bluuebunny/crossref_metadata_2025_split huggingface dataset:
An analytical study to evaluate the impact of distributed zone fans on the air flow rate in a mechanical ventilation system
Authors: Ju Fa-Li , Liu Liying , Yu Xiaoping 
Published: September 2019

Based on air flow rate testing of each branch fan in a distributed fan ventilation system under different branch air duct inlet static pressures, the conclusion can be drawn that there is a branch fan air flow rate deviation phenomenon. The air flow rate of the branch fan increases with the branch air duct inlet static pressure at the same branch fan speed, and the branch fan hinders the air flow rate in some cases. In this study, a theoretical expression of the deviation of the branch air duct design air flow rate was established, and the influencing factors of the deviation were determined to include the branch air duct resistance characteristics, branch fan performance, and branch air duct inlet pressure ratio. A graphic analytical method for determining the deviation of the branch fan design air flow rate was also proposed. Both methods can provide a theoretical basis for calculating and analysing the deviation of the branch fan design air flow rate in a distributed fan ventilation system. Practical application: This paper provides new data on the performance of a distributed fan ventilation system. Our results could be used to evaluate the impact of distributed zone fans on the air flow rate in a mechanical ventilation system. Crucially, we not only propose two types of methods that can be applied to predict deviations of the air flow rate in a distributed fan ventilation system caused by the branch air duct inlet static pressures but also obtain the factors that are important for understanding the true impact of the deviation of the branch fan air flow rate. This study lays an important foundation for the design and operation of building mechanical ventilation systems.
Diabetes Risk Perception Among Immigrant and Racial/Ethnic Minority Adults in the United States
Authors: Hsueh Loretta , Peña Juan M. , Hirsh Adam T. , de Groot Mary , Stewart Jesse C. 
Published: September 2019

Purpose The purpose of the study was to examine associations of immigrant and racial/ethnic status with diabetes risk perception among a population-based sample of US adults without diabetes. Racial/ethnic minorities are at increased risk of developing diabetes. Emerging research shows that immigrant (foreign born) individuals are also at increased risk, but less is understood about risk perception in this group. Methods Respondents were 11,569 adults from the NHANES (2011-2016; National Health and Nutrition Examination Survey) reporting no diabetes or prediabetes. Immigrant status was coded as foreign born or US born and analyses used NHANES racial/ethnic categories: white, black, Mexican American, other Hispanic, Asian, and other/multiracial. Immigrant status and variables comparing each minority group with whites were simultaneously entered into models predicting risk perception (yes/no), adjusting for demographic and diabetes risk factors. Results Being foreign born was associated with decreased odds of perceived risk, while being Mexican American, Asian, and other/multiracial were associated with increased odds of perceived risk. Discussion Foreign-born adults are less likely than US-born adults to report perceived risk for diabetes. Lower diabetes risk perception among immigrants could result in poorer preventative behaviors and later diabetes detection.
The clinical evaluation of the wish to hasten death is not upsetting for advanced cancer patients: A cross-sectional study
Authors: Porta-Sales Josep , Crespo Iris , Monforte-Royo Cristina , Marín Mar , Abenia-Chavarria Sonia , Balaguer Albert 
Published: September 2019

Background: An important concern of healthcare professionals when exploring the wish to hasten death with patients is the risk of causing them some type of distress. Aim: To assess the opinion of hospitalized patients with advanced cancer about the proactive assessment of the wish to hasten death. Design: Descriptive, cross-sectional study. Setting/participants: We assessed 193 advanced cancer patients admitted to an oncology ward for the wish to hasten death using a semi-structured clinical interview. After the assessment the participants were surveyed to determine whether they found the interview upsetting and, if so to what extent, and also their opinion regarding the assessment’s importance. Results: The wish to hasten death was reported by 46 (23.8%) patients. The majority of patients (94.8%) did not find talking about the wish to hasten death to be upsetting, regardless of whether they presented it or not. The majority of patients (79.3%) considered that it was either quite or extremely important for the clinician to proactively assess the wish to hasten death and discuss this topic, regardless of whether they experienced it. Conclusions: In this study, most of the advanced cancer patients did not find the assessment of wish to hasten death to be upsetting, and a substantial proportion of patients in this study believe that it is important to routinely evaluate it in this setting. These findings suggest that healthcare professionals can explore the wish to hasten death proactively in routine clinical practice without fear of upsetting patients.
Positivity and prevalence of human papillomavirus among a large population of women in southeastern China
Authors: Liu Sudong , Gu Xiaodong , Weng Ruiqiang , Liu Jing , Zhong Zhixiong 
Published: September 2019

Objective To formulate strategies for prevention of cervical cancer, we investigated the prevalence of human papillomavirus (HPV) infection and the age-specific distribution among female participants in southeastern China. Methods From January 2016 to July 2018, 36,871 women from Meizhou People’s Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University were enrolled in this prospective study. HPV genotypes were detected using Luminex technology. Results HPV infection was observed in 18.34% of the participants, and 79.98% were infected with high-risk HPVs. The five most prevalent genotypes were HPV52 (18.18%), HPV16 (16.06%), HPV58 (11.37%), HPV53 (8.82%), and HPV39 (6.42%). The 9-valent HPV vaccine efficiently reduced the HPV infection rate by more than 10%, which is twofold the rate of other vaccines. Most HPV infections were observed in women age 40 to 49 years, and those age 30 to 59 years accounted for 79.62% of positive patients. Conclusion Our findings regarding HPV genotypes and the age-specific distribution of HPV infection in the study area will contribute to the development of cervical cancer screening programs and vaccine strategies.
Development and Evaluation of a Pharmacist-Driven Screening Tool to Identify Patients Presenting to the Emergency Department Who Are Eligible for Outpatient Treatment of Deep Vein Thrombosis
Authors: Musco Shaina E. , Smallwood Shannon M. , Gossard Jill 
Published: September 2019

Background: Deep vein thrombosis (DVT) is a critical and costly health issue. Treatment in the outpatient setting is preferred compared to the inpatient setting. However, there is a lack of evidence regarding how best to identify patients who are ideal for outpatient DVT treatment. Objective: To design and evaluate a pharmacist-driven screening tool for the identification of patients presenting to the emergency department (ED) at a community hospital with DVT who are appropriate for outpatient treatment. Methods: This study was conducted in sequential phases: compilation and vetting of screening criteria, descriptive evaluation of criteria through retrospective chart review, and quantification of potential cost savings by avoiding admissions. Criteria were collected via literature search and assembled into a screening tool, which was applied retroactively to a cohort of ED patients admitted with DVT diagnosis. Results: A screening tool was developed with multidisciplinary input and consisted of 5 categories with individual patient and disease state criteria. The majority (91%) of patients reviewed would not have qualified for outpatient DVT treatment based on the retrospective application of the screening tool. The most common disqualification criteria category was high risk of bleeding/clotting (n = 81), and the most frequently represented parameter within that category was antithrombotic therapy prior to admission (n = 53). Conclusion: A screening tool may not be the most efficient method for health-care practitioners such as pharmacists to identify ED patients appropriate for outpatient management of DVT. Other avenues should be explored for improving the cost-effective management of these patients.
Health and social care educators' ethical competence
Authors: Koskinen Camilla , Koskinen Monika , Koivula Meeri , Korpi Hilkka , Koskimäki Minna , Lähteenmäki Marja-Leena , Mikkonen Kristina , Saaranen Terhi , Salminen Leena , Sjögren Tuulikki , Sormunen Marjorita , Wallin Outi , Kääriäinen Maria 
Published: September 2019

Background and purpose Educators’ ethical competence is of crucial importance for developing students’ ethical thinking. Previous studies describe educators’ ethical codes and principles. This article aims to widen the understanding of health- and social care educators’ ethical competence in relation to core values and ethos. Theoretical background and key concepts The study is based on the didactics of caring science and theoretically links the concepts ethos and competence. Methods Data material was collected from nine educational units for healthcare and social service in Finland. In total 16 semi-structured focus group interviews with 48 participants were conducted. The interviews were analysed with a thematic analysis according to Braun and Clarke. Ethical considerations The study is approved by the Declaration of Helsinki, the legislation regarding personal data and the General Data Protection Regulation. The study received ethical permission from the University of Jyväskylä. Informed consent was obtained from all the educational units and participants in the study. Findings The findings are presented based on three general patterns, an ethical basic motive, an ethical bearing and ethical actions. Subthemes are Humane view of students as unique individuals with individual learning, Bearing of tactfulness and firmness, Bearing of perceptiveness and accessibility, Bearing of satisfaction and joy over student learning, Valuing bearing towards each oneself and colleagues, Ability to interact and flexibility, Collegiality and a supportive work community and Educators as role models and inspirators. Conclusion Educators’ personal and professional ethos is crucial to student learning, personal growth and ethical reasoning. Therefore, it is important to further develop educators’ training regarding ethical competence.
Curcumin Regulates the Progression of Colorectal Cancer via LncRNA NBR2/AMPK Pathway
Authors: Yu Hua , Xie Yangyang , Zhou Zhendong , Wu Zhou , Dai Xiaoyu , Xu Binbin 
Published: September 2019

Objective: To identify the effect of curcumin on tumor suppression and the possible molecular pathways involved. Methods: The expression of long noncoding RNA neighbor of BRCA1 lncRNA 2 (NBR2) was quantified using reverse transcription-polymerase chain reaction on cultured colorectal cancer cells. Next, we used Western blot to measure the activation of adenosine monophosphate-activated protein kinase and mechanistic target of rapamycin kinase (mTOR) signaling molecules. Both cell proliferation and viability were measured via MTT assay, and the cell ratio and S phase were detected by BrdU assay. Colorectal cancer cells were pretreated with curcumin or transfected with shNBR2 or adenosine monophosphate-activated protein kinase inhibitor Compound C to examine the molecular pathway involved. Results: Current data showed that glucose deficiency increased the expression of NBR2 in colorectal cancer cells, and NBR2 knockdown affected the progression of colorectal cancer cells under glucose starvation conditions. When NBR2 was silenced in the treated colorectal cancer cells, the proliferation, the clone formation, and the percentage of S-phase cells suppressed by glucose deprivation were compromised. Furthermore, NBR2 knockdown could suppress glucose deprivation-induced adenosine monophosphate-activated protein kinase activation plus mTOR inactivation. Similarly, when colorectal cancer cells were treated with curcumin, the expression of NBR2 was significantly increased. NBR2 knockdown reversed curcumin-suppressed proliferation, clone formation, and the percentage of S-phase colorectal cancer cells. Furthermore, NBR2 knockdown abolished curcumin-induced activation of adenosine monophosphate-activated protein kinase and inactivation of the mTOR signaling pathway. Conclusion: This study revealed a novel mechanism by which long noncoding RNA NBR2 mediates curcumin suppression of colorectal cancer proliferation by activating adenosine monophosphate-activated protein kinase and inactivating the mTOR signaling pathway.
Early Outcomes of 3D Printed Total Talus Arthroplasty
Authors: Scott Daniel J. , Steele John , Fletcher Amanda , Parekh Selene G. 
Published: September 2019

Background. Patients with talar avascular necrosis (AVN) have limited treatment options to manage their symptoms. Historically, surgical options have been limited and can leave patients with little ankle motion and have high failure rates. The use of custom 3D printed total talar replacements (TTRs) has arisen as a treatment option for these patients, possibly allowing better preservation of hindfoot motion. We hypothesized that patients undergoing TTR will demonstrate a statistically significant improvement in Foot and Ankle Outcome Score (FAOS) at 1 year after surgery. Methods. We retrospectively reviewed 15 patients who underwent a TTR over a 2-year period. Patient outcomes were reviewed, including age, sex, comorbidities, etiology of talar pathology, number and type of prior surgeries, radiographic alignment, FAOS and Visual Analog Scale (VAS) score, and range of motion. Data analysis was performed with Student t-tests and multivariate regression. Results. FAOSs and VAS scores showed statistically significant improvements postoperatively as compared with preoperative scores. There was a statistically significant decrease in VAS pain scores from 7.0 preoperatively to 3.6 (P < .001). Average follow-up was 12.8 months. With the number of patients available, there was no statistically significant change in radiographic alignment parameters postoperatively as compared with preoperatively (P values ranged from .225 to .617). Conclusion. Our hypothesis that these patients show statistically significant improvements in FAOSs at 1 year was confirmed. TTR represents an exciting treatment option for patients with talar AVN, though longer-term follow-up is needed. Level of Evidence: Level IV: Case series
Impact of the 2015 NICE guidance for urgent assessment of patients with non-visible haematuria
Authors: John Joseph B , Wijeyaratne Saliya , Speakman Mark 
Published: September 2019

Objectives: To assess the impact of the 2015 National Institute of Health and Care Excellence (NICE) guidance for referral of non-visible haematuria (NVH) and to compare diagnostic findings in patients referred using 2005 and 2015 guidance. Patients and method: Review of the referral details and diagnostic findings for urgent NVH referrals was assessed over a 27-month period. Referrals continued to be received under 2005 and 2015 NICE guidance during this period, and the diagnostic findings from each pathway were compared. Results: The number of urgent haematuria referrals reduced by 34% over the 27-month period. NVH referrals fell from 144 in the first quarter to 30 in the last quarter. The transitional cell carcinoma (TCC) diagnosis rate was low in patients referred using 2005 and 2015 criteria (1.7 and 1.9% respectively). No muscle-invasive bladder cancer (MIBC) was diagnosed. There was a high rate of benign urological findings. Non-adherence to referral criteria was high in the 2015 pathway (56%). Conclusion: The reduction in NVH referrals following introduction of 2015 NICE guidance could allow resource re-allocation. Low adherence to referral criteria should be investigated. The absence of MIBC and low rate of TCC diagnosis is reassuring and consideration should be given to investigating NVH patients semi-urgently. Level of evidence: 2C
Early Clinical Results of Arthroscopically Assisted Drilling via the Radius in a Distal-to-Proximal Direction for Osteochondritis Dissecans of the Elbow
Authors: Arai Yuji , Hara Kunio , Inoue Hiroaki , Minami Ginjiro , Kida Yoshikazu , Fujiwara Hiroyoshi , Kubo Toshikazu 
Published: September 2019

Background: We have previously reported the technique of arthroscopically assisted drilling of osteochondritis dissecans (OCD) lesions of the elbow via the radius in a distal-to-proximal direction. With this technique, the entire OCD lesion can be drilled vertically under arthroscopic guidance with pronation and supination of the forearm and flexion and extension of the elbow joint. Purpose: To retrospectively evaluate return to sport, range of motion, and the Japanese Orthopaedic Association–Japan Elbow Society Elbow Function Score (JOA-JES score) after treatment of an elbow OCD lesion by drilling through the radius. Study Design: Case series; Level of evidence, 4. Methods: From November 2003 to January 2006, a total of 7 male adolescent baseball players with OCD lesions of the elbow were treated through use of arthroscopically assisted drilling via the radius. The stage of the OCD lesion was evaluated based on preoperative plain radiographs. Patients were observed for a minimum of 36 months, and clinical analysis included time for return to sport, elbow range of motion, and the JOA-JES score before intervention and at final follow-up. Results: We evaluated all 7 patients at a mean follow-up time of 36.1 months (range, 24-68 months). The stage of the OCD lesion on plain radiography was “translucent” in 1 patient, “sclerotic” in 5 patients, and “loosening” in 1 patient. The mean range of motion before surgery was 131.2° and –4.7° in flexion and extension, respectively, and this improved to 138.6° and 1.1° at final follow-up. The improvement in extension was statistically significant ( P = .04). The mean JOA-JES score of 83.0 before surgery significantly improved to 94.0 at final follow-up ( P < .001). One patient required excision of a free body at 51 months postoperatively, but all patients returned to sports early and without pain at an average of 4.6 months postoperatively. No feature of osteoarthrosis was noted on radiography on the final examination in any patient. Conclusion: The findings of this study demonstrate that arthroscopically assisted drilling of an elbow OCD lesion through the radial head allows for early return to sporting activities as well as improved motion and functional scores.
Association between Autism Spectrum Disorder and Caregiver-Reported Dental Caries in Children
Authors: Burgette J.M. , Rezaie A. 
Published: September 2019

Introduction: There is evidence that dental caries is both increased and decreased in children with autism spectrum disorder (ASD). Objectives: This study examined the association between ASD and the probability of a child having caregiver-reported dental caries based on a nationally representative sample. We hypothesized that when compared with children without ASD, children with ASD would have greater odds of dental caries. Methods: We performed a cross-sectional analysis of the 2016 National Survey of Children’s Health. Caregivers reported whether a health provider informed them that their children had ASD and “decayed teeth or cavities” during the past 12 mo. We used logistic regression controlling for child characteristics (age, sex, race/ethnicity, insurance, preventive dental use) and family characteristics (education and federal poverty level). Results: Among the 45,155 children in our sample, 1,228 (2.5%) had ASD. The prevalence of caregiver-reported dental caries was 14.7% in children with ASD and 9.5% in children without ASD. The odds of having caregiver-reported child dental caries (adjusted odds ratio = 1.4, 95% CI = 1.2 to 1.7) was greater among children with ASD than children without ASD when controlling for the aforementioned covariates. Conclusion: Using a nationally representative sample, we found that children with ASD had significantly greater odds of having caregiver-reported dental caries as compared with children without ASD. Families can be educated on the increased odds of having dental caries in children with ASD. Moreover, this finding highlights a need for oral health services and policies to prevent and treat dental caries, which are tailored to the increasing number of American children with ASD. Knowledge Transfer Statement: The results of this study support the need for policy makers, clinicians, and families to improve oral health services that prevent and treat dental caries in the increasing number of American children with autism spectrum disorder.
The Resurgence of the Heritage of Indigenous Peoples of Thailand in the Aftermath of Development
Authors: Miranda Marcelo Marques 
Published: September 2019

The dichotomy between nature and culture in heritage and conservation is inappropriate in the case of indigenous peoples. Many natural sites are often considered sacred and consequently of both spiritual and biodiversity conservation significance. However, this dualist definition is the one usually imposed by nation states. Until 2002, Thailand’s development strategies involving indigenous peoples were mostly connected to what was referred to as the ‘hill tribes’ problems’. These strategies were designed without respecting indigenous peoples’ world views and concepts of good life. Consequently, a fragmentary world view was created among indigenous peoples. These issues are reflected in the establishment of national parks and ‘heritage sites’ as the lack of participation and consent generated many conflicts such as land tenure disputes, resettlement of the communities, difficulties in acquiring citizenship and cultural loss. As a counteracting measure, indigenous peoples have been creating community museums and organizations at local, regional and even transnational level to sustain their cultures and territories. This article suggests that heritage can play a role in a wide range of social, political and economic endeavours in our contemporary world and is used both by nation states to legitimize their interests and by indigenous peoples to legitimize struggles for self-determination.