bluuebunny/crossref_metadata_2025 huggingface dataset:
Otolaryngology Education in the Setting of COVID‐19: Current and Future Implications
Authors: Comer Brett T. , Gupta Nikita , Mowry Sarah E. , Malekzadeh Sonya
Published: April 2020

The COVID‐19 pandemic continues to garner extensive international attention. The pandemic has resulted in significant changes in clinical practice for otolaryngologists in the United States; many changes have been implemented to mitigate risks identified by otolaryngologists in other countries. COVID‐19–induced limitations include social distancing and triaging of patient acuity. Additionally, a recent publication by Stanford University has drawn attention to the risks that otolaryngologists may face with regard to manipulation of the upper airway and mucosal disruption. As a result of COVID‐19 recommendations, multiple institutions have overhauled resident clinical rotations and resident education. The result has been a rapid and significant change in resident education at most academic institutions. This commentary outlines the development of the otolaryngology resident education consortiums, with implications for future education within and outside of otolaryngology.
Reimagining Religiously Segregated Spaces: Building Interfaith Sites Through Participatory Photography
Authors: Bhatia Kiran V. , Pathak-Shelat Manisha
Published: April 2020

This article discusses the findings of a participatory photography project that was conceptualized to help Hindu and Muslim students reimagine the religiously marked public spaces they inhabit in their villages. This study is a part of a 2-year long ethnographic project undertaken by the researchers to codesign, with 180 students, critical media literacy curriculum to counter religious discrimination among adolescents in three villages of the Sanand tehsil of Ahmedabad district in Gujarat. In this study, we argue that the configuration of public sites and residential complexes which use religious identities as a categorical imperative reinforce the communal divide in interfaith societies. It is, thus, crucial to create a site for interfaith engagements where young individuals can collectively participate to make sense of the spaces they inhabit and in this participation change the normalized code of conduct. In this article, we concede that participatory photography provides an avenue through which the young student-participants can find ways to communicate with the “religious other” and insert public imagination with new meanings related to the physical sites they frequent.
UTE T2* mapping of tendinopathic patellar tendons: an MRI reproducibility study
Authors: Agergaard Anne-Sofie , Malmgaard-Clausen Nikolaj M , Svensson Rene B , Nybing Janus D , Boesen Mikael , Kjaer Michael , Magnusson S. Peter , Hansen Philip
Published: April 2020

Background

There is currently a lack of imaging modalities that can be used as a sensitive measure in tendinopathy. Recent findings suggest the applicability of ultra-short echo time (UTE) magnetic resonance imaging (MRI) T2* mapping in tendons, but the reproducibility remains unknown.

Purpose

To evaluate test–retest reproducibility of UTE MRI T2* mapping of tendinopathic patellar tendons and to evaluate the intra- and inter-observer reproducibility of the measurement.

Material and Methods

Fifteen patients with chronic patellar tendinopathy were evaluated with UTE MRI twice in a 3.0-T scanner on the same day. Manual segmentation of the patellar tendon was performed by two blinded investigators and automated T2*map reconstruction was performed in custom-made software.

Results

There was a significant and numerically small difference in test–retest T2* values (T2*meandiff = 0.06 ± 0.07 ms ≈ 3.7%; P = 0.006) with an ICC = 0.91 (95% confidence interval [CI] 0.58–0.98; typical error of 3.0%). The intra- and inter-observer reproducibility showed no significant bias ( P = 0.493 and P = 0.052), and generally substantial reproducibility was demonstrated for T2* (intra-observer ICC = 0.99; 95% CI 0.98–1.00 and inter-observer ICC = 0.99; 95% CI 0.96–1.00, and typical error 1.3% and 1.3%, respectively).

Conclusion

These data demonstrate a small bias between repeated measurements for UTE T2*, but with a very low associated mean difference (3.7%) between the two tests. The high ICC values and low typical error % demonstrate reproducibility of repeated T2*-mapping sessions. Further, the method showed substantial intra- and inter-observer reproducibility for T2* values proving feasibility for use of UTE T2* mapping in research and clinical practice.
Mycoplasma pneumoniae infection mimicking tuberculous pleurisy in a young woman: a case report and literature review
Authors: Wen Peng , Wei Min , Guo Xue , Xu Yu-Rong
Published: April 2020

A 30-year-old woman was admitted to a different hospital with a 2-day history of fever, cough, and expectoration. She had a history of left pulmonary tuberculosis 8 years previously. Chest computed tomography showed an infiltrate in the inferior lobe of the left lung and spot-like calcifications in the anterior lobe of the upper left lobe and lower lobe of the left lung. After antibacterial treatment, the patient’s condition deteriorated and she developed significant pleural effusion on the left side. The pleural effusion assay showed a lymphocyte-predominant exudate with a significantly increased adenosine deaminase level. The patient was transferred to our hospital with a suspected diagnosis of tuberculous pleuritis. A serum test for Mycoplasma pneumoniae-specific immunoglobulin M was positive. Because of the limitations of this test in determining the occurrence of recent infection, a thoracoscopic pleural biopsy was performed, and M. pneumoniae DNA was detected in the biopsy tissue using M. pneumoniae-specific polymerase chain reaction. Thus, the patient was diagnosed with M. pneumoniae-related parapneumonic effusion. Clinicians must be aware of the usefulness and limitations of a high adenosine deaminase level and know that lymphocyte predominance in pleural effusion does not always indicate tuberculous pleurisy, especially in areas of high tuberculosis prevalence.
A Multicenter Study of Radiographic Measures Predicting Failure of Arthroscopy in Borderline Hip Dysplasia: Beware of the Tönnis Angle
Authors: McQuivey Kade S. , Secretov Erwin , Domb Benjamin G. , Levy Bruce A. , Krych Aaron J. , Neville Matthew , Hartigan David E.
Published: April 2020

Background:

Hip arthroscopy has been previously demonstrated to be an effective treatment for adult mild hip dysplasia. There are many radiographic parameters used to classify hip dysplasia, but to date few studies have demonstrated which parameters are of most importance for predicting surgical outcomes.

Purpose:

To identify preoperative radiographic parameters that are associated with poor outcomes in the arthroscopic treatment of adult mild hip dysplasia.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

Radiographic analysis was performed in patients with mild hip dysplasia who underwent arthroscopic surgery between 2009 and 2015. Preoperative radiographic measurements included lateral center edge angle, Tönnis angle, neck shaft angle, anterior center edge angle, alpha angle, femoral head extrusion index, and acetabular depth-to-width ratio. Failure was defined as failure to achieve the minimal clinically important difference (MCID) utilizing the modified Harris Hip Score or as the need for secondary operation. The equal variance t test was used to analyze radiographic parameters. Statistical significance was determined using a P value of .05.

Results:

A total of 373 hips underwent analysis with an average follow-up of 41 months (range, 24-102 months). Of these, 46 hips (12%) required secondary operation, and 95 (25%) failed to meet the MCID. The overall failure rate was 32.4%. There was no single measurement or combination thereof associated with failure to reach the MCID. Higher preoperative Tönnis angles were associated with secondary operation, with a mean of 6.7° (95% CI, 5.3°-8.1°) in the secondary operation group versus 4.8° (95% CI, 4.4°-5.3°) in the nonsecondary operation group ( P = .006). The odds ratio was 1.12 (95% CI, 1.0-1.2; P = .05) per degree increase in Tönnis angle for secondary operation. In patients with a Tönnis angle >10°, 84% required secondary operation.

Conclusion:

Higher Tönnis angles portend a higher risk for revision surgery. The probability of secondary operation was increased by a magnitude of 1.12 with each degree increase in the Tönnis angle. In patients with a Tönnis angle >10°, 84% required a secondary operation.
Anxiety Impedes Adaptive Social Learning Under Uncertainty
Authors: Lamba Amrita , Frank Michael J. , FeldmanHall Oriel
Published: April 2020

Very little is known about how individuals learn under uncertainty when other people are involved. We propose that humans are particularly tuned to social uncertainty, which is especially noisy and ambiguous. Individuals exhibiting less tolerance for uncertainty, such as those with anxiety, may have greater difficulty learning in uncertain social contexts and therefore provide an ideal test population to probe learning dynamics under uncertainty. Using a dynamic trust game and a matched nonsocial task, we found that healthy subjects ( n = 257) were particularly good at learning under negative social uncertainty, swiftly figuring out when to stop investing in an exploitative social partner. In contrast, subjects with anxiety ( n = 97) overinvested in exploitative partners. Computational modeling attributed this pattern to a selective reduction in learning from negative social events and a failure to enhance learning as uncertainty rises—two mechanisms that likely facilitate adaptive social choice.
A study of fan-distortion interaction within the fan rotor
Authors: Li Zhihui , Du Juan , Zhang Qianfeng , Ji Guofeng , Zhang Hongwu
Published: April 2020

Boundary-layer-ingesting fans and compressors in the next-generation turbofan engines require high-performance operations under distorted inflow. The aim of this work is to study the effects of inlet distortions including inlet stagnation pressure and temperature distortion, on the aerodynamic performance of a transonic axial fan. Firstly, the validated full-annulus, unsteady, three-dimensional computational fluid dynamic code in conjunction with detached Eddy simulation approach is used here to simulate the fan flows assembly with individual inlet stagnation pressure/temperature distortion. Then, the propagation process of the inlet distortion waves is analyzed to understand how the aerodynamic performance degradation is triggered. The simulation results show that the fan performance is remarkably degraded when the inlet distortion is introduced. The leading-edge spillage, the trailing edge back flow and the “tornado vortex” occur when parts of fan blades encounter the incoming distorted flows. Finally, the responses of fan to the combined inlet stagnation distortion effects are discussed in this paper. It is found that the combined distortion effects can be predicted based on the sum of the performance responses to the individual constituent distortions. Furthermore, the relative location of the constituent distortions shows a non-ignorable influence on the overall fan performance, especially for the intensified inlet distortion.
“Loading, please wait” – Temporality and (bodily) presence in mobile digital communication
Authors: Sebald Gerd
Published: April 2020

Mobile digital communications, as currently the most complex forms of communication, offer a broad view on the phenomenon of communication. The last ten years have seen the addition of new forms of communication (WhatsApp, Facebook, etc.) and the restructuring of a (growing?) share of traditional communication into digitalized forms. Taking these changes as a guideline, this article examines the concept of communication in its temporality, (use of) technology, and physicality and attempts to adapt this concept to current forms.
Integrating Rules for Genomic Research, Clinical Care, Public Health Screening and DTC Testing: Creating Translational Law for Translational Genomics
Authors: Wolf Susan M. , Ossorio Pilar N. , Berry Susan A. , Greely Henry T. , McGuire Amy L. , Penny Michelle A. , Terry Sharon F. ,   for the LawSeq Framework Task Force
Published: April 2020

Human genomics is a translational field spanning research, clinical care, public health, and direct-to-consumer testing. However, law differs across these domains on issues including liability, consent, promoting quality of analysis and interpretation, and safeguarding privacy. Genomic activities crossing domains can thus encounter confusion and conflicts among these approaches. This paper suggests how to resolve these conflicts while protecting the rights and interests of individuals sequenced. Translational genomics requires this more translational approach to law.
General-Purpose Privacy Regulation and Translational Genomics
Authors: McGeveran William , Schmitz Caroline
Published: April 2020

At one time, specialized health privacy laws represented the bulk of the rules regulating genetic privacy, Today, however, as both the field of genomics and the content of privacy law change rapidly, a new generation of general-purpose privacy laws may impose new restrictions on collection, storage, and disclosure of genetic data. This article surveys these laws and considers implications.
Who Are the People in Your Neighborhood? Personas Populating Unregulated mHealth Research
Authors: Doerr Megan , Guerrini Christi
Published: April 2020

A key feature of unregulated mHealth research is the diversity of participants in this space. Applying an approach drawn from user experience design, we describe a set of archetypal unregulated mHealth researcher “personas,” which range from individuals who seek empowerment or have philanthropic objectives to those who are primarily motivated by financial gain or have misanthropic objectives. These descriptions are useful for evaluating policies applicable to mHealth to understand how they will impact various stakeholders.
Mobile Research Applications and State Research Laws
Authors: Tovino Stacey A.
Published: April 2020

This article assesses the protections provided by state research laws for participants in mobile application (mobile app) mediated health research conducted by independent scientists, citizen scientists, and patient researchers. Prior scholarship in this area focuses on the lack of application of: (1) federal regulations governing research conducted or funded by one of sixteen signatory federal departments and agencies (the Common Rule); and (2) separate federal regulations promulgated by the Food and Drug Administration applicable to research conducted in anticipation of a submission to the FDA for approval of a drug or medical device. This article builds on this prior scholarship by carefully examining state research laws and suggesting ways in which these laws could be improved to better protect participants of mobile appmediated research conducted by independent scientists, citizen scientists, and patient researchers.
Mobile Research Applications and State Data Protection Statutes
Authors: Tovino Stacey A.
Published: April 2020

This article focuses on state privacy, security, and data breach regulation of mobile-app mediated health research, concentrating in particular on research studies conducted or participated in by independent scientists, citizen scientists, and patient researchers. Prior scholarship addressing these issues tends to focus on the lack of application of the HIPAA Privacy and Security Rules and other sources of federal regulation. One article, however, mentions state law as a possible source of privacy and security protections for individuals in the particular context of mobile app-mediated health research. This Article builds on this prior scholarship by: (1) assessing state data protection statutes that are potentially applicable to mobile app-mediated health researchers; and (2) suggesting statutory amendments that could better protect the privacy and security of mobile health research data. As discussed in more detail below, all fifty states and the District of Columbia have potentially applicable data breach notification statutes that require the notification of data subjects of certain informational breaches in certain contexts. In addition, more than two-thirds of jurisdictions have potentially applicable data security statutes and almost one-third of jurisdictions have potentially applicable data privacy statutes. Because all jurisdictions have data breach notification statutes, these statutes will be assessed first.
Return of Results in Participant-Driven Research: Learning from Transformative Research Models
Authors: Wolf Susan M.
Published: April 2020

Participant-driven research (PDR) is a burgeoning domain of research innovation, often facilitated by mobile technologies (mHealth). Return of results and data are common hallmarks, grounded in transparency and data democracy. PDR has much to teach traditional research about these practices and successful engagement. Recommendations calling for new state laws governing research with mHealth modalities common in PDR and federal creation of review mechanisms, threaten to stifle valuable participant-driven innovation, including in return of results.
Stabilization of coupled inverted pendula: From discrete to continuous case
Authors: Semenov Mikhail E , Solovyov Andrey M , Meleshenko Peter A
Published: April 2020

This study is focused on the investigation of stabilization problem for the system of coupled inverted pendula. The corresponding algorithm of control is based on the feedback principles and demonstrates some features in the physical implementation of the stabilization process. In the discrete case, the wave-like motion appears and leads to an observable interference pattern. In the continuous case, the provided feedback algorithm allows to simulate the stabilization process for the initially unstable solid medium. In these case conditions, ensuring the stabilization process is presented in the form of corresponding physical restrictions on the wave motion. Also, within the small parameter method, we investigate the nonlinear oscillatory motion of the material (the solid medium is modeled by the proposed system with nonlinear coupling). Results of numerical simulation for the system under consideration are presented and discussed. Particularly, numerical results show that the nonlinear material exhibits greater stability than the linear one.
Abdominal Organ Transplantation: Noteworthy Literature in 2019
Authors: Romano Diana N. , Smith Natalie K. , Vasisko Corey R. , Zerillo Jeron , Sakai Tetsuro
Published: April 2020

In the year 2019, we identified and screened over 400 peer-reviewed publications on pancreatic transplantation, over 200 on intestinal transplantation, and over 1900 on kidney transplantation. The liver transplantation section focuses on and features selected articles among 70 clinical trials published in 2019. This review highlights noteworthy literature pertinent to anesthesiologists and critical care physicians caring for patients undergoing abdominal organ transplantation. We explore a broad range of topics, including risks for and prediction of perioperative complications, updated indications for transplantation, recommendations on perioperative management, including Enhanced Recovery After Surgery programs, and topics relevant to optimization of patient and graft outcomes and survival.
Enhanced effects of footwarmer by wearing sandals in winter office: A Swedish case study
Authors: Yang Bin , Li Zhe , Zhou Bin , Olofsson Thomas , Li Angui
Published: April 2020

Human-centred thermal environment conditioning can guarantee thermal comfort needs of human occupants in their micro-environments by using localized heating/cooling devices. Meanwhile, less intensified thermal conditioning of unoccupied surrounding environments can achieve heating/cooling energy efficiency. The concept was originated from task/ambient conditioning, which was developed for personal comfort systems. Most of the localized heating/cooling devices are workstation based or chair based. Task conditioning would become more closely to targets (human bodies) by using special clothing materials or thermoelectric elements. From thermal physiological viewpoints, thermal stimulus to thermally sensitive body parts may generate better results for not only local thermal comfort but also for whole body thermal comfort. Thermal stimulus to the extremities (feet) has demonstrated good thermal comfort effects. Scandinavians are accustomed to outdoor harsh environments and prefer wearing heavy shoes' outdoors in winter. They have the habit of changing heavy shoes to sandals when entering offices, which give the opportunity to enhance localized heating effects of footwarmers by reducing shoes’ thermal resistance. Climatic chamber tests with 32 Nordic subjects were performed under different indoor ambient heating temperatures with/without the aid of footwarmers. With footwarmers and sandals, indoor heating temperature at 16°C was acceptable, which achieved energy efficient thermal comfort.
Incomplete utterances as critical assessments
Authors: Park Innhwa , Kline Jacob
Published: April 2020

Using video recordings of draft meetings conducted as part of an intramural basketball program as data, this conversation analytic study examines the use of an incomplete utterance in a joint evaluative activity. In particular, we focus on how the participants, volunteer coaches, who meet to draft players for their respective teams, produce a syntactically incomplete utterance as a means to critically assess a player, a non-present third party to the interaction. Analysis reveals that the participants use an incomplete utterance as part of dispreferred design; it allows them to withhold articulating overt criticism of others. By trailing off where the criticism is due, the participants display reluctance to verbalize what is to be said and treat its articulation as delicate. The syntactic structure of the utterance that includes a contrastive conjunction (‘but’) and accompanying embodied actions such as head shakes help them convey a critical stance. We examine the use of incomplete utterances in both agreement and disagreement sequences; the recipients display their unproblematic understanding of the critical assessment and respond by providing their own assessments that either affiliate or disaffiliate with the conveyed critical stance.
Using one’s body: sex, money and agency from the coast to the backlands of Northeast Brazil
Authors: Garcia Loreley Gomes , Olivar Jose Miguel Nieto
Published: April 2020

This article presents a discussion about using one’s body – in its several occurrences, forms and meanings – for sex, affection and money transactions, within and beyond the scope of prostitution. It results from research carried out with young women involved in prostitution in two Brazilian north-eastern towns. The women’s views, conceptualisations and experiences reveal a prolific construction of discursive differentiation categories, which are linked to a set of moralities within local/regional economies and within notions of family. Through the women’s personal narratives and experiences, our study demystifies the persistent idea of victimisation; it aims at understanding the young women prostitutes in their own contexts – loci that are highly stigmatised and seen as needing to be controlled or ‘developed’. We collected data that allows us to build a counter-discourse to oppose the ever-present attempts at weakening these voices and effacing their meaning-making. Within this context of knowledge production, our research is meaningful and purposeful in addressing the situation of young women in contexts of prostitution. Our main argument is that in certain contexts, such as those studied in this project, sex, affection and kinship are structured as normative – rather than exceptional – ways for women to have access to money.
Damage evaluation of quartz woven fabrics during needle punching process
Authors: Du Peijian , Chen Li , Xie Junbo , Lv Qingtao , Chen Xiaoming , Wang Xinmiao
Published: April 2020

This paper reports an experimental study on the damage evaluation of quartz woven fabrics during needle punching process under different needle punching densities. The straight fiber bundles begin appearing in Z direction at 50 punches · cm−2 and the “U-shaped” fiber bundles begin being observed at 210 punches · cm−2. The retention ratio of mean breaking force (RRMF) of the needle-punched quarts woven fabrics in warp direction decreases from 100% to 49.4% with an increase in needle punching density from 0 to 10 punches · cm−2, and that in weft direction decreases from 100% to 50.21% with the same increments in needle punching density, but the RRMF in warp direction decreases from 49.4% to 0.35% when the needle punching density increases from 10 to 245 punches  ·  cm−2 and that in weft direction decreases from 50.21% to 0.19% with the same increments in needle punching density; obviously, the initial needle punching density increments (0 to 10 punches  ·  cm−2) seem to have weakened tensile property more significantly compared with needle punching density increments from 10 to 245 punches · cm−2. The retention ratios in warp and weft directions are 0.61% and 0.34%, respectively, at 210 punches · cm−2, which are roughly equal with those at 245 punches · cm−2. Therefore, it could be concluded that the tensile property has reached the minimized at 245 punches · cm−2. In addition, there is an obvious paired similarity existing in the macro damage morphologies, the load–displacement curve trend at the adjacent needle punching density from 70 to 245 punches · cm−2 in 35 punches · cm−2 increments, also such similarity exists when the needle punching density is at 10 to 60 punches · cm−2.
Geometric modeling of knitted fabrics using helicoid scaffolds
Authors: Wadekar Paras , Goel Prateek , Amanatides Chelsea , Dion Genevieve , Kamien Randall D , Breen David E
Published: April 2020

We present a bicontinuous, minimal surface (the helicoid) as a scaffold on which to define the topology and geometry of yarns in a weft-knitted fabric. Modeling with helicoids offers a geometric approach to simulating a physical manufacturing process, which should generate geometric models suitable for downstream mechanical and validity analyses. The centerline of a yarn in a knitted fabric is specified as a geodesic path, with constrained boundary conditions, running along a helicoid at a fixed distance. The shape of the yarn’s centerline is produced via an optimization process over a polyline. The distances between the vertices of the polyline are shortened and a repulsive potential keeps the vertices at a specified distance from the helicoid. These actions and constraints are formulated into a single “energy” function, which is then minimized. The yarn geometry is generated as a tube around the centerline. The optimized configuration, defined for a half loop, is duplicated, reflected, and shifted to produce the centerlines for the multiple stitches that make up a fabric. In addition, the parameters of the helicoid may be used to control the size and shape of the fabric’s stitches. We show that helicoid scaffolds may be used to define both knit and purl stitches, which are then combined to produce models of all-knit, rib, and garter fabrics.
Open Reduction Internal Fixation of Distal Radius Fractures: Retrospective Cohort Analysis of the Geriatric Population Using the NSQIP Database
Authors: Skochdopole Anna , Tarabishy Sami , Hermiz Steven , Mailey Brian , Herrera Fernando A.
Published: April 2020

Background: Distal radius fractures (DRFs) are the most common upper extremity fractures with more than 600 000 cases per year in the United States and account for up to 18% of fractures in the geriatric population. The purpose of our study was to identify the influence of age on 30-day postoperative outcomes while adjusting for patient demographics and comorbidities. Methods: The National Surgery Quality Improvement Program database was queried for patients having undergone open reduction internal fixation (ORIF) of DRFs. Current Procedural Terminology codes 25607, 25608, and 25609 between the years 2007 and 2016 were collected and analyzed. Patients were divided into 2 groups: group 1, 18 to 64 years; and group 2, 65 years and older. Patient demographics; preoperative, perioperative, and postoperative variables; and complications were recorded and analyzed. Results: In all, 5894 patients were identified; group 1 consisted of 4056 patients aged <64 years, and group 2 consisted of 1838 patients aged 65 years and older. The total complication rate was 2.7% for all patients, 2.2% for group 1, and 3.4% for group 2. The most common complications included surgical site infection for group 1 and urinary tract infection for group 2. Univariate analysis demonstrated association between age ≥65 years and complication (hazard ratio, 1.55; 95% confidence interval, 1.12-2.14; P = .009). However, after controlling for statistically significant factors, age was not an independent predictor of complications ( P = .685). Admission status, American Society of Anesthesiologists classification, operative time, renal failure, and bleeding disorders were independent predictors of 30-day complications across all patients. Conclusion: Our data suggest that patients aged 65 years and older without high-risk comorbidities should be offered ORIF of DRFs as their complication risk remains low.
Politico-Critical Analysis: A New Research Framework Applied to Psychiatry
Authors: Grech Paulann , Grech Reuben
Published: April 2020

Background:

This article presents a new framework called politico-critical analysis based on the contentions of Foucauldian discourse analysis. The framework was developed to address a number of shortcomings and assess further aspects of importance to fields such as mental health and psychiatry.

Aim:

To present the main principles and steps of the politico-critical analysis framework and, subsequently, to demonstrate its application to a study on the therapeutic alliance in psychiatry.

Method:

The rationale and main principles of politico-critical analysis are described and applied to a study, the aim of which was to explore the knowledge and power interface in the therapeutic alliance in a psychiatric hospital in Malta. Data were collected during two phases; in the first phase, 10 care receivers, who were selected through purposeful random sampling in a psychiatric hospital in Malta, were interviewed to explore their perception of the knowledge–power balance in the psychiatric therapeutic alliance. The second phase consisted of collecting data from and analyzing a 60-page sample of medical records pertaining to the study participants interviewed in Phase 1.

Results:

Four themes emerged from the politico-critical analysis of care receivers’ interviews, depicting the knowledge–power interface within therapeutic alliances. From the analysis of medical records, three themes emerged, which shed light on the knowledge–power matrix within the alliances under study.

Conclusions:

The politico-critical analytical framework was regarded as a helpful agent in facilitating the exploration of the knowledge–power matrix within the psychiatric therapeutic alliance. Strengths and limitations were acknowledged, and the framework might help guide similar potential research.
The obesity epidemic – Nature via nurture: A narrative review of high-income countries
Authors: Jackson Sarah E , Llewellyn Clare H , Smith Lee
Published: April 2020

Over the last three decades, the prevalence of obesity has increased rapidly in populations around the world. Despite a wealth of research, the relative contributions of the different mechanisms underlying this global epidemic are not fully understood. While there is growing consensus that the rapid rise in obesity prevalence has been driven by changes to the environment, it is evident that biology plays a central role in determining who develops obesity and who remains lean in the current obesogenic environment. This review summarises evidence on the extent to which genes and the environment influence energy intake and energy expenditure, and as a result, contribute to the ongoing global obesity epidemic. The concept of genetic susceptibility to the environment driving human variation in body weight is discussed.
Study on microstructure and mechanical properties of Fe-based amorphous particle-reinforced Al-based matrix composites
Authors: Zhou Xiang , Long Wei , Zhou Xiaoping
Published: April 2020

Fe52Cr15Mo26C3B1Y3 amorphous particle-reinforced pure aluminum (Al) matrix composite was prepared by powder metallurgy. The ferrum (Fe)-based amorphous particles prepared by atomization method have good amorphous structure, and the circular reinforcement particles are evenly distributed in the Al matrix. The composite has high strength, hardness, and excellent corrosion resistance. The hardness of the composite increases gradually with the increase in the content of the reinforcement, from 46 Vickers hardness (HV) of pure Al to 220.5 HV, with remarkable effect. The tensile strength of the composite increases first and then decreases with the increase in the content of the reinforcement. When the content of reinforcement is 15%, the maximum tensile strength is 234 MPa, which is 154% higher than that of pure Al. The fracture mode of the composite is the mixture of plastic fracture and brittle fracture. The corrosion resistance of pure Al is significantly improved by the addition of reinforcements, which shows that the composite has a smaller corrosion current density and a more positive corrosion potential than that of pure Al.
Evaluation of Domestication Loci Associated with Awnlessness in Cultivated Rice, Oryza sativa
Authors: Amarasinghe Yaddehige Priya Jayantha , Kuwata Rie , Nishimura Akinori , Phan Phuong Dang Thai , Ishikawa Ryo , Ishii Takashige
Published: April 2020

Background

Awns are bristle-like organs at the tips of the glumes. Wild rice has maintained long awns for successful seed propagation through seed dispersal. Seed awning is an interesting trait in rice domestication. Long awns might have been beneficial for seed gatherers in the initial phase of domestication; however, awnless phenotypes were preferably selected in a later phase with non-seed-shattering plants. Investigation of domestication loci associated with awnlessness in cultivated rice will be useful in clarifying the process and history of rice domestication.

Results

Quantitative trait locus (QTL) analysis for seed awning was carried out using a BC3F2 population between Oryza sativa IR36 (a cultivated donor parent with awnless phenotype) and O. rufipogon W630 (a wild recurrent parent with awns). As a result, two QTLs on chromosome 4 (corresponding to An-1 and LABA1) and one on chromosome 2 (designated as qAWNL2) were detected. Gene interaction among three seed-awning QTLs were further examined with the plants having eight different combinations of homozygous genotypes. Their awn length variation indicated that the IR36 alleles at these loci had the additive awnlessness effects in the genetic background of wild rice. The shortest awn length was observed for the plants having IR36 homozygous alleles at all loci, giving about 75% reduction in awn length. By the fine mapping, the candidate region of the novel qAWNL2 locus was delimited in a 157.4-kb region containing 22 predicted genes in Nipponbare genome.

Conclusions

QTL analysis revealed that three loci, An-1, LABA1 and qAWNL2, were mainly responsible for the awnlessness of O. sativa IR36. In the wild genetic background, loss-of-function alleles at three awning loci showed additive effects on length reduction. In rice domestication, awnless forms may be gradually generated through the accumulation of mutations at awning loci.
Acute pain assessment and management in the prehospital setting, in the Western Cape, South Africa: a knowledge, attitudes and practices survey
Authors: Lourens Andrit , Hodkinson Peter , Parker Romy
Published: April 2020

Background

Acute pain is frequently encountered in the prehospital setting, and therefore, a fundamental aspect of quality emergency care. Research has shown a positive association between healthcare providers’ knowledge of, and attitudes towards pain and pain management practices. This study aimed to describe the knowledge, attitudes, and practices of emergency care providers regarding acute pain assessment and management in the prehospital setting, in the Western Cape, South Africa. The specific objectives were to, identify gaps in pain knowledge; assess attitudes regarding pain assessment and management; describe pain assessment and management behaviours and practices; and identify barriers to and enablers of pain care.

Methods

A web-based descriptive cross-sectional survey was conducted among emergency care providers of all qualifications, using a face-validated Knowledge, Attitudes and Practices of Pain survey.

Results

Responses of 100 participants were included in the analysis. The survey response rate could not be calculated. The mean age of respondents was 34.74 (SD 8.13) years and the mean years’ experience 10.02 (SD 6.47). Most respondents were male (69%), employed in the public/government sector (93%) as operational practitioners (85%) with 54% of respondents having attended medical education on pain care in the last 2 years. The mean percentage for knowledge and attitudes regarding pain among emergency care providers was 58.01% (SD 15.66) with gaps identified in various aspects of pain and pain care. Practitioners with higher qualifications, more years’ experience and those who did not attend medical education on pain, achieved higher scores. Alcohol and drug use by patients were the most selected barrier to pain care while the availability of higher qualified practitioners was the most selected enabler. When asked to record pain scores, practitioners were less inclined to assign scores which were self-reported by the patients in the case scenarios. The participant dropout rate was 35%.

Conclusion

Our results suggest that there is suboptimal knowledge and attitudes regarding pain among emergency care providers in the Western Cape, South Africa. Gaps in pain knowledge, attitudes and practices were identified. Some barriers and enablers of pain care in the South African prehospital setting were identified but further research is indicated.
Is the fast-track process efficient and safe for older adults admitted to the emergency department?
Authors: Gasperini B. , Pierri F. , Espinosa E. , Fazi A. , Maracchini G. , Cherubini A.
Published: April 2020

Background

The efficiency of the fast-track (FT) process in the management of patients in Emergency Departments is well demonstrated, but there is a lack of research focused on older adults. The aim of our study was to verify whether the FT process is efficient and safe for older adults admitted to ED.

Methods

Observational case-control single-centre study.

Results

Five hundred four cases and 504 controls were analysed.The mean age was 75 years, and there was a predominance of women. In total 96% of subjects were classified with a “less-urgent” tag. The length of stay was significantly lower in the fast-track group than in the control group (median 178 min, interquartile range 184 min, and 115 min, interquartile range 69 min, respectively,p < 0.001), as well as the time spent between the ED physician’s visit and patient discharge (median 78 min, interquartile range 120 min, and median 3 min, interquartile range 6 min, respectively,p < 0.001). There weren’t any increases in the number of unplanned readmissions within 48 h, 7 days and 30 days.

Conclusions

The fast-track appears to be an efficient and safe strategy to improve the management of older adults admitted to the ED with minor complaints.
Natural presence of the V179D and K103R/V179D mutations associated with resistance to nonnucleoside reverse transcriptase inhibitors in HIV-1 CRF65_cpx strains
Authors: Liu Yongjian , Zhang Yu , Li Hanping , Wang Xiaolin , Jia Lei , Han Jingwan , Li Tianyi , Li Jingyun , Li Lin
Published: April 2020

Background

There is increasing evidence that HIV-1 genetic diversity can have an impact on drug resistance. The aim of this study is to investigate the epidemiological situation of CRF65_cpx and the impact of natural polymorphisms of this variant on genotypic resistance.

Methods

We used the BLAST search program followed by phylogenetic analysis to identify additional CRF65_cpxpolsequences from the Los Alamos HIV Sequence Database. Maximum likelihood phylogeny was estimated to clarify the epidemiological relationship of CRF65_cpx strains. Genotypic resistance was determined by submitting sequences to the Stanford HIV Drug Resistance Database.

Results

A total of 32 CRF65_cpxpolsequences were obtained. The CRF65_cpx strains were detected in seven provinces with large geographic distance. Yunnan CRF65_cpx sequences were mainly derived from a heterosexual risk group, whereas the CRF65_cpx sequences in other provinces were almost exclusively derived from an MSM population. With one exception of V179E, the other 31 strains harbored V179D mutation. The combination of V179D and K103R, conferring intermediate resistance to EFV and NVP, was detected in seven treatment-naive MSM patients.

Conclusions

This study confirmed the expansion CRF65_cpx in China. Furthermore, we found the natural presence of the V179D and K103R/V179D mutations associated with resistance to NNRTIs in HIV-1 CRF65_cpx. Our findings highlight the contribution of polymorphic mutations to drug resistance and underscore the challenges in treating patients harboring CRF65_cpx strains.
Variants in clopidogrel-relevant genes and early neurological deterioration in ischemic stroke patients receiving clopidogrel
Authors: Yi Xingyang , Zhou Qiang , Zhang Yongyin , Zhou Ju , Lin Jing
Published: April 2020

Background

Early neurological deterioration (END) is common in acute ischemic stroke (IS). However, the underlying mechanisms for END are unclear. The aim of this study was to evaluate the associations of 16 variants in clopidogrel-relevant genes and interactions among these variants with END in acute IS patients receiving clopidogrel treatment.

Methods

We consecutively enrolled 375 acute IS patients between June 2014 and January 2015. Platelet aggregation was measured on admission and after the 7–10 days of clopidogrel treatment. The 16 variants in clopidogrel-relevant genes were examined using mass spectrometry. The primary outcome was END within the 10 days of admission. Gene-gene interactions were analyzed by generalized multifactor dimensionality reduction (GMDR) methods.

Results

Among the 375 patients, 95 (25.3%) patients developed END within the first 10 days of admission. Among the 16 variants, only CYP2C19*2 (rs4244285) AA/AG was associated with END using single-locus analytical approach. GMDR analysis revealed that there was a synergistic effect of gene-gene interactions among CYP2C19*2 rs4244285, P2Y12 rs16863323, and GPIIIa rs2317676 on the risk for END. The high-risk interactions among the three variants were associated with the higher platelet aggregation and independent predictor for END after adjusting for the covariates (hazard ratio: 2.82; 95% confidence interval: 1.36–7.76; P = 0.003).

Conclusions

END is very common in patients with acute IS. The mechanisms leading to END are most likely multifactorial. Interactions among CYP2C19*2 rs4244285, P2Y12 rs16863323, and GPIIIa rs2317676 may confer a higher risk for END. It was very important to modify clopidogrel therapy for the patients carrying the high-risk interactive genotypes.

Clinical trial registration information

The study described here is registered at http://www.chictr.org/ (unique Identifier: ChiCTR-OCH-14004724). The date of trial registration was May 30, 2014.
Outcome of uterine rupture and associated factors in Yirgalem general and teaching hospital, southern Ethiopia: a cross-sectional study
Authors: Gebretsadik Achamyelesh , Hagos Hailemichael , Tefera Kebede
Published: April 2020

Background

The occurrence of uterine rupture has dropped significantly in high income countries. It continues, however, to be a major public and clinical health problem in low income countries including Ethiopia. Aim of this study was to assess management outcomes of uterine rupture and associated factors in Yirgalem General and Teaching Hospital in South Ethiopia.

Methods

Institution-based cross-sectional study was conducted to examine medical records of women with uterine rupture between January 1, 2012, and Decem”ber 31, 2017. Data were collected based on a checklist. Descriptive statistics and logistic regression analyses were performed.

Results

Incidence of uterine rupture was 345 in 13,500 live births (25.5 in 1000 live births) in the study period. Of these, 331 cases were included. Poor maternal outcome occurred in 224 (67.7%) women. There were 13 (3.7%) maternal deaths and 320 (96.7%) stillbirths. Wound site infection (131; 39.6%) and anemia (129; 39%) were the most common post-operative complications. Prolonged duration of labor (more than 24 h) (adjusted odds ratio (aOR) 3.6; 95% CI 1.7–7.4), women with sepsis on admission (aOR 2.9; 95% CI 1.4–6.1), hemoglobin level < 7 g/dl prior to surgical intervention (aOR 4.5; 95% CI 1.1–17.8), delayed surgical intervention after hospitalization (4 h or more before surgery) (aOR 3.8; 95% CI 1.8–8), women who did not receive blood transfusion (aOR 4.0; 95% CI 2.1–7.9) and prolonged intraoperative time (aOR 5.5; 95% CI 2.8–10.8) were all factors associated with poor maternal outcome of uterine rupture.

Conclusion

Poor maternal outcome of uterine rupture was high in the study area as compared to other studies. Proper management of anemia, prompt surgical treatment, proper labor progress monitoring, surgical skills, improved infection prevention, maximizing blood transfusion availability and improving the quality of maternal healthcare all play a significant role in reducing uterine rupture and enhancing the chance of good outcomes.
Higher number of multidisciplinary tumor board meetings per case leads to improved clinical outcome
Authors: Freytag Marius , Herrlinger Ulrich , Hauser Stefan , Bauernfeind Franz G. , Gonzalez-Carmona Maria A. , Landsberg Jennifer , Buermann Jens , Vatter Hartmut , Holderried Tobias , Send Thorsten , Schumacher Martin , Koscielny Arne , Feldmann Georg , Heine Mario , Skowasch Dirk , Schäfer Niklas , Funke Benjamin , Neumann Michael , Schmidt-Wolf Ingo G. H.
Published: April 2020

Background

This analysis aims at evaluating the impact of multidisciplinary tumor boards on clinical outcome of multiple tumor entities, the effect of the specific number of multidisciplinary tumor boards and potential differences between the tumor entities.

Methods

By a matched-pair analysis we compared the response to treatment, overall survival, relapse or disease free survival and progression free survival of patients whose cases were discussed in a tumor board meeting with patients whose cases were not. It was performed with patients registered in the cancer registry of the University of Bonn and diagnosed between 2010 and 2016. After the matching process with a pool of 7262 patients a total of 454 patients with 66 different tumor types were included in this study.

Results

First, patients with three or more multidisciplinary tumor board meetings in their history show a significantly better overall survival than patients with no tumor board meeting. Second, response to treatment, relapse free survival and time to progression were not found to be significantly different. Third, there was no significant difference for a specific tumor entity.

Conclusion

This study revealed a positive impact of a higher number of multidisciplinary tumor boards on the clinical outcome. Also, our analysis hints towards a positive effect of multidisciplinary tumor boards on overall survival.