bluuebunny/crossref_metadata_2025 huggingface dataset:
Radionuclide Imaging for Neuroscience: Current Opinion and Future Directions
Authors: Gee Antony D. , Herth Matthias M. , James Michelle L. , Korde Aruna , Scott Peter J. H. , Vasdev Neil
Published: September 2020

This meeting report summarizes a Consultants Meeting that was held at International Atomic Energy Agency headquarters in Vienna to provide an update on radionuclide imaging for neuroscience applications.
An Epigenetic Perspective on Lifestyle Medicine for Depression: Implications for Primary Care Practice
Authors: Lee Jenny Sunghyun , Jaini Paresh Atu , Papa Frank
Published: September 2020

Depression is the most common presenting mental health disorder in primary care. It is also a major contributor to somatic complaints, worsening of chronic medical conditions, poor quality of life, and suicide. Current pharmacologic and psychotherapeutic approaches avert less than half of depression’s cumulative burden on society. However, there is a growing body of research describing both how maladaptive lifestyle choices contribute to the development and worsening of depression and how lifestyle-oriented medical interventions can reduce the incidence and severity of depression. This research, largely derived from an emerging field called epigenetics, elucidates the interactions between our lifestyle choices and those epigenetic factors which mediate our tendencies toward either health, or the onset, if not worsening of disease. The present review highlights how lifestyle choices involving diet, physical activity, sleep, social relationships, and stress influence epigenetic processes positively or negatively, and thereby play a significant role in determining whether one does or does not suffer from depression. The authors propose that medical training programs consider and adopt lifestyle medicine oriented instructional initiatives that will enable tomorrow’s primary care providers to more effectively identify and therapeutically intervene in the maladaptive choices contributing to their patients’ depression.
A reward–punishment feedback control strategy based on energy information for wrist rehabilitation
Authors: Wang Jiajin , Zhang Jiaji , Zuo Guokun , Shi Changcheng , Guo Shuai
Published: September 2020

Based on evidence from the previous research in rehabilitation robot control strategies, we found that the common feature of the effective control strategies to promote subjects’ engagement is creating a reward–punishment feedback mechanism. This article proposes a reward–punishment feedback control strategy based on energy information. Firstly, an engagement estimated approach based on energy information is developed to evaluate subjects’ performance. Secondly, the estimated result forms a reward–punishment term, which is introduced into a standard model-based adaptive controller. This modified adaptive controller is capable of giving the reward–punishment feedback to subjects according to their engagement. Finally, several experiments are implemented using a wrist rehabilitation robot to evaluate the proposed control strategy with 10 healthy subjects who have not cardiovascular and cerebrovascular diseases. The results of these experiments show that the mean coefficient of determination ( R 2) of the data obtained by the proposed approach and the classical approach is 0.7988, which illustrate the reliability of the engagement estimated approach based on energy information. And the results also demonstrate that the proposed controller has great potential to promote patients’ engagement for wrist rehabilitation.
How to lead a successful university transformation: The case of École Polytechnique Fédérale de Lausanne (EPFL)
Authors: Jiang Xiaohua
Published: September 2020

Research universities worldwide have been taking reform actions to enhance their competitiveness in the global higher education market; however, the implementation of new initiatives may lead to challenges for university leadership. Faculty resistance is regarded as one of the most common obstacles faced by university leaders. Taking a qualitative approach based on Kotter’s leading change model, this study adopts École Polytechnique Fédérale de Lausanne as a case study to explore change management strategies adopted by university leadership in an attempt to ensure a planned transformational change. By analysing 22 interviews with university administrators and faculty members, this study reveals that the president of École Polytechnique Fédérale de Lausanne managed changes through approaches that included vision creation, coalition formation, communication, faculty empowerment and culture consolidation. Additionally, the study shows that Kotter’s change model, which was designed for business organizations, could not be applied to the analysis of the change management process in the context of higher education without modifications due to institutional and cultural differences.
Job demands amid work intensity: British Columbia school administrators’ perceptions
Authors: Wang Fei
Published: September 2020

Job demands overburden school administrators’ personal and professional capacity and affect their performance and well-being. However, studies on principals and vice-principals’ work intensification fail to highlight how their work demands and challenges are manifested, and how work demands contribute to the changing nature of their work. This qualitative study explores in what ways job demands are manifested in school administers’ intensified work conditions and how their perceptions of job demands help them create a sense of control. The study utilizes the job demands model as a framework to help closely examine two types of job demands: job challenges; and job hindrances though principals’ accounts. The results show that job challenges tend to be transitory and are more likely to be overcome; job hindrances however tend to be more institutional and less temporary and harder to overcome. Attempting to deal with job challenges the same as dealing with job hindrances may become challenging itself and build up rather than alleviate work-related stress among school principals.
Memetic copaganda: Understanding the humorous turn in police image work
Authors: Wood Mark A , McGovern Alyce
Published: September 2020

Recently, numerous police organisations have made a strategic decision to employ humour on social media, via memes and other comical posts, to increase community engagement with their content and manage their public image. One key example of this practice comes from New South Wales Police, a state-based Australian police force whose self-described ‘meme strategy’ led to considerable increases in the organisation’s social media following. Through analysing the content of NSW Police’s memetic copaganda, in this article we unpack this approach to police public relations, detailing its rationale and implications. Police on social media, we argue, must address two very different regimes of visibility: ‘policing’s new visibility’, characterised by the increased visibility of police indiscretion as a result of citizen-produced content, and a ‘threat of invisibility’, in which the visibility of police-produced content on social media is always provisional, never assured. We consequently argue that the humorous turn in police image work represents a countermeasure to not only policing’s new visibility but also the ‘threat of invisibility’ facing police-produced content on social media.
Global transcriptome analysis of rat dorsal root ganglia to identify molecular pathways involved in incisional pain
Authors: Tran Phu V , Johns Malcolm E , McAdams Brian , Abrahante Juan E , Simone Donald A , Banik Ratan K
Published: September 2020

To develop non-opioid therapies for postoperative incisional pain, we must understand its underlying molecular mechanisms. In this study, we assessed global gene expression changes in dorsal root ganglia neurons in a model of incisional pain to identify pertinent molecular pathways. Male, Sprague–Dawley rats underwent infiltration of 1% capsaicin or vehicle into the plantar hind paw (n = 6–9/group) 30 min before plantar incision. Twenty-four hours after incision or sham (control) surgery, lumbar L4–L6 dorsal root ganglias were collected from rats pretreated with vehicle or capsaicin. RNA was isolated and sequenced by next generation sequencing. The genes were then annotated to functional networks using a knowledge-based database, Ingenuity Pathway Analysis. In rats pretreated with vehicle, plantar incision caused robust hyperalgesia, up-regulated 36 genes and downregulated 90 genes in dorsal root ganglias one day after plantar incision. Capsaicin pretreatment attenuated pain behaviors, caused localized denervation of the dermis and epidermis, and prevented the incision-induced changes in 99 of 126 genes. The pathway analyses showed altered gene networks related to increased pro-inflammatory and decreased anti-inflammatory responses in dorsal root ganglias. Insulin-like growth factor signaling was identified as one of the major gene networks involved in the development of incisional pain. Expression of insulin-like growth factor -2 and IGFBP6 in dorsal root ganglia were independently validated with quantitative real-time polymerase chain reaction. We discovered a distinct subset of dorsal root ganglia genes and three key signaling pathways that are altered 24 h after plantar incision but are unchanged when incision was made after capsaicin infiltration in the skin. Further exploration of molecular mechanisms of incisional pain may yield novel therapeutic targets.
At the end: A vignette-based investigation of strategies for managing end-of-life decisions in the intensive care unit
Authors: Reader Tom W , Dayal Ria , Brett Stephen J
Published: September 2020

Background

Decision-making on end-of-life is an inevitable, yet highly complex, aspect of intensive care decision-making. End-of-life decisions can be challenging both in terms of clinical judgement and social interaction with families, and these two processes often become intertwined. This is especially apparent at times when clinicians are required to seek the views of surrogate decision makers (i.e., family members) when considering palliative care.

Methods

Using a vignette-based interview methodology, we explored how interactions with family members influence end-of-life decisions by intensive care unit clinicians ( n = 24), and identified strategies for reaching consensus with families during this highly emotional phase of care.

Results

We found that the enactment of end-of-life decisions were reported as being affected by a form of loss aversion, whereby concerns over the consequences of not reaching a consensus with families weighed heavily in the minds of clinicians. Fear of conflict with families tended to arise from anticipated unrealistic family expectations of care, family normalization of patient incapacity, and belief systems that prohibit end-of-life decision-making.

Conclusions

To support decision makers in reaching consensus, various strategies for effective, coherent, and targeted communication (e.g., on patient deterioration and limits of clinical treatment) were suggested as ways to effectively consult with families on end-of-life decision-making.
Salter-Harris II distal radial fractures treated with the intrafocal K-wire technique: a retrospective study of 20 cases
Authors: Jerome J. Terrence Jose
Published: September 2020

We retrospectively reviewed 20 children with Salter-Harris II fractures of the distal radius treated with intrafocal pinning according to Kapandji. Unlike conventional crossed K-wire pinning, this method avoids crossing the physis with the pins and thus minimizes the risk of physeal damage. None of the children had fracture re-displacement, angulation or growth deformities. The age, sex, side of injury, fracture displacement or angulation, treatment delay or immobilization period had any significant impact on the functional outcome. At a mean follow-up of 49 months (range 47–60), plain radiographs and MRI showed no growth arrests or physeal bars or bridges. Grip strength, wrist motion and patient-reported outcomes were almost normal with no or minimal pain at the injury site. We conclude that intrafocal K-wire pinning is simple, safe and affordable. We cannot provide data on what is acceptable fracture displacement for different age groups to allow for acceptable final remodelling of any malalignment.

Level of evidence: IV
A quality improvement project to standardise decontamination procedures in a single NHS board in Scotland
Authors: Shepherd Emer , Leitch Anne , Curran Evonne ,   Infection Prevention and Control Team NHS Lanarkshire
Published: September 2020

Background:

A project was designed to improve decontamination procedures in our hospitals. This included: improving skills with training provided within clinical areas, simplifying procedures to reduce variation and increasing access to decontamination products.

Aim:

To make it easy for healthcare workers (HCWs) to do the right thing and for HCWs to be confident that they were doing the right thing.

Methods:

A pre-intervention survey of 120 HCWs in 10 wards on three hospital sites identified variations in the products used, variations in precautions taken and deficits in HCWs’ capabilities due to unmet training needs.

Intervention:

We streamlined the available products, provided an education programme and then undertook a second survey involving 133 HCWs in 12 wards.

Results:

Significant improvements were attained in the reported time taken to clean and disinfect ( P < 0.0001) and in HCW capability ( P < 0.0001) (reported training received); other improvements in the use of appropriate products and the use of personal protective equipment were evident. The key finding was that a large, previously unrecognised, unmet training need existed; only 44% of HCWs in the pre-intervention survey reported having received training on the topic.

Conclusion:

The utility of a pre-intervention survey is critical to knowing whether any change becomes improvement and to set the priorities for change. By focusing on the process rather than the outcomes, greater improvements can be attained. The assumption that all nurses know how to clean is erroneous.
Radiofrequency ablation in combination with an mTOR inhibitor restrains pancreatic cancer growth induced by intrinsic HSP70
Authors: Gao Shanshan , Pu Ning , Yin Hanlin , Li Junhao , Chen Qiangda , Yang Minjie , Lou Wenhui , Chen Yi , Zhou Guofeng , Li Changyu , Li Guoping , Yan Zhiping , Liu Lingxiao , Yu Jun , Wang Xiaolin
Published: September 2020

Background:

Radiofrequency ablation (RFA) is widely used in palliative therapy of malignant cancers. Several studies have shown its applicability and safety for locally advanced pancreatic cancer (LAPC). The objective of this study was to modify the current regimen to improve its therapeutic effect.

Methods:

Immune cell subtypes and related cytokines were quantified to uncover the immune pattern changes post-RFA treatment. Then, high-throughput proteome analysis was performed to identify differentially expressed proteins associated with RFA, which were further validated in in vitro and in vivo experiments. Finally, a combined therapy was tested in a murine model to observe its therapeutic effect.

Results:

In preclinical murine models of RFA treatment, no significant therapeutic benefit was observed following RFA treatment. However, the proportion of tumor-infiltrating CD8+ T cells was significantly increased, whereas that of regulatory T cells (Tregs) was decreased post-RFA treatment, which indicated a beneficial anti-tumor environment. To identify the mechanism, high-throughput mass spectrum was obtained that identified heat shock protein 70 (HSP70) as the top differentially expressed protein. HSP70 expression in residual cancer cells was significantly increased post-RFA treatment, which notably promoted pancreatic cancer growth. Elevated HSP70 promoted cell proliferation by activating AKT–mTOR signaling. Finally, RFA treatment combined with an mTOR inhibitor exerted a synergetic repressive effect on tumor growth in the preclinical murine cancer model.

Conclusions:

RFA treatment in combination with mTOR signaling blockade can not only promote tumor immune response, but also restrain residual cancer cell proliferation. Such a combination may be a promising and effective therapeutic strategy for LAPC patients.
Rutin as a Promising Inhibitor of Main Protease and Other Protein Targets of COVID-19: In Silico Study
Authors: Al-Zahrani Ateeq Ahmed
Published: September 2020

The process of investigating a possible cure for coronavirus disease 2019 (COVID-19) in vitro and in vivo may take a long time. For this reason, several in silico studies were performed in order to produce preliminary results that could lead to treatment. Extract of Juniperus procera Hochst is used as a traditional medicine for recovery from flu in Saudi Arabia. In the present study, more than 51 phytochemicals of J. procera were docked against the main protease of COVID-19. Rutin gave the highest interaction score among all the phytochemicals and the commercially available antiviral drugs. Lopinavir showed the second highest binding score. Rutin and lopinavir were further investigated using homology models of COVID-19. Rutin showed a better inhibition score in 9 of the 11 of homology models compared with lopinavir. Analysis of ligand-protein interaction contacts revealed that 3 residues (Glu166, Gly143, and Thr45) of the main protease formed hydrogen bonds with rutin. This simulation study suggests that rutin could be a possible effective inhibitor of several COVID-19 protein targets, including the main protease. Rutin, already available for commercial use, was evaluated for its ability as a possible drug. To our knowledge, this is the first study that suggests rutin having a possible strong inhibitory role against several protein targets of COVID-19.
Study of the Mechanism of the Reyanning Mixture Involved in Treating Novel Coronavirus Pneumonia Based on Network Pharmacology
Authors: Yang Anping , Liu Hui , Liu Fang , Fan Lixia , Liao Wanqin , Guo Jialiang , He Kan
Published: September 2020

At present, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread all over the world, and the best way to effectively carry out drug diagnosis and treatment presents difficulties for all medical staff. In China, some traditional Chinese medicines (TCMs) have been successfully applied to the treatment of SARS-CoV-2 and have achieved good clinical results, including the Reyanning mixture. In this study, we systematically analyzed the mechanism of the Reyanning mixture and its effects against SARS-CoV-2 based on the method of network pharmacology. Here, we used the TCM Systems Pharmacology database and employed a similarity algorithm to screen and identify the bioactive ingredients and potential targets of the Reyanning mixture. The GeneCards database was used to predict and screen the disease targets and build the active ingredient target network diagram. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed to construct the target signal pathway associations. The STRING tool was used to reconstruct the protein-protein interaction network. As a result, 27 candidate targets, such as tumor necrosis factor, interferon gamma, tumor protein P53, C-reactive protein, and peroxisome proliferator-activated receptor gamma, were identified among the 33 bioactive ingredients of the 4 TCMs in the Reyanning mixture with effects on treating SARS-CoV-2. These targets were significantly enriched in 20 KEGG pathways and associated with 48 diverse GO terms. All of these targets may play a role in inhibiting inflammatory reactions, regulating immune function, and reducing lung injury to achieve the purpose of treating SARS-CoV-2.
Lower Limb Salvage Using Patent-Specific 3D-Printed Titanium Cage Following Severe Left Ankle Traumatic Partial Amputation: A Pediatric Case Report
Authors: Dow Todd , Lowe Dani , Morash Joel
Published: September 2020

Background

Patients with large bony defects of the ankle who wish to avoid amputation have limited surgical intervention options for limb salvage. Each of these interventions are technically complex and present significant risk for complications. The use of a patient-specific 3D-printed titanium cage in conjunction with a tibiotalocalcaneal (TTC) arthrodesis using a retrograde nail is another management option. This case adds to the scarce published literature on this technique.

Case presentation

This report presents the case of a 16-year-old female who suffered a traumatic partial amputation of her left distal lower extremity following an all-terrain-vehicle accident that resulted in a 10.0 × 10.0 cm skin laceration and a 5-cm subsegmental bony loss of the distal tibia. She was successfully treated using a patient-specific 3D-printed titanium truss cage in conjunction with a TTC arthrodesis using a retrograde nail.

Conclusions

The decision to amputate or attempt limb salvage in a severely injured lower limb is still a topic of active debate. However, literature has shown that patients who undergo limb salvage surgery have better psychological health outcomes and equivalent functional outcomes as patients who have undergone amputation. Therefore, research on techniques that optimize and advance limb salvage surgery is needed. As the numerous potential benefits and limitations of patient-specific 3D-printed implants are assessed throughout the field of orthopedics, further research and cost-analysis will be required. Cases such as the one presented add to the limited existing literature of patient-specific 3D-printed implant for treatment of large distal lower extremity bony defects.

Levels of Evidence

Level V (Case Report)
A successful management of late-presenting transposition with intact septum and severe coarctation of the aorta
Authors: Busro Pribadi Wiranda , Sani Alvin Ariyanto , Caesario Michael
Published: September 2020

A 13-week-old baby was referred with dextrocardia, situs inversus, transposition of the great arteries, intact ventricular septum, patent foramen ovale, right aortic arch with severe preductal aortic coarctation and large patent ductus arteriosus. Left ventricular mass index as well as thickness was adequate, 118 g/m2 and 5.9 mm, respectively; thus, a primary arterial switch with aortic coarctation repair was performed. The patient made a full recovery without the need for extracorporeal life support. Adequate left ventricular mass index and thickness in late-presenting transposition of the great arteries with intact ventricular septum might justify primary arterial switch.
Cannabis Use for Restless Legs Syndrome and Uremic Pruritus in in patients treated with maintenance dialysis: A Survey
Authors: Samaha Daniel , Kandiah Trisha , Zimmerman Deborah
Published: September 2020

Background:

Restless legs syndrome (RLS) and uremic pruritus reduce the quality of life in patients with end-stage kidney disease (ESKD) and current treatments are often insufficient. There is an increasing interest in using cannabinoids for symptom management, and preliminary evidence suggests cannabinoids may help alleviate RLS and pruritus.

Objectives:

(1) To assess the frequency and severity of RLS and pruritus in our ESKD population with the current treatment options, (2) to estimate patient use of cannabinoids for these symptoms, and (3) to determine interest in participating in future trials to treat RLS and/or pruritus.

Design:

Survey.

Patients:

Adult prevalent patients with ESKD treated with dialysis at the Ottawa Hospital.

Measurements:

International RLS Study Group Rating Scale and visual analogue scale for symptom severity of RLS and pruritus, respectively.

Methods:

Eligible patients with ESKD treated at the Ottawa Hospital were invited to complete a survey to identify symptoms and severity of RLS and pruritus using validated scales, cannabis use for management, and interest in future trials. Basic demographic statistics to describe the study population and results were used.

Results:

Sixty-nine percent (192 of 277) of eligible patients completed the surveys, 35 declined participation, and 50 surveys were not returned. Eighty-six (45%) and 129 patients (67%) reported symptoms of RLS and pruritus, respectively. Only 18 previously symptomatic patients were relieved with current treatment. Fifteen patients reported cannabis use for symptoms; 9 noted improvement. Most (>2 of 3) symptomatic patients were interested in participating in a future trial.

Limitations:

Single-center study in a tertiary-care hospital in Canada limiting generalizability. Quoted prevalence of symptoms is dependent on survey return.

Conclusions:

A large proportion of ESKD patients suffer from RLS and/or pruritus, most of which are not relieved by existing treatments. Few patients reported trying cannabis to decrease their symptoms despite legalization. This study confirms strong patient interest for future trials regarding cannabis for symptom relief.

Trial Registration:

Not applicable.
Frailty and the Kidney Transplant Wait List: Protocol for a Multicenter Prospective Study
Authors: Tennankore Karthik K. , Gunaratnam Lakshman , Suri Rita S. , Yohanna Seychelle , Walsh Michael , Tangri Navdeep , Prasad Bhanu , Gogan Nessa , Rockwood Kenneth , Doucette Steve , Sills Laura , Kiberd Bryce , Keough-Ryan Tammy , West Kenneth , Vinson Amanda
Published: September 2020

Background:

Understanding how frailty affects patients listed for transplantation has been identified as a priority research need. Frailty may be associated with a high risk of death or wait-list withdrawal, but this has not been evaluated in a large multicenter cohort of Canadian wait-listed patients.

Objective:

The primary objective is to evaluate whether frailty is associated with death or permanent withdrawal from the transplant wait list. Secondary objectives include assessing whether frailty is associated with hospitalization, quality of life, and the probability of being accepted to the wait list.

Design:

Prospective cohort study.

Setting:

Seven sites with established renal transplant programs that evaluate patients for the kidney transplant wait list.

Patients:

Individuals who are being considered for the kidney transplant wait list.

Measurements:

We will assess frailty using the Fried Phenotype, a frailty index, the Short Physical Performance Battery, and the Clinical Frailty Scale at the time of listing for transplantation. We will also assess frailty at the time of referral to the wait list and annually after listing in a subgroup of patients.

Methods:

The primary outcome of the composite of time to death or permanent wait-list withdrawal will be compared between patients who are frail and those who are not frail and will account for the competing risks of deceased and live donor transplantation. Secondary outcomes will include number of hospitalizations and length of stay, and in a subset, changes in frailty severity over time, change in quality of life, and the probability of being listed. Recruitment of 1165 patients will provide >80% power to identify a relative hazard of ≥1.7 comparing patients who are frail to those who are not frail for the primary outcome (2-sided α = .05), whereas a more conservative recruitment target of 624 patients will provide >80% power to identify a relative hazard of ≥2.0.

Results:

Through December 2019, 665 assessments of frailty (inclusive of those for the primary outcome and all secondary outcomes including repeated measures) have been completed.

Limitations:

There may be variation across sites in the processes of referral and listing for transplantation that will require consideration in the analysis and results.

Conclusions:

This study will provide a detailed understanding of the association between frailty and outcomes for wait-listed patients. Understanding this association is necessary before routinely measuring frailty as part of the wait-list eligibility assessment and prior to ascertaining the need for interventions that may modify frailty.

Trial Registration:

Not applicable as this is a protocol for a prospective observational study.
Self-reported non-communicable diseases and associated socio-demographic status among ethnic minority populations in Vietnam, 2019
Authors: Van Minh Hoang , Long Khuong Quynh , Ha Nguyen Thanh , Duong Doan Thi Thuy , Trung Tran , Huong Hoang Thi , Van Huan Nguyen , Hanh Tran Thi Tuyet , Lan Vu Thi Hoang , Huong Nguyen Mai , Oanh Luu Thi Kim , Trang Nguyen Thi Thu , Quang Cao Huu , Thanh Nguyen Duc , Anh Bui Thi My , Ha Bui Thi Thu
Published: September 2020

The aim of this study was to report the prevalence of self-reported non-communicable diseases among ethnic minority populations in Vietnam and related factors. A total of 5033 individuals aged 15 years and older who belonged to ethnic minority populations from 12 provinces in Vietnam completed a household survey. The overall prevalence of self-reported non-communicable diseases was 12.4% (95% CI: 11.5%–13.4%). Cardiovascular diseases were the most prevalent, followed by diabetes. Ethnicity was shown to have an independently significant correlation to having any non-communicable diseases. Older people, near-poor and non-poor people had significantly higher odds of having non-communicable diseases as compared to younger and poor people.
Considerations for Building Sustainable Community Health Worker Programs to Improve Maternal Health
Authors: Mehra Renee , Boyd Lisa M. , Lewis Jessica B. , Cunningham Shayna D.
Published: September 2020

Objectives

Community health workers (CHWs) are a critical part of the healthcare workforce and valuable members of healthcare teams. However, little is known about successful strategies for sustaining CHW programs. The aim of this study is to identify institutional and community factors that may contribute to the sustainability of CHW programs to improve maternal health outcomes.

Methods

We conducted focus groups and in-depth interviews with 54 CHWs, CHW program staff, and community partners involved in implementing three Merck for Mothers-funded CHW programs in the United States serving reproductive-age women with chronic health conditions. Additionally, a review of documents submitted by CHW programs during the evaluation process provided context for our findings. Data were analyzed using an inductive qualitative approach.

Results

Three themes emerged in our analysis of factors that may influence the sustainability of CHW programs to improve maternal health: CHW support from supervisors, providers, and peers; relationships with healthcare systems and insurers; and securing adequate, continuous funding. Key findings include the need for CHWs to have strong supervisory structures, participate in regular care team meetings, and interact with peers; advantages of CHWs having access to electronic health records; and importance of full-cost accounting and developing a broad base of financial support for CHW programs.

Conclusion

Research should continue to identify best practices for implementation of such programs, particularly regarding effective supervisory support structures, integration of programs with healthcare systems, and long-term revenue streams.
Flipping the Classroom to Enhance Academic Vocabulary Learning in an English for Academic Purposes (EAP) Course
Authors: Knežević Ljiljana , Županec Vera , Radulović Branka
Published: September 2020

The present study explores the efficiency of the flipped classroom approach on English for Academic Purposes (EAP) students’ academic vocabulary acquisition in comparison with the conventional teaching approach. The efficiency is examined by evaluating students’ post-test performance, self-perceived mental effort employed in completing post-test tasks, and perceptions regarding the learning experiences. To this end, 60 undergraduates divided into flipped (E) and conventional (C) group participated in the survey. Quantitative data analysis revealed that the flipped classroom approach showed higher instructional efficiency than the conventional approach as the E group significantly outperformed the C group and reported investing considerably lower mental effort in completing the post-test tasks. In addition, the E group expressed significantly more positive perceptions toward the learning experience than the C group. Considering the positive results obtained in the study, the article points out the use of the flipped approach as an example of good practice for enhancing academic vocabulary acquisition in EAP context.
Entrepreneurial Networks and Venture Growth: Insights from Information Technology Firms in an Emerging Market
Authors: Bhushan Bharat , Kovid Raj K. , Kumari Deepa
Published: September 2020

This study uses the network approach of entrepreneurship to investigate the relationship between networks and the growth of entrepreneurial ventures. Most of the earlier researchers have maintained a static view of entrepreneurial networks which underplays the dynamic nature of networks. This study attempts to identify the major network characteristics during different growth stages of the ventures in the context of India. The data were collected from 173 information technology entrepreneurs through a cross-sectional survey. The study found that the characteristics of network diversity and network governance have a significant discriminative magnitude and thus play a significant role across all growth stages. Endorsement and embeddedness characteristics also have a significant discriminative magnitude but not in the initial stages. However, network inertia and relational mix were found to have a discriminative magnitude only during the survival and success stages of growth. Overall, the study contributes to further extend the dynamic view of entrepreneurial networks with evidences from an emerging market.
Patient Information on Benign Colorectal Disease: An Assessment of the Value and Effectiveness of Traditional Methods
Authors: Boyle Connor , Bear Greg , van Winsen Marjolein , Nicholson Gary
Published: September 2020

Health literacy is the best predictor of health status, with patient information leaflets (PILs) commonly used to improve information access. However, they can often be inconsistent. Benign colorectal disease can be challenging for patients and ensuring they are accurate and understandable is important. Available PILs in a tertiary unit were assessed. The Flesch reading ease and Flesch-Kincaid Grade level scores were used to calculate objective readability. Subjective assessment of readability, understandability, and patient opinion was assessed using a questionnaire. All PILs had objective readability scores at age 14 or older, above recommended advice. Three hundred sixty patient questionnaires were collected. The relationship between subjective readability and understandability was significant ( P < .05); the easier a patient was able to read the information the more likely they were to understand it. There was no link between objective and subjective readability—a more difficult calculated reading score didn’t correspond to the patient finding it harder to read. Patients preferring paper information were significantly older than patients who preferred online information ( P = .01). Patient information leaflets remain valued by patients, and PILs that patients find easier to read are then better understood; however, ease of reading is not related to objective readability scoring and there was no consensus that a shift to online information is merited.
Acquisition of Procedural Skills in Preregistration Physiotherapy Education Comparing Mental Practice Against No Mental Practice: The Learning of Procedures in Physiotherapy Education Trial – A Development of Concept Study
Authors: Sattelmayer Karl Martin , Jagadamma Kavi C. , Hilfiker Roger , Baer Gillian
Published: September 2020

Introduction:

Procedural skills are a central element in the education of physiotherapists. Procedural skills relate to the execution of a practical task. An educational intervention, which can be used to support skill acquisition of procedural skills, is mental practice (MP). Several studies have investigated the use of MP or imaging in medical education. This pilot study evaluated the application of MP on the acquisition of procedural skills in physiotherapy education.

Methods:

This pilot randomised controlled study recruited a convenience sample of 37 BSc physiotherapy student participants. Two different complex task procedures (transfer and vestibular rehabilitation) were trained during this study. Participants in both the transfer (task procedure 1) and the vestibular rehabilitation (task procedure 2) arm of the study were randomly assigned to either MP or no MP.

Results:

For the transfer task, median performance at post-acquisition testing showed a moderate effect size in favour of the group using MP ( r: −0.3), but the findings were not statistically significant ( P: 0.2). Similar results were found for the vestibular rehabilitation task ( r: 0.29; P: 0.21). In addition, the self-reported confidence was higher in the MP group.

Conclusion:

Moderate effect sizes were identified in favour of MP at post-acquisition testing. In addition, the between-group difference was higher than the minimally important difference. The feasibility of the study was high based on quantitative feasibility measures such as the recruitment rate. Both these findings suggest larger well-powered studies should be considered to confirm the findings of this pilot study.
Organisation of cingulum bundle fibres connecting the anterior thalamic nuclei with the rodent anterior cingulate and retrosplenial cortices
Authors: Bubb Emma J. , Nelson Andrew J. D. , Cozens Thomas C. , Aggleton John P.
Published: September 2020

Despite considerable interest in the properties of the cingulum bundle, descriptions of the composition of this major pathway in the rodent brain have not kept pace with advances in tract tracing. Using complementary approaches in rats and mice, this study examined the dense, reciprocal connections the anterior thalamic nuclei have with the cingulate and retrosplenial cortices, connections thought to be major contributors to the rodent cingulum bundle. The rat data came from a mixture of fluorescent and viral tracers, some injected directly into the bundle. The mouse data were collated from the Allen Mouse Brain Atlas. The projections from the three major anterior thalamic nuclei occupied much of the external medullary stratum of the cingulum bundle, where they were concentrated in its more medial portions. These anterior thalamic projections formed a rostral-reaching basket of efferents prior to joining the cingulum bundle, with anteromedial efferents taking the most rostral routes, often reaching the genu of the corpus callosum, while anterodorsal efferents took the least rostral route. In contrast, the return cortico-anterior thalamic projections frequently crossed directly through the bundle or briefly joined the internal stratum of the cingulum bundle, often entering the internal capsule before reaching the anterior thalamus. These analyses confirm that anterior thalamic connections comprise an important component of the rodent cingulum bundle, while also demonstrating the very different routes used by thalamo-cortical and cortico-thalamic projections. This information reveals how the composition of the cingulum bundle alters along its length.
Revealing the impact of storm surge on taxi operations: Evidence from taxi and typhoon trajectory data
Authors: Fang Zhixiang , Wu Yichen , Zhong Haoyu , Liang Jianfeng , Song Xiao
Published: September 2020

Storm surges are one of the most destructive natural ocean disasters in the world, which pose a great threat to economic development, public safety, and transport in coastal cities. Investigating the response of urban traffic conditions during storm surges and discovering sensitive urban areas are crucial to urban planning, disaster prevention, and emergency rescue. Therefore, this study investigates the impact of typhoons on taxi operations to target sensitive areas of the city. In this study, the change in taxi service operation in Shenzhen during typhoon storm surges from 2012 to 2014 was explored at the city district scale using a diverse set of data including taxi trajectory data, typhoon track data, and tide level data. Several aspects were included to access this impact, for example the number of daily orders per taxi, the trip length, the degree of closeness to the typhoon-affected area, the coverage area of the taxi service, and the spatial dynamics of the origin and destination matrix. The regular trend and correlation of storm surge elements and taxi parameters were first analyzed. The distribution of the taxi trajectory data was then used to detect variations in the service area, and the reasons for these variations were discussed. The result shows that storm surges with diverse characteristics do affect taxi operations to differing degrees, and that there was a potential correlation between tide level and taxi service area. The sensitive areas for taxis during typhoon storm surges were mainly located at the boundary between the central urban area and other districts of Shenzhen, they were constrained by the dynamic changes in the origins and destinations, and they were likely related to important transportation hubs in the city. This finding provides a reference to support disaster prevention preparedness and decision-making by local authorities.
Perceptions and Preparedness: Preservice Music Educators and Popular Music Teaching Skills
Authors: Sorenson Rachel
Published: September 2020

The purpose of this study was to examine the perceptions of undergraduate music education majors regarding the skills needed to teach popular music classes, and their comfort level with those skills. Preservice music educators ( N = 81) completed a researcher-designed questionnaire describing their previous experiences with popular music, their perceptions of necessary teaching skills for popular music instruction, their comfort level with those skills, and their overall feelings of preparedness to teach popular music. Respondents rated the teaching skills of ear training, piano/keyboard, and informal learning practices as most important. In addition, respondents indicated that they were most comfortable with the teaching skills of singing, music theory, and informal learning practices. In general, respondents felt moderately prepared to teach popular music, but many believed they were lacking important knowledge and skills, including proficiency on various instruments, understanding how to integrate popular music, and music software proficiency. Implications for music educators are discussed.
Periostin: contributor to abnormal airway epithelial function in asthma?
Authors: Burgess Janette K. , Jonker Marnix R. , Berg Marijn , ten Hacken Nick T.H. , Meyer Kerstin B. , van den Berge Maarten , Nawijn Martijn C. , Heijink Irene H.
Published: September 2020

Periostin (POSTN) may serve as a biomarker for Type-2 mediated eosinophilic airway inflammation in asthma. We hypothesised that a Type-2 cytokine, interleukin (IL)-13, induces airway epithelial expression ofPOSTN, which in turn contributes to epithelial changes observed in asthma.

We studied the effect of IL-13 onPOSTNexpression in BEAS-2B and air–liquid interface differentiated primary bronchial epithelial cells (PBECs). Additionally, the effects of recombinant human POSTN on epithelial-to-mesenchymal transition (EMT) markers and mucin genes were assessed.POSTNsingle cell gene expression and protein levels were analysed in bronchial biopsies and induced sputum from asthma patients and healthy controls.

IL-13 increasedPOSTNexpression in both cell types and this was accompanied by EMT-related features in BEAS-2B. In air–liquid interface differentiated PBECs, IL-13 increased POSTN basolateral and apical release. Apical administration of POSTN increased the expression ofMMP-9,MUC5BandMUC5AC. In bronchial biopsies,POSTNexpression was mainly confined to basal epithelial cells, ionocytes, endothelial cells and fibroblasts, showing higher expression in basal epithelial cells from asthma patientsversusthose from controls. A higher level of POSTN protein expression in epithelial and subepithelial layers was confirmed in bronchial biopsies from asthma patients when compared to healthy controls. Although sputum POSTN levels were not higher in asthma, levels correlated with eosinophil numbers and with the coughing-up of mucus.

POSTNexpression is increased by IL-13 in bronchial epithelial cells and is higher in bronchial biopsies from asthma patients. This may have important consequences, as administration of POSTN increases epithelial expression of mucin genes, supporting the relationship of POSTN with Type-2 mediated asthma and mucus secretion.
Elevated D-dimers and lack of anticoagulation predict PE in severe COVID-19 patients
Authors: Mouhat Basile , Besutti Matthieu , Bouiller Kevin , Grillet Franck , Monnin Charles , Ecarnot Fiona , Behr Julien , Capellier Gilles , Soumagne Thibaud , Pili-Floury Sébastien , Besch Guillaume , Mourey Guillaume , Lepiller Quentin , Chirouze Catherine , Schiele François , Chopard Romain , Meneveau Nicolas
Published: September 2020

Background

Coronavirus disease 2019 (COVID-19) may predispose to venous thromboembolism. We determined factors independently associated with computed tomography pulmonary angiography (CTPA)-confirmed pulmonary embolism (PE) in hospitalised severe COVID-19 patients.

Methods

Among all (n=349) patients hospitalised for COVID-19 in a university hospital in a French region with a high rate of COVID-19, we analysed patients who underwent CTPA for clinical signs of severe disease (oxygen saturation measured by pulse oximetry ≤93% or breathing rate ≥30 breaths·min−1) or rapid clinical worsening. Multivariable analysis was performed using Firth penalised maximum likelihood estimates.

Results

162 (46.4%) patients underwent CTPA (mean±sdage 65.6±13.0 years; 67.3% male (95% CI 59.5–75.5%). PE was diagnosed in 44 (27.2%) patients. Most PEs were segmental and the rate of PE-related right ventricular dysfunction was 15.9%. By multivariable analysis, the only two significant predictors of CTPA-confirmed PE were D-dimer level and the lack of any anticoagulant therapy (OR 4.0 (95% CI 2.4–6.7) per additional quartile and OR 4.5 (95% CI 1.1–7.4), respectively). Receiver operating characteristic curve analysis identified a D-dimer cut-off value of 2590 ng·mL−1to best predict occurrence of PE (area under the curve 0.88, p<0.001, sensitivity 83.3%, specificity 83.8%). D-dimer level >2590 ng·mL−1was associated with a 17-fold increase in the adjusted risk of PE.

Conclusion

Elevated D-dimers (>2590 ng·mL−1) and absence of anticoagulant therapy predict PE in hospitalised COVID-19 patients with clinical signs of severity. These data strengthen the evidence base in favour of systematic anticoagulation, and suggest wider use of D-dimer guided CTPA to screen for PE in acutely ill hospitalised patients with COVID-19.