bluuebunny/crossref_metadata_2025 huggingface dataset:
Transcriptomic Classification of Neurons Innervating Teeth
Authors: Emrick J.J. , von Buchholtz L.J. , Ryba N.J.P.
Published: July 2020

Toothache is a common painful consequence of damage to the teeth, particularly when coupled to infection. Clinical restoration of tooth integrity, sometimes involving physical and chemical sterilization of the tooth with nerve fiber ablation (i.e., endodontic therapy), generally alleviates pain and allows long-lasting dental function. These observations raise questions regarding the biological role of tooth-innervating fibers. Here, we determined the transcriptomic diversity of the sensory neurons that can be retrogradely labeled from mouse molar teeth. Our results demonstrate that individual molars are each targeted by a dedicated population of about 50 specialized trigeminal neurons. Transcriptomic profiling identifies the majority of these as expressing markers of fast-conducting neurons, with about two-thirds containing nociceptive markers. Our data provide a new view of dental innervation, extending previous reports that used candidate gene approaches. Importantly, almost all retrogradely labeled neurons, including nociceptors, express the recently characterized mechanosensor Piezo2, an ion channel that endows cells with sensitivity to gentle touch. Intriguingly, about a quarter of the labeled neurons do not appear to be nociceptors, perhaps insinuating a role for them in discriminative touch. We hypothesize that dental neurons are capable of providing mechanosensitive information to drive rapid behavioral responses and protect teeth from damage. Damage to the teeth and exposure of the large population of molar nociceptors may trigger prolonged or abnormal activation driving toothache. Future studies examining the responses of these transcriptomically defined classes of neurons will help define their significance in oral sensation.
Validation of Short Form of Preferences for Routines Scale: Norms in Older Adults
Authors: Bergua Valérie , Edjolo Arlette , Bouisson Jean , Meillon Celine , Pérès Karine , Amieva Hélène
Published: July 2020

High level of preferences for routines is an indicator of psychological vulnerability in older adults. However, the psychometric properties of the Preferences for Routines Scale (PRS) initially validated in a small selected sample of older adults revealed a low Cronbach’s α (.50) in the general elderly population. The present study aims to improve the PRS using the data from the “AMI” and “PAQUID” population-based studies. Among 718 older persons, the most discriminative items are identified using item response theory methodology. A short form of the PRS (PRS-S) included five of the ten items of the original scale and showed improved internal consistency and test–retest reliability. The factors associated with the PRS-S are similar to those found in previous studies. Norms are provided according to gender and educational level. The reduction of the number of items tends to facilitate its administration and promote its use in both clinical and epidemiologic research contexts.
Direct and Indirect Associations of Food Insecurity, Adolescent–Parent Relationship, and Adolescent Future Orientation
Authors: Masa Rainier , Bates Claire , Chowa Gina
Published: July 2020

This cross-sectional study on Ghanaian adolescents examined the direct and indirect associations of food insecurity, parent–adolescent relationship, and adolescent future orientation. We used structural equation modeling to examine reliability and validity of our latent constructs and our hypothesized direct and indirect relationships. Results indicated adequate fit of our measurement and structural models with the data. Results also showed a significant direct and indirect effect of food insecurity. Food insecurity was directly associated with parental connection, orientation toward success, and uncertainty about the future. Food insecurity was also indirectly associated with orientation toward success and uncertainty about the future, via parental connection. Further, higher levels of parental connection were directly associated with higher levels of orientation toward success and with lower levels of uncertainty about the future. Understanding the direct and indirect effect of food insecurity is important for the design of appropriate interventions that promote holistic and positive adolescent development.
Appearance of cerebellar cyst following microvascular decompression to treat hemifacial spasm: a report of two cases and literature review
Authors: Cui Yu , Yang Zhong-Xi , Wang Chun-Mei , Zhu Zhan-Peng
Published: July 2020

Microvascular decompression (MVD) is an effective and safe approach for treating hemifacial spasm (HFS). Postoperative complications may include facial nerve palsy, hearing loss, intracerebral haematoma, and brainstem infarction. The occurrence of intracranial cyst following MVD is extremely rare, with few cases documented in the literature. Herein, the cases of two patients with HFS who developed ipsilateral cerebellar cyst following MVD are reported. The first patient was a 50-year-old male presenting with a 6-year history of HFS on the right side of his face. MVD was performed, and 12 days postoperatively he developed dizziness and nausea. Magnetic resonance imaging (MRI) showed a cyst in the ipsilateral cerebellum. Antibiotic treatment provided no benefit, and the cyst was drained. The second patient was a 44-year-old female presenting with a 4-year history of HFS on the right side of her face. MVD was performed, and 18 days following surgery, she developed dizziness and nausea. MRI showed an ipsilateral cerebellar cyst. Conservative treatment was applied and the cyst shrunk. At the 2-month follow-up appointment, symptoms were completely resolved in both patients. Cerebellar cyst is a rare complication following MVD. Timely diagnosis and appropriate treatment should be emphasized, and surgical treatment may be unnecessary.
Correlations of UICC tumor stage and tumor regression on T2-weighted MRI sequences during definitive radiotherapy of cervical cancer
Authors: Arend Florian , Oechsner Markus , Weidenbächer Clara B. , Combs Stephanie E. , Borm Kai J. , Duma Marciana N.
Published: July 2020

Background:

The purpose of this study is to detect a correlation between the preradiation tumor staging and the relative volumetric regression of the primary tumor through external beam radiation therapy (EBRT).

Methods:

Clinical data of 32 patients with a mean age of 60±12 years treated with primary radiation therapy (RT) of cervical carcinoma were analyzed. Union Internationale Contre le Cancer (UICC) stages were T1 = 4 patients, T2 = 15 patients, T3 = 8 patients, T4 = 5 patients; N1 = 26 patients, N0 = 6 patients; and M0 = 25 patients, M1 = 7 patients. All patients received pelvic magnetic resonance imaging (MRI) before RT as well as during RT. The cervical primary tumor was delineated as gross tumor volume (ptGTV) in T2-weighted MRI sequences. We compared ptGTV reduction by stage, lymph node status, metastatic status, and grading.

Results:

Mean ptGTV reduction during RT was 61.4±28.9%. T1 tumors shrank by 88.2±13.4%, T2 by 67.6±28.7%, T3 by 50.8±23.6%, and T4 by 38.7±27.2%. The difference in tumor shrinkage was statistically significant between the lower T stages and the higher T stages ( p < 0.05). There was no statistical difference in the mean ptGTV before treatment in the group with lymph node metastases (LNM) (54.1±47.7 cm3) as compared to the group without LNM (76.6±52.2 cm3). Nonetheless, ptGTV shrank significantly differently: by 68.9±25.7% (N1 patients) and by 29.0±17.7% (N0 patients). No significant differences in ptGTV shrinkage were observed in M0 versus M1 and G2 versus G3 tumors.

Conclusion:

There is a correlation between mean ptGTV reduction during EBRT and tumor stages. Tumors with higher T stages shrank less under radiation treatment, and the ptGTV of N1 patients responded better than that of N0 patients.
Effectiveness of anxiety reduction interventions on test anxiety: A comparison of four techniques incorporating sensory modulation
Authors: Keptner Karen M , Fitzgibbon Carolyn , O’Sullivan Julie
Published: July 2020

Introduction

Anxiety is one of the most commonly diagnosed mental health disorders on post-secondary campuses, often brought on by stressors unique to the college environment. Traditional psychological approaches to manage anxiety might focus on breathing techniques and progressive muscle relaxation. However, additional techniques that use specific sensory input to reduce anxiety have not received the same attention in the literature.

Method

This longitudinal study compared four interventions for state anxiety (deep breathing, progressive muscle relaxation, an adapted dive reflex, and use of a weighted lap object) in a cohort of professional occupational therapy students.

Results

This study found that all four interventions significantly reduced state anxiety. The sensory-based interventions of adapted dive reflex and weighted lap object appeared to have a longer duration of impact than the traditional interventions of deep breathing and PMR.

Conclusion

These results suggest that both traditional and sensory-based approaches may be effective in reducing anxiety before a testing situation.
Investigating Untapped Capacity at Single-Runway Airports using Short Final Curved Approach, Dual Glide Slope, and Double Threshold
Authors: Tošić Vojin , Mirković Bojana
Published: July 2020

In Europe more than one third of the 100 busiest airports have only one runway and most of them have no possibility to build another one. Aircraft of all types and sizes must use that same runway which affects operational complexity. In such situations the problem of capacity appears since separation between aircraft is based on all of them following the same path and smaller aircraft following larger ones have to wait for the wake vortex to dissipate, in the case of both arrivals and departures. This paper offers a possible concept for increasing single-runway airport landing capacity. It is based on separating smaller aircraft to a final approach path that is not affected by the wake vortices produced by the larger aircraft. Published references dealing with this topic are included and discussed. The operation rules proposed are based on existing standards and some best practices. This paper does not discuss available technological solutions.
Diet Quality and Urbanization in Mozambique
Authors: Smart Jennifer Cairns , Tschirley David , Smart Francis
Published: July 2020

Robust income growth combined with the highest urban population growth in the world is driving rapid changes in the food system of sub-Saharan Africa. Demand is increasing for higher quality as well as more processed foods. Countries are increasingly experiencing a double burden of over and under nutrition as the overweight and obesity epidemic spreads. In this context, we seek to understand the key drivers and likely evolution of diet quality in Mozambique, in both its positive and negative dimensions, while specifically examining the role of farm ownership among increasingly urban populations. We use national household expenditure survey data and a set of ordinary least square and analysis of variance regressions to observe patterns of current diet quality across city size categories, household income, household education, and other demographic variables. We then anticipate the likely directions of change in diet quality over these same dimensions based on expected income growth and expenditure elasticities developed for several alternative nutrients. We find that growing incomes and the consumption of processed foods are associated with a worsening of negative factors in the diet. Furthermore, urbanization, controlling for income, is associated more strongly with a worsening of negative factors than with an improvement in positive factors in the diet. The effect on diet quality of farm ownership, however, is positive and significant, primarily driven by these households purchasing fewer unhealthy foods. African cities need to consider what mix of policies will counteract the negative effects of continued urbanization and rising incomes on diets.
Not collateral damage: Trends in violence and hate crimes experienced by sex workers in the Republic of Ireland
Authors: Campbell Rosie , Smith Lucy , Leacy Becky , Ryan Miriam , Stoica Billie
Published: July 2020

The Republic of Ireland’s new Criminal Law (Sexual Offences) Act 2017 (2017 Act) criminalised sex purchase. Drawing on primary data from reports made by sex workers in Ireland to UglyMugs.ie, we analyse trends in violent and other crimes against sex workers in Republic of Ireland (hereafter Ireland). Examining the four-year period 2015–2019, we highlight the various crimes sex workers experience, including incidents of hate crime. Analysis of UglyMugs.ie data found that crimes (including violent offences) against sex workers increased following the introduction of the new law and continued with low levels of reporting of said crimes to the police. The data suggest that the 2017 Act heightens the risks for sex workers. Here, we advocate an intersectional framework to provide a more nuanced understanding of how sex workers in Ireland experience violent and other hate crimes (ICRSE, 2014). We suggest that considering the international research evidence, the most conducive framework in which to reduce violence against sex workers is that of full decriminalisation ( Platt et al, 2018 ). But, as others have pointed out, that legal reform needs to be in tandem with other policies and a refocusing of police resources on sex worker safety, better enabling reporting and access to justice.
Clinical outcomes of once-daily darunavir in treatment-experienced patients with darunavir resistance-associated mutations through 48 weeks of treatment
Authors: Rolle Charlotte-Paige , Marquez Omar , Nguyen Vu , Hinestrosa Federico , DeJesus Edwin
Published: July 2020

Darunavir (DRV) is approved for once-daily use in patients with no DRV resistance-associated mutations (RAMs) and twice-daily use in those with DRV RAMs. Several studies suggest that once-daily DRV retains efficacy in the setting of 1–2 DRV RAMs whereas three or more DRV RAMs are needed for DRV resistance. There are few data to support the long-term use of once-daily DRV in patients with DRV RAMs. This observational study evaluated 48-week clinical outcomes of 22 treatment-experienced patients with ≥1 DRV RAMs switched to once-daily DRV between 2014 and 2017. The primary endpoint was HIV-1 RNA <50 copies/ml at week 48. Safety parameters were analyzed throughout the study. The median age of the sample was 53 years, 18 (82%) had baseline HIV-1 RNA <50 copies/ml, and the median number of historical DRV RAMs was 2. At week 48, 20 (91%) had HIV-1 RNA < 50 copies/ml, and 2 (9%) had HIV-1 RNA of 82 and 59,637 copies/ml and reported non-adherence. No adverse drug reactions were observed through week 48. Once-daily DRV maintained virologic control in patients with ≥1 historical DRV RAMs and was safe and well-tolerated. Further data are needed to validate this as a viable treatment option in this population.
Antiretroviral therapy adherence among patients enrolled after the initiation of the Universal Test and Treat strategy in Dessie town: a cross-sectional study
Authors: Damtie Yitayish , Tadese Fentaw
Published: July 2020

Poor adherence was the major challenge in providing treatment, care, and support for people living with HIV (PLHIV). Evidence of adherence to antiretroviral therapy (ART) after initiation of the Universal Test and Treat (UTT) strategy was limited in Ethiopia. So, this study aimed to determine the proportion of ART adherence after the initiation of UTT strategy and associated factors among adult PLHIV in Dessie town using two adherence measurements. A cross-sectional study was conducted on 293 PLHIV selected using a systematic sampling technique. The data were collected by face-to face-interview using a pretested questionnaire; chart review was also used to collect the data. The proportion of ART adherence measured by using the Morisky scale and seven-day recall was 49.3% (95% CI: [43.5%, 54.8%]) and 95.9% (95% CI: [93.2%, 98.2%]), respectively. Being urban in residence (AOR = 3.72, 95% CI: [1.80, 7.68]), the absence of depression (adjusted odds ratio [AOR] = 3.72, 95% CI: [1.22, 11.35]), taking one tablet per day (AOR = 3.26, 95% CI: [1.64, 6.49]), and the absence of concomitant illness (AOR = 0.23, 95% CI: [0.09, 0.59]) were factors associated with ART adherence. The proportion of ART adherence measured by the Morisky scale was very low; however, adherence measured by seven-day recall was higher and consistent with World Health Organization recommendations. Residence, depression, and the number of tablets taken per day had a positive association with good ART adherence whereas having concomitant illness had a negative association with good ART adherence. Efforts should be made to improve adherence and interventions should be given to overcome factors linked with poor adherence.
Primary breast tuberculosis in an HIV-infected patient
Authors: Xiao Ke , Zhong Li
Published: July 2020

The presentation of tuberculosis can be nonspecific and atypical in patients with human immunodeficiency virus infection, especially in the extrapulmonary forms. The incidence of breast tuberculosis is very low. We report a case of primary breast tuberculosis: a 26-year-old woman with a 5-month history of a left-sided breast lump associated with pain. Biopsy of the breast lump for histological examination suggested granulomatous inflammation, secretions tested with GeneXpert for Mycobacterium tuberculosis were positive, and no evidence of tuberculosis was found in other organs. She was treated with incision, drainage, dressing, and 6 months of anti-tuberculosis treatment; her prognosis was good.
Multi-objective optimal energy management of microgrids including plug-in electric vehicles with the vehicle to grid capability for energy resources scheduling
Authors: Jiao Feixiang , Zou Yuan , Zhang Xudong , Zou Runnan
Published: July 2020

As more battery electric vehicles and plug-in hybrid electric vehicles are connected to the microgrid, plug-in electric vehicles have a major impact on the microgrid. This paper proposes a multi-objective optimization energy management model including plug-in electric vehicles and other distributed generations. By analyzing the powertrain structure of different kinds of plug-in electric vehicles, the engine fuel consumption model, the charging model, the discharge model, and the battery state of charge model of plug-in electric vehicle in microgrids are given. The proposed model considers the plug-in electric vehicle battery state of charge constraints to prevent the battery from overcharging and over-discharging and gives the state of charge curve in microgrids. Simultaneously, an improved gray wolf algorithm, introducing optimization control factors and greedy strategies to better balance the mining and exploration capabilities of the gray wolf algorithm, is proposed to solve this multi-objective optimization energy management model. Compared with particle swarm optimization and traditional gray wolf algorithm, the improved algorithm further improves the accuracy and convergence speed. Besides, the improved algorithm is applied to three scheduling schemes, and the results show that plug-in hybrid electric vehicles have more advantages in energy economy in some special cases.
Light at the museum – A near impossible result
Authors: Power AC , Ingleby S , Chapman J , Cozzolino D
Published: July 2020

The monitoring and quantification of the illegal harvest of protected animal products is very vital for the conservation and protection of endangered species. Most of the methods and techniques used in the trade of these products are recognised to be incredibly time consuming and labour intensive requiring significant analyst expertise. In this study, we have demonstrated the potential of near-infrared spectroscopy combined with either principal component analysis or partial least square discriminant analysis regression as a rapid and non-invasive tool to classify horn and ivory samples stored in the Australian Museum, Sydney. This study has also demonstrated the attractiveness of the near-infrared technique as a screening tool that could revolutionise the tracking and identification of contraband materials produced from horn and ivory biomaterials.
Syk inhibitor attenuates inflammation in lupus mice from FcgRIIb deficiency but not in pristane induction: the influence of lupus pathogenesis on the therapeutic effect
Authors: Issara-Amphorn Jiraphorn , Somboonna Naraporn , Pisitkun Prapaporn , Hirankarn Nattiya , Leelahavanichkul Asada
Published: July 2020

Macrophages are responsible for the recognition of pathogen molecules. The downstream signalling of the innate immune responses against pathogen molecules, lipopolysaccharide (LPS) and (1→3)-β-D-glucan (BG), and the adaptive immune response to antibodies, Fc gamma receptor (FcgR), is spleen tyrosine kinase (Syk). Because pathogen molecules and antibodies could be presented in lupus, impact of Syk and macrophages in lupus is explored. FcgR-IIb deficient (FcgRIIb-/-) mice, a model of inhibitory signalling loss, at 40 weeks old, but not pristane mice (a chemical induction lupus model) demonstrated spontaneous elevation of LPS and BG in serum from gut translocation despite the similarity in faecal microbiome analysis. Syk abundance in FcgRIIb–/– mice was higher than in pristane mice, possibly due to several Syk activators (anti-dsDNA, LPS and BG), and Syk inhibitor–attenuated proteinuria and serum cytokines only in FcgRIIb–/– mice. In addition, LPS + BG enhanced the expression of activating FcgRs, NF-κB and Syk, together with supernatant TNF-α predominantly in FcgRIIb–/– compared to wild-type macrophages. The inhibitors against Dectin-1, Syk and nuclear factor kappa B, but not anti-Raf-1, reduced supernatant TNF-α in LPS+BG-activated macrophages, implying Syk-dependent signalling. The pathogen molecules enhanced activating-FcgRs, without inhibition, through Syk, a shared downstream innate and adaptive signalling, is responsible for the hyper-responsiveness in FcgRIIb–/– macrophages. In conclusion, Syk inhibitor attenuated inflammation in FcgRIIb–/– but not in pristane mice, implying the influence of a lupus genetic background in treatment modalities.
Reproducing the military and heteropatriarchal normal: Army Reserve service as serious leisure
Authors: Catignani Sergio , Basham Victoria M
Published: July 2020

The notions that military violence engenders security and that military service is a selfless and necessary act are orthodoxies in political, military and scholarly debate. The UK Army Reserve’s recent expansion prompts reconsideration of this orthodoxy, particularly in relation to the suggestion that reservists serve selflessly. Drawing on fieldwork with British Army reservists and their spouses/partners, we examine how this orthodoxy allows reservists to engage in everyday embodied performances, and occasionally articulations, of the need to serve, in order to free themselves up from household responsibilities. This supposed necessity of military service necessitates heteropatriarchal divisions of labour, which facilitate participation in military service and the state’s ability to conduct war/war preparations. However, while reserve service is represented as sacrificial and necessary, it is far more self-serving and is better understood as ‘serious leisure’, an activity whose perceived importance engenders deep self-fulfilment. By showing that the performances of sacrifice and necessity reservists rely on are selfish, not selfless, we show how militarism is facilitated by such everyday desires. We conclude by reflecting on how exposing reserve service as serious leisure could contribute to problematizing the state’s ability to rely on everyday performances and articulations of militarism and heteropatriarchy to prepare for and wage war.
Moral distress in emergency and critical care nurses: A metaethnography
Authors: Arnold Tracey C
Published: July 2020

Background:

Moral distress has detrimental effects on nurses which impacts the entire healthcare cycle. Described as a crescendo effect, resolved situations of moral distress leave residue on the nurse with three potential outcomes: moral numbing, conscious objection to the situation, and burnout.

Objective:

This metaethnography strives to achieve a fuller understanding of moral distress by interpreting the body of qualitative work of moral distress in emergency and critical care nurses.

Method:

This study used the Noblit and Hare’s approach of interpretative synthesis. Ten studies met the criteria and were used in this synthesis.

Ethical considerations:

Ethical issues were minimal since no human subjects were involved. Ethical requirements were respected in all study phases.

Results:

The synthesis of qualitative research on moral distress resulted in one central theme, “the battle within,” and five subthemes.

Conclusions:

The unique nature of this nursing specialty resulted in a lasting inner conflict for nurses that is consistent with the previously described crescendo effect. The effects are complex and long lasting and may potentially affect the nurses’ future patient care.
Convergent and divergent trajectories of corporate governance
Authors: Gindis David , Veldman Jeroen , Willmott Hugh
Published: July 2020

This Special Issue revisits the classic question of comparative corporate governance research, namely whether national corporate governance systems are converging. More specifically, it focuses on several ‘convergence vectors’ which comprise the political, legal, economic and social arrangements that influence or drive the international trajectories of governance systems towards a common denominator. Taken together, the contributors to this Special Issue invite us to think critically about the functional explanations commonly mobilized in favour of convergence and consider instead the convergence debate from a broader and more interdisciplinary point of view.
PrabotulinumtoxinA-xvfs for the Treatment of Moderate-to-Severe Glabellar Lines
Authors: Gadarowski Mary B. , Ghamrawi Rima I. , Taylor Sarah L. , Feldman Steven R.
Published: July 2020

Objective

PrabotulinumtoxinA-xvfs (Jeuveau), a botulinum toxin type A, was approved by the Food and Drug Administration for the temporary improvement in the appearance of moderate-to-severe glabellar lines in February 2019. This article will review phase II and III clinical trials to assess the efficacy, safety, and clinical application of this novel, aesthetic-only drug.

Data sources

A systematic literature review was performed using the terms “glabellar lines AND prabotulinumtoxinA” in the PubMed database. ClinicalTrials.gov was searched to identify nonpublished studies.

Study Selection and Data Extraction

Articles written in English between November 2019 and June 2020 discussing phase II and phase III clinical trials were evaluated.

Data Synthesis

By the primary efficacy end point on day 30, more patients achieved a greater than 2-point improvement on the Glabellar Line Scale (GLS) at maximum frown compared with baseline on day 0. The proportions of participants who responded to treatment with prabotulinumtoxinA were 67.5% and 70.4% versus 1.2% and 1.3% in placebo groups across 2 identical clinical trials ( P < 0.001). Patients receiving prabotulinumtoxinA experienced greater improvement in GLS at maximum frown on day 30 (87.2%) compared with onabotulinumtoxinA (82.8%) and placebo (4.2%; P < 0.001). PrabotulinumtoxinA was well tolerated across all studies.

Relevance to Patient Care and Clinical Practice

This review provides a detailed analysis of the safety and efficacy of prabotulinumtoxinA-xvfs and includes special considerations to help guide patients and clinicians.

Conclusion

PrabotulinumtoxinA is a safe and effective new addition to the repository of available treatments for the appearance of glabellar lines.
Midterm Fate of the Contralateral Foot in Charcot Arthropathy
Authors: Waibel Felix W. A. , Berli Martin C. , Gratwohl Viviane , Sairanen Kati , Kaiser Dominik , Shin Laura , Armstrong David G. , Schöni Madlaina
Published: July 2020

Background:

The contralateral foot in Charcot arthropathy or neuroarthropathy (CN) is subject to increased plantar pressure. To date, the clinical consequences of this pressure elevation are yet to be determined. The aim of this study was to evaluate ulcer and amputation rates of the contralateral foot in CN.

Methods:

We abstracted the medical records of 130 consecutive subjects with unilateral CN. Rates of contralateral CN development and recurrence, contralateral ulcer development, and contralateral amputations were recorded. Statistical analysis was performed to identify possible risk factors for contralateral CN and ulcer development, and contralateral amputation. Mean follow-up was 6.2 (SD 4) years.

Results:

After a mean of 2.5 years, 19.2% patients developed contralateral CN. Female gender was associated with contralateral CN development (odds ratio 3.13, 95% confidence interval 1.27, 7.7). Overall, 46.2% patients developed a contralateral ulcer. Among the patients who developed contralateral CN, 60% developed an ulcer. Sanders type 2 at the index foot (midfoot CN) was significantly associated with contralateral ulcer development. Ulcer-free survival (UFS) differed significantly between patients with diabetes type 1 (median UFS 5131 days) and patients with diabetes type 2 (median UFS 2158 days). A total of 25 amputations had to be performed in 22 (16.9%) patients. Three of those 22 patients (2.3%) needed major amputation.

Conclusion:

Almost 20% of patients developed contralateral CN. Nearly half of people with CN developed a contralateral foot ulceration. Patients with type 2 diabetes had significantly shorter UFS than patients with diabetes type 1. Every sixth patient needed an amputation, with the majority being minor amputations. The contralateral foot should be monitored closely and included in the treatment in patients with CN.

Level of Evidence:

Level IV, retrospective study.
Virtual Manipulative-Based Intervention Package to Teach Multiplication and Division to Secondary Students With Developmental Disabilities
Authors: Bouck Emily C. , Shurr Jordan , Park Jiyoon
Published: July 2020

Mathematics instruction for students with intellectual disabilities and autism is important. However, it is imperative for researchers and practitioners to focus on the maintenance of mathematical concepts and not just acquisition for these students. Through a single-case multiple probe across participants study, researchers explored an intervention package consisting of a manipulative-based instructional sequence involving virtual manipulatives and then representations (i.e., drawings; referred to as the virtual-representational instructional sequence), explicit instruction, the system of least prompts, overlearning, and support fading to support students with intellectual disability and autism to acquire and maintain multiplication or division skills. The three middle school students who completed the entire intervention acquired and maintained their targeted mathematics skill—in multiplication or division. The results have implications for use of intervention packages to teach foundational mathematics skills to students with developmental disabilities.
Associations Between Hormonal Biomarkers and Preterm Infant Health and Development During the First 2 Years After Birth
Authors: Cho June , Chien Lung-Chang , Holditch-Davis Diane
Published: July 2020

Background:

Testosterone levels have been used to examine infant boys’ vulnerability to health and developmental problems, following the general theories of gender differences and the theory of extreme male brain of autism.

Objectives:

As testosterone is a representative androgen hormone and is higher in preterm than full-term infants, we used this steroid to determine if hypothalamic pituitary hormones, testosterone, and cortisol, were related to physical growth, health, and development of very-low-birthweight (VLBW, BW < 1,500 g) infants.

Method:

For this comparative longitudinal study, 40 VLBW infants were recruited from a neonatal intensive care unit of a tertiary medical center. Data were collected from medical record reviews, questionnaires, and assessments of infant development at 6, 12, and 24 months. We collected saliva at the three time points and measured hormones using enzyme-immunoassays.

Results:

General and generalized mixed models showed that a 1pg/ml increment of testosterone was related to a −0.42% decrease in body weight, a −0.18% decrease in length, and a −0.10% decrease in head circumference. Cortisol levels were not associated with any outcome variable. The interactions between testosterone and time on physical growth and socioemotional development also occurred.

Discussion:

Elevated testosterone levels can be a biological risk factor for poor infant growth and development. Theories about the effects of elevated prenatal testosterone could be useful in predicting health and developmental outcomes among VLBW infants. Research beyond the first 2 years will be needed as infants show more socioemotional and behavioral problems as they grow older.
Detection of serum uric acid in primary open angle glaucoma: A pilot study
Authors: Serra Rita , Coscas Florence , Pinna Antonio , Peri Marcella , Zucca Ignazio , Sellam Alexandre , Giancipoli Ermete , Boscia Francesco
Published: July 2020

Purpose:

To assess the association between the serum levels of uric acid (UA) and primary open-angle glaucoma (POAG).

Methods:

In this pilot study, 46 eyes of 23 patients with a clinical history of POAG and 30 eyes of 15 healthy subjects were included. All patients underwent a complete ophthalmological examination, including best corrected visual acuity (BCVA), intraocular pressure (IOP), and gonioscopy. Visual field parameters, such as mean deviation (MD) and pattern standard deviation (PSD), and optical coherence tomography (OCT) values of the optic nerve head, including retinal nerve fiber layer (RNFL) thickness and vertical cup/disc ratio (VCDR), were noted. A blood sample was collected from each subject for serum UA measurement.

Results:

IOP, MD, PSD, RNFL thickness, and VCDR resulted significantly different in POAG patients, when compared with controls ( p < 0.05). POAG patients showed significantly lower levels of mean serum UA than healthy controls (4.00 ± 0.66 mg/dL vs 4.95 ± 0.86 mg/dL, respectively, p < 0.0001). Furthermore, severe POAG patients showed mean serum levels of UA lower than mild POAG patients (3.36 ± 0.70 mg/dL vs 4.22 ± 0.51 mg/dL, respectively, p = 0.01). Visual field and OCT parameters were statistically correlated with the mean serum levels of UA in POAG eyes ( p < 0.05).

Conclusion:

Results suggest that in POAG patients, serum UA levels may be decreased and correlated with visual field and OCT parameters worsening. Further larger multi-center prospective studies are necessary to confirm our findings and establish the role of UA in glaucoma.
Corneal optical density in Fuchs endothelial dystrophy determined by anterior segment optical coherence tomography
Authors: Wertheimer Christian M , Elhardt Carolin , Wartak Andreas , Luft Nikolaus , Kassumeh Stefan , Dirisamer Martin , Siedlecki Jakob , Vounotrypidis Efstathios , Priglinger Siegfried G , Mayer Wolfgang J
Published: July 2020

Purpose:

In this study, we propose a method to grade corneal stromal opacity using optical density measurements by anterior segment optical coherence tomography (AS-OCT) and validate the approach in Fuchs endothelial corneal dystrophy (FECD).

Methods:

A retrospective analysis of human corneal OCT scans was performed on 48 eyes of 32 patients with FECD and 33 control eyes of 21 patients using the Carl Zeiss Cirrus HD-OCT 5000. In addition, corneal edema in fresh rabbit cadaver eyes was artificially induced by distilled water and imaged with the Thorlabs TELESTO-II spectral domain OCT at different time points during saturation. The increase of opacity due to corneal edema was proposed to directly correlate with enhanced reflectivity sites in the OCT images, corresponding to higher optical density. The increase was determined as the image area above a statistically established gray-scale value using ImageJ and correlated with other disease characteristics.

Results:

Optical densities in human corneas showed significant differences between FECD patients and the control group ( p = 0.002). The increased optical densities determined in FECD corneas correlated well with other disease characteristics such as corneal pachymetry or visual acuity. Likewise, rabbit corneas showed a time dependent increase in thickness and in corneal optical density during soaking in distilled water.

Conclusion:

This study presents corneal optical density by AS-OCT as an objective value for corneal changes in FECD. Complementing other diagnostic tools in FECD the assessment of corneal optical density may identify progression of FECD, gauge novel therapeutic strategies and support risk and benefit analyses for corneal surgery.
Targeting Nonsmokers to Help Smokers Quit: Features of a Large-scale Intervention
Authors: Tedeschi Gary J , Zoref Leslie S , Cummins Sharon E , Zhu Shu-Hong
Published: July 2020

Smoking continues to be a major public health problem, despite a substantial decline in prevalence rates over the last decades. Quit smoking interventions typically target smokers, whether through individual or group treatment or through broader public health campaigns. Yet, nonsmokers represent a vast and largely untapped resource to help smokers quit. This article describes an innovative approach that targeted nonsmokers through a media-style campaign with repeated reminders about smoking cessation. We tested the nonsmoker intervention in a large randomized trial and showed it to be effective in helping smokers quit. Components of the intervention included repeated mailings with relevant cessation messages over a 10-week period, 2 brief check-in telephone calls, and access to a study Web site. In this article, we discuss details of the intervention development, content, and implementation.
High Prudent diet factor score predicts lower relapse hazard in early multiple sclerosis
Authors: Simpson-Yap Steve , Oddy Wendy H , Taylor Bruce , Lucas Robyn M , Black Lucinda J , Ponsonby Anne-Louise , Blizzard Leigh , van der Mei Ingrid , Dear Keith , Dwyer Terry , Taylor Bruce V , Broadley Simon , Kilpatrick Trevor , Williams David , Lechner-Scott Jeanette , Shaw Cameron , Chapman Caron , Coulthard Alan , Pender Michael P , Valery Patricia
Published: July 2020

Background:

Dietary patterns and their association with subsequent clinical course have not been well studied in early multiple sclerosis (MS).

Objectives:

To describe dietary patterns in people in 5 years following first clinical demyelination and assess associations with MS conversion and relapse.

Methods:

This study included baseline food frequency questionnaire dietary intake (entry to the Ausimmune Study) and 5-year follow-up; iterated principal factor analysis was applied. MS conversion and relapse risks were assessed by Cox proportional hazards models, adjusted for age, sex, study site, education, body mass index (BMI), smoking and omega-3 supplement use.

Results:

In cases with a first clinical diagnosis of central nervous system (CNS) demyelination, we identified three major dietary patterns, ‘Prudent’, ‘High-Vegetable’ and ‘Mixed’, explaining 43%, 37% and 24% of diet variance in dietary intake, respectively. Fruits, vegetables, fish, wholegrains and nuts loaded highly on the Prudent pattern, starchy vegetables and legumes on the High-Vegetable pattern, and meats and alcohol on the Mixed pattern. Diet factor scores were not associated with MS conversion risk. Those with baseline Prudent scores above the median had significantly lower relapse risk (adjusted hazard ratio = 0.54, 95% confidence interval (CI) 0.37, 0.81) with some evidence of a plateau effect.

Conclusion:

Prudent diet factor score above the median was prospectively associated with lower relapse risk in the 5 years following the first clinical demyelinating event.
The influence of theocratic rule and political turmoil on tourists’ length of stay
Authors: Hateftabar Fahimeh , Chapuis Jean Michel
Published: July 2020

The average tourist’s length of stay (LOS) is in a global decline. This downward trend underscores the need to study the factors that affect this variable in order to enable more effective management and marketing. This paper moves beyond the literature by investigating the determinants of international tourists’ LOS in a Muslim destination amid political crisis. LOS was evaluated using a survival analysis approach with data from 726 international tourists in Tabriz, Iran to ascertain the significant factors influencing trip length. The results reveal that the determinant factors are as follows: socio-demographic profiles, trip characteristics, and destination attributes. In addition, political turmoil and religious regulations are pivotal factors in LOS. The empirical findings provide valuable theoretical contributions to researchers and actionable guidance to tourism managers and marketers.
Language experience of immigrant women in bilingual couples with Poles
Authors: Stępkowska Agnieszka
Published: July 2020

Aims and objectives/purpose/research questions:

The article focuses on language experiences shared by female expatriates and aims to investigate the circumstances which are related to their language acquisition and communication in the couple. The research question concerns the degree of socialization of these women into the Polish language as adult bilinguals via marriages to Poles.

Design/methodology/approach:

Based on my recent data from in-depth interviews, analyzed by means of qualitative methodology, I concentrate on the sociolinguistic complexity of bilingual couples in Poland.

Data and analysis:

I analyze excerpts of interviews produced by eight couples of immigrant women who settled down in Poland to live with Poles. I investigate these women’s talk with regard to their subjective evaluations of language repertoires resulting from their individual histories of L2 acquisition and their language ideologies reflected in communication patterns with their Polish husbands.

Findings/conclusions:

My data suggest that language competence relates to the communication quality in cross-lingual and intercultural couples, as subjectively assessed by the target women. I found evidence for apparent reshuffles in language repertoires, an appreciation for formal language learning and the specific hierarchy of priorities in private communication. The results reveal language attitudes which affect the dyadic communication and the sense of ethnicity among mixed couples.

Originality:

The article views multilingualism and immigration from a new perspective by giving the voice to women living in bilingual couples. The novelty relies on the less studied Polish context where immigrant women from different ethnic backgrounds share language experiences and life situations.

Significance/implications:

This is significant because the qualitative investigation of the socialization process through language helps understand and interpret linguistic phenomena in terms of the meanings brought to intercultural relationships.
From peat to Google power: Communications infrastructures and structures of feeling in Groningen
Authors: Mayer Vicki
Published: July 2020

This article further develops Raymond Williams’ concept of structures of feeling as plural, competing and sometimes antagonistic. This theoretical work is done through capturing the dual structures of feeling surrounding the development of a Google data center in the Groningen region from 2015 to the present. To understand how people understood this industrial development, the article traces both a regional and an urban structure of feeling back more than 400 years through the histories of other infrastructures in the Northern Netherlands. Conflicts around the meaning of the Google data center thus can be better understood as extensions of longer communications infrastructural histories and their embedded social tensions. This article is based on a paper presented at the Media in Transition symposium (Utrecht, June 28, 2018), in the Industries and Infrastructures panel organised by Judith Keilbach. Also published in this issue of ECS are Amanda D. Lotz, ‘Unpopularity and cultural power in the age of Netflix: new questions for cultural studies’ approaches to television texts’ and Jennifer Holt & Michael Palm, ‘More than a number: the telephone and the history of digital identification’.
A Systematic Literature Review of Animal-Assisted Interventions in Oncology (Part II): Theoretical Mechanisms and Frameworks
Authors: Holder Timothy R. N. , Gruen Margaret E. , Roberts David L. , Somers Tamara , Bozkurt Alper
Published: July 2020

Animal-assisted interventions (AAIs) can improve patients’ quality of life as complementary medical treatments. Part I of this 2-paper systematic review focused on the methods and results of cancer-related AAIs; Part II discusses the theories of the field’s investigators. Researchers cite animal personality, physical touch, physical movement, distraction, and increased human interaction as sources of observed positive outcomes. These mechanisms then group under theoretical frameworks such as the social support hypothesis or the human-animal bond concept to fully explain AAI in oncology. The cognitive activation theory of stress, the science of unitary human beings, and the self-object hypothesis are additional frameworks mentioned by some researchers. We also discuss concepts of neurobiological transduction connecting mechanisms to AAI benefits. Future researchers should base study design on theories with testable hypotheses and use consistent terminology to report results. This review aids progress toward a unified theoretical framework and toward more holistic cancer treatments.
Management of the Left Subclavian Artery in TEVAR for Chronic Type B Aortic Dissection
Authors: Conway Allan M. , Qato Khalil , Nhan Nguyen Tran N. , Giangola Gary , Carroccio Alfio
Published: July 2020

Objectives:

Left subclavian artery (LSA) revascularization in thoracic endovascular aortic repair (TEVAR) remains controversial. Left subclavian artery coverage without revascularization can cause stroke and death. TEVAR has gained popularity for the treatment of chronic type B aortic dissection (cTBD). Using the Vascular Quality Initiative (VQI) database, we reviewed outcomes of LSA revascularization in TEVAR for cTBD.

Methods:

The VQI registry identified 5683 patients treated with TEVAR from July 2010 to July 2016, including 208 repairs for cTBD. We analyzed outcomes per the Society for Vascular Surgery reporting standards.

Results:

Of the 208 patients, 150 (72.1%) were male with a median age of 65.0 years (interquartile range [IQR], 55.0-72.0). Median aneurysm diameter was 5.7 cm (IQR, 5.0-6.5 cm). Data on the patency of the LSA was available in 131 (63.0%) patients. Twenty-five (19.1%) had occlusion of the LSA without revascularization, while 106 (80.9%) maintained patency or had revascularization. Successful device delivery occurred in all 131 (100%) patients. Maintaining LSA patency did not affect the rate of cerebrovascular accident ( P = .16), spinal cord ischemia ( P = 1.00), or death ( P = 1.00). This was also nonsignificant when analyzing the subgroup of 98 elective cases. There was no difference in the rates of endoleak. Any intervention for the LSA (revascularization or occlusion) led to a longer procedure time (203.6 minutes vs 163.7 minutes, P = .04).

Conclusions:

Maintaining LSA patency during TEVAR for cTBD offers no advantage in perioperative morbidity or endoleak. Occlusion of LSA may be performed safely in this cohort and revascularization reserved for those who have anatomy that compromises perfusion to critical organs.