bluuebunny/crossref_metadata_2025 huggingface dataset:
Developing a sociocultural framework of compliance: an exploration of factors related to the use of early warning systems among acute care clinicians
Authors: Flenady Tracy , Dwyer Trudy , Sobolewska Agnieszka , Lagadec Danielle Le , Connor Justine , Kahl Julie , Signal Tania , Browne Matthew
Published: August 2020

Background

Early warning systems (EWS) are most effective when clinicians monitor patients’ vital signs and comply with the recommended escalation of care protocols once deterioration is recognised.

Objectives

To explore sociocultural factors influencing acute care clinicians’ compliance with an early warning system commonly used in Queensland public hospitals in Australia.

Methods

This interpretative qualitative study utilised inductive thematic analysis to analyse data collected from semi-structured interviews conducted with 30 acute care clinicians from Queensland, Australia.

Results

This study identified that individuals and teams approached compliance with EWS in the context of 1) the use of EWS for patient monitoring; and 2) the use of EWS for the escalation of patient care. Individual and team compliance with monitoring and escalation processes is facilitated by intra and inter-professional factors such as acceptance and support, clear instruction, inter-disciplinary collaboration and good communication. Noncompliance with EWS can be attributed to intra and inter-professional hierarchy and poor communication.

Conclusions

The overarching organisational context including the hospital’s embedded quality improvement and administrative protocols (training, resources and staffing) impact hospital-wide culture and influence clinicians’ and teams’ compliance or non-compliance with early warning system’s monitoring and escalation processes. Successful adoption of EWS relies on effective and meaningful interactions among multidisciplinary staff.
Radiocarpal joint stiffness following surgical treatment for distal radius fractures: the incidence and associated factors
Authors: Kong Lingde , Zhai Yajie , Zhang Zuzhuo , Lu Jian , Zhang Bing , Tian Dehu
Published: August 2020

Background

Postoperative radiocarpal joint stiffness (RJS) is common in patients with distal radius fractures (DRFs). The purpose of this study was to record the incidence of RJS and to determine potential risk factors that may be associated with it.

Methods

We retrospectively included a series of patients who suffered from DRFs and underwent volar plate fixation. Patients’ basic data, radiographic data, and postoperative data were collected. The incidence of RJS during follow-up was recorded, and both univariate analyses and multivariate logistic regression were used to determine factors associated with it.

Results

A total of 119 patients were included in this study. After surgical procedures, there were 42 (35.3%) patients with RJS and 77 (64.7%) patients without. The incidence of RJS after surgical treatment is 35.3%. Multivariate analysis showed that intra-articular fracture (OR, 1.43; 95% CI, 1.13–1.81), pre-operative severe swelling (OR, 1.35; 95% CI, 1.05–1.74), post-operative unsatisfied volar tile (OR, 1.38; 95% CI, 1.01–1.89), and improper rehabilitation exercise (OR, 1.72; 95% CI, 1.18–2.51) were correlated with the incidence of RJS during follow-up.

Conclusions

Patients with intra-articular fracture, pre-operative severe swelling, post-operative unsatisfied volar tile, and improper rehabilitation exercise were factors associated with the incidence of wrist stiffness. Preoperative risk notification and postoperative precautions are necessary for relevant patients.
Correction to: LINC00673 is activated by YY1 and promotes the proliferation of breast cancer cells via the miR-515-5p/MARK4/Hippo signaling pathway
Authors: Qiao Kun , Ning Shipeng , Wan Lin , Wu Hao , Wang Qin , Zhang Xingda , Xu Shouping , Pang Da
Published: August 2020

An amendment to this paper has been published and can be accessed via the original article.
Large scale analysis of violent death count in daily newspapers to quantify bias and censorship
Authors: Casolino Marco
Published: August 2020

In this work we develop a series of techniques and tools to determine and quantify the presence of bias and censorship in newspapers. These algorithms are tested analyzing the occurrence of keywords ‘killed’ and ‘suicide’ (‘morti’’, ‘suicidio’ in Italian) and their changes over time, gender and reported location on the complete online archives (42 million records) of the major US newspaper (The New York Times) and the three major Italian ones (Il Corriere della Sera, La Repubblica, La Stampa). Using these tools, since the Italian language distinguishes between the female and male cases, we find the presence of gender bias in all Italian newspapers, with reported single female deaths to be about one-third of those involving single men. Analyzing the historical trends, we show evidence of censorship in Italian newspapers both during World War 1 and during the Italian Fascist regime. Censorship in all countries during World Wars and in Italy during the Fascist period is a historically ascertained fact, but so far there was no estimate on the amount on censorship in newspaper reporting: in this work we estimate that about 75% of domestic deaths and suicides were not reported. This is also confirmed by statistical analysis of the distribution of the least significant digit of the number of reported deaths. We also find that the distribution function of the number of articles vs. the number of deaths reported in articles follows a power law, which is broken (with fewer articles being written) when reporting on few deaths occurring in foreign countries. The lack of articles is found to grow with geographical distance from the nation where the newspaper is being printed. Whereas the assessment of the truth of a single article or the debunking of what are now called ‘fake news’ requires specific fact-checking and becomes more difficult as time goes by, these methods can be used in historical analysis and to evaluate quantitatively the amount of bias and censorship present in other printed or online publication and can thus contribute to quantitatively assess the freedom of the press in a given country. Furthermore, they can be applied in wider contexts such as the evaluation of bias toward specific ethnic groups or specific accidents.
Occupational status, working conditions, and health: evidence from the 2012 China Labor Force Dynamics Survey
Authors: Qi Yaqiang , Liang Tongxin , Ye Hua
Published: August 2020

This study investigates the relationship between occupational status and health inequality in the working population by analyzing data from the 2012 China Labor Force Dynamics Survey. The results show that individual health varies substantially by occupational status, including self-assessed health, work-related injury, and self-reported occupational disease. Low occupational status is associated with poorer self-assessed health and increased incidences of work-related injuries, while people with the high occupational status report more occupational diseases. Further analysis indicates that working condition is the main mediator between occupational status and individual health. Based on the results from the Karlson–Holm–Breen decomposition, the disparities in working conditions, including working overtime, environmental and occupational hazards, job demand and control, and perceived rewards, account for approximately half of the effects of occupation status on individual health.
Inability to obtain sperm for fresh IVF cycles: analysis and incidence of outcomes using a database from the United States
Authors: Berger Alexandra Joice , Raup Valary , Abou Ghayda Ramy , Lanes Andrea , Kathrins Martin
Published: August 2020

Background

Azoospermia is present in 10% of men presenting with infertility and surgical sperm retrieval rates for men with azoospermia due to spermatogenic dysfunction remain low. We investigated the incidence of failed fresh IVF cycles due to inability to obtain sperm and describe predictors for subsequent IVF.

Methods

A national IVF database was used to identify fresh IVF cycles in which there was failure to obtain sperm. Patient linkage was utilized to determine outcomes of subsequent IVF.

Results

243,291 fresh IVF cycles were identified; 719 (0.3%) listed “inability to obtain sperm” as reason for embryo non-transfer. Male infertility was a factor in 537 (75%) and ejaculation was the most common anticipated sperm source (414, 57%). 713 (99.2%) cycles resulted in retrieved oocytes, but only 627 (87.2%) cryopreserved oocytes. 265 (37%) of couples underwent subsequent IVF. On multivariable analysis, lack of initial oocyte cryopreservation (OR 0.34, p = 0.01) and male infertility (OR 0.14, p = 0.01) were associated with having no subsequent cycles. Partner sperm was used in 213 (80%) second cycles and sperm retrieval method was largely conserved (181/213, 85%). Embryos were transferred in 186 (70%) second cycles. Failed embryo transfers were due to repeat inability to obtain sperm in 5 (6%) cycles.

Conclusions

Failure to obtain sperm during fresh IVF is rare, but most affected couples will not pursue further cycles of IVF after their initial failed attempt.
Extremely rare case of H-type gallbladder duplication coexistent with carcinoma: a case report and review of the literature
Authors: Furuhashi Takashi , Abe Toshihiko , Sakata Koichiro , Noda Mayaka , Fuchikami Tadafumi , Ishikawa Nobuhisa , Fujito Hiroyuki , Onari Norihiro , Hamada Tetsuo
Published: August 2020

Introduction

Multiple gallbladders represent a rare congenital disorder, and coexistence with carcinoma is extremely rare, leading to a high possibility of misdiagnosis and surgical complications. In this study, a case was reported and the literature was reviewed.

Case presentation

An 80-year-old woman was diagnosed with acute cholecystitis via ultrasonography and was successfully treated with antibiotics. After the patient’s biliary colic relapsed, she was referred to our hospital. Multiple imaging modalities revealed duplication of her gallbladder (H-type) and suggested coexistence with carcinoma. According to preoperative evaluations, we assumed the patient had stage IIIA disease, and cholecystectomy, cholangiography using a near-infrared ray vision system, and sectionectomy of segments 4a and 5 were performed. Contrary to the high standardized uptake values obtained by 18F-fluoro-2-deoxy-D-glucose positron emission tomography, gallbladder carcinoma was pathologically diagnosed as stage 0 mucosal cancer. Seven days after the operation, portal thrombosis of the posterior branch was revealed, and conservative therapy was indicated; satisfactory results were achieved. The patient was discharged 65 days after surgery. No recurrence was observed for 1 year after surgery.

Conclusions

An extremely rare case of malignancy in a duplicated gallbladder was reported, and the literature was reviewed. Accurate estimations are feasible for diagnoses of multiple gallbladders, where correct evaluations are vital, especially in malignant cases. Because of the possibility of malignancy, resected accessory gallbladders should be scrutinized pathologically.
Family planning practices of women working in the Cambodian garment industry: a qualitative study
Authors: Masuda Chisato , Oreglia Elisa , Ly Sokhey , McLaren Megan , Free Caroline , Tijamo Camille , Ou Amra , van Velthoven Michelle Helena , Williamson Amy , Smith Chris
Published: August 2020

Background

Women working in Cambodian garment factories have unmet needs for family planning (contraception and safe abortion) services, because of their background and living conditions. This study describes their experiences regarding abortion and contraception as part of a larger project to develop an intervention to support comprehensive post-abortion care.

Methods

We conducted semi-structured interviews with women seeking abortion services at private health facilities. In addition, we interviewed the private providers of abortion and contraception services surrounding garment factories. Interviews lasted up to 60 min and were conducted in Khmer and later translated into English. A thematic analysis was undertaken, with medical abortion experiences coded according to the Cambodia comprehensive abortion care protocol.

Results

We interviewed 16 women and 13 providers between August and November 2018. Most women reported being married and had at least one child. Among factory workers the major reported reasons for abortion were birth spacing and financial constraints. Family, friends, or co-workers were the major information resources regarding abortion and contraception, and their positive or negative experiences strongly influenced women’s attitude towards both. Medical abortion pills were not always provided with adequate instructions. Half of the participants had a manual vacuum aspiration procedure performed after medical abortion. While women knew the side effects of medical abortion, many did not know the adverse warning signs and the signs of abortion completion. Only three women started post abortion family planning, as most of the women expressed fear and hesitation due to concerns about side effects of modern contraception. Fear of infertility was particularly reported among young women without children.

Conclusion

This research shows that in this setting not all women are receiving comprehensive abortion care and contraceptive counselling. Provision of accurate and adequate information about abortion methods and modern contraception was the dominant shortfall in abortion care. Future work to address this gap could involve the development of appropriate interventions and informative tools for women in the Cambodian garment industry such as through existing client contact-centres or social media, including creation of videos or posts on topics that come from clients questions.
Different selection processes, different outcomes? Comparing labor market integration of asylum refugees, resettled refugees and their reunited family members in Finland
Authors: Tervola Jussi
Published: August 2020

This study compares the longitudinal dynamics of labor market integration between asylum refugees, resettled refugees and their reunited family members. The labor market integration of the three refugee groups are compared by using unique longitudinal register data of total refugee population in Finland during 2003–2015. The results show that among males, family reunion migrants integrate faster than asylum refugees and resettled refugees. Contrary to the previous results from Nordic countries, among females, resettled refugees integrate the fastest and family reunion migrants demonstrate the slowest integration. The overall small differences between admission categories are for the large part explained by discrepancies in observed factors such as fertility patterns among females and arrival during recession among males.
Ultrasound-assisted intrathecal injection of nusinersen in a patient with severe vertebral deformity: a case report
Authors: Nagano Takashi , Sakura Shinichi , Imamachi Noritaka , Saito Yoji
Published: August 2020

Background

Spinal muscular atrophy (SMA) is a mostly autosomal recessive genetic disease characterized by progressive muscle weakness from anterior horn degeneration. Nusinersen has recently been approved as a disease-modifying drug for SMA that needs to be administered intrathecally. Its injection is often associated with extreme difficulty since patients with SMA have severe vertebral deformity and may be with vertebral instrumentation.

Case description

A 21-year-old female with type 2 SMA and spinal deformity underwent a series of intrathecal injections of nusinersen. The intrathecal injections have been safely and successfully done by using computed tomography imaging and ultrasonography-assisted technique.

Conclusion

This the first report in which ultrasound-assisted technique has been used for the injection of nusinersen through a lumbar puncture in patients with severe spinal deformity. Use of preprocedural ultrasound imaging is highly recommended for treatments that repeatedly require intrathecal access.
Refractory ventricular arrhythmias during aortic valve replacement and cardiac artery bypass requiring 16 attempts of electrical cardioversion: a case report
Authors: Kodaka Mitsuharu , Mori Tetsu , Ichikawa Junko , Ando Kazuyoshi , Komori Makiko
Published: August 2020

Background

We report a patient in whom we failed to suppress ventricular fibrillation (VF) using nifekalant but succeeded using amiodarone during cardiopulmonary bypass (CPB).

Case presentation

A 65-year-old male with hemodialysis complained of dyspnea and was diagnosed with aortic valve stenosis and angina pectoris; he was opted for elective aortic valve replacement. When the aortic forceps were declamped during CPB, immediate VF was observed; several attempts of electrical cardioversion (EC) with lidocaine and landiolol and three administrations of nifekalant were temporarily effective. However, the rhythm subsequently changed to torsades de pointes. We administered 2 g of magnesium sulfate followed by three doses of amiodarone and initiated continuous infusion. Furthermore, we initiated the pacemaker and intra-aortic balloon pumping. These procedures seemed to be effective; the sinus rhythm was sustained until the end of the surgery.

Conclusion

We experienced a cardiac surgery requiring 16 EC attempts to terminate the life-threatening arrhythmias using amiodarone.
Larval feeding capacity and pollination efficiency of the aphidophagous syrphids, Eupeodes frequens (Matsmura) and Episyrphus balteatus (De Geer) (Diptera: Syrphidae) on the cabbage aphid (Brevicoryne brassicae L.) (Homoptera: Aphididae) on mustard crop
Authors: Singh Paramveer , Thakur Meena , Sharma Karishan Chander , Sharma Harish Kumar , Nayak Rohit Kumar
Published: August 2020

The present investigation was carried out on in vitro mass multiplication, larval feeding capacity, and pollination efficiency of two aphidophagous syrphidsviz.,Eupeodes frequens(Matsmura) andEpisyrphus balteatus(De Geer) (Diptera: Syrphidae) on cabbage aphid (Brevicoryne brassicaeL.) (Homoptera: Aphididae) on mustard crop under mid hill conditions. The results revealed that the incubation, larval, and pupal periods were 3.5, 12.4, and 11.9 days, respectively forE. frequensand 3.8, 13.7, and 8.8 days, forE. balteatus. Longevity of male and female was 15.2 and 17.6 days forE. frequensand 10.6 and 12.6 days forE. balteatus, respectively. When the adults were fed on different diets, adult longevity and fecundity recorded significantly maximum on 10% honey solution + fresh pollen grains.E. frequensconsumed an average of 261.7 individuals of cabbage aphids per larva during total larval period, whereas the larva ofE. balteatusconsumed 393.6 cabbage aphids. The pollination efficiency of hoverflies on Indian mustard (Brassica junceaL.) was studied under caged conditions. It was observed that the plants pollinated byE. balteatusandE. frequensshowed 55.12 and 52.97% seed set. Among the different diets, fresh pollen grains + 10% honey solutions recorded to be the best diet for mass rearing of syrphids.
Study of serum pentraxin 3 level in patients with diabetic nephropathy
Authors: Dawood Alaaeldin Abdelsalam , Kamel Mai Ashraf , Omar Thoria Ahmed , Agaba Ahmed Ahmed Mohammed
Published: August 2020

Background

Pentraxin 3 (PTX3), a member of a superfamily of conserved proteins called pentraxins. PTX3 and C-reactive protein (CRP) are members of this family and play an important role in the innate immune system. PTX3 is classified as a long pentraxin, while CRP is a short pentraxin. PTX3 is reported to be a vascular inflammatory marker providing prognostic information of vasculopathy, such as diabetic nephropathy (DN). The purpose of this study is to evaluate the association between serum PTX3 concentrations and the development and/or progression of DN. A total number of 66 patients with type 2 diabetes mellitus (T2DM) and 22 healthy subjects were enrolled in this study. Patients with T2DM were divided, according to the levels of urinary albumin/creatinine ratio (UACR), into three groups: normoalbuminuric, microalbuminuric, and macroalbuminuric groups. Serum PTX3 and high-sensitivity C-reactive protein (hs-CRP) concentrations were determined using ELISA kits.

Results

Serum PTX3 and hs-CRP concentrations were significantly higher in patients with T2DM compared with the controls. Furthermore, serum PTX3 concentrations were significantly higher in macroalbuminuric patients than in microalbuminuric patients (P < 0.001) and also were significantly higher in microalbuminuric patients than in normoalbuminuric patients (P < 0.001). However, there were no significant differences between controls and T2DM patients with normoalbuminuria regarding serum PTX3 concentrations (P > 0.05). Moreover, like PTX3, hs-CRP concentrations were higher in microalbuminuric patients than in normoalbuminuric patients (P < 0.05), and also, there were no significant differences between controls and T2DM patients with normoalbuminuria regarding hs-CRP concentrations (P > 0.05). But, unlike PTX3, there were no significant differences between macroalbuminuric and microalbuminuric patients regarding hs-CRP concentrations (P > 0.05).

Conclusions

Serum PTX3 is positively associated with DN development and progression, and may be a more accurate predictor of DN development than hs-CRP as it can discriminate between macroalbuminuric and microalbuminuric DN patients, while hs-CRP cannot.
Genesis of Quality Measurements to Improve the Care Delivered to Patients With Brain Metastases
Authors: Silvestre Julio , Gosse Tracey , Read Paul , Gentzler Ryan , Purow Benjamin , Asthagiri Ashok , Gaughan Elizabeth , Dillon Patrick M. , Larner James M. , Anderson Roger T. , Sheehan Jason P. , Fadul Camilo E.
Published: August 2020

PURPOSE:

High-value and high-quality health care requires outcome measurements to inform treatment decisions, but, to our knowledge, no standardized measurements exist to evaluate brain metastases (BMs) care. We propose a set of measurements and report on their implementation in the care of patients with BMs.

METHODS:

On the basis of a stakeholders’ needs assessment and review of the literature, we identified outcome and process measurements to assess the care of patients with BMs according to treatment modality. Retrospectively, we applied these indicators of care to all patients diagnosed and treated at our institution over 2 years.

RESULTS:

We ascertained 5 outcome and 6 process measurements of relevance in the care of BMs. When applied to 209 patients (89.7%) who received cancer treatment, 77% were alive > 90 days after diagnosis. The proportion alive at 90 days after surgery, whole-brain radiation therapy (WBRT), and stereotactic radiosurgery (SRS) was 82%, 59%, and 81%, respectively. Other performance measurements included 30-day postoperative readmission rate (6%), SRS within 30 days of surgery (79%), use of memantine with WBRT (41%), advance directives within 6 months of diagnosis (53%), and palliative care consultation for patients with poor prognosis or receiving WBRT (45%). Measurements for the 24 patients (10.3%) receiving best supportive care were advance directives documentation (67%) and referral to palliative or hospice care (83%).

CONCLUSION:

We propose a set of measurements to apprise quality improvement efforts, inform treatment decision-making, and to use in evaluation of the performance of interdisciplinary BMs programs. Their refinement can potentially enhance the quality and value of care delivered to patients with BMs.
Laparoscopic Gastric Resection for Gastric Cancer: Is Intracorporeal Anastomosis Necessary?
Authors: Ersen Ogun , Ünal Ali Ekrem , Yüksel Cemil , Çulcu Serdar , Başçeken Salim İlksen , Mercan Ümit , Demirci Salim
Published: August 2020

Background and Objective: In surgical dissection, laparoscopic approach and open techniques do not differ significantly, but there is still no consensus on how anastomosis should be performed in both cardia and distal gastric tumors. Anastomosis can be performed by laparoscopy-assisted mini-laparotomy or by intracorporeal suture techniques. In this study, we aim to present our four years of clinical experience and short-term surgical results from 133 cases in order to evaluate the necessity of laparoscopic anastomosis.

Methods: This study was approved by Ethics Committee (No: 1-8-19, date: 14/01/2019). Patients who underwent curative resection with the diagnosis of gastric adenocarcinoma between January 2014 and January 2018 in the Ankara University Surgical Oncology Department were included in the study.

Results: Of the 133 patients included in the study, 108 (81.2) were male and the mean age was 60.51 ± 12.0 years. The time of anastomosis was significantly longer in patients undergoing intracorporeal anastomosis (p = 0.021). The incidence of anastomotic leakage was significantly higher in the group undergoing intracorporeal anastomosis (p = 0.004).

Conclusions: We think that esophagojejunostomy and jejunojejunostomy anastomoses in patients undergoing total gastrectomy should be performed with intracorporeal techniques in terms of benefit risk assessment. We believe that it is more feasible to continue the case with mini laparotomy when anastomosis is reached in patients who are planned to have gastrojejunostomy. In addition, in terms of intracorporeal anastomoses and advanced laparoscopic techniques, intracorporeal anastomoses performed in gastric cancer surgery for a laparoscopist who has completed the learning curve do not appear to be very different in terms of anastomosis safety.

doi: https://doi.org/10.12669/pjms.36.6.1915

How to cite this:Ogun E, Ekrem UA, Yuksel C, Serdar C, Basceken SI, Umit M, et al. Laparoscopic Gastric Resection for Gastric Cancer: Is Intracorporeal Anastomosis Necessary? Pak J Med Sci. 2020;36(6):1177-1182. doi: https://doi.org/10.12669/pjms.36.6.1915

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Affective rating of audio and video clips using the EmojiGrid
Authors: Toet Alexander , van Erp Jan B. F.
Published: August 2020

Background: In this study we measured the affective appraisal of sounds and video clips using a newly developed graphical self-report tool: the EmojiGrid. The EmojiGrid is a square grid, labeled with emoji that express different degrees of valence and arousal. Users rate the valence and arousal of a given stimulus by simply clicking on the grid.

Methods: In Experiment I, observers (N=150, 74 males, mean age=25.2±3.5) used the EmojiGrid to rate their affective appraisal of 77 validated sound clips from nine different semantic categories, covering a large area of the affective space. In Experiment II, observers (N=60, 32 males, mean age=24.5±3.3) used the EmojiGrid to rate their affective appraisal of 50 validated film fragments varying in positive and negative affect (20 positive, 20 negative, 10 neutral).

Results: The results of this study show that for both sound and video, the agreement between the mean ratings obtained with the EmojiGrid and those obtained with an alternative and validated affective rating tool in previous studies in the literature, is excellent for valence and good for arousal. Our results also show the typical universal U-shaped relation between mean valence and arousal that is commonly observed for affective sensory stimuli, both for sound and video.

Conclusions: We conclude that the EmojiGrid can be used as an affective self-report tool for the assessment of sound and video-evoked emotions.
Case Report: A case of encephalopathy presenting the lentiform fork sign on MRI in a diabetic dialysis patient - diabetic uremic syndrome or metformin-related encephalopathy?
Authors: Ishizaki Yuri , Nishizono Ryuzoh , Kikuchi Masao , Inagaki Hiroko , Sato Yuji , Fujimoto Shouichi
Published: August 2020

Basal ganglia lesions showing an expansile high signal intensity on T2-weighted MRI are termed the lentiform fork sign. This specific finding is mainly observed in diabetic patients with uremic encephalopathy with metabolic acidosis, although there are also reports in patients with ketoacidosis, dialysis disequilibrium syndrome, intoxication, and following drug treatment (e.g., metformin). A 57-year-old Japanese man on chronic hemodialysis for four years because of diabetic nephropathy was admitted to our hospital for relatively rapid-onset gait disturbance, severe dysarthria, and consciousness disturbance. Brain T2-weighted MRI showed the lentiform fork sign. Hemodialysis was performed the day before admission, and laboratory tests showed mild metabolic (lactic) acidosis, but no uremia. Surprisingly, metformin, which is contraindicated for patients with end-stage kidney disease, had been prescribed for six months in his medication record, and his sluggish speaking and dysarthria appeared gradually after metformin treatment was started. Thus, the encephalopathy was considered to be related to metformin treatment. He received hemodialysis treatment for six consecutive days, and his consciousness disturbance and dysarthria improved in one week. At the eight-month follow-up, the size of the hyperintensity area on MRI had decreased, while the mild gait disturbance remained. Considering the rapid onset of gait and consciousness disturbance immediately before admission, diabetic uremic syndrome may also have occurred with metformin-related encephalopathy, and resulted in the lentiform fork sign, despite the patient showing no evidence of severe uremia on laboratory data.
Actividad física, salud y funcionalidad entre adultos mayores según la localidad geográfica
Authors: Oliveira Daniel Vicentini de , Loyola Walter Aquiles Sepúlveda , Freire Gabriel Lucas Morais , Maciel Renata Pires Tricanico , Kerber Vera Lúcia , Nascimento Júnior José Roberto Andrade do
Published: August 2020

Este estudio transversal comparó las diferencias sociodemográficas, auto percepción de salud, nivel de actividad física y la funcionalidad de los adultos mayores adscritos a centros de atención pública de diferentes sectores geográficos de una ciudad brasileira. Estudio epidemiológico con 654 adultos mayores (69,42 ± 7,51 años), de ambos los sexos, de la comuna de Maringá, Brasil. Los sujetos fueron reclutados de cuatro diferentes regiones. Fue evaluado el perfil sociodemográfico, nivel educacional, auto percepción de salud, nivel de actividad física y la funcionalidad. Los ancianos entre 60 - 69 y 70 - 79 años tenían tres veces más probabilidades de vivir en las regiones sur y oeste. Las personas mayores con educación superior tienen más probabilidades de vivir en el este y oeste. Las personas mayores con mala percepción de salud y que informaron tomar más de dos medicamentos tenían más del 50,0% de probabilidades de vivir en la región oriental. La prevalencia del uso de más de dos medicamentos es mayor en el sector oeste (51,0%) y sur (52,0%). Los adultos mayores del sector norte realizan menos tiempo de actividad física moreda y vigorosa (p = 0.001), y los adultos mayores de la región sur presentan menor tiempo sentado (p = 0.001). Los adultos mayores de la región norte presentaban mejor funcionalidad (p = 0.001).  Existen diferencias entre los factores sociodemográficos, condición de salud, nivel de actividad física, funcionalidad y participación social entre los adultos mayores que viven en diferentes barrios de una comuna que deben ser consideradas al momento de crear estrategias de salud pública.
Research Roundup
Authors: Winter George
Published: August 2020

George Winter provides an overview of recently published articles that are of interest to practice nurses. Should you wish to look at any of the papers in more detail, a full reference is provided.
Are UK and Ireland trauma and orthopaedic surgeons maintaining their research output?
Authors: Scotcher M , Asif A , Kulkarni K
Published: August 2020

Introduction

Healthcare faces growing challenges. With reports of diminishing research output from the UK and Ireland in the leading surgical journals, this study aimed to ascertain whether this trend had been echoed in the trauma and orthopaedic literature.

Materials and methods

Citable research output from the 10 globally leading trauma and orthopaedic journals was analysed from five individual years, over a 20-year period, to ascertain trends in absolute output, geographical mix, and level of evidence.

Results

The overall number of published articles fell by 14.5%. North America saw the greatest decline (–8.0%), followed by Japan (–5.6%) and Europe (–3.3%). The UK and Ireland (+2.9%) and the rest of the world (+13.9%) saw rising output. A decline in lower (levels IV and V) and a rise in higher (levels I, II and III) quality evidence was observed. The UK and Ireland had a greater proportion of higher-quality studies than North America and Japan, but lower than Europe and the rest of the world. The impact factor of the leading journal rose from 4.47 to 7.01.

Discussion

The research landscape has evolved, with leading journals placing greater emphasis on higher-quality evidence. UK and Irish research output remains stable, contributing 14% of the most highly cited publications in 2018, and challenging North America’s dominance with a greater proportion of level I and II evidence in the leading journals.

Conclusion

With the growing emergence of Europe and the rest of the world, UK and Irish authors must build upon the region’s output despite political challenges such as Brexit. Increasing international collaboration will continue to play an important role.
Eliminating photon noise biases in the computation of second-order statistics of lidar temperature, wind, and species measurements
Authors: Gardner Chester S. , Chu Xinzhao
Published: August 2020

The precision of lidar measurements is limited by noise associated with the optical detection process. Photon noise also introduces biases in the second-order statistics of the data, such as the variances and fluxes of the measured temperature, wind, and species variations, and establishes noise floors in the computed fluctuation spectra. When the signal-to-noise ratio is low, these biases and noise floors can completely obscure the atmospheric processes being observed. We describe a novel data processing technique for eliminating the biases and noise floors. The technique involves acquiring two statistically independent datasets, covering the same altitude range and time period, from which the various second-order statistics are computed. The efficacy of the technique is demonstrated using Na Doppler lidar observations of temperature in the upper mesosphere and lower thermosphere acquired recently at McMurdo Station, Antarctica. The results show that this new technique enables observations of key atmospheric parameters in regions where the signal-to-noise ratio is far too low to apply conventional processing approaches.
Plattform-Bereitstellungsstrategien im Maschinen- und Anlagenbau: Strategien deutscher Unternehmen im Industrie 4.0-Kontext
Authors: Bender Benedict , Lass Sander , Habib Natalie , Scheel Laura
Published: August 2020

Digitale Plattformen finden zunehmende Verbreitung in unterschiedlichen Industriezweigen. Immer mehr Unternehmen sind an der Erschließung verbundener Potenziale für ihr Geschäft interessiert. Im Maschinen- und Anlagenbau wird die Vernetzung von Maschinen zunehmend ein Wettbewerbsfaktor für Hersteller. Der Einsatz digitaler Plattformen im Maschinen- und Anlagenbau bietet Herstellern Möglichkeiten zur gezielten Erweiterung des Geschäftsmodells. Für die Bereitstellung digitaler Plattformen können Unternehmen auf unterschiedliche Strategien zurückgreifen. Hierbei sollten Unternehmen die für ihre Konstellation geeignete Variante systematisch identifizieren, um die angestrebten Ziele zu erreichen. Die geeignete Strategie ist von einer Vielzahl an Faktoren abhängig. Als Grundlage für die Identifikation der geeigneten Strategie bietet dieser Beitrag eine systematische Untersuchung der möglichen Bereitstellungsstrategien für Unternehmen. Neben der theoretischen Systematisierung werden gegenwärtig genutzte Strategien am Beispiel des Maschinen- und Anlagenbaus in Deutschland vorgestellt. Zudem werden spezifische Merkmale, welche die Nutzung einer Strategie beeinflussen, als Ansatzpunkt für einen Strategieformulierungsprozess identifiziert. Im Maschinen- und Anlagenbau ist die Bereitstellung einer eigenen Plattform, insbesondere bei Großunternehmen vorherrschend. Die Strategien von KMU unterschieden sich von Großunternehmen.
Designing with microbial cellulose to feed new biological cycles1
Authors: Cohen Nitzan , Sicher Emma , Uğur Yavuz Seçil
Published: August 2020

Waste from food packaging and food processing raises a broad scope of critical questions to the food industry revolving around effects to man, nature and society. Reacting on this reality, designers are getting more and more involved as catalysers of innovative and interdisciplinary research by generating alternative proposals and scenarios for more sustainable futures. One of the emerging biodesign fields tackling this issue is growing design, in which organisms such as bacteria, fungi or algae enable the development of more eco-compatible processes and products. Fermentation is an ancient microbial process widely used by food producers. One such fermentation process commonly used to brew Kombucha tea is simultaneously generating microbial cellulose (MC) growing from a symbiotic culture of bacteria and yeasts (SCOBY). In this process, waste coming from food production can be used as nourishment to feed the culture, transforming it into valuable substances. This article addresses an ongoing research project ‘InnoCell’, a follow-up of ‘From Peel To Peel’, a design project investigating the fermentation of fruit and vegetable scraps to nourish SCOBY cultures in order to obtain both a beverage (Kombucha tea) and a promising material source (MC). The article highlights the innovative potential of an edible, non-edible and compostable material, proposing alternative biological cycles and speculative future scenarios.
Assessing the role of global media assistance in promoting public service broadcasting in Indonesia
Authors: Masduki
Published: August 2020

In today’s globally connected society, the transformation of state-administered broadcasters into public service broadcasters (PSB) in new democracies is part of international media development projects that seek to democratize media systems following the collapse of authoritarian ideologies in the 1990s. This article traces the ‘what, who, when and how’ of international media assistance, with particular focus on projects that sought to transform Indonesia’s state-run broadcasters into PSBs during the 2000s–2010s. Drawing on extensive library research and semi-structured interviews, this article demonstrates the role of international agencies in the promotion of public service media in post-authoritarian Indonesia. They have influenced civil societies, policy-makers and media elites and promoted a belief that an independent and public-owned media enable people to better participate in a mediated public sphere. In this manner, international agencies have influenced policy design as Indonesia has transformed its national state-owned broadcast channels from state institutions into public ones. However, this article also finds that global intervention has failed to influence the more specific elements of PSB policy and implementation. In Indonesia, global work has focused on national regulatory design, leaving implementation to local actors. Furthermore, Indonesia’s PSB policy is but ‘an imitative version’ of PSB policies in developed western countries, lacking a detailed guide for transforming the country’s state-channels into true PSBs.
Mission impossible? Research praxis and activist interventions in New Zealand media policy
Authors: Thompson Peter A.
Published: August 2020

Over the last two decades, public media arrangements in many countries have been eroded by unsympathetic governments cutting subsidies/license fees or, in some cases, actively dismantling their institutional arrangements. The proliferation of online/mobile/interactive media has legitimated a view among some policy-makers and vested interests within the private media sector that public service provisions are an anachronism in the digital media ecology. In such a context, critical media scholars whose research is intended to not only inform the academic community but influence public policy face significant challenges. Drawing on the author’s own experience of praxis in the New Zealand media policy sector, the article presents three case studies: the campaign to save TVNZ7, the campaign to unfreeze Radio New Zealand’s funding and the Fairfax-NZME merger. These serve to highlight some of the practical and normative challenges for research praxis, particularly those encountered by scholars who engage with pro-public service media advocacy coalitions. In doing so, the analysis will identify several points of tension that arise when research praxis attempts to extend beyond describing the world to trying to influence the policies and practices being studied. These include questions of whether it is possible/desirable to sustain academic objectivity/neutrality in seeking to develop stakeholder relations or whether commitment to an ideological or politically partisan position is necessary or problematic. The complexities and compromises of seeking access to policy-makers as an ‘insider’ as opposed to neutral ‘outsider’ are also considered. The analysis concludes that there is no necessary contradiction between critical praxis and scholarly independence and, indeed, that praxis may serve to improve the quality of academic scholarship through stakeholder engagement.
Public service media, an overview: Reflecting on news and trends
Authors: Wilson Sally-Ann
Published: August 2020

This commentary outlines the impacts of new media technologies and changed global geopolitics on public service broadcasting (PSB); documents the core values of public broadcasting as a media system, noting its evolution to public service media (PSM); and provides an overview of the current threats to and erosion of independent public media worldwide. However, PSM remains the most trusted source for news and information and a call for better global advocacy for public media.
Why advocate for public service media? Perspectives from organizations for media development
Authors: Aslama Horowitz Minna , D’Arma Alessandro , Michalis Maria
Published: August 2020

In this commentary, we discuss how five prominent media development organizations (BBC Media Action, Council of Europe, DWA, PMA and UNESCO) define public service broadcasting (PSB)/public service media (PSM) and how they envisage its role and functions in their recent projects and reports. In view of the increasing challenges of the current media landscape, international donors are looking at models to provide a path to independent media and journalism and several international organizations support projects and institutional arrangements they label PSB/PSM. However, given the fundamental questions that existing PSBs face, is PSB a meaningful tool for media development? And how do these various advocates for PSB/PSM understand the concept and why do they feel that it is worth supporting? We find that there seems to have been a shift, common to all five organizations, towards defining PSB/PSM in terms of public service ethos, and we explain why this should be seen as a welcome development.
Perfil farmacoterapêutico de pacientes renais crônicos hemodialíticos em uma clínica da Bahia
Authors: Brasileiro Lemos Lucas , Silva Moraes Gabriela , Da Silveira Lemos Gisele , Alves Nery Adriana
Published: August 2020

A doença renal crônica (DRC) configura-se como um problema de saúde pública devido a prevalência e morbimortalidade crescentes. As múltiplas comorbidades associadas a DRC exigem um manejo adequado dos medicamentos mitigando riscos e problemas farmacoterapêuticos. Assim, esse estudo teve como objetivo descrever o perfil farmacoterapêutico e clínico de pacientes renais crônicos hemodialíticos e caracterizar seu modo de utilização de medicamentos: prescritos e por automedicação. Trata-se de um estudo transversal realizado em um centro de hemodiálise no Estado da Bahia, através da aplicação de um formulário, sendo os pacientes selecionados em março de 2015. Dentre os participantes, predominaram os do sexo masculino (64,1%), com média de idade 50,5±14,9 anos. Entre os participantes 83,5% declararam renda familiar mensal de até 2 salários mínimos, 20% nunca estudaram, 48,2% estavam em diálise por períodos compreendidos entre 1 e 5 anos e 92,9% não possuíam plano de saúde. Hipertensão Arterial Sistêmica foi a causa mais frequente da perda da função renal (57,8%). O número médio de medicamentos prescritos foi de 8,11±3,56, e por automedicação 2,04±1,40, sendo que 39,4% dos participantes declararam ter se automedicado em algum momento da vida. O medicamento mais frequentemente prescrito foi a eritropoetina (10,6%) e o mais frequente dentre os classificados como de automedicação o calcitriol (9,6%), influenciado por falha na comunicação entre o prescritor e paciente. Os dados apresentados servem de subsídio para um aprimoramento da assistência ao paciente com DRC, principalmente em relação ao uso racional de medicamentos.
Inovações e desafios no acompanhamento de pacientes crônicos em tempos de covid-19 na Atenção Primária à Saúde
Authors: Rios Rodrigues Ivana , Silvano da Silva Filho Messias
Published: August 2020

Diante da pandemia por Covid-19, faz-se necessário a adoção de estratégias para acompanhamento de pacientes crônicos, objetivando diminuir a infecção desses indivíduos e a descompensação das doenças de base. Nesse sentido, foi criado um fluxo de atendimento na Unidade de Atenção Primária à Saúde – UAPS Manoel Gomes da Silva, Caucaia (Ceará), que tem possibilitado o monitoramento remoto das demandas de saúde da população adscrita e a resposta, praticamente em tempo real, das necessidades de saúde da população. Nesses cenários de crise, são essenciais adoção de práticas criativas, acessíveis e de fácil implementação para otimizar o atendimento e manter os cuidados de saúde a população com o menor risco possível para profissionais e comunidade.
A atuação do cirurgião-dentista, vinculado a um programa de residência multiprofissional em saúde, no combate à COVID–19 na Atenção Primária à Saúde
Authors: Xavier Jamile , Silva Andresa , Carvalho Leilane , Soares Juliana , Lopes Síntique , Moreira Marcela
Published: August 2020

Identificado no final do ano de 2019, em uma cidade da China, o SARS-coV-2, agente da doença COVID-19, provocou um estado de pandemia e alerta global. No Brasil, o setor saúde transformou a dinâmica do seu processo de trabalho, inclusive da Atenção Primária à Saúde. Dentre os profissionais de saúde atuantes nesse nível de atenção, é fundamental destacar a essencialidade do cirurgião-dentista como ator no enfrentamento à COVID-19. Diante desse contexto, o objetivo do presente artigo é relatar a atuação de cirurgiões-dentistas, vinculados a um Programa de Residência Multiprofissional em Saúde, em uma Unidade de Saúde da Família, alocada em um município do nordeste brasileiro, no cenário da pandemia relativa à COVID-19. Trata-se de um relato de experiência de caráter descritivo e exploratório, desenvolvido pela Equipe de residentes do Núcleo de Odontologia, sob supervisão da preceptoria e apoio pedagógico vinculados ao núcleo profissional, no período entre março e junho de 2020. Para tanto, a trajetória metodológica percorrida apoiou-se na análise retrospectiva de estudos/normativas que tiveram enfoque na temática abordada, contribuindo para o processo de discussão e reflexão das experiências vivenciadas no contexto sanitário vigente. A partir da construção, em equipe, de um novo fluxo de atendimento na unidade de saúde, durante este período, gerou reflexões magníficas e que mereciam ser compartilhadas. Entrementes, identificou-se que esta categoria profissional se destacou no aprimoramento de habilidades de cuidado que extrapolam a cavidade bucal, principalmente no que tange ao acolhimento à demanda espontânea.