bluuebunny/crossref_metadata_2025 huggingface dataset:
Asymmetric bending response of shape memory alloy beam with functionally graded porosity
Authors: Fahimi Pouya , Hajarian Amin , Eskandari Amir Hossein , Taheri Ali , Baghani Mostafa
Published: July 2020

In this study, an innovative semi-analytical model is presented to simulate the bending behavior of a shape memory alloy porous beam throughout loading and unloading cycles. The basis of the proposed method is the improved Brinson model which can capture the asymmetry behaviors of shape memory alloys in tension and compression. The comparison of the semi-analytical solution with two-dimensional finite element analysis results for both symmetric and asymmetric models of a homogeneous shape memory alloy beam is presented for model validation. Afterward, bending analysis of shape memory alloy beams with uniform porosity and functionally grading porosity is studied. For this purpose, first, the bending analysis of a shape memory alloy beam with uniform porosity is investigated to show the effects of porosity coefficient on the free tip deflection and slope. Then, the bending analysis of a shape memory alloy beam with functionally grading porosity is simulated. Reported findings with respect to symmetric and asymmetric models indicate that raising the porosity coefficient brings about an increase in deflection and slope. Also, it highlights the significant difference between the results of the asymmetric and symmetric models. The proposed semi-analytical solution can be utilized as an efficient tool for studying the effects of changing any of the porosity coefficient, the geometry, and material of shape memory alloy beams.
Modern Band and Special Learners
Authors: Knapp David
Published: July 2020

For the greater part of the past 50 years, music educators have advocated for contemporary approaches to music education that reflect the interests of students. This has recently manifested in an approach to music education that scholars call Modern Band. Though the term lacks any one definition, Modern Band classes typically involve popular music making with guitars, drum set, electric bass, and keyboard. Among the features of this approach is a student-centered orientation that is focused on the individual learner. Additionally, Modern Band is rooted in informal music-learning theory, which easily lends itself to the inclusive principles of universal design for learning and differentiated instruction. Because of this, Modern Band may be a perfect fit for inclusive music classrooms.
Intensification and Individualization of Self-Regulation Components Within Self-Regulated Strategy Development
Authors: Sanders Sara , Rollins Lauren Hart , Mason Linda H. , Shaw Ashley , Jolivette Kristine
Published: July 2020

Self-regulated strategy development (SRSD) is an effective instructional approach used to teach academic strategies for skills such as writing and reading comprehension. Included in SRSD are direct strategy instruction and explicit procedures for teaching self-regulation skills, a method that has been effective at improving academic skills of students with disabilities, including those with emotional and behavioral disorders (EBD). However, due to pre-existing deficits in self-regulation skills, students with EBD may benefit from intensifying the four self-regulation skills already present in SRSD. This article provides practical examples for intensifying goal setting, self-monitoring, self-instructions, and self-reinforcement within the existing SRSD instructional approach.
Effect of Novel Anteromedial Approach on Wound Complications Following Ankle Arthroplasty
Authors: Halai Mansur M. , Pinsker Ellie , Daniels Timothy R.
Published: July 2020

Background:

The purpose of this study was to evaluate all wound complications following total ankle arthroplasty (TAA) before and after the implementation of a novel extensile anteromedial surgical approach. We further investigated patients and operative factors associated with wound complications.

Methods:

A series of 660 TAAs were collected. The median follow-up was 84 months (range, 12-204 months). Minor wound complications included discoloration, swelling, or clinical concern that merited bringing the patient back sooner for review. Major wound complications included plastic surgical consultation, debridement by the nurse specialist, negative pressure therapy, or reoperation. All major complications initially had a course of empirical oral antibiotics. Since 2011, higher-risk patients have had their TAA performed through an extensile anteromedial approach.

Results:

Fifty-six patients (8.5%) had wound healing issues (17 major [2.6%], 39 minor [5.9%]). All issues became evident <21 days postoperatively. Inflammatory arthritis, smoking, and coronary disease were patient factors associated with major wound complications. Four patients were treated with negative pressure therapy, 4 with debridement in the operating room, and 2 eventually converted to fusions. Fourteen patients (82%) who had major complications had an ancillary procedure to balance the TAA through a separate incision. All major wound complications had an anterior surgical approach for their TAA. Before 2011, there were 13 major wound complications. Since 2012, there have been 4 major wound complications overall, with no wound complications in the anteromedial approach cohort.

Conclusion:

We recommend an extensile anteromedial approach for smokers and patients with heart disease or inflammatory arthritis undergoing TAA. If a wound complication developed, a multidisciplinary team to evaluate wounds was useful.

Level of Evidence:

Level III, retrospective comparative series.
An Educational Intervention Incorporating Digital Storytelling to Implement Family Nursing Practice in Acute Care Settings
Authors: Beierwaltes Patricia , Clisbee David , Eggenberger Sandra K.
Published: July 2020

This project describes implementation of an educational intervention designed to initiate practice changes that support families and nurses during acute illness. An academic–practice partnership and digital storytelling methodology provided a foundation. A quasi-experimental research design included quantitative and qualitative measurement before and after the educational intervention. Themes identified in digital stories of nurse experiences caring for families provided direction for the educational intervention including the digital stories, empirical evidence, and proposed changes in nursing practice focused on families. Nurse participants ( n = 160) in the educational intervention reported positive responses on a qualitative questionnaire. Comparing pretest and posttest results of the Family Nurse Practice Scale reflected positive, though not significant change. Family members ( n = 49) reported significantly improved perceptions of support on 7 of the 14 items on the Iceland Perceived Family Support Questionnaire. This project highlighted digital storytelling’s power to promote family interventions and move family nursing knowledge into practice.
The Evolutionary Nature of Parent–Provider Relationships at Child’s End of Life With Cancer
Authors: dos Santos Maiara R. , Szylit Regina , Deatrick Janet A. , Mooney-Doyle Kim , Wiegand Debra L.
Published: July 2020

Relationship strains between families and providers can have intense repercussions on the bereavement experience. Little is known about how to define and differentiate relationships within various interpersonal contexts and how those families manifest their bereavement. Therefore, the purpose of this study was to understand parental experiences about their relationships with providers at their child’s end of life with cancer and describe the manifestations of their grief. In this hermeneutic study, data were collected through interviews with bereaved parents and observation of families and health care providers in the hospital setting. Parents variously experienced complex relationships characterized by support, collaboration, trust, silence, deterioration, hierarchy, and tolerating, which were interchangeable and varied overtime, as new meanings were incorporated into their experiences. Through better understanding of the nature of these relationships, nurses can provide leadership in research and practice for identifying consequences of their care.
A Meta-Analysis Evaluating the Incidence of Bleeding Events With Intravenous Defibrotide Treatment Outside the Veno-Occlusive Disease/Sinusoidal Obstruction Syndrome Setting
Authors: Tappe William , Aggarwal Saurabh , Topaloglu Ozlem , Iacobelli Massimo
Published: July 2020

Defibrotide is approved to treat hepatic veno-occlusive disease/sinusoidal obstruction syndrome (VOD/SOS) with renal/pulmonary dysfunction following hematopoietic cell transplantation (HCT) in adult and pediatric patients in the United States, and to treat severe hepatic VOD/SOS post-HCT in adult and pediatric patients aged >1 month in the European Union. The defibrotide prescribing information warns that defibrotide may increase bleeding risk in VOD/SOS patients. To broaden our understanding of the incidence of bleeding with defibrotide, we performed a meta-analysis of the published literature of defibrotide use outside of the post-HCT VOD/SOS setting. Of 1857 records identified, 125 reported on defibrotide; 23 contained data on bleeding events. The estimated overall incidence of bleeding events was 1% (95% confidence interval [CI]: 0%-2%) and 8% (95% CI: 3%-14%) in studies using intravenous defibrotide and studies with controls, respectively. The risk ratio for bleeding events with intravenous defibrotide versus controls was 0.36 (95% CI: 0.24-0.52; P < .00001) among studies with data on intravenous defibrotide and controls. This meta-analysis of defibrotide use outside of the post-HCT VOD/SOS setting suggests that the incidence of bleeding with defibrotide is lower than controls.
The Debate About the Human Papilloma Virus Vaccine: The Impact of an Evidence-Based Communicative Method on Increasing Free Choice
Authors: Ramis-Salas Mimar
Published: July 2020

Democratic access to scientific evidence contributes to the freedom of individuals to make informed decisions regarding scientific findings that affect their lives. In the case of the human papilloma virus (HPV), which causes cervical cancer, a debate exists regarding preventing HPV infection that is not supported by evidence-based interventions. For instance, there are positions both in favor of and against an HPV vaccine that are not evidence-based, thus preventing women from deciding freely whether to be vaccinated. Based on a communicative approach, this article describes the use of communicative focus groups and communicative daily life stories in which the researcher shares up-to-date information on HPV prevention, particularly through vaccination and screening, with high-schoolgirls in an urban context in Spain. Through the focus groups and daily life stories, the young women evaluated the impact of evidence-based dialogues, which could increase their opportunities to make free choices regarding the HPV vaccine and other medicines.
Poetry Spheres, Flower Poems: A Dimensional Poetry Experience
Authors: Lahman Maria K. E. , De Oliveira Becky
Published: July 2020

In a doctoral course on Narrative Inquiry, graduate students participated in an activity creating dimensional research poetry. The resulting poems, which were shaped like spheres or orbs and/or flowers, were made up of lines of narrative interview transcripts and researchers’ reflections, either computer printed or handwritten on strips of construction paper. In this article, a review of dimensional poetry, including concrete poetry and three-dimensional poetry, is provided. Examples of flowers in poetry from descriptive to symbolic of resistance against poverty, class, war, and race are presented throughout. The instructor and a student in the course who also served as the photographer reflect on the experience.
Real-world data on patients with metastatic non-small-cell lung cancer treated with checkpoint inhibitors in an Italian Teaching Hospital in 2015–2018
Authors: Veraldi Marianna , Esposito Stefania , Naturale Maria D. , Oradei Marco , Cosco Donato , Francesco Adele E. De , Cicchetti Americo , Bidino Rossella Di
Published: July 2020

Background

Non-small-cell lung carcinoma (NSCLC) accounts for 85–90% of all forms of lung cancer. Immuno-oncology represents a valid new approach but the high cost requires a specific evaluation of the health outcomes. This study describes the real-world efficacy, safety and cost profiles of the new anti-PD-1 immune-checkpoint inhibitors nivolumab and pembrolizumab on a cohort of 56 selected patients with advanced NSCLC.

Methods

A retrospective, observational analysis was conducted on patients treated with immune checkpoint inhibitors from September 2015 to September 2018 at Azienda Ospedaliera Universitaria “Mater Domini” in Catanzaro, Italy. Data sources were medical records, internal prescription cards and reports of adverse reactions.

Results

Fifty-six patients were diagnosed with advanced NSCLC, 64.3% characterized by a non-squamous histology, 30.3% squamous and 5.4% not specified. First-line treatment with pembrolizumab was administered to 11 patients for an average of 4.4 months, while 45 patients were treated with nivolumab for an average of 8.6 months. Data showed a survival rate of 95% after 6 months and 88% after 12 months. Most patients received immunotherapy as a second-line or subsequent treatment. In terms of prior therapy among all the patients, 43 had received platinum-based treatments. Indirect comparison with other real-world data studies showed variability in methodologies and an alignment in terms of results.

Conclusion

This study, based on real-world data, was a first step in the assessment of the impact of the introduction of a significant new class of treatments, i.e. immunotherapy, and covers patients, treatments and outcomes, as well as organizational and economic variables.
Parsing out the “Hispanic Effect” in Disaggregated Homicide Trends at the Intersection of Race, Ethnicity, and Gender from 1990 to 2016
Authors: Gaston Shytierra , Sewell CheyOnna
Published: July 2020

This study contributes to homicide research by parsing out the Hispanic Effect and applying an intersectional approach to examining U.S. homicide victimization trends by race, ethnicity, and gender, jointly. Drawing on mortality data, we document and describe total, firearm, and non-firearm homicide victimization rates from 1990 to 2016 for six subgroups: Black women, Black men, Hispanic women, Hispanic men, White women, and White men. The analysis of within- and between-group homicide trends reveals important subgroup-specific patterns that prior studies using aggregate or confounded data have masked. The findings have important research, theory, and policy implications and advocate for an intersectional approach to studying homicide.
Aflatoxin B1-Induced COX-2 Expression Promotes Mitophagy and Contributes to Lipid Accumulation in Hepatocytes In Vitro and In Vivo
Authors: Ren Xin-Lu , Han Peiyu , Meng Yiteng
Published: July 2020

Aim:

Aflatoxin B1 (AFB1) is hepatotoxic. Numerous studies have shown that mitochondria play an essential role in AFB1-induced steatosis. However, the mechanisms of AFB1-induced steatosis via mitochondria are still obscure. The present study aimed to confirm that AFB1 causes hepatocyte steatosis regulated by cyclooxygenase-2 (COX-2)-induced mitophagy, both in vivo and in vitro.

Methods:

Adult male C57BL/6 mice were randomly divided into control group with the same volume of peanut oil and exposure group administered 0.6 mg/kg AFB1 once in 2 days for 1 month. HepG2 and Cas9-PTGS2 cells were treated with 5 μM AFB1 for 48 hours. Then, various indicators were evaluated.

Results:

Aflatoxin B1 causes liver injury and steatosis with increased alanine aminotransferase, aspartate aminotransferase, total cholesterol, total triglyceride levels in vivo and in vitro, and elevated lipid droplets in HepG2 cells. Cyclooxygenase-2 and mitophagy pathway were induced by AFB1 in both liver tissues and cultured HepG2 cells. Further studies have shown that knockout of COX-2 with the CRISPR/Cas9 system inhibited the AFB1-induced mitophagy and steatosis in HepG2 cells. Also, the inhibition of PTEN-induced putative kinase with RNA interference attenuated the AFB1-induced steatosis.

Conclusions:

The results of the current study suggested that AFB1 increases the expression of COX-2, which, in turn, elevates the level of mitophagy, thereby disrupting the normal mitochondrial lipid metabolism and causing steatosis. Thus, this study implies that COX-2 may be a potential target for therapy against AFB1-induced steatosis.
Hospitality Bridging Healthcare: Career Opportunities for The Future Hotel School Graduate
Authors: DeMicco Frederick J. , La Forgia John
Published: July 2020

Hospitality Bridging Healthcare or H2H services can create a satisfying experience for the patient/guest, which can lead to long-lasting loyalty. Hospitality and health care services will play a critical role for success in the entirety of the process. University graduates of hotel and hospitality schools that focus on this intersection of H2H will be rewarded with challenging and lucrative careers. The path forward includes developing a core curriculum and courses for this promising new H2H career track. It will be an intersection of business management, health care administration, and hotel/hospitality business management theory and practice with an appropriate industry internship with hands-on learning in the hospitals, health care, and medical centers.
Pilot study assessing the use of cabergoline for the treatment of cats with hypersomatotropism and diabetes mellitus
Authors: Scudder Christopher J , Hazuchova Katarina , Gostelow Ruth , Church David B , Forcada Yaiza , Fowkes Robert C , Niessen Stijn JM
Published: July 2020

Objectives

An affordable and effective treatment is needed to manage feline hypersomatotropism. The aim of this study was to assess whether treatment with oral cabergoline for 90 days in cats with hypersomatotropism and diabetes mellitus improved diabetic and insulin-like growth factor 1 (IGF-1) control.

Methods

This was a prospective cohort non-blinded pilot study enrolling client-owned cats with spontaneously occurring diabetes mellitus and hypersomatotropism. Cats received oral cabergoline (5–10 µg/kg q24h) for 90 consecutive days. Serum IGF-1 and fructosamine concentrations were measured on days 1, 30 and 90. Quality of life was determined using the DIAQoL-pet questionnaire on days 1 and 90.

Results

Nine cats were enrolled and eight completed the study. There was no significant change in the following: IGF-1 (day 1 median 2001 ng/ml [range 890–2001 ng/ml]; day 30 median 2001 ng/ml [range 929–2001 ng/ml]; day 90 median 1828 ng/ml [range 1035–2001 ng/ml]; χ2(2) = 0.667, P = 0.805); fructosamine (day 1 median 499 µmol/l [range 330–887 µmol/l], day 30 median 551 µmol/l [range 288–722 µmol/l], day 90 median 503 [range 315–851 µmol/l]; χ2(2) = 0.581, P = 0.764); or DIAQoL-pet score (median on day 1 –2.79 [range –4.62 to –0.28], median on day 90 –3.24 [range –4.41 to –0.28]; P = 0.715). There was a significant change of insulin dose (χ2(2) = 8.667, P = 0.008) with cats receiving higher insulin doses at day 90 compared with day 1 (median on day 1 was 0.98 [range 0.63–1.49] and median on day 90 was 1.56 [range 0.49–2.55] units/kg q12h; P = 0.026).

Conclusions and relevance

Cabergoline did not improve diabetic control or normalise insulin-like growth factor concentration, or improve patient quality of life.
Brain-derived neurotrophic factor in non-proliferative diabetic retinopathy with diabetic macular edema
Authors: Jun Yong Hyun , Kim Seong Taeck
Published: July 2020

Purpose:

To investigate aqueous humor (AH) and serum levels of brain-derived neurotrophic factor (BDNF) in non-proliferative diabetic retinopathy (NPDR) patients with diabetic macular edema (DME).

Methods:

The prospective study consists of 20 patients with DME NPDR, 20 patients with no-DME NPDR, and 20 healthy control subjects. Serum and AH samples were obtained during cataract surgery and intravitreal injection. Serum and AH levels of BDNF were measured by enzyme-linked immunosorbent assay.

Results:

The mean serum levels of BDNF were lower in both NPDR groups compared to the control group (DME NPDR group, p = 0.015; no-DME NPDR group, p = 0.024). Furthermore, the mean serum level of BDNF was lower in the DME NPDR group compared to the no-DME NPDR group ( p = 0.041). The mean AH levels of BDNF were significantly reduced in both NPDR groups compared to the control group (DME NPDR group, p < 0.001; no-DME NPDR group, p = 0.006). Further, the mean AH level of BDNF was significantly lower in the DME NPDR group compared to the no-DME NPDR group ( p = 0.037).

Conclusion:

Serum and AH levels of BDNF were reduced in NPDR patients with DME than without DME.
Corneal collagen cross-linking for management of keratoconus in patients affected by Tourette syndrome
Authors: Knutsson Karl Anders , Paganoni Giorgio , Ambrosio Oriella , Ferrari Giulio , Rama Paolo
Published: July 2020

Purpose:

To present a series of two patients affected by Tourette syndrome (TS) and progressive keratoconus.

Case series:

Two young male patients with keratoconus and TS were referred to our center. In both patients eye rubbing was present and in one patient, an ocular tic was present determining blepharospasm. Progression of keratoconus occurred in both cases and corneal collagen cross-linking (CXL) was performed. All treated eyes showed topographic stability with stable refraction and conserved visual acuity, with a follow-up period ranging from 1.5 to 2.5 years.

Conclusion:

Patients with keratoconus and TS should be observed frequently to document topographical and refractive changes, and in case of progressing disease, CXL should be performed in order to prevent further progression.
How do policy evaluators understand complexity?
Authors: Barbrook-Johnson Pete , Proctor Amy , Giorgi Sara , Phillipson Jeremy
Published: July 2020

There is a well-documented interest in how insights from the study of complexity can be applied to policy evaluation. However, important questions remain as to how complexity is understood and used by policy evaluators. We present findings from semi-structured interviews with 30 UK policy evaluators working in food, energy, water and environment policy domains. We explore how they understand, use and approach complexity, and consider the implications for evaluation research and practice. Findings reveal understandings of complexity arising from contextual factors, scale-related issues and perceptions of unpredictability. The evidence indicates terminological and analogical use of complexity and its concepts by policy evaluators, but limited evidence of its literal use. Priorities for the future include framing complexity more pragmatically and as an opportunity not a cost. Communicating this up the policy hierarchy is the key to progressing complexity-appropriate evaluation – this can be enabled by strengthening links between policy evaluation and academic communities.
Service use by youth with autism within a system-driven implementation of evidence-based practices in children’s mental health services
Authors: Stadnick Nicole A , Lau Anna S , Dickson Kelsey S , Pesanti Keri , Innes-Gomberg Debbie , Brookman-Frazee Lauren
Published: July 2020

Public mental health systems play an important role in caring for youth with autism spectrum disorder. Like other dually diagnosed populations, youth with autism spectrum disorder may receive services in the context of evidence-based practice implementation efforts within public mental health systems. Little is known about service use patterns within the context of system-driven implementations efforts for this population. This case–control study examined mental health service patterns of 2537 youth with autism spectrum disorder compared to 2537 matched peers receiving care in the Los Angeles County Department of Mental Health, the largest public mental health department in the United States, within the context of a system-driven implementation of multiple evidence-based practices. Although not the primary target of this implementation effort, youth with autism spectrum disorder were served when they met criteria for the services based on their presenting mental health symptoms. Comparative analyses using administrative claims data were conducted to examine differences in mental health utilization patterns and clinical characteristics. Findings revealed significant differences in the volume and duration of mental health services as well as differences in the service type and evidence-based practice delivered between youth with and without autism spectrum disorder. Results provide direction targeting implementation efforts for youth with autism spectrum disorder within a public mental health system care reform.
Implementing a socio-technical system for computer-aided tuberculosis diagnosis in Peru: A field trial among health professionals in resource-constraint settings
Authors: Ugarte-Gil Cesar , Icochea Maria , Llontop Otero Juan Carlos , Villaizan Katerine , Young Nicola , Cao Yu , Liu Benyuan , Griffin Terence , Brunette Maria J
Published: July 2020

A major challenge of tuberculosis diagnosis is the lack of universal accessibility to bacteriological confirmation. Computer-aided diagnostic interventions have been developed to address this gap and their successful implementation depends on many health systems factors. A socio-technical system to implement a computer-aided diagnostic tuberculosis diagnosis was preliminary tested in five primary health centers located in Lima, Peru. We recruited nurses (n = 7) and tuberculosis physicians (n = 5) from these health centers to participate in a field trial of an mHealth tool (eRx X-ray diagnostic app). From September 2018 to February 2019, the nurses uploaded images of chest X-rays using smartphones and the physicians reviewed those images on web-based platforms using tablets. Both completed weekly written feedback about their experience. Each nurse participated for a median duration of 12 weeks (interquartile range = 7.5–15.5), but image upload was only possible at a median of 58 percent (interquartile range = 35.1%–84.4%) of those weeks. Each physician participated for a median duration of 17 weeks (interquartile range = 12–17), but X-ray image review was only possible at a median of 52 percent (interquartile range = 49.7%–57.4%) of those weeks. Heavy workload was most frequently provided as the reason for missing data. Several infrastructural and technological challenges impaired the effective implementation of the mHealth tool, irrespective of its diagnostic accuracy.
To deport or to ‘adopt’? The Israeli dilemma in dealing with children of non-Jewish undocumented migrants
Authors: Kalir Barak
Published: July 2020

This article analyses the unprecedented decision taken by the Israeli state in 2005 to legalize the status of non-Jewish undocumented migrants’ children. In explaining how the plight of culturally assimilated non-Jewish children succeeded in penetrating the hermetic ethno-religious definition of citizenship in Israel, the article focuses on the subtle yet critical influence of kinship on modern state-making and the affective fashioning of national belonging. By insisting on treating culturally assimilated non-Jewish children as Others, Israel increasingly ran the risk of unveiling the feeble construction of the Jewish nation in terms of kinship as ‘one big family’. The Israeli media increasingly began to question the refusal of the state to recognize children who were evidently ‘Israelis in every way’. Such a development, as some Israeli politicians undoubtedly realized, could have potentially been more detrimental to the mythological foundations of the Jewish state than the ‘adoption’ of a few hundred non-Jewish children.
No Evidence for a Trade-Off Between Competitive Traits and Ejaculate Quality in Humans
Authors: DeLecce Tara , Shackelford Todd K. , Fink Bernhard , Abed Mohaned G.
Published: July 2020

Research in nonhuman animals (including insects, birds, and primates) suggests a trade-off in males between investment in competitive traits and investment in ejaculate quality. Previous research reported a negative association between perceived strength and ejaculate quality, suggesting that this trade-off also applies to human males. We conducted novel analyses of data secured as part of a larger project to assess the relationship between competitive traits (shoulder-to-hip ratio, handgrip strength, and height) and ejaculate quality (indexed by sperm morphology, sperm motility, and sperm concentration) in a sample of 45 men (ages ranging 18–33 years; M = 23.30, SD = 3.60). By self-report, participants had not had a vasectomy and had never sought treatment for infertility. We controlled for several covariates known to affect ejaculate quality (e.g., abstinence duration before providing an ejaculate) and found no statistically significant relationships between competitive traits and ejaculate quality; our findings therefore do not accord with previous research on humans. We highlight the need for additional research to clarify whether there is a trade-off between investment in competitive traits and investment in ejaculate quality in humans.
High myopia is protective against diabetic retinopathy via thinning retinal vein: A report from Fushun Diabetic Retinopathy Cohort Study (FS-DIRECT)
Authors: Lin Zhong , Li Dong , Zhai Gang , Wang Yu , Wen Liang , Ding Xiao Xia , Wang Feng Hua , Dou Yu , Xie Cong , Liang Yuan Bo
Published: July 2020

Purpose:

To investigate the association between high myopia and diabetic retinopathy, and its possible mechanism, in a northeastern Chinese population with type 2 diabetic mellitus.

Methods:

Patients were included from Fushun Diabetic Retinopathy Cohort Study. High myopia was defined as spherical equivalent of autorefraction less than −5D.

Results:

A total of 1817 patients [688 (37.9%) diabetic retinopathy, 102 (5.6%) high myopia] were included. Compared to eyes without high myopia, the frequency of diabetic retinopathy and non-proliferative diabetic retinopathy was significantly less in eyes with high myopia (23.5% vs 38.7%, p = 0.002; 22.5% vs 35.3%, p = 0.005). Eyes with high myopia were less likely to have diabetic retinopathy (multivariate odds ratio, 95% confidence interval: 0.39, 0.22–0.68) or non-proliferative diabetic retinopathy (odds ratio, 95% confidence interval: 0.40, 0.23–0.70). High myopia was negatively associated with central retinal venular equivalent (multivariate β, 95% confidence interval: −37.1, −42.3 to −31.8, p < 0.001). Furthermore, central retinal venular equivalent (per 10 μm increase) had a significant association with diabetic retinopathy (odds ratio, 95% confidence interval: 1.24, 1.17–1.31) as well as non-proliferative diabetic retinopathy (odds ratio, 95% confidence interval: 1.24, 1.18–1.31).

Conclusions:

High myopia was negatively associated with both diabetic retinopathy and non-proliferative diabetic retinopathy in this northeastern Chinese population. This protective effect may have been partially achieved via thinning retinal veins.
2P or not 2P: The Question of Seizure Initiation
Authors: Somarowthu Ala , Goldberg Ethan M.
Published: July 2020

[Box: see text]
Researching Lived Experience in Education: Misunderstood or Missed Opportunity?
Authors: Farrell Emma
Published: July 2020

Phenomenological research approaches have become increasingly popular in fields such as psychology, nursing, tourism, and health science but remain underrepresented in education research. This is surprising given that education, a discipline founded on attending to, and building upon, the knowledge and experiences of others, can only benefit from the insights and explication of human experience offered by phenomenological research. One reason for its disfavor may be the oft-intimidating philosophy that underpins, and is critical to the application of, phenomenological approaches to research. This article provides an overview of some of the phenomenology’s key philosophical principles. It pays particular attention to transcendental and hermeneutic phenomenology, their key proponents, and tenets and outlines some similarities and differences between these two phenomenological lineages. Efforts to translate the philosophical principles of phenomenology into an approach to research are discussed, and examples of the application of transcendental and hermeneutic phenomenological approaches to education settings are explored. Once described as more a carefully cultivated thoughtfulness than a technique, phenomenology as a methodology is examined in terms of its trustworthiness and its potential to deepen our Understanding (with a capital U) of the experiences of others. This article acts as a theoretical handrail to support researchers’ first steps into this rich philosophical and theoretical terrain with a view to encouraging increased adoption of this approach to research in education settings.
A real-time identification and mitigation solution generation method of random disturbance in a manufacturing system
Authors: Kang Yuyun , Feng Guifang , Wang Zhenhai
Published: July 2020

In order to timely identify and mitigate the adverse effect of the random disturbance in the manufacturing system, a method of identifying and mitigating the random disturbance is proposed. In the method, the disturbance is structured into several categories, and each is subdivided into several events. The disturbance data detected by the hardware system are normalized to 10 scales for more accurate monitoring. An evaluation model is built and it has a bi-layer criteria system, which can evaluate every category disturbance and the whole system at the same time. The fuzzy analytic hierarchy process is utilized to calculate the criteria weights and evaluate the impacts of the disturbance. Time and cost used as constraints are combined into the adjustment solution. The BP neural network is used to generate adjustment solution for the disturbance, and then the resource and task scheduler are adjusted to mitigate the loss caused by the disturbance. Finally, the proposed method is illustrated by an example, and the validity of the method is verified.
PD-1 expression on uveal melanoma induces tumor proliferation and predicts poor patient survival
Authors: Jiang Zhongming , Yan Yuexiang , Dong Juan , Duan Lingling
Published: July 2020

Introduction:

Uveal melanoma is one of the most common primary intraocular malignant tumors with poor prognosis and limited treatments. Programmed cell death receptor-1 (PD-1) blockade represents the primary treatment strategy of immune checkpoint inhibition; however, there is a lack of studies on whether PD-1 expression in primary (ocular) uveal melanoma affects tumor progression.

Methods:

PD-1 expression in 82 cases of primary (ocular) uveal melanoma was detected by immunohistochemistry. The clinical significance of PD-1 expression was evaluated using univariate and multivariate analysis. PD-1 overexpression and knockdown studies were conducted in C918 and Mum-2B cell lines to analyze the effect of PD-1 expression on tumor cell proliferation and intracellular cell signaling transduction. real-time qPCR (RT-qPCR) and western blot analysis were performed to investigate the gene expression level. CCK8 assays were performed to examine the cell proliferation ability.

Results:

High expression of primary (ocular) intratumor PD-1 was associated with poor patient survival. Moreover, PD-1 expression was correlated with the largest tumor diameter. PD-1 expression and optic nerve invasion were independent prognostic risk factors. PD-1 overexpression in uveal melanoma cell lines promoted tumor cell proliferation, while knockdown of PD-1 inhibited cell proliferation capacity.

Conclusion:

Our study established the role of PD-1 in the progression of uveal melanoma and provided a new potential treatment selection for uveal melanoma.
Ferrocenyl imidazolo[2,1-b]-1,3,4-thiadiazoles: A microwave-assisted catalyst-free synthesis, characterization, and biological activities
Authors: Liu Yuting , Yang Lan , Yin Dawei
Published: July 2020

Ferrocenyl imidazolo[2,1- b]-1,3,4-thiadiazoles are synthesized using 2-amino-5-substituted-1,3,4-thiadiazole and α-bromoacetyl ferrocene as substrates under microwave-assisted and catalyst-free conditions. The structures are characterized by infrared, 1H nuclear magnetic resonance, 13C nuclear magnetic resonance, mass spectrometry, and elemental analysis. Compared with conventional methods, the present protocol has the advantages of being rapid, efficient, environmentally friendly, and low cost. The results of biological activity studies showed that the products displayed better activities than those of 2-amino-5-substituted-1,3,4-thiadiazole. The biological activities of compounds in which R = phenyl were better than those with alkyl groups. Compounds with electron-withdrawing groups on the aryl moiety showed increased biological activities.
Intercarpal ligamentoplasty for scapholunate dissociation: comparison of two techniques
Authors: Athlani Lionel , Pauchard Nicolas , Dautel Gilles
Published: July 2020

We modified our original surgical technique of scapholunate intercarpal ligamentoplasty for treating chronic scapholunate dissociation. The aim of this study was to compare the outcomes in patients treated by the same surgical team with the original method and the modified method over two different time periods. Nineteen patients with a mean age of 40 years were treated with the original method (mean follow-up of 34 months, range 12–54), and 21 patients with a mean age of 38 years were treated with the modified method (mean follow-up of 27 months, range 13–40). In both groups, we found a significant improvement in pain levels, grip strength, functional scores in terms of QuickDASH and Patient-Rated Wrist Evaluation, and radiographic scapholunate gap and scapholunate angle after surgery. There were no significant differences between the two groups in outcome measures except the scapholunate gap, which was significantly better controlled by the modified procedure. Between the immediate postoperative period and the last follow-up, there was a significant increase in the scapholunate gap and scapholunate angle after the original method, while there only a small increase after the modified method. We conclude that both versions of the scapholunate intercarpal ligamentoplasty yield satisfactory clinical and radiological results in the short to mid-term. The modified method makes the triquetral surgical step easier and seems to better optimize the tension across the ligamentoplasty, thus maintaining the intercarpal correction.

Level of evidence: III
How to save time in surveillance without losing quality: comparison of two methods of surgical site infection surveillance in orthopaedic prosthetics in a French university hospital
Authors: Kuczewski Elisabetta , Munier-Marion Elodie , Amour Sélilah , Bénet Thomas , Rongieras Frédéric , Monneuse Olivier , Vanhems Philippe
Published: July 2020

Surgical site infection (SSI) surveillance methods are not standardised and are often time-consuming. We compared an active method, based on orthopaedic department staff reporting suspected SSI, with a semi-automated method, based on computerised extraction of surgical revisions, after total hip and knee arthroplasty. Both methods allowed finding the same SSI cases. We found the same sensitivity but higher specificity with a straightforward time gain using the passive method. This represents an added value for the organisation of an effective SSI surveillance, based on existing hospital databases.
A Digital Lifestyle Program in Outpatient Treatment of Type 2 Diabetes: A Randomized Controlled Study
Authors: Hilmarsdóttir Eva , Sigurðardóttir Árún K. , Arnardóttir Ragnheiður Harpa
Published: July 2020

Background:

Lifestyle is important in type 2 diabetes mellitus (T2DM). This study’s aim was to investigate whether a healthy-lifestyle-supporting smartphone application could affect treatment outcomes at an endocrinology outpatient clinic.

Methods:

Consecutively invited patients were randomly assigned to an intervention or control group after age and gender stratification. In addition to standard care, intervention group participants used a smartphone application to access a lifestyle program (SidekickHealth) through which they received personalized recommendations and education about healthy lifestyles. Tests at baseline and every other month for six months included body weight and blood tests for glycated hemoglobin (HbA1c) and blood lipids, as well as questionnaires about distress related to diabetes, health-related quality of life, depression, and anxiety. Statistics included comparisons both within and between groups.

Results:

A total of 37 patients (23 women) were included, whereof 30 finished, 15 in each group (19% dropout); the average age was 51.2 ± 10.6 (25-70) years. No significant differences emerged between groups, but within the intervention group, there was a significant decrease in HbA1c from 61 ± 21.4 to 52.7 ± 15.2 mmol/mol, in disease-specific distress from 19.5 ± 16.5 to 11.7 ± 13.4, and in anxiety symptoms from 5.4 ± 4.0 to 4.1 ± 3.8. No significant changes occurred within the control group. The application usage was most frequent during the first months and differed interpersonally.

Conclusions:

Our results indicate that the SidekickHealth digital lifestyle program could potentially enhance outpatient treatment in T2DM, in terms of both glycemic control and psychological well-being but larger confirmative studies are needed.
The Importance of Patience in Kierkegaard’s Becoming Self
Authors: Bowen Amber
Published: July 2020

This article examines the significance of patience in Søren Kierkegaard’s 1843–1844 discourses on patience as a needed corrective for the “common sense” perception of time as an adversary rather than a friend. Kierkegaard stresses the biblical idea of the goodness of time especially in connection to the formation of the self. According to his authorship, the self is not a static being, but one that develops, expands, and becomes its most mature expression through God’s transformative work in time. This perspective on the self and its relationship to time illuminates the crucial role of patience as an essential formative virtue. While there are many insights to be garnered from Kierkegaard’s idea of patience for philosophical discussions on the nature of the self, this article focuses on how they are especially salient and applicable for spiritual formation and discipleship.
School Nurses on the Front Lines of Healthcare: Children With Medical Devices—A “BOLUS” of Information About Gastrostomy Tube Malfunctions and Infections
Authors: Farou Noa , Lucas Christy , Olympia Robert P.
Published: July 2020

An important subgroup of children with special healthcare needs are children with medical complexities that require long-term, intensive healthcare interventions and treatments. As medical technology continues to advance and children with complex medical needs survive the neonatal period and progress into school-age, it is essential for school nurses to be able to recognize and acutely manage complications and malfunctions of devices in children requiring assistance from medical devices. An example of a common medical device includes gastrostomy tubes (aka G-tubes or GJ-tubes), ensuring nutrition in children with failure to thrive, significant developmental delay, swallowing dysfunction, or severe gastroesophageal reflux. These devices put children at serious medical or surgical risk when they malfunction, so it is important for healthcare providers, especially school nurses who are the first responders in schools, to recognize malfunctions and initiate appropriate care management.
Clinically Relevant Molecular Biomarkers for Use in Human Knee Osteoarthritis: A Systematic Review
Authors: Convill James G. , Tawy Gwenllian F. , Freemont Anthony J. , Biant Leela C.
Published: July 2020

Objective

Biomarkers in osteoarthritis (OA) could serve as objective clinical indicators for various disease parameters, and act as surrogate endpoints in clinical trials for disease-modifying drugs. The aim of this systematic review was to produce a comprehensive list of candidate molecular biomarkers for knee OA after the 2013 ESCEO review and discern whether any have been studied in sufficient detail for use in clinical settings.

Design

MEDLINE and Embase databases were searched between August 2013 and May 2018 using the keywords “knee osteoarthritis,” “osteoarthritis,” and “biomarker.” Studies were screened by title, abstract, and full text. Human studies on knee OA that were published in the English language were included. Excluded were studies on genetic/imaging/cellular markers, studies on participants with secondary OA, and publications that were review/abstract-only. Study quality and bias were assessed. Statistically significant data regarding the relationship between a biomarker and a disease parameter were extracted.

Results

A total of 80 studies were included in the final review and 89 statistically significant individual molecular biomarkers were identified. C-telopeptide of type II collagen (CTXII) was shown to predict progression of knee OA in urine and serum in multiple studies. Synovial fluid vascular endothelial growth factor concentration was reported by 2 studies to be predictive of knee OA progression.

Conclusion

Despite the clear need for biomarkers of OA, the lack of coordination in current research has led to incompatible results. As such, there is yet to be a suitable biomarker to be used in a clinical setting.
Cardiorespiratory fitness and survival following cancer diagnosis
Authors: Fardman Alexander , Banschick Gabriel D , Rabia Razi , Percik Ruth , Fourey Dana , Segev Shlomo , Klempfner Robert , Grossman Ehud , Maor Elad
Published: July 2020

Aims

Data on the association of cardiorespiratory fitness with survival of cancer patients are limited. This study aimed to evaluate the association between midlife cardiorespiratory fitness and survival after a subsequent cancer diagnosis.

Methods

We evaluated 19,134 asymptomatic self-referred adults who were screened in preventive healthcare settings. All subjects were free of cardiovascular disease and cancer at baseline and completed a maximal exercise stress test. Fitness was categorised into age-specific and sex-specific quintiles according to the treadmill time and dichotomised to low (quintiles 1–2) and high fitness groups.

Results

The mean age was 50 ± 8 years and 72% were men. During a median follow-up of 13 years (interquartile range 7–16) 517 (3%) died. Overall, 1455 (7.6%) subjects developed cancer with a median time to cancer diagnosis of 6.4 years (interquartile range 3–10). Death from the time of cancer diagnosis was significantly lower among the high fitness group (Plog rank = 0.03). Time-dependent analysis showed that subjects who developed cancer during follow-up were more likely to die (P < 0.001). The association of cancer with survival was fitness dependent such that in the lower fitness group cancer was associated with a higher risk of death, whereas among the high fitness group the risk of death was lower (hazard ratio 20 vs. 15; Pfor interaction = 0.047). The effect modification persisted after applying a 4-year blanking period between fitness assessment and cancer diagnosis (Pfor interaction = 0.003).

Conclusion

Higher midlife cardiorespiratory fitness is associated with better survival among cancer patients. Our findings support fitness assessment in preventive healthcare settings.