bluuebunny/crossref_metadata_2025 huggingface dataset:
Channel geomorphology and riparian vegetation interactions along four anabranching reaches of the Upper Yellow River
Authors: Han Meiqin , Brierley Gary
Published: July 2020

The fluvial biogeomorphic succession (FBS) phase model is used to appraise biogeomorphic interactions along four anabranching reaches of the Upper Yellow River. Geomorphic features and vegetation distribution patterns are combined to assess the dominant FBS phase. A notable increase in shrub and tree cover and a decrease in sedges occur with decreasing elevation from 4200 to 2200 m asl. The Maduo reach (4185 m) is characterized by the biogeomorphic phase, while the Dari (3960 m) reach is at the pioneer phase, with short shrubs playing a prominent role. Both the Maqu (3450 m) and the Guide (2117 m) reaches are ecological phase dominated (the Guide reach has been impacted by flow regulation in recent decades). Reaches other than the Maduo have experienced an increase in post-pioneer vegetation (woody plants) in recent decades, with a decrease in pioneer plant communities (grass and sedges). The Dari reach experienced the most dynamic channel planform changes, with a marked increase in short shrub patches from 2007 to 2017. An increase in woody vegetation underpinned increasingly stable geomorphic dynamics in the Maqu reach. Human activities have restricted geomorphic impacts of expanded areas of woody riparian vegetation in the Guide reach. Variability in dominant FBS phases exerts a primary control upon channel behavior and evolutionary traits in the four study reaches.
All the world's a stage: How Irish immigrants negotiated life in England in the 1950s/1960s using Goffman's theory of impression management
Authors: Maye-Banbury Angela
Published: July 2020

This paper uses oral history to consider the relative merits of symbolic interactionism in revealing new insights regarding the Irish immigration experience in England during the 1950s and 1960s. Using a variety of rubrics attributed to Canadian sociologist Erving Goffman, I critically examine the nature of identity work performed by Irish men and women when in their new host country. The paper highlights the interface between citizenship and sociocultural identity epitomised by both the use props (corporeal modifications) and the power of sign vehicles, notably Irish accents in shaping the nature of social interactions. The extent to which Goffman neglects sensory driven constructs of identity is highlighted. The way in Irish immigrants negotiated two simultaneous worlds front and back stage in response to the anticipated reaction of the given audience evokes the metaphor of a revolving door of identity fluid and chameleon like in nature. Actions were at times driven the anticipated reactions of others following presentation but then reclaimed elsewhere manifested by front and back stage behaviours. The Irish men and women worked inside and alongside systems of control where their identities were contested, ambiguous, or problematised to create a fluid sense of self (selves).
Development of Gentamicin Resistance During Treatment of Escherichia coli Ventilator-Associated Pneumonia in a Neonate
Authors: Newby Brandi D.
Published: July 2020

A neonate born at 25 + 1/7 weeks developed ventilator-associated pneumonia at 29 + 3/7 weeks post-menstrual age with Escherichia coli that was originally sensitive to gentamicin. After 3 days of treatment with gentamicin, the minimum inhibitory concentration (MIC) changed from less than 1 mg/L to more than 16 mg/L. It appears that suboptimal gentamicin dosing led to the development of gentamicin resistance. As the patient was not improving clinically, the antibiotics were changed once the gentamicin resistance was identified. To minimize resistance and treatment failure, clinicians should consider the patient-specific pharmacokinetic parameters, achieved peak level, and the amount of time the gentamicin level will remain below the MIC of the organism being treated.
Epstein–Barr virus, cytomegalovirus and BK polyomavirus burden in juvenile systemic lupus erythematosus: correlation with clinical and laboratory indices of disease activity
Authors: Aygun Deniz , Kuskucu Mert Ahmet , Sahin Sezgin , Adrovic Amra , Barut Kenan , Yıldız Mehmet , Sharifova Sabina , Midilli Kenan , Cokugras Haluk , Camcıoglu Yıldız , Kasapcopur Ozgur
Published: July 2020

Objectives

Clinical and laboratory investigations have revealed that Epstein–Barr virus (EBV) is involved in altered immunological response of systemic lupus erythematosus (SLE). Higher seroprevalence rates of anti-EBV antibodies and increased viral load are demonstrated in adult SLE patients. The prevalence of BK polyomavirus (BKV) reactivation is also suggested to be higher in SLE. Herein, we aimed to evaluate the immune response of children with SLE to EBV antigens in addition to EBV and BKV DNA. We also tried to evaluate whether these serological results differ from another connective tissue disease – juvenile systemic sclerosis (jSS) – and healthy individuals.

Methods

Serum levels of EBV early antigen diffuse (EA-D) IgG, EBV nuclear antigen-1 IgG, EBV viral capsid antigen (VCA), cytomegalovirus (CMV) IgG, EBV DNA, CMV DNA and urinary BKV DNA were evaluated in healthy controls and in patients with a diagnosis of juvenile SLE (jSLE) and jSS.

Results

A total of 70 jSLE patients, 14 jSS patients and 44 sex-matched healthy individuals were involved in the study. EBV VCA was positive in 84.2% of jSLE patients, 85.7% of jSS patients and 36.3% of healthy controls. EBV EA-D IgG positivity was significantly higher in jSLE patients compared to jSS patients and healthy controls (20% vs. 7.1% and 0%, p = 0.005). EBV VCA positivity was associated with malar rash and immunological disorder, but there was no statistical significance in other antibody positivity in terms of clinical and haemogram findings and autoantibody positivity. CMV DNA positivity was present in only 2.8% of jSLE patients. None of the jSS patients or the healthy controls had CMV DNA positivity. EBV DNA and BKV DNA were also negative in all three groups.

Conclusion

The results of our study assume a relationship between SLE and EBV, but we could not demonstrate an association between CMV and BKV. The negative DNA results in contrast to serological positivity can be interpreted as an altered and impaired immune system and increased viral susceptibility. These results suggest that EBV contributes to disease continuity, even if it does not directly cause development.
Electroacupuncture for post-stroke overactive bladder: a multi-centre pilot randomized controlled trial
Authors: Chen Haiyong , Wang Changde , Zhou Minjie , Yan Chan Pui , Lo Yam Lo , Lok Lam Wing , Leung Kwok-Pui , Li Sheung-Wai , Tsang Wai-Yin , Fung-Leung Ng Bacon , Tat-Chi Ziea Eric , Yeung Wing-Fai , Lao Lixing
Published: July 2020

Background

Although acupuncture has been shown to be effective at treating overactive bladder (OAB) following stroke, to our knowledge, no randomized controlled trial (RCT) examining the effects of acupuncture on patients with post-stroke OAB has been conducted. The aim of this preliminary study was to explore the effects of electroacupuncture (EA) in the treatment of post-stroke OAB.

Methods

This study was a multi-site randomized, assessor-blind, controlled pilot trial of patients with post-stroke OAB. In all, 34 post-stroke subjects (mean age: 71.0 years; 32.4% female) with OAB symptoms were randomly assigned to the treatment group or control group in a 1:1 ratio. The subjects in the treatment group were treated with six sessions of EA for 4 weeks, while the subjects in the control group received usual care. The primary outcome measure was the overactive bladder symptom scale (OABSS). Secondary outcome measures included a three day bladder diary and the stroke-specific quality-of-life scale (SSQoL).

Results

EA showed a moderate effect size (ES) on the perceived severity of OAB symptoms as measured by the OABSS at week 5 (one week post-treatment, ES 0.57; p = 0.034) and week 8 (three weeks post-treatment, ES 0.60; p = 0.021), although the results did not remain statistically significant after Bonferroni correction for multiple testing. No significant differences in bladder diary parameters or SSQoL score were found. The EA treatment was well tolerated by the post-stroke subjects.

Conclusion

A six-session EA treatment was feasible and appeared to reduce OAB symptoms in post-stroke patients. Further fully powered trials are warranted to confirm the efficacy of EA for those with post-stroke OAB.
Real-time and field monitoring of the key parameters in industrial trough composting process using a handheld near infrared spectrometer
Authors: Huang Yuanping , Sun Xiaoxi , Liao Keke , Han Lujia , Yang Zengling
Published: July 2020

Producing organic fertilizer by aerobic composting is an effective way to solve the livestock manure pollution problem and to achieve economic utilization of the valuable resource. To control the composting process effectively and ensure the quality of such organic fertilizers, it is necessary to quantify the key parameters and provide timely feedback of their changes during the composting process. In the industrial field, the traditional laboratory analysis is being transferred into process analysis. This study explored the application of real-time and field monitoring of the key parameters in the industrial trough composting process using handheld near infrared (NIR) spectroscopy and evaluated its ability to accurately predict these changes. The results showed that the handheld NIR could accurately detect moisture content (MC), total nitrogen (TN), total carbon (TC), the carbon/nitrogen (C/N) ratio, organic matter (OM) and electrical conductivity (EC) during the trough composting process, with excellent predictions for MC, good predictions for TN and OM, approximate predictions for TC, C/N ratio and EC. Changes in NIR-predicted values and measured values were consistent as the composting process progressed. The handheld NIR sensor shows good potential for real-time and field monitoring of the composting process and organic fertilizer quality assurance.
Prevalence and Characteristics of Home-Based Child Care Providers Serving Children With Provider-Reported Disabilities
Authors: Hooper Alison , Hallam Rena
Published: July 2020

This study examines the prevalence of home-based child care providers who report serving at least one child whom they identify as having a disability. Although many families choose home-based child care, researchers know very little about how many home-based providers care for young children with disabilities. Through secondary analysis of the National Survey of Early Care and Education (NSECE) data about home-based child care providers, we examined the prevalence and predictors of serving children with provider-reported disabilities among listed and unlisted home-based providers. Descriptive analyses showed that 21.7% of listed providers, 20.5% of unlisted paid providers, and 10.1% of unlisted unpaid providers reported serving at least one child whom they identified as having a disability. These providers reported relatively low rates of connecting families to outside resources and utilizing outside resources to support them in their work with children. Providers who reported higher enrollment and who received child care subsidies were more likely to report serving a child with a disability.
Correlation of 3D Joint Space Width From Weightbearing CT With Outcomes After Intra-articular Calcaneal Fracture
Authors: Day Molly A. , Ho Michael , Dibbern Kevin , Rao Karan , An Qiang , Anderson Donald D. , Marsh J. Lawrence
Published: July 2020

Background:

Posttraumatic osteoarthritis (PTOA) of the subtalar joint is a serious, disabling, and frequent complication following intra-articular calcaneal fractures (IACFs). Using plain radiographs to assess the subtalar joint for PTOA is imprecise and insensitive, hindering progress toward improving treatment and assessing outcomes. This study explored how low-dose weightbearing computed tomography (WBCT) can be used to provide reliable, quantitative 3D measures of subtalar joint space width (JSW) following IACF and correlated the 3D JSW with clinical outcomes.

Methods:

After institutional review board approval, 21 patients (15 male; age, 28-70 years) who sustained IACFs and were treated with percutaneous surgical reduction underwent WBCT scans at follow-up visits 2 to 15 years (average, 7.8 years) after surgical treatment. Subtalar joint 3D JSW was computed after a semiautomated protocol was used to segment the talus and calcaneus from the WBCT data. Mean and minimum 3D JSW measurements were calculated and compared with Kellgren-Lawrence (KL) radiographic osteoarthritis grade, RAND-36 Physical (PCS) and Mental (MCS) Component Scores, and visual analog scale (VAS) pain scores. Spearman’s rank correlation was used to detect the strength of association between variables, with significance set at P < .05.

Results:

Mean 3D JSW values measured from WBCT for patients with IACFs ranged from 0.9 to 2.5 mm (1.7 ± 0.4 mm) over the entire subtalar joint. Intra- and interrater reliabilities for the WBCT-based JSW measurement technique were 0.95 (95% CI, 0.91-0.97) and 0.97 (95% CI, 0.95-0.98), respectively. Mean and minimum 3D JSW values correlated inversely with VAS pain scores and KL grade ( P < .05), particularly in central and posterior subtalar regions.

Conclusion:

WBCT-based methods were used to quantify the preservation/loss of JSW in patients with IACFs, enabling more accurate, definitive measurement of subtalar PTOA. The results of this study demonstrate that WBCT can be utilized to objectively assess subtalar PTOA and help us to better understand how arthritic changes affect actual patient experience.

Level of Evidence:

Level III, prognostic comparative study.
Spatialities of queer globalization: Middle- and working-class Hong Kong gay men’s subjective constructions of homophobia
Authors: Yu Ting-Fai
Published: July 2020

This article formulates a class critique that fosters productive tensions between global queering discourses and a Chinese homophobic order affecting Hong Kong and other ethnic Chinese societies. Vis-à-vis middle- and working-class Hong Kong gay men’s subjective constructions of homophobia, the findings demonstrate that class was configured through different geographical referents of everyday queer struggle, namely the West and China, with which my informants compared Hong Kong. This spatial manifestation of class was the result of an unequal cosmopolitan condition which enabled my middle-class informants to see, while excluding their working-class counterparts from seeing, Hong Kong as a gay-friendly city. Drawing on the geography of sexuality and the sociology of class and mobility, this article argues that Hong Kong is a significant site for understanding multidirectional flows of queer globalization.
Enhancing police engagement: An examination of the links between fair treatment and job engagement in a Canadian police organization
Authors: Workman-Stark Angela
Published: July 2020

This study examined the relationships between organizational justice and job engagement, and whether these relationships were stronger for civilian staff vs police officers. Using survey data from a Canadian police organization, the results suggested that when police personnel perceived they were treated fairly, they were more likely to have a sense of psychological safety, which, in turn, enhanced their identification with their organization and increased their engagement with work. Findings further demonstrated that distributive justice (i.e., equitable outcomes) was more important to police officers than civilian staff, particularly, in relation to enhancing their attachment with the organization. In other words, as perceptions of distributive justice increased so did organizational identification; however, this effect was strongest for police officers. In general, organizational justice has positive implications for police organizations, namely in encouraging police personnel to engage their full selves at work.
Reclaiming learning
Authors: Papastephanou Marianna
Published: July 2020

Many educational philosophers have criticized the shift from lifelong education to lifelong learning. Gert Biesta, in particular, claims that learning individualistically promotes ‘learnification’, that is, a pernicious politics at the expense of relational educational experiences. While I endorse many of his critical points, I have argued that his theorization of learning overlooks conceptual nuance and semantic tensions. Ingerid Straume has also illustrated some such tensions by referring to Cornelius Castoriadis’ notion of politics. But, in this article, I wish to develop this critical discussion by examining Castoriadis’ conception of learning alongside Biesta’s. Pointing out ambiguities of learning, I conclude with a conception of learning as diversified and inclusive of anamorphic (transformative) possibilities throughout a person’s life, in tensed company with others and in a complex engagement with the cultural and socio-political milieu.
An Automated Approach to Examining Pausing in the Speech of People With Dementia
Authors: Sluis Rachel A. , Angus Daniel , Wiles Janet , Back Andrew , Gibson Tingting (Amy) , Liddle Jacki , Worthy Peter , Copland David , Angwin Anthony J
Published: July 2020

Dementia is a common neurodegenerative condition involving the deterioration of cognitive and communication skills. Pausing in the speech of people with dementia is a dysfluency that may be used to signal conversational trouble in social interaction. This study aimed to examine the speech-pausing profile within picture description samples from people with dementia and healthy controls (HCs) within the DementiaBank database using the Calpy computational speech processing toolkit. Sixty English-speaking participants between the ages of 53 and 88 years (Mage = 67.43, SD = 8.33; 42 females) were included in the study: 20 participants with mild cognitive impairment, 20 participants with moderate cognitive impairment, and 20 HCs. Quantitative analysis shows a progressive increase in the duration of pausing between HCs, the mild dementia group, and the moderate dementia group, respectively.
Evaluation of an Integrative Care Program in Pediatric Oncology
Authors: Stritter Wiebke , Rutert Britta , Eggert Angelika , Längler Alfred , Holmberg Christine , Seifert Georg
Published: July 2020

Purpose: This article discusses the results of an evaluation of the one-year implementation period of an integrative care program at a pediatric oncology ward, which consists of integrative care treatments offered three times a week to the patients. The guiding questions are how the model was implemented, which factors have to be considered for successful implementation, and which factors showed to be obstacles during implementation. Methods: A mixed-methods approach was applied for data saturation. Qualitative data consist of participant observations and informal conversations during the implementation phase. All observational records were filed in the data program MAXQDA. For the quantitative data, all integrative care treatments applied on the intensive care unit were documented and subsequently filed in an Excel sheet. Both sets of data were analyzed for the evaluation. Results: Four main thematic clusters influenced the implementation: (1) the organization and structure of the intensive care unit; (2) mood and atmosphere; (3) feedback on treatment; and (4) time and experience. All factors are interlinked and cannot be looked at independently. Results of the quantitative data show that the most frequent used treatments were those with calming and relaxing effects, followed by treatments for stomachache, nausea, and obstipation. Conclusions: The implementation of an integrative model of care is a process that demands thorough understanding of the complex setting of the ward, ongoing adaptation to the structures and organization of the ward, and the integration of factors like feedback, time, atmosphere, and the mood of parents, patients, and nurses.
One-Stage Versus Sequential Hybrid Radiofrequency Ablation: An In Vitro Evaluation
Authors: Matteucci Francesco , Maesen Bart , Vernooy Kevin , De Asmundis Carlo , Maessen Jos G. , La Meir Mark , Gelsomino Sandro
Published: July 2020

Objective

To compare lesion size and depth between a 1-step, a sequential, and a delayed radio-frequency ablation in a hybrid setup.

Methods

Left atrium tissues obtained from fresh porcine hearts were mounted into the ABLABOX simulator. Based on the time differences between the index epicardial (epi) and consequent endocardial (endo) ablation, 3 study groups were compared: a 1-stage (SEQ- 0) group (0-minute delay), an SEQ 1 group (60-minute delay), and an SEQ 2 group (240-minute delay). During the experiment, a constant epicardial (300 gr) and endocardial (30 gr) force were applied. Per group, 20 samples were studied, and the resulting lesion size and depth were quantified with morphometric evaluation.

Results

Overall, no transmural lesion was obtained. Lesions in SEQ 0 had better maximum and minimum diameters ( P < 0.001), a larger total area ( P < 0.001), and volume ( P < 0.001) than SEQ 1 and SEQ 2. There was no statistical difference in morphometric parameters (all, P > 0.05) between the delayed procedures (SEQ 1 and SEQ 2).

Conclusions

In our in vitro model, different time sequences of combined epi–endo ablation did not result in transmural lesions. However, simultaneous epi–endo ablation produced broader and deeper lesions. Our findings need to be confirmed by further research.
A prospective randomised study on efficacy of music for decreasing preoperative anxiety in children
Authors: Nguyen Cynthia V , Alvin Madeleine , Lee Carol , George Darrell , Gilmore Allison , Tripi Paul A , Liu Raymond W
Published: July 2020

Background

The operating room can be a frightening environment for paediatric patients. This study investigated whether music medicine can mitigate preoperative anxiety in children.

Materials and methods

One hundred and fifty children undergoing general anaesthesia were randomised to listen to music of the child’s choice, lullaby music or no music before induction. Heart rates were measured in the waiting room, upon first entry into the operating room and just prior to induction.

Results

There was no significant difference in average heart rate change from the waiting room to induction in the patient choice, lullaby and control groups. Older age was associated with higher heart rate changes between baseline and entering the operating room. Pharmacologic sedation showed a significant beneficial effect on heart rate change at induction.

Conclusion

Use of music medicine in the operating room does not show efficacy to reduce anxiety in children based on heart rate changes.
Emerging Neurology of COVID-19
Authors: Somani Sana , Agnihotri Shruti P.
Published: July 2020

The virus, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is responsible for the current pandemic known as coronavirus disease 2019 (COVID-19) with severe respiratory illness as the predominant manifestation. Neurologic complications from COVID-19 were reported in the early stages of the pandemic and are now increasingly recognized. These include various symptoms like headache and anosmia as well as neurologic complications of severe COVID-19 like encephalopathy, seizures, and stroke. There are few reports of direct involvement of the central nervous system with SARS-CoV-2 causing meningoencephalitis. There is concern for higher incidence and severity of COVID-19 in patients with chronic neurologic conditions. Here, we review the emerging literature along with our anecdotal experience in regard to these neurologic manifestations in patients with COVID-19 and detail the putative pathophysiologic mechanisms for the same.
The Status of Arabic Social Psychology: A Review of 21st-Century Research Articles
Authors: Saab Rim , Ayanian Arin H. , Hawi Diala R.
Published: July 2020

This article explores the current state of Arabic social psychology through a selective review of articles written by Arabs, on Arabs, in Arabic (144 articles, published between 2000 and 2015), a basic profiling of first authors, and a regional mapping of graduate social psychology programs. The Levant emerged as the most productive subregion. The most studied topics overall were “the self” and “social adjustment.” Most articles relied primarily on regional references. Furthermore, articles were mostly empirical, correlational, with adult samples, particularly university students. Most first authors were males and very few were specialized in social psychology. Finally, very few graduate social psychology programs were found. We discuss some ways forward for addressing the seemingly marginalized state of social psychology in the Arab region.
Full-Thickness Gluteus Medius Tears With or Without Concomitant Hip Arthroscopy: Minimum 2-Year Outcomes Using an Open Approach and Contemporary Tendon Repair Techniques
Authors: Maldonado David R. , Annin Shawn , Chen Jeffery W. , Rosinsky Philip J. , Shapira Jacob , Lall Ajay C. , Domb Benjamin G.
Published: July 2020

Background:

Gluteus medius (GM) tears are a well-established source of pain and disability. An open approach has been recognized with complete full-thickness and large GM tears, yet the current literature provides few reports on outcomes for this specific situation.

Purpose:

To report and analyze minimum 2-year patient-reported outcomes (PROs) from patients who underwent open GM repair in the setting of a full-thickness tear with or without concomitant hip arthroscopy through use of contemporary tendon repair techniques.

Study Design:

Case series; Level of evidence, 4.

Methods:

Prospectively collected data were retrospectively reviewed for patients who underwent hip preservation surgery and total hip arthroplasty (THA) between April 2008 and May 2017. Patients were included in this study if they underwent open repair of GM full-thickness tears. The exclusion criteria were incomplete follow-up, workers’ compensation status, repair regarding size and pattern of the GM, open repair of partial GM tear, open repair with allograft or autograft augmentation, and/or additional gluteus maximus transfer. Pre- and postoperative PROs for the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score Sport-Specific Subscale (HOS-SSS), and visual analog scale (VAS) score for pain and satisfaction were recorded. Statistical significance was set at P < .05.

Results:

A total of 36 patients were included, of whom 12 received concomitant hip arthroscopy for intra-articular procedures. The mean ± SD age, body mass index, and follow-up time were 65.18 ± 12.69 years, 28.97 ± 4.95 kg/m2, and 40.8 ± 26.19 months, respectively. At minimum 2-year follow-up, the following outcome measures improved significantly: mHHS (from 54.72 ± 15.89 to 73.12 ± 19.47; P < .0001), NAHS (from 56.05 ± 12.47 to 75.22 ± 19.15; P < .0001); HOS-SSS (from 20.30 ± 20.21 to 44.23 ± 35.85; P < .0001), and VAS (from 4.95 ± 2.70 to 2.67 ± 2.81; P < .0001). There was 1 (2.8%) conversion to THA at 48 months after the index procedure.

Conclusion:

Patients who underwent open repairs in the setting of full-thickness GM tears via contemporary tendon repair techniques, with or without concomitant hip arthroscopy, achieved favorable results in several PRO scores at minimum 2-year follow-up.
Effects of Education on the Use of Personal Protective Equipment for Reduction of Contamination: A Randomized Trial
Authors: Yeon Jeong Hwa , Shin Yong Soon
Published: July 2020

Introduction

Accurate doffing personal protective equipment (PPE) is one of the key practices of infection control because of increased risk of infection transmission caused by medical garments or environmental contamination.

Objectives

The study aimed to develop a reality-based education program and identify its effects on nurses’ knowledge, attitudes, and contamination after PPE doffing.

Methods

Randomized control group pretest–posttest design. A total of 56 nurses were randomly assigned to experimental ( n = 28) and control ( n = 28) groups. The experimental group underwent a new reality-based education program to improve PPE use. Subsequently, participants were assessed on knowledge of and attitude toward PPE use, as well as number and area of contaminated sites after removing PPE and mask fitting test.

Results

There were no significant differences in knowledge and attitude to PPE use. The experimental group had significantly fewer contaminated sites than the control group (42 vs. 89), and a significantly lower mean contaminated site area (16.63 ± 24.27 vs. 95.41 ± 117.51 cm2). The tuberculosis mask fitting test success rates were 68% and 50% in the experimental and control groups, respectively, but the difference was not significant.

Conclusion

The reality-based education on use of PPE helps to reduce contamination and improve performance related to the use of PPE for infection control.
The Curriculum at the College of Medicine and Medical Sciences at Arabian Gulf University: A Way Forward to Meet the Future Medical Education Needs
Authors: Bindayna Khalid Mubarak , Deifalla Abdelhalim
Published: July 2020

Arabian Gulf University (AGU) follows a curriculum based on Problem Based Learning (PBL). PBL is a learner-centered approach that empowers students for life-long learning. Students are taught through problems that are designed based on global health problems customized to the local needs. The classroom teaching is complemented through adjunct programs like community health activities and professional skills program. Medical education aims to meet the changing needs of society. Demographics, disease epidemiology and healthcare needs of the gulf countries have changed over 38 years since the inception of AGU. To keep pace with the changing demands, it is imperative that the curriculum is reviewed in the light of advances in technology and newer techniques of medical education.In the present article the curriculum at AGU is reviewed based on the predictors for future medical education and alternative teaching methods that can be integrated to optimize the student outputs are explored.
Spaces of Islamophobia and spaces of inequality in Greater Paris
Authors: Najib Kawtar
Published: July 2020

This paper draws upon quantitative data collected from one of the principal associations fighting Islamophobia in France along with the population census, and provides a step forward in understanding the operation and distribution of Islamophobia. It presents a geography of Islamophobia in Paris based on statistical data, and aims to observe whether or not this geography corresponds or contrasts with geographies of inequality (such as those associated with gentrification, deprivation and marginalisation), by analysing the various spatial patterns stemming from the maps. This socio-spatial analysis of anti-Muslim discrimination is important in Paris because since the terrorist attacks in 2015, anti-Muslim sentiment has increased sharply. The mapping of Islamophobia and its association with the spatial distribution of different socioeconomic and demographic variables synthetized in a typological map display significant forms, relations and diversities within Paris. This cartographic analysis demonstrates that the geography of Islamophobia does not necessarily refer to spaces where ‘Muslims’ and the victims of Islamophobia live in great majority, and rather refers to more privileged and central areas such as Paris intra-muros. Victims mostly experience anti-Muslim incidents outside their everyday spaces away from their homes, such as public institutions and workplaces. Indeed, the findings raise the significance of the exact place where incidents occur as well as societal attitudes to these ‘hierarchical’ places where the perpetrator probably feels more comfortable in behaving in an antisocial and sometimes violent way.
Targeted FGFR inhibition results in a durable remission in an FGFR1-driven myeloid neoplasm with eosinophilia
Authors: Kasbekar Monica , Nardi Valentina , Dal Cin Paola , Brunner Andrew M. , Burke Meghan , Chen Yi-Bin , Connolly Christine , Fathi Amir T. , Foster Julia , Macrae Molly , McAfee Steven L. , McGregor Kristin , Narayan Rupa , Ramos Aura Y. , Som Tina T. , Vartanian Meghan , Friedman Robb S. , Benhadji Karim A. , Hobbs Gabriela S.
Published: July 2020

Key Points

A novel PCM1-FGFR1 gene rearrangement was identified in a patient with a myeloid neoplasm with eosinophilia. Futibatinib, an oral selective small molecule inhibitor of FGFR1-4, resulted in a durable complete hematologic and cytogenetic remission.
Peripherally administered cisplatin activates a parvocellular neuronal subtype expressing arginine vasopressin and enhanced green fluorescent protein in the paraventricular nucleus of a transgenic rat
Authors: Akiyama Yasuki , Yoshimura Mitsuhiro , Ueno Hiromichi , Sanada Kenya , Tanaka Kentaro , Sonoda Satomi , Nishimura Haruki , Nishimura Kazuaki , Motojima Yasuhito , Saito Reiko , Maruyama Takashi , Hirata Keiji , Uezono Yasuhito , Ueta Yoichi
Published: July 2020

Cisplatin is one of the most potent anti-cancer drugs, though several side effects can induce stress responses such as activation of the hypothalamic–pituitary adrenal (HPA) axis. Arginine vasopressin (AVP) and corticotrophin-releasing hormone (CRH) expressed in the parvocellular division of the paraventricular nucleus (pPVN) play an important role in the stress-induced activation of the HPA axis. We aimed to evaluate whether intraperitoneal (i.p.) administration of cisplatin could activate parvocellular neurons in the pPVN, using a transgenic rat model that expresses the fusion gene of AVP and enhanced green fluorescent protein (eGFP). Along with the induction of FosB, a marker of neuronal activation, i.p. administration of cisplatin significantly increased eGFP fluorescent intensities in the pPVN. In situ hybridization histochemistry revealed that AVP-eGFP and CRH mRNAs in the pPVN were increased significantly in cisplatin-treated rats. These results suggest that cisplatin administration increases neuronal activation and upregulates AVP and CRH expression in the pPVN.
A long non-coding RNA, HOTAIR, promotes cartilage degradation in osteoarthritis by inhibiting WIF-1 expression and activating Wnt pathway
Authors: Yang Yang , Xing Dan , Wang Yawei , Jia Haobo , Li Bing , Li Jiao Jiao
Published: July 2020

Background

Long noncoding RNAs (lncRNAs) are recently found to be critical regulators of the epigenome. However, our knowledge of their role in osteoarthritis (OA) development is limited. This study investigates the mechanism by which HOTAIR, a key lncRNA with elevated expression in OA, affects OA disease progression.

Results

HOTAIR expression was greatly elevated in osteoarthritic compared to normal chondrocytes. Silencing and over-expression of HOTAIR in SW1353 cells respectively reduced and increased the expression of genes associated with cartilage degradation in OA. Investigation of molecular pathways revealed that HOTAIR acted directly on Wnt inhibitory factor 1 (WIF-1) by increasing histone H3K27 trimethylation in the WIF-1 promoter, leading to WIF-1 repression that favours activation of the Wnt/β-catenin pathway.

Conclusions

Activation of Wnt/β-catenin signalling by HOTAIR through WIF-1 repression in osteoarthritic chondrocytes increases catabolic gene expression and promotes cartilage degradation. This is the first study to demonstrate a direct link between HOTAIR, WIF-1 and OA progression, which may be useful for future investigations into disease biomarkers or therapeutic targets.
The association between care left undone and temporary Nursing staff ratios in acute settings: a cross- sectional survey of registered nurses
Authors: Senek Michaela , Robertson Steve , Ryan Tony , King Rachel , Wood Emily , Tod Angela
Published: July 2020

Background

The shortage of health workers is a global phenomenon. To meet increasing patient demands on UK health services, providers are increasingly relying on temporary staff to fill permanent posts. This study examines the occurrence of ‘care left undone’, understaffing and temporary staffing across acute sector settings.

Methods

“Secondary data analysis from an RCN administered online survey covering nurses from hospitals and trusts across all four UK countries. Staffing and ‘care left undone’ measures were derived from the responses of 8841 registered nurses across the UK. A locally smoothed scatterplot smoothing regression analysis (Loess) was used to model the relationship between any ‘care left undone’ events and full complement, modest and severely understaffed shifts, and proportions of temporary staff.

Results

Occurrence of ‘care left undone’ was highest in Emergency Departments (48.4%) and lowest in Theatre settings (21%). The odds of ‘care left undone’ increase with increasing proportion of temporary staff. This trend is the same in all understaffing categories. On shifts with a full quota of nursing staff, an increase in the proportion of temporary staff from 0 to 10% increases the odds of care left undone by 6% (OR = 1.06, 95% CI, 1.04–1.09). Within the full quota staffing category, the difference becomes statistically significant (p < 0.05) on shifts with a proportion of temporary nursing staff of 40% or more. On shifts with a full quota of nursing staff the odds of a ‘care left undone’ event is 10% more with the proportion of temporary nursing staff at 50%, compared to shifts with modest understaffing of 25% or less with no temporary nursing staff (OR = 1.1, 95%CI, 0.96–1.25).

Conclusion

The odds of a ‘care left undone’ event are similar for fully staffed shifts with a high temporary nursing staff ratio compared to severely understaffed shifts with no temporary nursing staff. Increasing the proportion of temporary nurse staff is associated with higher rates of self-reported care left undone by nursing staff. This has significant implications for nurse managers and policy makers.
Integration of an interpretable machine learning algorithm to identify early life risk factors of childhood obesity among preterm infants: a prospective birth cohort
Authors: Fu Yuanqing , Gou Wanglong , Hu Wensheng , Mao Yingying , Tian Yunyi , Liang Xinxiu , Guan Yuhong , Huang Tao , Li Kelei , Guo Xiaofei , Liu Huijuan , Li Duo , Zheng Ju-Sheng
Published: July 2020

Background

The early life risk factors of childhood obesity among preterm infants are unclear and little is known about the influence of the feeding practices. We aimed to identify early life risk factors for childhood overweight/obesity among preterm infants and to determine feeding practices that could modify the identified risk factors.

Methods

A total of 338,413 mother-child pairs were enrolled in the Jiaxing Birth Cohort (1999 to 2013), and 2125 eligible singleton preterm born children were included for analyses. We obtained data on health examination, anthropometric measurement, lifestyle, and dietary habits of each participant at their visits to clinics. An interpretable machine learning-based analytic framework was used to identify early life predictors for childhood overweight/obesity, and Poisson regression was used to examine the associations between feeding practices and the identified leading predictor.

Results

Of the eligible 2125 preterm infants (863 [40.6%] girls), 274 (12.9%) developed overweight/obesity at age 4–7 years. We summarized early life variables into 25 features and identified two most important features as predictors for childhood overweight/obesity: trajectory of infant BMI (body mass index) Z-score change during the first year of corrected age and maternal BMI at enrollment. According to the impacts of different BMI Z-score trajectories on the outcome, we classified this feature into the favored and unfavored trajectories. Compared with early introduction of solid foods (≤ 3 months of corrected age), introducing solid foods after 6 months of corrected age was significantly associated with 11% lower risk (risk ratio, 0.89; 95% CI, 0.82 to 0.97) of being in the unfavored trajectory.

Conclusions

The trajectory of BMI Z-score change within the first year of life is the most important predictor for childhood overweight/obesity among preterm infants. Introducing solid foods after 6 months of corrected age is a recommended feeding practice for mitigating the risk of being in the unfavored trajectory.
Addressing advanced HIV disease and mortality in global HIV programming
Authors: Boyd Andrew T. , Oboho Ikwo , Paulin Heather , Ali Hammad , Godfrey Catherine , Date Anand , Sean Cavanaugh J.
Published: July 2020

Introduction

The US President’s Emergency Plan for AIDS Relief (PEPFAR) was launched to increase access to antiretroviral treatment (ART) among people living with HIV (PLHIV) and to prevent new HIV infections globally. As new infections have decreased in many PEPFAR-supported countries, PEPFAR is increasingly focusing on understanding and decreasing mortality among PLHIV, specifically by addressing advanced HIV disease (AHD) and its attendant opportunistic infections (OIs). Several developments in identifying AHD, in preventing, diagnosing, and treating selected OIs, and in PEPFAR’s support for mortality surveillance make this an opportune moment for PEPFAR to address HIV-related mortality.

Discussion

AHD upon diagnosis or re-engagement in HIV care is not uncommon, and it substantially increases risk of death from OIs. The World Health Organization provides evidence-based guidelines for a package of interventions for preventing, diagnosing, and treating common OIs, including tuberculosis (TB), cryptococcal meningitis, and severe bacterial infections. PEPFAR facilitates implementation of these guidelines. To identify PLHIV with low CD4, PEPFAR plans to support expanded access to CD4 testing, including a point-of-care assay that differentiates CD4 cell count as a binary of greater than or less than 200 cells/µL. To prevent AHD-related mortality, PEPFAR supports rapid ART initiation with integrase inhibitor–based regimens and implementation and documentation of TB preventive treatment. To diagnose selected OIs, PEPFAR is implementing urine lateral flow lipoarabinomannan use to identify TB among PLHIV who have a CD4 cell count < 200 cells/µL. To treat selected OIs, PEPFAR has focused on improving patient-centered care in TB/HIV co-infection services and scaling up implementation of new drug regimens for cryptococcal meningitis. To better understand mortality, PEPFAR has introduced an indicator, TX_ML, to routinely and systematically categorize outcomes, including deaths, among PLHIV on ART.

Conclusions

PEPFAR is increasing its efforts to identify AHD; to prevent, diagnose, and treat OIs; and to track mortality in its programs. These ongoing efforts, done in collaboration with other stakeholders, seek to decrease mortality among PLHIV.
Effects of green tea consumption on glycemic control: a systematic review and meta-analysis of randomized controlled trials
Authors: Xu Renfan , Bai Yang , Yang Ke , Chen Guangzhi
Published: July 2020

Background

The results of human clinical trials investigating the effects of green tea on glycemic control are inconsistent.

Methods

We conducted a systematic review and meta-analysis of RCTs that examined the effects of green tea supplementation on glycemic control. A literature search in PubMed, Embase, and Cochrane Library databases for RCTs that investigated the effect of green tea consumption on glycemic control was performed up to February 2020. A random-effects model was used to estimate weighted mean difference (WMD) with 95% confidence intervals (CIs).

Results

Twenty-seven trials involving 2194 subjects were included in the meta-analysis. The pooled results showed that green tea significantly lowered fasting blood glucose by − 1.44 mg/dL (95%CI:-2.26, − 0.62 mg/dL; P < 0.001) with no obvious heterogeneity (I2 = 7.7%). However, green tea consumption did not significantly affect fasting insulin and HbA1c values. The mean differences were − 0.46μIU/mL (95% CI: − 1.10, 0.17μIU/mL; P = 0.21) for fasting insulin and − 0.06%; (95% CI: − 0.12, 0.01%; P = 0.07) for HbA1c concentrations. Heterogeneity was significant in fasting insulin (I2 = 46.8%) and mild in HbA1c (I2 = 1.7%).

Conclusions

In short-term trials, green tea supplementation significantly reduced fasting glucose, but had no significant effect on fasting insulin and HbA1c. Long-term trials assessing the effects of green tea supplementation on glycemic control are needed.
Knowledge transmission patterns at the border: ethnobotany of Hutsuls living in the Carpathian Mountains of Bukovina (SW Ukraine and NE Romania)
Authors: Mattalia Giulia , Stryamets Nataliya , Pieroni Andrea , Sõukand Renata
Published: July 2020

Background

Cross-border research is a novel and important tool for detecting variability of ecological knowledge. This is especially evident in regions recently divided and annexed to different political regimes. Therefore, we conducted a study among Hutsuls, a cultural and linguistic minority group living in Northern and Southern Bukovina (Ukraine and Romania, respectively). Indeed, in the 1940s, a border was created: Northern Bukovina was annexed by the USSR while Southern Bukovina remained part of the Kingdom of Romania. In this research, we aim to document uses of plants for food and medicinal preparations, discussing the different dynamics of Local Ecological Knowledge (LEK) transmission among Hutsuls living in Ukraine and Romania.

Methods

Field research was conducted using convenience and snowball sampling techniques to recruit 31 Hutsuls in Ukraine and 30 in Romania for participation in semi-structured interviews regarding the use of plants for medicinal and food preparation purposes and the sources of such knowledge.

Results

The interviews revealed that, despite a common cultural and linguistic background, ethnobotanical knowledge transmission occurs in different ways on each side of the border. Family is a primary source of ethnobotanical knowledge transmission on both sides of the border; however, in Romania, knowledge from other sources is very limited, whereas in Ukraine interviewees reported several other sources including books, magazines, newspapers, the Internet and television. This is especially evident when analysing the wild plants used for medicinal purposes as we found 53 taxa that were common to both, 47 used only in Ukraine and 11 used only in Romania. While Romanian Hutsuls used almost exclusively locally available plants, Ukrainian Hutsuls often reported novel plants such as Aloe vera, Aronia melanocarpa and Elaeagnus rhamnoides. Knowledge related to these plants was transferred by sources of knowledge other than oral transmission among members of the same family. Therefore, this may imply hybridization of the local body of knowledge with foreign elements originating in the Soviet context which has enriched the corpus of ethnobotanical knowledge held by Ukrainian Hutsuls.

Conclusions

While ethnobotanical knowledge among Romanian Hutsuls is mainly traditional and vertically transmitted, among Ukrainian Hutsuls there is a considerable proportion of LEK that is transmitted from other (written and visual) sources of knowledge. This cross-border research reveals that despite a common cultural background, socio-political scenarios have impacted Hutsul ethnobotanical knowledge and its transmission patterns.