bluuebunny/crossref_metadata_2025 huggingface dataset:
Aligning Graduate Medical Education Improvement Projects With Merit Incentive-Based Payment System Requirements via Functional Outcome Measures
Authors: Gruner Marc , Mansfield John T. , Gall Nolan , Murtaugh Bryan , Maxwell Matthew
Published: May 2020

The Merit-based Incentive Payment System (MIPS) is a requirement for all physicians for value-based reporting. Medicare has approved registries as a mechanism for MIPS reporting. Concurrently, residencies continue to abide by the Accreditation Council for Graduate Medical Education’s (ACGME’s) curriculum requirement of utilizing/practicing quality improvement (QI).The objectives of this study were as follows: (1) incorporate a meaningful functional outcome measure into an electronic health record (EHR) to track spine functional outcomes; (2) generate a report containing covariables extracted from the EHR system to provide trackable data for current and future resident QI projects/investigations; and (3) establish an infrastructure to align ACGME QI initiatives with the MIPS requirements. This pilot study and retrospective analysis successfully demonstrates how a meaningful functional outcome measure can be incorporated into the EHR system for QI. Moreover, it demonstrates successful establishment of infrastructure for alignment of QI projects for ACGME residency requirements with MIPS requirements.
Comparison of 5-Year Patient-Reported Outcomes (PROMs) of Total Ankle Replacement (TAR) to Total Knee Replacement (TKR) and Total Hip Replacement (THR)
Authors: Ramaskandhan Jayasree , Rashid Anjum , Kometa Simon , Siddique Malik S.
Published: May 2020

Background:

Total ankle replacement (TAR) is becoming a more common alternative to ankle arthrodesis for the improvement of pain and function in end-stage arthritis of the ankle. The effects of end-stage arthritis of the ankle are similar to those of end-stage hip arthritis. There is a paucity of literature on patient-reported outcome measures (PROMs) following TARs in comparison with total hip replacement (THR) or total knee replacement (TKR). We aimed to study the 1-, 3-, and 5-year outcomes of TAR in comparison with TKR and THR.

Methods:

PROMs data from patients who underwent a primary THR, TKR, or TAR performed between March 2008 and 2013 over a 5-year period were collected from our hospital patient registry. They were divided into 3 groups based on the type of primary joint replacement. Patient demographics and patient-reported outcomes (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC], 36-item Short-Form (SF-36) scores, and patient satisfaction scores at follow-up) were compared preoperatively and at the 1-, 3-, and 5-year follow-ups.

Results:

There were data available on 2672 THR, 3520 TKR, and 193 TAR patients preoperatively. Preoperatively, TAR patients reported statistically significantly higher function scores when compared with THR and TKR patients (40 vs 33; P = .001 [ P < .05] and 40 vs 36; P = .001 [ P < .05]). For SF-36 scores, there was no statistically significant difference between groups for the general health and role emotional components ( P = .171 and .064, respectively [ P > .05]); TAR patients reported similar scores to TKR patients for physical domains at the 3- and 5-year follow-ups ( P > .05), and TAR patients also reported similar scores to both THR and TKR patients for the mental domains ( P > .05). At 5 years postoperatively, TAR patients reported lower scores than THR and TKR patients for function and stiffness. For SF-36 scores, TAR patients reported similar outcomes to THR and TKR patients for mental health components ( P > .05), similar scores to TKR patients for 3 of 4 physical domains ( P < .05), but lower satisfaction rates for activities of daily living (ADL) and recreation when compared with THR ( P < .05).

Conclusion:

TAR patients had similar outcomes to THR and TKR patients for disease-specific and mental health domains, and lower patient satisfaction rates in terms of pain relief, ADL, and recreation. Further research is warranted including clinical outcomes along with PROMs with a long-term follow-up.

Level of Evidence:

Level III, retrospective comparative series.
Measurement Invariance of Three Narcissism Questionnaires Across the United States, the United Kingdom, and Germany
Authors: Wetzel Eunike , Lang Felix J. , Back Mitja D. , Vecchione Michele , Rogoza Radoslaw , Roberts Brent W.
Published: May 2020

With a recent surge of research on narcissism, narcissism questionnaires are increasingly being translated and applied in various countries. The measurement invariance of an instrument across countries is a precondition for being able to compare scores across countries. We investigated the cross-cultural measurement invariance of three narcissism questionnaires (Brief Pathological Narcissism Inventory [B-PNI], Narcissistic Personality Inventory [NPI], and Narcissistic Admiration and Rivalry Questionnaire [NARQ]) and mean-level differences across samples from the United States ( N = 2,464), the United Kingdom ( N = 307), and Germany ( N = 925). Overall, the B-PNI and NARQ functioned equivalently for the U.S. and U.K. participants. More violations of measurement invariance were found between Germany and the combined U.S. and U.K. samples, and for the NPI. In the B-PNI and NARQ, Americans scored higher than individuals from the United Kingdom regarding agentic aspects (self-sacrificing self-enhancement, admiration), while Germans scored lower than both Americans and U.K. individuals regarding antagonistic (entitlement rage, rivalry) and neurotic (hiding the self, contingent self-esteem) aspects. More inconsistent results were found for NPI facets. When noninvariance was present, observed means yielded biased results. Thus, the degree of measurement invariance across translated instrument versions should be considered in cross-cultural comparisons, even with culturally similar countries.
Effect of Cold Application on Pain and Bruising in Patients With Subcutaneous Injection of Low-Molecular-Weight Heparin: A Meta-Analysis
Authors: Wang Haifeng , Guan Jingjing , Zhang Xiaohan , Wang Xinxin , Ji Tianliang , Hou Dandan , Wang Guiru , Sun Jiao
Published: May 2020

To evaluate the effect of cold application on pain and bruising after the subcutaneous injection of low-molecular-weight heparin, 8 electronic databases were searched for randomized controlled trials and quasiexperimental studies from the inception of the databases to June 2019. Review Manager 5.3 software was used for the heterogeneity test and meta-analysis. A total of 8 studies including 694 participants were analyzed. The cold application group assessed with the Verbal Descriptor Scale pain assessment tool showed significant reductions in pain intensity immediately after injection. Compared to the control group, the cold application group showed a reduction in the occurrence of bruises at 12 hours, 24 hours, and 48 hours after injection. There was no significant difference in the area of bruising in the cold application group at 48 hours after injection, but the area of bruising at 72 hours after injection was significantly reduced. These results show that cold application can reduce the incidence of pain and bruising after subcutaneous injection of low-molecular-weight heparin and reduce the area of bruising 72 hours after injection. Additional studies with larger sample sizes are needed to confirm these findings.
Frequency characteristics of a viscoelastic graphene nanoplatelet–reinforced composite circular microplate
Authors: Ghabussi Aria , Habibi Mostafa , NoormohammadiArani Omid , Shavalipour Aghil , Moayedi Hossein , Safarpour Hamed
Published: May 2020

This is the first research on the frequency analysis of a graphene nanoplatelet composite circular microplate in the framework of a numerical-based generalized differential quadrature method. Stresses and strains are obtained using the higher order shear deformation theory. The microstructure is surrounded by a viscoelastic foundation. Rule of the mixture is used to obtain varying mass density and Poisson’s ratio, whereas the module of elasticity is computed by a modified Halpin–Tsai model. Governing equations and boundary conditions of the graphene nanoplatelet composite circular microplate are obtained by implementing Hamilton’s principle. The results show that outer to inner radius ratio [Formula: see text], ratios of length scale and nonlocal to thickness ( l/ h and [Formula: see text]), and graphene nanoplatelet weight fraction [Formula: see text] have significant influence on the frequency characteristics of the graphene nanoplatelet composite circular microplate. Another necessary consequence is that by increasing the value of [Formula: see text], the distribution of the displacement field extends from radial to tangent direction, especially in the lower mode numbers; this phenomenon appears much more remarkable. A useful suggestion of this research is that for designing the graphene nanoplatelet composite circular microplate at a low value of [Formula: see text], [Formula: see text] and [Formula: see text] should be given more attention, simultaneously. An interesting result which has come down from the article is that the effect of [Formula: see text] on the dimensionless frequency of the structure is really dependent on the value of C d.
Fractional-order nonsingular terminal sliding mode control via a disturbance observer for a class of nonlinear systems with mismatched disturbances
Authors: Razzaghian Amir , Kardehi Moghaddam Reihaneh , Pariz Naser
Published: May 2020

This study investigates a novel fractional-order nonsingular terminal sliding mode controller via a finite-time disturbance observer for a class of mismatched uncertain nonlinear systems. For this purpose, a finite-time disturbance observer–based fractional-order nonsingular terminal sliding surface is proposed, and the corresponding control law is designed using the Lyapunov stability theory to satisfy the sliding condition in finite time. The proposed fractional-order nonsingular terminal sliding mode control based on a finite-time disturbance observer exhibits better control performance; guarantees finite-time convergence, robust stability of the closed-loop system, and mismatched disturbance rejection; and alleviates the chattering problem. Finally, the effectiveness of the proposed fractional-order robust controller is illustrated via simulation results of both the numerical and application examples which are compared with the fractional-order nonsingular terminal sliding mode controller, sliding mode controller based on a disturbance observer, and integral sliding mode controller methods.
The Poetic Vocation
Authors: Bullock Owen
Published: May 2020

This hybrid critical/creative essay discusses the vocation of being a poet and the attendant problems of earning a living. It describes the lure and attraction of writing poetry, employment history, barriers to the academic world and an eventual, fruitful encounter with it, as well as ideas associated with creativity and play. The original poems included, largely in the prose poetry form, work in counterpoint with discussion of key issues surrounding the poetic vocation as an example of the wider topic of the protean career and cultural vocations, with particular reference to sociologist Vincent Dubois.
Fragments of Truth and Post-Truth: An Associative Collage
Authors: Francis Badley Graham
Published: May 2020

This set of fragments provides a glued-together patchwork of key ideas about truth and post-truth. It contains a critique of notions of reified Truth and shows that it is our understanding of ordinary truth which matters. “Post-Truthers” refers to those who believe we have passed the stage when pure or objective Truth is a useful issue to explore. “Post-Truthers” are challenged because of their tendency to parade their feelings as important truths. A provisional conclusion is that ordinary, quotidian truth is what matters to us as citizens of well-functioning democracies.
Tg.rasH2 Mouse Model for Assessing Carcinogenic Potential of Pharmaceuticals: Industry Survey of Current Practices
Authors: Bogdanffy Matthew S. , Lesniak Jacob , Mangipudy Raja , Sistare Frank D. , Colman Karyn , Garcia-Tapia David , Monticello Thomas , Blanset Diann
Published: May 2020

The Tg.rasH2 mouse was developed as an alternative model to the traditional 2-year mouse bioassay for pharmaceutical carcinogenicity testing. This model has found extensive use in support of pharmaceutical drug development over the last few decades. It has the potential to improve quality and timeliness, reduce animal usage, and in some instances allow expedient decision-making regarding the human carcinogenicity potential of a drug candidate. Despite the increased use of the Tg.rasH2 model, there has been no systematic survey of current practices in the design, interpretation of results from the bioassay, and global health authority perspectives. Therefore, the aim of this work was to poll the pharmaceutical industry on study design practices used in the dose range finding and definitive 6-month studies and on results relative to the ongoing negotiations to revise The International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use S1 Guidance. Twenty-two member companies of International Consortium for Innovation and Quality in Pharmaceutical Development DruSafe Leadership Group participated in the survey, sharing experiences from studies conducted with 55 test compounds between 2010 and 2018. The survey results provide very useful insights into study design and interpretation. Importantly, the results identified several key opportunities for reducing animal use and increasing the value of testing for potential human carcinogenicity using this model. Recommended changes to study designs that would reduce animal usage include eliminating the requirement to include positive control groups in every study, use of nontransgenic wild-type littermates in the dose range finding study, and use of microsampling to reduce or eliminate satellite groups for toxicokinetics.
Orbital malformation with dysplastic infraorbital artery in neurofibromatosis type 1
Authors: Li Zhengkang , Zhang Leilei , Deng Yuan
Published: May 2020

Purpose:

To report a case with neurofibromatosis type 1 presenting as prominent enophthalmos and abnormal infraorbital artery.

Case description:

A 19-year-old man with a family history of neurofibromatosis presented with prominent right enophthalmos. Computed tomography showed orbital dysplasia and enlarged inferior orbital fissure but no plexiform neurofibroma. Prominent intraoperative hemorrhage originated from several abnormal arteries in the infraorbital region during orbital reconstruction. A tortuous and dysplastic infraorbital artery was verified postoperatively by computed tomography angiography. The bleeding vessels were supposed to be the orbital branches of the dysplastic infraorbital artery.

Conclusions:

The orbital malformation and enlargement of inferior orbital fissure probably resulted in an abnormal infraorbital artery. Selective artery embolization may be chosen as a preceding treatment before orbital reconstruction surgery.
An observational study of the securement of central venous access devices with a subcutaneous anchor device in a paediatric population at a tertiary level hospital
Authors: Fitzsimons Kathryn Marie , Speekman Joseph , Senior Temora , Curtis Kerrie , Cochrane-Davis Alex , Barnes Richard
Published: May 2020

Paediatric central venous access devices are associated with significant complications. Failure rates have been estimated to be as high as 25%, with securement failure a significant contributing factor. In this study, we evaluate the use of a subcutaneous securement device, securAcathTM, in minimising rates of central venous access device dislodgement and unintended early removal within a paediatric population. Data were collected on 52 consecutive paediatric patients, aged less than 18 years old, who required peripherally inserted central catheters and non-cuffed tunnelled centrally inserted central catheters. We found that the rate of securement failure with securAcathTM was 2.01 per 1000 catheter days. This compared to 2.58 in our previous practice without securAcathTM. With the use of securAcathTM, no securement failures were observed in our patients with non-cuffed tunnelled centrally inserted central catheters. There were three instances of securement failure in patients with peripherally inserted central catheters. We conclude that the use of a securAcathTM fixation device in central venous access devices is an effective method of securement, especially in use with non-cuffed tunneled centrally inserted central catheters. However, when significant tension is applied to the central venous access devices migration is still possible.
Outcomes of arteriovenous fistula creation: A Jordanian experience
Authors: Obeidat Khaled A , Saadeh Rami A , Hammouri Hanan M , Obeidat Motaz A , Tawalbeh Ra’fat A
Published: May 2020

Objective:

The arteriovenous fistula is considered the preferred hemodialysis access due to its lower complication rate and longer patency. The aim of this study is to report the outcomes of arteriovenous fistula creation and to study the predictive factors for these outcomes.

Study design and method:

This is a retrospective study of all patients who underwent autogenous arteriovenous fistula creation procedure by a single surgeon during the period from October 2011 till December 2017.

Material:

All the procedures were performed at an academic referral center by a single surgeon. All patients who underwent arteriovenous fistula creation in the upper limb during the study period were included. All patients were diagnosed with end-stage renal disease and referred for arteriovenous fistula creation either before or after initiating hemodialysis.

Method:

Data were collected from the patients’ charts. The primary outcomes were the primary failure and secondary patency rates. Secondary outcome was to find the factors associated with decreased patency. The Kaplan–Meier curve with the log-rank test was used to describe the patency while univariate and multivariate analyses were done to the factors considered relevant to the patency.

Results:

The total number of procedures was 291; of which, 18 were lost to follow-up. The primary failure rate was 12%. Secondary patency rate at 1 and 5 years was 79% and 53%, respectively. Diabetes mellitus and fistulae placed on right side were associated with decreased patency.

Conclusion:

The primary failure rate was relatively low in this study but the long-term functionality of the arteriovenous fistulae needs to be improved.
Migration, identity, and television audiences: Sri Lankan women’s soap opera clubs and diasporic life in Melbourne
Authors: Gamage Shashini
Published: May 2020

This article examines a soap opera club of Sri Lankan Sinhalese migrant women in Melbourne and their collective engagement with television soap operas from the home country. Teledramas, as Sri Lankan Sinhalese-language soap operas are known, have a predominantly female viewership in Sri Lanka and also constitute a significant presence in the media diets of Sinhalese migrant women in Melbourne, and elsewhere in the world. Furthermore, at a women’s teledrama club affiliated to a Sri Lankan diasporic association, Sinhalese migrant women come together to exchange and archive reproduced DVDs of teledramas broadcast in Sri Lanka, bought from Sri Lankan grocery shops in Melbourne. This article builds on ethnographic research conducted at the teledrama club to show how what may appear to be an informal gathering of female teledrama fans is complexly interwoven into the expression of identity and belonging in Australian society. The article positions trans-Asia media flows in Australia within the everyday lives of migrants by examining the Sri Lankan soap opera club as a gendered space as well as a cultural space of identity, belonging and expression. This article finds that the teledrama club provided the women a symbolic national identity as an audience and the Sri Lankan narratives offered audiovisual access to the value systems of their distant geography and past.
Rebel governance in de facto states
Authors: Florea Adrian
Published: May 2020

De facto states, such as Somaliland (Somalia), are unrecognized separatist enclaves that display characteristics of statehood but lack an international legal status. To acquire domestic and external legitimacy, these actors engage in a wide range of governance practices: they set up military and police forces; executive, legislative, and judicial branches; hospitals; schools; banks; or social security networks. In spite of the obvious gains that can be accrued through the establishment of a complex governance architecture, de facto states exhibit great variation in the range of statelike institutions that they build: some, like Luhansk People’s Republic (Ukraine), put together a rudimentary governance apparatus, while others, like Transnistria (Moldova), manage to construct a complex system of rule. What explains the variation in governance practices across these separatist enclaves? Using original data on governance institutions across all de facto states (1945–2016), this study offers an empirical examination of the key factors that shape separatists’ incentives to supply governance. The findings reveal that de facto state separatists are less likely to provide governance when they have access to lootable mineral resources but are more likely to do so when they receive external military support, when peacekeepers are present, when they have access to relatively immobile assets, when they adopt a Marxist ideology, and when they control the territory for a long time. The findings help us better understand the conditions under which armed nonstate actors supplant sovereign states as de facto authorities and successfully institutionalize their rule.
Feasibility and acceptability of a brief cognitive-behavioral group intervention for chronic irritability in youth
Authors: Derella Olivia J , Burke Jeffrey D , Romano-Verthelyi Ari M , Butler Emilie J , Johnston Oliver G
Published: May 2020

Chronic irritability is a core feature of oppositional defiant disorder (ODD) and disruptive mood dysregulation disorder (DMDD), but few irritability-specific interventions have been tested. Existing evidence-based treatments for disruptive behavior problems offer a strong template. This pilot study was conducted to develop and evaluate a brief irritability-specific module of a validated cognitive-behavioral group intervention for children (Stop Now And Plan (SNAP) Program). Stop now and plan for irritability (I-SNAP) retained core elements of SNAP in a shortened 6-week format. Community families with irritable children ( M = 8.44 years, SD = 1.42) were recruited for parent and child emotion regulation skills groups. Of 18 children enrolled (72% male), 14 completed (78%). Half of children attended all six sessions, though homework compliance was lower. All parents reported favorable impressions and would recommend I-SNAP to others. Significant improvements were seen from pre- to post-treatment across parent-reported irritability, ODD symptoms, emotion regulation, and disciplinary effectiveness. This pilot study provides initial support suggesting I-SNAP may be feasible to implement and acceptable to parents. In addition, pilot analyses demonstrated that this brief group intervention was associated with positive outcomes consistent with treatment targets. This preliminary evidence supports the need for further research to assess I-SNAP’s effects on irritability relative to control groups.
COVID-19 pandemic as a watershed moment: A call for systematic psychological health care for frontline medical staff
Authors: Zaka Agustina , Shamloo Soraya E , Fiorente Pasquale , Tafuri Alessandro
Published: May 2020

The COVID-19 pandemic is producing a huge health care burden with millions of cases and thousands of deaths. The coronavirus’ high virulence and contagiousness and the frequent sudden onset of illness is overwhelming critical care and frontline healthcare staff. Frontline professionals are exposed to unprecedented levels of intensive existential threat requiring systematic, specialized psychological intervention and support. New psychological services need to be urgently implemented to manage the mental healthcare needs of frontline medical staff working with patients with COVID-19. The COVID-19 pandemic is a watershed moment: health care systems universally require a step-change to improve our preparedness for future pandemics.
Literature in contemporary foreign language school textbooks in Russia: Content, approaches, and readability
Authors: Calafato Raees , Gudim Freda
Published: May 2020

In light of the growing importance placed by states on the use of authentic materials in foreign language education programs, this study explored the literary content found in the 18 English, French, and German ministry-approved language textbooks used in upper-secondary schools in Russia. The study identified 150 literary texts, following which it compared how English, French, and German textbooks differed in their approaches to incorporating literature. The findings indicate significant differences between textbooks across languages, as well as some similarities. The study discusses the implications of the findings for learner achievement and motivation, and offers recommendations regarding what can be done to incorporate literature in ways that can deepen learner interest and engagement.
Crime witness accounts
Authors: Weiss Karen G
Published: May 2020

Contrary to the social expectation that good citizens should help others in need, persons who witness crime do not always intervene to help, or see it as their responsibility to do so. This study explores the reasons why witnesses choose not to call police or help in other ways by elucidating the accounts that nonintervening witnesses use to convince others and themselves that intervention was not necessary or appropriate. Drawing from open-ended survey responses, five neutralizing accounts are identified, two that deny the intervenability of crime (by denying harm or blaming victims), and three that deny responsibility to help (by denying capability, asserting risk, or rejecting a guardianship role). Identifying the accounts that normalize crime and make it easier for witnesses to “do nothing” contributes to a more nuanced understanding of witness decision making and nonintervening responses that, in turn, can contribute to the persistence of crime.
Exploring heterogeneous ICT use among older adults: The warm experts’ perspective
Authors: Hänninen Riitta , Taipale Sakari , Luostari Raija
Published: May 2020

In this article, we (1) examine the various forms of support required by older users (75+) of digital technology and (2) provide a concrete, everyday life rationale for why warm experts play such a pivotal role in the processes of adopting and using ICT. Although warm experts are usually not older adults themselves, they provide an important mediating view on the technology use among older people that has not been rigorously addressed in previous studies. Thus, in our analysis we examine the younger family members’ views on acting as warm experts to their older family members. The research data consist of 22 extended group interviews (EGI) and observation carried out in Finland. Based on our analysis, we argue that older adults use ICT in very heterogeneous ways and that the roles bestowed upon warm experts can be understood precisely through this heterogeneity.
Coupled finite and discrete element shot peening simulation based on Johnson–Cook material model
Authors: Ahmad Abdulrahaman Shuaibu , Wu Yunxin , Gong Hai
Published: May 2020

Shot peening is an essential treatment that produces a beneficial compressive layer on the material’s surface, which significantly improves its fatigue life. To minimizes the cost and resources used in determining the finest shot peening parameters based on the experimental approach, a numerical model capable of computing the induced compressive residual stress accurately is required. Hence, the numerical simulation of the shot peening process with multiple random shots that depict the actual shot peening is presented in this paper. The model is developed using the coupled finite and discrete element methods. The two numerical tools were coupled via code in ABAQUS, whereby shot–shot and shot–target interaction behaviors were accurately included. The induced compressive residual stress was computed due to the multiple random shots impact based on the Johnson–Cook material model. The model was experimentally validated and applied to evaluated the influence of shot velocity, shot size, and angle of impact on the final compressive residual stress.
Angiotensin II type 1 receptor blockers favorably affect renal angiotensin II and MAS receptor expression in patients with diabetic nephropathy
Authors: Ma Ye-Ping , Yang Yue , Jiang Shi-Min , Liu Lin , Zhang Zheng , Wang Yi-Ning , Zou Gu-Ming , Li Wen-Ge
Published: May 2020

Introduction:

The aims of this study were to assess the renal expression of angiotensin II type 1 receptor (AT1R), angiotensin II type 2 receptor (AT2R), and MAS receptor in human type 2 diabetic nephropathy (DN).

Materials and methods:

In total, 115 patients diagnosed with DN by renal biopsy were enrolled in this study. The protein expression levels of the AT1R, AT2R, and MAS receptors were assessed by immunohistochemistry.

Results:

The protein expression levels of AT1R, AT2R, and MAS receptor in the renal biopsy tissue were correlated with the pathologic classification of DN. Tubulointerstitial AT1R expression in patients of class IIb was significantly stronger than control samples ( p < 0.05). Expression of AT2R and MAS receptors were highest with class IIb DN patients. When DN patients were treated with AT1R blocker (ARB), the expression of AT1R was downregulated ( p < 0.05), and the MAS receptor was upregulated in tubular interstitial ( p < 0.05).

Conclusions:

Our results directly observed that renal expression levels of AT1R increase during the early stages of DN, ARB reducing AT1R while increasing MAS receptor. Therefore, ARB should be used as soon as possible in patients with DN.
Identification of key genes, pathways and potential therapeutic agents for IgA nephropathy using an integrated bioinformatics analysis
Authors: Chen Xiaoxue , Sun Mindan
Published: May 2020

Purpose:

This study aims to identify immunoglobulin-A-nephropathy-related genes based on microarray data and to investigate novel potential gene targets for immunoglobulin-A-nephropathy treatment.

Methods:

Immunoglobulin-A-nephropathy chip data was obtained from the Gene Expression Omnibus database, which included 10 immunoglobulin-A-nephropathy and 22 normal samples. We used the limma package of R software to screen differentially expressed genes in immunoglobulin-A-nephropathy and normal glomerular compartment tissues. Functional enrichment (including cellular components, molecular functions, biological processes) and signal pathways were performed for the differentially expressed genes. The online analysis database (STRING) was used to construct the protein-protein interaction networks of differentially expressed genes, and Cytoscape software was used to identify the hub genes of the signal pathway. In addition, we used the Connectivity Map database to predict possible drugs for the treatment of immunoglobulin-A-nephropathy.

Results:

A total of 348 differentially expressed genes were screened including 107 up-regulated and 241 down-regulated genes. Functional analysis showed that up-regulated differentially expressed genes were mainly concentrated on leukocyte migration, and the down-regulated differentially expressed genes were significantly enriched in alpha-amino acid metabolic process. A total of six hub genes were obtained: JUN, C3AR1, FN1, AGT, FOS, and SUCNR1. The small-molecule drugs thapsigargin, ciclopirox and ikarugamycin were predicted therapeutic targets against immunoglobulin-A-nephropathy.

Conclusion:

Differentially expressed genes and hub genes can contribute to understanding the molecular mechanism of immunoglobulin-A-nephropathy and providing potential therapeutic targets and drugs for the diagnosis and treatment of immunoglobulin-A-nephropathy.
Acting on the invisible: Computational tools and community action in the landscapes of air quality
Authors: Mondor Christine Ann , Azel Nicolas
Published: May 2020

This article proposes that designers and planners can better manage wicked problems by developing a strategic alignment of computational technology with a theory of change. Together with an understanding of the most effective places to intervene in a system, designers’ informed use of technology enables them to orchestrate community action and leverage large-scale environmental change. Aligning technology with a theory of change deepens the relevance of computational tools and suggests that technologies or tools that augment one’s ability to perceive, understand relevance, or prioritize raise the potential for action; technologies or tools that aggregate information on collective beliefs or actions help to build a community of concern; and technologies that elevate community capacity and create a sense of identity can contribute to the long-term transformation of values. Through a case study, this article demonstrates a nested approach to computation, which enhances public awareness and enables action in a small community which is trying to manage an extra-territorial problem of air quality. This article also proposes that while computational tools have extended the reach and effectiveness of advocacy, designers should continue to push for expanded application. By aggregating lessons learned from technological networks, such as the emerging clean air network described in this article, we can add another socio-ecological dimension to the practices of landscape and urbanism.
Locally Identified Priorities for Continuous Quality Improvement (CQI) During Early Implementation of an Evidence-Based Early Childhood Home Visiting Program
Authors: Gregson Jennifer , Byrne Kimberly M. , Gilmore-Zarate Catherine , Wilhelmsen Erica , Rogers Kristen
Published: May 2020

The 2010 Affordable Care Act provided for evidence-based home visiting and an accompanying continuous quality improvement (CQI) process in all states and territories. This is an organizational-level study of one state’s qualitative approach to CQI during early implementation, when data system infrastructure and local agency capacity were still developing. We examined the CQI topics created by local agencies and operationalized through a qualitative, strength-based CQI process. During the first 18 months, state and local site teams (n = 21) participated in 150 CQI teleconferences. We used qualitative content analysis of teleconference notes to identify issues important to sites and that could be addressed through a qualitative CQI process. Seven categories of CQI topics emerged: participant enrollment and retention; administrative infrastructure and capacity; programmatic resources and practices; community advisory boards; home visitor skill development; systems integration and strategic partnerships; and hiring home visiting staff. Sites added local nuances to frame and address CQI topics. When local sites identify their own CQI topics in early implementation, they addressed program need at multiple levels of influence. A few sites addressed individually focused topics traditional to CQI. Most often, sites engaged with institution- or community-focused topics atypical for CQI but nonetheless essential to launching a program: building skills and capacity for administrative and program implementation, and engaging with the local system of services. Oversight agencies should be prepared to address program, organization, partner or system level issues through CQI to foster program establishment. A site-centered, strength-based approach can support programs even when quantitative data are limited.
Efficacy of Maggot Debridement Therapy on Refractory Atypical Diabetic Foot Ulcers: An Open-Label Study
Authors: Siavash Mansour , Najjarnezhad Ali , Mohseni Nader , Abtahi Seyed Mohammad , Karimy Azadeh , Sabzevari Mohammad Hosein
Published: May 2020

Atypical or refractory diabetic foot ulcers (DFUs) are still a major health problem. Maggot debridement therapy (MDT) by larva of Lucilia sericata is an ancient and a modern option for wound healing. It works by debridement, stimulation of wound healing, and disinfection. In this study, we aimed to evaluate the efficacy of MDT for healing atypical and refractory DFUs. Patients with atypical DFUs were selected and further evaluated for some predefined differential diagnoses like atypical fungal, parasitic, or bacterial infections, malignancy, trauma, and so on. Multiple MDT sessions were carried out. Ulcer size was measured before every MDT session. Complete wound healing, time to heal, and adverse effects were recorded as well. Forty-two DFU patients (26 men, 16 women) with 42 nonhealing atypical ulcers participated in this study. Complete wound healing was achieved in 35 patients (83.3%) by MDT. Complete debridement and then healing of the wounds happened in less than 1.79 ± 0.8 months. Four ulcers persisted, and 3 (7.1%) were eventually amputated. MDT may be considered as an effective treatment for atypical DFUs, which are unresponsive to conventional therapies.
Persistence of Latinas in STEM at an R1 Higher Education Institution in Texas
Authors: Gonzalez Elsa , Aguirre Cecilia Contreras , Myers Joenie
Published: May 2020

This study examined the success and persistence of Latina students in the complex environment of science, technology, engineering, and mathematics (STEM) fields at a Tier 1 Research higher education institution in Texas. For this qualitative study, 10 Latina students pursuing STEM majors were interviewed within a framework focusing on Greene’s resilience theory. Results of this study suggest a strong likelihood for Latinas to succeed in STEM fields because of their development of resilience.
Management of Complex Traumatic Renal Artery–Inferior Vena Cava Fistula: A Case Report and Review of the Literature
Authors: Choudhary Narendra , Agarwal Harshit , Ghoshal Soumya , Uniyal Madhur , Kumar Abhinav , Gupta Amit
Published: May 2020

Background:

Renal artery–inferior vena cava (IVC) fistula is usually caused by penetrating injury to the back. However, it is a very rarely reported entity with only 20 cases reported in the literature. They may present acutely with hemodynamic instability or chronically as congestive heart failure. A thorough examination and adequate imaging are required to avoid missing such injuries.

Case Presentation:

A 28-year-old gentleman presented after sustaining stab injury to the back. The stab had penetrated the renal artery and IVC, leading to arteriovenous fistula. He was managed surgically, as he went into hemorrhagic shock, with a successful outcome. The case is also unique as an accessory renal artery was also involved in the fistula.

Conclusion:

Early identification and management of renal artery–IVC fistula is important to ensure a successful outcome. Such fistulas can be managed by either endovascular approach or surgical approach. The decision of approach depends on the level of expertise available and hemodynamic status of the patient.
Endovascular Therapy for Spontaneous Ilio-Iliac Arteriovenous Fistula Due To Iliac Artery Aneurysm Rupture With Multi-Organ Dysfunction
Authors: Rishi Muhammad Tipu , Maijub John , Wang S. Keisin , Peshkepija Andi , King Justin , Gupta Alok , Fajardo Andres , Motaganahalli Raghu L.
Published: May 2020

Iliac artery aneurysms can rarely present with rupture into adjacent iliac vein resulting in arteriovenous fistula leading to acute cardiac failure or multi-organ failure. End-organ damage can be reversed with timely diagnosis and intervention. Endovascular therapy is an attractive option to treat this pathology besides allowing for a quick recovery and mitigating the risk of mortality associated with open surgical treatment options. We report treatment of this pathology with Endovascular repair with preservation of ipsilateral hypogastric artery flow using an iliac branch graft device. The postoperative course was complicated by type 3 endoleak due to the separation of components between iliac branch graft and aortic stent graft with resultant recurrence of the fistula. Additional endovascular techniques, including placement of a venous stent and stent grafts to bridge the components, was used to treat the endoleak. We present this report due to the unique nature of the recurrent arteriovenous fistula, technical complexity, and resultant multi-organ dysfunction.
Outcomes of bell-bottom technique compared to standard endovascular aneurysm repair
Authors: Massière Bernardo , Leão Ronaldo , Vescovi Alberto , Leal Daniel , Vivas Paula , Vasconcelos Adriana , von Ristow Arno
Published: May 2020

Objective

The bell-bottom technique is a widely used technique to treat aortoiliac aneurysms with preservation of the hypogastric arteries. The published data are scarce with conflicting results regarding the evolution. The aim of this study was to compare the outcomes of patients submitted to endovascular abdominal aortic aneurysm repair with standard technique (S-EVAR) versus bell-bottom technique.

Methods

This retrospective cohort study compared the outcomes of standard endovascular aneurysm repair (<16 mm iliac limbs) and bell-bottom technique (≥16 mm iliac limbs) in a tertiary vascular center between 2010 and 2015. The end points of this study were type IB endoleak, reintervention and 30-day mortality. The follow-up protocol included CT scans within 30 days of implantation and 12 months. Duplex ultrasound was performed yearly thereafter.

Results

Two hundred and three patients were treated with bell-bottom technique ( n = 84, mean age 72.2 ± 8.9) and S-EVAR ( n = 119, mean age 72.7 ± 8.4). The overall 30-day mortality was 1.9%, with no significant difference between groups. There was higher prevalence of coronary heart disease in the bell-bottom technique group compared to the S-EVAR group (41.6% vs. 18.4%, p < 0.01). One patient in the S-EVAR group (0.85%) and four patients in the bell-bottom technique (4.6%) developed type IB endoleak. The mean follow-up period was 35.2 ± 30.4 months. By Kaplan-Meier analysis, freedom from type IB endoleak in 80 months was 85.2% in the bell-bottom technique group and 98.7% in the S-EVAR group ( p = 0.05). The freedom from reintervention in 80 months was 74.0% in the bell-bottom technique group and 94.1% in the S-EVAR group ( p = 0.6).

Conclusions

This study shows lower freedom from type IB endoleak in the bell-bottom group compared to the standard repair group. There is no significant difference in reoperation rate and 30-day mortality.
Transportable open-source application program interface and user interface for generic humanoids: TOUGH
Authors: Jagtap Vinayak , Agarwal Shlok , Wagh Ameya , Gennert Michael
Published: May 2020

Humanoid robotics is a complex and highly diverse field. Humanoid robots may have dozens of sensors and actuators that together realize complicated behaviors. Adding to the complexity is that each type of humanoid has unique application program interfaces, thus software written for one humanoid does not easily transport to others. This article introduces the transportable open-source application program interface and user interface for generic humanoids, a set of application program interfaces that simplifies the programming and operation of diverse humanoid robots. These application program interfaces allow for quick implementation of complex tasks and high-level controllers. Transportable open-source application program interface and user interface for generic humanoids has been developed for, and tested on, Boston Dynamics’ Atlas V5 and NASA’s Valkyrie R5 robots. It has proved successful for experiments on both robots in simulation and hardware, demonstrating the seamless integration of manipulation, perception, and task planning. To encourage the rapid adoption of transportable open-source application program interface and user interface for generic humanoids for education and research, the software is available as Docker images, which enable quick setup of multiuser simulation environments.
Managing cultural diversity for collective identity: A case study of an ELT department in Omani higher education
Authors: Al Muqarshi Amal , Kaparou Maria , Kelly Anthony
Published: May 2020

This paper employs a social identity approach to explore the management of a collective organizational culture in a culturally diverse context. Literature suggests that cultural diversity can be an asset for organizations if managed effectively. This study employs a qualitative case-study design, drawn on data generated for a larger project that utilized 16 interviews, eight team meetings’ observations, document analysis and field notes. It instrumentally uses a Department of English as its site due to the prevalence of cultural diversity in such context. The paper explores whether leadership is perceived as effective towards establishing a collective identity in an Omani higher education (HE) domain. The findings suggest that leadership impact is restricted by the central management of the system that translates largely into transactional leadership and hierarchical approaches at the level of the group and largely fails to establish such an inclusive identity. The paper argues that in a globalizing era, Omani HE can only view cultural diversity as an asset that aids its intellectual capital establishment. Hence, it should cater for such a composition and engineer it effectively to achieve better alignment with the requirements of the current market. These findings can be of value to policy makers, researchers and professionals in HE.
A randomized controlled trial of high-intensity interval training and inspiratory muscle training for chronic heart failure patients with inspiratory muscle weakness
Authors: Sadek Zahra , Salami Ali , Youness Mahmoud , Awada Charifa , Hamade Malek , Joumaa Wissam H , Ramadan Wiam , Ahmaidi Said
Published: May 2020

Objectives

Chronic heart failure is a major public health problem in which supervised exercise programs are recommended as part of non-pharmacological management. There are various reports of the success of high-intensity aerobic interval training (HI-AIT) and inspiratory muscle training (IMT) in the management of chronic heart failure patients. This study tested the hypothesis that the combination of HI-AIT and IMT could result in additional benefits over the IMT and the HI-AIT alone in terms of inspiratory muscle function, exercise capacity, and quality of life in patients with chronic heart failure and inspiratory muscle weakness.

Methods

Forty patients with ejection fraction ≤45% and inspiratory muscle weakness described by maximal inspiratory pressure <70% predicted, underwent three exercise training sessions per week for 12 weeks. Patients were randomly allocated to one of four groups: the HI-AIT group, the IMT group, the combined (HI-AIT & IMT) group, and the control group. Before and after completing their training period, all patients underwent different tests that are mentioned above.

Results

No changes were detected in the control group. However, the combined group, when compared to HI-AIT and IMT groups, respectively, resulted in additional significant improvement in maximal inspiratory training (62%, 24%, 25%), exercise time (62%, 29%, 12%), the 6-minute walk test (23%, 15%, 18%), and the Minnesota Living with Heart Failure Questionnaire (56%, 47%, 36%).

Conclusion

In patients with chronic heart failure and inspiratory muscle weakness, the combination of the HI-AIT and the IMT resulted in additional benefits in respiratory muscle function, exercise performance, and quality of life compared to that of HI-AIT or IMT alone. Trial Registration number: NCT03538249