bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimization of polymer electrolytes with the effect of concentration of additives in PEO-NH4HF2 polymer electrolytes
Authors: Sharma Jitender Paul , Guleria Neelam
Published: June 2020

In the present work, nanocomposite polymer electrolyte films were prepared by solution casting technique using nanosized fumed silica to polyethylene oxide (PEO)-based polymer electrolytes containing ammonium bifluoride (NH4HF2). The ionic conductivity of 1.19 × 10−5 S cm−1 has been observed at room temperature (25°C) for 3 wt% fumed silica in PEO-10 wt% NH4HF2 polymer electrolytes after which the conductivity was observed to decrease. Furthermore, the addition of high dielectric constant plasticizer propylene carbonate (PC) in the optimized composition of nanocomposite polymer electrolytes has increased the number of charge carriers by the large dissolution of ionic salt, amorphous content, and hence the ionic conductivity. Maximum ionic conductivity obtained at room temperature was found to be 1.55 × 10−4 S cm−1 in the case of PEO-10 wt% NH4HF2-3 wt% fumed silica-0.3 (ml) PC polymer electrolytes which is five orders of magnitude higher than that of the polymer host material. Temperature-dependent ionic conductivity, activation energy, and dielectric constant studies have been described for all the compositions of polymer electrolytes. Ionic conductivity and dielectric constant studies were determined from impedance data. Polymer electrolytes containing both fumed silica and PC highlight that there is no phase transition in the polymer electrolyte and temperature dependence of ionic conductivity in the temperature range is of almost Arrhenius type. The lowest activation energy value for the highest conducting polymer electrolyte was found to be 0.172 eV. Change in melting temperature, % crystallinity ( χc), and mechanical properties have also been observed in polymer electrolytes containing fumed silica as well as PC as studied by Differential Scanning Calorimetry/Thermogravimetric Analysis (DSC/TGA) and universal testing machine, respectively.
Hemodynamic Safety of Continuous Infusion Labetalol Versus Esmolol Combination Therapies for Type B Aortic Dissections
Authors: Myers Kayla L. , Leong Christopher R. , Mahmoud Ahmed A.
Published: June 2020

Background:

Medical management for type B aortic dissections (TBADs) require aggressive blood pressure and heart rate control to minimize further dissection extension and to restore perfusion to vital organs. Current guidelines recommend β-blockers (BB) as first-line therapy, however do not differentiate an ideal agent for use.

Objective:

This study evaluated the hemodynamic safety of continuous infusion labetalol compared to esmolol combination (EC) therapies for TBADs.

Methods:

This single-center, retrospective analysis identified patients with a TBAD who received high dose continuous intravenous labetalol (HD-CIVL) or EC therapies. Patients who received HD-CIVL or EC therapies for a minimum of 2 hours, during which a minimum of 4 blood-pressure readings were recorded, were included. The primary end point was the incidence of hemodynamic instability with the use of HD-CIVL versus EC therapies.

Results:

A total of 20 patients receiving HD-CIVL and 22 patients receiving EC therapy were included in the analysis. Ten (50%) of patients receiving HD-CIVL and 7 (32%) of patients receiving EC therapies met the clinical definition of hemodynamic instability ( P = .23). Patients experiencing hemodynamic instability were all due to hypotension, with one also being due to bradycardia. Over half the patients in both groups had discontinued therapy ( P = .06) and were administered bolus fluids ( P = .27). Only one patient receiving HD-CIVL required vasopressor administration while none in the EC group ( P = .48).

Conclusion:

Our study suggests that HD-CIVL is associated with a nonstatistical significant higher incidence of hemodynamic instability compared to an EC regimen in TBADs. Further studies are warranted in this patient population.
Design of a low noise turbofan duct via an acoustic gradient-enhanced Kriging method
Authors: Qiu S
Published: June 2020

The Kriging models which are frequently used in aerodynamic shape optimization may become computationally inefficient when solving problems with large numbers of design variables. One solution to this problem would be the application of gradient-enhanced Kriging model. A gradient-enhanced Kriging and acoustic adjoint-method approach to duct acoustic problems is developed, aimed to improve the efficiency and accuracy of the existing Kriging approach at acoustic problems with many design parameters. To our knowledge, it is the first application of gradient-enhanced Kriging for duct acoustic problem. It employs a Kriging response surface in the parameter space, augmented with gradients obtained from the acoustic adjoint equations efficiently. The present paper aims at describing the potential of the gradient-enhanced Kriging method for low noise turbofan duct design. Prior to the optimization process, the implementation of the unsteady aeroacoustic adjoint method in shape optimization is validated by comparing the gradient values with that obtained by finite differences. In this work, the ordinary Kriging model and gradient-enhanced Kriging method are applied firstly to a benchmark functions and the results show that the additional gradient information can signiﬁcantly enhance the accuracy of Kriging model. And then, the original Kriging-based, adjoint-based and the gradient-enhanced Kriging method are all used to model 50 variable duct acoustic problems, respectively. The test results show that this approach whose gradient information is introduced by using acoustic adjoint method developed from multimode LEE, named as acoustic gradient-enhanced Kriging, can signiﬁcantly enhance the accuracy of Kriging models when the gradient data are available and thus provide an optimized low noise intake while maintaining the aerodynamic performance.
Racism in European Health Care: Structural Violence and Beyond
Authors: Hamed Sarah , Thapar-Björkert Suruchi , Bradby Hannah , Ahlberg Beth Maina
Published: June 2020

Research shows how racism can negatively affect access to health care and treatment. However, limited theoretical research exists on conceptualizing racism in health care. In this article, we use structural violence as a theoretical tool to understand how racism as an institutionalized social structure is enacted in subtle ways and how the “violence” built into forms of social organization is rendered invisible through repetition and routinization. We draw on interviews with health care users from three European countries, namely, Sweden, Germany, and Portugal to demonstrate how two interrelated processes of unequal access to resources and inequalities in power can lead to the silencing of suffering and erosion of dignity, respectively. The strength of this article lies in illuminating the mechanisms of subtle racism that damages individuals and leads to loss of trust in health care. It is imperative to address these issues to ensure a responsive and equal health care for all users.
Post-Qualitative Projects: Exhilarating and Popular “Fashion”?
Authors: Koro Mirka
Published: June 2020

The purpose of this article is to “do something less intentional” with post-qualitative inquiry while thinking about scholarship and “methodologies” as hesitant moves and uncertain stances always in necessary and immanent flux. Coming from hesitation and uncertainty post-qualitative inquiry does not mean anything specific or particular to me. Rather, I focus on the potential embedded in post-qualitative projects while I also worry about creating boundaries around immanently shifting practices.
Scoring Dimension-Level Job Performance From Narrative Comments: Validity and Generalizability When Using Natural Language Processing
Authors: Speer Andrew B.
Published: June 2020

Performance appraisal narratives are qualitative descriptions of employee job performance. This data source has seen increased research attention due to the ability to efficiently derive insights using natural language processing (NLP). The current study details the development of NLP scoring for performance dimensions from narrative text and then investigates validity and generalizability evidence for those scores. Specifically, narrative valence scores were created to measure a priori performance dimensions. These scores were derived using bag of words and word embedding features and then modeled using modern prediction algorithms. Construct validity evidence was investigated across three samples, revealing that the scores converged with independent human ratings of the text, aligned numerical performance ratings made during the appraisal, and demonstrated some degree of discriminant validity. However, construct validity evidence differed based on which NLP algorithm was used to derive scores. In addition, valence scores generalized to both downward and upward rating contexts. Finally, the performance valence algorithms generalized better in contexts where the same qualitative survey design was used compared with contexts where different instructions were given to elicit narrative text.
The gay scientist: Kane Race on the unexpected possibilities of experimental intimacies
Authors: Hakim Jamie , Race Kane
Published: June 2020

In this interview with Jamie Hakim, Kane Race talks about his most recent monograph The Gay Science: Intimate Experiments With the Problem of HIV (2018). In The Gay Science, he explores how practices of sex and intimacy between gay men are shifting amidst what he calls the changing infrastructures of gay life – digital, chemical and communal. As such the book is empirically oriented and looks at a wide range of topics from hook-up apps, to PreP to chemsex/party ‘n’ play, to the history and politics of Sydney’s Mardi Gras as they take place on the ground. Theoretically he blends the thought of philosophers such as Michel Foucault and Friedrich Nietzche with critical perspectives such as actor-network theory and Science and Technology Studies to argue that as scholars of sexual practice we need to pay more attention to what emerges within the contingencies of the assemblages and infrastructures that make sex between gay men possible. In so doing, the book is far more optimistic about gay sex and digital media then either popular media or influential strands of queer theory, offering path-breaking insight into the major concerns of this special issue on Chemsex Cultures.
Is it all about storytelling? Living and learning hereditary cancer on Twitter
Authors: Vicari Stefania
Published: June 2020

Storytelling has long been used as a theoretical framework for understanding how we share information and learn about health – and illness – online. But is it all about storytelling on social media platforms? To explore how and to what extent personal stories shape health content on these platforms, this article presents an analysis of tweets discussing the BRCA gene mutation – a hereditary cancer condition. Theoretically, the study advances a new conceptual framework to explore social media practices within issue-based and long-lived social media threads. Methodologically, it develops a platform-oriented discourse analytic approach. Findings show that non-narrative content is actually more common than storytelling in Twitter conversations about BRCA, with a number of patient advocates acting as gatekeepers of scientific information. Most BRCA storytelling is mediated and shared in third person, with those at the heart of these stories becoming exemplars within the BRCA ‘subculture’.
“The Only Option Is Failure”: Growing Safe to Fail Workplaces for Critical Reflection
Authors: Nicolaides Aliki , Poell Rob F.
Published: June 2020

The Problem

Whereas critical reflection has been the hallmark of learning from experience in the workplace, performance has been the hallmark for productivity. In the face of complex, ongoing, disruptive change, failing safe is a necessary condition for learning from experience, and critical reflection the method of learning from safe to fail experiments. How can workplaces be safe to fail spaces where critical reflection is embraced, encouraged, and rewarded?

The Solution

We focus especially on the role of the leader to create a climate of psychological safety where it is safe to practice critical reflection. The workplace needs to become a safe place to fail to facilitate productivity, innovation, and creative responses to the demands that ensue from disruption at work.

The Stakeholders

This article is relevant to human resource development (HRD) scholars and practitioners who are interested in developing the workplace in times of uncertainly and constant disruption.
Do You Get What You Pay for? Salary and Ex Ante Player Value in Major League Baseball
Authors: Solow John L. , Krautmann Anthony C.
Published: June 2020

The last few years have seen a resurgence of very long, very expensive guaranteed contracts in Major League Baseball. Commentators who examine the outcomes of earlier long-term contracts generally conclude that teams greatly overpay in these situations. These assessments suffer from the use of perfect hindsight, however. In this article, we estimate the economic gain that could be anticipated at the time of signing of a contract. We forecast the player’s expected future productivity in terms of winning based on recent performance at the time of the contract signing and adjusted for player aging. We translate this expected performance into a stream of expected marginal revenues using estimates of the team-specific value of a marginal win and discount these to present value at the time of signing. The economic cost of the contract to the team is measured by the discounted stream of guaranteed future salaries across the contract horizon. Comparing these benefits and costs indicates that teams overpay on average and more so for longer contracts. Some part of this is likely explained by benefits beyond the effect of games won.
From Open Data to “Grounded Openness”: Recursive Politics and Postcolonial Struggle in Hong Kong
Authors: Hoyng Rolien
Published: June 2020

This article maps the parameters of an emerging field of struggle around “openness” pertaining to digital data in the postcolonial smart city. Whereas colonial governance operated in relative secrecy with archives not quite available to ordinary citizens, what do we make of current institutions from government departments to banks flaunting their commitment to Open Data? Looking at data activism in Hong Kong, this article highlights the (post)colonial histories that have shaped the reception of Open Data in this context. More so, it explores the ways in which the techno-materialities of data infrastructures affect and reconfigure postcolonial struggle. Building on Kelty’s discussion of “recursive publics” and Hui’s account of recursivity, my notion of recursive politics underscores the mutuality of social history and techno-materiality. While recursive politics can contribute to technodiversity, I analyze how such politics weigh up against the political and ethical investments of postcolonial struggle.
A new algorithm for considering green communication and excellent sensing performance in cognitive radio networks
Authors: Huang Tangsen , Yin Xiangdong , Cao Qingjiao
Published: June 2020

Multi-node cooperative sensing can effectively improve the performance of spectrum sensing. Multi-node cooperation will generate a large number of local data, and each node will send its own sensing data to the fusion center. The fusion center will fuse the local sensing results and make a global decision. Therefore, the more nodes, the more data, when the number of nodes is large, the global decision will be delayed. In order to achieve the real-time spectrum sensing, the fusion center needs to quickly fuse the data of each node. In this article, a fast algorithm of big data fusion is proposed to improve the real-time performance of the global decision. The algorithm improves the computing speed by reducing repeated computation. The reinforcement learning mechanism is used to mark the processed data. When the same environment parameter appears, the fusion center can directly call the nodes under the parameter environment, without having to conduct the sensing operation again. This greatly reduces the amount of data processed and improves the data processing efficiency of the fusion center. Experimental results show that the algorithm in this article can reduce the computation time while improving the sensing performance.
Examining Work Experiences Among Collegiate Recreation Employees
Authors: Lopez Colin , Taylor Elizabeth A. , Jones Gareth J. , Huml Matt R. , Funk Daniel
Published: June 2020

Research on the experiences of employees has been plentiful over the last decade; however, work examining the experiences of collegiate recreation employees is limited. In order to enhance employee well-being, it is important that management understands the experiences of their employees and can invest in job supports that best suit the needs of their employees. Therefore, this research study examined the impact of work and family conflict, workaholism, work engagement, burnout, and coping on employees within the industry of collegiate recreation. In this study, 2,474 National Intramural and Recreational Sports Association (NIRSA) professional and student members were sent a survey in which 621 participated and 522 were analyzed. Results indicate employees with young children and those in early career positions may experience significant work–family conflict/family–work conflict and burnout.
Safety and feasibility of the Woven EndoBridge device deployment with monitored anesthesia care
Authors: Ishii Daizo , Li Luyuan , Zanaty Mario , Roa Jorge A , Allan Lauren , Samaniego Edgar A , Hasan David M
Published: June 2020

Objective

The Woven EndoBridge (WEB) device can be used for complex intracranial aneurysms (IAs), mostly under general anesthesia (GA). However, it remains controversial if anesthetic management could affect procedural outcomes after endovascular treatments using the WEB for IAs. The purpose of this study is to investigate the safety and feasibility of the WEB deployment for patients under monitored anesthesia care (MAC).

Methods

We reviewed 27 IAs in 25 patients who were treated by using the WEB device from February to December in 2019. Our first-line anesthetic management of patients during the procedures was the MAC. GA was performed based on patient’s clinical status or preference. Subjects’ demographic data, aneurysms’ characteristics, procedure-related complications, grade of stasis after the WEB deployment, duration of procedure, and length of hospital stay were compared between subjects who underwent GA versus those who underwent MAC.

Results

Successful deployment of the WEB device was obtained in all patients. In total, 10 and 17 IAs were treated with GA and MAC, respectively. There was no significant difference in demographics (age: p = 0.12, sex: p = 0.54), aneurysms’ characteristics (ruptured: p = 1.00, neck width: p = 0.96, aspect ratio: p = 0.98, maximum diameter: p = 0.69), complications ( p = 1.00), postprocedural grade of stasis ( p = 1.00), duration of the procedure ( p = 0.23), and the length of hospital stay ( p = 0.81) between GA and MAC.

Conclusions

MAC can be used for the WEB device deployment safely and effectively.
Hard knock coaching: A cross-cultural study of the effects of abusive leader behaviors on athlete satisfaction and commitment through interactional justice
Authors: Kim Seungmo , Hong Sungil , Magnusen Marshall J , Rhee Yoojung
Published: June 2020

The objective of this study was to examine the direct and indirect relationships between abusive coaching behaviors and athletes’ satisfaction and affective organizational commitment through interactional justice and to explore the differences in the relationships between Hong Kong and Korea. A total of 521 student-athletes (Hong Kong: 232; Korea: 289) in intercollegiate athletics participated in the survey. The results of structural equation modeling (SEM) indicated partial mediations of interactional justice between abusive and supportive coaching styles and satisfaction and commitment. Although the multigroup SEM results revealed no differences in terms of the directions and levels of significance of the relationships among the variables between two countries, there was a significant difference in the size of the effect of abusive leadership on the outcomes between the two groups.
A rare case of peliosis hepatis in primary immune deficiency
Authors: Angulo Evelyn , Joyner Sydney , Majeed Nasma K , Nyenhuis Sharmilee
Published: June 2020

Peliosis hepatis is a rare condition characterized by blackish-blue blood-filled cavities in hepatic parenchyma caused by dilatation of hepatic sinusoids. Peliosis hepatis has been described in secondary immunodeficiencies and certain medications. We present the first case of peliosis hepatis in a patient with a primary immunodeficiency, common variable immunodeficiency. A 44-year-old African-American male presented with gastrointestinal bleeding and elevated liver function tests. His medical history included common variable immunodeficiency and chronic kidney disease. The patient had jaundice, regenerative nodules on liver pathology, and low immunoglobulin levels. A magnetic resonance imaging of the abdomen with contrast revealed a cirrhotic liver, a 5 × 3 cm lesion, and poorly defined nodules which had decreased enhancement. A computed tomography-guided liver biopsy revealed peliosis hepatis, focal nodular hyperplasia, and fibrosis. No other etiology of his liver disease was found. The etiology of peliosis hepatis in patients with primary immunodeficiencies remains unclear. Additional studies are needed to understand the underlying mechanisms.
Interaction Between Age and Change in Velocity During a Baseball Training Program
Authors: Antonacci Christopher , Atlee Thomas R. , Chalmers Peter N. , Hadley Christopher , Bishop Meghan E. , Romeo Anthony A. , Erickson Brandon J.
Published: June 2020

Background:

Pitching velocity is one of the most important metrics used to evaluate a baseball pitcher’s effectiveness. The relationship between age and pitching velocity after a lighter ball baseball training program has not been determined.

Purpose/Hypothesis:

The purpose of this study was to examine the relationship between age and pitching velocity after a lighter ball baseball training program. We hypothesized that pitching velocity would significantly increase in all adolescent age groups after a lighter baseball training program, without a significant difference in magnitude of increase based on age.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

Baseball pitchers aged 10 to 17 years who completed a 15-week training program focused on pitching mechanics and velocity improvement were included in this study. Pitchers were split into 3 groups based on age (group 1, 10-12 years; group 2, 13-14 years; group 3, 15-17 years), and each group trained independently. Pitch velocity was assessed at 4 time points (sessions 3, 10, 17, and 25). Mean, maximum, and mean change in pitch velocity between sessions were compared by age group.

Results:

A total of 32 male baseball pitchers were included in the analysis. Mean/maximum velocity increased in all 3 age groups: 3.4/4.8 mph in group 1, 5.3/5.5 mph in group 2, and 5.3/5.2 mph in group 3. While mean percentage change in pitch velocity increased in all 3 age groups (group 1, 6.5%; group 2, 8.3%; group 3, 7.6%), the magnitude of change was not significantly different among age groups. Program session number had a significant effect on mean and maximum velocity, with higher mean and maximum velocity seen at later sessions in the training program ( P = .018). There was no interaction between age and program session within either mean or maximum velocity ( P = .316 and .572, respectively).

Conclusion:

Age had no significant effect on the magnitude of increase in maximum or mean baseball pitch velocity during a velocity and mechanics training program in adolescent males.
Heme induces rapid endothelial barrier dysfunction via the MKK3/p38MAPK axis
Authors: James Joel , Srivastava Anup , Varghese Mathews Valuparampil , Eccles Cody A. , Zemskova Marina , Rafikova Olga , Rafikov Ruslan
Published: June 2020

Several studies demonstrate that hemolysis and free heme in circulation cause endothelial barrier dysfunction and are associated with severe pathological conditions such as acute respiratory distress syndrome, acute chest syndrome, and sepsis. However, the precise molecular mechanisms involved in the pathology of heme-induced barrier disruption remain to be elucidated. In this study, we investigated the role of free heme in the endothelial barrier integrity and mechanisms of heme-mediated intracellular signaling of human lung microvascular endothelial cells (HLMVECs). Heme, in a dose-dependent manner, induced a rapid drop in the endothelial barrier integrity of HLMVECs. An investigation into barrier proteins revealed that heme primarily affected the tight junction proteins zona occludens-1, claudin-1, and claudin-5, which were significantly reduced after heme exposure. The p38MAPK/HSP27 pathway, involved in the regulation of endothelial cytoskeleton remodeling, was also significantly altered after heme treatment, both in HLMVECs and mice. By using a knockout (KO) mouse for MKK3, a key regulator of the p38MAPK pathway, we showed that this KO effectively decreased heme-induced endothelial barrier dysfunction. Taken together, our results indicate that targeting the p38MAPK pathway may represent a crucial treatment strategy in alleviating hemolytic diseases.
A case of thrombomodulin mutation causing defective thrombin binding with absence of protein C and TAFI activation
Authors: Okada Masahiko , Tominaga Norio , Honda Goichi , Nishioka Junji , Akita Nobuyuki , Hayashi Tatsuya , Suzuki Koji , Moriuchi Hiroyuki
Published: June 2020

Thrombomodulin functions as an anticoagulant through thrombin binding and protein C activation. We herein report the first case of hereditary functional thrombomodulin deficiency presenting with recurrent subcutaneous hemorrhage and old cerebral infarction. The patient had a homozygous substitution of glycine by aspartate at amino acid residue 412 (Gly412Asp) in the thrombin-binding domain of the thrombomodulin gene (designated thrombomodulin-Nagasaki). In vitro assays using a recombinant thrombomodulin with the same mutation as the patient showed a total lack of thrombin binding and activation of protein C and thrombin-activatable fibrinolysis inhibitor (TAFI). Marked clinical and laboratory improvement was obtained with recombinant human soluble thrombomodulin therapy.
Vancomycin use and cytomegalovirus reactivation after allogeneic hematopoietic cell transplantation
Authors: Zhang Shijia , Shanley Ryan , Weisdorf Daniel J. , Rashidi Armin
Published: June 2020

Key Points

Vancomycin exposure in the pre-engraftment period was associated with an increased risk for CMV reactivation after allogeneic HCT. Some gram-positive bacteria may protect against CMV reactivation.
Jejunal inflammatory cytokines, barrier proteins and microbiome-metabolome responses to early supplementary feeding of Bamei suckling piglets
Authors: Jin Jipeng , Jia Jianlei , Zhang Liping , Chen Qian , Zhang Xiaoyan , Sun Weibo , Ma Cunming , Xu Fafang , Zhan Shoujun , Ma Limin , Zhou Guihua , Chen Qiaoxi
Published: June 2020

Background

Dietary intervention has been reported to improve intestinal health. The intestinal microbiota of newborn animals plays a fundamental role in the development of intestinal function and the innate immune system. However, little is currently known about dietary interventions in the gut microbiota and barrier function of livestock, especially suckling Bamei piglets. To this end, we studied the effect of early dietary supplementation on intestinal bacterial communities and intestinal barrier function in piglets.

Results

10 purebred Bamei sows were randomly allocated into two groups. In group one, the piglets received a supplementary milk replacer on day 7 of age, whereas the other control group was allowed sow’s milk alone. At 21 days, 18 and 17, respectively, piglets in each group of average weight were randomly selected and sacrificed. Tissue and digesta samples were collected from the jejunum to evaluate differences in the microbiome-metabolome and the mRNA expression of inflammatory cytokines (TLR4, TNFα and IL-8) and barrier proteins (ZO-1, Occludin and Claudin-1). Sequencing of 16S rRNA revealed that ES improved the gut microbiome composition of Bamei suckling piglets. The relative abundances of some bacterial species such as Lactobacillales, Romboutsia, Actinobacillus, Bacteroides were significantly reduced in the ES group. Metabolomics analysis indicated that 23 compounds were enriched and 35 compounds decreased in the ES group. And correlation analysis demonstrated that some gut bacterial genera were highly correlated with altered gut microbiota-related metabolites. Meanwhile, ES of Bamei suckling piglets altered the gene expression of inflammatory cytokine and barrier protein in the jejunum.

Conclusions

In summary, these results provide important insights on the relationships between jejunal microbiota and related metabolites, and jejunal barrier function during the early life of Bamei suckling piglets.
Impact of guideline awareness in public pharmacies on counseling of patients with acute or chronic constipation in a survey of pharmacy personnel
Authors: Eberlin Marion , Landes Sabine , Biber-Feiter Doerthe , Michel Martin C.
Published: June 2020

Background

Constipation is often self-managed by patients and guidelines are available to aid healthcare professionals in the counseling of patients for self-management. Therefore, we have explored the knowledge and attitude of pharmacy personnel towards guidelines for the management of acute and functional chronic constipation and how they affects their recommendations.

Methods

An online survey was conducted among 201 pharmacists and pharmacy technicians from an existing panel. They were presented with two typical cases, a 62-year old woman with functional chronic constipation and a 42-year old woman with travel plans. For each case, they were asked about their treatment recommendations and the underlying rationale. Thereafter, they were provided with contents from an applicable national guideline and asked again about their recommendations and the underlying rationale. In line with the exploratory nature, data were analyzed in a descriptive manner only.

Results

Before exposure to guideline content, the most frequent recommendations for chronic constipation were macrogol, fiber and lactulose and for acute constipation sodium picosulfate, bisacodyl and enemas. Following guideline exposure, the most frequent recommendations for chronic constipation were macrogol, bisacodyl and sodium picosulfate and for acute constipation bisacodyl, sodium picosulfate and macrogol (all three equally recommended by the guideline for the management of acute and chronic constipation). Correspondingly, the rationale behind the recommendations shifted with guideline conformity becoming a leading reason.

Conclusions

Awareness of the content of an applicable guideline on the management of constipation was poor among pharmacy personnel. Accordingly, recommendations in many cases were not in line with the guideline. Greater awareness of guideline content is desirable to enable more evidence-based recommendations in the management of constipation.
The risk of rheumatoid arthritis among patients with inflammatory bowel disease: a systematic review and meta-analysis
Authors: Chen Yi , Chen Lang , Xing Changsheng , Deng Guangtong , Zeng Furong , Xie Tingting , Gu Lei , Yang Huixiang
Published: June 2020

Background

Studies have suggested that patients with inflammatory bowel disease (IBD) have an increased risk of rheumatoid arthritis (RA). However, the available data on this association are inconsistent. This meta-analysis aimed to determine the association between IBD and the risk of RA.

Methods

Observational studies investigating the RA risk among patients with IBD (Crohn disease (CD) and/or ulcerative colitis (UC)) were searched in PubMed, Embase, and Web of Science from the date of inception to December 2019. The methodological quality of the included studies was assessed using the Newcastle-Ottawa Scale. Relative risks (RRs) and corresponding 95% confidential intervals (CIs) were pooled with a random-effects model. Heterogeneity was evaluated using I2 statistics while publication bias was determined using Begg’s and Egger’s tests. Subgroup and sensitivity analyses were performed.

Results

A total of three cohort studies, three cross-sectional studies, and two case-control studies were included in the meta-analyses. Compared to the non-IBD control or general population, there was a significantly higher risk of RA among patients with IBD (RR = 2.59; 95% CI: 1.93–3.48). Moreover, both CD (RR = 3.14; 95% CI: 2.46–4.01) and UC (RR = 2.29; 95% CI: 1.76–2.97) were associated with a significantly increased risk of RA. However, heterogeneity was substantial across studies and the subgroup analyses failed to identify the potential source of heterogeneity.

Conclusions

Patients with IBD have a greater risk of developing RA. Rheumatologists should be consulted when patients with IBD present with undifferentiated joint complaints. However, more prospective cohort studies are needed to validate these results.
Validation of a new risk score system for non-variceal upper gastrointestinal bleeding
Authors: Kim Min Seong , Moon Hee Seok , Kwon In Sun , Park Jae Ho , Kim Ju Seok , Kang Sun Hyung , Sung Jae Kyu , Lee Eaum Seok , Kim Seok Hyun , Lee Byung Seok , Jeong Hyun Yong
Published: June 2020

Background

Recently, a new international bleeding score was developed to predict 30-day hospital mortality in patients with upper gastrointestinal bleeding (UGIB). However, the efficacy of this newly developed scoring system has not been extensively investigated. We aimed to validate a new scoring system for predicting 30-day mortality in patients with non-variceal UGIB and determine whether a higher score is associated with re-bleeding, length of hospital stay, and endoscopic failure.

Methods

A retrospective study was performed on 905 patients with acute non-variceal UGIB who were examined in our hospital between January 2013 and December 2017. Baseline characteristics, endoscopic findings, re-bleeding, admission, and mortality were reviewed. The 30-day mortality rate of the new international bleeding risk score was calculated using the receiver operating characteristic curves and compared to the pre-endoscopy Rockall score, AIMS65, Glasgow Blatchford score, and Progetto Nazionale Emorragia Digestiva score. To verify the variable for the 30-day mortality of the new scoring system, we performed multivariate logistic regression using our data and further analyzed the score items.

Results

The new international bleeding scoring system showed higher receiver operating characteristic (ROC) curve values in predicting mortality (area under ROC curve 0.958; [95% confidence interval (CI)]), compared with such as AIMS65 (AUROC, 0.832; 95%CI, 0.806–0.856; P < 0.001), PNED (AUROC, 0.865; 95%CI, 0.841–0.886; P < 0.001), Pre-RS (AUROC, 0.802; 95%CI, 0.774–0.827; P < 0.001), and GBS (AUROC, 0.765; 95%CI, 0.736–0.793; P < 0.001). Multivariate analysis was performed using our data and showed that the 30-day mortality rate was related to multiple comorbidities, blood urea nitrogen, creatinine, albumin, syncope at first visit, and endoscopic failure within 24 h during the first admission. In addition, in the high-score group, relatively long hospital stay, re-bleeding, and endoscopic failure were observed.

Conclusion

This is a preliminary report of a new bleeding score which may predict 30-day mortality better than the other scoring systems. High-risk patients could be screened using this new scoring system to predict 30-day mortality. The use of this scoring system seemed to improve the outcomes of non-variceal UGIB patients in this study, through proper management and intervention.
Epidemiology, vaccine effectiveness, and risk factors for mortality for pneumococcal disease among hospitalised adults in Singapore: a case-control study
Authors: Chan Tyson , Tay Min Zhi , Kyaw Win Mar , Chow Angela , Ho Hanley J.
Published: June 2020

Background

Streptococcus pneumoniae infections can lead to severe morbidity and mortality, especially in patients with invasive pneumococcal disease (IPD). This study evaluated factors associated with pneumococcal disease, pneumococcal vaccine effectiveness, and risk factors for all-cause mortality in hospitalised adults with pneumococcal disease in Singapore.

Methods

Retrospective case-control study of patients tested for pneumococcal disease with streptococcal urinary antigen testing and at least one sterile site culture, during their admission to a tertiary hospital in Singapore from 2015 to 2017. Patients were defined as cases of IPD or non-IPD, or as controls, based on laboratory results and clinical diagnoses. Multivariable models were constructed to determine factors associated with IPD/non-IPD, and risk factors for mortality from pneumococcal disease. Vaccine effectiveness against IPD/non-IPD was estimated using a variation of the test-negative design.

Results

We identified 496 pneumococcal disease cases, of whom 92 (18.5%) had IPD. The mean age of cases was 69.1 ± 15.4 years, and 65.5% were male. Compared with controls (N = 9181), IPD patients were younger (mean age 61.5 ± 16.3 years, vs 72.2 ± 16.1 years in controls; p < 0.001) and with less co-morbidities [median Charlson’s score 1 (IQR 0–4), vs 3 (1–5) in controls; p < 0.001]. IPD patients also had the highest proportions with intensive care unit (ICU) admission (20.7%), inpatient mortality (26.1%) and longest median length of stay [9 (IQR 8–17) days]. On multivariable analysis, IPD was negatively associated with prior pneumococcal vaccination (adjusted relative risk ratio = 0.20, 95%CI 0.06–0.69; p = 0.011). Risk factors for mortality among pneumococcal disease patients were ICU admission, diagnosis of IPD, age ≥ 85 years and Charlson’s score > 3.

Conclusion

Patients with pneumococcal disease (especially IPD) were younger and had less co-morbidities than controls, but had higher risk of severe clinical outcomes and mortality. Pneumococcal vaccination effectiveness against IPD was estimated to be about 80%, and should be encouraged among high-risk patients.
MicroRNA-182-5p protects human lens epithelial cells against oxidative stress-induced apoptosis by inhibiting NOX4 and p38 MAPK signalling
Authors: Li Zhao-Na , Ge Ming-Xu , Yuan Zhong-Fang
Published: June 2020

Background

MicroRNAs (miRNAs) are abnormally expressed in various ocular diseases, including age-related cataract. However, the role of miR-182-5p in the progression of age-related cataract remains unclear.

Methods

The expression of miR-182-5p in HLE-B3 cells was detected by qRT-PCR. HLE-B3 cells were transfected with miR-182-5p mimics. CCK-8, EdU, flow cytometry, 2′,7′-dichlorodihydrofluorescein diacetate, JC-1 kit, and western blot were used to assess the cell viability, proliferation, apoptosis, reactive oxygen species (ROS) level, mitochondrial membrane potential (MMP), and protein expression, respectively, in vitro. The relationship between miR-182-5p and NOX4 was confirmed using the dual-luciferase reporter gene analysis.

Results

We found that miR-182-5p expression was significantly decreased by the H2O2 exposure. Overexpression of miR-182-5p promoted cell proliferation and inhibited ROS production and apoptosis in H2O2-induced HLE-B3 cells. Moreover, p-p-38, p-ERK, and p-JNK were up-regulated in H2O2-treated HLE-B3 cells, and overexpression of miR-182-5p reversed the effects of H2O2 on HLE-B3 cells. In addition, dual-luciferase reporter assay substantiated that NOX4 was a direct target and downregulated by miR-182-5p.

Conclusions

We concluded that miR-182-5p inhibited lens epithelial cells apoptosis through regulating NOX4 and p38 MAPK signaling, providing a novel biomarker for treatment of age-related cataract.
A case of pheochromocytoma presenting with cardiac manifestation: case report
Authors: Molaei Akbar , Abarzadeh-Bairami Vahideh , Sadat-Ebrahimi Seyyed-Reza
Published: June 2020

Background

Pheochromocytomas are rare tumors originating in chromaffin cells which predominantly are located in adrenal glands. Sustained or paroxysmal hypertension (HT) is the most frequent sign of pheochromocytoma. In some cases, it is associated with the classic triad including episodic headaches, sudoresis, and tachycardia; however, we present a case of pheochromocytoma with first presentation of cardiomyopathy.

Case presentation

The authors describe a rare case of a pheochromocytoma which was first presented with cardiomyopathy in a 7-year-old patient. The patient was admitted with malaise, abdominal pain, polydipsia, and myalgia. Further evaluations revealed hyperglycemia, mild dehydration and sinus tachycardia but no HT. Echocardiography demonstrated some of the signs of cardiomyopathy which was incorrectly diagnosed as viral myocarditis. The patient was discharged with this diagnosis but he presented again with HT crisis a few months later. A diagnosis of pheochromocytoma was assigned after the evaluation of the HT secondary causes. The diagnosis was confirmed by metanephrine assay and the tumor was localized in the adrenal gland using the abdominal MRI.

Conclusion

Pheochromocytoma can present itself with normotensive cardiomyopathy. Therefore, the possibility of pheochromocytoma should be considered in patients with cardiomyopathy especially in those with positive familial history.
Health inequality: a longitudinal study on geographic variations in lung cancer incidence and mortality in Taiwan
Authors: Hsu Jason C. , Tseng Yu-Chi , Chang Sheng-Mao , Lee Yang-Cheng , Lin Peng-Chan , Chu Hone-Jay
Published: June 2020

Background

This study is aimed toward an analysis of the variations in lung cancer incidence and mortality, adjusted by population factors (age, gender, and year), between administrative areas.

Methods

This is a retrospective study, using 2005–2014 data in each administrative area from the Taiwan Cancer Registry database organized by the Health Promotion Administration. The yearly age-standardized (overall) and crude (stratified by gender and age) incidence/mortality (and their growth rates) for each administrative area were collected and calculated. We used a mixed model to analyze the repeated measurements of yearly incidence and mortality rates and used general linear regression to analyze their growth rates.

Results

It was found that male and elderly populations had significantly higher lung cancer incidence and mortality in Taiwan. After adjusting for gender, age, and calendar year, there were no significant variations in incidence among the administrative areas, while the mortality in Yilan County was significantly higher than that in Taipei City (the capital city of Taiwan). On the other hand, the incidence in the female and younger population and mortality growth rates were higher. The incidence growth rate in Keelung City was significantly lower than that in Taipei City, while there were no significant variations in mortality growth rate among administrative areas.

Conclusions

This study found an inequality in the lung cancer burden among cities in Taiwan, which can serve as the basis for future resource allocations for lung cancer prevention and treatment in Taiwan.
Interference chromatography: a novel approach to optimizing chromatographic selectivity and separation performance for virus purification
Authors: Santry Lisa A. , Jacquemart Renaud , Vandersluis Melissa , Zhao Mochao , Domm Jake M. , McAusland Thomas M. , Shang Xiaojiao , Major Pierre M. , Stout James G. , Wootton Sarah K.
Published: June 2020

Background

Oncolytic viruses are playing an increasingly important role in cancer immunotherapy applications. Given the preclinical and clinical efficacy of these virus-based therapeutics, there is a need for fast, simple, and inexpensive downstream processing methodologies to purify biologically active viral agents that meet the increasingly higher safety standards stipulated by regulatory authorities like the Food and Drug Administration and the European Agency for the Evaluation of Medicinal Products. However, the production of virus materials for clinical dosing of oncolytic virotherapies is currently limited—in quantity, quality, and timeliness—by current purification technologies. Adsorption of virus particles to solid phases provides a convenient and practical choice for large-scale fractionation and recovery of viruses from cell and media contaminants. Indeed, chromatography has been deemed the most promising technology for large-scale purification of viruses for biomedical applications. The implementation of new chromatography media has improved process performance, but low yields and long processing times required to reach the desired purity are still limiting.

Results

Here we report the development of an interference chromatography-based process for purifying high titer, clinical grade oncolytic Newcastle disease virus using NatriFlo® HD-Q membrane technology. This novel approach to optimizing chromatographic performance utilizes differences in molecular bonding interactions to achieve high purity in a single ion exchange step.

Conclusions

When used in conjunction with membrane chromatography, this high yield method based on interference chromatography has the potential to deliver efficient, scalable processes to enable viable production of oncolytic virotherapies.
The impact of flavonoids-rich Ziziphus jujuba Mill. Extract on Staphylococcus aureus biofilm formation
Authors: Miao Weiwei , Sheng Lei , Yang Tao , Wu Guizhen , Zhang Minfang , Sun Juan , Ainiwaer Aikemu
Published: June 2020

Background

To evaluate the in vitro antibacterial effect of flavonoids-richZiziphus jujubaMill. extract (FZM) against the formation of bacterial biofilms (BBFs) inStaphylococcus aureus.

Results

FZM can effectively inhibit the formation ofS. aureusbiofilms in vitro. Morphological observation showed a decrease in both biofilm adhesion and thickness. Results of confocal laser scanning microscopy used to detect the thickness of the BBFs showed that FZM treatment reduced the thickness of the BBFs. Furthermore, after the Image-Pro Plus v.6.0 analysis of the fluorescence intensity, FZM treatment reduced the thickness of the BBFs as well as the proportion of green fluorescence. Scanning electron microscopy showed that FZM can disrupt the channels available for substance exchange in the biofilm, thus exposing the bacterial cells and damaging its three-dimensional structures.

Conclusion

FZM can inhibit biofilm formation, improve the bacterial pH environment, and eliminate the hydrophobic effect of reactive oxygen species and flavonoids.