bluuebunny/crossref_metadata_2025 huggingface dataset:
Supporting Main Idea Identification and Text Summarization in Middle School Co-Taught Classes
Authors: Shelton Alexandra , Lemons Christopher J. , Wexler Jade
Published: July 2020

Being able to identify the main ideas within a complex multi-paragraph content-area text is an essential reading comprehension skill. It is especially important for content-area and special education co-teachers to provide explicit instruction in this skill to meet the needs of their students with learning disabilities who frequently struggle with understanding text they read. To help students with main idea identification, co-teachers can provide students with explicit instruction on how to generate a main idea statement for individual paragraphs or sections of a text. Co-teachers can extend this instruction by incorporating peer-mediated practice to help students strengthen their main idea statements. Finally, co-teachers can instruct students to use their statements to summarize the text. This article provides guidance for supporting the main idea identification and text summarization skills of middle school students in a co-taught classroom.
Masculinities and Biomedical Governmentality in the Contexts of HIV Prevention and Treatment for Latinx Immigrants
Authors: Lozano-Verduzco Ignacio , Cortes Wendolyn , Melendez Rita , Gonzalez Violeta
Published: July 2020

In this article, we discuss notions of masculinities from an understudied group in the United States: Latinx immigrants in regards to medical services regarding HIV and AIDS. We understand this group from the result of the intersection between migration policies and binational discourses, the idea of “vulnerability” and “risk” produced by an acute biomedicalization of bodies and human groups, and gender-particularly masculinity as a discourse that governs sex. Notions were obtained from focalized individual interviews with Latinx immigrants and medical services providers in rural areas of California. Results show that notions on masculinity deploy different forms of sexual behaviors and relationships that diminish men’s responsibility around sexual health and stigmatize femininity and homosexuality. We conclude that reformulating health policies in order to recognize Latino’s vulnerability from cojuntural and intersectional conditions is of most importance.
Safety Assessment of High-Purity, Synthetic Nicotinamide Riboside (NR-E) in a 90-Day Repeated Dose Oral Toxicity Study, With a 28-Day Recovery Arm
Authors: Marinescu Anca G. , Chen Jayson , Holmes Holly E. , Guarente Leonard , Mendes Odete , Morris Mark , Dellinger Ryan W.
Published: July 2020

Nicotinamide riboside (NR) is a naturally occurring form of vitamin B3 shown to preferentially elevate the nicotinamide adenine dinucleotide (NAD+) metabolome compared to other vitamin B3 forms (nicotinic acid and nicotinamide). Although daily requirements of vitamin B3 are typically met through the diet, recent studies have shown that additional supplementation with NR may be an effective method to counter the age-related decline in NAD+ levels as NR bypasses the rate-limiting step in NAD+ biosynthesis. Furthermore, pharmaceutical applications of NR for age-related disorders have been proposed. In this study, the safety of a high-purity, nature-identical, synthetic NR (NR-E), manufactured under the guidelines of good manufacturing practices for dietary supplements (21 CFR 111) as well as for drugs (21 CFR 210), was investigated in a 90-day oral toxicity study in Sprague Dawley rats at 300, 500, and 1,200 mg/kg/d. There were no mortality or clinical observations attributable to the test substance at any dose. A small but statistically significant decrease in body weight was observed at day 92 in the 1,200 mg/kg/d NR-treated male rats only. In contrast to a previously published safety assessment using a different synthetic NR (NIAGEN), whose no-observed-adverse-effect-level (NOAEL) was reported to be 300 mg/kg/d, there were no adverse changes in clinical pathology parameters and no notable macroscopic or microscopic findings or treatment-related effects at similar doses. In the current study, the NOAEL for systemic toxicity of NR-E in Sprague-Dawley rats was conservatively determined to be 500 mg/kg/d for males (solely based on body weight) and 1,200 mg/kg/d for females.
Prednisolone-induced diabetes mellitus in the cat: a historical cohort
Authors: Nerhagen Sivert , Moberg Hanne L , Boge Gudrun S , Glanemann Barbara
Published: July 2020

Objectives

Prednisolone is a commonly used drug in cats and potential adverse effects include hyperglycaemia and diabetes mellitus. The aims of this study were to evaluate the frequency and investigate potential predisposing risk factors for the development of prednisolone-induced diabetes mellitus (PIDM) in cats.

Methods

The electronic records of a tertiary referral centre were searched for cats receiving prednisolone at a starting dose of ⩾1.9 mg/kg/day, for >3 weeks and with follow-up data available for >3 months between January 2007 and July 2019. One hundred and forty-three cats were included in the study.

Results

Of the 143 cats, 14 cats (9.7%) were diagnosed with PIDM. Twelve out of 14 cats (85.7%) developed diabetes within 3 months of the initiation of therapy.

Conclusions and relevance

Cats requiring high-dose prednisolone therapy should be closely monitored over the first 3 months of therapy for the development of PIDM.
Transformational party events and legislative turnover in West European democracies, 1945–2015
Authors: Gouglas Athanassios , Katz Gabriel , Maddens Bart , Brans Marleen
Published: July 2020

This paper examines the influence of party change on party-level legislative turnover. Analyzing a novel dataset tracking 251 parties in eight West European democracies between 1945 and 2015, we assess how transformational party events affect the renewal of parties’ parliamentary delegations. Transformational party events refers to party changes resulting from deliberate strategic decisions that redistribute power within parties, change their identity, and/or shift alliances within and between them. We focus in particular on changes in parties’ leadership and name, the formation of electoral cartels, mergers and divisions, applying empirical methods suitable for dealing with fractional outcomes and multi-level data to test their impact on turnover rates. Our estimates indicate that leadership change is a key determinant of MP renewal, leading to systematically higher rates of legislative turnover. Party relabeling and divisions affect turnover as well, although their influence is contingent on other characteristics of the parties and their environment.
Comprehensive sensitivity analysis of rotational stability of a super-deep underground spherical structure considering uncertainty
Authors: Wan Hua-Ping , Zheng Yanfeng , Luo Yaozhi , Yang Chao , Xu Xian
Published: July 2020

Jiangmen Underground Neutrino Observatory central detector is located 700 m below the ground and also submerged into an ultrapure water pool. The main structure of the Jiangmen Underground Neutrino Observatory central detector is a hybrid spherical shell that is vulnerable to rotation under the buoyancy effect. The influences of the model parameters on the rotational stability of this complex and unique structure are investigated. Since the model parameters are inevitably subjected to many sources of uncertainties (e.g. manufacturing tolerances and geometrical imperfections), the parameter uncertainty is taken into account. In addition, linear and nonlinear rotational stabilities of this super-deep underground spherical structure are also under consideration. Specifically, the critical loading multiplier is used as the evaluation indicator of linear rotational stability and the load proportionality factor- θ curve is considered as the evaluation indicator of nonlinear rotational stability. The sensitivity of linear and nonlinear rotational stabilities to uncertain parameters is systematically studied in terms of univariate and multivariate global sensitivity analyses. The univariate global sensitivity analysis is able to evaluate the effects of uncertain parameters on each evaluation indicator, whereas multivariate global sensitivity analysis enables to assess the global influence of uncertain parameters on all evaluation indicators. A polynomial chaos expansion surrogate model is utilized to replace the time-consuming simulation model for analytical implementation of the univariate and multivariate global sensitivity analyses. The present polynomial chaos expansion-based univariate and multivariate global sensitivity analyses effectively and efficiently reveal the sensitivity of the rotational stability of this super-deep underground spherical structure to uncertain parameters, and provide a practical method for comprehensive sensitivity analysis of similar structures.
Analysis of activity, space and user relations in urban squares
Authors: Acar Habibe , Yavuz Aysel , Eroğlu Engin , Acar Cengiz , Sancar Cenap , Değermenci Ahmet Salih
Published: July 2020

With the increasing density of built spaces in urban areas, the need for open spaces increases every day. Squares are one of the most important of these open spaces. Urban squares allow various activities and exhibit functional differences based on location and culture. The diversity of activities conducted in squares is extremely important for the quality and viability of liveable urban spaces. Urban residents prefer spaces that are suitable for individual requirements and desires and allow for a variety of activities. These spaces also contribute to social life. This article aimed to determine the user profile, occupancy, facilities and activity diversity at the Atatürk Plaza (Trabzon urban square) in Trabzon, the capital city of Trabzon Province, Turkey. The occupants of the square and their numbers were analysed via the behaviour observation method. As a result of the observations conducted in the square over one year, 17 activities were identified. The majority of these activities were necessary activities and that the most common activity was walking. The occupancy density and distribution in the square were analysed using the Geographical Information System (GIS). These research findings and analyses could serve as a guide for future urban square and urban open space designs.
Tribological assessment of NiCr, Al2O3/TiO2, and Cr3C2/NiCr coatings applied on a cylinder liner of a heavy-duty diesel engine
Authors: Biyiklioğlu Onur , Tat Mustafa Ertunc
Published: July 2020

Internal combustion engines consume about 90% of fuel refined from crude oil which supplies 30% of the annual global flow of energy. Heavy-duty diesel engines are the primary source of power used in highways, marine, railroads, and power stations. The right coating can improve the tribological properties of cylinder liners and increase the mechanical efficiency of an engine. Also, it can help to extend the maintenance periods, and enhance the reliability of the vehicles. In this research, tribological and economic evaluations were performed for coated and uncoated substrates from a cylinder liner of a heavy-duty diesel engine, aiming to lower friction, wear rate, and maintenance cost. A reciprocating friction test was conducted under dry condition using Wolfram carbide (tungsten carbide) ball applied a 10 N normal load on a ball on disk geometry. The cylinder liner was made of gray cast iron, and the substrates obtained were coated with three different coating materials (Cr3C2/NiCr, NiCr, and Al2O3/TiO2) through the thermal spray and high-velocity oxy-fuel coating process. Tribological evaluations showed that the substrates coded with Al2O3/TiO2 and Cr3C2/NiCr had the lowest friction coefficient and wear rate. The most economical coating was Al2O3/TiO2, being able to supply about 61% lower coefficient of friction and 94% less wear rate relative to the uncoated sample, for the price of one-third of the Cr3C2/NiCr coating and one half of a new gray cast iron cylinder liner.
Efficient development of vision-based dense three-dimensional displacement measurement algorithms using physics-based graphics models
Authors: Narazaki Yasutaka , Gomez Fernando , Hoskere Vedhus , Smith Matthew D , Spencer Billie F
Published: July 2020

This research investigates a framework for the efficient development of vision-based dense three-dimensional displacement measurement algorithms to support reliable structural health monitoring of civil structures. The framework exploits the use of a photo-realistic synthetic model, termed a physics-based graphics model, to simulate the entire process of vision-based measurement. At the same time, the synthetic environment is used to evaluate the performance of different post-processing algorithms quantitatively for a given measurement scenario, such as camera selection and camera placement. The effectiveness of the framework is demonstrated by optimizing the algorithms for the three-dimensional displacement measurement of a 14-bay laboratory truss structure. The vision-based dense three-dimensional displacement estimation algorithms optimized in this study consist of four steps: (1) camera parameter estimation, (2) camera motion estimation and compensation, (3) vision-based two-dimensional tracking, and (4) projection of two-dimensional tracking results to three-dimensional space. The algorithms use the knowledge from the finite element model to facilitate the implementation and maximize the measurement outcome, that is, model-informed approach. To test and evaluate the model-informed approach, synthetic videos are rendered for two measurement scenarios, that is, using a Digital Single Lens Reflex camera mounted on a tripod and using an Unmanned Aerial Vehicle camera. Then, the performance of the model-informed approach is evaluated by comparing the estimated displacement with the ground truth values. Based on the performance evaluation, an algorithm with the highest expected performance is selected for each of the two measurement scenarios. Finally, the selected algorithm is tested in a laboratory experiment. In contrast to the existing literature that investigates fixed individual measurement scenarios, the proposed framework can be used to test different measurement scenarios and estimate the outcome of each scenario before performing actual tests, facilitating the implementation of vision-based measurement for the structural health monitoring of civil structures.
“Talk to Each Other Like It’s 1995”: Mapping Nostalgia for the 1990s in Contemporary Media Culture
Authors: Ewen Neil
Published: July 2020

Twenty years on from Television & New Media’s first issue, we find ourselves in an era defined by fracture, anger, anxiety, and nervousness. This short article considers one notable response to this crisis: nostalgia for the 1990s manifesting across a number of cultural fields, including television, music, and celebrity.
Concentration standardization improves the capacity of drainage CRP and IL-6 to predict surgical site infections
Authors: Bi Xiaoqin , Li Yan , Lin Jie , Li Chunjie , Li Jiping , Cao Yubin
Published: July 2020

The early detection of surgical site infection (SSI) remains an unsolved problem. Inflammatory factors in fluids drained from surgical sites may be a promising tool for predicting SSI. Previous attempts to predict SSI via such factors have not taken baseline concentrations into account. However, this may have comprised predictive efficacy. In the current study, concentrations of C-reactive protein (CRP) and interleukin 6 (IL-6) in fluid samples drained from surgical sites in 20 patients with SSI and 60 matched controls were assessed, and concentrations from day 2 to day 4 were divided by the concentration at day 1 to achieve concentration standardization. There were no significant differences of CRP or IL-6 concentrations at day 1 or day 2 ( p >  0.05), but there were significant differences at day 3 and day 4 ( p <  0.05). The areas under the curve (AUCs) for SSI of standardized concentrations were higher than those of the corresponding absolute concentrations of CRP and IL-6 in fluid drained at days 3 and 4. Standardized concentrations of CRP at day 4 yielded the highest AUC (0.92; 95% confidence interval: 0.84–0.97), with a sensitivity of 90% and specificity of 80% at the best cutoff. Concentration standardization may improve the efficacy of predicting SSI via CRP and IL-6 in fluids drained from surgical sites. Although the sample size was small, the study demonstrated the feasibility of non-invasive, accurate, and early detection of postoperative SSI in a diverse real population. Further studies are needed to validate the results of the present study and investigate their broader applicability.

Impact statement

The ability to predict surgical site infections (SSIs) early would be advantageous. Previous studies have investigated the use of inflammatory factors in fluids drained from surgical sites to predict SSI, but the diagnostic efficacy of this method requires improvement. Baseline levels of inflammatory factors vary between individuals, but this variation tends to differ in patients with and without SSIs. Therefore, we standardized subsequently acquired concentrations of interleukin 6 and C-reactive protein in fluids drained from surgical sites by dividing them by the concentrations determined at day 1 to preclude the confounding effects of differences in baseline levels. The standardized concentrations had higher predictive efficacy than the absolute concentrations. Standardizing the data rendered SSI prediction more precise and practical in a diverse group of real patients. This translational study suggests that inflammatory factors in fluid drained from injury sites are promising tools for the prediction of SSI in the clinic.
Will Kyiv’s Soviet Industrial Districts Survive? A Study of Transformation, Preservation, and Demolition of Industrial Heritage in Ukraine’s Capital
Authors: Ponomaryova Anastasiya , Ryan Brent D.
Published: July 2020

In the 1930s and 1940s, multiple five-year Soviet plans for national industrialization transformed Ukraine’s capital Kyiv (Russian Kiev) into a dramatic industrial metropolis. By 1960, Kyiv was a core industrial city with renovated prerevolutionary factories and massive new industrial enterprises. Ukraine’s 1991 independence threatened industrial complexes with demolition for retail, residential, and office uses. We examine Kyiv’s Soviet industrial legacy as prescribed in master plans of 1936 and 1947, and successive five-year plans. We profile five significant industrial complexes and their divergent fates today. We call for future transformations of Kyiv’s monumental Soviet industrial enterprises with enhanced awareness of heritage value.
Changing Cultural Practices: A Case Study of Male Circumcision in South Africa
Authors: Palmer Eurica , Rau Asta , Engelbrecht Michelle
Published: July 2020

This article presents a case study of Simon, a 25-year old Black South African male. According to his Pedi customs, Simon underwent traditional male circumcision (TMC) as a 12-year-old adolescent. He tells of his fears relative to this experience and how, over time, he transitioned from a belief in TMC to a strong preference for medical male circumcision (MMC). Using a single-case study design, the aim of the research was to explore the value of the exercise of choice in TMC, which may influence cultural perceptions of gender and masculinity. The study unpacks the way in which the meaning and experience of TMC is shaped by the social and cultural contexts of South Africa. This qualitative exploration complements conventional medical accounts of circumcision, which are often focused on the medical procedure while ignoring cultural and social factors. Issues of gender, particularly the construction of hegemonic masculinity and how it positions men, women, and young boys in relation to each other and their communities, are discussed. Simon’s case study provides new insights and perspectives on personally and culturally sensitive issues which are not easily accessed nor commonly understood. Data collected via in-depth interviews were transcribed and analyzed thematically. Analysis applied information from the literature and key concepts from the theoretical standpoint of social constructivism. Case study analysis allowed space for unexpected, emergent themes to arise from the data. Four main themes were identified, notably language, silence, patriarchy, and masculinity.
The influence of rhythm on short-term memory for serial order
Authors: Gorin Simon
Published: July 2020

In the field of verbal short-term memory (STM), numerous theoretical models have been proposed to explain how serial order information is processed and represented. Evidence suggests that serial order is represented through associations between items and a varying contextual signal coding the position of each item in a sequence, but the nature of this contextual signal is still a matter of debate (i.e., event-based vs. time-based varying signal). According to event-based models of serial order, the contextual signal coding serial order is not sensitive to temporal manipulations, as it is the case in irregularly timed sequences. Up to now, the study of the temporal factors influencing serial order STM has been limited to temporal grouping and temporal isolation effects. The goal of the present study is to specify in more detail the role played by temporal factors in serial order STM tasks. To accomplish this, we compared recall performance and error patterns for sequences presenting items at a regular or an irregular and unpredictable timing in three experiments. The results showed that irregular timing does not affect serial recall nor the pattern of errors. These data clearly favour the view that serial order in verbal STM is represented with event-based rather than time-based codes.
Does a delay in surgery for distal radial fractures affect patient outcome?
Authors: Howard Matthew , Curtis Alex , Everett Sam , Harries Luke , Donaldson Oliver , Sheridan Barnaby
Published: July 2020

Current guidelines from the British Orthopaedic Association state that if fractures of the distal radius are operated on then this should take place within 3 days of injury for intra-articular fractures, 7 days for extra-articular fractures and 3 days when a trial of conservative management has failed. This retrospective cohort study aimed to assess whether there was any difference in outcome between patients receiving timely or delayed surgery, using the Patient-Rated Wrist Evaluation score at >12 months after injury as the primary outcome measure. Data from 380 patients treated at two district general hospitals over a 5-year period were obtained using electronic databases to capture the demographics and treatment details and postal questionnaires to assess current function. The study showed no statistical or clinical differences in outcome measures between the timely or delayed cohorts in any of the three treatment groups.

Level of evidence: III
Recurrent granulomatous cheilitis associated with Crohn’s disease successfully treated with ustekinumab: case report and literature review
Authors: Taxonera Carlos , Alba Cristina , Colmenares Michel , Olivares David , Rey Enrique
Published: July 2020

Granulomatous cheilitis, characterized by persistent inflammation of the lips and a granulomatous histology, is sometimes associated with Crohn’s disease and is a therapeutic challenge. Reported evidence indicates treatment with an anti-TNF agent (mainly infliximab) is the most recommended therapeutic option after failure of conventional treatments. The clinical case reported the effectiveness of ustekinumab, a monoclonal antibody against interleukins 12/23, to induce the remission of severe and recurrent granulomatous cheilitis in a patient with Crohn’s disease.
Improved urinary melatonin level as the perspective indicator that leads to better sleeping quality in bladder cancer patients
Authors: Cheng Tse-Chou , Lee Yi-Hua , Chang Yuan-Ping , Lee De-Chih
Published: July 2020

Background:

Individuals with higher-than-average melatonin concentrations are less likely to develop cancer. In cancer patients, psychosomatic coping patterns and treatment side effects are important indicators of cancer prevention and immune system deterioration. This study focused on changes in the urinary melatonin concentration, life resilience, and sleep quality in bladder cancer patients before, and 3 months after, treatment.

Methods:

A controlled before-and-after study was performed. The subjects were patients who were previously diagnosed with bladder cancer and had received treatment (transurethral resection of bladder tumor + intravesical chemotherapy). Data from 23 subjects were analyzed.

Results:

The results showed a significant difference in the melatonin concentration before and after treatment (Wilcoxon signed-rank test, Z = −2.220, p = 0.026). The melatonin concentration in 16 patients (70%) increased after treatment. The mean Pittsburgh Sleep Quality Index (PSQI) score before treatment was 7.348 (SD = 4.030), which was associated with poor sleep quality. The mean PSQI score after treatment was 6.435 (SD = 3.300; Z = −2.071; p = 0.038). These results represent the improved sleep quality in patients post-treatment.

Conclusions:

After treatment, the urinary melatonin concentration and sleep quality (PSQI) improved, both of which were statistically significant in bladder cancer patients. Consequently, bladder cancer treatment should be initiated as soon as possible. There was no significant difference in overall life resilience before and after treatment, possibly because elderly individuals have strong personality traits and emotional stability and are not easily affected by life events or stress.
How do firm and market characteristics affect airports’ Beta risk?
Authors: Binz Tobias
Published: July 2020

I present a graphical framework based on Subrahmanyam and Thomadakis (1980) that allows to study the impact from firm and market characteristics on systematic risk associated with the return on capital, i.e. Beta risk, for utilities under price control. Within this framework, Beta risk is driven by the magnitude of profit fluctuations following demand shocks. The framework is then applied to airport firm characteristics and airport market environment features. I find that the frequency of price control resets, the level of operating leverage, the extent of capacity constraints, and the degree of market power all have an unambiguous effect on the level of Beta risk. The scope of the regulatory perimeter and the type of traffic mix may also affect Beta risk; however, the magnitude and direction of their impact rely on the specifics of the case. The article may assist policy makers to formulate economically sound recommendations on how the regulatory rate of return for airport operators should be determined. Specifically, my findings suggest criteria that can be used to choose adequate peer companies of comparable systematic risk.
Book review: Norm Contestation: Insights into Non-conformity with Armed Conflict Norms, Betcy Jose, Electronic edition
Authors: Okhade Sonal
Published: July 2020

Norm Contestation: Insights into Non-conformity with Armed Conflict Norms, Betcy Jose, Electronic edition, Springer, Switzerland, 2018–2019. pp. 112 (Paperback), ₹4,116.00/$ 54.55 (Kindle Edition).
Pharmacogenomics Instruction Depth, Extent, and Perception in US Medical Curricula
Authors: Basyouni Dara , Shatnawi Aymen
Published: July 2020

Introduction:

This descriptive study aimed to evaluate the depth, extent, and perception of pharmacogenomics instruction in schools and colleges of medicine in the United States. Changes in medical pharmacogenomics instruction over the past decade were also assessed by comparing our results with those of a previous study.

Methods:

An electronic survey was emailed to all accredited allopathic and osteopathic medical schools across the US using Qualtrics online survey software. Multiple email reminders were sent to increase the response rate.

Results:

Of 151 targeted eligible medical schools across the United States, 22 responded to the survey. One invalid response was excluded, resulting in a response rate of 13.9%. Of responding schools, 85.7% cover pharmacogenomics in their curriculum, mainly in the second year, however, none teach pharmacogenomics as a stand-alone course. The depth and the extent of pharmacogenomics coverage varied among responding programs. Although 66.7% of respondents believe that neither physicians nor other health care professionals possess appropriate knowledge in pharmacogenomics, only 23.8% plan to increase pharmacogenomics instruction in their curricula in the near future.

Conclusions:

Most medical schools surveyed include some pharmacogenomics instruction in their curricula, although the depth and the extent of the instruction varies. Most respondents believe that physicians and other health care professionals today do not possess an appropriate level of knowledge in pharmacogenomics; however, few institutions report short-term plans to increase pharmacogenomics instruction. Pharmacogenomics plays a significant role in personalized medicine; greater efforts by medical school decision-makers are needed to improve the level of pharmacogenomics instruction in medical curricula.
A model to strengthen utility of quality pharmaceutical health systems data in resource-limited settings
Authors: Kagoya Harriet Rachel , Kibuule Dan , Rennie Timothy William , Kabwebwe Mitonga Honoré
Published: July 2020

Background:

Limited utility of quality health data undermines efforts to strengthen healthcare delivery, particularly in resource-limited settings. Few studies model the effective utility of quality pharmaceutical information system (PIS) data in sub-Saharan Africa, typified with weak health systems.

Aim:

To develop a model and guidelines for strengthening utility of quality PIS data in public healthcare in Namibia, a resource-limited setting.

Methods:

A qualitative model based on Dickoff et al. practice-oriented theory, Chinn and Jacobs’ systematic approach to theory, and applied consensus techniques. Data from nationwide studies on quality and utility of PIS data in public healthcare conducted between 2018 and March 2020 informed the development of the model concepts. Pharmaceutical and public health systems experts validated the final model.

Results:

Overall, four preliminary national studies that recruited 58 PIS focal persons at 38 public health facilities and national level informed the development of four model concepts. The model describes concepts on access, management, dissemination, and utility of quality PIS data. Activities to implement the model in practice include grass-root integration of real-time automated pharmaceutical intelligence systems to collect, consolidate, monitor, and report PIS data. Strengthening coordination, human resources, and technical capacity through support supervisory systems at grass-root facilities are key activities. PIS focal persons at health facility and national level are agents to implement these activities among recipients, that is, healthcare professionals at points of care. Guidelines for implementation of the model at point of care are included. Experts described the model as clear, simple, comprehensive, and integration of pharmaceutical intelligence systems at point of care as novel and of importance to enhance utility of quality PIS data in resource-limited settings.

Conclusion:

While utility of quality PIS data is limited in Namibia, advantages of the model are encouraging, toward building resilient pharmaceutical intelligence systems at grass roots in resource-limited countries, where there are not only weak health systems, but high burden of misuse of medicines.
Bilateral, Solitary, Extramacular Vitelliform Retinal Lesions in a Patient With Best Disease
Authors: Duker Jacob , Patel Nimesh A. , Yannuzzi Nicolas A. , Prakhunhungsit Supalert , Negron Catherin I. , Berrocal Audina M.
Published: July 2020

Purpose:

This work describes the first published case of Best vitelliform macular dystrophy (BVMD) with bilateral, solitary, extramacular retinal lesions.

Methods:

A case report is presented.

Results:

An 8-year-old girl with a family history of BVMD was referred for suspicious peripheral retinal lesions. Multimodal imaging disclosed bilateral, solitary, extramacular lesions consistent with the vitelliform lesions found in BVMD. There were no abnormalities in the macula.

Conclusions:

This is the first documented case of solitary, bilateral, extramacular vitelliform lesions in BVMD.
SARS-CoV-2 and the Eye: Implications for the Retina Specialist From Human Coronavirus Outbreaks and Animal Models
Authors: Kennedy Alasdair , Shantha Jessica G. , Olivia Li Ji-Peng , Faia Lisa J. , Hartley Caleb , Kuthyar Sanjana , Albini Thomas A. , Wu Henry , Chodosh James , Ting Daniel S.W. , Yeh Steven
Published: July 2020

Purpose:

The current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has escalated rapidly since December 2019. Understanding the ophthalmic manifestations in patients and animal models of the novel coronavirus may have implications for disease surveillance. Recognition of the potential for viral transmission through tear film has ramifications for patients, physicians, and the public.

Methods:

Information from relevant published journal articles was surveyed using a computerized PubMed search and public health websites. We summarize knowledge of ophthalmic manifestations of SARS-CoV-2 infection in patients and animal models, risk-mitigation measures for patients and providers, and implications for retina specialists.

Results:

SARS-CoV-2 is efficiently transmitted among humans, and although the clinical course is mild in most infected patients, severe complications including pneumonia, acute respiratory distress syndrome, and death can ensue, most often in elderly patients and individuals with comorbidities. Conjunctivitis occurs in a minority of patients with COVID-19, and SARS-CoV-2 RNA has been identified primarily with conjunctivitis. Uveitis has been observed in animal models of coronavirus infection, and cotton-wool spots have been reported recently.

Conclusions:

SARS-CoV-2 and other coronaviruses have been rarely associated with conjunctivitis. Identification of SARS-CoV and SARS-CoV-2 RNA in the tear film of patients and its highly efficient transmission via respiratory aerosols supports eye protection, mask, and gloves as part of infection prevention and control recommendations for retina specialists. Disease surveillance during the COVID-19 pandemic may also include ongoing evaluation for uveitis and retinal disease given prior findings from animal models and a recent report of retinal manifestations.
Entangled agencies: Rethinking causality and health in political-ecology
Authors: Neely Abigail H
Published: July 2020

The question of non-human agency has been particularly important and generative in political-ecology. Drawing from science studies, scholars have used actor-network theory and assemblage theory to decenter humans from analyses. Building on this scholarship, this article offers a decolonial approach for rethinking of agency in health for political-ecologies of health drawing from work in feminist science studies that stresses non-proscriptive relationships over individuals. By unpacking the example of isibhobho, a witchcraft illness, through the work of Karen Barad, I argue for an understanding of agency as the reconfiguration of entanglements. This approach offers new possibilities for understanding what causes illness, which moved beyond humans and non-humans to focus on entanglements. This approach challenges models of causality, taken up in both biomedicine and in political-ecology, offering a vision of causality that is relational and opening up new possibilities for healing and for politics more broadly.
Pulmonary arterial hypertension-associated changes in gut pathology and microbiota
Authors: Sharma Ravindra K. , Oliveira Aline C. , Yang Tao , Kim Seungbum , Zubcevic Jasenka , Aquino Victor , Lobaton Gilberto O. , Goel Ruby , Richards Elaine M. , Raizada Mohan K.
Published: July 2020

Emerging evidence implicates an interplay among multiple organs such as brain, vasculature, gut and lung in the development of established pulmonary arterial hypertension (PAH). This has led us to propose that activated microglia mediated-enhanced sympathetic activation contributes to PAH pathophysiology. Since enhanced sympathetic activity is observed in human PAH and the gut is highly innervated by sympathetic nerves that regulate its physiological functions, we hypothesized that PAH would be associated with gut pathophysiology.

A monocrotaline rat model of PAH was utilized to investigate the link between gut pathology and PAH. Haemodynamics, histology, immunocytochemistry and 16S RNA gene sequencing were used to assess cardiopulmonary functions, gut pathology and gut microbial communities respectively.

Monocrotaline treatment caused increased right ventricular systolic pressure, haemodynamics and pathological changes associated with PAH. PAH animals also showed profound gut pathology that included increased intestinal permeability, increased muscularis layer, decreased villi length and goblet cells. These changes in gut pathology were associated with alterations in microbial communities, some unique to PAH animals. Furthermore, enhanced gut–neural communication involving the paraventricular nucleus of the hypothalamus and increased sympathetic drive were observed.

In conclusion, our data show the presence of gut pathology and distinct changes in gut microbiota and increased sympathetic activity in PAH. They suggest that dysfunctional gut–brain crosstalk could be critical in PAH and considered a future therapeutic target for PAH.
Amyloidosis of the respiratory system: 16 patients with amyloidosis initially diagnosedante mortemby pulmonologists
Authors: Yamada Masami , Takayanagi Noboru , Yamakawa Hideaki , Ishiguro Takashi , Baba Tomohisa , Shimizu Yoshihiko , Okudela Koji , Takemura Tamiko , Ogura Takashi
Published: July 2020

Background

Ante mortemdiagnosis of amyloidosis of the respiratory system is rare. Few data are available regarding clinical presentation, precursor proteins, diagnostic procedures, comorbidities, complications, and outcome. We assessed clinical features of a series of patients with amyloidosis of the respiratory system in two Japanese centres.

Methods

Medical records of 16 patients with amyloidosis of the respiratory system were retrospectively analysed. Amyloid was diagnosed by polarisation microscopy using Congo red-stained tissue specimens and classified immunohistochemically.

Results

Median patient age was 71 years, and median follow-up period was 5 years. Immunoglobulin light-chain (AL)-λ amyloidosis was found in eight and AL-κ in five patients. Two patients harboured wild-type transthyretin and one harboured serum amyloid A-derived amyloid. Five different forms of amyloidosis of the respiratory system were observed: nodular pulmonary amyloidosis (seven patients), diffuse alveolar-septal amyloidosis (five), mediastinal lymph node amyloidosis (three), tracheobronchial amyloidosis (one), and pleural amyloidosis (one). One patient had diffuse alveolar-septal amyloidosis and mediastinal lymph node amyloidosis. Three of five patients with diffuse alveolar-septal amyloidosis were diagnosed by transbronchial lung biopsy as having concurrent diffuse alveolar haemorrhage or pneumocystis pneumonia. Two of three patients with mediastinal lymph node amyloidosis were diagnosed by endobronchial ultrasound-guided transbronchial needle aspiration.

Conclusions

Not only nodular pulmonary amyloidosis, diffuse alveolar-septal amyloidosis, and tracheobronchial amyloidosis but also mediastinal lymph node amyloidosis and pleural amyloidosis should be considered in the differential diagnosis of amyloidosis of the respiratory system. Useful diagnostic methods include transbronchial lung biopsy for diffuse alveolar-septal amyloidosis and endobronchial ultrasound-guided transbronchial needle aspiration for mediastinal lymph node amyloidosis.
Influence of age, sex and hospitalisation on the administration of tuberculosis medication: an evaluation of routine data from a German health insurer
Authors: Kersten Jan F. , Wobbe-Ribinski Stefanie , Diel Roland , Nienhaus Albert , Schablon Anja
Published: July 2020

Background

So far, there is no reliable information on the drugs actually taken by tuberculosis patients. With billing data from a large German health insurance company, valid data from practice will be used for analysis. The objective here is to use the claims data of a health insurer to gain an insight into the prescriptions issued to patients with tuberculosis in Germany.

Methods

The study design encompasses a longitudinal, analytical observational study of selected insurance holders. Descriptive analyses of the outpatient drug supply of pulmonary tuberculosis patients are determined for 6 payroll years. We have studied whether different doses of tuberculosis medication are associated with age, sex, inpatient status and comorbidity. Quantile regression is used as a method to identify subgroups or characteristic dosages.

Results

The number of defined daily doses prescribed per patient varies among insurance holders and encompasses widely differing timeframes. Higher doses are observed with increasing age, as well as in patients with tuberculosis-related hospitalisations. The sex of the patient has no identifiable effect on the prescribed doses for any of the first-line tuberculosis drugs. Comorbidity partially has a significant impact on the duration and intensity of tuberculosis drug prescriptions.
Spontaneous hyphema associated with ocular syphilis
Authors: Deibert Brent , Wark Kellie , Diaz Rocio , Blodi Christopher
Published: July 2020

The purpose of this case series is to illustrate a novel presentation of ocular syphilis. Two cases of ocular syphilis presenting with spontaneous hyphema are described, demonstrating that spontaneous hyphema can be caused by ocular syphilis. This association has not previously been reported.
The antibacterial activity and toxin production control of bee venom in mouse MRSA pneumonia model
Authors: Kong Ryong , Lee Young-Seob , Kang Dam-Hee , Wang Shu , Li Qianqian , Kwon Dong-Yeul , Kang Ok-Hwa
Published: July 2020

Background

The current antimicrobial therapy is still important for the treatment of pneumonia due to MRSA infection, but there are some limitations, including the route of administration, side effect profile, and increased microbial resistance patterns. Therefore, we investigated whether BV, which shows a strong antimicrobial effect against MRSA, would be effective in a pneumonia model.

Methods

In vitro, we checked MIC, qRT-PCR, western blot, ELISA, LDH-assay. In vivo, we checked survival rate, gross pathological change, histopathology, lung bacterial clearance assay, and the expression of inflammatory related gene.

Results

The minimum inhibitory concentration of BV against MRSA is 15.6 μg/ml by broth dilution method. The production of toxins and related gene were reduced by BV in MRSA. The secretion of cytokines were decreased by treatment with BV in 264.7 RAW macrophages stimulated by MRSA Also, BV protected A549 from pathogenicity of MRSA. Bee venom reduced the number of bacteria in the lungs and alleviated the symptoms of MRSA-induced pneumonia in mouse.

Conclusion

BV inhibited the virulence of the bacterium and the number of bacterial cells present in lung tissue, thereby alleviating the symptoms of pneumonia in mice. This study suggested that BV may be a candidate substance for the treatment of pneumonia caused by MRSA infection.
Surgical approach strategies for open reduction internal fixation of closed complex tibial Pilon fractures based on axial CT scans
Authors: Zhao Yu , Wu Jian , Wei Shijun , Xu Feng , Kong Changwang , Zhi Xiaosong , Huang Ming , Cai Xianhua
Published: July 2020

Background

To explore the application and clinical efficacy of surgical approach strategies in open reduction internal fixation of closed complex tibial Pilon fractures based on axial CT scans.

Methods

This retrospective cohort study included data of 25 patients with closed complex tibial Pilon fractures treated from October 2011 to March 2014, including 19 males and 6 females aged 18–54 years (average 39.5 years). According to classification criteria of the Association for Osteosynthesis/Orthopedic Trauma Association (AO/OTA), 4 patients were type 43C1, 10 type 43C2, and 11 type 43C3. Surgical approaches were selected based on fracture line distribution and bone displacement revealed by axial CT scans, and an open reduction method was adopted for internal fixation of the bone plates. Postoperatively, Burwell-Charnley radiographic criteria were used to determine fracture reduction quality. Functional evaluation was performed using the American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale. Complications, fracture union time, and the AOFAS scores at last follow-up were recorded.

Results

The 25 included patients were followed for 22–60 months postoperatively (average follow-up 33.9 months). Of these, 19 patients achieved anatomical reduction of the articular surface, 5 achieved good reduction, and one achieved fair reduction. Two patients developed superficial infection on the anteromedial incision and delayed union but recovered well after local dressing change and oral administration of antibiotics. Another patient developed deep infection on the anterolateral incision, which was controlled by debridement, catheter irrigation, and intravenous antibiotic injection. All fractures healed well and average union time was 2.8 months (range, 2–3 months). No fracture malunion or internal fixation failures were found at last follow-up. All 25 patients had AOFAS scores ranging from 80 to 100 at last follow-up (average 88.4). Overall, 15 patients were excellent, 10 good, and 0 fair or poor, with excellent and good rates of 100%.

Conclusions

Surgical approach strategies for complex tibial Pilon fractures based on axial CT scans accurately reconstruct the articular surface and achieve solid internal fixation of assembled locking plates, while early postoperative functional exercises contribute to the functional recovery of affected limbs and reduce related complications.
Intimate partner violence during pregnancy and risk of still birth in hospitals of Tigray region Ethiopia
Authors: Gebreslasie Kahsay Zenebe , Weldemariam Solomon , Gebre Gelawdiyos , Mehari Mihret-Ab
Published: July 2020

Background

Pregnancy may represent a time of exceptional vulnerability to intimate partner violence because of changes in women’s conditions. Despite the fact that intimate partner violence during pregnancy confers considerable risk to the health of the woman and her fetus, data regarding to association of stillbirth and intimate partner violence is lacking in Tigray region. The objective of this study is to assess intimate partner violence during pregnancy and its association with still birth among postpartum mothers in hospitals in Tigray Region of Ethiopia.

Methods

Cross-sectional study design was used to assess 648 women about intimate partner violence during pregnancy and its association with still birth. Simple random sampling technique was employed to select health facilities and systematic sampling was used to select the study participants. Data was entered by using Epi info version 3.5.1 and analyzed using SPSS version 20. Logistic regression analysis was done to assess the association between exposure to intimate partner violence during pregnancy and stillbirth while adjusting for possible confounders.

Results

The prevalence of still birth was 3.6%in this study population. There was a statistically significant association between exposure to intimate partner violence during pregnancy and still birth. Pregnant women who were exposed to intimate partner violence during pregnancy were three times more likely to have still birth 3.3(95% CI: 1.1–9.7) as compared to those who were not exposed. Another important factor associated with stillbirth was low birthweight 16.7(95% CI,6–46).

Conclusions

The prevalence of still birth in this study was high. Women who subjected to intimate partner violence during pregnancy had greater risk of having stillbirth baby.