bluuebunny/crossref_metadata_2025 huggingface dataset:
Prognostic Significance of Tumor Deposits in Combination with Lymph Node Metastasis in Stage III Colon Cancer: A Propensity Score Matching Study
Authors: Zheng Peilin , Lai Chen , Yang Weimin , Chen Zhikang
Published: June 2020

Tumor deposits in colon cancer are related to poor prognosis, whereas the prognostic power of tumor deposits in combination with lymph node metastasis (LNM) is controversial. This study aimed to compare the overall survival between LNM alone and LNM in combination with tumor deposits, and to verify whether the number of tumor deposits can be considered LNM in patients with both LNM and tumor deposits in stage III colon cancer by propensity score matching (PSM). Patients carrying resected stage III adenocarcinoma of colon cancer were identified from the Surveillance, Epidemiology, and End Results database (2010–2015). The Kaplan-Meier method, Cox proportional hazard models and PSM were used. On the whole, 23,168 patients (20,451 (88.3%) with only LNM and 2,717 (11.7%) with both LNM and tumor deposits) were selected. After undergoing PSM, patients with both LNM and tumor deposits showed worse overall survival (hazard ratio = 1.33, 95% confidence interval: 1.20–1.47, P < 0.001). After the number of tumor deposits was added with that of positive regional lymph nodes, patients with both LNM and tumor deposits seemed to have prognostic implications similar to those with LNM alone (hazard ratio = 1.02, 95% confidence interval: 0.93–1.12, P = 0.66). The simultaneous presence of LNM and tumor deposits, as compared with the presence of only LNM, had an association with a worse outcome. Tumor deposits should be considered as LNM in patients with both tumor deposits and LNM in stage III colon cancer.
“The Living Monument”: The Desegregation of Grady Memorial Hospital and the Changing South
Authors: Lovasik Brendan P. , Rajdev Priya R. , Kim Steven C. , Srinivasan Jahnavi K. , Ingram Walter L. , Sayed Blayne A.
Published: June 2020

Grady Memorial Hospital is a pillar of public medical and surgical care in the Southeast. The evolution of this institution, both in its physical structure as well as its approach to patient care, mirrors the cultural and social changes that have occurred in the American South. Grady Memorial Hospital opened its doors in 1892 built in the heart of Atlanta's black community. With its separate and unequal facilities and services for black and white patients, the concept of “the Gradies” was born. Virtually, every aspect of care at Grady continued to be segregated by race until the mid-20th century. In 1958, the opening of the “New Grady” further cemented this legacy of the separate “Gradies,” with patients segregated by hospital wing. By the 1960s, civil rights activists brought change to Atlanta. The Atlanta Student Movement, with the support of Dr. Martin Luther King Jr., led protests outside of Grady, and a series of judicial and legislative rulings integrated medical boards and public hospitals. Eventually, the desegregation of Grady occurred with a quiet memo that belied years of struggle: on June 1, 1965, a memo from hospital superintendent Bill Pinkston read “All phases of the hospital are on a non-racial basis, effective today.” The future of Grady is deeply rooted in its past, and Grady's mission is unchanged from its inception in 1892: “It will nurse the poor and rich alike and will be an asylum for black and white.”
Predictors of Change in Code Status from Time of Admission to Death in Critically Ill Surgical Patients
Authors: Purcell Laura N. , Tignanelli Christopher J. , Maine Rebecca , Charles Anthony
Published: June 2020

Racial and gender disparities in end-of-life decision-making practices have not been well described in surgical patients. We performed an eight-year retrospective analysis of surgical patients within the Cerner Acute Physiology and Chronic Health Evaluation Outcomes database. ICU patients with documented admission code status, and death or ICU discharge code status, respectively, were included. Logistic regression analysis was performed to assess change in code status. Of 468,000 ICU patients, 97,968 (20.9%) were surgical, 63,567 (95%) survived, and 3,343 (5%) died during their hospitalization. Of those, 50,915 (80.1%) and 2,625 (78.5%) had complete code status data on admission and discharge or death, respectively. Women were less likely than men to remain full code at ICU discharge and death (n = 20,940, 95.6% and n = 141, 11.9% vs n = 29,320, 97.4% and n = 233, 16.3%, P < 0.001). Compared with whites, blacks and other minorities had a 0.46 odds (95% confidence interval [CI]: 0.33–0.64, P < 0.001) and 0.54 odds (95% CI: 0.34–0.85, P = 0.01) of changing from full code status before death, respectively. Before ICU discharge, blacks and other minorities had a 0.56 odds of changing from full code status when compared with whites (95% CI: 0.40–0.79, P < 0.001 vs 95% CI: 0.36–0.87, P = 0.01, respectively). Women were more likely to be discharged or die after a change in code status from full code (odds ratio 1.27, 95% CI: 1.06–1.07, P < 0.001; odds ratio 1.39, 95% CI: 1.09–1.79, P = 0.009). Men and minorities are more likely to be discharged from the ICU or die with a full code status designation.
Lung Resection for Trauma: A Propensity Score Adjusted Analysis Comparing Wedge Resection, Lobectomy, and Pneumonectomy
Authors: Aiolfi Alberto , Inaba Kenji , Martin Matthew , Matsushima Kazuhide , Bonitta Gianluca , Bona Davide , Demetriades Demetrios
Published: June 2020

The resection of lung parenchyma for thoracic trauma is uncommon. Different surgical procedures with a wide range of complexities have been described depending on the severity of trauma and the presence of associated injuries. The aim of this study was to analyze outcomes of wedge resection, lobectomy, and pneumonectomy. Data for this study were obtained from an eight-year retrospective National Trauma Data Bank study (2007–2015). Adult patients who sustained severe chest trauma (Abbreviated Injury Scale > 3) that required any type of lung resection were included. Propensity score (PS) analysis was adopted. Overall, 3107 patients were included. Wedge resection was performed in 54.3 per cent, lobectomy in 38.2 per cent, and pneumonectomy in 7.5 per cent of patients. Longer in-hospital length of stay ( P = 0.01), ICU length of stay ( P = 0.002), and mechanical ventilation days ( P = 0.038) were found in case of major resections. The overall morbidity and mortality were 32 per cent and 27.5 per cent, respectively. A stepwise increase in mortality occurred when comparing wedge (20.3%), lobectomy (30.8%), and pneumonectomy (63.4%) ( P < 0.001). After PS analysis, lobectomy and pneumonectomy were associated with higher mortality compared with wedge resection (odds ratio [OR] 1.42; 95% confidence interval 1.26–1.71 and OR 4.16; 95% confidence interval 2.84–6.07, respectively). Similarly, after PS analysis, lobectomy and pneumonectomy were associated with higher overall complications compared with wedge resection (OR 1.21 and OR 1.56, respectively). Comparable results were found in the subgroup analysis of patients with isolated lung injury. After PS matching, lobectomy and pneumonectomy were associated with significantly higher morbidity and mortality compared with nonanatomical wedge resection.
Factors Affecting Research Productivity of Trauma Surgeons
Authors: Elkbuli Adel , Zajd Sarah , Narvel Raed Ismail , Dowd Brianna , Hai Shaikh , Mckenney Mark , Boneva Dessy
Published: June 2020

This study aimed to identify factors that promote and impede research participation and productivity by Eastern Association for the Surgery of Trauma (EAST) surgeons. In addition, the study aimed to determine what changes can be implemented by surgical departments to improve this research productivity and granting. A 25-question anonymous research survey tool was offered to EAST surgeons. The questions analyzed factors including demographics, career accomplishments, current institution type, educational/research background, perceived barriers to research, and current research productivity, including grants. Chi-square tests were used to analyze significance at P < 0.05. The overall response rate was 26.2 per cent (445/1699). Most respondents reported not having any protected research time (86.3%), and no research resources were provided by their institution (78.7%). Factors that were significantly associated with greater research productivity included protected research time ( P < 0.0001), having a mentor ( P < 0.001), practicing in a university-affiliated hospital ( P < 0.0001), publication(s) before completing residency training ( P = 0.02), having institutional resources dedicated to research ( P = 0.015), and male gender ( P = 0.003). Age, race, marital status, and additional educational qualifications were not associated with statistically significant differences in research productivity in this study ( P > 0.05). EAST surgeons are more likely to have scholarly productivity if they are supported with protected time, mentors, nonclinical staff dedicated to research, a history of research before completion of residency, and research resources from their institution. Barriers to research productivity include lack of institutional support, lack of protected research time, and increased regulatory policies.
Advancing the Time to the Initiation of Adjuvant Chemotherapy and Improving Postoperative Outcome: Enhanced Recovery after Surgery in Pancreaticoduodenectomy
Authors: Li Min , Wang Xinbo , Shen Rongxi , Wang Sizhen , Zhu Daojun
Published: June 2020

Early initiation of chemotherapy could improve overall survival after pancreaticoduodenectomy (PD). The concept of enhanced recovery after surgery (ERAS), which aims to reduce the stress response to surgery and accelerate recovery, is relatively limited in PD. The aim of the study was to retrospectively analyze the relationships of ERAS with the time of initiation of postoperative chemotherapy and recovery in PD patients. Between January 1, 2008 and December 31, 2017, all patients who underwent open PD for malignant tumor at our unit were studied retrospectively. Patients were divided into ERAS and conventional groups. The time to initiation of adjuvant chemotherapy and postoperative outcomes were analyzed. There were 344 consecutive patients in this study, with 203 patients in the ERAS group. There were no significant differences between the ERAS and conventional groups in morbidity, mortality, and readmission. The median time of initiation of adjuvant chemotherapy in the ERAS group (54.1 days) was significantly shorter than that of initiation of adjuvant chemotherapy in the conventional group (67.8 days). The ERAS group had a shorter postoperative length of stay than the conventional group (14.9 vs 19.3 days). The ERAS program is safe and feasible in PD. These protocols improve postoperative recovery and advance the time of initiation of adjuvant chemotherapy.
A Potential Role for Robotic Cholecystectomy in Patients with Advanced Liver Disease: Analysis of the NSQIP Database
Authors: Aziz Hassan , Zeeshan Muhammad , Kaur Navpreet , Emamaullee Juliet , Ahearn Aaron , Kulkarni Sujit , Genyk Yuri , Selby Robert R. , Sheikh Mohd Raashid
Published: June 2020

Robotic surgery has been widely adopted by many specialties, including hepatobiliary surgery. However, robotic procedures generally require longer operative times and are costlier than their laparoscopic counterparts. The role for robotic cholecystectomy (RC), particularly in patients with advanced liver disease, has not been established. A retrospective analysis of the NSQIP database was performed, focusing on patients with chronic liver disease who underwent cholecystectomy. Patients were categorized based on their model for end-stage liver disease (MELD) score and the type of surgical procedure: open, laparoscopic, or RC. Rates of a variety of postoperative complications including length of stay (LOS) were analyzed. In patients with a MELD score of 21 to 30, open cholecystectomy was associated with a long hospital LOS (3 vs 1 vs 1; P 20.01). RC was equivalent to laparoscopic cholecystectomy in terms of perioperative mortality for higher MELD score patients but was associated with lower conversion rates and overall LOS. This data suggests that RC should be considered in patients with advanced liver disease needing cholecystectomy.
Blunt Cardiac Injury: A Single-Center 15-Year Experience
Authors: Gao Jin-Mou , Li Hui , Wei Gong-Bin , Liu Chao-Pu , Du Ding-Yuan , Kong Ling-Wen , Li Chang-Hua , Yang Jun , Yang Qian
Published: June 2020

In recent years, the incidence of blunt cardiac injury (BCI) has increased rapidly and is an important cause of death in trauma patients. This study aimed to explore early diagnosis and therapy to increase survival. All patients with BCI during the past 15 years were analyzed retrospectively regarding the mechanism of injury, diagnostic and therapeutic methods, and outcome. The patients were divided into two groups according to the needs of their condition—nonoperative (Group A) and operative (Group B). Comparisons of the groups were performed. A total of 348 patients with BCI accounted for 18.3 per cent of 1903 patients with blunt thoracic injury. The main cause of injury was traffic accidents, with an incidence of 48.3 per cent. In Group A (n = 305), most patients sustained myocardial contusion, and the mortality was 6.9 per cent. In Group B (n = 43), including those with cardiac rupture and pericardial hernia, the mortality was 32.6 per cent. Comparisons of the groups regarding the shock rate and mortality were significant ( P < 0.01). Deaths directly resulting from BCI in Group B were greater than those in Group A ( P < 0.05). In all 348 patients, the mortality rate was 10.1 per cent. When facing a patient with blunt thoracic injury, a high index of suspicion for BCI must be maintained. To manage myocardial contusion, it is necessary to protect the heart, alleviate edema of the myocardium, and control arrhythmia with drugs. To deal with those requiring operation, early recognition and expeditious thoracotomy are essential.
Right Patient, Right Place, Right Time: Field Triage and Transfer to Level I Trauma Centers
Authors: Gough Benjamin L. , Painter Matthew D. , Hoffman Autumn L. , Caplan Richard J. , Peters Cynthia A. , Cipolle Mark D.
Published: June 2020

Introduction

This study sought to compare the outcomes of trauma patients taken directly from the field to a level I trauma center (direct) versus patients that were first brought to a level III trauma center prior to being transferred to a level I (transfer) within our inclusive Delaware trauma system.

Methods

A retrospective review of the level I center’s trauma registry was performed using data from 2013 to 2017 for patients brought to a single level I trauma center from two surrounding counties. The direct cohort consisted of 362 patients, while the transfer cohort contained 204 patients. Linear regression analysis was performed to investigate hospital length of stay (LOS), while logistic regression was used for mortality, complications, and craniotomy. Covariates included age, gender, county, and injury severity score (ISS). Propensity score weighting was also performed between the direct and transfer cohorts.

Results

When adjusting for age, gender, ISS, and county, transferred patients demonstrated worse outcomes compared to direct patients in both the regression and propensity score analyses. Transferred patients were at increased risk of mortality (OR 2.17, CI 1.10-4.37, P = .027) and craniotomy (OR 3.92, CI 1.87-8.72, P < .001). Age was predictive of mortality ( P < .001). ISS was predictive of increased risk of mortality ( P < .001), increased LOS ( P < .001), and craniotomy ( P < .001). Older age, Sussex County, and higher ISS were predictive of patients being transferred ( P < .001).

Discussion

Delays in presentation to our level I trauma center resulted in worse outcomes. Patients that meet criteria should be considered for transport directly to the highest level trauma center in the system to avoid delays in care.
Is Primary Tumor Excision and Specific Metastases Sites Resection Associated With Improved Survival in Stage Ⅳ Colorectal Cancer? Results From SEER Database Analysis
Authors: Yi Chenghao , Li Jinpeng , Tang Fuxin , Ning Zhikun , Tian Huakai , Xiao Longlin , Wang Anan , Zong Zhen
Published: June 2020

Objective

We aimed to explore the prognostic value of primary tumor and specific metastases excision on survival among patients with stage IV colorectal cancer (CRC) in the Surveillance, Epidemiology, and End Results (SEER) database.

Methods

Patients with stage IV CRC were selected using SEER database between 2010 and 2013. Survival rate was calculated according to the Kaplan-Meier method, and differences between curves were tested by the log-rank test. Cox proportional hazards model was used in the multivariable analysis.

Results

Included in this study were 27 878 patients with distant metastatic CRC. Among the single organ site of metastatic CRC, patients with solitary metastasis of lung showed the highest median overall survival (OS). Both primary and metastatic sites surgical resection for patients with liver, lung, and simultaneous liver and lung metastases had better median OS. Age younger than 65 years, Asian and Pacific Islander, distal colon and rectum, and palliative primary tumor and metastatic lesions resection were associated with better OS after multivariate analysis. Palliative primary tumor and metastatic lesions resection had a significant survival benefit compared with nonsurgical group in selected patients.

Conclusion

These findings support the use of preemptive surgery in the management of highly selected metastatic CRC patients.
Predicting Aggressive Behavior in Nonfunctional Pancreatic Neuroendocrine Tumors With Emphasis on Tumor Size Significance and Survival Trends: A Population-Based Analysis of 1787 Patients
Authors: Fathi Amir H. , Romanyshyn Jonathan , Barati Mehdi , Choudhury Uzair , Chen Allen , Sosa Julie Ann
Published: June 2020

Background

Nonfunctional pancreatic neuroendocrine tumors (NF-PNETs) are rare tumors with continued controversies in management. This study aims to identify demographic and clinicopathologic characteristics associated with aggressive behavior and survival.

Methods

The Surveillance, Epidemiology, and End Results database was used to identify patients with NF-PNETs from 1988 to 2012. Multivariate regression analysis and Cox proportional hazards modeling were used to assess the impact of patient, tumor, and treatment characteristics on tumor behavior and overall survival.

Results

In 1787 patients identified, size was a major determinant of aggressive behavior. The probability of aggressiveness increased 100% for tumor size ≥2 cm. For tumors ≥2 cm, every 1-cm increase in size was associated with an increase in probability of aggressive behavior by 11.3%. Patient age, tumor grade, and surgical resection were independent predictors of survival. Surgical resection was associated with improved survival but not grade I or II tumors with size <2 cm.

Discussion

Patient age, tumor size, and grade should be in the decision-making process around the surgical management of NF-PNETs. For tumors ≤2 cm with histologic grades of I or II, the probability of aggressive behavior is low, and surgical resection does not appear to afford survival benefit. Therefore, close observation could be justified.
Systems modelling and simulation to inform strategic decision making for suicide prevention in rural New South Wales (Australia)
Authors: Atkinson Jo-An , Skinner Adam , Hackney Sue , Mason Linda , Heffernan Mark , Currier Dianne , King Kylie , Pirkis Jane
Published: June 2020

Background:

The need to understand and respond to the unique characteristics and drivers of suicidal behaviour in rural areas has been enabled through the Australian Government’s 2015 mental health reforms facilitating a move to an evidence-based, regional approach to suicide prevention. However, a key challenge has been the complex decision-making environment and lack of appropriate tools to facilitate the use of evidence, data and expert knowledge in a way that can inform contextually appropriate strategies that will deliver the greatest impact. This paper reports the co-development of an advanced decision support tool that enables regional decision makers to explore the likely impacts of their decisions before implementing them in the real world.

Methods:

A system dynamics model for the rural and remote population catchment of Western New South Wales was developed. The model was based on defined pathways to mental health care and suicidal behaviour and reproduced historic trends in the incidence of attempted suicide (self-harm hospitalisations) and suicide deaths in the region. A series of intervention scenarios were investigated to forecast their impact on suicidal behaviour over a 10-year period.

Results:

Post-suicide attempt assertive aftercare was forecast to deliver the greatest impact, reducing the numbers of self-harm hospitalisations and suicide deaths by 5.65% (95% interval, 4.87−6.42%) and 5.45% (4.68−6.22%), respectively. Reductions were also projected for community support programs (self-harm hospitalisations: 2.83%, 95% interval 2.23−3.46%; suicide deaths: 4.38%, 95% interval 3.78−5.00%). Some scenarios produced unintuitive impacts or effect sizes that were significantly lower than what has been anticipated under the traditional evidence-based approach to suicide prevention and provide an opportunity for learning.

Conclusion:

Systems modelling and simulation offers significant potential for regional decision makers to better understand and respond to the unique characteristics and drivers of suicidal behaviour in their catchments and more effectively allocate limited health resources.
OneCommunity Reads: A Model for Latino Parent-Community Engagement and Its Effect on Grade-Level Reading Proficiency
Authors: Stauss Kimberly , Koh Eun , Johnson-Carter Charlene , Gonzales-Worthen Diana
Published: June 2020

The importance of establishing effective literacy/reading skills at an early age, preschool to early elementary, is well known and accepted among educators. For students whose heritage language is not English, the influential factors of cultural relevance and parent/family involvement for the acquisition of these fundamental skills are underscored. OneCommunity (OC) Reads is a literacy program focused on enhancing Latino children’s reading proficiency in a culturally sensitive manner utilizing the funds of knowledge of parents/families and community. Using a community-based, participatory evaluation/research paradigm, the impact of OC Reads was examined using both quantitative and qualitative data. Findings indicated parents/families were affected positively, resulting in increased empowerment and involvement in the schools and the community. Themes derived from the qualitative data included (a) broad empowerment, (b) increased mutual understanding and respect, (c) shared responsibility, and (d) academic and reading improvement. Strengths were noted in the areas of culturally sensitive and helpful processes, and additional activities and enhancements. OC Reads’ success in enhancing literacy/reading proficiency with its nontraditional approach of empowering parents and building on the cultural realities of the students gives further credence to the literature regarding the success of such approaches.
Significant Published Articles for Pharmacy Nutrition Support Practice in 2019
Authors: Dickerson Roland N. , Bingham Angela L. , Canada Todd W. , N. Chan Lingtak , Cober M. Petrea , V. Cogle Sarah , Tucker Anne M. , Kumpf Vanessa J.
Published: June 2020

Purpose

The purpose of this article is to assist the pharmacist engaged in nutrition support therapy in staying current with pertinent literature. Methods: Several clinical pharmacists engaged in nutrition support therapy compiled a list of articles published in 2019 considered important to their clinical practice. The citation list was compiled into a single spreadsheet where the author participants were asked to assess whether the article was considered important to nutrition support pharmacy practice. A culled list of publications was then identified whereby at least 5 out of the 8 author participants considered the paper to be important. Guideline and consensus papers from professional organizations, important to practice but not ranked, were also included. Results: A total of 111 articles were identified; 6 from the primary literature were voted by the group to be of high importance. An additional 9 organizational guidelines, position, recommendation, or consensus papers were also identified. The top-ranked articles from the primary literature were summarized and a narrative regarding its implications to pharmacy nutrition support practice were provided. Conclusion: We recommend that pharmacists engaged in nutrition support therapy be familiar with these articles as it pertains to their practice.
Book review: Markus C. Becker, Thorbjørn Knudsen and Richard Swedberg (Eds.), The Entrepreneur-Classic Texts by Joseph A. Schumpeter
Authors: Mohapatra Gadadhara
Published: June 2020

Markus C. Becker, Thorbjørn Knudsen and Richard Swedberg (Eds.), The Entrepreneur-Classic Texts by Joseph A. Schumpeter. Stanford University Press, 2011, ix + 368 pp., $35.00 (Paperback). ISBN: 9780804762830.
Book review: Narendra Shukla, British Raj aur Abhivyakti ki Swatantrata: Aupniveshik Bharat Mein Pratibandhit Sahitya
Authors: Roy Himanshu
Published: June 2020

Narendra Shukla, British Raj aur Abhivyakti ki Swatantrata: Aupniveshik Bharat Mein Pratibandhit Sahitya. New Delhi: Vani Prakashan, 2017, 308 pp., ₹695. ISBN: 978-93-88434-11-9.
Kemetic Principles in African American Public Address: An Interrogation of the Rhetoric of Joseph C. Price and the Kemetic Tradition
Authors: Smith Damariyé L.
Published: June 2020

The purpose of this essay is to promote the utilization of Kemetic principles in approaching African American public address. Although there have been recent studies on African American public address, the employment of the Kemetic philosophy is limited. Using the four overarching ethical principles of Kemetic rhetorical tradition as outlined by Karenga, this essay interrogates Joseph C. Price’s 1890 speech at the National Education Association national convention. A Kemetic analysis of Price’s speech reveals that African American public address endorses the dignity and rights of the human person, the well-being of family and community, the integrity and value of the environment, and the reciprocal solidarity and cooperation for the mutual benefit of humanity. This suggests that a Kemetic understanding of African American public address can (a) civically benefit the broader community because of its ethical foundation, (b) facilitate the recognition of contemporary ethical appeals in any given discourse, and (c) serve as an impetus for collective advancement toward a social justice–oriented world.
Organic dye anchor peptide conjugates as an advanced coloring agent for polypropylene yarn
Authors: Zimmermann Marc , Stomps Benjamin , Schulte-Osseili Christine , Grigoriev Dmitry , Ewen Dirk , Morgan Andrew , Böker Alexander
Published: June 2020

Polypropylene as one of the world's top commodity polymers is also widely used in the textile industry. However, its non-polar nature and partially crystalline structure significantly complicate the process of industrial coloring of polypropylene. Currently, textiles made of polypropylene or with a significant proportion of polypropylene are dyed under quite harsh conditions, including the use of high pressures and temperatures, which makes this process energy intensive. This research presents a three-step synthesis of coloring agents, capable of adhering onto synthetic polypropylene yarns without harsh energy-consuming conditions. This is possible by encapsulation of organic pigments using trimethoxyphenylsilane, introduction of surface double bonds via modification of the silica shell with trimethoxysilylpropylmethacrylate and final attachment of highly adhesive anchor peptides using thiol-ene chemistry. We demonstrate the applicability of this approach by dyeing polypropylene yarns in a simple process under ambient conditions after giving a step-by-step guide for the synthesis of these new dyeing agents. Finally, the successful dyeing of the yarns is visualized, and its practicability is discussed.
The rise (and rise) of vertical studentification: Exploring the drivers of studentification in Australia
Authors: Holton Mark , Mouat Clare M.
Published: June 2020

The conditions for studentification are changing with increasing numbers of students living in high-rise – and high-quality – micro-apartment-style accommodation provided through purpose-built student accommodation (PBSA) blocks. This ‘verticalisation’ of studentification is a global phenomenon, with Australia representing a frontier with distinctive geographies that result from its rapid ascension to the second-ranked global destination for international students. Yet, despite rising student numbers being recognised as positively impacting national and state economies, little is understood of how student accommodation development fits within the broader scheme of Australian urban revitalisation. To address this, we combine concepts relating to condo-ism and condo-isation to offer an original analytical framework that examines how PBSA has created new conditions through which vertical studentification can be produced in and of cities. We therefore ask how vertical studentification relates to wider Australian housing and urban development trends in ways that differentiate PBSA development and trajectories from other forms of accommodation. We also question how vertical studentification relates to the realities and regulation expressed as intra-urban geographies of Australian university cities and their resident-host communities. We argue that deliberately recognising and dovetailing several self-reinforcing and contradicting urban development dimensions invites a foundation for further interrogating vertical studentification in existing and emerging sites in Australia and beyond.
Does Location Matter for Micro Shops Resilience? Evidence from Uganda
Authors: Scuderi Raffaele , Tesoriere Giuseppe , Fasone Vincenzo
Published: June 2020

This article analyzes the relationship between location and resilience of micro shops in Uganda. We use a unique city-level data set and consider the longevity of business as a proxy for resilience. After controlling for a set of relevant variables, our findings suggest positive correlation between longevity and proximity to Kampala, the capital city and vibrant commercial center of Uganda. We also find that entrepreneurship-related factors and natural events are further significant elements. We stress the importance to strengthen the integration between core and lagging areas as opposed to the current territorial development pattern. This calls for development models where the creation of satellite hubs and commercial platforms may positively influence the resilience of micro business.
Caregiving Attitudes and Needs of Later-generation Chinese-American Family Caregivers of Older Adults
Authors: Miyawaki Christina E.
Published: June 2020

Due to linguistic and cultural adjustments to a new country, first-generation immigrant’s caregiving challenges have been well-documented. However, little is known of U.S.-born, U.S.-educated, English-speaking later-generation caregivers’ (2nd, 2.5, and 3rd-generation) attitudes and needs regarding caregiving. Given this context, we interviewed 40 later-generation Chinese-American caregivers in Seattle and Houston. Caregivers had a mean age of 59 years, were married, college-educated, and working females with children. The later the caregiver’s generation, the higher their acculturation, but their sense of filial responsibility remained high across generations. While Seattle caregivers wish to live in a high-quality, long-term care facility, Houston caregivers prefer to live with their adult children for their future care. Findings emphasize the importance of understanding the caregivers’ ethnically and generationally specific caregiving attitudes and preferences for geographically specific services. Collaborating with existing local organizations, it is critical to ensure that the provision of services meets local Chinese-American caregivers’ needs and preferences.
Bluespace, Senses, Wellbeing, and Surfing: Prototype Cyborg Theory-Methods
Authors: lisahunter  , Stoodley Lyndsey
Published: June 2020

Bluespace, where water people immerse themselves for thrills, therapy, or thalassography, is constantly fluctuating, influenced by materials, nature, and discourse. Drawing on onto-epistemological aspects of embodied theory-method, we report entangled prototype “cyborg” in situ strategies (mobile, sensory [auto]ethnography, and self-interview) to notice, record, and ultimately create human–water relations, from the perspective of a surfer. Audio/-visual evidence, from multiple perspectives, folding time, and several point-of-view devices, enabled unique insights into voiced thoughts, sights, sounds, and conscious/subconscious practices that occur in surfing. Such insights into the relationships, experiences, and movements of surfers inform research, such as to wellbeing and to the challenges of investigating bluespace. We offer cyborg theory-method for further methodological and onto-epistemological consideration in such relationships, contributing to a growing understanding of more-than-human engagement with watery worlds.
Long-Term Observation of the Progression From Nodal Marginal Zone Lymphoma to Diffuse Large B-Cell Lymphoma in a Dog
Authors: Shiga Takanori , Chambers James K. , Sugawara Mei , Goto-Koshino Yuko , Tsujimoto Hajime , Nakayama Hiroyuki , Uchida Kazuyuki
Published: June 2020

A 4-year and 10-month old female Pembroke Welsh Corgi presented with an enlarged right popliteal lymph node, and a histopathological diagnosis of nodal marginal zone lymphoma (nMZL) was made. After resection of the lymph node, follow-up observation was continued without chemotherapy. At 22 months after initial presentation, the dog developed enlargement of peripheral lymph nodes, and the histopathological diagnosis was late-stage nMZL. Multidrug chemotherapy induced clinical complete remission, but the tumor relapsed with enlargement of peripheral and abdominal lymph nodes 42 months after initial presentation. Second-round multidrug chemotherapy induced complete clinical remission again; however, the tumor relapsed with lymphadenopathy 47 months after initial presentation. The dog died 59 months after initial presentation, and postmortem examination revealed generalized lymphadenopathy; the histopathological diagnosis was diffuse large B-cell lymphoma (DLBCL). Polymerase chain reaction for antigen receptor gene rearrangements revealed that the nMZL and DLBCL samples were derived from the same B-lymphocyte clone.
How Much of Which Mode? Using Revealed Preference Data to Design Mobility As a Service Plans
Authors: Reck Daniel J. , Axhausen Kay W.
Published: June 2020

Mobility as a service (MaaS) seeks to integrate emerging shared mobility modes with existing public transportation (PT). Decisive to its uptake will be attractive subscription plans that cater for heterogeneous mobility needs. Research on willingness to pay for such plans has commenced, yet remains divided on a central question: how much to include of which mode, and how? Complementing previous research building on stated preference data, in this study revealed preference data is used to analyze the viability of different subscription plan components (PT, car-sharing, bike-sharing, taxi), modes of inclusion (budgets in minutes and season tickets) and subscription cycles (weekly, monthly). PT season tickets are found to be viable for 83% of all respondents. Interestingly, the viability of minute budgets of car- and bike-sharing depends on subscription cycle length. Using a monthly subscription cycle, car-/bike-sharing appears viable to include in a bundle for 35%/31% of all respondents, respectively. Using a weekly subscription cycle, these figures drop to 1.4%/0.4%, respectively, as weekly variation in demand is much higher than monthly variation. In contrast to many current MaaS pilots, taxi use remains too infrequent to include as recurring credit in MaaS plans. Rather, pay-as-you-go is the economically more sensible option for consumers. This research therefore challenges the idea of all-inclusive mobility flat rates and suggests a more modular design.
Cost estimation of landfill leachate treatment by reverse osmosis in a Brazilian landfill
Authors: de Almeida Ronei , Bila Daniele Maia , Quintaes Bianca Ramalho , Campos Juacyara Carbonelli
Published: June 2020

The reverse osmosis (RO) process has been increasingly applied to landfill leachate treatment. The published literature reports several studies that investigated the technical feasibility of RO. However, information about process costs is scarce. Also, companies that run leachate treatment plants do not provide actual costs. To fill this gap, this study aimed to evaluate the treatment costs of a full-scale RO for the treatment of landfill leachate located in Rio de Janeiro State, Brazil. A procedure was proposed to estimate the capital expenses (CAPEX), operational expenses (OPEX), and specific total treatment cost, the total cost per m3 of treated leachate, of the leachate treatment by membrane process, and the results obtained are discussed. The CAPEX for this full-scale RO was estimated at MUS$ 1.413, and OPEX ranged from US$ 0.132 to US$ 0.265 m−3 per year. The cost of leachate treatment has been estimated at US$ 8.58 m−3 considering the operation of the RO-unit for 20 years after landfill closure.
Reclaiming Alleyways to Improve Network Connectivity: Lessons from Dubai’s Neighborhoods
Authors: Alawadi Khaled , Alameri Hind , Scoppa Martin
Published: June 2020

This study highlights the necessity of studying both streets and alleyways when assessing network connectivity efficiency. Taking Dubai as a case, the research evaluates eleven neighborhoods with different streets and alleyways systems designed during different growth periods. The focus is placed on the efficiency of different street layouts and explores the contribution of alleys to that efficiency. A Pedestrian Route Directness (PRD) test is used to assess the efficiency of neighborhoods streets and alleys system. Findings show that alleys improved connectivity once added to the network showing an improvement in average PRD values, network densities, and plots passing the test.
Intimate Partner Violence Victimization and Mental Health Among Men Who Have Sex With Men Living With HIV in Guatemala
Authors: Davis Dirk A. , Rock Amelia , Santa Luce Renato , McNaughton-Reyes Luz , Barrington Clare
Published: June 2020

Gay, bisexual, and other men who have sex with men (MSM) are disproportionately affected by poor mental health compared to their heterosexual counterparts. One factor that may increase mental health problems among MSM is intimate partner violence (IPV) victimization. The objectives of this study are to (a) describe the prevalence of different forms of IPV victimization experienced by MSM living with HIV in Guatemala City and (b) examine the relationship between IPV victimization and mental health. We analyzed cross-sectional survey data from a cohort of MSM living with HIV in Guatemala City ( n = 374) to describe the burden of IPV, including physical, sexual, and emotional IPV. We then examined relationships between lifetime IPV and each form of recent IPV (past 12 months) with self-reported anxiety and depression using multivariable logistic regression. Over a quarter (27.3%) of the participants screened positive for anxiety and nearly one fifth (17.9%) screened positive for depression. Over a quarter of the participants (28.6%) reported ever having experienced any IPV victimization and 8.8% reported having experienced any form of recent IPV. In multivariable analyses, participants who experienced any form of lifetime IPV had roughly twice the odds of experiencing anxiety (OR: 1.86; 95% CI = [1.03, 3.38]) and depression (OR: 2.02; 95% CI = [1.02, 3.99]) compared to those who had not. Participants who experienced recent emotional IPV had over seven times the odds of experiencing anxiety (OR: 7.23; 95% CI = [1.46, 38.85]) compared to those who had not. MSM living with HIV in Guatemala experience a high burden of anxiety, depression, and IPV victimization. Those participants who had experienced lifetime IPV and recent emotional IPV were significantly more likely to screen for anxiety and depression. To improve their mental health, HIV clinics and other health services should provide support for MSM who have experienced IPV victimization.
The Effect of Doll Therapy on Agitation and Cognitive State in Institutionalized Patients With Moderate-to-Severe Dementia: A Randomized Controlled Study
Authors: Yilmaz Cemile Kütmeç , Aşiret Güler Duru
Published: June 2020

This study is aimed at identifying the effect of doll therapy on agitation and cognitive state in institutionalized patients with moderate-to-severe dementia. This randomized controlled experimental study was conducted from April 8, 2019, to October 30, 2019, in a nursing home in Aksaray, Turkey. In total, 29 people with dementia participated in this study, 15 of whom comprised the intervention group. The control group, in which no intervention was made, was composed of the remaining 14 individuals. Data were collected using the introductory information form and the Standardized Mini-Mental State Examination (SMMSE) to evaluate cognitive status, and the Neuropsychiatric Inventory (NPI) and Cohen-Mansfield Agitation Inventory (CMAI) to evaluate behavioral disturbances. Patients with dementia in the intervention group received doll therapy for 8 weeks. We found that there was no statistically significant change between fourth- and eighth-week SMMSE scores for either the intervention or control groups ( P > .05), while there was a significant change in the CMAI and NPI scores of the intervention group ( P < .05). This study found that doll therapy was effective in decreasing agitation and behavioral problems in people diagnosed with moderate-to-severe dementia.

Trial registration:

ClinicalTrials.gov , ID: NCT04120103 Retrospectively registered on 8 April 2019.
Young- and Late-Onset Dementia: A Comparative Study of Quality of Life, Burden, and Depressive Symptoms in Caregivers
Authors: Kimura Nathália R. S. , Simões José Pedro , Santos Raquel Luiza , Baptista Maria Alice Tourinho , Portugal Maria da Glória , Johannessen Aud , Barca Maria Lage , Engedal Knut , Laks Jerson , Rodrigues Valeska Marinho , Dourado Marcia C. N.
Published: June 2020

Objective:

To compare the quality of life, burden, and depressive symptoms of caregivers of individuals with young-onset dementia (YOD) and late-onset dementia (LOD).

Methods:

Using a cross-sectional design, a convenience sample of 110 dyads of individuals with dementia and their caregivers, all living in the community, was included. The care recipients completed assessments about cognition, quality of life, and awareness of disease. Caregivers’ quality of life, resilience, depressive and anxiety symptoms, hopelessness, and burden of care were assessed.

Results:

A significant difference was found in caregivers’ burden and depressive symptoms according to the age of onset. However, there was no difference in caregivers’ quality of life between YOD and LOD groups. In both groups, a linear regression analysis indicated that caregivers’ perspective of quality of life of care recipient and caregivers’ hopelessness were associated with their quality of life. In addition, in the LOD group, caregivers’ burden was associated with their perspective of the quality of life of care recipient, type of kinship, and presence of emotional problems. In the YOD group, caregivers’ burden was associated with duration of caregiving role, cohabitating with care recipient, and their anxiety symptoms. Caregivers’ depressive symptoms were associated with anxiety symptoms in the YOD group, whereas hopelessness was associated with caregivers’ depressive symptoms in both the groups.

Conclusion:

Our findings suggest that the factors that affect quality of life, burden, and depressive symptoms of caregivers of individuals with LOD differ from those that affect the caregivers of individuals with YOD.
Pharmacist-Driven Implementation of Outpatient Antibiotic Prescribing Algorithms Improves Guideline Adherence in the Emergency Department
Authors: Stoll Kristin , Feltz Erik , Ebert Steven
Published: June 2020

Background:

Inappropriate prescribing of antibiotics has been identified as the most important modifiable risk factor for antimicrobial resistance.

Objective:

The purpose of this project was to improve guideline adherence and promote optimal use of outpatient antibiotics in the emergency department (ED).

Methods:

Prescribing algorithms for community-acquired pneumonia (CAP), skin and soft tissue infections (SSTI), and urinary tract infections (UTI) were developed to integrate clinical practice guideline recommendations with local ED antibiogram data. Outcomes were evaluated through chart review of patients prescribed outpatient antibiotics by ED providers. The primary outcome was adherence to clinical practice guidelines, defined as the selection of an appropriate antibiotic agent, dose, and duration of therapy for each patient discharged.

Results:

When compared to patients discharged from the ED prior to algorithm implementation (N = 325), the post-implementation group (N = 353) received more antibiotic prescriptions that were completely guideline adherent (61.5% vs 11.7%, P < .00001). Post-implementation discharge orders demonstrated improvement in the selection of an appropriate agent (87.3% vs 45.5%, P < .00001), dose (91.5% vs 77.2%, P < .00001), and duration of therapy (71.1% vs 39.1%, P < .01). Additionally, fluoroquinolone prescribing rates were reduced (2.3% vs 12.3%, P < .00001). A reduction in all-cause 30-day returns to the ED or urgent care was observed (15.3% vs 21.5%, P = .036).

Conclusion:

Pharmacist-driven implementation of antibiotic prescribing algorithms improved guideline adherence in the outpatient treatment of CAP, SSTI, and UTI.
A method to automatically push keywords for biological information searching in bio-inspired design
Authors: Chen Chen , Li Yan , Tao Ye , Chen Jiadui , Liu Qiyu , Li Song
Published: June 2020

In bio-inspired design, identifying keywords is an important step of biological information searching. Based on existing information retrieval approaches, the amount of relevant biological information in a search result largely depends on the identified keywords. Due to the limitation of biological knowledge, design engineers are difficult to identify the appropriate keywords that can find the biological information related to engineering requirements. To address this issue, we present an algorithm that can calculate the Composite Correlation Intension of functionally combined words, which integrates semantic similarity computation, data normalization, and corpus technology. Based on the algorithm, a method that automatically pushes keywords for biological information searching in bio-inspired design is also proposed. The method decomposes engineering requirements and structures functionally combined words, calculates the Composite Correlation Intension values of all functionally combined words, ranks the functionally combined words by the Composite Correlation Intension values, takes the functionally combined words with larger Composite Correlation Intension values as keywords, and pushes them. Through these keywords, design engineers retrieve the relevant biological information and discover the required design knowledge. In order to facilitate the use of proposed method, an auxiliary tool was developed in Python environment. Finally, the possibility of proposed method was demonstrated by a preliminary validation and an application case. The results show that the proposed method would be a promising alternative to identify keywords for biological information searching in bio-inspired design.