bluuebunny/crossref_metadata_2025 huggingface dataset:
Circulating Leptin, Adiponectin, and Tumor Necrosis Factor-Alpha in Patients Undergoing Surgery Due to Colorectal Cancer
Authors: Tojek Krzysztof , Anaszewicz Marzena , Szukay Beata , Czerniak Beata , Socha Ewa , Lis Kinga , Żbikowska-Gotz Magdalena , Bartuzi Zbigniew , Banaszkiewicz Zbigniew , Budzyński Jacek
Published: November 2019

Background: Adipocytokines have been proposed as factors mediating associations between obesity and inflammation in patients with colorectal cancer (CRC). Thus, the aim of this study was to determine the clinical relationships between blood concentrations of leptin (LEP), adiponectin (ADP), and tumor necrosis factor alpha (TNF-alpha) and the outcomes measured in patients with CRC undergoing surgery. Patients and Methods: History, body composition, and blood concentrations of LEP, ADP, and TNF-alpha were determined in 107 patients undergoing surgery due to CRC. The patients were followed up for 619.72 ± 371.65 days. Results: Compared to patients with stage II CRC, individuals with clinical stage I CRC had significantly lower ADP and higher TNF-alpha blood concentrations. We found significant correlations between the clinical stage of CRC (early vs. localized vs. metastatic) and the following: crude blood ADP concentration (R = 0.25; p = 0.015), ADP-to-TNF-alpha ratio (R = 0.31; p = 0.002), and ADP when indexed to body surface area (R = 0.25; p = 0.008) and to fat mass (R = 0.25; p = 0.016). The risk of death during the long-term follow-up period was independently related to the clinical stage of CRC, impairment of the patient’s functional status, and higher blood carcinoembryonic antigen concentration. In Kaplan-Meier survival analysis, patients with blood LEP concentrations adjusted to a visceral adipose tissue score of ≥0.47 had a significantly better likelihood of surviving than their counterparts. Conclusions: In patients with CRC undergoing surgery, blood ADP and TNF-alpha concentrations were associated with the clinical stage of the cancer, likelihood of radical tumor excision, occurrence of nonsurgical postoperative complications, and long-term survival, which suggests the role of dysregulation in the endocrine function of adipose tissue in response to the neoplasmatic process.
An Analysis of Long-Term Outcomes in Patients Treated by Extensive Bowel Resection Due to Advanced Ovarian Cancer Relative to the Effectiveness of Surgery
Authors: Lepinay Katarzyna , Szubert Sebastian , Lewandowska Agnieszka , Sierant Antoni , Wicherek Lukasz
Published: November 2019

Introduction: Surgery for advanced ovarian cancer (AOC) often requires bowel resections. However, the impact of bowel surgery on patient overall survival (OS) has not yet been precisely determined. Objective: The aim of the study was to analyze the OS rates in a group of AOC patients undergoing bowel resection. Methods: We carried out a retrospective analysis of patients who had undergone low anterior resection of the rectum (LAR) during primary or interval debulking surgery for AOC. We divided the patients into 2 groups: Group 1 included 69 patients who underwent only LAR; Group 2 included 66 patients who underwent LAR and additional bowel resection. The control group included 71 AOC patients who did not required bowel resection. Results: In the subgroup of patients with no gross residual disease (NGR), there were no differences in OS between Groups 1 and 2. In the subgroup of “optimally” (tumors <1 cm) debulked patients, Group 1 patients had a higher median OS than Group 2 patients. Additionally, there was no difference between Groups 1 and 2 as far as the number of severe adverse events. Conclusions: Multiple bowel resections seem to improve OS in patients when NGR is achieved but should be avoided when complete resection is not possible.
E quando o subalterno fala? Ideologia, tradução e ética
Authors: Auad Pedro Trindade
Published: November 2019

Este artigo parte do seminal texto de Gayatri Chakravorty Spivak, Pode o Subalterno Falar? para refletir sobre as impossibilidade de fala, mas também de escuta.  Para tal abordagem, retomamos as discussões sobre ideologia presentes na obra da teórica indiana e seus desdobramos sobre o problema do subalterno. Assim, sendo um problema que se inscreve na linguagem, acionamos teóricos com afinidade com a autora, notadamente Judith Butler e Jacques Derrida, para pensarmos sobre os paradoxos que nascem tanto em certa sujeição ideológica quanto na apropriação da linguagem. Nesse sentido, chegamos ao problema da tradução, entendida como um procedimento social e ético. A tradução, assim, se torna condição necessária para que o subalterno tenha alguma possibilidade de fala.
No tempo de migrar
Authors: Alves Jenima De Souza , Jubran Safa A. C.
Published: November 2019

Resultante do contato com a alteridade inglesa, o texto de Tayeb Salih, Tempo de migrar para o norte, publicado há mais de meio século, continua a suscitar reflexões de uma questão que causa conflitos no mundo hodierno, a migração dos povos. Retratando de maneira intensa a intrincada relação Colônia versus Metrópole, o autor nos apresenta uma outra versão da história que, por tanto tempo, esteve sob controle do colonizador. Considerada uma das mais importantes obras árabes do século XX, foi traduzida ao português pela primeira vez no ano de 2004, e é o único texto árabe, com exceção de As mil e uma noites, a ser reeditado no Brasil.  Dada a importância da novela tanto para o sistema literário árabe como para os estudos pós-coloniais, no presente trabalho propomos uma abordagem do texto que não só o apresente como uma obra que denuncia a exploração colonial inglesa, mas também se posta como um contradiscurso no processo dialógico nas relações Oriente-Ocidente. Por fim, analisaremos alguns excertos do texto que julgamos expressivos e que o distingue como uma obra vanguardista.
Stefan Zweig no país do futuro: Um Intelectual sem pátria o olhar da Imprensa Brasileira, 1936-1942
Authors: Colffield Carol
Published: November 2019

A vida e a morte de Stefan Zweig, um dos mais celebrados escritores em língua alemã a exilar-se no Brasil, são vistos como símbolo do drama dos intelectuais perseguidos pelo nazismo. Embora sua presença física como exilado naquele que denominou o “país do futuro” tenha sido breve –somente alguns meses–, no período que se estende entre a primeira chegada como visitante ao Rio de Janeiro em 1936 e o suicídio em Petrópolis em 1942, seu nome esteve presente na imprensa escrita brasileira quase ininterruptamente. A maneira como sua figura foi retratada nos jornais do país ao longo desses seis anos, no entanto, não foi de maneira alguma unânime e evoluiu ao ritmo dos embates político-históricos da época. Assim, este artigo busca expor por meio de uma seleção de artigos publicados na época, parte dessa evolução através de três momentos: a primeira viagem de Zweig ao país em 1936; a segunda visita em 1940, quando realizou as pesquisas para o livro Brasil, País do Futuro; os meses entre a última chegada em agosto de 1941 e o suicídio em fevereiro de 1942.
Patients’ Willingness to Accept Mitral Valve Procedure-Associated Risks Varies Across Severity of Heart Failure Symptoms
Authors: Reed Shelby D. , Fairchild Angelyn O. , Johnson F. Reed , Gonzalez Juan Marcos , Mentz Robert J. , Krucoff Mitchell W. , Vemulapalli Sreekanth
Published: November 2019

Background:

The Food and Drug Administration’s Center for Devices and Radiological Health issued Guidance in 2016 on generating patient preference information to aid evaluation of medical devices. Consistent with this guidance, we aimed to provide quantitative patient preference evidence on benefit-risk tradeoffs relevant to transcatheter mitral valve repair versus medical therapy for patients with heart failure and symptomatic secondary mitral regurgitation.

Methods:

A discrete-choice experiment survey was designed to quantify patients’ tolerance for 30-day mortality or serious bleeding risks to achieve improvements in physical functioning or reductions in heart failure hospitalizations. Two samples were recruited: an online US panel of individuals reporting a diagnosis of heart failure (n=244) and patients with heart failure treated at Duke University Health System (n=175). Random-effects logit regression was used to model treatment choices as a function of benefit and risk levels.

Results:

Across both samples, approximately one-quarter (23.5%) consistently chose device profiles offering the higher level of physical functioning despite mortality and bleeding risks as high as 10%. Among respondents who at least once chose a device profile offering a lower level of functioning, improvement in physical functioning equivalent to a change from New York Heart Association class IV to III was ≈6 times more preferred than a change from New York Heart Association class III to II. Estimated discrete-choice experiment utility gains and losses revealed that respondents would accept up to a 9.7 percentage-point (95% CI, 8.2%–13.3%) increase in risk of 30-day mortality with devices that could improve functioning from New York Heart Association class IV to III, or up to 2.0% (95% CI, 1.4%–2.7%) for an improvement from New York Heart Association class III to II.

Conclusions:

Severity of heart failure symptoms influences patients’ willingness to accept risks associated with mitral valve medical devices. These findings can inform shared decision-making discussions with patients who are being evaluated for transcatheter mitral valve repair.
Severe Hypouricemia Impairs Endothelium‐Dependent Vasodilatation and Reduces Blood Pressure in Healthy Young Men: A Randomized, Placebo‐Controlled, and Crossover Study
Authors: De Becker Benjamin , Coremans Catherine , Chaumont Martin , Delporte Cédric , Van Antwerpen Pierre , Franck Thierry , Rousseau Alexandre , Zouaoui Boudjeltia Karim , Cullus Pierre , van de Borne Philippe
Published: November 2019

Background

Uric acid (
UA
) is a plasmatic antioxidant that has possible effects on blood pressure. The effects of
UA
on endothelial function are unclear. We hypothesize that endothelial function is not impaired unless significant
UA
depletion is achieved through selective xanthine oxidase inhibition with febuxostat and recombinant uricase (rasburicase).

Methods and Results

Microvascular hyperemia, induced by iontophoresis of acetylcholine and sodium nitroprusside, and heating‐induced local hyperemia after iontophoresis of saline and a specific
nitric oxide
synthase inhibitor were assessed by laser Doppler imaging. Blood pressure and renin‐angiotensin system markers were measured, and arterial stiffness was assessed. CRP (C‐reactive protein), allantoin, chlorotyrosine/tyrosine ratio, homocitrulline/lysine ratio, myeloperoxidase activity, malondialdehyde, and interleukin‐8 were used to characterize inflammation and oxidative stress. Seventeen young healthy men were enrolled in a randomized, double‐blind, placebo‐controlled, 3‐way crossover study. The 3 compared conditions were placebo, febuxostat alone, and febuxostat together with rasburicase. The allantoin (μmol/L)/
UA
(μmol/L) ratio differed between sessions (
P
<0.0001). During the febuxostat‐rasburicase session, heating‐induced hyperemia became altered in the presence of
nitric oxide
synthase inhibition; and systolic blood pressure, angiotensin
II,
and myeloperoxidase activity decreased (
P
≤0.03 versus febuxostat). The aldosterone concentration decreased in the febuxostat‐rasburicase group (
P
=0.01). Malondialdehyde increased when
UA
concentration decreased (both
P
<0.01 for febuxostat and febuxostat‐rasburicase versus placebo). Other parameters remained unchanged.

Conclusions

A large and short‐term decrease in
UA
in humans alters heat‐induced endothelium‐dependent microvascular vasodilation, slightly reduces systolic blood pressure through renin‐angiotensin system activity reduction, and markedly reduces myeloperoxidase activity when compared with moderate
UA
reduction. A moderate or severe hypouricemia leads to an increase in lipid peroxidation through loss of antioxidant capacity of plasma.

Clinical Trial Registration

URL
:
http://www.clinicaltrials.gov
. Unique identifier:
NCT
03395977.
Plasma Aldosterone Levels Are Not Associated With Cardiovascular Events Among Patients With High‐Risk Vascular Disease: Insights From the ACCELERATE Trial
Authors: Kumar Anirudh , Patel Divyang R. , Brennan Danielle M. , Wolski Kathy E. , Lincoff A. Michael , Ruotolo Giacomo , McErlean Ellen , Weerakkody Govinda , Riesmeyer Jeffrey S. , Nicholls Stephen J. , Nissen Steven E. , Menon Venu
Published: November 2019

Background

The failure of cholesteryl ester transfer protein inhibitor torcetrapib was associated with an off‐target increase in plasma aldosterone. We sought to evaluate the impact of evacetrapib on plasma aldosterone level and determine the association between plasma aldosterone level and major adverse cardiovascular events among patients with stable high‐risk vascular disease enrolled in the
ACCELERATE
(Assessment of Clinical Effects of Cholesteryl Ester Transfer Protein Inhibition With Evacetrapib in Patients at a High Risk for Vascular Outcomes) trial.

Methods and Results

We included all patients with a plasma aldosterone level (N=1624) and determined the impact of evacetrapib exposure compared with placebo on plasma aldosterone levels after 12 months of treatment. Using baseline and postexposure aldosterone levels, hazard ratios for major adverse cardiovascular events (cardiovascular death, nonfatal myocardial infarction, cerebrovascular accident, hospitalization for unstable angina, and revascularization) with increasing quartile of baseline and percentage change in plasma aldosterone level at follow‐up were calculated. The average age was 65.2 years, 75.7% were men, 93.7% were hypertensive, 73.3% were diabetic, and 57.6% had a prior myocardial infarction. Baseline plasma aldosterone level (85.2 [43, 150] versus 86.8 [43, 155] pmol/L;
P
=0.81) and follow‐up percentage change (13.6% [−29, 88] versus 17.9% [−24, 87];
P
=0.23) were similar between those who received evacetrapib and placebo. During median follow‐up of 28 months, major adverse cardiovascular events occurred in 263 patients (16.2%). The hazard ratios for increasing quartile of baseline or percentage change in plasma aldosterone level at follow‐up were not significant for major adverse cardiovascular events. These findings remained consistent when adjusting for significant characteristics.

Conclusions

Exposure to evacetrapib did not result in significant change in plasma aldosterone levels compared with placebo. Among patients with stable high‐risk vascular disease, plasma aldosterone levels were not a predictor for future cardiovascular events.

Clinical Trial Registration

URL
:
http://www.ClinicalTrials.gov
. Unique identifier:
NCT
01687998.
The History of Quantification in History: The JIH as a Case Study
Authors: Ruggles Steven , Magnuson Diana L.
Published: November 2019

The use of quantitative methods in leading historical journals increased dramatically in the 1960s and declined sharply after the mid-1980s. The JIH is an invaluable source for analysis of the boom and bust in the use of quantitative methods in history; the journal remained under the same editors for almost fifty years and made no attempt to change editorial policies during that period. Shifting patterns of content and authorship in the JIH from the 1980s to the early 2000s reveal how the journal responded to a dramatic decline in quantitative submissions by U.S.-based historians. Recent years have seen a revival of quantification both in the JIH and in mainstream historical journals, especially among historians located at institutions outside the United States.
Bicentennial Thoreau
Authors: Buell Lawrence
Published: November 2019

Recent Thoreau scholarship is remarkable for breakthroughs in the study of his life, writing, and scientific pursuits and for conceiving this proverbial outlier's genius as expressing itself within norms of family, community, discipline. Studies of the political Thoreau test the limits variously set by Walls, Gross, Thorson, Arsić, and others.
Effects of food restriction on body mass, energy metabolism and thermogenesis in a tree shrew (Tupaia belangeri)
Authors: Hong-bi Peng , Dong-min Hou , Di Zhang , Wan-long Zhu
Published: November 2019

The metabolic switch hypothesis refers to an ability to adjust metabolic rate. It plays a key role in animals adapted to periods of food shortage, enabling them to “switch down” their resting metabolic rate and to survive and maintain their weight indefinitely on limited rations. The present study investigates the energy strategies of a small mammal in response to food shortages as a function of food restriction, metabolic rate and ambient temperature. We subjected tree shrews (Tupaia belangeri) to food restriction and measured body mass, survival rate, resting metabolic rate, non-shivering thermogenesis and cytochrome c oxidase activity of brown adipose tissue. Cold-exposed animals restricted to 80% of ad libitum food intake had significantly increased resting metabolic rate and non-shivering thermogenesis and decreased body mass and survival rates compared with those kept as control group on the same ood restriction level. Animals classified as having a high resting metabolic rate consumed 30.69% more food than those classified as having a low resting metabolic rate, but showed no differences in body mass or survival when restricted to 80% of ad libitum food intake. These results indicate that tree shrews, known for their relatively high metabolic rates, are sensitive to periods of food restriction, which supports the metabolic switch hypothesis. Our findings are also consistent with the prediction that small mammals with food hoarding behaviors, like tree shrews, may have a lower tolerance for food shortages than non-hoarding species.
American Gnosis: Jesus Mysticism in A Course in Miracles
Authors: Joseph Simon J.
Published: November 2019

Since its publication in 1975, A Course in Miracles (ACIM) has continued to grow in popularity as a major feature of New Age spirituality. While the text of the Course is not a direct imitation of any particular form of ancient Gnosticism, A Course in Miracles represents an example of the emergence, reception, and popularity of gnosticizing trajectories of thought in the New Age movement. As a modern-day neo-Gnostic text, A Course in Miracles reflects significant trends in contemporary Western religiosity, especially the quest for alternative forms of esoteric, spiritual, and mystical knowledge and experience in a nominally Christian or post-Christian Western world increasingly disillusioned with traditional orthodox theology, Christology, and ethics.
A Taxonomic Revision of Fern Genus Pseudocyclosorus (Thelypteridaceae) from China and the Pan-Himalaya Region, with Special Reference to the Identity of Pseudocyclosorus stramineus

Authors: LI ZHONG-YANG , ZHANG XIAN-CHUN , LIANG ZHEN-LONG , LI JIE
Published: November 2019

The fern genus Pseudocyclosorus (Thelypteridaceae) from China and the Pan-Himalaya region is revised based on morphological study. Reduced basal pinnae, angles between costule and costae, and glands/hairs on abaxial surfaces/indusia are considered as the most diagnostic morphological characters for species delimitation. Genus Trigonospora was excluded from genus Pseudocyclosorus. This segregation is supported by multiple morphological features. Eight species were recognized here, namely Pseudocyclosorus tylodes, P. pseudofalcilobus, P. falcilobus, P. subochthodes, P. stramineus, P. ornatipes, P. esquirolii and P. canus. Twenty-one names were reduced as new synonyms. One name (P. duclouxii) was considered a dubious species. A key to these eight species, their descriptions, spore morphology and distribution map of each species are given.         Pseudocyclosorus stramineus was a long overlooked species, which has always been misidentified as other similar species, and was wrongly reduced as a synonym of P. duclouxii. Here based on morphology characters, the identity of P. stramineus as a species was reclaimed. A more detailed description with photographs and illustrations, and its whole distribution range are given here.
A taxonomic revision of Chinese Boesenbergia (Zingiberaceae), with a new record

Authors: CHEN JUAN , XIA NIAN-HE
Published: November 2019

The taxonomic history of Boesenbergia (Zingiberaceae) in China is reviewed. Based on field observations and herbarium specimen studies, a comprehensive taxonomic revision of Chinese Boesenbergia is carried out. The results suggest that those specimens previously misidentified as B. longiflora and B. fallax in China should be either B. maxwellii or B. kingii. Boesenbergia maxwellii is newly recorded for the country. Altogether, four species are recognized for China. Keys, descriptions, distributions and illustrations of all recognized species are presented.
Building Regional Identity: Social and Cultural Significance of Railways for Cornwall in the Late Nineteenth and Early Twentieth Centuries
Authors: Harris Richard J.P.
Published: November 2019

Railways have contributed to the complex mosaic of Cornish identity in three ways. First, as a holiday destination promoted from late Victorian times until the Second World War by companies such as the Great Western Railway, London and South Western Railway and Southern. Initially marketing its mild climate and health benefits as an alternative to holidaying abroad evolved, from the 1920s, into an enduring tourist gaze of romantic landscapes, myth and legend. Second, structural changes in the Cornish economy in association with a decline in metal mining precipitated large-scale emigration which continued until the start of the First World War. Railways represented the initial phase of the emigrant journey and the volume of migration was such that their role has become part of a cultural text signifying both loss and opportunity. Lastly, their physical presence and contribution to the landscape adds a further layer of social and cultural significance to Cornish identity.
The Impact of a Brief Meeting on Employer Attitudes, Knowledge, and Intent to Hire
Authors: McDonnall Michele C. , Antonelli Karla
Published: November 2019

We evaluated the ability of an intervention that consisted of a one-on-one meeting between a vocational rehabilitation (VR) professional and an employer to improve employer attitudes, knowledge, and intent to hire people who are blind or visually impaired. We evaluated the relative effectiveness of two approaches (dual customer vs. educational) and the impact of the VR professionals’ vision status (blind or sighted) on our primary outcome measures and on interest in follow-up. Participants were 59 hiring managers employed by a large company who completed measures at three time points: pre, post, and 4-month follow-up. We found that, regardless of approach used or vision status of the VR professional, the intervention was successful at improving employers’ attitudes, knowledge, and intent to hire. The educational approach resulted in increases in knowledge that were retained at follow-up, while the dual customer approach did not. Improvements in intent to hire were not retained at follow-up, suggesting that ongoing contact with employers will be beneficial to positively impact the hiring of people who are blind or visually impaired. These findings are particularly relevant given the Workforce Innovation and Opportunity Act’s focus on employer engagement for VR agencies.
Methodological Thinking Drills: A Novel Technique for Boosting Real-World Methodological Thinking Ability
Authors: Cascio Ted V.
Published: November 2019

Multiple studies have demonstrated the efficacy of various psychological critical thinking interventions. The current study tests a novel technique for improving introductory psychology students’ ability to identify and evaluate methodological concepts in real-life media by prompting them to analyze secondary source news and blog articles. Participants randomly assigned to the experimental group completed three separate methodological thinking drills (MTDs), whereas control participants completed two reflection activities followed by a single MTD. Evidence for the effectiveness of the MTD intervention was found with respect to the within-group comparisons in the experimental condition and also the between-group comparison, indicating linear improvements in scores over time and across groups. These results suggest that methodological thinking can be taught and assessed simultaneously using a single, internally valid procedure.
Comparing Two Models of Collaborative Testing for Teaching Statistics
Authors: Eastridge June A. , Benson Wendi L.
Published: November 2019

Research on collaborative testing has shown that it decreases test anxiety, increases learning and critical thinking skills, and allows students to practice collaboration and teamwork. However, it has most often been used as a second test following traditional individual testing. This quasi-experimental study compared two models of collaborative testing in an introductory statistics course. Students who experienced collaborative testing as a pretest ( n = 35) and as a posttest ( n = 33) were compared with a control group ( n = 61) that experienced traditional individual testing only. Grade book data and a survey administered at the end of the semester provided information on student attitudes and perceptions toward learning statistics and use of collaborative testing, and the impact of each model on student learning. The same instructor taught all students and administered the same tests. The authors found that group-first testing was favored by students and provided the greatest benefit for reducing anxiety while still supporting student learning.
Longitudinal study of cerebral blood flow regulation during exercise in pregnancy
Authors: Matenchuk Brittany A , James Marina , Skow Rachel J , Wakefield Paige , MacKay Christina , Steinback Craig D , Davenport Margie H
Published: November 2019

Cerebrovascular adaptation to pregnancy is poorly understood. We sought to assess cerebrovascular regulation in response to visual stimulation, hypercapnia and exercise across the three trimesters of pregnancy. Using transcranial Doppler (TCD) ultrasound, middle and posterior cerebral artery mean blood velocities (MCAvmean and PCAvmean) were measured continuously at rest and in response to (1) visual stimulation to assess neurovascular coupling (NVC); (2) a modified Duffin hyperoxic CO2 rebreathe test, and (3) an incremental cycling exercise test to volitional fatigue in non-pregnant ( n = 26; NP) and pregnant women (ﬁrst trimester [ n = 13; TM1], second trimester [ n = 21; TM2], and third trimester [ n = 20; TM3]) in total 47 women. At rest, MCAvmean and PETCO2 were lower in TM2 compared to NP. PCAvmean was lower in TM2 but not TM1 or TM3 compared to NP. Cerebrovascular reactivity in MCAvmean and PCAvmean during the hypercapnic rebreathing test was not different between pregnant and non-pregnant women. MCAvmean continued to increase over the second half of the exercise test in TM2 and TM3, while it decreased in NP due to differences in ΔPETCO2 between groups. Pregnant women experienced a delayed decrease in MCAvmean in response to maximal exercise compared to non-pregnant controls which was explained by CO2 reactivity and PETCO2 level.
An Age-Based Approach to Anterior Shoulder Instability in Patients Under 40 Years Old: Analysis of a US Population
Authors: Leland Devin P. , Bernard Christopher D. , Keyt Lucas K. , Krych Aaron J. , Dahm Diane L. , Sanchez-Sotelo Joaquin , Camp Christopher L.
Published: November 2019

Background:

While a large volume of literature has focused on risk factors for anterior shoulder instability, the rates of recurrence are inconsistent and require additional population-based epidemiologic data.

Purpose/Hypothesis:

The purpose was to report the effect of patient age on the number of instability events before physician consultation, rate of surgical stabilization, recurrent instability, and progression to osteoarthritis in patients <40 years old with anterior shoulder instability, utilizing an established US geographic population. We hypothesized that younger patients would be more likely to experience multiple episodes of instability before evaluation, undergo surgery, and experience recurrent instability after surgical intervention.

Study Design:

Descriptive epidemiologic study.

Methods:

An established geographic database of more than 500,000 patients was used to identify patients <40 years of age with anterior shoulder instability between 1994 and 2016. Medical records were reviewed to obtain patient characteristics, history, imaging, surgical details, and outcomes. Patients were divided into 5 groups based on age (≤15, 16-20, 21-25, 26-30, and 31-40 years) at initial instability. Comparative analysis was performed to identify differences between groups.

Results:

The study population consisted of 654 patients with a mean follow-up of 11.1 years (range, 2.0-25.2 years). This resulted in 118 patients (18%) ≤15 years of age at initial instability; 250 (38%), 16 to 20 years; 110 (17%), 21 to 25 years; 80 (12%), 26 to 30 years; and 96 (15%), 31 to 40 years. Of patients ≤15 years old at initial instability 47% had 3+ instability events, compared with 12% of patients aged 31 to 40 years ( P < .001). At 10 years of follow-up, patients ≤15 and 16 to 20 years old demonstrated the highest recurrent instability rates of 38.8% and 47.1% after nonoperative management, respectively. Patients 16 to 20 years old demonstrated the highest rates of both surgical intervention (40.4%) and recurrence after surgery (24.8%). Patients 31 to 40 years of age were significantly more likely to develop clinically symptomatic osteoarthritis (15.6%) than all other age groups.

Conclusion:

In a US epidemiologic population of patients <40 years old, the rate of recurrent anterior shoulder instability was roughly one-third after initial physician consultation. Younger patients, particularly those ≤15 and 16 to 20 years of age, were more likely to have experienced multiple instability events at the time of initial evaluation, require surgery, and experience recurrent instability compared with older patients. For every year of decrease in age at initial instability, the risk of recurrent instability or surgical intervention after physician consultation increased by 4.1% and 2.8%, respectively.
Sustainable municipal solid waste disposal supply chain analysis under price-sensitive demand: A game theory approach
Authors: Ghalehkhondabi Iman , Maihami Reza
Published: November 2019

The impacts of price and sustainability on municipal waste disposal demand have largely been ignored by waste management researchers. This paper considers a waste disposal supply chain that includes a disposal facility and a contractor. Both parties try to improve source sorting for waste collection to reduce the recycling cost at the disposal facility. Improving source sorting requires investment that would increase the price of the waste disposal service, thereby affecting the price-sensitive demand. The relationship between the service price and investments in waste sorting motives is analyzed in this paper via studying the trade-off between the optimal source sorting and the waste disposal service prices. Different scenarios based on the various players’ power structures are developed. Nash and Stackelberg games have been applied in order to find the optimal decision values in each scenario. The impact of cost sharing on optimal supply chain decisions is also studied. The numerical results show that the waste supply chain is more profitable when it is working under an integrated management structure. Moreover, reducing the required investment motivates supply chain players to select higher levels of waste sorting at the source. A numerical example is provided, followed by some managerial insights.
Response surface optimization and statistical analysis of composites made from calcium carbonate filler-added recycled polypropylene and rubberwood fiber
Authors: Srivabut Chainarong , Ratanawilai Thanate , Hiziroglu Salim
Published: November 2019

Mixture design method of experiments was used to determine the compositions of wood-plastic composite samples manufactured from recycled polypropylene (rPP), rubberwood flour (RWF), and calcium carbonate (CC). Factors were determined the mixture compositions rPP, RWF, CC, maleic anhydride-grafted polypropylene (MAPP), ultraviolet (UV) stabilizer, and lubricant (Lub) on properties of the samples, namely tension, compression, surface roughness, water absorption (WA), thickness swelling (TS), and thermogravimetric analysis (TGA). The specimens were produced by extrusion and compression molding methods. The analysis of variance and response surface methodology were employed for the analysis and optimization of the compositions. Optimal composition for overall response was 51.8 wt% rPP, 35.9 wt% RWF, 7.2 wt% CC, 3.9 wt% MAPP, 0.2 wt% UV stabilizer, and 1.0 wt% Lub with desirability score combining their output value of 0.757. The addition of CC content increased the mechanical properties but decreased the WA and TS. A high RWF content increased WA and TS with longer immersion times. The TGA of composites mainly depends on the chemical components of RWF and rPP types. The scanning electron microscope morphology in the composites with different amount of CC increased their densities due to good dispersion of CC as filler and good contact between the RWF reinforcement and rPP matrix.
A multi-objective model for a nurse scheduling problem by emphasizing human factors
Authors: Hamid Mahdi , Tavakkoli-Moghaddam Reza , Golpaygani Fereshte , Vahedi-Nouri Behdin
Published: November 2019

Assigning nurses to appropriate departments and work shifts based on human factors can strengthen teamwork and boost the efficiency of healthcare systems. The human factors considered in this study include skill, preference, and compatibility of nurses. In this regard, a unique multi-objective mathematical model for nurse scheduling is proposed in this article, in which nurses’ decision-making styles are taken into account. Three objectives, including minimization of the total cost of staffing, minimization of the sum of incompatibility among nurses’ decision-making styles assigned to the same shift days, and maximization of the overall satisfaction of nurses for their assigned shifts, are addressed in this model. Three meta-heuristics, namely, multi-objective Keshtel algorithm, non-dominated sorting genetic algorithm II, and multi-objective tabu search, are developed to solve the problem. Moreover, a data envelopment analysis method is employed to rank the obtained Pareto solutions. Afterwards, a real-life case at a large hospital in Tehran, Iran, is investigated. Eventually, the applicability and effectiveness of the proposed model are assessed based on the experimental results.
Disability as a predictor of breast cancer screening uptake: A population-based study of 57,328 women
Authors: Ross Emma , Maguire Aideen , Donnelly Michael , Mairs Adrian , Hall Clare , O’Reilly Dermot
Published: November 2019

Objective

Despite a growing body of evidence suggesting inequalities in breast cancer screening uptake in the United States for women with disabilities, few attempts have been made to examine whether this association applies to the United Kingdom. We conducted the first population-wide study investigating the impact of disability on uptake of breast cancer screening in Northern Ireland.

Methods

Breast screening records extracted from the National Breast Screening System were linked to the Northern Ireland Longitudinal Study. This identified a cohort of 57,328 women who were followed through one complete three-year screening cycle of the National Health Service Breast Screening Programme in Northern Ireland. The presence of disability was identified from responses to the 2011 Census.

Results

Within this cohort, 35.8% of women reported having at least one chronic disability, and these individuals were 7% less likely to attend compared with those with no disability (odds ratio 0.93; 95% confidence interval 0.89–0.98). Variation in the degree of disparity observed was evident according to the type and number of comorbid disabilities examined.

Conclusion

This is the first population-wide study in Northern Ireland to identify disparities in breast screening uptake for women with chronic disabilities, in particular, those with multimorbidity. This is of particular concern, given the projected rise in the prevalence of disability associated with the ageing population.
Thinking beyond the binary: Barriers to trans* participation in university sport
Authors: Phipps Catherine
Published: November 2019

Sport is a significant part of university life in the UK, where students may try new sports for the first time. Research also demonstrates links between sport participation and mental health and employment prospects. Despite the positive aspects of university sports, by mimicking wider sport practices, they may also be environments that exclude non-normative bodies, including those who are trans*. The experiences of trans* people in sport is still a limited research area, with existing studies suggesting a range of exclusionary practices are evident. However, it is currently unclear to what extent these practices are replicated in the university sport environment across institutions in the UK. As part of a broader study on LGBT+ inclusion in UK university sport, focus groups with student union officers and LGBT+ students were conducted, with one student identifying as trans*. Data derived from the trans* student, alongside the viewpoints of officers, suggests further action can be taken to ensure university sport is inclusive to all, particularly in regard to the reliance on wider binary gender structures in sport, which are also evident in the British Universities and Colleges Sport transgender policy. This research may be useful for student unions, university sport clubs and other bodies in control of sport provision to increase inclusion for all.
Development of a high-throughput real-time PCR system for detection of enzootic pathogens in pigs
Authors: Goecke Nicole B. , Hjulsager Charlotte K. , Krog Jesper S. , Skovgaard Kerstin , Larsen Lars E.
Published: November 2019

Respiratory and intestinal diseases in pigs can have significant negative influence on productivity and animal welfare. A wide range of real-time PCR (rtPCR) assays are used in our laboratory (National Veterinary Institute, Technical University of Denmark) for pathogen detection, and PCR analyses are performed on traditional rtPCR platforms in which a limited number of samples can be analyzed per day given limitations in equipment and personnel. To mitigate these restrictions, rtPCR assays have been optimized for the high-throughput rtPCR BioMark platform (Fluidigm). Using this platform, we developed a high-throughput detection system that can be used for simultaneous examination of 48 samples with detection specificity for 18 selected respiratory and enteric viral and bacterial pathogens of high importance to Danish pig production. The rtPCR assays were validated and optimized to run under the same reaction conditions using a BioMark 48.48 dynamic array (DA) integrated fluidic circuit chip, and the sensitivity and specificity were assessed by testing known positive samples. Performance of the 48.48DA was similar to traditional rtPCR analysis, and the specificity of the 48.48DA was high. Application of the high-throughput platform has resulted in a significant reduction in cost and working hours and has provided production herds with a new innovative service with the potential to facilitate the optimal choice of disease control strategies such as vaccination and treatment.
Exploring Relational and Parental Factors for Permanency Outcomes of Children in Care
Authors: Antle Becky F. , Barbee Anita P. , Sar Bibhuti K. , Sullivan Dana J. , Tarter Kirsten
Published: November 2019

This research examined the impact of individual and relational characteristics of foster parents on permanency outcomes for children in care. Previous research has focused on child and case characteristics. The sample consisted of 233 foster parents from the public child welfare system surveyed at the end of a training. The results of the surveys showed that couple relationship quality and altruism were predictive of reunification of foster children with biological parent. The significant predictors of placement in a residential facility were age, education, and avoidant attachment style of the foster parent. Practice and policy implications are discussed.
Project Stomp: Using Graphic Notation for Effective Multimodal Collaborative Learning
Authors: Ng Hoon Hong
Published: November 2019

A mode is a socially and culturally shaped resource for making meaning. Examples of modes include written and oral language, visuals, audio, and gestures. In music learning, multiple modes may be used to help students develop greater musical understanding and achievement. This article details the three steps utilized in Project Stomp, a systematic pedagogical course of study that utilized multiple representational modes to engage a diverse group of secondary students in a composition- and performance-based module of study.
Self-Reported Parenting Stress and Cortisol Awakening Response Following Mindfulness-Based Stress Reduction Intervention for Parents of Children With Developmental Delays: A Pilot Study
Authors: Roberts Lisa R. , Boostrom G. Griffin , Dehom Salem O. , Neece Cameron L.
Published: November 2019

Background:

Many parents of children with developmental delays (DDs) experience high levels of parental stress, and young children with DDs are likely to exhibit clinical levels of behavioral problems. The reciprocal relationship between the two issues makes these families vulnerable to stress-related health risks. To address this, the current study aims to investigate the effectiveness of mindfulness-based stress reduction (MBSR) at reducing parent stress, as measured by both psychological self-report and a physiological biomarker.

Method:

A pretest–posttest design with a 6-month follow-up assessment was used to establish effectiveness with analyses of within-subject effects. Parents ( N = 47) of children (2.5–5 years of age) with DDs participated in a standard 8-week MBSR intervention. Measures included the Parenting Daily Hassles, a self-report measure of perceived frequency and intensity of parenting stress, and salivary samples for measurement of the cortisol awakening response (CAR), a biological marker of stress response.

Results:

Both self-reported parenting stress and CAR decreased following MBSR for parents of children with DDs. The greatest difference in means over time was between baseline and follow-up, where changes in effect size were even stronger for biological markers than for self-report measures.

Conclusion:

The MBSR intervention reduced both perceived and physiologic stress. Health-care professionals caring for these families might consider encouraging parents to participate in MBSR as both treatment and prevention of parenting stress.
Diverse Australians on television: from nostalgic whiteness to aspirational multiculturalism
Authors: Khorana Sukhmani
Published: November 2019

This article delivers preliminary findings from a series of interviews with Australian migrant producers, directors and writers. With the increasing calls for diversity in the media generally, and on television screens specifically from a wide range of stakeholders (institutions like Screen Australia, advocacy groups and high-profile media personnel of colour), there is ample empirical evidence that our public and commercial broadcasters have a long way to go in terms of ‘reflecting’ contemporary Australia. There is also more emphasis on institutionalised strategies, and looking towards overseas models to make this happen. Using the discourses of official and everyday multiculturalism, this article unpacks what it means to ‘reflect reality’, versus the meaning of various kinds of aspirational content, especially in drama and comedy. Such an analysis is crucial to understand the value of diversity beyond the simplistic rationale of ‘reflection’, and particularly in a changing mediascape.
Testing the efficacy of the economic policy uncertainty index on tourism demand in USMCA: Theory and evidence
Authors: Işık Cem , Sirakaya-Turk Ercan , Ongan Serdar
Published: November 2019

The global economic outlook is more uncertain than ever before and sensitive to uncertainties related to a variety of economic policies decisions of all stakeholders and governments. These perceived uncertainties may be the culprit in shrinking the size of overall economic activity. Under increasing uncertainties, travel and vacation plans of consumers can be canceled or postponed. Therefore, policy-related economic uncertainties are expected to affect tourism demand beyond well-established economic and noneconomic factors. In this study, we explore the efficacy and the impact of the economic policy uncertainty (EPU) index in predicting the tourism demand on international tourist arrivals (a measure of tourism demand) to the United States from Mexico and Canada over the period of January 1996–September 2017. The findings of the study reveal that EPU is a significant predictor as increases in the EPU index lead to decreases in tourism demand to the United States. Canadian tourists seem to be more sensitive to EPUs. Increases in the EPU index cause them to reduce Canadians’ vacations to the United States proportionally more than the Mexicans. To enhance the explanatory power of current models, the uncertainty can be a theoretically significant construct thus needs to be included when calibrating demand models.
Instructions to attend to an observed action increase imitation in autistic adults
Authors: Gowen Emma , Vabalas Andrius , Casson Alexander J , Poliakoff Ellen
Published: November 2019

This study investigated whether reduced visual attention to an observed action might account for altered imitation in autistic adults. A total of 22 autistic and 22 non-autistic adults observed and then imitated videos of a hand producing sequences of movements that differed in vertical elevation while their hand and eye movements were recorded. Participants first performed a block of imitation trials with general instructions to imitate the action. They then performed a second block with explicit instructions to attend closely to the characteristics of the movement. Imitation was quantified according to how much participants modulated their movement between the different heights of the observed movements. In the general instruction condition, the autistic group modulated their movements significantly less compared to the non-autistic group. However, following instructions to attend to the movement, the autistic group showed equivalent imitation modulation to the non-autistic group. Eye movement recording showed that the autistic group spent significantly less time looking at the hand movement for both instruction conditions. These findings show that visual attention contributes to altered voluntary imitation in autistic individuals and have implications for therapies involving imitation as well as for autistic people’s ability to understand the actions of others.