bluuebunny/crossref_metadata_2025 huggingface dataset:
Knowledge of Essential Newborn Care and Associated Factors among Nurses and Midwives: A Cross-Sectional Study at Public Health Facilities in Wolaita Zone, Southern Ethiopia, 2019
Authors: Arba Aseb , Zana Zerihun
Published: April 2020

Background. Knowledge of essential newborn care and proper practice is important for the survival, growth, and development of a newborn. In spite of its essentiality, most health-care professionals do not know and follow the World Health Organization recommendation. Therefore, this study is aimed at assessing knowledge of essential newborn care and associated factors among nurses and midwives working in maternal health case team at public health facilities of Wolaita Zone, Ethiopia, 2019. Methods. Institution-based cross-sectional study design was conducted from March to April 2019. Data were collected by using pretested questionnaire, and 36 public health facilities were selected after stratifying them based on their level of service and number of nurses and midwives working in maternal health-care team. All 218 nurses and midwives who were working in the delivery unit from selected facilities were included in the study. The collected data were entered into Epi data 3.02 and exported to statistical software for social sciences version 22 for analysis. Descriptive, bivariate, and multivariate analyses were done. Statistical significance of variables was declared as a p value<0.05, and strength of association was adjusted odds ratio at 95% confidence interval in the final model. Result. A total of 218 nurses and midwives were participated in the study. Among them, 57.9% of participants had good knowledge of essential newborn care. The type of profession (AOR=5.79, [2.47, 13.58]), educational level (AOR=3.26, [1.42, 7.52]), interest to work in delivery room (AOR=4.85, [1.89, 12.42]), and presence of guidelines (AOR=2.29, [1.18, 4.45]) were the factors significantly associated with having knowledge of essential newborn care. Conclusion and Recommendation. The nurses and midwives had poor knowledge of some components of essential newborn care in the study area. Bachelor level of study, interest to work in delivery room, and being a midwife were the factors independently associated with knowledge of essential newborn care among nurses and midwives. Therefore, the head of labor ward and institution, zonal and woreda health units, and nongovernmental organizations who are working on maternal and child health should work on providing continuous education, providing incentives and motivators to improve interest to work in delivery unit, and providing guidelines in the unit.
FDT Perimetry for Glaucoma Detection in Comprehensive Health Checkup Service
Authors: Terauchi Ryo , Wada Takashi , Ogawa Shumpei , Kaji Masanobu , Kato Tomohiro , Tatemichi Masayuki , Nakano Tadashi
Published: April 2020

We aimed to investigate the efficacy of frequency doubling technology (FDT) perimetry for glaucoma detection in comprehensive screening examinations. We performed a retrospective analysis of prospectively collected data of participants who underwent a comprehensive health checkup service. Participants with glaucoma were excluded. In the first year, 2024 participants (46.8 ± 9.4 years) who underwent FDT perimetry and fundus photography were classified as the FDT group, whereas 3052 participants (42.2 ± 8.2 years) who underwent only fundus photography were classified as the non-FDT control group. Participants with abnormal findings on FDT perimetry and/or fundus photography were recommended to undergo further complete examination. All participants reported whether they had been newly diagnosed with glaucoma within 2 years of the first visit. In the FDT group, 23 (1.14%) participants were newly diagnosed with glaucoma. Among them, 20 (87.0%) had abnormal FDT perimetry findings and 12 (52.2%) had abnormal findings on fundus photography. The positive-predictive value (PPV) of FDT perimetry was 16.5% (20/121) and that of fundus photography was 13.3% (12/90). In participants with abnormal findings on both tests, the PPV was 26.2%. In the non-FDT group, 15 (0.49%) participants were newly diagnosed with glaucoma. Among them, 9 (60.0%) had abnormal findings on fundus photography. The PPV of fundus photography was 10.8% (9/83). The glaucoma detection rate, analyzed using age adjustment, was significantly higher in the FDT group than that in the non-FDT group (0.97% versus 0.47%, P=0.041). FDT perimetry, even if performed by nonspecialized physicians, could improve glaucoma detection when used in addition to fundus photography. This study was registered with UMIN000037951.
Extraction-Free, Direct Determination of Caffeine in Microliter Volumes of Beverages by Thermal Desorption-Gas Chromatography Mass Spectrometry
Authors: Peng Xianglu , Brown Melanie , Bowdler Paul , Honeychurch Kevin C.
Published: April 2020

An extraction-free method requiring microliter (μL) volumes has been developed for the determination of caffeine in beverages. Using a pyrolysis-gas chromatography mass spectrometry system, the conditions required for the direct thermal desorption-gas chromatography mass spectrometry (TD-GC/MS) determination of caffeine were optimised. A 5 μL aliquot was introduced to the thermal desorption unit, dried, and thermally desorbed to the GC/MS. The response was linear over the range 10 to 500 μg/mL (R2 = 0.996). The theoretical limit of detection (3σ) was 0.456 μg/mL. No interferences were recorded from endogenous beverage components or from commonly occurring drugs, such as nicotine, ibuprofen, and paracetamol. Replicate caffeine determinations on fortified latte style white coffee and Pepsi Max® gave mean recoveries of 93.4% (%CV = 4.1%) and 95.0% (%CV = 0.98%), respectively. Good agreement was also obtained with the stated values of caffeine for an energy drink and for Coca-Cola®. These data suggest that the method holds promise for the determination of caffeine in such samples.
Current Approaches for Personalized Therapy of Soft Tissue Sarcomas
Authors: Kirsanov Kirill I. , Lesovaya Ekaterina A. , Fetisov Timur I. , Bokhyan Beniamin Yu , Belitsky Gennady A. , Yakubovskaya Marianna G.
Published: April 2020

Soft tissue sarcomas (STS) are a highly heterogeneous group of cancers of mesenchymal origin with diverse morphologies and clinical behaviors. While surgical resection is the standard treatment for primary STS, advanced and metastatic STS patients are not eligible for surgery. Systemic treatments, including standard chemotherapy and newer chemical agents, still play the most relevant role in the management of the disease. Discovery of specific genetic alterations in distinct STS subtypes allowed better understanding of mechanisms driving their pathogenesis and treatment optimization. This review focuses on the available targeted drugs or drug combinations based on genetic aberration involved in STS development including chromosomal translocations, oncogenic mutations, gene amplifications, and their perspectives in STS treatment. Furthermore, in this review, we discuss the possible use of chemotherapy sensitivity and resistance assays (CSRA) for the adjustment of treatment for individual patients. In summary, current trends in personalized management of advanced and metastatic STS are based on combination of both genetic testing and CSRA.
Molecular Signatures of Humic Acids from Different Sources as Revealed by Ultrahigh Resolution Mass Spectrometry
Authors: Qin Shuai , Xu Chengbin , Xu Yingzi , Bai Yingchen , Guo Fei
Published: April 2020

Humic acid (HA) is extremely important for understanding the geochemical cycle of pollutants in different environments. Fourier transform ion cyclotron resonance mass spectrometry (FT-ICR MS) has performed molecular-level analysis of two standard HAs from the Suwannee River (SRHA) and leonardite (LEHA) and HA from Jiufeng forest in Beijing (JFHA), which is impossible for other conventional instruments. Regardless of the source of HA, compounds containing more heteroatoms (such as nitrogen and sulfur) have a higher degree of unsaturation and aromaticity. JFHA, SRHA, and LEHA from soil, river, and leonardite, respectively, are arranged in order from the lowest to highest degree of humification, according to molecular unsaturation and aromaticity of HAs. Soil HA is more labile and contains many large molecular weight compounds with low unsaturation. Regardless of unsaturation, molecules of River HA have a homogeneous molecular mass distribution and contain many plant-derived lignin- and tannin-like compounds, which are more stable than lipid and more labile than condensed aromatics. Leonardite HA with a high degree of humification contains a large number of compounds with high aromaticity and more heteroatoms and has low lability. Our results reveal the diversity of humic acid at molecular level because of different degree of humification and the lability. These conclusions are significant for understanding the role of humic acid from different sources in pollutant transformation and the geochemical cycle at the molecular level.
Identification of Potential Biomarkers for Thyroid Cancer Using Bioinformatics Strategy: A Study Based on GEO Datasets
Authors: Shen Yujie , Dong Shikun , Liu Jinhui , Zhang Liqing , Zhang Jiacheng , Zhou Han , Dong Weida
Published: April 2020

Background. The molecular mechanisms and genetic markers of thyroid cancer are unclear. In this study, we used bioinformatics to screen for key genes and pathways associated with thyroid cancer development and to reveal its potential molecular mechanisms. Methods. The GSE3467, GSE3678, GSE33630, and GSE53157 expression profiles downloaded from the Gene Expression Omnibus database (GEO) contained a total of 164 tissue samples (64 normal thyroid tissue samples and 100 thyroid cancer samples). The four datasets were integrated and analyzed by the RobustRankAggreg (RRA) method to obtain differentially expressed genes (DEGs). Using these DEGs, we performed gene ontology (GO) functional annotation, pathway analysis, protein‐protein interaction (PPI) analysis and survival analysis. Then, CMap was used to identify the candidate small molecules that might reverse thyroid cancer gene expression. Results. By integrating the four datasets, 330 DEGs, including 154 upregulated and 176 downregulated genes, were identified. GO analysis showed that the upregulated genes were mainly involved in extracellular region, extracellular exosome, and heparin binding. The downregulated genes were mainly concentrated in thyroid hormone generation and proteinaceous extracellular matrix. Pathway analysis showed that the upregulated DEGs were mainly attached to ECM‐receptor interaction, p53 signaling pathway, and TGF‐beta signaling pathway. Downregulation of DEGs was mainly involved in tyrosine metabolism, mineral absorption, and thyroxine biosynthesis. Among the top 30 hub genes obtained in PPI network, the expression levels of FN1, NMU, CHRDL1, GNAI1, ITGA2, GNA14 and AVPR1A were associated with the prognosis of thyroid cancer. Finally, four small molecules that could reverse the gene expression induced by thyroid cancer, namely ikarugamycin, adrenosterone, hexamethonium bromide and clofazimine, were obtained in the CMap database. Conclusion. The identification of the key genes and pathways enhances the understanding of the molecular mechanisms for thyroid cancer. In addition, these key genes may be potential therapeutic targets and biomarkers for the treatment of thyroid cancer.
CSF1R Is Required for Differentiation and Migration of Langerhans Cells and Langerhans Cell Histiocytosis
Authors: Lonardi Silvia , Scutera Sara , Licini Sara , Lorenzi Luisa , Cesinaro Anna Maria , Gatta Luisa Benerini , Castagnoli Carlotta , Bollero Daniele , Sparti Rosaria , Tomaselli Michela , Medicina Daniela , Calzetti Federica , Cassatella Marco Antonio , Facchetti Fabio , Musso Tiziana , Vermi William
Published: April 2020

Langerhans cell histiocytosis (LCH) is a rare disorder characterized by tissue accumulation of CD1a+CD207+ LCH cells. In LCH, somatic mutations of the BRAFV600E gene have been detected in tissue LCH cells, bone marrow CD34+ hematopoietic stem cells, circulating CD14+ monocytes, and BDCA1+ myeloid dendritic cells (DC). Targeting BRAFV600E in clonal Langerhans cells (LC) and their precursors is a potential treatment option for patients whose tumors have the mutation. The development of mouse macrophages and LCs is regulated by the CSF1 receptor (CSF1R). In patients with diffuse-type tenosynovial giant cell tumors, CSF1R inhibition depletes tumor-associated macrophages (TAM) with therapeutic efficacy; however, CSF1R signaling in LCs and LCH has not been investigated. We found through IHC and flow cytometry that CSF1R is normally expressed on human CD1a+CD207+ LCs in the epidermis and stratified epithelia. LCs that were differentiated from CD14+ monocytes, BDCA1+ DCs, and CD34+ cord blood progenitors expressed CSF1R that was downregulated upon maturation. Immature LCs migrated toward CSF1, but not IL34. Administration of the c-FMS/CSF1R kinase inhibitors GW2580 and BLZ945 significantly reduced human LC migration. In LCH clinical samples, LCH cells (including BRAFV600E cells) and TAMs retained high expression of CSF1R. We also detected the presence of transcripts for its ligand, CSF1, but not IL34, in all tested LCH cases. CSF1R and CSF1 expression in LCH, and their role in LC migration and differentiation, suggests CSF1R signaling blockade as a candidate rational approach for treatment of LCH, including the BRAFV600E and wild-type forms of the disease.
Immune Escape during Breast Tumor Progression
Authors: Gil Del Alcazar Carlos R. , Alečković Maša , Polyak Kornelia
Published: April 2020

Immunotherapy using checkpoint inhibitors is one of the most promising current cancer treatment strategies. However, in breast cancer, its success has been limited to a subset of patients with triple-negative disease, whose durability of observed responses remain unclear. The lack of detailed understanding of breast tumor immune evasion mechanisms and the treatment of patients with highly heterogeneous metastatic disease contribute to these disappointing results. Here we discuss the current knowledge about immune-related changes during breast tumor progression, with special emphasis on the in situ-to-invasive breast carcinoma transition that may represent a key step of immunoediting in breast cancer. Comprehensive characterization of early-stage disease and better understanding of immunologic drivers of disease progression will likely expand the tools available for immunotherapy and improve patient stratification.
HPV Genotype Prevalence and Success of Vaccination to Prevent Cervical Cancer
Authors: Leite Katia Ramos Moreira , Pimenta Ruan , Canavez Juliana , Canavez Flavio , de Souza Fernando R. , Vara Ligia , Estivallet Carmen , Camara-Lopes Luiz Heraldo
Published: April 2020

Background: Nearly 500,000 new cases of cervical cancer are estimated annually worldwide. Three vaccines are currently licensed to prevent cervical cancer. The success of vaccination depends mainly on the prevalence of HPV genotypes, and many cases of HPV infection have been diagnosed after vaccination. Our aim was to search for HPV genotyping in cervical samples to verify the proportion of women that remain susceptible to infection even after vaccination. Methods: 21,017 liquid-based cervical (LBC) specimens were received for cytology and HPV detection from 2015 to 2018. Before slide preparations for cytology, a 1,000-μL aliquot was taken from the LBC fixative and subjected to automated DNA extraction and multiplex PCR followed by capillary electrophoresis to detect and classify HPV. Results: HPV was detected in 895 (4.3%) specimens. The most prevalent genotype was HPV-16, followed by HPV-58 and HPV-66. A total of 258 (28.8%) cases were positive for high-risk (HR)-HPV types (66, 59, 39, 56, 30, 35, 53, 51, 68, 82, and 70) that are not covered by the HPV vaccines. Conclusion: A significant proportion of HPV types detected in cytological specimens are representative of HR-HPV not covered by the available vaccines. The health system should be aware of the considerable percentage of women who are not being immunized and will continue to need cervical cancer screening.
O fenômeno da neologia lexical nas eleições de 2018
Authors: Chishman Rove Luiza De Oliveira , Santos Aline Nardes dos , Martins Paola
Published: April 2020

Este trabalho apresenta um estudo do fenômeno da neologia lexical através da análise de neologismos produzidos no período das eleições realizadas no Brasil no ano de 2018. Para o delineamento de nossa metodologia, utilizamos os preceitos estabelecidos pelo projeto Observatório de Neologia do Português (ONP), sob a coordenação de Margarita Correia, assim como a sistematização apresentada por Correia e Almeida (2012). Com base nos dados levantados, foram detectados 73 neologismos, sendo 24 formados por derivação (33% do total de palavras novas), 21 por processos deformacionais (28% dos casos), nove por lexicalização, sete por extensão semântica, sete por composição e cinco por empréstimos. Os casos de derivação sufixal servem para corroborar ser a sufixação o mecanismo mais rico e diversificado da língua portuguesa. É nessa classe que encontramos os casos de neologia denominativa, ainda que em sua maioria restritos a nomes de políticos ou a partidos, e não a objetos ou conceitos. Já os neologismos criados por processos deformacionais se destacam por indicarem, em sua grande maioria, casos de neologia estilística, evidenciando a intenção dos usuários em criar tais termos como forma de expressar sua opinião ou sua repulsa a um ou outro candidato.
Data-Driven Learning, termes et collocations terminologiques
Authors: Dechamps Christina
Published: April 2020

Dans le cadre de cet article, nous nous proposons, 1) de réfléchir aux défis de la formation initiale et/ou continue des traducteurs juridiques en ce qui concerne notamment l’emploi correct des termes et des collocations terminologiques, 2) de présenter une méthodologie de travail à appliquer au niveau de cette formation, méthodologie inspirée principalement des principes du Data - Driven Learning et faisant l’objet d’une expérience déjà en cours dans l’université dans laquelle nous travaillons et 3) de démontrer les avantages scientifiques et pédagogiques du Data - Driven Learning dans l’acquisition d’une compétence stratégique en traduction.
Exploração de corpora para extração e descrição de léxico de especialidade
Authors: Barbero Chiara , Amaro Raquel
Published: April 2020

A exploração de corpora para a extração de léxico de especialidade é um método consensual e comum na construção de recursos lexicais. No entanto, as metodologias empregadas não são explicitamente discutidas, dificultando a comparação e a determinação de abordagens robustas. Para preencher essa lacuna, neste artigo apresentamos e discutimos uma metodologia detalhada para extração de léxico de especialidade a partir de corpora, conjugando abordagens linguísticas e estatísticas. O método proposto prevê tanto o uso de corpora de especialidade como de corpora monitores e inclui: i) análise de dados de frequência; ii) extração de concordâncias e colocações; iii) extração de informação de ordem textual, permitindo a extração de unidades lexicais atómicas e multipalavra e de relações semânticas relevantes. Desse modo, o objetivo da metodologia é a determinação de listas de potenciais unidades lexicais de especialidade e de informações relevantes para a sua descrição que permitam uma validação final rápida e eficiente, maximizando o valor informacional da interação com os especialistas.
Mythopoesis, Mysticism, Messianism, and Modernity in Aaron Zeitlin’s Metatron
Authors: Wolski Nathan
Published: April 2020

This article presents an analysis of Aaron Zeitlin’s Metatron: Apokaliptishe poeme, published in Warsaw in 1922. Written at the height of the Yiddish avant-garde, the book-length poem represents the highpoint of Zeitlin’s “neo-kabbalistic” phase. Focusing on the mythopoesis and mystical messianism in the composition, I situate Zeitlin’s thought in the context of Uri Tsvi Greenberg’s Mefisto as well as Hillel Zeitlin’s messianism and ruminations on duality and evil. Paul Tillich’s writings about the divine-demonic provide another lens. Uncovering Zeitlin’s kabbalistic sources reveals the depth of his mythopoetic imagination, which I locate amidst divergent attitudes to myth in Yiddish literature in the early 1920s.
A Four-Fold Evil? The Crime of Aggression and the Case of Western Sahara
Authors: Smith J.J.
Published: April 2020

In 2010 the international community codified the crime of aggression. But the jurisdiction of courts and definition of acts encompassed by the crime would remain incomplete. Western Sahara now appears to be the only situation where it is possible to prosecute aggression. The development of the crime is reviewed and the circumstances of aggression in Western Sahara are addressed starting with the territory’s invasion in 1975. The analysis moves to Spain’s 2014 adoption of the crime, its national criminal law jurisdiction and the limits to retroactivity in the case of Western Sahara. Occupation and annexation, as presumptive second and third acts of aggression in Western Sahara, are reviewed. A fourth act of aggression not explicitly defined in 2010 is examined, the intentional denial of a non-self-governing people’s right to self-determination. Defences to aggression in Western Sahara are evaluated. Lessons for future development and application of the crime are discussed.
الترجمة إلى العربيّة ومحاولة تأسيس مصطلحات علم للترجمة
Authors: حمزة حسن
Published: April 2020

This paper deals with translation science and its terminology in Arabic. It shows that this science is not based on the creation of new concepts, neither its terminology is extracted from looking at the translation process. This terminology is rather based on the transfer of foreign terms, French and English, into Arabic, and on the creation of new terms that call for the imported concepts. Nevertheless, old terms, or similar terms that Arab scholars have invented since the third century A.H. – they are limited terms anyway – have not been developed, while others are at risk of falling.
الـلـغـة والـهـويّة: الـترمـيـز الـمـراوغ
Authors: سليمان ياسر
Published: April 2020

The paper deals with the language-identity nexus at the collective level against the elusive nature of both language and identity. Invoking the principles of continuity and change in this nexus, the paper recognizes the role of myth in maintaining the element of continuity and the imperatives of ideological manipulation in motivating change to respond to emerging socio-political contexts. To achieve this, the paper employs the concepts of identification, differentiation and distanciation as well as the distinction between the instrumental and the symbolic roles of language. Examples from Arab and non-Arab domains of socio-political action are used to support the main thesis of the paper.
وَهْم اجتماع الحركات وتبعاتُه النحويّة
Authors: الزين عبد الفتّاح
Published: April 2020

The purpose of this paper is to consider the grammatical implications that result from the traditional philological misconception of the succession of short and long vowels. Most grammarians accepted the analysis of morphologists, thus wrongly assuming that short vowels that are represented in writing after long ones are separate entities. In fact, it is impossible for our vocal apparatus to utter consecutive “sister” vowels (i.e. short and long ones) in one single place, even though we can represent them separately in writing.

But the misconceptions of the ancient grammarians regarding certain issues should not deter us from rejecting them and proposing alternative suggestions. This research will present some of the methods of parsing (iʿrāb) that grammarians have enacted and which can still be found in books of grammar up to the present day. It will also adduce arguments in favor of the suggested alternatives.
Africa Rising: a Pathway of Three Frontiers – Internet of Things, Population Growth and Free Trade Area
Authors: Mutuku Richard Kyalo
Published: April 2020

Africa rising is a raging discourse among policy wonks and African scholars. Some have questioned the veracity of this proposition, while others agree that indeed Africa’s prospects are incontrovertible. In this article, the author developed an exegesis to theorize that Africa’s future growth, at least for the next one century, shall depend on three praxes: internet of things, population growth and the eventual implementation of AfCFTA. Internet of things accentuated by increased internet connectivity is going to create prodigious solutions to African problems, especially in increasing financial inclusion, solving election malpractices through blockchain technology, raising income earnings for rural communities via the sharing economy and improving agribusiness productivity through smart farming. These solutions will mostly target small-holder business players and poor households in hinterland Africa, aiming to lift them from poverty and narrowing the inequality gap. Besides, Africa’s population growth is estimated to reach 2.4 billion by 2050 and theorized to create a market revolution punctuated by a demographic dividend of 15–64-year-olds. The youthful population shall be necessary for providing workforce and technological innovations for driving the wheels of growth in the continent. Moreover, AfCFTA shall be the largest Free Trade Area since the formation of WTO, providing a 1.2 billion people mass market (Signe, 2018: 3). In retrospect, the author intends to demonstrate that the three pathways – the internet of things, population growth and AfCFTA – shall be quintessential building blocks for actualizing the Africa Rising narrative.
Two new balsams (Balsaminaceae) from Eastern Himalayas, India

Authors: HAREESH VADAKKOOT SANKARAN , SABU MAMIYIL
Published: April 2020

Two new balsams (Impatiens), I. tirbinensis and I. shiyomiensis are described from Arunachal Pradesh, India. Species shows affinities towards I. drepanophora and I. rugosipetala but distinct in many attributes. Detailed descriptions, distribution, ecology and colour photographs of the new species are provided along with the comparison of I. drepanophora.
Three new species of penicillate millipedes from the Con Dao Islands of southeast Vietnam (Diplopoda, Lophoproctidae and Polyxenidae)
Authors: HUYNH CUONG , VEENSTRA ANNEKE A
Published: April 2020

We describe three new penicillate millipede species from Con Dao Archipelago in southeastern Vietnam: Alloproctoides consonensis n. sp. (Lophoproctidae), Monographis condorensis n. sp. (Polyxenidae), and Unixenis moniqueae n. sp. (Polyxenidae). Comparative morphological and genetic studies based on 18S and COI genes indicate that all three species differ from previously described species.
Associations between perceived injustice, unforgiveness, and psychological well-being among ex-communicants
Authors: Boon Susan D. , Brown Jac
Published: April 2020

Through the experiences of individuals excommunicated from a small religious sect ( N = 95), we explored the association between perceptions of injustice resulting from chronic social exclusion and reduced psychological well-being. We also tested whether unforgiveness toward the church—particularly a tendency for participants to experience lingering negative affect and rumination about their treatment by the church—mediates this association. Analysis of responses to an online survey about participants’ experiences of chronic ostracism revealed the predicted association between perceived injustice and both anxiety and loneliness but not depression and supported our prediction that emotional-ruminative unforgiveness explains this association. Our findings also call into question whether the psychological outcomes of prolonged social exclusion are necessarily chronic and debilitating.
Managing uncertainty and references to time in prognostic conversations with family members at the end of life: A conversation analytic study
Authors: Anderson Rebecca J , Stone Patrick C , Low Joseph T S , Bloch Steven
Published: April 2020

Background:

When patients are likely to die in the coming hours or days, families often want prognostic information. Prognostic uncertainty and a lack of end-of-life communication training make these conversations challenging.

Aim:

The objective of this study is to understand how clinicians and the relatives/friends of patients at the very end of life manage uncertainty and reference time in prognostic conversations.

Design:

Conversation analysis of audio-recorded conversations between clinicians and the relatives/friends of hospice inpatients.

Setting/participants:

Experienced palliative care clinicians and relatives/friends of imminently dying hospice inpatients. Twenty-three recorded conversations involved prognostic talk and were included in the analysis.

Results:

Requests for prognostic information were initiated by families in the majority of conversations. Clinicians responded using categorical time references such as ‘days’, allowing the provision of prognostic estimates without giving a precise time. Explicit terms such as ‘dying’ were rare during prognostic discussions. Instead, references to time were understood as relating to prognosis. Relatives displayed their awareness of prognostic uncertainty when requesting prognostic information, providing clinicians with ‘permission’ to be uncertain. In response, clinicians often stated their uncertainty explicitly, but presented evidence for their prognostic estimates, based on changes to the patient’s function previously discussed with the family.

Conclusion:

Prognostic uncertainty was managed collaboratively by clinicians and families. Clinicians were able to provide prognostic estimates while being honest about the related uncertainty, in part because relatives displayed their awareness of uncertainty within their requests. The conversation analytic method identified contributions of both clinicians and families, and identified strategies based on real interactions, which could inform communication training.
Real-time dynamic 3-T MRI assessment of spine kinematics: a feasibility study utilizing three different fast pulse sequences
Authors: Walter William R , Alizai Hamza , Bruno Mary , Portugal Salvador , Burke Christopher J
Published: April 2020

Background

Half-Fourier acquisition single-shot turbo spin-echo (HASTE), continuous radial gradient-echo (GRE), and True FISP allow real-time dynamic assessment of the spine.

Purpose

To evaluate the feasibility of adding dynamic sequences to routine spine magnetic resonance imaging (MRI) for assessment of spondylolisthesis.

Material and Methods

Retrospective review was performed of patients referred for dynamic MRI of the cervical or lumbar spine between January 2017 and 2018 who had flexion-extension radiographs within two months of MRI. Exclusion criteria were: incomplete imaging; spinal hardware; and inability to tolerate dynamic examination. Blinded, independent review by two board-certified musculoskeletal radiologists was performed to assess for spondylolisthesis (>3 mm translation); consensus review of dynamic radiographs served as the gold standard. Cervical spinal cord effacement was assessed. Inter-reader agreement and radiographic concordance was calculated for each sequence.

Results

Twenty-one patients were included (8 men, 13 women; mean age 47.9 ± 16.5 years). Five had MRI of the cervical spine and 16 had MRI of the lumbar spine. Mean acquisition time was 18.4 ± 1.7 min with dynamic sequences in the range of 58–77 s. HASTE and True FISP had the highest inter-reader reproducibility (κ = 0.88). Reproducibility was better for the lumbar spine (κ = 0.94) than the cervical spine (κ = 0.28). Sensitivity of sequences for spondylolisthesis was in the range of 68.8%–78.6%. All three sequences had high accuracy levels: ≥90.5% averaged across the cervical and lumbar spine. Cervical cord effacement was observed during dynamic MRI in two cases (100% agreement).

Conclusion

Real-time dynamic MRI sequences added to spine MRI protocols provide reliable and accurate assessment of cervical and lumbar spine spondylolisthesis during flexion and extension.
The Role of the Medical Expert in the Retrospective Assessment of Testamentary Capacity
Authors: Shulman Kenneth , Herrmann Nathan , Peglar Hayley , Dochylo Daniel , Burns Clare , Peisah Carmelle
Published: April 2020

Objectives:

Physicians and other mental health experts are increasingly called on to assist the courts with the determination of testamentary capacity. We aim to improve the understanding of the retrospective assessment of testamentary capacity for medical experts in order to provide more useful reports for the court’s determinations and to provide a methodology for the retrospective assessment of testamentary capacity.

Method:

Medical experts with experience in the retrospective assessment of testamentary capacity collaborated with lawyers who practice estate litigation. The medical literature on the assessment of testamentary capacity was reviewed and integrated. The medical experts provided a clinical perspective, while the lawyers ensured that the case law and legal perspective were integrated into this review.

Results:

The focus and limitations of the medical expert are outlined including the need to be objective, nonpartisan, and fair. For the benefit of the court, the medical expert should describe the nature and severity of relevant medical, psychiatric, and cognitive disorders, and how they may impact on the specific criteria for testamentary capacity as defined by the leading case of Banks v Goodfellow. Medical experts should opine only on the issue of vulnerability to influence and defer to the court to determine the facts of the case regarding any influence that may have been exerted.

Conclusions:

Although the ultimate determination of testamentary capacity is a legal one, medical experts can help the court achieve the most informed legal decision by providing relevant information on clinical issues that may impact the criteria for testamentary capacity.
Physical Activity, Screen Time, and Sleep Duration Among Youth With Chronic Health Conditions in the United States
Authors: Healy Sean , Foley John , Haegele Justin A.
Published: April 2020

Purpose:

To compare the degree to which youth with and without chronic conditions in the United States met physical activity (PA), screen time, and sleep duration guidelines.

Design:

A cross-sectional study using data from the 2016 National Survey of Children’s Health.

Participants:

A total of 24 405 youth (aged 10-17 years) with and without 1 of 19 prevalent chronic health conditions who participated in the 2016 National Survey of Children’s Health.

Measures:

Parents reported on the time spent by their children in PA, screen time, and sleep.

Analysis:

Descriptive and bivariate analyses were conducted to estimate and compare health behavior guideline adherence rates among children with and without chronic conditions.

Results:

Overall, 18.7% of children with chronic conditions did not meet any health behavior guidelines compared to 15.6% of children without chronic conditions. Children with hearing impairments, diabetes, and depression were most likely to not meet any health behavior guidelines (27.9%, 25.4%, and 21.7%, respectively). Of the 3 guidelines, children with and without chronic conditions were least likely to meet the PA guideline (18.6% and 21%, respectively).

Conclusions:

This study identifies specific groups of children with chronic conditions that are most at risk of not meeting health behavior guidelines. The findings highlight specific behaviors in most need of intervention for children with chronic conditions; PA was identified as the most frequently unmet guideline. Overall findings suggest a need for a more integrated, holistic view of health promotion for children with chronic conditions.
Serum Oxytocin Levels and Logical Memory in Older People in Rural Japan
Authors: Kunitake Yutaka , Imamura Yoshiomi , Mizoguchi Yoshito , Matsushima Jun , Tateishi Hiroshi , Murakawa-Hirachi Toru , Nabeta Hiromi , Kawashima Toshiro , Kojima Naoki , Yamada Shigeto , Monji Akira
Published: April 2020

Objective:

The present study aimed to investigate the relationship between serum oxytocin (OT) and logical memory among older people in rural Japan.

Methods:

This was a cross-sectional study using a survey conducted from October 2009 through March 2011. Most of the study was conducted as part of a national prevalence survey of dementia in Japan. The final sample comprised 385 community-dwelling people aged 65 years or older living in rural Japan. The mean age and standard deviation were 75.7 ± 6.76 years (144 men, mean age 75.0 ± 6.48 years; 241 women, mean age 76.2 ± 6.91 years). The participants underwent screening examinations for a prevalence survey of dementia. The screening examinations were the Mini-Mental State Examination, Clinical Dementia Rating, and “logical memory A” from the Wechsler Memory Scale–Revised (WMSR). We used the WMSR Logical Memory II delayed recall score (LM II-DR) to assess logical memory. Levels of serum OT were obtained using the enzyme immunoassay method.

Results:

Serum OT levels were significantly higher among women than men. The present study revealed that serum OT levels were positively associated with LM II-DR in older women living in rural Japan in multiple linear regression analyses.

Conclusions:

The present results suggested a positive correlation between OT and logical memory in older women living in rural Japan.
Pharmacy Personnel’s Involvement in Transitions of Care of Intensive Care Unit Patients: A Systematic Review
Authors: Rice Mikhaila , Lear Alyssa , Kane-Gill Sandra , Seybert Amy L. , Smithburger Pamela L.
Published: April 2020

Objective:

Do pharmacy personnel- (ie, pharmacist or pharmacy technician) driven interventions at transitions of care into or out of the intensive care unit (ICU) improve medication safety measures compared to interventions made by other health-care team members or no intervention?

Data Sources:

A literature search of MEDLINE and Embase limited to English language and humans was performed (from 1969 until January 2019). Bibliographies of included investigations were reviewed for additional citations.

Methods:

Investigations were selected if they described a pharmacy-driven intervention at any point of transfer into or out of an ICU setting. Ten investigations were included. Five described interventions relevant to the entire ICU population, and 5 described interventions targeted to specific medications or disease.

Results:

A variety of interventions were utilized in the 10 included investigations. A significant improvement was demonstrated with pharmacy-driven intervention in all 4 studies that evaluated the entire ICU patient population. Interventions specific to certain medication and disease improved medication safety measures but were not always statistically significant. Medication error rates are high in patients transferred into and out of the ICU, and limited data exist to address this concern. This review compares and evaluates the current literature to guide future interventions and research in this area.

Conclusions:

Although pharmacy-driven interventions demonstrated some benefit in various medication safety measures in the majority of studies, additional randomized and prospective trials with patient-centered outcomes that assess morbidity and mortality are needed.
Determined to succeed: Can goal commitment sustain interagency collaboration?
Authors: Scott Rodney James , Boyd Ross
Published: April 2020

Governments have struggled with addressing problems that cross agency boundaries. Since 2012, the New Zealand Government has achieved significant success by holding groups of agencies collectively responsible for achieving intermediate outcome targets (the ‘Results Programme’). The Results Programme has been described as the most important change in how public services are delivered in New Zealand in 20 years. This article uses a mixed methods approach to triangulate 10 features of the Results Programme that appear to contribute to its success. Collaboration literature typically focuses on reducing barriers, often expressed in terms of transaction costs; in contrast, the successes of the Results Programme are explained here as methods for engineering a sense of joint goal commitment, that provides the sustained impetus to succeed despite the barriers encountered.
Hapless, helpless, hopeless: An analysis of stepmothers’ talk about their (male) partners
Authors: Roper Sandra , Capdevila Rose
Published: April 2020

The identity of stepmother is, in many ways, a troubled one – constructed as “other” and often associated with notions of “wickedness” in literature and everyday talk. This paper reports findings from a study on the difficulties faced by stepmothers and how they use talk about their (male) partners, often constructing men as hapless, helpless or hopeless, to repair their “troubled” identities. The data were collected from a web forum for stepmothers based in the UK and 13 semi-structured face-to-face interviews with stepmothers. The analysis took a synthetic narrative-discursive methodological approach, underpinned by feminist theory with particular attention to the discourses that were drawn on by participants and the constraints that these imposed. This paper presents these findings in relation to three constructions of their partners through which repair work was attempted: men as in need of rescue; men as flawed fathers; and men as damaged. The paper concludes with some suggestions for supporting stepmothers by challenging dominant narratives around families in talk, in the media and in government and institutional policies.
The Neuronal Regeneration of Adult Zebrafish After Spinal Cord Injury Is Enhanced by Transplanting Optimized Number of Neural Progenitor Cells
Authors: Zeng Chih-Wei , Sheu Jin-Chuan , Tsai Huai-Jen
Published: April 2020

Cell transplantation is commonly used to study the regeneration and repair of the nervous system in animals. However, a technical platform used to evaluate the optimum number of transplanted cells in the recipient’s spinal cord is little reported. Therefore, to develop such platform, we used a zebrafish model, which has transparent embryos, and transgenic line huORFZ, which generates green fluorescent protein (GFP)-expressing cells in the central nervous system under hypoxic stress. After GFP-expressing cells, also termed as hypoxia-responsive recovering cells, were obtained from hypoxia-exposed huORFZ embryos, we transplanted these GFP-(+) cells into the site of spinal cord injury (SCI) in adult wild-type zebrafish, followed by assessing the relationship between number of transplanted cells and the survival rate of recipients. When 100, 300, 500, and 1,000 GFP-(+) donor cells were transplanted into the lesion site of SCI-treated recipients, we found that recipient adult zebrafish transplanted with 300 donor cells had the highest survival rate. Those GFP-(+) donor cells could undergo proliferation and differentiation into neuron in recipients. Furthermore, transplantation of GFP-(+) cells into adult zebrafish treated with SCI was able to enhance the neuronal regeneration of recipients. In contrast, those fish transplanted with over 500 cells showed signs of inflammation around the SCI site, resulting in higher mortality. In this study, we developed a technological platform for transplanting cells into the lesion site of SCI-treated adult zebrafish and defined the optimum number of successfully transplanted cells into recipients, as 300, and those GFP-(+) donor cells could enhance recipient’s spinal cord regeneration. Thus, we provided a practical methodology for studying cell transplantation therapy in neuronal regeneration of zebrafish after SCI.
Isolation and pathogenicity testing of avian reticuloendotheliosis virus from layer chickens in China
Authors: Xu Ahui , Huo Caiyun , Zhong Qi , Xu Meiyu , Yang Yurong , Tian Haiyan , Zhang Guozhong , Hu Yanxin
Published: April 2020

Reticuloendotheliosis virus (REV) can cause runting, immunosuppression, acute reticulum cell neoplasia, and chronic lymphoid tumors in a variety of domestic and wild birds. We diagnosed a case of reticuloendotheliosis with obvious tumors in liver and kidney. We isolated and sequenced the virus and performed pathogenicity testing of the REV strain. Immunohistochemistry and PCR confirmed that the diseased layer chickens were infected with REV. The strain, named BJ1503, was successfully isolated from the case by inoculation of tissue homogenates onto chicken embryo fibroblasts. The length of the proviral REV genome is 8,293 nucleotides. The isolate had 99.7% identity with REV-HA9901 (AY842951.1), which was isolated from Jiangsu, China, in 1999. The chickens infected with REV-BJ1503 had depressed weight gain and lymphoid atrophy. Our findings suggest that REV isolate BJ1503 was phylogenetically close to the earlier strain found in China, with minor variations, and the virus was associated with severe production problems.
Pathways From Parental Substance Use to Child Internalizing and Externalizing Behaviors in a Child Protective Services Sample
Authors: Seay Kristen D.
Published: April 2020

This study examines the role of mediation in the pathway from parental substance use to children developing child internalizing and externalizing behaviors. Using the National Survey of Child and Adolescent Well-Being II, a random half sample (i.e., split-half approach) of children aged 18 months to 17 years who remained in the home following a child welfare investigation ( N = 1,633) was used to examine direct and mediated pathways from parental self-reported alcohol and drug use to, separately, parent report of child internalizing and externalizing behaviors. Four parallel mediators were examined: child-reported exposure to violence, child-reported parental monitoring, parent-reported harsh physical discipline, and parent-reported emotional maltreatment. The strongest models for both parental alcohol and drug use to internalizing and externalizing behaviors were single-mediator models through emotional maltreatment. Results suggest emotional maltreatment is a crucial intervention target for families with substance use disorders. Parenting interventions must also strengthen parent–child relationships in order to be effective at improving child outcomes.
Two-dimensional bending behavior of the three-layered shear deformable nanoshells: Electro-elastic size-dependent
Authors: Arefi Mohammad
Published: April 2020

First-order shear deformation theory and nonlocal piezoelasticity relations are employed in this work for size-dependent electro-elastic bending analysis of three-layered piezoelectric nanoshells. The three-layered nanoshell includes a nano core and two piezo-magnetic face-sheets as sensor and actuator. A two-dimensional formulation along the axial and radial directions is presented based on first-order shear deformation theory to account shear strains and stresses especially at boundaries. Principle of virtual work is used to derive the governing equations of electro-elastic bending for a size-dependent piezoelectric nanoshell. The numerical results are presented based on analytical approach to investigate the influence of significant parameters such as nonlocal parameter, two parameters of Pasternak’s foundation and initial electric potential on the electro-elastic bending results.