bluuebunny/crossref_metadata_2025 huggingface dataset:
The Dilemma of Drains after Pancreatoduodenectomy: Still an Issue?
Authors: Andersson R. , Søreide K. , Ansari D.
Published: August 2019

Background and Aims:

Routine drainage after pancreatoduodenectomy is a controversial issue. In this article, we present and discuss the current evidence on abdominal drains in pancreatic surgery.

Material and Methods:

Review of the pertinent English-language literature.

Results:

There is a growing body of evidence showing a lack of benefit of prophylactic drainage after pancreatoduodenectomy. Randomized trials have reported similar outcomes with or without routine drains. If drains were used, early removal was found to be superior to late removal in patients with a low risk of postoperative pancreatic fistula. Consequently, criteria for early drain removal have been developed based on the measurement of drain amylase levels. On the contrary, there exists a subgroup of patients where drains may have a role. In patients with high risk of pancreatic fistula formation, such as those having a soft pancreatic texture, small pancreatic duct and high body mass index, the placement of drains may give sentinel information about future clinical deterioration. The drain may thus help reduce failure-to-rescue rates.

Conclusion:

Despite much research, there are many unanswered questions regarding drains in pancreatic surgery. It is evident that routine drainage should be abandoned for a more selective strategy. Furthermore, what is needed is a postoperative warning score that early on can identify patients at risk of a pancreatic fistula, without the routine placement of drains.
Fuel-efficient thermal management in diesel engines via valvetrain-enabled cylinder ventilation strategies
Authors: Gosala Dheeraj B , Shaver Gregory M , McCarthy James E , Lutz Timothy P
Published: August 2019

Modern diesel engine aftertreatment systems require elevated temperatures for effective reduction of engine-out emissions. Maintaining elevated aftertreatment temperatures in a fuel-efficient manner is a challenge, especially at low-load engine operation where engine-outlet temperatures are low; therefore, higher engine-outlet temperatures are typically achieved via increased fuel consumption. Previous studies have demonstrated that strategies such as cylinder deactivation (method where there is neither valve motion nor fuel injection in a subset of cylinders, thereby isolating the deactivated cylinders from the gas exchange process) and cylinder cutout (method where there is no fuel injection in a subset of cylinders, implemented with high recirculated gas rates) reduce fuel consumption while elevating engine-outlet temperatures, by reducing the overall airflow through the engine. This article introduces and characterizes “non-fired cylinder ventilation” as alternate means to achieve fuel-efficient aftertreatment thermal management, by reduction of overall airflow through the engine. Fuel injection is deactivated from a subset of cylinders during non-fired cylinder ventilation, and the non-firing cylinders participate in the gas exchange process with the same manifold at a time, thereby reducing the intake-to-exhaust manifold gas exchange through the cylinders. It is demonstrated that non-fired cylinder ventilation shows similar fuel efficiency and thermal management as cylinder deactivation when the valves of the non-firing ventilated cylinders are open by at least 4 mm, due to similar, negligible, gas-exchange losses, while non-fired cylinder ventilation with lower valve lifts enables elevated engine-outlet temperatures with relatively higher fuel consumption than cylinder deactivation. Non-fired cylinder ventilation strategies demonstrate 75 °C higher temperatures at fuel-neutral conditions, and up to 35% fuel savings at similar temperatures, compared to six-cylinder operation.
Marginality and banality in the segregated city: Reflections on the ‘riots’ in Oslo
Authors: Andersen Bengt
Published: August 2019

The Israeli invasion of Gaza in late December 2008 triggered demonstrations—or, as several commentators termed them, riots—in Oslo’s city centre, as it did in other European cities. Many young people from the Oslo’s ‘immigrant-dense’ suburbs participated in these protests. The demonstrations in December 2008 were followed by unusually violent protests on 8 and 10 January 2009. Oslo’s city centre was turned into a battlefield, with vandalised shops and ‘warlike’ clashes between demonstrators and police. Media coverage emphasised that most of the ‘rioters’ were young males from immigrant backgrounds. Commentators speculated that the demonstrations offered these males an opportunity to vent their frustrations towards both Israel and mainstream Norwegian society. Explanations of the urban unrest were similar to those put forth in the aftermath of unrest in other European cities. It was suggested that Norwegian youth were taking the opportunity to release their pent-up rage as marginalised residents of stigmatised neighbourhoods. This paper does not attempt to identify any universal, deeper-lying causes of urban unrest. However, based on prolonged fieldwork in Oslo prior to, during and following the demonstrations, it is argued that contextual knowledge of ordinary life can be helpful when trying to understand such extraordinary events.
Diversity in an Anti-immigration Era: Theories, controversies, principles
Authors: Parvin Phil
Published: August 2019

This piece introduces the overarching themes of the special issue. It maps the current intellectual landscape, and describes the disconnect between a lot of influential academic research on cultural and religious diversity and political reality. It argues that the rise of anti-immigration and anti-diversity sentiments in many democratic states around the world renders conventional arguments for multiculturalism inapplicable in these states, and calls for a re-appraisal of these theories in order to assess their feasibility and persuasiveness. It outlines the contributions to the special issue, and analyses the themes on which they touch.
Revised energy efficiency design index parameters for inland cargo ships of Bangladesh
Authors: Hasan SM Rashidul , Karim Md Mashud
Published: August 2019

A generalized CO2 emission benchmark (energy efficiency design index) cannot be established for inland ships in a similar fashion like the one established by International Maritime Organization for seagoing vessels. Difference in environmental, geographical and economic conditions, for example, shallow and restricted water effects, different fuel quality (to reduce operational cost), reduction in speed, increase in engine power, reduction in carrying capacity and cargo availability, forbids the direct use of energy efficiency design index as formulated by International Maritime Organization. These conditions have been addressed at first in this research, and revision of some parameters is presented for calculating energy efficiency design index for inland cargo ships of Bangladesh. Moreover, the ship data stored at different organizations of Bangladesh deviate from the existing ship data. As a result, the collected data have undergone through several verification processes. Based on the verified real data, CO2 emission benchmark for inland cargo ships of Bangladesh was established. This benchmark is one of the world’s first CO2 emission benchmark for inland cargo shipping. This benchmark will force ship designers of Bangladesh to design more energy efficient ships that will consume less energy per ton-mile. It is interesting to note that the energy efficiency design index curve for inland cargo ships using revised energy efficiency design index parameters is below the energy efficiency design index curve using International Maritime Organization formulation. The prime reasons behind this fact have also been explained in this research.
A Mixed-Methods Evaluation of a Nurse-Led Community-Based Health Home for Ethnically Diverse Older Adults With Multimorbidity in the Adult Day Health Setting
Authors: Sadarangani Tina , Missaelides Lydia , Eilertsen Emily , Jaganathan Harini , Wu Bei
Published: August 2019

Multimorbidity affects 75% of older adults (aged 65 years and older) in the United States and increases risk of poor medical outcomes, especially among the poor and underserved. The creation of a Medicaid option allowing states to establish health homes under the Affordable Care Act was intended to enhance coordinated care for Medicaid beneficiaries with multimorbidity. The Community-Based Health Home (CBHH) model uses the infrastructure of the Adult Day Health Center (ADHC) to serve as a health home to improve outcomes for medically complex vulnerable adults. Between 2017 and 2018, we used a sequential explanatory mixed-methods approach to (a) quantitatively examine changes in depression, fall risk, loneliness, cognitive function, nutritional risk, pain classification, and health care utilization over the course of 12 months in the program and (b) qualitatively explore the perspectives of key stakeholders (registered nurse navigators, participants, ADHC administrators, and caregivers) to identify the most effective components of CBHH. Using data integration techniques, we identified components of CBHH that were most likely driving outcomes. After 12 months in CBHH, our racially diverse sample ( N = 126), experienced statistically significant ( p < .05) reductions in loneliness, depression, nutritional risk, poorly controlled pain, and emergency department utilization. Stakeholders who were interviewed ( n = 40) attributed positive changes to early clinical intervention by the registered nurse navigators, communication with providers across settings, and a focus on social determinants of health, in conjunction with social stimulation and engagement provided by the ADHC. CBHH positions the ADHC as the locus of an effective health home site and is associated with favorable results. CBHH also demonstrates the unique capacity and skill of registered nurses in integrating health and social services across community settings. Continued exploration of CBHH among diverse populations with multimorbidity is warranted.
Identification of Prognostic Biomarkers and Drugs Targeting Them in Colon Adenocarcinoma: A Bioinformatic Analysis
Authors: Dong Shu , Ding Zhimin , Zhang Hao , Chen Qiwen
Published: August 2019

Objective: To identify prognostic biomarkers and drugs that target them in colon adenocarcinoma (COAD) based on the Cancer Genome Atlas (TCGA) and Gene Expression Omnibus databases. Methods: The TCGA dataset was used to identify the top 50 upregulated differentially expressed genes (DEGs), and Gene Expression Omnibus profiles were used for validation. Survival analyses were conducted with the TCGA dataset using the RTCGAToolbox package in the R software environment. Drugs targeting the candidate prognostic biomarkers were searched in the DrugBank and herbal databases. Results: Among the top 50 upregulated DEGs in patients with COAD in the TCGA dataset, the Wnt signaling pathway and cytokine-cytokine receptor interactions and pathways in cancer Kyoto Encyclopedia of Genes and Genomes pathway analysis were enriched in DEGs. Tissue development and regulation of cell proliferation were the main Gene Ontology biological processes associated with upregulated DEGs. MYC and KLK6 were overexpressed in tumors validated in the TCGA, GSE41328, and GSE113513 databases (all P < .001) and were significantly associated with overall survival in patients with COAD ( P = .021 and P = .047). Nadroparin and benzamidine were identified as inhibitors of MYC and KLK6 in DrugBank, and 8 herbs targeting MYC, including Da Huang ( Radix Rhei Et Rhizome), Hu Zhang ( Polygoni Cuspidati Rhizoma Et Radix), Huang Lian ( Coptidis Rhizoma), Ban Xia ( Arum Ternatum Thunb), Tu Fu Ling ( Smilacis Glabrae Rhixoma), Lei Gong Teng ( Tripterygii Radix), Er Cha ( Catechu), and Guang Zao ( Choerospondiatis Fructus), were identified. Conclusion: MYC and KLK6 may serve as candidate prognostic predictors and therapeutic targets in patients with COAD.
Transforming Personal Narratives: An Evaluation of a Songwriting Workshop for Rural Women
Authors: Madsen Wendy
Published: August 2019

The purpose of this article was to evaluate the contribution to the social and emotional well-being of rural women of a 3-day songwriting workshop. Six participants wrote songs and performed these locally and at the Women of the World Festival. Guided by narrative inquiry and transformative learning theory, this case study included data from reflective journals, one-on-one interviews, and written songs. Vignettes of the women’s key life moments were constructed and analyzed thematically. Four themes were identified: the importance and influence of personal experiences on songwriting, learning from process and one another, intrapersonal benefits, and interpersonal benefits. The article argued songwriting workshops provide opportunities for participants to reflect on experiences and to transform their worldviews. That is, songs and the songwriting process can help participants to restory their lives and enhance their sense of social and emotional well-being.
The Effect of Training, Used-Hand, and Experience on Endoscopic Surgery Skills in an Educational Computer-Based Simulation Environment (ECE) for Endoneurosurgery Training
Authors: Cagiltay Nergiz Ercil , Ozcelik Erol , Isikay Ilkay , Hanalioglu Sahin , Suslu Ahmet E. , Yucel Taskin , Berker Mustafa
Published: August 2019

Today, virtual simulation environments create alternative hands-on practice opportunities for surgical training. In order to increase the potential benefits of such environments, it is critical to understand the factors that influence them. This study was conducted to determine the effects of training, used-hand, and experience, as well as the interactions between these variables, on endoscopic surgery skills in an educational computer-based surgical simulation environment. A 2-hour computer-based endoneurosurgery simulation training module was developed for this study. Thirty-one novice- and intermediate-level resident surgeons from the departments of neurosurgery and ear, nose, and throat participated in this experimental study. The results suggest that a 2-hour training during a 2-month period through computer-based simulation environment improves the surgical skills of the residents in both-hand tasks, which is necessary for endoscopic surgical procedures but not in dominant hand tasks. Based on the results of this study, it can be concluded that computer-based simulation environments potentially improve surgical skills; however, the scenarios for such training modules need to consider especially the bimanual coordination of hands and should be regularly adapted to the individual skill levels and progresses.
How Does Games Critique Impact Game Design Decisions? A Case Study of Monetization and Loot Boxes
Authors: Perks Matthew E.
Published: August 2019

Games critics arguably influence the form games take, identities of players, and identities of game developers. However, very little work in Game Studies examines how critical games journalism, games, developers, and independent actors intersect. This article argues that pragmatic sociology of critique, developed by Luc Boltanski, can act as a theoretical framework to aid in understanding these processes of critique. Utilizing a theoretical lens such as this helps us better understand the function of games critique within the video game industry. Applying this framework to a case study of monetization and “loot boxes,” this article emphasizes the role and power of journalistic critique in shaping gaming cultures, and the consumption and production of media more generally.
When Hate Comes to Campus: Campus Readiness for Conflict, Safety, and Student Voice
Authors: Kruse Sharon D. , Rodela Katherine C.
Published: August 2019

A state voter proposition concerning gun regulation motivated a local far-right political group to organize a pro-gun rally on campus. Overriding the safety and security concerns of faculty and students, freedom of speech rights required that the group be allowed to assemble on campus. The case explores interactions among administration, faculty, and students that illuminate campus tensions related to race, readiness for conflict, student safety, and student voice. Authors suggest exploring these tensions and issues through the lenses of organizational leadership theory and Critical Race Theory, providing readers the opportunity to better analyze similarly charged incidents in their contexts.
Effect of phase change material integration in clay hollow brick composite in building envelope for thermal management of energy efficient buildings
Authors: Kumar S , Arun Prakash S , Pandiyarajan V , Geetha NB , Antony Aroul Raj V , Velraj R
Published: August 2019

The present trend in building research is to improve sustainability in building construction and operation. The development of new renewable technologies is essential to improve the sustainability and to reduce emissions. The incorporation of phase change materials in buildings is an effective way to reduce the room temperature fluctuations and cooling loads/heating loads. Although several works have been carried out in this field, a novel phase change material clay hollow-brick composite has been used in this work. This article discusses the research on investigating the thermal performance of phase change material integration in building walls. Two identical test rooms (3 m × 3 m × 3.65 m) were constructed to study the effect of phase change material integration in buildings. The experimental buildings were constructed for the warm and humid weather conditions of Chennai city, India. Phase change material integration in the building wall is beneficial for reduction of room temperature and provides passive cooling of the building. The temperature drop in a phase change material room compared with a non-phase change material room varies from 6°C to 2°C, during various months of the year. DESIGNBUILDER simulation was carried out for phase change material and non-phase change material buildings during the months of January, March, May, and July. The simulated room temperature variation follows the same pattern in these months.
Family carers of people with intellectual disabilities in Ireland: Changes over 10 years
Authors: Kelly Caraíosa , McConkey Roy , Craig Sarah
Published: August 2019

Data were obtained on nearly 20,000 Irish children and adults living in various family care arrangements in 2007, 2012, and 2017. Over 10 years, the percentage increase in adult persons living with family carers was three times higher than the rise in the general population, with people aged 50 years and over having the highest proportional increase. Also a greater number of persons aged 40–49 group continued to live with both parents in 2017 (47%) compared to 2007 (33%). However, there was marked variation across the nine Community Health Organization areas in the proportions of adults living with family carers (from 49% to 62%). In the coming decades, increased provision will be required in both the quantum and type of supports provided to families so as to sustain their caring role but ensuring equity of provision nationally will be a major challenge.
Antinociceptive effectiveness of the inhibition of NCX reverse-mode action in rodent neuropathic pain model
Authors: Huang Yang , Wen Li-Li , Xie Jing-Dun , Ouyang Han-Dong , Chen Dong-Tai , Zeng Wei-An
Published: August 2019

Background

Chronic neuropathic pain is a debilitating condition that remains difficult to treat. The Na+-Ca2+ exchanger (NCX) is a transporter that can exchange Ca2+ with Na+ in either direction to maintain intracellular Ca2+ homeostasis. However, the effect of NCX on neuropathic pain remains unclear. Therefore, in this study, we aimed to clarify whether neuropathic pain is altered by NCX.

Methods

Adult Sprague–Dawley rats and mice (NCX2 knockout and wild type) were randomized to receive spinal nerve ligation surgery or intrathecal injection. Using behavioral testing to analyze the withdrawal thresholds and thermal withdrawal latency of rats after surgery or intrathecal injection. Immunohistochemistry and Western blotting were used to analyze the changes of NCX protein and downstream signaling pathways in rats dorsal root ganglion. We isolated the dorsal root ganglion neurons of adult rats using Fluo-4AM to detect the Ca2+ imaging in neurons after drug treatment.

Results

NCX was expressed in the sensory neurons of rodent dorsal root ganglia. NCX expression was altered in ipsilateral L4–6 dorsal root ganglion neurons in spinal nerve ligation rats. Intrathecal injection of an inhibitor of reverse-mode NCX activity (KB-R7943 5∼20 µg) had an antinociceptive effect in spinal nerve ligation rats, and the effect lasted for 3 h. We measured the expression of signaling pathway molecules in dorsal root ganglion neurons, and only the p-extracellular signal-regulated kinase (ERK) 1/2 level was reduced after intrathecal injection in the spinal nerve ligation group compared to the control group. In cultured dorsal root ganglion neurons, inhibitors of reverse-mode NCX activity (KB-R7943 and ORM-10103) restrained Ca2+ overload after tumor necrosis factor alpha (TNF-α) or lipopolysaccharide (LPS) treatment. NCX2 knockout mice presented an antinociceptive effect that lasted for more than 28 days after spinal nerve ligation surgery. The p-ERK1/2 level in NCX2 knockout mice ipsilateral L4–6 dorsal root ganglion neurons was lower than that in wild-type mice.

Conclusions

NCX proteins may mediate neuropathic pain progression via the Ca2+ and ERK pathways. NCX represents a potential target for the treatment of neuropathic pain.
Low-molecular synthetic peptides with non-narcotic type of analgesia: comparative study and mechanism of analgesic activity
Authors: Kotin Arkady M , Emelyanov Maksim O , Kotin Oleg A
Published: August 2019

The group of synthetic low-molecular peptides exhibiting profound analgesic activity was developed by modifying the salmon calcitonin molecule fragment sCT16-21, which retains the previously reported analgesic activity of the full-sized molecule. The mechanism of analgesic action of these synthetic oligopeptides has been investigated and their analgesic effect was compared with analgesic activity of ketorolac tromethamine, one of the strongest non-steroidal anti-inflammatory drug painkiller. It was demonstrated that the analgesic effect of the developed synthetic oligopeptides was associated with the specific binding of the clathrin heavy chain. It is postulated that inhibition of clathrin-mediated endocytosis of pain receptors in the postsynaptic vesicular cycle causes is more efficient analgesia than inhibition of those receptors on plasma membranes that may allow to replace opioid and non-steroidal anti-inflammatory drug’s analgesics with a much less toxic low-molecular synthetic peptides with non-narcotic type of analgesia.
Reproductive health care utilization among refugees in Jordan: Provisional support and domestic violence
Authors: Pierce Hayley
Published: August 2019

Objectives:

Conflict and displacement are associated with poverty, disruption of services, loss of identity, reduced care for reproductive needs, and reduced provision of health care, among other things. This article uses the framework outlined by Obermeyer and Potter to test how refugee and native status influence utilization of reproductive health services and experience with domestic violence in a context of high refugee inhabitants and strong refugee-focused non-governmental organization presence. This article addresses the following: (1) coverage, source, and method of contraceptives; (2) variation in reproductive health experience by source of contraception; and finally, (3) factors determining variation in the utilization of reproductive health services and domestic violence experiences for individuals living in and out of refugee camps.

Methods:

The data is the 2012 Jordan Demographic and Health Survey, and the method utilized is logistic regression.

Results:

Findings suggest that refugee women serviced by the United Nations Relief and Works Agency have greater access to health-related resources (family planning and contraception), but they have weaker positions in the family as evidenced by domestic violence experiences.

Conclusion:

It is plausible that provisional resources are the easiest for an aid organization to provide, while the complications of identity loss and the loss of a sense of space pose a challenge for refugees and aid organizations.
Specificity of Future Thinking in Depression: A Meta-Analysis
Authors: Gamble Beau , Moreau David , Tippett Lynette J. , Addis Donna Rose
Published: August 2019

Reduced specificity of autobiographical memory has been well established in depression, but whether this overgenerality extends to future thinking has not been the focus of a meta-analysis. Following a preregistered protocol, we searched six electronic databases, Google Scholar, and personal libraries and contacted authors in the field for studies matching search terms related to depression, future thinking, and specificity. We reduced an initial 7,332 results to 46 included studies, with 89 effect sizes and 4,813 total participants. Random-effects meta-analytic modeling revealed a small but robust correlation between reduced future specificity and higher levels of depression ( r = −.13, p < .001). Of the 11 moderator variables examined, the most striking effects were related to the emotional valence of future thinking ( p < .001) and the sex of participants ( p = .025). Namely, depression was linked to reduced specificity for positive (but not negative or neutral) future thinking, and the relationship was stronger in samples with a higher proportion of males. This meta-analysis contributes to our understanding of how prospection is altered in depression and dysphoria and, by revealing areas where current evidence is inconclusive, highlights key avenues for future research.
Long-term follow up after endoscopic valve therapy in patients with severe emphysema
Authors: Gompelmann Daniela , Heinhold Tobias , Rötting Matthias , Bischoff Elena , Kontogianni Konstantina , Eberhardt Ralf , Herth Felix J. F.
Published: August 2019

Background and objective:

Endoscopic valve therapy is a treatment modality in patients with advanced emphysema and absent interlobar collateral ventilation (CV). So far, long-term outcome following valve implantation has been insufficiently evaluated. The aim of this study was to investigate the real-world efficacy of this interventional therapy over 3 years.

Methods:

From 2006 to 2013, 256 patients with severe emphysema in whom absent CV was confirmed underwent valve therapy. The 3-year effectiveness was evaluated by pulmonary function testing (VC, FEV1, RV, TLC), 6-minute-walk test (6-MWT) and dyspnea questionnaire (mMRC). Long-term outcome was also assessed according to the radiological outcome following valve placement.

Results:

Of 256 patients treated with valves, 220, 200, 187, 100 and 66 patients completed the 3-month, 6-month, 1-year, 2-year and 3-year follow-up (FU) visit, respectively. All lung function parameters, 6-MWT and mMRC were significantly improved at 3- and 6-month FU. At 1-year FU, patients still experienced a significant improvement of all outcome parameters expect VC (L) and TLC (%). At 2 years, RV (L and %) and TLC (L and %) remained significantly improved compared to baseline. Three years after valve therapy, sustained significant improvement in mMRC was observed and the proportion of patients achieving a minimal clinically important difference from baseline in RV and 6-MWT was still 71% and 46%, respectively. Overall, patients with complete lobar atelectasis exhibited superior treatment outcome with 3-year responder rates to FEV1, RV and 6-MWT of 10%, 79% and 53%, respectively.

Conclusions:

Patients treated by valves experienced clinical improvement over 1 year following valve therapy. Afterwards, clinical benefit gradually declines more likely due to COPD progression. The reviews of this paper are available via the supplemental material section.
Therapeutic exercise for adults post-distal radius fracture: An overview of systematic reviews of randomized controlled trials
Authors: Ziebart Christina , Nazari Goris , MacDermid Joy C
Published: August 2019

Introduction

Optimizing recovery after a distal radius fracture is a major concern. There continues to be discrepancies in findings on whether therapeutic exercise improves activity and participation by reducing limitations such as pain and range of motion after fracture. The main objective of this overview was to critically appraise the evidence to establish the effectiveness of therapeutic exercise to improve impairment for adults after a distal radius fracture.

Methods

An overview of systematic reviews was used, which summarizes a number of systematic reviews. PubMed, CINAHL, PEDro, Scopus, Web of Science, and Cochrane Library were searched. Systematic reviews were included in this overview if the study population was adults after a distal radius fracture, and the intervention group was therapeutic exercise. A systematic review was excluded from this overview if it did not include randomized controlled trials, the full text was not published, or if they were scoping or narrative reviews. The outcomes evaluated were pain, function/disability, range of motion, and strength.

Results

Five systematic reviews were included in this overview, with between 7 and 26 randomized controlled trials included in the SRs. The overall quality of the reviews was low with two systematic reviews rated as low quality and three rated as critically low quality on the AMSTAR 2 assessment tool.

Conclusion

The quality of reviews was low, with high risk of bias. All reviews were inconclusive due to limitations in the number and quality of randomized controlled trials. Due to the low quality of evidence, it remains unclear what the effectiveness of exercise is to improve impairments after a distal radius fracture.
Assessing the information quality and usability of My Health Record within a health literacy framework: What’s changed since 2016?
Authors: Walsh Louisa , Hemsley Bronwyn , Allan Meredith , Dahm Maria R , Balandin Susan , Georgiou Andrew , Higgins Isabel , McCarthy Shaun , Hill Sophie
Published: August 2019

Background:

This study examined the health literacy demands of My Health Record (MyHR) in the context of preparing for a government-announced opt-out system by repeating two studies of health information and usability conducted in 2016.

Objective:

To examine whether Australia’s MyHR meets the information and usability needs of people at risk of low health literacy and changes since 2016.

Method:

Content analysis: Informed by the 2016 methods and findings, measures of information quality, themes and target audiences were recorded and reported for each online consumer-facing health information resource. Heuristic evaluation: An evaluation of the MyHR and supporting information website was conducted using a predetermined checklist of usability criteria. A list of usability violations for both websites was identified.

Results:

Total number of resources grew from 80 in 2016 to 233 in 2018. There was little change since 2016 to average readability levels, target audiences, presentation style, links between resources and usability of MyHR. Compared to 2016, this study demonstrated increases in resources from non-government organisations; video resources; translated resources; and resources with themes of privacy, security and post-registration use.

Conclusion:

This study identified some improvements in information quality since 2016, but gaps remain in information quality and usability which may negatively impact the ability for people with low health literacy to access and use MyHR.

Implications:

This study provides a framework for ongoing monitoring and evaluation of the suitability of MyHR for people at risk of low health literacy.
Split Thickness Skin Graft of the Foot and Ankle Bolstered With Negative Pressure Wound Therapy in a Diabetic Population: The Results of a Retrospective Review and Review of the Literature
Authors: Gkotsoulias Efthymios
Published: August 2019

Split thickness skin graft (STSG) is a versatile procedure performed for the treatment of wounds resulting from varying pathology. This remains very useful because of its ability for quick healing and low complication rate. The surface of the foot and ankle is an area frequently affected by severe skin and soft tissue structure infections (SSTIs) whose treatment results in wounds. These infections and resultant surgical wounds are commonly seen patients with diabetes. The objective of the present study was to retrospectively evaluate initial healing and immediate post-operative outcomes following STSG application in a diabetic population when negative pressure wound therapy (NPWT) was used as a bolster. Ten patients were identified, including 11 surgical wounds, who underwent STSG bolstered with NPWT from January 2016 to October 2018. Mean follow-up was 13 months (range 1-33 months) with an average time to heal of 17 days (range 14-30 days) for 11 surgical wounds averaging 57 cm2 (range 6.3 - 91 cm2). Consistent improved outcomes have been demonstrated when compared to alternative bolstering techniques available in the literature making a STSG bolstered with NPWT a powerful tool in the reconstruction of diabetic foot wounds resulting from the treatment of infection.

Levels of Evidence: Level IV
A 3-Dimensional In Vitro Model of Zonally Organized Extracellular Matrix
Authors: Walzer Sonja M. , Toegel Stefan , Chiari Catharina , Farr Sebastian , Rinner Beate , Weinberg Annelie-Martina , Weinmann Daniela , Fischer Michael B. , Windhager Reinhard
Published: August 2019

Objective

Functional cartilage repair requires the new formation of organized hyaline cartilaginous matrix to avoid the generation of fibrous repair tissue. The potential of mesenchymal progenitors was used to assemble a 3-dimensional structure in vitro, reflecting the zonation of collagen matrix in hyaline articular cartilage.

Design

The 3-dimensional architecture of collagen alignment in pellet cultures of chondroprogenitors (CPs) was assessed with Picrosirius red staining analyzed under polarized light. In parallel assays, the trilineage capability was confirmed by calcium deposition during osteogenesis by alizarin S staining and alkaline phosphatase staining. Using reverse transcription–quantitative polymerase chain reaction (RT-qPCR), mRNA levels of ALP, RUNX2, and BGLAP were assessed after 21 days of osteoinduction. Lipid droplets were stained with oil red O and adipogenic differentiation was confirmed by RT-qPCR analysis of PPARG and LPL gene expression.

Results

Under conditions promoting the chondrogenic signature in self-assembling constructs, CPs formed an aligned extracellular matrix, positive for glycosaminoglycans and collagen type II, showing developing zonation of birefringent collagen fibers along the cross section of pellets, which reflect the distribution of collagen fibers in hyaline cartilage. Induced osteogenic and adipogenic differentiation confirmed the trilineage potential of CPs.

Conclusion

This model promotes the differentiation and self-organization of postnatal chondroprogenitors, resulting in the formation of zonally organized engineered hyaline cartilage comparable to the 3 zones of native cartilage.
The expression of survivin in irreversible pulmonary arterial hypertension rats and its value in evaluating the reversibility of pulmonary arterial hypertension secondary to congenital heart disease
Authors: Li Gang , Zhang Han , Zhao Lei , Zhang Yaozhong , Yan Daole , Liu Yinglong , Su Junwu , Fan Xiangming
Published: August 2019

The reversibility of pulmonary arterial hypertension (PAH) determines the operability of congenital heart disease (CHD) complicating with PAH, but it lacks a method for evaluating the reversibility. The current study aims to investigate the serum survivin level in irreversible PAH rats and to explore its potential as a biomarker for evaluating the reversibility of PAH in CHD patients. Irreversible PAH rats were characterized by prominent obstructive lesions resulting from the intimal formation, which was associated with decreased apoptosis and increased survivin expression, while reversible PAH rats were featured by medial hypertrophy resulting in mild occlusion, with increased apoptosis and unchanged survivin expression. In addition, the serum survivin was significantly increased in irreversible PAH rats when compared to both reversible PAH and control rats, and a positive correlation of serum survivin with survivin expression in the lung was confirmed. Third, the preoperative serum survivin was significantly higher in patients with irreversible CHD‐PAH than in these with reversible CHD‐PAH, and significant correlations between the serum survivin and BNP, preoperative pulmonary vascular resistance index, and postoperative mean pulmonary arterial pressure were also identified. In conclusion, the increased survivin level is a feature of irreversible PAH and the serum survivin represents a candidate biomarker reflecting the operability of CHD‐PAH patients.
Algorithms as folding: Reframing the analytical focus
Authors: Lee Francis , Bier Jess , Christensen Jeffrey , Engelmann Lukas , Helgesson Claes-Fredrik , Williams Robin
Published: August 2019

This article proposes an analytical approach to algorithms that stresses operations of folding. The aim of this approach is to broaden the common analytical focus on algorithms as biased and opaque black boxes, and to instead highlight the many relations that algorithms are interwoven with. Our proposed approach thus highlights how algorithms fold heterogeneous things: data, methods and objects with multiple ethical and political effects. We exemplify the utility of our approach by proposing three specific operations of folding— proximation, universalisation and normalisation. The article develops these three operations through four empirical vignettes, drawn from different settings that deal with algorithms in relation to AIDS, Zika and stock markets. In proposing this analytical approach, we wish to highlight the many different attachments and relations that algorithms enfold. The approach thus aims to produce accounts that highlight how algorithms dynamically combine and reconfigure different social and material heterogeneities as well as the ethical, normative and political consequences of these reconfigurations.
Sources and Impact of Work-Related Stress Among HIV/AIDS Health Care Providers in Guangxi, China: A Qualitative Research
Authors: Tong Huiru , Li Xiaoming , Qiao Shan , Zhou Yuejiao , Shen Zhiyong , Yang Xueying , Zhang Quan , Zeng Chengbo
Published: August 2019

Work-related stress can negatively impact health care providers’ (HCPs) ability to provide care. We examined the sources of work-related stress experienced by HCPs who provided medical care for people living with HIV/AIDS and the impact of the stress on HCPs’ well-being and work performance. We conducted in-depth interviews with 46 HIV/AIDS HCPs in Guangxi, China. The interviews were audio-recorded, transcribed, and imported into NVivo V.11 for data management and data analysis using a thematic approach. We found that the key sources of stress at work included general work-related sources and HIV/AIDS-related sources. All stress was seen to have a substantial impact on the HCPs’ individual well-being, family and social life, and quality of care they provided. We recommended that government and health care facilities should take measures to improve institutional culture and professional development for HIV/AIDS HCPs. More professional training schemes should be provided to strengthen HCPs’ competence, improve universal protection from occupational exposure, and reduce the stigma toward HIV/AIDS patients and their care providers.
The Forensic and Clinical Relevance of Evidence-Based Investigative Interview Methods in Historical Sexual Abuse Cases
Authors: Dodier Olivier , Otgaar Henry
Published: August 2019

Decades-old child sexual abuse cases stress the need to examine the accuracy of long-term memory regarding traumatic events. The article by Goldfarb, Goodman, Larson, Eisen, and Qin (published in the March 2019 issue of Clinical Psychological Science) showed that memories of genital contact occurring decades ago were highly accurate. We argue that their findings emphasize the use of investigative interviewing in past abuse cases. Such cognitive interviewing (CI) is known to increase the completeness of memory reports. We also contend that the CI may reduce a victim’s anxiety at the time of the interview. Therefore, besides a well-proven legal relevance, investigative interviewing could also have clinical value.
Antimicrobial activity of endodontic sealers and medications containing chitosan and silver nanoparticles against Enterococcus faecalis
Authors: Loyola-Rodríguez Juan Pablo , Torres-Méndez Fernando , Espinosa-Cristobal León Francisco , García-Cortes José Obed , Loyola-Leyva Alejandra , González Francisco Javier , Soto-Barreras Uriel , Nieto-Aguilar Renato , Contreras-Palma Guillermo
Published: August 2019

Background:

The main microorganism associated with the failure of endodontic treatments is Enterococcus faecalis. Although several endodontic therapeutics have demonstrated antimicrobial activity against E. faecalis, the antimicrobial effectiveness of chitosan (CsNPs) and silver nanoparticles (AgNPs) included into conventional endodontic sealers for endodontic therapies is still unclear.

Aim:

The objective of this study was to evaluate the antibacterial activity increment (AAI) of endodontic sealers containing CsNPs and AgNPs as well as some chemical components against E. faecalis by direct contact assays.

Methods:

CsNPs and AgNPs were synthesized by reduction and ionic gelation methods, respectively. Nanoparticles were characterized by dynamic light scattering and energy dispersive X-ray analysis. The bactericidal activity was tested on monolayers on agar plates and collagen membrane surface assays against E. faecalis.

Results:

The size of CsNPs was 70.6±14.8 nm and zeta potential was 52.0±5.4 mV; the size of AgNPs was 54.2±8.5 nm, and zeta potential was –48.4±6.9 mV. All materials, single or combined, showed an AAI, especially when CsNPs, chlorhexidine (Chx), and the combination of CsNPs-Chx were added. However, the combination of CsNPs-Chx showed the highest (55%) AAI, followed by Chx (35.5%) and CsNPs (11.1%), respectively. There was a significant statistical difference in all comparisons ( p < 0.05). Tubliseal (40%) and AH Plus (32%) sealants showed a higher AAI on E. faecalis in the monolayer test and collagen membrane assay analyzed by scanning electron microscopy.

Conclusions:

Tubliseal and AH plus sealers combined with nanoparticles, especially CsNPs-Chx, could be used for conventional endodontic treatments in the control of E. faecalis bacteria.
Long-Term Effects of Social–Emotional Learning on Receipt of Special Education and Grade Retention: Evidence From a Randomized Trial of INSIGHTS
Authors: McCormick Meghan P. , Neuhaus Robin , Horn E. Parham , O’Connor Erin E. , White Hope I. , Harding Samantha , Cappella Elise , McClowry Sandee
Published: August 2019

Social–Emotional Learning (SEL) programs are school-based preventive interventions that aim to improve children’s social–emotional skills and behavioral development. Although meta-analytic research has shown that SEL programs can improve academic and behavioral outcomes in the short term, few studies have examined program effects on receipt of special education services and grade retention in the longer term. Using an experimental design, the current study leveraged administrative data available through students’ school records (N = 1,634) to examine the impacts of one SEL program implemented in kindergarten and first grade on receipt of special education and grade retention in fifth grade. The study further considered whether impacts varied for low- versus high-income students. Findings revealed no difference between treatment and control group students in grade retention. However, treatment group students were less likely to ever receive special education services by the end of fifth grade, with low-income students appearing to drive this effect. Implications are discussed.
Measuring University Students’ Perceptions About the Role of Self-efficacy on Entrepreneurial Intentions in Cape Town
Authors: Kalitanyi Vivence , Bbenkele Edwin
Published: August 2019

Entrepreneurial self-efficacy is best perceived as a multidimensional variable built from individuals’ beliefs about their abilities and capabilities for tackling the challenges and nurture entrepreneurial intentions towards the establishment of a new venture. Numerous studies are unanimous about the insufficient level of entrepreneurship in South Africa, as well as its below average total entrepreneurial activity of 7.8per cent compared to all efficiency-driven economies (developed countries) which have 11.4 per cent of activity. This study conducted in Cape Town—South Africa—aims at identifying the factors of self-efficacy and the role self-efficacy plays in rising entrepreneurial intentions among university students. Data were collected with the use of a questionnaire survey, where entrepreneurship students were the respondents. SPSS 22 was used to conduct bivariate and multivariate tests of statistical significance. The reliability of the data collection instrument was tested with the use of Cronbach’s Alpha and the variable of self-efficacy scored a reliability level of 0.877. The validity was ensured by the assessment of the instrument by two statisticians and two academics who are experts in their fields. The findings reveal the existence of a positive relationship between entrepreneurship university students’ self-efficacy and their entrepreneurial intentions. Recommendations to enhance self-efficacy among students and other aspiring business people have been formulated.
Sonographic Detection of a Urinoma/Biloma Combination
Authors: Waskey Alex , Anderson Sharlette
Published: August 2019

Urinoma formation is usually a consequence of trauma to the urinary collecting system. It is a collection of urine that is outside of the kidneys, ureters, or bladder. Similarly, a collection of bile outside of the biliary system is a biloma. Diagnosis of these is possible with a combination of imaging techniques such as sonography and computed tomography. A case is presented of a combination urinoma/biloma that formed after penetrating trauma to the superior pole of the right kidney and lower segment of the right liver lobe. Computed tomography was used to diagnose the pathology, and sonography was used to further characterize the lesion and place the drain that was used as treatment. Use of both of these modalities allowed the patient to receive a quick diagnosis and appropriate intervention.