bluuebunny/crossref_metadata_2025 huggingface dataset:
Renal Registry and Peritoneal Dialysis Management: The Hong Kong Perspective
Authors: Ho Yiu Wing , Leung Chi Bon , Choy Bo Ying , Fung Ka Shun , Wong Ping Nam , Cheng Yuk Lun , Wai Man Lai , Yong Sai Ping , Kwan Tze Hoi , Lo Stanley , Sin Herman , Lam Johnny , Chau Ka Foon
Published: October 2020

The Hong Kong Renal Registry (HKRR) is an electronic paperless registry that services as database for patients on various renal replacement therapies in the territory. The database consists of demographic data, dialysis and transplant treatments, complications, and inquiries and reports. The HKRR can be helpful for individual patient's management, for renal center management, and for territory-wide management.
The Most Recent Trends of Peritoneal Dialysis in Japan
Authors: Masakane Ikuto , Tsubakihara Yoshiharu , Akiba Takashi , Watanabe Yuzo , Iseki Kunitoshi
Published: October 2020

By 31 December 2006, more than 260 000 patients were on dialysis therapy in Japan, and 9243 of them (3.6%) were on peritoneal dialysis (PD). The mean age of PD patients was 5 years less than that of all patients with chronic kidney disease, and the prevalence of diabetes among them was 9.4% lower. Among the PD patients, 18.0% were being treated with a combination of PD and hemodialysis, and 33.4% were being treated with automated PD. A peritoneal equilibration test (PET) had been performed in 22.0% of the patients, who were then classified into the four PET categories. Of the tested patients, 10.3% were placed in the low (L) category; 38.3% in the low-average (LA) category; 38.4%, in the high-average (HA) category; and 13.0%, in the high (H) category. Icodextrin was used by 27.3% of patients classified L, 30.5% of those classified LA, 47.1% of those classified HA, and 55.1% of those classified H. The annual death rate was 6.1%, which was lower than the rate for HD (9.7%); and the annual withdrawal rate was 19.8%. Infectious complications were the main cause for lowered rates of patient and technique survival. Use of PD for older and diabetic patients and of combination therapy with hemodialysis are key perspectives in the most recent report on PD in Japan.
Peritoneal Dialysis in India: Current Status and Challenges
Authors: Jha Vivekanand
Published: October 2020

With its ambulatory nature and freedom from complicated and expensive technology, chronic peritoneal dialysis (PD) is the ideal renal replacement therapy for resource-poor India. Despite being available for more than 15 years, PD has been limited in its growth because of economic factors, inadequate government policies, nephrologist bias, and lack of adequate pre-dialysis care. The number of patients initiated on therapy has increased in recent years, but the number of early dropouts remains high. Single-center studies suggest that contributors to poor outcome include gram-negative peritonitis, malnutrition, and failure to increase the dialysis dose as residual renal function declines. Development of a national PD registry and increased educational activities to position PD as part of integrated therapy for end-stage kidney disease would improve utilization of the PD modality.
The Status of, and Obstacles to, Continuous Ambulatory Peritoneal Dialysis in Thailand
Authors: Tungsanga Kriang , Kanjanabuch Talerngsak , Mahatanan Nanta , Praditpornsilp Kearkiat , Avihingsanon Yingyos , Eiam–Ong Somchai
Published: October 2020

The prevalence of dialysis in Thailand is 282 per million population, and utilization of peritoneal dialysis (PD) is only 4.6% of the utilization of hemodialysis (HD). The causes of low PD utilization include • a relatively higher cost of PD care, especially from the patient's perspective; • less incentive for PD care on the part of health care providers and hospitals; • fewer continuing medical and nursing education programs in PD; • unavailability of certified PD nurses; • lack of confidence in the quality of PD care; • fewer offers of PD as a renal replacement therapy option during pre-dialysis counseling; • fear of peritonitis on the part of the patient, and also fear of burdening family members; • a less stringent government policy regarding the “PD first” strategy.

To increase PD utilization. mandatory strategies are • lower PD cost, • make all PD equipment reimbursable, • launch a stringent “PD first” policy, • provide incentives to health care providers and hospitals, and • improve the quality of PD care.
Training of Peritoneal Dialysis Patients—Taiwan's Experiences
Authors: Chen Tzen-Wen , Li Szu-Yuan , Chen Jinn-Yang , Yang Wu-Chang
Published: October 2020

In Taiwan, peritoneal dialysis (PD) was launched in 1984. Since then, the Taiwan Society of Nephrology (TSN) has taken the responsibility for supervising PD programs. All PD programs are required to pass evaluations from the TSN before inception. Every new PD patient receives individual training from a qualified PD nurse. The training, accompanied by a review test, is usually provided in the hospital during the week right after catheter implantation.

To evaluate the effect of the patient training program on PD outcomes, we designed a retrospective observation study and reviewed the post-training tests of 100 new PD patients. The post-training test has 10 parts: anatomy and physiology, overview of chronic kidney disease, overview of PD, complications of peritonitis and exit-site infection, diet control, cardiovascular complications, PD skills and procedures, aseptic techniques, management of peritonitis, and routine tasks. The relationship between the post-training test scores and peritonitis was analyzed.

Results showed that risk of peritonitis is not related to the post-training test score. However, based on our experiences, we believe that PD patient training should be lengthened and repeated periodically as suggested by the International Survey of Peritoneal Dialysis Training Programs. Training on certain issues such as the signs and symptoms of peritonitis should be especially enhanced.
Transforming Growth Factor β1 Induces Epithelial–mesenchymal Transition by Activating the Jnk–SMAD3 Pathway in Rat Peritoneal Mesothelial Cells
Authors: Liu Qinghua , Mao Haiping , Nie Jing , Chen Wei , Yang Qiongqiong , Dong Xiuqing , Yu Xueqing
Published: October 2020

⋄ Background

Peritoneal fibrosis is a serious complication in long-term peritoneal dialysis (PD) patients. Epithelial-mesenchymal transition (EMT) plays an important role in peritoneal fibrosis, and TGFβ1 is the crucial inducer of EMT. Phosphorylation of Smad proteins is required for TGFβ1-induced EMT. It was reported that C-Jun N-terminal kinase (JNK) was involved in the TGFβ1/Smad signaling pathway and might regulate the activation of Smad proteins. However, whether JNK is activated by TGFβ1 in rat peritoneal mesothelial cells (RPMCs) and the role taken by JNK signaling in EMT induced by TGFβ1 remains undetermined. In the present study, we investigated the role of JNK-Smad pathway in EMT induced by TGFβ1 in RPMCs.

⋄ Methods

We harvested RPMCs from the peritoneum of male Sprague-Dawley rats and then cultured the cells in Dulbecco modified Eagle medium / F12 medium with 15% (volume:volume) fetal bovine serum. The cells were pretreated with SP600125, a specific inhibitor of JNK, for 4 hours before incubation with TGFβ1. The protein expression levels of phosphorylated JNK, Smad2, and Smad3 were detected by Western blotting. The messenger RNA levels and protein expression of α-smooth muscle actin (α-SMA), E-cadherin, and collagen I were determined with reverse transcriptase polymerase chain reaction and Western blotting respectively.

⋄ Results

Expression of α-SMA and collagen I were significantly increased and expression of E-cadherin decreased with TGFβ1 in RPMCs. Transforming growth factor β1 can stimulate phosphorylated JNK expression from 5 minutes, with the peak at 10 minutes, and phosphorylated Smad2 and Smad3 expression from 10 minutes, with the peak at 30 minutes. The addition of SP600125, which blocked activation of JNK, effectively inhibited TGFβ1-induced phosphorylation of Smad3, but not Smad2. Also, our results showed that SP600125 effectively suppressed TGFβ1-induced high expression of α-SMA and collagen I, and prevented TGFβ1-induced downregulation of E-cadherin expression in RPMCs.

⋄ Conclusions

This study demonstrated that JNK signaling may play an important role in EMT induced by TGFβ1 in RPMCs through activation of Smad3, suggesting that JNK inhibitor may prove to be a novel therapeutic agent for peritoneal fibrosis.
The Association between the Vascular Endothelial Growth Factor–to–Cancer Antigen 125 Ratio in Peritoneal Dialysis Effluent and the Epithelial-to-Mesenchymal Transition in Continuous Ambulatory Peritoneal Dialysis
Authors: Do Jun-Young , Kim Yong-Lim , Park Jong-Won , Chang Kyung-Ae , Lee Seung-Hyun , Ryu Dong-Han , Kim Chan-Duk , Park Sun-Hee , Yoon Kyung-Woo
Published: October 2020

We examined peritoneal growth factors, mesothelial mass, and epithelial-to-mesenchymal transition (EMT) in response to peritoneal exposure to peritoneal dialysate with standard and low concentrations of glucose degradation products (GDPs). We randomized 56 incident continuous ambulatory peritoneal dialysis (CAPD) patients to receive either low-GDP (30 patients) or high-GDP (standard) peritoneal dialysis (PD) solution (26 patients). The effects of the PD solutions on EMT and peritoneal growth factors in overnight dialysate effluent were compared at 1, 6, and 12 months. Assessment of EMT was performed after human peritoneal mesothelial cells (HPMCs) were cultured from overnight effluent. The low-GDP solution group showed significantly higher dialysate levels of cancer antigen 125 (CA125), fibronectin, transforming growth factor β(TGFβ)–induced gene product (βig-h3), and interleukin-6 (IL-6), but the rate of EMT was significantly lower in the low-GDP solution group during the initial 12 months of CAPD treatment. After adjusting peritoneal growth factors for dialysate CA125 concentration, the low-GDP solution group showed significantly lower ratios of fibronectin/CA125, βig-h3/CA125, IL-6/CA125, TGFβ/CA125, and vascular endothelial growth factor (VEGF)/CA125 than did patients in the high-GDP (standard) solution group. Factors associated with higher EMT were the type of solution (high in GDPs), the mass of HPMCs (low CA125), and higher VEGF/CA125. Adjustment of dialysate VEGF for effluent CA125 revealed a significant association with EMT. It suggests that fibroblastoid transition from HPMCs could be affected by the intraperitoneal VEGF per unit mass of HPMCs.
Differences in Corrective Mode for Divalent Ions and Parathyroid Hormone between Standard- and Low-Calcium Dialysate in Patients on Continuous Ambulatory Peritoneal Dialysis—Result of a Nationwide Survey in Japan
Authors: Yamamoto Hiroyasu , Kasai Kenji , Hamada Chieko , Hasegawa Hirofumi , Higuchi Chieko , Hiramatsu Makoto , Hosoya Tatsuo , Itami Noritomo , Kawanishi Hideki , Kubota Minoru , Masakane Ikuto , Minakuchi Jun , Mitarai Tetsuya , Nakao Toshiyuki , Suzuki Hiromichi , Tomo Tadashi , Kawaguchi Yoshindo
Published: October 2020

⋄ Background

In patients on continuous ambulatory peritoneal dialysis (CAPD), dialysate calcium concentration has a strong influence on correction of serum calcium, phosphorus, and parathyroid hormone (PTH); however, the optimal concentration of Ca in PD solution is still uncertain. The aim of the survey reported here was to evaluate the prevalence of patients treated with standard- [SCD (approximately 3.25 – 4.0 mEq/L)] or low-calcium [LCD (approximately 1.8 – 2.5 mEq/L)] dialysate and differences in the clinical effects for correction of abnormalities in divalent ions and PTH.

⋄ Materials and Methods

We used a questionnaire to survey 333 peritoneal dialysis facilities nationwide in Japan. Then, we analyzed serum Ca, P, and PTH levels and the prescription rates for CaCO3 as a P binder and for vitamin D (VitD) analogs.

⋄ Results

The 2384 CAPD patients enrolled in this analysis had a mean age of 60.5 ± 14.2 years and a mean duration of CAPD of 44.1 ± 39.2 months. The prevalences of SCD, LCD, and combination of SCD and LCD were, respectively, 49%, 50%, and 1% at initiation, and 40%, 38%, and 22% at the time of the survey. In 735 and 876 patients respectively, LCD and SCD had been prescribed from initiation to the time of the survey. In these two groups, we observed no difference in initiation and current serum levels of Ca and P. But prescription rates for CaCO3 and VitD analogs were higher in the LCD group than in the SCD group, and PTH levels were higher in the LCD group than in the SCD group.

⋄ Conclusions

A beneficial effect of LCD was revealed in the increased doses of CaCO3 and VitD analogs seen in that group without the occurrence of hypercalcemia; however, PTH levels in that group were not maintained within an acceptable range. The survey suggests that more serious attention should be paid to the Ca concentration in peritoneal dialysate so as to lessen mineral and PTH disorders in CAPD.
Quantification of Peritoneal Transport
Authors: Yamashita Akihiro C.
Published: October 2020

Kinetic models have been used in both hemodialysis (HD) and peritoneal dialysis (PD) therapies. Because many different theoretical models are available, users should choose a model that suits the purpose of their studies. In general, simple models are useful for clinical investigations and research; rigorous models may be available with the use of computers. Several commercial software packages with rigorous models specifically designed for PD are also useful for analyzing patient data and for constructing prescriptions. Although the overall mass transfer area coefficient (MTAC) is a parameter for diffusion transport, it may become a useful tool for predicting peritoneal ultrafiltration by defining a new “index for peritoneal diffusive selectivity” (IPDS), the ratio of the MTACs for urea and creatinine. Kinetic models are especially useful in treatments with relatively complex prescriptions such as combined PD and HD (“complementary”) therapy, sample calculations of which are discussed.
New Insights into the Physiology of Peritoneal Fluid Transport
Authors: Krediet Raymond T. , Coester Annemieke M. , Parikova Alena , Smit Watske , Struijk Dirk G.
Published: October 2020

A review is given on the mechanisms of free water transport, the various methodologies for its measurement, its dependency on the osmotic gradient, and the assessment of osmotic conductance in individual patients. The importance of impaired free water transport in long-term ultra-filtration failure is discussed, relative to peritoneal solute transport status. Furthermore, the relationship of free water transport with locally released potassium is considered, together with a potential role of impaired K+ channel function with peritoneal alterations. Finally, the role of impaired osmotic conductance to glucose and its effects on free water transport in long-term patients with ultrafiltration failure is reviewed.
Peritonitis and Exit-Site Infection in Pediatric Automated Peritoneal Dialysis
Authors: Chiu Man-Chun , Tong Pak-Chiu , Lai Wai-Ming , Lau Shing-Chi
Published: October 2020

We reviewed 30 patients in an automated peritoneal dialysis (APD) program from 2002 to 2006 for peritonitis. Patients were 11.6 ± 5.5 years old at initiation of peritoneal dialysis (PD) and had a total of 976 PD months. The overall peritonitis rate was 1 episode in 54.2 patient– months, for a rate of 0.22 episode annually. The rate was considered low, which other than being an APD program, may be attributed to adherence to guidelines and in-charge nurse policy. A total of 17 episodes of peritonitis were identified in 9 patients, and the distribution of patient-specific peritonitis incidence appeared bimodal: 87% patients had no or only 1 episode of peritonitis, and 4 patients accounted for 12 episodes, with an average peritonitis rate of 1.0 annually. Causative organisms included Staphylococcus aureus, coagulase-negative Staphylococcus, methicillin-resistant S. aureus (MRSA), Pseudomonas aeruginosa, enterococci, alpha-hemolytic Streptococcus. Five episodes had concurrent exit-site infection with the same organism. During the same period in these 30 patients, 40 episodes of exit-site infection (ESI) were recorded in 23 patients. The overall ESI rate was 1 episode in 24.4 PD months. S. aureus and Pseudomonas aeruginosa were the two most common pathogens, accounting for 70% of the infections. Nasal carriage of MRSA was found in 4 patients, and MRSA ESIs in 2. The ESI rate was not low as that observed in peritonitis, which may be attributed to the humid climate.
Predictors of Faster Decline of Residual Renal Function in Taiwanese Peritoneal Dialysis Patients
Authors: Liao Chia-Te , Shiao Chih-Chung , Huang Jenq-Wen , Hung Kuan-Yu , Chuang Hsueh-Fang , Chen Yung-Ming , Wu Kwan-Dun , Tsai Tun-Jun
Published: October 2020

⋄ Objective

Loss of residual renal function (RRF) in peritoneal dialysis (PD) patients is a powerful predictor of mortality. The present study was conducted to determine the predictors of faster decline of RRF in PD patients in Taiwan.

⋄ Methods

The study enrolled 270 patients starting PD between January 1996 and December 2005 in a single hospital in Taiwan. We calculated RRF as the mean of the sum of 24-hour urea and creatinine clearance. The slope of the decline of residual glomerular filtration rate (GFR) was the main outcome measure. Data on demographic, clinical, laboratory, and treatment parameters; episodes of peritonitis; and hypotensive events were analyzed by Student t-test, Mann–Whitney U-test, and chi-square, as appropriate. All variables with statistical significance were included in a multivariate linear regression model to select the best predictors ( p < 0.05) for faster decline of residual GFR.

⋄ Results

All patients commencing PD during the study period were followed for 39.4 ± 24.0 months (median: 35.5 months). The average annual rate of decline of residual GFR was 1.377 ± 1.47 mL/min/m2. On multivariate analysis, presence of diabetes mellitus ( p < 0.001), higher baseline residual GFR ( p < 0.001), hypotensive events ( p = 0.001), use of diuretics ( p = 0.002), and episodes of peritonitis ( p = 0.043) independently predicted faster decline of residual GFR. Male sex, old age, larger body mass index, and presence of coronary artery disease or congestive heart failure were also risk factors on univariate analysis.

⋄ Conclusions

Our results suggested that diabetes mellitus, higher baseline residual GFR, hypotensive events, and use of diuretics are independently associated with faster decline of residual GFR in PD patients in Taiwan.
High Prevalence of Orodental Disorders in South Brazilian Cart Horses: Walking a Tightrope Between Animal Welfare and Socioeconomic Inevitability
Authors: Kunz Joao R. , Granella Milena C. S. , Mendes Rubens P. , Müller Thiago R. , Kau Silvio , Fonteque Joandes H.
Published: October 2020

In developing and emerging countries, many people make a living from picking municipal solid waste to sell for reuse or recycling. These people depend on cost-effective transport vehicles like horse-drawn carts. It is indisputable that the general health of these horses not only plays a major economic role but is a welfare issue as well. Orodental disorders are likely to be of particular importance as they directly impair health, performance, and therefore influence animal welfare and income. However, studies investigating prevalence and distribution of orodental disorders in working horses are scarce. This cross-sectional study is a survey of orodental alterations in 70 South Brazilian urban mixed-breed cart horses. All animals were subjected to a standardized clinical and subsequent specific orodental examination, and no horse had previously received dental treatment. Age and gender-related distribution and correlation of type and prevalence of orodental disorders were assessed. Excessively sharp enamel points (98.6%), cheek tooth diastema (65.7%), and mucosal ulcers (65.7%) occurred most frequently. Diastemata were more likely to be present between maxillary and mandibular Triadan 06/07 and mandibular 10/11. Male horses showed a higher individual number of orodental alterations than females ( P = .048). Incisors were often worn down and endodontically affected, occurring most frequently in horses >18 years ( P = .004) and males ( P = .048). Results indicate a high prevalence of orodental changes among South Brazilian cart horses. Poor orodental health in working horses is an animal welfare issue and may be influenced by the socioeconomic status of waste pickers.
After-School Tutoring, Electronic Device Availability, and Obesity Among Fifth-Grade Students in Ho Chi Minh City, Vietnam
Authors: To Quyen G. , Do Dung Van , To Kien Gia , Gallegos Danielle
Published: October 2020

This study investigates associations between after-school tutoring and availability of electronic devices with overweight/obesity among fifth-grade children in Ho Chi Minh City, Vietnam. A complex cross-sectional design was used to randomly select students and their parents in 8 public schools in Ho Chi Minh City in 2016. Students were categorized as overweight/obesity if their body mass index z score >+1 using the World Health Organization reference. Parents self-reported child’s attendance in after-school tutoring and availability of electronic devices at home. Sampling weights were used to account for unequal selection probability and nonresponses in analyses. Students attending tutoring were more likely to be overweight/obesity (odds ratio = 1.59, P < .001). Overweight/obesity students spent on average about 1.5 hours/week more attending tutoring; most of these hours were during weekdays ( P < .05). Students living in households with ≥2 types of devices were more likely to be overweight/obesity (odds ratio = 2.83, P < .001). Strategies to reduce study sitting time and the use of electronic devices may help with childhood overweight/obesity prevention.
Effect of intraocular pressure lowering on the capillary density of optic nerve head and retinal nerve fiber layer in patients with glaucoma
Authors: de Paula Alessandro , Perdicchi Andrea , Di Tizio Federico , Fragiotta Serena , Scuderi Gianluca
Published: October 2020

Purpose:

To evaluate the effect of IOP lowering on the capillary density of optic nerve head and retinal nerve fiber layer in patients with primary open angle glaucoma.

Methods:

Twenty eyes of 14 glaucomatous patients and 15 eyes of nine normal patients were enrolled. The most appropriate hypotonic treatment was applied to every patient. A HD Angio Disc 4.5 scan (Avanti-AngioVue) was performed at baseline and after a month in the glaucomatous eyes. The following parameters were analyzed: Radial Papillary Capillaries (RPC) density, inside disc, peripapillary, superior-hemi, inferior-hemi, quadrants, and peripapillary, hemi-superior, hemi-inferior, and quadrants RNFL thickness. Optic nerve head analysis was also evaluated. In addition, the RPC density and the RNFL were assessed in the eight sectors provided by the software.

Results:

The RPC density did not significantly change after IOP reduction ( p > 0.05). The inferior-temporal ( p = 0.005) and inferior-nasal sectors ( p < 0.001) showed a greater capillary density than the respective superior sectors in healthy eyes. In contrast in the glaucomatous eyes, the superior-nasal exhibited greater capillary density with respect to the inferior-nasal sectors. The aggregate RPC density of the inferior sectors was greater than the superior ones in the control group ( p < 0.001). An improvement of the average disc area ( p = 0.01) and the average cup volume ( p = 0.059) were also observed along with increased RNFL thickness at different locations (all, p < 0.05) after IOP lowering therapy was initiated.

Conclusion:

The glaucomatous eyes presented rarefaction of the radial papillary capillaries density in the inferior sectors, but no significant changes in the density after IOP-lowering medications.
Long-term evaluation of pars plana vitrectomy in children with Abusive head trauma
Authors: Kozner Pavel , Stepankova Jana , Dotrelova Dagmar
Published: October 2020

Purpose:

To determine the efficacy of pars plana vitrectomy (PPV) in children with intraocular hemorrhage (IOH) secondary to Abusive head trauma (AHT).

Methods:

A long-term retrospective analysis evaluating epidemiology, management, safety, anatomical and functional results of PPV for IOH in children with AHT at tertiary referral center for children in the Czech Republic from 2004 to 2017.

Results:

18 children were identified with IOH due to AHT during observation period of 14 years. Overall incidence of IOH related to AHT was 29.6/100 000, in children under 1 year 22.2/100 000, in children 1 to 5 years 7.4/100 000. Mean age at the time of diagnosis was 13.7 (SD±20.53) months, median 5 months. IOH resolved in 56% of children, 64% eyes, spontaneously. 44% children, 36% eyes, underwent PPV. PPV was performed 30.5 (SD±16.98) days after established diagnosis on average. Postoperatively, 80% of eyes had anatomical improvement, 20% eyes had preexisting irreversible changes in the posterior pole. Vision of 50% eyes improved after surgery, vision of 20% eyes remained poor, 30% of eyes was not possible to test due to severe neurological impairment. Mean observational period was 33.4 (SD±38.21) months. Mortality rate of AHT in our group was 17%, all victims were younger 4 months.

Conclusions:

PPV is a safe and effective procedure to clear IOH in children with AHT. Ophthalmology outcomes are strongly associated with degree of neurological impairment. Best outcomes were achieved with PPV performed between 2 and 5 weeks after trauma. Opportunity to plan surgery within this time frame indicates a good neurological prospect and prevents deprivation amblyopia.
Measures of vote-seat disproportionality for incomplete data
Authors: Bochsler Daniel
Published: October 2020

Measures of the proportionality of distributions are used across disciplines. ‘Disproportionality indices’ represent an application in politics, comparing the seat allocation in parliaments to the votes expressed for political parties. Disproportionality in elections is particularly high when many votes are expressed for parties not entering parliament; in some elections such ‘wasted votes’ add up to two-digit vote percentages. However, ‘wasted votes’ for small parties below the electoral threshold, as well as votes for non-partisan candidates, are often not listed in detail in election statistics, and are instead lumped together in residual categories such as ‘Others’ or ‘Independents’. This can hide major discrepancies between vote and seat distributions. This risks introducing systematic bias into the analysis of elections. This paper discusses several theoretically based methods to estimate indices of disproportionality for incomplete data, based on different theoretical scenarios concerning the distribution of votes and seats, and inspired by Taagepera’s method of ‘logical boundaries’. Empirical tests, relying on a dataset of 735 parliamentary elections worldwide, show that residual categories substantially affect indices of disproportionality. Several methods can considerably improve the measurement validity compared to the frequently used ‘naive’ procedures.
Residents’ perception of a mature and mass tourism destination: The determinant factors in Gran Canaria
Authors: Moreira Gregori Pedro Ernesto , Román Concepción , Martín Juan Carlos
Published: October 2020

Residents’ perception towards tourism has been studied in previous literature, but, in many cases, the analysis is based on studies of the impacts of new developments. In this study, we analyse the main determinant factors of residents’ perception in Gran Canaria, a well-known mature and mass tourism destination in Europe. In addition to tourism, the analysis is extended towards the tourists themselves after more than 50 years of residents and tourists interaction. The analysis is based on a stratified random sample of 504 residents and ordinal logit models that extract the main determinant factors that explain different residents’ perceptions towards tourism: (1) creation of new jobs; (2) development of infrastructures; (3) generation of wealth and economic growth; (4) the economy of the municipality; and towards tourists: (5) purchasing power; (6) behaviour; and (7) respect for the environment. The main determinant factors, the varied nuances and other third variables involved are obtained and commented. The article contributes empirically shedding some light in the complex phenomenon of residents’ perception towards tourism and tourists.
The prevalence of psychological consequences of COVID-19: A systematic review and meta-analysis of observational studies
Authors: Arora Teresa , Grey Ian , Östlundh Linda , Lam Kin Bong Hubert , Omar Omar M , Arnone Danilo
Published: October 2020

A systematic review and a meta-analysis were conducted to examine the overall prevalence of psychological health outcomes during COVID-19. Seven databases were systematically searched to include studies reporting on at least one psychological outcome. The pooled prevalence of primary psychological outcomes was 26% (95%CI: 21–32). Pooled prevalence for symptoms of PTSD was 33% (0–86), anxiety 28% (21–36), stress 27% (14–43), and depression 22% (13–33). The prevalence of psychological outcomes was similar in healthcare workers and in the general population (34% [24–44] and 33% [27–40] respectively). High prevalence figures support the importance of ensuring adequate provision of resources for mental health.
Narratives of Leaving and Returning to Homeland: The Example of Greek Brain Drainers Living in the UK
Authors: Chalari Athanasia , Koutantou Efi-Irini
Published: October 2020

Narratives of why people migrate can be primarily associated with the study of migration in terms of people’s drivers of leaving and returning to homeland. Greek people have been very familiar with the idea of leaving as well as returning home, throughout modern Greek history; yet, due to the ongoing Greek crisis and prolonged austerity, a new migration wave has been formed associated with young professionals and scientists (brain drainers). This study utilises the qualitative collection and analysis of 31 narrative interviews contacted with Greek brain drainers currently living in the UK, in an attempt to examine, understand, and explain the drivers of leaving and returning to homeland. We argue that factors leading to the decision of leaving as well as the consideration (or hesitation) of returning are associated with (a) macro-factors relating to the socio-economic situation of the origin country (associated with the eliminating economic and personal development) as well as (b) powerful drivers of enduring cultural and social mentalities, associated with a mosaic of distinctive norms formed and established beyond the Greek crisis.
Fiscal solidarity: The conditional role of political knowledge
Authors: Armingeon Klaus
Published: October 2020

In order to cope with the economic fall-out from the COVID-19 pandemic, the EU countries hit hardest by the virus requested fiscal support from the other EU member states. Likewise, the Eurozone arguably depends on some form of a fiscal union. This international redistribution critically depends on citizens’ support. Do politically knowledgeable citizens develop preferences for fiscal redistribution that are different from those of ignorant citizens? Based on the 2014 European Election Study, this article argues that knowledge plays a limited and conditional role. It hardly exerts a systematic independent effect. Rather, it helps crystallize party cues and basic European integration values. My findings are consistent with a theory, according to which knowledge eases the process of rationalizing preferences that originate in previous basic orientations.
Mothering through a child's addiction journey: Linking lived experience to the lenses that shape intervention
Authors: O'Connor Deborah
Published: October 2020

Someone dies from an opioid overdose every two hours in North America. These statistics became personal when my eldest son died from a drug overdose—he had been in recovery for a year, excited about the prospect of welcoming his unborn daughter into the world, and desperately committed to staying drug-free. He had been struggling with substance abuse for over twelve years. As a mother and Social Worker, I spent those years feeling helpless and deficient as things spiraled further and further out of control, committed to supporting my beloved son in a system that was not working.

Findings

This article is about this journey. My goal is to critically examine how our treatment lenses for understanding addiction create unacknowledged ethical issues and tensions that stigmatize not only those with substance use issues, but their family as well.

Application

The purpose is two-fold: to examine how the experience of mothering a child with addictions who dies is constructed as a problematic, and to invite Social Workers to think critically about their practices and the lenses they are drawing on when working with this population.
Vortex shedding modes around oscillating non-uniform double heave plates
Authors: Abazari Abuzar , Alvandi Mehdi , Behzad Mehdi , Thiagarajan Krish P
Published: October 2020

Multiple co-axial heave plates of uniform geometry are attached to offshore platforms for inducing damping and added mass. These effects generally decrease the magnitude of the dynamic response of the platform under applied environmental excitation forces. When spacing between heave plates is decreased the damping and added mass performance are altered due to their strong vortex interaction. A new non-uniform plate configuration is proposed that may create different hydrodynamic characteristics. The modes of vortex shedding around plate edges in a non-uniform arrangement under forced harmonic oscillation are investigated via the CFD method. Furthermore, a new simplified formula for the total theoretical added mass of a general non-uniform double disk is proposed when it is in the zone which vortex interaction take places. The results show that a non-uniform double disk has better hydrodynamic performance as compared to the uniform double configuration for a given spacing. It is also observed that the mode and direction of the vortex shedding are different for uniform and non-uniform arrangements in a given spacing and KC value.
A review of flexible electric heating element and electric heating garments
Authors: Fang Shu , Wang Rui , Ni Haisu , Liu Hao , Liu Li
Published: October 2020

Electric heating garment can improve the thermal comfort for people living and working in cold environment. Compared with passive heating materials, electrical heating shows dominant advantages on reusability, controlled temperature, safety and so on. This review article systematically introduced the material preparation, electric-thermal properties, advantages and disadvantages of the existing flexible heating elements, and elaborated the research and application progress of smart garments in detail, providing reference for the research of flexible heating elements and smart garments. And the existing challenges and the possible future perspectives were also discussed.
Parent Ethical Concerns About Patient Feedback Measures to Improve Pediatric Clinical Care
Authors: Lim Paulina S. , Lang Amy C. , Davies W. Hobart
Published: October 2020

There are limited studies evaluating parental willingness to complete patient feedback measures to improve pediatric clinical care. Parents were randomly assigned to read a vignette that varied by parent satisfaction and type of feedback measure. Parents were generally willing to participate in the hypothetical research study aimed to improve their child’s clinical care. Parents in the dissatisfied condition invited to participate in a potentially identifiable interview, compared to an anonymous survey, reported they would be less likely to respond honestly and more likely to feel obligated to participate. Researchers aiming to improve pediatric clinical care should be encouraged to use patient feedback measures that collect potentially identifiable information; however, researchers must consider the potential impact of parent satisfaction on feedback.
Dissecting aneurysms of the posterior cerebral artery – A retrospective review of imaging, angiographic characteristics, endovascular management and outcome
Authors: Jabeen Shumyla , Pendharkar Hima S , Prasad Chandrajit , HR Arvinda , Saini Jitender , Gupta Arun Kumar , Shukla Dhaval
Published: October 2020

Purpose

To review management, clinical and imaging outcomes of dissecting posterior cerebral artery (PCA) aneurysms with emphasis on endovascular management in the form of parent vessel occlusion (PVO) at a tertiary care center.

Methods

Thirty-six dissecting PCA aneurysms (19 ruptured) encountered at our center between January 2013 and November 2019 were reviewed for aneurysm location/size/presence of fetal PCA/management. Postprocedural imaging of patients who underwent endovascular intervention was reviewed for PCA territory infarcts and clinical records assessed for presence of neuro-deficits and outcome. None of the patients underwent a balloon test occlusion (BTO) prior to PVO.

Results

The location of the aneurysms was as follows-P1 = 8/P1-P2 = 11/P2 = 5/P2-P3 = 10/P3 = 2. The mean size was 11.7x6.8 mm. Endovascular intervention was carried out in 20 patients in the form of PVO with coiling in 16 patients, coiling alone in 3 patients, and reconstruction of the left PCA with flow diverter deployment in one patient. Postprocedural PCA territory infarct was seen in 5 cases of PVO out of which 4 had a good functional recovery. Overall, 15/16 patients (93.7%) who underwent PVO had mRS ≤ 2 on follow-up. The single case with flow diverter also developed an infarct and had adverse outcome on follow up.

Conclusion

Among the various management strategies for dissecting PCA aneurysms, PVO is feasible and relatively safe even in absence of BTO in scenarios like critically ill patients with ruptured aneurysms, difficult access and financial constraints. Thromboembolic complications and antiplatelet therapy is a concern in reconstructive strategies.
Unwilling and Unprepared: Collective Responsibility for Traumatic Wartime Motherhood
Authors: Prundeanu-Thrower Andreea M.
Published: October 2020

What does it mean to mother children born of illicit wartime relations? This article examines the detrimental effects of motherhood as a patriarchal institution shaped by nationalism/ethnocentrism and its impact on “sentimental collaborators” in WWII France, survivors of genocidal rape in Rwanda, and returning Lord’s Resistance Army (LRA) “wives” in Uganda. Using a corpus of written and oral testimonies by/about mothers of children born of war (CBOW), it argues that all mothers experienced trauma in their maternal roles and that communities were often complicit in perpetuating mother–child trauma post-conflict. Understanding such collective responsibility is crucial to our capacity to help future survivors of systemic violence.
Facing Father Absences and Troubling Memories of Our Fathers
Authors: Soler Gabriel , Purnell David F. , Clarke Daniel W.
Published: October 2020

This paper explores masculinity in light of the relationship three men had with their fathers. Three stories are offered as individual poetic inquiries, initiating discussion among the authors. By understanding the relationship with our fathers through collaborative writing, we are comprehending our own embedded masculinity in society and at the same time, we are finding new understandings of what it means to be a man. We reflect on the idea of fathering as something we need to think about in the process of connecting with our emotional needs.
Gynecologic large cell neuroendocrine carcinoma: A review
Authors: Burkeen Grant , Chauhan Aman , Agrawal Rohitashva , Raiker Riva , Kolesar Jill , Anthony Lowell , Evers B. Mark , Arnold Susanne
Published: October 2020

Large cell neuroendocrine carcinomas (LCNEC) are rare, aggressive high-grade neuroendocrine neoplasms within the neuroendocrine cell lineage spectrum. This manuscript provides a detailed review of published literature on LCNEC of gynecological origin. We performed a PubMed search for material available on gynecologic LCNEC. We analyzed 104 unique cases of gynecologic LCNECs, of which 45 were cervical primary, 45 were ovarian, 13 were uterine, and 1 was vaginal. A total of 45 cases of cervical LCNEC were identified with a median age of 36 years. Median overall survival was 16 months. We identified 45 ovarian LCNEC cases in the published literature with a median age of 54 years. Median overall survival was 8 months. 13 LCNEC cases of uterine origin were identified; 12 out of 13 were of endometrial origin and the median age was 71 years. The majority of patients presented with Stage III/IV disease (stages I–IV were 31%, 8%, 38%, and 23%, respectively). Gynecologic LCNEC is an aggressive malignancy. Our current understanding of the disease biology is very limited. Efforts are required to better understand the genomic and molecular characterizations of gynecological LCNEC. These efforts will elucidate the underlying oncogenic pathways and driver mutations as potential targets.
Emerging Adults’ Representations of Work: A Qualitative Research in Seven Countries
Authors: Cohen-Scali Valérie , Masdonati Jonas , Disquay-Perot Soazig , Ribeiro Marcelo Afonso , Vilhjálmsdóttir Guðbjörg , Zein Rowayda , Kaplan Bucciarelli Janet , Moumoula Issa Abdou , Aisenson Gabriela , Rossier Jerome
Published: October 2020

With the recent evolution of the labor market, emerging adults with no diploma are particularly exposed to unsatisfying jobs and barriers to access decent work. The aim of the research was to identify their representations of work, based on the psychology of emerging adulthood and the psychology of working theory. Differences related to each country’s level of development and to the work situations met by the participants were expected. Ten emerging adults aged 20–25 were interviewed in seven countries ( N = 70). Data were processed using a thematic content analysis. The results stress that these emerging adults associate “decent work” with two specific qualities: the extent to which work allows survival needs to be met and the experience of positive social relationships in the workplace. This article discusses the similarities and differences in their representations of work and their role on identity development.
Inter-rater reliability of a newly developed gait analysis and motion score
Authors: Dürregger Christina , Adamer Klemens A , Pirchl Michael , Fischer Michael J
Published: October 2020

Background:

Gait analysis constitutes an essential part of orthopedic rehabilitation assessment. Previous studies indicate that observational-based gait analysis lacks reliability and requires extensive clinical training. Therefore, gait analysis in the clinical practice heavily relies on technical aids. The aim of the present study is to develop a reliable gait analysis assessment tool that can accurately assess clinically relevant gait cycle parameters in daily clinical practice.

Methods:

In this pilot study, a new gait analysis and motion score (GAMS), comprising 10 observational and 5 technically measured (e.g. pressure plate) gait parameters, was developed. The parameters were dichotomously operationalized, reflecting pathological versus physiological manifestations of the parameters. The rating algorithm was administered by 12 raters using videotaped treadmill sessions of 10 orthopedic subjects ( n = 120 ratings). Inter-rater reliability was calculated using the intraclass correlation coefficient (ICC) and the percentage of rating agreement.

Results:

The mean (standard deviation (SD)) GAMS ratings ranged from 10.0 (1.1) to 21.5 (1.3) points. The overall GAMS ICC was 0.98 (95% confidence interval (CI) 0.96–1.00), whereas the ICC of observational parameters alone was 0.97 (95% CI 0.93–0.99). The mean (SD) percentage of rating agreement was 86.1% (3.3%). For the observational parameters, the mean (SD) rating agreement was 82.5% (4.5%).

Conclusion:

This new GAMS shows excellent overall inter-rater reliability for a continuum of functional gait statuses. The new score may be an appropriate clinical tool to objectively evaluate patients’ gait patterns. Furthermore, the GAMS may find application as a clinician-reported outcome measure in orthopedic rehabilitation. Further studies are required to verify the validity and accuracy of the new GAMS and its functionality in assessing clinical changes in gait patterns.
Comparative analysis of a locking plate with an all-suture anchor versus hook plate fixation of Neer IIb distal clavicle fractures
Authors: Seo Joong-Bae , Kwak Kwon-young , Yoo Jae-Sung
Published: October 2020

Background:

The coracoclavicular fixation with suture anchors adds stability to type IIb distal clavicle fractures fixed with a plate and screws when loaded to failure. The purpose of this study was to compare the clinical and radiological outcomes between the use of a locking compression plate (LCP) with all-suture anchor fixation and hook LCP fixation of Neer IIb distal clavicle fractures.

Methods:

A total of 82 consecutive patients who underwent plate fixation for Neer IIb distal clavicle fractures were included. The subjects were divided into two groups: an LCP with all-suture anchor fixation group and hook LCP fixation group. For clinical assessments, the American Shoulder and Elbow Surgeons score, Korean shoulder score (KSS), and Constant score were recorded. A percentage of the coracoclavicular distance (CCD%) was used to evaluate fracture reduction. Typical reported complications, such as secondary dislocation, implant failure or loosening, peri-implant fracture, acromion osteolysis, stiffness, peri-anchor osteolysis, postoperative acromioclavicular joint arthrosis, nonunion, or delayed union, were also analyzed.

Results:

There were no differences in the clinical and radiological outcomes at the final follow-up between the two groups. The period for bone union and CCD% showed no significant differences between groups. Stiffness at 3 months after surgery of LCP with all-suture anchor fixation ( n = 3, 10.7%) was less than that of hook LCP fixation ( n = 17, 31.5%). The complication rate also showed no significant differences between groups. However, LCP with all-suture anchor fixation had anchor-related complications, although it can reduce hook-related complications.

Conclusion:

LCP with all-suture anchor fixation showed satisfactory outcomes in comparison with hook LCP fixation. In Neer IIb distal clavicle fractures, LCP with all-suture anchor fixation is a useful method for the maintenance of reduction, avoiding implant removal, and hook-related complications. However, anchor fixation should be carefully used, especially in osteoporotic patients or patients with underlying diseases.

Level of Evidence:

Level III, retrospective study.