bluuebunny/crossref_metadata_2025 huggingface dataset:
Acupuncture at LR3 and KI3 shows a control effect on essential hypertension and targeted action on cerebral regions related to blood pressure regulation: a resting state functional magnetic resonance imaging study
Authors: Zhang Jiping , Lyu Taibiao , Yang Yicheng , Wang Yanjie , Zheng Yu , Qu Shanshan , Zhang Zhinan , Cai Xiaowen , Tang Chunzhi , Huang Yong
Published: June 2020

Objective

The aim of this study was to investigate the effects of acupuncture at LR3 and KI3 on hypertension at different time points and on related cerebral regions using resting-state functional magnetic resonance imaging (rs-fMRI).

Methods

We randomly divided 29 subjects into two groups: Group A (receiving acupuncture at LR3 + KI3; 15 subjects) and group B (receiving acupuncture at LR3 and a sham location not corresponding to any traditional acupuncture point; 14 subjects). Acupuncture was performed. Blood pressure (BP) changes were recorded and analyzed using SPSS 20.0 statistical software. We used a 3.0T MRI scanner and standard GE 8 channel head coil to collect whole brain fMRI data in both groups. Data analysis and processing was based on the R2009a MATLAB platform. REST 1.8 software was used to analyze the whole brain amplitude of low-frequency fluctuation (ALFF).

Results

After acupuncture, a statistically significant reduction in BP at different time points was observed in group A. In group B, a statistically significant reduction was found only in diastolic blood pressure (DBP) and was not sustained. Acupuncture at LR3 + KI3 specifically affected brain areas involved in BP regulation, as well as those involved in auditory sense, speech, vision, movement and sensation.

Conclusion

Acupuncture at LR3 + KI3 showed positive immediate and long-term effects on BP, particularly systolic blood pressure (SBP). After ALFF analysis, we concluded that LR3 + KI3 activates brain areas related to BP regulation. In addition, after acupuncture at LR3 + KI3, a highly targeted effect was observed in brain areas associated with BP. In addition, extracerebral areas involving vision, motion control, cognition and hearing were activated, which could potentially contribute to the mitigation of hypertensive complications in patients in an advanced stage of the disease.
Performance of non-uniform functionally graded piezoelectric energy harvester beams
Authors: Hajheidari Peyman , Stiharu Ion , Bhat Rama
Published: June 2020

The appearance of functionally graded piezoelectric materials has solved the lamination problem of the conventional piezoelectric structures. Functionally graded piezoelectric materials are the new materials with unexplored capabilities. This article theoretically investigates the effects of non-uniformity on the performance of the functionally graded piezoelectric material cantilever beams subjected to harmonic excitation. The governing equations are derived based on Timoshenko and Euler–Bernoulli beam theories. The finite element method with the application of superconvergent element is employed here for the discretization and the vibration analysis of the system. This model is validated by comparing the numerical results with the experimental results of piezoelectric energy harvesters of conventional shapes available in the open literature. Parametric studies are carried out with respect to the effects of tapering ratios, the degree of non-uniformity, load resistance, and the volume fraction parameter on the electrical output power and the fundamental resonance frequency. It was observed that the application of diverging beams noticeably enhances the power output per mass of piezoelectric element extracted while decreases the natural frequency which is advantageous for scavenging energy from ambient surroundings. The results reveal that there is an optimal value for the non-homogeneous parameter leading to the maximized harvested energy under different operating conditions.
The Endorsement of Traditional Masculine Ideology by South African Navy Men: A Research Report
Authors: Martin Jarred H. , Van Wijk Charles H.
Published: June 2020

Although the study of masculinity/ies in South Africa has been a point of academic interest, especially since the fall of apartheid; there has been little focus on masculinity/ies peculiar to the South African military establishment. Where there has been, this has focused on the army environment and adopted a smaller-scale qualitative approach. In contrast, this study focuses on the South African Navy. The study provides a brief report of findings from the administration of a traditional masculine ideology scale with 1,185 South African navy men, between 19 and 59 years of age (mean of 25 years). Descriptive statistics, a multiple regression analysis, one-sample t-test, and one-way analysis of variance were run to analyze the data. Results demonstrated that this sample of navy men significantly endorsed constructs of self-sufficiency, physical toughness, and emotional restrictedness, as dimensions of traditional masculine ideology. Avoidance of femininity and risk-taking were not significantly endorsed.
Running as a Woman? Candidate Presentation in the 2018 Midterms
Authors: McDonald Maura , Porter Rachel , Treul Sarah A.
Published: June 2020

The record high number of women who ran for the U.S. Congress during the midterm elections led many journalists to proclaim 2018 as another “Year of the Woman.” Although not every female candidate was successful, this large number of women running for office provides the opportunity to advance our understanding of the ways in which women present themselves to their voters. Using the “Biography” pages of more than 1,500 2018 congressional campaign websites, we use a structural topic model to examine how these candidates present themselves to their constituencies. In doing this, we find great variance in the presentation styles of women running for Congress in 2018. We also find that prior political experience, more so than gender, is the primary driver in influencing how candidates (both men and women) present themselves. Experienced candidates use similar styles that highlight their past political work while amateur candidates are more likely to use “values-driven” language.
Nonlinear free vibration and damping analysis of a microbeam with pseudoelastic shape memory alloy layer based on the modified couple stress theory
Authors: Ashrafi Mohammad Javad , Ghaffari Iman , Elahinia Mohammad , Nematollahi Mohammad Reza
Published: June 2020

The aim of this investigation is to evaluate the size effects on the nonlinear free vibration of the sandwich composite microbeam with an extensible shape memory alloy layer in the midplane. A one-dimensional constitutive model is considered to simulate the pseudoelastic behavior of the shape memory alloy layer. The governing equation of motion is derived using the Euler–Bernoulli beam theory together with the modified couple stress theory through the Hamilton’s principle. Midplane stretching and phase transformation of the shape memory alloy which are sources of nonlinearity were considered, and a numerical solution method is presented. A damped response of the sandwich composite microbeam is observed because of the hysteresis behavior of the extensible shape memory alloy layer in the midplane. Results are appraised by comparing with the available literature. The influence of material length scale, temperature, and initial velocity on the loss factor and other pivotal vibrational behavior is evaluated. Results show that increasing the material length scale to thickness ratio has a decreasing effect on damping capacity.
Variation in the Heartland: Explaining the Use of Economic Development Incentives in Three Great Lakes States
Authors: Craft Andrea , Drucker Joshua , Weber Rachel
Published: June 2020

We identify the factors correlated with the use of economic development incentives after the Great Recession of 2007–2009 to determine the presence of entrepreneurial development regimes. We utilize a unique dataset that combines information on incentives (tax increment financing districts and selected tax abatements and business assistance) with economic, fiscal, and political characteristics for all municipalities in the largest Metropolitan Statistical Areas of Illinois, Wisconsin, and Michigan. These three states bordering Lake Michigan share similar histories and settings, thus targeting the research focus on the key attributes of interest. Our empirical results demonstrate substantial dissimilarity between incentive types and across states, most likely due to policy structures and reforms at the state level that encourage different municipal development regimes. Whereas municipalities, particularly larger ones, continue to use tax abatements, exemptions, and credits to pursue employment growth, the municipalities gravitating toward tax increment financing tend to be suburbs with low unemployment rates and relatively highly educated residents, and not places with greater employment density or manufacturing employment.
Comparing the clinical efficacy and safety of abiraterone and enzalutamide in metastatic castration-resistant prostate cancer: A systematic review and meta-analysis
Authors: Wang Xin , Yang Hui , Hu Xiaopeng , Wang Wei , Yu Xiaojia , Wang Shihui , Zhang Xiaodong , Liu Lihong
Published: June 2020

Background

Two new drugs, abiraterone and enzalutamide, had recently shown beneficial effects on survival in patients with metastatic castration-resistant prostate cancer. We systematically reviewed the efficacy and safety of abiraterone and enzalutamide in metastatic castration-resistant prostate cancer in real-world practice.

Methods

A search from PubMed, Web of Science, Cochrane, Embase was conducted up to 6 March 2019. Available articles from conferences were searched. The endpoint was prostate-specific antigen response, overall survival, progression-free survival, number of patients with any adverse event.

Results

Fourteen cohort studies involving 3469 participants were included. Pooled result showed that prostate-specific antigen response was higher for patients receiving enzalutamide than abiraterone (790 patients, odds ratio (OR) 0.47, 95% confidence interval (CI) 0.29–0.77, P = 0.003, I2=59%). Enzalutamide was significantly associated with increased adverse events rate in comparison with abiraterone (730 patients, OR 0.35, 95%CI 0.13–0.92, P = 0.03, I2=65%). There was no statistical difference between abiraterone and enzalutamide with respect to perceived cognitive impairments (1856 patients, OR 0.90, 95%CI 0.29–2.76, P = 0.85, I2=5%). Enzalutamide was significantly associated with increased fatigue risk in comparison with abiraterone (2477 patients, OR 0.46, 95%CI 0.34–0.63, P＜0.00001, I2=0%).

Conclusions

Our results demonstrated that enzalutamide was more efficacious than abiraterone for patients with metastatic castration-resistant prostate cancer, but was associated with a significantly elevated risk of side effects, particularly fatigue.
A new treatment of alopecia induced by palbociclib: Topical cetirizine
Authors: Caro Gemma , Fortuna Maria C , Magri Francesca , Federico Alessandro , Carlesimo Marta , Rossi Alfredo
Published: June 2020

Introduction

Recently CDK4/6 inhibitors have been introduced for the treatment of hormone positive breast cancer resistant to endocrine therapy. Among their side effects, alopecia is often reported being associated to patients’ distress and depressive symptoms.

Case Report

We report the case of a 70-year-old woman affected by breast cancer in treatment with Palbociclib, who developed alopecia. Management and Outcome: We prescribed a topical solution with cetirizine. Global photography, trichoscopy and trichogram were assessed. All evaluations demonstrated alopecia improvement.

Discussion

Currently, no treatment options for CDK 4/6 inhibitors induced alopecia have been proposed. Herein, we report the use of topical cetirizine.
Asymptotic stability for a laminated beam with structural damping and infinite memory
Authors: Liu Wenjun , Kong Xiangyu , Li Gang
Published: June 2020

In this paper, we consider a one-dimensional laminated beam with structural damping and an infinite memory acting on the effective rotation angle. Under appropriate assumptions imposed on the relaxation function, we show that the system is well-posed by using the Hille–Yosida theorem, and then we establish general decay results, from which exponential and polynomial decays are only special cases, in the case of equal speeds of wave propagation as well as that of nonequal speeds. In the particular case when the wave propagation speeds are different and the relaxation function decays exponentially, we show the lack of exponential stability.
Feedback control for non-stationary 3D Navier–Stokes–Voigt equations
Authors: Zeng Biao
Published: June 2020

The goal of this article is to study the feedback control for non-stationary three-dimensional Navier–Stokes–Voigt equations. Based on the existence, uniqueness, and boundedness result of the weak solutions to the equations, we obtain the existence of solutions to the feedback control system. An existence result for an optimal control problem is also given. We illustrate our main result with an evolutionary hemivariational inequality.
Developing Collective Leadership Capacity to Drive Sustainable Practices: Destination Case of Leadership Development in Australia
Authors: Fang Marcela , Nguyen Thu-Huong , Armstrong Anona
Published: June 2020

Previous research had already established that sustainable destination outcomes can be realized when stakeholders engage in tourism destination management, yet the state of the needed engagement is still seen as problematic. It is evident that some change is required to enable behavioral change that will awaken a progress. Thus, new knowledge is needed to help advance this important destination management field. The aim of this exploratory case study was to present a new perspective which is underpinned by theories in the leadership and leadership development fields. The case study findings show that tourism-based leadership programs have the capacity to foster development of collective leadership capacity, which is needed to build the effective stakeholder networks that drive change at workplace, tourism destination, and community levels. The study suggests that sustainable development goals and sustained competitive advantage are developed through the bundle of collective leadership capacity and stakeholder causal scope.
An Evaluation of the Caught Being Good Game With an Adolescent Student Population
Authors: Bohan Clare , Smyth Sinéad , McDowell Claire
Published: June 2020

This study investigated the Caught Being Good Game (CBGG), for use with an adolescent student population. The CBGG is a positive variation of the Good Behavior Game (GBG), a popular group contingency intervention in classroom management literature. In this positive version, teams of students receive points for engaging in desirable behavior, rather than marks for breaking class rules. Research on the CBGG has garnered empirical interest in recent years; however, there is little published research on the game with adolescent populations. This study investigated if visual feedback displayed on a scoreboard during the CBGG is a necessary part of the game. This was examined by implementing the game both with and without overt visual feedback, using an ABACABAC reversal design. Academically engaged behavior and disruptive behavior were monitored. The CBGG was effective in both formats, leading to increases in academically engaged behavior and decreases in disruptive behavior in the participating class group. This suggests that perhaps immediate visual feedback is not an essential component of the CBGG for adolescent, mainstream students. This may be a time-saving measure for teachers wishing to implement the game. Students and their teacher rated the game favorably on social validity measures.
A 15-year retrospective epidemiologic study of ocular trauma in the north of Portugal
Authors: Marta Ana , Silva Nisa , Correia Nuno , Pessoa Bernardete , Ferreira Natália , Beirão Melo , Meireles Angelina
Published: June 2020

Purpose:

The primary objective of this study was to better understand the epidemiological risk factors associated with severe eye injury of patients and the secondary objective was to evaluate functional outcomes of these severe eye injuries.

Methods:

A retrospective, noncomparative cohort study of severe ocular trauma, in patients assessed in an emergency room from January 2004 to December 2018 at Centro Hospitalar Universitário do Porto was performed and statistically analyzed.

Results:

This study included a total of 751 patients (758 eyes) suffering ocular trauma. Men had a higher rate of ocular trauma than women (81.4% vs 18.6%). The mean age was 48.9 years old. The most common types of injury were rupture (33.8%) and penetrating (20.9%). Work-related accidents were responsible for 19.3% of injuries. Home was the most common location of trauma (46.3%). In 8.8% of trauma the best corrected visual acuity at presentation was superior to 20/40 while in 6.5% of cases no light perception (NLP) was registered. In 44.8% of trauma the best corrected visual acuity at last follow-up visit (BCVAF) was superior to 20/40 while in 15.7% of cases NLP was registered.

Conclusion:

The epidemiological high-risk factors identified were: adult males, economic crisis, home, blunt objects in man and falls in woman. Future primary prevention should take into account these factors. This study also demonstrated an important visual impairment associated with severe ocular trauma, even with timely surgical treatment, with BCVAF of NLP in 15.7% of cases.
Effectiveness of transparent film dressing for peripheral intravenous catheter
Authors: Atay Selma , Yilmaz Kurt Fatma
Published: June 2020

Background:

The intravenous applications are the most common type of such interventions. It is underlined that in cases where the peripheral intravenous catheter is not properly secured in place, even a minor movement inside the vein would result in injury of vein.

Objective:

The insertion of peripheral intravenous catheter is a common practice. This is a randomized controlled prospective study aiming at investigating the effectiveness of use of transparent film dressing for peripheral intravenous catheter.

Methods:

The universe of this study included inpatients in the Internal Diseases clinic of a University Hospital, and the sample included a total of 110 peripheral intravenous catheters that were calculated by power analysis. The patient identification form, the peripheral venous catheter and treatment information form, and the visual infusion phlebitis identification scale were used to collect data. The forms were completed by the investigators on the basis of daily observations. The data were assessed by the percentage, chi-square test, and logistic regression analysis via the software SPSS 20.00.

Results:

The individuals in the study group and the control group included in the sample are comparable in terms of gender, having/not having a chronic disease, the site of peripheral intravenous catheter, use of antibiotics, intravenous fluid therapy, and mean age. There were no statistically significant differences between the groups. There was a significant relationship between the dwell time for the catheter and development of any complications and the groups.

Conclusion:

The use of transparent film dressing for insertion of peripheral intravenous catheter can be recommended as it increases the dwell time for the catheter and reduces incidence of complications.
“Working Against Gravity”: The Uphill Task of Overcapacity Management
Authors: Kreindler Sara A , Star Noah , Hastings Stephanie , Winters Shannon , Johnson Keir , Mallinson Sara , Brierley Meaghan , Goertzen Leah Nicholson , Anwar Mohammed Rashidul , Aboud Zaid
Published: June 2020

While most health systems have implemented interventions to manage situations in which patient demand exceeds capacity, little is known about the long-term sustainability or effectiveness of such interventions. A large multi-jurisdictional study on patient flow in Western Canada provided the opportunity to explore experiences with overcapacity management strategies across 10 diverse health regions. Four categories of interventions were employed by all or most regions: overcapacity protocols, alternative locations for emergency patients, locations for discharge-ready inpatients, and meetings to guide redistribution of patients. Two mechanisms undergirded successful interventions: providing a capacity buffer and promoting action by inpatient units by increasing staff accountability and/or solidarity. Participants reported that interventions demanded significant time and resources and the ongoing active involvement of middle and senior management. Furthermore, although most participants characterized overcapacity management practices as effective, this effectiveness was almost universally experienced as temporary. Many regions described a context of chronic overcapacity, which persisted despite continued intervention. Processes designed to manage short-term surges in demand cannot rectify a long-term mismatch between capacity and demand; solutions at the level of system redesign are needed.
How do you think about stress? A qualitative analysis of beliefs about stress
Authors: Kilby Christopher Jon , Sherman Kerry A , Wuthrich Viviana
Published: June 2020

This qualitative study aimed to identify common stress beliefs. Undergraduate psychology students ( N = 35) completed semi-structured interviews discussing the sensations, causes, purpose, valence, consequences, control, and timeline of stress. Interviews were analysed via double-coded thematic analysis employing a latent, inductive, and realist framework. Five themes (cognition, emotion, physical health, interpersonal relations, and behaviour) and 17 subthemes were identified. Themes and subthemes were validated in a Delphi study of experts in stress research ( N = 14). Many of these identified beliefs have not been incorporated into current measures of stress beliefs, suggesting the need for new approaches to measuring this construct.
Objects of safety and imprisonment: Breathless patients’ use of medical objects in a palliative setting
Authors: Binnie Kate , McGuire Coreen , Carel Havi
Published: June 2020

In this article, the authors consider breathless adults with advanced non-malignant lung disease and their relationship with health objects. This issue is especially relevant now during the Covid-19 pandemic, where the experiences of breathlessness and dependence on related medical objects have sudden and global relevance. These objects include ambulatory oxygen, oxygen concentrators and inhalers, and non-pharmacological objects such as self-monitoring devices and self-management technologies. The authors consider this relationship between things and people using an interdisciplinary approach employing psychoanalytic theory (in particular Winnicott’s theory of object relations and object use), Science and Technology Studies (STS) and phenomenology. This collaborative approach allows them to relate patient use of health objects to ways of thinking about the body, dependency, autonomy, safety and sense-making within the context of palliative care. The authors illustrate the theoretical discussion with three reflective vignettes from therapeutic practice and conclude by suggesting further interdisciplinary research to develop the conceptual and practice-based links between psychoanalytic theory, STS and phenomenology to better understand individual embodied experiences of breathlessness. They call for palliative care-infused, psychoanalytically informed interventions that acknowledge breathless patients’ dependence on things and people, concomitant with the need for autonomy in being-towards-dying.
Queer theory from the South: A contribution to the critique of sexual democracy
Authors: Seely Stephen D
Published: June 2020

This essay draws on the turn to southern epistemologies in social theory as a provocation for rethinking the problems and possibilities of ‘sexual democracy.’ First, I situate ‘queer theory from the South’ in relation to ongoing queer and decolonial critiques of sexual democracy. I then turn to the case of South Africa, examining ubuntu as an alternative framework for developing a sexual politics that can negotiate between the Euro-American liberal rights frames and indigenous values. Finally, I conclude by illustrating this with the work of a Zulu lesbian sangoma, whose theory and practice offers a vision of decolonizing erotic justice.
Reliability analysis of mooring lines for floating structures using ANN-BN inference
Authors: Zhao Yuliang , Dong Sheng , Jiang Fengyuan
Published: June 2020

The harsh marine environment is a significant threat to the safety of floating structure systems. To address this, mooring systems have seen widespread application as an important component in the stabilization of floating structures. This article proposes a methodology to assess the reliability of mooring lines under given extreme environmental conditions based on artificial neural network–Bayesian network inference. Different types of artificial neural networks, including radial basis function neural networks and back propagation neural networks, are adopted to predict the extreme response of mooring lines according to a series of measured environmental data. A failure database under extreme sea conditions is then established in accordance with the failure criterion of mooring systems. There is a failure of mooring lines when the maximum tension exceeds the allowable breaking strength. Finally, the reliability analysis of moored floating structures under different load directions is conducted using Bayesian networks. To demonstrate the proposed methodology, the failure probability of a sample semi-submersible platform at a water depth of 1500 m is estimated. This approach utilizes artificial neural networks’ capacity for calculation efficiency and validates artificial neural networks for the response prediction of floating structures. Furthermore, it can also be employed to estimate the failure probability of other complex floating structures.
Reclaiming My Sister, Medusa: A Critical Autoethnography About Healing From Sexual Violence Through Solidarity, Doll-Making, and Mending Myth
Authors: Reilly Rosemary C.
Published: June 2020

According to the poet Ovid, Medusa was a beautiful maiden, who was raped by Poseidon in Athena’s temple. Medusa called upon the goddess Athena for revenge, but, instead, Athena punished Medusa for defiling her temple, subjecting her to a terrible transformation. Her beautiful hair became poisonous serpents; her face so horrifying to behold it turned onlookers to stone. Some stories portray Medusa as asking for it or depict her as being uppity. Medusa, therefore, stands as a strong metaphor for the experiences of women who have survived sexual violence. This critical autoethnography presents my experience, along with 11 other women, finding community, voice, and courage with other survivors of sexual violence through community art, doll-making, and collectively reclaiming our sister, Medusa.
Meta-Analysis of the Role of Intermittent Pneumatic Compression of the Lower Limbs to Prevent Venous Thromboembolism in Critically Ill Patients
Authors: Haykal Tarek , Zayed Yazan , Dhillon Harsukh , Miran Muhammad Shah , Kerbage Josiane , Bala Areeg , Samji Varun , Deliwala Smit , Bachuwa Ghassan
Published: June 2020

Critically ill patients (patients treated in a medical or surgical intensive care unit) are at high risk of venous thromboembolism (VTE) development (deep vein thrombosis [DVT] and/or pulmonary embolism). Multiple thromboprophylaxis strategies have been used for the prevention of VTE in this population with various outcomes. Therefore, we aimed to evaluate the efficacy of intermittent pneumatic compression (IPC) prophylaxis in the lower limb compared with no treatment, anticoagulant use, or their combinations in reducing risk. A comprehensive electronic database search was conducted for all randomized clinical trials (RCTs) comparing the clinical outcomes of IPC versus anticoagulants or no treatment or their combinations for the prevention of VTE for critically ill patients. The primary outcome was VTE. The secondary outcome was DVT. We performed a Bayesian network meta-analysis to calculate odds ratios (ORs) and 95% credible intervals (CrIs). We included 5 RCTs with 3133 total patients, represented by a mean age of 49.61 ± 18 years, while 60.28% were male. There was a significant reduction of the primary outcome (incidence of VTE events) when no treatment was compared with IPC (OR = 0.36; 95% CrI = 0.18-0.71), anticoagulation alone (OR = 0.30; 95% CrI = 0.12-0.68), or anticoagulation with IPC (OR = 0.34; 95% CrI = 0.13-0.81). In addition, there was a significant reduction in DVT when no treatment was compared with IPC (OR = 0.45; 95% CrI = 0.21-0.9), anticoagulation alone (OR = 0.16; 95% CrI = 0.03-0.66), or anticoagulation with IPC (OR = 0.18; 95% CrI = 0.03-0.84). However, there were no significant differences between other comparisons (IPC vs anticoagulation alone, anticoagulation alone vs anticoagulation with IPC, or anticoagulation with IPC vs IPC alone) regarding VTE or DVT incidence. Among critically ill patients, IPC alone, anticoagulation alone, and IPC with anticoagulation were associated with a significant reduction of VTE and DVT incidence compared with no treatment. However, there was no significant difference between these modalities when compared together. Therefore, further larger studies comparing those different thromboprophylaxis modalities and their combinations are needed to provide more robust results for future clinical recommendations.
Effect of Family Empowerment on HbA1c Levels and Healing of Diabetic Foot Ulcers
Authors: Appil Rasnah , Sjattar Elly Lilianty , Yusuf Saldy , Kadir Kasmawati
Published: June 2020

Objective. To evaluate the effectiveness of family empowerment through educational interventions against HbA1c level and healing progress of diabetic foot ulcers. Method. A quasi-experimental design was employed involving 33 participants from 4 wound care clinics in Makassar, eastern Indonesia. The intervention group consisted of 17 participants and their families; the control group was composed of 16 participants who received nonstructural education. Family empowerment was measured by the Indonesian version of the Family Empowerment Scale instrument. Glycemic control was evaluated with HbA1c levels, and the wound healing process was evaluated on the Diabetic Foot Ulcers Assessment Scale. Result. After 3 months, Family Empowerment Scale scores improved, particularly in the subdomain of family knowledge (16.59 ± 3.92 vs 13.38 ± 1.26; P = .005) and attitude (3.65 ± 0.93 vs 2.75 ± 0.45; P = .002). After 3 months of intervention, HbA1c decreased (from 10.47 ± 2.44% to 8.81 ± 1.83%), compared with the control group ( P = .048). Meanwhile, an independent t test further revealed that the wound healing process tended to be better with the intervention group (4.71 ± 7.74) compared with the control group (17.25 ± 17.06), with P = .010 at the third month. Conclusion. Family-based education intervention creates family empowerment to control HbA1c levels and accelerate wound healing of diabetic foot ulcer.
Diagnosis, prevention and control of urinary tract infections: a survey of routine practices in Belgian nursing homes
Authors: Latour Katrien , Lepeleire Jan De , Jans Béatrice , Buntinx Frank , Catry Boudewijn
Published: June 2020

Background:

Urinary tract infections (UTIs) are one of the most frequently reported infections in older adults and the most common reason for antimicrobial prescribing in nursing homes (NHs). In this vulnerable population, both a good diagnosis and prevention of these infections are crucial as overuse of antibiotics can lead to a variety of negative consequences including the development of multidrug-resistant organisms.

Objective:

To determine infection prevention and control (IPC) and diagnostic practices for UTIs in Belgian NHs.

Methods:

Local staff members had to complete an institution-level questionnaire exploring the availability of IPC practices and resources and procedures for UTI surveillance, diagnosis, and urinary catheter and incontinence care.

Results:

UTIs were the second most common infections in the 87 participating NHs (prevalence: 1.0%). Dipstick tests and urine cultures were routinely performed in 30.2% and 44.6% of the facilities, respectively. In non-catheterised residents, voided or midstream urine sampling was most frequently applied. Protocols/guidelines for urine sampling, urinary catheter care and incontinence care were available in 43.7%, 45.9% and 31.0% of the NHs, respectively. Indwelling catheters were uncommon (2.3% of the residents) and urinary retention (84.9%) and wound management (48.8%) were the most commonly reported indications. Only surveillance was found to significantly impact the UTI prevalence: 2.2% versus 0.8% in NHs with or without surveillance, respectively ( P < 0.001).

Discussion:

This survey identified key areas for improving the diagnosis and prevention of UTIs, such as education and training regarding the basics of urine collection and catheter care.
Wound healing of metastatic perineal Crohn’s disease using hyperbaric oxygen therapy: A case series
Authors: Lansdorp Corine A , Buskens Christianne J , Gecse Krisztina B , D’Haens Geert RAM , Van Hulst Rob A
Published: June 2020

Background

Metastatic Crohn’s disease (CD) is a rare manifestation of CD. It involves inflammatory skin lesions with histopathological findings (granulomas) similar to CD, without connection to the gastrointestinal tract. Hyperbaric oxygen therapy (HBO) has been suggested as a possible treatment option.

Objective

This study aimed to identify and treat a consecutive series of patients with biopsy‐proven metastatic CD and monitor wound healing using prospectively acquired outcomes.

Methods

Pathology results of all patients with ongoing perineal wound‐healing problems after proctectomy between 2005 and 2018 at the Amsterdam University Medical Centre were assessed for metastatic CD. Patients with a biopsy‐proven diagnosis of perineal metastatic CD were offered HBO (40 daily sessions of 100% oxygen at 2.4 atmosphere absolute). Wound healing was monitored using photographs and standardised questionnaires (the Inflammatory Bowel Disease Questionnaire, EuroQol Visual Analogue Scale and the Female Sexual Function Index) at baseline and 1 and 3 months after HBO.

Results

Out of 13 patients in the cohort with persisting perineal wounds after proctectomy, six (46%) had biopsy results consistent with metastatic CD. Of these, three accepted treatment with HBO. All three patients were female. One patient had complete healing of her perineal wound; another patient showed initial improvement but had a flare of luminal and perineal disease at the 3‐month follow‐up. The third patient showed improvement solely in the questionnaires, with higher scores on all three questionnaires.

Conclusion

A high rate of metastatic CD was found in patients with ongoing wound‐healing problems after proctectomy, implying that the disease might not be as rare in these selected patients as previously thought. HBO might be beneficial in the treatment of metastatic CD.
Giant ureteral fibro-epithelial polyp: A rare but important differential of ureteral urothelial cell carcinoma
Authors: Bansal Devanshu , Maheshwari Ruchir , Chaturvedi Samit , Kumar Anant
Published: June 2020

Background:

Fibro-epithelial polyps (FEPs) of the ureter are rare benign tumours and constitute an important differential for ureteral urothelial cell carcinoma (UCC).

Case presentation:

We describe a case of a 56-year-old lady presenting with gross haematuria. On initial evaluation elsewhere, she was diagnosed with lower ureteric UCC and was advised left nephroureterectomy. Careful evaluation at our centre established the diagnosis of a left ureteral FEP. Robot-assisted excision of the ureteral FEP was successfully done.

Conclusion:

Diagnosis of these rare tumours may be made with a combination of imaging, ureteroscopy and histopathological analysis. Resection of giant FEPs may be done with a robot-assisted technique. Proper diagnosis and management of these tumours are essential to avoid unnecessary nephroureterectomies. Level of evidence: 4
Long-term survival in a cat with pancreatic adenocarcinoma treated with surgical resection and toceranib phosphate
Authors: Todd Johanna E , Nguyen Sandra M
Published: June 2020

Case summary

Primary pancreatic adenocarcinoma is an uncommon neoplasm seen in cats and often has a poor prognosis. We report a case of an 8-year-old male neutered domestic shorthair cat weighing 5.8 kg diagnosed with pancreatic adenocarcinoma treated with surgical resection and toceranib phosphate, which had a progression-free interval of 1148 days and survived for more than 1436 days. The treatment was well tolerated; however, the cat developed generalised coat hypopigmentation.

Relevance and novel information

To our knowledge, the cat in our report has the longest progression-free interval and survival time post-surgical resection of pancreatic carcinoma treated with toceranib. Hypopigmentation as a side effect of toceranib has been reported in dogs, but this is the first case reported in cats.
Factors Predicting Inquiry-Based Teaching in Science Across One Belt One Road Countries and Regions: A Multilevel Analysis
Authors: Tang Hanwei , Qiu Chen , Meng Lingqi , Li Yujia , Zhang Jiangkun
Published: June 2020

The present study aimed to investigate factors predicting inquiry-based teaching in science across One Belt One Road countries and regions (OBOR economies). Teacher-level ( N = 8,603) and school-level ( N = 1,385) data were drawn from the Program for International Student Assessment (PISA) 2015. Hierarchical linear modeling was adopted for data analysis. The results showed at the teacher level that teacher collaboration was positively correlated with inquiry-based teaching in OBOR economies, and that teacher beliefs were positively associated with inquiry-based teaching in each sample. At the school level, no consistent result was found among OBOR economies. School location was positively related to inquiry-based teaching in the Dominican Republic, Macao, and the United Arab Emirates. By contrast, science-specific resources showed a negative association with inquiry-based teaching in Taiwan, the Czech Republic, and Macao. Other specific findings were presented and the implications of all findings were discussed.
A Genre Approach to the Translation of Political Speeches Based on a Chinese-Italian-English Trilingual Parallel Corpus
Authors: Danni Yu
Published: June 2020

Using a trilingual parallel corpus, this article investigates the translation of Chinese political speeches in Italian and English, with the aim to explore cross-linguistic variations regarding translation shifts of key functional elements in the genre of political speeches. The genre-based methodology includes a rhetorical move analysis, which is used to highlight key functional elements of the genre, and a functional grammar analysis of translation shifts of the lexico-grammatical elements identified in the previous stage. The findings show that the core communicative function of the genre is “Proposing deontic statements,” and modality of obligation is essential for the realization of this rhetorical function. Afterwards, the analysis of translation shifts of deontic modality reveals that the English translation is characterized by higher modality value shifts in comparison to the Italian translation. This difference may be related to the degree of autonomy in translation choice and understanding of the communicative purposes of the translation genre. In terms of methodological implications, this functionalist approach attempts to providing insights into the communicative purposes of the translation genre by focusing on how key functional elements are translated.
Fluid Boundaries and Moving Targets: Midwife Leaders’ Perspectives on Continuing Professional Education
Authors: Røseth Idun , Austenå Halvor , Sommerseth Eva , Dahl Bente , Lyberg Anne , Bongaardt Rob
Published: June 2020

In this study, we aim to understand midwife leaders’ perspectives on continuing professional education among midwives in their work unit. We used a phenomenological perspective and method in the process of interviewing the participants and analyzing the data. Five midwife leaders who worked in large maternity wards and had considerable experience as managers were recruited. Results revealed three essential constituents: (a) constraints and the individualization of continuing professional education, (b) normal and at-risk births: fluid boundaries and moving targets, and (c) a personal approach: dimensions of control and trust-driven leadership. We discuss these findings in relation to current research and perspectives on how professional cultures and leadership impact continuing professional education and knowledge management, revealing possible implications to further promote professional development in public health organizations. We conclude that midwife leaders’ views on continuing professional education as practical skills training may hinder professional communication and knowledge development in maternity care.
Latarjet Procedure for Anterior Glenohumeral Instability: Early Postsurgical Complications for Primary Coracoid Transfer Versus Revision Coracoid Transfer After Failed Prior Stabilization
Authors: Updegrove Gary F. , Buckley Patrick S. , Cox Ryan M. , Selverian Stephen , Patel Manan S. , Abboud Joseph A.
Published: June 2020

Background:

The Latarjet procedure (coracoid transfer) is often used to successfully treat failed instability procedures. However, given the reported increased complication rates in primary Latarjet surgery, there is a heightened concern for complications in performing the Latarjet procedure as revision surgery.

Purpose:

To evaluate the early outcomes and complications of the Latarjet procedure as primary surgery compared with revision surgery.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

A total of 157 patients were included and retrospectively reviewed: 103 patients in the revision group and 54 patients in the primary group. Patients were evaluated by physical examination findings as well as by documentation of complications and reoperations extracted from their electronic medical records.

Results:

The mean follow-up was 7.8 ± 11.0 months for the primary group and 7.0 ± 13.2 months for the revision group. There were no significant differences in overall complication rates between the primary and revision groups (16.7% vs 8.7%, respectively; P = .139). The complication rate was significantly higher in patients in the revision group who had undergone a prior open procedure compared with those who had undergone only arthroscopic procedures (30.0% vs 4.1%, respectively; P < .001). Of those patients who sustained a complication, 7 of the 9 underwent a reoperation in the primary group (13.0%), and 7 of the 9 did so in the revision group (6.8%); the risk of reoperations was not different between groups ( P = .198). There were 4 patients in the primary group (7.4%) and 5 patients in the revision group (4.9%) who experienced recurrent dislocations during the follow-up period ( P = .513). There was no difference in postoperative range of motion.

Conclusion:

The Latarjet procedure is a reasonable option for the treatment of failed arthroscopic instability repair with an early complication rate similar to that found in primary Latarjet surgery.
Do You See What I See? A Case of Alice in Wonderland Syndrome With EEG Correlate
Authors: Shah Arya , Magaña Setty M. , E. Youssef Paul
Published: June 2020

Alice in Wonderland syndrome is a disorienting perceptual disorder characterized by discrete episodes of bizarre visual illusions and spatial distortions which has been associated with numerous neurologic and psychiatric conditions. Little is known regarding the electrophysiologic correlates of the visual symptoms described in this syndrome. The authors report the unique case of an 8-year-old boy presenting with visual distortions consistent with Alice in Wonderland syndrome, and an electroencephalogram demonstrating bilateral temporo-occipital slowing which correlated with symptoms of micropsia, teleopsia, and dysmorphopsia. Identification of this clinical syndrome and its electroclinical features are important for establishing a proper diagnosis and subsequent reassurance or appropriate treatment directed toward the underlying etiology.
Deconvolution of bulk blood eQTL effects into immune cell subpopulations
Authors: Aguirre-Gamboa Raúl , de Klein Niek , di Tommaso Jennifer , Claringbould Annique , van der Wijst Monique GP , de Vries Dylan , Brugge Harm , Oelen Roy , Võsa Urmo , Zorro Maria M. , Chu Xiaojin , Bakker Olivier B. , Borek Zuzanna , Ricaño-Ponce Isis , Deelen Patrick , Xu Cheng-Jiang , Swertz Morris , Jonkers Iris , Withoff Sebo , Joosten Irma , Sanna Serena , Kumar Vinod , Koenen Hans J. P. M. , Joosten Leo A. B. , Netea Mihai G. , Wijmenga Cisca ,   BIOS Consortium, Franke Lude , Li Yang
Published: June 2020

Background

Expression quantitative trait loci (eQTL) studies are used to interpret the function of disease-associated genetic risk factors. To date, most eQTL analyses have been conducted in bulk tissues, such as whole blood and tissue biopsies, which are likely to mask the cell type-context of the eQTL regulatory effects. Although this context can be investigated by generating transcriptional profiles from purified cell subpopulations, current methods to do this are labor-intensive and expensive. We introduce a new method, Decon2, as a framework for estimating cell proportions using expression profiles from bulk blood samples (Decon-cell) followed by deconvolution of cell type eQTLs (Decon-eQTL).

Results

The estimated cell proportions from Decon-cell agree with experimental measurements across cohorts (R ≥ 0.77). Using Decon-cell, we could predict the proportions of 34 circulating cell types for 3194 samples from a population-based cohort. Next, we identified 16,362 whole-blood eQTLs and deconvoluted cell type interaction (CTi) eQTLs using the predicted cell proportions from Decon-cell. CTi eQTLs show excellent allelic directional concordance with eQTL (≥ 96–100%) and chromatin mark QTL (≥87–92%) studies that used either purified cell subpopulations or single-cell RNA-seq, outperforming the conventional interaction effect.

Conclusions

Decon2 provides a method to detect cell type interaction effects from bulk blood eQTLs that is useful for pinpointing the most relevant cell type for a given complex disease. Decon2 is available as an R package and Java application (https://github.com/molgenis/systemsgenetics/tree/master/Decon2) and as a web tool (www.molgenis.org/deconvolution).