bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychoeducation
Authors: Brown Jacqueline A. , Russell Samantha , Hattouni Emily , Kincaid Ashlyn
Published: June 2020

Providing psychoeducation to teachers, families, and other school staff is pivotal to best support students within the school setting. Psychoeducation is generally known as the information and resources provided to school staff, families, and students by mental health professionals to better educate them about the student’s emotions, behaviors, and achievement. Within the school setting, the school (or educational) psychologist often takes on this role when working with students and their families. School/educational psychologists are typically the most knowledgeable about psychological practices, theories, and foundations, and also have expertise in special education services, learning barriers, behavioral and mental health interventions, academic learning, and family–school collaboration, along with consultation and assessment practices. Consequently, these professionals are in a good position to effectively provide psychoeducation to a wide range of individuals.

There are various methods of psychoeducation that can be used, such as disseminating resources and reading materials to teachers and families, meeting individually with families or teachers to provide detailed information about what the student is experiencing, and conducting psychoeducational groups with children and/or their caregivers on a variety of topics related to the child’s academic, behavior, or social-emotional well-being. When examining these methods, it is also important to understand how psychoeducation can be used for a wide range of educational practices that promote student well-being. These include using psychoeducation to increase academic achievement, for the prevention of problem behavior, to increase social-emotional well-being, promote educational practices, and provide professional development for school staff, and to inform educational policies. These psychoeducation practices have been widely used globally to better assist student functioning. Although psychoeducation is a widespread practice, there are still different views on how it should be delivered and questions that have arisen from the research.
Using Online Engagement Activities in International Studies Courses
Authors: Sasikumar Karthika
Published: June 2020

Although instructors are increasingly adopting the practices of online engagement in the field of international studies, there are few discussions in the disciplinary literature of its methods, advantages and disadvantages. Online engagement can be considered as a type of class participation that takes place on the Internet. It refers to engagement between groups of students and an instructor, as well as engagement among students. Online engagement activities can be integrated into fully-online courses, or they may supplement in-class participation in traditional courses., There are five common methods that can be used to create online engagement among students: online discussion boards, class blogs, social networking sites such as Twitter and Facebook, wikis, and online simulations. Each of these has its advantages and disadvantages. For each there are case studies in the literature, and best practices can be summarized. Online engagement should not be technology-driven; rather, it should be integrated with the course content and learning outcomes. Instructors should craft assignments in ways that encourage creative and critical thinking, and should take into account the particular problems that arise in the absence of face-to-face interaction. Online engagement activities should be chosen to mitigate some of the issues with traditional classroom activities, and/or develop novel skills that are relevant to the 21st-century economy. These activities should be accessible to all—including, but not restricted to, students with disabilities. Instructors and institutions should also be aware of ethical and legal issues, such as privacy, and the ownership of the data generated by online engagement activities by users.
Southern Africa’s Later Stone Age and Hunter-Gatherer Ethnography
Authors: Forssman Tim
Published: June 2020

Reviews of southern Africa’s Later Stone Age (LSA) have seen many different iterations. Generally, however, they summarize the technocomplex from its earliest industry until it ceases to be recognizable in the archaeological record, summarizing the variety of research topics, questions, and approaches. Binding much of this together, despite the diaspora of studies, is the use of ethnography to understand past hunter-gatherer lifeways. This resource has guided interpretations of the past and helped design research approaches since the 1970s. And yet, from as early as the 1980s, archaeologists as well as anthropologists have debated the influence ethnography plays in understanding the past. Nonetheless, without it, significantly less would be written of hunter-gatherer prehistory in southern Africa, which includes belief systems, settlement structures, mobility patterns, subsistence habits, and social relations. Using ethnography as a vehicle, it is possible to navigate the LSA pathways created by scholars and examine the aforementioned contributions this knowledge system has made to interpretations of the past. From this vantage, envisioning a future for ethnography within the field is possible. This should involve expanding the ethnographies archaeologists use, moving beyond the Kalahari Desert, creating a diverse group of LSA researchers, and decolonizing the discipline.
Alterations of the Gut Microbiota in Patients With Coronavirus Disease 2019 or H1N1 Influenza
Authors: Gu Silan , Chen Yanfei , Wu Zhengjie , Chen Yunbo , Gao Hainv , Lv Longxian , Guo Feifei , Zhang Xuewu , Luo Rui , Huang Chenjie , Lu Haifeng , Zheng Beiwen , Zhang Jiaying , Yan Ren , Zhang Hua , Jiang Huiyong , Xu Qiaomai , Guo Jing , Gong Yiwen , Tang Lingling , Li Lanjuan
Published: June 2020

Background

Coronavirus disease 2019 (COVID-19) is an emerging serious global health problem. Gastrointestinal symptoms are common in COVID-19 patients, and severe acute respiratory syndrome coronavirus 2 RNA has been detected in stool specimens. However, the relationship between the gut microbiome and disease remains to be established.

Methods

We conducted a cross-sectional study of 30 patients with COVID-19, 24 patients with influenza A(H1N1), and 30 matched healthy controls (HCs) to identify differences in the gut microbiota by 16S ribosomal RNA gene V3–V4 region sequencing.

Results

Compared with HCs, COVID-19 patients had significantly reduced bacterial diversity; a significantly higher relative abundance of opportunistic pathogens, such as Streptococcus, Rothia, Veillonella, and Actinomyces; and a lower relative abundance of beneficial symbionts. Five biomarkers showed high accuracy for distinguishing COVID-19 patients from HCs with an area under the curve (AUC) up to 0.89. Patients with H1N1 displayed lower diversity and different overall microbial composition compared with COVID-19 patients. Seven biomarkers were selected to distinguish the 2 cohorts (AUC = 0.94).

Conclusions

The gut microbial signature of patients with COVID-19 was different from that of H1N1 patients and HCs. Our study suggests the potential value of the gut microbiota as a diagnostic biomarker and therapeutic target for COVID-19, but further validation is needed.
Occurrence and Timing of Subsequent Severe Acute Respiratory Syndrome Coronavirus 2 Reverse-transcription Polymerase Chain Reaction Positivity Among Initially Negative Patients
Authors: Long Dustin R , Gombar Saurabh , Hogan Catherine A , Greninger Alexander L , O’Reilly-Shah Vikas , Bryson-Cahn Chloe , Stevens Bryan , Rustagi Arjun , Jerome Keith R , Kong Christina S , Zehnder James , Shah Nigam H , Weiss Noel S , Pinsky Benjamin A , Sunshine Jacob E
Published: June 2020

Using data for 20 912 patients from 2 large academic health systems, we analyzed the frequency of severe acute respiratory syndrome coronavirus 2 reverse-transcription polymerase chain reaction test discordance among individuals initially testing negative by nasopharyngeal swab who were retested on clinical grounds within 7 days. The frequency of subsequent positivity within this window was 3.5% and was similar across institutions.
Iron Deficiency Is Associated With Reduced Levels of Plasmodium falciparum-specific Antibodies in African Children
Authors: Bundi Caroline K , Nalwoga Angela , Lubyayi Lawrence , Muriuki John Muthii , Mogire Reagan M , Opi Herbert , Mentzer Alexander J , Mugyenyi Cleopatra K , Mwacharo Jedida , Webb Emily L , Bejon Philip , Williams Thomas N , Gikunju Joseph K , Beeson James G , Elliott Alison M , Ndungu Francis M , Atkinson Sarah H
Published: June 2020

Background

Iron deficiency (ID) and malaria are common causes of ill-health and disability among children living in sub-Saharan Africa. Although iron is critical for the acquisition of humoral immunity, little is known about the effects of ID on antibody responses to Plasmodium falciparum malaria.

Methods

The study included 1794 Kenyan and Ugandan children aged 0–7 years. We measured biomarkers of iron and inflammation, and antibodies to P. falciparum antigens including apical merozoite antigen 1 (anti-AMA-1) and merozoite surface antigen 1 (anti-MSP-1) in cross-sectional and longitudinal studies.

Results

The overall prevalence of ID was 31%. ID was associated with lower anti-AMA-1 and anti-MSP-1 antibody levels in pooled analyses adjusted for age, sex, study site, inflammation, and P. falciparum parasitemia (adjusted mean difference on a log-transformed scale (β) −0.46; 95 confidence interval [CI], −.66, −.25 P < .0001; β −0.33; 95 CI, −.50, −.16 P < .0001, respectively). Additional covariates for malaria exposure index, previous malaria episodes, and time since last malaria episode were available for individual cohorts. Meta-analysis was used to allow for these adjustments giving β −0.34; −0.52, −0.16 for anti-AMA-1 antibodies and β −0.26; −0.41, −0.11 for anti-MSP-1 antibodies. Low transferrin saturation was similarly associated with reduced anti-AMA-1 antibody levels. Lower AMA-1 and MSP-1-specific antibody levels persisted over time in iron-deficient children.

Conclusions

Reduced levels of P. falciparum-specific antibodies in iron-deficient children might reflect impaired acquisition of immunity to malaria and/or reduced malaria exposure. Strategies to prevent and treat ID may influence antibody responses to malaria for children living in sub-Saharan Africa.
Posttreatment Lymphopenia Is Associated With an Increased Risk of Redeveloping Nontuberculous Lung Disease in Patients With Mycobacterium avium Complex Lung Disease
Authors: Furuuchi Koji , Fujiwara Keiji , Uesgi Fumiko , Shimoda Masafumi , Seto Shintaro , Tanaka Yoshiaki , Yoshiyama Takashi , Yoshimori Kozo , Kurashima Atsuyuki , Ohta Ken , Morimoto Kozo
Published: June 2020

Background

Lymphopenia has been reported as a risk factor for poor prognosis in various infectious diseases, including Mycobacterium avium complex lung disease (MAC-LD), and recurrence in several infectious diseases. However, the association between lymphopenia and the risk of redeveloping nontuberculous lung disease (NTM-LD) after completed treatment for MAC-LD is unknown.

Methods

We performed a retrospective cohort study with 147 patients with MAC-LD who successfully completed guideline-based therapy. Lymphopenia was defined as an absolute lymphocyte count (ALC) <1000 cells/μL based on commonly accepted reference values.

Results

During the median follow-up period of 41.9 months after treatment completion, 59 (40.1%) patients redeveloped NTM-LD. Patients with NTM-LD redevelopment had significantly lower posttreatment ALCs (median, 1260 vs 1420 cells/μL) than those without, and the univariate Cox proportional hazard analysis identified posttreatment ALC as a predictive factor for redevelopment (hazard ratio, .94 [95% confidence interval, .89–.99] for every increase of 100 cells/μL; P = .04). In the multivariate analysis, posttreatment ALC and the extent of bronchiectasis were independently associated with NTM-LD redevelopment. The cumulative rate of NTM-LD redevelopment was significantly higher in patients with posttreatment lymphopenia than in those without (P = .008).

Conclusions

Posttreatment lymphopenia could predict an increased risk of NTM-LD redevelopment after completed treatment for MAC-LD.
MRSA Transmission in Intensive Care Units: Genomic Analysis of Patients, Their Environments, and Healthcare Workers
Authors: Popovich Kyle J , Green Stefan J , Okamoto Koh , Rhee Yoona , Hayden Mary K , Schoeny Michael , Snitkin Evan S , Weinstein Robert A
Published: June 2020

Background

Methicillin-resistant Staphylococcus aureus (MRSA)—and now USA300 MRSA—is a significant intensive care unit (ICU) pathogen; healthcare worker (HCW) contamination may lead to patient cross-transmission.

Methods

From September 2015 to February 2016, to study the spread of MRSA, we enrolled HCWs in 4 adult ICUs caring for patients on MRSA contact precautions. Samples were collected from patient body sites and high-touch surfaces in patient rooms. HCW hands, gloves, and personal protective equipment were sampled pre/post-patient encounter. Whole genome sequencing (WGS) was used to compare isolates from patients, HCWs, and environment.

Results

There were 413 MRSA isolates sequenced (38% USA300, 52% USA100) from 66 patient encounters. Six of 66 HCWs were contaminated with MRSA prior to room entry. Isolates from a single patient encounter were typically either USA100 or USA300; in 8 (12%) encounters both USA300 and USA100 were isolated. WGS demonstrated that isolates from patients, HCWs, and environment often were genetically similar, although there was substantial between-encounter diversity. Strikingly, there were 5 USA100 and 1 USA300 clusters that contained similar strains (<22 single-nucleotide variants [SNVs], with most <10 SNVs) within the cluster despite coming from different encounters, suggesting intra- and inter-ICU spread of strains, that is, 4 of these genomic clusters were from encounters in the same ICU; 5 of 6 clusters occurred within 1 week.

Conclusions

We demonstrated frequent spread of MRSA USA300 and USA100 strains among patients, environment, and HCWs. WGS identified possible spread within and even between ICUs. Future analysis with detailed contact tracing in conjunction with genomic data may further elucidate pathways of MRSA spread and points for intervention.
The long and winding road of cardiomyocyte maturation
Authors: Maroli Giovanni , Braun Thomas
Published: June 2020

Knowledge about the molecular mechanisms regulating cardiomyocyte (CM) proliferation and differentiation has increased exponentially in recent years. Such insights together with the availability of more efficient protocols for generation of CMs from induced pluripotent stem cells (iPSCs) have raised expectations for new therapeutic strategies to treat congenital and non-congenital heart diseases. However, the poor regenerative potential of the postnatal heart and the incomplete maturation of iPSC-derived CMs represent important bottlenecks for such therapies in future years. CMs undergo dramatic changes at the doorstep between prenatal and postnatal life, including terminal cell cycle withdrawal, change in metabolism, and further specialization of the cellular machinery required for high-performance contraction. Here, we review recent insights into pre- and early postnatal developmental processes that regulate CM maturation, laying specific focus on genetic and metabolic pathways that control transition of CMs from the embryonic and perinatal to the fully mature adult CM state. We recapitulate the intrinsic features of CM maturation and highlight the importance of external factors, such as energy substrate availability and endocrine regulation in shaping postnatal CM development. We also address recent approaches to enhance maturation of iPSC-derived CMs in vitro, and summarize new discoveries that might provide useful tools for translational research on repair of the injured human heart.
Assessing absolute stroke risk in patients with atrial fibrillation using a risk factor-based approach
Authors: Lee Christina J -Y , Toft-Petersen Anne Pernille , Ozenne Brice , Phelps Matthew , Olesen Jonas Bjerring , Ellinor Patrick T , Gislason Gunnar , Lip Gregory Y H , Torp-Pedersen Christian , Gerds Thomas Alexander
Published: June 2020

Aim

To assess the risk of stroke and thromboembolism in patients with atrial fibrillation (AF) based on risk factor combinations of the CHA2DS2-VASc score.

Methods and results

Using nationwide Danish registries, patients with AF were included from 1997 to 2015 in this retrospective observational study. A multiple logistic regression, including interactions of history of stroke with age at AF, calendar year of AF, and the CHA2DS2-VASc score risk factors (congestive heart failure, hypertension, diabetes, vascular disease, and female sex) were used to predict the personalized risks of stroke within 1 year. A total of 147 842 patients with AF were included in the study cohort (median age 76 years, range 20–100 years, 51% females). Within the first year, 6% of the cohort were diagnosed with stroke. The predicted personalized 1-year absolute risk of stroke varied widely within each CHA2DS2-VASc score. To estimate the personalized risk of stroke an online calculator was created, the Calculator of Absolute Stroke Risk (CARS), which allows calculation of all the possible combinations of the CHA2DS2-VASc score (https://hjerteforeningen.shinyapps.io/riskvisrr/).

Conclusion

Calculation of the individual risk using a risk factor-based approach as opposed to using average risk for a particular CHA2DS2-VASc score can improve risk estimates. Furthermore, CARS can assist in the communication of the stroke risk for a more evidence-based shared decision-making of whether to initiate oral anticoagulation therapy.
QRS complex axis deviation changing in catheter ablation of left fascicular ventricular tachycardia
Authors: Zhou Genqing , Lu Xiaofeng , Nie Zhenning , Chen Songwen , Wei Yong , Cai Lidong , Xu Juan , Ding Yu , Peng Shi , Wu Xiaoyu , Wang Zulu , Liu Shaowen
Published: June 2020

Aims

The mechanisms of the QRS complex axis deviation changing of idiopathic left fascicular ventricular tachycardia (FVT) during or after radiofrequency catheter ablation were investigated in this study, which were still not well defined.

Methods and results

In the index procedure, FVTs characterized by right bundle branch block configuration and left-axis deviation (LAD-FVT) were ablated at the VT exit site guided by the earliest ventricular activation with fused presystolic Purkinje potential (PP) in 234 consecutive patients. A new type of FVT characterized by right-axis deviation (RAD-FVT) was identified after successful elimination of the LAD-FVT in 12 patients, including 9 patients during the index procedure and 3 patients during follow-up. The QRS duration of RAD-FVT was shorter than that of LAD-FVT (115.3 ± 15.2 vs. 125.3 ± 16.4 ms, P = 0.006). The RAD-FVTs showed an earliest ventricle activation site localized at anterior fascicle area in 11 patients and anterior-median fascicle area in 1. However, the earliest PP during the RAD-FVT was still identified within the posterior fascicular network. Elimination of the RAD-FVTs was successfully achieved by applying radiofrequency current at a more proximal site within the left posterior fascicular network guided by the earliest PP. After a mean of 1.6 ± 0.8 ablation procedures and median follow-up of 132 (range 19–216) months since the last procedure, no recurrence was observed in any patients.

Conclusion

The axis deviation changing of QRS complex in FVT may be attributed to the different exit sites of the reentry.
Anxiety and depression symptoms in Danish patients with an implantable cardioverter-defibrillator: prevalence and association with indication and sex up to 2 years of follow-up (data from the national DEFIB-WOMEN study)
Authors: Frydensberg Vivi Skibdal , Johansen Jens Brock , Möller Sören , Riahi Sam , Wehberg Sonja , Haarbo Jens , Philbert Berit Thornvig , Jørgensen Ole Dan , Larsen Mogens Lytken , Nielsen Jens Cosedis , Pedersen Susanne S
Published: June 2020

Aims

To investigate (i) the prevalence of anxiety and depression and (ii) the association between indication for implantable cardioverter-defibrillator (ICD) implantation and sex in relation to anxiety and depression up to 24 months’ follow-up.

Methods and results

Patients with a first-time ICD, participating in the national, multi-centre, prospective DEFIB-WOMEN study (n = 1496; 18% women) completed the Hospital Anxiety and Depression Scale at baseline, 3, 6, 12, and 24 months. Data were analysed using linear mixed modelling for longitudinal data. Patients with a secondary prophylactic indication (SPI) had higher mean anxiety scores than patients with a primary prophylactic indication (PPI) at baseline, 3, and 12 months and higher mean depression scores at all-time points, except at 24 months. Women had higher mean anxiety scores as compared to men at all-time points; however, only higher mean depression scores at baseline. Overall, women with SPI had higher anxiety and depression symptom scores than men with SPI. Symptoms decreased over time in both women and men. From baseline to follow-up, the prevalence of anxiety (score ≥8) was highest in patients with SPI (13.3–20.2%) as compared to patients with PPI (range 10.0–14.7%). The prevalence of depression was stable over the follow-up period in both groups (range 8.5–11.1%).

Conclusion

Patients with a SPI reported higher anxiety and depression scores as compared to patients with PPI. Women reported higher anxiety scores than men, but only higher depression scores at baseline. Women with SPI reported the highest anxiety and depression scores overall.
Culture and application of conditionally reprogrammed primary tumor cells
Authors: Zhong Mengjun , Fu Liwu
Published: June 2020

Cancer is still a major public-health problem that threatens human life worldwide and further study needs to be carried out in the basic and preclinical areas. Although high-throughput sequencing technology and individualized precise therapy have made breakthroughs over the years, the high failure rate of clinical translational research has limited the innovation of antitumor drugs and triggered the urgent need for optimal cancer-research models. The development of cancerous cell lines, patient-derived xenograft (PDX) models, and organoid has strongly promoted the development of tumor-biology research, but the prediction values are limited. Conditional reprogramming (CR) is a novel cell-culture method for cancer research combining feeder cells with a Rho-associated coiled-coil kinase (ROCK) inhibitor, which enables the rapid and continuous proliferation of primary epithelial cells. In this review, we summarize the methodology to establish CR model and overview recent functions and applications of CR cell-culture models in cancer research with regard to the study of cancer-biology characterization, the exploration of therapeutic targets, individualized drug screening, the illumination of mechanisms about response to antitumor drugs, and the improvement of patient-derived animal models, and finally discuss in detail the major limitations of this cell-culture system.
Education in the genomics era: Generating high-quality genome assemblies in university courses
Authors: Prost Stefan , Winter Sven , De Raad Jordi , Coimbra Raphael T F , Wolf Magnus , Nilsson Maria A , Petersen Malte , Gupta Deepak K , Schell Tilman , Lammers Fritjof , Janke Axel
Published: June 2020

Recent advances in genome sequencing technologies have simplified the generation of genome data and reduced the costs for genome assemblies, even for complex genomes like those of vertebrates. More practically oriented genomic courses can prepare university students for the increasing importance of genomic data used in biological and medical research. Low-cost third-generation sequencing technology, along with publicly available data, can be used to teach students how to process genomic data, assemble full chromosome-level genomes, and publish the results in peer-reviewed journals, or preprint servers. Here we outline experiences gained from 2 master's-level courses and discuss practical considerations for teaching hands-on genome assembly courses.
Application of high-rate GPS for earthquake rapid response and modelling: a case in the 2019 Mw 7.1 Ridgecrest earthquake
Authors: Fang Jin , Xu Caijun , Zang Jianfei , Wen Yangmao , Song Chuang , Li Yanyan
Published: June 2020

The 2019 Mw 7.1 Ridgecrest earthquake opens an opportunity to investigate how soon we can produce a reliable fault geometry and subsequently a robust source model based on high-rate Global Positioning System (GPS) data. In this study, we conduct peak ground displacement (PGD) magnitude scaling, real-time centroid moment tensor (CMT) calculation and rapid kinematic slip inversion. We conclude that a four-station PGD warning with a magnitude of Mw 7.03 can be issued at 24 s after initiation of the rupture. Fast CMT inversion can initially recover the correct nodal planes at 30 s. The kinematic slip model reveals that the Mw 7.1 earthquake is a predominant dextral strike-slip event with both normal and thrust components resolved. The earthquake shows a bilateral rupture with a low propagation speed of ∼2.1 km s−1 and a slip maxima of ∼4 m. The total moment is 5.18 × 1019 N m (Mw 7.11). We further suggest that a reasonable source model will be available in a simulated real-time mode within 30 s after the earthquake occurring, without using full high-rate GPS waveforms. This research highlights the significance of high-rate GPS for rapid earthquake response and modelling of kinematic rupture, which is also generalized by the hypothetical real-time GPS analysis for the 2016 Mw 7.8 Kaikoura earthquake and the 2010 Mw 7.2 El Mayor-Cucapah earthquake.
High-resolution palaeomagnetic record from Sea of Marmara sediments for the last 70 ka
Authors: Makaroğlu Özlem , Nowaczyk Norbert R , Eriş Kadir K , Çağatay M Namık
Published: June 2020

Magnetostratigraphic and geochemical analyses were performed on two sediment cores recovered from the Sea of Marmara to investigate geomagnetic field variations over the last 70 ka. A chronology for each of the two cores was developed from eight AMS 14C datings, tephrochronology, and tuning of Ca concentrations with stadials and interstadials observed in Greenland ice core oxygen isotope data. Based on the age models, cores MD01–2430 and MRS-CS19 reach back to 70 and 32 ka, respectively. High average sedimentation rates of 43 cm kyr–1 for core MD01–2430 and 68 cm kyr–1 for core MRS-CS19 allow high-resolution reconstruction of geomagnetic field variations for the Sea of Marmara. Mineral magnetic properties are sensitive to glacioeustatic sea level changes and palaeoclimate variations in this region, reflecting the variable palaeoenvironmental conditions of the Sea of Marmara during last 70 ka. Despite the impairment of the palaeomagnetic record in some stratigraphic intervals due to early diagenesis, relative palaeointensity variations in the Sea of Marmara sediments correlate well with similar records derived from other regions, such as the nearby Black Sea and the GLOPIS-75 stack. The directional record derived from the Sea of Marmara cores exhibits typical palaeosecular variation patterns, with directional anomalies at 41 and 18 ka, representing the Laschamps and postulated Hilina Pali excursions, respectively. Both directional anomalies are also associated with palaeointensity minima. A further palaeointensity minimum at 34.5 ka is likely related to the Mono Lake excursion, with no directional deviation documented in the Sea of Marmara palaeomagnetic record so far.
Toward a more robust competition policy regime for Hong Kong
Authors: Lin Ping , Ross Thomas W
Published: June 2020

After years of debate, Hong Kong’s new competition law, the Competition Ordinance (CO), took effect in December 2015. Laying out rules to support competitive markets and creating the institutions to administer and enforce those rules, the CO is a modern competition law in many respects, following many best-practices and respecting recent learning in competition economics. This article argues, however, that—at least from an economist’s perspective—in its drafting a series of decisions were made that weaken the law. None is that unusual or critical on its own, however collectively they leave the law less powerful than competition enthusiasts might desire in a modern market economy. We discuss the implications of these decisions and go on to consider some other more unique aspects of the law that might need reconsideration at some point. Finally, we document and discuss the early activities of the Competition Commission of Hong Kong. We conclude that Hong Kong is off to a good start with its new law and its enforcement but that several reforms have the potential to bring a more robust competition policy regime.
Nocturnal Mosquitoes of Pará State in the Brazilian Amazon: Species Composition, Habitat Segregation, and Seasonal Variation
Authors: de Araújo Walter Santos , Vieira Thallyta Maria , de Souza Guilherme Antunes , Bezerra Isaque Clementino , Corgosinho Paulo Henrique Costa , Borges Magno Augusto Zazá
Published: June 2020

Mosquitoes (Diptera: Culicidae) are one of the most important disease vector species in the world. Many species have a high degree of anthropophilia and are often found in human habitations. In the present study, we have inventoried the nocturnal mosquito assemblage in intra-, peri-, and extradomicile environments in four municipalities in Pará, Brazil. At each municipality, a residence was selected and the mosquitoes were sampled using the protected human attraction capture and Shannon trap methods in April (rainy season) and August 2018 (dry season). We have collected a total of 696 mosquito specimens belonging to 8 genera and 17 species. The most abundant species were Mansonia (Mansonoides) titillans (Walker) (366/696, 52.6%), Anopheles (Nyssorhynchus) albitarsis Lynch-Arribálzaga (97/696, 13.9%), and Culex (Culex) quinquefasciatus Say (93/696, 13.4%). Mosquito richness, abundance, and composition did not differ between intra-, peri-, and extradomicile environments suggesting limited habitat segregation among the different species. However, mosquito species richness and mosquito species abundance were significantly higher during the rainy season than during the dry season, suggesting increased mosquito activity during the rainy season. We detected several important vector species of human diseases including Aedes (Stegomyia) aegypti (Linnaeus), Anopheles (Nyssorhynchus) darlingi Root, Haemagogus (Conopostegus) leucocelaenus (Dyar and Shannon), Coquillettidia (Coquillettidia) venezuelensis (Theobald), and Culex (Culex) quinquefasciatus which are the main transmitters of dengue, malaria, yellow fever, mayaro, and oropouche fever, respectively. As inventories of disease-carrying mosquitoes in the region are very scarce, mainly in residential environments, our results suggest high potential for mosquito-borne disease transmission in Pará State.
Openness and Integrity in Antitrust
Authors: Makris Stavros
Published: June 2020

Reasonable disagreements are pervasive in antitrust, yet the leading antitrust systems function in a broadly effective and consistent manner. How can we explain this paradox? The tentative reply to this question is that the two main antitrust jurisdictions have managed to do so by adopting the features of ‘responsive law’ (RL). Therefore, antitrust institutions could further benefit if they adopt the RL framework to understand and deal with reasonable disagreements.

To support this argument, I contend that reasonable disagreements are endogenous in antitrust systems, as they derive from antitrust’s fuzzy mandate, conceptually elastic vocabulary, and rules and standards mode of analysis. In a nutshell, reasonable disagreements are the by-product of two complementary yet antithetical forces of antitrust: openness and integrity. Nonetheless, conventional wisdom has it that such disagreements are temporary indeterminacies that will eventually be eradicated. This view stems from a conceptualization of antitrust as a form of ‘autonomous law’. However, this model of law does not take reasonable disagreements seriously and as a result offers an inadequate modus operandi for dealing with them. The ‘RL’ model, on the contrary, recognizes the endogeneity of reasonable disagreements and the underlying forces that generate them. Instead of attempting to eliminate them, therefore, the RL model suggests that antitrust institutions should seek to tame and exploit them. For this purpose, this model proposes a legal-institutional modus operandi for calibrating the eliciting forces of reasonable disagreements, that is, openness and integrity. The hallmarks of this approach are constructive teleological interpretation, experimentalist network-based enforcement by postbureaucratic enforcers, and courts operating as catalysts.
Associations of Serum Pepsinogens and Helicobacter Pylori Infection with High-Sensitivity C-Reactive Protein in Medical Examination Population
Authors: Liu Huixing , Fei Chunrong , Zhang Jun
Published: June 2020

Objective

This study aimed to clarify the distribution characteristics of serum pepsinogen (PG) and Helicobacter pylori in the medical examination population and to explore the relationships of PG level and H. pylori infection status with the high-sensitivity C-reactive protein (hsCRP) level and their significance in health examination.

Methods

We detected H. pylori infection by C13 urea breath test, the serum pepsinogen I (PGI) and pepsinogen II (PGII) contents were measured by chemiluminescence microparticle immunoassay, and the PGI/PGII ratio was calculated. In addition, the serum hsCRP level was determined by the Abbott C16000 automatic biochemical analyzer.

Results

The PGI and hsCRP levels were significantly higher in men than in women, and the PGII level was slightly higher in men than in women (both P <.05). The PGI, PGII, and hsCRP levels were positively correlated with age (r = 0.210, 0.287, and 0.133, respectively; P <.05), whereas the PGI/PGII ratio was negatively correlated with age (r = –0.190; P <.05). The positive H. pylori infection rate was 30.2% among the patients in this study; H. pylori infection was not related to sex (P >.05), and the difference in age stratification was not statistically significant (P >.05). The abnormal PGI/PGII ratio in the medical examination population was not correlated with sex (P >.05). In the H. pylori positive infection group, the proportion of PGI/PGII ratio <3, the PGI and PGII levels were significantly higher than those in the H. pylori negative infection group, and the PGI/PGII ratio was significantly lower than that in the negative group (both P <.05). The hsCRP level was not associated with H. pylori infection (P >.05), and it was significantly higher in the PGI/PGII ratio <3 group than in the PGI/PGII ratio ≥3 group (P <.05).

Conclusion

The PGI and PGII levels and the PGI/PGII ratio are correlated with H. pylori infection. The abnormal PGI/PGII ratio is closely related to H. pylori infection and hsCRP level. Therefore, H. pylori infection status and hsCRP level should be considered when determining atrophic gastritis by the PGI/PGII ratio.
Potential Areas of Concern and How to Address Them
Authors: Papazoglou Emily
Published: June 2020

Organized alphabetically, this chapter will introduce you to some of the more commonly encountered areas of concern. Medical, behavioral/emotional, cognitive, and academic concerns are reviewed here. This includes attention deficit hyperactivity disorder, anxiety, autism, epilepsy, executive functioning difficulties, language disorders, learning disabilities, motor problems, and premature birth. Commonly encountered terms are explained, the signs of different conditions are reviewed, and things to watch for are highlighted. Frequently asked questions about how to support development across a variety of different areas are answered and strategies are provided to help you maximize your child’s development.
How Microaggressions Are Harmful
Authors: Williams Monnica T.
Published: June 2020

Abstract: This chapter discusses the research regarding microaggressions and negative mental health outcomes. Microaggressions are associated with increased stress, increased physical ailments such as hypertension and impaired immune responses, increased depression and depressive symptoms, lower self-esteem and self-efficacy, increased alcohol abuse and binge drinking, substance use disorders, increased post-traumatic stress disorder symptoms, higher levels of suicidal ideation, increased anxiety, increased somatic symptoms and negative affect, and increased obsessive–compulsive disorder symptoms. Overall, those who experience everyday discrimination have higher odds of any lifetime mental health issue. This is illustrated using a case example of a student who developed depression and anxiety from experiencing microaggressions in school, leading to a negative impact on mental health. The chapter presents an example interaction between a client and a therapist illustrating that microaggressions can be harmful to White people as well in indirect ways. Furthermore, to address mental health disparities and treatment barriers as a result of various pathways including microaggressions, clinicians need to address their own possible implicit biases that can lead to perpetuating these problems.
Issues and Controversies
Authors: Williams Monnica T.
Published: June 2020

Abstract: Are microaggressions really just people being too sensitive? Not everyone agrees that microaggressions are a problem, and some view the increased social dialogue surrounding the harms of microaggressions as a sign of a threatening shift in cultural values. Are microaggressions truly aggressive? Microaggressions are believed to be often unintentional and harms are often small, so they may not automatically be considered a form of violence or aggression. However, there are many disciplines that consider all forms of racism to be violence and aggression. Should we just give offenders the benefit of the doubt? Some critics of microaggressions research have urged victims to simply choose not to be offended, but it is also important to consider the dangers of ignoring microaggressions. In this chapter, issues and controversies in the literature regarding microaggressions are reviewed. Reducing microaggressions on campuses and in the workplace is discussed including the Racial Harmony Workshop, a diversity workshop designed to be both educational and experiential, using the experiences and diversity of the participants to promote sharing and social connection. Future directions in the area of microaggressions include more funding opportunities for research to operationalize how to best help people who are experiencing distress resulting from microaggressions. Research is still needed to determine if and how certain responses can protect against the negative sequelae of experiencing a microaggression.
Introduction
Authors: Croskerry Pat
Published: June 2020

Medical error is one of the leading causes of death, and most of these errors appear to occur in the ways that practitioners’ thoughts and feelings impact their decision making. Major gains have been made in the cognitive sciences in the past few decades that have provided a model for understanding how decisions are made—dual process theory. It is an excellent platform on which to examine the different ways decisions are made. Importantly, it allows for the examination of the pervasive influence of cognitive and affective biases on clinical decision making. Current medical training appears to fall short of what is needed to produce rational decision makers, due to what has been referred to as a mindware gap. Practitioners need to move from routine expertise to a higher level of expertise that will close this gap. A clear difficulty lies in finding ways of understanding and teaching the clinical decision-making process that do not violate the ecological characteristics of real-time clinical practice. By preserving as much as possible the rich clinical detail that makes up clinical medicine, this book attempts to offer important insights into the process.
Distraught Distraction
Authors: Croskerry Pat
Published: June 2020

This case involves a middle-aged woman who is hyperventilating and appears to be suffering an acute anxiety reaction. Several individual and group biases are demonstrated in her management, including groupthink, fundamental attribution error, psych-out error, and gender bias. She is eventually correctly diagnosed and managed appropriately.
The Blind Leading the Blindable
Authors: Croskerry Pat
Published: June 2020

In this case, a middle-aged patient is referred to a tertiary referral eye hospital by an ophthalmologist for the diagnostic assessment of a pigmented lesion on the sclera of his left eye. Ostensibly, the referral is to rule out malignant melanoma. The patient has a history of a penetrating injury to his left eye from a high-velocity metallic object 10 years earlier. He is seen by multiple ophthalmologists who ruled out melanoma, concluding the lesion is a metallic foreign body exterior to the globe that did not require removal. However, an obvious and important detail is missed by all but one ophthalmologist.
A Tale of Two Cycles
Authors: Croskerry Pat
Published: June 2020

Two cases are presented here, both involving traumatic injuries resulting from cycle accidents. Significant X-ray findings are missed by the emergency physicians (EPs) but picked up by radiologists in both cases. These are good demonstrations of the common search satisficing error. The first case also demonstrates a significant interference from factors that tend to push decision making into Type 1 processing—cognitive loading, fatigue, and dysphoria. The second case is an example of error due to the EPs’ routine being disrupted by a corridor consultation and authority gradient effects.
Misleading Mydriasis
Authors: Croskerry Pat
Published: June 2020

In this case, a middle-aged male presents to an emergency department (ED) with eye pain, visual blurring, and photophobia following trauma to the eye the previous day. It is some time before the patient is seen because the ED is extremely busy. Some drops are instilled in the eye for pain relief. When the physician finally gets to see the patient, he finds that the pupil of the affected eye is fixed and dilated—ominous signs but not consistent with the trauma the patient reports. After further investigation, it is determined that the patient had earlier received the wrong medication. Several biases can be identified in the case, as well as the likely error-producing condition rapid task switching.
Double Trouble
Authors: Croskerry Pat
Published: June 2020

In this case, a middle-aged female presents to the emergency department in a state of agitation and distress, having taken the contents of a bottle of aspirin with the intent to end her life. Her salicylate level confirms that she has taken a significant overdose, and she shows signs of toxicity. Treatment is initiated for a salicylate toxidrome. Later, in talking to the patient’s partner, the emergency physician realizes the situation is more complex than initially imagined. Although she initially shows some signs of improvement, subsequently she critically deteriorates and requires intubation. The patient is eventually transferred to the intensive care unit. The case powerfully illustrates the consequences of the cognitive biases anchoring, search satisficing, and confirmation bias.
Tracking Fast and Slow
Authors: Croskerry Pat
Published: June 2020

In this case, an elderly female presents to the emergency department with a complaint of shoulder sprain that occurred while she was mowing her lawn earlier in the day. She is assumed to have a minor injury and is seen and assessed in the fast-track area. This first visit is an example of patient cueing leading to triage cueing, confirmation bias, and ultimately misdiagnosis. She returns later the same day, at which time the correct diagnosis is made. The case provides an opportunity to examine the influence of fatigue and important diurnal influences on decision making.
What a Pain in the Neck!
Authors: Wiswell Walter , McCarty Bryan
Published: June 2020

The chapter on cervical spine controversies in children describes what initial steps need to be taken in assessing a pediatric patient with neck pain after trauma, and discusses the decision-making process that goes into further evaluation and testing. Clinical actions and assessments of the patient on-scene, whether to pursue imaging once in the emergency department setting, and what imaging is most appropriate depending on the patient presentation are discussed. Indications and contraindications for cervical spine immobilization and spinal positioning, including proper techniques based on a patient’s age and whether or not such steps are necessary. It also discusses the pros and cons of x-rays, CT scans, and MRIs in the context of pediatric neck trauma, and current guidelines that should be followed when deciding to order such studies.
Down a Slippery Slope
Authors: Melvin Jennifer E.
Published: June 2020

Trauma is the most common cause of morbidity and mortality in the pediatric population. Although chest trauma represents less than 10% of all pediatric traumas, it accounts for 14% of all pediatric trauma-related deaths. Thoracic trauma includes injuries to the chest wall, lungs, heart, tracheobronchial tree, diaphragm, and aorta. The most common injuries include pneumothorax, hemothorax, pulmonary contusion, and rib fractures. Sternal fractures occur less commonly and may be seen in cases of isolated or severe chest trauma. Although chest trauma may result from a direct force and therefore result in an isolated injury, when present, it is most often secondary to an extreme mechanism and associated with other clinically significant injuries.
The Rocking Pelvis
Authors: Tsao Hoi See , Wing Robyn
Published: June 2020

This chapter reviews the pelvic and genitourinary physical examination in the setting of pelvic trauma, the types of pelvic fractures, and diagnostic tests available, including ultrasound, plain radiography, and computed tomography, to evaluate for pelvic injuries. It discusses the management principles of fluid resuscitation and hemorrhage control with an unstable pelvis, including consideration of consultation with trauma surgery, orthopedic surgery, and interventional radiology. It examines the types of concomitant injuries that may be expected, including splenic, hepatic, urethral, and rectal injuries and emphasizes the need for individualized workup and management for each patient based on a thorough physical examination. The indications for a retrograde urethrogram and treatment options for pelvic fractures are also briefly reviewed.
Is FAST  Too FAST?
Authors: Malia Laurie , Rabiner Joni E.
Published: June 2020

Blunt abdominal trauma is common in pediatric trauma. This chapter discusses a child who presents to the emergency department with left upper quadrant pain after being struck by a motor vehicle. The point-of-care focused assessment with sonography for trauma (FAST) examination provides quick, reliable information on bleeding into the peritoneal, pericardial, and pleural spaces in the setting of trauma. The FAST exam is highly sensitive for identification of hemoperitoneum but is less accurate for ruling out hemoperitoneum and intra-abdominal injury. Discussion of the trauma evaluation and utility of the FAST examination in the context of pediatric blunt abdominal trauma is presented.