bluuebunny/crossref_metadata_2025 huggingface dataset:
General Surgery Residency and Emergency General Surgery Service Reduces Readmission Rates and Length of Stay in Nonoperative Small Bowel Obstruction
Authors: Manning Sarah Waterman , Orr Scotta L. , Mastriani Katherine S.
Published: September 2020

Background

Nonoperative management of adhesive small bowel obstruction (ASBO) results in resolution for the majority of patients. Previous studies have demonstrated that outcomes for patients with ASBO are improved when patients are admitted to a surgical service, but the effect of general surgery resident coverage is unclear. This study measures quality outcomes for patients with ASBO after the establishment of a new general surgery residency program.

Methods

An institutional review board-approved retrospective chart review of admissions for ASBO was conducted following the implementation of a protocol for ASBO nested within a newly developed resident-run emergency general surgery (EGS) service. Patients successfully treated without operative intervention were analyzed.

Results

During the study period, 612 patients were admitted for ASBO. After initiation of the residency, 74% of ASBO were admitted to a surgical service compared with 35% prior to residency ( P < .01). Length of stay was reduced by 0.77 days ( P = .016), average direct total cost per patient was reduced by 24% ( P = .002), and 30-day readmissions were reduced by 35.7% ( P = .046). There was no significant difference in mortality (1.4% vs 1.0%).

Discussion

Admission to a resident-run surgical service was associated with statistically significant improvement in outcomes for patients with ASBO. These data corroborate prior studies demonstrating the positive impact of residency programs on patient outcomes and provide additional evidence that general surgery residency programs improve outcomes for patients with surgical disease.
Evaluation of Susceptibility Patterns in Uropathogens and Empiric Antibiotic Therapy in the Emergency Department
Authors: Koro Mira , Borgert Samuel , Abbott Andrew , Venugopalan Veena
Published: September 2020

Objectives: Urinary Tract Infections (UTIs) are the most common bacterial infections encountered in the Emergency Department (ED). Objectives of this study are to describe the urological pathogens associated with UTIs in the ED, report antibiotic susceptibilities, and assess empiric antibiotic treatment. Methods: A retrospective chart review of 154 patients with positive urine cultures from January to June 2016 were reviewed for inclusion in the study. Patients were excluded if less than 18 years of age, hospitalized, discharged from the ED without antibiotics or diagnosed with pyelonephritis. Patient demographics, uropathogens isolated, in-vitro susceptibility to commonly prescribed oral antibiotics (nitrofurantoin, ciprofloxacin, and sulfamethoxazole/trimethoprim), and antibiotics selected for treatment were recorded. Results: One hundred patients were included in the final analysis. Of the 106 bacterial isolates, Escherichia coli, Klebsiella pneumoniae, and Group B Streptococcus accounted for 62.5%, 8%, and 8% of pathogens, respectively. Overall susceptibilities were 88.1%, 87.9%, 85.4%, and 70.6% for nitrofurantoin, cefazolin, ciprofloxacin, and sulfamethoxazole/trimethoprim, respectively. Escherichia coli was most susceptible to nitrofurantoin at 96.9% followed by cefazolin at 94%. Ciprofloxacin was the most prescribed antibiotic followed by cephalexin, nitrofurantoin and sulfamethoxazole/trimethoprim. Conclusions: Based on bacterial susceptibility patterns, nitrofurantoin and cephalexin are reasonable first line agents in the empiric treatment of urinary tract infections identified in the emergency department. The most frequently prescribed antibiotic was ciprofloxacin, highlighting the importance of implementing antimicrobial stewardship initiatives and designing specific tools and educational programs for the emergency department targeted at minimizing fluoroquinolone use.
Saliva in the Diagnosis of COVID-19: A Review and New Research Directions
Authors: Fernandes L.L. , Pacheco V.B. , Borges L. , Athwal H.K. , de Paula Eduardo F. , Bezinelli L. , Correa L. , Jimenez M. , Dame-Teixeira N. , Lombaert I.M.A. , Heller D.
Published: September 2020

This review presents literature that highlights saliva’s utility as a biofluid in the diagnosis and monitoring of COVID-19. A systematic search was performed in 5 electronic databases (PubMed, Embase, LILACS, Scopus, and Web of Science). Studies were eligible for inclusion if they assessed the potential diagnostic value and/or other discriminatory properties of biological markers in the saliva of patients with COVID-19. As of July 22, 2020, a total of 28 studies have investigated the presence of SARS-CoV-2 RNA in saliva. Several of those studies confirmed reliable detection of SARS-CoV-2 in the saliva of patients with COVID-19. Saliva offered sensitivity and specificity for SARS-CoV-2 detection comparable to that of the current standard of nasopharyngeal and throat swabs. However, the utility of saliva in diagnosing COVID-19 infection remains understudied. Clinical studies with larger patient populations that measure recordings at different stages during the disease are still necessary to confirm the accuracy of COVID-19 diagnosis with saliva. Nevertheless, the utility of saliva as a diagnostic tool opens the possibility of using rapid and less invasive diagnostic strategies by targeting bioanalytes rather than the pathogen.
Hiding hate speech: political moderation on Facebook
Authors: Kalsnes Bente , Ihlebæk Karoline Andrea
Published: September 2020

Facebook facilitates more extensive dialogue between citizens and politicians. However, communicating via Facebook has also put pressure on political actors to administrate and moderate online debates in order to deal with uncivil comments. Based on a platform analysis of Facebook’s comment moderation functions and interviews with eight political parties’ communication advisors, this study explored how political actors conduct comment moderation. The findings indicate that these actors acknowledge being responsible for moderating debates. Since turning off the comment section is impossible in Facebook, moderators can choose to delete or hide comments, and these arbiters tend to use the latter in order to avoid an escalation of conflicts. The hide function makes comments invisible to participants in the comment section, but the hidden texts remain visible to those who made the comment and their network. Thus, the users are unaware of being moderated. In this paper, we argue that hiding problematic speech without the users’ awareness has serious ramifications for public debates, and we examine the ethical challenges associated with the lack of transparency in comment sections and the way moderation is conducted in Facebook.
Continuous versus intermittent bolus milk feeding in preterm infants: a meta-analysis
Authors: Ye Juan , Chen Hong , Zhang Hong-Gang
Published: September 2020

Objectives

To analyze the evidence comparing the benefits and risks of continuous versus intermittent milk feeding in low birth weight (LBW) infants.

Methods

Three electronic databases were searched and screened to identify randomized controlled trials of continuous and intermittent milk feeding of LBW infants up to October 2016.

Results

Eight trials were included in this meta-analysis. Continuous feeding had no effect on days to full feeds and time to regain birth weight. There were no significant differences in the number of apneas, invasive ventilation, changes in body length, occipitofrontal circumference, skinfold thickness, and total protein, and in the number of stools between the two feeding strategies. Continuous feeding was associated with higher gastric residual volume, noninvasive ventilation, weight gain, increase in bilirubin, and longer nil by mouth. There were no significant differences in adverse events and confounders between the two feeding strategies.

Conclusions

Continuous milk feeding was superior to intermittent feeding in LBW infants in terms of weight gain. However, continuous feeding was also associated with increased nil by mouth duration, increased bilirubin, increased noninvasive support, and increased gastric residuals. Continuous feeding thus confers advantages in terms of weight gain, but also has disadvantages compared with bolus feeding.
Immune-related adverse events associated with immune checkpoint inhibitors in patients with cancer
Authors: Sengul Samanci Nilay , Cikman Duygu Ilke , Oruc Kerem , Bedir Sahin , Çelik Emir , Degerli Ezgi , Derin Sumeyra , Demirelli Fuat Hulusi , Özgüroğlu Mustafa
Published: September 2020

Introduction:

With the widespread use of immune checkpoint inhibitors (ICIs), we are facing challenges in the management of immune-related adverse events (irAEs). We aimed to characterize the spectrum of toxicity, management, and outcomes for irAEs.

Methods:

Patients who were treated with at least one ICI in clinical trials, expanded access programs, or routine clinical practice were included. Clinical and laboratory parameters were collected retrospectively to determine the incidence of irAEs, methods of management, and treatment outcomes.

Results:

A total of 255 patients were screened retrospectively. Of these, 71 (27.8%) patients developed irAEs. More than 2 different types of irAEs were detected in 16 (6.2%) out of 255 patients. A total of 3177 doses were given to 255 patients. In 93 (2.9%) of the 3177 doses, 1 episode of irAEs was experienced. A total of 22 out of 93 (23.7%) episodes were reported as grade 1, 49 (52.7%) as grade 2, 19 (20.4%) as grade 3, and 3 (3.2%) as grade 4. The most frequently seen irAEs were pneumonitis, hepatitis, and hypothyroidism. With regard to treatment, 39 out of 93 episodes (42%) of any grade irAEs occurred after anti–programmed cell death-1 therapy, 47 (50.5%) occurred following administration of anti–programmed death-ligand 1, and 7 (7.5%) occurred after combination treatments.

Conclusion:

With the increased use of immunotherapeutic agents, increased awareness and early recognition are required for effective management of irAEs. Our experience as a single institution might be of use for health care providers in oncology.
Cross-State Comparison of Income and Vehicle-Ownership Effects on Household Mobility
Authors: Chung Yi-Shih , Wu Chi-Hung
Published: September 2020

The study investigated the effects of income and vehicle ownership on household mobility (measured as trip frequency, miles traveled, and transit use) across states on the basis of the 2017 National Household Travel Survey. Bayesian multilevel (or random-effect) regression models were developed to include state-policy variables and overcome the concern of small sample sizes in some household strata. The analysis results indicated that household income levels were positively associated with vehicle ownership and mobility; however, extremely high-income households were not necessarily more likely than high-income households to own more vehicles. Owning at least one vehicle was the norm for most households, except under two conditions: when the household income was extremely low or when the state transit level of service (LOS) was high. Moreover, states with a high transit LOS exhibited similar household mobility as long as households had similar income levels and vehicle ownership rates; by contrast, household mobility in states with a low transit LOS was relatively varied. Fully equipped (at least one vehicle per driver) and car-light households (having more drivers than vehicles) exhibited a similar trip frequency number; however, the vehicle miles traveled of car-light households were significantly shorter, especially in states with a high transit LOS. These results suggest that the mobility benefits of being fully equipped are more limited than we had anticipated. Transit services can affect household vehicle ownership and mobility only when being provided above a certain LOS.
Analysis of Vehicle-Following Behavior in Mixed Traffic Conditions using Vehicle Trajectory Data
Authors: Kashyap N. R. Madhuri , Chilukuri Bhargava Rama , Srinivasan Karthik K. , Asaithambi Gowri
Published: September 2020

In mixed traffic streams without lane discipline, driving behaviors are complex and difficult to model. However, limited attempts have been made to study the characteristics of these maneuvers using trajectory data. This paper proposes a novel use of vehicle trajectory data to identify car–car and auto–car pairs in the following regime and the regime duration, classify pairs as strict and staggered following, and investigate the factors influencing the following vehicle’s speed under different regimes in mixed traffic. Oblique trajectories and relative speed hysteresis plots are used to identify vehicle pairs in the steady-state following regime. Two new variables, oblique spacing (R) and the angle between the leader and the follower (θ), are proposed. Multiple linear regression models for the follower speed in strict and staggered following regimes are developed. The results show that cars exhibit following behavior more often than other vehicles. Also, while car–car pairs display both left and right staggered following, auto–car pairs predominantly demonstrate left staggered following. Regression analysis shows that the relationship between R and the speed of the following vehicle differs significantly when θ is close to 90° than when it deviates from 90°. The speed of followers is affected by leader and relative speeds. However, the relative speed has a smaller influence in both right and left staggered cases than strict follower cases. Finally, this study provides empirical evidence of qualitative and quantitative differences among following behaviors that can help in developing better microscopic traffic flow models for mixed traffic conditions.
Q-Learning-Based Coordinated Variable Speed Limit and Hard Shoulder Running Control Strategy to Reduce Travel Time at Freeway Corridor
Authors: Zhou Weiyi , Yang Mofeng , Lee Minha , Zhang Lei
Published: September 2020

To increase traffic mobility and safety, several types of active traffic management (ATM) strategies, such as variable speed limit (VSL), ramp metering, dynamic message signs, and hard shoulder running (HSR), are adopted in many countries. While all kinds of ATM strategies show promise in releasing traffic congestion, many studies indicate that stand-alone strategies have very limited capability. To remedy the defects of stand-alone strategies, cooperative ATM strategies have caught researchers’ attention and different combinations have been studied. In this paper, a coordinated VSL and HSR control strategy based on a reinforcement learning technique—Q-learning—is proposed. The proposed control strategy bridges up a direct connection between the traffic flow data and the ATM control strategies via intensive self-learning processes, thus reducing the need for human knowledge. A typical congested interstate highway, I-270 in Maryland, United States, was selected as the study area to evaluate the proposed strategy. A dynamic traffic assignment simulation model was introduced to calibrate the network with real-world data and was used to evaluate the regional impact of the proposed algorithm. Simulation results indicated that the proposed coordinated control could reduce corridor travel time by up to 27%. The performance of various control strategies were also compared. The results suggested that the proposed strategy outperformed the stand-alone control strategies and the traditional feedback-based VSL strategy in mitigating congestion and reducing travel time on the freeway corridor.
Pedestrian Fatal Crash Location Analysis in Ohio using Exploratory Spatial Data Analysis Techniques
Authors: Apardian Rebekka E. , Monwar Alam Bhuiyan
Published: September 2020

Pedestrian safety is a top priority within the transportation planning community as cities promote sustainable transportation, alternative travel modes, and healthy lifestyles. If people feel unsafe while walking, they will choose other modes of transportation if they are able. To prioritize safety, it is important to know where pedestrian crashes are occurring and with what severity. Using spatial statistical methods including nearest neighbor index, Moran’s I, local indicators of spatial autocorrelation (LISA), and Getis-Ord G-statistic, this study seeks to analyze the pedestrian fatality locations within the state of Ohio over a 10-year period (2007–2016) to identify hot spots, cold spots, and spatial patterns across three different spatial scales: county, census tract, and traffic analysis zone (TAZ). It seeks to understand the effects of aggregated data across these spatial scales on the outcome of the analysis and determine the most useful spatial scale at which to study pedestrian fatalities. The study concludes that spatial analyses at small scales are most informative. It goes on to recommend locations within Ohio for further analysis based on the resulting maps, including areas with outliers. As of writing this, there is no current statewide pedestrian fatality analysis for the state of Ohio.
Primer on Aircraft Induced Clouds and Their Global Warming Mitigation Options
Authors: Sherry Lance , Thompson Terrence
Published: September 2020

Pressure is increasing on all industrial sectors to address climate sustainability, not only for the welfare of the planet, but also to preserve the customer base and manage operating costs. The aviation industry has a unique opportunity to halve its global radiative forcing (RF) contribution by minimizing the generation of aircraft induced clouds (AIC). These anthropogenic (human-made) condensation trails create a greenhouse effect by absorbing or directing back to Earth approximately 33% of emitted outgoing thermal longwave radiation. The effect of AIC accounts for 2% of the Earth's total anthropogenic RF. The effect of reducing AIC on global warming is immediate (unlike CO2 emissions which have a 2-decade delay in affecting global warming).

This paper describes the physics of AIC formation and RF to identify candidate interventions to reduce AIC RF: 1) reduce the quantity of soot generated, 2) reduce or eliminate ice crystal formation, and 3) modify RF properties of AIC. The highest utility and lowest costs is to reduce ice crystal formation by avoiding cruise flight levels in the atmospheric conditions that are conducive to AIC generation. Reducing soot through drop-in biofuels, and synthetic fuels, require significant investment to scale production. Options that require the redesign of jet engines or use of alternative fuels such as liquid natural gas and liquid hydrogen, require significant research and turn-over of the existing fleets. Fuel additives to suppress ice crystal formation, change the RF properties of ice crystals, or both, are still nascent research topics. The implications and limitations are discussed.
Group-based Compassion-focused Therapy on Experiential Avoidance, Meaning-in-life, and Sense of Coherence in Female Survivors of Intimate Partner Violence with PTSD: A Randomized Controlled Trial
Authors: Daneshvar Somayeh , Shafiei Masumeh , Basharpoor Sajjad
Published: September 2020

The current study was carried out to investigate the effects of compassion-focused therapy (CFT) on experiential avoidance, meaning-in-life, and sense of coherence (SoC) in women suffering from post-traumatic stress disorder (PTSD) due to the intimate partner violence (IPV).

42 women suffering from PTSD due to the IPV exposure were randomized to the two groups of experimental and control (21 per group). All participants completed the questionnaires of experiential avoidance, meaning-in-life, and SoC as pre-test measures. The experimental group received eight sessions of CFT, while the controls did not receive any treatment. After that, all subjects responded to the questionnaires of experiential avoidance, meaning-in-life, and SoC as the post-test measures. Data were analyzed using one-way repeated measures MANOVA.

Subjects of the experimental group indicated a greater reduction in post-test scores of experiential avoidance, and a significant rise in the level of meaning-in-life and its subscales including the presence of meaning-in-life and search for meaning-in-life when compared to the controls. Nevertheless, there was no change in the level of SoC as a function of CFT.

Applying CFT can result in reducing experiential avoidance and raising the meaning of life in women with PTSD due to IPV exposure. CFT is highly recommended to strengthen the well-being of patients with PTSD and reduce the PTSD symptoms.
Medicolegal Implications of Mild Neurocognitive Disorder
Authors: Bejenaru Anca , Ellison James M.
Published: September 2020

Introduction:

The syndromes of mild cognitive impairment (MCI) or mild neurocognitive disorder (MiND), often prodromal to dementia (Major Neurocognitive Disorder), are characterized by acquired clinically significant changes in one or more cognitive domains despite preserved independence. Mild impairment has significant medicolegal consequences for an affected person and their care system. We review the more common etiologies of MiND and provide a systematic review of its medicolegal implications.

Methods:

We conducted a systematic review of the peer-reviewed English literature on medicolegal aspects of MCI or MiND using comprehensive search terms and expanding our review to include sources cited by these reports.

Results:

Impairment of memory, executive function, social cognition, judgment, insight or abstraction can alter an individual’s abilities in a variety of areas that include decision making, informed consent, designation of a surrogate decision-maker such as a health care proxy, understanding and management of financial affairs, execution of a will, or safe driving.

Conclusion:

Even mild cognitive impairment can have significant behavioral consequences. Clinicians can assist care partners and persons with MCI or MiND by alerting them to the medicolegal concerns that often accompany cognitive decline. Early recognition and discussion can help a care system manage medicolegal risk more effectively and promote thoughtful advance planning.
Limitless? Imaginaries of cognitive enhancement and the labouring body
Authors: Bloomfield Brian P. , Dale Karen
Published: September 2020

This article seeks to situate pharmacological cognitive enhancement as part of a broader relationship between cultural understandings of the body-brain and the political economy. It is the body of the worker that forms the intersection of this relationship and through which it comes to be enacted and experienced. In this article, we investigate the imaginaries that both inform and are reproduced by representations of pharmacological cognitive enhancement, drawing on cultural sources such as newspaper articles and films, policy documents, and pharmaceutical marketing material to illustrate our argument. Through analysis of these diverse cultural sources, we argue that the use of pharmaceuticals has come to be seen not only as a way to manage our brains, but through this as a means to manage our productive selves, and thereby to better manage the economy. We develop three analytical themes. First, we consider the cultural representations of the brain in connection with the idea of plasticity – captured most graphically in images of morphing – and the representation of enhancement as a desirable, inevitable, and almost painless process in which the mind-brain realizes its full potential and asserts its will over matter. Following this, we explore the social value accorded to productive employment and the contemporary (biopolitical) ethos of working on or managing oneself, particularly in respect of improving one’s productive performance through cognitive enhancement. Developing this, we elaborate a third theme by looking at the moulding of the worker’s productive body-brain in relation to the demands of the economic system.
Missed opportunities within healthcare for an earlier diagnosis of HIV
Authors: Powell Maria , Krentz Hartmut B , Eagles Matthew E , Gill M John
Published: September 2020

Despite guidelines, many individuals are not routinely tested for HIV within healthcare settings. Our objective was to quantify and characterize preceding clinical encounters by newly-diagnosed persons living with HIV in southern Alberta, Canada. We discuss the clinical impact of missed HIV testing, and options for remediation. Clinical encounters prior to HIV diagnosis including the discharge diagnosis were collected between 1 April 2011 and 1 April 2016. We followed the HIV Indicator Diseases across Europe Study criteria to identify HIV Clinical Indicator Conditions (HCICs) present at clinical encounters. Patients accessing prior care were compared to those who had not previously accessed care. Of 393 individuals, 231 (58.7%) had ≥1 encounter prior to diagnosis; 224 (57%) of encounters occurred in outpatient clinics, 130 (33.1%) in emergency departments, and 39 (9.9%) in urgent care clinics. Approximately 25% (n = 57) of patients who engaged healthcare had ≥ 1 recognized HCIC but did not receive HIV testing. The most frequent HCICs were infection (n = 34; 60%) and hematological disorders (n = 12; 21%). The median CD4 cell count at HIV diagnosis for patients with an HCIC was 127 cells/mm3. In this population, three of five patients had accessed healthcare prior to diagnosis with one of four presenting with HCICs but were not offered HIV testing. Protocols beyond the current recommendations are urgently required to address missed HIV diagnostic opportunities who engaged healthcare.
Late Onset Hypocalcemic Seizures in Formula-Fed, Vitamin D Deficient Babies: Revisited
Authors: Qureshi Umar Amin , Bhat Abdus Sami , Jan Muzaffar , Qureshi Uruj
Published: September 2020

Purpose: Late onset neonatal hypocalcemia (LNH) is defined as hypocalcemia detected after day 3 of life. Its occurrence in babies fed with cow’s milk is well understood. Since the advent of modern-day formulas, the incidence has however decreased.

Methods: A prospective descriptive study (January 2017 to December 2017) of LNH seizures in neonates was conducted. LNH was defined as the total serum calcium of less than 7 mg/dL in preterm or less than 8 mg/dL in term newborns after 72 h of life.

Results: 14 neonates were presented with myoclonic and focal seizures due to late hypocalcemia. All were formula fed. Their mean serum calcium, phosphorus, alkaline phosphatase, magnesium, 25-OH vitamin D, intact PTH levels were 4.93 mg/dL, 9.19 mg/dL, 244 U/L, 1.2 mg/dL, 30 nmol/L, 38.6 pg/mL, respectively. Mean maternal vitamin D levels were 43 nmol/L. Mean hospital stay was 4 days. Clinical response to treatment was brisk in those who were able to shift to total breast feeding early.

Conclusions: LNH in formula-fed and vitamin D deficient babies is not uncommon. Emphasis should be laid on exclusive breast feeding even in vitamin D deplete mothers. However, mothers at risk should be supplemented with vitamin D during pregnancy.
Job Stress and Health of Elementary and Secondary School Educators in the United States
Authors: Landsbergis Paul A. , Shtridler Elina , Bahruth Amy , Alexander Darryl
Published: September 2020

Elementary and secondary school educators face many work stressors, which appear to be increasing due to economic, political, and social trends. Therefore, we analyzed data from a 2017 national American Federation of Teachers survey of U.S. education staff, including data from two New York School districts that have adopted collaborative labor-management practices. The national American Federation of Teachers sample of educators reported significantly higher prevalences of several work stressors and poorer physical and mental health compared to the U.S. workers overall, adjusted for age, gender, and race/ethnicity. Compared with educators nationally, educators in districts with collaborative labor-management practices did not have a consistently higher or lower prevalence of work stressors or poorer health. Findings suggest the importance of reducing work stressors among U.S. educators. Results should be interpreted with caution due to the low educator survey response rate.
A Pedagogy of Play: Reasons to be Playful in Postsecondary Education
Authors: Leather Mark , Harper Nevin , Obee Patricia
Published: September 2020

Background: Teaching experientially in postsecondary education has challenges; institutional constraints, neoliberal management, and a colonized learning environment. We discuss playing as a form of experiential education. Purpose: We challenge conventional teaching and offer an alternative to enrich and broaden conventional pedagogies. We argue for the benefits of playfulness and how this leads to creativity, wellness, and improved graduate employability. Methodology/Approach: As provocation to the consequences of neoliberalism in education, we examine the literature from a biased position as advocates of play and experiential education. We argue for faculty to adopt an ontology and pedagogy of play. Findings/Conclusions: Play is well represented in the literature; contributing positively to a range of health and educational outcomes. As play manifests in numerous forms in postsecondary education, faculty would benefit from a clear educational rationale for an ontology and pedagogy of play. We share examples from our practice which highlight spontaneous and planned play and playful attitudes/behaviors and suggest how play may be integrated as planned curriculum. Implications: Ideally, these concepts resonate with faculty allowing them to challenge conventional pedagogies and confirm play in practice with the underpinning of experiential education research.
A Test of the Reproducibility of the Clustering of Cultural Variables
Authors: Fog Agner
Published: September 2020

Cultural variables from many different cross-cultural studies can be divided into two clusters of variables that are strongly correlated within each cluster. This is reflected in two factors that are found to be reproduced by independent sets of cultural variables and also reflected in several different cross-cultural studies. The first factor, called superfactor, reflects the combined effects of development and modernization, together with social-psychological effects such as collectivism, conservatism, regality, and tightness. The second factor, called East Asian factor, combines several effects related to East Asian cultures, and possibly also differences in response style. These two factors can be found in several previously published cultural maps, but rotated differently. The common practice of factor rotation has obscured similarities between many different cross-cultural studies. Many previously published cultural factors with different names are in fact differently rotated solutions reflecting the same or closely related underlying cultural differences.
Design and vibration suppression performance of magnetic suspension dynamic vibration absorber
Authors: Jin Chaowu , Dong Yue , Guan Xudong , Zhou Jin , Wang Fan
Published: September 2020

In this article, a magnetic suspension technique was introduced into the field of vibration absorption. Using the advantage of adjustable control parameters of a magnetic suspension system, a type of a magnetic suspension dynamic vibration absorber that can achieve broadband vibration suppression was designed. First, the theoretical model of a magnetic suspension dynamic vibration absorber was established. Then, the cantilever beam with sinusoidal excitation is seen as the main system of vibration suppression; combined with the fixed point theory (Seto K (2013) Dynamic Vibration Absorber and its Application. Mechanic Industry Press), the specific structure of the magnetic suspension dynamic vibration absorber was designed. Based on that, the simulation study of vibration suppression performance of the magnetic suspension dynamic vibration absorber was carried out. The results indicated that the vibration of the main system at the 1st modal frequency was reduced by 65.38% under the action of the magnetic suspension dynamic vibration absorber, compared with that without the action of the magnetic suspension dynamic vibration absorber. Furthermore, the vibration of the main system can be suppressed in the frequency band of [16 Hz, 32 Hz]. Finally, a vibration test rig of the magnetic suspension dynamic vibration absorber was built up for experimental study. And the results showed that the absorber can decrease the vibration of the main system by 43.03% at the 1st modal frequency compared with that without the action of magnetic suspension dynamic vibration absorber and had a certain suppression effect (decrease varies from 0 to 43.03%) on the vibration of the main system in the frequency band of [20 Hz, 32 Hz].
Hypertriglyceridemia induced by S-1: A novel case report and review of the literature
Authors: Saito Yoshitaka , Takekuma Yoh , Komatsu Yoshito , Sugawara Mitsuru
Published: September 2020

Introduction

S-1, a compounding agent of tegafur, gimeracil, and oteracil potassium, is one of the most effective chemotherapeutic agents for colorectal cancer. In this case, following S-1 administration, we observed predominant elevation of serum triglyceride.

Case report

A 49-year-old man with stage IV transverse colon adenocarcinoma received S-1 + irinotecan + bevacizumab. At the end of the S-1 administration period in every course, his serum triglyceride level was found to be elevated. Finally, it reached grade 4, without any symptoms of acute pancreatitis in the fifth course, and fenofibrate 80 mg once a day was administered. Management & outcome: Interestingly, the elevation spontaneously normalized without any pharmacotherapy 14 days after S-1 withdrawal, and this elevation did not occur when S-1 was not administered. Further, fenofibrate administration attenuated the hypertriglyceridemia to grades 1-3, with no complications.

Discussion

S-1 administration induced hypertriglyceridemia owing to the elevated serum triglyceride; however, a contrasting result was observed in the S-1 withdrawal period and during the S-1-cessation cycle. Since dietary intake was poorer during the S-1 administration period, it is considered that S-1 might have disturbed lipid metabolism. Further, we know that capecitabine, which is a prodrug of fluorouracil, also induces hypertriglyceridemia. As the end product of these medicines is fluorouracil, the presence of fluorouracil or its metabolizing enzymes, the genetic background of the patient might have affected the results. We have to be aware of the risk of asymptomatic and temporal occurrence of hypertriglyceridemia by S-1 administration for the early detection with appropriate pre-emptive treatment.
Investigating perceptions of patient-centred care in orthodontics
Authors: Amin Nima , Cunningham Susan J , Jones Elinor M , Ryan Fiona S
Published: September 2020

Objectives:

To assess and compare patient and clinician perceptions of patient-centredness for adults about to commence active orthodontic treatment, and to assess whether the following variables affected perceptions of patient-centredness: patient gender and age; clinician gender and grade; and stage of treatment.

Design:

A prospective, cross-sectional questionnaire study.

Setting:

Eastman Dental Hospital, UCLH NHS Foundation Trust.

Participants:

A total of 112 adult patients and 30 clinicians completed 224 questionnaires (112 patient and 112 clinician questionnaires).

Methods:

A validated, dyadic questionnaire, the ‘9-Item Patient Perception of Patient-Centredness’ (PPPC), was used to collect data from both patients and their corresponding clinicians after initial assessment or records/treatment planning consultations. Total PPPC scores (possible score range = 9–36) were calculated for each patient and clinician to ascertain the extent to which they perceived they were engaging in patient-centredness, where higher scores corresponded with better performance.

Results:

Patients and clinicians perceived high engagement in patient-centredness with median scores of 32/36 and 29/36, respectively. There was a statistically significant difference between total scores with patients perceiving consultations to be more patient-centred than clinicians ( P < 0.001). None of the variables (patient gender and age, clinician gender and grade, stage of treatment) were statistically significant.

Conclusion:

Patients and clinicians both perceived high engagement in patient-centredness. Patients perceived consultations to be significantly more patient-centred than clinicians ( P < 0.001).
Near-Infrared Fluorescence Cholangiography can be a Useful Adjunct during Emergency Cholecystectomies
Authors: Di Maggio Francesco , Hossain Naveed , De Zanna Andrea , Husain Danya , Bonomo Luca
Published: September 2020

Background. Emergency cholecystectomy is the gold standard treatment for acute cholecystitis according to National Institute for Health and Care Excellence recommendations. The procedure is feasible but carries a higher risk of iatrogenic injury to the bile duct, which should be considered preventable. Intraoperative fluorescence cholangiography following injection of indocyanine green (ICG) has been reported to aid identification of the extrahepatic bile duct. Data on its feasibility in the context of emergency cholecystectomies are missing. Materials and Methods. Fluorescent ICG was used intraoperatively to enhance the biliary anatomy during 33 consecutive emergency laparoscopic cholecystectomies at our institution. Primary outcomes of surgery were considered the length of hospital stay, conversion to open and complications rate, including bile duct injury. Secondary outcome was operating time. A historical population of emergency cholecystectomies was used as control. Results. There were no common bile duct injuries, no adverse effects from ICG, no conversion to open surgery and no deaths. 90% of patients went home within 48 hours after the operation in the absence of complications. ICG demonstrated intraoperative biliary anatomy allowing greater confidence to the surgeon performing emergency cholecystectomies. Six patients were operated beyond 72 hours from admission, without experiencing any complication Clavien-Dindo ≥3. ICG population had the same post-operative hospitalisation and complications rate of the control group, with a shorter operating time. Conclusion. Intraoperative augmented visualisation of biliary anatomy with ICG cholangiography can be a useful technology tool, with the potential to extend the 72 hours window of safety for emergency cholecystectomies.
Thrombolytic Salvage of the Frostbitten Upper Extremity: A Systematic Review
Authors: Drinane James , Heiman Adee J. , Ricci Joseph A. , Patel Ashit
Published: September 2020

Background

Vascular thrombosis secondary to frostbite can lead to ischemic tissue damage in severe cases. Threatened extremities may be salvaged with thrombolytics to restore perfusion; however, current data are limited to single institution case series. The authors performed a systematic review to determine the efficacy of thrombolytic therapy in treating upper extremity frostbite.

Methods

PubMed, EBSCO, and Google Scholar were queried using the keywords “thrombolytics,” “frostbite,” “fibrinolytics,” and “tPA.” Exclusion criteria were failure to delineate anatomic parts injured, failure to report number of limbs salvaged, animal studies, and non-English language publications. Thrombolytic therapy was defined as intraarterial (IA) or intravenous (IV) administration of tissue plasminogen activator (tPA), alteplase, urokinase, streptokinase, or any tPA derivative.

Results

A total of 42 studies were identified, with 13 satisfying inclusion criteria. Eight studies reported catheter-directed IA thrombolysis, four reported systemic IV administration, and 1 reported both methods. A total of 157 patients received thrombolytics. In all, 73 upper extremity digits were treated by IA route and 136 digits were treated by IV route. Overall upper extremity digit salvage rate was 59%. There was a significantly higher salvage rate in digits treated by the IA route compared to the IV route.

Conclusions

Thrombolytics, particularly when administered by the intra-arterial route, are emerging as a promising treatment of severe frostbite of the upper extremity, increasing digit salvage rates.
The use of alemtuzumab in patients with relapsing-remitting multiple sclerosis: the Gulf perspective
Authors: Alroughani Raed , Van Wijmeersch Bart , Al Khaboori Jabber , Alsharoqi Isa Ahmed , Ahmed Samar F. , Hassan Ali , Inshasi Jihad , Krieger Derk W. , Shakra Mustafa , Shatila Ahmed Osman , Szolics Miklos , Khallaf Mohamed , Ezzat Aly
Published: September 2020

Over the past decade, the development of high-efficacy disease-modifying therapies (DMTs) has been responsible for more effective management of relapsing-remitting multiple sclerosis (RRMS). However, the gaps in optimal care for this complex disease remain. Alemtuzumab (Lemtrada®) is a highly efficacious DMT that shows better patient outcomes and therapeutic benefits, but its use is under-recognized in the Gulf region. Experts in the care of multiple sclerosis shared their opinions based on study data and daily clinical experience in identifying the appropriate patient profile suitable for alemtuzumab’s therapeutic benefits. Age, disease activity and severity, disability status, physician experience, and economic condition are some of the key indicators for alemtuzumab use.
Electronic Diabetes Management System Replaces Paper Insulin Chart: Improved Quality in Diabetes Inpatient Care Processes Due to Digitalization
Authors: Kopanz Julia , Lichtenegger Katharina M. , Koenig Constanze , Libiseller Angela , Mader Julia K. , Donsa Klaus , Truskaller Thomas , Bauer Norbert , Hahn Brigitte , Sendlhofer Gerald , Beck Peter , Höll Bernhard , Sinner Frank , Feichtner Franz , Pieber Thomas R.
Published: September 2020

Background:

GlucoTab, an electronic diabetes management system (eDMS), supports healthcare professionals (HCPs) in inpatient blood glucose (BG) management at point-of-care and was implemented for the first time under routine conditions in a regional hospital to replace the paper insulin chart.

Method:

To investigate quality of the eDMS for inpatients with type 2 diabetes mellitus a monocentric retrospective before-after evaluation was conducted. We compared documentation possibilities by assessing a blank paper chart vs the eDMS user interface. Further quality aspects were compared by assessing filled-in paper charts ( n = 106) vs filled-in eDMS documentation ( n = 241). HCPs ( n = 59) were interviewed regarding eDMS satisfaction.

Results:

The eDMS represented an improvement of documentation possibilities by offering a more structured and comprehensive user interface compared to the blank paper chart. The number of good diabetes days averaged to a median value of four days in both groups (paper chart: 4.38 [0-7] vs eDMS: 4.38 [0-7] days). Median daily BG was 170 (117-297) mg/dL vs 168 (86-286) mg/dL and median fasting BG was 152 (95-285) mg/dL vs 145 (69-333) mg/dL, and 0.1% vs 0.4% BG values <54 mg/dL were documented. Diabetes documentation quality improved when using eDMS, for example, documentation of ordered BG measurement frequency (1% vs 100%) and ordered BG targets (0% vs 100%). HCPs stated that by using eDMS errors could be prevented (74%), and digital support of work processes was completed (77%). Time saving was noted by 8 out of 11 HCPs and estimated at 10-15 minutes per patient day by two HCPs.

Conclusions:

The eDMS completely replaced the paper chart, showed comparable glycemic control, was positively accepted by HCPs, and is suitable for inpatient diabetes management.
Replication and Extension of Alicke (1985) Better-Than-Average Effect for Desirable and Controllable Traits
Authors: Ziano Ignazio , Mok Pui Yan (Cora) , Feldman Gilad
Published: September 2020

People tend to regard themselves as better than average. We conducted a replication and extension of Alicke’s classic study on trait dimensions in evaluations of self versus others with U.S. American Mechanical Turk workers in two waves (total N = 1,573; 149 total traits). We successfully replicated the trait desirability effect, such that participants rated more desirable traits as being more descriptive of themselves than of others (original: [Formula: see text] = .78, 95% confidence interval [CI] [.73, .81]; replication: sr 2 = .54, 95% CI [.43, .65]). The effect of desirability was stronger for more controllable traits (effect of Desirability × Controllability interaction on self–other-ratings difference; original: [Formula: see text] = .21, 95% CI [.12, .28]; replication: sr 2 = .07, 95% CI [.02, .12]). In an extension, we found that desirable traits were rated as more common for others, but not for the self. Thirty-five years later, the better-than-average effect appears to remain robust. All materials, data, and code are available at https://osf.io/2y6wj/ .
Taking Social Comparison to the Extremes: The Huge-Fish-Tiny-Pond Effect in Self-Evaluations
Authors: Zell Ethan , Lesick Tara L.
Published: September 2020

People evaluate themselves more favorably when they are a big fish in a little pond than a little fish in a big pond. The present research demonstrates that this tendency is exacerbated in extreme social comparison conditions, explains why, and highlights practical implications. Study 1 participants were told that they were a big (little) fish in a little (big) pond or a huge (tiny) fish in a tiny (huge) pond. Results provided evidence for a huge-fish-tiny-pond effect and showed that it is significantly larger than the big-fish-little-pond effect. Study 2 demonstrated that the huge-fish-tiny-pond effect reflects a neglect group rank information and Study 3 suggests that it inflates self-views. These experiments are the first to document the huge-fish-tiny-pond effect, which was highly robust (overall d = 2.05) and suggest that extreme social comparisons magnify self-evaluation tendencies.
Engineering 3D degradable, pliable scaffolds toward adipose tissue regeneration; optimized printability, simulations and surface modification
Authors: Jain Shubham , Yassin Mohammed Ahmad , Fuoco Tiziana , Liu Hailong , Mohamed-Ahmed Samih , Mustafa Kamal , Finne-Wistrand Anna
Published: September 2020

We present a solution to regenerate adipose tissue using degradable, soft, pliable 3D-printed scaffolds made of a medical-grade copolymer coated with polydopamine. The problem today is that while printing, the medical grade copolyesters degrade and the scaffolds become very stiff and brittle, being not optimal for adipose tissue defects. Herein, we have used high molar mass poly(L-lactide-co-trimethylene carbonate) (PLATMC) to engineer scaffolds using a direct extrusion-based 3D printer, the 3D Bioplotter®. Our approach was first focused on how the printing influences the polymer and scaffold’s mechanical properties, then on exploring different printing designs and, in the end, on assessing surface functionalization. Finite element analysis revealed that scaffold’s mechanical properties vary according to the gradual degradation of the polymer as a consequence of the molar mass decrease during printing. Considering this, we defined optimal printing parameters to minimize material’s degradation and printed scaffolds with different designs. We subsequently functionalized one scaffold design with polydopamine coating and conducted in vitro cell studies. Results showed that polydopamine augmented stem cell proliferation and adipogenic differentiation owing to increased surface hydrophilicity. Thus, the present research show that the medical grade PLATMC based scaffolds are a potential candidate towards the development of implantable, resorbable, medical devices for adipose tissue regeneration.