bluuebunny/crossref_metadata_2025 huggingface dataset:
Protective Effects of Acridocarpus smeathmannii (DC.) Guill. & Perr. Root Extract against Phenylhydrazine-Induced Haematotoxicity, Biochemical Changes, and Oxidative Stress in Rats
Authors: Kale Oluwafemi Ezekiel , Awodele Olufunsho , Akindele Abidemi James
Published: November 2019

Several strategies for discovering drugs from unexplored natural products continue to strengthen research and development with current commercial evidence supporting their applications. We assessed the effects of the hydroethanolic extract of Acridocarpus smeathmannii root (HEASR) against phenylhydrazine (PHZ)-induced haematotoxicity, biochemical changes, and oxidative stress in male Wistar rats. Groups 1 and 2 controls received normal saline (10 mL/kg/day) and PHZ (60 mg/kg, day 4 and 5), respectively, via oral gavage. Groups 3, 4, and 5 were administered dexamethasone (DXM, 0.014 mg/kg/day, p.o.), HEASR1 (50 mg/kg/day, p.o.) and HEASR2 (200 mg/kg/day, p.o.), respectively. Groups 6, 7, and 8 received HEASR2 (200 mg/kg/day), DXM (0.014 mg/kg/day), or their combination, respectively, and further received PHZ (60 mg/kg/day) intervention on day 4 and 5 only. Treatments lasted for 7 days. Phenylhydrazine toxicity manifested as lowered haemoglobin, white blood cells, lymphocytes, red blood cells, and platelet levels by 45.86%, 53.47%, 75.69%, 46.89%, and 30.29%, respectively, in rats. This was accompanied by an increase in serum alanine (ALT; 108.25%) and aspartate (AST; 78.79%) aminotransferases, urea (84.36%), total cholesterol (81.55%), and triglycerides (123.42%) levels. Similarly, malondialdehyde levels and serum cyclooxygenase-2 activity were elevated ( P < 0.05) in the rats liver and spleen, respectively. Just HEASR alone, or in combination with DXM, preserved haematological and biochemical parameters, cyclooxygenase-2 activity, and corticosterone levels during PHZ intoxication and restored renal histopathological alterations in rats. The HEASR was found to contain high flavonoid and phenolic phytochemicals and demonstrated better in vitro antioxidants inhibitory action.
Preparation and tribological properties of a kind of lubricant containing cerium borate nanoparticles as additives
Authors: Hao Lifeng , Cao Feng , Jiang Zewen , Li Jiusheng , Ren Tianhui
Published: November 2019

Oil-soluble compounds containing boron as lubricating additives were restricted by the hydrolysis of borate ester. In order to overcome this problem, cerium borate nanoparticles modified with oleic acid (O-CeB) as a potential substitute for conventional lubricant additive were studied in detail. The microstructures of the prepared nanoparticles were characterized. Tribological properties of cerium borate nanoparticles used as additive in base oil were evaluated, and the worn surface of the steel ball was investigated. The results show that O-CeB possesses better anti-wear ability at relatively higher concentration; in particular, it shows better friction-reducing ability under all these studied concentrations. Under higher load, its anti-wear property and friction-reducing property are better than that of Vanlube 289 in the base oil. Based on these results of interferometric surface profilometer and X-ray photoelectron spectroscopy, it can be deduced that a continuous resistance film containing depositions and the tribochemical reaction products was formed during the sliding process.
Speech perception, real-ear measurements and self-perceived hearing impairment after remote and face-to-face programming of hearing aids: A randomized single-blind agreement study
Authors: Venail Frederic , Picot Marie C , Marin Gregory , Falinower Sylvain , Samson Jacques , Cizeron Gilles , Balcon Maxime , Blanc Denis , Bricaud Jeremy , Lorenzi Antoine , Ceccato Jean-Charles , Puel Jean-Luc
Published: November 2019

Introduction

Current literature does not provide strong evidence that remote programming of hearing aids is effective, despite its increasing use by audiologists. We tested speech perception outcomes, real-ear insertion gain, and changes in self-perceived hearing impairment after face-to-face and remote programming of hearing aids in a randomized multicentre, single-blind crossover study.

Methods

Adult experienced hearing aid users were enrolled during routine follow-up visits to audiology clinics. Hearing aids were programmed both face to face and remotely, then participants randomly received either the face-to-face or remote settings in a blinded manner and were evaluated 5 weeks later. Participants then received the other settings and were evaluated 5 weeks later.

Results

Data from 52 out of 60 participants were analysed. We found excellent concordance in performance of hearing aids programmed face to face and remotely for speech understanding in quiet (phonetically balanced kindergarten test – intraclass correlation coefficient of 0.92 (95% confidence interval: 0.87–0.95)), and good concordance in performance for speech understanding in noise (phonetically balanced kindergarten +5 dB signal-to-noise ratio – intraclass correlation coefficient of 0.71 (95% confidence interval: 0.55–0.82)). Face-to-face and remote programming took 10 minutes (±2.9) and 10 minutes (±2.8), respectively. Real-ear insertion gains were highly correlated for input sound at 50, 65 and 80 dB sound pressure levels. The programming type did not affect the abbreviated profile of hearing aid questionnaire scores.

Conclusions

In experienced hearing aid users, face-to-face and remote programming of hearing aids give similar results in terms of speech perception, with no increase in the time spent on patients’ care and no difference in self-reported hearing benefit.

ClinicalTrials.gov Identifier

NCT02589561
How to Validate Data Quality in a Trauma Registry? The Helsinki Trauma Registry Internal Audit
Authors: Heinänen M. , Brinck T. , Lefering R. , Handolin L. , Söderlund T.
Published: November 2019

Background and Aims:

Trauma registry data are used for analyzing and improving patient care, comparison of different units, and for research and administrative purposes. Data should therefore be reliable. The aim of this study was to audit the quality of the Helsinki Trauma Registry internally. We describe how to conduct a validation of a regional or national trauma registry and how to report the results in a readily comprehensible form.

Materials and Methods:

Trauma registry database of Helsinki Trauma Registry from year 2013 was re-evaluated. We assessed data quality in three different parts of the data input process: the process of including patients in the trauma registry (case completeness); the process of calculating Abbreviated Injury Scale (AIS) codes; and entering the patient variables in the trauma registry (data completeness, accuracy, and correctness). We calculated the case completeness results using raw agreement percentage and Cohen’s κ value. Percentage and descriptive methods were used for the remaining calculations.

Results:

In total, 862 patients were evaluated; 853 were rated the same in the audit process resulting in a raw agreement percentage of 99%. Nine cases were missing from the registry, yielding a case completeness of 97.1% for the Helsinki Trauma Registry. For AIS code data, we analyzed 107 patients with severe thorax injury with 941 AIS codes. Completeness of codes was 99.0% (932/941), accuracy was 90.0% (841/932), and correctness was 97.5% (909/932). The data completeness of patient variables was 93.4% (3899/4174). Data completeness was 100% for 16 of 32 categories. Data accuracy was 94.6% (3690/3899) and data correctness was 97.2% (3789/3899).

Conclusion:

The case completeness, data completeness, data accuracy, and data correctness of the Helsinki Trauma Registry are excellent. We recommend that these should be the variables included in a trauma registry validation process, and that the quality of trauma registry data should be systematically and regularly reviewed and reported.
Episodes of concealing: the invisibility of political ontologies in sacred forests
Authors: Smith Thomas Aneurin
Published: November 2019

Indigenous research has demonstrated how Indigenous ontologies are political and how they have been articulated politically to express counter-narratives to modern understandings of human–nature relations. This article argues that current characterisations of political ontology, particularly in relation to environmental conservation, have yet to fully take account of African Indigenous spiritualities. Current thinking on Indigenous ontologies and decolonial scholarship, and their political manifestations, faces two problems: (1) they assume the visibility and availability of Indigenous ontologies to ‘doing politics’ and (2) presumptions are made about the comparability of place-based Indigenous ontologies and wider attempts to reform the state, and that the political goals of Indigenous people will straightforwardly align with those of the researcher. Drawing from research on sacred natural site protection among the Nyiha in Mbozi District, southwestern Tanzania, I examine how these problems might be addressed in a context where notions of Indigeneity are articulated quite differently to those predominantly evident in current writing on Indigeneity and decolonial scholarship. Nyiha ontologies, although already-political at the local scale, resist becoming ‘available’ to environmental politics at wider scales, making straightforward notions of solidarity problematic. Through a particular encounter with Christian groups attempting to spatially appropriate Nyiha sites, I explore the various ways in which ontologies are made politically available and visible and how the Nyiha analyse Christianity as colonial. Finally, I turn to how Nyiha ontologies and their sacred forest sites are replete with ‘episodes of concealing’ and variable invisibilities, which call into question how visible practices are utilised as ‘evidence-of-ontology’, or as part of a wider decolonial project.
Tracing Long- and Short-term Migrants for Participation in Demographic and Epidemiological Studies: Evidence from Senegal
Authors: Kanyangarara Mufaro , Douillot Laetitia , Pison Gilles , Ndiaye Cheikh Tidiane , Delaunay Valerie , Helleringer Stephane
Published: November 2019

Migration of participants in demographic and epidemiological studies results in missing data. One approach to reduce resulting losses in statistical power and potential biases is to follow up migrants at their new residence. We describe the follow-up of migrants who were eligible for participation in a trial of a new questionnaire to measure adult mortality in Niakhar, Senegal. We conducted a short inquiry in the migrant’s last known household to obtain contact information and then attempted to contact and interview 661 migrants who resided in Dakar, Mbour, and rural areas close to Niakhar. About two-thirds of migrants were successfully enrolled in the study. Having a contact phone number and knowing the name of the head of compound at destination increased the likelihood of successful enrollment. Following up migrants in demographic studies is feasible in low- and middle-income countries, including long-term migrants who have not been contacted for extended periods of time.
The BodyMind Approach® as Transformative Learning to Promote Self-Management for Patients With Medically Unexplained Symptoms
Authors: Payne Helen , Roberts Amanda , Jarvis Joy
Published: November 2019

This article describes how adults learn to self-manage chronic bodily symptoms, a complex and costly health problem. It proposes a theory of learning for an innovative, research-informed intervention, The BodyMind Approach® (TBMA) aimed at developing confidence, competence, skills, and knowledge and understanding for self-management for people with medically unexplained symptoms. TBMA is interdisciplinary, combining embodiment and arts in health with transformative learning. Having explored the problem, the article presents TBMA and argues for how it cultivates the type of learning which sustains the self-management of symptoms. Promoting self-management fills the gap between patient needs and health service capacity. Previous studies identify learning through this method enables people to manage their symptoms when under stress in an ever-changing environment, supporting sufficient structure, agency, reflexivity, self-efficacy, and self-regulatory strategies to maintain resilience in the face of life adversity, despite their symptoms.
A deep learning platooning-based video information-sharing Internet of Things framework for autonomous driving systems
Authors: Zhou Zishuo , Akhtar Zahid , Man Ka Lok , Siddique Kamran
Published: November 2019

To enhance the safety and stability of autonomous vehicles, we present a deep learning platooning-based video information-sharing Internet of Things framework in this study. The proposed Internet of Things framework incorporates concepts and mechanisms from several domains of computer science, such as computer vision, artificial intelligence, sensor technology, and communication technology. The information captured by camera, such as road edges, traffic lights, and zebra lines, is highlighted using computer vision. The semantics of highlighted information is recognized by artificial intelligence. Sensors provide information on the direction and distance of obstacles, as well as their speed and moving direction. The communication technology is applied to share the information among the vehicles. Since vehicles have high probability to encounter accidents in congested locations, the proposed system enables vehicles to perform self-positioning with other vehicles in a certain range to reinforce their safety and stability. The empirical evaluation shows the viability and efficacy of the proposed system in such situations. Moreover, the collision time is decreased considerably compared with that when using traditional systems.
Boundary layer flow and heat transfer in a thin-film second-grade nanoliquid embedded with graphene nanoparticles
Authors: Khan Noor Saeed , Zuhra Samina
Published: November 2019

The two-dimensional magnetohydrodynamic unsteady movement and transmission of energy confined to finite domain layer of the second-grade nanofluid embedded with graphene nanoparticles on an expanding space are studied. Graphene nanoparticles have continuous electrical conductivity because the charge carrier movement in graphene bears extremely peak points compared to the available nanomaterials. The well-known system of equations for movement and energy of the second-grade nanofluid film accompanying the additional information have been transformed into the fourth-order coupled differential systems accompanying the auxiliary facts on behalf of simplifying substitutions. The simplified systems are evaluated via an efficient approach through homotopy analysis method which provides very clear relations for the motion and energy representatives. All the potential factors of the output are debated and portrayed pictorially. The results are useful in the analysis, design of coating, and cooling/heating processes.
An Old Law for a New Literature: Authors, Publishers and the Early Years of the Victorian Copyright Act 1869
Authors: Ailwood Sarah , Sainsbury Maree
Published: November 2019

This article analyses the early years of the operation of copyright legislation in the colony of Victoria, Australia. The Copyright Act 1869 (Vic) was introduced into a thriving but volatile colonial literary marketplace. The law was based almost wholly on the UK law at the time, existing in a very different environment. This article notes that despite the rhetoric of the protection of the right of authors as an aim of the law, the effect was something quite different. We examine the use of copyright by some key players in that colonial market, both publishers and authors. That analysis reveals that the prophetic words of George Higinbotham, that the law was not for the protection of the author, but the publisher, can be demonstrated to be true. This is evident both in the implementation of the law itself and in a number of inconsistencies in its operation. We conclude that, despite public and parliamentary rhetoric drawing on the romantic conception of the author as creator, the law’s conception of the author as proprietor offered little protection to local Australian authors writing new literature for a new country.
The State of Emergency and the State Without a Name in Carl Schmitt’s Thought: A Proposal for Radical Separation
Authors: Engelking Wojciech
Published: November 2019

The concept of the state of emergency is one of the most frequently evoked elements from Carl Schmitt’s thought. In discussions which are referring to it, however, the conceptualization of the state of emergency, which Schmitt proposed in his juridical comment on Article 48 of the Weimar Republic’s constitution, is often linked with the theory of Ausnahmezustand. In this article I propose to separate the state of emergency from Ausnahmezustand. The main difference between the two consists in the different types of legitimacy. The state of emergency from the Constitution of the Weimar Republic finds its legitimacy in this document, however, read by Schmitt in a way that in his Constitutional Theory, he referred to it as relativization. To find legitimacy of the state without a name, one must refer to Schmitt’s political theology as not just a proposal rooted in the faith in Revelation.
Mapping the Social-Norms Literature: An Overview of Reviews
Authors: Legros Sophie , Cislaghi Beniamino
Published: November 2019

The theoretical literature on social norms is multifaceted and at times contradictory. Looking at existing reviews, we aimed to offer a more complete understanding of its current status. By investigating the conceptual frameworks and organizing elements used to compare social-norms theories, we identified four theoretical spaces of inquiry that were common across the reviews: what social norms are, what relationship exists between social norms and behavior, how social norms evolve, and what categories of actors must be considered in the study of social norms. We highlight areas of consensus and debate in the reviews around these four themes and discuss points of agreement and disagreement that uncover trajectories for future empirical and theoretical investigation.
Climate change and migration in the UK news media: How the story is told
Authors: Sakellari Maria
Published: November 2019

This research article explores the textual and visual representations of climate change induced migration within online news media in the UK. This article innovates in two-senses: it demonstrates how images interact with text to co-construct and present specific discursive packages to the general public, and also by pinning down their content more precisely to understand how they might affect policy and public understanding of the issue. Despite their differences, similar policy options emerge in relation to divergent discursive packages. The figure of climate migrant/refugee is depoliticised and divested of context and complexity, and as such it resembles the referent objects of securitising claims. This article suggests that this may work in favour of xenophobic sentiments and policies and, ultimately, deepen existing migrant and refugee integration challenges in traditional host societies.
Improving satisfaction with postoperative pain management for patients with persistent pain: a preoperative pain medicine consultation intervention
Authors: Mazer Laura S , Lovett Pamela J , Miller Joanne M , Pitruzzello Nancy E , Boone Margaret K , Irizarry Alvarado Joan M
Published: November 2019

Purpose

Preoperative pain medicine consultations with opioid-tolerant patients allow for an accurate medication history, patient involvement in the postoperative plan, and realistic goal setting. The purpose of this quality improvement project was to increase attendance at preoperative pain consultations, thereby increasing patient satisfaction.

Methods

Retrospective chart reviews identified patients who had a preoperative pain consultation ordered from May through July 2016. Patient interviews determined reasons for not attending appointments, involvement in goal setting, engagement in pain management planning, and satisfaction with postoperative pain management.

Results

Retrospective chart reviews and interviews were conducted after the intervention (May–July 2017). Scheduling changes increased attendance at preoperative pain consultations by 14 percentage points (50% vs 64%). Those who attended consultations were more involved in goal setting and decisions and were more satisfied.

Conclusions

Preoperative pain consultations with opioid-tolerant patients can increase satisfaction through realistic goal setting and involvement in the pain management plan.
Mass spectrometry-based metabolomics for irritable bowel syndrome biomarkers
Authors: Yu Qihong , Liu Xinru , Huang Haojie , Zheng Xingfeng , Pan Xue , Fang Junwei , Meng Liyuan , Zhou Chunhua , Zhang Xiaocui , Li Zhaoshen , Zou Duowu
Published: November 2019

Background:

Irritable bowel syndrome (IBS) is a common gastrointestinal disorder without obvious structural abnormalities or consistent associated biomarkers, making its diagnosis difficult. In the present study, we used a urine-based metabolomics approach to identify IBS biomarkers.

Methods:

We used an ultra-performance liquid chromatography/quadrupole time-of-flight mass spectrometry (UPLC-QTOF-MS) on urine samples from patients suffering from IBS and healthy controls. Data were coupled for multivariate statistical analysis methods.

Results:

We selected 30 differential metabolites associated with IBS and found steroid hormone biosynthesis and histidine metabolism alterations in patients with IBS that may be involved in the pathogenesis of the disease. In addition, we identified a panel of five metabolite markers composed of cortisone, citric acid, tiglylcarnitine, N6,-N6,-N6-trimethyl-L-lysine and L-histidine that could be used to discriminate between patients and healthy controls and may be appropriate as IBS diagnosis biomarkers.

Conclusion:

Our findings indicate that metabolomics combined with pattern recognition can be useful to identify disease diagnostic IBS markers.

Clinical trial registration:

ChiCTR1800020072
A Simulation Study to Assess the Effect of Analytic Error on Neonatal Glucose Measurements Using the Canadian Pediatric Society Position Statement Action Thresholds
Authors: Inman Mark , Parker Kayla , Strueby Lannae , Lyon Andrew W. , Lyon Martha E.
Published: November 2019

Background:

The Canadian Pediatric Society (CPS) has endorsed an algorithm for the screening and immediate management of babies at risk of neonatal hypoglycemia that provides time-dependent glucose concentration action thresholds. The objective of this study was to evaluate the impact of glucose analytic error (bias and imprecision) on the misclassification of glucose meter results from a neonatal intensive care unit (NICU) using the CPS guidelines.

Methods:

A simulation dataset of true glucose values ( N = 100 000) was derived by finite mixture model analysis of NICU glucose data ( N = 23 749). Bias and imprecision were added to create measured glucose values. The percentages of measured glucose values that were misclassified at CPS action thresholds were determined by Monte Carlo simulation.

Results:

Measurement biases ranging from −20 to +20 mg/dL combined with coefficients of variation 0% to 20% were evaluated to predict misclassification rates at 32, 36, and 47 mg/dL. The models demonstrated low risk of false normoglycemia—at 5% CV and +10 mg/dL bias: 0.8% to 5% misclassification at the 32 and 47 mg/dL thresholds due to bias. The models demonstrated risk of false hypoglycemia—at 5% CV and −10 mg/dL bias: 3% to 12.5% misclassification at 32 and 47 mg/dL thresholds due to both bias and imprecision.

Conclusion:

Using CPS action thresholds, the simulation model predicted the proportion of neonates at risk of inappropriate clinical action—both of omission or “failure to treat” and commission or “overtreatment” in response to NICU glucose meter results at specific bias and imprecision values.
Between health and salary: The incomplete regulation of working time in European law
Authors: Ferrante Vincenzo
Published: November 2019

The European Union competences on health and safety of workplace constituted the legal basis for the 93/104 Directive to be adopted (and for the consolidated text of 2003/88 Directive). The Court of Justice has firmly maintained this approach refusing to take into account the history of international regulation on working time, which links together work and salary in perspective to give the workers the right to fair and equal treatment as regards their working conditions (as has been recently proclaimed also by the European Pillar of Social Rights). Building on these general premises, this article analyses the more recent European pieces of legislation and cases related to on-call time and proposes a new model for the definition of working time in the light of CJEU case law.
Adjunctive ceftaroline in combination with daptomycin or vancomycin for complicated methicillin-resistant Staphylococcus aureus bacteremia after monotherapy failure
Authors: Hornak Joseph Patrik , Anjum Seher , Reynoso David
Published: November 2019

Background:

Methicillin-resistant Staphylococcus aureus bacteremia (MRSA-B) may fail to improve with standard monotherapy, particularly in patients with multifocal infection, incomplete source control, or persistent bacteremia. Synergy observed in vitro between ceftaroline (CPT) and daptomycin (DAP) or vancomycin (VAN) may translate into clinical benefit. Here, we describe our experience with DAP/CPT and VAN/CPT for complicated MRSA-B after monotherapy failure.

Methods:

Single-center, retrospective review of consecutive patients treated with DAP/CPT or VAN/CPT for MRSA-B after monotherapy failure from 1 January 2016 to 30 November 2018.

Results:

We identified 11 instances of combination therapy in 10 patients (DAP/CPT = 6, VAN/CPT = 5) with 1 patient receiving VAN/CPT followed by DAP/CPT. Rates of multifocal infection, incomplete source control, persistent bacteremia, and infective endocarditis were high (100%, 80%, 60%, and 60%, respectively). Combination therapy was initiated most commonly for persistent bacteremia (60%). When patients were persistently bacteremic, median preceding duration was 13 days and median time to clearance was 3 days. Total microbiologic cure rate was 100%. There were zero instances of bacteremia relapse at 30 days (30D) or 60 days (60D). All-cause 30D and 60D mortality rates were 11.1% and 33.3%, respectively.

Conclusions:

Combination therapy demonstrated success in diverse cases of refractory MRSA-B, including instances of persistent bacteremia paired with incomplete source control. Optimal timing and therapeutic cadence for combination therapy remain unclear. Our findings suggest that DAP/CPT and VAN/CPT can be considered for complicated MRSA bacteremia when other treatment options fail or are unavailable. We propose persistent bacteremia with incomplete source control to be a clinical niche particularly worthy of further investigation.
The Early 1990s and Its Afterlives: Transgender Nation Sociality in Digital Activism
Authors: Steinbock Eliza
Published: November 2019

This article considers the continuities afforded by digital platforms for reactivating the 1990s Transgender Nation politics, by providing a means to bond like-minded people into imagined nations cohered into an affective public. The media archeology approach facilitates the investigation into stylistic and conceptual continuities between the 1992 and 1994 Transgender Nation’s “direct action” and militant politics into cases of digital activism from 1995 until 2016. The article further tracks early queer and trans connection and discord into later digital incarnations. The author considers digital culture as a significant site for personal and group transformation, but finds in the touchstone activities of Transgender Day of Remembrance an imagined community styled by necropolitical attunements. Direct actions online are still fueled by contesting hostility to trans life, but the critique of transgender marginalization must also account for sexual and racial dynamics.
The 2019 Australian election
Authors: Johnson Carol
Published: November 2019

Opinion polls suggested that Australia’s Coalition (Liberal and National Party) government was likely to be replaced by a Labor government at the 2019 election. However, in fact the government was returned. Key issues in the 2019 election centred around managing the economy, including levels of taxation and issues of inequality; around spending on government services such as health and education; and around issues of climate change. There were elements of populism in both major parties’ campaigns, and two minor populist parties played a significant role in preference distribution. There were also some simmering issues that reflect the broader geopolitical and geo-economic changes that are impacting upon Australia. These include not only challenges for Australia’s economy and identity in the ‘Asian Century’, but also issues of Australia’s relationship with China.
Effects of Patient- and Family-Centered Care for Young Adults With Chronic Health Conditions and Their Family Members: A Systematic Review
Authors: Allen David , Scarinci Nerina , Hickson Louise
Published: November 2019

Patient- and family-centered care has been shown to improve outcomes across a range of health conditions. The purpose of this study was to determine the impact of interventions to improve the patient- and family-centeredness of care (PFCIs) on the effectiveness of care of young adults (16–25) with chronic health conditions. A segregated design mixed-methods systematic review with meta-analysis and meta-synthesis of the literature was conducted. Thirteen quantitative papers and three qualitative papers were identified for inclusion. Random-effects meta-analysis was performed on quantitative findings, and a meta-synthesis was performed on qualitative findings. Preliminary evidence suggests that PFCIs were associated with improvements in the self-efficacy of young people with chronic health conditions. However, there were very few identified studies, and those that were identified were primarily in the field of mental health, requiring ongoing further research.
Changes in Positive and Negative Affect During Pharmacological Treatment and Cognitive Therapy for Major Depressive Disorder: A Secondary Analysis of Two Randomized Controlled Trials
Authors: Dunn Barnaby D. , German Ramaris E. , Khazanov Gabi , Xu Colin , Hollon Steven D. , DeRubeis Robert J.
Published: November 2019

The cardinal symptoms of major depressive disorder (MDD) are heightened depressed mood (negative affectivity, or NA) and diminished interest or pleasure (positive affectivity, or PA). It is unknown how well treatments for MDD repair either symptom. Two secondary analyses of randomized controlled trials were therefore conducted. In Study 1, 180 adult outpatients with MDD received 16 weeks of antidepressant medication (ADM; n = 120) or cognitive therapy (CT; n = 60). In Study 2, adult outpatients with MDD were treated until remission with ADM ( n = 225) or ADM and CT ( n = 227). Across trials and treatments, intake disturbances were more marked in PA than NA, there was smaller repair of PA than NA during treatment, and disturbances remained more pronounced for PA than NA after treatment. Greater change in PA and NA were independently associated with depression symptom change. These findings suggest that depression treatments more effectively repair NA than PA and that outcomes may be improved with more effective targeting of the latter.
Cervical Computed Tomography Angiography Rarely Leads to Intervention in Patients With Cervical Spine Fractures
Authors: Dunn Conor John , Changoor Stuart , Issa Kimona , Moore Jeffrey , Moontasri Nancy J. , Faloon Michael Joseph , Sinha Kumar , Hwang Ki Soo , Ruoff Mark , Emami Arash
Published: November 2019

Study Design:

Retrospective cohort study.

Objectives:

To evaluate the impact of computed tomography angiography (CTA) in the management of trauma patients with cervical spine fractures by identifying high-risk patients for vertebral artery injury (VAI), and evaluating how frequently patients undergo subsequent surgical/procedural intervention as a result of these findings.

Methods:

All trauma patients with cervical spine fractures who underwent CTA of the head and neck at our institution between January 2013 and October 2017 were identified. Patients were indicated for CTA according to our institutional protocol based on the modified Denver criteria, and included patients with cervical fractures on scout CT. Those with positive VAI were noted, along with their fracture location, and presence or absence of neurological deficit on physical examination. Statistical analysis was performed and odds ratios were calculated comparing the relationship of cervical spine fracture with presence of VAI.

Results:

A total of 144 patients were included in our study. Of those, 25 patients (17.4%) were found to have VAI. Two patients (1.4%) with VAI underwent subsequent surgical/procedural intervention. Of the 25 cervical fractures with a VAI, 20 (80%), were found to involve the upper cervical region (4.2 OR, 95% CI 1.5-12.0; P = .007). Of the 25 who had a VAI, 9 were unable to undergo reliable neurologic examination. Of the remaining 16 patients, 5 (31.3%) had motor or sensory deficits localized to the side of the VAI, with no other attributable etiology.

Conclusions:

Cervical spine fractures located in the region of the C1-C3 vertebrae were more likely to have an associated VAI on CTA. VAI should also be considered in cervical trauma patients who present with neurological deficits not clearly explained by other pathology. Despite a finding of VAI, patients rarely underwent subsequent surgical or procedural intervention.
Multimorbidity at sea level and high-altitude urban and rural settings: The CRONICAS Cohort Study
Authors: Miranda J Jaime , Bernabe-Ortiz Antonio , Gilman Robert H , Smeeth Liam , Malaga German , Wise Robert A , Checkley William ,   CRONICAS Cohort Study Group
Published: November 2019

Objective:

To characterize the prevalence and clustering of multimorbidity in four diverse geographical settings in Peru.

Methods:

Multimorbidity, defined as having ≥2 chronic conditions, was studied in adults aged ≥35 years in four diverse settings in Peru: Lima, Tumbes, and urban and rural Puno. Six of these conditions (alcohol disorder, asthma, chronic obstructive pulmonary disease, depression, diabetes, and hypertension) were cataloged as objectively ascertained chronic conditions and paired in dyads to explore clusters of multimorbidity.

Results:

We analyzed data from 2890 adults, mean age 55.2 years, 49% males. Overall, 19.1% of participants had multimorbidity, ranging from 14.7% in semi-urban Tumbes to 22.8% in Lima. The dyads with the highest coexistence (approximately 20%) were observed in hypertension and diabetes in Tumbes, whereas the dyads with lowest coexistence (approximately 1%) were those involving asthma in all study sites. In terms of clusters, Tumbes showed a predominance of hypertension and diabetes, urban and rural Puno a predominance of depression and alcohol disorders, and Lima a higher degree of coexistence of all of the six conditions than in the other clusters.

Conclusion:

Multimorbidity is common and the pattern of clusters is highly heterogeneous. The conditions to prioritize will vary in each setting.
Health behaviour, social support, socio-economic status and the 5-year progression of multimorbidity: Results from the MultiCare Cohort Study
Authors: Schäfer Ingmar , Hansen Heike , Kaduszkiewicz Hanna , Bickel Horst , Fuchs Angela , Gensichen Jochen , Maier Wolfgang , Riedel-Heller Steffi G , König Hans-Helmut , Dahlhaus Anne , Schön Gerhard , Weyerer Siegfried , Wiese Birgitt , van den Bussche Hendrik , Scherer Martin
Published: November 2019

Background:

Multimorbidity in elderly patients is a major challenge for physicians, because of a high prevalence of and associations with many adverse outcomes. However, the mechanisms of progressing multimorbidity are not well-understood. The aim of our study was to determine if the progression of multimorbidity is influenced by health behaviour and social support and to analyse if the patients’ socio-economic status had an effect on these prognostic factors.

Methods:

The study was designed as prospective cohort study based on interviews of 158 GPs and 3189 patients randomly selected from GP records (response rate: 46.2%). Patients were aged 65–85 years at recruitment and observed in four waves of data collection (dropout rate: 41.5%). Statistical analyses of the ‘hot deck’ imputed data included multilevel mixed-effects linear regression allowing for random effects at the study centre and GP practice within study centre level.

Results:

Regarding cardiovascular and metabolic diseases, multimorbidity progressed more rapidly in patients who reported less physical activity ( ß = −0.28; 95% confidence interval = −0.35 to −0.20), had more tobacco-related pack years (0.15; 0.07–0.22) and consumed less alcohol (−0.21; −0.31 to −0.12) at baseline. Multimorbidity related to psychiatric and pain-related disorders progressed more rapidly if the patients had less perceived social support (−0.31; −0.55 to −0.07) and reported less physical activity (−0.08; −0.15 to −0.02) at baseline. Education and income only slightly modified the effects of these variables.

Conclusion:

Depending on the multimorbidity cluster, different strategies should be used for slowing down the progression of multimorbidity. Changing lifestyle and increasing social support are beneficial for the entire group of elderly multimorbid patients – regardless of their socio-economic status.

Registration:

ISRCTN89818205
Mahatma Gandhi and North East India
Authors: Syiemlieh David R.
Published: November 2019

It is of concern to many in the North East that despite the tremendous influence Gandhi had on the region, there is as yet no detailed study of this involvement. It is appropriate that the North-Eastern Regional Centre, Anthropological Survey of India, is commemorating the life and work of the Mahatma. To an organization engaged in anthropological studies working primarily in the fields of physical anthropology and cultural anthropology and maintaining focus on indigenous populations, the study of the Mahatma is relevant, in his own time and remains so today. So significant has been his impact on humankind that for generations to come this man of peace and unique leadership will be remembered and emulated. The presentation will focus on the Indian national movement and Gandhi’s involvement and influence at the regional level in North East India.
Taming the Raging Bully! A Case Study Critically Exploring Anti-bullying Measures to Support Neurodiverse Employees
Authors: Mellifont Damian
Published: November 2019

Disclosure of neurodiversity in the workplace can attract unfavourable attention. The aim of this case study is to critically investigate the collective potential of specialized and generic mental health promotion guides to help prevent or treat the bullying of neurodiverse employees. Applying qualitative thematic analysis to eight of these guides originating from Australia, Canada and England, this research offers three key messages that should be of interest to policymakers and practitioners working in the Asia-Pacific region and elsewhere. First, guides as reviewed by this study collectively support anti-bullying themes across dimensions of policy/procedures, education, legal, leadership and monitoring/support. Second, evidence sourced from scholarly and grey literature raise challenges that if overlooked might reduce the effectiveness of guide endorsed anti-bullying measures. Finally, this study raises the prospect that anti-bullying measures to assist mentally diverse staff might be more effective when potential synergies between these are recognized and encouraged.
Clavicle Elevation or Shoulder Girdle Depression in Acromioclavicular Joint Dislocation: A Radiological Investigation
Authors: Azar Fady , Pfeifer Christian , Alt Volker , Pregler Benedikt , Weiss Isabella , Mayr Agnes , Kerschbaum Maximilian
Published: November 2019

Background:

The side-comparative coracoclavicular (CC) distance is used to describe the vertical instability component of acute acromioclavicular (AC) joint dislocations. Elevation of the clavicle or a depression of the shoulder girdle can lead to an increased CC distance. The dislocation direction has not yet been investigated and is not included in common classification systems.

Hypothesis:

Clavicle elevation is primarily responsible for vertical dislocation in AC joint separation.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

Weighted and nonweighted bilateral plain anteroposterior views of the shoulder girdles of patients with AC joint dislocations (Rockwood [RW] types III and V), diagnosed in our trauma department between 2001 and 2018, were included in this study. After determining the CC distance, a side-comparative determination of the positions of both the clavicle and shoulder girdle, with reference to the spinal column, was conducted.

Results:

In total, 245 bilateral plain anteroposterior views were evaluated (RW III, n = 116; RW V, n = 129). All patients showed a side-comparative clavicle elevation (mean ± SD: RW III, 5 ± 14 mm; RW V, 11 ± 17 mm) in weighted and nonweighted views. While no depression of the shoulder girdle was measured in RW III injuries (weighted and nonweighted views, 0 ± 11 mm), dropping of the shoulder girdle in RW V lesions on nonweighted views was observed (–5 ± 11 mm).

Conclusion:

Vertical dislocation is mostly associated with clavicle elevation in RW III injures, while in high-grade AC joint dislocations (RW V), a combination of clavicle elevation and shoulder girdle depression is present. A significantly greater superior displacement of the clavicle in RW V injuries was seen in weighted views, while a depression of the shoulder girdle could be detected in nonweighted views. For the first time, these results include the dislocation direction in the classification of an AC joint injury. Further studies are needed to investigate the extent to which dislocation types differ in optimal therapy and outcome.
A Language for Israel: The Role of Translation in Building the Resources of Hebrew
Authors: Woodsworth Judith Weisz
Published: November 2019

Contrary to common misperceptions, translation is not merely a subsidiary or secondary art but is a critical, productive, and generative process. At key moments in history, translation has helped to strengthen languages, build national literatures, and construct national identities. The case of Hebrew provides a unique example of an ancient sacred language that has evolved into a modern and functional one, now the primary official language of Israel. This article provides an overview of translational activity in Israel, with a focus on the profound impact that translation has had on the development of the Hebrew language. Translations of foreign literature served to nourish an emerging Hebrew literature, diversify its repertoire, and build the resources of the language itself. Translation was even viewed as an integral part of nation building, as illustrated by the vision and personal involvement of Israel’s first Prime Minister, David Ben-Gurion, which culminated in a program of translating world masterpieces to create an “Intellectual State” in addition to the new political one.
Comparison of Generic, Musculoskeletal-Specific, and Foot and Ankle–Specific Outcome Measures Over Time in Tibial Plafond Fractures
Authors: Sepehri Aresh , Lefaivre Kelly A. , O’Brien Peter J. , Broekhuyse Henry M. , Guy Pierre
Published: November 2019

Background:

This study performed a psychometric analysis assessing and comparing the responsiveness of the relevant components of a generic (Short Form–36 [SF36]), a musculoskeletal-specific (Short Musculoskeletal Functional Assessment [SMFA]), and a foot and ankle–specific (Foot and Ankle Outcome Score [FAOS]) outcome score when evaluating surgically treated tibial plafond fractures over time.

Methods:

Fifty-one patients were followed for 12 months after their tibial plafond fracture. Responsiveness, or the ability to detect clinical change in a disease, was evaluated through the standardized response mean (SRM), the proportion meeting a minimal clinically important difference (MCID), and floor and ceiling effects.

Results:

The SRM of the SF36–Physical Component Summary (PCS) was significantly greater than the SMFA–dysfunction index (DI) ( P < .01) and FAOS–Activities of Daily Living (ADL) ( P = .01) between baseline and 6 months, whereas the SRMs of only SF36-PCS and FAOS-ADL differed ( P = .01) between 6 and 12 months. The proportion of patients achieving an MCID for SF36-PCS was higher than FAOS-ADL ( P = .03) between baseline and 6 months and higher than SMFA-DI ( P = .04) between 6 and 12 months. The FAOS-ADL showed substantial ceiling effects at baseline (88.2%) but much less at 6 months (5.9%) and 12 months (9.8%). Smaller ceiling effects were observed for the SMFA-DI (11.8%) at baseline, whereas none were observed for the SF36-PCS.

Conclusions:

This study found that the SF36-PCS had greater responsiveness in assessing tibial plafond fractures compared to the SMFA-DI and FAOS-ADL, particularly in the first 6 months after surgery. In addition, limitations were revealed in the SMFA-DI and FAOS-ADL. This study illustrates the necessary diligence required for selection of outcome measures, as musculoskeletal and anatomy specific scores are not necessarily superior.

Level of Evidence:

Level II, prospective cohort study.
ERS/TSANZ Task Force Statement on the management of reproduction and pregnancy in women with airways diseases
Authors: Middleton Peter G. , Gade Elisabeth J. , Aguilera Cristina , MacKillop Lucy , Button Brenda M. , Coleman Courtney , Johnson Barbara , Albrechtsen Charlotte , Edenborough Frank , Rigau David , Gibson Peter G. , Backer Vibeke
Published: November 2019

This European Respiratory Society/Thoracic Society of Australia and New Zealand statement outlines a review of the literature and expert opinion concerning the management of reproduction and pregnancy in women with airways diseases: asthma, cystic fibrosis (CF) and non-CF bronchiectasis. Many women with these diseases are now living into reproductive age, with some developing moderate-to-severe impairment of lung function in early adulthood. The statement covers aspects of fertility, management during pregnancy, effects of drugs, issues during delivery and the post-partum period, and patients’ views about family planning, pregnancy and parenthood. The statement summarises current knowledge and proposes topics for future research, but does not make specific clinical recommendations.