bluuebunny/crossref_metadata_2025 huggingface dataset:
Experimental investigation on the structures and induced drag of wingtip vortices for different wingtip configurations
Authors: Cheng Ze-Peng , Xiang Yang , Liu Hong
Published: August 2020

As an effective method to reduce induced drag and the risk of wake encounter, the winglet has been an essential device and developed into diverse configurations. However, the structures and induced drag, as well as wandering features of the wingtip vortices ( WTVs) generated by these diverse winglet configurations are not well understood. Thus, the WTVs generated by four typical wingtip configurations, namely the rectangular wing with blended/raked/split winglet and without winglet (Model BL/ RA/ SP/NO for short), are investigated in this paper using particle image velocimetry technology. Comparing with an isolated primary wingtip vortex generated by Model NO, multiple vortices are twisted coherently after installing the winglets. In addition, the circulation evolution of WTVs demonstrates that the circulation for Model SP is the largest, while Model RA is the smallest. By tracking the instantaneous vortex center, the vortex wandering behavior is observed. The growth rate of wandering amplitude along with the streamwise location from the quickest to the slowest corresponds to Model SP, Model NO, Model BL, Model RA in sequence, implying that the WTVs generated by model SP exhibit the quickest mitigation. Considering that the induced drag scales as the lift to power 2, the induced drag and lift are estimated based on the wake integration method, and then the form factor λ, defined by [Formula: see text], is calculated to evaluate the aerodynamic performance. Comparing with the result of Model NO, the form factor decreases by 7.99%, 4.80%, and 2.60% for Model RA, Model BL, Model SP, respectively. In sum, Model RA and BL have a smaller induced drag coefficient but decay slower; while Model SP has a larger induced drag coefficient but decays quicker. An important implication of these results is that reducing the strength of WTVs and increasing the growth rate of vortex wandering amplitude can be the mutual requirements for designing new winglets.
Automated removal of carbon fiber reinforced plastic layers for the repair by adhesive bonding
Authors: Brieskorn Leander , Hintze Wolfgang
Published: August 2020

For the industrial repair of carbon fiber reinforced plastics (CFRP), scarfing is used to re-establish the load path. In the industry today, the state of the art removal of CFRP layers for a repair process is done mainly manually, leading to a time-consuming process. Therefore, an automation of this process is desirable. Today, vacuum suction blasting is used to pre-treat CFRP surfaces only for the superficial removal of impurities or the removal of the cover layer before bonding. With the common used blasting agents and nozzle geometries, the even removal of larger areas together with the fiber was not possible. This work shows that the technology of vacuum suction blasting was adapted to be used as an automated scarfing method. A combination of blasting parameters, especially the nozzle geometries together with a blasting agent were found to be able to remove CFRP layers precisely, detecting and correcting errors in-line with a line scanner-measuring unit. The presented method allows treating large-scale surfaces, scarfing the area one single layer at a time, increasing the removal rate in comparison to common blasting. With vacuum suction blasting the grinding dust emissions and process forces are low, post cleaning or further surface activation are not necessary and the removal results can directly be controlled. Challenges still exist with inaccurate removal due to interruptions in the blasting program and the generation of sharp edges for a stepped scarf.
Lubricants and rectal douching: associations with rectal gonorrhea, chlamydia, and/or syphilis infection among men who have sex with men
Authors: Blair Cheríe S , Javanbakht Marjan , Comulada W Scott , Richter E India , Bolan Robert , Shoptaw Steven , Gorbach Pamina M
Published: August 2020

Despite widespread prevalence of lubricant use and rectal douching for receptive anal intercourse (RAI) among men who have sex with men (MSM), research evaluating the association of these behaviors with sexually transmitted infections (STIs) is limited. This is an observational analysis of a longitudinal cohort of predominantly Black/Latino MSM in Los Angeles. Every six months from August 2014 to January 2018, participants received STI screening and surveys evaluating lubricant use, douching, substance use, and sexual risk behaviors. General estimating equations evaluated the association between consistent lubricant use and douching for RAI with positive rectal Neisseria gonorrhoeae, Chlamydia trachomatis, and/or syphilis (positive STI). Among 313 participants across 552 study visits, 16.5% (91/552) had positive STI. Consistent lubricant use was reported in 52.7% (243/552) and rectal douching in 57.6% (318/552) of study visits. Consistent lubricant use was associated with STI diagnosis (adjusted OR [AOR] 1.81; 95% CI 1.11–2.96; p = 0.018). Each episode of rectal douching before RAI was associated with 2% increased odds of positive STI (AOR 1.02; 95% CI 1.00–1.04; p = 0.041). Among this cohort of HIV-positive and high-risk HIV-negative MSM, lubricant use and douching was common and independently associated with an STI, suggesting the utility of prevention messaging around barrier methods/condoms for sexual encounters involving douching/lubricant use.
More than meets the eye: Papilledema from syphilis posing as idiopathic intracranial hypertension
Authors: Chi Sharon , Weintrob Amy
Published: August 2020

Idiopathic intracranial hypertension (IIH), or pseudotumor cerebri, is a diagnosis of exclusion. Elevated intracranial pressure (ICP) can result from a variety of inflammatory and structural causes affecting cerebrospinal fluid production and absorption. First described in 1935, syphilis is a well-established cause of elevated ICP, referred to as syphilitic hydrocephalus. We report a case of a 49-year-old man presenting with vision changes and headache who was treated for IIH without resolution of symptoms, and eventually diagnosed with syphilitic hydrocephalus. Syphilis should be considered as a cause of elevated ICP prior to a diagnosis of IIH.
Human-environment interaction during the Holocene along the shoreline of the Ancient Lake Ladoga: A case study based on palaeoecological and archaeological material from the Karelian Isthmus, Russia
Authors: T Alenius , D Gerasimov , T Sapelko , A Ludikova , D Kuznetsov , A Golyeva , K Nordqvist
Published: August 2020

This paper presents the results of pollen, diatom, charcoal, and sediment analyses from Lake Bol’shoye Zavetnoye, situated between the Gulf of Finland and Lake Ladoga on the Karelian Isthmus, north-western Russia. The main goal is to contribute to the discussion of Neolithic land use in north-eastern Europe. The article aims to answer questions related to Stone Age hunter-gatherer economy, ecology, and anthropogenic environmental impact through a comprehensive combination of multiple types of palaeoecological data and archaeological material.

According to diatom data, Lake Bol’shoye Zavetnoye was influenced by the water level oscillations of Ancient Lake Ladoga during much of the Holocene. Intensified human activity and prolonged human occupation become visible in the Lake Bol’shoye Zavetnoye pollen data between 4480 BC and 3250 BC. During the final centuries of the Stone Age, a new phase of land use began, as several anthropogenic indicators, such as Triticum, Cannabis, and Plantago lanceolata appear in the pollen data and a decrease in Pinus values is recorded. In general, the results indicate that socio-cultural transformations could have taken place already from the mid-5th millennium BC onwards, including new ways of utilizing the environment, perhaps also in the field of subsistence, even though the livelihood was based on foraging throughout the period.
“APS pregnancy – The offspring”
Authors: Bitsadze Viktoria , Nalli Cecilia , Khizroeva Jamilya , Lini Daniele , Andreoli Laura , Lojacono Andrea , Fazzi Elisa , Shoenfeld Yehuda , Tincani Angela , Makatsariya Alexander
Published: August 2020

Background

Antiphospholipid antibody syndrome (APS) is an autoimmune disease that affects women in childbearing age. In recent years, great improvements were achieved in the management of pregnancies in these women. Prematurity could be an issue in these pregnancies, mainly due to the direct pathogenic effect of antiphospholipid antibodies (aPL) on the placental surface. Maternal IgG aPL can cross the placenta and theoretically interact with the growing fetus; it could reach the fetal brain because of the incompleteness of the fetal blood-brain barrier: whether this can have an effect on brain development is still debated. Neonatal thrombosis episodes have been described in children positive for aPL, not always associated with maternal antibody positivity, suggesting the hypothesis of a possible aPL de novo synthesis in fetus and neonates.

Methods

A keyword-based literature search was conducted. We also described a case of neonatal catastrophic antiphospholipid syndrome (CAPS).

Results

Offspring of patients with APS are generally healthy but the occurrence of neonatal thrombosis or minor neurological disorders were reported.

Conclusions

The limited number of the available data on this sensitive issue supports the need for further studies. Clinical follow-up of children of mothers with APS seems to be important to exclude, in the neonatal period, the occurrence of aPL associated pathological events such as thrombosis, and in the long-term, impairment in learning skills or behavioral problems.
Why the Promotion of Family Planning Makes More Sense Now Than Ever Before?
Authors: Sharma Vinit , De Beni Davide , Sachs Robertson Annette , Maurizio Federica
Published: August 2020

The COVID-19 pandemic presents unprecedented scenarios and challenges for programme managers. Health systems have been overwhelmed with the increasing number of cases, and the focus has shifted to saving lives. Furthermore, lockdowns have adversely affected the production and distribution of products and availability of commodities, while the restrictions in movement have limited individuals’ access to services. This article analyses the possible consequences of the pandemic on the rights of individuals and couples and endeavours to provide justifications for continued national commitment and investments in family planning, especially during these challenging times. As sexual and reproductive health and reproductive rights are fundamental to achieving the Sustainable Development Goals, it is critical to focus on ensuring rights-based family planning, because it is intimately associated with fundamental human rights, addresses the issue of equity, equality and universality and provides valid and practical solutions to the vital economic quagmire that has unfolded as a consequence of this global crisis.
Sailing Ships, Naval Expeditions and ‘Project Mausam’
Authors: Ray Himanshu Prabha
Published: August 2020

In recent years, sailing ships of the Indian Navy have been increasingly involved in diplomatic missions and cultural voyages across the world, in addition to their primary purpose of providing practical training in navigation techniques and seamanship. These three-masted barques built at the Goa Shipyard and used by the Indian Navy are very different from wooden sailing vessels that traversed the Indian Ocean in the premodern period prior to the development of steamship navigation in the nineteenth century. Nonetheless, these distinctions have often been blurred as these modern naval ships have been utilised to recreate historical ‘expeditions’ such as the much-celebrated Chola invasion of Srivijaya in the Indonesian archipelago. Nor is India the only country to be involved in promoting this ‘popular history’ for contemporary geopolitical interests, as is evident from China’s efforts to rebuild ships used in the Voyages of Admiral Zheng He across the Indian Ocean. What gets short shrift in the process is investment in research in underwater archaeology and the discovery and preservation of shipwreck sites. This article highlights the urgent need for interdisciplinary research in premodern shipping and seafaring activity beyond the rhetoric of valorising national heroes.
Nutritional Status and Its Contributing Factors among Older Adults with Cancer Receiving Chemotherapy
Authors: Abd Allah Eman Shokry , Gad Hanan Mohammed Mohammed , Abdel-Aziz Hassanat Ramadan
Published: August 2020

The study aimed to assess nutritional status and its contributing factors among older adults with cancer receiving chemotherapy so, a descriptive study design was used. The study was conducted at Zagazig University Hospitals, Egypt. The study’s sample was selected purposively which composed of 194 older adults. Nutritional status was measured by the Arabic version of the Mini-Nutritional Assessment (MNA). Contributing factors were identified by examining the relationship of nutritional status with demographic and clinical variables. Study results revealed that 33% of the older patients were malnourished and 51.5% were at risk for malnutrition. Statistically significant relations were found between nutritional status and advanced age, illiteracy, insufficient monthly income, comorbidities, cancer stage four at diagnosis, and receiving ≥4 chemotherapy cycles. High prevalence of malnutrition and many contributing factors were identified among older patients with cancer receiving chemotherapy. So, continuous malnutrition screening along chemotherapy courses with special concern for contributing factors assessed in this study is recommended.
A Comparison of Facial Muscle Activation for Vocalists and Instrumentalists
Authors: Fisher Ryan A. , Hoult Aubrey R. , Tucker W. Steven
Published: August 2020

The purpose of this study was to compare the muscle activation of singers and instrumentalists while performing simple vocal exercises. Volunteer participants ( N = 28) were undergraduate music majors and minors, with an equal number being vocalists and instrumentalists. Participants performed five vowel sounds (ah, eh, ee, oh, oo), while electromyography of the zygomaticus and masseter muscles was sampled at 1,000 Hz. A statistically significant multivariate analysis of variance effect was obtained and follow-up analyses of variance showed instrumentalists had more masseter muscle activation than vocalists when performing “eh” and “ee.” Instrumentalists also had more zygomaticus muscle activation than vocalists when performing the “eh” vowel, but vocalists had more zygomaticus muscle activation when performing the “ah” vowel.
Designing a First Responders Call Center for a Pandemic
Authors: Bitan Yuval , Abramovich Itamar , Jaffe Eli
Published: August 2020

Emergency response to a pandemic requires health care systems to initiate many activities. One of these activities is providing the public with information and guidance about the symptoms and the actions that need to be taken. A dedicated call center should facilitate the public need. Such a call center needs to be carefully designed to protect the call takers from potentially being infected by other staff members. An ad hoc facility has the flexibility to adjust to evolving demands and constraints. This article presents the need, the concerns, and the guidelines used to design such call center during the COVID-19 pandemic outbreak.
Prospective Randomized Evaluation of Local Injection of Allogeneic Growth Factors in Plantar Fasciitis
Authors: Kandil Mahmoud Ibrahim , Tabl Eslam Abdelshafi , Elhammady Adel Samy
Published: August 2020

Background:

The aim of this study was to evaluate the efficacy and safety of injection of allogeneic growth factors in patients with plantar fasciitis.

Methods:

This study included 150 patients who were randomly divided into 2 equal groups; the patients were locally injected with allogeneic growth factors (GFs) (treatment group) or with saline 0.9% (control group). The patients were assessed using visual analog scale (VAS) and Foot Function Index–Revised short form (FFI-Rs) scores preinjection and 1, 3, 6, and 12 months postinjection. The patients were questioned about their satisfaction. Any adverse effects were recorded.

Results:

At baseline, there was no significant difference between both groups regarding the mean VAS and FFI-Rs scores. At 3-month follow-up, the reduction in mean VAS score was 87% in the treatment group and 55% in the control group ( P < .001), and the reduction in mean FFI-Rs score was 62% in the treatment group and 40% in the control group ( P < .001). Treatment group and study visit were significant factors affecting both VAS and FFI-Rs scores. Overall, 92% were satisfied in the treatment group, and 78.2% in the control group. Postinjection pain occurred in 5 patients in the treatment group.

Conclusion:

This study provides Level I evidence regarding the efficacy and safety of allogeneic GF injection in patients with plantar fasciitis. However, additional studies are needed to evaluate their adverse effects, immunogenicity, and microbiological safety.

Level of Evidence:

Level I, prospective randomized controlled case series.
The Effects of Noninvasive Traction on SSEPs During Ankle Arthroscopy
Authors: Altbuch Tristan , Ayzenberg Mark , Bloze A. Elizabeth , Ferkel Richard D.
Published: August 2020

Background:

The purpose of this study was to evaluate the effects of noninvasive ankle distraction on intraoperative somatosensory evoked potentials (SSEPs) and peripheral nerve sensibility of the foot during ankle arthroscopy.

Methods:

Twenty patients undergoing ankle arthroscopy were prospectively evaluated using noninvasive ankle traction. All had preoperative clinical examination with baseline neurologic evaluation and static 2-point discrimination (2PD) test. Intraoperative SSEPs were monitored continuously throughout surgery. Thirty pounds of traction was applied using noninvasive traction. A 50% decrease in amplitude or a 10% increase in latency was considered significant. At 2 weeks postoperatively, the 2PD test was repeated. Pre- and postoperative 2PD was compared and subsequently correlated with intraoperative SSEPs.

Results:

Three patients sustained significant SSEP signal alterations during surgery. The changes were transient and directly related to application of traction but returned to baseline without traction release. Abnormal postoperative 2PD testing was found in the operative extremity in 12 patients but resolved by the second postoperative visit. Only 2 of 12 had intraoperative SSEP changes. Eleven patients had abnormal postoperative 2PD testing in the nonoperative limb. Nine had changes in both limbs. Routine history and clinical examination did not suggest any neurologic injury. There was no statistically significant correlation between intraoperative SSEP alterations and subsequent development of abnormal postoperative 2PD testing.

Conclusion:

Transient intraoperative SSEP changes occurred with noninvasive distraction but were reversible when using 30 pounds of traction. 2PD testing changes were common postoperatively but not correlated to changes in SSEP. Patients with increased 2PD did not have sensory changes detectable on clinical exam or subjective patient history.

Level of Evidence:

Experimental level II, prospective comparative study.
How Is Morocco Reacting to COVID-19 Crisis in Anticancer Centers?
Authors: Oualla Karima , Nouiakh Lamiae , Acharfi Nisrine , Amaadour lamiae , Benbrahim Zineb , Arifi Samia , Mellas Nawfel
Published: August 2020

The world is facing the pandemic linked to COVID-19 virus infection that has rapidly spread worldwide, and severe complications have been reported to occur in around a third of patients. To date, there is no approved vaccine or specific therapy against COVID-19, but many trials are ongoing with some of them showing promising results. It has been shown recently that patients with cancer are at high risk of infection and they are more susceptible to develop severe events such as the necessity of invasive ventilation and death. Therefore, this crisis presents a real challenge for health systems especially in low- and middle-income countries where the health systems are already fragile such as African countries. In this article, we describe the epidemiological situation of the infection in Morocco and the different challenges in cancer centers in the era of COVID-19, in addition to various strategies that have been implemented to prevent and control the infection spread in oncological units in order to ensure the continuation of adequate cancer care.
Public Performances and Art-Based Interventions in Liminal Academic Spaces
Authors: Koro Mirka , Löytönen Tejia , Cruz Joshua
Published: August 2020

In this research, we brought together various theories and speculative conceptual connections of otherness associated with liminality especially as seen through one methodological experiment and art-based intervention, namely flash mobs. From our perspective, liminality and liminal spaces are incomplete and always becoming since often they cannot be documented or described through existing language and normative concepts. Moving away from normativity and speaking back from liminal spaces carry risks since complex and intersubjective liminal spaces challenge the authority of the researcher, knowing, and doing in Academia. In this work, we use examples from our flash mob events to bridge theorizing and public performances, actual limit experiences, and twisted forms of (normative) scholarship. We ask what is being produced through art-based interventions, resistance, liminality, and twisted scholarship in the context of inquiry.
Nonkeratinizing Nasopharyngeal Carcinoma, Undifferentiated Type With Trisomy 2: A Case Report and Short Review of Cytogenetic and Molecular Literature
Authors: Pontoriero Francesco , Silverman Ayaka M , Pascasio Judy M , Bajaj Renu
Published: August 2020

Carcinoma originating from the surface epithelium of the nasopharynx is classified by the World Health Organization (WHO) as nasopharyngeal carcinoma (NPC) and has 3 main types: keratinizing squamous cell carcinoma (WHO type 1) and nonkeratinizing carcinoma, differentiated (WHO type II), and undifferentiated (WHO type III). Nonkeratinizing NPC is strongly associated with prior Epstein–Barr virus (EBV) infection. These tumors may be divided into differentiated and undifferentiated carcinoma. Histologically, the tumor is characterized by syncytia of large malignant cells with vesicular nuclei, conspicuous nucleoli, and easily observed mitotic figures. We report a case of a 14-year-old boy diagnosed with EBV and human papillomavirus (HPV)-positive NPC (WHO type 3) with cytogenetics showing the presence of mosaic trisomy 2. This case report brings to light a rare cytogenetic aberration to our knowledge only reported once before in the literature in a xenograft model.
How To Build a Better Robot . . . for Quick-Service Restaurants
Authors: Zemke Dina Marie V. , Tang Jason , Raab Carola , Kim Jungsun
Published: August 2020

Hospitality firms are exploring opportunities to incorporate innovative technologies, such as robotics, into their operations. This qualitative study used focus groups to investigate diner perspectives on issues related to using robot technology in quick-service restaurant (QSR) operations. QSR guests have major concerns regarding the societal impact of robotics entering the realm of QSR operations; the cleanliness and food safety of robot technology; and communication quality, especially voice recognition, from both native and nonnative English speakers. Participants also offered opinions about the functionality and physical appearance of robots, the value of the “human touch,” and devised creative solutions for deploying this technology. Surprisingly, few differences in attitudes and perceptions were found between age groups, and the participants were highly ambivalent about the technology. Future research may consider further exploration of robot applications in other restaurant segments, using quantitative methods with a larger sample.
Relationships Between Systematically Observed Movement Integration and Classroom Management in Elementary Schools
Authors: Moon Jongho , Webster Collin A. , Herring Jekesha , Egan Cate A.
Published: August 2020

Movement integration (MI), which involves incorporating physical activity into regular classroom time, is a research-supported strategy to reduce off-task behavior and support academic performance. However, teachers’ rate of adopting MI has been slow. Teachers are more likely to adopt MI if they perceive it as compatible with their current teaching practices. Accordingly, this study examined relationships between systematically observed MI and other evidence-based classroom management practices in elementary schools. Participants were classroom teachers ( n = 12) and their students ( n = 229). Classroom observations were conducted using the System for Observing Student Movement in Academic Routines and Transitions (SOSMART) and the Brief Classroom Interaction Observation–Revised (BCIO-R). Correlational analyses showed that MI was positively associated with effective instructional management and proactive management strategies, and negatively associated with reactive management strategies and disruptive student behavior. This study demonstrated that MI and other established classroom management practices are co-occurring.
COVID-19 and race: Protecting data or saving lives?
Authors: Webber Richard
Published: August 2020

This article uses the COVID-19 pandemic to demonstrate how our understanding of ethnic inequalities could be improved by greater use of algorithms that infer ethnic heritage from people’s names. It starts from two inter-connected propositions: the effectiveness of many public sector programs is hampered by inadequate information on how differently different ethnic groups behave, and anxiety over how to discuss matters to do with race inhibits proper evaluation of methodologies which would address this problem. This article highlights four mindsets which could benefit from challenge: the officially sanctioned categories by which ethnic data are tabulated are too crude to capture the subtler differences which are required for effective communications; while self-identification should continue to drive one-to-one communications, it should not preclude the use of more appropriate methods of recording ethnic heritage when analyzing data for population groups; public servants often fail to recognize the limitations of directional measures such as the Index of Multiple Deprivation as against “natural” classifications such as Mosaic and Acorn; and in their quest for predictive accuracy statisticians often overlook the benefit of the variables they use being “actionable,” defining population groups that are easy to reach whether geographically or using one-to-one communications.
Experiencing dementia: How does assessment of cognition and language relate to daily life?
Authors: Lindeberg Sophia , Samuelsson Christina , Müller Nicole
Published: August 2020

This Swedish study investigates how persons living with dementia report their experiences of cognitive and linguistic testing, as well as their perspectives on the communicative resources and barriers they experience in daily interactions. Eight dyads were included in this qualitative exploratory study; eight persons with dementia and eight family members with whom they interact with daily. Semi-structured interviews, with questions focusing on experiences of diagnostic pathways as well as communicative and cognitive function in daily life, were carried out together with standard clinical testing. The data were analysed using qualitative content analysis. The results shed light on the experiences of uncertainty during the dementia assessment process related to the assessment tasks, the consequences of the assessment and receiving a diagnosis. We interpret this as a result of the unfamiliar clinical focus on function as measured in decontextualised tasks, compared to the participants’ view based on their abilities in everyday life. The study also reveals that adjustments in daily life that are necessitated by the consequences of neurological change are often developed in collaboration between the person with dementia and their conversation partners. There are, however, reports of conflicting feelings by the persons diagnosed with dementia, and by their families, as well as their views on how to best handle change, while maintaining a sense of being a competent person through the progression of disease.
Mind the gap: Comparing perspectives of service providers to the needs of people with dementia living in the community
Authors: Morrisby Claire , Ciccarelli Marina , Joosten Annette
Published: August 2020

Introduction

Research with West Australian people with dementia and their carers living in the community identified that they have a diverse range of needs. However, little is known about the needs of people with dementia and their carers from the perspectives of service providers who provide formal support. This study aimed to investigate the needs of people with dementia and their carers living in the community from the perspectives of service providers, and compare this to service recipients.

Method

This interpretive descriptive study used focus groups to collect qualitative data from service providers ( N = 10). Data were analysed using a hybrid inductive–deductive approach to compare the needs identified by service providers to those identified by people with dementia and their carers.

Results

Three major themes were identified: (i) services and supports required by people with dementia and their carers should be flexible, tailored, and equitable; (ii) building capacity to support carers and people with dementia; and (iii) systems designed to care were fragmented and difficult to navigate. Service providers prioritise needs that are limited to their current capacity to provide in contrast to the holistic needs of people with dementia and their carers.

Conclusion

There was poor alignment between the perceived needs of people with dementia and their carers and the needs prioritised by service providers in the West Australian community. This gap may reduce the ability of services to effectively support people with dementia to remain living in the community.
Supplementing Substance Use Prevention With Sexual Health Education: A Partner-Informed Approach to Intervention Development
Authors: Powell Terrinieka W. , Jo Meghan , Smith Anne D. , Marshall Beth D. , Thigpen Santha , Offiong Asari , Geffen Sophia R.
Published: August 2020

Supplementing substance use prevention with sexual health education would allow educators to address the risk and protective factors that influence both health issues. This streamlined approach may minimize the inefficiencies of multisession, single-purpose interventions. Our team developed a supplemental sexual and reproductive health (SRH) unit to align with an existing evidence-based intervention, LifeSkills Training (LST). This goal of this article is to describe our process, final product, lessons learned, and future directions. Our partner-informed approach took place across three key phases: (1) formative insights, (2) unit development, and (3) pilot implementation. The final supplemental SRH unit is ten, 45-minute sessions offered to seventh- and eighth-grade students and includes a set of learning objectives that are aligned with individual sessions. The supplemental SRH unit also mirrors existing LST modules in length, flow, layout, facilitator instructions, focus on prevention, and utilization of a student workbook. Lessons learned include strategies to effectively incorporate a wide range of ongoing feedback from multiple sources and quickly respond to staff turnover. This partnership approach serves as a model for researchers and practitioners aiming to extend the reach of existing evidence-based programs.
Assessin’ the Vexin’ Connexin Between Severity of Epilepsy and Hippocampal Gliosis
Authors: Courtney Connor D. , Christian-Hinman Catherine
Published: August 2020

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Addressing the quality of submissions to ClinicalTrials.gov for registration and results posting: The use of a checklist
Authors: Tetteh Oswald , Nuamah Prince , Keyes Anthony
Published: August 2020

Background:

US Federal regulations since the late 1990s have required registration of some clinical trials and submission of results for some of these trials on a public registry, ClinicalTrials.gov. The quality of the submissions made to ClinicalTrials.gov determines the duration of the Quality Control review, whether the submission will pass the review (success), and how many review cycles it will take for a study to be posted. Success rate for all results submitted to ClinicalTrials.gov is less than 25%. To increase the success of investigators’ submissions and meet the requirements of registration and submission of results in a timely fashion, the Johns Hopkins ClinicalTrials.gov Program implemented a policy to review all studies for quality before submission. To standardize our review for quality, minimize inter-reviewer variability, and have a tool for training new staff, we developed a checklist.

Methods:

The Program staff learned from major comments received from ClinicalTrials.gov and also reviewed the Protocol Registration and Results System review criteria for registration and results to fully understand how to prepare studies to pass Quality Control review. These were summarized into bulleted points and incorporated into a checklist used by Program staff to review studies before submission.

Results:

In the period before the introduction of the checklist, 107 studies were submitted for registration with a 45% (48/107) success rate, a mean (SD) of 18.9 (26.72) days in review, and 1.74 (0.78) submission cycles. Results for 44 records were submitted with 11% (5/44) success rate, 115.80 (129.33) days in review, and 2.23 (0.68) submission cycles. In the period after the checklist, 104 studies were submitted for registration with 80% (83/104) success rate, 2.12 (3.85) days in review, and 1.22 (0.46) submission cycles. Results for 22 records were submitted with 41% (9/22) success rate, 39.27 (19.84) days in review, and 1.64 (0.58) submission cycles. Of the 44 results submitted prior to the checklist, 30 were Applicable or Probable Applicable Clinical Trials, with 10% (3/30) being posted within 30 days as required of the National Institutes of Health. For the 22 results submitted after the checklist, 17 were Applicable or Probable Applicable Clinical Trials, with 47% (8/17) being posted within 30 days of submission. These pre- and post-checklist differences were statistically significant improvements.

Conclusion:

The checklist has substantially improved our success rate and contributed to a reduction in the review days and number of review cycles. If Academic Medical Centers and industry will adopt or create a similar checklist to review their studies before submission, the quality of the submissions can be improved and the duration of review can be minimized.
Effect of seasonal and temperature variation on hospitalizations for stroke over a 10-year period in Brazil
Authors: Kurtz Pedro , Bastos Leonardo SL , Aguilar Soraida , Hamacher Silvio , Bozza Fernando A
Published: August 2020

Background

Seasonal variation in stroke incidence remains controversial.

Aims

We aimed to describe the pattern of seasonality in hospitalizations for stroke in Brazil.

Methods

We evaluated age-adjusted hospitalization rates for stroke per month using data from the Brazilian Unified Healthcare System and median monthly temperature data obtained from the National Institute of Meteorology. To detect a seasonality pattern in time series, we used seasonal-trend decomposition using LOESS. We calculated a seasonal strength statistic and used Kruskal–Wallis test to evaluate the presence of seasonality in Brazil and its five regions. We also assessed the association of temperature and stroke hospitalization rates using Spearman’s rho correlation.

Results

We identified 1,422,496 stroke-related hospitalizations between 2009 and 2018. Mean age was 67 years, 51% were male and 77.5% of stroke diagnoses were not specified as ischemic or hemorrhagic. Median temperature was 23.8℃ (IQR 22.3–24.4). Age-adjusted hospitalizations demonstrated significant seasonal variation during all the years analyzed, with increased rates during the winter. When regional differences were analyzed, seasonal behavior was present in the south, southeast and northeast regions of the country. These were also the regions with lower median temperatures during the winter months and greater amplitude of average temperatures between warmer and colder months.

Conclusions

In this large national cohort of stroke patients in Brazil, we demonstrated the presence of seasonal variation in the age-adjusted hospitalization rate, with peak rates during the winter months. The regional gradient of incidence of stroke was directly associated with colder winters and greater amplitude of temperature.
Movement disorders and tremors
Authors: Mishra Apurva , Earley David
Published: August 2020

Movement disorders are a heterogeneous group of disorders with different clinical presentations and different underlying aetiologies. They are commonly seen in primary care in the form of tremors or rigidity. This article covers the common and important movement disorders as outlined in the RCGP curriculum. Movement disorders can be divided into hyperkinetic and hypokinetic, depending on increase or decrease in activity of a muscle or muscle group leading to abnormal movement or posture. It is important to note that tremors, although commonly hyperkinetic, can be sometimes be hypokinetic in nature.
Use of Computer Vision to Identify the Frequency and Magnitude of Insulin Syringe Preparation Errors
Authors: Cabri Ann , Bagley Berit , Brown Kevin
Published: August 2020

Background:

No current technology exists to ensure the dose of insulin administered in hospitals matches the physician order.

Objective:

Assess the feasibility of using computer vision to identify insulin syringe preparation errors.

Methods:

Twenty-two nurses prepared 50 insulin doses (n=1100) each. A computer vision device (CVD) measured the volume drawn up and identified air present. Syringes identified as inaccurate by the CVD were confirmed by two observers, and a random sample of 100 syringes identified as accurate was validated by two independent observers.

Results:

Ten syringes (1.0%) had the wrong volume prepared, and 68 syringes (6.5%) contained air sufficient to meet the definition of inaccuracy. All errors were confirmed by two independent observers.

Conclusion:

CVDs could reduce insulin administration errors in hospitalized patients.
Information asymmetries in intrafamily business succession
Authors: Wolff Sven , Schell Sabrina , Moog Petra
Published: August 2020

The often long-lasting process of intrafamily business succession involves contracts for management and ownership transfer that unfold in a complex series of stages. The older and larger a family business, the more heterogeneous the involved family members’ interactions and interests can become. These differences become obvious in the succession process. Also, in entrepreneurial families, information is not easy to obtain and is neither perfect nor unlimited, for example, with regard to expectations regarding the duration or the type of business succession. Information asymmetries can arise. This article investigates the drivers of information asymmetries and provides insight into the current research by investigating information asymmetries and their impact during different phases of intrafamily business succession. Data from 215 German firms reveal the occurrence of specific information asymmetries during different phases of intrafamily business succession.

JEL CLASSIFICATION M1; M59; D82; L2
Rare case of recurrent renal cell carcinoma with tumour thrombosis of circumaortic renal vein
Authors: Hule Ashwini , Desai Sanjay
Published: August 2020

Renal cell carcinomas are the most common renal neoplasm with high mortality. Recurrence of neoplasm is not uncommon following treatment. However, we present an extremely rare case of 74-year-old male patient of recurrent renal cell carcinoma with tumour thrombosis into left circumaortic vein which has not been reported previously in literature to our best knowledge. CT urography is the study of choice for clear delineation of the site and extension of the neoplastic lesion. Rare venous anomalies of renal vein are of utmost importance in order to plan surgical management and prognosis in follow-up cases especially after partial nephrectomy.
Sonography of Magnetically Controlled Growing Rods: A Quality Initiative in the Creation of a Multidisciplinary Clinic
Authors: Riemann Monique C. , Bailey Smita S. , Rubert Nicholas , Barnes Craig E. , Karlen Judson W.
Published: August 2020

Objective:

The MAGEC (Magnetic Expansion Control) rods were introduced to a medical institution in 2015. The rod expansion procedures were initially evaluated with radiographs. The staff undertook a quality initiative to reduce radiation exposure by utilizing sonography.

Material and Methods:

The radiation dose for a typical visit was measured by examining DICOM imaging data, stored in PACS. Imaging visit time was determined from the difference between times of first radiograph/sonogram before distraction to last radiograph/sonogram after distraction.

Results:

The 21 patients (8 male, 13 female) were an average age of 11.4 ± 2.82 years (age at implant = 7.5 ± 1.94) when evaluated. The average length of time for a radiographic visit was 40.7 ± 20.7 minutes, whereas a sonography visit was 10.7 ± 3.7 minutes. Radiation dose per study visit prior to the introduction of the MAGEC clinic was 0.42 ± 0.39 mSv. Given an ideal patient schedule, the MAGEC clinic could reduce radiation dose by 1.3 to 2.5 mSv annually, with 95% confidence.

Conclusion:

This quality improvement study demonstrated a reduction in radiation exposure and imaging time. The added benefits were providing a successful multidisciplinary imaging clinic and creation of a new exam that aligned with the “ultrasound first” initiative.
An Exploratory Configurational Analysis of Knowledge Hiding Antecedents in Project Teams
Authors: Moh’d Shaima’ Salem , Černe Matej , Zhang Pengcheng
Published: August 2020

Drawing on achievement goal theory and job design frameworks, this study explores how certain antecedents combine in configurations to trigger knowledge hiding behavior among project teammates. We, therefore, adopted a configurational approach and performed fuzzy-set qualitative comparative analysis to a data set of 292 employees nested into 10 Chinese medium-sized firms. This inductive analytic approach enabled us to explore configurations of conditions of different levels of antecedents. Results identified four equifinal configurations of antecedents leading to knowledge hiding in project teams, in addition to six different configurations restraining this behavior, generating propositions to be tested by future research in a deductive manner. Our study may guide firms to better counteract and manage knowledge hiding behavior in teams by suggesting different pathways and solutions that can minimize knowledge hiding behavior among project team members.
Hepatosplenic T-cell lymphoma: a rare but challenging entity
Authors: Pro Barbara , Allen Pamela , Behdad Amir
Published: August 2020

Hepatosplenic T-cell lymphoma (HSTCL) is a rare T-cell neoplasm that most commonly arises from a small subset of γ/δ T-cell receptor–expressing lymphocytes. HSTCL is more common in adolescent and young adults and has a rapidly progressive clinical course and poor outcome due to its refractoriness to conventional chemotherapy regimens. Approximately 20% of the cases arise in the background of chronic immunosuppression or immune dysregulation. Patients commonly present with constitutional symptoms, hepatic and liver enlargement, and cytopenias; hematophagocytic syndrome can also occur. The most frequent chromosomal aberrations associated with HSTCL are isochromosome 7q and trisomy 8, and most cases harbor mutations in genes involved in chromatin modification or the JAK/STAT pathway. The rarity of this disease, along with lack of nodal involvement and presenting symptoms that mimic different entities including infectious etiologies, makes this lymphoma a significant diagnostic challenge. In this review, we highlight the clinical and pathologic features of HSTCL. Moreover, we summarize the results of recent molecular studies suggesting potential targets for novel therapeutics strategies.
Prostaglandin E2 stimulates cAMP signaling and resensitizes human leukemia cells to glucocorticoid-induced cell death
Authors: Roderick Justine E. , Gallagher Kayleigh M. , Murphy Leonard C. , O’Connor Kevin W. , Tang Katherine , Zhang Boyao , Brehm Michael A. , Greiner Dale L. , Yu Jun , Zhu Lihua Julie , Green Michael R. , Kelliher Michelle A.
Published: August 2020

Glucocorticoid (GC) resistance remains a clinical challenge in pediatric acute lymphoblastic leukemia where response to GC is a reliable prognostic indicator. To identify GC resistance pathways, we conducted a genome-wide, survival-based, short hairpin RNA screen in murine T-cell acute lymphoblastic leukemia (T-ALL) cells. Genes identified in the screen interfere with cyclic adenosine monophosphate (cAMP) signaling and are underexpressed in GC-resistant or relapsed ALL patients. Silencing of the cAMP-activating Gnas gene interfered with GC-induced gene expression, resulting in dexamethasone resistance in vitro and in vivo. We demonstrate that cAMP signaling synergizes with dexamethasone to enhance cell death in GC-resistant human T-ALL cells. We find the E prostanoid receptor 4 expressed in T-ALL samples and demonstrate that prostaglandin E2 (PGE2) increases intracellular cAMP, potentiates GC-induced gene expression, and sensitizes human T-ALL samples to dexamethasone in vitro and in vivo. These findings identify PGE2 as a target for GC resensitization in relapsed pediatric T-ALL.
Predictors of preprocedural direct oral anticoagulant levels in patients having an elective surgery or procedure
Authors: Shaw Joseph R. , Li Na , Vanassche Thomas , Coppens Michiel , Spyropoulos Alex C. , Syed Summer , Radwi Mansoor , Duncan Joanne , Schulman Sam , Douketis James D.
Published: August 2020

The Perioperative Anticoagulation Use for Surgery Evaluation (PAUSE) study prospectively evaluated a prespecified periprocedural-interruption strategy of direct oral anticoagulants (DOACs) among patients with atrial fibrillation. Logistic regression analyses were performed to identify clinical parameters associated with residual DOAC levels ≥30 ng/mL or ≥50 ng/mL. Patients undergoing low-bleed-risk procedures were more likely to have residual levels of ≥30 ng/mL and ≥50 ng/mL. For low-risk procedures, age ≥75 years, female sex, a creatinine clearance (CrCl) <50 mL/min, and an interruption of <36 hours were associated with a greater likelihood of levels ≥30 ng/mL, whereas age ≥75 years, female sex, a CrCl of <50 mL/min, and standard DOAC dosing were associated with levels ≥50 ng/mL. For high-risk procedures, weight of <70 kg, CrCl <50 mL/min, and standard DOAC dosing were associated with residual levels ≥30 ng/mL, whereas female sex was associated with levels ≥50 ng/mL. For low-risk procedures, apixaban was associated with a higher likelihood of levels ≥30 ng/mL as compared with dabigatran (P = .0019) and of levels ≥50 ng/mL when compared with rivaroxaban (P = .0003). For high-risk procedures, apixaban was marginally associated with a higher likelihood of residual levels ≥30 ng/mL when compared with dabigatran (P = .05), whereas rivaroxaban was associated with a higher likelihood of levels ≥30 ng/mL as compared with apixaban. Further study is required to determine whether adjustments to perioperative plans based on these clinical parameters could result in a lower risk of residual DOAC levels. The PAUSE trial was registered at www.clinicaltrials.gov as #NCT2228798.