bluuebunny/crossref_metadata_2025 huggingface dataset:
Pioneering orthopaedic trauma surgery in Turkey: Burhaneddin Toker (1890–1951), the stormy 1930s, and refugees running from Nazism
Authors: Bagatur Erdem
Published: June 2020

Orthopedic surgery, the medical discipline that deals with diseases and injuries of the musculoskeletal system has been considered a distinct medical discipline in the west since the beginning of the twentieth century. However, in Turkey, the acceptance of musculoskeletal traumatology as an integral part of orthopedic surgery actualized as late as 1961. Previously, orthopedic trauma patients were usually treated in general surgery departments. Dr. Burhaneddin Toker, a true pioneer, changed this conduct of the time in Turkey. He transformed Cerrahpaşa Hospital, then a municipality hospital today the well-known Cerrahpaşa Medical School of Istanbul University, to a trauma center. He pioneered systematic surgery of the musculoskeletal injuries, created a separate service for musculoskeletal traumatology, trained many surgeons in this field, wrote textbooks, and reported his clinical experience in scientific publications. This study examines the biography of Burhaneddin Toker and how he was able to further medical training in Turkey with a focus on Turkey in the stormy 1930s, the way the young republican government under Atatürk’s leadership handled educational issues, and the refugee scientists who found a safe haven in Turkey fleeing Nazism.
The Tsar’s doctor: The selfless and devoted life of Dr Eugene Botkin
Authors: Jimenez Rafael E
Published: June 2020

Eugene Botkin was Nicholas II’s court physician from 1908 until the abolition of the monarchy. He accompanied the royal family into exile and shared their fate at Ekaterinburg in 1918. The son of a prominent St. Petersburg physician, he trained at the Universities of St. Petersburg, Berlin, and Heidelberg. As court physician, he participated in the management of the Tsarevich Alexei’s hemophilia, but most of his time was spent taking care of the Tsarina’s multiple psychosomatic ailments. A deep sense of duty, rendered him unable to part from the royal family during the difficult months of exile and imprisonment. During this period there were several episodes of imminent threat to his life, where despite having the opportunity to leave, he voluntarily decided to stay with the Romanovs. In up to three occasions he said his goodbyes to his children, only to find out the next day that the threat had been contained. Ironically, the last time he spoke to them he did not think they would be separated for long. In this study, we will analyze his life, in particular the events of his last days, and will explore the reasoning behind his selfless actions.
The attempted murder of a surgeon (1882): Frank Algernon Hall of Lewes, Sussex
Authors: Cooper Maxwell J
Published: June 2020

Frank Algernon Hall (1846-1899) was an English surgeon who practised in Lewes, Sussex. He is remembered for an attempt on his life in 1882 by “feloniously shooting”. This premeditated act took place at the Lewes surgery where he practised and lived. No reason for the attack is documented and his assailant, Edwin Battersby, was removed to Broadmoor asylum. The author reflects on the value of historical accounts in promoting awareness of assaults on clinicians.
Collective rights of platform workers: The role of EU law
Authors: Gyulavári Tamás
Published: June 2020

Platform work is a new umbrella concept which covers a heterogeneous group of economic activities performed through digital platforms. Effective collective rights and bargaining would be essential for platform workers due to their vulnerable employment status. Yet collective organization of platform workers is troublesome, so trade unions face difficulties. The protection of the labour law directives is limited by their personal scope, which may be gradually expanded by the broad ECJ interpretation of the ‘worker’ concept. The effective right to collective bargaining would be particularly important, but it is restricted by EU antitrust rules with an exemption only for employees. In the last decade, the European Court has moved towards a wider personal scope of collective bargaining by interpreting the concept of ‘worker’. The recent FNV Kunsten decision used the notion of ‘false self-employed’ to go beyond the national concept of ‘employee’, but the wide interpretation of ‘worker’ shall be based on the need and necessity of employment protection deriving from economic dependency. As an alternative, the Gebhard formula may be invoked to grant the right to collective bargaining for platform workers.
Continuous-infusion and outpatient setting: A chance for patients, a challenge for hospital pharmacists
Authors: Perego Gianluca , Gregis Francesco , Rossi Laura , Mazzoleni Marta , Nozza Silvia , Nozza Renata , Gatti Vincenzo P
Published: June 2020

The use of continuous-infusion in outpatient setting could be widely used in oncology and haematology care. Many times the lack of data stability about single drug or admixture of drugs, together with patient education and safety, make difficult the transition from inpatient to outpatient setting. Nowadays, this is a big challenge for hospital pharmacists, who must take into consideration the critical issues related to chemical and physical stability, besides microbiological one, in order to ensure high quality preparations and guarantee the safety and quality of care, to protect patients and their health. The aim of this article is to highlight the critical issues concerning the transition from inpatient to outpatient setting, with particular interest regarding chemotherapy protocols, which require preparation with long-term continuous-infusion.
Effect of contact stress on the tribology behaviors of PTFE/316L seal pairs under various abrasive-contained conditions
Authors: Shen Ming-xue , Li Bo , Ji De-hui , He Xiao-Rong , Lin Xiu-zhou , Xiong Guang-yao
Published: June 2020

This study focuses on the tribological characteristics of polytetrafluoroethylene rubbing against 316L stainless steel in the presence of various Al2O3 abrasive particles. The ranges of the contact stresses and abrasive sizes were 2.50–5.01 MPa and 2.0–230 µm, respectively. The evolution of the coefficient of friction, abrasive invasion behavior and damage characteristics on worn surfaces, and the transformation of damage mechanisms under different contact stresses are summarized. Results demonstrate that contact stress exerts a considerable effect on abrasive invasion behavior, the coefficient of friction trends become complicated at low contact stress. With decreasing particle sizes under a contact stress of 2.50 MPa, the wear failure changes from two-body wear to three-body wear, or two wear behaviors exist simultaneously. As contact stress increases, the wear mechanism is gradually simplified. The particle size threshold that causes the change of the wear mechanism is also gradually reduced. The wear rate of polytetrafluoroethylene has no linear relationship with abrasive size, whereas wear increases with contact stress. Under 2.50 MPa conditions, the particles easily invade the tribo-interface in the friction process, thus increasing the wear rate of the metallic counterpart. In addition, with increases contact stress, the polytetrafluoroethylene material transfers to the counterface, and local adhesion occurs. When the contact stress is increased to 5.01 MPa, polytetrafluoroethylene even shows an obvious creep.
‘We needed to talk about it’: The experience of sharing the emotional impact of health care work as a panellist in Schwartz Center Rounds® in the UK
Authors: McCarthy Imelda , Taylor Cath , Leamy Mary , Reynolds Ellie , Maben Jill
Published: June 2020

Objectives

Schwartz Center Rounds® (‘Rounds’) are multidisciplinary forums where health care staff come together to reflect upon the emotional impact of their work. In each Round, a small number of staff (panellists) share experiences through stories to trigger reflection in audience members. Previous research has identified impacts associated with Rounds’ attendance, but little is known about the experience and impact of Rounds from panellists’ perspectives. This study is the first to explore the role of disclosure and reflection through storytelling in Rounds, specifically exploring panellists’ motivations, experiences and reported impacts associated with panel participation.

Methods

Interviews with 50 panellists, from nine case-study sites in the United Kingdom, representing acute, community and mental health National Health Service trusts and hospices. Data were analysed using thematic analysis.

Results

Most panellists spoke positively about their experience of sharing their stories in Rounds. Reported impacts included: increased emotional resilience and acceptance of experiences; reduced negative assumptions about colleagues and increased approachability and trust increasing tolerance and compassion; the creation of a space to stop and think and to reframe negative patient experiences facilitating greater empathy and emotional disclosure becoming more visible and normative, thereby helping change culture. Impacts on staff were similar regardless of contextual variability, including their professional group or role, with the exception of impact on patient care, which was not mentioned by non-clinical staff. The extent of panel preparation and audience characteristics (e.g. size, composition and response to their stories) influenced panellists’ experiences and outcomes.

Conclusions

Rounds highlight the important role of disclosure and reflection through storytelling to support panellists with the emotional aspects of their work, providing a space for support with the emotional demands of health care, reducing the need for employees to be stoic. Panel participation also offers an important source of validation in organizations marked by scrutiny.
Effects of home-based occupational therapy telerehabilitation via smartphone for outpatients after hip fracture surgery: A feasibility randomised controlled study
Authors: Li Cabbee TL , Hung Goris KN , Fong Kenneth NK , Gonzalez Pablo Cruz , Wah Shu-hong , Tsang Hector WH
Published: June 2020

Introduction

This study aimed to investigate the effects of a home-based occupational therapy telerehabilitation (TR) via smartphone in enhancing functional and motor performance and fall efficacy for outpatients receiving day hospital rehabilitation after hip fracture surgery in Hong Kong.

Methods

This was a feasibility randomised controlled trial with two groups – an experimental group and a comparison group – and a sample of 31 older adults attending a geriatric day hospital who had undergone hip fracture surgery within 12 weeks of diagnosis. Patients were assessed at baseline, immediately after a three-week intervention and at three-week post-intervention follow-up for motor performance, activities of daily living (ADL) functioning and fall efficacy. The experimental group received a home programme using the Caspar Health e-system and a mobile app for smartphones, while the comparison group received paper-and-pencil instructions for the home programme on a weekly basis for three weeks.

Results

Compared to the comparison group, significant improvements in fall efficacy and instrumental ADL performance at post intervention and follow-up were found in the experimental group. However, in the comparison group, inadequate social support was a factor contributing to better muscle strength testing in both the affected and non-affected legs. There were no significant differences between the two groups in regard to the other variables.

Discussion

This study supports the potential use of TR via smartphone as an alternative home programme for use in occupational therapy practice with older adults after hip fracture surgery.
The totalizing meritocracy of heterosex: Subjectivity in NoFap
Authors: Hartmann Marlene
Published: June 2020

NoFap is a growing online community of mostly heterosexual men seeking to abstain from masturbation. Rereading scholarship on the history of men’s masturbation, I undertake a critical discourse analysis of NoFap-videos on YouTube to investigate NoFap’s interpellative matrix. NoFap offers a specific mode of becoming a man by advocating a particular form of self-relation. To become a man, one needs to reconcile one’s self-government with one’s organismic existence as a body ‘naturally’ built for meritocratic heterosexuality. Reflecting on NoFap as a community connected to the manosphere, I conclude by suggesting that we thoroughly analyze manospherian modes of self-relation.
Wear behavior of electrodeposited nickel coating on ZP5 zinc alloy
Authors: Croccolo Dario , De Agostinis Massimiliano , Fini Stefano , Olmi Giorgio , Francesco Robusto , Tonelli Lavinia
Published: June 2020

Nickel coating on zinc alloy is quite promising for the achievement of an additional wear improvement in corrosive environment. To investigate this point, block-on-ring tests were carried out. Blocks measuring 5 × 5×20 mm3 were obtained from real locking components, made of ZP5 EN 12844 and coated by Zn/Cu1Ni5s ISO 1458. As counter material, an AISI 304 with a 40 mm diameter cylindrical geometry was used. Three load levels (5, 10 and 15 N) and three coating thickness levels (low: 5 to 10 µm; medium: 10 to 15 µm; high: 15 to 20 µm) were considered. The sliding distance was initially set to 500 m. Then, since the coating was worn out very quickly during the test, the sliding distance was set to 150 m. The results, in terms of volume loss due to wear, were processed using the statistical tool of two-way ANOVA and Fisher test. It was assessed that the wear rate is strongly affected by the applied load. The coating thickness does not significantly affect the wear.
Perspectives of adult undergraduate women working towards a degree
Authors: Tyson Michele A
Published: June 2020

Adult learners have identified financial challenges in their pursuit of a college education. While it is understood that tuition and other educational expenses are among these challenges, perspectives on daily financial challenges and their impact on college-going are not as heavily represented in the literature. The purpose of this study was to investigate the financial experiences adult women in the United States encounter in pursuit of a college degree in order to better support adult learners more broadly. Using feminist narrative framework, the study introduces eight women who were in the final stages of bachelor’s degree completion at a private women’s college and overcame various financial obstacles to do so. The findings indicate that women’s lives are a complex web of challenges that create educational barriers.
Hypoxic tumor microenvironment: Implications for cancer therapy
Authors: Roy Sukanya , Kumaravel Subhashree , Sharma Ankith , Duran Camille L , Bayless Kayla J , Chakraborty Sanjukta
Published: June 2020

Hypoxia or low oxygen concentration in tumor microenvironment has widespread effects ranging from altered angiogenesis and lymphangiogenesis, tumor metabolism, growth, and therapeutic resistance in different cancer types. A large number of these effects are mediated by the transcription factor hypoxia inducible factor 1⍺ (HIF-1⍺) which is activated by hypoxia. HIF1⍺ induces glycolytic genes and reduces mitochondrial respiration rate in hypoxic tumoral regions through modulation of various cells in tumor microenvironment like cancer-associated fibroblasts. Immune evasion driven by HIF-1⍺ further contributes to enhanced survival of cancer cells. By altering drug target expression, metabolic regulation, and oxygen consumption, hypoxia leads to enhanced growth and survival of cancer cells. Tumor cells in hypoxic conditions thus attain aggressive phenotypes and become resistant to chemo- and radio- therapies resulting in higher mortality. While a number of new therapeutic strategies have succeeded in targeting hypoxia, a significant improvement of these needs a more detailed understanding of the various effects and molecular mechanisms regulated by hypoxia and its effects on modulation of the tumor vasculature. This review focuses on the chief hypoxia-driven molecular mechanisms and their impact on therapeutic resistance in tumors that drive an aggressive phenotype.

Impact statement

Hypoxia contributes to tumor aggressiveness and promotes growth of many solid tumors that are often resistant to conventional therapies. In order to achieve successful therapeutic strategies targeting different cancer types, it is necessary to understand the molecular mechanisms and signaling pathways that are induced by hypoxia. Aberrant tumor vasculature and alterations in cellular metabolism and drug resistance due to hypoxia further confound this problem. This review focuses on the implications of hypoxia in an inflammatory TME and its impact on the signaling and metabolic pathways regulating growth and progression of cancer, along with changes in lymphangiogenic and angiogenic mechanisms. Finally, the overarching role of hypoxia in mediating therapeutic resistance in cancers is discussed.
Distal radioulnar joint stability measured with radiostereometry during the piano key test
Authors: Thillemann Janni Kjærgaard , De Raedt Sepp , Jørgensen Peter Bo , Rømer Lone , Hansen Torben Bæk , Stilling Maiken
Published: June 2020

Distal radioulnar joint instability is difficult to grade by clinical examination and interobserver reliability is low. This study used a new and precise radiostereometry method for measurement of distal radioulnar joint translation. Eight human donor arms were positioned in a custom-made fixture and a standardized piano key test was done with pressure on the ulnar head. Examination was done before and after dividing the styloid and foveal insertions of the triangular fibrocartilage complex. In the intact wrists, the piano key test induced a mean 1.36 mm translation of the ulnar head, which increased statistically significantly to 1.96 mm after a lesion of the styloid ligament insertion and to 2.3 mm after combined lesions of the styloid and foveal ligament insertions. This experimental cadaver study demonstrates a radiological method for precise quantification of distal radioulnar joint stability after different grades of triangular fibrocartilage complex injury.
Retinal Periphery Is Insensitive to Sudden Transient Motion
Authors: Anstis Stuart
Published: June 2020

Peripherally viewed targets moved around against a background of random dynamic noise. Slow movements were visible, fast movements were not. Thus, a target that repetitively drifted to the right and snapped back appeared to drift endlessly to the right with no visible snapbacks.
Added sugar intake is associated with pericardial adipose tissue volume
Authors: Yi So-Yun , Steffen Lyn M , Terry James G , R Jacobs David , Duprez Daniel , Steffen Brian T , Zhou Xia , Shikany James M , Harnack Lisa , J Carr John
Published: June 2020

Aim

The purpose of this study was to determine the relationships of pericardial adipose tissue and visceral adipose tissue volume with added sugar and sugar-sweetened beverage intakes. We hypothesized that both added sugar and sugar-sweetened beverages were positively associated with pericardial adipose tissue and visceral adipose tissue volumes in black and white men and women enrolled in the prospective Coronary Artery Risk Development in Young Adults study.

Methods and results

Dietary intake was assessed by diet history at baseline, year 7 and year 20 examinations in 3070 participants aged 18-30 and generally healthy at baseline. After 25 years follow-up, participants underwent a computed tomography scan of chest and abdomen; the computed tomography scans were read, and pericardial adipose tissue, visceral adipose tissue, and subcutaneous adipose tissue volumes were calculated. Quintiles were created for the average of baseline, year 7 and year 20 added sugar and for the average of sugar-sweetened beverages. General linear regression analysis evaluated the associations of pericardial adipose tissue and visceral adipose tissue volumes across quintiles of added sugar and across quintiles of sugar-sweetened beverage intakes adjusted for potential confounding factors. In a multivariable model, pericardial adipose tissue volume was higher across increasing quintiles of added sugar and sugar-sweetened beverage intakes (ptrend = 0.001 and ptrend < 0.001, respectively). A similar relation was observed for visceral adipose tissue (ptrend < 0.001 for both added sugar and sugar-sweetened beverages).

Conclusions

Long-term intakes of added sugar and sugar-sweetened beverages were associated with higher pericardial adipose tissue, visceral adipose tissue, and subcutaneous adipose tissue volumes. Because these ectopic fat depots are associated with greater risk of disease incidence, these findings support limiting intakes of added sugar and sugar-sweetened beverages.
Altering the availability of products within physical micro-environments: a conceptual framework
Authors: Pechey Rachel , Hollands Gareth J. , Carter Patrice , Marteau Theresa M.
Published: June 2020

Altering the availability of products (e.g. food, alcohol or tobacco products) is one potential intervention to change behaviours to help reduce preventable premature deaths worldwide. However, research on these interventions lacks consistent conceptualisation, hindering clear reporting and cumulative synthesis. This paper proposes a conceptual framework – categorising intervention types and summarising constituent components – with which interventions can be reliably described and evidence synthesised. Three principal distinctions are proposed: interventions altering: (i) Absolute Availability (changing the overall number of options, while keeping the proportions comprised by any subsets of options constant); (ii) Relative Availability (changing the proportion comprised by a subset of options, yet keeping the overall number of options constant); (iii) Absolute and Relative Availability (changing both the overall number of options and the proportions comprised by subsets of options). These are subdivided into those targeting (a) a product or (b) a category of products. Mechanisms that might underlie each of these intervention types are discussed, and implications for future research highlighted. The proposed framework aims to facilitate study of a set of interventions that could contribute significantly to healthier behaviour across populations.
The barriers and facilitators influencing the sustainability of hospital-based interventions: a systematic review
Authors: Cowie Julie , Nicoll Avril , Dimova Elena D. , Campbell Pauline , Duncan Edward A.
Published: June 2020

Background

Identifying factors that influence sustained implementation of hospital-based interventions is key to ensuring evidence-based best practice is maintained across the NHS. This study aimed to identify, appraise and synthesise the barriers and facilitators that influenced the delivery of sustained healthcare interventions in a hospital-based setting.

Methods

A systematic review reported in accordance with PRISMA. Eight electronic databases were reviewed in addition to a hand search of Implementation Science journal and reference lists of included articles. Two reviewers were used to screen potential abstracts and full text papers against a selection criteria. Study quality was also independently assessed by two reviewers. Barriers and facilitators were extracted and mapped to a consolidated sustainability framework.

Results

Our searching identified 154,757 records. We screened 14,626 abstracts and retrieved 431 full text papers, of which 32 studies met the selection criteria. The majority of studies employed a qualitative design (23/32) and were conducted in the UK (8/32) and the USA (8/32). Interventions or programmes were all multicomponent, with the majority aimed at improving the quality of patient care and/ or safety (22/32). Sustainability was inconsistently reported across 30 studies. Barriers and facilitators were reported in all studies. The key facilitators included a clear accountability of roles and responsibilities (23/32); ensuring the availability of strong leadership and champions advocating the use of the intervention (22/32), and provision of adequate support available at an organisational level (21/32). The most frequently reported barrier to sustainability was inadequate staff resourcing (15/32). Our review also identified the importance of inwards spread and development of the initiative over time, as well as the unpredictability of sustainability and the need for multifaceted approaches.

Conclusions

This review has important implications for practice and research as it increases understanding of the factors that faciliate and hinder intervention sustainability. It also highlights the need for more consistent and complete reporting of sustainability to ensure that lessons learned can be of direct benefit to future implementation of interventions.

Trial registration

The review is registered on PROSPERO (CRD42017081992).
Expression of serotonin 1A and 2A receptors in molecular- and projection-defined neurons of the mouse insular cortex
Authors: Ju Anes , Fernandez-Arroyo Beatriz , Wu Yifan , Jacky Débora , Beyeler Anna
Published: June 2020

The serotonin (5-HT) system is the target of multiple anxiolytics, including Buspirone, which is a partial agonist of the serotonin 1A receptor (5-HT1A). Similarly, ligands of the serotonin 2A receptor (5-HT2A) were shown to alter anxiety level. The 5-HT1A and 2A receptors are widely expressed across the brain, but the target region(s) underlying the influence of those receptors on anxiety remain unknown. Interestingly, recent studies in human and non-human primates have shown that the 5-HT1A and 5-HT2A binding potentials within the insular cortex (insula) are correlated to anxiety. As an initial step to define the function of 5-HT transmission in the insula, we quantified the proportion of specific neuronal populations of the insula expressing 5-HT1A or 5-HT2A. We analyzed seven neural populations, including three defined by a molecular marker (putative glutamate, GABA or parvalbumin), and four defined by their projections to different downstream targets. First, we found that more than 70% of putative glutamatergic neurons, and only 30% of GABAergic neurons express the 5-HT1A. Second, within insular projection neurons, 5-HT1A is highly expressed (75–80%) in the populations targeting one sub-nuclei of the amygdala (central or basolateral), or targeting the rostral or caudal sections of the lateral hypothalamus (LH). Similarly, 70% of putative glutamatergic neurons and only 30% of insular GABAergic neurons contain 5-HT2A. Finally, the 5-HT2A is present in a majority of insula-amygdala and insula-LH projection neurons (73–82%). These observations suggest that most glutamatergic neurons can respond to 5-HT through 5-HT1A or 5-HT2A in the insula, and that 5-HT directly affects a limited number of GABAergic neurons. This study defines a molecular and neuroanatomical map of the 5-HT system within the insular cortex, providing ground knowledge to identify the potential role of serotonergic modulation of selective insular populations in anxiety.
Allele-specific DNA methylation is increased in cancers and its dense mapping in normal plus neoplastic cells increases the yield of disease-associated regulatory SNPs
Authors: Do Catherine , Dumont Emmanuel L. P. , Salas Martha , Castano Angelica , Mujahed Huthayfa , Maldonado Leonel , Singh Arunjot , DaSilva-Arnold Sonia C. , Bhagat Govind , Lehman Soren , Christiano Angela M. , Madhavan Subha , Nagy Peter L. , Green Peter H. R. , Feinman Rena , Trimble Cornelia , Illsley Nicholas P. , Marder Karen , Honig Lawrence , Monk Catherine , Goy Andre , Chow Kar , Goldlust Samuel , Kaptain George , Siegel David , Tycko Benjamin
Published: June 2020

Background

Mapping of allele-specific DNA methylation (ASM) can be a post-GWAS strategy for localizing regulatory sequence polymorphisms (rSNPs). The advantages of this approach, and the mechanisms underlying ASM in normal and neoplastic cells, remain to be clarified.

Results

We perform whole genome methyl-seq on diverse normal cells and tissues and three cancer types. After excluding imprinting, the data pinpoint 15,112 high-confidence ASM differentially methylated regions, of which 1838 contain SNPs in strong linkage disequilibrium or coinciding with GWAS peaks. ASM frequencies are increased in cancers versus matched normal tissues, due to widespread allele-specific hypomethylation and focal allele-specific hypermethylation in poised chromatin. Cancer cells show increased allele switching at ASM loci, but disruptive SNPs in specific classes of CTCF and transcription factor binding motifs are similarly correlated with ASM in cancer and non-cancer. Rare somatic mutations affecting these same motif classes track with de novo ASM. Allele-specific transcription factor binding from ChIP-seq is enriched among ASM loci, but most ASM differentially methylated regions lack such annotations, and some are found in otherwise uninformative “chromatin deserts.”

Conclusions

ASM is increased in cancers but occurs by a shared mechanism involving disruptive SNPs in CTCF and transcription factor binding sites in both normal and neoplastic cells. Dense ASM mapping in normal plus cancer samples reveals candidate rSNPs that are difficult to find by other approaches. Together with GWAS data, these rSNPs can nominate specific transcriptional pathways in susceptibility to autoimmune, cardiometabolic, neuropsychiatric, and neoplastic diseases.
Omeprazole-induced and pantoprazole-induced asymptomatic hyponatremia: a case report
Authors: van der Zalm Isabel J. B. , Tobé Tom J. M. , Logtenberg Susan J. J.
Published: June 2020

Background

Hyponatremia is the most common electrolyte disorder. Thiazides, antidepressants, antipsychotic drugs, and antiepileptic drugs are well-known causes of hyponatremia. Proton pump inhibitor use is a rare cause of hyponatremia and, when reported, it is due to one specific proton pump inhibitor, mostly omeprazole.

Case presentation

A 67-year-old Caucasian male was referred to our out-patient clinic because of hyponatremia (127 mmol/L) found at routine laboratory examination. He had consulted his general practitioner because of abdominal pains. No other symptoms were present. At physical examination, he appeared euvolemic and had no abdominal tenderness. Besides omeprazole for reflux esophagitis he used no medication. Additional laboratory results included: serum osmolarity 274 mOsmol/kg, urinary osmolarity 570 mOsmol/kg, and urinary sodium 35 mmol/L. Other causes of hyponatremia were excluded and we diagnosed hyponatremia due to the syndrome of inappropriate antidiuretic hormone secretion secondary to use of omeprazole. Omeprazole was replaced by ranitidine after which his serum sodium levels normalized to 135 mmol/L. During follow-up, because of persistent reflux complaints despite ranitidine use, ranitidine was switched to another proton pump inhibitor: pantoprazole. After this intervention, his serum sodium level declined again to 133 mmol/L. We concluded that both omeprazole and pantoprazole induced syndrome of inappropriate antidiuretic hormone secretion in this patient.

Conclusion

Hyponatremia is worrisome and awareness of medication-induced hyponatremia, especially due to proton pump inhibitors, is needed. In our case, sequential hyponatremia occurred with two different proton pump inhibitors, suggesting a class effect. Therefore, when syndrome of inappropriate antidiuretic hormone secretion due to a proton pump inhibitor is diagnosed, preferably no other medication from the same class is prescribed. When after consideration another proton pump inhibitor is prescribed, serum sodium concentrations should be monitored.
The role of variety attributes in the uptake of new hybrid bananas among smallholder rural farmers in central Uganda
Authors: Sanya Losira Nasirumbi , Sseguya Haroon , Kyazze Florence Birungi , Diiro Gracious Milton , Nakazi Florence
Published: June 2020

Background

While advances in agricultural research and development have led to generation of improved new cooking hybrid banana varieties (HBVs) with enhanced yield potential to restore production levels, these have been received with mixed feelings on production and consumption attributes among the farming communities in Uganda. Some farmers prefer HBVs that are comparable to their local varieties in terms of consumption attributes such as soft food, color when cooked, flavor and taste while others prefer high-yielding HBVs to produce surplus output for sale.

Methods

Using cross-sectional survey data from 242 randomly selected smallholder banana farmers in Nakaseke and Luwero districts in Central Uganda, the study applied a Tobit regression model to analyze the influence of socio-economic factors and variety attributes on the adoption of new hybrid bananas.

Results

The results on the perception of farmers on banana variety attributes showed that the new HBVs had desirable production-related attributes, while local cultivars were rated superior to hybrids on consumption-related attributes. Evidence further showed that production-related and consumption-related attributes influenced farmers’ decisions in the adoption of HBVs. Further, an assessment of the socio-economic factors that influence the adoption of HBVs showed that education of the farmer, household size, interaction with different banana actors, experience (number of years growing HBVs), and source of planting materials had a significant influence on farmers’ adoption of the new HBVs.

Conclusion

The study findings provide insights into the need for agricultural research and development initiatives to target the development of banana varieties with multi-traits that meet end-users’ preferences and needs. Facilitating the establishment of multi-actor platforms that bring together the different actors to share information and learn might be useful in increasing the intensity of HBVs adoption.
Clinical comparison between Multi-Stranded Wires and Single strand Ribbon wires used for lingual fixed retainers
Authors: Arash Valiollah , Teimoorian Mehran , Farajzadeh Jalali Yasamin , Sheikhzadeh Sedigheh
Published: June 2020

Background

Long-term retention with fixed retainers with a high success rate seems to be a reasonable solution to minimize or prohibit relapse of orthodontic treatment.

Methods

Two hundred sixty patients between 13 and 30 years old were recruited for this study. The 0.0175 stainless steel twisted wire (G&H Orthodontics, USA) was compared with a single-strand ribbon titanium lingual retainer wire (Retainium, Reliance orthodontics, USA) was used. When treatment was completed, the retainers were bonded from canine to canine in the mandibular arch of the participants. In the follow-up visits, the patients were recalled every 3 months during the 24 months. Detachments, the time of debonding, and side effects were recorded. Statistical analysis was performed by a blinded statistician using a statistical package for Social Science (SPSS, Version20). After descriptive statistics, Kaplan-Meier analysis was performed to measure the survival rates of each retainer. P value < 0.05 was considered as significant.

Results

Finally, 138 patients who received twisted wire splint and 112 patients who received ribbon wire were included in the analysis. The average duration of success was about 23 months for twisted wire and ribbon wire, according to the Kaplan-Meier estimates. The analysis showed no significant overall difference between the treatments (p = 0.13). Failure rates in terms of detachments in all groups occurred at the enamel junction, and it was 25 in twisted retainer group (18.1%) and was 10 in ribbon retainer group (8.9%); the Kaplan-Meier analysis test detected a significant difference in the failure rates between the groups (p = 0/006).

Conclusions

Although the conventional twisted stainless steel wire and single-strand titanium flat metal ribbon wire as fixed orthodontic retainers have the same clinical effects, it was shown that the ribbon wire has less failure in terms of detachments.
“Mixed” subjective class identity: a new interpretation of Chinese class identity
Authors: Xu Qi
Published: June 2020

This article investigates factors influencing the subjective class identity of Chinese people and the bias of this identity using data from the Chinese General Social Survey in 2010 and 2013. In contrast with previous studies that have only focused on the social status of the respondents, this paper introduces the concept of “mixed” class identity and finds that (1) the social statuses of a person’s spouse and parents can also affect subjective class identity and its bias, in addition to the social status of the respondents themselves; (2) the social status of parents has a stronger effect on children who are younger and who co-reside with parents, and the effect of a spouse’s social status is stronger for married women than for married men; and (3) the influence of parents and a spouse’s social statuses on individuals’ class identity has been growing over time. This paper notes that to understand the subjective class identity of the Chinese and its change over time, sociologists should focus on family as the basic unit of analysis, fully consider the heterogeneity effect of different factors affecting the class identity of different social groups and situate the analysis within the context of China’s unique modernization process.
Efficacy of stem cell allograft in maxillary sinus bone regeneration: a randomized controlled clinical and blinded histomorphometric study
Authors: Whitt Josh , Al-Sabbagh Mohanad , Dawson Dolphus , Shehata Ehab , Housley-Smith Moly , Tezanos Alejandro , Kutkut Ahmad
Published: June 2020

Purpose

This study aimed to evaluate the quality and quantity of newly generated bone in the maxillary sinus grafted with stem cell-based allograft material.

Methods

This study was a single site, prospective, blinded, randomized, and controlled clinical trial. Eleven subjects with 18 edentulous posterior maxillary sites requiring sinus augmentation for delayed implant placement using a lateral window approach were enrolled. At the time of sinus augmentation, test sinus was grafted with stem cell-based allograft (Osteocel Plus; NuVasive Therapeutics), while the control sinus was grafted with conventional cortico-cancellous allograft (alloOss; ACE Surgical). Cone beam computer tomography (CBCT) scan was taken before and 14 weeks post-sinus augmentation procedure, i.e., 2 weeks before implant placement. Thirty-six trephined core bone biopsies were harvested from the anterior and posterior grafted lateral-window osteotomy sites at the time of implant placement.

Results

The results showed a statistically significant difference in the vital bone percentage between the test and the control groups at the posterior grafted sites (p= 0.03). There was no significant difference in the percentage of vital bone between the anterior and posterior grafted sites within the test and control groups (p> .05). The CBCT analysis showed that the maxillary sinuses at the posterior grafted sites were statistically wider than those at the anterior grafted sites in both groups (p< .05).

Conclusions

Different allograft bone materials can be used in the maxillary sinus augmentation procedures. Stem cell allograft has more osteogenic potential with a better outcome in the wide posterior sinus.
Correction to: Methanol extract of Spathodea campanulata P. (Beauv.) leaves demonstrate sedative and anxiolytic like actions on swiss albino mice
Authors: Begum Anawara , Biswas Purobee , Shahed-Al-Mahmud Md.
Published: June 2020

An amendment to this paper has been published and can be accessed via the original article.
Burnout syndrome in university professors and academic staff members: psychometric properties of the Copenhagen Burnout Inventory–Brazilian version
Authors: Rocha Fernanda Ludmilla Rossi , de Jesus Lilian Carla , Marziale Maria Helena Palucci , Henriques Silvia Helena , Marôco João , Campos Juliana Alvares Duarte Bonini
Published: June 2020

The aims of this study were to evaluate the psychometric properties of the Copenhagen Burnout Inventory–Brazilian version (CBI-Br) in a sample of university professors and academic staff members of Brazilian public universities, to estimate the level of burnout syndrome (BS) among these workers, and to assess the associations of BS with demographic and occupational determinants of the syndrome. A total of 676 workers participated in the study. Confirmatory factor analysis results supported a three-factor model with 18 items and an acceptable overall fit. Adequate convergent and discriminant validity of the CBI-Br’s factors were observed, as well as adequate reliability of the instrument for the sample. In conclusion, the results of this study provide evidence of the validity and reliability of the CBI-Br for the measurement of BS in Brazilian university professors and academic staff members. In addition, the CBI-Br may be an important tool for the diagnosis of psychosocial risks related to BS in the academic environment.
Changes in nutritional status of children who lived in temporary shelters in Bhaktapur municipality after the 2015 Nepal earthquake
Authors: Dhoubhadel Bhim Gopal , Raya Ganendra Bhakta , Shrestha Dhruba , Shrestha Raj Kumar , Dhungel Yogendra , Suzuki Motoi , Yasunami Michio , Smith Chris , Ariyoshi Koya , Parry Christopher M.
Published: June 2020

Background

The nutritional status of children may deteriorate after natural disasters such as earthquakes. A 7.8 Richter scale earthquake struck Nepal in 2015 that affected 1.1 million children. Children whose homes were destroyed and had to live in temporary shelters were at risk of malnutrition. With the support of Nagasaki University School of Tropical Medicine and Global Health (TMGH) and Siddhi Memorial Hospital (SMH), we conducted a nutritional survey of under-5 children living in temporary shelters in Bhaktapur Municipality in 2015 immediately after the earthquake and a follow-up survey in 2017.

Results

We found 591 under-5 children living in 22 temporary shelters in 2015. A total of 285 children were followed up and re-assessed in 2017. In a paired analysis (n = 285), the prevalence of underweight children increased from 10.9% in 2015 to 14.0% in 2017 (P < 0.001), stunting increased from 26.7 to 31.9% (P = 0.07), and wasting decreased from 4.2 to 2.5% (P = 0.19).

Conclusions

Children who lived in temporary shelters after the 2015 Nepal earthquake might be at increased risk of a deterioration in nutritional status.
An improved MPPT control strategy based on incremental conductance algorithm
Authors: Shang Liqun , Guo Hangchen , Zhu Weiwei
Published: June 2020

PV power production is highly dependent on environmental and weather conditions, such as solar irradiance and ambient temperature. Because of the single control condition and any change in the external environment, the first step response of the converter duty cycle of the traditional MPPT incremental conductance algorithm is not accurate, resulting in misjudgment. To improve the efficiency and economy of PV systems, an improved incremental conductance algorithm of MPPT control strategy is proposed. From the traditional incremental conductance algorithm, this algorithm is simple in structure and can discriminate the instantaneous increment of current, voltage and power when the external environment changes, and so can improve tracking efficiency. MATLAB simulations are carried out under rapidly changing solar radiation level, and the results of the improved and conventional incremental conductance algorithm are compared. The results show that the proposed algorithm can effectively identify the misjudgment and avoid its occurrence. It not only optimizes the system, but also improves the efficiency, response speed and tracking efficiency of the PV system, thus ensuring the stable operation of the power grid.
Endovascular flow-diversion of visceral and renal artery aneurysms using dual-layer braided nitinol carotid stents
Authors: van Veenendaal Penelope , Maingard Julian , Kok Hong Kuan , Ranatunga Dinesh , Buckenham Tim , Chandra Ronil V. , Lee Michael J. , Brooks Duncan Mark , Asadi Hamed
Published: June 2020

Background

Visceral and renal artery aneurysms (VRAAs) are uncommon but are associated with a high mortality rate in the event of rupture. Endovascular treatment is now first line in many centres, but preservation of arterial flow may be difficult in unfavourable anatomy including wide necked aneurysms, parent artery tortuosity and proximity to arterial bifurcations. Endovascular stenting, and in particular flow-diversion, is used in neurovascular intervention to treat intracranial aneurysms but is less often utilised in the treatment of VRAAs. The CASPER stent is a low profile dual-layer braided nitinol stent designed for carotid stenting with embolic protection and flow-diversion properties. We report the novel use of the CASPER stent for the treatment of VRAAs. We present a case series describing the treatment of six patients with VRAAs using the CASPER stent.

Results

Six patients with unruptured VRAAs were treated electively. There were three splenic artery aneurysms and three renalartery aneurysms. Aneurysms were treated with the CASPER stent, with or without loose aneurysm coil packing or liquid embolic depending on size and morphology. All stents were successfully deployed with no immediate or periprocedural complications. Four aneurysms completely occluded after serial imaging follow up with one case requiring repeat CASPER stenting for complete occlusion. In one patient a single aneurysm remained patent at last follow up, A single case was complicated by delated splenic infarction and surgical splenectomy.

Conclusion

Preliminary experience with the CASPER stent suggests it is technically feasible and effective for use in the treatment of VRAAs.
Correction to: Aerodynamics and dynamic stability of micro-air-vehicle with four flapping wings in hovering flight
Authors: Cheng Cheng , Wu Jianghao , Zhang Yanlai , Li Han , Zhou Chao
Published: June 2020

An amendment to this paper has been published and can be accessed via the original article.
Application of periareolar mastopexy technique for giant phyllodes tumor resection in an adolescent female with breast asymmetry: a case report and literature review
Authors: Hifny Mahmoud A. , A. Mohamed Yousef , R. Asmaa Gaber , Mohamed Mohamed Abdelshafy , Abdelhameid Mahmoud
Published: June 2020

Background

The phyllodes tumors are rare neoplastic disease which exhibits a benign behavior in adolescents female. After resection of a large benign breast tumor, insufficient breast contour may result with nipple areola complex malposition. As symmetry of the breast is psychologically extremely crucial, especially in adolescents, in such cases, an immediate mammoplasty-like breast reduction or mastopexy technique of the affected breast will be necessary to provide symmetry of the bilateral breasts at the initial surgery.

Case presentation

A 16-year-old woman reported rapid enlargement of a large mass in her left breast over 12 months. The physical examination revealed a huge mass that occupied the lower quadrants of her left breast causing expansion of both the overlying skin and the nipple areolar complex. A biopsy was constant with a benign phyllodes tumor. We have applied a periareolar mastopexy technique to allow tumor resection through exposure incision at the lower half of the outer periareolar circular incision. At the same time, we reduced the expanded skin envelope and mobilized the nipple–areola complex to restore breast symmetry.

Conclusion

The periareolar mastopexy approach provides a wide surgical exposure, allows excision of benign giant breast tumor, and simultaneous restoration of the breast shape with favorable aesthetic results and minimal postoperative scarring.