bluuebunny/crossref_metadata_2025 huggingface dataset:
Bacterial biofilms in infective endocarditis: an in vitro model to investigate emerging technologies of antimicrobial cardiovascular device coatings
Authors: Lauten Alexander , Martinović Marc , Kursawe Laura , Kikhney Judith , Affeld Klaus , Kertzscher Ulrich , Falk Volkmar , Moter Annette
Published: May 2020

Objective

In spite of the progress in antimicrobial and surgical therapy, infective endocarditis (IE) is still associated with a high morbidity and mortality. IE is characterized by bacterial biofilms of the endocardium, especially of the aortic and mitral valve leading to their destruction. About one quarter of patients with formal surgery indication cannot undergo surgery. This group of patients needs further options of therapy, but due to a lack of models for IE prospects of research are low. Therefore, the purpose of this project was to establish an in vitro model of infective endocarditis to allow growth of bacterial biofilms on porcine aortic valves, serving as baseline for further research.

Methods and results

A pulsatile two-chamber circulation model was constructed that kept native porcine aortic valves under sterile, physiologic hemodynamic and temperature conditions. To create biofilms on porcine aortic valves the system was inoculated with Staphylococcus epidermidis PIA 8400. Aortic roots were incubated in the model for increasing periods of time (24 h and 40 h) and bacterial titration (1.5 × 104 CFU/mL and 1.5 × 105 CFU/mL) with 5 L cardiac output per minute. After incubation, tissue sections were analysed by fluorescence in situ hybridization (FISH) for direct visualization of the biofilms. Pilot tests for biofilm growth showed monospecies colonization consisting of cocci with time- and inocula-dependent increase after 24 h and 40 h (n = 4). In n = 3 experiments for 24 h, with the same inocula, FISH visualized biofilms with ribosome-containing, and thus metabolic active cocci, tissue infiltration and similar colonization pattern as observed by the FISH in human IE heart valves infected by S. epidermidis.

Conclusion

These results demonstrate the establishment of a novel in vitro model for bacterial biofilm growth on porcine aortic roots mimicking IE. The model will allow to identify predilection sites of valves for bacterial adhesion and biofilm growth and it may serve as baseline for further research on IE therapy and prevention, e.g. the development of antimicrobial transcatheter approaches to IE.

Graphic abstract
Safety and feasibility of prolonged versus early laparoscopic cholecystectomy for acute cholecystitis: a single-center retrospective study
Authors: Cheng Xing , Cheng Ping , Xu Peng , Hu Ping , Zhao Gang , Tao Kaixiong , Wang Guobin , Shuai Xiaoming , Zhang Jinxiang
Published: May 2020

Background

Laparoscopic cholecystectomy (LC) is the standard treatment for acute cholecystitis (AC), and it should be performed within 72 h of symptoms onset if possible. In many undesired situations, LC was performed beyond the golden 72 h. However, the safety and feasibility of prolonged LC (i.e., performed more than 72 h after symptoms onset) are largely unknown, and therefore were investigated in this study.

Methods

We retrospectively enrolled the adult patients who were diagnosed as AC and were treated with LC at the same admission between January 2015 and October 2018 in an emergency department of a tertiary academic medical center in China. The primary outcome was the rate and severity of adverse events, while the secondary outcomes were length of hospital stay and costs.

Results

Among the 104 qualified patients, 70 (67.3%) underwent prolonged LC and 34 (32.7%) underwent early LC (< 72 h of symptom onset). There were no differences between the two groups in mortality rate (none for both), conversion rates (prolonged LC 5.4%, and early LC 8.8%, P = 0.68), intraoperative and postoperative complications (prolonged LC 5.7% and early LC 2.9%, P ≥ 0.99), operation time (prolonged LC 193.5 min and early LC 198.0 min, P = 0.81), and operation costs (prolonged LC 8,700 Yuan, and early LC 8,500 Yuan, P = 0.86). However, the prolonged LC was associated with longer postoperative hospitalization (7.0 days versus 6.0 days, P = 0.03), longer total hospital stay (11.0 days versus 8.0 days, P < 0.01), and subsequently higher total costs (40,400 Yuan versus 31,100 Yuan, P < 0.01).

Conclusions

Prolonged LC is safe and feasible for patients with AC for having similar rates and severity of adverse events as early LC, but it is also associated with longer hospital stay and subsequently higher total cost.
The prevalence of adult de novo scoliosis: A systematic review and meta-analysis
Authors: McAviney Jeb , Roberts Carrie , Sullivan Bryony , Alevras Alexander J. , Graham Petra L. , Brown Benjamin Thomas
Published: May 2020

Introduction

Primary degenerative scoliosis represents a new scoliosis developing in patients with no prior history of spinal curvature. Researchers sought to determine the prevalence of this type of scoliosis.

Methods

MEDLINE, Embase, CINAHL, Web of Science and PubMed were searched from inception to 28th March, 2018. Studies that assessed adults from the general population for scoliosis using imaging techniques were included. Studies were included only if the study authors had excluded participants with previously diagnosed scoliosis and/or spinal disorders. Mixed-effects logistic-regression was used to establish an overall prevalence estimate with 95% confidence intervals (primary outcome) and to examine the effect of age and sex (secondary outcomes).

Results

Four cross-sectional studies and one cohort study, involving 4069 participants (66.6% Female), aged between 41 and 94 years, were eligible for inclusion. Reported prevalence figures ranged from 13 to 68%. The pooled prevalence estimate from the mixed-effects logistic regression analysis was 37.6% (95% CI 18.7–61.8). Females were more likely to suffer from scoliosis compared with males (p < 0.001), with prevalence figures of 41.2% (95% CI 20.7–65.8) versus 27.5% (95% CI 12.2–51.1), respectively. Individuals aged < 60 years had a prevalence of 13% (95% CI 5.2–30.2), whereas the prevalence estimates were substantially higher in the > 60 age group [36% (95% CI 17.4–60.6)].

Conclusion

Primary degenerative scoliosis is a highly prevalent condition, especially in females. Further research targeting this type of scoliosis is required to obtain more precise global prevalence estimates and to understand the influence of age and sex.
Differences between auto-fluorescence and tetracycline-fluorescence in medication-related osteonecrosis of the jaw—a preclinical proof of concept study in the mini-pig
Authors: Ristow Oliver , Nehrbass Dirk , Zeiter Stephan , Arens Daniel , Moratin Julius , Pautke Christoph , Hoffmann Jürgen , Freudlsperger Christian , Otto Sven
Published: May 2020

Objectives

Fluorescence-guided bone surgery is a well-established technique in the treatment of medication-related osteonecrosis of the jaw. No histopathological evidence for bone auto-fluorescence is currently available, and thus, any differences from tetracycline-fluorescence remain unclear. Therefore, the goals of this study were to find out if macroscopic and histological differences occur between the auto- and tetracycline-fluorescence in the delineation of viable and necrotic jawbone in the mini-pig.

Materials and methods

According to the proof of concept, osteonecrosis was provoked in eight Göttingen minipigs. Pigs were divided into two groups (AF group: no fluorochrome label; TF group: tetracycline label). Delineation of necrosis and viable bone was evaluated in vivo and in vitro macro−/microscopically, correlated to fluorescence properties and compared between the two study groups.

Results

No macroscopic and microscopic clinical differences were seen in fluorescence between the AF and TF groups. Macroscopic and microscopic viable bone fluoresced green, whereas necrotic bone showed no or only pale fluorescence in both groups. The auto-fluorescence was attributable to the arrangements and structure of collagen and the cell-filled bone lacunae.

Conclusion

Neither in vivo nor in vitro macroscopically differences are apparent between the auto-fluorescence and the tetracycline-fluorescence of bone. The auto-fluorescence is attributable to the arrangements and structure of collagen and the cell-filled bone lacunae. Tetracycline-fluorescence is a mixture of tetracycline (at the bone edges with increased bone formation) and large components of auto-fluorescence.

Clinical relevance

Because auto-fluorescence is easy to apply, reproducible, and does not rely on the subjective impression of the surgeon, it promises to be an important standardized alternative to tetracycline-labeled MRONJ therapy.
Towards High-Performance Code Generation for Multi-GPU Clusters Based on a Domain-Specific Language for Algorithmic Skeletons
Authors: Wrede Fabian , Kuchen Herbert
Published: May 2020

In earlier work, we defined a domain-specific language (DSL) with the aim to provide an easy-to-use approach for programming multi-core and multi-GPU clusters. The DSL incorporates the idea of utilizing algorithmic skeletons, which are well-known patterns for parallel programming, such as map and reduce. Based on the chosen skeleton, a user-defined function can be applied to a data structure in parallel with the main advantage that the user does not have to worry about implementation details. So far, we had only implemented a generator for multi-core clusters and in this paper we present and evaluate two prototypes of generators for multi-GPU clusters, which are based on OpenACC and CUDA. We have evaluated the approach with four benchmark applications. The results show that the generation approach leads to execution times, which are on par with an alternative library implementation.
Spatio-temporal deep learning methods for motion estimation using 4D OCT image data
Authors: Bengs Marcel , Gessert Nils , Schlüter Matthias , Schlaefer Alexander
Published: May 2020

Purpose

Localizing structures and estimating the motion of a specific target region are common problems for navigation during surgical interventions. Optical coherence tomography (OCT) is an imaging modality with a high spatial and temporal resolution that has been used for intraoperative imaging and also for motion estimation, for example, in the context of ophthalmic surgery or cochleostomy. Recently, motion estimation between a template and a moving OCT image has been studied with deep learning methods to overcome the shortcomings of conventional, feature-based methods.

Methods

We investigate whether using a temporal stream of OCT image volumes can improve deep learning-based motion estimation performance. For this purpose, we design and evaluate several 3D and 4D deep learning methods and we propose a new deep learning approach. Also, we propose a temporal regularization strategy at the model output.

Results

Using a tissue dataset without additional markers, our deep learning methods using 4D data outperform previous approaches. The best performing 4D architecture achieves an correlation coefficient (aCC) of 98.58% compared to 85.0% of a previous 3D deep learning method. Also, our temporal regularization strategy at the output further improves 4D model performance to an aCC of 99.06%. In particular, our 4D method works well for larger motion and is robust toward image rotations and motion distortions.

Conclusions

We propose 4D spatio-temporal deep learning for OCT-based motion estimation. On a tissue dataset, we find that using 4D information for the model input improves performance while maintaining reasonable inference times. Our regularization strategy demonstrates that additional temporal information is also beneficial at the model output.
Detailed energy efficiency strategies for converting an existing office building to NZEB: a case study in the Pacific Northwest
Authors: Alajmi Ali , Short Abby , Ferguson Janna , Poel Kalina Vander , Griffin Corey
Published: May 2020

This paper is an attempt to identify a methodology for converting conventional energy consumption buildings to net-zero energy buildings (NZEB). The first step was rather different from the usual energy audit, which is to analyze a facility’s energy consumptions from both macro- and micro-scales. To implement such an approach, a governmental office building (Metro) in Portland, OR, was chosen as a case study. After a building model was validated against a real measurement, it was then used to evaluate different energy efficiency strategies (EESs) so as to reduce the energy consumption. The EESs showed a reduction in energy use intensity (EUI) from 166 to 66 kWh/m2.year, which is 60% less than the current consumption. The remaining energy demand of the building will be compensated by implementing renewable energy technologies (RETs), namely photovoltaic. The photovoltaic (PV) panels showed viability since they will produce 532 MWh on-site throughout the year, which is sufficient for the future remaining energy demand of the building (490.5 MWh). In conclusion, the simple payback period (SPP) and the life cycle cost analysis proved the feasibility of EESs and RETs. Environmentally, a total of 106 tons of CO2was prevented per year; in addition, 64.6 tons of CO2will also be avoided by the PVs on a yearly basis.
Pure high-grade papillary urothelial bladder cancer: a luminal-like subgroup with potential for targeted therapy
Authors: Schnitzler Tician , Ortiz-Brüchle Nadina , Schneider Ursula , Lurje Isabella , Guricova Karolina , Buchner Alexander , Schulz Gerald Bastian , Heidenreich Axel , Gaisa Nadine Therese , Knüchel Ruth , Garczyk Stefan
Published: May 2020

Purpose

Non-invasive high-grade (HG) bladder cancer is a heterogeneous disease that is characterized insufficiently. First-line Bacillus Calmette-Guérin instillation fails in a substantial amount of cases and alternative bladder-preserving treatments are limited, underlining the need to promote a further molecular understanding of non-invasive HG lesions. Here, we characterized pure HG papillary urothelial bladder cancer (pure pTa HG), a potential subgroup of non-invasive HG bladder carcinomas, with regard to molecular subtype affiliation and potential for targeted therapy.

Methods

An immunohistochemistry panel comprising luminal (KRT20, ERBB2, ESR2, GATA3) and basal (KRT5/6, KRT14) markers as well as p53 and FGFR3 was used to analyze molecular subtype affiliations of 78 pure pTa HG/papillary pT1(a) HG samples. In 66 of these, ERBB2 fluorescence in situ hybridization was performed. Additionally, targeted sequencing (31 genes) of 19 pTa HG cases was conducted, focusing on known therapeutic targets or those described to predict response to targeted therapies noted in registered clinical trials or that are already approved.

Results

We found that pure pTa HG/papillary pT1(a) HG lesions were characterized by a luminal-like phenotype associated with frequent (58% of samples) moderate to high ERBB2 protein expression, rare FGFR3 alterations on genomic and protein levels, and a high frequency (89% of samples) of chromatin-modifying gene alterations. Of note, 95% of pTa HG/papillary pT1 HG cases harbored at least one potential druggable genomic alteration.

Conclusions

Our data should help guiding the selection of targeted therapies for investigation in future clinical trials and, additionally, may provide a basis for prospective mechanistic studies of pTa HG pathogenesis.
I disordini da carenza nutrizionale di iodio in Europa: aggiornamento 2019
Authors: Lazarus John H.
Published: May 2020

Sommario

Il gozzo endemico in Europa è riconosciuto da diversi secoli e la carenza nutrizionale di iodio (IDD) è nota da più di 150 anni. L’impatto della IDD sullo sviluppo del sistema nervoso e particolarmente sul quoziente intellettivo (QI) e sul rendimento scolastico dei bambini è stato documentato negli ultimi 40 anni ma i Ministeri della Salute hanno dedicato scarsa attenzione al problema e, di conseguenza, il consumo di sale fortificato con iodio in Europa è molto variabile. L’Unione Europea ha finanziato un ulteriore progetto Horizon 2020 per valutare la discrepanza nelle misurazioni dello iodio, determinare il ruolo della tireoglobulina circolante quale marcatore di IDD in gravidanza e studiare lo stato di nutrizione iodica combinando i risultati di tre grandi studi di coorte in Spagna, Regno Unito e Paesi Bassi. In aggiunta è stato sviluppato un modello di coorte aperta “state-transition”, finalizzato a prevedere le conseguenze sanitarie ed economiche di un programma di prevenzione delle IDD. Tale analisi ha concluso per il positivo costo/beneficio dell’uso del sale fortificato con iodio quale misura preventiva contro l’IDD in una popolazione moderatamente iodo-deficiente, quale quella residente in Europa. È auspicabile che la dichiarazione di Cracovia possa sostenere future politiche di implementazione a livello dei Ministeri della Salute.
Project leaders’ control resources and role overload as predictors of project success: developing the job demands–resources model
Authors: Lattrich Kai-Kristina , Büttgen Marion
Published: May 2020

Drawing on the job demands–resources model (JD–R model), this article introduces information control and team control as project leader-specific job resources, as well as role overload as a demand, and then examines their influences on project experience appraisals and project success. With a sample of 185 project leaders, this study reveals that all three factors drive project success and project leader well-being. The moderating effects of role overload on the relationships between team control and negative experience and between team control and goal attainment are particularly remarkable; goal attainment is highest with high team control and high role overload. Similarly, the most positive experiences occur with high team control and high role overload. This further development of the JD–R model, thus, identifies information and team control as resources specific to project leaders and role overload as a predominant challenge stressor, with an ambivalent nature.
Cocoon Silk-Derived, Hierarchically Porous Carbon as Anode for Highly Robust Potassium-Ion Hybrid Capacitors
Authors: Luo Haiyan , Chen Maoxin , Cao Jinhui , Zhang Meng , Tan Shan , Wang Lei , Zhong Jiang , Deng Hongli , Zhu Jian , Lu Bingan
Published: May 2020

Potassium-ion hybrid capacitors (KIHCs) have attracted increasing research interest because of the virtues of potassium-ion batteries and supercapacitors. The development of KIHCs is subject to the investigation of applicable K+ storage materials which are able to accommodate the relatively large size and high activity of potassium. Here, we report a cocoon silk chemistry strategy to synthesize a hierarchically porous nitrogen-doped carbon (SHPNC). The as-prepared SHPNC with high surface area and rich N-doping not only offers highly efficient channels for the fast transport of electrons and K ions during cycling, but also provides sufficient void space to relieve volume expansion of electrode and improves its stability. Therefore, KIHCs with SHPNC anode and activated carbon cathode afford high energy of 135 Wh kg−1 (calculated based on the total mass of anode and cathode), long lifespan, and ultrafast charge/slow discharge performance. This study defines that the KIHCs show great application prospect in the field of high-performance energy storage devices.
Reform and Rebellion in Weak States
Authors: Finkel Evgeny , Gehlbach Scott
Published: May 2020

Throughout history, reform has provoked rebellion - not just by the losers from reform, but also among its intended beneficiaries. Finkel and Gehlbach emphasize that, especially in weak states, reform often must be implemented by local actors with a stake in the status quo. In this setting, the promise of reform represents an implicit contract against which subsequent implementation is measured: when implementation falls short of this promise, citizens are aggrieved and more likely to rebel. Finkel and Gehlbach explore this argument in the context of Russia's emancipation of the serfs in 1861 - a fundamental reform of Russian state and society that paradoxically encouraged unrest among the peasants who were its prime beneficiaries. They further examine the empirical reach of their theory through narrative analyses of the Tanzimat reforms of the nineteenth-century Ottoman Empire, land reform in ancient Rome, the abolition of feudalism during the French Revolution, and land reform in contemporary Latin America.
Empirical Evidence of Changing Food Demand and Consumer Preferences in Russia
Authors: Hovhannisyan Vardges , Kondaridze Magdana , Bastian Christopher , Shanoyan Aleksan
Published: May 2020

We investigate food preference changes in Russia that may have resulted from political, economic, and other changes. Our empirical framework utilizes advances in consumer theory and exploits provincial-level panel data on food consumption and supply shifters to identify price and income effects. Our findings indicate that consumers underwent a structural preference change that began in 2007 and continued into 2014. To illustrate the magnitude of this change, we contrast economic effects for select food commodities across regions. The new insights will be useful in designing timely and effective food and trade policies, as well as informing strategy decisions of agribusiness industry players.
Evaluating design uncertainties in additive manufacturing using design artefacts: examples from space industry
Authors: Dordlofva Christo , Törlind Peter
Published: May 2020

The use of metal Additive Manufacturing (AM) has increased in recent years with potential benefits for novel design solutions and efficient manufacturing. In order to utilise these potentials, engineers need to address uncertainties related to product design and the AM process. This paper presents a design process utilising product-specific AM Design Artefacts (AMDAs) to assess uncertainties identified during design. The process emphasises the importance of concurrently developing the product and AM knowledge. Based on a research collaboration with industry, three case studies describe the use of this process in the development of products for AM. In total, six different types of AMDAs show how AM-related uncertainties are resolved to provide confidence in design solutions and manufacturability. The contributions of this paper are: (i) a design process where AMDAs are used as support in evolving and defining an AM design specification, (ii) an example of how Design for AM (DfAM) is practiced in industry and of typical AM uncertainties that are encountered and addressed, and (iii) an example of how collaborative research can facilitate new knowledge for both industry and academia. The practical implication is a DfAM process for engineers to use and adapt according to existing AM knowledge.
Global burden, point sources, and outbreak management of healthcare-associatedBurkholderia cepaciainfections: An integrative review
Authors: Shaban Ramon Z. , Sotomayor-Castillo Cristina , Nahidi Shizar , Li Cecilia , Macbeth Deborough , Mitchell Brett G. , Russo Philip L.
Published: May 2020

Objective:

To examine the global burden, associated point sources, and successful prevention and control measures for documented outbreaks ofBurkholderia cepaciahealthcare-associated infections (HAIs).

Design:

Integrative review.

Methods:

A review of all outbreaks ofBurkholderia cepaciaHAIs published in the peer-reviewed literature between January 1970 and October 2019 was conducted to identify the global burden, associated point sources, and successful prevention and control measures using theGuidelines for Outbreak Reports and Intervention Studies of Nosocomial Infections(ORION).

Results:

In total, we reviewed 125 documented outbreaks ofBurkholderia cepacia–related HAIs worldwide. The reportedB. cepaciaHAIs for this period involved 3,287 patients. The point sources were identified in most outbreaks ofB. cepaciaHAIs (n = 93; 74.4%); they included medication vials, disinfectants, and antiseptics. Moreover, 95 of the outbreak reports (76%) described effective prevention and control measures, but only 33 reports indicated the use of a combination of environment-, patient- and staff-related measures. None of the outbreak reports used the ORION guidelines.

Conclusions:

Outbreaks ofBurkholderia cepaciaHAIs are an ongoing challenge. They are often associated with immunocompromised patients who acquire the infection from exposure to contaminated medications, products, and equipment. These outbreaks are not infrequent, and a range of infection prevention and control measures have been effective in arresting spread. The use of ORION guidelines for outbreak reporting would improve the quality of information and data to generate evidence for translation into practice.
Geography of human capital in Italy: a comparison between macro-regions
Authors: Baldissera Alberto , Cornali Federica
Published: May 2020

Interest in the spread of human capital has grown in recent decades, as it is acknowledged to play an increasingly important role in supporting social and economic development. This paper, starting from the distinction between education – assessed by educational attainment – and literacy proficiency – that is, what people are actually able to do with the written word – examines the distribution of these properties in Italy. Results of analysis show that while the longstanding gap between the North and the South is gradually closing with regard to the distribution of educational credentials, there is still a significant difference in the acquired level of competence. There is also an unexpected result: the regions of the North-West, once the main driver of Italy's economic development, today deploy a smaller stock of human capital than the North-East and Central macro-regions. In light of these findings, improving the education system's effectiveness and creating adequate political, institutional and legal arrangements that favour the development of human capital appear to be an absolute priority for Italy.
Everyday Nationalism in Unsettled Times: In Search of Normality during Pandemic
Authors: Goode J. Paul , Stroup David R. , Gaufman Elizaveta
Published: May 2020

Pandemics and other crisis situations result in unsettled times, or ontologically insecure moments when social and political institutions are in flux. During such crises, the ordinary and unnoticed routines that structure everyday life are thrust into the spotlight as people struggle to maintain or recreate a sense of normalcy. Drawing on a range of cases including China, Russia, the UK, and USA, we examine three categories of everyday practice during the COVID-19 pandemic that respond to disruptions in daily routines and seek a return to national normality: performing national solidarities and exclusions by wearing face masks; consuming the nation in the form of panic buying and conspiracy theories; and enforcing foreign policies through social media and embodiment. This analysis thus breaks with existing works on everyday nationalism and banal nationalism that typically focus on pervasively unnoticed forms of nationalism during settled times, and it challenges approaches to contentious politics that predict protest mobilization for change rather than restoration of the status quo ante. In highlighting the ways that unsettled times disrupt domestic and international structures, this work also presents a first attempt to link everyday nationalism with growing work on international practices.
To PEG or not to PEG that is the question
Authors: Welbank Thomas , Kurien Matthew
Published: May 2020

Nutrition support involves the use of oral supplements, enteral tube feeding or parenteral nutrition. These interventions are considered when oral intake alone fails to meet nutritional requirements. Special diets and oral supplements are usually the first approach to managing malnutrition; however, their role becomes limited when oral intake is restricted or if swallowing is unsafe. Enteral tube feeding or parenteral nutrition are alternative means of providing nutrition support for this select group of patients. Percutaneous endoscopic gastrostomy (PEG) feeding was introduced into clinical practice in 1980. It describes a feeding tube placed directly into the stomach under endoscopic guidance. It is an established means of providing enteral nutrition to those who have functionally normal gastrointestinal tracts, but who cannot meet their nutritional requirements due to inadequate oral intake. The intervention is usually reserved when nutritional intake is likely to be inadequate for more than 4–6 weeks. Although the benefits of PEG have been shown for a select group of patients, there currently exists concerns about the increasing frequency of this intervention, and also uncertainty about the long-term benefits for certain patients. The 2004 UK National Confidential Enquiry into Patient Outcome and Death report emphasised this concern, with almost a fifth of PEG being undertaken for futile indications that negatively influenced morbidity and mortality. The present review paper discusses the indications for, controversies surrounding and complications of gastrostomy feeding and provides practical advice on optimising patient selection for this intervention.
Intention to use respite services among informal care-givers of frail older adults in China: the role of care needs change
Authors: Sun Qian , Lu Nan , Jiang Nan , Lou Vivian W. Q.
Published: May 2020

Population ageing in China calls for evidence-based solutions, especially in terms of fulfilling long-term care needs among frail older adults. Respite services are identified as effective resources for alleviating care-giver burden and promoting the wellbeing of both older adults and their family care-givers. However, respite care is often under-used in China. This research aimed to examine factors associated with intention to use respite services among informal care-givers in Shanghai, mainland China. This study was part of the Longitudinal Study on Family Caregivers for Frail Older Adults in Shanghai. Pairs of older adults and their care-givers (N = 583) who successfully completed the 2013 and 2016 waves were included in the data analysis. Two logistic regression models were conducted, one with time-invariant and one with time-variant factors. The model with time-variant factors had greater explanatory power than the original Andersen model with time-invariant factors influencing intention to use respite services among care-givers. Care-givers had higher odds of intending to use respite services if they had higher care-giving burden, were caring elderly people who experienced care-giver transitions, or were caring for elderly people with increased function of ambulation or decreased function of feeding. The findings imply that change in functional health was a significant determinant of intention to use respite care. Relevant policy and service implications will be discussed.
Candida meningitis in neurosurgical patients: a single-institute study of nine cases over 7 years
Authors: Chen Mantao , Chen Chongchao , Yang Qing , Zhan Renya
Published: May 2020

Candida meningitis in neurosurgical patients is relatively unusual but is associated with a high mortality rate. We present our experience with this infection and discuss the clinical characteristics, treatment options and outcomes. We retrospectively reviewed neurosurgical patients with multiple positive cerebrospinal fluid (CSF) culture results in our hospital from January 2013 to December 2019. Nine patients were available for review according to our inclusion and exclusion criteria. Four species of Candida were isolated from the CSF samples and Candida albicans accounted for half of all infections. Eight infections were associated with ventricle peritoneal shunt, lumbar cistern peritoneal shunt or external ventricular drain. All of these foreign intracranial materials were removed or changed and all the patients received antifungal treatment, including fluconazole and/or voriconazole. It is associated with severe long-term outcomes in survivors and a mortality rate that reaches 11.1%. Prior treatments with broad-spectrum and high-grade antibiotics and anaemia are possible risk factors for Candida meningitis. We advise that foreign intracranial material should be removed or changed as early as possible and the timing of re-shunt operation can be 1 month after control of Candida meningitis has been achieved, with several negative CSF culture results.
The COVID-19 Pandemic: Healthcare Crisis Leadership as Ethics Communication
Authors: HÄYRY MATTI
Published: May 2020

Governmental reactions to crises like the COVID-19 pandemic can be seen as ethics communication. Governments can contain the disease and thereby mitigate the detrimental public health impact; allow the virus to spread to reach herd immunity; test, track, isolate, and treat; and suppress the disease regionally. An observation of Sweden and Finland showed a difference in feasible ways to communicate the chosen policy to the citizenry. Sweden assumed the herd immunity strategy and backed it up with health utilitarian arguments. This was easy to communicate to the Swedish people, who appreciated the voluntary restrictions approach and trusted their decision makers. Finland chose the contain and mitigate strategy and was towards the end of the observation period apparently hesitating between suppression and the test, track, isolate, and treat approach. Both are difficult to communicate to the general public accurately, truthfully, and acceptably. Apart from health utilitarian argumentation, something like the republican political philosophy or selective truth telling are needed. The application of republicanism to the issue, however, is problematic, and hiding the truth seems to go against the basic tenets of liberal democracy.
An Incidental Learning Method to Improve Face-Name Memory in Older Adults With Amnestic Mild Cognitive Impairment
Authors: Biss Renée K. , Rowe Gillian , Hasher Lynn , Murphy Kelly J.
Published: May 2020

Objective:

Forgetting names is a common memory concern for people with amnestic mild cognitive impairment (aMCI) and is related to explicit memory deficits and pathological changes in the medial temporal lobes at the early stages of Alzheimer’s disease (AD). In the current experiment, we tested a unique method to improve memory for face–name associations in people with aMCI involving incidental rehearsal of face–name pairs.

Method:

Older adults with aMCI and age- and education-matched controls learned 24 face–name pairs and were tested via immediate cued recall with faces as cues for associated names. During a 25- to 30-min retention interval, 10 of the face–name pairs reappeared as a quarter of the items on a seemingly unrelated 1-back task on faces, with the superimposed names irrelevant to the task. After the delay, surprise delayed cued recall and forced-choice associative recognition tests were administered for the face–name pairs.

Results:

Both groups showed reduced forgetting of the names that repeated as distraction and enhanced recollection of these pairs.

Conclusions:

The results demonstrate that passive methods to prompt automatic retrieval of associations may hold promise as interventions for people with early signs of AD.
Cassava consumption and the occurrence of cyanide in cassava in Vietnam, Indonesia and Philippines
Authors: Mota-Gutierrez Jatziri , O’Brien Gerard Michael
Published: May 2020

Objective:

To make a tentative assessment of the consumption of cassava in three countries in South-east Asia and the cyanogenic potential (CNp) of the crop as a possible food safety issue.

Design:

We used data from the Ministry of Health in Vietnam and Statistics Authorities in Indonesia and Philippines (mean household consumption per province) to assess cassava consumption. Conversions of units were needed to facilitate the comparison of cassava consumption between countries. The most up-to-date data available regarding both cassava consumption and the CNp of cassava grown in the respective countries were assessed.

Settings:

Vietnam, Indonesia and Philippines.

Participants:

Respondents from provinces in Vietnam (nineteen), Indonesia (thirty-three) and Philippines (eighty-one) were asked to complete a recall questionnaire detailing either the previous 24-h’ or the 7-d’ cassava consumption.

Results:

Among the three countries, available data indicated that the highest median cassava-consumption figurespercapitawere from Indonesia and the Philippines (9·01 and 7·28 g/capita per d, respectively), with Vietnam having the least (1·14 g/capita per d). Published information regarding the CNp of cassava in the three countries was limited.

Conclusions:

While the findings of the present study are somewhat limited by a lack of available information regarding both the extent of cassava consumption and the CNp of cassava consumed in the three countries, it appears likely that cyanogen intake arising from cassava consumption among the three countries exceeds the FAO/WHO Provisional Maximum Tolerable Daily Intake, although any risk to public health appears limited to a minority of provinces in each country.
Hezbollah, Neoliberalism and Political Economy
Authors: Daher Joseph
Published: May 2020

Hezbollah, like other Islamic fundamentalist movements in the region, professes an “Islamic way of life” as an objective to achieve and implement in society, but its actual practices can best be understood as harmonious with—and reflective of—the nature of the capitalist environment in which it operates, despite discourses appealing to the popular classes of society. Religious fundamentalist movements should indeed not been considered as fossilized elements from the past. While they may employ symbols and narratives from earlier periods, fundamentalisms are alive, dynamic, and representative of major contemporary trends. Their emergence must thus be fully situated in the political, economic, and social context of the contemporary period. In this perspective, the article analyzes the political economy of Hezbollah and its support for neoliberal policies.
Safer cash in conflict: Exploring protection risks and barriers in cash programming for internally displaced persons in Cameroon and Afghanistan
Authors: Freccero Julie , Taylor Audrey , Ortega Joanna , Buda Zabihullah , Awah Paschal Kum , Blackwell Alexandra , Cordero Ricardo Pla , Stover Eric
Published: May 2020

As cash increasingly becomes an essential part of humanitarian assistance, it is critical that practitioners are aware of, and work to mitigate, exposure to protection risks among the most vulnerable recipients. This article presents findings from qualitative research exploring protection risks and barriers that arise in cash programming for internally displaced persons at high risk of violence and exploitation in Cameroon and Afghanistan. The authors conclude with recommendations for mainstreaming global protection principles into cash programmes, as well as key considerations for designing and implementing cash programmes in ways that minimize existing risks of harm and avoid creating new ones.
Born in the twilight zone: Birth registration in insurgent areas
Authors: Hampton Kathryn
Published: May 2020

Insurgent groups are registering births in territories which they control, and yet States do not recognize insurgent birth registration, resulting in a legal vacuum with harsh consequences for children. Based on international human rights and humanitarian law provisions related to birth registration, this article argues that insurgent groups have an inherent power to register births in order to fulfil their obligations under international humanitarian law, and that State obligation to ensure the right to recognition as a person under the law should require States to recognize insurgent birth registration in order to prevent harm to children.
Caregiver involvement in psychiatric inpatient treatment – a representative survey among triads of patients, caregivers and hospital psychiatrists
Authors: Schuster F. , Holzhüter F. , Heres S. , Hamann J.
Published: May 2020

Aims

Studies on the frequency of caregiver involvement in representative inpatient samples are scarce. The aim of our study was to conduct a representative survey on caregiver involvement in routine inpatient care involving all three parties (patients, caregivers, psychiatrists). Therefore, we performed face-to-face interviews consisting of open-ended questions to gain a deeper understanding of when and how caregivers are involved in care treatment and to identify which topics are mainly discussed.

Methods

This cross-sectional survey included inpatients from 55 acute psychiatric wards across ten psychiatric hospitals, their treating psychiatrists and, when possible, their caregivers. In total, we performed semi-structured face-to-face interviews with 247 patients, their treating psychiatrists and 94 informal caregivers. Each psychiatrist named the next two to three patients to be discharged. After a patient had given informed consent, the interview was performed by a researcher. In addition, the psychiatrist and, when possible, the primary caregiver identified by the patient, were also interviewed.

Results

It was perceived by both patients and psychiatrists that contact between caregiver and psychiatrist had taken place in one-third of the patient cases. Predictors for psychiatrist-caregiver-contact were revealed in the patient's diagnosis (schizophrenia), a lower history of inpatient stays, and the respective hospital. According to psychiatrists the most frequent subjects of discussion with caregivers involved therapeutic issues and organisational and social-psychiatric topics (e.g. work, living and social support). Patients and caregivers stated that psychiatric treatment and the diagnostic classification of the mental illness were the most frequent topics of conversation. For all three groups, the most often cited reason for missed caregiver involvement was the subjective perception that a caregiver was not in fact needed.

Conclusions

Whether or not caregivers were contacted and involved during an inpatient stay strongly depended on the individual hospital. The frequency of involvement of caregivers can certainly be increased by changing processes and structures in hospitals. All three parties (patients, caregivers and psychiatrists) most often stated that the caregiver was not involved in the treatment because they thought it was unnecessary. Evidence demonstrates the positive effect of caregivers' involvement on the therapeutic process but also on the well-being of the caregiver, therefore it is necessary to increase awareness of this evidence among all three interest groups.
Modeling the Acoustic Flux Inside the Magmatic Conduit by 3D‐FDTD Simulation
Authors: Lacanna G. , Ripepe M.
Published: May 2020

Infrasound measurements at open‐vent volcanoes are crucial parameters for monitoring and exploring the explosive source dynamics. Volcano infrasound depicts the pressure variation within the volcanic conduit generated by the sudden expansion of volcanic gases during the fragmentation process, and it can provide important constraints on the explosive source parameters (i.e., volumetric flux and exit velocity). The acoustic source of volcanic explosions is modeled by infrasonic signals measured near the volcano vent (<3 km) assuming linear theory of sound and considering the effects of topography and atmosphere on the acoustic wavefield. However, little is known on the initial conditions within the volcanic conduit. In linear acoustics, the wavefield in a cylindrical duct propagates as a plane wavefront, which becomes spherical outside the vent. The acoustic impedance at the open end of the duct is a function of the vent radius and the pressure wavelength, and it controls the acoustic wavefield radiated outside the duct in terms of amplitude and radiation pattern. We present here a 3D‐Finite Difference Time Domain (FDTD) numerical method to evaluate the scattering effects on the infrasound signal produced by topography around the crater and along the source‐receiver path in terms of Green's function. Once the effects of topography are removed, we show how pressure perturbation is largely affected by the impedance contrast at the vent which, when not considered, is introducing errors in the way we quantify explosive dynamics.
Time‐Lapse Acoustic Imaging of Mesoscale and Fine‐Scale Variability within the Faroe‐Shetland Channel
Authors: Dickinson Alex , White N. J. , Caulfield C. P.
Published: May 2020

We describe and analyze the results of a three‐dimensional seismic (i.e., acoustic) reflection survey from the Faroe‐Shetland Channel that is calibrated with near‐coincident hydrographic and satellite observations. 54 vertical seismic transects were acquired over a period of 25 days. On each transect, a 250‐ to 400‐m‐thick band of reflections is observed within the water column. Hydrographic measurements demonstrate that this reflective band is caused by temperature variations within the pycnocline that separates warm, near‐surface waters of Atlantic origin from cold, deep waters that flow southward from the Nordic Seas. Tilting of reflective surfaces records geostrophic shear between these near‐surface and deep waters. Measurements of temporal changes of pycnoclinic depth and of reflection tilt are used to infer the existence of an anticyclonic vortex that advects northeastward. Comparison with satellite measurements of sea‐surface temperature and height suggests that this vortex is caused by meandering of the Continental Slope Current. A model of a Gaussian vortex is used to match seismic and satellite observations. This putative vortex grows to have a core radius of 40–50 km. It has a maximum azimuthal velocity of 0.3–0.4 m s−1and translates at 0.01–0.1 m s−1. Within the pycnocline, diapycnal diffusivity,K, is estimated by analyzing the turbulent spectral subrange of tracked reflections.Kvaries between 10−5.7m2s−1and 10−5.0 m2 s−1in a pattern that is broadly consistent with translation of the vortex. Our integrated study demonstrates the ability of time‐lapse seismic reflection surveys to dynamically resolve the effects that mesoscale activity has upon deep thermohaline structure on scales from meters to hundreds of kilometers.
Sources and Sinks of Isoprene in the Global Open Ocean: Simulated Patterns and Emissions to the Atmosphere
Authors: Conte Ludivine , Szopa Sophie , Aumont Olivier , Gros Valérie , Bopp Laurent
Published: May 2020

The ocean is a source of isoprene to the atmosphere. Although their global estimates are relatively low compared with the terrestrial source, these emissions have an influence on atmospheric chemistry. The lack of knowledge about the sources and sinks of isoprene in the ocean has hitherto precluded a precise assessment of when and where these emissions might be significant. Here we use the general circulation and biogeochemistry model Nucleus for European Modelling of the Ocean, Pelagic Interaction Scheme for Carbon and Ecosystem Studies (NEMO‐PISCES) to explore different parameterizations of the 3D oceanic sources and sinks of isoprene. In addition, we investigate a representation of the isoprene emission due to photoproduction in the sea surface microlayer. Our model estimates are complemented by a new data compilation of laboratory isoprene production rates and in situ isoprene concentrations. This study constitutes the first attempt to simulate isoprene in a global 3D ocean biogeochemical model. We find that sea surface temperature is an important driver modulating phytoplankton isoprene production and that light levels only play a secondary role at the scale of the global ocean. Furthermore, the use of a variable biochemical consumption rate improves the model‐data comparison. We show the importance of isoprene production below the mixed layer and, as a consequence, demonstrate that models based on 2D surface satellite chlorophyll‐a could miss up to 18.5% of oceanic isoprene emissions. The oceanic isoprene emissions to the atmosphere are estimated to 0.66 (0.43–0.82) Tg C yr−1 in the low range of previous estimates.