bluuebunny/crossref_metadata_2025 huggingface dataset:
To Braille or Not to Braille …?
Authors: Lipman Miriam H.
Published: March 2020

A special forum for individuals to respond in detail to material published in the New Outlook for the Blind or elsewhere, to present new ideas, or to raise issues which relate to the specialized field of work with blind and visually handicapped persons. Contributions should be 350-1,000 words in length.
Listening Skills: A Review of the Literature
Authors: Daugherty Kathryn M.
Published: March 2020

This 106-item annotated bibliography includes material on the developmental and educational aspects of listening skills; it was compiled as part of a project to establish the frame of reference for the development of a listening skills program. Appended to the bibliography is an annotated list of eight tests related to listening skills and a list of 25 problems that need further research.
Low Vision Services in an Agency: Structure and Philosophy
Authors: Faye Eleanor E. , Hood Clare M.
Published: March 2020

The development and present structure of the comprehensive Low Vision Service of the New York Association for the Blind are used as the basis for a full discussion of the operation of such a clinical service, including its positive and negative features. The clinic is administered by a medical director and by an administrator who coordinates the work of a staff consisting of ophthalmologists, optometrists, low vision assistants, volunteers, registrar, and receptionist. A separate Optical Aids Service stocks low vision aids which it sells by prescription to clinics, doctors, and patients within and without the agency. Referrals for special services are made to the other departments of the agency. Also described are the low vision examination itself, follow-up and training services, and the aid loan system.
Developmental Assessment of Handicapped Infants and Young Children: With Special Attention to the Visually Impaired
Authors: Chase Joan B.
Published: March 2020

To effectively plan for services for young handicapped children, early objective developmental assessments are necessary. Although caution must be exercised in their use, assessment measures for infants can help to prevent, ameliorate, or uncover the difficulties that the handicapped child might face. By using a battery of assessments, a profile of the child's abilities, strengths, weaknesses, and disabilities is yielded.
Faster Braille Reading: Preparation at the Reading Readiness Level
Authors: Olson Myrna R.
Published: March 2020

Research on braille readers has shown that they lag increasingly farther behind print readers in terms of reading rate as they progress through school. Since the younger a reader is, the more he benefits from training in rapid reading techniques, training should begin as soon as possible. This article describes six skills related to more efficient braille reading that should be considered for use as early as the reading readiness level. Specific activities are suggested for developing each of these skills.
Helen Keller: A Remembrance
Authors: Lowenfeld Berthold
Published: March 2020

Berthold Lowenfeld, well-known educator and author in the field of work with the blind, knew Helen Keller for many years. In this centennial year of her birth, he recalls times he spent with her, including her visit to the California School for the Blind, where he was superintendent, for the consecration of the Helen Keller Building. In quoting from letters she wrote to him, Dr. Lowenfeld allows Helen Keller's intelligence, thoughtfulness, compassion, dynamism, curiosity, and alertness to speak for themselves.
Drop-Off Detection in the Touch Technique
Authors: Uslan Mark M. , Schriebman Kenneth
Published: March 2020

Using a theoretical model of walking with the cane, drop-off detection in the touch technique was analyzed. Sufficient cane length for detecting curb drop-offs was found to be measurable and a chart was generated to enable the practitioner to determine cane length easily. Synchronous walking, called “in-step,” was shown to be advantageous when approaching the rounded part of a corner down-curb. For locating downcurbs, the cane is a reasonably efficient drop-off detector when compared to its obstacle detection characteristics.
A Survey on the Use of the Abacus in Residential Schools
Authors: Steinbrenner Arthur H. , Becker Carol , Kalina Ken
Published: March 2020

Surveys the practices in residential schools concerning the use of computational devices and the types of teacher training in the use of the abacus. Consensus of facts and opinions voiced by respondents from 30 residential schools is reported. The major emphasis is on the effective use of the abacus.
A Guide to the Psychological Assessment of Deaf-Blind Adults
Authors: Vernon Mccay , Green David
Published: March 2020

Discusses the special problems involved in the psychological evaluation of deaf-blind adults. Outlines three major limiting factors in this area: (1) the lack of psychological tests designed for these clients, (2) the dearth of psychologists trained to work with them and (3) the failure to obtain complete case histories. Describes several methods of overcoming these drawbacks.
Psychodrama with Blind Psychiatric Patients
Authors: Altman Kerry P.
Published: March 2020

After reviewing the general principles of psychodramatic group psychotherapy, the author provides a descriptive analysis of the first six sessions of a psychodrama group for blind psychiatric patients that was initiated recently at Saint Elizabeths Hospital in Washington, D. C. He also offers suggestions for using action methods with such patients.
Piano Tuning: Something Blind Persons Can Do?
Authors: Van Dyke Paul
Published: March 2020

A special forum for individuals to respond in detail to material published in the Journal of Visual Impairment and Blindness or to raise issues which relate to the specialized field of work with blind and visually handicapped persons. Contributions should be 350-1000 words in length.
Blindness in the Information Age: Equality or Irony?
Authors: Scadden Lawrence A.
Published: March 2020

Describes predictions for the information society, implications for blind and visually impaired people, and an agenda of needed activities to be undertaken for the purpose of ensuring the highest level of equality in employment, education, and daily living at the dawning of the 21st century.
Constraints on Microcompute Access for Visually Impaired Persons
Authors: Young Michael F.
Published: March 2020

Microcomputers are an increasingly important part of educational and professional activities. There are six constraints on equal opportunity for visually impaired persons to access microcomputers. They are the absence of (1) a standard computer braille code, (2) a standard system for the audio encoding of braille, (3) a means for accessing unique disk-operating system (DOS) copy-protected programs, (4) reasonably priced equipment, (5) an interactive tactile graphics display, and (6) specially designed software; there may be others. These issues must be addressed if visually impaired persons are to have equal access to the benefits of microcomputers.
A Test of Tactile Concentration and Short-term Memory
Authors: Kainthola S.D. , Singh T.B.
Published: March 2020

This article reports the initial findings of a two-part test of tactile concentration and short-term memory involving the reproduction of the order of finger stimulation—a forward series and a backward series. A newly devised instrument, the Finger Knocking Box, was used for the mechanical stimulation of fingers and the recording of responses by 65 totally blind or partially sighted subjects of average intelligence.
The Extemalization of Spatial Representation by Blind Persons
Authors: Huertas J.A. , Ochaita E.
Published: March 2020

This article compares two procedures for the externalization of spatial representation. Blind children and adolescents had to learn two unknown environments and to externalize the spatial representation by building a model and estimating distances. High correlations were found between the two externalization methods and between those methods and two systems of measuring mobility.
Psychosocial Adjustment to Age-related Macular Degeneration
Authors: Davis C. , Lovie-Kitchin J. , Thompson B.
Published: March 2020

This article reports on a study of the psychosocial adjustment to age-related macular degeneration of 30 elderly persons by comparing the responses of subjects with this condition to those from age- and sex-matched controls on four psychosocial scales: life satisfaction, daily hassles, social support, and self-esteem. The subjects with the condition reported significantly poorer life satisfaction and greater stress, perhaps as a result of poor social support.
The Development of Social Understanding in Children with Visual Impairments
Authors: McAlpine L.M. , Moore C.L.
Published: March 2020

This article reports on the performance of 16 visually impaired children, aged 4–12, on tasks designed to assess their understanding of false belief, a central aspect of social understanding. The study found that the development of understanding of another's false belief is delayed in children with severe visual impairments and that the degree of vision loss seems to be a key variable in that development.
Incident cerebral lacunes: A review
Authors: Ling Yifeng , Chabriat Hugues
Published: March 2020

Lacunes on magnetic resonance imaging (MRI) are considered as a key hallmark for evaluating the progression and severity of cerebral small vessel diseases. We aimed to review the MRI diagnostic criteria, frequency, predictors and clinical impact of incident lacunes in the largest longitudinal studies. Analyses were restricted to cohort studies of more than 50 individuals that investigated incident lacunes over a duration of at least one year. We observed that: (1) MRI parameters and definition of lacunes are inconsistent across studies, (2) the frequency of incident lacunes is strongly related to the previous clinical and MRI status at individual level, (3) both age and hypertension diagnosed at onset predict incident lacunes but the exact impact of blood pressure level during follow-up remains undetermined, (4) the clinical correlates of these lesions on cognition are repeatedly observed but the exact consequences on motor or gait performances are not always evaluated. Homogenization of imaging techniques, the use of strict diagnostic criteria and a broader clinical assessment considering motor and gait performances should be recommended in future longitudinal studies of incident lacunes including clinical trials testing preventative treatments in cerebral small vessel diseases.
Why Do Line Drawings Work? A Realism Hypothesis
Authors: Hertzmann Aaron
Published: March 2020

Why is it that we can recognize object identity and 3D shape from line drawings, even though they do not exist in the natural world? This article hypothesizes that the human visual system perceives line drawings as if they were approximately realistic images. Moreover, the techniques of line drawing are chosen to accurately convey shape to a human observer. Several implications and variants of this hypothesis are explored.
Acid–base kinetics during hemodialysis using bicarbonate and lactate as dialysate buffer bases based on the H+ mobilization model
Authors: Leypoldt John K , Pietribiasi Mauro , Ebinger Anna , Kraus Michael A , Collins Allan , Waniewski Jacek
Published: March 2020

Background:

The H+ mobilization model has been recently reported to accurately describe intradialytic kinetics of plasma bicarbonate concentration; however, the ability of this model to predict changing bicarbonate kinetics after altering the hemodialysis treatment prescription is unclear.

Methods:

We considered the H+ mobilization model as a pseudo-one-compartment model and showed theoretically that it can be used to determine the acid generation (or production) rate for hemodialysis patients at steady state. It was then demonstrated how changes in predialytic, intradialytic, and immediate postdialytic plasma bicarbonate (or total carbon dioxide) concentrations can be calculated after altering the hemodialysis treatment prescription.

Results:

Example calculations showed that the H+ mobilization model when considered as a pseudo-one-compartment model predicted increases or decreases in plasma total carbon dioxide concentrations throughout the entire treatment when the dialysate bicarbonate concentration is increased or decreased, respectively, during conventional thrice weekly hemodialysis treatments. It was further shown that this model allowed prediction of the change in plasma total carbon dioxide concentration after transfer of patients from conventional thrice weekly to daily hemodialysis using both bicarbonate and lactate as dialysate buffer bases.

Conclusion:

The H+ mobilization model can predict changes in plasma bicarbonate or total carbon dioxide concentration during hemodialysis after altering the hemodialysis treatment prescription.
Spiritual skepticism? Heterogeneous science skepticism in the Netherlands
Authors: Rutjens Bastiaan T. , van der Lee Romy
Published: March 2020

Recent work points to the heterogeneous nature of science skepticism. However, most research on science skepticism has been conducted in the United States. The current work addresses the generalizability of the knowledge acquired so far by investigating individuals from a Western European country (The Netherlands). Results indicate that various previously reported findings hold up: Mirroring North American patterns, climate change skepticism is associated with political conservatism (but only modestly), and scientific literacy does not contribute to skepticism, except about genetic modification (Study 1 only) and vaccine skepticism (Study 2 only). Results also reveal a crucial difference: Religiosity does not consistently contribute to science skepticism, except about evolution. Instead, spirituality is found to most consistently predict vaccine skepticism and low general faith in science—which in turn predicts willingness to support science. Concerns about societal impact play an additional role. These findings speak to the generalizability of previous findings, improving our understanding of science skepticism.
Effectiveness of Steroid Treatment for Sudden Sensorineural Hearing Loss: A Meta-analysis of Randomized Controlled Trials
Authors: Li Jinfei , Ding Lei
Published: March 2020

Background:

The best way to administer steroids for sudden sensorineural hearing loss (SSHL) is still unclear. The present study was aimed at estimating the efficacy of steroids by intratympanic, systemic, and combined therapy (CT) routes.

Methods:

A systematic literature search was performed from 1950 to October 2019 for randomized controlled trials comparing the use of intratympanic, systemic, and combined steroid therapy for SSHL. The outcomes of recovery rate and pure tone average (PTA) improvement were assessed by random-effects and fixed-effects meta-analysis.

Results:

A total of 20 articles identified from 7 countries were eligible for analysis. Although no significant difference in recovery rate was observed between intratympanic steroid therapy (IST) and systemic steroid therapy (SST), IST did demonstrate better hearing improvement, as evidenced by a higher PTA than SST. Compared with SST, CT comprising IST and SST had significant recovery rate improvement. Patients treated with CT had a significantly higher PTA than those treated with SST. Through subgroup analysis based on the equivalent dose of prednisone, it was shown that CT led to a significantly higher PTA than SST only in the high-dose CT versus high-dose SST groups and moderate-dose CT versus high-dose SST groups.

Conclusion:

Moderate and high dose of CT could accelerate hearing improvement in SSHL.
Functional Results of All-Inside Arthroscopic Broström-Gould Surgery With 2 Anchors Versus Single Anchor
Authors: Feng Shi-Ming , Wang Ai-Guo , Sun Qing-Qing , Zhang Zai-Yi
Published: March 2020

Background:

The all-inside arthroscopic Broström-Gould technique gained particular attention among clinicians and researchers due to its high rate of satisfactory results. Thus far, there is a lack of evidence regarding the differences in clinical outcomes between the use of 1 anchor and 2 anchors. The purpose of this study was to compare the differences in clinical function and activity levels in patients treated with 1 or 2 anchors in all-inside arthroscopic Broström-Gould surgery for chronic lateral ankle instability (CLAI).

Methods:

The data of 75 patients with CLAI (unilateral) admitted from May 2013 to July 2016 were retrospectively analyzed. All patients were treated with all-inside arthroscopic Broström-Gould surgery. The patients were divided into a single-anchor group ( n = 36) and double-anchor group ( n = 39) according to the number of anchors used. There was no statistical difference in general characteristics between the 2 groups before surgery. After 36 to 72 months of follow-up, the pain visual analog scale (VAS) score, American Orthopaedic Foot & Ankle Society (AOFAS) score, Karlsson Ankle Functional Score (KAFS), and Foot and Ankle Outcome Score (FAOS) were used to evaluate and compare the clinical function results between the 2 groups.

Results:

The incidence of wound complications; reaction to the suture; injury to the nerve, blood vessel, or tendon; and length of postoperative hospitalization were similar between the 2 groups. At the last follow-up, there was no significant difference in the VAS and AOFAS scores between single- and double-anchor groups, but the KAFS and FAOS in the double-anchor group were significantly higher than in the single-anchor group. Additionally, more patients in the double-anchor group returned to preinjury sports activities.

Conclusion:

All-inside arthroscopic Broström-Gould surgery for the treatment of CLAI yielded a better functional effect and better recovery to preinjury mobility when 2 anchors were used instead of a single anchor.

Level of Evidence:

Level III, comparative study.
Gender Wage Gap in Hospitality
Authors: Oliver Xisco , Sard Maria
Published: March 2020

This article analyzes the gender wage gap in the hospitality sector. First, it explores whether the gender wage gap is partly explained by the economic sector. Second, it measures how this gap changes across the wage distribution using quantile regression. Third, it decomposes the gender wage gap in the hospitality sector to distinguish which part can be explained by observed attributes and which part is explained by other factors (unobserved characteristics or gender discrimination). Methodologically, this article introduces the use of quantile regression to the analysis of the gender wage gap and its decomposition in the hospitality sector. The main findings are as follows. First, on average in the hospitality sector, wages (without taking into account worker skills) are below the overall average wages. However, if a deeper look is taken, this research reveals that unskilled workers are better paid in hospitality than in most of the other sectors. The opposite is true for skilled workers, since mid- and high-wage workers in the hospitality sector receive wages below their counterparts in other sectors. Second, the gender wage gap is particularly low in the hospitality sector and the gap changes across the wage distribution. Third, a large part of the gender wage gap in hospitality is not explained by worker or company characteristics. The segregation of women into worse-paid jobs and gender discrimination (or unobserved characteristics) seem to be the main sources of the gender wage gap.
Effects of shape of the neck of classical acoustical resonators on the sound absorption quality for large amplitudes: Experimental results
Authors: Gourdon Emmanuel , Ture Savadkoohi Alireza , Cauvin Bertrand
Published: March 2020

This article presents some experimental results on Helmholtz resonators for large sound amplitudes with two general geometries of their necks: the resonators with classical (cylindrical) and quadratic nonlinear necks. Obtained results for large amplitudes show accelerated amplitude dependency of resonant frequencies of the resonators with modified shape of the neck compared to classical ones. This nonlinear response can be used as a passive controller system with nonlinear restoring forcing function for having broadband frequency absorption.
A Process-Oriented Guided-Inquiry Learning (POGIL)-Based Curriculum for the Experimental Psychology Laboratory
Authors: Rumain Barbara , Geliebter Allan
Published: March 2020

We implemented NSF-funded computerized Experimental Psychology Laboratories at Touro College and incorporated process-oriented guided-inquiry learning (POGIL). We designed POGIL modules for the labs and conducted workshops for faculty on the implementation of the guided-inquiry approach, including learning teams. Data were collected from students who took experimental psychology with and without using POGIL, to assess the impact of the curriculum materials. Achievement was measured with (a) selected items from the Major Field Achievement Tests (MFAT) and (b) our own assessment instrument. Results indicated that students using the POGIL materials performed significantly better on both achievement tests than students not using them. This is the first demonstration that POGIL led to higher achievement than non-POGIL instruction for experimental psychology. These results are consistent with previous POGIL findings in the field of chemistry.
Myocarditis in athletes: A clinical perspective
Authors: Halle Martin , Binzenhöfer Leonhard , Mahrholdt Heiko , Johannes Schindler Michael , Esefeld Katrin , Tschöpe Carsten
Published: March 2020

Myocarditis is an important cause of arrhythmias and sudden cardiac death (SCD) in both physically active individuals and athletes. Elite athletes seem to have an increased risk for viral infection and subsequent myocarditis due to increased exposure to pathogens (worldwide traveling/international competition) or impaired immune system (continuing training during infections/resuming training early thereafter, strenuous exercise training or competition, and exercising in extreme weather conditions). Initial clinical presentation is variable, but athletes characteristically express non-specific symptoms of fatigue, muscle soreness, increased heart rate at rest, as well as during exercise and reduced overall exercise capacity. Beyond resting electrocardiogram (ECG), cardiac biomarkers, echocardiography, and 24-hour Holter ECG, diagnostic work-up should include cardiac magnetic resonance imaging (CMR) assessing inflammation, oedema, and fibrosis by late gadolinium enhancement (LGE), respectively, as these measures are crucial for prognosis and sports eligibility. For patients with insufficient cardiac recovery, endomyocardial biopsy is recommended to clarify differential diagnoses and initiate specific treatment options. In uncomplicated cases with normal left ventricular function during acute phase and absent LGE, eligibility for sports can be attested to three months after clinical recovery. In those with persistent pathological findings, even after six months, the risk for SCD remains increased and resuming exercise beyond recreational activities can only be recommended individually based on course of disease, left ventricular function, arrhythmias, pattern of LGE in CMR, as well as intensity and volume of exercise performed during training and competition. For all athletes, follow-up examination should be performed yearly.
Genome-wide association studies for yield component traits in a macadamia breeding population
Authors: O’Connor Katie , Hayes Ben , Hardner Craig , Nock Catherine , Baten Abdul , Alam Mobashwer , Henry Robert , Topp Bruce
Published: March 2020

Background

Breeding for new macadamia cultivars with high nut yield is expensive in terms of time, labour and cost. Most trees set nuts after four to five years, and candidate varieties for breeding are evaluated for at least eight years for various traits. Genome-wide association studies (GWAS) are promising methods to reduce evaluation and selection cycles by identifying genetic markers linked with key traits, potentially enabling early selection through marker-assisted selection. This study used 295 progeny from 32 full-sib families and 29 parents (18 phenotyped) which were planted across four sites, with each tree genotyped for 4113 SNPs. ASReml-R was used to perform association analyses with linear mixed models including a genomic relationship matrix to account for population structure. Traits investigated were: nut weight (NW), kernel weight (KW), kernel recovery (KR), percentage of whole kernels (WK), tree trunk circumference (TC), percentage of racemes that survived from flowering through to nut set, and number of nuts per raceme.

Results

Seven SNPs were significantly associated with NW (at a genome-wide false discovery rate of < 0.05), and four with WK. Multiple regression, as well as mapping of markers to genome assembly scaffolds suggested that some SNPs were detecting the same QTL. There were 44 significant SNPs identified for TC although multiple regression suggested detection of 16 separate QTLs.

Conclusions

These findings have important implications for macadamia breeding, and highlight the difficulties of heterozygous populations with rapid LD decay. By coupling validated marker-trait associations detected through GWAS with MAS, genetic gain could be increased by reducing the selection time for economically important nut characteristics. Genomic selection may be a more appropriate method to predict complex traits like tree size and yield.
Concordance rate between copy number variants detected using either high- or medium-density single nucleotide polymorphism genotype panels and the potential of imputing copy number variants from flanking high density single nucleotide polymorphism haplotypes in cattle
Authors: Rafter Pierce , Gormley Isobel Claire , Parnell Andrew C. , Kearney John Francis , Berry Donagh P.
Published: March 2020

Background

The trading of individual animal genotype information often involves only the exchange of the called genotypes and not necessarily the additional information required to effectively call structural variants. The main aim here was to determine if it is possible to impute copy number variants (CNVs) using the flanking single nucleotide polymorphism (SNP) haplotype structure in cattle. While this objective was achieved using high-density genotype panels (i.e., 713,162 SNPs), a secondary objective investigated the concordance of CNVs called with this high-density genotype panel compared to CNVs called from a medium-density panel (i.e., 45,677 SNPs in the present study). This is the first study to compare CNVs called from high-density and medium-density SNP genotypes from the same animals. High (and medium-density) genotypes were available on 991 Holstein-Friesian, 1015 Charolais, and 1394 Limousin bulls. The concordance between CNVs called from the medium-density and high-density genotypes were calculated separately for each animal. A subset of CNVs which were called from the high-density genotypes was selected for imputation. Imputation was carried out separately for each breed using a set of high-density SNPs flanking the midpoint of each CNV. A CNV was deemed to be imputed correctly when the called copy number matched the imputed copy number.

Results

For 97.0% of CNVs called from the high-density genotypes, the corresponding genomic position on the medium-density of the animal did not contain a called CNV. The average accuracy of imputation for CNV deletions was 0.281, with a standard deviation of 0.286. The average accuracy of imputation of the CNV normal state, i.e. the absence of a CNV, was 0.982 with a standard deviation of 0.022. Two CNV duplications were imputed in the Charolais, a single CNV duplication in the Limousins, and a single CNV duplication in the Holstein-Friesians; in all cases the CNV duplications were incorrectly imputed.

Conclusion

The vast majority of CNVs called from the high-density genotypes were not detected using the medium-density genotypes. Furthermore, CNVs cannot be accurately predicted from flanking SNP haplotypes, at least based on the imputation algorithms routinely used in cattle, and using the SNPs currently available on the high-density genotype panel.
Trends in microbial profile of burn patients following an event of dust explosion at a tertiary medical center
Authors: Chen Yin-Yin , Wu Ping-Feng , Chen Chii-Shya , Chen Ian-Horng , Huang Wan-Tsuei , Wang Fu-Der
Published: March 2020

Background

Microbial infection is the main cause of increased morbidity and mortality in burn patients, especially infections caused by multiple drug-resistant organisms (MDRO). The purpose of this study was to explore major microbial trends in burn patients.

Methods

This retrospective study was conducted at burn wards and intensive care units, where burn patients were admitted following an event of dust explosion. Data were collected for a number of variables including severity of burns, demographic and clinical characteristics, laboratory data, and therapeutic devices.

Results

A total of 1132 specimens were collected from 37 hospitalized burn patients with mean TBSA of 46.1%.The most commonly isolated species were Staphylococcus spp. (22.4%). The highest rate of antibiotic resistance was observed in carbapenem–resistant A. baumannii (14.6%), followed by methicillin-resistant S. aureus (11.3%). For each additional 10% TBSA, the isolation of MDRO increased 2.58–17.57 times (p < 0.05); for each additional 10% of the third-degree burn severity, the risk of MDRO significantly decreased by 47% (95% CI, 0.38–0.73, p < 0.001) by Cox model.

Conclusions

The proportion of overall microbial isolates increased with the increase in TBSA and duration of time after burns. The extent of TBSA was the most important factor affecting MDRO.
Sarcopenia as a predictor of mortality in women with breast cancer: a meta-analysis and systematic review
Authors: Zhang Xiao-Ming , Dou Qing-Li , Zeng Yingchun , Yang Yunzhi , Cheng Andy S. K. , Zhang Wen-Wu
Published: March 2020

Background

Breast cancer is the most commonly diagnosed cancer and the leading cause of cancer death in women worldwide. Recently, studies have been published with inconsistent findings regarding whether sarcopenia is a risk factor for mortality in breast cancer patients. Therefore, the aim of this systematic review and meta-analysis was to systematically assess and quantify sarcopenia as a risk factor for mortality in breast cancer patients.

Methods

In a systematic literature review of PubMed, EMBASE, and the Cochrane CENTRAL Library, we searched for observational studies written in English (from database inception until April 30, 2019) that reported an association between sarcopenia and breast cancer in women who were 18 years or older.

Results

A total of six studies (5497 participants) were included in this meta-analysis. Breast cancer patients with sarcopenia were associated with a significantly higher risk of mortality, compared to breast cancer patients without sarcopenia (pooled HR-hazard ratio = 1.71, 95% CI: 1.25–2.33, I2 = 59.1%). In addition, the results of age subgroup analysis showed that participants younger than 55 years with sarcopenia had a lower risk of mortality than participants aged 55 years and older with sarcopenia (pooled HR = 1.46, 95% CI: 1.24–1.72 versus pooled HR = 1.99, 95% CI: 1.05–3.78), whereas both have an increased risk of mortality compared to non-sarcopenic patients. Subgroup analyses regarding stage at diagnosis revealed an increased risk of mortality in non-metastatic patients compared to participants without sarcopenia (pooled HR = 1.91, 95% CI: 1.32–2.78), whereas the association was not significant in metastatic breast cancer patients. Other subgroup analyses were performed using different follow-up periods (> 5 years versus ≤5 years) and the results were different (pooled HR = 1.81, 95% CI: 1.23–2.65 versus pooled HR = 1.70, 95% CI: 0.80–3.62).

Conclusions

The present study found that sarcopenia is a risk factor for mortality among female early breast cancer patients. It is imperative that more research into specific interventions aimed at treating sarcopenia be conducted in the near future in order to provide evidence which could lead to decreased mortality rates in breast cancer patients.
An innovative method for manufacturing the Tuebingen palatal plate for infants with Robin sequence
Authors: Müller-Hagedorn Silvia , Arand Jörg , Scholz Thilo , Poets Christian F. , Wiechers Cornelia
Published: March 2020

Background

Robin sequence (RS) is characterized by mandibular micro- and retrognathia, glossoptosis, upper airway obstruction and optionally a cleft palate. With an incidence of 1:8000, it belongs to the so-called rare diseases; 30–50% of patients have RS as part of a syndrome. A comparatively well-studied treatment option is the Tuebingen Palatal Plate (TPP), which has proven effective in both, isolated and syndromic RS, but often requires multiple endoscopies for perfect fit and effectiveness. We report on a new method for fitting the TPP with only one session of nasopharyngeal endoscopy resulting in the plate being finished in one day.

Methods and results

First, a prototype is produced, consisting of a traditional acrylic palatal part and a velar extension made of thermoplastic resin, usually measuring 10x40mm. Using polymerization, a scale is added to the posterior part of the extension to help with determining its optimal length during endoscopic evaluation. The extension is pre-bent in the dental laboratory to achieve an approximate shape. During endoscopy, the prototype can be adjusted to the infant’s anatomy: first, the angulation is customized by controlled heating, bending and cooling of the thermoplastic spur. Second, the length of the spur is adapted by grinding its tip. Then the prototype is returned to the dental laboratory for completion; the final plate can be delivered to the patient on the same day. It acts by shifting the tongue into a more anterior position, thereby opening the airway and releasing upper airway obstruction, as well as by acting as a functional orthodontic appliance that stimulates mandibular growth through exerting pressure on the base of the tongue.

Conclusions

With the thermoplastic spur presented here, a TPP can be produced within one day, requiring only one endoscopy. This approach may facilitate fabricating the TPP.
Content and system development of a digital patient-provider communication tool to support shared decision making in chronic health care: InvolveMe
Authors: Seljelid Berit , Varsi Cecilie , Solberg Nes Lise , Stenehjem Aud-E , Bollerslev Jens , Børøsund Elin
Published: March 2020

Background

Chronic conditions present major health problems, affecting an increasing number of individuals who experience a variety of symptoms that impact their health related quality of life. Digital tools can be of support in chronic conditions, potentially improving patient-provider communication, promoting shared decision making for treatment and care, and possibly even improving patient outcomes. This study aimed to develop a digital tool for patient-provider communication in chronic health care settings and describes the data collection and subsequent content and software development of the InvolveMe tool. InvolveMe will provide patients with the opportunity to report symptoms and preferences to their health care providers (HCP), and to use secure messaging to interact with the HCPs.

Method

The study employed a combination of interviews with patients with chronic conditions and focus groups with HCPs, examining experiences with chronic conditions and the potential use of a digital tool for support. Participants were recruited from two outpatient clinics at a university hospital. Data collected from interviews and focus groups were analysed using thematic analysis. Content and software development was informed by the data collection and by tool development workshops.

Results

Analyses from interviews with patients (n = 14) and focus groups with HCPs (n = 11) generated three main themes: 1) Making symptoms and challenges visible, 2) Mastering a new life, and 3) Digital opportunities for follow-up. Each main theme generated separate subthemes. Theme 1 and 2 gave input for content development of the symptom and needs assessment part of the tool, while theme 3 provided ideas for the software development of the InvolveMe tool. Tool development workshops with patients (n = 6) and HCPs (n = 6) supplemented the development.

Conclusions

A digital tool such as InvolveMe has the potential to support shared decision making for patients with chronic health conditions. Through integration with an existing patient portal such a tool can provide opportunities for meaningful interactions and communication between patients and HCP’s, particularly with regards to symptoms, needs and preferences for care.
Challenges with scale-up of GeneXpert MTB/RIF® in Uganda: a health systems perspective
Authors: Nalugwa Talemwa , Shete Priya B. , Nantale Mariam , Farr Katherine , Ojok Christopher , Ochom Emma , Mugabe Frank , Joloba Moses , Dowdy David W. , Moore David A. J. , Davis J. Lucian , Cattamanchi Adithya , Katamba Achilles
Published: March 2020

Background

Many high burden countries are scaling-up GeneXpert® MTB/RIF (Xpert) testing for tuberculosis (TB) using a hub-and-spoke model. However, the effect of scale up on reducing TB has been limited. We sought to characterize variation in implementation of referral-based Xpert TB testing across Uganda, and to identify health system factors that may enhance or prevent high-quality implementation of Xpert testing services.

Methods

We conducted a cross-sectional study triangulating quantitative and qualitative data sources at 23 community health centers linked to one of 15 Xpert testing sites between November 2016 and May 2017 to assess health systems infrastructure for hub-and-spoke Xpert testing. Data sources included a standardized site assessment survey, routine TB notification data, and field notes from site visits.

Results

Challenges with Xpert implementation occurred at every step of the diagnostic evaluation process, leading to low overall uptake of testing. Of 2192 patients eligible for TB testing, only 574 (26%) who initiated testing were referred for Xpert testing. Of those, 54 (9.4%) were Xpert confirmed positive just under half initiated treatment within 14 days (n = 25, 46%). Gaps in required infrastructure at 23 community health centers to support the hub-and-spoke system included lack of refrigeration (n = 14, 61%) for sputum testing and lack of telephone/mobile communication (n = 21, 91%). Motorcycle riders responsible for transporting sputum to Xpert sites operated variable with trips once, twice, or three times a week at 10 (43%), nine (39%) and four (17%) health centers, respectively. Staff recorded Xpert results in the TB laboratory register at only one health center and called patients with positive results at only two health centers. Of the 15 Xpert testing sites, five (33%) had at least one non-functioning module. The median number of tests per day was 3.57 (IQR 2.06–4.54), and 10 (67%) sites had error/invalid rates > 5%.

Conclusions

Although Xpert devices are now widely distributed throughout Uganda, health system factors across the continuum from test referral to results reporting and treatment initiation preclude effective implementation of Xpert testing for patients presenting to peripheral health centers. Support for scale up of innovative technologies should include support for communication, coordination and health systems integration.
Betaine attenuates LPS-induced downregulation of Occludin and Claudin-1 and restores intestinal barrier function
Authors: Wu Jingtao , He Caimei , Bu Jie , Luo Yue , Yang Shuyuan , Ye Chengyan , Yu Silei , He Binsheng , Yin Yulong , Yang Xiaoping
Published: March 2020

Background

The intestinal epithelial barrier, which works as the first line of defense between the luminal environment and the host, once destroyed, it will cause serious inflammation or other intestinal diseases. Tight junctions (TJs) play a vital role to maintain the integrity of the epithelial barrier. Lipopolysaccharide (LPS), one of the most important inflammatory factors will downregulate specific TJ proteins including Occludin and Claudin-1 and impair integrity of the epithelial barrier. Betaine has excellent anti-inflammatory activity but whether betaine has any effect on TJ proteins, particularly on LPS-induced dysfunction of epithelial barriers remains unknown. The purpose of this study is to explore the pharmacological effect of betaine on improving intestinal barrier function represented by TJ proteins. Intestinal porcine epithelial cells (IPEC-J2) were used as an in vitro model.

Results

The results demonstrated that betaine enhanced the expression of TJ proteins while LPS (1 μg/mL) downregulates the expression of these proteins. Furthermore, betaine attenuates LPS-induced decreases of TJ proteins both shown by Western blot (WB) and Reverse transcription-polymerase chain reaction (RT-PCR). The immunofluorescent images consistently revealed that LPS induced the disruption of TJ protein Claudin-1 and reduced its expression while betaine could reverse these alterations. Similar protective role of betaine on intestinal barrier function was observed by transepithelial electrical resistance (TEER) approach.

Conclusion

In conclusion, our research demonstrated that betaine attenuated LPS-induced downregulation of Occludin and Claudin-1 and restored the intestinal barrier function.
Novel therapeutic strategies and perspectives for metastatic pancreatic cancer: vaccine therapy is more than just a theory
Authors: Luo Wenhao , Yang Gang , Luo Wentao , Cao Zhe , Liu Yueze , Qiu Jiangdong , Chen Guangyu , You Lei , Zhao Fangyu , Zheng Lianfang , Zhang Taiping
Published: March 2020

Pancreatic cancer is an aggressive and malignant tumor with an exceedingly high mortality rate. The quality of life and survival rates of pancreatic cancer patients with metastasis are poor compared with those without metastasis. Thus far, no effective treatment strategy has been established for metastatic pancreatic cancer patients. Therefore, an appropriate therapeutic method based on the elimination of metastatic pancreatic cancer is critical to improve patient outcome. Tumor-targeted vaccines have been widely discussed in recent studies and enabled important breakthroughs in the treatment of pancreatic cancer by preventing the escape of tumor cells from immune surveillance and activating the immune system to eliminate cancer cells. T cells can be activated by the stimulation of tumor-targeted vaccines, but to mount an effective immune response, both immune checkpoint inhibitors and positive costimulatory molecules are required. In this review, we discuss potential tumor-targeted vaccines that can target pancreatic cancer, elaborate the probably appropriate combination of vaccines therapy and evaluate the underlying benefits as well as obstacles in the current therapy for metastatic pancreatic cancer.
Quality of life in subjects with upper- and lower-limb spasticity treated with incobotulinumtoxinA
Authors: Fheodoroff Klemens , Rekand Tiina , Medeiros Luisa , Koßmehl Peter , Wissel Jörg , Bensmail Djamel , Scheschonka Astrid , Flatau-Baqué Birgit , Simon Olivier , Dressler Dirk , Simpson David M.
Published: March 2020

Background

We evaluated quality of life among subjects with upper- and lower-limb spasticity who received escalating doses of incobotulinumtoxinA (total body doses up to 800 U) in the prospective, single-arm, dose-titration TOWER study.

Methods

In this exploratory trial, subjects (N = 155; 18–80 years of age) with upper- and lower-limb spasticity due to cerebral causes who were deemed to require total body doses of up to 800 U incobotulinumtoxinA received three consecutive injection cycles of incobotulinumtoxinA (400, 600, and up to 800 U), each with 12 to 16 weeks’ follow-up. QoL was assessed using the EuroQol 5-dimensions questionnaire, three-level (EQ-5D), before and 4 weeks post-injection in each injection cycle and at the end of injection cycle 3.

Results

The mean EQ-5D visual analog scale scores of 155 participants continuously improved from study baseline to 4 weeks post-injection in all injection cycles (mean [standard deviation] change 6.7 [14.1], 9.6 [16.3], and 8.6 [17.0] for injection cycles 1, 2, and 3, respectively; p < 0.0001 for all, paired sample t-test). In general, among those with a change in the EQ-5D rating of their condition, the proportion of subjects with ‘improvement’ was greater than that with ‘worsening’ for individual EQ-5D dimensions across all injection cycles. At the end of injection cycle 3, the proportion of subjects rating their condition as ‘normal’ increased from study baseline for all dimensions, and there was a ≥ 46% reduction in the proportion of subjects with a rating of ‘severe impairment’.

Conclusion

These preliminary results suggest that escalating incobotulinumtoxinA doses up to 800 U are associated with improvement in quality of life ratings in subjects with multifocal upper- and lower-limb spasticity, and form a basis for future comparator studies.

Trial registration

ClinicalTrials.gov, NCT01603459. Date of registration: May 22, 2012.
Mobile phone support to sustain exclusive breastfeeding in the community after hospital delivery and counseling: a quasi-experimental study
Authors: Jerin Iftia , Akter Monira , Talukder Khurshid , Talukder Muhammad Qudrat e Khuda , Rahman Mohammad Abdur
Published: March 2020

Background

Rapid increases in hospital and cesarean deliveries threaten an already falling exclusive breastfeeding rate (EBR) in Bangladesh. There is neither a sustained Baby-Friendly Hospital Initiative (BFHI) nor any community support for breastfeeding mothers. Our aim was to find out whether breastfeeding support after hospital delivery and subsequently by mobile phone at home is effective in improving EBR in infants under six-months of age.

Methods

A quasi-experimental study was carried out in 2010 at the Centre for Woman and Child Health (CWCH), Savar, Bangladesh. A total of 129 mothers delivered at CWCH were recruited in pre-intervention phase and their infants followed up between 0 and 5 months of age in the community for exclusive breastfeeding (EBF), anthropometry and illness. An intervention package was then implemented with postpartum support for first hour breastfeeding initiation, correction of position and attachment and face-to-face counseling in hospital followed by mobile phone support by two trained Research Assistants once every 15 days after discharge up to six months of age. During the intervention phase, 164 pregnant women delivered at CWCH were recruited and followed up as in the pre-intervention phase.

Results

In the pre-intervention phase among 114 infants, 66 (58%) were found to be exclusively breastfed. In the intervention phase among 151 infants, 118 (78%) were exclusively breastfed (p = 0.000). In the pre-intervention phase EBR at less than one month and five months were 85 and 42% as in the intervention phase these EBR were 89 and 71% respectively. Wasting (weight-for-height Z-score < − 2.00), stunting (height-for-age Z-score < − 2.00), and underweight (weight-for-age Z-score < − 2.00) was 17 (15%), 7 (6%), and 14 (13%) respectively in the pre-intervention phase. In the intervention phase wasting, stunting, and underweight was 16 (11%), 16 (11%), and 15 (10%) respectively. Therefore, there was no statistically significant differences in nutritional status of the infants in the two phases. There was also no significant differences in child morbidity (pneumonia and diarrhea) between the two phases.

Conclusion

A combination of hospital support and mobile phone counseling in the community sustained higher rates of EBF in the community after hospital delivery.