bluuebunny/crossref_metadata_2025 huggingface dataset:
Adverse pregnancy outcomes among multi-ethnic systemic lupus erythematosus patients in Malaysia
Authors: Shaharir Syahrul S , Maulana Suhaida A , Shahril Nor S , Mohd Rozita , Mustafar Ruslinda , Said Mohd S Mohamed , Rahman Rahana A
Published: July 2020

Background

Despite the improvement in the live birth rate among patients with systemic lupus erythematosus (SLE), they are still at an increased risk of adverse pregnancy outcomes (APOs).

Objective

To determine the prevalence and factors associated with APOs in the multi-ethnic SLE populations in Malaysia. Methodology: This was a retrospective review of the consecutive SLE patients who attended the outpatient clinic in two major rheumatology centres from January 2016 until December 2019 with complete pre-pregnancy, antenatal and intra-partum records. APOs include pregnancy loss, prematurity, pre-eclampsia, intra-uterine growth restriction (IUGR) and maternal death. Univariate and multivariable logistic regression with generalised estimating equation (GEE) analyses were performed to determine the factors associated with APOs.

Results

A total of 153 patients with 240 pregnancies were included and the majority of the patients were Malay (69.9%), followed by Chinese (24.2%) and Indian (5.9%). The prevalence of APOs was 61.7% with the commonest complication being prematurity (28.3%), followed by pregnancy loss (24.6%) and pre-eclampsia (21.8%). Logistic regression model-based GEE analysis revealed that the independent predictors of APOs were active haematological system during pregnancy, pre-pregnancy active disease, Indian patients and positive lupus anticoagulant. Hydroxychloroquine use was associated with lower APOs including pre-eclampsia, prematurity and IUGR in the univariate analyses but it was no longer significant in the GEE analysis.

Conclusion

The prevalence of APOs was high particularly among the Indian patients. Positive lupus anticoagulant and pre-pregnancy active disease were the factors strongly associated with APOs in our multi-ethnic cohort. Hydroxychloroquine may protect against APOs but further larger studies are needed to confirm this.
A Comparison of Automated Perfusion- and Manual Diffusion-Based Human Regulatory T Cell Expansion and Functionality Using a Soluble Activator Complex
Authors: Jones Mark , Nankervis Brian , Roballo Kelly Santos , Pham Huong , Bushman Jared , Coeshott Claire
Published: July 2020

Absence or reduced frequency of human regulatory T cells (Tregs) can limit the control of inflammatory responses, autoimmunity, and the success of transplant engraftment. Clinical studies indicate that use of Tregs as immunotherapeutics would require billions of cells per dose. The Quantum® Cell Expansion System (Quantum system) is a hollow-fiber bioreactor that has previously been used to grow billions of functional T cells in a short timeframe, 8–9 d. Here we evaluated expansion of selected Tregs in the Quantum system using a soluble activator to compare the effects of automated perfusion with manual diffusion-based culture in flasks. Treg CD4+CD25+cells from three healthy donors, isolated via column-free immunomagnetic negative/positive selection, were grown under static conditions and subsequently seeded into Quantum system bioreactors and into T225 control flasks in an identical culture volume of PRIME-XV XSFM medium with interleukin-2, for a 9-d expansion using a soluble anti-CD3/CD28/CD2 monoclonal antibody activator complex. Treg harvests from three parallel expansions produced a mean of 3.95 × 108(range 1.92 × 108to 5.58 × 108) Tregs in flasks (mean viability 71.3%) versus 7.00 × 109(range 3.57 × 109to 13.00 × 109) Tregs in the Quantum system (mean viability 91.8%), demonstrating a mean 17.7-fold increase in Treg yield for the Quantum system over that obtained in flasks. The two culture processes gave rise to cells with a memory Treg CD4+CD25+FoxP3+CD45RO+phenotype of 93.7% for flasks versus 97.7% for the Quantum system. Tregs from the Quantum system demonstrated an 8-fold greater interleukin-10 stimulation index than cells from flask culture following restimulation. Quantum system–expanded Tregs proliferated, maintained their antigenic phenotype, and suppressed effector immune cells after cryopreservation. We conclude that an automated perfusion bioreactor can support the scale-up expansion of functional Tregs more efficiently than diffusion-based flask culture.
The Polygenic Risk Score of Subjective Well-Being, Self-Employment, and Earnings Among Older Individuals*
Authors: Patel Pankaj C. , Rietveld Cornelius A. , Wolfe Marcus T. , Wiklund Johan
Published: July 2020

We investigate whether the polygenic risk score (PRS) of subjective well-being (SWB), a weighted combination of multiple genetic variants which captures an individual’s time-invariant genetic predisposition to SWB, influences the choice of self-employment and whether it explains differences in earnings between older self-employed and employed workers. In a sample of 4,571 individuals (50 to 65 years old) representing 14,937 individual-year observations from the Health and Retirement Study, we find that the PRS of SWB is positively associated with self-employment and earnings. However, contrary to our expectations, the positive association with earnings is not significantly different between self-employed and employed individuals.
Happiness at the End of Life: A Qualitative Study
Authors: O’Callaghan Anne , Bickford Ben , Rea Conor , Fernando Antonio , Malpas Phillipa
Published: July 2020

Background:

Happiness is a core ingredient of health and well-being, yet relatively little is known about what happiness means for individuals near the end of life, and whether perceptions of happiness change as individuals approach the end of their lives.

Aim:

The aim of this study was to explore, through interviews, how individuals experiencing hospice care understood and conceptualized happiness.

Design:

Qualitative interviews with hospice patients were analyzed thematically.

Setting/Participants:

Adult patients (n = 20) in a New Zealand hospice who were receiving palliative care and who could give their informed consent were invited by hospice nurse coordinators to an interview.

Results:

Four themes emerged from analysis of the transcribed interviews. Participants defined happiness most frequently and in most depth in relation to connection with others. They identified being in the present moment, particularly in relation to nature, and that happiness had become less associated with money, status, or possessions. They had an attitude of determination to focus on what mattered now.

Conclusion:

Patients receiving palliative care were generally happy with their lives, appreciated the simpler aspects of life away from the material. There was a common exhortation to young people to avoid focusing too much on acquisition and the internet and to prioritize instead social connection and engagement with the natural world.
Anterior-Posterior (AP) Calcaneal Profile View: A Novel Radiographic Image to Assess Varus Malalignment
Authors: Kwon John Y. , Moura Bruno , Gonzalez Tyler , Miller Christopher P. , Briceno Jorge
Published: July 2020

Background:

Assessing and correcting malalignment is important when treating calcaneus fractures. The Harris axial view is commonly utilized to assess varus deformity but may be inherently inaccurate due to its tangential nature. The anterior-posterior (AP) calcaneal profile view is a novel radiographic view that is easily obtained with demonstrated increased accuracy for assessing calcaneal axial alignment.

Methods:

Five nonpaired ankle cadaveric specimens were used in this investigation. Oblique osteotomies were created in relation to the long axis, and varus deformities were produced by inserting solid radiolucent wedges into the osteotomies to create models of 10, 20, and 30 degrees of angulation of the calcaneal tuberosity. Specimens were imaged using both the Harris axial view and the AP calcaneal profile view.

Results:

For cadavers with 10 degrees of actual varus angulation, the mean Harris axial view angle and the AP calcaneal profile view angle were 10.9 ± 4.8 (range, 5.5-16.0) degrees and 13.0 ± 5.5 (range, 7.3-20.9) degrees, respectively. For cadavers with 20 degrees of actual varus angulation, the mean Harris view angle and the AP calcaneal profile view angle were 11.5 ± 2 (range, 8.2-13.6) degrees and 18.1 ± 4.8 (range, 11.7-23.5) degrees, respectively ( P = .005). On pairwise comparison with Bonferroni correction, there was a significant difference between the Harris axial view angle and both the AP calcaneal profile view angle ( P = .012) and actual angulation ( P = .011). For cadavers with 30 degrees of actual varus angulation, the mean Harris axial view angle and the AP calcaneal profile view angle were 18.3 ± 4.3 (range, 13.3-23.6) degrees and 28.3 ± 2.9 (range, 24.4-31.1) degrees, respectively ( P < .001). On pairwise comparison with Bonferroni correction, there was a significant difference between the Harris axial view angle and both the AP calcaneal profile view angle ( P = .001) and actual angulation ( P < .001). There was no significant difference between the AP calcaneal profile view angle and actual angulation ( P > .999).

Conclusion:

The AP calcaneal profile view is a novel radiographic view that is easily obtained with demonstrated increased accuracy for assessing calcaneal axial alignment. While both views demonstrated similar measurement error for lesser degrees of varus malalignment, the AP calcaneal profile view demonstrated more accurate measurement of increasing heel varus compared with the Harris view.

Clinical Relevance:

The AP calcaneal profile view could be used in addition to other radiographic views when treating displaced, intra-articular calcaneus fractures to help optimize correction of hindfoot alignment.
Optimizing care for high-risk neuroblastoma patients treated with dinutuximab: Challenges for the multidisciplinary team
Authors: Bauters Tiene , Van de Velde Veronique , Bekaert Stefanie , Laureys Geneviève
Published: July 2020

Current treatment protocols for high-risk neuroblastoma include high-dose chemotherapy, surgery, stem cell transplantation and radiation. Recently, dinutuximab, a chimeric monoclonal antibody, specifically targeting the disialoganglioside highly expressed on neuroblastoma cells, has been licensed. Its incorporation in maintenance therapy represents a promising treatment approach. The introduction of its use was a challenge for the entire multidisciplinary team in our pediatric hematology and oncology ward just as for the pharmacy team. An overview of the key points that were observed is presented.
Impending Paradoxical Embolism: Perioperative Management and Role of Transesophageal Echocardiography
Authors: Dabaliz Al-Awwab M. , Arain Faisal D.
Published: July 2020

Impending paradoxical embolism is a rare but potentially life-threatening complication of venous thromboembolism that is usually associated with acute pulmonary embolism and a right to left atrial shunt. Patients may have associated right ventricular pressure or volume overload with subsequent failure. Transesophageal echocardiography is the preferred diagnostic test of choice in this patient group. Definitive management has yet to be clearly defined. However, emergent surgical removal of the entrapped intracardiac blood thrombus may be necessary. In this article, we review a case of impending paradoxical embolism managed surgically and describe the perioperative anesthetic considerations in this patient population, along with the role of intraoperative transesophageal echocardiography.
Obesity-Related Parameters Are Associated with Blood Pressure in Palestinian Children
Authors: Ejheisheh Moath Abu , Correa-Rodríguez María , Fernández-Aparicio Ángel , Batran Ahmad , Membrive-Jiménez María José , Schmidt-RioValle Jacqueline
Published: July 2020

Hypertension has been established as a common health condition in young people. Most studies have focused on the impact of body mass index (BMI), but the relationships between body composition parameters and blood pressure in Palestinian children has not previously been investigated. We aimed to analyze the prevalence of overweight/obesity and elevated blood pressure/hypertension and investigate the associations among obesity-related parameters, including anthropometric and body composition markers and blood pressure levels in a population of 971 Palestinian school children (50% girls; mean age 10.3 ± 1.1 years). Anthropometric measurements including height, waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), and waist to height ratio (WHtR) were assessed. A body composition analyzer was used to measure body weight, fat mass, and fat-free mass. Blood pressure including systolic (SBP), diastolic (DBP) and mean arterial pressure (MAP) were measured using a Dinamap vital signs monitor. The prevalence of overweight/obesity was 25.3% in the girls and 23.1% in the boys. 26.3% of the children had elevated systolic blood pressure, or systolic hypertension; whereas 23.4% had elevated diastolic blood pressure, or diastolic hypertension. All obesity-related variables, with the exception of WHR and WHtR, showed statistical differences among the normotension, elevated blood pressure and hypertension groups for systolic and diastolic blood pressure ( p < 0.05). Children with elevated blood pressure or hypertension had significantly higher weight, BMI, WC, HC, fat mass, and fat-free mass values compared to participants with normotension, supporting the direct association between obesity and hypertension in this population. Weight-reduction interventions are essential for reducing the prevalence of childhood hypertension in Palestinian children.
Evaluation of the potential complications of surgical wound drainage in primary total hip arthroplasty: a prospective controlled double-blind study
Authors: Lychagin Alexey V , Rosenberg Nahum , Gritsyuk Andrey A
Published: July 2020

Background:

The routine use of postoperative wound drainage following total hip arthroplasty (THA) to avoid the creation of excessive haematomas is controversial because of the potential risk of blood loss and wound infection.

Methods:

In a prospective double-blind controlled study, 2 groups of patients with hip joint osteoarthritis were operated with primary THA, 1 with surgical wound negative pressure drainage (Group 1 – 635 patients) and the other without (Group 2 – 527 patients). Postoperative blood haemoglobin and haematocrit levels, the necessity for blood transfusion, values of the potential infection markers (serum C-reactive protein values and erythrocyte sedimentation rate), postoperative pain level (according to the VAS scale) and functional outcome (according to Harris Hip Score [HHS] and SF-36 scores) at 12 months postoperatively were compared.

Results:

A significantly higher drop in blood haemoglobin and haematocrit values was observed in the Group 1 patients (mean drop of 2.2 gr/dl ± 0.25 vs. 1.6 gr/dl ± 0.35 and mean drop of 16% ± 4.0 vs. 11% ± 3.0, respectively, p  < 0.01, paired t test). The need for blood transfusion was significantly higher in the Group 1 patients (4.9% vs. 3.9%, p  < 0.05, t test). The severity of pain (VAS scale) on the first day after the operation was significantly lower in the Group 1 patients ( p < 0.05, t test), but overall, in both groups it was of low intensity (VAS <3). A similar postoperative wound infection rate was observed in both groups (0.4%). HHS and SF-36 scores were similar in both groups.

Conclusions:

The drainage of surgical wounds following primary THA due to hip osteoarthritis has a low added value and might cause an increased requirement for blood transfusion.
Making a Case for Infection Control at Public Places of Convenience in Accra, Ghana
Authors: Donkor Eric S , S. Anyen Nana Esi , Akumwena Amos
Published: July 2020

In Ghana, environmental hygiene remains a major problem and infection control measures are hardly practised, particularly outside of the hospital. To provide evidence for infection control measures at public places of convenience in Accra (capital city of Ghana), this study was performed. The aim of the study was to evaluate microbial contamination of door handles at public places of convenience in Accra and assess the public health risk. A total of 183 swab specimens were collected aseptically from door handles of public places of convenience of shops, schools, hospitals, lorry stations, churches, and markets. The samples were cultured on bacteriological media, and the isolated organisms were identified. The most prevalent bacterial agent isolated was Bacillus spp. (55.7%), followed by Staphylococcus aureus (20.2%), coagulase-negative staphylococcus spp. (17.1%), Citrobacter freundii (6.0%), Citrobacter koseri (4.4%), and Salmonella Paratyphi A (3.8%). Although in low prevalence, a wide range of enteric bacteria were isolated from door handles, accounting for 12 of the 16 isolated organisms. In conclusion, door handles of places of convenience in Accra harbour several pathogenic microorganisms, especially enteric organisms. This study highlights the need for proper disinfection of door handles of places of convenience in Accra as well as handwashing after visiting such places.
Design and optimization of textures on the surface of crankpin bearing to improve lubrication efficiency and friction power loss of engine
Authors: Wu Zhenpeng , Nguyen Vanliem , Le Vanquynh , Le Xuanlong , Bui Vancuong
Published: July 2020

The study proposes a design and optimization of textures on the surface of crankpin bearing to improve the lubrication efficiency and friction power loss (LE-FPL). A hydrodynamic lubrication model of crankpin bearing considering the impact of the external dynamic load and micro asperity contact is established. Based on the established model, the lubrication textures designed on the bearing surface are then simulated and optimized through the algorithms developed in Matlab environment and multi-objective optimization method. Increasing the oil film pressure and reducing the contact force ( Wac) in the asperity contact region, friction force ( Ff), and friction coefficient ( µ) of crankpin bearing are the objective functions to evaluate the LE-FPL. The study results indicate that the lubrication textures designed on the bearing surface have an obvious effect on improving the LE-FPL. Especially, with the optimized textures, the maximum oil film pressure is greatly increased by 44.8% while the maximum values of Wac and Ff are significantly reduced by 22% and 25%. Consequently, the lubrication textures added on the surface of crankpin bearing can greatly improve the LE-FPL.
Alexithymic and autistic traits: Relevance for comorbid depression and social phobia in adults with and without autism spectrum disorder
Authors: Albantakis Laura , Brandi Marie-Luise , Zillekens Imme Christina , Henco Lara , Weindel Leonie , Thaler Hanna , Schliephake Lena , Timmermans Bert , Schilbach Leonhard
Published: July 2020

High alexithymic traits and psychiatric comorbidities such as depression and social phobia are frequently observed among adults with autism spectrum disorder. In this study, we tested whether alexithymic and/or autistic traits are risk factors for depressive and social phobic symptoms in adults with autism spectrum disorder ( n = 122), patients with social interaction difficulties other than autism ( n = 62), and neurotypical participants ( n = 261). Multiple regression analyses of these three groups demonstrated that both traits explained considerable variance of depressive and social phobic symptoms. In adults with autism spectrum disorder, alexithymic traits were predictive of depressive symptoms, while autistic traits predicted social phobic symptoms. In patients with social interaction difficulties other than autism, alexithymic and autistic traits were identified as predictors of social phobic symptoms, while no variable predicted depressive symptoms. In neurotypicals, both alexithymic and autistic traits were predictive of depressive and social phobic symptoms. Our results, therefore, highlight the importance of assessing both alexithymic and autistic traits in patients with and without autism spectrum disorder for identifying comorbid psychopathology. Depending on the underlying core symptomatology, alexithymic and/or autistic traits increase the risk of depressive and social phobic symptoms calling for therapeutic strategies to prevent or at least reduce comorbid psychopathology.

Lay abstract

Adults with autism often develop mental health problems such as depression and social phobia. The reasons for this are still unclear. Many studies found that alexithymia plays an important role in mental health problems like depression. People with alexithymia have difficulties identifying and describing their emotions. Almost every second person with autism has alexithymia. Therefore, we explored in this study whether alexithymia is linked to worse mental health in autistic people. We looked at two common diagnoses, depression and social phobia. We found that alexithymia increased symptoms of depression, while autistic traits increased symptoms of social phobia. Our results suggest that alexithymia and autistic traits can increase the risk of mental health problems. An early assessment could help prevent mental health problems and improve quality of life.
Reliability-based assessment of flexural timber components with ultimate deflection performance
Authors: Tian Pan-Pan , Qiu Hong-Xing , Liang Zhou-Zhou , Sun Jian
Published: July 2020

Assessing the deflection performance of existing flexural timber components is of paramount importance for making better, reliable, and substantiated decisions. The main purpose of this article is to propose four-level reliability index β and deflection criteria for updating existing flexural timber components (main beam, joist, purlin, and rafter) based on long-term deflection probabilistic model, limit state functions, and load combinations. The long-term deflection probabilistic model was obtained through creep deflection and short-term deflection model. Limit state functions were considered to be ultimate limit states of load-bearing capacity. In addition, four-level reliability index β were calculated by three live loads (residential live load, office live load, and snow live load) and seven load ratios ρ (0.2, 0.3, 0.5, 1.0, 2.0, 3.0, and 4.0). The results of proposed four-level criterion were illustrated with the reliable safety assessment for flexural timber components.
Resilience and vulnerability: Emotional and affective labour in mom blogging
Authors: Mäkinen Katariina
Published: July 2020

This article investigates the empirical case of commercial mom blogging as indicative of the particular ways in which the digital economy invites and exploits women’s affective and emotional labour. Based on Finnish mom bloggers’ interviews, the article explores the ways in which emotional labour is needed to tackle the mean and degrading comments that most bloggers have to come to terms with, and the ways in which their affective involvement is an inseparable part of their work as mom bloggers. Looking at vulnerability, control and emotional resilience as sites of emotional and affective labour in blogging, the article shows how gendered and embodied burdens are carried on to the digital realm, and how new vulnerabilities and forms of affective labour are formed and normalized.
How do you identify the patient with ‘high expectations’ of orthodontic treatment: An empirical approach
Authors: Sayers Mark S , Cunningham Susan J , Newton J Tim
Published: July 2020

Objectives:

To identify an empirical method for identifying patients with ‘high expectations’ of orthodontic treatment with fixed appliances using a questionnaire-based approach.

Design:

Secondary analysis of data from four studies which collected data on patients’ expectations of orthodontic treatment using the same questionnaire.

Setting:

Secondary care orthodontic services.

Participants:

All four datasets comprised new patients aged 12–15 years, with no history of orthodontic treatment, who fulfilled the criteria for NHS treatment using the Index of Orthodontic Treatment Need (IOTN). Unpublished dataset 1 comprised 100 participants, while dataset 2 had 70 participants, dataset 3 had 67 participants and dataset 4 comprised 40 participants.

Methods:

The questionnaire utilised in all studies had a question which asked respondents to rate seven different expectations of outcome relating to straight teeth, better smile, ease of eating, speaking, cleaning teeth, improved career prospects and social confidence. Dataset 1 was analysed to determine the proportion of patients who had rated all seven outcome expectation items at a maximum score. Similar analyses were performed for the other three datasets to explore the trend in the proportion of patients with high expectations over time.

Results:

For dataset 1, 2.0% of participants had high expectations, as defined by their scores on the questionnaire. The proportions for the datasets 2, 3 and 4 were 4.0%, 4.5% and 2.5%, respectively.

Conclusion:

The method outlined provides an empirical basis for identifying patients with statistically infrequent high expectations. This can potentially help clinicians in the management of such patients.
Effect of alkali treatment on performance characterization of Ziziphus mauritiana fiber and its epoxy composites
Authors: Vinod A , Vijay R , Lenin Singaravelu D , Khan Anish , Sanjay MR , Siengchin Suchart , Verpoort Francis , Alamry Khalid A , Asiri Abdullah M
Published: July 2020

This study aims to investigate the natural cellulosic fibers extracted from novel Ziziphus Mauritiana plants. The fibers were treated with alkali solution and epoxy composites were developed for both untreated and chemically modified fibers through hand lay-up process. Physico-chemical and thermomechanical characterization were carried for both untreated and alkali treated Ziziphus Mauritiana fibers through physical analysis, chemical analysis, Thermogravimetric analysis, Fourier transform infrared spectroscopy, X-Ray diffraction test and single fiber tensile test. The alkali treatment facilitates to remove amorphous constituents and improves the crystalline index by 1.31 times, thermal stability by 1.15 times and fiber strength by 1.44 times, which is supported by chemical analysis and Fourier transform infrared spectroscopy analysis. Later, developed Ziziphus Mauritiana composites were analyzed as per ASTM for its mechanical and sound absorption characteristics. The reduction in amorphous constituents after chemical treatment improved the surface roughness in alkali-treated Ziziphus Mauritiana fibers which influenced the bonding behavior. Also it improved the ultimate tensile strength by 2.12 times, flexural strength by 1.38 times and sound absorption coefficient by 1.15 times. Thus, the Ziziphus Mauritiana fibers are potentially suitable for use in lightweight structures.
Evaluation of Voiding Position on Uroflowmetry Parameters and Post Void Residual Urine in Patients With Benign Prostatic Hyperplasia and Healthy Men
Authors: Alrabadi Adel , Al Demour Saddam , Mansi Hammam , AlHamss Sohaib , Al Omari Lujain
Published: July 2020

Uncertainty remains whether it is best for men to void in a sitting or standing position. The objective of this study is to evaluate the effect of standing and sitting voiding position on uroflowmetry parameters and post void residual urine (PVRU) in patients with lower urinary tract symptoms (LUTS) due to benign prostate hyperplasia (BPH) and healthy men. A total of 116 participants with BPH (Group 1) and 78 healthy men (Group 2) were enrolled in the study. The uroflowmetry parameters were measured in both positions. The PVRU volume was measured using transabdominal ultrasound after each voiding. Uroflowmetry parameters and PVRU were measured and compared between the two different voiding positions using Wilcoxon signed rank test. In Group 1, there were significant statistical differences in uroflowmetry parameters between standing and sitting voiding position. The median of maximum flow rate in Group 1 in standing and sitting position was 14.7 ml/s (IQR; 11.7–17.5) and 11 ml/s (IQR; 8.9–13.3), respectively ( p < .0001). The median voided volume at standing position was 340 ml (IQR; 276–455) while it was 267 ml (IQR; 194–390) at sitting position ( p < .0001). Median average flow rate in standing position was 5.9 ml/s (IQR; 4.5–7.5) and 5 ml (IQR; 3.2–6.4) in sitting position. There was a statistically significant difference between the median of PVRU in standing and sitting position ( p < .0001). In patients with BPH, voiding in standing position showed better uroflowmetry parameters and significant less PVRU volume.
Principal succession in schools: A literature review (2003–2019)
Authors: Aravena Felipe
Published: July 2020

Principal succession is an inevitable phenomenon in school systems. Given the relevance of principal succession for leadership quality and school improvement, there has been a lack of research in recent decades that has synthesized principal succession. This study aims to review the literature from 2003 to 2019 on principal succession in schools. Using a systematic review as the methodological approach, the eight core educational management and administration leadership journals were selected to collect the sources. Among this corpus of data, four main topics emerged: (a) factors affecting principal succession; (b) the dilemma between change and continuity; (c) the impact of principal succession on teachers; and (d) the evaluation of succession programs. We found that the volume of evidence on principal succession in K-12 schools is low and narrow, even with the importance of the topic. Given the increasingly common pattern of principal movements across the school system, it is urgent to research principal succession in greater detail. Otherwise, the association between principal succession and school failure will be maintained.
Inhaled nitric oxide has pulmonary vasodilator efficacy both in the immediate and prolonged phase of acute pulmonary embolism
Authors: Kramer Anders , Mortensen Christian Schmidt , Schultz Jacob Gammelgaard , Lyhne Mads Dam , Andersen Asger , Nielsen-Kudsk Jens Erik
Published: July 2020

Background

Inhaled nitric oxide (iNO) effectively reduces right ventricular afterload when administered in the immediate phase of acute pulmonary embolism (PE) in preclinical animal models. In a porcine model of intermediate-risk PE, we aimed to investigate whether iNO has pulmonary vasodilator efficacy both in the immediate and prolonged phase of acute PE.

Methods

Anesthetized pigs (n = 18) were randomized into three subgroups. An acute PE iNO-group (n = 6) received iNO at 40 ppm at one, three, six, nine and 12 hours after onset of PE. Vehicle animals (n = 6) received PE, but no active treatment. A third group of sham animals (n = 6) received neither PE nor treatment. Animals were evaluated using intravascular pressures, respiratory parameters, biochemistry and intracardiac pressure-volume measurements.

Results

The administration of PE increased mean pulmonary artery pressure (mPAP) (vehicle vs sham; 33.3 vs 17.7 mmHg, p < 0.0001), pulmonary vascular resistance (vehicle vs sham; 847.5 vs 82.0 dynes, p < 0.0001) and right ventricular arterial elastance (vehicle vs sham; 1.2 vs 0.2 mmHg/ml, p < 0.0001). Significant mPAP reduction by iNO was preserved at 12 hours after the onset of acute PE (vehicle vs iNO; 0.5 vs –3.5 mmHg, p < 0.0001). However, this response was attenuated over time (p = 0.0313). iNO did not affect the systemic circulation.

Conclusions

iNO is a safe and effective pulmonary vasodilator both in the immediate and prolonged phase of acute PE in an in-vivo porcine model of intermediate-risk PE.
Impact of Perceived Health Competence on the Quality of Life of Emerging Adults With Chronic Health Conditions
Authors: Lang Amy C. , Greenley Rachel N. , Davies W. Hobart
Published: July 2020

Emerging adults with chronic health conditions (CHCs) face additional challenges compared to their peers during this transitional period, which can exacerbate their symptoms and negatively impact their quality of life (QoL). This study assessed the impact of CHC status and the potential protective factor of perceived health competence (PHC) on QoL. Nine hundred twenty-nine emerging adults, aged 18–25 years ( M age = 22.19, SD = 1.95; 55% female), participated in the current study as part of a larger online survey. Results showed that those with a CHC reported significantly lower QoL than those without a CHC. Additionally, higher PHC was associated with higher QoL for both groups of emerging adults. Although the current study identified some factors that may differentially impact this positive association, the results consistently suggest that promotion of emerging adults’ PHC may play a key role in improving their QoL during this transitional period, regardless of CHC status.
Postinfectious Acute Disseminated Encephalomyelitis Associated With Antimyelin Oligodendrocyte Glycoprotein Antibody
Authors: Sato Ryosuke , Okanari Kazuo , Maeda Tomoki , Kaneko Kimihiko , Takahashi Toshiyuki , Kenji Ihara
Published: July 2020

Myelin oligodendrocyte glycoprotein is a major target of the humoral immune response in children affected by inflammatory demyelinating diseases of the central nervous system. Although myelin oligodendrocyte glycoprotein causes autoimmune encephalitis in different animal models, the relevance of this mechanism in human autoimmune diseases of the central nervous system is unclear. We herein report a child with acute disseminated encephalomyelitis possibly triggered by central nervous system infection of primary herpes simplex virus in the presence of antimyelin oligodendrocyte glycoprotein antibody. A healthy 5-year-old Japanese boy suffered from acute disseminated encephalomyelitis. He was positive for antimyelin oligodendrocyte glycoprotein antibody in both the serum and the cerebrospinal fluid, and herpes simplex virus-1 DNA on polymerase chain reaction of the cerebrospinal fluid. We speculated that the central nervous system infection of primary herpes simplex virus disrupted the blood–brain barrier, and antimyelin oligodendrocyte glycoprotein antibody already present in serum was transferred to the cerebrospinal fluid, resulting in the onset of acute disseminated encephalomyelitis. This might be the mechanism underlying postinfectious acute disseminated encephalomyelitis associated with myelin oligodendrocyte glycoprotein antibody.
Health Lifestyles and the Transition to Adulthood
Authors: Lawrence Elizabeth , Mollborn Stefanie , Goode Joshua , Pampel Fred
Published: July 2020

Prior research has shown the theoretical importance and empirical feasibility of health lifestyles but has not examined their patterns over the life course or their dynamic associations with socioeconomic status (SES) and adult roles. The authors develop and apply a life-course approach to understanding individuals’ health lifestyles across the transition to adulthood, using U.S. data from the National Longitudinal Study of Adolescent to Adult Health ( n = 6,863). The results show that ascribed SES is associated with adolescent health lifestyles, and those health lifestyles are associated with later health lifestyles. The results also demonstrate the developmental specificity of health lifestyles. Dissimilarities and variations in the clusterings of behaviors and their associations with SES, along with patterning of adult roles, support a contextualized, life course–focused interpretation of health lifestyle development. The authors highlight the need for an integrated life-course model of the development of health disparities that combines both stability and change.
From Baptist Tenant Farmer to Indigenous Oblate Priest: Jim Holland’s Journey of Missionary Hybridity
Authors: Effa Allan
Published: July 2020

This biographical essay identifies the key factors and people that played a role in the development of Jim Holland’s hybrid identity. From his beginning as a Baptist in rural North Carolina, it traces his conversion to Roman Catholicism and his pursuit of priestly vocation to Canada’s Indigenous people, highlighting the significant ways he identified with the Indigenous community and offered ministry to them.
Measuring patient safety culture: A study at a teaching hospital in Ghana
Authors: Muftawu Musilimu , Aldogan Ece Ugurluoglu
Published: July 2020

Objective

This study examined the current patient safety culture from the perspective of healthcare workers in a teaching hospital in Ghana and drew comparison with the Agency for Healthcare Research and Quality 2018 Patient Safety Culture Comparative Database Report.

Methods

A cross-sectional survey was conducted using the Hospital Survey on Patient Safety Culture developed by the Agency for Healthcare Research and Quality. A total of 435 questionnaires were distributed and 322 valid responses were received (a response rate of 74%). The study sample included 178 nurses, 59 doctors, 19 pharmacists, 35 technicians ((laboratory and radiology), and 31 management staff. The Hospital Survey Excel Tool 1.6 and the Statistical Package for the Social Sciences (SPSS) version 20 were used to analyze the data.

Results

The overall average score for the 12 dimensions of patient safety culture was 53% which is 12% lower than the Agency for Healthcare Research and Quality 2018 benchmark report of 65%. The dimension with the highest positive mean score was “Teamwork within Hospital Units” (77%) while the one with the lowest score was “Frequency of Event Reporting” (33%). All 12 domains except for Frequency of Event Reporting ( p = 0.414), Management Support for Patient Safety ( p = 0.823), and Teamwork within Units ( p = 0.070) have significant relationship with patient safety culture.

Conclusions

Generally, the patient safety culture dimension in the teaching hospital was low. Training of healthcare workers on patient safety and a broad based research including all categories of healthcare staff is highly needed in other to fully understand and change the patient safety culture in Ghanaian Hospitals.
Recording microindentation and adhesion tests to analyse the depth-dependent mechanical and adhesive properties of multilayer polymer films as shown for gelatine-coated polyethylene terephthalate and polyethylene films
Authors: Lach Ralf , Richter Sandra , Heilmann Andreas , Grellmann Wolfgang
Published: July 2020

Further developed methods based on an indenter penetration into a material allow generalised quantitative statements on the composition, the depth-dependent mechanical properties and the delamination behaviour of multilayer polymer films, which is demonstrated on gelatine-coated polyethylene terephthalate and polyethylene films. These highly sensitive polymer testing methods, include the recording microindentation test and the recording adhesion test, describe the material behaviour multi-parametrically and are fast (raw data acquisition within several minutes) and relatively simple, requiring a minimum 1 gram sample depending on the film thickness. Based on the Vickers hardness under load approach, the hardness–depth diagrams calculated from the recording microindentation test provide information about the structure, the thickness and the coating hardness and the substrates. The tangential load vs. tangential path length diagrams from recording adhesion test can detect different scratch processes such as continuous scratching or non-continuous stick-slip layer delamination. Furthermore, they form the basis to quantitatively analyze adhesion, i.e. to determine the critical tangential load and the critical tangential delamination work. Both are highly dependent on the substrate type and treatment.
Persistent post-traumatic headache: a migrainous loop or not? The preclinical evidence
Authors: Benemei Silvia , Labastida-Ramírez Alejandro , Abramova Ekaterina , Brunelli Nicoletta , Caronna Edoardo , Diana Paola , Gapeshin Roman , Hofacker Maxi Dana , Maestrini Ilaria , Pías Enrique Martínez , Mikulenka Petr , Tikhonova Olga , Martelletti Paolo , MaassenVanDenBrink Antoinette ,   On behalf of the European Headache Federation School of Advanced Studies (EHF-SAS)
Published: July 2020

Background

According to the International Classification of Headache Disorders 3, post-traumatic headache (PTH) attributed to traumatic brain injury (TBI) is a secondary headache reported to have developed within 7 days from head injury, regaining consciousness following the head injury, or discontinuation of medication(s) impairing the ability to sense or report headache following the head injury. It is one of the most common secondary headache disorders, and it is defined as persistent when it lasts more than 3 months.

Main body

Currently, due to the high prevalence of this disorder, several preclinical studies have been conducted using different animal models of mild TBI to reproduce conditions that engender PTH. Despite representing a simplification of a complex disorder and displaying different limitations concerning the human condition, animal models are still a mainstay to study in vivo the mechanisms of PTH and have provided valuable insight into the pathophysiology and possible treatment strategies. Different models reproduce different types of trauma and have been ideated in order to ensure maximal proximity to the human condition and optimal experimental reproducibility.

Conclusion

At present, despite its high prevalence, PTH is not entirely understood, and the differential contribution of pathophysiological mechanisms, also observed in other conditions like migraine, has to be clarified. Although facing limitations, animal models are needed to improve understanding of PTH. The knowledge of currently available models is necessary to all researchers who want to investigate PTH and contribute to unravel its mechanisms.
Health impacts of environmental contamination of micro- and nanoplastics: a review
Authors: Jiang Baorong , Kauffman Alexandra E , Li Lei , McFee Wayne , Cai Bo , Weinstein John , Lead Jamie R , Chatterjee Saurabh , Scott Geoffrey I , Xiao Shuo
Published: July 2020

Plastics are extensively used in our daily life. However, a significant amount of plastic waste is discharged to the environment directly or via improper reuse or recycling. Degradation of plastic waste generates micro- or nano-sized plastic particles that are defined as micro- or nanoplastics (MNPs). Microplastics (MPs) are plastic particles with a diameter less than 5 mm, while nanoplastics (NPs) range in diameter from 1 to 100 or 1000 nm. In the current review, we first briefly summarized the environmental contamination of MNPs and then discussed their health impacts based on existing MNP research. Our review indicates that MNPs can be detected in both marine and terrestrial ecosystems worldwide and be ingested and accumulated by animals along the food chain. Evidence has suggested the harmful health impacts of MNPs on marine and freshwater animals. Recent studies found MPs in human stool samples, suggesting that humans are exposed to MPs through food and/or drinking water. However, the effect of MNPs on human health is scarcely researched. In addition to the MNPs themselves, these tiny plastic particles can release plastic additives and/or adsorb other environmental chemicals, many of which have been shown to exhibit endocrine disrupting and other toxic effects. In summary, we conclude that more studies are necessary to provide a comprehensive understanding of MNP pollution hazards and also provide a basis for the subsequent pollution management and control.
Trauma team conformation in a war-influenced middle-income country in South America: is it possible?
Authors: Carvajal Sandra , Uribe-Buritica Francisco L , Ángel-Isaza Ana Maria , López-Girón María Camila , González Andres , Chica Julian , Benitez Manuel , García Alberto F
Published: July 2020

Introduction

Trauma teams (TTs) improve outcomes in trauma patients. A multidisciplinary TT was conformed in September 2015 in a tertiary level I trauma university hospital in southwestern Colombia, a middle-income war-influenced country.

Objective

To evaluate the impact of a TT in admission-tomography and admission-surgery times as well as mortality in a tertiary center university hospital in a middle-income country war-influenced country.

Material and methods

Retrospective analytical study. Patients older than 17 years admitted to the emergency room 15 months prior and 15 months after the TT implementation were included. Patients prior to the TT implementation were taken as controls. No exclusion criteria. Four hundred sixty-four patients were included, 220 before the TT implementation (BTT) and 244 after (ATT). Demographic data, trauma characteristics, admission-tomography, and admission-surgery time interval as well as mortality were recorded. Requirement of CT scan or surgery was based on physician decision. The analysis was made on Stata 15.1®. Categorical variables were described as quantities and proportions, and continuous variables as mean and standard deviation or median and interquartile range (IQR). Categorical variables were compared using χ2 or Fisher’s test and continuous variables using Student’s T test or Wilcoxon-Mann-Whitney. A multiple logistic regression model was created to evaluate the impact of being treated in the ATT group on mortality, adjusted by age, trauma severity, and physiological response upon admission.

Results

The admission-tomography time interval was 56 min (IQR 39–100) in the BTT group and 40 min (IQR 24–76) in the ATT group, p < 0.001. The admission-surgery time interval was 116 min (IQR 63–214) in the BTT group and 52 min (IQR 24–76) in the ATT group, p < 0.001. Mortality in the BTT group was 18.1% and 13.1% in the ATT group. Adjusted OR was 0.406 (0.215–0.789) p = 0.006

Conclusions

A trauma team conformation in a war-influenced middle-income country is feasible and reduces mortality as well as admission-surgery and admission-tomography time intervals in trauma patients.
Conditional permutation importance revisited
Authors: Debeer Dries , Strobl Carolin
Published: July 2020

Background

Random forest based variable importance measures have become popular tools for assessing the contributions of the predictor variables in a fitted random forest. In this article we reconsider a frequently used variable importance measure, the Conditional Permutation Importance (CPI). We argue and illustrate that the CPI corresponds to a more partial quantification of variable importance and suggest several improvements in its methodology and implementation that enhance its practical value. In addition, we introduce the threshold value in the CPI algorithm as a parameter that can make the CPI more partial or more marginal.

Results

By means of extensive simulations, where the original version of the CPI is used as the reference, we examine the impact of the proposed methodological improvements. The simulation results show how the improved CPI methodology increases the interpretability and stability of the computations. In addition, the newly proposed implementation decreases the computation times drastically and is more widely applicable. The improved CPI algorithm is made freely available as an add-on package to the open-source software R.

Conclusion

The proposed methodology and implementation of the CPI is computationally faster and leads to more stable results. It has a beneficial impact on practical research by making random forest analyses more interpretable.