bluuebunny/crossref_metadata_2025 huggingface dataset:
Response control of cable-stayed arch bridge using modified hanger system
Authors: Farahmand-Tabar Salar , Barghian Majid
Published: April 2020

Vertical or inclined cables which are placed in bridges as a hanger system affect the dynamic performance of bridges. Inclined hangers can be used instead of vertical hangers to improve the stability of the bridge aerodynamically. However, inclined hangers are susceptible to fatigue more than vertical ones. Considerable signs of distress or slackness might be shown by some inclined hangers because of their location on the bridge. In this study, a cable-stayed arch bridge with vertical and inclined hangers has been compared to investigate the effect of hangers on the dynamic performance of the bridge. To reduce the internal cable forces and the probability of fatigue or force fluctuation in hangers, additional horizontal cables are applied on inclined hangers that transfer the tensile load from overstressed hangers to adjacent ones with lower forces. By modification, the results demonstrate the higher stiffness and human comfort level for the bridge that improve the dynamic behavior and control the responses of the bridge.
Pars plana Ex-Press mini shunt for management of persistent glaucoma in vitrectomized eyes: A novel technique
Authors: Abdullatif Abdussalam , El-Saied Heba
Published: April 2020

Purpose:

To evaluate the safety and efficacy of a novel approach to implant Ex-Press mini shunt via the pars plana under a scleral flap in pseudophakic or aphakic, vitrectomized patients with secondary refractory glaucoma.

Methods:

A prospective interventional case series of three patients with secondary glaucoma after pars plana vitrectomy. Intraocular pressure was not controlled by silicone oil removal, if the patient was siliconized, nor the maximum medical treatment. Ex-Press mini shunt via the pars plana was implanted. We evaluated the control of intraocular pressure and the development of intraoperative and postoperative complications.

Results:

During 1-year follow-up, control of intraocular pressure was achieved; 14, 15, and 15 mmHg at the 3 months, and 15, 15, and 16 mmHg at the 6 months in our three cases without antiglaucoma treatment and 16, 16, and 18 with single antiglaucoma medication at 1 year. Blebs were posterior and diffuse. No complications were encountered intraoperatively or postoperatively. Ultrasound biomicroscopy showed suprachoroidal posterior lake of fluid as an additional filtration route without any choroidal or retinal complication.

Conclusion:

Implantation of Ex-Press mini shunt via the pars plana in aphakic or pseudophakic, vitrectomized eyes is a promising, safe, and effective technique in patients with secondary glaucoma.
Allergic Contact Dermatitis Secondary to Moisturizers
Authors: Cohen Stephanie R. , Cárdenas-de la Garza Jesús A. , Dekker Paige , Haidari Wasim , Chisolm Sarah S. , Taylor Sarah L. , Feldman Steven R.
Published: April 2020

Background: Moisturizers are cosmetic products used routinely to manage various skin conditions. Even though moisturizers are often thought to have minimal or no adverse reactions, allergic contact dermatitis (ACD) to these products can develop in some cases. Methods: We studied ingredients included in 3 of the most commonly used moisturizer brands, identified their presence in standard patch testing series, and evaluated their allergenic potential, categorizing the allergens as frequent or infrequent. The standard patch testing series used as reference were the Thin-layer Rapid Use Epicutaneous patch test (T.R.U.E. test), the North American Contact Dermatitis Group (NACDG) screening standard series, and the American Contact Dermatitis Society (ACDS) core allergen series. Results: Aveeno, Cetaphil, and Cerave products had a total of 12, 14, and 9 potential allergens, respectively, the majority of which were infrequent and not included in standard patch testing series. Conclusion: Being aware of the allergenic potential of commonly used moisturizers may help healthcare providers when evaluating patients with ACD. Further testing is recommended in a targeted manner when suspecting ACD with negative standard patch testing series or when ACD is refractory to treatment.
An experimental study on the performance of fine-grained concrete incorporating recycled steel spring exposed to acidic conditions
Authors: Pachideh Ghasem , Gholhaki Majid
Published: April 2020

This article aims to study the effects of adding steel fibers and galvanized recycled spring on mechanical properties and crack development in the fine-grained concrete exposed to the acidic environment containing magnesium sulfate. To this end, specimens containing 0.3% and 0.6% of steel fibers and springs, respectively, by concrete volume, were built in normal temperature using 10 cm × 20 cm standard steel formworks so as to conduct the compressive and tensile strength tests. All specimens were cured in 28 days exposed to the environment containing 0%, 5%, and 10% of magnesium sulfate. Based on the results, addition of steel fibers and recycled spring improves the compressive and tensile strength by 50% and 60%, respectively. Moreover, the specimens containing recycled spring better withstood against the acidic environments in comparison with the specimens including steel fibers. In general, it was found that due to the negligible difference between the strength of the specimens, the application of metal-recycled spring in the fine-grained concrete is technically and economically justifiable.
Enhancing resilience in cross-boundary families: A parent–child parallel group intervention
Authors: Yu Nancy Xiaonan , Kam-fung Liu Iris , Bu He
Published: April 2020

Cross-boundary children and their parents suffer from various stressors and mental health problems. This pilot study aimed to investigate whether an emotion regulation parallel intervention for children and parents enhanced resilience and mental health among both groups. A total of 38 pairs of cross-boundary children and parents participated in concurrent but separate intervention sessions. Three waves of tests (i.e. pre-, post-, and one-month follow-up tests) were conducted, using t-tests to evaluate the time effects during the intervention.

Findings

The children and parents reported significant improvements in positive affect, resilience, and family harmony, as well as a reduction in depressive symptoms following the emotion regulation intervention. For both children and parents, over half of the participants who were in the high-depression category have crossed the threshold, from high to low level of depression at post-test, and participants with higher depression levels generally benefited more from the intervention.

Applications

Future researchers seeking to implement demand-driven and practice-based interventions in community settings should consider contextual and cultural sensitivity, and involve community stakeholders (e.g. cross-boundary family members and social workers) in all aspects of the research process with a given community-based participatory research approach. Screening based on depression may maximize the benefits to the participants. The essential components, as well as the fidelity measures of the intervention, should be refined. Randomized controlled trials are advocated in future studies to test the efficacy and effectiveness of the intervention in different contexts (e.g. clinical and community populations).
Susceptibility of LED street lamps to voltage dips
Authors: Sakar S , Bagheri A , Rönnberg S , Bollen MHJ
Published: April 2020

There is an ongoing transition from high-pressure sodium lamps to LED street lamps that offer higher efficiency, cost saving and better photometric performance. This transition could lead to unintended consequences such as light flicker and extinguishing in street lighting applications when they are exposed to voltage dips. The goal of this paper is to analyse the light intensity variation of various street lamps when they are exposed to voltage dips. Several performance metrics for quantifying immunity of lamps have been proposed. Values for these metrics are obtained by applying artificial voltage dips to lamps. For voltage dips with residual voltage above 38%, lamps are immune in terms of a short-term light flicker metric. For residual voltage above 25%, light intensity reduces but without extinguishing. Compared to an incandescent lamp and high-pressure sodium lamp, LED street lamps exhibit longer zero-light intensity duration. Most of the studied LED street lamps exhibit uncoordinated light intensity drops, i.e. longer or shifted, with respect to the applied voltage dip. Individual characteristics of LED street lamps require testing before installation to prevent unexpected consequences. Recommendations are given for standardisation committees to implement an assessment method for lighting equipment.
An Eye for an Eye: A Randomized Placebo-Controlled Trial of IVIG in Antibody-Mediated Encephalitis
Authors: Gaspard Nicolas
Published: April 2020

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Endovascular Treatment of a Persistent Traumatic Deep Femoral Arteriovenous Fistula After Gunshot Injury
Authors: Liao Jane L. , Wang S. Keisin , Dalsing Michael C. , Motaganahalli Raghu L.
Published: April 2020

This article describes a deep femoral arteriovenous fistula (AVF) diagnosed over a decade after a small caliber gunshot injury to the groin. The fistula persisted following 2 previous attempts at endovascular exclusion and was referred to our institution for further care. We describe the successful exclusion of the AVF via a combination of endovascular techniques. Postoperatively, obliteration was noted to be durable for 4 additional years of follow-up.
Examining the “Gang Penalty” in the Juvenile Justice System: A Focal Concerns Perspective
Authors: Walker D’Andre , Cesar Gabriel T.
Published: April 2020

There are hundreds of thousands of juvenile gang members in the United States who are at heightened risk of criminal offending, violent victimization, and incarceration. Importantly, however, incarceration in itself is a lifelong risk factor for negative social outcomes. That said, little is known about the effects of gang membership on the sentencing outcomes of juvenile offenders. The primary research question of the current study is: How does self-reported gang membership influence the likelihood of incarceration relative to similarly situated non-gang-involved juvenile defendants? To address this question, the current study uses data obtained from the Pathways to Desistance study. In a sample of 1,067 serious adolescent offenders drawn from Wave I, results show that gang affiliation is a significant predictor of incarceration. This finding was consistent across the two study sites (Phoenix, AZ, and Philadelphia, PA), ultimately providing support for a “gang penalty” in juvenile sentencing outcomes. The implications for future research, juvenile justice policy, and youth development are discussed.
Expression of Caveolin-1 Is Associated With Thyroid Function in Patients With Human Papillary Thyroid Carcinoma
Authors: Zhang Jingyi , Yan Dongxia , He Lianping , Zhang Qing , Wen Shuang , Liu Peiyu , Zhou Hong , Peng Yongde
Published: April 2020

Objective:

The aim of this study was to evaluate the levels of caveolin-1 in thyroid follicular epithelial cells of papillary thyroid cancer, follicular thyroid cancer, and nonmalignant thyroid nodule benign follicular adenoma, as well as to explore the relationship between the levels of caveolin-1 and thyroid function.

Methods:

Thirty cases of papillary thyroid cancer, 10 cases of follicular thyroid cancer, 32 cases of nonmalignant thyroid nodule benign follicular adenoma, and 30 controls were enrolled in this study. Caveolin-1 expression in tissue specimens obtained from these cases was evaluated by immunohistochemistry and Western blotting.

Results:

Caveolin-1 expression in thyroid epithelial cells of patients with papillary thyroid cancer, particularly female patients, was significantly higher than that in patients with follicular thyroid cancer and nonmalignant thyroid nodule benign follicular adenoma ( P < .005). Serum thyroid-stimulating hormone (TSH) levels in the caveolin-1-positive expression group were lower than that in the caveolin-1-negative expression group, and the lowest expression of caveolin-1 was detected in tissues of patients with Graves’ disease. The serum TSH level was associated with caveolin-1 expression in thyroid epithelial cells.

Conclusion:

Caveolin-1 may participate in regulating thyroid function and is a potential biomarker of follicular thyroid cancer.
Progressive multi-damage analysis of composite laminate using higher order zig-zag plate theory
Authors: Wu Zhaotian , Zhou Chuwei
Published: April 2020

In this article, a finite element model of multi-layer composite laminates with delamination based on higher order zig-zag theory is studied for the progressive delamination analysis. The degrees of freedom are simplified by the continuity conditions of shear stress between layers and the free-surface conditions at the bottom and top of laminates. The numbers of degrees of freedom are not reduced with this method while the model can take the initiation of delamination into consideration in return. Static loading analysis is implemented to simulate the performance in delamination resistance with two different plies and under two different boundary conditions. The present model can present good performance in the prediction of delamination phenomenon.
Oral application of bulleyaconitine A attenuates morphine tolerance in neuropathic rats by inhibiting long-term potentiation at C-fiber synapses and protein kinase C gamma in spinal dorsal horn
Authors: Mai Jie-Zhen , Liu Chong , Huang Zhuo , Mai Chun-Lin , Zhou Xin , Zhang Jun , Liu Xian-Guo
Published: April 2020

Morphine is frequently used for the treatment of chronic pain, while long-term use of the drug leads to analgesic tolerance. At present, the prevention of the side effect remains a big challenge. Bulleyaconitine A, a diterpenoid alkaloid from Aconitum bulleyanum plants, has been used to treat chronic pain in China for more than 30 years. In the present study, we tested the effect of bulleyaconitine A on analgesic tolerance induced by morphine injections (10 mg/kg s.c., b.i.d.) in the lumbar 5 spinal nerve ligation model of neuropathic pain. We found that intragastrical application of bulleyaconitine A (0.4 mg/kg) 30 min before each morphine injection substantially inhibited the decrease in morphine’s inhibitory effect on mechanical allodynia and thermal hyperalgesia. Mechanistically, morphine injections further potentiated the lumbar 5 spinal nerve ligation induced long-term potentiation at C-fiber synapses in the spinal dorsal horn, a synaptic model of chronic pain. This effect was completely blocked by intragastrical bulleyaconitine A. It has been well established that activation of protein kinase C gamma and of glial cells in the spinal dorsal horn are critical for the development of opioid tolerance and neuropathic pain. We found that morphine injections exacerbated the upregulation of phospho-protein kinase C gamma (an active form of protein kinase C gamma), and the activation of microglia and astrocytes in the spinal dorsal horn induced by lumbar 5 spinal nerve ligation, and the effects were considerably prohibited by intragastrical bulleyaconitine A. Thus, spinal long-term potentiation at C-fiber synapses may underlie morphine tolerance. Oral administration of bulleyaconitine A may be a novel and simple approach for treating of opioid tolerance.
The influence of breast cancer related lymphedema on women’s return-to-work
Authors: Sun Yuanlu , Shigaki Cheryl L , Armer Jane M
Published: April 2020

Background:

Lymphedema is one of the major treatment complications following breast cancer surgery and radiation. As the majority of women who develop breast cancer are at the age of employment, occupational functioning and employment are issues of concern. This study is novel in exploring the ways that lymphedema affects their work experience.

Methods:

A multiple-case study methodology drawn from Yin’s definition was employed. A total of 13 female survivors who developed breast cancer–related lymphedema participated by completing a survey and a 60-min semi-structured interview.

Results:

Four main themes emerged: (1) breast cancer–related lymphedema affects physical and emotional functioning associated with work; (2) ongoing treatment for breast cancer–related lymphedema creates challenges for work; (3) environmental factors affect the return-to-work experience; and (4) personal factors play a key role in adjusting to return-to-work.

Conclusion:

Both breast cancer–related lymphedema and its treatment have direct and indirect effects on work, with environmental and personal factors also shaping the work-return experience. This study suggests that breast cancer survivors with lymphedema who wish to return to work face potential barriers, and that gaps remain in the availability of supports.
It’s not always about me: The effects of prior beliefs and stimulus prevalence on self–other prioritisation
Authors: Falbén Johanna K , Golubickis Marius , Wischerath Darja , Tsamadi Dimitra , Persson Linn M , Caughey Siobhan , Svensson Saga L , Macrae C Neil
Published: April 2020

Although self-relevance is widely acknowledged to enhance stimulus processing, the exclusivity of this effect remains open to question. In particular, in commonly adopted experimental paradigms, the prioritisation of self-relevant (vs. other-relevant) material may reflect the operation of a task-specific strategy rather than an obligatory facet of social-cognitive functioning. By changing basic aspects of the decisional context, it may therefore be possible to generate stimulus-prioritisation effects for targets other than the self. Based on the demonstration that ownership facilitates object categorisation (i.e., self-ownership effect), here we showed that stimulus prioritisation is sensitive to prior expectations about the prevalence of forthcoming objects (owned-by-self vs. owned-by-friend) and whether these beliefs are supported during the task. Under conditions of stimulus uncertainty (i.e., no prior beliefs), replicating previous research, objects were classified more rapidly when owned-by-self compared with owned-by-friend (Experiment 1). When, however, the frequency of stimulus presentation either confirmed (Experiment 2) or disconfirmed (Experiment 3) prior expectations, stimulus prioritisation was observed for the most prevalent objects regardless of their owner. A hierarchical drift diffusion model (HDDM) analysis further revealed that decisional bias was underpinned by differences in the evidential requirements of response generation. These findings underscore the flexibility of ownership effects (i.e., stimulus prioritisation) during object processing.
Brain death in early pregnancy: A legal and ethical challenge coming to your intensive care unit?
Authors: Warren Alex , Kelly Sarah , Karus-McElvogue Antonia , Burnstein Rowan
Published: April 2020

Increasingly, reports are emerging of maternal physiological support after brain death in pregnant women declared brain dead long before the gestational age of foetal viability. While these ‘miracle babies’ often receive significant media attention – such as the recent case of Catarina Sequeira – it is difficult to estimate the probability of a live birth in such circumstances given a clear publication bias in favour of reporting good outcomes. In a number of highly publicised cases, continuation of maternal physiological support after brain death has been attempted against the express wishes of the patient's family in jurisdictions where a foetal right to life is given weight in law. The legal issues around discontinuation of maternal physiological support after brain death have not yet been assessed by a UK court. The scenario is easily envisioned, however, where conflict emerges as to the appropriateness of such support. While there is no statutory definition of death in the UK, the courts have accepted brain-dead patients as legally dead upon completion of brainstem testing. However, as UK law grants few explicit legal rights to a foetus, it is unclear as to how conflicts are to be resolved. This article is not intended as a systematic review of the medical or legal academic literature, nor as a review of the clinical management of the pregnant brain-dead patient; rather, it aims to summarise the evidence base for maternal physiological support after brain death and the relevant case law. Using a recent case as an example, this article will outline the legal approach to death in the UK, contrast the status in law of a brain-dead mother and her foetus, and advance an argument of the circumstances in which maternal physiological support after brain death may be ethically justifiable. The authors hope this will assist the UK intensivist in the complex decision-making such cases demand.
Reconciliaction: Reconciling contestation in the academy
Authors: Styres Sandra
Published: April 2020

This article emerges from an analysis of the data from a Social Sciences and Humanities Research Council of Canada-funded research project that examined the ways two universities were taking up the Truth and Reconciliation Commission and its Calls to Action. This article focuses on reconcili action as critical social action. A multi-levelled analysis of the data revealed that colonialism and violence in the academy was a theme of critical importance to research participants. This article concludes by making recommendations for ways universities can unpack and address violence and contestation to move reconciliation forward in meaningful and respectful ways.
Jihadism and Far-Right Extremism: Shared Attributes With Regard to Violence Spectacularisation
Authors: Brzuszkiewicz Sara
Published: April 2020

This article argues that similarities between jihadism and far-right radicalism are increasing, particularly with regard to the spectacularisation of violence. Spectacularisation means representing and performing violence in the form of a show, for instance through live-streaming, with a renewed emphasis on captivating symbols and much less attention paid to the ideological foundations on which the radical project is supposed to rely. After the March 2019 shooting in Christchurch, New Zealand, the spectacularisation of racist, anti-Islamic and anti-Semitic violence increased, thus consolidating that event as a turning point in the evolution of the contemporary far right and the history of jihadism—which has far-right affinities. Lured by the performance of violence, the number of contemporary far-right sympathisers is steadily growing in a virtual environment that closely resembles that of jihadists, where patterns and mechanisms of online recruitment and grooming are proliferating.
EU Search and Rescue Activities in the Mediterranean
Authors: Düpont Lena
Published: April 2020

This article focuses on the EU’s search and rescue activities in the Mediterranean, the location of some of the world’s deadliest migration routes. It argues that saving lives at sea is not an act of grace, nor of simple solidarity with those at risk. Rather, it is first and foremost a legal obligation under international law. Understanding this fact is essential when engaging in the underlying and frequently misleading debate on our humanitarian obligation to render assistance to people in distress at sea. The article also makes the point that the EU must clearly distinguish between economic migrants and refugees in need of humanitarian protection, and prioritise dedicating its resources to those genuinely in need of safeguarding. Legal pathways and humanitarian corridors can only be set up for refugees.
Covenant and pedagogy
Authors: Faber Ben
Published: April 2020

This article argues that “covenant” ought to serve universally as a framework for education, beyond the exclusive sense of covenant in use in Reformed Christian education. The article begins with covenant as creation’s answerable relationship with the Creator, then offers a brief account of language as a form of covenantal exchange, and concludes with pedagogy as a function of the covenantal structures of being and of speaking.
Extracorporeal Membrane Oxygenation After Glenn Procedure in a Child With Influenza B Pneumonia
Authors: Matic Toni , Bakos Matija , Belina Drazen , Duric Zeljko , Bartonicek Dorotea , Malcic Ivan
Published: April 2020

A five-month-old male with a hypoplastic left heart syndrome developed severe respiratory insufficiency due to influenza type B viral pneumonia following bidirectional Glenn. He was treated with extracorporeal membrane oxygenation and successfully weaned without neurological consequences.
Single-Stage Fontan Operation in a Patient With Coronary Sinus Ostium Atresia
Authors: Korun Oktay , Altın Hüsnü Fırat , Yurdakök Okan , Çiçek Murat , Kılıç Yiğit , Selçuk Arif , Altuntaş Yasemin , Yılmaz Emine Hekim , Aydemir Numan Ali , Şaşmazel Ahmet
Published: April 2020

An eight-year-old boy with tricuspid atresia was found to have atretic coronary sinus ostium during cardiac catheterization. Single-stage extracardiac fenestrated Fontan operation was performed with surgical unroofing of the coronary sinus into the left atrium to avoid the risk of cardiac congestion.
Unusual Ventriculo-Arterial Alignments and Connections
Authors: Sanders Stephen P. , Toba Shuhei
Published: April 2020

In this issue of World Journal for Pediatric and Congenital Heart Surgery, Kari and colleagues present a case of anatomically corrected malposition {S, L, L} with ventricular septal defect and complex subaortic stenosis managed by staged biventricular repair. This rare case with interesting management strategy provides an opportunity to clarify this and related unusual ventriculo-arterial alignments.
Lymphatic Decompression Concomitant With Fontan/Kreutzer Procedure: Early Experience
Authors: Kreutzer Christian , Klinger Daniel Alberto , Chiostri Benjamin , Sendoya Santiago , Daneri Mariana Lopez , Gutierrez Augusto , Fraire Rafael Alfredo , Torres Silvio Fabio
Published: April 2020

Objective:

To present a strategy for identifying patients at risk of lymphatic failure in the setting of planned Fontan/Kreutzer completion, allowing a tailored surgical approach.

Methods:

Since January 2017, clinical evaluation before performance of the Fontan/Kreutzer procedure included T2-weighted magnetic resonance imaging (MRI) lymphangiography. Thoracic lymphatic abnormalities were categorized using a scale of I to IV according to progression of severity. Patients with severe lymphatic abnormalities (types III and IV) underwent Fontan/Kreutzer with lymphatic decompression via connection of the left jugular–subclavian junction containing the thoracic duct to the systemic atrium (group A).

Results:

Thirteen patients were enrolled. Magnetic resonance imaging showed type I abnormalities in four cases (30.7%), II in four (30.7%), III in two (15.3%), and IV in three (23.3%). Patients in types III and IV underwent a Fontan/Kreutzer with lymphatic decompression (group A, n = 5), while patients in types I and II underwent a fenestrated extracardiac Fontan/Kreutzer procedure without lymphatic decompression (group B, n = 8). Preoperatively, there were no differences in age, weight, ventricular dominance (right vs left), superior vena cava pressure, incidence of chylothorax after previous superior cavopulmonary anastomosis (Glenn), or need for concomitant procedures at Fontan/Kreutzer completion. There were no differences in procedural times between the groups, nor were there differences in mortalities and Fontan/Kreutzer takedowns. There were no statistically significant differences in early and late morbidity between the two groups with the exception of total volume of effusions output postoperatively. At median follow-up of 18 months (range, 4-28 months), all patients in group A are in New York Heart Association class 1 with no differences between groups in arterial oxygen saturation.

Conclusions:

Lymphatic decompression during Fontan/Kreutzer procedure was successfully performed in patients identified by MRI as predisposed to lymphatic failure. A larger cohort of patients and longer follow-up are required to determine the efficacy of this approach in preventing early- and long-term Fontan/Kreutzer failure.
Efforts to Reduce Infections in Delayed Sternal Closure Patients: A Survey of Pediatric Practice
Authors: Woodward Cathy , Taylor Richard , Son Minnette , Taeed Roozbeh , Husain S. Adil
Published: April 2020

Background:

Pediatric patients with sternum left open after cardiac surgery experience a higher risk for sternal wound infection (SWI). These infections are costly for programs, payers, and patients and their families. Despite efforts by individual programs to reduce infections in patients undergoing delayed sternal closure (DSC), there are no established guidelines that address preventive procedures. The purpose of this study was to determine the practice of pediatric cardiac surgery programs to prevent infection in their DSC patients and if preventive measures were associated with less infections.

Methods:

A 33 question survey on institutional practices was sent to chief surgeons at pediatric cardiac surgery programs in the United States.

Results:

Twenty-eight (35%) surgical programs responded. The mean number of pediatric cardiac bypass operations performed by programs in 2016 was 227 (range: 69-872). Data represented 6,484 patients <18 years of age who underwent cardiac surgery with 807 (12%) of those undergoing DSC. One hundred fifty-eight (2.4%) of all patients and 51 (6.3%) of the DSC patients developed a SWI. Patients with DSC who received preoperative baths were less likely to become infected (5.9% vs 15.8%; P = .015). Patients in programs with feeding protocols had fewer infections (5.7% vs 14.8%; P = .008).

Conclusions:

The results of this survey of children’s cardiac surgery programs describe their practices to reduce infection rates in DSC patients. A multicenter project on wound care and closure techniques that might impact this costly complication is needed.
A Review on the Surgical Management of Subvalvular Aneurysm
Authors: George Niwin , Chowdhury Ujjwal Kumar , Singh Sukhjeet , Sankhyan Lakshmi Kumari , Sushamagayatri B , Sengupta Sanjoy , Malik Vishwas , Angadi Suryalok
Published: April 2020

The present perspective is a synthesis of published investigations in the setting of subvalvular aortic aneurysms. We identified 75 investigations and reviewed the clinical presentation, diagnostic modalities used, surgical techniques employed, and their outcomes. Clinical presentation, radiographic findings, transthoracic and transesophageal echocardiography, electrocardiogram-gated computerized tomography, and magnetic resonance imaging provided the diagnostic information and were used to define the disease entity before surgery. In this article, we have attempted to address several issues concerning establishment of diagnosis, varied clinical presentation, and their management. We submit that an increased appreciation of this disease entity will contribute to improved surgical management.
Pulmonary Valve Replacement in Repaired Tetralogy of Fallot Through Limited Left Anterolateral Thoracotomy: An Alternative to Repeat Sternotomy
Authors: Ramman Tarun Raina , Chowdhuri Kuntal Roy , Raja Nayem , Girotra Sumir , Azad Sushil , Iyer Parvathi Unninayar , Iyer Krishna Subramony
Published: April 2020

We report two patients with repaired tetralogy of Fallot who underwent pulmonary valve replacement through a limited left anterolateral thoracotomy. We describe the technique in detail. Both patients were at risk of cardiac injury during repeat sternotomy. This approach reliably avoids the risk of cardiac injury during repeat sternotomy and appears to be safe, simple, and reproducible.
Critical Reflections on Individual Collages as a Research Method With Young Women Living With HIV in Zambia
Authors: Mackworth-Young Constance R. S. , Wringe Alison , Clay Sue , Chonta Mutale , Chiiya Chipo , Konayuma Katongo , Sievwright Kirsty , Mbewe Madalitso , Mwale Mwangala , Stangl Anne L. , Bond Virginia
Published: April 2020

Art-based research methods can enable young people to generate data that provide insights into their lives. We assessed the feasibility, value, and limitations of collages as a participatory research method to understand the experiences of young women living with HIV. Individual collages were created in participatory workshops, firstly in 2015 and secondly in 2017, by a cohort of young women living with HIV in Lusaka, Zambia. Collages were analyzed visually and thematically and compared to other qualitative methods. Participants engaged readily with making collages and expressed how the collages represented themselves. The collages conveyed aspirations, resilience, optimism, and identities beyond HIV. Other data generation methods focused more on challenges associated with HIV. The second collages demonstrated more complex portrayals of participants’ life and developmental transitions. Collages provided a feasible, effective, and therapeutic method of empowering young women living with HIV to tell their own stories and express their full selves.
I‘timād ‘Ali-

Kh

ān: The career of a Mu

gh

al officer through his own diary
Authors: Rezavi Syed Ali Nadeem
Published: April 2020

I‘timād ‘Alī Khān (to go by his last title), is unique among Mughal officials for having left behind a diary from 1693 to 1727, covering his period of service in Gujarat, then his journey to Delhi and Allahabad and back and, finally, his sojourn at Surat. He gives us much information about individual officials, and the slowly collapsing Mughal administration. The following article reconstructs his career from the diary.
Liberating India: Contextualising Nationalism, Democracy and Dr Ambedkar
Authors: Raut Santosh I.
Published: April 2020

Dr B. R. Ambedkar (1891–1956) is the principal architect of the Indian constitution and one of the most visionary leaders of India. He remains to this day a symbol of humanity. He is the father of Indian Democracy and a nation builder who shaped modern India. But his notion of nationalism and democracy envisioning an egalitarian society has rarely received adequate academic attention. His views on religion, how it affects socio-political behaviour, and what needs to be done to build an egalitarian society are unique. Such reflections in terms of nationalism and freedom of the people are of great significance in contemporary time in India and the world in general. This article attempts to analyse Ambedkar’s vision of nation and democracy. It also seeks to study how caste system is the major barrier to creating a true nation and a harmonious society. What role does religion play in society and politics? Can socio-spiritual values inspire to break down the barriers of caste differences to form an egalitarian society?

History bears witness to instances where great minds empowered with deep contemplation on meeting with the suffering of the people (which in itself is both a prerequisite and an inseparable element of social reform and liberation), resulting in radical shifts in perception. Ambedkar is one such genius whose compassionate engagement and deep imagination envisioned the establishment of an ideal society based on non-discrimination and love.
Narrative comprehension and engagement with e-books vs. paper-books in autism spectrum condition
Authors: Wainwright Bethany R , Allen Melissa L , Cain Kate
Published: April 2020

Background and aims

Children with autism spectrum condition often have specific difficulties with narrative comprehension, a skill which has a strong association with both concurrent and longitudinal reading comprehension. A better understanding of narrative comprehension skills in autism spectrum condition has the potential to provide insight into potential later reading comprehension difficulties and inform early targeted intervention. In the current study, the main objective was to investigate how differences in the medium of story presentation (paper-book vs. e-book) and differences in story narration (adult narration vs. in-app narration) would influence narrative comprehension in general, and between groups (autism spectrum condition and a receptive language-matched control group). We were also interested in how task engagement (visual attention and communication) differed between group and conditions and whether task engagement was related to narrative comprehension.

Method

Forty-two children with autism spectrum condition and 42 typically developing children were read a story either via a paper-book or an e-book with interactive and multimedia features. The e-book was either narrated by the experimenter (adult narrated iPad condition) or narrated by an in-app voiceover (e-book narrated iPad condition). Children’s behaviour during storybook reading was video recorded and coded for engagement (visual attention and communication). They then completed two measures of narrative comprehension: multiple-choice questions (measuring recall of literal information) and a picture ordering task (measuring global story structure).

Results

Contrary to predictions, we did not find any significant group or condition differences on either measure of narrative comprehension, and both groups demonstrated a similar level of narrative comprehension across the three conditions. We found differences in engagement between conditions for both groups, with greater visual attention in the e-book conditions compared to the paper-book condition. However, visual attention only significantly correlated with narrative comprehension for the typically developing group.

Conclusion

Overall, this study suggests that children with autism spectrum condition are just as able as language-matched peers to comprehend a narrative from storybooks. Presenting a story on an iPad e-book compared to a paper-book does not influence narrative comprehension, nor does adult narration of the story compared to in-app narration. However, on-task engagement is linked to narrative comprehension in typically developing children. Implications: Taken together, our findings suggest that e-books may be more successful than paper-based mediums at encouraging visual attention towards the story, but no better at supporting narrative comprehension and eliciting communication.
Introduction: Research agendas raised by the Belt and Road Initiative
Authors: Sidaway James D , Rowedder Simon C , Woon Chih Yuan , Lin Weiqiang , Pholsena Vatthana
Published: April 2020

We introduce this symposium on the politics and spaces of China’s Belt and Road Initiative, locating the papers as concept explorations resting on case studies that contextualize and historicize Belt and Road Initiative. In the case of the first paper that follows, this includes an exploration of the historiography of one of Belt and Road Initiative’s conditions of possibility, the Silk Road idea. We chart a burgeoning field of debate about Belt and Road Initiative, most often operating at broad levels of geopolitical abstraction. The papers here encourage further investigations of Belt and Road Initiative’s dynamics. Such work holds promise for wider theorizing of the interfaces between culture, economy, place, space, politics and infrastructure. Our closing remarks sketch key research agendas in these domains in the light of Belt and Road Initiative.
Treatment of Eyes With Diabetic Macular Edema That Had a Suboptimal Response to Antivascular Endothelial Growth Factor Therapy: 2-mg Intravitreal Triamcinolone Acetonide vs 0.7-mg Dexamethasone Implant
Authors: Kuley Brandon , Storey Philip P. , Pancholy Maitri , Wibbelsman Turner D. , Obeid Anthony , Regillo Carl , Garg Sunir
Published: April 2020

Purpose:

This article compares 2-mg intravitreal triamcinolone (IVT) and 0.7-mg dexamethasone (DEX) implant for the treatment of diabetic macular edema in eyes that had a suboptimal response to antivascular endothelial growth factor therapy.

Methods:

A single-center, retrospective review was conducted of patients receiving either IVT between January 1, 2013, and January 1, 2018, or patients receiving DEX between October 1, 2015, and January 1, 2018. Visual acuity and central macular thickness (CMT) were recorded at visit of first injection and all subsequent visits.

Results:

Twenty-five eyes were included in the DEX group and 32 eyes were included in the IVT group. Change in vision from baseline was similar between DEX and IVT at 6-month follow-up (1.1 lines vs 2.3 lines, respectively; P = .24). Mean decrease in CMT from baseline was not different at 6-month follow-up (DEX: 120 µm vs IVT: 185 µm; P = .17).

Conclusions:

DEX and 2-mg IVT both achieved improvement in vision and CMT with no significant differences between treatment groups at 6-month follow-up.
Adhesion to fibronectin via α5β1 integrin supports expansion of the megakaryocyte lineage in primary myelofibrosis
Authors: Matsuura Shinobu , Thompson Cristal Reyna , Ng Seng Kah , Ward Christina Marie , Karagianni Aikaterini , Mazzeo Carla , Malara Alessandro , Balduini Alessandra , Ravid Katya
Published: April 2020

Excessive accumulation of extracellular matrix (ECM) is a hallmark of bone marrow (BM) milieu in primary myelofibrosis (PMF). Because cells have the ability to adhere to the surrounding ECM through integrin receptors, we examined the hypothesis that an abnormal ECM-integrin receptor axis contributes to BM megakaryocytosis in JAK2V617F+ PMF. Secretion of ECM protein fibronectin (FN) by BM stromal cells from PMF patients correlates with fibrosis and disease severity. Here, we show that Vav1-hJAK2V617F transgenic mice (JAK2V617F+) have high BM FN content associated with megakaryocytosis and fibrosis. Further, megakaryocytes from JAK2V617F+ mice have increased cell surface expression of the α5 subunit of the α5β1 integrin, the major FN receptor in megakaryocytes, and augmented adhesion to FN compared with wild-type controls. Reducing adhesion to FN by an inhibitory antibody to the α5 subunit effectively reduces the percentage of CD41+ JAK2V617F+ megakaryocytes in vitro and in vivo. Corroborating our findings in mice, JAK2V617F+ megakaryocytes from patients showed elevated expression of α5 subunit, and a neutralizing antibody to α5 subunit reduced adhesion to FN and megakaryocyte number derived from CD34+ cells. Our findings reveal a previously unappreciated contribution of FN-α5β1 integrin to megakaryocytosis in JAK2V617F+ PMF.
Treating neutropenia and neutrophil dysfunction in glycogen storage disease type Ib with an SGLT2 inhibitor
Authors: Wortmann Saskia B. , Van Hove Johan L. K. , Derks Terry G. J. , Chevalier Nathalie , Knight Vijaya , Koller Andreas , Oussoren Esmee , Mayr Johannes A. , van Spronsen Francjan J. , Lagler Florian B. , Gaughan Sommer , Van Schaftingen Emile , Veiga-da-Cunha Maria
Published: April 2020

Neutropenia and neutrophil dysfunction cause serious infections and inflammatory bowel disease in glycogen storage disease type Ib (GSD-Ib). Our discovery that accumulating 1,5-anhydroglucitol-6-phosphate (1,5AG6P) caused neutropenia in a glucose-6-phosphatase 3 (G6PC3)–deficient mouse model and in 2 rare diseases (GSD-Ib and G6PC3 deficiency) led us to repurpose the widely used antidiabetic drug empagliflozin, an inhibitor of the renal glucose cotransporter sodium glucose cotransporter 2 (SGLT2). Off-label use of empagliflozin in 4 GSD-Ib patients with incomplete response to granulocyte colony-stimulating factor (GCSF) treatment decreased serum 1,5AG and neutrophil 1,5AG6P levels within 1 month. Clinically, symptoms of frequent infections, mucosal lesions, and inflammatory bowel disease resolved, and no symptomatic hypoglycemia was observed. GCSF could be discontinued in 2 patients and tapered by 57% and 81%, respectively, in the other 2. The fluctuating neutrophil numbers in all patients were increased and stabilized. We further demonstrated improved neutrophil function: normal oxidative burst (in 3 of 3 patients tested), corrected protein glycosylation (2 of 2), and normal neutrophil chemotaxis (1 of 1), and bactericidal activity (1 of 1) under treatment. In summary, the glucose-lowering SGLT2 inhibitor empagliflozin, used for type 2 diabetes, was successfully repurposed for treating neutropenia and neutrophil dysfunction in the rare inherited metabolic disorder GSD-Ib without causing symptomatic hypoglycemia. We ascribe this to an improvement in neutrophil function resulting from the reduction of the intracellular concentration of 1,5AG6P.
Effect of Trace Addition of Ceramic on Microstructure Development and Mechanical Properties of Selective Laser Melted AlSi10Mg Alloy
Authors: Li Yuxin , Gu Dongdong , Zhang Han , Xi Lixia
Published: April 2020

Selective laser melting (SLM) is an emerging additive manufacturing technology for fabricating aluminum alloys and aluminum matrix composites. Nevertheless, it remains unclear how to improve the properties of laser manufactured aluminum alloy by adding ceramic reinforcing particles. Here the effect of trace addition of TiB2 ceramic (1% weight fraction) on microstructural and mechanical properties of SLM-produced AlSi10Mg composite parts was investigated. The densification level increased with increasing laser power and decreasing scan speed. A near fully dense composite part (99.37%) with smooth surface morphology and elevated inter-layer bonding was successfully obtained. A decrease of lattice plane distance was identified by X-ray diffraction with the laser scan speed decreased, which implied that the crystal lattices were distorted due to the dissolution of Si and TiB2 particles. A homogeneous composite microstructure with the distribution of surface-smoothened TiB2 particles was present, and a small amount of Si particles precipitated at the interface between reinforcing particles and matrix. In contrast to the AlSi10Mg alloy, the composites showed a stabilized microhardness distribution. A higher ultimate tensile strength of 380.0 MPa, yield strength of 250.4 MPa and elongation of 3.43% were obtained even with a trace amount of ceramic addition. The improvement of tensile properties can be attributed to multiple mechanisms including solid solution strengthening, load-bearing strengthening and dispersion strengthening. This research provides a theoretical basis for ceramic reinforced aluminum matrix composites by additive manufacturing.
Ocean Observation Technologies: A Review
Authors: Lin Mingwei , Yang Canjun
Published: April 2020

Covering about three quarters of the surface area of the earth, the ocean is a critical source of sustenance, medicine, and commerce. However, such vast expanse in both surface area and depth, presents myriad observing challenges for researchers, such as corrosion, attenuation of electromagnetic waves, and high pressure. Ocean observation technologies are progressing from the conventional single node, static and short-term modalities to multiple nodes, dynamic and long-term modalities, to increase the density of both temporal and spatial samplings. Although people’s knowledge of the oceans has been still quite limited, the contributions of many nations cooperating to develop the Global Ocean Observing System (GOOS) have remarkably promoted the development of ocean observing technologies. This paper reviews the typical observing technologies deployed from the sea surface to the seafloor, and discusses the future trend of the ocean observation systems with the docking technology and sustained ocean energy.