bluuebunny/crossref_metadata_2025 huggingface dataset:
Rapid formation of a radiolucent pancreatic stone: a case report (with video)
Authors: Wang Dan , Bi Ya-Wei , Xu Hao , Wang Teng , Li Zhao-Shen , Xu Zheng-Lei , Hu Liang-Hao
Published: September 2020

Background

Over 90% of pancreatic stones are radiopaque and can be treated with endoscopy or surgery. However, radiolucent stones are different than radiopaque stones in nature and formation, and therefore, treatment varies. Case presentation: A 25-year-old woman was admitted because of recurrent acute pancreatitis. Imaging examinations confirmed the diagnosis of chronic pancreatitis (CP), and which revealed the existence of radiolucent stones. Endoscopic retrograde cholangiopancreatography (ERCP) was performed and abundant protein-like radiolucent stones were extracted. Three 10F, 7-cm plastic stents were placed. However, the stents were completely occluded by radiolucent stones 1 month later. A nasopancreatic tube was then inserted and flushed regularly, but protein-like stones formed continuously. After multidisciplinary consultation, the following conservative treatment strategy was applied: 1) no more endotherapy; 2) a diet with 40% to 50% of calories from fat was recommended; 3) no pancreatic enzyme replacement therapy; and 4) regular exercise. The above advice aimed to stimulate the secretion of pancreatic fluid to achieve auto-flushing of the pancreatic duct and prevent protein-like stones from depositing. No acute pancreatitis recurred during the 5-year follow-up.

Conclusions

This strategy was effective for auto-flushing the pancreatic duct in patients with radiolucent pancreatic stones after the main pancreatic duct stricture was resolved.
Establishment of a quality control circle to reduce biofilm formation in flexible endoscopes by improvement of qualified cleaning rate
Authors: Luo Yingxia , Yang Qixuan , Li Bingkun , Yao Yao
Published: September 2020

Objective

In recent years, the Emergency Care Research Institute has advised that endoscope cleaning is of considerable importance. In the present study, a quality control circle (QCC) was used to reduce the formation of biofilms in flexible endoscopes within one hospital in Guangdong Province, China.

Methods

During reprocessing of 235 flexible endoscopes in the urology surgical suite, adenosine triphosphate (ATP) detection was used to monitor the efficacy of biofilm removal. The internal and external parts of flexible endoscopes were used as sampling sites by means of the flushing and smudge methods, respectively. When the two results reached the standard of less than 500 relative light units/piece at the same time, endoscopic biofilm clearance was considered to be qualified. A QCC was established to implement a 10-step plan-do-check-act model.

Results

The baseline qualified rate (i.e., ATP monitoring pass rate) during reprocessing of 235 flexible endoscopes was 50%. During the study, the qualified rate increased to 85.29% after establishment of the QCC. During reprocessing of 150 flexible endoscopes in the following 6 months, the qualified rate remained at 90%.

Conclusion

Establishment of the QCC improved the removal of biofilm from flexible endoscopes in the urology surgical suite.
Headache and rhinosinusitis: A review
Authors: Ceriani Claire EJ , Silberstein Stephen D
Published: September 2020

Purpose of review

To explain our current understanding of headache attributed to rhinosinusitis, an often inappropriately diagnosed secondary headache.

Recent findings

Recent studies have shown that headache attributed to rhinosinusitis is often over-diagnosed in patients who actually have primary headache disorders, most commonly migraine. Failure to recognize and treat rhinosinusitis, however, can have devastating consequences. Abnormalities of the sinuses may also be treatable by surgical means, which may provide headache relief in appropriately selected patients.

It is important for the practicing physician to understand how rhinosinusitis fits into the differential diagnosis of headache, both to avoid overdiagnosis in patients with primary headache, and to avoid underdiagnosis in patients with serious sinus disease.
Efficacy of an orally administered combination of Lactobacillus paracasei LC11, cranberry and D-mannose for the prevention of uncomplicated, recurrent urinary tract infections in women
Authors: Murina Filippo , Vicariotto Franco , Lubrano Chiara
Published: September 2020

Background:

Most women experience a urinary tract infection (UTI) at least once in their lifetime. The present study determined the efficacy and safety of a combination of Lactobacillus paracasei LC11, cranberry and D-mannose (Lactoflorene Cist®) in the prophylaxis of recurrent uncomplicated UTIs in premenopausal women.

Methods:

This single-centre study enrolled premenopausal women aged 18–50 years with an acute UTI and a history of recurrent uncomplicated UTIs. Patients were first treated with fosfomycin (3 g once a day for 2 days) to eliminate any underlying infection, followed by treatment with Lactoflorene Cist® once a day for 10 days/month for 90 days (Group 1), Lactoflorene Cist® once daily for 90 days (Group 2) or no treatment (Group 3; control). The main study endpoint was the rate of UTI recurrence during the study period. Any adverse events with treatment were also recorded.

Results:

A total of 55 women (mean age 39.3 years; range: 20–46) were enrolled in the study. A significantly higher proportion of patients in the control group experienced UTIs during the study period compared with the two treatment groups (52.9% vs 16.0% in Group 1 and 15.5% in group 2; p < 0.01). Similarly, a higher proportion of patients in Group 1 (65.8%) and Group 2 (68.7%) remained UTI-free during the study versus the control group. No adverse events were reported in the treated patients.

Conclusion:

Prophylactic treatment with Lactoflorene Cist® was effective and safe in the management of recurrent uncomplicated UTIs in premenopausal women.
Structural Brain Alterations in Female Survivors of Intimate Partner Violence
Authors: Daugherty Julia C. , Verdejo-Román Juan , Pérez-García Miguel , Hidalgo-Ruzzante Natalia
Published: September 2020

Intimate partner violence (IPV) has been related to brain alterations in female survivors. Nonetheless, few studies have used an exploratory approach, focusing on brain regions that are traditionally studied in other populations with post-traumatic stress. Traumatic brain injury (TBI), strangulation, and childhood trauma are highly prevalent among this population, and have also been associated with brain alterations and functional deterioration. As such, it is difficult to determine how different brain regions are affected by the complex interplay of these factors in female survivors. The aim of this study is to assess (a) brain alterations in female survivors of IPV as compared to non-victim females and (b) the potential causal mechanisms associated with such alterations. We hypothesized that structural brain differences would be found between female survivors of IPV and non-victims, and that these differences would be related to IPV-related TBI, strangulation, IPV severity, depression, post-traumatic stress, generalized anxiety, and childhood adverse experiences. A total of 27 non-victims and 28 survivors completed structural magnetic resonance imaging and questionnaires to measure the potential causal mechanisms for brain alterations. Structural brain differences were found between groups, principally in volumetric analyses. The brain regions in which between-group differences were found were related to attempted strangulation, IPV-related TBI, severity of IPV, adverse childhood experiences, and post-traumatic stress. These results demonstrate that a wider range of brain regions may be impacted by IPV and that various factors are implicated in the structural brain alterations found in female survivors. This study demonstrates the importance of post-traumatic stress, childhood and adult trauma, and physical violence in assessing brain alterations in IPV survivors. Further, it serves as a critical first step in assessing an extensive list of potential causal mechanisms for structural brain alterations, using a more comprehensive a whole-brain structural analysis of IPV female victims, a largely understudied and vulnerable population.
Motorcycling in a Repair Society: A Maintenance and Repair–Centered Approach to Automobility
Authors: Jderu Gabriel
Published: September 2020

In a departure from car-centered analyses of the automobility systems, this article highlights the importance of motorcycles and motorcycling in the mobility practices of socialist countries. For at least half of the existence of socialist mobility systems, and especially during the 1950s and 1960s, there were more motorcycles on the roads than cars. Motorcycling was important in commuting, for the mobility of lower-ranking administrative personnel in the countryside, and for mass tourism and leisure. Although in that era maintenance and repair practices were equally central to motorcycling and car-driving, the distinction between user-owner and mechanic was much more fluid in the case of motorcyclists. As a result, the centrality of maintenance and repair to socialist-era motorcycling offers an ideal opportunity to enrich current interdisciplinary conversations about breakdown, maintenance, and repair. Building on the car-centered research into maintenance and repair activities, I add additional material on the nature, types, and complexity of such practices for motorcycling. I outline nine forms of material engagement with motorcycles that reference, but transcend, the current dichotomies between necessity and pleasure, the formal and the informal, the technical and the aesthetic, and the repair of existing objects and the creation of new ones.
Experimental evaluation and numerical simulation of performance of the bypass dual throat nozzle
Authors: Hamedi-Estakhrsar Mohammad Hadi , Mahdavy-Moghaddam Hossein
Published: September 2020

Bypass dual throat nozzle (BDTN) is a modern concept of fluidic thrust vector control. This method able to solve the problem of thrust loss without need the secondary mass flow from other part of engine. Internal nozzle performance and thrust vector angles have been measured in the BDTN experimentally and numerically. A new simple approach is proposed to detect the thrust deflection angle. Numerical simulation of 3-D turbulent air flow is carried out by using the RNG k-e turbulence model. The obtained results of thrust coefficient, discharge coefficient and thrust deflection angle have been validated by comparing with measured experimental data. The results show that for nozzle pressure ratio of 1–4 the tested nozzle able to deflect the thrust vector of 26.5°-19°. By increasing NPR from 2 up to 4, the thrust coefficient values will change in the range of 0.85-0.93. Also the effect of different positions of the bypass channel on the BDTN performance parameters has been investigated numerically. The predicted results show that the BDTN configuration with bypass duct on the first nozzle throat has the highest value of thrust deflection angle over the range of NPRs.
Leadership Effectiveness and Psychological Well-being: The Role of Workplace Spirituality
Authors: Riasudeen S. , Singh Pankaj
Published: September 2020

The purpose of this article is to examine the relationship of leadership effectiveness and psychological well-being with the work outcomes of intention to quit, job involvement and organization-based self-esteem (OBSE), and whether workplace spirituality plays a role in mediating the associations of leadership effectiveness and psychological well-being with work outcomes. The study is cross-sectional and non-experimental. Data were obtained from 630 information technology (IT) employees from South India, adopting ‘power calculations’. The analysis was performed using SPSS version 20 for Windows and LISREL version 8.72. Results reveal that leadership effectiveness and psychological well-being have a significant positive association with workplace spirituality, and this, in turn, has an impact on the work outcomes of intention to quit, job involvement and OBSE. Workplace spirituality can limit any negative associations of leadership effectiveness and psychological well-being with work outcomes. This research adds to the existing body of knowledge in the spirituality literature by drawing attention to the positive aspects of the interplay between spirituality, leadership transformation and well-being at work. The article concludes that building core values anchoring spirituality would lead to greater connectedness and healthier employee outcomes.
Chinese martial arts and the Olympics: Analysing the policy of the International Wushu Federation
Authors: Han Qing-song , Theeboom Marc , Zhu Dong
Published: September 2020

The International Wushu Federation (IWUF) has been striving to get wushu (Chinese martial arts) into the Olympics for over three decades. As these efforts have not been successful to date, a study was set up to identify and evaluate the IWUF’s underlying ‘Olympic policy’ assumptions. A theory-based evaluation approach was used which was based on data collected through 20 semi-structured interviews including senior IWUF officials, coaches, national federation officers and scholars. Findings suggest that the IWUF’s Olympic policy is characterised by a number of implementation and theory failures. Regarding the former is the unequal continental breakdown of board members, overrepresentation of Chinese nationals in specific positions and the use of mostly Chinese social media. And the latter, among other things, relates to simultaneously trying to enrich the cultural diversity of the Olympic programme by introducing a traditional Chinese sport, as well as detraditionalising the sport in an attempt to comply more with Olympic standards and facilitating comparison between performances. Results also showed that different perspectives exist among respondents with regard to China’s dominance in the Olympic policy of the IWUF. It is suggested to use specific policy analysis theories to further investigate this aspect.
Prognostic Significance of ALDH1, Bmi1, and OCT4 Expression in Oral Epithelial Dysplasia and Oral Squamous Cell Carcinoma
Authors: Rao Roopa S. , Raju K Lizbeth , Augustine Dominic , Patil Shankargouda
Published: September 2020

Background:

Increasing evidence suggests the involvement of cancer stem cells (CSCs) in both oral epithelial dysplasia (OED) and oral squamous cell carcinoma (OSCC). Among the various CSC markers, aldehyde dehydrogenase (ALDH) 1, B cell-specific Moloney murine leukaemia virus integration site 1 (Bmi1), and octamer-binding protein 4 (OCT4) have been noted to increase in OSCC. The aim of the study was to analyze ALDH1, Bmi1, and OCT4 expression in OED and OSCC with clinicopathologic correlation and survival analysis.

Methods:

A total of 40 cases each of OED and OSCC were retrieved from departmental archives. Expression of ALDH1, Bmi1, and OCT4 was analyzed using immunohistochemistry and was correlated with clinicopathological parameters. A follow-up ranging from 6 to 52 months was considered for Kaplan-Meier survival analysis. The log-rank test was performed to analyze significant difference in survival rates.

Results:

The expression levels of ALDH1, Bmi1, and OCT4 increased significantly from OED through OSCC ( P < .05). The expression of ALDH1 and OCT4 showed a significant correlation with lymph node metastasis. Positive cases of ALDH1 showed a significantly reduced survival rate compared to cases showing negative expression. Kaplan-Meier survival analysis showed a significant reduction of survival rate ( P = .00) in patients showing a positive expression for all the 3 markers.

Conclusion:

ALDH1 and OCT4 could be used as individual prognostic markers for assessing prognosis. ALDH1, Bmi1, and OCT4 could be used as a collective panel of markers to enable surgeons in predicting the prognosis of patients and thereby carry out prompt follow-up for such cases.
Is It Possible to Establish a Tumor-Suppressive Microenvironment With Glycine and Valine Supplement?
Authors: An Shanshan , Yan Sirui , Zhang Ying , Xu Huan , Gan Tao , Liu Qiuyun
Published: September 2020

A tumorigenic microenvironment can give rise to neoplasm. A shift from this condition to a tumor-suppressive microenvironment is of significant benefit to susceptible individuals. The carbonyl groups of glycine and valine have long bond lengths, consequently generating potent affinities to divalent cations such as calcium. We hypothesize that the formation of insoluble and rigid calcium oxalate augmented by glycine and valine counteracts strong acids such as HCl chemically, thus reducing cancer risks. The anticancer effects of the 2 amino acids can be explained from a chemical and biochemical perspective. A tumor-suppressive microenvironment could be established via the modification of the proteome without genome editing at the DNA level.
Gene Signatures and Prognostic Values of m6A RNA Methylation Regulators in Ovarian Cancer
Authors: Han Xiao , Liu Jie , Cheng Guomei , Cui Shihong
Published: September 2020

Background:

N6-methyladenosine (m6A) is the most common form of mRNA modification under the field of “RNA epigenetics.” However, its role in ovarian cancer (OC) development is poorly understood. In the current study, we aimed to identify gene signatures and prognostic values of m6A RNA methylation regulators.

Method:

Specifically, we downloaded Mutations and Copy number variant (CNV) data from the TCGA database for 579 OC patients, then analyzed gene expression and prognosis value using integrative bioinformatics. Thereafter, we verified the related biological processes of Wilms’ tumor 1-associating protein (WTAP) gene using Gene set enrichment analysis (GSEA).

Results:

Results showed that almost all ovarian cancer patients (99.31%) have CNVs with at least 1 m6A regulatory gene, whereas 83.76% of cases exhibited concurrence of CNVs in more than 4 m6A regulatory genes. Additionally, alteration of m6A regulators was associated with historical grade, whereas integrative bioinformatics and Cox multivariate model analysis revealed a significant correlation between high WTAP expression and worse ovarian cancer outcomes. Moreover, GSEA revealed that high WTAP expression was associated with cell cycle regulation and MYC targets.

Conclusion:

Overall, our findings demonstrate the significance of high-frequency genetic alterations of m6A RNA methylation regulators and WTAP’s poor prognosis value in OC. These findings provide valuable insights into the role of m6A methylation in OC, and will be vital in guiding development of novel treatment therapies.
Hypertension and QT interval prolongation associated with targeted systemic cancer therapies
Authors: Fahey Olivia G , Piccolo Jennifer K , Bergsbaken Jason J , N Dow-Hillgartner Elizabeth
Published: September 2020

Objective

To summarize the proposed mechanisms behind hypertension and QT interval prolongation associated with use of targeted systemic cancer therapies and provide recommendations for monitoring or managing these toxicities.

The cardiotoxic effects of targeted systemic cancer therapies represents a new paradigm of cancer treatment associated cardiovascular adverse events. National guidelines regarding optimal monitoring and management strategies for hypertension and QT interval prolongation associated with use of these therapies are lacking. While the pathophysiological drivers of hypertension due to targeted systemic cancer therapies differ by class of targeted therapy, general management strategies do not. Routine blood pressure monitoring throughout the duration of therapy is recommended for all agents. Patients who experience hypertension often can be treated with the addition or modification of antihypertensive therapies. Uncontrolled hypertension despite optimal medical management may require dose modifications or discontinuation of the targeted systemic cancer therapy. Electrocardiogram monitoring is recommended for patients who receive targeted therapies that may prolong the QT interval. Minimizing or managing drug interactions with other QT prolonging medications is recommended in addition to ensuring adequate electrolyte supplementation. Dose modifications or discontinuation of the targeted systemic therapy may be necessary for patients who experience QT interval prolongation.

Conclusions

Appropriate cardiovascular monitoring and timely management of treatment-emergent toxicities can optimize therapy for patients receiving targeted systemic cancer therapies associated with a risk of drug-induced hypertension or QT interval prolongation.
Lymphocytic Colitis With Increased Apoptosis: A Marker of Mutation in T-Cell-Mediated Immunity?
Authors: Bernieh Anas , Hakar Melanie , Stanek Jerzy
Published: September 2020

Lymphocytic colitis is a subtype of microscopic colitis that is mostly seen in adults. It presents mainly as chronic nonbloody diarrhea, with the hallmark of normal or near-normal endoscopy. In this case series, we are presenting 4 pediatric patients with lymphocytic colitis with prominent apoptosis of the colonic gland epithelium. Remarkably, all the patients have genetic mutations known to be associated with autoimmune enteropathy. Three patients have a CTLA4 mutation, and 1 patient has an STAT3 mutation. These mutations were previously reported in association with inflammatory bowel disease, but a specific connection with lymphocytic colitis has not been described. This report investigates the histopathology of such lesions in children and adolescents.
Australian Sudanese and South Sudanese Youths’ Perspectives on the Youth/Parent Relationship and Its Influence on the Transition to Adulthood
Authors: Macaulay Luke
Published: September 2020

Youth/parent relations can be an important influence on young peoples’ transition to adulthood. For youths and their parents from migrant and refugee backgrounds, this transition can also be influenced by a series of unique challenges linked to processes of acculturation in a new cultural setting. The purpose of this qualitative study was to better understand the influence of youth/parent relationships throughout Australian Sudanese and South Sudanese youths’ transitions to adulthood. Using a voice-centred relational methodology (VCRM) approach and Bourdieu’s theory of practice, the voices of participants are placed at the centre of the research. Findings suggest that youth/parent relationships within these communities have a considerable influence on Australian Sudanese and South Sudanese youths’ perspectives on the transition to adulthood. This was found to be particularly influenced by navigations of Australian and Sudanese/South Sudanese cultural norms and expectations and how these are balanced throughout the transition to adulthood.
Socio-economic challenges faced by traditional healers in Limpopo province of South Africa: conversations from below
Authors: Masoga Mogomme Alpheus , Shokane Allucia Lulu
Published: September 2020

Traditional healing remains core to many local communities in South Africa. This research was aimed at fostering stronger relationships between traditional healers and biomedical medicine focusing on their socio-economic challenges. This research involved collaboration between two Universities in South Africa and the USA, focusing on the social welfare and traditional healing, by articulating the experiences and positions of 40 selected traditional healers. Afro-sensed and developmental social welfare approaches were used for this study. Qualitative research approaches using focus group discussions, direct observations and in-depth interviews with selected traditional healers were applied. A thematic analysis approach was used to cluster emerging themes and sub-themes. Carefully presented themes were sifted from the data that referred to traditional healers’ experiences of their socio-economic realities. It should be noted that, while the socio-economic status of healers was significant, the scope of spiritual and philosophical dimensions related to traditional healing could not be ignored.
Australian Press, Radio and Television Historiography: An Update
Authors: Griffen-Foley Bridget
Published: September 2020

The thirtieth anniversary issue of MIA in May 2006 (no. 119) featured ‘Australian Press, Radio and Television Historiography: An Update’. In it, Bridget Griffen-Foley produced a bibliography of books, theses and special journal issues concerning the history of the Australian media completed or commenced since the publication of two well-known bibliographical essays by Henry Mayer and John Henningham in 1987–88. Bridget has now expanded and updated her bibliography. The websites of MIA and the new Centre for Media History at Macquarie University, to be headed by Bridget, aim to publish periodic updates of the ‘Update’.

Readers of MIA might also be interested to learn that an email discussion list for those interested in Australian media history has recently been established. For information on the listserv, or to subscribe, go to: http://listserv.mq.edu.au/mailman/listinfo/amhlist
Mapping Media
Authors: Ward Susan , Moran Albert
Published: September 2020

This issue addresses a ‘spatial turn’ in communication or media studies. By becoming attuned to the specificities of place, research inevitably becomes embedded within real-life situations that acknowledge the similarities but also differences between localities brought about by, for example, processes of uneven development, local variations in social organisation and the articulation of creative networks that are critical to the cultural production industries. The field of media studies is still opening up to the productive possibilities that come with a primacy on the specificities of place. Her we begin a survey of this spatial turn in media studies by collating articles that are concerned with a variety of mediascapes and their relation to places and spaces.
Multiplex Cinemas and Urban Redevelopment in India
Authors: Athique Adrian Mabbott , Hill Douglas
Published: September 2020

The aim of this article is to introduce the phenomenon of the multiplex theatre as it is being played out within the complex urban geographies of metropolitan India. Since its inception a decade ago, the multiplex cinema in the subcontinent has become an intrinsic component of a new leisure infrastructure configured around the notion of a ‘consuming class’ keen to take its place amongst a ‘global middle class’. The dramatic growth in multiplex cinemas, projected to grow in numbers by 300 per cent over the next three years, has been greatly encouraged by urban planning and taxation policies designed to encourage new commercial and residential developments arising out of urban regeneration programmes and the growth of satellite conurbations. This article makes the case that, while the multiplex is an example of flagship architecture employed in the ‘globalisation ‘of the urban environment, the demand for such facilities is also a logical extension of the long-running contest over public spaces between different segments of the urban population in Indian cities.
Localising Global Television
Authors: Moran Albert
Published: September 2020

With format programming now a business and cultural mainstay of global television, this article focuses on processes whereby adaptation takes place. A key figure in such an interchange is the visiting producer who has production expertise in the adaptation of a particular format. These occasions of remaking or translation involve cross-cultural exchange between the global and the local. Usually, there is mutual recognition of the need to vary a format to suit specific conditions and situations. Adaptation of television formats is a complex dialogue involving at least three levels of negotiation or translation. The analysis highlights the turbulent, messy nature of both local and global culture as they are involved in this interchange.
Junk Food or Junk TV: How will the Uk Ban on Junk Food Advertising Affect Children's Programs?
Authors: Potter Anna
Published: September 2020

The implementation of a partial junk food television advertising ban in the United Kingdom is adding to the woes of commercial broadcasters already under pressure in a fiercely competitive multi-channel environment. The UK free-to-air channel ITV1 recently announced the closure of its children's programs production unit and children's television production in the United Kingdom has been described as being ‘in meltdown’. The United Kingdom represents a crucial market for Australian producers of children's programs, who have traditionally sourced up to 80 per cent of their production budgets from UK partners. Australian cultural policy is adding to the challenges facing these producers, through the demands inherent in the ‘C classification. If Australia is to remain committed to the provision of dedicated children's programs, alternative sources of funding will have to be found.
Adhesive joining of sisal/jute/hybrid composites with drilled holes in lap area
Authors: Melese Kassahun Gashu , Naik Tejas P , Singh Inderdeep
Published: September 2020

Growing awareness about sustainable development and the environmental problems involved in using nonbiodegradable materials has motivated the research community to develop environment-friendly materials. Developments have been achieved in the field of natural fibers and biopolymers, still there remain unanswered questions regarding the high-quality cost-effective manufacturing of natural fiber reinforced composites. The natural fiber-based polymeric composites are being used extensively in engineering applications, especially in the nonstructural parts and components. Near-net processing techniques such as compression molding, extrusion, and injection molding are well-developed for natural fiber reinforced composites. However, secondary processes such as joining, machining, and surface modification are still unexplored and need to be investigated in detail. The present research endeavor is an attempt to experimentally investigate the adhesive joining behavior of jute/sisal reinforced epoxy composites. The laminates based on three different material configurations in woven mat form, namely, pure jute, pure sisal, and hybrid jute/sisal reinforced epoxy have been fabricated by hand layup process. Different lap joint configurations with through holes in adherends overlapping area have been investigated. It has been established experimentally that the holes in the adherends provide a hinge-effect in the overlapping area and help in defining the failure load of the composite joint. The different arrangement of holes has been investigated and the best design of hole arrangement has been proposed for adhesive joining of jute/sisal fiber reinforced epoxy laminates. It was found that the holes (filled with an epoxy adhesive) in the overlap area result in 6–18% improvement in the failure load for different materials as compared to the joints with only adhesive bonding. Moreover, the field-emission scanning electron microscopy micrographs have been used to understand the failure mechanism of the adhesively bonded natural fiber reinforced composite laminates.
An audit of questions asked by participants during the informed consent process for regulatory studies at a tertiary referral centre – An analysis of consent narratives
Authors: Saxena Unnati , Bose Debdipta , Maurya Mitesh Kumar , Gogtay Nithya Jaideep , Thatte Urmila Mukund
Published: September 2020

Objective

To evaluate the questions asked during the informed consent process by adult and adolescent participants as well as their parents in five interventional regulatory studies conducted at our center from 2018 to 2019.

Methods

The study protocol was approved by Institutional Ethics Committee [EC/OA-116/2019]. Consent narratives in the source documents for the studies were evaluated. Questions asked were classified as per Indian Council of Medical Research’s (ICMR) guidelines (2017). We evaluated total number of questions, nature of questions and whether there was an association between education, gender, phase of trials, physician taking consent and number questions being asked.

Results

A total of five studies that had N = 297 consent narratives were evaluated. Narratives of n = 284 adult participants/Guardians and of n = 13 children were analysed. A total of 374 questions were asked of which children asked only 10 questions. A total of 131/284 (40%) of the participants did not ask any question. Among the participants who asked questions, the majority132/171 (77%) participants asked about risks related to investigational products followed by questions related to study procedures 83/171 (49%). Participants/guardians with higher education (relative to those who were educated upto the secondary school and primary school) and those who consented for Phase III studies (relative to Phase I studies) asked significantly more questions (p < 0.0001).

Conclusion

A majority of the queries were related to the risks associated with the investigational products. Educational status and the Phase of the trial were found to be significantly associated with the number of questions being asked.
Obstetric medicine care in South Europe
Authors: Ateka-Barrutia O , Palma dos Reis I , Maina A , Bezanahary H
Published: September 2020

Obstetric medicine is an emerging area of interest within Internal Medicine in Europe. Despite that, “OM” is still an unpopular concept and an unrecognised subspecialty in South Europe. A considerable number of internists and medical specialists deal with maternal medical problems in association with obstetricians and other specialists on a daily basis. Due to their interest and mostly part-time dedication to maternal care, a growing mass of physicians are getting specific training in the field either locally or, less frequently, abroad, and are also building specific clinics, inpatient care services and other new bonds with obstetricians in numerous tertiary care centres. In this article, we aim to describe the state of the growing field of obstetric medicine in Portugal, Italy, France and Spain, the particular clinical, educational and academic efforts and steps that have recently been developed by internists in each country, as well as planned initiatives for the future.
Olfactory Function After Surgical Treatment of CRS: A Comparison of CRS Patients to Healthy Controls
Authors: Mattos Jose L. , Soler Zachary M. , Schlosser Rodney J. , Mace Jess C. , Alt Jeremiah A. , Ramakrishnan Vijay R. , Payne Spencer C. , Smith Timothy L. , Beswick Daniel M.
Published: September 2020

Background

Many patients with chronic rhinosinusitis (CRS) have persistent olfactory dysfunction (OD) following endoscopic sinus surgery (ESS). Few studies compare outcomes to control subjects so it is unknown if residual OD is due to persistent CRS.

Objective

Compare postoperative measures of OD in case patients with CRS to healthy controls without sinonasal disease.

Methods

Prospective, observational, multicenter cohort study between October, 2016 and May, 2019. Case participants were selected from referred adult patients diagnosed with CRS, with or without nasal polyposis (NP), electing ESS as subsequent treatment modality. Controls voluntarily enrolled from a community-based sample without a history of CRS. Primary outcomes included measures of preoperative and postoperative OD using “Sniffin’ Stick” pens which summarize odorant threshold (T), discrimination (D), and identification (I) scores. Secondary outcomes included the Questionnaire of Olfactory Disorders-Negative Statements (QOD-NS) survey and olfactory cleft endoscopy scores (OCES).

Results

Outcomes were compared between 113 cases and 164 controls of similar average age and gender. Cases reported significantly worse baseline Sniffin’ Sticks TDI total scores (−6.8[SE ± 1.0]; 95% CI: −4.9 to −8.7), QOD-NS (8.9[SE ± 1.1]; 95% CI: 6.8–10.9), and OCES (3.5[SE ± 0.4]; 95% CI: 2.9–4.2) on average. Cases reported significant postoperative improvement in TDI total score (3.7[SD ± 8.2]; 95% CI: 2.2–5.2), QOD-NS (−5.9[SD ± 8.7]; 95% CI: −7.6 to −4.3), and OCES (−1.7[SD ± 3.8]; 95% CI: −2.7 to −0.8) on average, while 63% of anosmics reported improved postoperative olfaction. Multivariate regression identified that NP (OR = 0.4; 95% CI: 0.2–1.0) and previous ESS (OR = 0.3; 95% CI: 0.1–0.8) decreased the odds of postoperative improvement equal to mean TDI scores of controls, while septoplasty increased those odds (OR = 4.5; 95% CI: 1.5–13.7).

Conclusion

ESS improved olfactory metrics and restored olfactory function in approximately 50% of patients with CRS to that of healthy controls. Concurrent septoplasty increased the likelihood of achieving normal olfaction, while NP and previous ESS decreased those odds.
Extracellular vesicles released from p18 overexpressing pulmonary endothelial cells are barrier protective – potential implications for acute respiratory distress syndrome
Authors: Harrington Elizabeth O. , Braza Julie , Shil Aparna , Chichger Havovi
Published: September 2020

The novel endosome protein, p18, and the early endosome GTPase, Rab4, play a significant role in protecting the pulmonary vasculature against permeability associated with acute respiratory distress syndrome. Recently, endothelial‐derived extracellular vesicles have been identified to play a key role in the endothelial permeability associated with acute respiratory distress syndrome. Therefore, we investigated the effect of these microparticles, released from endothelial cells overexpressing p18 and Rab4, on pulmonary endothelial barrier function. Endothelial‐derived extracellular vesicles isolated from lung microvascular endothelial cells which overexpressed cDNA for wild‐type p18 protected a naïve monolayer against lipopolysaccharide‐induced permeability. In contrast, endothelial‐derived extracellular vesicles from cells overexpressing the non‐endosomal binding p18 mutant (p18N39) exerted no protective effect on the endothelial monolayer. Cells overexpressing either dominant active or inactive Rab4 released endothelial‐derived extracellular vesicles which had no effect on lipopolysaccharide‐induced permeability. miRNA analysis and permeability studies of endothelial‐derived extracellular vesicle isolated from wild‐type p18‐overexpressing cells demonstrates that let‐7i‐5p, miR‐96‐5p, and miR‐137‐3p are endothelial‐derived extracellular vesicle cargo which exert protective effects on the pulmonary endothelium. Finally, we observed down‐regulation of p18 protein expression in both the lung and endothelium in an in vivo and in vitro model of acute respiratory distress syndrome. These results demonstrate that endothelial‐derived extracellular vesicle released from cells overexpressing p18, but not Rab4, contain miRNA cargo which likely promote a barrier‐protective effect on the pulmonary endothelium in settings of acute respiratory distress syndrome. Findings indicate the importance of p18 in the pulmonary vasculature and demonstrate that targeting this protein may provide a novel therapeutic strategy to reduce endothelial permeability associated with acute respiratory distress syndrome.
Identifying the challenges to successfully teaching about genetic diversity among Japanese junior high school students
Authors: Kohama Natsu , Kawasaki Hiromi , Kukinaka Chieko , Goda Hiromi , Rahman Md Moshiur
Published: September 2020

Objectives:

Creating a diverse and inclusive symbiotic society is specified in the sustainable development goals. In a symbiotic society, support for those who need, it is called “reasonable support.” However, it is unclear in the classroom that many children understand “reasonable” as a consideration to support children with special needs. The aim of this study is to identify the actual understanding of junior high school students and the challenges related to genetic diversity through school health teachers in readiness for developing a symbiotic society.

Methods:

A focus group interview was conducted for five school health teachers working in public junior high schools to identify the perspectives of their feeling about the current understanding of children in regard to genetics and diversity. Participants were recruited who agreed to engage voluntarily in this research. A qualitative descriptive design was used in this study.

Results:

The results of the analysis revealed three categories consisting of 67 codes and 10 subcategories. Three categories were identified: I—understanding the heterogeneity and diversity of children’s ambivalent minds; II—limitation of school health teachers’ involvement in genetics and diversity-related issues; and III—importance for children to understand heterogeneity and diversity to build life skills.

Conclusions:

School health teachers remarked on the limitations of learning and teaching genetics and diversity. They paid attention to the flexibility of a child. It suggests that the purpose of genetic education is to develop children’s life skills with the flexibility to live in the future. There is a need to consider new genetic education for school health teachers and students to learn about diversity.
The vulnerability of nursing home residents to the Covid-19 pandemic
Authors: Wagner Edward H
Published: September 2020

Residents in nursing homes and other long-term care facilities comprise a large percentage of the deaths from Covid 19. Is this inevitable or are there problems with NHs and their care that increase the susceptibility of their residents. The first U.S. cluster of cases involved the residents, staff, and visitors of a Seattle-area nursing home. Study of this cluster suggested that infected staff members were transmitting the disease to residents. The quality of nursing home care has long been a concern and attributed to chronic underfunding and resulting understaffing. Most NH care is delivered by minimally trained nursing assistants whose low pay and limited benefits compel them to work in multiple long-term care settings, increasing their risk of infection, and work while ill. More comparative studies of highly infected long-term care facilities with those organizations that were able to better protect their residents are urgently needed. Early evidence suggests that understaffing of registered nurses may increase the risk of larger outbreaks.
Dignity therapy online: Piloting an online psychosocial intervention for people with terminal illness
Authors: Bentley Brenda , O’Connor Moira , Williams Anne , Breen Lauren J
Published: September 2020

Objective

Dignity therapy is a life review intervention shown to reduce distress and enhance the quality of life for people with a terminal illness and their families. Dignity therapy is not widely used in clinical practice because it is time and cost prohibitive. This pilot study examined the feasibility and acceptability of dignity therapy delivered through therapist-supported web-based delivery to reduce costs, increase time efficiency, and promote access to treatment.

Methods

This study employed a one-group pre-test post-test design to pilot methods. Australian adults diagnosed with a terminal illness with a prognosis of six months or less were recruited for the study. The primary outcome measure was a Participant Feedback Questionnaire used in previous face-to-face dignity therapy studies. Data regarding therapist time and details about final documents were recorded.

Results

Six people were recruited; four chose to complete the intervention via videoconference and two chose email. Participants reported high levels of acceptability and efficacy comparable to face-to-face delivery; meanwhile therapist time was about 40% less and legacy documents were longer. Participants described dignity therapy online as convenient, but technological issues may create challenges.

Conclusions

Online delivery of dignity therapy is feasible and acceptable, reduces therapist time and clinical cost, and appears to reach people who would not otherwise receive the therapy. Dignity therapy via email may have the greatest potential to reduce time and cost barriers. This pilot study demonstrates a need for further research to determine the full benefits of online delivery of dignity therapy.
Comparison of image quality of head and neck lesions between 3D gradient echo sequences with compressed sensing and the multi-slice spin echo sequence
Authors: Kami Yukiko , Chikui Toru , Togao Osamu , Ooga Masahiro , Yoshiura Kazunori
Published: September 2020

Background

Although magnetic resonance imaging (MRI) provides excellent soft-tissue contrast, long acquisition times are major disadvantages.

Purpose

To evaluate the usefulness of compressed sensing (CS) for contrast-enhanced oral and maxillofacial MRI by comparing the 3D T1 turbo field echo with compressed SENSE (CS-3D-T1TFE) sequence with the multi-slice spin echo (MS-SE) sequence as the reference standard.

Material and Methods

Thirty patients with orofacial lesions participated in this study. The scan times for MS-SE and CS-3D-T1TFE were 5 min 56 s and 1 min 43 s, respectively. The signal-to-noise ratio (SNR) was calculated for quantitative analysis and seven parameters (degree of lesion conspicuity, motion artifacts, metal artifacts, pulsation artifacts, quality of fat suppression, homogeneity of blood vessel signal intensity, and overall image quality) were evaluated using a 5-point scale (5 = excellent, 1 = unacceptable) by two observers for qualitative analysis. For comparisons between MS-SE and CS-3D-T1TFE, the paired t-test was used.

Results

The SNR of CS-3D-T1TFE was higher than or equal to that of MS-SE. The CS-3D-T1TFE scores for motion artifacts, pulsation artifacts, and homogeneity of blood vessel signal intensity were higher than the corresponding MS-SE scores in assessments by both observers. The MS-SE scores for fat suppression were higher than or equal to the CS-3D-T1TFE scores. There were no significant differences in lesion conspicuity, metal artifacts, and overall image quality between the two sequences.

Conclusion

CS-3D-T1TFE imaging, less than 30% of the scan time for MS-SE, showed no image degradation while retaining equal or higher SNR and image quality.
Lexical Competition and Change: A Corpus-Assisted Investigation of Gambling and Gaming in the Past Centuries
Authors: Li Longxing , Huang Chu-Ren , Wang Vincent Xian
Published: September 2020

This article investigates the interplay of lexical competition and socio-historical events through a close examination of the use of gambling and gaming based on large-scale synchronic and diachronic corpora. We first set the background for comparison through a synchronic study of the collocational patterns and grammatical relations of the two words using Sketch Engine. We show that gambling tends to be associated with negatively perceived activities and strong disapproval, whereas gaming tends to collocate with recreational activities, business, and technology. Using Google Books Ngram Viewer, we focus on the drastic diachronic changes in use of the two words, from competition to co-development. Based on corpora trends, we correlate the rise and fall of the two words and the change in their competition relation to particular socio-historical events: gold rushes, sports betting, the popularity of video games, and the gaming industry boom. The classical competition model of near synonyms remained valid until recent socio-economic events introduced additional and unique meanings for both words. The article thus shows that linguistic variations as collective human behavior changes can be leveraged to evidence other collective human behavior changes.