bluuebunny/crossref_metadata_2025 huggingface dataset:
It’s a Peoples Game, Isn’t It?! A Comparison Between the Investment Returns of Business Angels and Machine Learning Algorithms
Authors: Blohm Ivo , Antretter Torben , Sirén Charlotta , Grichnik Dietmar , Wincent Joakim
Published: September 2020

Investors increasingly use machine learning (ML) algorithms to support their early stage investment decisions. However, it remains unclear if algorithms can make better investment decisions and if so, why. Building on behavioral decision theory, our study compares the investment returns of an algorithm with those of 255 business angels (BAs) investing via an angel investment platform. We explore the influence of human biases and experience on BAs’ returns and find that investors only outperformed the algorithm when they had extensive investment experience and managed to suppress their cognitive biases. These results offer novel insights into the role of cognitive limitations, experience, and the use of algorithms in early stage investing.
Gaps and Overlaps in Cancer Multidisciplinary Team Communication: Analysis of Speech
Authors: Soukup Tayana , Murtagh Ged M. , Lamb Benjamin W. , Bali Anish , Gandamihardja Tasha , Darzi Ara , Green James S. A. , Sevdalis Nick
Published: September 2020

Guided by the principles of conversation analysis, we examined the communication practices used to negotiate levels of participation in cancer multidisciplinary team meetings and their implications for patient safety. Three cancer teams participated. Thirty-six weekly meetings were video recorded, encompassing 822 case reviews. A cross-section was transcribed using Jefferson notation. We found a low frequency of gaps between speakers (3%), high frequency of overlaps (24%), and no-gaps-no-overlaps (73%), suggesting fast turn transitions. Securing a turn to speak is challenging due to a systematic reduction in turn-taking opportunities. We contribute to group research with the development of a microlevel methodology for studying multidisciplinary teams.
Gratitude in Health Care: A Meta-narrative Review
Authors: Day Giskin , Robert Glenn , Rafferty Anne Marie
Published: September 2020

Research into gratitude as a significant sociological and psychological phenomenon has proliferated in the past two decades. However, there is little consensus on how it should be conceptualized or investigated empirically. We present a meta-narrative review that focuses on gratitude in health care, with an emphasis on research exploring interpersonal experiences in the context of care provision. Six meta-narratives from literatures across the humanities, sciences, and medicine are identified, contextualized, and discussed: gratitude as social capital; gifts; care ethics; benefits of gratitude; gratitude and staff well-being; and gratitude as an indicator of quality of care. Meta-narrative review was a valuable framework for making sense of theoretical antecedents and findings in this developing area of research. We conclude that greater attention needs to be given to what constitutes “evidence” in gratitude research and call for qualitative studies to better understand and shape the role and implications of gratitude in health care.
Measurement of Nasalance Scores Without Touching the Philtrum for Better Comfort During Speech Assessment and Therapy: A Preliminary Study
Authors: Yang Xiaopeng , Pratama Gradiyan Budi , Choi Younggeun , You Heecheon , Tâm Nguyễn Phu'ò'c Minh , Kim Gi-Wook , Jo Yun-Ju , Ko Myoung-Hwan
Published: September 2020

Objective:

The Kay Pentax nasometer uses a separator plate that touches the philtrum of a patient to separate the nasal and oral sound energies for nasalance measurement. However, the separator plate can restrict the natural movement of the patient’s upper lip and generate unpleasant pressure on the patient’s philtrum. The present study was intended to measure nasalance scores without touching the philtrum for better comfort during speech assessment and therapy.

Methods:

Nasalance scores of 10 males and 10 females having no speech disorders were measured under 4 levels (0, 5, 10, and 15 mm) of the gap between the plate and the philtrum (denoted as plate-to-philtrum gap) using Nasometer II 6450 for nasal (Nasal Sentences) and oral (Zoo Passage) stimuli. Regression formulas were established to examine the relationships between nasalance score and plate-to-philtrum gap for the stimuli. To provide nasalance scores equivalent to those measured for the contact condition, compensation factors for the 5 mm plate-to-philtrum gap measurement condition were identified for the stimuli.

Results:

The nasalance scores were significantly different between the 4 different plate-to-philtrum gaps for the stimuli. Compensation factors for the Nasal Sentences and the Zoo Passage were identified as 1.17 and 0.71, respectively.

Conclusions:

The 5 mm plate-to-philtrum gap condition after multiplying the compensation factors can provide equivalent nasalance scores to the conventional contact measurement condition which may provide better comfort in speech assessment and therapy.
Environmental Risk Factors for Nonsyndromic Cleft Lip and/or Cleft Palate in Xinjiang Province, China: A Multiethnic Study
Authors: Hong Yu , Xu Xianrong , Lian Fuzhi , Chen Rong
Published: September 2020

Objective:

To determine the risk factors of the occurrence of nonsyndromic cleft lip and/or cleft palate (NSCL/P) in Xinjiang Province, China.

Design:

The study included 359 patients of NSCL/P and 310 controls. Information about sociodemographic characteristics, lifestyle behaviors, negative life events, possible environmental hazards exposures, and use of supplementations were collected from cases and controls. Both t test and χ2 tests were used for group comparisons. Multivariable logistic regression was used to estimate the independent associations between environmental risk factors and the presence of NSCL/P. The receiver operating characteristic curve was used to establish the predictive variables for the occurrence of NSCL/P.

Results:

The results showed that maternal pesticide exposure (odds ratio [OR] = 11.40, 95%CI: 5.40-24.10), antibiotic drugs use (OR = 1.32, 95%CI: 1.14-1.53), paternal smoking (OR = 3.30, 95%CI: 1.87-5.83), threatened abortion (OR = 12.2, 95%CI: 3.29-45.25) were associated with increased risk of NSCL/P in offspring. In contrast, maternal moderate (OR = 0.43, 95%CI: 0.20-0.92) and middle physical workload (OR = 0.48, 95%CI: 0.0.23-0.97), vitamin-B complex supplementations (OR = 0.11, 95%CI: 0.03-0.41), calcium and iron (OR = 0.27, 95%CI: 0.08-0.90) supplementations were associated with reduced risk of NSCL/P in offspring. These variables together explain nearly 60% of the variation of occurrence of NSCL/P.

Conclusion:

These findings from our study may help to develop primary prevention strategies for NSCL/P in Xinjiang.
Initial Dosage Optimization of Tacrolimus in Pediatric Patients With Thalassemia Major Undergoing Hematopoietic Stem Cell Transplantation Based on Population Pharmacokinetics
Authors: Zhou Siru , Zhang Ren , Lv Chunle , Lu Jiejiu , Wei Yinyi , Li Chengxin , Chen Ming , Li Qiaochuan , Liu Taotao
Published: September 2020

Background:

Hematopoietic stem cell transplantation (HSCT) is an effective treatment for hematological disorders. Tacrolimus is widely used after HSCT, but it has highly interindividual variable pharmacokinetics. Population pharmacokinetics (PPK) researches of tacrolimus in children with β-thalassemia major (β-TM) undergoing HSCT are insufficient.

Objective:

To establish a PPK model of tacrolimus in children with β-TM and optimize initial dosing regimen for achieving target concentration of 5 to 15 ng/mL.

Methods:

Data on patients aged <18 years were retrospectively collected from January 2017 to December 2018. PPK analysis and Monte Carlo simulations were performed using nonlinear mixed-effects modeling.

Results:

A data set of 55 patients with 332 concentrations was included. A 2-compartment model could best describe the pharmacokinetics of tacrolimus. The body surface area and gender were significant covariates in the final model. The typical value of clearance, the distribution volume of the central room, the distribution volume of the peripheral room, and the intercompartmental clearance were 5.05L/h, 4.33L, 155L, and 6.22L/h, respectively. The optimal initial dosing regimen of 0.03, 0.04, 0.05, 0.06, and 0.10 mg/kg were appropriate for female children with a weight (WT) of 50 to 10 kg. The regimen of 0.04, 0.05, 0.06, 0.07, and 0.12 mg/kg is suitable for male children with a WT of 50 to 10 kg. The probability of target attainment (PTA) of each regimen reached 91%.

Conclusion and Relevance:

A stable PPK model of tacrolimus was established. The proposed dosage regimen reached a good PTA, which could provide a reference for tacrolimus therapy.
Epithelium Involving Bilateral Axillary Lymph Nodes: Metastasis, Misplaced, or Mullerian!
Authors: Singh Kamaljeet , Sardana Ruhani , Quddus M. Ruhul , Harigopal Malini
Published: September 2020

During breast cancer staging, histological evaluation of axillary sentinel lymph nodes (SLN) is usually straightforward. However, the exact characterization of a small epithelial deposit in an SLN can be challenging, especially during the frozen section examination. We report the first case of endosalpingiosis involving bilateral axillary lymph nodes. We review published literature on axillary endosalpingiosis and discuss the differential diagnosis of small epithelial deposits in an axillary SLN. Pathologists should consider benign epithelial rests and displaced epithelium as differential diagnoses for the microscopic epithelial nodal deposit, especially during the frozen section examination.
Do “Non-Partisan” Municipal Politicians Match the Partisanship of Their Constituents?
Authors: Lucas Jack
Published: September 2020

Recent research in the United States has found that municipal governments are responsive to the ideological complexion of their cities even in the absence of partisan elections. In this paper, I test for the presence of party match—a match between the partisan character of a district and the partisanship of its municipal representative—in Canada, where municipal elections are distinctively non-partisan. Using new data on district-level party support and the partisanship of Canadian municipal politicians, I find clear evidence for party match. This match is equally likely in at-large and ward elections, partisan and non-partisan elections, and large and small cities. I thus argue that partisan and ideological representation is an important and widespread feature of Canadian municipal politics. I discuss the implications of these findings for theories of municipal representation and the role of ideology in municipal politics.
Do Project Labor Agreements Reduce the Number of Bidders on Public Projects? The Case of Community Colleges in California
Authors: Philips Peter , Waitzman Emma
Published: September 2020

Project labor agreements (PLAs) are commonly found on larger California public works in urban areas. Nonetheless, they remain a controversial public procurement practice. One issue not examined in the literature is whether as some critics suggest, PLAs reduce the number of bidders on public projects. Analyzing 263 bid openings for community college construction in California over the period 2007 to 2016, this first-ever study of PLA effects on the number of bids finds that controlling for the location where the project occurred, the size of projects, the business cycle and the season when the project was let, the number of bidders on a project was not altered by the presence or absence of project of PLAs. This study also finds that relative to engineer’s estimates available on 99 of these projects, the lowest bids on prevailing wage projects were not higher than the lowest bids on projects without PLA agreements.
Cultural Differences Reflected in the Experience Economy
Authors: Chang Seohee
Published: September 2020

This study investigated the potential effects of culture on the experience economy in the hospitality and tourism industry by comparing Korean and American consumers. The study investigated patterns in the gain and loss values of service and experience for hospitality and tourism products as well as experiential products for both sets of consumers to explore collectivism and individualism as reflected in perceived monetary values. The study analyzed responses from a sample comprising 543 Korean and 424 American respondents using descriptive analysis, a paired samples t test, and an independent t test. The findings show that Koreans rely on service components, whereas Americans prioritize experience components. These results deepen our understanding of how the experience economy reflects the cultural distinction in terms of ideal affective states and prevention (risk avoiding) and promotion (risk taking) behaviors.
Radiographic assessment of the dynasty biofoam acetabular component with a minimum 2 years follow-up
Authors: Carli Alberto V , Galmiche Romain , Dobransky Johanna , Beaulé Paul E
Published: September 2020

Introduction:

Acetabular components utilising novel ultraporous metal matrices have been recently introduced into clinical practice with improved interference fit, decreased stress shielding, and hope for more reliable osseointegration. 1 such example is the Dynasty Biofoam cup, which has been in clinical use for over a decade but has few reports documenting its clinical and radiographic performance.

Methods:

A single-centre retrospective study was performed evaluating 96 Dynasty Biofoam acetabular components implanted between March 2010 and August 2014 with minimum 2-year radiographic follow-up. Patients that received components for revision surgery or that had early complications postoperatively (femur fracture, prosthetic infection) were excluded. Biofoam patients were compared to 96 patients that received the Trident PSL acetabular component and were matched for age, gender, and BMI. Patient reported outcomes, component position and radiographic features of cup loosening, including radiolucent lines and sclerosis were compared among groups.

Results:

Patient-reported outcomes at 2 years were similar among groups. Cup anteversion was similar but inclination was significantly greater in the Biofoam group ( p = 0.006). A significantly greater number of Biofoam components exhibited 2-zone (27.2%) and 3-zone (12.0%) radiolucencies compared to 0% of the Trident shells ( p < 0.05). 2 Biofoam cups were revised for aseptic loosening compared to no Trident cups ( p = 0.49).

Discussion:

Despite adequate implant survivorship, over a quarter of Biofoam cups had 2 or more radiolucent zones in early follow-up. Longer follow-up is needed to determine if the aseptic revision rate for this cup will increase.
Improving autism and developmental screening and referral in US primary care practices serving Latinos
Authors: Zuckerman Katharine E , Chavez Alison E , Wilson Laura , Unger Katie , Reuland Colleen , Ramsey Katrina , King Margaret , Scholz Julie , Fombonne Eric
Published: September 2020

Improving autism spectrum disorder screening and referral in primary care may reduce autism spectrum disorder disparities for Latino children. The REAL-START intervention aimed to increase primary care provider adherence to autism spectrum disorder and developmental screening guidelines, and to increase Early Intervention referral for children at developmental risk in primary care clinics serving Latinos. This quasi-experimental study enrolled six Oregon primary care clinics. Clinic staff attended one initial and three follow-up trainings. Trainings addressed screening, billing, referral, and follow-up issues specific to Latinos. Clinic leaders met with a quality improvement facilitator to review performance. Medical record review measured screening and referral at 18- and 24-month well-child visits at baseline and 3, 6, 9, and 12 months. State Early Intervention database queries assessed Early Intervention eligibility. Overall, 2224 well-child visits were assessed (39% Latino). Clinics improved rates of autism spectrum disorder screening from 70% to 94% and general developmental screening from 62% to 95%. Adherence to screening guidelines increased from 46% to 91%. Proportion of children referred to Early Intervention was unchanged, but total referrals increased and age range of referred children broadened. Time to Early Intervention evaluation was slightly shorter among screening-age children. REAL-START may improve screening and referral for autism spectrum disorder and developmental delay in Latino communities.

Lay abstract

Latino children experience delays in access to diagnosis and treatment of autism spectrum disorder. Primary care–based screening of all children for autism spectrum disorder and referring them for services may reduce racial/ethnic differences and improve care. REAL-START, a yearlong screening intervention, was effective in increasing screening for autism spectrum disorder and general developmental delays, increasing therapy referrals, and shortening time for developmental assessment in primary care clinics with Latino patients.
Novel higher-order zigzag theory for analysis of laminated sandwich beams
Authors: Garg Aman , Chalak HD
Published: September 2020

In the present work, a new higher-order zigzag theory is proposed for the analysis of laminated sandwich beams under static and free vibration conditions. Fourth-order in-plane and transverse displacement fields are chosen along with linear unit Heaviside step function. The present theory satisfies interlaminar transverse stress continuity conditions along with zero value at the top and bottom surface for transverse shear stresses. The proposed approach is also free from any kind of C-1 or penalty requirements. A three-noded one-dimensional finite element having eight degrees of freedom per node is used during analysis. The efficiency of the proposed model is carried out by comparing the present results with those available based on elasticity solutions and zigzag theories in the literature. New results are also reported in the present work, which will serve as a benchmark for future studies. The influence of boundary condition on the nature of stress distribution across the length of beam and frequencies of the beam with different end conditions is also carried out. A comparative study has also been carried out between symmetric and unsymmetric laminated sandwich beam.
Saccharose cluster ions as mass calibrants in positive-ion direct analysis in real time-mass spectrometry
Authors: Gross Jürgen H
Published: September 2020

In positive-ion direct analysis in real time-mass spectrometry (DART-MS), mono-, di, and trisaccharides form [M+NH4]+ ions. Some of them, in addition, yield abundant [Mn+NH4]+ cluster ions (n = 1–6)), and thus, can serve for mass calibration. Saccharose, C12H22O11, the most common sugar, also termed sucrose, is among the [Mn+NH4]+ cluster ion forming species. Saccharose may therefore be employed as a cheap and ubiquitous mass calibration standard. The extent of saccharose cluster ion formation depends on the temperature of the DART gas, sample load, and instrumental parameters like trapping conditions of ions prior to mass analysis. This study identifies optimized experimental conditions and demonstrates the application of saccharose cluster ion-based mass calibration for accurate mass measurements in DART mode on a Fourier transform ion cyclotron resonance (FT-ICR) mass spectrometer.
Enrolment of children in clinical research: Understanding Ghanaian caregivers’ perspectives on consent/assent procedures, and their attitudes towards storage of biological samples for future use
Authors: Adjei George O , Laar Amos , Kurtzhals Jorgen AL , Goka Bamenla Q
Published: September 2020

Child assent is recommended in addition to parental consent when enrolling children in clinical research; however, appreciation and relevance ascribed to these concepts vary in different contexts, and information on attitudes towards storage of biological samples for future research is limited, especially in developing countries. We assessed caregivers’ understanding and appreciation of consent and assent procedures, and their attitudes towards use of stored blood samples for future research prior to enrolling a child in clinical research. A total of 17 in-depth interviews were conducted with primary caregivers of children (fathers [n = 3], mothers [n = 12], and grandmothers [n = 2]) at enrolment or on the immediate follow-up date. All caregivers recalled significant amount information from the study information sheet and were able to appropriately link such information to the consent process. While all participants confirmed information received prior to blood sampling as adequate, a few noted that the purpose was not sufficiently well communicated. Caregivers felt children were cognitively vulnerable, and prone to decisions that were not necessarily in their best interest. Nearly all caregivers felt it was their right and responsibility to overrule objections from their ward’s regarding enrolment into specific study or receipt of a therapeutic procedure. There were no objections or concerns regarding use of stored biological samples for future research purposes. There is thus, a need to improve understanding of caregivers on the information provided during the informed consent process. Context-specific studies on the age of assent in specific populations are needed.
The barriers to observing professional ethics in the practice of nursing care from nurses’ viewpoints
Authors: Azadian Marzieh , Rahimi Azar , Mohebbi Mohammad , Iloonkashkooli Raziyeh , Maleki Maryam , Mardani Abbas
Published: September 2020

Aims

This study aimed to investigate barriers in the observation of professional ethics during clinical care from a nursing viewpoint. Also, it examined the association between these barriers and nurse demographic variables.

Methods

A descriptive-analytic design was carried out on 207 nurses working in selected hospitals within an urban area of Iran in 2019. Data were collected using a standard questionnaire containing 33 questions that measured barriers to observation of professional ethics. The questionnaire measures three domains of management, environment and individual care.

Results

In the management dimension, the most important barrier preventing observation of professional ethics was the shortage of personnel. For the environmental dimension, biological changes due to working on the nightshift, and for the individual care dimension, a lack of time were the most important barriers preventing observation of clinical ethics. Findings additionally highlighted a significantly inverse association between barriers to observing professional ethics and the male gender, participating in the ethics workshop and high work-level experiences.

Conclusions

It is suggested that nursing managers in hospitals correct and remove obstacles with careful planning and emphasis on principles and standards of care including environmental and managerial factors and training professional ethics to nurses.
Distal radial artery (snuffbox) access for carotid artery stenting – Technical pearls and procedural set-up
Authors: Kühn Anna Luisa , Singh Jasmeet , Moholkar Viraj M , Satti Sudhakar R , Rodrigues Katyucia de Macedo , Massari Francesco , Gounis Matthew J , McGowan Archie , Puri Ajit S
Published: September 2020

Purpose

To report use of distal radial artery (dRA) access for carotid artery stenting (CAS) and to discuss procedural setup and technical considerations for a successful intervention.

Methods

A retrospective review of our prospective neurointerventional database of CAS was conducted between May 2019 and March 2020. All CAS cases via dRA in the anatomical snuffbox were identified. Patient demographics, clinical information, procedural and radiographic data was collected.

Results

22 CAS procedures in 20 patients via dRA were identified. Patients’ mean age was 69.4 years (range 53–87 years). 3 patients were female. Mean radial artery diameter was 2.1 mm (range 1.6–2.8 mm). dRA access was achieved in all cases. Conversion to femoral access was required in 2 cases (9.1%) due to persistent radial artery vasospasm resulting in patient discomfort despite multiple additional doses of intraarterial vasodilators and added intravenous sedation as well as tortuous vessel anatomy and limited support of the catheters in a type 3 aortic arch for left CAS.

Conclusion

Our preliminary experience with dRA access for CAS suggests this approach to be feasible and safe for patients. Technical considerations are important and preprocedural planning is necessary for a successful intervention. Catheter systems and devices specifically designed for radial access are needed to enable more interventionalists to safely perform neurointerventional procedures via wrist access.
Optimization of sequential excavation method for large-section urban subway tunnel: A case study
Authors: Wu Bo , Huang Wei
Published: September 2020

In response to the requirement for population increase, the cross-section area of the urban subway is enlarged, resulting in that one-time excavation technology cannot be directly applied to the excavation of large-section tunnels. Consequently, how to partition the cross-section of the large-section tunnels and optimize the corresponding construction parameters is of great significance. In this paper, we establish a unified planar partition optimization model based on the four parameters of the number of horizontal layers, the number of transverse partitions, the height of the step, and the width of sections. Moreover, using the dynamic programming principle, we can further obtain the optimal excavation sequence and the construction parameters of the large-section tunnels by solving the planar partition optimization model. Combined with the case of an extra-large cross-section tunnel excavation of Chongqing Metro Central Park East Station, the paper optimizes the excavation method of the tunnel with the aim of the maximum construction efficiency and tunnel stability to obtain the optimal excavation sequence, the optimal construction parameters, and the optimal comprehensive evaluation index. The practice has proved that the optimization model based on the dynamic programming principle can effectively solve the problem of large-section tunnel construction. The case analysis can provide an effective reference for similar large-section tunnel projects.
Dynamic analysis of material motion using MATLAB/Simulation environment and test verification
Authors: Fang Mei , Yu Zhihong , Zhang Wenjie
Published: September 2020

Throwing device is an important factor that directly affects the performance of chaff cutter. In this work, the dynamic analysis linked with the problem of low efficiency and residue blockage of disc knife chaff cutter is executed. Based on this perspective, the mathematical model, simulation, and testing of the material movement have been carried out. Simulations are performed in MATLAB/Simulink environment. An anemometer records the airflow velocity, which provides data for simulation analysis. The simulation results showed that during the movement along the blade, the material first performs deceleration and then accelerates; in other stages, only deceleration. And finally calculated the throwing distance. To support the presented simulations, an experimental study is conducted. The experimental results are compared with simulation results, the maximum relative error between the simulated value and the experimental value is 9.42%, which verified the correctness of the model. This research provides a theoretical basis for the structural design, parameter optimization, and matching of the chaff cutter.
Seeking Justice Elsewhere: Informal and formal justice in the true crime podcasts Trace and The Teacher’s Pet
Authors: Pâquet Lili
Published: September 2020

Following Carol Smart’s argument that feminists have reason to mistrust legal institutions and to seek justice elsewhere, this article suggests that contemporary Australian true crime podcasts offer women and their families alternatives to seek justice beyond formal systems. This article will examine the representation of women in two recent and popular Australian true crime podcasts that followed inconclusive investigations of murder cases. Trace (2017–2018) is a seven-episode true crime podcast by Rachael Brown for the ABC about the 1980 murder of Maria James in her Melbourne bookshop, where she lived with her two sons. The Teacher’s Pet by Hedley Thomas for The Australian is about the disappearance of Lynette Dawson from the northern beaches of Sydney in 1982, leaving behind her two daughters. Thomas explicitly accuses Dawson’s husband, former professional rugby player, Chris Dawson, of murdering her and disposing of her body. Both true crime podcasts represent women in ways that—while not always feminist—use the affordances of mass media to draw support from the public, effectively inviting the audience to perform as an alternate jury. In both cases, this jurified audience has then engendered changes in formal processes.
RNA-activated protein kinase differentially modulates innate immune response mediated by supraphysiological concentrations of thyroid hormone
Authors: Ishaq Mohammad , Natarajan Ven
Published: September 2020

Nuclear hormone receptor ligands are known to modulate innate immunity by dampening the immune response induced by pathogens. Here, we report that unlike other ligands, 3,3′,5-triiodo-l-thyronine (T3) induced the type 1 IFN response and expression of IFN-stimulated genes (ISGs). T3 action was found to be significantly amplified at supraphysiological concentrations (SPC) and in combination with double-stranded RNA mimic polyinosinic–polycytidylic acid. Induction by T3 was due to non-genomic mechanisms involving integrin binding, calcium mobilization, and phosphatidyl-inositol 3-kinase–AKT pathways, but was independent of TLR3, RIG-I, and IFN-β1 pathways. Whereas siRNA-induced knockdown of RNA-activated protein kinase (PKR) was found to abrogate the T3-induced expression of select ISGs, expression of other T3-induced ISGs was strongly induced by PKR knockdown, indicating the differential role of PKR in modulating T3 action. Together, we describe a novel role of T3 in modulating the innate immune response and identify the importance of PKR in regulating T3-induced immune activation. These findings have important implications in the basic understanding of the mechanisms of T3 function at SPCs and crosstalk involved in the thyroid hormone function and the innate immune response.
Local and systemic treatment for HER2-positive breast cancer with brain metastases: a comprehensive review
Authors: Chan Wing-Lok , Lam Tai-Chung , Lam Ka-On , Luk Mai-Yee , Kai-Cheong Roger Ngan , Kwong Lai-Wan Dora
Published: September 2020

The management of human epidermal growth factor receptor (HER2)-positive breast cancer has improved over the past decade. However, despite improvements in systemic control, a substantial proportion of patients with advanced HER2-positive breast cancer suffer from central nervous system metastases and even intracranial progression after aggressive local treatment. There is paucity of data and no consensus on the systemic therapies for patients with intracranial progression. This review discusses both local and systemic treatments for HER2-positive breast cancer with brain metastases with a special focus on the response of central nervous system metastases. A recommended practical treatment algorithm to guide physicians in selecting the most appropriate anti-HER2 therapy for their patients is suggested.
Epidemiology of High Ankle Sprains: A Systematic Review
Authors: Prakash Akilesh Anand
Published: September 2020

Syndesmotic sprains or high ankle sprains are reported to be associated with increasing morbidity and time loss. The aim of this study was to critically appraise literature on epidemiology of syndesmotic sprains through systematic review of published literatures. A systematic review was conducted online for literature published in English using PubMed and Google Scholar, as per PRISMA guidelines up to April 30, 2019. Predefined eligibility criteria were applied, and the data thus compiled were analyzed. A total of 26 studies were found to be eligible, of which three-fourths involved sporting population. Considerable inconsistency in assessment procedure reporting, injury and injury severity definition with variable unit measures used to describe incidence or injury rate was observed. Meta-analysis and intra- and intersports comparison could not be performed owing to the study heterogeneity and methodological variability. There is a need for standardization in future research, specifically with regard to injury assessment and reporting, demanding heightened awareness and improved diagnostic modalities, as injury epidemiology is integral to the overall injury-prevention conundrum.

Levels of Evidence: Systematic review, Level III
The Effect of Internationalization on Firm Performance: A Moderating Role of Heterogeneity in TMTs’ Nationality
Authors: Song Sujin , Lee Seoki
Published: September 2020

The effect of internationalization on firm performance has been investigated in the hospitality literature in a relatively extensive manner. However, the literature has still provided mixed findings. Furthermore, the moderating role of top management teams (TMTs) on the relationship between internationalization and firm performance has not been explored yet in the hospitality literature. Considering the increasing importance of internationalization in the hospitality industry and a significant role of TMTs in implementing this internationalization, this study performs a comprehensive examination on the effect of internationalization on firm performance using three different internationalization measures (i.e., degree, diversification, and speed) and three different performance measures (i.e., Tobin’s q, return on assets, and international returns). This study also tests the moderating role of heterogeneity in TMTs’ nationality based on the upper echelons theory, employing hierarchical linear modeling (HLM) to test the proposed hypotheses.
Problematizing “Activism”: Medical Volunteer Tourism in Central America, Local Resistance, and Academic Activism
Authors: Stanley Phiona
Published: September 2020

This paper critically examines epistemological, ontological, and axiological tensions of activism in three related contexts. These are, first, (primarily medical) volunteer tourism ideologies and practices in Central America, including U.S.-American teenagers volunteering in medical centers where, entirely untrained, they do sutures and injections, deliver babies, and help with amputations. Second, the paper considers and critiques local norms (e.g., widespread homophobia) and materials (e.g., the use of short-handled agricultural hoes) that may be discursively constructed as resistance to western imperialism. Finally, the critique turns back on the researcher gaze itself, problematizing the notion of academic activism in spaces, like these, where criticality itself is an imported—arguably luxurious—folly. Local people, it is apparent, do not want convoluted theorizing or Western hand-wringing; they want proper medical care. The paper therefore considers the extent to which academic work in such spaces can call itself activism at all. Three years of ethnographic research inform the paper (2013–2015, predominantly in Guatemala and Nicaragua), including hundreds of hours of interviews and participant observational fieldwork, in Spanish and English, with local stakeholders (e.g., teachers and homestay hosts) and Western volunteer tourists. The paper is theorized with reference to postcolonial theory, critical medical ethics, and liberation theology.
School Nurses on the Front Lines of Healthcare: The Approach to a Student With Anxiety and Posttraumatic Stress Disorder
Authors: Chardavoyne Paige , Olympia Robert P.
Published: September 2020

Mental illness is common, and its severity ranges from subclinical to severe, where the condition affects daily social and academic functioning. Because of its ubiquity, it is necessary that school nurses have an enhanced understanding of some of the mental health conditions that children and adolescents may be facing. As will be discussed, some mental health concerns present with somatic symptoms that may bring the student into the school nurse’s office. If the nurse identifies mental health symptoms, he or she may be able to intervene, provide support, and direct the student for further management if necessary. This article will focus on anxiety in general before focusing on specific anxiety disorders, including posttraumatic stress disorder. We will begin by defining these conditions and then move into discussing potential present-day stressors, such as fear and anxiety associated with the recent coronavirus disease 2019 pandemic, and screening tools before closing with some suggestions for practice and a case wrap-up.
Clozapine prescribing in COVID-19 positive medical inpatients: a case series
Authors: Butler Matthew , Bano Felicity , Calcia Marilia , McMullen Isabel , Sin Fai Lam Chun Chiang , Smith Laura Jane , Taylor David , Gee Siobhan
Published: September 2020

There is both uncertainty regarding the safety of clozapine in COVID-19 patients owing to limited published data and a lack of consensus on continuing clozapine in patients with severe respiratory infections. COVID-19 is known to induce an acute immune response which can affect haematological parameters associated with clozapine monitoring, and systemic infection may reduce clozapine clearance. Clozapine, which has been associated with worse outcomes in some pneumonias, may in theory worsen outcomes in COVID-19. Despite these concerns, there are some data to indicate it is safe to continue clozapine in COVID-19 infection. In this retrospective case series, we describe our experiences of clozapine prescribing and disease progression of eight SARS-CoV-2 positive patients on medical wards in a major London teaching hospital. In four cases clozapine was stopped during the hospital admission. A COVID-19 pneumonia developed in four patients: three of these required intensive care unit admission for an average of 34 days. At the time of writing, three patients had died (two directly from COVID-19 pneumonia), two remained in general hospital wards, two were recovering in the community and one had been transferred to an inpatient psychiatric hospital. Follow-up length varied but in each case was not more than 104 days. Delirium was the most common adverse neuropsychiatric event, and in one case a relapse of psychosis occurred after cessation of clozapine. This retrospective case series illustrates the safe use of clozapine during COVID-19 infection. Our experiences suggest that consideration should be made to continuing clozapine even in those most unwell with COVID-19. We also identify areas which require larger scale hypothesis-testing research.
Paravalvular leak closure with real time transesophageal echocardiography and fluoroscopy fusion
Authors: Ahmed Hosam F , Petersen John W , Bavry Anthony A , Alhussaini Mahmoud , Beaver Thomas M
Published: September 2020

Transcatheter technology has been increasingly used for paravalvular leak closure. We report the use of “ Fusion Technology” (EchoNaviagator, Phillips, Tustin, CA) that combines real-time 2 and 3 dimensional trans-esophageal echocardiography with fluoroscopy imaging to facilitate paravalvular leak closure. This could help to identify the exact site, size, depth and shape of the paravalvular leak for proper positioning of the occluder device, which may result in saving time and effort.
Iatrogenic thermal burn after hot water immersion for weever fish sting treatment: a case report
Authors: Abdul Jalil Khairun Izlinda , Qayyum Muhammad Tayyab
Published: September 2020

Introduction:

Lesser weever fish are saltwater fish that are found on the Mediterranean and European coasts, over sandy and muddy seabed areas, typically around the summer season. These bottom dwellers have envenoming dorsal spines that sting when stepped on. Severe pain is the main symptom. Initial treatment involves wound irrigation, removal of spines if they are visible and immediate hot water immersion (HWI). Tetanus prophylaxis, leg elevation and analgesia are recommended after pain subsides. HWI treatment is described as immersion of the affected area in hot, but not scalding, water to tolerance (upper limit 45 °C) for 30–90 min or until there is significant pain relief. While HWI is an effective therapy for the pain control of marine envenomation, it presents a potential risk of thermal burn injury in the untrained or unsupervised. Here, we present a case of an iatrogenic thermal burn after HWI for the treatment of a weever fish sting.

Case report:

A 16-year-old girl was referred to our outpatient department with a superficial dermal thickness burn to her big toe 12 days after accidental stepping on a lesser weever fish. She reported receiving HWI treatment at the scene of the injury. She was treated with dressing, oral antibiotics and leg elevation. This healed with no sequalae at nine-month follow-up.

Conclusion:

Thermal burn injury can occur after HWI treatment. Providers should be aware and diligent while the patient needs to be educated in the potential risks.

Lay Abstract 5, e, s

Stings from lesser weever fish occur mostly in the summer months. These bottom dweller saltwater fish are found in the Mediterranean and European coasts, over sandy and muddy seabed areas; it releases venom from its dorsal spine when stepped on. Severe pain is the main symptom. Recommended first aid includes wound irrigation, removal of spines if they are visible and immediate hot water immersion (HWI) treatment. HWI means immersion of the affected part into hot, but not scalding, water (upper limit 45 °C) for 30–90 min or until pain is alleviated. In an ideal situation, the water temperature should be checked with a thermometer. However, in practice, where no thermometer is available, the water must be tested before immersion. It is advised to ensure that the water should be no hotter than the first aider can stand or the highest temperature tolerable by the patient. However, HWI treatment has a potential risk of burn injury. Here we describe a case of a 16-year-old patient who sustained burn injury after HWI therapy received after a sting by a weever fish. The patient was treated with dressings and the wound healed without requiring surgical intervention. Here, we like to highlight that although HWI is effective in treating stings from marine animals, both the provider and the patient need to be aware of potential burn injury associated with this treatment.
Work–Life Fit During A Pandemic
Authors: Phillips Jennan A.
Published: September 2020

Occupational health nurses can promote resilience and encourage work–life fit by understanding organizational design and offering mental health and stress management resources.
Patient-Provider Communication and Information, Motivation, and Behavioral Skills in HIV-Positive Adults Initiating Antiretroviral Therapy in Haiti
Authors: Ramaiya Megan K. , Haight Elizabeth , Simoni Jane M. , Chéry Jean Marcxime , Dervis Witson , Genna Wilner , Dubé Jean Géto , Calixte Guirlène , Balan Jean Gabriel , Honoré Jean Guy , Puttkammer Nancy
Published: September 2020

While Haiti has scaled up use of antiretroviral therapy (ART), current studies suggest sub-optimal adherence threatens long-term viral suppression in this understudied setting. Patient-provider communication (PPC) and information, motivation, and behavioral skills (IMB) have been implicated in ART adherence globally. However, no studies have examined their relevance in Haiti. The present mixed-methods study utilized cross-sectional survey data from 128 ART-initiating patients at 2 large HIV treatment sites in Haiti, as well as observational data from 12 clinic visits, to document associations between adherence-related PPC and IMB. Multivariate regression analyses suggested that PPC is associated with IMB constructs. At the bivariate level, more effective PPC was associated with higher levels of adherence-related information and motivation, but not behavioral skills. Observational findings indicate infrequent and non-collaborative adherence support. Taken together, findings lay the groundwork for additional research in the area of PPC, IMB, and ART adherence in Haiti.
Hypothermia in Preterm Newborns: Impact on Survival
Authors: Demtse Asrat G. , Pfister Riccardo E. , Nigussie Assaye K. , McClure Elizabeth M. , Ferede Yirgu G. , Tazu Bonger Zelalem , Mekasha Amha , Demisse Abayneh G. , Gidi Netsanet Workneh , Metaferia Gesit , Worku Bogale , Goldenberg Robert L. , Muhe Lulu M.
Published: September 2020

Background. Globally, prematurity is the leading cause of neonatal mortality, and hypothermia is one of its contributing factors. The goal of this study was to determine the association between hypothermia and mortality. Methods. A prospective, multi-center, descriptive clinical study was conducted in 5 hospitals in Ethiopia. Axillary temperatures were taken at the time of admission to the newborn intensive care units (NICU) and followed during the NICU stay. Results. A total of 3852 premature neonates (<37 weeks) were admitted to the NICUs from July 2016 to May 2018. Of these infants, 1109 (28.8%) died and 2991 (79.6%) had hypothermia. Hypothermia was associated with perinatal asphyxia (89.5%), RDS (86.2%), and resuscitation at birth (82.7%). Admission temperatures in preterm newborns were inversely associated with mortality and morbidity. Conclusion. Hypothermia at admission is associated with neonatal mortality in premature neonates in Ethiopia. RDS and perinatal asphyxia were the main factors associated with hypothermia. The very high prevalence and association with mortality warrants quality improvement interventions.
Human Capital and Harnessing Value in the Digital Realm
Authors: Dey Adhiraj
Published: September 2020

The human capital paradigm for value creation for the future of work, particularly in the digital realm, requires a fundamental reappraisal. The orientation of the traditional employee framework, where the employee is involved with a small part of the project may not work in the future. The challenge for human capital in the future of work is to translate ideas into successful offerings. This requires a shift in the orientation from being a traditional employee to being a risk-embracing micro-producer. It implies a reorientation of the human capital imagination to take ownership of the entire journey from idea to offering.
Harnessing PTEN’s Growth Potential in Neuronal Development and Disease
Authors: Fuchs Joachim , Eickholt Britta J. , Leondaritis George
Published: September 2020

PTEN is a powerful regulator of neuronal growth. It globally suppresses axon extension and branching during both nervous system development and regeneration, by antagonizing growth-promoting PI3K/PI(3,4,5)P3 signaling. We recently identified that the transmembrane protein PRG2/LPPR3 functions as a modulator of PTEN function during axon morphogenesis. Our work demonstrates that through inhibition of PTEN activity, PRG2 stabilizes membrane PI(3,4,5)P3. In turn, PRG2 deficiency attenuates the formation of branches in a PTEN-dependent manner, albeit without affecting the overall growth capacity of extending axons. Thus, PRG2 is poised to temporally and locally relieve growth suppression mediated by PTEN in neurons and, in effect, to redirect growth specifically to axonal branches. In this commentary, we discuss potential implications and unresolved questions regarding the regulation of axonal PTEN in neurons. Given their widespread implication during neuronal development and regeneration, identification of mechanisms that confer spatiotemporal control of PTEN may unveil new approaches to reprogram PI3K signaling in neurodevelopmental disorders and regeneration research.