bluuebunny/crossref_metadata_2025 huggingface dataset:
Repeated measurements of renal function in evaluating its decline in cats
Authors: Finch Natalie C , Syme Harriet M , Elliott Jonathan
Published: February 2018

Objectives

The aim of this study was to describe the variability in renal function markers in non-azotaemic and azotaemic cats, and also the rate of change in the markers.

Methods

Plasma creatinine concentration and its reciprocal, glomerular filtration rate (GFR) and urine specific gravity (USG) were studied as markers of renal function in client-owned cats. GFR was determined using a corrected slope-intercept iohexol clearance method. Renal function testing was performed at baseline and a second time point. The within-population variability (coefficient of variation; CV%) was determined at the baseline time point. Within-individual variability (CV%) and rate of change over time were determined from the repeated measurements.

Results

Twenty-nine cats were included in the study, of which five had azotaemic chronic kidney disease. The within-individual variability (CV%) in creatinine concentration was lower in azotaemic cats than in non-azotaemic cats (6.81% vs 8.82%), whereas the within-individual variability in GFR was higher in azotaemic cats (28.94% vs 19.98%). The within-population variability was greatest for USG (67.86% in azotaemic cats and 38.00% in non-azotaemic cats). There was a negative rate of change in creatinine concentration in azotaemic and non-azotaemic cats (–0.0265 and –0.0344 µmol/l/day, respectively) and a positive rate of change of GFR in azotaemic and non-azotaemic cats (0.0062 and 0.0028 ml/min/day, respectively).

Conclusions and relevance

The within-individual variability data suggest creatinine concentration to be the more useful marker for serial monitoring of renal function in azotaemic cats. In contrast, in non-azotaemic cats, GFR is a more useful marker for serial monitoring of renal function. The majority of cats with azotaemic CKD did not have an appreciable decline in renal function during the study.
Extending access to care across the rural US south: Preliminary results from the Alabama eHealth programme
Authors: Jain Kriti M , Bhat Prashanth , Maulsby Cathy , Andersen Alexandria , Soto Tomas , Tarrant Ashley , Holtgrave David R , Nortrup Erin , Werner Melissa , Dill Laurie
Published: February 2018

Purpose

Using a mixed-methods formative evaluation, the purpose of this study was to provide a broad overview of the Alabama eHealth programme set-up and initial patient outcomes. The Alabama eHealth programme uses telemedicine to provide medical care to people living with HIV in rural Alabama. It was led by a community-based organisation, Medical Advocacy and Outreach (MAO), and supported by AIDS United and the Corporation for National Community Service’s Social Innovation Fund with matching support from non-federal donors.

Methods

We conducted and transcribed in-depth interviews with Alabama eHealth staff and then performed directed content analysis. We also tracked patients’ ( n = 240) appointment attendance, CD4 counts, and viral loads.

Findings

Staff described the steps taken to establish the programme, associated challenges (e.g., costly, inadequate broadband in rural areas), and technology enabling this programme (electronic medical records, telemedicine equipment). Of all enrolled patients, 76% were retained in care, 88% had antiretroviral therapy and 75% had a suppressed viral load. Among patients without missing data, 96% were retained in care, 97% used antiretroviral therapy and 93% had suppressed viral loads. There were no statistically significant demographic differences between those with and without missing data.

Conclusions

Patients enrolled in a telemedicine programme evaluation successfully moved through the HIV continuum of care.
Risk factors influencing severity of attention deficit hyperactivity disorder in a sample of preparatory school students in Cairo
Authors: Ramy Hisham , El Sheikh Mona , Sultan Marwa , Bassim Rasha , Eid Maissa , Ali Ramy , El Missiry Marwa
Published: February 2018

Background:

Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood psychiatric disorders. Severity of symptoms is associated with more behavioral problems, poor academic performance, and persistence of symptoms into adulthood.

Methods:

To examine the clinical and social correlates that may be identified as risk factors associated with ADHD severity in a sample of adolescent ADHD school students. A total of 925 students were recruited from two public and two private schools from eastern Cairo. They were interviewed using Conners-Wells Adolescent Self-Report—short version (CASS-S); students scoring more than 65 were further interviewed with Kiddie Schedule for Affective Disorders and Schizophrenia—present and lifetime version (K-SADS-PL) to confirm the diagnosis, then Conners-Wells Adolescent Self-Report—long version (CASS-L) to assess severity and Wechsler Intelligence Scale for Children (WISC) to ascertain intellectual ability.

Results:

About 10.3% of cases were severe, 5.7% were moderate, and 83.9% were mild. Severity was significantly associated with female gender, psychiatric comorbidity, family problems, conduct symptoms, and poor anger management. Diagnostic and Statistical Manual of Mental Disorders (4th ed.) ( DSM-IV) hyperactive–impulsive type was the only predictive factor of ADHD severity.

Conclusions:

The diagnosis of hyperactive–impulsive subtype may predict the severity of ADHD symptoms.
Colonising antinormative sex: The flexibility of post-porn heterosex in random webcam sex
Authors: Gregory Tim
Published: February 2018

Random webcam encounters first came into popular consciousness with the rise of Chatroulette in 2009. Since then, various websites have emerged based on a similar model, catering specifically to webcam based sexual practices. This article focuses on one of these sites, Dirtyroulette, and argues that it is an example of what I am calling ‘post-porn heterosex’—defined by the increasing acceptance of pornography into heterosex. An examination of the dialectics of engagement on Dirtyroulette—the complex navigation of public and private, boredom and attention, exhibitionism and voyeurism, signal and noise, and randomness and consistency—reveals how users perform post-porn sex acts. For Dirtyroulette users the normative is not opposed to the nonnormative, and sex acts which appear transgressive or homosocial may be demonstrating how heterosex colonises emergent sexual practices and spaces. This article speculates as to why the site is not a space for antinormative sex, and why the majority of sex acts should be considered as post-porn heterosex. Dirtyroulette demonstrates that post-porn heterosex is more fluid than the public, symbolic and static images of heterosex that form the foundation of heterosexuality’s ‘natural’ claims. This article asks: Does the visibility of Dirtyroulette provide a potential rupture in heterosex—does it produce opportunities in which the ‘natural’ claims of heterosex are contradicted by an image that is not fixed and does not have a foundational orientation? Or is a correlation between the symbolic image of heterosex and the gestures of heterosex no longer required for the maintenance of heterosexual culture?
Macro interventions and their influence on individual and community well-being
Authors: Ferguson Kristin M , Teixeira Samantha , Wernick Laura J , Burghardt Steve
Published: February 2018

Due to the focus of micro-practice interventions on clinical outcomes and macro-practice interventions on structural outcomes, limited research exists on the clinical benefits resulting from clients’ involvement in macro therapeutic interventions (i.e. structural interventions that target community, organizational, systems, and/or policy-level change and which also have clinical benefits to clients or consumers). In response to this knowledge gap, the authors present four case studies of macro therapeutic interventions in the areas of social enterprise creation, community-based participatory research, transformative organizing, and community-based partnerships.

Findings

Collectively, these interventions draw from community, economic, and social development theory, empowerment theory, feminist theory, and critical theory. The authors synthesize the key intervention components across case studies that contribute to clinical and collective empowerment outcomes.

Applications

The authors then offer recommendations to the social work profession for developing, implementing, and evaluating macro therapeutic interventions within clinical practice settings.
Offenders living with mental illness: How are they perceived by future professionals?
Authors: Weaver Cynthia , Lee Joohee , Choi Hwanseok , Johnson W Wesley , Clements Carl
Published: February 2018

This study investigates the attitudes of Criminal Justice and Social Work majors toward offenders living with mental illness. Multivariate regression analyses were used to explore differences in attitudes between student majors, controlling for factors such as age, race, and political ideology among a sample of 358 respondents. Participant attitudes and beliefs were assessed using the Attitudes toward Mentally Ill Offenders scale which consists of four factors: negative stereotypes, rehabilitation/compassion, community risk, and diminished responsibility.

Findings

Results of multivariate regression analyses indicated that Social Work students were less likely to have negative stereotypes toward offenders with mental illness and tended to be more supportive of their potential for rehabilitation.

Applications

It is important to understand attitudes toward and beliefs about adult offenders living with mental illness among future professionals likely to serve this population. Understanding these attitudes has the potential to both inform the higher education curricula as well as strengthen the implementation of evidence-supported practices and policies that require cross-systems collaboration.
Physarum-inspired multi-parameter adaptive routing protocol for coal mine hybrid wireless mesh networks
Authors: Han Guangzhi , Jiang Haifeng , Lu Liansheng , Ma Shanshan , Xiao Shuo
Published: February 2018

Hybrid wireless mesh networks are suitable for complex environment communication in coal mine. Mesh clients with application service and routing function in hybrid wireless mesh networks can form a highly robust hybrid network with mesh routers. The processes of nutrient flux transfer and path choice in Physarum network are similar to data transmission and routing selection in hybrid wireless mesh networks. In this article, we use Physarum-inspired autonomic optimization model to design a Physarum-inspired multi-parameter adaptive routing protocol to improve the service quality of coal mine hybrid wireless mesh networks. Physarum-inspired multi-parameter adaptive routing protocol has achieved distributed routing decision by drawing the hybrid wireless mesh network parameters into Poisson’s equation of Physarum-inspired autonomic optimization model to measure the quality of link and implements two adjustment strategies to make the protocol more adaptive. The resource-dependent adjustment, which considers the irreversible energy consumption and recoverable buffer occupation, makes the energy consumption problem prominent when there is a lack of energy. The position-dependent adjustment makes routing decision efficient according to the load of different positions, which is caused by many-to-one data transmission model in coal mine. Based on NS2, simulation experiments are performed to evaluate the performance of Physarum-inspired multi-parameter adaptive routing protocol, and the results are compared with those of ad hoc on-demand distance vector, HOPNET, ANT-DSR, and Physarum-inspired routing protocols. The experimental results show that the route path selected by Physarum-inspired multi-parameter adaptive routing protocol is better than those selected by the other four protocols in the performance of average end-to-end delay and delivery ratio. The balance of energy consumption and network load is achieved and the network lifetime is effectively prolonged when using Physarum-inspired multi-parameter adaptive routing protocol.
Biological Entanglement–Like Effect After Communication of Fish Prior to X-Ray Exposure
Authors: Mothersill Carmel , Smith Richard , Wang Jiaxi , Rusin Andrej , Fernandez-Palomo Cris , Fazzari Jennifer , Seymour Colin
Published: February 2018

The phenomenon by which irradiated organisms including cells in vitro communicate with unirradiated neighbors is well established in biology as the radiation-induced bystander effect (RIBE). Generally, the purpose of this communication is thought to be protective and adaptive, reflecting a highly conserved evolutionary mechanism enabling rapid adjustment to stressors in the environment. Stressors known to induce the effect were recently shown to include chemicals and even pathological agents. The mechanism is unknown but our group has evidence that physical signals such as biophotons acting on cellular photoreceptors may be implicated. This raises the question of whether quantum biological processes may occur as have been demonstrated in plant photosynthesis. To test this hypothesis, we decided to see whether any form of entanglement was operational in the system. Fish from 2 completely separate locations were allowed to meet for 2 hours either before or after which fish from 1 location only (group A fish) were irradiated. The results confirm RIBE signal production in both skin and gill of fish, meeting both before and after irradiation of group A fish. The proteomic analysis revealed that direct irradiation resulted in pro-tumorigenic proteomic responses in rainbow trout. However, communication from these irradiated fish, both before and after they had been exposed to a 0.5 Gy X-ray dose, resulted in largely beneficial proteomic responses in completely nonirradiated trout. The results suggest that some form of anticipation of a stressor may occur leading to a preconditioning effect or temporally displaced awareness after the fish become entangled.
LEARNS: A creative approach to analysing and representing narrative data incorporating photo-elicitation techniques
Authors: Marsh Wendy , Leamon Jen , Robinson Ann , Shawe Jill
Published: February 2018

Background

Diversity exists in how storied data gathered in narrative inquiry is analysed and represented, more so when there is a need to combine multiple data collection methods, including photographs.

Aim

This paper discusses the use of an analytical framework entitled LEARNS developed as part of a PhD study that has potential to fill this gap.

Results

The step-by-step framework presented in this paper was developed in order to analyse the data collected in this research study and gives understanding and insight into the experience of mothers whose babies are removed at birth. The LEARNS framework provides transparency and credibility; it also negates the need to restrict findings to broad themes via content/thematic analysis.

Conclusions

LEARNS could offer other researchers a reliable framework to use for future social science research.
Thinking in a Foreign language reduces the causality bias
Authors: Díaz-Lago Marcos , Matute Helena
Published: February 2018

The purpose of this research is to investigate the impact of a foreign language on the causality bias (i.e., the illusion that two events are causally related when they are not). We predict that using a foreign language could reduce the illusions of causality. A total of 36 native English speakers participated in Experiment 1, 80 native Spanish speakers in Experiment 2. They performed a standard contingency learning task, which can be used to detect causal illusions. Participants who performed the task in their native tongue replicated the illusion of causality effect, whereas those performing the task in their foreign language were more accurate in detecting that the two events were causally unrelated. Our results suggest that presenting the information in a foreign language could be used as a strategy to debias individuals against causal illusions, thereby facilitating more accurate judgements and decisions in non-contingent situations. They also contribute to the debate on the nature and underlying mechanisms of the foreign language effect, given that the illusion of causality is rooted in basic associative processes.
Paired associate learning deficits in poor readers: The contribution of phonological input and output processes
Authors: Litt Robin A , Wang Hua-Chen , Sailah Jessica , Badcock Nicholas A , Castles Anne
Published: February 2018

It is well-established that poor readers exhibit deficits in paired associate learning (PAL), and there is increasing evidence for a phonological locus of these deficits. However, it remains unclear whether poor performance stems from difficulties specific to the phonological output system or difficulties that affect both phonological input and output processes. Understanding these deficits is important not only in the context of PAL but also for informing broader theories of typical and atypical reading development. We developed a novel paradigm that allowed us to assess PAL in the presence and absence of phonological output demands. In total, 14 poor readers and 14 age-matched controls were first trained to criterion in verbal-visual PAL before being tested in the visual-verbal direction. The results showed that poor readers learned at the same rate as controls in verbal-visual PAL, even when the nonword stimuli were phonologically confusable. Yet, despite having reached the same criterion as controls in verbal-visual PAL, poor readers exhibited robust impairments for those same paired associates in visual-verbal PAL. The overall pattern of results is most consistent with the conclusion that PAL deficits reflect impairments to the phonological output system; however, results that may challenge this interpretation are also discussed.
Reliability sensitivity analysis of coherent systems based on survival signature
Authors: Huang Xianzhen , Coolen Frank PA
Published: February 2018

The reliability sensitivity can be used to rank distribution parameters of system components concerning their impacts on the system’s reliability. Such information is essential to purposes such as component prioritization, reliability improvement, and risk reduction of a system. In this article, we present an efficient method for reliability sensitivity analysis of coherent systems using survival signature. The survival signature is applied to calculate the reliability of coherent systems. The reliability importance of components is derived analytically to evaluate the relative importance of the component with respect to the overall reliability of the system. The closed-form formula for the reliability sensitivity of the system with respect to component’s distribution parameters is derived from the derivative of lifetime distribution of a component to further investigate the impacts of the distribution parameters on the system’s reliability. The effectiveness and feasibility of the proposed approaches are demonstrated with two numerical examples.
A three-dimensional printed patient-specific scaphoid replacement: a cadaveric study
Authors: Honigmann Philipp , Schumacher Ralf , Marek Romy , Büttner Franz , Thieringer Florian , Haefeli Mathias
Published: February 2018

We present our first cadaveric test results of a three-dimensional printed patient-specific scaphoid replacement with tendon suspension, which showed normal motion behaviour and preservation of a stable scapholunate interval during physiological range of motion.
Antimicrobial resistance: A biopsychosocial problem requiring innovative interdisciplinary and imaginative interventions
Authors: Flowers Paul
Published: February 2018

To date, antimicrobials have been understood through largely biomedical perspectives. There has been a tendency to focus upon the effectiveness of pharmaceuticals within individual bodies. However, the growing threat of antimicrobial resistance demands we reconsider how we think about antimicrobials and their effects. Rather than understanding them primarily within bodies, it is increasingly important to consider their effects between bodies, between species and across environments. We need to reduce the drivers of antimicrobial resistance (AMR) at a global level, focusing on the connections between prescribing in one country and resistance mechanisms in another. We need to engage with the ways antimicrobials within the food chain will impact upon human healthcare. Moreover, we need to realise what happens within the ward will impact upon the environment (through waste water). In the future, imaginative interventions will be required that must make the most of biomedicine but draw equally across a wider range of disciplines (e.g. engineering, ecologists) and include an ever-increasing set of professionals (e.g. nurses, veterinarians and farmers). Such collective action demands a shift to working in new interdisciplinary, inter-professional ways. Mutual respect and understanding is required to enable each perspective to be combined to yield synergistic effects.
Assessing Quality Control Strategies for HbA1c Measurements From a Patient Risk Perspective
Authors: Parvin Curtis A. , Baumann Nikola A.
Published: February 2018

Background:

Current laboratory risk management principles emphasize the importance of assessing laboratory quality control (QC) practices in terms of the risk of patient harm. Limited practical guidance or examples on how to do this are available.

Methods:

The patient risk model described in a published laboratory risk management guideline was combined with a recently reported approach to computing the predicted probability of patient harm to produce a risk management index (RMI) that compares the predicted probability of patient harm for a QC strategy to the acceptable probability of patient harm based on the expected severity of harm caused by an erroneously reported patient result.

Results:

Measurement procedure capability and quality control performance for two instruments measuring HbA1c in a laboratory were assessed by computing the RMI for each instrument individually and for the laboratory as a whole.

Conclusions:

This assessment provides a concrete example of how laboratory QC practices can be directly correlated to the risk of patient harm from erroneously reported patient results.
Evaluation of a New Noninvasive Glucose Monitoring Device by Means of Standardized Meal Experiments
Authors: Pfützner Andreas , Strobl Stephanie , Demircik Filiz , Redert Lisa , Pfützner Johannes , Pfützner Anke H. , Lier Alexander
Published: February 2018

Background:

Frequent blood glucose readings are the most cumbersome aspect of diabetes treatment for many patients. The noninvasive TensorTip Combo Glucometer (CoG) component employs dedicated mathematical algorithms to analyze the collected signal and to predict tissue glucose at the fingertip. This study presents the performance of the CoG (the invasive and the noninvasive components) during a standardized meal experiment.

Methods:

Each of the 36 participants (18 females and males each, age: 49 ± 18 years, 14 healthy subjects, 6 type 1 and 16 type 2 patients) received a device for conducting calibration at home. Thereafter, they ingested a standardized meal. Blood glucose was assessed from capillary blood samples by means of the (non)invasive device, YSI Stat 2300 plus, Contour Next at time points –30, 0, 15, 30, 45, 60, 75, 90, 120, 150, and 180 minutes. Statistical analysis was performed by consensus error grid (CEG) and calculation of mean absolute relative difference (MARD) in comparison to YSI.

Results:

For the noninvasive (NI) CoG technology, 100% of the data pairs were found in CEG zones A (96.6%) and B (3.4%); 100% were seen in zone A for the invasive component and Contour Next. MARD was calculated to be 4.2% for Contour Next, 9.2% for the invasive component, and 14.4% for the NI component.

Conclusions:

After appropriate individual calibration of the NI technology, both the NI and the invasive CoG components reliably tracked tissue and blood glucose values, respectively. This may enable patients with diabetes to monitor their glucose levels frequently, reliably, and most of all pain-free.
Factors affecting the effectiveness of quality control circles in a hospital using a combination of fuzzy VIKOR and Grey Relational Analysis
Authors: Bahadori Mohammadkarim , Teymourzadeh Ehsan , Faizy Bagejan Foad , Ravangard Ramin , Raadabadi Mehdi , Hosseini Seyed Mojtaba
Published: February 2018

Background:

One of the techniques used to achieve productivity, employees’ job satisfaction and higher quality goods and services, as well as to solve the problems by using a team, is the formation of quality control circles. Quality control circles enable managers to meet the organization’s and employees’ needs through making effective use of resources and facilities. On the other hand, the quality of services is always affected by uncertainty and ambiguous and implicit judgments, which make its measurement uncertain.

Aim:

The present study aimed to identify important factors affecting the effectiveness of quality control circles in a hospital, as well as rank them using a combination of fuzzy VIKOR and Grey Relational Analysis (GRA).

Methodology:

This was an applied, cross-sectional and descriptive–analytical study conducted in 2016. The study population consisted of five academic members and five experts in the field of nursing working in a hospital, who were selected using a purposive sampling method. Also, a sample of 107 nurses was selected through a simple random sampling method using their employee codes and the random-number table. The required data were collected using a researcher-made questionnaire which consisted of 12 factors. The validity of this questionnaire was confirmed through giving the opinions of experts and academic members who participated in the present study, as well as performing confirmatory factor analysis. Its reliability also was verified (α=0.796). The collected data were analyzed using SPSS 22.0 and LISREL 8.8, as well as VIKOR–GRA and IPA methods.

Results:

The results of ranking the factors affecting the effectiveness of quality control circles showed that the highest and lowest ranks were related to ‘Managers’ and supervisors’ support’ (Š = 6.80, [Formula: see text] = 0.36) and ‘Group leadership’ (Š = 2.63, [Formula: see text] = 0.98). Also, the highest hospital performance was for factors such as ‘Clear goals and objectives’ and ‘Group cohesiveness and homogeneity’, and the lowest for ‘Reward system’ and ‘Feedback system’, respectively.

Conclusion:

The results showed that although ‘Training the members’, ‘Using the right tools’ and ‘Reward system’ were factors that were of great importance, the organization’s performance for these factors was poor. Therefore, these factors should be paid more attention by the studied hospital managers and should be improved as soon as possible. Applying quality control circles in any organization is very helpful and provides opportunities for maximum use of employees’ creativity, initiative and skills in reaching their and their organization’s goals and objectives, and prepares favorable working conditions for the employees’ optimal performance through increasing the managers’ sense of responsibility and commitment.
Editor’s Choice - Frailty and the management of patients with acute cardiovascular disease: A position paper from the Acute Cardiovascular Care Association
Authors: Walker DM , Gale CP , Lip G , Martin-Sanchez FJ , McIntyre HF , Mueller C , Price S , Sanchis J , Vidan MT , Wilkinson C , Zeymer U , Bueno H
Published: February 2018

Frailty is increasingly seen among patients with acute cardiovascular disease. A combination of an ageing population, improved disease survival, treatable long-term conditions as well as a greater recognition of the syndrome has accelerated the prevalence of frailty in the modern world. Yet, this has not been matched by an expansion of research. National and international bodies have identified acute cardiovascular disease in the frail as a priority area for care and an entity that requires careful clinical decisions, but there remains a paucity of guidance on treatment efficacy and safety, and how to manage this complex group. This position paper from the Acute Cardiovascular Care Association presents the latest evidence about frailty and the management of frail patients with acute cardiovascular disease, and suggests avenues for future research.
Encouraging accountability: Evangelicals and American health care reform
Authors: Franz Berkeley
Published: February 2018

Although scholars have thoroughly assessed American Evangelical Protestants’ beliefs about government intervention in addressing socioeconomic stratification and racial discrimination, they have paid considerably less attention to interpretations of health care reform. Especially important is that American Evangelicalism in recent years has incorporated personal accountability in such a way that makes this group distinctive when considering social responsibility toward others. Whereas earlier Evangelicals were instrumental in furthering the social gospel, American Evangelicals today prioritize matters of personal accountability ahead of social action. The cultural toolkit available to Evangelicals includes a rationale for caring for others, but an emphasis on personal accountability shapes how they evaluate government health care interventions. This paper employs qualitative methods to understand how Evangelicals link such individualism with strategies for caring for others in the context of health care. The findings suggest that Evangelicals emphasize personal accountability, especially when evaluating government programs. However, personal accountability is accompanied by a conflicting ethical responsibility to provide care to others. The priority given to personal accountability or an ethic of care, however, varies according to the situational context or social location of white Evangelicals. These findings may be helpful in framing future health policies to draw Evangelical support.
Legitimacy of consumer associations and perceived vulnerability of their users: Effects on intentions to trust consumerist associations
Authors: Lichtlé Marie-Christine , Nabec Lydiane , Roux Dominique , Chevalier Corinne
Published: February 2018

The trust that people place in consumer associations to protect their interests in dealing with commercial entities is at the heart of the consumerist mission. It is therefore important to identify the factors underpinning this trust. The results of one qualitative study (51 respondents) and one quantitative study (315 individuals) reveal that intentions to trust a consumer association depend on its recognized degree of cognitive, pragmatic and moral legitimacy. Furthermore, the effect of pragmatic legitimacy on such intentions varies in accordance with the perceived vulnerability of consumers in dealing with commercial entities. However, perceived vulnerability does not moderate the relationship between cognitive and moral legitimacy and intentions to trust consumer associations: it has a direct influence on this response variable.
Practice Patterns in the Treatment and Monitoring of Acute T Cell–Mediated Kidney Graft Rejection in Canada
Authors: Leblanc Julie , Subrt Peter , Paré Michèle , Hartell David , Sénécal Lynne , Blydt-Hansen Tom , Cardinal Héloïse
Published: February 2018

Background:

One of the goals of the Canadian National Transplant Research Program (CNTRP) is to develop novel therapies for acute rejection that could positively affect graft outcomes with greater efficacy or less toxicity. To develop innovative management strategies for kidney graft rejection, new modalities need to be compared with current clinical practices. However, there are no standardized practices concerning the management of acute T cell–mediated rejection (TCMR).

Objectives:

To describe clinicians’ practice patterns in the diagnosis, treatment, and monitoring of acute TCMR in Canada.

Design:

Survey.

Setting, Patients/Participants:

Canadian transplant nephrologists and transplant surgeons involved in the management of acute TCMR.

Methods and Measurements:

We developed an anonymous, web-based survey consisting of questions related to the diagnosis, treatment, and monitoring of TCMR. The survey was disseminated on 3 occasions between June and October 2016 through the Canadian Society of Transplantation (CST) kidney group electronic mailing list.

Results:

Forty-seven respondents, mostly transplant nephrologists (97%), originating from at least 18 of the 25 Canadian centers offering adult or pediatric kidney transplantation, participated in the study. Surveillance biopsies were used by 28% of respondents to screen for kidney graft rejection. High-dose steroids were used by most of the respondents to treat clinical and subclinical Banff grade 1A and 1B rejections. Nine percent (95% confidence interval [CI]: 1-17) of practitioners used lymphocyte-depleting agents as the first-line approach for the treatment of Banff grade 1B acute rejection. Eighteen percent (95% CI: 7-29) and 36% (95% CI: 8-65) of respondents reported that they would not use high-dose steroids for treating clinical and subclinical borderline rejections, respectively. Seventy percent (95% CI: 54-83) of respondents answered that there was no indication to assess histological response to treatment independent of the change in kidney function.

Limitations:

The limitations of this study are its limited sample size and the low representation of pediatric specialists.

Conclusions:

There is heterogeneity regarding the use of surveillance biopsies, treatment of borderline rejection, and modalities to monitor treatment response among transplant physicians. Our results illustrate the current state of practice patterns across Canada and can be used to inform the design of future trials.
“We All Have Stories”: Black Muslim Immigrants’ Experience With the Police
Authors: Ellis B. Heidi , Lincoln Alisa K. , Abdi Saida M. , Nimmons Elizabeth A. , Issa Osob , Decker Scott H.
Published: February 2018

Understanding the relationships between immigrants and refugees and the police is a critical research task with implications for both community–police partnerships and the effectiveness of law enforcement efforts. This study contributes to such an understanding by examining perceptions of police and police interactions among Somali immigrants and refugees (both first and second generation) in three communities in the United States and Canada. This article presents in-depth analyses of qualitative interview data and draws upon multiple theoretical perspectives, specifically procedural justice and minority group threat theory. These perspectives have been employed to account for police–minority relationships in other works and we extend their application to a new group. We find that despite some evidence of positive interactions with police, current policing could do more to establish community trust and implement principles of procedural justice with Somalis in the United States and Canada. This article also finds support for the minority group threat theory in that study participants perceive that they experience harsher and more frequent policing due to their multiple marginalized statuses (Black, immigrant, and Muslim). Implications for both Somali immigrants/refugees and law enforcement are discussed.
Severe Multi-Organ Failure and Hypereosinophilia: When to Call It “Idiopathic”?
Authors: Radin Massimo , Bertero Luca , Roccatello Dario , Sciascia Savino
Published: February 2018

The hypereosinophilic syndrome is a rare disease characterized by the association between high absolute eosinophil count and eosinophil-mediated organ damage. We describe a case of a 70-year-old male with an absolute eosinophil count of 2130 cells/µL. Clinical symptoms and signs included the following: severe asthenia, axonal sensitive motor neuropathy, basal pleural effusion with signs of hypoventilation on chest radiography, and gastrointestinal symptoms such as severe diarrhea, weight loss (−10 kg in 6 months), abdominal pain, and vomiting. On physical examination he had an urticarial dermatitis on his back, abdomen, and lower limbs. An extensive instrumental and laboratory diagnostic workup was performed. When all causes of primary and secondary hypereosinophilic syndrome were excluded, treatment with solumedrol infusion and oral prednisone was started, with a rapid recover of clinical symptoms and normalization of laboratory parameters. A complete remission of the laboratory and clinical findings was achieved after 2 months and maintained over 1-year follow-up.
Ulnar Collateral Ligament Reconstruction Versus Repair With Internal Bracing: Comparison of Cyclic Fatigue Mechanics
Authors: Jones Christopher M. , Beason David P. , Dugas Jeffrey R.
Published: February 2018

Background:

Ulnar collateral ligament (UCL) injuries have increased significantly in recent years, and reconstruction has become the preferred treatment for UCL injury over ligament repair. In a recent study, UCL repair with internal bracing demonstrated significantly greater resistance to gap formation in biomechanical tests, even at low cycles of valgus loading.

Purpose/Hypothesis:

The purpose of this study was to compare the fatigue and failure mechanics of traditional UCL reconstruction with UCL repair and internal bracing. We hypothesized that repaired specimens would have less gap formation, closer return to native gap formation, and greater maximum torque to failure versus traditionally reconstructed specimens.

Study Design:

Controlled laboratory study.

Methods:

Ten matched pairs of cadaveric elbows were positioned at 90° of flexion and the native UCL subjected to 500 cycles of subfailure valgus loading. A simulated tear was created, and the 10 cycles were repeated. Each pair of specimens was next given repair with internal bracing on 1 side and a modified Jobe reconstruction on the contralateral side, followed by 100 manual cycles of flexion-extension, 500 cycles of valgus rotation, and, finally, rotation to failure.

Results:

The specimens that received the repair unexpectedly experienced significantly less gapping in the torn state than did those in the reconstruction group. At the 10th cycle, repaired UCL injuries had significantly less gap formation than the reconstructed UCLs. At the 100th and 500th cycles, repaired UCL injuries continued to experience significantly less gap formation as compared with the reconstructed injuries.

Conclusion:

When compared with the gold standard reconstruction technique, UCL repair with internal bracing is more resistant to gap formation under fatigue loading. However, the unexpected early difference between the torn states may have confounded this finding. Time-zero failure properties of this repair technique are on par with those of traditional reconstruction, even after 500 cycles of valgus loading.

Clinical Relevance:

UCL reconstruction has become a common procedure among adolescent and elite-level throwers. Recent data suggest that UCL repair may be a viable option for younger athletes with acute proximal or distal UCL tears, allowing a faster return to play.
Bilaterally Combined Electric and Acoustic Hearing in Mandarin-Speaking Listeners: The Population With Poor Residual Hearing
Authors: Tao Duo-Duo , Liu Ji-Sheng , Yang Zhen-Dong , Wilson Blake S. , Zhou Ning
Published: February 2018

The hearing loss criterion for cochlear implant candidacy in mainland China is extremely stringent (bilateral severe to profound hearing loss), resulting in few patients with substantial residual hearing in the nonimplanted ear. The main objective of the current study was to examine the benefit of bimodal hearing in typical Mandarin-speaking implant users who have poorer residual hearing in the nonimplanted ear relative to those used in the English-speaking studies. Seventeen Mandarin-speaking bimodal users with pure-tone averages of ∼80 dB HL participated in the study. Sentence recognition in quiet and in noise as well as tone and word recognition in quiet were measured in monaural and bilateral conditions. There was no significant bimodal effect for word and sentence recognition in quiet. Small bimodal effects were observed for sentence recognition in noise (6%) and tone recognition (4%). The magnitude of both effects was correlated with unaided thresholds at frequencies near voice fundamental frequencies (F0s). A weak correlation between the bimodal effect for word recognition and unaided thresholds at frequencies higher than F0s was identified. These results were consistent with previous findings that showed more robust bimodal benefits for speech recognition tasks that require higher spectral resolution than speech recognition in quiet. The significant but small F0-related bimodal benefit was also consistent with the limited acoustic hearing in the nonimplanted ear of the current subject sample, who are representative of the bimodal users in mainland China. These results advocate for a more relaxed implant candidacy criterion to be used in mainland China.
Mouse and human HSPC immobilization in liquid culture by CD43- or CD44-antibody coating
Authors: Loeffler Dirk , Wang Weijia , Hopf Alois , Hilsenbeck Oliver , Bourgine Paul E. , Rudolf Fabian , Martin Ivan , Schroeder Timm
Published: February 2018

Key Points

Anti-CD43– and anti-CD44–antibody coating immobilizes live mouse and human HSPCs. This enables 2D colony formation, medium exchange without cell-identification loss, and increased throughput of time-lapse imaging.
LSD1 inhibition exerts its antileukemic effect by recommissioning PU.1- and C/EBPα-dependent enhancers in AML
Authors: Cusan Monica , Cai Sheng F. , Mohammad Helai P. , Krivtsov Andrei , Chramiec Alan , Loizou Evangelia , Witkin Matthew D. , Smitheman Kimberly N. , Tenen Daniel G. , Ye Min , Will Britta , Steidl Ulrich , Kruger Ryan G. , Levine Ross L. , Rienhoff Hugh Y. , Koche Richard P. , Armstrong Scott A.
Published: February 2018

Key Points

LSD1 inhibition induces a global increase in chromatin accessibility, whereas DOT1L inhibition induces global decreases in accessibility. Perturbation of PU.1 and C/EBPα expression renders AML cells more resistant to LSD1 inhibition.
Young and middle-aged adults with airflow limitation according to lower limit of normal but not fixed ratio have high morbidity and poor survival: a population-based prospective cohort study
Authors: Çolak Yunus , Afzal Shoaib , Nordestgaard Børge G. , Vestbo Jørgen , Lange Peter
Published: February 2018

A presumed consequence of using a fixed ratio for the definition of airflow limitation (AFL) has been overdiagnosis among older individuals and underdiagnosis among younger individuals. However, the prognosis of younger individuals with potentially underdiagnosed AFL is poorly described. We hypothesised that potential underdiagnosis of AFL at a younger age is associated with poor prognosis.

We assigned 95 288 participants aged 20–100 years from the Copenhagen General Population Study into the following groups: individuals without AFL with forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ≥0.70 and ≥lower limit of normal (LLN) (n=78 779, 83%); individuals with potentially underdiagnosed AFL with FEV1/FVC ≥0.70 and <LLN (n=1056, 1%); individuals with potentially overdiagnosed AFL with FEV1/FVC <0.70 and ≥LLN (n=3088, 3%); and individuals with AFL with FEV1/FVC <0.70 and <LLN (n=12 365, 13%). We assessed risk of exacerbations, pneumonias, ischaemic heart disease, heart failure and all-cause mortality. Median follow-up was 6.0 years (range: 2 days–11 years).

Compared to individuals without AFL, individuals with potentially underdiagnosed AFL had an increased risk of morbidity and mortality with age- and sex-adjusted hazard ratios (HR) of 2.7 (95% CI: 1.7–4.5) for pneumonias, 2.3 (95% CI: 1.2–4.5) for heart failure, and 3.1 (95% CI: 2.1–4.6) for all-cause mortality.

Young and middle-aged adults with AFL according to LLN but not fixed ratio experience increased respiratory and cardiovascular morbidity and early death.
Predictive painting across faults
Authors: Xue Zhiguang , Wu Xinming , Fomel Sergey
Published: February 2018

Predictive painting can effectively spread information in 3D volumes following the local structures (dips) of seismic events. However, it has trouble spreading information across faults with significant displacement. To address this problem, we incorporate fault-slip information into predictive painting to correctly spread information across faults. The fault slip is obtained using a local similarity scan to measure local shifts of the different sides of a fault. We have developed three methods to use the fault-slip information: (1) the area partition method, which uses the fault slip to correct the painting result after predictive painting in each divided area; (2) the fault-zone replacement method, which replaces fault zones with smooth transitions calculated with the fault slip information to avoid sharp jumps; and (3) the unfaulting method, in which we use the fault slip information to unfault the volume, perform predictive painting in the unfaulted domain, and then map the painting result back to the original space. Our methods are tested in application of predictive painting to horizon picking. Numerical examples demonstrate that predictive painting after incorporating fault slip information can correctly spread information across faults, which makes the proposed three approaches of using fault-slip information effective and applicable.
Using a Federated Network of Real-World Data to Optimize Clinical Trials Operations
Authors: Topaloglu Umit , Palchuk Matvey B.
Published: February 2018

Clinical trials, whether industry, cooperative group sponsored, or investigator initiated, have an unacceptable rate of failure as a result of the inability to recruit sufficient numbers of patients. Even those trials that are completed often require time-consuming protocol amendments to achieve accrual goals. These inefficiencies in clinical trial research result in increasing costs and prolong the time needed to bring improved treatments to cancer clinical practice. TriNetX has developed a clinical research collaboration platform—deployed by a federated network of health care organizations (HCOs), pharmaceutical firms (Pharma), and contract research organizations (CROs)—to enable data-driven clinical research study design to reduce accrual failure and protocol amendment. Currently, the network extends to 55 HCOs and covers 84 million patients, mostly within the United States, but with a growing international presence. (Many of the HCOs in United States are Clinical and Translational Science Awardees and/or National Cancer Institute–designated cancer centers.) The TriNetX business model includes Pharma and the CROs as sponsors whose subscriptions financially support the network, including the software and hardware costs of the HCOs. Furthermore, as each HCO network member has their data harmonized with the TriNetX model upon joining, data sharing among them does not require any technical processes to establish connectivity. To date, on the basis of the data on the network, HCOs have been presented approximately 757 studies by Pharma and CROs, and four data-sharing subnetworks have been formed among member HCOs.
Bivalirudin for Pediatric Procedural Anticoagulation: A Narrative Review
Authors: Zaleski Katherine L. , DiNardo James A. , Nasr Viviane G.
Published: February 2018

Bivalirudin (Angiomax; The Medicines Company, Parsippany, NJ), a direct thrombin inhibitor, has found increasing utilization as a heparin alternative in the pediatric population, most commonly for the treatment of thrombosis secondary to heparin-induced thrombocytopenia. Due to the relative rarity of heparin-induced thrombocytopenia as well as the lack of Food and Drug Administration–approved indications in this age group, much of what is known regarding the pharmacokinetics and pharmacodynamics of bivalirudin in this population has been extrapolated from adult data. This narrative review will present recommendations regarding the use of bivalirudin for procedural anticoagulation in the pediatric population based on the published literature.