bluuebunny/crossref_metadata_2025 huggingface dataset:
Examining Community Stability in the Face of Mass Extinction in Communities of Digital Organisms
Authors: Luo Tian-tong , Heier Lise , Khan Zaki Ahmad , Hasan Faraz , Reitan Trond , Yasseen Abdool S. , Xie Zi-xuan , Zhu Jian-long , Yedid Gabriel
Published: January 2019

Digital evolution is a computer-based instantiation of Darwinian evolution in which short self-replicating computer programs compete, mutate, and evolve. It is an excellent platform for addressing topics in long-term evolution and paleobiology, such as mass extinction and recovery, with experimental evolutionary approaches. We evolved model communities with ecological interdependence among community members, which were subjected to two principal types of mass extinction: a pulse extinction that killed randomly, and a selective press extinction involving an alteration of the abiotic environment to which the communities had to adapt. These treatments were applied at two different strengths, along with unperturbed control experiments. We examined how stability in the digital communities was affected from the perspectives of division of labor, relative shift in rank abundance, and genealogical connectedness of the community's component ecotypes. Mass extinction that was due to a Strong Press treatment was most effective in producing reshaped communities that differed from the pre-treatment ones in all of the measured perspectives; weaker versions of the treatments did not generally produce significant departures from a Control treatment; and results for the Strong Pulse treatment generally fell between those extremes. The Strong Pulse treatment differed from others in that it produced a slight but detectable shift towards more generalized communities. Compared to Press treatments, Pulse treatments also showed a greater contribution from re-evolved ecological doppelgangers rather than new ecotypes. However, relatively few Control communities showed stability in any of these metrics over the whole course of the experiment, and most did not represent stable states (by some measure of stability) that were disrupted by the extinction treatments. Our results have interesting, broad qualitative parallels with findings from the paleontological record, and show the potential of digital evolution studies to illuminate many aspects of mass extinction and recovery by addressing them in a truly experimental manner.
On the taxonomic position of Hesperophanes cinereus Blanchard in Gay, 1851 (Coleoptera: Cerambycidae)
Authors: VITALI FRANCESCO
Published: January 2019

Hesperophanes cinereus was described by Blanchard (1851) in the Fauna of Coleoptera of Chile and mentioned as such by Fairmaire & Germain (1859) and Aurivillius (1912). Noting that this name was a junior secondary homonym of the well-known European species H. cinereus (Villers, 1789), originally described as Cerambyx cinereus, Plavilstshikov (1917) proposed H. gayi as a substitute name for Blanchard’s species.
Larval morphology of the water mite Forelia brevipes (Neuman, 1880) (Acari: Hydrachnidia: Pionidae)
Authors: TUZOVSKIJ PETR V.
Published: January 2019

The fauna of the genus Forelia collected in Russia currently includes six species: F. brevipes, F. diaphana (Croneberg, 1899), F. liliacea (Müller, 1776), F. mutata (Piersig, 1901), F. samarica Tuzovskij, 1997 and F. variegator (Koch, 1837) (Uchida 1936, Sokolow 1940, Tuzovskij 1997). The larvae are known in F. liliacea, F. variegator (Wainstein 1980) and F. samarica (Tuzovskij 1997). Larvae of the genus Forelia are abdominal parasites of chironomid Diptera (Kouwets & Davids 1984, Smit & Oliver 1986). The aim of this paper is to present the morphology of the previously unknown larva of F. brevipes and to give an identification key for larvae of the genus Forelia species known in Russia.
The taxonomic status of Nectomys saturatus Thomas, 1897 (Cricetidae: Sigmodontinae)
Authors: CHIQUITO ELISANDRA ALMEIDA , PERCEQUILLO ALEXANDRE REIS
Published: January 2019

Nectomys (Sigmodontinae, Oryzomyini) is currently composed by five species: Nectomys apicalis, N. magdalenae, N. palmipes, N. rattus, and N. squamipes. These rodents have strong morphologic adaptations to semiaquatic habit and inhabit forests along river and streams in almost the entire South American continent. Although Nectomys is not a very speciose genus, 23 nominal taxa are associated with this group. Among these names is Nectomys saturatus, described in 1897 and currently allocated as synonym of N. apicalis, the west-Amazon species of Nectomys. Based on the examination of type material of the genus Nectomys, we hypothesize that Nectomys saturatus is a valid species. To test this hypothesis, we examined morphological and morphometric traits of 570 specimens of genus Nectomys of the same age class, belonging to the five recognized species, including the N. saturatus type series. We analyzed the external dimensions through descriptive statistics and we assessed the variation in craniodental measurements by means of Discriminant Analysis. Our results indicate N. saturatus individuals are considerably larger than the samples of congeneric species in all external traits, and they were also discriminated from the other species in the multivariate space. Qualitatively, N. saturatus shows two exclusive traits, the presence of paralophule on M1 and almost parallel-sided interorbital region. In this sense, our set of evidences indicates that our hypothesis should be accepted and the name Nectomys saturatus represents a valid species.
Redescription of Micronephthys longicornis (Perejaslavtseva, 1891) (Annelida: Nephtyidae)
Authors: DNESTROVSKAYA NATALIYA YU. , JIRKOV IGOR A.
Published: January 2019

Micronephthys longicornis (Perejaslavtseva, 1891) is re-described on the base of topotypes. The distinguishing characters are: dentate barred chaetae with a peak in center of each bar (on first notopodia only), presence of two pairs of visible subdermal coalesced eyes middorsally in C3, branchiae absent; lyrate chaetae with unequal rami. It is shown that Micronephthys stammeri (Augener, 1932) should be accepted as its junior synonym.
Orthoptera (Ensifera & Caelifera) collected using carrion traps in a Quercus forest in Jalisco, Mexico, with description of a new genus and a new species (Trigonidiidae: Nemobiinae)
Authors: CADENA-CASTAÑEDA OSCAR J. , RODRÍGUEZ WILLIAM DAVID , NAVARRETE-HEREDIA JOSÉ L.
Published: January 2019

An annotated list of Orthoptera species collected in carrion traps in a Quercus forest was compiled. Marcelonemobius mutum n. gen. et n. sp. (Trigonidiidae; Nemobiinae) is described. Four sites were chosen in an altitudinal gradient: 2,100, 2,300, 2,500 and 2,700 m. and monthly captures between September 2013 to August 2014. At each site, three carrion traps were placed separated by 100 m. A data logger situated at each altitude recorded temperature and humidity data. 175 individuals were registered belonging to seven families, 13 genera, and 15 species.
Basothorhynchus, a new Oosomini genus from the highland plateau of Lesotho (Coleoptera: Curculionidae: Entiminae)
Authors: BOROVEC ROMAN
Published: January 2019

A new genus, Basothorhynchus gen. n. (Coleoptera: Curculionidae: Entiminae: Oosomini) is described with one new species from Lesotho, Basothorhynchus endroedyi sp. n. The new genus is well defined by its small glabrous body, the rostrum continuous with the head, all femora with a distinct tooth, the tibiae abruptly enlarged on the inside, the metatibiae lacking a corbel and the free claws.
Geriatric Dysphonia: Characteristics of Diagnoses in Age-Based Cohorts in a Tertiary Voice Clinic
Authors: Applebaum Jeremy , Harun Aisha , Davis Ashley , Hillel Alexander T. , Best Simon R. A. , Akst Lee M.
Published: January 2019

Objective:

An aging population has increased focus on geriatric otolaryngology. Those ≥65 years old are not a uniform population, however, and recent gerontology literature recognizes important physiologic differences between the young-old (ages 65-74 years), middle-old (75-84), and old-old (≥85). This study evaluates differences within these groups among dysphonia patients ≥65 years relative to diagnosis and voice-related quality of life (V-RQOL).

Methods:

Chart review of all new patients ≥65 years presenting to the Johns Hopkins Voice Center between April 2015 and March 2017 identified chief complaint, diagnosis, and self-reported voice handicap. Etiology of dysphonia diagnoses were classified. Diagnostic categories and V-RQOL were evaluated as functions of patient age and gender.

Results:

Of 839 new patients ≥65 years, 463 (55.2%) reported chief complaint of dysphonia, with the most common etiologies being vocal fold immobility (28.3%) and atrophy (21.6%). Younger cohorts were more likely to present with benign vocal fold lesion and vocal fold immobility, while older cohorts were more likely to present with atrophy ( P = .016). The odds of having a diagnosis of vocal fold atrophy increased 7% with each year of life (odds ratio = 1.07; 95% CI, 1.03-1.11). V-RQOL scores were similar across gender and age categorization.

Conclusion:

Dysphonia patients ≥65 years are not a uniform group, and important differences exist in terms of diagnosis as a function of age. Knowledge of these differences may inform further investigations in the growing field of geriatric otolaryngology.
Pure Tone Audiometry Threshold Changes for 10 Years in the Same Individuals of General Population: A Retrospective Cohort Study
Authors: Kim Hantai , Ha Jungho , Park Hun Yi
Published: January 2019

Objectives:

The objectives of this study were to measure the changes in hearing thresholds in the same individuals during a period of 10 years and suggest a clinical reference for the threshold changes by aging.

Methods:

In this retrospective cohort study, we used regular health checkup data including 2 pure tone audiometry results with a 10-year interval in the same individuals from 1288 subjects. The subjects’ data including demographics, smoking habits, and the diagnosis of chronic diseases were used.

Results:

Age, male gender, smoking, and osteoporosis were identified as factors affecting age-related hearing loss (ARHL). The sole effect of aging on ARHL for 10 years according to age groups and genders was as follows: a loss of 1.4 dB in 20s, 4.0 dB in 30s, 5.0 dB in 40s, 8.2 dB in 50s, and 11.2 dB in 60s of males compared to a loss of 2.3 dB in 20s, 2.9 dB in 30s, 5.1 dB in 40s, 6.5 dB in 50s, and 9.4 dB in 60s of females.

Conclusions:

We could demonstrate the actual effect of aging on ARHL, and it can be used as a clinical reference. Hearing ability decreases more in males than females but seems to decrease exponentially with age in both males and females.
Clustering Mixed Datasets Using Homogeneity Analysis with Applications to Big Data
Authors: Sambasivan Rajiv , Das Sourish
Published: January 2019

Datasets with a mixture of numerical and categorical attributes are routinely encountered in many application domains. Such datasets do not have a direct representation in Euclidean space. As a consequence, dissimilarity measures such as the Gower distance are used when partitioning clustering approaches are used with such datasets. Homogeneity analysis (HA) can be used to determine a Euclidean representation of mixed datasets. Such a representation can be analysed by leveraging the large body of tools and techniques for data with a Euclidean representation. The utility of the representation obtained from HA is not limited to clustering. This representation can be used to visualize mixed datasets and generate succinct numerical summaries. Such summaries can yield clues about associations between variables which may be difficult to discover otherwise.

AMS Classification Code: 62-07
Double Jeopardy? Disproportionality in First Juvenile Court Involvement by Disability Status
Authors: Kincaid Aleksis P. , Sullivan Amanda L.
Published: January 2019

The overrepresentation of youth with disabilities in the juvenile justice system is a persistent concern, but estimates of their involvement vary dramatically due to differences in how disability is conceptualized and when involvement in juvenile justice is measured. This study linked juvenile court and educational records for 230,760 students in one state to describe the involvement of students with and without disabilities in juvenile court. Overrepresentation of students with disabilities was not robust to sociodemographic controls (relative risk ratio [RR] = 1.07) but varied by disability category such that students with emotional or behavioral disorders (RR = 1.98) and other health impairments (RR = 1.12) remained overrepresented. Students with disabilities were charged with more severe offenses than their peers without disabilities and were more likely to be petitioned to court with a higher degree of offense even after controlling for the type of offense. Implications for policy, practice, and research are discussed.
Financial Crisis in Portugal: Effects in the Health Care Sector
Authors: Morais Nunes Alexandre , Cunha Ferreira Diogo , Campos Fernandes Adalberto
Published: January 2019

Portugal has faced an economic and financial crisis that began circa FY2009 and whose effects are still ongoing. In FY2011, the Portuguese state and the European triumvirate – composed of the European Commission, the International Monetary Fund, and the European Central Bank – signed the Memoranda of Understanding. This troika agreement aimed to improve the operational efficiency of public services. This crisis had a considerable impact on the Portuguese citizens’ life and productivity, as well as on the public health care system. Cuts over public expenditures have been made to reduce the risk of noncompliance with budgetary targets, despite their potential impact on quality and access to health care services. We analyzed the main policies and measures undertaken by the Portuguese Ministry of Health with respect to the bailout program associated with the troika agreement. Then, we focused on the budgetary cuts–related risks over the social performance of the care system. Evidence suggests that structural reforms in the health care sector in the troika period had positive effects in terms of drugs administration and consumption, on the one hand, and secondary care expenditures reduction, on the other hand. Nonetheless, we observed some divestitures on infrastructures and the worsening of access to health care services.
Dual-Targeting Approach Degrades Biofilm Matrix and Enhances Bacterial Killing
Authors: Ren Z. , Kim D. , Paula A.J. , Hwang G. , Liu Y. , Li J. , Daniell H. , Koo H.
Published: January 2019

Biofilm formation is a key virulence factor responsible for a wide range of infectious diseases, including dental caries. Cariogenic biofilms are structured microbial communities embedded in an extracellular matrix that affords bacterial adhesion-cohesion and drug tolerance, making them difficult to treat using conventional antimicrobial monotherapy. Here, we investigated a multitargeted approach combining exopolysaccharide (EPS) matrix-degrading glucanohydrolases with a clinically used essential oils–based antimicrobial to potentiate antibiofilm efficacy. Our data showed that dextranase and mutanase can synergistically break down the EPS glucan matrix in preformed cariogenic biofilms, markedly enhancing bacterial killing by the antimicrobial agent (3-log increase versus antimicrobial alone). Further analyses revealed that an EPS-degrading/antimicrobial (EDA) approach disassembles the matrix scaffold, exposing the bacterial cells for efficient killing while concurrently causing cellular dispersion and “physical collapse” of the bacterial clusters. Unexpectedly, we found that the EDA approach can also selectively target the EPS-producing cariogenic bacteria Streptococcus mutans with higher killing specificity (versus other species) within mixed biofilms, disrupting their accumulation and promoting dominance of commensal bacteria. Together, these results demonstrate a dual-targeting approach that can enhance antibiofilm efficacy and precision by dismantling the EPS matrix and its protective microenvironment, amplifying the killing of pathogenic bacteria within.
From What to Where: A setting-sensitive approach to organizational storytelling
Authors: van Hulst Merlijn , Ybema Sierk
Published: January 2019

Extant literature on organizational storytelling assumes storytelling to be context-bound, but does not empirically detail or theorize how storytelling might differ across organizational settings. In the context of members’ everyday work lives, organizational storytelling research tends to focus on the content of stories and not on the actual telling. By addressing this omission, this paper makes three contributions. First, we offer a generic framework for analysing storytelling in situ by zooming in on the situated occurrence of storytelling through a focus on four questions: (1) What makes an event tellable? (2) What triggers its telling? (3) What form does the storytelling take? (4) What work does it do? By using ethnographic data gathered on storytelling in everyday police work, we empirically substantiate this framework. Our second contribution, then, is to show how a setting-specific approach to studying storytelling may help to flesh out a fuller, more grounded account of story life in organizations. Finally, we propose a typology of different forms of setting-specific discourse – meeting-room talk, workstation talk, canteen talk and closed-door talk – which allows researchers to further sensitize organizational research to the situated nature of organizational discourse.
Test–retest reliability and limits of agreement of the Six-Spot Step Test in people with Parkinson’s disease
Authors: Brincks John , Callesen Jacob , Dalgas Ulrik , Johnsen Erik
Published: January 2019

Objective:

The aim of this study was to evaluate the within-day and day-to-day agreement and reliability of the Six-Spot Step Test in mild to moderately disabled people with Parkinson’s disease.

Design:

Cross-sectional cohort study.

Setting:

Outpatient clinics.

Subjects:

Forty-four people with Parkinson’s disease.

Main measure:

The Six-Spot Step Test was completed twice on day 1. Two days later, the Six-Spot Step Test was completed again. The agreement was estimated by Bland–Altman statistics with 95% limits of agreement, and reliability was estimated by the intraclass correlation coefficient.

Results:

Subjects had a mean (SD) age of 67.8 (6.8) years, a median (range) Hoehn and Yahr score of 2.5 (1–4) and a mean (SD) Six-Spot Step Test score of 8.1 (1.8), 7.6 (1.7) and 7.6 (1.6) seconds on test occasions 1 to 3. An agreement for within-day and day-to-day of ±1.8 (±23.7%) and ±2.2 (±26.7%) seconds was found, respectively. The reliability was 0.81 and 0.76 within-day and day-to-day, respectively. A small learning effect was observed ( P < 0.05) between the first and second Six-Spot Step Test, but there was no learning between the second and third occasions.

Conclusion:

The Six-Spot Step Test has an acceptable within-day and day-to-day agreement and reliability in mild to moderately disabled people with Parkinson’s disease. A change of 2.2 seconds can be regarded as a true change. To minimize learning effects, test trials of the Six-Spot Step Test are recommended before use.
Maternal HIV and Adolescent Functioning in South Africa: The Role of the Mother-Child Relationship
Authors: LeCroix Rebecca Hill , Chan Wing Yi , Henrich Chris , Palin Frances , Shanley Jenelle , Armistead Lisa
Published: January 2019

Black South Africans are disproportionately affected by HIV compared with White counterparts. In their unique social context, South African families affected by HIV are vulnerable to adverse psychosocial effects. U.S.-based and emerging South African research suggests mothers living with HIV may experience compromised parenting. In the United States, mother-child relationship quality has been associated with internalizing (anxiety, depression) and externalizing (delinquency, acting out) child behaviors. This study adds to South African research with emphasis on the role of the mother-child relationship among HIV-affected South Africans from multiple communities. Structural equation modeling examined relationships between maternal health and child adjustment, operating through mother-child relationship. The best-fitting model suggested maternal health influences youth externalizing behaviors through the mother-child relationship, but that maternal health is directly related to child internalizing problems. Findings support and extend previous results. Further research would benefit from investigating ways the unique South African context influences these variables and their interactions.
Detecting recurrent ovarian cancer: revisit the values of whole-body CT and serum CA 125 levels
Authors: Wang Pieh-Hsu , Huang Yu-Ting , Ng Koon-Kwan , Chou Hung-Hsueh , Lu Hsin-Ying , Ng Shu-Hang , Lin Gigin
Published: January 2019

Background

Computed tomography (CT) has served as the first-line imaging modality but its role for detecting recurrent ovarian cancer should be revisited in the era of whole-body CT.

Purpose

To study anatomical distributions and imaging patterns of recurrent ovarian epithelial cancer through whole-body CT and their associations with serum cancer antigen 125 (CA 125) levels.

Material and Methods

This retrospective study approved by the institutional review board comprised a cohort of 497 patients with ovarian cancer. The specific anatomical locations and imaging features of recurrent lesions on CT at the time of recurrence were analyzed.

Results

Fifty-nine patients had ovarian cancer recurrence. The median time from diagnosis to recurrence was 17 months (range = 8–51). Among the 144 recurrent lesions, the leading recurrent sites were the intraperitoneal cavity and lymph nodes. Cystic lesions were significantly more frequently located intraperitoneally ( P = 0.026), in particular with locoregional recurrence ( P = 0.006). Serum CA 125 levels in the patients were significantly higher in the presence of peritoneal metastases ( P = 0.010), locoregional lesions at the cul-de-sac or vaginal stump ( P = 0.002), and metastases to infradiaphragmatic organs ( P = 0.013). Among the 18 patients with CA 125 levels ≤ 35 U/mL at recurrence, 10 patients had supradiaphragmatic lesions in the lung and brain. None of the studied patients had bony metastasis at recurrence.

Conclusion

In patients with suspected recurrence, extended-field CT to cover the thoracic region might be useful during follow-up of patients with ovarian cancer, regardless of CA 125 levels.
Protective role of arnebin-1 in rats with nonalcoholic fatty liver disease
Authors: Yang Weijia , Yang Minchun , Yao Hui , Ma Yelin , Ren Xuanxuan , Teng Long , Wang Tao
Published: January 2019

Objective

To examine the effects of arnebin-1 on nonalcoholic fatty liver disease (NAFLD) induced by a high-fat diet (HFD).

Methods

Male Sprague–Dawley rats were fed an HFD for 10 weeks and then treated with arnebin-1 at a dose of 5, 10 or 20 mg/kg/day by gavage for a further 12 weeks of a 22-week HFD. Peripheral blood and liver tissues were collected for biochemical and histopathological examination. The mechanisms of arnebin-1 on liver fibrosis and insulin resistance (IR) were determined by Western blotting and real-time quantitative polymerase chain reaction.

Results

Arnebin-1 treatment attenuated the increase of total cholesterol, triglycerides, low-density lipoprotein cholesterol, aspartate aminotransferase and alanine aminotransferase in serum and lipid accumulation in the livers of HFD-fed rats. Furthermore, arnebin-1 abrogated HFD-induced liver fibrosis and the increase of fibrotic biomarkers. The HFD-induced decrease of hepatic proliferator-activated receptor γ and pro-matrix-metalloproteinase (MMP)-9 levels and the increase of tissue inhibitor of metalloproteinase-1 (TIMP-1) levels were reversed after arnebin-1. Arnebin-1 attenuated IR through activating the insulin receptor substrate-1/Akt/mTOR signalling pathway.

Conclusion

This study demonstrated that arnebin-1 ameliorates NAFLD, in part, by attenuating hepatic fibrosis and IR, suggesting that arnebin-1 may be a therapeutic agent for NAFLD treatment.
Whole-exome sequencing as a powerful tool for identifying genetic causes in a patient with POLG-related disorders and phenylketonuria
Authors: Li Lin , Zhao Jin-Qi , Wang Chengrong , Yang Nan , Gong Li-Fei , Yang Hai-He , Yin Chenghong , Kong Yuan-Yuan
Published: January 2019

Objective

This study’s aim was to identify the genetic causes in a patient with phenylketonuria and hearing loss, liver disease, developmental and mental retardation, hypotonia, and external ophthalmoplegia.

Methods

Whole-exome sequencing and Sanger sequencing analysis were used to determine the genetic causes of manifestations in a young boy with hearing loss, liver disease, develop-mental and mental retardation, hypotonia, and external ophthalmoplegia.

Results

We found that the child harbored polymerase gamma ( POLG) compound heterozygous mutations, c.2617G>A (p.E873K) and c.3550G>A (p.D1184N), and phenylalanine hydroxylase ( PAH) compound heterozygous mutations, c.721C>T (p.R241C) and c.728G>A (p.R243Q). Among them, the POLG p.E873K mutation is a novel mutation and is not present in the Exome Aggregation Consortium database, Genome Aggregation database, and 1000 Genomes database. The two heterozygous mutations were each inherited from both of the child’s parents. This finding suggested that the phenotype and the genotype were segregated.

Conclusion

Using whole-exome sequencing, we not only identified PAH mutations causing phenylketonuria, but also identified the genetic cause of the mitochondrial disease and found a novel POLG mutation. Our findings could be useful in helping future parents obtain healthy embryos through assisted reproductive technology.
Chavista ‘thugs’ vs. opposition ‘civil society’: western media on Venezuela
Authors: MacLeod Alan
Published: January 2019

Since the election of Hugo Chavez in 1998, Venezuela has undergone a period of intense racial and class conflict, as a multiethnic subaltern coalition has begun to assert itself politically against a previously hegemonic and inordinately dominant white elite. Scholars have highlighted the local media’s racial and class snobbery when covering social movements and civil society, attempting to split the country into two groups: ‘underclass mobs’ and ‘respectable’ civil society. This article, which analyses media coverage at crucial points of conflict – 1998/9, 2002, 2013 and 2014 – finds that western media have overwhelmingly matched the local media, portraying only the largely dark-skinned working-class chavista groups as vicious ‘mobs’, ‘hordes’ and ‘thugs’, while representing the white, upper-class opposition as ‘civil society’.
Low vision rehabilitation services: Perceived barriers and facilitators to access for older adults with visual impairment
Authors: Kaldenberg Jennifer
Published: January 2019

Introduction

The aim of this study is to describe the barriers and facilitators to accessing low vision rehabilitation services in Massachusetts, USA, and determine differences between communities with and without existing low vision rehabilitation services for older adults with visual impairment.

Method

A sample of older adults with visual impairment ( n = 64) from both communities participated in the study. Barriers and facilitators to accessing the services were explored through focus groups and prioritized during one-on-one interviews, which allowed for comparison between communities.

Results

Twelve themes were identified: (a) bureaucracy and funding (public policy); (b) public awareness and stigma (community); (c) services available, knowledge of providers, care coordination, transportation (organizational); (d) people and lack of awareness of family/friends (interpersonal); and (e) income, health status, knowledge, self-advocacy, and time (individual).

Conclusion

This study provides insights into the perceived barriers and facilitators of accessing low vision rehabilitation services for older adults with vision impairment living in Massachusetts, USA. Key findings indicate the need for improved awareness of these services at the provider and consumer level, coordinated care, increased education on the efficacy of occupational therapy low vision rehabilitation services, client-centered care provided when the client is ready to accept services, and service provision that addresses sociodemographic factors.
Occupational therapy international undergraduate students’ perspectives on the purpose of practice education and what contributes to successful practice learning experiences
Authors: Lalor Aislinn , Yu Mong-Lin , Brown Ted , Thyer Laura
Published: January 2019

Introduction

Practice placements (also referred to as fieldwork) are a significant component of occupational therapy education. For international students enrolled in occupational therapy education programmes outside their own country, completing practice placements can be challenging. There is scarce literature that examines the perspectives of international students undertaking practice placements. The study’s aim was to understand international students’ perceptions, what they believe to be the purpose of practice placements and what attributes contribute to successful practice education.

Method

Qualitative, semi-structured interviews were used to elicit the perspectives of seven fourth-year international undergraduate occupational therapy students enrolled at an Australian university.

Results

Thematic analysis identified two key themes: ‘the purpose of practice placements’ (sub-themes: translating knowledge into practice, adapting to real life experiences and building our communication skills), and ‘a successful practice placement’ (sub-themes: the environment, the clinical educator and my responsibilities).

Conclusion

Findings identified what international occupational therapy students believed to contribute to a positive and quality practice placement. All students valued the opportunities that practice education afforded, including developing communication skills and integrating theory into practice. These findings will assist academic and practice educators in the delivery of high quality practice education placement learning experiences for international students.
Attenuation of Electroconvulsive Therapy Induced Hypertension with Sublingual Nifedipine
Authors: Wells D. G. , Davies G. G. , Rosewarne F.
Published: January 2019

Five patients known to be previously hypertensive but not currently receiving anti-hypertensive medications were studied for a total of twenty-six administrations of electroconvulsive therapy Patients randomly received sublingual nifedipine 10 mg, 20 minutes prior to half of their treatments, and for the remaining treatments acted as their own controls. The use of nifedipine resulted in significant attenuation of the blood pressure response to therapy. Systolic pressure increase was 24 mmHg (SD 14) versus 62 mmHg (SD 24) (P< 0.01). There was no difference in heart rate between the two groups. It is concluded that nifedipine reduces the pressor response to electroconvulsive therapy in individuals with a history of hypertension.
Cardiovascular Responses to Tracheal Intubation: A Comparison of Direct Laryngoscopy and Fibreoptic Intubation
Authors: Finfer S. R. , MacKenzie S. I. P. , Saddler J. M. , Watkins T. G. L.
Published: January 2019

The cardiovascular responses to tracheal intubation using a fibreoptic bronchoscope or Macintosh laryngoscope were compared in twenty in-patients and twenty day-stay patients. Within these groups patients were randomly allocated to direct laryngoscopic or fibreoptic bronchoscopic intubation. Arterial blood pressure, heart rate and arterial oxygen saturation were recorded before induction and at one-minute intervals until four minutes after intubation. In both groups both laryngoscopic and bronchoscopic intubation resulted in a significant rise in blood pressure and heart rate. At no stage was there a significant difference in mean blood pressure in either group, or in heart rate in the day-stay patients, between the different methods of intubation. In the in-patients mean heart rate was significantly higher in those patients intubated with the bronchoscope at three and four minutes after intubation. Time taken for intubation was significantly longer in those patients intubated with the bronchoscope. In no patient did the arterial oxygen saturation fall below 98%.
Anaesthesia and Anaesthetic Training in the Pacific Islands
Authors: Hatfield A. H.
Published: January 2019

These are thoughts and impressions on the practice of anaesthesia, the management of operating theatres, and a plan for the training of anaesthetists for the Pacific island nations. They are based on accumulated experience and personal observations gained over ten years of working and travelling throughout the Pacific region. The concepts and ideas expressed are a correlation and condensation of many conversations with local anaesthetists and people involved with managing hospitals and administering the health services of many of the countries in the Pacific.
A Comparison of Fifteen Pulse Oximeters. Part I: A Clinical Comparison; Part II: A Test of Performance under Conditions of Poor Perfusion
Authors: Morris R. W. , Nairn M. , Torda T. A.
Published: January 2019

Fifteen pulse oximeters were compared. Their physical characteristics, price, warranty, information handling and displays were catalogued. Times for changes in data display and susceptibility to interference were assessed.

A model for comparison of oximeters under conditions of poor perfusion was developed using a tourniquet to progressively diminish limb perfusion pressure (systolic minus tourniquet pressure).

The oximeters evidenced a wide variety of features and performance in poor perfusion states. Instruments lacking a beep varying in pitch with saturation or a waveform/pulse bar display of plethysmograph signal were considered less satisfactory. The majority of instruments, with some notable exceptions, performed remarkably well in a state of diminished perfusion.

The study demonstrates that purchasers of pulse oximeters need to exercise care in assessing the suitability of particular instruments to their specific requirements.
Constancy of Air-Oxygen Mixtures in Intensive Care
Authors: Johnson P. A. , Outhred A. K. , Raper R. F. , Fisher M. McD.
Published: January 2019

The performance of ten high-flow Bird blenders (3M Company) was assessed to ascertain the stability of the oxygen delivery both over time and within a single respiratory cycle. Blended oxygen concentrations were assessed for both continuous low flow and for intermittent flow with variable tidal volumes as is seen with mechanical ventilation. Studies were repeated after the addition of a high flow bleed from the blender via a T-piece. We observed clinically significant variations in the oxygen concentrations delivered by several blenders when the relationship between air and oxygen supply pressures varied. This variability was greatest when the air and oxygen pressures were nearly equal. When the line pressures were stable, mixed oxygen concentrations were constant but variations in oxygen delivery were found within individual breath cycles. This could be explained by postulating that at the initiation of flow from the blender a small pocket of unblended gas (pure air or pure oxygen) was issued by the blender before the balancing mechanism stabilised to deliver the desired oxygen concentration. This variability of oxygen delivery may have considerable impact on the measurement of oxygen consumption using the open circuit technique. The addition of a high flow bleed completely ablated this blender-derived variation in oxygen delivery.
Patient-Administered Anxiolysis — A Pilot Study
Authors: Galletly D. C. , Short T. G. , Forrest P.
Published: January 2019

The feasibility of self-premedication with intravenous diazepam was examined in an open study of 50 preoperative patients. Using a Bard ‘Harvard PCA’ patient-controlled analgesia system, patients were instructed to deliver the drug in a dose sufficient to remove their anxiety for the scheduled surgical procedure. Aliquots of diazepam 2 mg were delivered on demand up to a total dose of 20 mg over a 30 minute premedication period.

The mean dose administered was 8.1 mg (range 0-16 mg) producing a highly significant reduction in both patient- and anaesthetist-assessed anxiety rating.

Neither the patient's sex nor the nature of the surgical procedure influenced the dose administered. Although poor, the best predictor of self-premedicating dose was the patient's own preoperative anxiety rating with the anaesthetist's assessment of patient anxiety not correlating with the dose administered. No patient was considered excessively sedated by the premedication. Patient-administered anxiolysis is suggested as a useful research tool in the examination of anxiety and of value in premedicating patients with high preoperative anxiety levels.
Double-Blind Comparison of Midazolam and Temazepam as Oral Premedicants for Outpatient Anaesthesia
Authors: Short T. G. , Galletly D. C.
Published: January 2019

Oral premedication with midazolam 7.5 mg was compared with temazepam 20 mg in a double-blind study of sixty patients undergoing day-stay urological surgery. One hour following ingestion similar degrees of anxiolysis and sedation were reported by patients for both compounds. However, midazolam was observed by anaesthetists to produce the greater anxiolytic effect and was given the better overall assessment. Midazolam produced significantly greater amnesia both at the time of induction and 30 minutes postoperatively. At the time of discharge four hours postoperatively no significant difference could be observed in psychomotor performance or subjective sedation although on the evening of surgery the temazepam group had a greater incidence of sleepiness and an earlier time to retiring. Although the differences were small, the residual post-discharge effects of temazepam lead us to conclude that midazolam 7.5 mg is the more suitable premedicant for outpatient use.
Interpleural Administration of Bupivacaine after Cholecystectomy: A Comparison with Intercostal Nerve Block
Authors: Blake D. W. , Donnan G. , Novella J.
Published: January 2019

Pethidine requirements and verbal pain scores were recorded in 36 patients after cholecystectomy via subcostal incision. All patients also received 20 ml 0.5% bupivacaine with adrenaline 1/200,000. Group 1 (12 patients) received unilateral intercostal nerve blocks. Interpleural catheters were inserted through the 8th intercostal space in the remaining patients; 12 received local anaesthetic via the catheter immediately after surgery (Group 2) and 12 were given local anaesthetic at three hours (Group 3). Small asymptomatic pneumothoraces were noted on chest X-ray in six of the 24 patients with interpleural catheters. Both types of local anaesthesia produced lower pain scores than pethidine alone (P < 0.05) with 25% of intercostal nerve blocks and 63% of interpleural catheters requiring no pethidine in the following three hours. The provision of catheter ‘top-ups’ between six and 18 hours after surgery also resulted in lower pain scores and a reduction in pethidine requirements (P < 0.05).
A Comparison of Alfentanil, Halothane and Enflurane as Supplements for Outpatient Urological Surgery
Authors: Biswas T. K. , Hatch P. D.
Published: January 2019

Seventy-seven patients presenting for outpatient cystoscopy participated in a trial to assess postoperative recovery when either alfentanil, halothane, or enflurane were used in combination with nitrous oxide/oxygen anaesthesia. Anaesthesia was uneventful in all cases. Apnoea occurred once with alfentanil, but naloxone was not required. Vomiting occurred once with alfentanil and once with enflurane. Anti-emetics were not required. Blood pressure and pulse rate variations from preoperative levels occurred with similar frequency in all groups. Times to open eyes, show left thumb, and give correct date of birth were significantly less with alfentanil than with the other agents tested. Trieger testing failed to demonstrate an advantage of alfentanil, although two patients in each of the halothane and enflurane groups were insufficiently recovered to complete the tests. As tested, alfentanil represents a useful alternative to halothane or enflurane as postoperative recovery of mental function is significantly more rapid than with the inhalational agents.
Comparison of the Processed Electroencephalogram and Awake Neurological Assessment during Carotid Endarterectomy
Authors: Silbert B. S. , Koumoundouros E. , Davies M. J. , Cronin K. D.
Published: January 2019

A processed electroencephalogram (EEG) produced by the Lifescan monitor (Neurometrics), was compared to awake neurological assessment for detecting cerebral ischaemia in seventy patients undergoing carotid endarterectomy under cervical plexus block. Of the six patients demonstrating neurological signs on cross-clamping the carotid, five displayed simultaneous EEG changes, four being detected during surgery, and one being detected after reviewing the EEG postoperatively. Another four patients displayed EEG changes indicative of ischaemia but unassociated with neurological signs. A further patient displayed contralateral intraoperative EEG changes. Hypotension resulted in one EEG change and two cases were associated with technical difficulties with the monitor. The presence of false negatives, possible false positives, technical errors and subjective interpretation associated with the processed EEG make it less reliable than awake neurological assessment for the detection of cerebral ischaemia.
Haemodynamic Responses to Acute Blood Loss: New Roles for the Heart, Brain and Endogenous Opioids
Authors: Van Leeuwen A. F. , Evans R. G. , Ludbrook J.
Published: January 2019

Information has come forward recently from several sources which provides new insights into the mechanisms that underlie the haemodynamic responses to acute blood loss. In unanaesthetised animals and human volunteers there are two distinct phases to these responses. At first, the engagement of baroreflexes results in a progressive rise in sympathetic vasoconstrictor drive and peripheral resistance, and the maintenance of arterial blood pressure at a near-normal level. When about one-third of blood volume has been lost, reflex sympathetic drive is switched off, and peripheral resistance and blood pressure fall abruptly to low levels despite a burst of vasopressin release.

Research in conscious animals has now shown that the onset of this decompensatory phase is triggered by a signal from the heart, which activates an endogenous opioid mechanism in the brain. Activation of this mechanism can be prevented by administering a selective δ-receptor antagonist, or selective μ-receptor agonists (including alfentanil). It has not yet been established that this endogenous opioid mechanism is responsible for the decompensatory phase of acute blood loss in man, nor that it can be prevented or reversed by selective opioid agonists or antagonists.
Foot Surgery in Vanuatu: Results of Combined Tibial, Common Peroneal and Saphenous Nerve Blocks in Fifty-six Adults
Authors: Sparks C. J. , Higeleo T.
Published: January 2019

Combined tibial and common peroneal nerve anaesthesia was used for foot and ankle surgery in fifty-six adults. Where necessary, the saphenous nerve was also blocked. A calibrated constant current nerve stimulator was used to localise the nerves in the popliteal fossa. Using lignocaine 1%, an opioid premedication, but no other sedation or top-up injection, 60% of the blocks were successful. If a patient felt pain at incision or during surgery, the block was recorded as a failure.
Initial Approach to Performance (Balanced) Mix Design: The Virginia Experience
Authors: Diefenderfer Stacey D. , Bowers Benjamin F.
Published: January 2019

Performance mix design (PMD) of asphalt mixtures, often referred to as balanced mix design, is a design methodology that incorporates performance testing into the mix design process. The Virginia Department of Transportation (DOT), like many owner agencies, is interested in ways to specify asphalt mix designs better in an effort to make its roadway network more sustainable, longer lasting, and more economical. By adding performance criteria through a PMD framework, that goal can be achieved. Further, a PMD framework should allow for the development of new, innovative methods to increase pavement recyclability, new performance additives, and other means to enhance pavement performance. This paper provides details and documentation of the approach being taken by the Virginia DOT in their efforts to develop a PMD specification. Aspects of development presented include PMD method options, selection of performance tests, and determination of acceptance criteria. A discussion about validating specifications with in-service performance data and addressing quality control and quality assurance is also provided. Although additional work is needed for full development and implementation, the methodology being applied has been found to provide useful outcomes for the Virginia DOT even in the initial stages of development.
Arbiters of Value: The Nationalization of Art and the Politics of Expertise in Early Socialist Romania
Authors: Grama Emanuela
Published: January 2019

In 1948, immediately after the Communist Party came to power in Romania, state officials commissioned a group of art experts to radically transform the existing public and private art collections into a national system of museums. These professionals became the new regime’s arbiters of value: the ultimate authority in assessing the cultural and financial value of artwork, and thus deciding their fate and final location. Newly available archival evidence reveals the specific strategies that they employed, and the particular political needs of the state they were able to capitalize on in order to survive and even thrive under a regime that, in principle, should have disavowed them.

Even though many of them had professionally come of age during the interwar period, the art experts managed to make themselves indispensable to the new state. They functioned as a pivotal mediator between state officials and a broader public because they knew how to use the national network of museums to put the new state on display. Through the rearrangement of public and private collections across the country, and the centralization of art in museums, they produced a particular “order of things” meant not only to entice the public to view the socialist state as the pinnacle of progress and as a benefactor to the masses but also to validate their expertise and forge a new political trajectory for themselves. The strategic movement of art objects that they orchestrated reveals the material and spatial dimensions of state-making in early socialism.
The Nonprofit Starvation Cycle: Empirical Evidence From a German Context
Authors: Schubert Peter , Boenigk Silke
Published: January 2019

The nonprofit starvation cycle describes a phenomenon in which nonprofit organizations continuously underinvest in their organizational infrastructure in response to external expectations for low overhead expenditure. In this study, we draw on nonprofit financial data from 2006 to 2015 to investigate whether the German nonprofit sector is affected by this phenomenon, specifically in the form of falling overhead ratios over time. We find reported overhead ratios to have significantly decreased among organizations without government funding and that the decrease originates from cuts in fundraising expenses—two results that are in contrast to previous findings from the U.S. nonprofit sector. With this study, we contribute to nonprofit literature by engaging in a discussion around the starvation cycle’s generalizability across contexts.