bluuebunny/crossref_metadata_2025 huggingface dataset:
COVID-19 Pandemic Significantly Decreases Acute Surgical Complaints
Authors: Riley John S. , Luks Valerie L. , de Pina Luis Filipe , Al Adas Ziad , Stoecker Jordan B. , Jackson Benjamin M. , Braslow Benjamin M. , Holena Daniel N.
Published: August 2020

Background

The coronavirus disease 2019 (COVID-19) pandemic significantly reduced elective surgery in the United States, but the impact of COVID-19 on acute surgical complaints and acute care surgery is unknown.

Study design

A retrospective review was performed of all surgical consults at the Hospital of the University of Pennsylvania in the 30 days prior to and 30 days following confirmation of the first COVID-19 patient at the institution. Consults to all divisions within general surgery were included.

Results

Total surgical consult volume decreased by 43% in the post-COVID-19 period, with a significant reduction in the median daily consult volume from 14 to 8 ( P < .0001). Changes in consult volume by patient location, chief complaint, and surgical division were variable, in aggregate reflecting a disproportionate decrease among less acute surgical complaints. The percentage of consults resulting in surgical intervention remained equal in the 2 periods (31% vs 28%, odds ratio 0.85, 95% CI 0.61-1.21, P = .38) with most but not all operation types decreasing in frequency. The rise in the COVID-19 inpatient census led to increased consultation for vascular access, accommodated at our center by the creation of a new surgical procedures team.

Conclusion

The COVID-19 pandemic significantly altered the landscape of acute surgical complaints at our large academic hospital. An appreciation of these trends may be helpful to other Departments of Surgery around the country as they deploy staff and allocate resources in the COVID-19 era.
Sociology’s encounter with the decolonial: The problematique of indigenous vs that of coloniality, extraversion and colonial modernity
Authors: Patel Sujata
Published: August 2020

How did the process of decolonization reframe the social sciences? This article maps the interventions made by theorists of and from the ex-colonial countries in reconceptualizing sociology both as practice and as an episteme. It argues that there are geographically varied and intellectually diverse decolonial approaches being formulated using sociological theory to critique the universals propounded by the traditions of western sociology/social sciences; that these diverse knowledges are connected through colonial and global circuits and that these create knowledge geographies; that collectively these diverse intellectual positions argue that sociology/social sciences are constituted in and within the politics of ‘difference’ organized within colonial, nationalist and global geopolitics; that this ‘difference’ is being reproduced in everyday knowledge practices and is being structured through the political economy of knowledge; and that the destabilization of this power structure and democratization of this knowledge is possible only when there is a fulsome interrogation of this political economy, and its everyday practices of knowledge production within universities and research institutes. It argues that this critique needs to be buffered by the constitution of alternate networks of circulation of this knowledge.
Colonial management of death: To be or not to be dead in Palestine
Authors: Daher-Nashif Suhad
Published: August 2020

During the late 1960s, Israel had a policy of withholding Palestinian corpses in secret cemeteries, in which each corpse was designated by a number, called the ‘secret cemeteries of numbers’. During the last Palestinian ‘al-Quds [Jerusalem] uprising’ in October 2015, Israel again began withholding killed Palestinians’ bodies, this time storing them in refrigerators. Tens of families experienced the detention and release of the frozen dead body of their relative. Drawing on 19 semi-structured interviews with families from al-Khalil (Hebron), this article traces Israel’s political use of Palestinian bodies to dismantle Palestinian collectivity, and the Palestinians’ use of the same bodies to rebuild their national collectivism. This article also describes Israel’s use of its necropolitical and biopolitical powers to manage the Palestinian death, and the resistance strategies used by Palestinian families to oppose these powers. This study argues that necropolitics includes the coloniser’s management of the colonised grief and bereavement, and the decisions about how, when, where and with whom the colonised should die. That is, it is the power to manage the structure and process of ‘letting die’ and being dead.
Theorizing societalization across borders: Globality, transnationality, postcoloniality
Authors: Amelina Anna , Boatcă Manuela , Bongaerts Gregor , Weiß Anja
Published: August 2020

The editorial summarizes the main conceptual and epistemological challenges of theorizing on society across borders. Its particular aim is to initiate the dialogue between theories of society and cross-border studies that address global, transnational and postcolonial relations. In essence, this special issue addresses four interrelated concerns of studying societal processes across borders. The first of these concerns is prompted by a decades-old critique of methodological nationalism. The second concern addresses the question of how can ‘society’ and the boundaries of ‘societalization’ be conceptualized, if global, transnational and postcolonial processes straddle the boundaries of nation-states? The third concern relates to the fact that sociological ‘grand’ theories have been criticized for failing to analyze recent developments of societies on a meso- and micro-level. Fourthly, a conversation between social theory and cross-border studies is also challenged by epistemic inequalities. Therefore, theories of society should be able to take into account not only the ‘grand scale’ of societal contexts and societal changes but also the positionality of the theorizing subject within global asymmetries of power.
The Behavioral Response to Increased Pedestrian and Staying Activity in Public Space: A Field Experiment
Authors: Zapata Oscar , Honey-Rosés Jordi
Published: August 2020

William Whyte originally hypothesized that the presence of people in a public space would attract more people. Contemporary planners now refer to “sticky streets” as places where pedestrians are compelled to linger and enjoy vibrant public life. We test the hypothesis that adding users to a public space will attract more people using an experimental design with confederates to add pedestrian movement and staying activity in a residential street for 45 randomly selected hours. We observed staying behavior by gender with and without our intervention. We find that the addition of public users reduced the total number of people staying in our study area, especially among women. We find that women’s right to the city may be constrained by the mere presence of other individuals, even in safe spaces and during daylight hours. Our findings suggest that Whyte’s claim is not universal, but depends on the conditions of a particular site.
Career capital in global versus second-order cities: Skilled migrants in London and Newcastle
Authors: Kozhevnikov Andrew
Published: August 2020

This study explores the impact of city-specific factors on skilled migrants’ career capital within the intelligent career framework. It compares global and secondary cities as distinct career landscapes and examines how differently they shape development and utilisation of three ways of knowing (knowing-how, knowing-whom and knowing-why). Findings from 82 qualitative interviews with skilled migrants in global (London) and secondary (Newcastle) UK cities explain the importance of cities at an analytical level, as skilled migrants’ careers were differently constrained and enabled by three groups of city-specific factors: labour market, community and lifestyle. By exploring the two types of cities in career context, this article contributes to developing an interdisciplinary dialogue and problematises careers as a relational and contextually embedded phenomenon. Limitations and recommendations are discussed.
Language Learner Engagement During Speaking Tasks: A Longitudinal Study
Authors: Aubrey Scott , King Jim , Almukhaild Haydab
Published: August 2020

Learner engagement is crucial for ensuring the quality of learning experiences, and yet the study of ‘task engagement’ has received relatively little empirical attention in the language education domain. This article reports on a study exploring the factors contributing to learners’ engagement and disengagement during task performance in an English as a foreign language classroom. Thirty-seven learners performed 10 different speaking tasks implemented over a 10-week period in a Japanese university task-supported classroom. The participants’ engagement was measured using a post-task questionnaire on perceived levels of anxiety, confidence, focus and desire to speak. Learners’ written self-report reflections revealed complementary in-depth qualitative data about the underlying factors behind their engagement or otherwise during speaking tasks. The results revealed a variety of learner-level, lesson-level, task-level and post-task-level factors contributing to learners’ engagement and disengagement in tasks. Findings indicate that certain task features such as the nature and purpose of the tasks, task repetition, familiar and easier task topics led to successful engagement. On the other hand, lack of social cohesion and motivational baggage were reported as primary factors in determining learners’ silences and disengagement in tasks. The authors offer pedagogical implications for teachers on how speaking tasks can be better implemented to enhance engagement in foreign language classrooms.
Rethinking China’s Rural Revitalization from a Historical Perspective
Authors: Wong Siu Wai , Tang Bo-sin , Liu Jinlong
Published: August 2020

Rural revitalization calls for a new type of urban–rural relations in urbanizing China. Although the importance of urban–rural dichotomy has received increasing attention by scholars interested in studying urban development and governance in contemporary China, their interpretations about the connection between urban and rural areas remain fragmented and ambiguous. This article seeks to trace the origin of the Chinese city and its relations with the countryside in the imperial era. It generates a more complete understanding of the rural–urban relationship in the traditional Chinese society and to appeal for a more rounded research agenda for the Chinese urbanization based on a sound historical perspective. The findings of this study explain why and how the traditional urban–rural continuum has disappeared in contemporary China, and identifies the key lessons and wisdoms that we can borrow from the imperial era when we come to tackle the present urban–rural development.
Skeletal Muscle Fatigue State Evaluation with Ultrasound Image Entropy
Authors: Li Pan , Yang Xuebing , Yin Guanjun , Guo Jianzhong
Published: August 2020

Muscle fatigue often occurs over a long period of exercise, and it can increase the risk of muscle injury. Evaluating the state of muscle fatigue can avoid unnecessary overtraining and injury of the muscle. Ultrasound imaging can non-invasively visualize muscle tissue in real-time. Image entropy is commonly used to characterize the texture of an image. In this study, we evaluated changes in the ultrasound image entropy (USIE) during the fatigue process. Twelve volunteers performed static sustained contractions of biceps brachii at four different intensities (20%, 30%, 40%, and 50% of maximal voluntary contraction torque). The ultrasound images and surface electromyography (sEMG) signals were acquired during exercise to fatigue. We found that (1) the root-mean-square of the sEMG signal increased, the USIE decreased significantly with time during the sustained contractions; (2) the maximum endurance time (MET) and the decline percentage of USIE were significantly different ( p < .05) among the four contraction intensities; (3) the decline slope of USIE of the same volunteer was basically the same at different contraction intensities. The USIE could be a new method for the evaluation of skeletal muscle fatigue state.
Ideological Discourses of Fathers on Paternity Leave in Spain
Authors: Barbeta-Viñas Marc , Muntanyola-Saura Dafne
Published: August 2020

This article analyzes the ideological discourses of fathers on the use of paternity leave in Spain. The goal is to reconstruct the ideological positions that fathers from different social locations develop around the existence of paternity leave as well as to explore their attitudes toward the impending length equalization of paternity and maternity leaves. A qualitative analysis was applied through the configuration of eight focus groups with fathers from two Spanish cities, Madrid and Barcelona. The results show the diversity of the fathers’ ideological positions in their representations about paternity leave. Different conceptions and degrees of legitimacy are observed, often conditioned by work, and institutional and gender contexts to which these fathers belong. Only some discourses and specific positions back up the change of legislation toward the equivalent duration of paternity and maternity leaves.
Correlation between lifestyle and social factors in functional dyspepsia among college freshmen
Authors: Huang Zhen-peng , Wang Ke , Duan Yu-hang , Yang Guang
Published: August 2020

Objective

We aimed to examine the relationship between the prevalence of functional dyspepsia (FD) and lifestyle habits, to identify social factors that may contribute to psychosocial disorders.

Methods

We enrolled 759 university freshmen in this study, who were categorized into the FD group and healthy group. All participants completed the validated Self-Rating Depression Scale and Self-Rating Anxiety Scale questionnaires, to assess lifestyle and social factors among participants.

Results

The proportion of participants with FD was 16.86%, and 67.97% were women. Diet irregularities and sleep impairment may have an effect on FD. Tea consumption may play a role in preventing FD. Participants with FD were more likely to have mood disorders than healthy participants. Most participants with FD who had mood disorders experienced mild anxiety or depression. Participants’ main sources of stress arose from daily life, development, social life, life events, and participants’ daily schedule.

Conclusion

Sex and lifestyle habits, including sleeping patterns and dietary habits, can have an impact on FD. Social stress and mood disorders also have an effect on FD. FD may be prevented by adjusting lifestyle habits and psychological counseling.
Associations Between Alzheimer’s Disease and Related Dementias and Depressive Symptoms of Partner Caregivers
Authors: Harris Melissa L. , Titler Marita G. , Hoffman Geoffrey J.
Published: August 2020

Family members—mainly spouses and partners—are the primary caregivers for individuals with Alzheimer’s disease and related dementias (ADRDs), chronic progressive illnesses requiring increasing levels of care. We performed a retrospective observational analysis comparing depressive symptoms of 16,650 older individuals with partners without ADRDs, and those recently (within 2 years) or less recently diagnosed (≥2 years prior), controlling for lagged sociodemographic and health characteristics. The mean number of reported depressive symptoms was 1.2 ( SD = 1.8). Compared with respondents with partners with no ADRD, having a partner with any ADRD was associated with a 0.35 increase (95% confidence interval [CI] = [0.30, 0.41]), or 30% increase, in depressive symptoms. A less recent partner diagnosis was associated with a 33% increase, while a recent diagnosis was associated with a 27% increase. Clinically meaningful and longitudinally worsening depressive symptoms amplify the need to prioritize partner health and family-centered care following an ADRD diagnosis.
Examining the Social Emotional Health Survey-Secondary for Use with Latinx Youth
Authors: Hinton Tameisha , Dowdy Erin , Furlong Michael J. , Nylund-Gibson Karen , Carter Delwin , Wagle Rhea
Published: August 2020

Culturally responsive assessment practices include validated measures appropriate for use with diverse populations. Considering the increasing population of Latinx students in US schools, measures need co-validated English and Spanish (Social and Emotional Health Survey (SEHS)) language forms. This study examined the SEHS-Secondary with Latinx students who completed a form in either Spanish or English. With a matched sample of 1404 Latinx students across 113 California schools, the analyses examined the factor structure, measurement invariance, and latent trait factor means of students who completed the SEHS in either Spanish or English. The factor structure was invariant across groups with some latent mean differences observed. Educational practice implications are considered.
African American online newspapers’ coverage of policy debate on the Affordable Care Act in 2017
Authors: Biswas Masudul , Kim Nam Young
Published: August 2020

Using content analysis, this study examined the coverage on the repeal and replace efforts of the Affordable Care Act (ACA) in 2017 in three African American online newspapers—Afro.Com, AtlantaBlackStar.Com, and PhillyTrib.com. Top three news frames across the news coverage by these online newspapers reflected political contention and political maneuverings around the ACA and potential policy implications of the Republicans’ proposed bills to replace the ACA.
The Association Between Child Marriage and Domestic Violence in Afghanistan
Authors: Qamar Mavra , Harris M. Anne , Tustin Jordan L.
Published: August 2020

Child marriage and intimate partner violence have been globally recognized as human rights violations. Both indicators can derail an individual’s future and have various public health implications. Previous studies have shown an association between child marriage and domestic violence in low- and middle-income countries; however, data in Afghanistan are not known. This study aimed to assess the association between child marriage and domestic violence in Afghanistan. We used nationally representative data collected by the Demographic and Health Surveys to conduct logistic regression analyses. Child marriage was separated into three categories: very early marriage (<15 years), early marriage (15–17 years), and adult marriage (≥18 years). Domestic violence was the response variable and was assessed as any violence, physical violence, emotional violence, and sexual violence. Of the sample ( N = 21,324), 15% of the respondents were married before the age of 15; 35% were married between the ages of 15 and 17; and 50% were married as adults. After adjusting for current age, place of residence, and socioeconomic status, the odds of sexual violence were 22% higher among women who married before age 15 compared with those married as adults (OR = 1.22, 95% CI = [1.05, 1.40], p = .005). However, the odds of reporting any violence, physical violence, and emotional violence among those who married as children did not differ compared with those who married as adults. This may be due to a shift in traditional norms or underreporting in Afghanistan. This study adds to the body of research on child marriage and intimate partner violence, and specifically provides novel information on this association in Afghanistan.
Maintaining Gaps in Teacher Diversity, Preparedness, Effectiveness, and Retention? A Program Theory Evaluation of Mathematics Teacher Training in the New York City Teaching Fellows
Authors: Brantlinger Andrew , Grant Ashley A. , Miller Julie , Viviani William , Cooley Laurel , Griffin Matt
Published: August 2020

This study examines the extent to which the New York City Teaching Fellows (NYCTF) has delivered on its promise of improving mathematics teacher diversity, preparedness, effectiveness, and retention in hard-to-staff city schools. As a program theory evaluation study, it articulates the theory of action for selective alternative route programs and uses this to evaluate NYCTF’s program for secondary mathematics. The analysis draws on longitudinal data from 620 secondary mathematics teachers who began NYCTF in the prior decade. While the results point to potential improvements, it provides evidence that selective programs like NYCTF serve to maintain important gaps in teacher quality that they were designed to address.
Quality of moxa wool contained in commercial moxibustion devices: test method and examples of waste particle concentration
Authors: Kwon O Sang , Cho Seong Jin , Choi Kwang-Ho , Kang Suk-Yun , Seo Suyeon , Ryu Yeonhee
Published: August 2020

Background:

Moxibustion treatment involves a combination of thermal and chemical stimulation applied by the combustion of moxa wool. The quality of moxa wool is considered to be an important factor in moxibustion treatment traditionally and clinically. However, despite its importance, quantitative and objective methods for determining moxa wool quality are lacking.

Methods:

Moxa wool and commercial indirect moxibustion (CIM) device specimens were randomly collected, dried and strained through sieves of various sizes for 10 h. After sieving, the residues remaining on each sieve were collected. The collected samples were weighed and microscopically observed.

Results:

In this study, we observed that fibres mainly remained on sieves sized 425 μm, and particles were smaller than 300 μm. The residues between 425 and 300 μm varied between the products. In addition, moxa wool for direct moxibustion (DMW) exhibited significantly more fibres than moxa wool for indirect moxibustion (IMW). Most of the CIM devices using moxa wool had a quality similar to IMW, except for one CIM brand using moxa wool that contained three times more waste particles than IMW.

Conclusion:

Based on the results of this study, we conclude that the sieving method is useful for testing the quality of moxa wool even after the CIM manufacturing process. The sieve sizes of 425 and 300 μm could be used as a yardstick to determine the quality of moxa wool. Although this approach requires larger scale validation against existing standard methodologies, we believe it has great potential to be used to improve and safeguard the quality of moxa wool contained in commercial moxibustion devices.
Romosozumab: A Novel Injectable Sclerostin Inhibitor With Anabolic and Antiresorptive Effects for Osteoporosis
Authors: Nealy Kimberly Lovin , Harris Kira B.
Published: August 2020

Objective:

To review the clinical pharmacology, efficacy, and safety of romosozumab, a humanized monoclonal antibody with a novel mechanism of action for monthly injection, and its place in the management of osteoporosis.

Data Sources:

PubMed, MEDLINE, and ClinicalTrials.gov searches (1966 to July 2020) were conducted using the keywords romosozumab and osteoporosis.

Study Selection and Data Extraction:

Published phase 2 and 3 clinical trials and 2 meta-analyses in patients with osteoporosis were included.

Data Synthesis:

Romosozumab increased bone mineral density (BMD) at the lumbar spine (12.1%-13.3%), femoral neck (2.2%-5.9%), and total hip (2.5%-6.9%) in patients with osteoporosis. After 12 months, romosozumab provided greater BMD gains at the lumbar spine and hip than teriparatide. However, teriparatide is likely to further increase BMD if continued for up to 24 months. In postmenopausal women at a high fracture risk, 1 year of romosozumab followed by 1 year of alendronate resulted in lower vertebral, nonvertebral, clinical, and hip fractures than alendronate alone for 2 years. Although absolute event rates were low, serious cardiovascular and cerebrovascular events were numerically higher in 2 clinical trials when compared with alendronate (2.5% vs 1.9%, respectively) and placebo (4.9% vs 2.5%, respectively).

Relevance to Patient Care and Clinical Practice:

This review discusses the place in therapy for romosozumab in osteoporosis management as a novel agent.

Conclusions:

Romosozumab offers an alternative for patients with a high risk of osteoporotic fractures. Clinicians should avoid romosozumab in patients with a history of myocardial infarction or stroke in the past 12 months.
A review of vehicle active safety control methods: From antilock brakes to semiautonomy
Authors: Ahangarnejad Arash Hosseinian , Radmehr Ahmad , Ahmadian Mehdi
Published: August 2020

A comprehensive review of technologies and approaches for active safety systems designed to reduce ground vehicle crashes, as well as the associated severity of injuries and fatalities, is provided. Active safety systems are commonly referred to as systems that can forewarn a driver of a potential safety hazard, or automatically intervene to reduce the likelihood of an accident without requiring driver intervention. The data from naturalistic drivers has shown that such systems are instrumental in improving vehicle safety in various conditions, particularly at higher speeds and under adverse road conditions. The increased integration of sensors, electronics, and real-time processing capabilities has served as one of the critical enabling elements in the widespread integration of active safety systems in modern vehicles. The emphasis is placed on control approaches for active safety systems and their progression over the years from antilock brakes to more advanced technologies that have nearly enabled semiautonomous driving. A review of key active safety control approaches for antilock braking, yaw stability, traction control, roll stability, and various collision avoidance systems is provided.
Disparities in autism spectrum disorder diagnoses among 8-year-old children in Colorado: Who are we missing?
Authors: Hill Trenesha L , White Tiffany C , Anthony Bruno J , Reaven Judy , Harris Bryn , Reyes Nuri , Anthony Laura G
Published: August 2020

There is often a large time gap between caregivers’ initial concerns and the diagnosis of autism spectrum disorder. The current study aimed to identify factors associated with missed or delayed autism spectrum disorder diagnoses among children in Colorado. In a surveillance-based sample of 8-year-old children with autism spectrum disorder ( N = 572), we examined differences between children who were identified with autism spectrum disorder by a community provider and/or were eligible for special education services under an autism eligibility (documented diagnosis) and children who were first identified with autism spectrum disorder through a systematic record review (newly identified). Compared to documented diagnosis children, newly identified children were more likely to be female, aggressive, and argumentative. They were less likely to have had a developmental regression, sleep abnormalities, or an autism screener or diagnostic measure in their records. Newly identified children also had a poorer quality of information in their records. Furthermore, among documented diagnosis children, variations in clinical presentations were associated with significantly different mean ages at autism spectrum disorder diagnosis; children who showed early delays, motor abnormalities, hyperactivity and attention deficits, and odd responses to sensory stimuli received a diagnosis much earlier than documented diagnosis children with other clinical presentations.

Lay abstract

Although autism can be reliably diagnosed as early as 2 years of age, many children are not diagnosed with autism until much later. We analyzed data to determine why many of the 8-year-old children who resided in Colorado and were identified as having autism through a review of their health and/or educational records did not have a documented clinical diagnosis of autism and were not eligible for special education services under an autism eligibility. We found that children who did not have a documented clinical diagnosis of autism and were not eligible for special education services under an autism eligibility were more likely to be female, aggressive, and argumentative. They had a poorer quality of information in their records and were less likely to have had a developmental regression, sleep problems, or an autism screener or diagnostic measure in their records. These results suggest that the symptoms characteristic of autism among this group of children may have been attributed to another disorder and that clinicians may be able to recognize autism more readily in children with more functional impairment and those who experience a developmental regression. We also discovered that differences in symptom presentations among children who had a documented clinical diagnosis of autism and/or were eligible for special education services under an autism eligibility were associated with different ages at autism diagnosis.
Spousal order of migration, gender, and hospitalization among immigrants in Denmark
Authors: Caputo Jennifer , Carollo Angela , Mussino Eleonora , Ahrenfeldt Linda Juel , Lindahl-Jacobsen Rune , Drefahl Sven , Oksuzyan Anna
Published: August 2020

Background: Certain migration contexts that may help clarify immigrants’ health needs are understudied, including the order in which married individuals migrate. Research shows that men, who are healthier than women across most populations, often migrate to a host country before women. Using Danish register data, we investigate descriptive patterns in the order that married men and women arrive in Denmark, as well as whether migration order is related to overnight hospitalizations. Methods: The study base includes married immigrants who lived in Denmark between January 1, 1980 and December 31, 2014 ( N = 13,680). We use event history models to examine the influence of spousal migration order on hospitalizations. Results: The order that married individuals arrive in Denmark is indeed highly gendered, with men tending to arrive first, and varies by country of origin. Risk of hospitalization after age 50 does not depend on whether an individual migrated before, after, or at the same time as their spouse among either men or women. However, among those aged 18+, men migrating before their wives are more likely to experience hospitalizations within the first 5 years of arrival. Conclusions: These findings provide the first key insights about gendered migration patterns in Denmark. Although spousal order of migration is not related to overnight hospitalization among women, our findings provide preliminary evidence that men age 18+ who are first to arrive experience more hospitalization events in the following 5 years. Future research should explore additional outcomes and whether other gendered migration contexts are related to immigrants’ health.
Of wine and whiteboards: Enacting feminist reflexivity in collaborative research
Authors: Linabary Jasmine R , Corple Danielle J , Cooky Cheryl
Published: August 2020

Reflexivity is considered a hallmark of qualitative research. With the continued growth in team-based research, more attention is needed to what it means to practice reflexivity within the context of these research collaborations. In this article, we draw upon scholarship on reflexivity and our own experiences to develop what we term ‘collaborative feminist reflexivity’ (CFR). CFR represents a form of reflexivity that is distinctly collaborative in how it is enacted, grounded in feminist epistemological and ethical commitments, holistically engaged throughout the research process, and multifaceted, involving multiple formal and informal practices. In critically analyzing our own reflexive practices in the context of an interdisciplinary, multi-method study on hashtag activism related to domestic violence, we seek to identify specific practices for research teams as well as interrogate the potentials and limitations of these practices for enacting feminist reflexivity.
Effect of renal denervation on catecholamines and the renin–angiotensin–aldosterone system
Authors: Feyz Lida , van den Berg Sjoerd , Zietse Robert , Kardys Isabella , Versmissen Jorie , Daemen Joost
Published: August 2020

Introduction:

The effect of renal sympathetic denervation (RDN) on neurohormonal responses is largely unknown. We aimed to assess the effect of RDN on the renin–angiotensin–aldosterone system (RAAS) and endogenous catecholamines.

Methods:

A total of 60 patients with hypertension underwent RDN and remained on a stable antihypertensive drug regimen. Samples for plasma aldosterone, plasma renin and urine (nor)metanephrine were collected at baseline and at 6 months post procedure. Ambulatory blood pressure (BP) recordings were obtained at baseline and at 6 months post procedure.

Results:

Mean age was 64±9 years, and 30/60 patients were male. At 6 months, average daytime systolic and diastolic ambulatory BP decreased by 10 and 6 mmHg, respectively ( p<0.001). No significant change was observed in plasma aldosterone (median=248.0 pmol/L (interquartile range (IQR) 113.3–369.5 pmol/L) vs. median=233.0 pmol/L (IQR 110.3–360.8 pmol/L); p=0.66); renin (median=19.5 µIU/mL (IQR 6.8–119.5 µIU/mL) vs. median=14.3 µIU/mL (IQR 7.2–58.0 µIU/mL); p=0.32), urine metanephrine (median=0.46 µmol/L (IQR 0.24–0.77 µmol/L) vs. median=0.46 µmol/L (IQR 0.22–0.88 µmol/L); p=0.75) and normetanephrine (median=1.41 µmol/L (IQR 0.93–2.00 µmol/L vs. median =1.56 (IQR 0.74–2.50 µmol/L); p=0.58) between baseline and 6 months, respectively. No correlation was found between the decrease in mean systolic daytime BP and changes in RAAS hormones or endogenous catecholamines.

Conclusion:

Despite significant reductions in ambulatory BP, RDN did not result in a significant change in endogenous catecholamines or in RAAS hormones at 6 months.
On some fundamental issues about the safety of marine structures
Authors: Cui WC
Published: August 2020

Safety analysis and prediction of a marine structure is a very important field which has received attention from many scientists. Prof. R. Ajit Shenoi has made significant contributions in investigating various issues in this field. In this invited paper of recollection nature, a philosophical attitude is taken to re-examine some fundamental issues about the safety of marine structures with a purpose to identify the key issues to be solved in the future. It is intended to help young generations of scientists how to focus on more important problems related to the safety of marine structures.
A Whole Food Plant-Based Diet With a Novel Potassium-Binding Resin in a Patient With Advanced Chronic Kidney Disease
Authors: Manley-Casco Dario , Berkowitz Paul
Published: August 2020

Chronic kidney disease (CKD) is a major health problem with substantial morbidity and mortality. Plant-based diets decrease the incidence of CKD and progression of kidney disease and help prevent and treat the important comorbidities of obesity, type 2 diabetes, hypertension, and cardiovascular disease. However, in patients with CKD, there is concern that a plant-based diet may contribute to life-threatening hyperkalemia. We present a patient with CKD secondary to hypertensive glomerulosclerosis that worsened despite standard of care treatment. Shared decision making was used to initiate a whole food plant-based diet along with a potassium-binding resin (Patiromer) to control the potassium levels. The patient was able to be maintained on the whole food plant-based diet and an angiotensin-converting enzyme inhibitor without the development of hyperkalemia. This case shows that patients with CKD may be able to enjoy the benefits of a whole food plant-based diet while decreasing the risk of hyperkalemia by using the new potassium binders.
Effects of Structured Lifestyle Education Program for Individuals With Increased Cardiovascular Risk Associated With Educational Level and Socioeconomic Area
Authors: Lidin Matthias , Hellenius Mai-Lis , Rydell Karlsson Monica , Ekblom-Bak Elin
Published: August 2020

Background. Differences in socioeconomic status contribute to inequalities in lifestyle habits and burden of noncommunicable diseases. We aimed to examine how the effects of a 1-year structured lifestyle education program associate with the participant’s educational level and socioeconomic area (SEA) of residence. Methods. One hundred individuals (64% women) with high cardiovascular risk were included. Education level (nonuniversity vs university degree) was self-reported and SEA (low vs high) defined by living in different SEAs. Lifestyle habits and quality of life were self-reported, cardiovascular risk factors and Framingham 10-year cardiovascular disease risk were measured at baseline and after 1 year. Results. Sedentary behavior decreased in both nonuniversity degree and low SEA group over 1 year, with a significantly greater improvement in daily activity behavior in low- compared with high-SEA group. Abdominal obesity decreased significantly more in the nonuniversity compared with the university degree group. Cardiovascular risk and quality of life improved in all groups, however, with greater discrimination when using educational level as the dichotomization variable. Conclusion. The results are clinically and significantly relevant, suggesting that low socioeconomic status measured both as educational level and SEA are no barriers for changing unhealthy lifestyle habits and decreasing cardiovascular risk after participation in a lifestyle program.
Intestinal stenosis in Crohn’s disease shows a generalized upregulation of genes involved in collagen metabolism and recognition that could serve as novel anti-fibrotic drug targets
Authors: van Haaften Wouter Tobias , Blokzijl Tjasso , Hofker Hendrik Sijbrand , Olinga Peter , Dijkstra Gerard , Bank Ruud A. , Boersema Miriam
Published: August 2020

Background and Aims:

Crohn’s disease (CD) can be complicated by intestinal fibrosis. Pharmacological therapies against intestinal fibrosis are not available. The aim of this study was to determine whether pathways involved in collagen metabolism are upregulated in intestinal fibrosis, and to discuss which drugs might be suitable to inhibit excessive extracellular matrix formation targeting these pathways.

Methods:

Human fibrotic and non-fibrotic terminal ileum was obtained from patients with CD undergoing ileocecal resection due to stenosis. Genes involved in collagen metabolism were analyzed using a microfluidic low-density TaqMan array. A literature search was performed to find potential anti-fibrotic drugs that target proteins/enzymes involved in collagen synthesis, its degradation and its recognition.

Results:

mRNA expression of collagen type I ( COL1A1, 0.76 ± 0.28 versus 37.82 ± 49.85, p = 0.02) and III ( COL3A1, 2.01 ± 2.61 versus 68.65 ± 84.07, p = 0.02) was increased in fibrotic CD compared with non-fibrotic CD. mRNA expression of proteins involved in both intra- and extracellular post-translational modification of collagens (prolyl- and lysyl hydroxylases, lysyl oxidases, chaperones), collagen-degrading enzymes (MMPs and cathepsin-K), and collagen receptors were upregulated in the fibrosis-affected part. A literature search on the upregulated genes revealed several potential anti-fibrotic drugs.

Conclusion:

Expression of genes involved in collagen metabolism in intestinal fibrosis affected terminal ileum of patients with CD reveals a plethora of drug targets. Inhibition of post-translational modification and altering collagen metabolism might attenuate fibrosis formation in the intestine in CD. Which compound has the highest potential depends on a combination anti-fibrotic efficacy and safety, especially since some of the enzymes play key roles in the physiology of collagen.
Sterile processing in low- and middle-income countries: an integrative review
Authors: Cuncannon Alexander , Dosani Aliyah , Fast Olive
Published: August 2020

Background:

Worldwide disparities in surgical capacity are a significant contributor to health inequalities. Safe surgery and infection prevention and control depend on effective sterile processing (SP) of surgical instruments; however, little is known about SP in low- and middle-income countries (LMICs), where surgical site infection is a major cause of postoperative morbidity and mortality.

Aim:

To appraise and synthesise available evidence on SP in LMICs.

Methods:

An integrative review of research literature was conducted on SP in LMICs published between 2010 and 2020. Studies were appraised and synthesised to identify challenges and opportunities in practice and research.

Results:

Eighteen papers met the inclusion criteria for qualitative analysis. Challenges to advancing SP include limited available evidence, resource constraints and policy-practice gaps. Opportunities for advancing SP include tailored education and mentoring initiatives, emerging partnerships and networks that advance implementation guidelines and promote best practices, identifying innovative approaches to resource constraints, and designing and executing quality assurance and surveillance programmes.

Discussion:

Research investigating safe surgery, including SP, in LMICs is increasing. Further research and evidence are needed to confirm the generalisability of study findings and effectiveness of strategies to improve SP practice in LMICs. This review will help researchers and stakeholders identify opportunities to contribute. The burdens of unsafe surgery transcend geopolitical borders, and the global surgery and research communities are called upon to negotiate historical and present-day inequities to achieve safe surgery for all.
Analysis of the ADA’s Standard of Diabetes Care Recommendation for Continuous Glucose Monitoring System
Authors: Zafra-Tanaka Jessica Hanae , Brañez-Condorena Ana , Soriano-Moreno David R. , Taype-Rondan Alvaro
Published: August 2020

Transparency is a key factor to understand how recommendations were reached and to decide whether to adopt them or not. Currently, the American Diabetes Association (ADA) recommends the usage of real-time continuous glucose monitors in certain subgroups of people living with type 1 diabetes mellitus. In this commentary we sought to critically appraise this recommendation, mainly regarding the outcomes assessed, the evidence used for each outcome, and how the balance of benefits and harms was made. We found that the decision-making process followed to reach the ADA recommendation was not clear, and that the final recommendation does not seem to be supported in the assessed evidence.
Financial citizenship as a broader democratic context of financial literacy
Authors: Khalil Medhat
Published: August 2020

Financial citizenship is crucial in our modern world. Financial citizenship is underpinned by the education of future generations so that they can understand both their local and global economies to make the best financial decisions concerning their lives. This paper discusses financial literacy, how it relates to individual citizens, and how it correlates with social, political and business spheres. According to current financial capability models, every individual’s financial well-being can be boosted by developing their financial knowledge and competency, which will improve their motivations and confidence. Societal constructs significantly create financial socialization, which increases our accessibility and engagements with institutions, businesses, political systems and society as a whole. Being educated about the details required for financial literacy is every human being’s right. Citizens have been characterized as being personally responsible, participatory or justice oriented; each person’s specific perspective can impact their financial lives, which supports the importance of the current concept of financial citizenship. Boosting global education about economic citizenship will help to reduce poverty, create more sustainable economic environments, and improve social outcomes and the life satisfaction of the world population. These concepts will be explored and discussed in this paper.
Persistent hyperprolactinemia, transient hypopituitarism, and transient contralateral third nerve palsy after endovascular treatment of an internal carotid artery aneurysm: Case report and review of the literature
Authors: Wende Tim , Hamerla Gordian , Quäschling Ulf , Haase Amelie , Meixensberger Jürgen , Nestler Ulf
Published: August 2020

Intracranial aneurysms have an estimated prevalence of about 3%. A rare subgroup are aneurysms of the internal carotid artery that develop medially into the sellar region. Due to the risk of rupture with subsequent subarachnoid hemorrhage and of compression of surrounding structures, mechanical occlusion is advised. Hypopituitarism is not a rare disease and most often related to pituitary adenoma. Only 0.17% of cases with hypopituitarism are caused by unruptured intracranial aneurysms. Today, the predominant treatment of these aneurysms is endovascular coiling or application of flow diverting stents. We present the case of a 60-year-old female patient, who was treated with endovascular coiling for a right-sided, intracavernous, incidental internal carotid artery aneurysm. On postinterventional day 6, she was readmitted with contralateral third nerve palsy, mild hyponatremia und thyreotropic insufficiency. The symptoms recovered after anti-edematous treatment with corticosteroids; only an asymptomatic hyperprolactinemia persisted. To the best of our knowledge, this is the first case report of transient contralateral cranial nerve palsy combined with transient hypopituitarism after endovascular treatment of an internal carotid aneurysm. As treatment we propose corticosteroids, if necessary in combination with nonsteroidal anti-inflammatory drugs, in order to inhibit inflammatory reactions of the aneurysm wall compromising the nearby, partially compressed neural structures.
Perceived Challenges and Unmet Primary Care Access Needs among Bangladeshi Immigrant Women in Canada
Authors: Turin Tanvir C. , Rashid Ruksana , Ferdous Mahzabin , Chowdhury Nashit , Naeem Iffat , Rumana Nahid , Rahman Afsana , Rahman Nafiza , Lasker Mohammad
Published: August 2020

Introduction:

Understanding barriers in primary health care access faced by Canadian immigrants, especially among women, is important for developing mitigation strategies. The aim of this study was to gain an in-depth understanding of perceived challenges and unmet primary health care access needs of Bangladeshi immigrant women in Canada.

Methods:

In this qualitative study, we conducted 7 focus groups among a sample of 42 first-generation immigrant women on their experiences in primary health care access in their preferred language, Bangla. Descriptive analysis was used for their socio-demographic characteristics and inductive thematic analysis was applied to the qualitative data.

Results:

The hurdles reported included long wait time at emergency service points, frustration from slow treatment process, economic losses resulting from absence at work, communication gap between physicians and immigrant patients, and transportation problem to go to the health care centers. No access to medical records for walk-in doctors, lack of urgent care, and lack of knowledge about Canadian health care systems are a few of other barriers emerged from the focus group discussions.

Conclusions:

The community perception about lack of primary health care resources is quite prevalent and is considered as one of the most important barriers by the grassroots community members.