bluuebunny/crossref_metadata_2025 huggingface dataset:
Have changes in computerised tomography guidance positively impacted detection of cervical spine injury in children? A review of the Trauma Audit and Research Network data
Authors: Nunn Catherine , Negus Samantha , Lawrence Tomas , Lecky Fiona , Roland Damian
Published: July 2020

Background

Clinically significant damage to the cervical spine in children is uncommon, but missing this can be life-changing for patients. The balance between rarity and severity leads to inconsistent scanning, with both resource and radiation implications. In 2014, the United Kingdom’s National Institute for Health and Care Excellence updated their computerised tomography neck imaging guidance in children. The aim of this study was to assess if the change in guidance had resulted in a change in diagnosis or imaging rates.

Methods

A retrospective review of the national Trauma Audit and Research Network’s data for computerised tomography spine imaging in children in 2012–2013 was compared to the same data sample collected in 2015–2016.

Results

The percentage of children presenting with neck trauma who were imaged reduced from 15.5 to 14.1% with an increase in confirmed cervical spine injury from 1.6 to 2.3% between the two time periods. The specificity of computerised tomography scanning increased from 10 to 16.4%. There was variation in scan rates, with major trauma centres scanning a greater percentage of children of all ages and with all injury scores, than trauma units.

Discussion

This study suggests national guidance can impact clinical care in a relatively short timeframe. Variation in how guidance is applied, with major trauma centres scanning proportionately more children with a lower yield, could be because scanning is more readily available, or because trauma protocols encourage more scans. Twenty per cent of injuries were not found on the initial computerised tomography, in keeping with previously reported data, because the injuries were ligamentous or cord contusion. This suggests a role for early magnetic resonance imaging in children with suspected spinal injury.
Going with the flow: Nudging attention online
Authors: Wu Angela Xiao , Taneja Harsh , Webster James G
Published: July 2020

Theories explaining the impacts of online media often swing between the actions of empowered individuals and the distribution structures put in place by powerful corporations. To explicate how these factors interact, we adapt the concept of audience flow to highlight the temporal dimension of web use and demonstrate how digital architectures subtly nudge masses of people into online attention flows. We identify sequential usage patterns through a network analysis of passively measured clickstreams, combined with data on website ownership and website architectures. Our sample, based on a panel of 1 million users, includes 1761 websites that reached at least 1% of Internet users in the United States. Our findings reveal previously unseen patterns of online audience formation, which have implications for studying media effects and understanding institutional power on the Internet.
Betting on DOTA 2’s Battle Pass: Gamblification and productivity in play
Authors: Zanescu Andrei , French Martin , Lajeunesse Marc
Published: July 2020

The transformation of games with the advent of platformized distribution systems continues to produce new and agile forms of consumption and exploitation. Valve Corporation’s DOTA 2 is a key example of a gaming space that is constantly atomized and rebuilt with the aim of optimizing player participation. This participatory form is ever-more gamblified and framed by systems designed to habituate players to a new form of consumption. This article explores how DOTA 2 transforms every year with the advent of a yearly Battle Pass, brimming with gambling systems aimed at eliciting specific forms of user participation. We catalog and schematize these systems with the aim of shedding light on the inner workings of DOTA 2 during this season. The purpose of our work is to move the discussion beyond a regulatory focus on symptomatic loot boxes and toward a deeper understanding of the rhetorical systems hiding beneath game systems.
Mental health among the Hmong population in the U.S.: A systematic review of the influence of cultural and social factors
Authors: Vang Cindy , Sun Fei , Sangalang Cindy C
Published: July 2020

As refugees of the war in Southeast Asia, Hmong experienced various traumatic events. Evidence suggests the persistence of psychiatric disorders related to trauma in refugees even after prolonged resettlement in their host country. This systematic review aimed to summarize the mental health literature on the Hmong population with a focus on cultural and social factors. The databases PsycINFO, PsycARTICLES, Social Services Abstracts, Web of Science, and PubMed were reviewed for peer-reviewed articles published up to April 2018. Forty articles were included in the final review.

Findings

Results highlight three primary themes: (1) mental health outcomes were associated with a variety of premigration and postmigration factors, (2) group and community-based treatment and interventions provided promising results, and (3) barriers to mental health care were primarily stigma, communication challenges, discrimination, and mental health literacy. The results of this systematic review shed light on the limited and small studies with the Hmong population.

Applications

Implications for social work and culture-sensitive research, practice, and policymaking for this population are discussed.
Africa’s heterogeneous middle class: A 10-city study of consumer lifestyle indicators
Authors: Lappeman James , du Plessis Lara , Ho Emma , Louw Ellen , Egan Paul
Published: July 2020

Income and living standards measures have long been used in market research and marketing in Africa. This study examined a set of lifestyle indicators (both belongings and behaviors) to determine their success in profiling middle-class consumers in sub-Saharan Africa. The African middle class exhibits robust growth and the definition of the lifestyle of these consumers is a major topic for debate between researchers and marketing organizations. Existing absolute monetary definitions do not adequately provide insights into the true nature of middle-class consumer behavior in sub-Saharan Africa. Similarly, current living standards measures are very focused on capturing consumer durables but do not consider other daily lifestyle factors. By analyzing six key lifestyle indicators (housing, income and expenditure, education, employment, mobile and internet penetration, and health care), middle-class lifestyle was assessed in 10 cities across sub-Saharan Africa. The research used a multi-method approach by designing a structured questionnaire that was completed by a probability sample of 6,465 participants from the sample cities. The study found large lifestyle differences between cities and that no single lifestyle indicator could be applied to all middle-class consumers across the cities. The implications of these findings relate directly to understanding broad middle-class consumer behavior. Specifically, international businesses targeting middle-class growth in Africa must consider both the similarities and differences between countries when proposing strategies to successfully engage middle-class consumers in sub-Saharan Africa.
New public policy for teacher training in Brazil: Vincent van Gogh as an inspiration for the action of the Pedagogical Residency program?
Authors: Feitosa Raphael Alves
Published: July 2020

In Brazil, in 2018, the federal government proposed the creation of a new public education policy, the Pedagogical Residence program, as one of the actions that integrate the National Teacher Training Policy. The primary function of the Pedagogical Residence program is to support Higher Education Institutions in the implementation of innovative projects that stimulate the articulation between theory and practice in undergraduate courses managed in conjunction with public basic education networks. This paper aims to analyze the possibilities of articulation between art and human formation based on van Gogh's proposal for the formation of a Studio of the South, as inspiration for the performance/training of teachers within the Brazilian Pedagogical Residency program. As a methodological mechanism we used bibliographic and documental of works related to van Gogh's biography and letters exchanged between the painter and his associates, as well as texts by researchers in the field of teacher training and teacher artists. The article is divided in two parts: the first provides a brief description of Vincent van Gogh's life, focusing on his proposal to train artists in a creative atelier, the Studio of the South. The second component of the text presents some aspects of the relationship between art and teacher training, aiming to list arguments around the formation of teachers based on the van Goghian idea.
Association of Housing Stress With Child Maltreatment: A Systematic Review
Authors: Chandler Caroline E. , Austin Anna E. , Shanahan Meghan E.
Published: July 2020

Child maltreatment is a significant public health issue in the United States. Understanding key risk factors for child maltreatment is critical to informing effective prevention. Poverty is an established risk factor for child maltreatment. However, recent research indicates that material hardship (i.e., difficulties meeting basic needs) may serve as a more direct measure of the way in which poverty affects daily life. One form of material hardship that is common among families is housing stress. Previous reviews have summarized the existing literature regarding the association of economic insecurity with child maltreatment, but no reviews have synthesized and critically evaluated the literature specific to the association of various types of housing stress with child maltreatment. We conducted a systematic search of multiple electronic databases to identify peer-reviewed studies conducted in the U.S. regarding the association of housing stress with child maltreatment. We identified 21 articles that used nine distinct measures of housing stress including homelessness or eviction, homeless or emergency shelter stays, foreclosure filing, housing instability, inadequate housing, physical housing risk, living doubled-up, housing unaffordability, and composite housing stress indicators. Overall, results from this body of literature indicate that housing stress is associated with an increased likelihood of caregiver or child self-reported maltreatment, child protective services (CPS) reports, investigated and substantiated CPS reports, out-of-home placements, and maltreatment death. Additional theory-driven research is needed to further our understanding of the contribution of specific types of housing stress to risk for specific types of maltreatment.
Healthy Eating Index of Living Donor Renal Transplantation Recipients During the First Year Posttransplant
Authors: Le Nhi , Moore Linda W. , Fong Joy V. Nolte , Doan Thong , Mitch William E. , Workeneh Biruh , Moore Carolyn E.
Published: July 2020

Background:

The aim of this study was to examine the relationship between diet quality and weight gain in kidney transplant recipients from pretransplant baseline through posttransplant at 3 months and 1 year.

Methods:

Data from a prospective, observational cohort study of kidney transplant patients (n = 26) were analyzed. Participants were adult (aged 18-65 years), living donor kidney transplant recipients who were participating in a prospective body composition study. Body weight, body mass index, dietary intake, and Healthy Eating Index scores were used to assess changes in weight, nutrient intake, and diet quality.

Findings:

At the time of kidney transplantation, 42% (n = 11) were obese and 27% (n = 7) were overweight. Weight significantly increased from transplantation to 12 months (mean [SD]: 83 [18] kg and 90 [18] kg, respectively; mean change 8.4%, P = .002). At 12 months posttransplant, dietary fat intake significantly increased ( P = .033). Body weight was strongly correlated with total dietary fat intake ( r = 0.56, P = .003). The Healthy Eating Index total scores at baseline and 1-year posttransplant were not significantly different (45.75 [14.99] and 42.59 [12.70]). Likewise, component scores did not change from pretransplant to posttransplant.

Discussion:

Diet quality of transplant recipients was poor both before and after transplantation. Using the Healthy Eating Index confirmed that improvements in food intake are needed. Further research is warranted to identify dietary recommendations for the prevention of excessive weight gain and the potential adverse health complications following kidney transplantation.
Avoidance and Period-Shortening of Neoadjuvant Chemotherapy Against Triple-Negative Breast Cancer in Stages I and II: Importance of Ki-67 Labeling Index and the Recognition of Apocrine-Type Lesions
Authors: Kubouchi Koichi , Shimada Kyosuke , Yokoe Takamichi , Tsutsumi Yutaka
Published: July 2020

Background:

Triple-negative breast cancer encompasses heterogeneous subtypes. Neoadjuvant chemotherapy is ineffective against some triple-negative breast cancers, while others show a favorable prognosis despite chemoresistance.

Methods:

A total of 51 cases with stages I and II triple-negative breast cancer were analyzed; 34 triple-negative breast cancers treated with neoadjuvant chemotherapy were divided into “good responders” (n = 22), showing therapeutic effect G2b or G3 in surgical specimens, and “poor responders” with therapeutic effect G0, G1a, G1b, and G2a (n = 12). Neoadjuvant chemotherapy was spared in 17 cases (non-neoadjuvant chemotherapy group). Apocrine-type triple-negative breast cancer was defined as triple-negative breast cancer immunoreactive for both androgen receptor and forkhead-box protein A1. Triple-negative breast cancer other than apocrine-type (n = 16) and special types (myoepithelial, medullary, adenoid cystic, and spindle cell carcinomas, n = 6) was categorized as basal-like subtype (n = 29). Prognosis was evaluated in each category.

Results:

Neoadjuvant chemotherapy provoked significant effects against basal-like triple-negative breast cancer with high Ki-67 labeling (≧50%), and tumor-infiltrating lymphocytes predicted high chemosensitivity. Neoadjuvant chemotherapy was avoidable in triple-negative breast cancer of apocrine- and special types showing low (<50%) Ki-67 labeling. Ten (59%) lesions in the non-neoadjuvant chemotherapy group belonged to the apocrine-type. When clinical complete remission shown by contrast-enhanced magnetic resonance imaging was reached in the course of neoadjuvant chemotherapy against basal-like triple-negative breast cancer, the neoadjuvant chemotherapy period was shortened in 14 (64%) of 22 good responders. Disease-free and overall survival rates were excellent in all groups.

Conclusions:

The following 2 hypothetical proposals should be proven by large-scale clinical trials. Immunohistochemical recognition of apocrine-type triple-negative breast cancer with low Ki-67 labeling is important for avoiding ineffective/unnecessary neoadjuvant chemotherapy. By employing appropriate clinical imaging, period-shortening is achievable in basal-like triple-negative breast cancer with high Ki-67 labeling.
Endovascular Treatment of Cancer-Associated Venous Obstruction: Comparison of Efficacy Between Stent Alone and Stent Combined With Linear Radioactive Seeds Strand
Authors: Wu Bei , Yin Guowen , He Xu , Chen Guoping , Zhao Boxiang , Song Jinhua , Gu Jianping
Published: July 2020

Objectives:

To investigate the safety and efficacy of a stent combined with a linear strand of 125I seeds to treat malignant cancer–associated venous obstruction.

Methods:

We retrospectively analyzed the data of 57 patients with malignant cancer–associated venous obstruction. Nineteen patients underwent the placement of a stent combined with a linear strand of 125I seeds (group A), and 38 patients underwent the placement of a bare stent (group B). The following parameters were compared between the 2 groups of patients: symptom relief rate, duration of venous patency, survival time, quality of life, and adverse events.

Results:

A total of 34 stents and 527 seeds were implanted in group A, while a total of 57 stents were implanted in group B. The surgery success rate was 96.5%, and no serious complication related to the surgery was reported. Symptoms of venous obstruction improved significantly after surgery. The score of group A decreased from 14.74 ± 0.562 points before surgery to 2.79 ± 1.357 points after surgery( P < .001), and the score of group B decreased from 13.79 ± 1.398 points before surgery to 5.55 ± 3.674 points after surgery ( P < .001). The patency rate of group A was significantly higher than that of group B at 1 to 6 months after surgery (100%, 84.2%, 68.4%, 63.2%, 36.8%, 21.1% vs 68.4%, 23.7%, 18.4%, 7.9%, 5.3%, 2.6%, respectively; P < .05). Before treatment, there was no statistically significant difference in the Karnofsky Performance Status (KPS) score between the groups ( P = .791). After 1 to 6 months of treatment, the KPS score was significantly higher in group A than in group B ( P = .013). The median patency duration in groups A and B was 125 days (95% CI: 80.018-169.982) and 35 days (95% CI: 20.501-49.499), respectively ( P < .001). The median survival time of group A was 155 days (95% CI: 110.406-199.594), and that of group B was 98 days (95% CI: 55.712-140.288; P = .325). Multivariate analysis showed that the implantation of a stent combined with a linear strand of 125I seeds and the KPS score (≥80 points) were independent factors of long-term patency after stent placement.

Conclusions:

The placement of a stent combined with a linear strand of 125I seeds is a safe and effective treatment for venous obstruction caused by malignant tumors. This treatment provides prolonged patency compared with the placement of bare stent, and while it does not significantly improve the survival time of patients, it can improve their quality of life.
Shoulder Rotation Function Following the Sup-ER Protocol in Children with Brachial Plexus Injuries
Authors: Yefet Leeor S. , Bellows Doria , Bucevska Marija , Courtemanche Rebecca , Durlacher Kim , Hynes Sally , Verchere Cynthia
Published: July 2020

Background: Our group previously developed an upper extremity repositioning (Sup-ER) protocol for brachial plexus birth injuries (BPBIs) that may improve supination and external rotation (ER) at 2 years of age. Questions were raised about the potential for the protocol to cause internal rotation (IR) deficits. The goal of this study was to explore the longer-term outcomes of the Sup-ER protocol and investigate IR/ER function. Methods: This prospective cross-sectional cohort study examined 16 children older than 4 years of age with significant enough BPBI to be treated with the Sup-ER protocol. Total shoulder and elbow function were assessed, including passive and active ranges of motion and strength of IR and ER. Results: Range of motion (ROM) for most active movements was decreased in the affected compared to unaffected arm. Notably, IR passive ROM was similar in the affected (78.7°) and unaffected arm (82.8°). External rotation strength of the affected arm was weaker (42.8 N) compared to the unaffected arm (57.9 N). IR strength had a greater deficit in the affected (43.2 N) arm compared to the unaffected arm (72.2 N), but both ER and IR showed less deficit than described in the literature. Conclusions: Despite differences in ranges of motion between the affected and unaffected arms, ROMs for the affected arm were comparable to the functional limits as reported in the literature. The Sup-ER protocol shows potential to optimize long-term shoulder rotation function in children with BPBI without compromising IR.
The Association Between PM2.5 and Depression in China
Authors: He Guangye , Chen Yunsong , Wang Senhu , Dong Yiqun , Ju Guodong , Chen Buwei
Published: July 2020

While China has been experiencing unprecedented economic growth, depression is becoming one of the most striking social and mental health problems in recent years. Such a paradox to progress may partially be due to the notoriously poor air quality of the country. To verify this argument, we constructed an index of the prevalence of depression (IPD) using internet search query volumes in Baidu to proxy the potential depression and examined how IPD is associated with PM2.5, the major air pollutant in China. Our results from 2-way fixed effects models reveal that a 100 μg·m−3 increase in previous week’s PM2.5 in a city is significantly associated with 0.279 increase in its IPD, comparable to 7.34 hours decrease in weekly daylight, and such relationship is particularly pronounced in the spring and summer and in East and South areas. Our findings of large-scale pattern suggest that PM2.5 at current levels in China poses serious mental health risks.
Barriers to uptake of the hip fracture core outcome set: An international survey of 80 hip fracture trialists
Authors: Fletcher Jessica , Sheehan Katie Jane , Smith Toby O
Published: July 2020

Background:

Core outcome sets are an agreed recommendation to inform the selection of outcome measures in clinical trials. There has been low uptake of the 2014 hip fracture core outcome set. The reasons for this remain unclear. The aim of this study was to understand the reasons for the non-adoption and approaches to increase adoption of the hip fracture core outcome set.

Methods:

Randomised controlled trials from PubMed (2017–2019) and ClinicalTrials.gov (2015–2019) were identified. Corresponding authors for each identified trial (n = 302) were surveyed using five questions on awareness of the hip fracture core outcome set, reasons for non-adoption and approaches to increase adoption. Data were analysed descriptively using frequencies, mean values and standard deviations.

Results:

Fifty-four percent of the respondents (n = 43) were aware of the concept of core outcome set. Only 15% (n = 12) based the outcome measure selection on the 2014 hip fracture core outcome set. Key reasons for non-adoption included the following: authors being unaware and perceived inappropriateness to their trial design. Eighty-six percent (n = 69) of respondents agreed to the need for increased awareness of core outcome sets through research training, academic and clinical journal requirements, and funding or publication stipulations. Eighty-eight percent (n = 70) of respondents indicated the current core outcome set required revision to focus on trials investigating people with cognitive impairment, caregivers, rehabilitation, surgical interventions and anaesthetic trial designs.

Conclusion:

Barriers to the adoption of the hip fracture core outcome set centre on education, awareness of the core outcome sets and applicability to the breath of hip fracture trial designs. Further consideration should be made to address these, to improve the harmonisation of outcome measures across hip fracture trials.
CFD-CFD coupling: A novel method to develop a fast urban microclimate model
Authors: Zhang Ruijun , Mirzaei Parham A
Published: July 2020

Computational fluid dynamics (CFD) technique is well-known for its powerful capability of modelling the cross-ventilation. CFD is broadly coupled with energy simulation programmes, such as EnergyPlus, to expand its application in building energy calculation. During the coupling process, iterative calculation is required to improve the accuracy of the coupling method, which means the scale of the model should be designed with extra care so that the simulation can be practical in terms of computational cost. A coarse-resolution mesh (here denoted as CFDc) cannot properly represent the required local environment to study the underlying physics. However, a fine-resolution CFD microclimate model (here denoted as CFDf), which includes both indoor and outdoor spaces, always requires a large number of cells to capture the complexities of environment; this makes the coupling procedure a challenging problem. This study aims to propose an innovative, high-resolution and computationally cost-effective CFDf-CFDc model to overcome this gap. The full-scale CFDf works in an off-line manner at the preliminary simulation stage and generates detailed flow parameters at the interfaces for CFDc. At the dynamic stage of the simulation, CFDc participates in the coupling procedure with the other tools, for example, building energy simulation (BES) tool (e.g. EnergyPlus). The coupling of CFDf-CFDc-BES is about 200 times faster than an ordinary coupled CFDf-BES method with a significantly quicker and more stable achievement in the convergence.
Synthesis of an Ag@AgCl catalyst with amorphous copper as the support and its catalytic performance in the reduction of 4-nitrophenol
Authors: Zhang Jian , Qin Chenchen , Liu Luying , Dong Hanfeng , Wang Yujuan , Bao Lei , Gan Wei , Fu Xucheng , Hao Hequn
Published: July 2020

The support used in a composite catalyst has an important influence on the catalytic performance of the catalyst. Amorphous metals have good electron-transfer properties and the presence of defect structures on the surface will introduce additional active sites and should be excellent catalyst supports. In this study, an Ag@AgCl composite catalyst with amorphous Cu (a-Cu) as the support is prepared by a two-step precipitation method at room temperature and a light irradiation reduction method. Compared to the Ag@AgCl and a-Cu, the catalytic rate of the Ag@AgCl/a-Cu composite catalytic rate was 2.04 times and 6.69 times faster during the reduction of 4-NP in NaBH4 aqueous solution. The high-performance catalytic efficiency and reusability of Ag@AgCl/a-Cu may be attributed to the synergistic effect between Ag@AgC and amorphous metal elements. This work may provide an effective reference for the synthesis of high activity catalysts using amorphous metals as supports.
The attributes of hospital-based coronary artery diseases registries with a focus on key registry processes: A systematic review
Authors: Garavand Ali , Rabiei Reza , Emami Hassan , Pishgahi Mehdi , Vahidi-Asl Mojtaba
Published: July 2020

Background:

The management of data on coronary artery disease (CAD) plays a significant role in controlling the disease and reducing the mortality of patients. The diseases registries facilitate the management of data.

Objective:

This study aimed to identify the attributes of hospital-based CAD registries with a focus on key registry processes.

Method:

In this systematic review, we searched for studies published between 2000 and 2019 in PubMed, Scopus, EMBASE and ISI Web of Knowledge. The search terms included coronary artery disease, registry and data management (MeSH terms) at November 2019. Data gathering was conducted using a data extraction form, and the content of selected studies was analysed with respect to key registry processes, including case finding, data gathering, data abstracting, data quality control, reporting and patient follow-up.

Results:

A total of 17,604 studies were identified in the search, 55 of which were relevant studies that addressed the 21 registries and were selected for the analysis. Results showed that the most common resources for case finding included admission and discharge documents, physician’s reports and screening results. Patient follow-up was mainly performed through direct visits or via telephone calls. The key attributes used for checking the data quality included data accuracy, completeness and definition.

Conclusion:

CAD registries aim to facilitate the assessment of health services provided to patients. Putting the key registry processes in place is crucial for developing and implementing the CAD registry. The data quality control, as a CAD registry process, requires developing standard tools and applying appropriate data quality attributes.

Implications:

The findings of the current study could lay the foundation for successful design and development of CAD registries based on the key registry processes for effective data management.
Volatile Composition, Toxicity, Analgesic, and Anti-Inflammatory Activities of Mucuna pruriens
Authors: Avoseh Opeyemi N. , Ogunwande Isiaka A. , Ojenike Gbenga O. , Mtunzi Fanyana M.
Published: July 2020

The volatile constituents, toxicity, antinociception, and anti-inflammatory activities of the essential oil obtained from the leaf of Mucuna pruriens utilis collected from Nigeria are reported. The essential oil was analyzed comprehensively utilizing gas chromatography (GC)-flame ionization detector and GC coupled with mass spectrometry (MS) using the HP-5 column. The antinociceptive and anti-inflammatory assays were analyzed by a hot plate, formalin, and carrageenan-induced edema assays, respectively. The essential oil was obtained in a yield of 0.2% (v/w) calculated on a dry weight basis. A total of 36 compounds representing 94.8% of the oil contents were identified. The oil contained a high content of ( E)-2-hexenal (19.0%), linalool (8.9%), 1-hexanol (6.6%), and trans-dehydroxylinalool oxide (5.2%). The analgesic property of the essential oil was slightly significant ( P < 0.5) only at the third hour for the 400 mg/kg while other doses are less active. The rate of inhibition was moderate (24.1%-54%) during the analgesic phase of the formalin assay. The rate of inhibition at the anti-inflammatory phases of both formalin and carrageenan were significantly high (100%) and P < 0.001 for all the doses during the reaction duration. The potential proinflammatory mechanism might be due to effects on several proinflammatory mediators, including, histamine, serotonin, and bradykinin, and the ability of the essential oils to act as centrally mediated opioid analgesic. Mucuna pruriens essential oils displayed a high anti-inflammation potential and can be used as a potential centrally mediated opioid antagonist against analgesia.
Impact of the Rising Number of Rentable E-scooter Accidents on Emergency Care in Berlin 6 Months After the Introduction: A Maxillofacial Perspective
Authors: Wüster Jonas , Voß Jan , Koerdt Steffen , Beck-Broichsitter Benedicta , Kreutzer Kilian , Märdian Sven , Lindner Tobias , Heiland Max , Doll Christian
Published: July 2020

Study Design:

Retrospective study of all patients presented at our emergency department after an accident while riding an e-scooter between 15 June 2019 and 15 December 2019. Out of this group, we subgrouped all patients with injuries to the head and neck area.

Objective:

Shared e-scooter systems have recently been introduced in many big cities worldwide and are becoming increasingly popular. This retrospective study aimed to give a detailed overview of clinical data on consequences of e-scooter accidents, with particular attention to the maxillofacial point of view.

Methods:

We performed a single-center retrospective study of all patients presented at our emergency department after an accident while riding an e-scooter between June 15, 2019 and December 15, 2019.

Results:

Within the observation period, 43 patients (mean age of 32 years; range: 17-64 years) suffered from an accident while riding an e-scooter. Of these, 25 patients (58%) required maxillofacial treatment whereby 9 patients (36%) suffered a fracture (56% fracture of the mandible; 33% fracture of the nasal bone; 11% fracture of the maxilla). Six patients required maxillofacial surgical treatment. Twelve patients (28%) stated to have been driving under the influence of alcohol at the time of the accident (blood alcohol level between 0.77 g/L and 2.32 g/L). None of the patients used body protection, and only one patient wore a helmet (2%).

Conclusions:

With the introduction of shared e-scooter systems, health-care facilities are faced with an increasing number of accidents related to the use of e-scooters, suffering from a high percentage of injuries in the maxillofacial region. Facial injuries might be reduced by the mandatory use of a helmet with faceguard. The trauma mechanism, in particular, seems to differ from other common trauma cases and needs to be examined more closely.
The penetration of limestone targets by rigid projectiles: Revisited
Authors: Rosenberg Zvi , Vayig Yaniv , Malka-Markovitz Alon , Kositski Roman
Published: July 2020

We reanalyze the results from a set of terminal ballistics tests in which large limestone targets were impacted by similarly shaped rigid projectiles having different sizes. Our first goal is to show that the data in terms of penetration depths as a function of impact velocity can be accounted for by a model in which the limestone’s resistance to penetration is constant throughout the penetration process. It turns out that the actual values of this penetration resistance, as derived from the data, decrease with the projectile’s size. This is a clear manifestation of a scaling issue in the terminal ballistics of the limestone rock. In order to account for this issue we assume that it is closely related to the size effect in the compressive strengths of rock specimens. Finally, we offer a simple procedure by which one can define a surrogate material model for the targets in numerical simulations, in order to predict the penetration depths in limestone, and possibly other rock targets, under both normal and oblique impacts.
Survival of an infant with massive fetomaternal hemorrhage with a neonatal hemoglobin concentration of 1.2 g/dL without evident neurodevelopmental sequelae
Authors: Miyahara Jun , Sugiura Hiroshi , Ohki Shigeru
Published: July 2020

Fetomaternal hemorrhage is referred to as the passage of fetal blood into the maternal circulation. Massive hemorrhage can cause severe fetal anemia, affecting fetal and neonatal outcomes. A neonatal hemoglobin concentration (Hb), which is reportedly a significant prognostic factor, of <5.0 g/dL has been reported to carry a high risk of poor outcomes (death and major morbidity). We present a case of massive fetomaternal hemorrhage with the lowest value of neonatal Hb ever previously reported in a survivor, who subsequently met all the developmental milestones at the corrected age of 18 months. A male infant born at 27 weeks gestation, weighing 998 g, presented with severe anemia with an Hb of 1.2 g/dL and an HbF level in the mother’s blood of 2.4%, which led to a diagnosis of fetomaternal hemorrhage. Since there were no findings of hypovolemia, exchange transfusion was performed for prompt correction of the severe anemia without precipitating volume overload. The present case suggested that exchange transfusion might promptly correct anemia in patients with fetomaternal hemorrhage without hypovolemia without causing volume overload.
Referenda as commitment devices – an experimental approach
Authors: Justwan Florian , Fisher Sarah K. , Kerr Ashley , Berejikian Jeffrey D.
Published: July 2020

This research note evaluates the claim that referenda can serve as useful commitment devices in international negotiations. More specifically, we relied on individual-level survey data to test the claim that governments can successfully “tie their hands” to policy choices by calling referenda on political issues. Our empirical analysis relied on original survey data collected in April 2019 in Belize. In so doing, we took advantage of an unusual political event. On 8 May (shortly after our survey), Belizean citizens participated in a countrywide plebiscite. During this vote, they decided to send their country’s territorial dispute with Guatemala for adjudication to the International Court of Justice. From a research perspective, this event allowed us to assess the effect of disregarded referendum results in a highly salient political environment. Our experimental analysis suggested that individuals do reprimand their governments for failing to implement a majority vote (a) even if this choice precipitates a person’s favored substantive outcome, and (b) irrespective of an individual’s preferred party.
Protective effect of resveratrol on estrogen deficiency-induced osteoporosis though attenuating NADPH oxidase 4/nuclear factor kappa B pathway by increasing miR-92b-3p expression
Authors: Zhang Ye , Liu Ming-wei , He Yun , Deng Ning , Chen Yan , Huang Jiecong , Xie Wei
Published: July 2020

Introduction:

Resveratrol (RES) exhibits estrogen-like effects and has potential applications to treatment of osteoporosis caused by estrogen deficiency; however, the specific mechanism of action of RES remains unclear. Here, we examined the therapeutic effects of RES on ovariectomized (OVX) rats with osteoporosis and determined the underlying mechanism.

Methods:

We established an OVX rat model to study osteoporosis caused by estrogen deficiency. The treatment groups were given orally with RES (50, 100, and 200 mg/day), the estrogen group received 0.8 mg/kg E2 daily via oral route, and the sham-operated and control groups received an equivalent dose of sodium carboxymethylcellulose orally. After 12 weeks of treatment, we used real-time quantitative polymerase chain reaction (PCR) and Western blot analysis to measure the gene and protein expression of miR-92b-3p, Nox4, NF-κBp65, IκB, BMP2, Smad7, and RUNX-2 in bone tissues. Right femur structural parameters were evaluated by micro-CT. Dual-energy X-ray 4500 W was used to determine systemic bone mineral density (BMD). Enzyme-linked immunosorbent assay (ELISA) kits were used to determine the serum levels of bone alkaline phosphatase (BALP), osteoprotegerin (OPG), anti-tartrate acid phosphatase-5b (PTRA5b), and carboxylated terminal peptide (CTX-I). The rat femoral bone specimens were stained using hematoxylin and eosin for pathological examination

Results:

We observed increased levels of serum estrogen in both ovaries, elevated miR-92b-3p levels in bone tissues, reduced levels of Nox4, NF-κBp65, p-IκB-a, and cathepsin K, and elevated gene and protein expression of BMP2, Smad7, and RUNX-2 in the OVX rat model of osteoporosis after treatment with RES. Elevated levels of BALP, OPG, ALP, and BMD along with reduced levels of TRAP-5b and CTX-I were also observed. The structural model index (SMI) and the trabecular space (Tb. Sp) decreased, while the trabecular thickness (Tb. Th), bone volume fraction (BV/TV), trabecular number (Tb.N), and tissue bone density (Conn.D) increased, thereby improving osteoporosis induced by estrogen deficiency in both ovaries.

Conclusion:

Cathepsin K expression and Nox4/NF-κB signaling pathway were suppressed by the elevated expression of miR-92b-3p. This inhibition was pivotal in the protective effect of RES against osteoporosis induced by estrogen deficiency in both ovaries. Thus, RES efficiently alleviated osteoporosis induced by estrogen deficiency in rats.
Geographical Profiles of COVID-19 Outbreak in Tokyo: An Analysis of the Primary Care Clinic–Based Point-of-Care Antibody Testing
Authors: Takita Morihito , Matsumura Tomoko , Yamamoto Kana , Yamashita Erika , Hosoda Kazutaka , Hamaki Tamae , Kusumi Eiji
Published: July 2020

Introduction: The primary care clinic plays a major role in triage for coronavirus disease 2019 (COVID-19), where seroprevalence in the setting of primary care clinic remains less clear. As a point-of-care immunodiagnostic test for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the serosurvey represents an alternative to the polymerase chain reaction (PCR) test to measure the magnitude of COVID-19 outbreak in the communities lacking sufficient diagnostic capability for PCR testing. Methods: We assessed seropositivity for the SARS-CoV-2 IgG between April 21 and May 20, 2020, at 2 primary care clinics in Tokyo, Japan. Results: The overall positive percentage of SARS-CoV-2 IgG was 3.83% (95% confidence interval [CI]: 2.76-5.16) for the entire cohort (n = 1071). The 23 special wards of central Tokyo exhibited a significantly higher prevalence compared with the other areas of Tokyo after classification by residence ( P = .02, 4.68% [3.08-6.79] vs 1.83 [0.68-3.95] in central and suburban Tokyo, respectively). In central Tokyo, the southern area showed the highest seroprevalence compared with the other areas (7.92% [3.48-15.01]), corresponding to the cumulative number of confirmed COVID-19 patients by PCR test reported by the Tokyo Metropolitan Government. Conclusion: The seroprevalence surveyed in this study was too low for herd immunity, suggesting the need for robust disease control and prevention. A regional-level approach, rather than state- or prefectural-level, could be of importance in ascertaining detailed profiles of the COVID-19 outbreak.
Making Choices to Resolve Conflict: An Evaluation of the Kelso’s Choice Program for Elementary Students
Authors: Mariani Melissa , Silvestro Kristi
Published: July 2020

This article outlines an action research project designed to deliver and assess the impact of a conflict-resolution intervention for elementary-aged students, Kelso’s Choice (KC). Findings gathered by the school counselor indicated that participating students increased in their ability to accurately identify a majority of conflict-resolution strategies taught in the program. Teachers also reported that students’ behavior improved greatly after KC was implemented. This article is meant to encourage expansion on the evaluation of KC.
Local Pakistani Citizens’ Benefits and Attitudes Toward China–Pakistan Economic Corridor Projects
Authors: Kanwal Shamsa , Pitafi Abdul Hameed , Malik Muhammad Yousaf , Khan Naseer Abbas , Rashid Rao Muhammad
Published: July 2020

The China–Pakistan Economic Corridor (CPEC) is a mega development plan in the South Asian region with the mutual cooperation of Pakistan and China. However, CPEC projects are still in the preliminary phase, and scholars and policymakers have continuously assured that CPEC projects will boost the economy of Pakistan through business creation and immense employment opportunities. This study investigated the influence of CPEC projects on the community lifestyle of local Pakistani citizens. The samples were gathered using an online survey from 335 respondents living in Pakistan. Most of the hypotheses supported by the existing data set showed the positive responses of local Pakistani citizens toward CPEC projects. The findings of this study will help government officials and the representatives of the CPEC understand the attitudes of the host community and their cooperation for the development of CPEC projects.
Quantitative Evaluation of Functional Instability Due to Anterior Cruciate Ligament Deficiency
Authors: Matsuo Takayuki , Koyanagi Maki , Okimoto Ryo , Moriuchi Toshitaka , Ikeda Koji , Nakae Naruhiko , Nakagawa Shigeto , Shino Konsei
Published: July 2020

Background:

A safe and simple procedure to evaluate functional instability due to anterior cruciate ligament (ACL) deficiency (ACLD) has not been established. The angle of trunk backward tilting, which is known as a posture at risk for ACL injuries, could be used as a parameter to evaluate functional instability due to ACLD.

Purpose:

To measure the backward tilt angle of the trunk with participants standing upright on 1 leg and to investigate its usefulness to quantitatively evaluate functional instability due to ACLD.

Study Design:

Cohort study (diagnosis); Level of evidence, 3.

Methods:

Our cohort included 50 participants with unilateral ACLD and 40 participants with bilateral healthy knees. The trunk backward tilt (TBT) test was conducted as follows: the participant was asked to maximally tilt the trunk backward in a single-leg standing position, while forward tilt of the index leg was blocked with a custom-made device. The TBT angle was measured using a side-view photograph. Subjective knee instability during the test was recorded using a visual analog scale (VAS). The relative and absolute reliability of the TBT test were verified in a sample of healthy participants and those with ACLD, and comparisons between indicators were performed. Multiple regression analysis was performed with the injured/uninjured side ratio (I/U ratio) of the TBT angle as the dependent variable and the following independent variables: (1) I/U ratio of knee extension muscle strength, (2) I/U ratio of knee flexion muscle strength, (3) side-to-side difference (SSD) of the KT-1000 arthrometer measurement, (4) sex, and (5) SSD of the VAS score.

Results:

The TBT test had high reliability among healthy participants and those with ACLD. The TBT angle was significantly smaller and the VAS score was significantly higher on the injured side compared with the uninjured side and with healthy knees ( P < .001 for all). Among the independent variables, the SSD of the VAS score had a negative influence on the I/U ratio of the TBT angle ( R 2 = 0.59; P < .001).

Conclusion:

The TBT test is a simple, safe, and reliable method for quantitatively evaluating functional instability due to ACLD under weightbearing conditions that reflect subjective knee instability. The test will provide an index of treatment outcomes and return to sports through additional objective measurements before and after ACL reconstruction.
A Love Letter to My Public Health Students During a Global Pandemic
Authors: Godley Sophie
Published: July 2020

Reflecting on the remarkable, unprecedented experience of teaching public health during a global pandemic, this reflection highlights the unexpected and delightful connections that were made in spring of 2020. Transitioning to online/remote reading was initially dreaded, and yet proved to be a vital link of connection between faculty and students.
Language and Cultural Discordance: Barriers to Improved Patient Care and Understanding
Authors: Soled Derek
Published: July 2020

Providing optimal health care to patients whose first language is not English remains a major challenge. Medical students, residents, and attendings receive limited cultural competency training, but these short sporadic training courses are not nearly enough to give physicians the proper resources or preparation to understand all their patients’ beliefs. Medical interpreters can fill this gap and strengthen health care for these already marginalized communities. It is important to reconceptualize medical interpreters as true collaborators in medicine who can provide valuable insights that extend beyond language interpretation at the bedside. Physicians would benefit from the insights of these professionals who can function as both language and cultural interpreters who know these patient communities well. Improved communication between physicians and interpreters would not violate traditional physician–patient boundaries but would instead strengthen this relationship to provide the best possible care.
Relationship Between Patient Satisfaction and Willingness to Comply With Physicians’ Recommendation in Referral Surgical Outpatient Clinic in Nigeria
Authors: Okonta KE , Ogaji DS
Published: July 2020

The relationship between patient satisfaction with surgical care and their willingness to comply with doctors’ recommendations has not been studied in the country. This study determined the relationship between ambulatory patients’ satisfaction with care and their willingness to adhere to the surgeons’ recommendations in the surgical outpatient clinic (SOPC) of the University Teaching Hospital. This analytical cross-sectional study was conducted among 490 adult respondents at the SOPC selected through a systematic sampling method with a sample interval of 1:2. The short form of the Patient Satisfaction Questionnaire with 7 domains and tool developed for patient willingness to comply with surgeons’ recommendations were used. Descriptive and inferential analyses were performed, and P values of <.05 were considered significant. A total of 466 respondents’ data were analyzed, giving a response rate of 95.1%. About 52.8% were males and 47.2% were females. The associations between domains of patient satisfaction and willingness to surgical instructions were mostly weak and nonsignificant. Their satisfaction with communication with the surgeons was the most consistent predictor of patient willingness and showed significant relationships with their willingness to accept follow-up visits ( P = .002), drug prescription ( P < .001), and further investigation ( P < .001). Access/convenience and general satisfaction were significantly associated with their willingness to recommend the surgery clinic to close friends and relatives. Patient satisfaction with care has a significant relationship with their willingness to adhere to surgical recommendations.