bluuebunny/crossref_metadata_2025 huggingface dataset:
Mechanisms of fuel injector tip wetting and tip drying based on experimental measurements of engine-out particulate emissions from gasoline direct-injection engines
Authors: Medina M , Alzahrani FM , Fatouraie M , Wooldridge MS , Sick V
Published: May 2020

Gasoline fuel deposited on the fuel injector tip has been identified as a significant source of particulate emissions at some operating conditions of gasoline direct-injection engines. This work proposes simplified conceptual understanding for mechanisms controlling injector tip wetting and tip drying in gasoline direct-injection engines. The objective of the work was to identify which physical mechanisms of tip wetting and drying were most important for the operating conditions and hardware considered and to relate the mechanisms to measurements of particulate number emissions. Trends for each of the physical processes were evaluated as a function of engine operating conditions such as engine speed, start of injection timing, engine load, fuel rail pressure, and coolant temperature. The effects of fuel injector geometries on the tip wetting and drying mechanisms were also considered. Several mechanisms of injector tip wetting were represented with the conceptual understanding including wide plume wetting, vortex droplet wetting, fuel dribble wetting, and fuel condensation wetting. The main tip drying mechanism considered was single-phase evaporation. Using the conceptual understanding for tip wetting and drying mechanisms that were created in this work, the effects of engine operating conditions and fuel injector geometries on the mechanisms were compared with experimental results for particulate number. The results indicate that measured particulate number was increased by increasing injected fuel mass. Increasing injected fuel mass was suspected to increase tip wetting via wide plume wetting and vortex droplet wetting mechanisms. Particulate number was also observed to increase with hole length. Longer hole length was suspected to result in higher tip wetting via vortex droplet and fuel dribble wetting mechanisms. Longer timescale was found to decrease particulate number emissions. Lower speeds and early injection timings increased the timescale. Similarly, higher coolant temperature decreased particulate number. The coolant temperature influenced tip temperature resulting in higher tip drying.
Tidal spaces: choreographies of remembrance and forgetting
Authors: Bissell Laura
Published: May 2020

This article explores the potential of tidal spaces to perform acts of remembrance and forgetting. Using oceanographer Rachel Carson’s The Edge of the Sea to contextualise tidal spaces, this analysis will discuss how constantly shifting and eroding coastlines act as a site for writing, rewriting and performing acts of cultural and personal memory. The concept of tidal choreographies will be introduced via two contemporary works performed on shorelines: 14-18 NOW’s Pages of the Sea, a large-scale public memorial performed on multiple beaches across the United Kingdom on Remembrance Sunday 2018; and Chloe Smith’s Tidal, an intergenerational, participatory, community work which was performed on the shore at Berwick-upon-Tweed in 2015. I will offer reflections on my own collaborative work Tide Times created with Tim Cooper to explicate ideas of the potential of tidal spaces (in this case a tidal island) further. In explicating various artworks which explore ideas of remembrance using tidal spaces, this article will also acknowledge the forgetting that is implicit in performing these actions. The markings in the sand are washed away, community groups that participate in the performance disperse and detritus left is eroded by the elements. What can the legacy of commemorations traced in such a transient and precarious space as a tidal zone be? This article argues that while shorelines provide sites for large and small-scale acts of public remembering, they are simultaneously acts of forgetting as the twice-daily tides cause inevitable erasure.
Epilepsy Surgery in Childhood Versus Adulthood: What Are We Waiting for?
Authors: Nickels Katherine
Published: May 2020

[Box: see text]
Continuous EEG Monitoring in Neonates: One Size Does Not Fit All
Authors: Kotagal Prakash
Published: May 2020

[Box: see text]
QEEG as a Useful Tool for the Evaluation of Early Cognitive Changes in Dementia and Traumatic Brain Injury
Authors: Koberda J. Lucas
Published: May 2020

Quantitative electroencephalography (QEEG)-electrical neuroimaging has been underutilized in general neurology practice. Recent advances in computer technology have made this electrophysiological testing relatively inexpensive as well as precise in identifying brain areas with electrical dysfunction related to either traumatic injury or neurodegenerative process. In this article, the author presents 2 cases that can be frequently encountered in every general neurological practice: case of early dementia and traumatic brain injury. The clinical usefulness of QEEG is demonstrated by showing evidence of electrical abnormalities and networks dysfunctions (including an elevation of frontal/temporal delta and theta powers as well as abnormalities in functional connectivity). In addition, the correlation of QEEG and findings from structural imaging technique—magnetic resonance imaging diffusion tensor imaging and another functional imaging—positron emission tomography is presented.
Single-stage basilic vein transposition—An effective and viable autogenous access for dialysis
Authors: Basavanthappa Rajendraprasad , Luthra Luv , Gangadharan Ashwini Naveen , A Ranjith Kumar , M Adharsh Kumar , JP Vivek Vardhan , AR Chandrashekar , Desai Sanjay C
Published: May 2020

Introduction

The National Kidney Foundation’s/Kidney Disease Outcomes Quality Initiative recommends autogenous arteriovenous fistulas as the preferred method for long-term hemodialysis access. Basilic vein transposition is not only an alternative in patients with failed arteriovenous access but also can be the first option for arteriovenous access in patients with inadequate cephalic vein. Several studies have shown better patency rates, cost-effectiveness, and fewer complications of autogenous access over prosthetic arteriovenous grafts.

Aims and objectives

To analyze patency, complication rates, and outcomes of single-stage basilic vein transposition.

Materials and methods

A single-center retrospective non-randomized study conducted at Ramaiah Medical College and Hospitals, Bangalore from July 2015 to June 2018. A total of 94 consented patients who underwent single-stage basilic vein transposition were included in the study. All the surgeries were done in a single stage under regional anesthesia. All the complications and patency rates were calculated at the end of one year. Statistical analysis was performed using the Chi-square test, and patency rates were assessed using the Kaplan–Meir survival curve.

Results

A total of 94 single-stage basilic vein transposition was performed. Fifty-four patients had a previous failed autogenous access and 40 had either absent or thrombosed cephalic vein. The mean age was 56.6 years with 59.57% males. The mean basilic vein and brachial artery diameter was 3.6 and 3.8 mm, respectively. The primary patency rate at one year was 84%. Edema and thrombosis were the most common complication in our study.

Conclusion

Single-stage basilic vein transposition is a feasible surgical option in end-stage renal disease patients and provides durable autogenous access with very reasonable outcomes in terms of complication rates and patency rates.
Diagnostic Value of Albumin to Fibrinogen Ratio in Cervical Cancer
Authors: Huang Li , Mo Zhuning , Zhang Linyan , Qin Shanzi , Qin Simeng , Li Shan
Published: May 2020

Background:

Albumin to fibrinogen ratio (AFR) play a crucial role in the progression and prognosis of many malignant tumors. This study aimed to comprehensively assess the diagnostic value of AFR as single markers or in combination with squamous cell carcinoma antigen (SCC-Ag), cancer antigen 125 (CA-125) in cervical cancer.

Methods:

A total of 323 cervical cancer inpatients, 143 patients with cervical intraepithelial neoplasia (CIN) and 317 healthy controls were analyzed. Differences in laboratory parameters and clinicopathological features were calculated using the Mann–Whitney U or Kruskal–Wallis H test. The receiver operating characteristic (ROC) curve was used to evaluate the predicted value of AFR, alone or combined with SCC-Ag, CA-125 for the diagnosis of cervical cancer.

Results:

The levels of AFR in patients with cervical cancer were significantly lower than those in the CIN patients and the control subjects. AFR were not only negatively correlated with the tumor stage, but also related to histology typing, lymph node metastasis, distant metastasis, depth of stromal infiltration, tumor size, and tumor stage; however, it was not associated with the blood group. AFR combined with SCC-Ag possessed a larger area under the curve (AUC; AUCAFR+SCC-Ag = 0.924, 95% confidence interval (CI) 0.900, 0.944) than AFR ( P < 0.001), SCC-Ag ( P < 0.001), or CA-125 ( P < 0.001) did alone.

Conclusions:

The pretreatment levels of AFR, alone or combined with SCC-Ag, CA-125 could improve the diagnostic efficiency of cervical cancer.
Research on active collision avoidance algorithm for intelligent vehicle based on improved artificial potential field model
Authors: Yuan Chaochun , Weng Shuofeng , Shen Jie , Chen Long , He Youguo , Wang Tong
Published: May 2020

In this article, an active collision avoidance based on improved artificial potential field is proposed to satisfy collision avoidance for intelligent vehicle. A longitudinal safety distance model based on analysis of braking process and a lane-changing safety spacing model based on minimum time of lane changing under the constraint of sideslip angle are presented. In addition, an improved artificial potential field method is introduced, which represents the influence of environmental information with artificial force. Simulation results demonstrate the superior performance of the proposed algorithm over collision avoidance for intelligent vehicle.
Practical design and implementation of an autonomous surface vessel prototype: Navigation and control
Authors: Tang Xinhua , Pei Zhonghai , Yin Shiming , Li Cong , Wang Peng , Wang Yu , Wu Zhiqiang
Published: May 2020

As the development of multidisciplinary techniques and ever-growing demands, autonomous system has been widely investigated in a variety of fields. In recent two decades, autonomous surface vessels have gained increasing attention from both industry and research communities, previous related work mainly focuses on the design of maneuver controllers, most algorithms are under some specific assumptions and always involve too many parameters that need to be tuned, leading to the lack of practical application or validation in real autonomous surface vessel platform. To tackle the issues, an integrated autonomous surface vessel prototype is designed and implemented, both navigation and maneuver control subsystems are improved, especially in terms of autonomous control, a simple geometrical model and constrained pure pursuit algorithm is firstly tried in autonomous surface vessel, the results show that the proposed system can achieve the path tracking with the error smaller than 40 cm, and even given a complicated waypoint mission, it can still maintain the accuracy of path tracking, demonstrating the stability and validity of the autonomous surface vessel prototype.
Emergency obstacle avoidance trajectory tracking control based on active disturbance rejection for autonomous vehicles
Authors: Liu Runqiao , Wei Minxiang , Sang Nan
Published: May 2020

To solve the problem of understeer and oversteer for autonomous vehicle under high-speed emergency obstacle avoidance conditions, considering the effect of steering angular frequency and vehicle speed on yaw rate for four-wheel steering vehicles in the frequency domain, a feed-forward controller for four-wheel steering autonomous vehicles that tracks the desired yaw rate is proposed. Furthermore, the steering sensitivity coefficient of the vehicle is compensated linearly with the change in the steering angular frequency and vehicle speed. In addition, to minimize the tracking errors caused by vehicle nonlinearity and external disturbances, an active disturbance rejection control feedback controller that tracks the desired lateral displacement and desired yaw angle is designed. Finally, CarSim® obstacle avoidance simulation results show that an autonomous vehicle with the four-wheel steering path tracking controller consisting of feed-forward control and feedback control could not only improve the tire lateral forces but also reduce tail flicking (oversteer) and pushing ahead (understeer) under high-speed emergency obstacle avoidance conditions.
Psychological Antecedents of Refugee Integration (PARI)
Authors: Echterhoff Gerald , Hellmann Jens H. , Back Mitja D. , Kärtner Joscha , Morina Nexhmedin , Hertel Guido
Published: May 2020

The successful management of refugee immigration, including refugee integration in host societies, requires a sound understanding of underlying psychological processes. We propose the psychological antecedents of refugee integration (PARI) model, highlighting perceived forcedness (i.e., coercion and loss of control from “push” factors) and ensuing perils (risks and potential suffering during migration) as distinctive factors of refugee (vs. voluntary) migration. According to our model, perceptions and subjective representations of forcedness and associated perils activate specific psychological processes relevant to refugee integration and thus moderate responses to the demands and stressors of the immigration situation. We conceptualize these distinctive influences for integration-relevant processes in both refugees and in residents. By pinpointing the unique features of refugee migration, PARI generates novel and specific hypotheses about psychological processes predicting refugee integration. For instance, refugees’ memories of forcedness and associated perils should lead to a high level of preoccupation with the restoration of basic needs after arrival in a receiving country that interferes with integration-related activities. Conversely, residents’ perceptions of forcedness and related perils may enhance empathy with refugees but may also magnify feelings of anxiety and threat. Implications for refugee integration are discussed for the domains of occupational work, education, and mental health.
Frailty assessment in older urological patients prior to surgery: a systematic review and narrative synthesis
Authors: Haren Andrea , Lal Rajni , Walker David , Nair Rajesh , Partridge Judith , Dhesi Jugdeep
Published: May 2020

Background:

Radical cystectomy (RC) and urinary diversion are the recommended treatment for patients with muscle invasive bladder cancer. This is complex surgery, associated with significant patient morbidity and mortality. Frailty has been shown to be an independent risk factor for adverse outcomes in several surgical populations. Preoperative assessment of frailty is advocated in current guidelines but is not yet standard clinical practice.

Aims:

This systematic review and narrative synthesis aims to examine whether patients undergoing RC are assessed for frailty, what tools are used, and whether an association is found between frailty and adverse outcomes in this population.

Results:

Nine studies, published within the last 4 years, describe the use of tools reporting to measure frailty in the RC population. All demonstrate increased risk of adverse postoperative outcomes with higher frailty levels. Only one study used a validated frailty tool. The majority of studies measure frailty using variations on a tool derived from a large database (ACS-NSQIP) effectively counting co-morbidities, rather than assessing the multidomain nature of the frailty syndrome.

Conclusion:

The recognition of frailty as an important consideration in the perioperative period is welcome. This systematic review and narrative synthesis demonstrates the need for collaboration in research and delivery of clinical care for older surgical patients. Such collaboration may provide clarity regarding terms such as frailty and multimorbidity, preventing the development of assessment tools inaccurately measuring these discreet syndromes interchangeably. More accurate assessment of patients in terms of frailty, multimorbidity and functional status may allow better modification and shared decision making leading to improved postoperative outcomes in older patients undergoing RC.
Novel antibody–drug conjugates for triple negative breast cancer
Authors: Nagayama Aiko , Vidula Neelima , Ellisen Leif , Bardia Aditya
Published: May 2020

Triple negative breast cancer (TNBC) is a heterogenous subtype of breast cancer often associated with an aggressive phenotype and poor prognosis. Antibody–drug conjugate (ADC), comprising of a monoclonal antibody linked to a cytotoxic payload by a linker, is gaining increasing traction as an anti-cancer therapeutic. Emerging ADC drugs such as sacituzumab govitecan (IMMU-132) and trastuzumab deruxtecan (DS-8201a) are in late stages of clinical development for patients with metastatic breast cancer, including TNBC. In this article, we review and discuss the development and clinical application of ADCs in patients with advanced TNBC.
Local Dynamics and Global Engagements of the Islamic Modernist Movement in Contemporary Indonesia: The Case of Muhammadiyah (2000-2020)
Authors: Latief Hilman , Nashir Haedar
Published: May 2020

This article examines the engagement of Indonesian Islamic civil society organisations in the international arena by paying particular attention to the role of the Islamic modernist movement, Muhammadiyah. Beyond its vibrant religious and social activism in the domestic context of Indonesia, Muhammadiyah has, in the past thirty years, engaged in various international affairs such as peacekeeping operations, humanitarian activities, and politics. This engagement indicates that Muhammadiyah has attempted to strengthen its international exposure and contribute to the global community. By examining Muhammadiyah’s vision and activism, both discursively and practically, this article seeks to know why it is so essential for Indonesian Islamic civil society organisations, such as Muhammadiyah, to be involved in the international arena, and what Muhammadiyah engagement means for the global picture of Islam in the Muslim world.
Factional Dynamics in Philippine Party Politics, 1900–2019
Authors: Teehankee Julio Cabral
Published: May 2020

The Philippines is a rich case study in the examination of intra-party factions and factionalism in competitive party systems of Southeast Asia. Intra-party factionalism is a recurring, yet understudied, aspect of Philippine party politics. The factional nature of Philippine party politics has endured through time – from bifactionalism of the post-war two-party system to the multi-factionalism of the post-authoritarian multi-party system. All the major political parties that have dominated politics at different historical epochs have experienced intense factional splits. Intra-party factionalism remains a consistent feature of party politics and has become more complicated over time. The number of factions has increased at every period of party system development, while the level of party institutionalization has remained generally low. This article seeks to address this puzzle by tracing the history of political factionalism in the Philippines. It maintains that factional resilience in Philippine party politics is an outcome of combined institutional and structural factors rooted in history. Adopting a historical institutional approach, it will delineate the path-dependent trajectory of intra-party factionalism at critical political junctures. Moreover, it will examine the role of intra-party factionalism in the under-institutionalization of the Philippine party system.
Clientelist and Programmatic Factionalism Within Malaysian Political Parties
Authors: Ufen Andreas
Published: May 2020

This article analyses factionalism within ruling and opposition parties in Malaysia, with a focus on party splits and/or the toppling or near-toppling of dominant factions at the national level. Political parties are either composed of clientelist or programmatic factions or represent hybrids that combine clientelist and programmatic factionalism. The strength and the type of factionalism depend upon policy space and the intensity of control over party groups. Programmatic factionalism is more probable if policy space is wide. Policy space is an effect of the positioning (relatively dependent or independent from other parties in the coalition) and the basic ideology of a party, that is, the major stance on religion, ethnicity, and the shape of the political system at large. If there is hardly any policy space, factionalism will be clientelistic rather than programmatic. Whether this type of factionalism arises is contingent upon the intensity of control over groups within the party and the availability of patronage goods. The control of party members is dependent upon the strength of the party leader and the centralisation of party organisation. This is demonstrated with reference to UMNO (United Malays National Organisation) (from programmatic to clientelist factionalism), some coalition partners of UMNO such as the MCA (Malaysian Chinese Association) (clientelist factionalism), and the Islamist PAS (Parti Islam Se-Malaysia) (programmatic clientelism). Moreover, a brief analysis of East Malaysian parties in Sabah and Sarawak helps to further elucidate the major dynamics of factionalism.
Inpatient Hypoglycemia: The Challenge Remains
Authors: Cruz Paulina
Published: May 2020

Hypoglycemia in inpatients with diabetes remains the most common complication of diabetes therapies. Hypoglycemia is independently associated with increased morbidity and mortality, increased length of stay, increased readmission rate, and increased cost. This review describes the importance of reporting and addressing inpatient hypoglycemia; it further summarizes eight strategies that aid clinicians in the prevention of inpatient hypoglycemia: auditing the electronic medical record, formulary restrictions and dose-limiting strategies, hyperkalemia order sets, electronic glucose management systems, prediction tools, diabetes self-management, remote surveillance, and noninsulin medications.
The surprising decline of international mediation in armed conflicts
Authors: Lundgren Magnus , Svensson Isak
Published: May 2020

We identify and investigate a fundamental puzzle in contemporary mediation of armed conflicts. Although the preparedness of international mediators has increased, the proportion of armed conflicts that receive mediation has not increased, but decreased. Using quantitative data on the occurrence of mediation between 1989 and 2013, our analysis suggests that this puzzling contradiction cannot be explained by conflicts being more fragmented, intractable or internationalized. Instead, we argue that the puzzling decline of mediation can be explained by a mismatch between supply and demand in the international mediation ‘market’. Although there are more mediators available, the rise in the number of conflicts involving Islamist armed actors, coupled with increased reliance on terror-listing, especially since 2001, has placed a growing number of conflicts beyond the reach of international mediators. Our findings challenge the conventional belief that the post-Cold War era is characterized by high mediation rates and point to the need to develop the practice of mediation to maintain its relevance in the contemporary conflict landscape.
Facilitating Guideline Implementation in Primary Health Care Practices
Authors: Peters Sanne , Bussières André , Depreitere Bart , Vanholle Stijn , Cristens Julie , Vermandere Mieke , Thomas Aliki
Published: May 2020

Introduction: Many patients continue to receive suboptimal services, inappropriate, unsafe, and costly care. Underutilization of research by health professionals is a common problem in the primary care setting. Although many theoretical frameworks can be used to help address such evidence-practice gaps, health care professionals may not be aware of the benefits of frameworks or of the most appropriate ones for their context and thus, may be faced with the challenge of selecting and using the most relevant one. Aim: The aim of this article was to describe the process used to adapt a knowledge translation framework to meet the local needs of health professionals working in one large primary care setting. Methods: The authors developed a 5-step approach for guideline implementation. This approach was informed by prior research and the authors’ experiences in supporting multidisciplinary teams of health care professionals during the implementation of evidence-based clinical guidelines into primary care practices. To ensure that the 5-step approach was practical and suitable for the context of guideline implementation by multidisciplinary teams in primary health care, the implementation team adapted the “knowledge-to-action” framework using a multistep process. Results: The implementation approach consisted of the following 5 steps: identification, context analysis, development of implementation plan, evaluation, and sustainability. All 5 steps were described alongside details about a national low back pain project. Discussion: This article describes a collaborative, grassroots process that addressed an identified need in one complex context by adapting a knowledge translation framework to meet the local needs of health professionals working in primary care settings. Existing implementation frameworks may be too complex or abstract for use in busy clinical contexts. The 5-step approach presented in this paper resulted in practical steps that are more readily understood by health care professionals and staff on “the ground.”
Christian Medical College and Hospital: Serving with a Sense of Calling
Authors: Jain Puja
Published: May 2020

Doctors of Christian Medical College and Hospital (CMC&H), Ludhiana do not moonlight. In today’s world where people run behind money, there are doctors who do not do private practice and instead have chosen to work with CMC&H. Due to financial constraints, CMC&H neither is a very good paymaster nor has swanky infrastructure. The case study tries to explore answers to certain questions like what is the approach of doctors towards their work, and what is there in this charismatic CMC&H due to which doctors decide to stay with it? The case discusses the measures taken by CMC&H to pursue its mission to serve the society, especially the poor and the marginalized ones. The case also discusses the challenges which CMC&H is facing, which further raise questions like: will its financial constraints allow it to maintain its momentum to serve the society and continue with its legacy of healing and education? The case can be used to teach certain Human Resource Management/Organisational Behaviour (HR/OB) concepts like sense of calling, perception, HR practices, culture and moonlighting

Dilemma: Should CMC&H continue with the existing systems/practices or should it bring some changes? Should doctors continue avoiding moonlighting in order to pursue their sense of calling? They stay longer even with low compensation. Moreover, they do not practise in private.

Theory: Unique business model of the hospital

Type of the case: Experience-based applied single case study

Protagonist: Not needed

Options

Build a value-based culture. Invoke sense of calling. Redefine the purpose in life with a higher cause of helping others.

Discussions and case Questions

Analyse the reasons for the stay of doctors with CMC&H. What are the steps taken by CMC&H and its doctors to continue moving ahead on the road of its mission? How has CMC&H maintained its momentum to serve the society and continued with its legacy of healing and education? Will it be possible for CMC&H to continue doing so in the competitive environment that offers attractive alternatives for doctors as well as for patients? Should the doctors continue avoiding moonlighting?
Acting local, thinking global: Globalizing resilience through 100 Resilient Cities
Authors: Zebrowski Chris
Published: May 2020

This article investigates the globalization of resilience by examining a particular and prominent vehicle for the dissemination of resilience ideas: the Rockefeller Foundation’s 100 Resilient Cities (100RC) initiative. As a philanthropic initiative organized through a network of international cities, 100RC demonstrates how the spread of resilience thinking has been facilitated by exploiting changes in the structures and processes of global governance afforded by neoliberal globalization. The analysis focuses on explicating100RC’s animating logic of governance, which is committed to the cultivation of network connectivity. Rather than directly fostering resilience, connectivity is established as a condition under which resilience solutions can be immanently surfaced from the interactions of a diverse selection of stakeholders brought together through these networks. The article situates this governmental logic within broader changes associated with neoliberal globalization, namely the emergence of multi-scalar governance networks, the rise of philanthrocapitalism and the inception of platform capitalism. The conclusion discusses the implications of this analysis for further study of the relation between connectivity, danger, knowledge and value contained within resilience discourses.
Challenging Perceptions of Modern Arab Art
Authors: A. M. Lutfi Dina
Published: May 2020

The understanding of modern Arab art is, more often than not, based on individual and collective perceptions that relate to beliefs, culture, and social constructs. Defining qualities or characteristics that make a work of art “Arab” is not a clear-cut endeavor. Many Arab artists appropriated Western techniques, while they strived to combine their newly acquired artistic processes with content inherent in their respective cultures. Some audiences appreciated the new direction the Arab art was taking; however, many artists were harshly criticized of advocating cultural colonialism. A struggle in the field of art, and in other aspects of life took place, due to the increasing fear of losing one’s own tradition and Arab identity in the face of Western culture. This article explores the nature of modern Arab art and Arab identity, its place within a global modernism, and the ways in which Western influences have shaped its development, in addition to understanding the different particularities that have shaped Arab modernism in art specifically.
Representations of Saudi Male’s Guardianship System and Women’s Freedom to Travel in Western Newspapers: A Critical Discourse Analysis
Authors: Elyas Tariq , Aljabri Abdulrahman
Published: May 2020

There has been a tremendous interest in the Western media concerning the status of women in Saudi Arabia. The recent reform in women’s rights and guardianship system has Western media gone into motion frenzy. A few research has been done on the representation of Saudi women in Arabic newspapers, but there is a scarce of research in Western English newspapers to date. This article exercises a critical discourse analysis approach to investigate the language used in three famous Western newspapers to uncover the hidden ideologies behind the representation of Saudi women’s guardianship system. To this end, van Dijk’s (2004) analytical framework was employed to reveal the underlying ideologies of six reports by The Washington Post, The Guardian, and Toronto Star. The findings show that the three newspapers have expressed the notion of “otherness” in their descriptions of Saudi Arabia and Saudi women. Furthermore, the newspapers have shared the employment of consensus and negative other-presentation to portray Saudi women as being oppressed and subordinate.
Medical Student Workshop Improves Student Confidence in Working With Trained Medical Interpreters
Authors: Coetzee Donna , Pereira Anne G. , Scheurer Johannah M , Olson Andrew PJ
Published: May 2020

Introduction:

Many physicians care for patients whose primary spoken language is not English, and these interactions present challenges in physician-patient communication. These challenges contribute to the significant health disparities experienced by populations with limited English proficiency (LEP). Using trained medical interpreters is an important step in addressing this problem, as it improves communication outcomes. Despite this, many medical education programs have little formal instruction on how to work effectively with interpreters.

Methods:

To address this gap, we created an interactive workshop led by professional trained interpreters and faculty facilitators for medical students in their clinical years. Students were asked to evaluate the session based on relevance to their clinical experiences and helpfulness in preparing them for interactions with patients with LEP.

Results:

Immediately after the session, students reported that the clinical scenarios presented were similar those seen on their clinical clerkships. They also reported increased confidence in their ability to work with interpreters. On later follow-up, students reported that the instruction helped prepare them for subsequent patient interactions that involved interpreters.

Conclusion:

A workshop is an effective method for improving medical student comfort and confidence when working with interpreters for populations with LEP.
Is cannabidiol hepatotoxic or hepatoprotective: A review
Authors: Stohs SJ , Ray SD
Published: May 2020

Questions have been raised regarding the potential hepatotoxicity of cannabidiol (CBD). Conversely, several animal studies have demonstrated the hepatoprotective effects of CBD against bile duct ligation, cocaine, thioacetamide, alcohol, and several other chemicals. This review summarizes the current literature concerning the hepatic effects of CBD in humans and animals. Based on the available data, it may be concluded that there is a low probability of serious hepatotoxicity at the high therapeutic doses that are used and a much lower risk of adverse hepatic effects and a potential for hepatoprotection effects at the lower doses commonly used in dietary supplements and food products. However, a detailed safety study in rats using highly purified CBD rather than enriched Cannabis extracts is needed, enabling the determination of hepatic as well as other tissue effects and potential margin of safety.
Methylation analysis of NPTX2 and SH2D5 genes in chronic migraine: A case–control study
Authors: Pérez Pereda Sara , Toriello Suárez María , González Quintanilla Vicente , Oterino Agustín
Published: May 2020

Background:

Methylation of two CpG sites related to neuronal pentraxin II protein (NPTX2) and SH2 domain containing 5 protein (SH2D5), corresponding to two neuroplasticity genes, has been associated to headache chronification. We aimed to investigate the epigenetic modification of these two genes in chronic migraine (CM).

Methods:

We conducted a case–control study in which the DNA of 305 age- and sex-matched subjects classified according to the International Classification of Headache Disorders version beta (ICHD-III β) in CM (109), episodic migraine (EM; n = 98), and healthy controls (HC; 98) was analyzed. Real-time quantitative methylation-specific PCR was performed using specific methylation primers for two representative CpG sites within these genes.

Results:

We found no significant differences in methylation level between CM, EM, and HC in the first exon of the NPTX2 gene nor in the 5′ upstream region of the SH2D5 gene. Methylation level in the first exon of the NPTX2 showed a low correlation with age ( r = 0.266; p < 0.005).

Conclusion:

We did not find methylation level differences in analyzed regions related to NPTX2 and SH2D5 in our CM sample. Despite the potential relevance of neuroplasticity genes in headache chronification, we conclude that CM is a more heterogeneous clinical diagnosis than desired and that an epigenetic marker remains elusive.
Mergers and the Psychology of the Acquiring: Is It that of Conquest?
Authors: Ahmad Saleha , Kumar Sundar Ray Subrat
Published: May 2020

This paper is an attempt to understand the psychology of the senior managers of a large acquiring bank in the recently announced merger of public sector banks in India through a case study. The data revealed that contrary to the conventional wisdom, which suggests that employees of the acquiring organisation are likely to have a sense of ‘conquest’ or ‘pride’, the senior managers, in this case, did not display any such feelings. Rather, they had concerns regarding the merger, which are discussed. A few had apprehensions and some showed confidence that the process will be a success. We conclude that each case of merger is impacted by its unique history, HR practices and cultural moorings and needs to be understood in its unique background. The interventions for successful mergers will therefore need to be designed with this uniqueness in mind.
Evaluation of the shear bond strength of resin cement to enamel after bleaching with Er: YAG and diode laser
Authors: Ceyda Akin , Müjde Sevimay , Yusuf Ozyilmaz Ozgun , Neslihan Cokuk
Published: May 2020

Objective:

The shear bond strength (SBS) of composite resin cement and color change to enamel bleached with two different concentrations of hydrogen peroxide (HP) bleaching agents in combination with two different laser applications was evaluated.

Materials and Methods:

The Er: YAG laser ( λ = 2940 nm) and diode laser ( λ = 940 nm) were used with the bleaching agent consisting of 40% HP opalescence (Opalescence Xtra Boost, Ulgen, South Jordan, UT, USA) and 35% HP whiteness (Whiteness HP Blue, FGM Dental Products, Joinville, SC, Brazil). Seventy-two human extracted teeth were randomly divided into two groups: For the 40% HP treatment, 36 specimens were divided into three subgroups: (1) HP agent with no laser treatment, (2) HP agent treated with Er: YAG laser, and (3) HP agent treated with diode laser. The same protocol was performed for the 35% HP. The color change was analyzed using the Commission Internationale de l’ Eclairage (CIE) L* a* b* system and surface roughness was analyzed by an atomic force microscope. The specimens were bonded with resin cement and a shear bond test was performed at 0.5 mm/min. The failure surfaces were evaluated using scanning electron microscope analysis.

Results:

Δ E value of the 40% HP + Er: YAG group was significantly higher than the other groups while diode groups showed the lower SBS values than the control groups ( p < 0.05).

Conclusions:

The Er: YAG laser with 40% HP may be effective for the brighter teeth and the use of Er: YAG laser produced higher adhesion between enamel and resin cement than diode laser.
Surgical adhesions among women undergoing laparoscopic gynecological surgery with or without adhesiolysis – prevalence, severity, and implications: retrospective cohort study at a University Hospital
Authors: Al-Husban Naser , Elayyan Yousef , El-Qudah Malab , Aloran Bayan , Batayneh Rima
Published: May 2020

Objective:

To find out the prevalence of adhesions, severity, and their relation to the current clinical scenario and to the type of previous surgery.

Methods and Materials:

A retrospective study of patients who already had different previous abdominopelvic surgery and subsequently underwent gynecological laparoscopic surgery for various indications. The patients’ clinical and operative notes were reviewed and analyzed.

Results:

There were 654 procedures performed. The most common indication for the laparoscopic surgery was secondary infertility 23.5%, followed by adnexal lesions 22.0% and primary infertility 19.6%. Intraoperative adhesions were found in 45.3%. Adhesions were deemed relevant to the clinical scenario in 21.3%. Patients who had a previous history of open (traditional) surgery were more likely to be found with adhesions in comparison with patients with history of laparoscopic surgery (odds ratio: 2.7, 95% confidence interval: 1.4–5.3, p = 0.0025). The presence of adhesions was found to be strongly associated with previous abdominopelvic surgery than non-abdominopelvic surgery (odds ratio: 4.3, p = 0.0078, 95% confidence interval: 1.5–12.5). The most common location of the adhesions was abdominal (36.1%), mixed abdominal and pelvic (35.1%), and pelvic adhesions (28.1%). Severe adhesions were found in 36.1%; 13.6% of converted laparoscopy to open surgery was due to adhesions. Cesarean sections were significantly associated with adhesions. Patients who had cesarean sections were more likely to have adhesions than those who had not (odds ratio: 5.7, 95% confidence interval: 3.8–8.6, p < 0.0001). Adhesiolysis was done without complications in 19.6% of patients with adhesions.

Conclusion:

Adhesions were prevalent in gynecological patients with previous abdominopelvic surgery. They were a significant contributor to the gynecological and reproductive issues. To minimize the risk of postoperative adhesions, laparoscopic approach should be encouraged instead of traditional surgery and rates of cesarean section should be reduced. Further high-quality studies are needed to establish conclusion and practical guidance toward the use of adhesion barriers.
A Survey of Rural Principals: Preferences Regarding Teacher Candidates
Authors: Diamond Lindsay L. , Demchak MaryAnn , Abernathy Tammy V.
Published: May 2020

Rural school principals continue to have difficulty hiring and retaining qualified teachers. Researchers have sought to determine the preferred type of preparation programs and the specific characteristics of teacher candidates, but few have specifically focused on the perceptions of the rural principal. The purpose of this study was to understand current rural school principals’ perceptions regarding various factors affecting the selection of teacher candidates. Using an online, cross-sectional survey of rural school principals, data were collected to understand their perspectives regarding various factors that may affect the selection of potential teacher candidates. Results indicate that rural principals prefer to hire applicants who have completed a traditional 4-year college/university preparation program. In addition, when reviewing applicant materials they look for specific factors such as experience, those who are known in the community, cooperating/lead teacher evaluations, and areas of licenses held among teacher candidates. Rural school principals specifically reported a preference toward hiring applicants who hold a dual license in elementary and special education.
Inflammatory signaling in dengue-infected platelets requires translation and secretion of nonstructural protein 1
Authors: Quirino-Teixeira Anna Cecíllia , Rozini Stephane Vicente , Barbosa-Lima Giselle , Coelho Diego Rodrigues , Carneiro Pedro Henrique , Mohana-Borges Ronaldo , Bozza Patrícia T. , Hottz Eugenio D.
Published: May 2020

Emerging evidence identifies major contributions of platelets to inflammatory amplification in dengue, but the mechanisms of infection-driven platelet activation are not completely understood. Dengue virus nonstructural protein-1 (DENV NS1) is a viral protein secreted by infected cells with recognized roles in dengue pathogenesis, but it remains unknown whether NS1 contributes to the inflammatory phenotype of infected platelets. This study shows that recombinant DENV NS1 activated platelets toward an inflammatory phenotype that partially reproduced DENV infection. NS1 stimulation induced translocation of α-granules and release of stored factors, but not of newly synthesized interleukin-1β (IL-1β). Even though both NS1 and DENV were able to induce pro-IL-1β synthesis, only DENV infection triggered caspase-1 activation and IL-1β release by platelets. A more complete thromboinflammatory phenotype was achieved by synergistic activation of NS1 with classic platelet agonists, enhancing α-granule translocation and inducing thromboxane A2 synthesis (thrombin and platelet-activating factor), or activating caspase-1 for IL-1β processing and secretion (adenosine triphosphate). Also, platelet activation by NS1 partially depended on toll-like receptor-4 (TLR-4), but not TLR-2/6. Finally, the platelets sustained viral genome translation and replication, but did not support the release of viral progeny to the extracellular milieu, characterizing an abortive viral infection. Although DENV infection was not productive, translation of the DENV genome led to NS1 expression and release by platelets, contributing to the activation of infected platelets through an autocrine loop. These data reveal distinct, new mechanisms for platelet activation in dengue, involving DENV genome translation and NS1-induced platelet activation via platelet TLR4.
Adult T-cell leukemia/lymphoma incidence rate in French Guiana: a prospective cohort of women infected with HTLV-1
Authors: Ramassamy Jill-Léa , Tortevoye Patricia , Ntab Balthazar , Seve Béatrice , Carles Gabriel , Gaquière Dominique , Madec Yoann , Fontanet Arnaud , Gessain Antoine
Published: May 2020

Adult T-cell leukemia/lymphoma (ATL) is an aggressive malignancy caused by the human T-cell leukemia virus type 1 (HTLV-1). The incidence of ATL among HTLV-1 carriers remains largely unknown in endemic countries other than Japan as very few prospective studies have been performed. We assessed the ATL incidence rate among HTLV-1 infected women in a prospective cohort in French Guiana. This is the first prospective study to assess the ATL incidence rate in an area of South America where HTLV-1 prevalence is high. Patients were enrolled between 1991 and 2005, and follow-up continued until April 2018. In the general hospital in Saint-Laurent-du-Maroni, 307 pregnant women were diagnosed with HTLV-1 infection, and 268 of them were observed for a median of 16.7 years. During follow-up, 9 ATL incident cases occurred resulting in an ATL incidence rate of 2.03 per 1000 HTLV-1 carrier-years (95% confidence interval, 0.93-3.85 per 1000 HTLV-1 carrier-years). The median age at diagnosis was 47.4 years, and median survival from diagnosis was low at 3.5 months. The ATL incidence rate was elevated for a study population consisting mostly of young people, which could either be a general feature in South America or could be specific to the Noir Marron population that constituted most of the cohort.
Measuring inflammation in paediatric severe asthma: biomarkers in clinical practice
Authors: Licari Amelia , Manti Sara , Castagnoli Riccardo , Leonardi Salvatore , Marseglia Gian Luigi
Published: May 2020

Severe asthma in children is a highly heterogeneous disorder, encompassing different clinical characteristics (phenotypes) and immunopathological pathways (endotypes). Research is focusing on the identification of noninvasive biomarkers able to predict treatment response and assist in designing personalised therapies for severe asthma. Blood and sputum eosinophils, serum IgE and exhaled nitric oxide fraction mostly reflect type 2 airway inflammation in children. However, in the absence of available point-of-care biomarkers, the diagnosis of non-type 2 asthma is still reached by exclusion. In this review, we present the most recent evidence on biomarkers for severe asthma and discuss their implementation in clinical practice. We address the methods for guiding treatment decisions and patient identification, focusing on the paediatric age group.

Key points

Severe asthma in children is a highly heterogeneous disorder, encompassing different clinical characteristics (phenotypes) and immunopathological pathways (endotypes).

Research is focusing on the identification of noninvasive biomarkers able to predict treatment response and assist in designing personalised therapies for severe asthma.

Blood and sputum eosinophils, serum IgE and exhaled nitric oxide fraction mostly reflect type 2 airway inflammation in children. However, knowledge regarding non-type 2 inflammation and related biomarkers is still lacking.

Educational aims

To summarise the most recent evidence on biomarkers for severe asthma in children.

To discuss their implementation in clinical practice through guiding patient identification and treatment decisions.