bluuebunny/crossref_metadata_2025 huggingface dataset:
Nudging in Public Health Lifestyle Interventions: A Systematic Literature Review and Metasynthesis
Authors: Ledderer Loni , Kjær Marianne , Madsen Emilie Kirstine , Busch Jacob , Fage-Butler Antoinette
Published: June 2020

Nudging is increasingly used in public health interventions in Western societies to produced health-promoting behavior changes; however, there is lack of clarity as to what constitutes a nudge, scant knowledge of the effectiveness of nudging techniques in public health lifestyle interventions and a number of ethical and value-based concerns. The aim of this review is to address these research lacunae and identify the characteristics of nudges in empirical research on public health interventions intended to induce healthy lifestyle changes, including whether they are effective. We conducted systematic searches for relevant articles published between January 2008 and April 2019 in three databases, PubMed, CINAHL and PsycINFO, and combined this with a metasynthesis to construct interpretative explanations. A total of 66 original studies met the inclusion criteria. The findings of the systematic review showed that most nudging interventions involved diet/nutrition, most were carried out as single experiments, and the majority had the intended effects. Specific nudging techniques were identified with respect to the broader nudging categories of accessibility, presentation, using messages and pictures, technology-supported information, financial incentives, affecting the senses, and cognitive loading; several studies included more than one nudging technique. Although many nudging techniques had the intended effects, it is unclear whether they would work outside the study setting. The synthesis revealed that the studies lacked critical reflection on the assumptions about health that were implicit in nudging interventions, the cultural acceptability of nudges, the context-free assumptions of nudging theory, and the implications of these aspects for the public health context.
Accordion effect: A red herring during percutaneous angioplasty of arteriovenous dialysis access
Authors: Rao Indu Ramachandra , Paramasivam Ganesh , Devasia Tom , Prabhu Attur Ravindra , Nagaraju Shankar Prasad
Published: June 2020

Accordion or concertina effect is the angiographic appearance of pseudostenosis caused by interaction of a stiff guidewire with a tortuous vessel during endovascular procedures. This phenomenon may often mislead the interventionist into performing unnecessary and potentially harmful procedures in a bid to treat the ‘stenotic’ lesion. The resolution of ‘stenosis’ on withdrawal of the guidewire clinches the diagnosis. While well described in coronary vessels, the occurrence of this phenomenon in arteriovenous fistula or graft has not been reported. We describe a case of accordion effect observed during endovascular intervention for arteriovenous graft salvage.
Randomised clinical study of the impact of routine preoperative Doppler ultrasound for the outcome of autologous arteriovenous fistulas for haemodialysis
Authors: Lopes Jocefábia Reika Alves , Marques Ana Lígia de Barros , Correa João Antonio
Published: June 2020

Background:

Arteriovenous fistulas are the gold standard of vascular accesses in haemodialysis; however, they have a considerable primary failure rate. This study evaluated the comparative reliability of routine preoperative Doppler ultrasound with an isolated physical examination of autologous arteriovenous fistulas within the Single Health System of Brazil and analysed the potential clinical benefit, improvement in primary failure rates and its economic impact.

Methods:

A non-blind randomised clinical study group of patients undergoing a vessel mapping with preoperative Doppler ultrasound (ultrasound group) and a control group who had undergone only a physical examination (clinical group) before the vascular procedures was performed. The role of the arteriovenous fistula in dialysis and possible alterations was evaluated in both the groups and followed up for 6 months.

Results:

Of the initial 248 eligible patients, there was a randomisation of 230 patients, 228 of whom were submitted for surgery, 114 in each group. In the clinical group, a significantly higher rate of primary failure was recorded, with 13.6% versus 4.4% in the ultrasound group ( p = 0.002). The Kaplan–Meier curve with log-rank analysis showed a significantly higher primary patency in the ultrasound group ( p = 0.042). Regarding the cost-effectiveness of the use of Doppler ultrasound, there was no increase in the final cost compared to the physical examination (US$1.28/fistula day × US$1.29/fistula day).

Conclusion:

It was concluded that Doppler ultrasound contributed to the reduction of primary failure, leading to a significantly superior primary patency of arteriovenous fistulas, and no increase in the final cost. This justifies its routine preoperative use in the Single Health System. Registration number RBR-474xhn ( http://www.ensaiosclinicos.gov.br ).
Rare Causes of Isolated and Progressive Splenic Lesions: Challenges in Differential Diagnosis, Evaluation, and Treatment of Primary Splenic Lymphomas
Authors: Sinit Ryan B , Dorer Russell K , Flores John Paul , Aboulafia David M
Published: June 2020

The spleen is among the most common extranodal sites for Hodgkin and non-Hodgkin lymphomas (NHLs); however, among lymphomas arising from the spleen, primary splenic lymphomas (PSLs) are rare. The group of PSLs includes primary splenic diffuse large B-cell lymphoma (PS-DLBCL), splenic red pulp small B-cell lymphoma, splenic marginal zone lymphoma (SMZL), and a splenic hairy cell leukemia variant. Delineating between the PSL variants can be challenging, especially as fine-needle aspirate and core needle biopsy of the spleen are not routinely offered at most medical centers. Herein, we describe the clinical course of 2 representative patients who presented with non-specific gastrointestinal symptoms, the first who was diagnosed with PS-DLBCL and the second who was diagnosed with SMZL. We review and contrast the clinical presentations, imaging techniques, and laboratory findings of these discrete lymphoma variants and offer strategies on how to delineate between these varied splenic processes. We also examine the use of splenectomy and splenic needle biopsy as diagnostics and, in the case of splenectomy, a therapeutic tool. Finally, we also briefly review treatment options for these varied lymphoma sub-types while acknowledging that randomized trials to guide best practices for PSLs are lacking.
Atypical visual-auditory predictive coding in autism spectrum disorder: Electrophysiological evidence from stimulus omissions
Authors: van Laarhoven Thijs , Stekelenburg Jeroen J , Eussen Mart LJM , Vroomen Jean
Published: June 2020

Autism spectrum disorder is a pervasive neurodevelopmental disorder that has been linked to a range of perceptual processing alterations, including hypo- and hyperresponsiveness to sensory stimulation. A recently proposed theory that attempts to account for these symptoms, states that autistic individuals have a decreased ability to anticipate upcoming sensory stimulation due to overly precise internal prediction models. Here, we tested this hypothesis by comparing the electrophysiological markers of prediction errors in auditory prediction by vision between a group of autistic individuals and a group of age-matched individuals with typical development. Between-group differences in prediction error signaling were assessed by comparing event-related potentials evoked by unexpected auditory omissions in a sequence of audiovisual recordings of a handclap in which the visual motion reliably predicted the onset and content of the sound. Unexpected auditory omissions induced an increased early negative omission response in the autism spectrum disorder group, indicating that violations of the prediction model produced larger prediction errors in the autism spectrum disorder group compared to the typical development group. The current results show that autistic individuals have alterations in visual-auditory predictive coding, and support the notion of impaired predictive coding as a core deficit underlying atypical sensory perception in autism spectrum disorder.

Lay abstract

Many autistic individuals experience difficulties in processing sensory information (e.g. increased sensitivity to sound). Here we show that these difficulties may be related to an inability to process unexpected sensory stimulation. In this study, 29 older adolescents and young adults with autism and 29 age-matched individuals with typical development participated in an electroencephalography study. The electroencephalography study measured the participants’ brain activity during unexpected silences in a sequence of videos of a handclap. The results showed that the brain activity of autistic individuals during these silences was increased compared to individuals with typical development. This increased activity indicates that autistic individuals may have difficulties in processing unexpected incoming sensory information, and might explain why autistic individuals are often overwhelmed by sensory stimulation. Our findings contribute to a better understanding of the neural mechanisms underlying the different sensory perception experienced by autistic individuals.
The formation of suspicion: A vignette study
Authors: Phillips Scott W
Published: June 2020

Being suspicious is part of police training, and is emphasized in police culture. Tversky and Kahneman argued that people make decisions based on a limited number of heuristic factors to reduce a complex task to likely probabilities ( Tversky A and Kahneman D [1974] Judgment under uncertainty: heuristics and biases. Science 185[4157]: 1124–1131). This study contributes to the body of scholarship studying police suspicion. It uses vignettes describing an incident involving characteristics important when police officers form suspicion. This design allows respondents to judge a situation before actual engagement. A convenience sample of police officers, supervisors, and administrators from police agencies of different sizes located in two different states responded to an online survey. Results demonstrated that the time of an event, the person’s race, and their manner of dress, contributed to the formation of suspicion. Other factors (i.e., suspect age, neighborhood) were not significantly related to suspicion. Further, respondents with few years of experience were more likely to see the conditions within a vignette as suspicious. The findings indicate that unacceptable stereotyping can result from using scanty or outdated heuristic tools to simplify decision-making. Further, there is a need for additional research examining the conditions related to suspicion formation.
‘We Just Want to be Treated with Respect!’: Using Restorative Approaches and the Dramatic Arts to Build Positive Relationships Between the Police and Young People
Authors: Payne Brian , Hobson Jonathan , Lynch Kenneth
Published: June 2020

This article examines the Gloucestershire Youth Forums, an arts-based restorative intervention deployed in response to perceived issues with procedural justice, legitimacy and community relations between police and young people in the area. Through an ethnographic study of the forum processes and procedures, we show how such community-based arts programmes can be a powerful and effective tool for challenging entrenched views and have the potential to improve future encounters between police and young people. We also argue that the relevance and effectiveness of arts-based interventions can be increased by combining with restorative justice principles.
A Bayesian machine learning approach for online detection of railway wheel defects using track-side monitoring
Authors: Ni Yi-Qing , Zhang Qiu-Hu
Published: June 2020

Wheel condition assessment is of great significance to ensure the operation safety of trains and metro systems. This study is intended to develop a Bayesian probabilistic method for online and quantitative assessment of railway wheel conditions using track-side strain-monitoring data. The proposed method is a fully data-driven, nonparametric approach without the need of a physical model. To enable defect identification using only response measurement, the measured dynamic strain responses of rail tracks during the passage of trains are processed to elicit the normalized cumulative distribution function values representative of the effect of individual wheels, which in conjunction with the frequency points are used to formulate a probabilistic reference model in terms of sparse Bayesian learning. Through cleverly realizing sparsity by introducing hyper-parameters and their priors, the sparse Bayesian learning makes the resulting model to exempt from overfitting and generalize well on unseen data. Only the monitoring data in healthy state are needed in formulating the reference model. A novel Bayesian null hypothesis significance testing in terms of scale-invariant intrinsic Bayes factor, which does not suffer from the Jeffreys–Lindley paradox, is then pursued in the presence of new monitoring data collected from possibly defective wheel(s) to detect wheel defects and quantitatively assess wheel condition. The proposed method in fully Bayesian inference framework is verified by utilizing the real-world monitoring data acquired by a distributed fiber Bragg grating–based track-side monitoring system and comparing with the offline inspection results.
Alleviating concerns of misappropriation in corporate venture capital: Creating credible commitments and calculative trust
Authors: Sears Joshua B , McLeod Michael S , Evert Robert E , Payne G Tyge
Published: June 2020

Ventures are often hesitant to accept corporate venture capital due to concerns of intellectual property misappropriation. This is likely to be especially true with startup stage ventures operating in weak intellectual property rights regimes. Drawing on transaction costs economics and game theory, we examine how corporate investors might alleviate concerns of misappropriation by establishing credible commitments to their corporate venture capital program, which discourages opportunistic behavior. We submit that corporate investors can demonstrate credible commitments through prior investment quantity and prior investment continuity, therefore increasing the chances of forming a corporate venture capital–venture investment relationship. Our findings—using data from 11,136 ventures, 300 corporate venture capital investors, and 1782 investments across 18 years—demonstrate that ventures are more likely to pair with corporate venture capital investors that have made a credible commitment to their corporate venture capital program. Also, we find evidence that both quantity and continuity possess an enhanced effect on alleviating fears of misappropriation when a startup venture operates in the same industry as a potential corporate venture capital partner; this is because the corporate venture capital investor possesses both the absorptive capacity to understand the venture’s intellectual property and complementary capabilities to beat them to market.
Perceptions of intensive care unit nurses of therapeutic futility: A scoping review
Authors: Vieira João V. , Deodato Sérgio , Mendes Felismina
Published: June 2020

Introduction

Intensive care units are contexts in which, due to the remarkable existence of particularly technological resources, interventions are promoted to extend the life of people who experience highly complex health situations. This ability can lead to a culture of death denial where the possibility of implementing futile care and treatment cannot be excluded.

Objective

To describe nurses’ perceptions of adult intensive care units regarding the therapeutic futility of interventions implemented to persons in critical health conditions.

Method

Review of the literature following the Scoping Review protocol of the Joanna Briggs Institute. The Population, Concept, and Context mnemonic was used to elaborate the research question and the research was performed using the EBSCOHost search engine in the CINAHL Complete databases, MEDLINE Complete, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews to identify studies published between 1990 and 2019. Seven studies were selected.

Results

Nurses consider that therapeutic futility, a current problem in adult intensive care units, may have a negative impact on persons in critical health conditions and that contributes directly to resource expenditure and moral conflicts and consequently leads to emotional exhaustion.

Conclusion

Due to the complexity of this concept, knowing and understanding people’s and families’ perceptions is crucial to the decision-making process, for which reason nurses can play a key role in managing these situations.
The odd malaise of democratic education: Horace Mann, Amy Gutmann and the inordinate influence of business
Authors: Ford Brian
Published: June 2020

This article is the third of three on “Sources of Authority in Education.” All use the work of Amy Gutmann as a heuristic device to describe and explain the prevalence of market-based models of education reform in the US and the business-influenced Global Education Reform Movement. The other two are “Negating Amy Gutmann: Deliberative Democracy, Business Influence and Segmentation Strategies in Education” and “Neoliberalism and Four Spheres of Authority in American Education: Business, Class, Stratification and Intimations of Marketization.” All three are intended to be included together as chapters of my Democratic Education and Markets: Segmentation, Privatization and Sources of Authority in Education Reform.

The “Negating Amy Gutmann” article looks primarily at deliberative democracy. The “Neoliberalism and Four Spheres of Authority” article, considers its main theme to be the promise of egalitarian democracy and how figures ‘such as Horace Mann, John Dewey and Gutmann’ have argued it is largely based on the promise of public education. It thus begins with a consideration of what might be called a partial historical materialist analysis – the growth of inequality in the US (and other countries) since the 1970s that correlates with much of the basis for changes in the justifications and substance of education reform.

The present article, “The Odd Malaise of Democratic Education and the Inordinate Influence of Business,” continues the argument by offering some historical background and comparisons and ends by considering what happens to the philosophy of education when democracy and capitalism are at odds.

It thus starts with recent history, looking at how the content and context of educational policy have changed in the US since Gutmann wrote in the 1980s. Specifically, it concerns itself with the increasing prevalence of twin notions: that our system of education must be reformed because of global competition and that the educational system should emulate the market.

The article then goes back a little bit further, to the origins of the common school in the 1600s and Horace Mann’s articulation of the principles behind public education, which are shown to be in stark contrast to Education Reform. The narrative describes how the standards movement, variously, coalesced around George H. W. Bush’s America 2000 and Bill Clinton’s Goals 2000 programs, was reflected in a ‘21st-century schools’ discourse, found programmatic form in George W. Bush’s No Child Left Behind and it’s offspring, Arne Duncan’s Race to the Top. All of the preceding were, to a shocking degree, based on misleading and selective statistical analysis and sets goals that are unreachable even in the best of all possible worlds. The article concludes by considering paradigm change in education and its causes; I draw on both Peter Hall’s exposition of social learning 1 and Antonio Gramsci’s conceptualization of hegemony. 2
Application of Easy Wet Healing Therapy for Chronic Noninfectious Wounds in Limbs
Authors: Ni Zhimin , Sun Jiachen , Qi Shiling
Published: June 2020

Chronic wounds in limbs without infection are common. This study was to identify an economical, simple, and useful wet healing therapy for patients with chronic noninfectious wounds in the limbs, especially for low-income patients. In total, 56 patients with chronic limb wounds without infection from April 2018 to March 2019 were included. They underwent wound cleaning by iodine and wound covering by recombinant human epidermal growth factor gel, zinc oxide ointment, and erythromycin eye ointment at a 1:1:1 ratio and thickness of 0.8 cm. After applying the drug, a slight-pressure dressing was applied to the wound with a cotton pad and bandage, and the dressing was changed every 3 days. All the wounds completely healed within 12 to 45 days (26.2 ± 11.9 days). The healing time showed a positive correlation with the area of the wound ( r = 0.328, P < .05) and the course of disease ( r = 0.485, P < .01). The healing time of deep second-degree wounds was 17.2 ± 3.3 days, which was shorter than that of deep third-degree wounds (34.8 ± 8.4 days; P < .05). There was no significant difference in the healing time according to sex. Upper limb wounds healed faster than lower limb wounds (16 ± 2.7 days versus 31.7 ± 9.7 days, P < .05). The simple therapy required a low cost of 0.07 dollars per square centimeter for each dressing change. This wet healing therapy is easy, effective, relatively safe, and affordable, with no obvious side effects.
Hybrid Treatment Combining Lymphaticovenous Anastomoses and the Oriental Herbal Medicine Bofutsushosan for Obesity-Associated Lower Leg Elephantiasis Nostras Verrucosa: A Case Report
Authors: Shimbo Keisuke , Okuhara Yukako , Yokota Kazunori
Published: June 2020

Elephantiasis nostras verrucosa (ENV) is a rare dermatological disease associated with chronic lymphedema caused by obesity, soft tissue infection, or chronic venous insufficiency. Although surgical debridement may be sufficient to treat the skin manifestations of ENV, treatment of ENV should focus on reducing lymph stasis to improve the skin changes and prevent recurrence. In this case report, we present the case of a 79-year-old woman who developed obesity-associated ENV in the lower leg. She was successfully treated by a combination of lymphaticovenous anastomoses and the oriental herbal medicine Bofutsushosan. To our knowledge, this is the first reported obesity-associated ENV case in which skin pathology was not only healed, but both edema relief and weight loss were successful. A treatment combining both surgery and the herbal medicine could be a potential therapeutic candidate for obesity-associated ENV.
A knitted wearable flexible sensor for monitoring breathing condition
Authors: Wang Jinfeng , Soltanian Saeid , Servati Peyman , Ko Frank , Weng Ming
Published: June 2020

This article presents the development of a knitted flexible sensor, which is embedded into a seamless garment, for monitoring health condition. The sensor is designed as an elastic weft-knitted plain structure, where the conductive silver-plating filament yarn is used for breathing signal collection and the spandex core-spun yarn is used to ensure good attachment of the garment to human body. The breathing amplitude and breathing frequency are obtained from the variations in sensor resistance. The sensor can measure various kinds of breathing conditions, such as normal breathing, slow breathing, fast breathing, and shallow breathing. The results are in reasonable agreement with the actual condition. Such kind of flexible sensors have the advantages of wearable and comfort.
Evaluating an inpatient deprescribing initiative at a rural community hospital in Ontario
Authors: Gazarin Mohamed , Devin Brian , Tse Darren , Mulligan Emily , Naciuk Mary , Duncan Simon , Burnett Sean , Hall Lynn , Elbeddini Ali
Published: June 2020

Background:

Deprescribing is an effective means to reduce polypharmacy in elderly patients. However, geriatric day care deprescribing services are challenging to implement in rural regions. In this study, we examined whether a subacute care unit of a rural hospital could deliver a comprehensive and multidisciplinary intervention to promote deprescribing in patients and whether this intervention would succeed in achieving significant and lasting deprescribing results.

Methods:

We conducted a cross-sectional analysis of a deprescribing program at a rural hospital in Eastern Ontario, Canada. Participants were 11 patients, aged 65 or older, who were admitted to the hospital’s medical/surgical unit or who presented to the emergency department. Clinicians followed a structured, comprehensive and multidisciplinary approach designed to facilitate deprescribing, which concluded with an outcome evaluation at discharge and follow-up phone calls. Outcomes included the frequency and total number of medications successfully removed, reduced, substituted and restarted after discharge and emergency department visits and hospitalizations 6 months before and after the intervention.

Results:

Of a total 57 deprescribed medications, 38 were eliminated, 8 were switched to a safer alternative, and 11 were dose reduced. Postdischarge deprescribing reversal occurred in only 5 of 57 deprescribed medications. Among the study population, a 59.2% reduction was observed in the combined number of emergency department visits and hospitalizations 6 months after deprescribing.

Conclusions:

This feasibility study was successful in showing the potential added value for offering a rehabilitative, subacute care, inpatient, comprehensive and multidisciplinary approach toward patients with complex deprescribing needs. It also showed proof of concept in reducing polypharmacy-induced adverse health outcomes. Can Pharm J (Ott) 2020:153:xx-xx.
The landscape of gene mutations and clinical significance of tumor mutation burden in patients with soft tissue sarcoma who underwent surgical resection and received conventional adjuvant therapy
Authors: Xu Li-Bin , Zhao Zhen-Guo , Xu Song-Feng , Zhang Xin-Xin , Liu Ting , Jing Chang-You , Zhang Shu-Guang , Yu Sheng-Ji
Published: June 2020

Background

The aim of this study was to evaluate the landscape of gene mutations and the clinical significance of tumor mutation burden (TMB) in patients with soft tissue sarcoma who underwent surgical resection and received conventional adjuvant therapy.

Methods

A total of 68 patients with soft tissue sarcoma were included. Postoperative tumor tissue specimens from the patients were collected for DNA extraction. Targeted next-generation sequencing of cancer-relevant genes was performed for the detection of gene mutations and the analysis of TMB. Univariate analysis between TMB status and prognosis was carried out using the Kaplan–Meier survival analysis, and multivariate analysis was adjusted by the Cox regression model.

Results

No specific genetic mutations associated with soft tissue sarcoma were found. The mutation frequency of TP53, PIK3C2G, NCOR1, and KRAS of the 68 patients with soft tissue sarcoma were observed in 19 cases (27.94%), 15 cases (22.06%), 14 cases (20.59%), and 14 cases (20.59%), respectively. With regard to the analysis of TMB, the overall TMB of the 68 patients with soft tissue sarcoma was relatively low (median: 2.05 per Mb (range: 0∼15.5 per Mb)). Subsequently, TMB status was divided into TMB-Low and TMB-Middle according to the median TMB. Patients with TMB-Low and TMB-Middle were 37 cases (54.41%) and 31 cases (45.59%), respectively. Overall survival analysis indicated that the median overall survival of patients with TMB-Low and TMB-Middle was not reached, and 4.5 years, respectively ( P=0.015).

Conclusion

This study characterizes the genetic background of patients with STS soft tissue sarcoma. The TMB was of clinical significance for patients with soft tissue sarcoma who underwent surgical resection and received conventional adjuvant therapy.
Optimized visual recognition algorithm in service robots
Authors: Wu Jun W , Cai Wei , Yu Shi M , Xu Zhuo L , He Xue Y
Published: June 2020

Vision-based detection methods often require consideration of the robot’s sight. For example, panoramic images cause image distortion, which negatively affects the target recognition and spatial localization. Furthermore, the original you only look once method does not have a reasonable performance for the image recognition in the panoramic images. Consequently, some failures have been reported so far when implementing the visual recognition on the robot. In the present study, it is intended to optimize the conventional you only look once algorithm and propose the modified you only look once algorithm. Comparing the obtained results with the experiment shows that the modified you only look once method can be effectively applied in the graphics processing unit to reach the panoramic recognition speedup to 32 frames rate per second, which meets the real-time requirements in diverse applications. It is found that the accuracy of the object detection when applying the proposed modified you only look once method exceeds 70% in the studied cases.
Sonographers’ level of autonomy in communication in Australian obstetric settings: Does it affect their professional identity?
Authors: Thomas Samantha , O’Loughlin Kate , Clarke Jill
Published: June 2020

Introduction

Unlike the United Kingdom, policies in Australia prevent sonographers from exercising autonomy in their level of communication with pregnant patients in the event of adverse findings. The organisational structure makes the sonographer dependent on the sonologist because sonographers do not have the authority to provide the official report. The emotional labour on sonographers is increased as they struggle to provide patient-centred care, given the limits put on their communication during the ultrasound examination. The aim of this study was to explore Australian sonographers’ views on communicating adverse findings, including their level of autonomy in communicating with patients and how this influences their sense of professional identity.

Methods

Following a national survey, seven purposively selected participants, who were qualified to perform obstetric ultrasound examinations, completed follow-up interviews. The interviews were thematically analysed with iterative comparison to the survey results. Three case studies show sonographers differed in their ‘communicator type’ due to geographical location and workplace setting.

Results

The case studies illustrate a sonographer’s communication role, and level of autonomy is negotiated/renegotiated depending on the needs and expectations of each workplace. Their communication practices varied due to the sonologist (radiologist/obstetrician) policy on sonographer/patient communication, presence and support in the clinical setting. A strong professional identity and level of autonomy came from the construction of attributes that were built over time based on multiple factors, including previous experience, geographical location, critical incidents, training and supportive work environments.

Conclusion

The sonography profession demands autonomy and a strong professional identity free of hierarchical barriers within a collaborative model of care.
Knowing our air from them: Exploring perception of foreign media affinity, dependency and accessibility as activators for Chinese publics
Authors: Zhu Yicheng
Published: June 2020

This study explores the effect of foreign media on publics’ psychological activeness during a foreign media–spurred national problem: air pollution in China. Building on theories of media diplomacy and public relations, it finds that affinity with foreign media significantly activates Chinese publics to engage communication actions against air pollution, as it relieves publics’ constraint recognition. Dependency on foreign media also mediates such an effect. Moreover, the results show that perceived accessibility of foreign media heightens such mediation, such that when access to foreign media is low, the direct activation effect of foreign media vaporizes.
Typicality guides attention during categorical search, but not universally so
Authors: Robbins Arryn , Hout Michael C
Published: June 2020

The degree to which an item is rated as being a typical member of its category influences an observer’s ability to find that item during word-cued search. However, there are conflicting accounts as to whether or not typicality affects attentional guidance to categorical items, or whether it affects some other aspect of the search process. In this study, we employed word-cued search and eye tracking to disentangle typicality effects on attentional guidance and target verification across differing category cue specificities (i.e., superordinate or basic-level cues), while also varying the degree of similarity between targets and non-targets. We found that typicality influenced attentional guidance when searchers were cued at the superordinate level (e.g., clothing). When cues were provided at the basic level (e.g., pants), typicality did not influence attentional guidance, and only affected target verification when there was featural similarity between targets and non-targets. When a searcher uses a target template comprising features cued at the basic level, therefore, target/non-target similarity produces interference that affects attentional guidance, but we did not find evidence that it also affects target verification.
Comment: Historians in the Emotion Laboratory
Authors: Dror Otniel E.
Published: June 2020

In this comment, I indicate several challenges and opportunities—out of the many—for an integrated science–humanities approach to emotions, from the perspective of a historian of the modern sciences of emotions.
Comment: Developing and Maintaining High-Quality Relationships via Emotion
Authors: Algoe Sara B.
Published: June 2020

This comment addresses opportunities for understanding the social functions of emotion by taking a developmental perspective. I agree that understanding emotions and their development will meaningfully illuminate understanding of prosociality in everyday life. Taking Vaish and Hepach’s (2020) approach one step further, I suggest that rather than using the framing of questions about prosociality from the adult literature to guide questions about the development of social emotions in children, in the future, developmental researchers consider the social milieu in which emotions evolved and in which children’s emotions may develop, to guide their questions. This may feed forward to a richer understanding of cooperation and reciprocity in the literature regarding adult strangers.
Breathing resistance in metabolic systems: Its effects on pulmonary ventilation and oxygen uptake in elite athletes with high aerobic power
Authors: Ainegren Mats , Jensen Kurt , Rosdahl Hans
Published: June 2020

The aim of this study was to investigate the effects on pulmonary ventilation and oxygen uptake ( [Formula: see text]O2) in athletes with a very high maximal oxygen uptake ( [Formula: see text]O2 max) and corresponding high ventilation capacity when using a modern metabolic system with relatively high resistance to breathing (HIGHRES), compared to a traditional system with low resistance to breathing (LOWRES). Four rowers and three cross-country skiers (without asthma), competing at a high international level, performed in experimental conditions with LOWRES and HIGHRES using a rowing ergometer and roller skis on a treadmill. The results showed that [Formula: see text]O2, blood lactate, heart rate and respiratory exchange ratio were not different between the LOWRES and HIGHRES test conditions during both submaximal and maximal exercise. Also, the athlete’s time to exhaustion (treadmill) and mean power (rowing ergometer) from maximal tests were no different between the two conditions. However, ventilation and expiratory O2 and CO2 concentrations were different for both submaximal and maximal exercise. Thus, the authors have concluded that the differences in resistance to breathing of metabolic systems influence elite endurance athletes [Formula: see text] E at low to very high workloads, thus affecting the expired gas fractions, but not the submaximal [Formula: see text]O2, [Formula: see text]O2 max and performance in a laboratory setting at sea level.
A novel combined anorectal biofeedback and percutaneous tibial nerve stimulation protocol for treating fecal incontinence
Authors: Mazor Yoav , Prott Gillian M. , Sequeira Carol , Jones Michael , Ejova Anastasia , Kellow John E. , Schnitzler Margaret , Malcolm Allison
Published: June 2020

Background/Aims:

Fecal incontinence (FI) is a common, debilitating condition that causes major impact on quality of life for those affected. Non-surgical treatment options include anorectal biofeedback therapy (BF) and percutaneous tibial nerve stimulation (PTNS), usually performed separately. The aims of the current study were to determine the feasibility, tolerability, safety, and efficacy of performing a combined BF and PTNS treatment protocol.

Methods:

Female patients with urge FI were offered a novel pilot program combining BF with PTNS. The treatment protocol consisted of 13 weekly sessions: an educational session, followed by 5 combined BF and PTNS sessions, 6 PTNS and a final combined session. Anorectal physiology and clinical outcomes were assessed throughout the program. For efficacy, patients were compared with BF only historical FI patients matched for age, parity, and severity of symptoms.

Results:

A total of 12/13 (93%) patients completed the full program. Overall attendance rate was 93% (157/169 sessions). Patient comfort score with treatment was rated high at 9.8/10 (SD 0.7) for PTNS and 8.6/10 (SD 1.7) for the BF component. No major side effects were reported. A reduction of at least 50% in FI episodes/week was achieved by 58% of patients by visit 6, and 92% by visit 13. No physiology changes were evident immediately following PTNS compared with before, but pressure during sustained anal squeeze improved by the end of the treatment course. Comparing outcomes with historical matched controls, reductions in weekly FI episodes were more pronounced in the BF only group at visit 6, but not week 13.

Conclusions:

In this pilot study, concurrent PTNS and anorectal biofeedback therapy has been shown to be feasible, comfortable, and low risk. The combined protocol is likely to be an effective treatment for FI, but future research could focus on optimizing patient selection.
Orodispersible budesonide tablets for the treatment of eosinophilic esophagitis: a review of the latest evidence
Authors: Miehlke Stephan , Lucendo Alfredo J. , Straumann Alex , Jan Bredenoord Albert , Attwood Stephen
Published: June 2020

Eosinophilic esophagitis (EoE) is a chronic inflammatory disorder of the esophagus characterized by symptoms of esophageal dysfunction and eosinophil-predominant inflammation. The incidence of EoE has increased substantially over the past two decades in Europe and North America. The natural course of EoE appears to be progressive with a high risk of stricture formation. The current European guideline recommend swallowed topical corticosteroids, proton-pump inhibitors or dietary intervention for initial and long-term treatment of EoE. Swallowed topical corticosteroids can be considered to be the best studied drug class in EoE, with more than 1000 patients enrolled in randomized clinical trials worldwide. In most of them, fluticasone or budesonide formulations have been used that were originally designed for asthma therapy, thus presumably suboptimal for EoE treatment. The new orodispersible budesonide tablet with effervescent properties is the first approved esophageal-targeted formulation specifically developed for the treatment of EoE, which has become available in many European countries. This article gives an overview of the evolution of topical corticosteroids in EoE and provides an update on recent data from large-scale multicenter trials exploring the efficacy and safety of the orodispersible budesonide tablet with effervescent properties in adult EoE patients.
Reassessing classification of Kazakhstan’s ethnic management model: A comparative approach
Authors: Daminov Ildar
Published: June 2020

Kazakhstan’s model of ethnic management is often classified as a typical example of national identity-building. Kazakhstani politicians and media, however, prefer to refer to it as their unique third way. The article attempts to disprove both these claims. It argues that Kazakhstan merely uses two different ethnic management approaches—national identity-building and hegemonic exchange. The article tests this hypothesis by conducting a comparative analysis of various theoretical approaches to ethnic management and applying them to Kazakhstan. Furthermore, it explains what this dual approach means in terms of operationality by outlining the key challenges the model faces. The final section of the article summarizes its findings and provides recommendations.
Patient Controlled, Off-label Use of Continuous Glucose Monitoring: Real-World Medical Costs and Effects of Patient Controlled Sensor Augmented Pump Therapy in Adult Patients Type 1 Diabetes
Authors: Hidefjäll Patrik , Berg Lars
Published: June 2020

Background:

Continuous glucose monitoring (CGM) has shown promise to reduce glycated hemoglobin (HbA1c) levels, but its cost-effectiveness is seen as uncertain by reimbursement agencies. The aim of this study was to explore the impact of real-world, off-label, patient controlled CGM use in combination with continuous subcutaneous insulin infusion (CSII) on costs and effects in patients with type 1 diabetes in a Swedish clinic.

Methods:

A real-world, retrospective study with questionnaire on CGM use by adult patients with type 1 diabetes on CSII (Animas Vibe) were offered sensor augmented pump therapy (SAPT) (Dexcom G4) as part of hospital innovation funding program. Direct medical costs, HbA1c, and complications following switch from CSII with self-monitoring of blood glucose (SMBG) to SAPT were calculated.

Results:

Questionnaire data showed that CGM sensors were on average used 92% of the time for 22 days. One hundred and thirty-nine (95%) of 146 respondents used each sensor for longer than one week. Data analysis showed a statistically significant HbA1c decrease of 0.56% (6.1 mmol/mol) after change to SAPT. In patients using the sensor 100%, the decrease was 0.89% (9.8 mmol/mol). The analysis showed that SAPT led to higher costs (5500 USD/year) than CSII + SMBG (3680 USD/year), with incremental costs being 1815 USD per year to achieve an HbA1c decrease of 0.56% (6.1 mmol/mol). The incidence of all complications declined after switch to SAPT.

Conclusion:

The primary data analysis showed a decrease in HbA1c values following switch to SAPT, corresponding to previous cost-effectiveness studies, but at substantially lower costs due to longer sensor off-label use.
Whole-Body Metabolism, Carbohydrate Utilization, and Caloric Energy Balance After Sport Concussion: A Pilot Study
Authors: Walton Samuel R. , Malin Steven K. , Kranz Sibylle , Broshek Donna K. , Hertel Jay , Resch Jacob E.
Published: June 2020

Background:

Sport concussion (SC) causes an energy crisis in the brain by increasing energy demand, decreasing energy supply, and altering metabolic resources. Whole-body resting metabolic rate (RMR) is elevated after more severe brain injuries, but RMR changes are unknown after SC. The purpose of this study was to longitudinally examine energy-related changes in collegiate athletes after SC.

Hypothesis:

RMR and energy consumption will increase acutely after SC and will return to control levels with recovery.

Study Design:

Case-control study.

Level of Evidence:

Level 4.

Methods:

A total of 20 collegiate athletes with SC (mean age, 19.3 ± 1.08 years; mean height, 1.77 ± 0.11 m; mean weight, 79.6 ± 23.37 kg; 55% female) were compared with 20 matched controls (mean age, 20.8 ± 2.17 years; mean height, 1.77 ± 0.10 m; mean weight, 81.9 ± 23.45 kg; 55% female). RMR, percentage carbohydrate use (%CHO), and energy balance (EBal; ratio between caloric consumption and expenditure) were assessed 3 times: T1, ≤72 hours after SC; T2, 7 days after T1; and TF, after symptom resolution. A 2 × 2 × 3 (group × sex × time) multivariate analysis of variance assessed RMR, %CHO, and EBal. Changes in RMR, %CHO, and EBal (T1 to TF) were correlated with days to symptom-free and days to return to play in the concussed group.

Results:

Women reported being symptom-free (median, 6 days; range, 3-10 days) sooner than men (median, 11 days; range, 7-16 days). RMR and %CHO did not differ across time between groups or for group × sex interaction. SC participants had higher EBal than controls at T1 ( P = 0.016) and T2 ( P = 0.010). In men with SC, increasing %CHO over time correlated with days to symptom-free ( r = 0.735 and P = 0.038, respectively) and days to return to play ( r = 0.829 and P = 0.021, respectively).

Conclusion:

Participants with SC were in energy surplus acutely after injury. Although women recovered more quickly than men, men had carbohydrate metabolism changes that correlated with recovery time.

Clinical Relevance:

This pilot study shows that male and female student-athletes may have differing physiologic responses to SC and that there may be a role for dietary intervention to improve clinical outcomes after SC.
A prospective cohort study of home blood pressure monitoring based on an intelligent cloud platform (the HBPM-iCloud study): rationale and design
Authors: Zhu Hailan , Liang Xiaoyan , Pan Xiong-Fei , Huang Chunyi , Kuang Jian , Lv Weibiao , Zeng Qingchun , Mai Weiyi , Huang Yuli
Published: June 2020

Background:

Hypertension, as a predominant risk factor for cardiovascular disease, is a severe public health burden in China. Home blood pressure monitoring (HBPM) is an important tool in the detection and management of hypertension. However, there is a lack of HBPM data from prospective cohorts in China. Hence, we designed this study to investigate the impact of HBPM on major health outcomes in Chinese population participating in regular health check-ups.

Methods:

Leveraging telemedicine technology, the open prospective, multicenter, HBPM-iCloud (Home Blood Pressure Monitoring Based on an Intelligent Cloud Platform) cohort study will recruit participants from three participating health check-up centers in southern China to participate in cloud-based HBPM for 1 week. The prevalence of sustained hypertension, white coat hypertension (WCH), masked hypertension (MH), white coat uncontrolled hypertension (WUCH), and masked uncontrolled hypertension (MUCH) will be defined by a combination of average readings of home-based and office-based blood pressure (BP). Cardiovascular risk factors and subclinical target organ damage will be recorded. Participants will be followed-up for 5 years to examine the incidence and associated risk factors of composite major adverse cardiovascular and cerebrovascular event.

Conclusion:

The study will help to determine the best way to implement telemedicine technology in BP control for better prevention and treatment of hypertension. Results will provide data for a Chinese population to aid in the construction of screening, risk stratification, and intervention strategies for abnormal BP phenotypes, including WCH, MH, WUCH, and MUCH.
Garment worker rights and the fashion industry’s response to COVID-19
Authors: Brydges Taylor , Hanlon Mary
Published: June 2020

In this commentary, we examine the fashion industry’s early responses to COVID-19. Looking across fashion’s global production networks, we argue the fashion industry’s response has been rapid, yet highly inequitable, reflecting—and further entrenching—existing inequalities in the industry.
Tourist as vector: Viral mobilities of COVID-19
Authors: Iaquinto Benjamin Lucca
Published: June 2020

Tourist mobilities helped COVID-19 become a global pandemic. This commentary argues that mobilities perspectives are vital to understanding the impacts of COVID-19 on global tourism. It assists scholars and policy-makers in two ways: by demonstrating how tourism is implicated in political issues heightened by the pandemic, and by advancing research on low carbon tourist mobilities.