bluuebunny/crossref_metadata_2025 huggingface dataset:
Outcomes of endosutured aneurysm repair with the Heli-FX EndoAnchor implants
Authors: Karaolanis Georgios , Antonopoulos Constantine N , Koutsias Stylianos , Antoniou George A , Beropoulis Efthymios , Torsello Giovanni , Taneva Gergana T , Donas Konstantinos P
Published: May 2020

Objective

Endovascular aneurysm repair has gained field over open surgery for the treatment of abdominal aortic aneurysm. However, type Ia endoleak represents a common complication especially in hostile neck anatomy that is recently faced using endoanchors. We conducted a systematic review and meta-analysis to collect and analyse all the available comparative evidence on the outcomes of the endosuture aneurysm repair in patients with or without hostile neck in standard endovascular aneurysm repair.

Methods

The current meta-analysis was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. All the prospective and retrospective studies reporting primary use of the Heli-FX EndoAnchor implants were considered eligible for inclusion in this study. The main study outcomes (technical success of endoanchor implantation, incidence of type Ia endoleak, aortic stent graft migration and the percentage of patients who presented regression or expansion of aneurysm sac throughout the follow-up) were subsequently expressed as proportions and 95% confidence intervals.

Results

Eight studies with a total of 968 patients were included in a pooled analysis. The technical success of the primary endoanchor fixation was 97.12% (95%CI: 92.98–99.67). During a mean six months follow-up period, a pooled rate of 6.23% (95%CI: 0.83–15.25) of the patients developed a persistent type Ia endoleak despite the primary implantation. Migration of the main graft was reported in five studies, in which a 0.26% (95%CI = 0.00–1.54) of the patients required an additional proximal aortic cuff. Regression of the aneurysm sac was observed at 68.82% (95%CI: 51.02–84.21). An expansion of the aneurysm sac was found in 1.93% (95%CI: 0.91–3.24) of the participants. The overall survival rate was 93.43% (95%CI: 89.97–96.29) at a mean six months follow-up period.

Conclusions

Endosuture aneurysm repair with the Heli-FX EndoAnchor implants seems to be technically feasible and safe either for prevention or for repair of intraoperative type Ia endoleak. Despite the primary implants of endoanchors, few cases of persistent type Ia endoleak and migration are still conspicuous. Long-term follow up is needed to determinate the role of this therapeutic option in the treatment of aortic aneurysms.
Is it possible to predict the complexity of peripheral artery disease with atherogenic index?
Authors: Mesut Engin , Cihan Aydın , Orhan Guvenc
Published: May 2020

Objectives

Lower extremity peripheral artery disease develops mainly due to atherosclerosis and occurs as a result of the systemic atherosclerotic process. Increased triglyceride (TG) and decreased high density lipoprotein cholesterol (HDL-C) values increase atherosclerosis risk. With regard to this information, TG/HDL-C ratio is used as the atherogenic index. The aim of the present study was to evaluate the role of TG/HDL-C ratio to predict the complexity of disease in patients with peripheral artery disease.

Methods

Patients who were diagnosed with peripheral artery disease and admitted to our clinic between August 2013 and August 2019 were included in this study retrospectively. Patients were divided into two groups based on angiographic evaluations with TransAtlantic Inter-Society Consensus-II classification. Those with TASC A-B lesions were included in Group 1 and those with TASC C-D lesions constituted Group 2.

Results

The mean ages of Group 1 ( n = 314) and Group 2 ( n = 98) patients were 56.1 ± 9.3 and 58.4.1 ± 8.1 years, respectively. The frequency of male gender and coronary artery disease was significantly higher in Group 2 ( p = 0.043, p = 0.001, respectively). In Group 2, triglyceride and TG/HDL-C ratios were significantly high, while HDL-C was significantly low ( p = 0.022, p < 0.001, p = 0.010, respectively). The multivariate logistic regression analysis performed to evaluate the parameters in predicting the angiographic complexity of peripheral artery disease showed that coronary artery disease (OR: 1.009 CI 95%: 1.003–1.021 p = 0.016) and TG/HDL-C ratio (OR: 5.385 CI 95%: 2.553–9.357 p = 0.001) were independent predictors for complexity. ROC analysis revealed that the cut-off value of TG/HDL-C was 2.9 (AUC = 0.670, p < 0.001) with 75.5% sensitivity and 56.7% specificity.

Conclusions

It is possible to predict the angiographic complexity of peripheral artery disease with TG/HDL-C ratio, also known as atherogenic index, which is easily obtained by routine biochemical parameters.
Analysis of internal spermatic vein embolization through catheter versus laparoscopic high ligation in treatment of left varicocele
Authors: Jing Ye-Xiang , Wang Rui-Hua , Liu Zhao-Xuan , Meng Qing-Yi
Published: May 2020

Objective

Varicocele is a common disease in young and middle-aged men. This study aims to compare the efficacy of internal spermatic vein embolization of left varicocele versus laparoscopic high ligation.

Methods

From January 2017 to September 2018, a total of 69 varicocele patients were admitted and given the opportunity to choose the treatment option. Among these, 26 patients were treated with sclerosing agent injection, while 43 patients underwent laparoscopic surgery. They were followed up for 12 months after surgery, and the technical success rate, recurrence rate, complication rate, cost, operative time, and hospitalization time with regard to these two methods were analyzed.

Results

All patients completed the medical procedures. There was no recurrence in patients in the sclerotherapy group during the follow-up period; however, the complication rate was 19.2%. Furthermore, the operative time, hospitalization time, and cost of treatment were 31.1 ± 11.1 min, 1.2 ± 0.49 days, and 9613.11 ± 895.97 Yuan, respectively. In the laparoscopic group, 9 patients underwent laparoscopic bilateral high ligation, while 34 patients received treatment on the left side alone. The recurrence rate of left varicocele was 4.7% and the complication rate was 44.2%. Furthermore, the operative time, hospitalization time, and treatment cost were 50.4 ± 14.48 min, 4.0 ± 2.02 days, and 10,948.29 ± 2547.00 Yuan, respectively. Moreover, there were statistically significant differences ( P <  0.05) in operative time, hospitalization time, and treatment cost. Patients in the sclerotherapy group had an advantage with respect to the overall complication rate when compared with patients from the laparoscopic group ( X2 = 4.448, P <  0.05), and there was a statistically significant difference in hydrocele ( X2 = 4.555, P <  0.05). However, there was no significant difference in the recurrence rate between these two groups ( X2 = 1.245, P >  0.05).

Conclusion

Patients who underwent sclerotherapy showed a higher technical success rate, a lower recurrence rate, fewer complications, and shorter hospitalization time compared to those treated with laparoscopic ligation. Transcatheter sclerosing agent injection may be a preferable treatment option for patients with unilateral varicocele.
Association of immune-related pneumonitis with the efficacy of PD-1/PD-L1 inhibitors in non-small cell lung cancer
Authors: Cui Pengfei , Huang Di , Wu Zhaozhen , Tao Haitao , Zhang Sujie , Ma Junxun , Liu Zhefeng , Wang Jinliang , Huang Ziwei , Chen Shixue , Zheng Xuan , Hu Yi
Published: May 2020

Background:

Cutaneous adverse events (AEs) have been positively associated with immune checkpoint inhibitor (ICI) efficacy in patients with melanoma, but little is known regarding the association between checkpoint inhibitor pneumonitis (CIP) and programmed cell death protein 1/programmed death ligand 1 (PD-1/PD-L1) inhibitor efficacy in non-small cell lung cancer (NSCLC).

Methods:

A single-institution, retrospective medical record review of patients with advanced or recurrent NSCLC who were treated with PD-1/PD-L1 inhibitors between 1 September 2015 and 1 June 2019 was conducted. A total of 276 NSCLC patients with or without immune-related pneumonitis who received at least one dose of ICIs and had at least one follow-up visit were identified. Kaplan–Meier curves of the progression-free survival (PFS) of patients stratified according to immune-related pneumonitis development were evaluated with the log-rank test as a preplanned primary objective. Multivariate analysis of PFS was performed with Cox proportional hazard regression models.

Results:

In the cohort of 276 patients, 42 patients developed CIP attributed to PD-1/PD-L1 inhibitors. Survival analysis showed that the overall response rate was significantly higher in patients with CIP than in those without CIP (61.90% versus 29.91%, respectively, p < 0.01), and that CIP development was significantly associated with increased PFS (45.80 weeks versus 21.15 weeks, respectively, p < 0.01). Additionally, 16-week landmark analysis produced the same results. Similarly, subgroup analysis of PD-1 inhibitor-treated, nivolumab-treated, and pembrolizumab-treated groups also revealed that CIP increased survival in NSCLC patients. Additionally, grade 1–2 pneumonitis showed an association with increased ICI efficacy in NSCLC; however, grade 3–4 pneumonitis did not. In addition, only two of the four pneumonitis radiological subtypes showed associations with increased ICI efficacy in NSCLC.

Conclusion:

CIP is associated with enhanced PD-1/PD-L1 inhibitor efficacy in NSCLC patients. Grade 1–2 pneumonitis and the radiological features of hypersensitivity and cryptogenic organizing pneumonia (COP) may be signs of enhanced ICI efficacy. However, further studies with larger numbers of patients and longer follow-up times are needed to validate our findings.
Cutaneous Reactions to Continuous Glucose Monitoring and Continuous Subcutaneous Insulin Infusion Devices in Type 1 Diabetes Mellitus
Authors: Rigo Rachel S. , Levin Laura E. , Belsito Donald V. , Garzon Maria C. , Gandica Rachelle , Williams Kristen M.
Published: May 2020

Background:

Continuous glucose monitoring (CGM) and continuous subcutaneous insulin infusion (CSII) are the standard of care for type 1 diabetes in children. There is little reported on device-related skin complications and treatment options. This study documents cutaneous reactions to CGM and CSII devices in children and young adults with type 1 diabetes.

Methods:

One hundred and twenty-one subjects (3-25 years) with type 1 diabetes and CGM and/or CSII use were recruited over a three-month period from the Naomi Berrie Diabetes Center at Columbia University Irving Medical Center. A five-question survey was completed for each subject detailing demographic data, diabetes management, and device-related skin complications.

Results:

Sixty percent of subjects reported skin complications related to CGM and/or CSII use. Terms most frequently used to describe cutaneous reactions were “red,” “itchy,” “painful,” and “rash.” Subjects who used both CGM and CSII were more likely to report skin problems than those who used only CSII (odds ratio 2.9, [95% confidence interval: 1.2-6.7]; P = .015). There were no associations between skin complications and sex or race/ethnicity. Twenty-two percent of subjects with adverse skin event(s) discontinued use of a device due to their skin problem. Seven percent were evaluated by a dermatologist. Eighty-one percent used a range of products to treat their symptoms, with variable perceived clinical outcomes.

Conclusions:

Skin complications related to CSII or CGM devices are commonly reported in pediatric patients with type 1 diabetes and may lead to interruption or discontinuation of device use. Future studies are needed to elucidate the causes of these reactions and determine the best methods for prevention.
Glycemic Characteristics and Clinical Outcomes of COVID-19 Patients Hospitalized in the United States
Authors: Bode Bruce , Garrett Valerie , Messler Jordan , McFarland Raymie , Crowe Jennifer , Booth Robby , Klonoff David C.
Published: May 2020

Introduction:

Diabetes has emerged as an important risk factor for severe illness and death from COVID-19. There is a paucity of information on glycemic control among hospitalized COVID-19 patients with diabetes and acute hyperglycemia.

Methods:

This retrospective observational study of laboratory-confirmed COVID-19 adults evaluated glycemic and clinical outcomes in patients with and without diabetes and/or acutely uncontrolled hyperglycemia hospitalized March 1 to April 6, 2020. Diabetes was defined as A1C ≥6.5%. Uncontrolled hyperglycemia was defined as ≥2 blood glucoses (BGs) > 180 mg/dL within any 24-hour period. Data were abstracted from Glytec’s data warehouse.

Results:

Among 1122 patients in 88 U.S. hospitals, 451 patients with diabetes and/or uncontrolled hyperglycemia spent 37.8% of patient days having a mean BG > 180 mg/dL. Among 570 patients who died or were discharged, the mortality rate was 28.8% in 184 diabetes and/or uncontrolled hyperglycemia patients, compared with 6.2% of 386 patients without diabetes or hyperglycemia ( P < .001). Among the 184 patients with diabetes and/or hyperglycemia who died or were discharged, 40 of 96 uncontrolled hyperglycemia patients (41.7%) died compared with 13 of 88 patients with diabetes (14.8%, P < .001). Among 493 discharged survivors, median length of stay (LOS) was longer in 184 patients with diabetes and/or uncontrolled hyperglycemia compared with 386 patients without diabetes or hyperglycemia (5.7 vs 4.3 days, P < .001).

Conclusion:

Among hospitalized patients with COVID-19, diabetes and/or uncontrolled hyperglycemia occurred frequently. These COVID-19 patients with diabetes and/or uncontrolled hyperglycemia had a longer LOS and markedly higher mortality than patients without diabetes or uncontrolled hyperglycemia. Patients with uncontrolled hyperglycemia had a particularly high mortality rate. We recommend health systems which ensure that inpatient hyperglycemia is safely and effectively treated.
The Way I Paint—How Image Composition Emerges During the Creation of Abstract Artworks
Authors: Redies Christoph
Published: May 2020

In recent years, there has been an increasing number of studies on objective image properties in visual artworks. Little is known, however, about how these image properties emerge while artists create their artworks. In order to study this matter, I produced five colored abstract artworks by myself and recorded state images at all stages of their creation. For each image, I then calculated low-level features from deep neural networks, which served as a model of responses properties in visual cortex. Two-dimensional plots of variances that were derived from these features showed that the drawings differ greatly at early stages of their creation, but then follow a narrow common path to terminate at or close to a position where traditional paintings cluster in the plots. Whether other artists use similar perceptive strategies while they create artworks remains to be studied.
Preexisting coronary heart disease and susceptibility to long-term effects of traffic-related air pollution: A matched cohort analysis
Authors: Cohen Gali , Steinberg David M , Keinan-Boker Lital , Yuval   , Levy Ilan , Chen Shimon , Shafran-Nathan Rakefet , Levin Noam , Shimony Tal , Witberg Guy , Bental Tamir , Shohat Tamar , Broday David M , Kornowski Ran , Gerber Yariv
Published: May 2020

Background

Individuals with coronary heart disease are considered susceptible to traffic-related air pollution exposure. Yet, cohort-based evidence on whether preexisting coronary heart disease modifies the association of traffic-related air pollution with health outcomes is lacking.

Aim

Using data of four Israeli cohorts, we compared associations of traffic-related air pollution with mortality and cancer between coronary heart disease patients and matched controls from the general population.

Methods

Subjects hospitalized with acute coronary syndrome from two patient cohorts (inception years: 1992–1993 and 2006–2014) were age- and sex-matched to coronary heart disease-free participants of two cycles of the Israeli National Health and Nutrition Surveys (inception years: 1999–2001 and 2005–2006). Ambient concentrations of nitrogen oxides at the residential place served as a proxy for traffic-related air pollution exposure across all cohorts, based on a high-resolution national land use regression model (50 m). Data on all-cause mortality (last update: 2018) and cancer incidence (last update: 2016) were retrieved from national registries. Cox-derived stratum-specific hazard ratios with 95% confidence intervals were calculated, adjusted for harmonized covariates across cohorts, including age, sex, ethnicity, neighborhood socioeconomic status, smoking, diabetes, hypertension, prior stroke and prior malignancy (the latter only in the mortality analysis). Effect-modification was examined by testing nitrogen oxides-by-coronary heart disease interaction term in the entire matched cohort.

Results

The cohort (mean (standard deviation) age 61.5 (14) years; 44% women) included 2393 matched pairs, among them 2040 were cancer-free at baseline. During a median (25th–75th percentiles) follow-up of 13 (10–19) and 11 (7–17) years, 1458 deaths and 536 new cancer cases were identified, respectively. In multivariable-adjusted models, a 10-parts per billion nitrogen oxides increment was positively associated with all-cause mortality among coronary heart disease patients (hazard ratio = 1.13, 95% confidence interval 1.05–1.22), but not among controls (hazard ratio = 1.00, 0.93–1.08) (pinteraction = 0.003). A similar pattern was seen for all-cancer incidence (hazard ratioCHD = 1.19 (1.03–1.37), hazard ratioCHD-Free = 0.93 (0.84–1.04) (pinteraction = 0.01)). Associations were robust to multiple sensitivity analyses.

Conclusions

Coronary heart disease patients might be at increased risk for traffic-related air pollution-associated mortality and cancer, irrespective of their age and sex. Patients and clinicians should be more aware of the adverse health effects on coronary heart disease patients of chronic exposure to vehicle emissions.
Effects of Maharishi Light Technology with Gems: A random-assignment, placebo-controlled, blinded pilot study
Authors: Travis Frederick , Melzer Ayala , Scharf David
Published: May 2020

Objectives:

This blinded random-assignment, placebo-controlled pilot study investigated the effects of Maharishi Light Technology with Gems on three self-report measures: a questionnaire with a 5-point Likert-type scale, the Profile of Mood States (POMS), and an open-ended question. This pilot is the beginning of a research program to test the effects of this therapy.

Methods:

In total, 18 meditating subjects received two treatments on consecutive days, randomly either Maharishi Light Technology or placebo, then 2 weeks rest, and then the other treatment on consecutive days.

Results:

In comparison to placebo treatments, Maharishi Light Technology treatments were (1) rated as being significantly more settled, (2) higher on the Positive Self-Esteem subscale of the POMS and (3) described by the terms: healing, wholeness, and bliss.

Conclusion:

These treatments lead to significant improvements on self-report measures. Future research could assess their effects across both meditating and nonmeditating populations, using physiological measures to probe possible mechanisms of the effects.
A rare case of adrenal collision tumor: Myelolipoma and schwannoma in the adrenal gland
Authors: Gomez Mariangela , Mehta Rohin
Published: May 2020

Adrenal collision tumors refer to coexistence of two adjacent, but histologically distinct, neoplasms involving the adrenal gland without histologic admixture at the interface. Myelolipoma is a rare but benign neoplasm. As its name implies, displays both mature adipose tissue and hematopoietic elements. These are usually unilateral and asymptomatic. Schwannomas, tumors derived from the peripheral nerve sheath, are also uncommon lesions in the adrenal gland. Here, we present a rare case of a 65-year-old male with clinical history of abdominal aortic aneurysm who was found to have a 13-cm “incidentaloma” by interventional radiologist during his aortic endograft control. Giving the size of the mass, team decided to excise it, and histopathological examination was performed. While most incidentally discovered adrenal tumors are benign, surgical excision is recommended in large lesions to exclude malignancy, avoid hemorrhage, and/or acute adrenal insufficiency. Given the rarity of such entity, its clinical course and prognosis remains unclear.
It is all in the name: The importance of correct terminology in hormone replacement therapy
Authors: Pirhadi Roxanna , Sinai Talaulikar Vikram , Onwude Joseph , Manyonda Isaac
Published: May 2020

The global increase in life expectancy to 74 years for women, while the median age of the menopause remains at 51 years, means that an increasing number of women will live a significant portion of their adult lives in the menopause. The WHI publications in 2003/4 reported on the dangers of hormone replacement therapy, in particular with respect to breast cancer and dementia risk. This resulted in a dramatic reduction in hormone replacement therapy prescription and use. However, the findings from the WHI studies have been re-appraised, and the new perspective is reflected in the guidance published by NICE in 2015 in which they recommended that more women be offered hormone replacement therapy as the benefits are now perceived to outweigh the risks for most women. However, controversy continues to surround hormone replacement therapy, and there are probably few areas in medicine where the misuse of terminology causes quite as much confusion as in hormone replacement therapy. Commonly used terms such as ‘menopausal hormone therapy’ and ‘hormone replacement therapy’ lack specificity and there is an urgent need for correct terminology to accurately describe the hormones replaced.
Investigating EFL Teachers’ Views on Listening Difficulties Among Their Learners: The Case of Iranian Context
Authors: Nushi Musa , Orouji Fereshte
Published: May 2020

Listening has long been recognized as a challenging skill for teachers, students, and researchers working within the English as a Second Language (ESL)/English as a Foreign Language (EFL) contexts. Moreover, up until the recent past, it was the least researched of the four language skills in second language acquisition studies. One of the issues regarding the skill that has not been sufficiently investigated is EFL teachers’ views on listening difficulties their students face. This study, therefore, investigates 208 teachers’ views on listening difficulties among Iranian EFL learners. A mixed-methods approach, integrating a questionnaire and an interview, was employed. Results from the questionnaire suggested that the top 10 identified difficulties ranged from practical issues such as poor-quality audio materials to content-based impediments such as unfamiliar topics. Furthermore, analysis of variance (ANOVA) tests revealed that there was no significant relationship between either the teachers’ educational or professional background and the gravity of the difficulties they reported. Among different components of the questionnaire, the input and process components were highly correlated, indicating that learners’ problems with input perception could lead to problems in listening comprehension. Moreover, based on the results of the interviews, it was concluded that the teachers believed that the learners’ listening difficulties belonged to three categories, namely, pronunciation-based, individual characteristics–based, and content-based difficulties. This study suggests that overcoming listening difficulties without listening strategies, though not impossible, seems to be much more time consuming. Therefore, there are many benefits to both students and teachers if some class time is dedicated to acquaint learners with the strategies.
Communitainment on Instagram: Fitness Content and Community-Driven Communication as Social Media Entertainment
Authors: Stollfuß Sven
Published: May 2020

This article discusses fitness content on Instagram as a form of social media entertainment (SME). A conceptual article that presents a literature review of studies on fitness postings on social media, it examines the research on communitainment values in online fitness content. While online entertainment on social media differs from traditional mass media such as television and movies, new concepts of social media–related entertainment have been described in the field of communication and media studies. Based on a literature review of online entertainment research on media effects and content-oriented approaches of so-called “social media entertainment” (SME), this article intends to discuss fitness postings and their corresponding community-driven communication as “communitainment.” Aspects of fitness content will be further explained in terms of (a) self-representation and self-disclosure, (b) community building, and (c) media use and well-being, thereby highlighting the new dynamics of fitness communitainment on social networking sites (SNSs).
The Quandary of the Quadricuspid Aortic Valve—The “Unlucky” 4-Leaf Clover: Case Report and Brief Clinical Review
Authors: Seecheran Rajeev Virender , Seecheran Valmiki Krishna , Persad Sangeeta Anjali , Rampersad Fidel , Maharaj Paramanand , Khan Shari , Seecheran Naveen Anand
Published: May 2020

The quadricuspid aortic valve is an exceedingly rare congenital valvular anomaly, characterized by a tetrad of leaflets that typically presents with aortic regurgitation. Almost one third of cases are associated with coexisting cardiac defects with one fifth warranting surgical intervention. In this article, we describe the first documented-in-Caribbean case and present a brief clinical review of its pathophysiology, diagnosis, and management.
The Vehement, Volatile, Value-seeking and Viral: The New Era of Employees and Why HR Preparedness and Future-skilling Is Key to a Healthy Business Enterprise—A Perspective
Authors: Kesavan Rajeev Rohini
Published: May 2020

For a human resource professional, training and learning are a way of life. They have to constantly re-invent themselves to tread the water. Understanding the needs of the new generation (Gen Z) of employees, charting new initiatives for them while making business sense of those initiatives is essential for the human resource managers of today. A changing world brings with it different perspectives on employee morale and new-age challenges (such as the abuse of technology and social media play). Positive mental health and its impact on a stable, sustainable and productive workforce is another critical aspect of human resource management. This paper is based on the journalistic construction of human resources and perspectives based on personal experience. The aim is to provide a basic view on human resources preparedness to meet the challenges of tomorrow by analysing the operations of yesterday and recalibrating the workings of today.
Integration in Mergers and Acquisitions: Bringing Together Type of Diversification, Synergy Potential and Cultural Distance
Authors: Sengupta Shayani
Published: May 2020

The literature on mergers and acquisitions reveal mixed findings with respect to synergy potential and cultural distance. While some researchers suggest that high cultural distance would lead to better performance, others suggest that low cultural distance would lead to better synergy and performance. I propose that the degree of relatedness between the two firms and the integration approach adopted by the management could be potential moderators in this relationship. The aim of this article is to explore which integration approach (absorption, preservation and symbiosis) would lead to maximum synergy in mergers and acquisitions of firms from related and unrelated industries. A review of literature and case studies on mergers and acquisitions was done to develop a framework for the same. Limitations and directions for future research have been discussed.
Molecular Sieve-Modified Separator for High-Performance Lithium-Ion Batteries
Authors: Kang Yuqiong , Deng Changjian , Wang Zhengyang , Chen Yuqing , Liu Xinyi , Liang Zheng , Li Tao , Hu Quan , Zhao Yun
Published: May 2020

Lithium-ion batteries (LIBs) are currently the most important energy storage system. Separators in the battery play a critical role in terms of the rate capability, cycle life, and safe operation. However, commercial separators exhibit poor electrolyte wettability and limited safety. It is also extremely important to eliminate the hazardous small molecules (e.g., H2O and HF) inside the battery to enhance the service life. Herein, a functionalized poly(vinylidene fluoride-co-hexafluoropropylene)@polyacrylonitrile (PVDF-HFP@PAN) separator modified by 4-Å molecular sieves (MS) was fabricated by hydrothermal method for LIBs. MS@PVDF-HFP@PAN separator exhibits high thermal stability and carbonate electrolyte wettability. In addition, it can lower the moisture value in the battery system to 13 ppm, which significantly improves the electrolyte quality. When the current density increased from 0.2 to 5 C, the discharging capacity of the cell with MS@PVDF-HFP@PAN declines from 177.6 to 143.2 mAh g−1, demonstrating an excellent capacity retention of 80.6%. The discharge capacity retention of NMC622 half-cell with MS@PVDF-HFP@PAN after 100 cycles is 98.6% of its initial discharge capacity, which is higher than that of a cell with the Celgard 2400 separator (91.9%).
Applied evolutionary education: the benefits and costs of hosting regional evolution conferences
Authors: Lynn Christopher Dana , Guitar Amanda , Keck Chloe M. T. , Rector Amy L.
Published: May 2020

Regional academic conferences provide a variety of benefits to attendants, but hosting them can be costly. Here, we share benefits and drawbacks of hosting regional evolution meetings from the vantages of a tenured associate professor, a tenure-track assistant professor, and a doctoral student. We use experiences of hosting the NorthEastern Evolutionary Psychology Society (NEEPS), the Southeastern Evolutionary Perspectives Society (SEEPS), and the Mid-Atlantic Bioanthropology Interest Group (MABIG) as cases to address the benefits and costs. We highlight what are likely universal benefits and costs of hosting evolution conferences while also discussing the risks of excess service to women and underrepresented faculty members. We also draw attention to personal and circumstantial contingencies that evolution conference hosts may encounter.
The role of numerical tests in assessing road restraint system functionality
Authors: Budzynski Marcin , Jamroz Kazimierz , Wilde Krzysztof , Witkowski Wojciech , Jelinski Lukasz , Bruski Dawid
Published: May 2020

Key to understanding the needs and building road infrastructure management tools to prevent and mitigate run-off-road accidents is to identify hazards and their sources which are a result of wrong design, construction, and installation of road restraint systems. Building such tools requires advanced studies with field tests, simulations and models to demonstrate the effects of selected parameters on road user safety. The research work included building numerical models which were validated with crash tests and mathematical models to assess the effects of selected parameters on the safety and functionality of devices. Twenty five field tests were the basis for conducting 670 numerical tests. Preliminary results of numerical tests are also presented looking at selected problems such as barriers on curves, presence of kerbs and obstacles within barrier working width. The methodology will help with an optimal selection of parameters leading to improved safety as regards errant vehicles.
Safety, efficiency and health-related quality of telephone triage conducted by general practitioners, nurses, or physicians in out-of-hours primary care: a quasi-experimental study using the Assessment of Quality in Telephone Triage (AQTT) to assess audio-recorded telephone calls
Authors: Graversen D. S. , Christensen M. B. , Pedersen A. F. , Carlsen A. H. , Bro F. , Christensen H. C. , Vestergaard C. H. , Huibers L.
Published: May 2020

Background

To explore and compare safety, efficiency, and health-related quality of telephone triage in out-of-hours primary care (OOH-PC) services performed by general practitioners (GPs), nurses using a computerised decision support system (CDSS), or physicians with different medical specialities.

Methods

Natural quasi-experimental cross-sectional study conducted in November and December 2016. We randomly selected 1294 audio-recorded telephone triage calls from two Danish OOH-PC services triaged by GPs (n = 423), nurses using CDSS (n = 430), or physicians with different medical specialities (n = 441). An assessment panel of 24 physicians used a validated assessment tool (Assessment of Quality in Telephone Triage - AQTT) to assess all telephone triage calls and measured health-related quality, safety, and efficiency of triage.

Results

The relative risk (RR) of poor quality was significantly lower for nurses compared to GPs in four out of ten items regarding identifying and uncovering of problems. For most items, the quality tended to be lowest for physicians with different medical specialities. Compared to calls triaged by GPs (reference), the risk of clinically relevant undertriage was significantly lower for nurses, while physicians with different medical specialties had a similar risk (GP: 7.3%, nurse: 3.7%, physician: 6.1%). The risk of clinically relevant overtriage was significantly higher for nurses (9.1%) and physicians with different medical specialities (8.2%) compared to GPs (4.3%). GPs had significantly shorter calls (mean: 2 min 57 s, SD: 105 s) than nurses (mean: 4 min 44 s, SD: 168 s).

Conclusions

Our explorative study indicated that nurses using CDSS performed better than GPs in telephone triage on a large number of health-related items, had a lower level of clinically relevant undertriage, but were perceived less efficient. Calls triaged by physicians with different medical specialities were perceived less safe and less efficient compared to GPs. Differences in the organisation of telephone triage may influence the distribution of workload in primary and secondary OOH services. Future research could compare the long-term outcomes following a telephone call to OOH-PC related to safety and efficiency.
Impact of NPS MedicineWise general practitioner education programs and Choosing Wisely Australia recommendations on prescribing of proton pump inhibitors in Australia
Authors: Wu Jianyun , Dickinson Scott , Elgebaly Zain , Blogg Suzanne , Heaney Aine , Soo Yien , Daniels Benjamin , Weekes Lynn
Published: May 2020

Background

This study evaluated the impact of multifaceted NPS MedicineWise programs that targeted all general practitioners (GPs) in Australia in 2009 and 2015 with the aim of reducing unnecessary prescribing of proton pump inhibitors (PPIs) and encouraged stepping down to a lower strength PPI or to discontinue treatment. The 2015 intervention coincided with the release of Choosing Wisely Australia recommendations from the Royal Australian College of General Practitioners (RACGP).

Methods

Outcome measures included monthly dispensing rates of different strength PPIs prescribed by GPs to concessional patients in Australia. All PPIs were categorized according to the May 2019 revised classifications for standard and low strength PPIs except for esomeprazole 40 mg which was classified as a standard strength and esomeprazole 20 mg as low strength for this analysis. Time series analyses was conducted of the dispensing rates of PPI prescriptions for concessional patients between January 2006 and June 2016 using the Pharmaceutical Benefits Scheme (PBS) and Medicare Benefits Schedule (MBS) databases in Australia. Participants were GPs with dispensed PPI prescriptions to concessional patients between January 2006 and June 2016.

Results

Following the 2009 NPS MedicineWise program we observed a 6.7% reduction in the expected dispensing rate of standard strength PPIs for concessional patients between April 2006 and March 2015, and an 8.6% reduction between April 2009 and June 2016 following the 2015 program launch. We observed a significant increase of 5.6% in the dispensing rate of low strength PPIs for concessional patients between April 2009 and March 2015, and no significant change in trend following the 2015 program.

Conclusions

The NPS MedicineWise programs were associated with reductions in the dispensing rate of standard strength PPIs by June 2016 and an increase in the dispensing rate of low-strength PPIs by March 2015 although this trend did not continue following the 2015 program. This suggests that GPs are stepping down patients to lower strength PPIs following the educational programs. However, lower strength PPIs are still not the majority of PPIs dispensed in Australian and regular interventions to sustain and improve PPI management by GPs may be warranted.
Dental anomalies as a possible clue of 1p36 deletion syndrome due to germline mosaicism: a case report
Authors: Nistico’ D. , Guidolin F. , Navarra C. O. , Bobbo M. , Magnolato A. , D’Adamo A. P. , Giorgio E. , Pivetta B. , Barbi E. , Gasparini P. , Cadenaro M. , Sirchia F.
Published: May 2020

Background

Monosomy 1p36 is the most common terminal deletion syndrome with an autosomal dominant pattern of inheritance. This syndrome is defined by an extremely wide spectrum of characteristics; however, developmental delay and intellectual disability of various degree are present in all patients and about the 90% of patients have a severe intellectual disability. Dental agenesis or other dental anomalies have not been described in previous reports.

Case presentation

We report the case of two little sisters born from healthy and non-consanguineous parents, presenting with dental anomalies and one of them with epilepsy, dilated cardiomyopathy with left-ventricular non-compaction, strabismus, history of poor growth, hypotonia and mild language delay. Patients were evaluated in several departments (genetic, child neuropsychiatric, cardiology, odontostomatology, ophthalmology, otorhinolaryngology) of Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy. They underwent investigations such as electrocardiogram, echocardiogram, dental orthopantomography X-Ray and Computed Tomography, electroencephalograms, abdomen ultrasound, blood tests, IQ tests, genetic analysis. They both have an Intelligence Quotient greater than 70 and a negative neurologic exam. Each sister carries the same 1p36 deletion of about 2.3 Mb. Genetic analysis of the parents’ blood samples (Single Nucleotide Polymorphism- array, karyotype and Fluorescent In Situ Hybridization) did not reveal any deletion, translocation or inversion and confirmed the paternity. A third sib of the probands does not carry the 1p36 deletion or other quantitative alterations.

Conclusion

This report describes a new trait linked to monosomy 1p36, namely a mild intellectual outcome associated with significant dental anomalies. Our finding suggests that 1p36 deletion syndrome may present with a mild cognitive impairment or even with a normal intellectual development: this is very important for the genetic counselling, especially in a prenatal setting. Moreover, we report the third study with recurrent 1p36 deletion syndrome in two siblings, likely due to germline mosaicism. Finally, we believe that the dental anomalies should be investigated in 1p36 deletion syndrome and that the spectrum of the condition could be broader than we assume.
Outcomes of children with hepatoblastoma who underwent liver resection at a tertiary hospital in China: a retrospective analysis
Authors: Li Jiahao , Li Huixian , Wu Huiying , Niu Huilin , Li Haibo , Pan Jing , Yang Jiliang , Tan Tianbao , Hu Chao , Xu Tao , Zhang Xiaohong , Zheng Manna , Li Kuanrong , Zou Yan , Yang Tianyou
Published: May 2020

Background

To report the outcomes of hepatoblastoma resected in our institution.

Methods

We diagnosed 135 children with hepatoblastoma at our institution between January 2010 and December 2017. Patients who underwent liver resection were included for analysis. However, patients who abandoned treatment after diagnosis were excluded from analysis, but their clinical characteristics were provided in the supplementary material.

Results

Forty-two patients abandoned treatment, whereas 93 patients underwent liver resection and were included for statistical analysis. Thirty-six, 23, 3, and 31 patients had PRETEXT stages II, III, IV, and unspecified tumours, respectively. Seven patients had ruptured tumour; 9 had lung metastasis (one patient had portal vein thrombosis concurrently). Sixteen patients underwent primary liver resection; 22, 25, and 30 patients received cisplatin-based neoadjuvant chemotherapy and delayed surgery, preoperative transarterial chemoembolization (TACE) and delayed surgery, and a combination of cisplatin-based neoadjuvant chemotherapy, TACE, and delayed surgery, respectively. Forty patients had both PRETEXT and POST-TEXT information available for analysis. Twelve patients were down-staged after preoperative treatment, including 2, 8, and 2 patients from stages IV to III, III to II, and II to I, respectively. Ten patients with unspecified PRETEXT stage were confirmed to have POST-TEXT stages II (n = 8) and I (n = 2) tumours. Seven tumours were associated with positive surgical margins, and 12 patients had microvascular involvement. During a median follow-up period of 30.5 months, 84 patients survived without relapse, 9 experienced tumour recurrence, and 4 died. The 2-year event-free survival (EFS) and overall survival (OS) rates were 89.4 ± 3.4%, and 95.2 ± 2.4%, respectively; they were significantly better among patients without metastasis (no metastasis vs metastasis: EFS, 93.5 ± 3.7% vs 46.7 ± 19.0%, adjusted p = 0.002. OS, 97.6 ± 2.4% vs 61.0 ± 18.1%, adjusted p = 0.005), and similar among patients treated with different preoperative strategies (chemotherapy only vs TACE only vs Both: EFS, 94.7 ± 5.1% vs 91.7 ± 5.6% vs 85.6 ± 6.7%, p = 0.542. OS, 94.1 ± 5.7% vs 95.7 ± 4.3% vs 96.7 ± 3.3%, p = 0.845).

Conclusion

The OS for patients with hepatoblastoma who underwent liver resection was satisfactory. Neoadjuvant chemotherapy and TACE seemed to have a similar effect on OS. However, the abandonment of treatment by patients with hepatoblastoma was common, and may have biased our results.
Decomposing socioeconomic inequality in poor mental health among Iranian adult population: results from the PERSIAN cohort study
Authors: Najafi Farid , Pasdar Yahya , Karami Matin Behzad , Rezaei Satar , Kazemi Karyani Ali , Soltani Shahin , Soofi Moslem , Rezaeian Shahab , Zangeneh Alireza , Moradinazar Mehdi , Hamzeh Behrooz , Jorjoran Shushtari Zahra , sajjadipour Mansour , Eslami Saeid , khosrojerdi Maryam , Shabestari Sahar , Mehrparvar Amir Houshang , Kashi Zahra , Nejatizadeh Azim , Naghipour Mohammadreza , Sadeghi Boogar Shahrokh , Fakhari Ali , Cheraghian Bahman , Heidari Haydeh , Molavi Parviz , Hajizadeh Mohammad , Salimi Yahya
Published: May 2020

Background

Socioeconomic inequality in mental health in Iran is poorly understood. This study aimed to assess socioeconomic inequality in poor mental health among Iranian adults.

Methods

The study used the baseline data of PERSIAN cohort study including 131,813 participants from 17 geographically distinct areas of Iran. The Erreygers Concentration index (E) was used to quantify the socioeconomic inequalities in poor mental health. Moreover, we decomposed theEto identify factors contributing to the observed socioeconomic inequality in poor mental health in Iran.

Results

The estimated E for poor mental health was − 0.012 (95% CI: − 0.0144, − 0.0089), indicating slightly higher concentration of mental health problem among socioeconomically disadvantaged adults in Iran. Socioeconomic inequality in poor mental health was mainly explained by gender (19.93%) and age (12.70%). Region, SES itself, and physical activity were other important factors that contributed to the concentration of poor mental health among adults with low socioeconomic status.

Conclusion

There exists nearly equitable distribution in poor mental health among Iranian adults, but with important variations by gender, SES, and geography. These results suggested that interventional programs in Iran should focus on should focus more on socioeconomically disadvantaged people as a whole, with particular attention to the needs of women and those living in more socially disadvantaged regions.
Patriarchy and gender-inequitable attitudes as drivers of intimate partner violence against women in the central region of Ghana
Authors: Sikweyiya Yandisa , Addo-Lartey Adolphina Addoley , Alangea Deda Ogum , Dako-Gyeke Phyllis , Chirwa Esnat D. , Coker-Appiah Dorcas , Adanu Richard M. K. , Jewkes Rachel
Published: May 2020

Background

In order to reduce women’s exposure to violence and develop culturally appropriate interventions, it is important to gain an understanding of how men who use violence rationalize it. The present study sought to explore the perspectives of men who had used violence on their female partners, specifically their views on intimate partner violence (IPV), gender norms, manhood, their gender attitudes and to understand how these may drive male perpetrated IPV against women in the Central Region of Ghana.

Methods

This was a qualitative study involving purposively sampled adult men who had participated in a household-based survey in selected districts in the Central Region of Ghana and who had self-reported perpetration of IPV in the past 12 months. In-depth interviews were conducted with 17 men.

Results

Data revealed how a range of social, cultural, and religious factors ̶ stemming from patriarchy ̶ combined to inform the construction of a traditional masculinity. These factors included the notion that decision-making in the home is a man’s prerogative, there should be rigid and distinct gender roles, men’s perceptions of owning female partners and having the right to have sex with them whenever they desire, and the notion that wife beating is legitimate discipline. Findings suggest that it was through performing, or aspiring to achieve, this form of masculinity that men used varying forms of violence against their female partners. Moreover, data show that the men’s use of violence was a tactic for controlling women and emphasizing their authority and power over them.

Conclusions

Developers of interventions to prevent IPV need to recognize that there is a coherent configuration of aspirations, social norms and behaviours that is drawn on by some men to justify their use of IPV. Understanding the perspectives of men who have perpetrated IPV against women and their motivations for perpetration is essential for interventions to prevent IPV. This is discussed as drawing authority from ‘tradition’ and so engaging traditional and religious leaders, as well as men and women throughout the community, in activities to challenge this is likely to be particularly fruitful.