bluuebunny/crossref_metadata_2025 huggingface dataset:
The Evaluation of Music Teacher Candidates’ Awareness of Music Applications and Software, Their Frequency of Use and Purpose of Use
Authors: Lehimler Emrah
Published: August 2019

The purpose of the study is to examine the music teacher candidates' awareness of music applications and software, their frequency of use and purpose of use in terms of gender and grade level variables. The study group consists of 452 students studying in department of music education in 6 universities in Turkey during the 2018-2019 academic year. In order to collect data, a two-part questionnaire developed by the researcher was used.According to the results of the research, it was seen that music teacher candidates who are aware of the existence of applications for music notation, applications containing instruments for music performance, applications for listening/watching music and applications for recording/mixing stage were quite high compared to those who were not aware. It was observed that the number of those who were not aware of the applications of instrument education, applications of choir/singing and applications of music theory and hearing education were higher than those who were aware. It was seen that the most commonly used applications were applications that include instruments for music performance and applications for listening/watching music. It was seen that applications for choir/singing, applications for instrument education, applications for music theory and hearing education, and applications for recording/mixing stage were rarely used.According to the results obtained from the research, applications for music theory and hearing education, applications for instrument education and applications that include instruments for music performance were mostly used for professional development. It was found that applications for writing notes were mostly used for homework. Applications for listening/watching music, recording / mixing stage and chorus/singing applications were mostly used for entertainment purposes.The results of the study showed that music teacher candidates were less familiar with applications and software especially for the performance aspect of music. According to the results, it can be said that music teacher candidates do not know music applications and software adequately.
The Effectiveness of the Combination of Visual Prompt-Fading and Direct Instruction Method in Teaching Pattern Building Skills to Students with Intellectual Disabilities
Authors: Rasmussen Meryem Uçar , Çetin Müzeyyen Eldeniz
Published: August 2019

The aim of this study was to examine the effectiveness of the combination of visual prompt-fading and direct instruction method in teaching pattern building skills to students with intellectual disabilities. Three students at the age of six and seven diagnosed with intellectual disabilities and enrolled in a full-time inclusion program participated in the study, and multiple-probe design across subjects used to conduct the research. The dependent variable of the study was the participants' level of ability to build a pattern, and the independent variable was the combination of visual prompt-fading and direct instruction method. The data has been collected using tool sets and worksheets consisting of objects and object images. Graphical analysis technique has been utilized for data analysis. The findings of the study showed that a combination of visual prompt-fading and direct instruction method was effective in teaching pattern building skills to students with intellectual disabilities, but it was limited in terms of the generalization of these skills.
Re-established after hundred years: Definition of Hygrobates prosiliens Koenike, 1915, based on molecular and morphological evidence, and redescription of H. longipalpis (Hermann, 1804) (Acariformes, Hydrachnidia, Hygrobatidae)

Authors: Pešić Vladimir , Broda Lukasz , Dabert Miroslawa , Gerecke Reinhard , Martin Peter , Smit Harry
Published: August 2019

DNA-barcodes reveal that European populations attributed to Hygrobates longipalpis (Hermann, 1804), thus far considered a common inhabitant of standing and slowly flowing running waters all over the Western Palaearctic, represent two distinct lineages, both widely distributed over the continent. They are differentiated also from an ecological point of view, with specimens from standing waters ("clade I") separated from specimens collected in slowly running waters ("clade II"). Morphological examination revealed that, based on the length ratio of proximo- and distomedial setae on terminal segments of fourth legs, two morphospecies correspond to these two clades. As molecular examination of a specimen from the type locality of H. prosiliens Koenike, 1915 (Bremen, Heiligenrode) shows that it belongs to "clade I", populations from standing waters are attributed to that species. In view of the sketchy original description, loss of holotype and insufficient locality data of H. longipalpis, we arbitrarily assign to it stream-dwelling populations of "clade II" and designate a neotype.
Differential charging analysis of Nb-TiO2 thin films on SiO2 substrates
Authors: Bergman Susanna L. , Sahasrabudhe Girija , Loh Tamie Ai Jia , Bernasek Steven L.
Published: August 2019

Chemical vapor deposition (CVD) prepared TiO2 films, with and without Nb doping, were subjected to enhanced differential charging using an external bias and analyzed by x-ray photoelectron spectroscopy (XPS). It was found that charge barriers exist between the Ti and Si/O components in the undoped sample indicating an incomplete chemical interaction. After Nb doping, these differences are eliminated showing good electrical connection between all sample components. These results illustrate how differential charging can be used to identify electrical and chemical properties of doped films beyond traditional XPS measurements. They also provide information that is relevant to the understanding of passivation in the composite samples. The authors show the importance of additional charge compensation as well as correct mounting when employing the technique.
Effects of Exoplanetary Gravity on Human Locomotion Ability
Authors: Poljak Nikola , Klindzic Dora , Kruljac Mateo
Published: August 2019

At some point in the future, if mankind hopes to settle planets outside our solar system, it will be crucial to determine the range of planetary conditions under which human beings could survive and function. In this article, we apply physical considerations to determine the limitations that gravity imposes on several systems governing the human body. Initially, we examine the ultimate limits at which the human skeleton breaks and muscles become unable to lift the body from the ground. We also produce a new model for the energetic expenditure of walking, by modeling the leg as an inverted pendulum. Both approaches conclude that, with rigorous training, humans could perform normal locomotion at gravity no higher than 4gEarth.
Miniature Tesla Coil Teaching Lab
Authors: Tompkins Nathan
Published: August 2019

The Tesla coil is one of the most famous and popularly recognizable high voltage devices. Utilizing the fame of recognizability of the Tesla coil in a “Build Your Own” laboratory exercise is a great way to create a successful and highly interesting learning activity. Classical Tesla coils utilize a spark gap as the primary switch, whereas modern Tesla coils use solid state components instead such as the transistor for the Tesla coil described here. Building a miniature Tesla coil is also a convenient teaching tool for the instruction of electric fields, electromagnetic induction, and transistors. The equipment needed is readily available and affordable while the resulting “mini” Tesla coil is robust and entertaining. In addition, the concepts needed to give a basic description are readily available to students finishing a typical algebra-based physics course.
Robert A. Millikan and the Undergraduate Physics Laboratory
Authors: Greenslade Thomas B.
Published: August 2019

Ask a physics person what the name of Robert A. Millikan brings to mind, and most would immediately think of the eponymous experiments that he did with the charge on the electron in the years 1908 to 1913. A few might remember his work, starting in 1914, with the experimental determination of Planck’s constant using the photoelectric effect. Few will remember his work with bringing experiment into the education of undergraduate physics students in the early years of the 20th century. In this paper I will show how he achieved this by examining the numerous textbooks that he wrote.
Using a Simple Method to Estimate (Approximate) the Angle Between the Lunar Orbit and the Ecliptic
Authors: Isildak R. Suat , Kucukozer H. Asuman , Kucukozer Huseyin , Yurumezoglu Kemal
Published: August 2019

This paper describes a method to demonstrate that the plane of the lunar orbit around Earth and the plane of the ecliptic (the plane of Earth’s orbit around the Sun) are inclined with respect to each other, and to present a method for measuring the angle of the inclination. The angle between the diameter of the Moon’s orbit when the Moon passes through the local meridian and the diameter of Earth’s orbit when the Sun passes through the local meridian is the angle between the two planes. The paths of the Sun and the Moon as they appear when the Sun is at the local meridian were defined and the angle between them was measured as 42.5° by an observer. Then, these measurements were used to determine the inclination and to calculate an approximate value for the angle between the plane of the lunar orbit and plane of the ecliptic, which was found to be approximately 4.5°. This angle could be closely approximated with a simple method that everyone could use realistically and provide an answer for the question, “Since there is a full Moon every month as well as a new Moon, why is there no lunar eclipse and solar eclipse every month?”
Simple determination of Curie temperature using a smartphone magnetometer
Authors: Nuryadin Bebeh Wahid , Rusman Rusman
Published: August 2019

The Curie temperature, also called the Curie point, is the temperature at which magnetic material undergoes a phase transition from ferromagnetic to paramagnetic properties. The characteristics of permanent magnets appear below the Curie temperature—below 400 °C (673 K) for commercial ferromagnetic materials such as ferrite or neodymium. In ferromagnetic materials, atomic magnets are spontaneously oriented in the same direction in each microscopic domain (crystal region), resulting in a strong magnetic field. Raising the temperature of ferromagnetic materials to the Curie point will interfere with various spontaneous arrangements, and only the weak type of magnetization remains, called paramagnetic. The common method for ascertaining Curie temperature is by using a pendulum Curie point, or using a small magnet attached to a horizontal ferromagnetic wire. The pendulum or ferromagnetic wire, which is heated through combustion or electric heating, will turn into paramagnetic material when it reaches the Curie temperature, so that the pendulum or magnet will fall. The magnet/wire heating method allows the quantitative determination of Curie temperature, with a quite complex measurement and calculation parameters. Therefore, our study focused on demonstrating the Curie temperature of the ferromagnetic material (permanent magnet) quantitatively using a smartphone magnetometer. Measuring and analyzing the magnetization vs. temperature relationship of ferromagnetic material is carried out using the mean field theory (Ising model) approach, so that the Curie temperature of permanent magnets can be easily determined.
Teaching physics with a local positioning system
Authors: Siebert Cora , DeStefano Paul R. , Widenhorn Ralf
Published: August 2019

Recently available local positioning systems (LPS) have the potential to be used for interactive physics laboratory activities and classroom demonstrations. The Pozyx LPS combines multiple sensors with position data for any object that one of the devices is attached to. Devices referred to as “tags” (Fig. 1[a]) are mobile devices that can be tracked, and those referred to as “anchors” are stationary devices that are employed to calculate the tag’s position. At data rates of 30 Hz (2D and 3D tracking) to 200 Hz (1D tracking), the position is measured to an accuracy of about ±10 cm. We have found that this particular LPS works best for physics laboratory setups at distance scales of at least two meters and up to tens of meters.
Sexism in Professional Sports: How Women Managers Experience and Survive Sport Organizational Culture
Authors: Hindman Lauren C. , Walker Nefertiti A.
Published: August 2019

Women remain the minority in sport organizations, particularly in leadership roles, and prior work has suggested that sexism may be to blame. This study examines women’s experiences of both overt and subtle sexism in the sport industry as well as the impact such experiences have on their careers. Based on interviews and journal entries from women managers working in a men’s professional sports league, the findings suggest that the culture of sport organizations perpetuates sexism, including the diminishment and objectification of women. Sexism occurs in women’s everyday interactions with their supervisors and coworkers, as well as others that they interact with as part of their jobs. Such experiences result in professional and emotional consequences, which women navigate by employing tactics that enable their survival in the sport industry.
Bulk ultrafine grained/nanocrystalline metals via slow cooling
Authors: Cao Chezheng , Yao Gongcheng , Jiang Lin , Sokoluk Maximilian , Wang Xin , Ciston Jim , Javadi Abdolreza , Guan Zeyi , De Rosa Igor , Xie Weiguo , Lavernia Enrique J. , Schoenung Julie M. , Li Xiaochun
Published: August 2019

Bulk ultrafine grained/nanocrystalline metals were fabricated via slow cooling for the first time.
Near-UV to mid-IR reflectance imaging spectroscopy of paintings on the macroscale
Authors: Gabrieli F. , Dooley K. A. , Facini M. , Delaney J. K.
Published: August 2019

Near-UV to mid-IR reflectance imaging spectroscopy can identify and map pigments and paint binders in Old Master paintings.
Exploiting mammalian low-complexity domains for liquid-liquid phase separation–driven underwater adhesive coatings
Authors: Cui Mengkui , Wang Xinyu , An Bolin , Zhang Chen , Gui Xinrui , Li Ke , Li Yingfeng , Ge Peng , Zhang Junhu , Liu Cong , Zhong Chao
Published: August 2019

Designer proteins form strong underwater adhesive fibrous coatings via coacervation, followed by liquid-to-solid maturation.
In Vitro
Activity of Rifampin, Rifabutin, Rifapentine, and Rifaximin against Planktonic and Biofilm States of Staphylococci Isolated from Periprosthetic Joint Infection
Authors: Albano Mariana , Karau Melissa J. , Greenwood-Quaintance Kerryl E. , Osmon Douglas R. , Oravec Caitlin P. , Berry Daniel J. , Abdel Matthew P. , Patel Robin
Published: August 2019

The
in vitro
activities of rifampin, rifabutin, rifapentine, and rifaximin were tested against 200 periprosthetic joint infection (PJI)-associated staphylococci. Seven rifampin-resistant isolates had MICs of ≥4 μg/ml. Three isolates had rifampin MICs of 0.25 to 1 μg/ml and harbored an Asp471Gly RpoB variant, suggesting that the CLSI rifampin-susceptible staphylococcal breakpoint of ≤1 μg/ml may be too high.
The Epstein-Barr Virus BMRF1 Protein Activates Transcription and Inhibits the DNA Damage Response by Binding NuRD
Authors: Salamun Samuel G. , Sitz Justine , De La Cruz-Herrera Carlos F. , Yockteng-Melgar Jaime , Marcon Edyta , Greenblatt Jack , Fradet-Turcotte Amelie , Frappier Lori
Published: August 2019

The Epstein-Barr virus (EBV) BMRF1 protein is critical for EBV infection, playing key roles in viral genome replication, activation of EBV genes, and inhibition of host DNA damage responses (DDRs). Here we show that BMRF1 targets the cellular nucleosome remodeling and deacetylation (NuRD) complex, using a motif in the BMRF1 transcriptional activation sequence. Mutation of this motif disrupts the ability of BMRF1 to activate transcription and interfere with DDRs, showing the importance of the NuRD interaction for BMRF1 functions. BMRF1 was shown to act at the same step in the DDR as NuRD, suggesting that it interferes with NuRD function.
Hepatitis C Virus NS3 Protein Plays a Dual Role in WRN-Mediated Repair of Nonhomologous End Joining
Authors: Chen Tsu-I , Hsu Yuan-Kai , Chou Chia-Yi , Chen Yu-Hsin , Hsu Shing-Tzu , Liou Yan-Shuo , Dai Yu-Ching , Chang Ming-Fu , Chang Shin C.
Published: August 2019

HCV infection is a worldwide problem of public health and a major contributor to hepatocellular carcinoma. The single-stranded RNA virus with RNA-dependent RNA polymerase experiences a high error rate and develops strategies to escape the immune system and hepatocarcinogenesis. Studies have revealed the involvement of HCV proteins in the impairment of DNA repair. The present study aimed to further elucidate mechanisms by which the viral NS3 protein impairs the repair of DNA damage. Our results clearly indicate that HCV NS3/4A protease targets WRN for degradation, and, at the same time, diminishes the repair efficiency of nonhomologous end joining by interfering with the recruitment of Ku protein to the DNA double-strand break sites. The study describes a novel mechanism by which the NS3 protein influences DNA repair and provides new insight into the molecular mechanism of HCV pathogenesis.
Regulation of
Listeria monocytogenes
Virulence
Authors: Johansson Jörgen , Freitag Nancy E.
Published: August 2019

Whereas obligate human and animal bacterial pathogens may be able to depend upon the warmth and relative stability of their chosen replication niche, environmental bacteria such as
Listeria monocytogenes
that harbor the ability to replicate both within animal cells and in the outside environment must maintain the capability to manage life under a variety of disparate conditions. Bacterial life in the outside environment requires adaptation to wide ranges of temperature, available nutrients, and physical stresses such as changes in pH and osmolarity as well as desiccation. Following ingestion by a susceptible animal host, the bacterium must adapt to similar changes during transit through the gastrointestinal tract and overcome a variety of barriers associated with host innate immune responses. Rapid alteration of patterns of gene expression and protein synthesis represent one strategy for quickly adapting to a dynamic host landscape. Here, we provide an overview of the impressive variety of strategies employed by the soil-dwelling, foodborne, mammalian pathogen
L. monocytogenes
to straddle diverse environments and optimize bacterial fitness both inside and outside host cells.
How to… collect urine samples from young children
Authors: Kaufman Jonathan
Published: August 2019

Urine samples are commonly collected from young children to diagnose or exclude urinary tract infections, but collection from precontinent children is challenging. Each collection method has advantages and limitations. Non-invasive methods (urine pads, bags, clean catch) are convenient but can be time-consuming and are limited by sample contamination. Voiding stimulation methods (bladder-lumbar stimulation, Quick-Wee) can expedite clean catch collection. Invasive methods (catheter, suprapubic aspiration) can be more reliable, but require expertise to perform and cause pain for the child. This article reviews each collection method, and describes collection procedures, indications and strategies to optimise success and reduce contamination.
DPP-4 inhibitor (sitagliptin)-induced seronegative rheumatoid arthritis
Authors: Padron Simonette , Rogers Everett , Demory Beckler Michelle , Kesselman Marc
Published: August 2019

Sitagliptin is a dipeptidyl peptidase-4 inhibitor commonly used in the treatment of type 2 diabetes mellitus for glycaemic control. Concerns have arisen regarding adverse events caused by this drug, particularly concerning arthralgias. Here, we report on a 56-year-old man being treated with sitagliptin who developed inflammatory arthritis after taking the drug for 6 months. The patient presented with pain, swelling and erythema in multiple joints and was eventually diagnosed with seronegative rheumatoid arthritis (RA) under the 2010 American College of Rheumatology/European League Against Rheumatism classification criteria. His symptoms continued for several months after stopping sitagliptin and eventually went into remission after a tapered course of steroids, hydroxychloroquine and methotrexate. Furthermore, the patient is HLA-DRB3 positive, a genetic marker that is still being investigated for its role in the pathogenesis of RA and that may have been a predisposing factor in the development of this patient’s inflammatory arthropathy.
Unusual cause for intestinal perforation in juvenile dermatomyositis
Authors: Bhaskaran Harikrishnan , Balan Suma
Published: August 2019

We report a case of juvenile dermatomyositis (JDM) with cytomegalovirus (CMV) colitis which was further complicated with perforation. The patient, a 6-year-old girl, was diagnosed with JDM 1 month prior to the current presentation. After 2 weeks of optimising her treatment with steroid, intravenous Ig and methotrexate, she was readmitted with diffuse abdominal pain. Erect abdominal X-ray revealed gas under diaphragm. An exploratory laparotomy showed perforation of the large intestine. A biopsy showed inclusion bodies of CMV with immunohistochemistry for CMV positive. Strong positive CMV DNA PCR from tissue specimen, positive IgG CMV and negative IgM CMV in blood suggested a reactivation of CMV. The treatment followed included surgery and strategic use of antiviral agents as well as immunomodulators. CMV enteritis with complications should also be suspected in optimally treated autoimmune disease patients, including JDM, when they present with abdominal symptoms.
Pulmonary rehabilitation for pneumoconiosis: protocol for a systematic review and meta-analysis
Authors: Zhao Hulei , Xie Yang , Wang Jiajia , Li Xuanlin , Li Jiansheng
Published: August 2019

Introduction

Pneumoconiosis is characterised by diffuse fibrosis in lung tissue, and its incidence is on the rise. At present, there are limited therapeutic options for pneumoconiosis. Pulmonary rehabilitation (PR) has been widely used to treat pneumoconiosis，however, there is limited evidence concerning its efficacy. Therefore, we plan to conduct a systematic review to investigate the efficacy and safety of PR for pneumoconiosis.

Methods and analysis

The following databases will be searched from their inception to 1 April 2019: PubMed, Embase, The Cochrane Library, Web of Science, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Chongqing VIP and Wanfang Data. Randomised controlled trials of PR for pneumoconiosis will be included. Primary outcomes will include 6 min walk distance and St. George’s Respiratory Questionnaire. Study selection, extraction of data and assessment of study quality each will be independently undertaken. Statistical analysis will be conducted using Review Manager software.

Ethics and dissemination

This systematic review will provide up-to-date information on PR for pneumoconiosis. The review does not require ethical approval and will be disseminated electronically through a peer-reviewed publication or conference presentations.

PROSPERO registration number

CRD42018095266.
Association between educational level and total and cause-specific mortality: a pooled analysis of over 694 000 individuals in the Asia Cohort Consortium
Authors: Yang Keming , Zhang Ying , Saito Eiko , Rahman Md Shafiur , Gupta Prakash Chandra , Sawada Norie , Tamakoshi Akiko , Gao Yu-Tang , Koh Woon-Puay , Shu Xiao-Ou , Tsuji Ichiro , Sadakane Atsuko , Nagata Chisato , You San-Lin , Yuan Jian-Min , Shin Myung-Hee , Chen Yu , Pan Wen-Harn , Pednekar Mangesh S , Tsugane Shoichiro , Cai Hui , Xiang Yong-Bing , Ozasa Kotaro , Tomata Yasutake , Kanemura Seiki , Sugawara Yumi , Wada Keiko , Wang Renwei , Ahn Yoon-Ok , Yoo Keun-Young , Ahsan Habibul , Chia Kee Seng , Boffetta Paolo , Kang Daehee , Potter John D , Inoue Manami , Zheng Wei , Nan Hongmei
Published: August 2019

Objective

To study the association of educational level and risk of death from all causes, cardiovascular disease (CVD) and cancer among Asian populations.

Design

A pooled analysis of 15 population-based cohort studies.

Setting and participants

694 434 Asian individuals from 15 prospective cohorts within the Asia Cohort Consortium.

Interventions

None.

Main outcome measures

HRs and 95% CIs for all-cause mortality, as well as for CVD-specific mortality and cancer-specific mortality.

Results

A total of 694 434 participants (mean age at baseline=53.2 years) were included in the analysis. During a mean follow-up period of 12.5 years, 103 023 deaths were observed, among which 33 939 were due to cancer and 34 645 were due to CVD. Higher educational levels were significantly associated with lower risk of death from all causes compared with a low educational level (≤primary education); HRs and 95% CIs for secondary education, trade/technical education and ≥university education were 0.88 (0.85 to 0.92), 0.81 (0.73 to 0.90) and 0.71 (0.63 to 0.80), respectively (ptrend=0.002). Similarly, HRs (95% CIs) were 0.93 (0.89 to 0.97), 0.86 (0.78 to 0.94) and 0.81 (0.73 to 0.89) for cancer death, and 0.88 (0.83 to 0.93), 0.77 (0.66 to 0.91) and 0.67 (0.58 to 0.77) for CVD death with increasing levels of education (both ptrend<0.01). The pattern of the association among East Asians and South Asians was similar compared with ≤primary education; HR (95% CI) for all-cause mortality associated with ≥university education was 0.72 (0.63 to 0.81) among 539 724 East Asians (Chinese, Japanese and Korean) and 0.61 (0.54 to 0.69) among 154 710 South Asians (Indians and Bangladeshis).

Conclusion

Higher educational level was associated with substantially lower risk of death among Asian populations.
The joint effect of insomnia symptoms and lifestyle factors on risk of self-reported fibromyalgia in women: longitudinal data from the HUNT Study
Authors: Skarpsno Eivind Schjelderup , Nilsen Tom Ivar Lund , Sand Trond , Hagen Knut , Mork Paul Jarle
Published: August 2019

Objectives

To investigate the association between insomnia symptoms and risk of self-reported fibromyalgia in women, and to explore whether leisure time physical activity and body mass index (BMI) modify this association.

Design

Prospective cohort study.

Setting

We used longitudinal data from the Norwegian Nord-Trøndelag Health Study collected in 1995–1997 (baseline) and 2006–2008 (follow-up).

Participants

A total of 14 172 women who reported to be free from fibromyalgia at baseline.

Primary outcome measures

We estimated adjusted risk ratios (RRs) with 95% CI for self-reported fibromyalgia at follow-up associated with baseline insomnia symptoms, leisure time physical activity and BMI.

Results

Overall, 466 incident cases of fibromyalgia were reported during the follow-up period of approximately 11 years, corresponding to a crude absolute risk (AR) of 3.3%. Compared with women without insomnia symptoms (crude AR=2.8%), women who reported one, two or three symptoms had RRs of fibromyalgia of 1.39 (95% CI: 1.08 to 1.80), 1.86 (95% CI: 1.33 to 2.59) and 2.66 (95% CI: 1.75 to 4.06), respectively. Compared with highly physically active women without insomnia symptoms (crude AR=2.7%), women with one or more insomnia symptoms had a RR of fibromyalgia of 1.90 (95% CI: 1.30 to 2.79) if they reported low physical activity and a RR of 1.55 (95% CI: 1.12 to 2.13) if they reported high physical activity. We found no synergistic effect between insomnia symptoms and BMI on risk of fibromyalgia; however, overweight and obese women with one or more insomnia symptoms had RRs of 2.35 (95% CI: 1.73 to 3.21) and 2.18 (95% CI: 1.42 to 3.35) compared with the reference group of normal weight women without insomnia symptoms (crude AR=2.3%).

Conclusions

Insomnia symptoms are strongly and positively associated with risk of fibromyalgia in adult women. Leisure time physical activity may compensate for some of the adverse effect of insomnia symptoms on risk of fibromyalgia.
Phenylketonuria incidence in China between 2013 and 2017 based on data from the Chinese newborn screening information system: a descriptive study
Authors: Xiang Liangcheng , Tao Jing , Deng Kui , Li Xiaohong , Li Qi , Yuan Xuelian , Liang Juan , Yu Erling , Wang Meixian , Wang Huiqing , Liu Hanmin , Zhu Jun
Published: August 2019

Objective

This study examines the incidence and spatial clustering of phenylketonuria (PKU) in China between 2013 and 2017.

Methods

Data from the Chinese Newborn Screening Information System were analysed to assess PKU incidence with 95% CIs by province, region and disease severity. Spatial clustering of PKU cases was analysed using global and local spatial autocorrelation analysis in the geographic information system.

Results

The database contained 4925 neonates with confirmed PKU during the study period, corresponding to an incidence of 6.28 (95% CI: 6.11 to 6.46) per 100 000 neonates screened. Incidence was highest in the provinces of Gansu, Ningxia and Qinghai, where it ranged from 19.00 to 28.63 per 100 000 neonates screened. Overall incidence was higher in the northern part of the country, where classical disease predominated, than in the southern part, where mild disease predominated. PKU cases clustered spatially (global Moran’s I=0.3603,Z=5.3097, p<0.001), and local spatial autocorrelation identified four northern provinces as high–high clusters (Gansu, Qinghai, Ningxia and Shanxi).

Conclusions

China shows an intermediate PKU incidence among countries, and incidence differs substantially among Chinese provinces and between northern and southern regions. Our results suggest the need to focus efforts on screening, diagnosing and treating PKU in high-incidence provinces.
Enriching medical trainees’ learning through practice: a video reflexive ethnography study protocol
Authors: Noble Christy , Billett Stephen , Hilder Joanne , Teodorczuk Andrew , Ajjawi Rola
Published: August 2019

Introduction

Supporting medical students’ and junior doctors’ development in busy clinical settings is challenging. As opportunities for developing trainees, for example, traditional bedside teaching, are decreasing, teaching outside of clinical practice is increasing. However, evidence suggests that effective learning through practice arises via an interplay between, first, what experiences are afforded by clinical settings and, second, how trainees engage with these affordances. Many studies investigating clinician learning through practice focus on only one of these two factors. Yet, a well-recognised methodological challenge of enabling learners to articulate how and what they are learning through practice exists. We need, therefore, to understand how this relationship plays out in practice in ways that enrich learning.

Methods and analysis

This protocol describes a video reflexive ethnographic approach to illuminate how learning through practice in hospital settings occurs and can be enriched. The study will be conducted in two phases. In phase I, senior clinicians from emergency medicine, medicine and surgical specialties will be interviewed about how they guide trainees’ learning through practice. These forms of guidance, analysed using the framework method, will inform phase II comprising observations of practice in: (1) emergency, (2) medical and (3) surgical departments. Video recorded episodes of clinicians’ guiding learning through practice will be shared and appraised in reflexive sessions with each clinical team. Relational interdependent learning theory informs the design and data analyses to elicit and evaluate strategies for guiding learning through practice.

Ethics and dissemination

Ethical approval has been received from both healthcare and university settings. The findings should provide important insights for clinicians about workplace learning practices. Findings will be disseminated across the project phases and to diverse audiences—locally, nationally and internationally. The dissemination strategy will use seminars, grand rounds, conference presentations and academic papers to articulate practical, theoretical and methodological findings.
Mechanisms of atrial fibrillation
Authors: Wijesurendra Rohan S , Casadei Barbara
Published: August 2019

Atrial fibrillation (AF) is the most common sustained arrhythmia, currently affecting over 33 million individuals worldwide, and its prevalence is expected to more than double over the next 40 years. AF is associated with a twofold increase in premature mortality, and important major adverse cardiovascular events such as heart failure, severe stroke and myocardial infarction. Significant effort has been made over a number of years to define the underlying cellular, molecular and electrophysiological changes that predispose to the induction and maintenance of AF in patients. Progress has been limited by the realisation that AF is a complex arrhythmia that can be the end result of various different pathophysiological processes, with significant heterogeneity between individual patients (and between species). In this focused Review article, we aim to succinctly summarise for the non-specialist the current state of knowledge regarding the mechanisms of AF. We address all aspects of pathophysiology, including the basic electrophysiological and structural changes within the left atrium, the genetics of AF and the links to comorbidities and wider systemic and metabolic perturbations that may be upstream contributors to development of AF. Finally, we outline the translational implications for current and future rhythm control strategies in patients with AF.
Tricuspid regurgitation severity after atrial septal defect closure or pulmonic valve replacement
Authors: Martin-Garcia Agustin C , Dimopoulos Konstantinos , Boutsikou Maria , Martin-Garcia Ana , Kempny Aleksander , Alonso-Gonzalez Rafael , Swan Lorna , Uebing Anselm , Babu-Narayan Sonya V , Sanchez Pedro Luis , Li Wei , Shore Darryl , Gatzoulis Michael A
Published: August 2019

Objectives

Cardiac surgery or catheter interventions are nowadays commonly performed to reduce volume loading of the right ventricle in adults with congenital heart disease. However, little is known, on the effect of such procedures on pre-existing tricuspid regurgitation (TR). We assessed the potential reduction in the severity of TR after atrial septal defect (ASD) closure and pulmonic valve replacement (PVR).

Methods

Demographics, clinical and echocardiographic characteristics of consecutive patients undergoing ASD closure or PVR between 2005 and 2014 at a single centre who had at least mild preoperative TR were collected and analysed.

Results

Overall, 162 patients (mean age at intervention 41.6±16.1 years, 38.3% male) were included: 101 after ASD closure (61 transcatheter vs 40 surgical) and 61 after PVR (3 transcatheter vs 58 surgical). Only 11.1% received concomitant tricuspid valve surgery (repair). There was significant reduction in the severity of TR in the overall population, from 38 (23.5%) patients having moderate or severe TR preoperatively to only 11 (6.8%) and 20 (12.3%) at 6 months and 12 months of follow-up, respectively (McNemar p<0.0001). There was a significant reduction in tricuspid valve annular diameter (p<0.0001), coaptation distance (p<0.0001) and systolic tenting area (p<0.0001). The reduction in TR was also observed in patients who did not have concomitant tricuspid valve (TV) repair (from 15.3% to 6.9% and 11.8% at 6 and 12 months, respectively, p<0.0001). On multivariable logistic regression including all univariable predictors of residual TR at 12 months, only RA area remained in the model (OR 1.2, 95% CI 1.04 to 1.37, p=0.01).

Conclusions

ASD closure and PVR are associated with a significant reduction in tricuspid regurgitation, even among patients who do not undergo concomitant tricuspid valve surgery.
National trends in endovascular therapy for acute ischemic stroke: utilization and outcomes
Authors: Stein Laura , Tuhrim Stanley , Fifi Johanna , Mocco J , Dhamoon Mandip
Published: August 2019

Objective

Following widespread acceptance of endovascular therapy (ET) for large vessel occlusion stroke in 2015, we assessed nationwide utilization of revascularization for acute ischemic stroke (AIS).

Methods

We utilized the 2013–2016 Healthcare Cost and Utilization Project Nationwide Readmissions Database. We identified AIS admissions, treatment with intravenous thrombolysis (IVT), ET, and vascular risk factors using International Classification of Disease Clinical Modification codes. Main predictor of outcome was the time period of index admission (‘pre-endovascular era (pre-EA)’ January 2013–January 2015 and ‘endovascular era (EA)’ February 2015– December 2016). We calculated the proportion of AIS admissions in which, first, VT and second, ET was performed. Among patients treated with ET, we examined the association between era and discharge disposition, in-hospital mortality during index admission, and 30-day readmission.

Results

There were 925 363 index AIS admissions before the EA and 857 347 during. A higher proportion of AIS patients received IVT (8.4% vs 7.8%) and ET (2.6% vs 1.3%) in the EA. Although length of stay (LOS) was shorter in the EA (5.70 vs 6.80 days), total charges were greater ($56 691 vs $53 878), and admissions were more often to a metropolitan hospital (65.2% vs 57.2%). Among those treated with ET, a smaller proportion received IVT (29.7% vs 44.9%), LOS was substantively shorter (9.75 vs 12.76 days), and patients had a lower odds of discharge home.

Conclusions

The utilization of ET has doubled in the EA but ET remains underutilized. ET is predominantly provided at metropolitan teaching hospitals and associated with higher charges despite shorter LOS and unchanged in-hospital mortality.
Police killings of Black people and rates of sexually transmitted infections: a cross-sectional analysis of 75 large US metropolitan areas, 2016
Authors: Ibragimov Umedjon , Beane Stephanie , Friedman Samuel R , Smith Justin C , Tempalski Barbara , Williams Leslie , Adimora Adaora A , Wingood Gina M , McKetta Sarah , Stall Ronald D , Cooper Hannah LF
Published: August 2019

Objectives

Emerging literature shows that racialised police brutality, a form of structural racism, significantly affects health and well-being of racial/ethnic minorities in the USA. While public health research suggests that structural racism is a distal determinant of sexually transmitted infections (STIs) among Black people, no studies have empirically linked police violence to STIs. To address this gap, our study measures associations between police killings and rates of STIs among Black residents of US metropolitan statistical areas (MSAs).

Methods

This cross-sectional ecological analysis assessed associations between the number of Black people killed by police in 2015 and rates of primary and secondary syphilis, gonorrhoea and chlamydia per 100 000 Black residents of all ages in 2016 in 75 large MSAs. Multivariable models controlled for MSA-level demographic and socioeconomic characteristics, police expenditures, violent crime, arrest and incarceration rates, insurance rates and healthcare funding.

Results

In 2015, the median number of Black people killed by police per MSA was 1.0. In multivariable models, police killings were positively and significantly associated with syphilis and gonorrhoea rates among Black residents. Each additional police killing in 2015 was associated with syphilis rates that were 7.5% higher and gonorrhoea rates that were 4.0% higher in 2016.

Conclusions

Police killings of Black people may increase MSA-level risk of STI infections among Black residents. If future longitudinal analyses support these findings, efforts to reduce STIs among Black people should include reducing police brutality and addressing mechanisms linking this violence to STIs.
Alcohol and drug use, partner PrEP use and STI prevalence among people with HIV
Authors: Hojilla J Carlo , Marcus Julia , Volk Jonathan E , Leyden Wendy , Hare C Bradley , Hechter Rulin C , Edelman E Jennifer , Silverberg Michael , Satre Derek D
Published: August 2019

Objectives

People with HIV (PWH) have a high burden of bacterial sexually transmitted infections (STIs). We examined the relationship of alcohol and drug use and partner pre-exposure prophylaxis (PrEP) use to STI prevalence in a cohort of PWH with a history of unhealthy alcohol use.

Methods

We analysed data from a primary care-based alcohol intervention study at Kaiser Permanente Northern California (KPNC). Participants were recruited between April 2013 and May 2015 and were followed for up to 24 months. We linked participant responses to questions from the 24 month follow-up interview, including alcohol and drug use and partner PrEP use, with STI test results (ie, syphilis, chlamydia, gonorrhoea) in the KPNC electronic health record. Prevalence ratios (PR) were estimated using Poisson models fitted with robust variance estimators to evaluate the association of substance use and partner use of PrEP with STIs.

Results

In the analytic sample (n=465), the median age was 52 years (IQR 45–59); 67% were white; 95% were men who have sex with men. Thirty-two per cent of participants had HIV-positive partners only; 31% had HIV-negative partners with at least one on PrEP in the previous year and 37% had HIV-negative partners without any on PrEP. Twenty-three per cent reported alcohol and drug use prior to sex in the last 6 months. Eight per cent of participants had an STI. Partner PrEP use (adjusted PR (aPR) 2.99 (95% CI 1.11 to 8.08)) was independently associated with higher STI prevalence. Participants who reported use of alcohol (aPR 1.53 (0.61 to 3.83)), drugs (aPR 1.97 (0.71 to 5.51)) or both (aPR 1.93 (0.75 to 4.97)) prior to sex had a higher STI prevalence.

Conclusions

The higher prevalence of STIs among PWH with unhealthy alcohol use who have partners on PrEP suggests that this subgroup may be a high-yield focus for targeted outreach, STI screening and sexual health counselling.
To treat or not to treat?
Authors: Ackermann Mathias , Hatt Jean‐Michel
Published: August 2019

In a world of ever‐increasing liability, the decision not to treat a patient comes less and less easily, even though both evidence‐based medical and financial reasons may speak against treatment. Elephant haemorrhagic disease (EHD), associated with viraemia with elephant endotheliotropic viruses (EEHV), may kill within hours after onset of clinical signs. Here, the authors present a case, where a three‐year‐old female Asian elephant (Elephas maximus) developed viraemia with EEHV1 but was deliberately left without antiviral treatment and survived without developing clinical signs. Considering the mostly fatal outcome of EHD, this decision may at first glance appear hazardous. However, the reasoning included knowledge about herpesviruses in general, past and present EEHV status of the individual, EEHV epidemiology within the herd as well as stress and costs involved in treatment. It is important to consider those parameters for each impeding case separately in order to assure the best welfare of the animal.
EXAMINING BARRIERS TO SUCCESS AND SOURCES OF ASSISTANCE FOR U.S. HISPANIC FEMALE ENTREPRENEURS
Authors: YOUNG MARILYN , CATER JOHN JAMES , JAMES KEVIN
Published: August 2019

This study examined the barriers to success and sources of assistance available for U.S. Hispanic female entrepreneurs. The goal of this research was to identify the problems, determine the source of solutions and then provide advice for the success of Hispanic female entrepreneurs. Our findings indicate that major barriers to success included a lack of capital and lack of marketing knowledge. In addition, our findings suggest that Hispanic female entrepreneurs turned to family members for assistance, rather than other sources of assistance. We advise that a break from this traditional behavior in seeking assistance is warranted. We provide suggestions for practitioners, researchers, and advisors in the form of three propositions.
PERFORMANCE OF INDIAN CEMENT INDUSTRY: DRIVERS, MODELS AND EMPIRICS
Authors: MAITY BIPASHA , SURESH VIDYA , BAIDYA MEHIR KUMAR
Published: August 2019

A firm’s performance depends on efficient management of economic resources. Performance is usually a function of firm-specific economic factors and macroeconomic factors. In other words, an efficient allocation, management and manipulation of these factors is required to enhance profitability. This study attempts to identify some factors to understand how and to what extent these factors influence the profitability of the Indian cement industry. Seven hypotheses were framed. Panel data of 146 firms were gathered over a period of 22 years, spanning from 1996 to 2017. Thereafter, a Fixed Effect Regression (FER) model was fitted to the data. Results suggested that both firm-specific (e.g. size of firm; age of firm; fixed asset turnover) and macroeconomic variables (e.g. GDP; inflation; export intensity) made a significant impact on profitability of this industry. The findings of this study should assist managers as well as policy makers to frame sustainable policies of this mature industry. This research fulfills a need for a study that shows the degree of contribution of firm-specific and macroeconomic factors to profitability of the Indian cement industry.
Long-Term Results of Surgically Treated Radial Polydactyly – An Outcome Correlation Study
Authors: Yeung Ching Man , Choi Alexander Kai Yiu , Tong Jennifer Wing Sze , Fok Winnie , Chan Yat Fai , Chow Yuk Yin
Published: August 2019

Background: Thumb polydactyly is one of the commonest congenital hand differences. Traditional surgeon-based outcome scores capture outcomes mainly on bodily structure and function. Outcomes on the long-term well-being of the patients in the domains of activity and participation are not fully studied.

Methods: Forty-eight thumbs in forty-five Chinese patients with radial polydactyly underwent surgical treatment at or before 3 years old were recruited. Mean follow-up was 11.6 years. Surgical outcomes were collected and compared to the normal opposite thumb. The results were compiled into the Japanese Society for Surgery of the Hand (JSSH) score, Cheng score and Tada score. Patients’ activity involving hands were assessed by both objective tools and patient-reported outcome measure while their health-related quality of life (HRQoL) was assessed by Patient- and Parent-reported Pediatric Quality of Life Inventory (PedsQL). Correlations between outcomes were analysed.

Results: Overall, both parents and patients themselves reported good quality of life with mean score of 86.6% and 92.1% respectively in PedsQL. The combined surgical scores ranged from 52% good or excellent results using JSSH score to 100% good result using Cheng score. None of the outcomes on bodily structure and function showed positive correlation with patient’s well-being. Negative correlation was noted in total passive range of movement, active movement and Cheng score. All patients reported no activity restriction. Writing test did not show significant slowing. The operated hands had significantly poorer fine motor dexterity than normal. No significant correlation is noted between activity outcomes and PedsQL.

Conclusions: Outcomes on bodily structure, function and activity showed little correlation with patients’ well-being after thumb polydactyly correction. It should be careful in using or analysing patient/parent-reported outcome measures on HRQoL as outcome assessment of surgical treatment of radial polydactyly.