bluuebunny/crossref_metadata_2025 huggingface dataset:
Microwave processing of carbon fibre polymer composites: a review
Authors: Galos Joel
Published: February 2020

Microwave processing of carbon fibre-reinforced polymer (CFRP) composites is gaining increasing attention as an alternative to conventional thermal processing techniques. It has the potential to reduce part processing times and alleviate the bottleneck that often exists in composite component production. The present study reviews the current research and the state-of-the-art of microwave processing of CFRP composites. The benefits and limitations of microwave processing compared with traditional thermal processing methods are examined. The mechanical properties of microwave-cured composites are compared against conventionally-cured counterparts with varying levels of success. Current industrial microwave heating technologies are also examined. It is evident that microwave processing of polymer composites is promising but has notable limiting factors which have stunted its uptake in industry. Due to their prevalence in literature, CFRP composites with thermosetting matrices are the focus of this review. However, potential applications to carbon fibre-reinforced thermoplastics are also briefly described.
Alliances Operational Framework, Initiatives and Key Challenges
Authors: Bukhari Faheem , Hussain Saima
Published: February 2020

Alliances and loyalty programmes play an important role in building brand awareness and increasing customer loyalty. An effective alliance initiative in the credit card domain strengthens the product’s features by offering value to current and potential credit card users. The purpose of this case study is to highlight the holistic alliance roadmap developed by the local bank visa credit card team. The data have been acquired from the field. This real-life example highlights several challenges and raises questions about how to measure success in alliance initiatives and the lessons learned from the experience, especially regarding strategy modification.
Understanding Japan–South Korea Cooperation and Friction Through Neoclassical Realist Theory
Authors: Kim Anna
Published: February 2020

The relationship between Japan and the Republic of Korea (ROK) 1 1 Used interchangeably with ‘South Korea’. has largely eluded theoretical explanations as to why these two allies of the USA continue to share a volatile relationship. The friction between these countries has largely been attributed to their colonial past. The historical aspect is no doubt an indispensable factor contributing to a fractured relationship. However, historical animosity in itself cannot explain the causes behind intermittent friction and cooperation. Bilateral relations between the two countries do not follow balance of threat theory predictions either. Alliance theory states that states will ally against a common threat. Despite this, Japan and the ROK have failed to cooperate even when regional threat level was high. Here, Victor Cha's quasi-alliance theory potentially sheds light on the puzzle. It stresses on the role of a third-party patron and its level of commitment to each of its allies as a determining factor in cooperation or friction between the regional players. The purpose of this article is to test the predictions of this theory. The article tries to determine Japan and the ROK’s perception of US commitment during the Obama administration and the Trump administration, respectively. The next task is to ascertain whether Japan and ROK actions reflected the predictions of the theory. The article concludes on theory implications in the recent climate of bilateral volatility.
Digital Environment in Global Markets: Cross-Cultural Implications for Evolving Customer Journeys
Authors: Nam Hyoryung , Kannan P.K.
Published: February 2020

Digital technologies and digital media are changing the environments in which firms interact with customers. However, the evolution of digital organizational forms, customer technology use, and the nature of customer journeys differ significantly across global markets. Drawing on observations of customer journeys across different international markets, the authors propose a framework to explain the observed differences in terms of the cross-cultural and socioeconomic factors that influence customer journeys. The authors put forth several propositions built on logical extensions of the extant research findings and identify areas for future academic research. In addition, they outline the managerial implications arising from the application of the framework for multinational firms seeking to market their products and services across global markets.
Selling brands while staying “Authentic”: The professionalization of Instagram influencers
Authors: van Driel Loes , Dumitrica Delia
Published: February 2020

While Instagram influencers may have started out as ordinary people documenting their everyday life through a stream of photographs, they are increasingly emerging as an intermediary between advertisers and consumers. This study examines the professionalization of Instagram influencers, combining data from 11 interviews with travel influencers with a visual and textual content analysis of their 12 most recent Instagram posts ( N = 132). We show how the increasing professionalization of the influencer steers their relationship with their audience, the advertisers they work with, and the platform Instagram. We argue that, for the Instagram influencer to be perceived as successful, they need to negotiate a tension: they need to appear authentic, yet also approach their followers in a strategic way to remain appealing to advertisers. Although Instagram influencers are seen as more trustworthy than traditional forms of advertising, this tension ultimately leads to a standardization of the content shared by influencers.
Static and dynamic behavior of steel-reinforced epoxy granite CNC lathe bed using finite element analysis
Authors: Chinnuraj Shanmugam , Thyla PR , Elango S , Venugopal Prabhu Raja , Mohanram PV , Nataraj Mahendrakumar , Mohanraj S , Manojkumar KN , Ayyasamy Siddarth
Published: February 2020

Machine tools are used to manufacture components with desired size, shape, and surface finish. The accuracy of machining is influenced by stiffness, structural damping, and long-term dimensional stability of the machine tool structures. Components machined using such machines exhibit more dimensional variations because of the excessive vibration during machining at higher speeds. Compared to conventional materials like cast iron, stone-based polymer composites such as epoxy granite have been found to provide improved damping characteristics, by seven to ten folds, due to which they are being considered for machine tool structures as alternate materials. The stiffness of structures made of epoxy granite can be enhanced by reinforcing with structural steel. The current work highlights the design and analysis of different steel reinforcements in the lathe bed made of the epoxy granite composite to achieve equivalent stiffness to that of cast iron bed for improved static and dynamic performances of the CNC lathe. A finite element model of the existing the cast iron bed was developed to evaluate the static (torsional rigidity) and dynamic characteristics (natural frequency) and the results were validated using the experimental results. Then finite element models of five different steel reinforcement designs of the epoxy granite bed were developed, and their static and dynamic behaviors were compared with the cast iron bed through numerical simulation using finite element analysis. The proposed design (Design-5) of the epoxy granite bed is found to have an improvement in dynamic characteristics by 4–10% with improved stiffness and offers a mass reduction of 22% compared to the cast iron bed, hence it can be used for the manufacture of the CNC lathe bed and other machine tool structures for enhanced performance.
Demystifying engagement: Chinese advertising practitioners’ perspective
Authors: Chen Huan , Wang Rang , Liang Xuan
Published: February 2020

A qualitative study was conducted to explore Chinese advertising practitioners’ perceptions and interpretations of engagement in the digital era. Twenty-three in-depth interviews were conducted to collect data. Findings revealed that Chinese advertising practitioners emphasize interactive experience in defining engagement, which acknowledges multiple dimensions of engagement; they believe that the execution of engagement should emphasize content creation, media selection, and proper interaction; they tend to discuss engagement in a very holistic way, while they consider the effort versus effect dual-approach as an appropriate criterion to measure engagement, confusions, and discrepancies exist surrounding the engagement measurement among Chinese advertising practitioners. The current study offers insightful implications for the conceptualization of engagement in different cultural contexts as well as on how to bridge the perceptional gap between academia and industry regarding the execution of engagement.
Core leadership practices of school principals in the Kingdom of Saudi Arabia
Authors: Alqahtani Abdulaziz Saeed , Noman Mohammad , Kaur Amrita
Published: February 2020

This qualitative study aims to explore the core leadership practices of school principals in the Kingdom of Saudi Arabia. Given the exploratory nature of this study, a qualitative research design methodology was employed through which an in-depth, multi-perspective study of the practices of four secondary school principals was carried out. Employing a semi-structured interview protocol developed specifically for this study, data was collected from the principals and four teachers and four parents from each of the participating schools. The findings of the data analysis revealed that the principals demonstrated a repertoire of five core practices, namely, setting achievement goals, developing teachers, building strong relationships with parents, focusing on academic excellence and developing school climate. The principals enacted these core practices in a variety of ways. These core practices are discussed in detail along with the important implications for further research and practice.
Incorporating Social-Marketing Insights Into Prejudice Research: Advancing Theory and Demonstrating Real-World Applications
Authors: Campbell Mitchell R. , Brauer Markus
Published: February 2020

Prejudice researchers have proposed a number of methods to reduce prejudice, drawing on and, in turn, contributing to our theoretical understanding of prejudice. Despite this progress, relatively few of these methods have been shown to reliably improve intergroup relations in real-world settings, resulting in a gap between our theoretical understanding of prejudice and real-world applications of prejudice-reduction methods. In this article, we suggest that incorporating principles from another field, social marketing, into prejudice research can help address this gap. Specifically, we describe three social-marketing principles and discuss how each could be used by prejudice researchers. Several areas for future research inspired by these principles are discussed. We suggest that a hybrid approach to research that uses both theory-based and problem-based principles can provide additional tools for field practitioners aiming to improve intergroup relations while leading to new advances in social-psychological theory.
Suspected hepatopathy and pancreatitis associated with mycophenolate mofetil use in a cat with immune-mediated haemolytic anaemia
Authors: Kopke Matthew A , Galloway Pru E J
Published: February 2020

Case summary

A 5-year-old spayed female domestic shorthair cat was referred for severe anaemia. Findings on initial work-up were consistent with a diagnosis of idiopathic immune-mediated haemolytic anaemia. A combination of prednisolone and mycophenolate mofetil (MMF) was instituted. On revisit approximately 2 months later, red blood cell parameters were normal, but the plasma was described as icteric, prompting further investigation. Concurrent hepatopathy and pancreatitis were diagnosed, suspected as being adverse reactions to MMF, as has been reported with use of the drug in humans. Resolution of serum biochemistry abnormalities took approximately 2 months, following discontinuing MMF. At the time of writing, the cat remained clinically well 1 year after initial presentation.

Relevance and novel information

With increasing use of MMF as an immunosuppressive agent in cats, clinicians should be aware of both common and potentially rare adverse effects, such as those described herein. In addition, suitable monitoring tools need to be in place to facilitate early detection and appropriate management.
No Need for Sternal Fixation in Traumatic Sternovertebral Fractures: Outcomes of a 10-Year Retrospective Cohort Study
Authors: Klei Dorine S. , Öner F. Cumhur , Leenen Luke P. H. , van Wessem Karlijn J. P.
Published: February 2020

Study Design:

Retrospective cohort study.

Objectives:

Combined sternal and spinal fractures are rare traumatic injuries and present a high risk of spinal and thoracic wall instability. Limited research has addressed the treatment of sternovertebral injuries and biomechanical need for sternal fixation to achieve spinal healing.

Methods:

A 10-year retrospective cohort study was conducted, including patients with sternovertebral fractures admitted to our level-1 trauma centre between 2007 and 2016. Patients who died during hospital admission, military patients, patients with isolated upper cervical spine or lower lumbar spine fractures, and patients lost to follow-up were excluded.

Results:

In 10 years, 73 patients with sternovertebral fractures were included. Mean injury severity score was 24 (range 4-57). Most sternal fractures were located in the sternal body and manubrium. Spinal fractures were type A (52%), B (40%), or C (8%), and were located in the subaxial cervical (21%), upper thoracic (16%), thoracic (21%), thoracolumbar (47%) area; 7 patients had spinal fractures at multiple levels. Fourteen patients (19%) had a neurological deficit. A total of 42 patients received conservative and 31 patients received operative spinal treatment. Two patients (3%) underwent primary sternal fixation. Sternal failure rate was 1% and biomechanical spinal failure rate was 8%, there was no difference in treatment failure between surgical and conservative spinal treatment. Associated thoracic injuries did not influence sternal or spinal treatment outcomes.

Conclusions:

These findings indicate that conservative sternal treatment in presence of spinal fractures is safe and effective. The low spinal treatment failure rates imply that sternal fixation is not necessary to achieve spinal stability.
Stakeholder Assessment of Evidence-Based Guideline Dissemination and Implementation in a Dental Group Practice
Authors: Gruß I. , Pihlstrom D.J. , Kaplan C.D. , Yosuf N. , Fellows J.L. , Guerrero E.G. , Polk D.E.
Published: February 2020

Objective:

This evaluation captures the perspectives of multiple stakeholders within a salaried dental care delivery organization (dentists, dental assistants, dental hygienists, and dental management) on the implementation of a pit-and-fissure sealant guideline in the Kaiser Permanente Dental Program. Also assessed is the role of formal processes and structures in providing a framework for guideline implementation.

Methods:

We collected qualitative data through field observations, stakeholder interviews (n = 6), and focus groups (30 participants in 5 focus groups). Field observation notes captured summaries of conversations and other activities. Interviews and focus groups were recorded and transcribed. We analyzed transcripts and field notes using a template analysis with NVivo 12 software to identify themes related to the existing implementation process of clinical guidelines and stakeholder perspectives on the strengths and weaknesses of this process.

Results:

Stakeholders perceived 2 main barriers for achieving implementation of the pit-and-fissure sealant guideline: 1) shortcomings in the implementation infrastructure resulting in lack of clarity about the roles and responsibilities in the guideline implementation process and lack of effective mechanisms to disseminate guideline content and 2) resource constraints, such as limited human, space, and material resources. Perceived opportunities for the dissemination and implementation of guidelines included recognition of the importance of guidelines in dental practice and well-functioning workflows within dental specialties.

Conclusion:

Our research points to the importance of developing and maintaining an infrastructure to ensure standardized, predictable mechanisms for implementation of guidelines and thereby promoting practice change. While addressing resource constraints may not be possible in all circumstances, an important step for improving guideline implementation—wherever feasible—would be the development of a robust implementation infrastructure that captures and delineates roles and responsibilities of different clinical actors in the guideline implementation process.

Knowledge Transfer Statement:

The results of this study can be used by health care leadership and administrators to understand possible reasons for a lack of guideline implementation and provide suggestions for establishing sustainable infrastructure to promote the adoption of clinical guidelines in salaried dental clinics.
Pro-kidney transplantation should be considered in patients with multiple myeloma
Authors: Owoyemi Itunu , El Ters Mireille
Published: February 2020

Multiple myeloma is the most frequent malignant monoclonal gammopathy and the second most common hematological malignancy after non-Hodgkin lymphoma. There continues to be evolving therapies in the treatment which has significantly changed progression-free and overall survival of the patients. Increasingly, evidence shows that multiple myeloma no longer portends poor and lethal prognosis. With the advances in treatment of multiple myeloma and improved survival as seen in several studies, perhaps more attention should focus on kidney transplantation in these individuals given their suboptimal outcomes on dialysis. We would like to propose that a diagnosis of multiple myeloma not be considered as an absolute contraindication for kidney transplantation. Rather, a careful consideration of kidney transplantation is appropriate for a subset of patients with multiple myeloma and end-stage kidney disease. The candidacy of these patients should be reviewed by a multidisciplinary team comprising experts in hematology, kidney transplantation, and key stakeholders (including laboratory medicine, renal pathologists, and pharmacists) to allow appropriate risk stratification, prognostication for a successful and safe kidney transplantation.
Quantitative Analysis of Ellipsoid Zone in Acute Posterior Multifocal Placoid Pigment Epitheliopathy
Authors: Browne Andrew W. , Ansari Waseem , Hu Ming , Baynes Kimberly , Lowder Careen Y. , Ehlers Justis P. , Srivastava Sunil K.
Published: February 2020

Purpose:

Quantitative end points for uveitis are needed. Here we quantify the rate of ellipsoid zone (EZ) recovery on optical coherence tomography (OCT) and correlate it with visual acuity (VA) improvement in patients with acute posterior multifocal placoid pigmented epitheliopathy (APMPPE). We use automated and manually graded EZ area analysis to assess EZ recovery in APMPPE.

Methods:

We performed a retrospective review of 9 APMPPE cases (18 eyes) that had characteristic clinical examination and fluorescein angiography findings, outer retinal disruption on spectral-domain OCT, and treatment with systemic steroids after an unambiguous laboratory workup. The EZ was delineated using custom software to perform automated analysis and manual grading by 2 independent physicians. Quantitation of EZ changes was performed in ImageJ (National Institutes of Health). EZ maps were compared with equivalent findings from EZ en face OCT segmentation.

Results:

The 9 cases in our study were followed for an average of 198 days. Symptomatic improvement occurred in all eyes. VA recovery occurred in 83% of eyes and depended on presenting foveal involvement. Positive slopes of EZ area over time demonstrated recovery. EZ recovery profiles determined by manual and automated software demonstrated high Pearson correlation coefficients (0.78-0.94). Slab en face EZ analysis demonstrated moderate agreement.

Conclusions:

EZ recovery correlates with symptomatic and VA recovery. Automated EZ analysis shows strong agreement with manually graded EZ analysis in APMPPE. EZ recovery in patients with APMPPE provides a biomarker for recovery and may be applied to other diseases affecting the outer retina.
Venetoclax response is enhanced by selective inhibitor of nuclear export compounds in hematologic malignancies
Authors: Fischer Melissa A. , Friedlander Sharon Y. , Arrate Maria P. , Chang Hua , Gorska Agnieszka E. , Fuller Londa D. , Ramsey Haley E. , Kashyap Trinayan , Argueta Christian , Debler Sophie , Byrne Michael , Villaume Matthew T. , Shaver Aaron C. , Senapedis William , Landesman Yosef , Baloglu Erkan , Shacham Sharon , Savona Michael R.
Published: February 2020

The selective inhibitor of nuclear export (SINE) compounds selinexor (KPT-330) and eltanexor (KPT-8602) are from a novel class of small molecules that target exportin-1 (XPO1 [CRM1]), an essential nucleo-cytoplasmic transport protein responsible for the nuclear export of major tumor suppressor proteins and growth regulators such as p53, p21, and p27. XPO1 also affects the translation of messenger RNAs for critical oncogenes, including MYC, BCL2, MCL1, and BCL6, by blocking the export of the translation initiation factor eIF4E. Early trials with venetoclax (ABT-199), a potent, selective inhibitor of BCL2, have revealed responses across a variety of hematologic malignancies. However, many tumors are not responsive to venetoclax. We used models of acute myeloid leukemia (AML) and diffuse large B-cell lymphoma (DLBCL) to determine in vitro and in vivo responses to treatment with venetoclax and SINE compounds combined. Cotreatment with venetoclax and SINE compounds demonstrated loss of viability in multiple cell lines. Further in vitro analyses showed that this enhanced cell death was the result of an increase in apoptosis that led to a loss of clonogenicity in methylcellulose assays, coinciding with activation of p53 and loss of MCL1. Treatment with SINE compounds and venetoclax combined led to a reduction in tumor growth in both AML and DLBCL xenografts. Immunohistochemical analysis of tissue sections revealed that the reduction in tumor cells was partly the result of an induction of apoptosis. The enhanced effects of this combination were validated in primary AML and DLBCL patient cells. Our studies reveal synergy with SINE compounds and venetoclax in aggressive hematologic malignancies and provide a rationale for pursuing this approach in a clinical trial.
Concepts and forms of greenwashing: a systematic review
Authors: de Freitas Netto Sebastião Vieira , Sobral Marcos Felipe Falcão , Ribeiro Ana Regina Bezerra , Soares Gleibson Robert da Luz
Published: February 2020

Background

The aggravation of environmental problems has led companies to seek the development and commercialization of green products. Some companies mislead their stakeholders through a phenomenon called greenwashing.

Results

This paper aims to explore the phenomenon of greenwashing through a systematic literature review in search of its main concepts and typologies in the past 10 years. This research has followed the proceedings of a systematic review of the literature, based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We identified a major classification of greenwashing: firm-level executional, firm-level claim, product-level executional, and product-level claim.

Conclusion

It was possible to highlight and catalog the types of the phenomenon. A structure based on such type has been observed in the literature.
Brain SegNet: 3D local refinement network for brain lesion segmentation
Authors: Hu Xiaojun , Luo Weijian , Hu Jiliang , Guo Sheng , Huang Weilin , Scott Matthew R. , Wiest Roland , Dahlweid Michael , Reyes Mauricio
Published: February 2020

MR images (MRIs) accurate segmentation of brain lesions is important for improving cancer diagnosis, surgical planning, and prediction of outcome. However, manual and accurate segmentation of brain lesions from 3D MRIs is highly expensive, time-consuming, and prone to user biases. We present an efficient yet conceptually simple brain segmentation network (referred as Brain SegNet), which is a 3D residual framework for automatic voxel-wise segmentation of brain lesion. Our model is able to directly predict dense voxel segmentation of brain tumor or ischemic stroke regions in 3D brain MRIs. The proposed 3D segmentation network can run at about 0.5s per MRIs - about 50 times faster than previous approaches Med Image Anal 43: 98–111, 2018, Med Image Anal 36:61–78, 2017. Our model is evaluated on the BRATS 2015 benchmark for brain tumor segmentation, where it obtains state-of-the-art results, by surpassing recently published results reported in Med Image Anal 43: 98–111, 2018, Med Image Anal 36:61–78, 2017. We further applied the proposed Brain SegNet for ischemic stroke lesion outcome prediction, with impressive results achieved on the Ischemic Stroke Lesion Segmentation (ISLES) 2017 database.
Arnold–Chiari malformation type I and the posterior dislocation of the odontoid process aggravate prolonged weaning in a patient with severe viral pneumonia: a case report
Authors: Ding Renyu , Meng Yulan , Jia Xingjuan , Ma Xiaochun
Published: February 2020

Background

Prolonged and difficult weaning is associated with higher rates of complications and mortality. Therefore, it is important to identify the associated factors.

Case presentation

We describe our experience with a 37-year-old man diagnosed with severe viral pneumonia (influenza A). He presented with acute respiratory failure type I on admission. During intubation, his blood pressure and heart rate decreased, and epinephrine and norepinephrine were administered. Although his clinical condition improved 8 days after intensive care unit (ICU) admission, he experienced difficulty weaning. He remained conscious but had a poor spontaneous cough with sputum production and weak limb muscle strength. His cough reflex was absent during bronchoscopic sputum suction, and he used abdominal breathing during the T-tube test. Magnetic resonance imaging revealed an Arnold–Chiari malformation type I, posterior dislocation of the odontoid process, and syringomyelia, with compression and deformation of the medulla and high cervical cord. The patient was successfully weaned from the ventilator at 20 days after ICU admission.

Conclusions

Arnold–Chiari malformation type I and posterior dislocation of the odontoid process, which aggravate medullary compression and increase the risk of cervical nerve injury, might be a rare factor affecting prolonged weaning in critical illness.
An evaluation of the real world use and clinical utility of the Cxbladder Monitor assay in the follow-up of patients previously treated for bladder cancer
Authors: Koya Madhusudan , Osborne Sue , Chemaslé Christophe , Porten Sima , Schuckman Anne , Kennedy-Smith Andrew
Published: February 2020

Background

Surveilling recurrent urothelial carcinoma (UC) requires frequent cystoscopy, which is invasive, expensive and time-consuming. An accurate urinary biomarker has the potential to reduce the number of cystoscopies required during post-treatment surveillance.

Objective

To audit the clinical utility of a new surveillance protocol incorporating the Cxbladder Monitor (CxbM) test in real-world practice.

Methods

Three hospitals implemented a new surveillance protocol. Patients were risk stratified, and then provided urine samples for CxbM testing. Low-risk CxbM-positive patients and all high-risk patients had cystoscopy at 2–3 months. Low-risk CxbM-negative patients had cystoscopy at ~ 12 months.

Results

443 CxbM tests were conducted on samples from 309 patients: 257 (83.2%) low-risk and 52 (16.8%) high-risk. No pathology-confirmed recurrences were seen in low-risk CxbM-negative patients (n = 108) during the first post-CxbM cystoscopy undertaken a mean ± SD 10.3 ± 3.9 months after testing. Three recurrences were detected during cystoscopy at 2.7 ± 3.4 months in 53 low-risk CxbM-positive patients. In 49 high-risk patients, 39 (79.6%) were CxbM-negative with no pathology-confirmed recurrences. Ten high-risk patients (20.4%) were CxbM-positive with four confirmed recurrences; 2 high-grade and 2 low-grade. The median time to first cystoscopy was 12.13 (95% CI: 11.97–12.4) months in patients with a CxbM-negative result versus 1.63 (95% CI: 1.13–2.3) months in patients with a CxbM-positive result (p < 0.00001). No positive cases were missed, no patients progressed to invasive or metastatic disease, and no patient died of cancer over 35 months of follow-up.

Conclusions

CxbM accurately identified a high proportion of patients (77.8%) who were safely managed with only one cystoscopy per year. Including CxbM in the protocol for patient surveillance provided clinical utility by reducing the average number of annual cystoscopies by approximately 39%, thereby sparing patients the potential discomfort and anxiety, without compromising detection rates. No advantage was observed for risk stratification prior to CxbM.
Effects of Qilin pills on spermatogenesis, reproductive hormones, oxidative stress, and the TSSK2 gene in a rat model of oligoasthenospermia
Authors: Zhang Kaishu , Fu Longlong , An Qi , Hu Weihong , Liu Jianxin , Tang Xiuming , Ding Yu , Lu Wenhong , Liang Xiaowei , Shang Xuejun , Gu Yiqun
Published: February 2020

Abstracts

Background

Qilin pills (QLPs), a classic Traditional Chinese Medicine (TCM) formula for treating male infertility, effectively improve semen quality in clinical trials. This study was designed to evaluate the effects of QLPs on spermatogenesis, reproductive hormones, oxidative stress, and the testis-specific serinekinase-2 (TSSK2) gene in a rat model of oligoasthenospermia.

Methods

Forty adult male Sprague-Dawley (SD) rats were randomly divided into four groups. The rat model with oligoasthenospermia was generated by intragastric administration of tripterygium glycosides (TGs) once daily for 4 weeks. Then, two treatment groups were given different doses (1.62 g/kg and 3.24 g/kg) of QLPs once daily for 60 days. Sperm parameters, testicular histology and reproductive hormone measurements, oxidative stress tests, and TSSK2 expression tests were carried out.

Results

QLPs effectively improved semen parameters and testicular histology; restored the levels of FSH, LH, PRL, fT, and SHBG; reduced the levels of oxidative stress products (ROS and MDA); increased testicular SOD activity; and restored the expression of spermatogenesis-related gene TSSK2.

Conclusion

QLPs have a therapeutic effect on a rat model of oligoasthenospermia, and this effect is manifested as improvement of semen quality and testis histology, gonadal axis stability, decreased oxidative stress, and the regulation of testis-specific spermatogenesis-related gene TSSK2.
Problems lowering the study quality in traditional medicine, introspection from an example of meta-analysis of acupuncture
Authors: Chen Qiliang , Wang Qiong , Ding Shanshan , Li Shunan , Zhang Yuanyuan , Chen Shujiao , Lin Xuejuan , Li Candong , Asakawa Tetsuya
Published: February 2020

Background

Most randomized controlled trials (RCTs) of traditional medicine (such as traditional Chinese medicine (TCM), psychotherapy or behavioral therapy, and dietary interventions, etc.) have reported that they could not provide convincing evidence to support the efficacy because of the low quality of their studies. Here, we aimed to determine the underlying problems of the study quality using standards of evidence-based medicine (EBM) to evaluate the efficacy of traditional medicine.

Methods

We conducted an example of meta-analysis to evaluate the efficacy of acupuncture, a classical treatment of TCM, for treatment of intracerebral hemorrhage (ICH). The quality of the included studies was evaluated by using a Jadad score.

Results

A total of 24 Chinese RCTs that enrolled 1815 patients with ICH were included. Although the results suggested that acupuncture had good efficacy for relief of neurological deficits and improvement of the activities of daily living despite the high heterogeneity of the included studies, the low quality of the included literature reduced the worthiness of the evidence. Two systematic problems (lack of blinding and allocation concealment and high heterogeneity) and one non-systematic problem (lack of reports on adverse events and follow-up) of the TCM studies were found in this illustrational meta-analysis. We believed that other interventions of traditional medicine also suffer from these problems.

Conclusions

Non-systematic problems can be improved by perfecting the experimental design, educating the researcher, and improving the reporting system. However, systematic problems are derived from the characteristics of traditional medicine that are difficult to be corrected. We propose that adoption of objective indexes might be a better solution to improve the systematic problems of traditional medicine. We summarized the problems and the underlying solutions, which may contribute to improve the study quality of systematic review in traditional medicine, strictly complying with the principles of EBM.
Brucella melitensis B115-based ELISA to unravel false positive serologic reactions in bovine brucellosis: a field study
Authors: Trotta Adriana , Marinaro Mariarosaria , Cirilli Margie , Sposato Alessio , Adone Rosanna , Beverelli Matteo , Buonavoglia Domenico , Corrente Marialaura
Published: February 2020

Background

Brucellosis is a zoonosis whose incidence is not declining worldwide despite the global effort to control the disease. Accurate and precise diagnosis is a crucial step in any prophylaxis program but single tests to unequivocally detect animals infected with Brucella spp. are currently unavailable. In Italy, serological diagnosis of bovine brucellosis is performed with two official tests: a rapid agglutination test (i.e., Rose Bengal Plate test, RBPT) and a complement fixation test (CFT) that detect antibodies directed mainly to the smooth lipopolysaccharide (S-LPS). Neither of the two tests is able to avoid the detection of false positive serological reactions (FPSRs) caused by bacteria sharing S-LPS components with Brucella spp. and responsible for the single reactors (SR) phenomenon. A B. melitensis R strain-based ELISA showed a good diagnostic performance in unravelling FP animals; however, since a limited number of animals were analyzed in that study, a large field study was conducted here to discriminate between Brucella-infected from FP animals, with the final aim of reducing the unnecessary slaughter of the latter. An ELISA based on a R strain of Brucella, i.e., Brucella melitensis B115, was employed to measure specific IgG responses in a collection of bovine sera (n = 648). Sera were obtained from 180 farms (either officially brucellosis-free or not brucellosis-free) recruited during an extended period of time (2014–2018) and were preliminarily assayed with the official tests by the Italian Reference Centers and then subjected to the ELISA.

Results

Negative sera, when subjected to the ELISA, gave O.D. values below the cutoff; SR sera, i.e. RBPT positive and CFT negative, as well as double positive (DP) sera, i.e. RBPT and CFT positive, gave O.D. values that were below the cutoff. All positive sera, i.e. from Brucella-infected animals, were RBPT positive and CFT positive (ICFTU ranging from 20 to 1280) and gave ELISA O.D. values above the cutoff.

Conclusions

The B. melitensis B115-based ELISA systematically unravelled all false positive (FP) sera while confirming the diagnosis in Brucella-infected animals. Thus, the test employed in the present study may complement the official assays to avoid the costly slaughter of FP animals.
Two novel porcine teschovirus strains as the causative agents of encephalomyelitis in the Netherlands
Authors: Vreman Sandra , Caliskan Nermin , Harders Frank , Boonstra Jan , Peperkamp Klaas , Ho Cynthia K. Y. , Kuller Wikke , Kortekaas Jeroen
Published: February 2020

Background

Porcine teschovirus (PTV) circulates among wild and domesticated pig populations without causing clinical disease, however neuroinvasive strains have caused high morbidity and mortality in the past. In recent years, several reports appeared with viral agents as a cause for neurologic signs in weanling and growing pigs among which PTV and new strains of PTV were described.

Case presentation

On two unrelated pig farms in the Netherlands the weanling pig population showed a staggering gate, which developed progressively to paresis or paralysis of the hind legs with a morbidity up to 5%. After necropsy we diagnosed a non-suppurative encephalomyelitis on both farms, which was most consistent with a viral infection. PTV was detected within the central nervous system by qPCR. From both farms PTV full-length genomes were sequenced, which clustered closely with PTV-3 (98%) or PTV-11 (85%). Other common swine viruses were excluded by qPCR and sequencing of the virus.

Conclusion

Our results show that new neuroinvasive PTV strains still emerge in pigs in the Netherlands. Further research is needed to investigate the impact of PTV and other viral agents causing encephalomyelitis within wild and domestic pig populations supported by the awareness of veterinarians.
Bioinformatics analyses on the immune status of renal transplant patients, a systemic research of renal transplantation
Authors: Meng Mei , Zhang Weitao , Tang Qunye , Yu Baixue , Li Tingting , Rong Ruiming , Zhu Tongyu , Xu Ming , Shi Yi
Published: February 2020

Background

Kidney transplantation is the most effective treatment for end-stage renal disease. Allograft rejections severely affect survivals of allograft kidneys and recipients.

Methods

Using bioinformatics approaches, the present study was designed to investigate immune status in renal transplant recipients. Fifteen datasets from Gene Expression Omnibus (GEO) were collected and analysed. Analysis of gene enrichment and protein-protein interactions were also used.

Results

There were 40 differentially expressed genes (DEGs) identified in chronic rejection group when compared with stable recipients, which were enriched in allograft rejection module. There were 135 DEGs identified in acute rejection patients, compared with stable recipients, in which most genes were enriched in allograft rejection and immune deficiency. There were 288 DEGs identified in stable recipients when compared to healthy subjects. Most genes were related to chemokine signalling pathway. In integrated comparisons, expressions of MHC molecules and immunoglobulins were increased in both acute and chronic rejection; expressions ofLILRBandMAP 4 K1were increased in acute rejection patients, but not in stable recipients. There were no overlapping DEGs in blood samples of transplant recipients.

Conclusion

By performing bioinformatics analysis on the immune status of kidney transplant patients, the present study reports several DEGs in the renal biopsy of transplant recipients, which are requested to be validated in clinical practice.
Preoperative mechanical bowel preparation with oral antibiotics reduces surgical site infection after elective colorectal surgery for malignancies: results of a propensity matching analysis
Authors: Lei Purun , Ruan Ying , Yang Xiaofeng , Wu Juekun , Hou Yujie , Wei Hongbo , Chen Tufeng
Published: February 2020

Background

Surgical site infections (SSIs) are a major postoperative complication after colorectal surgery. Current study aims to evaluate prophylactic function of oral antibiotic (OA) intake in combination with mechanical bowel preparation (MBP) relative to MBP alone with respect to postoperative SSI incidence.

Methods

A retrospective analysis of eligible patients was conducted using the databases of the Gastrointestinal Surgery Centre, Third Affiliated Hospital of Sun Yat-sen University from 2011 to 2017. Data pertaining to postoperative hospital stay length, expenses, SSI incidence, anastomotic fistula incidence, and rates of other complications were extracted and compared. A propensity analysis was conducted to minimize bias associated with demographic characteristics. Subgroup analyses were performed to further explore protective effects of OA in different surgical sites.

Results

The combination of OAs and MBP was related to a significant decrease in the incidence of overall SSIs, superficial SSI, and hospitalization expenses. The MBP + OA modality was particularly beneficial for patients undergoing left-side colon or rectum resections, with clear prophylactic efficacy. The combination of MPB + OA did not exhibit significant prophylactic efficacy in patients undergoing right hemi-colon resection. Age, surgical duration, and application of OA were all independent factors associated with the occurrence of SSIs.

Conclusion

These results suggest that the combination of OA + MBP should be recommended for patients undergoing elective colorectal surgery, particularly for operations on the left side of the colon or rectum.

Trial registration

NCT04258098. Retrospectively registered
What is known about paediatric nurse burnout: a scoping review
Authors: Buckley Laura , Berta Whitney , Cleverley Kristin , Medeiros Christina , Widger Kimberley
Published: February 2020

Burnout in healthcare providers has impacts at the level of the individual provider, patient, and organization. While there is a substantial body of literature on burnout in healthcare providers, burnout in pediatric nurses has received less attention. This subpopulation may be unique from adult care nurses because of the specialized nature of providing care to children who are typically seen as a vulnerable population, the high potential for empathetic engagement, and the inherent complexities in the relationships with families. Thus, the aim of this scoping review was to investigate, among pediatric nurses, (i) the prevalence and/or degree of burnout, (ii) the factors related to burnout, (iii) the outcomes of burnout, and (iv) the interventions that have been applied to prevent and/or mitigate burnout. This scoping review was performed according to the PRISMA Guidelines Scoping Review Extension. CINAHL, EMBASE, MEDLINE, PsycINFO, ASSIA, and The Cochrane Library were searched on 3 November 2018 to identify relevant quantitative, qualitative, and mixed-method studies on pediatric nurse burnout. Our search identified 78 studies for inclusion in the analysis. Across the included studies, burnout was prevalent in pediatric nurses. A number of factors were identified as impacting burnout including nurse demographics, work environment, and work attitudes. Similarly, a number of outcomes of burnout were identified including nurse retention, nurse well-being, patient safety, and patient-family satisfaction. Unfortunately, there was little evidence of effective interventions to address pediatric nurse burnout. Given the prevalence and impact of burnout on a variety of important outcomes, it is imperative that nursing schools, nursing management, healthcare organizations, and nursing professional associations work to develop and test the interventions to address key attitudinal and environmental factors that are most relevant to pediatric nurses.
Research co-design in health: a rapid overview of reviews
Authors: Slattery Peter , Saeri Alexander K. , Bragge Peter
Published: February 2020

Background

Billions of dollars are lost annually in health research that fails to create meaningful benefits for patients. Engaging in research co-design – the meaningful involvement of end-users in research – may help address this research waste. This rapid overview of reviews addressed three related questions, namely (1) what approaches to research co-design exist in health settings? (2) What activities do these research co-design approaches involve? (3) What do we know about the effectiveness of existing research co-design approaches? The review focused on the study planning phase of research, defined as the point up to which the research question and study design are finalised.

Methods

Reviews of research co-design were systematically identified using a rapid overview of reviews approach (PROSPERO: CRD42019123034). The search strategy encompassed three academic databases, three grey literature databases, and a hand-search of the journalResearch Involvement and Engagement. Two reviewers independently conducted the screening and data extraction and resolved disagreements through discussion. Disputes were resolved through discussion with a senior author (PB). One reviewer performed quality assessment. The results were narratively synthesised.

Results

A total of 26 records (reporting on 23 reviews) met the inclusion criteria. Reviews varied widely in their application of ‘research co-design’ and their application contexts, scope and theoretical foci. The research co-design approaches identified involved interactions with end-users outside of study planning, such as recruitment and dissemination. Activities involved in research co-design included focus groups, interviews and surveys. The effectiveness of research co-design has rarely been evaluated empirically or experimentally; however, qualitative exploration has described the positive and negative outcomes associated with co-design. The research provided many recommendations for conducting research co-design, including training participating end-users in research skills, having regular communication between researchers and end-users, setting clear end-user expectations, and assigning set roles to all parties involved in co-design.

Conclusions

Research co-design appears to be widely used but seldom described or evaluated in detail. Though it has rarely been tested empirically or experimentally, existing research suggests that it can benefit researchers, practitioners, research processes and research outcomes. Realising the potential of research co-design may require the development of clearer and more consistent terminology, better reporting of the activities involved and better evaluation.