bluuebunny/crossref_metadata_2025 huggingface dataset:
An analysis of the determinants of failure processes in UK SMEs
Authors: Makropoulos Alexios , Weir Charlie , Zhang Xin
Published: April 2020

Purpose

This paper has two purposes. First, it evaluates the extent to which different failure processes are present in failed UK SMEs, by considering non-financial metrics including director characteristics, in addition to the financial ones. Second, it analyses the determinants of the transition to failure in relation to the different failure processes that have been identified.

Design/methodology/approach

The study is based on a sample of failed UK SMEs. The data covers financial ratios, board characteristics, the macroeconomic environment, sectoral details and regional information. First, failure processes are identified using a combination of factor analysis and cluster analysis. Second, the determinants of firms' transition to failure for the whole sample and in the individual failure clusters are analysed using panel data analysis.

Findings

Four different firm failure processes were identified. Director characteristics differ between firm failure processes. We find evidence that director characteristics including director age and board gender structure, affect the transition to failure of UK SMEs. We also find that different factors affect the different failure processes.

Originality/value

The paper is the first to analyse the reasons for failure of UK SMEs in the firm failure process context by considering non-financial metrics such as the characteristics of the firms' directors. In addition the paper also identifies a number of different determinants that affect the various failure processes. This finding is important because it suggests that policies designed to reduce the incidence of firm failure should take account of the different failure processes.
Frequency, clinical characteristics, and determinants of partial remission in type 1 diabetes: Different patterns in children and adults
Authors: Zhong Ting , Tang Rong , Xie Yuting , Liu Fang , Li Xia , Zhou Zhiguang
Published: April 2020

Background

Partial remission (PR) is a special stage in type 1 diabetes (T1D). The different patterns of PR frequency, characteristics, and determinants in juvenile and adult patients are unclear, and data on Chinese are lacking.

Methods

A total of 186 children and 114 adults with T1D who were regularly followed up in a cohort were included for analysis. PR was defined according to C‐peptide ≥300 pmol/L or index of insulin dose‐adjusted hemoglobin A1c ≤9, as previously recommended. C‐peptide and islet autoantibodies were determined with chemiluminescence and radioimmunoassay, respectively.

Results

The frequency of PR in children was higher than that in adults, with the proportion being 69.9% and 58.8%, respectively (P < .05). For juvenile‐onset T1D, the frequency of PR gradually decreased as the onset age decreased, from 87.5% in 13‐ to 18‐year olds to 46.5% in under 6‐year olds. Multivariable analyses showed that onset age and male sex were positively related with the frequency of PR in children, while the related factors in adults were initial glycosylated hemoglobin A1c and C‐peptide levels. The median PR duration was similar in children (14.8 ± 1.2 months) and adults (16.4 ± 1.9 months). Older onset age was related with a longer PR duration in children, but no such associations were found in adult individuals.

Conclusions

Children and adults with T1D have different patterns on PR frequency, clinical characteristics, and determinants. For patients during this special phase, the relatively high C‐peptide level and to reduce insulin dosage accordingly should be emphasized in clinical practice.
Potential for pharmacokinetic interactions between Schisandra sphenanthera and bosutinib, but not imatinib: in vitro metabolism study combined with a physiologically‐based pharmacokinetic modelling approach
Authors: Adiwidjaja Jeffry , Boddy Alan V. , McLachlan Andrew J.
Published: April 2020

Aims

This study aimed to investigate the potential interaction between Schisandra sphenanthera, imatinib and bosutinib combining in vitro and in silico methods.

Methods

In vitro metabolism of imatinib and bosutinib using recombinant enzymes and human liver microsomes were investigated in the presence and absence of Schisandra lignans. Physiologically‐based pharmacokinetic (PBPK) models for the lignans accounting for reversible and mechanism‐based inhibitions and induction of CYP3A enzymes were built in the Simcyp Simulator (version 17) and evaluated for their capability to predict interactions with midazolam and tacrolimus. Their potential effect on systemic exposures of imatinib and bosutinib were predicted using PBPK in silico simulations.

Results

Schisantherin A and schisandrol B, but not schisandrin A, potently inhibited CYP3A4‐mediated metabolism of imatinib and bosutinib. All three compounds showed a strong reversible inhibition on CYP2C8 enzyme with ki of less than 0.5 μmol L−1. The verified PBPK models were able to describe the increase in systemic exposure of midazolam and tacrolimus due to co‐administration of S. sphenanthera, consistent with the reported changes in the corresponding clinical interaction study (AUC ratio of 2.0 vs 2.1 and 2.4 vs 2.1, respectively). The PBPK simulation predicted that at recommended dosing regimens of S. sphenanthera, co‐administration would result in an increase in bosutinib exposure (AUC ratio 3.0) but not in imatinib exposure.

Conclusion

PBPK models for Schisandra lignans were successfully developed. Interaction between imatinib and Schisandra lignans was unlikely to be of clinical importance. Conversely, S. sphenanthera at a clinically‐relevant dose results in a predicted three‐fold increase in bosutinib systemic exposure.
Effect of liraglutide on food consumption, appetite sensations and eating behaviours in overweight people with type 1 diabetes
Authors: Dubé Marie‐Christine , D'Amours Martin , Weisnagel S. John
Published: April 2020

Aims

To investigate the effects of 24 weeks of treatment with liraglutide added to basal/bolus insulin on energy intake, appetite sensations and eating behaviours in overweight/obese participants with type 1 diabetes (T1D).

Methods

In a double‐blinded crossover fashion, 15 participants were randomly assigned (1:1) to receive placebo or liraglutide for 24 weeks including a 1‐month titration period from 0.6 to 1.2 to 1.8 mg, in addition to their insulin. The treatment was followed by a 1‐month wash‐out period. Participants were then assigned to the other treatment for another 24 weeks. Food intake was measured, visual analogue scales and Three‐Factor Eating Questionnaires were completed. Paired rank tests were used to compare the variables.

Results

When treated with liraglutide, participants modified their ad libitum food consumption with decreased total intake and % fat and increased carbohydrates. Their appetite sensations were modified: fasting desire to eat, hunger and prospective food consumption were significantly reduced. The sensation of fullness was prolonged for a few hours after a standardized breakfast. Restraint and disinhibition were significantly reduced by liraglutide.

Conclusions

In this randomized clinical trial, the addition of liraglutide to basal/bolus insulin therapy for 24 weeks in overweight/obese individuals with T1D significantly improved their food consumption, appetite sensations and eating behaviours.
Beyond antioxidant actions: Insights into the antioxidant activities of tyr‐containing dipeptides in aqueous solution systems and liposomal systems
Authors: Chen Chong , Sun‐Waterhouse Dongxiao , Zhao Mouming , Sun Weizheng
Published: April 2020

Tyr‐containing dipeptides deserve close attention because of their interesting bioactivities. This study aimed to make a contribution to the antioxidant activity evaluation of these dipeptides, through examining the chemical reactions underlying the results obtained in ABTS, ORAC assays and liposomal systems. Among Tyr‐Tyr, Tyr‐Phe, Phe‐Tyr, Tyr‐Ala and Tyr‐Ser, Tyr‐Tyr displayed the highest activity in all methods. Compared with Tyr‐Phe, Phe‐Tyr exhibited a higher activity in ORAC assay but a lower activity in ABTS assay. In liposomal systems, significant differences were found among the dipeptides in antioxidant actions against lipid peroxidation initiated by water or lipid‐soluble radicals. Electron and/or hydrogen transfer were involved in the detected antioxidant actions, with the location of Tyr at the C‐/N‐terminus being a crucial factor. Besides the structural features of peptides, the characteristics of liposomes, location of lipid oxidation initiation and peptide distribution in/on liposomal membranes all influenced the outcome of antioxidant actions.
I am the person who knows myself best: Perception on shared decision‐making among hospitalized people diagnosed with schizophrenia in China
Authors: Huang Chongmei , Plummer Virginia , Wang Yun , Lam Louisa , Cross Wendy
Published: April 2020

Shared decision‐making is related to better health outcomes in serious mental illness. It is not well addressed in non‐Western cultures, for example Chinese culture. Chinese could be influenced by both paternalism and familism when making treatment decisions. However, this is unexplored. The study purpose is to explore shared decision‐making from perspectives of inpatients diagnosed with schizophrenia in China. This study adopted qualitative descriptive approach. Through semi‐structured interviews, twelve participants from the psychiatry department of a tertiary hospital shared their perceptions of shared decision‐making. An inductive thematic approach was used to analyse the transcripts. Primary results included three main themes with nine subthemes: (1) Having a positive attitude: i) wanting my voice to be heard, ii) needing my family to be involved, and iii) preferring the psychiatrist to decide; (2) Feeling excluded: i) having limited financial capacity, ii) lacking interactive communication, iii) too few psychiatrists, and iv) being unsatisfied with informed consent process; and (3) Self‐motivation in decision‐making by: i) easing the burden on the family and ii) actively collecting health information. In this context, patients have fewer treatment options and a limited role in SDM. Yet, they have preference for SDM, actively seeking health information from mental health professionals particularly nurses.
Periodontal regeneration versus extraction and dental implant or prosthetic replacement of teeth severely compromised by attachment loss to the apex: A randomized controlled clinical trial reporting 10‐year outcomes, survival analysis and mean cumulative cost of recurrence
Authors: Cortellini Pierpaolo , Stalpers Gabrielle , Mollo Aniello , Tonetti Maurizio S.
Published: April 2020

Background

Periodontal regeneration can change tooth prognosis and represents an alternative to extraction in teeth compromised by severe intra‐bony defects. The aim of this study was to compare periodontal regeneration (PR) with tooth extraction and replacement (TER) in a population with attachment loss to or beyond the apex of the root in terms of professional, patient‐reported and economic outcomes.

Methods

This was a 10‐year randomized controlled clinical trial. 50 stage III or stage IV periodontitis subjects with a severely compromised tooth with attachment loss to or beyond the apex were randomized to PR or TER with either an implant‐ or a tooth‐supported fixed partial denture. Subjects were kept on a strict periodontal supportive care regimen every 3 months and examined yearly. Survival and recurrence analysis were performed.

Results

88% and 100% survival rates were observed in the PR and TER groups. Complication‐free survival was not significantly different: 6.7–9.1 years for PR and 7.3–9.1 years for TER (p = .788). In PR, the observed 10‐year attachment gain was 7.3 ± 2.3 mm and the residual probing depths were 3.4 ± 0.8 mm. Recurrence analysis showed that the 95% confidence interval of the costs was significantly lower for PR compared with TER throughout the whole 10‐year period. Patient‐reported outcomes and oral health‐related quality‐of‐life measurements improved in both groups.

Conclusions

Periodontal regeneration can change the prognosis of hopeless teeth and is a less costly alternative to tooth extraction and replacement. The complexity of the treatment limits widespread application to the most complex cases but provides powerful proof of principle for the benefits of PR in deep intra‐bony defect.
Perisynaptic Schwann cells phagocytose nerve terminal debris in a mouse model of Guillain‐Barré syndrome
Authors: Cunningham Madeleine E. , Meehan Gavin R. , Robinson Sophie , Yao Denggao , McGonigal Rhona , Willison Hugh J.
Published: April 2020

In mouse models of acute motor axonal neuropathy, anti‐ganglioside antibodies (AGAbs) bind to motor axons, notably the distal nerve, and activate the complement cascade. While complement activation is well studied in this model, the role of inflammatory cells is unknown. Herein we aimed to investigate the contribution of phagocytic cells including macrophages, neutrophils and perisynaptic Schwann cells (pSCs) to distal nerve pathology. To observe this, we first created a subacute injury model of sufficient duration to allow inflammatory cell recruitment. Mice were injected intraperitoneally with an anti‐GD1b monoclonal antibody that binds strongly to mouse motor nerve axons. Subsequently, mice received normal human serum as a source of complement. Dosing was titrated to allow humane survival of mice over a period of 3 days, yet still induce the characteristic neurological impairment. Behaviour and pathology were assessed in vivo using whole‐body plethysmography and post‐sacrifice by immunofluorescence and flow cytometry. ex vivo nerve‐muscle preparations were used to investigate the acute phagocytic role of pSCs following distal nerve injury. Following complement activation at distal intramuscular nerve sites in the diaphragm macrophage localisation or numbers are not altered, nor do they shift to a pro‐ or anti‐inflammatory phenotype. Similarly, neutrophils are not significantly recruited. Instead, ex vivo nerve‐muscle preparations exposed to AGAb plus complement reveal that pSCs rapidly become phagocytic and engulf axonal debris. These data suggest that pSCs, rather than inflammatory cells, are the major cellular vehicle for axonal debris clearance following distal nerve injury, in contrast to larger nerve bundles where macrophage‐mediated clearance predominates.
1,8‐cineole and castor oil in sodium lauryl ether sulphate disrupt reproduction and ovarian tissue of Rhipicephalus (Boophilus) microplus
Authors: de Queiroz V. T. , Campos N. C. , Nunes E. T. , Costa A. V. , Coelho J. D. , Trivilin L. O. , de Melo D. C. A. , Morais P. A. B. , Martins I. V. F.
Published: April 2020

Essential and fixed oils have been researched as alternatives to chemical acaricides. The activity of volatile compounds from essential oils (1,8‐cineole, citral and eugenol) at 1.0% (w/v) and fixed oil (castor oil) at 0.3% (w/v) dissolved in 2.0% (v/v) dimethyl sulfoxide (DMSO) + 0.2% (w/v) Tween 80® was assessed against Rhipicephalus microplus using immersion tests. 1,8‐cineole (29.0%) and castor oil (30.2%) had the highest reproductive inhibition rate. A second experiment was performed to verify the effect of the 1,8‐cineole (10.0% w/v) and, or castor oil (0.3% w/v) on tick reproduction using different solubilizing agents. The highest reproductive inhibition was observed for the combination of 1,8‐cineole/castor oil (94.1%) and 1,8‐cineole in 2.0% (w/v) sodium lauryl ether sulphate (SLES) (92.8%). A third experiment showed morphological changes in R. microplus oocytes at different stages of development, as well as in pedicel cells. The most intense effects were observed when ticks were immersed in the formulation containing 1,8‐cineole (10.0% w/v) and castor oil (0.3% w/v) dissolved in 2% (w/v) SLES. These findings highlight the potential of this formulation as an alternative for managing cattle ticks as their cytotoxic effects can reduce R. microplus reproductive success.
A case of MV2K subtype of sporadic Creutzfeldt–Jakob disease with florid‐like plaques: Similarities and differences to variant Creutzfeldt–Jakob disease
Authors: Bošnjak Matic , Zupan Andrej , Fiorini Michele , Popović Katarina Š. , Popović Mara
Published: April 2020

Variant Creutzfeldt–Jakob disease (vCJD) is traditionally regarded as having a distinct clinical course, imaging study findings and neuropathological features, which in combination should allow a clear distinction from the six currently well‐defined subtypes of sporadic Creutzfeldt‐Jakob disease (sCJD). This is of major importance, especially from the standpoint of epidemiology. As we would like to demonstrate through this case report, the MV2K subtype of sCJD, being rare and heterogeneous in both clinical and neuropathological presentations, might challenge this concept by virtue of partial overlapping, both clinically and neuropathologically, with the characteristic phenotype of vCJD. Chiefly, we observed prolonged isolated psychiatric prodrome, new onset limb pain and late cognitive decline clinically, while florid‐like plaques were present on routine histology, albeit in scarce and regionally restricted distribution when compared to vCJD. However, the issue is further complicated by the fact that a case of vCJD in a heterozygous (i.e. methionine – M and valine ‐ V) allelic state with regard to the polymorphic codon 129 of the prion protein gene (PRNP) has recently been described in the UK, which deviated from the otherwise well‐defined and constant clinicopathological phenotype that vCJD had thus far demonstrated. Taking both the facts into account, we would like to emphasize the use of complementary diagnostic methods to the established and otherwise reliable histological type‐based model, particularly when confronted with a rare or atypical phenotype such as ours.
Predictive value of control of COPD for risk of exacerbations: An international, prospective study
Authors: Miravitlles Marc , Sliwinski Pawel , Rhee Chin Kook , Costello Richard W. , Carter Victoria , Tan Jessica H.Y. , Lapperre Therese S. , Alcazar Bernardino , Gouder Caroline , Esquinas Cristina , García‐Rivero Juan Luis , Kemppinen Anu , Tee Augustine , Roman‐Rodríguez Miguel , Soler‐Cataluña Juan José , Price David B. ,   the Respiratory Effectiveness Group (REG)
Published: April 2020

Background and objective

The concept of clinical control in COPD has been developed to help in treatment decisions, but it requires validation in prospective studies.

Methods

This international, multicentre, prospective study aimed to validate the concept of control in COPD. Patients with COPD were classified as controlled/uncontrolled by clinical criteria or CAT scores at baseline and followed up for 18 months. The main outcome was the difference in rate of a composite endpoint of moderate and severe exacerbations or death over the 18‐month follow‐up period.

Results

A total of 307 patients were analysed (mean age = 68.6 years and mean FEV1% = 52.5%). Up to 65% and 37.9% of patients were classified as controlled by clinical criteria or CAT, respectively. Controlled patients had significantly less exacerbations during follow‐up (by clinical criteria: 1.1 vs 2.6, P < 0.001; by CAT: 1.1 vs 1.9, P = 0.014). Time to first exacerbation was significantly prolonged for patients controlled by clinical criteria only (median: 93 days, IQR: 63; 242 vs 274 days, IQR: 221; 497 days; P < 0.001). Control status by clinical criteria was a better predictor of exacerbations compared to CAT criteria (AUC: 0.67 vs 0.57).

Conclusion

Control status, defined by easy‐to‐obtain clinical criteria, is predictive of future exacerbation risk and time to the next exacerbation. The concept of control can be used in clinical practice at each clinical visit as a complement to the current recommendations of initial treatment proposed by guidelines.
An orally bioavailable broad-spectrum antiviral inhibits SARS-CoV-2 in human airway epithelial cell cultures and multiple coronaviruses in mice
Authors: Sheahan Timothy P. , Sims Amy C. , Zhou Shuntai , Graham Rachel L. , Pruijssers Andrea J. , Agostini Maria L. , Leist Sarah R. , Schäfer Alexandra , Dinnon Kenneth H. , Stevens Laura J. , Chappell James D. , Lu Xiaotao , Hughes Tia M. , George Amelia S. , Hill Collin S. , Montgomery Stephanie A. , Brown Ariane J. , Bluemling Gregory R. , Natchus Michael G. , Saindane Manohar , Kolykhalov Alexander A. , Painter George , Harcourt Jennifer , Tamin Azaibi , Thornburg Natalie J. , Swanstrom Ronald , Denison Mark R. , Baric Ralph S.
Published: April 2020

A ribonucleoside analog inhibits SARS-CoV-2 in human airway epithelial cell cultures and SARS-CoV and MERS-CoV in mice.
A Virus Hosted in Malaria-Infected Blood Protects against T Cell-Mediated Inflammatory Diseases by Impairing DC Function in a Type I IFN-Dependent Manner
Authors: Hassan Ali , Wlodarczyk Myriam F. , Benamar Mehdi , Bassot Emilie , Salvioni Anna , Kassem Sahar , Berry Antoine , Saoudi Abdelhadi , Blanchard Nicolas
Published: April 2020

Any infection modifies the host immune status, potentially ameliorating or aggravating the pathophysiology of a simultaneous inflammatory condition. In the course of investigating how malaria infection modulates the severity of contemporaneous inflammatory diseases, we identified a nonpathogenic mouse virus in stabilates of two widely used rodent parasite lines:
Plasmodium berghei
K173 and
Plasmodium yoelii
17X YM. We established that the protective effects of these
Plasmodium
lines on cerebral malaria and multiple sclerosis are exclusively due to this virus. The virus induces a massive type I interferon (IFN-I) response and causes quantitative and qualitative defects in the ability of dendritic cells to promote pathogenic T cell responses. Beyond revealing a possible confounding factor in rodent malaria models, our work uncovers some bases by which a seemingly innocuous viral (co)infection profoundly changes the immunopathophysiology of inflammatory diseases.
Immunogenicity of cell death driven by immune effectors
Authors: Galluzzi Lorenzo , Petroni Giulia , Kroemer Guido
Published: April 2020

Whether cell death caused by T lymphocytes and natural killer (NK) cells would be immunogenicper sehas been a matter of intense debate. Two back-to-back papers from the Melero’s and Pardo’s groups have now resolved this conundrum, demonstrating that T and NK cell–mediated cytotoxicity represents indeed abona fidevariant of immunogenic cell death.
Advances in the Science of Asking Questions
Authors: Schaeffer Nora Cate , Dykema Jennifer
Published: April 2020

In recent decades, research about survey questions has emphasized decision-based approaches. Current research focuses on identifying and systematizing characteristics of questions that are key in researchers’ decisions. We describe important classes of decisions and question characteristics: topic, type of question (e.g., event or behavior, evaluation or judgment), response dimension (e.g., occurrence, frequency, intensity), conceptualization and operationalization of the target object (e.g., how to label the object being asked about and the response dimension), question structure (e.g., use of a filter question, placement in a battery), question form or response format (e.g., yes–no, selection from ordered categories, choice from a list, discrete value), response categories, question wording, and question implementation. We use the framework of question characteristics to summarize key results in active research areas and provide practical recommendations. Progress depends on recognizing how question characteristics co-occur, using a variety of methods and appropriate models, and implementing study designs with strong criteria.
Highly Conducting Bombyx mori Silk Fibroin-Based Electrolytes Incorporating Glycerol, Dimethyl Sulfoxide and [Bmim]PF6
Authors: Fernandes Tânia C. D. , Rodrigues Helena M. R. , Paz Filipe A. A. , Sousa Joana F. M. , Valente Artur J. M. , Silva Maria M. , de Zea Bermudez Verónica , Pereira Rui F. P.
Published: April 2020

Green, transparent and flexible electrolyte films composed of a Bombyx mori silk fibroin (SF) host biopolymer doped with glycerol (G), dimethyl sulfoxide (DMSO, D) and 1-butyl-3-methylimidazolium hexafluorophosphate ([Bmim]PF6) ionic liquid (IL), were synthesized. The materials were represented by the notation SF@GD@IL
x
(x = 15, 20 and 30 is the mass ratio of SF/[Bmim]PF6 in %). SF@, SF@G, SF@D and SF@GD samples were also prepared. DMSO was found to play a dual-role, acting as solvent of [Bmim]PF6, and enhancing ionic conductivity. DMSO, alone or combined with [Bmim]PF6, led to the increase of the mean roughness and induced the formation of more ordered Silk II conformations (β-sheets). No structural modifications were detected in the SF@GD@IL
x
samples upon increasing the temperature up to 100 °C. The highest ionic conductivity was exhibited by the IL-rich sample SF@GD@IL30 (1.07 and 4.61 mS cm−1, at 22 and 100 °C, respectively). In the [Bmim]PF6-doped electrolytes “free” and coordinated PF6
− ions coexist. The weight losses occurring below 200 °C involved essentially the release of adsorbed water and DMSO. The suitable mechanical properties, high ionic conductivity and good electrochemical stability suggest that these electrolytes are attractive candidates for application in electrochemical devices.
Delayed Rapid Anode Potential Decrease During Fixed Resistive Load Overdischarge of LiFePO4/Graphite Lithium-Ion Cells
Authors: Crompton K. R.
Published: April 2020

A lithium-ion 0.7 mAh LiFePO4/graphite pouch cell with 1.0 M LiPF6 ethylene carbonate:ethyl methyl carbonate 1:1 v/v electrolyte was overdischarged by application of a fixed resistive load for 336 h after cell conditioning. A rapid (<5 min) decrease in the anode potential was observed after the anode reached 3.3–3.4 V vs Li/Li+ for about 6 h during the overdischarge. Non-uniform depositions of fluorine, oxygen, phosphorous, lithium and copper were observed on the surface of the anode from the overdischarged cells by SEM/EDS and XPS. Three-electrode measurements show lithium inventory in the cell increased after overdischarge, increasing cell discharge capacity. Tests on additional LiFePO4/graphite cells show that 1) the rapid anode potential decrease doesn’t occur if the anode potential doesn’t increase to >1.8 V vs Li/Li+ during overdischarge, although oxygen deposition on the anode does occur, 2) fluorine, oxygen and phosphorous increases on the anode surface are not observed when the fixed resistive load is removed before the rapid anode potential decrease and 3) fluorine, copper and oxygen deposition occur without cell recharge. Collectively, results indicate the rapid anode potential decrease is an oxidative breakdown of the electrolyte on the surface of the anode that is initiated by copper oxidation.
Preeclampsia beyond pregnancy: long-term consequences for mother and child
Authors: Turbeville Hannah R. , Sasser Jennifer M.
Published: April 2020

Preeclampsia is defined as new-onset hypertension after the 20th wk of gestation along with evidence of maternal organ failure. Rates of preeclampsia have steadily increased over the past 30 yr, affecting ∼4% of pregnancies in the United States and causing a high economic burden ( 22 , 69 ). The pathogenesis is multifactorial, with acknowledged contributions by placental, vascular, renal, and immunological dysfunction. Treatment is limited, commonly using symptomatic management and/or early delivery of the fetus ( 6 ). Along with significant peripartum morbidity and mortality, current research continues to demonstrate that the consequences of preeclampsia extend far beyond preterm delivery. It has lasting effects for both mother and child, resulting in increased susceptibility to hypertension and chronic kidney disease ( 45 , 54 , 115 , 116 ), yielding lifelong risk to both individuals. This review discusses recent guideline updates and recommendations along with current research on these long-term consequences of preeclampsia.
Diagnostic Value of Systematic Imaging Examination in Embedded Optic Disc Drusen in Adolescents with Mild Visual Impairment
Authors: Jia Xiuhua , Bao Tiancheng , Wang Shasha , Jiang Ting , Zhong Zhijian , Zhang Yanling , Li Qigen , Zhu Xiang
Published: April 2020

Aim. To evaluate the diagnostic value of systematic ophthalmologic imaging examination in the diagnosis of embedded optic disc drusen (ODD) in adolescents with mild visual impairment. Methods. Eleven patients were evaluated through optometric examination, fundus photography, visual field inspection, optical coherence tomography (OCT), ultrasonography (US), and fundus fluorescein angiography (FFA). Of the 11 patients, three also underwent cranial and orbital magnetic resonance imaging (MRI). Results. All 11 patients had either no apparent abnormality or only mild refractive abnormalities. In all patients, fundus inspection revealed flushing the optic disc with varying degrees of limited boundary ambiguity and optic disc congestion with disappearance of the fovea. One patient had a visual field defect during the period of edema of ODD, but the visual field returned to normal after the optic disc edema subsided. US revealed discoid acousto-optic masses in front of the optic disc in six patients. OCT showed a slight elevation and thinning of the retinal nerve fiber layer (RNFL) of the optic disc in all patients. Quasicircular, hyperreflex signals of different sizes could be observed below the RNFL. Late-stage FFA revealed focal staining at the edge of the optic disc without fluorescence leakage in all patients. Orbital and cranial MRI findings were normal in the three patients. Conclusion. A systematic ophthalmologic imaging examination can not only improve the detection rate of embedded ODD but also avoid excessive examinations and treatments.
It Is Always Early with Point-of-Care Ultrasound
Authors: Bitar Zouheir Ibrahim , Zaalouk Tamer Mohamed , Maadarani Ossama Sajeh , Elshabasy Ragab Desouky
Published: April 2020

A 56-year-old male was admitted to the emergency department for acute pulmonary edema and septic shock, yet no clear source of infection was noted upon physical examination. Due to his unstable condition, bedside ultrasound was performed. A heterogeneous mass in the liver was noted; hence, a tentative diagnosis of liver abscess was made. The abscess was confirmed by abdominal magnetic resonance imaging. Drainage of the abscess was attempted and guided by early ultrasound. This case highlights that point-of-care ultrasound, when performed by an ultrasound-capable critical care physician, can significantly decrease the time to diagnosis for septic patients.
Screening for Platelet Dysfunction and Use of Prophylactic Tranexamic Acid in Patients Undergoing Deep Brain Stimulation: A Retrospective Analysis of Incidence and Outcome of Intracranial Hemorrhage
Authors: Helmers Ann-Kristin , Kubelt Carolin , Birkenfeld Falk , Deuschl Günther , Falk Daniela , Mehdorn Hubertus Maximilian , Witt Karsten , Nowak-Göttl Ulrike , Synowitz Michael , Paschen Steffen
Published: April 2020

Introduction: The rate of intracranial hemorrhage (ICH) after deep brain stimulation (DBS) is between 1.5 and 6.1%, with prolonged deficits occurring in 0.4–2.5% of the patients. This retrospective study investigates whether the prophylactic administration of tranexamic acid (TA) to patients with abnormal platelet function detected preoperatively by platelet function analyzer (PFA) lowered the risk for an ICH event. Methods: We performed a systematic review of the medical records of 485 consecutively admitted patients who underwent bilateral DBS surgery in a single-center university hospital setting between 2009 and 2018. The cohort was split into two groups. In one group, preoperative PFA screening was performed (n = 156, patients recruited from 2014 to 2018), and TA was administered if platelet function was abnormal. No preoperative PFA was performed in the second group (n = 359, patients recruited from 2009 to 2013). Both cohorts were analyzed for the occurrence of ICH, defined by (i) detection of ICH in routine postoperative magnetic resonance/computed tomography imaging or (ii) in non-routine imaging for the onset of new neurological symptoms. Results: Fourteen of the 156 screened patients (9%) showed reproducible PFA-100 closure abnormalities (3 with von Willebrand disease, 11 with no identifiable cause of platelet dysfunction). Two of the 156 patients (1.3%) in this cohort revealed an ICH on imaging, 1 of whom (0.6%) exhibited a prolonged neurological deficit as a result of ICH. In the cohort without platelet testing, 11 of the 329 patients (3.3%) demonstrated ICH on imaging, of whom 5 (1.5%) suffered from a prolonged neurological deficit. Conclusion: In this retrospective study, the screening and the administration of TA appeared to lower the risk of an ICH by 1.8%. One patient with von Willebrand disease suffered an ICH despite TA treatment. A prospective study is needed to clarify the impact of platelet testing and TA administration on the of incidence ICH.
Impact of Sociodemographic Characteristics on the Quality of Care in the Surgical Management of Endometrial Cancer: An Analysis of a National Database in the United States
Authors: Benoit Louise , Pauly Lea , Phelippeau Juliette , Koskas Martin
Published: April 2020

Introduction: Quality of care is an emerging concern, notably in oncology. The aim of the present study was to identify the sociodemographic factors influencing the quality of care in the USA concerning the surgical management of endometrial cancer (EC) through the Surveillance Epidemiology and End Results (SEER) database using already published Belgian quality indicators (QI). Methods: Using the SEER database 1988–2013, we identified 151,752 patients treated for EC. Six QI were extracted from a Belgian study on quality of care in EC because of their applicability to the SEER. These QI evaluated only the surgical management. We examined the association between sociodemographic characteristics and quality of care with a logistic regression model. We compared our results with those defined as theoretical target by the Belgian initiative and considered a QI to be accurately met if >80% of the population met the indicator, moderately met between 50 and 80%, and poorly met under 50%. Results: Concerning the 6 surgical QIs, one was accurately met, 3 were moderately met, and 2 were poorly met. For example, 73% of the patients with a high-risk EC underwent a pelvic lymphadenectomy. Age over 75 years old, black ethnicity, lower-income group, without partner, and uninsured had a negative impact on adherence to QIs. Conclusion: Demographic discrepancies persist in the surgical management of EC, impacting evidence-based care.
NOS3 Gene rs1799983 and rs2070744 Polymorphisms in Patients with Unstable Angina
Authors: Pawlik Andrzej , Błaszczyk Halina , Rać Monika , Maciejewska-Skrendo Agnieszka , Safranow Krzysztof , Dziedziejko Violetta
Published: April 2020

Acute coronary syndrome occurs when the heart muscle does not receive adequate oxygen and nutrients in a timely manner. Acute coronary syndromes are primarily due to atherosclerosis of the coronary arteries, i.e., coronary heart disease. Nitric oxide (NO) is synthesised from L-arginine in endothelial cells by the constitutive calcium-calmodulin-dependent enzyme, nitric oxide synthase (NOS), which mediates endothelium-dependent vasodilatation. Endothelial nitric oxide synthase (eNOS) is predominantly expressed in endothelial cells. Three NOS isoforms have been detected in different tissue: (1) neuronal NOS (nNOS) (NOS1), (2) eNOS (NOS2), and (3) inducible NOS (iNOS) (NOS3). These isoforms are encoded by three different genes. NOS3 is located on chromosome 7q35–36 and contains 26 exons. Previous studies have suggested that NOS3 polymorphisms may be associated with acute coronary syndromes. Therefore, the aim of the study was to examine the associations between NOS3 rs1799983 (894G/T)andrs2070744 (–786T/C) polymorphisms and unstable angina. This study included 246 patients with unstable angina, as confirmed by coronary angiography. We also included 189 healthy controls who were also assessed by this technique. There were no significant differences in genotype distributions of NOS3 rs1799983and rs2070744 polymorphisms in patients with unstable angina and healthy controls in both univariate and multivariate analyses. In patients with the NOS3 rs1799983 TT genotype, we observed a higher BMI (TT vs. GT + GG, p = 0.068), and in patients with the NOS3 rs2070744 TT genotype, we observed a higher waist circumference (TT vs. TC + CC, p = 0.023; TT vs. CC, p = 0.0053). These data suggest a lack of association between the NOS3 rs1799983andrs2070744 polymorphisms and unstable angina in our patient population. However, these polymorphisms may be associated with some obesity parameters, rs1799983 in females and rs2070744 in males.
A Case Report of Acupuncture at Neiguan Point (P6) for Paroxysmal Supraventricular Tachycardia
Authors: Liu Peizhong , Li Chuangpeng , Lu Yiting , Liu Qing
Published: April 2020

Paroxysmal supraventricular tachycardia (PSVT) is a common medical emergency, and this case report describes an acupuncture treatment of traditional Chinese medicine terminating PSVT. In this case report, a 67-year-old female patient diagnosed with PSVT had a recurrence in the ward; accompanying symptoms were heart palpitations and shortness of breath. Modified Valsalva maneuver, the first-line treatment, failed to convert paroxysmal supraventricular tachycardia. However, acupuncture at Neiguan point (P6) for about 1 min on her right hand successfully treated the patient. This case indicates that the application of acupuncture in the clinic may serve as an alternative and complementary treatment for PSVT.
Magnetic Resonance-Guided Focused Ultrasound Thalamotomy to Treat Essential Tremor in Nonagenarians
Authors: Paff Michelle , Boutet Alexandre , Neudorfer Clemens , Elias Gavin J.B. , Germann Jürgen , Loh Aaron , Kucharczyk Walter , Fasano Alfonso , Schwartz Michael L. , Lozano Andres M.
Published: April 2020

Essential tremor (ET) is a disabling movement disorder that is most prevalent among the elderly. While deep brain stimulation surgery targeting the ventral intermediate nucleus of the thalamus is commonly used to treat ET, the most elderly patients or those with multiple medical comorbidities may not qualify as surgical candidates. Magnetic resonance-guided focused ultrasound (MRgFUS) constitutes a less invasive modality that may be used to perform thalamotomy without the need for a burr hole craniotomy. Here, we report on 2 patients over the age of 90 years who benefited significantly from MRgFUS thalamotomy to relieve their symptoms and improve their quality of life. The procedure was well tolerated and performed safely in both patients. We conclude that age should not be a limiting factor in the treatment of patients with MRgFUS.
Exploring the Relationship Between Campaign Discourse on Facebook and the Public’s Comments: A Case Study of Incivility During the 2016 US Presidential Election
Authors: Rossini Patrícia , Stromer-Galley Jennifer , Zhang Feifei
Published: April 2020

Social media is now ubiquitously used by political campaigns, but less attention has been given to public discussions that take place on candidates’ free public accounts on social media. Also unclear is whether there is a relationship between campaign messaging and the tone of public comments. To address this gap, this article analyzes public comments on Facebook accounts of candidates Trump and Clinton during the US election presidential debates in 2016. We hypothesize that attack messages posted by the candidates predict uncivil reactions by the public and that the public is more likely to be uncivil when attacking candidates. We use content analysis, supervised machine learning, and text mining to analyze candidates’ posts and public comments. Our results suggest that Clinton was the target of substantially more uncivil comments. Negative messages by the candidates are not associated with incivility by the public, but comments are significantly more likely to be uncivil when the public is attacking candidates. These results suggest that the public discourse around political campaigns might be less affected by what campaigns post on social media than by the public’s own perceptions and feelings toward the candidates.
Not quite clean: Trailing schoon and its resonances
Authors: Mol Annemarie
Published: April 2020

When words are translated from one linguistic repertoire to another, their resonances stay behind. This is a challenge for those who write in academic English while working and living in another tongue. Here, I exemplify this with stories about the Dutch word schoon. The dictionary translates schoon into English as clean, but it is not quite clean. For a start, the songs, books and other cultural resources that resonate in schoon are distinctively local. Next, the particular sites (say, waste water treatment plants) where schoon is strived for differ from their (diverse) counterparts where English is spoken and the ambition is clean. And if dirt has notoriously been defined as ‘matter out of place’, this spatial thought would never have arisen in Dutch, because vies, the most prominent antonym of schoon, is invariably visceral. Finally, in urban settings in the Netherlands, schoon stands out as an aesthetic, a moral and a hygienic ideal; knowing whether this is also true for clean would require fieldwork in English (but where, in which English?). These examples suggests that hoping to purify one’s theoretical notions of empirical filth is a monolingual delusion. For, however well-polished, English concepts will never have universal salience: they are just (a version of) English. Good academics therefore artfully, carefully, mind the gaps between different ways of knowing, acting and speaking.
Enabling effective oversight: Enterprise risk management and board governance in healthcare
Authors: Martin Nyranne
Published: April 2020

Lengthy emergency room wait times leaving patients waiting for essential care. Dwindling annual budgets putting core services at risk. Cyberattacks resulting in ransomed data. These are just some of the ever-present risks in the healthcare sector. Each of these risks has a potential for high likelihood of occurrence, impact, and velocity. Identifying, assessing, mitigating, and reporting risk are therefore crucial to Enterprise Risk Management (ERM), and should be built into healthcare institutional processes. This column provides some recommendations for health leaders on how to enable effective oversight through ERM.
Effect of fungal degradation on technological properties of carbon nanotubes reinforced polypropylene/rice straw composites
Authors: Kord Behzad , Ayrilmis Nadir , Ghalehno Mohammad Dahmardeh
Published: April 2020

Effects of fungal decay period on the technological properties of polypropylene/rice straw composites reinforced with different amount of carbon nanotubes (CNTs) were evaluated in this research work. The composite specimens were prepared using an internal mixer followed by compression molding. The specimens were then subjected to the fungal decay using white-rot fungus ( Coriolus versicolor) for 1, 2, 3, and 4 months. The degree of fungal attack was recorded by determining the weight loss of the specimens. The physical and mechanical properties including water uptake, flexural strength, and impact strength (IS) were investigated. The results indicated that the weight loss of the specimens was significantly reduced by increasing the CNT loading levels. The weight loss ratio of the specimens with the CNT was lower than that of the specimens without the CNT. The modulus of rupture, modulus of elasticity, and IS of the specimens exposed to the fungal degradation increased in the presence of CNT. Furthermore, the decayed specimens without CNT had higher water uptake than those of the specimens with CNT. This was attributed to the decrease in the number of cavities on the surface of the composites containing CNT. Based on the findings obtained from the present study, it was concluded that the amount of the CNT should be considered according to the severity and duration of the fungal exposure.
Relational inquiry approach for developing deeper awareness of patient suffering
Authors: Younas Ahtisham
Published: April 2020

To practice compassion, the recognition, understanding, and alleviation of patient suffering are of utmost importance. Nursing literature provides ample guidance about the nature and meaning and patients’ views about compassion and physical and psychological suffering. However, missing is the discussion about how nurses can achieve a deeper awareness of patients’ suffering to practice compassion. This paper aims to describe the relational inquiry nursing approach and illustrate how this approach can enable nurses to develop a deeper awareness of patient suffering. The relational inquiry approach encompasses two components: a relational consciousness and inquiry as a form of action. Relational consciousness requires the nurses to focus on the concrete situations and relationships as well as recognize the intrapersonal, interpersonal, and contextual factors affecting the situations. The interpersonal factors are among and between the individuals, intrapersonal factors are within the individuals, and contextual factors are the hidden factors influencing the individuals and situations. Inquiry as an action requires a critical analysis of the experiences of individuals, situational contexts, and knowledge to inform the nursing care modalities and actions. This approach encourages nurses to use the philosophies of hermeneutic phenomenology, critical theory, and pragmatism. The phenomenological worldview allows nurses to interpret their own and patients’ experiences, the critical theory worldview allows nurses to examine the influence of social and cultural factors, and pragmatism allows nurses to question their prior knowledge and develop new knowledge in each situation. The relational inquiry approach allows nurses to develop a deeper understanding of patient suffering through building a therapeutic and trustworthy relationship, active listening, focusing on the details, and engaging in broad and situations specific inquiries to understand the patient narrative of suffering. Two case exemplars are shared to demonstrate how relational inquiry allowed nurses to move beyond recognizing physical suffering and understand patients’ emotional and psychological suffering.
Impact monitoring characteristics of piezoelectric paint sensor by thermal fatigue analysis for railroad vehicle applications
Authors: Choi Kyungwho , Hwang Mun-Young , Kang Donghoon , Kang Myeongcheol , Ahn Dahoon , Kang Lae-Hyong
Published: April 2020

The strong aerodynamic drag under a railroad vehicle in motion causes the track ballast to fly up and around. The flying ballast can collide with the underside of the coach, damaging the electronics installed there. There are even cases wherein the aerodynamics of fast-moving train causes the gravel to hit the side of the coach and break the windows. Extensive and numerous studies are underway to reduce the damage caused by such phenomena. In this study, a “smart paint sensor” for impact monitoring was fabricated using piezoelectric nano powder and commercial paint for railroad vehicles, and the application of impact monitoring to railroad vehicles was analyzed. The process was simplified because the use of commercial paint eliminated the need to apply an additional layer of functionalized paint. Furthermore, the fact that the paint can be evenly sprayed on a large surface made it suitable for use on large and intricate objects such as a railroad vehicle bogie. Because railroad vehicles are exposed to thermal stress for a long period of time, a thermal fatigue test was conducted in order to figure out the stability of the polymer-based material, which is relatively vulnerable to temperature variations. The test results were used to analyze the impact sensitivity of the piezoelectric paint sensor. For the analysis, a full-size mock-up of the railroad vehicle bogie and an impact monitoring system with piezoelectric paint sensor were implemented in order to visualize the impact signals from differently shaped objects with large surfaces.