bluuebunny/crossref_metadata_2025 huggingface dataset:
Safety, Efficacy, and Predictive Factors of Conventional Epithelium-Off Corneal Crosslinking in the Treatment of Progressive Keratoconus
Authors: Farhat Rebecca , Ghannam Mohamad Khaled , Azar Georges , Nehme Joseph , Sahyoun Marwan , Hanna Najib Georges , Abi Karam Mariana , El Haber Charbel , Schakal Alexandre , Jalkh Alexandre , Samaha Ameed
Published: May 2020

Purpose. To report predictive factors of outcome of conventional epithelium-off corneal crosslinking (CXL) in the treatment of progressive keratoconus. Methods. This is a monocentric observational retrospective study conducted at Eye and Ear International Hospital, Lebanon. All patients with progressive keratoconus who underwent CXL between January 2008 and January 2016, with minimal 3-years follow-up were included. Primary treatment outcomes were maximum keratometry (K max), best-corrected distance visual acuity (CDVA), and failure. Failure was defined as an increase of 1.00 diopters (D) or more in K max and/or an increase of 0.1 logMAR or more in CDVA and conversion to corneal transplantation. Statistical analysis was done to identify predictors of treatment success. Univariate and multivariate analyses were performed to determine the correlations between baseline parameters and outcomes, and an equation for predicting K max and CDVA was created. Results. 156 eyes of 102 patients were enrolled. The mean age was 23.85 ± 6.52 years. Failure occurred in 31 eyes (19.87%). Gender and thinnest pachymetry did not have any impact on postoperative outcomes. Concerning the CDVA outcome, multivariate analysis showed that a better preoperative CDVA was associated with higher improvement in CDVA, and higher baseline K max and higher posterior mean K were associated with a worse outcome CDVA. Regarding postoperative K max, a higher baseline K max, a worse baseline CDVA, and a younger age were associated with less flattening postoperatively. Conclusion. CXL is a safe and effective method in treating progressive keratoconus. However, the clinical benefits can differ among patients, and in our series, a nonnegligible number of cases show a continued progression of their ectasia. Further studies to identify predictors of postoperative progression prior to the procedure could help sort out good responders to treatment.
Locomotion Variations of Arch Index and Interlimb Symmetry in Shod and Barefoot Populations
Authors: Yu Peimin , Liang Minjun , Ren Feng
Published: May 2020

The purpose of this study was to investigate the variations of arch index from static standing to dynamic walking and running; furthermore, the interlimb symmetry was checked in the two populations. A total of eighty male participants were recruited for this study, with forty habitually barefoot and forty habitually shod males, respectively. Arch index (AI) was calculated following the previously established “gold standard” measurement via contact areas recorded from EMED. Repeated measure analysis of variance (ANOVA) was employed to compare the difference between static and dynamic walking and running arch index. Paired-samples t-test and symmetry index (SI) were used to investigate the symmetry of the left foot arch index and right foot arch index. It was found that the dynamic arch index was significantly higher than the static arch index in barefoot and shod males, showing an increase from static weight-bearing standing to dynamic walking and running. However, interlimb (right-left) symmetry in the foot arch index was observed in the two populations. Dynamic changes of the arch index may provide implications that need to be considered while designing shoe lasts or insoles. Knowledge of the healthy arch index range reported from this study could also be used as a standard baseline to probe into foot and arch disorders.
Improved Kaplan-Meier Estimator in Survival Analysis Based on Partially Rank-Ordered Set Samples
Authors: Nematolahi Samane , Nazari Sahar , Shayan Zahra , Ayatollahi Seyyed Mohammad Taghi , Amanati Ali
Published: May 2020

This study presents a novel methodology to investigate the nonparametric estimation of a survival probability under random censoring time using the ranked observations from a Partially Rank-Ordered Set (PROS) sampling design and employs it in a hematological disorder study. The PROS sampling design has numerous applications in medicine, social sciences and ecology where the exact measurement of the sampling units is costly; however, sampling units can be ordered by using judgment ranking or available concomitant information. The general estimation methods are not directly applicable to the case where samples are from rank-based sampling designs, because the sampling units do not meet the identically distributed assumption. We derive asymptotic distribution of a Kaplan-Meier (KM) estimator under PROS sampling design. Finally, we compare the performance of the suggested estimators via several simulation studies and apply the proposed methods to a real data set. The results show that the proposed estimator under rank-based sampling designs outperforms its counterpart in a simple random sample (SRS).
Sarcopenia: Influence of Regional Skeletal Muscle Cutoff Points and Fat-Free Mass in Older Mexican People—A Pilot Study
Authors: Alemán-Mateo Heliodoro , López-Teros Miriam T. , Ruiz-Valenzuela Roxana E. , Ramírez-Torres Maribel , Urquidez-Romero René
Published: May 2020

Background. Variation in the prevalence of sarcopenia is related to the skeletal muscle index cutoff points applied. The objective of this pilot study was to examine the recruitment process for testing different sarcopenia definitions (ASMI cutoffs) in older Mexican adults. It explored whether the prevalence of sarcopenia decreased by applying ethnic- and gender-specific, DXA-derived appendicular skeletal muscle index (ASMI)-cutoff points in the definitions, as well as some associated factors in a sample of community-dwelling older Mexican people. Methods. This is a pilot feasibility study that included a convenience sample of 217 community-dwelling older adults. Volunteers underwent DXA measurements and an assessment of functional status based on hand grip strength and physical performance. Six definitions were formed based on the 2010 EWGSOP criteria, but using different cutoff points for each of the three components, including regional cutoff points for ASMI derived from young Mexican adults. Several risk factors for sarcopenia were also assessed. Results. The prevalence of sarcopenia varied according to the different definitions applied. The lowest level was found with the definition that applied regional ASMI-cutoff points (p<0.01). The sarcopenic older adults had significant lower body weight, fat mass, and fat-free mass (FFM) than the nonsarcopenic subjects. The risk of sarcopenia increased with age and low FFM (p<0.001). Conclusion. The present study demonstrates the feasibility of the main study, and our data support the notion that using regional ASMI cutoff points resulted in a low prevalence of sarcopenia. Therefore, it is preferable to estimate the prevalence of this condition using ethnic- and gender-specific cutoff points and to explore associated factors such as low FFM.
Modeling the Influence of Nonclinic Visits on the Transmission of Respiratory Diseases
Authors: Bao Yunting , Xu Yanlong , Qi Longxing , Zhai Sulan
Published: May 2020

According to the information reflected by Anhui Center for Disease Control (Anhui CDC) in Hefei, Anhui province of China, some patients infected with respiratory diseases did not seek medical treatment (nonclinic visits) due to their strong resistance, and the influence of them on the spread of respiratory diseases has not been known. A SIS model with considering the nonclinic visits was established; a qualitative theory of the model was analyzed to obtain the basic reproduction number R0, disease-free equilibrium, endemic equilibrium, and stability of two equilibriums. Then, the model is combined with the daily number of respiratory diseases for parameter estimation and numerical simulation. Numerical simulation results showed that respiratory diseases were easy to break out in the autumn and winter and were relatively stable in the spring and summer. Through parameter estimation, the unknown parameter value was achieved and the result was obtained that the initial number of nonclinic visits is 10-11 times that of clinic visits. Finally, the result of sensitivity analysis displayed that the proportion of the number of nonclinic visits to the total number of patients has a significant influence on the final number of patients. If persons improve their resistance so that the number of nonclinic visits increases, the total number of patients will be reduced or even reduced to zero. Besides, reducing contact infection rate of disease and increasing the cure rate can also reduce the final total number of patients.
Prevalence and Determinants of Hypertension Awareness, Treatment, and Control in Botswana: A Nationally Representative Population-Based Survey
Authors: Tapela Neo M. , Clifton Lei , Tshisimogo Gontse , Gaborone Moagi , Madidimalo Tebogo , Letsatsi Virginia , Masupe Tiny , Mosepele Mosepele , Makhema Joseph , Lockman Shahin , Hunter David J.
Published: May 2020

Introduction. Hypertension is a leading risk factor for cardiovascular mortality and an emerging public health concern in sub-Saharan Africa. Few studies have examined performance on the management of hypertension in this region, where the context may be distinct from other developing regions. Objectives. We aimed to determine the prevalence and correlates of hypertension, awareness, treatment, and control among adults in Botswana, a middle-income African country undergoing rapid demographic transition and with high HIV burden. Methods. In this 2014 cross-sectional survey of adults aged 15–69 years, information on sociodemographic characteristics, lifestyle behavior, and medical history was collected through in-person interviews and physical measurements (body mass index and triplicate blood pressure (BP)). Hypertension was defined as self-report of use of antihypertensives in the previous two weeks and/or having elevated BP (≥140/90 mmHg). Multivariable logistic regression was employed to explore factors associated with hypertension, awareness (report of previous diagnosis), treatment (antihypertensives), and control (BP < 140/90). Results. Our analysis (N = 4,007) yielded an age-standardized hypertension prevalence of 30% (95% CI: 28%–32%, N = 1,393). Among hypertensives, 54% (50–58%) were unaware of their condition, 45% (40–50%) of those aware were untreated, and 63% (55–70%) of those on medications were suboptimally treated (BP ≥ 140/90 mmHg). A fifth of hypertensives who were diagnosed but not on medications had BP ≥ 180/110 mmHg. Diabetes was the strongest correlate of hypertension and awareness (aOR 4.00, 1.86–8.59; aOR 3.30, 1.44–7.55, respectively). Males were less likely to be aware (aOR 0.62, 0.41–0.94) or controlled (aOR 0.36, 0.16–0.83). Obese individuals were more likely to be treated (aOR 2.17, 1.12–4.22), yet less likely to be controlled (aOR 0.32, 0.15–0.66). Conclusions. We report the first nationally representative estimates of the hypertension care cascade performance in Botswana, which will support planning and future policy evaluations. Findings contribute to the relatively sparse evidence on this subject and may inform development of innovations that improve quality of hypertension management and adherence support in similar settings.
Position Control of a Maglev System Fed by a DC/DC Buck Power Electronic Converter
Authors: Hernández-Guzmán Victor Manuel , Silva-Ortigoza Ramón , Marciano-Melchor Magdalena
Published: May 2020

In this paper, we solve the problem of position regulation in a magnetic levitation system that is fed by a DC/DC Buck power electronic converter as a power amplifier. We present a formal asymptotic stability proof. Although this result is local, the merit of our proposal relies on the fact that this is the first time that such a control problem is solved for a magnetic levitation system, a nonlinear electromechanical plant. In this respect, we stress that most works in the literature on control of electromechanical systems actuated by power electronic converters are devoted to control brushed DC motors which are well known to have a linear model. Furthermore, despite the plant that we control in the present paper is complex, our control law is simple. It is composed by four nested loops driven by one sliding mode controller, two proportional-integral controllers, and a nonlinear proportional-integral-derivative position controller. Each one of these loops is devoted to control each one of the subsystems that compose the plant: electric current through the converter inductor, voltage at the converter capacitor, electric current through the electromagnet, and position of the ball. Thus, our proposal is consistent with the simple and intuitive idea of controlling each subsystem of the plant in order to render robust the control scheme. We stress that such a solution is complicated to derive using other control approaches such as differential flatness or backstepping. In this respect, our proposal relies on a novel passivity-based approach which, by exploiting the natural energy exchange between the mechanical and electrical dynamics, renders possible the design of a control scheme with the above cited features.
Determinants of Active Tuberculosis Occurrences after ART Initiation among Adult HIV-Positive Clients in West Showa Zone Public Hospitals, Ethiopia: A Case-Control Study
Authors: Nugus Gerbaba Guta , Irena Mergitu Eliyas
Published: May 2020

Introduction. Tuberculosis is a major public health concern globally, especially in sub-Saharan African countries. It is the most common opportunistic infection and leading cause of mortality among people living with human immunodeficiency virus despite increased deliverance of antiretroviral therapy. Objectives. The aim of this study was to identify determinants of active tuberculosis among adult HIV positive patients after ART initiation in West Showa Zone public hospitals, Ethiopia. Methods. Multicentred unmatched case-control study was conducted on selected public hospitals in West Showa Zone from February to June, 2019. A total of 406 participants (203 cases and 203 controls) were included in the study. Cases were adult HIV patients who developed tuberculosis after ART initiation while controls were adult HIV patients who did not develop tuberculosis after ART initiation. Data were collected using interviewer administered structured questionnaire. Logistic regression analysis was performed using SPSS version 24 statistical software. Statistical significance test was set at 95% confidence level. Results. This study identified that patient’s previous TB history (AOR = 2.41; 95% CI: 1.49, 3.90; P value<0.001), haemoglobin level (AOR = 3.67; 95% CI: 1.98, 6.79; P value<0.001), CD4 cells count (AOR = 2.02; CI: 1.24, 3.29; P value=0.004), adherence level (AOR = 19.00; CI: 5.59, 64.59; P vaue<0.001), and WHO HIV/AIDS clinical stage (AOR = 2.58; CI: 1.59, 4.18; P vaue<0.001) were found to be statistically significant determinants for the occurrence of tuberculosis among PLHIV after ART initiation. Conclusion. Patient’s previous TB history, haemoglobin level, CD4 cells count, adherence level, and WHO clinical stage were significant determinants of occurrence of tuberculosis after ART initiation in PLHIV.
On-Device Detection of Repackaged Android Malware via Traffic Clustering
Authors: He Gaofeng , Xu Bingfeng , Zhang Lu , Zhu Haiting
Published: May 2020

Malware has become a significant problem on the Android platform. To defend against Android malware, researchers have proposed several on-device detection methods. Typically, these on-device detection methods are composed of two steps: (i) extracting the apps’ behavior features from the mobile devices and (ii) sending the extracted features to remote servers (such as a cloud platform) for analysis. By monitoring the behaviors of the apps that are running on mobile devices, available methods can detect suspicious applications (simply, apps) accurately. However, mobile devices are typically resource limited. The feature extraction and massive data transmission might consume substantial power and CPU resources; thus, the performance of mobile devices will be degraded. To address this issue, we propose a novel method for detecting Android malware by clustering apps’ traffic at the edge computing nodes. First, a new integrated architecture of the cloud, edge, and mobile devices for Android malware detection is presented. Then, for repackaged Android malware, the network traffic content and statistics are extracted at the edge as detection features. Finally, in the cloud, similarities between apps are calculated, and the similarity values are automatically clustered to separate the original apps and the malware. The experimental results demonstrate that the proposed method can detect repackaged Android malware with high precision and with a minimal impact on the performance of mobile devices.
Effects of Microecological Preparations on Obese Patients after Bariatric Surgery: A Systematic Review and Meta‐Analysis
Authors: Zhu Hanfei , Ren Ziqi , Zang Yan , Hua Hongxia , Lu Jinling , Xu Qin , Zhu Shuqin
Published: May 2020

Vitamin deficiency, bacterial overgrowth, and gastrointestinal symptoms can be detected in obese patients after bariatric surgery that influences their quality of life (QoL) and weight. It is unclear if microecological preparations benefit obese patients following bariatric surgery. The aim of this study is to investigate the effects of microecological preparations on QoL, excess weight loss (EWL), and levels of vitamin B12 and inflammatory markers. We searched seven databases to identify reports published till December 1, 2019, and included randomized controlled trials investigating the effects of microecological preparations in obese adults undergoing bariatric surgery. The primary outcomes included QoL and EWL, while secondary outcomes comprised serum levels of vitamin B12, interleukin 6, TNF‐α, and C‐reactive protein (CRP). Study bias was analyzed using the Cochrane risk‐of‐bias tool. Statistical analyses were performed using Review Manager. The mean difference in outcomes was calculated using standardized mean difference (SMD) with a confidence interval (CI) of 95%. A majority of the studies showed a low or moderate risk of bias. Meta‐analysis showed significantly higher levels of vitamin B12 in postoperative patients administered with microecological preparations (SMD = 0.52; 95% CI = 0.08–0.95; P = 0.02). There were no significant differences in QoL (SMD = −0.14; 95% CI = −0.45–0.17; P = 0.38), EWL (SMD = 0.45; 95% CI = −0.16–1.05; P = 0.15), and levels of TNF‐α (SMD = −0.29; 95% CI = −0.64–0.05; P = 0.09), interleukin 6 (SMD = −0.1; 95% CI = −0.81–0.61; P = 0.78]), and CRP (SMD = 0.02; 95% CI = −0.32–0.36; P = 0.93). The trials examined indicated that microecological preparations had limited efficacy in improving QoL, EWL, and inflammatory response, but they stimulated the synthesis of vitamin B12. This may help in designing efficient microecological preparations to supplement bariatric surgery in obese individuals.
Classification and Improvement Strategy for Design Features of Mobile Tourist Guide Application: A Kano-IPA Approach
Authors: Li Shun , Xiao Quan
Published: May 2020

An increasing number of people are using mobile applications to obtain travel-related information and activities due to the prosperity of the internet and mobile technologies nowadays. The design, development, and improvement of mobile tourist guide application (MTGA) are particularly important for travel-related companies. As an emerging application scenario of mobile technologies in the field of tourism, existing research on MTGA lacks analysis of its specific design, especially from the perspective of users to investigate the microscopic design features and improvement strategies. The Kano model was adopted by prior studies to analyse product quality attribute, while importance-performance analysis (IPA) was used to prioritize quality attributes for improvement. However, due to the limitation of the Kano model in neglecting the attribute performance and importance and the weakness of IPA in considering only the one-dimensional quality attributes, the use of single approach has its shortcomings for analysing the design features of MTGA. We attempt to integrate Kano model and IPA to conduct a study on the classification and improvement strategy issues for the design features of MTGA. Particularly, we identify design features of MTGA first, propose a method to classify them, and determine their priorities for developing and improving as well. An online questionnaire survey is conducted. The paper extends research on Kano model and IPA into the domain of mobile application design and provides insights into management strategies about the design of MTGA, which also offers novel and important implications for travel-related companies to increase the users’ satisfaction by optimizing their mobile application design.
Is Traditional Chinese Medicine “Mainstream” in China? Trends in Traditional Chinese Medicine Health Resources and Their Utilization in Traditional Chinese Medicine Hospitals from 2004 to 2016
Authors: Shi Xuefeng , Zhu Dawei , Nicholas Stephen , Hong Baolin , Man Xiaowei , He Ping
Published: May 2020

Background. Traditional, complementary, and alternative medicine (TCAM) has attracted increasing attention in developed countries, but its mainstream status in China, the home of TCAM, is unclear. Over the period of 2004–2016, we analyze the health resources and health resource utilization of traditional medicine in traditional Chinese medicine (TCM) hospitals in China. Methods. Over 2004–2016, we obtained data from all TCM hospitals in all Chinese provinces to create a hospital‐based, longitudinal dataset. TCM health resources and their utilization were measured by two outcome variables: (1) primary outcome variables comprising the proportion of TCM physicians, TCM pharmacists, revenue from TCM drugs, and TCM prescriptions and (2) the secondary outcome variables, as proxies of westernization for TCM hospitals, comprising the number of medical equipment above RMB 10,000 and the proportion of surgery in inpatient visits. We used linear regression models with hospital‐fixed effects to analyze time trends for the outcome variables. Results. The number of public TCM hospitals remained stable from 2004 to 2016, while the number of private TCM hospitals increased from 294 in 2004 to 1560 in 2016. There was a small percentage increase in the proportion of TCM physicians (0.280%), TCM pharmacists (0.298%), and revenue from Chinese medicines (0.331%) and TCM prescriptions (1.613%) per hospital per year. Chinese drugs accounted for less than a half of the total drug prescriptions, and accordingly, just one‐third of the drug revenue was from Chinese medicines at TCM hospitals. The proportions of physicians, pharmacists, revenue from Chinese drug sales, and traditional medicine prescriptions never reach the 60% benchmark target for mainstream in TCM hospitals. As proxies for Western medicine practices in TCM hospitals, the number of medical equipment above RMB 10,000 rapidly rose by over 13 percent per hospital per year, but the proportion of inpatient surgeries declined by 0.830 percentage points per hospital per year, reflecting a mixed trend in the use of Western medicine practices. Conclusion. For the 2004–2016 period, traditional medicine, although making progress towards the mainstream benchmark of 60% TCM services, was still not mainstream at TCM hospitals.
Stability of a Nonlinear Stochastic Epidemic Model with Transfer from Infectious to Susceptible
Authors: Wang Yanmei , Liu Guirong
Published: May 2020

We investigate a stochastic SIRS model with transfer from infectious to susceptible and nonlinear incidence rate. First, using stochastic stability theory, we discuss stochastic asymptotic stability of disease-free equilibrium of this model. Moreover, if the transfer rate from infectious to susceptible is sufficiently large, disease goes extinct. Then, we obtain almost surely exponential stability of disease-free equilibrium, which implies that noises can lead to extinction of disease. By the Lyapunov method, we give conditions to ensure that the solution of this model fluctuates around endemic equilibrium of the corresponding deterministic model in average time. Furthermore, numerical simulations show that the fluctuation increases with increase in noise intensity. Finally, these theoretical results are verified by numerical simulations. Hence, noises play a vital role in epidemic transmission. Our results improve and extend previous related results.
Determinantal Representations of the Weighted Core-EP, DMP, MPD, and CMP Inverses
Authors: Kyrchei Ivan I.
Published: May 2020

In this paper, new notions of the weighted core-EP left inverse and the weighted MPD inverse which are dual to the weighted core-EP (right) inverse and the weighted DMP inverse, respectively, are introduced and represented. The direct methods of computing the weighted right and left core-EP, DMP, MPD, and CMP inverses by obtaining their determinantal representations are given. A numerical example to illustrate the main result is given.
Epithelial–Mesenchymal Transition Programs and Cancer Stem Cell Phenotypes: Mediators of Breast Cancer Therapy Resistance
Authors: Gooding Alex J. , Schiemann William P.
Published: June 2020

Epithelial–mesenchymal transition (EMT) programs play essential functions in normal morphogenesis and organogenesis, including that occurring during mammary gland development and glandular regeneration. Historically, EMT programs were believed to reflect a loss of epithelial gene expression signatures and morphologies that give way to those associated with mesenchymal cells and their enhanced migratory and invasive behaviors. However, accumulating evidence now paints EMT programs as representing a spectrum of phenotypic behaviors that also serve to enhance cell survival, immune tolerance, and perhaps even metastatic dormancy. Equally important, the activation of EMT programs in transformed mammary epithelial cells not only enhances their acquisition of invasive and metastatic behaviors, but also expands their generation of chemoresistant breast cancer stem cells (BCSC). Importantly, the net effect of these events results in the appearance of recurrent metastatic lesions that remain refractory to the armamentarium of chemotherapies and targeted therapeutic agents deployed against advanced stage breast cancers. Here we review the molecular and cellular mechanisms that contribute to the pathophysiology of EMT programs in human breast cancers and how these events impact their “stemness” and acquisition of chemoresistant phenotypes.
COMUNIDADE NIKKEI DE PARACATU-MG E SUAS EXPERIÊNCIAS DE DESENVOLVIMENTO NO CONTEXTO DO PRODECER
Authors: Sant’Anna Nanahira de Rabelo e
Published: May 2020

O artigo apresenta resumo de tese sobre outras possíveis leituras e perspectivas sobre processos de desenvolvimento a partir de relatos orais a respeito da trajetória da comunidade nikkei de Paracatu-MG, composta de pessoas e grupos que migraram para o Município na segunda metade do Século XX, no contexto da abertura de novas fronteiras agrícolas no Cerrado, proporcionada por programas como o PRODECER. Um entendimento sobre processos de desenvolvimento como experiências que emergem de subjetividades em sua diversidade e complexidade, agrupadas nas dimensões de migração, trabalho, educação, comunidade e cultura, foi obtido com a aplicação de conceitos e abordagens dos estudos pós-coloniais na análise das aspirações, valores e expectativas de desenvolvimento dos nikkeis ao longo de suas trajetórias de vida.
Approach to Acute Cardiovascular Complications in COVID-19 Infection
Authors: Ranard Lauren S. , Fried Justin A. , Abdalla Marwah , Anstey D. Edmund , Givens Raymond C. , Kumaraiah Deepa , Kodali Susheel K. , Takeda Koji , Karmpaliotis Dimitrios , Rabbani LeRoy E. , Sayer Gabriel , Kirtane Ajay J. , Leon Martin B. , Schwartz Allan , Uriel Nir , Masoumi Amirali
Published: June 2020

The novel coronavirus disease 2019, otherwise known as COVID-19, is a global pandemic with primary respiratory manifestations in those who are symptomatic. It has spread to >187 countries with a rapidly growing number of affected patients. Underlying cardiovascular disease is associated with more severe manifestations of COVID-19 and higher rates of mortality. COVID-19 can have both primary (arrhythmias, myocardial infarction, and myocarditis) and secondary (myocardial injury/biomarker elevation and heart failure) cardiac involvement. In severe cases, profound circulatory failure can result. This review discusses the presentation and management of patients with severe cardiac complications of COVID-19 disease, with an emphasis on a Heart-Lung team approach in patient management. Furthermore, it focuses on the use of and indications for acute mechanical circulatory support in cardiogenic and/or mixed shock.
Marx on Social Reproduction
Authors: Cammack Paul
Published: May 2020

Marx is generally reckoned to have had too little to say about what has come to be defined as ‘social reproduction’, largely as a consequence of too narrow a focus on industrial production, and a relative disregard for issues of gender. This paper argues in contrast that the approach he developed with Engels and in Capital, Volume 1, provides a powerful framework for its analysis. After an introductory discussion of recent literature on social reproduction the second section sets out Marx’s approach to the ‘production of life, both of one’s own in labour and of fresh life in procreation’. The third addresses his account of reproduction in Capital, Volume 1, Chapter 23. The fourth and fifth compare the relationship of the family to industry and exchange as depicted in Capital and in the present day respectively. The conclusion suggests some implications for theories of social reproduction.
The Feminist Case Against Relational Autonomy
Authors: Khader Serene J.
Published: May 2020

Feminist socially constitutive conceptions of autonomy make the presence of idealized social conditions necessary for autonomy. I argue that such conceptions cannot, when applied under nonideal conditions, play two key feminist theoretical roles for autonomy: the roles of anti-oppressive character ideal and paternalism-limiting concept. Instead, they prescribe action that reinforces oppression. Treated as character ideals, socially constitutive conceptions of autonomy ask agents living under nonideal ones to engage in self-harm or self-subordination. Moreover, conceptions of autonomy that make idealized social conditions a requirement of autonomy yield the conclusion that oppressed agents are appropriate objects of paternalism.
Judicial Enforcement of Environmental Democracy: a Critical Analysis of Case Law on Access to Environmental Information in the European Union
Authors: Peeters Marjan
Published: June 2020

Since the 1970s, the concept of environmental democracy, including the right to gain access to environmental information, has emerged as an important concept to promote and ensure public engagement in governmental environmental decision-making. While it is, generally, understood that environmental procedural rights deserve protection across the globe, it remains to be identified to what extent, in practice, the application of such rights differs across jurisdictions. Such differences may be caused by specific understandings of democracy and institutional characteristics. In light of this, this article analyses the case law of the Court of Justice of the European Union (CJEU) regarding the right of access to environmental information. It observes that the EU legislature has implemented the right of access to environmental information more ambitiously than required under the Aarhus Convention, particularly with regard to legislative information. Moreover, the CJEU has steered EU institutions, including the European Commission, towards even greater transparency. The judicial reasoning by the CJEU is principled and refers to general values regarding openness and transparency codified in primary EU law and in the EU Charter of Fundamental Rights. These judicial developments also highlight the importance of promoting discourse on the implications of a rigorous approach to the right of access to environmental information, including the question of whether enabling wider public engagement necessarily leads to better decision-making. Finally, the article promotes the need for comparative research on how the right to gain access to environmental information is developing across the world.
Astragalus polysaccharides protect renal function and affect the TGF-β/Smad signaling pathway in streptozotocin-induced diabetic rats
Authors: Meng Xue , Wei Mingmin , Wang Dong , Qu Xiaohan , Zhang Kun , Zhang Nan , Li Xinjian
Published: May 2020

Objectives

The objective was to observe the effects of Astragalus polysaccharides on diabetes and on regulation of the TGF-β/Smad signaling pathway.

Methods

A type 2 diabetic rat model was established with a high-fat diet in combination with low-dose streptozotocin (35 mg/kg). Astragalus polysaccharides were applied as treatment intervention and changes in blood glucose and kidney morphology and function were assessed.

Results

Eight weeks after model establishment, kidney weight as a proportion of total weight (KW/TW) in the high-, medium-, and low-dose Astragalus polysaccharide groups was significantly lower than that in the model group, and the KW/TW value gradually decreased with increasing dose of polysaccharides in each treatment group. Fasting blood glucose in the low- and medium-dose Astragalus polysaccharide groups was numerically lower than that in the model group and fasting blood glucose in rats in the high-dose group was significantly lower than that in the model group. Levels of 24-hour urinary microalbumin, creatinine, blood urea nitrogen, collagens I, III, and IV, α-smooth muscle actin, transforming growth factor-β1, and Smad3 in Astragalus polysaccharide groups (all doses) were significantly lower than those in the model group.

Conclusions

Astragalus polysaccharide significantly improved blood glucose and protected kidney function in a rat diabetes model.
Cecal amebiasis mimicking inflammatory bowel disease
Authors: Cheng Chiao-Wen , Feng Cheng-Min , Chua Chian Sem
Published: May 2020

Amebiasis is a frequently occurring parasitic infection in South East Asia. We present a case of a 54-year-old man with right lower quadrant abdominal pain that persisted for longer than 1 year. He had been diagnosed with inflammatory bowel disease in Indonesia. His abdominal pain persisted, despite therapy, and he visited Malaysia for transnational medical advice. Abdominal ultrasound showed fatty liver, gallbladder polyps, and a small left renal stone. Colonoscopy showed multiple ulcers in the cecum and a histopathological examination confirmed amebic infection of the cecum. The colonic ulcers subsided after anti-amebic treatment. This case highlights the need to consider the differential diagnosis of amebic colitis in patients presenting with manifestations of inflammatory bowel disease, especially in patients who live in or have traveled to endemic areas.
Clinical evaluation of the T-SPOT.TB test for detection of tuberculosis infection in northeastern Guangdong Province, China
Authors: Zhong Hua , Wu Heming , Yu Zhikang , Zhang Qunji , Huang Qingyan
Published: May 2020

Objective

We evaluated clinical performance of the T-SPOT.TB test for detecting tuberculosis (TB) infection in Meizhou, China.

Methods

We enrolled 2,868 patients who underwent T-SPOT.TB, smear, and TB-DNA at the same time. The tests’ sensitivity and specificity were evaluated and compared in different groups, and in pulmonary TB (PTB) and extrapulmonary TB (EPTB) subgroups. Receiver operator characteristic (ROC) curve analysis was used to evaluate T-SPOT.TB’s diagnostic value and determine its cutoff value.

Results

T-SPOT.TB, TB-DNA, and sputum smear sensitivity was 61.44%, 37.12%, and 14.02%; and specificity was 76.49%, 99.20% and 99.60%, respectively. The T-SPOT.TB positive rate was higher in the PTB and EPTB subgroups than in patients with other pulmonary diseases (61.38% and 61.76% vs. 23.34%). The T-SPOT.TB test had better diagnostic accuracy and sensitivity when the positive cutoff value of marker ESAT-6 was 2.5 [area under ROC curve = 0.701, 95%CI 0.687–0.715] and marker CFP-10 was 6.5 [area under ROC curve = 0.669, 95%CI 0.655–0.683].

Conclusion

T-SPOT.TB sensitivity was higher than that of TB-DNA or sputum smear, but the specificity was lower. T-SPOT.TB had moderate sensitivity and specificity for diagnosing TB. T-SPOT.TB’s new positive cutoff value may be clinically valuable according to ROC analysis.
A health education model based on knowledge, attitude, and practice used as adjunct therapy for metabolic syndrome complicated with acute pancreatitis: A case report
Authors: Xiong Shuyun , Ding Meizhu , Li Ping , Pan Shufen , Li Guanlan , He Wenfang
Published: May 2020

Herein, a relatively rare case is reported in which a knowledge, attitude, and practice (KAP) health education model was applied in a young female patient with metabolic syndrome (MS) and acute pancreatitis (AP), with a satisfactory effect. The purpose of this report is to provide a reference for a viable health education program in clinical practice for intervention of MS with concurrent AP in the absence of clinical trials. The patient’s unhealthy lifestyle led to obesity, diabetes mellitus, severe fatty liver, hyperlipidemia, and AP. We used a KAP health education model in a nursing intervention and evidence-based multidisciplinary cooperation to develop a personalized diet, exercise plan, education plan, and continuous care of the patient after discharge from the hospital. Within 2 months, the patient achieved weight loss, stable blood lipids, controlled blood sugar levels, and decreased glycated hemoglobin level from 9.0% to 5.4%. This KAP-based health education model has clinical importance as an intervention for lifestyle modification in patients with MS and AP. This approach can be adopted to help other patients to effectively control and prevent the recurrence of diseases.
A de Winter electrocardiographic pattern caused by left main coronary artery occlusion: A case report
Authors: Zhan Zhong-Qun , Li Yang , Wu Li-Hao , Han Li-Hong
Published: May 2020

A de Winter electrocardiographic (ECG) pattern comprising precordial junctional ST depression followed by tall, positive symmetrical T waves in leads V1/V2 to V4/V6 is often concomitant with ST elevation in lead aVR. This finding strongly suggests proximal left anterior descending coronary artery occlusion. We described a patient who had the de Winter ECG pattern in leads V2 to V4 by acute left main coronary artery (LMCA) occlusion. The ECG also showed maximal ST depression in leads V4 to V5 and inverted T waves in leads V5 to V6. This finding indicated a global subendocardial ischemia ECG pattern, which suggested LMCA or three-vessel disease. Early recognition of this ECG manifestation is important for averting a disastrous prognosis in acute LMCA occlusion because emergent coronary intervention may be life-saving.
Analysis of Overtaking Maneuvers to Cycling Groups on Two-Lane Rural Roads using Objective and Subjective Risk
Authors: López Griselda , Pérez-Zuriaga Ana María , Moll Sara , García Alfredo
Published: June 2020

In Spain, the presence of cyclists’ groups riding on two-lane rural roads in a single file or in parallel line is growing. The number of overtaking maneuvers to them is also increasing. This is one of the most dangerous interactions between motor vehicles and bicycles. However, the risk of these maneuvers has not been analyzed in depth. This research analyzes the objective and subjective risk of overtaking maneuvers to cyclists’ groups. During this maneuver, the motorized vehicle overtakes the bicycles with a certain speed and lateral distance. These are the surrogate measures used to analyze the objective risk, whereas the subjective risk was analyzed based on the subjective risk perception that 10 cyclists riding instrumented bicycles (in different group configurations) indicated when every motor vehicle overtook them. Results show that the cyclists most exposed to the overtaking maneuver are those at the front and at the rear of the group. In relation to the configuration, the risk is higher in parallel lines, as the lateral clearance is lower compared with a single line. It is even higher when the overtaking maneuver is flying, which is usually performed at higher speeds and lower lateral clearance. The subjective risk perception increases with higher speed and lower lateral clearance, and is higher at the rear positions. Overtaking in which lateral distance is less than 1.5 m is perceived as the riskiest. These results provide scientific recommendations to enhance safety for cyclists’ groups, and to integrate cycling with vehicular traffic on two-lane rural roads.
Social Support for Arab People with Chronic Conditions: A Scoping Review
Authors: Alananzeh Ibrahim , Lord Heidi , Fernandez Ritin
Published: June 2020

Social support can play a crucial role in psycho-social well-being of people with chronic conditions. There is limited information about the experiences, barriers and sources of social support of Arab people affected by chronic conditions. The purpose of this review is to explore the experiences, barriers and sources of social support of Arab people affected by chronic conditions. A scoping review of the literature, based on Preferred Reporting Items for Scoping Reviews and Meta-Analyses (PRISMA) guidelines. Articles (n = 13) were identified for appraisal based on a group of inclusion and exclusion criteria. Eight articles were included in the final analysis. Three broad themes were identified: (a) Social support benefits—physical, emotional and financial benefits; (b) Source of social support—family and friends support, and (c) Support services utilization—cultural barrier, Arab migrants language and unfamiliarity with the health system barriers. Appropriate future support programs should be tailored based on Arab cultural beliefs and the inherent responsibility of the family together inside the Arab community.
The Global Impact of COVID-19 on Craniomaxillofacial Surgeons
Authors: van der Tas Justin , Dodson Thomas , Buchbinder Daniel , Fusetti Stefano , Grant Michael , Leung Yiu Yan , Roethlisberger Erich , Aniceto Gregorio Sánchez , Schramm Alexander , Bradley Strong Edward , Wolvius Eppo
Published: May 2020

Study Design:

The COrona VIrus Disease-19 (COVID-19) pandemic has disrupted craniomaxillofacial (CMF) surgeons practice worldwide. We implemented a cross-sectional study and enrolled a sample of CMF surgeons who completed a survey.

Objective:

To measure the impact that COVID-19 has had on CMF surgeons by (1) identifying variations that may exist by geographic region and specialty and (2) measuring access to adequate personal protective equipment (PPE) and identify factors associated with limited access to adequate PPE.

Methods:

Primary outcome variable was availability of adequate PPE for health-care workers (HCWs) in the front line and surgeons. Descriptive and analytic statistics were computed. Level of statistical significance was set at P < .05. Binary logistic regression models were created to identify variables associated with PPE status (adequate or inadequate).

Results:

Most of the respondents felt that hospitals did not provide adequate PPE to the HCWs (57.3%) with significant regional differences ( P = .04). Most adequate PPE was available to surgeons in North America with the least offered in Africa. Differences in PPE adequacy per region ( P < .001) and per country ( P < .001) were significant. In Africa and South America, regions reporting previous virus outbreaks, the differences in access to adequate PPE evaporated compared to Europe ( P = .18 and P = .15, respectively).

Conclusion:

The impact of COVID-19 among CMF surgeons is global and adversely affects both clinical practice and personal lives of CMF surgeons. Future surveys should capture what the mid- and long-term impact of the COVID-19 crisis will look like.
Using generalizability theory to evaluate the comparative reliability of developmental measures in neurogenetic syndrome and low-risk populations
Authors: Hamrick Lisa R. , Haney Alison M. , Kelleher Bridgette L. , Lane Sean P.
Published: June 2020

Background

The lack of available measures that can reliably characterize early developmental skills in children with neurogenetic syndromes (NGS) poses a significant challenge for research on early development in these populations. Although syndrome-specific measures may sometimes be necessary, a more cost- and time-efficient solution would be to identify existing measures that are appropriate for use in special populations or optimize existing measures to be used in these groups. Reliability is an important metric of psychometric rigor to consider when auditing and optimizing assessment tools for NGS. In this study, we use Generalizability Theory, an extension of classical test theory, as a novel approach for more comprehensively characterizing the reliability of existing measures and making decisions about their use in the field of NGS research.

Methods

We conducted generalizability analyses on a popular early social communication screener, the Communication and Symbolic Behavior Scales—Infant-Toddler Checklist (CSBS-ITC), collected on 172 children (41 Angelman syndrome, 30 Prader-Willi syndrome, 42 Williams syndrome, 59 low-risk controls).

Results

Overall, the CSBS-ITC demonstrated at least adequate reliability in the NGS groups included in this study, particularly for the Prader-Willi and Williams syndrome groups. However, the sources of systematic error variance in the CSBS-ITC varied greatly between the low-risk control and NGS groups. Moreover, as unassessed in previous research, the CSBS-ITC demonstrated substantial differences in variance sources among the NGS groups. Reliability of CSBS-ITC scores was highest when averaging across all measurement points for a given child and was generally similar or better in the NGS groups compared to the low-risk control group.

Conclusions

Our findings suggest that the CSBS-ITC communicates different information about the reliability of stability versus change, in low-risk control and NGS samples, respectively, and that psychometric approaches like Generalizability Theory can provide more complete information about the reliability of existing measures and inform decisions about how measures are used in research on early development in NGS.