bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of omega-3 fatty acids and punctal plugs in the prevention of isotretinoin-associated ocular surface disease
Authors: Elhamaky Tarek Roshdy
Published: July 2020

Purpose:

To investigate the effects of omega-3 fatty acids and punctal plugs on tear film and ocular surface parameters in patients receiving systemic isotretinoin therapy.

Methods:

This is a prospective randomized study that included 180 eyes of 90 patients who had systemic isotretinoin therapy (120–150 mg/kg for at least 4–6 months). Exclusion criteria: DED according to the diagnostic criteria of TFOS DEWS II. Patients were assigned into three groups; (1) O3FAs/PPs group: A soft preloaded silicone plug was inserted in the inferior punctum of both eyes and received oral O3FAs two capsules twice daily total daily dose of 1040 mg/day for 6 months. (2) PPs group: A soft preloaded silicone plug was inserted in the inferior punctum of both eyes and received oral placebo. (3) Isotretinoin group: No intervention was done. At baseline, 1 week, 1, 3, and 6 months of study, Ocular surface evaluation tests were done in following order: OSDI, tear osmolarity, Schirmer’s I test, TBUT, ocular surface staining score, and meibomian gland expression.

Primary outcome measures:

The changes in measurement of ocular surface evaluation tests including ocular surface disease index (OSDI), tear film breakup time (TFBUT), corneal staining, tear osmolarity, and meibomian gland expression at 6 months.

Results:

There are significant changes between all groups at 6 months follow-up. The ocular surface parameters were better for the PPs and O3FAs/PPs groups than the isotretinoin group. The isotretinoin group showed worsening of ocular surface parameters including a significant decrease of FTBUT and an increase of OSDI score, corneal staining score, tear osmolarity, and meibomian expression score. There was no significant difference in ST1 throughout the whole study in all groups. At 6 months follow-up, there were no statistically significant differences between PPs and O3FAs/PPs groups except meibomian expression score which showed a significant increase in PPs group.

Conclusion:

Our cohort highlights the beneficial effects of the combination of O3FAs supplementation with PPs in the prevention of isotretinoin-associated OSD in this sample study.
Does perceived normativity of intergenerational contact enhance the effects of imagined intergenerational contact?
Authors: Fowler Craig , Harwood Jake
Published: July 2020

Two experiments investigated effects of imagined intergroup contact (IIC) on young adults’ stereotypical perceptions of and intention to communicate with older adults. Both studies tested a third-person variant of IIC (extended IIC). Also, Study 1 explicitly manipulated the perceived normativity of intergenerational contact by providing relevant information, and Study 2 implicitly manipulated perceived normativity via task repetition. In Study 1, IIC (including extended IIC) had few effects. However, the explicit norms manipulation changed perceptions of norms, which improved perceptions of older adults and increased desire for future intergenerational communication. In Study 2, some forms of IIC reduced intergenerational anxiety, which translated into more positive intergenerational perceptions. Moreover, repeated IIC had positive effects on intergenerational perceptions that were mediated by perceptions of norms and that persisted for a week. We advocate more attention to the effect of IIC on norms, and to the conditions under which IIC works (and does not).
Investigation on dynamic behaviour of condensation heat transfer in indirective evaporative cooler
Authors: Min Yunran , Chen Yi , Yang Hongxing
Published: July 2020

Indirect evaporative cooling is a rapidly developing air-handling technology and has great application potentials for energy recovery in hot and humid regions. The condensation in dry channels of an indirect evaporative cooler (IEC) occurs when the dew point temperature of outdoor air is high. However, the dynamic heat transfer performance of an IEC during the process of condensation evolution was rarely discussed. This paper aims to experimentally investigate the dynamic behaviour of primary air condensation and its effects on the convective and total heat transfer rate of an IEC. A transparent cover plate is placed outside an aluminium heat exchanger plate to visualize the evolution process of droplets retained on the surface. The droplets' falling frequency was recorded and the accumulated condensate mass was correlated based on an analytical method taking into account the contact angle and droplet volume. Results showed that the dynamic dehumidification performance can pose great influences on the convective heat transfer in IEC. The gradually diminished dropwise regions and increase of filmwise regions deteriorate the wet-bulb effectiveness of IEC by 14.8%. The convective heat flux keeps decreasing with the accumulation of condensate retention until a dynamic equilibrium is achieved between the retained and falling droplets.
The demographics and traumatic causes of spinal cord injury in Nepal: An observational study
Authors: Willott Arran , Dhakal Raju , Groves Christine , Mytton Julie , Ellis Matthew
Published: July 2020

Introduction

There has been little systematic study of the epidemiology of traumatic spinal cord injury (TSCI) in Nepal, South-East Asia, and low- and middle-income countries (LMICs) in general. One third of the global morbidity and mortality due to injuries is concentrated in South-East Asia. We need to better understand the circumstances leading to TSCI if we are to make progress with prevention.

Method

The Spinal Injury Rehabilitation Centre (SIRC) in Nepal systemically collected prospective data describing people with TSCI admitted between September 2015 and August 2016. Descriptive analyses of variables yielded demographic, aetiological and clinical descriptors of this cohort. Cross-tabulations were used to explore the associations between variables.

Results

Of 184 admissions over one year, males were admitted to SIRC almost 2.3 times more often than females. Young adults (21–30 years) were the largest age group (34%). The majority of TSCI resulted in paraplegia (67%) and was complete in nearly half (49%). Falls caused the majority of TSCI (69%), and falls from trees were the most common. Road traffic injuries (RTIs) were the second leading cause (29%); the majority involved two- or three-wheeled motorised vehicles and patients were most commonly driving.

Conclusion

Falls were the leading cause of TSCI across both genders and all age groups, followed by RTIs, which occurred most often in young adults and men. Injury surveillance and further research would provide a greater understanding of the pattern of TSCI and enable progress in TSCI prevention and rehabilitation.
Factors influencing low-frequency noise reduction in typical Chinese dwelling layouts
Authors: Song Yang , Kang Jian
Published: July 2020

Existing approaches to reducing the low-frequency noise exposure of dwellings are not always sufficient. This study investigated the significance of dwelling layout design for low-frequency noise control. The sound distribution in six typical Chinese dwelling layouts was analysed using in-situ measurements under steady-state noise of various low frequencies. The results showed that among two-bedroom dwelling layouts, the overall average noise reduction varied considerably (6 dB). The noise reduction for room levels (number of rooms sound crosses) 1–2 and 2–3 varies by 5 and 3 dB, respectively, and the noise reduction at door openings varies by 5 dB. A model to approximate the low-frequency noise reduction of a layout was developed using the polyline distance from the noise source and the number of walls the polyline has to cross, which were clearly shown to influence low-frequency noise reduction and seem to be the strongest investigated factors.
Characterization of AZ91 magnesium alloy processed by cyclic contraction/expansion extrusion using the experimental and micromechanical cellular automaton finite element approach
Authors: Hatami Sadr M , Jafarzadeh H
Published: July 2020

The feasibility to fabricate ultra-fine-grained AZ91 Mg alloy is investigated with a newly presented severe plastic deformation method entitled cyclic contraction/expansion extrusion. In this method, an initial cylindrical AZ91 Mg billet is placed into a die and the moving punch causes the large deformations by extruding the material in two different regions entitled contraction and extrusion. The evolution of AZ91 microstructure and mechanical properties during cyclic contraction/expansion extrusion was studied through different experimental observations. The microstructure observations showed the ultra-fine-grained structure of AZ91 at the end of the third pass where the average grain size of 600 nm obtained from the initial value of 130 µm. The tensile tests showed that the ultimate tensile strength, yield strength, hardness, and elongation of AZ91 cyclic contraction/expansion extrusion-processed samples are increased significantly. Discontinuous dynamic recrystallization has a main role in the grain refinement of Mg alloys during hot deformations. The evolution of grains in microlevel is analyzed by the cellular automaton finite element method in the DEFORM software environment. The macroscopic flow parameters including effective plastic strain, stain rate, and temperature were calculated in finite element. By tracing these data in defined domain of cellular automaton, the discontinuous dynamic recrystallization of material is analyzed through a devised cellular automaton finite element post-processing step. The imposed plastic strain and variation of dislocation density are the two main driven forces in discontinuous dynamic recrystallization of AZ91 samples during cyclic contraction/expansion extrusion processing. The experimentally observed grains and the cellular automaton finite element predicted microstructure were reasonably in good agreement.
South African parents’ view of their role in the education of their young children in South Africa as democratic citizens
Authors: Klopper Cecilia
Published: July 2020

This study addressed the knowledge gap regarding South African parents’ view of their role in the education of young children as democratic citizens. The study was conducted with parents of children younger than 8 years in 2 multicultural primary schools in Gauteng, South Africa. The explanatory sequential mixed methods research design was used to collect data from parents in order to answer the research question. The quantitative data were gathered first by means of a questionnaire, and afterwards the qualitative data were gathered by means of semi-structured interviews. The research results showed that when educating their young children to democratic citizenship, participating parents consider various values of a democratic citizen as important including responsibility, respect, participation, norms and values, peacebuilding, love, loyalty, deliberations, kindness, commitment, non-racism, non-sexism, equality, reconciliation, self-control, forgiveness, compassion, tolerance, open-mindedness, a sense of belonging, rule of law and social justice. Participating parents also regard their example as democratic citizens, respect, participation and the creation of a safe, proud and free democratic society as important. They did, however, consider the media and other bad role models as challenges when educating their young children towards democratic citizenship. The most important finding of the study is the influence of negative societal and political factors on the attitudes and opinions of the participating parents. New insights that emerged from the study includes that these parents want to do their best to educate their children as democratic citizens in South Africa, in the best interest of their children as future democratic citizens, but are hindered by certain societal and political factors.
Employment and crime: A longitudinal follow-up of organized crime offenders
Authors: van Koppen Vere , van der Geest Victor , Kleemans Edward , Kruisbergen Edwin
Published: July 2020

Employment is considered to help offenders desist from crime. Studies focusing on organized crime offenders, however, have suggested that employment may promote rather than inhibit crime for these offenders, but lacked quantitative individual-level data to confirm this finding. Using a large sample of organized crime offenders ( N = 1921) and longitudinal individual data on offending, employment, income and financial support, the current study aims to clarify the role of employment in the offending careers of these offenders. Fixed effects models show the effects of employment, self-employment and employment on the payroll. For organized crime offenders, being employed is associated with a 10 percent increase in offending and having their own business is associated with a 23 percent increase in offending. For organized crime offenders in leadership positions, employment is associated with a 47 percent increase in offending and owning a business is associated with a 68 percent increase in offending.
Refractory suffering at the end of life and the assisted dying debate: An interview study with palliative care nurses and doctors
Authors: Gustad Kristine Espegren , Askjer Åsta , Nortvedt Per , Fredheim Olav Magnus S , Magelssen Morten
Published: July 2020

Background

How often does refractory suffering, which is suffering due to symptoms that cannot be adequately controlled, occur at the end of life in modern palliative care? What are the causes of such refractory suffering? Should euthanasia be offered for refractory suffering at the end of life? We sought to shed light on these questions through interviews with palliative care specialists.

Methods

Semi-structured interviews with six nurses and six doctors working in palliative care in five Norwegian hospitals. Transcripts were analysed with systematic text condensation, a qualitative analysis framework.

Results

Informants find that refractory suffering is rare, and that with palliative sedation satisfactory symptom control can nearly always be achieved at the end of life. However, the process of reaching adequate symptom control can be protracted, and there can be significant suffering in the meantime. Both somatic, psychological, social and existential factors can contribute to refractory suffering and potentiate each other. However, informants also place significant weight on factors pertaining to the organization of palliative care services as contributing to insufficient symptom control.

Conclusions

If refractory suffering is indeed rare, then this arguably weakens a common prima facie argument for the legalization of assisted dying. However, the process of reaching adequate symptom control can be protracted and involve significant suffering. The experiences of palliative care clinicians constitute important empirical premises for the assisted dying debate. The study points to several areas in which palliative care can be improved.
When conscientious objection runs amok: A physician refusing HIV preventative to a bisexual patient
Authors: Brummett Abram
Published: July 2020

This paper reports of a case where a physician conscientiously objected to prescribing PrEP to a bisexual patient so as not to “enable immoral sexual behavior.” The case represents an instance of conscience creep, a phenomenon whereby clinicians invoke conscientious objection in sometimes objectionable ways that extend beyond the traditional contexts of abortion, sterilization, or physician aid in dying. This essay uses a reasonability view of conscientious objection to argue that the above case represents a discriminatory instance of conscience creep that should not be permitted.
Estimating the number of preventable cardiovascular disease events in the United States using the EMPA-REG OUTCOME trial results and National Health and Nutrition Examination Survey
Authors: Wong Nathan D , Fan Wenjun , Pak Jonathan
Published: July 2020

Aim:

We examined eligibility and preventable cardiovascular disease events in US adults with diabetes mellitus from the Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients (EMPA-REG OUTCOME).

Methods:

We identified adults with diabetes mellitus eligible for EMPA-REG OUTCOME based on trial eligibility criteria available from the National Health and Nutrition Examination Surveys, 2007–2016. We estimated composite cardiovascular disease endpoints, as well as all-cause deaths, death from cardiovascular disease and hospitalizations for heart failure from trial treatment and placebo event rates, the difference indicating the preventable events.

Results:

Among 29,629 US adults aged ⩾18 years (representing 231.9 million), 4672 (27.3 million) had diabetes mellitus, with 342 (1.86 million) meeting eligibility criteria of EMPA-REG OUTCOME. We estimated from trial primary endpoint event rates of 10.5% and 12.1% in the empagliflozin and placebo groups, respectively, that based on the ‘treatment’ of our 1.86 million estimated EMPA-REG OUTCOME eligible subjects, 12,066 (95% confidence interval: 10,352–13,780) cardiovascular disease events could be prevented annually. Estimated annual preventable deaths from any cause, cardiovascular causes and hospitalizations from heart failure were 17,078 (95% confidence interval: 14,652–19,504), 14,479 (95% confidence interval: 12,422–16,536) and 9467 (95% confidence interval: 8122–10,812), respectively.

Conclusion:

Empagliflozin, if provided to EMPA-REG OUTCOME eligible US adults, may prevent many cardiovascular disease events, cardiovascular and total deaths, as well as heart failure hospitalizations.
The Dark Side of the Rainbow: Queer Women’s Experiences of Intimate Partner Violence
Authors: Harden Jacqueline , McAllister Paige , Spencer Chelsea M. , Stith Sandra M.
Published: July 2020

Intimate partner violence (IPV) is a worldwide issue that, although often thought of as a very gendered and heteronormative crime (male perpetrators and female victims within heterosexual relationships), occurs in all kinds of relationships. The purpose of this study is to examine and raise awareness of how IPV operates within female same-gender relationships. Researchers utilized a narrative inquiry framework, as well as thematic analysis, in order to conduct a qualitative synthesis of articles that examined IPV in female same-gender relationships. Articles were identified through database searches for studies published between 2000 and 2019 using key search terms. Studies were included if they were qualitative in nature (including direct quotes from participants), examined IPV within female same-gender relationships, and were written in English. A total of 19 studies were included in the qualitative synthesis. Findings were categorized as barriers to help and support, themes within experiences of IPV, or recommendations for helping professionals. Themes within categories included, among others, a lack of framework to identify abuse; mistrust of law enforcement; power dynamics related to parenthood, race, and gender presentation; and fears of contributing to heterosexism. Findings from this study can serve to better inform helping professionals about considerations to keep in mind when working within lesbian, gay, bisexual, transgender, plus various additional sexual minorities’ communities and survivors of female same-gender violence.
Development of real-time Internet of Things motion detection platform applying non-contact sensor based on open source hardware
Authors: Kim Jung Woo , Sul Sang Hun , Choi Jae Boong
Published: July 2020

Recently, Internet-based devices have evolved into platforms for new networks, with Internet of Things technology being applied in various areas. The expansion of scope of this technology and exchange of real-time information enables users to check their content whenever. The real-time Internet of Things motion detection platform has been developed to detect and monitor users in installed spaces. In this article, the real-time Internet of Things motion detection platform utilizes a non-contact sensor module and motion recovery printed circuit board module to quickly respond to emergency situations through real-time monitoring. This is visualized on the display by sending data extracted from the motion recovery printed circuit board module combined with open source hardware by the non-contact sensor module receiving information from smartphone users. The administrator’s display continuously analyzes real-time moving objects by detecting them with respect to location coordinates and providing automatically recognized data to the cloud server. In addition, real-time Internet of Things motion detection monitoring system was configured to quickly respond to real-time alerts and effectively manage problems. Therefore, installing real-time Internet of Things motion detection platform at an actual site will enable quick resolving of emergency situations through information provision and user awareness monitoring.
A comparative study of electrospun polyvinylidene fluoride and poly(vinylidenefluoride-co-trifluoroethylene) fiber webs: Mechanical properties, crystallinity, and piezoelectric properties
Authors: Zhang Wenxin , Zaarour Bilal , Zhu Lei , Huang Chen , Xu Bugao , Jin Xiangyu
Published: July 2020

Energy scavenging has been attracting the consideration of researchers in recent years. In this study, the fabrication and characterization of electrospun randomly oriented and aligned grooved polyvinylidene fluoride (PVDF) and poly(vinylidenefluoride-co-trifluoroethylene) (PVDF-TrFE) fiber webs are studied. The fibers are generated with comparable diameters and the webs which are used as an active layer to directly make a piezoelectric nanogenerator are fabricated with the same thickness for accurate comparison. The results show that PVDF-TrFE fiber webs have better mechanical properties, crystallinity, and piezoelectric properties than PVDF fiber webs. Furthermore, the piezoelectric nanogenerator based on PVDF-TrFE fiber webs has higher electrical outputs than piezoelectric nanogenerator based on PVDF fiber webs owing to its high β phase content (F(β)). Moreover, the electrical outputs of the piezoelectric nanogenerator based on aligned fiber webs are higher than those based on randomly oriented fiber webs due to the increase in the friction area. We believe that our work can be served as a good reference for the comparison between the mechanical, physicochemical, and piezoelectric properties of PVDF and PVDF-TrFE fiber webs generated via electrospinning.
Endovascular treatment of complex middle cerebral artery aneurysms using TuBridge flow diverters
Authors: Liang Feng , Yang Yibing , Luo Lijuan , Liao Bingye , Zhang Guofeng , Ou Siqi , Xiao Weiping , Guo Ning , Qi Tiewei
Published: July 2020

Background

The safety and efficacy of the TuBridge flow diverter in treating middle cerebral artery aneurysms remains unknown. In this study, we report our preliminary experience treating complex middle cerebral artery aneurysms using the TuBridge flow diverter.

Methods

A prospectively maintained database of intracranial aneurysms treated with the TuBridge flow diverter was retrospectively reviewed, and patients with middle cerebral artery aneurysms were included in this study. Demographics, aneurysm features, complications, and clinical and angiographic outcomes were assessed. Evaluation of the angiographic results included occlusion grade of aneurysm (O’Kelly–Marotta grading scale), patency of jailed branch(es), and in-stent stenosis.

Results

Eight patients with eight middle cerebral artery aneurysms were included in this study. The mean aneurysm size was 11.8 ± 6.8 mm. There were no procedure-related complications and there was no morbidity or mortality at a mean follow-up of 11.3 ± 3.6 months. All patients had follow-up angiograms at a mean of 7.5 ± 4.0 months after surgery. Of the eight patients, there was 1 (12.5%) O’Kelly–Marotta grading scale A, 3 (37.5%) O’Kelly–Marotta grading scale B, 1 (12.5%) O’Kelly–Marotta grading scale C, and 3 (37.5%) O’Kelly–Marotta grading scale D. Of the seven patients with jailed branch, the blood flow of jailed branch was unchanged in 4 (57.1%), decreased in 2 (28.6%), and occluded in 1 (14.3%). In-stent stenosis was mild in 2 (25%) patients and moderate in 1 (12.5%) patient.

Conclusion

Midterm results suggest that endovascular treatment of middle cerebral artery aneurysms using the TuBridge flow diverter is safe and associated with good outcomes. The TuBridge flow diverter may be an option for complex middle cerebral artery aneurysms that are difficult to treat with either clipping or coiling.
The impact of Behçet’s disease on intimate relationships in women: A qualitative study
Authors: Sweeting Fay , Arden-Close Emily
Published: July 2020

Objective

Behçet’s disease is a rare and incurable condition where the body’s immune system attacks healthy tissue. Behçet’s can cause blood clots and ulcerations to form in every organ and system in the body, including deep and painful genital ulceration. The psychological impact of the disease on intimacy and relationships is unexplored. This study aimed to explore how the disease impacts on female patients’ intimate partner relationships.

Methods

Participants were seven female, UK patients with Behçet’s disease who were in committed relationships. In depth, semi-structured interviews lasting approximately 80 minutes were conducted via video conferencing about participants’ sexual functioning and intimate relationships. Data was analysed using Interpretative Phenomenological Analysis.

Results

Patients’ sexual relationships and intimacy were impacted by issues due to lack of knowledge of symptoms (misdiagnosis of herpes), issues due to symptoms (genital manifestations, painful sex, exhaustion), difficulties communicating with medical professionals, medication, partner support, and support from fellow Behçet’s patients.

Discussion

Female Behçet’s patients are at risk of developing psychological problems with intimacy due to symptoms, lack of knowledge of symptoms, and negative impacts of medication. Intimacy needs to be discussed in medical consultations so these issues can be addressed before a lack of intimacy negatively impacts relationships.
Transnational identity: The struggles of being and becoming a Japanese female professor in a neo-kokusaika phase of Japan
Authors: Nonaka Chisato
Published: July 2020

As the 2020 Tokyo Olympics approached (though now tentatively postponed to 2021), Japan stepped up on its nationwide kokusaika (“internationalization”) campaign to prepare for the big moment. This frenzied internationalization movement is not a new trend for Japan, particularly in the education sector where since the 1980s, the government has advanced a number of megaprojects in the name of kokusaika. Having completed my PhD in the United States on the internationalization of Japanese higher education, and having returned to Japan to begin working as a faculty member at a national university, I look into the development of my transnational identity through incidents, moments, and practices against the rhetoric and realities of kokusaika. This article argues that my analysis of the kokusaika phenomenon has shifted along with the changing tenor of my transnational experience from being a PhD student in the United States to becoming a Japanese female professor back in Japan. My transnational experience, as demonstrated in the article, helps put my own theorization of kokusaika in perspective, while also posing questions regarding “shifting transnationality” in knowledge production.
The making and transforming of a transnational in dialog: Confronting dichotomous thinking in knowledge production, identity formation, and pedagogy
Authors: Le Ha Phan , Mohamad Azmi
Published: July 2020

This article, through autoethnographic narrative and reflection, in-depth interviews, and focus group discussions, explores how the transnational academic mobility experiences of a Muslim scholar of Islam based in Brunei may influence his identity, research, and teaching. It pinpoints how transnational academic mobilities could (re)produce, sustain and endorse East/West, local/global, and religious/secular dichotomies and binary thinking. Likewise, it shows that transnational academic mobilities often generate ambiguous and divided spaces concerning knowledge production, pedagogy, and identity formation. The article also maintains that contextualizing and engaging (with) the specificity and particularity of place and academic discipline are pivotal in studying transnational academic mobilities. Methodologically, it highlights the role of autoethnographic reflection in bringing out complex experiences and accounts that academics undergo but rarely acknowledge and conceptualize in scholarly work. Such accounts and experiences serve as reminders of the importance of humility, trust, ethics, and reflexivity in academia. Transnational academic mobilities, after all, must not be privileged.
Bradycardia and pacemakers
Authors: Ahmed Mohammed Sohail , Shaheen Tahir
Published: July 2020

Bradyarrhythmias are frequently encountered in primary care; they comprise various rhythm disturbances including sinoatrial node and atrioventricular conduction disorders. Clinical presentation varies from a wide range of symptomatic presentations including dizziness, syncope, dyspnoea, fatigue and heart failure symptoms to the asymptomatic, incidental finding. Diagnosing patients correctly including a symptom–rhythm correlation is important, especially as some carry a risk of sudden death. In this article we will discuss disease states, diagnosis, referral and an essential guide to cardiac pacemakers, the primary lifelong treatment option for selected patients without reversible causes.
Adverse Events Related to Cartiva Hemiarthroplasty of First Metatarsal: An Analysis of Reports to the United States Food and Drug Administration
Authors: Metikala Sreenivasulu , Mahmoud Karim , O’Connor Kathryn M. , Chao Wen , Wapner Keith L. , Farber Daniel C.
Published: July 2020

Background: The results supporting Cartiva, a synthetic cartilage implant (Wright Medical) in hallux rigidus have come from limited institutions creating observational bias. Complications experienced in community centers are not routinely included in the published literature. To look at a broader range of potential complications, we reviewed the United States Food and Drug Administration’s (FDA) voluntary device database and compared that data with published literature. Methods: The Manufacturer and User Facility Device Experience (MAUDE) database of the FDA was retrospectively reviewed between July 2016 and October 2019 using the product code: PNW, assigned for Cartiva. Results: A total of 49 events have been reported and implant subsidence was the most common with 16 reports. Others include fragmentation (9), infection (4), bone erosion (3), foreign body reaction (1) and unspecified (16). Thirty-five events mentioned further surgeries at a mean interval of 4.75 months. Conclusions: The analysis of the MAUDE database disclosed certain device-related dysfunctions that have been underreported in the published literature. Because of the voluntary nature of reporting, the true incidence of each complication is unknown with this data representing a baseline. The MAUDE database could be further strengthened by a more robust reporting mechanism or mandatory reporting of device-related complications.

Levels of Evidence: Level IV: Case series from large database analysis
Citizen preferences about border arrangements in divided societies: Evidence from a conjoint experiment in Northern Ireland
Authors: Morgan-Jones Edward , Sudulich Laura , Cochrane Feargal , Loizides Neophytos
Published: July 2020

Border arrangements are often critical to the successful negotiation of peace settlements and the broader politics of post-conflict societies. However, developing an understanding of popular preferences about these arrangements is difficult using traditional surveys. To address this problem, we used a conjoint survey experiment to assess preferences about post-Brexit border arrangements in Northern Ireland. We mapped areas of convergence and divergence in the preferences about post-Brexit border arrangements of unionist and nationalist communities, simulated the degree of public support for politically plausible outcomes and identified the border arrangements that both communities could agree upon. In so doing, we outlined an empirical approach to understanding public preferences about border arrangements that could be used to understand the degree of support for similar institutional arrangements in other divided societies.
The probation service in England and Wales: A decade of radical change or more of the same?
Authors: Tidmarsh Matt
Published: July 2020

This article reviews developments in probation in England and Wales since 2010, a decade in which services were exposed to the logic of competition and profit. In 2014, the Conservative-Liberal Democrat Coalition government’s Transforming Rehabilitation ( TR) reforms promised an end to a top-down, target-centric culture of state intervention by outsourcing services for low-to-medium risk offenders to 21 privately-owned Community Rehabilitation Companies (CRCs). And yet, just four years after the reforms were implemented, the Conservative government announced that CRCs’ contracts would be terminated, with all offender management services returned to the public sector. With a focus on the private sector, the article argues that radical change to the probation service’s structure has entrenched a focus on centrally-administered performance targets and audit. In other words, contrary to the decentralising rhetoric at the core of TR, the decade has in many ways produced more of the same managerialism that the reforms were presented as a means to displace. The result has been a general decline in the quality of probation services.
A Meta-Analysis of the Relationship Between Sleep Problems and Loneliness
Authors: Hom Melanie A. , Chu Carol , Rogers Megan L. , Joiner Thomas E.
Published: July 2020

In this meta-analysis, we aimed to evaluate the cross-sectional and longitudinal relationships between various forms of sleep problems and loneliness. A total of 84 articles (110 samples, N = 227,112) were identified for inclusion. Random effects models revealed a significant medium association between overall sleep problems and loneliness ( r = .336, 95% confidence interval = [.315, .357]) as well as specific sleep complaints (i.e., insomnia, nightmares, poor sleep efficiency, and poor sleep quality) and loneliness ( rs = .165–.354). The longitudinal relationships between overall sleep problems and subsequent loneliness, and vice versa, were also significant ( rs = .249–.297). Although no consistent moderation patterns emerged, several significant moderators were identified for specific associations. Results support a robust association between more severe sleep problems and greater perceptions of loneliness; both also appear reciprocally associated longitudinally. Findings point to research directions that may enhance understanding of the interplay between sleep problems and loneliness—constructs with transdiagnostic relevance.
Extremely Preterm Infant Born to a Mother With Severe COVID-19 Pneumonia
Authors: Easterlin Molly C. , De Beritto Theodore , Yeh Amy M. , Wertheimer Fiona B. , Ramanathan Rangasamy
Published: July 2020

Little is known about the effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on pregnant women, fetuses, and neonates, especially when the virus is contracted early in pregnancy. The literature is especially lacking on the effects of SARS-CoV-2 on extremely preterm (<28 weeks gestation) infants who have underdeveloped immune systems. We report the case of an extremely preterm, 25-week 5-days old infant, born to a mother with severe COVID-19 (coronavirus disease-2019) pneumonia. In this case, there is no evidence of vertical transmission of SARS-CoV-2 based on reverse transcription-polymerase chain reaction testing, despite extreme prematurity. However, it appears that severe maternal COVID-19 may have been associated with extremely preterm delivery, based on observed histologic chorioamnionitis. This is the first reported case of an extremely preterm infant born to a mother with severe COVID-19 pneumonia who required intubation, and was treated with hydroxychloroquine, azithromycin, remdesivir, tocilizumab, convalescent plasma, inhaled nitric oxide, and prone positioning for severe hypoxemic respiratory failure prior to and after delivery of this infant. The infant remains critically ill with severe respiratory failure on high-frequency ventilation, inotropic support, hydrocortisone for pressor-resistant hypotension, and inhaled nitric oxide for severe persistent pulmonary hypertension with a right to left shunt across the patent ductus arteriosus and foramen ovale. Pregnant women or women planning to get pregnant should take all precautions to minimize exposure to SARS-CoV-2 to decrease adverse perinatal outcomes.
Emerging Innovations and Professional Skills Needed Within Pharmacy Curricula
Authors: Olsen Amanda A , Minshew Lana M , Morbitzer Kathryn A , Brock Tina P , McLaughlin Jacqueline E
Published: July 2020

To ensure students are prepared for the rapidly evolving world of health care, curricula must be aligned with emerging innovations, as well as professional skills likely to influence students’ abilities to be successful. At the 2019 annual meeting of PharmAlliance institutions, we asked experts to identify innovations and professional skills necessary for the future of pharmacy practice. Experts identified a wide range of topics, including personalized and precision medicine, digital health, interprofessional collaboration, clinical decision making, and overcoming complexity and ambiguity. While these findings are useful for informing curriculum content, we must also commit to ensuring our pharmacy curricula are emerging, forward thinking, and effective at preparing students for the challenges in health care.
Travel flow aggregation: Nationally scalable methods for interactive and online visualisation of transport behaviour at the road network level
Authors: Morgan Malcolm , Lovelace Robin
Published: July 2020

Origin–destination datasets representing millions of travel desire lines and routes are common in transport planning, but visualising such datasets is challenging. Existing methods often produce illegible results, low spatial resolution, or only a relative indication of the variation of flow on each road. This paper presents a new open-source algorithm called overline along with an accompanying method, to efficiently convert disparate geographical transport data into a policy-relevant summary form. Specifically, overline aggregates many individual routes into a route network map. These vector and raster maps provide total flow counts for each road and junction and are scalable to regional or national datasets. The method is demonstrated by visualising four million routes for a publicly accessible web mapping application, the Propensity to Cycle Tool, across the whole of England and Wales.
Making insects tick: Responsibility, attentiveness and care in edible insect farming
Authors: Bear Christopher
Published: July 2020

Insects are increasingly promoted as a sustainable and nutritious source of protein, with ‘edible insect’ sectors emerging in many countries not traditionally associated with their consumption. A number of studies have examined the attitudes of potential consumers to eating insects but the understandings and practices of farmers have largely been ignored. This article expands nature-society scholarship’s engagement with the edible insect sector by investigating how farmers make sense of their responsibilities to insects through their everyday practices. Drawing on a qualitative study of the UK’s edible insect farmers, the article contributes to wider ongoing debates within science and technology studies and animal studies around multispecies companionship involving apparently ‘awkward’ creatures, and around the relationship between ‘care’ and ‘ethical regard’ in more-than-human relations. Such debates are especially pertinent here, as insects have often been understood as lacking sentience and beyond moral considerability, resulting in their exclusion from animal welfare codes and regulation. Insect farmers are therefore faced with questions not only about how to care for their ‘minilivestock’ but also whether to care. Following an outline of the UK’s edible insect production sector, and framed by a discussion of literature on awkward creatures, attentiveness and practices of care, the article reports on: (1) the relationship between sentience and farmers’ constructions of insects’ moral significance; (2) farmers’ motives for, and approaches to, becoming attentive to their insects; and (3) how farmers respond to the actions of insects. It concludes by reflecting on the nature of attentiveness encountered in edible insect farming, arguing that it offers a promising yet unstable basis for the development of harmonious more-than-human relations.
Psychological first aid to support healthcare professionals
Authors: Everly George S
Published: July 2020

Psychological first aid (PFA) may be considered a form of acute psychological crisis intervention designed to foster human resilience. PFA has been universally endorsed as an important addition to the corpus of mental health-related support services in the wake of disasters. As support grows for its utilization beyond disasters alone, consideration should be given to the application of PFA to high-risk occupational setting. While PFA has begun to be used in the emergency services, it would also seem to be well suited for fostering resilience in healthcare settings where burnout and vicarious traumatization may approach the prevalence of silent epidemics. This paper describes PFA and argues for its utilization as a non-stigmatizing approach to foster the resilience of healthcare professionals and in doing so avoiding the “second victim” phenomenon.
Let bees be bees
Authors: Johnson Norman A.
Published: July 2020

Thomas Seeley reviews a half century of research, mostly conducted by himself and his colleagues on the ecology, evolution, and natural history of wild honey bees. He provides insights into how bees reproduce, how they forage, and how they defend the colony. The final chapter, “Darwinian beekeeping” discusses how ecological and evolutionary principles can be incorporated into the practice of beekeeping.
Comparison of different bacteriological testing strategies and factors for bacteriological confirmation among pulmonary TB patients: a retrospective study in Tianjin, China, 2017–2018
Authors: Zhang Guoqin , Zhang Yuhua , Chen Mingting , Zhang Fan
Published: July 2020

Background

Bacteriological confirmation (BC) proportion among notified pulmonary TB patients in China is among the lowest in the world. This study was to understand the yield of BC using different testing strategies and patient-level factors associated with BC among pulmonary TB patients in Tianjin, China during 2017–2018.

Methods

A retrospective study was conducted, enrolling pulmonary TB patients reported to National TB Information Management System (TBIMS) in Tianjin during 2017–2018. BC was defined as a positive result by any of the followings: smear microscopy, culture, or nucleic acid amplification test. Individual characteristics were compared between patients with positive and negative bacteriological results using contingency tables and χ2 test. Multivariable logistic regression was applied to analyze factors associated with BC, calculating adjusted odds ratios (aOR) and 95% confidence intervals (CI) (α = 0.05).

Results

Of 6364 reported patients, 4181 (65.7%) were bacteriologically confirmed. Positivity proportion was 43.1% (2746/6364) for smear microscopy, 57.7% (3380/5853) for culture, 61.7% (1608/2605) for Xpert® MTB/RIF assay (Xpert) and 73.4% (1824/2484) for combination of the three. The unemployed (aOR = 1.5, 95% CI: 1.0–2.2) and farmers (aOR = 1.7, 95% CI: 1.1–2.8) compared with students; diagnosis by inpatient hospitals compared with TB clinics (aOR = 3.4, 95% CI: 2.6–4.4); having symptoms for ≥2 weeks (aOR = 1.4, 95% CI: 1.1–1.8); cough (aOR = 2.2, 95% CI: 1.8–2.8); blood sputum (aOR = 1.5, 95% CI: 1.0–2.2); cavitation on chest X-ray (aOR = 3.3, 95% CI: 2.5–4.3); bilateral lung lobes affected (aOR = 1.7, 95% CI: 1.4–2.2) were factors associated with BC.

Conclusions

Combination test was an effective way to improve BC among pulmonary TB patients. Being unemployed, farmers, having prolonged symptoms, and more severe in TB condition were factors associated with BC. We recommend combination of tests to improve BC for pulmonary TB patients, especially who are in early stage of the disease or with conditions tend to be bacteriologically negative.
Binary Tönnis classification: simplified modification demonstrates better inter- and intra-observer reliability as well as agreement in surgical management of hip pathology
Authors: Shapira Jacob , Chen Jeffrey W. , Bheem Rishika , Rosinsky Philip J. , Maldonado David R. , Lall Ajay C. , Domb Benjamin G.
Published: July 2020

Background

The traditional Tönnis Classification System has inherent drawbacks as it is vulnerable to the subjectivity of a four-grade system. A two-grade classification could potentially be more reliable. The purpose of this study is to (1) compare the inter-observer and intra-observer reliability of the traditional Tönnis Classification System and a simplified Binary Tönnis Classification System for hip osteoarthritis and to (2) evaluate the clinical applicability of both systems. Our hypothesis is that the proposed Binary Tönnis Classification System will have better reliability and agreement for surgical decision-making.

Methods

Forty consecutive patients were selected to participate in this study. Patients were included in this study if they were between 35 and 60 years old. Patients were excluded if they had prior hip surgeries or conditions. All radiographs were randomized and blinded by a non-observer. Five fellowship-trained hip surgeons from a single center, in a fully crossed design, analyzed and graded all the radiographs utilizing the traditional Tönnis Classification System and the proposed Binary Tönnis Classification System. Intra- and inter-observer reliability values for both the systems were calculated using the Cohen’s κ coefficient. A multi-rater κ was calculated using the weighted Fleiss method.

Results

The study sample contained 40 anterosuperior hip radiographs. For the traditional Tönnis Classification System, the weighted κ showed a fair inter-observer reliability (κ = 0.474) and excellent intra-observer reliability (κ mean = 0.866). For the proposed Binary Tönnis Classification System, both inter-observer and intra-observer reliability demonstrated excellent values, (κ = 0.858 and 0.928, respectively). On average, the Binary Tönnis Classification System correctly captured 87% of cases. When the traditional Tönnis Classification System was dichotomized, the capture rate was 84%.

Conclusion

A simplified binary Tönnis Classification System demonstrates better reliability and clinical implementation than the traditional Tönnis Classification System.