bluuebunny/crossref_metadata_2025 huggingface dataset:
Long-Term Mechanical Ventilation: Recommendations of the Swiss Society of Pulmonology
Authors: Janssens Jean-Paul , Michel Franz , Schwarz Esther Irene , Prella Maura , Bloch Konrad , Adler Dan , Brill Anne-Kathrin , Geenens Aurore , Karrer Werner , Ogna Adam , Ott Sebastien , Rüdiger Jochen , Schoch Otto D. , Soler Markus , Strobel Werner , Uldry Christophe , Gex Grégoire ,   on behalf of the Special Interest Group on Ventilation and Oxygen Therapy of the Swiss Society of Pneumology
Published: December 2020

Long-term mechanical ventilation is a well-established treatment for chronic hypercapnic respiratory failure (CHRF). It is aimed at improving CHRF-related symptoms, health-related quality of life, survival, and decreasing hospital admissions. In Switzerland, long-term mechanical ventilation has been increasingly used since the 1980s in hospital and home care settings. Over the years, its application has considerably expanded with accumulating evidence of beneficial effects in a broad range of conditions associated with CHRF. Most frequent indications for long-term mechanical ventilation are chronic obstructive pulmonary disease, obesity hypoventilation syndrome, neuromuscular and chest wall diseases. In the current consensus document, the Special Interest Group of the Swiss Society of Pulmonology reviews the most recent scientific literature on long-term mechanical ventilation and provides recommendations adapted to the particular setting of the Swiss healthcare system with a focus on the practice of non-invasive and invasive home ventilation in adults.
Hysteroscopic Intact Removal of Angular and Caesarean Scar Pregnancy: A Novel and Markedly Less Invasive Surgical Treatment
Authors: Mollo Antonio , Battagliese Alessandra , Mascolo Massimo , Raffone Antonio , Travaglino Antonio , D’Armiento Maria , Insabato Luigi , Zullo Fulvio
Published: December 2020

Introduction: Ectopic pregnancy is the most common cause of mortality during the first trimester of pregnancy, and intrauterine ectopic pregnancies show significantly higher morbidity and mortality than extrauterine ones. Despite being less invasive, safety and effectiveness of the hysteroscopic treatment are still unclear. Moreover, such approach is not standardized. We aimed to evaluate safety and effectiveness of hysteroscopic intact removal of angular or cesarean section scar pregnancies, defining a novel and markedly less invasive hysteroscopic technique with a 5-mm Bettocchi hysteroscope or a 3.5-mm Versascope hysteroscope. Materials and Methods: Medical records and video archives were reviewed for all the patients with angular or caesarean scar pregnancies treated with hysteroscopic intact removal technique from January 2000 to December 2018 at our Department. Success and complication rates were assessed. Results: Four patients with angular (n = 1) or cesarean scar pregnancy (n = 3) met inclusion criteria. Case #1 was treated with bipolar resectoscope, cases #2 and #3 with 5-mm Bettocchi hysteroscope, and case #4 with 3.5-mm Versascope hysteroscope. Cases #2–4 did not require cervical dilatation. Before hysteroscopic treatment, cases #2–4 underwent unsuccessful medical therapy with multiple-dose methotrexate. Hysteroscopic treatment success rate was 100%, while complication rate was 0%. All patients were treated with a novel technique: hysteroscopic intact removal of angular or cesarean scar pregnancies. Such technique was described step-by-step. Conclusions: Hysteroscopic treatment of angular and cesarean scar pregnancies may be a safe and effective minimally invasive option. The novel technique of hysteroscopic intact removal technique may allow a markedly less invasive approach.
Identification of Candidate Genes and Pathways in Nonsegmental Vitiligo Using Integrated Bioinformatics Methods
Authors: Liu Baoyi , Xie Yongyi , Wu Zhouwei
Published: December 2020

Background: Nonsegmental vitiligo (NSV) is an acquired depigmentation disorder of unknown origin. Enormous interests focus on finding novel biomarkers and pathways responsible for NSV. Methods: The gene expression level was obtained by integrating microarray datasets (GSE65127 and GSE75819) from the Gene Expression Omnibus database using the sva R package. Differentially expressed genes (DEGs) between each group were identified by the limma R package. The interaction network was constructed using STRING, and significant modules coupled with hub genes were identified by cytoHubba and molecular complex detection. Pathway analyses were conducted using generally applicable gene set enrichment and further visualized in R environment. Results: A total of 102 DEGs between vitiligo lesional skin and healthy skin, 14 lesion-specific genes, and 29 predisposing genes were identified from the integrated dataset. Except for the anticipated decrease in melanogenesis, three major functional changes were identified, including oxidative phosphorylation, p53, and peroxisome proliferator-activated receptor (PPAR) signaling in lesional skin. PPARG, MUC1, S100A8, and S100A9 were identified as key hub genes involved in the pathogenesis of vitiligo. Besides, upregulation of the T cell receptor signaling pathway was considered to be associated with susceptibility of the skin in NSV patients. Conclusion: Our study reveals several potential pathways and related genes involved in NSV using integrated bioinformatics methods. It might provide references for targeted strategies for NSV.
Technical Principles and Clinical Workflow of Transcranial MR-Guided Focused Ultrasound
Authors: Meng Ying , Jones Ryan M. , Davidson Benjamin , Huang Yuexi , Pople Christopher B. , Surendrakumar Shanan , Hamani Clement , Hynynen Kullervo , Lipsman Nir
Published: December 2020

Transcranial MR-guided focused ultrasound (MRgFUS) is a rapidly developing technology in neuroscience for manipulating brain structure and function without open surgery. The effectiveness of transcranial MRgFUS for thermoablation is well established, and the technique is actively employed worldwide for movement disorders including essential tremor. A growing number of centers are also investigating the potential of microbubble-mediated focused ultrasound-induced opening of the blood-brain barrier (BBB) for targeted drug delivery to the brain. Here, we provide a technical overview of the principles, clinical workflow, and operator considerations of transcranial MRgFUS procedures for both thermoablation and BBB opening.
Ludoevaluación de la emoción del miedo en educación infantil
Authors: Cruz Purificación , Borjas Mónica Patricia , López Marta
Published: December 2020

Resumen (analítico)La educación emocional es un objetivo que debemos incorporar en el proceso formativo de la primera infancia, trabajando desde la familia y la escuela. La presente investigación relaciona la promoción de la educación emocional con la emoción del miedo en los niños y niñas, promoviendo un mayor autoconocimiento personal y aceptación de la frustración ante situaciones adversas que puedan darse en su vida. Se llevó a través de un estudio de caso en tercer grado de educación infantil en un centro público de Toledo (España). En este participaron 24 niños y niñas, el profesorado que los atiende y sus familiares, consiguiendo, a través del desarrollo de actividades evidenciados a través de procesos de ludoevaluación, resultados positivos en lo concerniente a la participación, reconocimiento emocional y comunicación asertiva.
Palabras clave: Desarrollo afectivo, miedo, evaluación formativa, educación preescolar.
Single Mutation in the
NFU1
Gene Metabolically Reprograms Pulmonary Artery Smooth Muscle Cells
Authors: James Joel , Zemskova Marina , Eccles Cody A. , Varghese Mathews V. , Niihori Maki , Barker Natalie K. , Luo Moulun , Mandarino Lawrence J. , Langlais Paul R. , Rafikova Olga , Rafikov Ruslan
Published: December 2020

Objective:

NFU1 is a mitochondrial iron-sulfur scaffold protein, involved in iron-sulfur assembly and transfer to complex II and LAS (lipoic acid synthase). Patients with the point mutation NFU1
G208C
and CRISPR/CAS9 (clustered regularly interspaced short palindromic repeats/clustered regularly interspaced short palindromic repeat–associated 9)-generated rats develop mitochondrial dysfunction leading to pulmonary arterial hypertension. However, the mechanistic understanding of pulmonary vascular proliferation due to a single mutation in NFU1 remains unresolved.

Approach and Results:

Quantitative proteomics of isolated mitochondria showed the entire phenotypic transformation of NFU1
G206C
rats with a disturbed mitochondrial proteomic landscape, involving significant changes in the expression of 208 mitochondrial proteins. The NFU1 mutation deranged the expression pattern of electron transport proteins, resulting in a significant decrease in mitochondrial respiration. Reduced reliance on mitochondrial respiration amplified glycolysis in pulmonary artery smooth muscle cell (PASMC) and activated GPD (glycerol-3-phosphate dehydrogenase), linking glycolysis to oxidative phosphorylation and lipid metabolism. Decreased PDH (pyruvate dehydrogenase) activity due to the lipoic acid shortage is compensated by increased fatty acid metabolism and oxidation. PASMC became dependent on extracellular fatty acid sources due to upregulated transporters such as CD36 (cluster of differentiation 36) and CPT (carnitine palmitoyltransferase)-1. Finally, the NFU1 mutation produced a dysregulated antioxidant system in the mitochondria, leading to increased reactive oxygen species levels. PASMC from NFU1 rats showed apoptosis resistance, increased anaplerosis, and attained a highly proliferative phenotype. Attenuation of mitochondrial reactive oxygen species by mitochondrial-targeted antioxidant significantly decreased PASMC proliferation.

Conclusions:

The alteration in iron-sulfur metabolism completely transforms the proteomic landscape of the mitochondria, leading toward metabolic plasticity and redistribution of energy sources to the acquisition of a proliferative phenotype by the PASMC.
PRECAF Randomized Controlled Trial
Authors: Kuo Ling , Frankel David S. , Lin Aung , Arkles Jeffrey , Hyman Matthew , Santangeli Pasquale , Marchlinski Francis E. , Nazarian Saman
Published: December 2020

Background:

We have previously shown that the presence of dual muscular coronary sinus (CS) to left atrial (LA) connections, coupled with rate-dependent unidirectional block in one limb, is associated with atrial fibrillation (AF) induction. This study sought to examine whether ablation of distal CS to LA connections at a first AF ablation reduces arrhythmia recurrence during follow-up.

Methods:

In this single-center, randomized, controlled trial, 35 consecutive patients with drug-refractory AF undergoing first-time ablation between August 2018 and August 2019, were randomly assigned to (1) standard ablation (pulmonary vein isolation and nonpulmonary vein trigger ablation) versus (2) standard ablation plus elimination of distal CS to LA connections targeting the earliest LA activation during distal CS pacing with a deca-polar catheter placed with its proximal electrode at the ostium. Change of the local CS atrial electrogram and LA activation sequence to early activation of the LA septum or roof during distal CS pacing were the end point for CS-LA connection elimination.

Results:

Thirty patients completed 6 months study follow-up (15 patients in each group). Demographic characteristics including age and AF persistence were similar in both groups. After a mean follow-up of 170±22 days, there were 7 atrial arrhythmia recurrences in the standard group and 1 recurrence in the CS-LA connection elimination group (46.7% versus 6.7%, hazard ratio, 0.12,
P
=0.047).

Conclusions:

Elimination of distal CS to LA connections reduced atrial arrhythmia recurrences compared with standard pulmonary vein isolation and nonpulmonary vein trigger ablation in patients undergoing a first AF ablation procedure in a small randomized study. This strategy warrants further evaluation in a multicenter randomized trial.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03646643.
Prospective Randomized Evaluation of High Power During CLOSE-Guided Pulmonary Vein Isolation
Authors: Wielandts Jean-Yves , Kyriakopoulou Maria , Almorad Alexandre , Hilfiker Gabriela , Strisciuglio Teresa , Phlips Thomas , El Haddad Milad , Lycke Michelle , Unger Philippe , Le Polain de Waroux Jean-Benoît , Vandekerckhove Yves , Tavernier Rene , Duytschaever Mattias , Knecht Sebastien
Published: December 2020

Background:

CLOSE-guided atrial fibrillation (AF) ablation is based on contiguous (intertag distance ≤6 mm), optimized (Ablation Index >550 anteriorly and >400 posteriorly) point-by-point radiofrequency lesions. The optimal radiofrequency power remains unknown.

Methods:

The POWER-AF study is a prospective, randomized controlled monocentric study including patients with paroxysmal AF, planned for first CLOSE-guided pulmonary vein isolation using a contact force radiofrequency catheter (Thermocool SmartTouch, Biosense Webster, Inc, Irvine, CA). A total of 100 patients were randomized into 2 groups (1:1). The control group received AF ablation using the standard CLOSE protocol (35 W), whereas in the experimental group, pulmonary vein isolation was performed using high power (45 W). Endoscopic evaluation was performed in patients with intraesophageal temperature rise >38.5 °C.

Results:

The resulting sample size was 96 (48+48) patients. In the high power group, shorter procedure time (80 versus 102 minutes,
P
<0.001), shorter total radiofrequency application time (16 versus 26 minutes,
P
<0.001), and radiofrequency time per application (26 versus 37 s anteriorly,
P
<0.001 and 13 versus 17 s posteriorly,
P
<0.001) were observed. Endoscopic evaluation (performed in 19/48 versus 25/48 patients respectively,
P
=0.31) showed an ulcerative perforation in a high power group patient (treated by endoscopic stenting and normalization after ≈4 months) and a superficial ulcerative lesion in a control group patient (conservative treatment). Both occurred following excessive Ablation Index applications (up to 460 and 480, respectively) with excessive contact force (30 g on average, with peaks up to 50 g). Six-months AF recurrence was not significantly different (10% in high power versus 8% in control,
P
=0.74).

Conclusions:

This randomized controlled study shows that a 45 W radiofrequency power CLOSE protocol in patients with paroxysmal AF significantly increases the global procedural efficiency with similar midterm efficacy. However, our study showed a narrower safety margin and a limited increased efficiency at the posterior wall using high power. This advocates against the use of high power in the region neighboring the esophagus.
Posttraumatic Stress Disorder, Antidepressant Use, and Hemorrhagic Stroke in Young Men and Women
Authors: Gaffey Allison E. , Rosman Lindsey , Burg Matthew M. , Haskell Sally G. , Brandt Cynthia A. , Skanderson Melissa , Dziura James , Sico Jason J.
Published: December 2020

Background and Purpose:

Antidepressants are commonly prescribed for posttraumatic stress disorder (PTSD) and may increase the risk of bleeding, including hemorrhagic stroke.

Methods:

We prospectively examined independent effects of PTSD, selective serotonin and norepinephrine reuptake inhibitors (SSRI and SNRI) on the risk of incident hemorrhagic stroke in a nationwide sample of 1.1 million young and middle-aged veterans. Time-varying multivariate Cox models were used to examine hemorrhagic stroke risk by PTSD status and use of SSRI or SNRI while adjusting for demographics, lifestyle factors, stroke, and psychiatric comorbidities. Sensitivity analyses controlled for health care utilization.

Results:

During 13 years of follow-up (2.14 years on average), 507 patients (12% women) suffered a hemorrhagic stroke. The overall incidence rate was 1.70 events per 10 000-person years. In unadjusted models, PTSD was associated with an 82% greater risk of new-onset hemorrhagic stroke (hazard ratio [HR], 1.82 [95% CI, 1.48–2.24]), SSRI use was associated with a >2-fold risk (HR, 2.02 [95% CI, 1.66–2.57]), and SNRI use was associated with a 52% greater risk (HR, 1.52 [95% CI, 1.08–2.16]). In fully adjusted models, effects of PTSD and SNRI were attenuated (adjusted HR, 1.03 [95% CI, 0.81–1.34]; adjusted HR, 1.19 [95% CI, 0.83–1.71]), but SSRI use remained associated with a 45% greater risk of hemorrhagic stroke (adjusted HR, 1.45 [95% CI, 1.13–1.85]). Hypertension, drug abuse, and alcohol abuse were also associated with increased stroke risk. Nonobesity and being non-Hispanic were protective factors. In sensitivity analyses, health care utilization was a small but significant predictor of stroke.

Conclusions:

In the largest known investigation of PTSD and antidepressant-associated risk for hemorrhagic stroke in young adults, use of SSRIs, but neither PTSD nor SNRIs were independently associated with incident stroke. SNRIs may be preferable for treating PTSD and comorbid conditions, although pursuing other modifiable risk factors and non-pharmacological treatments for PTSD also remains essential.
Paracremastaptera, a new apterous genus of Mezirinae from China (Hemiptera: Aradidae)
Authors: SURNAA SURNAA , BAI XIAOSHUAN , HEISS ERNST , CAI WANZHI
Published: December 2020

A new apterous flat bug genus and species, Paracremastaptera ximaensis Bai, Heiss & Cai, gen. nov. and sp. nov., is described from Yunnan, China. The diagnostic morphological features of the new genus and species are illustrated.
Impact of the South China Sea Summer Monsoon on the Indian Ocean Dipole in CMIP5 Models
Authors: Zhang Yazhou , Li Jianping , Zheng Fei , Yu Miao , Feng Juan , Sun Cheng
Published: December 2020

The impact of the South China Sea summer monsoon (SCSSM) on the Indian Ocean dipole (IOD) has been systematically investigated in observations. This study focuses on the ability of climate models participating in phase 5 of the Coupled Model Intercomparison Project (CMIP5) to reproduce the observed relationship between the SCSSM and IOD and the relevant physical mechanisms. All 23 models reproduce significant correlations between the SCSSM and IOD during boreal summer [June–August (JJA)], whereas the influence of the SCSSM on the IOD varies considerably across the CMIP5 models. To explore the causes, all models are divided into two groups. Models that successfully simulated both the correlations between the SCSSM and JJA IOD and of the SCSSM and JJA IOD with precipitation over the western North Pacific and Maritime Continent are classified as Type I, and these produce stronger low-level wind anomalies over the tropical southeastern Indian Ocean. The stronger low-level wind anomalies enhance local sea surface temperature (SST) anomalies via positive wind–evaporation–SST (WES) and wind–thermocline–SST (Bjerknes) feedbacks. This corresponds to a strengthening of IOD events due to the increased zonal gradient of SST anomalies over the tropical Indian Ocean. In contrast, Type II models perform poorly in representing the relationship between the SCSSM and JJA IOD or relevant physical processes, corresponding to weaker WES and Bjerknes feedbacks, and produce weaker IOD events. These results demonstrate that the better the model simulation of the critical physical processes, the larger contribution of the SCSSM to the IOD.
The American Histories of President Trump: Beyond the Jacksonian Parallel
Authors: Brown Robert E.
Published: December 2020

This article begins with a consideration of the putative parallels between the presidencies of Andrew Jackson, the nation’s 7th president, and Donald Trump, the 45th. Underlying Trump’s and his supporters’ partisan case for his Jacksonian populism and similarly volatile temperament is another argument explored in this article: that such a Jacksonian framing implicitly situates Trump in the pantheon of the nation’s greatest, most consequential presidents who have expanded the powers of the office itself. Several standards of judgment are adduced for the critical consideration of the Trump presidency as it nears the completion of its first term. The consequentialism of the Trump presidency is weighed against standards of ethics and the personality trait known as Machiavellianism.
Trump, Mueller Investigation, and Alleged Russian Election Meddling: Russian Media Coverage in 2017-2019
Authors: Gavra Dmitrii , Slutskiy Pavel
Published: December 2020

The article analyses Russian media coverage of the charges of Russian meddling in the presidential elections in 2016, including the Mueller investigation and the publication of the Report on the Investigation into Russian Interference in the 2016 Presidential Election. The research utilizes content analysis of three daily newspapers and one official TV channel, with all the materials matching the relevant keywords being included in the sample. Several questions are discussed, including the following: all accusations in the presidential elections meddling are completely rejected, and the very existence of the accusations is attributed to several factors, such as U.S. internal political confrontation between Democrats and the Republicans, ongoing “Russophobia,” and general incompetence of American politicians and secret services. As a result Russian audiences are groomed to believe that all the accusations are completely false and should not be taken seriously. These accusations, however, are positioned by the media as belonging to a wider category of “fake news” and as such are portrayed as a threat not only to Russia, but to the global security in general.
Treatment of Perianal Abscess and Fistula in Infants and Young Children: From Basic Etiology to Clinical Features
Authors: Ding Wei , Sun Yao-Ran , Wu Zhi-Jiu
Published: December 2020

Perianal abscess and anal fistula are 2 common anorectal diseases in infants and young children. However, their causes, clinical diagnosis, and treatment remain controversial. Compared to adults, infants with these 2 diseases exhibit unique clinical characteristics. Blind pursuit of conservative treatment or surgery may worsen the condition, resulting in increased pain in young patients and greater economic burden and psychological harm to parents. Therefore, it is crucial to select correct and effective treatments. This review summarizes the relevant literature from the past 10 years and systematically explains the pathogenesis, clinical characteristics, and treatment measures of perianal abscess and anal fistula in infants with the goal of providing clinicians a deeper understanding of perianal abscess and anal fistula in infants and summarizing safe and effective treatment methods.
Ionizing Radiation Exposure in Pediatric Patients With Intestinal Failure
Authors: Rauh Jessica L. , Almond Angie , Glock Michael , Anthony Evelyn , Zeller Kristen A.
Published: December 2020

Background

Children with intestinal failure (IF) are frequently exposed to imaging studies using ionizing radiation. Due to many advancements in care of pediatric patients with IF, the number of patients living with this condition is growing. This burden of disease as pertains to pediatric IF patients has not been previously described.

Methods and Results

10 patients in a multidisciplinary clinic for IF were included in a retrospective review of ionizing imaging studies. Ages ranged from 2-6 years old. The average number of studies performed exposing patients to ionizing radiation was 69.1 (±41.0). A majority of the studies were plain radiographs. Fluoroscopy studies were common. The Computed tomography scans were less common. An average of 31% (±25.7%) of these studies were obtained before the first discharge from the hospital.

Conclusions

While survival and outcomes of IF patients continue to improve, it is important to consider the impact of radiation-related exposure to which this population is frequently subjected. Long-term follow-up will be necessary to determine whether or not this translates to increased risks or complications in this already vulnerable patient population.
Patient Attitudes Toward Spoken Surveys in a Low-Income Urban Surgical Clinic
Authors: Burgoon Montgomry L. , Miller Parker A. , Hoover-Hankerson Bryson , Strand Nicolle , Ross Howard
Published: December 2020

Diverse groups in urban settings demonstrate poor participation in health care and low levels of literacy. It is possible the method of health information delivery (eg, spoken vs. written) in these settings could impact health care related communication and understanding, though little is known on this topic. The objective of this study was to uncover the advantages and disadvantages of spoken survey administration in a low-income urban setting. The data for this study were collected via spoken survey with eighty patients in 9 surgery clinics at Temple University Hospital (TUH) in North Philadelphia. Survey responses were coded into various groups until categories and relationships among them emerged to produce themes relevant in demonstrating the advantages and disadvantages of spoken survey. 69% (55) of respondents preferred a spoken survey format. Of the 55 patients who preferred the spoken format, 33% (18) possessed some level of college education and 47% (26) had finished high school. Of the 23 patients who primarily spoke Spanish or another language at home, 78% (18) preferred a spoken interview format. Overall, 53% (42) of patients experienced at least 1 instance of poor understanding throughout the survey. Patients were better able to understand questions in a spoken survey compared to written ones that they had completed in the past due to the opportunity for surveyors to explain questions when needed. It is possible that question explanation is necessary in low-income urban settings due to low-literacy levels or improved feelings of survey intimacy and efficiency.
Operative Traumatic Aortic Injuries at an Urban Pediatric Hospital
Authors: Wang Shihuan K. , Severance Sarah , Troja Weston , Drucker Natalie A. , Gray Brian W. , Rouse Thomas M. , Dalsing Michael C. , Maijub John G.
Published: December 2020

Purpose

Limited data are available describing the long-term results of pediatric patients undergoing aortic repair secondary to trauma. Therefore, this descriptive investigation was completed to abrogate this deficit.

Methods

A retrospective review of an urban level 1 pediatric trauma database maintained at a high-volume dedicated children’s hospital between 2008-2018 was completed to capture all cases of severe traumatic aortic injury and associated demographics, mechanisms, injury severity, treatment, and clinical outcomes.

Results

In the prespecified interval, 2189 children (age <18 years) presented to our facility as a level 1 trauma activation. Of these cases, a total of 10 patients (.5%) had a demonstrable thoracic or abdominal aortic injury. The mean age of our study cohort was 10.4 ± 5.7 years. The mechanism of injury consisted of 8 participants involved in motor vehicle accidents, 1 pedestrian struck by a vehicle, and 1 struck by a falling boulder. Injuries were identified via CT angiogram (n = 9) or autopsy (n = 1) and consisted of 6 thoracic aortas and 4 abdominal aortas. The mean trauma injury severity score was 37.6 ± 19.9. Seven of the patients underwent open surgical intervention, 1 underwent endovascular intervention, 1 was treated with medical management, and 1 patient expired in the trauma bay before surgery could be performed. Aortic pathologies observed were 6 transections, 2 dissections, and 2 occlusions. Five of the ten patients underwent nonaortic surgical procedures. To determine operative outcomes, we excluded the 2 patients who did not receive aortic intervention. In the 8 remaining patients, the mean hospital length of stay was 12.8 ± 4.8 days with 6.8 ± 4.1 days in the intensive care unit. All 9 participants who survived the initial trauma evaluation were discharged from the hospital. Mean follow-up was 38.3 ± 43.0 months; during which, we observed no additional aortic-related morbidity, mortality, and reinterventions. The only stent-graft deployed remained in stable position without evidence of endoleak or migration by duplex.

Conclusion

Traumatic aortic injury is exceedingly rare in children and primarily of blunt etiology. Of the patients who survive the scene, operative repair seems to be associated with excellent perioperative and long-term survival.
Predictors of Occurrence and Timing of Post-Tonsillectomy Hemorrhage: A Case-Control Study
Authors: Gross Jennifer H. , Lindburg Miranda , Kallogjeri Dorina , Molter Michelle , Molter David , Lieu Judith E. C.
Published: December 2020

Objective:

To describe cases and timing of pediatric post-tonsillectomy hemorrhage (PTH), to evaluate predictors of PTH, and to determine the optimal amount of postoperative care unit (PACU) monitoring time.

Study Design:

Using the Pediatric Health Information System (PHIS) database and electronic medical records, a matched case-control study from 2005 to 2015 was performed.

Setting:

A single, tertiary-care institution.

Subjects and Methods:

Each case of PTH was matched with 1 to 4 controls for the following factors: age, sex, surgeon, and time of year. A total of 124 cases of PTH and 479 tonsillectomy controls were included. The rate and timing of postoperative bleeding were assessed, and matched pair analysis was performed using conditional logistic regression.

Results:

Our institutional PTH rate of 1.9% (130 of 6949) included 124 patients; 15% (19) were primary (≤24 hours), with 50% (9) occurring within 5 hours. Twenty-one percent (4 of 19) of primary PTH patients received operative intervention. Eighty-five percent (105 of 124) of all cases were secondary PTH, and 47% (49) of those patients received operative intervention. Cold steel (OR 1.9, 95% CI 1.1-3.3) and Coblation (OR 1.9, 95% CI 1.2-3.1) techniques and tonsillectomy alone (OR 3.7, 95% CI 1.9-7.2) increased odds of PTH. Patients who developed PTH had 4 times the odds of having a preceding postoperative respiratory event than controls (OR 4.0, 95% CI 1.6-10.0).

Conclusion:

We conducted a rigorous case-control study for PTH, finding that PTH was associated with use of cold steel and Coblation techniques and with tonsillectomy alone. Patients with a postoperative respiratory event may be more likely to develop a PTH and should be counseled accordingly. A PACU monitoring time of 4 hours is sufficient for outpatient tonsillectomy.
The Effects of Vehicle Automation on Driver Engagement: The Case of Adaptive Cruise Control and Mind Wandering
Authors: Weaver Starla M. , Roldan Stephanie M. , Gonzalez Tracy B. , Balk Stacy A. , Philips Brian H.
Published: December 2020

Objective

This field study examined the effects of adaptive cruise control (ACC) on mind wandering prevalence.

Background

ACC relieves the driver of the need to regulate vehicle speed and following distance, which may result in safety benefits. However, if ACC reduces the amount of attentional resources drivers must devote to driving, then drivers who use ACC may experience increased periods of mind wandering, which could reduce safety.

Methods

Participants drove a prescribed route on a public road twice, once using ACC and once driving manually. Mind wandering rates were assessed throughout the drive using auditory probes, which occurred at random intervals and required the participant to indicate whether or not they were mind wandering. Measures of physiological arousal and driving performance were also recorded.

Results

No evidence of increased mind wandering was found when drivers used ACC. In fact, female drivers reported reduced rates of mind wandering when driving with ACC relative to manual driving. Driving with ACC also tended to be associated with increased physiological arousal and improved driving behavior.

Conclusion

Use of ACC did not encourage increased mind wandering or negatively affect driving performance. In fact, the results indicate that ACC may have positive effects on driver safety among drivers who have limited experience with the technology.

Application

Driver characteristics, such as level of experience with in-vehicle technology and gender, should be considered when investigating driver engagement during ACC use. Field research on vehicle automation may provide valuable insights over and above studies conducted in driving simulators.
Foreign policy advice in the Prime Minister’s Office: Mackenzie King to Brian Mulroney
Authors: Bryden Penny
Published: December 2020

The Department of External Affairs (DEA) has always been anomalous—more closely associated with the prime minister than any other department, yet also more independent from cabinet in its necessarily far-flung structure than any other department. The unique position of the DEA has meant that its influence has been closely tied to changes in the structure of the Prime Minister’s Office (PMO). This article examines the ways that the advisory capacity of the DEA has gradually been eroded, while the foreign policy advice from the PMO has concomitantly increased, in the period between the 1930s and the 1990s.
Socio-economic inequalities in social network, loneliness and mental health during the COVID-19 pandemic
Authors: Jaspal Rusi , Breakwell Glynis M
Published: December 2020

Background:

During the COVID-19 pandemic, a focus on isolation and loneliness is important, especially as social distancing policies (which for some groups involve self-isolation or quarantine) are likely to accentuate these experiences and affect mental health.

Aims:

This study focuses on socio-economic inequalities in social network, loneliness and mental health during the COVID-19 pandemic.

Methods:

Two-hundred and fourteen residents of Wandsworth, a South West London Borough in the United Kingdom completed an online cross-sectional survey on the impact of COVID-19 on mental health. Data were analysed using independent samples t-tests and multiple regression.

Results:

Middle-aged people reported a less strong social network and more loneliness, anxiety and depression than younger people. People with a long-term health condition reported a less strong social network, more loneliness, more general practitioner (GP) and hospital visits, and poorer mental health than those with no long-term health conditions. People receiving State financial benefits reported less use of public spaces, a less strong social network, more loneliness, more GP and hospital visits and poorer mental health than those not receiving benefits. Greater neighbourhood identification was associated with a stronger social network and better mental health outcomes. Multiple regression analyses showed that, over and above loneliness, perceived personal risk of COVID-19 constitutes an additional precipitant for both depression and anxiety when controlling for other variables.

Conclusion:

As a novel stressor associated with the pandemic, the situational and involuntary perception of being at risk of COVID-19 may be stimulating anxiety and depressive symptomatology, which will need to be managed effectively as resurgences of the disease are predicted and communicated to the general public under growing mistrust and uncertainty.
A meta-analysis of the problematic social media use and mental health
Authors: Huang Chiungjung
Published: December 2020

Background:

Although previous meta-analyses were conducted to quantitatively synthesize the relation between problematic social media (SM) use and mental health, they focused on Facebook addiction.

Aims:

The purpose of this meta-analysis is to examine this relation by extending the research scope via the inclusion of studies examining problematic use of all platforms.

Method:

One hundred and thirty-three independent samples ( N =244,676) were identified.

Results:

As expected, the mean correlations between problematic SM use and well-being are negative, while those between problematic SM use and distress are positive. Life satisfaction and self-esteem are commonly used to represent well-being, while depression and loneliness are usually used to indicate distress. The mean correlations of problematic SM use with life satisfaction and self-esteem are small, whereas those of problematic SM use with depression and loneliness are moderate. The moderating effects of publication status, instruments, platforms and mean age are not significant.

Conclusions:

The magnitude of the correlations between problematic SM use and mental health indicators can generalize across most moderator conditions.
World of Change: Reflections within an educational and health care perspective in a time with COVID-19
Authors: Damsgaard Janne Brammer , Phoenix Ann
Published: December 2020

Background:

Besides handling the physical impacts of COVID-19 there is more than ever a need to understand what can help when mental health is challenged. Within this context our practical wisdom – our ability to understand and recognise when ‘the other’, for example the patient, is feeling lonely or anxious is particularly important.

Aim:

This article aims to contribute to the understanding of how the competence of health professionals may be advanced by helping them develop the self-understanding essential to being wise practitioners.

Method:

The article is based on a discussion informed by reflections (written in Danish and translated into English) by Masters students (and registered nurses) participating in a university programme “Patient and user focused nursing”.

Findings:

The first part of the article considers a student nurse’s reflection on understanding herself and one of her patients. The second part considers reflections on the contemporary world of change from a student nurse trying to engage with a world she experiences as falling apart. The third part addresses the impact of resonant places and encounters on developing self/other understandings; encounters that may also be produced through songs and lyrics. The final part draws conclusions on how it is possible to reach understandings of oneself and others as student health practitioners in time of a pandemic.

Conclusion:

In the process of developing understanding and recognition, competence built on self-understanding is central for helping form health professionals into ‘wise practitioners’. It is concluded that the existential implications of the COVID-19 pandemic, paradoxically, may direct many people’s awareness to a more sensitive, resonant, attitude towards the other. For some, this may produce a more humanized world and perception of others. Within this perspective the arts may help us develop self-understanding and recognition of ‘the other’.
Keeping Your Friends Close, but Acquaintances Closer: Why Weakly Allied States Make Committed Coalition Partners
Authors: Gannon J. Andrés , Kent Daniel
Published: December 2020

Why do states join wartime coalitions despite the absence of a salient threat or strong ties to the coalition leader? We argue states make unexpectedly high contributions to coalition warfare as a costly signal of their desire for a stronger relationship with the coalition leader. Conventional theories insufficiently explain why states without immediate security interests or strong ties to the lead state over-contribute relative to their capacity. Using newly compiled data on troop contributions to the war in Afghanistan (2001–2014), we find states are most likely to contribute a higher share of their armed forces when their relationship with the US has unrealized alliance potential. States with under-performing alignments leave substantial room for subsequent gains to be had from signaling their commitment to the leading coalition actor. Our finding helps explain why states risk the costs of war—casualties and domestic accountability—by participating in coalition warfare.
Assessable learning outcomes for the EU Education and Training Framework core and Function A specific modules: Report of an ETPLAS WORKING Group
Authors: Dontas Ismene A , Applebee Kenneth , Vlissingen Martje Fentener van , Galligioni Viola , Marinou Katerina , Ryder Kathy , Schenkel Johannes , Prins Jan-Bas , Degryse Anne-Dominique , Lewis David I
Published: December 2020

Article 23(2) of the European Union Directive 2010/63/EU, which regulates welfare provisions for animals used for scientific purposes, requires that staff involved in the care and use of animals for scientific purposes be adequately educated and trained before they undertake any such work. However, the nature and extent of such training is not stipulated in the Directive. To facilitate Member States in fulfilling their education and training obligations, the European Commission developed a common Education and Training Framework, which was endorsed by the Member States Competent Authorities. An Education & Training Platform for Laboratory Animal Science (ETPLAS) Working Group was recently established to develop further guidance to the Learning Outcomes in the Framework, with the objective to clarify the levels of knowledge and understanding required by trainees, and to provide the criteria by which these Learning Outcomes should be assessed. Using the Framework document as a starting point, assessment criteria for the Learning Outcomes of the modules required for Function A persons (carrying out procedures on animals) for rats, mice and zebrafish were created with sufficient detail to enable trainees, providers and assessors to appreciate the level of knowledge, understanding and skills required to pass each module. Adoption and utilization of this document by training providers and accrediting or approving bodies will harmonize introductory education and training for those involved in the care and use of animals for scientific purposes within the European Union, promote mutual recognition of training within and between Member States and therefore free movement of personnel.
The NAfME Position Statement on Sacred Music in Schools: A Genealogical Inquiry
Authors: Koperniak Matthew R.
Published: December 2020

This article examines the NAfME Position Statement on Sacred Music in Schools, which has not been significantly updated since it was first published in 1984. Using genealogical inquiry, the author examines the conditions surrounding the construction of this document in relation to the conditions in the present. Relationships between the history of school prayer, the archive of Music Educators Journal, and relevant case law are investigated. Postsecularsim is described and explored as a possible theoretical framework for a future revision of the position statement.
Fuerza Civil: Capital Accumulation and Social Control in Nuevo León, Mexico
Authors: Buderath Markus , Heath Matthew
Published: December 2020

Policing is central to the promotion and enforcement of neoliberalization efforts across the globe. The militarization and police reform associated with the Mexican drug war must be viewed in this context. Examining Nuevo León’s highly militarized semiprivate police force, the Fuerza Civil, reveals that political-economic objectives are inextricably linked to policing reform in the Mexican border state and highlights the role of the city’s industrial elite in these processes.

La vigilancia policial es fundamental para la promoción y aplicación de los esfuerzos de neoliberalización en todo el mundo. La militarización y la reforma policial asociadas a la guerra del gobierno mexicano contra las drogas deben ser consideradas en este contexto. Un análisis de la fuerza policial semiprivada y altamente militarizada de Nuevo León, conocida como la Fuerza Civil, revela que los objetivos político-económicos están inextricablemente vinculados a la reforma policial en este estado fronterizo mexicano y destaca el papel de la élite industrial de la ciudad en estos procesos.
Hybrid Governance in Northeastern Mexico: Crime, Violence, and Legal-Illegal Energy Markets
Authors: López-Vallejo Marcela , del Pilar Fuerte-Celis María
Published: December 2020

Despite the presence of organized crime in northeastern Mexico, the region has a functioning economy that attracts new investment to energy projects, especially those involving fossil fuels. This may be because legal and illegal markets there tend to overlap and function under hybrid governance schemes. The hybridization of governance is an expression of the fact that legality and illegality are embedded in contemporary capitalist markets. This embeddedness is not an abnormal condition but the way in which societies deal locally with organized crime, and violence serves as the primary regulatory mechanism in disputed territories and markets.

A pesar de la presencia del crimen organizado en el noreste de México, la región tiene una economía funcional que atrae nuevas inversiones a proyectos energéticos, especialmente aquellos relacionados con combustibles fósiles. Esto puede deberse a que, ahí, los mercados legales e ilegales tienden a solaparse y funcionar en el marco de los sistemas de gobernanza híbrida. La hibridación de la gobernanza es una expresión del hecho de que la legalidad y la ilegalidad están incrustadas en los mercados capitalistas contemporáneos. Dicha incrustación no es una condición anormal, sino la forma en que las sociedades se ocupan localmente del crimen organizado, y la violencia sirve como el principal mecanismo regulador en los territorios y mercados en disputa.
Institutional Injustice: How Public Administration Has Fostered and Can Ameliorate Racial Disparities
Authors: House-Niamke Stephanie , Eckerd Adam
Published: December 2020

In a culture with institutionalized racial disparities, administrative norms that attempt to ensure rational decisions through the use of aggregation and quantification can exacerbate the racial disparities that policy attempts to address. We argue that it will be difficult for policy to address the problem without a fundamental reorientation of the ways that administrators make decisions based on race. We conclude by offering some suggestions for how this reorientation can begin.
Does the household context matter for job satisfaction among low-wage workers?
Authors: Pohlig Matthias , Israel Sabine , Dingeldey Irene
Published: December 2020

Previous research has established that low-wage earners have on average lower job satisfaction. However, several studies have found personal characteristics, such as gender, age and educational level, moderate this negative impact. This article demonstrates additional factors at the household level, which have not yet been empirically investigated, and which may exacerbate gender differences. The authors analyse the job satisfaction of low-wage earners depending on the contribution of individual earnings to the household income and on household deprivation using the 2013 special wave of the EU-SILC for 18 European countries. The study finds that single earners in low-wage employment report lower job satisfaction whereas low-wage employment does not seem to make a difference for secondary earners. Furthermore, low-wage earners’ job satisfaction is linked with the ability of their household to make ends meet.
Students learning experiences during COVID-19: Work from home period in Malaysian Higher Learning Institutions
Authors: Selvanathan Mahiswaran , Hussin Nur Atikah Mohamed , Azazi Noor Alyani Nor
Published: December 2020

Recently, the whole globe was affected by the Coronavirus disease (COVID-19), which caused a major disruption in every economy sector as well as the education sector. Most of the education systems in the world shifted to a full online learning method, either conducted in a synchronous or asynchronous method. Thus, making the traditional teaching and learning methods were no longer option of learning method. This reality of online teaching and learning methods by the Malaysian education system, especially the Higher Learning Institution as an alternative teaching method is compulsory throughout the pandemic. This paper evaluates the experience of the students of higher learning institutions in Malaysia with the implementation of online learning during this pandemic.