bluuebunny/crossref_metadata_2025 huggingface dataset:
Evidence that Horizontal Moisture Advection Regulates the Ubiquitous Amplification of Rainfall Variability over Tropical Oceans
Authors: Inoue Kuniaki , Biasutti Michela , Fridlind Ann M.
Published: November 2020

The column moist static energy (MSE) budget equation approximates the processes associated with column moistening and drying in the tropics, and is therefore predictive of precipitation amplification and decay. We use ERA-Interim (ERA-I) and TRMM 3B42 data to investigate day-to-day convective variability and distinguish the roles of horizontal MSE (or moisture) advection versus vertical advection, sources, and sinks. Over tropical convergence zones, results suggest that horizontal moisture advection is a primary driver of day-to-day precipitation fluctuations; when drying via horizontal moisture advection is smaller (greater) than Chikira’s “column process,” precipitation tends to amplify (decay). In the absence of horizontal moisture advection, precipitation tends to increase spontaneously almost universally through a positive column process feedback. This bulk positive feedback is characterized by negative effective gross moist stability (GMS), which is maintained throughout the tropical convergence zones. How this positive feedback is achieved varies geographically, depending on the shape of vertical velocity (omega) profiles. In regions where omega profiles are top-heavy, the effective GMS is negative primarily owing to strong feedbacks between convection and diabatic MSE sources (radiative and surface fluxes). In these regions, vertical MSE advection stabilizes the atmosphere (positive vertical GMS). Where omega profiles are bottom-heavy, by contrast, a positive feedback is primarily driven by import of MSE through a shallow circulation (negative vertical GMS). The diabatic feedback and vertical GMS are in a seesaw balance, offsetting one another. Our results suggest that ubiquitous convective variability is amplified by the same mechanism as moisture-mode instability.
Tailoring composite materials for nonlinear viscoelastic properties using artificial neural networks
Authors: Xu Xianbo , Elgamal Mariam , Doddamani Mrityunjay , Gupta Nikhil
Published: November 2020

Polymer matrix composites exhibit nonlinear viscoelastic behavior over a wide range of temperatures and loading frequencies, which requires an elaborate experimental characterization campaign. Methods are now available to accelerate the characterization process and recover elastic modulus from storage modulus ( E′). However, these methods are limited to the linear viscoelastic region and need to be expanded to nonlinear viscoelastic problems to enable materials design. The present work aims to build a general machine learning based architecture to accelerate the characterization and materials design process for nonlinear viscoelastic materials using the E′ results. To expand outside the linear viscoelastic region, general relations of viscoelasticity are first developed so the master relation of E′ considering nonlinear viscoelasticity can be transformed to time domain relaxation function. The transform starts with building the master relation by optimizing the artificial neural network (ANN) formulation using Kriging model and genetic algorithm. Then the master relation is transformed to a relaxation function, which can be used to predict the stress response with a given strain history and to further extract the elastic modulus. The transform is tested on high density polyethylene matrix syntactic foams and the accuracy is found by comparing the predicted materials properties with those obtained from tensile tests. The good agreements indicate the transform can predict the elastic modulus under a wide range of temperatures and strain rates for any composition of the composite and can be used for material design problems.
Why the French Said ‘Non’: A New Perspective on the Hoover Moratorium of June 1931
Authors: Banholzer Simon , Straumann Tobias
Published: November 2020

Why did the French government delay its endorsement of the Hoover Moratorium in the summer of 1931? Key policymakers were fully aware that their stance would exacerbate the German financial crisis, which ultimately dragged the European economy into the abyss. Most historical accounts identify the plan for an Austro-German customs union, which became known publicly in March 1931, as a major cause for the French ‘non’. We suggest a different chronology by showing that the French government was reluctant to help Germany as early as the fall of 1930 when, in the wake of the Nazi victory in the Reichstag elections, a currency crisis threatened to ruin the German monetary and financial system and bring down the government. We also argue that the reason for this French reluctance to extend financial help to Germany was the traumatic experience resulting from the evacuation of the Rhineland in June 1930. This chauvinistic outburst in Germany not only frightened the French public, but also made it clear to French politicians how the lack of military cooperation with the Anglo-Saxon powers had made France highly vulnerable on its Eastern front. After June 1930 a financial bargain with Germany became unrealistic, due to domestic opposition.
A Multisite Quality Improvement Initiative to Enhance the Adoption of Screening Practices for Intimate Partner Violence Into Routine Primary Care for Women Veterans
Authors: Portnoy Galina A. , Iverson Katherine M. , Haskell Sally G. , Czarnogorski Maggie , Gerber Megan R.
Published: November 2020

Objective

The Veterans Health Administration established comprehensive women’s health clinics (CWHCs) to provide coordinated, high-quality primary care to women veterans. Intimate partner violence (IPV) is prevalent among women using these clinics. The Veterans Health Administration recommends screening women for IPV, yet screening uptake is low in CWHCs nationwide. We describe a multisite quality improvement initiative to enhance the adoption of IPV screening practices in the Veterans Health Administration’s CWHCs.

Methods

This quality improvement initiative, implemented in 2017-2018, included 4 steps in which we (1) conducted a baseline survey of screening practices at CWHCs throughout the United States; (2) selected and tailored evidence-based implementation strategies based on identified barriers and facilitators; (3) deployed multicomponent implementation support, targeting low-adopting facilities; and (4) conducted a follow-up survey to evaluate changes in IPV screening practices from baseline (winter 2017) to 1-year follow-up (winter 2018) using quantitative and qualitative analyses.

Results

Responders from 62 CWHC sites provided information on IPV screening practices and barriers; 42 low-adopting sites were targeted for implementation support. At follow-up, responders provided information on IPV screening practices, perceived usefulness of implementation support strategies, and continued barriers. Among sites that responded to both surveys (n = 47), the number of sites that implemented recommended screening practices increased by 66.7%, from 15 at baseline to 25 at follow-up ( P = .02). Emergent themes reflected barriers and facilitators for IPV screening implementation.

Conclusions

Improvement in IPV screening practices in CWHCs is a pivotal step toward enhancing care for women. Yet, even with numerous implementation supports, barriers to adoption persist at many sites. Findings on modifiable barriers and unique facilitators can inform next steps for increasing screening uptake.
Drivers and Persistence of Death in Conflicts: Global Evidence
Authors: Asongu Simplice A. , Uduji Joseph I. , Okolo-Obasi Elda N.
Published: November 2020

We investigate persistence and determinants of deaths from conflicts in a sample of 163 countries for the period 2010–2015. The empirical evidence is based on the Generalized Method of Moments. First, the findings are contingent on income levels, religious domination, landlockedness, regional proximity, and legal origins. We find that the persistence of deaths in internal conflict is more apparent in coastal, French civil law, and Islam-oriented countries, compared to landlocked, English common law, Christian-oriented countries, respectively. Second, the following factors are generally responsible for driving deaths from internal conflicts: homicides, conflict intensity, and conflicts fought. Furthermore, incarcerations have negative effects on internal conflicts. Justifications for the established tendencies and policy implications are discussed.
Access to Non-farm Employment in Contemporary India: A Study of Bihar and Punjab
Authors: Singh Gurpreet
Published: November 2020

Rural non-farm diversification in India is taking up new roles amidst increasing agrarian distress. In this context, two issues have been examined in this paper: first, the nature of rural non-farm diversification, and second, the accessibility of households to rural non-farm employment in the states of Bihar and Punjab. The study is predominantly based on unit level data of the latest round of the Situational Assessment Survey of Agricultural Households (NSSO). Findings suggest that while non-farm activities are largely adopted by landless and marginal land households in both states, there are a few lucrative options available which are being accessed by large landholders in Punjab. Overall, caste, gender and education are dominant determinants that work as barriers to the entry for rural households. The findings recommend that institutional reforms along with public policies should be prioritised towards generating sustainable non-farm livelihood options while eliminating multi-dimensional exclusions in rural labour markets considering regional prerequisites.
An Angiomyomatous Hamartoma With Features of Vascular Transformation of Sinuses in the Mediastinal Lymph Node of a Beagle Dog
Authors: Nelissen Sophie , Chamanza Ronnie
Published: November 2020

Two similar benign, nonneoplastic vascular lesions have been described in the lymph nodes of humans and animals: angiomyomatous hamartoma (AMH), which is characterized by the replacement of lymphoid tissue by blood vessels, smooth muscle, and fibrous tissue, and vascular transformation of sinuses (VTS), which is considered a reactive transformation of lymph node sinuses into capillary-like vascular channels. We hereby report a lesion with features common to both lesions in the mediastinal lymph nodes of a 1-year-old beagle dog in a 1-month toxicity study. Grossly, enlargement and red discoloration were observed, while microscopically, the lesion was characterized by effacement of the lymph node parenchyma with replacement by mature blood vessels, smooth muscle, and fibrous tissue, associated with lymphoid atrophy, which is consistent with AMH. However, multifocal areas of anastomosing or plexiform capillary-like channels lined by normal to slightly plump endothelium, similar to those described for VTS, were also present. Immunohistochemistry analysis revealed abundant positive staining for smooth muscle actin and endothelial cells (von Willebrand factor/factor VIII) and the absence of proliferation (Ki67). In conclusion, these lesions most likely represent a mixture of both AMH and VTS.
Nonclinical Toxicology and Biocompatibility Program Supporting Clinical Development and Registration of the Port Delivery System With Ranibizumab for Neovascular Age-Related Macular Degeneration
Authors: Bantseev Vladimir , Horvath Joshua , Barteselli Giulio , Ranade Shrirang , Maia Mauricio , Yadav Daniela Bumbaca , Schuetz Chris , Shelton Amy , Booler Helen S.
Published: November 2020

The Port Delivery System with ranibizumab (PDS) is an investigational drug delivery system designed to provide continuous intravitreal release of ranibizumab for extended durations. The PDS consists of a permanent, surgically placed, refillable intraocular implant; a customized formulation of ranibizumab; and ancillary devices to support surgery and refill procedures. A toxicology program was conducted to evaluate the ocular toxicology and biocompatibility of the PDS to support its clinical development program and product registrational activities. PDS safety studies included a 6-month chronic toxicology evaluation in minipigs as well as evaluation of nonfunctional surrogate implants (comprised of the same implant materials but without ranibizumab) in rabbits. Biocompatibility of the implant and ancillary devices was evaluated in both in vitro and in vivo studies. Implants and extracts from implants and ancillary devices were nongenotoxic, noncytotoxic, nonsensitizing, and nonirritating. Ocular findings were comparable between implanted and sham-operated eyes, and no systemic toxicity was observed. The results of this nonclinical toxicology program demonstrated that the PDS was biocompatible and that intravitreal delivery of ranibizumab via the PDS did not introduce any new toxicology-related safety concerns relative to intravitreal injections, supporting ongoing PDS clinical development and product registrational evaluation.
Brain Lesions in Aging Zoo-Housed Naked Mole-Rats (Heterocephalus glaber)
Authors: Ward Jerrold M. , Cartoceti Andrew N. , Delaney Martha A.
Published: November 2020

Naked mole-rats (NMRs) are common in the managed care of zoos and valuable models for aging research. Limited information on NMR neuropathology is available despite many studies regarding their aging physiology. Histologic sections of brain from 27 adult (5–27 years old) NMRs from 2 zoos were reviewed to determine presence or absence of lesions associated with advanced age in humans and other mammals. A majority (23/27; 85%) of NMR brains had cerebral cortical neuronal changes with rounded or angular neurons, cytoplasmic vacuoles containing pale yellow pigment, periodic acid–Schiff (PAS)-positive granules and green autofluorescence, compatible with lipofuscinosis. Less severe lesions were present in cerebellar Purkinje cells, medulla, and hippocampal neurons. The hypothalamic neuropil of all NMRs had scattered variably sized PAS-positive granules and 10 (37%) had larger round bodies consistent with corpora amylacea. The youngest NMRs, 5 to 7 years old, generally had minimal or no cerebrocortical lesions. Further studies will help understand brain aging in this long-lived species.
Comparative Evaluation of Newer Remineralizing Agents on Surface Characteristics of Tooth Surface After Slenderization: An In Vitro Study
Authors: Nanwal Renu , Gupta Seema , Bhambri Eenal , Ahuja Sachin , Kothari Ridhi
Published: November 2020

Aim:

The aim of the present study was to compare the effects of remineralizing agents (nano-hydroxyapatite [n-HAP], NovaMin, calcium sucrose phosphate [CaSP], and Pro-Argin) on surface characteristics of slenderized enamel using Vickers microhardness and scanning electron microscope–energy dispersive X-ray (SEM-EDX) analysis.

Materials and Method:

Sixty extracted premolar teeth were divided into 6 groups: group 1—natural teeth; group 2—slenderization and polishing; group 3—n-HAP; group 4—NovaMin; group 5—CaSP; and group 6—Pro-Argin. Remineralizing agents were applied for 21 days. Specimens were evaluated using Vickers microhardness and SEM-EDX analysis. A 1-way analysis of variance (ANOVA) and post-hoc Tukey honestly significant difference (HSD) test were used for intragroup comparisons.

Results:

Among all remineralizing agents, CaSP showed significantly maximum surface microhardness, followed by NovaMin, n-HAP, and Pro-Argin. SEM also showed increased surface roughness for all remineralizing agents. EDX showed maximum increase in mineral content obtained with CaSP.

Conclusion:

All remineralizing agents significantly remineralized the stripped enamel surface. CaSP demonstrated promising results by effectively and significantly remineralizing the enamel lesions as compared to other test agents.
An investigation of influence of cutting parameters on three-dimensional surface topography in micromilling SiCp/Al composites
Authors: Liu Junwei , Cheng Kai , Ding Hui , Chen Shijin
Published: November 2020

Surface topography is an important characteristic of the surface integrity, and influences the performance and mechanical properties of the workpiece to a great extent in micro milling SiCp/Al composites. It is evaluated by three-dimensional surface roughness ( Sq) and fractal dimension ( Ds) in this paper. Based on the single factor experiment and the orthogonal experiment, the influence of process parameters (feed per tooth, spindle speed, milling depth, and milling width) on surface topography is studied. The results show that Sq is mainly affected by milling width and milling depth and optimal results for minimum Sq are: ae = 1.5 mm, ap = 0.08 mm, n = 12000 r/min, and fz=1 μm/z. While Ds is mainly affected by milling width and optimal parameters for maximum Ds are: ae=1 mm, n = 14000 r/min, fz = 1.5 μm/z and ap = 0.12 mm. There is a weak negative correlation between Sq and Ds. In addition, Ds is more sensitive to the main defects and in general a large Ds corresponds to a good surface.
Comparison of the effects of nano date seed as reinforcement material for medium-density polyethylene (MDPE) and polyethylene terephthalate (PET) using multilevel factorial design
Authors: Elkhouly Heba I
Published: November 2020

In the last few decades, there has been an increasing demand for low-cost raw materials and environmentally eco-friendly end products. This demand stimulated a growing interest in natural particles as potential reinforcement materials for composite manufacturing. In this paper, we introduce organic date-seed nanofillers (DSN) as reinforcement materials for the development of enhanced polymer nanocomposites. We particularly investigate the effect of these nanoparticles on two types of polymer base materials, namely medium-density polyethylene (MDPE) and polyethylene terephthalate (PET). A collection of MDPE and PET nanocomposite samples with DSN content ranging from 0.0–0.75 wt% has been prepared using a hot compression method. The MDPE-DSN and PET-DSN nanocomposite structures were analyzed using a scanning electron microscope (SEM), energy-dispersive X-ray analysis (EDXA), and Fourier-transformed infrared spectroscopy (FTIR). The mechanical characteristics of these nanocomposites were experimentally examined through wear loss and Vickers micro-hardness tests. The experimental results show that the MDPE-DSN composite is chemically more stable than the PET-DSN one. Moreover, the MDPE-DSN nanocomposite shows enhanced hardness and wear resistance properties, while the PET-DSN one shows less noticeable enhancements. The best enhancements were obtained with a DSN reinforcement of 0.75 wt%., and a normal load of 10 N. As well, the experimental outcomes show a good agreement with theoretical predictions. In general, the DSN material enhances the mechanical properties of polymer materials and reduces their economic costs.
Using the iPad as a Compositional and Pedagogical Tool
Authors: Norman Timothy David
Published: November 2020

iPads are becoming increasingly prevalent in schools and offer significant potential as both a compositional and pedagogical tool in general music classes. In this article, I discuss a composition activity that I implemented with general primary/elementary music classes in Australia. This activity involved using iPads, namely the apps iMovie and GarageBand. I identified several potential benefits of the iPad, which I attributed to its portable, functional and accessible design.
Moving Past the Loss: A Longitudinal Qualitative Study of Health Care Staff Experiences of Disinvestment
Authors: Mitchell Deb , O’Brien Lisa , Bardoel Anne , Haines Terry
Published: November 2020

This longitudinal qualitative study examines staff experience of disinvestment from a service they are accustomed to providing to their patients. It took place alongside a disinvestment trial that measured the impact of the removal of weekend allied health services from acute wards at two hospitals. Data were gathered from repeated interviews and focus groups with 450 health care staff. We developed a grounded theory, which explains changes in staff perceptions over time and the key modifying factors. Staff appeared to experience disinvestment as loss; a key difference to other operational changes. Early staff experiences of disinvestment were primarily negative, but evolved with time and change-management strategies such as the provision of data, clear and persistent communication approaches, and forums where the big picture context of the disinvestment was robustly discussed. These allowed the disinvestment trial to be successfully implemented at two health services, with high compliance with the research protocol.
Stick-slip and wear phenomena at the contact interface between an elastic beam and a rigid substrate
Authors: D’Annibale Francesco , Casalotti Arnaldo , Luongo Angelo
Published: November 2020

In this paper, the static behavior of an elastic beam resting on a rigid substrate is investigated. The structure lies on a rigid substrate and exchanges with it tangential forces, in correspondence with a finite number of contact points. These actions entail extension of the beam in the longitudinal direction together with a negligible bending, owing to the small eccentricity between the beam’s axis line and the rigid substrate. The beam obeys a linear elastic law, while, at the interface, different nonlinear constitutive models are considered to account for stick-slip phenomena due to friction, as well as wear due to abrasion. It is assumed that the contact points are a-priori known, thus entailing that the structural system can be treated as naturally discrete. The static problem is accordingly shown to be governed by a system of nonlinear ordinary differential equations in time, which rules, in incremental form, the equilibrium at the contact points in the longitudinal direction. A numerical solution for the equilibrium equations is carried out, under different imposed time histories of the longitudinal displacement assigned at the boundary. Numerical results are presented to compare and discuss the in-time evolution of the contact interactions between the beam and the substrate.
Adsorptive Removal of Phosphate From Wastewater Using Ethiopian Rift Pumice: Batch Experiment
Authors: Fetene Yohannis , Addis Taffere
Published: November 2020

Phosphorous from municipal and industrial wastewater is the main cause of eutrophication of rivers and lakes, because effluent quality from conventional secondary wastewater treatment plants does not meet the discharge standard that demands further treatment. Therefore, we investigated pumice as a potential low-cost adsorbent for the tertiary treatment of phosphate from municipal wastewater. The phosphate adsorption process reached equilibrium after 60 minutes contact time and achieved a removal efficiency of 94.4% ± 0.7% for an adsorbent dose of 10 g/L in 3 mg/L phosphate solution. The highest phosphate removal was recorded at pH 7. The experimental data best fitted with the Redlich-Peterson isotherm and the pseudo-second-order kinetic models. The coexisting anions decreased phosphate adsorption in the order of mixture >SO42– > HCO3− > NO3− > Cl− > CO3−. Pumice removed 95% ± 0.2% of phosphate from effluents of the secondary treatment unit of a municipal wastewater treatment plant. Furthermore, effective regeneration of saturated pumice was possible with a 0.2 M NaOH solution. Therefore, pumice could be a technically workable low-cost reusable adsorbent for phosphate removal from wastewater as a tertiary treatment to curb eutrophication of surface waters. However, further column adsorption study is recommended for a continuous flow system to optimize process design variables and scale up for field applications.
Siponimod: Disentangling disability and relapses in secondary progressive multiple sclerosis
Authors: Cree Bruce AC , Magnusson Baldur , Rouyrre Nicolas , Fox Robert J , Giovannoni Gavin , Vermersch Patrick , Bar-Or Amit , Gold Ralf , Piani Meier Daniela , Karlsson Göril , Tomic Davorka , Wolf Christian , Dahlke Frank , Kappos Ludwig
Published: November 2020

Background:

In multiple sclerosis, impact of treatment on disability progression can be confounded if treatment also reduces relapses.

Objective:

To distinguish siponimod’s direct effects on disability progression from those on relapses in the EXPAND phase 3 trial.

Methods:

Three estimands, one based on principal stratum and two on hypothetical scenarios (no relapses, or equal relapses in both treatment arms), were defined to determine the extent to which siponimod’s effects on 3- and 6-month confirmed disability progression were independent of on-study relapses.

Results:

Principal stratum analysis estimated that siponimod reduced the risk of 3- and 6-month confirmed disability progression by 14%–20% and 29%–33%, respectively, compared with placebo in non-relapsing patients. In the hypothetical scenarios, risk reductions independent of relapses were 14%–18% and 23% for 3- and 6-month confirmed disability progression, respectively.

Conclusion:

By controlling the confounding impact of on-study relapses on confirmed disability progression, these statistical approaches provide a methodological framework to assess treatment effects on disability progression in relapsing and non-relapsing patients. The analyses support that siponimod may be useful for treating secondary progressive multiple sclerosis in patients with or without relapses.
Social interaction in the Spanish classroom: How proficiency and linguistic background impact vocabulary learning
Authors: Tocaimaza-Hatch C. Cecilia , Santo Jonathan
Published: November 2020

Spanish learners engaged in two-way interaction gap tasks where, through social interaction, they identified and defined low-frequency vocabulary. Participants (referred to as actors to differentiate them from task partners) completed two such tasks. Each time, they collaborated with different partners of varying degrees of Spanish proficiency and linguistic background, either an L2 learner or a heritage speaker (HS). The purpose of the study was thus to shed light on if and how features of the collaborating partners in mixed (HS–L2) and matched (L2–L2; HS–HS) partnerships impacted vocabulary learning. Through a mixed methods analysis of the data (perception measures and qualitative responses, plus pre- and post-vocabulary tests), it was deduced that learners’ language proficiency level alone was not associated with differences in vocabulary gains. Rather, the nature of the partnerships among learners was more salient. In particular, learners in mixed partnerships had greater gains than those in matched partnerships. In addition, actors’ perceptions of the experience of working with their partner had no discernible effect on vocabulary, except for HSs who increased less when working with partners’ whose linguistic abilities they had rated as low. Pedagogical implications address learners’ social interaction in mixed language classrooms.
The influence of foreign elite rhetoric: National identity, emotions, and attitudes toward austerity
Authors: Ponte Alessandro Del
Published: November 2020

How does foreign elite rhetoric affect citizens’ emotions and attitudes about austerity? In a survey experiment conducted on the online blogs of the two major Italian newspapers, participants read a fictional news article where the German Chancellor addressed Italians. Across treatments, I varied whether the message blamed or praised Italians, and whether the message focused on economic or symbolic concerns. Praise generated enthusiasm whereas blame spurred anger and anxiety. Moreover, respondents with a strong national or European identity who read a message of praise were more enthusiastic, less angry, and less opposed to austerity. Finally, people who identify strongly with the nation reacted more to economic messages whereas those who identify strongly with Europe reacted more to symbolic messages. The results suggest that rhetoric by a prominent European leader can influence citizens’ emotions and attitudes toward austerity in the emerging European public sphere.
Jealousy Mediates the Link Between Women’s Upward Physical Appearance Comparison and Mate Retention Behavior
Authors: Arnocky Steven , Locke Ashley
Published: November 2020

Previous research has demonstrated that men’s lower mate value predicts increased perpetration of mate retention, especially with respect to cost inflicting behaviors. It is less clear if lower mate value women, including those who perceive themselves as being less physically attractive than their intrasexual rivals, also perpetrate more mate retention. Moreover, it is presently unclear whether romantic jealousy, which has been proposed to motivate compensatory behavior in response to evidence that a valued mating relationship is threatened, might mediate this link. The present study addressed this gap in knowledge by examining whether women’s overall self-perceived mate value and upward physical appearance comparisons predicted their cost inflicting and benefit provisioning mate retention, as well as whether jealousy mediated these relationships. In a sample of 167 heterosexual undergraduate women, results found self-perceived mate value predicted greater benefit provisioning mate retention, but not romantic jealousy. In contrast, jealousy mediated the relationship between women’s upward physical appearance comparisons and both their cost-inflicting and benefit-provisioning mate retention, supporting the hypothesis that jealousy in the face of unfavorable social comparisons on important mate value traits can promote action aimed at retaining a mate.
A Scoping Review of Intimate Partner Violence as It Relates to the Experiences of Gay and Bisexual Men
Authors: Callan Aisling , Corbally Melissa , McElvaney Rosaleen
Published: November 2020

Intimate partner violence (IPV) is a global health issue that encroaches beyond parameters of age, gender, sexual orientation and is the subject of extensive scholarly inquiry. Research on IPV in heterosexual couples, in particular on heterosexual women, has been prolific. However, there is a dearth of literature to document the distinct experiences of gay and bisexual men, despite the evidence of prevalence of IPV as reported equal or higher to heterosexual women. Studies have found that one in four gay men and four in 10 bisexual men have experienced IPV in their lifetime. This scoping review examines studies between 1931 and 2019 that had a predominant focus on violence among gay and bisexual men. Four electronic databases were searched in 2019. Arksey and O’Malley’s framework was utilized to extract 28 studies using a range of research designs that represented 13,224 sexual minority male participants. Across studies, gay and bisexual men were observed to experience IPV similarly to heterosexual couples involving psychological, physical, and sexual violence. However, as a marginalized and sexual minority group, they experience distinctive features of violence including sexual orientation outing, unprotected sexual intercourse, homophobia, internalized homophobia, and difficulties accessing minority men–focused services. Minority stress theory is posited as a useful lens in understanding the above features. In keeping with previous scholarship, a paucity of knowledge on gay and bisexual men’s experience of IPV was observed, and additional research is recommended.
Dependence of poly(vinyl butyral) electrospun fibres diameter on molecular weight and concentration
Authors: Filip Petr , Peer Petra , Zelenkova Jana
Published: November 2020

In electrospinning, a proper choice of a mean diameter for electrospun fibres plays a significant role in a number of applications. The diameter is dependent on various entry parameters (concerning polymer, solvent, solution or the process of electrospinning itself) and is qualitatively evaluated based on a series of experiments. However, the studies on quantitative evaluation are rather scarce. The aim of this contribution is to propose and experimentally verify simple algebraic relationships; interlacing the mean diameter, concentration of poly(vinyl butyral) (PVB) dissolved in ethanol, molecular weight, and viscosity. The proposed explicit relationship for evaluating a mean diameter is valid for discrete values of specific molecular weights and is also applicable in continuous ranges of the studied parameters with a mean deviation not exceeding 10%, where PVB molecular weight is 30-60 kg/mol and PVB concentration is full range. Hence, it also provides the ability to determine optimised values of molecular weight for a chosen mean diameter including a dispersion of its value dependent on dispersion of molecular weights for the individual PVB charges. A direct evaluation of mean diameter can substitute a classical trial-and-error method for determining a required diameter.
Community-Based Participatory Research in Action: The Patient-Centered Medical Home and Neighborhood
Authors: Williams-Livingston Arletha , Henry Akintobi Tabia , Banerjee Ananya
Published: November 2020

Background:

The Morehouse School of Medicine Patient Centered Medical Home and Neighborhood Project was developed to implement a community-based participatory research driven, integrated patient-centered medical home and neighborhood (PCMH) pilot intervention. The purpose of the PCMHN was to develop a care coordination program for underserved, high-risk patients with multiple morbidities served by the Morehouse Healthcare Comprehensive Family Health Clinic.

Measures:

A community needs assessment, patient surveys and provider interviews were administered.

Results:

Among a panel of 367 high-risk patients and potential participants, 93 participated in the intervention and 42 patients completed the intervention. The patients self-reported increased utilization of community support, increased satisfaction with health care options, and increased self-care management ability.

Conclusion:

The results were largely attributable to the efforts of community health workers and targeted community engagement. Lessons learned from implementation and integration of a community-based participatory approach will be used to train clinicians and small practices on how to affect change using a care coordination model for underserved, high-risk patients emphasizing CBPR.
Applied Machine Learning for Spine Surgeons: Predicting Outcome for Patients Undergoing Treatment for Lumbar Disc Herniation Using PRO Data
Authors: Pedersen Casper Friis , Andersen Mikkel Østerheden , Carreon Leah Yacat , Eiskjær Søren
Published: November 2020

Study Design:

Retrospective/prospective study.

Objective:

Models based on preoperative factors can predict patients’ outcome at 1-year follow-up. This study measures the performance of several machine learning (ML) models and compares the results with conventional methods.

Methods:

Inclusion criteria were patients who had lumbar disc herniation (LDH) surgery, identified in the Danish national registry for spine surgery. Initial training of models included 16 independent variables, including demographics and presurgical patient-reported measures. Patients were grouped by reaching minimal clinically important difference or not for EuroQol, Oswestry Disability Index, Visual Analog Scale (VAS) Leg, and VAS Back and by their ability to return to work at 1 year follow-up. Data were randomly split into training, validation, and test sets by 50%/35%/15%. Deep learning, decision trees, random forest, boosted trees, and support vector machines model were trained, and for comparison, multivariate adaptive regression splines (MARS) and logistic regression models were used. Model fit was evaluated by inspecting area under the curve curves and performance during validation.

Results:

Seven models were arrived at. Classification errors were within ±1% to 4% SD across validation folds. ML did not yield superior performance compared with conventional models. MARS and deep learning performed consistently well. Discrepancy was greatest among VAS Leg models.

Conclusions:

Five predictive ML and 2 conventional models were developed, predicting improvement for LDH patients at the 1-year follow-up. We demonstrate that it is possible to build an ensemble of models with little effort as a starting point for further model optimization and selection.
Cervical Spine Injuries in the Ice Hockey Player: Current Concepts in Epidemiology, Management and Prevention
Authors: Morrissette Cole , Park Paul J. , Lehman Ronald A. , Popkin Charles A.
Published: November 2020

Study Design:

This review article examines the biomechanics that underly hockey-related cervical spine injuries, the preventative measures to curtail them, optimal management strategies for the injured player and return to play criteria.

Objective:

Hockey is a sport with one of the highest rates of cervical spine injury, but by understanding the underlying pathophysiology and context in which these injuries can occur, it is possible to reduce their incidence and successfully manage the injured player.

Methods:

Multiple online databases including PubMed, Google Scholar, Columbia Libraries Catalog, Cochrane Library and Ovid MEDLINE were queried for original articles concerning spinal injuries in ice hockey. All relevant papers were screened and subsequently organized for discussion in our subtopics.

Results:

Cervical fractures in ice hockey most often occur due to an increased axial load, with a check from behind the most common precipitating event.

Conclusions:

Despite the recognized risk for cervical spine trauma in ice hockey, further research is still needed to optimize protocols for both mitigating injury risk and managing injured players.
Factors Associated With Patient Satisfaction After Opening-Wedge High Tibial Osteotomy
Authors: Goshima Kenichi , Sawaguchi Takeshi , Shigemoto Kenji , Iwai Shintaro , Fujita Kenji , Kataoka Tomoyuki , Taninaka Atsushi
Published: November 2020

Background:

Opening-wedge high tibial osteotomy (OWHTO) is expected to result in higher patient satisfaction compared with knee arthroplasty due to joint preservation. However, patient satisfaction rates as well as factors associated with satisfaction after OWHTO remain unclear.

Purpose:

To evaluate patient subjective satisfaction after OWHTO and determine factors associated with patient satisfaction after OWHTO.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

This study enrolled 123 patients (123 knees) who underwent unilateral OWHTO. Clinical parameters, including range of motion (ROM), visual analog scale (VAS) score for pain, Knee injury and Osteoarthritis Outcome Score (KOOS), weightbearing line ratio (WBLR), and medial proximal tibial angle (MPTA), were assessed before surgery and at the final follow-up at a minimum of 2 years. Patient satisfaction was evaluated using a 5-point scale regarding (1) surgery, (2) pain relief, (3) knee mobility, (4) daily living function, and (5) lower extremity alignment. The mean overall satisfaction scores for the 5 questions were calculated, and the sample was divided into 2 main groups (satisfied or unsatisfied). Preoperative characteristics, physical activity level, patient expectations for surgery, ROM, and KOOS were compared between the groups. Cartilage regeneration was assessed at the time of plate removal, and WBLR and MPTA were also assessed. Factors associated with patient satisfaction were analyzed using multivariable logistic regression analysis.

Results:

The mean ± SD follow-up was 54.6 ± 20.6 months. The mean WBLR significantly changed from 20.7% ± 11.8% preoperatively to 66.9% ± 10.2% at the final follow-up, and all KOOS subscale scores significantly improved after surgery. Of the 123 patients, 109 (88.6%) were graded as satisfied. Factors associated with patient satisfaction were expectations met (odds ratio, 17.4; P = .026), better postoperative KOOS Pain score (odds ratio, 1.30; P = .001), and better postoperative KOOS Activities of Daily Living score (odds ratio, 1.36; P = .002).

Conclusion:

OWHTO is an effective treatment in terms of subjective satisfactory outcomes. Patient expectations for surgery have a significant effect on patient satisfaction. Surgeons should consider patient expectations before OWHTO and provide patient education to improve patient satisfaction.
Assessment of platelet-to-lymphocyte ratio in patients with retinal vein occlusion
Authors: Kurtul Bengi Ece , Çakmak Ayșe İdil , Elbeyli Ahmet , Özarslan Özcan Deniz , Özcan Sait Coșkun , Cankurtaran Veysel
Published: November 2020

Purpose:

To investigate platelet-to-lymphocyte ratio (PLR) in retinal vein occlusion (RVO) patients.

Methods:

In this study, we retrospectively reviewed data of 32 patients with RVO (RVO group) and 32 age- and sex-matched participants without RVO (control group) between January 2017 and March 2019. The PLR was determined by dividing the platelet count by the lymphocyte count.

Results:

Age and gender were comparable between the groups ( p = 0.204 and p = 0.800, respectively). PLR was significantly elevated in the RVO group compared with the control group (137 (113–164) vs 101 (86–129), p = 0.001)). In the receiver operator characteristics curve analysis, the optimal cut-off value of PLR for predicting RVO was 123, with 69% sensitivity and 72% specificity.

Conclusion:

We report that PLR are elevated in RVO, suggesting that PLR may be a useful marker for RVO.
Coinfection withPseudomonas aeruginosaandAspergillus fumigatusin cystic fibrosis
Authors: Keown Karen , Reid Alastair , Moore John E. , Taggart Clifford C. , Downey Damian G.
Published: November 2020

Objectives

Cystic fibrosis (CF) lung disease is characterised by mucus stasis, chronic infection and inflammation, causing progressive structural lung disease and eventual respiratory failure. CF airways are inhabited by an ecologically diverse polymicrobial environment with vast potential for interspecies interactions, which may be a contributing factor to disease progression.Pseudomonas aeruginosaandAspergillus fumigatusare the most common bacterial and fungal species present in CF airways respectively and coinfection results in a worse disease phenotype.

Methods

In this review we examine existing expert knowledge of chronic co-infection withP. aeruginosaandA. fumigatusin CF patients. We summarise the mechanisms of interaction and evaluate the clinical and inflammatory impacts of this co-infection.

Results

P. aeruginosainhibitsA. fumigatusthrough multiple mechanisms: phenazine secretion, iron competition, quorum sensing and through diffusible small molecules.A. fumigatusreciprocates inhibition through gliotoxin release and phenotypic adaptations enabling evasion ofP. aeruginosainhibition. Volatile organic compounds secreted byP. aeruginosastimulateA. fumigatusgrowth, whileA. fumigatusstimulatesP. aeruginosaproduction of cytotoxic elastase.

Conclusion

A complex bi-directional relationship exists betweenP. aeruginosaandA. fumigatus, exhibiting both mutually antagonistic and cooperative facets. Cross-sectional data indicate a worsened disease state in coinfected patients; however, robust longitudinal studies are required to derive causality and to determine whether interspecies interaction contributes to disease progression.
Design of pulmonary rehabilitation programmes during acute exacerbations of COPD: a systematic review and network meta-analysis
Authors: Machado Ana , Matos Silva Pedro , Afreixo Vera , Caneiras Cátia , Burtin Chris , Marques Alda
Published: November 2020

This systematic review aimed to systematise the different designs used to deliver pulmonary rehabilitation during acute exacerbations of COPD (AECOPD) and explore which ones are the most effective. PubMed, Scopus, Web of Science, EBSCO and Cochrane were searched. Randomised controlled trials comparing pulmonary rehabilitation or at least one of its components with usual care or comparing different components of pulmonary rehabilitation were included. Network meta-analysis was conducted in MetaXL 5.3 using a generalised pairwise modelling framework. Pooled effects compared each treatment to usual care.

42 studies were included. Most studies were conducted in an inpatient setting (57%) and started the intervention 24–48 h after hospital admission (24%). Exercise training (71%), education and psychosocial support (57%) and breathing techniques (55%) were the most used components. Studies combining exercise with breathing techniques presented the larger effects on exercise capacity (weighted mean difference (WMD) −41.06, 95% CI −131.70–49.58) and health-related quality of life (WMD 14.64, 95% CI 8.73–20.54), and breathing techniques presented the larger effects on dyspnoea (WMD 1.90, 95% CI 0.53–3.27) and length of hospitalisation (effect size =0.15, 95% CI −0.28–0.57). A few minor adverse events were found.

Pulmonary rehabilitation is a safe intervention during AECOPD. Exercise, breathing techniques, and education and psychosocial support seem to be the core components for implementing pulmonary rehabilitation during AECOPD. Studies may now focus on comparisons of optimal timings to start the intervention, total duration of the intervention, duration and frequency of sessions, and intensity for exercise prescription.
Therapeutic bronchoscopy for central airway diseases
Authors: Rosell Antoni , Stratakos Grigoris
Published: November 2020

Over the past century rigid bronchoscopy has been established as the main therapeutic means for central airway diseases of both benign and malignant aetiology. Its use requires general anaesthesia and mechanical ventilation usually in the form of manual or high-frequency jet ventilation. Techniques applied to regain patency of the central airways include mechanical debulking, thermal ablation (laser, electrocautery and argon plasma coagulation) and cryo-surgery. Each of these techniques have their advantages and limitations and best results can be attained by combining different modalities according to the type, location and extent of the airway blockage. If needed, deployment of airway endoprostheses (stents), as either fixed-diameter silicone or self-expandable metal stents, may preserve the airways patency often at the cost of several complications. Newer generation of customised stents either three-dimensional printed or drug-eluting stents constitute a promise for improved safety and efficacy results in the near future.

Treating central disease of benign or malignant aetiology, foreign body aspiration or massive bleeding in the airways requires a structured approach with combined techniques, a dedicated team of professionals and experience to treat eventual complications. Specific training and fellowships in interventional pulmonology should therefore be offered to those who wish to specialise in this field.