bluuebunny/crossref_metadata_2025 huggingface dataset:
Cardiopulmonary bypass management and acute kidney injury in 118 Jehovah’s Witness patients: a retrospective propensity-matched multicentre cohort from 30,942 patients
Authors: Willcox Timothy W , Newland Richard F , Baker Robert A
Published: February 2020

Introduction:

Patients refusing blood products in cardiac surgery present challenges for cardiopulmonary bypass. Accurate detail of the modifiable factors of cardiopulmonary bypass relating to acute kidney injury is previously unreported in this patient population.

Methods:

A total of 118 adult Jehovah’s Witness patients refusing transfusion were propensity matched to 118 adult patients accepting transfusion from the 30,942 patients in the Australian and New Zealand Collaborative Perfusion Registry. The primary endpoint was acute kidney injury. Intraoperative and bypass management characteristics were also compared between early (2007-2012) and late (2013-2018) cohorts along with the acceptance or refusal of transfusion.

Results:

In patients accepting transfusion, 49% received a blood product. In patients refusing transfusion, acute kidney injury was lower (8% vs. 22%; p = 0.003) cell salvage use was higher (70% vs. 22%; p < 0.001), as was use of haemofiltration (8% vs. 4%; p = 0.03) and tranexamic acid in the early period (87% vs. 62%, p = 0.004) but not late (100% vs. 97%; p = 0.15). There was no difference in modifiable cardiopulmonary bypass factors (mean arterial pressure, minimum oxygen delivery (DO2i), retrograde autologous prime, circuit prime volume) between the two groups; however, prime volume decreased and DO2i increased over time for both. Patients refusing transfusion had lower postoperative blood loss (p = 0.02) and shorter postoperative length of stay (p < 0.001) with no difference in morbidity (p = 0.46) or mortality (p = 0.68).

Conclusion:

Refusal of transfusion in patients undergoing cardiopulmonary bypass was associated with reduced acute kidney injury, hospital stay and postoperative blood loss, while not impacting mortality.
Self-Care and Medical Treatment-Seeking Behaviors of Older Adults in Rural Areas of Taiwan: Coping With Low Literacy
Authors: Chen Stephanie Yu-ching
Published: February 2020

This study focused on ascertaining the effects of low literacy on the self-care and medical treatment-seeking behaviors of older adults. A qualitative research method was adopted in this study wherein a semistructured questionnaire was used to conduct one-on-one interviews with 35 older adults with a primary school education or less who lived in rural areas of Taiwan. The results indicated that low literacy was an evident limitation to their range of activities, and the assistance of family members was required for medical treatment seeking and medication administration. The low self-esteem attributable to low literacy had a negative influence on doctor–patient communication. Older adults had a lower awareness of illnesses and their severity, and this insufficient health literacy resulted in delayed medical treatment. In addition, older adults rarely took the initiative to receive preventive services. This study suggests integrating literacy and health education program for older adults with low literacy.
Magnetic resonance radiomics for prediction of extraprostatic extension in non-favorable intermediate- and high-risk prostate cancer patients
Authors: Losnegård Are , Reisæter Lars A. R. , Halvorsen Ole J. , Jurek Jakub , Assmus Jörg , Arnes Jarle B. , Honoré Alfred , Monssen Jan A. , Andersen Erling , Haldorsen Ingfrid S. , Lundervold Arvid , Beisland Christian
Published: February 2020

Background

To investigate whether magnetic resonance (MR) radiomic features combined with machine learning may aid in predicting extraprostatic extension (EPE) in high- and non-favorable intermediate-risk patients with prostate cancer.

Purpose

To investigate the diagnostic performance of radiomics to detect EPE.

Material and Methods

MR radiomic features were extracted from 228 patients, of whom 86 were diagnosed with EPE, using prostate and lesion segmentations. Prediction models were built using Random Forest. Further, EPE was also predicted using a clinical nomogram and routine radiological interpretation and diagnostic performance was assessed for individual and combined models.

Results

The MR radiomic model with features extracted from the manually delineated lesions performed best among the radiomic models with an area under the curve (AUC) of 0.74. Radiology interpretation yielded an AUC of 0.75 and the clinical nomogram (MSKCC) an AUC of 0.67. A combination of the three prediction models gave the highest AUC of 0.79.

Conclusion

Radiomic analysis combined with radiology interpretation aid the MSKCC nomogram in predicting EPE in high- and non-favorable intermediate-risk patients.
Diagnostic value of diffusion-weighted magnetic resonance imaging in discriminating between metastatic and non-metastatic pelvic lymph nodes in endometrial cancer
Authors: Arian Arvin , Easa Ahmed Mohamedbaqer , Arab-Ahmadi Mehran
Published: February 2020

Background

Researchers have recently focused on assessing the accuracy of diffusion-weighted magnetic resonance imaging (DW-MRI) in predicting pelvic lymph node metastases in gynecological malignancies.

Purpose

To evaluate the diagnostic value of DW-MRI in discriminating between metastatic and non-metastatic pelvic lymph nodes in endometrial cancer patients.

Material and Methods

This retrospective database study was conducted with 33 women aged 30–84 years with pathologically proven endometrial cancer that had been assessed by DW-MRI before their first treatment initiation at our referral hospital from March 2016 to April 2019. The diffusion technique (b = 50, 400, and 1000 mm2/s) was used in the imaging, and continuous apparent diffusion coefficient (ADC) metrics (ADCmin, ADCmax, ADCmean, ADCSD, and rADC) were compared between the metastatic and non-metastatic lymph nodes.

Results

In total, 48 lymph nodes from 33 patients were assessed. All metastatic lymph nodes were restricted, while among the non-metastatic lymph nodes, only 19.3% were restricted. Considering pathological reports of metastatic and non-metastatic lymph nodes as the gold standard, DWI-related restricted and non-restricted features had a sensitivity of 80.6%, a specificity of 100%, and an accuracy of 87.5% to discriminate between a metastatic and non-metastatic pattern. ADC metrics of ADCmin, ADCmax, ADCmean, ADCSD, and rADC showed high values enabling differentiation between metastatic and non-metastatic lymph nodes. The best cut-off values were 0.7 × 10−3, 1.2 × 10−3, 1.01 × 10−3, 123, and 0.78, respectively.

Conclusion

DW-MRI is a useful quantitative tool for differentiating between metastatic and benign lymph nodes in endometrial cancer patients.
Perceived Hearing Loss, Social Disengagement, and Declines in Memory
Authors: Moorman Sara M. , Greenfield Emily A. , Lee Connie Seo Hyun
Published: February 2020

A growing body of evidence suggests that age-related hearing loss is related to changes in older adults’ memory. We test the hypothesis that the association is due to social disengagement following the onset of perceived hearing loss. At ages 65 (2004) and 72 years (2011), 3,986 participants from the Wisconsin Longitudinal Study (WLS) self-reported on hearing problems and several types of social engagement and completed three tests of memory. We estimated fixed effects regression models. Perceived hearing loss was related to significant decline in memory. Declines in frequency of in-person social contact were also associated with declining memory, but there was no evidence of a mechanism wherein reductions in social engagement explained the association between perceived hearing loss and memory decline. We conclude that self-reported hearing loss and social disengagement are likely independent risk factors for memory loss among older adults.
Flame-retardant hybrid materials based on expandable polystyrene beads
Authors: Reuter Jens , Standau Tobias , Altstädt Volker , Döring Manfred
Published: February 2020

A highly efficient flame-retardant hybrid foam material combining expandable polystyrene foam beads and a waterborne resin equipped with inorganic flame retardants is described. The resin and the inorganic fillers were varied, and the different compositions were investigated in small burner and cone calorimeter tests. The burning time during the small burner test decreases from >60 s for neat expandable polystyrene to 0 s for optimized hybrid specimens. The peak of the heat release rate decreases from 661.0 kW/m2 for neat expandable polystyrene to 121.36 kW/m2 for a hybrid composition of 1:1:1 (expandable polystyrene:aluminum hydroxide:phenol formaldehyde resin). The hybrid materials containing inorganic flame retardants are burning slower and release heat and smoke more constantly at significantly lower rates. Furthermore, a continuous network of the cured thermoset is shown, which leads to embedded expandable polystyrene beads. The flame-retardant thermoset protects the expandable polystyrene from fire and leads to a material with high dimensional stability and efficient flame retardancy.
Transitioning to Life in a Nursing Home: The Potential Role of Palliative Care
Authors: Halifax Elizabeth , Bui Nhat Minh , Hunt Lauren J. , Stephens Caroline E.
Published: February 2020

Background and Objectives:

Transitioning to a nursing home (NH) is a major life event for 1.4 million NH residents in the United States. Most post-acute NH admissions plan for rehabilitation and discharge home, but with nearly 70% of NH residents being palliative care (PC) eligible, many evolve into long-term placements secondary to poor health and associated decline in function and/or cognition. This article describes the perceptions of NH PC-eligible residents and families transitioning to life in a NH.

Methods:

Residents at 3 NHs in Northern California (N = 228) were screened for PC eligibility. A convenience sample of PC-eligible residents and their family members (n = 28) participated in qualitative interviews that explored the experience of living as a NH resident with serious illness. Data were analyzed using grounded theory methodology.

Results:

Our study provides insights into the experiences of transitioning to a NH from the perspectives of PC-eligible residents and their families. These data describe how PC-eligible residents and their families experienced disempowerment as they perceived being left out of decisions to go to a NH, loss of autonomy once at the NH, dealt with the realization that they would not be going home, and described perceived barriers to going home.

Discussion and Implications:

The inclusive and person-centered model of care that PC provides naturally empowers residents and family members. Adequate provision of PC services, together with changes in policy related to NH culture and benefit management, could improve the experience of transitioning to a nursing home.
Reducing Relationship Conflict in Virtual Teams With Diversity Faultlines: The Effect of an Online Affect Management Intervention on the Rate of Growth of Team Resilience
Authors: Peñarroja Vicente , González-Anta Baltasar , Orengo Virginia , Zornoza Ana , Gamero Nuria
Published: February 2020

The aim of this study was to analyze the effect of an online affect management intervention on relationship conflict through the rate of growth of team resilience in virtual teams with diversity faultlines. Fifty-two 4-person teams participated in a randomized controlled trial design with repeated measures (i.e., three measurement occasions). Teams were randomly assigned to either an intervention designed to help them manage emotions in virtual teams or a control condition. Our findings showed that affect management can reduce the level of relationship conflict in virtual teams with diversity faultlines and that this effect can be explained by the pattern of change in team resilience in response to the intervention. This study contributes to past research on identifying ways to prevent or mitigate team conflicts arising from diversity faultlines.
Protégé Ego-Resiliency and Perceived Mentoring: An Additive Multiple Moderation Model of Cultural Orientations
Authors: Baig Muhammad Usman Anwar , Bashir Sajid , Ishaq Erum
Published: February 2020

This study proposed protégé’s ego-resiliency as a parsimonious predictor of perceived mentoring. Uncertainty-avoidance and collectivism orientations were hypothesized as boundary conditions of this relationship. An additive multiple moderation model was developed using conservation of resource theory. Data were collected from 193 employees of a large Southeast Asian commercial bank. Results of structural equation modeling indicated that protégé’s ego-resiliency was positively related to perceived mentoring. This positive relation was stronger for protégés who held weaker uncertainty-avoidance orientations and was stronger for those who held collectivistic orientations. Implications for theory and practice are discussed.
Practising Pragmatism: The Framing of Gender Among Development Professionals in India
Authors: Bhatnagar Isha
Published: February 2020

This article identifies the ways in which researchers and practitioners situated in different institutions engage with different systems of knowledge in their study of gender in the context of development, and the implications it has on how these professionals work together. Key informant interviews with 25 gender specialists from universities, research organizations, NGOs, UN agencies and donors undertaken in Delhi, India, are used as an illustration. The study finds that researchers/practitioners perceive that they study gender in dissimilar ways based on differences in academic training, professional roles and explicit affiliation with feminism. In practice, however, they have adopted ‘pragmatic’ ways to bridge the epistemological divide between the perspectives of ‘gender and development’ and ‘feminism’. These pragmatic practices are visible in the ways in which they work with the government, academia and donor organizations. I voice their need to traverse the quantitative–qualitative divide in order to strengthen our understanding of gender. The study demonstrates that researchers can negotiate epistemological differences for the sake of achieving the common goal of gender justice. This is important as the field of research on gender expands globally, with the emergence of new sites of knowledge production and emphasis on numerical evidence.
Implementing Ecopedagogy as an Experiential Approach to Decolonizing Science Education
Authors: Zocher Joella L. , Hougham R. Justin
Published: February 2020

Background: The field of environmental education (EE) aims to produce an environmentally literate citizenry that is not only aware of environmental problems but is motivated to work toward their solution. However, much of the U.S. EE curricular focus has been on understanding the biophysical environment with rural populations, with little discussion about the environmental problems created by the dominant Western cultural norms. Purpose: Freire’s ecopedagogical framework provides a framework for this discourse, yet there are few studies exploring how to put the theory to action. Experiential education’s principles of practice provide a platform to help environmental educators make this shift. Methodology/Approach: This mixed-methods participatory action research study includes observations, 71 document reviews, 29 interviews, and 15 surveys. Findings/Conclusions: This study presents two unique curricular interventions that aim to disrupt cultural patterns of environmental oppression through the use of ecopedagogy. Implications: This work expands on conclusions drawn in research by Smith and Segbers which recommended both transcultural pedagogy and a willingness to move beyond traditional models of curricula. Specifically, White environmental educators and researchers must rise to the challenge of adopting and innovating ecopedagogies that empower youth to explore solutions in their communities.
EU Funding and Euroskeptic Vote Choice
Authors: Hlatky Roman
Published: February 2020

Why do voters in Central and Eastern Europe (CEE) vote for Euroskeptic political parties? Existing explanations of Euroskepticism suggest that those benefiting economically due to the European Union (EU) are less likely to be Euroskeptic. These approaches fail to take into account the social purpose of EU economic transfers. I argue that the minority advancement realized through EU funding drives voters toward Euroskeptic electoral options. I provide evidence of this relationship through two methods: a large-N statistical analysis and a survey experiment. The large-N analysis employs time-series, regional data from ten CEE member states. The survey experiment tests the hypothesis with a nationally representative sample of the Slovak population. Results from both methods corroborate the hypothesized relationship. Importantly, results suggest that reactionary voters may undermine the long-term institutional goals of the EU due to the short-term consequences of EU policies.
Case Report of Isolated Gastric Metastasis of Pancreatic Cancer From a Diagnostic Biopsy: Management of a Rare Oncologic Entity
Authors: Rothermel Luke D. , Strosberg Carolina , Centeno Barbara A. , Malafa Mokenge P.
Published: February 2020

Pancreatic ductal adenocarcinoma behaves aggressively, with surgically resectable disease having the best chance of long-term survival. Recurrence after surgery and adjuvant therapy is commonly due to distant metastatic disease and is typically managed with systemic therapies, not surgery. We present a rare case of an isolated gastric metastasis due to endoscopic ultrasound-guided with fine-needle aspiration (EUS-FNA) needle tract seeding that was managed surgically. Treatment was informed by input from a mutlidisciplinary team of medical, surgical, and radiation oncologists, radiologists, and pathologists. Rising carbohydrate antigen (CA)19-9 levels suggested disease recurrence, but the tumor’s unusual location and slow growth made diagnosing the cause difficult, resulting in the late identification of the tumor. Palliative resection was performed, rending the patient with no evidence of disease followed by normalized CA19-9 levels. This case highlights the importance of multidisciplinary decision-making in detecting and treating the uncommon but significant tumor seeding with EUS-FNA biopsies in pancreatic ductal adenocarcinoma.
From Progressive Cities to Resilient Cities: Lessons from History for New Debates in Equitable Adaptation to Climate Change
Authors: Shi Linda
Published: February 2020

Planners and activists are identifying ways to promote equitable adaptation that counter climate injustice. This article explores how this progressive turn in adaptation compares with past progressive movements. I argue urban progressive politics have cyclical tendencies toward liberalism and radicalism, and that the evolution of planning for climate adaptation mirrors these waves. I review 10 recent guidance documents that recommend strategies for enhancing racially just adaptation. I then assess how these recommendations advance the three pillars of progressive reforms: redistribution, expansion of democracy, and structural reform. I find that proposed strategies for racially just resilience are a welcome advance from mainstream, unjust resilience planning. However, history suggests that the focus on procedural justice for oppressed communities seen in recent discourse may limit their scope and durability. I conclude with suggestions for areas where climate activists and scholars can expand given emerging political space for ambitious thinking under a Green New Deal.
Low-velocity impact properties of composite reinforced by auxetic warp-knitted spacer fabric
Authors: Xu Wanli , Ma Pibo , Wu Liwei , Jiang Gaoming
Published: February 2020

Auxetic warp-knitted spacer fabric composite is famous for its excellent mechanical properties and has been applied in many potential fields, such as automobile industry, aerospace field, and so on. Four kinds of composites with different negative Poisson’s ratios were used for low-velocity impact tests. The influence of different negative Poisson’s ratio effect and initial impact energy on the impact resistance and energy absorption ability of composites are studied. Result shows that the peak impact load, energy absorption, and impact resistance of composites increase with an increase in the auxetic effect of reinforcement. The composite with better auxetic effect shows lower damage level after low-velocity impact. And the higher initial impact energy can easily weaken the impact resistance ability of composites.
Cross-cultural indigenous training: The South African experience
Authors: Marovic Zana
Published: February 2020

In this paper, the author explores the relevance of indigenous training from a cross-cultural perspective. We start by examining the broader context of traditional Western psychology and its relevance in a multicultural society. A brief description of the indigenous paradigm is followed by a discussion of differences between Western and indigenous psychology, and a proposal of cultural eclecticism as a potential frame for their integration. Next, we discuss the South African context in relation to comparative-cultural aspects of medical and psychological services.

 The author’s clinical experience informs her increased awareness of culturally inadequate service at the state hospital, developing curiosity about African indigenous healing, and subsequent encounters and collaboration with African traditional healers. Ultimately, the author develops culturally sensitive training that explores cultural biases and generates cross-cultural knowledge and competence.

 In conclusion, the author advocates that in the area of globalisation and multicultural societies, psychological training and clinical practice, should include dialogue and facilitate collaboration between Western and indigenous knowledge, hopefully leading to a more holistic and culturally inclusive service to a population of different backgrounds. Such collaboration and integration of Western and indigenous knowledge may be a source of professional stimulation as well as a benefit to health-care consumers.
The online anti-public sphere
Authors: Davis Mark
Published: February 2020

In this article, I outline the online ‘anti-public sphere’ as an object for analysis, defined as that space of online socio-political interaction where discourse routinely and radically flouts the ethical and rational norms of democratic discourse. This is a formerly offline space made newly visible by digital networked media. It includes discursive spaces and forms such as White supremacist websites, anti-climate science forums, militant ‘men’s rights’ sites, anti-immigration Facebook pages, gay hate memes, misogynist trolling, anti-Semitic websites, alt-right websites and ‘truth’ (conspiracy) websites, to name a few, where discussion flouts norms of public debate, rules of argument and requirements for the rational consideration of evidence for its own ends. Building on earlier work on anti-publics by McKenzie Wark and Bart Cammaerts, and working from examples from several different domains of online anti-public discourse, I argue that despite its size and complexity, it is possible and necessary to theorise this heterogeneous discursive field, not least because while such discourse is often dismissed, the meanings developed in such domains increasingly intermingle with and inform everyday democratic discourse. While we tend to think of extreme and irrational online discourse as aberrant and alien to everyday democratic discourse, analysis suggests that such discourse in fact is a precise reflection of an everyday ‘post-normative’ democratic discourse that has itself become deeply inflected with reactionary and populist themes.
Angiotensin-converting enzyme gene insertion/deletion polymorphism and high-altitude pulmonary edema: An updated meta-analysis
Authors: Zheng Yan , Huang Jin
Published: February 2020

Objective:

The purpose of the study was to investigate the association between angiotensin-converting enzyme gene insertion/deletion polymorphism and high-altitude pulmonary edema.

Methods:

A systematic search for relevant literature was performed in MEDLINE, CNKI, and EMBASE. The pooled odds ratios and their corresponding 95% confidence intervals were calculated in STATA 12.0 software.

Results:

Seven studies, with a total of 304 patients and 564 controls, qualified for the inclusion in the analysis. There was no significant association between angiotensin-converting enzyme insertion/deletion polymorphism and high-altitude pulmonary edema risk in the total population (DD vs II: odds ratio=1.07, 95% confidence interval 0.52–2.24; DI vs II: odds ratio=1.12, 0.85–1.49; dominant model: odds ratio=1.07, 0.83–1.40; recessive model: odds ratio=0.96, 0.53–1.77). Subgroup analysis according to race also revealed no significant correlation between angiotensin-converting enzyme gene insertion/deletion polymorphism and high-altitude pulmonary edema.

Conclusions:

Our findings suggest that angiotensin-converting enzyme insertion/deletion polymorphism does not contribute to the risk of high-altitude pulmonary edema. Larger, well-designed studies are required to further validate these results.
A general framework for prediction in penalized regression
Authors: Carballo Alba , Durban Maria , Kauermann Göran , Lee Dae-Jin
Published: February 2020

There are two main approaches to carrying out prediction in the context of penalized regression: with low-rank basis and penalties or through the smooth mixed models. In this article, we give further insight in the case of P-splines showing the influence of the penalty on the prediction. In the context of mixed models, we can connect the new predicted values to the observed values through a joint normal distribution, which allows us to compute prediction intervals. In this work, we propose an alternative approach, called the extended mixed model approach, that allows us to fit and predict data simultaneously. The methodology is illustrated with two real datasets, one of them on aboveground biomass and the other on monthly sulphur dioxide ([Formula: see text]) levels in a selection of monitoring sites in Europe.
Effects of surface morphology of electrospun polystyrene fiber on its air filtration performance
Authors: Zheng Yuansheng , Li Xueqin , Xin Binjie , Meng Na , Helian Xiaowei
Published: February 2020

A series of membranes, made from polystyrene microfibers and with different morphologies, were fabricated via electrospinning method in this study. In addition, not only porous fibers but also beaded fibers were obtained by adjusting the experimental temperature in a reasonable and appropriate way. Assisted by a high-speed camera, the images of jet behaviors at different experimental temperatures were captured for the purpose of in-depth and comprehensive understanding of formation mechanism of different fiber morphologies. Mono-disperse sodium chloride aerosol particles with different sizes and cigarette smoke were used, for the attainment of the objective of evaluation on the filtration performance of fabricated membranes. The experimental results showed that straight fiber with narrow pores on its surface can be obtained at 20°C spinning temperature because of the rapid jet motion and solvent evaporation, and also, beaded fibers can be fabricated in the situation of spinning temperature higher than 25°C due to the sudden change of surface tension resulted from the fast solvent evaporation. The porous straight fibers exhibited excellent filtration performance to cigarette smoke and aerosol containing particles of all sizes (99.76%, 99.92%, and 99.99% filtration efficiency for particles with sizes of 0.3 µm, 0.5 µm, and 1 µm, respectively).
Independent Older Adult’s IADL and Executive Function According to Cognitive Performance
Authors: Lahav Orit , Katz Noomi
Published: February 2020

Participation in Instrumental Activities of Daily Living (IADL) is essential in occupational therapy aiming to improve the life situation of elderly. Effective executive function (EF) is important to successful functioning in IADL. The purpose of this study was to examine EF and IADL performance differences according to cognitive levels as measured by the Montreal Cognitive Assessment (MoCA), age, and gender. In all, 80 elderly (49% female; age M = 73.4) were assessed at home, with Weekly Calendar Planning Activity (WCPA-10), IADL scale, and MoCA as a cognitive screening tool for dividing into normal cognitive (NC) level and mild cognitive impairment (MCI). The comparison between the MoCA groups on the WCPA-10 and IADL shows significant differences between the groups; gender and age differed only in IADL. IADL and WCPA-10 performance among independent elderly relates to their cognitive level. We suggest that intervention that will focus on EF may assist in improving performance and maintaining participation in occupation.
Advanced Data Analytics for Clinical Research Part I: What are the Tools?
Authors: Zhou Nicolas , Corsini Erin M. , Jin Shida , Barbosa Gregory R. , Kell Trey , Antonoff Michael H. , Antonoff Mara B.
Published: February 2020

The concept of Big Data is changing the way that clinical research can be performed. Cardiothoracic surgeons need to understand the dynamic digital transformation taking place in the healthcare industry. In the last decade, technological advances and Big Data analytics have become powerful tools for businesses. In healthcare, rapid expansion of Big Data infrastructure has occurred in parallel with attempts to reduce cost and improve outcomes. Many hospitals around the country are augmenting traditional relational databases with Big Data infrastructure. Advanced data capture and categorization tools such as natural language processing and optical character recognition are being developed for clinical and research use, while Internet of Things in the form of wearable technology serves as an additional source of data usable for research. As cardiothoracic surgeons seek ways to innovate, novel approaches to data acquisition and analysis enable a more rigorous level of investigatory efforts.
The Impact of Incentives on Weight Control in Men: A Randomized Controlled Trial
Authors: Rounds Tiffany , Crane Melissa , Harvey Jean
Published: February 2020

Overweight and obese men were recruited to a 6-month, randomized controlled weight loss trial, which compared the Gutbusters weight loss program alone to the Gutbusters program with incentives for successful weight loss. The intervention was delivered primarily online, with weekly in-person weight collections. Gutbusters was designed using a template from the REFIT intervention and encouraged participants ( N = 102, 47.0 ± 12.3 years, 32.5 kg/m2) to make six 100-calorie changes to their typical daily diet for a total of 42 changes per week. Weight loss was significantly greater in the Gutbusters+Incentive group compared to the Gutbusters alone group at both 12 and 24 weeks ( p’s = < .01). The Gutbusters+Incentive group’s a mean weight loss was 9.9 pounds at 12 weeks (95% CI: 6.9, 12.9) and 8.4 pounds at 24 weeks (95% CI: 3.9, 13.0). The Gutbusters alone group mean weight loss was 3.7 pounds at 12 weeks (95% CI: –.06, 7.5) and 3.4 pounds at 24 weeks (95% CI: –2.2, 9.0). This study adds to the literature of behavioral weight programs that are designed for men. Unlike the majority of previous male weight loss interventions, which were designed with an intervention comparison to a no treatment or waitlist control, Gutbusters was implemented as a comparative effectiveness trial, which will help bolster the evidence base for real-world application.
Development of an autonomous object transfer system by an unmanned aerial vehicle based on binocular vision
Authors: Liu Xu , Chen Bo , He Yuqing , Li Decai
Published: February 2020

This article describes the development of an unmanned aerial vehicle system that had a remarkable performance in the 6th International Unmanned Aerial Vehicle Innovation Grand Prix, which was held on November 2–4, 2018, in Anji, China. The main mission of the competition was to build a simulated tower using prefabricated components by an unmanned rotorcraft, which could be decomposed into the following four subtasks: (1) navigation and control, (2) recognition and location, (3) grasp and construction, and (4) task planning and scheduling. All the tasks were required to perform autonomously without human intervention. According to the requirement of the mission, the unmanned aerial vehicle system was designed and implemented with high degree of autonomy and reliability, whose hardware was developed on a quadrotor platform by integrating various system components, including sensors, computers, power, and grasp mechanism. Software algorithms were exploited, and executable computer codes were implemented and integrated with the developed unmanned aerial vehicle hardware system. Integration of the two provided onboard intelligence to complete the mission. This article addresses the major components and development process of the unmanned aerial vehicle system and describes its applications to the competition mission.
Two Rediscoveries of the Autostereogram in the 1960s
Authors: Sawada Tadamasa , Rozhkova Galina I.
Published: February 2020

The autostereogram (ASG) was discovered in the 1840s and again in the 1960s. It is acknowledged that Pete Stephens rediscovered the ASG serendipitously when he constructed an image with a repetitive pattern manually in the late 1960s. But, the principle and application of the ASG were described by Lev Mogilev from Irkutsk State University earlier in the 1960s.
Pathological demand avoidance: What and who are being pathologised and in whose interests?
Authors: Moore Allison
Published: February 2020

The term ‘pathological demand avoidance’ was first coined in 1983. In recent years, diagnostic tools have emerged to enable practitioners to identify, name and treat pathological demand avoidance and, at least in the United Kingdom, there is an increasing number of children who attract this label. In addition to what are defined as the core ‘deficits’ of autism, including assumed difficulties in social communication, difficulties in social interaction and restrictive interests, children with pathological demand avoidance are thought to have an extreme anxiety-driven need to control their environment and control the demands and expectations of others. This article will argue that we must exercise extreme caution in accepting the validity of pathological demand avoidance and will suggest that it can be seen as an attempt to psychiatarise autistic children’s resistance, which, in so doing, restricts their agency. First, it will draw on the arguments put forward by some autistic scholars who have claimed that pathological demand avoidance is better understood as rational demand avoidance – an understandable and rational response to the circumstances that one finds oneself in. Second, it will consider the intersection between autism and childhood. When one of the defining characteristics of pathological demand avoidance is an inability to recognise and, presumably, respect social hierarchy, children’s competencies as social actors and active meaning makers of their world can easily become pathologised as defiance. Finally, the article will address the intersections of autism, childhood and gender. Girls are much less likely to be diagnosed as having an autism spectrum condition than boys are, with a ratio traditionally estimated at approximately 1:4. However, pathological demand avoidance diagnoses are fairly evenly spread between boys and girls. It will be argued that it is girls’ resistance to the ordinary and everyday demands of her as a girl and her subsequent rejection or transgression of those expectations that is being pathologised.
Vascular homeostasis at high‐altitude: role of genetic variants and transcription factors
Authors: Chanana Neha , Palmo Tsering , Newman John H. , Pasha M.A. Qadar
Published: February 2020

High‐altitude pulmonary edema occurs most frequently in non‐acclimatized low landers on exposure to altitude ≥2500 m. High‐altitude pulmonary edema is a complex condition that involves perturbation of signaling pathways in vasoconstrictors, vasodilators, anti‐diuretics, and vascular growth factors. Genetic variations are instrumental in regulating these pathways and evidence is accumulating for a role of epigenetic modification in hypoxic responses. This review focuses on the crosstalk between high‐altitude pulmonary edema‐associated genetic variants and transcription factors, comparing high‐altitude adapted and high‐altitude pulmonary edema‐afflicted subjects. This approach might ultimately yield biomarker information both to understand and to design therapies for high‐altitude adaptation.
Long-term follow-up with a smartphone application improves exercise capacity post cardiac rehabilitation: A randomized controlled trial
Authors: Lunde Pernille , Bye Asta , Bergland Astrid , Grimsmo Jostein , Jarstad Even , Nilsson Birgitta Blakstad
Published: February 2020

Background

Mobile health interventions, especially smartphone applications (apps), have been proposed as promising interventions for supporting adherence to healthy behaviour in patients post cardiac rehabilitation (CR). The overall aim of the study was to examine the effect of individualized follow-up with an app for one year on peak oxygen uptake (VO2peak) in patients completing CR.

Design

The study was designed as a single-blinded multicentre randomized controlled trial.

Methods

The intervention group (IG) received individualized follow-up enabled with an app for one year, while the control group (CG) received usual care. The primary outcome was difference in VO2peak. Secondary outcomes included exercise performance (time to exhaustion, peak incline (%) and peak velocity (km/h)), bodyweight, resting blood pressure, lipid profile, triglycerides, exercise habits, health-related quality of life, health status and self-perceived goal achievement.

Results

In total, 113 patients completing CR (73.4% with coronary artery disease, 16.8% after valve surgery and 9.8% with other heart diseases) were randomly allocated to the IG or CG. Intention to treat analyses showed a statistically significant difference in VO2peak between the groups at follow-up of 2.2 ml/kg/min, 95% confidence interval 0.9–3.5 ( p < 0.001). Statistically significant differences were also observed in exercise performance, exercise habits and in self-perceived goal achievement.

Conclusions

Individualized follow-up for one year with an app significantly improved VO2peak, exercise performance and exercise habits, as well as self-perceived goal achievement, compared with a CG in patients post-CR. There were no statistically significant differences between the groups at follow-up in the other outcome measures evaluated.
Venoarterial extracorporeal membrane oxygenation in heart surgery post-operative pediatric patients: A retrospective study at Christus Muguerza Hospital, Monterrey, Mexico
Authors: Vargas-Camacho Gerardo , Contreras-Cepeda Verónica , Gómez-Gutierrez Rene , Quezada-Valenzuela Guillermo , Nieto-Sanjuanero Adriana , Santos-Guzmán Jesús , González-Salazar Francisco
Published: February 2020

Objectives:

Extracorporeal membrane oxygenation is a life support procedure developed to offer cardiorespiratory support when conventional therapies have failed. The purpose of this study is to describe the findings during the first years using venoarterial extracorporeal membrane oxygenation in pediatric patients after cardiovascular surgery at Christus Muguerza High Specialty Hospital in Monterrey, Mexico.

Methods:

This is a retrospective, observational, and descriptive study. The files of congenital heart surgery post-operative pediatric patients, who were treated with venoarterial extracorporeal membrane oxygenation from January 2013 to December 2015, were reviewed.

Results:

A total of 11 patients were reviewed, of which 7 (63.8%) were neonates and 4 (36.7%) were in pediatric age. The most common diagnoses were transposition of great vessels, pulmonary stenosis, and tetralogy of Fallot. Survival rate was 54.5% and average life span was 6.3 days; the main complications were sepsis (36.3%), acute renal failure (36.3%), and severe cerebral hemorrhage (9.1%). The main causes of death were multi-organ dysfunction syndrome (27.3%) and cerebral hemorrhage (18.2%).

Conclusion:

The mortality rates found are very similar to those found in a meta-analysis report published in 2013 and the main complication and causes of death are also very similar to the majority of extracorporeal membrane oxygenation reports for these kinds of patients. Although the results are encouraging, early sepsis detection, prevention of cerebral hemorrhage, and renal function monitoring must be improved.
What are the association patterns between handgrip strength and adverse health conditions? A topical review
Authors: McGrath Ryan , Johnson Nathaniel , Klawitter Lukus , Mahoney Sean , Trautman Kara , Carlson Caroline , Rockstad Ella , Hackney Kyle J
Published: February 2020

Measures of handgrip strength can be used to conveniently assess overall muscle strength capacity. Although stand-alone measures of handgrip strength provide robust health information, the clinical meaningfulness to determine prevention and treatment options for weakness remains limited because the etiology of muscle weakness remains unclear. Moreover, clinical outcomes associated with handgrip strength are wide-ranging. Therefore, disentangling how handgrip strength is associated with health conditions that are metabolically or neurologically driven may improve our understanding of the factors linked to handgrip strength. The purpose of this topical review was to highlight and summarize evidence examining the associations of handgrip strength with certain health outcomes that are metabolically and neurologically driven. From this perusal of the literature, we posit that stand-alone handgrip strength be considered an umbrella assessment of the body systems that contribute to strength capacity, and a panoptic measurement of muscle strength that is representative of overall health status, not a specific health condition. Recommendations for future strength capacity–related research are also provided.
Frozen section analysis for organ-conserving surgery in penile cancer: Assessing oncological outcomes and trends of local recurrence
Authors: Ellul T , Grice P , Mainwaring A , Bullock N , Shanahan A , Cave D , Dormer J , Harrison R , Brown G , Younis A , Bose P , Goddard JC , Summerton DJ
Published: February 2020

Introduction and objectives:

The local recurrence rate of penile cancer following surgical excision is reported in many series to be between 6 and 29%. Intra-operative frozen section (FS) is a useful tool to ensure safe microscopic margins in organ-sparing procedures in penile cancer. In this series, we assessed the rates of positive margins and patterns of local recurrence in a multicentre cohort of patients undergoing penile-preserving surgery assisted by intra-operative FS analysis.

Materials and methods:

We reviewed all those patients for whom intra-operative FS was employed during penile-preserving surgery in three tertiary referral centres between 2003 and 2016. We assessed whether the use of FS altered the surgical technique and what affect it had on positive margins and recurrence rates.

Results:

A total of 169 patients were identified. Of these, intra-operative FS examination of the surgical margin was positive in 21 (12%) cases. Final histological examination confirmed cancer-free margins in all but one patient (99.4%). Overall, 9 patients developed local recurrence (5.3%).

Conclusions:

In this series, intra-operative FS contributed to a very low rate (5.3%) of local recurrence. We noted an extremely low positive margin rate (0.6%) which highlights the benefit of incorporating FS analysis into organ-preserving surgery for penile cancer.

Level of evidence:

Not applicable for this multicentre audit.
A Rare Case of Drug-Resistant Nocardia transvalensis Infection in a Renal Transplant Patient
Authors: Kapoor Rajan , Adapa Sreedhar , Vakiti Anusha , Gani Imran Yaseen , Mulloy Laura , Padala Sandeep Anand
Published: February 2020

Nocardia transvalensis is a rare species of Nocardia and is known to be a drug-resistant organism. Multiple cases have been reported of Nocardia species causing opportunistic infections in immunocompromised hosts. To our knowledge, we report the first case of successfully treated drug-resistant Nocardia transvalensis causing pulmonary nocardiosis in a renal transplant patient. Our case validates the importance of prompt identification of Nocardia species and their drug sensitivities to improve clinical outcomes and reduce mortality.
Liquid Biopsy: The Unique Test for Chasing the Genetics of Solid Tumors
Authors: Aghamir Seyed Mohammad Kazem , Heshmat Ramin , Ebrahimi Mehdi , Khatami Fatemeh
Published: February 2020

Blood test is a kind of liquid biopsy that checks cancer cells or cancer nucleic acids circulating freely from cells in the blood. A liquid biopsy may be used to distinguish cancer at early stages and it could be a game-changer for both cancer diagnosis and prognosis strategies. Liquid biopsy tests consider several tumor components, such as DNA, RNA, proteins, and the tiny vesicles originating from tumor cells. Actually, liquid biopsy signifies the genetic alterations of tumors through nucleic acids or cells in various body fluids, including blood, urine, cerebrospinal fluid, or saliva in a noninvasive manner. In this review, we present an overall description of liquid biopsy in which circulating tumor cells, cell-free nucleic acids, exosomes, and extrachromosomal circular DNA are included.
Professionalising Indian Family Firms: An Analysis of the Role of HR—Current Reality and Future Perspectives
Authors: Jayakumar Tulsi
Published: February 2020

A critical challenge in the long-term survival and growth of family businesses is the adoption of professionalisation. The latter itself, when viewed as a multi-dimensional construct, would involve a critical role assigned to HR and HR control systems. This article then seeks to undertake an exploratory research to understand the current reality and the future perspectives of professionalisation in Indian family businesses through the lens of HR and HR control systems. Six caselets explore the experiences of six representative family businesses with regard to their professionalisation journey. The article finds that while the next-generation views professionalisation as imperative for scaling up, HR is still in its infancy stage in these Indian family firms. This would have ramifications for the outcomes of such professionalisation. The article concludes that HR would need to be assigned the role of a regenerative function, rather than a back-end administrative role that seems to be the current reality.