bluuebunny/crossref_metadata_2025 huggingface dataset:
Developing a Scale to Measure Tourist Perceived Safety
Authors: Xie Chaowu , Zhang Jiangchi , Morrison Alastair M.
Published: August 2020

Safety for tourists at places visited is essential to their enjoyment and experiences, as well as a determinant of destination success. Yet, little attention has been paid to the conceptualization and scale development for tourist perceived safety at destinations (TPSD). The primary purpose of this research was to identify the dimensions of TPSD and develop a scale for measuring it based on safety system theory. A three-stage study in a mixed-method design was conducted to develop and validate TPSD. Stage 1 identified the dimensions and initial items of TPSD through extensive literature reviewing and content analysis of travel blogs. In stage 2 (n = 300), an explanatory factor analysis was conducted to refine and validate the preliminary items. Stage 3 (n = 1,830) provided empirical support for a 20-item, five-dimension (human, facility and equipment, natural environment, social environment, management) TPSD scale through confirmatory factor analysis.
Non-alcoholic fatty liver disease in patients with hypothyroidism presenting at a rural tertiary care centre in north India
Authors: Grewal Harpreet , Joshi Sandeep , Sharma Ruby , Mittal Puneet , Goel Ankur
Published: August 2020

Apart from its association with metabolic syndrome and diabetes mellitus, non-alcoholic fatty liver disease (NAFLD) has been thought to be linked with other endocrine and metabolic disorders. Recent data suggest that hypothyroidism may be a significant risk factor for development and progression of NAFLD. The present study was conducted to evaluate the presence of NAFLD in patients with hypothyroidism presenting to a rural tertiary care centre in north India. The diagnosis of NAFLD was made on the basis of radiological findings and derangement of liver enzymes. Our findings showed that ultrasonographic evidence of fatty liver as well as increase in the serum transaminase level above normal range were significantly higher in hypothyroidism patients as compared with controls. On multivariate regression analysis of the patients’ data, the presence of hypothyroidism was independently associated with risk of NAFLD. We therefore conclude that hypothyroidism is a significant independent risk factor.
Prevalence, correlates, and experiences of school bullying among adolescents: A national study in Jordan
Authors: Shahrour Ghada , Dardas Latefa Ali , Al-Khayat Amjad , Al-Qasem Atef
Published: August 2020

School bullying is recognized as a global problem and sparks public concerns for students’ safety. While it has recently emerged as a critical concern in the Arab world, particularly in Jordan, no national studies have yet investigated the extent of bullying in Jordanian schools. The purpose of this study was to investigate the prevalence, correlates, and experiences of bullying among a national sample of Jordanian adolescent students. A stratified random sampling procedure was used to select schools that represent the three main regions of Jordan (i.e. north, middle, and south) and a weighted sample of schools was randomly selected using Statistical Analysis System 9.4 based on provinces’ density. A nationally representative sample of 1083 adolescents aged 12 to 17 was included in the study. Data were collected using self-administered questionnaires on school bullying and adolescent sociodemographics. The prevalence of bullying among Jordanian adolescents was consistent with international studies; 7% reported their involvement in bullying as a victim, 7.6% as a bully, and 1.7% as both. Verbal bullying was the most common form of bullying among victims and bully-victim, while relational bullying was the most prevalent bullying for bullies. Being a perpetrator was more prevalent among boys than girls. Adolescent students who came from low socioeconomic status or whose fathers were illiterate reported more victimization experience. The majority of students who experienced bullying reported negative attitudes of bystanders, parents, and teachers towards intervening or responding to the bullying experience. Bullying exists among Jordanian students and active steps towards addressing this phenomenon are discussed. This is the first known Jordanian study representing a national sample of adolescent students’ experience of bullying. Findings present valuable information for school professionals, parents, and students regarding bullying and its associated factors. These findings also provide an avenue for the adoption and implementation of available anti-bullying programs to ameliorate bullying behaviors among Jordanian school students.
Initial Experience Using 3-Dimensional Printed Models for Head and Neck Reconstruction in Haiti
Authors: Vimawala Swar , Gao Terry , Goldfarb Jared , Gadaleta Dominick , Ku Bon , Jean-Gilles Patrick , Luginbuhl Adam , Pugliese Robert , Weed Donald , Curry Joseph M.
Published: August 2020

This report describes the first use of a novel workflow for in-house computer-aided design (CAD) for application in a resource-limited surgical outreach setting. Preoperative computed tomography imaging obtained locally in Haiti was used to produce rapid-prototyped 3-dimensional (3D) mandibular models for 2 patients with large ameloblastomas. Models were used for patient consent, surgical education, and surgical planning. Computer-aided design and 3D models have the potential to significantly aid the process of complex surgery in the outreach setting by aiding in surgical consent and education, in addition to expected surgical applications of improved anatomic reconstruction.
Risk Factors for the Recurrence of Benign Paroxysmal Positional Vertigo: A Systematic Review and Meta-Analysis
Authors: Li Shichang , Wang Zijing , Liu Yan , Cao Jie , Zheng Hongwei , Jing Yuanyuan , Han Lin , Ma Xin , Xia Ruiming , Yu Lisheng
Published: August 2020

Objective:

Benign paroxysmal positional vertigo (BPPV) has a high recurrence rate, but the risk factor–associated recurrence are elusive.

Methods:

Searches were performed in PubMed, Embase, Cochrane library, Web of science, Chinese National Knowledge Infrastructure, and Sino Med up to November 3, 2019. The effect size was analyzed by odds ratio and 95% CI. Data from eligible studies were meta-analyzed using Stata version 15.0.

Results:

Our search resulted in a total of 4076 hits. Twenty-four outcomes of sixty articles were included in the meta-analysis. Risk factors for the recurrence of BPPV included female gender, age (≥65years), hyperlipidemia, diabetes, hypertension, migraine, cervical spondylosis, osteopenia/osteoporosis, head trauma, otitis media, abnormal vestibular evoked myogenic potential, and long use of computers. No significant differences were found in side, type of the involved semicircular canals, smoking, alcohol consumption, stroke, ear surgery, duration of vertigo before treatment, the times of repositioning, Meniere disease, sleep disorders, hypercholesterolemia, and 25-hydroxy vitamin D.

Conclusion:

These findings strengthen clinical awareness of early warning to identify patients with potential relapse risk of BPPV and clinicians should counsel patients regarding the importance of follow-up after diagnosis of BPPV.
Adsorption of organic pollutants from the aqueous phase using graphite as a model adsorbent
Authors: Ivancev-Tumbas Ivana , Landwehrkamp Lucas , Hobby Ralph , Vernillo Marco , Panglisch Stefan
Published: August 2020

Although graphite is not effective as an adsorbent in water treatment, it provides a homogenous, non-porous, carbonaceous structure that is ideal for studying fundamental adsorption mechanisms. High-purity graphite powder (C content 99.5%) was oxidized in an ozone stream, producing a near-surface oxygen content of 5.9 at.%, and was used together with the virgin material to establish adsorption isotherms for organic compounds in aqueous solutions. We examined how the aromaticity and substituents of the adsorptives affect adsorption on the model-activated carbon surface. For both virgin and oxidized graphite, the adsorption capacity for the aromatic compounds decreased in the order 1-naphthol > 2-methoxynaphthalene > naphthalene > anisole > phenol, with significant differences in the adsorption capacities of the two graphite species observed only for anisole, naphthalene, and 1-naphthol. The Freundlich constants (KF) for the five compounds on virgin graphite were 23.9, 10.3, 5.5, 1.4, and 0.8 (nmol mg−1 )/(µmol L−1) n, respectively. Naphthalene and 1-naphthol were slightly more adsorbed on the virgin material, whereas oxidized graphite had marginally better adsorption properties for anisole. The results underline the importance of dispersive and π– π interactions in the adsorption of organic compounds on carbonaceous adsorbents; a second aromatic ring in 1-naphthol and 2-methoxynaphthalene greatly increased the adsorption capacity for these compounds compared with their one-ring counterparts phenol and anisole. Differences were also observed in the adsorption of compounds containing hydroxyl or methoxy substituents, which have electron-donating properties (a resonance effect) but different electron-withdrawal characteristics (caused by induction). Two amino acids occurring as zwitterions, l-tryptophan and l-tyrosine, were also tested as adsorptives. l-Tryptophan, which has a larger aromatic system, achieved higher loading on graphite, suggesting an adsorption mechanism primarily governed by dispersive and π– π interactions for these two ionic compounds as well.
Removal of caffeine from aqueous solution by green approach using Ficus Benjamina zero-valent iron/copper nanoparticles
Authors: Abdel-Aziz Hossam Mohammed , Farag Rabie Saad , Abdel-Gawad Soha Ali
Published: August 2020

Green synthesis approach was successful used extract was successful in preparing bimetallic zero-valent Iron/Copper nanoparticles [FB-nZVFe/Cu]. Scanning Electron Microscope [SEM], Fourier Transform Infrared Spectroscopy [FTIR], and Dispersive X-ray Spectroscopy [EDX] showing the synthesizing of FB-nZVFe/Cu. The removal efficiency of Caffeine [5 mg L−1] reached 86% under the conditions [0.2 g L−1, 45 min, and pH 5]. The adsorption data are more appropriate by the Langmuir model [R2 = 0.9987] with qmax = 34.34 mg g −1. Kinetic results showed that Caffeine uptake is following pseudo-second-order. Langmuir and pseudo-second-order are more appropriate in linear and non-linear models. Overall, FB-Fe/Cu is a committed green substance for removal Caffeine from aqueous solutions. Functional parameters affect investigated using the Linear regression analysis, we found them to account for over 98% of the variables affecting the removal procedure.
Macrophage ablation significantly reduces uptake of imaging probe into organs of the reticuloendothelial system
Authors: Sabel Bastian O , Brand Karsten , Rueckel Johannes , Hoppe Boj , Fink Nicola , Bartling Soenke
Published: August 2020

Background

Macrophages engulf particulate contrast media, which is pivotal for biomedical imaging.

Purpose

To introduce a macrophage ablation animal model by showing its power to manipulate the kinetics of imaging probes.

Material and Methods

The kinetics of a particulate computed tomography (CT) contrast media was compared in macrophage ablative mice and normal mice. Liposomes (size 220 µg), loaded with clodronate, were injected into the peritoneum of three C57BL/6 mice. On the third day, 200 µL of the particulate agent ExiTron nano 6000 were injected into three macrophage-ablative mice and three control mice. CT scans were acquired before and 3 min, 1 h, 6 h, and 24 h after the ExiTron application. The animals were sacrificed, and their spleens and livers removed. Relative CT values (CTV) were measured and analyzed.

Results

Liver and spleen enhancement of treated mice and controls were increasing over time. The median peak values were different with 225 CTV for treated mice and 582 CTV for controls in the liver ( P = 0.032) and 431 CTV for treated and 974 CTV in controls in the spleen ( P = 0.016).

Conclusion

Macrophage ablation leads to a decrease of enhancement in organs containing high numbers of macrophages, but only marginal changes in macrophage-poor organs. Macrophage ablation can influence the phagocytic activity and thus opens new potentials to investigate and manipulate the uptake of imaging probes.
Clinical value of matrix metalloproteinase-2 and -9 in ultrasound-guided radiofrequency ablation treatment for papillary thyroid carcinoma
Authors: Pan Qunyan , Yuan Tao , Ding Qian
Published: August 2020

Objective

This study aimed to investigate serum matrix metalloproteinase (MMP)-2 and MMP-9 levels in patients with papillary thyroid carcinoma (PTC).

Methods

Forty-one patients with PTC undergoing ultrasound-guided radiofrequency ablation (RFA) and 56 controls were included. Serum MMP-2 and MMP-9 levels were determined by enzyme-linked immunosorbent assay before and after surgery. Potential affecting factors were evaluated by logistic regression analysis.

Results

Serum MMP-2 and MMP-9 levels were significantly higher in PTC patients compared with controls, and decreased significantly after surgery. According to receiver operating characteristic curve analysis, diagnostic values for preoperative serum MMP-2 and MMP-9 levels were 82.4% and 86.6%. There was no contrast-agent perfusion in the ablation zone in 88.5% of lesions, and enhancement within or at the lesion edge in 11.4%. The volume reduction at 3 months’ follow-up was >40%. Age, microcalcification, irregular shape, and lesion diameter and number were influencing factors for PTC. Age, and lesion diameter and number were independent risk factors, while calcification and morphology were protective factors.

Conclusion

Serum MMP-2 and MMP-9 levels have important clinical values for the diagnosis and treatment of PTC by RFA. Preoperative serum MMP-2 and MMP-9 levels, combined with other affecting factors, contribute to disease prognosis.
Adductor canal block combined with local infiltration analgesia versus isolated adductor canal block in reducing pain and opioid consumption after total knee arthroplasty: a systematic review and meta-analysis
Authors: Lv Jianyong , Huang Cuiyuan , Wang Zuofeng , Ou Shan
Published: August 2020

Objective

To evaluate the efficacy and safety of the addition of local infiltration analgesia (LIA) to adductor canal block (ACB) for pain control after primary total knee arthroplasty (TKA).

Methods

Two reviewers independently searched for potentially relevant published studies using electronic databases, including PubMed® (1966 to June 2019), Embase® (1974 to June 2019) and Web of Science (1990 to June 2019). The results were pooled using the random-effects model to produce standard mean differences for continuous outcome data and odds ratio for categorical outcome data.

Results

A total of three randomized controlled trials (RCTs) and three non-RCTs were included for data extraction and meta-analysis. There were significant differences between the two groups regarding the postoperative pain score on postoperative day (POD) 0 and POD 1. The cumulative opioid consumption in the ACB plus LIA groups was significantly lower than that in the ACB groups on POD 0 and POD 1. No significant differences were found in terms of postoperative range of motion or length of hospitalization.

Conclusion

ACB plus LIA significantly reduced the postoperative pain score on POD 0 and POD 1 compared with isolated ACB. In addition, ACB plus LIA was associated with a significant reduction in opioid consumption during the early postoperative period.
Disparate effects of methicillin-resistant Staphylococcus aureus infection on renal function in IgA-dominant infection-associated glomerulonephritis and menstrual toxic shock syndrome: a case report and literature review
Authors: Zhang Yan , Wang He-bo , Chu Bao , Zhao Hui-zhi , Li Hang , Zhou Hui-min , Wang Tao
Published: August 2020

The sudden outbreak of severe acute respiratory syndrome coronavirus 2 pneumonia posed a significant challenge to medical professionals because treatment of critically ill patients requires the efforts of a multidisciplinary team. To highlight this principle, we examined acute kidney injury (AKI) in IgA-dominant infection-associated glomerulonephritis (GN) and menstrual toxic shock syndrome (mTSS). Both GN and mTSS are rare diseases caused by staphylococcal infection, and renal function is frequently impaired. The resulting AKIs are disparate pathological entities driven by distinct immune mechanisms. We begin by describing the case of a diabetic man with pyopneumothorax following methicillin-resistant Staphylococcus aureus (MRSA). He had endocapillary proliferative GN with in situ IgA-dominant immune-complex formation in the mesangium accompanied by complement C3 deposition in the glomerular capillary wall. By contrast, acute tubular necrosis was observed in a case of mTSS; the patient’s immune response was stimulated differently by MRSA enterotoxin and exotoxin resulting in aberrant IgA deposition, complement activation, and insufficient antibody production. As a multidisciplinary communication covering the fields of nephrology, immunology, and pathology, this report may help clinicians to understand these distinct renal lesions and make optimal therapeutic decisions expeditiously.
Factors associated with nonadherence to antihypertensive medication among middle-aged adults with hypertension: findings from the Taiwan National Health Interview Survey
Authors: Chou Chia-Pei , Chen Chun-Yu , Huang Kun-Siang , Lin Shih-Chun , Huang Chih-Fang , Koo Malcolm
Published: August 2020

Objective

We aimed to investigate factors associated with nonadherence to antihypertensive medication among middle-aged Taiwanese adults with hypertension.

Methods

We used data from the 2009 Taiwan National Health Interview Survey (NHIS) to identify adults age 40 to 65 years with hypertension. We used logistic regression analyses to investigate factors associated with nonadherence to antihypertensive medication.

Results

A total 1,256 respondents with hypertension taking antihypertensive medication were included in this study. Multiple logistic regression analyses revealed that six factors were significantly and independently associated with nonadherence to medication: younger age (odds ratio, [OR] = 1.85), mean monthly personal income < TWD 20,000 (USD 660) (OR = 1.87), outpatient medical services use in the past month (OR = 0.57), hospitalization in the past year (OR = 1.70), diabetes or dyslipidemia (OR = 0.63), and alcohol use in the past month (OR = 2.38).

Conclusions

This secondary data analysis of the population-based NHIS identified six factors associated with nonadherence to antihypertensive medication. These factors should be considered when planning and implementing blood pressure control interventions among middle-aged adults with hypertension.
Combination of pegylated liposomal doxorubicin and docetaxel as neoadjuvant therapy for breast cancer with axillary lymph node metastasis
Authors: Wang Li , Hong Yang , Ma Jie , Han Meng , Zhang Shuo , Shan Baoen , Liu Yunjiang
Published: August 2020

Objective

To evaluate the efficacy and safety of the combination of pegylated liposomal doxorubicin and docetaxel as neoadjuvant therapy for breast cancer (BC) in patients with axillary lymph node metastasis.

Methods

In this single-arm study, 91 patients with clinical stage IIA–IIIc breast cancer received six cycles of pegylated liposomal doxorubicin plus docetaxel as neoadjuvant chemotherapy (NAC). Trastuzumab was allowed for patients with human epidermal growth factor receptor 2-positive tumors. The primary endpoint was pathologic complete response (pCR) in the breast after surgery. The overall response rate (ORR), Miller–Payne (MP) score of the primary tumors, and incidence of adverse events were also evaluated.

Results

In total, 88 patients completed all cycles of NAC. Fourteen patients (15.4%, 95% confidence interval [CI] = 7.8–22.9) achieved pCR. The ORR was 89% (95% CI = 82.5–95.6), and 72 lesions (79.1%) were rated as MP grade 3 or higher. The left ventricular ejection fraction (LVEF) was within the normal range, although four (4.4%) patients experienced an LVEF decline exceeding 10%. No symptomatic cardiac events were reported.

Conclusion

Preoperative NAC with pegylated liposomal doxorubicin and docetaxel appears effective and safe for treating BC with axillary lymph node metastasis.
Uncemented versus cemented total hip arthroplasty for displaced femoral neck fractures in elderly patients with osteoporosis: A retrospective analysis
Authors: Zhou Xiang , Chen Meiji , Yu Weiguang , Han Guowei , Ye Junxing , Zhuang Jintao
Published: August 2020

Objective

This study was performed assess the clinical outcomes of elderly patients with osteoporotic femoral neck fractures (FNFs) (AO/OTA: 31B/C) treated by initial uncemented total hip arthroplasty (UTA) or cemented total hip arthroplasty (CTA).

Methods

This study involved consecutive elderly patients with osteoporotic FNFs (AO/OTA: 31B/C) treated by initial UTA or CTA in our medical centre from 2010 to 2015. The primary outcomes were the Harris hip score (HHS) and the rates of revision, loosening, periprosthetic fracture, and dislocation.

Results

In total, 224 patients were included in the final analysis (UTA, n = 114; CTA, n = 110). The mean follow-up duration was 60 months (range, 32–68 months). The mean HHS was 75.34 ± 18.82 for UTA and 80.12 ± 17.83 for CTA. Significant dissimilarities were detected in the rates of revision, loosening, and periprosthetic fracture between UTA and CTA (14.0% vs. 5.5%, 20.2% vs. 10.0%, and 12.3% vs. 4.5%, respectively). A significant difference was also detected in the probability of revision between the two groups.

Conclusion

Elderly patients with osteoporotic FNFs (AO/OTA: 31B/C) treated with CTA show greater improvements in functional outcomes and key orthopaedic complications than those treated with UTA.
Dexmedetomidine versus magnesium sulfate as an adjuvant to local anesthetics in spinal anesthesia: a meta-analysis of randomized controlled trials
Authors: Wang Jinguo , Wang Zaitang , Song Xuesong , Wang Na
Published: August 2020

Objective

To compare the efficacy of dexmedetomidine and magnesium sulfate as an adjuvant to local anesthetics in spinal anesthesia.

Methods

A search of PubMed, Medline, Embase, the Cochrane Library, and Google Scholar was performed. Randomized controlled trials comparing the efficacy of dexmedetomidine and magnesium sulfate as a local anesthetic adjuvant in spinal anesthesia were identified. The primary outcome was sensory block duration. The mean difference (MD) or odds ratio along with the 95% confidence interval (CI) was used to analyze the outcomes.

Results

Six studies involving 360 patients were included. Intrathecal dexmedetomidine was associated with a significantly longer sensory block duration (MD = −73.62; 95% CI = −101.09 to −46.15), faster onsets of sensory blockade and motor blockade, and a longer motor block duration than intrathecal magnesium sulfate. There was no significant difference between the regarding the rates of hypotension, bradycardia, shivering, and postoperative nausea and vomiting between the groups.

Conclusions

Dexmedetomidine is superior to magnesium sulfate as an adjuvant to local anesthetics in spinal anesthesia because of its more rapid onset and longer duration of spinal block without significant adverse effects.
The politics of scale through Rancière
Authors: Blakey Joe
Published: August 2020

This paper argues that human geography’s scale debate has arrived at somewhat of an impasse surrounding scale’s relative position to ontology. Divides are most evident between those that see scales as ‘already existing’ and those considering this as a form of ‘ontological reification’ that stifles our understanding of politics. I suggest that reading the ‘politics of scale’ through Jacques Rancière’s political thinking, and in particular his aesthetic approach to the problem of ontological reductionism, can offer one way forward. It enables geographers to take existing ‘common-sense’ ideas around scale seriously whilst also being sensitive to emergent politics.
Impacts of Connected and Autonomous Vehicles on Traffic Flow with Heterogeneous Drivers Spatially Distributed over Large-Scale Networks
Authors: Fakhrmoosavi Fatemeh , Saedi Ramin , Zockaie Ali , Talebpour Alireza
Published: August 2020

Connected and automated vehicle technologies are expected to significantly contribute in improving mobility and safety. As connected and autonomous vehicles have not been used in practice at large scale, there are still some uncertainties in relation to their applications. Therefore, researchers utilize traffic simulation tools to model the presence of these vehicles. There are several studies on the impacts of vehicle connectivity and automation at the segment level. However, only a few studies have investigated these impacts on traffic flow at the network level. Most of these studies consider a uniform distribution of connected or autonomous vehicles over the network. They also fail to consider the interactions between heterogeneous drivers, with and without connectivity, and autonomous vehicles at the network level. Therefore, this study aims to realistically observe the impacts of these emerging technologies on traffic flow at the network level by incorporating adaptive fundamental diagrams in a mesoscopic simulation tool. The adaptive fundamental diagram concept considers spatially and temporally varying distributions of different vehicle types with heterogeneous drivers. Furthermore, this study considers the intersection capacity variations and fundamental diagram adjustments for arterial links resulting from the presence of different vehicle types and driver classes. The proposed methodology is applied to a large-scale network of Chicago. The results compare network fundamental diagrams and hysteresis loop areas for different proportions of connected and autonomous vehicles. In addition to quantifying impacts of connected and autonomous vehicles, the results demonstrate the impacts of various factors associated with these vehicles on traffic flow at the network level.
The healing power of an analytical group in working through the trauma of rape
Authors: Stjepanović Tanja
Published: August 2020

This article deals with the efforts to understand the dynamics of unconscious processes in the matrix of a group which were triggered by the trauma of a female member who was raped during puberty. Her suffering set the challenge for everyone in the group to face the force of human destructiveness, both externally and internally. The therapeutic group was invaluable in helping Nina reintegrate her identity as a woman, to embrace and accept aspects of herself that she saw as weak or inferior, her sexuality as well as her destructive feelings.
Early Onset of Postoperative Gastrointestinal Dysfunction Is Associated With Unfavorable Outcome in Cardiac Surgery: A Prospective Observational Study
Authors: Seilitz Jenny , Edström Måns , Sköldberg Martin , Westerling-Andersson Kristian , Kasim Alhamsa , Renberg Anja , Jansson Kjell , Friberg Örjan , Axelsson Birger , Nilsson Kristofer F.
Published: August 2020

Objective:

The distribution of postoperative gastrointestinal (GI) dysfunction and its association with outcome were investigated in cardiac surgery patients. Gastrointestinal function was evaluated using the Acute Gastrointestinal Injury (AGI) grade proposed by the European Society of Intensive Care Medicine.

Design:

Prospective observational study at a single center.

Setting:

University hospital.

Patients:

Consecutive patients presenting for elective cardiac surgery with extracorporeal circulation (ECC).

Interventions:

None.

Results:

Daily assessment using the AGI grade was performed on the first 3 postoperative days in addition to standard care. For analysis, 3 groups were formed based on the maximum AGI grade: AGI 0, AGI 1, and AGI ≥2. Five hundred and one patients completed the study; 32.7%, 65.1%, and 2.2% of the patients scored a maximum AGI 0, AGI 1, and AGI ≥2, respectively. Patients with AGI grade ≥2 had more frequently undergone thoracic aortic surgery and had longer surgery duration and time on ECC. Patients with AGI grade ≥2 had statistically significant higher frequency of GI complications within 30 days (63.6% vs 1.2% and 5.5% in patients with AGI 0 and AGI 1) and higher 30-day mortality (9.1% vs 0.0% and 1.8% in patients with AGI 0 and AGI 1).

Conclusions:

Early GI dysfunction following cardiac surgery was associated with an unfavorable outcome. Increased attention to GI dysfunction in cardiac surgery patients is warranted and the AGI grade could be a helpful adjunct to a structured approach.
Implantable zoledronate-PLGA microcapsules ameliorate alveolar bone loss, gingival inflammation and oxidative stress in an experimental periodontitis rat model
Authors: Yao Chun , Zhang Qingqing , Li Jun , She Peng , Kong Fanzhi , Du Yanxiao , Zhang Feimin
Published: August 2020

The effect of implantable Zoledronate-PLGA microcapsules (PLGA-ZOL) in periodontitis remains unclear. In this study, we aimed to explore the potential role of PLGA-ZOL in protecting periodontitis and elucidate the underlying mechanism. A rat model of periodontitis was established by ligation the mandibular first molars, then PLGA-ZOL was implanted. The healing volume was scanned by cone-beam computed tomography. Cytokine levels in the gingival tissues were determined by ELISA and RT-PCR. Oxidative stress was indicated by detecting superoxide dismutase concentration and catalase activity. After periodontitis model was successfully established in rats, PLGA-ZOL treatment significantly attenuated alveolar bone loss, as indicated by the increased total healing volume, bone volume/tissue volume and osteoprotegerin level, as well as decreased sRANKL level. PLGA-ZOL treatment also suppressed the inflammatory activities by inhibiting pro-inflammatory cytokine production (TNF-α, IL-1β) but increasing anti-inflammatory cytokine secretion (IL-10). Furthermore, PLGA-ZOL was found to ameliorate oxidative stress in gingival tissues. In conclusion, PLGA-ZOL microcapsules ameliorate alveolar bone loss, gingival inflammation and oxidative stress in an experimental rat model of periodontitis.
Witnessing Intimate Partner Violence Across Contexts: Mental Health, Delinquency, and Dating Violence Outcomes Among Mexican Heritage Youth
Authors: Williams Lela Rankin , Adams Rueda Heidi
Published: August 2020

Immigrant Mexican American (MA) youth are at greater risk for violence exposure due to risk factors associated with migration–postmigration processes and as they settle into urban U.S. communities marked by crime and poverty. Less is known about the contexts of this exposure. Specifically, what are the ecological contexts in which youth witness intimate partner violence (IPV), how do these experiences differ by immigration generational status, and what is the impact on youth’s externalizing and internalizing behaviors? MA adolescents ( N = 279; 15–17 years, M = 16.17, SD = 0.81) from the Southwest United States participated in an online survey. Over half of adolescents had witnessed at least one incidence of IPV in the prior 2 weeks, usually involving their peers. Adolescents who had spent more time in the United States were more likely to witness violence and rated it as more severe than more recently immigrated youth. A cross-sectional path model revealed that witnessing IPV was associated with internalizing and externalizing problems. However, the associations between witnessing IPV and dating violence perpetration and victimization were mediated through acceptance of dating violence norms. Each successive generation may be more likely to witness violence across a range of ecological contexts. Witnessing violence may be central to a host of negative outcomes, including deviancy, poor mental health, and dating violence. However, preventive interventions can help youth to challenge violence norms within intimate partnerships as well as to cope with violence in their homes, peer groups, and communities.
Social Control and Self-Control: A Serial Mediation Model From Economic Hardship to Juvenile Aggression
Authors: Jiang Shan , Dong Lei
Published: August 2020

Economic hardship is a well-established risk factor for aggressive behaviors in adolescents, yet understanding of the individual and social mediators is limited. The present study aims to investigate whether the association between economic hardship and juvenile aggression is mediated by social control and self-control. Respondents included 1,280 adolescents (47.4% male) with an average age of 15.68 years ( SD = 1.23). Structural equation modeling was used to test the hypothesized model. The findings revealed that economic hardship was related to a low level of social bonds, which in turn led to a low level of self-control, thereby increasing physical, verbal, and relational aggression in adolescents. Our study combined social control and self-control into an integrated model, highlighting the role of social and individual processes in juvenile aggression. Several implications for interventions and policies are suggested for reducing aggression in adolescents.
Bathroom Modifications, Clutter, and Tripping Hazards: Prevalence and Changes after Incident Falls in Community-Dwelling Older Adults
Authors: Gell Nancy M. , Brown Harrison , Karlsson Lee , Peters Denise M. , Mroz Tracy M.
Published: August 2020

Objectives: To describe the prevalence of bathroom modifications, clutter, and tripping hazards in the homes of US older adults and to examine changes after an incident fall. Methods: We used data from the 2015–2017 National Health and Aging Trends Study ( n = 7499). Outcomes were the prevalence of bathroom modifications, clutter, and tripping hazards and changes after incident fall. Results: In 2015, 26.5% of community-dwelling older adults had clutter or tripping hazards in the home, and 69.3% had at least one bathroom modification. Compared to nonfallers, older adults with multiple falls were significantly more likely to modify the bathroom. The magnitude of hazard reduction was similar after multiple falls but was not statistically significant. Discussion: Bathroom modifications are common and increase after multiple falls. A single incident fall does not appear to lead to home environment changes to reduce fall risk. Targeting home hazards may be an opportunity to reduce fall risk.
Steering column support topology optimization including lattice structure for metal additive manufacturing
Authors: Mantovani S , Campo GA , Giacalone M
Published: August 2020

Structural engineering in the automotive industry has moved towards weight reduction and passive safety whilst maintaining a good structural performance. The development of Additive Manufacturing (AM) technologies has boosted design freedom, leading to a wide range of geometries and integrating functionally-graded lattice structures.

This paper presents three AM-oriented numerical optimization methods, aimed at optimizing components made of: i) bulk material, ii) a combination of bulk material and graded lattice structures; iii) an integration of solid, lattice and thin-walled structures.

The optimization methods were validated by considering the steering column support of a mid-rear engine sports car, involving complex loading conditions and shape.

The results of the three methods are compared, and the advantages and disadvantages of the solutions are discussed. The integration between solid, lattice thin-walled structures produced the best results, with a mass reduction of 49.7% with respect to the existing component.
Do the same socio-demographic variables predict testing uptake and sero-status? HIV and syphilis among an observational sample of Chinese men who have sex with men in Shanghai, China
Authors: Hall Casey D Xavier , Luu Minh , Nehl Eric J , He Na , Zheng Tony , Haardörfer Regine , Wong Frank Y
Published: August 2020

HIV and syphilis are pronounced among men who have sex with men (MSM) in China and often occur as co-infections, while testing remains low. Few studies examine common predictors across these outcomes. This observational venue-based sample of 546 MSM in Shanghai, China used a common set of psychosocial predictors to construct logistic models for the outcomes (HIV non-testing, syphilis non-testing, HIV sero-status, and syphilis sero-status). Fifty-seven (10.7%) participants tested positive for HIV, 126 (23.5%) for syphilis, and 33% of HIV-positive participants had a co-infection. Non-sex working MSM had consistently higher odds of HIV and syphilis non-testing (OR= 2.2, 95% CI 1.4–3.5, p <  0.001; OR = 2.4, 95, 95% CI 1.5–3.8, p <  0.001, respectively) compared to ‘money boy’ sex workers. Participants with a 0 score on HIV knowledge had 4.1 times (95% CI 1.4–12.5, p =  0.01) the odds of reporting HIV non-testing, 6.0 (95% CI 1.96–18.5, p <  0.01) times the odds of reporting non-testing for syphilis, and 8.44 times (95% CI 1.19–59.7, p =  0.03) the odds of testing positive for HIV, compared to a score of 8. The results highlighted the importance of integrating HIV/syphilis education and promoting testing for both HIV and syphilis among all sub-groups of MSM in China.
Multimodality assessment of sleep outcomes in people living with HIV performed using validated sleep questionnaires
Authors: Milinkovic Ana , Singh Suveer , Simmons Bryony , Pozniak Anton , Boffito Marta , Nwokolo Nneka
Published: August 2020

Studies conducted in people living with HIV (PLHIV) report high rates of sleep disturbance, without a clear explanation as to cause or effect. Therefore, we proposed use of multiple validated questionnaires that would allow a more comprehensive evaluation of sleep quality in PLHIV. We administered eight validated sleep and wellbeing questionnaires, recording different aspects of sleep in order to provide a comprehensive description of sleep quality, quantity, daytime functioning, wakefulness, and general wellbeing. Associations with demographics and clinical data were analyzed by univariable/multivariable analyses. Of 254 subjects 99% were male (98% men who have sex with men), 88% white, mean age 41 (SD ± 9.9) years, HIV duration eight years (SD ± 6.3), 94% were on antiretroviral therapy, mean CD4 cell count was 724 cells/mm3, 81% had HIV RNA<40 copies/ml, 72% were university educated, and 60% used ‘chemsex’ drugs. Almost half (45%) reported poor sleep quality, 22% insomnia, 21% daytime sleepiness, and 33% fatigue. As individual factors, HIV duration ≥10 years, anxiety, depression, and recreational drug use were associated with poor quality sleep, fatigue, and poorer functional outcomes (p ≤ 0.05). The prevalence of sleep disturbance was high in our cohort of PLHIV. Sleep disturbance was associated with longer duration of HIV infection, depression, anxiety, and recreational drug use.
Soluble ST2 and CXCL-10 may serve as biomarkers of subclinical diastolic dysfunction in SLE and correlate with disease activity and damage
Authors: Chorin Ehud , Hochstadt Aviram , Arad Uri , Ghantous Eihab , Gertel Smadar , Levartovsky David , Litinsky Irena , Elaluof Ofir , Polachek Ari , Kaufman Ilana , Aloush Valerie , Borok Sara , Wigler Irena , Wollman Jonathan , Caspi Dan , Laufer-Perl Michal , Letourneau-Shesaf Sevan , Berliner Shlomo , Elkayam Ori , Topilsky Yan , Paran Daphna
Published: August 2020

Objective

Subclinical myocardial dysfunction has been reported to occur early in systemic lupus erythematous (SLE). The study aim was to search for biomarkers of subclinical myocardial dysfunction which may correlate with disease activity in SLE patients.

Methods

This is a prospective, controlled, cross-sectional study of 57 consecutive patients with SLE and 18 controls. Serum samples were obtained to determine serum soluble ST2 (sST2), CXCL-10 and high-sensitivity troponin (hs-troponin) levels. All participants underwent an echocardiographic tissue Doppler study.

Results

sST2, CXCL-10 and hs-troponin levels were higher in patients with higher SLE disease activity (SLEDAI). sST2 and CXCL-10 levels were higher in patients with more disease damage as measured by the SLE damage index. Measures of diastolic dysfunction, as assessed by echocardiographic tissue Doppler negatively correlated with log CXCL-10: including E/A; E/e′lateral and E/e′septal, while E/e′ positively correlated with CXCL-10. Diastolic dysfunction parameters also correlated with log sST2 levels, a negative correlation was seen with E/e′lateral and a positive correlation was seen with E/e′. Systolic dysfunction parameters positively correlated with hs-troponin: LVED, LVES, IVS, LVMASS and LVMASS index. In a multivariate analysis, sST2 and CXCL-10 were found to be significantly different in SLE vs. healthy controls, independent of each other and independent of cardiovascular risk factors.

Conclusions

Soluble ST2 and CXCL-10 are markers of disease activity and accrued damage in SLE and may serve as sensitive biomarkers for detection of subclinical diastolic dysfunction, independent of traditional cardiovascular risk factors.
Acupuncture for tinnitus: a systematic review and meta-analysis of randomized controlled trials
Authors: Huang Kaiyu , Liang Shuang , Chen Lei , Grellet Antoine
Published: August 2020

Objective:

To evaluate the efficacy/effectiveness of acupuncture for the treatment of tinnitus.

Methods:

Four English and four Chinese databases were searched for randomized controlled trials (RCTs) of acupuncture for tinnitus published before 30 September 2018. RCTs applying acupuncture alone compared with conventional treatments, sham acupuncture, or no treatment, as well as acupuncture plus conventional treatments compared with conventional treatments alone, were included. The primary outcome was the visual analogue scale (VAS). Secondary outcomes included tinnitus handicap inventory (THI) and tinnitus severity index (TSI) scores. Meta-analysis was conducted using RevMan V5.3 software. The protocol was registered in the PROSPERO database (ref. CRD42018108692).

Results:

Eight studies involving 504 participants were included. Meta-analysis showed no significant differences in the VAS score (mean difference (MD) = −1.81, 95% confidence interval (CI) = −3.69 to 0.07; p = 0.06) between the acupuncture and control groups. However, favorable effects of acupuncture on changes in THI score (MD = −10.11, 95% CI = −12.74 to −7.48; p < 0.001) and TSI score (MD = −8.36, 95% CI = −8.87 to −7.86; p < 0.001) were found.

Conclusion:

Acupuncture had no significant effect on the primary outcome of VAS score compared with control treatment; however, positive effects on secondary outcomes (THI and TSI score) were observed in acupuncture versus control groups. Due to the low quality and small sample size of the included trials, the level of evidence was insufficient to draw any definitive conclusions. Further rigorous and high-quality studies with larger sample sizes should be conducted to confirm the efficacy/effectiveness of acupuncture for tinnitus.
Hybrid polymer composites made of sugarcane bagasse fibres and disposed rubber particles
Authors: Oliveira Pablo Resende , Ribeiro Filho Sergio Luiz Moni , Panzera Tulio Hallak , Christoforo André Luis , Durão Luís Miguel Pereira , Scarpa Fabrizio
Published: August 2020

This work describes a novel hybrid polymer composite made from sugarcane bagasse and discarded rubber particles. A 25 full factorial design is performed to identify the effects of bagasse fibres and rubber particles on the physical and mechanical properties of the composites. The mechanical properties are evaluated by tensile and compression tests, and the physical properties by apparent porosity, water absorption and bulk density. The mechanical and physical properties are substantially affected by the amount and size of the rubber particles. The length and treatment of bagasse fibres affect the stiffness and strength of the composites with less contribution. The presence of sugarcane bagasse increases the compressive toughness of hybrid composites.
Implications of the COVID-19 Pandemic for Food Security and Social Protection in India
Authors: Summerton Siân Alice
Published: August 2020

The COVID-19 pandemic is considered to have already negatively impacted upon all four dimensions of food security as defined by the Food and Agriculture Organization of the United Nations. The subsequent lockdown in India to restrict social contact and spread of the disease has caused disruption to economic activity and has created widespread unemployment in the informal sector. It is anticipated to give rise to the adoption of coping strategies by the most vulnerable, which is likely to be accompanied by a decline in nutritional status. The bailout package announced in this context is insufficient to meet the needs of Indian citizens. Furthermore, without adequate government support, existing social protection programmes have struggled to adapt to lockdown restrictions. This commentary concludes by advocating extensive investment in social protection in line with other nations, and a shift in focus from feeding schemes and cash transfers to equity, empowerment and defined rights for marginalised groups.
Addiction psychiatry training in rural Australia: a Victorian initiative
Authors: Hill Harry , Hearn Catherine , Devarakonda Sharada , Claassen Jacques
Published: August 2020

Objective:

The shortage of addiction psychiatrists in Australia results in poor access to specialist care. This is most evident in rural Australia, a population experiencing significant issues related to drugs, alcohol and mental illness. This problem is exacerbated by the lack of addiction psychiatry training in rural Australia. Purposeful and well-coordinated educational opportunities for health professionals in rural settings can assist in recruitment and retention. This report will describe the establishment of an addiction psychiatry training programme in regional Victoria.

Conclusion:

Rural addiction psychiatry training programmes that ensure trainees meet the competencies required of an addiction psychiatrist can be established. Key components in establishing programmes are: collaboration between a breadth of local services; provision of quality supervision; support of the Royal Australian and New Zealand College of Psychiatrists (RANZCP), senior psychiatrists and managers; provision of assistance to trainees and their families; and appropriate selection of trainees.
Circummaxillary Sutures in Patients With Apert, Crouzon, and Pfeiffer Syndromes Compared to Nonsyndromic Children: Growth, Orthodontic, and Surgical Implications
Authors: Meazzini Maria Costanza , Corradi Federica , Mazzoleni Fabio , De Ponti Elena , Maccagni Muriel , Novelli Giorgio , Bozzetti Alberto
Published: August 2020

Objective:

To evaluate patency of circummaxillary sutures in children with Apert, Crouzon, and Pfeiffer Syndromes and to compare it to a nonsyndromic matched control group.

Design:

Case–control study.

Setting:

Tertiary care public hospital.

Materials and Methods:

Thirty-eight computed tomography (CT) scans of patients affected by syndromic craniofacial synostosis (13 patients with Apert syndrome, 20 patients with Crouzon syndrome, and 5 patients with Pfeiffer syndrome), average age 5 ± 2.8 years, range 1.9 to 12 years, were compared to age- and sex-matched control CTs of 38 nonsyndromic children. Computed tomography scans of the study group had to be performed prior to any midfacial surgery.

Main Outcome Measures:

Midpalatal suture, zygomaticomaxillary sutures, and pterigomaxillary sutures were evaluated and scored.

Results:

The syndromic group showed a significant earlier ossification of all sutures compared to the nonsyndromic group. Significant differences were already present in early childhood and continued through adolescence.

Conclusions:

Based on the differences in terms of maxillary sutural ossification identified, midfacial hypoplasia does not seem to be only secondary to premature cranial base ossification, but also to primary synostosis of facial sutures, thus providing new insights into the pathogenesis of midface deficiency in children with craniofacial-synostosis. Care should be taken when planning any maxillary orthopedics, such as expansion or maxillary protraction, given the high frequency of early fusion of circummaxillary sutures.