bluuebunny/crossref_metadata_2025 huggingface dataset:
Maternal Mortality in Dodoma Regional Referral Hospital, Tanzania
Authors: Nassoro Mzee M. , Chetto Paul , Chiwanga Enid , Lilungulu Athanase , Bintabara Deogratius , Wambura Jacquiline
Published: June 2020

Background. Maternal mortality has remained a challenge in Tanzania. The Tanzania Demographic and Health Survey 2015-16 has shown that the problem has been increasing despite various strategies instituted to curb it. It has been shown that most of the maternal deaths occurring in health facilities, whether direct or indirect, have other contributing factors. The objective of this study was to analyse causes and associated factors for maternal deaths in Dodoma Regional Referral Hospital (DRRH). Methods. A retrospective review of all files of the women who died in 2018 and were classified as maternal deaths. Results. A total of 8722 women gave birth in DRRH, out of which 35 died and were confirmed as maternal deaths. The number of live births was 8404 making the maternal mortality ratio of 417 per 100,000 live births. The leading causes of maternal death were eclampsia (9), sepsis (6), ruptured uterus (5), and haemorrhage (5). The third-phase delay was the leading contributing factor to 19 maternal deaths. This includes delays in referral from another facility as well as delays in getting treatment at DRRH and inadequate skills of providers at both the referring facilities and DRRH. The first-phase and second-phase delays contributed to 7 and 6 deaths, respectively. Furthermore, poor antenatal care contributed to 2 deaths. Conclusion. Maternal mortality is still high in Dodoma Regional Referral Hospital. Eclampsia was the leading cause of maternal deaths in 2018 followed by sepsis and obstetric haemorrhage. Delays associated with health system factors (third-phase delay) contributed much more to maternal mortality than the first-phase delay. Mentorship programmes on management of obstetric complications need to be instituted in order to reduce maternal deaths in Dodoma Regional Referral Hospital.
A Proposal to Improve the Early Diagnosis of Symptomatic Cancers in the United States
Authors: Sarma Elizabeth A. , Kobrin Sarah C. , Thompson Matthew J.
Published: June 2020

Many people are diagnosed with cancer after presenting with signs and symptoms of their disease to a healthcare provider. Research from developed countries suggests that, in addition to indicating later-stage disease, symptoms can also indicate earlier-stage disease, leading to investment in research and quality improvement efforts in the early detection of symptomatic cancers. This approach, labeled early diagnosis of symptomatic cancers, focuses on identifying cancer at the earliest possible stage in patients with potential signs and symptoms of cancer, and subsequently diagnosing and treating the cancer without delay. In the United States, early detection has focused on cancer screening, with relatively less research focused on early diagnosis of symptomatic cancers. In this commentary, we propose that research focused on early diagnosis of symptomatic cancers provides an important opportunity to achieve more earlier-stage cancer diagnoses in the United States. We highlight the potential of these efforts to improve cancer outcomes, and outline a research agenda to improve early diagnosis of symptomatic cancers in the United States focused on defining and describing pathways to cancer diagnosis, identifying signs and symptoms that can be used to promote early cancer detection, and developing interventions to improve early diagnosis of symptomatic cancers.
Acute Kidney Injury Caused by TAFRO Syndrome in a Chinese Patient: Efficacy of Long-Term Corticosteroids Combined with Bortezomib and Cyclophosphamide
Authors: Xia Peng , Zhang Lu , Zou Menglian , Zhang Tengyue , Li Ran , Shi Xiaoxiao , Wang Jing , Qin Yan , Li Xuemei , Li Jian , Chen Limeng
Published: June 2020

Introduction: Thrombocytopenia, ascites, myelofibrosis, renal dysfunction, and organomegaly (TAFRO) syndrome is a newly recognized and rare clinical subtype of Castleman disease. Renal involvement in TAFRO syndrome usually presents with mild proteinuria, microscopic hematuria, and acute renal injury requiring temporary renal replacement. There is no standard therapy available and treatment failures are common, leading to a poor prognosis. We report a case of acute renal failure caused by TAFRO syndrome, successfully managed by long-term corticosteroids combined with bortezomib and cyclophosphamide. Case Presentation: The patient was a 52-year-old female who presented with fever, anasarca, oliguria, and abdominal distension at first. She progressed rapidly to anuric renal failure requiring hemodialysis. She also demonstrated thrombocytopenia, anemia, coagulopathy, and a hyperinflammatory status. Her CT scan showed severe polyserositis, splenomegaly, and lymphadenopathy. Her serum vascular epithelial growth factor level was significantly elevated. Axillary lymph node biopsy showed hyaline-vascular type Castleman disease, supporting the diagnosis of TAFRO syndrome. Her renal function recovered after high-dose steroids and supportive treatment. A weekly dosing regimen of bortezomib, cyclophosphamide, and dexamethasone combined with medium dose prednisone in between were deployed. Her blood cell count and renal function remained stable after 6 months. The inflammation was suppressed and the polyserositis resolved completely. Conclusion: TAFRO syndrome is rare and has a poor prognosis due to the lack of standard treatment. Our patient might be the first TAFRO case successfully treated by bortezomib, cyclophosphamide, and corticosteroids.
Clinical Characteristics and Functional Outcomes of Wake-Up Stroke in the Chinese Population
Authors: Zhang Wen-yu , Li Qi , Zou Ning , Zhang Gang , Qin Xin-yue , Zhu Chen
Published: June 2020

Background: Wake-up stroke (WUS) accounts for up to 25% of all new ischemic strokes, but debate exists regarding whether WUS differs from non-WUS in previous studies. Our study aimed to investigate the proportion of WUS cases and to examine differences in clinical characteristics and outcomes in these two groups. Methods: Data from acute ischemic stroke patients who presented to the First Affiliated Hospital of Chongqing Medical University between April 2017 and September 2017 were prospectively collected. Admission demographic information, clinical and radiological characteristics, and 3-month functional outcomes were assessed and compared between patients with WUS and those with non-WUS. Poor functional outcome was defined as modified Rankin Scale ≥ 3 at the 90-day follow-up. Risks of poor outcomes for WUS were estimated with logistic regression analysis. Results: A total of 473 eligible patients were included, of which 132 had been diagnosed with WUS (27.9%). Forty WUS patients had poor functional outcomes and 92 WUS patients had good functional outcomes. WUS and non-WUS patients were similar in regard to stroke risk factors, severity, etiology, and prognosis at 90 days (p > 0.05), but WUS patients were more likely to have had previous stroke (p < 0.001) and a tendency of higher albumin levels (p = 0.051). WUS patients show significant differences in terms of age, gender, prior stroke, atrial fibrillation, impaired consciousness at admission, levels of albumin and triglycerides, stroke severity, and stroke etiology between the good outcome group and the poor outcome group (p < 0.05). Multivariate logistic regression analysis showed that age (odds ratio [OR] 1.079, 95% confidence interval [CI] 1.021–1.141; p < 0.05), previous stroke (OR 4.017, 95% CI 1.197–13.484; p < 0.05), and admission National Institutes of Health Stroke Scale (NIHSS) score ≥5 (OR 5.453, 95% CI 1.510–19.696; p < 0.05) were independently associated with an unfavorable outcome of WUS. Conclusions: WUS accounts for 27.9% of 473 ischemic strokes in the Chinese population. WUS and non-WUS patients were similar in terms of stroke risk factors, severity, etiology, and early outcomes. Age, previous stroke, and a high admission NIHSS score were independent risk factors for unfavorable outcomes in patients with WUS.
Physical Activity and Outcomes in Colorectal Surgery: A Pilot Prospective Cohort Study
Authors: Martin David , Romain Benoît , Pache Basile , Vuagniaux Aurélie , Guarnero Valentine , Hahnloser Dieter , Demartines Nicolas , Hübner Martin
Published: June 2020

Background: Mobilization after surgery is recommended to reduce the risk of adverse effects and to improve recovery. The aim of this study was to examine the associations between perioperative physical activity and postoperative outcomes in colorectal surgery. Methods: The daily number of footsteps was recorded from preoperative day 5 to postoperative day 3 in a prospective cohort of patients using wrist accelerometers. Timed Up and Go Test (TUGT), 6 Min Walking Test (6MWT), and peak expiratory flow (PEF) were assessed preoperatively. ROC curves were used to assess the performance of physical activity as a diagnostic test of complications and prolonged length of stay (LOS) of more than 5 days. Results: A total of 50 patients were included. Patients with complications were significantly older (67 years) than those without complications (53 years, p = 0.020). PEF was significantly lower in the group with complications (mean flow 294.3 vs. 363.6 L/min, p = 0.038) while there was no difference between groups for the other two tests (TUGT and 6MWT). The tests had no capacity to discriminate the occurrence of complications and prolonged LOS, except the 6MWT for LOS (AUC = 0.746, p = 0.004, 95% CI: 0.604–0.889). There was no difference in the mean number of preoperative footsteps, but patients with complications walked significantly less postoperatively (mean daily footsteps 1,101 vs. 1,243, p = 0.018). Conclusions:Colorectal surgery patients with complications were elderly, had decreased PEF, and walked less postoperatively. The 6MWT could be used preoperatively to discriminate patients with potentially increased LOS and foster mobilisation strategies.
A Case Report of a Rapidly Growing Giant Pilomatrixoma on the Posterior Shoulder in a 12-Year-Old Male Patient
Authors: Egger Andjela , Li Yumeng , Gonzalez Mercedes E.
Published: June 2020

Introduction: Giant pilomatrixomas are quite rare and can be clinically challenging to diagnose. Case Presentation: Here, we report a case of a rapidly growing mass on the shoulder of a 12-year-old previously healthy boy. The lesion on his right shoulder appeared as a painless, pink-blue-colored solitary mass that started 6 months ago and rapidly enlarged to 4.5 × 6 cm in size. Previous biopsy results were inconclusive, showing only hypercellular spindle cell proliferation in a collagenous stroma. There was concern for malignancy versus mixed lymphatic venous malformation or benign soft tissue tumor. An excisional biopsy was done and demonstrated features of a pilomatrixoma. Complete surgical removal with clear margins was curative. Conclusion: Diagnosis and management of rapidly enlarging skin lesions in children can be difficult for clinicians and dermatopathologists. Excisional biopsy can be both diagnostic and therapeutic. A timely exclusion of malignancy is of utmost importance.
Reflectance Confocal Microscopy Applied to Folliculitis Decalvans: Preliminary Results of a Multicenter Study
Authors: Mazzilli Sara , Vollono Laura , Tassone Francesco , Cappilli Simone , Peris Ketty , Bianchi Luca
Published: June 2020

Although trichoscopic criteria indicative of disease severity and inflammatory activity have been recently proposed, the potential use of reflectance confocal microscopy (RCM) in the evaluation of the inflammatory stage of FD has never been published to date. Our study investigated RCM features of 14 patients with a histopathological diagnosis of FD, evaluating clinical and trichoscopic findings. RCM findings were divided into 2 main patterns: “follicular” and “interfollicular.” Our results suggest a potential role for RCM as a noninvasive, fast technique for a complementary investigation in the diagnostic process, as well as in the therapeutic management decision.
Roux-en-Y Gastric Bypass as an Effective Bariatric Revisional Surgery after Restrictive Procedures
Authors: Marti-Fernandez Rosa , Cassinello-Fernandez Norberto , Cuenca-Ramirez Maria Desamparados , Lapeña-Rodriguez Maria , Fernandez-Moreno Maria Carmen , Alfonso-Ballester Raquel , Ortega-Serrano Joaquin
Published: June 2020

Introduction: Revisional surgery must be considered when insufficient weight loss is attained or weight is subsequently regained. This study aimed to investigate the value of Roux-en-Y gastric bypass (RYGB) as a revisional procedure after restrictive surgery. Materials and Methods: An observational, retrospective study including patients initially operated on for morbid obesity with restrictive techniques (vertical-banded gastroplasty [VBG], adjustable gastric band [AGB], and sleeve gastrectomy) and reoperated with RYGB in our centre between December 1994 and January 2019. Demographic and anthropometric data, associated comorbidities (diabetes mellitus type II, arterial hypertension, dyslipidaemia, and chronic obstructive pulmonary disease) and surgery-related data (approach, complications, and hospital stay) were evaluated at 5 different time points: initial (prior to first intervention), after the first surgical intervention, before the second intervention (gastric bypass), after the gastric bypass, and at present. Results: A total of 63 patients were included. VBG was the most frequent initial procedure (n = 33). The mean age was 39 ± 9.52 years, and the average initial weight was 143.53 ± 28.6 kg. Weight loss was achieved in all groups, with a median excess weight loss of 58% after the first surgery and 40.3% after gastric bypass. In terms of weight loss, the best results after the second surgery were obtained when the first surgery was AGB, with statistically significant differences. Conclusions: RYGB is effective as a conversion procedure after a previous restrictive surgery, obtaining a significant reduction in weight and BMI. It has an acceptable morbidity rate and is more effective after an AGB.
Phenotypic and Functional Analysis of T Follicular Cells in Common Variable Immunodeficiency
Authors: Kasahara Taissa de Matos , Bento Cleonice Alves de Melo , Gupta Sudhir
Published: June 2020

Introduction: One of the most frequent abnormalities of B cells in common variable immunodeficiency (CVID) is reduced number of class-switched memory B cells, suggesting an impaired germinal center response. Therefore, due to its pivotal role in regulating the development of humoral immunity, the objective of this study was to evaluate the role of circulating T follicular helper (cTFH) and circulating T follicular regulatory (cTFR) cells in the pathogenesis of CVID. Methods: cTFH and cTFR cells from CVID patients and healthy subjects were phenotypically characterized by flow cytometry. cTFH and memory B cells from CVID patients and healthy subjects were isolated and cocultured. Results: Our results showed a reduced proportion of cTFH17 cells in patients with CVID and an increased ratio of cTFH/cTFR cells in CVID patients with autoimmune diseases. Furthermore, the proportion of IL-21-producing cTFH cells was directly related to the proportion of CD27+ IgD− B cells. Interestingly, coculture assay showed that CVID-derived cTFH cells are able to help memory B cells from healthy controls to produce immunoglobulins. Conclusions: The proportions of cTFH17 and cTFR cells are altered in CVID patients; however, the cTFH function in assisting B cells to produce antibodies in vitro is preserved.
Revisiting classic ecogeographical rules, using a widely distributed mouse species (Apodemus draco)
Authors: Cui Jifa , Wang Bingxin , Ji Shengnan , Su Huawei , Zhou Youbing
Published: June 2020

Ecogeographical rules predict an association between specific adaptive morphological/physiological traits and latitude, elevation or cooler climates. Such ecogeographical effects are often expressed most clearly in widely distributed species due to continuous selective adaptation occurring over their geographic range. Based on 40 population sampling sites of 116 adult individuals (female, ; male, ) across an elevational range of 191–2573 m, we tested whether morphological traits accorded with predictions of Bergmann’s rule, Allen’s rule and Hesse’s rule for the South China field mouse (Apodemus draco). The effects of elevation on body size, appendage length and heart size were tested by fitting Linear Mixed-Effects Models. None conformed to Bergmann’s, Allen’s or Hesse’s rule. Clines in body size opposed Bergmann’s rule, and foot and snout length ratios opposed Allen’s rule. We conclude that South China field mice, a widely distributed species, exhibit an acute thermoregulation mechanism in which in colder conditions body sizes decrease – as opposed to altering heart sizes or surface area to volume ratios – requiring less energy to regulate body temperatures. Also, there was a stronger selective pressure to increase partial appendage lengths (i.e., foot and snout) to adapt to the specific environment (e.g. longer period of snow cover, up to 2573 m) rather than on a general shortening of appendages to cope with colder conditions.
The Law and Policy of Police and Prosecutorial Control of Detention in China
Authors: Zhu Kuibin , Siegel David M
Published: June 2020

In China, police control of street protests can be accomplished under existing law both directly, through administrative penalties including detention that police can impose on their own authority, and indirectly, through the threat of detention as part of the ordinary criminal process. In the ordinary criminal process Chinese law provides police and prosecutors extensive discretionary authority to detain suspects and defendants for periods of six months or more without judicial review. While the structure of these detention provisions superficially resembles that in Western countries, their operation is wholly subject to internal policies and practices of police and prosecutors. In addition to providing an overview of these provisions, we review here a recent prosecutorial policy change in decision-making on extended detention (dàibǔ, 逮捕) that places the same prosecutor in charge of both this decision and the ultimate presentation of the case. We conclude that this may encourage individual prosecutors to assess their cases more thoroughly and realistically at an earlier stage and may alter the litigation dynamics of detention during the investigative phase, but it does not reduce the threat of detention as a means of deterring protests. At most, the change may provide negotiation opportunities for defence counsel. Until a Chinese criminal case is formally presented to a court, control over detainees remains firmly in the hands of the police and prosecutors.
Confessions of ‘the Weak’: The Ecclesiastical Hindrance of Determinism in Silence
Authors: McEntire Jeffrey L.
Published: June 2020

Christ imagery in Silence represents Endō’s intentional progression from ‘father-religion’ to ‘mother-religion’. This paper explicates the former as a distortive ideological belief—the determinism of the ‘strong’ and ‘weak’—that conveys Endō’s aversion for institutionalized and paternal aspects of Christianity; that sows feelings of superiority toward ‘the weak’ in Rodrigues (revealed especially as he administers confession); and that anthropomorphizes as an internal voice that accuses and haunts with fears of inadequacy. Christ’s immediacy through and sympathy for universal suffering relinquishes the categories of ‘strong’ and ‘weak,’ assures a doubting Rodrigues of forgiveness, and—along with the Christian-Buddhist foundation of Rodrigues’ self-renunciation—illustrates the interreligious nature of Endō’s mother-religion.
The Activation of the International Criminal Court’s Jurisdiction over the Crime of Aggression: International Institutional Law and Dispute Settlement Perspectives
Authors: Wong Meagan S.
Published: June 2020

In 2017, the plenary organ of the International Criminal Court (ICC), the Assembly of States Parties (ASP), adopted Resolution ICC-ASP/16/Res.5, deciding to activate the Court’s jurisdiction over the crime of aggression; and confirming an interpretation of the Rome Statute of the ICC (“Rome Statute”). While the characterization of this Resolution as either a subsequent agreement or subsequent practice under Articles 31(3) and 32 of the Vienna Convention on the Law of Treaties 1959 (“VCLT”) may be of relevance to treaty interpretation of the Rome Statute, this article submits that this Resolution is clearly a Rule of the International Organization, made by one of its organs. Resolution ICC-ASP/16/Res.5 may constitute a ‘relevant rule’ of interpretation with regard to the Rome Statute, thereby taking precedence over the general rules of interpretation in Articles 31 and 32 of the VCLT, particularly when the interpreter is an organ of the ICC. If a dispute arises with regard to the interpretation of the Rome Statute on the crime of aggression, two separate regimes at the ICC exist for the settlement of disputes depending on whether the dispute is one concerning the judicial functions of the Court. In the event that the dispute may be other than a ‘judicial function’, the ASP may be a mechanism for dispute settlement, along with other mechanisms of dispute settlement under international law.
The Chilling Effect of Indirect Expropriation Clauses on Host States’ Public Policies: a Call for a Legislative Response
Authors: Malakotipour Maryam
Published: June 2020

While International Investment Agreements (IIAs) can potentially contribute to host states’ development, the chilling effect of IIAs on host states’ public policies is the flip side of investment treaties. The lack of a clear statutory formulation of indirect expropriation and, hence, the interpretive loopholes in investor-state jurisprudence have caused unfavourable consequences attached to the application of IIAs on the protection and promotion of public welfare. This paper encourages states to revisit the formulation of their indirect expropriation clauses in line with the provided practical solutions, which allow states to have more policy space for their legitimate public policy actions without having their Foreign Direct Investment inflows decreased.
Do Civil Liberties Really Matter During Pandemics?
Authors: Nyamutata Conrad
Published: June 2020

The outbreak of the coronavirus disease (covid-19) in December 2019 precipitated public health control measures in many states across the world. The impact of covid-19 was as unprecedented as were the measures introduced by states to control it. The outbreak provides an opportunity to analyse responses of states to pandemics. At the core of this article is the question whether civil liberties matter during pandemics. A rights-based approach is founded on human rights protected in international human rights treaties. In cases of massive disease outbreaks, states adopt and enforce typically radical measures to contain the spread of the infection. After the outbreak of covid-19, a range of restrictions was imposed by the affected states. However, in the haste to contain a rapidly spreading pandemic, human rights are potentially vulnerable to violations. This article assesses the responses to the pandemic by states within the context of human rights. As the article seeks to illustrate, in times of pandemics, the law on management of pandemics does not favour human rights observance. Even states with deep-rooted democratic cultures resort to illiberal responses. The rhetoric of inalienability of rights becomes hollow as even traditional democratic states mimic authoritarian regimes.
Review of Euthycerina Malloch (Diptera, Sciomyzidae), with description of a new species from Chile
Authors: MORTELMANS JONAS , HENDRIX JEF
Published: June 2020

We review and summarize the present knowledge of the Neotropical genus Euthycerina Malloch, 1933. Habitus and male terminalia are described and figured in detail for the first time. Euthycerina uachi sp. nov. is described, based on two males and four females from two locations in the province of Valdivia, Chile. An illustrated key is given for the three described species of Euthycerina, together with maps, phenology plots, and a summary of diagnostic characters that will enable researchers to confidently identify all species of Euthycerina.
A new species of Aricoris Westwood, 1851 (Lepidoptera: Riodinidae) from the Neotropical Cerrado savanna
Authors: LEMES JOSÉ R. A. , CALLAGHAN CURTIS J. , KAMINSKI LUCAS A.
Published: June 2020

A new species of Aricoris Westwood, 1851, until now treated erroneously as Aricoris tutana (Godart, [1824]), is described and illustrated from the Neotropical Cerrado savanna. Aricoris emeryi Callaghan, Lemes & Kaminski, sp. nov. can be identified by a set of characters on wings and male genitalia that differentiates it from other species belonging to the constantius group.
Strengthened Relationship between Tropical West Pacific and Midsummer Precipitation over Northeast China after the Mid-1990s
Authors: Han Tingting , Zhang Minghua , Zhou Botao , Hao Xin , Li Shangfeng
Published: June 2020

The relationship between the tropical west Pacific (TWP) and East Asian summer monsoon/precipitation has been documented in previous studies. However, the stability for the signals of midsummer precipitation in the TWP sea surface temperature (SST_TWP), which is important for climate variation, has drawn little attention. This study identifies a strengthened relationship between the leading empirical orthogonal function mode (EOF1) of midsummer precipitation over Northeast China (NEC) and the SST_TWP after the mid-1990s. The EOF1 mode shows a significant positive correlation with the SST_TWP for 1996–2016, whereas the relationship is statistically insignificant for 1961–90. Further results indicate that the North Pacific multidecadal oscillation (NPMO) shifts to a positive phase after the 1990s. In the positive NPMO phase, the anomalous circulation over the northeast Pacific expands westward over the central North Pacific–Aleutian Islands region. Concurrently, the SST_TWP-associated wavelike pattern propagates northeastward from the west Pacific to the northwest Pacific and farther to the North Pacific, facilitating the poleward expansion and intensification of the SST_TWP-related circulation anomalies over the North Pacific. Therefore, the SST_TWP has an enhanced influence on NEC precipitation through the modulation of the circulation anomalies over the central North Pacific–Aleutian Islands region after the mid-1990s. Additionally, the tropical anticyclone/cyclone associated with the SST_TWP expands westward to South China, exerting an intensified impact on meridional wind anomalies along eastern China and on moisture transport over NEC. These conditions jointly contribute to the strengthened relationship between the SST_TWP and the EOF1 mode of NEC midsummer precipitation after the mid-1990s.
Estimation of Wind Speed and Roughness Length Using Smartphones: Method and Quality Assessment
Authors: Hintz K. S. , Vedel H. , Kaas E. , Nielsen N. W.
Published: June 2020

Crowdsourced data are now seen as a potential source of high-resolution observations in the atmospheric sciences. In this paper we investigate a potential data source, wind observations obtained using anemometers connected to handheld smartphones. The aim of this paper is twofold: to assess the quality of raw and height-extrapolated wind measurements from the handheld anemometer against professional-grade surface synoptic observation (SYNOP) stations, and to use these data of opportunity to infer a more accurate estimation of terrain roughness lengths. Roughness lengths are essential in numerical weather prediction; however, they are often poorly determined. Roughness lengths are also necessary when correcting near-surface wind observations for height offsets. For the analysis we performed a series of field experiments measuring wind profiles using handheld anemometers at roughly 2 m above ground. These raw measurements were then extrapolated to 10-m height using roughness lengths from three different sources. The extrapolation enabled us to compare the quality of roughness lengths estimated from smartphone measurements with those from traditional sources, as well as to assess the quality of these wind measurements against the professional-grade stations. We find that the handheld wind measurements are comparable in quality to wind measurements from SYNOP stations at 10-m height and that for some cases the handheld measurements can be more representative than SYNOP stations only about a kilometer away. To determine the roughness lengths, we examine a method that is based on the turbulent intensity derived from the high-frequency signal of the smartphone wind measurements. Under certain circumstances, the roughness lengths obtained with the approach presented here are superior to traditional sources.
Exploring Climate Change Threats to Beach Tourism Destinations: Application of the Hazard–Activity Pairs Methodology to South Africa
Authors: Friedrich Jonathan , Stahl Jannik , Hoogendoorn Gijsbert , Fitchett Jennifer M.
Published: June 2020

Climate change poses significant threats to the sustainability of tourism economies globally. This is particularly true for beach tourism, which is highly dependent on the mean climate, daily weather, and natural setting of a destination to attract and satisfy tourists. This case study of the South African coastline provides new insights to the applicability of the vulnerability assessment methodology of hazard–activity pairs to the global south and specifically to sub-Saharan Africa. Through this method, tourists’ climate perceptions were analyzed and related to potential future impacts of climate change, creating hazard–activity pairs. Tourists’ perceptions of climate were captured by means of a questionnaire. Downscaled CMIP5 climate projections (RCP4.5 and RCP8.5) for six weather stations close to major beach tourism destinations were used to estimate changes in precipitation and temperature. This study reveals that future projections of a mean reduction in precipitation and increasing temperature may have positive rather than negative direct effects on South African beach tourism destinations because what tourists perceive as “comfortable” weather conditions are increasing in prevalence. Nevertheless, indirect and induced effects of an already changing climate, defining further hazard–activity pairs, must be considered in vulnerability assessments. This work endorses the applicability of the hazard–activity pair methodology to South Africa and the global south at large.
Healthy Habits Questionnaire Feasibility and Utility for High-Risk Children
Authors: Camp Nadine L. , Robert Rebecca C. , Kelly Katherine P.
Published: June 2020

The American Academy of Pediatrics provides guidance for pediatric primary care providers to promote healthy weight during childhood. Screening questions on diet and activity habits can help provider assessment and assist counseling for targeted behavior change. We implemented the parent completed, 10-item 5210 Healthy Habits Questionnaire (Ages 2-9 year) in our primary care practice serving low-income minority children with high rates of overweight and obesity. Adherence to the intervention protocol was high, and providers found the content and method of assessment useful for their counseling of individual patients. The aggregate Healthy Habits Questionnaire data provided a snapshot of the health habits in our local clinic population of children, prompting greater awareness for providers and informing their patient care.
Impact of a Personalized Audit and Feedback Intervention on Antibiotic Prescribing Practices for Outpatient Pediatric Community-Acquired Pneumonia
Authors: Diaz Maria Carmen G. , Handy Lori K. , Crutchfield James H. , Cadilla Adriana , Hossain Jobayer , Werk Lloyd N.
Published: June 2020

Antibiotic choice for pediatric community-acquired pneumonia (CAP) varies widely. We aimed to determine the impact of a 6-month personalized audit and feedback program on primary care providers’ antibiotic prescribing practices for CAP. Participants in the intervention group received monthly personalized feedback. We then analyzed enrolled providers’ CAP antibiotic prescribing practices. Participants diagnosed 316 distinct cases of CAP (214 control, 102 intervention); among these 316 participants, 301 received antibiotics (207 control, 94 intervention). In patients ≥5 years, the intervention group had fewer non–guideline-concordant antibiotics prescribed (22/103 [21.4%] control; 3/51 [5.9%] intervention, P < .05) and received more of the guideline-concordant antibiotics (amoxicillin and azithromycin). Personalized, scheduled audit and feedback in the outpatient setting was feasible and had a positive impact on clinician’s selection of guideline-recommended antibiotics. Audit and feedback should be combined with other antimicrobial stewardship interventions to improve guideline adherence in the management of outpatient CAP.
A Continuous Observation Workflow Time Study to Assess Intravenous Push Waste
Authors: Hertig John , Jarrell Kaitlyn , Arora Prachi , Nwabueze Jonell , Moureaud Charlotte , Degnan Daniel D. , Trujillo Tate
Published: June 2020

Background: There are significant costs associated with proper controlled substance disposal, management, and regulatory compliance. Given the high abuse potential of fentanyl, hydromorphone, and morphine it is imperative that (1) product waste is minimized; and (2) waste procedures are followed to ensure safe disposal. Research is needed to better understand the financial and workforce impacts of drug waste on inpatient hospital units. The primary objective of this study was to quantify the waste associated with administering fentanyl, hydromorphone, and morphine via the intravenous push route. Two categories of waste were evaluated: (1) the quantity (mg/µg) of drug disposed; and (2) workforce time associated with the waste disposal process. Methods: A workflow time study design, a sub-set of continuous direct observation time motion studies, was employed to achieve the research objectives. A data collection tool was developed to capture medication type, waste amount, activity time stamps, total time, and number of interruptions at two separate study sites. Descriptive statistics were conducted on all the data measures. The number of assessments, total values, and mean values were reported for each drug (fentanyl, hydromorphone, and morphine) separately as well as grouped data. Results: A total of 669 distinct waste observations meeting inclusion criteria were collected during a study period of 15 days. In total, 207 mg of hydromorphone and 17 962.50 µg of fentanyl were wasted during this study. Nursing staff time associated with the wasting process totaled 50 990 seconds (849.83 minutes or 14.16 hours). A combined waste (loss) of approximately $1605.39 was associated with controlled substance wasting. The cost per dose wasted in this study was found to be $2.40 for all medications. When a yearly extrapolation model was applied to the four study units, the total combined product and workforce waste cost was $35 425. Conclusion: There are financially significant costs associated with wasting both the product and the valuable time of a skilled workforce. Optimizing product size, taking special note to match product availability with common practice use, would reduce the associated financial burden on our health-systems nationwide.
Augmented Visual Feedback: Cure or Distraction?
Authors: Eisma Yke Bauke , Borst Clark , Paassen René van , Winter Joost de
Published: June 2020

Objective

The aim of the study was to investigate the effect of augmented feedback on participants’ workload, performance, and distribution of visual attention.

Background

An important question in human–machine interface design is whether the operator should be provided with direct solutions. We focused on the solution space diagram (SSD), a type of augmented feedback that shows directly whether two aircraft are on conflicting trajectories.

Method

One group of novices ( n = 13) completed conflict detection tasks with SSD, whereas a second group ( n = 11) performed the same tasks without SSD. Eye-tracking was used to measure visual attention distribution.

Results

The mean self-reported task difficulty was substantially lower for the SSD group compared to the No-SSD group. The SSD group had a better conflict detection rate than the No-SSD group, whereas false-positive rates were equivalent. High false-positive rates for some scenarios were attributed to participants who misunderstood the SSD. Compared to the No-SSD group, the SSD group spent a large proportion of their time looking at the SSD aircraft while looking less at other areas of interest.

Conclusion

Augmented feedback makes the task subjectively easier but has side effects related to visual tunneling and misunderstanding.

Application

Caution should be exercised when human operators are expected to reproduce task solutions that are provided by augmented visual feedback.
COVID-19 quarantine: Post-traumatic stress symptomatology among Lebanese citizens
Authors: Fawaz Mirna , Samaha Ali
Published: June 2020

Background:

In the light of the global spread of the novel Coronavirus known as COVID-19 and in the absence of an approved treatment and vaccination, Lebanon has taken national measures, among which was home quarantine of the general public in an attempt to flatten the epidemic curve and avoid flooding the health care system.

Aim:

This study aimed at evaluating the prevalence of post-traumatic stress symptomatology (PTSS) during the times of COVID-19 quarantine among Lebanese citizens.

Method:

This quantitative cross-sectional study recruited 950 civilians and is aimed at measuring the prevalence of PTSS among the Lebanese citizens at an interval of 2 weeks and 1 month of COVID-19 quarantine.

Results:

The results have shown that quarantine in Lebanon has started to give rise to Post-traumatic Stress Disorder symptomatology during the second week which was worsened in the fourth week of COVID-19 quarantine.

Conclusion:

COVID-19 quarantine has influenced the psychology of Lebanese citizens and might have persistent effects after the end of this phase which is recommended to be explored.
Fotheringham’s 1920 Accelerations of the Sun and Moon Revisited
Authors: Morrison Leslie V. , Stephenson F. Richard , Hohenkerk Catherine Y.
Published: June 2020

One hundred years ago, J.K. Fotheringham famously derived the “accelerations” of the Sun and Moon from the reports of 11 classical solar eclipses. We review critically the reliability of these eclipse reports and rework his diagrammatic method, treating the deceleration of the Earth’s rotation as an unknown, rather than the “acceleration” of the Sun. There is some serendipity in his choice of the critical eclipses, which opportunely facilitated his derivation of seemingly accurate results for the accelerations.
The Determination of Stellar Temperatures From Baron B. Harkányi to the Gaia Mission
Authors: Petrovay Kristóf
Published: June 2020

The first determination of the surface temperature of stars other than the Sun is due to the Hungarian astrophysicist Béla Harkányi. Prompted by the recent unprecedented increase in the availability of stellar temperature estimates from Gaia, coinciding with the 150th anniversary of Harkányi’s birth, this article presents the life and work of this neglected, yet remarkable figure in the context of the history of stellar astrophysics.
Longomontanus’ Model for the Longitudes of Mars
Authors: Carman Christián C.
Published: June 2020

When at the beginning of 1600, Kepler arrived to work with Tycho Brahe, Longomontanus, Tycho’s principal assistant, who was working with a model for Mars that predicted with remarkable accuracy its longitudes at oppositions. According to Kepler, this hypothesis “represented all these oppositions within a distance of two minutes in longitude.” The model, however, was unsuccessful in predicting longitudes at other elongations from the Sun, and latitudes even at opposition. Much has been said on how Kepler developed his model after this meeting, arriving finally at the so-called first two laws published in his Astronomia Nova in 1609. By contrast, Longomontanus’ attempt, published as a final model in his Astronomia Danica, has received little scholarly attention. In this paper, I will systematically analyse and explain this model. Even if Longomontanus’ solution is not as elegant as Kepler’s, it deserves scholarly attention, both because it solves the problems posed by the model that he and Tycho were working on when Kepler arrived and because it offers an interesting though heterodox solution that, by contrast, helps to highlight the elegance and simplicity of Kepler’s own solution.
Does the Uniform Determination of Death Act Need to Be Revised?
Authors: Nguyen Doyen
Published: June 2020

Prompted by concerns raised by the rise in litigations, which challenge the legal status of brain death (BD), Lewis and colleagues recently proposed a revision of the Uniform Determination of Death Act (UDDA). The revision consists of (i) narrowing down the definition of BD to the loss of specific brain functions, namely those functions that can be assessed on bedside neurological examination; (ii) requiring that the determination of BD must be in accordance with the specific guidelines designated in the revision; and (iii) eliminating the necessity for obtaining consent prior to performing the tests for BD determination. By analyzing Lewis and colleagues’ revision, this article shows that this revision is fraught with difficulties. Therefore, this article also proposes two approaches for an ethical revision of the UDDA; the first is in accordance with scientific realism and Christian anthropology, while the second is grounded in trust and respect for persons. If the UDDA is to be revised, then it should be based on sound ethical principles in order to resolve the ongoing BD controversies and rebuild public trust.

This article critically examines the recent revision of the Uniform Determination of Death Act (UDDA) advanced by Lewis and colleagues. The revision only further reinforces the status quo of brain death without taking into account the root cause of the litigations and controversies about the declaration of death by neurological criteria. In view of this deficiency, this article offers two approaches to revising the UDDA, both of which are founded on sound moral principles.
Reliability-based performance analysis of mining drilling operations through Markov chain Monte Carlo and mean reverting process simulations
Authors: Ugurlu Omer Faruk , Kumral Mustafa
Published: June 2020

In recent years, commodity prices have swiftly decreased, narrowing the profit margin for many mining operations and forcing them to find effective cost management strategies to respond to low prices. Given that equipment is one of the most significant assets of a mining company, efficient equipment utilization has strong potential to reduce costs. This paper focuses on the relationship between the number of available drilling machines based on reliability analysis and the number of holes to be created on a bench of an open pit mining operation. Since equipment availability is random in nature, a range of holes to be drilled corresponding to a specified probability level was determined. To assess the performance of the proposed approach, a case study was carried out using two stochastic modeling techniques. Evolutions of reliabilities of 10 rotary drilling machines over a specific time were simulated by Markov chain Monte Carlo and mean reverting processes, using historical data. Multiple simulations were then used for risk quantification. Results show that the proposed approach can be used as a tool to assist production scheduling and assess the associated risk.
Pipeline Dreams: Occupational Plans and Gender Differences in STEM Major Persistence and Completion
Authors: Weeden Kim A. , Gelbgiser Dafna , Morgan Stephen L.
Published: June 2020

In the United States, women are more likely than men to enter and complete college, but they remain underrepresented among baccalaureates in science-related majors. We show that in a cohort of college entrants who graduated from high school in 2004, men were more than twice as likely as women to complete baccalaureate degrees in science, technology, engineering, and mathematics (STEM) fields, including premed fields, and more likely to persist in STEM/biomed after entering these majors by sophomore year. Conversely, women were more than twice as likely as men to earn baccalaureates in a health field, although persistence in health was low for both genders. We show that gender gaps in high school academic achievement, self-assessed math ability, and family-work orientation are only weakly associated with gender gaps in STEM completion and persistence. Gender differences in occupational plans, by contrast, are strongly associated with gender gaps in STEM outcomes, even in models that assume plans are endogenous to academic achievement, self-assessed math ability, and family-work orientation. These results can inform efforts to mitigate gender gaps in STEM attainment.
Why does everyone think cities can save the planet?
Authors: Angelo Hillary , Wachsmuth David
Published: June 2020

This article identifies and explains an underlying transition in global urban policy and discourse from the city as a sustainability problem to the city as a sustainability solution. We argue that contemporary policy discourses of cities saving the planet should be understood in the context of three major historical developments which have their roots in the 1970s and which intensified throughout the 1990s. The first is sprawl: the urban sustainability policy agenda in the Global North has been in large part a reaction to several decades of urban expansion and car-based planning. The second is informal settlements: since the introduction of UN-HABITAT in 1978, an international policy agenda has formed around addressing the environmental deficits associated with processes of informal urbanisation above all in the Global South. And the third is climate change, as the overarching concern that connects urban-environmental problems and policies in the North and South. We then contextualise the articles in this special issue by outlining a new research agenda for decoding the notion that cities can save the planet, which emphasises the need for an historical, multi-spatial, political and representational analysis of urban sustainability thinking and policy.