bluuebunny/crossref_metadata_2025 huggingface dataset:
Efeitos da meditação associada a educação em neurociências da dor em adultos com fibromialgia: ensaio clínico controlado e randomizado
Authors: Carvalho Lucas Pelegrini Nogueira de , Araújo Lílian Silva , Say Karina Gramani , Avelar Maria do Perpétuo Socorro Lage
Published: February 2021

Objetivo: analisar os efeitos do mindfulness associado com educação em neurociências da dor na percepção da dor, sono e capacidade funcional de adultos com fibromialgia. Método: trata-se de um estudo experimental controlado e randomizado cujos participantes foram divididos em dois grupos: grupo mindfulness e grupo mindfulness e educação em neurociência da dor. Resultados: foram observadas melhorias de algumas variáveis relacionadas à dor, na capacidade funcional, ansiedade, depressão, qualidade do sono e na catastrofização. Não houve diferença na comparação intergrupos, porém  existiram diferenças na comparação intra-grupos. Conclusão: intervenções baseadas na prática de mindfulness e educação em neurociências da dor se mostraram eficazes na melhora doquadro de pacientes com fibromialgia. Registro do Ensaio clínico: REBEC RBR-58pgs4.
Intervenção baseada em mindfulness para cuidadores de idosos com demência
Authors: Sanchez Marília Graciela de Almeida Prado , Caparrol Ana Julia de Souza , Martins Gabriela , Alves Ludmyla Caroline de Souza , Monteiro Diana Quirino , Gratão Aline Cristina Martins
Published: February 2021

Objetivo: analisar os efeitos da Intervenção baseada em Mindfulness sobre sintomas depressivos, ansiosos e sobrecarga de cuidadores familiares de idosos com demência.Método: trata-se de um ensaio clínico randomizado e controlado com amostra (n=29) composta por Grupo Intervenção com Mindfulness (GIM) (n=11) e Grupo Controleativo (GCa) (n=18). Para GIM foram oito encontros (um por semana) aplicando a meditação mindfulness, durante quatro meses, no domicílio, individualmente e para GCa foi realizadauma visita domiciliar com orientações acerca da doença. Foram comparadas as medidas dos sintomas de sobrecarga (Zarit) e sintomas de ansiedade e depressão entre os grupose analisadas pelos testes t de student, teste de variância simples ANOVA e em seguida o post hoc Bonferroni (α<0,05). Resultados: na análise dois a dois houve redução no nível médio da HAD após a intervenção com a prática de Mindfulness para o grupo intervenção (p=0,048). Ao se comparar todos os grupos entre si, houve diferença entre o grupo GIM pré intervenção e GCa pós intervenção (p=0,021). Conclusão: de forma geral, a intervenção apresentou melhora no instrumento HAD, destacando a importância da intervenção baseada em Mindfulness para cuidadores de idosos com demência para amenizar sintomas de ansiedade e depressão.
Diplomatic Doctrine and Style with Chinese Characteristics
Authors: Freeman Chas W.
Published: February 2021

Chinese diplomatic style is the product of many influences. It is rooted in 2,000 years of history but also reflects changes resulting from the Chinese Revolution and the dramatic expansion of its wealth, power, status and interests ongoing today. Much is made of the hierarchical tradition in China’s diplomatic thinking and its resistance to Western diplomatic norms. However, these provide unreliable guides for contemporary Chinese diplomacy. While ‘face’, in terms of the respect of others remains an important consideration, Chinese diplomacy is influenced by upholding its understanding of the principles of sovereignty, non-intervention and self-determination. It is also influenced by the ruling Chinese Communist Party’s conceptions of how political leadership and control are exercised and maintained. These concerns manifest themselves in the way Chinese diplomatic style has avoided force, favoured ambiguity and operated with a clear, but creatively interpreted, distinction between non-negotiable core principles and more flexible concrete arrangements.
Cowpea (Vigna Unguiculata (L.) Walp.): Traditional and Improved Cropping Methods in Northern Nigeria
Authors: Sampers Wim
Published: February 2021

The present article describes the traditional cowpea cropping system in Dambatta, Kano State, Nigeria. Through a baseline survey it becomes clear that traditionally cowpea is mostly intercropped with cereals, that the importance of land preparation is marginal, that yields are low and that, in general, the technical level of the cowpea grower is low (low inputs of fertilizer and pesticide). In a second part some data are given about a project that introduced a new cowpea variety, T.V.X. – 3,236, and improved methods. It is shown that, although better yields are possible, the extension service does not succeed in motivating the farmers enough so that the outcome of the project intervention is uncertain.
Cinéma et Racisme “The Gods Must be Crazy / Les Dieux Sont Tombés sur la Tête” en Afrique Australe
Authors: Cantin Chantal , Juste Hervé
Published: February 2021

Commentary on the Film “The Gods must be Crazy”

This critical comment on the film “The Gods must be Crazy” deals with the controversial reactions it provoked. The Anti-Apartheidlobby has condemned it as implicitely racist but others qualified it as an amusing, entertaining comedy.

In the first part the authors analyze a number of differing press-comments. In the second part they try to identify the stereotypes about Black and White. Finally the authors describe the reactions of some 40 spectators by means of a debate with a preceding description of the South African political context (“contextualization”) aiming at orienting the audience towards the thesis of a racist film.
The Foreign Debt Problem of Africa
Authors: Decoodt Patrick
Published: February 2021

The foreign debt problem of Sub Saharan Africa {SSA), although an important obstacle against economic growth, is not the region's major economic problem.

The creditors are less concerned about the relative small debt figures of SSA because of the lower risks for the equilibrium of the financial system. But from the debtors' viewpoint, the debt situation is possibly even more critical in low-income Africa than in the richer major debtor countries.

SSA has a predominance of official creditors with the best obtainable credit terms. Notwithstanding these good terms, SSA is so poor that it has difficulties with fulfilling its debt service.

There is no single solution for the African debt crisis. Anyway the official creditors have to adopt a more flexible attitude. The debtor countries have also to accept their own responsibility in the solutions of the problem.
The Political Transformation Of Libya under Qadhafi
Authors: Haghebaert Bruno
Published: February 2021

In the Third World, the function of political leadership is more pivotal than in western countries. The subjective factor of Qadhafi has vital bearing on developments in Libya. There was no historical neccessity for Libya to have developed along the revolutionary path that it has. The formation of the Arab Socialist Union, the Popular Revolution, the creation of the Jamahiriya, the inauguration of the Revolutionary Committee movement and the programme of militarisation - all these issues are a result of Qadhafi’s wish to “revolutionarize” Libyan society.

His ultimate aim was to eliminate all intermediaries between the people and the political power. In practice, real power remained in the hands of Qadhafi and the Revolutionary Committees. A drastic fall in oil revenues and the arrogance and arbitrariness of Qadhafi’s revolutionary zealots led to growing discontent among the Libyan population.

The American raid on Tripoli and Benghazi in April 1986 was meant to precipitate Qadhafi’s downfall. But his regime was not overthrown and the Libyan leader proved to be a master of political survival. A (temporary) political and economic liberalisation has boosted his popularity. On the eve of the twentieth anniversary of the Libyan revolution, his position still seems to be secure.
Military Budgets, Underdevelopment and Dependency
Authors: Nauwelaerts Philip
Published: February 2021

Military expenditures are considered to be one of the causes of underdevelopment. This statement is not easy to prove. The article tries to explain that relatively small military expenditures might have large consequences, e.g. on external debt and scarcity of foreign exchange. The problem for Africa is not in the first place the amount of military expenses or external debt, but the low productivity rate which makes repayment difficult.

Africa still remains dependent in different economic fields from industrialized countries. The African situation would improve by more stable regimes and a better internal organization of the state, so that natural resources and other activities will really benefit the country.
A Japoniste Friendship in Translation: Hayashi Tadamasa and Philippe Burty (1878–1890)
Authors: Emery Elizabeth
Published: February 2021

Art critic and collector Philippe Burty (1830–1890) was one of the first friends the Japanese interpreter (and future art dealer) Hayashi Tadamasa (1853–1906) made on arrival in Paris in 1878. The previously unknown letters translated into English within this essay present Hayashi’s work in Paris (1878) and Brussels (1880), his first impressions of Normandy (1882) and New York (1886), and his explanation of the evolution of Japanese painting (1885). They furnish valuable insights into the cross-cultural aesthetics that led the Japanese, the French, the British, the German, and Americans to collaborate in the development of the phenomenon now known as Japonisme, thereby filling in some of the information gaps surrounding Burty’s international networks and Hayashi’s early years in Europe.
New genera for species of Jassa Leach (Crustacea: Amphipoda) and their relationship to a revised Ischyrocerini
Authors: CONLAN KATHLEEN E.
Published: February 2021

Four Southern Hemisphere and one Northern Hemisphere species of Jassa (Crustacea: Amphipoda: Ischyrocerini) are removed from this genus. The south temperate Jassa barnardi Stephensen, 1949 is synonymized with Ventojassa frequens (Chilton, 1883). The south temperate and subantarctic Jassa multidentata Schellenberg, 1931 and Jassa wandeli Chevreux, 1906 are transferred to Pleojassa n. gen., with the addition of P. lowryi n. sp., P. moorei n. sp. and P. orientalis n. sp. Hemijassa Walker, 1907 is resurrected for the Antarctic Jassa goniamera Walker, 1903. The Northern Hemisphere Jassa ocia (Bate, 1862) is transferred to Plumulojassa n. gen. and shown to range throughout the temperate coasts of the northeastern Atlantic and its eastern seas. Placed in context of the other genera of the Ischyrocerini Stebbing, 1899, Jassa, Pleojassa, Hemijassa and Plumulojassa join Parajassa Stebbing, 1899 in having a unique uropod 3 morphology. Characteristics of the uropod 3 and other appendages are used to revise four other genera of the Ischyrocerini. Ischyrocerus Krøyer, 1838 now becomes a temperate to polar genus, with Neoischyrocerus Conlan, 1995 embracing tropical species of Ischyrocerus and all members of Coxischyrocerus Just, 2009 and Tropischyrocerus Just, 2009. A new diagnosis and illustrated key to the 18 genera of Ischyrocerini is given.
Predictive Value of Hypoalbuminemia for Contrast-Associated Acute Kidney Injury: A Systematic Review and Meta-Analysis
Authors: Liu Liwei , Lun Zhubin , Wang Bo , Lei Li , Sun Guoli , Liu Jin , Guo Zhaodong , He Yibo , Song Feier , Liu Bowen , Chen Guanzhong , Chen Shiqun , Chen Jiyan , Liu Yong
Published: February 2021

Contrast-associated acute kidney injury (CA-AKI) is a major adverse complication of intravascular administration of contrast medium. Current studies have shown that hypoalbuminemia might be a novel risk factor of CA-AKI. This systematic review and meta-analysis was performed to evaluate the predictive value of hypoalbuminemia for CA-AKI. Relevant studies were identified in Ovid-Medline, PubMed, Embase, and Cochrane Library up to December 31, 2019. Two authors independently screened studies, consulting with a third author when necessary to resolve discrepancies. The pooled odds ratio (OR) was calculated to assess the association between hypoalbuminemia and CA-AKI using a random-effects model or fixed-effects model. Eight relevant studies involving a total of 18 687 patients met our inclusion criteria. The presence of hypoalbuminemia was associated with an increased risk of CA-AKI development (pooled OR: 2.59, 95% CI: 1.80-3.73). Hypoalbuminemia is independently associated with the occurrence of CA-AKI and may be a potentially modifiable factor for clinical intervention. This systematic review and meta-analysis was registered in PROSPERO (CRD42020168104).
The Impact of COVID‐19 on Otolaryngology Community Practice in Massachusetts
Authors: Fan Timothy , Workman Alan D. , Miller Lauren E. , Sakats Mallory Mason , Rajasekaran Karthik , Brant Jason A. , Parasher Arjun K. , Huckins David , Aliphas Avner , Glicksman Robin , Eskander Antoine , Glicksman Jordan T.
Published: February 2021

Objectives

Coronavirus disease 2019 (COVID‐19) significantly affected many health care specialties, including otolaryngology. In response to governmental policy changes, many hospitals and private practices in Massachusetts canceled or postponed nonurgent office visits and elective surgeries. The objective of this study was to quantify the impact of COVID‐19 on the provision and practice trends of otolaryngology services for 10 private practices in Massachusetts.

Study Design

Retrospective review.

Setting

Multipractice study for community practices in Massachusetts.

Methods

Electronic billing records from 10 private otolaryngology practices in Massachusetts were obtained for the first 4 months of 2019 and 2020. Questionnaires from these otolaryngology practices were collected to assess financial and staffing impact of COVID‐19.

Results

The local onset of the COVID‐19 pandemic had a significant decrease of 63% of visits in comparison to equivalent weeks in 2019. Virtual visits overtook in‐person visits over time. A greater decline in operating room (OR) procedures than for office procedures was recorded. Ninety percent of practices reduced working hours, and 80% furloughed personnel. Seventy percent of practices applied for the Paycheck Protection Program (PPP).

Conclusion

COVID‐19 has had a multifaceted impact on private otolaryngology practices in Massachusetts. A significant decline in provision of otolaryngology services aligned with the Massachusetts government’s public health policy changes. The combination of limited personnel and personal protective equipment, as well as suspension of nonessential office visits and surgeries, led to decrease in total office visits and even higher decrease in OR procedures.
Immigrant entrepreneurs in rural England – An examination of the socio- cultural barriers facing migrant small businesses in Lincolnshire
Authors: Hack-Polay Dieu , Tenna Ogbaburu Justice , Rahman Mahfuzur , Mahmoud Ali B
Published: February 2021

A growing body of literature recognises the crucial role played by immigrant entrepreneurs. However, certain socio-cultural barriers adversely affect their businesses in rural areas. Thus, this article examines the socio-cultural barriers facing immigrant entrepreneurs in Lincolnshire. Eleven semi-structured interviews were held with businesses owned by immigrants from diverse ethnic backgrounds. The findings identified migrant ethnocentrism, stereotypes, cultural differences and language differences as key socio-cultural barriers adversely affecting immigrant businesses in Lincolnshire. The research found that immigrant enterprises experienced growth issues, not just owing to the size of the market but also due to issues of embeddedness in the socio-economic nomenclature. The study found mixed embeddedness to be key to immigrant entrepreneurial success. This involves immigrant adaptation to develop relational embeddedness with the hosts, involvement with its social, structural and institutional frameworks. The study contributes to our understanding of the role of social, relational, structural and institutional embeddedness in steering fertile approaches to immigrant entrepreneurship in rural England which has been under-researched.
Predictors in Initiating and Maintaining Nutritional Behaviors to Deal With Menopausal Symptoms Based on Multi-Theory Model
Authors: Yoshany Nooshin , Sharma Manoj , Bahri Narjes , Jambarsang Sara , Morowatisharifabad Mohammad Ali
Published: February 2021

This cross-sectional study was conducted in 2019 on 204 postmenopausal women aged 45–55 years who referred to Yazd health centers to determine the predictors in initiating and sustaining nutritional behaviors to deal with menopausal symptoms based on the multi-theory model (MTM). The participants were required to complete the demographic information questionnaire and a researcher-made questionnaire over the effective nutritional behaviors in menopause based on the MTM. The data were summarized and analyzed using SPSS 18 and AMOS23 by running descriptive indicators and path analysis. Behavioral confidence (β = 0.61, P < 0.001) had a higher predictive power in initiating a nutritional behavior compared to the changes in the physical environment (β  = 0.13, P < 0.05) and participatory dialogue (β = 0. 10, p < 0.05). Among the behavior-related constructs, only emotional transformation (β = 0.78, P < 0.001) could predict the behavioral sustaining. A positive and significant association was observed between nutritional behavior sustaining and quality of life (β = −0.41, P < 0.001). The MTM is an appropriate model for predicting the initiation and sustaining of the nutritional behaviors in dealing with menopause. The behavioral confidence, changes in physical environment, and participatory dialogue constructs played a significant role in predicting the initiation of behavior. The emotional transformation construct was also an important predictor in maintaining nutritional behaviors to deal with menopausal symptoms. So, future researchers are recommended to conduct MTM-based investigations according to the predictive constructs among menopausal women.
Bartter syndrome with long-term follow-up: a case report
Authors: Wu Xueling , Yang Gang , Chen Shiyu , Tang Min , Jian Shan , Chen Fuhui , Wu Xiulin
Published: February 2021

Bartter syndrome is a rare inherited disease caused by CLCNKB mutation, which results in inactivation of the chloride channel Kb protein. Bartter syndrome is characterized by extreme hypokalemia, hypochloremia, metabolic alkalosis, hyperrenin-induced angiotensinemia, hyperaldosteronemia, and normal blood pressure. We herein report a case of Bartter syndrome that manifested as vomiting, hypokalemia, metabolic alkalosis, normal blood pressure, and significant hyperrenin-induced angiotensinemia. The patient, a 5-month-old girl, carried two known heterozygous pathogenic mutations: c.88C > T (p.Arg30*), which she had inherited from her father, and c.1313G > A (p.Arg438His), which she had inherited from her mother. Treatment with indomethacin, a nonsteroidal anti-inflammatory drug, led to rapid improvement of the hypokalemia, and treatment was continued for 14 years. The indomethacin also induced a sustainable reduction in the hypokalemia and metabolic alkalosis.
Lipoxin A4 promotes autophagy and inhibits overactivation of macrophage inflammasome activity induced by Pg LPS
Authors: Zhao Jie , Geng Wenjing , Wan Kefei , Guo Kailei , Xi Fengjun , Xu Xiangqun , Xiong Xiujuan , Huang Xu , Liu Jiayi , Kuang Xiaodong
Published: February 2021

Objective

To explore the role of lipoxin A4 (LXA4) on inflammasome and inflammatory activity in macrophages activated by Porphyromonas gingivalis lipopolysaccharide (PgLPS) one of the major causative agents of chronic periodontitis.

Methods

The mouse macrophage cell line RAW264.7 was used to produce an activated inflammation model. Markers of inflammasome and inflammatory activity and autophagy were assessed by ELISA, reverse transcription polymerase chain reaction (RT-PCR), and Western blot assay.

Results

Markers of inflammasome activity, inflammation and autophagy increased with Pg LPS concentration. They also increased with increasing exposure to Pg LPS up to 12h but decreased at 24h. However, markers of autophagy increased. Phosphorylated NF-κBp65 decreased with LXA4, which was similar to results obtained with the autophagy inducer, rapamycin.

Conclusions

LXA4 promoted autophagy and inhibited activation of inflammasomes and inflammation markers in macrophage inflammation induced by PgLPS and this action was linked to the phosphorylation of NF-κB.
Efficacy of rapid on-site cytological evaluation (ROSE) by a pulmonologist in determining specimen adequacy and diagnostic accuracy in interventional diagnosis of lung lesions
Authors: Yuan Mingli , Wang Yafei , Yin Wen , Xiao Yang , Hu Manman , Hu Yi
Published: February 2021

Objective

To evaluate the efficacy of rapid on-site cytological evaluation (ROSE) in determining specimen adequacy and diagnostic accuracy in the interventional diagnosis of lung lesions.

Methods

This retrospective study included 127 consecutive cases of lung lesions, which were sampled by bronchoscopy or transthoracic fine needle aspiration, and diagnosed on ROSE followed by histopathology. ROSE was performed by a trained pulmonologist and the diagnosis of ROSE was compared with the final diagnosis.

Results

The sensitivity of ROSE in determining adequacy of specimens was 97.5% and specificity in determining inadequacy was 85.7%. The diagnostic efficacy of ROSE for assessing malignancy (sensitivity of 94.5% and specificity of 100%) and non-malignancy (sensitivity of 97.8% and specificity of 100%) was excellent. The sensitivity of ROSE for diagnosing small cell carcinoma (100%) was highest, followed by adenocarcinoma (89.2%) and squamous cell carcinoma (75.0%). Performance of ROSE by a trained pulmonologist also determined tuberculosis with a high diagnostic sensitivity (83.3%) and specificity (100%).

Conclusions

A trained pulmonologist can reliably carry out ROSE to ensure the adequacy of the sample, distinguish between malignancy and non-malignancy, and make a preliminary diagnosis in a large number of cases.
Lessons Learned from Countries That Have Introduced Palliative Care Services into Their National Health System: A Narrative Review
Authors: Abu-Odah Hammoda , Molassiotis Alex , Liu Justina
Published: February 2021

Objective:

This review aims at gaining a broad overview of national approaches about Palliative care (PC) implementation into health care systems in countries that have PC identified within their national policies and strategies.

Methods:

Paper searching was conducted using both peer-reviewed databases and gray literature sources covering governmental reports with PC strategies from 2000 onward. Articles published in English that cited at least 1 category of the WHO’s public health PC model were included. Qualitative content analysis was used for data analysis and synthesis of findings.

Results:

Thirteen reports met the inclusion criteria. Education and appropriate policies were the most frequent strategies covered by all countries included. Under education; information about training health care providers was needed for the effective introduction of a PC program. Reviewing standards of care required to deliver PC effectively, and financial support for PC service development were considered the central policies needed. Furthermore, partnerships and collaborations across the health systems as well as providing care based on patients’ needs were required for the provision of a PC program.

Conclusion:

It is of the essence to learn from countries demonstrating enhanced PC practices before the implementation of a new PC program in a given country. Such practices could be used as a guide and to address barriers that may hinder the development of PC at a national level. Best practices can be achieved by focusing on educational and policy-based strategies through identifying patients’ needs, assessing general public awareness, health care providers’ knowledge and training as well as incorporating stakeholders’ perspectives.
Effect of quenching media on microstructural evolution, mechanical and wear properties of AISI4135 steel
Authors: Singh Praveen , Singh Satnam
Published: February 2021

The aim of this work is to study the effect of various quenching media on the microstructural evolution and properties enhancement of AISI 4135 alloy steel. The formation of dual microstructures and their effect on mechanical and wear properties are investigated in this work. An attempt is made to correlate the microstructure-properties relation based on the quenching method used. Steel is heated above the austenitic temperatures (A3) and subsequently cooled down through various quenching media to obtain the variations in microstructures and related properties. The heat treated samples were investigated for microstructural evolution through optical microscopy and scanning electron microscope; mechanical characterization through microhardness study, tensile testing and impact testing; and wear characterization through pin on disc tribometer. It was observed that increased cooling rates increased the volume fraction of martensitic structures whereas oil quenching enhanced fine pearlite and bainite formation. The air cooling led to the formation of fine pearlite along with ferrite structures. Strength, hardness and wear resistance is favored with martensite formation but toughness decreases.
Estimation of surface roughness and cutting speed in CNC WEDM by artificial neural network that employed trainable activation function
Authors: Gürbüz Hüseyin
Published: February 2021

Activation functions are the most significant properties of artificial neural networks (ANN) because these functions are directly related with the ability of ANN in learning or modelling a system or a function. Furthermore, another reason for the significance of the fact that determination of optimal activation function in ANN is its relationship with success level. In this experimental study, the effects of different types of wire electrodes, cooling techniques and workpiece materials on surface roughness (Ra) and cutting speed (Vc) in wire electrical discharge machining (WEDM) were investigated by using trainable activation functions (AFt) and modelling them in ANNs. So far, a number of methods have been performed according to the data set in order to optimally predict Ra and Vc results. Among these methods, randomized ANN with AFt was found to be the best one for robust prediction according to RMSE values. While the value was 0.280 for Vc, it was 0.2104 for Ra. Optimum activation functions in Ra and Vc were found at first and third degree trainable functions, respectively.
Evaluation of a high-throughput nucleic acid extraction method for the detection of Mycobacterium avium subsp. paratuberculosis in bovine fecal samples by PCR
Authors: Thirumalapura Nagaraja R. , Feria Willard , Hue Eric , Zellers Corey , Tewari Deepanker
Published: February 2021

Johne’s disease (paratuberculosis) is an economically important disease of cattle worldwide. The disease is caused by Mycobacterium avium subsp. paratuberculosis (MAP), a fastidious gram-positive bacterium. PCR is increasingly used in diagnostic laboratories for the detection of MAP in fecal samples given the rapid test turnaround time and sensitivity and specificity comparable to fecal culture. However, efficient extraction of DNA for sensitive detection of MAP by PCR is affected by the complex lipid-rich cell wall of MAP and the presence of PCR inhibitors in feces. We evaluated a high-throughput nucleic acid extraction method (MagMAX core nucleic acid purification kit with mechanical lysis module) in conjunction with an hspX gene PCR for the detection of MAP from bovine fecal samples, which resulted in correct identification of all negative (13 of 13) and positive (35 of 35) proficiency test samples obtained from the National Veterinary Services Laboratories. In addition, all 6 negative and 50 of 51 positive diagnostic specimens tested were categorized correctly.
Proactive Evaluation: The Program Stress Test
Authors: Chen Huey T. , Morosanu Liliana , Bellury Lanell M. , Teleaga Jessica , Hardin Abigail E.
Published: February 2021

Intervention programs are open systems that must withstand the disturbances of the environments in which they are implemented if they are to thrive. Stakeholders can benefit from proactive insights related to potential program malfunction or failure. Evaluators have not developed approaches to serve this preventive function. This study proposes the program stress test as a holistic, preventive approach to program evaluation, aiming to identify vulnerable areas at risk of failure, and to suggest preventive strategies. The stress test can be used in the planning stage of a program (called ex-ante stress test), or during the implementation stage (called ex-post stress test). This study illustrates an ex-post test. The authors introduce its concept, methodology, research steps, and application to a student retention program, including findings of structural and functional issues, as well as solutions proposed by participants. The authors call the evaluators’ attention to the need to expand the traditional scope of evaluation, to include future-focused assessments.
Imaging in inherited retinal disorders
Authors: Muftuoglu Ilkay Kilic , Al-Sheikh Mayss , J Sushma , Rasheed Mohammed Abdul , Singh Sumit Randhir , Chhablani Jay
Published: February 2021

Inherited retinal diseases, which results from mutations in over 260 identified genes, affect more than 2 million people globally. The diseases mostly cause severe vision loss in young working population and have severe impact on social economic status of the population. Advances in retinal imaging techniques along with developments in gene identification and cell biology techniques have yielded to a better understanding of the genetic and biochemical mechanisms causing these diseases. Retinal imaging along with through ophthalmological examination is essential to make an accurate diagnosis, to decrease the burden of unneccessary anciliary tests and to select the potential patients that can get benefit from the gene treatment. The purpose of the review is to yield an update on inherited retinal diseases by highlighting microstructural changes in retina and to summarize the retinal changes detected by currently available multimodal imaging techniques.
Bilateral dysthyroid compressive optic neuropathy responsive to teprotumumab
Authors: Hwang Catherine J , Nichols Erin E , Chon Brian H , Perry Julian D
Published: February 2021

Thyroid eye disease is an auto-immune mediated orbitopathy which can cause dysthyroid compressive optic neuropathy. Traditional management of active thyroid eye disease includes temporizing high-dose steroids, orbital radiation and surgical decompression, which each possess significant limitations and/or side effects. Teprotumumab is an IGF-IR inhibitor recently FDA-approved for active thyroid eye disease. The authors report reversal of bilateral dysthyroid compressive optic neuropathy managed medically utilizing teprotumumab.
The association of aldosterone with papillophlebitis and retinal artery occlusion: A case report
Authors: Kuo Che-Yuan , Lin Po-Kang
Published: February 2021

Purpose:

To explore the association between elevated blood aldosterone levels and papillophlebitis and retinal artery occlusion in a young, healthy woman.

Case description:

A 19-year-old woman with an unremarkable medical history presented with sudden-onset visual loss in the right eye, which lasted for 10 hours. Fundus examination revealed retinal whitening, splinter hemorrhages, disc swelling, and tortuous vessels in the right eye. Optical coherence tomography revealed inner retinal thickening. Fluorescein angiography demonstrated a delayed arteriovenous transit time and delayed filling of the cilioretinal artery circulation. Further workup showed a high aldosterone level and aldosterone-to-renin ratio. The patient was treated with steroid pulse therapy and combined intravitreal injection of dexamethasone implant and aflibercept. Visual acuity was recovered from count finger at initial presentation to 6/15 on the fifth day. For over 2 months, the fundal manifestations gradually subsided. Three months after the episode, her visual acuity further improved to 6/6.7.

Conclusion:

This report emphasizes the potential role aldosterone plays in the complex disease mechanism of retinal vasculopathy. In addition, steroid pulse therapy is more effective when applied in conjunction with combined intravitreal injection therapy for rescuing impaired vision caused by retinal vascular occlusion.
The impact of telemedicine on patients with uncontrolled type 2 diabetes mellitus during the COVID-19 pandemic in Saudi Arabia: Findings and implications
Authors: M Tourkmani Ayla , J ALHarbi Turki , Rsheed Abdulaziz M Bin , Alrasheedy Alian A , ALMadani Wedad , ALJuraisi Fahad , AlOtaibi Azzam Fahad , AlHarbi Mohammed , AlAbood Abood F , Alshaikh Abdulaziz A Ibn
Published: February 2021

Introduction

Routine diabetes care changed during the COVID-19 pandemic due to precautionary measures such as lockdowns, cancellation of in-person visits, and patients’ fear of being infected when attending clinics. Because of the pandemic, virtual clinics were implemented to provide diabetes care. Therefore, we conducted this study to assess the impact of these virtual clinics on glycaemic control among high-risk patients with type 2 diabetes mellitus (DM).

Methods

A prospective single-cohort pre-/post telemedicine care intervention study was conducted on 130 patients with type 2 DM attending a virtual integrated care clinic at a chronic Illness center in a family and community medicine department in Riyadh, Saudi Arabia during the COVID-19 pandemic.

Results

The mean age of the participants was 57 years (standard deviation (SD) = 12) and the mean (SD) duration of diabetes was 14 (7) years. Over a period of 4 months, the HbA1c decreased significantly from 9.98 ± 1.33 pre-intervention to 8.32 ± 1.31 post-intervention (mean difference 1.66 ± 1.29; CI = 1.43–1.88; P <0.001). In addition, most in-person care visits were successfully replaced, as most patients (64%) needed only one or two in-person visits during the 4-month period, compared with typically one visit every 1–2 weeks in the integrated care programme before the pandemic for this group of high-risk patients.

Discussion

The current study found a significant positive impact of telemedicine care on glycaemic control among high-risk patients with DM during the COVID-19 pandemic. Moreover, it showed that telemedicine could be integrated into diabetic care to successfully replace many of the usual in-person care visits. Consequently, health policy makers need to consider developing comprehensive guidelines in Saudi Arabia for telemedicine care to, ensure the quality of care and address issues such as financial reimbursement and patient information privacy.
Enhanced self-regulation: The case of Facebook’s content governance
Authors: Medzini Rotem
Published: February 2021

Content regulation on digital platforms has become a contested issue on the public and scholarly agendas. To understand how digital platform providers experiment with making commitments regarding their regulation, this article process-traces Facebook’s content regulation to ask how it self-regulates despite constant pressures for policy intervention. The first part of the article shows how Facebook moved from its initial “thin” self-regulatory regime toward what I call “enhanced self-regulation,” which relies on first-party and independent third-party intermediaries. Thereafter, I show how Facebook self-regulated the balance between public and private interests over time and across the regimes. The findings suggest that powerful actors such as Facebook can innovate in self-regulation by reallocating content-related responsibilities to intermediaries and subsequently create polycentric governance regimes. Lessons about how self-regulators that face public criticism can make more credible commitments to public interests are then drawn from the strengths and weakness of enhanced self-regulation.
Micro-mechanical analysis of the pineapple-reinforced polymeric composite by the inclusion of pineapple leaf particulates
Authors: Saha Abir , Kumar Santosh , Zindani Divya , Bhowmik Sumit
Published: February 2021

The present study is focused on investigating the effect of the micro-mechanical properties of the natural fiber- (pineapple leaf fiber) reinforced polymeric composites by the addition of pineapple leaf micro-particulates. For the investigation, a two-step approach has been used. In the first step, finite element method-based analysis has been used to characterize the tensile and shear properties of the pineapple leaf fiber-reinforced polymeric composites (FRP) and pineapple paticulate-reinforced polymeric composites (PRC), and the adopted finite element method-based analysis has been validated through the experimental approach. In the second step, the validated finite element method-based analysis has been used to characterize the micro-mechanical properties of the hybrid fiber-reinforced polymeric composites (HFRP) fabricated using the pineapple leaf micro-particle embedded epoxy as a matrix material and the pineapple leaf fiber has been used as reinforcing material. It has been observed through the analysis that the micro-mechanical properties of HFRP were superior to that of FRP. There has been a 10.16% increment in Young’s modulus in the longitudinal direction and a 26.36% increment in Young’s modulus in the transverse direction for HFRP over FRP. Further, a 9.91% increment for in-plane shear modulus and 26.17% increment in outer-plane shear modulus have been observed for HFRP in comparison to FRP. These results suggest that pineapple leaf particulates are good reinforcing materials to enhance the transverse direction and outer plane micro-mechanical properties of the fiber-reinforced composite.
‘Smash the patriarchy’: the changing meanings and work of ‘patriarchy’ online
Authors: Hill Rosemary Lucy , Allen Kim
Published: February 2021

This article discusses the resurgence of the term ‘patriarchy’ in digital culture and reflects on the everyday online meanings of the term in distinction to academic theorisations. In the 1960s–1980s, feminists theorised patriarchy as the systematic oppression of women, with differing approaches to how it worked. Criticisms that the concept was unable to account for intersectional experiences of oppression, alongside the ‘turn to culture’, resulted in a fall from academic grace. However, ‘patriarchy’ has found new life through Internet memes (humorous, mutational images that circulate widely on social media). This article aims to investigate the resurgence of the term ‘patriarchy’ in digital culture. Based on an analysis of memes with the phrase ‘patriarchy’ and ‘smash the patriarchy’, we identify how patriarchy memes are used by two different online communities (feminists and anti-feminists) and consider what this means for the ongoing usefulness of the concept of patriarchy. We argue that, whilst performing important community-forming work, using the term is a risky strategy for feminists for two reasons: first, because memes are by their nature brief, there is little opportunity to address intersections of oppression; secondly, the underlying logic of feminism is omitted in favour of brevity, leaving it exposed to being undermined by the more mainstream logic of masculinism.
Competing risks joint models using R-INLA
Authors: Niekerk Janet van , Bakka Haakon , Rue Håvard
Published: February 2021

The methodological advancements made in the field of joint models are numerous. None the less, the case of competing risks joint models has largely been neglected, especially from a practitioner's point of view. In the relevant works on competing risks joint models, the assumptions of a Gaussian linear longitudinal series and proportional cause-specific hazard functions, amongst others, have remained unchallenged. In this article, we provide a framework based on R-INLA to apply competing risks joint models in a unifying way such that non-Gaussian longitudinal data, spatial structures, times-dependent splines and various latent association structures, to mention a few, are all embraced in our approach. Our motivation stems from the SANAD trial which exhibits non-linear longitudinal trajectories and competing risks for failure of treatment. We also present a discrete competing risks joint model for longitudinal count data as well as a spatial competing risks joint model as specific examples.
Leading edge serrations for the reduction of aerofoil self-noise at low angle of attack, pre-stall and post-stall conditions
Authors: Lacagnina Giovanni , Chaitanya Paruchuri , Kim Jung-Hoon , Berk Tim , Joseph Phillip , Choi Kwing-So , Ganapathisubramani Bharathram , Hasheminejad Seyed Mohammad , Chong Tze Pei , Stalnov Oksana , Shahab Muhammad Farrukh , Omidyeganeh Mohammad , Pinelli Alfredo
Published: February 2021

This paper addresses the usefulness of leading edge serrations for reducing aerofoil self-noise over a wide range of angles of attack. Different serration geometries are studied over a range of Reynolds number [Formula: see text]. Design guidelines are proposed that permit noise reductions over most angles of attack. It is shown that serration geometries reduces the noise but adversely effect the aerodynamic performance suggesting that a trade-off should be sought between these two considerations. The self-noise performance of leading edge serrations has been shown to fall into three angle of attack (AoA) regimes: low angles where the flow is mostly attached, moderate angles where the flow is partially to fully separated, and high angles of attack where the flow is fully separated. Leading edge serrations have been demonstrated to be effective in reducing noise at low and high angles of attack but ineffective at moderate angles. The noise reduction mechanisms are explored in each of three angle regimes.
Designing hybrid nanofibers based on keratin-poly (vinyl alcohol) and poly (Ɛ-caprolactone) for application as wound dressing
Authors: Ranjbar-Mohammadi Marziyeh , Arab-Bafrani Zahra , Karimi Fatemeh , Javid Naeme
Published: February 2021

In this study, the production of hybrid scaffolds containing keratin/polyvinyl alcohol (Ker/PVA) and poly (Ɛ-caproactone) (PCL) for application in skin regeneration has been investigated. In the first step, the extraction of keratin from wool fibers was done, and then electrospinning process was used to fabricate hybrid nanofibers. Ker/PVA blend solution was extruded from one syringe and poly(ε-caprolactone) solution from the other one and hybrid nanofibers were gathered onto a rotary drum collector. The effect of different ratios of Ker/PVA (30:70), (50:50), and (70:30) with PCL were studied on the morphology, hydrophilicity and mechanical features of the scaffolds. The Ker/PVA (50:50)-PCL nanofibers presented an appropriate modulus and mechanical strength similar to the natural skin. These scaffolds possessed high levels of hydrophilicity, which improved cell-scaffold adhesion and increased the growth and proliferation of fibroblast cells. Keratin based nanofibers demonstrated antibacterial characteristic against Gram-negative Escherichia coli and Gram-positive Staphylococcus aureus.
The battle for influence: Commemoration of transnational martyrs in the Italian diaspora of the U.S. under fascism
Authors: King Amy
Published: February 2021

This article analyses the role commemoration of Fascist and anti-fascist martyrs played in the battle for political influence in the Italian diaspora of the United States during Mussolini’s early rule. It is structured around two case studies: the socialist leader Giacomo Matteotti, killed in Rome in 1924, and Giuseppe Carisi and Michele Ambrosoli, two Blackshirts killed in the Bronx on their way to the Memorial Day parade of 1927 in New York. Through an examination of sites of memory and commemoration ceremonies held in both Italy and the U.S., it adds a transnational element to the study of the role of secular martyrdom in the construction of collective identity, concluding that the transnational exchange evident in commemoration of both case studies added to the propagandistic power of the martyrological narrative by drawing meaning from geographical distance from Italy.
Acceptance of a Symptom-Based Approach for COVID-19 rtRT-PCR Testing to Conserve Resources in a Lower Middle-Income Setting
Authors: Islam S. M. Rashed Ul , Akther Tahmina , Nasif Md. Abdullah Omar , Sultana Sharmin , Munshi Saif Ullah
Published: February 2021

SARS-CoV-2 initially emerged in Wuhan, China in late 2019. It has since been recognized as a pandemic and has led to great social and economic disruption globally. The Reverse Transcriptase Real-Time Polymerase Chain Reaction (rtRT-PCR) has become the primary method for COVID-19 testing worldwide. The method requires a specialized laboratory set up. Long-term persistence of SARS-CoV-2 RNA in nasopharyngeal secretion after full clinical recovery of the patient is regularly observed nowadays. This forces the patients to spend a longer period in isolation and test repeatedly to obtain evidence of viral clearance. Repeated COVID-19 testing in asymptomatic or mildly symptomatic cases often leads to extra workload for laboratories that are already struggling with a high specimen turnover. Here, we present 5 purposively selected cases with different patterns of clinical presentations in which nasopharyngeal shedding of SARS-CoV-2 RNA was observed in patients for a long time. From these case studies, we emphasized the adoption of a symptom-based approach for discontinuing transmission-based precautions over a test-based strategy to reduce the time spent by asymptomatic and mildly symptomatic COVID-19 patients in isolation. A symptom-based approach will also help reduce laboratory burden for COVID-19 testing as well as conserve valuable resources and supplies utilized for rtRT-PCR testing in an emerging lower-middle-income setting. Most importantly, it will also make room for critically ill COVID-19 patients to visit or avail COVID-19 testing at their convenience.
Feasibility of Atlas Pedicle Screw Fixation Perpendicular to the Coronal Plane—A 3D Anatomic Analysis
Authors: Wu Chao , Deng Jiayan , Wang Qing , Pan Jian , Hu Haigang , Li Guangzhou , Tan Lun , Wei Qin
Published: February 2021

Study Design:

An anatomic analysis.

Objective:

To investigate the feasibility of the ideal atlas pedicle screw trajectory perpendicular to the coronal plane via atlas digital 3D reconstruction.

Methods:

One hundred adult atlases were evaluated in this study. The projection of the corridor for atlas pedicle screw fixation perpendicular to the coronal plane was quickly obtained using the perspective model of 3D reconstruction, and the area, long axis, short axis and width of the pedicle corridor were measured. The inner trajectory was near the lateral wall of the pedicle, and the center of the corridor was point A. The lateral trajectory was near the lateral wall of the transverse foramen, and the center of the trajectory was point C. The midpoint of A and C was B. The length of the inner, middle and lateral trajectorys were measured. The distances from points A, B and C to the posterior tubercle of the atlas and safety swing angle were measured.

Results:

From the dorsal view, the pedicle corridor was fitted into an ellipse with an average long axis of 13.6 mm, an average short axis of 5.2 mm, and an average area of 56.3 mm2. From the axial view, the pedicle corridor had an average width of 9.4 mm. The average lengths of the inner trajectory, middle trajectory and lateral trajectory were 31.7 mm, 28.7 mm and 25.1 mm, respectively; The average distances from the posterior tubercle to points A, B and C were 17.1 mm, 20.8 mm and 24.5 mm, respectively. The average swing angles from points A, B and C were 16.1°, 25.5°, and 28.1°, respectively.

Conclusion:

Atlas pedicle screw fixation perpendicular to the coronal plane is feasible for almost all the volunteers. Pedicle screws close to the pedicle lateral wall of the atlas posterior arch perpendicular to the coronal plane is an advanced technique that is easy to master.