bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of chemotherapy-related peripheral neuropathy in lung cancer treatment
Authors: Dasdemir Ilkhan Gulay , Celikhisar Hakan
Published: December 2020

Objective:

Chemotherapy-related peripheral neuropathies are observed frequently in lung cancer treatment in clinical practice. The present study aimed to evaluate the electrophysiologic findings and clinical symptoms in patients treated for lung cancer with different chemotherapy regimens who had the findings of peripheral neuropathy.

Methods:

Patients who had electromyography (EMG) examinations with the prediagnosis of peripheral neuropathy at two different centers between January 2011 and December 2019 were included. The demographic data, neurologic examination findings, symptoms, EMG findings, and chemotherapeutic agents used in the treatment were evaluated retrospectively.

Results:

A total of 742 patients were included in the study, with 630 (84.90%) male and 112 (15.10%) female patients. Of the patients included in the study, 406 (54.71%) had positive sensorial symptoms, 494 (66.57%) had negative sensorial symptoms, 162 (21.83%) had motor symptoms, and 254 (34.23%) had pain symptoms. The patients were classified into two groups on the basis of the presence of polyneuropathy detected via EMG as group I (n = 500, 67.38%) including the patients with polyneuropathy and group II (n = 242, 32.61%) including the patients without polyneuropathy. Negative sensorial symptoms and motor symptoms in group I along with dysesthesia and paresthesia symptoms in group II were observed at ratios that were higher at a statistically significant level ( p = 0.001, p = 0.001, p = 0.001, p = 0.001).

Conclusion:

Sensorial symptoms are observed most frequently in chemotherapy-related peripheral neuropathies in lung cancer treatment and motor symptoms may also increase according to the chemotherapy regimen.
Structural violence and hope in catastrophic times: from Camus’ The Plague to Covid-19
Authors: Kabel Ahmed , Phillipson Robert
Published: December 2020

Covid-19 has triggered a resurgence of interest in Albert Camus’ book, The Plague. The novel is a complex narrative of an epidemic, stressing the human factor in addressing a social crisis as well as how individuals experience the personal drama of quarantine, isolation and death. These existentialist tropes have powerful resonance in the age of Covid-19. However, Covid’s interlocking with structural violence worldwide requires a different engagement with The Plague beyond an aesthetics of suffering and hope. Both Camus’ book and Covid-19 intersect with structural violence and suffering which are mediated differentially. Covid-19 intensifies other social catastrophes feeding on the ruins of structural inequality and the racism that condemns the marginalised to loss of agency, social apartheid and disposability. It also lays bare the necropolitics of neoliberalism – its power to dictate life and death undergirded by racialised, class, gendered and neocolonial logics. We witness emerging cartographies of power combined with virulent nationalism, authoritarianism and xenophobia. The Covid crisis is also likely to expand disaster capitalism, digital imperialism and algorithmic surveillance, further entrenching racial, class and gender hierarchies. If humanity is to avoid the pitfalls of these myriad fields of disaster intervention, what is needed is reflective analysis that has to aim at major societal change, at decolonisation that ends systemic abandon and racist structural violence. Camus’ book fails to assist this.
A Rare Type of Isis Dolente Figurine from the Pushkin State Museum of Fine Arts in Moscow
Authors: Vasilyeva Olga , Malykh Svetlana
Published: December 2020

The collections of the Pushkin State Museum of Fine Arts in Moscow and the Benaki Museum of Athens contain terracotta figurines with unusual iconography. These figures have been interpreted in numerous different ways, and the authors do not think that a completely correct interpretation has yet been found. The ‘problematic’ elements are the pose, gestures and the headdress of the figurines, which resemble both the Isis Dolente type and some depictions of Harpokrates. Perhaps an ancient artisan combined iconographical features of Isis and another deity(-ies) to create these figurines.
Aesthetic Identity Development Among Trans Adolescents and Young Adults
Authors: McGuire Jenifer K. , Reilly Andrew
Published: December 2020

Dress is used by transgender and nonbinary (TNB) individuals as a way to develop and maintain identity, whether to reinforce a binary gender code or disrupt social expectations. However, safety issues of living in a society where TNB persons are discriminated against, harassed, and assaulted, and where binary gender violations are met with resistance, creates tension between expression of authentic gender identity and navigation of social systems. A framework for creating an aesthetic identity based on dress and identity development scholarship was created and used to analyze responses from interviews with 90 TNB individuals located in the United States, Canada, and Ireland. Findings revealed the dialectic tension between performativity and safety. The framework explores aesthetic identity through concepts including sensory, cognitive, and emotional aspects of clothing; scaffolding and feedback; role making and role taking; and exploration and commitment. Limitations and future research are discussed.
Experiences associated with psychological richness
Authors: Oishi Shigehiro , Choi Hyewon , Liu Ailin , Kurtz Jaime
Published: December 2020

Psychologists typically conceptualize a good life either in terms of hedonic (e.g. life satisfaction, positive affect) or eudaimonic well-being (e.g. meaning, fulfillment of potential). In the current research, we explored another form of a good life: the psychologically rich life. In Study 1, we conducted a 14-day daily diary study ( N = 203). In Study 2, we compared Chinese studying in the United States ( N = 97) with Chinese studying in China ( N = 169). In Study 3, we conducted a 12-week weekly survey study among Americans studying abroad ( N = 43) and Americans studying in the United States ( N = 100). In Study 4, we recruited students who had studied abroad ( N = 84) and their friends (informants) who did not ( N = 76). Study 1 showed that participants who scored higher in a psychologically rich life were more likely to take a short trip during the 14-day period. In Studies 2 to 4, those who studied abroad reported higher levels of a psychologically rich life than those who did not. Unusual experiences such as study abroad were consistently associated with higher levels of psychological richness, whereas they were not consistently associated with life satisfaction, positive affect, and meaning in life.
Organizational Logic in Coworking Spaces: Inequality Regimes in the New Economy
Authors: Sargent Amanda C. , Yavorsky Jill E. , Sandoval Rosalyn G.
Published: December 2020

Globalization, technological advances, and changing employment structures have facilitated greater flexibility in how and where many Americans do their paid work. In response, a new work arrangement, coworking, has emerged in the United States. Coworking organizations bring together professionals from different companies to share a common workspace and build community. Despite the prevalence and potential benefits of coworking, little systematic research about coworking contexts exists, let alone research focused on gender inequality therein. Using 78 interviews and more than 700 hours of observation across nine coworking spaces, we examine the organizational logics that shape gender dynamics, as well as intersecting racial and class dynamics, in coworking spaces. Building on Acker’s inequality regimes framework, we uncover organizational logic that either reduces or reproduces inequality for diverse groups of women in coworking contexts. We conclude by discussing important theoretical and empirical implications of these findings.
Design and control of an automatic high-viscosity sealant filling system
Authors: Tian Dongzuo , Song Xingyong
Published: December 2020

In this article, a novel vision-based automatic liquid filling control system is proposed. The method can be used for many high-viscosity liquid filling applications, especially for packaging of fuel tank sealant in the aerospace industry. Due to the high viscosity and highly adhesive properties, filling and packaging this type of liquid can have challenges in terms of time and cost. A new control scheme based on motion synchronization with vision feedback is proposed in this article, which enables a new filling method for this type of liquid. The method can effectively resolve the challenges and enable an efficient filling process. Considering the time delay caused by image processing of the vision system, the Smith delay compensator is employed with an iterative learning control framework to improve the reliability of the feedback control under disturbances. The hardware implementation and experimental results demonstrate the convergence of tracking errors over the learning iterations, proving the effectiveness of the proposed control algorithm.
Multi-objective optimization of magneto-rheological mount structure based on vehicle vibration control
Authors: Deng Zhaoxue , Yang Qinghua , Zhao Shuen , Wei Hanbing
Published: December 2020

Considering the influence of mount structure parameters on the quality of vehicle noise, vibration and harshness (NVH), a multi-objective optimization method of the magneto-rheological (MR) mount based on vehicle vibration control was proposed. A lumped parameter model was used to establish the relationship between the structure parameters of the MR mount and the NVH performance of the vehicle. Considering the influence of current on the magneto-rheological fluid viscosity and flow rate in damping channel, the dynamic characteristics of MR mount was obtained by the lumped parameter model. Then, a 10 degrees of freedom (DOF) vehicle model with MR mounting system was established. Finally, a co-simulation optimal platform was developed by the ISIGHT, MATLAB, and ANSYS software, and the non-dominated sorting genetic algorithm II was used to optimize the design of the mount magnetic circuit with the goal of improving the quality of vehicle NVH. The results showed that under the start/stop and the constant speed conditions, the root mean square values of vibration acceleration of the driver’s seat rail of the vehicle with the optimal design magneto-rheological mount decreases by 31.6% and 7.8%, respectively compared with the initial design mount, improved the ride comfort of the vehicle.
Combat Workplace Sexual Harassment by Third Parties? Reframing Institutional Measures and Cultural Transformation in South Korea
Authors: Lee Jusung , Oh Mihyun
Published: December 2020

This study investigated the risk factors for workplace sexual harassment in South Korea using cross-sectional data of the 2014 and 2017 Korean Working Conditions Survey (KWCS). A generalized linear model specified with a Poisson distribution and log link function was performed. Females, younger adults, jobs in services or sales, tasks that involve visiting places where clients reside, and significant work time contribution to customers were associated with increased gender harassment and unwanted sexual attention. Evidence suggests that third parties and male-oriented culture may pose a serious threat to healthy working conditions.
Histological evaluation of acetabular bone quality during revision hip arthroplasty
Authors: Bistolfi Alessandro , Linari Alessandra , Aprato Alessandro , Fusini Federico , Cravero Ester , Papotti Mauro , Ferracini Riccardo , Massè Alessandro
Published: December 2020

Purpose:

Aim of this study was to evaluate acetabular bone vitality during revision hip arthroplasty and to compare the bone quality between revision and primary acetabular arthroplasty.

Methods:

During primary and revision total hip arthroplasty surgeries, biopsies were taken from the acetabulum after reaming. The samples (osteochondral cylinders of approximately ⩽1 cm long and 3 mm thickness), after removing the mineral component, were cut longitudinally with a thickness section of 5 µm and colored with hematoxylin-eosin dichromic dye and then evaluated histologically by optical microscopy with 40× magnification. Preoperative radiographs were evaluated.

Results:

According to inclusion and exclusion criteria, 14 patients formed the revision group patients (mean age: 67.9 years, average time before revision 8.8 years, SD ± 7.06) and 5 patients formed the control primary group (mean age: 61.4 years). The bone quality of the revision group was generally poorer than the primary group, while similar vitality and bone quality has been found between septic and aseptic group. Variables such as age, gender and BMI did not significantly contribute to define bone quality classes.

Conclusions:

The study confirms the differences in quality and bone vitality between cases and controls and the necessity to find strategies to improve the osteointegrative processes in revision arthroplasties.
Impact of general anesthesia on posterior circulation large vessel occlusions after endovascular thrombectomy
Authors: Terceño Mikel , Silva Yolanda , Bashir Saima , Vera-Monge Víctor A , Cardona Pere , Molina Carlos , Chamorro Ángel , de la Ossa Natalia P , Hernández-Pérez María , Werner Mariano , Camps-Renom Pol , Rodríguez-Campello Ana , Cánovas David , Purroy Francisco , Serena Joaquín ,   on behalf of the Catalan Stroke Code and Reperfusion Consortium (Cat-SCR)
Published: December 2020

Background

The impact of general anesthesia on functional outcome in patients with large vessel occlusion remains unclear. Most studies have focused on anterior circulation large vessel occlusion; however, little is known about the effect of general anesthesia in patients with posterior circulation—large vessel occlusion.

Methods

We performed a retrospective analysis from the prospective CICAT registry. All patients with posterior circulation—large vessel occlusion—and undergoing endovascular therapy between January 2016 and January 2020 were included. Demographics, baseline characteristics, procedural data, and anesthesia modality (general anesthesia or conscious sedation) were evaluated. The primary outcome was the proportion of patients with good clinical outcome (modified Rankin Scale score of 0–2) at three months.

Results

298 patients underwent endovascular treatment with posterior circulation—large vessel occlusion—were included. Age, diabetes mellitus, renal insufficiency, baseline National Institutes of Health Stroke Scale score, puncture to recanalization length, ≥3 device passes, absent of successful recanalization (defined as treatment in cerebral ischemia of 3), and general anesthesia were statistically associated with poor outcome (mRS: 3-6). In the multivariable regression, general anesthesia and ≥3 device passes were independently associated with poor outcome (aOR: 3.11, (95% CI: 1.34–7.2); P = 0.01 and 3.77, (95% CI: 1.29–11.01); P = 0.02, respectively). Patients treated with general anesthesia were less likely to have a good outcome at three months compared to conscious sedation (19.7% vs. 45.1%, P < 0.001).

Conclusions

In our study population, general anesthesia use is associated with poor clinical outcome in patients with posterior circulation—large vessel occlusion—treated endovascularly.
Lyrics and artistic improvisations in health promotion for the COVID-19 pandemic control in East Africa
Authors: Mulemi Benson A.
Published: December 2020

News about the outbreak of coronavirus disease 2019 (COVID-19) in Wuhan City, Hubei Province, China in December 2019 diffused gradually to East Africa through mainstream media and social media. The general public construed the pandemic threat as being ‘far away’ and associated it with foreign practices and behaviours. Social media discourse was initially replete with indifference about the perceived risk. Conflicting views about the possibility of the pandemic spreading to Africa and the complexity of explaining its causes delayed the desired understanding of the reality of the global public health concern. The popular public response to the COVID-19 control discourse is therefore characterised by ambivalence about embracing the pandemic control protocols. Drawing on content and discourse analysis of musical and poetic compositions on COVID-19 by artists in East Africa and shared among WhatsApp users in Kenya, this article describes local perspectives on COVID-19 risk and their health promotion implications. It explores local construction of the meaning of the COVID-19 pandemic and its consequences for effective health promotion. The article considers the spontaneous musical and poetic performances by experienced and amateur artists as local attempts to enhance compliance with the global COVID-19 control protocols and popular participation in local health promotion. The basic premise is that artists’ creation and sharing of digital COVID-19 lyrics denote their attempt to go beyond the medical logic of health promotion by including broad aspects of a cultural logic of care. This approach would establish an integrated and sustainable health promotion framework to prevent the spread of COVID-19 and its impact on local societal wellbeing.
White matter: A good reference for the signal intensity evaluation in magnetic resonance imaging for the diagnosis of uveal melanoma
Authors: Hirunpat Pornrujee , Sanghan Nuttha , Hirunpat Siriporn
Published: December 2020

Background

Comparing the signal intensity (SI) of an ocular mass to that of the vitreous body has been suggested. Most ocular lesions show a hyper-intense signal compared to the vitreous body on T1-weighted (T1w) images, and malignant melanomas have been almost always determined as ‘cannot be excluded’ in reports.

Purpose

This study aimed to determine the accuracy of magnetic resonance imaging (MRI) in the diagnosis of uveal melanoma by using normal white matter as reference tissue for SI evaluation on T1w images and vitreous body on T2w compared to the conventional method using the vitreous body as a reference on both T1w and T2w images.

Methods

The MRIs of 43 patients (between August 2006 and July 2018) sent to rule out uveal melanoma were blindly reviewed by two radiologists. By using white matter as a reference for SI evaluation on T1w images and vitreous body as a reference on T2w images, uveal melanomas were suggested by hyper-intense signal on T1w and hypo-intense signal on T2w with homogeneous enhancement. The accuracy of diagnosis of uveal melanoma using white matter as a reference on T1w was compared to the conventional method using the vitreous body as a reference on both T1w and T2w images.

Results

The diagnosis of uveal melanoma using white matter as a reference gave a sensitivity of 92.31% (95% confidence interval (CI) 63.97–99.81) and specificity of 100.0% (95% CI 88.43–100.0). By using the vitreous body as a reference, sensitivity as high as 100.0% (95% CI 100.0–100.0) was obtained, but specificity was low at 53.33% (95% CI 34.33–71.66).

Conclusions

White matter is a good reference for the diagnosis of uveal melanoma, with high sensitivity and much higher specificity than conventional methods using the vitreous body as a reference.
The role of diffusion tensor imaging in idiopathic normal pressure hydrocephalus: A literature review
Authors: Grazzini Irene , Venezia Duccio , Cuneo Gian Luca
Published: December 2020

Idiopathic normal pressure hydrocephalus (iNPH) is a syndrome that comprises a triad of gait disturbance, dementia and urinary incontinence, associated with ventriculomegaly in the absence of elevated intraventricular cerebrospinal fluid (CSF) pressure. It is important to identify patients with iNPH because some of its clinical features may be reversed by the insertion of a CSF shunt. The diagnosis is based on clinical history, physical examination and brain imaging, especially magnetic resonance imaging (MRI). Recently, some papers have investigated the role of diffusion tensor imaging (DTI) in evaluating white matter alterations in patients with iNPH. DTI analysis in specific anatomical regions seems to be a promising MR biomarker of iNPH and could also be used in the differential diagnosis from other dementias. However, there is a substantial lack of structured reviews on this topic. Thus, we performed a literature search and analyzed the most recent and pivotal articles that investigated the role of DTI in iNPH in order to provide an up-to-date overview of the application of DTI in this setting. We reviewed studies published between January 2000 and June 2020. Thirty-eight studies and four reviews were included. Despite heterogeneity in analysis approaches, the majority of studies reported significant correlations between DTI and clinical symptoms in iNPH patients, as well as different DTI patterns in patients with iNPH compared to those with Alzheimer or Parkinson diseases. It remains to be determined whether DTI could predict the success after CSF shunting.
Neuroimaging lesion assessment by pseudo-subtraction of overlaid semi-transparent volumes: A technical description and feasibility series
Authors: Delgado Anna Falk , Delgado Alberto Falk
Published: December 2020

Assessing and reporting clinical images constitutes the mainstay of clinical neuroradiology. Continually increasing numbers of neuroradiology referrals and follow-up examinations call for reproducible, accurate, and rapid workflows. Readily available and easy to use, advanced workstation tools such as co-registration of volume series can be used to overlay volume series from two different time points as semi-transparent images, with an inverse color scale. By overlaying semi-transparent inverse color maps, stationary findings will be shaded out in grey, whereas progressing or regressing lesions will be highlighted as white or black in the resulting pseudo-subtraction map. Pseudosubtraction in longitudinal neuroradiology imaging might enhance workflow and imaging assessment.
The impact of adenotonsillectomy on monosymptomatic primary nocturnal enuresis in children with obstructive sleep apnea syndrome
Authors: Ghanem Mazen A , Swaid Ali I , Adawi Essa A , Ghanem Rim M , Ghanem Ahmed M , Aqeel Mohammed A , Safan Manal A
Published: December 2020

Objectives:

To analyze the outcome of monosymptomatic primary nocturnal enuresis (MPNE) after adenotonsillectomy in children with obstructive sleep apnea syndrome (OSAS).

Methods:

The study included 74 MPNE children with OSAS qualified for an adenotonsillectomy procedure. MPNE was assessed prior to surgical procedure as well as 3 and 6 months after surgery. In addition to polysomnographic parameters, serum antidiuretic hormone (ADH) and brain natriuretic peptide (BNP) levels were measured preoperatively and 3 months postoperatively.

Results:

The mean age was 9.8 years and the mean number of nocturnal wetting weekly was 4.1. Thirty-eight percent of patients had family history of MPNE. All the patients underwent a successful adenotonsillectomy. Nocturnal enuresis was still reported in 18% of children 6 months after adenotonsillectomy. An increased risk of MPNE was significantly demonstrated in children with high obstructive apnea-hypopnea index (O-AHI), high oxygen desaturation index (ODI), high frequent nocturnal enuresis and family history. After surgery, ADH levels were significantly lower, whereas BNP levels were significantly higher in non-resolution children. Univariate analysis showed that higher O-AHI, higher ODI, severe enuresis, low serum ADH and higher serum BNP levels were indicative of persistent nocturnal enuresis. Multivariate analysis showed that higher ODI and higher BNP levels are independent prognostic markers for MPNE.

Conclusions:

Adenotonsillectomy in MPNE children with OSAS is an effective treatment for resolution of MPNE. Also, higher ODI caused by apnea and elevated serum BNP levels are the most important factors affecting the outcome of MPNE patients.

Level of evidence:

Not applicable for this multicentre audit.
Socio-Demographic Factors Associated with Health Condition among Adult Bhantu Population of Andaman: A Cross-Sectional Study
Authors: Mukherjee Koel , Pandi Muthu , Rao K. Veereshwar
Published: December 2020

Malnutrition encompassing both under and over nutrition increases health risks in the adult population. In recent days, the increase in obesity and in turn, the incidence of chronic disease in adult population, now urges weight management interventions in obese adults. Bhantu, a De-notified Community of Andaman, labelled as a Criminal Tribe during British administration for their criminal acts, was settled here after their imprisonment. The present study is the first attempt to understand the impact of socio-economic determinants of health condition of Bhantu. It is a community-based study conducted among 305 adult individuals including males and females. Anthropometric measurements of height (cm) and weight (kg) were taken using standard technique and Body Mass Index (BMI) was calculated. To access socio-demographic condition of Bhantu community, a well-structured questionnaire was used for all participants to collect information on their income, literacy, marital status, types of family and so on. Results revealed that maximum number of males and females were overweight and socio-demographic variables have shown effect on their health. In conclusion, this study highlighted the importance of considering socio-demographic factors in the context of health study and incorporation of socio-demographic determinants in further research work is crucial for maintenance of health, functional independence and quality of life.
Parent Perspectives on Short-Term Recovery After Spinal Fusion Surgery in Children With Neuromuscular Scoliosis
Authors: Garrity Brigid M , Singer Sara J , Ward Erin , Bastianelli Lucia , Berry Jay G , Crofton Charis , Glader Laurie , Casto Elizabeth L ,   EHRLL Working Group56, Cox Joanne E
Published: December 2020

Family perspectives on short-term recovery after spinal fusion for neuromuscular scoliosis are essential for improving patient outcomes. Semistructured interviews were conducted with 18 families of children within 3 months after spinal fusion performed August 2017 to January 2019 at a children’s hospital. Interviews were recorded, transcribed, and coded line-by-line by 2 independent reviewers using grounded theory to identify themes. Five themes emerged among families when reflecting back on the postoperative recovery: (1) communicating and making shared decisions regarding postoperative care in a patient- and family-centered manner, (2) setting hospital discharge goals and being ready for discharge, (3) planning for transportation from hospital to home, (4) acquiring supports for caregiving at home after discharge, and (5) anticipating a long recovery at home. Important family perceptions were elicited about the recovery of children from spinal fusion for neuromuscular scoliosis that will inform better perioperative planning for clinicians, future patients, and their families.
Disappearing reeds on Chongming Island: An environmental microhistory of Chinese eco-development
Authors: Xie Linjun , Mauch Christof , Tan-Mullins May , Cheshmehzangi Ali
Published: December 2020

This paper critically examines current ecological development planning and practice in China through an environmental microhistory approach. By tracing the gradual disappearance of an indigenous plant – the common reed ( Phragmites australis) – on Chongming Island in Shanghai, which is known for the grand Eco-Islands development plan, this paper reveals the paradox of ecological destruction through eco-development in China. Based on data collected from archives, through oral history and through on-site fieldwork, we have reconstructed and analysed the transformation of Chongming Island’s reed ecology over time. Our research documents the historical importance of reeds to Chongming culture and identity. The transformation of the reed landscape mirrors, we argue, broader environmental and social transformations on the island. The near extinction of the once abundant reed in the coastal wetlands due to massive land reclamation projects for the purpose of industrialisation and urbanisation is a reflection of the prevailing pursuit for economic growth. Land reclamation projects in the early 2000s were facilitated by the planting of an invasive grass that replaced reeds and other native wetland plants. Ironically, the invasive grass served to legitimise continuous land reclamation as part of Chongming’s eco-development. Moreover, reeds that grew by the rivers and constituted a central part of local livelihoods were gradually wiped out as a result of a series of river regulation projects under the eco-development. Our research reveals that the current ecological agenda has privileged modern engineering solutions and aesthetics while largely ignoring local traditional knowledge. The case of Chongming delivers a sobering message that well-intentioned ecological initiatives can in fact have disastrous effects if the local environment, its ecological features, cultural characteristics, and historical and social contexts are not fully considered. Overall, this paper pioneers an environmental microhistory approach in evaluating contemporary urban ecological initiatives and contributes methodological and empirical insights to advance Chinese eco-developments.
Conflicts, cooperation and experimentation: Analysing the politics of urban water through Accra’s heterogeneous water supply infrastructure
Authors: Alba Rossella , Kooy Michelle , Bruns Antje
Published: December 2020

In this paper, we analyse the heterogeneity of water supply infrastructure in Accra, Ghana, to understand the politics of water in cities where infrastructural diversity has always been the norm. We do this by extending the use of heterogeneous infrastructure configurations as a heuristic device, shifting the focus and scale of urban political ecological analyses of infrastructural diversity from users and access to water distributions at city scale. To explain the impacts of three experiments in the distribution of water across the city, we analyse how changes in the technical and operational arrangements of Accra’s bulk water filling points reflect changes in the social relations of cooperation or conflict between the diversity of actors and infrastructure supplying water across the city. We find the uneven waterscape of the city is shaped by a plurality of actors whose practices are informed by a range of motives. These motives exceed profit-making, political legitimacy, patronage and petty corruption including also solidarity, religious beliefs and pragmatic choices. We show that distributions of water, risks and responsibilities among different actors involved in operating the water filling points are constantly contested with ambiguous and unforeseen outcomes foreclosing but also opening new possibilities for progressive experimentation. Documenting how relations between actors and technologies of water provisioning are dynamic, and open to incremental improvements towards progressive (re)distributions of water, our analysis at the city scale calls for further focus on how practices and policies of solidarity can be extended across heterogeneous provisioning systems.
LabPipe: an extensible bioinformatics toolkit to manage experimental data and metadata
Authors: Zhao Bo , Bryant Luke , Cordell Rebecca , Wilde Michael , Salman Dahlia , Ruszkiewicz Dorota , Ibrahim Wadah , Singapuri Amisha , Coats Tim , Gaillard Erol , Beardsmore Caroline , Suzuki Toru , Ng Leong , Greening Neil , Thomas Paul , Monks Paul , Brightling Christopher , Siddiqui Salman , Free Robert C.
Published: December 2020

Background

Data handling in clinical bioinformatics is often inadequate. No freely available tools provide straightforward approaches for consistent, flexible metadata collection and linkage of related experimental data generated locally by vendor software.

Results

To address this problem, we created LabPipe, a flexible toolkit which is driven through a local client that runs alongside vendor software and connects to a light-weight server. The toolkit allows re-usable configurations to be defined for experiment metadata and local data collection, and handles metadata entry and linkage of data. LabPipe was piloted in a multi-site clinical breathomics study.

Conclusions

LabPipe provided a consistent, controlled approach for handling metadata and experimental data collection, collation and linkage in the exemplar study and was flexible enough to deal effectively with different data handling challenges.
Characteristic patterns of emergency ambulance assignments for older adults compared with adults requiring emergency care at home in Sweden: a total population study
Authors: Hjalmarsson Anna , Holmberg Mats , Asp Margareta , Östlund Gunnel , Nilsson Kent W. , Kerstis Birgitta
Published: December 2020

Background

Since the vast majority of older adults in Sweden live in their private homes throughout life, the emergency medical services need to adapt accordingly. Hence, we aimed to describe characteristic patterns of dyadic staffed emergency ambulance assignments for older adults aged > 70 years compared with adults aged 18–69 years requiring emergency care at home in Sweden.

Methods

A descriptive retrospective study was performed using anonymized registry data from the emergency medical services in a region of Sweden during 2017–2018. One-sample χ2 test, one-way analysis of variance, and binary logistic regression models were used for investigating group differences. Variables for analysis were age, gender, clinical assessments, on-scene time, priority levels, result of response, and temporal patterns.

Results

Of all included emergency ambulance assignments (n = 28,533), 59.9% involved older adults, of which 53.8% were women. The probability for older adults to receive the highest priority was decreased for both dispatch (p < 0.001, odds ratio [OR] 0.63, 95% confidence interval [CI] 0.59–0.66), and transport priorities (p < 0.001, OR 0.74, 95% CI 0.68–0.80). Older adults were more likely to receive dispatch priority levels 2 (p < 0.001, OR 1.48, 95% CI 1.40–1.56), and 3 (p < 0.001, OR 1.73, 95% CI 1.46–2.06). The older adults were similarly more likely to receive transport priority level 3 (p < 0.001, OR 1.40, 95% CI 1.28–1.52) compared with adults. Age had a small but additive effect in relation to on-scene time (p < 0.001, R2 = 0.01, F = 53.82). Distinguishing initial clinical assessments for older adults were circulatory, respiratory, trauma, infection, and nonspecific assessments. Emergency ambulance assignments for older adults were more frequently occurring on Mondays (p < 0.001, χ2 = 232.56), and in the 08:00–11:59 interval (p < 0.001, χ2 = 1224.08).

Conclusion

The issues of the lower priority level preponderance, and the decreased probability for receiving the highest priority warrant further attention in future research and clinical practice.
Splenic infarction and infectious diseases in Korea
Authors: Im Jae Hyoung , Chung Moon-Hyun , Lee Hye-Jin , Kwon Hea Yoon , Baek Ji Hyeon , Jang Ji-Hun , Lee Jin-Soo
Published: December 2020

Background

The spleen contains immune cells and exhibits a pattern of infarction different from other organs; as such, splenic infarction (SI) may provide important clues to infection. However, the nature of the relationship between SI and infectious disease(s) is not well understood. Accordingly, this retrospective study investigated the relationship between SI and infection.

Methods

Hospital records of patients with SI, who visited Inha University Hospital (Incheon, Republic of Korea) between January 2008 and December 2018, were reviewed. Patient data regarding clinical presentation, causative pathogens, risk factors, and radiological findings were collected and analyzed.

Results

Of 353 patients with SI, 101 with infectious conditions were enrolled in this study, and their data were analyzed to identify associations between SI and infection. Ten patients were diagnosed with infective endocarditis (IE), and 26 exhibited bacteremia without IE. Twenty-seven patients experienced systemic infection due to miscellaneous causes (negative result on conventional automated blood culture), including the following intracellular organisms: parasites (malaria [n = 12], babesiosis [n = 1]); bacteria (scrub typhus [n = 5]); viruses (Epstein–Barr [n = 1], cytomegalovirus [n = 1]); and unidentified pathogen[s] (n = 7). Splenomegaly was more common among patients with miscellaneous systemic infection; infarction involving other organs was rare. Thirty-eight patients had localized infections (e.g., respiratory, intra-abdominal, or skin and soft tissue infection), and most (35 of 38) had other risk factors for SI.

Conclusions

In this study, various infectious conditions were found to be associated with SI, and intracellular organisms were the most common causative pathogens. Further studies are needed to examine other possible etiologies and the underlying pathophysiological mechanisms.
Low birthweight, prematurity, and intrauterine growth restriction: results from the baseline data of the first indigenous birth cohort in Brazil (Guarani Birth Cohort)
Authors: Barreto Carla Tatiana Garcia , Tavares Felipe Guimarães , Theme-Filha Mariza , Farias Yasmin Nascimento , Pantoja Lídia de Nazaré , Cardoso Andrey Moreira
Published: December 2020

Background

Low birthweight (LBW) remains an important global health problem, associated with a range of adverse life-course health outcomes. Evidence suggests that LBW is a relevant determinant of morbidity and mortality in indigenous groups, who generally have limited access to public policies on health and nutrition. Knowledge of the prevalence of LBW and its underlying causes can contribute essential steps to the prevention of its health effects. The study aimed to estimate the prevalence rates of LBW, prematurity, and intrauterine growth restriction (IUGR) and to investigate their determinants in the first indigenous birth cohort in Brazil.

Methods

This cross-sectional study used baseline data collected from the first indigenous birth cohort in Brazil, the Guarani Birth Cohort. Brazil is one of the most ethnically diverse countries in the world, with 305 indigenous peoples and 274 native languages. The Guarani are one of the five largest ethnic groups, with villages located mostly in the southern region. All singleton births from June 1, 2014, to May 31, 2016, were selected in 63 Guarani indigenous villages in the South and Southeast regions. Hierarchical multiple logistic regression was performed.

Results

Prevalence rates for LBW, prematurity, and IUGR were 15.5, 15.6, and 5.7%, respectively. The odds of LBW were lower in newborns of mothers living in brick and mortar housing (OR: 0.25; 95%CI: 0.07–0.84) and were higher in children of mothers ≤20 years of age (OR: 2.4; 95%CI: 1.29–4.44) and with chronic anemia before pregnancy (OR: 6.41; 95% CI: 1.70–24.16). Prematurity was statistically associated with the type of energy source for cooking (wood-burning stove – OR: 3.87; 95%CI: 1.71–8.78 and bonfires – OR: 2.57; 95%CI: 1.31–5.01). IUGR was associated with primiparity (OR: 4.66; 95%CI: 1.68–12.95) and chronic maternal anemia before pregnancy (OR: 7.21; 95%CI: 1.29–40.38).

Conclusions

Maternal age, nutritional status, and parity, housing conditions, and exposure to indoor pollution were associated with perinatal outcomes in the Guarani indigenous population. These results indicate the need to invest in access to, and improvement of, prenatal care; also in strengthening the Indigenous Healthcare Subsystem, and in inter-sector actions for the development of housing policies and sanitation and environmental improvements adjusted to needs and knowledge of the indigenous people.
Selective expression of KCNA5 and KCNB1 genes in gastric and colorectal carcinoma
Authors: Farah Azer , Kabbage Maria , Atafi Salsabil , Gabteni Amira Jaballah , Barbirou Mouadh , Madhioub Mouna , Hamzaoui Lamine , Mohamed Mousadak Azzouz , Touinsi Hassen , Kchaou Asma Ouakaa , Chelbi Emna , Boubaker Samir , Abderrazek Rahma Ben , Bouhaouala-Zahar Balkiss
Published: December 2020

Background

Gastric and colorectal cancers are the most common malignant tumours, leading to a significant number of cancer-related deaths worldwide. Recently, increasing evidence has demonstrated that cancer cells exhibit a differential expression of potassium channels and this can contribute to cancer progression. However, their expression and localisation at the somatic level remains uncertain. In this study, we have investigated the expression levels of KCNB1 and KCNA5 genes encoding ubiquitous Kv2.1 and Kv1.5 potassium channels in gastric and colorectal tumours.

Methods

Gastric and colorectal tumoral and peritumoral tissues were collected to evaluate the expression of KCNB1 and KCNA5 mRNA by quantitative PCR. Moreover, the immunohistochemical staining profile of Kv2.1 and Kv1.5 was assessed on 40 Formalin-Fixed and Paraffin-Embedded (FFPE) gastric carcinoma tissues. Differences in gene expression between tumoral and peritumoral tissues were compared statistically with the Mann-Whitney U test. The association between the clinicopathological features of the GC patients and the expression of both Kv proteins was investigated with χ2 and Fisher’s exact tests.

Results

The mRNA fold expression of KCNB1 and KCNA5 genes showed a lower mean in the tumoral tissues (0.06 ± 0.17, 0.006 ± 0.009) compared to peritumoral tissues (0.08 ± 0.16, 0.16 ± 0.48, respectively) without reaching the significance rate (p = 0.861, p = 0.152, respectively). Interestingly, Kv2.1 and Kv1.5 immunostaining was detectable and characterised by a large distribution in peritumoral and tumoral epithelial cells. More interestingly, inflammatory cells were also stained. Surprisingly, Kv2.1 and Kv1.5 staining was undoubtedly and predominantly detected in the cytoplasm compartment of tumour cells. Indeed, the expression of Kv2.1 in tumour cells revealed a significant association with the early gastric cancer clinical stage (p = 0.026).

Conclusion

The data highlight, for the first time, the potential role of Kv1.5 and Kv2.1 in gastrointestinal-related cancers and suggests they may be promising prognostic markers for these tumours.
Changing nursing practice within primary health care innovations: the case of advanced access model
Authors: Abou Malham Sabina , Breton Mylaine , Touati Nassera , Maillet Lara , Duhoux Arnaud , Gaboury Isabelle
Published: December 2020

Background

The advanced access (AA) model has attracted much interest across Canada and worldwide as a means of ensuring timely access to health care. While nurses contribute significantly to improving access in primary healthcare, little is known about the practice changes involved in this innovative model. This study explores the experience of nurse practitioners and registered nurses with implementation of the AA model, and identifies factors that facilitate or impede change.

Methods

We used a longitudinal qualitative approach, nested within a multiple case study conducted in four university family medicine groups in Quebec that were early adopters of AA. We conducted semi-structured interviews with two types of purposively selected nurses: nurse practitioners (NPs) (n = 6) and registered nurses (RNs) (n = 5). Each nurse was interviewed twice over a 14-month period. One NP was replaced by another during the second interviews. Data were analyzed using thematic analysis based on two principles of AA and the Niezen & Mathijssen Network Model (2014).

Results

Over time, RNs were not able to review the appointment system according to the AA philosophy. Half of NPs managed to operate according to AA. Regarding collaborative practice, RNs were still struggling to participate in team-based care. NPs were providing independent and collaborative patient care in both consultative and joint practice, and were assuming leadership in managing patients with acute and chronic diseases. Thematic analysis revealed influential factors at the institutional, organizational, professional, individual and patient level, which acted mainly as facilitators for NPs and barriers for RNs. These factors were: 1) policy and legislation; 2) organizational policy support (leadership and strategies to support nurses’ practice change); facility and employment arrangements (supply and availability of human resources); Inter-professional collegiality; 3) professional boundaries; 4) knowledge and capabilities; and 5) patient perceptions.

Conclusions

Our findings suggest that healthcare decision-makers and organizations need to redefine the boundaries of each category of nursing practice within AA, and create an optimal professional and organizational context that supports practice transformation. They highlight the need to structure teamwork efficiently, and integrate and maximize nurses’ capacities within the team throughout AA implementation in order to reduce waiting times.
Patient involvement in quality improvement – a ‘tug of war’ or a dialogue in a learning process to improve healthcare?
Authors: Bergerum Carolina , Engström Agneta Kullén , Thor Johan , Wolmesjö Maria
Published: December 2020

Background

Co-production and co-design approaches to quality improvement (QI) efforts are gaining momentum in healthcare. Yet, these approaches can be challenging, not least when it comes to patient involvement. The aim of this study was to examine what might influence QI efforts in which patients are involved, as experienced by the patients and the healthcare professionals involved.

Methods

This study involved a qualitative design inspired by the constructivist grounded theory. In one mid-sized Swedish hospital’s patient process organisation, data was collected from six QI teams that involved patients in their QI efforts, addressing care paths for patients with transient, chronic and/or multiple parallel diagnoses. Field notes were collected from participant observations during 53 QI team meetings in three of the six patient processes. Individual, semi-structured interviews were conducted with 12 patients and 12 healthcare professionals in all the six QI teams.

Results

Patients were involved in QI efforts in different ways. In three of the QI teams, patient representatives attended team meetings regularly. One team consulted patient representatives on a single occasion, one team collected patient preferences structurally from individual interviews with patients, and one team combined interviews and a workshop with patients. The patients’ and healthcare professionals’ expressions of what might influence the QI efforts involving patients were similar in several ways. QI team members emphasized the importance of organisational structure and culture. Furthermore, they expressed a desire for ongoing interaction between patients and healthcare professionals in healthcare QI.

Conclusions

QI team members recognised continuous dialogue and collective thinking by the sharing of experiences and preferences between patients and healthcare professionals as essential for achieving better matches between healthcare resources and patient needs in their QI efforts. Significant structural and cultural aspects of performing QI in complex hospital organisations were considered to be obstructions to progress. Therefore, to sustain learning and behaviour change through QI efforts at the team level, a deeper understanding of how structural and cultural aspects of QI promote or prevent success appears essential.