bluuebunny/crossref_metadata_2025 huggingface dataset:
The Development and Piloting of a Digital Checklist to Increase Access and Usage of Campus Online Sexual Violence Resources
Authors: Corcoran Casey T. , Miller Elizabeth , Sohn Lisa , Chugani Carla D.
Published: May 2020

As colleges seek to respond to campus sexual assault, administrators are making policies, programs, and resources related to sexual violence available to students and members of the school community online. Keeping this content current and accessible can be challenging in the context of rapidly changing information and competing priorities across campuses. In response to this challenge, we developed a free, online protocol for campus leaders to quickly assess gaps in their online sexual violence resources. The “Digital Checklist” delineates action steps that campus administrators can take to determine whether information related to campus sexual assault is easily located, current, relevant, and accessible. We found that while schools made an effort to increase the availability of information online, the checklist helped identify gaps that, if remedied, would allow more students to access that information. The overall goal for the checklist is to provide schools with actionable, real-time, and trackable data regarding the utility and accessibility of online sexual violence information and resources and to complement other campus sexual assault prevention and intervention efforts.
One-year real-life results on effect of intravitreal aflibercept in patients with diabetic macular oedema switched from ranibizumab
Authors: Lukic Marko , Williams Gwyn , Shalchi Zaid , Patel Praveen J , Hykin Philip G , Hamilton Robin D , Rajendram Ranjan
Published: May 2020

Purpose

To assess visual and optical coherence tomography–derived anatomical outcomes of treatment with intravitreal aflibercept (Eylea®) for diabetic macular oedema in patients switched from intravitreal ranibizumab (Lucentis®).

Design

Retrospective, cohort study.

Participants

Ninety eyes (of 67 patients) receiving intravitreal anti–vascular endothelial growth factor therapy were included.

Methods

This is a retrospective, real-life, cohort study. Each patient had visual acuity measurements and optical coherence tomography scans performed at baseline and 12 months after the first injection of aflibercept was given.

Main Outcome Measures

We measured visual acuities in Early Treatment Diabetic Retinopathy Study letters, central foveal thickness and macular volume at baseline and at 12 months after the first aflibercept injection was given.

Results

Ninety switched eyes were included in this study. The mean (standard deviation) visual acuity was 63 (15.78) Early Treatment Diabetic Retinopathy Study letters. At baseline, the mean (standard deviation) central foveal thickness was 417.7 (158.4) μm and the mean macular volume was 9.96 (2.44) mm3. Mean change in visual acuity was +4 Early Treatment Diabetic Retinopathy Study letters (p = 0.0053). The mean change in macular volume was −1.53 mm 3 in SW group (p = 0.21), while the change in central foveal thickness was −136.8 μm (p = 0.69).

Conclusion

There was a significant improvement in visual acuity and in anatomical outcomes in the switched group at 12 months after commencing treatment with aflibercept for diabetic macular oedema.
Ophthalmology and SARS-CoV-2: Blind toward those who fight blindness?
Authors: Arrigo Alessandro , Aragona Emanuela , Parodi Maurizio Battaglia , Loperfido Francesco , Bandello Francesco
Published: May 2020

SARS-CoV-2 infection recently reached pandemic proportions, with high risk of death for the worldwide population. In this dramatic scenario, all the resources are addressed to the intensive care units for the assessment of the emergency. However, more attention should be paid with respect to the risk of viral diffusion among asymptomatic people. Italy is the second most involved country in the world, and we needed to gain a lot of experience in a very limited time. At least 1 m of distance among people is recommended; however, some clinical practices cannot allow this distance. In this context, we believe that the careful safety assessment of clinical settings, like ophthalmologic ones, may have a remarkable impact on the fight against SARS-CoV-2 spread.
How are Substance Use Disorder Treatment Programs Adjusting to Value-Based Payment? A Statewide Qualitative Study
Authors: O’Grady Megan A. , Lincourt Patricia , Gilmer Evan , Kwan Michael , Burke Constance , Lisio Carla , Neighbors Charles J.
Published: May 2020

Healthcare systems are implementing value-based payment (VBP) arrangements in efforts to incentivize cost-effective, high quality of care. These arrangements represent a major shift for substance use disorder (SUD) treatment providers who may need to make changes to their clinical and business operations to meet new demands for quality under value-based contracts. This qualitative study was conducted in the context of New York State’s efforts to implement VBP among SUD treatment providers to understand their experiences, challenges, and needs. Five focus groups were conducted across the State with a total of 68 treatment professionals. Content analysis was conducted and five themes emerged. First, competing demands, limited workforce and technology infrastructure, and perceived lack of information were leading to overwhelmed administrators. Second, confusion and financial fear was being driven by the need for new clinical roles, business practices, and external partnerships. Third, providers were undertaking a number of measures to address workforce needs. Fourth, providers were building new business models and clinical practices. Fifth, providers desired more support and information. As VBP models are being adopted, healthcare systems should identify ways to mitigate challenges and support SUD treatment providers that may have limited resources to address complex workforce, client, and infrastructure needs.
‘Hey Alexa, what did I forget?’: Networked devices, Internet search and the delegation of human memory
Authors: Atkinson Paul , Barker Richie
Published: May 2020

This article examines how we increasingly delegate the task of memorisation to networked devices and associated applications, such as Google search. Human memory is supplemented by the proliferation of voice assistants embedded in mobile, wearable and situated devices that provide ready access to common knowledge as well as reminders for procedural tasks. Previous research in the field of transactive memory, investigating how search engines and networked information discourage memorisation, underpins the examination of these emergent technologies. However, the article extends the argument further by examining not just access to information but when it is interpolated into everyday activity and how this is facilitated by voice interfaces. At stake is deciding which aspects of our networked technology should be developed in order to support rather than supplant human memory in conscious decision-making.
Looking for contact-induced language change: Converbs in heritage Turkish
Authors: Turan Dilek , Antonova-Ünlü Elena , Sağın-Şimşek Çiğdem , Akkuş Mehmet
Published: May 2020

Aims and objectives/purpose/research questions:

The aim of the study is to contribute to the debate about a possible contact-induced change in the heritage language and to examine whether there is contact-induced language change at the morpho-syntactic level in Turkish spoken in Germany. We focus on the perception and use of the converbs –Ip and –IncA in heritage Turkish.

Design/methodology/approach:

The perception and production of the converbs –Ip and –IncA by 30 German–Turkish bilinguals, who were born and have resided in Germany, are compared with those of the control group.

Data and analysis:

Two tasks are used in the study: a grammaticality judgement task and a picture-story description task. Both quantitative and qualitative analyses are utilized.

Findings/conclusions:

The analysis of the perception of the converbs by the participants revealed that the bilinguals’ perception of the grammatical constructions with –IncA and of the ungrammatical constructions with –Ip and –IncA differed significantly from that of the monolinguals; however, the perception of the grammatical constructions with –Ip was found to be similar between the bilingual and monolingual groups. The analysis of the production of the converbs by the bilingual participants showed that they tended to use the converbs significantly less than the monolingual control group did. The qualitative analysis of the production task also revealed that there were several cases in the use of the converbs that could be considered as ungrammatical and/or unconventional.
Populist parties and foreign policy: The case of Italy’s Five Star Movement
Authors: Coticchia Fabrizio , Vignoli Valerio
Published: May 2020

The role of political parties in foreign policy is gaining increasing attention. Nonetheless, despite an extraordinary interest in ‘populism’, the foreign policy of populist parties has rarely been investigated. This article provides an innovative theoretical framework, applying it on a rare example of a ‘pure’ populist party: Italy’s Five Star Movement. How has Five Star Movement positioned on Italian contribution to military operations abroad? What does such positioning say about its ideological leaning? In order to address such questions, the article analyses Five Star Movement’s MPs’ votes and speeches on foreign policy during its first term in Parliament (2013–2018). We find that, notwithstanding some ambiguities, the Movement’s stance has been mostly pacifist and humanitarian, resembling more a ‘left-libertarian populist party’ than a ‘sovereigntist far-right one’. Through these findings, the article contributes to the debate on populist parties and foreign policy in Europe, clarifying also the elusive ideological leaning of the Five Star Movement.
Privatized Democracy: The Role of Election Services Vendors in the United States
Authors: Gibson Nadine Suzanne
Published: May 2020

Election equipment in the United States is exclusively purchased from private-sector vendors. When a jurisdiction purchases voting equipment, it is actually purchasing the hardware and software along with a variety of services for the initial implementation and long-term maintenance and support of the system. Election services constitute roughly one third of county-level election expenditures. The results of logistic regression analyses estimating the likelihoods of county purchases of different election services from election services vendors suggest a relationship between purchasing decisions and county demographics, namely the size of the minority population. Localities in states with centralized contracting systems were also substantially more likely to purchase all forms of vendor services.
A Case of Isolated External Iliac Vein Compression Syndrome and the Role of Advanced Imaging
Authors: Mukarram Osama , Dahal Khagendra , Azrin Michael , Lee Juyong
Published: May 2020

Isolated external iliac vein compression syndrome is an uncommon cause of nonthrombotic venous stenosis that causes chronic venous hypertension leading to painful swelling, skin discoloration, and ulcer formation. We present a case of an 86-year old man with refractory lower extremity edema for several years who had been treated with diuretics and antibiotics without relief of symptoms. With the help of invasive and noninvasive imaging modalities, we were able to diagnose and manage isolated nonthrombotic left external iliac vein stenosis as a result of ipsilateral external iliac artery compression.
Calciphylaxis and Mönckberg’s Arteriosclerosis in a Diabetic Patient
Authors: Fields Christina
Published: May 2020

Diffuse arterial calcification is characteristic of peripheral arterial disease (PAD), particularly in diabetic patients. In diabetic patients, the rates of PAD and the more advanced forms of vascular disease such as critical limb ischemia are higher, and vascular intervention is known to be more difficult and less effective. For 1 in 6 patients, below-knee amputations can result from microvascular disease without traditional PAD. Microvascular disease occurs in vessels with a diameter around 100 µm and is most commonly present in diabetic patients. Calciphylaxis is a life-threatening complex disorder that presents with painful ischemic skin lesions caused by occlusion of blood vessels in subcutaneous fat and dermis. Mönckberg’s arteriosclerosis results in extensive calcium deposits in the tunica media without obstruction into the lumen. This case highlights a young diabetic patient with rapidly progressing acute onset ulcers of the bilateral lower extremities status post beginning peritoneal dialysis. The patient underwent upper and lower arterial noninvasive studies, angiogram, computerized tomography angiography, and punch biopsy. The arterial duplex examinations were normal with the exception of noncompressible calcified vessels. Microvascular disease was correlated with angiogram. Computed tomography angiogram findings were conclusive for calciphylaxis and Mönckberg’s arteriosclerosis. Punch biopsy was performed to confirm calciphylaxis and patient was started on the appropriate treatment regimen. Unfortunately, limb salvage was not possible and amputations were ultimately performed. There are other vascular pathologies that are not associated with traditional large artery atherosclerosis, such as calciphylaxis and Mönckberg’s arteriosclerosis. Even with seemingly normal arterial testing, the prognosis can be catastrophic. Although rare, these additional disease processes should be considered in dialysis patients with acute ulcerations.
The Long-term Results of Proximal Interphalangeal Joint Arthroplasty of the Osteoarthritic Index Finger
Authors: Richards Tomos , Ingham Laura , Russell Ian , Newington David
Published: May 2020

Background: Arthroplasty of the proximal interphalangeal (PIP) joint is a widely performed procedure for patients with osteoarthritis. Its use in the index finger is often discouraged due to concerns over implant longevity and stability secondary to coronal forces this digit is exposed to during pinch. Methods: We analyzed 47 consecutive index finger silastic interposition arthroplasties, performed through a dorsal approach, at a mean follow-up of 5.15 years. Results: Only 2 patients had ulnar deviation greater than 15°. The reoperation rate was 12.8%, with only 1 finger requiring arthrodesis. The mean Visual Analog Scale score was 1.1; and of the whole series, only 1 patient would retrospectively have preferred a fusion. Conclusions: Our series shows that excellent functional results and patient satisfaction can be gained using silastic PIP joint arthroplasty in the index finger. We would advocate offering this procedure, especially in lower demand patients as an alternative to arthrodesis, with the benefit of providing good pain relief while preserving movement.
Outcomes After Flexor Tendon Injuries in the Pediatric Population: A 10-Year Retrospective Review
Authors: Huynh Minh N. Q. , Ghumman Ammara , Agarwal Amisha , Malic Claudia
Published: May 2020

Background: Pediatric outcomes after flexor tendon repairs are variable, and evidence in the literature remains scarce. Methods: Repair of pediatric flexor tendon injuries was reviewed over a 10-year period (2005-2015). Data collection consisted of patient demographics, injury characteristics, anesthetic choice, repair technique, rehabilitation protocol, American Society for Surgery of the Hand Total Active Motion (TAM) scores, and complications. Results: There were 109 patients included in our study, with a total of 162 digits injured and 235 flexor tendon injuries. The mean age was 12 ± 4.6 years. The small finger (48 of 162; 30%) and the flexor digitorum profundus tendon (126 of 235) were the most commonly injured. The mechanism of injury was mainly from a knife (46 of 109; 42.2%) in zone II (82 of 159; 52%). Injuries were mostly repaired under general anesthetic (61 of 104; 56%). The Kessler technique was the predominant repair mechanism (111 of 225 repairs; 49%). Most patients (103 of 109; 95%) had excellent or good TAM scores with 5 postoperative ruptures reported. The most common complication was stiffness (17 of 121 complications; 14%), with most patients having no complications ( 74 of 109 patients; 68%). Patients were commonly immobilized (mean 8.4 ± 10.3 weeks) with a splint (93 of 109; 85%). There were 85 patients who followed a postoperative rehabilitation protocol for 12 ± 18 weeks. Patient demographics, time of repair, injury characteristics, anesthetic choice, and rehabilitation protocol were not significantly correlated with TAM scores or complication rates. Conclusions: Pediatric tendon injuries have good outcomes with no predictive factors identified. Surgical repairs performed under local anesthetic have similar outcomes without increased rates of complications, but remain underused in the pediatric population.
Reaching out to the voter? Campaigning on Twitter during the 2019 European elections
Authors: Daniel William T. , Obholzer Lukas
Published: May 2020

This article draws upon the literature on comparative political institutions in order to re-examine the logic of Twitter usage during campaign periods, now that social media has become a standard tool that is used across the political spectrum. We test how electoral institutions and individual characteristics shaped Twitter activity during the 2019 European elections cycle and compare the nature of this usage with the previous 2014 campaign. Our findings allow for an evaluation of social media campaigning against the backdrop of its dynamic evolution, while also confirming its normalisation in the European elections’ revival of the Spitzenkandidat process. Rather than seeking to differentiate themselves from party-internal and external competitors or highlighting their own qualities, our findings suggest that Members of the European Parliament used Twitter in 2019 to emphasise the lead candidate that they have in common.
Political equality without social equality? Social distortion of voter turnout in the European elections 2019 across nine European capitals
Authors: Haußner Stefan , Kaeding Michael
Published: May 2020

Although we know a lot about why citizens vote or abstain in elections, the social inequality of low turnout in European elections has attracted little attention. This paper focuses on voter turnout in the last 2019 European elections and examines whether low voter turnout in second-order elections is automatically associated with high social inequality, using Tingsten’s law as inspiration. By contrasting a second-order election with other high and low turnout elections, the paper deepens our understanding of the mechanisms behind low turnout in European elections. Following the argument that the macrolevel social imbalances of low turnout can best be analysed at the neighbourhood level, we develop a small-scale analysis of turnout across nine capitals of the European Union for the 2019 European Parliament (election and perform a regression model with interaction effects to examine the effects between different types of elections. Our results do not find differences in the effect of neighbourhoods’ social context on voter turnout between these elections. Although turnout in all cities is socially biased across all types of elections, jeopardising the ideal of political equality across Europe, we find no evidence that the 2019 European Parliament elections were more socially unequal than other elections – regardless of their second-order nature.
Community-Dwelling Adults at Nutrition Risk: Characteristics in Relation to the Consumption of Oral Nutritional Supplements
Authors: Sulo Suela , Schiffer Linda , Sheean Patricia , Farrar Isabel , Partridge Jamie , Fitzgibbon Marian
Published: May 2020

Purpose: Nutrition risk and utilization rate of simple but effective interventions such as oral nutritional supplementation (ONS) in community settings in the United States, particularly among older adults, has received little emphasis. We conducted a cross-sectional study of community-dwelling adults ≥55 years of age and living independently to assess their risk of poor nutrition and characteristics in relation to ONS consumption. Methods: Demographic characteristics, activities of daily living (ADL), and health care resource utilization in the past 6 months were also collected via telephone survey. Nutrition risk was assessed with the abridged Patient-Generated Subjective Global Assessment (abPG-SGA) and the DETERMINE Checklist. A logistic regression model tested possible predictors of ONS use. Results: Of 1001 participants surveyed, 996 provided data on ONS use and 11% (n = 114) reported consuming ONS during the past 6 months. ONS users were more likely to be at high nutrition risk than nonusers based on both abPG-SGA (43% vs 24%, P < .001) and DETERMINE Checklist (68% vs 48%, P < .001) scores. ONS users reported less functional independence based on ADL scores (86% vs 92%, P = .03), taking ≥3 medications/day (77% vs 53%, P < .001), and utilizing more health care services. Higher nutrition risk (per abPG-SGA), lower body mass index, hospitalization in the past 6 months, and ≥3 medications/day were each independently associated with ONS use ( P < .05). Conclusions: Although one in four, urban community-dwelling adults (≥55 years of age) were classified as at high nutrition risk in our study, only 11% reported consuming ONS—a simple and effective nutrition intervention. Efforts to improve identification of nutrition risk and implement ONS interventions could benefit nutritionally vulnerable, community-dwelling adults.
Antenatal Care Practices Among Hard-to-Reach Fishing Communities on Lake Victoria: A Community-Based Cross-Sectional Survey
Authors: Ssetaala Ali , Nabawanuka Joan , Matovu Gideon , Nakiragga Nusula , Namugga Judith , Nalubega Phiona , Lutalo Kaluuma Henry , Perehudoff Katrina , Michielsen Kristien , Bagaya Bernard , Kiwanuka Noah , Degomme Olivier
Published: May 2020

Background: Uganda has one of the highest maternal deaths in sub-Saharan Africa, with a mortality ratio of 336 per 100 000 live births. Early regular antenatal care (ANC) helps prevent adverse outcomes, including deaths, through prevention, identification, treatment, and/or referral of at-risk women. We explored ANC practices and associated factors among women from hard-to-reach Lake Victoria islands fishing communities in Kalangala district, Uganda. Methods: A cross-sectional survey among 486 consenting women aged 15 to 49 years, who were pregnant or had a birth or abortion in the past 6 months was conducted in 6 island fishing communities of Kalangala district, Uganda, during January to May 2018. ODK software interviewer-administered questionnaires were used to collect data on sociodemographics and ANC practices. Regression modeling using STATA version 15 was used to determine factors associated with ANC visits. Results: Women’s median (range) age was 26 (15-45) years, 63% (304/486) had up to primary level education, 45% (219/486) were housewives (stay home mums), 87% (423/486) were married. ANC visits ranged from 0 to 10, with over three-fifths of women having their first visit late after 3 months of being pregnant (63%, 198/316). Women without a history of pregnancy loss (adjusted odds ratio [AOR] = 1.8, 95% CI 1.1-3.0), those not staying with their partners (AOR = 2.5, 95% CI 1.1-6.0), and those whose partners were working in fishing-related activities (AOR = 1.8, 95% CI 1.0-3.0) were likely to have started care late. Women from communities with a public health facility and those with partners working in none fishing-related activities had the highest predicted number of visits. Conclusion: Antenatal practices among these communities are characterized by late start of care. Community-led early ANC awareness interventions are needed. Targeted health policies need to consider public ANC facilities for each island for improved antenatal outcomes and maternal health.
The Role of North Carolina Medical Schools in Producing Primary Care Physicians for the State
Authors: Campbell Kendall M. , Infante Linares Jhojana L. , Tumin Dmitry , Faison Keia , Heath Miranda N.
Published: May 2020

Introduction: Primary care physicians serve on the front lines of care and provide comprehensive care to patients who may have difficulty accessing subspecialists. However, not enough students are entering residency in primary care fields to meet the primary care physician shortage. The authors sought to compare primary care match rates among graduates of medical schools in the state of North Carolina from 2014 to 2018. Methods: The 4 allopathic medical schools in the state of North Carolina were selected for this study: East Carolina University (ECU) Brody School of Medicine, University of North Carolina (UNC) Chapel Hill, Duke School of Medicine, and Wake Forest School of Medicine. Primary care specialties were defined as family medicine, internal medicine, pediatrics, and internal medicine/pediatrics. The proportion of students matching to a residency in any of these fields, and in each specific field, was compared across schools. Results: Over 2014-2018, 214 ECU Brody School of Medicine graduates, 386 UNC graduates, 165 Duke graduates, and 196 Wake Forest graduates matched to a primary care specialty. ECU had the highest proportion of its graduates match in a primary care specialty (53%, compared with 34% to 45% at other schools; P < .001), and was particularly distinguished by having the highest proportions of graduates match to residencies in family medicine (18%) and pediatrics (16%). Conclusion: During the study period of 2014-2018, the ECU Brody School of Medicine matched more medical students into primary care specialties than the other medical schools in the state. This school’s community-driven mission and rural location, among other characteristics facilitating sustained student commitment to primary care careers, can inform the development of new medical schools in the United States to overcome the primary care physician shortage.
Conceptualizing Dementia Crisis and Preferences for Resolution: A Public Perspective
Authors: Yates Jennifer A. , Stanyon Miriam R. , Redley Marcus , Coleston-Shields Donna Maria
Published: May 2020

Background: Crisis intervention services for people with dementia in the United Kingdom are poorly defined with no standardized model of working. This may be due to the lack of a clear conceptualization of dementia crisis, resulting in variation in national service delivery. Methods: This study employed a novel public engagement questionnaire data collection technique with 57 participants to gain an updated perspective on the concept of health-related crisis from the point of view of the public. Results: Analysis revealed crisis as a transformational moment that may arrive unexpectedly but could also be the culmination of a sequence of events. Crisis resolution requires external and expert help, and associated feelings of panic and despair can engender the task of resolution by oneself insurmountable. Conclusions: Participants had clear expectations of crisis intervention services, with initial practical and emotional support to reduce risks, and a person-centered approach with family involvement.
Effectiveness of Interpersonal Leadership for Engagement and Task Performance of Nurses
Authors: Habib Nazia , Awan Sajid Hussain , Naveed Shaheryar , Shoaib Akhtar Chaudhry
Published: May 2020

Transformational leadership has been studied as an essential trait for nurse leaders in the past; however, there is a dearth of studies on interpersonal leadership which is a combined construct of transformational leadership and interactional justice. The main objective of this article was to examine the relationship between interpersonal leadership and task performance. A cross-sectional research design was adopted for this study. 700 questionnaires were circulated among nurses from 14 major hospitals across the country. Out of these, 336 nurses replied. The final usable sample size was 283 full-time nurses, out of which 91.8% were female. The online and paper-based instruments were floated twice, at different timings with different cover letters to avoid common method bias. Nurses perceive that interpersonal leadership can significantly enhance their task performance. Similarly the study also found significant mediation of work engagement in the positive relationship between interpersonal leadership and task performance. Moreover, there was no significant difference between public and private sector nurses about interpersonal leadership and its relationship with work engagement and task performance. Interpersonal leadership has been found as significantly and positively effective toward work engagement and task performance of nurses working both in public and private sector hospitals. The results establish that by adopting the interpersonal leadership style, a nurse leader can enhance the work engagement of her followers. The study suggests that interpersonal leadership should be adopted as a total concept in nurse management to achieve better results in terms of work engagement and task performance.
Mind–Body Health Technique Liu Zi Jue: Its Creation, Transition, and Formalization
Authors: Shi Juan , Wang Rou-Jia , Wang Feng-yan
Published: May 2020

Liu Zi Jue, a traditional mind–body health technique, is highly regarded and has been widely spread nowadays due to its easy learning, easy operation, and demonstrable physical and psychological therapeutic value. However, due to the lack of understanding of its complex development process, practitioners and researchers are easily confused by different versions. This study identified the historical development of Liu Zi Jue systematically, and then divided it into three stages, including (a) the creation, which was a breathing regimen; (b) the transition, which became a therapeutic form of Vipassanā (insight meditation) and was identified as a new relationship between the six sounds and internal organs; and (c) the formalization, which became a comprehensive regimen that integrated Tu Na (breathing techniques in Qigong), mindfulness, Dao Yin (movement–breath–mind techniques, helping the stagnated Qi to flow smoothly), and natural and seasonal nurturing. Besides, future research directions are proposed.
Antecedents of Maternal Rejection Across Cultures: An Examination of Child Characteristics
Authors: Son Heimi , Lee Young Ae , Ahn Dong Hyun , Doan Stacey N. , Ha Eun Hye , Choi Yun Seo
Published: May 2020

Maternal rejection may be associated with individual child characteristics. This relationship may vary across cultures. This study aimed to identify group differences in maternal rejection as well as child characteristics. We also explored the moderating role of culture in influencing the relations between child characteristics and maternal rejection. In total, 153 mothers with a child aged 3 to 6 years participated in the survey. Participants were from the East Coast of the United States ( N = 48); Seoul, Korea ( N = 65); and Japan (Tokyo and Saitama) ( N = 40). American mothers perceived their children to be more active and extroverted than did Korean mothers, who perceived their children to be better at controlling their behavior than American and Japanese mothers. American mothers reported significantly higher levels of their children’s behavior problems than Korean and Japanese mothers. It was observed that culture moderated the relations between child factors (e.g., effortful control and internalizing problems) and maternal rejection. These findings suggest that culture influences the association between child characteristics (temperament and behavior) and maternal rejection.
Locational Contiguity and Business Continuity: Perceived Organizational Resilience of Small- and Medium-Sized Enterprises in U.K. Business Parks
Authors: Herbane Brahim
Published: May 2020

As the ability to respond and adapt to crises, we conceptualize and examine organizational resilience through four components (active, temporal, posture, and performance). This multidimensional view of resilience combines the perceptions of senior managers and other indicators including the presence and nature of formal business continuity management. This study examines whether relationships with neighboring firms in a business park substitute wider network relationships. Relationships between locational attributes (locational contiguity within a business park), entrepreneurs’ social networks, and the perceived resilience of small- and medium-sized enterprises (SMEs) in the United Kingdom are examined using data collected from 268 SMEs. Locational attributes are positively associated with organizational resilience (in both aggregated and constituent forms) while revealing an inverse relationship between social networks and perceived resilience. Importantly, the study contributes to a place-based view of resilience to explain why the impact of social networks differs from the positive associations that are found in prior theoretical and empirical work.
Adult Asthma Diagnosis: Physician Reported Challenges in Alberta-Based Primary Care Practices
Authors: Sharpe H. , Claveria-Gonzalez F. C. , Davidson W. , Befus A. D. , Leung J. P. , Young E. , Walker B. ,   on behalf of the Asthma Working Group, Respiratory Health Strategic Clinical Network, Alberta Health Services
Published: May 2020

Introduction

An estimated 8.1% of Canadians adults have asthma. While there are challenges associated with the use of objective measurement of lung function in the diagnosis of asthma, we are uncertain of the barriers that impact the use of objective measures, and have limited understanding of the challenges experienced by primary care providers in diagnosis of asthma. The objectives of this quality improvement initiative were to identify primary care providers’ methods of diagnosing asthma and to identify challenges with diagnosis.

Methods

An online survey was disseminated using a snowball methodology.

Setting

Primary care practices in Alberta, Canada.

Participants

A total of 84 primary care providers completed the survey.

Main Outcome Measures

Participants were asked their ideal and sufficient methods for diagnosing asthma and to identify challenges in their practice related to asthma diagnosis.

Results

They identified full pulmonary function testing (54%), pre- and postbronchodilator spirometry (54%), complete history and physical (42%), peak flow measurement overtime (26%), pulmonary consult (26%), and trial of asthma medication(s) (23%), as ideal methods of diagnosing asthma. The most significant barriers to diagnosis included episodic care–care provided typically during times of worsening symptoms without ongoing preventative/maintenance care (55%), patient follow-up (44%), conflict between clinical impression and pulmonary function results (43%), patient already on asthma medications (43%), and interpreting spirometry/pulmonary function results (39%).

Conclusion

The results of this survey indicate that the majority of primary care providers would choose full pulmonary function testing or pre- and postbronchodilator spirometry as the ideal methods of diagnosing asthma. However, barriers related to the nature of asthma care, patient factors, and challenges with diagnostic testing create challenges. This study also highlights that primary care providers have adapted to challenges in leveraging objective measurement and may rely upon other methods for diagnosis such as trials of medications.
Are Labor Market Institutions Countercyclical?
Authors: Thompson Daniel , Grabowski Lukasz
Published: May 2020

The deregulatory perspective on labor market institutions argues that such institutions push up wage and employment costs while discouraging hiring and job seeking. In contrast, an institutionalist perspective argues that labor market institutions support deeper skill formation and better job searches. Building on this literature, the authors focus on temporal variation, emphasizing that some labor market institutions are likely countercyclical: they can potentially limit job losses in economic downturns. For 21 countries from 1985 to 2012, the authors examine the association of labor market institutions with overall employment outcomes as well as how these associations vary during financial crises. They find limited first-order associations of institutions with employment outcomes, procyclical associations for union density, and countercyclical associations for unemployment insurance and employment protection legislation. These findings suggest that labor market institutions could be a useful countercyclical tool in an era of recurrent financial crises.
Increasing Internal Medicine Resident Confidence in Leading Inpatient Cardiopulmonary Resuscitations and Improving Patient Outcomes
Authors: Douthit Nathan T , McBride Christine M , Townsley Erin Coleman
Published: May 2020

Introduction:

Residents do not feel confident or competent in leading inpatient resuscitations. This is a crucial part of training future internists. Our objective was to develop a low-cost intervention to improve resident confidence in leading cardiopulmonary resuscitations and patient outcomes.

Methods:

A “code-conference” including a lecture on a high-yield topic, a low-fidelity simulation, and review of resident-led resuscitations was created at our institution for the 2017-2018 academic year. Patient outcomes were assessed using objective measures of return of spontaneous circulation (ROSC) and survival to discharge (sDC). Confidence was assessed via survey before and after the intervention, with a focus on beginning postgraduate year 2 (PGY-2) residents.

Results:

In 2017, 8 out of 8 (100%) PGY-2 residents responded, while in 2018, 8 out of 10 (80%) responded. Patient outcomes did not show a statistically significant improvement. There was a trend toward positive outcomes in the resident group alone. Return of spontaneous circulation increased from 63% to 79% ( P = .08, total n = 97). Resident confidence was not improved in a statistically significant way, but there was a trend toward improvement and residents agreed it was an important part of their training.

Discussion:

There was no statistically significant improvement in code-blue outcomes; however, there was a positive trend with increased ROSC and stable sDC for resident-led resuscitations, despite hospital-wide decreases in both. Resident confidence also showed a positive trend with no statistical significant changes. It is possible to institute a low-cost high-yield intervention to improved resident confidence in leading code-blue resuscitations. It may also improve patient outcomes; however, further studies are needed to determine if it can improve patient survival outcomes.
Effect of hygrothermal aging on the mechanical properties of IMA/M21E aircraft-grade CFRP composite
Authors: Shetty Kishora , Bojja Ramesh , Srihari Shylaja
Published: May 2020

Unidirectional carbon fiber-reinforced plastic (CFRP) IMA/M21E polymer composite was manufactured by standard autoclave curing method. This is a new aircraft-grade CFRP composite presently used in the manufacture of aircraft wing parts. Test specimens as per ASTM standards for weight gain, tensile and compression tests were obtained from this composite laminates. Some of the test specimens were subjected to hygrothermal (hot–wet) aging in an environmental chamber under three different conditions, that is, (i) 45°C/85% relative humidity (RH), (ii) 70°C/85% RH and (iii) 55°C/100% RH until reaching moisture absorption saturation. Matrix-dominated mechanical properties, that is, transverse tensile and longitudinal compression were determined for dry and hygrothermally aged test specimens. During mechanical testing in a servo-hydraulic test machine, the respective hygrothermal conditions were maintained while testing. It was noted that the rate of moisture absorption increases progressively and reaches saturation around 0.76–1.24 wt% depending on the aging conditions. Moisture absorption followed Fickian diffusion behavior in all the conditions of the study. Also, a software program was developed to predict the moisture content and time of saturation. The predicted results from this software program correlated with experimental results. It was observed that the presence of moisture reduced the tensile strength significantly by about 9–31% and compression strength by about 2–8%. Microscopic observation of tested samples was carried out using scanning electron microscope to study the failure behavior.
Determination of the Optimal Procalcitonin Threshold for Infection in Patients With Impaired Renal Function at a Community Hospital
Authors: Bowman Caitlin , Covington Elizabeth W.
Published: May 2020

Background: Procalcitonin (PCT) is a biomarker that can help identify bacterial infections but can be difficult to interpret in the presence of renal dysfunction, which can elevate PCT even in the absence of infection. Objective: To determine the optimal PCT threshold to identify infection in patients with renal dysfunction and pneumonia or sepsis. Methods: A retrospective analysis was performed for inpatients with creatinine clearance of ≤60 mL/min and PCT level from 2018 to 2019. A pharmacist blinded to study outcomes classified patients as infected or noninfected based on predetermined criteria. Receiver operating characteristic curve analysis was performed to establish the optimal PCT threshold overall, as well as in subgroups of patients with chronic kidney disease (CKD), acute kidney injury (AKI), and end-stage renal disease (ESRD). Institutional review board approval was obtained. Results: A total of 198 patients were included in the study (99 infected, 99 noninfected). The optimal threshold in the AKI, CKD, and ESRD subgroups was determined to be 1.5 ng/mL, 0.1 ng/mL, and 1.75 ng/mL, respectively. Conclusion: The results of this study show that PCT thresholds were specific to type of renal dysfunction. These results differ from the traditionally accepted PCT threshold of 0.5 ng/mL for sepsis and 0.25 mg/mL for pneumonia. Future studies should confirm the appropriate PCT threshold in ESRD and CKD patient populations.
Unexpected enhancement of FVIII immunogenicity by endothelial expression in lentivirus-transduced and transgenic mice
Authors: Shi Qizhen , Carman Christopher V. , Chen Yingyu , Sage Peter T. , Xue Feng , Liang Xin M. , Gilbert Gary E.
Published: May 2020

Factor VIII (FVIII) replacement therapy for hemophilia A is complicated by development of inhibitory antibodies (inhibitors) in ∼30% of patients. Because endothelial cells (ECs) are the primary physiologic expression site, we probed the therapeutic potential of genetically restoring FVIII expression selectively in ECs in hemophilia A mice (FVIIInull). Expression of FVIII was driven by the Tie2 promoter in the context of lentivirus (LV)-mediated in situ transduction (T2F8LV) or embryonic stem cell–mediated transgenesis (T2F8Tg). Both endothelial expression approaches were associated with a strikingly robust immune response. Following in situ T2F8LV-mediated EC transduction, all FVIIInull mice developed inhibitors but had no detectable plasma FVIII. In the transgenic approach, the T2F8Tg mice had normalized plasma FVIII levels, but showed strong sensitivity to developing an FVIII immune response upon FVIII immunization. A single injection of FVIII with incomplete Freund adjuvant led to high titers of inhibitors and reduction of plasma FVIII to undetectable levels. Because ECs are putative major histocompatibility complex class II (MHCII)-expressing nonhematopoietic, “semiprofessional” antigen-presenting cells (APCs), we asked whether they might directly influence the FVIII immune responses. Imaging and flow cytometric studies confirmed that both murine and human ECs express MHCII and efficiently bind and take up FVIII protein in vitro. Moreover, microvascular ECs preconditioned ex vivo with inflammatory cytokines could functionally present exogenously taken-up FVIII to previously primed CD4+/CXCR5+ T follicular helper (Tfh) cells to drive FVIII-specific proliferation. Our results show an unanticipated immunogenicity of EC-expressed FVIII and suggest a context-dependent role for ECs in the regulation of inhibitors as auxiliary APCs for Tfh cells.
Is fibroid location associated with hemorrhage and complication rates following laparoscopic myomectomy?
Authors: Aslan Kiper , Orhan Adnan , Türkgeldi Engin , Suer Ebru , Duzok Nergis , Özerkan Kemal , Ata Barış , Uncu Gürkan
Published: May 2020

Objective

To determine whether hemorrhage and complication rates vary according to the location of the dominant fibroid following laparoscopic myomectomy.

Background

Laparoscopic myomectomy is associated with less postoperative pain, analgesic requirement, shorter hospitalization period, and less febrile complications when compared to conventional laparotomy. Despite the advantages, complications like hemorrhage, blood transfusion, bowel and urinary tract injury, and conversion to laparotomy may be seen in laparoscopic myomectomy. We do not know whether the fibroid location affects these complications.

Materials and methods

Women, who underwent laparoscopic myomectomy at two different tertiary academic hospitals, were analyzed retrospectively. Only women with at least one intramural fibroid (Monroe type 3, 4, or 5) were included. Patients were categorized according to localization of the dominant fibroid, i.e., anterior uterine wall, posterior uterine wall, and fundus. Change in hemoglobin levels before and after surgery and complication rates were compared across categories.

Results

Two hundred nineteen women with a mean age of 35.7 ± 6 years were included. There were 81 women with fundal fibroid, 56 with anterior wall, and 72 with posterior wall fibroid. The other ten women with intraligamentary and isthmic fibroid were excluded. The mean fibroid diameter was 6.7 ± 2.6, 6.6 ± 2.3, and 6.7 ± 2.3 cm in the fundal, anterior, and posterior groups, respectively (p = 0.9). The median (25th–75th percentile) changes in hemoglobin levels were 1.5 (0.8–2.2), 1.3 (0.6–2.1), and 1.3 (0.9–2) g/dl in fundal, anterior, and posterior wall groups, respectively (p = 0.55). There were 5 (6.2%), 5 (8.9%), and 2 (2.8%) complications in fundal, anterior, and posterior wall groups, respectively (p = 0.33).

Conclusion

The incidence of hemorrhage or complication does not seem to vary depending on the fibroid location. However, the sample size was limited; observed values suggest that fibroid location does not affect hemorrhage and complication rates.
Improving the Conductivity of Solid Polymer Electrolyte by Grain Reforming
Authors: Wei Zhaohuan , Ren Yaqi , Wang Minkang , He Jijun , Huo Weirong , Tang Hui
Published: May 2020

Polyethylene oxide (PEO)-based solid polymer electrolyte (SPE) is considered to have great application prospects in all-solid-state li-ion batteries. However, the application of PEO-based SPEs is hindered by the relatively low ionic conductivity, which strongly depends on its crystallinity and density of grain boundaries. In this work, a simple and effective press-rolling method is applied to reduce the crystallinity of PEO-based SPEs for the first time. With the rolled PEO-based SPE, the LiFePO4/SPE/Li all-solid li-ion battery delivers a superior rechargeable specific capacity of 162.6 mAh g−1 with a discharge-charge voltage gap of 60 mV at a current density of 0.2 C with a much lower capacity decay rate. The improvement of electrochemical properties can be attributed to the press-rolling method, leading to a doubling conductivity and reduced activation energy compared with that of electrolyte prepared by traditional cast method. The present work provides an effective and easy-to-use grain reforming method for SPE, worthy of future application.