bluuebunny/crossref_metadata_2025 huggingface dataset:
N-acetylcysteine for adults with acute respiratory distress syndrome: A meta-analysis of randomized controlled trials
Authors: Lu Xin , Ma Yong , He Jianqiang , Li Yi , Zhu Huadong , Yu Xuezhong
Published: January 2019

Background:

Acute respiratory distress syndrome is regarded as a formidable clinical challenge due to its high prevalence and mortality. The treatment of acute respiratory distress syndrome is very complex and difficult. As an adjuvant therapy, the antioxidant N-acetylcysteine has been investigated for several years but the benefit is controversial.

Objectives:

We performed the systematic review and meta-analysis of randomized controlled trials to evaluate the efficacy of N-acetylcysteine on patients with acute respiratory distress syndrome.

Methods:

We searched PubMed, CENTRAL, and CBM databases. Randomized controlled trials comparing the effects of N-acetylcysteine and control were included. Overall mortality was the primary outcome; length of intensive care unit stay, duration of mechanical ventilation, glutathione levels, and PaO2/FiO2 were the secondary outcomes.

Results:

Eight trials with a total of 289 patients were included. Compared to the control group, the N-acetylcysteine group did not lower the overall mortality (risk ratio: 0.83; 95% confidence interval: 0.62 to 1.11; P = 0.21; I2 = 0%). However, N-acetylcysteine significantly shortened intensive care unit stay in the random-effects model (mean difference: –4.47 days; 95% confidence interval: –8.79 to −0.14; P = 0.04; I2 = 46%). Due to substantial heterogeneity and limited number of studies, the data of duration of mechanical ventilation, glutathione levels, and PaO2/FiO2 could not be pooled in the meta-analysis.

Conclusion:

N-acetylcysteine is ineffective in reducing mortality but beneficial for intensive care unit stay. Nonetheless, the effectiveness of N-acetylcysteine for acute respiratory distress syndrome is limited and further research is required before strong recommendations can be made.
Geometrically nonlinear finite element simulation of smart laminated shells using a modified first-order shear deformation theory
Authors: Mallek Hanen , Jrad Hanen , Wali Mondher , Dammak Fakhreddine
Published: January 2019

This article investigates geometrically nonlinear and linear analysis of multilayered shells with integrated piezoelectric materials. An efficient nonlinear shell element is developed to solve piezoelastic response of laminated structure with embedded piezoelectric actuators and sensors. A modified first-order shear deformation theory is introduced in the present method to remove the shear correction factor and improve the accuracy of transverse shear stresses. The electric potential is assumed to be a linear function through the thickness of each active sub-layer. Several numerical tests for different piezolaminated geometries are conducted to highlight the reliability and efficiency of the proposed implementation in linear and geometrically nonlinear finite element analysis.
Experiences of Families With Young Power Wheelchair Users
Authors: Currier Beth A. , Jones Maria A. , DeGrace Beth W.
Published: January 2019

Independent mobility in typically developing infants and young children has been linked to growth in many areas of child development and changes in family behavior and interaction. Research suggests similar benefits in young children with motor disability who use powered mobility. The purpose of this study was to gain an understanding of how families experienced their child’s development, growth, and abilities after using a power wheelchair for 1 year with the intent to generate a preliminary model to capture the process and relationships among these experiences. Eight families participated in interviews, and using grounded theory methodology the research team investigated their experiences. Results informed the development of the preliminary model that framed three key themes: (a) child competence, (b) parenting experience, and (c) the influence of power wheelchair use along with the key category It will help in the long run that titled and anchored the model. This model provides a possible view into how the use of powered mobility may influence development by supporting both child competence and the parenting experience.
Pain Trajectory After Ankle Surgeries for Osteoarthritis
Authors: Guichard Leah , Vanhaesebrouck Alexis , Fletcher Dominique , Stiglitz Yves , Rouquette Alexandra , Martinez Valeria
Published: January 2019

Background:

The pain trajectory after ankle surgeries for osteoarthritis is relevant to describe. The purpose of this prospective study was to describe pain after ankle surgery and explore the link between perioperative factors and the development of postoperative pain.

Methods:

Duration, severity, type of preoperative pain, psychological distress, opioid consumption, and type of surgery were evaluated in 49 patients who were followed for 18 months. Acute postoperative pain in the first 10 days after surgery was modeled by a pain trajectory. Univariate analysis was conducted to identify predictors of acute pain trajectory and chronic pain.

Results:

Eighty-seven percent of patients had preoperative chronic pain, 34% had a high postoperative pain trajectory, 44% of whom reported chronic pain at 18 months. The patients who developed a high acute pain trajectory had higher preoperative opioid consumption (50% vs 19.4%, P = .04), a higher incidence of preoperative neuropathic pain (68.8% vs 32.3%, P = .02), a higher brief pain inventory score (51.5 vs 34, P = .01), and a higher psychological distress score (8 vs 3, P = .002). The patients who developed chronic pain had a higher brief pain inventory score (42 vs 33, P = .04), a higher psychological distress score (6 vs 4, P = .04), and a higher preoperative pain intensity (8 vs 6, P = .008). No association was found between the type of ankle surgery and pain.

Conclusion:

Patients with psychological distress and more severe preoperative pain were more at risk to develop acute pain and chronic pain after ankle surgery regardless of the surgery performed.

Level of Evidence:

Level II, prospective comparative study.
Validation of the Ankle Osteoarthritis Scale Instrument for Preoperative Evaluation of End-Stage Ankle Arthritis Patients Using Item Response Theory
Authors: Liu Guiping , Peterson Alexander C. , Wing Kevin , Crump Trafford , Younger Alastair , Penner Murray , Veljkovic Andrea , Foggin Hannah , Sutherland Jason M.
Published: January 2019

Background:

Significant ankle arthritis results in functional limitations and patient morbidity. There is a need to measure symptoms and the impact of interventions on patient’s quality of life using valid and reliable patient-reported measurement instruments. The objective of this research was to validate the Ankle Osteoarthritis Scale instrument in the preoperative setting using factor analysis, item response theory, and differential item function methods.

Methods:

This research is based on secondary analysis of patients scheduled for ankle arthrodesis or total ankle replacement in Vancouver, Canada. Participants completed the instrument between September 2014 and August 2017. Item response theory was used to estimate item difficulty and discrimination parameters, controlling for study participants’ underlying level of ankle function. Differential item function was examined for sex, age group, and surgery. There were 88 participants.

Results:

Modification indices suggested that item 10, “walking around the house,” would better fit the pain domain rather than the disability domain. Items in the pain domain displayed a range of discrimination and difficulty. Items in the disability domain exhibited a range of discrimination, though the disability domain had low difficulty. Differential item functioning for sex, age group, and ankle arthrodesis or total ankle replacement appeared to be ignorable.

Conclusion:

This evaluation of the Ankle Osteoarthritis Scale found the instrument to be a strong measure of the effect of pain and dysfunction among patients with end-stage ankle arthritis, even when removing items 7 and 8, supporting its prior use in numerous clinical studies.

Level of Evidence:

Level II, prospective comparative study.
Adaptive fault detection of the bearing in wind turbine generators using parameterless empirical wavelet transform and margin factor
Authors: Teng Wei , Wang Wei , Ma Haixing , Liu Yibing , Ma Zhiyong , Mu Haihua
Published: January 2019

Wind turbines revolve in difficult operating conditions due to stochastic loads and produce massive vibration signals, which cause obstacles in detecting potential fault information. To overcome this, an adaptive fault detection approach is presented in this paper on the basis of parameterless empirical wavelet transform (PEWT) and the margin factor. PEWT can decompose the vibration signal into a series of empirical modes (EMs) through splitting its Fourier spectrum, using the scale space method and adaptively constructing an orthogonal wavelet filter bank. The margin factor is utilized as a key metric for automatically selecting the EM which is sensitive to the potential faults. The method presented in this paper will improve the efficiency and accuracy of fault information for the condition monitoring of wind turbines.
Acceleration of tensor-product operations for high-order finite element methods
Authors: Świrydowicz Kasia , Chalmers Noel , Karakus Ali , Warburton Tim
Published: January 2019

This article is devoted to graphics processing unit (GPU) kernel optimization and performance analysis of three tensor-product operations arising in finite element methods. We provide a mathematical background to these operations and implementation details. Achieving close to peak performance for these operators requires extensive optimization because of the operators’ properties: low arithmetic intensity, tiered structure, and the need to store intermediate results during the kernel execution. We give a guided overview of optimization strategies and we present a performance model that allows us to compare the efficacy of these optimizations against an empirically calibrated roofline.
A nation of families: traditional indigenous kinship, the foundation for Cheyenne sovereignty
Authors: Killsback Leo Kevin
Published: January 2019

One of the major destructive forces to American Indian peoples were the assimilation-based policies that destroyed traditional kinship systems and family units. This destruction contributed to the cycle of dysfunction that continues to plague families and homes in Indian country. A second major destructive blow occurred when colonial forces, through law and policy, reinforced white male patriarchal kinship and family systems. In this colonial system, American Indian concepts, roles, and responsibilities associated with fatherhood and motherhood were devalued and Indian children grew up with a dysfunctional sense of family and kinship. This article examines the traditional kinship system of the Cheyenne Indians, highlighting the importance of kinship terms, roles, and responsibilities. The traditional Cheyenne kinship system emphasized familial relationships for the sake of childrearing and imparting traditional values of respect, reciprocity, and balance. Traditional principles of heške’estovestôtse (motherhood), héhe’estovestôtse (fatherhood), and méhósánestôtse (love) were the backbone of the Cheyenne family.
The place of human rights in the foreign policy of Cameron’s conservatives: Sceptics or enthusiasts?
Authors: Beech Matt , Munce Peter
Published: January 2019

The purpose of this article is to explain the place of human rights in the foreign policy thinking of David Cameron’s Conservatives (2005–2016). The article asks three interrelated questions: First, what role has human rights come to acquire in international political discourse? Second, did the Conservative Party’s view on the place of human rights result in a change to their approach to foreign policy on humanitarian intervention? Third, to what extent was there a tension between increasing scepticism towards the Human Rights Act and the jurisdiction of the European Court of Human Rights and the Conservative Party’s approach to foreign policy? The authors employ a mixed methodological approach which combines hermeneutic textual analysis of speeches from leading Conservatives with semi-structured, elite interview material from four former Conservative Foreign Secretaries.
Aluminium alloy channels subjected to web crippling
Authors: Zhou Feng , Young Ben
Published: January 2019

This article reports experimental and numerical investigations of aluminium alloy plain and lipped channels subjected to web crippling. A total of 240 data are presented that include 24 test results and 216 numerical results. A series of tests was conducted first on channels fabricated by extrusion using 6063-T5 and 6061-T6 heat-treated aluminium alloys under end-two-flange and interior-two-flange loading conditions. The concentrate transverse loads were applied by means of bearing plates. The flanges of the specimens were not fastened (unrestrained) to the bearing plates. A non-linear finite element model is then developed and verified against experimental results. Geometric and material non-linearities were included in the finite element model. It was shown that the finite element model closely predicted the web crippling strengths and failure modes of the tested specimens. Hence, the model was used for an extensive parametric study of cross-section geometries, and the web slenderness value ranged from 24.0 to 207.3. The test results and the web crippling strengths predicted from the finite element analysis were compared with the design strengths obtained using the American, Australian/New Zealand and European specifications for aluminium structures. An empirical unified web crippling equation with new coefficients for aluminium alloy channels under end-two-flange and interior-two-flange loading conditions is proposed. Since two failure modes of web buckling and web yielding were observed in the tests, the web crippling strength is also predicted using the proposed theoretical design rules for channels. The web crippling strength is the lesser of the web buckling strength and web yield strength.
Turning on the tap: the benefits of using ‘real-life’ vignettes in qualitative research interviews
Authors: Sampson Helen , Johannessen Idar Alfred
Published: January 2019

The use of vignettes that are based upon fictionalised accounts is well-established in contemporary social science. Vignettes have been used in a variety of ways to contribute to studies with both a quantitative and a qualitative orientation. This paper reflects on two recent qualitative studies which have made innovative use of ‘real-life’ vignettes. In each case, the paper describes some of the unanticipated and overlapping benefits that accrued from their incorporation into the research design and reflects on the advantages that ‘real-life’ vignettes might bring to future research. Drawing on two different research projects, the paper highlights the further potential contribution of ‘real-life’ vignettes to the repertoire of research methods currently available to social scientists.
Exploring and modelling team performances of the Kaggle European Soccer database
Authors: Carpita Maurizio , Ciavolino Enrico , Pasca Paola
Published: January 2019

This study explores a big and open database of soccer leagues in 10 European countries. Data related to players, teams and matches covering seven seasons (from 2009/2010 to 2015/2016) were retrieved from Kaggle, an online platform in which big data are available for predictive modelling and analytics competition among data scientists. Based on both preliminary data analysis, experts’ evaluation and players’ position on the football pitch, role-based indicators of teams’ performance have been built and used to estimate the win probability of the home team with the binomial logistic regression (BLR) model that has been extended including the ELO rating predictor and two random effects due to the hierarchical structure of the dataset.

The predictive power of the BLR model and its extensions has been compared with the one of other statistical modelling approaches (Random Forest, Neural Network, k-NN, Naïve Bayes). Results showed that role-based indicators substantially improved the performance of all the models used in both this work and in previous works available on Kaggle. The base BLR model increased prediction accuracy by 10 percentage points, and showed the importance of defence performances, especially in the last seasons. Inclusion of both ELO rating predictor and the random effects did not substantially improve prediction, as the simpler BLR model performed equally good. With respect to the other models, only Naïve Bayes showed more balanced results in predicting both win and no-win of the home team.
Gaia’s Graveyards – Bearing witness as first person inquiry
Authors: Kettleborough Helena Mary
Published: January 2019

Humanity is overwhelmingly in denial about the ‘biological annihilation’ facing the other species on the planet, heirs to a 13.8 billion year shared history. This paper argues that these questions can be addressed through action research, an ethical research practice, focused on issues of pressing concern to humans and the ecological communities of which they are part. At the heart of the paper is a story, which takes the reader on the author’s 20-year journey to cross a threshold into empathy with the more-than-human world. The story is presented as a worked example of a first person practice demonstrating how, in the face of denial within us all, it is possible to stop, bear witness and to seek positive outcomes. Located within action research and its qualities, the characteristics of bearing witness are explored, resulting in a potential definition, description and critical appreciation. Finally the paper argues that first person inquiry into bearing witness needs to become a bedrock for practice across society and offers recommendations for how this might be achieved.
A monocular vision–based perception approach for unmanned aerial vehicle close proximity transmission tower inspection
Authors: Bian Jiang , Hui Xiaolong , Zhao Xiaoguang , Tan Min
Published: January 2019

Employing unmanned aerial vehicles to conduct close proximity inspection of transmission tower is becoming increasingly common. This article aims to solve the two key problems of close proximity navigation—localizing tower and simultaneously estimating the unmanned aerial vehicle positions. To this end, we propose a novel monocular vision–based environmental perception approach and implement it in a hierarchical embedded unmanned aerial vehicle system. The proposed framework comprises tower localization and an improved point–line-based simultaneous localization and mapping framework consisting of feature matching, frame tracking, local mapping, loop closure, and nonlinear optimization. To enhance frame association, the prominent line feature of tower is heuristically extracted and matched followed by the intersections of lines are processed as the point feature. Then, the bundle adjustment optimization leverages the intersections of lines and the point-to-line distance to improve the accuracy of unmanned aerial vehicle localization. For tower localization, a transmission tower data set is created and a concise deep learning-based neural network is designed to perform real-time and accurate tower detection. Then, it is in combination with a keyframe-based semi-dense mapping to locate the tower with a clear line-shaped structure in 3-D space. Additionally, two reasonable paths are planned for the refined inspection. In experiments, the whole unmanned aerial vehicle system developed on Robot Operating System framework is evaluated along the paths both in a synthetic scene and in a real-world inspection environment. The final results show that the accuracy of unmanned aerial vehicle localization is improved, and the tower reconstruction is fast and clear. Based on our approach, the safe and autonomous unmanned aerial vehicle close proximity inspection of transmission tower can be realized.
Conducting clinical trials—costs, impacts, and the value of clinical trials networks: A scoping review
Authors: Bentley Colene , Cressman Sonya , van der Hoek Kim , Arts Karen , Dancey Janet , Peacock Stuart
Published: January 2019

Background

A significant barrier to conducting clinical trials is their high cost, which is driven primarily by the time and resources required to activate trials and reach accrual targets. The high cost of running trials has a substantial impact on their long-term feasibility and the type of clinical research undertaken.

Methods

A scoping review of the empirical literature on the costs associated with conducting clinical trials was undertaken for the years 2001–2015. Five reference databases were consulted to elicit how trials costs are presented in the literature. A review instrument was developed to extract the content of in-scope papers. Findings were characterized by date and place of publication, clinical disease area, and network/cooperative group designation, when specified. Costs were captured and grouped by patient accrual and management, infrastructure, and the opportunity costs associated with industry funding for trials research. Cost impacts on translational research and health systems were also captured, as were recommendations to reduce trial expenditures. Since articles often cited multiple costs, multiple cost coding was used during data extraction to capture the range and frequency of costs.

Results

A total of 288 empirical articles were included. The distribution of reported costs was: patient management and accrual costs (132 articles), infrastructure costs (118 articles) and the opportunity costs of industry sponsorship (72 articles). 221 articles reported on the impact of undertaking costly trials on translational research and health systems; of these, the most frequently reported consequences were to research integrity (52% of articles), research capacity (36% of articles) and running low-value trials (34% of articles). 254 articles provided recommendations to reduce trial costs; of these, the most frequently reported recommendations related to improvements in: operational efficiencies (33% of articles); patient accrual (24% of articles); funding for trials and transparency in trials reporting (18% of articles, each).

Conclusion

Key findings from the review are: 1) delayed trial activation has costs to budgets and research; 2) poor accrual leads to low-value trials and wasted resources; 3) the pharmaceutical industry can be a pragmatic, if problematic, partner in clinical research; 4) organizational know-how and successful research collaboration are benefits of network/cooperative groups; and 5) there are spillover benefits of clinical trials to healthcare systems, including better health outcomes, enhanced research capacity, and drug cost avoidance. There is a need for more economic evaluations of the benefits of clinical research, such as health system use (or avoidance) and health outcomes in cities and health authorities with institutions that conduct clinical research, to demonstrate the affordability of clinical trials, despite their high cost.
Therapeutic challenges in the treatment of systemic inflammatory disease in pregnancy
Authors: Fredrickson Jared S , Kolfenbach Jason R , Holmes Jennifer L , Cathcart Jennifer N , Lynch Anne M , Palestine Alan G
Published: January 2019

Background

Granulomatosis with polyangiitis and Behçet’s disease can occur during pregnancy and may be treated by ophthalmologists, rheumatologists, and obstetricians. We hypothesized that specialty training would affect the way physicians selected therapy.

Methods

Using an online questionnaire, 209 uveitis specialists, 853 rheumatologists, and 2500 obstetricians were surveyed. Respondents were given clinical vignettes containing a female patient who was contemplating pregnancy or in the first trimester and was diagnosed with granulomatosis with polyangiitis or Behçet’s disease.

Results

In the patient with granulomatosis with polyangiitis, therapy choice between specialties for biologic versus non-biologic systemic immunosuppressive medications was significantly different for both the non-pregnant and pregnant patient (p < 0.00001, p < 0.00003). In the non-pregnant patient diagnosed with Behçet’s disease, the therapy choice between biologic versus non-biologic medications was also significantly different (p < 0.0003).

Conclusions

Specialty training affects how physicians manage granulomatosis with polyangiitis and Behçet’s disease. Development of inter-specialty guidelines and treatment plans may improve outcomes, communication, and patient care.
Morphological effect of titanate nanostructures on the photocatalytic degradation of crystal violet
Authors: Rashad Shimaa , Zaki A.H. , Farghali A.A.
Published: January 2019

The heterogeneous photocatalysis using semiconductor nanocrystals is an important process in the field of water treatment since it is a low cost, environmentally friendly, and zero waste technique. In this work, titanate nanostructures (sheets, tubes, and wires) were prepared by simple hydrothermal method. All samples were characterized by X-ray diffraction, transmission electron microscopy, Brunauer–Emmett–Teller surface area analysis, and Zetasizer. The results revealed that tuning the morphology of TiO2 changed the activity of the prepared nanostructures, where titanate nanowires exhibited the highest photocatalytic activity toward crystal violet dye, reaching 100% at pH 3 under ultraviolet illumination for 35 min.
Utilization of a Standardized Post-Occupancy Evaluation to Assess the Guiding Principles of a Major Academic Medical Center
Authors: Altizer Zack , Canar William J. , Redemske Dave , Fullam Francis , Lamont Mike
Published: January 2019

Facility planning for healthcare organizations has become increasingly important in recent years, due primarily to the complicated needs of patient rooms and the escalating pressure to provide high-quality care to satisfy patients. Concurrently, there has been a considerable development in the field of evidence-based design (EBD) on the impact the healthcare environment has on patients and the operations of clinical staff. Although tools are being developed to assist in measuring EBD principles, they have not been universally adopted by organizations regarding how they either develop or assess healthcare facilities. This case study focuses on our attempt to implement an internal facilities evaluation process and a Post-Occupancy Evaluation (POE) on a major Academic Medical Center’s (AMC) new bed tower. An assembled auditing team comprised of diverse professional healthcare backgrounds performed an audit on three patient rooms using a Center for Health Design POE Questionnaire. The results of this evaluation were then compared to the guiding principles developed for the hospital during its design. Results indicated that the project narrowly missed the threshold score agreed upon by the AMC’s facilities leadership. This project demonstrated the difficulty in implementing a POE without prior experience, while highlighting the value of a standardized evaluation tool to assess past and future facilities projects.
Fructosuria and recurrent hypoglycemia in a patient with a novel c.1693T>A variant in the 3′ untranslated region of the aldolase B gene
Authors: Morales-Alvarez Martha Catalina , Ricardo-Silgado Maria Laura , Lemus Hernan Nicolas , González-Devia Deyanira , Mendivil Carlos O
Published: January 2019

Hereditary fructose intolerance, caused by mutations in the ALDOB gene, is an unusual cause of hypoglycemia. ALDOB encodes the enzyme aldolase B, responsible for the hydrolysis of fructose 1-phosphate in the liver. Here, we report the case of a 33-year-old female patient who consulted due to repetitive episodes of weakness, dizziness and headache after food ingestion. An ambulatory 72-h continuous glucose monitoring revealed multiple short hypoglycemic episodes over the day. After biochemical exclusion of other endocrine causes of hypoglycemia, hereditary fructose intolerance seemed a plausible diagnosis. Repeated measurements of urinary fructose revealed pathologic fructosuria, but genetic testing for the three most common mutations in ALDOB resulted negative. We decided to perform complete Sanger sequencing of the ALDOB gene and encountered a variant consisting of a T>A substitution in position 1963 of the ALDOB transcript (c.1693T>A). This position is located within the 3′ untranslated region of exon 9, 515 nucleotides downstream the stop codon. After complete withdrawal of dietary fructose and sucrose, the patient presented no new hypoglycemic episodes.
Lithium: contributor to movement disorder sensitivity after anoxic brain injury?
Authors: Pikard Jennifer L , Oliver Dijana , Saraceno Justin , Groll Dianne
Published: January 2019

Although lithium-induced dystonia has been well documented in the literature, conflicting evidence discusses whether a patient may be susceptible to adverse effects from the drug after an anoxic brain injury. More recent literature discusses that lithium may, in fact, be neuroprotective. This case report presents a 35-year-old male who, after an anoxic brain injury after a suicide attempt, developed lithium-induced dystonia with characteristic symptoms of sustained muscle contractions, repetitive movements, and postures, which was not markedly improved with benztropine or benzodiazepines. It is postulated that because this patient received a depot neuroleptic with a subsequent anoxic brain injury, he may have become more sensitive to lithium and its rare complications.
Survivin and insulin-like growth factor-I: potential role in the pathogenesis of acne and post-acne scar
Authors: El-Tahlawi Samar , Ezzat Mohammad Noha , Mohamed El-Amir Azza , Sayed Mohamed Heba
Published: January 2019

Backgrounds/objectives:

Acne is an inflammatory disease of the pilosebaceous unit (PSU). The over-expression of survivin and insulin-like growth factor (IGF)-I in some fibrotic disorders suggests a possible implication in the pathogenesis of acne and or post-acne scar. We aimed to evaluate their potential role in pathogenesis in acne and post-acne scar.

Methods:

Serum survivin and IGF-I levels were estimated in 30 patients with acne and post-acne scar compared to 30 controls.

Results:

There was a statistically significant difference in survivin and IGF-I levels between controls and patients ( P < 0.05). However, there was no linear correlation between survivin and IGF-I.

Conclusions:

Survivin and IGF-I could have a possible role in the pathogenesis of active acne and in post-inflammatory acne scar.
Factors Influencing eSports Viewership: An Approach Based on the Theory of Reasoned Action
Authors: Xiao Min
Published: January 2019

The current study employs the theory of reasoned action to examine factors that correlate with the behavioral intentions of watching eSports. A structural equation modeling analysis is performed to examine the relationship between intentions to watch eSports, attitude toward watching eSports, subjective norms, behavioral beliefs, and normative beliefs. The results suggested that three behavioral beliefs-related factors (aesthetics, drama, and escapism) and subjective norms were positively related to attitude toward watching eSports. Normative beliefs positively influenced subjective norms. Finally, attitude toward watching eSports positively influenced behavioral intention.
A Conceptual Framework of Antecedents of Service Loyalty in Health Care: Patients’ Perspective
Authors: George Ajimon , Sahadevan Jobin
Published: January 2019

As the health care sector in India is becoming more and more competitive, researchers and practitioners are getting increasingly interested in exploring how post-purchase behaviour of patients can be managed and high level of patient loyalty can be ensured. Patient loyalty has gained immense importance in health care service sector in India because of the drastic changes that have taken place in health care market in the last two decades. Today, the health care market is characterized by intense competition and specialization. Hospital management is increasingly recognizing the need to focus on patient loyalty as a means to achieve profitability and also to improve their competitive position. In this article, we theoretically explore the relationship of the antecedents of patient loyalty (service quality, perceived value, corporate image and perceived price fairness) and its outcomes (patients’ satisfaction and patient loyalty). The outcome of this research is a conceptualization of antecedents of patients’ loyalty in the context of health care supported by research propositions based on the existing literature. The article contributes to the existing literature a hypothesized model that permits the examination of consumer behavioural procedures with regard to service quality, perceived value, perceived price fairness, corporate image, patient satisfaction and patient loyalty. Exploring these processes through empirical studies in future will provide new insights, which will help hospital management retain existing customers and attract new customers.
Adherence to Recommendations from Comprehensive Geriatric Assessment of Older Individuals with HIV
Authors: Bitas Christiana , Jones Sian , Singh Harjot Kaur , Ramirez Mildred , Siegler Eugenia , Glesby Marshall
Published: January 2019

This retrospective cohort study sought to assess the effectiveness of comprehensive geriatric assessment (CGA) for older patients at an HIV clinic in a large US city. We systematically reviewed medical records of all patients who underwent CGA from June 2013 to July 2017. In addition, physicians and social workers completed an anonymous survey about the impact of CGA on their patients. For the 76 patients (median age 67.2; Q1, Q3 = 60.9, 72.6) seen by geriatricians at the clinic, there were 184 recommendations, 54 instances of counseling, and 11 direct actions. Overall adherence to recommendations was 32.8%, 34.9% for patient-directed, and 31.7% for provider-directed recommendations. No demographic or CGA variables were associated with adherence. Despite this lack of adherence, surveyed providers reported that they usually or always followed recommendations; the most frequently cited barrier to implementation was lack of feasibility. Further research will be needed to determine how CGA can improve outcomes for this population.
Comparison of Frequency Transposition and Frequency Compression for People With Extensive Dead Regions in the Cochlea
Authors: Salorio-Corbetto Marina , Baer Thomas , Moore Brian C. J.
Published: January 2019

The objective was to determine the effects of two frequency-lowering algorithms (frequency transposition, FT, and frequency compression, FC) on audibility, speech identification, and subjective benefit, for people with high-frequency hearing loss and extensive dead regions (DRs) in the cochlea. A single-blind randomized crossover design was used. FT and FC were compared with each other and with a control condition (denoted ‘Control’) without frequency lowering, using hearing aids that were otherwise identical. Data were collected after at least 6 weeks of experience with a condition. Outcome measures were audibility, scores for consonant identification, scores for word-final /s, z/ detection ( S test), sentence-in-noise intelligibility, and a questionnaire assessing self-perceived benefit (Spatial and Qualities of Hearing Scale). Ten adults with steeply sloping high-frequency hearing loss and extensive DRs were tested. FT and FC improved the audibility of some high-frequency sounds for 7 and 9 participants out of 10, respectively. At the group level, performance for FT and FC did not differ significantly from that for Control for any of the outcome measures. However, the pattern of consonant confusions varied across conditions. Bayesian analysis of the confusion matrices revealed a trend for FT to lead to more consistent error patterns than FC and Control. Thus, FT may have the potential to give greater benefit than Control or FC following extended experience or training.
Involving Public Health Graduate Students and Trainees in the Scholarship of Teaching and Learning
Authors: Walker Elizabeth Reisinger , Lang Delia L. , Woodruff Rebecca C.
Published: January 2019

As the scholarship of teaching and learning (SoTL) research expands in schools of public health to inform pedagogic and curricular approaches, it is crucial to consider how student voices are included in this work. Based on our experience with course-level and curriculum-level evaluations, we describe the process, benefits, and challenges of engaging students and pre- and postdoctoral trainees in SoTL. The degree of student and trainee involvement can vary based on interest, availability, and level of training. Graduate student roles can range from research support to full collaboration. Due to their advanced training, pre- and postdoctoral trainees can take a lead role in SoTL projects. Engaging students and trainees provides multiple benefits. First, the students and trainees gain experience on a research team; second, faculty have support to feasibly conduct SoTL; and third, programs can evolve by gaining in-depth information about courses and curricula. Challenges include student and trainee availability, turnover as students graduate, and availability of resources. Additional factors to consider are how students and trainees are chosen to participate and power differentials between students and faculty. Involving graduate students and trainees in SoTL facilitates the evaluation of pedagogical approaches and has the potential to contribute to the development of a strong evidence base for effective teaching models in public health education.
Outcomes in adulthood of adoption after long-term foster care: A sibling study
Authors: Hjern Anders , Vinnerljung Bo , Brännström Lars
Published: January 2019

Prior research has reported a positive impact of adoption on developmental outcomes for children with experience of foster care. To inform decisions about permanent care arrangements, we used Swedish national population registers to create a sibling population consisting of 194 children born 1973–1982 who had been in out-of-home care (OHC) at least 5 years before adolescence but were never adopted (50% boys) and their 177 maternal birth siblings who also had been in OHC at least 5 years before their teens but were adopted before adolescence (52.5% boys). We constructed 14 outcome variables spanning social, educational, and health outcomes in adult age with information from Swedish national registers. Based on multilevel logistic random effects and fixed effects regression models (supplemented with a sensitivity analysis assessing the potential impact of unobserved confounding), results showed that adopted siblings tended to have considerably better outcomes in adult age in educational achievement, income, criminality, disability, and suicidality. Outcomes related to mental health and substance abuse were more similar, but differences pointed in the same direction. Implications for child welfare policy and practice are discussed.
Use of videotaped personal compulsions to enhance motivation in obsessive–compulsive disorder
Authors: du Mortier Johanna A. M. , Visser Henny A. D. , van Geijtenbeek - de Vos van Steenwijk Malinda F. R. , van Megen Harold J. G. M. , van Balkom Anton J. L. M.
Published: January 2019

Background

Watching videotaped personal compulsions together with a therapist might enhance the effect of cognitive–behavioural therapy in obsessive–compulsive disorder (OCD) but little is known about how patients experience this.

Aims

To performed a qualitative study that describes how watching these videos influences motivation for treatment and whether patients report any adverse events.

Method

In this qualitative study, data were gathered in semi-structured interviews with 24 patients with OCD. The transcripts were coded by two researchers. They used a combination of open and thematic coding and discrepancies in coding were discussed.

Results

The experience of watching videos with personal compulsions helped patients to realise that these compulsions are aberrant and irrational. Patients report increased motivation to resist their OCD and to adhere to therapy. No adverse events were reported.

Conclusions

Videos with personal compulsions create more awareness in patients with OCD that compulsions are irrational, leading to enhanced motivation for treatment.

Declaration of interest

None.
Regional-specific endodermal signals direct neural crest cells to form the three middle ear ossicles
Authors: Ankamreddy Harinarayana , Min Hyehyun , Kim Jae Yoon , Yang Xiao , Cho Eui-Sic , Kim Un-Kyung , Bok Jinwoong
Published: January 2019

Defects in the middle ear ossicles - malleus, incus, and stapes - can lead to conductive hearing loss. During development, neural crest cells (NCCs) migrate from the dorsal hindbrain to specific locations in pharyngeal arch (PA) 1 and 2, to form the malleus-incus and stapes, respectively. It is unclear how migratory NCCs reach their proper destination in PA and initiate mesenchymal condensation to form specific ossicles. We show that secreted molecules sonic hedgehog (SHH) and bone morphogenetic protein 4 (BMP4) emanating from the pharyngeal endoderm are important in instructing regional-specific NCC condensation to form malleus-incus and stapes, respectively. Tissue-specific knockout of Shh in the pharyngeal endoderm or Smoothened (a transducer of SHH signaling) in NCCs causes the loss of malleus-incus condensation in PA1 but only affects the maintenance of stapes condensation in PA2. By contrast, knockout of Bmp4 in the pharyngeal endoderm or Smad4 (a transducer of TGF-β/BMP signaling) in the NCCs disrupts NCC migration into the stapes region in PA2, affecting the stapes formation. These results indicate that regional-specific endodermal signals direct formation of specific middle ear ossicles.
Co-option of the PRDM14–CBFA2T complex from motor neurons to pluripotent cells during vertebrate evolution
Authors: Kawaguchi Masanori , Sugiyama Kota , Matsubara Kazumi , Lin Che-Yi , Kuraku Shigehiro , Hashimoto Shota , Suwa Yoshiaki , Yong Luok Wen , Takino Koji , Higashida Shota , Kawamura Daisuke , Yu Jr-Kai , Seki Yoshiyuki
Published: January 2019

Gene regulatory networks underlying cellular pluripotency are controlled by a core circuitry of transcription factors in mammals, including POU5F1. However, the evolutionary origin and transformation of pluripotency-related transcriptional networks have not been elucidated in deuterostomes. PR domain-containing protein 14 (PRDM14) is specifically expressed in pluripotent cells and germ cells, and required for establishing embryonic stem cells (ESCs) and primordial germ cells in mice. Here, we compared the functions and expression patterns of PRDM14 orthologues within deuterostomes. Amphioxus PRDM14 and zebrafish PRDM14, but not sea urchin PRDM14, compensated for mouse PRDM14 function in maintaining mouse ESC pluripotency. Interestingly, sea urchin PRDM14 together with sea urchin CBFA2T, an essential partner of PRDM14 in mouse ESCs, complemented the self-renewal defect in mouse Prdm14 KO ESCs. Contrary to the Prdm14-expression pattern in mouse embryos, Prdm14 was expressed in motor neurons of amphioxus embryos as observed in zebrafish embryos. Thus, Prdm14 expression in motor neurons was conserved in non-tetrapod deuterostomes and the co-option of the PRDM14-CBFA2T complex from motor neurons into pluripotent cells may have maintained the transcriptional network for pluripotency during vertebrate evolution.
Recent advances in understanding and managing acute pancreatitis
Authors: Mandalia Amar , Wamsteker Erik-Jan , DiMagno Matthew J.
Published: January 2019

This review highlights advances made in recent years in the diagnosis and management of acute pancreatitis (AP). We focus on epidemiological, clinical, and management aspects of AP. Additionally, we discuss the role of using risk stratification tools to guide clinical decision making. The majority of patients suffer from mild AP, and only a subset develop moderately severe AP, defined as a pancreatic local complication, or severe AP, defined as persistent organ failure. In mild AP, management typically involves diagnostic evaluation and supportive care resulting usually in a short hospital length of stay (LOS). In severe AP, a multidisciplinary approach is warranted to minimize morbidity and mortality over the course of a protracted hospital LOS. Based on evidence from guideline recommendations, we discuss five treatment interventions, including intravenous fluid resuscitation, feeding, prophylactic antibiotics, probiotics, and timing of endoscopic retrograde cholangiopancreatography (ERCP) in acute biliary pancreatitis. This review also highlights the importance of preventive interventions to reduce hospital readmission or prevent pancreatitis, including alcohol and smoking cessation, same-admission cholecystectomy for acute biliary pancreatitis, and chemoprevention and fluid administration for post-ERCP pancreatitis. Our review aims to consolidate guideline recommendations and high-quality studies published in recent years to guide the management of AP and highlight areas in need of research.
Complete assembly of a dengue virus type 3 genome from a recent genotype III clade by metagenomic sequencing of serum
Authors: Dias Mary , Pattabiraman Chitra , Siddappa Shilpa , Gowda Malali , Shet Anita , Smith Derek , Muehlemann Barbara , Tamma Krishnapriya , Solomon Tom , Jones Terry , Krishna Sudhir
Published: January 2019

Background:Mosquito-borne flaviviruses, such as dengue and Japanese encephalitis virus (JEV), cause life-threatening diseases, particularly in the tropics.

Methods:Here we performed unbiased metagenomic sequencing of RNA extracted from the serum of four patients and the plasma of one patient, all hospitalized at a tertiary care centre in South India with severe or prolonged febrile illness, together with the serum from one healthy control, in 2014.

Results:We identified and assembled a complete dengue virus type 3 sequence from a case of severe dengue fever. We also identified a small number of JEV sequences in the serum of two adults with febrile illness, including one with severe dengue. Phylogenetic analysis revealed that the dengue sequence belonged to genotype III. It has an estimated divergence time of 13.86 years from the most highly related Indian strains. In total, 11 amino acid substitutions were predicted for this strain in the antigenic envelope protein, when compared to the parent strain used for development of the first commercial dengue vaccine. 

Conclusions:We demonstrate that both genome assembly and detection of a low number of viral sequences are possible through the unbiased sequencing of clinical material. These methods may help ascertain causal agents for febrile illnesses with no known cause.