bluuebunny/crossref_metadata_2025 huggingface dataset:
Offense–defense confrontation decision making for dynamic UAV swarm versus UAV swarm
Authors: Xing Dongjing , Zhen Ziyang , Gong Huajun
Published: June 2019

This paper studies a dynamic swarm versus swarm unmanned aerial vehicle (UAV) combat problem and proposes a self-organized offense–defense confrontation decision-making (ODCDM) algorithm. This ODCDM algorithm adopts the distributed architecture to account for real-time implementation, where each UAV is treated as an agent and able to solve its local decision problem through the information exchange with neighbors. At each decision making step, the swarm seeks an optimal target allocation scheme and each UAV further selects the corresponding behavioral rules, leading to emergent offensive and defensive behaviors. Therefore, the offense–defense confrontation decision-making process is divided into the target allocation decision based on distributed consensus-based auction algorithm (CBAA) and social-force-based swarm motion decision. An offense–defense preference is introduced to the target allocation optimization model, providing the tactics options for UAV to adopt more offensive or more defensive posture. On the basis of classic collective behaviors of cohesion, separation and alignment, a combat stimulus is considered to drive UAV towards the assigned target. Finally, simulation experiments are carried out to verify the effectiveness of the ODCDM algorithm, and analyze the influences of the external deployment and internal tactics on the combat results.
Viral suppression and HIV transmission behaviors among hospitalized patients living with HIV
Authors: Pan Yue , Metsch Lisa R , Gooden Lauren K , Philbin Morgan M , Daar Eric S , Douaihy Antoine , Jacobs Petra , del Rio Carlos , Rodriguez Allan E , Feaster Daniel J
Published: June 2019

From July 2012 to January 2014, the CTN0049 study, Project HOPE (Hospital Visit as Opportunity for Prevention and Engagement for HIV-infected Drug Users) interviewed 1227 people with HIV infection from 11 hospitals in the US to determine eligibility for participation in a randomized trial. Using these screening interviews, we conducted a cross-sectional study with multivariable analysis to examine groups that are at highest risk for having a detectable viral load (VL) and engaging in HIV transmission behaviors. Viral suppression was 42.8%. Persons with a detectable VL were more likely to have sex partners who were HIV-negative or of unknown status (OR = 1.72, 95% CI = 1.22–2.38), report not cleaning needles after injecting drugs (OR = 3.13, 95% CI = 1.33–7.14), and to engage in sex acts while high on drugs or alcohol (OR = 1.85, 95% CI = 1.28–2.7) compared to their counterparts. Many hospitalized people with HIV infection are unsuppressed and more likely to engage in HIV transmission behaviors than those with viral suppression. Developing behavioral interventions targeting HIV transmission behaviors toward patients with unsuppressed HIV VLs in the hospital setting has the potential to prevent HIV transmission.
Analysis of Synapses in Cerebral Organoids
Authors: Yakoub Abraam M. , Sadek Mark
Published: June 2019

Cerebral organoids are an emerging cutting-edge technology to model human brain development and neurodevelopmental disorders, for which mouse models exhibit significant limitations. In the human brain, synaptic connections define neural circuits, and synaptic deficits account for various neurodevelopmental disorders. Thus, harnessing the full power of cerebral organoids for human brain modeling requires the ability to visualize and analyze synapses in cerebral organoids. Previously, we devised an optimized method to generate human cerebral organoids, and showed that optimal organoids express mature-neuron markers, including synaptic proteins and neurotransmitter receptors and transporters. Here, we give evidence for synaptogenesis in cerebral organoids, via microscopical visualization of synapses. We also describe multiple approaches to quantitatively analyze synapses in cerebral organoids. Collectively, our work provides sufficient evidence for the possibility of modeling synaptogenesis and synaptic disorders in cerebral organoids, and may help advance the use of cerebral organoids in molecular neuroscience and studies of neurodevelopmental disorders such as autism.
Pancreatic Stellate Cells Facilitate Perineural Invasion of Pancreatic Cancer via HGF/c-Met Pathway
Authors: Nan Ligang , Qin Tao , Xiao Ying , Qian Weikun , Li Jie , Wang Zheng , Ma Jiguang , Ma Qingyong , Wu Zheng
Published: June 2019

Pancreatic cancer (PC) is a highly lethal cancer that has a strong ability for invasion and metastasis, poor prognosis, and a stubbornly high death rate due to late diagnosis and early metastasis. Therefore, a better understanding of the mechanisms of metastasis should provide novel opportunities for therapeutic purposes. As a route of metastasis in PC, perineural invasion (PNI) occurs frequently; however, the molecular mechanism of PNI is still poorly understood. In this study, we show that the hepatocyte growth factor (HGF)/c-Met pathway plays a vital role in the PNI of PC. We found that HGF promotes PC cell migration and invasion by activating the HGF/c-Met pathway, and enhances the expression of nerve growth factor (NGF) and matrix metalloproteinase-9 (MMP9) in vitro. Furthermore, HGF significantly increased PC cell invasion of the dorsal root ganglia (DRG) and promoted the outgrowth of DRG in cocultured models of PC cells and DRG. In contrast, the capacity for invasion and the phenomenon of PNI in PC cells were reduced when the HGF/c-Met pathway was blocked by siRNA. In conclusion, PSCs facilitate PC cell PNI via the HGF/c-Met pathway. Targeting the HGF/c-Met signaling pathway could be a promising therapeutic strategy for PC.
Counseling Twins: A Family Counseling Issue
Authors: Noble Nicole , Bradley Loretta
Published: June 2019

Although twins belong to the same family, they experience unique challenges throughout their life span. If counselors recognize the family issues involved in the unique concerns of twins, counselors can more effectively counsel twins. This article will explore the twin bond and the close relationship that twins share. Specifically, both strengths and weaknesses of the twin bond will be depicted. A case example will demonstrate common concerns among twin clients, and a case conceptualization will be included. By identifying the family issues experienced by twins, counselors will be more successful in addressing twin clients’ needs. Implications for counseling and future research will be recommended.
Learning Curve for Open Reduction and Internal Fixation of Displaced Intra-articular Calcaneal Fracture by Extensile Lateral Approach Using the Cumulative Summation Control Chart
Authors: Ahn Jungtae , Kim Tae Yong , Kim Tae Wook , Jeong Bi O
Published: June 2019

Background:

Open reduction and internal fixation (ORIF) of displaced intra-articular calcaneal fracture (DIACF) by extensile lateral approach is widely used but is technically challenging. In this study, the learning curve for ORIF of DIACF by extensile lateral approach was investigated.

Methods:

Between March 2014 and July 2018, 45 cases consisting of 40 patients underwent operative treatment for DIACF by the extensile lateral approach performed in all instances by a single surgeon. A moving average and cumulative summation control chart (CUSUM) were used for learning curve analyses. Operative failure was defined when at least 1 of the following parameters were unsatisfactory: reduction of Gissane angle and Böhler angle, posterior facet congruency, calcaneal width, subfibular impingement, axial alignment, or calcaneocuboid joint congruency.

Results:

The mean operating time was 117.4 minutes. Regarding the quality of reduction, the mean preoperative sum of the 7 parameters was 5.1 and improved to 0.6 postoperatively. The CUSUM for operative success peaked in the 20th case. The CUSUM and moving average graphics of operating time peaked at the 9th case and registered nadirs at the 34th case, with slight ascent and decent. The operating time for 20 cases in phase 1 (1-20) and for 25 cases in phase 2 (21-45) of the learning curve did not differ significantly. There was no statistical difference in the severity of fracture pattern. By comparison, in phase 2, patients showed a significantly better postoperative reduction quality.

Conclusion:

As indicated by multidimensional statistical analyses, primary technical competence in improving the reduction quality of DIACF was achieved after the initial learning period with 20 cases. After the learning curve for ORIF of DIACF, a better reduction quality in the sum of reduction parameters was observed.

Level of Evidence:

Level III, comparative series.
Transient response of sandwich plate with transversely flexible and viscoelastic frequency-dependent material core based on a three-layered theory
Authors: Safari M , Biglari H
Published: June 2019

In this paper, the dynamic response of a simply supported sandwich plate with viscoelastic transversely flexible core is investigated, analytically using three-layered sandwich plate theory. Hamilton’s principle is employed to obtain governing equations of motion. Also, GHM (Golla–Hughes–McTavish) method is used to model the Frequency-Dependent Material properties of viscoelastic core. Modal superposition method is used to convert partial differential equations of motion to ordinary differential equations with time varying coefficients. Newmark approach is applied to solve the ordinary differential equations, numerically. Results of dynamic analysis in the present model are validated by the results published in the literatures. The natural frequencies and modal loss factors of the sandwich plate are extracted at 30°C and 90°C and effects of geometrical parameters are discussed. The advantages of the GHM model over the classical models such as Kelvin–Voigt are illustrated. The obtained results show that GHM model presents a more accurate description of transient response of the sandwich plate with viscoelastic core by considering the frequency dependency behavior of viscoelastic material. Core flexibility causes a difference between deflection of lower and upper surfaces, so that the three-layered sandwich theory will lead to more exact results with a remarkable deviation from the high-order single-layered theory.
Rev-erbs and Glia—Implications for Neurodegenerative Diseases
Authors: Griffin Percy , Dimitry Julie M , Musiek Erik S
Published: June 2019

Recently, we described a role for the circadian clock protein and nuclear receptor Rev-erbα in regulating glial activation states in the brain. Deletion of Rev-erbα resulted in microglial as well as astrocytic activation, while a Rev-erbα agonist diminished the severity of lipopolysaccharide (LPS)-induced neuroinflammation. Concomitant with this glial activation is impaired neuronal health. These findings suggest that Rev-erb proteins may play critical roles in glial biology. Pertinent ideas such as the glial cell type of most importance, the translatability of these findings to human disease, and the effect of manipulating Rev-erbs in models of neurodegeneration, need to be explored further. In this commentary, we will address the potential role of Rev-erbs in neuroinflammation related to neurodegenerative diseases and speculate on Rev-erbs as potential therapeutic targets for these conditions.
Displacement-based seismic design for buildings installed hysteretic dampers with hardening post-yielding stiffness
Authors: Li Gang , Zhu Li-Hua , Li Hong-Nan
Published: June 2019

Passive energy dissipation devices have been proved to be effective and low-cost means of structural control, and a variety of dampers have been developed over the past decades. Hysteretic dampers with hardening post-yielding stiffness have multiphased energy dissipation characteristics because of their hardening behavior, which can compensate for stiffness loss and postpone the collapse of damaged structures. In this article, a hysteretic model is proposed for hysteretic dampers with hardening post-yielding stiffnesses, and a formula is derived for equivalent yield strength expressed by the additional damping of the structure. A procedure is developed for displacement-based seismic design that transforms the relatively complex damping into an acceptable yield strength. A numerical example is only presented for demonstrating the design process and simply validating the proposed method. The results show that the proposed procedure is easy to implement and could produce adequate hysteretic dampers with hardening post-yielding stiffness hardening behavior. The maximum displacement responses of the existing structure retrofitted using the proposed procedure satisfy the expected performance objective well. Thus, this procedure could be an alternative to seismic retrofitting for structures with energy dissipation systems.
Case comment – Fracking and the scope for public dissent: The sentencing of The Frack Three (Richard Roberts, Simon Blevins, Richard Loizou, (Case Number T20180167)) and R v Roberts (Richard) [2018] EWCA Crim 2739
Authors: Hawkins Joanne
Published: June 2019

Peaceful protest has a long and important history in the UK. Non-violent crimes, in the course of peaceful protest do not generally impute high levels of culpability. Despite this, in September 2018, three anti-fracking protesters were sent to prison for ‘lorry surfing’. The protest caused severe disruption to travel in the area and the defendants were prosecuted for causing a public nuisance. Their sentences, (15 months for Loizou and 16 months each for both Blevins and Roberts) were designed to reflect the level of harm and culpability which the judge felt was appropriate, given the length of the disruption endured by the public (the protest totalling almost four days). On appeal, the sentences were quashed and ruled to be manifestly excessive. This commentary highlights that this case and the apparent attempt to curb peaceful protest raises a broader question about the increasingly restrictive legal framework, where scope for dissent around fracking is becoming progressively more confined.
Editors versus audiences facing news: Is this discrepancy also repeated on social news networks?
Authors: Urrutia Santi , Zalbidea Begoña , Camacho Idoia , Pastor Jose Mari
Published: June 2019

This study examines whether the frequent discrepancy between publishers and audiences over the news that interests them – the former preferring hard news, the latter soft news – is repeated on social networks. Based on a sample of 8,000 news stories uploaded to a Spanish-language news aggregator over 10 years (2006–2015), the number of hard, soft and general news stories published on its front page was calculated. In addition, the news stories that received the most votes, comments and visits were analysed, and correlations were sought among these three variables. The results show that users mainly chose hard news when voting (50.2%), followed by soft news (30.9%) and general news (18.9%). This was in sharp contrast to the results found for news consumption, where visitors access soft news much more than hard news. The investigation offers some clues about the extent to which the disparity of interests between journalists and readers facing news poses a real problem, and it also provides a new outlook on how editors can deal with audiences.
Action research in business and management: A reflective review
Authors: Shani Abraham B. (Rami) , Coghlan David
Published: June 2019

In the context of business and management, action research operates in the realm of strategies, practical tasks, and structured hierarchical organizational systems in diverse industries and across multiple business functions and disciplines. This article reflects on action research in generating actionable knowledge in this particular domain and shares the authors’ perspective on future developments. The reflection explores a small number of action research studies undertaken across multiple fields and disciplines in business and management and advances distinct common denominators that can guide further research and action and aid future reflection. Through the mode of interiority, readers are invited to engage in a similar reflection on their assumptions, questions, and insights in coming to judgement about the state of the field and its future.
A long-term retrospective study of patients with biopsy-proven cryptogenic organizing pneumonia
Authors: Zhou Ying , Wang Lei , Huang Mei , Ding Jingjing , Jiang Hanyi , Zhou Kefeng , Meng Fanqing , Xiao Yonglong , Cai Hourong , Dai Jinghong
Published: June 2019

Cryptogenic organizing pneumonia (COP) is characterized by good response to corticosteroids, but frequent relapses after reduction or cessation of treatment are noted. The incidence, risk factors of relapse, and long-term outcomes of patients with COP remain undetermined. Patients with COP from September 2010 to December 2017 were enrolled. Hospital and office records were used as data sources. Clinical information, lab examinations, chest radiographs, treatment courses, and follow-up data were collected. Relapse group was defined as worsening of clinical manifestations in combination with progression of radiographic abnormalities in the absence of identified causes. Eighty-seven patients with COP were enrolled. Of them, 73 patients were treated with corticosteroids with relapse rate yielding 31.5% (23 of 73). Eleven patients were treated with macrolides and none of them relapsed. Fever was more common (65.2% vs. 32.0%, p = 0.004), C-reactive protein (CRP) was higher (31.5 ± 39.4 mg/L vs. 17.5 ± 32.2 mg/L, p = 0.038), and diffusion capacity for carbon monoxide (DLCO) % predicted was lower (45.9 ± 14.2% vs. 57.6 ± 18.5%, p = 0.050) in relapse group compared to nonrelapse group. Four patients who presented with organizing pneumonia (OP) as the first manifestation were ultimately diagnosed with OP secondary to autoimmune disease in follow-up. We showed relapse was common in COP patients treated with corticosteroids, but the prognosis was favorable. Fever, elevated CRP, and a reduced DLCO were related to relapse. As OP may not always be cryptogenic, a careful follow-up should be programmed to diagnose the underlying systemic disease.
Influence of substrates and inhibitors on the structure ofKlebsiella pneumoniaecarbapenemase-2
Authors: Shurina Ben A , Page Richard C
Published: June 2019

The hydrolysis of last resort carbapenem antibiotics by Klebsiella pneumoniae carbapenemase-2 (KPC-2) presents a significant danger to global health. Combined with horizontal gene transfer, the emergence KPC-2 threatens to quickly expand carbapenemase activity to ever increasing numbers of pathogens. Our understanding of KPC-2 has greatly increased over the past decade thanks, in great part, to 20 crystal structures solved by groups around the world. These include apo KPC-2 structures, along with structures featuring a library of 10 different inhibitors representing diverse structural and functional classes. Herein we focus on cataloging the available KPC-2 structures and presenting a discussion of key aspects of each structure and important relationships between structures. Although the available structures do not provide information on dynamic motions with KPC-2, and the family of structures indicates small conformational changes across a wide array of bound inhibitors, substrates, and products, the structures provide a strong foundation for additional studies in the coming years to discover new KPC-2 inhibitors.

Impact statement

The work herein is important to the field as it provides a clear and succinct accounting of available KPC-2 structures. The work advances the field by collecting and analyzing differences and similarities across the available structures. This work features new analyses and interpretations of the existing structures which will impact the field in a positive way by making structural insights more widely available among the beta-lactamase community.
Calcimimetic R568 improved cardiac remodeling by classic and novel renin-angiotensin system in spontaneously hypertensive rats
Authors: Zhang Tian , Tang Na , Xi Dongmei , Zhao Yongli , Liu Yongmin , Wang Lamei , Tang Yan , Zhang Xiaoni , Zhong Hua , He Fang
Published: June 2019

One major cause of cardiac mortality is heart disease caused by hypertension. The formation of cyclic adenosine monophosphate (cAMP) is inhibited by calcium-sensitive receptor (CaSR) activation which increases intracellular Ca2+ concentrations and suppresses renin release. As we know, renin-angiotensin system (RAS) is closely related to development of essential hypertension (EH). Therefore, we focused on exploring the roles of NPSR568 (R568)-activated CaSR in cardiac remodeling of spontaneously hypertensive rats (SHRs), as well as the activity of classic and novel RAS. Wistar-Kyoto rats (WKYs) and SHRs were treated by R568 for four and eight weeks, respectively, and their blood pressure (BP), echocardiographic values, heart-to-body weight ratio (HW/BW%), and left ventricle-to-body weight ratio (LVW/BW%) were evaluated. Then Masson’s trichrome staining and hematoxylin and eosin staining as well as RT-qPCR analysis of β-isoform of myosin heavy chain and brain natriuretic peptide mRNA expression were performed. A Terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) assay and analysis of apoptosis marker proteins were used to assess the extent of myocardial apoptosis. The CaSR expression and the activity of classic and novel RAS were examined by immunohistochemistry, western blotting, and enzyme-linked immunosorbent assay. The present study revealed that the development of hypertension was accompanied by increased BP, apoptosis, hypertrophy, and fibrosis, along with decreased expression of CaSR, decreased novel RAS, and increased classic RAS in myocardial tissues. R568 administration for four and eight weeks reduced BP and myocardial remodeling and reversed the low expression of CaSR; moreover, classic RAS was suppressed and novel RAS was activated in the myocardium. Taken together, these data indicate that R568 may effectively inhibit EH myocardial remodeling by inhibiting classic RAS and activating novel RAS in SHRs.

Impact statement

Our study reveals that low calcium-sensitive receptor (CaSR) expression is associated with the occurrence and development of essential hypertension-mediated myocardial remodeling. The activation of CaSR can reverse adverse myocardia remodeling by inhibiting local classical renin-angiotensin system (RAS) and activating novel RAS in cardiac tissues. CaSR is closely related to many cardiovascular diseases, but its specific mechanism remains not to be elucidated. To date, CaSR has not been investigated with regard to cardiovascular treatment; however, given the important relationship between CaSR and cardiovascular disease, CaSR regulators can be potential drugs for the treatment of cardiovascular disease.
How Qualitative Case Study Methodology Informs Occupational Therapy Practice: A Scoping Review
Authors: Hercegovac Suzana , Kernot Jocelyn , Stanley Mandy
Published: June 2019

Qualitative case study methodology (QCSM) is a useful research approach that has grown in popularity within the social sciences; however, it has received less attention in the occupational therapy literature. The current scoping review aims to explore how studies utilizing a QCSM help inform occupational therapy knowledge and practice. Electronic searches were conducted in April 2017, and the resultant 388 publications were screened by three reviewers in Covidence. In all, 27 publications met the inclusion criteria and were included in the scoping review. Case studies in the occupational therapy literature have explored phenomena relating to the delivery of intervention, theoretical concepts, clinical reasoning, and education and research methods and were situated in a range of different practice areas and contexts. QCSM is a valuable approach in occupational therapy research that contributes to the body of knowledge and theory that informs occupational therapy practice.
The Infant Toddler Activity Card Sort: A Caregiver Report Measure of Children’s Occupational Engagement in Family Activities and Routines
Authors: Hoyt Catherine R. , Fernandez Jianna D. , Varughese Taniya E. , Grandgeorge Emma , Manis Hannah E. , O’Connor Kelly E. , Abel Regina A. , King Allison A.
Published: June 2019

Early intervention (EI) therapy services aim to address family-centered goals to facilitate young children’s development and participation in meaningful life activities. Current methods to evaluate children in EI assess discrete developmental skills but provide little information on the child’s ability to successfully incorporate that skill in everyday life. Furthermore, traditional measures have limited opportunity for parent report, despite parent engagement being a critical component for successful implementation of EI services. A measure that involves parents in the therapeutic process to track family-driven EI goals related to a child’s occupational engagement in meaningful family activities and routines is desperately needed. Using a qualitative design and conventional content analysis, we identified 41 distinct activities of infant–toddlers from a cohort of 23 caregivers. Activity items were matched with photographs and validated with experts in pediatric rehabilitation using the Delphi method. The resulting 40 activity/photograph pairs were used to develop a new measure of pediatric occupational engagement, the Infant Toddler Activity Card Sort (ITACS).
Performance of a Haptic Feedback Grasper in Laparoscopic Surgery: A Randomized Pilot Comparison With Conventional Graspers in a Porcine Model
Authors: Alleblas Chantal C. J. , Vleugels Michel P. H. , Stommel Martijn W. J. , Nieboer Theodoor E.
Published: June 2019

Background. Compared with open surgery, minimally invasive surgery is limited by reduced sensation of tissue properties. A laparoscopic grasper with integrated haptic feedback technology that improves the ability to sense tissue properties might provide a solution. The force reflecting operation instrument (FROI) is a new laparoscopic grasper, designed to provide information about the interaction forces between the instrument and tissue through resistance in the handle. This pilot study aimed to assess the functionality of the FROI compared with a conventional grasper in an in vivo setting. Methods. In this randomized trial, we used a standard laparoscopic surgical setup to perform laparoscopic surgery in pigs. In all, 11 surgeons performed colorectal, gynecological, or urological procedures, once with the FROI and once with a conventional grasper. Participants were asked to complete the NASA Task Load Index Rating Scale and rate 5 specific features for both graspers. To capture opinions on the overall functionality of the FROI, participants were asked to answer 8 open questions. Results. The surgeons reported that the use of the FROI significantly improved tissue consistency perception, arterial pulse detection, and force control compared with the conventional grasper. No significant differences were found in surgeons’ muscular strain or operative time. The most emphasized topics in the open questions were improved soft-tissue handling and importance for complex procedures. Conclusion. Through this first in vivo analysis of the functionality of the FROI, a multispecialty group of laparoscopic surgeons confirmed the added value of haptic feedback technology in a live surgical setting.
Bringing Art to Life: Examining Poetic Gameplay Devices in Interactive Life Stories
Authors: Chew Evelyn C. , Mitchell Alex
Published: June 2019

A life story’s ability to evoke the emotion experienced by a protagonist is crucial to its success. Authors of interactive life stories sometimes strategically alter the interactive feedback loop to help convey this subjective experience. Using Mitchell’s conception of defamiliarizing poetic gameplay, this study identifies poetic gameplay devices, which creatively alter the feedback loop for emotional narrative impact. The article suggests extending the term “poetic gameplay” beyond interactive devices whose primary goal is critical appreciation of aesthetic form, to techniques directed at deepening a player’s narrative involvement, via alterations to interactivity designed to evoke emotions that mirror a protagonist’s experience. Close readings of 19 interactive life stories identified 13 devices, which fall into two categories: alterations to manipulation rules (involving local agency) and alterations to goal rules (involving higher level agency). The findings reveal some of the expressive possibilities of interactivity in digital narrative.
Unusual ophthalmic artery origin: Implications for intraarterial chemotherapy of retinoblastoma
Authors: Balci Sinan , Arat Anıl
Published: June 2019

We report two pediatric retinoblastoma patients with unusual ophthalmic artery (OA) origins who were referred to our interventional neuroradiology department for intraarterial chemotherapy. The first patient had double OAs arising from the ipsilateral internal carotid artery and a central retinal artery (CRA) arising from the more cranially located artery, whereas the second patient had an OA originating from the A1 segment of the ipsilateral anterior cerebral artery. In both cases the CRA arose from the artery entering the orbit through the optic foramen. Both patients tolerated the procedures well. To the best of our knowledge, our retinoblastoma patients with unusual OA origins are the first in the literature in which detailed knowledge of the orbital vasculature and especially CRA origin carried immediate clinical implications, altering access strategies. These variations were proved both by flat-panel detector computed tomography findings and superselective injections of OAs with unusual origins. Our results show that in patients with retinoblastoma, a detailed angiographic work-up may be necessary to evaluate the orbital vasculature and possible abnormal origin of the OA. Recognition of possible variations of OA origin and its branching patterns is of the utmost importance for successful treatment and avoidance of adverse events among retinoblastoma patients.
“Those songs were the ones that made me, nobody asked me this question before”: Music Elicitation with ex-gang involved men about their experiences of childhood domestic violence and abuse
Authors: Levell Jade
Published: June 2019

This article describes the use of music and music videos as an elicitation tool within life-story narrative interviews. The study focused on the lives of men who had experienced domestic violence and abuse in childhood and become involved on road and/or with gangs. Music elicitation was used as participants were asked to select three music tracks that aided them telling their life stories, with particular reference to their experiences of domestic violence in childhood and their involvement on road and in gangs. The music tracks and in many cases the accompanying music videos were viewed in the interview space by both the researcher and participant together. In this case, music elicitation was found to be a very valuable element to the interviews and enhanced the experience for both the participant and researcher. Music elicitation operated in three main ways. Firstly, music often had been used as a personal coping mechanism, and this was recalled in the interview, acting as an anchor to the memory. Secondly, at points, both the music lyrics and their accompanying music videos were used as tools for communication by the participant, through them being used as metaphors, or as illustrations of the past. Lastly, the music was used by the participants as a narrative tool to structure and pace the interviews, giving them greater control over the interview space. This article shows promising results in using music as an elicitation tool for research with this participant group discussing sensitive issues.
Heavy menstrual bleeding
Authors: Castronovo Grace
Published: June 2019

Menorrhagia, or heavy menstrual bleeding (HMB), is a common presenting complaint, accounting for 5% of female primary care consultations and 20% of gynaecology clinic consultations every year. The majority of these patients can be managed competently in primary care, referring patients requiring surgical intervention or those with suspected malignancy to secondary care. This article will explore the diagnosis and management of women presenting with HMB in primary care in accordance with guidelines from the National Institute for Health and Care Excellence (NICE) and the RCGP curriculum.
A New Framework for School Nurse Self-Reflection and Evaluation
Authors: Wallin Robin Landes , Rothman Susan
Published: June 2019

The purpose of this article is to demonstrate how the Framework for 21st Century School Nursing Practice™ can provide a structure for evaluation using the School Nursing: Scope and Standards of Practice (3rd ed.), thus allowing the school nurse and school nurse evaluators to gain a better understanding of school nursing practice. According to NASN’s Position Statement Supervision and Evaluation of the School Nurse, standards should be used to evaluate the clinical practice of school nurses. Our project accomplishes this integration of the Framework, the standards, and the evaluation of school nursing practice.
Persistent emotional distress after a first-time myocardial infarction and its association to late cardiovascular and non-cardiovascular mortality
Authors: Lissåker Claudia T , Norlund Fredrika , Wallert John , Held Claes , Olsson Erik MG
Published: June 2019

Background

Patients with symptoms of depression and/or anxiety – emotional distress – after a myocardial infarction (MI) have been shown to have worse prognosis and increased healthcare costs. However, whether specific subgroups of patients with emotional distress are more vulnerable is less well established. The purpose of this study was to identify the association between different patterns of emotional distress over time with late cardiovascular and non-cardiovascular mortality among first-MI patients aged <75 years in Sweden.

Methods

We utilized data on 57,602 consecutive patients with a first-time MI from the national SWEDEHEART registers. Emotional distress was assessed using the anxiety/depression dimension of the European Quality of Life Five Dimensions questionnaire two and 12 months after the MI, combined into persistent (emotional distress at both time-points), remittent (emotional distress at the first follow-up only), new (emotional distress at the second-follow up only) or no distress. Data on cardiovascular and non-cardiovascular mortality were obtained until the study end-time. We used multiple imputation to create complete datasets and adjusted Cox proportional hazards models to estimate hazard ratios.

Results

Patients with persistent emotional distress were more likely to die from cardiovascular (hazard ratio: 1.46, 95% confidence interval: 1.16, 1.84) and non-cardiovascular causes (hazard ratio: 1.54, 95% confidence interval: 1.30, 1.82) than those with no distress. Those with remittent emotional distress were not statistically significantly more likely to die from any cause than those without emotional distress.

Discussion

Among patients who survive 12 months, persistent, but not remittent, emotional distress was associated with increased cardiovascular and non-cardiovascular mortality. This indicates a need to identify subgroups of individuals with emotional distress who may benefit from further assessment and specific treatment.
Comparison of the Effects of Cytotoxicity and Antimicrobial Activities of Self-adhesive, Eugenol and Noneugenol Temporary and Traditional Cements on Gingiva and Pulp Living Cells
Authors: Alkurt Murat , Duymus Zeynep Yesil , Sisci Tugay
Published: June 2019

Aims and objectives:

The aim of this in vitro study was to investigate the antibacterial and cytotoxic effect of cements: zinc polycarboxylate, glass ionomer, self-adhesive resin cement, eugenol-containing and eugenol-free temporary cements.

Materials and methods:

The agar-diffusion test was carried out on 4 types of bacteria: Streptococcus mutans ( S. mutans; ATCC 35668), Streptococcus salivarius ( S. salivarius; ATCC 13419), Streptococcus sangius ( S. sangius; ATCC 10556), and Lactobacillus casei ( L. casei; ATCC 27139). Freshly prepared cement samples were placed on a brain heart infusion medium and left at 37°C for 24 hours in a CO2 incubator. Ampicillin disks of 10 mg were used as positive controls. Antimicrobial effects were determined using the zone of inhibition measurement in millimeters at 24 and 48 hours. Cytotoxicity was assessed through a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay (SERVA Electrophoresis GmbH, Heidelberg, Germany). To evaluate cell viability, an optical density microplate reader (Tecan™ Sunrise, Männedorf, Switzerland) was used at 24 and 48 hours at 570 and 630 nm, respectively.

Results:

Except the positive control group, the Adhesor luting cement showed a higher inhibitory effect on S. sangius and L. casei. RelyX Temp E temporary cement showed an inhibitory effect on S. sangius and L. casei, whereas the Cavex temporary cement showed an inhibitory effect on only S. sangius at 24 and 48 hours. At 100% concentration, Cavex temporary cement showed the least toxicity (23.6% pulp cell and 9.9% gingival cell) and highest cell viability (76.4% pulp cell and 90.1% gingival cell) at 24 hours. However, Meron, Adhesor, Panavia SA luting, and RelyX Temp E temporary cements showed the highest toxicity (above 94% gingival cell and 95% pulp cell) at 100% concentration.

Conclusions:

Meron, Adhesor, Panavia SA luting, and RelyX Temp E temporary cements may have a cytotoxic potential. None of the cements showed an inhibitory effect on S. mutan and S. salivarius, whereas Adhesor luting cement has a higher inhibitory effect than that of S. sangius and L. casei.
Assessment of Postoperative Pain Using Different Root Canal Irrigants in Mandibular Molars with Symptomatic Irreversible Pulpitis: An Observational Study
Authors: Khateeb Shafait Ullah , Algarni Youssef A. , Baba Suheel Manzoor , Mir Shugufta , Yaqoob Ashfaq , Jeri Sumaya Yousuf
Published: June 2019

Background:

The present study was conducted to assess postoperative pain using different root canal irrigants in mandibular molars with symptomatic irreversible pulpitis.

Materials and methods:

The present study was conducted on 84 patients (40 males and 44 females) having 126 mandibular molars with symptomatic irreversible pulpitis. In all molars, access cavity preparation was done and the root canal shaping procedures were performed according to the manufacturer’s instructions for each instrument system. Teeth were divided into 2 groups. In Group I, the 5.25% sodium hypochlorite (NaOCl) solution was used as an irrigating solution. In Group II, the 2% chlorhexidine gluconate (CHX) was used as an irrigating solution. A visual analog scale (VAS) was used to assess postobturation pain on the 1st, 3rd, and 7th days.

Results:

There were 40 males and 44 females in the present study. In Group I, the 5.25% NaOCl solution was used as an irrigating solution. In Group II, the 2% CHX was used as an irrigating solution. Each group had 63 teeth. VAS was 9 in Group I and 8 in Group II on Day 1; 5 and 3 in Groups I and II, respectively, on Day 3; and 3 and 1 on Day 7 in Groups I and II, respectively. The difference was significant ( P < .05).

Conclusions:

There were excellent results obtained with the 2% CHX solution as compared with the 5.25% NaOCl solution. Group II exhibited less VAS than Group I.
A Young Black MSM on PrEP Is Lost to Follow-Up and Acquires HIV Infection: A Case to Call for Improved Strategies to Support Youth Adherence and Engagement in HIV Prevention
Authors: Marsh Ketzela Jacobowitz , Rothenberger Meghan
Published: June 2019

Young men who have sex with men (YMSM) are disproportionately affected by HIV in the United States. High-risk sexual behaviors are difficult to modify; thus, HIV pre-exposure prophylaxis (PrEP) with a daily pill is a promising prevention tool for this vulnerable population. We present a case of a young black MSM who was able to successfully access PrEP with the help of a community program but was not able to adhere to the regimen or engage in care. He ultimately acquired HIV infection. We review the existing literature and advocate for increased services and research to support youth’s adherence to PrEP and engagement in HIV prevention programs, with a focus on YMSM of color.
Using Reflections to Gauge Audience Awareness in Business and Professional Communication Courses
Authors: Schieber Danica L. , Robles Vincent D.
Published: June 2019

This study describes how reflections allowed students to express their audience awareness as they wrote a multiaudience messages packet. We present an analysis of 27 reflections in which students described their experience when responding to the various audiences. Students’ reflective depth varied, though deeper reflections demonstrate sophistication in considering audience constraints and values. Students reported difficulty with negative and persuasive messages and indicated concern about their credibility. Reflections can help instructors understand how students are considering audiences for business documents, which instructors can use to improve their instruction and assess how well students consider business audiences.
Feasibility of Collecting Multiple Patient-Reported Outcome Measures Alongside the Dutch Arthroplasty Register
Authors: Tilbury Claire , Leichtenberg Claudia S , Kaptein Bart L , Koster Lennard A , Verdegaal Suzan H M , Onstenk Ron , der Zwaag Henrike M J van der Linden-van , Krips Rover , Kaptijn Herman H , Vehmeijer Stephan B W , Marijnissen Willem-Jan C M , Meesters Jorit J L , van Rooden Stephanie M , Brand Ronald , Nelissen Rob G H H , Gademan Maaike G J , Vlieland Thea P M Vliet
Published: June 2019

Background:

Compliance rates with patient-reported outcome measures (PROMs) collected alongside arthroplasty registries vary in the literature. We described the feasibility of a routinely collected set PROMs alongside the Dutch Arthroplasty Register.

Methods:

The longitudinal Leiden Orthopaedics Outcomes of OsteoArthritis Study is a multicenter (7 hospitals), observational study including patients undergoing total hip or total knee arthroplasty (THA or TKA). A set of PROMs: Short Form-12, EuroQol 5 Dimensions, Hip/Knee injury and Osteoarthritis Outcome Score, Oxford Hip/Knee Score was collected preoperatively and at 6, 12, 24 months, and every 2 years thereafter. Participation rates and response rates were recorded.

Results:

Between June 2012 and December 2014, 1796 THA and 1636 TKA patients were invited, of whom 1043 THA (58%; mean age 68 years [standard deviation, SD: 10]) and 970 TKA patients (59%; mean age 71 years [SD 9.5]) participated in the study. At 6 months, 35 THA/38 TKA patients were lost to follow-up. Response rates were 90% for THA (898/1000) and 89% for TKA (827/932) participants. At 1 and 2 years, 8 and 18 THA and 17 and 11 TKA patients were lost to follow-up, respectively. The response rates among those eligible were 87% (866/992) and 84% (812/972) for THA and 84% (771/917) and 83% (756/906) for TKA patients, respectively. The 2-year questionnaire was completed by 78.5% of the included THA patients and by 77.9% of the included TKA patients.

Conclusions:

About 60% of patients undergoing THA or TKA complete PROMs preoperatively, with more than 80% returning follow-up PROMs. To increase the participation rates, more efforts concerning the initial recruitment of patients are needed.
Nanoparticle diffusion in spontaneously expectorated sputum as a biophysical tool to probe disease severity in COPD
Authors: Chisholm Jane F. , Shenoy Siddharth K. , Shade Julie K. , Kim Victor , Putcha Nirupama , Carson Kathryn A. , Wise Robert , Hansel Nadia N. , Hanes Justin S. , Suk Jung Soo , Neptune Enid
Published: June 2019

Perturbations in airway mucus properties contribute to lung function decline in patients with chronic obstructive pulmonary disease (COPD). While alterations in bulk mucus rheology have been widely explored, microscopic mucus properties that directly impact on the dynamics of microorganisms and immune cells in the COPD lungs are yet to be investigated.

We hypothesised that a tightened mesh structure of spontaneously expectorated mucus (i.e.sputum) would contribute to increased COPD disease severity. Here, we investigated whether the mesh size of COPD sputum, quantified by muco-inert nanoparticle (MIP) diffusion, correlated with sputum composition and lung function measurements.

The microstructure of COPD sputum was assessed based on the mean squared displacement (MSD) of variously sized MIPs measured by multiple particle tracking. MSD values were correlated with sputum composition and spirometry. In total, 33 samples collected from COPD or non-COPD individuals were analysed.

We found that 100 nm MIPs differentiated microstructural features of COPD sputum. The mobility of MIPs was more hindered in sputum samples from patients with severe COPD, suggesting a tighter mucus mesh size. Specifically, MSD values inversely correlated with lung function.

These findings suggest that sputum microstructure may serve as a novel risk factor for COPD progression and severity.
Variable utility of mosaic attenuation to distinguish fibrotic hypersensitivity pneumonitis from idiopathic pulmonary fibrosis
Authors: Barnett Joseph , Molyneaux Philip L. , Rawal Bhavin , Abdullah Rezaur , Hare Samanjit S. , Vancheeswaran Rama , Desai Sujal R. , Maher Toby M. , Wells Athol U. , Devaraj Anand
Published: June 2019

Background

Mosaic attenuation on computed tomography (CT) has been identified in international guidelines as an important diagnostic feature of fibrotic hypersensitivity pneumonitis (FHP) as opposed to idiopathic pulmonary fibrosis (IPF). However, mosaic attenuation comprises several different radiological signs (low-density lobules, preserved lobules, air trapping and the so-called “headcheese sign”) which may have differing diagnostic utility. Furthermore, the extent of mosaic attenuation required to distinguish these two diagnoses is uncertain and thresholds of mosaic attenuation from international guidelines have not been validated.

Methods

Inspiratory and expiratory CT scans were evaluated by two readers in 102 patients (IPF n=57; FHP n=45) using a semiquantitative scoring system for mosaic attenuation. Findings were validated in an external cohort from a secondary referral institution (IPF n=34; FHP n=28).

Results

Low-density lobules and air trapping were a frequent finding in IPF, present in up to 51% of patients. A requirement for increasing extent of low-density lobules and air trapping based on guidelines (American Thoracic Society and Fleischner Society) was associated with increased specificity for the diagnosis of FHP (0.96 and 0.98, respectively) but reduced sensitivity (0.16 and 0.20, respectively). The headcheese sign was found to be highly specific (0.93) and moderately sensitive (0.49) for a high-confidence diagnosis of FHP. The high specificity of the headcheese sign was maintained in the validation cohort and when patients with other CT features of FHP were excluded.

Conclusion

Mosaic attenuation is a frequent finding in IPF. However, the headcheese sign can be confidently considered as being inconsistent with a diagnosis of IPF and specific for FHP.