bluuebunny/crossref_metadata_2025 huggingface dataset:
When This Happens, You Want the Best Care: Players’ Experiences of Barriers and Facilitators of the Immediate Management of Rugby-Related Acute Spinal Cord Injury
Authors: Badenhorst Marelise , Verhagen Evert , Lambert Mike , van Mechelen Willem , Brown James
Published: March 2019

Most contact sports, including rugby union, carry a risk of injury. Although acute spinal cord injuries (ASCIs) in rugby are rare, the consequences of such injuries are far-reaching. Optimal management of these injuries is challenging, and a detailed understanding of the different barriers and facilitators to optimal care is needed. In this study, we aimed to describe the perception of players, regarding factors related to the optimal immediate management of a catastrophic injury in a developing country with socioeconomic and health care inequities. The most frequently reported barriers were transportation delays after injury and admission to appropriate medical facilities. Other barriers included inadequate equipment, the quality of first aid care, and barriers within the acute hospital setting. Barriers were more prevalent in rural and lower socioeconomic areas. These findings are relevant for all rugby stakeholders and may help shape education, awareness, and future policy around the immediate management of ASCIs.
Scientific Emergence and Instantiation Part II: Assembling Synthetic Biology 2006–2015
Authors: Codding Kimberly , Faber Brenton
Published: March 2019

Synthetic biology is a newly emerging interdisciplinary field that aligns engineering principles with biological equipment for adapting life. This article describes an incremental rhetorical experiment to insert human-focused (ethical) equipment into a technical project that adapted a clustered regularly interspaced short palindromic repeat/Cas9 gene-editing system. This ethical equipment was inserted via a contemporaneous study of the public instantiation of synthetic biology. The findings from this experiment show that by enacting multiple representations, accounts of synthetic biology have elicited similar discourse forms and actions as prior emergent technologies. But the discourses associated with synthetic biology have not (yet) coalesced into stabilized forms, suggesting that synthetic biology has yet to be instantiated as formal practice, so its meanings remain alterable. This article concludes by documenting an attempt to influence this emerging interdisciplinary field with an integrated ethical narrative.
Evaluation of intervention measures at different stages of the production chain in Argentinian exporting abattoirs
Authors: Brusa Victoria , Restovich Viviana , Signorini Marcelo , Pugin Daniela , Galli Lucía , Díaz Vanesa Ruíz , Arias Romina , Leotta Gerardo A
Published: March 2019

Antimicrobial treatments could help to decrease the transmission of microorganisms to beef carcasses and abattoir environments. The aim of this study was to evaluate the effectiveness of interventions in reducing Shiga toxin genes ( stx1 and stx2) presence in a commercial abattoir. Intervention measures included the application of electrolytically generated hypochlorous acid to steer pens (experiment 1), chlorinated water, electrolytically generated hypochlorous acid, and isoclor to steer pens (experiment 2), electrolytically generated hypochlorous acid to knocking pens (experiment 3), and aqueous ozone and electrolytically generated hypochlorous acid onto beef carcasses (experiment 4). Detection of stx in samples was performed with BAX® System Real-Time PCR Assay. Our results showed that treatment with pressurized electrolytically generated hypochlorous acid and isoclor were effective to reduce stx presence from hides on steer pens. Although there is no single strategy to ensure the reduction of stx presence in a commercial abattoir, the combined application of several antimicrobial interventions would be ideal.
Machine learned domain decomposition scheme applied to parallel multi-scale muscle simulation
Authors: Ivanović Miloš , Kaplarević-Mališić Ana , Stojanović Boban , Svičević Marina , Mijailovich Srboljub M
Published: March 2019

Since multi-scale models of muscles rely on the integration of physical and biochemical properties across multiple length and time scales, they are highly processor and memory intensive. Consequently, their practical implementation and usage in real-world applications is limited by high computational requirements. There are various reported solutions to the problem of parallel computation of various multi-scale models, but due to their inherent complexity, load balancing remains a challenging task. In this article, we present a novel load balancing method for multi-scale simulations based on finite element (FE) method. The method employs a computationally simple single-scale model and machine learning in order to predict computational weights of the integration points within a complex multi-scale model. Employing the obtained weights, it is possible to improve the domain decomposition prior to the complex multi-scale simulation run and consequently reduce computation time. The method is applied to a two-scale muscle model, where the FE on macroscale is coupled with Huxley’s model of cross-bridge kinetics on the microscale. Our massive parallel solution is based on the static domain decomposition policy and operates in a heterogeneous (central processing units + graphics processing units) environment. The approach has been verified on a real-world example of the human tongue, showing high utilization of all processors and ensuring high scalability, owing to the proposed load balancing scheme. The performance analysis shows that the inclusion of the prediction of the computational weights reduces execution time by about 40% compared to the run which uses a trivial load balancer which assumes identical computational weights of all micro-models. The proposed domain decomposition approach possesses a high capability to be applied in a variety of multi-scale models based on the FE method.
Merging Efforts: The Intersections of Domestic Violence Intervention, Men, and Masculinities
Authors: Hall Christopher M.
Published: March 2019

Feminist-focused activism and domestic violence services have grown in tandem, both developing analysis of systemic interventions for abusive men and in men’s role to address violence against women. Research on men and masculinities create a space for enhancing the view of toxic and healthy masculinities; however, analysis of masculinities without specific discussion on topics of intersectionality can avoid directly addressing men's violent behavior. There is a growing need to combine two focal points of work: honoring the foundations of anti-oppression work by encouraging non-abusive men to address their entitlement and disconnect from women, and motivating domestically abusive and violent men to choose respectful behavior that integrates healthy masculinities. Consideration for LGBTQ+ analysis of masculinities and opportunities for combined work are also explored.
Fundamental frequency of a sandwich cylindrical panel with clamped edges
Authors: Lopatin AV , Morozov EV
Published: March 2019

A novel solution of the free vibration problem formulated for a shallow sandwich cylindrical panel with fully clamped edges is presented in the paper. Based on this solution, an analytical formula for the fundamental frequency is derived. The panel vibrations are modelled using the engineering theory of laminated cylindrical shells taking into account the transverse shear deformations. The governing equations derived in terms of the panel displacements, deflections and angles of rotation of the normal element, are solved using the Galerkin method. The functions approximating the shape of the vibrating panel are obtained based on the analysis of the bending deformation of clamped–clamped sandwich beam subjected to a uniformly distributed inertial load. The analytical formula is applied to calculations of the fundamental frequencies for sandwich panels with various structural parameters. The results of these calculations have been successfully verified using the finite element method and implemented in the design analysis of sandwich panels considering a constraint imposed on the value of their fundamental frequency.
Smoking and Smoking Cessation Among Criminal Justice–Involved Older Adults
Authors: Ahalt Cyrus , Buisker Timothy , Myers Janet , Williams Brie
Published: March 2019

Background:

In jails and prisons worldwide, older adults are among the fastest growing demographic groups. Criminal justice–involved populations smoke tobacco at high rates. Older adults are also disproportionate smokers and have more difficulty quitting smoking than other age groups. Yet, little is known about tobacco use or knowledge and attitudes toward smoking cessation among the growing population of incarcerated older adults.

Methods:

A descriptive, cross-sectional survey study of 102 adults aged 55 years or older recently incarcerated in an urban jail using items from the Global Adult Tobacco Survey (GATS).

Results:

More than 70% of participants reported being current smokers despite strong knowledge (95%) of the connection between smoking and serious illness. More than half of current smokers reported a past failed quit attempt (62%) and/or said they would like to quit (60%).

Conclusions:

High rates of tobacco use in this population suggest that correctional institutions represent a critical site for the delivery of appropriate smoking cessation interventions to older adults, including integrated treatment approaches for those with co-occurring behavioral health diagnoses.
Retrospective Analysis of Medication Utilization and Clinical Outcomes in Patients With Idiopathic Pulmonary Fibrosis Treated With Nintedanib or Pirfenidone
Authors: Ipatova Anastasia Y , Koerner Pamela H , Miller Richard T , Staskon Francis , Radi Melanie
Published: March 2019

Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive lung disease which results in thickening and scarring of the interstitial tissue. As the only 2 Food and Drug Administration (FDA)-approved medications on the market, it is valuable to compare the impact of nintedanib and pirfenidone on clinical outcomes. Records of patients who started nintedanib or pirfenidone between calendar years 2015 and 2016 at a national specialty pharmacy were retrospectively reviewed. Data collection was derived from patient management applications and statistical data analysis was completed in SAS (SAS Institute Inc®). The nintedanib population contained 2605 patients and of the population completing clinical assessment surveys (n = 1343), 46% of respondents (n = 612) reported no adverse events, with the remaining 54% reporting at least 1 adverse event. Average proportion of days covered (PDC) was 84.2% (SD = 17.0). Average final monthly copay for this group was $235. The pirfenidone population had 1322 patients, and of the surveyed population (n = 764), 58% of respondents (n = 445) reported no adverse events, with the remaining 42% reporting at least 1 adverse event. Average PDC was 83.4% (SD = 17.3). Average final monthly copay for this group was $339. Outcomes in the studied IPF population were similar for nintedanib and pirfenidone.
Identifying Clinical Predictors of Switching From Direct Oral Anticoagulants to Warfarin
Authors: Rollins Amber , Hanigan Sarah , Pogue Kristen , Renner Elizabeth , Barnes Geoffrey , Dorsch Michael
Published: March 2019

Purpose:

Direct oral anticoagulants (DOACs) have been shown to be as effective or superior to warfarin, but warfarin use remains constant. Knowledge regarding the patient population who have switched from a DOAC to warfarin is limited. The objective of this study was to identify clinical predictors which may influence a patient’s likelihood of switching from a DOAC to warfarin for atrial fibrillation (AF) or venous thromboembolism (VTE).

Methods:

In this single-center, case-control study, patients who switched from a DOAC to warfarin were compared with patients who remained on a DOAC. Baseline demographics were compared between the switch and control groups. Independent factors that increased the likelihood of switching from a DOAC to warfarin were analyzed using logistic regression.

Results:

A total of 150 patients were included in the control (n = 100) and switch (n = 50) groups. Patients switched from a DOAC to warfarin had more medications at baseline (9 [7, 13] vs 11 [8, 18], P = 0.009). The presence of heart failure (HF) increased the likelihood of switching (odds ratio [OR] = 3.95, confidence interval [CI] = 1.70-9.21, P = 0.002), and for every 10 mL/min increase in creatinine clearance (CrCl), the likelihood of switching decreased ( R = 0.89 [0.80-0.99], P = 0.026). Patients with pulmonary embolism (PE) were less likely to switch from a DOAC to warfarin (OR = 0.20, CI = 0.05-0.86, P = 0.031). Explicitly listed reasons for switching included left ventricular assist device (LVAD) implantation (20%) and valve replacement procedures (20%).

Conclusion:

Congestive HF was a clinical predictor associated with an increased likelihood of switching from a DOAC to warfarin. Anticoagulation therapy for PE and higher CrCl was associated with a decreased likelihood in switching from DOAC to warfarin.
Changing patterns of party unity in the Knesset: The consequences of the Israeli anti-defection law
Authors: Nikolenyi Csaba
Published: March 2019

This article explores the consequences of the Israeli anti-defection law for the rate and timing of party switching in the Knesset. Its central finding is that while the anti-defection law has failed to act as a strong deterrent against party exits and defections, it (i) moved defections to the immediate pre-electoral period and (ii) encouraged collective party switching via the formation of new party groups as opposed to solo defections. While these effects can be directly attributed to the incentives that are generated by the legislation, the Israeli case holds an important implication for the comparative study of anti-defection laws: such laws may not improve legislative party unity if there are other institutions, such as the electoral system and candidate selection practices, that have a countervailing effect and incentivize party exit.
The party (un)faithful: Explaining party members’ defecting voting behaviour in different contexts (Belgium and Britain)
Authors: de Vet Benjamin , Poletti Monica , Wauters Bram
Published: March 2019

Party members are often depicted as loyal voters that supply the party with a small but steady electoral base. Research, however, suggests that party members occasionally vote for other parties in general elections. This might either be a strategic choice or an indication of their discontent, possibly preceding a choice to exit the party. Using original survey data on more than 9000 party members in Flanders (Belgium) and Britain, this article aims to extend our understanding of why party members defect. We test hypotheses that take into account both individual and party-level considerations (ideological concerns, leadership evaluations and strategic choices) and the conditioning effects of party and electoral systems. Our analysis shows that institutional settings are crucial for strategic voting, whereas ideological concerns and leadership evaluations matter equally in both countries. As such, our study provides important insights in the attitudes and behaviour of party members, contributing to current debates on the contemporary meaning of party membership.
Intra-party conflict at grassroots: Party-councillor ideological congruence in Croatia
Authors: Kukec Marko
Published: March 2019

Party-councillor ideological congruence reinforces party linkages with local voters and credibility of councillors as future party elites. This contribution examines the role of career motivations and selective incentives, as well as party branch characteristics in forming party-councillor congruence. The empirical analysis draws on the original survey of Croatian local councillors. The results find councillors with progressive ambition and those exposed to intra-branch competition reporting higher levels of ideological congruence with their parties, while no effect was found for holders of upper level party positions. Branch power has the opposite effect from expected. Party grassroots shape ideologically congruent professional politicians, but this function is challenged by shrinking supply of candidates.
Combining Theories of Change and Realist Evaluation in practice: Lessons from a research on evaluation study
Authors: Rolfe Steve
Published: March 2019

A rapidly growing range of studies apply Theories of Change or Realist Evaluation approaches to get to grips with complex causal processes. Each methodology has been criticised in terms of practicality, usefulness and theoretical difficulties. The hypothesis that combining the two approaches could overcome some of these problems and generate deeper learning has been put forward, but there have been no published assessments of the combined methodology. This article provides findings from an evaluation of community participation policy and practice, which specifically aimed to utilise and evaluate the application of the two approaches within one study. It suggests that there are still challenges in applying Theories of Change and Realist Evaluation approaches, but they can be practically employed together, and that this synthesis can partially overcome the critiques of each individual methodology.
Physical Therapist–Led Exercise Assessment and Counseling in Integrative Cancer Care: Effects on Patient Self-reported Symptoms and Quality of Life
Authors: Lopez Gabriel , Eddy Carol , Liu Wenli , Li Yisheng , Chen Minxing , Bruera Eduardo , Cohen Lorenzo
Published: March 2019

Background. Exercise - contributes to improved treatment-related outcomes. We reviewed characteristics of cancer patients referred for physical therapist–led exercise counseling at a comprehensive cancer center and its effects on self-reported symptoms and quality of life. Methods. Patients presenting for outpatient exercise counseling from February 2016 to May 2017 completed the Edmonton Symptom Assessment Scale (ESAS; 0-10 scale, 10 most severe) pre-encounter/post-encounter and Patient-Reported Outcomes Measurement Information System (PROMIS10) global health assessment pre-encounter. Counseling included assessment and education. ESAS individual items and subscales of physical distress (PHS), psychological distress, and global distress (GDS) were analyzed. We used paired t-tests to compare (1) ESAS symptoms pre-encounter/post-encounter and (2) ESAS and PROMIS10 scores at baseline (pre-encounter) and first follow-up. Results. Of 350 participants, most were female (77.7%), Caucasian (66.3%), and had breast cancer (43%). Baseline (pre-encounter) symptom scores (frequency; mean) included poor sleep (68.2%; 3.5), poor well-being (67.4%; 3.2), and fatigue (64.7%; 3.1). Comparing pre-encounter/postencounter ESAS outcomes, we observed statistically and clinically significant reduction in GDS (−3.32; SD = 6.52; P < .001). On follow-up, statistically and clinically significant improvements were observed for fatigue (−1.22; P = .01), GDS (−4.81; P = .01), PHS (−3.1; P = .03) and PROMIS10 global health, mental health, and physical health scores (all P <.05). Conclusion. Patients presenting for exercise counseling had a low to moderate symptom burden and experienced significant improvement in GDS. Longitudinal evaluation revealed improvement in global health and fatigue. Additional research is needed to learn more about patient selection and timing of exercise counseling.
A dynamic simulation of the circuit breaking electromagnetic system with a drive circuit
Authors: Huang Shize , Zhang Fan , Liu Yue , Guo Qiyi
Published: March 2019

A circuit breaking electromagnetic system is the actuator and digital controller for a switching device. Its performance can significantly affect operations of the switching device. We propose a dynamic simulation method coupling the electric field and the magnetic field for the circuit breaking electromagnetic system and its drive circuit. The method combines both statistic and dynamic analyses, and differential equations. Finally, we utilize the flux transformer as an example to validate this method and reveal the dynamic characteristics of the drive transformer by changing the parameters of the drive circuit.
The effect of high-frequency torsional impacts on the dynamic response of a drill string in a stick state
Authors: Tang Liping , He Wei , Zhu Xiaohua
Published: March 2019

Stick–slip vibration is common in the oil well drilling process and is detrimental to down-hole equipment and drilling efficiency. In recent years, a new type of drilling technology, torsional impact drilling, has been developed to mitigate the stick–slip phenomena, particularly in the drilling of deep or abrasive formations. With this drilling technique, high-frequency torsional impacts are generated and applied to the drill bit, providing the drill bit with auxiliary energy. By mitigating or suppressing the stick–slip vibration, part of the energy wasted as a result of vibration can be regained. However, the effect of these impact loads on the dynamic response of a drill string in a stick state is unknown. In order to address this issue, a continuous system model of a drill string that includes torsional impact load was constructed. In the model, a Fourier series approach was used for the impact load, and the mechanical model was resolved with the mode superposition method. Case studies were done to understand the drill string dynamics, with and without the impact. The case study results demonstrate that high-frequency torsional impacts have little influence on the dynamic response of a drill string in a stick state.
Bridge health monitoring and damage identification of truss bridge using strain measurements
Authors: Xiao Feng , Fan Jin , Chen Gang S , Hulsey J Leroy
Published: March 2019

A novel technique to identify bridge damage using genetic algorithms and simulated annealing is proposed in this article. In the proposed method, the cross-sectional area of the damaged member is set as a variable that can be updated. An objective function was investigated to estimate the current condition of the damaged members. This function is the relationship between the measured strain and the analytical strain at the damage location. To obtain better agreement, the parameters were then identified using a genetic algorithm and simulated annealing to minimize the objective function. The proposed method was verified by a truss bridge and can directly estimate the damage based on strain measurements.
A novel localization approach for underwater welding vehicles in spent fuel pools via attitude heading reference system and altimeters
Authors: Luo Yang , Tao Jianguo , Sun Hao , Hao Zhuang , Li Hao , Na Qiang , Gao Haibo , Ding Liang , Deng Zongquan
Published: March 2019

In this article, a novel localization approach incorporating attitude and heading reference system and underwater altimeters is presented to accurately localize the underwater welding vehicles in spent fuel pools of the nuclear power stations. Different from the conventional underwater localization technologies, the presented localization approach is a more suitable approach in cases of confined structured water areas. Firstly, a multi-regions division localization algorithm is proposed for calculating the coordinate of the underwater welding vehicle through data from sensors. Also, considering the attitude errors of the underwater welding vehicle, the beam angle of the altimeters, and the boundary effects of cross-regions, an optimized multi-regions division localization algorithm is introduced for general applicability of the multi-regions division localization. Then, computer simulations are employed to evaluate the validity and the performance of multi-regions division localization and optimized multi-regions division localization. Finally, the efficiency of the proposed approach is confirmed via system experiments. The experimental results are consistent with simulation results which further indicate that the presented approach holds great potential in effective underwater vehicles localization for confined structured water scenarios.
Commission errors with forced response lag
Authors: Schaper Philipp , Grundgeiger Tobias
Published: March 2019

It is often necessary to retrieve intentions once a certain cue occurs in the environment. However, such prospective memory (PM) tasks can also be erroneously recalled even though they are no longer relevant and may result in commission errors. According to the dual mechanism account, commission errors occur because the intention is spontaneously retrieved, and there is a subsequent failure to suppress the associated action, resulting in erroneous instant execution. In three experiments, we tested whether failed response suppression is a prerequisite for commission errors. We set up a response lag condition in which participants had to delay their response to ongoing task trials for 1 s (Experiment 1) or 2 s (Experiments 2 and 3) and a pause condition in which the delay occurred between ongoing task trials. In both conditions, participants learned about a PM task and were then told that the PM task was cancelled. In addition, a control group with response lag executed the PM task and was subsequently told the task was finished. Later, all participants encountered several irrelevant PM cues. If failed response suppression is a prerequisite for commission errors, commission error rates should be non-existent in the response lag conditions, because participants had designated time to suppress the PM action. However, commission errors occurred at an equal rate in all lag and pause conditions. Due to this contradiction to the dual mechanism account, we suggest that the process for commission error occurrence should be reconsidered. Because commission errors appear not to be caused by failed response suppression, we discuss the idea that erroneous intentions might be formed when encountering the former PM cue and persist over delays between formation and execution.
Medium- to long-term results of acromioclavicular joint stabilisation using the Ligament Augmentation Reconstruction System (LARS) ligament
Authors: Hunter Thomas JA , Abdus-Samee Mohammed , Balasubramanian Sivaraman , Grocott Natalie , McClelland Damian
Published: March 2019

Background

Opinion is divided as to optimum management of grade III acromioclavicular joint injuries that have failed conservative management. We objectively investigated the radiological and functional outcome of acromioclavicular joint reconstruction using the Ligament Augmentation Reconstruction System (LARS®).

Methods

Retrospective review of patients with LARS reconstruction of acromioclavicular joint dislocations with minimum six-year follow-up. Functional assessment was performed using the constant score, Disability of Arm Shoulder and Hand score and simple satisfaction score. Radiological assessment was undertaken using plain radiographs. Results were compared with the uninjured limb.

Results

Twenty-four of 25 patients were included. Mean constant score for the injured shoulder was 87.0, Disability of Arm Shoulder and Hand score was 11.6. All patients indicated that they would have the operation again. There were five complications including two patients that suffered small cracks in the clavicle. Coracoid erosion was frequently seen but was most often minor. In two cases, this resulted in a complete dissociation of the coracoid tip but without functional detriment.

Discussion

LARS is a safe and effective method of acromioclavicular joint reconstruction producing good results, and we recommend its use for these injuries. We also caution clinicians who use cerclage methods to be aware of coracoid erosion when following up their patients.
Using the Past to Legitimise the Present: The Portrayal of Good Governance in Chinese History Textbooks
Authors: Weatherley Robert , Magee Coirle
Published: March 2019

This article examines how Chinese middle-school history textbooks are written as a means of legitimising the rule of the Chinese Communist Party (CCP), by carefully utilising China's past. The authors identify (or perhaps “construct”) a sinified model of good governance in the textbooks that derives from the teachings of Confucius and Mencius, and the subsequent practises of certain revered Chinese emperors. This model is then applied to CCP leaders in the modern-era textbooks in order to cast them as diligently upholding a time-honoured Chinese tradition of legitimate rule. In a broader context, our analysis fits within the ongoing discussions about the continuing legacy of Confucianism in contemporary China and the CCP's efforts to locate itself within this as a way of fortifying its own legitimacy. We also note how some of the themes of good governance contained in the textbooks are closely linked to contemporary government policies and priorities, such as anti-corruption schemes and constitutionalism. The objective in so doing is to propagate the importance of these themes to a young audience.
Time to Insulin Initiation in Type 2 Diabetes Patients in 2010/2011 and 2016/2017 in Germany
Authors: Kostev Karel , Gölz Stefan , Scholz Bernd-M. , Kaiser Marcel , Pscherer Stefan
Published: March 2019

Background:

The aim of the current study was to determine whether the time to insulin therapy initiation in patients with type 2 diabetes in primary care in Germany has changed in recent years.

Methods:

Longitudinal data from general practices in Germany (Disease Analyzer) were analyzed. These data included information of 7128 patients (age: 68.5 [SD: 11.5] years; 54.4% male) receiving incident insulin therapy in 2010/2011 and 8216 patients (age: 69.1 [SD: 11.9] years; 54.9% male) receiving incident insulin therapy in 2016/2017. Changes in time to insulin initiation in the practices and the last HbA1c value before the start of insulin therapy were analyzed, stratified by index date. To analyze the impact of covariables on the time to insulin initiation, a multivariate regression analysis was performed, adjusted for age, sex, diabetologist care, and HbA1c as independent variables.

Results:

Median time from T2D diagnosis to insulin therapy in the Disease Analyzer database increased from 1717 days in 2010/2011 to 1917 days in 2016/2017 ( P < .001). The proportion of patients with a HbA1c value ≥9% before insulin initiation was high in both groups (2010/2011: 33.0%, 2016/2017: 34.2%, P = .347). The time to insulin initiation in DPP-4i patients was 112 days longer, and in SGLT2 patients 346 days longer than in patients treated with sulfonylurea.

Conclusions:

The present analysis confirms an increasing delay of the insulin therapy initiation as a consequence of the more frequent use of newer oral antidiabetics. However, the rather moderate increase of time to insulin might display insufficient long-term glycemic control using these agents. Still, more than one-third of patients receive insulin only when HbA1c levels exceed 9%.
Overtime: Re-Interpreting the opt-out derogation
Authors: Aharoni-Goldenberg Sharona
Published: March 2019

The 2003/88/EC Working Time Directive limits maximum weekly working time to 48 hours per week and establishes minimum daily rest periods of 11 hours. Article 22 thereof allows Member States to opt-out of the 48-hours limitation, thus limiting daily working hours to 13, subject to the respect of the general principles of the protection of the health and safety of workers and to employees’ consent. This article attaches great weight to Member States’ obligations to respect the General Principles, which include, inter alia, the protection of workers’ health and safety; workers’ right to reasonable working hours and to dignity; and the notion of adapting work to workers. It refers to empirical research exposing the distinctly negative implications of work lasting more the 12 daily hours on both workers’ health and safety. It suggests that the limitation of working hours should be treated as equivalent to the supplying of employees in industrial plants with protective equipment. It regards employers’ duty to adapt work to workers as having double meaning: first, longitude of hours worked should fit the physical and mental limitations characterising the human body; second, workload should be adapted to employees’ physical and psychological limitations vis-à-vis work hours. The article concludes that it is doubtful whether allowing regular working hours of up to 13 hours complies with the General Principles; proposes to interpret the derogation as limiting regular daily working hours to 12; and to amend the derogation accordingly. It further concludes that the Directive rightly prioritises workers’ health and safety over economic considerations. Indeed, workers are not a means to achieve employers’ goals; rather, they are human beings whose physical and psychological well-being must be respected in the context of working hours and must prevail over commercial interests. Further, commercial interests actually call for the limitation of working hours to up to 12 on a regular basis. The derogation is also subject to workers’ consent and thus reflects their rights to autonomy in the workplace and to free choice of occupation. Hence, employees should be treated as (part) authors of their own work environments and should therefore have the power to shape the length of their overtime. However, their right to autonomy may be hindered by direct or indirect pressures, especially as they have little bargaining powers and alternatives. In order to achieve actual autonomy in the workplace, this article suggests that: employers inform employees as to their freedom to choose whether or not to opt-out and of the risks to health and safety emanating from overtime; consent be written; and that overtime performed beyond 48 weekly hours without free and informed consent be regarded as unconsenting and deserving of reparation.
Experimental procedure for determination of the energy dissipation capacity of ultra-high-performance fibre-reinforced concrete under localized impact loading
Authors: Konrád Petr , Sovják Radoslav
Published: March 2019

Research presented in this article is aimed to investigate the ability of ultra-high-performance fibre-reinforced concrete to absorb and dissipate mechanical energy at elevated strain rate loading. Specimens made of ultra-high-performance fibre-reinforced concrete were subjected to the low-velocity impact using the new testing procedure where no fixed supports that hold the sample during the impact were applied. The fibre volume fraction of the ultra-high-performance fibre-reinforced concrete was set as the main test variable in the framework of this study and the volumetric fraction of fibres was ranging from 0.125% to 2%. A high-speed camera was used to measure velocities of the impactor and the ultra-high-performance fibre-reinforced concrete specimen before and after the impact. Consequently, the energy dissipated by the ultra-high-performance fibre-reinforced concrete specimen during the impact was calculated using a simple energy balance equation. To determine the basic material properties of ultra-high-performance fibre-reinforced concrete, quasi-static loading rate was applied and conventional methods were used. A significant difference between the values of dissipated energies for different loading rates and various fibre volumetric fractions was observed. It can be noted that the new procedure shows a reasonable approach for testing the fibre-reinforced cementitious composites under localized impact loading and is worthy of further optimization.
Anthropomorphic virtual assistants and the reactions of Internet users: An experiment on the assistant’s voice
Authors: Chérif Emna , Lemoine Jean-François
Published: March 2019

Virtual assistants are increasingly common on commercial websites. In view of the benefits they offer to businesses for improving navigation and interaction with the consumers, researchers and practitioners agree on the value of providing them with anthropomorphic characteristics. This study focuses on the effect of the voice of the virtual assistant. Although there are some studies of human–computer interaction in this field, there is no work that addresses the topic from a marketing perspective and compares the effect of a human voice versus a synthetic voice. Our findings show that consumers who interact with a virtual assistant with a human voice have a stronger impression of social presence than those interacting with a virtual assistant with a synthetic voice. The human voice also builds trust in the virtual assistant and generates stronger behavioural intentions.
Cervical Ossification of the Posterior Longitudinal Ligament: A Computed Tomography–Based Epidemiological Study of 2917 Patients
Authors: Bakhsh Wajeeh , Saleh Ahmed , Yokogawa Noriaki , Gruber Jillian , Rubery Paul T. , Mesfin Addisu
Published: March 2019

Study Design:

Retrospective cohort study.

Objectives:

To identify prevalence of ossification of the posterior longitudinal ligament (OPLL) of the cervical spine in a large sample, to characterize spinal involvement, and to identify associations with patient characteristics.

Methods:

Computed tomography (CT) scans of all patients receiving cervical spine CT imaging in a level-1 emergency department from January 1, 2014 to December 31, 2014 were reviewed. Diagnosis and classification of OPLL was performed, and data for associated patients was obtained (age, sex, race, ethnicity, body mass index, diabetes). US Census data was referenced for the sample population. Statistical analysis included t test and chi-square testing, with significance cutoff P < .05.

Results:

There were no significant differences between the sample and population data. Of 2917 patients reviewed, 74 exhibited OPLL (2.5%). Age distribution between OPLL and non-OPLL cohorts was significantly different ( P < .01), with highest prevalence of OPLL between ages 40 to 49 and 50 to 59 years. Comorbid diabetes also differed between groups (27% OPLL, 13% non-OPLL, P < .01). There was no difference in distribution of sex, race, or ethnicity. For OPLL, segmental type is most common (67.6%), involving on average 3.4 levels. OPLL involvement begins at any level, but ends most commonly at C6 (40.5%) or C7 (36.5%). Among OPLL patients, 18 (24.3%) demonstrated concurrent ponticulus posticus.

Conclusions:

This review of 2917 patients reaffirms previous data, with OPLL prevalence of 2.5%. In asymptomatic patients, incidental diagnosis is frequently seen as early as ages 40 to 49 years. OPLL is better characterized with a significant association with diabetes, segmental type being the most common, and the caudal extent typically involving C6-7 (77%).
Enigmas of grievances about inequality: Effects of attitudes toward inequality and government redistribution on protest participation
Authors: Jo Jung-In , Choi Hyun Jin
Published: March 2019

This study explores the multifaceted calculus behind engagement in protests using data from 45 countries in the World Values Survey Wave 6 (2010–2014), employing a hierarchical linear model. It expands the current scholarship on protest politics by investigating how individual subjective assessment and evaluation of income inequality, and redistributive preferences influence participation in protests. We found that protest is a powerful outlet used by highly educated citizens with strong grievances about economic inequality, and labor union networks, especially in advanced industrialized countries. The empirical analysis further reveals that the salience of redistributive preferences may effectively filter individual responses and become channeled into action in protests in a broader sample. Moreover, we show that the impact of grievances about inequality on protest becomes significant when government social spending is increased and the level of inequality is high. Conversely, conventional macro-level indicators on their own, such as the Gini coefficient of income disparity and social spending, did not explain variance in protest participation. Findings suggest that more systematic research is necessary to detect the precise mechanisms at play that link grievances about inequality and the exponential expansion of protest politics.
Vulvar endometriosis in the setting of a traumatic neuroma
Authors: Wallace Erika , Marin Sara , Elkattah Rayan
Published: March 2019

Endometriosis is a rare documented source of vulvar pain. Extra-pelvic endometriosis and traumatic neuromas have been reported in individual cases as a source of pain in procedure-related scars following gynecologic surgery. However, the presence of vulvar endometriosis within a traumatic neuroma has not been documented before. We describe a case of a 42-year-old woman who presented with a chronic vulvar nodule that became swollen, painful, and pruritic 10 years following a Bartholin’s gland excision. Excision of the lesion was performed, and histological analysis revealed a traumatic neuroma with an embedded focus of endometriosis. The patient had complete resolution of her symptoms following excision. Endometriosis within a traumatic neuroma should be considered as a possible diagnosis in a post-operative scar that becomes painful, swollen, or pruritic in a cyclic nature. Surgical excision with routine and immunohistochemical pathologic analysis aids in the successful diagnosis and treatment.
Adherence to Antidiabetic Medications Among Sudanese Individuals With Type 2 Diabetes Mellitus: A Cross-Sectional Survey
Authors: Badi Safaa , Abdalla Ali , Altayeb Lina , Noma Mounkaila , Ahmed Mohamed H
Published: March 2019

Background:

Adherence to antidiabetic medications is crucial for optimum glycemic control and decreasing complications. This study aimed to assess adherence to antidiabetic medications and the associated factors among individuals with type 2 diabetes attending Jabir Abu Eliz Diabetes Centre in Khartoum state, Sudan.

Methods:

This was a descriptive cross-sectional study, recruited 213 individuals with type 2 diabetes, and used a pretested questionnaire. Data were analyzed using the Statistical Package of Social Sciences version 21. Logistic regression analysis was used to check for factors that linked to poor adherence to diabetes medication.

Results:

The median duration of antidiabetic medications use was 8 years; 15.0% were highly adherent to diabetes medications, 44.6% were medium adherent, and 40.4% showed low adherence. Main factors and barriers were medication side effects (18.3%), use of herbal medicine (12.3%), and unavailability of medication (7%). Predictors to nonadherence were gender, and housing status (0.043 and 0.042, respectively).

Conclusion:

Level of adherence to diabetes medication was unsatisfactory as only 15% showed high adherence. Predictors of nonadherence were gender, and housing status. Effective interventions should be implemented to improve medication adherence, like appropriate patient education and involvement in the treatment plan.
Two Cases of Worsening Psoriasis After Switching From Ustekinumab to Guselkumab
Authors: Casseres Rachel G. , Rosmarin David
Published: March 2019

Introduction:

Guselkumab is an Interleukin-23 inhibitor that has been shown to be effective for the treatment of psoriasis even in patients with an inadequate response to ustekinumab. At this time, there are no published reports of worsening psoriasis or psoriatic arthritis on guselkumab compared to ustekinumab.

Methods:

We reviewed the charts of two patients with psoriasis who were treated in our clinic with guselkumab after failing treatment with ustekinumab.

Results:

The patient in case 1 experienced a psoriasis flare after switching from ustekinumab to guselkumab. The patient in case 2 has an increase in body surface area of her psoriasis as well as worsening joint symptoms while on guselkumab compared to ustekinumab.

Discussion:

Not all patients will have a superior response to guselkumab than ustekinumab.
Building common cause towards sustainable consumption: A cross-generational perspective
Authors: Diprose Kristina , Valentine Gill , Vanderbeck Robert M , Liu Chen , McQuaid Katie
Published: March 2019

The notion of sustainable consumption has gained significant traction in recent decades, in parallel with unprecedented growth in global consumption and recognition of its catastrophic environmental impacts. In this context, there is a predominant generational narrative of frugality versus excess, with younger generations often negatively stereotyped as increasingly consumer-driven and environmentally destructive. We argue that it is important to develop a more nuanced understanding of generational difference, drawing on findings from a cross-generational study in Sheffield, UK, involving participants from the ages of 16–96. The aim of this research was to explore how citizens relate to the idea of sustainable consumption across generations, acknowledging but also seeking to look beyond the common tropes of thrift and the throwaway society. We draw on theories of intergenerational value change and consider how insights from the Common Cause framework, which encourages pro-environmental campaigners to make broad appeals to engage a range of intrinsic values, may be applied to sustainable consumption. In doing so, we reflect on the merits of adopting an expansive definition of sustainable consumption that encompasses the three pillars of sustainability – economic stability, environmental protection and human wellbeing – and identify insights from our research for campaigners and policy makers interested in working with intrinsic values to build common cause across generations.
Experiencing nature with sight impairment: Seeking freedom from ableism
Authors: Bell Sarah L
Published: March 2019

The idea of nature as freedom has long captured the human imagination, particularly since the Romantic era when notions of escapism were underpinned by the idealisation and externalisation of nature. The drive for freedom persists in the findings of much contemporary research examining the contribution of nature to human health and wellbeing. Yet, this work tells us little about how cultural narratives of freedom play out in the lives of people living with impairment and disability, or the constraining ableist assumptions that often underpin popular discourses of nature. This paper aims to address this, drawing on the findings of an in-depth qualitative study exploring how 31 people with varying forms and severities of sight impairment, living in rural and urban areas of England, describe their experiences with(in) diverse types of nature through the life course. Moving beyond the ‘wilderness ideal’ and sensationalised ‘supercrip’ stories that reproduce ableist ideas of bodies without limitation, this paper foregrounds the richly textured ways in which participants experienced feelings of freedom with nonhuman nature. These freedoms are characterised as social, mobile and exploratory. In doing so, it seeks to make room for a range of nature experiences, folding social justice into the growing momentum to connect people with nature in the name of health and wellbeing.