bluuebunny/crossref_metadata_2025 huggingface dataset:
Biological and microbiological performance of new polymer-based chitosan and synthesized amino-cyclodextrin finished polypropylene abdominal wall prosthesis biomaterial
Authors: El-Ghoul Yassine
Published: May 2020

This study deals with the development of a polypropylene (PP) artificial abdominal wall prosthesis textile with improved biological and antibiotic delivery properties. This added functionality was obtained by finishing of PP prosthesis textile with chitosan (CS), synthesized per-amino-cyclodextrin (CD-NH2) and polyacrylic acid (PAA). The finishing process involved polymerization between the three last mentioned reactants, which generated a cross-linked polymer that coated the PP surface meshes. Then different characterizations were performed on our wash-resistant functionalization to evaluate its efficiency. Firstly, wettability performance, for various grafting rates of the PP biomaterials, was assessed via the drop contact angle technique. Then, a mechanical characterization through an evaluation of the tensile strength revealed no influence of our grafting procedure on these properties. Scanning electron microscopy analysis was performed to evaluate the grafting mode and its effectiveness. Inclusion complex formation between the ciprofloxacin and both CD-NH2 and its polymer were studied via isothermal titration calorimetry measurements. Antibiotic sorption capacities of treated and untreated textile samples were then studied by batch assessments coupled with spectrophotometric analysis. The biological and microbiological properties of the PP mesh functionalized with the CS-CD-NH2 polymer and charged by selected antibiotic were assessed by cell culture analysis. After 3 and 6 days of cell contact, the results revealed an improved proliferation and adhesion of NIH3T3 fibroblastic cells and no obvious cytotoxicity on the chemical functionalized substrate. Finally, in vitro antimicrobial activity of the CS-CD-NH2-grafted PP biomaterial previously loaded with antibiotic was evaluated against the different bacteria strains, Staphylococcus aureus, Enterococcus faecalis and Escherichia coli. Results revealed a greatly superior activity with the functionalized PP meshes compared to that of the untreated PP within a 24 h batch experiment in human blood plasma medium. In summary, the different results from the present study provide an insight into the efficient performance of CS/CD-NH2 polymer as drug delivery system for various applications in the field of medical biomaterials.
Credibility Perceptions and Detection Accuracy of Fake News Headlines on Social Media: Effects of Truth-Bias and Endorsement Cues
Authors: Luo Mufan , Hancock Jeffrey T. , Markowitz David M.
Published: May 2020

This article focuses on message credibility and detection accuracy of fake and real news as represented on social media. We developed a deception detection paradigm for news headlines and conducted two online experiments to examine the extent to which people (1) perceive news headlines as credible, and (2) accurately distinguish fake and real news across three general topics (i.e., politics, science, and health). Both studies revealed that people often judged news headlines as fake, suggesting a deception-bias for news in social media. Across studies, we observed an average detection accuracy of approximately 51%, a level consistent with most research using this deception detection paradigm with equal lie-truth base-rates. Study 2 evaluated the effects of endorsement cues in social media (e.g., Facebook likes) on message credibility and detection accuracy. Results showed that headlines associated with a high number of Facebook likes increased credibility, thereby enhancing detection accuracy for real news but undermining accuracy for fake news. These studies introduce truth-default theory to the context of news credibility and advance our understanding of how biased processing of news information can impact detection accuracy with social media endorsement cues.
Considerations for Principals: Service Animals in K-12 Public Schools
Authors: Sears Julie A. , Driscoll Lisa G. , Sughrue Jennifer A.
Published: May 2020

Whether principals are required to allow service animals in the public schools is not entirely clear in law, policy, or practice. The matter is further complicated when the alleged harm caused by denying a request for a service animal is not clearly related to the educational program. The purpose of this article is to inform principals about the current laws and regulations that govern student requests regarding service animals, including a description of the rights and responsibilities of both students and school personnel in public schools. Guidance on developing actionable policies consistent with Fry v. Napoleon Community Schools, Americans with Disabilities Act of 2011, Individuals with Disabilities Education Act of 2004, and Section 504 of the Rehabilitation Act, 1973, is provided.
Relationship between Hospital Characteristics and Value-Based Program Measure Performance: A Literature Review
Authors: Renee Rutter Shannon , Park Shin Hye
Published: May 2020

Determining if the Centers for Medicare and Medicaid’s value-based programs accurately represent the quality of care provided by acute-care hospitals is critical. We performed an integrative literature review to summarize research articles examining hospital characteristics associated with overall performance on the value-based program measures. The literature review was conducted by searching the PubMed and CINAHL databases. The initial search returned 18 relevant articles, 12 of which met all inclusion criteria. The emergent hospital characteristics that heavily influenced value-based program performance included size, safety-net status, geographical location, and teaching status. This review determined that many factors largely outside of acute-care hospitals’ control create observed differences in value-based program performance. Additional factors such as a hospital’s patient populations, socioeconomic status, and level of acuity may need to be considered prior to assigning financial penalties to under-performing hospitals.
Kidnapping migrants as a tactic of border enforcement
Authors: Tazzioli Martina , De Genova Nicholas
Published: May 2020

This article identifies and analyses the tactic of kidnapping migrants that is increasingly deployed by states to disrupt, decelerate, and block migrants’ mobility. Kidnapping, we argue, is one of the political technologies of capture used by state authorities in their efforts to reassert control over migratory movements. This analysis contributes to a new understanding of the politics of border enforcement through strategies aimed at the containment of migration. The article focuses on the U.S.–Mexico border and the European border in the Mediterranean Sea as crucial sites where states have increasingly engaged in heterogenous modes of kidnapping.It also considers migrant struggles against these diverse kidnapping tactics. Through a focus on kidnapping, the article expands how we understand border violence and interrogates accounts of the biopolitics and necropolitics of borders that rely on the overly reductive formula of ‘making live/letting die’. The article concludes by highlighting how the critical examination of kidnapping migrants allows us to trace affinities and partial continuities among various historical modes of racialised subjugation that have affected both contemporary migrants and previously colonised populations.
Effectiveness of Official Development Assistance in the Health Sector in Africa: A Case Study of Uganda
Authors: Sobtafo Nguefack Cyriaque Rene
Published: May 2020

This qualitative explanatory case study assessed the influence of Official Development Assistance on selected health development indicators in Uganda between 2005 and 2013 by reviewing development partners’ perceptions. Key health indicators included the following: (a) under 5-year-old mortality rates, (b) infant mortality rates, and (c) maternal mortality ratio. Results indicated slow progress in reducing infant mortality and under-5 mortality rates and almost no progress in the maternal mortality ratio despite the disbursement of a yearly average of nearly $400 million USD in the last 7 years to the health sector in Uganda. Five bottlenecks in the influence of development assistance on health indicators were identified: (a) poor governance and accountability framework in the country, (b) ineffective supply chain of health commodities, (c) negative cultural beliefs, (d) insufficient government funding to health care, and (e) insufficient alignment of development assistance to the National Development Plan and noncompliance with the Paris Declaration on Aid Effectiveness.
Free-breathing BLADE acquisition method improves T2-weighted cardiac MR image quality compared with conventional breath-hold turbo spin-echo cartesian acquisition
Authors: Liu Jingjing , Jin Hang , Chen Yinyin , Fu Caixia , Chen Caizhong , Zeng Mengsu
Published: May 2020

Background

Cardiac magnetic resonance (MR) has become an essential diagnostic imaging modality in cardiovascular disease. However, the insufficient image quality of traditional breath-hold (BH) T2-weighted (T2W) imaging may compromise its diagnostic accuracy.

Purpose

To assess the efficacy of the BLADE technique to reduce motion artifacts and improve the image quality.

Material and Methods

Free-breathing TSE-T2W imaging sequence with cartesian and BLADE k-space trajectory were acquired in 20 patients. Thirty patients underwent conventional BH turbo spin-echo (TSE) T2W imaging and free-breathing BLADE T2W (FB BLADE-T2W) imaging. Twenty-one patients who had a signal loss of myocardium in BH short-axis T2W turbo inversion recovery (TSE-T2W-TIR) were scanned using free-breathing BLADE T2W turbo inversion recovery (BLADE TSE-T2W-TIR). The overall image quality, blood nulling, and visualization of the heart were scored on a 5-point Likert scale. The signal loss of myocardium, incomplete fat suppression near the myocardium, and the streaking or ghosting artifacts were noted in T2W-TIR sequences additionally.

Results

The overall imaging quality, blood nulling, and the visualization of heart structure of FB BLADE-T2W imaging sequence were significantly better than those of FB T2W imaging with Cartesian k-space trajectory and BH TSE-T2W imaging sequence ( P<0.01). The FB BLADE TSE-T2W-TIR reduces the myocardium signal dropout ( P<0.05), incomplete fat suppression near myocardium ( P<0.05), and the streaking and ghosting artifacts ( P<0.05) in comparison with the BH TSE-T2W-TIR.

Conclusions

FB BLADE T2W imaging provides improved myocardial visibility, less motion sensitivity, and better image quality. It may be applied in patients who have poor breath-holding capability.
Professionals’ Understandings of and Attitudes to the Prevention of Sexual Abuse: An International Exploratory Study
Authors: McCartan Kieran , Uzieblo Kasia , Smid Wineke J.
Published: May 2020

Sexual abuse is a global issue and, therefore, responding to and preventing sexual abuse are global challenges. Although we have examples of and evidence for sexual abuse prevention initiatives internationally, these tend to come from a small, select group of countries (i.e., United Kingdom, United States, Canada, Germany, Netherlands, New Zealand, and Australia) and not from a broader global pool. This article will present the qualitative data from an online study ( n = 82), covering 17 countries, on professionals’ (i.e., people working in the arena of sexual offending from a clinical, criminal justice, policy, research, and/or practice perspective) perceptions sexual abuse prevention in theory, practice, and policy. The article identifies three main themes: (a) professionals’ understandings of the prevention of sexual abuse, (b) public understanding of sexual abuse prevention, and (c) governmental attitudes towards, and support of, sexual abuse prevention programs. The article highlights that, although there are similar understandings of sexual abuse prevention internationally, practice is characterised by national differences in the funding of, provision of, and public/policy perceptions of prevention as well as its impact on offending.
Situational Crime Prevention in Sexual Offenses Against Women: Offenders Tell Us What Works and What Doesn’t
Authors: Chiu Yi-Ning , Leclerc Benoit , Reynald Danielle M. , Wortley Richard
Published: May 2020

This study examined the perceived effectiveness of situational crime prevention (SCP) in sexual assault as rated by 140 offenders convicted for sex offenses against women in Australia. Participants were presented with three scenarios and asked to rate the perceived effectiveness of SCP techniques relating to guardianship, victim self-protective behavior, and crime prevention through environmental design (CPTED). Results indicate that the effectiveness of SCP methods was perceived to vary across different contexts. For offenses occurring in the private setting of an offender’s home, victim self-protective behavior was seen as most effective, followed by guardianship and CPTED. In public settings, although the perceived effectiveness of victim self-protective behavior remained the same, guardianship and CPTED were rated as significantly more effective. Further variations were identified regarding specific strategies. Findings highlight the nuances of offender decision making in different situations and environments, and provide the first empirical comparisons of SCP perceptions among sex offenders.
Persian participation measures for adolescents: A systematic review
Authors: Joveini Ghodsiyeh , Zareiyan Armin , Lajevardi Laleh , Khalafbeigi Mitra , Hassani Mehraban Afsoon
Published: May 2020

Introduction

Enhancing participation is the focus of occupational therapy. Comprehensive and accurate assessment ensures that clinicians can tailor an intervention to the client’s needs. This systematic review was completed to identify Persian adolescents’ participation measures and critically appraise them. It would be helpful in the selection of the most appropriate instrument to use in adolescent-related research and clinical practice.

Method

Ten bibliographic databases, four Iranian and six international, without year limits were searched up to June 2019. A systematic search was directed according to COSMIN guidelines for systematic reviews of patient-reported outcome measures and PRISMA guidelines (Systematic review registration: CRD42017073581).

Results

Seven measures were extracted from the articles. Reviewing the content and psychometric properties of the measures as well as the methodological quality of the studies indicated that the Modified Activity Questionnaire is the only measure with consistent and moderately reliable results. It measures adolescent participation in leisure activities but not all domains of participation.

Conclusion

There may be a growing need for adapting existing Persian measures or developing new ones based on specific age features related to puberty-stage alongside cultural, social and academic demands, which have a significant effect on adolescents’ participation in meaningful occupations. High methodological quality in designing such studies also has great importance.
Preliminary study of time estimation of daily activities in patients with chronic schizophrenia by questionnaire survey
Authors: Hoshino Aiko , Asakura Tatsumi , Cho Kilchoon , Murata Natsumi , Kogata Tomohiro , Kawamura Masashi , Kito Aki , Kato Urara
Published: May 2020

Introduction

Few studies have investigated time estimation of daily activities in patients with mental illness. Therefore, we conducted a preliminary study to extract the characteristics of time estimation in patients with schizophrenia.

Method

We conducted an investigation using the Questionnaire of Time Experience in Daily Activities in patients with schizophrenia and healthy controls. We compared the results between schizophrenia patients and healthy controls using t-tests.

Results

Thirty-four people participated in each group. T-tests showed significantly shorter length of time answers in the schizophrenia group for question 4, (“How long does it take you to go out after waking up in the morning?”). For question 5 (“When you have to take a bus, how long before departure time do you arrive at the bus stop?”) and question 6 (“You have an appointment with your friend. How long beforehand do you arrive at the appointed place?”), the answers of the schizophrenia group were significantly longer than the healthy controls.

Conclusion

Time estimations of some daily activities of patients with schizophrenia were significantly different from those of healthy controls. This study will support the next phase of psychometric testing of the Questionnaire of Time Experience in Daily Activities, after which the results will applicable to practice.
Veteran Treatment Court Clients’ Perceptions of Procedural Justice and Recidivism
Authors: Atkin-Plunk Cassandra A. , Armstrong Gaylene S. , Dalbir Nicky
Published: May 2020

Studies surrounding the effectiveness of veterans’ treatment courts (VTCs) are now emerging. Absent from this scholarship is an examination of the presence of procedural justice within VTCs and the influence of procedural justice on future criminal behavior of VTC clients. To begin this dialogue, this study surveys 41 clients enrolled in two VTCs in a Southern state. We explore client perceptions of procedurally just treatment by their judge and assigned supervision officer. Using an average follow-up time of 20 months, this study also examines the effects of perceptions of procedural justice on recidivism of court clients. Results find VTC clients perceive their judge and supervision officer treat them in a procedurally just manner. Interestingly, perceptions of procedural justice during interactions did not result in reduced recidivism among the current sample. Policy and program implications along with recommendations for future research are provided.
Flowchart-aided design of a novel spatial flapping wing mechanism
Authors: Analooee Ali , Ghayour Mostafa
Published: May 2020

The flapping wing mechanism is an important member in flapping wing micro air vehicles. In this paper, a novel flapping wing mechanism and a framework to facilitate its design are introduced. High degree of symmetry and being free from sliders are two important features of this mechanism. The mentioned design framework consists of three algorithms for dimensional synthesis and one algorithm for mechanical design, which are presented in four flowcharts. In order to achieve the dimensional synthesis flowcharts, a parametric dimensional synthesis is performed, which includes examining the effects of different parameters on the important variables of design. The flowchart of mechanical design facilitates determining the optimized thicknesses of the mechanism members. The force analysis of the mechanism, as a part of mechanical design algorithm, is conducted using a MATLAB code based on the D'Alembert and superposition principles. An example of designing the mechanism using the introduced algorithms, a manufactured sample of the mechanism, and some alternative structures for the mechanism are presented in the final sections of the paper.
Homelessness among an inpatient HIV-positive cohort at a tertiary care hospital in central London
Authors: Sivaraj Venkateshwaran , Pittrof Rudiger , Davies Olubanke , Kulasegaram Ranjababu
Published: May 2020

A cohort review was conducted at a central London tertiary care hospital trust on the prevalence of homelessness among human immunodeficiency virus (HIV)-positive inpatients over a year. Data were collected on the duration of inpatient stay, co-morbidities including acquired immune deficiency syndrome (AIDS)-defining illnesses, co-infections, initiation of antiretroviral therapy, CD4 cell count, HIV viral load and substance misuse. Homeless people were found to be at high risk for hepatitis C, mental health illness, substance misuse including injecting drug use, recurrent bacterial infections, AIDS-associated illnesses, lower CD4 cell counts and HIV viremia. They also had more missed HIV outpatient appointments. It was highlighted that a multidisciplinary approach in their care was necessary to address their needs and reduce the morbidity burden in this cohort.
Online determination of coffee roast degree toward controlling acidity
Authors: Yergenson Nathan , Aston D Eric
Published: May 2020

Three methods of measuring coffee roast degree were compared using titratable acidity as an indicator of roast-dependent flavor change. The first roast degree method was based on prediction of the cracks with online near infrared spectroscopy and partial least squares regression, the second was based on changes in online near infrared absorbance, and the third was the common L* value from the CIELAB color space in the visible spectrum. Roasting trials utilized arabica coffee from eight origins in an air roaster, and results demonstrated the superiority of an online near infrared sensor for real-time roast degree measurement. A second dataset with constant temperature roasts showed how acidity can be controlled by changing both the roasting temperature and roast degree, finding the linear effects of roast time and roast degree on acidity.
High School English Language Arts Teachers and Postsecondary Outcomes for Students With and Without Disabilities
Authors: Theobald Roddy J. , Goldhaber Dan D. , Gratz Trevor M. , Holden Kristian L.
Published: May 2020

We used longitudinal data on high school students in Washington State to assess the relationships between English Language Arts (ELA) teacher qualifications and the high school and postsecondary outcomes of their students, and whether these relationships differed for students with and without disabilities. We found that students assigned to 10th-grade ELA teachers with higher value added had better test scores, were more likely to graduate on-time, and were more likely to attend and graduate from a 4-year college than observably similar students assigned to 10th-grade ELA teachers with lower value added. We also found that many of these relationships varied for students with and without disabilities, as 10th-grade ELA teacher value added was more positively predictive of on-time graduation and 4-year college attendance for students without disabilities, but more positively predictive of 2-year college attendance and employment within 2 years of graduation for students with disabilities.
Homicide in Eight Countries From 1980 to 2000: The Flow From Crimes Committed to Time Served in Prison
Authors: Farrington David P.
Published: May 2020

This article summarizes national data on completed homicides for eight countries in three time periods: around 1980, 1990, and 2000. The eight countries are England/Wales, the United States, Sweden, Australia, Scotland, Switzerland, the Netherlands, and Canada. In each year, the article presents the number of police-recorded crimes, the number of persons convicted, the number of offenders sent to custody, average sentence length, average time served, and all linking probabilities. It also shows changes in all these measures between 1980, 1990, and 2000 in different countries. It would be desirable to carry out longitudinal research, tracking offenders through the criminal justice system.
Invented religions and the conceptualization of religion in a highly secular society: The Jedi religion and the Church of Beer in the Czech context
Authors: Lužný Dušan
Published: May 2020

This study illustrates the need to develop efforts that define scientific terms, namely, ‘religion’. Despite the fact that such efforts may seem to be practically unattainable, current phenomena testify to the need to continually improve standardized scholarly terminology (such as Invented Religion, Parody Religion). Using specific material (of new religious phenomena in the Czech Republic, specifically the Jedi religion and the Church of Beer), the study identifies several key ambiguities stemming from the cultural and social context in which both contemporary new religions and academic study of religions coexist. The study concludes that in a highly secular society, where the continuity of religious memory is disrupted (as in the Czech Republic), the academic study of religions plays an important role, functioning as an authority for the decision-making of state institutions.
Particle image velocimetry investigation on air distribution of surface-source buoyancy plume changing heating intensity and structure size in a thermostatic chamber
Authors: Wang Xin , Xu Yukun , Yang Yinchen , Song Bingyan
Published: May 2020

For large space buildings like industrial plants with huge heat generation, the role that surface-source plumes play becomes more crucial. To study the air distribution and movement of plumes, the first step is to quantify how the airflow gets distributed in chambers. The experiment was carried out in a thermostatic chamber where there was no ventilation. Four hundred flow field snapshots (in each region) were measured by a two-dimensional particle image velocimetry system at a sampling frequency of 3 Hz, and the time-average flow field was processed by the adaptive correlation algorithm to quantify the air distribution of the plume. According to the measured data, the variation law of the axial velocity of the surface-source plume under different heat source parameters was analysed. The formula coefficients of the axial velocity, the extended radius and the mass flow of the plume were discussed, and the coefficients from current two mainstream methods and those obtained in this paper were compared. The results of this study will be useful to predict motion of surface-plumes and optimize airflow patterns in large spaces.
Thermal and flow resistance characteristics of a parallel-pipe type natural heat transfer air-conditioning terminal device for nearly zero energy buildings
Authors: Shu Haiwen , Wang Hongbin , Cao Guangyu
Published: May 2020

A nearly zero energy building (NZEB) can achieve significant energy saving by reducing its air-conditioning load greatly. At the same time, an NZEB should also achieve a comfortable thermal environment. In this paper, a parallel-pipe type natural heat transfer air-conditioning terminal device is proposed and studied for use in NZEB. The terminal device is able to provide both heating and cooling (including sensible and latent cooling) for a building without noise or air disturbance. The advantages of the terminal device have been demonstrated by comparing with other air-conditioning terminals. Experimental data of the heating and cooling performance of the device under different operation conditions were collected and analysed. The calculation models for the heating and cooling capacities of the device were obtained through data regression analysis, and the flow resistance curve of the device was obtained by means of experimental measurement under various flow rates. In addition, comparison was made on the heating and cooling capacities between the device and a radiant floor that also features little noise or air disturbance. Results show that the heating and cooling capacities of the device were 41.5% and 46.8% higher than the maximum capacities of the radiant floor, respectively. This research laid a foundation for the engineering application of the air-conditioning terminal device.
The nature and challenges of guest house business in the Maldives: An exploratory study
Authors: Chia Kei Wei , Muiz Abdulla
Published: May 2020

The Maldives has long been perceived as an exclusive and expensive travel destination. However, the political changes have introduced another accommodation option, the guest house. This has provided an opportunity for many locally owned guest house owners to offer accommodation service at an affordable rate. The purpose of this study was to explore the nature of business and the challenges faced by the guest house business in the Maldives. The data were derived from in-depth interviews with nine key informants. The thematic analysis qualitative method was employed in identifying informants’ view of the current guest house business. A total of six themes (i.e. product image, service quality, marketing channel, infrastructure, competition, policies, laws and regulations) were identified. The contribution of the paper lies in growing knowledge within the research niche of guest houses in the Maldives and internationally. Implications of the factors that contribute to successful guest house operations, including customer-oriented and service quality are recommended based on the findings. These recommendations can benefit guest house managers in developing and managing their guest house business. Future research may be expanded to view differences in perception among different stakeholders. Such findings could provide insights into what is missing and what topics require further investigation in the future.
The saliency of geographical landmarks for community navigation: A photovoice study with persons living with dementia
Authors: Seetharaman Kishore , Shepley Mardelle M , Cheairs Cayce
Published: May 2020

This study uses the photovoice method to explore how persons living with mild-to-moderate dementia perceive neighborhood landmarks and identify characteristics that render these landmarks salient for outdoor navigation. Previous research has highlighted the role of well-designed, stable geographical landmarks in improving the navigability of neighborhoods for persons living with dementia. However, the specific attributes that render landmarks salient have not yet been sufficiently explored, resulting in inadequate evidence-based environmental design guidelines for dementia-friendly communities. To address this gap, a photovoice study was conducted with five community-dwelling persons living with dementia and their care partners, as part of a dementia-friendly neighborhood walking program in the city of Seattle, USA. Photovoice facilitated the exploration of saliency of neighborhood landmarks from an emic perspective by (i) empowering persons living with dementia to identify and take photos of salient landmarks during the group walk and (ii) interpret and reflect on attributes that contributed to saliency using the photos as visual aids in a focus group discussion and survey questionnaire. Participants associated the saliency of landmarks with two groups of attributes: (i) visual distinctiveness, which encompassed physical aspects, such as size, shape, color, texture; and (ii) meaningfulness, which included subjective factors of personal and emotional significance that linked the landmarks to participants’ pasts, passions, hobbies, and emotions related to having dementia. Findings suggest that outdoor landmarks should be designed for maximum legibility and noticeability, as well as familiarity, recognizability, and memorability. The evidence from this research also points to the likely positive effect of salient neighborhood landmarks on the community navigation of persons living with dementia.
The Influence of Socioeconomic Status and Academic Standing on Concussion-Reporting Intentions and Behaviors in Collegiate Athletes
Authors: Lempke Landon B. , Rawlins Michelle L. Weber , Anderson Melissa N. , Miller L. Stephen , Lynall Robert C. , Schmidt Julianne D.
Published: May 2020

Concussion education have served as a keystone for improving concussion reporting. Numerous factors affecting concussion reporting have been explored; however, the role of socioeconomic status (SES) in reporting has not been established. We examined the influence of SES and academic achievement (high-school grade point average [HS-GPA] and American College Testing [ACT] composite scores) on athletes’ concussion-reporting intentions and behaviors. A cross-sectional study was employed among 191 athletes (94 female; age 19.3 ± 1.2 years). Athletes reported SES metrics (parental education and occupation, household income, HS-GPA, and ACT composite score) prior to their athletic season and completed a survey assessing symptom- and concussion-reporting intentions. Symptom- and concussion-reporting behaviors were assessed among athletes who experienced a concussion within the past year. SES was determined using the Hollingshead Four-Factor Index grouping athletes into SES strata. Athletes were grouped into low/high categories for academic achievement and household income variables. The 191 athletes were included for symptom- and concussion-reporting intentions analyses, while 46 and 41 were included for symptom- and concussion-reporting behavior, respectively. Nonparametric statistics with false discovery rate adjusted p values were employed. We found symptom- and concussion-reporting intentions, and symptom- and concussion-reporting behaviors were not significantly different based on SES strata (all p values ≥.64), household income (all p values ≥.64), HS-GPA (all p values ≥.24), or ACT scores (all p values ≥.25). Overall, SES and academic achievement may not play a role in understanding concussion reporting among middle- to high-SES collegiate athletes. Implementing policies targeting certain SES and academic levels might be an ineffective health care strategy for increasing reporting.
Effects of Testosterone Treatment on Quality of Life in Patients With Chronic Kidney Disease
Authors: Yeo Jeong Kyun , Koo Ho Seok , Yu Jihyeong , Park Min Gu
Published: May 2020

Testosterone deficiency (TD) is common and impairs quality of life (QoL) in patients with chronic kidney disease (CKD). However, there are no studies about whether testosterone replacement therapy (TRT) can improve QoL in patients with CKD. Therefore, we investigated the effect of TRT on the QoL of patients with CKD and confirmed the safety of TRT. Twenty-five male patients with stages III–IV CKD whose serum testosterone levels were <350 ng/dl (TD) were enrolled and treated with testosterone gel for 3 months (group II). Age-matched controls with stages III–IV CKD and TD (group I) were recommended to exercise for the same period. Before and after the treatment, the BMI and handgrip strength were checked, serological tests were performed, and questionnaires were administered in both groups. Compared to baseline, there was no significant difference in serum testosterone levels, scores of the 36-Item Short Form Health Survey (SF-36), Aging Males’ Symptoms Scale (AMS), and International Prostate Symptom Score (IPSS), and grip strength in group I after 3 months. In group II, a significant increase in testosterone, hemoglobin (Hb), and hematocrit (Hct) was observed, and grip strength significantly increased after TRT. Significant improvement in scores of SF-36, AMS, and IPSS was also confirmed after TRT in group II. There was a significant difference in testosterone, Hb, Hct, grip strength, and scores of SF-36, AMS, and IPSS between the two groups after 3 months. The patients in group II showed positive results and continued with TRT. Therefore, we conclude that TRT safely improves the QoL and TD symptoms in patients with moderate-to-severe CKD.
Androgen Treatment in Adolescent Males With Hypogonadism
Authors: Rey Rodolfo A. , Grinspon Romina P.
Published: May 2020

During adolescence, androgens are responsible for the development of secondary sexual characteristics, pubertal growth, and the anabolic effects on bone and muscle mass. Testosterone is the most abundant testicular androgen, but some effects are mediated by its conversion to the more potent androgen dihydrotestosterone (DHT) or to estradiol. Androgen deficiency, requiring replacement therapy, may occur due to a primary testicular failure or secondary to a hypothalamic–pituitary disorder. A very frequent condition characterized by a late activation of the gonadal axis that may also need androgen treatment is constitutional delay of puberty. Of the several testosterone or DHT formulations commercially available, very few are employed, and none is marketed for its use in adolescents. The most frequently used androgen therapy is based on the intramuscular administration of testosterone enanthate or cypionate every 3 to 4 weeks, with initially low doses. These are progressively increased during several months or years, in order to mimic the physiology of puberty, until adult doses are attained. Scarce experience exists with oral or transdermal formulations. Preparations containing DHT, which are not widely available, are preferred in specific conditions. Oxandrolone, a non-aromatizable drug with higher anabolic than androgenic effects, has been used in adolescents with preserved testosterone production, like Klinefelter syndrome, with positive effects on cardiometabolic health and visual, motor, and psychosocial functions. The usual protocols applied for androgen therapy in boys and adolescents are discussed.
Prognostic Value of Ultrasound Imaging of the Median Nerve in Carpal Tunnel Syndrome
Authors: Demino Cory , Fowler John R.
Published: May 2020

Background: Ultrasound has been well established as a diagnostic modality for carpal tunnel syndrome, but its prognostic utility has not been deeply investigated. Few studies, showing contradictory results, exist investigating ultrasound results as a predictor of patient outcomes. Methods: Patients with ultrasound measurement of the cross-sectional area (CSA) of the median nerve who completed the Boston Carpal Tunnel Questionnaire (BCTQ) and followed up after surgery were included in the study. A total of 199 wrists from 172 patients met the inclusion criteria. Preoperative CSA of the median nerve at the wrist was compared with change in BCTQ at various follow-up times postoperatively. Results: The BCTQ score was found on average to decrease for patients after surgery at all 3 follow-up times. There was a larger decrease in the preoperative BCTQ with each progressive follow-up time, with the largest change of 1.43 points coming at 6+ months. The average change in BCTQ at each follow-up time was found to be greater than the minimal clinically important difference. The greatest R2 for preoperative CSA compared with change in BCTQ was 0.0552 for the 6+ month visits. No specific CSA value or range above or below which patients have better postoperative outcomes was found. Conclusions: Higher preoperative CSA, signifying worse carpal tunnel severity, showed almost no correlation with better outcomes after carpal tunnel release surgery as measured by improvement in patient-reported outcome scores.
Infliximab treatment in refractory vascular Behcet’s disease: A single-center experience
Authors: Kehribar Demet Yalçın , Ozgen Metin
Published: May 2020

Objective

This study aims to investigate the efficacy and reliability of infliximab treatment in Behcet’s disease with vascular involvement.

Methods

This single-center retrospective study included a total of 18 patients diagnosed with Behcet’s disease with vascular involvement who were initiated infliximab treatment after exhibiting resistance to conventional immunosuppressive treatments.

Results

Seventeen patients achieved remission with infliximab treatment. While 18 patients were receiving a median of 50 (IQR: 20–61) mg/day equivalent of methylprednisolone before infliximab treatment, after infliximab treatment, only four patients were receiving 4 mg/day equivalent of methylprednisolone ( p < 0.001). Only 4 patients were receiving oral anticoagulant treatment during infliximab treatment, and compared to the patients who were not receiving oral anticoagulants, there was no significant difference between the two groups according to occurrence of new vascular events.

Conclusion

Infliximab seems to be an effective and reliable treatment in Behcet’s disease with vascular involvement and may also allow reduced dosage or even the discontinuation of corticosteroids. The results of our study suggest that oral anticoagulant use is unnecessary in Behcet’s disease with vascular involvement. However, further long-term randomized controlled studies are needed to investigate the length of infliximab regimen, whether or not it should be discontinued, and if so, whether or not immunosuppressants should be given as maintenance after discontinuation.
DEVT: A randomized, controlled, multicenter trial of direct endovascular treatment versus standard bridging therapy for acute stroke patients with large vessel occlusion in the anterior circulation – Protocol
Authors: Qiu Zhongming , Liu Hansheng , Li Fengli , Luo Weidong , Wu Deping , Shi Zhonghua , Liu Wenhua , Huang Wenguo , Fu Xinmin , Qiu Tao , Wang Li , Yang Shiquan , Zhang Shuai , Wang Yan , Bai Yongjie , Liu Xuan , Li Huagang , Liu Yong , Li Wei , Wan Yue , Ai Zhibing , Yao Xiaoxi , Luo Jun , Pu Jie , Zhou Zhiming , Wang Shouchun , Wen Changming , Ling Wentong , Liu Shudong , Yang Weimin , Zeng Guoyong , Wu Youlin , Guo Fuqiang , Chen Shengli , Huang Junjie , Wang Zhen , Peng Miao , Zhang Min , Zhou Peiyang , Chen Luming , Liu Shuai , Yue Chengsong , Yang Jun , Gong Zili , Shuai Jie , Sang Hongfei , Nogueira Raul G , Zi Wenjie , Yang Qingwu ,   on behalf of the DEVT study investigators
Published: May 2020

Background

Eight randomized controlled trials have consistently shown that endovascular treatment plus best medical treatment improves outcome after acute anterior proximal intracranial large vessel occlusion strokes. Whether intravenous thrombolysis prior to endovascular treatment in patients with anterior circulation, large vessel occlusion is of any additional benefits remains unclear.

Objective

This study compares the safety and efficacy of direct endovascular treatment versus intravenous recombinant tissue-type plasminogen activator bridging with endovascular treatment (bridging therapy) in acute stroke patients with intracranial internal carotid artery or middle cerebral artery-M1 occlusion within 4.5 h of symptom onset.

Methods and design

The DEVT study is a randomized, controlled, multicenter trial with blinded outcome assessment. This trial uses a five-look group-sequential non-inferiority design. Up to 194 patients in each interim analysis will be consecutively randomized to direct endovascular treatment or bridging therapy group in 1:1 ratio over three years from about 30 hospitals in China.

Outcomes

The primary end-point is the proportion of independent neurological function defined as modified Rankin scale score of 0 to 2 at 90 days. The primary safety measure is symptomatic intracerebral hemorrhage at 48 h and mortality at 90 days.

Trial registry number

ChiCTR-IOR-17013568 ( www.chictr.org.cn ).
Infertility: Understanding investigation and treatment options
Authors: Lafferty Kirsten , Allan Katherine , Saravelos Sotirios , Raglan Olivia
Published: May 2020

The World Health Organisation has defined infertility as the inability to become pregnant after 12 months of regular unprotected vaginal sexual intercourse. Primary infertility refers to couples that have never conceived, whereas secondary infertility refers to couples that have failed to conceive despite previous pregnancy. In the general population, 80% of couples are expected to be able to conceive within a year and 90% by the end of 2 years. With the rising trend for increasing maternal age at time of first pregnancy and the obesity epidemic, the incidence of infertility is likely to increase. Couples unable to conceive will seek help and advice from their GP. Infertility is highly emotive, and patients and their partners subject to investigation and management for infertility are likely to experience anxiety. Although primarily managed in secondary care, a robust understanding of investigation and treatment options for infertility can enable GPs to educate and support patients, as well as manage expectations.
Biomechanical Changes of Repair Tissue after Autologous Chondrocyte Implantation at Long-Term Follow-Up
Authors: Paatela Teemu , Vasara Anna , Nurmi Heikki , Kautiainen Hannu , Jurvelin Jukka S. , Kiviranta Ilkka
Published: May 2020

Objective. This study aims to describe biomechanical maturation process of repair tissue after cartilage repair with autologous chondrocyte implantation (ACI) at long-term follow-up. Design. After ACI, 40 patients underwent altogether 60 arthroscopic biomechanical measurements of the repair tissue at various time points during an up to 11-year follow-up period. Of these patients, 30 patients had full-thickness cartilage lesions and 10 had an osteochondritis dissecans (OCD) defect. The mean lesion area was 6.5 cm2 (SD 3.2). A relative indentation stiffness value for each individually measured lesion was calculated as a ratio of repair tissue and surrounding cartilage indentation value to enable interindividual comparison. Results. Repair tissue stiffness improved during approximately 5 years after surgery. Most of the increase in stiffness occurred during the first 2 years. The curvilinear correlation between relative stiffness values and the follow-up time was 0.31 (95% CI 0.07-0.52), P = 0.017. The interindividual variation of the stiffness was high. Lesion properties or demographic factors showed no significant correlation to biomechanical outcome. The overall postoperative average relative stiffness was 0.75 (SD 0.47). Conclusions. Our clinical study describes a biomechanical maturation process of cartilage repair that may continue even longer than expected. A substantial increase in tissue stiffness proceeds for the first two years postoperatively. Minor progression proceeds for even longer. In some repairs, the biomechanical result was equal to native cartilage, suggesting hyaline-type repair. The variation in biomechanical results suggests substantial inconsistency in the structural outcome following ACI.
Distributed urban network systems in the tropical archaeological record: Toward a model for urban sustainability in the era of climate change
Authors: Scarborough Vernon L , Isendahl Christian
Published: May 2020

Identifying and employing the concept of sustainability in the social sciences remain a challenge. One approach presented here emphasizes its utility in examining past urban adaptations primarily from the archaeological record that demonstrate the role of low-density urbanism. Drawing upon early semitropical cities and their dispersed land-use and settlement patterns, both longevity and interconnectivity are shown to have developed in the context of environmental and societal diversity. The impact of climate change to our near-term futures can result in adaptations that accommodate positive societal transformations if all relevant disciplines are included in the dialogue. Past sustainable practices when melded with thoughtfully deployed technologies of today and tomorrow will assist with this new ecology. We argue that generating knowledge about tropical urban systems in the ancient past adds to a more diversified pool of urban models from which to draw for future urban planning. We specifically suggest that networked urban systems of distributed, low-density settlement repeatedly occurring throughout the tropical archaeological records have several social–environmental benefits toward a sustainability transition of cities in the era of climate change.