bluuebunny/crossref_metadata_2025 huggingface dataset:
Isozoanthus antumbrosus, a new species of zoanthid (Cnidaria: Anthozoa: Zoanthidea) symbiotic with Hydrozoa from the Caribbean, with a key to hydroid and sponge-symbiotic zoanthid species
Authors: SWAIN TIMOTHY D.
Published: July 2019

Isozoanthus antumbrosus, a new species of zooxanthellate zoanthid, is described. Colonies associate with the arborescent hydroid Dentitheca dendritica in the Caribbean Sea at 1–60 m. The coenenchyme, column, and oral disk are seal brown. The tentacles are golden brown and number 30–38. The coloration of the oral disk and tentacles recalls an annular solar eclipse. Polyps are 4.1–8.9 mm long and 2.2–4.3 mm in diameter. Genetic, morphological, and ecological characters differentiate this species from other hydroid-symbiotic zoanthids. Assignment to the genus Isozoanthus is based on morphology, with the acknowledgment that the currently accepted genera may not reflect evolutionary relationships.
First record of freshwater planarian Girardia tigrina (Platyhelminthes, Tricladida, Continenticola) in Eastern Europe
Authors: KANANA YULIIA , RIUTORT MARTA
Published: July 2019

The genus Girardia Ball, 1974 houses freshwater planarian species and is the second after Dugesia Girard, 1850 within Dugesiidae regarding the number of species. It contains 45 species (Tyler et al. 2006–2019) including three recently described: one from China—Girardia sinensis Chen & Wang 2015 (Chen et al. 2015), and two cave-dwelling planarians from Brasil—Girardia desiderensis Souza & Leal-Zanchet 2016 and Girardia pierremartini Souza & Leal-Zanchet 2016 (Souza et al. 2016).
Causes of Dimming and Brightening in China Inferred from Homogenized Daily Clear-Sky and All-Sky in situ Surface Solar Radiation Records (1958–2016)
Authors: Yang Su , Wang Xiaolan L. , Wild Martin
Published: July 2019

This paper presents a study on long-term surface solar radiation (SSR) changes over China under clear- and all-sky conditions and analyzes the causes of the “dimming” and “brightening.” To eliminate the nonclimatic signals in the historical records, the daily SSR dataset was first homogenized using quantile-matching (QM) adjustment. The results reveal rapid dimming before 2000 not only under all-sky conditions, but also under clear-sky conditions, at a decline rate of −9.7 ± 0.4 W m−2 decade−1 (1958–99). This is slightly stronger than that under all-sky conditions at −7.4 ± 0.4 W m−2 decade−1, since the clear-sky dimming stopped 15 years later. A rapid “wettening” of about 40-Pa surface water vapor pressure (SWVP) from 1985 to 2000 was found over China. It contributed 2.2% to the SSR decline under clear-sky conditions during the whole dimming period (1958–99). Therefore, water vapor cannot be the main cause of the long-term dimming in China. After a stable decade (1999–2008), an intensive brightening appeared under the clear-sky conditions at a rate of 10.6 ± 2.0 W m−2 decade−1, whereas a much weaker brightening (−0.8 ± 3.1 W m−2 decade−1) has been observed under all-sky conditions between 2008 and 2016. The remarkable divergence between clear- and all-sky trends in recent decades indicates that the clouds played two opposite roles in the SSR changes during the past 30 years, by compensating for the declining SSR under the cloud-free conditions in 1985–99 and by counteracting the increasing SSR under cloud-free conditions in 2008–16. Aerosols remain as the main cause of dimming and brightening over China in the last 60 years, although the clouds counteract the effects of aerosols after 2000.
Immigrants’ relative income and life satisfaction: Comparison groups from a multi-generational perspective
Authors: Shen Jing , Kogan Irena
Published: July 2019

With a focus on the immigrant population, this study examines how the association between a relative income position and life satisfaction varies when the comparison group changes. Drawing data from Understanding Society in the UK between 2009 and 2015, this study first shows that after migration, income comparisons with the mainstream and co-ethnic groups in the host country matter more than that with the source-country population for one’s life satisfaction. Furthermore, the relevance of comparison groups to life satisfaction varies across immigrant generations. Income comparison with the source-country population is more relevant to life satisfaction of the 1st generation, whereas 1.5 and 2nd generations consider income comparisons within the host country more relevant. In particular, favourable income comparison with the mainstream group in the host country is the most relevant to life satisfaction of the 2nd-generation, followed by the 1.5-generation, and last by the 1st-generation immigrants.
A multidirectional damage model for fiber-reinforced plastic laminates under static load
Authors: Qi Wenxuan , Yao Weixing , Shen Haojie
Published: July 2019

A multidirectional damage model based on continuum damage mechanics for fiber-reinforced composite laminates is proposed in this paper. The influence of three main damage mechanisms, including transverse matrix cracking, local delamination, and fiber breakage, on the multidirectional stiffness properties of composite laminates is analyzed by introducing macro phenomenological damage variables. Then the mechanical behavior of elementary ply in laminates is modeled based on these damage variables. Besides, relations between micro-level damage variables and macro-level damage variables are established. Damage evolution laws of the three damage mechanisms are proposed to predict the degradation of multidirectional stiffness and failure strength of composite laminates under quasi-static loading. The experiment of cross-ply glass fiber-reinforced plastic laminates is carried out, and the prediction results show good agreement with the experimental results.
The Defense Cooperation Agreement Dataset (DCAD)
Authors: Kinne Brandon J.
Published: July 2019

The academic study of defense cooperation focuses heavily on formal military alliances. Yet, governments rarely sign new alliances, and the global alliance structure has remained relatively static for decades. By contrast, governments are increasingly active in defense cooperation agreements (DCAs). These bilateral framework treaties institutionalize their signatories’ day-to-day defense relations, facilitating such wide-ranging activities as defense policy coordination, joint research and development, weapons production and arms trade, joint military exercises, training and exchange programs, peacekeeping, and information exchange. Nearly 2,000 DCAs have been signed since 1980. Preliminary evidence suggests that DCAs impact numerous security, military, and defense outcomes and that governments increasingly incorporate DCAs as core elements of their security strategies. This article introduces the new DCA Dataset (DCAD). I provide a brief historical background on DCAs and compare them to other commonly studied forms of defense cooperation. I then explain coding standards and describe the data set in detail. Finally, I illustrate applications of DCAD to militarized interstate disputes and arms trade.
Autonomous framework simulation tools for real-time multimedia streaming over wireless ad-hoc networks
Authors: Ahmed Adel A , Barukab Omar
Published: July 2019

Real-time video communication has become one of the most significant applications extensively used by homogeneous/heterogeneous wireless network technologies, such as Wi-Fi, the Internet of things, the wireless sensor network (WSN), 5G, etc. This leads to enhanced deployment of multimedia streaming applications over wireless network technologies. In order to accomplish the optimal performance of real-time multimedia streaming applications over the homogeneous/heterogeneous wireless network, it is therefore necessary to develop a simulation tool-set that effectively measures the quality of service (QoS) for different multimedia streaming applications over transport layer protocols. This paper proposes an autonomous simulation tool (AST) that is entirely independent from the source code of transport layer protocols. Furthermore, the AST is integrated into NS-2 to evaluate the QoS of real-time video streaming over numerous transport layer protocols and it uses new QoS measurement tools to test the video delivery quality based on I-frames to speeds up the assessment of multimedia streaming quality and ensure high accuracy of performance metrics. The simulation results show that using the AST to simulate real-time multimedia stream results in between 13% and 36% higher delivery ratio and 150–250% less cumulative jitter delay compared with using baseline simulation tools. Also, the AST guarantees an optimal QoS performance measurements in terms of the peak signal-to-noise Ratio and visual quality of the received video.
Studying Affective Tutoring Systems for Mathematical Concepts
Authors: Mastorodimos Dimitrios , Chatzichristofis Savvas A.
Published: July 2019

Students face difficulties in learning mathematical processes. As a result, they have negative emotions toward mathematics. The use of technology is employed to change the student’s attitude toward mathematics. Some methods utilize intelligent tutoring systems to recognize student’s emotional state and adapt the learning process accordingly. These systems, known as affective tutoring systems (ATSs), sense the emotional state of a student and then intelligently attempt to suggest appropriate strategies that can guide the learning process and ultimately shift the negative attitude of students toward mathematical learning. This article presents a survey of ATSs, which teach mathematic content, and tries to find common elements among them. It examines the kind and the number of student’s emotions that can be recognized and the strategies and methods that these ATSs use to recognize student’s emotional state. There are findings that agree with other studies about the recognized emotions and the methods that are used.
The Healthy Learning Organizations Model: Lessons Learned From the Canadian Federal Public Service
Authors: Beauregard Nancy , Lemyre Louise , Barrette Jacques
Published: July 2019

This study evaluates the predictive validity of the Healthy Learning Organizations (HLO) model in explaining mental health and organizational commitment among executives from the public sector. Data were derived from a cross-sectional sample of executives from the Canadian federal public service ( N = 1,601). Latent class analyses (LCA) assessed whether (a) associative patterns in executives’ psychosocial work environment and organizational learning process expressed a typology of healthy and learning organizations; and (b) executives’ mental health and organizational commitment varied according to this typology. LCA yielded a three-latent class solution, supporting evidence of (a) differential arrangements in the healthy and learning components of the HLO model; and (b) differential impacts on executives’ psychological distress and organizational commitment (i.e., affective, continuance). The HLO model offers novel grounds to assess healthy and learning organizations in the public administration sector.
Sensors and Sensing Practices: Reworking Experience across Entities, Environments, and Technologies
Authors: Gabrys Jennifer
Published: July 2019

This editorial examines how sensing practices are transforming through proliferating sensor technologies and altered sensing relations. Rather than engage with sensing as a project of the human mind or body as usually delineated within sensory classifications, this overview of sensors and sensing practices documents how sensing entities are emerging that are composed of shifting ensembles of multiple humans and more-than-humans, environments and technologies, politics and practices. By decoupling sensing from its exclusive human orientation, the editorial and collection demonstrate how reworked approaches to sensing make it possible to tune in to how involvement with environmental problems unfolds and endures. The collection asks how sensing practices might be crafted that attend to the distributed and accumulative inequalities of environmental problems and to speculate toward differential collectives for addressing environmental crisis and change.
Treatment of metastatic non-small cell lung cancer: 2018 guidelines of the Italian Association of Medical Oncology (AIOM)
Authors: Facchinetti Francesco , Pilotto Sara , Metro Giulio , Baldini Editta , Bertolaccini Luca , Cappuzzo Federico , Delmonte Angelo , Gasparini Stefano , Inno Alessandro , Marchetti Antonio , Passiglia Francesco , Puma Francesco , Ricardi Umberto , Rossi Antonio , Crinò Lucio , Novello Silvia
Published: July 2019

The treatment landscape of metastatic non-small cell lung cancer (NSCLC) has dramatically evolved in recent years, since the recognition of several clinical–biological entities requiring personalized treatment approaches, leading to significant improvements in patients’ survival outcomes. In particular, targeted therapies acting against EGFR, ALK, and ROS1, and immunotherapeutic agents modulating the PD-1/PD-L1 axis, represent new milestones in the treatment of advanced disease, supporting a chemotherapy backbone within a multidisciplinary model. The Italian Association of Medical Oncology (AIOM) has developed evidence-based guidelines for the management of lung tumors. Given the epidemiologic relevance, this report is dedicated to the treatment of advanced/metastatic NSCLC. These guidelines serve as a practical tool for oncologists, physicians, and other healthcare professionals to easily embrace the updated key points of NSCLC treatment strategies. Considering the upcoming introduction of potential new standards of care in several disease settings, these guidelines represent a benchmark from which to move forward.
The Stolen Voice Illusion
Authors: Brang David
Published: July 2019

Visual cues facilitate speech perception during face-to-face communication, particularly in noisy environments. These visual-driven enhancements arise from both automatic lip-reading behaviors and attentional tuning to auditory-visual signals. However, in crowded settings, such as a cocktail party, how do we accurately bind the correct voice to the correct face, enabling the benefit of visual cues on speech perception processes? Previous research has emphasized that spatial and temporal alignment of the auditory-visual signals determines which voice is integrated with which speaking face. Here, we present a novel illusion demonstrating that when multiple faces and voices are presented in the presence of ambiguous temporal and spatial information as to which pairs of auditory-visual signals should be integrated, our perceptual system relies on identity information extracted from each signal to determine pairings. Data from three experiments demonstrate that expectations about an individual’s voice (based on their identity) can change where individuals perceive that voice to arise from.
Watercooler Democracy: Rumors and Transparency in a Cooperative Workplace
Authors: Sobering Katherine
Published: July 2019

This article examines how rumors impact democracy and transparency in a cooperative workplace. Although literature on rumors generally analyzes them as negative to workplace culture, the author argues that rumors constitute a critical aspect of democratic participation. Drawing on long-term ethnographic fieldwork in a worker-recuperated business in Argentina, the author shows how members use rumors to incite deliberation, participate in decision-making, question organizational policy, and oversee managerial authority. Although informal communication at work can create uncertainty, confusion, and concerns about efficiency, the author finds that rumors can also increase worker influence, encourage organizational accountability, and ultimately protect against the consolidation of power.
Sealing performance and fatigue life of the fracturing packer rubber of various materials
Authors: Zhang Fuying , Shui Haoche , Yang Jun-Mei
Published: July 2019

The finite element model of four packer rubber materials was established by using ABAQUS and FE-SAFE software. The initial sealing load (the load is the pressure) was 11.85 MPa, and the working load was 58.15 MPa. The sealing evaluation coefficient, maximum contact stress, and fatigue life value of four material packer rubbers were considered when considering temperature changes and fatigue unit nodes. The results show that when the working load and the structural parameters of the rubber are the same, the sealing evaluation coefficient of the four material rubber increases with the increase of temperature. When the working temperature reaches 125 ℃, the value of the rubber seal evaluation coefficient of the HNBR material is the largest, and the value of the rubber seal evaluation coefficient of the EPDM material is the smallest. Similarly, the maximum contact stress of the four material rubbers increases with increasing temperature. When the temperature reaches 125 ℃, the maximum contact stress of the HNBR material is the largest, and the maximum contact stress of the EPDM material is the smallest. The rubber of the four materials increase the fatigue life value with the increase in the temperature within the operating temperature range studied. When the temperature is lower than 120 ℃, the fatigue life value of the HNBR material rubber is the largest. When the temperature is higher than 120 ℃, the fatigue life value of the CR material rubber is the largest. Regardless of the temperature change, the fatigue life value of the EPDM is the smallest. By comparing the results of field experiments with the results of finite element models, the two are found to have good consistency, which verifies the validity and feasibility of the model. The research results have important guiding significance for the fatigue life prediction of various material packer rubbers under different temperatures.
Differential steering-based electric vehicle lateral dynamics control with rollover consideration
Authors: Jing Hui , Wang Rongrong , Li Cong , Wang Jinxiang
Published: July 2019

This article investigates the differential steering-based schema to control the lateral and rollover motions of the in-wheel motor-driven electric vehicles. Generated from the different torque of the front two wheels, the differential steering control schema will be activated to function the driver’s request when the regular steering system is in failure, thus avoiding dangerous consequences for in-wheel motor electric vehicles. On the contrary, when the vehicle is approaching rollover, the torque difference between the front two wheels will be decreased rapidly, resulting in failure of differential steering. Then, the vehicle rollover characteristic is also considered in the control system to enhance the efficiency of the differential steering. In addition, to handle the low cost measurement problem of the reference of front wheel steering angle and the lateral velocity, an [Formula: see text] observer-based control schema is presented to regulate the vehicle stability and handling performance, simultaneously. Finally, the simulation is performed based on the CarSim–Simulink platform, and the results validate the effectiveness of the proposed control schema.
Humility
Authors: Van Tongeren Daryl R. , Davis Don E. , Hook Joshua N. , Witvliet Charlotte vanOyen
Published: July 2019

We review humility, a trait characterized by (a) an ability to accurately acknowledge one’s limitations and abilities and (b) an interpersonal stance that is other-oriented rather than self-focused. We explore two key contexts of humility, intellectual and cultural; explain why humility is important; and identify open questions for future research.
Class Politics and Social Protection: A Comparative Analysis of Local Governments in India
Authors: Roy Indrajit
Published: July 2019

Dramatic differences in the quality of human life are a prominent feature of today’s world. In response, many governments and international development agencies have begun to formulate and implement agendas for social protection. Nevertheless, the outcomes of such initiatives remain vastly varied.

What explains such variations? In this article, I direct attention to the role of class politics in shaping the implementation of social protection by local governments that implement India’s Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA). Based on a synthesis of official data, interviews with beneficiaries of social protections and elites, and direct observations in two Indian States, the author illustrates the ways in which variations in class politics influence the supply of employment works.

This article departs from existing analysis of factors that favour the implementation of social protections, namely commitment of bureaucrats and politicians, political party linkages and clientelism, and civil society activism. It also nuances extant class-focused analysis which tend to adopt a polarized model of class conflict between dominant classes and the laboring poor. This article, by contrast, appreciates the conflicts within dominant classes, and emphasizes the role of coalitions and competitions between elite fractions.

Where elite fractions successfully co-opt or eliminate one another, they successfully sabotage the labour-friendly MGNREGA. On the other hand, where elite fractions conflict with one another, labour-friendly programs such as the MGNREGA have a chance of being implemented. However, the transformative aspect of the program’s intent, in terms of dissolving the relations of power that bolster poverty, appears to be more in evidence in localities where precarious elites align with the laboring poor to challenge the influence of the entrenched elites. As we examine alternative means of addressing the dramatic differences in the quality of life that continue to blight the contemporary world, the imperative to analyze class politics becomes greater than ever before.
Palmer Luckey and the rise of contemporary virtual reality
Authors: Harley Daniel
Published: July 2019

Despite a lack of consumer interest as recently as 2012, virtual reality (VR) technologies entered the mainstream in 2014 backed by multinational corporations, including Facebook and Google. At the heart of this transition is Palmer Luckey, founder of Oculus and purported ‘face’ of VR. This article develops a case study centred on Palmer Luckey to examine the rise of contemporary VR within the overlapping, contemporaneous contexts of video game culture and the misogynistic gamergate movement. As gamergate expanded its scope with far-right political fervour, Luckey’s political ambitions also expanded in scope. I argue that Luckey’s promotion under the banner of ‘progress’ serves to reify White, male systems of power that are both established and contested within cultures of technological development.
Public discourse, the media, and international education in Canada
Authors: Lee Eunjung , Ko Bradyn , Johnstone Marjorie
Published: July 2019

The phenomenon of the internationalization of education has been prevalent in developed western countries, with varied and at times contested discourses about international education and students. We wonder how these discourses are constructed and contested in the media and further shape public opinions. Using the critical theories of language, power, and media, we analyzed 44 articles relevant to international education/students and their commentaries in the widely circulated Canadian newspapers. Our findings illustrate three dominant themes as the rhetoric of international education/students in Canada and how they are discursively constructed: (1) international education as a commodity; (2) international students as recipients of the generosity of Canada; and (3) international students as burden/harms to Canadian education/students as well as having moral deficits and being lawfully wrongdoers. This analysis highlights how international students are otherized, essentialized, and silenced as the voiceless despite their strong presence as the fastest growing migrant group in Canada with diverse identities and needs. We close with a discussion of the media analysis on international students as one such example of how dominance such as neoliberalism is taking up e-space like other public domains in social environments, which social workers deeply care about.
An investigation into the effects of a virtual reality system on phantom limb pain: a pilot study
Authors: Kulkarni Jai , Pettifer Steve , Turner Sue , Richardson Cliff
Published: July 2019

Background:

There is no first-line treatment available for phantom limb pain (PLP). For some years, there has been interest in the use of mirrors and other techniques based on visual feedback. Unfortunately, up until now, all published studies have had methodological weaknesses with two recent systematic reviews concluding that therapies of this kind need more evidence to support their use.

Aim:

To evaluate the effects of a virtual reality (VR) activity on PLP.

Methods:

This was a prospective pilot study of upper limb amputees using questionnaires to evaluate a VR system. Eleven participants were recruited, with nine completing all three sessions of VR. Participants undertook three sessions of VR, one a month for 3 months. Outcome measures were PLP pain intensity using an 11-point numerical rating scale (NRS), number of PLP episodes and duration of the PLP episodes. All participants were also asked for their judgement of change. Open-ended questions captured the qualitative experience of all aspects of the VR experience.

Results:

The mean PLP pain score following three VR sessions reduced (6.11 v 3.56) but this was not a statistical difference (t = 2.1, df = 8, p = 0.07). No statistical difference was found for the number of PLP episodes (Pearson chi-square = 3.43, df = 2, p = 0.18) or the duration of each PLP episode (Pearson chi-square = 22.50, df = 16, p = 0.13). Three groups emerged: those whose pain reduced (the majority), those whose pain remained the same (small number) and one those whose pain increased slightly.

Discussion:

There is insufficient evidence from these results to identify an effect of VR on PLP; however, this is a small group and qualitatively most were content with the treatment and wanted a longer trial.
Personality Facets, Writing Strategy Use, and Writing Performance of College Students Learning English as a Foreign Language
Authors: He Tung-hsien
Published: July 2019

This study applied the structural equation modeling (SEM) technique to explore the predictive relations among personality facets, writing strategy use, and writing performance of college students learning English as a foreign language (EFL). In total, 201 participants composed an argument-based essay, before being surveyed using two self-report instruments: the Personality Facet Scale (PFS), which measured 10 facets within the framework of the Five-Factor Model (FFM), and the Writing Strategy Scale (WSS) that assessed six types of strategy. The established structural model indicated the following: (a) Five types of strategy and six facets predicted writing performance, (b) nine facets predicted the use of at least one type of strategy, either positively or negatively, and (c) the five types of strategy mediated the relations between the nine facets and writing performance. As suggested, adding and treating strategy use as a mediator could help elaborate and elucidate the facet–performance relations in the EFL writing context.
The Incidental Acquisition of English Prepositions by Arabic-Speaking EFL Learners: Evidence From Al Ain University of Science and Technology
Authors: Altakhaineh Abdel Rahman Mitib , Ibrahim Mona Kamal
Published: July 2019

This study examined the incidental acquisition of English prepositions by Arabic-speaking English as a foreign language (EFL) learners. Employing reading comprehension exercises as a treatment, we adopted the experimental design of a pre- and post-test to determine the effectiveness of the treatment on the participants’ incidental acquisition of English prepositions. For the purpose of the study, we divided the participants into a treatment group, who engaged in reading comprehension exercises for one academic term, and a control group, who did not. We used a multiple-choice test and a fill-in-the-blank test to measure the participants’ receptive and productive knowledge of English prepositions, respectively. We also conducted an introspective session with the treatment group following the administration of the post-tests to determine the areas of difficulty. The results of the study mainly indicated that reading accompanied by exercises resulted in better incidental gains in the acquisition of English prepositions, especially on the multiple-choice test. The study concludes with recommendations for further research.
Research Motivations and Undergraduate Researchers’ Disciplinary Identity
Authors: Davis Shannon N. , Wagner Sarah E.
Published: July 2019

Disciplinary identity, or connection to a particular academic discipline, is constructed through a developmental process across a scholar’s academic life course. Using unique data from an online survey of students at four different colleges and universities, we investigate the extent to which disciplinary identity among undergraduate researchers reflects motivations for participating in research and varies by student discipline. We document key differences in disciplinary identity based upon two internal motivators, intellectual interest and grit, as well as demographic characteristics. We discuss implications for institutions and undergraduate programs desiring to encourage students to participate in undergraduate research.
Ambulatory Training Program to Expand Procedural Skills in Primary Care
Authors: Fortuna Robert J. , Marston Bethany , Messing Susan , Wagoner Gunnar , Pulcino Tiffany L. , Bingemann Todd , Caiola Enrico , Scofield Steven , Nead Karen , Robbins Brett W
Published: July 2019

Introduction:

Outpatient procedures are an important component of primary care, yet few programs incorporate procedural training into their curriculum. We examined a 4-year procedural curriculum to improve understanding of ambulatory procedures and increase the number of procedures performed.

Methods:

A total of 56 resident and 8 faculty physicians participated in a procedural curriculum directed at joint injections (knee, shoulder, elbow, trochanteric bursa, carpal tunnel, wrist, and ankle), subdermal contraceptive insertion/removal, skin biopsies, and ultrasound use in primary care. We administered annual surveys and used generalized estimating equations to model changes.

Results:

Across the 4 years, there was an average 96% response rate. Mean comfort level with the indications for procedures increased for both resident (62.5 to 78.8; P < .0001) and faculty physicians (61.5 to 94.8; P < .0001). Similarly, mean comfort with performing procedures increased for both resident (32.1 to 62.3; P < .0001) and faculty physicians (42.2 to 85.4; P < .0001). Residents’ comfort level performing procedures increased for all individual procedures measured. The mean number of procedures performed per year increased for resident (1.9 to 8.2; P < .0001) and faculty physicians (14.7 to 25.2; P = .087).

Conclusions:

A longitudinal ambulatory-based procedural curriculum can increase resident and faculty physician understanding and comfort performing primary-care-based procedures. This, in turn, increased the total number of procedures performed.
Evaluating the Impact of Secure Mobile Messaging on Communication and Cancer Care Team Satisfaction in a Large Radiation Oncology Clinic
Authors: Arscott W. Tristram , Gray Kathleen , Kuska Dennis , Nagda Suneel , Lustig Robert , Alonso-Basanta Michelle , Metz James M. , Jones Joshua
Published: July 2019

PURPOSE:

Communication is crucial in any clinical environment for efficient delivery of care and ensuring patient safety. A 2016 National Database of Nursing Quality Indicators questionnaire indicated poor physician-nurse satisfaction with communication in our department. We addressed gaps in our communication procedures by implementing a communication policy with a secure mobile messaging platform, and we surveyed care team members to evaluate the effectiveness of the implementation.

METHODS:

We designed a policy around best communication practices and implemented a secure mobile messaging platform, Cureatr, which enables closed-loop, two-way communication that is compliant with the Health Insurance Portability and Accountability Act. Pre- and postimplementation surveys evaluated self-reported impression of efficiency, timeliness, effectiveness, and overall quality of communication, which were scored on a 5-point Likert scale. The number of messages sent was evaluated as a measure of uptake in use, and patient navigation data were queried to measure changes in clinic workflow.

RESULTS:

After implementation of Cureatr and a communication policy, survey responses demonstrated a clear improvement in staff satisfaction with the efficiency, timeliness, effectiveness, and overall quality of communication. The number of messages sent reflected a progressive increase in use of Cureatr; however, a consistent improvement in clinical workflow as measured by a decrease in patient in-room time was not appreciated.

CONCLUSION:

Implementing a secure messaging application with a communication policy improved cancer care team satisfaction with communication on all levels. Additional work is needed to evaluate the impact of secure messaging on clinical workflows, patient satisfaction, and staff well-being.
Sex Difference in Corticosterone-Induced Insulin Resistance in Mice
Authors: Kaikaew Kasiphak , Steenbergen Jacobie , van Dijk Theo H , Grefhorst Aldo , Visser Jenny A
Published: July 2019

Prolonged exposure to glucocorticoids (GCs) causes various metabolic derangements. These include obesity and insulin resistance, as inhibiting glucose utilization in adipose tissues is a major function of GCs. Although adipose tissue distribution and glucose homeostasis are sex-dependently regulated, it has not been evaluated whether GCs affect glucose metabolism and adipose tissue functions in a sex-dependent manner. In this study, high-dose corticosterone (rodent GC) treatment in C57BL/6J mice resulted in nonfasting hyperglycemia in male mice only, whereas both sexes displayed hyperinsulinemia with normal fasting glucose levels, indicative of insulin resistance. Metabolic testing using stable isotope-labeled glucose techniques revealed a sex-specific corticosterone-driven glucose intolerance. Corticosterone treatment increased adipose tissue mass in both sexes, which was reflected by elevated serum leptin levels. However, female mice showed more metabolically protective adaptations of adipose tissues than did male mice, demonstrated by higher serum total and high-molecular-weight adiponectin levels, more hyperplastic morphological changes, and a stronger increase in mRNA expression of adipogenic differentiation markers. Subsequently, in vitro studies in 3T3-L1 (white) and T37i (brown) adipocytes suggest that the increased leptin and adiponectin levels were mainly driven by the elevated insulin levels. In summary, this study demonstrates that GC-induced insulin resistance is more severe in male mice than in female mice, which can be partially explained by a sex-dependent adaptation of adipose tissues.
Middle interhemispheric variant of holoprosencephaly in an asymptomatic adult
Authors: Özdemir Meltem , Turan Aynur , Kavak Rasime Pelin
Published: July 2019

Middle interhemispheric variant of holoprosencephaly is an uncommon subtype of holoprosencephaly which is characterized by a midline connection of the two cerebral hemispheres in the posterior frontal and parietal regions with the separation of the anterior frontal and occipital lobes. It usually presents in early childhood with facial dysmorphism, seizures, motor dysfunction and mental–motor retardation. We herein present an unusual case of middle interhemispheric variant of holoprosencephaly which was asymptomatic and incidentally found in adulthood.
tailfindr: alignment-free poly(A) length measurement for Oxford Nanopore RNA and DNA sequencing
Authors: Krause Maximilian , Niazi Adnan M. , Labun Kornel , Torres Cleuren Yamila N. , Müller Florian S. , Valen Eivind
Published: July 2019

Polyadenylation at the 3′-end is a major regulator of messenger RNA and its length is known to affect nuclear export, stability, and translation, among others. Only recently have strategies emerged that allow for genome-wide poly(A) length assessment. These methods identify genes connected to poly(A) tail measurements indirectly by short-read alignment to genetic 3′-ends. Concurrently, Oxford Nanopore Technologies (ONT) established full-length isoform-specific RNA sequencing containing the entire poly(A) tail. However, assessing poly(A) length through base-calling has so far not been possible due to the inability to resolve long homopolymeric stretches in ONT sequencing. Here we present tailfindr, an R package to estimate poly(A) tail length on ONT long-read sequencing data. tailfindr operates on unaligned, base-called data. It measures poly(A) tail length from both native RNA and DNA sequencing, which makes poly(A) tail studies by full-length cDNA approaches possible for the first time. We assess tailfindr’s performance across different poly(A) lengths, demonstrating that tailfindr is a versatile tool providing poly(A) tail estimates across a wide range of sequencing conditions.
Uterine natural killer cells: Time for a re-appraisal?
Authors: Bulmer Judith N. , Lash Gendie E.
Published: July 2019

The presence of unusual natural killer cells in human endometrium has been recognized for 30 years, but despite considerable research effort, the in vivo role of uterine natural killer (uNK) cells in both normal and pathological pregnancy remains uncertain. uNK cells may differentiate from precursors present in endometrium, but migration from peripheral blood in response to chemokine stimuli with in situ modification to a uNK cell phenotype is also possible. uNK cells produce a wide range of secretory products with diverse effects on trophoblast and spiral arteries which may play an important role in implantation and early placentation. Interactions with other decidual cell populations are also becoming clear. Recent evidence has demonstrated subpopulations of uNK cells and the presence of other innate lymphoid cell populations in decidua which may refine future approaches to investigation of the role of uNK cells in human pregnancy.
A unique insert in the genomes of high-risk human papillomaviruses with a predicted dual role in conferring oncogenic risk
Authors: Auslander Noam , Wolf Yuri I. , Shabalina Svetlana A. , Koonin Eugene V.
Published: July 2019

The differences between high risk and low risk human papillomaviruses (HR-HPV and LR-HPV, respectively) that contribute to the tumorigenic potential of HR-HPV are not well understood but can be expected to involve the HPV oncoproteins, E6 and E7. We combine genome comparison and machine learning techniques to identify a previously unnoticed insert near the 3’-end of the E6 oncoprotein gene that is unique to HR-HPV. Analysis of the insert sequence suggests that it exerts a dual effect, by creating a PDZ domain-binding motif at the C-terminus of E6 as well as eliminating the overlap between the E6 and E7 coding regions in HR-HPV. We show that as a result, the insert might enable coupled termination-reinitiation of the E6 and E7 genes, supported by motifs complementary to the human 18S rRNA. We hypothesize that the added functionality of E6 and positive regulation of E7 expression jointly account for the tumorigenic potential of HR-HPV.
Getting health information to internally displaced youth in Afghanistan: can mobile phone technology bridge the gap?
Authors: Alami Sayed Omar , Dulli Lisa , Dal Santo Leila , Rastagar Sayed Haroon , Seddiqi Sediq , Hemat Shafiqullah , Machlin Burke Jane , Todd Catherine S.
Published: July 2019

Background: Afghanistan ranks among the most disadvantaged globally for many key reproductive, maternal, newborn and child health (RMNCH) indicators, despite important gains in the past decade. Youth (15 to 24 years) are a key audience for RMNCH information as they enter adulthood, marry and begin families; however, reaching Afghan youth with health information is challenging. Internally displaced persons (IDPs), including youth, experience additional challenges to obtaining health-related information and services. This study measured current and preferred RMNCH information channels to explore the feasibility of using mobile phone technology to provide RMNCH information to IDP youth in Afghanistan.

Methods: We conducted a sub-group analysis of survey data from a mixed-methods, cross-sectional, formative assessment to understand current access to RMNCH information. The target population for this analysis includes 15-25-year-old male and female IDP youth from three Afghan Provinces. Survey data were collected using a structured questionnaire administered through face-to-face interviews. Data were analyzed descriptively.

Results: A total of 450 IDP youth were surveyed in the three provinces (225 male and 225 female). Access to RMNCH information outside of health facilities was limited. Mobile phone ownership was nearly universal among male participants, yet considerably lower among females; nearly all participants without personal phones reported access to phones when needed. Although few participants spontaneously mentioned mobile phones as a preferred source of RMNCH information, most male and female respondents reported they would be very or somewhat likely to use a free, mobile-phone-based system to access such information if offered.

Conclusions: Given widespread access and considerable interest voiced by participants, mobile phones may be a viable way to reach IDP youth with important RMNCH health information in this fragile setting. Interventions should be designed and pilot-tested to identify the most appropriate platforms and information content and to further document feasibility and acceptability.
Pediatrics: nominal symptoms and syndromes
Authors: Балыкова Лариса , Balykova Larisa , Печкуров Дмитрий , Pechkurov Dmitriy , Акашкина Екатерина , Akashkina Ekaterina , Балашова Елена , Balashova Elena , Верещагина Вероника , Vereschagina Veronika , Гаранин Андрей , Garanin Andrey , Гуменюк Ольга , Gumenyuk Ol'ga , Мазур Лилия , Mazur Liliya , Нечаев Владимир , Nechaev Vladimir , Панина Ольга , Panina Ol'ga , Порецкова Галина , Poreckova Galina , Раздолькина Татьяна , Razdol'kina Tat'yana , Тяжева Алена , Tyazheva Alena , Спиваковская Анна , Spivakovskaya Anna , Спиваковский Юрий , Spivakovskiy Yuriy , Черненков Юрий , Chernenkov Yuriy , Эйберман Александр , Eyberman Aleksandr
Published: July 2019

The guide will allow pediatricians to get information about the meaning of eponymous terms that they face in practice, educational and scientific activities, it contains 1212 eponymous symptoms, samples and reflexes, 752 symptom complexes, syndromes and diseases relevant to pediatric practice.
The book consists of two parts, the first part includes the semiotics of pediatric diseases and presents their symptoms and signs. In the second part of the guide are syndromes and nosological units, which are systematized in alphabetical order. Their interpretation, historical information, data on epidemiology, etiology, pathogenesis and clinical picture of nosological units are given. From the standpoint of evidence-based medicine provides information on the diagnosis, treatment and prevention of these conditions, which may occur in the practice of a pediatrician.
The guide is addressed to pediatricians, it is useful to researchers, teachers of higher medical school.
A coaching program to improve quality of life in older people in Japan: a randomised controlled trial
Authors: Ohashi Junko , Katsura Toshiki
Published: July 2019

As the world's population ages, efforts to improve quality of life (QOL) in old age are gaining public attention. In this study, a programme was conducted for older people with the aim of clarifying their life goals related to QOL and the meaning of their existence, and the effect of the programme in improving QOL was evaluated. Participants were randomly assigned to the intervention or control group after registration. The program consisted of four 90-minute classes. The primary outcome was the Philadelphia Geriatric Center Morale Scale score (PGC), and changes in outcomes were compared between groups. The intervention group had significantly improved PGC scores (P<0.003). Further, the scores of PGC subscales ‘Acceptance of one's own ageing’ and ‘Lonely dissatisfaction’ showed significant improvements after the intervention (P<0.001). The findings suggest the effectiveness of the developed program in improving QOL in people aged ≥65 years.
Community nursing and antibiotic stewardship: the importance of communication and training
Authors: Chater Angel , Courtenay Molly
Published: July 2019

Antimicrobial stewardship (using antimicrobials responsibly) can reduce the risk of antimicrobial resistance (AMR). Many health professionals identify themselves as ‘antibiotic guardians’, but patient expectations, time constraints, and a lack of confidence or underdeveloped communication skills can influence decisions to prescribe. Nurse prescribers have an important role to play in antibiotic stewardship, and their numbers continue to grow. While nurse prescribers welcome this extension to their traditional role, they are often faced with barriers to antibiotic stewardship activities. These barriers may relate to their Capability (knowledge/skill), Opportunity (norms of practice, influence of patients, environmental factors), and Motivation (attitudes and beliefs, concern over outcome, emotion and habit) [COM-B]. Education, training and enablement can help to overcome these barriers, and the development of knowledge, confidence and effective communication skills should be of priority. Further, communication skills can help nurse prescribers understand patient expectations, with the use of open-ended questions, active listening and creation of a patient-centred consultation that leads to a mutually agreed end goal and way forward.
Malnutrition: evaluating the effectiveness of supplements
Authors: Collins Abbie Jane , Clemett Victoria , McNaughton Amanda
Published: July 2019

This article explores the effectiveness of oral nutritional supplements through a literature review. A literature search was performed throughout various medical databases and one article was selected for a critical appraisal. The study focused on the use of high-energy, low-volume supplements for people living in care homes who are at risk of malnutrtion or who are already manourished. The methods and conclusions of the study are then scrutinised. This article recommends further research to be carried out into the type and volume of supplements needed and the implementation of evidence-based practice.
Breathe easy
Authors: Silverton Louise
Published: July 2019

Awareness of environmental issues is growing, including efforts to tackle air polluion. But, asks Louise Silverton CBE, is enough being done to protect pregnant women and their babies?
Diabetes in pregnancy: a practical guide for midwives
Authors: Surendran Aarthi , Dixon Danielle , Whyte Martin
Published: July 2019

Diabetes is a growing concern. With the rising incidence of obesity in the younger people, the incidence of diabetes has also increased. This has resulted in more women of childbearing age attending antenatal clinic with a diagnosis of either pre-existing or gestational diabetes. Management of these women is vital to avoid complications in both the mother and the child during pregnancy and childbirth. This article aims to provide a concise guide to the management of diabetes in pregnancy for midwives, who are often the first point of contact for these women.