bluuebunny/crossref_metadata_2025 huggingface dataset:
Trunk Dynamic Stability Assessment for Individuals With and Without Nonspecific Low Back Pain During Repetitive Movement
Authors: Asgari Morteza , Mokhtarinia Hamid Reza , Sanjari Mohammad Ali , Kahrizi Sedighe , Philip Gabel Charles , Parnianpour Mohamad , Khalaf Kinda
Published: July 2020

Objective

This study aimed to employ nonlinear dynamic approaches to assess trunk dynamic stability with speed, symmetry, and load during repetitive flexion-extension (FE) movements for individuals with and without nonspecific low back pain (NSLBP).

Background

Repetitive trunk FE movement is a typical work-related LBP risk factor contingent on speed, symmetry, and load. Improper settings/adjustments of these control parameters could undermine the dynamic stability of the trunk, hence leading to low back injuries. The underlying stability mechanisms and associated control impairments during such dynamic movements remain elusive.

Method

Thirty-eight male volunteers (19 healthy, 19 NSLBP) enrolled in the current study. All participants performed repetitive trunk FE movements at high/low speeds, in symmetric/asymmetric directions, with/without a wearable loaded vest. Trunk instantaneous rotation angle was computed for each trial to be assessed in terms of local and orbital stability, using maximum finite-time Lyapunov exponents (LyEs) and Floquet multipliers (FMs), respectively.

Results

Both groups demonstrated equivalent competency in terms of trunk control and stability, suggesting functional adaptation strategies may be used by the NSLBP group. Wearing the loaded vest magnified the effects of trunk control impairment for the NSLBP group. The combined presence of high-speed and symmetrical FE movements was associated with least trunk local stability.

Conclusion

Nonlinear dynamic techniques, particularly LyE, are potentially effective for assessing trunk dynamic stability dysfunction for individuals with NSLBP during various activities.

Application

This work can be applied toward the development of quantitative personalized spinal evaluation tools with a wide range of potential occupational and clinical applications.
The moderating role of a city’s institutional capital and people’s migration status on career success in China
Authors: Guo Liang , Baruch Yehuda
Published: July 2020

This article explores the role of cities’ institutional capital in the context of massive waves of migration from rural regions to cities in China. We examine reasons for and consequences of the accelerated urbanization process from both social and individual points of view. Based on surveys using a database of 8113 Chinese people, we identify and analyse factors that influence career success according to their migration status, comparing those who have migrated from rural to urban areas with those who have not moved. We also identify the role of an individual’s migration status and the role of a city’s institutional capital as moderators of the relationships between human, social capital and career success. We find that human, social and institutional capital, both individually and interactively play important roles in career success. The article offers an original contribution to career theory, in particular by incorporating migration status as a novel factor, and by determining the role of a city’s institutional capital in the process. With these overwhelming structural changes in populations, it may also inform internal migration policy and its implementation.
Cardiovascular effects of repeated subanaesthetic ketamine infusion in depression
Authors: Zhou Yan-Ling , Liu Wei-Jian , Wang Cheng-Yu , Zheng Wei , Lan Xiao-Feng , Weng Sui-Yun , Ning Yu-Ping
Published: July 2020

Background:

Ketamine produces significant rapid-onset and robust antidepressant effects in patients with major depressive disorder. However, this drug also has transient cardiovascular stimulatory effects, and there are limited data about potential predictors of these cardiovascular effects.

Methods:

A total of 135 patients with unipolar and bipolar depression received a total of 741 ketamine infusions (0.5 mg/kg over 40 min). Blood pressure and pulse were monitored every 10 min during the infusions and 30 min after the infusions. Depressive, psychotomimetic and dissociative symptom severity was assessed at baseline and 4 hours after each infusion.

Results:

The maximum blood pressure and pulse values were observed at 30–40 min during infusions. The largest mean systolic/diastolic blood pressure increases were 7.4/6.0 mmHg, and the largest mean pulse increase was 1.9 beats per min. No significant change in blood pressure and pulse was found in the second to sixth infusions compared with the first infusion. Patients who were older (age⩾50 years), hypertensive and receiving infusions while exhibiting dissociative symptoms showed greater maximal changes in systolic and diastolic blood pressure than patients who were younger (age<50 years), normotensive and without dissociative symptoms (all p < 0.05). Hypertensive patients had less elevation of pulse than normotensive patients ( p < 0.05). Ketamine dosage was positively correlated with changes in systolic and diastolic blood pressure (all p < 0.05).

Conclusions:

Blood pressure and pulse elevations following subanaesthetic ketamine infusions are transient and do not cause serious cardiovascular events. Older age, hypertension, large ketamine dosage and dissociative symptoms may predict increased ketamine-induced cardiovascular effects.
Art as praxis: Danko Grlić’s conception of art beyond technological determinism
Authors: Hočevar Marko
Published: July 2020

The article explores the specific conception of art developed by Danko Grlić, a prominent member of the Yugoslav Praxis School. Grlić conceptualised art beyond both aesthetic norms and technological determinism. Within the context of praxis philosophy, a distinct theory of the subject and a Marxist humanist approach, he reconceptualised art as a distinct type of praxis, a revolutionary and creative practice of changing existing living conditions. The article explains how his unique understanding of art leads Grlić to analyse, criticise and refute various Marxist approaches to art: art as an ideology, art as a reflection of the objective world, art as sociological analysis. Moreover, while sharing many ideas and conceptions with Walter Benjamin’s materialist conception of art, Grlić reached the point where he became critical due to Benjamin’s belief in technology concerning processes of emancipation, which Grlić viewed with scepticism.
Career Development Impacts of COVID-19: Practice and Policy Recommendations
Authors: Autin Kelsey L. , Blustein David L. , Ali Saba R. , Garriott Patton O.
Published: July 2020

The advent of the COVID-19 pandemic has resulted in drastic changes to employment around the globe. In the present article, we identify four emerging impacts of the pandemic and how career development professionals might respond through policy and practice. Specifically, we focus on four distinct but related domains: unemployment, worker mental health, the work–family interface, and employment disparities. For each domain, we offer recommendations for policy and practice with the hope that career development professionals might reframe the COVID-19 crisis as an opportunity for a renewed commitment to supporting worker well-being.
The fundamental effects of in-cylinder evaporation of liquefied natural gas fuels in engines
Authors: Finneran Joshua , Garner Colin P , Nadal Francois
Published: July 2020

Liquefied natural gas is emerging as viable and potentially sustainable transportation fuel with intrinsic economic and environmental benefits. Liquefied natural gas possesses thermomechanical exergy amounting to ∼1 MJ kg-1 which is currently wasted on liquefied natural gas vehicles, while it could be used to produce useful work. The present investigation proposes an indirect means of obtaining useful work from liquefied natural gas through charge cooling and also demonstrates additional benefits in terms of NOx emissions and power density. A thermodynamic engine model was used to quantify the performance benefits of such a strategy for a homogeneous-charge, spark-ignited, stoichiometric natural gas engine. Four fuelling strategies were compared in terms of fuel consumption, mean effective pressure and NOx emissions. Compared to the conventional port-injected natural gas engine (where gaseous fuel is injected), it was found that directly injecting the liquid phase fuel into the cylinder near the start of the compression stroke resulted in approximately -8.9% brake specific fuel consumption, +18.5% brake mean effective pressure and -51% brake specific NOx depending on the operating point. Port-injection of the fuel in the liquid phase carried similar benefits, while direct injection of the fuel in the gaseous phase resulted in minor efficiency penalties (∼+1.3% brake specific fuel consumption). This work highlights the future potential of liquefied natural gas vehicles to achieve high specific power, high efficiency and ultra-low emissions (such as NOx) by tailoring the fuel system to fully exploit the cryogenic properties of the fuel.
Self-care as an ethical obligation for nurses
Authors: Linton Mary , Koonmen Jamie
Published: July 2020

As members of the largest and most trusted healthcare profession, nurses are role models and critical partners in the ongoing quest for the health of their patients. Findings from the American Nurses Association Health Risk Appraisal suggested that nurses give the best patient care when they are operating at the peak of their own wellness. They also revealed that 68% of the surveyed nurses place their patients’ health, safety, and wellness before their own. Globally, several nursing codes of ethics include the requirement of self-care. Often, these codes embed the responsibility to protect and promote one’s own health within the clearly described obligation to provide safe patient care. The American Nurses Association Code of Ethics for Nurses is unique in that it states explicitly that nurses must adopt self-care as a duty to self in addition to their duty to provide care to patients. One of the basic assumptions of Watson’s Philosophy and Science of Caring is that caring science is the essence of nursing and the foundational disciplinary core of the profession. Watson’s theory of human caring provides support for the engagement in self-care. Two important value assumptions of Watson’s Caritas are that “we have to learn how to offer caring, love, forgiveness, compassion, and mercy to ourselves before we can offer authentic caring and love to others” and we also must “treat ourselves with loving-kindness and equanimity, gentleness, and dignity before we can accept, respect, and care for others within a professional caring-healing model.” Embedded within several caritas processes is an outline for a holistic approach to caring for self and others that can guide nurses to improve their mental, physical, emotional, and spiritual health.
Flow cytometry expression pattern of CD44 and CD18 markers on feline leukocytes
Authors: Martini Valeria , Bernardi Serena , Giordano Alessia , Comazzi Stefano
Published: July 2020

The paucity of specific feline antibodies for flow cytometry (FC) is an ongoing challenge. Flow cytometrists must extrapolate information from relatively few markers. We evaluated the expression pattern of the panleukocyte markers CD18 and CD44 on leukocyte (white blood cell, WBC) subclasses in the peripheral blood (PB) of 14 healthy cats. The degree of expression of CD18 and CD44 was calculated as the ratio between the median fluorescence intensity (MFI) value of antibody-stained cells and autofluorescence. All samples were acquired with the same cytometer with constant photomultiplier setting and compensation matrices. Both molecules were expressed at higher levels on monocytes, intermediate levels on polymorphonuclear cells (PMNs), and lower levels on lymphocytes. CD18-MFI discriminated well among the 3 populations, whereas CD44-MFI mostly overlapped between monocytes and PMNs. However, CD44-MFI had a lower intra-population variability. Evaluation of CD18 and CD44, together with morphologic parameters, was useful for discriminating among WBC subclasses in healthy cats. This information may be helpful for future studies given that an increase in CD18-MFI may indicate reactive changes, whereas fluctuations in CD44-MFI may suggest neoplasia.
ESG Standards: Looming Challenges and Pathways Forward
Authors: Cort Todd , Esty Daniel
Published: July 2020

We are pleased to serve as guest editors of this special issue of the journal Organization & Environment on the State of ESG (environmental, social, and governance) Standards. Calls for standardization of corporate sustainability data continue to mount as a growing segment of the mainstream investor community seeks greater clarity and comparability regarding relative company performance on ESG issues. While ESG reporting standards have driven greater transparency over the years, there remains a great deal of work to undertake in order to better understand and formulate the standards for ESG data that will underlie decision-useful information in future disclosures.
Augmented vertical rectus transpositions: Intraoperative measurement of torsion following sequential muscle detachment
Authors: Serafino Massimiliano , Scaramuzzi Matteo , Magli Adriano , Nucci Paolo
Published: July 2020

Introduction:

After vertical recti transposition surgery, a torsional change may occur. We hypothesized that step-by-step monitoring of the intraoperative torsional position of the eye can avoid any unexpected complications and identify critical moments of surgery that may have adverse effects.

Methods:

Nine patients with sixth nerve palsy that underwent complete transposition of the superior (SR) and inferior rectus (IR) muscles to the lateral rectus muscle by means of the technique of augmented vertical recti transposition were prospectively included. The torsional position of the eye was recorded at eight stages of the procedure.

Results:

We observed two distinct patterns of induced torsional deviation during partial disinsertion of a vertical rectus muscle depending on whether disinsertion began medially or laterally, after cutting about 3/4 of the muscle fibers: ¾ nasal disinsertion of the SR and ¾ temporal disinserton of the IR caused intorsion, ¾ temporal disinsertion of the SR and ¾ nasal disinsertion of the IR caused extorsion. Torsion improved after the vertical rectus was attached temporally to the sclera along the spiral of Tillaux with tying of the augmentation suture to the LR. The greatest change in torsion was from ¾ temporal disinsertion of the SR (5°extorsion), to reattachment along the spiral of Tillaux temporally (5°intorsion).

Conclusion:

The SR and IR have different torsional effects, which only appears when more than half of the fibers are detached. Augmented transposition does not cause any additional torsional effects. This intraoperative monitoring system can be used to detect unintended torsional complications, especially during transposition surgery.
Acupuncture for Hormone Therapy–Related Side Effects in Breast Cancer Patients: A GRADE-Assessed Systematic Review and Updated Meta-Analysis
Authors: Yuanqing Pan , Yong Tang , Haiqian Liang , Gen Chen , Shen Xiping , Dong Jin , Qi Cui , Miaomiao Qi
Published: July 2020

Purpose: To determine the efficacy of acupuncture on the management of hormone therapy–related side effects in breast cancer patients. Methods: Randomized controlled trials of acupuncture versus a control or placebo in breast cancer patients that examined reductions in therapy-related side effects were retrieved from PubMed, EMBASE, Web of Science, and the Cochrane Library through April 2020. Data on patient symptoms (hot flashes, fatigue, pain, stiffness, and gastrointestinal symptoms), physical capacity, cytokines, and general psychosomatic well-being were analyzed. We evaluated and analyzed the quality of all included studies with the 5.2 Cochrane Handbook standards using Stata software (version 10.0) and Revman software (version 5.2), respectively. We assessed the risk of bias using the Cochrane Risk of Bias tool and evaluated the quality of evidence using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) approach. Results: The pooled results suggested that acupuncture led to moderate improvements in hot flashes, fatigue, and stiffness. No significant differences were observed in pain, gastrointestinal symptoms, Kupperman index scores, Overall quality of life, tumor necrosis factor levels, and interleukin levels. Conclusions: Evidence for outcome indicators of symptom management were downgraded by the GRADE system for inconsistency, indirectness, and imprecision in the included RCTs. Nonetheless, acupuncture is a moderately appropriate alternative therapy for hormone therapy–related side effects in breast cancer patients. However, it still lacks large-sample, multicenter, prospective RCTs. Future research should focus on standardizing comparison groups and treatment methods, be at least single-blinded, assess biologic mechanisms, have adequate statistical power, and involve multiple acupuncturists.
Targeting the PI3K/Akt/mTOR pathway in estrogen-receptor positive HER2 negative advanced breast cancer
Authors: du Rusquec Pauline , Blonz Cyriac , Frenel Jean Sebastien , Campone Mario
Published: July 2020

Recently many therapeutic classes have emerged in advanced hormone receptor-positive breast cancer, which is the leading cause of cancer death in women. In absence of visceral crisis, treatment relies on endocrine therapy combined with cyclin dependent kinase 4 and 6 inhibitor. Many mechanisms lead to resistance to endocrine therapy, including the activation of intracellular signaling pathways critical for cell survival. Approximately 70% of breast tumors harbor an alteration in the phosphoinositide 3 kinase (PI3K)/Akt pathway, leading to its hyper activation. This pathway is involved in the regulation of growth, proliferation and cell survival as well as in angiogenesis and is consequently a major target in the oncogenesis. An aberrant PIK3CA mutation is a common phenomenon in breast cancer and found in approximately 40% of patients with advanced hormone receptor-positive breast cancer. For the moment, the only positive trials showing a progression free survival benefit in this population are BOLERO-2 (2012), SOLAR-1 (2019), which tested everolimus, a mammalian target of rapamycin inhibitor, and alpelisib, a PI3K inhibitor, and led to their marketing authorization. However, many other inhibitors of this pathway are promising; nevertheless their development is actually limited by toxicity, mainly cutaneous (rash), digestive (diarrhea) and endocrine (diabetes).
Cooperation between Financial Intelligence Units in the European Union: Stuck in the middle between the General Data Protection Regulation and the Police Data Protection Directive
Authors: Mouzakiti Foivi
Published: July 2020

Financial Intelligence Units (FIUs) hold a central position in the chain of actors responsible for the monitoring of money movements in the European Union. In support of their role, which is to receive, analyse and disseminate suspicious transaction reports, they have been furnished with significant information processing powers. At present, FIUs feature prominently in the EU’s anti-money laundering and counterterrorist financing agendas and plans to further enhance their powers of information exchange are underway. At the same time, however, the legal challenges that arise from their constant empowerment, particularly for the protection of personal data, are being overlooked. This article focuses on the cooperation between FIUs in the EU and argues that the latter takes place under a complex legal framework, which raises significant challenges for data protection. In particular, it highlights the present-day uncertainty over the data protection framework that governs their operations and discusses whether FIUs should be subject to the General Data Protection Regulation or to its law enforcement counterpart, the Police Data Protection Directive. The remaining of the article focuses on the ‘ FIU.net ’ – the decentralized network for information exchanges between EU FIUs – and on the data protection challenges that emerged from the recent integration of this network into Europol.
Intensity of statin treatment after acute coronary syndrome, residual risk, and its modification by alirocumab: insights from the ODYSSEY OUTCOMES trial
Authors: Diaz Rafael , Li Qian H , Bhatt Deepak L , Bittner Vera A , Baccara-Dinet Marie T , Goodman Shaun G , Jukema J Wouter , Kimura Takeshi , Parkhomenko Alexander , Pordy Robert , Reiner Željko , Roe Matthew T , Szarek Michael , Tse Hung-Fat , White Harvey D , Zahger Doron , Zeiher Andreas M , Schwartz Gregory G , Steg Ph Gabriel ,   for the ODYSSEY OUTCOMES Committees and Investigators
Published: July 2020

Aims

Statins are pivotal to the secondary prevention of major adverse cardiovascular events, but some patients are statin-intolerant. We examined the effects of the proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor alirocumab on the risk of major adverse cardiovascular events according to the intensity of background statin treatment.

Methods and results

The ODYSSEY OUTCOMES trial compared alirocumab with placebo in 18,924 patients with acute coronary syndrome and dyslipidaemia despite intensive or maximum-tolerated statin treatment (including no statin if intolerance was documented). The primary outcome (major adverse cardiovascular events) comprised coronary heart disease death, non-fatal myocardial infarction, ischaemic stroke, or unstable angina. Median follow-up was 2.8 years. Baseline statin treatment was high-intensity (88.8%), low/moderate-intensity (8.7%) or none (2.4%). Median baseline low-density lipoprotein cholesterol was 86, 89 and 139 mg/dL (P < 0.001) in these statin treatment categories, respectively. Alirocumab produced similar relative reductions in low-density lipoprotein cholesterol from baseline across statin treatment subgroups, but the mean absolute reductions differed (52.9, 56.7 and 86.1 mg/dL, respectively; P < 0.001). With placebo, the incidence of major adverse cardiovascular events was highest in the no statin subgroup (10.8%, 10.7% and 26.0% respectively). Alirocumab reduced major adverse cardiovascular events in each statin subgroup (hazard ratio 0.88, 95% confidence interval (CI) 0.80–0.96; 0.68, 0.49–0.94; and 0.65, 0.44–0.97, respectively; Pinteraction = 0.14) with a gradient of absolute risk reduction: 1.25%, 95% CI 0.34–2.16; 3.16%, 0.38–5.94; 7.97%, 0.42–15.51; Pinteraction = 0.106).

Conclusions

PCSK9 inhibition with alirocumab reduces the relative risk of major adverse cardiovascular events after acute coronary syndrome irrespective of background statin treatment. However, patients on no statin are at high absolute risk for recurrent major adverse cardiovascular events; alirocumab substantially reduces that risk. PCSK9 inhibition may be an important therapeutic strategy for statin-intolerant patients with acute coronary syndrome.
Alcoholic hepatitis: Towards an era of personalised management
Authors: Degré Delphine , Wandji Line C Ntandja , Moreno Christophe , Louvet Alexandre
Published: July 2020

Alcoholic hepatitis should be suspected in every patient with excessive chronic alcohol consumption and recent onset of jaundice. Diagnosis of alcoholic hepatitis is based on clinical and laboratory findings, and confirmed by a liver biopsy when available. Several scores are available to assess severity and prognosis of alcoholic hepatitis. The 1‐month mortality of patients with severe alcoholic hepatitis, as defined by Maddrey’s discriminant function, is 20–30%. Therefore, severe alcoholic hepatitis should be treated with a 28‐day course of oral prednisolone after systematic screening for infection. In this review, we discuss diagnosis of alcoholic hepatitis, the different scores to assess severity of the disease, indications for corticosteroid therapy and alternative therapeutic options for non‐responders to medical therapy.
Comparing ‘New’ and ‘Old’ Media for Violence Monitoring and Crisis Response: Evidence from Kenya
Authors: Dowd Caitriona , Justino Patricia , Kishi Roudabeh , Marchais Gauthier
Published: July 2020

This paper assesses the comparative opportunities and limitations of ‘new’ and ‘old’ data sources for early warning, crisis response and violence research by comparing reports of political violence, and both violent and peaceful demonstrations, produced through social media and traditional media during the Kenyan elections in August and October 2017. We leverage data from a sample of social media reports of violence through public posts to Twitter and compare these with events coded from media and published sources by the Armed Conflict Location & Event Data Project (ACLED) along two dimensions: 1) geography of violence; and 2) temporality of reporting. We find that the profile of violence recorded varies significantly by source. Records from Twitter are more geographically concentrated, particularly in the capital city and wealthier areas. They are timelier in the immediate period surrounding elections. Records from ACLED have a wider geographic reach, and are relatively more numerous than Twitter in rural and less wealthy areas. They are timelier and more consistent in the run-up to and following elections. While neither source can reveal the ‘true’ violence that occurred, the findings point to the value of drawing on a constellation of various source types given their complementary advantages.
Butterfly Film Festival: Teaching Transformational Leadership
Authors: Capitano Johnna , Fisher Kelly L. , Bozeman Jennifer
Published: July 2020

This article outlines an active learning exercise that gives students the opportunity to learn and apply the behaviors of transformational leadership theory. Students watch a brief, prerecorded “before” video depicting transactional manager–employee interactions. Students then revise the script so that the manager exhibits the four I’s of transformational leadership—inspirational motivation, individualized consideration, idealized influence, and intellectual stimulation—and act out the new script in a student-produced “after” video. Our experience demonstrates higher student engagement and better learning outcomes when compared with more passive teaching methods.
Effect of high-temperature saturated steam treatment on the physical, chemical, and mechanical properties of moso bamboo
Authors: Wang Xinzhou , Cheng Dali , Huang Xianai , Song Lulu , Gu Wenli , Liang Xingyu , Li Yanjun , Xu Bin
Published: July 2020

Moso bamboo (Phyllostachys heterocycla (Carr.) Mitford cv. Pubescens) was subjected to heat treatment with saturated steam at 140, 160, and 180 °C for 10–30 min to evaluate the effects of the treatment on the properties of bamboo. The changes in the physical, mechanical, and chemical properties as well as microscopic structures of moso bamboo were analyzed in this study. Results indicated that its equilibrium moisture content (EMC) decreased gradually after being treated by high-temperature saturated steam mostly due to the hemicelluloses’ degradation. Both the temperature and duration of treatment affect the mechanical properties of bamboo. The modulus of elasticity (MOE) of bamboo was prone to be affected by heat treatment with saturated steam as compared to the modulus of rupture (MOR). The MOR and MOE increased as compared to the control when the sample was treated at 140 °C. However, a severe treatment negatively affects the mechanical properties of bamboo. The MOR and MOE decreased by 47% and 20% as compared to the control when the sample was heated at 180 °C for 30 min.
Multi-trait multi-locus SEM model discriminates SNPs of different effects
Authors: Igolkina Anna A. , Meshcheryakov Georgy , Gretsova Maria V. , Nuzhdin Sergey V. , Samsonova Maria G.
Published: July 2020

Background

There is a plethora of methods for genome-wide association studies. However, only a few of them may be classified as multi-trait and multi-locus, i.e. consider the influence of multiple genetic variants to several correlated phenotypes.

Results

We propose a multi-trait multi-locus model which employs structural equation modeling (SEM) to describe complex associations between SNPs and traits - multi-trait multi-locus SEM (mtmlSEM). The structure of our model makes it possible to discriminate pleiotropic and single-trait SNPs of direct and indirect effect. We also propose an automatic procedure to construct the model using factor analysis and the maximum likelihood method. For estimating a large number of parameters in the model, we performed Bayesian inference and implemented Gibbs sampling. An important feature of the model is that it correctly copes with non-normally distributed variables, such as some traits and variants.

Conclusions

We applied the model to Vavilov’s collection of 404 chickpea (Cicer arietinum L.) accessions with 20-fold cross-validation. We analyzed 16 phenotypic traits which we organized into five groups and found around 230 SNPs associated with traits, 60 of which were of pleiotropic effect. The model demonstrated high accuracy in predicting trait values.
Online hemodiafilteration use in children: a single center experience with a twist
Authors: Ibrahim Magid A. A. , ElHakim Ihab Z. , Soliman Dina , Mubarak Muhammad A. , Said Ragia M.
Published: July 2020

Background

Haemodiafilteration (HDF) is a promising new modality of renal replacement therapy (RRT). It is an improvement in the quality of hemodialysis (HD) and thus in the quality of patients’lives. The main obstacle to using HDF is the cost, especially in developing countries. The purpose of this study was to evaluate the benefits of incorporating HDF with different regimens in the treatment of children with end stage renal disease (ESRD).

Methods

Thirty-four children with ESRD on regular HD in Pediatric Dialysis Unit, Children’s Hospital, Ain Shams University were followed up in 2 phases: initial phase (all patients: HD thrice weekly for 3 months) and second phase, patients were randomized into 2 groups, HDF group and HD group, the former was subdivided into once and twice weekly HDF subgroups. Evaluation using history, clinical and laboratory parameters at 0, 3, 9 and 18 months was carried out.

Results

On short term, we found that the HDF group was significantly superior to HD group regarding all clinical and laboratory parameters. Also, twice HDF subgroup was significantly superior to once HDF subgroup. This was confirmed on long term follow up, but the once HDF proved comparable to twice subgroup.

Conclusions

Incorporating online hemodiafilteration (OL-HDF) in the RRT of children was beneficial in most of the clinical and laboratory parameters measured. It’s not all or non; OL-HDF, even once a week, can improve outcomes of HD without significantly affecting the cost.
Pre- and during- labour predictors of dystocia in active phase of labour: a case-control study
Authors: Nahaee Jila , Abbas-Alizadeh Fatemeh , Mirghafourvand Mojgan , Mohammad-Alizadeh-Charandabi Sakineh
Published: July 2020

Background

Labour dystocia (LD) is associated with maternal and foeto-neonatal complications and increased rate of caesarean section. There are scant studies on predictive factors of labour dystocia in Iran, as well as in other countries. Therefore, this study aimed to identify the predictive factors of LD using an integrated and collaborative pre- and during- labour factors to help formulate more effective intervention strategies for prevention and management of LD.

Methods

In this case-control study, 350 women with and 350 women without LD, matched individually in terms of parity and hospital, were compared. The participants were in active labor, had singleton pregnancy, live foetus with a cephalic presentation, gestational age of 37+ 0–41+ 6 weeks, and were hospitalized for vaginal birth in two teaching hospitals in Tabriz, Iran. Data related to the socio-demographic characteristics, anxiety status (using the Spielberger State Anxiety Inventory), and woman dehydration were collected at cervical dilatation between 4 and 6 cm (before dystocia detection) and the other data at different phases of labour, and after birth (before discharge). The multivariate logistic regression was used to determine the predictors.

Results

The predictors of LD were severe [OR 58.0 (95% CI 26.9 to 125.1)] and moderate [8.6 (4.2 to 17.4)] anxiety, woman dehydration > 3 h [18.67 (4.0 to 87.3)] and ≤ 3 h [2.8 (1.7 to 4.8], insufficient support by the medical staff in the delivery room [5.8 (1.9 to 17.9)], remifentanil administration [3.1 (1.5 to 6.2)], labour induction [4.2 (2.5 to 7.2], low income [2.0 (1.2 to 3.3)], woman’s height < 160 cm [2.0 (1.1 to 3.3)], and woman age of 16–20 y [0.3 (0.2 to 0.6)]. The proportion of the variance explained by all these factors was 74%.

Conclusion

The controllable predictors, such as woman anxiety and dehydration, and insufficient support from medical staff during labour were strongly associated with the risk of LD. Therefore, it seems that responding to woman physical, psychological, and supportive needs during labour can play a significant role in LD prevention and control.

Ethical code

IR.TBZMED.REC.1397.624.
Risk factors of metachronous brain metastasis in patients with EGFR-mutated advanced non-small cell lung cancer
Authors: Ouyang Wen , Yu Jing , Zhou Yan , Hu Jing , huang Zhao , Zhang Junhong , Xie Conghua
Published: July 2020

Background

NSCLC patients with EGFR mutation were at a higher incidence of developing brain metastasis (BM). Patients with BM are associated with high mortality. Reducing BM incidence becomes increasingly significant for NSCLC patients to achieve prolonged survival. The aim of the study was to explore the possible risk factors of developing metachronous BM during EGFR-TKIs treatment, and to identify the potential candidates for prophylactic cranial irradiation (PCI) or the first-line Osimertinib treatment.

Methods

A total of 157 consecutive EGFR-mutated advanced NSCLC patients without BM at initial diagnosis in our institution from 2012 and 2018 were retrospectively reviewed. Comparisons of OS were performed based on BM status. The cumulative incidence of metachronous BM was calculated by the Kaplan-Meier method, and the independent risk factors of metachronous BM were investigated by multivariate analysis.

Results

Patients developing metachronous BM had worse survival (mOS: 22.1 months) than patients not-developing BM (mOS: 44.8 months). Moreover, the multivariate analysis indicated that age ≤ 49 years (P = 0.035), number of extracranial metastases (P = 0.013), and malignant pleural effusion (P = 0.002) were independent risk factors of metachronous BM. Furthermore, the 1-year actuarial incidence of developing metachronous BM in patients with no risk factor (n = 101), 1 risk factor (n = 46), and 2 risk factors (n = 10) were 7.01, 14.61, and 43.75%, respectively (P < 0.001).

Conclusions

Patients developing metachronous BM during EGFR-TKIs treatment have worse outcomes. Our results suggested that EGFR-mutated advanced NSCLC patients with ≥1 risk factors were candidates for PCI or the first-line Osimertinib treatment.
Relative position of the central hole after EVO-ICL implantation for moderate to high myopia
Authors: He Xiaojian , Niu Lingling , Miao Huamao , Zhao Feng , Zhou Xingtao
Published: July 2020

Background

This study aimed to evaluate the relative position of the central hole (CH) of EVO Implantable Collamer Lens (EVO-ICL), the pupil center (CP), and the corneal center (CC) after implantation of EVO-ICLs for moderate to high myopia.

Methods

Eighty-nine eyes of forty-seven patients with moderate to high myopia were evaluated. The mean preoperative spherical equivalent (SE) was − 12.58 ± 4.13D. A routine postoperative follow-up was performed within 1 ~ 12 months. Positions of the CH of EVO-ICLs, the CP and the CC were recorded using a slit lamp anterior segment photography system, and their relative distances were calculated with the Visio image analysis software.

Results

All surgeries were performed safely, and no complications were observed in follow-ups 4.3 ± 4.82 months after surgery. At the last follow-up, the safety index (postoperative CDVA/preoperative CDVA) was 1.23 ± 0.48, and the efficacy index (postoperative UDVA/preoperative CDVA) was 1.08 ± 0.31. The CH in 85 eyes (95.51%) was superior to the CC, with 47.19% (42/89) on the temporal side and 48.31% (43/89) on the nasal side. The CH in 84 eyes (94.38%) was located on the temporal side of the CP, with 56.18% (50/89) superior and 38.2% (34/89) inferior to the CP. The CP of 85 eyes (95.51%) was superior on the nasal side of the CC. On the defined x-axis, the average distance from the CH to CC was significantly shorter than the average distance from the CP to CC (p < 0.001).

Conclusions

An imperfect match between the central hole of EVO-ICLs and the pupil center does not necessarily indicate ICL dislocation. Compared to the pupil center, the position of the central hole of EVO-ICL is closer to the corneal center.
The pre-exposure prophylaxis (PrEP) consciousness of black college women and the perceived hesitancy of public health institutions to curtail HIV in black women
Authors: Chandler Rasheeta , Hull Shawnika , Ross Henry , Guillaume Dominique , Paul Sudeshna , Dera Nikita , Hernandez Natalie
Published: July 2020

Background

Consistent use of Pre-Exposure Prophylaxis (PrEP), a biomedical intervention for HIV seronegative persons, has been shown to significantly decrease HIV acquisition. Black women are a viable population segment to consider for PrEP use as their HIV incidence is overwhelmingly higher than all other women groups.

Methods

We developed and piloted a cultural- and age- appropriate PrEP education intervention to determine Black college women’s: 1) perceptions of and receptivity to PrEP use; and 2) preferences for PrEP information delivery.

Results

We recruited N = 43 Black college women. Most of our sample were sophomore and Juniors of whom identified as heterosexual (83%) and single (67%). Over 50% of young women had never been HIV tested and only 28% had been tested in the last 6 months; however, 100% of the women believed their HIV status was negative. Prior to participating in the study, most Black college women (67%) had not heard about PrEP and were unsure or apprehensive (72%) to initiate PrEP. The Black college women indicated that our educational intervention was extremely helpful (67%) for understanding and learning about PrEP. Post participating in our PrEP education module, regardless of delivery modality, participants reported being likely (62.55–70%) to initiate PrEP in the future.

Conclusions

Results indicate that Black college women would strongly consider PrEP when provided with basic knowledge, regardless of delivery modality. Participants also showed greater appreciation for in-person delivery and found it to be significantly more helpful and of greater quality for learning about PrEP; comprehension or perceived usefulness of PrEP-related content was relatively the same between groups. PrEP content delivery -- via in-person or online methods – is contingent on learning style and presentation.

Trial registration

This study has been registered under the ISRCTN Registry as of July 6, 2020. The trial registration number is ISRCTN14792715. This study was retrospectively registered.
A five-year trend analysis of malaria surveillance data in selected zones of Amhara region, Northwest Ethiopia
Authors: Lankir Damtie , Solomon Samrawit , Gize Addisu
Published: July 2020

Background

Trend analysis of malaria surveillance data is essential to inform stakeholders on progress towards malaria control. From the total 387,096 cases of malaria reported in Amhara region in 2017, 167,079 (43.2%) cases were in Central, North and West Gondar zones. From this total figure of zones, 15,445 (9.2%) were ≤ 5 years which contributes 4% of cases in the region. So, the purpose of this study was to analyze trends of malaria parasite in Selected Zones of Amhara Region, Northwest Ethiopia.

Methods

A Retrospective study was conducted on purposely selected Central, North and West Gondar zones from July 1–30/ 2018. Data were collected, entered, cleaned, analyzed and interpreted using Microsoft Excel-2010. Different tables, figures and maps were used to present results.

Result

A total of 2,827,722 cases have been received a diagnostic test of; Microscopy 1,712,193(60.56%) and Rapid Diagnostic Test (RDT) 1,115,529(39.44%). Trends of total patients treated as confirmed and clinical malaria cases in July 2017–June 2018 were decreased to 139,297 (14%) as compared from July 2015–June 2016, 249,571(25%). From total cases received diagnostic tests only 1,003,391 (36%) were confirmed and clinical cases treated with antimalaria. Of these Plasmodium falciparum and vivax malaria cases were confirmed to be 1002,946 (99.96%) and clinical malaria cases were 445(0.04%), respectively.

Conclusion

Risk of infection and diagnostic effort were high in West Gondar Zone. The Amhara public health institute including health Bureau, stakeholders and all responsible bodies should give special standing to highest malaria districts of West Gondar zone.
A biomechanical comparison of two screw fixation methods in a Letenneur type I Hoffa fracture
Authors: Yao Shu-Hsin , Su Wei-Ren , Hsu Kai-Lan , Chen Yueh , Hong Chih-Kai , Kuan Fa-Chuan
Published: July 2020

Background

The treatment of Hoffa fractures is challenging, for which the ideal fixation and approach are still controversial. Osteosynthesis with plate or screws fixation in different trajectories have been described in previous literature. The purpose of this study was to compare the biomechanical strength and stability of two types of screw trajectories used to stabilize displaced coronal fractures of the lateral femoral condyle.

Methods

Sixteen synthetic femurs (Sawbones Pacific Research Laboratories, Vashon, WA) were divided into two groups. A vertical osteotomy was performed to mimic a Letenneur type I Hoffa fracture. Group A (n = 8) was fixed with screw in anteroposterior direction (A-P) screws. Group B (n = 8) was fixed with crossed screws. Both groups were tested with a nondestructive axial compression aligned with the femur axis. After that, 10,000 cyclic loading tests were applied to the specimen with a force ranging between 200 to 600 N, and the interfragmental displacement was recorded, respectively, after 10, 100, 1000 and 10,000 cycles. Finally, a destructive axial compression test was applied until catastrophic failure.

Results

There were no statistical between-group differences in regard to the average axial stiffness, interfragmental displacement, and ultimate failure load. The average axial stiffness of the A-P screw was comparable to that of the crossed screw (361 ± 113 N/mm vs. 379 ± 65 N/mm, p = 0.753). All specimens completed the entire cyclic loading test without catastrophic failure, and the interfragmental displacement after loading for 10,000 cycles was 1.36 ± 0.40 mm for the A-P screw and 1.29 ± 0.61 mm for the crossed screw, there were no statistical differences between the groups (p = 0.823). The average ultimate failure loads for the A-P and crossed screws were 1214 ± 127 N and 1109 ± 156 N, respectively (p = 0.172).

Conclusions

Based on our in vitro study, the crossed screws can provide comparable mechanical performance as traditional A-P screws in Hoffa fracture fixation. Considering the screws trajectories are commonly determined by the choice of surgical approach, the current study provides support from a biomechanical perspective for the application of crossed screws in direct lateral approach.
Evaluation of zinc sulfate mucoadhesive formulation on recurrent aphthous stomatitis: a randomized double-blind, placebo-controlled clinical trial
Authors: Ghorbani Anahita , Akbari Jafar , Boorboor Maryam , Nekoukar Zahra , Eslami Gohar
Published: July 2020

Background

Recurrent aphthous stomatitis (RAS) is a common lesion that affects the oral mucosa. There are several methods to treat RAS, including systemic and topical formulations. This study was conducted to evaluate the anti-inflammatory effect of topical zinc sulfate and its efficacy in the treatment of RAS.

Methods

A double-blind randomized clinical trial was conducted on 46 patients with RAS. They were randomly assigned into two groups to receive a zinc sulfate mucoadhesive tablet or placebo for 7 days. The pain severity was measured at baseline and daily while the diameter of the lesion was measured at baseline and on days 3, 5, and 7. The obtained data were analyzed in SPSS V.16.

Results

There was no significant difference in the mean diameter of lesions and pain at baseline between the two groups (P = 0.643 and P = 0.842, respectively). However, on the third, fifth, and seventh days of the study, the diameter of the lesion significantly reduced in the intervention group (P = 0.001) and the pain intensity became significantly different between groups from the fourth day of the study (P = 0.001).

Conclusion

Zinc sulfate mucoadhesive tablet was effective in recovery and reducing the pain and diameter of the aphthous lesion and could be considered for the treatment of RAS.

Trial registration

Evaluation of the effectiveness of zinc sulfate mucoadhesive tablet in the improvement of recurrent aphthous stomatitis (RAS), IRCT20151109024975N9. Registered August 1, 2018, https://en.irct.ir/trial/32423. This project was registered by the Iranian Registry of Clinical Trials (http://www.irct.ir). The IRCT ID was IRCT20151109024975N9.
Acceptability of HPV screening among HIV-infected women attending an HIV-dedicated clinic in Abidjan, Côte d’Ivoire
Authors: Mensah Keitly , Assoumou Nelly , Duchesne Véronique , Pourette Dolorès , DeBeaudrap Pierre , Dumont Alexandre
Published: July 2020

Background

Cervical cancer incidence is high among women living with HIV due to high-risk HPV persistence in the cervix. In low-income countries, cervical cancer screening is based on visual inspection with acetic acid. Implementing human papilloma virus (HPV) screening through self-sampling could increase women’s participation and screening performance. Our study aims to assess the preintervention acceptability of HPV screening among HIV-infected women in Abidjan, Côte d’Ivoire.

Methods

Applying the Health Belief Model theoretical framework, we collected qualitative data through in-depth interviews with 21 HIV-infected women treated in an HIV-dedicated clinic. Maximum variation sampling was used to achieve a diverse sample of women in terms of level of health literacy. Interviews were recorded and transcribed with the participants’ consent. Data analysis was performed using NVivo 12.

Results

Screening acceptability relies on cervical cancer representations among women. Barriers were the fear of diagnosis and the associated stigma disregard for HIV-associated health conditions, poor knowledge of screening and insufficient resources for treatment. Fees removal, higher levels of knowledge about cervical cancer and of the role of HIV status in cancer were found to facilitate screening. Healthcare providers are obstacle removers by their trusting relationship with women and help navigating through the healthcare system. Self-confidence in self-sampling is low.

Conclusions

Free access to cervical screening, communication strategies increasing cervical cancer knowledge and healthcare provider involvement will foster HPV screening. Knowledge gathered through this research is crucial for designing adequate HPV-based screening interventions for women living with HIV in this setting.