bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of the axial gap on the energy consumption of a single-blade wastewater pump
Authors: Caruso Federico , Meskell Craig
Published: May 2020

The effect of the axial gap on the energy consumption of a single-blade wastewater pump (Sulzer XFP PE-2 150E CB1.1) is assessed using unsteady Reynolds-averaged Navier–Stokes simulations with ANSYS Fluent. The numerical model was compared to experimental data with a nominal design configuration (i.e. gap size) to provide confidence in the modeling approach. The global performance of the pump was evaluated in terms of pressure-discharge, torque, and efficiency for a range of volumetric flow rates (110 m3ċh−1 to 254 m3ċh−1) and gap sizes (0.3 mm to 1.15 mm). While it is found that the power consumption at a given flow rate is reduced with increased gap, this is at the expense of a drop in outlet pressure, and hence the efficiency of the pump drops significantly. At the largest volumetric flow rate considered (254 m3ċh−1), the sensitivity of the efficiency to the gap size is −13.5%ċmm−1 and the sensitivity of the reduction in mechanical power consumption to gap size is 0.58 kWċmm−1. These results emphasize the importance of active maintenance during the lifetime of a wastewater pump to avoid a reduction in the energy performance caused by increased gap size.
The complexity of childhood gender dysphoria
Authors: D’Angelo Roberto
Published: May 2020

Objective:

To explore a developmental understanding of childhood gender dysphoria and to compare it to the prevailing paradigm, gender-affirming care.

Conclusion:

Viewing gender dysphoria through a contemporary developmental frame generates a different understanding of the nature of the phenomenon and its treatment and raises ethical questions about our current gender-affirming approach.
The Relationship Between Health-Related Quality of Life and Saliva C-Reactive Protein and Diurnal Cortisol Rhythm in Latina Breast Cancer Survivors and Their Informal Caregivers: A Pilot Study
Authors: Pace Thaddeus W. W. , Badger Terry A. , Segrin Chris , Sikorskii Alla , Crane Tracy E.
Published: May 2020

Introduction: To date, no study has explored associations between objective stress-related biomarkers (i.e., inflammatory markers, diurnal rhythm of cortisol) and health-related quality of life (HRQOL) in Latina breast cancer survivors and their informal caregivers (i.e., family, friends). Method: This cross-sectional feasibility study assessed saliva C-reactive protein, saliva diurnal cortisol rhythm (cortisol slope), and self-reported HRQOL (psychological, physical, and social domains) in 22 Latina survivor–caregiver dyads. Feasibility was defined as ≥85% samples collected over 2 days (on waking, in afternoon, and in evening). Associations between biomarkers and HRQOL were examined with correlational analyses. Results: Collection of saliva was feasible. Strongest associations were observed between survivor evening cortisol (as well as cortisol slope) and fatigue, a component of physical HRQOL. Discussion: Associations presented may help promote investigations of mechanisms linking stress-related biomarkers and HRQOL in Latina breast cancer survivor–caregiver dyads, which will facilitate development of culturally congruent interventions for this underserved group.
Analysis of temperature-sensitive hydrogel microvalves in a T-junction flow sorter using full scale fluid–structure interaction
Authors: Khanjani Elham , Kargar-Estahbanaty Arash , Taheri Ali , Baghani Mostafa
Published: May 2020

Hydrogels have attracted attention in microfluidic applications as sensors and actuators due to their ability to undergo huge volume changes when subjected to environmental stimuli. In this study, a T-junction flow sorter is numerically investigated. Each of the branches involves one hydrogel microvalve with reverse sensitivity to temperature changes. The valve’s functionality is studied with and without considering fluid–structure interaction for various inlet pressures. The results of fluid–structure interaction and non-fluid–structure interaction solutions, such as fluid flow rate and valves close temperature, are presented and compared. In order to reduce hydrogel’s response time, the solution is employed for multiple valves patterns. It can be concluded that the hydrogel deformation due to the fluid pressure has a significant effect on the valves’ operational parameters which cannot be ignored in design and analysis.
Internet-Based Cognitive Behavioral Therapy for Depression: A Feasibility Study for Home Care Older Adults
Authors: Xiang Xiaoling , Sun Yihang , Smith Shawna , Lai Patrick Ho Lam , Himle Joseph
Published: May 2020

Purpose:

The present study examined the feasibility of internet-based cognitive behavioral therapy (iCBT) for home care older adults.

Method:

A feasibility open trial was conducted with 26 recipients of nonmedical home care with depressive symptoms. When possible, home care workers (HCWs) of older adults ( n = 13) were recruited to provide external support for iCBT usage.

Results:

The mean therapy sessions completed was 4.7 out of 8, and 86% would recommend the program to others with depressed mood. Participants’ depressive symptoms and anxiety symptoms decreased, whereas their quality of life ratings improved.

Discussion:

iCBT is a feasible and acceptable treatment modality for home care older adults with depressive symptoms and is potentially effective. Future studies are warranted to refine the existing treatment platform to achieve a better fit between the demands of the program and the needs and capabilities of homebound older adults and to examine treatment effectiveness as a function of HCW support.
Hypergrowth Exit Mindset: Destroying Societal Wellbeing through Venture Capital Biased Social Construction of Value
Authors: Lam Laura , Seidel Marc-David L.
Published: May 2020

Exit! Exit! Exit! Our innovation ecosystems are focused on this goal above all else, thanks to the reliance on venture capital. Young potential entrepreneurs talk about exit strategies before even creating an innovation or starting a business. Our innovation ecosystems push them to do so in many ways. Seemingly straightforward questions to budding entrepreneurs such as “What is your exit strategy?” drastically shift focus and outcomes away from creating long–term societally beneficial innovations. We argue that this hypergrowth exit mindset is destroying societal wellbeing due to its laser focus on increasing socially constructed exit value above all else. As a field we need much more research about the antecedents and consequences of the mindset, as well as research informed alternative innovation models. To address this fertile research area, we call for more research on alternative models of innovation built upon societal wellbeing as opposed to exit valuations.
Effects on Postoperative Gastrointestinal Motility After Neuromuscular Blockade Reversal With Sugammadex Versus Neostigmine/Glycopyrrolate in Colorectal Surgery Patients
Authors: Hunt Molly E. , Yates John R. , Vega Hannah , Heidel Robert E. , Buehler Jason M.
Published: May 2020

Background:

Neuromuscular blockers (NMBs) used during surgery have historically been reversed with acetylcholinesterase inhibitors and anticholinergic agents, which can slow gastrointestinal motility. Sugammadex (SUG) provides NMB reversal with minimal effects on gastrointestinal motility.

Objective:

The purpose of this study was to determine if SUG for reversal of NMB is associated with decreased time to first bowel movement (BM) following laparoscopic colorectal surgery.

Methods:

A retrospective cohort analysis divided 224 patients undergoing laparoscopic colorectal surgeries based on whether they received SUG or a combination of neostigmine and glycopyrrolate (NG) for NMB reversal. The primary outcome was time (in hours) from NMB reversal until first recorded BM. Secondary end points were postoperative ileus, postoperative nausea and vomiting, prevalence of residual NMB, and hospital length of stay. The relationship between NMB reversal agent and outcomes were analyzed using multivariable linear regression and Cox proportional hazards model.

Results:

There were 128 patients who received NG and 96 who received SUG. Time to first BM was faster in the SUG group by 11.7 hours ( P = 0.004). SUG maintained the effect in a multiple regression model ( P = 0.012). A Cox Proportional Hazards regression model found 50% increased odds of a BM across time for the SUG group ( P = 0.003). No adverse effects were noted.

Conclusion and Relevance:

This represents the first report demonstrating faster return of BM following colorectal surgery with SUG when compared with NG. Application of these data may add another tool to enhance recovery after colorectal surgery.
Examining Link Between Childhood ADHD and Sexual Assault Victimization
Authors: Wymbs Brian T. , Gidycz Christine A.
Published: May 2020

Objective: Adults with ADHD are often victims of psychological and physical violence by romantic partners, but less is known regarding whether ADHD is associated with sexual assault victimization. Method: Adults with ( n = 97) and without childhood histories of ADHD ( n = 121) rated their experiences with sexual assault victimization and additional risk factors (i.e., alcohol abuse, illicit drug use, and experiencing child abuse). Results: Adults with ADHD histories were more likely to report being victims of sexual assault, especially attempted rape or rape, than adults without ADHD histories. The rate of rape victimization was not greater for adults with ADHD histories and persistent symptoms or additional risk factors. Conclusion: Research is needed to investigate potential mechanisms explaining the link between ADHD and sexual victimization. Clinicians seeking to prevent at-risk populations from becoming victims, or to provide services for victims, should consider screening adults for ADHD histories.
Impact of the Duration of Coastal Flooding on Infrastructure
Authors: Pezza David A. , White John M.
Published: May 2020

Coastal communities are experiencing a gradual increase in flooding. Studies focus on the extent and depth of how coastal flooding will change as sea levels rise and impacts on infrastructure needed for risk assessments. However, there is limited information on how the duration of coastal flooding will change; specifically, in a format needed to support risk assessments. Therefore, the objective of this article is to highlight the need for annual exceedance probability curves by examining potential impacts on infrastructure in the city of Norfolk, Virginia. The analysis translates tide data to simulate stationarity and combines it with increments of rising sea levels to represent future tide elevations. The authors use a Poisson probability distribution to calculate flood duration exceedance levels for a specified threshold level and estimate how durations and probabilities could change over time. The article concludes with an assessment of how increasing flood durations can impact infrastructure systems.
Vector analysis of small incision lenticule extraction and toric implantable collamer lens implantation for astigmatism correction
Authors: Wan Ting , Yin Houfa , Wu Zhiyi , Yang Yabo
Published: May 2020

Objectives:

To compare the efficacy of small incision lenticule extraction (SMILE) and toric implantable collamer lens (TICL) implantation for myopic astigmatism correction using vector analysis.

Methods:

In this retrospective study, 171 eyes of 171 patients with cylinder ⩾1.0 diopters (D) were recruited, with 97 eyes underwent SMILE and 74 eyes underwent TICL implantation. Preoperative and 3-months postoperative visual and refractive results were examined. The astigmatism correction, graded by the degree of preoperative cylinder was compared between two groups using vector analysis.

Results:

At 3-months postoperatively, the residual cylinder was −0.10 ± 0.21 D in the SMILE group and −0.30 ± 0.32 D in the TCL group ( p < 0.05). Furthermore, 98% and 85% of eyes had the cylinder within ±0.5 D in the SMILE and TICL group, respectively. The vector analysis revealed similar target induced astigmatism vector in two groups. However, the difference vector, magnitude of error, angle of error, and index of success were significantly higher (0.30 ± 0.32 D, −0.19 ± 0.25, −2° ± 4.35°, and 0.16 ± 0.17 D, respectively) in the TICL group than the values in the SMILE group (0.10 ± 0.21 D, −0.05 ± 0.20, −0.03° ± 2.13°, and 0.05 ± 0.12, respectively), regardless of the degree of preoperative cylinder (all p < 0.05). For preoperative cylinder < 2.0 D, surgically induced astigmatism vector and correction index in the SMILE group were higher than those in the TICL group ( p < 0.05).

Conclusion:

Both SMILE and TICL implantation are effective techniques for myopic astigmatism correction. However, the accuracy of correction in the magnitude and axis of astigmatism with SMILE was better than that achieved with TICL implantation.
Herpes Simplex Virus: A Versatile Tool for Insights Into Evolution, Gene Delivery, and Tumor Immunotherapy
Authors: Mody Prapti H , Pathak Sushila , Hanson Laura K , Spencer Juliet V
Published: May 2020

Herpesviruses are prevalent throughout the animal kingdom, and they have coexisted and coevolved along with their host species for millions of years. Herpesviruses carry a large (120-230 kb) double-stranded DNA genome surrounded by a protein capsid, a tegument layer consisting of viral and host proteins, and a lipid bilayer envelope with surface glycoproteins. A key characteristic of these viruses is their ability to enter a latent state following primary infection, allowing them to evade the host’s immune system and persist permanently. Herpesviruses can reactivate from their dormant state, usually during times of stress or when the host’s immune responses are impaired. While herpesviruses can cause complications with severe disease in immune-compromised people, most of the population experiences few ill effects from herpesvirus infections. Indeed, herpes simplex virus 1 (HSV-1) in particular has several features that make it an attractive tool for therapeutic gene delivery. Herpes simplex virus 1 targets and infects specific cell types, such as epithelial cells and neurons. The HSV-1 genome can also accommodate large insertions of up to 14 kb. The HSV-1-based vectors have already achieved success for the oncolytic treatment of melanoma. In addition to serving as a vehicle for therapeutic gene delivery and targeted cell lysis, comparative genomics of herpesviruses HSV-1 and 2 has revealed valuable information about the evolutionary history of both viruses and their hosts. This review focuses on the adaptability of HSV-1 as an instrument for gene delivery and an evolutionary marker. Overall, HSV-1 shows great promise as a tool for treating human disease and studying human migration patterns, disease outbreaks, and evolution.
Moving global horizons: Imagining selfhood, mobility and futurities through creative practice in ethnographic research
Authors: Sjöberg Johannes , D’Onofrio Alexandra
Published: May 2020

This article explores imagined selfhood, mobility and futurities through creative practice in ethnography. Globalisation allows people with varying socio-economic and geographical backgrounds to imagine themselves with more possibilities. How can creative practice such as improvisation in ethnofictions, storytelling and participatory animation be applied in ethnographic research to explore the imaginary realm of selfhood and expectations on being elsewhere? Drawing on fieldwork on migration from Africa to Europe, Brazilian transgender mobility and British youth in environmental transformation, the article will show how existential immobility inspires production of global horizons through imagination.
Delayed presentation of blunt inferior vena cava injury following high-speed motor vehicle collision
Authors: Tupper Haley , Reiter Shelby , Rog Colin J , French Bryce , Hayes Paul Greg
Published: May 2020

This is a report of a case of acute-on-chronic inferior vena cava thrombosis 10 years following blunt abdominal trauma from a motor vehicle collision. Although more common risk factors for this pathology include anatomical variation or the long-standing presence of an inferior vena cava filter, history of blunt abdominal trauma serves as a rare etiology. Fewer than 20 cases of inferior vena cava thrombosis following blunt abdominal trauma have been reported in the literature, and most describe a presentation within weeks of inciting trauma. The lengthy time to diagnosis and acute-on-chronic presentation given substantial reconstitution of circulation by collateral veins make this case unique in the literature.
Atherosclerotic Peripheral Artery Disease in the United States: Gender and Ethnic Variation in a Multiple Cause-of-Death Analysis
Authors: Nwancha Andy-Bleck , Alvarado Eduardo , Ma Jiali , Gillum Richard F. , Hughes Kakra
Published: May 2020

Background:

Atherosclerotic peripheral artery disease (PAD) is an important cause of morbidity in the United States. In this article, we conducted a multiple cause-of-death analysis of PAD to determine patterns and trends in its contribution to mortality.

Methods:

The Centers for Disease Control and Prevention statistics data were used to determine the number of deaths with the following 10th revision of the International Statistical Classification of Diseases and Related Health Problems codes selected as an underlying cause of death (UCOD) or a contributing cause considering multiple causes of death (MCOD): 170.2, 170.9, 173.9, 174.3, and 174.4. The age-adjusted death rates per 100 000 population by age, gender, race, ethnicity, and region were computed for the United States between the years 1999 and 2017. In these years, there were 47 728 569 deaths from all causes.

Results:

In 1999 to 2017 combined, there were a total of 311 175 deaths associated with PAD as an UCOD. However, there were 1 361 253 deaths with PAD listed as an UCOD or a contributing cause in MCOD, which is 4.3 times higher than UCOD. Age-adjusted MCOD rates were higher in males (25.6) than in females (19.4). Among non-Hispanics, the rate in African American males and females was 1.2 times higher than in Caucasians. Age-adjusted MCOD rates have declined in African Americans and Caucasians irrespective of gender from 2000 to 2017.

Conclusion:

Peripheral artery disease is mentioned 4 times as often on death certificates as a contributing cause of death as it is chosen as the UCOD. Overall, age-adjusted MCOD rates were higher in African Americans than Caucasians, males than females, and declined between 2000 and 2017.
The automation control system of intelligent flexible clearing robot
Authors: Fan Jing
Published: May 2020

The cleaning of cement warehouse is a labor-intensive and high-risk operation. The applicability and cleaning effect of traditional work tools are poor. Therefore, most of the methods are manual cleaning, which is inefficient and prone to accidents. It is of great social significance and practical value to develop an intelligent flexible warehouse cleaning robot that replaces the manual cleaning of cement. When the top of the cement warehouse is small and the volume of the cement warehouse is very large, how to ensure that the working range of the cleaning system can cover the entire area, and effectively and quickly complete the cleaning operation, and the automatic control of the cleaning robot has become an automatic control. Key issues to be addressed. Although the human–machine interface configuration technology has been widely used in automated monitoring systems, its graphical and componentized interface construction methods and the flexibility and scalability of the configuration interface have been widely recognized, but the human–machine interface, the coding method is still used in the construction, the development efficiency is low, and the interface is not open and flexible enough. At the same time, there are few research attempts on interface configuration. Interface configuration mostly only stays in the graphical phase of interface construction. Data and interactive control cannot meet the configuration requirements, and there is no complete implementation plan for configuration. Therefore, it has become an urgent need to change the traditional interface development mode and realize the configuration of man–machine interface. Based on the above background, the research content of this article is the research on the automatic control system of intelligent flexible clearing robot. Based on the understanding of the relevant properties of cement powder, this article discusses its flow state in the cement storehouse theoretically and provides a basis for subsequent structural design and stability research. A modularized and component-based configuration method for the numerical control interface is proposed. The interface is divided into three modules: data, graphics, and interactive control. The functional modules are assembled and the components are combined to implement the interface configuration. The experimental simulation results in this article show that compared to the traditional method, the amount of code editing of the configured human–machine interface is reduced by 46.34%, the development cycle is shortened by 43.72%, and the development efficiency of the configured human–machine interface has been greatly improved. It is confirmed that the configuration technology studied in this article can meet the requirements of automatic control systems.
Therapeutic forgetting, agonistic remembrance: Conflicting memories of Izmir’s Kültürpark and contested narratives in contemporary Turkey
Authors: Gönlügür Emre , Sezer Devrim
Published: May 2020

This article proposes to read the history of Izmir’s Kültürpark as symptomatic of Turkey’s troubled relationship with its political past and urban heritage. Combining insights from political theory, urban and architectural history, and memory studies for a transdisciplinary analysis, it problematizes the oblivion surrounding Kültürpark and explores the ways in which this collective amnesia is questioned by contemporary artists and civic initiatives. First, we examine how Kültürpark rose on a foundation of forgetting of the uprooting of Izmir’s non-Muslim communities from their homeland and the disappearance of their cultural traces from collective memory. Second, we explore how contemporary artistic and civic interventions that engage with the themes of remembrance and coming to terms with the past contest highly selective memory constructs. Third, we raise the question of whether the agonistic debates on the national narratives about the past might open up a new memoryscape and signal a relatively late ‘memory turn’ in Turkey. Finally, we argue that these artistic and civic interventions might shed new light on the theoretical disputes in memory studies, in particular on the debates about cosmopolitan and agonistic modes of remembering. More specifically, we suggest that the recent memory turn Turkey has been experiencing demonstrates that these two modes of remembering are not mutually exclusive.
Bowel obstruction
Authors: Webster Peter John
Published: May 2020

Bowel obstruction is a surgical emergency and is the most common reason for undergoing emergency laparotomy within the United Kingdom. It has a diverse range of aetiologies with a significant mortality rate and high rates of morbidity amongst survivors. Prompt identification and management of the condition are essential for favourable outcomes. This article will focus on the causes of bowel obstruction in adults, assessment in primary care and subsequent management in secondary care.
Rationale and design of a phase II trial of durvalumab treatment in patients with NSCLC ineligible for stage III chemoradiotherapy following radiation monotherapy (SPIRAL-RT study)
Authors: Yamada Tadaaki , Uchino Junji , Chihara Yusuke , Shimamoto Takayuki , Iwasaku Masahiro , Tamiya Nobuyo , Kaneko Yoshiko , Kiyomi Fumiaki , Takayama Koichi
Published: May 2020

Background:

In the PACIFIC study, progression-free survival (PFS) and overall survival (OS) of patients with unresectable, locally advanced, stage III non-small cell lung cancer (NSCLC) were prolonged by durvalumab as maintenance therapy after radical concurrent chemoradiotherapy using platinum-based antitumor agents. However, no data were obtained to reveal the efficacy of durvalumab after radiation monotherapy in patients unsuitable for chemoradiotherapy. Here, we describe an ongoing single-arm, prospective, open-label, multicenter phase II trial of durvalumab in patients with NSCLC ineligible for stage III chemoradiotherapy following radiation monotherapy (SPIRAL-RT study).

Methods:

Durvalumab at 10 mg/kg body weight is administered every 2 weeks after radiation therapy until individual patients meet the discontinuation criteria. The treatment duration is up to 12 months. The primary endpoint is the 1-year PFS rate. Secondary endpoints are response rate, PFS, OS, and safety. Durvalumab treatment after radiation monotherapy is expected to prolong 1-year PFS rate and have acceptable adverse events.

Discussion:

We are conducting an intervention study to investigate the safety and efficacy of durvalumab treatment in patients with NSCLC ineligible for stage III chemoradiotherapy following radiation monotherapy.
Protecting American Lungs and Reversing Youth Tobacco Epidemic Act
Authors: Largent Piper , Mazyck Donna
Published: May 2020

Annually, the National Association of School Nurses (NASN) sets advocacy goals. The goals include legislative and policy priorities. This article sets forth current NASN legislative priorities and results of advocacy that benefit students. The NASN Board of Directors are instrumental in moving policy priorities forward. In addition, this article shares NASN advocacy during the COVID-19 pandemic.
Urethral recurrence after radical cystoprostatectomy: Experience from a high-volume tertiary referral centre
Authors: Pang Karl H , Esperto Francesco , Sproson Catherine , Yeung Maidie , Morgan Susan L , Downey Alison P , Hillary Christopher J , Catto James WF , Rosario Derek J , Noon Aidan P
Published: May 2020

Objectives:

To report our urethral surveillance programme and urethral cancer recurrence rate following radical cystoprostatectomy (RC).

Patients and methods:

A retrospective analysis of clinical and histopathological data of men who underwent RC and urethral surveillance, between January 2011 and October 2016.

Results:

RC was performed for 491 men; 31 and 19 men had a synchronous (malignancy, n = 10, 32.3%) and interval (malignancy, n = 6, 31.6%) urethrectomy, respectively. The remaining 441 men underwent surveillance; 183 (41.5%) men had at least one urethroscopy, 14 (3.2%) urethrectomies were performed and 12 (2.7%) specimens confirmed urethral recurrence (UR). Within the URs, 7/12 (58.3%) men presented symptomatically and 5/12 (41.7%) were detected through surveillance. At a median (interquartile range) follow-up of 21.8 (9.7–36.7) months, the 2-year disease-specific survival in men who had synchronous urethrectomy was 71.4% (versus no urethrectomy (84.6%) interval urethrectomy (92.9%) and urethrectomy for recurrence (83.8%)).

Conclusion:

UR following RC is low in men without risk factors for urethral disease. Annual urethroscopy and urine cytology may not be feasible and appropriate in all men after RC, and does not appear to impact survival at 2 years. A risk-adapted approach may allow the avoidance of annual urethroscopy in asymptomatic men post RC.

Level of Evidence:

3b
Scar-modulating agents post urethroplasty: Could phosphodiesterase-5 inhibitors be the answer?
Authors: Emara Shady , Alhasso Ammar
Published: May 2020

Background:

Phosphodiesterase enzyme inhibitors (PDEIs) are most commonly prescribed by urologists for the treatment of erectile dysfunction. They are also gaining popularity as a treatment for lower urinary tract symptoms, based on their effect on smooth muscles – either vascular smooth muscles or smooth muscles in the urinary tract. For vascular smooth muscles, they cause vasodilation, enhanced microcirculatory haemodynamics through inhibition of platelet aggregation and adhesion, induction of apoptosis of adhesion fibroblasts and a reduction in the scarring process.

Methodology:

We reviewed articles published in English and indexed in the PubMed, Embase and Google Scholar databases, and consulted textbooks. Key search terms used were: urethral stricture, anti-fibrotic, scar-modulating agent, PDEIs, urethral scarring and urethroplasty. We created a synopsis of relevant articles, including original research studies and reviews. Level of evidence: Not applicable.
Canadian Society of Nephrology COVID-19 Rapid Response Team Home Dialysis Recommendations
Authors:   Home Dialysis Workgroup Members:, Copland Michael , Hemmett Juliya , MacRae Jennifer M. , McCormick Brendan , McCormick Michael , Qirjazi Elena , Singh Rajinder S. , Zimmerman Deborah ,   On behalf of the CSN COVID-19 RRT, Antonsen John , Banks Cheryl , Clark David , Clark Edward , Davison Sara N. , Goldberg Aviva , Hiremath Swapnil , Kappel Joanne , Mac-Way Fabrice , Mathew Anna , Moist Louise , Moran Sarah , Pandeya Sanjay , Ryz Krista , Singh Suneet , Soroka Steven , Suri Rita , Tennankore Karthik , Thanabalasingam Susan , Wald Ron , Weir Matthew , White Christine , Levin Adeera , Mustafa Reem A. , Nesrallah Gihad
Published: May 2020

Purpose of program:

This paper will provide guidance on how to best manage patients with end-stage kidney disease who will be or are being treated with home dialysis during the COVID-19 pandemic.

Sources of information:

Program-specific documents, pre-existing, and related to COVID-19; documents from national and international kidney agencies; national and international webinars, including webinars that we hosted for input and feedback; with additional information from formal and informal review of published academic literature.

Methods:

Members of the Canadian Society of Nephrology (CSN) Board of Directors solicited a team of clinicians and administrators with expertise in home dialysis. Specific COVID-19-related themes in home dialysis were determined by the Canadian senior renal leaders community of practice, a group compromising medical and administrative leaders of provincial and health authority renal programs. We then developed consensus-based recommendations virtually by the CSN work-group with input from ethicists with nephrology training. The recommendations were further reviewed by community nephrologists and over a CSN-sponsored webinar, attended by 225 kidney health care professionals, for further peer input. The final consensus recommendations also incorporated review by the editors at the Canadian Journal of Kidney Health and Disease (CJKHD).

Key findings:

We identified 7 broad areas of home dialysis practice management that may be affected by the COVID-19 pandemic: (1) peritoneal dialysis catheter placement, (2) home dialysis training, (3) home dialysis management, (4) personal protective equipment, (5) product delivery, (6) minimizing direct health care provider and patient contact, and (7) assisted peritoneal dialysis in the community. We make specific suggestions and recommendations for each of these areas.

Limitations:

This suggestions and recommendations in this paper are expert opinion, and subject to the biases associated with this level of evidence. To expedite the publication of this work, a parallel review process was created that may not be as robust as standard arms’ length peer-review processes.

Implications:

These recommendations are intended to provide the best care possible during a time of altered priorities and reduced resources.
Hip Fracture Trends in America Between 2009 and 2016
Authors: Remily Ethan A. , Mohamed Nequesha S. , Wilkie Wayne A. , Mahajan Ashwin K. , Patel Nirav G. , Andrews Taj-Jamal , Nace James , Delanois Ronald E.
Published: May 2020

Background:

Hip fractures are a common condition associated with high morbidity and mortality. In this study, we assess (1) yearly incidences, (2) demographic factors, (3) postoperative outcomes, (4) primary diagnoses, and (5) primary procedures.

Materials and Methods:

The National Inpatient Sample was queried for patients admitted with hip fractures from 2009 to 2016 (n = 2 761 850). Variables analyzed were age, sex, race, obesity status, Charlson Comorbidity Index, smoking status, osteoporosis status, lengths of stay (LOS), discharge dispositions, charges, costs, mortalities, inpatient complications, primary and secondary diagnoses, and primary procedures.

Results:

From 2009 to 2016, the overall gross number of hip fractures decreased ( P < .001). At the conclusion of the study, more patients were male, obese, and smokers, while fewer had a diagnosis of osteoporosis ( P < .001 for all). Mean LOS significantly decreased ( P < .001), while charges and costs increased ( P < .001 for both). Both mortality and the overall complication rate decreased ( P < .001 for both). Specifically, complications that decreased included myocardial infarctions, deep vein thromboses, pulmonary emboli, pneumoniae, hematomas/seromas, urinary tract infections, and transfusions ( P < .001 for all). Complications that increased included cardiac arrests, respiratory failures, mechanical complications, and sepsis ( P < .001 for all). The most common diagnosis was “closed fracture of intertrochanteric section of neck of femur.” The procedure performed most often was “open reduction of fracture with internal fixation, femur.”

Conclusion:

An increasing number of males and smokers have sustained hip fractures, although fewer patients with osteoporosis experienced these injuries. A decreasing overall complication rate may indicate improving perioperative courses for hip fracture patients. However, several shortcomings still exist and can be improved to further decrease negative outcomes.
Rethinking the Black Box in Architecture Design Studio
Authors: Durmus Ozturk Serap
Published: May 2020

Design as a critical action can be defined as a concrete-utilitarian construction process and a state-related symbolic ritual. The process of design is defined by the abstraction area, which is accompanied by abstract forms of representation for the physical environment in a built environment and the response to problems. Black Box is defined as tool, system, or object that in art and science is evaluated by inputs and outputs and does not include any internal information. The Black Box problem, which is part of the architectural design process, has been reconstructed as a critical stance to the closed and implicit architectural production process, supporting open thought to the end but formally designing houses that remain faithful to this black box. Hence, this article is an example of a physical and semantic representation production with an emphasis on design as a critical action and metaphor. This article, which presents the black box problem through a theoretical perspective and architectural design studio examples, focuses on the semantic and formal representation of all conditions of a cube. This aspect aims to provide a creative cross section from the potential of infinite design.
Transformational Leadership and Knowledge Sharing: Determinants of Firm’s Operational and Financial Performance
Authors: Son Than Thanh , Phong Le Ba , Loan Bùi Thị Thu
Published: May 2020

The purpose of this study is to explore the effects of transformational leadership and knowledge-sharing processes on operational and financial performance in Chinese firms. The article applied structural equation modeling to inspect the influence of transformational leadership on knowledge sharing and their effects on organizational performance, based on the data collected from 263 respondents in 112 manufacturing and service companies in China. The findings show that knowledge collecting and knowledge donating mediate the correlation between transformational leadership and two specific aspects of organizational performance. In addition, transformational leadership has a greater influence on financial performance, whereas knowledge sharing is more significantly associated with operational performance. This article highlights the significance of practicing transformational leadership to stimulate individuals’ knowledge-sharing behaviors, which are important prerequisites for improving organizational performance. The article provides clearer understanding for scholars and practitioners about the new and effective pathway to promote firm’s operational and financial performance.
Prospective Randomized Controlled Trial to Study the Effect of Local Steroids in the Retropharyngeal Space After Anterior Cervical Discectomy and Fusion
Authors: Dahapute Aditya , Sonone Sandeep , Bhaladhare Shubhanshu , Sakhare Kuber , Marathe Nandan , Balasubramanian Sai Gautham , Keny Swapnil
Published: May 2020

Study Design:

Prospective randomized controlled trial.

Objective:

To study the effect of local steroids in the retropharyngeal space after anterior cervical discectomy and fusion (ACDF) in reducing prevertebral soft-tissue swelling (PSTS) and complications associated with it.

Methods:

A total of 50 consecutive patients operated with ACDF were double-blinded randomized into 2 groups: steroids (25) and control (25). Triamcinolone in collagen sponge was used in the steroid group and normal saline in gelatin sponge in the control group. Patients’ lateral radiographs were taken on the immediate postoperative day; days 2, 4, and 6; at 2 weeks; and 2 and 6 months postoperatively. The PSTS ratio at C3 to C7 and PSTS index were calculated. Patients were clinically evaluated using the Visual Analogue Scale (VAS) score for odynophagia and radiating pain, modified Japanese Orthopedic Association Score (mJOA), and Neck Disability Index (NDI).

Results:

PSTS showed a significant reduction in the steroid group as compared with the control group on the immediate postoperative day; days 2, 4, and 6; and at 2 weeks. However, at 2 and 6 months, PSTS remained the same. VAS score for odynophagia also showed a significant difference between the 2 groups on the immediate postoperative day; days 2, 4, and 6; and 2 weeks postoperatively, with no significant difference at the 2- and 6-month follow-up. mJOA and NDI showed no significant difference between the 2 groups at the 2- and 6-month follow-up.

Conclusion:

Use of retropharyngeal steroids helps in reducing the postoperative odynophagia on a short-term basis without any complication.
3D printing and spine surgery
Authors: Senkoylu Alpaslan , Daldal Ismail , Cetinkaya Mehmet
Published: May 2020

Rapid prototyping (RP), also known as three-dimensional printing (3DP), allows the rapid conversion of anatomical images into physical components by the use of special printers. This novel technology has also become a promising innovation for spine surgery. As a result of the developments in 3DP technology, production speeds have increased, and costs have decreased. This technological development can be used extensively in different parts of spine surgery such as preoperative planning, surgical simulations, patient–clinician communication, education, intraoperative guidance, and even implantable devices. However, similar to other emerging technologies, the usage of RP in spine surgery has various drawbacks that are needed to be addressed through further studies.
Climate Change Effects on the Crop Yield and Its Variability in Telangana, India
Authors: Guntukula Raju , Goyari Phanindra
Published: May 2020

This study has examined the effects of climatic factors on mean yields and yield variability of four primary crops (rice, cotton, jowar and groundnut) in Telangana state by applying the Just and Pope production function over a period of 1956–2015. Using the three-stage feasible generalised least squares estimation procedure, we have estimated the production function of four crops. The empirical results have revealed that the effects of changes in climatic factors vary among crops under study. Maximum temperature has a significant adverse effect on rice, cotton and groundnut yields. Minimum temperature has a substantial positive effect on rice, cotton and groundnut. Further, rainfall is adversely related to cotton and groundnut yields. Maximum temperature has appeared as a risk-reducing factor for all study crops while minimum temperature as a risk-enhancing factor for rice, cotton and jowar. Lastly, rainfall has been found as a risk-enhancing factor for rice and groundnut whereas it is a risk-reducing factor for jowar and cotton. Results from the study have important implications on how Telangana’s farming sector will adapt to climate variability and change for sustainable agricultural development.

JEL Codes: C23, Q18, Q51, Q54
Assessment of skin disease in scleroderma: Practices and opinions of investigators studying scleroderma
Authors: Showalter Kimberly , Merkel Peter A , Khanna Dinesh , Gordon Jessica K
Published: May 2020

Background:

The modified Rodnan skin score is a common primary outcome measurement tool in clinical trials of systemic sclerosis (scleroderma). However, it is unknown how often physicians perform the modified Rodnan skin score in clinical practice or what precise approach is most often used when assessing each of the 17 sites included in the modified Rodnan skin score (i.e. “maximizing,” “averaging,” “representative area”). This study assessed the experiences, perceptions, training, and practices of individuals studying scleroderma with regard to modified Rodnan skin score.

Methods:

An invitation with an online survey link was sent electronically to 282 individuals who are part of the Scleroderma Clinical Trials Consortium. The 46-item survey included three sections: participant demographics, modified Rodnan skin score background/training, and modified Rodnan skin score assessment practices. The survey was accessible for 5 weeks (October–November 2019).

Results:

The response rate was 41% (116 of 282 individuals). The majority of participants perform the modified Rodnan skin score in clinical care (>99%) and practice at academic institutions (90%) in North America (41%) or Europe (40%). Nearly all participants felt that the modified Rodnan skin score is either “somewhat important” (43%) or “essential” (56%) to the care of patients with systemic sclerosis. In total, 91% of participants reported having received modified Rodnan skin score training. The majority (60%) of those who had not received training were interested in receiving modified Rodnan skin score training, and 39% of participants felt either “uncomfortable” or only “somewhat comfortable” performing the modified Rodnan skin score. The modified Rodnan skin score approach varied: 44% used “maximizing,” 28% used “averaging,” and 18% used “representative area.”

Conclusion:

A majority of participants feel that the modified Rodnan skin score is “essential” to the care of patients with systemic sclerosis; however, the method used to measure modified Rodnan skin score varies greatly among systemic sclerosis investigators. These results indicate a continued role of modified Rodnan skin score for care and research in systemic sclerosis, support ongoing efforts to increase opportunities for modified Rodnan skin score training, and highlight a potential need to harmonize the technical approach to measuring the modified Rodnan skin score.
Filling the Gap in White-Collar Crime Detection Between Government and Governance: The Role of Investigative Journalists and Fraud Examiners
Authors: Gottschalk Petter
Published: May 2020

This article suggests that investigative journalists in the media and fraud examiners in private investigations have the potential of filling some of the detection gap. Based on the theory of crime signal detection, this article suggests that investigative journalists are in the position of detecting white-collar crime scandals as they rely on tips and whistleblowing. Empirical evidence from Norway documents that the media disclose a significant fraction of crime stories that later result in prosecution and conviction of white-collar offenders. Empirical evidence from Norway does not document any contribution from fraud examiners in private policing of economic crime, as they typically conclude with misconduct, but no crime, often to the satisfaction of their clients.
Towards elimination of childhood and adolescent tuberculosis in the Netherlands: an epidemiological time-series analysis of national surveillance data
Authors: Gafar Fajri , Ochi Taichi , van't Boveneind-Vrubleuskaya Natasha , Akkerman Onno W. , Erkens Connie , van den Hof Susan , van der Werf Tjip S. , Alffenaar Jan-Willem C. , Wilffert Bob
Published: May 2020

Background

Tuberculosis (TB) in children and adolescents is a sentinel event for ongoing transmission. In the Netherlands, epidemiological characteristics of childhood and adolescent TB have not been fully evaluated. Therefore, we aimed to assess TB epidemiology within this population to provide guidance for TB elimination.

Methods

A retrospective time-series analysis using national surveillance data from 1993–2018 was performed in children (aged <15 years) and adolescents (aged 15–19 years) with TB. Poisson regression models offset with log-population size were used to estimate notification rates and rate ratios. Trends in notification rates were estimated using average annual percentage changes (AAPC) based on the segmented linear regression analysis.

Results

Among 3899 children and adolescents with TB notified during 1993–2018, 2418 (62%) were foreign-born (725 (41.3%) out of 1755 children and 1693 (78.9%) out of 2144 adolescents). The overall notification rate in children was 2.3 per 100 000 person-years, declining steadily during the study period (AAPC −10.9%, 95% CI −12.6–−9.1). In adolescents, the overall notification rate was 8.4 per 100 000 person-years, strongly increasing during 1993–2001 and 2012–2018. Compared to Dutch-born children and adolescents, substantially higher notification rates were observed among African-born children and adolescents (116.8 and 316.6 per 100 000 person-years, respectively). Additionally, an increasing trend was observed in African-born adolescents (AAPC 18.5%, 95% CI 11.9–25.5). Among the foreign-born population, those from countries in the horn of Africa contributed most to the TB caseload.

Conclusion

TB notification rate among children was low and constantly declining across different demographic groups. However, heterogeneities were shown in adolescents, with an increasing trend in the foreign-born, particularly those from Africa.