bluuebunny/crossref_metadata_2025 huggingface dataset:
Subjective Global Assessment–Dialysis Malnutrition Score and arteriovenous fistula outcome: A comparison with Charlson Comorbidity Index
Authors: Spatola Leonardo , Finazzi Silvia , Calvetta Albania , Angelini Claudio , Badalamenti Salvatore
Published: June 2018

Introduction:

Malnutrition is a well-recognized risk factor for all-cause mortality in hemodialysis patients. However, its role for arteriovenous fistulas outcome has not been exhaustively investigated. Our aim was to point out the impact of Subjective Global Assessment–Dialysis Malnutrition Score as independent predictor of arteriovenous fistulas thrombosis (vascular access thrombosis) and/or significant stenosis (vascular access stenosis). In addition, we compared it with the widespread Charlson Comorbidity Index.

Methods:

We assessed 57 hemodialysis patients for a 2-year interval and evaluated the incidence of vascular access thrombosis and/or stenosis. Linear regression analysis was used to test the relation of variables with Subjective Global Assessment–Dialysis Malnutrition Score at baseline. Logistic and Cox regression analysis evaluated markers as predictors of both vascular access thrombosis and stenosis. Receiver operating characteristic curve analysis was used to compare area under the curve values of Subjective Global Assessment–Dialysis Malnutrition Score, Charlson Comorbidity Index, and modified Charlson Comorbidity Index.

Results:

Age and Charlson Comorbidity Index were positively related to Subjective Global Assessment–Dialysis Malnutrition Score: B = 0.06 (95% CI = 0.01; 0.11) and B = 0.31 (95% CI = 0.01; 0.63). Higher albumin and normalized protein catabolic rate levels had a protective role against vascular access failure: OR = 0.67 (95% CI = 0.56; 0.81) and OR = 0.46 (95% CI = 0.32; 0.67), respectively. Higher Subjective Global Assessment–Dialysis Malnutrition Score and Charlson Comorbidity Index values were significant risk factors: HR = 1.42 (95% CI = 1.04; 1.92) and HR = 1.48 (95% CI = 1.01; 2.17), respectively. Area under the curve of Subjective Global Assessment–Dialysis Malnutrition Score was significantly higher than those of both Charlson Comorbidity Index and modified Charlson Comorbidity Index: 0.70 (95% CI = 0.50; 0.88) versus 0.61 (95% CI = 0.41; 0.80) and 0.55 (95CI% = 0.41; 0.70).

Conclusion:

Subjective Global Assessment–Dialysis Malnutrition Score, as well as Charlson Comorbidity Index, are useful tools to predict vascular access failure and should be carefully and periodically evaluated in order to check significant variations that may compromise vascular access survival.
Is everybody human? The relationship between humanity and animality in Western and Amerindian myth narratives
Authors: Kawaguchi Douglas , Guimarães Danilo S
Published: June 2018

The general problem this research approaches is the observation that, in Western cultures, Human occupies a central place and is identified with the cosmological wholeness—a worldview which is in tune with the paradigm of massive abuses that are practiced against animals who 1 are exploited by industry worldwide and with the environmental catastrophe we witness nowadays. Departing from that problem, this paper presents and discusses the Western notion indicated above, comparing it with the notion of Yanomami indigenous people about human’s place in the universe. We use a dialogical methodology pertinent to semiotic-cultural constructivism in psychology, focusing on the relationship between “human” and non-human animal in the two mentioned cultures, through the analysis of two creation myths: The Book of Genesis, the first book of the Hebrew-Christian Bible; and The Falling Sky: Words from a Yanomami Shaman, a set of narratives from indigenous leader Davi Kopenawa. Results show that Western and Amerindian narratives present mostly opposite conceptions concerning the relationships between “humanity” and animality and that meanings for “human” and “animal” differ essentially in both. From the tension with Amerindian cosmology and its relationship with nonhuman animal, we call into question the ethno-anthropocentrism that is present in Western psychology since its birth. Given that psychology lays its foundations on a worldview that presupposes a strict split between nature and Humanity (assuming, e.g. an insurmountable incompatibility between the impulse of our “natural” desires and the regulation and prohibitions imposed by “culture”), this research intends to draw attention to the fact that the naturalist ontology is not an a priori nor a necessary condition for the construction of self-identity in the world. Whereas this presupposed Human “alienation” from nature remains taken for granted in the hegemonic theoretical–methodological reflections in psychology, we discuss the limits of Eurocentered psychology research and its implications in a dialogical epistemology.
Agreement between telehealth and face-to-face assessment of intellectual ability in children with specific learning disorder
Authors: Hodge Marie Antoinette , Sutherland Rebecca , Jeng Kelly , Bale Gillian , Batta Paige , Cambridge Aine , Detheridge Jeanette , Drevensek Suzi , Edwards Lynda , Everett Margaret , Ganesalingam Kalaichelvi , Geier Philippa , Kass Carol , Mathieson Susannah , McCabe Michael , Micallef Kay , Molomby Kirsty , Ong Natalie , Pfeiffer Silvia , Pope Sylvia , Tait Francine , Williamsz Marcia , Young-Dwarte Lynne , Silove Natalie
Published: June 2018

Introduction

Access to cognitive assessments for children living remotely is limited. Telehealth represents a potential cost- and time-effective solution. A pilot study was conducted to determine the feasibility of telehealth to assess cognitive function in children with learning difficulties.

Methods

Thirty-three children (median age = 9 years 11 months), recruited from the New South Wales (NSW) Centre for Effective Reading, underwent assessment of intellectual ability. Comparisons were made between the intellectual ability index scores obtained by a psychologist sitting face-to-face with the children and another psychologist via telehealth using a web-based platform, Coviu.

Results

The telehealth administration method yielded comparable results to the face-to-face method. Correlation analyses showed high associations between the testing methodologies on the intellectual ability indices (correlation coefficient range = 0.981–0.997).

Discussion

Findings indicate that telehealth may be an alternative to face-to-face cognitive assessment. Future work in a broader range of cognitive tests and wider range of clinical populations is warranted.
Rescue the child or treat the adult? Understandings among professionals in dual treatment of substance-use disorders and parenting
Authors: Wiig Eli Marie , Halsa Astrid , Bramness Jørgen , Myra Siv Merete , Haugland Bente Storm Mowatt
Published: June 2018

Aims:

Dual treatment of parents with substance-use disorders (SUD) is an approach which aims to meet the needs of both SUD patients and their children. Whereas the parents need to learn to live without substances, the children need a predictable and structured environment with parents who are sensitive and psychologically available. In this study we explore the possibilities and challenges of this joint approach from the perspectives of professionals employed in an in-patient facility for families with parental SUD.

Methods:

A qualitative design was used comprising three focus-group interviews with 15 professionals: two groups with ward staff and one with therapists, all working at a family ward for parents with SUD and their children. Data were analysed using thematic analysis.

Results:

Professionals faced difficulties combining the needs of parents and children and seemed to choose to prioritise either the adult with SUD or the wellbeing of the child. However, some professionals described what might be a third and alternative solution by supporting the mothers in everyday life, routines, and care, through exploring present moment situations. This approach seemed to help parents become more conscious of the child, their interaction with the child, and their own feelings. Professionals described working at the family ward as emotionally challenging.

Conclusion:

Combining treatment of parental SUD, interventions to improve parenting roles and practice, and at the same time focusing on the developmental needs of children, is experienced as a complex and demanding task. Different priorities and treatment aims may enhance tensions between professionals. Even though professionals experience in-patient dual treatment as challenging, they believe this approach facilitates positive development in substance dependent parents and their children.
A physics-based model for real-time prediction of ignition delays of multi-pulse fuel injections in direct-injection diesel engines
Authors: Samuel J Jensen , A Ramesh
Published: June 2018

Real-time prediction of in-cylinder combustion parameters is very important for robust combustion control in any internal combustion engine. Very little information is available in the literature for modeling the ignition delay period of multiple injections that occur in modern direct-injection diesel engines. Knowledge of the ignition delay period in diesel engines with multiple injections is of primary interest due to its impact on pressure rise during subsequent combustion, combustion noise and pollutant formation. In this work, a physics-based ignition delay prediction methodology has been proposed by suitably simplifying an approach available in the literature. The time taken by the fuel-spray tip to reach the liquid length is considered as the physical delay period of any particular injection pulse. An equation has been developed for predicting the saturation temperature at this location based on the temperature and pressure at the start of injection. Thus, iterative procedures are avoided, which makes the methodology suitable for real-time engine control. The chemical delay was modeled by assuming a global reaction mechanism while using the Arrhenius-type equation. Experiments were conducted on a fully instrumented state-of-the-art common-rail diesel engine test facility for providing inputs to develop the methodology. The thermodynamic condition before the main injection was obtained by modeling the pilot combustion phase using the Wiebe function. Thus, the ignition delays of both pilot and main injections could be predicted based on rail pressure, injection timing, injection duration, manifold pressure and temperature which are normally used as inputs to the engine control unit. When the methodology was applied to predict the ignition delays in three different common-rail diesel engines, the ignition delays of pilot and main combustion phases could be predicted within an error band of ±25, ±50 and ±80 µs, respectively, without further tuning. This method can hence be used in real-time engine controllers and hardware-in-the-loop systems.
Nostalgic environmentalities in the EPA’s Documerica and State of the Environment projects
Authors: Greenwalt Dustin A , Creech Brian
Published: June 2018

This article argues that environmental citizenship, understood as sustainable forms of consumption, is increasingly constructed through visual regimes of nostalgia for both pristine wilderness and an era of unfettered resource extraction. Drawing on the linkages between survey photography, popular constructions of nature, and nostalgia, it takes the Environmental Protection Agency’s Documerica and State of the Environment projects as opportunities to understand how depictions of the environment reinforce contemporary notions of sustainability. As the predominant discourse guiding environmentality, or the governance of our relationships with the non-human world, sustainability relies on scientific knowledges in order to harmonize economic growth, population health, and ecologies. To do so, sustainability draws on the power of media to encourage forms of consumption that might indefinitely perpetuate capitalist economies at the expense of the non-human world. Analysis of the images of small-town life, extraction industries, and pollution, as well as seemingly pristine wilderness in Documerica and State of the Environment demonstrates how these projects draw on widespread nostalgias in order to reinforce notions about sustainable modes of consumption and perpetual industrial growth. This article subsequently shows how the circulation of survey photographs harnesses the camera’s nostalgic lens in the service of contemporary environmentalities.
Action researcher to design innovation catalyst: Building design capability from within
Authors: Price Rebecca , Wrigley Cara , Matthews Judy
Published: June 2018

Design as a creative way of framing and solving problems is considered an essential business capability in an innovation era. Organizations with design capability can improve the lives of their customers, stakeholders and employees by creating valuable products, services and experiences. Design-led innovation is a framework that assists organizations to develop design capability for creating a better future as well as profitability. However, implementing design-led innovation requires support. This article presents insights from an action research extended to design innovation catalyst. The catalyst’s aim was to facilitate implementation of design-led innovation in an Australian Airport Corporation to develop design capability. To date, this extended role of action researcher as design innovation catalyst has received limited attention. Therefore, the purpose of this paper is to present insights from the experience of the action researcher as a design innovation catalyst. This paper contributes conceptual and practical insight into the research design, action research cycles and critical reflection of an action researcher operating as design innovation catalyst.
The Liminal Lives of Europe’s Transit Migrants
Authors: Paynter Eleanor
Published: June 2018

As Europe’s migration crisis mounts, bureaucratic hurdles and the limitations of humanitarian aid have created a uniquely vulnerable, often unwelcome urban lower class.
Motivating Factors for Latinas Earning a Family Studies Baccalaureate Degree at a University Extended Campus
Authors: Marrón Aryca Arizaga , Luna Gaye
Published: June 2018

The researchers studied motivating factors of Latinas studying at a university extended campus. Using mixed-methods, the following research question was investigated: What cultural, familial, and financial factors motivate Latinas to pursue a bachelor’s degree at a rural border extended campus? Study participants were Latina family studies students attending an extended campus of a university within a southwestern rural border community. Findings yielded familial factors to have the greatest impact on motivations, followed by financial factors.
Abnormal EEG Power Spectra in Acute Transient Global Amnesia: A Quantitative EEG Study
Authors: Imperatori Claudio , Farina Benedetto , Todini Federico , Di Blasi Chiara , Mazzucchi Edoardo , Brunetti Valerio , Della Marca Giacomo
Published: June 2018

Transient global amnesia (TGA) is a clinical syndrome characterized by retrograde and anterograde amnesia without other neurological deficits. Although electroencephalography (EEG) methods are commonly used in both clinical and research setting with TGA patients, few studies have investigated neurophysiological pattern in TGA using quantitative EEG (qEEG). The main aim of the present study was to extend these previous findings by exploring EEG power spectra differences between patients with acute TGA and healthy controls using the exact low-resolution brain electromagnetic tomography software (eLORETA). EEG was recorded during 5 minutes of resting state. Sixteen patients (mean age: 66.81 ± 7.94 years) during acute TGA and 16 healthy subjects were enrolled. All patients showed hippocampal or parahippocampal signal abnormalities in diffusion-weighted magnetic resonance imaging performed from 2 to 5 days after the onset of TGA. Compared with healthy controls, TGA patients showed a decrease of theta power localized in the temporal lobe (Brodmann areas, BAs 21-22-38) and frontal lobe (BAs 8-9-44-45). A decrease of EEG beta power in the bilateral precuneus (BA 7) and in the bilateral postcentral gyrus (BAs 3-4-5) was also observed in TGA individuals. Taken together, our results could reflect the neurophysiological substrate of the severe impairment of both episodic memory and autobiographical memory which affect TGA patients during the acute phase.
Understanding Medical Decision-making in Prostate Cancer Care
Authors: Thera Rachel , Carr Dr. Tracey , Groot Dr. Gary , Baba Nicole , Jana Dr. Kunal
Published: June 2018

The availability of several treatment options for prostate cancer creates a situation where patients may need to come to a shared decision with their health-care team regarding their care. Shared decision-making (SDM) is the concept of a patient and a health-care professional collaborating to make decisions about the patient’s treatment course. Nurse navigators (NNs) are health-care professionals often involved in the SDM process. The current project sought to evaluate the way in which patients with prostate cancer make decisions regarding their care and to determine patients’ perspectives of the role of the NN in the SDM process. Eleven participants were recruited from the Prostate Assessment Centre by a NN. They were interviewed via telephone and their responses were analyzed using thematic analysis. Five interacting factors were determined to influence the way participants made decisions including level of anxiety, desire to maintain normalcy, support system quality, exposure to cancer narratives, and extent of practical concerns. NNs were found to increase knowledge, decrease indecision, and provide reassurance for participants. Based on the beneficial aspects of NN interaction reported in this study, the use of NNs in SDM programs should be encouraged. The results of the study demonstrate the complexity of the decision-making process when it comes to prostate cancer treatment. The factors elucidated in the study should be considered during the development and implementation of prostate cancer SDM programs.
Clinicopathological significance and diagnostic approach of ROS1 rearrangement in non-small cell lung cancer: a meta-analysis: ROS1 in non-small cell lung cancer
Authors: Yang Jungho , Pyo Jung-Soo , Kang Guhyun
Published: June 2018

Purpose:

The aim of this study was to investigate the rate of ROS1 rearrangement and concordance between ROS1 immunohistochemistry (IHC) and molecular tests in non-small cell lung cancer (NSCLC).

Methods:

The study included 10,898 NSCLC cases from 21 eligible studies. ROS1 rearrangement rates were evaluated in NSCLC by a meta-analysis, including subgroup analyses. In addition, we performed a concordance analysis and a diagnostic test accuracy review of ROS1 IHC in NSCLC.

Results:

The estimated overall rate of ROS1 rearrangement and IHC positivity was 2.4% (95% confidence interval (CI) 1.5, 3.7). In the subgroup analysis, which was based on tumor subtype, the rate of ROS1 rearrangement and IHC positivity was 2.9% (95% CI 1.9, 4.5) and 0.6% (95% CI 0.3, 1.2) in adenocarcinoma and non-adenocarcinoma, respectively. The overall concordance rate between ROS1 IHC and molecular tests was 93.4% (95% CI 78.3, 98.2). In ROS1 IHC positive and negative cases, the concordance rates were 79.0% (95% CI 43.3, 94.9) and 97.0% (95% CI 83.3, 99.5), respectively. The pooled sensitivity and the specificity of ROS1 IHC were 0.90 (95% CI 0.70, 0.99) and 0.82 (95% CI 0.79, 0.84), respectively. The diagnostic odds ratio and the area under the curve of the summary receiver operating characteristic curve were 118.01 (95% CI 11.81, 1179.67) and 0.9417, respectively.

Conclusion:

The rates of ROS1 rearrangement differed by tumor histologic subtype in NSCLC. ROS1 IHC may be useful for the detection of ROS1 rearrangement in NSCLC. Detailed criteria for evaluating ROS1 IHC are needed before it can be applied in daily practice.
“Sweat a little water, sweat a little blood”: A spectacle of convict labor at an American amusement park
Authors: Morris Patricia , Arford Tammi
Published: June 2018

This article examines a representation of convict leasing in an unexpected and seemingly inconsequential place—an amusement park. Located in Branson, Missouri, the popular 1880s-themed Silver Dollar City proudly claims to offer historical education and entertainment through “realistic” constructions of the past. One of the park’s oldest and most popular attractions is the Flooded Mine ride, where park guests travel in “mine carts” through a depiction of a flooding mine, trying to “help the sheriff” by shooting laser light guns at kitschy animatronic convict laborers who are trying to escape. We first examine the Flooded Mine as a unique form of penal spectatorship, arguing that riders are able to enjoy the lighthearted mockery of the convict laborers’ suffering through a process of moral disengagement. Second, we use the lens of collective memory in an endeavor to expose the processes of remembering and forgetting at work in Silver Dollar City. We argue that the simulations of the past constructed in the park are not an apolitical platform for entertainment, but rather work to produce a narrative that perpetuates a kind of white nostalgia that erases black suffering. While ostensibly displaying a story of convict labor, the Flooded Mine depicts all the prisoners as white men, effectively performing an historical erasure of chattel slavery and its transmutation into convict leasing. By obscuring the incalculable pain produced by convict leasing and incarceration, the dissimulation allows riders to avoid any ethical engagement with these systems of racialized control.
Management of anogenital warts
Authors: Wright Sarah , Basrai Samrait , Ovens Katie
Published: June 2018

Patients often present to GPs with intimate problems that they find embarrassing. GPs need to be comfortable dealing with a vast array of sexual health problems and know when to refer to specialist genitourinary medicine (GUM) physicians. Anogenital warts are common, with approximately 130 000 cases treated annually in GUM clinics throughout the UK. However, for patients who do not wish to attend GUM services, or when these are not easily accessible, a basic knowledge of current guidance is essential to ensure that patients can be effectively managed in primary care.
How is communication of vaccines in traditional media: a systematic review
Authors: Catalan-Matamoros Daniel , Peñafiel-Saiz Carmen
Published: June 2018

Aim:

Taking into account that a key determinant in public approval of vaccinations is how the media constructs and frames messages about vaccination programmes, our aim is to review communication studies exploring media coverage of vaccines within traditional media venues.

Methods:

Using a registered protocol (PROSPERO: 42017072849), a systematic review was conducted that searched in three international electronic databases (PubMed, Scopus, and the International Bibliography of Social Science) for articles published between 2007 and 2017 following content-analysis methods. The characteristics and outcomes were systematically identified and described. The search yielded 24 eligible studies that were further analysed in the review.

Results:

Media coverage of vaccines has been largely studied during the last decade. Findings revealed that 62% ( n = 15) of studies analysed the human papillomavirus vaccine, 87% ( n = 21) examined newspapers, and 62% ( n = 15) examined North American media. In relation to media content analyses, 75% found negative messages on vaccines and 83% identified a lack of accurate information.

Conclusions:

This systematic review suggests an agenda for further research. There is a significant need to analyse other types of traditional media beyond newspapers. Future studies should focus on other geographical areas such as low-income countries and on analysing visual materials and digital media. We found that negative messages and inaccurate information are common in media coverage on vaccines; therefore, further research focusing on these topics is needed. Officials in public health organizations should develop a close collaboration with the media to improve public communication on vaccines.
CBSN: The Streaming Cable News Channel and the Argument for More Millennial-Focused Streaming News Networks
Authors: Whittle Chad
Published: June 2018

Thanks to the internet and steaming video options, traditional cable news channels have seen a decline in viewership among millennials. In 2014, CBS launched CBSN, an online streaming channel that offers coverage of news streamed to mobile devices and internet-connected television sets. The goal of this article is to argue that the traditional cable news channels should invest in creating similar services aimed at millennials that offers perspectives and coverage of the news from a presentation format that would appeal to this generation.
Dual Screening, Public Service Broadcasting, and Political Participation in Eight Western Democracies
Authors: Vaccari Cristian , Valeriani Augusto
Published: June 2018

We investigate the relationship between political dual screening—that is, watching political contents on television while reading and commenting on them on social media—and political participation across eight Western democracies: Denmark, Germany, Greece, Italy, Poland, Spain, the United Kingdom, and the United States. Based on custom built online surveys conducted between 2015 and 2016 on samples representative of the adult population with internet access in each country, we test hypotheses on both intra-country and cross-country direct and differential effects of political dual screening on various forms of offline and online political participation. We find a positive correlation between the frequency with which citizens dual screen political content and their overall levels of participation. Such correlation is stronger among respondents with lower levels of interest in politics, suggesting that dual screening has the potential to bridge participatory gaps between citizens who are more and less politically involved. The relationship between dual screening and participation is also significantly stronger in countries whose media systems feature the strongest Public Service Broadcasters. Our findings suggest that dual screening makes a positive contribution to democratic citizenship and political equality, and that it can also help public service media fulfill some of their key functions.
Utilization of online focus groups to include mothers: A use-case design, reflection, and recommendations
Authors: Skelton Kara , Evans Retta , LaChenaye Jenna , Amsbary Jonathan , Wingate Martha , Talbott Laura
Published: June 2018

Advances in technology over the past decade have allowed unique methodologies to emerge, enabling the engagement of hard-to-reach populations on sensitive topics in a way that was before thought not possible with traditional face-to-face modalities. This study aimed to use online focus group discussions (FGDs) to explore breastfeeding mothers’ use of social media. Results indicate participants had a positive experience with online FGDs, and almost all preferred this method to traditional face-to-face focus groups. We discuss reflections of the online FGD experience, including best practices and recommendations for innovative ways to include time-constrained or hard-to-reach participants, for yielding rich qualitative data.
Antifungal activity in the methanolic, aqueous and hexane extracts of Capparis deciduas
Authors: Jameel Shaista , Ahmad Saeed , Akram Muhammad , Zainab Rida , Sharif Aamir
Published: June 2018

The use of plants to cure specific ailments is as antique as human civilization. These days, in the modern era, there is a growing concern by public opinion regarding the use of synthetic medicine due to their side effects and cost. These facts led to the discovery of some economical and alternative drugs with fewer side-effects. In this study, methanolic, hexane and aqueous extracts of Capparis deciduas have been evaluated for their antifungal activity against medically important fungal strains – Candida albicans and Aspergillus niger using disc diffusion method at a dose of 1.8, 2.9, 6.5, 12.6, 25, 50 and 75 (µg/mL). Zone of inhibition for antifungal activity of these extracts was compared with that of a standard drug like fluconazole. The methanolic extracts of C. decidua showed significant activity against C. albicans (minimum inhibitory concentration (MIC): 1.8 µg/mL), for hexane extracts the MIC was 2.9 µg/mL and for aqueous extracts, no MIC can be observed. C. decidua did not show significant activity against A. niger. Our finding showed that C. decidua has antifungal activity and further phytochemical analyses of these plants should be carried out to determine the bioactive ingredients that may serve as a lead in the progress of novel research activities in the pharmaceuticals industry.
LEAD With Data
Authors: Michel Rebecca E. , Lorelle Sonya , Atkins Katherine M.
Published: June 2018

The listen, evaluate, advocate, disseminate (LEAD) training model for leadership skill development among school counselors in training is grounded in the American School Counselor Association National Model and Kouzes and Posner’s transformational leadership model. We introduce the LEAD model and report the results of a qualitative research study that investigated the lived experiences of 13 school counselors in training who participated in LEAD training during their counseling graduate program. We also discuss training implications for school counselors.
Examining the Relationship Between School Counselors’ Age, Years of Experience, School Setting, and Self-Perceived Transformational Leadership Skills
Authors: Lowe Christina , Gibson Donna M. , Carlson Ryan G.
Published: June 2018

This study examined influential factors in the development of transformational leadership skills of school counselors who are the members of the American School Counselor Association. Using multiple regression with a sample of 102 practicing school counselors, we examined the influence of age and/or years of experience to self-perceived transformational leadership skills. Results indicated no significance between age and self-perceived transformational leadership scores, but they showed a negative correlation between years of experience and transformational leadership. We discuss implications for counselor educators and school counselor leaders.
Black Girls Matter
Authors: Harris Pamela N. , Hockaday Marquita S. , McCall Marcia H.
Published: June 2018

Servant leadership may serve as a framework for school counselors to meet the needs of Black female students. Through mixed methodology research, the authors examined comparisons between school counselor and servant leadership frameworks. They also investigated the leadership experiences of seven practicing school counselors when serving Black female students. Findings emphasize both similarities and differences between school counselor leadership and servant leadership characteristics. This article provides implications for practice, training, and future research.
Comparative Usability Study of a Newly Created Patient-Centered Tool and Medicare.gov Plan Finder to Help Medicare Beneficiaries Choose Prescription Drug Plans
Authors: Stults Cheryl D , Fattahi Sayeh , Meehan Amy , Bundorf M Kate , Chan Albert S , Pun Ting , Tai-Seale Ming
Published: June 2018

Introduction:

In response to reported difficulties in selecting a Medicare Part D prescription drug plan, we designed a patient-centered online Part D plan selection tool (CHOICE1.0) to simplify the selection process and to provide personalized, expert recommendations.

Methods:

This ethnographic comparative usability study observed 44 patients using the first version of the tool during Medicare 2016 Open Enrollment. Participants were observed as they chose their drug plan using Medicare.gov and 1 of 3 versions of CHOICE1.0 that varied in amount of expert guidance. Descriptive statistics were used to analyze exit survey data. The observations were video-recorded, and field notes were analyzed thematically.

Results:

Participants were significantly more satisfied with CHOICE1.0 for choosing a plan, understanding information, and ease of use compared to Medicare.gov . Those using expert versions of CHOICE1.0 were more likely to indicate their intention to switch plans than those using Medicare.gov , though they wanted to know the source and content.

Conclusion:

The more patient-centered prescription drug choice tool improved user experience and enabled users to choose plans more consistent with expert recommendations.
Mass cytometry of Hodgkin lymphoma reveals a CD4+ regulatory T-cell–rich and exhausted T-effector microenvironment
Authors: Cader Fathima Zumla , Schackmann Ron C. J. , Hu Xihao , Wienand Kirsty , Redd Robert , Chapuy Bjoern , Ouyang Jing , Paul Nicole , Gjini Evisa , Lipschitz Mikel , Armand Philippe , Wu David , Fromm Jonathan R. , Neuberg Donna , Liu X. Shirley , Rodig Scott J. , Shipp Margaret A.
Published: June 2018

Key Points

Newly diagnosed primary cHLs have a concomitant increase in CD4+ Th1-polarized Tregs and differentiated Teffs. Primary cHLs exhibit 2 major complementary bases of immunosuppression: likely exhausted PD-1+ Th1 Teffs and active PD-1− Th1 Tregs.
Increased liver stiffness in patients with severe sleep apnoea and metabolic comorbidities
Authors: Trzepizur Wojciech , Boursier Jérôme , Le Vaillant Marc , Ducluzeau Pierre-Henri , Dubois Séverine , Henni Samir , Abraham Pierre , Aubé Christophe , Calès Paul , Gagnadoux Frédéric
Published: June 2018

The goal of this study was to assess the relationship between the severity of obstructive sleep apnoea (OSA) and liver stiffness measurement (LSM), one of the most accurate noninvasive screening tools for liver fibrosis in nonalcoholic fatty liver disease.

The study included 147 patients with at least one criterion for the metabolic syndrome, assessed by polysomnography for suspected OSA. LSM was performed using transient elastography (FibroScan). Significant liver disease and advanced liver fibrosis were defined as LSM ≥7.3 and ≥9.6 kPa, respectively.

23 patients were excluded because of unreliable LSM. Among 124 patients, 34 (27.4%) had mild OSA, 38 (30.6%) had moderate OSA and 52 (42.0%) had severe OSA. LSM values were 7.3– <9.6 kPa in 18 (14.5%) patients and ≥9.6 kPa in 15 (12.1%) patients. A dose–response relationship was observed between OSA severity and LSM values (p=0.004). After adjustment for age, sex, metabolic syndrome and insulin resistance, severe OSA was associated with an increased risk of LSM ≥7.3 kPa (OR 7.17, 95% CI 2.51–20.50) and LSM ≥9.6 kPa (OR 4.73, 95% CI 1.25–17.88).

In patients with metabolic comorbidities, severe OSA is independently associated with increased liver stiffness, which may predispose to a higher risk of significant liver disease and poorer prognosis.
Reliability and correlates of cross‐sectional area of abductor hallucis and the medial belly of the flexor hallucis brevis measured by ultrasound
Authors: Latey Penelope J. , Burns Joshua , Nightingale Elizabeth J. , Clarke Jillian L. , Hiller Claire E.
Published: June 2018

Background

Weakness of the intrinsic foot muscles is thought to produce deformity, disability and pain. Assessing intrinsic foot muscles in isolation is a challenge; however ultrasound might provide a solution. The aims of this study were to assess the reproducibility of assessing the size of abductor halluces (AbH) and the medial belly of flexor hallucis brevis (FHBM) muscles, and identify their relationship with toe strength, foot morphology and balance.

Methods

Twenty one participants aged 26–64 years were measured on two occasions for muscle cross‐sectional area using a Siemens Acuson X300 Ultrasound System with 5‐13 MHz linear array transducer. Great toe flexor strength was measured by pedobarography, the paper grip test and hand‐held dynamometry. Foot morphology was assessed by foot length, truncated foot length, Foot Posture Index (FPI) and dorsal arch height. Balance was measured by the maximal step test. Intra‐class correlation coefficients (ICC3,1) were used to evaluate intra‐rater reliability. Pearson's correlation coefficients were performed to assess associations between muscle size and strength, morphology and balance measures. To account for the influence of physical body size, partial correlations were also performed controlling for truncated foot length.

Results

Intra‐rater reliability was excellent for AbH (ICC3,1 = 0.97) and FHBM (ICC3,1 = 0.96). Significant associations were found between cross‐sectional area of AbH and great toe flexion force measured standing by pedobarography (r = .623, p = .003),), arch height measured sitting (r = .597, p = .004) and standing (r = .590, p = .005), foot length (r = .582, p = 006), truncated foot length (r = .580, p = .006), balance (r = .443, p = .044), weight (r = .662, p = .001), height (r = .559, p = .008), and BMI (r = .502, p = .020). Significant associations were found between cross‐sectional area of FHBM and FPI (r = .544, p = .011), truncated foot length (r = .483, p = .027) and foot length (r = .451, p = .040). Significant partial associations were found between AbH and great toe flexion force in standing by pedobarography (r = .562, p = .012) and FHBM and the FPI (r = .631, p = .003).

Conclusions

Measuring the cross‐sectional area of AbH and FHBM with ultrasound is reproducible. Measures of strength, morphology and balance appear to relate more to the size of AbH than FHBM. After controlling for physical body size, cross‐sectional area of AbH remained a significant correlate of great toe flexor strength and might be a useful biomarker to measure early therapeutic response to exercise.
The safety and efficacy of nicotine replacement therapy in the intensive care unit: a randomised controlled pilot study
Authors: de Jong Ben , Schuppers Anne Sophie , Kruisdijk-Gerritsen Arriette , Arbouw Maurits Erwin Leo , van den Oever Hubertus Laurentius Antonius , van Zanten Arthur R. H.
Published: June 2018

Background

Studies evaluating nicotine replacement therapy (NRT) to prevent nicotine withdrawal symptoms in ICU patients have yielded conflicting results. We performed a randomised controlled double-blind pilot study to assess the safety and efficacy of NRT in critically ill patients. Mechanically ventilated patients admitted to two medical–surgical intensive care units and smoking more than 10 cigarettes per day before ICU admission were enrolled in this study. Participants were randomised to transdermal NRT (14 or 21 mg per day) or placebo until ICU discharge or day 30. Smoking status was confirmed by the biomarkers serum cotinine and urinary NNAL. The primary endpoint was 30-day mortality. Among secondary endpoints and post hoc endpoints, 90-day mortality, safety, time spent without delirium, sedation and coma, and patient destination at day 30 were addressed.

Results

We enrolled 47 patients. No differences were found between NRT and control group patients concerning 30-day mortality (9.5 vs. 7.7%, p = 0.84) and 90-day mortality (14.3 vs. 19.2%, p = 0.67). The number of serious adverse events was comparable between groups (NRT: 4, control: 11, p = 0.13). At day 20, average time alive without delirium, sedation and coma was 16.6 days among NRT patients versus 12.6 days among control patients (p = 0.03). At day 30, more NRT group patients were discharged from the ICU or hospital compared with controls (p = 0.03).

Conclusions

NRT did not affect mortality or the number of (serious) adverse events compared with placebo. Time alive without delirium, sedation and coma at day 20 in NRT patients was longer than in control patients. An adequately powered randomised controlled trial to further study safety and efficacy of NRT in ICU patients seems feasible and is warranted.

Trial registration ClinicalTrials.gov, number NCT01362959, registered 1 June 2011
Phase III study of taselisib (GDC-0032) + fulvestrant (FULV) v FULV in patients (pts) with estrogen receptor (ER)-positive, PIK3CA-mutant (MUT), locally advanced or metastatic breast cancer (MBC): Primary analysis from SANDPIPER.
Authors: Baselga Jose , Dent Susan Faye , Cortés Javier , Im Young-Hyuck , Diéras Véronique , Harbeck Nadia , Krop Ian E. , Verma Sunil , Wilson Timothy R. , Jin Huan , Wang Lijia , Schimmoller Frauke , Hsu Jerry Y. , He Jing , DeLaurentiis Michelino , Drullinsky Pamela , Jacot William
Published: June 2018

LBA1006

Background: Taselisib, a potent, selective PI3K inhibitor, has enhanced activity in PIK3CA-MUT BC cell lines and confirmed partial responses in PIK3CA-MUT BC as a single-agent or with FULV. We assessed taselisib + FULV in pts with ER-positive, HER2-negative, PIK3CA-MUT locally advanced or MBC. Methods: SANDPIPER (NCT02340221) is a double-blind, placebo (PBO)-controlled, randomized, phase III study. Postmenopausal pts with disease recurrence or progression during or after an aromatase inhibitor were randomized 2:1 to receive taselisib (4 mg oral, qd) or PBO + FULV (500 mg). Stratification factors were: visceral disease, endocrine sensitivity, and geographic region. Pts with PIK3CA-MUT tumors, assessed by central cobas PIK3CA Mutation Test, were randomized separately from non-MUT tumors. The primary endpoint was investigator-assessed progression-free survival (INV-PFS) in pts with PIK3CA-MUT tumors. Secondary endpoints included objective response rate (ORR), overall survival (OS), clinical benefit rate (CBR), duration of objective response (DoR), PFS by blinded independent central review (BICR-PFS), and safety. Results: 516 pts were randomized in the PIK3CA-MUT intention-to-treat (ITT) population. Efficacy is shown in the Table. Taselisib + FULV significantly improved INV-PFS (hazard ratio [HR] 0.70) as confirmed by BICR-PFS (HR 0.66). OS is immature. The most common grade ≥3 adverse events (AEs; preferred terms) in the taselisib + FULV arm in safety-evaluable pts who received ≥ 1 dose of treatment were diarrhea (12%), hyperglycemia (10%), colitis (3%), and stomatitis (2%). AEs led to more taselisib discontinuations (17% v 2%) and dose reductions (37% v 2%), v PBO. Conclusions: Taselisib + FULV significantly improved INV-PFS, v PBO + FULV, in pts with ER-positive, HER2-negative, PIK3CA-MUT locally advanced or MBC. The safety profile is largely consistent with previous studies. Clinical trial information: NCT02340221. [Table: see text]
Health-Related Quality of Life in Patients With Progressive Midgut Neuroendocrine Tumors Treated With 177Lu-Dotatate in the Phase III NETTER-1 Trial
Authors: Strosberg Jonathan , Wolin Edward , Chasen Beth , Kulke Matthew , Bushnell David , Caplin Martyn , Baum Richard P. , Kunz Pamela , Hobday Timothy , Hendifar Andrew , Oberg Kjell , Sierra Maribel Lopera , Thevenet Thomas , Margalet Ines , Ruszniewski Philippe , Krenning Eric ,   on behalf of the NETTER-1 Study Group
Published: June 2018

Purpose

Neuroendocrine tumor (NET) progression is associated with deterioration in quality of life (QoL). We assessed the impact of 177Lu-Dotatate treatment on time to deterioration in health-related QoL.

Methods

The NETTER-1 trial is an international phase III study in patients with midgut NETs. Patients were randomly assigned to treatment with 177Lu-Dotatate versus high-dose octreotide. European Organisation for Research and Treatment of Cancer quality-of-life questionnaires QLQ C-30 and G.I.NET-21 were assessed during the trial to determine the impact of treatment on health-related QoL. Patients completed the questionnaires at baseline and every 12 weeks until tumor progression. QoL scores were converted to a 100-point scale according to European Organisation for Research and Treatment of Cancer instructions, and individual changes from baseline scores were assessed. Time to QoL deterioration (TTD) was defined as the time from random assignment to the first QoL deterioration ≥ 10 points for each patient in the corresponding domain scale. All analyses were conducted on the intention-to-treat population. Patients with no deterioration were censored at the last QoL assessment date.

Results

TTD was significantly longer in the 177Lu-Dotatate arm (n = 117) versus the control arm (n = 114) for the following domains: global health status (hazard ratio [HR], 0.406), physical functioning (HR, 0.518), role functioning (HR, 0.580), fatigue (HR, 0.621), pain (HR, 0.566), diarrhea (HR, 0.473), disease-related worries (HR, 0.572), and body image (HR, 0.425). Differences in median TTD were clinically significant in several domains: 28.8 months versus 6.1 months for global health status, and 25.2 months versus 11.5 months for physical functioning.

Conclusion

This analysis from the NETTER-1 phase III study demonstrates that, in addition to improving progression-free survival, 177Lu-Dotatate provides a significant QoL benefit for patients with progressive midgut NETs compared with high-dose octreotide.
Cardiac Structure and Function in Morbidly Obese Parturients: An Echocardiographic Study
Authors: Buddeberg Bigna S. , Fernandes Nicole L. , Vorster Adri , Cupido Blanche J. , Lombard Carl J. , Swanevelder Justiaan L. , Girard Thierry , Dyer Robert A.
Published: June 2018

BACKGROUND:

The increasing prevalence of obesity worldwide is a major threat to global health. Cardiac structural and functional changes are well documented for obesity as well as for pregnancy, but there is limited literature on morbidly obese parturients. We hypothesized that there are both cardiac structural and functional differences between morbidly obese pregnant women and pregnant women of normal body mass index (BMI).

METHODS:

This prospective cross-sectional study was performed in 2 referral maternity units in Cape Town, South Africa, over a 3-month period. Forty morbidly obese pregnant women of BMI ≥40 kg·m−2 (group O) were compared to 45 pregnant women of BMI ≤30 kg·m−2 (group N). Cardiac structure and function were assessed by transthoracic echocardiography, according to the recommendations of the British Society of Echocardiography. The 2-sample t-test with unequal variances was used for the comparison of the mean values between the groups.

RESULTS:

Acceptable echocardiographic images were obtained in all obese women. Statistical significance was defined as P < .0225 after applying the Benjamini–Hochberg correction for multiple testing. Mean (standard deviation) mean arterial pressure was higher in group O (91 [8.42] vs 84 [9.49] mm Hg, P < .001). There were no between-group differences in heart rate, stroke volume, or cardiac index (84 [12] vs 79 [13] beats·minute−1, P = .103; 64.4 [9.7] vs 59.5 [13.5] mL, P = .069; 2551 [474] vs 2729 [623] mL·minute−1·m−2, P = .156, for groups O and N, respectively). Stroke volume index was lower, and left ventricular mass was higher in group O (30.14 [4.51] vs 34.25 [7.00] mL·m−2, P = .003; 152 [24] vs 115 [29] g, P < .001). S′ septal was lower in group O (8.43 [1.20] vs 9.25 [1.64] cm·second−1, P = .012). Considering diastolic function, isovolumetric relaxation time was significantly prolonged in group O (73 [15] vs 61 [15] milliseconds, P < .001). The septal tissue Doppler index E′ septal was lower in group O (9.08 [1.69] vs 11.28 [3.18], P < .001). There were no between-group differences in E′ average (10.7 [2.3] vs 12.0 [2.7], P = .018, O versus N) or E/E′ average (7.85 [1.77] vs 7.27 [1.68], P = .137, O versus N). Right ventricular E′/A′ was lower in group O (1.07 [0.47] vs 1.29 [0.32], P = .016).

CONCLUSIONS:

Cardiac index did not differ between obese pregnant women and those with normal BMI. Their increased left ventricular mass and lower stroke volume index could indicate a limited adaptive reserve. Obese women had minor decreases in septal left ventricular tissue Doppler velocity, but the E/E′ average values did not suggest clinically significant diastolic dysfunction.