bluuebunny/crossref_metadata_2025 huggingface dataset:
Experiences and outcomes following diagnosis of congenital foetal anomaly and medical termination of pregnancy: A phenomenological study
Authors: Atienza‐Carrasco José , Linares‐Abad Manuel , Padilla‐Ruiz María , Morales‐Gil Isabel María
Published: December 2019

Aim

To determine and describe the experiences of pregnant women who receive a diagnosis of chromosomopathy and/or foetal malformation during a prenatal check‐up and who decide to legally terminate the pregnancy.

Background

When a pregnancy is terminated, the woman must cope with frustrated motherhood. The psychological consequences of this will largely depend on the care and support provided by health professionals. When a congenital anomaly is diagnosed, a patient‐centred communication helps understanding, influences adaptation to the new situation and ensures the person concerned has sufficient (autonomy or independence or ability) to make appropriate decisions.

Methods

A qualitative study, based on a phenomenological approach, was carried out through nonparticipant observation and semi‐structured interviews with 27 obstetric patients. NVivo 11 software was used, and content analysis was performed. The manuscript was developed using the COREQ guidelines to inform qualitative studies.

Results

The clinical relationship may be affected by communication problems such as patients' perceptions of scarce emotional involvement by obstetricians, by poor psychosocial support during the termination of the pregnancy and by insufficient follow‐up after discharge.

Conclusion

Nurses are in a privileged position to promote the empowerment of affected women. It is necessary to improve aspects related to the privacy of patients and the awareness and training of the interdisciplinary team in interpersonal communication. Post‐loss follow‐up is recommended to assess individual needs, thus facilitating an optimal approach to ease the grieving process.

Relevance to clinical practice

During the prenatal diagnosis, the existence of a fetal anomaly is emphasized, but support and follow up of the mother may be neglected; therefore, exhaustive knowledge about the obstetric history, the state of health and the expectations of patients is as important as a multidisciplinary team trained in counseling strategies and with a comprehensive care plan that covers all areas, especially those that control maternal emotions.
Occupational determinants of compassion satisfaction and compassion fatigue among Filipino registered nurses
Authors: Balinbin Chanel Bjanca V. , Balatbat Krystina Trizia R. , Balayan Alyssa Nicolette B. , Balcueva Maria Isabel C. , Balicat Mary Grace B. , Balidoy Thea Arabelle S. , Macindo John Rey B. , Torres Gian Carlo S.
Published: December 2019

Aims and objectives

To determine the prevalence and to identify the occupational determinants of compassion satisfaction and compassion fatigue among general medical–surgical registered nurses.

Background

Compassion fatigue and compassion satisfaction are caring concepts that have been explored among nurses in specialised hospital units. However, there is paucity of studies exploring the occupational determinants among general medical–surgical registered nurses.

Design

Cross‐sectional.

Methods

From August–November 2017, 121 consecutively selected general medical–surgical registered Nurses from five hospitals completed a four‐part survey packet composed of the participant information sheet, the Professional Quality of Life Version 5, the McCloskey‐Mueller Satisfaction Scale and the Eden Warmth Survey—Employee Questionnaire. Stepwise‐forward multiple linear regression was employed to identify the occupational determinants of compassion fatigue and compassion satisfaction. The STROBE checklist was followed in reporting this study (see Appendix S1).

Results

The prevalence of moderate to high levels of compassion satisfaction was 90.09% while burnout and secondary stress, the facets of compassion fatigue, had a prevalence of 74.38% and 83.47%, respectively. Among the identified occupational determinants, only job satisfaction and nurse colleague relationship positively influenced compassion satisfaction. In contrary, although higher monthly income positively influenced both dimensions of compassion fatigue, nurse colleague relationship had the strongest negative effect.

Conclusion

Among the occupational determinants of compassion fatigue and compassion satisfaction, nurse colleague relationship had the strongest influence. This result highlights the importance of positive nurse colleague relationships and paves way for the development and initiation of appropriate strategies.

Relevance to clinical practice

The findings of this study paves way for the development of institutional policies and individualised programmes geared towards building rapport and communication among registered nurses assigned in general medical–surgical units. Likewise, the high prevalence of compassion fatigue needs further exploration to develop appropriate measures to mitigate its development among general medical–surgical nurses.
National Early Warning Score: A survey of registered nurses' perceptions, experiences and barriers
Authors: Spångfors Martin , Molt Mats , Samuelson Karin
Published: December 2019

Aims & objectives

To describe registered nurses' perceptions, experiences and barriers for using the National Early Warning Score in relation to their work experience and medical affiliation.

Background

Indications of inconsistencies in adherence to the National Early Warning Score have emerged.

Design

Web‐based questionnaire study.

Methods

The questionnaire was sent to 3,165 registered nurses working in somatic hospitals in the southern part of Sweden. Strengthening the Reporting of Observational Studies in Epidemiology was adhered.

Results

Seventy‐one per cent of the 1,044 respondents reported adherence to the National Early Warning Score guidelines recommended frequency of monitoring and 74% to the clinical response scale. The shorter the working experience, the higher the proportion of registered nurses who answered positively to the National Early Warning Score allowing them to better prioritise their care with short nursing experience. When categorising nurses according to their workplace's medical affiliation, adherence to the National Early Warning Score guidelines recommended frequency of monitoring was reported highest in surgery and orthopaedics (66%) and lowest in the cardiac high dependency unit (52%). Corresponding proportions of reported adherence to the clinical response scale were highest in orthopaedics (82%) and lowest in the cardiac high dependency unit (48%). Lack of response from the doctor was reported as one of the main reasons for not adhering to the National Early Warning Score by 50% of the registered nurse.

Conclusion

In general, registered nurses perceived the National Early Warning Score as a useful tool, supporting their gut feeling about an unstable patient. Barriers to the National Early Warning Score were found in doctors and the most experienced registered nurses, indicating the need for resources to be focused on the adherence of these members of the healthcare team.

Relevance to clinical practice

In general, the registered nurses answered positively to the National Early Warning Score. We found indications that there is a need to focus resources on the adherence of the most experienced registered nurse and the doctors.
Efficacy of “Mentoring to Be Active” on Weight Loss, Body Mass Index, and Body Fat among Obese and Extremely Obese Youth in Rural Appalachia
Authors: Smith Laureen H. , Petosa Rick L. , Laurent Devin
Published: December 2019

Purpose

This study compares the efficacy of a behavioral skills mentoring program (Mentored Planning to Be Active [MBA]) to a teacher‐led program (Planning to Be Active [PBA]) for increasing physical activity in Appalachian teens on health outcomes (weight loss, body mass index (BMI), and body fat).

Methods

Secondary analysis of a larger group‐randomized controlled trial was conducted in 20 rural Appalachian schools. Descriptive Pearson correlations and multivariate analyses with between‐subject effects were conducted. Effect sizes (ES) using Cohen's d and odds ratios (OR) with 95% confidence intervals were calculated.

Findings

The obese MBA group lost 77.5% more weight by T3 compared to the PBA group; T2 was (F = 8.51, P = .000) and T3 was (F = 7.62, P = .000). ES was 0.34. OR = 1.45 (95% CI: 0.558‐3.792) at T2 and OR = 3.32 (95% CI: 1.103‐9.978) at T3. Extremely obese in the MBA group lost 80.0% more weight compared to the PBA group; T2 was (F = 5.23, P = .025) and at T3 (F = 6.33, P = .015) ES was 0.58. OR = 4.36 (95% CI: 0.981‐19.34). Extremely obese females lost more weight compared to males (F = 4.75, P = .034). BMI and body fat had similar results; youth in the MBA group had the most improvement.

Conclusions

Rural Appalachian youth are disproportionately extremely obese. BMI does not capture adiposity or cardiovascular risk. BMI, BMI percentile, raw weight, fat mass, and percent body fat are more complete analyses of adiposity and cardiovascular risk.
Replacing fish meal with cottonseed meal protein hydrolysate affects growth, intestinal function, and growth hormone/insulin‐like growth factor I axis of juvenile blunt snout bream (Megalobrama amblycephala)
Authors: Yuan Xiang‐Yang , Jiang Guang‐Zhen , Cheng Hui‐Hui , Cao Xiu‐Fei , Wang Cong‐Cong , Dai Yong‐Jun , Liu Wen‐Bin
Published: December 2019

This study aimed to assess the effects of replacing fish meal with cottonseed meal protein hydrolysate (CPH) on the growth, intestinal function, growth hormone/insulin‐like growth factor I (GH/IGF‐I) axis, and inflammation of blunt snout bream, Megalobrama amblycephala. A total of 300 fish (38.66 ± 0.08 g) were allocated into five groups and fed either the basal diet (CPH 0) or the basal diet that replaced fish meal with 1% (CPH 1), 3% (CPH 3), 5% (CPH 5), and 7% CPH (CPH 7). Dietary CPH 3 increased the activities of protease, Na+/K+‐ATPase, amylase, creatine kinase, and γ‐glutamyl transpeptidase; microvillus length in the anterior and mid intestines; and the mRNA levels of GH, growth hormone receptor (GHR), and IGF‐I without any negative effects on growth. Dietary CPH 7 increased the mRNA levels of tumor necrosis factor‐α, interleukin‐6, IκB kinase alpha, and nuclear factor κB but decreased the transcript level of inhibitor of κB‐α (p < .05). Therefore, replacing fish meal with CPH 3 improved intestinal function and the transcription of GH/IGF‐I axis genes without any adverse effect on growth or triggering of inflammation in juvenile blunt snout bream.
The Cosponsorship Patterns of Reserved Seat Legislators
Authors: Muraoka Taishi
Published: December 2019

This study analyzes the bill cosponsorship behavior of reserved seat legislators in the Pakistan National Assembly, where special legislative seats are reserved for women and religious minorities. It offers a critical case because two theories on reserved seat legislators—the theory of electoral incentives and the theory of institutional weakness—lead to opposite predictions about the extent to which such legislators will engage in bill cosponsorship, with the former (latter) predicting the negative (positive) effect of reserved seats. I find that women and minorities in reserved seats initiate a greater number of bills and cosponsor bills with a larger number of peers than nonreserved male legislators. Using network analysis, I also show that reserved legislators tend to play a role in bridging different partisan blocs of legislators within the cosponsorship network. These empirical patterns provide support to the theory of institutional weakness, rather than to the theory of electoral incentives.
Effectiveness of a locally produced ready‐to‐use supplementary food in preventing growth faltering for children under 2 years in Cambodia: a cluster randomised controlled trial
Authors: Borg Bindi , Sok Daream , Mihrshahi Seema , Griffin Mark , Chamnan Chhoun , Berger Jacques , Laillou Arnaud , Roos Nanna , Wieringa Frank T.
Published: December 2019

This cluster randomised controlled trial tested the effectiveness of a locally produced, fish‐based, ready‐to‐use supplementary food (RUSF) to prevent growth faltering (decline in z‐scores). Cambodian infants (n= 485), aged 6 to 11 months, were randomised by site to receive the RUSF, Corn‐Soy Blend++ (CSB++), micronutrient powders (MNP), or no supplement (control). The intervention was for 6 months. In unadjusted analysis, the control group had statistically significantly decreased weight‐for‐age z‐scores (WAZ; ‐0.02, 95%CI = ‐0.03 ‐ ‐0.01, P= 0.001) and height‐for‐age z‐scores (HAZ; ‐0.07, 95%CI = ‐0.09 ‐ ‐0.05, P < 0.001), and increased mid‐upper arm‐circumference (MUAC; 0.02cm, 95%CI = 0.01 ‐ 0.04, P = 0.010), but no statistically significant change in weight‐for‐height z‐scores (WHZ). The RUSF group did not differ significantly from the control for WAZ, HAZ or WHZ (in other words, WAZ and HAZ decreased and WHZ did not change), but had increased MUAC in comparison to the control (0.04cm, 95%CI = 0.01 ‐ 0.06, P = 0.008). There were no statistically significant differences between the RUSF group and the CSB++ or MNP groups with respect to WAZ, HAZ, WHZ or MUAC. Interestingly, in adjusted analysis, low consumers of RUSF had increased WAZ, WHZ and MUAC (0.03, 95%CI = 0.01‐0.06, P = 0.006; 0.04, 95%CI = 0.01‐0.08, P = 0.026; and 0.05cm, 95%CI = 0.02‐0.09, P = 0.004, respectively) compared with the control. The novel RUSF, particularly in small quantities, protected against ponderal growth faltering, but the improvements were of limited clinical significance.
Genomic processes underlying rapid adaptation of a natural Chironomus riparius population to unintendedly applied experimental selection pressures
Authors: Pfenninger Markus , Foucault Quentin
Published: December 2019

Evolve and Resquence (E&R) studies are a useful tool to study genomic processes during rapid adaptation, e.g., in the framework of adaptive responses to global climate change. We applied different thermal regimes to a natural Chironomus riparius (Diptera) population in an E&R framework to infer its evolutionary potential for rapid thermal adaptation. We exposed two replicates to three temperatures each (14°C, 20°C and 26°C) for more than two years, the experiment thus lasting 22, 44 or 65 generations, respectively. The two higher temperatures presented a priori moderate, respectively strong selection pressures. Life‐cycle fitness tests revealed no appreciable adaptation to thermal regimes but a common adaptation of all six replicates probably due to the rearing conditions, presumably increased larval density and water quality. Genomic analyses showed a strong, genome‐wide selective response in all replicates (mean s of selected SNPs = 0.305). This genomic response was significantly similar at all genomic levels among all replicates (SNPs, 10 kb windows, genes, exons, regions of elevated allele frequency change [REA]). The intersections among the replicates exposed to the same temperature were either insignificant or underrepresented. This confirmed a selective response to identical selection pressure(s), however, not to thermal regime. Genes closest to the SNP with the highest selection coefficient per REA were enriched for GO terms related to ion transport, regulation of transcription and signal transduction, which supported the presumed acting selection pressures. Our study showed the evolutionary potential for rapid adaptation by genome‐wide and probably polygenic selection on standing genetic variation in C. riparius. However, because of the impossibility to accurately predict the acting selective regime in evolutionary experiments, we discuss the sobering perspectives for inferring the evolutionary potential of natural populations with this approach.
To dwell within: Bridging the theory–practice gap
Authors: Zieber Mark , Wojtowicz Bernadine
Published: December 2019

Nursing has a considerable history of theory development but has consistently struggled to reconcile theoretical reality and practice realities. Many authors have attempted to reconcile what has been called the “theory–practice gap,” but the space where these two realities enmesh has remained problematic and contentious (Aimei, Macau Journal of Nursing, 14, 2015, 13; Factor, Matienzo, & de Guzman, Nurse Education Today, 57, 2017, 82). The idea of the theory–practice gap has a significant history in nursing, but also continues to have a significant presence within nursing literature and mythology up to the present (Aimei, Macau Journal of Nursing, 14, 2015, 13). In this paper, the space between theoretic reality and practice reality, as evidenced by the theory–practice gap, will be examined. A Heideggerian perspective of “dwelling” (Heidegger, 1971, Poetry, language, thought, New York, NY: Harper Colophon) will be used as a guiding discourse to move nursing away from this classic tension between theory and practice, towards a perspective where theory and practice are woven together as part of one reality.
Intravenous Tranexamic Acid for Reducing Perioperative Blood Loss During Revision Surgery for Vancouver Type B Periprosthetic Femoral Fractures After Total Hip Arthroplasty: A Retrospective Study
Authors: Wang Qiu‐ru , Yeersheng Releken , Li Dong‐hai , Yang Zhou‐yuan , Kang Peng‐de
Published: December 2019

Objective

To explore the efficacy and safety of intravenous tranexamic acid for reducing perioperative blood loss and allogeneic blood transfusions in revision surgery for Vancouver type B periprosthetic femoral fractures after total hip arthroplasty (THA).

Methods

We retrospectively reviewed 129 patients who underwent revision surgeries because of Vancouver type B periprosthetic femoral fractures from January 2008 to September 2018. Patients were divided into two groups according to whether they received intravenous tranexamic acid (n = 72) or not (n = 57). The two groups were compared in terms of estimated intraoperative blood loss, visible blood loss, hidden blood loss, the volume of allogeneic blood transfusion and the incidence of symptomatic venous thromboembolism (VTE). Patients were also compared depending on the Vancouver classification (Vancouver type B1, B2, and B3).

Results

Regardless of the subtype of Vancouver classification, patients who received tranexamic acid showed significantly lower estimated intraoperative blood loss, visible blood loss, hidden blood loss, and allogeneic blood transfusion volume. Use of tranexamic acid was not associated with significant changes in the incidence of postoperative symptomatic VTE. Similar results were obtained with subgroups of patients who had the Vancouver type B1, B2, or B3 periprosthetic femoral fractures.

Conclusions

The administration of intravenous tranexamic acid can safely and effectively reduce perioperative blood loss and allogeneic blood transfusions in revision surgery for Vancouver type B periprosthetic femoral fractures, without increasing the risk of symptomatic VTE.
Limited Influence of Comorbidities on Length of Stay after Total Hip Arthroplasty: Experience of Enhanced Recovery after Surgery
Authors: Ding Zi‐chuan , Xu Bing , Liang Zhi‐min , Wang Hao‐yang , Luo Ze‐yu , Zhou Zong‐ke
Published: December 2019

Objectives

To identify predictors of length of stay (LOS) after total hip arthroplasty (THA) in an enhanced recovery after surgery (ERAS) program and evaluate the safety and cost‐efficiency of the ERAS program with reduced LOS for unselected patients in a Chinese population.

Methods

A total of 311 consecutive, unselected patients undergoing primary THA at a single institution were retrospectively reviewed and divided into two groups: LOS ≤ 3 and LOS > 3 group. All patients were managed with the same ERAS protocol and went back home after discharge. Multivariate logistic regression analysis was used to determine independent risk factors for LOS > 3. Harris Hip Score at 90‐day follow‐up, 90‐day readmission rate, and hospitalization costs were compared between two groups.

Results

Multivariate regression analysis identified female gender (odds ratio [OR] = 2.623), living alone (OR = 4.127), and primary osteoarthritis of hip (OR = 3.565) to be correlated with LOS > 3. Preoperative hemoglobin (HB), postoperative HB, drain use, blood transfusion, diabetes, respiratory disease, osteoporosis, number of comorbidities, and CCI score showed no significant influence on LOS after adjusting for other risk factors in the multivariate model. Harris Hip Score and readmission rate at 90‐day follow‐up showed no significant differences between two groups. Patients in LOS > 3 group had approximately 3948.6 Chinese yuan higher hospital costs.

Conclusion

Female gender, living alone, and primary osteoarthritis of hip were identified as independent risk factors for prolonged LOS. The experience from our institution suggested aggressive management of comorbidities in the ERAS program can minimize the influence of comorbidities on LOS. The safety, efficiency, and costs‐saving benefits of the ERAS program with reduced LOS for unselected patients was confirmed in this study.
Neuromuscular‐blocking agents for tracheal intubation in pediatric patients (0‐12 years): A systematic review and meta‐analysis
Authors: Vanlinthout Luc E. , Geniets Bénédicte , Driessen Jacques J. , Saldien Vera , Lapré Raphaël , Berghmans Johan , Uwimpuhwe Germaine , Hens Niel
Published: December 2019

Background

The benefit of using neuromuscular‐blocking agents to facilitate tracheal intubation in pediatric patients remains unclear due to variations in design, treatments, and results among trials. By combining the available evidence, we aimed to establish whether scientific findings are consistent and can be generalized across various populations, settings, and treatments.

Methods

A systematic search for randomized controlled trials, related to the use of neuromuscular‐blocking agents for tracheal intubation in American Society of Anesthesiologists class I‐II participants (0‐12 years), was performed. We considered all randomized controlled trials that studied whether intubation conditions and hemodynamics obtained by using neuromuscular‐blocking agents were equivalent to those that were achieved without neuromuscular‐blocking agents. We combined the outcomes in Review Manager 5.3 (RevMan, The Cochrane Collaboration) by pairwise random‐effects meta‐analysis using a risk ratio (RR) for intubation conditions and mean difference for hemodynamic values (mean [95% Confidence Intervals]). Heterogeneity among trials was explored using sensitivity analyses.

Results

We identified 22 eligible randomized controlled trials with 1651 participants. Overall, the use of a neuromuscular‐blocking agent was associated with a clinically important increase in the likelihood of both excellent (RR = 1.41 [1.19‐1.68], I2 = 76%) and acceptable (RR = 1.13 [1.07‐1.19], I2 = 68%) intubating conditions. There is strong evidence that both unacceptable intubation conditions (RR = 0.35 [0.22‐0.46], I2 = 23%) and failed first intubation attempts (RR = 0.25 [0.14‐0.42], I2 = 0%) were less likely to occur when a neuromuscular‐blocking agent was used compared with when it was not. Higher systolic or mean arterial pressures (mean difference = 13.3 [9.1‐17.5] mm Hg, I2 = 69%) and heart rates (mean difference = 15.9 [11.0‐20.8] beats/min, I2 = 75%) as well as a lower incidence of arrhythmias were observed when tracheal intubation was facilitated by neuromuscular‐blocking agents.

Conclusion

The use of a neuromuscular‐blocking agent during light‐to‐moderate depth of anesthesia can improve the quality as well as the success rate of tracheal intubation and is associated with better hemodynamic stability during induction of anesthesia.
Woody tissue photosynthesis reduces stem CO2 efflux by half and remains unaffected by drought stress in young Populus tremula trees
Authors: De Roo Linus , Salomón Roberto Luis , Steppe Kathy
Published: December 2019

A substantial portion of locally respired CO2 in stems can be assimilated by chloroplast‐containing tissues. Woody tissue photosynthesis (Pwt) therefore plays a major role in the stem carbon balance. To study the impact of Pwt on stem carbon cycling along a gradient of water availability, stem CO2 efflux (EA), xylem CO2 concentration ([CO2]), and xylem water potential (Ψxylem) were measured in 4‐year‐old Populus tremula L. trees exposed to drought stress and different regimes of light exclusion of woody tissues. Under well‐watered conditions, local Pwt decreased EA up to 30%. Axial CO2 diffusion (Dax) induced by distant Pwt caused an additional decrease in EA of up to 25% and limited xylem [CO2] build‐up. Under drought stress, absolute decreases in EA driven by Pwt remained stable, denoting that Pwt was not affected by drought. At the end of the dry period, when transpiration was low, local Pwt and Dax offset 20% and 10% of stem respiration on a daily basis, respectively. These results highlight (a) the importance of Pwt for an adequate interpretation of EA measurements and (b) homeostatic Pwt along a drought stress gradient, which might play a crucial role to fuel stem metabolism when leaf carbon uptake and phloem transport are limited.
Insulin therapy for hyperglycemia in neonatal sepsis using a preterm mouse model
Authors: Miyauchi Harunori , Fujioka Kazumichi , Okubo Saki , Nishida Kosuke , Ashina Mariko , Ikuta Toshihiko , Okata Yuichi , Maeda Kosaku , Iijima Kazumoto , Bitoh Yuko
Published: December 2019

Background

Stress‐induced hyperglycemia is a frequent complication of neonatal sepsis. Hyperglycemia induces oxidative stress and immunosuppression. We investigated the glucose kinetics and effect of insulin administration during stress‐induced hyperglycemia in a neonatal sepsis mouse model.

Methods

A stock cecal slurry (CS) solution was prepared from adult cecums and 3.0 mg of CS/g (LD40) was administered intraperitoneally to 4‐day‐old FVB mouse pups. Blood glucose levels were measured at 1.5, 3, 6, and 9 h post‐sepsis induction and compared with basal levels. Two different doses of ultrafast‐acting insulin were administered subcutaneously, and blood glucose levels and survival rates were monitored.

Results

Blood glucose levels were significantly higher than those of baseline levels with a peak at 3 h, which progressively decreased from 6 to 9 h post‐sepsis induction. Insulin treatment reduced post‐sepsis‐induced hyperglycemia at 1.5 and 3 h. The mortality rate of CS‐only pups (39%) was similar to that of CS + 1 U/kg insulin pups (60%). However, the mortality rate of CS + 5 U/kg insulin pups (82%) was significantly higher than that of CS‐only pups.

Conclusions

Marked hyperglycemia was induced immediately after post‐sepsis induction, and the high‐dose insulin treatment increased mortality post‐induction. Stress‐induced hyperglycemia could therefore be a physiological and protective response for preterm sepsis, and aggressive treatment of this hyperglycemia might be contraindicated.
Gaps in the elimination of congenital syphilis in a tertiary care center in Thailand
Authors: Anugulruengkitt Suvaporn , Yodkitudomying Chatnapa , Sirisabya Anongnart , Chitsinchayakul Thaninee , Jantarabenjakul Watsamon , Chaithongwongwatthana Surasith , Puthanakit Thanyawee
Published: December 2019

Background

The World Health Organization has set a goal to eliminate mother‐to‐child transmission of syphilis to a target of <50 cases per 100 000 live births. This study aimed to determine the rate of congenital syphilis and identify gaps in prevention.

Methods

A retrospective chart review was conducted in a tertiary care center in Bangkok, Thailand. The study included all pregnant women with positive syphilis serology and their infants. All congenital syphilis cases were categorized according to Centers for Disease Control criteria.

Results

From 2013 to 2017, 69 syphilis‐infected pregnant women were included, with 30 congenital syphilis cases. The rate of congenital syphilis was 115 cases (95% CI 78–164) per 100 000 live births. The median (interquartile range) maternal age was 21 (18–32) years and 12 (17%) women had human immunodeficiency virus co‐infection. Regarding maternal treatment, 28 (41%) women had inadequate treatment due to 13 cases (19%) of late or no antenatal care, six cases (8%) of recent infection near delivery, five cases (7%) of failure of treatment provision, and four (6%) others. There were three syphilitic stillbirths who were prematurely born to untreated pregnant women and 67 live births (one set of twins) of which 27 met definitions of probable congenital syphilis. They received complete treatment with penicillin and had non‐reactive rapid plasma reagin within the first 6 months of life, with the exception of one who had non‐reactive rapid plasma reagin at the age of 7 months.

Conclusions

Congenital syphilis remains a problem in our setting. Nearly half of pregnant women who had syphilis had inadequate treatment. There is an urgent need to strengthen diagnosis and the treatment cascade of syphilis during antenatal care.
Motor outcome, executive functioning, and health‐related quality of life of children, adolescents, and young adults after ventricular assist device and heart transplantation
Authors: Barron Lucie‐Charlotte , Haas Nikolaus , Hagl Christian , Schulze‐Neick Ingram , Ulrich Sarah , Lehner Anja , Heinen Florian , Weinberger Raphael , Rosenthal Lale , Gerstl Lucia , Dalla‐Pozza Robert
Published: December 2019

Objective

The aim of the current study is to measure long‐term executive function, motor outcome, and QoL in children, adolescents, and young adults after VAD and Htx.

Methods

Patients were examined during routine follow‐up. Investigation tools were used as follows: Examination for MND of motor outcomes, Epitrack® for attention and executive functioning, and Kidscreen‐52 and EQ‐5D‐5L questionnaires for QoL. Additional data were retrospectively obtained by an analysis of patient medical records.

Results

Out of 145 heart transplant recipients at the department of pediatric cardiology of the University Hospital Munich, 39 were implanted with a VAD between 1992 and 2016. Seventeen (43.6%) patients died before or after Htx; 22 (56.4%) patients were included in our study. Mean age at transplant was 9.52 years (range: 0.58‐24.39 years, median 9), and the mean follow‐up time after Htx was 6.18 years (range: 0.05‐14.60 years, median 5.82). MND examination could be performed in 13 patients (normal MND: n = 11, simple MND: n = 1, complex MND: n = 1). Executive functioning was tested in 15 patients. Two (13.3%) patients had good results, six (40%) average results, three (20%) borderline results, and four (26.7%) impaired results. QoL (Kidscreen n = 7, EQ‐5D‐5L n = 8) was similar to a healthy German population.

Conclusion

Motor outcome, executive functioning and QoL in survivors of VAD bridging therapy and Htx can be good, though underlying diseases and therapies are associated with a high risk of cerebral ischemic or hemorrhagic complications.
Fluorescence and Treatment Light Monitoring for Interstitial Photodynamic Therapy
Authors: Heckl Christian , Aumiller Maximilian , Rühm Adrian , Sroka Ronald , Stepp Herbert
Published: December 2019

In interstitial photodynamic therapy, light is distributed to the tumor via light diffusers. The light dose and the related phototoxic effect achieved throughout the target volume critically depend on absorption, scattering and diffuser positioning. Using liquid tissue phantoms, we investigated the dependencies of treatment light transmission and protoporphyrin IX (PpIX) fluorescence on these parameters. This enabled monitoring hemoglobin oxygenation and methemoglobin formation during irradiation (635 nm, 200 mW cm−1 diffuser length). Starting with two parallel cylindrical diffusers at 10 mm radial separation, the light transmitted between the fibers was largely determined by the minimal distance between the diffusers, but rather insensitive to an additional axial displacement or tilting of one fiber with respect to the other. For fixed distance between the diffusor centers, however, tilting up to direct contact resulted in a 10‐fold signal increase. For hemoglobin within erythrocytes, irradiation leads to photobleaching of PpIX without marked change in hemoglobin oxygenation until hemolysis occurs. Afterward, hemoglobin is rapidly deoxygenized and methemoglobin is formed, leading to a dramatic increase in absorption. For lysed blood, these effects start immediately. A comparison of intraoperative monitoring of the signals with the experimental results might help prevent insufficient treatment by reconsidering treatment planning or prolonging irradiation.
Materials Science Challenges in Skin UV Protection: A Review
Authors: Egambaram Orielia Pria , Kesavan Pillai Sreejarani , Ray Suprakas Sinha
Published: December 2019

UV radiation is one of the critical environmental stress factors for human skin, which can trigger various problems such as pruritus, burning, erythema, premature skin aging and skin cancer. Hence, UV protection has become an indispensable daily routine and the use of topical sunscreen products is rapidly increasing. However, there are emerging concerns over the efficiency and safety of existing chemical and physical UV filters used in consumer products. Furthermore, there is no universally approved method for assessing sun protection efficiency regardless of the immediate end user need to develop safer sunscreen products that afford broad‐spectrum photoprotection. It is evident that the current organic and inorganic UV filters have significant unfavorable impacts on human, environmental, and marine safety. Therefore, effective alternative UV filters should be established. This article comprehensively reviews the properties, safety, health and ecological concerns of various UV filters including TiO2 and ZnO nanoparticles as well as the limitations of the testing protocols and guidelines provided by major regulatory bodies. The photoreactivity of UV filters used in sunscreen remains a major challenge, and it is crucial to develop new sunscreen ingredients, which not only protect the consumer, but also the environment.
Toxoplasma gondii protects from IgE sensitization and induces Th1/Th2 immune profile
Authors: Andrade Milena M. C. , Carneiro Valdirene L. , Galvão Alana A. , Fonseca Thales R. , Vitor Ricardo W. A. , Alcantara‐Neves Neuza Maria , Cruz Álvaro A. , Figueiredo Camila A.
Published: December 2019

Toxoplasma gondii (T gondii) infection has been associated with protection against allergy and autoimmune diseases. We investigated the effects of T gondii infection on cytokine and antibody responses in atopic and nonatopic Brazilian subjects. We have measured in whole‐blood cultures, Th1 (IFN‐γ and IL‐12), Th2 (IL‐5) and regulatory cytokine IL‐10 in blood cells unstimulated and stimulated with pokeweed mitogen or T gondii soluble tachyzoites antigen (STAg) or Dermatophagoides pteronyssinus antigen. A significant negative association was found between high levels of anti‐dust mite IgE and T gondii seropositivity (OR = 0.46; 95%CI = 0.25‐0.85). STAg stimulation induced a mixed profile of Th1 and Th2 cytokines (IFN‐γ, IL‐12 and IL‐5) in Tg‐positive atopic individuals compared with Tg‐negative atopic individuals (P < .0001, P = .033 and P = .003, respectively). In contrast, IL‐10 production was not different between these groups. No association was found between T gondii infection and asthma. We hypothesized that the protective effect on atopy might be related to the strong Th1 immune response to T gondii found on the seropositive subjects. From our knowledge, this is the first study to investigate the association between atopy and T gondii infection in Brazilian subjects, analysing the cellular immune responses.
U.S. R&D internationalization in less‐developed countries: Determinants and insights from Brazil, China, and India
Authors: Chiarini Tulio , Caliari Thiago , Bittencourt Pablo Felipe , Siqueira Rapini Marcia
Published: December 2019

The growing U.S. R&D internationalization has historically been concentrated in developed countries. However, in the past few decades, the internationalization has moved toward less‐developed countries (LDCs), particularly Brazil, China, and India. What location factors are making some LDCs more “inviting” for U.S. R&D offshore? To answer this first question, we constructed a panel data using secondary data from the U.S. Bureau of Economic Analysis regarding the R&D investment made by the majority‐owned foreign affiliates of U.S. parent companies in 71 countries. We then applied a Heckman two‐step correction for selection bias test. The results highlight some important differences between developed countries’ and LDCs’ attractiveness. Based on these initial results, we conducted a detailed analysis of the determinants of U.S. R&D investments in Brazil, China, and India, which revealed that China’s determinants mostly match those found in more developed countries.
Impact of oral conditions of children/adolescents with Down syndrome on their families’ quality of life
Authors: Carrada Camila Faria , Scalioni Flávia Almeida Ribeiro , Abreu Lucas Guimarães , Ribeiro Rosangela Almeida , Paiva Saul Martins
Published: December 2019

Aims

To assess the impact of oral conditions among children/adolescents with Down syndrome (DS) on the Oral Health‐related Quality of Life (OHRQoL) of their families in comparison with a group without DS.

Methods and results

Families of 144 children/adolescents with DS aged 4‐18 years were compared with families of individuals without DS. Dental caries experience (DMFT/dmft), clinical consequences of untreated dental caries (PUFA/pufa), gingival bleeding (GBI), visible plaque (VPI), and malocclusion were evaluated. Parents/caregivers answered the Family Impact Scale (FIS) and questionnaires on sociodemographic conditions and the health of children/adolescents. Data analysis included chi‐square test and Poisson regression. There was no difference between groups regarding the impact of the children's/adolescents' oral condition on their families’ OHRQoL for all domains and the total FIS score (P > 0.05). A negative impact on the OHRQoL of families of children/adolescents with DS was determined by dental caries (PR = 3.95, CI = 2.09‐7.46), clinical consequences of untreated dental caries (PR = 1.83, CI = 1.18‐2.84), defined malocclusion (PR = 2.75, CI = 1.23‐6.13), and severe malocclusion (PR = 2.82, CI = 1.02‐7.74).

Conclusion

There is no difference on the OHRQoL of families of children/adolescents with and without DS. Dental caries experience, clinical consequences of untreated dental caries, defined malocclusion, and severe malocclusion determined the negative impact on the OHRQoL of families of children/adolescents with DS.
School choice's idealized premises and unfulfilled promises: How school markets simulate options, encourage decoupling and deception, and deepen disadvantages
Authors: Chen Katherine K. , Moskop Megan
Published: December 2019

In school choice systems, families choose among publicly funded schools, and schools compete for students and resources. Using neoinstitutionalist and relational inequality theories, our article reinterprets recent critical sociological and education research to show how such markets involve actors' enacting myths; these beliefs and their associated practices normalized white, privileged consumption as a basis for revamping public education as market exchanges between schools and families. Proponents argue that choice empowers individuals, focuses organizations on improving quality, and benefits society more broadly by reducing inequality and segregation. We argue that such school choice myths' excessive emphases on individual decision‐making and provider performance obscure the actual impacts of school choice systems upon people, organizations, and society. First, rather than enlarging alternatives that families can easily research, select, and (if needed) exit, school choice systems often simulate options, especially for disadvantaged populations. Second, rather than focusing schools' efforts on performance, innovation, and accountability, they can encourage organizational decoupling, homogeneity, and deception. Third, rather than reducing societal harms, they can deepen inequalities and alienation. Future research should examine both how markets are animated by bounded relationality—routines that enable them to form, maintain, and complete exchanges with organizations—and how activism can challenge marketization.
Adaptation of the strain measurement in textile reinforced cementitious matrix composites by distributed optical fibre and 2D digital image correlation
Authors: Saidi M. , Gabor A.
Published: December 2019

The study presented in this paper aims to adapt and calibrate two strain measurement techniques used for textile reinforced cementitious matrix composites (TRCMCs): distributed optical fibres and 2D digital image correlation (DIC). These composites exhibit tensile behaviour characterised by a succession of transverse cracks along specimens. During the tensile test, out‐of‐plane parasitic displacements may occur due to the geometry of specimens and possible imperfections of the test method. These phenomena interfere with the measurement of the strain sensors, leading to loss of results and parasitic strain. In order to eliminate them and to finely analyse the complex behaviour of TRCMCs, a test methodology and experimental approach are proposed for optical fibres, and a practical and simple solution is proposed to quantify the parasitic strains of the 2D DIC. For optical fibres, Rayleigh backscatter is used, allowing a millimetric spatial resolution and a high recording frequency. For the DIC, required equipment is used, and the results are processed through existing commercial software.
A rare diarrheic parasite in a kidney transplant patient: Cystoisospora belli
Authors: Marques Joana , Menezes Maria , Mendes Filipa , Dutra Eduardo , Saiote Joana , Santos Sara , Cotovio Patrícia , Caeiro Fernando , Carvalho Dulce , Nolasco Fernando
Published: December 2019

Cystoisospora belli colitis is a rare complication of immunosuppression in solid organ transplant recipients. We describe a case of Cystoisospora belli infection with colitis following renal transplantation.
Comparative Study on Numerical Computation Methods for Radiation Forces on a Three-Dimensional Body With Edge in the Time Domain
Authors: Yang Jianye , Teng Bin , Gou Ying
Published: December 2019

A time-domain numerical model with the linear free surface condition and large amplitude body motions is developed based on the higher-order boundary element method. Five numerical formulations are used to compute the nonlinear radiation forces on a moving body in the domain. A series of submerged bodies that have sharp edges and rounded corners with small radii are considered to investigate their reliabilities. It is found that for the bodies with rounded corners the nonlinear radiation forces calculated by the five numerical formulations are close to each other, while large discrepancies exist for the body with sharp edges. Examination on the vertical nonlinear radiation forces due to the body surge motion reveals that the body edge has less influence on the method of the rate of change of the fluid momentum; however, it has a stronger effect on the other four formulations. The former applied a substitution of the spatial derivatives of the velocity potential, and the other four use a direct integration of the fluid pressure on the body surface.
Observation of selective optical manipulation of particles in acoustic levitation
Authors: Dumy Gabriel , Hoyos Mauricio , Aider Jean-Luc
Published: December 2019

Acoustic Radiation Force is commonly used to create stable large-scale aggregates of particles in levitation (so-called “acoustic levitation”) in a micro-cavity. The authors show in the following work that this well-known and well-controlled aggregation process can be reversed without contact or external flow if the aggregated particles are enlightened with the proper optical wavelength. This coupled optics and acoustics effect has been observed with various kinds of particles and different optic wavelengths, showing high reproducibility. The phenomenon is studied using fluorescent micro-metric polystyrene particles without flow, and the effects of acoustic energy and illumination power have been quantitatively assessed. It is then exploited to separate a mix of particles with identical mechanical properties based on their different optic absorption. If the phenomenon is not well understood, some possible mechanisms are proposed and discussed that could be responsible for the rapid ejection of the objects in levitation from the illuminated area. Since it is a tag free phenomenon that does not need high energies to happen and since it works with biological objects such as algae, red blood cells, and bacteria, it may open the way to a broad range of applications.
Which Low Back Instability Tests Should Be Incorporated Into a Stabilization Classification Exam for Athletes?: A Critically Appraised Topic
Authors: Sandrey Michelle A.
Published: December 2019

Clinical Question: Is there sufficient evidence to determine which low back instability tests should be incorporated into a stabilization classification exam for athletes? Clinical Bottom Line: There is moderate level 2 evidence to include, but not to use in isolation, the prone instability test along with other instability tests in a stabilization classification exam.
The Creation of a Mental Skills Training Program in Elite Youth Tennis: A Coach-Driven Approach to Developing Resilient, Confident Competitors
Authors: Lauer E. Earlynn , Lerman Mark , Zakrajsek Rebecca A. , Lauer Larry
Published: December 2019

In this paper, we describe the development and content of a mental skills training (MST) program and how a strength and conditioning coach/certified mental coach delivered this program within a United States Tennis Association (USTA) Player Development (PD) program. The purpose of the MST program was to create resilient, confident youth tennis competitors. Specific mental strategies (i.e., journaling, routines, breathing, imagery, self-talk) were identified to best meet the objectives of the MST program and were delivered using a three-pronged approach: (a) classroom lessons, (b) strength and conditioning sessions and on-court lessons, and (c) homework assignments. Specific ways that the USTA PD coaches reinforced the use of these strategies during tennis practice are described. Recommendations for coaches to integrate an MST program in high-performance youth sport environments are also provided.
Generalised tonic–clonic seizures on the subtherapeutic dose of olanzapine
Authors: Mansoor Marium , Mesiya Mohammad Hanif , Chachar Aisha Sanober
Published: December 2019

Olanzapine is a second-generation antipsychotic. Incidence of olanzapine-induced seizures (OIS) is low with monotherapy. Combination therapy with another antipsychotic, drug metabolism and old age are risk factors for OIS. Our patient was a 71-year-old man, admitted to the psychiatry unit. He was managed on the lines of bipolar affective disorder current episode depression and dementia. He was started on olanzapine 1.25 mg two times/day. The patient developed generalised tonic–clonic seizure that lasted for around two and a half minutes within 24 hours of olanzapine treatment. His electroencephalogram showed findings that were suggestive of mild slowing. Our case discusses the incidence of OIS on the subtherapeutic dose. This presentation involves multiple risk factors for OIS: a history of stroke, poststroke seizure, old age and cognitive impairment. Due to scarcity of evidence of OIS; mostly with recommended therapeutic dose range physicians may underestimate seizure risk at subtherapeutic doses.