bluuebunny/crossref_metadata_2025 huggingface dataset:
Bilateral adrenal myelolipomas presenting as acute adrenal insufficiency in an adult with congenital adrenal hyperplasia
Authors: Suchartlikitwong Sakolwan , Jasti Rahul , Lado-Abeal Joaquin , Rivas Mejia Ana Marcella
Published: February 2019

Adrenal myelolipomas are relatively rare tumours composed of adipocytes and myeloid cells that arise in response to chronic adrenocorticotropic hormone stimulation. We present the case of bilateral adrenal myelolipomas in a 39-year-old man with untreated congenital adrenal hyperplasia (CAH) presenting with acute adrenal insufficiency and severe virilisation. Phenotypically, he is a man of short stature and has hyperpigmentation of the skin, gingiva and nail beds. Genital examination revealed micropenis and no palpable testes. Laboratory testing was consistent with primary adrenal insufficiency. An abdominal CT showed bilateral adrenal myelolipomas. An MRI of the pelvis revealed female reproductive organs. Chromosome study showed a karyotype of 46,XX. ACYP21A2gene mutation confirmed diagnosis of CAH with 21-hydroxylase deficiency. The patient was treated with stress dose corticosteroids, subsequently tapered to physiological doses. We review previously reported cases and discussed diagnosis and treatment, including hormonal therapy and psychological approach.
Cleistanthus collinuspoisoning: a case report of intentional poisoning
Authors: Bompelli Nandakishore , Reddy C Rakesh , Modani Santosh , Deshpande Anirudda
Published: February 2019

We report a case of 50-year-old male patient from tribal area in South Indian state of Telangana, who ingested the liquid extract from crushed leaves of the plant, cleistanthus collinius with the intention of self-harm. Immediate gastric lavage and activated charcoal administration was done and the patient was subsequently admitted into an acute medical care unit. During first 24 hours of monitoring, the patient was clinically stable. There was mild normal anion gap metabolic acidosis and hypokalaemia on arterial blood gas (ABG) and was corrected accordingly. On second day of admission he developed acute onset shortness of breath. Chest auscultation revealed extensive bilateral coarse crackles. Chest X-ray was suggestive of acute respiratory distress syndrome (ARDS). The patient had to be intubated. Continuous renal replacement therapy (CRRT) was initiated in view of worsening metabolic acidosis and unstable haemodynamics. In spite of appropriate intensive care measures, the patient succumbed to illness. Immediate gastric lavage and activated charcoal administration was done and the patient was subsequently admitted into an acute medical care unit. During first 24 hours of monitoring, the patient was clinically stable. There was mild normal anion gap metabolic acidosis and hypokalaemia on ABG and was corrected accordingly. On second day of admission, he developed acute onset shortness of breath. Chest auscultation revealed extensive bilateral coarse crackles. Chest X-ray was suggestive of ARDS. The patient had to be intubated on day 2. CRRT was initiated in view of worsening metabolic acidosis and unstable haemodynamics. In spite of appropriate intensive care measures, the patient gradually deteriorated, had cardiac arrest and passed away on day 5 of his hospital stay.
Extranodal diffuse large B cell lymphoma of maxillary sinus presenting as a palatal ulcer
Authors: Janardhanan Mahija , Suresh Rakesh , Savithri Vindhya , Veeraraghavan Ravi
Published: February 2019

A multitude of disease processes ranging from periodontitis to malignancies can lead to formation of solitary ulcer on the palate. Hence solitary ulcers of palate can often be a challenging one to diagnose. We report an interesting case of a diffuse large B cell lymphoma of the maxillary sinus which perforated the palatal bone and presented clinically as a palatal ulcer. Initially the lesion manifested as a small ill-defined swelling in the posterior palatal slope in relation to 24and25 which were mobile and hence was erroneously diagnosed as chronic periodontal abscess. This paper is intended to stress the relevance of including non-Hodgkin’s lymphoma in the differential diagnosis of solitary palatal ulcers as it may be often misdiagnosed as more common reactive or inflammatory lesions.
Evaluation of the overdiagnosis in breast screening programmes using a Monte Carlo simulation tool: a study of the influence of the parameters defining the programme configuration
Authors: Forastero Cristina , Zamora Luis I , Guirado Damián , Lallena Antonio M
Published: February 2019

Objectives

To build up and test a Monte Carlo simulation procedure for the investigation of overdiagnosis in breast screening programmes (BSPs).

Design

A Monte Carlo tool previously developed has been adapted for obtaining the quantities of interest in order to determine the overdiagnosis: the annual and cumulative number of cancers detected by screening, plus interval cancers, for a population following the BSP, and detected clinically for the same population in the absence of screening. Overdiagnosis is obtained by comparing these results in a direct way.

Results

Overdiagnosis between 7% and 20%, depending on the specific configuration of the programme, have been found. These range of values is in agreement with some of the results available for actual BSPs. In the cases analysed, a reduction of 11% at most has been found in the number of invasive tumours detected by screening in comparison to those clinically detected in the control population. It has been possible to establish that overdiagnosis is almost entirely linked to ductal carcinoma in situ tumours.

Conclusions

The use of Monte Carlo tools may facilitate the analysis of overdiagnosis in actual BSPs, permitting to address the role played by various quantities of relevance for them.
Trends in cerebrovascular diseases mortality in Serbia, 1997–2016: a nationwide descriptive study
Authors: Ilic Irena , Ilic Milena , Sipetic Grujicic Sandra
Published: February 2019

Objectives

Over the last decades, mortality from cerebrovascular diseases (CVDs) has decreased in many countries. The aim of this study was to assess the trends of CVDs mortality in Serbia.

Methods

Descriptive epidemiological study. Age-standardised rates (ASRs) for CVDs mortality were assessed by joinpoint regression analysis to identify significant changes in trends and estimate annual per cent changes with 95% CI. The age-period-cohort analysis has been used to describe variations in mortality.

Results

Over this 20-year period, there were 312 847 deaths from CVDs, with the overall average annual ASR of 148.4 per 100 000. The trend of ASRs from CVDs mortality in males in Serbia showed a significant joinpoint: rates insignificantly decreased from 1997 to 2005 by −0.8% per year (95% CI −1.7% to 0.2%) and thereafter rapidly decreased by −5.0% per year (95% CI −5.6% to −4.5%). A joinpoint for females was found in 2006: the mortality trend was first significantly decreasing by −1.0% per year (95% CI −1.9% to −0.0%) and then sharply falling down by −6.0% per year (95% CI −6.8% to −5.3%). Results of age-period-cohort analysis indicated that the relative risk for CVDs mortality showed statistically significant (p<0.05) cohort and period effects, as well as the net drift and local drifts in Serbian population. The trends in mortality for all subtypes of CVDs were similar in both sexes: trends significantly decreased for most subtypes, with the exception of a significant increase for cerebral infarction.

Conclusions

After a decade of increase, CVDs mortality rates are declining in last decade in Serbia. However, mortality rates from CVDs remain exceedingly high in Serbia. Differences in mortality trends of the stroke subtypes should be taken into account in the creation of both prevention and treatment guidelines.
Temporal trends in relative survival following percutaneous coronary intervention
Authors: Hulme William J , Sperrin Matthew , Martin Glen Philip , Curzen Nick , Ludman Peter , Kontopantelis Evangelos , Mamas Mamas A
Published: February 2019

Objective

Percutaneous coronary intervention (PCI) has seen substantial shifts in patient selection in recent years that have increased baseline patient mortality risk. It is unclear to what extent observed changes in mortality are attributable to background mortality risk or the indication and selection for PCI itself. PCI-attributable mortality can be estimated using relative survival, which adjusts observed mortality by that seen in a matched control population. We report relative survival ratios and compare these across different time periods.

Methods

National Health Service PCI activity in England and Wales from 2007 to 2014 is considered using data from the British Cardiovascular Intervention Society PCI Registry. Background mortality is as reported in Office for National Statistics life tables. Relative survival ratios up to 1 year are estimated, matching on patient age, sex and procedure date. Estimates are stratified by indication for PCI, sex and procedure date.

Results

549 305 procedures were studied after exclusions for missing age, sex, indication and mortality status. Comparing from 2007 to 2008 to 2013–2014, differences in crude survival at 1 year were consistently lower in later years across all strata. For relative survival, these differences remained but were smaller, suggesting poorer survival in later years is partly due to demographic characteristics. Relative survival was higher in older patients.

Conclusions

Changes in patient demographics account for some but not all of the crude survival changes seen during the study period. Relative survival is an under-used methodology in interventional settings like PCI and should be considered wherever survival is compared between populations with different demographic characteristics, such as between countries or time periods.
Quality assessment of clinical trial registration with traditional Chinese medicine in WHO registries
Authors: Zhang Xuan , Tian Ran , Yang Zhen , Zhao Chen , Yao Liang , Lau Chungtai , Wu Taixiang , Shang Hongcai , Zhang Xiaoyang , Lu Aiping , Bian Zhaoxiang
Published: February 2019

Objective

This study aimed to assess the registration quality of clinical trials (CTs) with traditional Chinese medicine (TCM) in the WHO International Clinical Trials Registry Platform (ICTRP) and identify the common problems if any.

Methods

The ICTRP database was searched for all TCM CTs that were registered up to 31 December 2017. Registered information of each trial was collected from specific registry involved in ICTRP through hyperlink. The primary analysis was to assess the reporting quality of registered trials with TCM interventions, which is based on the minimum 20 items of WHO Trial Registration Data Set (TRDS, V.1.2.1) plus optional additional three items recommended by ICTRP, and some specific items for TCM information (including TCM intervention, diagnosis, outcome and rationale). Descriptive statistics were additionally used to analyse the baseline characteristics of TCM trial registrations.

Results

A total of 3339 records in 15 registries were examined. The number of TCM registered trials has increased rapidly after the requirement of mandatory trial registration proposed by International Committee of Medical Journal Editors on 1 July 2005, and the top two registries were Chinese Clinical Trial Registry and ClincialTrials.gov. Of 3339 trials, 61% were prospective registration and 12.8% shared resultant publications. There were 2955 interventional trials but none of them had a 100% reporting rate of the minimum 20 items and additional three items. The reporting quality of these 23 items was not optimal due to 11 of them had a lower reporting rate (<65%). For TCM details, 49.2% lacked information on description of TCM intervention(s), 85.9% did not contain TCM diagnosis criteria, 92.6% did not use TCM outcome(s) and 67.1% lacked information on TCM background and rationale.

Conclusion

The registration quality of TCM CTs should be improved by prospective registration, full completion of WHO TRDS, full reporting of TCM information and results sharing. Further full set of trial registration items for TCM trials should be developed thus to standardise the content of TCM trial registration.
Protocol for developing a mental imagery intervention: a randomised controlled trial testing a novel implementation imagery e-health intervention to change driver behaviour during floods
Authors: Hamilton Kyra , Keech Jacob J , Peden Amy E , Hagger Martin S
Published: February 2019

Introduction

Drowning due to driving into floodwater accounts for a significant proportion of all deaths by drowning. Despite awareness campaigns such as ‘If it’s flooded, forget it’, people continue to drive into floodwater. This causes loss of life, risk to rescuers and damage to vehicles. The aim of this study was to develop and evaluate an online e-health intervention to promote safe driving behaviour during flood events.

Methods and analysis

The study will use a 2×3 randomised controlled trial in which participants are randomised into one of two conditions: (1) education about the risks of driving into floodwater or (2) education about the risks of driving into floodwater plus a theory-based behaviour change intervention using planning and imagery exercises. The effect of the intervention on the primary outcome, intention to drive through floodwater and the secondary outcomes will be assessed using a series of mixed-model analysis of covariances.

Ethics and dissemination

The study has been approved by the Griffith University Human Research Ethics Committee. Participants will review a study information sheet and provide informed consent prior to commencing participation. Results will be disseminated through peer-reviewed publications, industry reports, media releases and at academic conferences. Deidentified data will be made publicly available following publication of the results.

Trial registration number

ACTRN12618001212246.
Maternity Log study: a longitudinal lifelog monitoring and multiomics analysis for the early prediction of complicated pregnancy
Authors: Sugawara Junichi , Ochi Daisuke , Yamashita Riu , Yamauchi Takafumi , Saigusa Daisuke , Wagata Maiko , Obara Taku , Ishikuro Mami , Tsunemoto Yoshiki , Harada Yuki , Shibata Tomoko , Mimori Takahiro , Kawashima Junko , Katsuoka Fumiki , Igarashi-Takai Takako , Ogishima Soichi , Metoki Hirohito , Hashizume Hiroaki , Fuse Nobuo , Minegishi Naoko , Koshiba Seizo , Tanabe Osamu , Kuriyama Shinichi , Kinoshita Kengo , Kure Shigeo , Yaegashi Nobuo , Yamamoto Masayuki , Hiyama Satoshi , Nagasaki Masao
Published: February 2019

Purpose

A prospective cohort study for pregnant women, the Maternity Log study, was designed to construct a time-course high-resolution reference catalogue of bioinformatic data in pregnancy and explore the associations between genomic and environmental factors and the onset of pregnancy complications, such as hypertensive disorders of pregnancy, gestational diabetes mellitus and preterm labour, using continuous lifestyle monitoring combined with multiomics data on the genome, transcriptome, proteome, metabolome and microbiome.

Participants

Pregnant women were recruited at the timing of first routine antenatal visits at Tohoku University Hospital, Sendai, Japan, between September 2015 and November 2016. Of the eligible women who were invited, 65.4% agreed to participate, and a total of 302 women were enrolled. The inclusion criteria were age ≥20 years and the ability to access the internet using a smartphone in the Japanese language.

Findings to date

Study participants uploaded daily general health information including quality of sleep, condition of bowel movements and the presence of nausea, pain and uterine contractions. Participants also collected physiological data, such as body weight, blood pressure, heart rate and body temperature, using multiple home healthcare devices. The mean upload rate for each lifelog item was ranging from 67.4% (fetal movement) to 85.3% (physical activity), and the total number of data points was over 6 million. Biospecimens, including maternal plasma, serum, urine, saliva, dental plaque and cord blood, were collected for multiomics analysis.

Future plans

Lifelog and multiomics data will be used to construct a time-course high-resolution reference catalogue of pregnancy. The reference catalogue will allow us to discover relationships among multidimensional phenotypes and novel risk markers in pregnancy for the future personalised early prediction of pregnancy complications.
Intracoronary near-infrared spectroscopy and the risk of future cardiovascular events
Authors: Karlsson Sofia , Anesäter Erik , Fransson Klara , Andell Pontus , Persson Jonas , Erlinge David
Published: February 2019

Objectives

The objectives of this study were to investigate if findings by intracoronary near-infrared spectroscopy (NIRS) and intravascular ultrasound (IVUS) are associated with future cardiovascular events and if NIRS can differentiate culprit from non-culprit segments in patients with coronary artery disease.

Methods

The study included 144 patients with coronary artery disease undergoing percutaneous coronary intervention and combined NIRS-IVUS imaging at two Swedish hospitals. The NIRS-derived lipid core burden index (LCBI), the 4 mm segment with maximum LCBI (MaxLCBI4mm) and the IVUS-derived maximum plaque burden (MaxPB) were analysed within the culprit segment and continuous 10 mm non-culprit segments of the index culprit vessels. The association with future major adverse cardiovascular and cerebrovascular events (MACCE), defined as all-cause mortality, acute coronary syndrome requiring revascularisation and cerebrovascular events during follow-up was evaluated using multivariable Cox regressions. A receiver operating characteristic (ROC) analysis was performed to test the ability of NIRS to discriminate culprit against non-culprit segments.

Results

A non-culprit maxLCBI4mm≥400 (HR: 3.67, 95% CI 1.46 to 9.23, p=0.006) and a non-culprit LCBI ≥ median (HR: 3.08, 95% CI 1.11 to 8.56, p=0.031) were both significantly associated with MACCE, whereas a non-culprit MaxPB ≥70% (HR: 0.61, 95% CI 0.08 to 4.59, p=0.63) was not. The culprit segments had larger lipid cores compared with non-culprit segments (MaxLCBI4mm425 vs 74, p<0.001), and the ROC analysis showed that NIRS can differentiate culprit against non-culprit segments (c-statistics: 0.85, 95% CI 0.81 to 0.89).

Conclusion

A maxLCBI4mm≥400 and LCBI ≥ median, assessed by NIRS in non-culprit segments of a culprit artery, were significantly associated with patient-level MACCE. NIRS furthermore adequately discriminated culprit against non-culprit segments in patients with coronary disease.
Complications and prognosis of patients undergoing apical or septal right ventricular pacing
Authors: Spath Nick B , Wang Kelvin , Venkatasumbramanian Sowmya , Fersia Omar , Newby David E , Lang Chris CE , Grubb Neil R , Dweck Marc R
Published: February 2019

Objectives

Optimal right ventricular lead placement remains controversial. Large studies investigating the safety and long-term prognosis of apical and septal right ventricular lead placement have been lacking.

Methods

Consecutive patients undergoing pacemaker insertion for high-degree atrioventricular block at Edinburgh Heart Centre were investigated. Periprocedural 30-day complications were defined (infection/bleeding/pneumothorax/tamponade/lead displacement). Long-term clinical outcomes were obtained from the General Register of Scotland and electronic medical records. The primary endpoint was a composite of all-cause mortality, new heart failure, hospitalisation for a major cardiovascular event, as per theCArdiacREsynchronization inHeartFailure trial. Secondary endpoints were all-cause mortality, new heart failure and their composite.

Results

820 patients were included, 204 (25%) paced from the septum and 616 (75%) from the apex. All baseline variables were similar with the exception of age (septal: 73.2±1.1 vs apical: 76.9±0.5 years, p<0.001). Procedure duration (58±23 vs 55±25 min, p=0.3), complication rates (18 (8.8) vs 46 (7.5)%, p=0.5) and postimplant QRS duration (152 (23) vs 154 (27) ms, p=0.4) were similar. After 1041 days (IQR 564), 278 patients met the primary endpoint, with no difference between the septal and apical groups in unadjusted (HR 0.86 (95% CIs 0.64 to 1.15)) or multivariable analysis correcting for age, gender and comorbidity (HR 0.97 (95% CI 0.72 to 1.30)). Similarly, no differences were observed in the secondary endpoints.

Conclusions

This large real-world cohort of patients undergoing right ventricular lead placement in the septum or apex demonstrated no difference in procedural complications nor long-term clinical outcomes. Both pacing strategies appear reasonable in routine practice.
Cost Analysis of a Multidisciplinary Vascular Anomaly Clinic
Authors: Straughan Alexander J. , Mudd Pamela A. , Silva Allison L. , Callicott Susan S. , Krakovsky Gina , Bauman Nancy M.
Published: February 2019

Objective:

Multidisciplinary vascular anomaly clinics (VACs) offer important value to pediatric patients with complex vascular anomalies whose care overlaps specialties. These clinics are labor intensive and costly to operate since providers see fewer patients compared to their individual specialty clinic. Our North American tertiary care institution’s VAC specialists include a pediatric otolaryngologist, pediatric surgeon, pediatric plastic surgeon, pediatric dermatologist, and interventional radiologist. To assess financial feasibility, we conducted a cost analysis of our VACs comprised of 2 half-day multidisciplinary physician attended clinics (5 specialists at our main campus and 2 specialists at a satellite clinic) and a half-day nurse practitioner clinic.

Method:

Assessment of net revenue based on net collections for clinic, professional, operative, hospital setting, and facility charges generated during 12 consecutive monthly VACs beginning July 1, 2015. Expense calculations included provider and staff salaries, benefits, supply costs, and clinic leasing costs.

Results:

There were 469 clinic visits, of which 202 were new patient evaluations. Sixty-eight patients underwent 93 procedures under general anesthesia, including procedures performed by our interventional radiologist, most commonly sclerotherapy or embolization (n = 37), surgical interventions including endoscopy (n = 36), or laser procedures (n = 20). Three patients were admitted. Fifty-seven patients received a new diagnosis different from that for which they were referred. Gross revenue was $1 810 525, and net revenue was 42.5%, or $783 152. Expenses totaled $453 415 for a net positive revenue of $329 737.

Conclusion:

When including direct downstream revenue, particularly from operative procedures, our VAC program operates on a net positive margin, making the program financially feasible.
Corticosteroids for Septic Shock: Another Chapter in the Saga
Authors: Yerke Jason , Strnad Kyle , Bauer Seth R.
Published: February 2019

The use of corticosteroids in the management of septic shock has been a highly debated topic for quite some time. Corticosteroids have the ability to combat hyperinflammatory and exaggerated vasodilatory responses, as well as to sensitize adrenergic receptors to decrease the duration of shock. While helpful clinically, this has not translated to consistent mortality benefits. Conflicting results from 2 landmark trials published in 2002 and 2008 have led to varying clinical practices, and a clearly defined role of corticosteroids in septic shock is lacking. A decade later, an influx of new data derived from 2 more large trials continues to echo diverging viewpoints regarding patient mortality. In combination with fluctuating study designs (eg, adjunctive therapies and shock management) and patient populations (eg, illness severity), generalized conclusions are still difficult to draw. Despite these challenges, this review critically analyzes recently published data in the context of historical debate to provide an updated comment on the role of corticosteroids in septic shock. In summary, hydrocortisone therapy is likely to demonstrate maximal benefit when initiated on patients with septic shock and organ failure refractory to vasopressor therapy and should be used judiciously in other settings as it comes without a demonstrated benefit in mortality and increased potential for adverse effects.
Cross-Cultural Mental State Reading Ability in Antillean Dutch, Moroccan Dutch, and Dutch Young Adults
Authors: van der Meulen Anna , de Ruyter Doret , Blokland Arjan , Krabbendam Lydia
Published: February 2019

Understanding how bicultural and monocultural individuals are oriented toward the cultures they come into frequent contact with can increase insights into their adaptation and well-being. Previous research has shown a relation between culture and mental state reading in the form of the cultural in-group effect, which is defined as the advantage in reading mental states from the own cultural group compared with other groups. Thus, orientation toward cultures can be assessed not only in self-reported behavioral and psychological acculturation but also in the domain of social–cognitive abilities. The aim of the current research is to gain insight into acculturation in the social–cognitive ability of mental state reading. In addition, it explores how this facet of acculturation is related to the more traditionally studied behavioral and psychological acculturation. Cross-cultural mental state reading, language and possession of friends (behavioral acculturation), and cultural identification (psychological acculturation) were assessed in Antillean Dutch ( n = 128), Moroccan Dutch ( n = 204), and Dutch ( n = 349) young adults between 19 and 24 years old ( M = 21.57 years, SD = 1.38 years). For cross-cultural mental state reading, the in-group effect was confirmed for the Dutch but not for the Antillean Dutch and Moroccan Dutch participants. Furthermore, there were no consistent associations between mental state reading and behavioral and psychological acculturation in the three groups. The present results extend fundamental research on cross-cultural mental state reading and also help to further understand the orientation of these specific cultural groups.
Meta-analysis, military expenditures and growth
Authors: Yesilyurt Filiz , Yesilyurt M Ensar
Published: February 2019

This article conducts a meta-analysis of the effect of military expenditures on growth within a structured analytic framework. We extend the pioneering study of Aynur Alptekin and Paul Levine, by using a much larger sample of studies. Like them we confine our attention to studies that use the share of military expenditure in GDP, the military burden, as the independent variable, but unlike them we include not just those that use the military burden directly, what we call the core sample, but also those that use other functions of it, such as logarithms, differences, etc., which we call the remaining sample. We also consider an overall sample which pools all results. The t-statistic on the coefficient of military burden is used as the dependent variable. Our null hypothesis is that military expenditure has no significant effect on growth and we explain why this is plausible. The estimates are sensitive to the sample and type of data used, estimation method adopted, and the controls included. Overall, the results are consistent with the hypothesis of no effect: the average effect across all studies is close to zero. Certain study characteristics appear significant determinants of the effect of military expenditure on growth, but there does not appear to be a simple pattern and different characteristics were significant in the three samples. This might be a result of data mining to produce a significant result. However, there does not appear to be strong evidence of publication bias towards positive or negative results, perhaps because there is no strong a priori belief in the direction of the effect.
The Strange Career of Urban Homesteading: Low-Income Homeownership and the Transformation of American Housing Policy in the Late Twentieth Century
Authors: Chappell Marisa
Published: February 2019

This article uses “urban homesteading” to argue that working-class activists played an important role in the transformation of American housing policy from the 1970s through the 1990s. Designed to tackle abandonment and promote gentrification, homesteading programs in the 1970s offered houses to individuals who would rehabilitate and reside in them. Through protest, negotiation, and squatting campaigns, working-class urban activists demanded that policymakers reorient homesteading programs to enable low-income homeownership. Activists’ alternative vision of homeownership demanded access to a regulated system of federally subsidized homeownership and often adopted limited equity ownership; at the same time, their celebration of homeownership as a strategy for self-reliance offered a useful tool for Republicans seeking to privatize public housing and bipartisan efforts to deregulate mortgage lending, both of which increased housing insecurity. The article thus argues that working-class urban residents, often seen as merely victims of neoliberal policymaking, played an important role in that process.
Sales Growth, CEO Pay, and Corporate Governance in India
Authors: Jaiswall Sudhir S. , Raman K. K.
Published: February 2019

Although stock return-based performance metrics are common in CEO compensation contracts in the United States, similar CEO pay arrangements may not be appropriate in India given higher stock return volatility and lower liquidity. Instead, sales growth as a performance metric could be useful in incentivizing Indian CEOs to pursue earnings growth consistent with shareholder value maximization. In this study, we examine the use of sales growth as a performance metric in extant Indian CEO pay arrangements and whether the usage is consistent with efficiency. Our findings suggest that the weight placed on sales growth in determining CEO compensation in India is positive and is higher for more powerful CEOs. We also find that board vigilance is effective in moderating the weight placed on sales growth in CEO pay arrangements. Finally, we show that the weight placed on sales growth in assessing CEO pay negatively impacts future firm performance, particularly for firms that are in the later stages of the firm life cycle, are less profitable, and have weaker shareholder monitoring. Collectively, our findings are consistent with inefficiency (efficiency) in CEO pay contracting in the use of sales growth as a performance metric in later (early) stage firms, less (more) profitable firms, and weaker (stronger) shareholder monitoring firms. More broadly, our findings albeit India-specific are of potential interest to CEO pay arrangement debates in the United States and elsewhere where sales growth is an important performance metric in determining CEO compensation.
Latino Immigrant Parents’ Experiences With Discrimination: Implications for Parenting in a Hostile Immigration Policy Context
Authors: Ayón Cecilia , García San Juanita
Published: February 2019

A growing anti-immigrant context has increased the discrimination Latino immigrant families confront in the United States. This study examines the relationship between discrimination and Latinos’ parenting practices. Using cross-sectional data on parenting practices, discrimination, immigration-related factors, and protective factors among Latino immigrant families, we conduct a latent profile analysis to (a) identify profiles of perceived discrimination, (b) assess the role of protective mechanisms in predicting discrimination profiles, and (c) examine the relationship between discrimination profiles and parenting outcomes. The findings revealed a four-class solution, Low Discrimination, Institutional and Language Discrimination, Moderate Discrimination, and High Discrimination. Parents in the High Discrimination profile experienced lower levels of monitoring, consistent discipline, and higher levels of harsh disciplining compared with the other profiles. Overall, this article has implications for effective family functioning given that parental discrimination may influence parenting practices, which has direct consequences on parent–child relationships.
Prescriber Variation in Relation to Prescribing Trends within the Preferred Drugs Initiative in Ireland (2012–2015): An Interrupted Time-Series Study Using Latent Curve Models
Authors: McDowell Ronald D. , Bennett Kathleen , Moriarty Frank , Clarke Sarah , Barry Michael , Fahey Tom
Published: February 2019

Objectives. To examine the impact of the Preferred Drugs Initiative (PDI), an Irish health policy aimed at reducing prescribing variation. Design. Interrupted time series spanning 2012 to 2015. Setting. Health Service Executive pharmacy claims data for General Medical Services (GMS) patients, approximately 40% of the Irish population. Participants. Prescribers issuing preferred drug group items to GMS adults before and after PDI guidelines. Primary Outcome. The percentage coverage of PDI medications within each drug class per calendar quarter per prescriber. Methods. Latent curve models with structured residuals (LCM-SRs) were used to model coverage of the preferred drugs over time. The number of GMS adults receiving medication and the percentage who were 65 years and older at the start of the study were included as covariates. Results. In the quarter following PDI guidelines, coverage of the preferred drugs increased most in absolute terms for proton pump inhibitors (PPIs) (1.50% [SE 0.15], P < 0.001) and selective and norepinephrine reuptake inhibitors (SNRIs) (1.17% [SE 0.26], P < 0.001). Variation between prescribers remained relatively unchanged and increased for urology medications. Prescribers who increased coverage of the preferred PPI also increased coverage of the preferred statin immediately following guidelines (correlation 0.47 [SE 0.13], P < 0.001). Where guidelines were disseminated simultaneously, coverage of one preferred drug did not significantly predict coverage of the other preferred drug in the next calendar quarter. Prescribing of preferred drugs was not moderated by prescriber-level factors. Conclusions. Modest changes in prescribing of the preferred drugs have been observed over the course of the PDI. However, the guidelines have had little impact in reducing variation between prescribers. Further strategies may be necessary to reduce variation in clinical practice and enhance patient care.
Allocating Spending between Hotspot and Systemic Approaches to Safety Management
Authors: Gross Frank , Harmon Tim
Published: February 2019

There are more opportunities to improve safety across a highway network than funds available to implement projects. As such, safety program managers are challenged with selecting projects and allocating resources to maximize the program’s return on investment. The hotspot and systemic approaches are two complementary approaches to safety management. A common question is how to allocate funding between these two approaches to achieve the maximum return on investment, considering the objectives and relative risks of each. This paper presents a framework to consider tradeoffs of allocating funding between hotspot and systemic projects as well as when to apply each approach. The framework is based on average project costs, average project effectiveness, and average crash costs. To demonstrate the framework, this paper presents average values based on six countermeasures that represent the hotspot approach and six countermeasures that represent the systemic approach. In general, this paper uses higher-cost and higher-effectiveness projects to represent the hotspot approach and lower-cost and lower-effectiveness projects to represent the systemic approach. Based on the sample of countermeasures and data included in this paper, the average cost-effectiveness of systemic countermeasures is greater than the average cost-effectiveness of hotspot countermeasures. Although systemic countermeasures tend to be more cost-effective than hotspot countermeasures on average, there is a need to balance these two approaches. The framework could also apply to other situations, such as allocating funding between other safety programs (e.g., roadway departure and intersection safety programs) or prioritizing among project alternatives within a program (e.g., roundabouts, signals, or signing).
State DOT Implementation of Statistical Analysis and Percent Within Limits
Authors: Coenen Aaron R. , Pforr James E. , Hefel Steven A. , Paye Barry C.
Published: February 2019

Verification testing, conducted by many state agencies, should serve an integral role in a quality assurance program. Many agencies seek a balance of physical and financial resources, as resources are routinely a limiting factor. For the Wisconsin Department of Transportation (WisDOT), it is datasets collected by both the contractor (quality control, QC) and department (quality verification, QV) at differing frequencies compared in a statistically valid method that provide balance. Statistical analyses, specifically F- and t-testing, have been chosen by WisDOT to accompany a Percent Within Limits (PWL) specification for hot mix asphalt (HMA). The analyses evaluate QC and QV data variances, means, standard deviations, and so forth, and determine whether it is reasonable to assume the test results of each dataset come from the same population, that is, are representative of the same material. If comparable, the more frequent QC data are considered verified and subsequently used in PWL calculations to approximate the percentage of material within specification limits. Anything less than comparable is subject to further investigation, for example, a dispute resolution process, to determine which test results most reliably represent the physical properties of the material, and are thus justifiably used in latter calculations. Such an approach has allowed WisDOT to adjust pay in accordance with material quality and consistency, ultimately connecting pay to anticipated long-term performance. This modified system of monitoring HMA materials has motivated multiple changes to industry processes and planning, and resulted in more consistent pavements, which should reduce the potential for isolated premature distresses.
Pollution analysis of soil polycyclic aromatic hydrocarbons from informal electronic waste dismantling areas in Xinqiao, China
Authors: Gu Weihua , Bai Jianfeng , Yuan Wenyi , Ma En , Zhang Chenglong , Wang Jingwei
Published: February 2019

Polycyclic aromatic hydrocarbons (PAHs) are considered to be persistent organic pollutants, which pose a great threat to human health and the surrounding environment. In order to explore the influence of informal electronic waste (e-waste) dismantling activities on inhabitants who live nearby, soil samples were collected from informal e-waste dismantling areas in Xinqiao, China and analysed for 16 United States Environmental Protection Agency (USEPA) priority PAHs. Results indicated that the 16 USEPA priority PAHs were found at all seven sampling locations. Sampling location 3, which was only 10 m away from a residential area, had 1053.69 μg kg−1 of PAHs and seriously exceeded the standard value specified by the Netherlands. The total percents of 4-ring and 5-ring PAHs accounted for 61.74 and 71.70%, respectively, indicating that most of the detected PAHs belonged to high-ring PAHs. The informal e-waste dismantling activities are the major sources of soil PAHs in Xinqiao. Furthermore, the concentration of seven carcinogenic PAHs was 114.76 μg kg−1 and represented a potential health risk to humans. Thereinto, benzo[a]pyrene contributed the most, accounting for more than 50% in these locations. Our results may provide a reference about the influence of informal e-waste dismantling activities on the surrounding inhabitants and suggest that e-waste dismantling activities must be conducted in a formal enterprise which is far away from residential areas.
Trade union strategies against precarious work: Common trends and sectoral divergence in the EU
Authors: Keune Maarten , Pedaci Marcello
Published: February 2019

We present comparative research on precarious work and trade union strategies in three sectors (construction, industrial cleaning, temporary agency work) across seven European countries. Specific sectors have a profile of precarious work that is remarkably similar across countries, originating from similar employer strategies and work organizations. This results in unions facing comparable challenges concerning precarious work at sectoral level and developing comparable sectoral strategies to combat precarious work. The success of these strategies depends to a large extent on the available power resources. Between sectors within single countries, we observe some similarities but also very substantial differences in their institutional configuration and in actors’ constellations, power resources and repertoires of action. National institutional contexts seem much less significant than often assumed.
Coinfection with Entamoeba polecki and Brachyspira hyodysenteriae in a pig with severe diarrhea
Authors: Cuvertoret-Sanz Maria , Weissenbacher-Lang Christiane , Lunardi Madeleine , Brunthaler René , Coma Mònica , Weissenböck Herbert , Segalés Joaquim
Published: February 2019

Enteric disease in pigs is usually of multifactorial etiology, including infectious and non-infectious factors. In many cases of endemic diarrhea in weaner-to-finisher pigs, the combination of 2 or more microorganisms leads to aggravation of intestinal lesions and, consequently, clinical signs. We autopsied a 4-mo-old fattening pig with diarrhea and diagnosed severe fibrinonecrotizing typhlocolitis. Numerous spiral-shaped bacteria and amoeba-like PAS-positive protozoa were observed in the cecal and colonic mucosa and submucosa. Brachyspira hyodysenteriae was detected by PCR from colonic content. By in situ hybridization, large numbers of Entamoeba polecki were found within the lamina propria and submucosa; moderate numbers of Blastocystis sp. and scattered trichomonads were present in intestinal content. In addition, Entamoeba polecki, Balantidium spp., Blastocystis sp., and Trichomonas sp. were also detected by PCR.
Nurses’ Perceptions of Basic Palliative Care in the Hmong Population
Authors: Neiman Tammy
Published: February 2019

Introduction: The purpose of this study was to describe basic palliative care from the acute care nurses’ perspective with consideration for culturally diverse populations. Participants focused their responses based on their experiences with Hmong patients. The concept of cultural safety was explored to improve basic palliative care practice in acute care settings. Method: A qualitative approach was utilized. Thirty-four nurses participated in either focus group or individual interviews. Results: Assisting tradition, understanding culture, and managing language barriers were identified as themes unique to providing basic palliative care to Hmong patients. Discussion: Nurses experienced uncertainty and inadequacy of resources when caring for patients from a Hmong background. Nurses also recognized the strong family ties in this specific population and the importance of supporting tradition while in the hospital. Utilizing Wood and Schwass’ framework of cultural safety could guide nurses providing basic palliative care to Hmong patients and other culturally diverse patients.
Faculty Perceptions of Engaging Students in Active Learning to Address Implicit Bias Using Videos Exemplifying the Prenatal Visit of a Lesbian Couple
Authors: Teall Alice M. , Graham Margaret , Jenkins Nathan , Ali Awais , Pryba John , Overcash Janine
Published: February 2019

Introduction: Implicit bias affects patient–nurse interactions and care management decisions. The purpose of this educational project was to explore faculty perceptions of engaging students in active learning to address implicit bias using videos vignettes. Method: Three videos were created with a corresponding instructor guide. The vignettes depicted insensitive behaviors, best practice clinical interactions, and a reflection about bias in health care. Faculty who implemented the active learning strategy were invited to complete an online, confidential survey regarding their perceptions. Results: Most faculty (83%) agreed that students benefit from discussing implicit bias using an active learning approach. All faculty ( N = 12) believed the videos and instructor guide to be effective tools in creating meaningful discussion. Discussion: Video vignettes illustrating insensitive behaviors and demonstrating best practice enable faculty to actively engage students in addressing the impact of implicit bias. Educational strategies intended to ensure equitable care are indicated to support positive patient outcomes.
Magneto-mechanical characterization of magnetorheological elastomers
Authors: Bellelli Alberto , Spaggiari Andrea
Published: February 2019

This work analyses the properties and the magneto-mechanical characteristics of magnetorheological elastomers, a class of smart materials not yet broadly investigated. First, set of several samples of this material was manufactured, each one characterized by a different percentage of ferromagnetic material inside the viscoelastic matrix. The specimens were manufactured in order to create isotropic and anisotropic configurations, respectively, with randomly dispersed ferromagnetic particles or with an aligned distribution, obtained through and external magnetic field. Then, the mechanical behaviour of each sample was analysed by conducting a compression test, both with and without an external magnetic field. Moreover, a three-point bending test was also performed on the same specimens. Stiffness, deformation at maximum stress and specific energy dissipated were calculated based on the experimental data. The results were analysed considering the mechanical responses, and an analysis of variance was carried out in order to assess the statistical influence of each variable. The experimental results highlighted a strong correlation between the percentage of ferromagnetic material in each sample and its mechanical behaviour. The anisotropicity of the material, aligned in columnar structures, also affects the stiffness measured in the compression test, while the external magnetic field’s main contribution is to reduce the samples’ maximum deformation. Using analysis of variance results as guidelines, we built a simple phenomenological model which produces quite reliable predictions regarding the mechanical response of the magnetorheological elastomers under compressive stress.
Managing the (In)visibility of Chronic Illness at Work: Dialogism, Parody, and Reported Speech
Authors: Thompson Laura , Ford Helen L. , Stroud Amanda , Madill Anna
Published: February 2019

Interactionally, the workplace may be dilemmatic for a person with “invisible” chronic illness. Risks of stigmatization exist if they disclose their condition to colleagues. Meanwhile, not disclosing threatens well-being and entitlements. Using Bakhtin’s dialogism as a theoretical framework, we explored these social aspects of illness: inductively analyzing narratives from 20 participants with multiple sclerosis (MS). Capitalizing on concepts from dialogical and conversation analysis, links between (in)visibility, knowledge, and belief were examined with respect to symptoms and co-worker judgment. Perceived medical legitimacy creates a core social dilemma. At the intersection of genre and action, participants systematically used parody to subvert the traditional workplace hierarchy. “Oh-prefaced” direct reported speech (OPDRS) was deployed to exaggerate workplace interactions, undermining managers/colleagues who misattributed (in)visible symptoms. Parodic OPDRS index emotive interactional dilemmas. As subversions of organizational power, OPDRS denote those very areas where employees feel disempowered. Sensitivity to OPDRS can provide diagnostic support and complement evaluation frameworks.