bluuebunny/crossref_metadata_2025 huggingface dataset:
Modeling the Optimal Transportation for Acute Stroke Treatment
Authors: Ernst Marielle , Schlemm Eckhard , Holodinsky Jessalyn K. , Kamal Noreen , Thomalla Götz , Fiehler Jens , Brekenfeld Caspar
Published: November 2019

Background and Purpose—

Health systems are faced with the challenge of ensuring fast access to appropriate therapy for patients with acute stroke. The paradigms primarily discussed are mothership and drip and ship. Less attention has been focused on the drip-and-drive (DD) paradigm. Our aim was to analyze whether and under what conditions DD would predict the greatest probability of good outcome for patients with suspected ischemic stroke in Northwestern Germany.

Methods—

Conditional probability models based on the decay curves for endovascular therapy and intravenous thrombolysis were created to determine the best transport paradigm, and results were displayed using map visualizations. Our study area consisted of the federal states of Lower Saxony, Hamburg, and Schleswig-Holstein in Northwestern Germany covering an area of 64 065 km
2
with a population of 12 703 561 in 2017 (198 persons per km
2
). In several scenarios, the catchment area, that is, the region that would result in the greatest probability of good outcomes, was calculated for each of the mothership, drip-and-ship, and the DD paradigms. Several different treatment time parameters were varied including onset-to-first-medical-response time, ambulance-on-scene time, door-to-needle time at primary stroke center, needle-to-door time, door-to-needle time at comprehensive stroke center, door-to-groin-puncture time, needle-to-interventionalist-leave time, and interventionalist-arrival-to-groin-puncture time.

Results—

The mothership paradigm had the largest catchment area; however, the DD catchment area was larger than the drip-and-ship catchment area so long as the needle-to-interventionalist-leave time and the interventionalist-arrival-to-groin-puncture time remain <40 minutes each. A slowed workflow in the DD paradigm resulted in a decrease of the DD catchment area to 1221 km
2
(2%).

Conclusions—

Our study suggests the largest catchment area for the mothership paradigm and a larger catchment area of DD paradigm compared with the drip-and-ship paradigm in Northwestern Germany in most scenarios. The existence of different paradigms allows the spread of capacities, shares the cost and hospital income, and gives primary stroke centers the possibility to provide endovascular therapy services 24/7.
Aeschynomene eridesii (Leguminosae, Papilionoideae, Dalbergiae), a new species from seasonally flooded environments of Brazil

Authors: ANTUNES LORENA LANA CAMELO , DA SILVA MARCOS JOSÉ
Published: November 2019

The new species Aeschynomene eridesii is here described, illustrated and has its geographical distribution discussed, including flowering and fruiting seasons, morphological relationships, and systematic position, besides assessed according to IUCN criteria. This species is endemic of Brazil and known to the states of Mato Grosso, Pará and Tocantins, where it grows in temporarily flooded environments and riverbanks. Diagnostic characters of A. eridesii include the size of leaves, stipules, bracts and flowers, leaflets with eccentric midvein, in addition to loments with long and curved stipe. This new species is compared with A. pluriarticulata and A. scabra, its congeners morphologically similar.
Role of Maritime Continent Land Convection on the Mean State and MJO Propagation
Authors: Ahn Min-Seop , Kim Daehyun , Ham Yoo-Geun , Park Sungsu
Published: November 2019

The Maritime Continent (MC) region is known as a “barrier” in the life cycle of the Madden–Julian oscillation (MJO). During boreal winter, the MJO detours the equatorial MC land region southward and propagates through the oceanic region. Also, about half of the MJO events that initiate over the Indian Ocean cease around the MC. The mechanism through which the MC affects MJO propagation, however, has remained unanswered. The current study investigates the MJO–MC interaction with a particular focus on the role of MC land convection. Using a global climate model that simulates both mean climate and MJO realistically, we performed two sensitivity experiments in which updraft plume radius is set to its maximum and minimum value only in the MC land grid points, making convective top deeper and shallower, respectively. Our results show that MC land convection plays a key role in shaping the 3D climatological moisture distribution around the MC through its local and nonlocal effects. Shallower and weaker MC land convection results in a steepening of the vertical and meridional mean moisture gradient over the MC region. The opposite is the case when MC land convection becomes deeper and stronger. The MJO’s eastward propagation is enhanced (suppressed) with the steeper (lower) mean moisture gradient. The moist static energy (MSE) budget of the MJO reveals the vertical and meridional advection of the mean MSE by MJO wind anomalies as the key processes that are responsible for the changes in MJO propagation characteristics. Our results pinpoint the critical role of the background moisture gradient on MJO propagation.
Changes in Lake Area in the Inner Mongolian Plateau under Climate Change: The Role of the Atlantic Multidecadal Oscillation and Arctic Sea Ice
Authors: Liu Yong , Chen Huopo , Zhang Guoqing , Sun Jianqi , Li Hua , Wang Huijun
Published: November 2019

The lake area in the Inner Mongolian Plateau (IMP) has experienced a rapid reduction in recent decades. Previous studies have highlighted the important role of intensive human activities in IMP lake shrinkage. However, this study found that climate change–induced summer precipitation variations can exert great influences on the IMP lake area variations. The results suggest that the decadal shift in the IMP summer precipitation may be the predominant contributor to lake shrinkage. Further analysis reveals that the Atlantic multidecadal oscillation (AMO) and Arctic sea ice concentration (SIC) play important roles in the IMP summer precipitation variations. The AMO seems to provide beneficial large-scale circulation fields for the decadal variations in the IMP summer precipitation, and the Arctic SIC decline is favorable for weakening the IMP summer precipitation intensity after the late 1990s. Evidence indicates that the vorticity advection related to the Arctic SIC decline can result in the generation of Rossby wave resources in the midlatitudes. Then, the strengthened wave resources become favorable for enhancing the stationary wave propagation across Eurasia and inducing cyclonic circulation over the Mongolia–Baikal regions, which might bring more rainfall northward and weaken the IMP summer precipitation intensity. Consequently, due to the decreased rainfall and gradual warming after the late 1990s, the lake area in the IMP has experienced a downward trend in recent years.
Compatibility of Lactated Ringer’s Injection With 94 Selected Intravenous Drugs During Simulated Y-site Administration
Authors: Vallée Margaux , Barthélémy Isabelle , Friciu Mihaela , Pelletier Élaine , Forest Jean-Marc , Benoit France , Leclair Grégoire
Published: November 2019

Objective: To test the compatibility of intravenous (IV) lactated Ringer’s injection (LR) with 94 injectable (IV) drugs during simulated Y-site administration. Methods: Ninety-four IV drugs were investigated for compatibility with LR (Baxter). Each sample was prepared in duplicate and performed at room temperature. Two observers performed visual evaluation independently immediately upon mixing and then 15 minutes, 1 hour, 2 hours, 3 hours, and 4 hours after admixture. Another observer performed a particle counting test on 1 of the 2 duplicates of each admixture that did not immediately show incompatibility and then after 4 hours by a light obscuration particle count test. Results: Of the 94 tested drugs, 86 were found to be compatible with LR. A total of 8 drugs were found to be physically incompatible. Of these incompatible drugs, 7 were directly identified visually and 1 was confirmed by the light obscuration particle count test. Conclusion: Lactated Ringer’s injection was physically compatible for 4 hours with 86 tested drugs during simulated Y-site administration. Eight drugs, ciprofloxacin, cyclosporine, diazepam, ketamine, lorazepam, nitroglycerin, phenytoin, and propofol, were found to be incompatible and should not be administered with LR.
Role of ENGOs in Promoting Corporate Social Responsibility (CSR): A Legal Study of Some Facets, Especially Environment Protection and e-Waste Management
Authors: Rattan Jyoti
Published: November 2019

Environment protection has become an area of grave significance in the present century, due to new developments, for saving the planet from the evils of pollution, climate change and so on. However, a new kind of pollutant, called ‘e-waste,’ has emerged due to the Internet revolution, otherwise a boon for development, but which is fast becoming one of the biggest threats to environment in the knowledge society of 21st century. It is significant to note that even the United Nations Environment Programme (UNEP) has admitted that the amount of e-waste generated per year grows rapidly. E-waste is dangerous and poses a threat to human health and environment. What is more shocking is its transportation from developed to developing countries, which is being done on a large scale and such e-waste there is being handled and disposed of unscientifically creating environmental damage. It is noteworthy that protection of the environment and e-waste management is fast becoming a major Corporate Social Responsibility (CSR). In promoting CSR as well as other responsibilities such as in the health or education sectors or poverty reduction, roughly 80 non-governmental organ sations (NGOs) (international or national) in collaboration with other actors have made sincere efforts raising awareness through campaigns by lobbying and so on. However, only a few of them are engaged in e-waste management related activates. This article is an attempt to study the role of Environmental NGOs (ENGOs) in promoting CSR, especially with regard to environment protection and e-waste management.
Computer Based Control Assignment — Digital Control of an Inverted Pendulum
Authors: Dunnigan M. W.
Published: November 2019

This paper describes an assignment study that is undertaken by undergraduate students who have elected to study the digital/state-space control module as part of their Electrical and Electronic Engineering degree course at Heriot-Watt University. The assignment is based around the inverted pendulum example and uses the computer package MATLAB/SIMULINK. An advantage of the way the assignment is structured is that unique solutions do not exist for the choice of the compensator, sample rate and discretisation method.
Developments in Current-Mode Signal Rectifier and Modulator Circuits
Authors: Wilson B. , Dodd A. J.
Published: November 2019

The improved performance in precision signal rectification that is now available through the use of current conveyors is outlined in this paper. Such current-steering techniques can also be adapted to produce novel ring- and chopper-modulators with promising intercept performance.
Media coverage of reports published by the Québec Ombudsman: an automated content analysis
Authors: Duval Dominic , Jacob Steve , Montigny Eric , Ouimet Mathieu
Published: November 2019

This article examines media coverage of reports published by the Québec Ombudsman, a body that upholds the rights of citizens and that goes by the name of ‘Public Protector’. A large part of the Québec Ombudsman’s mandate is to conduct investigations and issue recommendations following infringements by Québec’s administrative apparatus that affect one or several citizens. These infringements are reported to the ombudsman by citizens, which means that it must be visible to the public. Such visibility relies, to a great extent, on the media, hence the importance of analysing the Québec Ombudsman’s media coverage, a subject that has received little attention in the academic literature. Our article reveals that media coverage of the ombudsman’s reports is inconsistent. We also observe that, on average, newspaper articles adopt a more negative tone than the reports themselves. However, contrary to our expectations, reports with a more negative tone are not necessarily given more media coverage. The best predictor of the presence or absence of media coverage and tone congruence between reports and articles appears to be the presence of a press release issued by the ombudsman.

Points for practitioners

This article examines media coverage of reports published by the Québec Ombudsman. Based on an automated content analysis, it appears that the media coverage of the reports is not explained by the tone used in the documents published by the Québec Ombudsman. Reports that are more negative are not necessarily given greater coverage by journalists than positive reports. Direct communication efforts with the media (e.g. a press conference and the publication of a press release) are more likely to lead to media coverage.
Not decided in the kitchen! Technocracy and the regulatory-welfare politics of India’s Direct Benefits Transfer reform
Authors: Yerramsetti Srinivas
Published: November 2019

Public policies designed to advance governance reform without the corresponding legal frameworks that secure democratic values can exacerbate the power imbalance between the government and the policies’ targets. This article discusses India’s post-liberalization changes through the governance paradigms of New Public Management and technocracy. Using the case of Direct Benefits Transfer reform, it traces the emergence of technocracy as a governance paradigm. It discusses the implications of technocracy’s complementarity with contemporary populism for the restructuring of social citizenship. It makes a case for a neo-Weberian transformation through a renewed commitment to a legal approach to public administration in order to reinforce the public’s faith in the role of the administrative state as an instrument of emancipation and social progress.

Points for practitioners

Public administration, especially in non-Western contexts, is characterized by the prioritization of managerial innovations in government over the establishment of legal frameworks. In that context, this article illustrates two central points for practitioners: • The powers of delegated legislation should be exercised transparently and by establishing a clear relationship to the formally stated policy objectives. • The operations of the administrative state should be structured in order to advance the goals of both distributive and procedural justice.
Filipinos as EFL Teachers in Bangkok, Thailand: Implications for Language Education Policy in the ASEAN Region
Authors: Ulla Mark B.
Published: November 2019

In response to the increase in demand for teachers of English in Thailand, many Filipino teachers are now working as English as a Foreign Language (EFL) teachers in Bangkok. This study explores the perceptions of 56 Filipino teachers about the conditions and challenges of being EFL teachers in Bangkok, Thailand. A modified questionnaire and an individual follow-up interview were used to collect the data. Likewise, a qualitative content analysis was performed on the data in the study. Findings revealed that teacher-participants held a positive view with regards to being EFL teachers in Bangkok. Some reasons why they came to teach in Bangkok include good salary rates, a chance to provide for their families’ financial needs, an opportunity to widen their teaching experience, and a chance to work with people from different cultural backgrounds. However, some professional and personal issues like the perceived lack of teachers’ professional development programmes, cultural differences, language barriers, and absence from family celebrations and other important occasions were also noted. The findings suggest that although the experience was generally positive, Filipino teachers encountered some personal and professional issues, including those which stemmed from their status as so-called ‘non-native speaker teachers’ (NNEST) of English.
Dietary Intake Among Church-Affiliated African Americans: The Role of Intentions and Beliefs
Authors: Bauer Alexandria G. , Berkley-Patton Jannette , Bennett Kym , Catley Delwyn , Bowe-Thompson Carole , Lister Sheila , Christensen Kelsey
Published: November 2019

Diabetes and heart disease disproportionately burden African Americans, who tend to have worse nutritional intake than Whites. Many Black churches are influential institutions in the Black community, with potential to assist with promotion of healthy eating behaviors. The purpose of the current study was to use the Theory of Planned Behavior (TPB) to examine intention to eat a healthy diet and dietary behaviors among church-affiliated African Americans. It was hypothesized that TPB constructs would positively predict intention to eat a healthy diet and that intention to eat a healthy diet would be a predictor of fat and fruit and vegetable intake. It was also hypothesized that control beliefs would predict reduced fat intake and increased fruit and vegetable intake. Path analyses indicated behavioral, normative, and control beliefs were predictive of intention to eat a healthy diet. Intention to eat healthy was a significant predictor of dietary intake behaviors. These findings provide support for the use of the TPB in examining diet among church-affiliated African Americans. This study represents an opportunity to inform dietary interventions for the African American faith community.
Robust linear parameter varying attitude control of a quadrotor unmanned aerial vehicle with state constraints and input saturation subject to wind disturbance
Authors: Soltanpour Mohammad Reza , Hasanvand Farshad , Hooshmand Reza
Published: November 2019

In this paper, a gain scheduled [Formula: see text] state-feedback controller has been designed to control the attitude of a linear parameter varying (LPV) model of a quadrotor unmanned aerial vehicle (UAV). The scheduling parameters vector, which consists of some states and the control inputs, must vary in a specified polyhedron so that the affine LPV model would be analyzable; therefore, some pre-assumed constraints on states and input saturation have been taken into account in design process. The stabilization and disturbance attenuation conditions are obtained via elementary manipulations on the notion of [Formula: see text] control design. The resulting parameter dependent linear matrix inequalities are solved through a Robust LMI Parser (Rolmip) – which works jointly with YALMIP (A toolbox for modeling and optimization in MATLAB)– by transforming polynomial parameter dependent matrices into multi-simplex domain, to best deal with nonconvex problems. In the end, simulation results have been presented and compared with existing literature to examine the capability of such method in the presence and absence of wind disturbances.
Introduction to the special section on Developmental Perspectives on the Sexualization of Girls and Women
Authors: Bigler Rebecca S. , Tomasetto Carlo
Published: November 2019

We provide an overview of the special section of the International Journal of Behavioral Development titled, “Developmental Perspectives on the Sexualization of Girls and Women.”
Step-Grandparent–Step-Grandchild Relationships: Is There a “Grand Step-Gap” in Emotional Closeness and Contact?
Authors: Steinbach Anja , Silverstein Merril
Published: November 2019

High divorce and remarriage rates have expanded nontraditional family forms, as some family members leave and others join during the process of repartnering. A less explored consequence of the growth in step-families is the proliferation of step-grandparenthood. This paper focuses on emotional closeness and frequency of contact between step-grandparents and their step-grandchildren in childhood and adulthood. Based on 4,992 biological grandparents and step-grandparents participating in the 2014 wave of the German Ageing Survey, we compared 7,710 biological grandparent–grandchild relations to 465 step-grandparent–step-grandchild relations. Step-relations were differentiated by whether repartnering occurred in the grandparent or parent generation. Hierarchical linear regression results provided support for the hypothesis that step-grandparents feel less emotionally close to their step-grandchildren than biological grandparents feel to their biological grandchildren. In contrast, the observed lower frequency of contact in step-grandparent–step-grandchild relations was mostly explained by their weaker emotional ties.
Morphologic and Immunohistochemical Characterization of Spontaneous Lymphoma/Leukemia in NSG Mice
Authors: Tillman Heather , Janke Laura J. , Funk Amy , Vogel Peter , Rehg Jerold E.
Published: November 2019

The NOD.Cg- Prkdcscid Il2rgtm1Wjl/SzJ strain (NOD scid gamma, NSG) is a severely immunodeficient inbred laboratory mouse used for preclinical studies because it is amenable to engraftment with human cells. Combining scid and Il2rgnull mutations results in severe immunodeficiency by impairing the maturation, survival, and functionality of interleukin 2–dependent immune cells, including T, B, and natural killer lymphocytes. While NSG mice are reportedly resistant to developing spontaneous lymphomas/leukemias, there are reports of hematopoietic cancers developing. In this study, we characterized the immunophenotype of spontaneous lymphoma/leukemia in 12 NSG mice (20 to 38 weeks old). The mice had a combination of grossly enlarged thymus, spleen, or lymph nodes and variable histologic involvement of the bone marrow and other tissues. All 12 lymphomas were diffusely CD3, TDT, and CD4 positive, and 11 of 12 were also positive for CD8, which together was consistent with precursor T-cell lymphoblastic lymphoma/leukemia (pre-T-LBL). A subset of NSG tissues from all mice and neoplastic lymphocytes from 8 of 12 cases had strong immunoreactivity for retroviral p30 core protein, suggesting an association with a viral infection. These data highlight that NSG mice may develop T-cell lymphoma at low frequency, necessitating the recognition of this spontaneously arising disease when interpreting studies.
Reading the Social Sciences Theologically (Part 1): Approaching and Qualifying Models of Human Development
Authors: Trentham John David
Published: November 2019

Part 1 of 2. This series of articles seeks to present a viable hermeneutical framework according to which Christian scholars and educators may read social scientific literature with theological clarity. Part 1 establishes the manner in which Christians may profitably approach and qualify social science models of human development. The “principle of inverse consistency,” introduced at the conclusion of this article, is put forth as a conceptual tool for interpreting developmental models with confessional and intellectual virtue.
Associations Between Classroom Normative Climate and the Perpetration of Teen Dating Violence Among Secondary School Students
Authors: Beckmann Laura , Bergmann Marie Christine , Krieg Yvonne , Kliem Sören
Published: November 2019

The aim of this study was to investigate how classroom normative climate regarding the perpetration of teen dating violence (TDV) was related to adolescents’ self-reported perpetration of (verbal/emotional, threatening, relational, physical, and sexual) violence within romantic relationships in the previous 12 months. Based on Theory of Normative Conduct, we hypothesized that higher classroom levels of TDV perpetration were associated with a higher likelihood of individual TDV perpetration. Data were drawn from a large survey of ninth-grade students conducted in the state of Lower Saxony, Germany ( n = 10,638). From this sample, an analysis sample of n = 4,351 students at risk was drawn (mean age: 15.0, SD: 0.76; 46.6% male). More than half (54.8%) of the at-risk sample reported engagement in any form of TDV within the previous 12 months, whereby rates varied considerably by the dimension of TDV. Controlling for a range of risk factors on the classroom level (proportion of students dependent on social welfare, proportion of students with migration background) and individual level (exposure to family violence, sociodemographic characteristics, TDV victimization, and peer- and school-related factors), regression analyses showed that higher rates of classroom-level TDV perpetration were positively related to individual verbal/emotional TDV perpetration. This pattern of results was observable across all dimensions of TDV. Furthermore, gender-specific patterns of TDV perpetration were observable: Girls were more affected by classroom levels of verbal/emotional and physical TDV than boys, while boys were more affected by classroom levels of relational and sexual TDV. Results highlight the role of the wider peer context in shaping adolescent dating experiences and specifically point to the relevance of the classroom ecology for the socialization of dating violence in adolescents.
Statistical tests for latent class in censored data due to detection limit
Authors: He Hua , Tang Wan , Kelly Tanika , Li Shengxu , He Jiang
Published: November 2019

Measures of substance concentration in urine, serum or other biological matrices often have an assay limit of detection. When concentration levels fall below the limit, the exact measures cannot be obtained. Instead, the measures are censored as only partial information that the levels are under the limit is known. Assuming the concentration levels are from a single population with a normal distribution or follow a normal distribution after some transformation, Tobit regression models, or censored normal regression models, are the standard approach for analyzing such data. However, in practice, it is often the case that the data can exhibit more censored observations than what would be expected under the Tobit regression models. One common cause is the heterogeneity of the study population, caused by the existence of a latent group of subjects who lack the substance measured. For such subjects, the measurements will always be under the limit. If a censored normal regression model is appropriate for modeling the subjects with the substance, the whole population follows a mixture of a censored normal regression model and a degenerate distribution of the latent class. While there are some studies on such mixture models, a fundamental question about testing whether such mixture modeling is necessary, i.e. whether such a latent class exists, has not been studied yet. In this paper, three tests including Wald test, likelihood ratio test and score test are developed for testing the existence of such latent class. Simulation studies are conducted to evaluate the performance of the tests, and two real data examples are employed to illustrate the tests.
How to treat patients with acute respiratory failure? Conventional oxygen therapy versus high‐flow nasal cannula in the emergency department
Authors: Gedikloglu Mustafa , Gulen Muge , Satar Salim , Icen Yahya Kemal , Avci Akkan , Yesiloglu Onder , Karcioglu Ozgur
Published: November 2019

Objective:

To investigate whether high‐flow nasal cannula oxygen therapy could reduce the rate of endotracheal intubation and improve arterial blood gas values, vital signs, and clinical outcomes of patients with hypoxemic acute respiratory failure as compared with conventional oxygen therapy alone.

Methods:

This retrospective, observational study was performed in the 15‐month study period and included adult patients with tachypnea and hypoxemia, whose vital signs and arterial blood gas were monitored. The high‐flow nasal cannula oxygen group consisted of patients admitted to the emergency department with acute respiratory failure when high‐flow nasal cannula oxygen treatment was available in the hospital, while the conventional oxygen therapy group consisted of patients who have presented to the emergency department with acute respiratory failure in the absence of high‐flow nasal cannula oxygen device in the hospital. The primary outcome of the study was improvement in vital signs and arterial blood gas values within first and fourth hours of the treatment. The second outcome was the need for intubation in the emergency department, length of hospital stay, and hospital mortality.

Results:

The decrease in the pulse and respiratory rate of high‐flow nasal cannula oxygen–treated group was significantly greater than the conventional oxygen therapy group on the first and fourth hours of treatment (p < 0.001). PaO2 values were significantly higher in the high‐flow nasal cannula oxygen group at the first and fourth hours of treatment (p ⩽ 0.001). Likewise, mean SaO2 levels of patients receiving high‐flow nasal cannula oxygen treatment was significantly higher than those of patients in the conventional oxygen therapy group (p = 0.006 at 1 h and p < 0.001 at 4 h). In the hypercapnic patients, the decrease in PaCO2 and increase in pH and PaO2 values were significantly greater in high‐flow nasal cannula oxygen group (p < 0.001). The difference between the groups regarding the need for invasive mechanical ventilation was not statistically significant (p = 0.179).

Conclusion:

High‐flow nasal cannula oxygen treatment has been associated with favorable effects in vital signs and arterial blood gas values in patients with acute respiratory failure. High‐flow nasal cannula oxygen might be considered as the first‐line therapy for patients with hypoxemic and/or hypercapnic acute respiratory failure.
Comparison of histologic methods for the detection of Desmozoon lepeophtherii spores in the gills of Atlantic salmon
Authors: Herrero Ana , Padrós Francesc , Pflaum Sara , Matthews Chris , del-Pozo Jorge , Rodger Hamish D. , Dagleish Mark P. , Thompson Kim D.
Published: November 2019

Desmozoon lepeophtherii is a microsporidian associated with gill disease in farmed Atlantic salmon ( Salmo salar). Detection of the parasite in histologic tissue sections is challenging using common histochemical stains given that the small, widely distributed parasite spores typically occur individually or in small clusters. We compared the ability of 4 histologic methods to detect D. lepeophtherii spores in serial sections of Atlantic salmon gill tissue: hematoxylin and eosin (H&E), Gram–Twort (GT), calcofluor white (CW), and immunohistochemistry (IHC). Using CW as a benchmark to calculate a relative ratio, IHC consistently detected more spores than CW (median: 1.3), followed by GT (median: 0.2) and H&E (median: 0.1). IHC detected significantly more spores than GT ( p < 0.05) and H&E ( p < 0.05), and GT more than H&E ( p < 0.05). We found significant underestimation of numbers of microsporidia spores in gill disease in Atlantic salmon using conventional histochemical stains and recommend the use of CW or IHC to detect the parasite in tissue sections.
Increasing Adherence to Adjuvant Hormone Therapy Among Patients With Breast Cancer: A Smart Phone App-Based Pilot Study
Authors: Krok-Schoen Jessica L. , Naughton Michelle J. , Young Gregory S. , Moon Jennifer , Poi Ming , Melin Susan A. , Wood Marie E. , Hopkins Judith O. , Paskett Electra D. , Post Douglas M.
Published: November 2019

Purpose:

This study tested the feasibility and efficacy of using a text-based intervention to increase initiation, decrease discontinuation, and improve adherence as prescribed to adjuvant hormone therapy (AHT) among hyphenate post-menopausal breast cancer survivors.

Methods:

The 3-month intervention consisted of daily text message reminders to take medication, coupled with a dynamic (eg, feedback on progress) tailored intervention using weekly interactive surveys delivered by a smartphone app. Five clinic sites within the Alliance for Clinical Trials in Oncology participated. Hormone levels were measured prior to AHT initiation and at study exit.

Results:

Of the 39 patients recruited to the pilot study, 27 (69.2%) completed all study requirements (completed both the baseline and the exit surveys, both blood draws, and did not miss more than 2 weekly surveys). Significant improvements were observed pre- to postintervention for self-reported medication adherence ( P = .015), mental health functioning ( P = .007), and perceived stress ( P = .04). Significant decreases in estradiol, estrogen, and estrone hormone levels were observed from baseline to study exit ( P < .001), indicating the accuracy of self-reported AHT adherence. Participants (91.9%) and physicians (100%) agreed that participant participation in the intervention was beneficial.

Conclusions:

The results of this pilot study established the general feasibility and efficacy of an app-based intervention to support patient AHT adherence. Larger controlled, randomized trials are needed to examine the effectiveness of the app-based intervention in improving AHT and quality of life among breast cancer survivors.
Pembrolizumab- and/or pazopanib-induced remitting seronegative symmetrical synovitis with pitting edema in a patient with renal cell carcinoma
Authors: Bas Onur , Ozbek Aral , Guven Denizcan , Aktepe Oktay , Kılıc Levent , Kertmen Neyran , Erman Mustafa
Published: November 2019

Introduction

Immune checkpoint inhibitors and angiogenesis inhibitors are novel treatment options for renal cell carcinoma and widely used in clinical practice. They are related with adverse events that occur as a consequence of immune system activation and inhibition of angiogenesis. Herein, we report a rare case of inflammatory arthritis seen in a patient treated with an anti Programmed cell death-1 pembrolizumab and an anti-vascular endothelial growth factor pazopanib.

Case report

A 60-year-old Caucasian male presented to our clinic with inflammatory arthritis with pitting edema. He had been started on pembrolizumab therapy for metastatic renal cell carcinoma after enrolling in the KEYNOTE-679 study. After six cycles of treatment with pembrolizumab, metastasis had been determined in the lung. Then, the patient’s therapy was changed to pazopanib. While the patient was on pazopanib treatment, he noticed a gradual swelling of both hands. Rheumatoid factor, anti-nuclear antibody and anti-cyclic citrullinated peptide were negative. Joint ultrasonography revealed acute tenosynovitis and soft tissue swelling with pitting edema, and a diagnosis of remitting seronegative symmetrical synovitis with pitting edema was made. Management and outcome: He was started on 10 mg prednisolone daily. His symptoms dramatically responded to corticosteroid. He continued to take pazopanib. Then, the patient was discharged with 10 mg prednisolone daily.

Discussion

Pembrolizumab- and/or pazopanib-induced remitting seronegative symmetrical synovitis with pitting edema can be among the rare rheumatic immune-related adverse events that clinicians may encounter as the immune check point inhibitors and anti-VEGF use increases. Corticosteroid therapy can relieve symptoms and cessation of therapy may not be necessary.
Optic neuritis induced by 5-fluorouracil chemotherapy: Case report and review of the literature
Authors: Raina Anant J , Gilbar Peter J , Grewal Guranjan D , Holcombe David J
Published: November 2019

Introduction

For over 50 years, 5-Fluorouracil has played a critical role in the treatment of numerous malignancies, including colorectal cancer. Ocular side effects are uncommon and include blurred vision, conjunctivitis, excessive lacrimation and keratitis.

Case report

We report a 57-year-old male with metastatic colorectal cancer who had received extensive chemotherapy with 5-Fluorouracil-based regimens for over 12 months. Following his seventh cycle of cetuximab/FOLFIRI, he developed acute onset global headache, nausea and loss of vision in the right eye. After detailed investigations, including ophthalmologic and neurologic consultations, a diagnosis of optic neuritis was made.

Management and outcome

Chemotherapy was ceased immediately, and intravenous methylprednisolone (1 g) daily for five days was commenced. His headache resolved and vision started to improve within 24 h. Three weeks after completion of corticosteroids, constriction of the right visual field had fully resolved.

Discussion

Atypical optic neuritis is an inflammatory optic neuropathy that can be caused by ischaemia, mechanical compression, nutritional deficiency, toxins and drugs. Drug-induced optic neuritis, while rare, is associated with cytotoxic medications including methotrexate, cisplatin, carboplatin, vincristine and paclitaxel. There have only been five previous case reports implicating 5-Fluorouracil in the development of optic neuropathy. The likelihood of the adverse drug reaction due to 5-Fluorouracil was assessed using the Naranjo algorithm. A score of +7 indicates probable causality. Clinicians should be alert to this potential ocular toxicity in order to initiate prompt cessation of treatment and early ophthalmology referral to prevent visual loss and damage to ocular structures.
‘The play’s the thing’: A creative collaboration to investigate lived experiences in an urban community garden
Authors: Black Yvonne
Published: November 2019

Presenting the backstage story of a non-traditional qualitative research project, I illustrate how a creative approach can stimulate participant dialogue and encourage researcher reflexivity. Working with an award-winning playwright and the staff and volunteers at a community garden, I explored the meanings of connections between people and nature, and how these connections impact well-being, through a collaborative performance ethnography. The aim of the study is to stimulate discourse around the role of community gardens in enacting social and environmental change for well-being. This article is an exploration of how the creative approach we adopted, incorporating arts-based inquiry and performance as method, contributed to every aspect of the research process. First, it facilitated relaxed communications with the members of the community organisation who participated. Their interest was immediately piqued by the idea of being involved in the development of a play, which led to relaxed, playful discussion. Second, the creative approach provided new perspectives on the collection and analysis of data. It expanded my thinking, in developing my methodological approach to the research and in working towards a radical reflexivity. I suggest that creative approaches are applicable to many areas of organisational research.
Impact of door opening on the risk of surgical site infections in an operating room with mixing ventilation
Authors: Wang Cong , Holmberg Sture , Sadrizadeh Sasan
Published: November 2019

Operating rooms (ORs) often have door openings connected to uncontrolled areas that are more contaminated. Opening the door may allow an inflow of contaminated air, degrade the microbiological air cleanliness and possibly cause surgical site infections (SSIs). This study numerically investigated the transient airflow and bacteria-carrying particles spread caused by the opening of a sliding door in an OR with mixing ventilation. Results showed that a single door opening raises the overall OR contamination by 2.1 colony-forming units per cubic metre (CFU/m3) under a temperature difference of about 3°C. With a similar level of overall contamination, the risk of infections differs dramatically, as the corresponding contamination at the surgical site ranges from lower than 1 CFU/m3 to higher than 10 CFU/m3. This implies that quantifying only the air volume exchange is not sufficient for a valid and reliable assessment of the impact of door openings on the risk of SSIs. Temporarily reducing the OR exhaust flow during door operation was found to be an effective solution to minimize the impact of door openings on the risk of infections. In the case examined in the present study, a 20–30% reduction in OR exhaust flow decreases the airborne contamination to a sufficiently low level.
The mediating effects of micro country image by product category and country
Authors: Almousa Moudi , Jin Byoungho , Yang Heesoon , Kim Naeun
Published: November 2019

Although it is well accepted that country image plays a major role in product evaluation and purchase intention in the literature, there is insufficient evidence regarding the effects of country image dimensionality on purchase intentions by product category (handbags and cell phones) and country (the United States, Korea, Italy, and Malaysia). The current research investigates the mediating effects of micro country image on the relationship between macro country image and consumers’ purchase intentions. Moreover, it highlights how this mediated relationship differs by product category and country. Based on research findings for symbolic products (i.e., handbags), both macro and micro country image should be managed and communicated to consumers. However, for functional products (i.e., cell phones), only micro country image needs to be actively communicated to consumers because it has a direct influence on purchase intentions. Additionally, micro country image was found to play a full mediating role between macro country image and purchase intentions in case of cell phones. This article concludes with a discussion of theoretical and managerial implications and further research.
Hoping for an apocalypse? Political Realism in Apocalyptic Times by Alison McQueen
Authors: Sleat Matt
Published: November 2019

Central to the apocalyptic imaginary is the notion that history has some sort of purpose, or that it provides a perspective from which we can authenticate or redeem our human activities. As such, one might reasonably expect that realists would view such apocalypticism as precisely the sort of moralisation that they urge us to be deeply suspicious of. Yet in Political Realism in Apocalyptic Times Alison McQueen argues not only that the relationship between realism and apocalyptic visions is much more complex and nuanced than we might initially suspect, by exploring how it played out in the work of canonical figures in the realist tradition, Niccolò Machiavelli, Thomas Hobbes and Hans J Morgenthau, but also that, at a time when we live in the shadow of several possible global disasters, realist thought might offer us something in the way of instruction ‘in living through an age of catastrophe’. While McQueen is admirably honest as to the limitations of the realist approaches in the thinkers she focuses on, this review suggests that there may be good reason to be even less enthusiastic about their prospects.
Safe Father–Child Contact Postseparation in Situations of Intimate Partner Violence and Positive Fathering Skills: A Literature Review
Authors: Turhan Zeynep
Published: November 2019

The role of parenting may be challenging and complex for parents who are violent in their relationship and employ poor and negative parenting practices. Synthesizing the knowledge of safe father–child interactions in post–domestic violence incidents and positive fathering skills is the major goal of this review. It also aims to identify the available literature on key factors and conditions around child adjustment following intimate partner violence incidents. In order to achieve these goals, this article applied a narrative style literature review. Electronic databases and websites of children’s social services and domestic violence interventions were searched, and 12 research studies met the criteria for the review. The synthesis of the literature suggests that improving custody workers’ knowledge of intimate partner violence and developing father’s parenting practices during interventions are essential in achieving the safety of father–child interactions. The father’s regular participation in perpetrator interventions and parenting programs can prevent them from continuing to abuse their partners and children during visitations. As a result, an approach that acknowledges the multifaceted factors for safe father–child contact and the multifaceted means of reducing child adjustment problems after parental separation was developed.
Geometric Remodeling of the Perirenal Aortic Neck at and Adjacent to the Double Sealing Ring of the Anaconda Stent-Graft After Endovascular Aneurysm Repair
Authors: Koenrades Maaike A. , Bosscher Marianne R. F. , Ubbink Jouke T. , Slump Cornelis H. , Geelkerken Robert H.
Published: November 2019

Purpose: To evaluate if the radial force of the double sealing ring of the Anaconda stent-graft induces dilatation in the perirenal aortic neck adjacent to the rings. Materials and Methods: This study evaluated the serial electrocardiogram-gated computed tomography scans of 15 abdominal aortic aneurysm patients (mean age 72.8±3.7 years; 14 men) who were treated electively using an Anaconda stent-graft. Follow-up scans were conducted before discharge and at 1, 6, 12, and 24 months after endovascular repair. Diameter and area were assessed perpendicular to the aortic centerline along the perirenal aortic neck, which was subdivided into 3 zones: the suprastent, the stent, and the infrastent zones. Measurements were performed independently by 2 experienced observers using dedicated 3-dimensional image processing software. Results: Between discharge and the 2-year follow-up the diameter and area remained stable in the suprastent zone [average diameter change: −0.1±0.4 mm (−0.4%±1.7%), p=0.893; average area change: −2.9±17.2 mm2 (−0.7%±3.4%), p=0.946], increased in the stent zone [average diameter change: +1.9±1.0 mm (+7.3%±4.0%), p<0.001; average area change: +84.3±48.3 mm2 (+15.5%±8.7%), p<0.001], and diverged in the infrastent zone [average diameter change: −0.8±2.2 mm (−2.3%±7.4%), p>0.99; average area change: −34.6±102.3 mm2 (−4.1%±14.8%), p>0.99; increased in 4 patients, decreased in 9 patients]. Conclusion: After Anaconda implantation the infrarenal aortic neck accommodated to the expansion of the sealing rings at the stent zone. Below the stent zone the neck diameter decreased in the majority of patients, while an increase was related to downstream displacement of the main body. A decrease in size in the infrastent zone may contribute to durable sealing and fixation. A personalized follow-up scheme based on geometric neck remodeling should be feasible if our observations are confirmed in larger, long-term studies.
Come for the Game, Stay for the Cash Grab: The Ethics of Loot Boxes, Microtransactions, and Freemium Games
Authors: Neely Erica L.
Published: November 2019

In this article, I investigate the ethics of freemium games, microtransactions, and loot boxes. Three distinctions are relevant. First, there is a difference between a fixed-reward microtransaction and a random one, such as a loot box. Second, there is a difference between cosmetic items and those which affect gameplay; this is particularly pronounced in multiplayer games, where a player might have an advantage over another through the expenditure of real money. Third, there is a difference between items which are obtainable both for real money and for in-game effort and items which are only obtainable for real money. Ultimately, all three of these distinctions will prove necessary to show that fixed cosmetic rewards are ethically permissible, random rewards of all types are ethically problematic, and fixed functional rewards can be acceptable, but only under certain conditions.
Trust in Centralized Large-Scale Data Repository: A Qualitative Analysis
Authors: Broekstra Reinder , Aris-Meijer Judith , Maeckelberghe Els , Stolk Ronald , Otten Sabine
Published: November 2019

Exponential increases in digital data and calls for participation in human research raise questions about when and why individuals voluntarily provide personal data. We conducted 36 in-depth interviews with ex-participants, participants, and nonparticipants in a biobank to identify key factors influencing trust in centralized large-scale data repository for human research. Our findings indicated that trust depends strongly on whether such data repository benefits the public, the interests of data collectors, the characteristics of the collected data, and application of informed consent for retaining control over personal data. Concerns about the aims and range of data repository appeared to influence withdrawal of participation. Our findings underscore ethical and practical issues relating to data collection and consent procedures in human research.