bluuebunny/crossref_metadata_2025 huggingface dataset:
Relational‐Cultural Supervision: A Humanistic Approach to Promoting Vulnerability and Counselor Development
Authors: Stargell Nicole , Craigen Laurie , Bradley Nicole , Whisenhunt Julia , Campbell Emily , Kress Victoria E.
Published: October 2020

Humanistic counseling and supervision place an emphasis on authenticity and connection, two concepts that relate to vulnerability. Authenticity and vulnerability can lead to growth in the context of the supervisory relationship. Relational‐cultural supervision is discussed as a humanistic approach that can be used in promoting vulnerability and counselor development.
Exploring Cognitive Empathy: Further Validation of the Empathic Counselor Response Scale and Application to Practice
Authors: Bayne Hannah B. , Hankey Maria Stack
Published: October 2020

In this study, we explored findings from a Rasch analysis of the Empathic Counselor Response Scale using a new sample of professional counselors. We examined differences between cognitive and affective empathy, explored whether counselors view highly empathic statements as most helpful, and offered suggestions for future research.
Exploratory data science for discovery and ex‐ante assessment of operational policies: Insights from vehicle sharing
Authors: Brandt Tobias , Dlugosch Oliver
Published: October 2020

The proliferation of mobile devices and the emergence of the Internet of Things are leading to an unprecedented availability of operational data. In this article, we study how leveraging this data in conjunction with data science methods can help researchers and practitioners in the development and evaluation of new operational policies. Specifically, we introduce a two‐stage framework for exploratory data science consisting of a policy identification stage and an ex‐ante policy assessment stage. We apply the framework to the context of free‐floating carsharing—a novel mobility service that is an example of data‐rich smart city services. Through data exploration, we identify a novel preventive user‐based relocation policy and provide an ex‐ante assessment regarding the feasibility of its implementation. We discuss practical implications of our approach and results for shared‐mobility providers as well as the relationship between data science and operations management research.
Neuromodulators for Atypical Facial Pain and Neuralgias: A Systematic Review and Meta‐Analysis
Authors: Do Triet M. , Unis Graham D. , Kattar Nrusheel , Ananth Ashwin , McCoul Edward D.
Published: October 2020

Objective

To evaluate the effectiveness of neuromodulating agents for the management of atypical facial pain and primary facial neuralgias.

Methods

We searched MEDLINE, Embase, CINAHL, and ClinicalTrials.gov databases for original research articles that examine the effectiveness and adverse reactions of pharmacologic therapy for the treatment of trigeminal neuralgia and atypical facial pain. Studies that included surgical interventions for atypical facial pain or facial pain secondary to other causes were excluded. Meta‐analysis was conducted for reductions in symptom scores and adverse effects.

Results

Of 3,409 articles screened, 73 full‐text articles were included, consisting of 45 observational studies and 29 randomized controlled trials. Twenty‐four different pharmacological agents were assessed; carbamazepine was the most frequently studied while botulinum toxin A demonstrated the highest consistency in reduction of symptom scores. Pooled estimate of three randomized controlled trials revealed that patients with trigeminal neuralgia who received botulinum toxin A had higher odds (odds ratio 7.46; 95% CI 3.53–15.78) of achieving a ≥50% reduction in visual analogue scale scores compared to controls. Pooled estimate of 15 observational studies showed that three‐fourths of patients with trigeminal neuralgia who received carbamazepine experienced clinically significant pain reduction (prevalence proportion 0.75; 95% CI 0.66–0.83).

Conclusions

Patients receiving botulinum toxin A for trigeminal neuralgia had higher odds of achieving ≥50% reduction in pain scores. A significant proportion of patients with trigeminal neuralgia experienced positive response to carbamazepine. There was moderate evidence for amitriptyline in patients with atypical facial pain. Standardization of outcome reporting would facilitate future quantitative comparisons of therapeutic effectiveness. Laryngoscope, 131:1235–1253, 2021
On the in vivo origin of human nasal mesenchymal stem cell cultures
Authors: Choi Rhea , Goncalves Stefania , Durante Michael A. , Goldstein Bradley J.
Published: October 2020

Objectives

Mesenchymal stem cells (MSCs), classically expanded in culture from bone marrow, are of broad interest to the regenerative medicine community. Human nasal turbinate mesenchymal‐like stem cell cultures have also been described, defined by an in vitro phenotype similar to bone marrow MSCs. Nonetheless, the identity in vivo of the cells that give rise to nasal MSC‐like cultures remains unclear, and these cells are often suggested to be related to olfactory lineages. Here, we sought to define the in vivo phenotype of human nasal MSC‐like cells.

Methods

Human turbinate tissue samples were used for RNA and immunohistochemical analysis. We also analyzed a recently published single cell RNA‐sequencing dataset from adult human olfactory and respiratory mucosa samples from our lab, to focus on cell populations expressing MSC markers. Immunochemistry was performed to stain turbinate sections and nasal MSC cultures for selected markers.

Results

While there is no single MSC‐specific gene, we identified a human nasal mucosal cell population in vivo that uniquely expressed transcripts characteristic of typical MSC cultures, including ENG (CD105), NES, and CD34, and lacked expression of other transcripts associated with surface epithelia. The expression of transcription factors such as SOX17, EBF1, and FOXP1 suggests cells in the MSC‐like cluster maintain an ability to direct cell fate, consistent with the behavior of nasal MSC‐like cells in vitro. SOX17 was found to be uniformly expressed by nasal MSC cultures, consistent with the in vivo data. Immunohistochemistry of human nasal tissue samples indicated that ENG, CD34, and SOX17 expression localized selectively to cells surrounding blood vessels in the lamina propria.

Conclusion

Our findings provide evidence that the in vivo origin of nasal MSC‐like cultures is likely a vascular or pericyte population, rather than cells related to the olfactory neuronal lineage.

Level of evidence

NA.
One size does not fit all: Insights for engagingfront‐lineclinicians in pragmatic clinical trials
Authors: Tambor Ellen , Moloney Rachael , Greene Sarah M.
Published: October 2020

Introduction

Despite the proliferation of pragmatic clinical trials (PCTs) conducted in health care delivery settings, we know relatively little about how practicing clinicians perceive their potential roles in such research. Empirical evidence and practical guidance concerning clinician engagement in research is needed to inform the design and successful implementation of PCTs.

Methods

We conducted a two‐phase qualitative study to better understand how and to what extent practicing clinicians should be involved in PCTs and to develop guidance for researchers on engaging front‐line clinicians in PCTs. In phase one, clinicians who spend the majority of their time providing direct patient care participated in 90‐min focus groups. In phase two, we conducted key informant interviews with PCT research teams and clinicians participating in the ADAPTABLE (Aspirin Dosing: A Patient‐centric Trial Assessing Benefits and Long‐Term Effectiveness) trial.

Results

Thirty‐four physicians, nurses, and other care providers from four health care delivery organizations participated in focus groups. Focus group participants stressed the importance of engaging clinicians early in the PCT planning process to identify clinically relevant study questions, provide input on study design, and customize study protocols to fit unique clinic workflows. We conducted 18 interviews with principal investigators, project managers, and clinicians involved in the ADAPTABLE trial across six clinical data research networks. Study team members described trying multiple approaches to optimize in‐clinic recruitment and enrollment of eligible patients. Successful strategies involved several key factors related to research team interactions with eligible patients, clinicians, and clinic staff.

Conclusions

More active involvement by a range of clinical stakeholders in PCT planning may help researchers avoid common barriers to trial implementation. We propose a “medium‐touch” approach to involving clinicians in PCT recruitment and enrollment that focuses clinician effort where it is most critical—to reassure eligible patients that trial participation is a safe alternative for them.
Lipase‐Catalyzed Reactive Extrusion: Copolymerization of ε‐Caprolactone and ω‐Pentadecalactone
Authors: Li Changcun , Xu Weijian , Lu Yanbing , Gross Richard A.
Published: October 2020

This study assesses the use of immobilized lipase catalyst N435 during reactive extrusion (REX) versus magnetically stirred bulk and solution reaction conditions for the copolymerization of ε‐caprolactone with ω‐pentadecalactone (CL/PDL 1:1 molar). N435‐catalyzed REX for reaction times from 1 to 3 h results in total %‐monomer conversion, Mn, and Đ values increase from 92.7% to 98.8%, 36.1 to 51.3 kDa, and 1.85 to 1.96, respectively. Diad fraction analysis by quantitative 13C NMR reveals that, after just 1 h, rapid N435‐catalyzed transesterification reactions occur that give random copolyesters. In contrast, for bulk polymerization with magnetic stirring in round bottom flasks, reaction times from 1 to 3 h result in the following: Mn increases from 12.4 to 25.6 kDa, Đ decreases from 2.98 to 1.87, and the randomness index increases from 0.74 and 0.86 as PDL*–PDL diads are dominant. These results highlight that REX avoids problems associated with internal batch mixing that are encountered in bulk polymerizations. In sharp contrast to a previous study of 1:1 molar PDL/δ‐valerolactone (VL) copolymerizations by N435‐catalyzed REX, VL %‐conversion increases to just 40.1% in 1 h whereas CL reaches 94.7%.
Influence of Various Sol–Gel Parameters on the Physico‐Chemical Properties of Sulfuric Acid Chelated Zirconia Aerogels Dried at Ambient Pressure
Authors: Bangi Uzma K. H. , Patil Bhushan , Pawar Rajendra C. , Park Hyung‐Ho
Published: October 2020

This work represents the influence of various sol–gel parameters on the physico‐chemical properties of sulfuric acid chelated zirconia aerogels dried at ambient pressure. The sol–gel parameters such as concentrations of precursor, chelating agent and catalyst are found to be the dominant factors which influence the physical, chemical and textural properties of the aerogels. Therefore, the influence of concentration of Zr precursor, ZrPr:H2SO4 molar ratio and ZrPr:H2O molar ratio on these properties of zirconia aerogels is studied. Zirconia lacogels are formed by the hydrolysis and condensation of zirconium n‐propoxide in n‐propanol chelated with sulfuric acid (18.4 M) and catalyzed with deionized water. Aerogels are obtained by subsequent solvent exchange, silylation, washing and ambient pressure drying. The physico‐chemical properties of as synthesized zirconia aerogels are carried out using FESEM, EDS, BET analysis and FTIR spectroscopy. The good quality zirconia aerogels are obtained using the molar ratio of ZrPr:PrOH:H2SO4:H2O:HMDZ::1:2.93:1.18:1.77:0.59. They possess the density of 0.54 g cm‐3, BET surface area of 328 m2 g‐1 and micropore volume of 0.028 cm3 g‐1. These aerogels can be applied as heterogeneous catalysts in many fields.
Determination of Mass Attenuation Coefficient for some Technetium‐99m Compounds
Authors: Manjunath A. , Ashwini A. , Kerur B. R. , Pushpanjali G. M.
Published: October 2020

Mass attenuation is a measure of the average number of interaction between incident photons and the matter that occur in a given mass per unit area thickness of the substance. Hence, the importance of mass attenuation coefficient is found in different fields viz., radiation shielding, medical fields, aeronautical engineering, photon transport, space research, military, security checking purposes (most important now‐a‐days), and research and development, etc. Hence, in view of the above applications this mass attenuation coefficient is estimated by WinXCom program which is the successor of program Xcom for the technetium‐99m compounds such as mebrofenin, disofenin, lidofenin, bisicate, and exametazime for the photon energy range from 8 to 32 keV.
Preparation of Superhydrophobic Coating Using Silica–PMMA Nanocomposite
Authors: Jadhavar Sonali B. , Sutar Rajaram S. , Latthe Sanjay S. , Vhatkar R. S.
Published: October 2020

Lotus leaf shows high water repellency due to its hierarchical rough structure and thin layer of low surface energy material on it. In this work, superhydrophobic coatings are prepared by silica‐polymethylmethacrylate (PMMA) nanocomposite on a glass substrate using a cost effective and simple dip‐coating method. The superhydrophobicity of the coatings is controlled by varying the concentration of PMMA in the nanocomposite. At optimum concentration of PMMA, coating shows water contact angle of 155 ± 3° with a rolling angle of 7° as a result of development of rough microstructure. The stability of the coatings is examined by finger wiping, water jet impact, and adhesive tape test. These superhydrophobic coatings can be used in various industrial applications.
The Pathophysiological Correlates of Parkinson's Disease Clinical Subtypes
Authors: Belvisi Daniele , Fabbrini Andrea , De Bartolo Maria Ilenia , Costanzo Matteo , Manzo Nicoletta , Fabbrini Giovanni , Defazio Giovanni , Conte Antonella , Berardelli Alfredo
Published: October 2020

Background

Possible pathophysiological mechanisms underlying Parkinson's disease (PD) clinical subtypes are unknown. The objective of this study was to identify pathophysiological substrate of PD subtypes using neurophysiological techniques.

Methods

One hundred de novo PD patients participated. We collected patient demographic and clinical data, which were used to perform a hierarchical cluster analysis. The neurophysiological assessment tested primary motor cortex excitability and plasticity using transcranial magnetic stimulation. To evaluate motor performance, we performed a kinematic analysis of fast index finger abduction. To investigate sensory function and sensorimotor mechanisms, we measured the somatosensory temporal discrimination threshold at rest and during movement, respectively.

Results

Hierarchical cluster analysis identified 2 clinical clusters. Cluster I (“mild motor‐predominant”) included patients who had milder motor and nonmotor symptoms severity than cluster II patients, who had a combination of severe motor and nonmotor manifestations (diffuse malignant). We observed that the diffuse malignant subtype had increased cortical excitability and reduced plasticity compared with the mild motor‐predominant subtype. Kinematic analysis of motor performance demonstrated that the diffuse malignant subtype was significantly slower than the mild motor‐predominant subtype. Conversely, we did not observe any significant differences in sensory function or sensorimotor integration between the two PD subtypes.

Conclusions

De novo PD subtypes showed different patterns of motor system dysfunction, whereas sensory function and sensorimotor integration mechanisms did not differ between subtypes. Our findings suggest that the subtyping of PD patients is not a mere clinical classification but reflects different pathophysiological mechanisms. Neurophysiological parameters may represent promising biomarkers to evaluate PD subtypes and their progression. © 2020 International Parkinson and Movement Disorder Society
Biocompatible hydrogel ostomy adhesive
Authors: Pan William , Matsuda Beverly , Yuk Hyunwoo
Published: October 2020

Ostomies are digestive and excretory surgeries where waste is redirected to the outside of the abdomen, requiring a bag to catch excretion. Current methods use adhesives to create adhesion for 24‐h usage of the ostomy bag. However, current adhesives are weak and unstable, and often lead to leakages of ostomy effluents resulting in various clinical complications including irritant dermatitis and infection. Due to these challenges, no commercially available product provides strong enough adhesion nor mechanical softness to prevent skin damage from ostomy leaks. In this work, we introduce a hydrogel ostomy adhesive (HOA) made from a tough double‐network hydrogel based on polyacrylamide and sodium alginate that strongly adheres onto the skin for over 24 h and prevents leaks by maintaining fluid‐tight sealing against regular bodily movements. The adhesion of HOA to abdominal skin is achieved by the topological adhesion formed by a biopolymer chitosan solution. The HOA’s robust adhesion of an ostomy bag is demonstrated on ex vivo porcine skin and in vivo human skin and is compared with existing commercially available ostomy bag adhesives.
De novo variants in WDR45 underlie beta‐propeller protein‐associated neurodegeneration in five independent families
Authors: Tang Xiaojun , Lan Xiaoping , Song Xiaozhen , Xu Wuhen , Zhang Yuanfeng , Zhang Hong , Wu Shengnan
Published: October 2020

Background

Beta‐propeller protein‐associated neurodegeneration (BPAN) is a rare, X‐linked dominant neurodegenerative disease mainly characterized by developmental delay, intellectual disability, epilepsy in childhood and dystonia, parkinsonism, dementia in adulthood. BPAN is caused by variants in WD repeat domain 45(WDR45), which is characterized by iron accumulation in the basal ganglia, however, it may be atypical in early brain MRI.

Methods

Whole exome sequencing was performed for five parents‐offspring trios and phenotype‐driven data analyses were conducted. All candidate variants were confirmed by Sanger sequencing.

Results

Here, we report five independent children presented variable degree of developmental delay, intellectual disability, and/or epilepsy. Five de novo variants of WDR45 including four novel truncating variants (one splicing variant, two nonsense variants, and one frameshift variant) were identified. Although their early brain MRI showed no obvious iron accumulation, multifocal spikes, or polyspikes in electroencephalograms (EEG) were observed in four patients.

Conclusion

Our study reports four patients with new variants in WDR45, which expands the mutation spectrum of WDR45. In addition, our findings provide an early and precise diagnosis basis of BPAN, which is helpful for accurate genetic counseling and prenatal diagnosis.
Millennials, Generation Z targeted in new mental health initiative
Authors: Enos Gary
Published: October 2020

Conversations with his young‐adult peers kept demonstrating to Phillip Schermer the presence of a deep‐seated mental health crisis that couldn't be attributed to early‐career challenges alone. Commonly uttered themes around “stress” and “mood” were hinting at an epidemic of unaddressed depression and anxiety among those in the millennial and Generation Z age groups.
Theoretical feasibility of dual‐energy radiography for structural and functional imaging of chronic obstructive pulmonary disease
Authors: Basharat Fateen , Belli Michael , Kirby Miranda , Tanguay Jesse
Published: October 2020

Purpose

Chronic obstructive pulmonary disease (COPD) affects ∼200 million people worldwide. We propose two‐dimensional (2D) dual‐energy (DE) x‐ray imaging of lung structure and function for the assessment of COPD, and investigate the resulting image quality theoretically.

Methods

We investigated xenon‐enhanced DE (XeDE) radiography for functional imaging of COPD and unenhanced DE radiography for structural imaging of COPD. We modeled the ability of human observers to detect ventilation defects in XeDE images and emphysema in (unenhanced) DE images using the detectability index () as a figure of merit. We accounted for the extent of emphysematous destruction and functional impairment as a function of disease severity, defect/lesion contrast, spatial resolution, x‐ray scatter, quantum noise, anatomic noise, and the efficiency of human observers. Whether or not disease was detectable was determined based on a detectability threshold of two. For (unenhanced) DE imaging of emphysema, we compared detectability with that of single‐energy (SE) imaging. Models of signal and noise were compared to published data.

Results

Models of signal and noise agreed well with published data, and model predictions of the detectability of emphysema by SE radiography were consistent with poor sensitivity (i.e., ) to mild to moderate COPD but moderate sensitivity (i.e., ) to severe COPD. The detectability of emphysema by DE radiography was greater than that of SE radiography, but did not cross the threshold of detectability for mild to moderate COPD. The detectability index for XeDE imaging exceeded the detectability threshold for mild, moderate, and severe COPD.

Conclusions

Dual‐energy radiography may offer modest improvements in the detection of emphysema relative to SE imaging, but will unlikely enable detecting mild and moderate COPD. However, XeDE radiography may enable detection of functional abnormalities associated with mild, moderate and severe COPD at x‐ray exposures typical of those used in conventional chest radiography, thus warranting further investigation as a low‐dose, low‐cost alternative to CT‐ and MRI‐based approaches for functional imaging of COPD.
High spatial resolution nerve‐specific DTI protocol outperforms whole‐brain DTI protocol for imaging the trigeminal nerve in healthy individuals
Authors: Danyluk Hayden , Sankar Tejas , Beaulieu Christian
Published: October 2020

Diffusion tensor imaging (DTI) can provide markers of axonal micro‐structure of the trigeminal nerve (cranial nerve five [CNV]), which may be affected in trigeminal neuralgia (TN) and other disorders. Previous attempts to image CNV have used low spatial resolution DTI protocols designed for whole‐brain acquisition that are susceptible to errors from partial volume effects, particularly with adjacent cerebrospinal fluid (CSF). The purpose of this study was to develop a nerve‐specific DTI protocol in healthy subjects that provides more accurate CNV tractography and diffusion quantification than whole‐brain protocols. Four DTI protocols were compared in five healthy individuals (age 22–45 years, three males) on a 3 T Siemens Prisma MRI scanner: two newly developed nerve‐specific high resolution (1.2 x 1.2 x 1.2 = 1.7 mm3) DTI protocols without (3.5 minutes) and with CSF suppression (fluid‐attenuated inversion recovery [FLAIR]; 7.5 minutes) with limited slice‐coverage, and two typical whole‐brain protocols with either isotropic (2 x 2 x 2 = 8 mm3) or thicker slice anisotropic (1.9 x 1.9 x 3 = 10.8 mm3) voxels. Deterministic tractography was used to identify the CNV and quantify bilateral fractional anisotropy (FA), and mean (MD), axial (AD) and radial diffusivity (RD). CNV volume was determined by manual tracing on T1‐weighted images. High spatial resolution nerve‐specific protocols yielded better delineation of CNV, with less distortions and blurring, and markedly different diffusion parameters (42% higher FA, 35% lower MD, 27% lower RD and 43% lower AD) compared with the two lower resolution whole‐brain protocols. The anisotropic whole‐brain protocol showed a positive correlation between CNV FA and volume. The high resolution nerve‐specific protocol with FLAIR yielded additional reductions in CNV AD and MD with a value of 1.0 x 10−3 mm2/s, approaching that expected for healthy young adult white matter. In conclusion, high resolution nerve‐specific DTI with FLAIR enhances the identification of CNV and provides more accurate quantification of diffusion compared with lower resolution whole‐brain approaches.
Utilization of a standardized discharge checklist to improve the transition of care for patients receiving parenteral nutrition
Authors: Doh Jean , Hencken Laura , Mlynarek Linda , MacDonald Nancy
Published: October 2020

Background

Guidelines recommend using discharge checklists to discharge patients receiving parenteral nutrition (PN). Transition‐of‐care (TOC) tools have not been extensively studied in the PN population. The purpose of this study is to evaluate the impact of a standardized PN discharge checklist on TOC for PN patients.

Methods

This is an Institutional Review Board–approved, retrospective quasi‐experimental study of patients discharged receiving PN between January 1, 2014, and May 31, 2018. The primary end point was the completion of a PN discharge bundle (identification of a responsible provider to monitor PN after discharge, meeting daily caloric requirement of 20–35 kcal/kg/d, cycling PN prior to discharge). Secondary end points included documentation of PN discharge checklist components, hospital length of stay, frequency of 30‐day hospital encounters, cause of hospital encounters, and time to readmission.

Results

Fifty encounters were included in the pregroup and postgroup each (n = 100). There was a significant increase in completion of the TOC bundle in the postgroup (54% vs 76%, P = .035), driven by identification of a responsible provider for outpatient PN management (54% vs 82%, P = .005). Other PN discharge checklist components impacted included the following: case manager had the PN prescription for home infusion (50% vs 80%, P = .003), assessment for home glucometer (40% vs 90%, P < .001), and PN plan‐of‐care note documentation at discharge (18% vs 82%, P < .001).

Conclusions

A standardized PN discharge checklist improved completion of discharge bundle.
Efficacy of High‐Dose Vitamin D Supplementation as an Adjuvant Treatment on Pneumonia: Systematic Review and a Meta‐Analysis of Randomized Controlled Studies
Authors: Yang Chao , Lu Yifei , Wan Min , Xu Dengfeng , Yang Xian , Yang Ligang , Wang Shaokang , Sun Guiju
Published: October 2020

The purpose of this meta‐analysis was to summarize randomized controlled trial (RCT) evidence and evaluate the efficacy and safety of vitamin D (VD) supplementation as an adjunct to antibiotics for the treatment of pneumonia. Data sources published from the inception dates up to January 2020 were searched. RCTs of VD supplementation of any duration, age, and dosing regimen type were eligible for inclusion if data on pneumonia were collected. Thirteen studies (4786 randomized participants) fulfilled eligibility criteria. VD supplementation significantly increased levels of serum 25(OH)D (mean difference = 15.97; 95% CI, 7.49–24.44; P = .002) and reduced incidence of repeat episodes of pneumonia (risk ratio [RR] = 0.68; 95% CI, 0.50–0.93; P = .02). Subgroup analysis revealed VD supplementation had more reducing effects on repeat episodes of pneumonia among participants in trials in which the population were children (RR = 0.66; 95% CI, 0.48–0.90), duration <3 months (RR = 0.55; 95% CI, 0.33–0.91), or dose of VD <300,000 IU (RR = 0.51; 95% CI, 0.29–0.89). Although our results suggested that VD supplementation had a positive effect on recovery rate of pneumonia (RR = 1.28; 95% CI, 0.94–1.74; I2 = 13%), there was no statistical difference (P = .12). High‐dose VD intervention may have an effect on reducing the incidence rate of repeat episodes of pneumonia by enhancing immune efficacy, although more population studies are needed to support that VD supplementation has therapeutic effects on pneumonia itself.
The need for oral assessment and referral practices tool for palliative patients in Brunei Darussalam: A cross‐sectional study
Authors: Dhaliwal Jagjit S. , Murang Zaidah R. , Haji Husaini Hajah A. , Idris Deeni R. , Venkatasalu Munikumar R.
Published: October 2020

Aim

This study aimed to investigate knowledge, experiences, perceptions and barriers of healthcare professionals regarding palliative oral care.

Methods

The study involved 169 palliative care professionals in Brunei. Data collection tool was pretested, validated and self‐administered with sections on demographics; knowledge, attitude and practices; referral of patients; perspectives; and barriers to oral palliative care.

Results

97.3% of participants believed that palliative patients need oral care, and 11.6% of participants were trained in this area. 43.8% were unsure about referral process, and 66.1% of participants had never used a tool to assess oral conditions of palliative patients. Most common oral condition encountered was mucositis (54.5%). 74.1% of participants expected family members to be responsible, and the absence of proper guidelines for assessment (66.1%) was the top challenge in providing oral care for palliative patients.

Conclusion

This study highlights perceptions and experiences of healthcare professionals and need for improved care through development of oral assessment and referral practices tool for palliative patients.
“Often Relatives are the Key […]” –Family Involvement in Treatment Decision Making in Patients with Advanced Cancer Near the End of Life
Authors: Laryionava Katsiaryna , Hauke Daniela , Heußner Pia , Hiddemann Wolfgang , Winkler Eva C.
Published: October 2020

Background

Family communication has been increasingly recognized as an important factor in decision making near the end of life. However, the role of the family in decision making is less studied in oncology settings, where most patients are conscious and able to communicate almost until dying. The aim of this study was to explore oncologists’ and nurses’ perceptions of family involvement in decision making about forgoing cancer-specific treatment in patients with advanced cancer.

Materials and Methods

Qualitative semistructured interviews with 22 oncologists and 7 oncology nurses were analyzed according to the grounded theory approach. The results were discussed against the background of the clinical and ethical debate on family role near the end of life.

Results

We could identify two approaches shared by both oncologists and nurses toward family involvement. These approaches could be partly explained by different perception and definition of the concept of patients' autonomy: (a) a patient-focused approach in which a patient's independence in decision making was the highest priority for oncologists and (b) a mediator approach with a family focus in which oncologists and nurses assigned an active role to patients' family in decision making and strived for building consensus and resolving conflicts.

Conclusion

The main challenge was to involve family, increasing their positive influences on the patient and avoiding a negative one. Thereby, the task of both oncologists and oncology nurses is to support a patient's family in understanding of a patient's incurable condition and to identify a patient's preference for therapy.

Implications for Practice

This study focused on oncologists’ and oncology nurses’ perceptions of family involvement in decision making about treatment limitation in patients with advanced cancer who are able to communicate in a hospital setting. Oncologists and oncology nurses should be aware of both positive aspects and challenges of family involvement. Positive aspects are patients’ emotional support and support in understanding and managing the information regarding treatment decisions. Challenges are diverging family preferences with regard to treatment goals that might become a barrier to advanced care planning, a possible increased psychological burden for the family. Especially challenging is involving the family of a young patient because increased attention, more time investment, and detailed discussions are needed.
In Reply
Authors: Shaib Walid
Published: October 2020

This letter to the editor responds to questions about the role of blood-based next-generation testing for appendiceal cancer, supporting its complementary role with tissue-based testing.
Exploring settlement typologies in Post‐Apartheid South Africa
Authors: Jeeva Zaakirah I. , Cilliers Elizelle J.
Published: October 2020

Settlement categorisation differs tremendously between countries making their cross‐comparison, globally, close to impossible. In 2012, the United Nations (UN) proposed a manner in which settlements within its member states could be classified. However, the proposed typology is rather broad and does not offer much on how settlements are classified. Consequently, this paper explored how settlements in South Africa (one of the UN member states) have been categorised, as it is believed that at the least settlements should be categorised consistently within a particular country. This paper conducted an explorative literature review in order to uncover how settlements have been classified in South Africa between 1993 and 2016 in order to draw deduction on the typology of settlements in South Africa. Findings were drawn through a comparative analysis of the literature in order to determine if there was consistency in the understanding of how settlements are classified within the country. The paper found that the categorisation of settlements within South Africa has been a rather contentious matter and the method of classification being fickle in its application. The paper calls for a more structured approach to categorising settlements within the country and pose spatial considerations for other countries dealing with similar issues. Future research in this regard should be considered in order to understand the application of settlement typologies in the quest of a uniform classification as envisioned by the UN.
An exploratory and quantitative assessment of the sustainable competitiveness of supply chain: Evidence from Indian sugar industry
Authors: Sheetal  , Singh Randeep , Kumar Rajiv
Published: October 2020

The main aim of this paper is to examine the effect of prominent forces on the sustainable competitiveness of the Indian sugar supply chain with the role of government as a moderator. A survey involving managers working in Indian sugar companies was conducted and partial least square (PLS) method was used to test the proposed research model. The findings supported the positive relationshipbetween suppliers' power and competitiveness; suppliers and industry rivalry; buyers' power and industry rivalry; and government dynamics and competitiveness in the discussed industry. Furthermore, entry barriers exerted a hypothesized negative relationship with competitiveness. The government is working as a moderator between the suppliers' (sugarcane growers') power and the competitiveness of the discussed industry as hypothesized. This study discerns the foundational literature from extant research work; lays down basic underpinnings for contextual discussion on competitive forces in the discussed industry and adds empirical facet by surveying the industry professionals. These findings may draw the attention of incumbents, industry practitioners, academicians, and policy‐makers to the impact that selected environmental forces have on competitive landscape of the sugar industry.
Clinical impact of hypothalamic‐pituitary disorders after conformal radiation therapy for pediatric low‐grade glioma or ependymoma
Authors: van Iersel Laura , van Santen Hanneke M. , Potter Brian , Li Zhenghong , Conklin Heather M. , Zhang Hui , Chemaitilly Wassim , Merchant Thomas E.
Published: October 2020

Background

To determine the impact of hypothalamic‐pituitary (HP) disorders on health outcomes in children and adolescents who received conformal radiation therapy (RT) for central nervous system tumors.

Procedure

Cohort study including 355 patients (age ≤25 years at diagnosis) treated with high‐dose (50.4‐59.4 Gy) RT using photons for low‐grade glioma or ependymoma. Patients (median age, 6.4 years at RT) received systematic endocrine follow‐up (median duration, 10.1 years; range, 0.1‐19.6). Associations between HP disorders and adverse health outcomes were determined by multivariable analysis.

Results

Prevalence was 37.2% for growth hormone deficiency (GHD), 17.7% for gonadotropin deficiency (LH/FSHD), 14.9% for thyroid‐stimulating hormone deficiency (TSHD), 10.3% for adrenocorticotropic hormone deficiency (ACTHD), and 12.6% for central precocious puberty (CPP). Hypothalamus mean dose ≥ 36 Gy was associated with higher odds of any deficiency. GHD was associated with short stature (OR 2.77; 95% CI 1.34‐5.70), low bone mineral density (OR 3.47; 95% CI 1.16‐10.40), and TSHD with dyslipidemia (OR 5.54; 95% CI 1.66‐18.52). Patients with ACTHD and CPP had lower intelligence quotient scores, and memory scores were impaired in patients with GHD (P = 0.02). Treatment of GHD was not associated with increased risk for tumor recurrence, secondary tumors, or mortality.

Conclusions

HP disorders occur frequently in patients receiving high‐dose RT and are related to physical and neurocognitive well‐being. Future studies are needed to assess whether further optimization of endocrine management yields better health outcomes.
AI Makes Processing Smarter
Authors: Lamontagne Nancy D.
Published: October 2020

For plastics processers, manufacturing parts faster, better, and cheaper is a constant goal. However, accomplishing this across multiple plant sites or even across shift‐changes can be challenging. The latest machine learning (ML) and artificial intelligence (AI) technology is helping change the way processers work.
Auto OEMs Tap AM/3DP for Low‐Volume Parts
Authors: Malnati Peggy
Published: October 2020

Although additive manufacturing and 3D printing (AM/3DP) were originally used by automakers to prototype parts faster, the auto industry has greatly expanded its use of the technology to improve tooling and molding of plastic parts (see part 1 of this series in Plastics Engineering, Sept. 2020, p. 14), as well as to quickly produce aftermarket parts for older vehicles whose original tooling has become lost and for original equipment manufacturer (OEM) parts on specialty vehicles whose build volumes are too low to justify conventional tooling.
Cyclic dipeptides: Biological activities and self‐assembled materials
Authors: Zhao Kaili , Xing Ruirui , Yan Xuehai
Published: October 2020

Cyclic dipeptides (CDPs) are the smallest cyclic peptides containing 2,5‐diketopiperazine rings. CDPs have advantages of structures and properties, including excellent hydrogen‐bonding‐forming ability (two hydrogen bonding acceptors and two hydrogen bonding donors), structural rigidity, and enzymatic stability, which make CDPs potential candidates as core scaffolds for drug discovery and building blocks for self‐assembly. In this review, we focus on distinctive bioactivities of CDPs, such as antitumor, antimicrobial, antivirus and antioxidant, and self‐assembly properties of CDPs and their derivatives. Emphasis will be placed on the thermodynamics and kinetics CDPs self‐assembly and applications of self‐assembled materials. This review provides insight into the development of CDPs and their corresponding assembled materials as drug delivery carriers and optoelectronic materials.
Choice of Acid Suppressant Therapy and Long‐Term Graft Outcomes After Kidney Transplantation
Authors: January Spenser E. , Progar Kristin , Nesselhauf Nicole M. , Hagopian Jennifer C. , Malone Andrew F.
Published: October 2020

Study Objective

The purpose of this study was to comprehensively evaluate the long‐term adverse effects of proton pump inhibitors (PPIs) compared with histamine‐2 receptor antagonists (H2RAs) in kidney transplant recipients.

Methods

This retrospective cohort compared 582 patients treated with PPI with 705 patients treated with H2RA and evaluated adverse effects throughout their course of acid suppressant therapy to a maximum of nine years posttransplant. The primary outcome of interest was renal function at 1 year posttransplant; secondary outcomes included renal function at 30 days, 3, 5, and 9 years posttransplant as well as rejection, electrolyte and laboratory abnormalities, osteoporosis, pneumonia, and Clostridium difficile infections.

Results

Renal function did not significantly differ at any timepoint posttransplant. Rejection rates and Clostridium difficile infections were similar between groups; osteoporosis and pneumonia rates were numerically higher in the PPI treated arm but did not reach statistical significance. Proton pump inhibitor (PPI) treated patients were more likely to experience hypomagnesemia requiring supplementation. High dose PPI treated patients had significantly higher rates of pneumonia and osteoporosis compared with H2RA treated patients. Patients were maintained on PPI therapy for an average of 5 years and H2RA therapy for 3 years posttransplant, the majority without a clear indication for therapy.

Conclusions

There was no difference in renal function, rejection, or graft loss between PPI and H2RA treated patients. The majority of patients were maintained on PPI therapy for several years posttransplant without a clear indication; critical evaluation of ongoing need for acid suppressant therapy in the posttransplant course should be an area of future focus.
Fabrication and study of thermal and combustion resistance of DOPO‐functionalized polyamide reinforced with organo‐modified Mg(OH)2 nanoparticles
Authors: Hajibeygi Mohsen , Habibnejad Navid , Shabanian Meisam , Khonakdar Hossein Ali
Published: October 2020

DOPO‐based dicarboxylic acid (DODA) was synthesized and used to prepare DOPO‐based polyamide (DOPA) using a direct polycondensation reaction. Also, DODA was used for the surface modification of Mg(OH)2 nanoparticles. Polyamide/Mg(OH)2 nanocomposites (DPANC) were prepared based on DOPA and the organically modified Mg(OH)2 nanoparticles through the solvent casting method. Further, to investigate the effect of the DOPO structure on the thermal and combustion properties, a poly(amide‐imine) (PAIm) without the DOPO structure was synthesized. The structure and morphology of the prepared nanocomposites were studied using various techniques. The results indicated that nanoparticles were uniformly dispersed in the polymer matrix. According to thermogravimetric analysis results, the temperature at 10% mass loss was increased from 309 to 337 °C in the DPANC sample containing 8 mass% of nanoparticles as compared to DOPA in inert atmosphere. Further, according to microscale combustion calorimetry results, the peak heat release rate (pHRR) was decreased from 33 to 19 W g−1 in the DPANC 5 sample, as compared to DOPA. Also, the pHRR value of PAIm was obtained as 138 W g−1, which was about 105 W g−1 higher than that of polyamide. © 2020 Society of Industrial Chemistry
Preparation and characterisation of poly(ethylene glycol)‐adsorbed graphene oxide nanosheets
Authors: Al‐Bermany Ehssan , Chen Biqiong
Published: October 2020

Polymer–graphene nanocomposites are attracting growing attention of scientists and engineers as graphene‐based nanofillers may enhance the properties of polymers significantly. This study aims to understand the adsorption behaviour of polymers on graphene oxide (GO) nanosheets. GO is synthesised using Hummerʼs method by oxidising graphite. Poly(ethylene glycol)s (PEGs) with different molecular weights are used as polymer models. A series of PEG/GO nanohybrids is prepared by applying different parameters in the solution processing method. Fourier transform infrared spectroscopy, X‐ray diffraction, differential scanning calorimetry, thermogravimetric analysis, polarised optical microscopy, scanning electron microscopy and atomic force microscopy are used for characterising the hybrid nanomaterials. The characterisation results confirm the successful preparation of GO and the adsorption of the PEGs onto GO. The maximum amount of adsorbed PEG was 38 wt%. The adsorption amount of PEG increases by 46% after reducing the mixing time from 192 h to 72 h, 1700% due to an increase in the molecular weight from 1k to 100k, 13% for doubling the mixing ratio of PEG:GO from 1.5:1 to 3:1, 44% for applying no further washing procedure and 73% for applying all these parameters concurrently. The adsorption onto GO reduces the crystallinity of PEGs due to chain confinement. Different surface morphologies are observed in the hybrid nanomaterials showing various thicknesses of the PEG layer adsorbed on the GO nanosheets. This study may offer new insights into the manipulation of the interface in polymer–GO nanocomposites. © 2020 Society of Industrial Chemistry
Lower Trabecular Bone Score and Spine Bone Mineral Density Are Associated With Bone Stress Injuries and Triad Risk Factors in Collegiate Athletes
Authors: Tenforde Adam S. , Carlson Jennifer L. , Sainani Kristin L. , Chang Audrey O. , Kim Jae Hyung , Diaz Robert , Golden Neville H. , Fredericson Michael
Published: October 2020

Introduction

Determinants of bone health and injury are important to identify in athletes. Bone mineral density (BMD) is commonly measured in athletes with Female Athlete Triad (Triad) risk factors; the trabecular bone score (TBS) has been proposed to predict fracture risk independent of BMD. Evaluation of TBS and spine BMD in relation bone stress injury (BSI) risk has not been studied in female collegiate athletes.

Objective

We hypothesized that spine BMD and TBS would each independently predict BSI and that the combined measures would improve injury prediction in female collegiate athletes. We also hypothesized that each measure would be correlated with Triad risk factors.

Design: Retrospective cohort.

Setting: Academic Institution.

Methods

Dual energy x‐ray absorptiometry (DXA) of the lumbar spine was used to calculate BMD and TBS values. Chart review was used to identify BSI that occurred after the DXA measurement and to obtain Triad risk factors. We used logistic regression to examine the ability of TBS and BMD alone or in combination to predict prospective BSI.

Results

Within 321 athletes, 29 (9.0%) sustained a BSI after DXA. BMD and TBS were highly correlated (Pearson correlation r = 0.62, P < .0001). Spine BMD and TBS had similar ability to predict BSI; the C‐statistic and 95% confidence intervals were 0.69 (0.58 to 0.81) for spine BMD versus 0.68 (0.57 to 0.79) for TBS. No improvement in discrimination was observed with combined BMD + TBS (C‐statistic 0.70, 0.59 to 0.81). Both TBS and BMD predicted trabecular‐rich BSI (defined as pelvis, femoral neck, and calcaneus) better than cortical‐rich BSI. Both measures had similar correlations with Triad risk factors.

Conclusion

Lower BMD and TBS values are associated with elevated risk for BSI and similar correlation to Triad risk factors. TBS does not improve prediction of BSI. Collectively, our findings suggest that BMD may be a sufficient measure of skeletal integrity from DXA in female collegiate athletes.