bluuebunny/crossref_metadata_2025 huggingface dataset:
Dealing with missing delirium assessments in prospective clinical studies of the critically ill: a simulation study and reanalysis of two delirium studies
Authors: Raman Rameela , Chen Wencong , Harhay Michael O. , Thompson Jennifer L. , Ely E. Wesley , Pandharipande Pratik P. , Patel Mayur B.
Published: May 2021

Background

In longitudinal critical care studies, researchers may be interested in summarizing an exposure over time and evaluating its association with a long-term outcome. For example, the number of days a patient has delirium (i.e., brain dysfunction) during their critical care stay is associated with the presence and severity of long-term cognitive problems. In large pragmatic trials and multicenter observational studies, particularly when electronic medical record data is used, the information on daily exposure status may be available at some time points and not at others. Model-based multiple imputation is a well-established, widely adopted method to deal with missing data. But the uncertainty around multiple imputation for summary exposure variables is whether the imputation is to be performed at the summary level or at the daily assessment level.

Methods

We compare the following approaches to imputing and summarizing partially missing longitudinal data: 1) active imputation, where we impute the summary; 2) passive imputation, where we impute the daily missing data, and then compute the summary; 3) ad hoc methods where we assume all missing time points have the a) most or the b) least extreme value; and 4) complete case analysis where only participants with complete data are analyzed. These methods were applied under different missingness mechanisms, varying proportions of missingness, and association of missingness with an auxiliary variable using simulations that closely mirrors real-life critical care data to be relevant to real-world clinical practice. The performance of the approaches were compared using bias of the estimated coefficients, standard error of the estimate and coverage. We also apply these imputation strategies to two datasets in critical care.

Results

Simulations show that all methods performed comparably when the proportion of missingness was small, indicating that in such instances, the gain over using any imputation model is minimal. But as the proportion of missingness increases, the passive imputation approach provides efficient and less biased estimates under the missingness at random and missingness completely at random mechanism.

Conclusions

For longitudinal data where a summary exposure is of interest, we recommend practitioners adopting the passive imputation strategy.
The incidence, risk factors and maternal and foetal outcomes of uterine rupture during different birth policy periods: an observational study in China
Authors: Zhou Yangwen , Mu Yi , Chen Peiran , Xie Yanxia , Zhu Jun , Liang Juan
Published: May 2021

Background

Currently, there are no studies on changes in the incidence of uterine rupture or maternal and foetal outcomes in women with uterine rupture during different birth policy periods in China. Moreover, the results of association studies of maternal age, parity and previous caesarean section number with the risk of maternal and foetal outcomes in women with uterine rupture have not been consistent. This research aims to conduct and discuss the above two aspects.

Methods

We included singleton pregnant women with no maternal complications other than uterine rupture from January 2012 to June 2019 in China’s National Maternal Near Miss Surveillance System. The data in this study did not differentiate between complete and partial uterine rupture and uterine dehiscence. Through Poisson regression analysis with a robust variance estimator, we compared the incidences of uterine rupture and maternal and foetal outcomes in women with uterine rupture during different birth policy periods in China and determined the relationship between maternal age, parity or previous caesarean section number and uterine rupture or maternal and foetal outcomes in women with uterine rupture.

Results

This study included 8,637,723 pregnant women. The total incidences of uterine rupture were 0.13% (12,934) overall, 0.05% during the one-child policy, 0.12% during the partial two-child policy (aRR = 1.96; 95% CI: 1.53–2.52) and 0.22% (aRR = 2.89; 95% CI: 1.94 4.29) during the universal two-child policy. The maternal near miss and stillbirth rates in women with uterine rupture were respectively 2.35% (aRR = 17.90; 95% CI: 11.81–27.13) and 2.12% (aRR = 4.10; 95% CI: 3.19 5.26) overall, 5.46 and 8.18% during the first policy, 1.72% (aRR = 0.60; 95% CI: 0.32–1.17) and 2.02% (aRR = 0.57; 95% CI: 0.37–0.83) during the second policy, and 1.99% (aRR = 0.90; 95% CI: 0.52–1.53) and 1.04% (aRR = 0.36; 95% CI: 0.24–0.54) during the third policy. The risk of uterine rupture increased with parity and previous caesarean section number.

Conclusion

The uterine rupture rate in China continues to increase among different birth policy periods, and the risk of maternal near miss among women with uterine rupture has not significantly improved. The Chinese government, obstetricians, and scholars should work together to reverse the rising rate of uterine rupture and improve the pregnancy outcomes in women with uterine rupture.
Clinical teachers’ perceptions of role modeling: a qualitative study
Authors: Mohammadi Elaheh , Mirzazadeh Azim , Shahsavari Hooman , Sohrabpour Amir Ali
Published: May 2021

Background

Role modeling has been significantly considered in medical education in recent decades. In the clinical course, students learn necessary skills and accordingly their professional identity is formed by observing and working among clinical educators. Given the importance of the role modeling in medical education, in the present study, it was attempted to explore the clinical teachers’ perceptions of being a role model for medical students using a qualitative method.

Methods

A qualitative design, based on the content analysis approach, was used to analyze the perspectives of 15 clinical teachers. Participants were chosen by purposeful sampling. Data were collected using reflection paper writing.

Results

During the data analysis, five main categories emerged: influencing others, developing different dimensions of student, situational self-awareness, feedback and continuous effort.

Conclusions

This study will be useful to form role modeling educational programs. Encouraging clinical teachers to make continuous efforts to improve role modeling and educating time management and self-control skills can help reduce the challenges of role modeling for clinical teachers.
Description of pharmacists’ reported interventions to prevent prescribing errors among in hospital inpatients: a cross sectional retrospective study
Authors: Alzahrani Abdulhakim A. , Alwhaibi Monira M. , Asiri Yousif A. , Kamal Khalid M. , Alhawassi Tariq M.
Published: May 2021

Background

Prescribing errors (PEs) are a common cause of morbidity and mortality, both in community practice and in hospitals. Pharmacists have an essential role in minimizing and preventing PEs, thus, there is a need to document the nature of pharmacists’ interventions to prevent PEs. The purpose of this study was to describe reported interventions conducted by pharmacists to prevent or minimize PEs in a tertiary care hospital.

Methods

A retrospective analysis of the electronic medical records data was conducted to identify pharmacists’ interventions related to reported PEs. The PE-related data was extracted for a period of six-month (April to September 2017) and comprised of patient demographics, medication-related information, and the different interventions conducted by the pharmacists. The study was carried in a tertiary care hospital in Riyadh region. The study was ethically reviewed and approved by the hospital IRB committee. Descriptive analyses were appropriately conducted using the IBM SPSS Statistics.

Results

A total of 2,564 pharmacists’ interventions related to PEs were recorded. These interventions were reported in 1,565 patients. Wrong dose (54.3 %) and unauthorized prescription (21.9 %) were the most commonly encountered PEs. Anti-infectives for systemic use (49.2 %) and alimentary tract and metabolism medications (18.2 %) were the most common classes involved with PEs. The most commonly reported pharmacists’ interventions were dose adjustments (44.0 %), restricted medication approvals (21.9 %), and therapeutic duplications (11 %).

Conclusions

In this study, PEs occurred commonly and pharmacists’ interventions were critical in preventing possible medication related harm to patients. Care coordination and prioritizing patient safety through quality improvement initiatives at all levels of the health care system can play a key role in this quality improvement drive. Future studies should evaluate the impact of pharmacists’ interventions on patient outcomes.
Canadian national electrophysiology ablation registry report 2011–2016
Authors: Kaoutskaia Anna , Shurrab Mohammed , Amit Guy , Parkash Ratika , Exner Derek , Toal Satish , Sterns Laurence , Sarrazin Jean-Francois , Chauhan Vijay , Sultan Omar , Nair Girish , Deyell Marc , Macle Laurent , Klassen Steve , Glover Benedict , Crystal Eugene
Published: May 2021

Background/purpose

: Interventional cardiac electrophysiology (EP) is a rapidly evolving field in Canada; a nationwide registry was established in 2011 to conduct a periodic review of resource allocation.

Methods

The registry collects annual data on EP lab infrastructure, imaging, tools, human resources, procedural volumes, success rates, and wait times. Leading physicians from each EP lab were contacted electronically; participation was voluntary.

Results

All Canadian EP centres were identified (n = 30); 50 and 45 % of active centres participated in the last 2 instalments of the registry. A mean of 508 ± 270 standard and complex catheter ablation procedures were reported annually for 2015–2016 by all responding centres. The most frequently performed ablation targets atrial fibrillation (PVI) arrhythmia accounting for 36 % of all procedures (mean = 164 ± 85). The number of full time physicians ranges between 1 and 7 per centre, (mean = 4). The mean wait time to see an electrophysiologist for an initial non-urgent consult is 23 weeks. The wait time between an EP consult and ablation date is 17.8 weeks for simple ablation, and 30.1 weeks for AF ablation. On average centres have 2 (range: 1–4) rooms equipped for ablations; each centre uses the EP lab an average of 7 shifts per week. While diagnostic studies and radiofrequency ablations are performed in all centres, point-by-point cryoablation is available in 85 % centres; 38 % of the respondents use circular ablation techniques.

Conclusions

This initiative provides contemporary data on invasive electrophysiology lab practices. The EP registry provides activity benchmarks on national trends and practices.
Comparison of a mycobacterial phage assay to detect viable Mycobacterium avium subspecies paratuberculosis with standard diagnostic modalities in cattle with naturally infected Johne disease
Authors: Greenstein Robert J. , Su Liya , Grant Irene R. , Foddai Antonio C. G. , Turner Amy , Nagati Jason S. , Brown Sheldon T. , Stabel Judith R.
Published: May 2021

Background

Mycobacterium avium subspecies paratuberculosis (MAP), the cause of Johne disease, is a slow growing mycobacterium. Viable MAP detection is difficult, inconstant and time-consuming. The purpose of this study was to compare a rapid phage/qPCR assay performed on peripheral blood mononuclear cells (PBMCs) with three standard methods of MAP detection: fecal MAP PCR; plasma antigen-specific IFN-γ & serum MAP ELISA hypothesizing that, if sensitive and specific, Johne animals would be positive and Control animals negative. We studied a well characterized herd of Holstein cattle that were naturally infected with MAP and their Controls.

Results

With phage/qPCR 72% (23/32) of Johne and 35% (6/17) of Controls were MAP positive. With fecal PCR 75% (24/32) of Johne and 0% (0/17) of Controls were MAP positive. With plasma antigen-specific IFN-γ 69% (22/32) of Johne and 12% (2/17) of Controls were MAP positive. With serum MAP ELISA, 31% (10/32) of Johne and 0% (0/17) of Controls were MAP positive. When phage / qPCR and fecal PCR results were combined, 100% (32/32) Johne and 35% (6/17) of Control animals were MAP positive. Younger Control animals (1–3 years) had significantly fewer plaques (25 ± 17 SEM) than older Controls (4–12 years) (309 ± 134 p = 0.04). The same trend was not observed in the Johne animals (p = 0.19).

Conclusions

In contrast to our hypothesis, using the phage/qPCR assay we find that viable circulating MAP can rapidly be detected from the blood of animals infected with, as well as those in the Control group evidently colonized by MAP. These data indicate that the presence of viable MAP in blood does not necessarily signify that an animal must of necessity be demonstrably ill or be MAP positive by standard diagnostic methods.
Association of 45-bp ins/del polymorphism of uncoupling protein 2 (UCP2) and susceptibility to nonalcoholic fatty liver and type 2 diabetes mellitus in North-west of Iran
Authors: rezapour Saleheh , khosroshahi Shiva Ahdi , Farajnia Hadi , Mohseni Fatemeh , Khoshbaten Manouchehr , Farajnia Safar
Published: May 2021

Objective

Uncoupling protein 2 (UCP2) plays a crucial role in energy homeostasis via insulin secretion regulation, free fatty acid concentrations, and lipid metabolism. This study aimed to investigate the association of 45-bp ins/del polymorphism of UCP2 with susceptibility to NAFLD (Non-Alcoholic Fatty Liver Disease) and T2DM (Type 2 Diabetes Mellitus). DNA was extracted from the white blood cells of the subjects, and the gene polymorphism was determined using polymerase chain reaction (PCR). In this study, 72 patients with NAFLD, 71 healthy individuals as control, 80 patients with T2DM, and 77 healthy controls were enrolled in the study.

Results

A higher prevalence of insertion/insertion genotype was observed in T2DM patients compared to the controls (p- value˂ 0.05). There was no difference in genotype distribution between NAFLD patients and controls (p-value > 0.05). NAFLD patients with D/D, D/I genotype had higher triglyceride, ALT, and AST levels; however, their HDL levels were lower than healthy controls. Patients with T2DM with D/D or D/I genotype also had significantly higher fasting serum glucose (FSG). While we found an association between the 45 bp I/D polymorphism in 3ʹUTR of UCP2 and T2DM, no correlation between this polymorphism and NAFLD was identified.
Cardiac organoid — a promising perspective of preclinical model
Authors: Zhao Dandan , Lei Wei , Hu Shijun
Published: May 2021

Human cardiac organoids (hCOs), three-dimensional (3D) cellular constructs similar to in vivo organ, are new-generation models. To a large extent, a hCO retains the biological characteristics and functions of cells in vivo more accurately than previous models. With the continuous development of biotechnology, the hCO model is becoming increasingly complex and mature. High-fidelity hCOs help us better explore the mysteries of human physiology and integrate phenotypes with living functions into models. Here, we discuss recent advances in the methods of constructing human cardiac organoids and introduce applications of hCOs, especially in modeling cardiovascular diseases, including myocardial infarction, heart failure, genetic cardiac diseases, and arrhythmia. In addition, we propose the prospects for and the limitations of hCOs. In conclusion, a greater understanding of hCOs will provide ways to improve hCO construction and make these models useful for future preclinical studies.
Knowledge of prostate cancer presentation, etiology, and screening practices among women: a mixed-methods systematic review
Authors: Wiafe Ebenezer , Mensah Kofi Boamah , Mensah Adwoa Bemah Boamah , Bangalee Varsha , Oosthuizen Frasia
Published: May 2021

Background

With the burden of prostate cancer, it has become imperative to exploit cost-effective ways to tackle this menace. Women have demonstrated their ability to recognize early cancer signs, and it is, therefore, relevant to include women in strategies to improve the early detection of prostate cancer. This systematic review seeks to gather evidence from studies that investigated women’s knowledge about (1) the signs and symptoms, (2) causes and risk factors, and (3) the screening modalities of prostate cancer. Findings from the review will better position women in the fight against the late detection of prostate cancer.

Methods

The convergent segregated approach to the conduct of mixed-methods systematic reviews was employed. Five databases, namely, MEDLINE (EBSCOhost), CINAHL (EBSCOhost), PsycINFO (EBSCOhost), Web of Science, and EMBASE (Ovid), were searched from January 1999 to December 2019 for studies conducted with a focus on the knowledge of women on the signs and symptoms, the causes and risk factors, and the screening modalities of prostate cancer.

Results

Of 2201 titles and abstracts screened, 22 full-text papers were retrieved and reviewed, and 7 were included: 3 quantitative, 1 qualitative, and 3 mixed-methods studies. Both quantitative and qualitative findings indicate that women have moderate knowledge of the signs and symptoms and the causes and risk factors of prostate cancer. However, women recorded poor knowledge about prostate cancer screening modalities or tools.

Conclusions

Moderate knowledge of women on the signs and symptoms and the causes and risk factors of prostate cancer was associated with education. These findings provide vital information for the prevention and control of prostate cancer and encourage policy-makers to incorporate health promotion and awareness campaigns in health policies to improve knowledge and awareness of prostate cancer globally.

Systematic review registration

Open Science Framework (OSF) registration DOI: 10.17605/OSF.IO/BR456
Evaluation of the effect of apixaban using a viscoelastic coagulation assay with Russell’s viper venom reagent
Authors: Suzuki Kaoru , Katori Nobuyuki , Kimura Yoshihiro , Terui Takako , Sunaga Hiroshi , Kobayashi Shunsuke , Uezono Shoichi
Published: May 2021

Background

Conventional coagulation tests, such as prothrombin time and activated partial thromboplastin time, are not sensitive to anticoagulation by apixaban. We evaluated the antithrombotic effect of apixaban using a Russell viper venom (RVV) test for a patient who underwent posterior spine fusion surgery.

Case presentation

An 84-year-old man was scheduled for percutaneous posterior spine fusion. He continued apixaban until the night before surgery and resumed it on the first day after surgery. We performed an RVV test as point-of-care coagulation monitoring in combination with chromogenic anti-activated factor X (anti-Xa) activity, prothrombin time, and activated partial thromboplastin time. Clotting time with the RVV test was prolonged according to the anti-Xa activity of apixaban, which was in the therapeutic range during surgery.

Conclusions

An RVV test might be useful as a point-of-care assay for estimation of the anti-Xa level induced by apixaban during the perioperative period.
The Predation Game: Does dividing attention affect patterns of human foraging?
Authors: Thornton Ian M. , Tagu Jérôme , Zdravković Sunčica , Kristjánsson Árni
Published: May 2021

Attention is known to play an important role in shaping the behaviour of both human and animal foragers. Here, in three experiments, we built on previous interactive tasks to create an online foraging game for studying divided attention in human participants exposed to the (simulated) risk of predation. Participants used a “sheep” icon to collect items from different target categories randomly distributed across the display. Each trial also contained “wolf” objects, whose movement was inspired by classic studies of multiple object tracking. When participants needed to physically avoid the wolves, foraging patterns changed, with an increased tendency to switch between target categories and a decreased ability to prioritise high reward targets, relative to participants who could safely ignore them. However, when the wolves became dangerous by periodically changing form (briefly having big eyes) instead of by approaching the sheep, foraging patterns were unaffected. Spatial disruption caused by the need to rapidly shift position—rather the cost of reallocating attention—therefore appears to influence foraging in this context. These results thus confirm that participants can efficiently alternate between target selection and tracking moving objects, replicating earlier single-target search findings. Future studies may need to increase the perceived risk or potential costs associated with simulated danger, in order to elicit the extended run behaviour predicted by animal models of foraging, but absent in the current data.
Comparison of murine retroorbital plexus and facial vein blood collection to mitigate animal ethics issues
Authors: Jo Eun Jung , Bae Eunjin , Yoon Jeong-Hwan , Kim Ji Yeon , Han Jin Soo
Published: May 2021

Background

Blood collection is an important procedure used in animal experiments. Blood collection methods that reduce pain, injury, and stress in experimental animals are important with regard to animal ethics. Various comparative studies of blood collection methods have been reported; however, there are no comparative studies on serial blood collection considering animal ethics. To suggest simple methods that minimize pain during serial blood collection, we compared the retroorbital plexus (RP) and facial vein (FV) blood collection methods performed by both experienced and novice groups. The experienced and novice groups collected up to 0.4 mL of blood via the RP and FV methods every second day for 2 weeks. After blood collection, all mice were evaluated by corticosterone concentrations for stress, hematological, immunological, and histological analyses.

Results

We found that the FV methods reduced the collection time, pain, distress, tissue damage and lasting harms without anesthesia. Corticosterone concentrations in the peripheral blood were decreased in mice subjected FV methods compare with those subjected to RP methods. The proportion of granulocytes and monocytes, such as macrophages in the peripheral blood and spleen, was decreased in mice subjected to FV methods compared with that in mice subjected to RP methods in both experienced and novice groups. White blood cells were infiltrated in RP areas with severe tissue damage and inflammation.

Conclusions

With respect to animal ethics, we suggest that the FV method, a simple and fast technique that can easily be performed by both experienced and novice researchers, is suitable for serial blood collection.
Cable force estimation of cables with small sag considering inclination angle effect
Authors: He Wen-Yu , Meng Fan-Cheng , Ren Wei-Xin
Published: May 2021

Cable force estimation is essential for security assessment of cable-stayed bridges. Cable force estimation methods based on the relationship between cable force and frequency have been extensively studied and used during both construction phase and service phase. However, the effect induced by inclination angle of the cable is not included in the establishment of frequency-cable force relationship as horizontal cable model is normally employed. This study aims to investigate the influence of the inclination angle on vibration based cable force estimation and provide practical formulas accordingly. Firstly numerical examples of fixed-fixed and hinged-hinged cables are simulated to illustrate the necessity of considering the inclination angle effect on the modal parameters and cable force estimation for inclined cables with small sag. Then practical formulas considering the inclination angle effect to estimate the cable force of fixed-fixed and hinged-hinged cables via the fundamental frequency are established accordingly. For the inclined cables with unknown boundary conditions, the coefficients reflecting boundary condition are predicted via the practical formulas for fixed-fixed and hinged-hinged cables. And the cable force considering the influence of inclination angle and unknown boundary conditions is obtained by iteration method. Finally, numerical examples are presented to demonstrate the effectiveness of the proposed method.
Victimisation of individuals with serious mental illness living in sheltered housing: differential impact of risk factors related to clinical and demographic characteristics
Authors: Zarchev Milan , Mulder Cornelis L. , Henrichs Jens , Roeg Diana P. K. , Bogaerts Stefan , van Weeghel Jaap , Kamperman Astrid M.
Published: May 2021

Background

Sheltered housing is associated with quality-of-life improvements for individuals with serious mental illness (SMI). However, there are equivocal findings around safety outcomes related to this type of living condition.

Aims

We aimed to investigate raw differences in prevalence and incidence of crime victimisation in sheltered housing compared with living alone or with family; and to identify groups at high risk for victimisation, using demographic and clinical factors. We do so by reporting estimated victimisation incidents for each risk group.

Method

A large, community-based, cross-sectional survey of 956 people with SMI completed the Dutch Crime and Victimisation Survey. Data was collected on victimisation prevalence and number of incidents in the past year.

Results

Victimisation prevalence was highest among residents in sheltered housing (50.8%) compared with persons living alone (43%) or with family (37.8%). We found that sheltered housing was associated with increased raw victimisation incidence (incidence rate ratio: 2.80, 95% CI 2.36–3.34 compared with living with family; 1.87, 95% CI 1.59–2.20 compared with living alone). Incidence was especially high for some high-risk groups, including men, people with comorbid post-traumatic stress disorder and those with high levels of education. However, women reported less victimisation in sheltered housing than living alone or with family, if they also reported drug or alcohol use.

Conclusions

The high prevalence and incidence of victimisation among residents in sheltered housing highlights the need for more awareness and surveillance of victimisation in this population group, to better facilitate a recovery-enabling environment for residents with SMI.
Novel Gene Mutations Regulating Immune Responses in Autoimmune Polyglandular Syndrome With an Atypical Course
Authors: Yukina Marina , Erofeeva Taisia , Nuralieva Nurana , Andreeva Tatiana , Savvateeva Elena , Dudko Natalia , Troshina Ekaterina , Rogaev Evgeny , Melnichenko Galina
Published: May 2021

Context

Autoimmune polyglandular syndrome (APS) is a cluster of endocrine disorders arising from immune dysregulation, often combined with damage to nonendocrine organs. There are 2 types of APS: type 1 and type 2 (APS-1 and APS-2, respectively). In clinical practice, an atypical course of APS is often observed.

Objective

This work aims to find a novel genetic predictor of APS.

Methods

We performed exome sequencing in 2 patients with an atypical clinical APS picture and members of their families. Patient A presented with a manifestation of APS-2 in early childhood and patient B with a late manifestation of the main components of APS-1.

Results

In patient B, we identified inherited compound mutations as a novel combination of the c.769C > T and c.821delG alleles of AIRE and genetic variation in the CIITA gene. No homozygous or compound mutations in AIRE were found in patient A, but we did reveal mutations in genes encoding regulatory proteins of innate and acquired immunity in this patient.

Conclusion

Our data revealed novel combination of mutations in the AIRE gene in atypical APS and imply that mutations in immune-related genes may modify the clinical manifestation of APS in AIRE-mutation carriers and contribute to the development of autoimmune pathology in non-AIRE carriers with atypical APS.
Extended detail contrasts for TO.10 use on flat panel detector fluoroscopy systems
Authors: McCarthy Dean , Kenny Patrick
Published: May 2021

Objectives:

Leeds Test Object Ten (TO.10) is routinely used to subjectively estimate Threshold Contrast Detail Detectability (TCDD) as a measure of image quality in fluoroscopy. However, manufacturer guidance provides calibrated contrasts for only limited peak voltage and copper filtration thickness combinations. Prescribed testing conditions are often difficult to attain as modern flat panel fluoroscopic systems independently determine voltage and copper filtration thickness settings. This work aims to extend the range of TO.10 contrasts available for routine testing at peak voltage and copper thickness settings likely to be encountered.

Methods:

Two methods are described for generalising the calculation of target contrasts: a three-dimensional interpolation/extrapolation model in MATLAB®, and a multivariate log-polynomial function. Both methods utilise the available calibrated contrasts to estimate contrasts at voltage and copper thickness combinations routinely encountered.

Results:

Results are presented as Threshold Detection Index (HTA) curves fit by a second-order polynomial of log HTA to log A . Results are found to be more accurate at unprescribed conditions while also reproducible for relatively consistent input air kerma rate (IAKR) expected from automatic dose rate controls (ADRC).

Conclusions:

The calculation of TO.10 contrasts at non-standard conditions aids in the determination of an absolute estimate of image quality in fluoroscopy with greater accuracy, reproducibility and efficiency.

Advances in knowledge:

TO.10 detail contrasts for TCDD testing of fluoroscopy units have been significantly extended beyond those previously available. The described methods will aid the clinical physicist in absolute assessments of fluoroscopic image quality and facilitate inter system comparisons.
Factors related to loss of appetite in postoperative cardiac surgery patients: A systematic review
Authors: Prasankok Channarong , Banharak Samoraphop
Published: May 2021

Background: Postoperative cardiac surgery patients often experience appetite loss. Although nutritional status is known to be associated with time of recovery, functional status, and length of stay, less is known about factors related to patient’s loss of appetite after cardiac surgery. This review aimed to identify and understand factors related to loss of appetite in postoperative cardiac surgery patients, systematic review with narrative summary design was applied. Data sources including CINAHL, SCOPUS, PubMed, ProQuest, ScienceDirect, ThaiLIS, ThaiJo, and E-Thesis were searched without restriction on publication year through August 2020.

Methods: We conducted the review following the Joanna Briggs Institute methodology, using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist to categorize methodological quality and the PRISMA flow diagram to record the studies’ factors.

Results: Six studies reported one or more of 16 factors related to loss of appetite: older age, sex (female), illiteracy, history of chronic disease, not knowing someone in health field, pain score ≥ 7, pain medications containing codeine, constipation, depression, heart-lung machine ≥ 120 minutes, preoperative serum creatinine levels ≥ 179 µmol/L, emergency surgery, perfusion pressure ≤ 40 mmHg, low cardiac output syndrome, mechanical ventilation ≥ 96 hours, and a New York Heart Association class III and IV.

Conclusion: The small number of publications restrict our conclusions. Future research should focus on multiple factors related to appetite loss in postoperative cardiac surgery patients. Additional research will provide a foundation for evidence-based interventions to reduce appetite loss and improve patient nutritional status after cardiac surgery. Nurses and other health professionals should assess postoperative cardiac surgery patients for the presence of the 16 significant factors. To promote patients’ nutritional status, there should be evidence-based practice guidelines on the management of postoperative symptoms such as pain management, treatment of constipation, and reduction of emotional stress and depression.
Customs Audit: Problems of Formation and Development
Authors: Glazkova G.
Published: May 2021

The article is devoted to one of the tools of customs control, namely the institute of customs audit, which can develop in two directions - either as an independent type of entrepreneurial activity, or within the framework of existing legislation, organization and practice of audit activity.
Formation of Emotional Intelligence in Children of Nido and Toddler Classes
Authors: Sumnitel'nyy K. , Palkina T.
Published: May 2021

The article suggests paying attention to the possibilities of teachers to help a child in the formation of emotional intelligence. In particular, the prerequisites for this, which exist in Montessori pedagogy, are considered. It is argued that this pedagogy allows the development of emotional intelligence in children from very infancy. The authors provide proofs of this thesis, relying on the theory and modern practice of ‘Toddler’ Montessori classes.
Strength-based Versus Deficit-based Action Learning for Developing Leaders, Teams, and Organizations in Asia: A Field Report of an Appreciative Inquiry and Action Learning Practitioner
Authors: Tsui Corothy
Published: May 2021

Formal learning that equips learners with programmed knowledge extracted from the past is no longer sufficient. Action learning was founded to help managers deal with new unknowns. The author of this article poses the question ‘is it possible to run a deficit-based method positively using an Appreciative Inquiry model?’ using a case study from.
Sustainable Development and Landscape Protection in Low-Income Urban Coastal Areas: Empowerment Through Sovereignty and Deliberative Participation
Authors: Meilasari-Sugiana Astrid , Madonna Sandra , Putri Dianingtyas , Solikhah Solikhah
Published: May 2021

Background: The Government of Indonesia is currently implementing its Coastal Community Economic Empowerment Program or Pemberdayaan Ekonomi Masyarakat Pesisir (PEMP) to numerous coastal communities in the island of Java, Sumatra, Sulawesi, Kalimantan and Nusa Tenggara. The program is geared to empower local coastal communities through its integrated, holistic vision, its local-based, participatory method, and its public-partnership approach. Locality is important since the program aims to induce local initiatives and retain social and economic progress within the area, taking into account its ecological carrying capacity. Method: The research is a qualitative inquiry using ethnomethodological tools and purposive, snowball sampling. The research was conducted in 2015-2016 in Cilacap, Central Java.   Data analysis was conducted through tabulation, categorization, comparison, conceptualization and theorization. Results: Issues beset the government’s PEMP program, including its utilitarian framework to coastal resource governance, its adverse incorporation of small fishermen into the fishing industries, and its unsustainable public-private partnership to promote entrepreneurial growth. Attempts to resolve those issues include ensuring that funding for the PEMP program is incorporated within the yearly provincial and regency budgets and regulations, instilling consensus building over the program’s direction and activities with local communities and the private sector through the Provincial and Regency Level People’s Representative Council, and brokering with local communities and the private sector to achieve workable common ground should conflicts arise. Conclusion: Establishing sound intervention policies and programs require securing flexibility and adaptive management capacity through negotiations and brokering.
Cuidados maternos em ambiente penal: representação por meio de desenho-estória
Authors: Ferreira Ana Claudia Rodrigues , Rouberte Emília Soares Chaves , Nogueira Daiany Maria Castro , Maia Rebecca Silveira , Costa Edmara Chaves , Aguiar Maria Isis Freire de
Published: May 2021

Objetivo: compreender os sentimentos maternos em relação ao cuidado com o filho dentro da unidade penal. Método: a pesquisa tem abordagem qualitativa. Participaram do estudo gestantes a partir do terceiro trimestre e mães que se encontravam com os filhos no berçário de uma unidade Penal em Aquiráz/Ceará, totalizando 17 participantes nos 9 encontros realizados. A coleta se deu entre junho e outubro de 2018. Foi usada a técnica de Desenho-Estória. A análise dos desenhos foi feita de forma individual com cada detenta e categorizada pelas pesquisadoras. O trabalho obteve aprovação do Comitê de Ética. Resultados: a atividade de Desenho-Estória possibilitou a compreensão do sentimento materno em relação aos cuidados com os filhos e, a partir disso, foi possível a definição de ações vistas como cuidado dentro da unidade. Conclusão: a partir da análise da vivência da maternidade na prisão, é possível a compreensão de sentimentos que perpassam o desenvolvimento do papel materno.
Xavier, Lídia de Oliveira; Ávila, Carlos F. Domínguez; Fonseca, Vicente (Orgs.). Política, Cultura e Sociedade na América Latina: estudos interdisciplinares e comparativos - Volume 6. 1ª ed. Curitiba: Editora CRV, 2020, 510 p., ISBN:978-85-444-3629-5
Authors: Marques Ricardo Almeida
Published: May 2021

O livro é composto de vinte e dois capítulos, tendo por eixo principal a análise de diversos aspectos concernentes à América Latina, sobretudo relacionados a aspectos políticos, culturais e sociais. Ele possui devido valor para pesquisadores estudando a região, servindo de fonte para dados úteis, bem como de motivador para importantes questionamentos e reflexões pertinentes. Além disso, mostra-se uma leitura enriquecedora também para curiosos sobre o território latino-americano.Palavras-chave: América Latina; Sul Global; Política Latino-Americana. ABSTRACTThe book is composed of twenty-two chapters, the main axis being the analysis of several aspects concerning Latin America, mainly related to political, cultural and social aspects. It has due value for researchers studying the region, serving as a source of useful data, as well as a motivator for important questions and pertinent reflections. In addition, an enriching reading is also shown for those curious about the Latin American territory.Keywords: Latin America; Global South; Latin American Politics. Recebido em: 22 ago. 2020 | Aceito em: 19 mar. 2021.
Neto, Tomaz; Prado, Henrique (Orgs). União Europeia – Visões Brasileiras. 1 ed. Curitiba: Appris Editora, 2019, 255p. ISBN: 978-85-473-3200-6
Authors: De Araujo Flavia Loss
Published: May 2021

A obra discute diversos aspectos da União Europeia e de seu relacionamento com o Brasil que, apesar de longo, ainda não rompeu os limites do desconhecimento mútuo. Assim, os artigos analisam as experiências da integração europeia nas áreas do comércio, direitos humanos, educação, regulação de fronteiras e cooperação internacional, propondo a ampliação dessas agendas de pesquisa a partir de perspectivas brasileiras.Palavras-chave: União Europeia; Integração regional; Cooperação internacionalABSTRACTThe work discusses several aspects of the European Union (EU) and its long relationship with Brazil, seeking to identify areas of synergy to expand the partnership between the two actors. The authors emphasize the need for more work that addresses the theme and consolidates this research agenda in Brazil, especially in a context of growing distance between Brazil and the EU. Thus, the articles analyze the experiences of European integration in the areas of trade, human rights, education, border regulation and international cooperation, proposing the discussion of these themes from Brazilian perspectives. Keywords: European Union; Regional integration; International cooperation.Recebido em: 25 jan. 2021 | Aceito em: 30 mar. 2021.
What is lifestyle medicine and how can it help our patients?
Authors: Whitehead Katie
Published: May 2021

Lifestyle interventions can have a big impact on patients. Katie Whitehead explores what can be done to promote these simple lifestyle changes
Understanding autism in nursing practice
Authors: Palmer Sarah Jane
Published: May 2021

It is important that nurses working in general practice have an understanding of autism. Sarah Jane Palmer gives her perspective, as a nurse and someone with autism
RESEARCH ROUNDUP
Authors: Winter George
Published: May 2021

George Winter provides an overview of recently published articles that are of interest to practice nurses. Should you wish to look at any of the papers in more detail, a full reference is provided.
Nanostructure regularity in white beetle scales for stability and strong optical scattering [Invited]
Authors: Lee Seung Ho , Han Sang M. , Han Sang Eon
Published: May 2021

Cyphochilus white beetle scales exhibit exceptionally strong light scattering power that originates from their regular random fibrillar network nanostructure. The structure is believed to be formed by late-stage spinodal decomposition in a lipid membrane system. However, the structure is characterized by nonconstant mean curvatures and appreciable anisotropy, which are not expected from late-stage spinodal decomposition, so that the surface free energy is not minimized. Nevertheless, a high degree of regularity represented by the relatively uniform fibril dimensions and smooth fibril surfaces in the structure may result from a process similar to spinodal decomposition. In this study, we investigate the role of regularity in the Cyphochilus white beetle scale structure in realizing strong light scattering. Irregularity is computationally introduced into the structure in a systematic fashion such that its anisotropy is preserved and its surface area is kept constant. Calculations show that optical scattering power decreases as irregularity increases with a high sensitivity. This effect happens because, remarkably, irregularity on a scale much smaller than the wavelength destroys anisotropy in optical diffusion. Thus, the result shows that the in vivo process in Cyphochilus white beetle scales utilizes structural regularity and anisotropy to achieve strong light scattering at a tolerable surface free energy. In typical fabrication of random media, irregularity and multiple length scales typically increase surface area, so that durability of the nanostructures may be negatively affected. Our study indicates that regularity in anisotropic random nanostructures can achieve strong light scattering with a moderate surface free energy.
Outdoor cycling activity affected by COVID-19 related epidemic-control-decisions
Authors: Schweizer Anne-Maria , Leiderer Anna , Mitterwallner Veronika , Walentowitz Anna , Mathes Gregor Hans , Steinbauer Manuel Jonas
Published: May 2021

Aim

The lockdown of sports infrastructure due to the COVID-19 pandemic has substantially shifted people’s physical activity towards public green spaces. With Germany’s lockdown as one of the more severe governmentally imposed epidemic-control-decisions, we tested to what extent the frequency of outdoor cycling activities changed from March to June 2020.

Methods

User behaviour and frequency in 15 urban and 7 rural German public green spaces was quantified using cycling data from the fitness application Strava. Changes in cycling activities were analysed with four different generalised linear models, correcting for factors like weather conditions and temporal changes in the user base of the fitness application.

Results

We found a clear increase in outdoor cycling sport activities in urban public green spaces in response to epidemic-control decisions (e.g. increase by 81% in April relative to the expected value (95% CI [48%, 110%])). In contrast, biking in rural areas showed no significant change with epidemic-control-decisions in place.

Conclusion

Fitness App data, e.g. from Strava, can be used to monitor visitor behaviour and frequency. The increase in outdoor cycling activities during epidemic control decisions likely reflects a shift of sport activities from indoor and team sports to outdoor and individual sports. This highlights the importance of accessible green space for maintaining physical fitness and health. Beyond this shift, it is likely that outdoor activities may be of particularly importance for stress relief in times of crisis such as the current COVID-19 pandemic.
The use of digital texture image analysis in determining the masticatory efficiency outcome
Authors: Milić Lemić Aleksandra , Rajković Katarina , Radović Katarina , Živković Rade , Miličić Biljana , Perić Mirjana
Published: May 2021

The mixture level of gum samples consisting of two colours can be assessed visually, using the electronic colorimetric method, employing digital image processing techniques and specially designed software. The study investigates the possibility of an alternative method called “digital texture image analysis” (DTIA) to assess improvement of masticatory efficiency in denture wearers. The objectives were i) to evaluate whether DTIA discriminates changes in the colour mixing ability within a group over time; ii) to determine whether DTIA can be used to detect improvement in chewing ability; iii) to select the most appropriate DTIA feature that sufficiently describes masticatory efficiency in CDs wearers. The study was designed as an intra-individual evaluation of masticatory efficiency, which was assessed in participants with new dentures in three follow-up times. A set of four texture features was used in the current study. Uniformity, Contrast, Homogeneity and Entropy of the obtained chewing-gum samples were correlated to the degree of gum comminution. A statistically significant difference in masticatory efficiency was observed based on the values of the analysed DTIA variables of gum samples—Uniformity, Contrast, Homogeneity, and Entropy—have changed in the participants during the observation period. The improvement of the masticatory function in relation to the mixing ability of two-coloured chewing gum could be traced by monitoring changes in the values of DTIA variables. The most increasement of masticatory efficiency was observed by monitoring DTIA parameters such as contrast, and homogeneity.
Covichem: A biochemical severity risk score of COVID-19 upon hospital admission
Authors: Bats Marie-Lise , Rucheton Benoit , Fleur Tara , Orieux Arthur , Chemin Clément , Rubin Sébastien , Colombies Brigitte , Desclaux Arnaud , Rivoisy Claire , Mériglier Etienne , Rivière Etienne , Boyer Alexandre , Gruson Didier , Pellegrin Isabelle , Trimoulet Pascale , Garrigue Isabelle , Alkouri Rana , Dupin Charles , Moreau-Gaudry François , Bedel Aurélie , Dabernat Sandrine
Published: May 2021

Clinical and laboratory predictors of COVID-19 severity are now well described and combined to propose mortality or severity scores. However, they all necessitate saturable equipment such as scanners, or procedures difficult to implement such as blood gas measures. To provide an easy and fast COVID-19 severity risk score upon hospital admission, and keeping in mind the above limits, we sought for a scoring system needing limited invasive data such as a simple blood test and co-morbidity assessment by anamnesis. A retrospective study of 303 patients (203 from Bordeaux University hospital and an external independent cohort of 100 patients from Paris Pitié-Salpêtrière hospital) collected clinical and biochemical parameters at admission. Using stepwise model selection by Akaike Information Criterion (AIC), we built the severity score Covichem. Among 26 tested variables, 7: obesity, cardiovascular conditions, plasma sodium, albumin, ferritin, LDH and CK were the independent predictors of severity used in Covichem (accuracy 0.87, AUROC 0.91). Accuracy was 0.92 in the external validation cohort (89% sensitivity and 95% specificity). Covichem score could be useful as a rapid, costless and easy to implement severity assessment tool during acute COVID-19 pandemic waves.