bluuebunny/crossref_metadata_2025 huggingface dataset:
A retrospective analysis of CO2 derived goal-directed perfusion variables under normothermic conditions: do we need to re-evaluate threshold values?
Authors: Overdevest Eddy , van den Heuvel Evi , van Hoeven Marloes
Published: November 2020

This study investigated if current predictive values for increased lactate formation: VCO2i > 60 ml min−1 m−2, respiratory quotient (RQ) > 0.90, and DO2/VCO2 < 5.0, are valid under normothermic conditions. CO2 derived parameters were analyzed in 91 patients undergoing normothermic CABG and related to increase of blood lactate concentrations during bypass. In this study population, 85 patients (93%) had a median VCO2i above 60 ml min−1 m−2 and 53 patients (58%) had a DO2/VCO2 ⩽ 5.0. Eighteen patients (20%) had a median RQ ⩾ 0.90, but RQ remained with a maximum value of 0.94 below the biological threshold of 1.0. Increase of lactate concentrations remained without clinical significance and showed weak correlations with VCO2i (rs = 0.277, p = 0.008) and RQ (rs = 0.346, p = 0.001).

The cohort was separated for the different CO2 variables by their median value to compare increase in lactate concentration. Patients with a high VCO2i (⩾70 ml min−1 m−2) and a high RQ (⩾0.82) showed significant higher increase in lactate concentration compared to patients with VCO2i < 70 ml min−1 m−2 (p = 0.004), and a RQ < 0.82 (p = 0.012). Groups separated by a median DO2/VCO2 of 4.8 did not show a difference in increase of lactate concentration in blood. In summary, specific CO2 derived threshold values for the prediction of lactate formation, which have been reported in other studies, cannot be confirmed with our findings. However, a CO2 production ⩾70 ml min−1 m−2 and a RQ ⩾ 0.82 in this study population were correlated with increased lactate formation. Because CO2 production during bypass depends on patient temperature, a different cutoff value, that may take into account the influence of demographic variables, should be determined during normothermic CPB.
Age-related impairment of cerebral blood flow response to KATP channel opener in Alzheimer’s disease mice with presenilin-1 mutation
Authors: Liu Dong , Ahmet Ismayil , Griess Brandon , Tweedie David , Greig Nigel H , Mattson Mark P
Published: November 2020

Local cerebral blood flow (CBF) responses to neuronal activity are essential for cognition and impaired CBF responses occur in Alzheimer’s disease (AD). In this study, regional CBF (rCBF) responses to the KATP channel opener diazoxide were investigated in 3xTgAD, WT and mutant Presenilin 1(PS1M146V) mice from three age groups using Laser-Doppler flowmetry. The rCBF response was reduced early in young 3xTgAD mice and almost absent in old 3xTgAD mice, up to 30%–40% reduction with altered CBF velocity and mean arterial pressure versus WT mice. The impaired rCBF response in 3xTgAD mice was associated with progression of AD pathology, characterized by deposition of intracellular and vascular amyloid-β (Aβ) oligomers, senile plaques and tau pathology. The nitric oxide synthase (NOS) inhibitor Nω-nitro-L-arginine abolished rCBF response to diazoxide suggesting NO was involved in the mediation of vasorelaxation. Levels of phosphor-eNOS (Ser1177) diminished in 3xTgAD brains with age, while the rCBF response to the NO donor sodium nitroprusside remained. In PS1M146V mice, the rCBF response to dizoxide reduced and high molecular weight Abeta oligomers were increased indicating PS1M146V contributed to the dysregulation of rCBF response in AD mice. Our study revealed an Aβ oligomer-associated compromise of cerebrovascular function in rCBF response to diazoxide in AD mice with PS1M146V mutation.
Sorafenib for treating head and neck adenocarcinoma of unknown primary site: a case report
Authors: Chen Jingxian , Cheng Chien-shan , Chen Jie , Lv Lingling , Shen Xiaoheng , Zheng Lan
Published: November 2020

The aim of the present study was to report a rare case of head and neck adenocarcinoma with an unknown primary site in a 59-year-old man. After disease progression followed by multiple cycles of chemotherapy and radiotherapy, genetic screening using next-generation sequencing identified vascular endothelial growth factor A amplification and the TP53 R209Kfs mutation. Treatment with the multi-targeted protein kinase inhibitor sorafenib controlled the patient’s symptoms and improved his quality of life.
Carcinoembryonic antigen levels are increased with pulmonary output in pulmonary hypertension due to congenital heart disease
Authors: Zi-yang Yang , Kaixun Zhao , Dongling Luo , Zhou Yin , Chengbin Zhou , Jimei Chen , Caojin Zhang
Published: November 2020

Objective

Pulmonary artery hypertension (PAH) is a severe complication of congenital heart disease (CHD). Monitoring of pulmonary arterial pressure (PAP) and pulmonary vascular resistance (PVR) is essential during follow-up. This retrospective study aimed to examine carcinoembryonic antigen (CEA) as an additional marker for evaluation by investigating the correlation between CEA levels and hemodynamics in CHD-PAH.

Methods

Seventy-six patients with CHD-PAH (mean PAP [mPAP] >25 mmHg and PVR >3 Wood units, group A), 71 patients with CHD and pulmonary hypertension (CHD-PH, mPAP >25 mmHg and PVR ≤3 Wood units, group B), and 102 patients with CHD without PH (mPAP ≤25 mmHg, group C) were enrolled. Serum CEA levels and the relationships between CEA levels and hemodynamic data were assessed.

Results

Mean serum CEA levels were 1.99±1.61, 2.44±1.82, and 1.58±1.07 ng/mL, mPAP was 58.66±20.21, 30.2±4.83, and 17.31±4.51 mmHg, and PVR was 10.12±7.01, 2.19±0.56, and 2.2±1.1 Wood units in groups A, B, and C, respectively. Mean pulmonary output (PO) was 7.24±3.07, 15.79±5.49, 10.18±4.72 L/minute, respectively. CEA levels were positively correlated with PO and negatively correlated with PVR in all of the patients.

Conclusion

CEA levels are increased with PO and decreased with PVR in CHD-PH.
Body lateropulsion as the primary manifestation of medulla oblongata infarction: a case report
Authors: Li Hui , Wei Na , Zhang Lu , Liu Xiuli , Han Jingzhe
Published: November 2020

Background

Isolated body lateropulsion is a possible predominant manifestation of medulla oblongata infarction, and can occur without vestibular and cerebellar symptoms. However, it is relatively rare and challenging to diagnose.

Case presentation

A 67-year-old woman was admitted to the Harris International Peace Hospital complaining mainly of instability when standing and walking for the previous 8 hours. Based on the neural localization and multiple head magnetic resonance imaging (MRI) examinations, a diagnosis of cerebral infarction (vertebrobasilar system) was made. Consequently, the patient was managed using therapy aimed at preventing platelet aggregation, lowering plasma lipids, stabilizing plaques, protecting mitochondria, and improving circulation and brain function. The patient’s gait improved and she was discharged after 14 days because she was able to walk unaided. The patient was followed up for 6 months and had no noticeable undesirable side effects or signs of neurological deficits.

Conclusion

The possibility of lateral medulla oblongata infarction should be considered when patients present with isolated body lateropulsion, without other signs or symptoms of brainstem damage.
Canine Mammary Carcinoma With Vacuolated Cytoplasm: Glycogen-Rich Carcinoma, a Histological Type Distinct From Lipid-Rich Carcinoma
Authors: Muscatello Luisa Vera , Papa Valentina , Millanta Francesca , Sarli Giuseppe , Bacci Barbara , Cenacchi Giovanna , Poli Alessandro , Giudice Chiara , Brunetti Barbara
Published: November 2020

Lipid-rich carcinoma is a rare histotype of canine mammary tumors with cytoplasmic vacuolation. In humans, glycogen-rich carcinoma, secretory carcinoma, and myoepithelial neoplasms are included in the differential diagnosis for lipid-rich carcinoma. The aim of the study was to investigate the existence of histotypes other than lipid-rich in canine mammary carcinomas with vacuolated cytoplasm using a diagnostic algorithm based on histopathology, histochemistry, immunohistochemistry, and ultrastructure and to evaluate the molecular phenotype of these neoplasms. Ten mammary carcinomas were collected, histologically reviewed, and subjected to histochemistry (PAS, PAS with diastase, Alcian blue, Sudan III [1 case], and Congo red [1 case]); immunohistochemistry for CK19, CK5/6, CK14, p63, calponin, vimentin, ER, PR, and HER2; and transmission electron microscopy (TEM). Cytokeratin immunolabeling demonstrated the epithelial origin of all tumors. Sudan III and TEM confirmed the diagnosis of lipid-rich carcinoma in 8 tumors (one amyloid-producing). One tumor was reclassified as a glycogen-rich carcinoma based on PAS reactivity that was diastase-labile, and a second tumor was reclassified as a carcinoma-and-malignant myoepithelioma based on the differentiation markers. Lipid-rich carcinomas were basal-like (5/8), null-type (2/8), and luminal A phenotype (1/8). The glycogen-rich carcinoma was basal-like, while the carcinoma-and-malignant myoepithelioma was luminal A. Vacuolated morphology of neoplastic cells in canine mammary carcinoma can indicate either a neoplasm of luminal epithelial origin with cytoplasmic lipid or glycogen, or vacuolated neoplastic suprabasal myoepithelial cells. Glycogen-rich carcinoma is a novel histological type that should be considered in the differential diagnosis for canine mammary carcinomas with vacuolated cytoplasm.
Cerebral Ovine Herpesvirus 2 Infection of Cattle Is Associated With a Variable Neuropathological Phenotype
Authors: Hierweger Melanie M. , Boujon Céline L. , Kauer Ronja V. , Meylan Mireille , Seuberlich Torsten , Oevermann Anna
Published: November 2020

Cross-species infection with ovine herpesvirus 2 (OvHV-2) in cattle causes malignant catarrhal fever (MCF). MCF may involve the central nervous system (CNS) with necrotizing arteritis and/or vasculitis described to be unique to MCF and discriminatory compared to other viral CNS infections. However, a systematic histopathological characterization of the neural form of MCF in cattle is lacking. We examined medulla oblongata ( n = 9) or the entire brain ( n = 9) of 18 cattle in which OvHV-2 was identified by quantitative polymerase chain reaction (qPCR), in order to pinpoint potential variations in neuropathology. In 2/18 animals (11%) no lesions were identified, while 16/18 cattle (89%) had brain lesions of varying severity. Presence and quantities of OvHV-2 nucleic acid were determined by in situ hybridization and qPCR, respectively, and were related to the severity of lesions. Fifteen of 18 animals (83%) showed vasculitis, which was mainly of the lymphohistiocytic type, while pathognomonic necrotizing arteritis was only rarely present. Neuroparenchymal lesions included gliosis and/or neuronal changes in 7/16 brains with lesions (44%). The number of CD3+ lymphocytes was highest in animals with simultaneous vascular and neuroparenchymal lesions and high viral genome load. In one animal, OvHV-2 was exclusively observed in CD3+ lymphocytes but not in neurons or microglia. In conclusion, the neuropathological phenotype of bovine MCF in the brain was variable. In some cases, lesions mimicked neurotropic viral encephalitis, while pathognomonic necrotizing arteritis was not a consistent feature of neural MCF. Therefore, molecular detection of OvHV-2 is warranted in the presence of nonsuppurative encephalitis and in the absence of necrotizing arteritis.
Comparative Evaluation of Biofilm Adhesion to Different Types of Archwire and Microbiological Colonization During Orthodontic Treatment
Authors: Polke Pritish , Jain Upendra , Marothiya Sunita , Agrawal Purva , Dixit Siddharth , Dubey Chandrika
Published: November 2020

Objective:

To evaluate the biofilm adhesion to 4 types of ‘as retrieved’ archwires during orthodontic treatment. To compare biofilm formation by viable cell counting (colony-forming units [CFU]) of microbes ( Staphylococcus aureus, Streptococcus mutans and Candida albicans).

Methods:

The study was conducted on 40 patients who were divided into 4 equal groups based on the type of archwire of same cross-section (0.019" × 0.025"): group 1—copper-nickel titanium (Cu-NiTi); group 2—titanium molybdenum alloy (TMA); group 3—stainless steel (SS); and group 4—aesthetic coated SS. After 1 month of fixed orthodontic therapy, the archwires were removed carefully from the oral cavity.

Results:

Biofilm absorbance and biofilm concentration were significant ( P ≤ .05) in all the 4 groups.

Conclusion:

The group 2 wire showed the maximum affinity for biofilm absorbance and biofilm concentration, whereas the group 4 wire showed the least affinity. The group 4 wire promoted less retention of oral bacteria compared with the wires of the other groups, whereas the group 1 wire showed maximum retention. In the present study, all types of wire showed maximum affinity for S mutans and the least affinity for C albicans, except for the group 1 wire, which showed maximum affinity for S aureus. Biofilm adhesion could be a significant determining factor in the selection of orthodontic archwire for patients primarily at risk of dental caries or periodontal diseases, or both.
Difficult and failed intubation in the first 4000 incidents reported on webAIRS
Authors: Endlich Yasmin , Lee Julie , Culwick Martin D
Published: November 2020

A review of the first 4000 reports to the webAIRS anaesthesia incident reporting database was performed to analyse cases reported as difficult or failed intubation. Patient, task, caregiver and system factors were evaluated. Among the 4000 reports, there were 170 incidents of difficult or failed intubation. Difficult or failed intubation incidents were most common in the 40–59 years age group. More than half of cases were not predicted. A total of 40% involved patients with a body mass index >30 kg/m2 and 41% involved emergency cases. A third of the reports described multiple intubation attempts. Of the reports, 18% mentioned equipment problems including endotracheal tube cuff rupture, laryngoscope light failure, dysfunctional capnography and delays with availability of additional equipment to assist with intubation. Immediate outcomes included 40 cases of oxygen desaturation below 85%; of these cases, four required cardiopulmonary resuscitation. The majority of the incidents resulted in no harm or minor harm (45%). However, 12% suffered moderate harm, 3.5% severe harm and there were three deaths (although only one related to the airway incident). Despite advances and significant developments in airway management strategies, difficult and failed intubation still occurs. Although not all incidents are predictable, nor are all preventable, the information provided by this analysis might assist with future planning, preparation and management of difficult intubation.
Real-life treatment of cluster headache in a tertiary headache center – results from the Danish Cluster Headache Survey
Authors: Petersen Anja Sofie , Lund Nunu , Jensen Rigmor Højland , Barloese Mads
Published: November 2020

Background

Pharmacological treatment of cluster headache constitutes the core of clinical management, but evidence is sparse. We aimed to generate insight in the existing treatment and identify associations between clinical features and treatment response.

Methods

Patients aged 18–65 diagnosed with cluster headache according to the ICHD-2 completed a questionnaire followed by a structured interview. Multiple logistic regression was used to identify associations.

Results

The population consisted of 400 patients with an episodic: chronic ratio of 1.7:1. Episodic patients were more likely to respond to triptans (odds ratio = 1.77, confidence interval: 1.08–2.91, p = 0.023) and oxygen (odds ratio = 1.64, confidence interval: 1.05–2.57, p = 0.031) than chronic. Oxygen response was less likely if pain intensity was very severe (odds ratio = 0.53, confidence interval: 0.33–2.57, p = 0.006) and the risk of a poor response increased with disease duration (odds ratio = 0.79, confidence interval: 0.65–0.96, p = 0.016). Among current users of sumatriptan injection and oxygen, the proportion achieving 100% relief was higher with sumatriptan injection ( p > 0.001) than with oxygen. No associations were identified regarding verapamil. Only 57% of current users of preventive medication responded at a 50% level.

Conclusion

Episodic cluster headache is more responsive to acute therapy than chronic. Further, sumatriptan injection was more effective than oxygen and the responder-rate was limited with verapamil. More effective acute and preventive therapies are needed for cluster headache patients.
Responses of spinal trigeminal neurons to noxious stimulation of paranasal cavities – a rat model of rhinosinusitis headache
Authors: Koch Michael , Sertel-Nakajima Julika , Messlinger Karl
Published: November 2020

Background

The pathophysiology of headaches associated with rhinosinusitis is poorly known. Since the generation of headaches is thought to be linked to the activation of intracranial afferents, we used an animal model to characterise spinal trigeminal neurons with nociceptive input from the dura mater and paranasal sinuses.

Methods

In isoflurane anaesthetised rats, extracellular recordings were made from neurons in the spinal trigeminal nucleus with afferent input from the exposed frontal dura mater. Dural and facial receptive fields were mapped and the paranasal cavities below the thinned nasal bone were stimulated by sequential application of synthetic interstitial fluid, 40 mM potassium chloride, 100 µM bradykinin, 1% ethanol (vehicle) and 100 µm capsaicin.

Results

Twenty-five neurons with input from the frontal dura mater and responses to chemical stimulation of the paranasal cavities were identified. Some of these neurons had additional receptive fields in the parietal dura, most of them in the face. The administration of synthetic interstitial fluid, potassium chloride and ethanol was not followed by significant changes in activity, but bradykinin provoked a cluster of action potentials in 20 and capsaicin in 23 neurons.

Conclusion

Specific spinal trigeminal neurons with afferent input from the cranial dura mater respond to stimulation of paranasal cavities with noxious agents like bradykinin and capsaicin. This pattern of activation may be due to convergent input of trigeminal afferents that innervate dura mater and nasal cavities and project to spinal trigeminal neurons, which could explain the genesis of headaches due to disorders of paranasal sinuses.
Sex differences in prevalence of migraine trigger factors: A cross-sectional study
Authors: van Casteren Daphne S , Verhagen Iris E , Onderwater Gerrit LJ , MaassenVanDenBrink Antoinette , Terwindt Gisela M
Published: November 2020

Aim

To examine the effect of sex on migraine trigger factors.

Methods

Prevalence of 11 frequently reported trigger factors was determined in a cross-sectional study among migraine patients from a validated migraine database (n = 5725 females and n = 1061 males). Female-to-male odds ratios were calculated for each trigger, using a logistic regression model with attack frequency and migraine subtype (with or without aura) as covariates. Additionally, the effect of sex on total number of triggers per individual was determined.

Results

The top three most reported triggers in women were menstruation (78%), stress (77%), and bright light (69%). Men reported stress (69%), bright light (63%), and sleep deprivation (60%) most frequently as provoking factors. The following triggers were more often reported by women than men: Bright light (odds ratio 1.29 [95% CI 1.12–1.48]; p = 0.003), stress (1.47 [1.27–1.69]; p < 0.001), skipping a meal (1.24 [1.09–1.42]; p = 0.015), sleep deprivation (1.37 [1.20–1.57]; p < 0.001), high altitudes (1.70 [1.40–2.09]; p < 0.001), and weather changes (1.35 [1.18–1.55]; p < 0.001). Women reported more triggers than men, even when menstruation was disregarded (mean ± SD: 4.6 ± 2.3 and 4.3 ± 2.3; p < 0.001). Conclusion: Women report migraine trigger factors to be provocative of their attacks more frequently than men, which may be related to a lower migraine threshold due to sex hormonal changes.
The Computational Thinking Scale for Computer Literacy Education
Authors: Tsai Meng-Jung , Liang Jyh-Chong , Hsu Chung-Yuan
Published: November 2020

Computational thinking has received tremendous attention from computer science educators and educational researchers in the last decade. However, most prior literature defines computational thinking as thinking outcomes rather than thinking processes. Based on Selby and Woodland’s framework, this study developed and validated the Computational Thinking Scale (CTS) to assess all students’ thought processes of computational thinking for both general and specific problem-solving contexts in five dimensions: abstraction, decomposition, algorithmic thinking, evaluation and generalization. A survey including 25 candidate items for CTS as well as demographic variables was administered to 388 junior high school students in Taiwan. An explorative factor analysis using the principal axis method with the oblimin rotation was used to validate the scale. Finally, 19 items were extracted successfully under the designed five dimensions, with a total explained variance of 64.03% and an overall reliability of 0.91. Results of the demographic comparisons showed that boys had a greater disposition than girls in decomposition thinking when solving problems using computer programming. In addition, programming learning experience, especially self-directed learning and after-school learning, had significant positive effects on all dimensions of CTS. Several future studies are suggested using this tool.
External Validity and Worksite Wellness: Lessons From China and Illinois
Authors: Terry Paul E.
Published: November 2020

This editorial describes recent randomized controlled trials of worksite wellness interventions and argues that fidelity to intervention designs should be contingent on careful consideration of internal and external validity. A China based hypertension management study which achieved impressive outcomes across 60 workplaces using a comprehensive approach is contrasted with the traditional wellness practices employed in other randomized controlled trials conducted in America. Why studies with negative findings receive more media and professional scrutiny than studies with positive findings is discussed. Three reasons are posited for why bad is stronger than good when it comes to capturing attention. Adoption of new evidence is discussed along with what health promotion professionals can do to advance best practices by considering adoption as an ongoing process.
Characterization and properties of high-temperature resistant structure adhesive based on novel toughened bismaleimide resins
Authors: Wang Daosheng , Xiong Xuhai , Ren Rong , Ma Xinghua , Han Anchang , Chen Ping
Published: November 2020

A series of high-temperature resistant structural adhesives were prepared based on the copolymerization of 4,4′-bismaleimidediphenylmethane (BDM) and 2,2′-diallylbisphenol A (DABPA) together with a novel maleimide-capped polyetherimide containing cardo side groups (mPEI-C) as toughening agent. The chemical structure of the adhesives and their cured networks was characterized by Fourier transform infrared (FTIR) spectrometer. Their curing behavior and kinetics were analyzed using differential scanning calorimetry (DSC). The thermal properties, mechanical properties, bonding strength and moisture absorption behavior of the cured products were investigated by thermogravimetric analysis (TGA) and dynamic mechanical thermal analysis (DMA), etc. The modified resin system with mPEI-C exhibit similar curing behavior, and the apparent activation energy ( E a) and reaction order ( n) are equal to around 85.14 kJ/mol and 0.91, respectively. With increasing mPEI-C contends, the thermal stability is improved, the char yield is increased from 26.5% to 37.1%, and the glass transition temperatures have a slight decrease. The maximum flexural strength, impact strength and bonding strength are increased by 28.4%, 93.1% and 44.6%, respectively. The results of hygrothermal aging experiments exhibit the addition of mPEI-C has no obvious influence on the hygroscopicity of the modified resins.
Model-Based Definition and Enterprise: State-of-the-art and future trends
Authors: Goher Kamran , Shehab Essam , Al-Ashaab Ahmed
Published: November 2020

Model-Based Definition (MBD) is being adopted by the manufacturing industry as a single source for all product information in place of conventional 2D drawings. This paper aims to review the current literature on Model-Based Definition (MBD) and Model-Based Enterprise (MBE) to recognize the main contributions towards the development and implementation of MBD and explore its various perspectives. The publications encompassing technology and applications of MBD are categorized into seven domains. These domains are lifecycle information; design, discrete part manufacturing, and inspection; assembly; maintenance, repair, and overhaul; process planning; engineering change management; and contemporary aspects of digital product definition. The major outcomes of research literature, in these domains, are reviewed and future research directions are identified and formulated. Additionally, the paper highlights the issues and challenges associated with the realization of MBE by the manufacturing industry. These issues are categorized into technical, management, and certification categories. The prevalent issues in each of these categories are further discussed and analyzed.
Coin minting by additive manufacturing and forming
Authors: Pragana João PM , Rosenthal Stephan , Alexandrino Paulo , Araújo Andreia , Bragança Ivo MF , Silva Carlos MA , Leitão Paulo J , Tekkaya A Erman , Martins Paulo AF
Published: November 2020

Additive manufacturing is proposed as a novel alternative to coin blank’s production routes based on rolling, blanking and edge rimming. The presentation draws from laser powder bed fusion of cylinders, slicing into individual coin blanks by electro discharge machining and surface preparation by polishing, to coin minting in a laboratory press-tool system. Special emphasis is given to material deposition and coin minting due to the originality of producing coin blanks with complex intricate contoured holes and to the necessity of subjecting the additive manufactured coin blanks to extreme compressive stresses that are typical of coin minting. Numerical and experimental results confirm the excellent performance of the additive manufactured coin blanks. The new design layouts included in the additive manufactured coin blanks open the way to produce high value-added singular collector coins, which are disruptively different from those available in the market nowadays.
Surface properties of chitosan/montmorillonite films for biomedical applications
Authors: Chang Shih-Hang , Hsieh Ming-Han
Published: November 2020

In this study, we firstly investigated the surface and protein adsorption properties of montmorillonite (MMT)/chitosan (CS) composite films with various MMT/CS weight ratios for metallic implants coating applications. Bicinchoninic acid (BCA) protein assay results show that the neat CS film exhibits a high concentration of bovine serum albumin (BSA) protein adhesion because the abundant carbonyl and amide functional groups on the surface of the CS film easily form hydrogen bonds with the copious carboxylic acid groups on the surface of the BSA protein. The MMT/CS composite films with MMT/CS = 3, 5, 8, and 10 possess a much lower BSA adhesion concentration than that of the neat CS film, as some of the carbonyl and amide functional groups on the surface of the composite films are replaced by the –Si–O–Si and –Al–O–Al groups. Among these MMT/CS composite films, the film with MMT/CS = 5 exhibits the lowest BSA adsorption concentration because it possesses a higher MMT content than those with MMT/CS = 1 and 3 and a smoother and non-porous surface than those with MMT/CS = 8 and 10. According to our results, MMT/CS composite films with appropriate MMT/CS weight ratios exhibit better surface and protein adsorption properties than neat CS for biomedical applications.
Quality measures of a multicentre universal newborn hearing screening program in Malaysia
Authors: Wong Yun Ai , Mazlan Rafidah , Abdul Wahab Noor Alaudin , Ja’afar Roslan , Huda Bani Nurul , Abdullah Nurul Ain
Published: November 2020

Objective

To evaluate and discuss the outcomes of the universal newborn hearing screening program conducted at four public hospitals in Malaysia.

Method

A retrospective analysis of the universal newborn hearing screening database from each hospital was performed. The database consisted of 28,432 and 30,340 screening results of babies born in 2015 and 2016, respectively. Quality indicators (coverage rate, referral rate, return for follow-up rate, and ages at screening and diagnosis) were calculated.

Results

Overall coverage rate across the four hospitals was 75% in 2015 and 87.4% in 2016. Over the two years, the referral rates for the first screening ranged from 2.7% to 33.93% with only one hospital achieving the recommended benchmark of <4% in both years. The return for follow-up rates for each participating hospital was generally below the recommended benchmark of ≥95%. The mean age at screening was 3.9 ± 1.2 days and 3.3 ± 0.4 days, respectively. The mean age at diagnosis for 70 infants diagnosed with permanent hearing loss was 4.7 ± 0.7 months in 2015 and 3.6 ± 0.9 months in 2016.

Conclusions

Quality measures for the universal newborn hearing screening program in four public hospitals in Malaysia were lower than the required standards. Nevertheless, some quality indicators showed statistically significant improvements over the two years. Next steps involve identifying and implementing the best practice strategies to improve the outcome measures and thus the quality of the program.
Defining Normal: What Widowed Parents Make of Diagnosing Grief
Authors: Holmgren Helle
Published: November 2020

Following a lengthy debate about the possibilities of distinguishing abnormal from normal grief reactions, a diagnosis of prolonged grief disorder has been included in the newest edition of the International Classification of Diseases (ICD; WHO, 2018 ). In this online survey, spousally bereaved individuals (N = 86) with children in the home were asked about what they made of the grief diagnosis. The results varied from individuals being decidedly against diagnosing grief to others embracing a diagnosis as a means to a recognition of bereavement and grief—and possible access to help and support. The time criterion in the ICD diagnosis of PGD, however, met widespread criticism. While the diagnosis of PGD has already been included in the ICD, it remains to be seen whether it will lead to more understanding of bereaved individuals and an improved provision of help and support for adults and children in the future.
Evaluating a Novel Tool Design for the Removal of Chamber Lids at an Electrical Utility Company
Authors: Abdoli-Eramaki Mohammad , Templeton Cale , Sotoudeh-nia Yass , Lee Shan
Published: November 2020

The objective of this research was to design and examine a new tool for the removal of chamber lids (manhole covers) called the chamber lid removal tool (CLRT). The CLRT was compared to a pickaxe and J-hook for removing two types of lids using a handheld force meter and an inertial motion capture system. Wearable motion capture was used for monitoring motions in the field. At L4/L5, resultant moment was significantly lower when removing the lids with the CLRT. Significant ( p < .05) decreases in resultant moment were observed for the left and right shoulder when using the CLRT.
Traditional Approach vs Posterior Approach for Ankle Fractures Involving the Posterior Malleolus
Authors: Pilskog Kristian , Gote Teresa Brnic , Odland Heid Elin Johannessen , Fjeldsgaard Knut Andreas , Dale Håvard , Inderhaug Eivind , Fevang Jonas Meling
Published: November 2020

Background:

In the past, posterior malleolus fragments (PMFs) commonly have been indirectly reduced and fixed when fragments involve 25% or more of the tibial articular surface, while smaller fragments were left unfixed. The posterior approach has become increasingly popular and allows fixation of even smaller fragments. This study compares clinical outcome for the 2 treatment strategies.

Methods:

Patients with ankle fractures involving a PMF treated from 2014 to 2016 were eligible for inclusion. Patients were allocated to group A (treated with a posterior approach) or group B (treated with the traditional approach) according to the treatment given. A one-to-one matching of patients from each group based on the size of the PMF was performed. Patient charts were reviewed, and outcome evaluation was performed clinically, radiographically, and by patient-reported outcome measures (PROMs; Self-Reported Foot and Ankle Score, RAND-36, visual analog scale [VAS] of pain, and VAS of satisfaction). Forty-three patients from each group were matched. Median follow-up was 26 (interquartile range [IQR], 19-35) months postoperatively.

Results:

The median PMF size was 17% (IQR, 12-24) in both groups, and they reported similar results in terms of PROMs. Fixation of the PMF was performed in 42 of 43 (98%) patients in group A and 7 of 43 (16%) patients in group B ( P < .001). The former group more frequently got temporary external fixation (56% vs 12%, P < .01) and less frequently had syndesmotic fixation (14% vs 49%, P < .01), and they had less mechanical irritation and hardware removal but more noninfectious skin problems (28% vs 5%, P < .01). Median time from injury to definitive surgery (8 vs 0 days, P < .001) and median length of stay (12 vs 3 days, P < .001) were longer in group A.

Conclusion:

Comparison of treatment strategies for ankle fractures involving the posterior malleolus showed similar results between patients treated with a traditional approach and a posterior approach.

Level of Evidence:

Level III, retrospective comparative study.
Risk Factors Associated With Foot and Ankle Insufficiency Fractures in Postmenopausal Sedentary Women
Authors: Pereira Filho Miguel Viana , Stéfani Kelly Cristina , Ferreira Gabriel Ferraz , Nogueira Monica Paschoal
Published: November 2020

Background:

Insufficiency fractures occur in bones with low elastic resistance. In contrast to stress fractures, which affect normal bones and have been extensively studied, insufficiency fractures of the foot and ankle have been the subject of little research. The objective of this study was to identify risk factors associated with the development of foot and ankle insufficiency fractures.

Methods:

The study included 55 postmenopausal sedentary women with foot and ankle insufficiency fractures and 51 women in the control group. The data collected were the fracture site, body mass index, use of corticosteroids, T scores of the femur and lumbar spine measured by bone densitometry, and serum 25-OH vitamin D level. The calcaneal pitch (CP), talar–first metatarsal, and metatarsus adductus (MA) angles were measured on radiographs.

Results:

In 49 patients (89%), fractures occurred in the metatarsals. All metatarsals were affected, and the most common fracture site was the base of the fifth metatarsal, with 21 cases (33%). Twenty patients (36%) in the study group reported chronic use of corticosteroids and had lower bone mineral density levels than controls ( P < .05). The factors associated with fracture development ( P < .05) were the CP and MA angles and low lumbar bone mineral density.

Conclusion:

Insufficiency fractures in this population were associated with low bone mineral density and unfavorable biomechanical characteristics such as pes cavus and metatarsus adductus.

Level of Evidence:

Level IIIB, case-control study.
Effect of Lateral Column Lengthening on Subtalar Motion in a Cadaveric Model
Authors: Harris Mitchell C. , Hedrick Brittany N. , Zide Jacob R. , Thomas Danielle M. , Shivers Claire , Siebert Matthew J. , Pierce William A. , Kanaan Yassine , Riccio Anthony I.
Published: November 2020

Background:

Although lengthening of the lateral column through a calcaneal neck osteotomy is an integral component of flatfoot reconstruction in younger patients with flexible planovalgus deformities, concern exists as to the effect of this intra-articular osteotomy on subtalar motion. The purpose of this study was to quantify the alterations in subtalar motion following lateral column lengthening (LCL).

Methods:

The subtalar motion of 14 fresh-frozen cadaveric feet was assessed using a 3-dimensional motion capture system and materials testing system (MTS). Following potting of the tibia and calcaneus, optic markers were placed into the tibia, calcaneus, and talus. The MTS was used to apply a rotational force across the subtalar joint to a torque of 5 Nm. Abduction/adduction, supination/pronation, and plantarflexion/dorsiflexion about the talus were recorded. Specimens then underwent LCL via a calcaneal neck osteotomy, which was maintained with a 12-mm porous titanium wedge. Repeat subtalar motion analysis was performed and compared to pre-LCL motion using a paired t test.

Results:

No statistically significant differences in subtalar abduction/adduction (10.9 vs 11.8 degrees, P = .48), supination/pronation (3.5 vs 2.7 degrees, P = .31), or plantarflexion/dorsiflexion (1.6 vs 1.0 degrees, P = .10) were identified following LCL.

Conclusion:

No significant changes in subtalar motion were observed following lateral column lengthening in this biomechanical cadaveric study.

Clinical Relevance:

Although these findings do not obviate concerns of clinical subtalar stiffness following lateral column lengthening for planovalgus deformity correction, they suggest that diminished postoperative subtalar motion, when it occurs, may be due to soft tissue scarring rather than alterations of joint anatomy.
Hilbert transform approach to solve a problem of collinear Griffith crack in the mid-plane of an infinite orthotropic strip
Authors: Mondal Priti , De Jagabandhu
Published: November 2020

In this paper, an integral transformation of the displacement is employed to determine the solution of the elastodynamics problem of two collinear Griffith cracks with constant velocity situated in a mid-plane of an infinite orthotropic strip where the boundaries are assumed to be stress-free. By use of the integral transformation of the displacement, the problem is reduced to a solution of the triple integral equations and the finite Hilbert transformation technique is used to solve it. The expressions of stresses are obtained asymptotically for large values of strip depth. An analytical expression of the stress intensity factor at the crack tip is obtained and represented graphically for two different orthotropic materials.
Safety Assessment of Ceramides as Used in Cosmetics
Authors: Burnett Christina L. , Boyer Ivan J. , Bergfeld Wilma F. , Belsito Donald V. , Hill Ronald A. , Klaassen Curtis D. , Liebler Daniel C. , Marks James G. , Shank Ronald C. , Slaga Thomas J. , Snyder Paul W. , Gill Lillian J. , Heldreth Bart
Published: November 2020

The Expert Panel for Cosmetic Ingredient Safety (Panel) reviewed the safety of ceramides, which function in cosmetics primarily as hair-conditioning agents and skin-conditioning agents—miscellaneous. The Panel considered relevant data related to these ingredients. The Panel concluded that ceramides were safe in cosmetics in the present practices of use and concentration described in this safety assessment.
The Conditionality of Outdoor Sports Events on Weather-Induced Impacts and Possible Solution
Authors: Petrović Marko D. , Radovanović Milan M. , Vyklyuk Yaroslav , Milenković Milan , Tretiakova Tatiana N.
Published: November 2020

All over the globe, outdoor sports events are highly affected by weather conditions that frequently influence the comfort of the players and sports fans, the duration, or even the cancelation of the event. To verify the range of weather-induced impacts on selected Major League Baseball events, this interdisciplinary study investigated the causes of unexpected postponements of several Major League Baseball games in March and April 2018, according to official weather reports in the event host destinations. The impact was measured by a recurrent neural network with long short-term memory as an investigation model. Autocorrelation analysis was conducted between all input and target fields. The research focused on the explanation of the influence of weather risks on the event host destinations. Moreover, the study is based on projecting an effective instrument for managing weather risks and then evaluating the tourism services that the future climatic conditions will support. The long short-term memory analysis revealed that solar activity had the greatest influence on the temperature. On the other hand, humidity and air pressure depended very little on solar activity; this finding was confirmed by the zero values of the sensitivity. These values encourage further research on weather disturbances and their connections with outdoor sports and tourism activities.
Treatment of pelvic fractures in cats with patellar fracture and dental anomaly syndrome
Authors: Rodriguez Natalia Andrea Reyes , Bailey Steven J , Langley-Hobbs Sorrel J
Published: November 2020

Objectives

The aim of this study was to describe the treatment and outcome of acetabular and other pelvic fractures in cats with patellar fracture and dental anomaly syndrome (PADS) and to provide advice on how to manage these cases in practice.

Methods

Data were collated on cats with PADS that were reported to have sustained pelvic fractures or had fractures or fissures of the pelvis identified on submitted radiographs. The details of the fractures were recorded, in addition to any treatment and outcome information.

Results

Of the 215 cases reported with PADS, 58 cats (27%) were found to have pelvic fractures, none of which were known to have resulted from significant trauma. There were 101 fractures in total and of these 15 were treated with surgery, including 10 acetabular fractures, two ilial, two pubic and one ischial fracture. Screw loosening and loss of fracture reduction was seen in four of the surgically treated fractures (two pubic fractures, one ilial and one acetabular fracture). Fourteen cats were euthanased as a direct result of a fracture occurring. While most pelvic fractures healed uneventfully, some cats remained intermittently lame, but it was not always possible to determine the cause of the lameness from the information available and because all cats had concurrent patellar fractures.

Conclusions and relevance

Many of the pelvic fractures healed with conservative management. Fractures involving articular surfaces such as acetabular fractures may benefit from surgical stabilisation as surgery may offer the benefits of articular fracture repair with improved joint congruency and a faster return to normal activity.
When youth musicking is play
Authors: Stewart Rose Leslie , Countryman June
Published: November 2020

Wondering if there is more to learn from youth’s descriptions of the importance of music in their lives, the authors interviewed 35 youth (aged 12–22 years) using a constructivist grounded theory approach. The data analysis process led to the realization that youth were often describing episodes of play. The researchers synthesized essential characteristics of play from the scholarly play literature and particularized these characteristics with extracts from the interview conversations. The goal became to describe the play in youth musicking. The authors’ framework of musick-play reflects the interconnectedness of (a) conditions that constitute a musick-play-place; (b) sonic, and social processes that illuminate instances of youth musick-play and that highlight the centrality of self-caring in that play; (c) experiences that foster autonomy, competence, and relatedness (self-determination theory); and (d) opportunities for well-being. This framework is intended as a heuristic for those who seek to understand youth musicking through the lens of play.
Effects of ultrasound technology advances on measurement of carotid intima–media thickness: A review
Authors: Mitchell Carol , Korcarz Claudia E , Zagzebski James A , Stein James H
Published: November 2020

In this review, we describe how technological advances in ultrasound imaging related to transducer construction and image processing fundamentally alter generation of ultrasound images to produce better quality images with higher resolution. However, carotid intima–media thickness (IMT) measurements made from images acquired on modern ultrasound systems are not comparable to historical population nomograms that were used to determine wall thickness thresholds that inform atherosclerotic cardiovascular disease risk. Because it is nearly impossible to replicate instrumentation settings that were used to create the reference carotid IMT nomograms and to place an individual’s carotid IMT value in or above a clinically relevant percentile, carotid IMT measurements have a very limited role in clinical medicine, but remain a useful research tool when instrumentation, presets, image acquisition, and measurements can be standardized. In addition to new validation studies, it would be useful for the ultrasound imaging community to reach a consensus regarding technical aspects of ultrasound imaging acquisition, processing, and display for blood vessels so standard presets and imaging approaches could reliably yield the same measurements.
The untimeliness of trans youth: The temporal construction of a gender ‘disorder’
Authors: Pitts-Taylor Victoria
Published: November 2020

This article explores a quasi-diagnosis, “rapid-onset gender dysphoria”, which constructs the pathologized untimeliness of trans youth. I argue that rapid-onset is a concept with multiple, shifting meanings that encompass various dimensions of temporality. I show how constructions of rapid or fast time are used to call into question the claims of trans youth and the judgment of clinicians who treat them. The discourse of rapid, hasty, and etiologically suspect gender dysphoria assumes a view of gender as essential, fixed, and asocial, and of adolescence as a developmental stage of passivity, susceptibility, and risk. The study’s treatment of its research subjects as untimely obscures their varied, emergent, and dynamic experiences, I argue, which should not be read as signs of “incorrect” gender identity, but rather as indications of gender’s material performativity.
Recent cases and the future of Directive 79/7 on equal treatment for men and women in social security: How to realise its full potential
Authors: De la Corte-Rodríguez Miguel
Published: November 2020

Directive 79/7 on equal treatment for men and women in statutory social security has proven to be more relevant than ever, forty years after its adoption. Two new landmark judgments were handed down in 2019. The first ( Villar Láiz) concerned the calculation of the retirement pensions of part-time workers and the ruling marks an important milestone in the long road towards delivering better social protection for these workers, the majority of whom are women. The second ( WA) dealt with a pension supplement granted to female pensioners with two or more children (to the exclusion of men) and analysed, for the first time, whether affirmative action is permitted in the field of statutory social security. This article describes and makes some comments on the 2019 judgments. It also reflects, on the occasion of the 40th anniversary of Directive 79/7, on how its full potential can be realised. In particular, it proposes the generalisation of the pro rata temporis principle by removing affiliation thresholds for part-time workers, extending the scope of the Directive to all carers and carers’ allowances following the ruling in Drake, invalidating temporary derogations of the Directive in line with Test-Achats, and using Article 157(3) TFEU as a legal basis so that the Directive can be amended by qualified majority.