bluuebunny/crossref_metadata_2025 huggingface dataset:
Concussion Bingo: Taking an active learning approach to concussion education with vulnerable populations
Authors: Wallace Jessica , Covassin Tracey , Beidler Erica
Published: October 2018

Objective:

The ability of athletes in underserved communities to recognise sport-related concussion (SRC) may be complicated by the lack of a qualified professional, such as an athletic trainer, present. An active learning educational activity (Concussion Bingo) was developed to assist in SRC identification. This study examined learning outcomes following the use of this activity by athletes in two US Title I (low socioeconomic status) high schools.

Design:

Cross-sectional study.

Setting:

High school sports.

Methods:

Participants ( n = 102 athletes) completed 10-minute SRC knowledge of concussion surveys before and after participating in a Concussion Bingo activity. The 45-question survey assessed SRC knowledge through questions about SRC signs/symptoms, general injury information relating to loss of consciousness, the injured anatomical structure, complications of multiple SRCs and premature return to play. Participants had to mark key SRC terms on a Bingo card as they appeared throughout an SRC presentation including content from published consensus/position statements. Descriptive and parametric statistics were used to analyse the data.

Results:

Analysis of covariance revealed significant differences between pre- and post-Concussion Bingo scores. Athletes had the greatest knowledge increase of fogginess ( n = 30, 29.5%), mood changes ( n = 29, 28.5%), nausea ( n = 27; 26.5%) and sleep problems ( n = 27, 29.5%). On questions pertaining to the injury itself, athletes had the greatest increase on ‘you have to be hit in the head to get a concussion’ ( n = 51, 50%), ‘what kind of an injury is a concussion’ ( n = 31, 40.2%) and a concussion only occurs if you ‘black out’ ( n = 24, 23.4%).

Conclusion:

Concussion Bingo increased Title I high school athletes’ knowledge of SRCs, suggesting that it may be an effective active learning tool for increasing SRC knowledge.
Backtalk
Authors: Glazer Jeremy
Published: October 2018

The recent wave of teacher strikes and walkouts across the United States is focusing much-needed attention on the concerns of public school educators. But Jeremy Glazer argues that we have been ignoring a huge silent protest right in front of us: the increasing number of teachers leaving the profession. Through conversations with what he calls invested leavers (i.e., teachers who had invested years in their career, sometimes gaining additional degrees and certifications), Glazer learned that some are leaving teaching not because of a lack of experience or competence, but because they lacked job security or were no longer allowed to teach in the way they thought best.
Moral Innovation and Ambiguity in Asian American Christianity
Authors: Tran Jonathan
Published: October 2018

“The Parable of the Shrewd Manager” in Luke 16 illuminates some important features of Asian American life. Like the parable’s central character, Asian Americans live under a set of cultural expectations where success is achieved by accepting terms set by others. In America, those terms are often defined racially, where access gets indexed to one’s ethnicity, or to perceptions of one’s ethnicity. The terms can be of great benefit and can come at great cost, as was the case for managers in Jesus’ day. Understanding Asian American life requires the recognition of both sides of this dynamic. This article first examines the parable and then draws out its relevance for Asian American and Asian American Christian life, concluding with some thoughts on the relative status of normative judgment in the context of racialization.
Introduction
Authors: Giukin Lenuta
Published: October 2018

This introduction offers an overall framework for the eight articles in this issue of the Journal of European Studies, which focus on Romanian identity and consciousness. It looks at the general history of Romania and the Republic of Moldova to show the evolution of consciousness over a century, since the formation of ‘Great Romania’ in 1918 to the present day. Aspects such as collective memory, migration, the change in the role of women, the crisis of the contemporary state, education and religion, as well as an overall crisis of patriarchy within a globalized context are discussed based on the analysis offered by the authors in their articles.
A history of injection treatments – II sclerotherapy
Authors: Myers Kenneth
Published: October 2018

Introduction

Sclerotherapy in all its current forms is based on experience going back to the 1850s.

Methods

To trace the evolution of sclerotherapy over the past 250 years, using the internet for past documentation and the literature.

Conclusion

Sclerotherapy principles were established long ago, although current modifications have been made possible by the introduction of detergent sclerosants and ultrasound guidance.
Group music lessons for children aged 1–3 improve accompanying parents’ moods
Authors: Kawase Satoshi , Ogawa Jun’ichi
Published: October 2018

This study investigated the improvement in parents’ moods when attending group music lessons targeting their children aged 1–3 years. A questionnaire survey of parents’ moods was conducted under three conditions: immediately before and after the lesson, and on a non-lesson day. Results suggested that group music lessons for children enhanced parents’ positive mood and reduced anxiety. Thus, even peripheral participation in children’s group music lessons can be beneficial for parents. In addition, such mood improvements were more significant in the parents whose everyday state anxiety was high than in parents whose state anxiety was low. Since only few parents answered that their motivation in taking the lesson was to benefit themselves, the results of the study suggest side effects of children’s group music lessons for parents. These imply the potential benefits of musical activities for non-primary targeted participants who are not clearly aware of the positive musical effects for themselves.
Enhanced MASH TL-3 Short-Radius System: Promising Design to Accommodate Flat Terrain and Ditches
Authors: Abu-Odeh Akram Y. , Bligh Roger P. , Lindsey Christopher , Odell Wade
Published: October 2018

A challenging guardrail installation situation presents itself when two roadways intersect. Combining the guardrails from intersecting roadway results in what is commonly known as a short radius or T-intersection. It is difficult if not physically impossible to provide the required tensile capacity to the geometrical constraints of the curved section. Researchers and practitioners in the roadside safety area have been investigating the short-radius issue for many years. Investigators conducted numerous crash tests for different short-radius guardrail designs, yet none of those designs passed the National Cooperative Highway Research Program (NCHRP) Report 350 Test Level 3 (TL-3) criteria. In 2009, the crash testing guidelines were updated in the Manual for Assessing Safety Hardware (MASH). MASH guidelines increased the impact severity for TL-3 tests over those in NCHRP 350. This paper presents a MASH TL-3 short-radius design that was successfully crash tested for both a flat terrain and a 3H:1V sloped terrain behind the installation. The impact conditions adopted from the MASH terminal/crash cushion matrix were MASH 3-33, 3-32, 3-31, and 3-35 for the flat terrain. Additionally, a slightly modified design that was installed in front of a 3H:1V slope was successfully evaluated using MASH 3-33 and 3-32 test conditions. These tests used a 25° impact angle since it was shown to be more critical for installation during simulation of the system.
Planning to Build Resilience into Transportation Assets: Lessons Learned
Authors: Rodehorst Beth , Dix Brenda , Hurley Brad , Keller Jake , Hyman Robert , Beucler Brian , Mohamed Khalid , Kafalenos Robert
Published: October 2018

Although many state and local transportation agencies recognize the need to make transportation assets more resilient in the face of a changing climate, there have been few methods and best practices they can draw on to determine which assets may be compromised under future conditions and how to evaluate and select adaptation measures. Federal Highway Administration’s (FHWA’s) Transportation Engineering Approaches to Climate Resiliency project sought to synthesize lessons learned and innovations from a variety of recent FHWA studies and pilots to help transportation agencies address changing climate conditions and extreme weather events at the asset level. This paper describes considerations for why, where, and how to integrate climate considerations into the project development process. It also discusses the types of climate information that should be considered, and summarizes lessons learned from FHWA’s studies and pilots—such as implementing adaptive designs, considering assets in a regional context, and exploring ecosystem-based adaptation solutions—that can be used to guide the process of developing adaptation strategies.
Land Suitability Analysis for Emergency Medical Services Posts along State Highways: A Case Study of California
Authors: Tufuor Ernest O. A. , Rilett Laurence R. , Nam Yunwoo , Beltran Antonio Hurtado
Published: October 2018

The quicker the response time of emergency medical services (EMS) to road crashes the higher the likelihood of survival. For example, the California Strategic Highway Safety Plan highlights the need to improve the response time and recognizes that 37% and 8% of the fatal crashes are 30 or more miles away from a trauma center in rural and urban areas, respectively. This paper seeks to: (1) demonstrate the viability of using spatial multi-criteria analysis in road safety management; and (2) provide a logical and consistent approach for identifying potential EMS locations. This paper adopted a multi-criteria analysis using the weighted linear combination method on raster data of various impact factors. The area selection criteria were: (1) closeness to probable road fatality locations; (2) distance from existing trauma centers; (3) proximity to existing rest stops; and (4) land availability. An EMS response time of 10 minutes, which is 3 minutes shorter than the national average, is used in this paper for demonstration purposes. Note that the specific criterion will be a function of the decision maker’s goal. The proposed methodology, which is a first step in identifying potential areas for EMS locations, was demonstrated on information from the state of California. It was found that of the 155,779 square miles of the land area studied, 24% were suitable, 7% were moderately suitable, and 69% were unsuitable for new EMS locations. In general, the rural areas along the west side freeway corridor, linking Los Angeles and San Francisco, are highly suitable.
Enriching Activity-Based Models using Smartphone-Based Travel Surveys
Authors: Nahmias-Biran Bat-hen , Han Yafei , Bekhor Shlomo , Zhao Fang , Zegras Christopher , Ben-Akiva Moshe
Published: October 2018

Smartphone-based travel surveys have attracted much attention recently, for their potential to improve data quality and response rate. One of the first such survey systems, Future Mobility Sensing (FMS), leverages sensors on smartphones, and machine learning techniques to collect detailed personal travel data. The main purpose of this research is to compare data collected by FMS and traditional methods, and study the implications of using FMS data for travel behavior modeling. Since its initial field test in Singapore, FMS has been used in several large-scale household travel surveys, including one in Tel Aviv, Israel. We present comparative analyses that make use of the rich datasets from Singapore and Tel Aviv, focusing on three main aspects: (1) richness in activity behaviors observed, (2) completeness of travel and activity data, and (3) data accuracy. Results show that FMS has clear advantages over traditional travel surveys: it has higher resolution and better accuracy of times, locations, and paths; FMS represents out-of-work and leisure activities well; and reveals large variability in day-to-day activity pattern, which is inadequately captured in a one-day snapshot in typical traditional surveys. FMS also captures travel and activities that tend to be under-reported in traditional surveys such as multiple stops in a tour and work-based sub-tours. These richer and more complete and accurate data can improve future activity-based modeling.
Cognitive Change and Driving Behavior among Older Drivers
Authors: Fraade-Blanar Laura , Smith James P.
Published: October 2018

Per vehicle miles traveled, older adults have a high fatal crash rate. One factor is dementia. This study aims to assess how differences in cognition affect driving behavior among older drivers. We analyzed data from the Health and Retirement Study. Our study used cognition, demographics, and driving behavior from 2006 to 2014 for respondents aged 65 and above. Three levels of driving behavior were measured: whether the individual could drive, whether they had driven in the past month, and whether they drove long distances. Cognitive function was measured through the Telephone Interview for Cognitive Status. Additionally, individuals were coded as having no diagnosis of dementia, a diagnosis within 2 years, or a diagnosis more than 2 years previously. We estimated the likelihood of each driving behavior in association with cognition using a modified Poisson regression model for binary outcomes. Among respondents ( N = 16,061), 79% could drive. Of these, 93% had driven in the past month, and of these, 64% drove long distances. Compared with no impairment, mild impairment was associated with a significant 12% decrease in probability of being able to drive, an 8% decrease in driving within the past month, and a 24% decrease in driving long distances. The decrease was larger among those with severe impairment. Results were in a similar direction and strength comparing individuals without dementia with individuals 0 to 2 years after diagnosis, and to more than 2 years after diagnosis. A strong positive association exists between lower cognition and lower driving exposure.
Characterization and biological properties of a novel synthesized silicon-substituted hydroxyapatite derived from eggshell
Authors: Asadipour Kamal , Nezafati Nader , Nourbakhsh Mohammad Sadegh , Hafezi-Ardakani Masoud , Bohlooli Saleh
Published: October 2018

In the present study, the effect of adding different concentrations of silicon on physical, mechanical and biological properties of a synthesized aqueous precipitated eggshell-derived hydroxyapatite (e-HA) was evaluated. No secondary phases were detected by X-ray diffraction for the specimens e-HA and e-HA containing silicon (Si-e-HAs) before and after heating at 1200°C. A reduction in the crystallite size and a-axis as well as an increase in c-axis was occurred when silicon replacement was happened in the structure of e-HA. The presence of Si-O vibrations and carbonate modes for Si-e-HAs was confirmed by Fourier transform infrared spectroscopy analysis. The range of porosity and density was varied from 25% and 2.4 g cm–3 to 7% and 2.8 g cm–3 for e-HA and Si-e-HAs. The values of Young’s modulus ( E) and compressive strength were varied for e-HA and Si-e-HAs. The porous structure of the samples was reduced when they were heated as e-HA kept the porous microstructure containing some dense areas and Si-e-HAs possessed a rough surface including slight levels of microporosity. The acellular in vitro bioactivity represented different apatite morphologies for e-HA and Si-e-HAs. The G-292 osteoblastic cells were stretched well on the surface with polygon-shaped morphology for 0.8Si-e-HA after 7 days of culture. According to MTT assay and alkaline phosphatase test, the maximum cell activity was related to 0.8Si-e-HA. The minimum inhibitory concentration for 0.8Si-e-HA and e-HA was estimated to be about 3.2 and 4.4 mg/mL, respectively. In overall, the sample 0.8Si-e-HA exhibited a higher bacteriostatic effect than e-HA against gram-negative bacterial strain Escherichia coli.
Designing Impact Evaluation for Students’ Engagement with Communities in Planning Education
Authors: Sieh Louie , Frank Andrea I.
Published: October 2018

Universities increasingly promote community engagement that involves students. However, very little has been done to evaluate student-community engagement (SCE) for their impact on “the community.” This research innovatively juxtaposes literature on the evaluation of planning and public policy with three different instances of SCE to explore the scope and nature of such impact evaluation within the context of planning education. Results suggest considerable potential of a naturalistic, ongoing, and integrated evaluation approach for and with communities in planning-related SCEs and, by extension, as a practical theory for evaluation design in community planning itself.
La régression signée : principe et mode d’emploi
Authors: Windal Pierre Marie
Published: October 2018

Résumé

Il n’existe pas à notre connaissance de méthode de régression linéaire garantissant systématiquement que le signe des coefficients concorde avec celui de la corrélation simple entre la variable à expliquer et chacun des régresseurs et dont la valeur ne se cale pas sur la contrainte qu’on pourrait leur imposer. Or ce double impératif – un coefficient positif et suffisamment différent de zéro pour chaque variable – est souvent requis par les praticiens travaillant, notamment, dans le domaine de la satisfaction où la colinéarité statistique est la norme. L’objectif de cet article est de leur fournir une méthode formelle qui réponde à cette attente et produise des résultats comparables à ceux de méthodes statistiquement fondées, au respect strict et systématique du signe près.
A Review of MD STARnet’s Research Contributions to Pediatric-Onset Dystrophinopathy in the United States; 2002-2017
Authors: Sahay Kashika M. , Smith Tiffany , Conway Kristin M. , Romitti Paul A. , Lamb Molly M. , Andrews Jennifer , Pandya Shree , Oleszek Joyce , Cunniff Christopher , Valdez Rodolfo
Published: October 2018

Population studies of rare disorders, such as Duchenne and Becker muscular dystrophies (dystrophinopathies), are challenging due to diagnostic delay and heterogeneity in disorder milestones. To address these challenges, the Centers for Disease Control and Prevention established the Muscular Dystrophy Surveillance, Tracking, and Research Network (MD STAR net) in 2002 in the United States. From 2002 to 2012, MD STAR net longitudinally tracked the prevalence, clinical, and health care outcomes of 1054 individuals born from 1982 to 2011 with pediatric-onset dystrophinopathy through medical record abstraction and survey data collection. This article summarizes 31 MD STAR net peer-reviewed publications. MD STAR net provided the first population-based prevalence estimates of childhood-onset dystrophinopathy in the United States. Additional publications provided insights into diagnostic delay, dystrophinopathy-specific growth charts, and health services use. Ongoing population-based surveillance continually improves our understanding of clinical and diagnostic outcomes of rare disorders.
Perceived Barriers to Mobility in a Medical ICU: The Patient Mobilization Attitudes & Beliefs Survey for the ICU
Authors: Goodson Carrie M. , Friedman Lisa Aronson , Mantheiy Earl , Heckle Kevin , Lavezza Annette , Toonstra Amy , Parker Ann M. , Seltzer Jason , Velaetis Michael , Glover Mary , Outten Caroline , Schwartz Kit , Jones Antionette , Coggins Sarah , Hoyer Erik H. , Chan Kitty S. , Needham Dale M.
Published: October 2018

Purpose:

Early mobilization in the intensive care unit (ICU) can improve patient outcomes but has perceived barriers to implementation. As part of an ongoing structured quality improvement project to increase mobilization of medical ICU patients by nurses and clinical technicians, we adapted the existing, validated Patient Mobilization Attitudes & Beliefs Survey (PMABS) for the ICU setting and evaluated its performance characteristics and results.

Materials and Methods:

The 26-item PMABS adapted for the ICU (PMABS-ICU) was administered as an online survey to 163 nurses, clinical technicians, respiratory therapists, attending and fellow physicians, nurse practitioners, and physician assistants in one medical ICU. We evaluated the overall and subscale (knowledge, attitude, and behavior) scores and compared these scores by respondent characteristics (clinical role and years of work experience).

Results:

The survey response rate was 96% (155/163). The survey demonstrated acceptable discriminant validity and acceptable internal consistency for the overall scale (Cronbach α: 0.82, 95% confidence interval: 0.76-0.85), with weaker internal consistency for all subscales (Cronbach α: 0.62-0.69). Across all respondent groups, the overall barrier score (range: 1-100) was relatively low, with attending physicians perceiving the lowest barriers (median [interquartile range]: 30 [28-34]) and nurses perceiving the highest (37 [31-40]). Within the first 10 years of work experience, greater experience was associated with a lower overall barrier score (−0.8 for each additional year; P = 0.02).

Conclusions:

In our medical ICU, across 6 different clinical roles, there were relatively low perceived barriers to patient mobility, with greater work experience over the first 10 years being associated with lower perceived barriers. As part of a structured quality improvement project, the PMABS-ICU may be valuable in assisting to identify specific perceived barriers for consideration in designing mobility interventions for the ICU setting.
Do We Really Need Another Meeting? The Science of Workplace Meetings
Authors: Mroz Joseph E. , Allen Joseph A. , Verhoeven Dana C. , Shuffler Marissa L.
Published: October 2018

Meetings are routine in organizations, but their value is often questioned by the employees who must sit through them daily. The science of meetings that has emerged as of late provides necessary direction toward improving meetings, but an evaluation of the current state of the science is much needed. In this review, we examine current directions for the psychological science of workplace meetings, with a focus on applying scientific findings about the activities that occur before, during, and after meetings that facilitate success. We conclude with concrete recommendations and a checklist for promoting good meetings, as well as some thoughts on the future of the science of workplace meetings.
Influence of Ear Protectors on the Sleep of Preterm Newborns: A Randomized Controlled Clinical Study
Authors: Sato Mônica Hiromi , Pedreira Mavilde da Luz Gonçalves , Avelar Ariane Ferreira Machado , Tsunemi Miriam Harumi , Orsi Kelly Cristina Sbampato Calado , Pradella-Hallinan Marcia Lurdes de Cacia , Avena Marta José , Pinheiro Eliana Moreira
Published: October 2018

The purpose of this study was to compare the effect of ear protectors on the sleep of preterm newborns during the “quiet” times in intermediate care nursery. This was a clinical, randomized, controlled crossover study conducted in two neonatal units in São Paulo, Brazil. The sample consisted of preterm infants who met the inclusion and exclusion criteria for the study. Polysomnography and unstructured observation were used for data collection. Twenty-four preterm infants with a mean gestational age of 33.2 weeks and current weight of 1.747 g were analyzed. There was no significant difference in the total sleep time of preterm infants with and without the use of ear protectors. Newborns with lower gestational age showed a significant reduction in total sleep time with the use of ear protectors ( p < .05). The use of ear protection did not increase the total sleep time for preterm infants.
Flow-induced vibration analysis of a vehicle's front side window glass
Authors: He Yinzhi , Andonov Andon A. , Shi Zihao , Blumrich Reinhard , Yang Zhigang , Wiedemann Jochen
Published: October 2018

This study analyses the flow-induced vibration of a car's front side window glass. The following working steps were carried out: experimental modal analysis to yield the dynamic characteristics of the system; wind tunnel experiments and corresponding numerical simulations with a computational fluid dynamics (CFD) code to acquire the pressure field including the fluctuations on the side glass; and a MATLAB implementation of the vibration velocity response calculated with the Corcos model and Mellen elliptical model. The MATLAB model calculates the averaged vibration velocity response by means of the pressure loading from the wind tunnel test or from the CFD simulations as well as by means of the result of the experimental modal analysis. The hereby calculated vibration response of the side glass has been validated by the results of laser Doppler vibrometer measurements in the wind tunnel. Through parameter study with the MATLAB algorithm, it was found that flow convective velocity with U c = 0.6*U, flow decay rates with α x = 0.1 and α z = 0.77 could be considered as the suitable values for the structure vibration velocity response calculation in this type of flow with a low Mach number.
Arguing over Transportation Sales Taxes: An Analysis of Equity Debates in Transportation Ballot Measures
Authors: Lederman Jaimee , Brown Anne , Taylor Brian D. , Wachs Martin
Published: October 2018

What’s a fair way to pay for urban transportation? Local option sales taxes (LOSTs) for transportation are an increasingly common mechanism for locally financing transportation in the context of declining federal and state funding. LOSTs are typically regressive, raising equity concerns. But their fairness also depends on who benefits from them, based on which projects are funded, where projects are located, and when investments occur. We examine how perceptions of these four dimensions of equity (income, geographic, temporal, and modal) are represented and debated in the ballot arguments for 38 LOST elections in California. We find that measure supporters use subtle language to imply that proposed expenditure plans achieve equity on all dimensions, promising “something for everyone.” Measure opponents, by contrast, typically attack specific perceived inequities in proposed expenditure plans. We find that tradeoffs among types of equity debated in ballot arguments frame winners and losers across multiple equity dimensions.
Bali Tolak Reklamasi: The local adoption of global protest
Authors: Bräuchler Birgit
Published: October 2018

Diverted by the virality of social media and the powerful visibility of contemporary global protest, social movement research started to loose sight of the invisible and silent aspects of mobilization and underlying collective identities. Looking at a Balinese protest movement against land reclamation whose anti-capitalist and performative character remind of recent transnational protest, this article refocuses on collective identity and examines the local adoption of global protest. It analyses the evolving actor landscape and the negotiation processes between different cultures, ecologies, generations, media and networking strategies that prominently shape the Bali movement. The article conceptualizes the movement as an emerging information ecology and tracks its entanglements with local identity, national power politics and global activism through a culture and transmedia approach. It thus analyses the loud and the silent side of the protest and the movement’s decision-making strategies that involve human and non-human agency, an aspect that is largely missing in current social movement debates. Going beyond simplified notions of strong leadership or leaderless networks, it tracks the difficult balancing acts between openness and closedness, between an ideally consensual and inclusive movement and the necessity to make strategic decisions in a specific local, national and transnational setting.
How telehealth facilitates the provision of culturally appropriate healthcare for Indigenous Australians
Authors: Caffery Liam J , Bradford Natalie K , Smith Anthony C , Langbecker Danette
Published: October 2018

Introduction

The aim of this study was to explore how telehealth facilitates or impedes the provision of culturally appropriate healthcare to Indigenous Australians from the perspective of staff at an Aboriginal Community Controlled Health Service (ACCHS).

Methods

An exploratory qualitative study was performed. Semi-structured interviews were conducted with nine ACCHS staff. Interview transcripts were analysed using thematic analysis.

Results

One central theme and three sub-themes were identified. The central theme of Care provided in a supportive environment describes how telehealth enabled specialist consultations to be conducted in the safe environment of an ACCHS instead of a mainstream health service. The first sub-theme described how telehealth improved affordability and convenience and brought a reduction in the stress of healthcare. The second sub-theme explained the importance of the presence of an Indigenous health worker to facilitate culturally appropriate healthcare. The third sub-theme described how telehealth supported a holistic view of health.

Discussion

Our findings show culturally appropriate healthcare may be enhanced by the use of telehealth because it allows care to be provided in the supportive environment of an ACCHS. It allows the community member to have the advocacy and assistance of an Indigenous health worker and reduces the burden of travel and dislocation from community and family.
Educational inequalities in fracture-related mortality using multiple cause of death data in the Skåne region, Sweden
Authors: Lindéus Maria , Englund Martin , Kiadaliri Aliasghar A.
Published: October 2018

Aim: To assess the absolute and relative educational inequalities in mortality from hip and non-hip fractures in Skåne region, Sweden. Methods: We conducted a population-based open cohort study. People aged 30–99 years, resident in the region during 1998–2013 ( n = 999, 148) were followed until death, their 100th birthday, relocation outside Skåne, or the end of 2014. We obtained individual-level data from the Statistics Sweden and the Swedish National Board of Health and Welfare’s Cause of Death Register. Death certificates coded with any fracture diagnosis were defined as fracture-related deaths. Educational inequalities were assessed by slope and relative indices of inequality (SII and RII). Cox regression and additive hazard models were used to estimates these indices. Results: During a mean follow-up of 12.2 years, there were 5,121 fracture-related deaths, of which 3,110 were associated with hip fracture. Age-standardized, hip fracture-related mortality rates per 100,000 person-years were 31, 95% confidence interval (CI) (30, 32) and 23 (20, 26) in people with low and high levels of education, respectively (rate ratio 1.4, 95% CI (1.2, 1.5)). Corresponding mortality rates for non-hip-fracture related deaths were 20 (18, 21) and 16 (14, 19) (rate ratio 1.2, 95% CI (1.0, 1.4)). SII and RII revealed educational inequalities in hip fracture-related mortality in favour of highly educated people. For non hip fracture-related mortality, there were statistically significant educational inequalities in people aged <70 years. Conclusions: We found higher fracture-related mortality with lower education suggesting preventative and therapeutic interventions for fractures should pay special attention to people with low-level education.
Inexact modified positive-definite and skew-Hermitian splitting preconditioners for generalized saddle point problems
Authors: Shen Qin-Qin , Shi Quan
Published: October 2018

In this article, to better implement the modified positive-definite and skew-Hermitian splitting preconditioners studied recently (Numer. Algor., 72 (2016) 243–258) for generalized saddle point problems, a class of inexact modified positive-definite and skew-Hermitian splitting preconditioners is proposed with improved computing efficiency. Some spectral properties, including the eigenvalue distribution, the eigenvector distribution, and an upper bound of the degree of the minimal polynomial of the inexact modified positive-definite and skew-Hermitian splitting preconditioned matrices are studied. In addition, a theoretical optimal inexact modified positive-definite and skew-Hermitian splitting preconditioner is obtained. Numerical experiments arising from a model steady incompressible Navier–Stokes problem are used to validate the theoretical results and illustrate the effectiveness of this new class of proposed preconditioners.
Vitamin C supplementation in the critically ill: A systematic review and meta-analysis
Authors: Zhang Michael , Jativa David F
Published: October 2018

Background:

Low plasma levels of vitamin C are associated with adverse outcomes, including increased mortality, in critically ill patients. Several trials have suggested that the administration of intravenous vitamin C in this setting may have beneficial effects, such as reducing the incidence of organ failure and improving survival. However, these studies have generally involved combination therapies consisting of vitamin C along with other antioxidants, confounding the effects of vitamin C alone. The primary objective of this meta-analysis is to investigate the effects of isolated intravenous supplementation of vitamin C in adults with critical illness.

Methods:

A database search was conducted for studies on the use of intravenous vitamin C in adult patients with critical illness. The primary outcome assessed was mortality at the longest follow-up time available. Secondary outcomes were the duration of mechanical ventilation, duration of vasopressor support, fluid requirements, and urine output in the first 24 h of intensive care unit admission.

Results:

Five studies (four randomized controlled trials and one retrospective review) enrolling a total of 142 patients were included in this meta-analysis. Compared with controls, the administration of intravenous vitamin C was associated with a decreased need for vasopressor support (standardized mean difference −0.71; 95% confidence interval (−1.16 to −0.26); p = 0.002) and decreased duration of mechanical ventilation (standardized mean difference −0.5; 95% confidence interval (−0.93 to −0.06); p = 0.03), but no difference was found in mortality (odds ratio 0.76; 95% confidence interval (0.27 to 2.16); p = 0.6). Trends were also noted toward decreased fluid requirements and increased urine output. No adverse effects were reported.

Conclusion:

The administration of intravenous vitamin C may lead to vasopressor sparing effects and a reduced need for mechanical ventilation in the critically ill, without affecting overall mortality. However, these results should be interpreted in light of the limitations of the primary literature and should serve as a preview of upcoming trials in this area.
Acute stroke thrombolysis in infective endocarditis
Authors: Ashkanani Abdulaziz , Bitar Zouhair , Maadrani Osama
Published: October 2018

Intravenous recombinant tissue plasminogen activator is not recommended for the treatment of acute ischemic stroke in patients with infective endocarditis due to the risk of hemorrhagic transformation of septic emboli and few reported cases in the literature. Here, we present the successful outcome of intravenous recombinant tissue plasminogen activator administration for a patient with acute ischemic stroke who was later found to have infective endocarditis. This case adds to the small number of cases reported in the literature.
Abnormal Origin of the Left Coronary Artery From the Pulmonary Artery Discovered at Age 67: What to Do?
Authors: Lachhab Fadoua , Amri Rachida , Mahfoudi Loubna , Moughil Said
Published: October 2018

Anomalous left coronary artery from the pulmonary artery (ALCAPA) was described by Abbott in 1908. In most cases, it is an isolated lesion, being the most common cause of myocardial ischemia in children. The associated mortality rate without intervention reaches 90% during childhood. We report the case of a 67-year-old woman, who underwent coronary angiography for investigation of atypical chest pain and was found to have ALCAPA. The patient refused surgery and has remained asymptomatic on a medical regimen.
Gender, Couples’ Fertility Intentions, and Parents’ Depressive Symptoms
Authors: Stykes J. Bart
Published: October 2018

Unintended childbearing is associated with poorer parental well-being, but most scholarship in this area takes an individual-level approach to unintended childbearing. Drawing on couple data from the Early Childhood Longitudinal Study–Birth Cohort (ECLS-B), I treat unintended childbearing as a couple-level construct to provide a more comprehensive understanding of how individuals’ intentions, partners’ intentions, and gender are linked with psychological distress in the transition to parenthood. I make two chief contributions to prior research. First, the inclusion of fathers’ perspectives provides an important addition to research, which primarily focuses on mothers’ unintended childbearing. Second, I assess gender differences in the association between couples’ intentions and health. For mothers, one’s own intentions appeared most closely tied to distress regardless of the father’s intentions, whereas fathers reported more depressive symptoms if either parent did not intend the birth. Formal post-estimation tests of differences in the magnitude of coefficients for mothers and fathers suggest few gender differences exist in the association between couples’ intentions and psychological distress. For mothers and fathers alike, belonging to a couple where neither parent intended the birth was consistently associated with the highest levels of distress. Implications for policy and research are discussed in relation to findings.
Cardiac resynchronization therapy with a defibrillator (CRTd) in failing heart patients with type 2 diabetes mellitus and treated by glucagon-like peptide 1 receptor agonists (GLP-1 RA) therapy vs. conventional hypoglycemic drugs: arrhythmic burden, hospitalizations for heart failure, and CRTd responders rate
Authors: Sardu Celestino , Paolisso Pasquale , Sacra Cosimo , Santamaria Matteo , de Lucia Claudio , Ruocco Antonio , Mauro Ciro , Paolisso Giuseppe , Rizzo Maria Rosaria , Barbieri Michelangela , Marfella Raffaele
Published: October 2018

Objectives

To evaluate clinical outcomes in patients with diabetes, treated by cardiac resynchronization therapy with a defibrillator (CRT-d), and glucagon-like peptide 1 receptor agonists (GLP-1 RA) in addition to conventional hypoglycemic therapy vs. CRTd patients under conventional hypoglycemic drugs.

Background

Patients with diabetes treated by CRTd experienced an amelioration of functional New York Association Heart class, reduction of hospital admissions, and mortality, in a percentage about 60%. However, about 40% of CRTd patients with diabetes experience a worse prognosis.

Materials and methods

We investigated the 12-months prognosis of CRTd patients with diabetes, previously treated with hypoglycemic drugs therapy (n 271) vs. a matched cohort of CRTd patients with diabetes treated with GLP-1 RA in addition to conventional hypoglycemic therapy (n 288).

Results

At follow up CRTd patients with diabetes treated by GLP-1 RA therapy vs. CRTd patients with diabetes that did not receive GLP-1 RA therapy, experienced a significant reduction of NYHA class (p value < 0.05), associated to higher values of 6 min walking test (p value < 0.05), and higher rate of CRTd responders (p value < 0.05). GLP-1 RA patients vs. controls at follow up end experienced lower AF events (p value < 0.05), lower VT events (p value < 0.05), lower rate of hospitalization for heart failure worsening (p value < 0.05), and higher rate of CRTd responders (p value < 0.05). To date, GLP-1 RA therapy may predict a reduction of AF events (HR 0.603, CI [0.411–0.884]), VT events (HR 0.964, CI [0.963–0.992]), and hospitalization for heart failure worsening (HR 0.119, CI [0.028–0.508]), and a higher CRT responders rate (HR 3.707, CI [1.226–14.570]).

Conclusions

GLP-1 RA drugs in addition to conventional hypoglycemic therapy may significantly reduce systemic inflammation and circulating BNP levels in CRTd patients with diabetes, leading to a significant improvement of LVEF and of the 6 min walking test, and to a reduction of the arrhythmic burden. Consequently, GLP-1 RA drugs in addition to conventional hypoglycemic therapy may reduce hospital admissions for heart failure worsening, by increasing CRTd responders rate.

Trial registration NCT03282136. Registered 9 December 2017 “retrospectively registered”
Clinical Utility of Genomic Profiling in the Treatment of Advanced Sarcomas: A Single-Center Experience
Authors: Boddu Spandana , Walko Christine M. , Bienasz Stephanie , Bui Marilyn M. , Henderson-Jackson Evita , Naghavi Arash O. , Mullinax John E. , Joyce David M. , Binitie Odion , Letson G. Douglas , Gonzalez Ricardo J. , Reed Damon R. , Druta Mihaela , Brohl Andrew S.
Published: October 2018

Purpose

Sarcomas are a diverse group of malignant tumors that arise from soft tissues or bone. For most advanced cases, there is a substantial need for improved therapeutic options and, therefore, a desire to more precisely tailor therapy in individual cases. In this study, we review our institutional experience with next-generation sequencing (NGS)–based molecular profiling for non–GI stromal tumors sarcomas, with a focus on the clinical utility of the results.

Patients and Methods

We retrospectively analyzed results of NGS performed on tumors from 114 patients with a diagnosis of sarcoma. A chart review was conducted to review the clinical impact of NGS findings.

Results

A median of three putatively oncogenic gene alterations were identified per tumor sample (range, 0 to 19) and at least one mutation was detected in 96.7% of tumors. Fifty-six patients (49.1%) harbored a finding that was felt to be actionable after review by a molecular tumor board. Five patients (4.4%) had a diagnosis change as a result of NGS findings. In 15 patients (13.2%), therapeutic selection was influenced by NGS findings. Four of 15 (26.7%) of the NGS-influenced systemic therapies resulted in clinical benefit.

Conclusion

Putatively oncogenic mutations are readily detected in the majority of sarcomas. Genetic profiling affected the diagnosis and/or treatment approach in a sizeable minority of patients with sarcoma treated at our center. Additional study is required to determine if genetic profiling leads to improved clinical outcomes.
Live imaging of cortical granule exocytosis reveals that in vitro matured mouse oocytes are not fully competent to secret their content
Authors: Cappa Andrea I. , de Paola Matilde , Wetten Paula , De Blas Gerardo A. , Michaut Marcela A.
Published: October 2018

Oocyte in vitro maturation does not entirely support all the nuclear and cytoplasmic changes that occur physiologically and it is poorly understood whether in vitro maturation affects the competence of cortical granules to secret their content during cortical reaction. Here, we characterize cortical granule exocytosis (CGE) in live mouse oocytes activated by strontium chloride using the fluorescent lectin FITC-LCA. We compared the kinetic of CGE between ovulated (in vivo matured, IVO) and in vitro matured (IVM) mouse oocytes. Results show that: 1) IVM oocytes have a severely reduced response to strontium chloride; 2) the low response was confirmed by quantification of remnant cortical granules in permeabilized cells and by a novel method to quantify the exudate in non permeabilized cells; 3) the kinetic of CGE in IVO oocytes was rapid and synchronous; 4) the kinetic of CGE in IVM oocytes was delayed and asynchronous; 5) cortical granules in IVM oocytes show an irregular limit with the cortical granule free domain. We propose the analysis of CGE in live oocytes as a biological test to evaluate the competence of IVM mouse oocytes.
Characterization and in ovo vascularisation of a 3D-printed hydroxyapatite scaffold with different extracellular matrix coatings under perfusion culture
Authors: Burgio Floriana , Rimmer Natalie , Pieles Uwe , Buschmann Johanna , Beaufils-Hugot Marina
Published: October 2018

For the fabrication of appropriate bone tissue engineered constructs, several prerequisites should be fulfilled. It should offer long-term stability, allow proper cell attachment and proliferation, furthermore be osteoinductive and easy to be vascularized. Having these requirements as background, we fabricated a novel porous 3D-printed hydroxyapatite (HA) scaffold and treated it with oxygen plasma (OPT). MG-63 pre-osteoblast-seeded bone constructs allowed good cell attachment and proliferation, even better when cultivated in a perfusion flow bioreactor. Moreover, the deposition of extracellular matrix (ECM) on the otherwise inorganic surface changed the mechanical properties in a favourable manner: elasticity increased from 42.95±1.09 to 91.9±5.1 MPa (assessed by nanoindentation). Compared to static conditions, osteogenic differentiation was enhanced in the bioreactor, with upregulation ALP, collagen I and osteocalcin gene expression.

In parallel experiments, primary human bone marrow mesenchymal stromal cells (hBMSCs) were used and findings under dynamic conditions were similar; with a higher commitment towards osteoblasts compared to static conditions. In addition, angiogenic markers CD31, eNOS and VEGF were upregulated, especially when osteogenic medium was used compared to proliferative medium. To compare differently fabricated ECMs in terms of vascularisation, decellularized constructs were tested in the chorioallantoic membrane (CAM) assay with subsequent assessment of the functional perfusion capacity by MRI in the living chick embryo. Here, vascularisation induced by ECM from osteogenic medium led to a vessel distribution more homogenously throughout the construct, while ECM from proliferative medium enhanced vessel density at the interface and to a lower extent at the middle and top. We conclude that dynamic cultivation of a novel porous OPT HA scaffold with hBMSCs in osteogenic medium and subsequent decellularization provides a promising off-the-shelf bone tissue engineered construct.
Endodermal pouch-expresseddmrt2bis important for pharyngeal cartilage formation
Authors: Li Linwei , Mao Aihua , Wang Peng , Ning Guozhu , Cao Yu , Wang Qiang
Published: October 2018

Pharyngeal pouches, a series of outpocketings derived from the foregut endoderm, are essential for craniofacial skeleton formation. However, the molecular mechanisms underlying endodermal pouch-regulated head cartilage development are not fully understood. In this study, we find that zebrafish dmrt2b, a gene encoding Doublesex and Mab-3-related transcription factor, is specifically expressed in endodermal pouches and required for normal pharyngeal cartilage development. Loss of dmrt2b doesn't affect cranial neural crest (CNC) specification and migration, but leads to prechondrogenic condensation defects by reducing cxcl12b expression after CNC cell movement into the pharyngeal arches. Moreover, dmrt2b inactivation results in reduced proliferation and impaired differentiation of CNC cells. We also show that dmrt2b suppresses crossveinless 2 expression in endodermal pouches to maintain BMP/Smad signaling in the arches, thereby facilitating CNC cell proliferation and chondrogenic differentiation. This work provides insight into how transcription factors expressed in endodermal pouches regulate pharyngeal skeleton development through tissue-tissue interactions.