bluuebunny/crossref_metadata_2025 huggingface dataset:
A singular values approach in helicopter gas turbine engines flight testing analysis
Authors: Arush Ilan , Pavel Marilena D , Mulder Max
Published: April 2020

The process of empirical models evaluation is at the core business of experimental flight-testing data analysis. Accurate and convenient flight-testing of helicopter engine(s) available power is crucial for predicting the total helicopter performance. Common practice in estimation of in-flight helicopter gas turbine engine power consists of a reduction of flight-test data into simplistic single-variable analysis approach. While such an approach is convenient for practical use, it often results in unrealistic predictions of the available engine(s) power. A novel approach for the helicopter available power problem is the so-called Multivariable Polynomial Optimization under Constraints method. In this method, 18 regressors, constructed from the engine non-dimensional parameters, are used to define empirical polynomial models. This paper is intended to complement the Multivariable Polynomial Optimization under Constraints method and answer the question of which multivariable polynomial can be generally used in representing helicopter gas-turbine engine performance? In this sense, a variety of seven gas-turbine engines installed on different helicopters are analyzed, each one giving 512 possible polynomial models to be used for available-power calculations. While conventional statistical methods of hypothesis-testing failed in providing the answer to the question stated above of which the best general empirical model for representing engine performance is, an alternative approach based on the Singular-Value-Decomposition theorem, was proven successful in providing the answer. Moreover, this approach presented in the paper yielded a short list of 10 simple and convenient multivariable polynomials, best representing the performance of all seven engines analyzed as a group.
National sport success and the emergent social atmosphere: The case of Iceland
Authors: Halldorsson Vidar
Published: April 2020

Iceland attracted international attention when its national football team qualified for the 2018 Men’s World Cup. This surprise qualification made Iceland the smallest nation to qualify in the 88-year history of the prestigious competition. During the World Cup, life in Iceland seemed to center on the Icelandic team and attract interest and attention from almost every Icelander. But how widespread was the national interest in Iceland’s participation and did the inclusion of Iceland in the competition have any positive social/psychological impact on individuals and/or Icelandic society? Questionnaire data from a sample of the Icelandic population show that there was extensive interest among Icelanders in the participation of the Icelandic team in the World Cup. The findings further show that Iceland’s participation positively affected the mood of Icelanders and created a positive atmosphere among the Icelandic nation, as well as some critical attitudes, at least for the short term.
The map and the territory: Re-assessing EU law’s embeddedness in European societies
Authors: Vauchez Antoine
Published: April 2020

The Editorial takes stock of the current trends of inter-disciplinary scholarship on EU Law’s infrastructural power.
Validation of a quantitative PCR assay for the detection of 2 Flavobacterium columnare genomovars
Authors: Gibbs Gordon D. , Griffin Matthew J. , Mauel Michael J. , Lawrence Mark L.
Published: April 2020

Flavobacterium columnare is the causative agent of columnaris disease in a variety of fish hosts. Using modifications to previously established protocols, a quantitative PCR (qPCR) assay was validated for the detection of 2 predominant F. columnare genomovars. The oligonucleotide primer and probe combination was designed to amplify a 203-bp region of the chondroitin AC lyase gene (GenBank AY912281) of F. columnare. There were no significant differences in amplification between genomovars. Comparable quantities of genomic DNA from 10 F. columnare strains, 5 representatives of each genomovar, produced similar results. Serial dilutions of purified PCR product demonstrated the limit of sensitivity for the assay was ~ 10 copies per reaction. The presence of gill and spleen tissue did not significantly affect the sensitivity of the assay. Comparably, bacterial DNA detected from the liver and kidney was less sensitive than pure bacterial DNA. However, detection from these tissues was within one order of magnitude of other tissues, indicating this reduction may have minimal analytic significance. This validated assay was used to approximate the minimum infectious dose for F. columnare isolate 94-081 in channel catfish and assess bacterial loads in gill and kidney tissues 48 h post-infection.
Pathologic and flow cytometric features of a case of canine ventral cervical lymphangiosarcoma
Authors: Azevedo Carolina N. , Sterman Allyson A. , Stranahan Lauren W. , Taylor Brianne M. , Wiener Dominique J. , Davidson Jacqueline R. , Russell Karen E.
Published: April 2020

An 11-y-old spayed female German Shepherd was presented for a second opinion of ventral cervical swelling of 3-mo duration. On examination, the dog had significant dependent ventral cervical swelling. Enlarged lymph nodes with cystic changes and severe edematous facial swelling were noted on computed tomography. Fine-needle aspiration of the ventral cervical swelling revealed yellow-tinged fluid, with a predominance of lymphoid cells noted on cytologic examination. On cervical exploratory surgery, the left mandibular lymph node was surrounded by a large fluid pocket; biopsies of the lymph node were obtained. Impression smear cytology, flow cytometry, PCR for antigen receptor gene rearrangements, and histopathology were performed on samples from the left mandibular lymph node. Impression smear cytology revealed a population of atypical discrete cells. Flow cytometry identified a population of CD34+/CD45– large cells. A tumor of endothelial origin within the medulla of the lymph node was identified by histopathology, and lymphangiosarcoma was confirmed based on prospero-related homeobox gene 1 ( PROX1) immunoreactivity. Our study describes the challenges in the diagnosis of a rarely reported entity and highlights that neoplastic endothelial cells should be considered as a differential when high proportions of CD34+/CD45– cells are present in flow cytometry.
Luther’s Theologian of the Cross and Theologian of Glory Distinction Reconsidered
Authors: Jackson Christopher D.
Published: April 2020

This article argues that most of the contemporary appropriation of Martin Luther’s distinction between the theologian of the cross and the theologian of glory is mistaken, in five points: First, the distinction has a thin textual basis, found explicitly only a handful of times in Luther’s early writings. Second, recent scholarship and an examination of Luther’s wider writings call into question contemporary accounts as to what Luther meant by the distinction. Third, the theological tradition did not make use of this distinction until the 20th century. It would be a mistake, therefore, to demand that a distinction which was not popularly received until such a late time act as a normative framework. Fourth, when referring to God and His people, “glory” and “glorification” are useful biblical and theological terms, and this distinction casts these terms in a negative light. Fifth, a thorough-going theology of glory is crucial for Christian discipleship.
Leveraging Existing Cohorts to Study Health Effects of Air Pollution on Cardiometabolic Disorders: India Global Environmental and Occupational Health Hub
Authors: Walia Gagandeep K , Mandal Siddhartha , Jaganathan Suganthi , Jaacks Lindsay M , Sieber Nancy L , Dhillon Preet K , Krishna Bhargav , Magsumbol Melina S , Madhipatla Kishore K , Kondal Dimple , Cash Richard A , Reddy K Srinath , Schwartz Joel , Prabhakaran D
Published: April 2020

Air pollution is a growing public health concern in developing countries and poses a huge epidemiological burden. Despite the growing awareness of ill effects of air pollution, the evidence linking air pollution and health effects is sparse. This requires environmental exposure scientist and public health researchers to work more cohesively to generate evidence on health impacts of air pollution in developing countries for policy advocacy. In the Global Environmental and Occupational Health (GEOHealth) Program, we aim to build exposure assessment model to estimate ambient air pollution exposure at a very fine resolution which can be linked with health outcomes leveraging well-phenotyped cohorts which have information on geolocation of households of study participants. We aim to address how air pollution interacts with meteorological and weather parameters and other aspects of the urban environment, occupational classification, and socioeconomic status, to affect cardiometabolic risk factors and disease outcomes. This will help us generate evidence for cardiovascular health impacts of ambient air pollution in India needed for necessary policy advocacy. The other exploratory aims are to explore mediatory role of the epigenetic mechanisms (DNA methylation) and vitamin D exposure in determining the association between air pollution exposure and cardiovascular health outcomes. Other components of the GEOHealth program include building capacity and strengthening the skills of public health researchers in India through variety of training programs and international collaborations. This will help generate research capacity to address environmental and occupational health research questions in India. The expertise that we bring together in GEOHealth hub are public health, clinical epidemiology, environmental exposure science, statistical modeling, and policy advocacy.
‘A rapist in your path’: Transnational feminist protest and why (and how) performance matters
Authors: Serafini Paula
Published: April 2020

Since its second public enactment in Chile on 25 November 2019, the performance of ‘Un violador en tu camino’ (A rapist in your path) conceived by the Chilean feminist collective Las Tesis began to make the rounds on social media. Un violador en tu camino is an open, collective performance involving lyrics sung in unison to a catchy beat, and a simple choreography performed synchronously by a group of women in a public space. The performance centres on rape – or ‘the rapist in your path’ – and the lyrics address the structural nature of gender violence in society more broadly. But what is it specifically that makes a performance action powerful in and beyond a protest context? This article examines the values and processes behind Un violador en tu camino in order to generate a deeper understanding of why the performance was appropriated by women across the world. It proposes that it is a powerful, prefigurative performance action because it mobilises participants and appeals to audiences as a sharp denunciation of violence, a demonstration of collective, prefigurative political action and a visually impressive composition.
The rotating Presidency of the Council of the EU – Still an agenda-setter?
Authors: Vaznonytė Austė
Published: April 2020

What role does the rotating Council Presidency maintain a decade after Lisbon? This article argues that, regardless of institutional changes, the rotating Presidency still shapes the Council agenda to a large extent. Based on an original hand-coded dataset of rotating Presidency programmes between 1997 and 2017, I show that some policies are ‘stickier’ on the Council agenda, while the others exhibit significant changes in salience over time. Since the magnitude of these shifts varies from Presidency to Presidency, the analysis focuses on domestic political factors and the country positioning vis-à-vis the European Union to determine their relationship with agenda volatility. By means of a panel model, the examination demonstrates that the government issue salience can best explain the levels of issue salience in the Presidency programmes.
Empathy and nausea: virtual reality and Jordan Wolfson’s Real Violence
Authors: Bollmer Grant , Guinness Katherine
Published: April 2020

Jordan Wolfson’s Real Violence (2017) is a brief virtual reality (VR) piece that depicts the artist beating a man to death with a baseball bat. Wolfson uses the haptic possibilities of VR to rapidly induce nausea in the viewer, an act that both relies on empathetic aspects of VR simulation – ‘empathy’ here linked with its history in German aesthetic psychology as Einfühlung – and is a confrontational distancing that questions the politics of ‘empathetic’ immersion. Real Violence demonstrates how contemporary judgments of VR and empathy repeat debates from the late 19th and early 20th centuries, reinventing and emptying particular political/aesthetic strategies that have long characterized a strain of modernist art that uses the formal possibilities (and limits) of media in order to critique the very same possibilities (and limits). This article, through its discussion of Wolfson’s work, seeks to identify and inhabit the complex contradictions present in any discussion of empathy, transgressive confrontation, and the social function of art and VR today. It examines the limitations of immersion and emotional projection, along with the limitations of interpreting this work (and VR in general) as a means for enacting ‘progressive’ social and ideological change through the immersive, empathetic capacities of media. The article concludes by arguing that judgments of Real Violence (and the politics of ‘transgressive’ art more broadly) require assuming the will or intent of an artist who uses confrontation and transgression to ‘correct’ the experience of the viewer, which is something that cannot be assumed for either Wolfson or Real Violence, and rather his work is exemplary of emptying out the possibilities represented by both VR and critical aesthetic intervention.
Effect of Light-Emitting Diode Irradiation on Chronic Nonhealed Wound After Below-Knee Amputation
Authors: Elessawy Haitham Amin , Borhan Wafaa Hussein , Ghozlan Nasser Ahmed , Nagib Samah Hosny
Published: April 2020

Chronic nonhealed wound after below-knee amputation is a serious problem that is faced by the health care team; therefore, there is a need to find an adjuvant therapy to address this problem. The aim of the study is to evaluate the therapeutic efficacy of light-emitting diode (LED) irradiation on chronic nonhealed wound after below-knee amputation using a digitalized method of evaluation by Adobe Photoshop CS5 aided by magnetic lasso tool. Thirty patients with chronic nonhealed wound (≥4 weeks) after below-knee amputation were randomly divided into 2 equal groups, with 15 participants in each. Group A received the LED irradiation for 24 sessions (3 sessions per week) in addition to the standard medical treatment, and the second experimental group (group B) received the standard medical treatment for 8 weeks. Methods of evaluation included the wound surface area: for tracing the wound perimeter using a computerized software. Results showed that both LED irradiation therapy and standard medical treatment were effective in healing the chronic nonhealed wound, but the LED was more effective than standard medical treatment alone. A clear improvement in the results of wound healing surface area was found in group A, with an improvement percentage of 50.63%, when compared with group B, which used the standard medical treatment alone, with an improvement percentage of 43.96%.
Oxytocin and positive couple interaction affect the perception of wound pain in everyday life
Authors: Pfeifer Ann-Christin , Schroeder-Pfeifer Paul , Schneider Ekaterina , Schick Maren , Heinrichs Markus , Bodenmann Guy , Ehlert Ulrike , Herpertz Sabine C. , Läuchli Severin , Eckstein Monika , Ditzen Beate
Published: April 2020

A large body of animal and human laboratory research has linked social interaction and support to pain perception, with a possible role for the neuropeptide oxytocin as a neuroendocrine mediator. However so far, it has been unclear whether these effects translate to ecologically valid everyday life behavior and pain perception. In a randomized placebo-controlled study, a standard suction blister skin wound was induced to N = 80 romantic couples (N = 160 individuals). Couples then received intranasal oxytocin or placebo twice daily and were either instructed to perform a positive social interaction (partner appraisal task, PAT) once in the laboratory and two times during the following five days, or not. During these days, all participants reported their subjective pain levels multiple times a day using ecologically momentary assessment. Results from hierarchical linear modeling suggest that pain levels within the couples were inter-related. In men, but not in women, oxytocin reduced pain levels. Women reported lower pain levels in the group of positive social interaction, while this effect did not show in men. These results suggest that intranasal oxytocin might have sex-specific effects with pain reducing effects in men but the opposite effects in women. In contrast, especially women benefit from positive interaction in terms of dampened pain levels after positive interaction. The results add to the evidence for health-beneficial effects of positive couple interaction and point to underlying neuroendocrine mechanisms in everyday life pain specifically. The sex-specific effects, in particular, may have implications for psychopharmacological treatment of pain in men and women.
Cerebrovascular disease is associated with an increased disease severity in patients with Coronavirus Disease 2019 (COVID-19): A pooled analysis of published literature
Authors: Aggarwal Gaurav , Lippi Giuseppe , Michael Henry Brandon
Published: April 2020

Introduction

There is an urgent need to identify patients at high risk during the ongoing coronavirus disease (COVID-19) pandemic. Whether a history of stroke is associated with increased severity of disease or mortality is unknown.

Method

We pooled studies from published literature to assess the association of a history of stroke with outcomes in patients with COVID-19.

Results

A pooled analysis of 4 studies showed a ∼2.5-fold increase in odds of severe COVID-19. While a trend was observed, there was no statistically significant association of stroke with mortality in patients with COVID-19 infection.

Discussion

Our findings are limited by a small number of studies and sample size.

Conclusion

There is a ∼2.5-fold increase in odds of severe COVID-19 illness with a history of cerebrovascular disease.
COVID-19 and stroke—A global World Stroke Organization perspective
Authors: Markus Hugh S , Brainin Michael
Published: April 2020

The COVID-19 pandemic affecting all parts of the world is having huge implications for stroke care. Not only do stroke patients appear to be more susceptible to severe infection, but the pandemic is having major implications on how we deliver stroke care, while ensuing safety of both our patients and health care professionals. COVID-19 infection itself has also been described as a risk factor for stroke. The World Stroke Organization has been monitoring the impact of the pandemic globally, and has identified an initial marked fall in stroke presentations as well as a widespread impact on stroke services. The pandemic is changing the way we deliver care, and has highlighted the enormous potential of telemedicine in stroke care.
Living with a chronic disease: A quantitative study of the views of patients with a chronic disease on the change in their life situation
Authors: Benkel Inger , Arnby Maria , Molander Ulla
Published: April 2020

Objectives:

Chronic diseases have an impact on and change patient’s lives which means that they need to find ways to cope with the new situation. The aim was to describe how the chronic disease has influenced patients’ views of their life situation.

Methods:

The study was quantitative in design with data collected using a semi-structured questionnaire. Descriptive statistics were used to compare similarities and differences between patients with asthma-allergy, diabetes mellitus, cancer and inflammatory rheumatoid arthritis.

Results:

Changes in their life were experienced as a negative outcome for the majority of participants. Support can be in the form of interpersonal support from various persons, but also from activities and beliefs/religion. Family and friends as well as healthcare professionals were identified as being most supportive. Sadness and worry were the most common emotions among the participants and their surrounding networks.

Conclusion:

People with a chronic disease have to live with the consequences the disease has for their life situation. They need to find strategies to cope with the negative outcome in their new life. Support from their own network and healthcare professionals can be helpful in the new life situation.
Measurement of ex vivo resistance to proteasome inhibitors, IMiDs, and daratumumab during multiple myeloma progression
Authors: Walker Zachary J. , VanWyngarden Michael J. , Stevens Brett M. , Abbott Diana , Hammes Andrew , Langouët-Astrie Christophe , Smith Clayton A. , Palmer Brent E. , Forsberg Peter A. , Mark Tomer M. , Jordan Craig T. , Sherbenou Daniel W.
Published: April 2020

The oncogenic drivers and progression factors in multiple myeloma (MM) are heterogeneous and difficult to target therapeutically. Many different MM drugs have emerged, however, that attack various phenotypic aspects of malignant plasma cells. These drugs are administered in numerous, seemingly interchangeable combinations. Although the availability of many treatment options is useful, no clinical test capable of optimizing and sequencing the treatment regimens for an individual patient is currently available. To overcome this problem, we developed a functional ex vivo approach to measure patients’ inherent and acquired drug resistance. This method, which we termed myeloma drug sensitivity testing (My-DST), uses unselected bone marrow mononuclear cells with a panel of drugs in clinical use, followed by flow cytometry to measure myeloma-specific cytotoxicity. We found that using whole bone marrow cultures helped preserve primary MM cell viability. My-DST was used to profile 55 primary samples at diagnosis or at relapse. Sensitivity or resistance to each drug was determined from the change in MM viability relative to untreated control samples. My-DST identified progressive loss of sensitivity to immunomodulatory drugs, proteasome inhibitors, and daratumumab through the disease course, mirroring the clinical development of resistance. Prospectively, patients’ ex vivo drug sensitivity to the drugs subsequently received was sensitive and specific for clinical response. In addition, treatment with <2 drugs identified as sensitive by My-DST led to inferior depth and duration of clinical response. In summary, ex vivo drug sensitivity is prognostically impactful and, with further validation, may facilitate more personalized and effective therapeutic regimens.
CpG methylation in cell-free Epstein-Barr virus DNA in patients with EBV-Hodgkin lymphoma
Authors: Shamay Meir , Kanakry Jennifer A. , Low John S. W. , Horowitz Netanel A. , Journo Guy , Ahuja Anuj , Eran Yonatan , Barzilai Elinor , Dann Eldad J. , Stone Jennifer , Woo Wan Lu , Hsieh Wen-son , Xian Rena R. , Ambinder Richard F.
Published: April 2020

Epstein-Barr virus (EBV) is associated with a variety of tumors and nonmalignant conditions. Latent EBV genomes in cells, including tumor cells, are often CpG methylated, whereas virion DNA is not CpG methylated. We demonstrate that methyl CpG binding magnetic beads can be used to fractionate among sources of EBV DNA (DNA extracted from laboratory-purified virions vs DNA extracted from latently infected cell lines). We then applied the technique to plasma specimens and showed that this technique can distinguish EBV DNA from patients with EBV-associated tumors (nasopharyngeal carcinoma, Hodgkin lymphoma) and viral DNA from patients without EBV-associated tumors, including immunocompromised patients and patients with EBV(−) Hodgkin lymphoma.
Quality of gout care in the emergency departments: a multicentre study
Authors: Towiwat Patapong , Phungoen Pariwat , Tantrawiwat Kitti , Laohakul Pavita , Aiewruengsurat Duangkamol , Thanadetsuntorn Chokchai , Ruchakorn Nopparat , Sangsawangchot Passagorn , Buttham Bodin
Published: April 2020

Background

To report on prevalence of gout flare in emergency departments and to report the quality of gout care in emergency departments and causes of admission at emergency departments.

Methods

A retrospective chart review of visits that had a primary diagnosis in gout by the International Classification of Diseases, the tenth revision, at emergency departments from 6 universities in Thailand over a 5 year period from 1 January 2012 to 31 December 2016.

Results

Six hundred thirty-two visits were included to the study. Prevalence of gout flare in emergency departments was 0.04. Only 29.3% of the visits had arthrocentesis. 628/632 (99.4%) and 519/585 (88.7%) of the visits were prescribed medications in emergency departments and had home medications, respectively. Although all visits that were prescribed colchicine in emergency departments received adequate doses of colchicine, it was also found that more than 2.4 mg/day of colchicine was prescribed (3/394, 0.8%) for home medications. In addition, 183/343 (53.4%) of the visits with normal renal function were prescribed non-steroidal anti-inflammatory drugs (NSAIDs). However, prescribed NSAIDs in abnormal renal function (42/343, 12.2%) was also found. The interruption of dosing, including increase, decrease, addition or discontinuance of urate lowing therapy in a gout flare period was 42/632 (6.6%). The most common cause of admission was acute gouty arthritis (31/47, 66.0%).

Conclusions

Quality of gout care in the emergency departments was not good. Inappropriate management of gout flare in emergency departments was demonstrated in our study, particularly with regard to investigations and pharmacological management. Gaps between clinicians and guidelines, the knowledge of clinicians, and overcrowding in emergency departments were hypothesized in the results.
Characteristics and outcome of spontaneous bacterial meningitis in patients with diabetes mellitus
Authors: Pomar Virginia , de Benito Natividad , Mauri Albert , Coll Pere , Gurguí Mercè , Domingo Pere
Published: April 2020

Background

Studies on bacterial meningitis in diabetics patients versus non-diabetics are scarce. In patients with diabetes, bacterial meningitis may have a different presentation, etiology and course. We analyzed and compared the characteristics and outcome of spontaneous BM in adult patients with and without diabetes mellitus (DM).

Methods

We performed a single-center, prospective observational cohort study, conducted between 1982 and 2017, in a tertiary university hospital in Barcelona (Spain). The primary outcome measure was in-hospital mortality.

Results

We evaluated 715 episodes of bacterial meningitis; 106 patients (15%) had diabetes mellitus. Patients with diabetes were older (median 67 [IQR 17] vs 49 [IQR 40] years, p <  0.001) and more often had a Charlson comorbidity score of ≥3 (40% vs 15%, p <  0.001). Neck stiffness (56% vs 75%, p <  0.001), headache (41% vs 78%) p <  0.001), nausea and/or vomiting (32% vs 56% p < 0.001), and rash (12% vs 26%, p = 0.007) were less frequent in diabetics, whereas altered mental status was more common. Streptococcus pneumoniae and Listeria meningitis were the most common etiologic agents (24 and 18%, respectively). Listeria was more frequent (18% vs. 10%, p = 0.033), whereas meningococcal meningitis was less frequent (10% vs 32%, p < 0.001). Overall mortality was higher in patients with diabetes (26% vs 16%, p = 0.025) concerning non-diabetics.

Conclusions

Patients with bacterial meningitis and diabetes mellitus are older, have more comorbidities, and higher mortality. S. pneumoniae and L. monocytogenes are the predominant pathogens, Listeria being more common, whereas Neisseria meningitidis is significantly less frequent than in non-diabetics.
Endocrine disorders after heart transplantation: national cohort study
Authors: Rakusa Matej , Vrtovec Bojan , Poglajen Gregor , Janez Andrej , Jensterle Mojca
Published: April 2020

Background

Endocrine disorders in patients after heart transplantation (HT) remain understudied. We aimed to assess endocrine profiles and management of HT recipients in the early post- transplant period.

Methods

We conducted a retrospective cohort study on 123 consecutive HT recipients in the Advanced Heart Failure and Transplantation Programme between 2009 and 2018. All recipients had per-protocol endocrine follow-up within the first postoperative year. The median time to first post-transplant endocrine follow-up was 3 months (IQR 2–4). We assessed the incidence of vitamin D deficiency, bone mineral density, history of low energy fractures, hypogonadism in male recipients, posttransplant diabetes mellitus, and thyroid and parathyroid function.

Results

We enrolled 22 women and 101 men of median age 57 years (IQR 50–63). Post-transplant diabetes mellitus developed in 14 patients (11.4%). 18 of 25 patients (14.6%) with preexisting type 2 diabetes mellitus required intensification of antidiabetic therapy. 38 male patients (40.4%) had hypogonadism. 5 patients (4.6%) were hypothyroid and 10 (9.3%) latent hyperthyroid. Secondary hyperparathyroidism was present in 19 (17.3%), 25-hydroxyvitamin D deficiency in 64 (54.7%) of patients. Osteoporosis was present in 26 (21.1%), osteopenia in 59 (48.0%) patients. 47 vertebral fractures, 3 hip and 1 humerus fractures occurred in 21 patients. Most of the patients had coincidence of two or three disorders, while less than 5% did not have any endocrine irregularities. All patients received calcium and vitamin D supplements. Forty-six patients (37.4%) were treated with zoledronic acid, 12 (9.8%) with oral bisphosphonates. Two patients were treated with teriparatide.

Conclusions

The prevalence of multiple endocrine disorders early after heart transplantation is high. Assessment and management of increased fracture risk and all other potentially affected endocrine axes should be considered as a standard of care in this early period.
What implies registered nurses’ leadership close to older adults in municipal home health care? A systematic review
Authors: Claesson Maria , Jonasson Lise-Lotte , Lindberg Elisabeth , Josefsson Karin
Published: April 2020

Background

Registered nurses are key figures in municipal home health care for older adults. Thus, registered nurses’ leadership is crucial to a successful and preventive care process as well as a supportive organization in order to achieve safe care. However, there is limited research on what registered nurses’ leadership implies close to older adults in municipal home health care. Thus, the aim is to compile and critically evaluate how international research results describe registered nurses’ leadership close to older adults in municipal home health care.

Methods

A systematic literature review was performed in accordance with a qualitative research study. The main search was conducted on 20 April 2018. The review was reported according to the PRISMA guidelines and is registered in the PROSPERO database (ID# CRD42019109206). Nine articles from PubMed and CINAHL meet the quality criteria. A synthesis of data was performed in four stages according to qualitative research synthesis.

Results

Ten themes describe what registered nurses’ leadership close to older adults in municipal home health care entails: trust and control; continuous learning; competence through knowledge and ability; nursing responsibility on an organizational level; application of skills; awareness of the individual’s needs and wholeness; mutual support; mutual relationships; collaborating on organizational and interpersonal levels; and exposure to challenges.

Conclusions

Registered nurses leading close to older adults in municipal home health care implies being multi-artists. Nursing education, including specialist education for registered nurses, should prepare individuals for their unique and complex leadership role as a multi-artist. Municipal employers require knowledge about what registered nurses’ leadership implies in order to create adequate conditions for their leadership objectives to achieve safe care. Further research is warranted to explore registered nurses’ leadership close to older adults in municipal home health care from different perspectives, such as older adults and next of kin.
Integrating evolutionarily novel horns within the deeply conserved insect head
Authors: Linz David M. , Moczek Armin P.
Published: April 2020

Background

How novel traits integrate within ancient trait complexes without compromising ancestral functions is a foundational challenge in evo-devo. The insect head represents an ancient body region patterned by a deeply conserved developmental genetic network, yet at the same time constitutes a hot spot for morphological innovation. However, the mechanisms that facilitate the repeated emergence, integration, and diversification of morphological novelties within this body region are virtually unknown. Using horned Onthophagus beetles, we investigated the mechanisms that instruct the development of the dorsal adult head and the formation and integration of head horns, one of the most elaborate classes of secondary sexual weapons in the animal kingdom.

Results

Using region-specific RNAseq and gene knockdowns, we (i) show that the head is compartmentalized along multiple axes, (ii) identify striking parallels between morphological and transcriptional complexity across regions, yet (iii) fail to identify a horn-forming gene module. Instead, (iv) our results support that sex-biased regulation of a shared transcriptional repertoire underpins the formation of horned and hornless heads. Furthermore, (v) we show that embryonic head patterning genes frequently maintain expression within the dorsal head well into late post-embryonic development, thereby possibly facilitating the repurposing of such genes within novel developmental contexts. Lastly, (vi) we identify novel functions for several genes including three embryonic head patterning genes in the integration of both posterior and anterior head horns.

Conclusions

Our results illuminate how the adult insect head is patterned and suggest mechanisms capable of integrating novel traits within ancient trait complexes in a sex- and species-specific manner. More generally, our work underscores how significant morphological innovation in developmental evolution need not require the recruitment of new genes, pathways, or gene networks but instead may be scaffolded by pre-existing developmental machinery.
Enabling and hindering factors of health surveillance assistants’ roles in the provision of contraceptive services in Mangochi, Malawi
Authors: Kok Maryse , Tolani Madalitso , Mtonga Wongani , Salamba Thom , Mwabungulu Twambilire , Munthali Arnold , Smet Eefje , Chinsakaso Benedict
Published: April 2020

Background

Contraceptive services are essential for promoting people’s health, and economic and social well-being. Despite increased contraceptive use over the past decades, unmet need is still high in Malawi. As a result of task shifting, health surveillance assistants (HSAs), Malawi’s paid community health worker cadre, provide an expanded range of contraceptive services, aimed at increasing access at community level. We conducted a qualitative study to explore enabling and hindering factors of HSAs’ roles in the provision of modern contraceptive services in Mangochi district, Malawi.

Methods

The study involved HSAs and their supervisors, a variety of community members, health workers and policy makers using 34 interviews and 12 focus group discussions. Data were recorded, transcribed, translated, coded and thematically analysed according to a framework that included community-, HSA- and health system-related factors.

Results

HSAs were found to be trusted providers of contraceptive services. At community level, gender norms, decision-making and beliefs about contraceptives were intertwined. They resulted in women using contraceptive services, including those offered by HSAs, in secret. There were misconceptions about contraceptives among both men and women, which were insufficiently addressed by HSAs. Residence and age of HSAs influenced their role in the provision of contraceptive services to (young) community members, whereas sex was not regarded as an enabling or hindering factor. While most community members reported to be satisfied with the quality of HSAs’ services, quality was compromised by a lack of contraceptive supplies and other resources, and limited supportive supervision and training.

Conclusions

HSAs in Mangochi are important contraceptive service providers. Their ability to ensure male involvement, increase access to services for youth and address misconceptions about contraceptives needs improvement. This requires a thorough understanding of socio-cultural norms and improved behavioural change communication competencies, which need to be incorporated in future training under Malawi’s Community Health Strategy.
A qualitative study on acceptability of the mistreatment of women during childbirth in Myanmar
Authors: Maung Thae Maung , Show Kyaw Lwin , Mon Nwe Oo , Tunçalp Özge , Aye Nyein Su , Soe Yin Yin , Bohren Meghan A.
Published: April 2020

Background

Improving the quality of maternal health care is critical to reduce mortality and improve women’s experiences. Mistreatment during childbirth in health facilities can be an important barrier for women when considering facility-based childbirth. Therefore, this study attempted to explore the acceptability of mistreatment during childbirth in Myanmar according to women and healthcare providers, and to understand how gender power relations influence mistreatment during childbirth.

Methods

A qualitative study was conducted in two townships in Bago Region in September 2015, among women of reproductive age (18–49 years), healthcare providers and facility administrators. Semi-structured discussion guides were used to explore community norms, and experiences and perceptions regarding mistreatment. Coding was conducted using athematic analysis approach and Atlas.ti. Results were interpreted using a gender analysis approach to explore how power dynamics, hierarchies, and gender inequalities influence how women are treated during childbirth.

Results

Women and providers were mostly unaccepting of different types of mistreatment. However, some provided justification for slapping and shouting at women as encouragement during labour. Different access to resources, such as financial resources, information about pregnancy and childbirth, and support from family members during labor might impact how women are treated. Furthermore, social norms around pregnancy and childbirth and relationships between healthcare providers and women shape women’s experiences. Both informal and formal rules govern different aspects of a woman’s childbirth care, such as when she is allowed to see her family, whether she is considered “obedient”, and what type of behaviors she is expected to have when interacting with providers.

Conclusions

This is the first use of gender analysis to explore how gender dynamics and power relations contribute to women’s experiences of mistreatment during childbirth. Both providers and women expected women to understand and “obey” the rules of the health facility and instructions from providers in order to have better experiences. In this way, deviation from following the rules and instructions puts the providers in a place where perpetrating acts of mistreatment were justifiable under certain conditions. Understanding how gender norms and power structures how women are treated during childbirth is critical to improve women’s experiences.
Role of data measurement characteristics in the accurate detection of Parkinson’s disease symptoms using wearable sensors
Authors: Shawen Nicholas , O’Brien Megan K. , Venkatesan Sanjeev , Lonini Luca , Simuni Tanya , Hamilton Jamie L. , Ghaffari Roozbeh , Rogers John A. , Jayaraman Arun
Published: April 2020

Background

Parkinson’s disease (PD) is a progressive neurological disease, with characteristic motor symptoms such as tremor and bradykinesia. There is a growing interest to continuously monitor these and other symptoms through body-worn sensor technology. However, limited battery life and memory capacity hinder the potential for continuous, long-term monitoring with these devices. There is little information available on the relative value of adding sensors, increasing sampling rate, or computing complex signal features, all of which may improve accuracy of symptom detection at the expense of computational resources. Here we build on a previous study to investigate the relationship between data measurement characteristics and accuracy when using wearable sensor data to classify tremor and bradykinesia in patients with PD.

Methods

Thirteen individuals with PD wore a flexible, skin-mounted sensor (collecting tri-axial accelerometer and gyroscope data) and a commercial smart watch (collecting tri-axial accelerometer data) on their predominantly affected hand. The participants performed a series of standardized motor tasks, during which a clinician scored the severity of tremor and bradykinesia in that limb. Machine learning models were trained on scored data to classify tremor and bradykinesia. Model performance was compared when using different types of sensors (accelerometer and/or gyroscope), different data sampling rates (up to 62.5 Hz), and different categories of pre-engineered features (up to 148 features). Performance was also compared between the flexible sensor and smart watch for each analysis.

Results

First, there was no effect of device type for classifying tremor symptoms (p > 0.34), but bradykinesia models incorporating gyroscope data performed slightly better (up to 0.05 AUROC) than other models (p = 0.01). Second, model performance decreased with sampling frequency (p < 0.001) for tremor, but not bradykinesia (p > 0.47). Finally, model performance for both symptoms was maintained after substantially reducing the feature set.

Conclusions

Our findings demonstrate the ability to simplify measurement characteristics from body-worn sensors while maintaining performance in PD symptom detection. Understanding the trade-off between model performance and data resolution is crucial to design efficient, accurate wearable sensing systems. This approach may improve the feasibility of long-term, continuous, and real-time monitoring of PD symptoms by reducing computational burden on wearable devices.
Intrapreneurship concepts for engineers: a systematic review of the literature on its theoretical foundations and agenda for future research
Authors: Alam Muhammad Zubair , Nasir Nadia , Rehman Ch. Abdul
Published: April 2020

Understanding of intrapreneurship as a phenomenon is somewhat fragmented and inconsistent especially in the case of engineers or engineering firms. This paper seeks to assess the relevant intellectual territory of intrapreneurship or corporate entrepreneurship (CE) by taking a systematic review of relevant research to collect insights into research linking intrapreneurship with engineering firms. The purpose of the systematic review is to identify key concepts in intrapreneurial research with regard to engineers or engineering firms as deliberated by researchers in literature. This systematic literature review (SLR) found that the academic interest of researchers on intrapreneurship has increased over the last decade with a diverse focus. Based on the findings of the review, this study has suggested various areas for future research on the conceptual framework of intrapreneurship, relationship of intrapreneurship with corporate performance, and intrapreneurship for engineers.
Modelling scenarios for sustainable water supply and demand in Addis Ababa city, Ethiopia
Authors: Alemu Zinabu Assefa , Dioha Michael O.
Published: April 2020

Background

The city of Addis Ababa is under rapid development and there are enormous construction activities along with rapid urbanization, and industrialization. These anthropogenic actions combined with population growth rate are affecting the water demand of the city. The overall purpose of this study is to model water supply and demand of the city and to identify potential water management strategies that supports the sustainable development goal number six (SDG6)—clean water and sanitation.

Methods

We employed the Water Evaluation and Planning system (WEAP) modelling framework to analyze different scenarios for water demand and supply. The scenarios include population growth, living standard, as well as other supply and demand strategies.

Results

For the modelling period, the reference scenario shows unmet water demand increases by around 48%, from 208 to 307 million cubic meter in 2015 and 2030 respectively. High population growth rate and high living standard scenarios have a great negative impact on the water supply system.

Conclusions

Satisfying the future water demand of Addis Ababa will depend on the measures which are taken today. The integrated water management practices such as reuse of water and the selected future scenarios are proposed to decrease and manage the unmet water demand of the city. Hence, future predicted scenarios which is the combination of the external factors (i.e. population growth rate and living standard) and water management strategies were considered. From the analyzed scenarios, optimistic future strategies will support the management of the existing water supply and demand system of the city. Similarly, in the integrated management strategies scenario, it was assumed that measures were taken at both the demand and supply side to improve the efficiency of water in the entire chain. Thus, if the water sector professionals and other concerned bodies consider the selected scenarios, it will go a long way to solve the water shortage problem in the city, and this will also help to promote sustainable water management.