bluuebunny/crossref_metadata_2025 huggingface dataset:
Improving the Attitudes to Homeless Persons in a Family Medicine Residency
Authors: Zha Mengyi , Olson Cheri L. , Goulet Carol
Published: August 2020

Introduction:

Family medicine providers are at the forefront of serving homeless persons. It is important to prepare family medicine residents for this responsibility during residency. In the current study, we aimed to assess the effect of a series of enrichment activities on the attitudes toward homeless persons held by residents, faculty, and staff in a rural family medicine residency program.

Methods:

The residency program implemented a 6-month enrichment activities series that provided various educational experiences and aimed to improve the participants’ knowledge of and attitudes toward homeless persons. Participants completed 2 anonymous online surveys before and after the enrichment series: (1) the Health Professional’s Attitude Toward the Homeless Inventory (HPATHI) and (2) a short survey assessing the understanding of local issues that affected homeless persons. Two-tailed Student t tests were used to compare the survey results.

Results:

Of the 48 eligible participants, 42 (88%) completed the surveys before enrichment activities and 41 (85%) completed the surveys afterward. Engagement in the enrichment series was associated with a significant improvement in attitudes supporting social advocacy, but it did not affect self-reported levels of cynicism or personal advocacy. Participant knowledge of local homelessness issues improved, but the difference was not statistically significant.

Conclusions:

The longitudinal enrichment activities series, which was implemented in a rural family medicine residency program and aimed to provide experiences working with homeless individuals, was effective in improving attitudes supporting social advocacy among participants.
Congenital Aortic Insufficiency From an Abnormal Left Aortic Cusp Results in Acute Coronary Syndrome
Authors: Doan Tam T. , Qasim Amna , Kearney Debra , Imamura Michiaki , Kyle William
Published: August 2020

Acute coronary syndrome (ACS) is a rare presentation in children with isolated congenital aortic insufficiency (AI). We report the case of a six-week-old previously well male who presented with an out-of-hospital cardiac arrest and was diagnosed with severe AI from a left aortic cusp anomaly resulting in ACS. The infant successfully underwent an emergent Ross operation.
Customer Value Co-Creation in the Automobile Industry: Antecedents, Satisfaction, and Moderation
Authors: Opata Christian Narh , Xiao Wen , Nusenu Angela Abena , Tetteh Stephen , John Narh Tettey-Wayo
Published: August 2020

The buying of cars is an important decision that customers make. Consequently, customers in their attempt in ensuring that they get a good deal go a great length in providing their skills, knowledge, and ideas to effect the design and specifications of their purchase. In this context, the purpose of this article is to first, measure two antecedents of customer participation in value co-creation in terms of customer willingness and customer ability; second, to measure how co-creation translates into customer satisfaction; and finally to examine the moderating effect of both price fairness perception and service convenience on satisfaction. With this objective, empirical data were collected through the administration of questionnaires to customers of automobile buyers in 30 dealer shops in Ghana. The proposed hypotheses were tested using SmartPLS 3.2.6 to perform structural equation modeling. The results showed that the two antecedents (willingness and ability) positively influences co-creation; co-creation significantly influences customer satisfaction; price fairness perception and service convenience not only influences satisfaction but they both have a positive moderation. The direct results between willingness, ability, and satisfaction also indicated positive relationship. Theoretical contributions, managerial implications, and suggestions for future research were discussed.
LGBT+ Competent Care
Authors: Johnson Karmie M. , Phillips Jennan A.
Published: August 2020

Over 11 million U.S. adults identify as lesbian, gay, bisexual, or transgender. Occupational health nurses must understand issues specific to this population to deliver competent care.
Factors Associated With Short Length of Stay After Long Fusions for Adult Spinal Deformity: Initial Steps Toward Developing an Enhanced Recovery Pathway
Authors: Lovecchio Francis , Steinhaus Michael , Elysee Jonathan Charles , Huang Alex , Ang Bryan , Lafage Renaud , Yang Jingyan , Soffin Ellen , Craig Chad , Lafage Virginie , Schwab Frank , Kim Han Jo
Published: August 2020

Study Design:

Retrospective cohort study.

Objectives:

The identification of case types and institutional factors associated with reduced length of stay (LOS) is a key initial step to inform the creation of clinical care pathways that can assist hospitals to maximize the benefit of value-based payment models. The objective of this study was to identify preoperative, intraoperative, and postoperative factors associated with shorter than expected LOS after adult spinal deformity (ASD) surgery.

Methods:

A retrospective cohort study was performed of 82 patients with ASD who underwent ≥5 levels of fusion to the pelvis between 2013 and 2018. A LOS <6 days was determined as a basis for comparison, as 5.7 days was the “expected LOS” generated through Poisson regression modeling of the sample. Clinical, radiographic, surgical, and postoperative factors were compared between those staying ≥6 days (L group) and <6 days (S group). Logistic regression was used to identify factors associated with LOS <6 days.

Results:

A total of 35 patients were in group S (42.7%). Gender, age, body mass index, ASA (American Society of Anesthesiologists) class, and use of preoperative narcotics, revision surgery, day of admission, and surgical complications did not vary between the cohorts ( P > .05). Mild-moderate preoperative sagittal deformity (sagittal Schwab modifiers 0 or +), lower estimated blood loss (<1200 mL), fewer levels fused (7 vs 10 levels), shorter operating room time, procedure end time before 15:00, and no intensive care unit stay, were associated with short LOS ( P < .05). Only 1 major medical complication occurred in the short LOS group ( P < .05).

Conclusions:

This study identifies the ASD “case phenotype,” intra-, and postoperative benchmarks associated with shorter LOS, providing targets for pathways designed to reduce LOS.
Hydroxychloroquine-Induced Toxic Myopathy Causing Diaphragmatic Weakness and Lung Collapse Requiring Prolonged Mechanical Ventilation
Authors: Pillittere Julie , Mian Sundus , Richardson Timothy E. , Perl Andras
Published: August 2020

A 42-year-old woman with juvenile idiopathic arthritis was treated with anakinra, corticosteroids, and hydroxychloroquine when she developed chronic hypoxic respiratory myopathy. She was admitted to the intensive care unit for acute hypercapnic respiratory failure and required prolonged intubation, subsequent tracheostomy, and long-term ventilatory support due to multiple failed spontaneous breathing trials after discontinuation of anakinra and steroids. Muscle biopsy revealed type II fiber atrophy with the accumulation of autophagosomes and vacuoles presenting as curvilinear bodies, elevated MHC class I antigen expression, and infiltration by CD68+ macrophages and CD8+ T cells. Type II fiber atrophy was attributed to corticosteroid use and curvilinear bodies due to blockade of autophagy by hydroxychloroquine. After hydroxychloroquine was discontinued, the patient recovered to her prehospitalization baseline.
An Unpleasant Surprise: Abdominal Presentation of Malignant Mesothelioma
Authors: Uhlenhopp Dustin J. , Saliares Ann , Gaduputi Vinaya , Sunkara Tagore
Published: August 2020

Malignant mesothelioma is an aggressive cancer associated with asbestos exposure with median survival time of 8 to 14 months following diagnosis. Given that mesothelial cells also line the peritoneum and pericardium, malignant mesothelioma can present in unusual sites and in patients with nonrespiratory complaints. A 73-year-old male presented to the emergency department for worsening intermittent diffuse abdominal pain for the past 3 months with associated unintentional 40-pound weight loss, early satiety, and diarrhea. He denied exposure to asbestos. Computed tomography imaging revealed multiple masses concerning for malignancy including the primary retroperitoneal mass, a mass involving the terminal ileum, and a mass in the right upper lung. Esophagogastroduodenoscopy demonstrated significant mass effect within the stomach without signs of endoluminal infiltration. Computed tomography–guided biopsy of the retroperitoneal abdominal and intramuscular paraspinal masses was performed. Stage IV epithelioid mesothelioma was confirmed when hematoxylin and eosin staining revealed pleomorphic malignancy nuclei containing a vesicular chromatin pattern and prominent nucleoli and immunohistochemical staining was positive for CK Oscar, cytokeratin 7, GATA3, calretinin, EMA, and CK5/6. He was started on cisplatin, pemetrexed, and bevacizumab but developed severe abdominal pain with pneumoperitoneum and bowel perforation 1 month later and expired shortly thereafter. To our knowledge, this represents a highly atypical presentation of malignant mesothelioma considering the involvement of the retroperitoneum with diffuse lesions in the abdominopelvic cavity and thorax (sparing the lung pleurae). This case also calls attention to the occurrence of malignant mesothelioma in patients without known asbestos exposure and the crucial role of pathology in diagnosing atypical presentations.
From the Employee Perspective: Organizations’ Administration of Internal Social Media and the Relationship between Social Media Engagement and Relationship Cultivation
Authors: Men Linjuan Rita , O’Neil Julie , Ewing Michele
Published: August 2020

This study examined communication strategies used by organizations to encourage employee participation on internal social media and analyzed whether employees’ internal social media usage engenders increased transparency and relational outcomes from the employee perspective. Specifically, researchers proposed and tested a conceptual model that links perceived organizational communication strategies (i.e., strategic information dissemination, two-way symmetrical communication), employee internal social media usage, perceived organizational transparency, and employee-organization relationships. Through an online survey of 1,150 employees from various organizations in the United States that had adopted internal social media, results showed that strategic information dissemination and two-way symmetrical communication both encouraged employees’ use of internal social media, which in turn, led to employees’ perception of organizational transparency and quality relationship outcomes with the organization. Theoretical and practical implications are discussed.
Prompting Candidates in Oral Assessment Contexts: A Taxonomy and Guiding Principles
Authors: Pearce Jacob , Chiavaroli Neville
Published: August 2020

Prompting is an aspect of oral assessment that deserves more attention. There appears to be considerable variation in how practitioners conceptualise prompting and how it is deployed in practice. In order to unpack the term and promote the validity of its use in performance assessments, we present a taxonomy of prompting as a continuum of types, namely: presenting the task; repeating information; clarifying questions; probing questions; and finally, leading questions. We offer general principles for consideration when using prompting in oral assessment: neutrality; consistency; transparency; and reflexivity. Whenever oral assessment is planned, assessors should be appropriately trained in the type and degree of prompting required, and candidates suitably briefed to know what to expect. Overall, we aim to raise awareness that quite different behaviours tend to be subsumed under the general term ‘prompting’. This paper provides concrete guidelines for implementing the defensible and effective use of prompting in oral examinations, applicable to a wide range of assessment contexts.
Quantifying Subclinical and Longitudinal Microvascular Changes Following Episcleral Plaque Brachytherapy Using Spectral Domain–Optical Coherence Tomography Angiography
Authors: Green Kyle M. , Toy Brian C. , Ashimatey Bright S. , Mustafi Debarshi , Jennelle Richard L. , Astrahan Melvin A. , Chu Zhongdi , Wang Ruikang K. , Kim Jonathan , Berry Jesse L. , Kashani Amir H.
Published: August 2020

Purpose:

This work assesses longitudinal microvascular changes in eyes treated with iodine-125 episcleral plaque brachytherapy (EPB).

Methods:

High-resolution optical coherence tomography angiograms (OCTAs) of the central 3 × 3-mm macula were obtained from iodine-125 EPB–treated and untreated fellow eyes of 61 patients. Previously validated semiautomated algorithms quantified capillary density (vessel skeleton density [VSD]) and caliber (vessel diameter index). Nonperfusion was also quantified as flow impairment region (FIR). Examinations from treated and fellow eyes obtained before treatment and at 6-month, 1-year, and 2-year intervals were compared using generalized estimating equation linear models. Dosimetry maps evaluated spatial correlation between radiation dose and microvascular metrics.

Results:

At 6 months, treated eyes had significantly lower VSD (0.145 ± 0.003 vs 0.155 ± 0.002; P = .009) and higher FIR (2.01 ± 0.199 vs 1.46 ± 0.104; P = .01) compared with fellow eyes. There was a significant decrease in VSD and a corresponding increase in FIR even for treated eyes without clinically identifiable retinopathy at 6 months. Vessel diameter index was significantly higher in treated eyes than in fellow eyes at 2 years (2.92 ± 0.025 vs 2.84 ± 0.018; P  < .001). We categorized our cohort into low-dose (< 15 Gy) and high-dose (> 45 Gy) radiation to the fovea and noted significant differences in VSD and FIR between groups.

Conclusions:

OCTA can quantify and monitor EPB-induced retinopathy and can detect vascular abnormalities even without clinically observable retinopathy. OCTA may be useful in investigating treatment interventions aiming to delay EPB-induced radiation retinopathy.
Sesquisyllabicity, Chữ Nôm, and the Early Modern embrace of vernacular writing in Vietnam
Authors: Phan John D.
Published: August 2020

In East Asia, the relationship between script and language is determined to a great extent by the typological character of the languages involved. This is particularly so because sinographic writing generally relies on the syllable as the smallest unit of sound expressible. However, many languages that have adapted Sinitic writing throughout history display complex syllable structure not easily expressible by the monosyllabically inclined sinograph. Moreover, some languages have even displayed changing syllable structure throughout documented history. This article examines the so-called “monosyllabicization” of the Vietnamese language, and its impact on the history of the sinographic vernacular script known as Chữ Nôm. I argue that by the 17th century, the emergent monosyllabic character of Vietnamese was remarked upon by elites as a new justification for embracing vernacular writing, previously considered uncouth.
Exploring the relationships between Nôm characters by comparing forms, sounds, and meanings
Authors: Nguyễn Đình Hiền , Ha Vu Hai
Published: August 2020

This article identifies and distinguishes Nôm characters by comparing their forms, sounds, and meanings. In this light, the relationships between Nôm characters can be classified into eight specific cases. This article provides examples, in-depth analysis, and a discussion of issues related to each specific case. The corpus this article draws on includes the Nôm characters in Quốc Âm Thi Tập (National language poetry collection) by Nguyễn Trãi (1380–1442) and Truyện Kiều (The tale of Kieu) by Nguyễn Du (1766–1820). The research results of this article can carry implications for the identification of Nôm characters, the studies of authors and their works, phonetics research, as well as the investigation into other scripts adapted from the Chinese script.
Feasibility analysis for granulation of silver using Granshot method
Authors: Bairwa Ankit , Reddy Ashok Kumar , Singh Gurmeet
Published: August 2020

Metal granshot is a process that is used to convert metal lumps or scraps into metal grains of uniform sizes and shapes. The concept of metal granulation is based on the heat difference between melting and pouring medium. The commercial uses of metal granules are jewelry making and spray coating of costly metals such as silver, gold, and platinum. The basic aim of the silver granshot process is to get uniform size, shape, and maximum yield of silver metal granules. During processing, the metal gets superheated within vacuum up to viscosity more than 2.2 cP flow out of the minimum diameter orifice and allow to drop in the coolant with high pressurized argon gas. The present study focuses on the granulation of silver and tries to achieve the maximum yield of metal. The shape and size of the granules produced were observed using scanning electron microscopy and the results show that the average diameters of granules are between 1.2 mm and 3.8 mm. Yield is also considered as an important factor for granulation of valuable metals like silver, and after experimentation successfully achieved the 99.9 percent yield. The granulation process of silver will help to ease the trading of metal in the jewelry industry.
Sino-US Disorder: Power and Policy in Post-COVID Indo-Pacific
Authors: Basu Titli
Published: August 2020

Great powers have invested in order-building projects with competing vision of political values and ideologies. How the Coronavirus (COVID-19) pandemic shapes the balance of power and order are debated. The pandemic arrived in the midst of Sino-US strategic contestation, a crumbling European project, de-globalisation and contested economic governance architecture. While the pandemic exacerbated Washington abdicating leadership role, Beijing also has alienated itself from the followers of rules based order. It has sharpened the clash of rhetoric, narratives, and perceptions. The pandemic will reorganise the international system and power structures. Situating the Indo-Pacific project in this backdrop, this article critically analyses the debates, discourses and nuanced divergences that are shaping the Indo-Pacific puzzle in the power corridors of Washington, Tokyo and Delhi, in addition to mapping Beijing’s approach to Indo-Pacific. The article evaluates the contrast in their respective visions of order, China strategy, ASEAN centrality and multilateral free-trade regimes. But these subtle departures have not restricted major Indo-Pacific powers to weave a strategic web of democracies and pursue a win-win issue-based multi-alignment on matters of mutual strategic interests. With new realities in play, the India-US-Japan triangle will feature as one of the key building blocks of Indo-Pacific to deliver on the shared responsibility of providing global public goods.

JEL Codes: F5, K3
Physician snapshot: the forming landscape of MAiD in northwestern Ontario
Authors: Durant Keri-Lyn , Kortes-Miller Katherine
Published: August 2020

Background:

Options available to Canadians at the end of life increased with the legalization of medical assistance in dying (MAiD). Bill C-14 modified the Canadian Criminal Code allowing individuals who meet very specific criteria to receive a medical intervention to hasten their death. June 2019 marked 3 years since the legislation has changed and while met with favour from most Canadians who believe it will provide enhanced options for quality of life at the end of life, there remains much debate over both its moral implications and practical components. Little is known regarding the Canadian healthcare provider experience with MAiD, in particular in rural and remote parts of the country such as northwestern Ontario.

Objectives:

The purpose of this study was to explore physicians’ experiences in Northwestern Ontario with MAiD. The geographic location of this study is of particular significance as physicians in rural and remote parts of Canada face unique challenges in the provision of high-quality palliative and end-of-life services. This qualitative research focused on developing a better understanding of physicians’ perceptions and practices with MAiD, in particular regarding access, decision-making, provision of service and role clarity.

Methods:

The researchers employed an exploratory qualitative research approach, using 1 semi-structured focus group and 18 semi-structured interviews comprising 9 set of questions. Data were collected through audio-taped semi-structured interviews, in person and by telephone.

Findings:

Four distinct but interconnected themes emerged from thematic analysis of the transcripts of the focus group and interviews: physician perception of patient awareness, appreciation and understanding of MAiD; challenges providing true choice at end of life; burgeoning relationships between palliative care and MAiD; and physician recommendations.

Conclusion:

The results of this study provide a snapshot of the Northwestern physician experiences with MAiD and contribute to the growing body of work exploring these issues on a national scale. MAiD is highlighted as both a rewarding and challenging experience for physicians in Northwestern Ontario in this study.
Subunits of ARID1 serve as novel biomarkers for the sensitivity to immune checkpoint inhibitors and prognosis of advanced non-small cell lung cancer
Authors: Sun Dantong , Tian Lu , Zhu Yan , Wo Yang , Liu Qiaoling , Liu Shihai , Li Hong , Hou Helei
Published: August 2020

Introduction

Patients with advanced non-small cell lung cancer (NSCLC) benefit from treatment with immune checkpoint inhibitors (ICIs). Biomarkers such as programmed death-ligand 1 (PD-L1), the tumor mutational burden (TMB) and the mismatch repair (MMR) status are used to predict the prognosis of ICIs therapy. Nevertheless, novel biomarkers need to be further investigated, and a systematic prognostic model is needed for the evaluation of the survival risks of ICIs treatment.

Methods

A cohort of 240 patients who received ICIs from the cBioPortal for Cancer Genomics was evaluated in this research. Clinical information and targeted sequencing data were acquired for analyses. The Kaplan-Meier plot method was used to perform survival analyses, and selected variables were then confirmed by a novel nomogram constructed by the “rms” package of R software.

Results

Seven percent of the NSCLC patients harboredARID1Amutations, while 4% of the NSCLC patients harboredARID1Bmutations. Mutations inARID1AandARID1Bwere confirmed to be associated with sensitivity to ICIs. Patients harboring these mutations were found to have a better response to treatment (ARID1A:P = 0.045;ARID1B:P = 0.034) and prolonged progression-free survival (ARID1B:P = 0.032). Here, a novel nomogram was constructed to predict the prognosis of ICIs treatment. Elevation of the TMB, enhanced expression of PD-L1 and activation of the antigen presentation process and cellular immunity were found to be correlated withARID1AandARID1Bmutations.

Conclusion

ARID1A and ARID1B could serve as novel biomarkers for the prognosis and sensitivity to ICIs of advanced NSCLC.
Infectious endophthalmitis at a Philippine tertiary hospital: a ten-year retrospective study
Authors: Dimacali Victoria Grace , Lim Bon Siong Ruben
Published: August 2020

Background

Endophthalmitis is a sight-threatening disease characterized by marked progressive inflammation of the vitreous and/or aqueous humors. Limited information is currently available regarding endophthalmitis in the Philippines. This study aimed to provide long-term summary data on endophthalmitis cases seen at the largest tertiary referral hospital in the Philippines.

Methods

All endophthalmitis cases diagnosed at the Philippine General Hospital from January 1, 2007 to December 31, 2016 were retrieved and classified by etiology. Data pertaining to history, associated risk factors, isolated microorganisms, management, and final visual outcomes for each patient were reviewed.

Results

A total of 202 cases diagnosed within the audit period were included in the study. These were classified as post-traumatic (55.94%), endogenous (14.36%), acute post-operative (10.40%), keratitis-induced (6.93%), chronic post-operative (5.44%), bleb-associated (3.96%), and suture-associated (2.97%) endophthalmitis. Males comprised 71.29% of the population, while the largest age group affected was 0–10 years (24.75%). The culture-positive rate was 57.89%. The predominant etiology was Gram-positive bacteria (38.18%), followed by Gram-negative bacteria and mixed pathogens (21.82% each), and fungi (18.18%). The most common organisms were Streptococcus, Staphylococcus, Pseudomonas, Aspergillus, and Candida, accounting for 56.45% of isolates. Pars plana vitrectomy was done for 62.87% of patients, intravitreal and other antibiotic therapy in 23.27%, and primary enucleation/evisceration in 10.89%. The final outcomes and best corrected visual acuities were: anophthalmia 11.86%, no light perception/no dazzle 27.84%, light perception 8.76%, hand motions 24.23%, counting fingers 5.15%, 3/200 to 20/50 12.89%, and 20/40 to 20/20 9.28%.

Conclusions

There was a higher proportion of post-traumatic endophthalmitis cases compared to traditional estimates but consistent with studies from China and Thailand. The majority of these cases involved younger children as well as young to middle-aged males engaged in carpentry and construction work, implying a need for increased public health awareness and strengthening of childcare and workplace safety policies. Our microbiologic profile showed a lower proportion of Gram-positive infections and a higher proportion of mixed pathogen infections compared to other studies. There was also a higher proportion of fungi associated with post-operative and keratitis-induced endophthalmitis. The best outcomes were seen in acute post-operative and bleb-associated endophthalmitis, and the worst outcomes in endogenous and keratitis-induced endophthalmitis. Visual outcomes were poorer compared to other Western and Asian countries, with only 21.7% of patients improving from presentation.
A transcriptomic variation map provides insights into the genetic basis of Pinus massoniana Lamb. evolution and the association with oleoresin yield
Authors: Liu Qinghua , Xie Yini , Liu Bin , HuanhuanYin  , Zhou Zhichun , Feng Zhongping , Chen Yadong
Published: August 2020

Background

Masson pine (Pinus massoniana Lamb.), the dominant native coniferous species in southern China, is commercially important for supplying timber and oleoresin. However, knowledge of the genetic variability of masson pine germplasm is still limited. In this study, the genetic diversity and population structure of masson pine germplasm were assessed using 204 wild accessions from 10 main distribution regions using 94,194 core single-nucleotide polymorphisms (SNPs) obtained from transcriptome sequencing data.

Results

The average expected heterozygosity was 0.2724, implying abundant genetic diversity within masson pine germplasm. Analysis of molecular variance (AMOVA) revealed that 3.29% of the variation was sourced from genetic differentiation. Structure analysis identified two geographically distinct groups. Discriminant analysis of principal components (DAPC) showed that one of those groups was further divided into two clusters. Sichuan and Chongqing provenance is the geographical origin, which diffused outward along two different lines. Oleoresin yield is reflected in the evolution of the two groups, and exhibits two different trends along the two lines of diffusion. The oleoresin yield may be associated with the genes of chitinase, CYP720B, cytochrome P450, ABC transporter, and AP2/ethylene-responsive transcription factor (ERF) based on SNPs and expression.

Conclusions

SNP markers from transcriptome sequencing are highly capable of evaluating genetic diversity within different species, as well as the genetic control of objective traits. The functions of these genes will be verified in future studies, and those genes strongly associated with oleoresin yield will be used to improve yields by means of early genotype selection and genetic engineering.
Metabolic syndrome in haemodialysis patients: prevalence, determinants and association to cardiovascular outcomes
Authors: Delautre Arnaud , Chantrel François , Dimitrov Yves , Klein Alexandre , Imhoff Olivier , Muller Clotilde , Schauder Nicole , Hannedouche Thierry , Krummel Thierry
Published: August 2020

Background

In the general population, metabolic syndrome (MetS) is predictive of major adverse cardiovascular events (MACE). Waist circumference (WC), a component of the MetS criteria, is linked to visceral obesity, which in turn is associated with MACE. However, in haemodialysis (HD) patients, the association between MetS, WC and MACE is unclear.

Methods

In a cross-sectional study of 1000 HD patients, we evaluated the prevalence and characterised the clinical predictors of MetS. The relationship between MetS and its components, alone or in combination, and MACE (coronary diseases, peripheral arteriopathy, stroke or cardiac failure), was studied using receiver operating characteristics (ROC) curves and logistic regression.

Results

A total of 753 patients were included between October 2011 and April 2013. The prevalence of MetS was 68.5%. Waist circumference (> 88 cm in women, 102 cm in men) was the best predictor of MetS (sensitivity 80.2; specificity 82.3; AUC 0.80; p <  0.05). In multivariate analysis, MetS was associated with MACE (OR: 1.85; 95CI 1.24–2.75; p <  0.01), but not WC alone. There was a stronger association between the combination of abdominal obesity, hypertriglyceridaemia and low high-density lipoprotein cholesterol with MACE after exclusion of impaired fasting glucose and hypertension.

Conclusions

MetS is frequent and significantly associated with MACE in our haemodialysis cohort and probably in other European dialysis populations as well. In HD patients, a new simplified definition could be proposed in keeping with the concept of the “hypertriglyceridaemic waist”.
Quality of life and psychological distress during cancer: a prospective observational study involving young breast cancer female patients
Authors: Muzzatti Barbara , Bomben Francesca , Flaiban Cristiana , Piccinin Marika , Annunziata Maria Antonietta
Published: August 2020

Background

Despite the possible traumatic significance of cancer and of the incidence, prevalence, and survival of young women with breast cancer, these patients are underrepresented in multidimensional research. In the present survey, QoL and psychological distress were studied in a sample of young female breast cancer patients during the first year of their disease. More in detail, the study was firstly aimed to assess if QoL of 18–45 years old female breast cancer patients was different from QoL of women from the general population and if it changed over time. Secondly, it described the psychological distress and its change over time. Finally, it assessed if QoL registered 1 year post-surgery may be explained by QoL and/or psychological distress registered during the hospitalization.

Methods

One hundred six, consecutive 18–45 years old, female primary breast cancer patients undergoing anticancer surgery filled out the Short Form 36 Health Survey Questionnaire, the Hospital Anxiety and Depression Scale and a socio-demographic and clinical form during hospitalization to receive surgery (T0), and again at 12 months post-surgery (T1).

Results

At T0, participants showed a better physical functioning (p = 0.001) than the female normative sample, whereas their mental functioning was worse (p < 0.001). In this time, mental functioning within our sample was weaker than physical functioning (p < 0.001). Over time, physical functioning decreased (p < 0.001), whereas mental functioning increased (p < 0.001). Both at T0 and T1, anxiety was higher than depression (p < 0.05). Both distress dimensions decreased over time (p < 0.001). Nevertheless, at T0 the 25.5 and 26.4% of the sample were respectively possible and probable cases of anxiety, whereas the 17.9 and 9.4% were possible and probable cases of depression. At T1, the percentages were 17.9 and 18.9% for anxiety, and 8.5 and 6.6% for depression. In both considered times, a better QoL corresponded to less psychological distress. However, QoL and psychological distress assessed at T0 did not predict the QoL at T1.

Conclusions

This study documented as QoL and psychological distress may change during the first year after surgery for a primary breast cancer in young women; therefore, they should be monitored over time to detect and treat women with alarming levels on them.
DaVinci robotic-assisted laparoscopic resection of parapelvic cavernous hemangioma: a case report
Authors: Chen Zheng-Jun , Wang Dong , Fan Shi-Da , Ren Shang-Qing , Zhou Fang , Nie Yu , Lv Qian , Tian Jing-Zhi
Published: August 2020

Background

Cavernous hemangioma, as a rare tumor, is difficult to differentiate from retroperitoneal lymphoma and paraganglioma. They are more difficult to excise completely through open surgery and traditional laparoscopic surgery. The study aimed to evaluate the role of DaVinci surgical system in laparoscopic resection of parapelvic cavernous hemangioma.

Case presentation

A 46-year-old female, who diagnosed as parapelvic cavernous hemangioma accompanying with thrombosis and calcification, was performed laparoscopic resection using DaVinci surgical system under general anesthesia. The patient well recovered without recurrence or spread of the lesion after operation for 3 months as well as hydronephrosis was significantly relieved.

Conclusion

Laparoscopic resection of parapelvic cavernous hemangioma under the help of DaVinci surgical system was feasible and safe.
Association of snoring and body composition in (peri-post) menopausal women
Authors: Zhou Yang , Liu Fei , Li Changbin , Zheng Yanwei , Hu Jiangshan , Zhou Yibei , Geng Lulu , Jiang Susu , Teng Yincheng , Tao Minfang
Published: August 2020

Background

Little attention has been paid to whether snoring frequency is associated with body composition in menopausal women, particularly in China. This study objected to investigate the association between self-reported snoring and body composition in (peri-post) menopausal Chinese women as well as metabolic indicators.

Methods

This cross-sectional study enrolled 715 participants aged 40–67 years from the Menopause Clinic in the Shanghai Sixth People’s Hospital. Participants were categorized into four subgroups stratified by self-reported snoring frequency: never, rarely (< 1 night per week), occasionally (1–2 nights per week), regularly (≥3 nights per week), while body composition was measured using bioelectrical impedance analysis (BIA). Besides, blood sample were collected to test the glycolipid indicators.

Results

In our sample of investigation, regular snoring (≥3 nights per week) was found to be an independent risk factor for higher fat mass (total, upper limbs, trunk), with the highest risk of 2.4 times for fat mass of trunk after adjusting for metabolic confounders(p = 0.003). Meanwhile, regular snoring was independently associated with higher fat mass (total and each segment) only in menopausal transition (p = 0.023).

Conclusions

We suggested that self-reported regular snoring may be taken as a simple alternative to predict higher fat mass (≥17.11 kg, upper quartile) in menopausal women. Similarly, body composition should be attached to the great importance to those who in menopausal transition in order to help to prevent obstructive sleep apnea (OSA).
Fetal cardiac function at intrauterine transfusion assessed by automated analysis of color tissue Doppler recordings
Authors: Herling Lotta , Johnson Jonas , Ferm-Widlund Kjerstin , Bergholm Fredrik , Lindgren Peter , Sonesson Sven-Erik , Acharya Ganesh , Westgren Magnus
Published: August 2020

Background

Fetal anemia is associated with a hyperdynamic circulation and cardiac remodeling. Rapid intrauterine transfusion (IUT) of blood with high hematocrit and viscosity into the umbilical vein used to treat this condition can temporarily further affect fetal heart function. The aim of this study was to evaluate the short-term changes in fetal myocardial function caused by IUT using automated analysis of cine-loops of the fetal heart obtained by color tissue Doppler imaging (cTDI).

Methods

Fetal echocardiography was performed before and after IUT. cTDI recordings were obtained in a four-chamber view and regions of interest were placed at the atrioventricular plane in the left ventricular (LV), right ventricular (RV) and septal walls. Myocardial velocities were analyzed by an automated analysis software to obtain peak myocardial velocities during atrial contraction (Am), ventricular ejection (Sm), rapid ventricular filling (Em) and Em/Am ratio was calculated.

Myocardial velocities were converted to z-scores using published reference ranges. Delta z-scores (after minus before IUT) were calculated. Correlations were assessed between variables and hemoglobin before IUT.

Results

Thirty-two fetuses underwent 70 IUTs. Fourteen were first time transfusions. In the LV and septal walls, all myocardial velocities were significantly increased compared to normal values, whereas in the RV only Sm was increased before IUT (z-scores 0.26–0.52). In first time IUTs, there was a negative correlation between LV Em (rho = − 0.61, p = 0.036) and LV Em/Am (rho = − 0.82, p = 0.001) z-scores and hemoglobin before IUT. The peak myocardial velocities that were increased before IUT decreased, whereas LV Em/Am increased significantly after IUT.

Conclusions

This study showed that peak myocardial velocities assessed by cTDI are increased in fetuses before IUT reflecting the physiology of hyperdynamic circulation. In these fetuses, the fetal heart is able to adapt and efficiently handle the volume load caused by IUT by altering its myocardial function.
Histone acetylation and the role of histone deacetylases in normal cyclic endometrium
Authors: Gujral Palak , Mahajan Vishakha , Lissaman Abbey C. , Ponnampalam Anna P.
Published: August 2020

Histone acetylation is a critical epigenetic modification that changes chromatin architecture and regulates gene expression by opening or closing the chromatin structure. It plays an essential role in cell cycle progression and differentiation. The human endometrium goes through cycles of regeneration, proliferation, differentiation, and degradation each month; each phase requiring strict epigenetic regulation for the proper functioning of the endometrium. Aberrant histone acetylation and alterations in levels of two acetylation modulators - histone acetylases (HATs) and histone deacetylases (HDACs) - have been associated with endometrial pathologies such as endometrial cancer, implantation failures, and endometriosis. Thus, histone acetylation is likely to have an essential role in the regulation of endometrial remodelling throughout the menstrual cycle.
A pilot randomized controlled trial to assess the effect of Islamic spiritual intervention and of breathing technique with heart rate variability feedback on anxiety, depression and psycho-physiologic coherence in patients after coronary artery bypass surgery
Authors: Amjadian Mohiadin , Bahrami Ehsan Hadi , Saboni Kaivan , Vahedi Siamak , Rostami Reza , Roshani Daem
Published: August 2020

Background

This study investigated the effects of Islamic religious and breathing techniques with heart rate variability (HRV) biofeedback therapies on HRV and psycho-physiologic coherence (resonance frequency), depression and anxiety in coronary artery bypass graft surgery (CABG) patients.

Methods

Sixty CABG patients were chosen and randomly assigned to religious, breathing techniques and control groups. The experimental groups received 8  weeks of treatments; a 2-h session with home works in each week. The control group received only their normal hospital interventions. The groups’ depression, anxiety, HRV and psycho-physiologic coherence levels were assessed before and after the interventions by DASS-21 for depression and anxiety, and em-wave desktop software for HRV and psycho-physiologic coherence. The data were analyzed using ANCOVA with Bonferroni Comparison test and descriptive tests in SPSS software.

Results

The findings showed that there were significant differences in psycho-physiologic coherence (HRV), depression and anxiety scores among the three groups in the post-tests. In fact, depression and anxiety were reduced more in the religious group, while psycho-physiologic coherence raised more in the breathing with the HRV feedback group.

Conclusion

The results showed that both Islamic religious and breathing techniques with HRV biofeedback therapies can be used in rehabilitation programs for CABG patients in clinics and hospitals.
Mycoparasite Hypomyces odoratus infests Agaricus xanthodermus fruiting bodies in nature
Authors: Lakkireddy Kiran , Khonsuntia Weeradej , Kües Ursula
Published: August 2020

Mycopathogens are serious threats to the crops in commercial mushroom cultivations. In contrast, little is yet known on their occurrence and behaviour in nature. Cobweb infections by a conidiogenousCladobotryum-type fungus identified by morphology and ITS sequences asHypomyces odoratuswere observed in the year 2015 on primordia and young and mature fruiting bodies ofAgaricus xanthodermusin the wild. Progress in development and morphologies of fruiting bodies were affected by the infections. Infested structures aged and decayed prematurely. The mycoparasites tended by mycelial growth from the surroundings to infect healthy fungal structures. They entered from the base of the stipes to grow upwards and eventually also onto lamellae and caps. IsolatedH. odoratusstrains from a diseased standing mushroom, from a decaying overturned mushroom stipe and from rotting plant material infected mushrooms of different species of the genusAgaricuswhilePleurotus ostreatusfruiting bodies were largely resistant. Growing and grownA. xanthodermusandP. ostreatusmycelium showed degrees of resistance against the mycopathogen, in contrast to mycelium ofCoprinopsis cinerea. Mycelial morphological characteristics (colonies, conidiophores and conidia, chlamydospores, microsclerotia, pulvinate stroma) and variations of five differentH. odoratusisolates are presented. In pH-dependent manner,H. odoratusstrains stained growth media by pigment production yellow (acidic pH range) or pinkish-red (neutral to slightly alkaline pH range).
Bluetooth-based device-to-device routing protocol for self-organized mobile-phone mesh network
Authors: Fan Aihua , Tang Zhiqiang , Wu Weiwei , Tang Yu , Lin Di
Published: August 2020

The bluetooth technology provides a point-to-point communication interface to mobile phones and other electronic devices, which can be used to form a self-organized ad hoc mesh network consists of mobile phones. In such a self-organized mesh network, the data packets are not transferred by traditional telecommunication backbone network but through bluetooth-based hop-by-hop routing among mesh nodes in the network. Such an ad hoc mesh network may find a wide span of application scenarios where access to backbone network infrastructure is not available, yet it needs an efficient routing protocol to provide a timely transmission mechanism for data packets to reach their destination even under situations when network topology is in constant changes due to mobile node’s movement. In the bluetooth-based device-to-device routing protocol (BDRP) presented in this paper, we propose several key designs as processed data table, node exclusion by packet and source control routing to provide an end-to-end packet transmission solution in a dynamically changing topology with constraints on network bandwidth, battery power, and storage space on a mobile device. The processed data table and node exclusion by packet mechanisms contribute to eliminating a great number of non-useful duplicate packets in routing path, and the source control routing algorithm implemented with a cross-layer packet retransmission process provides a fast and low-overhead routing policy and an assurance to packet reaching destination. In the simulation experiment conducted BDRP demonstrates its effectiveness and efficiency in eliminating undesirable duplicate packets and adaptability to constant topological changes. The performance comparison experiment indicates that the BDRP outperforms the optimized link state routing (OLSR) protocol in packet arrival rate, particularly under situations when mobile nodes are in fast moving mode, yet manages to maintain the same level of transmission delay as OLSR’s even with the packet retransmission process. The work presented in this paper provides a key technology for the applications of Bluetooth mobile phone mesh network in a larger geographic area and a broader application domain.
Existence of solutions for nonlinear fractional integro-differential equations
Authors: Bragdi Ahmed , Frioui Assia , Guezane Lakoud Assia
Published: August 2020

In this paper, by means of the Krasnoselskii fixed point theorem, the existence of solutions for a boundary value problem of nonlinear sequential fractional integro-differential equations are investigated. Two examples are given to illustrate our results.
S-RASTER: contraction clustering for evolving data streams
Authors: Ulm Gregor , Smith Simon , Nilsson Adrian , Gustavsson Emil , Jirstrand Mats
Published: August 2020

Contraction Clustering (RASTER) is a single-pass algorithm for density-based clustering of 2D data. It can process arbitrary amounts of data in linear time and in constant memory, quickly identifying approximate clusters. It also exhibits good scalability in the presence of multiple CPU cores. RASTER exhibits very competitive performance compared to standard clustering algorithms, but at the cost of decreased precision. Yet, RASTER is limited to batch processing and unable to identify clusters that only exist temporarily. In contrast, S-RASTER is an adaptation of RASTER to the stream processing paradigm that is able to identify clusters in evolving data streams. This algorithm retains the main benefits of its parent algorithm, i.e. single-pass linear time cost and constant memory requirements for each discrete time step within a sliding window. The sliding window is efficiently pruned, and clustering is still performed in linear time. Like RASTER, S-RASTER trades off an often negligible amount of precision for speed. Our evaluation shows that competing algorithms are at least 50% slower. Furthermore, S-RASTER shows good qualitative results, based on standard metrics. It is very well suited to real-world scenarios where clustering does not happen continually but only periodically.