (TS) preparations were examined for all cases.

Results

Employing LEAN methodology, an algorithm was developed to markedly decrease the number of platelets counted and still ensure accurate results. WMs decay with time; a statistically significant difference in DB counts was noted between day 0 and day 1 ( p < .1). Twelve of 300 cases required both WM and TS preparations for a complete diagnosis.

Conclusion

It is possible to maintain accuracy and decrease 100 platelet DB counts by >75%. WMs must be counted on the day they are prepared to avoid false paucity of DB secondary to sample decay. An accurate evaluation of platelet morphology requires both the WM and TS techniques.
Teratoid Hepatoblastoma With Yolk Sac-Like and Neuroendocrine Elements
Authors: Smith Jacob A , Ranganathan Sarangarajan
Published: May 2020

Teratoid hepatoblastoma (HB) is a variant of mixed HB described as having a mixture of heterologous components. A 3-year-old boy presented for a liver transplant evaluation due to persistent HB. His liver was biopsied as well as a perirenal mass. Histologic examination demonstrated elements of yolk sac tumor and review of original resection showed a neuroendocrine component. This unique combination of histology has not been reported before in HB. Also, this case presents a unique diagnostic challenge as it presented with a metastasis containing yolk sac elements. Recognition and awareness of this histologic variant are important to accurately identify metastatic lesions.
Asynchronous computations for solving the acoustic wave propagation equation
Authors: Akbudak Kadir , Ltaief Hatem , Etienne Vincent , Abdelkhalak Rached , Tonellot Thierry , Keyes David
Published: May 2020

The aim of this study is to design and implement an asynchronous computational scheme for solving the acoustic wave propagation equation with absorbing boundary conditions (ABCs) in the context of seismic imaging applications. While the convolutional perfectly matched layer (CPML) is typically used for ABCs in the oil and gas industry, its formulation further stresses memory accesses and decreases the arithmetic intensity at the physical domain boundaries. The challenges with CPML are twofold: (1) the strong, inherent data dependencies imposed on the explicit time-stepping scheme render asynchronous time integration cumbersome and (2) the idle time is further exacerbated by the load imbalance introduced among processing units. In fact, the CPML formulation of the ABCs requires expensive synchronization points, which may hinder the parallel performance of the overall asynchronous time integration. In particular, when deployed in conjunction with the multicore-optimized wavefront diamond temporal blocking (MWD-TB) approach for the inner domain points, it results in a major performance slow down. To relax CPML’s synchrony and mitigate the resulting load imbalance, we embed CPML’s calculation into MWD-TB’s inner loop and carry on the time integration with fine-grained computations in an asynchronous, holistic way. This comes at the price of storing transient results to alleviate dependencies from critical data hazards while maintaining the numerical accuracy of the original scheme. Performance and scalability results on various x86 architectures demonstrate the superiority of MWD-TB with CPML support against the standard spatial blocking on various grid sizes. To our knowledge, this is the first practical study that highlights the consolidation of CPML ABCs with asynchronous temporal blocking stencil computations.
Scarcity-Based Price Promotions: How Effective are they in a Revenue Management Environment?
Authors: Noone Breffni M. , Lin Michael S.
Published: May 2020

Two key characteristics of revenue management (RM) environments–fixed capacity and the application of variable pricing–have the potential to influence consumers’ reactions to scarcity-based price promotions. In this study, we explore consumer reaction to two types of restrictions on price promotions-limited-time scarcity (LTS) and demand-driven limited-quantity scarcity (LQS)-in the RM context. We propose a moderated mediation model, wherein perceived consumer competition, perceived price uncertainty, and anticipated regret mediate the price promotion type (restricted vs. unrestricted)-booking intentions relationship, and booking lead-time moderates the relationship of price promotion type with perceived consumer competition and price uncertainty. Our findings suggest that LTS and LQS are effective in driving consumers’ perceptions of competition for available inventory and price uncertainty when booking lead-time is long. In turn, heightened perceptions of competition and price uncertainty amplify anticipated regret, leading to a positive effect on booking intentions. Conversely, when booking lead-time is short, restrictions-based price promotions do not differ significantly from nonrestricted promotions in terms of their effect on consumers’ booking intentions. This research provides guidance for hospitality marketing managers regarding how, and when, to employ scarcity-based price promotions to influence consumers’ booking behavior.
Morphological analysis of functional filtering blebs with anterior segment optical coherence tomography: A short-term prediction for success of trabeculectomy
Authors: Raj Anuradha , Bahadur Harsh
Published: May 2020

Purpose

The aim of the study was to analyze morphological parameters of apparently functional filtering blebs with anterior segment optical coherence tomography at 1 month post trabeculectomy and to correlate these parameters with intraocular pressure at 6 months of follow-up to predict the short-term success of trabeculectomy.

Methods

In this cross-sectional, descriptive study, apparently functional blebs were evaluated using anterior segment optical coherence tomography with crossline scans after 1 month of trabeculectomy.

Results

A total of 55 eyes of 55 cases with mean age 49.29 ± 13.72 years were included in the study. On anterior segment optical coherence tomography examination, the mean bleb height and mean bleb wall thickness, subconjunctival fluid space, and scleral flap thickness were 1.45 ± 0.39 mm, 0.63 ± 0.25 mm, 0.64 ± 0.26 mm, and 0.45 ± 0.068 mm, respectively. There was statistically significant negative correlation between intraocular pressure at 1 month and bleb height ( r = −0.25, p = 0.05). There was statistically significant negative correlation between extent of cavity and intraocular pressure at 6 months ( r = −0.318, p = 0.018). Bleb height showed significant negative correlation with supra-scleral space ( r = −0.31, p = 0.02). Multi reflective bleb walls showed statistically significant increased chances of successful functioning blebs at 6 months as compared to uniform wall reflectivity ( p = 0.00). Bleb function was successful in 37 (67.3%) and unsuccessful in 18 (32.7%) in short term of 6 months of follow-up.

Conclusion

Bleb walls with multiform wall reflectivity on anterior segment optical coherence tomography at 1 month post trabeculectomy show increased chances of success of functioning filtering bleb at 6 months. Bleb wall characteristics on anterior segment optical coherence tomography at 1 month can predict the short-term success of blebs at 6 months.
Computational micromechanical modelling of the material removal process in a carbon fibre composite under single-erodent particle impact
Authors: Deliwala Ajaz A , Yerramalli Chandra S
Published: May 2020

A multiscale model is developed to understand the material removal process in a unidirectional carbon fibre epoxy composite impacted by a single-erodent particle. The embedded cell approach is used to model the carbon fibre and epoxy at a microscale. The micromodel is embedded centrally in the macroscale lamina of the composite plate. The carbon fibre is considered to be elastic with orthotropic strain limits as the failure criteria. The epoxy matrix is modelled as an elastic--plastic material with multilinear isotropic hardening. The maximum equivalent plastic strain limit is used as the matrix material failure limit. Using this embedded micromechanics model, the role of matrix and the fibre in developing the composite material erosion behaviour has been clearly elucidated. The results from the simulation indicate the change in the matrix erosion behaviour as a function of the fibre volume fraction. For the current thermoset matrix, material erosion response changes from brittle behaviour to ductile behaviour with an increase in fibre volume fraction. The current study has been able to highlight the individual role of matrix and the fibre in developing the semi-ductile erosion response peculiar to a fibre-reinforced composite material.
A possible case of serum sickness after ocrelizumab infusion – Commentary
Authors: Al-Araji Sarmad , Ciccarelli Olga
Published: May 2020

Serum sickness is a type III delayed hypersensitivity reaction which causes deposition of immune-complexes in the tissues. It has been reported with rituximab, and in this issue of the journal, there is a case report of a patient with relapsing remitting multiple sclerosis who developed a possible serum sickness after the third infusion of ocrelizumab. In this commentary, we discuss the current literature on serum sickness, and how to diagnose and manage it. We provide our opinion on this particular case, and encourage neurologists and patients to remain vigilant of such a possibility.
Experimental investigations on red ochre for application in welding consumable development
Authors: Khan Waris Nawaz , Chhibber Rahul
Published: May 2020

This paper investigates the thermophysical, physicochemical, and surface properties of mineral waste red ochre, assessing suitability for application in welding consumable development. Red ochre is an anhydrous iron oxide derived from tailings of iron ore haematite. High iron and silica concentration makes it suitable for various engineering applications. Iron in the electrode coatings is known to increase arc stability, bead smoothness, and also it enhances slag detachability along with smoothening bead profile. The red ochre has been characterized for the properties of weight loss, density, specific heat, enthalpy, thermal conductivity, and diffusivity. Structural analysis of red ochre powder has been done using Fourier transformed infrared spectroscopy and X-ray diffraction. BET (Brunauer, Emmett, and Teller) surface area analysis has been done to estimate the surface properties, which include pore radius and specific surface area. The shielded metal arc welding electrodes have been developed by adding red ochre in a fixed proportion, and produced welds have been examined for visual defects, microstructure, and microhardness.
A Classroom Study on the Role of Prior Knowledge and Retrieval Tool in the Testing Effect
Authors: Francis Andrea P. , Wieth Mareike B. , Zabel Kevin L. , Carr Thomas H.
Published: May 2020

This quasi-experimental study investigated the role of prior psychology knowledge and in-class retrieval activity in the testing effect. Undergraduate introductory psychology students ( N = 53) from two classes at a small liberal arts college practiced retrieving information in class with multiple-choice quizzing and concept mapping. Prior psychology knowledge was measured using a 25-item multiple-choice pretest. Both students with high and low prior psychology knowledge had higher scores on examination material that was practiced in class with retrieval-based concept mapping compared to traditional multiple-choice quizzes and to no organized in-class retrieval activity at all. Only students with high prior psychology knowledge had higher scores on quizzed material compared to no organized in-class retrieval practice, and these scores were lower than those on material that was practiced with in-class concept mapping. In comparison to administering multiple-choice quiz questions, a more useful in-class activity might be to have students, especially those with less prior psychology knowledge, practice retrieving material through free recall and connection building activities such as a concept map.
Calculating luminous flux radiated to a camera lens via high dynamic range photogrammetry
Authors: Poling RM , Cai H
Published: May 2020

A camera-aided method of using high dynamic range photogrammetry was developed to calculate luminous flux radiated to the camera lens from an environment or its subareas, with per-pixel contributions from visible light-emitting sources, objects, and reflective surfaces. A series of equations were derived to calculate the luminous flux with valid sub-divisibility and additivity. A pilot study was first conducted, followed by a laboratory experiment using an integrating sphere to improve and validate this high dynamic range imaging method with a measurement error of 5.6%. This method was then tested in a real office space to estimate ‘visible’ luminous flux arriving at the camera lens simulating a typical view of 30 office users under four different test scenarios (fluorescent vs. LED lighting, with vs. without access to lighting controls). The luminous flux retrieved from each of a total of 120 high dynamic range images was checked with the illuminance measured at the camera lens. This camera-aided method for remote measurement of luminous flux was proven valid and useful for lighting practice and research. Further investigations on this method are necessary to overcome several limitations and issues of the present study.
Effect of surface treatment on moisture absorption, thermal, and mechanical properties of sisal fiber
Authors: Gudayu Adane Dagnaw , Steuernagel Leif , Meiners Dieter , Gideon Rotich
Published: May 2020

Natural fibers are increasingly being used as composite reinforcement for both thermoplastic and thermoset resin, mainly for automotive application. Due to their hydrophilic nature, natural fibers have certain limitations during composite manufacture especially owing to their poor resin wettability, weak fiber–polymer interface, high moisture absorption, and being affected by high temperature in case of thermoplastic resin. This work investigates the impact of sisal fiber modification techniques on moisture absorption, thermal, and mechanical properties of the fiber. Four sisal fiber samples were prepared; untreated, alkaline treated, acetylated, and a combined alkaline-treated/acetylation samples. The samples were evaluated for their hygroscopic nature, thermal stability, and tensile properties. It is found that acetylation resulted in a reduction of moisture absorption of sisal fiber as the acetylated and alkaline-treated/acetylated samples recorded a decrease of 42% and 28%, respectively. Alkaline treatment increased the absorbency owing to the removal of hemicellulose and lignin. The thermogravimetric result revealed that alkaline treatment improved the thermal stability as the alkali-treated and alkali-treated/acetylated samples showed improvement in thermal properties. The acetylated sample resulted in a significant reduction in tensile strength. But, the results from tensile tests of the alkaline-treated samples showed an insignificant decrease in tensile strength and improvement in the modulus for all treated samples. Fourier-transform infrared and scanning electron microscopic analysis were included in the study to supplement the results with structural and microstructural changes. The effect of those treatments on the sisal–PET composite properties was studied and will be submitted in part 2 of the study.
A reversible database watermarking method non-redundancy shifting-based histogram gaps
Authors: Li Yan , Wang Junwei , Luo Xiangyang
Published: May 2020

In relational databases, embedding watermarks in integer data using traditional histogram shifting method has the problem of large data distortion. To solve this problem, a reversible database watermarking method without redundant shifting distortion is proposed, taking advantage of a large number of gaps in the integer histogram. This method embeds the watermark bit by bit on the basis of grouping. First, an integer data histogram is constructed with the absolute value of the prediction error of the data as a variable. Second, the positional relationship between each column and the gap in the histogram is analyzed to find out all the columns adjacent to the gap. Third, the highest column is selected as the embedded point. Finally, a watermark bit is embedded on the group by the histogram non-redundant shifting method. Experimental results show that compared with existing reversible database watermarking methods, such as genetic algorithm and histogram shift watermarking and histogram gap–based watermarking, the proposed method has no data distortion caused by the shifting redundant histogram columns after embedding watermarks on forest cover type data set and effectively reduces the data distortion rate after embedding watermarks.
Stochastic allocation strategy for irregular arrays based on geometric feature control
Authors: Yu Jingjing , Xi Qi , Li Runlei , Tian Hui , Xie Yaxi
Published: May 2020

Irregularities in microphone distribution enrich the diversity of spatial differences to decorrelate interferences from the beamforming target. However, the large degrees of freedom of irregular placements make it difficult to analyse and optimize array performance. This article proposes fast and feasible optimal irregular array design methods with improved beamforming performance for human speech. Important geometric features are extracted to be used as the input vector of the neural network structure to determine the optimal irregular arrangements of sensors. In addition, a hyperbola design method is proposed to directly cluster microphones in the hyperbola areas to produce rich differential distance entropies and yield significant signal-to-noise ratio improvements. These methods can be easily applied to guide non-computer-aided optimal irregular array designs for human speech in acoustic scenes such as immersive cocktail party environments.
Skin in the Game: Personal Accountability and Journal Peer Review
Authors: Sacco Donald F. , Bruton Samuel V. , Brown Mitch , Medlin Mary M.
Published: May 2020

Two preregistered studies explored the likelihood paper reviewers would request clarification from authors regarding potential questionable research practices (QRPs). Study 1 participants were instructed to imagine reviewing a journal manuscript as either a coauthor or peer reviewer and rate the extent to which they would request clarification from the author when encountering potential QRPs. Participants reported greater likelihood of requesting clarification when assigned to the coauthor relative to the peer reviewer role. Study 2 participants were assigned to either an anonymous or open-review condition and rated the extent to which they would seek clarification from an author regarding potential QRPs. Men (but not women) in the open review condition reported greater likelihood of seeking clarification about potential QRPs than men in the blind review condition. Results provide tentative evidence that motivational factors influence the peer review process, and suggestions are made for improving peer review practices.
Filling the binary images of draped fabric with pix2pix convolutional neural network
Authors: Yu Zhicai , Zhong Yueqi , Gong R Hugh , Xie Haoyang
Published: May 2020

To fill the binary image of draped fabric into a comparable grayscale image with detailed shade information, the three-dimensional point cloud of draped fabric was obtained with a self-built three-dimensional scanning device. The three-dimensional point cloud of drape fabric is encapsulated into a triangular mesh, and the binary and grayscale images of draped fabric were rendered in virtual environments separately. A pix2pix convolutional neural network with the binary image of draped fabric as input and the grayscale image of draped fabric as output was constructed and trained. The relationship between the binary image and the grayscale image was established. The results show that the trained pix2pix neural network can fill unknown binary top view images of draped fabric to grayscale images. The average pixel cosine similarity between filling results and ground truth could reach 0.97.
Experimental study on the effects of the Miller cycle on the performance and emissions of a downsized turbocharged gasoline direct injection engine
Authors: Huang Zhao-Ming , Shen Kai , Wang Li , Chen Wei-Guo , Pan Jin-Yuan
Published: May 2020

The Miller cycle has been proven to be an effective way to improve the thermal efficiency for gasoline engines. However, it may show insufficient power performance at certain loads. In this study, the objective is to exploit the advantages of the Miller-cycle engines over the original Otto-cycle engines. Therefore, a new camshaft profile with early intake valve closure was devised, and two various pistons were redesigned to obtain higher compression ratio 11.2 and 12.1, based on the original engine with compression ratio 10. Then, a detailed comparative investigation of the effects of Miller cycle combined with higher compression ratio on the performance and emission of a turbocharged gasoline direct injection engine has been experimentally carried out based on the engine bench at full and partial loads, compared to the original engine. The results show that, at full load, for a turbocharged gasoline direct injection engine utilizing the Miller cycle, partial maximum power is compromised about 1.5% while fuel consumption shows a strong correlation with engine speed. At partial load, since the Miller effect can well reduce the pumping mean effective pressure, thus improves the fuel economy effectively. In addition, the suppression of the in-cylinder combustion temperature induced by the lower effective compression ratio contributes to the reduction of nitrogen oxide emission greatly. However, the total hydrocarbon emission increases slightly. Therefore, a combination of the Miller cycle and highly boosted turbocharger shows great potential in further improvement of fuel economy and anti-knock performance for downsized gasoline direct injection engines.
Simulation analysis of heat transfer performance of heat sink with reduced material design
Authors: Chang Ya-Chu
Published: May 2020

The field of electronic device applications is becoming more and more extensive. With the development of science and technology and the improvement of the integration of electronic components, local heating is becoming more and more serious. If heat cannot be discharged immediately, it will cause heat to accumulate, causing the temperature of each component to exceed the limit. The reliability of electronic equipment is greatly reduced. Especially in important fields such as military and aerospace, the thermal reliability of electronic components is higher. The research results show that increasing the Reynolds number is helpful to reduce the overall temperature and thermal resistance of the heat sink, but the increase of the Reynolds number and the decrease of the thermal resistance value are gradually flat. The design concept of material reduction has a significant impact on processing and cost. The results of this article show that selecting the appropriate heat sink fins and matching the specific Reynolds number can effectively improve the heat transfer performance of the heat sink.
From stigma to acceptance: Intellectual and developmental disabilities in Central China
Authors: Feaster Dennis , Franzen Aaron
Published: May 2020

Children with intellectual and developmental disabilities have historically been at high risk for social exclusion and other vulnerabilities. The Western world has shifted away from institutionally-based services and toward community-based services that allow for greater social inclusion as well as for meeting individual developmental needs, and China is beginning the process of exploring how to make this shift. In 2014 and 2015, a situation analysis examining the lived experiences of parents of children with disabilities in Zhengzhou, Henan, China, was undertaken. Perceptions of strengths, needs, opportunities, and barriers experienced by parents of children in intact families (i.e. families where children with disabilities remain in their birth families) were explored by means of parent interviews and focus groups. Families identify experiences of stigma and acceptance related to traditional and alternative social constructions of intellectual and developmental disabilities, and how they use social networks and information-sharing to help develop community-based services.
Cognitive engagement during reading on digital tablet: Evidence from concurrent recordings of postural and eye movements
Authors: Ballenghein Ugo , Kaakinen Johanna K , Tissier Geoffrey , Baccino Thierry
Published: May 2020

The present study utilised a novel combination of eye movement and motion capture recordings to examine cognitive engagement during reading on a hand-held tablet computer. Participants read a multiple-page text with a specific task in mind and after reading recalled the main contents of text from memory. The results showed that head distance from screen was slightly shorter, and readers spent longer time reading task-relevant than irrelevant segments of text and had better memory for task-relevant than irrelevant text information, indicating that there are task-induced momentary changes in engagement during reading. Moreover, head motion and individual fixation durations decreased during the course of reading of relevant segments, and even though there was an overall increase in table motion during reading, the slope of this increase was steeper for irrelevant than relevant text segments. These results suggest that readers become more engaged with relevant and less engaged with irrelevant text segments across the text. The novel methodological combination of eye and postural movements seems to provide valuable information about cognitive engagement during reading in digital environments. The cumulation of evidence from this and previous studies suggests that reading on a tablet affords different interactions between the reader and the text than reading on a computer screen. Reading on a tablet might be more similar to reading on paper, and this may impact the attentional processes during reading.
How do phonology and orthography feed back to influence syntactic encoding in language production? Evidence from structural priming in Mandarin
Authors: Wang Mengxing , Cai Zhenguang G , Wang Ruiming , Branigan Holly P , Pickering Martin J
Published: May 2020

Do speakers make use of a word’s phonological and orthographic forms to determine the syntactic structure of a sentence? We reported two Mandarin structural priming experiments involving homophones to investigate word-form feedback on syntactic encoding. Participants tended to reuse the syntactic structure across sentences; such a structural priming effect was enhanced when the prime and target sentences used homophone verbs (the homophone boost), regardless of whether the homophones were heterographic (homophones written in different character; Experiments 1 and 2) or homographic (homophones written in the same character; Experiment 2). Critically, the homophone boost was comparable between homographic and heterographic homophone primes (Experiment 2). Hence unlike phonology, orthography appears to play a minimal role in mediating structural priming in production. We suggest that the homophone boost results from lemma associations between homophones that develop due to phonological identity between homophones early during language learning; such associations stabilise before literacy acquisition, thus limiting the influence of orthographic identity on lemma association between homophones and in turn on structural priming in language production.
A rhenium(I) complex which reacts with aldehydes and ketones in aqueous media: A structural, spectroscopic and theoretical analysis
Authors: Harding Lindsay P , McRobbie Asuka AT , Riis-Johannessen T , Pope Simon JA , Rice Craig R , Rollinson Donna , Whitehead Martina
Published: May 2020

A Re(I) complex of 3,3′-diamino-2,2′-bipyridine reacts irreversibly with aldehydes and unhindered ketones in water to form bis-aminal cyclised derivatives with the solid-state structure of the reaction with benzaldehyde reported. This reaction produces a Re(I) complex which is significantly more emissive than the starting compound.
Subcritical hydrothermal synthesis of amorphous molybdenum disulfide spheres
Authors: Akram Hanane , Achak Ouafae , Chafik Tarik
Published: May 2020

Amorphous MoS2 spheres with diameters ranging from 150 nm to 1.5 μm are successfully prepared following a reliable one-pot hydrothermal route using a homemade autoclave and inexpensive reactants, at a low temperature (160 °C) and a short reaction time (12 h). The obtained material is comprehensively characterized by X-ray diffraction, scanning-electron microscopy, energy-dispersive X-ray spectroscopy, atomic force microscopy, and infrared spectroscopy. The X-ray diffraction pattern reveals the amorphous structure of the prepared sample without stacking layers, whereas scanning-electron microscopy and atomic force microscopy images indicate the formation of spheres with regular shape and morphology.
Tackling offensive behaviour in Scottish football: A how (not) to guide to developing criminal justice policy?
Authors: McBride Maureen
Published: May 2020

Since 2011, the issue of ‘sectarianism’ has dominated the Scottish political agenda as well as media and public discourse. The most high-profile aspect of the Scottish Government’s response to the problem was undoubtedly the Offensive Behaviour at Football (Scotland) Act 2012. This article is based on analysis of official documentation, speeches and media coverage relating to sectarianism and the Offensive Behaviour at Football and Threatening Communications Act since 2011. By tracing the Act’s journey from its introduction to its repeal in 2018, it challenges notions of a policymaking process built on consensus. It also casts doubt upon the Scottish Government’s claims of a socially progressive approach to criminal justice, as the behaviours of working-class youth around football have been increasingly problematised, criminalised and regulated. I argue that the Act highlights the need for an ongoing critique of the direction of criminal justice in Scotland and demonstrates the consequences of knee-jerk responses to complex social problems, which has relevance beyond the Scottish context.
Visibility and meaningful recognition for First Peoples: A critical discourse studies approach to communication, culture and conflict intersections in seeking social justice
Authors: Steele Godfrey A
Published: May 2020

Conflict revolves around communication and culture intersections. This interplay has historical antecedents and contemporary applications. Conflicts involving Indigenous Peoples and colonizers appear in literary representations (e.g. Shakespeare’s The Tempest), and contests between communities and cultures in historical, political and social settings. Amnesty International reports Indigenous Peoples’ realities and efforts to lobby for social justice. One effort is in becoming visible and seeking meaningful recognition examined in media coverage of the First Peoples’ holiday in Trinidad and Tobago, and resonates in conflicts reported elsewhere between Indigenous Peoples and others. Using media reports, interviews and other texts, this article employs a critical discourse studies approach to trace narrative elements and themes of communication, culture and conflict interplay, and interpret the contested expression and meaning of these texts to describe, understand, explain and construct a theoretical and applied account of resistance against unequal treatment.
Contemporary best practice in the management of pulmonary embolism during pregnancy
Authors: Wiegers Hanke M. G. , Middeldorp Saskia
Published: May 2020

Approximately 1–2 per 1000 pregnancies are complicated by venous thromboembolism (VTE). VTE includes deep vein thrombosis (DVT) and pulmonary embolism (PE) and the diagnostic management of pregnancy-related VTE is challenging. Current guidelines vary greatly in their approach to diagnosing PE in pregnancy as they base their recommendations on scarce and weak evidence. The pregnancy-adapted YEARS diagnostic algorithm is well tolerated and is the most efficient diagnostic algorithm for pregnant women with suspected PE, with 39% of women not requiring computed tomographic pulmonary angiography. Low-molecular-weight heparin is the first-choice anticoagulant treatment in pregnancy and should be continued until 6 weeks postpartum and for a minimum of 3 months. Direct oral anticoagulants should be avoided in women who want to breastfeed. Management of delivery needs a multidisciplinary approach in order to decide on an optimal delivery plan. Neuraxial analgesia can be given in most patients, provided time windows since last low-molecular-weight heparin dose are respected. Women with a history of VTE are at risk of recurrence during pregnancy and in the postpartum period. Therefore, in most women with a history of VTE, thromboprophylaxis in subsequent pregnancies is indicated.

The reviews of this paper are available via the supplemental material section.
Comparative evaluation of wearable devices for measuring elevation gain in mountain physical activities
Authors: Sánchez Raimundo , Villena Marcelo
Published: May 2020

The aim of this article is to examine the validity of elevation gain measures in mountain activities, such as hiking and mountain running, using different wearable devices and post-processing procedures. In particular, a total of 202 efforts were recorded and evaluated using three standard devices: GPS watch, GPS watch with barometric altimeter, and smartphone. A benchmark was based on orthorectified aerial photogrammetric survey conducted by the Chilean Air Force. All devices presented considerable elevation gain measuring errors, where the barometric device consistently overestimated elevation gain, while the GPS devices consistently underestimated elevation gain. The incorporation of secondary information in the post-processing can substantially improve the elevation gain measuring accuracy independently of the device and altitude measuring technology, reducing the error from −5% to −1%. These results could help coaches and athletes correct elevation gain estimations using the proposed technique, which would serve as better estimates of physical workload in mountain physical activities.
Dynamic monitoring of CD45-/CD31+/DAPI+ circulating endothelial cells aneuploid for chromosome 8 during neoadjuvant chemotherapy in locally advanced breast cancer
Authors: Ma Ge , Jiang Yi , Liang Mengdi , Li JiaYing , Wang Jingyi , Mao Xinrui , Veeramootoo Jordee Selvamanee , Xia Tiansong , Liu Xiaoan , Wang Shui
Published: May 2020

Background:

Neoadjuvant chemotherapy (NCT) is the standard treatment for patients with locally advanced breast cancer (LABC). The aim of this study was to verify this relationship, and to estimate the clinical value of aneuploid circulating endothelial cells (CECs) in LABC patients with different NCT responses.

Methods:

Breast cancer patients received an EC4-T4 NCT regimen. Peripheral blood mononuclear cells were obtained before NCT, and after the first and last NCT courses. A novel subtraction enrichment and immunostaining fluorescence in situ hybridization (SE-iFISH) strategy was applied for detection of circulating rare cells (CRCs). CECs (CD45–/CD31+/DAPI+) and circulating tumor cells (CTCs) with different cytogenetic abnormalities related to chromosome 8 aneuploidy were analyzed in LABC patients subjected to NCT.

Results:

A total of 41 patients were enrolled. Firstly, CD31+/EpCAM+ aneuploid endothelial-epithelial fusion cells were observed in LABC patients. Further, aneuploid CECs in the peripheral blood showed a biphasic response during NCT, as they initially increased and then decreased, whereas a strong positive correlation was observed between aneuploid CECs and CTC numbers.

Conclusion:

We determined that aneuploid CEC dynamics vary in patients with different response to chemotherapy. Elucidating the potential cross-talk between CTCs and aneuploid CECs may help characterize the process associated with the development of chemotherapy resistance and metastasis.
Secondary glioblastoma metastasis outside the central nervous system in a young HIV-infected patient
Authors: Rodrigues Leonardo Fonseca , Camacho Aline Helen da Silva , Spohr Tania Cristina Leite de Sampaio e
Published: May 2020

Glioblastoma is the most common adult primary brain tumor that occurs in the central nervous system and is characterized by rapid growth and diffuse invasiveness with respect to the adjacent brain parenchyma, which renders surgical resection inefficient. Although it is a highly infiltrative tumor, it is rarely disseminated beyond the central nervous system, wherein extracranial metastasis is a unique but rare manifestation of this kind of tumor. It is very common for acquired immunodeficiency syndrome (AIDS) patients to be infected with the human immunodeficiency virus (HIV), which suggests that a possible association between HIV infection and tumor development exists. In this paper, we present a new case of a young patient’s HIV-associated glioblastoma, with glioblastoma metastasis within the T9 vertebral body and lymph nodes in the anterior neck tissue. Initially, the patient was diagnosed with a grade III plastic astrocytoma. The patient lived a normal life for a year while being treated with temozolomide, radiotherapy, and highly active antiretroviral therapy. However, the tumor quickly evolved into a glioblastoma. We believe that the drastic progression of the tumor from a grade III anaplastic astrocytoma to a metastatic glioblastoma is due to the HIV infection that the patient had acquired, which contributed to a weakened immune system, thus accelerating progression of the cancer.
A Qualitative Identification of Gaps in Understanding About Brain Death Among Trainees, Health Care Personnel and Families at an Academic Medical Center
Authors: Chen Patrick M. , LaBuzetta Jamie Nicole
Published: May 2020

Background and Purpose:

Death by whole brain criteria (brain death) is a clinical diagnosis. We sought to identify aspects of brain death that were unclear to both health care personnel and patient families.

Methods:

Institutional review board approved cross-sectional survey study of attendings, medical trainees (residents and fellows), senior medical students, advanced practice providers (APPs), and critical care nursing (registered nurses [RNs]) at a tertiary referral center over 6 months (March 2018 to September 2018). Surveys were completed on paper or electronically. Participants supplied the top 3 of (1) their own personal questions regarding brain death and (2) questions received from patient families about brain death from a prepared list of questions.

Results:

Two hundred twenty-nine individuals participated in the survey, with a response rate of 46%. Participation rates in brain death declaration among attendings (92%), RNs (84%), APPs (100%), and trainees of which included fellows (92%) and residents (85%) were high. Most frequently asked questions by trainees and health care personnel were “What are brain death mimics?” and “What is the gold standard testing?”. Questions received from patient families most commonly include “What is brain death?” and “Is brain death reversible?”. All medical students had questions about brain death. Greater than 75% of attendings endorsed having questions regarding brain death.

Conclusion:

Many health care personnel are involved with brain death declaration, but there are gaps in their understanding about fundamentals regarding brain death. We identify a need for early and targeted brain death education regarding brain death and family communication for various members of the health care profession.
Incorporation of frailty estimated by gait speed within MELD-Na and the predictive potential for mortality in cirrhosis
Authors: Deng You , Lin Lin , Fan Xiaofei , Cui Binxin , Hou Lijun , Zhao Tianming , Hou Junjie , Mao Lihong , Wang Xiaoyu , Zhao Wei , Wang Bangmao , Yu Qingxiang , Sun Chao
Published: May 2020

Background:

The 5 m gait speed (5MGS), a simple and reliable performance metric and surrogate indicator of frailty, consistently predicts adverse events in elders. Additionally, MELD-Na (model for end-stage liver disease-sodium) scores fail to capture nutritional and functional decline of cirrhotic patients that may confer excess mortality. We hypothesized that 5MGS might be associated with all-cause mortality, and that inclusion of frailty assessment within MELD-Na could improve the prediction of mortality in cirrhosis.

Methods:

5MGS was measured at baseline in 113 hospitalized cirrhotic patients. Survival status over 2 years and cirrhosis-related complications were recorded. We evaluated the prognostic value of 5MGS (as a continuous variable and as a dichotomous variable). The definition of slow versus preserved 5MGS was 0.8 ms−1 based on previous publication. Using Cox proportional hazards regression, a novel MELDNa-5MGS score was derived. Receiver operating characteristics (ROC) curves estimated discrimination between the new score model and established prognostic indices.

Results:

The continuous 5MGS and slow 5MGS were independent predictors of all-cause mortality [5MGS: hazard ratio (HR) 0.133 (0.047–0.347), p < 0.001; slow 5MGS: HR 4.805 (1.536–15.026), p < 0.007]. The equation derived from Cox regression analysis was as follows: MELDNa-5MGS: MELD-Na score + 11 × slow 5MGS. The 2-year mortality in patients with high MELDNa-5MGS score was significantly higher ( p < 0.001). Discriminatory power was significantly better for MELDNa-5MGS than MELD-Na score (AUC: 0.802 versus 0.724, p = 0.014 for 1 year; 0.773 versus 0.709, p = 0.044 for 2 years).

Conclusion:

In cirrhotic patients, 5GMS is an independent risk factor of mortality. Modification of MELD-Na to include frailty estimated by low 5GMS is related to improved prognostication of mortality.
Hypoglycaemia and cardiac arrhythmias in diabetes
Authors: Andersen Andreas , Jørgensen Peter G. , Knop Filip K. , Vilsbøll Tina
Published: May 2020

Hypoglycaemia remains an inevitable risk in insulin-treated type 1 diabetes and type 2 diabetes and has been associated with multiple adverse outcomes. Whether hypoglycaemia is a cause of fatal cardiac arrhythmias in diabetes, or merely a marker of vulnerability, is still unknown. Since a pivotal report in 1991, hypoglycaemia has been suspected to induce cardiac arrhythmias in patients with type 1 diabetes, the so-called ‘dead-in-bed syndrome’. This suspicion has subsequently been supported by the coexistence of an increased mortality and a three-fold increase in severe hypoglycaemia in patients with type 2 diabetes receiving intensive glucose-lowering treatment in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. Studies have investigated the association between hypoglycaemia-induced cardiac arrhythmias. In a rat-model, severe hypoglycaemia resulted in a specific pattern of cardiac arrhythmias including QT-prolongation, ventricular tachycardia, second- and third-degree AV block and ultimately cardiorespiratory arrest. In clinical studies of experimentally induced hypoglycaemia, QTc-prolongation, a risk factor of ventricular arrhythmias, is an almost consistent finding. The extent of QT-prolongation seems to be modified by several factors, including antecedent hypoglycaemia, diabetes duration and cardiac autonomic neuropathy. Observational studies indicate diurnal differences in the pattern of electrocardiographic alterations during hypoglycaemia with larger QTc-prolongations during daytime, whereas the risk of bradyarrhythmias may be increased during sleep. Daytime periods of hypoglycaemia are characterized by shorter duration, increased awareness and a larger increase in catecholamines. The counterregulatory response is reduced during nightly episodes of hypoglycaemia, resulting in prolonged periods of hypoglycaemia with multiple nadirs. An initial sympathetic activity at plasma glucose nadir is replaced by increased vagal activity, which results in bradycardia. Here, we provide an overview of the existing literature exploring potential mechanisms for hypoglycaemia-induced cardiac arrhythmias and studies linking hypoglycaemia to cardiac arrhythmias in patients with diabetes.
Procedural democracy: Perceptions of the latest curriculum revision in British Columbia, Canada
Authors: Broom Catherine
Published: May 2020

In a historical review of curriculum revisions carried out in British Columbia, Canada, the author argued that these revisions were undemocratic in the sense that the revisions were carried out by a small selection of individuals associated with the Ministry/Department of Education. This article begins with a brief review of previous findings along with a discussion of how democracy, and in particular, procedural democracy, are understood. Procedural democracy is argued to relate to the public’s knowledge about government-initiated changes, ability to provide feedback, and how this feedback is attended to by those in government. This article then discusses the research methods and findings of a study carried out with British Columbian teachers and curriculum developers at a time when a major curriculum revision is occurring. The survey was designed based on the theoretical model of procedural model of democracy described. The findings focus on looking at the perceptions of teachers and curriculum developers regarding the process of curriculum reform carried out in British Columbia.