bluuebunny/crossref_metadata_2025 huggingface dataset:
Nanotechnology and Global Applications: Bench to Community
Authors: Chakraborty Ashok , Guha Smita , Patra Prabir
Published: September 2020

Advances in nanotechnology has become enormously promising in the field of health science, in developing many medical equipment. The possible effects of novel nanomedical technology significantly improve the diagnosis and therapeutic aspects of many diseases. Nanomaterials are being applied in operation, disease diagnosis as well as therapy, molecular imaging, implant technology, tissue engineering, as well as a device for efficient drug delivery, protein and gene release. In this review we discussed the utility of nanoscience in health issues, and the knowledge from there how can be disseminated to the educators and parents for expanding STEM (Science, Technology, Engineering and Math) programs.
A Case Illustrating the Practical Application of the AAOS Clinical Practice Guideline: Diagnosis and Prevention of Periprosthetic Joint Infection
Authors: Chen Antonia F. , Riedel Stefan
Published: September 2020

The American Academy of Orthopaedic Surgeons Clinical Practice Guideline “Diagnosis and Prevention of Periprosthetic Joint Infections (PJI)” is a summary of the available literature designed to help guide surgeons and other qualified physicians in the management of PJI. Obesity and intra-articular joint injections are associated with an increased risk of PJI according to this Clinical Practice Guideline. Serum erythrocyte sedimentation rate, C-reactive protein, and/or interleukin-6 should be obtained when diagnosing PJI. Synovial fluid leukocyte count, neutrophil percentage, aerobic and anaerobic bacterial cultures, leukocyte esterase, alpha-defensin, C-reactive protein, and nucleic acid amplification testing may assist with the diagnosis of PJI. Antibiotics should be held for 2 weeks before obtaining samples. Intraoperatively, Gram stains do not help with PJI diagnosis, whereas histopathology samples are helpful. These guidelines may help clinicians with the prevention and diagnosis of PJI.
A Matched Control Analysis on the Effects of Alcohol Use Disorder After Primary Total Knee Arthroplasty in Medicare Patients
Authors: Luo T. David , Vakharia Rushabh M. , Gwam Chukwuweike U. , Zuskov Andrey , Plate Johannes F. , Roche Martin W.
Published: September 2020

Introduction:

Several studies have found the negative impact of alcohol use disorder (AUD), most notably coagulation derangements. We sought to investigate the effects of AUD after primary total knee arthroplasty (TKA) for (1) postoperative complications, (2) lengths of stay, and (3) costs of care.

Methods:

This was a retrospective database analysis of Medicare patients with AUD undergoing primary TKA performed between 2005 and 2014. Patients with AUD were matched to controls in a 1:5 ratio by age, sex, and medical comorbidities. The query yielded 354,690 TKA patients: 59,126 with AUD and 295,564 without AUD.

Results:

Patients with AUD had significantly greater odds ratio (OR) of medical complications, including venous thromboembolism (VTE) within 90 days (OR: 1.41, P < 0.0001) and at 1 year (OR: 1.51, P < 0.0001) and greater 2-year implant-related complications after primary TKA. Furthermore, patients with AUD had significantly longer lengths of stay (4 versus 3 days, P < 0.0001) and incurred a significantly higher episode of care costs ($15,569.76 versus $13,763.06, P < 0.0001).

Discussion:

The present study demonstrated a significant association between AUD and the development of VTE. We hope this research will aid in risk stratification and tailoring of VTE chemoprophylaxis and postoperative management in this at-risk group after TKA.

Level of evidence:

Level III
Radical nephrectomy with resection of vena cava thrombus using extracorporeal circulation and deep hypothermic circulatory arrest
Authors: Nason Gregory J. , Ajib Khaled , Tan Guan Hee , Woon Dixon T.S. , Christakis George T. , Nam Robert K.
Published: September 2020

Introduction: Patients with renal cell carcinoma (RCC) with level 3 or 4 caval thrombus have a poor prognosis, with reported five-year survival rates of 30–40%. The aim of this study was to assess the perioperative morbidity and long-term oncological outcomes for radical nephrectomy with resection of vena cava thrombus using a combined surgical approach, including extracorporeal circulation and deep hypothermic circulatory arrest.

Methods: A retrospective review was performed of the institutional case log to identify all radical nephrectomies with caval thrombus performed from January 2006 to May 2020.

Results: Twenty-five patients were identified with level 2 thrombus in one (4%), level 3 thrombus in eight (32%), and level 4 in 16 (64%). The median followup was 20.6 months (range 0.2–133.3). The median age at surgery was 68.4 years (range 44.2–85.5). Twenty-one (84%) patients were symptomatic at presentation. Six (24%) patients had distant metastases at diagnosis. The median circulatory arrest time was 15 minutes (range 6–35). The 30-day grade ≥3 complication rate was 8%. The 30-day mortality rate was 8%. The one-year, two-year, three-year, and five-year recurrence-free survival (RFS) rates were 53%, 18%, 10%, and 10%, respectively. The median time to systemic treatment was 7.7 months (range 1.2–25.7). The one-year, two-year, three-year, five-year overall survival (OS) rates were 70%, 43%, 36%, and 31%, respectively.

Conclusions: Radical nephrectomy with resection of vena cava thrombus using extracorporeal circulation and deep hypothermic circulatory arrest is associated with some morbidity and mortality but remains a safe and effective strategy for advanced RCC patients who would otherwise be managed palliatively.
Assessment of Nine Micronutrients in Jasmine 85 Rice Grown in Ghana Using Neutron Activation Analysis
Authors: Vowotor Michael Kwame , Amoako George , Sefa-Ntiri Baah , Amoah Samuel , Sackey Samuel Sonko , Amuah Charles Lloyd Yeboah
Published: September 2020

The amount of micronutrients in food is a key factor that determines the health status of a person. The concentrations of nine micronutrients, Sodium (Na), Magnesium (Mg), Chlorine (Cl), Potassium (K), Calcium (Ca), Vanadium (V), Manganese (Mn), Copper (Cu) and Iodine (I), in polished Jasmine 85 rice, locally cultivated in five rice farming areas in Ghana (Afienya, Afife, Dawhenya, Ashaiman and Aveyime), were determined using Neutron Activation Analysis. The standard materials used as reference were the International Atomic Energy Agency (IAEA)-530 Tuna fish homogenate and the National Institute of Standard and Technology (NIST) USA 1566b Oyster Tissue. Recoveries of the elemental concentrations ranged from 88% to 111% of the certified values. Relative standardization method was used in the quantification of the elements. The range of concentrations measured in the rice are: 142.3-188.1 mg/kg for Na, 483.2-875.7 mg/kg for Mg, 465.6-718.0 mg/kg for Cl, 514.6-2949.0 mg/kg for K, 2303.0-2622.0 mg/kg for Ca, 0.0698-0.1925 mg/kg for V, 9.956-14.460 mg/kg for Mn, 0.8728-1.6790 mg/kg for Cu and 0.1181-0.1447 mg/kg for I. Using Hierarchical clustering analysis and Principal Component Analysis to evaluate the intensities of measured concentrations, K was established to be the most abundant, and was used to categorize two distinct clusters; Group 1 farms (Ashaiman, Afienya, and Dawhenya) and Group 2 farms (Aveyime and Afife). Group 2 farms recorded elevated intensities of micronutrients. With Pearson's correlation coefficient, some noteworthy correlations realized were between Na and K (r = 0.951), Na and V (r = 0.842) and K and V (r = 0.812). This indicated the same or similar source inputs for each pair. The calculated mean daily intake of K exceeded the mean Recommended Dietary Allowable and Adequate Intake for all Life Stage Groups. Estimated health risk associated with the consumption of rice was only present for children between the ages of 1 and 3 for Mg. The information on these nine micronutrients content of the rice from these five farming areas would be valuable in rice consumption studies to evaluate the overall availability of micronutrients to the Ghanaian populace and age groups and also in nutrition planning for analysis of nationwide rice supplies, mainly for regions and countries known to be susceptible to deficiencies of these micronutrients. The techniques espoused in this research can be used to accurately determine the concentration of micronutrients in rice and also trace the area where the rice was produced.
Improving Weathering Performance of Wood by Borates Impregnation and Liquid Glass Coating
Authors: Kucuktuvek Mustafa , Toker Hilmi , Turkoglu Turkay , Gunduz Ahmet , Altay Caglar , Baysal Ergun
Published: September 2020

Weathering performance of impregnated and coated wood products is an important issue that influences their appearance as well as their service life after outdoor or indoor exposure. A novel procedure to improve the weathering performance of Scots pine wood (Pinus sylvestris L.) is proposed in this study. Wood samples were impregnated with ammonium tetrafluoroborate (ATFB), ammonium pentaborate (APB) and boric acid (BA), and afterward coated with a layer of liquid glass (LG). Surface hardness, color changes, and surface roughness of wood samples were investigated after 250 h and 500 h of exposure to artificial weathering. The results revealed that, except for untreated (control), all other treatment groups caused an increase in surface hardness of Scots pine after weathering. A decrease in the CIE L* value corresponds to the darkening of samples after weathering. Borates-impregnated and LG-coated Scots pine samples possessed the highest color stability. However, all treatment combinations resulted in reddish and yellowish tones after weathering. Exposure to weathering increased surface roughness of wood samples. The surface roughness of the untreated (control) group was higher than that of impregnated and coated samples.
De ‘strijd om kerken’
Authors: Honingh Marlies , Nelissen Nico
Published: September 2020

The ‘struggle for churches’. A Public Administration sketch of a (religious and policy) sensitive subject

While many new churches were built in the Netherlands sixty years ago to meet the demands of religious communities for space for their worship, the situation in 2020 is completely different. It is true that a church is sometimes built here and there in the Netherlands, but the general picture is that many churches have been withdrawn as places of worship in recent years, that a number have been demolished and that many have been given a new designated purpose. The fate of a church building often evokes many emotions in people. For example, we experienced this when we, together with the Parisians, watched in disbelief as fire destroyed parts of Notre Dame. This is related to the fact that for many people churches are more than just ‘beautifully stacked stones’. They are directly linked to the highs and lows of people’s individual and collective lives. People were baptized and married in that church, funeral services of loved ones were held there and the church is still a familiar part of the image of city or village. Rightly so that churches are also seen as ‘affective monuments’. The central question, however, is how to deal with religious heritage (policy related) now that churches are emptying? In this article the authors first give a brief outline of the background, nature and scope of what they call the ‘church problem’. Then they discuss the ‘battle for churches’ associated with this problem, which they subsequently try to interpret from a number of Public Administration theories. The role of certain individuals and organizations in the ‘battle for churches’, the so-called ‘entrepreneurs’, is further explored. They pay specific attention to the role of the municipality in this as a whole and call on all parties involved to deal (politically) with the ‘church problem’ rather than ‘spasmodically’.
Neutraliteitsvraagstukken naar aanleiding van de leegloop van kerken
Authors: Vleugel Jos
Published: September 2020

Neutrality issues due to the emptying of churches

The author of this contribution asks whether and, if so, in which specific cases, the principle of the separation of church and state applies to situations related to the emptying of churches. As a result of the closure, restoration and re-designation of church buildings, governments may be confronted with issues that touch on this principle. The principle of the separation between church and state prescribes that the government must be neutral. This contribution explains that this neutral attitude differs according to the social domain in which the issue arises. Using a contextual approach, he makes clear which interests (religious, general, private and the interests of others) should be decisive in government policy in this area in the various domains.
Drie ‘entrepreneurs’ aan het woord
Authors: Ummelen Sander , Petersen Ankie , Ummelen Stephan
Published: September 2020

Three ‘entrepreneurs’ have their say

In this contribution, three entrepreneurs indicate how they are actively involved in the processes of re-designation of churches. Based on a number of tools, they try to offer prospects for the future of churches in close consultation with the parties involved. This is by no means easy and requires strategic, tactical and open action to bridge existing contradictions and guarantee a future for the religious heritage.
Jihadister som statsbyggere
Authors: Becker Aarseth Mathilde
Published: September 2020

Det siste tiåret har vi sett en oppblomstring av «stater» etablert av ekstreme jihadistgrupper, som rokker ved noen vedtatte sannheter om jihadister og opprørsstyrer.
Familienkonstellation und Bildungserfolg. Welche Rolle spielen ökonomisches, kulturelles und Sozialkapital?
Authors: Ludwig-Mayerhofer Wolfgang , Stawarz Nico , Wicht Alexandra
Published: September 2020

Die Familienkonstellation, in der Kinder und Jugendliche aufwachsen, hängt deutlich mit deren Bildungserfolg zusammen. Dieser Zusammenhang ist jedoch zu beträchtlichen Teilen über die Ressourcenausstattung unterschiedlicher Familienkonstellationen vermittelt. Genaue Analysen dieser Zusammenhänge stehen jedoch noch aus, auch deshalb, weil die Familienkonstellation häufig nicht ausreichend differenziert erfasst wird. Dieser Beitrag untersucht anhand von Daten des Nationalen Bildungspanels (NEPS), wie sich Familien mit zwei leiblichen Eltern, Stieffamilien sowie Familien mit allein erziehenden Müttern bzw. Vätern hinsichtlich der Ausstattung mit (sozio-)ökonomischem, kulturellem und Sozialkapital unterscheiden, und welchen Einfluss dies auf die Lese- und Mathematikkompetenzen von Jugendlichen in der 9. Klassenstufe hat. Unsere Analysen zeigen, dass vor allem das kulturelle Kapital und in geringerem Ausmaß das (sozio‑)ökonomische und das Sozialkapital für den Bildungserfolg verantwortlich sind. Familien mit zwei leiblichen Eltern verfügen über die meisten, solche mit allein erziehenden Eltern über die geringsten Ressourcen, wobei Unterschiede zwischen allein erziehenden Müttern und Vätern beobachtet werden können. Dennoch können nicht alle Unterschiede im Bildungserfolg zwischen den Kindern in verschiedenen Familienkonstellationen auf Ressourcenunterschiede zurückgeführt werden: Vor allem die Kinder, die mit allein erziehenden Vätern zusammenleben, schneiden auch nach Kontrolle der Ressourcen deutlich schlechter in den Kompetenztests ab.
Soziale Ungleichheit bei den Übergängen ins Studium und in die Promotion. Eine kumulative Betrachtung von sozialen Herkunftseffekten im nachschulischen Bildungsverlauf
Authors: Bachsleitner Anna , Neumann Marko , Becker Michael , Maaz Kai
Published: September 2020

Übergänge im Bildungssystem sind zentral für die Entstehung von sozialer Ungleichheit. Die bestehende Befundlage verweist dabei auf abnehmende Herkunftseffekte vom Übergang ins Gymnasium zum Übergang ins Studium sowie auf eine abnehmende Bedeutung primärer Herkunftseffekte (leistungsbezogener Herkunftseffekte) an den beiden Übergangsschwellen. Die vorliegende Studie untersucht daher auf Grundlage der Längsschnittstudie BIJU, wie sich soziale Herkunftseffekte im nachschulischen Bildungsverlauf vom Übergang ins Studium zum Übergang in die Promotion entwickeln und welchen Anteil primäre Herkunftseffekte an den Übergangsschwellen ins Studium und in die Promotion ausmachen. Mit Hilfe einer Effektdekomposition wird der Erklärungsanteil herkunftsspezifischer Leistungsunterschiede (Schul- und Studienabschlussnoten sowie Testleistungen) ermittelt. Um die kumulierten Herkunftseffekte im nachschulischen Bildungsverlauf zu betrachten, werden die Analysen zum Promotionsübergang neben der selektiven Stichprobe der Hochschulabsolventinnen und -absolventen auch auf die Ausgangsstichprobe der Hochschulzugangsberechtigen bezogen. Die Ergebnisse zeigen, dass an beiden Übergängen Effekte der Bildungsherkunft bestehen und diese vom Übergang ins Studium zum Übergang in die Promotion abnehmen, wobei der Ungleichheitseffekt insgesamt sich kumuliert. Die Bedeutung von herkunftsspezifischen Leistungsunterschieden nimmt relativ gesehen über beide Übergänge zu, absolut gesehen jedoch ab.
Climate change reporting: a commentary on key issues
Authors: Melloni Gaia
Published: September 2020

Firms are more and more considered key actors for the attainment of sustainable development goals, including climate change (CC) action. Corporate reporting on carbon emissions and CC related issues is considered fundamental not only to evaluate companies’ contributions to CC mitigation, but also to assess how CC affects organizations and how they are adapting to it. The importance of CC reporting has been acknowledged by the Financial Stability Board who has established, in 2015, the Task Force on Climate related Financial Disclosure (TCFD) to promote and set recommendations for an effective CC disclosure. Existing research documents conflicting results on the factors facilitating the implementation of CC reporting. In this commentary, I review prior literature on CC related disclosure with a particular focus on the most recent findings on the significant economic and ecological factors associated with it. I highlight that size bias, involvement of governance, relationship with emissions activity, integration in corporate reporting and assurance represent the key issues in such domain. I corroborate such findings in lights of early evidence on the TCFD implementation which points at the same factors representing challenges for an effective CC disclosure. This analysis could be of interest for academics, to develop future research on relevant although controversial areas, and for firms, policy makers and other stakeholders to unveil critical issues to be considered in the implementation of CC reporting.
Digitale Besonderheiten
Authors: Lochelfeldt Sven
Published: September 2020

Die Personalakte soll möglichst lückenlos Auskunft über die Person und die Tätigkeit des Arbeitnehmers geben. Immer mehr Arbeitgeber führen die Personalakten ihrer Mitarbeitenden in digitaler Form. Dabei sind jedoch rechtlich einige Bedingungen zu beachten. So sollten manche Dokumente wie Kündigungen und Aufhebungsverträge nach wie vor zusätzlich auf Papier archiviert werden, empfiehlt der Berliner Fachanwalt für Arbeitsrecht Dr. Sven Lochelfeldt.
Repräsentation ferner Wirklichkeiten
Authors: Zöhrer Michaela
Published: September 2020

Which depictions of ‘distant others’ are widespread and have a strong appeal in the Global North and which are not? Who speaks on whose behalf? Who remains unrepresented? And why does it seem increasingly important and advisable to ask such questions? This sociological study analyses and discusses controversial debates surrounding epistemic, political and ethical aspects of representation in the context of knowledge production for humanitarian and academic purposes. It demonstrates how international NGOs are criticised for but also justified in using photographs that depict suffering to ask for donations, and highlights why research into, for or with marginalised individuals should be conducted in a politically and ethically responsible manner.
Soziale Arbeit und Recht
Authors: Stock Christof , Schermaier-Stöckl Barbara , Klomann Verena , Vitr Anika
Published: September 2020

The second edition of this textbook focuses on the eight areas of activity that are essential in social work: social work with people in financial difficulties; with couples, families, children and young people; as a profession; in education; with people with disabilities; with the sick and those in need of care; with migrants and refugees; with victims of violence and with criminals.

Each chapter is preceded by a typical case, followed by a description of the area of activity in question from a social work perspective. After the respective legal framework is presented in each case, a case solution is offered. Within the same structure, the authors describe the people and institutions involved in social work as well as the legal system superordinate to it: civil and civil procedural law, administrative and social law, and criminal and criminal procedural law.
Molecular Detection of Genes Involved in Biofilm Formation in Staphylococcus aureus Strains Isolates: Evidence From Shahid Motahari Hospital in Tehran
Authors: Mohammadi Anis , Goudarzi Mehdi , Dadashi Masoud , Soltani Malihe , Goudarzi Hossein , Hajikhani Bahareh
Published: September 2020

Background: Infections caused by Staphylococcus aureus strains are a major public health challenge worldwide, especially in specialized burn hospitals. Infections caused by S. aureus account for more than 50% of burn-related deaths. Objectives: Since data on characteristics of these isolates are not sufficient, the current study aimed to assess the prevalence of resistance to antibacterial agents and to analyze the distribution of biofilm, and adhesion encoding genes among S. aureus strains isolated from burn patients in Motahari Hospital, Tehran, Iran. Methods: A total of 83 S. aureus strains were collected from burn wounds of patients admitted to a referral burn center in Tehran for 10 months. In vitro antibacterial susceptibility of isolates was evaluated using the Kirby-Bauer disk diffusion method. Strains were subjected to polymerase chain reaction (PCR) to determine the presence of nucA, mecA, ebps, cna, bbp, fnbA, fnbB, clfA, and clfB genes. Results: The highest frequency of resistance was found to cephalexin and cefoxitin (87.9%), followed by clindamycin (75.9%), erythromycin (72.3%), and ciprofloxacin (60.2%). Five resistance patterns were identified in which cephalexin, cefoxitin, clindamycin, erythromycin, and ciprofloxacin had the most predominant resistance profile (36.1%). Biofilm gene detection indicated a markedly high prevalence of cna (74.7%), clfB (54.2%), clfA (50.6%), fnbA (42.1%), ebp (13.2%), and fnbB (12%). Six different biofilm genetic patterns were identified, wherein clfA, clfB, fnbA, ebp, and cna (30.1%), clfA, clfB, fnbA, fnbB, ebp, and cna (12%), and clfA, clfB, and cna (8.4%) were the top three most frequently identified patterns. Conclusions: The prevalence of biofilm encoding genes, which are associated with multidrug resistance in S. aureus strains isolated from burn patients, is high. Therefore, identification of epidemiology, molecular characteristics, and biofilm management of S. aureus infection in burn units would be helpful.
Anticoagulation in Patients with End-Stage Renal Disease and Atrial Fibrillation: Confusion, Concerns and Consequences
Authors: Goel Narender , Jain Deepika , Haddad Danny B. , Shanbhogue Divya
Published: September 2020

End-stage renal disease (ESRD) patients have a higher prevalence of diabetes mellitus, hypertension, congestive heart failure and advanced age, along with an increased incidence of non-valvular atrial fibrillation (AF), thereby increasing the risk for cerebrovascular accidents. Systemic anticoagulation is therefore recommended in patients with ESRD with AF to reduce the risk and complications from thromboembolism. Paradoxically, these patients are at an increased risk of bleeding due to great degree of platelet dysfunction and impaired interaction between platelet and endothelium. Currently, CHA2DS2-VASc and Hypertension, Abnormal liver/kidney function, Stroke, Bleeding, Labile INR, Elderly, Drugs or alcohol (HAS-BLED) are the recommended models for stroke risk stratification and bleeding risk assessment in patients with AF. There is conflicting data regarding benefits and risks of medications such as antiplatelet agents, warfarin and direct oral anticoagulants in ESRD patients with AF. Moreover, there is no randomized controlled trial data to guide the clinical decision making. Hence, a multi-disciplinary approach with annual re-evaluation of treatment goals and risk-benefit assessment has been recommended. In this article, we review the current recommendations with risks and benefits of anticoagulation in patients with ESRD with AF.
Stroke in Coronavirus Disease 2019: A Systematic Review
Authors: Bhatia Rohit , Pedapati Radhakrishna , Komakula Snigdha , Srivastava M.V. Padma , Vishnubhatla Sreenivas , Khuranac Dheeraj
Published: September 2020

Background and Purpose Various neurological findings including stroke in patients with coronavirus disease 2019 (COVID-19) have been described, although no clarity exists regarding the nature and pattern of this association. This systematic review aims to report the characteristics of stroke in patients with COVID-19.Methods Three authors independently searched Web of Science, Embase, Scopus, and PubMed starting from inception up to May 22, 2020. The data for individual patients was extracted where available from published reports including clinical and laboratory parameters and analysed for any significant associations between variables.Results We identified 30 relevant articles involving 115 patients with acute or subacute stroke with COVID-19. The mean±standard deviation age was 62.5±14.5 years. Stroke was ischemic in majority of the patients (101 [87.8%]). Hypertension (42 [42%]), dyslipidaemia (24 [26.1%]), and diabetes (23 [23.2%]) were the major vascular risk factors. Most of the patients (80 [85.1%]) had COVID-19 symptoms at the time of stroke with a median interval of 10 days to stroke from the diagnosis of COVID-19. Three-fourths (86 [74.8%]) of the patients were critically ill which frequently delayed the diagnosis of stroke. High levels of D-dimer, and ferritin were observed in these patients. Patients with COVID-19 and stroke had a high mortality (47.9%). Factors associated with mortality were intensive care unit admission, having two or more vascular risk factors, particularly smoking and high levels of D-dimer, C-reactive protein, and lactate dehydrogenase.Conclusions The association between stroke and COVID-19 is probably multifactorial including an amalgamation of traditional vascular risk factors, proinflammatory and a prothrombotic state. Prospectively collected data is required in the future to confirm this hypothesis.
Geographic Variations of Stroke Incidence in Chinese Communities: An 18-Year Prospective Cohort Study from 1997 to 2015
Authors: Xia Fan , Yu Xuexin , Li Yunke , Chen Yuqi , Zhang Wei , You Chao , Hu Xin
Published: September 2020

Background and Purpose As a leading cause of disability and death in China, stroke as well as its epidemiologic features have gained increasing attention. Prior studies, however, have overgeneralized the north-to-south gradient in China. Whether the differences exist across urban and rural areas remains unexplored. This study therefore aims to investigate the north-to-south gradient in stroke incidence across urban and rural China.Methods The present prospective cohort study analyzed data from the China Health and Nutrition Survey 1997 to 2015. By including 16,917 individuals from diverse social contexts, we calculated the age-standardized incidence of stroke across regions and the age-adjusted risk ratio (aRR). Cox proportional hazards models with time-varying covariates were employed to analyze variations in incident stroke.Results During the follow-up, age-standardized incidence of stroke ranged from 4.17 per 1,000 person-years (95% confidence interval [CI], 3.38 to 4.96) in the north region to 1.95 (95% CI, 1.60 to 2.30) in the south region (aRR, 2.04; 95% CI, 1.58 to 2.64; P<0.001). The north-to-south gradient of stroke incidence was observed only in rural areas, but not in urban areas. Hierarchical modelling analyses further indicated that the regional differences could be mostly explained by the disparities in the prevalence of hypertension.Conclusions The present study extends the current evidence on the north-to-south gradient by demonstrating that the difference varied across urban and rural China. Our findings highlight the importance of hypertension management as the measure for alleviating regional differences in stroke incidence.
Evaluation of the Risk Factors for Acute Kidney Injury in Neonates Exposed to Antenatal Indomethacin
Authors: Pham Jennifer T. , Jacobson Jessica L. , Ohler Kirsten H. , Kraus Donna M. , Calip Gregory S.
Published: September 2020

OBJECTIVE

Evidence is limited about important maternal and neonatal risk factors that affect neonatal renal function. The incidence of acute kidney injury (AKI) and identification of associated risk factors in neonates exposed to antenatal indomethacin was studied.

METHODS

A retrospective cohort of neonates exposed to antenatal indomethacin within 1 week of delivery was analyzed for development of AKI up to 15 days of life. Adjusted hazard ratios (HRs) and 95% CIs for AKI risk were calculated in time-dependent Cox proportional hazards models.

RESULTS

Among 143 neonates with mean gestational age of 28.3 ± 2.4 weeks, AKI occurred in 62 (43.3%), lasting a median duration of 144 hours (IQR, 72–216 hours). Neonates with AKI had greater exposure to postnatal NSAIDs (48.4% vs 9.9%, p < 0.001) and inotropes (37.1% vs 3.7%, p < 0.001) compared with neonates without AKI. In multivariable-adjusted models, increased AKI risk was observed with antenatal indomethacin doses received within 24 to 48 hours (HR, 1.6; 95% CI, 1.28–1.94; p = 0.036) and <24 hours (HR, 2.33; 95% CI, 1.17–4.64; p = 0.016) prior to delivery. Further, postnatal NSAIDs (HR, 2.8; 95% CI, 1.03–7.61; p = 0.044), patent ductus arteriosus (HR, 4.04; 95% CI, 1.27–12.89; p = 0.018), and bloodstream infection (HR, 3.01; 95% CI, 1.37–6.60; p = 0.006) were associated significantly with increased risk of AKI following antenatal indomethacin. Neonates with AKI experienced more bloodstream infection, severe intraventricular hemorrhage, patent ductus arteriosus, respiratory distress syndrome, and longer hospitalization.

CONCLUSIONS

Extended risk of AKI with antenatal indomethacin deserves clinical attention among this population at an already increased AKI risk.
Levofloxacin for Antibacterial Prophylaxis in Pediatric Patients With Acute Myeloid Leukemia or Undergoing Hematopoietic Stem Cell Transplantation
Authors: Patel Bianka , Noda Andrew , Godbout Emily , Stevens Michael , Noda Cady
Published: September 2020

OBJECTIVE

This study aimed to evaluate the use of levofloxacin for the prevention of bacterial infections in pediatric patients with acute myeloid leukemia or those undergoing hematopoietic stem cell transplantation.

METHODS

This study was a single-center, retrospective review designed to assess the frequency of bacteremia with levofloxacin prophylaxis compared with historical controls that used other, clinician-directed antibacterial prophylaxis. The primary outcome of the study was microbiologically documented bacteremia. Secondary outcomes included febrile neutropenia, clinically documented infection, duration of neutropenia, treatment antibiotic exposure days, Clostridioides difficile infection, and infection-related mortality.

RESULTS

Of the 60 patients included, 24 patients with 32 hospital admissions received levofloxacin and 36 patients with 48 hospital admissions received clinician-directed prophylaxis. There was no difference found in the frequency of bacteremia between levofloxacin and clinician-directed prophylaxis (15.6% vs 10.4%, p = 0.49). There was no difference in the incidence of febrile neutropenia, clinically documented infection, treatment antibiotic exposure days, or 30-day infection-related mortality between the 2 groups. The levofloxacin group had a longer mean duration of neutropenia compared with clinician-directed prophylaxis (26.8 days vs 16.4 days, p = 0.01).

CONCLUSIONS

There was no difference in bacteremia between levofloxacin prophylaxis and clinician-directed prophylaxis in pediatric patients with acute myeloid leukemia or those undergoing hematopoietic stem cell transplantation. Levofloxacin prophylaxis is an appropriate alternative for the prevention of serious bacterial infections in this patient population, although further studies are needed to confirm these results.
Evaluation of Appropriateness and Cost Savings of Pharmacist-Driven Palivizumab Ordering
Authors: Weaver Krista L. , Bondi Deborah S. , Shah Pooja A. , Bhagat Palak H.
Published: September 2020

OBJECTIVES

Guidelines by the AAP for the use of palivizumab prophylaxis for respiratory syncytial virus (RSV) recommend administration within 72 hours prior to discharge for selected high-risk patient populations. Our institution historically administered palivizumab on a fixed-day schedule of Mondays and Thursdays, but adjusted the practice in fall 2017 to a pharmacist-driven flex-schedule based on anticipated discharge date. This review evaluated the effect of pharmacist-driven palivizumab ordering on the appropriateness of palivizumab administrations, based on AAP and institutional recommendations. Additionally, this review evaluated for effects on institutional cost.

METHODS

This was a retrospective single-center evaluation including patients for whom palivizumab was ordered between July 1, 2016, and June 30, 2018. Patients in the 2016–2017 RSV season were in the fixed-day group, while patients in the 2017–2018 RSV season were in the flex-schedule group.

RESULTS

A total of 142 palivizumab doses were evaluated. Overall, 97% of administrations were for an appropriate indication. All doses administered inappropriately (n = 4) occurred in the fixed-day group. In the fixed-day group, 48.6% of doses were given within 72 hours prior to discharge, which increased to 70.1% in the flex-schedule group (p = 0.01). The amount of drug saved by batching was 1 vial for every 4.9 patients in the fixed-day group, and 1 vial for every 4.8 patients in the flex-schedule group.

CONCLUSIONS

There was a statistically significant improvement in compliance with AAP recommendations following the implementation of pharmacist-driven flex-schedule for palivizumab, compared to a fixed-day batching schedule. There was no significant difference in cost.
The legal insignificance of the financial coverage at the bill of exchange and the cheque
Authors: Janković Svetislav
Published: September 2020

Due to the identical personal structure, the bill of exchange and the cheque have a common feature regarding the drawer's cover on a banking account which is administrated by the drawee. It seems that sufficiency of adequate funds, which should cover the drawer's order from these instruments, doesn't have any legal significance for the drawee and the acceptor. At first glance the position of drawee and acceptor is different because the drawee's obligation is also not derived from the bill of exchange; however, the acceptor has an obligation due to his acceptance of the drawer's order. However, at the stage of collection, drawee and acceptor have a similar position regarding financial cover by drawer's account. Regardless of whether there is financial coverage, the legal position of the drawee and acceptor remains unchanged, because their position could be changed only through their legally relevant will, manifested in the instrument as such.
Effect of Ageing on the Mechanical Performance of Thermoset Polymers: A Statistical Approach
Authors: Santos Francisco M. Dos , Oliveira Lívia Ávila de , Bueno Alysson H.S. , Silva Leandro José da , Pino Gilberto García del , Panzera Tulio H.
Published: September 2020

The present work investigates the effect of three different ageing processes (natural, 100% relative humidity and salt spray) on the mechanical performance of two thermoset polymers, epoxy and polyester, commonly used as matrix phase in composite materials. A full factorial design is conducted to evaluate the effect of significant factors and interactions on moisture absorption, tensile and compressive strength and modulus of elasticity of the thermosets. Both polymers reveal a decrease in moisture absorption in the saline environment compared to the completely saturated condition (100% RH). Polyester polymers in harsh environments exhibit higher compressive properties compared to those subjected to natural conditioning. In general, polyester polymers, which are most affected by the positive effect of additional cross-linking, have less moisture absorption and superior mechanical properties compared to epoxy, which is more affected by the negative effect of plasticization.
Modelling the emergence of whisker barrels
Authors: James Sebastian S , Krubitzer Leah A , Wilson Stuart P
Published: September 2020

Brain development relies on an interplay between genetic specification and self-organization. Striking examples of this relationship can be found in the somatosensory brainstem, thalamus, and cortex of rats and mice, where the arrangement of the facial whiskers is preserved in the arrangement of cell aggregates to form precise somatotopic maps. We show in simulation how realistic whisker maps can self-organize, by assuming that information is exchanged between adjacent cells only, under the guidance of gene expression gradients. The resulting model provides a simple account of how patterns of gene expression can constrain spontaneous pattern formation to faithfully reproduce functional maps in subsequent brain structures.
Lef1 expression in fibroblasts maintains developmental potential in adult skin to regenerate wounds
Authors: Phan Quan M , Fine Gracelyn M , Salz Lucia , Herrera Gerardo G , Wildman Ben , Driskell Iwona M , Driskell Ryan R
Published: September 2020

Scars are a serious health concern for burn victims and individuals with skin conditions associated with wound healing. Here, we identify regenerative factors in neonatal murine skin that transforms adult skin to regenerate instead of only repairing wounds with a scar, without perturbing development and homeostasis. Using scRNA-seq to probe unsorted cells from regenerating, scarring, homeostatic, and developing skin, we identified neonatal papillary fibroblasts that form a transient regenerative cell type that promotes healthy skin regeneration in young skin. These fibroblasts are defined by the expression of a canonical Wnt transcription factor Lef1 and using gain- and loss of function genetic mouse models, we demonstrate that Lef1 expression in fibroblasts primes the adult skin macroenvironment to enhance skin repair, including regeneration of hair follicles with arrector pili muscles in healed wounds. Finally, we share our genomic data in an interactive, searchable companion website (https://skinregeneration.org/). Together, these data and resources provide a platform to leverage the regenerative abilities of neonatal skin to develop clinically tractable solutions that promote the regeneration of adult tissue.
Coral reefs as a source of climate-active aerosols
Authors: Jackson Rebecca L. , Gabric Albert J. , Cropp Roger
Published: September 2020

We review the evidence for bio-regulation by coral reefs of local climate through stress-induced emissions of aerosol precursors, such as dimethylsulfide. This is an issue that goes to the core of the coral ecosystem’s ability to maintain homeostasis in the face of increasing climate change impacts and other anthropogenic pressures. We examine this through an analysis of data on aerosol emissions by corals of the Great Barrier Reef, Australia. We focus on the relationship with local stressors, such as surface irradiance levels and sea surface temperature, both before and after notable coral bleaching events. We conclude that coral reefs may be able to regulate their exposure to environmental stressors through modification of the optical properties of the atmosphere, however this ability may be impaired as climate change intensifies.
Identification of hub genes and small molecule therapeutic drugs related to breast cancer with comprehensive bioinformatics analysis
Authors: Hao Mingqian , Liu Wencong , Ding Chuanbo , Peng Xiaojuan , Zhang Yue , Chen Huiying , Dong Ling , Liu Xinglong , Zhao Yingchun , Chen Xueyan , Khatoon Sadia , Zheng Yinan
Published: September 2020

Breast cancer is one of the most common malignant tumors among women worldwide and has a high morbidity and mortality. This research aimed to identify hub genes and small molecule drugs for breast cancer by integrated bioinformatics analysis. After downloading multiple gene expression datasets from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) database, 283 overlapping differentially expressed genes (DEGs) significantly enriched in different cancer-related functions and pathways were obtained using LIMMA, VennDiagram and ClusterProfiler packages of R. We then analyzed the topology of protein–protein interaction (PPI) network with overlapping DEGs and further obtained six hub genes (RRM2, CDC20, CCNB2, BUB1B, CDK1, and CCNA2) from the network via STRING and Cytoscape. Subsequently, we conducted genes expression verification, genetic alterations evaluation, immune infiltration prediction, clinicopathological parameters analysis, identification of transcriptional and post-transcriptional regulatory molecules, and survival analysis for these hub genes. Meanwhile, 29 possible drug candidates (e.g., Cladribine, Gallium nitrate, Alvocidib, 1β-hydroxyalantolactone, Berberine hydrochloride, Nitidine chloride) were identified from the DGIdb database and the GSE85871 dataset. In addition, some transcription factors and miRNAs (e.g., E2F1, PTTG1, TP53, ZBTB16, hsa-miR-130a-3p, hsa-miR-204-5p) targeting hub genes were identified as key regulators in the progression of breast cancer. In conclusion, our study identified six hub genes and 29 potential drug candidates for breast cancer. These findings may advance understanding regarding the diagnosis, prognosis and treatment of breast cancer.
Leading for Innovation: A Case Study of Financial Services Organization in Sri Lanka
Authors: Madhuwanthi L. A. Pavithra
Published: September 2020

Leadership is a crucial determinant of Innovative Work Behavior (IWB) of employees in an organization. Many researchers have found the linkage of the leadership and IWB in various industries, yet very little attention has been paid on the financial services sector, particularly in Sri Lanka [1]. Hence, this study intends to examine how leadership affects employees’ IWB in the financial services sector in Sri Lanka. It is a qualitative study, which adopted a case study approach. The study used a purposive sample of 10 innovative employees in the organization, based on the recommendation of the management and in-depth face to face interviews were carried out with those employees. A thematic analysis was employed for data analysis. The findings of the study were the characteristics of transformational leadership predominantly made impact on promoting IWB among the employees in the chosen financial services organization. Further, IWB of the employees are encouraged if the leader provides more autonomy, resources, constructive feedback, recognition to the employees and the leader being a role model for the employees. The implications of the study suggests insights to the organizational leadership to foster IWB among the employees.
Nutritional Health Benefits and Bioactive Compounds of Mangifera indica L (Mango) Leaves Methanolic Extracts
Authors: Ali Bashir Alabi , Alfa Abdullahi Attah , Tijani Kokori Bajeh , Idris Egbeja Tsobaza , Unoyiza Umar Sabdat , Junaidu Yahaya
Published: September 2020

Mango leaves (Mangifera indica) contain a lot of beneficial phytopharmacological compounds to remedy various diseases through its nutritional bioactives. Mangifera indica leaves were successfully collected from healthy mango tree. The qualitative phytochemical analysis of obtained, indicated the presence of many medicinally important secondary metabolite present which are alkaloids, tannins, saponins, flavonoids, and total phenol with no trace of cardiac glycosides. This indicates that the (Mangifera indica) possess high profile values and can be used to treat various kinds of diseases. The quantitative phytochemical analysis of mango leave extract obtained revealed that, the content of total phenol was high (1.342 ± 0.001mg/g) and the least concentration was observed in cardiac glycosides (0.136 ± 0.001mg/g). It also contain 1.054 ± 0.001mg/g of flavonoid. The extract was found to contain 0.977 ± 0.001mg/g of tannins. The concentration of alkaloid observed was 0.300 ± 0.141mg/g. Saponins was 0.244 ± 0.001mg/g concentration. The proximate composition of a nutritional benefits of mango leaves. It has crude protein value of 18.59%, for the carbohydrates is higher in it has a value of 30.60%. The percentage ash content which is an indicator of the quality of mineral nutrients present has a value of 11.49%. Crude firbre content has a value of 13.99%. Estimation of vitamins in the leaves of Mango, where vitamin A, B, C, E (121, 189, 30, 10). The mineral compositions in the leaves of Mango are Na, K, Ca, Mg, Fe, Zn, P, N, Mn (28, 589, 368, 98, 343, 14, 480, 2, 3). The metalocompounds play a vital roles in human health physiology. This research classified a large number of nutritional benefits available from various sources and used in the treatment of various diseases such as Cardiovascular, anemia, Obesity, Diabetes, Cancer, Alzheimer, Parkinson, Inflammation, and Allergy. These are cured by herbal nutrition or food herb dietary condiment for phytotherapeutic purposes. The presence of various phytochemicals in the tested plant reveals that this plant may be a good source for production of new drugs for various ailments.