bluuebunny/crossref_metadata_2025 huggingface dataset:
Wholist–analytic cognitive styles modulate object-based attentional selection
Authors: Hu Saisai , Liu Meiyu , Wang Yonghui , Zhao Jingjing
Published: April 2020

Previous studies have shown that individual difference plays an important role in the object-based cueing effect observed in experiments on attentional selection. A wide range of studies have also used the theory of cognitive style to explain individual strategies in most cognitive processes. However, the characteristics of individuals that modulate object-based attentional selection are still unclear. To investigate the modulation of object-based attention by cognitive style, this study used a classic two-rectangle paradigm and compared space-based effects and object-based effects for individuals who had been preselected as wholists or analysts in terms of cognitive style. The results revealed that a space-based effect was obtained for both wholist and analytic individuals. However, an object-based effect was obtained only for analysts and not wholists, regardless of object orientation. The results further indicated that a wholist versus analytic cognitive style can modulate object-based attention by way of perceptual grouping. Our study provides the first evidence that object-based attention can indeed be influenced by individual characteristics and extends traditional model of cognitive style by indicating that wholist individuals tend to group two or more objects in a scene into one larger gestalt.
The influence of autonomous sensory meridian response on individual’s executive function
Authors: Wang Xieshun , Yang Xinyue , Sun Yiwen , Su Yanjie
Published: April 2020

Autonomous sensory meridian response (ASMR) is a special perceptual phenomenon in which some people can experience a tingling, static-like sensation in response to some certain auditory/visual stimulations. This study compared the performance of executive function (working memory, set shifting, and inhibitory control) between ASMR participants and control participants after three auditory treatment conditions, i.e., ASMR-triggering audio (Triggering), normal-speaking audio (Normal), and with no auditory treatment (Baseline). The results showed that the ASMR individuals did not differ in executive function with the control participants in either Normal or Baseline condition. However, the set shifting and inhibitory control of ASMR individuals slowed down after ASMR-triggering auditory treatment. In this study, ASMR individuals with ASMR-triggering auditory treatment reported that they all experienced three ASMR episodes before completing executive function tasks. These findings indicated that there was no intrinsic difference in executive function between ASMR and control individuals. But ASMR individuals’ executive function would be interfered when the ASMR was triggered.
Listening to speech and non-speech sounds activates phonological and semantic knowledge differently
Authors: Bartolotti James , Schroeder Scott R , Hayakawa Sayuri , Rochanavibhata Sirada , Chen Peiyao , Marian Viorica
Published: April 2020

How does the mind process linguistic and non-linguistic sounds? The current study assessed the different ways that spoken words (e.g., “dog”) and characteristic sounds (e.g., ) provide access to phonological information (e.g., word-form of “dog”) and semantic information (e.g., knowledge that a dog is associated with a leash). Using an eye-tracking paradigm, we found that listening to words prompted rapid phonological activation, which was then followed by semantic access. The opposite pattern emerged for sounds, with early semantic access followed by later retrieval of phonological information. Despite differences in the time courses of conceptual access, both words and sounds elicited robust activation of phonological and semantic knowledge. These findings inform models of auditory processing by revealing the pathways between speech and non-speech input and their corresponding word forms and concepts, which influence the speed, magnitude, and duration of linguistic and nonlinguistic activation.
Quantity matters: The frequency of deception influences automatic memory retrieval effects
Authors: Schreckenbach Franziska , Rothermund Klaus , Koranyi Nicolas
Published: April 2020

We investigated automatic retrieval of the knowledge of having lied or having told the truth to a question, depending on (a) the quality of the statement (true vs. false response) and (b) the overall proportion of (dis-)honest responses. We therefore manipulated the proportion of lies and truths being told in an oral interview. Automatic retrieval of this meta-knowledge was assessed with a categorisation task, where the probe words dishonest and honest had to be classified, while questions from the interview served as task-irrelevant prime stimuli. Results revealed an automatic retrieval of knowledge about having lied to a question only for participants who had told few lies in the interview, but not for those who had told many lies. No retrieval effects were obtained regarding questions that had been answered truthfully. These findings suggest a combined influence of quality and quantity of dishonest statements on automatic memory retrieval, thereby being in accordance with recent accounts of action control.
Microwave-assisted synthesis of a novel steroid-derived Schiff base chemosensor for detection of Al3+ in aqueous media
Authors: Chen Yu
Published: April 2020

A novel steroid-derived Schiff base chemosensor, N′-(2-hydroxybenzylidene)-3α-hydroxy-cholanhydrazide (LA), has been designed and prepared via microwave irradiation. The sensor LA showed highly selective fluorescent sensing for Al3+ with a low detection limit of 34 nM in the pH range from 6.05 to 9.32 in ethanol/water (1:2, v/v) solution. The binding stoichiometry between LA and Al3+ was determined as 1:1 by Job’s plot and further verified with 1H NMR studies. Under a UV lamp, the fluorescence color changes could be easily detected by the naked eye. In addition, the sensor LA has been applied in detection of Al3+ in real water samples.
Splinting versus extension-block pinning of bony mallet finger: a randomized clinical trial
Authors: Thillemann Janni K. , Thillemann Theis M. , Kristensen Pia K. , Foldager-Jensen Anders D. , Munk Bo
Published: April 2020

Surgical treatment of bony mallet fingers is frequently recommended, but the evidence is sparse. This randomized clinical trial aimed to compare nonoperative splinting versus extension-block pinning of bony mallet fingers with involvement of more than one-third of the joint surface but without primary joint subluxation. Thirty-two patients were randomized and 28 fulfilled the protocol. At 6 months follow-up, there were no significant differences in active extension lag in the distal interphalangeal joint (the primary outcome) or in patient-reported function and pain scores. Flexion and active range of motion in the distal interphalangeal joint and finger-to-palm distance were better in the splinting group, but three patients developed secondary subluxation. We conclude from this study, that splinting these injuries is safe and efficient in restoring joint motion, but splinting does not sufficiently prevent secondary subluxation of the joint. Radiographic follow-up during splinting appears to be necessary.

Level of evidence: I
Joint replacement for trapeziometacarpal osteoarthritis: implants and outcomes
Authors: Bæk Hansen Torben
Published: April 2020

For thumb carpometacarpal osteoarthritis, trapeziectomy provides generally good results with reduction of pain and restoration of thumb mobility, but shortening of the thumb may at least in theory lead to reduction in grip and pinch strength. Furthermore, instability of the base of the first metacarpal and contact with the scaphoid may occur regardless of the several described techniques with ligament reconstruction and tendon interposition. Thus, for years alternatives to trapeziectomy have been explored and reported with disputable success. Often the road from idea to implantation in patients seems to have been short, and high complication rates and failure of new implant designs have been fairly common. This has led to the general impression that the implants do not provide sufficient benefits compared with simple trapeziectomy. More recent uncemented total joint replacement designs have shown rapid rehabilitation, reduction of pain, restoration of grip strength and movement, and much improved long-term implant survival. These factors may make total joint replacement a realistic alternative to trapeziectomy. Still, patient selection has to be improved, as the benefits may be small in the low activity elderly patient.
Silicone arthroplasty versus screw arthrodesis in distal interphalangeal joint osteoarthritis
Authors: Neukom Lisa , Marks Miriam , Hensler Stefanie , Kündig Sylvia , Herren Daniel B. , Schindele Stephan
Published: April 2020

The aim of this study was to evaluate patient satisfaction after distal interphalangeal joint silicone arthroplasty and compare this outcome to that achieved with screw arthrodesis. On average 4.4 years after surgery, range of motion of the distal interphalangeal joint, pain on a numeric rating scale, satisfaction, and hand appearance of 48 patients (78 treated fingers) were assessed. For arthroplasty patients, mean distal interphalangeal joint motion was 28° with an extension deficit of 17°. Pain was low for arthroplasty and arthrodesis patients with scores of 0.2 and 0.6 out of a total of 10 points, respectively. The patients in both groups were satisfied with their outcomes, but arthroplasty patients were less satisfied with the appearance. Twenty-one per cent of the arthroplasties and 15% of the arthrodeses underwent reoperation. We suggest the motion-preserving distal interphalangeal arthroplasty as an alternative to distal interphalangeal arthrodesis for patients with higher functional demands and whose joints are stable preoperatively. In patients attaching importance to hand aesthetics and for unstable joints, distal interphalangeal joint arthrodesis is preferable.

Level of evidence: III
Patterns and predictors of low physical activity in patients with stable COPD: a longitudinal study
Authors: Sánchez-Martínez María Piedad , Bernabeu-Mora Roberto , García-Vidal Jose Antonio , Benítez-Martínez Josep , de Oliveira-Sousa Silvana Loana , Medina-Mirapeix Francesc
Published: April 2020

Background:

Despite the frequency and negative impact of low physical activity among patients with chronic obstructive pulmonary disease (COPD), little is known about how it persists and remits over time or the factors predicting new states of low physical activity. The aim of the study was to determine the probability of a transition between states of low and nonlow physical activity in a cohort of patients with stable COPD followed for 2 years. We also investigated different potentially modifiable factors to determine whether they can predict new states of low physical activity.

Methods:

We prospectively included 137 patients with stable COPD (mean age 66.9 ± 8.3 years). Physical activity was measured at baseline and at 1 and 2 years of follow up. Low physical activity was defined according to energy expenditure by cut-off points from the Fried frailty model. The likelihood of annual transition towards new states and recovery was calculated. We evaluated demographic, frailty, nonrespiratory, and respiratory variables as potential predictors, using generalized estimating equations.

Results:

At baseline, 37 patients (27%) presented with low physical activity. During the study period, a total of 179 annual transitions were identified with nonlow physical activity at the beginning of the year; 17.5% transitioned to low physical activity. In contrast, 34.3% of the 67 transitions that started with low physical activity recovered. Predictors of transition to new states of low physical activity were dyspnea ⩾2 (odds ratio = 3.21; 95% confidence interval: 1.20–8.61) and poor performance on the five sit-to-stand test (odds ratio = 4.75; 95% confidence interval: 1.30–17.47).

Conclusions:

The change between levels of low and nonlow physical activity is dynamic, especially for recovery. Annual transitions toward new states of low physical activity are likely among patients with dyspnea or poor performance on the five sit-to-stand test. The reviews of this paper are available via the supplemental material section.
Haematological disorders in pregnancy
Authors: Tufail Musarat , Lindow Stephen W
Published: April 2020

Pregnancy causes several physiological changes that can change normal haematological parameters. There are also pathological haematological conditions that can occur during pregnancy. This article will look at the presentation, causes, clinical features, initial investigations, and management of anaemia, white blood cell disorders, platelet disorders, bleeding disorders and prothrombotic conditions, and their effects on pregnancy.
Etiopathogenesis of Trismus in Patients With Head and Neck Cancer: An Exploratory Literature Review
Authors: Raj Radhu , Thankappan Krishnakumar , Janakiram Chandrasekhar , Iyer Subramania , Mathew Anil
Published: April 2020

Trismus refers to a person’s inability to normally open his or her mouth. Trismus can occur as a symptom due to tumor ingrowth or it can occur postsurgical following the treatment for head and neck cancer. Radiation-induced trismus is also a relatively common oral complication. This review aimed at reviewing the etiopathogenesis of trismus in patients with head and neck cancer. Of the 16 publications included after final screening, of which one was a nonrandomized control trial, one a randomized control trial, 6 prospective cohort studies, and 8 retrospective cohort studies. Among them, 6 articles addressed the possible mechanism for trismus related to tumor ingrowth, 8 articles suggested the likely reason for trismus in patients who had undergone radiation therapy and 2 articles addressed the postsurgical cause for trismus. This review highlights the possible involvement of infratemporal fossa as a predetermining factor for developing trismus related to tumor extension. The molecular mechanism of radiation-induced fibrosis is well studied in the literature.
The Symbolic Value of Ethnic Spaces
Authors: Kirby Teri A. , Tabak Joshua A. , Ilac Maria , Cheryan Sapna
Published: April 2020

In four experiments, students read that their university was creating either an ethnic space (a space geared to people of particular ethnic groups) or a general space for students. In an internal meta-analysis, underrepresented students of color ( N = 205), but not White students ( N = 760), who read about the ethnic space reported greater belonging, value of underrepresented students by the university, support, and academic engagement compared to those who read about a general space. Ethnic spaces may hold broader psychological significance than that of mere gathering places, improving outcomes even for those who do not frequently use them. Creating ethnic spaces may be one strategy for making university environments more welcoming for underrepresented students of color.
Targeted metabolomic analysis of serum phospholipid and acylcarnitine in the adult Fontan patient with a dominant left ventricle
Authors: Michel Miriam , Dubowy Karl-Otto , Zlamy Manuela , Karall Daniela , Adam Mark Gordian , Entenmann Andreas , Keller Markus Andreas , Koch Jakob , Odri Komazec Irena , Geiger Ralf , Salvador Christina , Niederwanger Christian , Müller Udo , Scholl-Bürgi Sabine , Laser Kai Thorsten
Published: April 2020

Background:

Patients with a Fontan circulation have altered cholesterol and lipoprotein values. We analysed small organic molecules in extended phopsholipid and acylcarnitine metabolic pathways (‘metabolomes’) in adult Fontan patients with a dominant left ventricle, seeking differences between profiles in baseline and Fontan circulations.

Methods:

In an observational matched cross-sectional study, we compared phosphatidylcholine (PC), sphingomyelin (SM), and acylcarnitine metabolomes (105 analytes; AbsoluteIDQ® p180 kit (Biocrates Life Sciences AG, Innsbruck, Austria) in 20 adult Fontan patients having a dominant left ventricle with those in 20 age- and sex-matched healthy controls.

Results:

Serum levels of total PC ( q-value 0.01), total SM ( q-value 0.0002) were significantly lower, and total acylcarnitines ( q-value 0.02) were significantly higher in patients than in controls. After normalisation of data, serum levels of 12 PC and 1 SM Fontan patients were significantly lower ( q-values <0.05), and concentrations of 3 acylcarnitines were significantly higher than those in controls ( q-values <0.05).

Conclusion:

Metabolomic profiling can use small specimens to identify biomarker patterns that track derangement in multiple metabolic pathways. The striking alterations in the phospholipid and acylcarnitine metabolome that we found in Fontan patients may reflect altered cell signalling and metabolism as found in heart failure in biventricular patients, chronic low-level inflammation, and alteration of functional or structural properties of lymphatic or blood vessels.

Trial registration number:

ClinicalTrials.gov Identifier NCT03886935
On the front lines of disclosure: A conceptual framework of disclosure events
Authors: Johnson Tiffany D. , Joshi Aparna , Hogan Toschia
Published: April 2020

An important yet understudied element of the stigma disclosure calculus is the response of individuals who are the recipients of stigmatizing information—individuals who are essentially on the front lines of disclosure. Stigma disclosure recipients (SDRs) have a profound influence on disclosers’ workplace experience, yet there is a minimal understanding of how SDRs manage their responses during disclosure encounters. This article contributes to stigma identity management and workplace diversity research by focusing on the antecedents and outcomes of SDRs’ responses in organizations. We apply a novel event systems perspective to disclosure events, which allows us to develop a generalizable framework to understand the psychological and behavioral responses of SDRs across different types of stigmas. Our framework offers a unique perspective on how disclosure events trigger stigma-induced identity threat, which underlies a range of SDRs’ hostile and supportive behaviors. Overall, we propose that these responses of SDRs have important implications for the perpetuation and dismantling of stigma in the workplace. We offer implications for research and practice.
A qualitative study of users’ experiences after 3 months: the first Rwandan diabetes self-management Smartphone application “Kir’App”
Authors: Kabeza Claudine B. , Harst Lorenz , Schwarz Peter E.H. , Timpel Patrick
Published: April 2020

Background:

Owing to the increasing popularity of smartphones in Rwanda, almost 75% of the entire population currently has access to the internet. Although it has been shown that smartphone applications can support diabetes self-management, there was no diabetes self-management application available in Rwanda until April 2019. Based on the findings of a prior study assessing the needs and expectations of potential users, ‘Kir’App’ was developed to fill that void. The aim of this study was to evaluate users’ experiences after 3 months of use of the first Kir’App prototype.

Methods:

The participants of the previous study were recruited to take part in the current study. Semi-structured, in-depth, face-to-face interviews were conducted. Findings were analysed thematically using Mayring’s method of qualitative content analysis. Both deductive and inductive approaches were used to analyse transcripts according to the original categories and subcategories of the previous study.

Results:

A total of 14 people with either type 1 or type 2 diabetes participated in the study. Age of participants ranged from 19 to 70 years, with a mean age of 34.4 years. Seven of the eight original themes and one additional theme were subjoined: diabetes education and desired information provision; increased diabetes knowledge and awareness; monitoring and reminder functions; nutrition; physical activity; coping with burden of disease; app features; use behaviour and usability. Overall, participants stated that the app increased their diabetes knowledge and assisted them with their diabetes self-management.

Conclusions:

We found that the first prototype of Kir’App meets the overall needs and expectations of participating Rwandan diabetics. Having followed a strict user-centred design process, their qualitative insights will help to further improve the app.
Positive imagery cognitive bias modification for symptoms of depression among university students in Pakistan: A pilot study
Authors: Bibi Akhtar , Margraf Jürgen , Blackwell Simon E.
Published: April 2020

Depression is highly prevalent among university students in Pakistan, but treatment provision is inadequate. Computerized interventions may provide one means of overcoming treatment barriers. The present study piloted a computerized cognitive training paradigm involving repeated generation of positive mental imagery, imagery cognitive bias modification (imagery CBM), as a potential brief intervention for symptoms of depression among university students in Pakistan. Fifty-five participants scoring above a questionnaire cutoff indicating at least mild levels of depression were randomly assigned to either imagery CBM or a sham training control condition (peripheral vision task [PVT]). Participants were instructed to complete one training session from home daily over the course of 1 week. Outcomes were measured at post-training and a subsequent 2-week follow-up and included measures of depression, anhedonia, and positive affect. Participants provided positive feedback about the imagery CBM intervention but encountered practical problems with the study schedule, resulting in high rates of attrition, particularly at follow-up. Further, internal consistency of outcome measures was often low, and the PVT did not appear to be an adequate control condition in this study. However, overall the results suggest that with appropriate adaptations to the study methods formal investigation of efficacy is warranted.
Whatever happened to urban governance?
Authors: Acuto Michele
Published: April 2020

Phelps and Miao are rightly reappraising the idea ‘urban entrepreneurialism’ at a time when calls for city leaders to be outgoing abound. In a brief response to their proposition as to better qualify the varieties of entrepreneurialism at work in cities, I argue that we need to attend more explicitly to the politics underpinning these varieties, not to forget the urban governance that underscores urban entrepreneurship. Only by taking into account the interdisciplinary encounter of geography and politics, as in the case of more aptly qualifying urban (or city) diplomacy, can we grasp the fundamental reconfigurations of urban governance these varieties are prompting.
Removal of 132-pound ovarian mucinous cystadenoma: A case report
Authors: Moon Ashley S. , DeAngelis Anthony M. , Fairbairn Melissa , Kulikowski Karl , Goldenberg David , Chuang Linus , Andikyan Vaagn
Published: April 2020

Ovarian masses larger than 100 pounds are rarely encountered in developed countries given advancements in early diagnosis and treatment. Their successful resections pose unique surgical and anesthetic challenges. An otherwise healthy 38-year-old para 1 woman developed a 50 × 60 cm pelvic mass. An exploratory laparotomy, left salpingo-oophorectomy and anterior abdominal wall reconstruction were performed. A total of 60 L of cystic fluid were drained. Close monitoring of hemodynamics and massive volume resuscitation required intensive care. Inpatient physical rehabilitation reinstated independent mobility. Final pathology revealed benign ovarian mucinous cystadenoma. A multidisciplinary approach in the preoperative, intraoperative and postoperative stages of management optimizes patient outcomes.
Cephalosporin-resistant typhoid
Authors: Pereira Noella Maria Delia , Shah Ira
Published: April 2020

Typhoid fever is endemic in developing countries like India. An increasing prevalence of resistance to cephalosporins and fluoroquinolones by Salmonella isolates is seen. We present an 8-month-old boy with invasive Salmonella typhi disease. Blood culture showed S. typhi sensitive to ampicillin–sulbactam and cotrimoxazole but resistant to fluoroquinolones and third-generation cephalosporins. Cerebrospinal fluid examination revealed an aseptic meningitic picture. He was treated with intravenous meropenem and azithromycin following which his condition improved. This case highlights the need for improvement in environment sanitation and hygiene combined with early vaccination against typhoid fever and antimicrobial stewardship to help reduce the emerging resistance to cephalosporins and fluoroquinolones.
Public understanding of science and common sense: Social representations of the human microbiome among the expert and non-expert public
Authors: Galli Ida , Fasanelli Roberto
Published: April 2020

The aim of this investigation is to examine the structure and the content of different social groups’ representations of the human microbiome. We employed a non-probabilistic sample comprising two groups of participants. The first group ( n = 244) included university students. The second group included lay people ( n = 355). We chose a mixed-method approach. The data obtained were processed using IRaMuTeQ software. The results allow us to identify the anchoring and objectification processes activated by the two different groups of interviewees. The results could be useful to those in charge of implementing campaigns aimed at promoting health literacy.
Ipsilateral femoral neck and intertrochanteric fractures with posterior dislocation of the hip: A report of two cases
Authors: Su Chenxian , Liu Yangbo , Wu Peng , Yuan Jiandong , Lang Junzhe , Wu Congcong , Zhang Yiou , Chen Li , Chen Lei
Published: April 2020

Traumatic hip dislocation usually occurs in young patients, with the increasing number of high-energy injuries, and 62–93% of reported adult traumatic hip dislocations were caused by high-speed motor vehicle crashes. However, ipsilateral femoral neck fractures and intertrochanteric fractures with posterior dislocation of the hip are extremely rare, and this injury poses a challenge to orthopaedic surgeons. Here, we report two cases of simultaneous ipsilateral femoral neck fracture, intertrochanteric fracture and posterior dislocation of the hip joint in young patients who were treated with proximal femoral locking compression plate (PFLCP). The long-term follow-up (one patient was followed up for 3 years and the other for 7 years) showed that these patients had excellent functional outcomes with near-normal ranges of hip movement. The authors believe that using smaller plates with the lateral PFLCP is an acceptable method to treat this injury in young patients.
Does Caffeic Acid Phenethyl Ester as an Irrigation Solution Increase the Adhesive Quality of Root Canal Sealer?
Authors: Tosun Samet , Karataslioglu Emrah
Published: April 2020

Aim:

To evaluate the effect of the caffeic acid phenethyl ester (CAPE) as a root canal irrigation agent on the push-out bond strength of the AH-Plus sealer.

Materials and Methods:

A total of 75 single-rooted teeth were decoronated and were randomly divided into 5 groups of 15 roots for irrigation protocols: Group NaOCl: 5.25 percent NaOCl; Group CAPE: 0.5 percent CAPE; Group NaOCl + ethylenediaminetetraacetic acid (EDTA): 5.25 percent NaOCl-17 percent EDTA; Group NaOCl + CAPE: 5.25 percent NaOCl-0.5 percent CAPE; and Group CAPE + EDTA: 0.5 percent CAPE-17 percent EDTA (for 3 min each group). All root canals were then obturated and 1-mm-thick horizontal slices were obtained from different root thirds of the root canal (coronal, middle, and apical, respectively). The groups were challenged with push-out tests. Modes of failure were determined under a stereomicroscope.

Results:

The CAPE-EDTA-treated group presented the highest mean bond strength in the coronal region of root dentin ( P < .05). The CAPE-treated group had a higher mean bond strength than the NaOCl-treated group ( P < .05). The mixed mode of failure was most predominant in all groups.

Conclusion:

Under the presented in vitro conditions, CAPE alone or in combination with EDTA or NaOCl demonstrated a positive effect that increased the push-out bond strength of the AH-Plus sealer to root dentin.
Lal Bahadur Shastri, 1964–1966: Leader at a Glance
Authors: Ankit Rakesh
Published: April 2020

Lal Bahadur Shastri has been recently recalled as ‘the original accidental Prime Minister’ and ‘architect of India’s real surgical strike’. His sudden death has lately been the subject of a film, The Tashkent Files (2019) and a book, Your Prime Minister is Dead (2018). A memorial to him is the Government of India’s National Academy of Administration, named after him since 1972. And yet, there is less written on him directly, as against approaching him indirectly as (a) Jawaharlal Nehru’s successor, (b) leader during the 1965 India-Pakistan war amidst a food crisis and (c) peacemaker of the 1966 Tashkent agreement. This article tries to reconstruct, from some of his papers, a slice of Shastri’s political life that has either fallen through the crack between the larger preceding period of the Nehruvian 1950s and the larger succeeding period of Indira’s India or is resurrected in a reactionary, outsized opposition to these.
Parents, Partners, Plans, and Promises: The Relational Work of Student Loan Borrowing
Authors: Stivers Abby , Berman Elizabeth Popp
Published: April 2020

When does student loan borrowing prompt relational work between borrowers and family members? Research on student loans has focused on quantitative estimation of the effects of borrowing on educational attainment, economic well-being, health, and life-course milestones. Drawing on 60 interviews with lawyers in the northeastern United States, the authors argue that student loans also have underappreciated relational effects, even for relatively privileged borrowers. Relational work around student loans is particularly visible during the decision to borrow, when establishing partnerships, and in transitioning to parenthood. It becomes prominent when there is a mismatch between family members’ economic expectations of one another and when shared expectations are difficult to fulfill. Scholars have implicitly assumed that difficulty repaying explains the impact of borrowing on family formation. Attention to relational work, however, shows how debt can create stressors even for borrowers capable of repayment and may help explain cross-group variation in how debt affects family decisions.
Measuring Stigma to Assess the Social Justice Implications of Health-Related Policy Decisions: Application to Novel Treatment Regimens for Multidrug-Resistant Tuberculosis
Authors: Dowdy David W. , Zwerling Alice A. , Stennett Andrea , Searle Alexandra , Dukhanin Vadim , Taylor Holly A. , Merritt Maria W.
Published: April 2020

In making policy decisions with constrained resources, an important consideration is the impact of alternative policy options on social justice. Social justice considers interactions between individuals and society and can be conceptualized across domains of agency, association, and respect. Despite its importance, social justice is rarely considered formally in health policy decision making, partially reflecting challenges in its measurement. We define three criteria for considering social justice in health-related policy decisions: 1) linkage of social justice to a measurable construct; 2) ability to reproducibly and feasibly estimate the impacts of a policy decision on the selected construct; and 3) appropriate presentation to decision makers of the expected social justice implications using that construct. We use preliminary data from qualitative interviews from three groups of respondents in South Africa and Uganda to demonstrate that stigma meets the first of these criteria. We then use the example of policy addressing novel treatment regimens for multidrug-resistant tuberculosis and a validated tuberculosis stigma scale to illustrate how policy effects on stigma could be estimated (criterion 2) and presented to decision makers in the form of justice-enhanced cost-effectiveness analysis (criterion 3). Finally, we provide a point-by-point guide for conducting similar assessments to facilitate consideration of social justice in health-related policy decisions. Our case study and guide for how to make social justice impacts more apparent to decision makers also illustrates the importance of local data and local capacity. Performing social justice assessments alongside more traditional evaluations of cost-effectiveness, budget impact, and burden of disease could help represent data-informed considerations of social justice in health care decision making more broadly.
Using Nudges to Enhance Clinicians’ Implementation of Shared Decision Making With Patient Decision Aids
Authors: Kostick Kristin M. , Trejo Meredith , Volk Robert J. , Estep Jerry D. , Blumenthal-Barby J.S.
Published: April 2020

Background. Although effective interventions for shared decision making (SDM) exist, there is a lack of uptake of these tools into clinical practice. “Nudges,” which draw on behavioral economics and target automatic thinking processes, are used by policy makers to influence population-level behavior change. Nudges have not been applied in the context of SDM interventions but have potential to influence clinician motivation, a primary barrier to long-term adoption of SDM tools. Objective. Describe, evaluate, and propose recommendations for the use of a behavioral economics framework (MINDSPACE) on clinician motivation and behavior during implementation of a validated decision aid (DA) for left ventricular assist device at nine hospitals. Methods. Qualitative thematic analysis of process notes from stakeholder meetings during the first 6 months of implementation to identify examples of how the MINDSPACE framework was operationalized. Quantitative implementation progress was evaluated using the RE-AIM framework. Results. MINDSPACE components were translated into concrete approaches that leveraged influential stakeholders, fostered ownership over the DA and positive emotional associations, spread desirable norms across sites, and situated the DA within established default processes. DA reach to eligible patients increased from 9.8% in the first month of implementation to 70.0% in the sixth month. Larger gains in reach were observed following meetings using MINDSPACE approaches. Limitations. The MINDSPACE framework does not capture all possible influences on behavior and responses to nudges may differ across populations. Conclusions. Behavioral economics can be applied to implementation science to foster uptake of SDM tools by increasing clinician motivation. Our recommendations can help other researchers effectively apply these approaches in real-world settings when there are often limited incentives and opportunities to change organizational- or structural-level factors.
Characteristics of patients with systemic sclerosis suffering from a lower limb amputation: Results of a French collaborative study
Authors: Bertolino Julien , Jouve Elisabeth , Skopinski Sophie , Agard Christian , Achille Aurélie , Thoreau Benjamin , Diot Elisabeth , Sanges Sebastien , Berthier Sabine , Chaigne Benjamin , Régent Alexis , Martin Thierry , Pugnet Gregory , Benyamine Audrey , Rossi Pascal , Launay David , Mouthon Luc , Granel Brigitte ,   for the French Research Group on Systemic Sclerosis (GFRS)
Published: April 2020

Objective:

Systemic sclerosis mainly affects the microvascular network. However, macrovascular manifestations have been reported. We aimed to investigate the characteristics of systemic sclerosis patients with an amputation of a lower limb segment.

Methods:

We designed a retrospective, case–control, multicentric study on systemic sclerosis patients with amputation of a lower limb segment secondary to critical ischemia via the French Research Group on Systemic Sclerosis. For each case, a control (systemic sclerosis patient without lower limb symptom) was matched with sex, age (±5 years), and cutaneous subset of systemic sclerosis.

Results:

In total, 26 systemic sclerosis patients (mean age of 67.2 ± 10.9 years, 20 females, 21 limited cutaneous forms) with a lower limb amputation and 26 matched controls (mean age of 67.3 ± 11.2 years, 20 females, 22 limited cutaneous forms) were included. At the time of amputation, the mean disease duration was 12.8 (±8.6) years. In comparison to controls, systemic sclerosis patients with amputation had more digital ulcers (p = 0.048), history of digital ulcers (p = 0.026), and a higher prevalence of pulmonary arterial hypertension (p = 0.024). Systemic sclerosis patients with amputation were more often smokers (p = 0.008) and under corticosteroids (p = 0.015). In the multivariate model, pulmonary arterial hypertension, smoking status, and corticosteroids were independent markers associated with lower limb amputation in systemic sclerosis. In the follow-up, 10 patients (38.5%) had recurrent ischemia requiring a new limb amputation, and five patients (19.2%) had an amputation of the contralateral limb.

Conclusion:

This study identifies some markers associated with lower limb amputation in systemic sclerosis such as digital ulcers and pulmonary arterial hypertension and points out the high risk associated with tobacco consumption and corticosteroid use.
The Complexities of New Venture Legitimacy
Authors: Fisher Greg
Published: April 2020

For entrepreneurs, establishing and maintaining new venture legitimacy is a complex endeavor. Various factors complicate this process, including issues of optimal distinctiveness, audience diversity, market category evolution, and multiple legitimacy thresholds. Moreover, the establishment and maintenance of new venture legitimacy is an intricate process that unfolds over time. In this essay, I review and integrate prior work on new venture legitimacy not only to highlight these complications, but also to consolidate insights, theoretical nuances, and empirical observations to describe what happens when entrepreneurs confront multiple complications at the same time. In so doing, I propose that configurational approaches provide a valuable theoretical perspective to enhance knowledge related to new venture legitimacy. I also highlight exemplar studies that have adopted these perspectives, accounting for multiple new venture legitimacy complications in a single analysis. This provides a basis to understand recent advances in the new venture legitimacy literature, and inspires and opens up new research opportunities for further exploration.
Tribological characterization of particulate-reinforced aluminum metal matrix nanocomposites: A review
Authors: Shinde Deepak M , Sahoo Prasanta , Davim J Paulo
Published: April 2020

Aluminum (Al)-based composites are on increasing usage in sectors like ground transportation, aerospace, sports, and infrastructure because of the improved properties such as high strength to weight ratio, corrosion, fatigue, and wear resistance. Several applications involving dynamic contact stresses require excellent wear and frictional performance for improved life. Nanocomposites are found to perform exceedingly better than microcomposites and alloys in several lab scale tribological investigations carried out so far in the last decade. In this article, an attempt is made to review those published reports about dry sliding tribological behavior of particulate-reinforced Al nanocomposites. Wear and friction being system properties are found to get influenced by intrinsic factors such as reinforcement, fabrication method, microstructure; extrinsic parameters like load, speed, contact conditions and the system generated in situ tribolayer all being interrelated.
Clinical phenotypes of SARS-CoV-2: implications for clinicians and researchers
Authors: Rello Jordi , Storti Enrico , Belliato Mirko , Serrano Ricardo
Published: April 2020

Patients with COVID-19 present a broad spectrum of clinical presentation. Whereas hypoxaemia is the marker of severity, different strategies of management should be customised to five specific individual phenotypes. Many intubated patients present with phenotype 4, characterised by pulmonary hypoxic vasoconstriction, being associated with severe hypoxaemia with “normal” (>40 mL·cmH2O−1) lung compliance and likely representing pulmonary microvascular thrombosis. Phenotype 5 is often associated with high plasma procalcitonin and has low pulmonary compliance, Which is a result of co-infection or acute lung injury after noninvasive ventilation. Identifying these clinical phenotypes and applying a personalised approach would benefit the optimisation of therapies and improve outcomes.
Assessment of Global Lung Function Initiative (GLI) reference equations for diffusing capacity in relation to respiratory burden in the Swedish CArdioPulmonary bioImage Study (SCAPIS)
Authors: Malinovschi Andrei , Zhou Xingwu , Bake Björn , Bergström Göran , Blomberg Anders , Brisman Jonas , Caidahl Kenneth , Engström Gunnar , Eriksson Maria J. , Frølich Andreas , Janson Christer , Jansson Kjell , Vikgren Jenny , Lindberg Anne , Linder Robert , Mannila Maria , Persson Hans L. , Sköld C. Magnus , Torén Kjell , Östgren Carl J. , Wollmer Per , Engvall Jan E.
Published: April 2020

The Global Lung Function Initiative (GLI) has recently published international reference values for diffusing capacity of the lung for carbon monoxide (DLCO). Lower limit of normal (LLN),i.e.the 5th percentile, usually defines impairedDLCO. We examined if the GLI LLN forDLCOdiffers from the LLN in a Swedish population of healthy, never-smoking individuals and how any such differences affect identification of subjects with respiratory burden.

Spirometry,DLCO, chest high-resolution computed tomography (HRCT) and questionnaires were obtained from the first 15 040 participants, aged 50–64 years, of the Swedish CArdioPulmonary bioImage Study (SCAPIS). Both GLI reference values and the lambda-mu-sigma (LMS) method were used to define the LLN in asymptomatic never-smokers without respiratory disease (n=4903, of which 2329 were women).

Both the median and LLN forDLCOfrom SCAPIS were above the median and LLN from the GLI (p<0.05). The prevalence ofDLCO<GLI LLN (and also GLI LLN but GLI LLN but <SCAPIS LLN (n=860) had more emphysema (14.3%versus4.5%, p<0.001), chronic airflow limitation (8.5%versus3.9%, p<0.001) and chronic bronchitis (8.3%versus4.4%, p<0.01) than subjects (n=13 600) with normalDLCO(>GLI LLN and >SCAPIS LLN). No differences were found with regard to physician-diagnosed asthma.

The GLI LLN forDLCOis lower than the estimated LLN in healthy, never-smoking, middle-aged Swedish adults. Individuals withDLCOabove the GLI LLN but below the SCAPIS LLN had, to a larger extent, an increased respiratory burden. This suggests clinical implications for choosing an adequate LLN for studied populations.
Minimal clinically important differences in average, best, worst and current intensity and unpleasantness of chronic breathlessness
Authors: Ekström Magnus , Johnson Miriam J. , Huang Chao , Currow David C.
Published: April 2020

Background

Chronic breathlessness has devastating consequences. The minimal clinically important difference (MCID) for current intensity has been estimated as 9 mm on a 100-mm visual analogue scale (VAS). We aimed to determine MCIDs for commonly used dimensions and recall periods: the current unpleasantness and current, average, best and worst intensity of the past 24 h for chronic breathlessness.

Methods

This was a secondary analysis of a randomised controlled trial of morphineversusplacebo over 7 days in people with chronic breathlessness from severe disease. The breathlessness scores were self-reported using a diary each evening on 100-mm VAS. The MCID for improvement in each score was estimated using anchor-based and distribution-based methods.

Results

283 participants (mean age 74.2 years; 63% male; 58% COPD; 87.0% modified Medical Research Council (mMRC) score 3–4) were included. Anchor-based MCIDs for breathlessness scores ranged from −13.9 mm to −9.5 mm. The MCIDs were similar when using different anchors and across all participants, and participants with more severe breathlessness (mMRC 3–4). Distribution-based effect sizes were classed as small (−4.7−6.3 mm), moderate (−9.4−12.5 mm) and large (−15.0−20.0 mm) effect. Sample sizes for trials using the different scores were proposed. MCIDs of absolute change were more stable than using relative change from baseline.

Conclusion

An improvement of ∼10 mm on a 100-mm VAS is likely to be clinically meaningful across commonly used measures of chronic breathlessness (current intensity, unpleasantness, and average, best and worst intensity over the past 24 h) to evaluate clinical benefit and effects in therapeutic trials.
High cytomegalovirus serology and subsequent COPD-related mortality: a longitudinal study
Authors: Nenna Raffaella , Zhai Jing , Packard Samuel E. , Spangenberg Amber , Sherrill Duane L. , Martinez Fernando D. , Halonen Marilyn , Guerra Stefano
Published: April 2020

Background

Positive serology for cytomegalovirus (CMV) has been associated with all-cause mortality risk but its role in COPD mortality is unknown. The objective of the present study was to assess the relationship between CMV serology and COPD mortality.

Methods

We analysed data from 806 participants in the Tucson Epidemiological Study of Airway Obstructive Disease who, at enrolment, were aged 28–70 years and had completed lung function tests. We tested CMV serology in sera from enrolment and defined “high CMV serology” as being in the highest tertile. Vital status, date and cause of death were assessed through death certificates and/or linkage with the National Death Index up to January 2017. The association of CMV serology with all-cause and cause-specific mortality risk was tested in Cox models adjusted for age, sex, level of education, body mass index, smoking status and pack-years.

Results

High CMV serology was marginally associated with all-cause mortality (p=0.071) but the effect was inversely dependent on age, with the association being much stronger among participants <55 years than among participants ≥55 years at enrolment (p-value for CMV-by-age interaction <0.001). Compared with low CMV serology, high CMV serology was associated with mortality from COPD among all subjects (adjusted hazard ratio (HR) 2.38, 95% CI 1.11–5.08; p=0.025) and particularly in subjects <55 years old at enrolment (HR 5.40, 95% CI 1.73–16.9; p=0.004). Consistent with these results, high CMV serology also predicted mortality risk among subjects who already had airflow limitation at enrolment (HR 2.10, 95% CI 1.20–3.68; p=0.009).

Conclusions

We report a strong relationship between CMV serology and the risk of dying from COPD, and thus identify a novel risk factor for COPD mortality.