bluuebunny/crossref_metadata_2025 huggingface dataset:
Tumours in European Shorthair cats: a retrospective study of 680 cases
Authors: Manuali Elisabetta , Forte Claudio , Vichi Gaia , Genovese Domenica Anna , Mancini Danilo , De Leo Alessia Arcangela Pia , Cavicchioli Laura , Pierucci Paolo , Zappulli Valentina
Published: February 2020

Objectives

Naturally occurring tumours in domestic cats are less common than in dogs and represent the leading cause of death among older animals. The main objective of this study was to analyse a large data set of histologically diagnosed tumours to highlight the most common World Health Organization (WHO) tumour histotypes, the effect of age and sex, and the International Classification of Diseases for Oncology (ICD-O) topographical site predilections of feline breed-specific tumours.

Methods

A total of 680 feline tumours diagnosed in European Shorthair cats by three veterinary diagnostic laboratories located in central Italy from 2013 to 2019 were collected. Data on age, sex and topography of lesions were recorded. Samples were morphologically and topographically coded using the WHO and the ICD-O-3 classification system.

Results

Skin and soft tissue neoplasms comprised 55.9% of all tumours, followed by mammary gland (11%), alimentary tract (7.9%), oral cavity and tongue (7.3%), nasal cavity and middle ear (6%), lymph node (3.1%), bone (1.8%) and liver/intrahepatic bile duct (1.3%) tumours. Squamous cell carcinoma (SCC), sarcoma, lymphoma and basal cell tumours were the most diagnosed neoplasms. Malignant tumours were 82.9% of the total and the topographical sites mainly involved were skin (C44), connective/subcutaneous/other soft tissues (C49), mammary gland (C50), small intestine (C17), nasal cavity and middle ear (C30), and gum (C03).

Conclusions and relevance

This study aimed to provide an in-depth evaluation of spontaneous feline tumours in the European Shorthair cat breed. Results identify SCC as the most commonly represented skin neoplasm. It is likely that the analysed feline population, living in southern latitudes, was more subject to prolonged exposure to ultraviolet light, explaining the discrepancy with previous studies in which SCC was less represented.
The Contradictory Role of Technology in Finnish Young People’s Images of Future Schools
Authors: Nikula Elina , Järvinen Tero , Laiho Anne
Published: February 2020

The aim of this study is to analyse the views of young people belonging to Generation Z about the role of technology in future schools in 2030. Without listening to young people’s voices, it has been stated that there is a strong need to increase the use of technology and digitalization in teaching and learning. Based on the essays collected from 89 Finnish young people aged 15–18 years from four different regions, this article presents four qualitatively different future images of technology in future schools. Our results show that the representatives of the same generation are divided into different units with different responses to the rapid technological change and hence one of the key formative experiences of their generation.
Individualized Treatment of Bone Marrow Edema of the Knee With the Aid of Classical Homeopathy: A Report of 2 Cases
Authors: Tsintzas Dionysis , Mahesh Seema , Vithoulkas George
Published: February 2020

Background:

Bone marrow edema lesions around the knee are a common magnetic resonance image finding. They constitute a central component of a wide variety of inflammatory and noninflammatory conditions affecting the knee joint. Those lesions are not only a significant source of pain, but are also connected to many musculoskeletal pathologies.

Case Report:

We describe 2 cases of bone marrow edema of the knee joint treated with the aid of Classical Homeopathy. In both of the cases, Arnica montana was the chosen homeopathic remedy.

Conclusions:

The results of the treatment are promising, encouraging for more research on this area.
Creating a communication space in the healthcare context: Children’s perspective of using the eHealth service, Sisom
Authors: Carlsson Ing-Marie , Arvidsson Susann , Svedberg Petra , Nygren Jens M , Viklund Åsa , Birkeland Anna-Lena , Larsson Ingrid
Published: February 2020

According to the United Nation’s Convention of the Rights of the Child, children have the right to participate in their own healthcare and make their opinions heard. The aim of this study was thus to explore the impact of using an eHealth service, Sisom, to gain the children’s perspectives during their healthcare appointments. Data were gathered through individual interviews with a purposeful sample of 16 children, aged 6–13 years old, treated for different diseases and using the eHealth service, Sisom, during their healthcare appointments. The interviews were analysed using a constructivist grounded theory. The results showed that using Sisom made children’s voice heard by creating a communication space in the healthcare setting. This meant that the children got involved in the communication, were acknowledged as an important person who could give the answers to questions and were given time. Implementing the use of Sisom is a way to make children’s needs and preferences explicitly visible for decision-making in practice and thereby supporting the further development of child-centred care in practice.
Linking loose ends: An interdisciplinary privacy and communication model
Authors: Bräunlich Katharina , Dienlin Tobias , Eichenhofer Johannes , Helm Paula , Trepte Sabine , Grimm Rüdiger , Seubert Sandra , Gusy Christoph
Published: February 2020

In the recent decades, privacy scholarship has made significant progress. Most of it was achieved in monodisciplinary works. However, privacy has a deeply interdisciplinary nature. Most importantly, societies as well as individuals experience privacy as being influenced by legal, technical, and social norms and structures. In this article, we hence attempt to connect insights of different academic disciplines into a joint model, an Interdisciplinary Privacy and Communication Model. The model differentiates four different elements: communication context, protection needs, threat and risk analysis, as well as protection enforcement. On the one hand, with this model, we aim to describe how privacy unfolds. On the other hand, the model also prescribes how privacy can be furnished and regulated. As such, the model contributes to a general understanding of privacy as a theoretical guide and offers a practical basis to address new challenges of the digital age.
Optimization of multiple autonomous underwater vehicle cooperative system communication network topology based on total energy consumption
Authors: Liang Qingwei , Ou Junlin , Shi Liang , Zhang Xin
Published: February 2020

Given the importance of the communication energy consumption of multiple autonomous underwater vehicle cooperative systems in practical work, this work optimizes the network topology to reduce total energy consumption. In accordance with the characteristics of underwater communication, the energy consumption of communication links is obtained, thereby obtaining the total communication energy consumption of multiple autonomous underwater vehicle cooperative systems. Taking the all-terminal reliability of the communication network as a constraint and the total energy consumption of network communication as the optimization goal, this work puts forward an optimization model for the communication network topology of multiple autonomous underwater vehicle cooperative systems. Furthermore, this work creatively describes the network topology optimization problem as a special path optimization problem suitable for the ant colony optimization algorithm presented to solve the optimization problem and shown to be effective and efficiency on this problem.
A randomized, controlled, equivalence study of authorized versus non-authorized deception in a model of pain following third molar extraction
Authors: Gogtay Nithya , Kuyare Mukta Sunil , Pai Nanda , Mehta Lopa , Rajapure Pranali , Thatte Urmila M
Published: February 2020

Background and rationale

When deception is used, a conflict ensues between the need to use it to answer a research question scientifically whilst protecting the participants’ autonomy simultaneously. Authorized deception (where participants are told they will be deceived) is a method that has been proposed to address the traditional “non-authorized” deception. Our study evaluated authorized versus non-authorized deception in a pain model of third molar extraction.

Methods

Adult patients requiring surgery for third molar extraction were enrolled after consent and randomized to either the authorized or “non-authorized” deception group. Within each group, they were further randomized to receiving either an “expensive” or an “inexpensive” painkiller. All participants actually received the same painkiller. The primary outcome measure was pain, while the proportion of patients taking rescue medication was the secondary outcome measure. All patients were debriefed at study completion.

Results

The median peak pain score was not significantly different between the groups. A little over 21% patients in the authorized deception group relative to 32.4% patients in the non-authorized group took rescue medication (p = 0.09). In the non-authorized deception group, 30% patients in the “inexpensive” group relative to 34.5% patients in the “expensive” group took rescue medication (p > 0.05). In the authorized deception group, 12.5% patients who received “expensive” relative to 30.4% who received the “inexpensive” painkiller took rescue medication (p = 0.04).

Conclusions

While our study showed equivalence of the two deception modalities, authorized deception may not be truly sterile.
Determining Middle-Aged and Older Adults’ Health Beliefs to Change Lifestyle and Health Behavior for Dementia Risk Reduction
Authors: Akyol Merve Aliye , Zehirlioğlu Lemye , Erünal Merve , Mert Hatice , Hatipoğlu Nur Şehnaz , Küçükgüçlü Özlem
Published: February 2020

Background:

Global population is getting older and the prevalence of dementia continuously increases. Understanding the related health beliefs is bound to enable lifestyle-based interventions that maximize public engagement in dementia risk reduction behaviors. The aim of this study was to determine health beliefs on dementia prevention behaviors and lifestyle changes and to determine the factors influencing these beliefs among middle-aged and older people in Turkey.

Materials and Methods:

This descriptive and cross-sectional study was conducted with 284 individuals aged 40 years and older, using nonprobability convenience sampling. Data were collected using a demographic characteristic form and the Turkish version of the Motivation for Changing Lifestyle and Health Behavior for Reducing the Risk of Dementia scale. The study utilized the value, mean, percentage frequency distribution, correlation, independent t test, and the one-way analysis of variance test.

Results:

The mean age of the participants included in the study was 56.99 ± 12.05, 68.7% of individuals were males. The mean education years of the participants were 11.22 ± 4.55. The majority (72.2%) of participants expressed subjective memory complaints. Presence of family history of dementia was 28.2%. Age, gender, education years, subjective memory complaints, presence family history of dementia, prior experience as a caregiver of dementia, and willingness to know their own risk were determined as essential factors that influence several health belief factors related to dementia risk reduction.

Conclusion:

Our findings indicate that males, older adults, and lower-educated and income are priority groups that should be guided for lifestyle and behavioral changes regarding dementia risk reduction.
Reduction of Amyloid in the Brain and Retina After Treatment With IVIG for Mild Cognitive Impairment
Authors: Kile Shawn , Au William , Parise Carol , Sohi Jaideep , Yarbrough Tracy , Czeszynski Alan , Johnson Ken , Redline Dan , Donnel Tammy , Hankins Andrea , Rose Kimberley
Published: February 2020

Objective:

To assess whether intravenous immunoglobulin (IVIG) in subjects with mild cognitive impairment (MCI) results in a reduction in amyloid in the central nervous system (CNS).

Methods:

Five subjects with MCI underwent baseline Florbetapir positron emission tomography and retinal autofluorescent imaging. All were administered IVIG (Octagam 10%) at 0.4 g/kg every 14 days for a total of 5 infusions. After 3 months, standard uptake value ratio (SUVR) and amyloid retinal deposits were reassessed.

Results:

Three subjects had a reduction in amyloid SUVR and all 5 subjects had a reduction in amyloid retinal deposits in at least 1 eye.

Conclusions:

A short course of IVIG over 2 months removes a measurable amount of amyloid from the CNS in persons with MCI.
The Selby-Russell Dispute Regarding the Nonreporting of Critical Data in the Mega-Mouse Experiments of Drs William and Liane Russell That Spanned Many Decades: What Happened, Current Status, and Some Ramifications
Authors: Selby P. B.
Published: February 2020

The Russells began their studies of the hereditary effects of radiation in the late 1940s, and their experiments contributed much to what is known about the induction of gene mutations in mice. I had a close association with them for about 26 years, and they relied on me considerably for database management and statistical support. In 1994, I was shocked to discover that, in experiments on males, they had failed to report numerous spontaneous mutations that arose during the perigametic interval and were detected as clusters of mutations. I realized that their nondisclosure of this information meant that the decades-long application of their data to estimate hereditary risks of radiation to humans using the doubling-dose approach had resulted in a several-fold overestimation of risk. I accordingly reported the situation to funding agencies. The resulting complicated situation is referred to here as the Selby-Russell Dispute. Highlights of the resulting investigation, as well as what occurred afterward, are described, and reasons will be provided to show why, in my opinion, the hereditary risk from radiation in humans was likely overestimated by at least 10-fold because the Russells decided not to report critical information from their massive experiments.
Are Physical Fitness and CRP Related to Framingham Risk Score in HIV+ Adults?
Authors: Lewis John E. , Poles Jillian , Garretson Eleanor , Tiozzo Eduard , Goldberg Sharon , Campbell Carmen S. G. , Simões Herbert G. , Woolger Judi M. , Konefal Janet
Published: February 2020

Background. People living with HIV (PLWH) have increased risk of cardiovascular disease (CVD). The Framingham Risk Score (FRS) predicts a 10-year CVD risk. Its relationships to physical fitness and C-reactive protein (CRP) are not well established. The current aim is to determine the links between FRS, physical fitness, and CRP in PLWH. Methods. Participants (n = 87) were assessed on multiple biomarkers. The FRS was calculated with the respective variables. Other variables that correlated significantly with FRS were entered into a regression equation to determine their relationship to FRS. Results. The FRS for men was more than twice that for women (12.8 vs 6.0, P < .001). Men were more fit than women, but most participants were not fit. Aerobic capacity was predictive of FRS in men, but not in women, and muscular strength was not predictive of FRS. Women had more than double the CRP compared with men (7.9 vs 3.5 mg/L, P < .01), and it was unrelated to FRS. Conclusions. In men, aerobic capacity was significantly predictive of FRS, but muscular strength and CRP were unrelated to FRS in both genders. These results do not conclusively demonstrate that physical fitness and CRP are related to FRS in PLWH.
Emergency carotid artery revascularization using Casper-RX stent: A single-center experience
Authors: Ozpeynirci Yigit , Capatana Cristian , Rosskopf Johannes , Schmitz Bernd L , Hamann Gerhard F , Braun Michael
Published: February 2020

Background

Casper-RX (MicroVention, Aliso Viejo, California, USA) is a dual-layer closed cell stent recently introduced as a carotid artery revascularization device. Although its effectiveness and safety has been proved in elective cases, there are contradictive results regarding its patency in emergency settings. The purpose of the study is to present our single-center experience with the Casper-RX stent in the emergency interventions.

Patients and methods

Consecutive patients who underwent emergency carotid artery stenting using Casper-RX system with or without additional intracranial thrombectomy between August 2016 and June 2019 at our institution were included. Primary end point was the short-term patency of the carotid stents evaluated before hospital discharge by use of Doppler ultrasonography.

Results

Twenty-nine procedures performed on 28 patients were included in the study. All stents were patent on final angiograms. Acute stent occlusion was observed only in one case (3.4%) with a spontaneous cervical internal carotid artery dissection the day after the procedure. In 26 (89.6%) cases, an additional intracranial thrombectomy was performed with a successful recanalization rate of 96.1%. Seven adverse events occurred peri-/post-procedural: two cases (6.9%) with iatrogenic dissection of distal cervical internal carotid artery during intracranial thrombectomy, two parenchymal hematoma type 2 (6.8%), and three patients (10.3%) developed massive infarction.

Conclusion

This study supports the safety and efficacy of the Casper-RX stent in emergency endovascular carotid artery revascularization procedures.
Design Method for N-Lobed Noncircular Bevel Gears
Authors: Shi Kan , Yao Yan-An , Lin Shuai
Published: February 2020

As a type of spatial transmission mechanism, noncircular bevel gears (NBGs) can transfer power and motion between two intersecting axes with variable transmission following a suitable program of motion. Utilizing the spherical triangle theorem and meshing principle, parametric equations are established in the spherical polar coordinate system for the driving and driven gears, for the pitch curves, and for the addendum and dedendum curves of a NBG for a given transmission ratio and axis angle. A formulation of the tooth profile of a NBG is deduced using an analytic method. Three-dimensional models of the 3- and 4-lobed NBGs are derived in verifying this method.
Asymmetries of leadership: Agency, response and reason
Authors: Tomkins Leah , Hartley Jean , Bristow Alexandra
Published: February 2020

Drawing on empirical data from an action research project in policing, we propose that the power relations of leadership unfold in asymmetries of agency, response and reason: Leaders both expect and experience more responsibility than control; more blame than praise; and interpretations of failure – both their own and others’ – based more on personal fault than on situational or task complexity. We focus, therefore, on power asymmetry not in the sense of structural inequality between leaders and followers, but rather, as constellations of incongruity, imbalance and unevenness which circumscribe leaders’ actions, choices, relationships and feelings about their work. From this perspective, privilege and disadvantage are not polar opposites reflecting the powerful versus the powerless; instead, they are intimately interwoven within leadership experience. The asymmetries of police leadership involve an intermingling of the necessary and the impossible; a decoupling of failure from irresponsibility; resilience at the prospect of being blamed for success as readily as for failure; and containment of society’s unresolved crises of responsibility, anxiety and risk. We crystallise this as a paradox of transparency and occlusion – of openness and closedness – in which police leaders are scrutinised by, and answerable to, those whom they must also protect, including from having to bear the full burden of knowledge of the dangers of the world. We reflect on the implications of this not just within policing, but for critical understandings of the power of leadership more generally.
Accuracy of Blood Glucose Measurement and Blood Glucose Targets
Authors: Eerdekens Gert-Jan , Rex Steffen , Mesotten Dieter
Published: February 2020

Background:

To summarize new evidence regarding the methodological aspects of blood glucose control in the intensive care unit (ICU).

Methods:

We reviewed the literature on blood glucose control in the ICU up to August 2019 through Ovid Medline and Pubmed.

Results:

Since the publication of the Leuven studies, the benefits of glycemic control have been recognized. However, the methodology of blood glucose control, notably the blood glucose measurement accuracy and the insulin titration protocol, plays an important but underestimated role. This may partially explain the negative results of the large, pragmatic multicenter trials and made everyone realize that tight glycemic control with less-frequent glucose measurements on less accurate blood glucose meters is neither feasible nor advisable in daily practice. Blood gas analyzers remain the gold standard. New generation point-of-care blood glucose meters may be an alternative when using whole blood of critically ill patients in combination with a clinically validated insulin dosing algorithm.

Conclusion:

When implementing blood glucose management in an ICU one needs to take into account the interaction between aimed glycemic target and blood glucose measurement methodology.
Topical Vitamin D May Modulate Human Sinonasal Mucosal Responses to House Dust Mite Antigen
Authors: Ma Sophia W. , Ende Jesse A. , Alvarado Raquel , Christensen Jenna M. , Kalish Larry , Sacks Raymond , Campbell Raewyn , Rimmer Janet , Harvey Richard
Published: February 2020

Background

Respiratory epithelium is a key defense against inhaled pathogens. Vitamin D3 (VD) has been suggested to modulate airway inflammation; however, its effect on innate airway defenses, the physical barrier, mucociliary apparatus, and cytokine release remains unclear.

Objective

To investigate the outcomes of VD application prior to challenge in an in vitro model of human sinonasal epithelium, through assessment of epithelial transepithelial resistance (TER), cilia beat frequency (CBF), and interleukin (IL)-6 release, and secondarily to determine whether topical VD is beneficial to patients with inflammatory sinonasal pathology.

Methods

Primary human sinonasal epithelial cells from patients with eosinophilic chronic rhinosinusitis (eCRS) and healthy controls were cultured in air–liquid interface (ALI). Well-differentiated cultures from each patient were pretreated for 24 hours with 4 different VD doses. Toxicity was quantified at 24 hours in unchallenged ALI by lactate dehydrogenase (LDH) assay. Innate responses were assessed by measuring TER and CBF before and up to 24 hours after house dust mite Dermatophagoides pteronyssinus challenge. IL-6 release was evaluated 24-hour postchallenge.

Results

Fifteen patients (53 ± 13.5 years, 60% females, 53% eCRS) representing 120 ALI wells were assessed. VD (0, 25, 50, 150 IU/mL) released less LDH than vehicle, indicating noncytotoxicity (0.15 ± 0.02; 0.15 ± 0.00; 0.14 ± 0.02; 0.11 ± 0.01 vs 0.17 ± 0.03, P = .004). VD increased TER for eCRS wells at 5 minutes (50 IU/mL: Δ6.76 ± 3.93 vs Δ3.87 ± 2.46, P = .04) and 24 hours (50 IU/mL: Δ0.88 ± 0.49 vs Δ0.40 ± 0.42, P = .02; 150 IU/mL: Δ1.06 ± 0.58 vs Δ0.47 ± 0.46, P = .01). CBF increased at 1 hour for eCRS wells (50 IU/mL: Δ0.62 ± 0.14 vs Δ0.41 ± 0.13, P = .001; 150 IU/ml: Δ0.60 ± 0.13 vs Δ0.38 ± 0.11, P < .001). IL-6 release was similar between normal and eCRS wells.

Conclusion

Topical VD supplementation in eCRS patients may be beneficial for innate epithelial defenses. VD is noncytotoxic and does not adversely affect the physical barrier, mucociliary apparatus, or IL-6 release. Further studies should clarify its potential as a therapeutic agent.
Synthetic Biphasic Scaffolds versus Microfracture for Articular Cartilage Defects of the Knee: A Retrospective Comparative Study
Authors: Wang Dean , Nawabi Danyal H. , Krych Aaron J. , Jones Kristofer J. , Nguyen Joseph , Elbuluk Ameer M. , Farshad-Amacker Nadja A. , Potter Hollis G. , Williams Riley J.
Published: February 2020

Objective

The purpose of this study was to compare the results of a biphasic synthetic scaffold (TruFit, Smith & Nephew) to microfracture for the treatment of knee cartilage defects and identify patient- and lesion-specific factors that influence outcomes.

Design

Prospectively collected data from 132 patients (mean age, 41.8 years; 69% male) with isolated chondral or osteochondral femoral defects treated with biphasic synthetic scaffolds ( n = 66) or microfracture ( n = 66) were reviewed. Clinical outcomes were evaluated longitudinally over 5 years with the Short Form–36 (SF-36), Activities of Daily Living of the Knee Outcome Survey (KOS-ADL), International Knee Documentation Committee (IKDC), and Marx Activity Scale. Cartilage-sensitive magnetic resonance imaging (MRI) was performed to evaluate osseous integration and cartilage fill in a subgroup of patients. Multivariate regression analysis was used to identify predictors of clinical outcomes within the scaffold group.

Results

Both groups demonstrated clinically significant improvements in knee clinical scores over 5 years ( P < 0.01). There were no significant differences in KOS-ADL and IKDC scores between groups up to 5 years postoperatively. Marx activity level scores in the microfracture group declined over time, while significant improvements in activity level scores were observed in the scaffold group over 5 years ( P < 0.01). Good-quality tissue fill and cartilage isointensity were more often observed in the scaffold group compared with the microfracture group, particularly with longer time intervals. Increasing age, high body mass index, prior microfracture, and traumatic etiology were predictors for inferior outcomes in the scaffold group.

Conclusions

Activity level and MRI appearance following treatment of cartilage lesions with the biphasic synthetic scaffold were superior to microfracture over time in this nonrandomized, retrospective comparison.
Are social ‘Rights’ rights?
Authors: Barnard Catherine
Published: February 2020

The Charter draws a distinction between rights and principles. Article 51(1) of the Charter says that rights must be ‘respected’ whereas principles must merely be ‘observed’. The question is how to tell whether a provision in the Charter contains a right or a principle and what implication this has for social rights – which in a number of national Constitutions are traditionally seen as principles, not rights, and thus not directly enforceable. However, for EU citizens this is not satisfactory; why is something described as a right in fact not a right? In this article I wish to argue that while it was originally intended that social rights should in fact be principles, the Court is beginning to adopt a more nuanced approach to this question.
Severe cutaneous adverse drug reactions manifesting as Stevens-Johnson syndrome and toxic epidermal necrolysis reported to the national pharmacovigilance center in Nigeria: a database review from 2004 to 2017
Authors: Oshikoya Kazeem Adeola , Ogunyinka Ibrahim Abayomi , Ogar Comfort Kunak , Abiola Abiodun , Ibrahim Ali , Oreagba Ibrahim Adekunle
Published: February 2020

Background:

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe cutaneous adverse reactions (SCARs). There is scant literature on the characteristics and causes of these conditions among the Nigerian population. Here, we describe the epidemiology, associated morbidity and mortality, and culpable drugs in SJS and TEN cases using the National Pharmacovigilance (NPC) database in Nigeria.

Methods:

A retrospective review of the NPC database was done to analyze SJS and TEN cases reported over a period of 14 years. Annual reports, age and sex of patients, type of reporter, suspects and concomitant drugs, time to onset (TTO) of the reactions, and outcome of SJS and TEN were evaluated.

Results:

The NPC received a total of 24,015 adverse drug reaction (ADR) reports. SJS and TEN accounted for 284 (0.1%) of the total reports, of which 254 (89.4%) were SJS and the remainder were TEN. Females ( n = 184, 64.8%) and individuals aged 19–40 years ( n = 181, 63.7%) were the most affected by SJS and TEN. Antiretrovirals, followed by antibiotics, were the most common drug classes reported to cause SJS and TEN, with nevirapine ( n = 174, 40.7%) and co-trimoxazole ( n = 143, 33.5%) being the most widely implicated drugs. Among patients with reported outcomes, 73 (28.7%) SJS and 3 (10.0%) TEN cases recovered without sequelae, at the time of reporting. Severity of the SCAR was reported for only 171 (69.0%) cases, of which 12 (4.7%) and 8 (26.7%) resulted in death (Grade 5) among SJS and TEN cases, respectively.

Conclusions:

Antiretroviral and antibiotics were the commonly reported offending group of drugs for SJS and TEN cases. Nevirapine and co-trimoxazole were the commonly reported suspect drugs. SJS and TEN were reported most frequently in females and in patients aged 19–40 years, indicating that drug surveillance and counseling in these groups of patients may be beneficial.
Added value of subjective assessed functional capacity before non-cardiac surgery in predicting postoperative myocardial injury
Authors: Marsman Marije , van Waes Judith A R , Grobben Remco B , Weersink Corien S A , van Klei Wilton A
Published: February 2020

Background

Functional capacity is used as an indicator for cardiac testing before non-cardiac surgery and is often performed subjectively. However, the value of subjectively estimated functional capacity in predicting cardiac complications is under debate. We determined the predictive value of subjectively assessed functional capacity on postoperative cardiac complications and mortality.

Design

An observational cohort study in patients aged 60 years and over undergoing elective inpatient non-cardiac surgery in a tertiary referral hospital.

Methods

Subjective functional capacity was determined by anaesthesiologists. The primary outcome was postoperative myocardial injury. Secondary outcomes were postoperative inhospital myocardial infarction and one year mortality. Logistic regression analysis and area under the receiver operating curves were used to determine the added value of functional capacity.

Results

A total of 4879 patients was included; 824 (17%) patients had a poor subjective functional capacity. Postoperative myocardial injury occurred in 718 patients (15%). Poor functional capacity was associated with myocardial injury (relative risk (RR) 1.7, 95% confidence interval (CI) 1.5–2.0; P < 0.001), postoperative myocardial infarction (RR 2.9, 95% CI 1.9–4.2; P < 0.001) and one year mortality (RR 1.7, 95% CI 1.4–2.0; P < 0.001). After adjustment for other predictors, functional capacity was still a significant predictor for myocardial injury (odds ratio (OR) 1.3, 95% CI 1.0–1.7; P = 0.023), postoperative myocardial infarction (OR 2.0, 95% CI 1.3–3.0; P = 0.002) and one year mortality (OR 1.4, 95% CI 1.1–1.8; P = 0.003), but had no added value on top of other predictors.

Conclusions

Subjectively assessed functional capacity is a predictor of postoperative myocardial injury and death, but had no added value on top of other preoperative predictors.
Perceived and Objective Kidney Disease Knowledge in Patients With Advanced CKD Followed in a Multidisciplinary CKD Clinic
Authors: Molnar Amber O. , Akbari Ayub , Brimble K. Scott
Published: February 2020

Background:

One of the key components of multidisciplinary CKD clinics is education; however, kidney disease knowledge among patients followed in these clinics is not routinely measured.

Objective:

The aim of this study was to determine objective and perceived kidney disease knowledge and patient characteristics associated with knowledge among patients followed in a multi-care kidney clinic.

Design:

This is a cross-sectional survey study.

Setting:

This study was conducted in a multi-care kidney clinic in Ontario, Canada.

Patients:

Patients who did not speak English, who were unable to read due to significant vision impairment, or who had a known history of dementia or significant cognitive impairment were excluded.

Measurements:

Perceived kidney disease knowledge was evaluated using a previously validated 9-item survey (PiKS). Each question on the perceived knowledge survey had 4 possible responses, ranging from “I don’t know anything” (1) to “I know a lot” (4). Objective kidney disease knowledge was evaluated using a previously validated survey (KiKS).

Methods:

The association between patient characteristics and perceived and objective kidney disease knowledge was determined using linear regression.

Results:

A total of 125 patients were included, 57% were male, the mean (SD) age and eGFR were 66 (13) years and 16 (5.9) mL/min/1.73 m2, respectively. The median (IQR) objective and perceived knowledge survey scores were 19 out of 27 (16, 21) and 2.9 out of 4 (2.4, 3.2), respectively. Only 25% of patients answered correctly that CKD can be associated with no symptoms, and 64% of patients identified correctly that the kidneys make urine. More than 60% of patients perceived themselves to know nothing or only a little about medications that help or hurt the kidney. Older age was independently associated with lower perceived and objective knowledge, but sex, income, and educational attainment were not.

Limitations:

This is a single-center study. Cognitive impairment was based on the treating team’s informal assessment or prior documentation in the chart; formal cognitive testing was not performed as part of this study.

Conclusions:

Despite resource-intensive care, CKD knowledge of patients followed in a multidisciplinary clinic was found to be modest. Whether enhanced educational strategies can improve knowledge and whether increasing knowledge improves patient outcomes warrants further study.
Barriers to older adults’ uptake of mobile-based mental health interventions
Authors: Pywell Jake , Vijaykumar Santosh , Dodd Alyson , Coventry Lynne
Published: February 2020

Background

To address increasing demand of mental healthcare treatments for older adults and the need to reduce delivery costs, healthcare providers are turning to mobile applications. The importance of psychological barriers have been highlighted in the uptake of mobile-based mental health interventions and efforts have been made to identify these barriers in order to facilitate initial uptake and acceptance. However, limited research has focused on older adults’ awareness of these applications and factors that might be hindering their use.

Objective

The purpose of this study was to explore the perceived barriers that older adults experience in the uptake of mobile-based mental health interventions.

Methods

Semi-structured interviews were conducted with a sample of 10 older adults, 50 years or older (female = 7, mean age = 68 years), who experienced periods of low mood. National Health Service applications were demonstrated to facilitate conversation and explore participants’ understanding of mental health and mobile-based mental health interventions. Thematic analysis was used to analyse the interview transcripts.

Results

The social ecological model was adopted as an organising framework for the thematic analysis which identified six distinct barriers to older adults’ uptake of mobile-based mental health interventions: mental electronic-health (e-health) awareness, interaction with technology, discontinuation, ‘seeing’ facilitates therapeutic alliance, incongruent role of the general practitioner and privacy and confidentiality.

Conclusions

Older adults experience a number of barriers to uptake ranging from the individual level to a macro, organisational level. The practical implications of these barriers are discussed such as the need for increased awareness of mobile-based mental health interventions among older adults.
Engaging Patients in their Health Care: Lessons From a Qualitative Study on the Processes Health Coaches Use to Support an Active Learning Paradigm
Authors: Caldwell Karen L , Vicidomini Delia , Wells Reese , Wolever Ruth Q
Published: February 2020

Background

While recent health-care trends rely on activated patients, few studies report direct observations of how to engage and activate patients to be full participants in their own health care. The interpersonal processes and communication strategies used in integrative health coaching (IHC) may offer important insight into how clinicians can help patients step into a more active learning model rather than more typical passive roles.

Objective

This study uses verbatim transcripts of medical patients’ first few IHC sessions to identify the actual processes used to help patients embrace this more active learning role.

Methods

A thematic analysis was conducted of 72 verbatim transcripts from IHC sessions of 26 patients with severe dysfunction from tinnitus. The patients participated in 6 months of IHC as part of a larger integrative intervention in a randomized, controlled pilot designed to assess feasibility for a larger randomized, controlled trial on the clinical effectiveness of an integrative intervention.

Results

Four themes emerged: (1) Describing the Health Coaching Process to patients; (2) Using Key Procedures for Action Planning—optimal health future self-visualization, Wheel of Health, and exploration of the gap between current and desired states to help patients set goals for themselves; (3) Supporting Action and Building Momentum—the creation and support of action steps with frequent reinforcement of self-efficacy; and (4) Active Listening and Inviting the Patient to Articulate Learning—coaches’ active listening process included reflection, clarifying questions, turning patient questions back to the patients, highlighting values, identifying potential barriers and resources, and inviting patients to articulate what they were learning.

Conclusion

The processes identified in IHC incorporate key principles of adult learning theory and engage patients’ innate resources of goal orientation, self-direction, and intrinsic motivation. These interpersonal processes help patients embrace a more active learning role, with implications for patient engagement in other clinical contexts.
Male Internalizing Heightens the Risk of Escalating Jealousy and Perceptions of Negativity in Romantic Relationships
Authors: Laursen Brett , Richmond Ashley , Dickson Daniel J.
Published: February 2020

The present study examined whether the spread of jealousy and negative relationship perceptions between romantic partners varies as a function of boyfriend and girlfriend internalizing symptoms. Participants included 152 emerging adults in 76 heterosexual romantic dyads. At least one partner was 17 years or older ( M = 19.52 years) at the outset. Participants completed reports twice, approximately 13 months apart. Dyadic analyses indicated that the spread of jealousy and negativity was moderated by boyfriend but not girlfriend internalizing symptoms. When boyfriends presented above average (but not below average) levels of internalizing symptoms, girlfriend perceptions of relationship negativity and jealousy predicted increases in boyfriend perceptions of the same. The findings underscore the risk that internalizing poses to negative affect contagion.
Critiquing Israeli Society Through Mirroring in Asaf Hanuka’s “The Realist”
Authors: Reingold Matt
Published: February 2020

Seven of Israeli cartoonist Asaf Hanuka’s comic strips from his weekly series The Realist make use montage-like elements by juxtaposing distorted mirror images of scenes. While published over the course of Hanuka’s almost 10-year run and addressing radically different topics, the structure and nature of the seven strips is remarkably similar. Each includes the juxtaposition of contrasting ideas to offer a commentary on a different aspect of the Israeli society. These topics include the historical mistreatment of Jewish immigrants to the country, the country’s policies toward foreign workers, and the economic challenges faced by the middle-class Israelis. While Hanuka’s technique provides an opportunity for considering different attitudes toward the topic, these strips consistently take a stance that places blame on Israelis themselves for either their attitudes or their electoral decisions. The comics serve, therefore, as political commentary which through the juxtaposition of images, encourages societal change.
Increasing American Political Tolerance: A Framework Excluding Hate Speech
Authors: Boch Anna
Published: February 2020

According to prior research, political tolerance has either stagnated since the 1970s (if to be tolerant one must be tolerant of every group in all circumstances) or steadily increased (if tolerance is measured using an index, averaging across groups). Using General Social Survey cross-sectional and panel data on civil liberties, this article proposes a new framework: separating out the groups that use hate speech from those that may be only controversial. The United States is unique among Western liberal democracies in not having a prohibition against hate speech. By applying a dichotomous hate speech framework to measuring political tolerance, this article finds that the proportion of Americans who are always tolerant has increased by 8 percentage points from 1996 to 2018. Meanwhile, tolerance of groups that use hate speech has remained flat and even decreased among groups that historically were more tolerant of such groups, including the college educated.
Progress in Thermomechanical Analysis of Friction Stir Welding
Authors: Meyghani Bahman , Wu Chuansong
Published: February 2020

This article reviews the status of thermomechanical analysis of the friction stir welding (FSW) process for establishing guidelines for further investigation, filling the available research gaps, and expanding FSW applications. Firstly, the advantages and applications of FSW process are introduced, and the significance and key issues for thermomechanical analysis in FSW are pointed out. Then, solid mechanic and fluid dynamic methods in modeling FSW process are described, and the key issues in modeling FSW are discussed. Different available mesh modeling techniques including the applications, benefits and shortcomings are explained. After that, at different subsections, the thermomechanical analysis in FSW of aluminum alloys and steels are examined and summarized in depth. Finally, the conclusions and summary are presented in order to investigate the lack of knowledge and the possibilities for future study of each method and each material.
Psychiatric illness and regression in individuals with Phelan-McDermid syndrome
Authors: Kohlenberg Teresa M. , Trelles M. Pilar , McLarney Brittany , Betancur Catalina , Thurm Audrey , Kolevzon Alexander
Published: February 2020

Background

Phelan-McDermid syndrome (PMS) is a genetic condition characterized by intellectual disability, speech and language deficits, hypotonia, autism spectrum disorder, and epilepsy. PMS is caused by 22q13.33 deletions or mutations affecting SHANK3, which codes for a critical scaffolding protein in excitatory synapses. SHANK3 variants are also known to be associated with an increased risk for regression, as well as for psychiatric disorders, including bipolar disorder and catatonia. This study aimed to further describe these phenomena in PMS and to explore any relationship between psychiatric illness and regression after early childhood.

Methods

Thirty-eight people with PMS were recruited to this study through the Phelan-McDermid Syndrome Foundation based on caregiver report of distinct development of psychiatric symptoms. Caregivers completed a clinician-administered semi-structured interview focused on eliciting psychiatric symptomatology. Data from the PMS International Registry were used to confirm genetic diagnoses of participants and to provide a larger sample for comparison.

Results

The mean age of the 38 participants was 24.7 years (range = 13 to 50; SD = 10.06). Females (31 of 38 cases; 82%) and sequence variants (15 of 38 cases; 39%) were over-represented in this sample, compared to base rates in the PMS International Registry. Onset of psychiatric symptoms occurred at a mean age of 15.4 years (range = 7 to 32), with presentations marked by prominent disturbances of mood. Enduring substantial loss of functional skills after onset of psychiatric changes was seen in 25 cases (66%). Symptomst indicative of catatonia occurred in 20 cases (53%). Triggers included infections, changes in hormonal status, and stressful life events.

Conclusions

This study confirms that individuals with PMS are at risk of developing severe neuropsychiatric illness in adolescence or early adulthood, including bipolar disorder, catatonia, and lasting regression of skills. These findings should increase the awareness of these phenotypes and lead to earlier diagnosis and the implementation of appropriate interventions. Our findings also highlight the importance of genetic testing in the work-up of individuals with intellectual disability and acute psychiatric illness or regression. Future research is needed to clarify the prevalence and nature of psychiatric disorders and regression among larger unbiased samples of individuals with PMS.
Branch Retinal Artery Occlusion as a presenting sign of Acute Retinal Necrosis: a rare association
Authors: Agarwal Manisha , Gupta Chanda , Jain Abhishek , Kumar Brajesh
Published: February 2020

Background

Acute retinal necrosis (ARN) is a potentially blinding necrotizing viral retinitis. It starts with one or more foci and spreads circumferentially and involves the posterior pole in the later stages. Vascular occlusions such as branch retinal artery occlusion, central retinal artery occlusion, and central retinal vein occlusion may occur secondary to underlying infectious etiology such as ARN.

Findings

An elderly male patient with a history of coronary artery disease was diagnosed with branch retinal artery occlusion (BRAO) in the right eye and referred to the treating cardiologist. Few days later, he complained of diminution of vision in the left eye which made him seek another consultation when he was diagnosed to have ARN in the left eye, encroaching the posterior pole. He was investigated and treated for the same leading to minimal improvement of vision in the left eye possibly due to a delay in the starting of the anti-viral therapy.

Conclusion

We report this case to highlight that occlusive vasculopathy can be a presenting sign of an underlying infectious etiology in any age group. BRAO was a rare presenting sign of ARN in our patient. A thorough peripheral examination is recommended in order to avoid missing infectious pathologies such as ARN which starts from the retinal periphery, progresses fast, and if not managed on time may lead to permanent loss of vision.