bluuebunny/crossref_metadata_2025 huggingface dataset:
Organisational support and safety management: A study of shipboard safety supervision
Authors: Xue Conghua , Tang Lijun
Published: August 2019

Shipping is a safety critical industry where operational errors may lead to maritime accidents involving property damage, loss of lives and environmental pollution. As part of the trend towards self-regulation, the International Maritime Organisation has adopted a worldwide International Safety Management Code which made ship managers responsible for workplace health and safety. This study, based on interviews in two Chinese shipping companies, examines how ship managers use ship visits to monitor shipboard safety management. Interviews with managers from company offices and crew members indicated that managerial ship visits mainly take the form of inspections that focus on low-trust surveillance and disciplinary action rather than genuine support, being based on the safe person rather than the more effective safe place approach. From the perspective of crew members, because the managers visited ships only occasionally, they were unlikely to have sound knowledge of the specific situations and work routines on their ships. Consequently, managers’ interventions for safety compliance were seen by crew members as failing to address real risk factors, and leading instead to increased workloads, psychological pressure and fatigue, the very antithesis of safety management. Meanwhile a coherent, supportive system for reducing risk remains underdeveloped in the shipping industry.
Using relational mindfulness to facilitate safety in the clinical encounter
Authors: Parnas Sophia , Isobel Sophie
Published: August 2019

Objective:

The therapeutic relationship in psychiatry is reliant upon first establishing a sense of interpersonal safety. This paper explores relational mindfulness as a way to facilitate safety in the clinical encounter, as well as proposes factors that enhance a clinician’s capacity to remain mindfully present.

Conclusions:

Through the ongoing practice of mindful awareness, self-care and self-awareness all clinicians can benefit from increased capacity for relational mindfulness to enhance interpersonal safety. This is then likely to benefit not only the patient and the therapeutic relationship but also the clinician.
The Representation of People With Disabilities in an Official Newspaper in China: A Longitudinal Study of the People’s Daily From 2003 to 2013
Authors: Ye Wen , Zeldes Geri Alumit
Published: August 2019

Examining 788 news articles in the People’s Daily from 2003 to 2013, this study explores basic trends in the representation of people with disabilities in an official newspaper in China. The study proposes that the portrayal of people with disabilities has increased because the living standards of people with disabilities in China have improved substantially and several significant events affecting people with disabilities took place during the decade under consideration. However, the results of content analysis did not support the general assumption of this study and show that the quantity of news coverage and the usages of the top three dominant news models and the top three major news sources did not increase significantly from year to year. The quantity of news articles and the usages of the top three dominant news models and the top three major news sources in 2009–2013 did not increase significantly compared with 2003–2007. The implications of the findings are discussed.
Smoking Effects in Foot and Ankle Surgery: An Evidence-Based Review
Authors: Beahrs Taylor R. , Reagan James , Bettin Clayton C. , Grear Benjamin J. , Murphy G. Andrew , Richardson David R.
Published: August 2019

Background:

The purpose of this article was to review the basic science pertaining to the harmful effects of cigarette smoke, summarize recent clinical outcome studies, and examine the benefits of smoking cessation and the efficacy of current smoking cessation strategies.

Methods:

The literature concerning basic science, clinical outcomes, and smoking cessation was reviewed; over half (56%) of the 52 articles reviewed were published in the last 5 years.

Results:

Smoking is associated with low bone mineral density, delayed fracture union, peri-implant bone loss, and implant failure. Orthopedic surgical patients who smoke have increased pain and lower overall patient satisfaction, along with significantly increased rates of wound healing complications.

Discussion/Conclusion:

Active smoking is a significant modifiable risk factor and should be discontinued before foot and ankle surgery whenever possible. Orthopedic surgeons play an important role in educating patients on the effects of smoking and facilitating access to smoking cessation resources.

Level of Evidence:

Level V, expert opinion.
Antimicrobial de-escalation in adult hematopoietic cell transplantation recipients with febrile neutropenia of unknown origin
Authors: Petteys Megan M , Kachur Ekaterina , Pillinger Kelly E , He Jiaxian , Copelan Edward A , Shahid Zainab
Published: August 2019

Background

The optimal duration of empiric antimicrobial therapy in febrile neutropenia of unknown origin is unclear. This study evaluated outcomes in autologous and allogeneic hematopoietic cell transplantation recipients with febrile neutropenia of unknown origin who received early de-escalation of broad-spectrum antimicrobials prior to hematopoietic recovery versus those who continued broad-spectrum antimicrobials until hematopoietic recovery.

Methods

A single-center, retrospective study assessed hematopoietic cell transplantation recipients with febrile neutropenia of unknown origin. Patients were categorized into either cohort 1, representing early de-escalation prior to hematopoietic recovery, or cohort 2, representing continuation of broad-spectrum antimicrobials until hematopoietic recovery.

Results

A total of 107 patients were included (22.4% in cohort 1 and 77.6% in cohort 2). Most patients (87.5%) in cohort 1 underwent haploidentical hematopoietic cell transplantation, whereas 84.3% of patients in cohort 2 received autologous hematopoietic cell transplantation. There were no significant differences in rates of recurrent fever (4.2% versus 7.2%, in cohorts 1 and 2, respectively, adjusted odds ratio = 0.84, P = 0.85), re-escalation (4.2% versus 4.8%, adjusted odds ratio = 1.57, P = 0.64), and Clostridioides difficile-associated infections (4.2% versus 2.4%, adjusted odds ratio = 2.27, P = 0.43). No patient experienced in-hospital mortality, intensive care unit admission, or bacteremia.

Conclusion

Hematopoietic cell transplantation recipients with febrile neutropenia of unknown origin in which broad-spectrum antimicrobials were de-escalated prior to hematopoietic recovery did not experience adverse outcomes. These results concur with recently published studies and the Fourth European Conference on Infections in Leukemia guidelines. An early de-escalation approach in haploidentical hematopoietic cell transplantation recipients specifically appears safe and may result in a reduction in antimicrobial utilization.
Durable response after discontinuation of nivolumab therapy in the absence of disease progression or toxicity with two advanced NSCLC patients
Authors: Yilmaz Mesut , Guven Mese Sermin
Published: August 2019

Background

Nivolumab is an immune checkpoint inhibitor that selectively blocks the programmed cell death-1 (PD-1). Nowadays, immune checkpoint inhibitors such as nivolumab are used in the treatment of many different types of cancer. In prospective clinical trials, the duration of therapy with nivolumab has been defined as up to the time of progressive disease or treatment limiting toxicity.

Case reports

In this article, we present two advanced non-small cell lung cancer (NSCLC) patients that were treated with anti-PD-1 monotherapy in the second-line setting. They have received nivolumab for nine and five months, respectively. After discontinuation of immunotherapy agent because of socioeconomic reasons, they had a durable response.

Management and outcome

After the discontinuation of nivolumab in the absence of progression or toxicity, the clinic and radiologic response are still ongoing.

Discussion

Optimal duration of anti-PD-1 therapy has not been established. There are some reports that indicate the durable response for the patients who have interrupted immunotherapy because of toxicity. Here, we present two advanced NSCLC patients having a durable response after discontinuing the treatment in the absence of toxicity and disease progression. More extensive research is needed to determine which subgroups of patients treated with immunotherapy can cease treatment and maintain an ongoing response.
Plasma homocysteine concentration in privately owned healthy adult cats: assessment of biological determinants and establishment of a reference interval
Authors: Drut Amandine , Soetart Nicolas , Bertin Carole , Le Corff Emmanuelle , Berder Caroline , Thorin Chantal , Nguyen Patrick , Simard Gilles , Mallem M Yassine
Published: August 2019

Objectives

The assessment of homocysteine status in diseased cats has indicated high plasma concentrations in chronic kidney disease and yielded conflicting results with respect to cardiovascular disorders. Previous investigations in small populations of normal cats revealed greater-than-expected variability in plasma homocysteine concentration. The purpose of this study was to determine biological determinants and the reference interval (RI) of plasma homocysteine concentration in the feline species, under strict pre-analytical conditions.

Methods

In this prospective observational study, privately owned healthy adult cats underwent a complete physical examination, urinalysis and blood testing, in order to rule out any signs of disease. Plasma homocysteine concentration was measured using high-performance liquid chromatography–tandem mass spectrometry.

Results

Of 151 cats recruited, 30 cats were not included owing to abnormal physical examination or fractious behaviour, and 30 cats were excluded based on abnormalities on blood work or urinalysis. Plasma homocysteine concentrations >28 µmol/l were associated with a dietary protein content >9.3 g/100 kcal metabolisable energy. The RI for plasma homocysteine concentration was determined to be 6.2–52.3 µmol/l.

Conclusions and relevance

Normal values for plasma homocysteine concentration in cats have a wide RI, suggesting high inter-individual variability. Whether some healthy cats exhibit impaired homocysteine metabolism remains to be elucidated.
Circulatory Levels of RANKL, OPG, and Oxidative Stress Markers in Postmenopausal Women With Normal or Low Bone Mineral Density
Authors: Azizieh Fawaz Y , Shehab Diaa , Jarallah Khaled Al , Gupta Renu , Raghupathy Raj
Published: August 2019

Introduction:

Receptor activator of nuclear factor κB ligand (RANKL), osteoprotegerin (OPG), and oxidative stress markers are suggested to contribute to bone loss in osteoporosis that occurs in menopause. However, the association between these markers and bone mineral density (BMD) is controversial. The aim of this study was to measure circulatory levels of these parameters in postmenopausal women with normal or low BMD.

Methods:

The study population included 71 postmenopausal women, of whom 25 had normal BMD, 31 had osteopenia, and 15 had osteoporosis. Serum levels of RANKL, OPG, and 5 oxidative stress markers (catalase, peroxiredoxin 2 [PRX2], superoxide dismutase 1 [SOD1], superoxide dismutase 2 [SOD2], and thioredoxin [TRx1]) were measured using the Multiplex system.

Results:

As compared with subjects having normal BMD, subjects with low BMD had significantly lower median serum levels of OPG, catalase, SOD2, and PRX2 ( P = .004, .031, .044, and .041 respectively). Although levels of RANKL were not different between the 2 groups, the RANKL/OPG ratio was higher in women with low BMD ( P = .027).

Conclusions:

These data provide insights into the possible roles of OPG, RANKL, and oxidative stress in the pathogenesis of postmenopausal osteoporosis. However, the lack of association between these markers and BMD indicates that osteoporosis is complex and multivariate.
Dealing with diversity: Australian television, homogeneity and indigeneity
Authors: Turner Graeme
Published: August 2019

This article focuses on how the Australian television industry deals with diversity: the extent to which the cultural diversity of Australian society has been reflected in the representations on our screens and in the provision of opportunity within the industry itself. While this has historically been approached by assessing the evidence of inclusiveness in the representations on screen, it is important to be reminded of the role played by the structure of Australia’s media: especially in television, we have a highly concentrated commercial system which still addresses the traditional conception of a mass media audience in ways that almost inevitably tend towards the reproduction of an image of cultural homogeneity. Research into one of the most important interventions into both the established patterns of representation and the make-up of the local production industry – the National Indigenous Television Network (NITV) – is discussed as a means of highlighting the difficulties faced by such interventions and those committed to ‘turning off the whitewash channel on Australian television’.
Laboratory and in situ sound absorption measurement under a synthetized diffuse acoustic field
Authors: Robin Olivier , Berry Alain , Kafui Amédin Celse , Atalla Noureddine , Doutres Olivier , Sgard Franck
Published: August 2019

This article reports numerical and experimental results concerning the estimation of the diffuse field sound absorption coefficient of several different materials under a synthetized diffuse acoustic field excitation in laboratory and in situ conditions. The proposed measurement method is based on a sound field reproduction approach and a synthetic array of acoustic monopoles facing the material to be tested. Numerical simulations are first conducted to optimize the geometrical parameters of the method and to compute theoretical sound absorption coefficients of the considered materials. Measurements on a set of six typical acoustic materials are then conducted following the standardized reverberant room method as well as the proposed approach in a hemi-anechoic room and in two realistic rooms. Albeit showing limitations in the low-frequency domain, the proposed method enables a significant reduction of the tested specimen dimensions compared with the reverberant room method and allows performing tests in non-ideal acoustic environments.
Strategic orientation of hotels: Evidence from a contingent approach
Authors: Presutti Manuela , Savioli Marco , Odorici Vincenza
Published: August 2019

Strategic orientation (SO) – a necessary condition to achieve and maintain a competitive advantage – should particularly be considered in the tourism industry, given the high competition and rapidly changing environment. This article investigates whether the different dimensions of SO (entrepreneurial orientation (EO), learning orientation (LO) and market orientation (MO)) have a direct effect on hotel performance and whether the relationship between SO and hotel performance is contingent on various hotel-specific characteristics. The hypotheses are tested against a sample of 120 small hotels operating in a mature Italian tourist destination. The results show that EO and MO are positive drivers of hotel performance, and LO is not important. Additionally, the intensity of the relationship between SO and performance is contingent on internal firm-related moderators (size and quality). Both the number of rooms and the star classification reinforce the performance achievement of innovative and customer-oriented hotels.
Effects of different landscape visual stimuli on psychophysiological responses in Chinese students
Authors: Jiang Mingyan , Hassan Ahmad , Chen Qibing , Liu Yinggao
Published: August 2019

Human–plant interactions have positive effects on human health. However, the effects of plants and the environment on psychophysiological responses have not been thoroughly explored. This study examined the physiological (electroencephalography (EEG)) and psychological (the semantic differential method (SDM) and State-Trait Anxiety Inventory (STAI)) responses of adults viewing different landscape pictures. The physiological responses of 50 Chinese students were recorded by measuring blood pressure and EEG, and psychological responses were measured using the STAI and SDM. The following treatments were assessed: (1) urban city traffic photographs (control), T0; (2) garden landscape photographs, T1; (3) natural scenery landscape photographs, T2; (4) forest landscape photographs, T3 and (5) city landscape photographs, T4. Students’ blood pressure was lowered after visual stimulation with different landscape pictures than with the control. In the (SDM) evaluation, students felt more natural, relaxed and comfortable after viewing landscape pictures and had low anxiety scores. EEG results showed higher alpha, beta, delta, theta and gamma frequencies after visual stimulation with landscape pictures than with the control. In conclusion, different landscape pictures have psychophysiological relaxation effects on adults.
Exploring normative complexity: (How) does the life history interview work in child welfare research?
Authors: Røkkum Nina Helen Aas , Kojan Bente Heggem
Published: August 2019

In this article, we shed light on the importance of addressing normative complexity when conducting life history research with marginalized respondents, who experience multiple needs and complex problems. We analyse 74 life history interviews with parents who are in contact with child welfare services in Norway, and who challenge what is considered an ‘ordinary’ life course. Data were collected from 2010 to 2012 in connection with the project The New Child Welfare Services. We perform a content analysis of a smaller selection of interviews followed by a visual analysis of the transcripts. Applying a class perspective, the ways in which parents’ life histories emerge in a narrative interview setting are explored. The article shows that although the aim of the life history interview is to empower respondents to construct their own life histories, this might be difficult to achieve in interview settings where the respondents are marginalized. Some of the respondents did not perceive life as flawless from beginning to end, as they encountered several obstacles and what they considered to be new beginnings. Another aim of the life history interview is the search for coherency; however, the respondents who experienced the most complex problems expressed difficulties in speaking coherently about their life histories. Based on our analysis, the article stresses awareness to the normative complexity in all phases of data collection when interviewing marginalized respondents who do not necessarily fit into the life history format within the narrative tradition, which was more common for middle-class respondents.
Reversing the trajectory of school disengagement? Lessons from the analysis of Warsaw youth’s educational trajectories
Authors: Tomaszewska-Pękała Hanna , Marchlik Paulina , Wrona Anna
Published: August 2019

The theoretical framework of the paper combines the notions of school disengagement and educational trajectories. Our current research has demonstrated that several trajectories of school disengagement can be distinguished: unanticipated crisis, parabola, downward spiral, boomerang, resilient route, shading out. The text focuses on two trajectory types – the parabola, when youngsters facing increasing school disengagement are provided with substantial support and their trajectory changes its direction, and the downward spiral, which despite the support leads to further school disengagement and school leaving.

Analysing the educational biographies of students from secondary schools in Warsaw, we focus on their perceptions of the support provided by different formal and informal sources. Investigating the protective factors and successful interventions might thus be useful in fostering the educational success of youth at risk. An analysis of the trajectories might be treated as guidance as to how to offset the negative impact of social and educational inequalities and hence to reverse the negative direction in one’s educational trajectory.

The text is based on qualitative analysis of data obtained within an international research project: individual semi-structured interviews with Polish students at risk of early school leaving and youngsters who left school early.
Open Science Promotes Diverse, Just, and Sustainable Research and Educational Outcomes
Authors: Grahe Jon E , Cuccolo Kelly , Leighton Dana C , Cramblet Alvarez Leslie D
Published: August 2019

Open science initiatives, which are often collaborative efforts focused on making research more transparent, have experienced increasing popularity in the past decade. Open science principles of openness and transparency provide opportunities to advance diversity, justice, and sustainability by promoting diverse, just, and sustainable outcomes among both undergraduate and senior researchers. We review models that demonstrate the importance of greater diversity, justice, and sustainability in psychological science before describing how open science initiatives promote these values. Open science initiatives also promote diversity, justice, and sustainability through increased levels of inclusion and access, equitable distribution of opportunities and dissemination of knowledge, and increased sustainability stemming from increased generalizability. In order to provide an application of the concepts discussed, we offer a set of diversity, justice, and sustainability lens questions for individuals to use while assessing research projects and other organizational systems and consider concrete classroom applications for these initiatives.
Political Determinants of Privatisation Reforms: A Comparative Analysis in Europe
Authors: Peña-Miguel Noemí , Cuadrado-Ballesteros Beatriz
Published: August 2019

This article analyses the effect of political factors on privatisation reforms and considers the practical implications of such policy from a comparative point of view in Europe. According to a sample of 25 countries in 1995–2013, our findings suggest that privatisation reforms could be impeded by veto players, fragmentised governments and political competition. These reforms tend to be used less by politicians who have been in power for a long period of time and implemented at the start of an office term, except in the case of right-wing governments. Our findings support greater privatisation in concentrated conservative governments, especially when the next elections are about to be held.
Design and fabrication of a piezoelectric out-put evaluation system for sensitivity measurements of fibrous sensors and actuators
Authors: Sorayani Bafqi Mohammad Sajad , Sadeghi Abdol-Hossein , Latifi Masoud , Bagherzadeh Roohollah
Published: August 2019

In last decades, using fibrous piezoelectric materials as energy harvesters and sensors attracted huge attention. Ductile behaviors and biocompatibility are the most beneficial characteristics of polymer-based materials, particularly poly vinylidene fluoride which is used for fabrication of wearable energy harvesters and sensors. Evaluation of piezoelectric properties, especially fiber and nanofiber piezo-polymers, is one of the most important inconveniences mode, particularly to quantify the sensitivity performance of fabricated devices, i.e. output voltage divided by the applied pressure. Conventional methods mostly are indirect, irrelevant and predominantly measure a related parameter instead of the main factor; they are also time consuming, expensive, constrained and have a high error rate. In this study, based on direct effect of piezoelectric, a novel universal system (PiezoTester) is presented to characterize piezoelectric properties and sensitivity of sensors and energy harvesters, especially flexible polymeric devices. This system was used to test three samples that are different in ZnO nanoparticle percentage in poly vinylidene fluoride/ZnO electrospun mats and its results compared by other measuring methods such as XRD, FTIR and differential scanning calorimeter as indirect methods and criterion piezoelectric method as a direct method to validate its performance. Promising evidence inferred PiezoTester could be used as a reliable system to evaluate piezoelectric properties of flexible energy harvesters and sensors as well as wearable gadget and smart textiles.
Cerebrospinal Fluid, Imaging, and Physiological Biomarkers in Dementia With Lewy Bodies
Authors: Mavroudis Ioannis , Petridis Foivos , Kazis Dimitrios
Published: August 2019

Dementia with Lewy bodies is a progressive neurodegenerative disorder, clinically characterized by gradual cognitive impairment and fluctuating cognition, behavioral changes and recurrent visual hallucinations, and autonomic function and movement symptoms in the type of parkinsonism. It is the second most common type of dementia in the Western world after Alzheimer disease. Over the last 20 years, many neurophysiological, neuroimaging, and cerebrospinal fluid (CSF) biomarkers have been described toward a better discrimination between dementia with Lewy bodies, Alzheimer disease, and other neurodegenerative conditions.In the present review, we aim to describe the neurophysiological, imaging, and CSF biomarkers in dementia with Lewy bodies and to question whether they could be reliable tools for the clinical practice.
Psychosocial Correlates and Early Substance Abuse Associated With Lifetime Hallucinogen Use Among Hispanic Young Adults
Authors: Yockey Andrew , King Keith , Vidourek Rebecca
Published: August 2019

Introduction:

The Hispanic population is among the most rapid growing populations in the United States. Continued research is needed regarding factors associated with substance abuse and Hispanic individuals. The present study examined psychosocial correlates to lifetime hallucinogen use among a national sample of Hispanic adults.

Method:

A secondary analysis of the 2017 National Survey on Drug Use and Health was conducted. Questions assessing previous lifetime substance use, psychosocial factors, and demographics were completed by 2,866 Hispanic adults. Weighted logistic regression analyses were used to identify significant predictors of lifetime hallucinogen use.

Results:

Results indicated that greater than one in seven (15.1%) of Hispanic adults reported having ever used hallucinogens (lifetime use). Findings from the final multivariate regression revealed that those most likely to report lifetime hallucinogen use were male, used alcohol, marijuana, cigars, cigarettes, inhalants, and cocaine before the age of 21, and binge drank in the past 30 days.

Discussion:

Culturally competent prevention strategies aimed at addressing hallucinogen use among Hispanics are needed. Further research studies examining psychosocial reasons explaining the high prevalence of hallucinogen use among this population are warranted.
Building and sustaining the defense simulation training workforce
Authors: Blackmore Karen Louise , Allitt Evan William Henry
Published: August 2019

The delivery of simulation training capability across the Australian Defence Force (ADF) requires a highly skilled workforce. Evolving training requirements, enabled by advances in computing power, network systems, display and peripheral technologies, and software environments, place increasing demands on the size of the workforce and the technical skills they are required to possess. In this research, we analyze existing simulation role frameworks and the various position descriptions and qualification requirements associated with these roles. To further explore the unique skillsets that translate to success in simulation roles, we also conduct a case study of a large external contract simulation workforce supplier, Cubic Defence Australia. Our findings highlight the complexity of the defense simulation workforce, including the lack of standardized position descriptions, competency frameworks, education and training pathways, and career progression options. Further complicating this is the importance of prior ADF service experience to the delivery of simulation systems that meet active training requirements, and the relationship between this service experience and career progression. From this analysis, recommendations for addressing the issues are made, including a call for a targeted and deliberate, multi-industry federal response to broaden the pool of candidates looking for careers in simulation.
A Comparison of Percutaneous Vertebroplasty Versus Conservative Treatment in Terms of Treatment Effect for Osteoporotic Vertebral Compression Fractures: A Meta-Analysis
Authors: Zhang Lin , Zhai Pei
Published: August 2019

Background. Osteoporotic vertebral compression fractures (OVCFs) are common in older patients, which can cause back pain and even increase morbidity. However, the optimal therapy for patients with OVCFs remains unknown. Percutaneous vertebroplasty (PVP), a minimally invasive procedure, has been a therapy option that is known to be effective in the pain management. Aim. The meta-analysis aims to summarize current best evidence on the efficacy of PVP and conservative treatment (CT) for pain management and functional results among OVCFs patients. Methods. We searched the publications on comparison of the efficacy of PVP versus CT for OVCFs patients up to November 2018. After rigorous reviewing on the quality, the data were extracted from eligible trials. All trials analyzed the summary hazard ratios of the endpoints of interest. Results. Moderate-strong evidence indicated that PVP had benefits on pain relief at 1 week and 1 month, but not at 3 months. With regard to the quality of life, no significant differences were found in the Roland-Morris Disability Questionnaire (RMDQ). However, there is significant difference in terms of EuroQol and Quality of Life Questionnaire of the European Foundation for Osteoporosis but not the RMDQ. Moreover, there were no any benefit in terms of vertebral fracture between groups. Conclusions. The meta-analysis showed that patients treated with vertebroplasty were associated with better pain relief and improved quality of life, without increasing the incidence of vertebral fracture compared with the CT group.
Facilitated Coupling of Magnetic Introducers During Thoracoscopic Ablation of Atrial Fibrillation
Authors: Ali Hassan Syed M. , Glover Benedict , Enriquez Andres , Bisleri Gianluigi
Published: August 2019

A 51-year-old man with long-standing persistent atrial fibrillation underwent a hybrid ablation procedure with right thoracoscopic epicardial ablation. Fluoroscopy was utilized in a novel way to visualize the magnetic tip catheters of the linear ablation surgical device and allow easier coupling of the tips, making this procedure more efficient and reducing the risk of improper positioning of the ablation device.
Cortisol and Racial Health Disparities Affecting Black Men in Later Life: Evidence From MIDUS II
Authors: Allen Julie Ober , Watkins Daphne C. , Chatters Linda , Geronimus Arline T. , Johnson-Lawrence Vicki
Published: August 2019

In the United States, Black men have poorer overall health and shorter life spans than most other racial/ethnic groups of men, largely attributable to chronic health conditions. Dysregulated patterns of daily cortisol, an indicator of hypothalamic–pituitary–adrenal (HPA) axis stress–response functioning, are linked to poor health outcomes. Questions remain regarding whether and how cortisol contributes to Black–White differences in men’s health. This exploratory study compared early day changes in cortisol levels (diurnal cortisol slopes from peak to pre-lunch levels) and their associations with medical morbidity (number of chronic medical conditions) and psychological distress (Negative Affect Scale) among 695 Black and White male participants in the National Survey of Midlife in the United States (MIDUS II, 2004–2009). Black men exhibited blunted cortisol slopes relative to White men (−.15 vs. −.21, t = −2.97, p = .004). Cortisol slopes were associated with medical morbidity among Black men ( b = .050, t = 3.85, p < .001), but not White men, and were unrelated to psychological distress in both groups. Findings indicate cortisol may contribute to racial health disparities among men through two pathways, including the novel finding that Black men may be more vulnerable to some negative health outcomes linked to cortisol. Further, results suggest that while cortisol may be a mechanism of physical health outcomes and disparities among older men, it may be less important for their emotional health. This study increases understanding of how race and male sex intersect to affect not only men’s lived experiences but also their biological processes to contribute to racial health disparities among men in later life.
Gazing Lean through the lens of System of Systems Dynamics: A case of weaving mill
Authors: Mahmood Asif
Published: August 2019

In this research article, System of Systems Methodologies framework has been extended in order to propose that System Dynamics approach has the capability to model and simulate the aspects of System of Systems. It, therefore, invokes a new concept of System of Systems Dynamics in the literature. Then, in order to perceive the practical implications, a case study account of a textile weaving organization has also been demonstrated. The organization under consideration had high cycle time due to unnecessary work in process, and reduced production capacity because of rolling blackouts. The study was conducted to model and modify the existing scenario intended to put forward a preferred future scenario. The proposed future state was constructed using selected Lean tools required to address the ongoing concerns. In order to realize the prospective Lean scenario, a capital investment model was run in relation with the setup developed to carry out capital budgeting for multi-fuel captive power plants. System of Systems Dynamics in the presence of lean concepts proved to be an intuitive and comprehensive approach for making strategic decisions. The model can serve as a planning tool to evaluate the financial impact on the overall profitability of the company under consideration.
Social Identity Map: A Reflexivity Tool for Practicing Explicit Positionality in Critical Qualitative Research
Authors: Jacobson Danielle , Mustafa Nida
Published: August 2019

The way that we as researchers view and interpret our social worlds is impacted by where, when, and how we are socially located and in what society. The position from which we see the world around us impacts our research interests, how we approach the research and participants, the questions we ask, and how we interpret the data. In this article, we argue that it is not a straightforward or easy task to conceptualize and practice positionality. We have developed a Social Identity Map that researchers can use to explicitly identify and reflect on their social identity to address the difficulty that many novice critical qualitative researchers experience when trying to conceptualize their social identities and positionality. The Social Identity Map is not meant to be used as a rigid tool but rather as a flexible starting point to guide researchers to reflect and be reflexive about their social location. The map involves three tiers: the identification of social identities (Tier 1), how these positions impact our life (Tier 2), and details that may be tied to the particularities of our social identity (Tier 3). With the use of this map as a guide, we aim for researchers to be able to better identify and understand their social locations and how they may pose challenges and aspects of ease within the qualitative research process. Being explicit about our social identities allows us (as researchers) to produce reflexive research and give our readers the tools to recognize how we produced the data. Being reflexive about our social identities, particularly in comparison to the social position of our participants, helps us better understand the power relations imbued in our research, further providing an opportunity to be reflexive about how to address this in a responsible and respectful way.
‘Switch’ technique to restore pronation and radial deviation in 17 patients with brachial plexus birth palsy
Authors: Özkan Türker , Aydin Hasan Utkan , Berköz Ömer , Özkan Safiye , Kozanoğlu Erol
Published: August 2019

We report outcomes of 17 children with brachial plexus birth palsy that underwent extensor carpi ulnaris to brachioradialis and brachioradialis to abductor pollicis longus transfers to correct supination and ulnar deviation deformity. Mean age at the time of surgery was 8.7 years and mean follow-up time was 21 months (8–44). These patients had marked increases in active forearm rotation and Canadian Occupational Performance Measure scores. Activity performance score on the measure increased from 1.1 to 6.7 and satisfaction score increased from 0.8 to 8.7 at final follow-up. We conclude from our patient series that these tendon transfers are effective in correction of the supination and ulnar deviation deformities in brachial plexus birth palsy.

Level of evidence: IV
Non-traumatic primary and secondary osteoarthritis of the distal radioulnar joint
Authors: Benis Szabolcs , Vanhove Wim , Van Tongel Alexander , Hollevoet Nadine
Published: August 2019

A retrospective radiographic study was conducted to determine the prevalence and severity of non-traumatic primary and secondary osteoarthritis of the distal radioulnar joint in a group of 718 patients. Non-traumatic primary and secondary osteoarthritis was found in 77 patients (11%) with a mean age of 63 years. In 34 cases it was bilateral. Mild signs of osteoarthritis were present in 53, moderate in 17 and severe in seven patients. The prevalence of primary osteoarthritis was 8.2% and 2.5% had secondary non-traumatic osteoarthritis. The prevalence and severity of the osteoarthritis were similar in women and men. Ulnar wrist pain was associated with osteoarthritis of the distal radioulnar joint in 13% of patients with mild, 35% with moderate and 43% with severe radiological degeneration.

Level of evidence: IV
Adult-Onset Subacute Sclerosing Panencephalitis With a 30-Year Latent Period
Authors: Holmes Brandon B. , Conell-Price Jessamyn , Kreple Collin J. , Ashraf Davin , Betjemann John , Rosendale Nicole
Published: August 2019

Subacute sclerosing panencephalitis (SSPE) is a rare progressive neuroinfectious disease due to a late complication of the measles virus. The hallmark clinical features of this disease include behavioral changes, myoclonus, dementia, visual disturbances, and pyramidal and extrapyramidal signs. The presence of characteristic high-amplitude periodic complexes on electroencephalography and raised antibody titers against measles in the cerebrospinal fluid help solidify the diagnosis. We present a case of a 40-year-old patient with SSPE who initially developed ophthalmologic manifestations 30 years after the primary measles infection. This case highlights both typical and atypical features of SSPE and provides a diagnostic framework for evaluating cases that fall outside of the standard scope of this disease.
Silencing TBX1 Exerts Suppressive Effects on Epithelial–Mesenchymal Transition and Inflammation of Chronic Rhinosinusitis Through Inhibition of the TGFβ-Smad2/3 Signaling Pathway in Mice
Authors: Zhong Yu , Li Yunqiu , Zhang Hua
Published: August 2019

Background

Chronic rhinosinusitis (CRS) is a multifactorial inflammatory disease characterized by high prevalence and morbidity, and little is known about the mechanisms that underlie its pathogenesis.

Objective

This study focuses on the effect of T-box 1 (TBX1) on the epithelial–mesenchymal transition (EMT) and inflammation of CRS via the transforming growth factor (TGF)β-Smad2/3 signaling pathway.

Methods

CRS mice models were established by Merocel nasal packing material, followed by the streptococcus pneumoniae cultivation. The expression levels of TBX1 in the sinus mucosa tissues of mice were measured accordingly. The successfully modeled mice were subsequently injected with TBX1 mimic or TBX1 inhibitor and the TGFβ-Smad2/3 signaling pathway inhibitor (SB-431542) to elucidate the influence of TBX1 on EMT and inflammation in CRS, with the expression of the EMT-related factors (E-cadherin, Vimentin, alpha-smooth muscle actin [α-SMA]), Th1 cytokines (interleukin [IL]-2, interferon-γ), and Th2 cytokines (IL-4, IL-8, total immunoglobulin E) assayed.

Results

TBX1 expression exhibited upregulated levels in the sinus mucosa tissues of the mice. In addition, TBX1 downregulation was found to inhibit the expression of TGFβ as well as the extent of Smad2 and Smad3 phosphorylation. Silencing TBX1 was shown to elevate the expression of Th1 cytokines and E-cadherin, while diminishing expression of Th2 cytokines, Vimentin and α-SMA.

Conclusions

Taken together, the key findings of our study highlight the inhibitory role of TBX1 in the process of EMT and inflammation in CRS mice via the inhibition of the TGFβ-Smad2/3 signaling pathway, underlining the promise of TBX1 as a potential target for CRS therapy.
Risk of bronchospasm and coronary arteriospasm with sugammadex use: a post marketing analysis
Authors: Aggarwal Pushkar
Published: August 2019

Introduction:

Sugammadex is used for the reversal of neuromuscular blockade caused by rocuronium bromide and vecuronium bromide. As part of the post licensing phase of drug development, adverse events related to the use of sugammadex are still being uncovered and being reported. The potential association between sugammadex and adverse events bronchospasm and coronary arteriospasm using a retrospective pharmacovigilance signal analysis was carried out.

Methods:

Food and Drug Administration’s Adverse Event Reporting System database was used to run disproportionality analyses to investigate the potential association of sugammadex with bronchospasm or coronary arteriospasm. In this analysis we report the adverse event signal using frequentist methods of Relative reporting ratio (RRR), proportional reporting ratio (PRR), reporting odds ratio (ROR) and the Bayesian based Information Component metric.

Results:

A statistically significant disproportionality signal is found between sugammadex and bronchospasm ( n = 44; chi-squared = 2993.87; PRR = 71.95 [95% CI: 54.00–95.85]) and sugammadex and coronary arteriospasm ( n = 6; chi-squared = 209.39; PRR = 43.82 [95% CI: 19.73–97.33]) as per Evans criteria. Both statistically significant disproportionality signals persisted when stratified by gender. Based upon dynamic cumulative PRR graph, the PRR value has steadily increased and the 95% CI narrowed since December 2012.

Conclusion:

The results of the pharmacovigilance analysis highlight a statistically significant disproportionality signal between sugammadex usage and bronchospasm and coronary arteriospasm adverse events. Physicians need to be aware of these adverse events when using sugammadex. The results of the pharmacovigilance signal analysis highlight a statistically significant disproportionality signal between sugammadex usage and bronchospasm and coronary arteriospasm adverse events. Physicians need to be aware of these adverse events when using sugammadex.
Exercise-induced cardio-pulmonary remodelling in endurance athletes: Not only the heart adapts
Authors: Domenech-Ximenos Blanca , Garza Maria Sanz-de la , Prat-González Susanna , Sepúlveda-Martínez Álvaro , Crispi Fatima , Perea Rosario J , Garcia-Alvarez Ana , Sitges Marta
Published: August 2019

Background

The cumulative effects of intensive endurance exercise may induce a broad spectrum of right ventricular remodelling. The mechanisms underlying these variable responses have been scarcely explored, but may involve differential pulmonary vasculature adaptation. Our aim was to evaluate right ventricular and pulmonary circulation in highly trained endurance athletes.

Methods

Ninety-three highly trained endurance athletes (>12 h training/week at least during the last five years; age: 36 ± 6 years; 52.7% male) and 72 age- and gender-matched controls underwent resting cardiovascular magnetic resonance imaging to assess cardiac dimensions and function, as well as pulmonary artery dimensions and flow. Pulmonary vascular resistance (PVR) was estimated based on left ventricular ejection fraction and pulmonary artery flow mean velocity. Resting and exercise Doppler echocardiography was also performed in athletes to estimate pulmonary artery pressure.

Results

Athletes showed larger biventricular and biatrial sizes, slightly reduced systolic biventricular function, increased pulmonary artery dimensions and reduced pulmonary artery flow velocity as compared with controls in both genders ( p < 0.05), which resulted in significantly higher estimated PVR in athletes as compared with controls (2.4 ± 1.2 vs. 1.7 ± 1.1; p < 0.05). Substantially high estimated PVR values (>4.2 WU) were found in seven of the 93 (9.3%) athletes: those exhibiting an enlarged pulmonary artery (indexed area cm2/m2: 4.8 ± 0.6 vs. 3.9 ± 0.6, p < 0.05), a decreased pulmonary artery distensibility index (%: 43.0 ± 15.2 vs. 62.0 ± 17.4, p < 0.05) and a reduced right ventricular ejection fraction (%: 49.3 ± 4.5 vs. 53.6 ± 4.6, p < 0.05).

Conclusions

Exercise-induced remodelling involves, besides the cardiac chambers, the pulmonary circulation and is associated with an increased estimated PVR. A small subset of athletes exhibited substantial increase of estimated PVR related to pronounced pulmonary circulation remodelling and reduced right ventricular systolic function.
Current status of stroke in Qatar: Including data from the BRAINS study
Authors: Jallow Ebrima , Al Hail Hassan , Han Thang S , Sharma Sapna , Deleu Dirk , Ali Musab , Al Hussein Hassan , Abuzaid Hassan O , Sharif Khalid , Khan Fahmi Y , Sharma Pankaj
Published: August 2019

Background

Qatar is located on the north-eastern coast of the Arabian Peninsula. Qatari natives account for less than 15% of the population while the largest migrant group comprising 60% derives from South Asia. Despite projections that stroke burden in Qatar will increase with population ageing, epidemiological studies focusing on stroke in Qatar are relatively scarce.

Method

We reviewed the available epidemiological publications relating to Qatar. In addition, we have added to this knowledge by incorporating Qatari data from the on-going Bio-Repository of DNA in Stroke, an independent multinational database of stroke patients.

Results

Qatar has low reported incidence and mortality rates of 58 and 9.17 per 100,000 per year, respectively, which may be explained by its middle-aged migrant worker majority population. Correspondingly, South Asian migrants in Qatar suffered younger strokes than Qatari natives (48.7 vs 63.4 years, P < 0.001). Among the most common risk factors identified in stroke patients were hypertension (77.9%), diabetes (43.8%) and hypercholesterolemia (28.5%). Ischaemic stroke was the most frequent subtype amongst migrant South Asians (71.1%). The majority of stroke cases had computed tomography and/or magnetic resonance imaging scans, but only 11.1% of ischaemic strokes were thrombolysed. Qataris on one-year follow up were more often found to have died (6.5% vs 0.3%) and had further stroke/transient ischaemic attack events (17.4% vs 6.4%, P = 0.009) compared to South Asians.

Conclusion

The burden of stroke is increasing in Qatar, and considerable disparities are observed between the native and migrant populations which likely will require different approaches to management by its healthcare system.