bluuebunny/crossref_metadata_2025 huggingface dataset:
Changes in perfusion can detect changes in the cardiac index in patients with septic shock
Authors: Lian Hui , Wang Xiaoting , Zhang Qing , Zhang Hongmin , Liu Dawei
Published: August 2020

Objective

The perfusion index (PI) is usually used to assess peripheral perfusion, which can be influenced by the cardiac index (CI). CI monitoring is often needed during the treatment of patients with shock. We investigated the relationship between changes in the PI (ΔPI) and changes in the CI (ΔCI) in patients with septic shock.

Methods

This retrospective study included patients with septic shock who underwent pulse-induced continuous cardiac output monitoring. We measured the CI and PI before and after fluid loading during the first 6 hours of intensive care unit admission. Fluid responsiveness was defined as a ≥10% ΔCI after fluid loading. Other hemodynamic and oxygen-derived parameters were also collected at the exact time of each CI measurement.

Results

Fifty-five patients were included in the study (29 fluid responders, 26 fluid non-responders). In the univariate analysis, ΔPI was positively correlated with ΔCI. In the multivariable analysis, ΔPI was independently associated with ΔCI. The receiver operating characteristic curve showed that ΔPI was an appropriate marker with which to discriminate a CI increase with an area under the curve of 0.776.

Conclusion

This study showed a positive correlation between ΔPI and ΔCI during the early treatment phase of septic shock.
Silencing lncRNA HOXA10-AS decreases cell proliferation of oral cancer and HOXA10-antisense RNA can serve as a novel prognostic predictor
Authors: Yan Xiaodong , Cong Bin , Chen Qinchao , Liu Lingyun , Luan Xidi , Du Jianxin , Cao Meng
Published: August 2020

Objective

Long noncoding (lnc)RNAs regulate multiple biological processes including cancer. Oral squamous cell carcinoma (OSCC) is a common malignancy with poor prognosis. We aimed to identify the function of lncRNA HOXA10 antisense RNA (HOXA10-AS) and its clinical significance.

Methods

We used differential expression analysis to identify aberrantly expressed lncRNAs associated with OSCC. We identified key genes related to HOXA10-AS and their biological functions using bioinformatics tools and functional enrichment analyses. We predicted the function of HOXA10-AS using gene set enrichment and variation analyses and analyzed proliferation markers at the mRNA and protein levels. Finally, we silenced HOXA10-AS using antisense oligonucleotide and assessed proliferation ability using a cell counting kit (CCK8) and clone formation assays.

Results

In total, 506 aberrantly expressed lncRNAs were identified. HOXA10-AS was identified as a risk factor for OSCC and its expression was positively associated with tumor grade. We identified hub genes involved in regulating proliferation and predicted that HOXA10-AS is associated with an active cell cycle and increased proliferation. Silencing HOXA10-AS decreased proliferation in OSCC cell lines.

Conclusions

HOXA10-AS is involved in cell proliferation and silencing it decreases proliferation. Thus, HOXA10-AS could serve as prognostic biomarker and therapeutic target for OSCC.
Increased risk markers in women with polycystic ovary syndrome and gestational diabetes mellitus during mid-pregnancy
Authors: Zhang Liqin , Zhang Lihua , Wang Zhangwei , Zhu Lingling , Wang Hongxing , Chen Honghui , Zhang Haibo
Published: August 2020

Objective

This study aimed to investigate application of the urine albumin-to-creatinine ratio (ACR), serum beta 2-microglobulin (β2-MG), and cystatin C as risk markers in a cohort of women with polycystic ovary syndrome (PCOS) for the incidence of gestational diabetes mellitus (GDM).

Methods

In this cross-sectional study, we analyzed 312 pregnant women with PCOS and classified them as those with and without GDM. For all participants, elbow venous blood and clean middle urine were collected in the morning after 8 hours of an empty stomach.

Results

Logistic regression analysis showed that the ACR, urine β2-MG levels, and serum cystatin C levels were important markers for women with PCOS concomitant with GDM. Receiver operating characteristic curve analysis showed that the area under the curve of CysC was 0.81 with the threshold based on >0.93 and that of β2-MG was 0.72 with the threshold based on >1.25.

Conclusions

Increased levels of β2-MG and cystatin C and a high ACR might be risk factors for Chinese women with PCOS and GDM during mid-pregnancy.
Clinical outcomes and quality of life in patients with acute and subacute type B aortic dissection after thoracic endovascular aortic repair
Authors: Bi Yonghua , Yi Mengfei , Han Xinwei , Ren Jianzhuang
Published: August 2020

Objective

Thoracic endovascular aortic repair (TEVAR) is considered the mini-invasive treatment of choice for patients with Stanford type B aortic dissection (TBAD). This study aimed to investigate the clinical outcomes and quality of life (QoL) in patients with acute and subacute TBAD after TEVAR.

Methods

From January 2014 until July 2016, 22 acute patients (Group A) and 18 subacute patients received TEVAR (Group B), and 13 patients were managed non-operatively (Group C). The Medical Outcomes Study Short Form-36 was used to assess QoL preoperatively and after TEVAR. Operative techniques and complications were retrospectively analyzed.

Results

The role emotion, vitality, and mental health domains scored well preoperatively. Except for role emotion, vitality, and mental health, the remaining domains significantly improved after TEVAR. There was no significant difference in QoL metrics between Groups A and B. In Group C, bodily pain and social functioning domains were improved, and role emotion was decreased, with no improvement in the remaining domains. The 3-year survival rates were 95.5%, 100%, and 85.7% for Groups A, B, and C, respectively.

Conclusions

TEVAR may be safe and effective in patients with acute and subacute TBAD with similar and favorable clinical and QoL metrics.
Challenges and Prospects of the Criminal Justice System in Handling Child Victims and Alleged Offenders in Ethiopia
Authors: Eyasu Nahom , Haile Sisay , Tesfaye Yosef
Published: August 2020

The current study aims to explore the challenges and prospects of the criminal justice system in handling child victims and alleged offenders in Bahir Dar metropolitan city, North West Ethiopia. A qualitative research design was adopted to achieve this goal. Primary data was collected through semi-structured interviews conducted with victimized children ( n = 25) and in-depth interviews conducted with key informants ( n = 15). Data were analyzed using inductive thematic analysis. The general emergent theme— encumbrance and motivation reflected the challenges and opportunities of the criminal justice system in handling child victims and alleged offenders, respectively. The results from the study revealed that the absence of child-friendly police stations, limited overall assessments and psychosocial supports for child victims, slow, tardy and insensitive justice process, and legal system gaps were critical issues at the initial police contact, investigation, and trial stages of the criminal justice system. It appears from this study that the wellbeing and support needs of victims and witnesses are not yet being adequately addressed. In this study, a major challenge identified was the deficit of law enforcement in the criminal justice system as to the detection and investigation of a crime involving child victims. On the other hand, the initiatives to introduce child protection units and child-friendly police stations, provision of support and assistance, and awareness-raising about child-friendly practices among the criminal justice system are the major prospects that have been taken place within the criminal justice system.
Toward a Tailored Model of Youth Justice: A Qualitative Analysis of the Factors Associated with Successful Placement in a Community-Integrated Facility
Authors: Souverein Fleur , Mulder Eva , van Domburg Lieke , Adriaanse Marcia , Popma Arne
Published: August 2020

Community-integrated facilities provide security and care for justice-involved youth, minimizing risks, while allowing youth to build on protective factors within their community. Literature on the specific factors that determine appropriate placement in a community-integrated facility, versus a more restrictive high-security setting, is scarce. Current screening and assessment tools for youth are mostly applied after placement and mainly focus on the reoffending risk. The current paper explored which youth, who would previously have been placed in a high-security setting, could be successfully placed in a less secure community-integrated facility. Through qualitative analysis, based on the perspectives of professionals, youth and parents, the current paper identified six distinct domains to guide appropriate screening and outlines guidelines for policy and practice. These domains include: motivation to comply, short and long-term perspective, current offense context, crime history, safety and support from youth’s network, and mental health and intellectual abilities.
Decomposing Racial and Ethnic Disparities in Nursing Home Quality of Life
Authors: Bowblis John R. , Ng Weiwen , Akosionu Odichinma , Shippee Tetyana P.
Published: August 2020

This study examines the racial/ethnic disparity among nursing home (NH) residents using a self-reported, validated measure of quality of life (QoL) among long-stay residents in Minnesota. Blinder–Oaxaca decomposition techniques determine which resident and facility factors are the potential sources of the racial/ethnic disparities in QoL. Black, Indigenous, and other People of Color (BIPOC) report lower QoL than White residents. Facility structural characteristics and being a NH with a high proportion of residents who are BIPOC are the factors that have the largest explanatory share of the disparity. Modifiable characteristics like staffing levels explain a small share of the disparity. To improve the QoL of BIPOC NH residents, efforts need to focus on addressing systemic disparities for NHs with a high proportion of residents who are BIPOC.
Analyzing open government policy adoption through the multiple streams framework: The roles of policy entrepreneurs in the case of Madrid
Authors: Ruvalcaba-Gomez Edgar A , Criado J Ignacio , Gil-Garcia J Ramon
Published: August 2020

Open government is expected to promote important changes related to transparency, participation, and collaboration in the public sector. This article analyzes the open government policy-making process in Madrid. In order to explain the adoption process of open government as a public policy, this study uses the “multiple streams framework,” originally developed by Kingdon and recently elaborated on by Zahariadis and Herweg et al. Our empirical data, based on semi-structured interviews and qualitative and quantitative analysis provide evidence about the adoption of open government policy in the city of Madrid and help to illustrate some of the multiple roles that policy entrepreneurs play in the policy adoption process. Overall, this article offers insights on how and why open government is adopted into the public agenda of local governments. Also, this article highlights the importance of analyzing the roles of “policy entrepreneurs” and the duality of transparency and citizen participation in open government policies.
Neurotoxicity in pre-eclampsia involves oxidative injury, exacerbated cholinergic activity and impaired proteolytic and purinergic activities in cortex and cerebellum
Authors: Ijomone OK , Erukainure OL , Shallie P , Naicker T
Published: August 2020

Women with a history of pre-eclampsia (PE) tend to have a higher risk of developing cardiovascular and neurological diseases later in life. Imbalance in oxidative markers and purinergic enzymes have been implicated in the pathogenesis of neurological disease. This study investigated the effect of PE on oxidative imbalance, purinergic enzyme inhibitory activity, acetylcholinesterase and chymotrypsin activities in the brain of PE rat model at post-partum/post-natal day (PP/PND) 60. Pregnant rats divided into early-onset and late-onset groups were administered with Nω-nitro-l-arginine methyl through drinking water at gestational days 8–17. Rats were allowed free access to water throughout the pregnancy and allowed to deliver on their own. The mother and the pups were euthanized at PP and PND 60, respectively, the cortex and the cerebellum excised, homogenized and stored for analyses of the enzymes. Results showed an increase in nitric oxide and malondialdehyde with a concomitant decrease in reduced glutathione and superoxide dismutase, an indication of oxidative damage. Also, there was an increase in acetylcholinesterase activity with a decrease in chymotrypsin, adenylpyrophosphatase and ecto-nucleoside triphosphate diphosphohydrolase activities in both the cortex and the cerebellum of the mother and the pups at PND 60. These results indicate the involvement of oxidative stress, increased cholinergic activity and depleted proteolytic and purinergic activities in PE-induced neurotoxicity.
Processes and Experiences of Creative Cognition in Seven Western Classical Composers
Authors: Schiavio Andrea , Moran Nikki , van der Schyff Dylan , Biasutti Michele , Parncutt Richard
Published: August 2020

In a qualitative study, we explored the range of reflections and experiences involved in the composition of score-based music by administering a 15-item, open-ended, questionnaire to seven professional composers from Europe and North America. Adopting a grounded theory approach, we organized six different codes emerging from our data into two higher-order categories ( the act of composing and establishing relationships). Our content analysis, inspired by the theoretical resources of 4E cognitive science, points to three overlapping characteristics of creative cognition in music composition: it is largely exploratory, it is grounded in bodily experience, and it emerges from the recursive dialogue of agents and their environment. More generally, such preliminary findings suggest that musical creativity may be advantageously understood as a process of constant adaptation – one in which composers enact their musical styles and identities by exploring novel interactivities hidden in their contingent and historical milieux.
Benchmarking to reduce restrictive practices in forensic mental health services: a Delphi study
Authors: Maguire Tessa , Ryan Jo , McKenna Brian
Published: August 2020

Objectives:

Forensic mental health services (FMHS) have higher rates, duration and frequency of restrictive practices (seclusion, physical restraint and mechanical restraint). Data generated by services can be used to set targets (benchmarks) with like services to reduce or eliminate restrictive practices. The aim of this study was to develop restrictive practice benchmarks for Australian and New Zealand FMHS.

Method:

A participatory action research methodology was used by conducting a Delphi study. FMHS experts provided de-identified service-specific restrictive practice data, which was used to stimulate reflection towards the development of restrictive practice benchmarks.

Results:

Consensus decision-making was reached on benchmarks for the rate, duration and frequency of seclusion and physical restraint. Mechanical restraint was found to be a rare event, requiring event specific review in each service.

Conclusions:

Benchmarking with FMHS may assist in working to reduce restrictive practices and encourage the scrutiny of service practice. Establishment of a FMHS network might assist to embed the proposed benchmarks.
Flattening the curve of COVID-19 for medical education in psychiatry and addiction medicine
Authors: Looi Jeffrey CL , Bonner Daniel , Maguire Paul , Finlay Angus , Keightley Philip , Parige Raj , Tedeschi Michael , Reay Rebecca , Davis Soo-Leng
Published: August 2020

Objective:

To describe the context, challenges and responses to COVID-19 public health measures for medical education in psychiatry, with an emphasis on sharing strategies for ongoing COVID-19 challenges.

Conclusion:

The rapidity of COVID-19 public health measures instituted in Australia required swift action for medical education to address lockdowns of student clinical placements. The responses included a transition to interim online learning followed by a return to truncated clinical placements renegotiated to conform to public health measures. Adjustment of formative and summative assessment has been necessary. However, further contingencies may emerge depending upon the overall progress of the COVID-19 pandemic.
COVID-19 and the mental well-being of Australian medical students: impact, concerns and coping strategies used
Authors: Lyons Zaza , Wilcox Helen , Leung Lianne , Dearsley Oliver
Published: August 2020

Objective:

Medical students are vulnerable to poor mental well-being. The recent COVID-19 pandemic has disrupted student life and had significant effects on curricula delivery at medical schools around Australia. The study aimed to assess the impact of COVID-19 on medical student mental well-being, assess concerns and determine activities used by students to help with the situation.

Method:

An online cross-sectional survey was designed. Questions focused on concerns and impact of COVID-19. The Kessler-10 (K10) measured psychological distress.

Results:

Two hundred and ninety-seven students participated with a 37.5% response rate. Mean K10 score was 20.6 indicating moderate psychological distress. There were no significant differences in K10 mean score or distress level (low, moderate, high, very high) between students in different years of the medical course. Deterioration in mental well-being since COVID-19 onset was reported by 68% students. Main negative impacts were on social connectedness, studies and stress levels. Concerns related to uncertainty about returning to normal and graduation. Common activities were using video chats, social media, exercise and hobbies.

Conclusions:

The impact of COVID-19 on mental well-being has led to legitimate concerns by students regarding their studies and progress through the medical course. We hope to minimise these disruptions, and reassure and support students to ensure that academic goals are achieved.
Dynamic analysis of magneto-electro-elastic nanostructures using node-based smoothed radial point interpolation method combined with micromechanics-based asymptotic homogenization technique
Authors: Zhou Liming , Nie Bin , Ren Chuanxin , Ren Shuhui , Meng Guangwei
Published: August 2020

The node-based smoothed radial point interpolation method combined with the asymptotic homogenization method was proposed, as an addition to the finite element method, to address the static and dynamic reactions of magneto-electro-elastic coupling micromechanical problems. First, several basic equations for relevant problems were derived. Second, asymptotic homogenization method was utilized to determine the material properties of magneto-electro-elastic nanomaterials. Third, node-based smoothed radial point interpolation method was applied to obtain the discrete equations of magneto-electro-elastic nanostructures. Then, the Newmark method was introduced to solve the response of microcosmic problems. Finally, several numerical examples were calculated to prove the accuracy, convergence, and reliability of node-based smoothed radial point interpolation method by comparing the results of node-based smoothed radial point interpolation method with those of finite element method.
Simulation-Based Research: A Scoping Review
Authors: Vemuri Sidharth , Hynson Jenny , Gillam Lynn , Williams Katrina
Published: August 2020

There is an increasing interest in using simulation in qualitative research outside evaluation of educational-based activities. To examine how data from simulation has been generated and used in qualitative research, we conducted a scoping review of research topics and data collection and analysis processes reported in qualitative research using simulation in the research method. Of the 665 articles that involved qualitative inquiry, 46 involved simulation in research independent from simulation-based education. Phenomena explored included communication and clinical decision-making during routine care and at highly sensitive times, such as the end of life, as well as the experiences when providing care in a variety of settings and patients, individually and within teams. Our findings highlight that simulation can be used for analysis of phenomena that are difficult for researchers to gain access to firsthand, and we discuss features for consideration when using simulation in qualitative health research.
Is Taping Alone an Efficient Presurgical Infant Orthopedic Approach in Infants With Unilateral Cleft Lip and Palate? A Randomized Controlled Trial
Authors: Abd El-Ghafour Mohamed , Aboulhassan Mamdouh A. , El-Beialy Amr Ragab , Fayed Mona M. Salah , Eid Faten Hussein Kamel , El-Gendi Mahmoud , Emara Dawlat
Published: August 2020

Objective:

The aim of the current randomized controlled trial (RCT) was to assess the effectiveness of taping alone in changing the maxillary arch dimensions (MADs) in infants with unilateral complete cleft lip and palate (UCLP) before surgical lip repair.

Design:

A prospective, balanced, randomized, parallel-group, single-blinded, controlled trial.

Setting:

All the steps of the current study were carried in the Department of Orthodontics, Cairo University in Egypt.

Participants:

Thirty-one, nonsyndromic infants with UCLP.

Interventions:

The eligible infants were randomly assigned to either no-treatment (control) or taping groups. In the taping group, all the infants received horizontal tape between the 2 labial segments aiming to decrease the cleft gap. No other interventions were performed to infants included in this group. Rubber base impressions were made to all the included infants in both groups at the beginning of the treatment (T1) and directly before surgical lip repair (T2). All the produced models were scanned using a desktop scanner producing digital models for outcome assessment.

Main Outcomes Measures:

A blinded assessor carried out all the MAD measurements virtually on the produced digital models at the beginning (T1) and after (T2) treatment.

Results:

Clinically and/or statistically significant changes in all the measured MADs were recorded in the taping group at T2 before surgical lip repair in comparison to the control group.

Conclusions:

It seems that taping alone is an efficient tool in changing the MADs before surgical lip repair in infants with UCLP.
The effect of contextual interference on the learning of adapted sailing for people with spinal cord injury
Authors: Menayo Ruperto , Egea María Felicia , Manzanares Aarón , Segado Francisco
Published: August 2020

The aim of this study was to determine the effect of contextual interference on learning of adapted sailing for people with spinal cord injury. Seven participants with traumatic spinal injury were selected to undergo learning in an adapted boat equipped with wind-measuring instrument. A learning program, defined by two conditions, (1) blocked practice and (2) random practice, was applied. In blocked schedule, fixed sequence of two maneuvers consist of tacking on a close-hauled course (45°–55°) and gybing on a broad reaching course (135°–145°). In random schedule, the same maneuvers were carried out randomly. Eight 30-min practice sessions were carried out over a period of 2 weeks, in 3 days per week. Velocity Made Good was analyzed in the familiarization test, pre-test, post-test, and retention test. The learning program was effective in both random and blocked practice conditions on all participants. However, there is an evident variability in the results. This study demonstrates the suitability of applying contextual interference to facilitate the learning of adapted sailing. The variability of the results could be related to the heterogeneity of the participants and suggests the need for further research that can provide information about how restricted mobility affects the learning process.
Outcomes of Medication Misadventure Among People With Cognitive Impairment or Dementia: A Systematic Review and Meta-analysis
Authors: Zaidi Anum Saqib , Peterson Gregory M. , Bereznicki Luke R.E. , Curtain Colin M. , Salahudeen Mohammed
Published: August 2020

Objective:

To investigate mortality and hospitalization outcomes associated with medication misadventure (including medication errors [MEs], such as the use of potentially inappropriate medications [PIMs], and adverse drug events [ADEs]) among people with cognitive impairment or dementia.

Data Sources:

Ovid MEDLINE, Ovid EMBASE, Ovid International Pharmaceutical Abstracts, Cumulative Index to Nursing and Allied Health Literature, and Cochrane Central Register of Controlled Trials were searched from inception to December 2019.

Study Selection and Data Extraction:

Relevant studies using any study design were included. Reviewers independently performed critical appraisal and extracted relevant data.

Data Synthesis:

The systematic review included 10 studies that reported the outcomes of mortality or hospitalization associated with medication misadventure, including PIMs (n=5), ADEs (n=2), a combination of MEs and ADEs (n=2), and drug interactions (n=1). Five studies examining the association between PIMs and mortality/hospitalization were included in the meta-analyses. Exposure to PIMs was not associated with either mortality (odds ratio [OR]=1.36; 95%CI=0.79-2.35) or hospitalization (OR=1.02; 95%CI=0.83-1.26). In contrast, single studies indicated that ADEs with cholinesterase inhibitors were associated with mortality and hospitalization.

Relevance to Patient Care and Clinical Practice:

Individuals with cognitive impairment or dementia are at increased risk of medication misadventure; based on relatively limited published data, this does not necessarily translate to increased mortality and hospitalization.

Conclusions:

Overall, medication misadventure was not associated with mortality or hospitalization in people with cognitive impairment or dementia, noting the limited number of studies, difficulty in controlling potential confounding variables, and that most studies focus on PIMs.
Small Cell Carcinoma of the Ovary: Clinicopathologic and Immunohistochemical Analysis of 7 New Cases of a Rare Malignancy
Authors: Gupta Parikshaa , Kapatia Gargi , Gupta Nalini , Dey Pranab , Rohilla Manish , Gupta Ankita , Rai Bhavana , Suri Vanita , Rajwanshi Arvind , Srinivasan Radhika
Published: August 2020

Background

Small cell carcinoma of ovary (SCCO) is extremely rare. Two types of SCCO are recognized, the pulmonary type (SCCOPT) and the hypercalcemic type (SCCOHT). Establishing an accurate diagnosis is challenging, owing to its rarity and paucity of data describing the distinctive histopathologic and immunohistochemical (IHC) features.

Methods

This was a retrospective study conducted over a period of 4 years. All cases reported as SCCO on histopathology were retrieved. All the available clinical, histopathological, and IHC features were studied in detail.

Results

A total of 7 cases of SCCO were diagnosed during the study period. There were 4 cases of SCCOPT and 3 cases of SCCOHT and with mean age of 57.25 and 22 years, respectively. All the cases presented as stage IV disease. Among the SCCOPT cases, 3 showed bilateral involvement with 1 showing concurrent uterine endometrioid adenocarcinoma. Microscopy revealed small hyperchromatic cells with brisk mitosis and multifocal necrosis. On IHC, these were consistently positive for chromogranin, CD56, and synaptophysin. All the SCCOHT cases showed unilateral involvement. Microscopically, in addition to small hyperchromatic cells, larger “rhabdoid” tumor cells were also seen. On IHC, chromogranin was negative, with positivity for vimentin and epithelial membrane antigen. The expression of SMARCA4/BRG1 was lost while SMARCB1/INI1 was retained in all cases. All of these patients developed recurrence and died due to disease progression despite treatment.

Conclusions

SCCO is an extremely infrequent ovarian malignancy with poor prognosis. Knowledge about its characteristic features is important for accurate tissue diagnosis and appropriate management.
Commentary
Authors: Hendry Petra
Published: August 2020

In this article, the author offers a commentary on papers in the special issue on “Embodying Narrative: Diffractive Readings of Ethical Relationality in Qualitative Inquiry.”
Bullous pemphigoid in elderly woman affected by non-small cell lung cancer treated with pembrolizumab: A case report and review of literature
Authors: Cosimati Antonella , Rossi Luigi , Didona Dario , Forcella Chiara , Didona Biagio
Published: August 2020

Introduction

Immunotherapy has changed the management of patients with various types of malignancies (melanoma, renal, lung, and bladder cancers) but immune checkpoint inhibitors may be associated with several adverse events. Up to 20% of patients treated with immune checkpoint inhibitors may develop dermatological immune-related adverse events, mostly rashes and pruritus but rarely even bullous pemphigoid.

Case report

We report a case of an elderly patient with advanced non-small cell lung cancer in therapy with pembrolizumab, 200 mg/body every three weeks. After 26 cycles of therapy, the patient developed widespread itching and then after 28 cycles she developed strained blisters filled with serous fluids on predominantly erythematous skin with suspicious of bullous pemphigoid. Management and outcome: Skin biopsy confirms bullous pemphigoid, so we decided to permanently discontinue therapy with pembrolizumab and the patient is currently on therapy with doxycycline, nicotinamide, and clobetasol propionate with good regression of symptoms and cutaneous lesions.

Discussion

In the literature, the first case of bullous pemphigoid induced by pembrolizumab has been described in 2015. On Pubmed, from 2015 to date, we have found 19 cases of bullous pemphigoid during pembrolizumab therapy but only three of them are related to non-small cell lung cancer, adding our patient we reach a total of 20 cases. It could be interesting to investigate if there is a specific relationship between the appearance of itching and the development of bullous pemphigoid.
Efficacy and safety of intravitreal dexamethasone implant in treatment naïve eyes with diabetic macular edema: Real world experience
Authors: Ratra Dhanashree , Sharma Unnati , Dalan Daleena
Published: August 2020

Purpose:

To evaluate the efficacy and safety of intravitreal dexamethasone implant in treatment naïve eyes with diabetic macular edema (DME).

Methods:

A retrospective analysis of treatment naïve eyes with DME which received intravitreal dexamethasone implant between January 2016 and March 2018 was done. Demographic details of the patients, ocular examination findings at baseline and on follow up visits were noted. Morphological features of DME and central macular thickness were noted on optical coherence tomography at each visit. The details regarding additional treatment for macular edema on follow up were noted.

Results:

Sixty five eyes were included in the study. The mean age was 59.14 ± 9.59 years. The follow up ranged from 6 to 48 months. Psuedophakic eyes showed visual improvement whereas the phakic eyes showed stable vision. The central foveal thickness showed significant reduction ( p = 0.05) in all the eyes. The best corrected visual acuity at final follow up (+0.65 logMAR) was slightly less as compared to baseline (+0.62 logMAR). Retreatment was needed in 37% eyes and antiglaucoma medications in 8% eyes. Cataract progression was noted in 24 eyes (37%); 17 eyes (26.1%) underwent surgery. Notably, 27 eyes (41.5%) had some degree of macular ischemia at baseline. And five eyes (7.7%) showed progression of retinopathy leading to vitreous hemorrhage.

Conclusion:

Dexamethasone implant is helpful in reducing the macular thickness and stabilizing the vision in treatment naïve DME; requiring less number of treatment sessions. However, it does not prevent progression of diabetic retinopathy. The visual improvement may be affected by cataract and macular ischemia.
The safety of bovine tissue arterial repair in removal of infected prosthetic hemodialysis grafts
Authors: Sowa Patrick , Halandras Peggie , Blecha Matthew
Published: August 2020

Background:

More than 400,000 Americans require dialysis, and many receive it via a prosthetic arteriovenous graft. Infection of these grafts is rare, but associated with significant morbidity and mortality. The gold standard is total graft excision with arteriotomy closure. This was previously done with autologous vein, but bovine tissue offers a reasonable alternative. The objective of this article is to evaluate a community hospital experience with bovine tissue arterial repair after total graft excision of infected prosthetic arteriovenous graft.

Methods:

A retrospective review was performed of all cases of infected prosthetic arteriovenous graft removal with bovine tissue arterial repair was performed. Thirteen cases were identified. Presentation, location of graft, and causative organism were reviewed; outcomes including reoperation and mortality were recorded.

Results:

Of the 13 patients, 12 (92%) had positive cultures of the graft, bloodstream, or wound. Methicillin-resistant Staphylococcus aureus was the most commonly isolated organism (54%). There were two unplanned reoperations including hematoma drainage and wound debridement within the first year. Over the 1-year follow-up period, 1 patient died for a mortality of 8%. There were no re-infections during follow-up.

Discussion:

Prosthetic arteriovenous graft infection remains a difficult challenge and is associated with significant morbidity and mortality. It presents in a variety of ways, including within an old thrombosed graft. Over the last several years, the causative organism has increasingly become drug resistant. Treatment with total graft excision requires arteriotomy closure, and for this bovine tissue has been demonstrated to be a viable option.
Multiple sclerosis management during the COVID-19 pandemic
Authors: Moss Brandon P , Mahajan Kedar R , Bermel Robert A , Hellisz Kelsey , Hua Le H , Hudec Timothy , Husak Scott , McGinley Marisa P , Ontaneda Daniel , Wang Zhini , Weber Malory , Tagliani Paula , Cárdenas-Robledo Simón , Zabalza Ana , Arrambide Georgina , Carbonell-Mirabent Pere , Rodríguez-Barranco Marta , Sastre-Garriga Jaume , Tintore Mar , Montalban Xavier , Douglas Morgan , Ogbuokiri Esther , Aravidis Berna , Cohen Jeffrey A , Mowry Ellen M , Fitzgerald Kathryn C
Published: August 2020

Background:

People with multiple sclerosis (MS) may be at higher risk for complications from the 2019 coronavirus (COVID-19) pandemic due to use of immunomodulatory disease modifying therapies (DMTs) and greater need for medical services.

Objectives:

To evaluate risk factors for COVID-19 susceptibility and describe the pandemic’s impact on healthcare delivery.

Methods:

Surveys sent to MS patients at Cleveland Clinic, Johns Hopkins, and Vall d’Hebron-Centre d’Esclerosi Múltiple de Catalunya in April and May 2020 collected information about comorbidities, DMTs, exposures, COVID-19 testing/outcomes, health behaviors, and disruptions to MS care.

Results:

There were 3028/10,816 responders. Suspected or confirmed COVID-19 cases were more likely to have a known COVID-19 contact (odds ratio (OR): 4.38; 95% confidence interval (CI): 1.04, 18.54). In multivariable-adjusted models, people who were younger, had to work on site, had a lower education level, and resided in socioeconomically disadvantaged areas were less likely to follow social distancing guidelines. 4.4% reported changes to therapy plans, primarily delays in infusions, and 15.5% a disruption to rehabilitative services.

Conclusion:

Younger people with lower socioeconomic status required to work on site may be at higher exposure risk and are potential targets for educational intervention and work restrictions to limit exposure. Providers should be mindful of potential infusion delays and MS care disruption.
The exhaustion of the herding effect in peer-to-peer accommodation
Authors: Benítez-Aurioles Beatriz
Published: August 2020

A significant reason for the concentration of demand in a subset of the supply in the peer-to-peer market for tourist accommodation is herding behavior, by which the decisions of the first guests are imitated by those who follow. This article proposes a profit- and utility-maximization microeconomic model and implements it with data of Airbnb listings corresponding to 10 European cities. Results show that the influence of each additional review is positive but decreasing, inducing a more balanced distribution of demand among offered accommodation and thus dampening the herding effect. Moreover, reservation policy—specifically, enabling the instant booking option—is a key to explain the initial push that accommodations need to be demanded now and, hence, to increase their possibilities of being demanded in the future.
Benefits of a support programme for family caregivers of patients at the end of life: A randomised controlled trial
Authors: Soto-Rubio Ana Lucila , Valero-Moreno Selene , Pérez-Marín Marián
Published: August 2020

This study aims to analyse the impact that a psychological intervention programme has on the emotional state of family caregivers of patients at the end of life. The study is longitudinal with two arms (control and experimental). Data was collected from 154 primary family caregivers of patients at the end of life as well as from their respective 154 care-recipients. The intervention programme has shown its effectiveness in reducing anxiety, emotional distress and burden in the family caregivers of end-of-life patients. A reduction of anxiety of patients whose family caregivers participated in the intervention was also observed.
Digital media and the affective economies of transnational families
Authors: Wilding Raelene , Baldassar Loretta , Gamage Shashini , Worrell Shane , Mohamud Samiro
Published: August 2020

Digital media are widely recognised as essential to the maintenance of transnational families. To date, most accounts have focused on the role of digital media practices as producing and sustaining transnational relationships, through, for example, the practices of ‘digital kinning’. In this article, we extend that body of work by drawing attention to the specific role of the emotions that are circulated through digital media interactions and practices. We use data from ethnographic interviews with older migrant adults to consider how people who fled civil wars and resettled in Australia bridge the distances between ‘here’ and ‘there’. Our analysis draws attention to the circulation of affect, arguing that it is the capacity of digital media to circulate emotions and support affective economies that gives substance to and defines the surfaces and boundaries of transnational families, and constitutes the mutuality of being that underpins familyhood at a distance.
(Be)Longing through visual narrative: Mediation of (dis)affect and formation of politics through photographs and narratives of migration at DiasporaTürk
Authors: Gencel Bek Mine , Prieto Blanco Patricia
Published: August 2020

Our article explores how diasporic journeys and identities are remembered and represented through the visual narratives of DiasporaTürk, a Turkish diasporic media presence consisting of a Twitter account, an Instagram page, and two books. These engagements revive past (dis)affects and highlight the contemporary relevance of nostalgia, sorrow and victimization as key themes in the migration experience of ‘guest-workers’ from Turkey. The evidentiary force of the index, inhabiting fictional characters while looking like factual and archival material, seems thus to both acknowledge and validate migrated ‘guest-workers’, who, as subaltern groups, have otherwise received little praise or recognition in Turkey or ‘host’ countries. At the same time, while converging past and present (dis)affects associated with Turkish migration, DiasporaTürk contributes to reaffirming the reduction and homogenization of official/normative collective memories of migration via concrete visibilities/presences and invisibilities/absences.
Emotional practices of unaccompanied refugee youth on social media
Authors: Neag Annamária , Supa Markéta
Published: August 2020

Migration for unaccompanied refugee youth is an emotionally complex process involving mediated experiences and expressions of emotions and affect. This article draws upon social media ethnography conducted with young refugees from African and Middle Eastern countries living in Europe. The participants’ emotional practices were explored through the multimodal analysis of content they shared on Facebook. The findings highlight how the young refugees performed multifaceted yet interconnected emotional practices. These emotional practices potentially assisted their negotiation of emotional losses and gains resulting from migration. The online mediated emotionality, however, cannot be fully comprehended through the reductionist lenses of binary oppositions such as losses and gains, presence and absence, or positive and negative emotions. This article shows that unaccompanied refugee youth’s experience and expression of emotions online are influenced by more than their migration experience, and that their interconnected nature and complexity need to be considered.
The illusion of universality: The use of Nordic population registers in studies of migration, employment and health
Authors: Gauffin Karl
Published: August 2020

Aims: Nordic register material is often considered to be a gold standard for studies of social epidemiology and population health, but it comes with certain limitations. This short communication aims to draw attention to lacking coverage as a potentially growing problem of Nordic register material. Methods: The article is based on a short review of previous studies and commentaries on the strengths and limitations of Nordic register data with a particular focus on studies of employment and migration. Results: In times of institutional and demographic change in the Nordic countries, the assumption of universal register coverage can be challenged. Precarious and informal employment arrangements, important social determinants of health, provide a good illustration of the problem. Work that is carried out in the semi-legal margins of the labour market, sometimes by a ‘hidden population’ of non-resident, short-term labour immigrants, will not be covered by the registers. Researchers may therefore run the risk of misrepresenting reality if they maintain the belief that population registers cover the entire population. Conclusions: The Nordic registers are an extraordinary resource for public health researchers, but continuous quality control and assessment of validity and completeness will be crucial to maintain relevance in a transitioning society.
Police subcultural influences on the transfer of training
Authors: Dulin Adam , Dulin Linda
Published: August 2020

This research assessed subcultural impacts on police motivation to learn and transfer new knowledge to the field by deploying a novel survey instrument, the Police Learning Environment Inventory (PLEI). Surveys were issued to 119 police officers in the southwest and northeast regions of the U.S. Subsequent statistical analyses, employing Ridge and Lasso regression, revealed that various dimensions of police subculture can impact police motivation to learn and apply new knowledge. However, two such dimensions, Innovation and Bureaucratic, were significant in all the statistical modelling. Innovation displayed a consistent and positive relationship with respondent motivation to learn and transfer training. Conversely, the Bureaucratic dimension was negatively associated with this motivation.
Expectations for ‘natural’ ways of talking: A context-dependent perspective on fixedness in conversation
Authors: Kaneyasu Michiko
Published: August 2020

This article aims to expand the concept of fixedness in language from stable autonomous structures to socially shared patterns of communication. The study examined conversational utterances that sounded strange or ‘unnatural’ to members of a speech community and explored the reasons behind such intuitive perceptions. Some of these utterances contradicted the community members’ expectations based on sedimented patterns of linguistic resources of various sizes and associated conventional meanings beyond dictionary definitions (i.e. cognitive frame). Others challenged their expectations concerning positional fitness and socio-relational concerns (i.e. interactional frame). The observed expectations for sedimented patterns of communication likely result from a lifetime of experience talking and hearing about the world around them in ways that are accepted by other members of the speech community. The dynamic perspective on fixedness is particularly meaningful for context-dependent languages like Japanese that rely heavily on unexpressed shared knowledge in co-constructing meanings and actions.
Defect size estimation in rolling element bearings with angled leading and trailing edges
Authors: Larizza Francesco , Howard Carl Q , Grainger Steven
Published: August 2020

Rolling element bearings eventually become worn and develop surface defects, such as spalls, dents, and pits. Previous researchers have used bearings with defects that have sharp [Formula: see text] rectangular edges to develop methods for the estimation of the size of a defect. However, these idealized rectangular defects do not occur in the real world, they are in fact sloped. Tests on bearings with sloped edges on the entry and exit of the defect exhibited similar vibration characteristics as bearing with sharp 90° edges. A new defect size estimation method was developed to improve the accuracy in estimating the size of a defect that has sloping leading and trailing edges. A large dataset was obtained and has been made publicly available.
Evolution of wireless sensor network design from technology centric to user centric: An architectural perspective
Authors: Singh Akhilendra Pratap , Luhach Ashish Kr , Gao Xiao-Zhi , Kumar Sandeep , Roy Diptendu Sinha
Published: August 2020

Wireless sensor networks form the crux of a wide range of automated applications that are gaining popularity with every passing day. The journey of wireless sensor networks has seen simple sensory monitoring to sensing-processing-actuation based end-to-end applications to the design and deployment of highly sophisticated service-oriented use cases. This highly disruptive field has seen rapid transformations to gain insights and assess the relative merits. Demerits of competing design strategies, it very important to know the evolutionary milestones this technology has undergone in achieving the state-of-the-art in this area. In this article, a systematic review is carried out that captures the evolution of architectural designs and developments in wireless sensor network–based applications. This review delves into the relative pros and cons of various epochs in developments and delineates the future areas of research in wireless sensor network design paradigm.