bluuebunny/crossref_metadata_2025 huggingface dataset:
Potentially Inappropriate Prescriptions for Anticholinergic Medications for Patients with Constipation
Authors: Valladales-Restrepo Luis Fernando , Paredes-Mendoza Milton , Machado-Alba Jorge Enrique
Published: March 2020

Introduction: Constipation is a very common functional gastrointestinal disorder in the general population and can be primary or secondary. Objective: The aim of this study was to estimate the anticholinergic burden of prescribed drugs in a population diagnosed with constipation in Colombia. Methods: This was a cross-sectional study that used a population database of 6.5 million people to identify the prescription of cholinergic antagonists and drugs for the management of constipation in outpatient services. The anticholinergic burden was evaluated using the Anticholinergic Drug Scale. Potentially inappropriate prescriptions that increased the risk of constipation were identified. Results: A total of 3,887 patients with constipation were identified; the identified patients had a mean age of 54.4 ± 21.9 years, and 69.4% were women. Eighty percent received at least one laxative, and the most prescribed laxative was bisacodyl (50.5%). Forty-one percent (n = 1,586) of all patients received drugs with cholinergic antagonist activity, in particular codeine (6.5%) and valproic acid (6.5%). Being over 30 years of age (odds ratio [OR]: 1.79; 95% confidence interval [CI]: 1.24–2.57), being treated in the cities of Manizales (OR: 2.20; 95% CI: 1.50–3.21) and Pereira (OR: 1.49; 95% CI: 1.07–2.09), and having hypothyroidism as a comorbidity (OR: 1.37; 95% CI: 1.08–1.73) were associated with a greater probability of receiving medications with an anticholinergic burden of 3 or more points. Conclusions: The majority of patients with constipation were women and were using laxatives to manage constipation. A large proportion of patients were prescribed at least one cholinergic antagonist drug, with an increased probability of use after 30 years of age.
RNA Sequencing and Bioinformatic Analysis on Retinoblastoma Revealing that Cell Cycle Deregulation Is a Key Process in Retinoblastoma Tumorigenesis
Authors: Nie Cong , Ma Huan , Gao Yang , Li Jinmiao , Tang Zhixin , Chen Ying , Lu Rong
Published: March 2020

Purpose: Retinoblastoma (RB) is a primary pediatric ocular malignancy that can be fatal with inadequate treatment. While multimodal treatments are applied for eye salvage, vision loss and metastasis can occur in some patients. The present study aimed to explore key pathways and factors in RB pathogenesis, which could be potential targets for novel RB treatments. Methods: RNA sequencing was performed on three RB tissues and referenced with three normal retinas. Differentially expressed genes (DEGs) were identified from sequencing data and further analyzed with clustering analysis, function and pathway enrichment, protein-protein interaction (PPI), and data-mining analysis in order to screen for tumorigenic relevancy. Results: A total of 331 DEGs were identified by clustering analysis of RB tissues, and the expression patterns were significantly distinguishable from normal retinas. Function and pathway enrichment and PPI analysis together showed that cell cycle was the most prominently upregulated pathway found in RB tissues. Following comprehensive bioinformatic analyses, six key genes relevant to cell cycle regulation were identified, namely BUB1, RRM2, TPX2, UBE2C, NUSAP1, and DTL. Conclusions: Cell cycle pathway and six relevant genes may be potential key factors in RB tumorigenesis and laying the foundation for prospective investigation on development of novel targeted therapies.
Fault detection for air conditioning system using machine learning
Authors: Sulaiman Noor Asyikin , Abdullah Md Pauzi , Abdullah Hayati , Zainudin Muhammad Noorazlan Shah , Md Yusop Azdiana
Published: March 2020

Air conditioning system is a complex system and consumes the most energy in a building. Any fault in the system operation such as cooling tower fan faulty, compressor failure, damper stuck, etc. could lead to energy wastage and reduction in the system’s coefficient of performance (COP). Due to the complexity of the air conditioning system, detecting those faults is hard as it requires exhaustive inspections. This paper consists of two parts; i) to investigate the impact of different faults related to the air conditioning system on COP and ii) to analyse the performances of machine learning algorithms to classify those faults. Three supervised learning classifier models were developed, which were deep learning, support vector machine (SVM) and multi-layer perceptron (MLP). The performances of each classifier were investigated in terms of six different classes of faults. Results showed that different faults give different negative impacts on the COP. Also, the three supervised learning classifier models able to classify all faults for more than 94%, and MLP produced the highest accuracy and precision among all.
Online dictionary learning for car recognition using sparse coding and LARS
Authors: Kamal Ilias , Housni Khalid , Hadi Youssef
Published: March 2020

The bag of feature method coupled with online dictionary learning is the basis of our car make and model recognition algorithm. By using a sparse coding computing technique named LARS (Least Angle Regression) we learn a dictionary of codewords over a dataset of Square Mapped Gradient feature vectors obtained from a densely sampled narrow patch of the front part of vehicles. We then apply SVMs (Support Vector Machines) and KMeans supervised classification to obtain some promising results.
Taxonomy of the leaf beetle genus Exomis Weise (Coleoptera: Chrysomelidae: Clytrini) with description of six new species from China
Authors: WANG FENG-YAN , ZHOU HONG-ZHANG
Published: March 2020

This publication revises the taxonomy of the leaf beetle genus Exomis Weise, 1889 (Coleoptera: Chrysomelidae: Clytrini) which is endemic to China. Six new species are described: E. deqinensis sp. nov., E. huangi sp. nov., E. pubescens sp. nov., E. pubipennis sp. nov., E. tanae sp. nov. and E. viridis sp. nov., in addition to two known species, namely E. degenevei Pic, 1932 and E. peplopteroides Weise, 1889. Exomis oblongum (Lopatin & Konstantinov, 2009) from China (Yunnan) is transferred to this genus as new combination. The total Chinese fauna of Exomis is thus increased to nine species. A key to these species is provided and, for each of them, also a color photo of habitus and line drawings of the aedeagus, spermatheca and kotpresse, in order to ease identification in the future.
Blurred Shots: Investigating the Information Crisis Around Vaccination in Italy
Authors: Lovari Alessandro , Martino Valentina , Righetti Nicola
Published: March 2020

This article aims at exploring a case of information crisis in Italy through the lens of vaccination-related topics. Such a controversial issue, dividing public opinion and political agendas, has received diverse information coverage and public policies over time in the Italian context, whose situation appears quite unique compared with other countries because of a strong media spectacularization and politicization of the topic. In particular, approval of the “Lorenzin Decree,” increasing the number of mandatory vaccinations from 4 to 10, generated a nationwide debate that divided public opinion and political parties, triggering a complex informative crisis and fostering the perception of a social emergency on social media. This resulted in negative stress on lay publics and on the public health system. The study adopted an interdisciplinary framework, including political science, public relations, and health communication studies, as well as a mixed-method approach, combining data mining techniques related to news media coverage and social media engagement, with in-depth interviews to key experts, selected among researchers, journalists, and communication managers. The article investigates reasons for the information crisis and identifies possible solutions and interventions to improve the effectiveness of public health communication and mitigate the social consequences of misinformation around vaccination.
Pharmacists’ Utilization of Non-HDL-C Levels in Managing Patients With Lipid Disorders
Authors: Plakogiannis Roda , Saseen Joseph J. , Stefanidis Abraham
Published: March 2020

Background: Since 2013 there have been cholesterol guideline changes impacting pharmacists’ clinical practice in managing lipid disorders. For more than a decade, cholesterol management was based on the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol Adult Treatment Panel III guideline, highlighting non-high-density lipoprotein cholesterol (non-HDL-C) as a secondary target in persons with triglycerides ≥200 mg/dL, after low-density lipoprotein cholesterol goal attainment. The 2013 American College of Cardiology and American Heart Association (ACC/AHA) guideline differed from the traditional management of dyslipidemia, in part no longer emphasizing the utilization of non-HDL-C levels. Objective: To measure pharmacists’ attitudes and behavior regarding utilization of non-HDL-C level calculation before and after the inception of the 2013 ACC/AHA cholesterol guideline. Methods: Pharmacists in the American College of Clinical Pharmacy ambulatory care listserv participated in an electronic survey in November 2013, before the inception of the 2013 ACC/AHA guideline, and again in October 2018. Results: We collected 391 usable responses from participants; 212 responses in 2013 and 179 responses in 2018. The before and after comparison revealed that respondents in 2013 reported significantly higher frequency of calculating non-HDL-C levels (mean = 1.88, SD = 0.80) than respondents in 2018 (mean = 1.66, SD = 0.79) ( P ≤ .001). Also, the frequency that non-HDL-C level calculation alters decisions regarding course of treatment was lower in the 2018 (mean = 3.50, SD = 1.06) in comparison with 2013 (mean = 3.77, SD = 0.88) ( P ≤ .05). Furthermore, pharmacists were more favorable toward the inclusion of non-HDL-C level calculation in 2018 (mean = 3.77, SD = 1.05) than in 2013 (mean = 3.13, SD = 1.33) ( P ≤ .001). Conclusion and Relevance: Clinical pharmacists’ utilization of non-HDL-C levels in the clinical management of patients with hypercholesterolemia has decreased, highlighting the need for further education on the importance of evaluating non-HDL-C levels in the very high-risk atherosclerotic cardiovascular disease population.
Topical Fluoride to Prevent Root Caries: Systematic Review with Network Meta-analysis
Authors: Zhang J. , Sardana D. , Li K.Y. , Leung K.C.M. , Lo E.C.M.
Published: March 2020

The aim of this systematic review and network meta-analysis was to summarize the direct and indirect clinical evidence on the effectiveness of professionally applied and self-applied topical fluorides in preventing dental root caries. Controlled clinical trials with any follow-up duration were included. MEDLINE, PubMed, Embase, Scopus, and Cochrane Library were searched. Two reviewers independently carried out the selection of studies, data extraction, risk-of-bias assessments, and assessment of the certainty in the evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Fixed effects model and frequentist approach were used in the network meta-analyses. Nine clinical trials involving 4,030 participants were included. Five professionally applied and 7 self-applied topical fluoride agents or combinations were included in the meta-analyses. Compared to control group, 38% silver diamine fluoride solution, 5% sodium fluoride varnish, and 1.2% acidulated phosphate fluoride reduced root caries increment after 2 y (ranging from 0.59 to 0.85 mean decayed or filled root [DF-root]). Fluoride mouth rinse and fluoride toothpaste, used alone or in combination, reduced root caries increment after 1 y (ranging from 0.29 to 1.90 mean DF-root). Among the professionally applied topical fluorides reviewed, an annually applied 38% silver diamine fluoride (SDF) solution combined with oral health education is most likely to be the most effective in preventing dental root caries. Among the reviewed self-applied topical fluoride methods, daily use of a 0.2% sodium fluoride (NaF) mouth rinse is most likely to be the most effective, followed by 1100 ppm to 1500 ppm fluoride toothpaste plus 0.05% NaF mouth rinse, and 1100 ppm to 1500 ppm fluoride toothpaste.
Spatial Design of Polymicrobial Oral Biofilm in Its Native Disease State
Authors: Kim D. , Koo H.
Published: March 2020

Biofilms are structured microbial communities adhered to surfaces that cause many human infections. The study of oral biofilms has revealed complex composition, spatial organization, and phenotypic/genotypic diversity of the resident microbiota at the various sites in the mouth. Yet, knowledge about the spatial arrangement, positioning, and function of the polymicrobial community across the intact biofilm architecture remains sparse. Using multiple length scale imaging and computational analysis, we discovered unique spatial designs comprising mixed interbacterial species and interkingdom communities within intact biofilms formed on teeth of toddlers with caries. Intriguing structural patterns ranging from intermixed communities with extensive coaggregation (including bacterial-fungal clustering) to spatially segregated species forming a multilayered architecture were found. Among them, a distinctive 3-dimensional structure exhibited densely clustered cariogenic pathogens that were surrounded by outer layers of mixed bacterial communities in juxtaposition, forming a highly ordered spatial organization. These findings are particularly relevant as we approach the postmicrobiome era whereby studying the spatial structure of the pathogen and commensal microbiota may be important for understanding the microbiome function at the infection site to coordinate the disease process in situ.
Non-sterilizing Hysterectomies? A Catholic Critique of the CDF
Authors: Schulz Joshua , Hamant William
Published: March 2020

In 2019, the Congregation for the Doctrine of the Faith (CDF) issued a statement that a woman could morally undergo a hysterectomy to avoid serial miscarriages if her uterus were incapable of sustaining a child until viability because the procedure would not constitute a direct sterilization. We believe the CDF’s conclusion and line of argumentation are both mistaken. Since the proposed hysterectomy seeks to make impossible what is presently possible—conceiving a child—it must therefore constitute a direct sterilization, which the Church has long taught is immoral. Using the Principle of Totality, we offer and defend a more straightforward interpretation of the case, arguing that while the woman’s condition is both tragic and chronic, spiritual counseling and training in natural family planning should be recommended, as a hysterectomy is not medically indicated in this case.

The Congregation for the Doctrine of the Faith (CDF)'s recently issued a statement claiming that a woman could morally undergo a hysterectomy to avoid serial miscarriages if her uterus were incapable of sustaining a child until viability on the grounds that the procedure would not constitute a direct sterilization. We argue this is mistaken, and that the procedure would constitute a direct sterilization.
Understanding Disability Biases in Undergraduate Rehabilitation Students: An Exploratory Study
Authors: Levine Allison , Park Jinhee , Kuo Hung Jen
Published: March 2020

Shaping and cultivating positive attitudes toward people with disabilities is an important task for all programs that prepare future rehabilitation practitioners. So too, is identifying potentially problematic attitudes or biases about ability status. With the growth of undergraduate rehabilitation programs, it is imperative for educators to understand the factors that may influence students’ biases about people with differing ability status. Many training programs address explicit biases (e.g., those measured via self report), but overlook the influence and existence of implicit biases among students. Furthermore, many trainings focus on stimulating awareness of potential bias, rather than diving into causes and impacts. In order to develop effective curricula for mitigating bias and training infused with social justice, it is critical to understand this phenomena. Using a quantiative design, the current study examines explicit and implicit biases of students in undergraduate rehabilitation programs at three institutions across the United States. Results support that explicit and implicit biases are two separate constructs and should be treated as such (i.e., educational activities about bias are not sufficient). In addition, the results were indicative of the importance of addressing biases as multidimensional, and the potential utility of contact experiences as a factor for mitigating bias.
Choosing Schools in Changing Places: Examining School Enrollment in Gentrifying Neighborhoods
Authors: Candipan Jennifer
Published: March 2020

School choice expansion in recent decades has weakened the strong link between neighborhoods and schools created under a strict residence-based school assignment system, decoupling residential and school enrollment decisions for some families. Recent work suggests that the neighborhood-school link is weakening the most in neighborhoods experiencing gentrification. Using a novel combination of individual, school, and neighborhood data that link children to both assigned and enrolled schools, this study examines family, school, and neighborhood factors that shape whether parents enroll in the assigned local school. I find that parents are more likely to opt out of neighborhood schools in gentrifying neighborhoods compared with non-gentrifying neighborhoods when nearby choice options are available. Recent movers to gentrifying neighborhoods bypass local schools more compared with parents who have lived in the neighborhood longer. Results have implications for thinking about neighborhood-school linkages in an era of school choice and urban change.
Analyzing the thermal and hygral behavior of wool and its impact on fabric dimensional stability for wool processing and garment manufacturing
Authors: Zhou Qi , Wang Wuchao , Zhang Yanyun , Hurren Christopher J , Li Qing
Published: March 2020

Wool is one of the most moisture sensitive natural fibers. This paper investigated changes of wool fiber diameter, fabric dimensions and fabric dimensional properties, as a function of moisture regain, temperature and pH. Experiments were conducted on fabrics with different weave structures as well as on fabrics with and without a permanent set.

Results showed that the fabrics tended to contract when they were subjected to increased temperature at saturated regain. The degree of contraction appeared to depend on the weave structure of the fabrics and permanent setting treatments. Dimensions of the wool fabrics were also found to be dependent on the pH. Greater fabric dimensions were observed at pH 7.2 than at pH 2.1. The contraction effect was almost reversible when unset fabric samples were measured in pH 2.1.

The reasons for the changes of dimensional property were analyzed in terms of changes in wool fiber swelling, yarn crimp and polymer relaxation phenomena with changes in regain, temperature and pH. Industrial implications from outcomes of this research to practical wool processing are discussed in the paper.
In situ characterization of the morphological wrinkling of woven fibrous materials by a mechanical test
Authors: Hu Xiaorui , Sun Fengxin , Wang Qicai , Gao Weidong
Published: March 2020

Wrinkling is one of the most common flaws of woven fabrics in domestic use and industrial applications. It is necessary to develop an objective evaluation method to quantify the smoothness appearance of fabrics effectively. Herein, a fabric multi-deformation tester (FMDT) was designed to evaluate the smoothness appearance of garment fabrics by one sequential mechanical test, overcoming the main difficulties of the existing visual measurement methods for wrinkling evaluation of fabrics with complex colors and patterns. The k-means clustering algorithm was used to objectively cluster the fabric samples based on the characteristic parameters, including the wrinkle-induced residual force ( F wr), hysteresis distance ( H fr), position deflection ( D fr) and stretching recovery slope ( S tr), from the testing curve and the thickness and weight of fabrics, and comparisons with subjective evaluation were also conducted. The results reveal that the k-means clustering is able to classify the smoothness appearance of fabrics using the selected characteristic parameters, showing a good consistency with the subjective clustering results. The feasibility of using the mechanical and deformation properties of textiles to characterize fabric smoothness appearance is proved, and the FMDT provides a potential method to analyze the wrinkling of fibrous materials in a convenient way.
Burdensome Administration and Its Risks: Competing Logics in Policy Implementation
Authors: Carey Gemma , Dickinson Helen , Malbon Eleanor , Weier Megan , Duff Gordon
Published: March 2020

Australia is currently undergoing significant social policy reform under the introduction of a personalized scheme for disability services: the National Disability Insurance Scheme (NDIS). This article explores the growing administrative burdens placed on disability providers operating under the new scheme, using an Australia-wide survey of the disability sector. The 2018 National Disability Services survey of the disability sector reveals that administrative burden is the most commented on challenge for providers. Moreover, providers linked this burden to questions concerning their financial sustainability and ability to continue to offer services within the NDIS. In this article, we explore the sources of these administrative burdens and their relationships with the institutional logics at play in the NDIS. In addition to documenting the impact of system change on the Australian disability service sector, this article raises questions regarding institutional hybridity within personalization schemes more broadly and whether they are a source of tension, innovation, or both.
Consensus conditions for higher-order descriptor multi-agent systems with communication time-delays
Authors: Gao Zhiyun , Zhang Huaguang , Duan Jie , Cai Yuliang
Published: March 2020

In this paper, the consensus problem for higher-order descriptor multi-agent systems (DMASs) with time-delays is investigated. Firstly, a distributed consensus protocol based on output feedback is proposed. Secondly, the state transformation is presented to convert the consensus problem into the stability problem. Based on the Lyapunov theory and the linear matrix inequality (LMI) method, sufficient conditions in terms of LMIs are derived to ensure that consensus of DMASs can be achieved. Moreover, the consensus problem for higher-order DMASs with delays is solved under two cases where interaction topologies are undirected and directed, which is more complicated and challenging. Finally, numerical simulations are provided to demonstrate the effectiveness of our results.
A data-driven approach for trajectory-based aircraft operation with controlled time of arrival and along-track wind effects
Authors: Jiang Gaoyang , Hou Zhongsheng
Published: March 2020

Trajectory-based aircraft operation and control is one of the hot issues in air traffic management. However, the accurate mechanism modeling of aircraft is tough work, and the operation data have not been effectively utilized in many studies. So, in this work, we apply the model-free adaptive iterative learning control method to address the time-of-arrival control problem in trajectory-based aircraft operation. This problem is first formulated into a trajectory tracking problem with along-track wind disturbance. Through rigorous analysis, it is shown that this method, combined with point-to-point iterative learning control (ILC) strategy, can effectively deal with the arrival time control problem with multiple time constraints. Then, the terminal ILC strategy is applied, aiming to resolve the same problem with a time constraint at the end point. Compared with the PID (Proportional Integral Derivative) type ILC, the proposed method improves control performance by 11.15% in root mean square of tracking error and 9.32% in integral time absolute error. The sensitivity and flexibility of the data-driven approach is further verified through numerical simulations.
Augmented Reality and Functional Skills Acquisition Among Individuals With Special Needs: A Meta-Analysis of Group Design Studies
Authors: Baragash Reem Sulaiman , Al-Samarraie Hosam , Moody Louise , Zaqout Fahed
Published: March 2020

Augmented reality (AR) has the potential to support individuals with special needs and to enable their development of daily living skills. This meta-analysis study examined the effect of AR on functional skills acquisition across individuals affected by different disabilities. Group design studies based on a random-effects model alongside the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were used in this study. A total of 119 individuals with different types of disabilities (including intellectual disability, autism spectrum disorder, attention deficit hyperactivity disorder, Down syndrome, hearing disability, and visual disability) were obtained from seven studies. The overall effect size of AR across the seven studies was significant. The results showed that AR can be effective and helpful for individuals with disabilities to help them make daily decisions and guide their actions in society. The implications for practice and research as well as the possible areas that require further investigation are discussed.
Assessment of the Mode of Action Underlying the Effects of GenX in Mouse Liver and Implications for Assessing Human Health Risks
Authors: Chappell Grace A. , Thompson Chad M. , Wolf Jeffrey C. , Cullen John M. , Klaunig James E. , Haws Laurie C.
Published: March 2020

GenX is an alternative to environmentally persistent long-chain perfluoroalkyl and polyfluoroalkyl substances. Mice exposed to GenX exhibit liver hypertrophy, elevated peroxisomal enzyme activity, and other apical endpoints consistent with peroxisome proliferators. To investigate the potential role of peroxisome proliferator-activated receptor alpha (PPARα) activation in mice, and other molecular signals potentially related to observed liver changes, RNA sequencing was conducted on paraffin-embedded liver sections from a 90-day subchronic toxicity study of GenX conducted in mice. Differentially expressed genes were identified for each treatment group, and gene set enrichment analysis was conducted using gene sets that represent biological processes and known canonical pathways. Peroxisome signaling and fatty acid metabolism were among the most significantly enriched gene sets in both sexes at 0.5 and 5 mg/kg GenX; no pathways were enriched at 0.1 mg/kg. Gene sets specific to the PPARα subtype were significantly enriched. These findings were phenotypically anchored to histopathological changes in the same tissue blocks: hypertrophy, mitoses, and apoptosis. In vitro PPARα transactivation assays indicated that GenX activates mouse PPARα. These results indicate that the liver changes observed in GenX-treated mice occur via a mode of action (MOA) involving PPARα, an important finding for human health risk assessment as this MOA has limited relevance to humans.
Assessing Communication Behaviours of Hospital Pharmacists: How Well Do the Perspectives of Pharmacists, Patients, and an Independent Observer Align?
Authors: Chevalier Bernadette A. M. , Watson Bernadette M. , Barras Michael A. , Cottrell William Neil
Published: March 2020

Pharmacists need effective communication skills to provide high-quality patient care. To date, little has been published about hospital pharmacists’ communication behaviours, most is atheoretical, and has not studied patients and pharmacists as a dyad. We investigated how well pharmacists’ and patients’ perspectives of their shared conversation aligned, and how closely these perspectives matched that of an outsider (observer). We invoked communication accommodation theory using audio-recorded, semi-structured interviews, held separately with hospital patients ( n = 48) and pharmacists ( n = 12). Quantitative analyses indicated where patients, pharmacists, and observer perspectives aligned and occasions where they did not. With some exceptions, most pharmacists and patients held similar opinions about pharmacist communication behaviours. Observer–pharmacist discrepancies highlighted areas for further communication development using communication accommodation theory as a training tool.
Intra-parotid lymph node metastasis in patients with non-cutaneous head and neck cancers: clinical and imaging features for differentiation from simultaneous parotid primary tumor
Authors: Kim Hye Jeong , Yoon Dae Young , Hong Ji Hyun , Yun Eun Joo , Baek Sora , Kim Eun Soo , Park Min Woo , Kwon Kee Hwan
Published: March 2020

Background

Although uncommon, intra-parotid lymph node (IPLN) metastasis should be considered in the differential diagnosis of parotid masses in patients with head and neck cancers.

Purpose

To compare the clinical and imaging features of IPLN metastases from head and neck cancers and simultaneous parotid primary tumors.

Material and Methods

A retrospective review of 2199 patients with non-parotid head and neck cancers revealed 63 patients who also underwent parotidectomy during curative resection of head and neck cancer. After exclusion of direct extension to the parotid gland from adjacent primary tumors (n = 12) and IPLN metastases from skin cancer (n = 5), the final study group was composed of 46 patients, including 26 (1.2%) with 33 IPLN metastases and 20 (0.9%) with 24 simultaneous parotid primary tumors. We compared clinical features of patients (sex, age, site of primary tumor, histologic type, history of prior treatment for malignancy, TNM stages, side of parotid lesion, multiplicity, and metastasis in ipsilateral cervical LNs) and the CT (location in parotid gland, maximum dimension, margins, and central necrosis or cystic change) and 18F-FDG PET/CT (maximum standardized uptake value) findings.

Results

Ipsilateral level II LN metastasis was more frequent in the IPLN metastasis group than in the simultaneous parotid primary tumor group (73.1% vs. 35.0%, P < 0.05). Imaging features such as location in parotid gland, maximum dimension, margins, central necrosis or cystic change, and maximum standardized uptake value showed no significant differences between the two groups.

Conclusion

CT and PET/CT findings of IPLN metastasis are indistinguishable from simultaneous parotid primary tumor in patients with head and neck cancers.
Rural-to-Urban Migration, Strain, and Bullying Perpetration: The Mediating Role of Negative Emotions, Attitude Toward Bullying, and Attachment to School
Authors: Cui Kunjie , To Siu-ming
Published: March 2020

Based on an integrated general strain theory, this study involved testing negative emotions (i.e., anxiety and depression), a social learning variable (i.e., attitude toward bullying), and a social control variable (i.e., attachment to school) as possible mediators of the strain–bullying relationship. A group comparison was also conducted to examine possible differences between migrant and non-migrant children. Data used in the study were derived from a questionnaire survey with a school-based multistage random sample of 1,666 children in Grades 4 to 9 in Nanjing and Guangzhou, China. Structural equation modeling and group comparison were performed with AMOS 25.0 to test the hypothesized model. The findings indicated that attitude toward bullying and attachment to school but not negative emotions mediated the strain–bullying relationship. The results also revealed that the mediation model was applicable to both migrant and non-migrant children, albeit with significant differences in certain paths within the model. The study’s framework bridged the integrated general strain theory and its typical emphasis on crime or delinquency with the pervasive behavior of school bullying in the context of Chinese rural-to-urban migration. Implications for theory and practice were discussed.
Measuring the Implementation of UDL in Classrooms and Schools: Initial Field Test Results
Authors: Basham James D. , Gardner J. Emmett , Smith Sean J.
Published: March 2020

The design, flexibility, and iterative nature that is inherent to Universal Design for Learning (UDL) makes it difficult to consistently measure. With federal policy encouraging the implementation of UDL, there is an increased need for practitioners to reliably measure the occurrence of UDL. The UDL Observation Measurement Tool (UDL-OMT) was developed to measure UDL implementation in classrooms. This article presents the conceptual underpinnings of UDL measurement and the results of an initial field test. Results indicate that the UDL-OMT has good to excellent internal consistency and can characterize differences in UDL implementation across a continuum of settings. Discussion focuses on the reliability of the UDL-OMT and its potential as a formative evaluation tool for practitioners and school-based personnel. Additional considerations include promising research applications and how the nature and context of classroom instructional factors as well as observers’ UDL knowledge influence interpretations of observations.
Intrinsically heat-sealable polyimide films with atomic oxygen resistance: Synthesis and characterization
Authors: Ni Hongjiang , Xing Yu , Dai Xiaoxiang , Zhang Daijun , Li Jun , Liu Jingang , Yang Shiyong , Chen Xiangbao
Published: March 2020

Intrinsically heat-sealable polyimides with atomic oxygen (AO) resistance (ARPIs) were synthesized from 2,3,3′,4′-oxydiphthalic anhydride (aODPA), 2,5-bis[(4-aminophenoxy)phenyl]diphenylphosphine oxide (BADPO), and para-phenylenediamine (PDA). The effects of the molecular structure and diamine ratio were investigated on the properties of the ARPI, including mechanical property, thermal property, heat sealability, and AO resistance. Heat sealability and AO resistance were realized for the ARPI film by combining the asymmetry of the aODPA moiety and the passivated layer forming characteristic of diphenylphosphine phosphine oxide group. Meanwhile, the deficiency of low mechanical strength and thermal resistance, commonly existing in a completely BADPO-derived polyimide system, was remedied effectively by the higher reactivity and rigidity of PDA.
Fear of the Dark? The CJEU adds electricity shortage to the reasons justifying an ex post regularization of projects without an EIA: Case C-411/17 Inter-Environnement Wallonie and Bond Beter Leefmilieu Vlaanderen, EU:C:2019:622
Authors: Iliopoulos Theodoros G. , Bijnens Daan
Published: March 2020

In July 2019, the CJEU delivered its judgment on the case C-411/17 Inter-Environnement Wallonie and Bond Beter Leefmilieu Vlaanderen. The case relates to the protracted debate on the production and use of nuclear energy in Belgium, which at present culminated with the legislative extension of the operation of two nuclear power stations. The CJEU ruled that the extension should have only been granted after an assessment on the stations’ impact on the environment had been carried out and, thus, the national measures were in breach of EU law. However, it is here argued that the judgment does not settle the dispute: it only initiates its second phase. Accordingly, this contribution focuses on the judgment’s expected implications for EU law and for the national constitutional order.
Walking on Eggshells: Parents’ First Year After Their Adolescent Completes Their Cancer Treatment
Authors: Walker Amy J. , Lewis Frances M. , Rosenberg Abby R.
Published: March 2020

Background: Despite an awareness that parents experience distress and heightened uncertainty at the end of their adolescent’s treatment for cancer, little is known about the specific challenges and concerns parents hold for their adolescent survivors or how they manage these challenges. This study described challenges parents experience in the first year after their adolescent’s cancer treatment and what parents did to manage those challenges. Method: Single occasion semistructured interviews were conducted with parents and were transcribed verbatim. Data were coded using inductive content analysis methods adapted from grounded theory. Results: Participants were 30 parents of adolescent survivors (13-18 years) who were in the first year following treatment completion. The core construct, “Walking on Eggshells,” explained the processes and experiences parents faced once treatment was complete. Two additional domains captured how parents managed posttreatment challenges (“Doing What We Can”) and the ways parents helped their adolescents adjust (“Balancing”). Conclusion: Study results suggest that services and materials are needed to help parents know common struggles that arise after treatment and ways to mitigate the severity of distress parents experience.
Strategies Used by Interprofessional Teams to Counter Healthcare Marginalization and Engage Complex Patients
Authors: Madden Erin Fanning , Kalishman Summers , Zurawski Andrea , O’Sullivan Patricia , Arora Sanjeev , Komaromy Miriam
Published: March 2020

Low-income U.S. patients with co-occurring behavioral and physical health conditions often struggle to obtain high-quality health care. The health and sociocultural resources of such “complex” patients are misaligned with expectations in most medical settings, which ask patients to mobilize forms of these assets common among healthier and wealthier populations. Thus, complex patients encounter barriers to engagement with their health behaviors and health care providers, resulting in poor outcomes. But this outcome is not inevitable. This study uses in-depth interviews with two interprofessional primary care teams and surveys of all six teams in a complex patient program to examine strategies for improving patient engagement. Five primary care team strategies are identified. While team member burnout was a common byproduct, professional support offered by the team structure reduced this effect. Team perspectives offer insight into mechanisms of improvement and the professional burdens and benefits of efforts to counter health care marginalization among complex patients.
Trends in Regional Supply of Peritoneal Dialysis in an Era of Health Reform, 2006 to 2013
Authors: Sloan Caroline E. , Coffman Cynthia J. , Sanders Linda L. , Maciejewski Matthew L. , Lee Shoou-Yih D. , Hirth Richard A. , Wang Virginia
Published: March 2020

Peritoneal dialysis (PD), a home-based treatment for kidney failure, is associated with similar mortality, higher quality of life, and lower costs compared with hemodialysis. Yet <10% of patients receive PD. Access to this alternative treatment, vis-à-vis providers’ supply of PD services, may be an important factor but has been sparsely studied in the current era of national payment reform for dialysis care. We describe temporal and regional variation in PD supply among Medicare-certified dialysis facilities from 2006 to 2013. The average proportion of facilities offering PD per hospital referral region increased from 40% (2006) to 43% (2013). PD supply was highest in hospital referral regions with higher percentage of facilities in urban areas ( p = .004), prevalence of PD use ( p < .0001), percentage of White end-stage renal disease patients ( p = .02), and per capita income ( p = .02). Disparities in PD access persist in rural, non-White, and low-income regions. Policy efforts to further increase regional PD supply should focus on these underserved communities.
The generation of non-ordinary state-based peridynamics by the weak form of the peridynamic method
Authors: Cui Hao , Li Chunguang , Zheng Hong
Published: March 2020

A weak form of the peridynamic (PD) method derived from the classical Galerkin framework by substituting the traditional derivatives into the PD differential operators is proposed. The attractive features of the proposed weak form of PD method include the following: (1) a higher-order approximation than the non-ordinary state-based peridynamic (NOSB-PD) in the strain construction; (2) the NOSB-PD is demonstrated as a special case of the weak form of the PD method; (3) as an extension of the NOSB-PD, the zero-energy mode oscillations in the weak form of the PD can be significantly reduced by introducing higher-order PD derivatives. In addition, a series of numerical tests are conducted. The results show the following: (1) the three proposed stabilization items containing higher-order PD derivatives have a better accuracy and stability than the traditional items of the NOSB-PD. In particular, the stress point stabilization item is preferred since it has the highest accuracy and efficiency and does not introduce any additional parameters; (2) the weak form of PD method is very suitable in dealing with the crack propagation and bifurcation problems.
Dynamic responses of hybrid lightweight composite sandwich panels with aluminium pyramidal truss cores
Authors: Yang Jin-Shui , Chen Si-Yuan , Li Shuang , Pang Yue-Zhao , Schmidt Rüdiger , Schröder Kai-Uwe , Qu Jia , Wu Lin-Zhi
Published: March 2020

This paper experimentally and numerically investigates the free vibration, quasi-static compressive and split Hopkinson pressure bar impact responses of hybrid composite pyramidal truss sandwich panels. Such sandwich panels made of carbon fibre composite face sheets and aluminium alloy pyramidal truss cores are fabricated using an interlocking and adhesive bonding approach. Modal tests and quasi-static compression tests are conducted. A good consistency for natural frequencies, modal shapes and static stress–strain curves of the specimen with the same specification is obtained, which ensures the good repeatability of the present specimens. Considering the effect of strain rate, a series of split Hopkinson pressure bar tests combined with numerical simulations is carried out to investigate their dynamic compression responses. A good agreement between simulation results and experimental data is observed, which shows that the adopted split Hopkinson pressure bar testing device and the modified Johnson-Cook model are reasonable and reliable. Results show that the dynamic compression modulus and strength of specimen are strongly influenced by the relative density of the truss cores and much higher than the corresponding static compression modulus and strength. Furthermore, it is also revealed that all the specimens have excellent energy absorption performance, which may have greatly advantage in shock isolation application.
Bilateral Boston keratoprosthesis type 1 in a case of severe Mooren’s ulcer
Authors: Jerez-Peña Marta , Salvador-Culla Borja , de la Paz María F , Barraquer Rafael I
Published: March 2020

Introduction:

Mooren’s ulcer is a painful, inflammatory chronic keratitis that affects corneal periphery, progressing centripetally, ultimately ending in perforation. The first line of treatment includes systemic immunomodulators, with surgery being the last option. We present a case of bilateral Boston keratoprosthesis implantation for severe Mooren’s ulcer that responded differently in each eye.

Clinical case:

A 32-year-old male with corneal opacification, anterior staphylomas, vision of hand movement, was started on systemic immunosuppression with cyclosporine. After two failed penetrating keratoplasties in each eye, high intraocular pressure despite diode cyclophotocoagulation, and cystic macular edema, we performed Boston keratoprosthesis type 1 in both eyes. The right eye responded initially well, with a best-corrected visual acuity of 20/80 and normal intraocular pressure. The left eye presented high intraocular pressure, which required cyclophotocoagulation, ultimately resulting in hypotony. Boston keratoprosthesis was performed but had peripheral corneal necrosis that progressed despite amniotic membrane transplantation and aggressive intensive treatment with medroxyprogesterone, autologous platelet-rich-in-growth-factors eye drops, and oral doxycycline. Thus, replacement of the semi-exposed Boston keratoprosthesis with tectonic penetrating keratoplasty was necessary. However, both eyes developed phthisis bulbi with final visual acuity of perception of light with poor localization.

Conclusion:

Mainstay treatment of Mooren’s ulcer is systemic immunomodulation. Surgical treatment must be considered only when risk of perforation, preferably with inflammation under control. Penetrating keratoplasty frequently fails, and Boston keratoprosthesis may be a viable option. However, postoperative complications, especially uncontrolled high intraocular pressure, corneal necrosis, and recurrence of Mooren’s ulcer may jeopardize the outcomes and need to be addressed promptly with intensive topical and systemic treatment.
Effects of passive music therapy on anxiety and vital signs in lung cancer patients undergoing peripherally inserted central catheter placement procedure
Authors: Mou Qianqian , Wang Xiuyun , Xu Huiqiong , Liu Xia , Li Junying
Published: March 2020

Purpose:

To evaluate the effects of passive music therapy on anxiety and vital signs among lung cancer patients at their first peripherally inserted central catheter placement procedure in China.

Methods:

A randomized controlled clinical trial was conducted in the cancer center of a hospital in Chengdu from May to December 2017. A total of 304 lung cancer patients who met the inclusion and exclusion criteria were recruited and randomly assigned to experimental ( n = 152) and control ( n = 152) group, respectively. The control group only received standard care, while the experimental group received standard care and passive music therapy during peripherally inserted central catheter placement (30–45 min) and after catheterization, until discharged from the hospital (twice a day, 30 min once). Measures include anxiety and vital signs (blood pressure, heart rate, and respiratory rate).

Results:

Repetitive measurement and analysis of variance showed that the patients in experimental group had a statistically significant decrease in anxiety, diastolic blood pressure, and heart rate over time compared to the control group, but no significant difference was identified in systolic blood pressure and respiratory rate.

Conclusion:

Passive music therapy can efficiently relieve the anxiety of lung cancer patients during peripherally inserted central catheter placement. It also can lower the patient’s diastolic blood pressure and slow down the heart rate. So, music therapy benefits patients with peripherally inserted central catheter.
Single-centre experience of an early cannulation graft for haemodialysis access
Authors: Sutaria Rupesh , Gilbert James A
Published: March 2020

Introduction:

As the demographics of the population changes, increasing challenges are being faced in providing reliable access for dialysis. This article reports on the outcomes from the largest series to date using the early cannulation graft Flixene in a single centre.

Methods:

Between May 2012 and March 2018, 141 Flixene grafts were placed for dialysis access. The outcomes of the arteriovenous grafts were reviewed retrospectively from electronically held records and imaging.

Results:

In 75 patients, placement of Flixene graft was performed on an emergency basis and in 66 patients on a planned elective list. The 12-month primary, assisted primary and secondary patency rates were 48.7%, 56.6% and 83.6%, respectively. Eight (5.7%) patients developed infections of the graft during the follow-up period.

Conclusion:

In our experience, we have found the use of the early cannulation graft Flixene to be safe with a low complication rate and favourable patency rates. We believe these early cannulation grafts provide a useful addition for vascular access surgeons preventing the use of tunnelled lines and providing more flexibility in the timing of placing a graft for dialysis.