bluuebunny/crossref_metadata_2025 huggingface dataset:
Association between 1,5-Anhydroglucitol and Acute C Peptide Response to Arginine among Patients with Type 2 Diabetes
Authors: Shen Yun , Si Yiming , Lu Jingyi , Ma Xiaojing , Zhang Lei , Mo Yifei , Lu Wei , Zhu Wei , Bao Yuqian , Hu Gang , Zhou Jian
Published: July 2020

Objective. The aim of this study was to explore the association of 1,5-anhydroglucitol with acute C peptide response (ACPR) to arginine among patients with type 2 diabetes. Methods. Patients with type 2 diabetes were enrolled from the Department of Endocrinology and Metabolism, Shanghai Sixth People’s Hospital. ACPR was assessed using arginine stimulation test. Decreased β-cell function was defined as ACPR<2.1. Multivariable logistic regression models were used to demonstrate the association between 1,5-anhydroglucitol and decreased β-cell function. Results. Finally, 623 patients with type 2 diabetes were enrolled into the analysis. Multivariable-adjusted odds ratios for decreased β-cell function across quartiles of 1,5-anhydroglucitol were 1.00, 0.47 (95% confidence interval (CI) 0.23-0.99), 0.41 (95% CI 0.20-0.84), and 0.27 (95% CI 0.13-0.57) (Ptrend=0.042), respectively. When 1,5-anhydroglucitol was considered as a continuous variable after logarithm, the corresponding odds ratio was 0.40 (95% CI 0.23-0.71). Conclusions. We demonstrated a dose-response linear association between 1,5-anhydroglucitol and ACPR. 1,5-Anhydroglucitol was likely to be associated with β-cell function. Further analysis with large sample size and prospective study design is warranted to validate our findings.
Fuke Qianjin Combined with Antibiotic Therapy for Pelvic Inflammatory Disease: A Systematic Review and Meta‐Analysis
Authors: Chen Yu , Wei Shaobin , Huang Li , Luo Mei , Wu Yang , Yin Caimmiao
Published: July 2020

Background. Pelvic inflammatory disease (PID) without timely and proper treatment can cause long‐term sequelae; meanwhile, patients will be confronted with the antimicrobial resistance and side effects. Chinese patent medicine as a supplement is used to treat PID with satisfactory clinical efficacy. This study evaluated the efficacy and safety of Fuke Qianjin (FKQJ) combined with antibiotics in the treatment of PID. Methods. Eight electronic databases and other resources were searched to make a collection of the randomized controlled trials (RCTs) from 1990 to 2019. The RCTs contrasting the effect of FKQJ combined with antibiotics regimens and antibiotics alone in reproductive women with PID were included. The antibiotics regimens are all recommended by the guidelines. Two reviewers independently screened the studies, extracted the data, and assessed the methodological quality of the included studies. Then, the meta‐analyses were performed by RevMan 5. 3 software if appropriate. Results. Twenty‐three RCTs (2527 women) were included in this review. The evidence showed that FKQJ combined with antibiotics improved the markedly effective rate compared to antibiotics alone group (RR = 1.38, 95% CI 1.27 to 1.49, I2 = 42%), shortened the improvement time of low abdominal pain (MD = −1.11, 95% CI −1.39 to −0.84, I2 = 38%), and increased the rate of lower abdominal pain improvement (RR = 1.35, 95% CI 1.19 to 1.55, I2 = 0). The implementation of adjuvant reduced the recurrent rate compared with antibiotics alone (RR = 0.27, 95% CI 0.13 to 0.56, I2 = 0%). Conclusions. Based on available evidence, FKQJ combined with antibiotics therapy have certain outcomes on increasing the markedly effective rate, decreasing the recurrent rate compared with antibiotics alone group. This therapy appears to improve lower abdominal pain and curtail the relief time. Due to the low quality and the risk of bias, any high‐quality evidence or longer follow‐up period should be advisable and necessary in the future.
Aplasia Cutis Congenita as a Sole Manifestation of Congenital Varicella Syndrome
Authors: Leung Alexander K. C. , Leong Kin Fon , Lam Joseph M.
Published: July 2020

Aplasia cutis congenita following maternal varicella is well known. On the other hand, aplasia cutis congenita as the sole manifestation of congenital varicella syndrome is very rare. A perusal of the literature revealed only one case. We report two infants with aplasia cutis congenita as the sole manifestation of congenital varicella syndrome.
The Diurnal Variations of GPS PWV near Poyang Lake in China during Midsummer
Authors: Wu Shanshan , Zou Haibo , Wu Junjie
Published: July 2020

With the 1 h-averaged data of atmospheric precipitable water vapor (PWV) for 2015–2018 retrieved from 18 ground-based Global Positioning System (GPS) observation stations near Poyang Lake (PL), China, the diurnal variations of the PWV during midsummer (July-August) are studied by the harmonic method. Results show that significant diurnal variations of PWV are found at the 18 GPS stations. The harmonics with 24 h cycle (diurnal cycle) over PL (i.e., Duchang and Poyang) and Nanchang city only have about 50% (or even smaller than 50%) of variance contribution with the amplitude of about 0.2 mm, while above 70% (or even 80%) of variance contribution occurs elsewhere around PL, with the amplitude of about 0.9 mm. The harmonics with diurnal cycles in most stations peak from afternoon to evening (i.e., 1200-2000 LST), but one exception is Duchang site, where the diurnal cycle peaks in the morning (i.e., 1000 LST). Moreover, the harmonics with 12 h cycle (semidiurnal cycle) have the relatively uniform amplitude of about 0.2 mm, but their variance contributions show uneven distribution, with the contributions of about or above 50% in PL and Nanchang city (the semidiurnal cycles peak about 0000 LST or 1200 LST) and below 30% (or even 10%) in other areas. The preliminary diagnosis analysis shows that the diurnal variation of the low-level (below 850 hPa) air temperature (increasing after the sunrise, decreasing after the sunset, and peaking around 1400-1800 LST) may be responsible for the diurnal cycle. Moreover, in PL (Duchang and Poyang) and Nanchang city, the effects (heating or cooling) of lake and urban, the diurnal variation of the 10 m wind over PL, and the acceleration of PL on overlying air also contributed to the diurnal variation of PWV.
Effect of High-Altitude Environment on Driving Safety: A Study on Drivers’ Mental Workload, Situation Awareness, and Driving Behaviour
Authors: Wang Xinyan , Bo Wu , Yang Weihua , Cui Suping , Chu Pengzi
Published: July 2020

This study aims to analyze the effect of high-altitude environment on drivers’ mental workload (MW), situation awareness (SA), and driving behaviour (DB), and to explore the relationship among those driving performances. Based on a survey, the data of 356 lowlanders engaging in driving activities at Tibetan Plateau (high-altitude group) and 341 lowlanders engaging in driving activities at low altitudes (low-altitude group) were compared and analyzed. The results suggest that the differences between the two groups are noteworthy. Mental workload of high-altitude group is significantly higher than that of low-altitude group, and their situation awareness is lower significantly. The possibility of risky driving behaviours for high-altitude group, especially aggressive violations, is higher. For the high-altitude group, the increase of mental workload can lead to an increase on aggressive violations, and the situation understanding plays a full mediating effect between mental workload and aggressive violations. Measures aiming at the improvement of situation awareness and the reduction of mental workload can effectively reduce the driving risk from high-altitude environment for lowlanders.
Giant Ileocecal Inflammatory Fibroid Polyp: Unique Clinical Presentation
Authors: Almaghrabi Hatim , Almaghrabi Murouj , Al-Maghrabi Haneen
Published: July 2020

Inflammatory fibroid polyps (IFPs) are infrequent gastrointestinal tract benign neoplasms. They mostly occur in the stomach especially the antrum. Signs and symptoms depend on their anatomic location and lesion size. Lesion biopsies are very challenging for accurate diagnosis in these lesions. Histopathological examination of resected tissue along with immunohistochemical studies is the perfect way to confirm the final diagnosis. In this paper, the authors present an unusual case of IFP in a 23-year-old female patient presented to the emergency room (ER) with a picture of intestinal obstruction and severe abdominal pain. Her investigations revealed a huge mass located at the ileocecal valve, with overall features mimic gastrointestinal stromal tumor (GIST) clinical presentation. Surgical resection is considered the most commonly used treatment method. The overall prognosis is good with a low risk of recurrence.
Diffusion Histology Imaging Combining Diffusion Basis Spectrum Imaging (DBSI) and Machine Learning Improves Detection and Classification of Glioblastoma Pathology
Authors: Ye Zezhong , Price Richard L. , Liu Xiran , Lin Joshua , Yang Qingsong , Sun Peng , Wu Anthony T. , Wang Liang , Han Rowland H. , Song Chunyu , Yang Ruimeng , Gary Sam E. , Mao Diane D. , Wallendorf Michael , Campian Jian L. , Li Jr-Shin , Dahiya Sonika , Kim Albert H. , Song Sheng-Kwei
Published: July 2020

Purpose:

Glioblastoma (GBM) is one of the deadliest cancers with no cure. While conventional MRI has been widely adopted to examine GBM clinically, accurate neuroimaging assessment of tumor histopathology for improved diagnosis, surgical planning, and treatment evaluation remains an unmet need in the clinical management of GBMs.

Experimental Design:

We employ a novel diffusion histology imaging (DHI) approach, combining diffusion basis spectrum imaging (DBSI) and machine learning, to detect, differentiate, and quantify areas of high cellularity, tumor necrosis, and tumor infiltration in GBM.

Results:

Gadolinium-enhanced T1-weighted or hyperintense fluid-attenuated inversion recovery failed to reflect the morphologic complexity underlying tumor in patients with GBM. Contrary to the conventional wisdom that apparent diffusion coefficient (ADC) negatively correlates with increased tumor cellularity, we demonstrate disagreement between ADC and histologically confirmed tumor cellularity in GBM specimens, whereas DBSI-derived restricted isotropic diffusion fraction positively correlated with tumor cellularity in the same specimens. By incorporating DBSI metrics as classifiers for a supervised machine learning algorithm, we accurately predicted high tumor cellularity, tumor necrosis, and tumor infiltration with 87.5%, 89.0%, and 93.4% accuracy, respectively.

Conclusions:

Our results suggest that DHI could serve as a favorable alternative to current neuroimaging techniques in guiding biopsy or surgery as well as monitoring therapeutic response in the treatment of GBM.
A Phase II Study of Abemaciclib in Patients with Brain Metastases Secondary to Hormone Receptor–Positive Breast Cancer
Authors: Tolaney Sara M. , Sahebjam Solmaz , Le Rhun Emilie , Bachelot Thomas , Kabos Peter , Awada Ahmad , Yardley Denise , Chan Arlene , Conte Pierfranco , Diéras Véronique , Lin Nancy U. , Bear Melissa , Chapman Sonya C. , Yang Zhengyu , Chen Yanyun , Anders Carey K.
Published: July 2020

Purpose:

The primary objective was to evaluate intracranial objective response rate (iORR) in patients receiving abemaciclib with brain or leptomeningeal metastases (LM) secondary to hormone receptor–positive (HR+) metastatic breast cancer (MBC). Secondary objectives evaluated extracranial response, abemaciclib pharmacokinetics, brain metastases tissue exposure, and safety.

Patients and Methods:

This nonrandomized, phase II study (NCT02308020) enrolled patients in tumor subtype–specific cohorts A–D: A (HR+, HER2− MBC), B (HR+, HER2+ MBC), C (HR+ MBC LM), and D (brain metastases surgical resection). Abemaciclib 200 mg was administered twice daily as monotherapy or with endocrine therapy, or 150 mg twice daily with trastuzumab. Cohorts A and B used a Simon two-stage design.

Results:

In cohort A (n = 58), 3 patients were confirmed responders resulting in an iORR of 5.2% [95% confidence interval (CI), 0.0–10.9], and the intracranial clinical benefit rate (iCBR) was 24% (95% CI, 13.1–35.2). Median overall survival (OS) was 12.5 months (95% CI, 9.3–16.4). A volumetric decrease in target intracranial lesions was experienced by 38% of patients. In cohort B (n = 27), there were no confirmed intracranial responses. An iCBR of 11% (95% CI, 0.0–23.0) was observed. Median OS was 10.1 months (95% CI, 4.2–14.3). A volumetric decrease in target intracranial lesions was experienced by 22% of patients. In cohort C (n = 10), one confirmed complete parenchymal response was observed. In cohort D (n = 9), unbound brain metastases concentrations of total active abemaciclib analytes were 96- [cyclin-dependent kinase 4 (CDK4)] and 19-fold (CDK6) above in vitro IC50. Safety was consistent with prior studies.

Conclusions:

This study did not meet its primary endpoint. Abemaciclib was associated with an iCBR of 24% in patients with heavily pretreated HR+, HER2− MBC. Abemaciclib achieved therapeutic concentrations in brain metastases tissue, far exceeding those necessary for CDK4 and CDK6 inhibition. Further studies are warranted, including assessing novel abemaciclib-based combinations.
Direct Interaction of Daxx and Androgen Receptor Is Required for Their Regulatory Activity in Cholesterol Biosynthesis
Authors: Li Tian-Ping , Sun Shao-Wei , Xiong Guo-Zuo , Qiu Fei , Yang Dong-Mei , Sun Si-Yu , Xie Xue-Jiao , Liao Duan-Fang , Chen Jian-Xiong , Tuo Qin-Hui
Published: July 2020

Introduction: Homeostasis of cholesterol is crucial for cellular function, and dysregulated cholesterol biosynthesis is a metabolic event that can lead to hepatic and cardiovascular abnormalities. Objective: The aim of this study was to investigate the effects and mechanisms of domain-associated protein (Daxx) and androgen receptor (AR) on intracellular cholesterol synthesis. Methods: HepG2 cells were transfected with pCDNA3.1(+)/Daxx plasmid or treated with testosterone propionate to observe the effects of Daxx and AR on intracellular cholesterol levels. Co-immunoprecipitation experiments were performed to identify the interaction between Daxx and AR and to explore the regulatory effects of this interaction on cholesterol synthesis. Results: Our experiments showed that AR promoted cholesterol synthesis and accumulation by activating sterol-regulatory element-binding protein isoform 2. AR-induced cholesterol synthesis was inhibited by Daxx; however, the expression of AR was not affected. Further studies demonstrated the existence of direct binding between Daxx and AR and this interaction was required to suppress AR activity. Conclusions: The Daxx-mediated antagonism of AR depicts a more complete picture as to how Daxx regulates intracellular cholesterol level and provides a new target for treatment of atherosclerosis.
The Combined Use of Tocilizumab and Hemoadsorption in a Patient with SARS-COV-2-19-Associated Pneumonia: A Case Report
Authors: Berlot Giorgio , Tomasini Ariella , Roman Pognuz Erik , Randino Anna , Chiella Fabrizio , La Fata Cristina , Piva Marco , Amato Paola , di Maso Vittorio , Bianco Francesco , Gerini Ugo , Tomietto Paola , Trenti Tommaso
Published: July 2020

The SARS-COV-2-19-associated respiratory involvement is caused by the massive release of inflammatory cytokines ultimately leading to interstitial pneumonia and acute respiratory distress syndrome (ARDS). In the absence of an effective antiviral treatment, a reasonable causal approach could be constituted by the neutralization of these substances. The authors describe the clinical course of a patient with SARS-COV-2-19 interstitial pneumonia treated with the combination of an anti-interleukin 6 (IL-6) agent (tocilizumab) and hemoadsorption (HA). This combination was used to abate the surge of inflammatory mediators leading to the lung damage. Blood levels of IL-6 and C-reactive protein (CRP) were measured before the initiation of the treatment and in the following 3 days. At the end of the treatment, the values of IL-6 and CRP decreased from 1,040 to 415 pg/mL and from 229 to 59 mg/L, respectively. The gas exchanges and the chest imaging rapidly improved, and the patient was extubated 10 days later. The combination of tocilizumab and HA could be valuable in the treatment of SARS-COV-2-19-associated pneumonia and ARDS that are caused by the release of inflammatory mediators.
Hope in the Context of Climate Change: Jonathan Sacks’ Interpretation of the Exodus and Radical Uncertainty
Authors: Hasselaar Jan Jorrit
Published: July 2020

The purpose of this article is to explore an understanding of hope that seeks to bridge the gap between a contemplative and action-oriented approach to hope. The argument is based in particular on an extensive study of the literature concerning the work of Jonathan Sacks. His reading of hope reaches back to the narrative of the Exodus and highlights several key assumptions to do with the principle of radical uncertainty. The intention is to situate these assumptions within the context of climate change. Most notably, Sacks’ concept of hope reveals a transformative response to climate change in which people gradually change their identity. For Sacks the key instrument of transformation for both religious and secular is a public Sabbath. An example of such is provided and Sacks’ thinking is set alongside the work of some leading theologians.
State estimation for a class of Linear Parameter-Varying systems with parametric uncertainties
Authors: He Zhongwei , Xie Wei
Published: July 2020

This paper is concerned with interval state estimation for a class of Linear Parameter-Varying systems with parametric uncertainties. Firstly, sufficient conditions to guarantee both the cooperativity and stability of observation error dynamics are presented in terms of parameterized matrix inequality formulations. Secondly, a novel method for scheduled controller law design is proposed in the framework of interval observer design. Under the assumptions that scheduled parameters have a polytopic structure property, the problems of the existence conditions of observers and scheduled controller design are transformed into finite linear matrix inequalities ones, which can be solved by convex optimization algorithms. The validity of the proposed state estimation methods is illustrated through a simple example.
Validation of a Sensor‐Fitted Simulator for Upper Airway Examination
Authors: Díez Nieves , Pacheco Sofía , Llorente Marcos , Fernández Secundino
Published: July 2020

Objective

To validate a simulator for upper airway examination, fitted with sensors, for use as an academic tool for learning how to conduct examination of the upper airway and for evaluation of that learning.

Study Design

Validation study.

Setting

Undergraduate medical education.

Subjects and Methods

A group of 18 fifth‐year medical students and another of 6 otorhinolaryngology specialists conducted 6 examinations each with the simulator. To investigate concurrent validity, we calculated the correlation between damage scores provided by the simulator and damage assessment by a specialist. To evaluate construct validity, we compared both groups with regard to damage scores, technical procedure, and time spent. To examine content and face validity, we used questionnaires based on a 5‐point Likert scale.

Results

For concurrent validity, the correlation between the simulator’s damage scores and the specialist’s damage assessment was high: Spearman’s ρ was 0.828 (P <. 001). For construct validity, the group of students differed from the group of specialists in damage scores (P =. 027) and in technical procedures (P <. 001) but not in time spent. For content validity, all questionnaire statements were scored highly, and both groups had similar average scores. For face validity, the group of specialists considered the simulator to be realistic, and all statements on the questionnaire were rated with at least 4/5.

Conclusion

Concurrent, construct, content, and face validity have been demonstrated for a sensor‐fitted simulator for upper airway examination, which is therefore accurate enough to be used as an academic tool for learning and evaluation of learning.
Cleft Lip and Palate in Newborns Diagnosed With Neonatal Abstinence Syndrome
Authors: Danis David O’Neil , Bachrach Kevin , Piraquive Jacquelyn , Marston Alexander P. , Levi Jessica R.
Published: July 2020

Objective

Cleft lip and/or cleft palate (CLP) is the most common major congenital malformation of the head and neck. Previous studies suggested an association between fetal opioid exposure and CLP. This study seeks to evaluate the associations between CLP and neonatal abstinence syndrome (NAS) in the United States.

Study Design

Population‐based inpatient registry analysis.

Setting

Academic medical center.

Subjects and Methods

Kids’ Inpatient Database (2016) was used to identify weighted in‐hospital births with diagnoses of CLP or NAS. Demographic information was obtained.

Results

Among 3.8 million weighted in‐hospital births, prevalence rates of CLP in the NAS and non‐NAS populations were 3.13 and 1.35 per 1000, respectively. The odds ratios for patients with NAS developing CLP, isolated cleft palate, isolated cleft lip, and cleft lip and palate when compared with the reference population were 2.33 (95% CI, 1.87‐2.91; P <. 001), 4.97 (95% CI, 3.84‐6.43; P <. 001), 1.01 (P =. 98), and 0.80 (P =. 46). Independent predictors of CLP within the NAS population included median household income for patients’ zip code, race, hospital region, payment method, and maternal use of tobacco or other drugs of addiction. The binary logistic regression model accounting for possible confounding variables produced an odds ratio of 1.74 (95% CI, 1.36‐2.23; P <. 001) for the association between NAS and CLP.

Conclusion

Our study found an association between NAS and CLP, specifically isolated cleft palate, suggesting that prenatal exposure to opioids may be an environmental risk factor in the development of CLP.
Effect of Powered Air‐Purifying Respirators on Speech Recognition Among Health Care Workers
Authors: Kempfle Judith S. , Panda Ashwin , Hottin Mary , Vinik Kevin , Kozin Elliott D. , Ito Christopher J. , Remenschneider Aaron K.
Published: July 2020

Powered air‐purifying respirators (PAPRs) are used as personalized protective equipment for health care personnel. PAPRs offer health care workers added protection when dealing with patients who have high‐risk infectious disease such as COVID‐19. Unfortunately, PAPRs can produce notable levels of background noise. We hypothesize that PAPR use may be associated with increased hearing thresholds and impaired word discrimination and may ultimately have a negative impact on effective communication. Herein, we (1) determined sound levels generated by PAPRs and (2) measured hearing thresholds and word discrimination with and without operational PAPRs. All participants had normal hearing. When the PAPR was operational, mean ± SD thresholds increased from 4.5 ± 3.6 to 38.6 ± 5.6 dB HL (P <. 001). Word discrimination dropped from 100% in all participants in quiet to a mean 48% ± 14% with operational PAPR (P <. 001). Thus, we find that use of PAPR hoods results in hearing impairment comparable to moderate to severe hearing loss, and we suspect that users will experience communication difficulties as a result.

Level of Evidence. Prospective study.
Time and Cost of Ultrasound‐Guided Fine‐Needle Aspiration Biopsy/Core‐Needle Biopsy for Primary Laryngohypopharyngeal Squamous Cell Carcinoma
Authors: Ahn Dongbin , Lee Gil Joon , Sohn Jin Ho
Published: July 2020

Objectives

This study aimed to evaluate benefits in terms of time and cost of percutaneous ultrasound‐guided fine‐needle aspiration biopsy/core‐needle biopsy (US‐FNAB/CNB) for the diagnosis of primary laryngeal and hypopharyngeal squamous cell carcinoma (LHSCC) in comparison with direct laryngoscopic biopsy (DLB) under general anesthesia.

Study Design

Retrospective case‐control study.

Setting

Single operator of a single center.

Subjects and Methods

From 2018 to 2019, 28 patients who underwent percutaneous US‐FNAB/CNB for the diagnosis of untreated LHSCC were enrolled. All US‐FNAB/CNBs were performed in the outpatient department by a single head and neck surgeon. Their results were compared with those of 27 patients who underwent DLB under general anesthesia.

Results

No major complications occurred in the US‐FNAB/CNB and DLB groups. Time to biopsy, time to pathologic diagnosis, and time to treatment initiation in the US‐FNAB/CNB and DLB groups were 0 and 14 days (P <. 001), 7 and 20 days (P <. 001), and 24 and 35 days (P =. 001), respectively. Procedure‐related costs were $368.5 and $981.0 in the US‐FNAB/CNB and DLB groups (P <. 001).

Conclusions

US‐FNAB/CNB offers true benefits in terms of time and cost over those given by conventional DLB for diagnosis of LHSCC in indicated patients.
Mechanical and processing properties of recycled PET and LDPE-HDPE composite materials for building components
Authors: Laria Julián Gonzalez , Gaggino Rosana , Kreiker Jerónimo , Peisino Lucas E , Positieri María , Cappelletti Ariel
Published: July 2020

Although several reports can be found in the literature about the recycling of plastic materials, only a few focus on recovering and molding them in a new process. Plastic material blends can be fabricated using several techniques, which allows the molding of a compound adaptable to each needed performance. This fact favors the recycling by allowing the use of mixed wastes without major processes, avoiding expensive treatments. This research work analyzes the mechanical properties of a material conformed by 100% recycled plastics: polyethylene terephthalate and low-/high-density polyethylene without previous separation or washing and drying pretreatments. Its macro and microscopic structure was studied and described, and formulations of different compound rates were analyzed. Mechanical resistance was around 60% of a material composed of virgin materials in compressive, flexural, and tensile strength tests. Its potential application to building components manufacture is analyzed.
Overcoming Barriers: Individual Experiences Obtaining Medication-Assisted Treatment for Opioid Use Disorder
Authors: Scorsone Krista L. , Haozous Emily A. , Hayes Leslie , Cox Kim J.
Published: July 2020

Medication-assisted treatment (MAT) for opioid use disorder (OUD) is accessed half as often in rural versus urban areas in the United States. To better understand this disparity, we used a qualitative descriptive approach to explore the experiences of individuals with OUD seeking MAT in rural New Mexico. Guided interviews were conducted with 20 participants. The frameworks of critical social theory, intersectionality theory, and the brain opioid theory of social attachment were used to guide data analysis and interpretation. Thematic content analysis derived five major themes which identified novel barriers and facilitators to MAT success, including a perceived gender disparity in obtaining MAT, challenges in building a recovery-oriented support system, and the importance of navigating a new normal social identity. This deeper knowledge of the experiences and perspectives of rural individuals with OUD could serve to address the rural–urban MAT disparity, leading to enhanced recovery capacity and transformative policies.
Amplitudes of components in vibration spectra of rolling bearings with localized defects under harmonic loads
Authors: Govardhan Tingarikar , Choudhury Achintya
Published: July 2020

In the present work, an attempt has been made to obtain the vibration response with relative amplitudes of the spectral components for a rolling element bearing with localized defect on different elements under the action of harmonic radial load. The bearing has been assumed as a multi-degree-of-freedom system, and the frequency of harmonic load has been considered to be the shaft frequency. The vibration spectra have been obtained using envelope detection technique. The modulating effects of the harmonic load has resulted in additional sidebands at shaft frequency about the components which are otherwise caused by static load for defects on the outer race and the rolling element. For inner race defect, no additional components exist because the modulating frequency is equal to the shaft frequency at which the sidebands appear even for the static load. A detailed experimental investigation has also been carried out in the present work to validate the theoretical results. The results of theoretical and experimental investigations show the amplitudes of spectral components for both the studies are of the same order and their normalized values have fair agreement between them.
Repeat Dose Toxicity Study of the AV7909 Anthrax Vaccine Candidate in Juvenile Rats
Authors: Zmarowski Amy , Ballin Jeff D. , Sharits Jessica , Carrico Kevin , Novak Joseph , Shearer Jeffry , Blauth Bruna , Ionin Boris , Reece Joshua , Savransky Vladimir
Published: July 2020

AV7909 is a next-generation anthrax vaccine candidate indicated for post-exposure prophylaxis of exposure to Bacillus anthracis. AV7909 consists of the Anthrax Vaccine Adsorbed (AVA) bulk drug substance and the immunostimulatory Toll-like receptor 9 agonist oligodeoxynucleotide adjuvant, CPG 7909. Safety testing for pediatric population is warranted to support the potential emergency use of AV7909 in children. This study was conducted to investigate the local tolerance and potential systemic toxicity and their reversibility in juvenile rats by repeat intramuscular injections of the AV7909 vaccine candidate. Animals were dosed on postnatal day (PND) 21 (at weaning), PND 28, and PND 35, with the test article (AV7909), the adjuvant alone (Alhydrogel + CPG 7909), or sterile water for injection. Core group animals were necropsied on PND 37 and recovery group on PND 49. Study end points included survival, clinical observations, injection site observations, body weights, clinical pathology (hematology, coagulation, and clinical chemistry), pro-inflammatory biomarker analysis (alpha-2 macroglobulin [A2M] and alpha-1 acid glycoprotein [AGP]), and anatomic pathology. Immune response to vaccination was measured using the high-throughput anthrax lethal toxin neutralization assay (htpTNA). The AV7909 vaccine candidate produced no apparent systemic or local toxicity. The AGP and A2M levels were elevated in both the adjuvant-alone and AV7909 groups at the end of treatment but were comparable to control levels by the end of the recovery period. All animals in the AV7909 group demonstrated a robust neutralizing antibody response. The results indicate that AV7909 has a favorable safety profile in juvenile rats.
The Oral and Gut Bacterial Microbiomes: Similarities, Differences, and Connections
Authors: Maki Katherine A. , Kazmi Narjis , Barb Jennifer J. , Ames Nancy
Published: July 2020

Background: The oral cavity is associated with local and systemic diseases, although oral samples are not as commonly studied as fecal samples in microbiome research. There is a gap in understanding between the similarities and differences in oral and gut microbiomes and how they may influence each other. Methods: A scoping literature review was conducted comparing oral and gut microbiome communities in healthy humans. Results: Ten manuscripts met inclusion criteria and were examined. The oral microbiome sites demonstrated great variance in differential bacterial abundance and the oral microbiome had higher alpha diversity as compared to the gut microbiome. Studies using 16S rRNA sequencing analysis resulted in overall community differences between the oral and gut microbiomes when beta diversity was analyzed. Shotgun metagenomics sequencing increased taxonomic resolution to strain level (intraspecies) and demonstrated a greater percentage of shared taxonomy and oral bacterial translocation to the gut microbiome community. Discussion: The oral and gut microbiome bacterial communities may be more similar than earlier research has suggested, when species strain is analyzed through shotgun metagenomics sequencing. The association between oral health and systemic diseases has been widely reported but many mechanisms underlying this relationship are unknown. Although future research is needed, the oral microbiome may be a novel interventional target through its downstream effects on the gut microbiome. As nurse scientists are experts in symptom characterization and phenotyping of patients, they are also well posed to lead research on the connection of the oral microbiome to the gut microbiome in health and disease.
PewDiePie, racism and Youtube’s neoliberalist interpretation of freedom of speech
Authors: Hokka Jenni
Published: July 2020

How and why the social limits of racist speech have become obscure and ‘outdated’ for a YouTube star PewDiePie and his over 100 million fans? How have the policies of YouTube affected the general understanding of the limits of racist discourse in the digital media context? In this article, I argue that the case of PewDiePie shows how YouTube exercises a neoliberalist understanding of freedom of speech. In my analysis, I contextualise PewDiePie’s own comments and YouTube’s publications into the history of Internet culture and introduce the development of YouTube into a neoliberalist sphere. I illustrate how neoliberal ideology is now implemented on three levels on YouTube: through creating an illusion of intimacy between a creator and his/her fans, through the promise of equal opportunity on YouTube and through a neoliberalist interpretation of the marketplace-of-ideas principle. The analysis reveals how YouTube’s policies and practices as ideological choices contribute to the normalisation of racism on social media.
Suicidal ideation among North Korean refugees in South Korea: Exploring the influence of social network characteristics by gender
Authors: Um Mee Young , Rice Eric , Lee Jungeun Olivia , Kim Hee Jin , Palinkas Lawrence A.
Published: July 2020

Rates of death by suicide among North Korean refugees are three times higher than those among their host-country counterparts in South Korea. However, social and cultural factors predicting suicidality among North Korean refugees are not well known. Thus, we explored how social networks affect suicidal ideation in a sample of 405 North Korean refugees in South Korea using egocentric network data. Network diversity (number of different types of ties) was a protective factor for suicidal ideation among women. Having a help-providing and trustworthy church-based tie was a protective factor for women, whereas it was a risk factor for men. It is likely that women connected to people in diverse social contexts received more support to effectively deal with adversities. Because South Korean churches provide tailored worship services and financial aid to North Korean refugees, women might receive emotional comfort from church-based ties whom they can trust and receive help from, whereas men might become distressed about being financially dependent on others, which contradicts cultural expectations of a man’s traditional role. Our findings have implications for mental health practitioners serving vulnerable populations, and highlight the importance of understanding the cultural context of social networks and gender in suicide research.
Social media and connective action: The case of the Saudi women’s movement for the right to drive
Authors: Khalil Ali , Storie Leysan Khakimova
Published: July 2020

This article explored the use of social media and mobile communication by women in Saudi Arabia who campaigned for the right to drive from 1990. Due to the globally unique ban on women driving in the Kingdom, females always needed a male driver to transport them. The Saudi government announced in September 2017 that women would be allowed to drive from June 2018. Using the theory of connective action, the article explored the role of social media in the movement for the right to drive, and looked at how activists used digital media platforms to get their messages across to the Saudi publics and the international community. Findings showed that both connective action and collective action offer tactics that can complement each other in an online movement. In addition, results offer in-depth insights about the role of identity in online movements. Threats to and limitations of online movements are also discussed.
Developing a Global Studies Curriculum: The Case of Northern High School
Authors: Saperstein Evan , Fancera Samuel F.
Published: July 2020

This fictional case presents the challenges school districts face when developing a new curriculum. After the school board voted to create a global studies program at Northern High School, the social studies supervisor had the responsibility of designing and implementing the curriculum. With only a few months to implement the curriculum, the supervisor embraced an ambitious whole-school approach. This included bringing teachers together from different disciplines to draft a curriculum; investing in professional development; and encouraging participation of students, the school, and the community. This case presents issues and questions that may arise during the curriculum design and development process.
What are acute NHS trusts in England doing to prevent the cross-border spread of carbapenem-resistant Enterobacteriaceae?
Authors: Mawdsley Sharon
Published: July 2020

Background:

Carbapenem-resistant Enterobacteriaceae (CRE) pose a significant threat to global public health as these organisms have the potential to cause infections which are easily spread and are associated with high mortality rates.

Aim/Objective:

The aim of this study was to establish which screening strategies acute NHS trusts in England have chosen to adopt and whether or not that strategy has prevented or is likely to prevent the cross-border spread of CRE.

Methods:

All acute NHS trusts in England were invited to participate in a multicentre quantitative study. Participants were asked to complete a questionnaire relating to their local CRE screening protocol.

Findings/Results:

Of the 91 participating trusts, 83 (91.2%) adhere to Public Health England (2013) guidance. However, only 22 (24.2%) trusts have adopted the European Centre for Disease Prevention and Control (2016) recommendations. In total, 31 (34.1%) trusts reported incidences of person-to-person transmission, of which 45.2% were related to foreign travel. Furthermore, 31 (34.1%) trusts reported that patients who have had an admission to a hospital in the UK not known to have a high prevalence of healthcare-associated CRE in the last 12 months had screened positive.

Discussion:

This study has demonstrated that inter-hospital transmission is as much of a concern as cross-border spread. Mandatory participation in enhanced surveillance could provide PHE with the epidemiological evidence required to support this stance and help to develop new national guidance.
Impact of a hospital-wide huddle on device utilisation and infection rates: a community hospital’s journey to zero
Authors: Mena Lora Alfredo J , Ali Mirza , Krill Candice , Spencer Sherrie , Takhsh Eden , Bleasdale Susan C
Published: July 2020

Background:

Device utilisation ratios (DUR) correlate with device-associated complications and rates of infection. We implemented a hospital-wide Daily Interdisciplinary Safety Huddle (DISH) with infection control and device components. The aim of this study was to evaluate the impact of DISH on DURs and rates of infection for indwelling urinary catheters (IUC) and central venous catheters (CVC).

Methods:

A quasi-experimental study assessing DURs and rates of infection before and after implementation of DISH. At DISH, usage of IUC and CVC is reported by managers and the infection preventionist reviews indications and plans for removal. Data before and after implementation were compared. Paired T-test was used to assess for differences between both groups.

Results:

DISH was successfully implemented at a community hospital. The average DUR for IUC in intensive care unit (ICU) and non-ICU settings was reduced from 0.56 to 0.35 and 0.27 to 0.12, respectively. CVC DUR decreased from 0.29 to 0.26 in the ICU and 0.14 to 0.12 in non-ICU settings. Catheter-associated urinary tract infections (CAUTIs) decreased by 87% and central line-associated bloodstream infections (CLABSIs) by 96%.

Conclusion:

DISH was associated with hospital-wide reductions in DUR and device-associated healthcare-associated infections. Reduction of CLABSIs and CAUTIs had estimated cost savings of $688,050. The impact was more profound in non-ICU settings. To our knowledge, an infection prevention hospital-wide safety huddle has not been reported in the literature. DISH increased device removal, accountability and promoted a culture of safety.
Utility of SNOMED CT in automated expansion of clinical terms in discharge summaries: Testing issues of coverage
Authors: Zivaljevic Aleksandar , Atalag Koray , Warren James
Published: July 2020

Objective:

This study tests coverage of SNOMED CT as an expansion source in the process of automated expansion of clinical terms found in discharge summaries. Term expansion is commonly used as a technique in knowledge extraction, query formulation and semantic modelling among other applications. However, characteristics of the sources might affect credibility of outputs, and coverage is one of them.

Method:

We developed an automated method for testing coverage of more than one source at a time. We used several methods to clean our corpus of discharge summaries before we extracted text fragments as candidates for clinical concepts. We then used Unified Medical Language System (UMLS) sources and UMLS REST API to filter concepts from the pool of text fragments. Statistical measures like true positive rate and false negative rate were used to decide on the coverage of the source. We also tested the coverage of the individual SNOMED CT hierarchies using the same methods.

Results:

Findings suggest that a combination of four terminologies tested (SNOMED CT, NCI, LNC and MSH) achieves over 90% of coverage for term expansion. We also found that the SNOMED CT hierarchies that hold clinically relevant concepts provided 60% of coverage.

Conclusion:

We believe that our findings and the method we developed will be of use to both scientists and practitioners working in the domain of knowledge extraction.
Health-Related Quality of Life and Cost–Utility Analysis of Employees With Musculoskeletal Disorders Receiving Vocational Physiotherapy
Authors: Chetty Laran
Published: July 2020

Background: The purpose of this project was to evaluate both health-related quality of life (HRQoL) and cost-utility associated with care for employees with musculoskeletal disorders who received vocational physiotherapy at a North London National Health Service (NHS) Foundation Trust in the United Kingdom. Methods: A pre- and post-physiotherapy EuroQol 5 Dimension (EQ-5D) questionnaire was administered to employees presenting to the vocational physiotherapy service (VPS) with musculoskeletal disorders. The cost-utility analysis of the physiotherapy service was calculated using cost data provided by VPS billing information and benefits measured using Quality-Adjusted Life Years (QALYs). Findings: Overall, there was a significant improvement in the EQ-5D index from baseline to discharge in all HRQoL domains. The visual analog scale (VAS) improved from a mean of 31.5 (SD = 18.3) at baseline to 73.2 (SD = 18.5) at discharge. A cost-utility analysis indicated that the VPS would continue to be cost-effective until the cost per employee increased by 82.5%. Conclusion/Application to Practice: The project supports integration of vocational physiotherapy services into an occupational health department.
Characterizing Microbiota from Sjögren’s Syndrome Patients
Authors: Singh M. , Teles F. , Uzel N.G. , Papas A.
Published: July 2020

Objective:

To compare the oral microbiota of Sjögren’s syndrome (SS) with that of healthy subjects (HS).

Methods:

Supragingival and subgingival biofilm samples were collected from the mesial-buccal tooth surfaces of SS patients (n = 57) and age- and sex-matched HS (n = 53). Unstimulated saliva and 8 oral tissue samples were taken using a buccal brush. Caries and periodontal measures were recorded. All supragingival samples and a subgroup of 24 SS and 28 HS subgingival samples, as well as 32 SS and 11 HS saliva and oral tissue samples, were analyzed for their content of 41 bacterial species using checkerboard DNA-DNA hybridization. Mean levels (×105 ± SEM) and percentage of DNA probe counts of each species were determined for each sample site and averaged within subjects in the 2 clinical groups. Kruskal-Wallis tests, adjusting for multiple comparisons and cluster analysis, were used for soft tissue and microbial analysis, and the Mann-Whitney test was used to compare caries and periodontal measures.

Results:

Mean (×105 ± SEM) total DNA probe counts in supragingival samples were significantly lower (P < 0.001) in the SS (13.3 ± .7) compared to the HS (44.1 ± 6.8) group. In supragingival samples, Veillonella parvula, Fusobacterium nucleatum ss vincenti, and Propionibacterium acnes were markedly elevated in the SS compared to the HS group in both mean (×105 ± SEM) and mean (± SEM) percentage DNA probe counts (P < 0.001). In subgingival samples of SS, V. parvula was significantly different compared to HS (P < 0.05). SS was characterized by high levels of purple and low levels of orange and red complexes. Cluster analysis of oral tissues and saliva demonstrated that the mean microbial profiles for SS patients and the HS group clustered separately. Active root caries (P < 0.003) and attachment loss were significantly higher (P < 0.029) in the SS group compared to the HS group.

Conclusion:

These findings indicate that saliva is a major controlling factor of intraoral biofilm. V. parvula may be a unique microbial biomarker for Sjögren’s syndrome.

Knowledge Transfer Statement

The microbiome characterized for Sjögren’s syndrome in salivary hypofunction is shown to be under stress and reduced. Veillonella parvula can be a possible identification of a biomarker for Sjögren’s syndrome.