bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Traditional Upper Airway Surgery and Upper Airway Stimulation for Obstructive Sleep Apnea
Authors: Huntley Colin , Boon Maurits , Tschopp Samuel , Tschopp Kurt , Jenks Carolyn M , Thaler Erica , Baptista Jardin Peter , Shah Janki , Kominsky Alan , Kezirian Eric J , Heiser Clemens , Waxman Jonathan , Lin Ho-Sheng
Published: August 2020

Objective:

To compare patients with moderate-severe obstructive sleep apnea (OSA) undergoing traditional single and multilevel sleep surgery to those undergoing upper airway stimulation (UAS).

Study Design:

Case control study comparing retrospective cohort of patients undergoing traditional sleep surgery to patients undergoing UAS enrolled in the ADHERE registry.

Setting:

8 multinational academic medical centers.

Subjects and Methods:

233 patients undergoing prior single or multilevel traditional sleep surgery and meeting study inclusion criteria were compared to 465 patients from the ADHERE registry who underwent UAS. We compared preoperative and postoperative demographic, quality of life, and polysomnographic data. We also evaluated treatment response rates.

Results:

The pre and postoperative apnea hypopnea index (AHI) was 33.5 and 15 in the traditional sleep surgery group and 32 and 10 in the UAS group. The postoperative AHI in the UAS group was significantly lower. The pre and postoperative Epworth sleepiness scores (ESS) were 12 and 6 in both the traditional sleep surgery and UAS groups. Subgroup analysis evaluated those patients undergoing single level palate and multilevel palate and tongue base traditional sleep surgeries. The UAS group had a significantly lower postoperive AHI than both traditional sleep surgery subgroups. The UAS group had a higher percentage of patients reaching surgical success, defined as a postoperative AHI <20 with a 50% reduction from preoperative severity.

Conclusion:

UAS offers significantly better control of AHI severity than traditional sleep surgery. Quality life improvements were similar between groups.
Maternal Oral Health Influences Infant Salivary Microbiome
Authors: Ramadugu K. , Bhaumik D. , Luo T. , Gicquelais R.E. , Lee K.H. , Stafford E.B. , Marrs C.F. , Neiswanger K. , McNeil D.W. , Marazita M.L. , Foxman B.
Published: August 2020

Oral microbiomes vary in cariogenic potential; these differences may be established early in life. A major concern is whether mothers transmit cariogenic bacteria to their children. Here we characterize early salivary microbiome development and the potential associations of that development with route of delivery, breastfeeding, and mother’s oral health, and we evaluate transmission of microbes between mother and child. We analyzed saliva and metadata from the Center for Oral Health Research in Appalachia. For this cohort study, we sequenced the V6 region of the 16S rRNA gene and used quantitative polymerase chain reaction to detect Streptococcus mitis, Streptococcus sobrinus, Streptococcus mutans, Streptococcus oralis, and Candida albicans in the saliva from mothers and their infants, collected at 2, 9, and 12 mo (Pennsylvania site) and 2, 12, and 24 mo (West Virginia site). Breastfed children had lower relative abundances of Prevotella and Veillonella. If mothers had decayed, missing, or filled teeth, children had greater abundances of Veillonella and Actinomyces. There was little evidence of maternal transmission of selected microbes. At 12 mo, children’s microbiomes were more similar to other children’s than to their mothers’. Infants’ salivary microbiomes became more adult-like with age but still differed with mothers’ microbiomes at 12 mo. There was little evidence supporting transmission of selected microbes from mothers to children, but risk of colonization was associated with tooth emergence. Children are likely to acquire cariogenic bacteria from a variety of sources, including foods and contact with other children and adults.
“When My Mother Died, I Think a Part of Me Died:” Maternal Fusion and the Relationship between Incarcerated Men and Their Mothers
Authors: Umamaheswar Janani
Published: August 2020

Drawing on theoretical literature on the mothering discourse, I explore how incarcerated men give meaning to their relationships with their mothers. Using 24 in-depth interviews with incarcerated adult men, I argue that adherence to the mothering discourse results in sons holding their mothers’ maternal practices to impossibly high standards while simultaneously feeling obligated to reconcile with their mothers even when doing so is tremendously difficult. I also advance the concept of “maternal fusion”—the process through which the identities of mothers and their children are intertwined—to examine how incarcerated adult sons reproduce gendered mothering ideologies in their narratives of (a) negative early childhood and adolescent relationships with their mothers and (b) reconciliation as they reflect on their relationships with their mothers as adult sons.
Anti-Xa versus time-guided anticoagulation strategies in extracorporeal membrane oxygenation: a systematic review and meta-analysis
Authors: Willems Ariane , Roeleveld Peter P , Labarinas Sonia , Cyrus John W , Muszynski Jennifer A , Nellis Marianne E , Karam Oliver
Published: August 2020

The purpose was to compare time-based vs anti-Xa-based anticoagulation strategies in patients on ECMO. We conducted a systematic review and meta-analysis using multiple electronic databases and included studies from inception to July 19, 2019. The proportion of bleeding, thrombosis, and mortality were evaluated.

Twenty-six studies (2,086 patients) were included. Bleeding occurred in 34.2% (95%CI 25.1;43.9) of the patients with anti-Xa-based versus 41.6% (95%CI 24.9;59.4) of the patients with time-based anticoagulation strategies. Thrombosis occurred in 32.6% (95%CI 19.1;47.7) of the patients with anti-Xa-based versus 38.4% (95%CI 22.2;56.1) of the patients with time-based anticoagulation strategies. And mortality rate was 35.4% (95%CI 28.9;42.1) of the patients with anti-Xa-based versus 42.9% (95%CI 36.9;48.9) of the patients with time-based anticoagulation strategies. Among the seven studies providing results from both anticoagulation strategies, significantly fewer bleeding events occurred in the anti-Xa-based anticoagulation strategy (adjusted OR 0.49 (95%CI 0.32;0.74), p < 0.001) and a significantly lower mortality rate (adjusted OR 0.61 (95%CI 0.40;0.95), p = 0.03). There was no significant difference in thrombotic events (adjusted OR 0.91 (95%CI 0.56;1.49), p = 0.71). In these seven observational studies, only a small fraction of the patients were adults, and data were insufficient to analyze the effect of the type of ECMO.

In this meta-analysis of observational studies of patients on ECMO, an anti-Xa-based anticoagulation strategy, when compared to a time-based strategy, was associated with fewer bleeding events and mortality rate, without an increase in thrombotic events.
Protective ileostomy does not prevent anastomotic leakage after anterior resection of rectal cancer
Authors: Niu Lei , Wang Jin , Zhang Peng , Zhao Xiaomu
Published: August 2020

Objective

To explore whether protective ileostomy is beneficial in preventing anastomotic leakage after anterior resection of rectal cancer.

Methods

A total of 347 patients underwent anterior resection of rectal cancer in our hospital. Ninety-five patients were treated with protective ileostomy (treatment group), and 252 patients were not (control group). The incidences of anastomotic leakage and permanent stoma were compared between the two groups.

Results

The overall incidences of anastomotic leakage were 6.32% (6/95) and 8.73% (22/252) in the treatment group and control group, respectively. In the cohort of patients who underwent neoadjuvant radiotherapy, the incidence of anastomotic leakage was 5.88% (2/34) and 12.0% (3/25) in the treatment group and control group, respectively. Logistic regression showed that the incidence of anastomotic leakage was not statistically significant. However, diabetes and the anastomotic height significantly affected the occurrence of anastomotic leakage. The permanent stoma rate was 6.42% (6/95) and 5.95% (15/252) in the treatment group and control group, respectively.

Conclusion

Protective ileostomy did not show a significant advantage in reducing the incidence of postoperative anastomotic leakage in patients with rectal cancer, and it may lead to a permanent stoma.
On the Urgent Need to Re-Engage Classical Marxism
Authors: Das Raju J
Published: August 2020

Humankind continues to face the two problems that have existed since the degeneration of the 1917 October Revolution that began in the mid-1920s. While it is experiencing enormous suffering caused by capitalism, there is also a crisis of anti-capitalist leadership. These two problems now cohabit with growing radicalization among sections of the working population and the youth, following the 2007 economic crisis; burgeoning threat of fascistic tendencies both within the state apparatuses and among the masses; and reformism among middle-class Marxist intellectuals (as well as among workers). In this global conjuncture, there is a need to return to the root of the Marxist agenda. This is the classical tradition, which includes the ideas of Marx and Engels and goes beyond their ideas. In this article, I offer an outline of that tradition.
Dimensionality of the State–Trait Inventory of Cognitive and Somatic Anxiety
Authors: Styck Kara M. , Rodriguez Madeline C. , Yi Esther H.
Published: August 2020

The State–Trait Inventory of Cognitive and Somatic Anxiety (STICSA) is a commonly administered self-report instrument of state–trait cognitive and somatic anxiety. Extant research has consistently supported the intended oblique two-factor scoring structure for the STICSA. However, this model assumes that population-level data have (or approximate) a simple structure and that item-level variance is unidimensional. These assumptions may not be tenable and have unintended consequences for STICSA subscore interpretation. Consequently, we tested these assumptions by fitting confirmatory and exploratory structural equation models to STICSA scores for a diverse sample of college students enrolled at a large Southwestern university in the United States ( n = 635). Results indicated that cognitive and somatic factors are not equally robust and that STICSA items appear to measure a nonnegligible mixture of both latent cognitive and somatic anxiety. It is recommended that future research use exploratory structural equation model in tandem with CFA to directly model data complexity.
Hysteresis Effects and Emotional Suffering: Chinese Rural Students’ First Encounters With the Urban University
Authors: Chen Jiexiu
Published: August 2020

In the Chinese context of a stratified higher education system and significant urban–rural inequality, rural students are generally facing constrained possibilities for social mobility through higher education. Despite these structural constraints, some exceptional rural students, like all the participants in this research, manage to get themselves enrolled in the urban university. Drawing on participants’ subjective narratives about their first encounters in the urban university, I argue that the rural students in this research were confronted with two levels of habitus–field disjunctures, namely, the rural–urban disjuncture and academic disjuncture. Then, through examining participants’ narratives about their hysteresis effects and emotional suffering, I suggest the sense of feeling lost and inferior reveals how various types of domination in the external structure of the field of the urban university play a part in affecting rural students’ inner emotional worlds.
Identifying relevant information in medical conversations to summarize a clinician-patient encounter
Authors: Quiroz Juan C , Laranjo Liliana , Kocaballi Ahmet Baki , Briatore Agustina , Berkovsky Shlomo , Rezazadegan Dana , Coiera Enrico
Published: August 2020

To inform the development of automated summarization of clinical conversations, this study sought to estimate the proportion of doctor-patient communication in general practice (GP) consultations used for generating a consultation summary. Two researchers with a medical degree read the transcripts of 44 GP consultations and highlighted the phrases to be used for generating a summary of the consultation. For all consultations, less than 20% of all words in the transcripts were needed for inclusion in the summary. On average, 9.1% of all words in the transcripts, 26.6% of all medical terms, and 27.3% of all speaker turns were highlighted. The results indicate that communication content used for generating a consultation summary makes up a small portion of GP consultations, and automated summarization solutions—such as digital scribes—must focus on identifying the 20% relevant information for automatically generating consultation summaries.
Stakeholders’ perspectives on adapting the World Health Organization iSupport for Dementia in Australia
Authors: Xiao Lily D , McKechnie Sue , Jeffers Lesley , De Bellis Anita , Beattie Elizabeth , Low Lee-Fay , Draper Brian , Messent Petrea , Pot Anne Margriet
Published: August 2020

Background

In Australia, informal caregivers (family, friends and neighbours) play a crucial role in supporting people with dementia to remain at home. Within the community aged care policy, informal caregivers are acknowledged as assisting with managing care. However, they usually receive very limited dementia care education and training to support them in their role. The World Health Organization (WHO) developed iSupport for Dementia, a comprehensive online dementia education and skill training programme, to address the gap in supporting informal caregivers.

Aim

The aim of the study was to identify stakeholders’ perspectives regarding adapting the WHO iSupport for use by informal caregivers of people with dementia in Australia.

Methods

An interpretive description study design was used. Data were collected in focus groups with informal caregivers and care staff of dementia and aged care service providers conducted in May–July 2018. A thematic analysis was utilised to analyse data and identify findings.

Results

In total, 16 informal caregivers and 20 care staff participated in the study. Five themes were identified. First, informal caregivers perceived iSupport as an opportunity to provide an online one-stop shop to meet their education needs and their needs to manage care services. Second, both informal caregivers and care staff believed that an integrated caregiver network moderated by a health professional was much needed to enable informal caregivers to share learning experiences and enhance social support. Third, both informal caregivers and care staff strongly suggested that dementia and aged care service providers had a role to play in promoting the iSupport. Fourth, informal caregivers were concerned about the time commitment to participate in the iSupport programme. Finally, informal caregivers expected the iSupport to be user-friendly.

Conclusion

Stakeholders perceived the adaptation of the WHO iSupport in Australia would strengthen informal caregiver education and optimise support for informal caregivers.
After Debord
Authors: Gloviczki Peter Joseph
Published: August 2020

This short essay considers media events in culture, turning toward the poststructuralist moment of spectacle as performance. I especially consider how images consolidate power. Employing a Debordian theoretical framework, I work to make sense of the importance of scrutinizing the content and context in which images are placed in the media environment.
The Unified Protocol for Transdiagnostic Treatment of Perinatal Depression: A Case Study
Authors: Crespo-Delgado Elena , Martínez-Borba Verónica , Osma Jorge
Published: August 2020

This case study aims to present the application of the Unified Protocol (UP) for the Transdiagnostic Treatment of Emotional Disorders in the case of a 38-year-old pregnant woman with a peripartum onset of major depressive disorder and anxiety symptoms. The UP is a cognitive-behavioral intervention based on the shared etiological and maintenance mechanisms of emotional disorders (i.e., mood, anxiety, and related disorders). The UP helps to modify maladaptive emotion-regulation strategies and enhance tolerance of unpleasant and intense emotions (sadness, anxiety, anger, etc.). Whereas previous studies demonstrate the efficacy of the UP in different emotional disorders, to our knowledge, none of them have used the UP to treat perinatal emotional disorders. After the eight UP modules of individual treatment, a significant decrease in anxiety, depression, negative affect, and anxiety sensitivity, and also an increase in positive affect were observed. These results were maintained at the 12-month follow-up. In addition to its clinical utility and acceptance, these results indicate that the UP can be adapted and personalized for the treatment of perinatal emotional disorders. Future studies with larger samples and controlled experimental designs should be developed to demonstrate its efficacy. Furthermore, as the UP seems to be useful in a group format, future efforts should be focused on the UP with perinatal women in a group format.
Energy-efficient chain-based data gathering applied to communicating concrete
Authors: Wan Hang , David Michael , Derigent William
Published: August 2020

Wireless Sensor Networks are very convenient to monitor structures or even materials, as in McBIM project (Materials communicating with the Building Information Modeling). This project aims to develop the concept of “communicating concretes,” which are concrete elements embedding wireless sensor networks, for applications dedicated to Structure Health Monitoring in the construction industry. Due to applicative constraints, the topology of the wireless sensor network follows a chain-based structure. Node batteries cannot be replaced or easily recharged, it is crucial to evaluate the energy consumed by each node during the monitoring process. This area has been extensively studied leading to different energy models to evaluate energy consumption for chain-based structures. However, no simple, practical, and analytical network energy models have yet been proposed. Energy evaluation models of periodic data collection for chain-based structures are proposed. These models are compared and evaluated with an Arduino XBee–based platform. Experimental results show the mean prediction error of our models is 5%. Realizing aggregation at nodes significantly reduces energy consumption and avoids hot-spot problem with homogeneous consumptions along the chain. Models give an approximate lifetime of the wireless sensor network and communicating concretes services. They can also be used online by nodes for a self-assessment of their energy consumptions.
Enhanced clinical microbiology methods in outbreak management
Authors: Moore John E , Millar Beverley C
Published: August 2020

Conventional microbiological investigations, including pathogen detection, antibiotic susceptibility testing and molecular epidemiological testing, are valuable tools in helping to manage nosocomial outbreaks. However, the microbiology laboratory, by using other techniques, can investigate additional microbiological aspects of outbreaks, which are often overlooked. Bacterial isolates (n=6) from an outbreak of Pseudomonas aeruginosa bacteraemia in a neonatal intensive care unit (NICU) in Belfast were examined. Enhanced microbiology testing included: (1) susceptibility of outbreak strains to biocides in common use in the unit; (2) effect of organic soils relevant to the area of the outbreak and their effect on the efficacy of biocide; and (3) the persistence of outbreak strains in organic soils. By emulating bespoke conditions of the outbreak, these methods were able to demonstrate that: (1) biocides were effective against the outbreak strains; (2) the critical concentration of soil which rendered biocide ineffective; and (3) how long the outbreak strains could persist. Enhanced microbiological analysis outside the conventional repertoire of testing may therefore offer valuable data that may help guide outbreak management teams.
Penetration of topical diclofenac into synovial tissue and fluid of osteoarthritic knees: a multicenter, randomized, placebo-controlled, pharmacokinetic study
Authors: Seefried Lothar , Blyth Mark , Maheshwari Rohit , McDonnell Stephen M. , Frappin Guillaume , Hagen Martina , Maybaum Nadine , Moreira Sebastian , Pandit Hemant
Published: August 2020

Background:

Topical diclofenac, a nonsteroidal anti-inflammatory drug, has proven efficacy and safety in the management of osteoarthritis pain. We investigated penetration of topical diclofenac into knee synovial tissue and fluid (primary objective) and evaluated relative exposure in the knee versus plasma (secondary objective).

Methods:

In this phase I, double-blind, multicenter study, patients scheduled for arthroplasty for end-stage knee osteoarthritis were randomly assigned 2:1 to 4 g diclofenac diethylamine 2.32% w/w gel (92.8 mg diclofenac diethylamine, equivalent to 74.4 mg diclofenac, per application) or placebo gel, applied to the affected knee by a trained nurse/designee every 12 h for 7 days before surgery. Diclofenac concentrations were measured in synovial tissue, synovial fluid and plasma from samples obtained during surgery ⩾12 h after last application. Treatment-emergent adverse events (TEAEs) were evaluated.

Results:

Evaluable synovial tissue or fluid samples were obtained from 45 (diclofenac n = 29; placebo n = 16) of 47 patients. All diclofenac-treated participants had measurable diclofenac concentrations in synovial tissue [geometric mean 1.57 (95% confidence interval (CI) 1.12, 2.20) ng/g] and fluid [geometric mean 2.27 (95% CI 1.87, 2.76) ng/ml] ⩾12 h after the last dose. Geometric mean (95% CI) ratio of diclofenac in synovial tissue:plasma was 0.32 (0.23, 0.45) and in synovial fluid:plasma was 0.46 (0.40, 0.54). TEAE rates were similar for diclofenac (55.2%) and placebo (58.8%); none were treatment related.

Conclusions:

Topical diclofenac diethylamine 2.32% w/w gel penetrated into the osteoarthritic knee after repeated application and remained detectable in synovial tissue and fluid at the end of the final 12 h dosing cycle.
Telemedicine for Disparity Patients With Diabetes: The Feasibility of Utilizing Telehealth in the Management of Uncontrolled Type 2 Diabetes in Black and Hispanic Disparity Patients; A Pilot Study
Authors: Myers Alyson , Presswala Lubaina , Bissoonauth Aditya , Gulati Neha , Zhang Meng , Izard Stephanie , Kozikowski Andrzej , Meyers Kerry , Pekmezaris Renee
Published: August 2020

Background:

Non-Hispanic Black (NHB) and Hispanic/Latinx (H/L) patients bear a disproportionate burden of type 2 diabetes and associated complications. Regular visits to a primary care doctor or diabetes specialist are warranted to maintain glycemic control, but for a myriad of reasons disparity populations may have difficulties receiving diabetes care. We seek to determine the feasibility of telehealth added to care as usual and secondarily to improve health outcomes (hemoglobin A1c [HbA1c]) in NHB and H/L with uncontrolled type 2 diabetes managed with two or three noninsulin agents.

Methods:

Twenty-nine patients were randomized to monthly phone calls or weekly to biweekly telehealth visits. Feasibility outcomes were summarized descriptively for the telehealth arm. Differences scores for A1C level and surveys were computed between baseline and three months and compared across arms using a two-sample t test or Mann-Whitney U test.

Results:

Patients in the telehealth arm completed a median of eight visits (IQR: 5, 8), and 53% of those in the telephone arm completed 100% of their calls. Change in HbA1c was greater for those in the telephone arm (−2.57 vs −2.07%, P = .70) but the mean baseline HbA1c was higher in the telephone group (11.1% vs 10.3%). Although the change in HbA1c was not statistically different across arms, it was clinically significant.

Conclusions:

Augmenting care as usual with telehealth provided by telephone or tablet can be of benefit in improving glycemic control in NHB and H/L with type 2 diabetes. Larger studies need to explore this further.
An unusual cause of polymorphic ventricular tachycardia: Acquired long QT syndrome from atypical variant of stress-induced cardiomyopathy
Authors: Alfarih Mashael , Moon James C , Fontana Marianna , Knight Dan , Captur Gabriella
Published: August 2020

A 55-year-old woman with a recent history of surgically and radioiodine treated thyroid cancer experienced a run of polymorphic ventricular tachycardia with hemodynamic perturbation during anaesthetic induction with propofol, fentanyl and rocuronium for elective surgical excision of right hip metastasis. Electrocardiography showed new T-wave inversion and QT prolongation that subsequently resolved. Cardiac enzymes were elevated but invasive coronary angiography showed unobstructed epicardial coronary arteries. Cardiovascular magnetic resonance showed not only normal biventricular size and systolic function but also a striking pattern of patchy myocardial oedema involving the basal-to-mid anterior, septal and inferior walls and some associated hypertrophy in the anteroseptum (representing focal myocardial swelling from the oedema) but no focal or diffuse myocardial fibrosis. All these abnormalities resolved on subsequent convalescent imaging. A diagnosis of multifactorial acquired long QT syndrome secondary to atypical variant stress-induced cardiomyopathy was made with the likely provoking factors in this case having been the female sex, understandable pre-operative anxiety, anaesthetic drugs, supraglottic airway placement and thyroid dysfunction. An implantable loop recorder during follow-up detected no further significant arrhythmias and she remains well and asymptomatic to date on a low dose of beta-blocker.
Mental Health Burden of the COVID-19 Outbreak in Germany: Predictors of Mental Health Impairment
Authors: Bäuerle Alexander , Steinbach Jasmin , Schweda Adam , Beckord Jil , Hetkamp Madeleine , Weismüller Benjamin , Kohler Hannah , Musche Venja , Dörrie Nora , Teufel Martin , Skoda Eva-Maria
Published: August 2020

Introduction:

COVID-19 is causing an enormous psychological burden for most people. This study aims to assess individual changes in mental health and health status before and after the COVID-19 outbreak, and to explore potential predictors of change.

Methods:

A cross-sectional study in Germany (n = 15 037) were conducted. Demographics, depression and anxiety symptoms (PHQ-2, GAD-2), distress (DT), and health status (EQ-5D-3L) were assessed. Additionally, all instruments used were adapted to measure the participants’ mental health and health status before the COVID-19 outbreak. COVID-19-related fear, trust in governmental actions to face COVID-19, and the subjective level of information about COVID-19 were examined.

Results:

Overall, the participants showed a significant increase in depression and anxiety symptoms, and distress, while health status deteriorated since the COVID-19 outbreak. Impairment in mental health was predicted by COVID-19-related fear. Pre-existing mental illness predicted an increase in depression symptoms and a deterioration in health status. Trust in governmental actions and the subjective level of information predicted less increase in psychological burden.

Conclusions:

Our data revealed that there have been changes in mental health and health status at an individual level since the outbreak of COVID-19. In order to maintain mental health, the observed predictors should be addressed.
Thematic Ideation: A Superior Supplementary Concept in Creativity and Innovation
Authors: Ummar Rakhshan , Saleem Sharjeel
Published: August 2020

New products improve competitiveness through their creativity and innovativeness. Creativity and innovativeness are parallel yet non-identical concepts; newly introduced products are either somewhat thematically similar or taxonomically similar to the existing products. There is a need for the explication of creativity and innovativeness as separate or as unified concepts in newly developed products, in particular, thematic products. A mixed-method design was adopted to establish definitions and components of creativity and innovativeness in the ideas presented at the innovation summit through 489 perceptual reports on 14 feature-based and theme-based product ideas. On the whole, three components—originality, value, and commercial appeal—were derived and tested. Results revealed the significance of originality as a major component of creativity and innovativeness in all products. Perceived value was significantly related to originality in both taxonomic and thematic products. Originality and value predicted creativity whereas innovativeness was predicted by commercial appeal along with originality and value in all products. The underlying purchase intention in taxonomic and thematic product ideas was the product’s relatedness with lifestyle. A product idea to be implemented in business as innovation was found to be dependent on its creativity and commercial appeal. This asserted three factors mandatory at the Fuzzy Front End (FFE), namely, originality, value, and commercial appeal. Discussion includes the interpretation of results and future directions.
Understanding Media Communication: On the Significance of Iconic Thinking for a Praxeological Model of Communication
Authors: Przyborski Aglaja , Slunecko Thomas
Published: August 2020

This article outlines the state of the art in picture analysis as it has been developed in the trajectory of reconstructive methodology. Analyzing pictures in their own right—that is, by adhering to the particular affordances of the medium “picture”—has strong implications for qualitative research some of which are discussed in this article. With regard to content, this discussion revolves around questions pertaining to bodily self-presentation in mass and social media. On this basis, the article concludes with a praxeological model of communication that offers a guideline for social research which is clued-up as to its own media and, thus, takes into account that meaning in pictures is constructed differently than meaning in language.
Relationships Matter: The Role Transition Specialists Play in Youth’s Reentry From the Juvenile Justice System
Authors: Sinclair James , Unruh Deanne , Kelly Kim
Published: August 2020

Increasing engagement to school, employment, and community are strong predictors of reducing recidivism for youth involved in the juvenile justice system. This study examined what occurs at reentry upon leaving a youth correctional setting. This study comprised of qualitative semi-structured interviews of transition specialists (TSs; n = 7) and young offenders ( n = 8) who participated in a 4-year reentry project in the Pacific Northwest. A total of 21 (13 TS and eight youth) interviews were thematically coded. Findings from this study included the important role of the TS in supporting a youth’s school, family, and community reentry. Key themes are described around the services to support employment, school engagement, and independent living during a youth’s reentry into a school setting.
Referral systems for preterm, low birth weight, and sick newborns in Ethiopia: a qualitative assessment
Authors: Teklu Alula M. , Litch James A. , Tesfahun Alemu , Wolka Eskinder , Tuamay Berhe Dessalegn , Gidey Hagos , Cheru Wondimye Ashenafi , Senturia Kirsten , Gezahegn Wendemaghen ,   And the Every Preemie–SCALE Ethiopia Implementation Research Collaboration Group, Hailu Tedros , Jebessa Solomie , Kahsay Amaha , Kuti Kemal A. , Levine Gillian , Robb-McCord Judith , Tadesse Yared , Tariku Abraham , Usman Abubeker Kedir , Weldetsadik Abate Yeshidinber
Published: August 2020

Background

A responsive and well-functioning newborn referral system is a cornerstone to the continuum of child health care; however, health system and client-related barriers negatively impact the referral system. Due to the complexity and multifaceted nature of newborn referral processes, studies on newborn referral systems have been limited. The objective of this study was to assess the barriers for effective functioning of the referral system for preterm, low birth weight, and sick newborns across the primary health care units in 3 contrasting regions of Ethiopia.

Methods

A qualitative assessment using interviews with mothers of preterm, low birth weight, and sick newborns, interviews with facility leaders, and focus group discussions with health care providers was conducted in selected health facilities. Data were coded using an iteratively developed codebook and synthesized using thematic content analysis.

Results

Gaps and barriers in the newborn referral system were identified in 3 areas: transport and referral communication; availability of, and adherence to newborn referral protocols; and family reluctance or refusal of newborn referral. Specifically, the most commonly noted barriers in both urban and rural settings were lack of ambulance, uncoordinated referral and return referral communications between providers and between facilities, unavailability or non-adherence to newborn referral protocols, family fear of the unknown, expectation of infant death despite referral, and patient costs related to referral.

Conclusions

As the Ethiopian Federal Ministry of Health focuses on averting early child deaths, government investments in newborn referral systems and standardizing referral and return referral communication are urgently needed. A complimentary approach is to lessen referral overload at higher-level facilities through improvements in the scope and quality of services at lower health system tiers to provide basic and advanced newborn care.
Circulating FABP4, nesfatin-1, and osteocalcin concentrations in women with gestational diabetes mellitus: a meta-analysis
Authors: Sun Jianran , Zhang Dai , Xu Jiang , Chen Chao , Deng Datong , Pan Faming , Dong Lin , Li Sumei , Ye Shandong
Published: August 2020

Objective

Recent studies have investigated the circulating adipocyte fatty acid binding protein (FABP4), nesfatin-1, and osteocalcin (OC) concentrations in women diagnosed with gestational diabetes mellitus (GDM), but the findings prove to be conflicting. The objective of this research was to systematically assess the relationship of circulating levels of above adipokines with GDM.

Methods

Pubmed, Embase, Web of Science, Cochrane library, OVID, and Scopus were performed to locate articles published up to January 31, 2020. Pooled standard mean differences (SMDs) with 95% confidence intervals (CIs), and 95% predictive intervals (PIs) were calculated by random-effects models to compare levels of adipokines between GDM cases and control groups. Cumulative and single-arm meta-analyses were also performed.

Results

Thirty-one studies comprising 4590 participants were included. No significant differences were found between GDM women and healthy controls in circulating nesfatin-1 levels (4.56 vs. 5.02 ng/mL; SMD = − 0.11, 95% CI -0.61–0.38, 95% PI -1.63–1.41). Nevertheless, circulating FABP4 and OC levels observed in GDM women outnumbered normal controls (FABP4, 23.68 vs. 16.04 ng/mL; SMD = 2.99, 95% CI 2.28–3.69, 95% PI 0.28–5.71; OC, 52.34 vs. 51.04 ng/mL; SMD = 0.68, 95% CI 0.31–1.05, 95% PI -0.48–1.84). The cumulative meta-analysis showed that the SMDs of circulating FABP4 and OC levels had stabilized between the two groups.

Conclusions

Elevated circulating FABP4 and OC levels were observed in GDM women, but nesfatin-1 levels did not change, the PI of OC crossed the no-effect threshold. The results suggested that FABP4 is more suitable as a biomarker of GDM compared to OC in a future study, which is useful in identifying pregnant women who are likely to develop GDM and providing prompt management strategies.
Atherogenic index of plasma is associated with the severity of Hidradenitis Suppurativa: a case-control study
Authors: Hernández José L. , Baldeón Cristina , López-Sundh Ana E. , Ocejo-Vinyals J. Gonzalo , Blanco Ricardo , González-López Marcos A.
Published: August 2020

Background

Hidradenitis suppurativa (HS) is a chronic inflammatory disease associated with several comorbidities and vascular risk factors, such as dyslipidemia. The present study aimed to assess the possible associations between the lipid profile and atherogenic indexes and the severity of HS.

Methods

This case-control study enrolled 78 HS patients and 62 healthy controls. Classic lipid profile and lipoprotein ratios, including the atherogenic index of plasma (AIP), were evaluated. The severity of HS was measured by the HS Physician Global Assessment (PGA).

Results

HS-patients had lower serum total cholesterol and HDL-C levels and higher AIP than the control group. AIP was positively correlated to BMI, waist circumference, systolic and diastolic blood pressure, LDL-C, triglycerides, non-HDL-C, ApoB, HOMA, and hs-CRP and negatively to HDL-C and ApoA1. For the overall lipid profile, only AIP was related to a more severe HS (PGA ≥ 3) after controlling for age, sex, BMI, insulin resistance (IR), active smoking, and statin use (r = 0.268; p = 0.023). Multiple logistic regression adjusted for age, sex, BMI, IR, smoking status and statin use, showed that AIP ≥ 0.11 was significantly associated with the severity of HS (OR, 4.38; CI 95%, 1.09–17.50; p = 0.037).

Conclusions

In conclusion, these results showed that AIP is significantly and independently associated with HS severity.
Activation of the executioner caspases-3 and -7 promotes microglial pyroptosis in models of multiple sclerosis
Authors: McKenzie Brienne A. , Fernandes Jason P. , Doan Matthew A. L. , Schmitt Laura M. , Branton William G. , Power Christopher
Published: August 2020

Background

Pyroptosis is a type of proinflammatory regulated cell death (RCD) in which caspase-1 proteolytically cleaves gasdermin D (GSDMD) to yield a cytotoxic pore-forming protein. Recent studies have suggested that additional cell death pathways may interact with GSDMD under certain circumstances to execute pyroptosis. Microglia/macrophages in the central nervous system (CNS) undergo GSDMD-associated pyroptosis in multiple sclerosis (MS) and its animal model experimental autoimmune encephalomyelitis (EAE) but the contribution of other cell death pathways to this phenomenon is unknown. Herein, we tested the hypothesis that multiple RCD pathways underlie microglial pyroptosis in the context of neuroinflammation.

Methods

A siRNA screen of genes with known RCD functions was performed in primary human microglia to evaluate their role in nigericin-induced pyroptosis using supernatant lactate dehydrogenase activity as a read-out of cell lysis. Activation of apoptotic executioner proteins and their contribution to pyroptosis was assessed using semi-quantitative confocal microscopy, high-sensitivity ELISA, immunoblot, cell lysis assays, and activity-based fluorescent probes. Quantification of pyroptosis-related protein expression was performed in CNS lesions from patients with progressive MS and mice with MOG35-55-induced EAE, and in matched controls.

Results

Among progressive MS patients, activated caspase-3 was detected in GSDMD immunopositive pyroptotic microglia/macrophages within demyelinating lesions. In the siRNA screen, suppression of caspase-3/7, caspase-1, or GSDMD expression prevented plasma membrane rupture during pyroptosis. Upon exposure to pyroptotic stimuli (ATP or nigericin), human microglia displayed caspase-3/7 activation and cleavage of caspase-3/7-specific substrates (e.g., DFF45, ROCK1, and PARP), with accompanying features of pyroptosis including GSDMD immunopositive pyroptotic bodies, IL-1β release, and membrane rupture. Pyroptosis-associated nuclear condensation and pyroptotic body formation were suppressed by caspase-3/7 inhibition. Pharmacological and siRNA-mediated inhibition of caspase-1 diminished caspase-3/7 activation during pyroptosis. In mice with EAE-associated neurological deficits, activated caspase-3 colocalized with GSDMD immunopositivity in lesion-associated macrophages/microglia.

Conclusions

Activation of executioner caspases-3/7, widely considered key mediators of apoptosis, contributed to GSDMD-associated microglial pyroptosis under neuroinflammatory conditions. Collectively, these observations highlight the convergence of different cell death pathways during neuroinflammation and offer new therapeutic opportunities in neuroinflammatory disease.
Serum amyloid A inhibits astrocyte migration via activating p38 MAPK
Authors: Lin Aihua , Liu Jin , Gong Ping , Chen Yanqing , Zhang Haibo , Zhang Yan , Yu Yang
Published: August 2020

Background

The accumulation of astrocytes around senile plaques is one of the pathological characteristics in Alzheimer’s disease (AD). Serum amyloid A (SAA), known as a major acute-phase protein, colocalizes with senile plaques in AD patients. Here, we demonstrate the role of SAA in astrocyte migration.

Methods

The effects of SAA on astrocyte activation and accumulation around amyloid β (Aβ) deposits were detected in APP/PS1 transgenic mice mated with Saa3−/− mice. SAA expression, astrocyte activation, and colocalization with Aβ deposits were evaluated in mice using immunofluorescence staining and/or Western blotting. The migration of primary cultures of mouse astrocytes and human glioma U251 cells was examined using Boyden chamber assay and scratch-would assay. The actin and microtubule networks, protrusion formation, and Golgi apparatus location in astrocytes were determined using scratch-would assay and immunofluorescence staining.

Results

Saa3 expression was significantly induced in aged APP/PS1 transgenic mouse brain. Saa3 deficiency exacerbated astrocyte activation and increased the number of astrocytes around Aβ deposits in APP/PS1 mice. In vitro studies demonstrated that SAA inhibited the migration of primary cultures of astrocytes and U251 cells. Mechanistic studies showed that SAA inhibited astrocyte polarization and protrusion formation via disrupting actin and microtubule reorganization and Golgi reorientation. Inhibition of the p38 MAPK pathway abolished the suppression of SAA on astrocyte migration and polarization.

Conclusions

These results suggest that increased SAA in the brain of APP/PS1 mice inhibits the migration of astrocytes to amyloid plaques by activating the p38 MAPK pathway.
Comorbidities and HCV coinfection in the management of HIV+ patients: evidence from the Italian clinical practice
Authors: Garagiola Elisabetta , Foglia Emanuela , Ferrario Lucrezia , Meraviglia Paola , Tebini Alessandro , Menzaghi Barbara , Atzori Chiara , Rizzardini Giuliano , Bini Teresa , D’Arminio Monforte Antonella , Croce Davide
Published: August 2020

Background

Since HIV+ treatment has become more effective, the average age of people living with HIV (PLWHIV) has increased, and consequently the incidence of developing comorbidities, making the clinical and economic management of HIV+ patients more complex. Limited literature exists regarding the management of comorbidities costs. This study is aimed at defining and comparing the total annual costs of comorbidities, in an Italian cohort of HIV and HIV/HCV patients, from the National Healthcare Service perspective. The authors hypothesised that there are higher costs, for patients with multiple comorbidities, and a greater consumption of resources for HIV/HCV co-infected patients versus HIV mono-infected patients.

Methods

An observational retrospective multi-centre health-economics study, enrolling HIV+ and HIV/HCV consecutive patients with at least one comorbidity, was conducted. The consecutive cases, provided by three Italian infectious diseases centres, were related to the year 2016. The enrolled patients were on a stable antiviral therapy for at least six months. Demographic and clinical information was recorded. Costs related to HIV and HCV therapies, other treatments, medical examinations, hospitalizations and outpatient visits were evaluated. Data from mono-infected and co-infected groups of patients were compared, and the statistical analysis was performed by t-tests, chi-square and ANOVA. A sub-analysis excluding HCV therapy costs, was also conducted. The hierarchical sequential linear regression model was used to explore the determinants of costs, considering the investigated comorbidities. All analyses were conducted with a significant level of 0.05.

Results

A total of 676 patients, 82% male, mean age 52, were identified and divided into groups (338 mono-infected HIV+ and 338 co-infected HIV/HCV patients), comparable in terms of age, gender, and demographic characteristics. A trend towards higher annual costs, for patients with multiple comorbidities was observed in HIV mono-infected patients (respectively € 8272.18 for patients without comorbidities and € 12,532.49 for patients with three or more comorbidities, p-value: 0.001). Excluding anti-HCV therapies costs, HIV/HCV co-infected patients generally required more resources, with statistically significant differences related to cardiovascular events (€10,116.58 vs €11,004.28, p-value: 0.001), and neurocognitive impairments events (€7706.43 vs €11,641.29 p- value: < 0.001).

Conclusions

This study provides a differentiated and comprehensive analysis of the healthcare resources needed by HIV and HIV/HCV patients with comorbidities and may contribute to the decision process of resources allocation, in the clinical management of different HIV+ patient populations.
USING THE ANALYTIC HIERARCHY PROCESS TO ASSESS THE IMPACT OF INTERNAL CONTROL WEAKNESSES ON FIRM PERFORMANCE
Authors: Wilford Amanda Lyn , Bodin Lawrence D. , Gordon Lawrence A.
Published: August 2020

Since the passage of the Sarbanes-Oxley Act (SOX) of 2002, many studies have examined the impact of material weaknesses in internal control systems (MWICS) on firm performance. Overall, these studies indicate that a negative association exists between poor internal control and firm performance. Prior research suggests that the above noted association between internal control and firm performance should be affected by both the actual number and the different types of MWICS. However, this stream of research has focused on using a binary measure for internal control and has not considered the combined impact that the different types of MWICS may have on firm performance. In this study, we create and introduce a new internal control index, derived from the Analytic Hierarchy Process (AHP). We then show that more information regarding the impact of MWICS can be obtained through our AHP index measure as opposed to the binary measure that is commonly used. These findings have important implications for a firm’s stakeholders (e.g., managers, stockholders, creditors, financial analysts, employees, and auditors).
M. Gabriela Sava Finalist of the 2020 MCDM Junior Researcher Best Paper Award
Authors: Karpak Birsen
Published: August 2020

In April 2020, M. Gabriela Sava received the great news that her paper “An analysis of the sensitivity and stability of patients’ preferences can lead to more appropriate medical decisions,” published in Annals of Operations Research  was selected as a finalist for the 2020 MCDM Junior Researcher Best Paper Award. The paper was in collaboration with Dr. Luis G. Vargas and Dr. Jerrold H. May from University of Pittsburgh and Dr. James G. Dolan from University of Rochester Medical Center. The award honors junior academic researchers and practitioners who work in the area of multi-criteria decision-making for their excellence, creativity and innovation. Gabriela was nominated for this prestigious award by the Associate Editor of the IJAHP, Dr. Birsen Karpak from Youngstown State University.