bluuebunny/crossref_metadata_2025 huggingface dataset:
Rheumatic mitral valve repair: the Score procedure
Authors: Luo Tiange , Meng Xu
Published: June 2020

We have defined a standard surgical procedure for rheumatic mitral valve repair (the Score procedure) including four steps: shaving, checking, commissurotomy, and relaxing. Here, we summarize the clinical pathological classification for making a decision on repair or replacement. Given the large number of patients in China, we consider it the responsibility of Chinese cardiac surgeons to adopt a therapeutic schedule for rheumatic mitral valve disease, which includes a simple operation with reliable effects and easy to promote. This schedule would ensure that millions of patients get the best treatment to extend survival and improve their quality of life.
Self-regulation of the newlyweds in Taiwan: Goals and strategies
Authors: Chang Szu-Chia , Chang Jenny Hsiu-Ying , Low Meng-Yeow , Chen Tzu-Chin , Kuo Shih-Hsien
Published: June 2020

The aim of this study is to explore the goals and strategies of self-regulation of the newlyweds in Taiwan. Through in-depth interviews with eight newlywed couples ( N = 16), qualitative data were gathered and analyzed using thematic analysis. The findings revealed that, under the influence of their cultural values, the newlywed participants pursue the goals of genuine harmony and superficial harmony in their self-regulation for marital adjustment. Genuine harmony can be attained through people’s fulfillment of their role norms in in-law relationships and establishment of affiliations with spouses in marital relationships. On the other hand, superficial harmony can be maintained by people through keeping sketchy relationships with their in-laws and inhibiting anger to prevent open conflicts with their spouses. To achieve relational harmony, various strategies of self-regulation were used depending on the situations involved. Such strategies direct to the principle of zhong-yong (the Doctrine of Mean) involving holistic information processing and avoidance of extremities in implementation. Gender differences in self-regulation were found in both goals and strategies.
MicroRNA-17 as a potential diagnostic biomarker in pulmonary arterial hypertension
Authors: Li Haiwen , Yang Zhiming , Gao Fen , Zhang Yueying , Meng Weihao , Rong Shuling
Published: June 2020

Objective

This study aimed to detect circulating microRNA (miR)-17 and miR-20a levels in patients with pulmonary arterial hypertension (PAH), and to investigate whether circulating miR-17 levels are associated with PAH.

Methods

Thirty-five PAH patients and 20 healthy controls were enrolled in the study. Circulating miR-17 and miR-20a levels were measured using real-time PCR analysis.

Results

miR-17 levels were significantly increased in PAH patients compared with healthy controls. They were also higher in PAH patients at World Health Organization functional class (WHO FC) III–IV than WHO FC I–II PAH patients. There was no significant difference in miR-20a levels between PAH patients and controls. miR-17 had a high area under the corresponding receiver operating characteristic curve. Further, we found that circulating miR-17 levels correlated with the 6-minute walk distance, mean pulmonary artery pressure, and mean right atrial pressure in PAH patients.

Conclusion

Circulating miR-17 levels may be associated with human PAH. Therefore, miR-17 could be used as a diagnostic index and prognostic factor for PAH patients.
Th17 cell frequency and IL-17A production in peripheral blood of patients with non-small-cell lung cancer
Authors: Chen Gang , Zhang Pei-Gang , Li Jun-Sheng , Duan Jing-Jing , Su Wen , Guo Shi-Ping , Wang Yan-Feng , Sun Jun-Ning , Yang Xiao-Tang
Published: June 2020

Objective

This study investigated the frequency of T-helper (Th)17 lymphocytes and production of cytokine interleukin (IL)-17 in peripheral blood of patients with non-small-cell lung cancer (NSCLC) and their use as a marker of clinical value.

Methods

Sixty patients with NSCLC and 60 healthy volunteers were enrolled in the study. Flow cytometry was used to detect the frequency of Th17 lymphocytes in peripheral blood, and enzyme-linked immunosorbent assay (ELISA) was used to detect serum levels of IL-17. We analyzed the association of Th17 lymphocytes and IL-17 levels in the peripheral blood of patients with their clinicopathological features.

Results

Frequency of Th17 lymphocytes and production of IL-17 were significantly higher in the NSCLC group than in the control group and were higher in patients with a smoking history compared with non-smokers. Moreover, Th17 lymphocyte and IL-17 expression levels were higher in patients with squamous cell carcinoma than in patients with adenocarcinoma, and significantly higher in patients with stage III and IV cancers than in patients at stage I or II.

Conclusion

Th17 lymphocytes and IL-17 play an important role in the development of NSCLC in patients and may have clinical value as markers for treatment of NSCLC.
Psychological aspects of infertility. A systematic review
Authors: Szkodziak Filip , Krzyżanowski Jarosław , Szkodziak Piotr
Published: June 2020

Objective

Fertility may be defined as a capacity to conceive and produce offspring. Infertility is characterized by failure to establish a clinical pregnancy after 12 months of regular and unprotected sexual intercourse. Infertility concerns an estimated 8–12% of the global population, and is associated with factors including time of unwanted non-conception, age of female partner and number of diseases impacting fertility. Unexplained infertility is described as idiopathic. This study aimed to analyse and evaluate the influence of mental disorders, often considered as reasons for idiopathic infertility, on female and male fertility, including stress, depression, sleep and eating disorders, and addictions.

Methods

This systematic review comprised a search of MEDLINE, Cochrane and PubMed databases for relevant articles that were analysed by two independent reviewers.

Results

A total of 106 articles published between 1955–2019 were included. Mental disorders modify endocrine gland and immune system functioning at both the tissue and cellular level, and are negatively associated with female and male fertility.

Conclusion

Mental disorders may negatively impact female and male fertility. Further studies are required to explain the exact role and contribution of mental disorders to fertility.
Sex- and age-specific mild cognitive impairment is associated with low hand grip strength in an older Chinese cohort
Authors: Liu Xinji , Chen Jun , Geng Renwen , Wei Rong , Xu Peiru , Chen Beijing , Liu Kaiyong , Yang Linsheng
Published: June 2020

Background

Few studies have demonstrated the impact of characteristics like age and sex on the association between hand grip strength (HGS) and mild cognitive impairment (MCI). In this cross-sectional study, we aimed to examine the effects of sex and age on the relationship between HGS and MCI.

Methods

We enrolled older adults age ≥60 years (n = 1009) and measured HGS and MCI in all participants. We analyzed the differences in MCI prevalence among the different variables. The role of sex and age in the association between MCI and HGS was analyzed using binary logistic regression.

Results

Women had significantly higher prevalence of MCI than men, as did the older group (age ≥70 years) compared with the younger group (age 60–70 years). In men, the low and middle HGS tertiles were significantly associated with MCI. In contrast, only the low tertile of HGS was associated with MCI in women. In the older group, the low tertile of HGS was significantly associated with MCI, which was not observed in the younger group.

Conclusions

HGS was associated with MCI in older adults, and this association was stronger in men. HGS may be useful for evaluating MCI in older adults.
Venovenous extracorporeal membrane oxygenation versus conventional mechanical ventilation to treat refractory hypoxemia in patients with acute respiratory distress syndrome: a retrospective cohort study
Authors: Tongyoo Surat , Permpikul Chairat , Sucher Siwalai , Thomrongpairoj Preecha , Poompichet Akekarin , Ratanarat Ranistha , Chierakul Nitipatana
Published: June 2020

Objective

To compare the treatment outcome of venovenous extracorporeal membrane oxygenation (VV-ECMO) versus mechanical ventilation in hypoxemic patients with acute respiratory distress syndrome (ARDS) at a referral center that started offering VV-EMCO support in 2010.

Methods

This retrospective cohort study enrolled adults with severe ARDS (PaO2/FiO2 ratio of <100 with FiO2 of ≥90 or Murray score of ≥3) who were admitted to the intensive care unit of Siriraj Hospital (Bangkok, Thailand) from January 2010 to December 2018. All patients were treated using a low tidal volume (TV) and optimal positive end-expiratory pressure. The primary outcome was hospital mortality.

Results

Sixty-four patients (ECMO, n = 30; mechanical ventilation, n = 34) were recruited. There was no significant difference in the baseline PaO2/FiO2 ratio (67.2 ± 25.7 vs. 76.6 ± 16.0), FiO2 (97 ± 9 vs. 94 ± 8), or Murray score (3.4 ± 0.5 vs. 3.3 ± 0.5) between the ECMO and mechanical ventilation groups. The hospital mortality rate was also not significantly different between the two groups (ECMO, 20/30 [66.7%] vs. mechanical ventilation, 24/34 [70.6%]). Patients who underwent ECMO were ventilated with a significantly lower TV than patients who underwent mechanical ventilation (3.8 ± 1.8 vs. 6.6 ± 1.4 mL, respectively).

Conclusion

Although VV-ECMO promoted lower-TV ventilation, it did not improve the in-hospital mortality rate. Trial registration: www.clinicaltrials.gov (NCT 04031794).
Exploration of Hazardous Material Truck Crashes on Wyoming’s Interstate Roads using a Novel Hamiltonian Monte Carlo Markov Chain Bayesian Inference
Authors: Ahmed Irfan U. , Gaweesh Sherif M. , Ahmed Mohamed M.
Published: June 2020

Crash severity of a hazardous material (HAZMAT) transporting truck increases manyfold compared with normal truck crash because of the possible exposure to dangerous substances. Crashes which involve a HAZMAT truck might result in a catastrophic incident causing horrendous damage to individuals involved in the crash. In-transit HAZMAT crashes in Wyoming caused a total damage of $3.1 million from 2015 to 2018. HAZMAT crashes on interstate roads represented 22% of the total HAZMAT crashes causing a total damage of $2.2 million, representing 71% of the cost of total damage. Previous studies in Wyoming investigated all vehicle crashes, including large truck crashes, but none has analyzed HAZMAT-related crashes or accounted for its type as a contributing factor. This study fills the gap by analyzing crash injury severity of HAZMAT-related crashes on all interstate freeways in Wyoming. Furthermore, the study introduces the No-U-Turn (NUT) Hamiltonian Monte Carlo (HMC) method of hierarchical Bayesian analysis into HAZMAT crash injury severity analysis. In recent developments, NUT HMC has been proven to be the most efficient Markov Chain Monte Carlo (MCMC) sampling method. The results showed that 30% of the unobserved heterogeneity arises from variation in summer and winter crashes which justifies the use of hierarchical model. Among the other covariates investigated, the population-averaged effects showed that number of trucks involved, hit-and-run crashes, animal-vehicle crashes, work-zone-related crashes, collision type, percentage of females involved, drivers’ drug/alcohol use, seat-belt use, crash location, roadway curves, and surface conditions significantly impact HAZMAT crash injury severity.
Influence of in utero di-n-hexyl phthalate and di-cyclohexyl phthalate exposure on the endocrine glands and T3, T4, and TSH hormone levels of male and female rats: Postnatal outcomes
Authors: Barlas Nurhayat , Göktekin Emre , Karabulut Gözde
Published: June 2020

The present study was designed to evaluate the effects of di- n-hexyl phthalate (DHP) and di-cyclohexyl phthalate (DCHP) on endocrine organs in rats. Oil control, 20-, 100-, and 500 mg/kg dose groups were selected and administered to pregnant rats on gestational days 6–19 by oral gavage. The neonatal stages of rats continued until postnatal day 20 and the- juvenile stages of rats continued until postnatal day of 32. The rats were allowed to mature until the neonatal and juvenile stages and there after, they were divided into four groups corresponding to the treatment levels. Body and organ weights were recorded, serum was collected, and thyroid, pancreas, pituitary gland, and adrenal gland were removed. There was a decrease in body weights in the 20- and 500mg/kg DHP and in the 20-mg/kg DCHP dose groups in neonatal male rats. In contrast, for female rats, there was an increase in body weights in the 100-mg/kg DCHP dose group and there was a decrease in body weights in the 500-mg/kg DHP dose group. Body weights were increased at 20 and 500 mg/kg in the DHP-exposed juvenile male rats. Serum thyroid-stimulating hormone (TSH) levels were increased in neonatal male rats, while they were increased in the 100-mg/kg DHP group of neonatal and juvenile female rats. Serum triiodothyronine (T3) levels were increased at the high dose of DHP for neonatal male rats and at the low and high dose levels of DCHP for female rats. Serum thyroxine (T4) levels were increased in neonatal rats for DHP. Also, some histopathological changes were observed in the thyroid, pancreas, adrenal, and pituitary gland. In conclusion, it was shown that DHP and DCHP caused negative effects on T3, T4, and TSH hormone levels.
Histogram Analysis of ADC Maps for Differentiating Brain Metastases From Different Histological Types of Lung Cancers
Authors: Bozdağ Mustafa , Er Ali , Çinkooğlu Akın
Published: June 2020

Purpose:

Our study aimed to investigate the role of histogram analysis derived from apparent diffusion coefficient (ADC) maps in brain metastases (BMs) from lung cancer for differentiating histological subtype.

Methods:

A total of 61 BMs (45 non-small cell lung cancer [NSCLC] comprising 32 adenocarcinoma [AC], 13 squamous cell carcinoma [SCC], and 16 small-cell lung cancer [SCLC]) in 50 patients with histopathologically confirmed lung cancer were retrospectively included in this study. Pretreatment cranial diffusion-weighted imaging was performed, and the corresponding ADC maps were generated. Regions of interest were drawn on solid components of the BM on all slices of the ADC maps to obtain parameters, including ADCmax, ADCmean, ADCmin, ADCmedian, ADCrange, skewness, kurtosis, entropy, ADC10, ADC25, ADC75, and ADC90. Apparent diffusion coefficient histogram parameters were compared among histological type groups. Kruskal-Wallis, Mann-Whitney U, chi-square tests, and receiver-operating characteristic (ROC) curve were used for statistical assessment.

Results:

ADCmin, ADC10, and ADC25 were found to be significantly different among AC, SCC, and SCLC groups; these parameters were higher for AC group, moderate for SCC group, and significantly lower for SCLC group. Skewness and kurtosis were not significantly different among all groups. The ROC analysis for differentiating BMs of NSCLC from SCLC showed that ADC25 achieved the highest area under the curve at 0.922 with 93.02% sensitivity and 81.25% specificity.

Conclusion:

Apparent diffusion coefficient histogram analysis of BMs from lung cancer has significant prognostic value in differentiating histological subtypes of lung cancer.
Symptom Score: A New Instrument to Assess Orthostatic Intolerance in Children and Adolescents
Authors: Cai Hong , Wang Shuo , Zou Runmei , Liu Ping , Yang Hong , Wang Yuwen , Wang Cheng
Published: June 2020

Objective:

To develop an orthostatic intolerance symptom scoring system to assess orthostatic intolerance and then to compare the symptom score among different head-up tilt test responses.

Methods:

272 subjects (5-18 years) presenting with orthostatic intolerance symptoms finished questionnaire and head-up tilt test. According to head-up tilt test hemodynamic responses, the subjects were divided into head-up tilt test negative, vasovagal syncope, and postural tachycardia syndrome groups.

Results:

We built up a symptom score according to the frequency of dizziness, headache, blurred vision, palpitations, chest discomfort, gastrointestinal symptoms, profuse perspiration, and syncope. The median score in postural tachycardia syndrome subjects was highest. A score of 2.5 for predicting vasovagal syncope yielded a sensitivity of 75.0% and specificity of 50.3%, a score of 5.5 for predicting postural tachycardia syndrome yielded a sensitivity of 69.7% and specificity of 72.0%. Furthermore, the median score in postural tachycardia syndrome subjects was significantly higher than that in head-up tilt test negative subjects with heart rate increment of 30-39 beats/min ( P < .01).

Conclusions:

This suggests that the symptom score has some predictive value in head-up tilt test results, which can be served as a preliminary assessment instrument.
Wet-electrospun PHBV nanofiber reinforced carboxymethyl chitosan-silk hydrogel composite scaffolds for articular cartilage repair
Authors: Gunes Oylum Colpankan , Albayrak Aylin Ziylan , Tasdemir Seyma , Sendemir Aylin
Published: June 2020

The objective of the study was to produce three-dimensional and porous nanofiber reinforced hydrogel scaffolds that can mimic the hydrated composite structure of the cartilage extracellular matrix. In this regard, wet-electrospun poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) nanofiber reinforced carboxymethyl chitosan-silk fibroin (PNFs/CMCht-SF) hydrogel composite scaffolds that were chemically cross-linked by poly(ethylene glycol) diglycidyl ether (PEGDE) were produced. To the best of our knowledge, this is the first study in cartilage regeneration where a three dimensional porous spongy composite scaffold was obtained by the dispersion of wet-electrospun nanofibers within a polymer matrix. All of the produced hydrogel composite scaffolds had an interconnected microporous structure with well-integrated PHBV nanofibers on the pore walls. The scaffold comprising an equal amount of PEGDE and polymer (PNFs/CMCht-SF1:PEGDE1) demonstrated comparable water content (91.4 ± 0.7%), tan δ (0.183 at 1 Hz) and compressive strength (457 ± 85 kPa) values to that of articular cartilage. Besides, based on the histological analysis, this hydrogel composite scaffold supported the chondrogenic differentiation of bone marrow mesenchymal stem cells. Consequently, this hydrogel composite scaffold presented a great promise for cartilage tissue regeneration.
The Contribution of Cognitive and Noncognitive Skills to Intergenerational Social Mobility
Authors: McGue Matt , Willoughby Emily A. , Rustichini Aldo , Johnson Wendy , Iacono William G. , Lee James J.
Published: June 2020

We investigated intergenerational educational and occupational mobility in a sample of 2,594 adult offspring and 2,530 of their parents. Participants completed assessments of general cognitive ability and five noncognitive factors related to social achievement; 88% were also genotyped, allowing computation of educational-attainment polygenic scores. Most offspring were socially mobile. Offspring who scored at least 1 standard deviation higher than their parents on both cognitive and noncognitive measures rarely moved down and frequently moved up. Polygenic scores were also associated with social mobility. Inheritance of a favorable subset of parent alleles was associated with moving up, and inheritance of an unfavorable subset was associated with moving down. Parents’ education did not moderate the association of offspring’s skill with mobility, suggesting that low-skilled offspring from advantaged homes were not protected from downward mobility. These data suggest that cognitive and noncognitive skills as well as genetic factors contribute to the reordering of social standing that takes place across generations.
Targeting within universalism
Authors: Jacques Olivier , Noël Alain
Published: June 2020

The idea of targeting within universalism has been evoked frequently, usually as a best of both worlds’ strategy. The approach remains difficult to identify, however, because targeting is usually measured as the opposite of universalism. This article proposes to consider targeting and universalism as two distinct dimensions of the welfare state, the opposite of universalism being more usefully understood as residualism, and not as pro-poor targeting. Four welfare state possibilities then emerge, combining a position on the universalism/residualism axis and one on the pro-poor/pro-rich axis: universalism (France, for instance), targeting within universalism (Denmark), targeting within residualism (the United States) and pro-rich residualism (Japan). We show that targeting within universalism entails pro-poor targeting without means testing, a combination that can be achieved with limits on the earnings-relatedness of the pension system and generous transfers to the working age population. Thus understood, targeting within universalism proves to be an effective redistributive strategy, better to redistribute than mere targeting, and less costly than universalism pure and simple.
Protective effect of alpha-pinene against isoproterenol-induced myocardial infarction through NF-κB signaling pathway
Authors: Zhang B , Wang H , Yang Z , Cao M , Wang K , Wang G , Zhao Y
Published: June 2020

Monoterpenes present in the essential oils exhibit anti-inflammatory properties. In this study, we investigated the preventive effect of alpha-pinene (AP), a monoterpene, against isoproterenol (ISO)-induced myocardial infarction and inflammation in Wistar rats. Male Wistar rats were pretreated with AP (50 mg/kg body weight (bw)) administration for 21 days and ISO (85 mg/kg bw) was administered subcutaneously for last two consecutive days (20th day and 21st day). We noticed that there was an increased activity of cardiac marker enzymes in ISO-treated rats. We also observed that elevated levels of lipid peroxidative indices decreased activities of antioxidant status in plasma, erythrocyte, and heart tissue in ISO-induced rats. Furthermore, ISO-treated rats showed an increase in the levels of inflammatory mediators like tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in the serum. Besides, we confirmed the upregulated expression of TNF-α, IL-6, and nuclear factor kappa-light-chain-enhancer of activated B cells in ISO-induced rat heart tissue. Conversely, we found that AP pretreatment significantly decreased levels of cardiac markers like serum cardiac troponin T and cardiac troponin I, lipid peroxidative markers, and restored antioxidants status in ISO-treated rats. Besides, AP administration attenuated ISO-induced inflammatory marker expression. The present findings demonstrated that AP significantly protects the myocardium and exerts cardioprotective and anti-inflammatory effects in experimental rats.
Neutrality in public libraries: How are we defining one of our core values?
Authors: Scott Dani , Saunders Laura
Published: June 2020

In recent years, library professionals have been struggling with the idea of neutrality, debating whether it is even possible to achieve and, if so, whether it is desirable. This study examined public librarians’ definitions of “neutrality” and asked questions about how this “neutrality” affects their work in libraries. A total of 540 US library workers from 40 different states responded. The most commonly held definition was “being objective in providing information.” Although definitions varied somewhat, there was a high level of agreement with what constitutes neutrality across different scenarios. There were also indications of conflict between personal beliefs and professional values.
Book review: Samuel Dinnar and Lawrence Susskind (Eds.), Entrepreneurial Negotiation Understanding and Managing the Relationships that Determine Your Entrepreneurial Success
Authors: Cellich Claude
Published: June 2020

Samuel Dinnar and Lawrence Susskind (Eds.), Entrepreneurial Negotiation Understanding and Managing the Relationships that Determine Your Entrepreneurial Success, The Netherlands: Palgrave MacMillan, 2019, 241 pp.
Book review: Joseph Yinka Fashagba, Ola-Rotimi Matthew Ajayi and Chiedo Nwankwor, The Nigerian National Assembly
Authors: Ojo Olayiwola Victor
Published: June 2020

Joseph Yinka Fashagba, Ola-Rotimi Matthew Ajayi and Chiedo Nwankwor, The Nigerian National Assembly, Springer International Publishing, 2019, 198 pp., €83.19 (Hardcover), $67.40 (eBook-PDF), $67.40 (eBook-EPUB), ISBN 978-3-030-11904-1, ISBN 978-3-030-11905-8.
Percutaneous CT-Guided Cryoablation of the Bilateral Pudendal Nerves for Palliation of Intractable Pain Related to Pelvic Neoplasms
Authors: Prologo John David , Manyapu Sivasai , Bercu Zachary L. , Mittal Ashmit , Mitchell Jason W.
Published: June 2020

Objectives:

The purpose of this report is to describe the effect of computed tomography–guided bilateral pudendal nerve cryoablations on pain and time to discharge in the setting of acute hospitalizations secondary to refractory pelvic pain from cancer.

Methods:

Investigators queried the medical record for patients who underwent pudendal nerve cryoablation using the Category III Current Procedural Technology code assignment 0442T or Category I code 64640 for cases prior to 2015. The resulting list was reviewed, and procedures performed on inpatients for intractable pelvic pain related to neoplasm were selected. The final cohort was then analyzed with regard to patient demographics, procedure details, technical success, safety, pain scores, and time to discharge.

Results:

Ten patients underwent cryoablation by 3 operators for palliation of painful pelvic neoplasms between June 2014 and January 2019. All probes were satisfactorily positioned and freeze cycles undertaken without difficulty. There were no procedure-related complications or adverse events. The mean difference in pre- and posttreatment worst pain scores was significant (n = 5.20, P = .003). The mean time to discharge following the procedure was 2.3 days.

Conclusion:

Computed tomography–guided percutaneous cryoablation of the bilateral pudendal nerves may represent a viable option in the setting of acute hospitalization secondary to intractable pain in patients with pelvic neoplasms.
Atrial Fibrillation and Mitral Regurgitation: Clinical Performance of Direct Oral Anticoagulants in a Real-World Setting
Authors: Melillo Enrico , Rago Anna , Proietti Riccardo , Attena Emilio , Carrella Maddalena , Golino Paolo , D’Onofrio Antonio , Nigro Gerardo , Russo Vincenzo
Published: June 2020

Background:

Atrial fibrillation (AF) is the most common cardiac arrhythmia and is frequently present in patients with mitral regurgitation (MR). Currently, there is a lack of real-world evidence specifically addressing the clinical performance of direct oral anticoagulants (DOACs) in patients with AF and concomitant MR. Therefore, the aim of the present study was to assess the efficacy and safety profile of DOACs therapy in patients with AF and MR.

Methods:

Data for this study were sourced from the Atrial Fibrillation Research Database in the Department of Cardiology at Monaldi Hospital. The database was queried for AF patients with MR who were prescribed DOACs therapy. The primary safety outcome was defined as the annual incidence rate of major bleeding events and the primary effectiveness outcome as the annual incidence rate of all events classified as ischemic stroke, transient ischemic attacks, and systemic embolisms.

Results:

Consecutive AF patients with concomitant mild to severe MR who received DOACs therapy (n = 259) were included. Patients were dichotomized in 2 groups according to MR severity: a mild-to-moderate group (MR 1-2+; n = 151) and a moderate-to-severe group (MR 3-4+; n = 108). The incidence rate of major bleedings was significantly higher in MR 3-4+ group (3.92%) compared with the MR 1-2+ group (1.18%; hazard ratio [HR]: 3.2; 95% CI: 1.4-7.3; P = .0059). The incidence rate of thromboembolic events between MR 3-4+ group (0.66%) and MR 1-2+ group (0.62%) was not significantly different (HR: 0.75; P = .823).

Conclusions:

In the present study, there was no difference in the efficacy profile of DOACs between AF patients with mild-to-moderate and moderate-to-severe MR. Considering the increased bleeding risk, a close and careful follow-up should be warranted for patients with moderate-to-severe MR.
Assessing Pharmacists Knowledge and Attitude Toward the Direct Oral Anticoagulants in Qatar
Authors: El-Bardissy Ahmed , Elewa Hazem , Khalil Ahmed , Mekkawi Walid , Mohammed Shaban , Kassem Mohamed , Alma’moon Mahmoud Mohamed , Abdelgelil Mohamed , Eltorki Yassin , Mohamed Fadl Abdelfattah A.
Published: June 2020

Pharmacists were found to play a key role in anticoagulation care. In order to make an appropriate selection and counselling regarding direct oral anticoagulants (DOACs), pharmacists should be knowledgeable and abiding by evidence-based practice. We aim in this study to assess the knowledge and practices of practicing hospital and community pharmacists in Qatar regarding DOACs and their reflection on the dispensing and patient education. A prospective cross-sectional survey was developed. It included questions on demographic and professional characteristics. Additionally, it evaluated the awareness regarding safety, efficacy, and dispensing of DOACs. Lastly, a separate question was used to address the participant’s satisfaction with their knowledge. A total response were received from 211 pharmacists participating in the survey. Overall awareness score was moderate (41.6% ± 26%). These scores were in alignment with participants’ self-satisfaction with knowledge on DOACs (72% of participants were not satisfied). Being a clinical pharmacist, of male gender, and with a board certification were factors associated with increased awareness on DOACs. Results from this survey point to the importance of having more educational activities in order to improve pharmacist’s knowledge of DOACs.
A straightforward gel-free proteomics pipeline assisted by liquid isoelectric focusing (OFFGEL) and mass spectrometry analysis to study bovine meat proteome
Authors: Sentandreu Enrique , Fuente-García Claudia , Navarro José L , Sentandreu Miguel A
Published: June 2020

Bovine sarcoplasmic sub-proteome was studied through a straightforward gel-free pipeline supported by liquid isoelectric focusing (OFFGEL) protein fractionation coupled to liquid chromatography-mass spectrometry (LC-MS) analysis. Full-MS and data-dependent MS/MS analyses were simultaneously performed by a conventional three-dimensional ion-trap addressing targeted quantitative and untargeted qualitative research, respectively. There were unambiguously identified 47 proteins distributed along 12 OFFGEL fractions assayed. Regarding intermediate- and high-abundant peptides, bulky quantitative data processing performed by MZmine 2 freeware yielded a satisfactory linearity and coefficient of variation with r2 in the 0.95–0.99 range and about 25%, respectively. Up to 41 peptides from 20 identified proteins were relatively quantified throughout OFFGEL fractions. This reliable, flexible and affordable gel-free proteomic approach could be readily implemented by industry to improve quality assessment of protein-based food products.
Predictable policing: New technology, old bias, and future resistance in big data surveillance
Authors: Minocher Xerxes , Randall Caelyn
Published: June 2020

Within this article, we explore the rise of predictive policing in the United States as a form of big data surveillance. Bringing together literature from communication, criminology, and science and technology studies, we use a case study of Milwaukee, Wisconsin, USA to outline that predictive policing, rather than being a novel development, is in fact part of a much larger, historical network of power and control. By examining the mechanics of these policing practices: the data inputs, behavioral outputs, as well as the key controllers of these systems, and the individuals who influenced their adoption, we show that predictive policing as a form of big data surveillance is a sociotechnical system that is wholly human-constructed, biases and all. Identifying these elements of the surveillance network then allows us to turn our attention to the resistive practices of communities who historically and presently live under surveillance – pointing to the types of actions and imaginaries required to combat the myth and allure that swirls around the rhetoric of big data surveillance today.
Experiences of older LGBT people ageing in place with care and support: A window on ordinary ageing environments, home-making practices and meeting activities
Authors: Hoekstra-Pijpers Roos
Published: June 2020

In the (near) future, a growing number of older LGBT people will ‘age in place’, receiving health and social care in their homes and wider ageing environments until a very advanced age. This article discusses the results of a survey research among 115 LGBT people aged 65 years and over who are ageing in place and who are weekly and monthly receivers of health and social care services, and follow-up interviews with 10 people. The research was situated in the Netherlands. The results show that older LGBT people’s experiences with ageing in place are related to differences in how ageing environments are able to accommodate LGBT lifestyles. The results further shed light on the meaning of receiving health and social care at home as an older LGBT person, and the ways in which LGBT life histories and identities are expressed in care relationships, both in verbal and in home-making practices. Finally, the results suggest that the links between older LGBT people and the wider LGBT community are vulnerable, and neighbourhood-based activities may not be sufficiently responsive to older LGBT people.
Digital habits of PR service-users: Implications for home-based interventions during the COVID-19 pandemic
Authors: Polgar Oliver , Aljishi Maha , Barker Ruth E , Patel Suhani , Walsh Jessica A , Kon Samantha SC , Man William DC , Nolan Claire M
Published: June 2020

Remote models of pulmonary rehabilitation (PR) are vital with suspension of face-to-face activity during the COVID-19 pandemic. We surveyed digital access and behaviours and PR delivery preferences of current PR service users. There was significant heterogeneity in access to and confidence in using the Internet with 31% having never previously accessed the Internet, 48% confident using the Internet and 29% reporting no interest in accessing any component of PR through a Web-based app. These data have implications for the remote delivery of PR during the COVID-19 pandemic and raise questions about the current readiness of service users to adopt Web-based delivered models of PR.
Participant Satisfaction and Acceptability of a Culturally Adapted Brief Intervention to Reduce Unhealthy Alcohol Use Among Latino Immigrant Men
Authors: Torres Vanessa N. , Williams Emily C. , Ceballos Rachel M. , Donovan Dennis M. , Ornelas India J.
Published: June 2020

Latino immigrant men are at increased risk for unhealthy alcohol use, yet few interventions have been designed to meet their unique needs. The current study assessed participant satisfaction and acceptability of a culturally adapted brief intervention to reduce unhealthy alcohol use in this population. Adaptations to the brief intervention included delivering it in Spanish by promotores in a community setting. The mixed methods approach included surveys ( N = 73) and in-depth interviews ( N = 20) with participants in a pilot randomized controlled trial. The study drew on Sekhon’s theoretical framework of acceptability to asses affective attitude, burden, and perceived effectiveness of the intervention, along with satisfaction with the content, setting, and promotor. Participants’ survey responses indicated that they were highly satisfied with the content, setting, and delivery of the brief intervention. In interviews participants noted that the brief intervention helped them reflect on their drinking behaviors, that they perceived promotores to be a trusted source of health information, and that they liked receiving personalized feedback via tablets. Some participants found the feedback did not match their own perceptions of their alcohol use and wanted clearer advice on how to reduce their drinking. Men felt they would benefit from more contact with promotores. These findings suggest that Latino immigrant men in this study were receptive to the culturally adapted brief intervention. Future interventions may be more effective if they include multiple contacts with promotores and more directive guidance on strategies to reduce drinking.
The Association Between Race, Obesity, and Sperm Quality Among Men Attending a University Physician Practice in Washington, DC
Authors: McCray Nathan L. , Young Heather A. , Irwig Michael S. , Frankfurter David , Schwartz Arnold M. , Witmyer Jeannine , Hynes Marijane , Jayanthi Vimala V. , Marcus Mia , Patel Mihir , Perry Melissa J.
Published: June 2020

A decades-long decline in sperm counts in Western countries has coincided with an increase in obesity rates, prompting study into their association. Few of these studies have incorporated men of color, the sperm health of whom is relatively unknown. The present exploratory study evaluated the association between body mass index (BMI), race, ethnicity, and sperm parameters among a diverse sample of U.S. men attending a Washington, DC physician practice. Semen samples were collected and processed at a single laboratory and sperm concentration, motility, morphology, and count were evaluated according to World Health Organization (WHO) 5th edition criteria. Multivariate models accounted for covariates related to sperm health. The study population ( n = 128) was largely obese (45.3%) or overweight (34.4%), and 36.0% were black or Hispanic. Black men had lower adjusted sperm concentration compared to white men (75.0 million/mL to 107.4 million/mL, p = .01) and were more likely to have oligozoospermia ( p = .01), asthenozoospermia ( p = .004), and low sperm count ( p < .0001). Hispanic men had higher adjusted sperm concentration compared to non-Hispanic men (124.5 million/mL to 62.1 million/mL, p = .007) and were less likely to have teratozoospermia ( p = .001). Obesity and BMI were associated with lower sperm motility and count in crude models only. Given the study’s sample size its findings should be interpreted with caution but align with the limited epidemiological literature to date that has evaluated racial and ethnic differences in semen quality. Heightened clinical research attention is needed to ensure men of color are included in representative numbers in studies of urologic and andrologic health.
Perioperative cardiovascular complications rate and activity of coagulation and fibrinolysis among patients undergoing vascular surgery for peripheral artery disease and abdominal aortic aneurysm
Authors: Polok Kamil , Górka Jacek , Fronczek Jakub , Iwaniec Teresa , Górka Karolina , Szczeklik Wojciech
Published: June 2020

Objectives

To compare preoperative coagulation and fibrinolysis activity and incidence of perioperative complications between patients undergoing vascular procedures for peripheral artery disease and abdominal aortic aneurysm.

Methods

This is a substudy of a prospective observational cohort study (VISION; NCT00512109) in which we recruited patients aged ≥45 years, undergoing surgery for peripheral artery disease and abdominal aortic aneurysm. Blood samples were obtained 24 h preoperatively to measure platelet count, concentrations of coagulation coagulation (fibrinogen, factor VIII, von Willebrand factor:Ristocetin cofactor, antithrombin III), fibrinolysis (dimer D, plasmin–antiplasmin complexes, tissue plasminogen activator) markers and level of soluble CD40 ligand. Incidence of myocardial infarction, stroke, and death (composite endpoint) was assessed in 30-day follow-up.

Results

The study group included 131 patients at the mean age of 68.3 years among whom reason for surgery was peripheral artery disease in 77 patients (58.8%) and abdominal aortic aneurysm in 54 patients (41.2%). Peripheral artery disease group was characterized by higher platelet count (250.5 versus 209.5 (×10 3 /µl), p = 0.001), concentrations of fibrinogen (5.4 versus 4.1 (g/l), p < 0.001), factor VIII (176.9 versus 141.9 (%), p < 0.001), von Willebrand factor:Ristocetin cofactor (188.9 versus 152.3 (%), p = 0.009), and soluble CD40 ligand (9016.0 versus 7936.6 (pg/ml), p = 0.005). The dimer D level was higher (808.0 versus 2590.5 (ng/ml), p < 0.001) in the abdominal aortic aneurysm group. Incidence of major cardiovascular events (death, myocardial infarction, stroke) within 30 days from surgery did not differ between the groups (39.0% versus 29.6%, p = 0.27).

Conclusions

The study suggests higher activation of coagulation and relatively lower fibrinolytic activity in peripheral artery disease group compared to patients undergoing surgery for abdominal aortic aneurysm without a significant difference in cardiovascular outcomes.
Second-order meta-analysis synthesizing the evidence on associations between school leadership and different school outcomes
Authors: Tan Cheng Yong , Gao Lin , Shi Meijia
Published: June 2020

The present study addresses the question of whether school leadership matters. It employs second-order meta-analysis to synthesize results from 12 first-order meta-analyses examining school leadership effects published 2003–2019. These meta-analyses collectively examined 512 primary studies published across four decades (1978–2019). Results showed that the overall mean effect size for school leadership was small in magnitude ( r = .33). Effect sizes for leadership models were larger than those for leadership practices, thereby indicating the utility of examining models as compared to practices for understanding leadership influence. Relatedly, findings of significant positive effects for eight different school leadership practices underscore the need to examine comprehensively the scope of school leaders’ work beyond that related to teaching-and-learning. Additionally, leaders require myriad competencies and skills including how to galvanize, motivate and equip teachers to achieve school goals. The substantially larger mean effect sizes for organizational and teacher as compared to student outcomes challenge the assertion by some that principals are less consequential than teachers in contributing to school effectiveness. Indeed, the larger effect sizes for principals as compared to other types of leaders reflect the key role they play in leading schools.
Barriers to leadership development: Why is it so difficult to abandon the hero?
Authors: Schweiger Sylvia , Müller Barbara , Güttel Wolfgang H
Published: June 2020

Critical consensus holds that leader-centred leadership theories reproduce romanticism by exaggerating the impact of individual leaders. In contrast, a processual perspective views leadership as an ongoing social interaction involving all organisational actors. Developing such a processual leadership meaning, however, is not easy, especially as formal leaders are embedded in a business world that still supports the heroic image of a leader. Critical literature highlights the difficult road towards meaning development, on which leaders are confronted with various obstacles that can impede development. In order to better understand potential barriers to the development of a processual leadership meaning, we analyse the development of leadership meaning for EMBA students over the course of two years. In particular, we identify two hindering dynamics that show how a leader-centred leadership meaning becomes reconstructed and reinforced over time, despite receiving training input on a processual leadership meaning. Additionally, we generate insights on two patterns that explain why it is so difficult to abandon a heroic image by revealing the crucial role of one’s sense of self-as-a-leader. Finally, we provide important practical implications for future leadership development.
Is group and save still a necessary test in the preoperative workup for breast cancer surgery?
Authors: Batt Jeremy , Chambers Alice , Mason Jennifer , Mullan Michelle
Published: June 2020

Introduction

Trust guidelines state that patients undergoing mastectomy have one group and save (G&S) sample preoperatively, or two for bilateral or complex mastectomy. Breast surgical patients rarely require blood transfusion, and G&S testing is costly and labour intensive. Our study assessed whether preoperative G&S testing is warranted for breast surgery patients.

Methods

Retrospective review of consecutive patients undergoing mastectomies from one centre, from June 2018 to June 2019 identified 190 women. Review of electronic records for G&S tests was performed and transfusions prescribed. Discussion with laboratory personnel regarding costs of processing G&S tests.

Results

Forty-six (32%) patients who underwent simple mastectomies had one G&S, eight (6%) patients had two. Twenty (45%) patients who underwent bilateral/complex mastectomy/reconstruction had one G&S and four (9%) had two. No patients required peri or postoperative blood transfusions. Seventy-eight G&S tests performed cost the trust £1,082.

Conclusion

Simple mastectomies rarely require blood transfusions. G&S tests cost £13.83 and are time consuming for the patient and laboratory. We propose that G&S tests are unnecessary for patients undergoing simple mastectomies and preoperative protocols require adjustment. Trust policy is to have ‘routine G&S'; however, 124 patients did not have any G&S testing. Had the guideline been followed, this would have cost the Trust a further £1,715.
Investigation of the enhanced recovery after surgery protocol outcome on post colectomy patients
Authors: Baoas Sharon D , Beninato Toni , Zenilman Michael , Ozuner Gokhan
Published: June 2020

Background

An enhanced recovery after surgery (ERAS) protocol was implemented to improve quality and cost effectiveness of surgical care in elective colorectal procedures.

Methods

A retrospective study was conducted from July 2017 to June 2018. The ERAS protocol was initiated on 9 July 2018 and retrospectively reviewed in July 2019 by chart review, the American College of Surgeons National Surgical Quality Improvement Project database and risk stratification using Clavien–Dindo classification for all elective colorectal procedures.

Results

A total of 109 patients, 55 (pre-ERAS) and 54 (post-ERAS) are included in the final analysis. There were no differences in complications were recorded ( p = 0.37) and 30-day readmissions ( p = 0.785). The mean hospital stay was 5.89 ± 2.62 days in pre-ERAS and 4.94 ± 2.27 days in post-ERAS group which was statistically significant ( p = 0.047).

Conclusions

An ERAS protocol for colorectal surgery harmonised perioperative care and decreased length of stay.