bluuebunny/crossref_metadata_2025 huggingface dataset:
Continuous Quality Improvement Processes in Child Protection: A Systematic Literature Review
Authors: Zuchowski Ines , Miles Debra , Woods Cindy , Tsey Komla
Published: November 2017

Purpose:

Protecting children from mistreatment is a global concern, and further research and evaluation in child protection services is required. Continuous Quality Improvement (CQI) has demonstrated potential, but to date, there is no systematic review of studies that evaluate the application of CQI in child protection.

Method:

This systematic literature review examined the application of CQI in child protection services. The review identified published, English-language evaluations of CQI in child protection from 2000 to 2016 and critiqued the characteristics, methodological quality, and reported benefits of the included studies.

Results:

A search of social science electronic databases identified eight peer-reviewed studies, including six quantitative studies, one mixed-methods study, and one qualitative study.

Discussion:

The review highlighted that many studies on this topic lack specific validating data, but there is evidence that CQI models have some potential to improve processes for working with children and families by promoting implementation fidelity.
Near-Winners in Status Competitions: Neglected Sources of Dynamism in the Matthew Effect
Authors: Otner Sarah M. G.
Published: November 2017

Current research on status hierarchy dynamics focuses on the potential for, and constraints to, individual mobility. In this essay, I argue that Merton’s Matthew Effect incorrectly categorizes activity below a status threshold as linear. This misspecification calls into question existing models of competitions for social status. I argue for an improved theory of status tournaments as asymmetric, non-binary, and agentic. Through that new perspective, I raise questions for the legitimacy and power of stratifying institutions.
A Department of Medicine Infrastructure for Patient Safety and Clinical Quality Improvement
Authors: Mathews Simon C. , Pronovost Peter J. , Daugherty Biddison E. Lee , Petty Brent G. , Anderson Mark E. , Nelson Terry S. , Outten Katie , Langlotz Ronald , Duda Denice , Herzke Carrie A. , Peairs Kimberly S. , Golden Sherita H. , Lautzenheiser Matthew B. , James Hailey J. , Desai Sanjay V. , Keller Sara C. , Feldman Leonard S. , Pahwa Amit K. , Berry Stephen A.
Published: November 2017

Payers, providers, and patients increasingly recognize the importance of quality and safety in health care. Academic Departments of Medicine can advance quality and safety given the large populations they serve and the broad spectrum of diseases they treat. However, there are only few detailed examples of how quality and safety can be organized. This article describes a practical model at The Johns Hopkins Hospital Department of Medicine and details its structure and operation within a large academic health system. It is based on a fractal model that integrates multiple smaller units similar in structure (composition of faculty/staff), process (use of similar tools), and approach (using a common framework to address issues). This organization stresses local, multidisciplinary leadership, facilitates horizontal connections for peer learning, and maintains vertical connections for broader accountability.
Malignant Mixed Germ Cell Tumor Overgrowing a Gonadoblastoma in a Female With a 46, XX Karyotype: A Case Report
Authors: Arafah Maria A. , Raddaoui Leen E.
Published: November 2017

Gonadoblastoma is an uncommon ovarian tumor arising primarily in females with gonadal dysgenesis and a 46, XY karyotype. Germ cell tumors arising within and/or overgrowing a gonadoblastoma have been reported. We report a rare case of a malignant mixed germ cell tumor (yolk sac tumor and choriocarcinoma) arising in a gonadoblastoma of the left ovary in a 19-year-old female with a 46, XX karyotype. The patient’s initial α-fetoprotein level was 20 000 KIU/L. The patient underwent a laparoscopic unilateral salpingo-oophorectomy with omentectomy and peritoneal washing followed by adjuvant chemotherapy.
Validation and Psychometric Properties of the German Version of the Delirium Motor Subtype Scale (DMSS)
Authors: Garcia Nuñez David , Boettger Soenke , Meyer Rafael , Richter André , Schubert Maria , Meagher David , Jenewein Josef
Published: November 2017

Objective: Delirium has been characterized into its subtypes—hypoactive, hyperactive, mixed, or no motor subtype—along with the use of the Delirium Motor Symptom Scale (DMSS). The German version of this scale (DMSS-G), however, has not yet been validated. Method: We determined internal consistency, reliability, and validity of the DMSS-G in the surgical intensive care unit, using DSM-IV-TR criteria and the Delirium Rating Scale–Revised–98. Results: In total, 289 patients were included, and out of these, 122 were delirious. The DMSS-G showed excellent internal consistency (Cronbach’s α = 0.92) and interrater reliability (Fleiss κ = 0.83). Additionally, the overall concurrent validity was substantial (Cramer’s V = 0.69); within subtypes, hyperactive, hypoactive, or mixed, the concurrent validity remained at least substantial (Cohen’s κ = 0.73-0.82) and the sensitivity ranged from 60% to 97%. In contrast, in those with no motor subtype, we found the concurrent validity (Cohen’s κ = 0.31) and sensitivity to be low (22%). Overall, specificity for all individual subtypes was high (82% to 100%). The DMSS was very sensitive in both rating hyperactive and hypoactive motor symptoms of delirium. Conclusion: The DMSS-G is a highly reliable and valid instrument for detecting motor symptoms in delirium, which provides an accurate instrument to classify the motor subtypes of delirium.
An adaptive hybrid differential evolutionary algorithm for the parameter identification of rotating machinery
Authors: Han Fang , Mo Changki , Gao Haiyang
Published: November 2017

An adaptive hybrid differential evolution algorithm for the dynamic parameter identification of rotating machinery is developed in this paper. Genetic algorithm (GA) is first used to reduce the range of the identification parameters to save computational time. Adaptive Cauchy and Gaussian mutations are then applied in a differential evolution algorithm (DEA) and dynamically updated during the evolutionary process according to the identification process, to obtain the global optimal solution more easily and more rapidly. Numerical studies of linear and nonlinear rotor-bearing systems are performed. The results indicate that the genetic algorithm-adaptive hybrid differential evolution algorithm (GA-AHDE) is more effective at identifying the dynamic parameters and faults of the rotor-bearing system compared to other evolutionary algorithms.
Surface texturing to promote formation of protective tribofilms on combustion engine valves
Authors: Elo Robin , Heinrichs Jannica , Jacobson Staffan
Published: November 2017

In a combustion engine, the valve system controls the flow of gases in to and out of the combustion chamber. The contacting surfaces experience a harsh tribological situation with high temperatures, high speed impacts, corrosive environment and high closing forces causing micro sliding in the interface. The components have to endure in the range of hundreds of millions to a billion operational cycles, resulting in extreme demands on low wear rate. Such low wear rates can be accomplished by the protective action from tribofilms forming from oil residues, avoiding a pure metal-to-metal contact. Such tribofilms are found on well-functioning engine valves from a variety of engines, but some stationary gas engines experience problems with wear occurring seemingly randomly at normal running conditions. For some reason, the tribofilm has not protected the surfaces sufficiently, causing wear. One way to combat the random behaviour could be to promote robust function of the protective tribofilms by texturing the valve sealing surfaces to improve the capture and storage of oil residues. By stabilising the supply in this way, the damage from periods with low access to tribofilm forming material could be reduced. The present work demonstrates that turning of the valve seat inserts, creating valleys perpendicular to the sliding motion, can be developed into a useful solution. The amount and localisation of tribofilms became more predictable and stable than without the texture, leading to reduced component wear. The valleys should not be too wide, since this increased the amount of exposed metal if the tribofilm flaked off. When having the same width, the deeper valleys showed less flaking off of the tribofilm.
L1–L2 differences in the L2 classroom: Anticipating Anglophone learners’ difficulties with French pronoun interpretation
Authors: Shimanskaya Elena , Slabakova Roumyana
Published: November 2017

In this article, we address the issue of targeted instruction on interpretive contrasts between native and second-language grammatical meanings. Such mismatches are predicted to create challenges for learners. We illustrate this with French and English pronouns. In French, clitic pronouns ( le, la) point to human as well as inanimate referents, while English pronouns distinguish between human ( him, her) and inanimate ( it) referents. While other grammatical differences between English and French pronouns are taught, this interpretive mismatch attracts less attention in instructional materials. We review the pedagogical literature and report the results of a study investigating this knowledge in Anglophone learners of French as a second language (L2). We document that the mismatch is indeed challenging, particularly to beginning learners, and propose ways to overcome this difficulty.
Proton affinities and ion enthalpies
Authors: Holmes John L , van Huizen Nick A , Burgers Peter C
Published: November 2017

Proton affinities of a number of alkyl acetates (CH3–C(=O)–OR) and of methyl alkanoates (R–C(=O)–OCH3, R=H, alkyl) have been assembled from the literature or measured using the kinetic method. It was observed that the proton affinities for the isomeric species CH3–C(=O)–OR and R–C(=O)–OCH3 are almost identical, an unexpected result as the charge in these protonated ester molecules is largely at the keto carbon atom and so this site should be more sensitive to alkyl substitution. Analysis of the data, including those from lone pair ionisation and core-electron ionisation experiments available from the literature, indicate that after protonation, extensive charge relaxation (or polarisation) takes place (as is also the case, according to the literature, after core-electron ionisation). By contrast, after lone pair ionisation, which results in radical cations, such relaxation processes are relatively less extensive. As a consequence, changes in ion enthalpies of these protonated molecules follow more closely the changes in neutral enthalpies, compared with changes in enthalpies of the corresponding radical cations, formed by electron detachment. Preliminary analyses of published energetic data indicate that the above finding for organic esters may well be another example of a more general phenomenon.
Exploration of doubtful cases of leucine and isoleucine discrimination in mass spectrometric peptide sequencing by electron-transfer and higher-energy collision dissociation-based method
Authors: Kovalyov Sergey V , Zhokhov Sergey S , Onoprienko Ludmila V , Vaskovsky Boris V , Lebedev Albert T
Published: November 2017

Electron-transfer dissociation (ETD) and electron-transfer and higher-energy collision dissociation (EThcD) spectra of short tryptic peptides with leucine/isoleucine residues in neighboring positions demonstrate intensive w-ions. On the contrary, u-ions possess very low intensities (if present at all). Therefore radical site migration is negligible in the applied conditions while ETD (EThcD) spectra allow for the reliable discrimination of the isomeric residues in the sequencing process. The presence of a fragment ion 43.055 mass units lower than z2-ion of peptides with IK sequence at their C-termini was shown to be a result of alternative fragmentation starting from the loss of propylammonium ion from the doubly protonated peptide molecule and formation of an oxazole fragment ion.
Peter J Derrick and the Grand Scale ‘Magnificent Mass Machine’ mass spectrometer at Warwick
Authors: Colburn AW , Derrick Peter J , Bowen Richard D
Published: November 2017

The value of the Grand Scale ‘Magnificent Mass Machine’ mass spectrometer in investigating the reactivity of ions in the gas phase is illustrated by a brief analysis of previously unpublished work on metastable ionised n-pentyl methyl ether, which loses predominantly methanol and an ethyl radical, with very minor contributions for elimination of ethane and water. Expulsion of an ethyl radical is interpreted in terms of isomerisation to ionised 3-pentyl methyl ether, via distonic ions and, possibly, an ion-neutral complex comprising ionised ethylcyclopropane and methanol. This explanation is consistent with the closely similar behaviour of the labelled analogues, C3H7CH2CD2OCH3+. and C3H7CD2CH2OCH3+., and is supported by the greater kinetic energy release associated with loss of ethane from ionised n-propyl methyl ether compared to that starting from directly generated ionised 3-pentyl methyl ether.
Social inequality in phase II cardiac rehabilitation attendance: The impact of potential mediators
Authors: Pedersen Maria , Egerod Ingrid , Overgaard Dorthe , Baastrup Marie , Andersen Ingelise
Published: November 2017

Background:

Cardiac rehabilitation participation is an essential component of the contemporary management of coronary heart disease. However, patients with low socioeconomic position are less likely to attend the rehabilitation programme.

Aim:

We aimed to explore the effect of potential mediators between socioeconomic position defined by educational attainment and cardiac rehabilitation attendance.

Methods:

Prospective observational study of patients with acute coronary syndrome ( N=302). Logistic regression and mediation analysis was conducted to explore mechanisms of non-attendance.

Results:

Thirty per cent attended full cardiac rehabilitation. Patients with low educational attainment, comorbidities, long commute to cardiac rehabilitation centre, and lone dwelling were less likely to attend full cardiac rehabilitation, whereas patients with high anxiety and depression score were more likely to attend full cardiac rehabilitation. Patients with low educational attainment had lower self-efficacy and longer commute compared with patients with high educational attainment. The potential mediators included in the study, however, did not have a significant mediation effect.

Conclusion:

Our study demonstrated a variety of mechanisms contributing to cardiac rehabilitation non-attendance. Further, the study demonstrated that non-attendance was especially related to the cardiac rehabilitation elements involving lifestyle modifications. However, the mechanisms explaining social inequality in full cardiac rehabilitation are still not fully understood.
A two-step approach to damage localization at supporting structures of offshore wind turbines
Authors: Schröder Karsten , Gebhardt Cristian Guillermo , Rolfes Raimund
Published: November 2017

This article introduces a new adaptive two-step optimization algorithm for finite element model updating with special emphasis on damage localization at supporting structures of offshore wind turbines. The algorithm comprises an enhanced version of the global optimization algorithm simulated annealing, the simulated quenching method that approximates an initial guess of damage localization. Subsequently, sequential quadratic programming is used to compute the final solution adaptively. For the correlation of numerical model and measurement data, both a measure based on eigenfrequencies and mode shapes and a measure employing time series are implemented and compared with respect to their performance for damage localization. Phase balance of the time signals is achieved using cross-correlation. The localization problem is stated as a minimization problem in which the measures are used in time and modal domain as the objective function subject to constraints. Furthermore, the objective function value of the adjusted model is used to distinguish correct from wrong solutions. The functionality is proven using a numerical model of a monopile structure with simulated damage and a lab-scaled model of a tripile structure with real damage.
Daily spirometry in an acute exacerbation of adult cystic fibrosis patients
Authors: Stephen Michael J , Long Alex , Bonsall Chad , Hoag Jeffrey B , Shah Smita , Bisberg Dorothy , Holsclaw Douglas , Varlotta Laurie , Fiel Stan , Du Doantrang , Zanni Robert , Hadjiliadis Denis
Published: November 2017

To help answer the question of length of intravenous antibiotics during an acute exacerbation of cystic fibrosis (CF), we had subjects to follow daily home spirometry while on intravenous antibiotics. CF patients, 18 and older, with an acute exacerbation requiring intravenous antibiotics had a daily FEV1. The average time to a 10% increase over their initial sick FEV1 was calculated, as well as the time to a new baseline. A total of 25 subjects completed the study. Ten of the 25 subjects did not have a sustainable 10% increase in FEV1. Of the 15 subjects with a sustainable 10% increase in FEV1, it took 5.2 days (±4.5) after day 1, while a new baseline was achieved on average at 6.6 days (±4.8) after day 1. Given the wide range of time to a 10% improvement and new baseline, it is recommended there should be flexibility in length of intravenous antibiotics in CF, not by a preset number.
Male IPV Perpetrator’s Perspectives on Intervention and Change: A Systematic Synthesis of Qualitative Studies
Authors: McGinn Tony , McColgan Mary , Taylor Brian
Published: November 2017

Objective:

To add to our understanding of change processes by analyzing perpetrators’ perspectives on intervention.

Method:

Fourteen databases were searched and 27 articles reporting relevant qualitative findings were identified. Analytic coding was applied across the findings and discussion sections of all 27 study reports to form an interpretive account of the data set. Studies were also grouped according to their perceived theoretical standpoints, and a summary of themes in each grouping is presented.

Findings:

Study participants were largely positive about their experiences in intervention; new learning such as conflict interruption techniques and new communication skills were commonly cited benefits. Perpetrators attend perpetrator intervention programs with a range of motivations, ranging from a determination to change who they are, to a determination to avoid a custodial sentence. The most common barriers to change, found in this analysis, were cognitive distortions, emotional dysregulation, gendered social constructions, and self-esteem issues.

Conclusion:

Further qualitative investigation, of rigor, with the intention-to-treat population of intimate partner violence perpetrators involved in perpetrator programs is needed. At this point, we would venture that qualitative research, with perpetrators, underlines the precept that formidable barriers to change exist in this population. The centrality of group work to perpetrator interventions should be reconsidered in light of the complexity of the change task and in light of the heterogeneity of this population.
Between Hyorish and Hyorism: A Korean TV Star and Social Media Activism
Authors: Kwon Jungmin
Published: November 2017

Since her solo debut album in 2003, Lee Hyori, one of the most famous stars in Korea, has kept her name in the limelight as a singer, actress, show host, advertising model, and fashion trendsetter. The Beyoncé-like diva in Korea metamorphosed after declaring a hiatus due to plagiarism on her fourth album. Suddenly, she became an animal-rights activist, a vegetarian, and a donor to poor citizens and encouraged political engagement. On her Twitter account, she updated all of her practices asking for public attention to social issues. Gradually, she transformed from a sexy TV diva to an exemplar of celebrity activism. However, she did not abandon her life and popularity as a top star; rather, she repositioned herself in between a beloved celebrity and a respected activist. This article examines how she has accomplished these two different tasks and what roles her social media engagement has played in the achievement.
Cultural Mediators Seduced by Mad Men: How Cultural Journalists Legitimized a Quality TV Series in the Nordic Region
Authors: Kristensen Nete Nørgaard , Hellman Heikki , Riegert Kristina
Published: November 2017

Based on theories about the role of cultural mediators in cultural production and using the TV series Mad Men as a case, this article investigates how cultural journalists in the Nordic countries have contributed to legitimizing “quality TV series” as a worthy field of aesthetic consumption. Key analytical points are as follows: (1) cultural journalists legitimize Mad Men’s quality by addressing aspects internal (aesthetic markers) and aspects external (culture industry markers) to the series, as well as the series’ broader social and historical anchoring; (2) Nordic cultural journalists position themselves positively toward the TV series based on their professional expertise and their personal taste preferences and predilections; (3) these legitimation processes take place across journalistic genres, pointing to the importance not only of TV criticism, epitomized by the review, but of cultural journalism more broadly in constructing affirmative attitudes toward popular culture phenomena such as TV series.
The Songs and Stories of Scotts Run
Authors: Haddox John Christopher
Published: November 2017

This work represents the authors’ contributions to a multidisciplinary community development project about Scotts Run—a community that sprang up along a creek of the same name in western Monongalia County, West Virginia. Lyrics and recitation resulted from intense engagement with a core of remaining residents who related their stories about life up and down the creek. The songs and recitation were combined with several other songs, readings, narrations, videos, images, and artifacts in a public performance that engaged the residents of Osage and Scotts Run in a telling of their own story.
Limit of intraoperative near-infrared spectroscopy monitoring during endovascular thrombectomy in acute ischemic stroke
Authors: Hiramatsu Ryo , Furuse Motomasa , Yagi Ryokichi , Ohnishi Hiroyuki , Ikeda Naokado , Nonoguchi Naosuke , Kawabata Shinji , Miyachi Shigeru , Kuroiwa Toshihiko
Published: November 2017

Endovascular thrombectomy is recommended for a persistent ischemic penumbra if recanalization cannot be achieved by the intravenous (IV) administration of recombinant tissue-plasminogen activator (rt-PA) alone. Although endovascular thrombectomy is a powerful treatment for major cerebral artery occlusion, the monitoring of recanalization and reperfusion during acute ischemic stroke presents a therapeutic challenge, and a previous study reported the usefulness of near-infrared spectroscopy (NIRS) for intraoperative monitoring during emergency endovascular thrombectomy for acute large ischemic stroke. Here we present our experience with a relevant case series. We applied NIRS monitoring during endovascular thrombectomy in two patients with large ischemic stroke following carotid artery occlusion and one patient with a non-large ischemic stroke caused by a distal middle cerebral artery (MCA) occlusion. In the patients with large ischemic stroke, complete recanalization of the internal carotid artery was achieved, and NIRS revealed a very good regional oxygen saturation (rSO2) response. By contrast, in the patient with non-large ischemic stroke, the rSO2 did not change, despite complete recanalization of the distal MCA. Our findings suggest the limited usefulness of intraoperative NIRS monitoring during emergency endovascular thrombectomy for non-large acute ischemic stroke caused by a distal MCA occlusion. However, intraoperative NIRS monitoring could be used practically to detect recanalization of the major artery during thrombectomy and early IV rt-PA administration in cases involving major artery occlusion.
Evaluating the potential for pharmacists to prescribe oral anticoagulants for atrial fibrillation
Authors: Sandhu Roopinder K. , Guirguis Lisa M. , Bungard Tammy J. , Youngson Erik , Dolovich Lisa , Brehaut Jamie C. , Healey Jeff S. , McAlister Finlay A.
Published: November 2017

Background:

Oral anticoagulant therapy (OAC) to prevent atrial fibrillation (AF)–related strokes remains poorly used. Alternate strategies, such as community pharmacist prescribing of OAC, should be explored.

Methods:

Approximately 400 pharmacists, half with additional prescribing authority (APA), randomly selected from the Alberta College of Pharmacists, were invited to participate in an online survey over a 6-week period. The survey consisted of demographics, case scenarios assessing appropriateness of OAC (based on the 2014 Canadian Cardiovascular Society AF guidelines) and perceived barriers to prescribing. Regression analysis was performed to determine predictors of knowledge.

Results:

A total of 35% (139/397) of pharmacists responded to the survey, and 57% of these had APA. Depending on the case scenario, 55% to 92% of pharmacists correctly identified patients eligible for stroke prevention therapy, but only about a half selected the appropriate antithrombotic agent; there was no difference in the knowledge according to APA status. In multivariable analysis, predictors significantly associated with guideline-concordant prescribing were having the pharmacist interact as part of an interprofessional team ( p = 0.04) and direct OAC (DOAC) self-efficacy (confidence in ability to extend, adapt, initiate or alter prescriptions; p = 0.02). Barriers to prescribing OAC for APA pharmacists included a lack of AF and DOAC knowledge and preference for consulting the physician first, but these same pharmacists also identified difficulty in contacting the physician as a major barrier.

Interpretation and Conclusion:

Community pharmacists can identify patients who would benefit from stroke prevention therapy in AF. However, physician collaboration and further training on AF and guidelines for prescribing OAC are needed.
Sodium butyrate enhances intestinal integrity, inhibits mast cell activation, inflammatory mediator production and JNK signaling pathway in weaned pigs
Authors: Wang Chun Chun , Wu Huan , Lin Fang Hui , Gong Rong , Xie Fei , Peng Yan , Feng Jie , Hu Cai Hong
Published: November 2017

The present study aimed to investigate the effects of sodium butyrate on the intestinal barrier and mast cell activation, as well as inflammatory mediator production, and determine whether mitogen-activated protein kinase signaling pathways are involved in these processes. A total of 72 piglets, weaned at 28 ± 1 d age, were allotted to two dietary treatments (control vs. 450 mg/kg sodium butyrate) for 2 wk. The results showed that supplemental sodium butyrate increased daily gain, improved intestinal morphology, as indicated by greater villus height and villus height:crypt depth ratio, and intestinal barrier function reflected by increased transepithelial electrical resistance and decreased paracellular flux of dextran (4 kDa). Moreover, sodium butyrate reduced the percentage of degranulated mast cells and its inflammatory mediator content (histamine, tryptase, TNF-α and IL-6) in the jejunum mucosa. Sodium butyrate also decreased the expression of mast cell-specific tryptase, TNF-α and IL-6 mRNA. Sodium butyrate significantly decreased the phosphorylated ratio of JNK whereas not affecting the phosphorylated ratios of ERK and p38. The results indicated that the protective effects of sodium butyrate on intestinal integrity were closely related to inhibition of mast cell activation and inflammatory mediator production, and that the JNK signaling pathway was likely involved in this process.
Decreased platelet number in multiple sclerosis during alemtuzumab infusion: a common, transient and clinically silent phenomenon
Authors: Puthenparampil Marco , Rinaldi Francesca , Federle Lisa , Cazzola Chiara , Perini Paola , Gallo Paolo
Published: November 2017

Background

The cause and clinical significance of the transient decrease in platelet (PLT) count observed in relapsing remitting multiple sclerosis (RRMS) during alemtuzumab administration remain undefined. The aim of this study was to analyse the kinetics and clinical relevance of early onset thrombocytopaenia in alemtuzumab-treated RRMS.

Methods

A total of 26 patients with RRMS were included in a longitudinal study. Blood samples were collected immediately before the first alemtuzumab infusion (D0), and after 3 days (D3), 28 days (D28) and 49 days (D49). PLT, red blood cell (RC), leucocyte and lymphocyte counts, haemoglobin (Hb) concentration and haematocrit (Htc) were measured. Patients with MS were clinically evaluated every day of drug infusion and then at D28 and D49 to verify the presence of signs or symptoms suggestive of thrombocytopaenia.

Results

PLT number significantly decreased at D3 ( p < 0.005) and was associated with a decrease in RC count ( r: 0.53, p < 0.01), Hb ( r: 0.42, p = 0.05) and Htc ( r: 0.53, p < 0.01). A progressive reversion of PLT number to normal values was observed at D28 and D49. A mild thrombocytopaenia was observed in 12 patients (46.2%), 8 of which (66.6%) had PLT nadir values at D3, and 4 (33.3%) at D28. No sign or symptom suggestive of thrombocytopaenia was observed. A strong correlation between pretreatment and nadir PTL counts ( r: 0.59, p < 0.005) was observed; indeed, mild thrombocytopaenia was observed more frequently in these patients with a baseline PTL count lower than 230 × 109/L (83.3% versus 42.9%, p < 0.05).

Conclusions

The early PLT decrease in alemtuzumab-treated patients is transient, mild, not associated with clinically relevant events and is probably related to the cytokine-released syndrome. Notwithstanding this, our findings suggest the opportunity for PLT monitoring during infusion and in the following 2 months, since a decrease in PLT count may occur.
Do Structural Changes of the Foot Influence Plantar Pressure Patterns During Various Stages of Pregnancy and Postpartum?
Authors: Ramachandra Preetha , Kumar Pratap , Kamath Asha , Maiya Arun G.
Published: November 2017

Background. The foot of a pregnant woman undergoes morphological changes with the advancement of pregnancy. It is important to understand the structural changes of the foot during pregnancy and postpartum because any such change may alter the plantar pressure pattern and the entire foot biomechanics. Method. Primigravidae with a gestational age of 12 weeks or less, aged between 18 and 35 years were included in the study. They were prospectively studied across 5 time periods during pregnancy and postpartum. The measures recorded were length, width, navicular height, truncated foot length and normalized navicular height, truncated ratio of the foot, and the static plantar pressure pattern. Repeated-measures ANOVA was done to analyze the changes across various time periods. Results. All the foot parameters, except foot length and truncated foot length, showed significant differences across various time periods of pregnancy and postpartum (P < .001). It was found that the static plantar pressures also varied significantly (P ≤ .001).The maximum pressure was recorded at the hindfoot of the dominant leg. Conclusion. The feet of pregnant women tend to get pronated as pregnancy advances but do not reach baseline values even at 6 weeks postpartum. Pregnant women tend to bear more weight on the dominant foot with an increased static hindfoot pressure as pregnancy progresses.

Levels of Evidence: Prognostic study, Level I: Prospective
Nothing Is True? The Credibility of News and Conflicting Narratives during “Information War” in Ukraine
Authors: Szostek Joanna
Published: November 2017

In international politics, the strategic narratives of different governments compete for public attention and support. The Russian government’s narrative has prompted western concern due to fears that it exerts a destabilizing effect on societies in Eastern Europe and elsewhere. However, the behavior and thought processes of news consumers targeted by contradictory strategic narratives are rarely subjected to analysis. This paper examines how Ukrainian news consumers decide where to get their news and what to believe in a media environment where “propaganda” and “disinformation” are regarded as major threats to national security. Evidence comes from thirty audio-diaries and in-depth interviews conducted in 2016 among adult residents of Odesa Region. Through qualitative analysis of the diary and interview transcripts, the paper reveals how participants judged the credibility of news and narratives based on their priorities (what they considered important), not just “facts” (what they believed had happened). The attribution of importance to different foreign policy issues was associated, in turn, with varying personal experiences, memories, and individual cross-border relationships.
Recovery benefits of using a heat and moisture exchange mask during sprint exercise in cold temperatures
Authors: Seifert John G , Frost Jeremy , St Cyr John A
Published: November 2017

Objectives:

Breathing cold air can lead to bronchoconstriction and peripheral vasoconstriction, both of which could impact muscular performance by affecting metabolic demands during exercise. Successful solutions dealing with these physiological changes during exercise in the cold has been lacking; therefore, we investigated the influence of a heat and moisture exchange mask during exercise in the cold.

Methods:

There were three trial arms within this study: wearing the heat and moisture exchange mask during the rest periods in the cold, no-mask application during the rest periods in the cold, and a trial at room temperature (22°C). Eight subjects cycled in four 35 kJ sprint sessions with each session separated by 20 min rest period. Workload was 4% of body mass.

Results:

Mean sprint times were faster with heat and moisture exchange mask and room temperature trial than cold, no-mask trial (133.8 ± 8.6, 134.9 ± 8.8, and 138.0 ± 8.4 s (p = 0.001)). Systolic blood pressure and mean arterial pressure were greater during the cold trial with no mask (15% and 13%, respectively), and heart rate was 10 bpm less during the third rest or recovery period during cold, no mask compared to the heat and moisture exchange mask and room temperature trials. Subjects demonstrated significant decreases in vital capacity and peak expiratory flow rate during the cold with no mask applied during the rest periods.

Conclusions:

These negative responses to cold exposure were alleviated by the use of a heat and moisture exchange mask worn during the rest intervals by minimizing cold-induced temperature stress on the respiratory system with subsequent maintenance of cardiovascular function.
Patient Engagement in Kidney Research: Opportunities and Challenges Ahead
Authors: Molnar Amber O. , Barua Moumita , Konvalinka Ana , Schick-Makaroff Kara
Published: November 2017

Purpose of Review:

Patient engagement in research is increasingly recognized as an important component of the research process and may facilitate translation of research findings. To heighten awareness on this important topic, this review presents opportunities and challenges of patient engagement in research, drawing on specific examples from 4 areas of Canadian kidney research conducted by New Investigators in the Kidney Research Scientist Core Education and National Training (KRESCENT) Program.

Sources of Information:

Research expertise, published reports, peer-reviewed articles, and research funding body websites.

Methods:

In this review, the definition, purpose, and potential benefits of patient engagement in research are discussed. Approaches toward patient engagement that may help with translation and uptake of research findings into clinical practice are highlighted. Opportunities and challenges of patient engagement are presented in both basic science and clinical research with the following examples of kidney research: (1) precision care in focal and segmental glomerulosclerosis, (2) systems biology approaches to improve management of chronic kidney disease and enhance kidney graft survival, (3) reducing the incidence of suboptimal dialysis initiation, and (4) use of patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs) in kidney practice.

Key Findings:

Clinical research affords more obvious opportunities for patient engagement. The most obvious step at which to engage patients is in the setting of research priorities. Engagement at all stages of the research cycle may prove to be more challenging, and requires a detailed plan, along with funds and infrastructure to ensure that it is not merely tokenistic. Basic science research is several steps removed from the clinical application and involves complex scientific concepts, which makes patient engagement inherently more difficult.

Limitations:

This is a narrative review of the literature that has been partly influenced by the perspectives and experiences of the authors and focuses on research conducted by the authors. The evidence base to support the suggested benefits of patient engagement in research is currently limited.

Implications:

The formal incorporation of patients’ priorities, perspectives, and experiences is now recognized as a key component of the research process. If patients and researchers are able to effectively work together, this could enhance research quality and efficiency. To effectively engage patients, proper infrastructure and dedicated funding are needed. Going forward, a rigorous evaluation of patient engagement strategies and their effectiveness will be needed.
Towards implementation of sustainable development goals (SDG) in developing nations: A useful funding framework
Authors: Akenroye Temidayo Olabode , Nygård Håvard Mokleiv , Eyo Ama
Published: November 2017

The 2030 Agenda for Sustainable Development is impressive in its breadth. However, the extensive nature of the agenda presents countries with a set of challenges. In particular, few if any countries will be able to focus on all goals in parallel, yet the agenda offers little clear guidance on how each country can determine their priority areas of focus and funding arrangements for such priority areas. Presently, few efforts have been made to analyse and examine the significance or importance of each sustainable development goal (SDG) and target for individual countries. More importantly, there is the challenge that governments would need to find the finances to fund the goals. Inevitably, politicians and policy makers in financially constrained countries are asking: what levers can we actually use to implement the SDGs efficiently and effectively? In this paper, we develop a simple framework that can help countries in leveraging existing budget resources to guide funding for the implementation of SDGs.
Qualitative Assessment of Pregnant Women’s Perceptions of Infant Sleep Boxes
Authors: Ahlers-Schmidt Carolyn R. , Schunn Christy , Redmond Michelle L. , Smith Sharla , Brown Molly , Kuhlmann Stephanie N. , Engel Matthew , Benton Mary
Published: November 2017

Although several states have implemented programs providing boxes for infant sleep, safe sleep experts express concern regarding the paucity of safety and efficacy research on boxes. The purpose of this study was to assess pregnant women’s perceptions regarding use of baby sleep boxes. A convenience sample was recruited from a community prenatal education program. Twenty-eight women were administered a brief semistructured interview about their knowledge of baby sleep boxes, opinions about the boxes, and questions they would have. For most (n = 15, 54%), this was their first pregnancy. Participants self-identified as white (43%), black (36%), Hispanic (18%), and “other” (4%). Ten subthemes emerged related to previous knowledge of boxes (useful for families in need, historic precedent in other countries), positive attributes (portable, compact, affordable, decorative), and negative attributes (low to ground, structural integrity/design, stability, stigma). Research on safety and efficacy could reduce concerns, but issues of stigma may persist.
Minor stroke due to large artery occlusion. When is intravenous thrombolysis not enough? Results from the SITS International Stroke Thrombolysis Register
Authors: Mazya Michael V , Cooray Charith , Lees Kennedy R , Toni Danilo , Ford Gary A , Bar Michal , Frol Senta , Moreira Tiago , Sekaran Lakshmanan , Švigelj Viktor , Wahlgren Nils , Ahmed Niaz
Published: November 2017

Purpose

Beyond intravenous thrombolysis, evidence is lacking on acute treatment of minor stroke caused by large artery occlusion. To identify candidates for additional endovascular therapy, we aimed to determine the frequency of non-haemorrhagic early neurological deterioration in patients with intravenous thrombolysis-treated minor stroke caused by occlusion of large proximal and distal cerebral arteries. Secondary aims were to establish risk factors for non-haemorrhagic early neurological deterioration and report three-month outcomes in patients with and without non-haemorrhagic early neurological deterioration.

Method

We analysed data from the SITS International Stroke Thrombolysis Register on 2553 patients with intravenous thrombolysis-treated minor stroke (NIH Stroke Scale scores 0–5) and available arterial occlusion data. Non-haemorrhagic early neurological deterioration was defined as an increase in NIH Stroke Scale score ≥4 at 24 h, without parenchymal hematoma on follow-up imaging within 22–36 h.

Findings

The highest frequency of non-haemorrhagic early neurological deterioration was seen in 30% of patients with terminal internal carotid artery or tandem occlusions (internal carotid artery + middle cerebral artery) (adjusted odds ratio: 10.3 (95% CI 4.3–24.9), p < 0.001) and 17% in extracranial carotid occlusions (adjusted odds ratio 4.3 (2.5–7.7), p < 0.001) versus 3.1% in those with no occlusion. Proximal middle cerebral artery-M1 occlusions had non-haemorrhagic early neurological deterioration in 9% (adjusted odds ratio 2.1 (0.97–4.4), p = 0.06). Among patients with any occlusion and non-haemorrhagic early neurological deterioration, 77% were dead or dependent at three months.

Conclusions

Patients with minor stroke caused by internal carotid artery occlusion, with or without tandem middle cerebral artery involvement, are at high risk of disabling deterioration, despite intravenous thrombolysis treatment. Acute vessel imaging contributes usefully even in minor stroke to identify and consider endovascular treatment, or intensive monitoring at a comprehensive stroke centre, for patients at high risk of neurological deterioration.
The contention of nail residents
Authors: Gui Xiaoweii
Published: November 2017

Demolition in China is normally described as a tired story of the confrontation between a muscular state and undercompensated residents. Based on detailed case studies conducted in a district in China, this article presents a different picture of demolition by clarifying how nail residents maximize their economic interests through unapproved constructions, procrastination, protests, and compensations. This study enriches our understanding of the contention of nail residents by setting out the whole range of their protest tactics. At the same time it casts further light on the characteristics of Chinese protests, which are often simplified by local authorities’ malpractice and protesters’ “rightful resistance.”
Mixed-Methods Analysis of Rural Special Educators’ Role Stressors, Behavior Management, and Burnout
Authors: Garwood Justin D. , Werts Margaret G. , Varghese Cheryl , Gosey Leanne
Published: November 2017

The researchers of this study used a mixed-methods approach to understand issues of rural special education teacher burnout. Results of survey responses ( n = 64) and follow-up focus group interviews ( n = 12) from rural special education teachers indicated several factors contributing to stress and burnout. Teachers noted that lack of clarity in their roles, too many facets to the roles, emotional exhaustion, and lack of accomplishment contributed to their perceptions. Good working relationships with colleagues and administrators, building relationships with students, and a high level of self-advocacy were noted as helping to maintain mental health and a work–life balance. Possible steps to alleviate risk factors of rural special education teacher burnout are discussed.
Flight metabolic rate of Locusta migratoria in relation to oxygen partial pressure in atmospheres of varying diffusivity and density
Authors: Snelling Edward P. , Duncker Rebecca , Jones Karl K. , Fagan-Jeffries Erinn P. , Seymour Roger S.
Published: November 2017

Flying insects have the highest mass-specific metabolic rate of all animals. Oxygen is supplied to the flight muscles by a combination of diffusion and convection along the internal air-filled tubes of the tracheal system. This study measured maximum flight metabolic rate (FMR) during tethered flight in the migratory locust Locusta migratoria under varying oxygen partial pressure (PO2) in background gas mixtures of nitrogen (N2), sulfur hexafluoride (SF6) and helium (He), to vary O2 diffusivity and gas mixture density independently. With N2 as the sole background gas (normodiffusive–normodense), mass-independent FMR averaged 132±19 mW g−0.75 at normoxia (PO2=21 kPa), and was not limited by tracheal system conductance, because FMR did not increase in hyperoxia. However, FMR declined immediately with hypoxia, oxy-conforming nearly completely. Thus, the locust respiratory system is matched to maximum functional requirements, with little reserve capacity. With SF6 as the sole background gas (hypodiffusive–hyperdense), the shape of the relationship between FMR and PO2 was similar to that in N2, except that FMR was generally lower (e.g. 24% lower at normoxia). This appeared to be due to increased density of the gas mixture rather than decreased O2 diffusivity, because hyperoxia did not reverse it. Normoxic FMR was not significantly different in He-SF6 (hyperdiffusive–normodense) compared with the N2 background gas, and likewise there was no significant difference between FMR in SF6-He (normodiffusive–hyperdense) compared with the SF6 background gas. The results indicate that convection, not diffusion, is the main mechanism of O2 delivery to the flight muscle of the locust when demand is high.
Heterogeneous Sticky-Information Economies
Authors: Carvalho Carlos Viana de
Published: November 2017

The literature that emerged from Mankiw and Reis' (2002) proposal of sticky information as an alternative to sticky-price models has focused on economies populated with (ex-ante) identical firms. This paper analyzes the implications of heterogeneity in the degree of information stickiness among price-setting firms in different sectors for the dynamic response of the economy to various shocks. I compare multisector sticky-information models with otherwise identical one-sector economies that feature the same frequency of information updating. I find that the effects of such shocks on the output gap -- the difference between actual output and the output level that would prevail in the absence of information frictions -- are larger in heterogeneous economies.
A lei
Authors: Silva José Afonso da
Published: November 2017

I - Sociedade e direito. II - Lei e direito. III - A problemática da lei. IV - O conceito de lei. V - A relevância da lei. VI - Legitimidade da lei.
Alteração dos contratos administrativos
Authors: Szklarowsky Leon Frejda
Published: November 2017

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Correção monetária de débitos judiciais
Authors: Wagner José Luis , Cassel Rudi Meira
Published: November 2017

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