bluuebunny/crossref_metadata_2025 huggingface dataset:
Development and validation of a self-management scale of type 1 diabetes for Chinese adults
Authors: Zhu Song , Liu Fang , Li Jina , Guan Yuzhu , Meng Meng , Li Xia , Zhou Zhiguang , Xu Rong , Li Lezhi
Published: August 2020

Objective

Self-management is beneficial for improving health outcomes in adults with type 1 diabetes. However, there are no validated instruments to assess self-management in Chinese adults with type 1 diabetes. The aim of this study was to develop and validate the Self-Management of Type 1 Diabetes for Chinese Adults (SMOD-CA) scale.

Methods

Qualitative and quantitative methods were used to develop the SMOD-CA. We conducted a literature review and semi-structured interviews to generate an initial item pool. An expert panel examined the content validity. We conducted a cross-sectional survey to evaluate scale reliability and validity. A total of 243 participants were recruited. Exploratory factor analyses were used to test the construct validity, and internal consistency and test-retest reliability were assessed.

Results

The expert panel determined that the SMOD-CA content validity index was satisfactory. The final 30-item scale consisted of four factors explaining 49.50% of the total variance in the data. Cronbach’s α was 0.901 for the total scale and 0.911 for test–retest reliability.

Conclusions

The SMOD-CA demonstrated good reliability and validity. The scale is a credible and effective instrument that can be used by social workers and health care professionals to assess self-management in Chinese adults with type 1 diabetes. Trial registration number NCT03610984
Influence of different erythrocyte storage times on the macrophage response in haemorrhagic shock mice
Authors: Li Zhen-Zhou , Wang Xiao-Xiao , Ma Li , Wang Huan , Xu Jia-Ming , Zhou Xiao-Fang , Liu Yang , Guo Jian-Rong
Published: August 2020

Objective

To investigate the characteristics of the macrophage response to transfusion of erythrocytes kept at different storage times in the mouse model of haemorrhagic shock.

Methods

Erythrocytes were isolated from mice and stored for 7, 21 or 35 days and samples injected intravenously into haemorrhagic shock mice. Changes in macrophages, inflammatory cytokines and T cell differentiation were assessed using flow cytometry or enzyme-linked immunosorbent assay (ELISA). In a second experiment, haemorrhagic shock mice were injected with 21D-erythrocytes and the expression of nuclear factor erythroid 2 p45-related factor 2 (Nrf2), arginine -1 (Arg-1) and inducible nitrous oxide (iNOS) determined.

Results

The proportion of M1-polarized macrophages was greatest in the 21D group while M2 macrophages tended to increase with the erythrocyte storage time. Levels of inflammatory cytokines and T helper 1 (Th1) cells increased in proportion to erythrocytes storage time. Most regulatory T cells (Treg) were found at 21D. Arg-1 expression was significantly increased in a group that received an heme oxygenase 1 (HO-1) agonist and significantly decreased in a group that received an HO-1 inhibitor but there were no differences in the expression of iNOS or Nrf2.

Conclusion

21D storage time may be an important time point for erythrocyte storage and immunity response and Arg-1 may have a role in the macrophage response to erythrocyte infusion.
Synchronous papillary thyroid carcinoma and breast ductal carcinoma
Authors: Kong Heng , Chen JiXin , Tang Shou-Ching
Published: August 2020

A 48-year-old woman was admitted to our hospital with a lump in her left breast. She was diagnosed with synchronous papillary thyroid carcinoma and breast ductal carcinoma. The patient underwent four cycles of neoadjuvant chemotherapy with epirubicin and cyclophosphamide, and one cycle of docetaxel. She then underwent left breast mastectomy and radical resection of thyroid cancer (total thyroidectomy and bilateral central group [levels VI and VII] lymph node dissection) at the same time. She was administered three cycles of chemotherapy with docetaxel and radiotherapy. The patient had no metastasis in the follow-up period. A literature search was performed to characterize the epidemiology, etiology, management, and prognosis of this condition. We speculate that hormone treatment could be a probable pathogenesis of synchronous breast and thyroid cancers.
Analysis of the clinical characteristics of 202 patients with liver abscess associated with diabetes mellitus and biliary tract disease
Authors: Song Huiwen , Wang Xianbin , Lian Yubao , Wan Tuer
Published: August 2020

Objective

Clinical characteristics of patients with pyogenic liver abscess (PLA) of varying etiologies may be different. This study aimed to analyze the clinical characteristics, pathogenic bacteria, treatment, and prognosis of patients with PLA associated with diabetes and biliary disease.

Methods

Clinical, imaging, and laboratory data from 202 inpatients with PLA were retrospectively analyzed.

Results

Eighty-eight patients (43.6%) had a history of diabetes, 73 (36.1%) had a history of underlying biliary tract disease, and 24 (11.9%) had both the diseases. The level of C-reactive protein (CRP) increased in 99.2% (119/120) patients, and the level of procalcitonin (PCT) increased in 95.5% (148/155) patients. The main pathogen of PLA was Klebsiella pneumoniae. The incidence of bloodstream infection increased by 34.4% (22/64) in patients with PLA that was associated with diabetes mellitus, and that of K. pneumoniae infection was 88.6% (39/44). The readmission rate for patients with PLA with underlying biliary diseases was 10.2 to 12.5%.

Conclusion

The main pathogen of PLA is K. pneumoniae, which is sensitive to most antibiotics. Patients with PLA associated with diabetes were more likely to have bloodstream infections, and the recurrence rate of PLA with underlying biliary diseases was higher than without biliary duct disease.
Roles of the pyroptosis signaling pathway in a sepsis-associated encephalopathy cell model
Authors: Wang Yan , Liu Xueyan , Wang Qiang , Yang Xin
Published: August 2020

Objectives

The inhibition of pyroptosis has a protective effect in sepsis-associated encephalopathy (SAE). However, the mechanisms underlying pyroptosis in SAE remain to be elucidated.

Methods

Here, we investigated the effects of the caspase inhibitors, Belnacasan (Beln) and Wedelolactone (Wede), on an induced model of SAE in P12 cells, using immunofluorescence, ELISA, western blotting, and flow cytometry.

Results

The cell viability decreased, IL-1β and IL-18 secretion increased, and the levels of the caspase cleavage products, N-terminal gasdermin D, cleaved caspase-1, and cleaved caspase-11, increased in P12 cells following combined treatment with lipopolysaccharides (LPS) and adenosine triphosphate (ATP). However, treatment with Beln or Wede ameliorated the effects induced by LPS and ATP. Neither Beln nor Wede notably affected the levels of cell apoptosis-associated proteins but these inhibitors regulated the levels of cell pyroptosis-associated proteins. Further, the combination of Beln and Wede exerted greater inhibitory effects on cell pyroptosis than either Beln or Wede alone.

Conclusions

The results demonstrated that both the canonical and non-canonical signaling pathways of cell pyroptosis are involved in LPS-induced cell damage and that the non-canonical signaling pathway may be involved to a greater extent. This suggests that the inhibition of pyroptosis may exert potential therapeutic effects on SAE.
Predictive value of the sequential organ failure assessment (SOFA) score for prognosis in patients with severe acute ischemic stroke: a retrospective study
Authors: Qin Wei , Zhang Xiaoyu , Yang Lei , Li Yue , Yang Shuna , Li Xuanting , Hu Wenli
Published: August 2020

Objective

To identify the risk factors for early death and determine the predictive value of the sequential organ failure assessment (SOFA) score for prognosis of severe acute ischemic stroke (AIS).

Methods

A total of 110 patients with severe AIS were enrolled and divided into the non-survivor (n = 34) and survivor groups (n = 76). Logistic regression analysis was conducted to identify risk factors for early death, while the receiver operator characteristic (ROC) curve was used to determine the predictive effect of the SOFA score on prognosis.

Results

Logistic regression analysis showed that urinary tract infection (odds ratio [OR] = 17.364, 95% confidence interval [CI]: 1.903–158.427), mechanical ventilation (OR = 1.754, 95% CI: 1.648–2.219), and osmotic therapy (OR = 2.835, 95% CI: 1.871–5.102) were significantly correlated with early death of severe AIS. ROC curve analysis of the area under the curve after hospitalization showed that the maximum SOFA and ΔSOFA scores exceeded 0.7.

Conclusion

Our study shows that urinary tract infection, mechanical ventilation, and osmotic therapy are risk factors for early death of severe AIS. The SOFA score has good predictive value for prognosis of severe AIS. These findings may provide a guideline for improving clinical outcome.
Redefined hyponatremia as a marker to exclude the diagnosis of anastomotic leakage after colorectal cancer surgery
Authors: Zhang Guochao , Lian Rui , Sun Lichao , Liu Haibin , Wang Yan , Zhou Lei
Published: August 2020

Objective

Our objective was to investigate the association between anastomotic leakage (AL) and hyponatremia after colorectal cancer surgery.

Methods

All anastomoses in colorectal cancer surgery performed in our hospital between January 2015 and December 2017 were retrospectively identified. According to the diagnostic criteria of AL, the patients were divided into an AL group and a no anastomotic leakage (NAL) group.

Results

We reviewed records of 498 consecutive colorectal cancer patients. The total incidence of AL was 5.4%. Postoperative serum sodium levels differed significantly: 137.63 ± 4.29 and 139.81 ± 3.41 mmol/L in the AL and NAL groups, respectively. By using area under the receiver-operating characteristic (auROC) curves, we determined the optimum postoperative serum sodium cut-off to be 139.5 mmol/L and redefined hyponatremia as postoperative serum sodium <139.5 mmol/L. Redefined hyponatremia had an auROC of 0.65, corresponding to a 97.2% negative predictive value. The negative predictive value reached 99.1% when serum sodium level was combined with leukocytosis. Multivariable analysis found that redefined hyponatremia (odds ratio, 1.176) was an independent predictive factor for AL.

Conclusions

Redefined hyponatremia has good negative predictive value for AL diagnosis after colorectal cancer surgery and could be used as a marker to exclude the diagnosis.
An alternative world: a perspective from the North on racism and migration
Authors: Loftsdóttir Kristín
Published: August 2020

With the rise of populist movements of various kinds, racism has become one of the key issues debated in the present. This piece stresses the need to recognise racism as a part of the wider social and cultural contexts that populist movements operate within in Nordic countries and beyond. Populist movements’ claims of not being racist gain legitimacy through discourses of race and difference that are generally not recognised as racist but seen as constituting common-sense knowledge that creates an alternative world where racist claims seem to make sense. The article discusses this through three points of emphasis: everyday racism and racist exceptionalism; the idea of prior immobility; and the continued existence of structural racism. Finally, the discussion focuses on this alternative world from the perspective of debates about migration revolving essentially around future anticipation, which become particularly salient during times of crisis.
Return to Play After Medial Patellofemoral Ligament Reconstruction: A Systematic Review
Authors: Manjunath Amit K. , Hurley Eoghan T. , Jazrawi Laith M. , Strauss Eric J.
Published: August 2020

Background:

Medial patellofemoral ligament (MPFL) reconstruction is being performed more frequently in athletes experiencing recurrent patellar instability.

Purpose/Hypothesis:

The purpose was to systematically review the evidence in the orthopaedic sports medicine literature to determine both the rate and timing of return to play after MPFL reconstruction and the rate of further patellar instability. Our hypothesis was that there would be a high rate of return to play after MPFL reconstruction.

Study Design:

Systematic review.

Methods:

A systematic literature search was performed based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, which utilized EMBASE, MEDLINE, and the Cochrane Library databases. Inclusion criteria for literature included clinical studies reporting on return to play after MPFL reconstruction. Rate of return to play, level of return, timing of return, rate of recurrent instability, and patient-reported outcomes were evaluated. Statistical analysis was performed using SPSS.

Results:

Our review found 27 studies including 1278 patients meeting our inclusion criteria. The majority of patients were women (58%), and the total group had a mean age of 22.0 years and a mean follow-up of 39.3 months. The overall rate of return to play was 85.1%, with 68.3% returning to the same level of play. The average time to return to play was 7.0 months postoperatively. The rate of recurrent instability events following reconstruction was 5.4%. There was an improvement in both mean visual analog scale, pain scores (preoperative: 4.3, postoperative: 1.6) and Tegner activity scores (preoperative: 4.8, postoperative: 5.5).

Conclusion:

The overall rate of return to play was high after MPFL reconstruction for the treatment of recurrent patellar instability. However, a relatively high percentage of those patients were unable to return to their preoperative level of sport. Additionally, there was a moderate time taken to return to play, at approximately 7 months after the procedure.
Experimental investigation on flexural behaviour of spherical core sandwich structure
Authors: Pandyaraj V , Rajadurai A
Published: August 2020

The flexural behaviour of a novel spherical core sandwich structure made up of glass fibre reinforced plastic is investigated. The core orientation is modified into four different types called as regular, inverted, interlock and stagger. Vinyl ester resin is used as a matrix and two glass fibre reinforcements, namely chopped strand mat and woven fabrics, are used. The spherical core diameter is taken as 16 mm, whereas 24 and 32 mm are taken as the pitch distances. Three-point and four-point configurations are taken for the flexural tests. The flexural stiffness of these 16 different types of cored structures is found as per the ASTM D7250 standard. The failure patterns are analysed as per the ASTM C393 standard. In both the loading configuration of interlock model with 32 mm pitch, distance shows an improved flexural stiffness. Most of the failures are observed to be debonding between the facing sheet and the core, whereas in the interlocking model with 32 mm pitch, the failure is due to the fracture of the facing sheet.
Preventing Functional Urinary Incontinence in Hip-Fractured Older Adults Through Patient Education: A Randomized Controlled Trial
Authors: Córcoles-Jiménez María-Pilar , Candel-Parra Eduardo , del Egido-Fernández Maria-Ángeles , Villada-Munera Ascensión , Moreno-Moreno Mónica , Piña-Martínez Antonio-Javier , Jiménez-Sánchez María-Delirio , Azor-García Ramón-Jesús
Published: August 2020

The purpose of this study was to evaluate whether an educational intervention would reduce the incidence of functional urinary incontinence (UI) in older adults with a fall-related hip fracture. The project was conducted as a multicenter randomized controlled trial (RCT). A total of 109 patients that had been admitted to six hospitals in Castilla-La Mancha (Spain) for acute treatment of hip fracture, previously continent and without cognitive impairment, were enrolled and randomly assigned to the experimental group (EG) or the control group (CG). Intervention (on EG): urinary habit training (Nursing Interventions Classifications taxonomy) was performed during hospital stay (second to fourth postoperative day), with a telephonic reinforcement 10 days after discharge. The CG received routine care. Primary outcome measure: incidence of UI. Follow-up: telephone assessment 3 and 6 months after discharge (blinded evaluation). The incidence of UI at 6 months was 49% (CG) versus 25.5% (EG) (relative risk = 0.52, 95% confidence interval [0.3, 0.9]; number necessary to treat = 4). The mean of UI episodes was 0.54 (EG) versus 1.8 (CG), p = .007. The educational intervention prevents the development of UI and decreases the number of episodes in case of appearance, in a statistically significant way.
Practical learnings from an epidemiology study on TDI-related occupational asthma: Part I—Cumulative exposure is not a good indicator of risk
Authors: Plehiers Patrick M , Chappelle Anne H , Spence Mark W
Published: August 2020

The anonymized data of an epidemiology study on incidence of toluene diisocyanate (TDI)-related occupational asthma in three US-based TDI production facilities have been reanalyzed to identify where to best focus exposure reduction efforts in industrial practice to reduce the risk of sensitization to TDI. Since the induction of sensitization has sometimes been attributed to cumulative exposure, this relationship was examined first. Gross cumulative exposure values (i.e. not taking into account whether respiratory protection was used or not) and net cumulative exposure values (i.e. accounting for the use of respiratory protection) per participant were calculated based on the duration of their study participation and the average time-weighted average value of the exposure group to which they belonged. These two sets of cumulative exposure data were compared with asthma incidence using logistic regression. Incidence was zero among workers who rarely come into contact with open plant systems (e.g. during maintenance or spills). Notwithstanding, no statistically significant relationship between asthma incidence and either gross or net cumulative exposure could be determined. This is shown to be consistent with the results of several other epidemiology studies on TDI-related occupational asthma. In conclusion, cumulative exposure values are not a good indicator of the risk of developing TDI-related occupational asthma.
Computational Radiology in Breast Cancer Screening and Diagnosis Using Artificial Intelligence
Authors: Tran William T. , Sadeghi-Naini Ali , Lu Fang-I , Gandhi Sonal , Meti Nicholas , Brackstone Muriel , Rakovitch Eileen , Curpen Belinda
Published: August 2020

Breast cancer screening has been shown to significantly reduce mortality in women. The increased utilization of screening examinations has led to growing demands for rapid and accurate diagnostic reporting. In modern breast imaging centers, full-field digital mammography (FFDM) has replaced traditional analog mammography, and this has opened new opportunities for developing computational frameworks to automate detection and diagnosis. Artificial intelligence (AI), and its subdomain of deep learning, is showing promising results and improvements on diagnostic accuracy, compared to previous computer-based methods, known as computer-aided detection and diagnosis.

In this commentary, we review the current status of computational radiology, with a focus on deep neural networks used in breast cancer screening and diagnosis. Recent studies are developing a new generation of computer-aided detection and diagnosis systems, as well as leveraging AI-driven tools to efficiently interpret digital mammograms, and breast tomosynthesis imaging. The use of AI in computational radiology necessitates transparency and rigorous testing. However, the overall impact of AI to radiology workflows will potentially yield more efficient and standardized processes as well as improve the level of care to patients with high diagnostic accuracy.
Issue Salience and Pledge Fulfilment in Minority and Majority Coalitions: Evidence from the Czech Republic
Authors: Vodová Petra
Published: August 2020

The article focuses on the differences in pledge fulfilment strategies in majority and substantive minority governments. Issue ownership and dynamic agenda-setting literature are applied, expecting that government parties will focus on fulfilling the party’s most salient pledges, and also the pledges that are publicly salient for the whole electorate. Adding these expectations to the context of substantive minority governments, parties must accommodate these attempts because they face the opposition actor(s) with veto power and their own policy motivation. Compared to majority governments, the odds of adopting party-salient pledges should decrease for minority coalition parties. The effect of public-salient issues should also differ from the majority governments. This analysis is conducted on government party pledges in one minority and two majority governments in the Czech Republic (formed after 2006, 2010, and 2013 elections). The analysis shows a generally weak effect for party and public issue salience on pledge fulfilment. The decreasing effect of party issue salience for minority government parties is supported; the effect of public issue salience does, however, not differ in its decreasing direction from the majority governments. The additional model including combinations of the high and low party and public salience shows that for minority governments, public salience decreases the odds of fulfilment regardless of party issue salience. The article concludes with a contextual explanation of the minority government’s special character in the Czech case.
Intraperitoneal vancomycin for peritoneal dialysis-associated peritonitis in children: Evaluation of loading dose guidelines
Authors: Hennessy Kathleen , Capparelli Edmund V , Romanowski Gale , Alejandro Lawrence , Murray William , Benador Nadine
Published: August 2020

Background:

Current pediatric International Society for Peritoneal Dialysis guidelines for initial treatment of peritoneal dialysis (PD)-associated peritonitis suggest either monotherapy with cefepime or double therapy with first-generation cephalosporin or glycopeptide and ceftazidime or aminoglycoside. When using vancomycin, the intraperitoneal (IP) recommended pediatric loading dosage is 1000 mg/L of dialysate. This is based on adult pharmacokinetic (PK) studies and roughly translates to the adult recommendation where 30 mg/kg in 2 L is approximately 1000 mg/L. However, since the dialysate volume in pediatric patients is normalized to body surface area and not weight, the current recommended dosing can result in high vancomycin exposure in children. Vancomycin can potentially cause adverse effects. We aimed to determine if the IP vancomycin dosing of 1000 mg/L was causing elevated vancomycin levels and to offer possible dosing recommendations based on PK modeling and simulation.

Methods:

Retrospective review of pediatric patients who had been treated with IP vancomycin for PD-associated peritonitis. Vancomycin levels obtained for clinical monitoring were analyzed using NONMEM to generate population and individual (empiric Bayesian) estimates of vancomycin PK parameters and estimated peak levels. Predicted vancomycin peaks were also simulated from virtual pediatrics patients 3–70 kg following various dosing strategies.

Results:

Six episodes of peritonitis in three patients were analyzed. In the two episodes treated with 1000 mg/L, the first vancomycin levels (h post) were 95.6 ug/mL (3) and 49 (33) and following 500 mg/L were 33.2 (11), 30.2 (11), 23.6 (24), and 22.1 (11). All patients were cured of their peritonitis without the need for catheter removal. Based on our population PK model, a 1000 mg/L IP vancomycin loading dose will typically result in peak > 50 mg/L in patients weighing <35 kg and >60 mg/L in patients <15 kg. Vancomycin levels will remain above 20 mg/L for over 2 days without additional vancomycin dosing.

Conclusion:

The data suggest that a loading dose of vancomycin 1000 mg/L leads to higher than desired vancomycin levels and should be lowered. A 500 mg/L loading dosing appears more appropriate and needs further study.
Gender, Class, and the Gig Economy: The Case of Platform-Based Food Delivery
Authors: Milkman Ruth , Elliott-Negri Luke , Griesbach Kathleen , Reich Adam
Published: August 2020

Drawing on original survey and interview data on platform-based food delivery workers, we deploy an intersectional lens to analyze the ways in which the white working-class women who predominate in this sector of the gig economy interpret their work experience. With a focus on the gender–class nexus, we explore the reasons why these workers, especially mothers and other caregivers, self-select into this sector. These include: scheduling flexibility, which facilitates balancing paid work and family care; the opportunity to use previously unpaid food shopping skills to generate income, a neoliberal form of “wages for housework”; and the emotional rewards of serving elderly and disabled customers who cannot easily shop for themselves. Although these workers embrace the traditional gender division of labor and normative femininity, at the same time they express strong class resentment of both the companies they work for and the class and gender entitlements of their most privileged customers.
A finite element based simulation framework for robotic grasp analysis
Authors: Dharbaneshwer SJ , Thondiyath Asokan , Subramanian Sankara J , Chen I-Ming
Published: August 2020

The commonly used grasp simulators such as GraspIt! and OpenRAVE use wrench space formulations and grasp quality metrics such as ϵ and v to identify stable grasps in dynamic conditions. However, wrench space formulations are derived based on static mechanical equilibrium equations, and the physical attributes of the object such as stiffness and mass are also not considered for grasp analysis. Above all, these grasp analysis frameworks cannot be experimentally validated, thereby resulting in grasps that are not reliable. In this paper, an experimentally validatable Finite Element (FE) based grasp analysis framework is proposed for evaluation of robotic grasps in dynamic conditions. By applying standard solutions of Hertzian contact theory to a few robotic grasps, Finite Element Method (FEM) is validated. A real-world grasp situation is then simulated using FEM, and the FE model is validated based on the contact area measured in real-time using a pressure sensor. By applying dynamic perturbations to the validated FE model, the stability of the grasp is evaluated, and the most stable grasp is identified using the contact area based metric, π. It is observed that FE simulations agree with the analytical solutions and experimental results, with a relative error of not more than 7%.
Effect of ceramic particles reinforcement on the ballistic resistance of friction stir processed thick AA6061 surface composite targets
Authors: Magarajan U , Suresh Kumar S
Published: August 2020

In this paper, the effect of ceramic particles (Zirconium, Boron Carbide and Graphene) on the ballistic resistance of Friction Stir Processed (FSPed) thick AA6061 targets had been explored. The Base Metal AA6061 plates of 25 mm thickness were FSPed by reinforcing Zirconium (Zr), Boron Carbide (B4C) and Graphene (G), thus producing FSPed-Zr, FSPed-B4C and FSPed-G surface composite targets. Microhardness test was carried out and the hardness of FSPed-Zr, FSPed-B4C and FSPed-G were found to be 96, 106 and 122 HV respectively. High velocity ballistic experiments were conducted on all the targets against Ø7.62x51 mm Armour Piercing Projectile at an initial velocity of 680 ± 10 m/s. AA6063 backing plates were used to identify the ballistic resistance of the FSPed targets by Depth of Penetration (DOP) method. Consequently, higher microhardness along with frictional characteristics had increased the ballistic resistance of FSPed-G targets by 70.8%. Further, by analyzing the penetration channel, it was noticed that in FSPed-G target, the jacket detachment occurred in the entry region predominantly where the microhardness was the highest compared to other two regions. This phenomenon occurred just after the entry region for FSPed-B4C target and in middle region for FSPed-Zr target. Scanning Electron Microscopy (SEM) images inferred that, FSPed targets have absorbed maximum projectile’s kinetic energy at the entry region itself, resulting in formation of cracks. As a result, middle and exit region experienced less impact. Post ballistic microhardness test showed enhanced microhardness in the entry region of FSPed-G target due to severe work hardening. Hence the ceramic particles deposited by FSP have reduced the kinetic energy of the projectile with FSPed-G target resulting in maximum ballistic resistance.
A transferable method for estimating the economic impacts of track interventions: Application to ground-borne noise reduction measures for whole sections of route
Authors: Young Marcus , Rempelos Georgios , Ntotsios Evangelos , Blainey Simon , Thompson David , Preston John
Published: August 2020

The environmental impacts of noise and vibration are becoming increasingly important in the assessment of new and upgraded railway routes. Vibration from railways propagates through the ground to nearby buildings where it may cause annoyance as feelable vibration or as re-radiated noise. To tackle the adverse effects of ground-borne noise a range of possible interventions are available, including softer rail pads, under-sleeper pads and under-ballast mats. The installation costs of such interventions are generally higher for the higher-performing track types. Additionally, there are potential effects on track maintenance costs which may be positive or negative, for example by reducing sleeper damage or increasing the need for ballast tamping. This study presents a socio-economic analysis of the effects of several interventions to reduce ground-borne noise. By selecting a whole route, the installation and whole-life costs are assessed using Network Rail’s Vehicle-Track Interaction Strategic Model (VTISM) and these are offset against benefits in terms of reduced social costs. Ground-borne noise is predicted at various distances from the alignment using the Modelling of Train Induced Vibration (MOTIV) model and the effect of track interventions is determined as insertion loss spectra. The re-radiated noise within a typical domestic building is then estimated using generic building transfer functions. Geographic Information System tools are used to estimate the population affected by ground-borne noise and their expected level of exposure. The methodology is illustrated using a case study route between Brighton and Portsmouth in the South of England.
Preverbal Infants Discover Statistical Word Patterns at Similar Rates as Adults: Evidence From Neural Entrainment
Authors: Choi Dawoon , Batterink Laura J. , Black Alexis K. , Paller Ken A. , Werker Janet F.
Published: August 2020

The discovery of words in continuous speech is one of the first challenges faced by infants during language acquisition. This process is partially facilitated by statistical learning, the ability to discover and encode relevant patterns in the environment. Here, we used an electroencephalogram (EEG) index of neural entrainment to track 6-month-olds’ ( N = 25) segmentation of words from continuous speech. Infants’ neural entrainment to embedded words increased logarithmically over the learning period, consistent with a perceptual shift from isolated syllables to wordlike units. Moreover, infants’ neural entrainment during learning predicted postlearning behavioral measures of word discrimination ( n = 18). Finally, the logarithmic increase in entrainment to words was comparable in infants and adults, suggesting that infants and adults follow similar learning trajectories when tracking probability information among speech sounds. Statistical-learning effects in infants and adults may reflect overlapping neural mechanisms, which emerge early in life and are maintained throughout the life span.
How journalists and experts metaphorically frame emerging information technologies: The case of cyberinfrastructure for big data
Authors: Droog Ellen , Burgers Christian , Kee Kerk F.
Published: August 2020

Journalists and experts contribute to the creation of frames (frame-building) of innovations. However, little is known about the specific contribution of these different societal actors to the frame-building of emerging information technologies. This article focuses on a specific emerging information technology – cyberinfrastructure for big data. In particular, we investigated the role of metaphors in the frame-building of cyberinfrastructure during its early development, and contrast the metaphorical framing of cyberinfrastructure by journalists in a corpus of US news texts (Study 1) with the metaphorical framing of experts in a corpus of interviews (Study 2). Results show considerable differences between the frames by journalists and experts in the frame-building process. Journalists, to a great extent, employ their own frames in conceptualizing cyberinfrastructure rather than drawing on the frames used by experts. Future research should investigate the impact of these different metaphorical frames on audience members.
Centenary memorabilia of Adam Politzer
Authors: Mudry Albert , Young John Riddington
Published: August 2020

Adam Politzer (1835–1920) was one of the greatest otologists of all time. On the 100th Anniversary of his death, this paper pays tribute to his legacy to our specialty and examines various memorabilia made during those hundred years in his honour. Items as diverse as book plates, postage stamps and postcards stand alongside commemorative medals, busts and plaques, all bearing witness to his legendary status and contribution to our specialty.
Impact of changes to cervical screening guidelines on age and interval at which women are tested: Population-based study
Authors: Castanon Alejandra , Sheikh Shama , Pearmain Philippa , Sasieni Peter
Published: August 2020

Background

English cervical screening programme guidelines changed between 2009 and 2012. We explore the impact on the age and intervals at which women receive a cytology test.

Methods

Eligible women were controls from a population-based case–control study in England. Tests taken between 1980 and 2017 were extracted from the call/recall database. Using the Kaplan–Meier estimator by birth cohort and age at (or time since) last test, we explore proportions tested since or prior to a given age, years since previous test, and interval following a negative test.

Results

Screening histories from 46,037 women were included. Proportion tested by age 26 has increased from 55% among birth cohorts 1978–1979 to 67% among those born 1990–1991, despite more recent cohorts only having received one invitation (instead of two) prior to age 26. The proportion of women tested at aged 28 with a test three years earlier increased by 20% (from 36% in 1997–2006 to 56% in 2012–2017) whereas the proportion tested at ages 23–27 without a prior test increased from 34% to 80%. The age at last test prior to exiting the programme has decreased: among those born 1928–1931 86% had a test aged 60–65, but only 71% of those born 1947–1951.

Conclusion

Clear programme guidance alongside quality assurance has improved the cervical screening programme by standardising the age and intervals at which women are screened.
Striving to Meet Global Health Competencies Without Study Abroad
Authors: Amerson Roxanne
Published: August 2020

Introduction:

The COVID-19 (coronavirus disease 2019) pandemic has radically changed the future of study abroad, yet students require the knowledge, skills, and attitudes to provide care for diverse cultures across geographical boundaries. The purpose of this article is to facilitate innovative learning opportunities in order to meet global health competencies in the physical or virtual classroom when study abroad is not feasible.

Approach:

Based on a review of published literature related to global health competencies and nursing over the last decade, a description of suggested global learning activities is provided.

Results:

Few research publications exist to describe activities for meeting global health competencies when travel abroad is restricted. The proposed activities provide a foundation to address the gap in literature and to establish a trajectory for future research.

Discussion:

The challenge is to demonstrate evidence of global health competency attainment when students are confined to their local community.
Low-Molecular-Weight Heparin and Fondaparinux Use in Pediatric Patients With Obesity
Authors: Garner Michael P. , Onuoha Chimnonso P. , Fenn Norman E.
Published: August 2020

Objective:

The objective of this study is to comprehensively review the efficacy and safety data of low-molecular-weight heparins (LMWHs) and fondaparinux in pediatric patients with obesity.

Data Sources:

A comprehensive literature search of PubMed, SCOPUS, CINAHL, Academic Search Complete, PsycInfo, Cochrane Library, and Web of Science databases was conducted (1900 to July 2020). Search terms utilized included LMWH, low-molecular-weight heparin, enoxaparin, dalteparin, tinzaparin, fondaparinux, pediatric, child, children, obese, obesity, overweight. No limits or timeline restrictions were imposed.

Study Selection and Data Extraction:

Studies that reported pediatric patients with described overweight or obesity and utilized LMWHs or fondaparinux were considered.

Data Synthesis:

Of 207 studies screened, 12 were included. Average dose reductions of 12.9% to 37.3% from the starting dose were observed with treatment indications of enoxaparin and increased up to 27.3% for prophylactic indications. Trends could not be concluded in the dalteparin and fondaparinux studies. Four thrombotic and 15 bleeding events were reported in the studies.

Relevance to Patient Care and Clinical Practice:

Pediatric patients with obesity may initially be underdosed or overdosed with enoxaparin compared with children with healthy body weight, depending on the indication.

Conclusion:

Pediatric patients with obesity may benefit from proactively adjusting enoxaparin dosing on initiation of therapy. Further studies are needed for dalteparin and fondaparinux in these populations. Clinical controversy exists with the relevance of monitoring these high-risk medications for therapeutic and prophylactic indications. Thrombotic and hemorrhagic events were similar to reported adult outcomes.
The Father’s Kenosis: A Defense of Bonaventure on Intra-trinitarian Acts
Authors: Wood Jordan Daniel
Published: August 2020

Russell Friedman identifies two “rival accounts” in medieval trinitarian theology. The “emanation account,” which Bonaventure represents, prefers to emphasize the constitutive role of “act” or “operation” among the intra-trinitarian persons. The “relation account,” that of Thomas Aquinas, prefers rather to say that relations alone constitute divine persons. A specific question illustrates their difference: Does the Father generate the Son because the Father is Father, or is He Father because He generates the Son? Aquinas thinks the former, Bonaventure the latter. Bonaventure’s position attracts criticism from contemporary Thomists. And even Franciscan sympathizers have conceded ambiguity around this point of his trinitarian theology. To wit: If the Father’s act of begetting the Son makes him Father, doesn’t this presume a “Proto-Father,” as Friedman has it, who begets? I argue that this criticism ignores the uniquely Christian-Neoplatonic premises Bonaventure’s view presumes. Perceiving them manifests Bonaventure’s deep coherence on this point and beyond.
Handling Missing Data in the Short Form–12 Health Survey (SF-12): Concordance of Real Patient Data and Data Estimated by Missing Data Imputation Procedures
Authors: Wirtz Markus A. , Röttele Nicole , Morfeld Matthias , Brähler Elmar , Glaesmer Heide
Published: August 2020

If information on single items in the Short Form–12 health survey (SF-12) is missing, the analysis of only complete cases causes a loss of statistical power and, in case of nonrandom missing data (MD), systematic bias. This study aimed at evaluating the concordance of real patient data and data estimated by different MD imputation procedures in the items of the SF-12 assessment. For this ends, MD were examined in a sample of 1,137 orthopedic patients. Additionally, MD were simulated (a) in the subsample of orthopedic patients exhibiting no MD ( n = 810; 71%) as well as (b) in a sample of 6,970 respondents representing the German general population (95.8% participants with complete data) using logistic regression modelling. Simulated MD were replaced by mean values as well as regression-, expectation-maximization- (EM-), and multiple imputation estimates. Higher age and lower education were associated with enhanced probabilities of MD. In terms of accuracy in both data sets, the EM-procedure (ICC2,1 = .33-.72) outperformed alternative estimation approaches substantially (e.g., regression imputation: ICC2,1 = .18-.48). The EM-algorithm can be recommended to estimate MD in the items of the SF-12, because it reproduces the actual patient data most accurately.
Drug–Drug Interactions of 257 Antineoplastic and Supportive Care Agents With 7 Anticoagulants: A Comprehensive Review of Interactions and Mechanisms
Authors: Peixoto de Miranda Érique José F. , Takahashi Thamy , Iwamoto Felipe , Yamashiro Suzete , Samano Eliana , Macedo Ariane Vieira Scarlatelli , Ramacciotti Eduardo
Published: August 2020

Data on drug–drug interactions (DDI) of antineoplastic drugs with anticoagulants is scarce. We aim to evaluate factors associated with DDI of antineoplastic and supportive care drugs with anticoagulants resulting in modification of pharmacokinetics of these last mentioned. A literature review on DDI databases and summaries of products characteristics (SmPC) was done. Drug–drug interactions of 257 antineoplastic and supportive care drugs with direct oral anticoagulants (DOACs), warfarin, enoxaparin, or fondaparinux were categorized as no clinically significant expected DDI, potentially weak DDI, potentially clinically significant DDI, and recommendation against coadministration. Logistic regression models were performed to analyze the association between the dependent variable potentially clinically significant interaction/recommendation against coadministration and the mechanisms of DDI. Of the 1799 associations, 84.4% were absence of DDI, 3.6% potentially weak DDI, 10.2% potentially clinically relevant DDI, and 2.0% recommendation against coadministration. Warfarin has higher DDI potential than other anticoagulants. Enoxaparin and fondaparinux have fewer DDI than others. There was no difference between DOACs. Drug–drug interactions with apixaban and rivaroxaban was independently associated with the absence of CYP3A4 competition, P-glycoprotein inhibition, CYP3A4 induction, and drug class of tyrosine kinase inhibitors. Drug–drug interactions with dabigatran and edoxaban was associated with inhibition of P-glycoprotein and tyrosine kinase inhibitors. Warfarin, induction of CYP3A4, and inhibition of CYP2C9. Enoxaparin and fondaparinux, only tyrosine kinase inhibitors. Direct oral anticoagulants did not differ regarding DDI with antineoplastic agents. Warfarin presented more DDI than other anticoagulants. P-glycoprotein inhibition and CYP3A4 induction were independently associated with DDI of antineoplastic agents with DOACs.
Safety, Immunogenicity, and Hemostatic Efficacy of Nonacog Gamma in Patients With Severe or Moderately Severe Hemophilia B: A Continuation Study
Authors: Windyga Jerzy , Stasyshyn Oleksandra , Lissitchkov Toshko , Mamonov Vasily , Serban Margit , Rusen Luminita , Ploder Bettina , Tangada Srilatha
Published: August 2020

This phase 3, prospective, open-label, multicenter, continuation study (NCT01286779) investigated the use of a recombinant factor IX (FIX), nonacog gamma (BAX 326, RIXUBIS®) in patients with severe or moderately severe hemophilia B. The study population included 85 patients transitioning from a phase 1/3 pivotal study (NCT01174446), a pediatric study (NCT01488994), and 30 newly recruited patients, naïve to nonacog gamma. Patients received nonacog gamma as prophylaxis treatment (standard, modified or PK-tailored) or on-demand, as determined by the investigator. Treatment was assessed for safety, immunogenicity, hemostatic efficacy and consumption. In this study, after ≥100 exposure days, nonacog gamma resulted in no treatment-related serious adverse events, and no patients developed inhibitory antibodies to FIX. Nonacog gamma was efficacious at controlling bleeding episodes, with an 89.1% overall hemostatic efficacy rating of excellent or good, and 56% of bleeds resolved with one infusion. The annualized bleeding rate was considerably lower during prophylactic treatment (median ABR of 1.3 in 108 patients) than during on-demand treatment (median ABR of 16.5 in 13 patients). These results show that in previously treated patients and nonacog gamma-naïve patients, long-term use of nonacog gamma had acceptable safety and tolerability, and was efficacious as a prophylactic treatment for the management of bleeding episodes.

NCT01286779, EudraCT: 2010-022726-33
Association of Acidemia With Short-Term Mortality of Acute Myocardial Infarction: A Retrospective Study Base on MIMIC-III Database
Authors: Zhang Tang , Guan Yao-Zong , Liu Hao
Published: August 2020

Acute myocardial infarction (AMI) is a leading cause of death and not a few of these patients are combined with acidemia. This study aimed to detect the association of acidemia with short-term mortality of AMI patients. A total of 972 AMI patients were selected from the Medical Information Mart for Intensive Care (MIMIC) III database for analysis. Propensity-score matching (PSM) was used to reduce the imbalance. Kaplan-Meier survival analysis was used to compare the mortality, and Cox-proportional hazards model was used to detect related factors associated with mortality. After PSM, a total of 345 non-acidemia patients and 345 matched acidemia patients were included. The non-acidemia patients had a significantly lower 30-day mortality (20.0% vs. 28.7%) and lower 90-day mortality (24.9% vs. 31.9%) than the acidemia patients ( P < 0.001 for all). The severe-acidemia patients (PH < 7.25) had the highest 30-day mortality (52.6%) and 90-day mortality (53.9%) than non-acidemia patients and mild-acidemia (7.25 ≤ PH < 7.35) patients ( P < 0.001). In Cox-proportional hazards model, acidemia was associated with improved 30-day mortality (HR = 1.518; 95%CI = 1.110-2.076, P = 0.009) and 90-day mortality (HR = 1.378; 95%CI = 1.034 -1.837, P = 0.029). These results suggest that severe acidemia is associated with improved 30-day mortality and 90-day mortality of AMI patients.