bluuebunny/crossref_metadata_2025 huggingface dataset:
Norman R. James F.F.A.R.A.C.S., a Pioneer of High Quality Anaesthesia in Australia
Authors: Giesecke A. H.
Published: July 2019

Dr Norman R. James was a multi-talented, highly accomplished clinician, teacher and innovator broadly recognized on three continents. In the United Kingdom, he served in London's Emergency Medical Service during World War II and was dubbed “England's foremost exponent of regional anaesthesia”. In his native land, he was the first Director of Anaesthetics at The Royal Melbourne Hospital with many innovations to his credit including a serious effort to reform anaesthetic practice in Australia. Dr M. T. “Pepper” Jenkins, the charismatic founder of anesthesiology at the University of Texas Southwestern Medical School, recruited him to Dallas in 1960, where he taught the art and science of anesthesiology at Parkland Memorial Hospital until his retirement in 1974. He died in 1987 and is buried in Winnsboro, Texas. A brief story of his life and career follows.
Vivian Richard Ebsary, A.M. Biomedical Engineer, Inventor, Philanthropist
Authors: O'brien H. D.
Published: July 2019

Vivian Ebsary was an inventor, designer and manufacturer of varied pieces of medical equipment, particularly those involving pumps. These included hypothermia machines and the heart-lung cardiopulmonary bypass machines used in Australian and New Zealand hospitals from the mid 1950s until well into the 1970s. Ebsary also designed and manufactured anaesthetic machines, a hyperbaric unit, scoliosis implant equipment, a chairlift and many other devices for use in the general community.

This paper presents an overview of his life's involvement with medicine and medical technology in Australia.
Perturbation Methods for Protection of Sensitive Location Data: Smartphone Travel Survey Case Study
Authors: Badu-Marfo Godwin , Farooq Bilal , Patterson Zachary
Published: July 2019

Smartphone based travel data collection has become an important tool for the analysis of transportation systems. Interest in sharing travel survey data has gained popularity in recent years as “open data initiatives” by governments seek to allow the public to use these data, and hopefully to contribute their findings and analysis to the public sphere. The public release of such precise information, particularly location data such as place of residence, opens the risk of privacy violation. At the same time, in order for such data to be useful, as much spatial resolution as possible is desirable for utility in transportation applications and travel demand modeling. This paper evaluates the efficacy of two geographic random perturbation methods—geo-indistinguishability and donut geomask—in protecting the privacy of respondents whose residential location may be published. The study measures the performance of location privacy methods, preservation of utility, and randomness in the distribution of perturbation distances with varying parameters. It is found that both methods produce distributions of spatial perturbations that conform closely to common probability distributions and, as a result, that the original locations can be inferred with little information and a high degree of precision. It is also found that while achieved k -estimate anonymity increases linearly with desired anonymity for the donut geomask, geo-indistinguishability is highly dependent upon its privacy budget factor and is not very effective at assuring desired achieved k -estimate anonymity.
“Not an Environmentalist”: Strategic Centrism, Cultural Stereotypes, and Disidentification
Authors: Cherry Elizabeth
Published: July 2019

Birding has long been associated with environmental activism, from its origins as a scientific hobby in the nineteenth century to today’s citizen scientist birders. My research with birders shows that despite their political activism, personal actions, and ecological beliefs, many disidentify as activists or environmentalists. Using data from 30 in-depth interviews and three years of ethnographic research with birders, I argue their disidentification comes from two interrelated sources. First, these birders followed the Audubon Society’s approach of strategic centrism, espousing a centrist identity and strategy of conservation. Second, these birders disidentified with the identity of “environmental activist” because of negative cultural stereotypes about environmental activists, which was bolstered by the Audubon Society’s strategic centrism. These mutually reinforcing phenomena create a situation that doubly discourages these birders from identifying as environmental activists. This paper contributes to sociological understandings of the interplay between culture, identity, and environmental activism.
Impact of State Laws Governing Physical Education on Attendance Among US High School Students, 2003 to 2017
Authors: An Ruopeng , Ji Mengmeng , Clarke Caitlin , Guan Chenghua
Published: July 2019

Purpose:

This study assessed the influence of state laws governing physical education (PE) on weekly PE class attendance among US high school students.

Design:

Cross-sectional.

Setting:

2003 to 2017 US national Youth Risk Behavior Survey (YRBS).

Participants:

A total of 533 468 high school students.

Measures:

Data on state laws governing PE came from National Cancer Institute’s Classification of Laws Associated with School Students (CLASS). Eight distinct state PE policies were scored, with higher scores denoting stronger laws.

Analysis:

Individual-level YRBS data were merged with CLASS data based on students’ residential state and survey year. State fixed-effect negative binomial regressions were performed, adjusting for individual-level characteristics and YRBS survey design.

Results:

A 1-score increase in state laws governing PE class time, staffing for PE, joint use agreement for physical activity, assessment of health-related fitness, and PE curriculum was associated with an increase in weekly PE attendance by 0.30, 0.28, 0.22, 0.20, and 0.13 days ( P < .001), respectively. In contrast, a 1-score increase in state laws governing moderate-to-vigorous-intensity physical activity time in PE, PE proficiency, and recess time was associated with a reduction in weekly PE attendance by 0.25, 0.15, and 0.09 days ( P < .001), respectively. The effects of most state PE policies on PE class attendance were larger among girls than boys.

Conclusion:

State PE policies differentially impacted US high school students’ PE class attendance, with larger effects on female students.
Methods for aligning near-continuous railway track inspection data
Authors: Palese Joseph W , Zarembski Allan M , Attoh-Okine Nii O
Published: July 2019

Railroads have long used track inspection vehicles that capture data on a defined interval as the vehicle travels longitudinally down the track. These data can be captured on a constant interval, near-constant interval, or temporally. The data are normally evaluated in real time against exception thresholds, which define locations of safety or maintenance concern. In addition, railways evaluate multiple inspection runs of the same track over time to determine the rates of degradation. Since most inspection vehicles rely on the operator input of location events (mile posts, signals, switches, etc.) and tachometer-based distance measurement, the resulting inspection data are often longitudinally misaligned, on occasion by as much as several hundred feet. This paper presents an application of classical and advanced time-series methods for aligning data longitudinally. It also presents a novel methodology for aligning data with a nonconstant sampling interval, utilizing a combination of classical techniques.
Albanian Transnational Fighters: From the Spanish Civil War to the European Resistance Movements (1936–1945)
Authors: Acciai Enrico
Published: July 2019

This article investigates the trajectories of a small group of Albanian veterans of the Spanish Civil War after leaving Spain, in early 1939. By focusing on the way in which Albanian veterans reached the European resistance movements between 1941 and 1943, we both enhance and problematize our understanding of the European resistance movement as a transnational phenomenon with its roots in the Spanish Civil War. This article aims to contribute further to a better understanding of the longue durée of the anti-fascist fight between 1936 and the end of the Second World War.
Circulating and bone marrow myeloid cells containing Leishmania amastigotes in a case of advanced canine leishmaniosis
Authors: Oikonomidis Ioannis L. , Tsouloufi Theodora K. , Mylonakis Mathios E. , Psalla Dimitra , Soubasis Nectarios , Rallis Timoleon , Kritsepi-Konstantinou Maria
Published: July 2019

A 5-y-old male Poodle mix was presented with intermittent vomiting, anorexia, and weight loss. Physical examination revealed emaciation, lethargy, dehydration, hypothermia, respiratory distress, and splenomegaly. Based on clinicopathologic, serologic, and parasitologic findings, diagnoses of severe leishmaniosis and dirofilariasis were made. Extracellular, intraneutrophilic, and intramonocytic Leishmania amastigotes were observed on blood smear and buffy coat smear examination. In blood smears, 0.2% of neutrophils were observed to be infected; in buffy coat smears, 0.5% of neutrophils and 0.1% of monocytes were found to be infected. Leishmania amastigotes were also found engulfed by eosinophils and neutrophil precursors in bone marrow aspiration cytology. The detection of Leishmania amastigotes in blood smears is rare, and the clinical significance is uncertain. In circulating blood, Leishmania amastigotes are primarily found phagocytized by neutrophils. Although debatable, there is growing evidence that neutrophils are used as carriers enabling the “silent entry” of the protozoa into macrophages (“Trojan horse” theory). To date, cytologic screening of blood smears for the diagnosis of canine leishmaniosis is not a routine practice. Clinical pathologists and practitioners should be aware that Leishmania amastigotes may be present in neutrophils and less frequently monocytes during blood smear evaluation; neutrophil precursors and eosinophils may also be parasitized in bone marrow specimens.
Cognitive, Affective, and General Empathy in Individuals Convicted of a Sexual Offense: A Meta-Analysis
Authors: Morrow Elijah Paul
Published: July 2019

Empathy has an important role in promoting proper societal functions. Those who violate societal functions, such as those convicted of having committed a criminal offense, are theorized to possess deficits in their empathic capacity. This assumption has been adopted by many criminological models, including for individuals convicted of a sexual offense (ICSO). However, contradictory research results have resulted in conflicting theories regarding the level of empathy within ICSO. This meta-analysis compiled available data to provide empirical clarity in a divided theoretical field. Results of the meta-analysis indicate that ICSO have lower levels of cognitive (Hedges’s g = −.303, p = .007) and general empathy (Hedges’s g = −.188, p = .020) than those in the general population but do not have significantly lower levels of affective empathy (Hedges’s g = .023, p = .849). Several moderator analyses were conducted, including type of sexual offense, assessment instrument used, and age at conviction.
Inactivation of Staphylococcus aureus and Escherichia coli O157:H7 on fresh kashar cheese with pulsed ultraviolet light
Authors: Keklik Nene M , Elik Adil , Salgin Uğur , Demirci Ali , Koçer Gamze
Published: July 2019

Pulsed ultraviolet light is a potential postprocessing decontamination method which is able to reduce pathogens on solid food surfaces. Cheese surfaces may become easily contaminated with pathogens due to improper handling or contact with unhygienic surfaces during or after processing. In this study, the effects of pulsed ultraviolet light on Staphylococcus aureus and Escherichia coli O157:H7 on fresh kashar cheese were investigated. Pulsed ultraviolet light was applied to kashar cheese for different times (5, 15, 30, 45, 60 s) at 5, 8, and 13 cm from the quartz window in a pulsed ultraviolet light system. Based on the inactivation level, time, and visual evaluation, the most favorable treatment was determined as the 45 s–13 cm treatment (∼44 J/cm2). This treatment yielded about 1.62 and 3.02 log10 reductions (cfu/cm2) for S. aureus and E. coli O157:H7, respectively, while did not alter (p>0.05) the pH, lipid oxidation, and moisture content of kashar cheese, except the color parameters. When 0.5 cm thick kashar cheese was treated with pulsed ultraviolet light at a distance of 5 cm from the quartz window, the highest energy transmittance was found to be about 9.16%. These findings demonstrate that pulsed ultraviolet light has the potential for postprocessing decontamination of semi-hard cheese surfaces.
Effects of Levosimendan on Inflammation and Oxidative Stress Pathways in a Lipopolysaccharide-Stimulated Human Endothelial Cell Model
Authors: Rodríguez-González Raquel , Pollesello Piero , Baluja Aurora , Álvarez Julián
Published: July 2019

Levosimendan is a myocardial Ca2+ sensitizer and opener of ATP-dependent potassium channels with inotropic, vasodilating, and cardioprotective properties. It was originally developed for the treatment of acute decompensated heart failure, but its complex mechanism of action means that it could also play a role in organ protection in response to infection. Using an in vitro approach, we explored whether levosimendan administration influenced cell responses to lipopolysaccharide (LPS). Primary human umbilical vein endothelial cells were stimulated with 1 µg/ml LPS from Escherichia coli ( E. coli). Cells were treated with levosimendan at 0, 0.1, 1, or 10 µM 3 hr later. Samples were taken 24 hr after treatment to measure cell necrosis, apoptosis, pro-inflammatory mediators (interleukin 6 [IL-6] and toll-like receptor 4 [TLR4]), and oxidative stress (total reactive oxygen species/reactive nitrogen species [ROS/RNS]). Levosimendan at 1 and 10 µM protected against LPS-induced endothelial cell death and reduced TLR4 expression ( p < .05). All doses reduced levels of IL-6 and ROS/RNS ( p < .05). Findings suggest that levosimendan may exert protective effects against endothelial cell death in this model via attenuation of inflammation and oxidative stress pathways. Future studies might explore the potential beneficial role of levosimendan in modulating molecular mechanisms triggered by infections.
Traumatic Lesion of the Brachial Artery in a Pediatric Patient: Treatment With Bioresorbable Vascular Scaffold
Authors: Tomei Francesca , Berchiolli Raffaella , Cervelli Rosa , Bargellini Irene , Adami Daniele , Cioni Roberto , Marconi Michele , Ferrari Mauro
Published: July 2019

Purpose:

Neurovascular injuries and hand ischemia can occur in up to 20% of cases of supracondylar fractures of the humerus (SCH) in children, and their management is still controversial.

Case report:

We report a case of a brachial artery acute occlusion related to a SCH fracture in a child, successfully treated by endovascular implantation of a bioresorbable vascular scaffold.

Conclusions:

Bioresorbable vascular stent represents an alternative solution in treatment of traumatic children vascular lesions.
Retroduction, reflexivity and leadership learning: Insights from a critical realist study of empowerment
Authors: Willis Paul
Published: July 2019

This article contributes to leadership learning by discussing how retroduction can be used to enhance the reflexive capabilities of a professional group. The study shares insights from a critical realist research project to illustrate how the application of retroductive inference in interview design supports an investigation of the contextual constraints preventing practitioners from enacting desired leadership behaviours. This focus considers retroduction’s potential as a stimulus intended to encourage a practical, conversational and collaborative form of reflexivity between researcher and research participant. The leadership context investigated concerns the work place experiences of senior corporate communicators who express a desire to be empowering leaders. The study shows how the interplay between retroduction and reflexivity can enhance understanding of the conditions under which knowledge is enacted, or rather not enacted, in a specific leadership context. The article then highlights how the learning generated by the research was used to inform the development of a reflexive process which has since been applied in a range of professional learning environments. The discussion of its application contributes to the growing scholarly interest in reflexive pedagogy, meeting the need for alternative approaches to leadership learning which reconnect with context and explore the influence of power.
Experiential consumption of a South African wine farm destination as an agritourism attraction
Authors: Back Robin M , Tasci Asli DA , Milman Ady
Published: July 2019

As agritourism has been gaining in popularity as a form of special interest tourism, researchers have investigated different aspects of this phenomenon. However, academic literature seems to be mostly atheoretical thus far. Considering the highly experiential nature of agritourism activities, the current study tested the potential power of experiential consumption dimensions on explaining visitor flow experience, satisfaction with, and loyalty toward an agritourism attraction located on a wine farm in South Africa. A large data set collected with an onsite survey was analyzed. The study reveals several theoretical findings and extends the literature on the experiential dimensions of agritourism/wine tourism/farm tourism, as well as providing practical implications that may aid operators of such attractions to make more informed decisions with regard to their tourism product and budget allocation.
Acute Carotid Stent Thrombosis in an Ultrarapid Clopidogrel Metabolizer: Case Report and Literature Review
Authors: Toljan Karlo , Jovanović Ivan , Starčević Katarina , Ljevak Josip , Blažević Nikola , Radoš Marko , Poljaković Zdravka
Published: July 2019

Introduction:

Carotid angioplasty and stenting (CAS) represents an effective procedure for treating carotid artery disease. The acute in-stent thrombosis is an extremely rare complication of CAS especially when it occurs postprocedurally during the first 24 hours. Improper antiplatelet therapy or poor response to antiplatelet medications is known to be associated with a higher risk of in-stent thrombosis during early postprocedural period following a successful intervention.

Material and Methods:

A patient who experienced acute carotid in-stent thrombosis in early postprocedural period is described. He had been taking dual antiplatelet therapy for 2 weeks before undergoing a successful CAS. Moreover, pharmacogenetics studies showed the patient to be a clopidogrel ultrarapid metabolizer, which theoretically confers hyperresponsivity to medication. Alongside the report itself, a brief literature review of relevant sources pertinent to the case has been conducted.

Results:

According to the available literature, this is the first case report describing an ultrarapid clopidogrel metabolizer who underwent an uneventful CAS but experienced acute carotid in-stent thrombosis in early postprocedural period. A rescue procedure included an endovascular intervention consisting of thrombectomy and local alteplase application, followed by postprocedural administration of intravenous eptifibatide. At discharge, patient’s dual antiplatelet therapy included ticagrelor instead of clopidogrel.

Conclusion:

Acute carotid in-stent thrombosis is a highly unexpected complication of CAS and can occur despite ultrarapid clopidogrel metabolism trait.
Asymptomatic carotid stenosis and concomitant silent brain infarctions
Authors: Rudolph Claudina , Eldrup Nikolaj
Published: July 2019

Objectives

This review aims to clarify (1) the definition of silent brain infarct (SBI), (2) the diagnostic criteria of SBI using magnetic resonance imaging (MRI), (3) the prevalence of patients with asymptomatic carotid stenosis and SBI based on MRI assessment, (4) the association of SBI and asymptomatic carotid stenosis and the risk of stroke compared to patients without SBI, (5) the association between development of dementia/cognitive impairment in people with asymptomatic carotid stenosis and SBI, and (6) the evidence for treating patients with carotid stenosis and SBI.

Methods

A systematic search of PubMed and Scopus including all studies published from 2000 to 2018 and written in English.

Results

No consensus of the definition and diagnostic criteria for SBI was found. The prevalence of SBI in asymptomatic carotid patients is 17–33.3%. SBI is a significant risk factor for future stroke, OR 4.6 (95% CI: 3.0–7.2; p < 0.0001). One substudy showed that immediate CEA is beneficial compared to delayed CEA in these patients, showing a 45% reduction in annual stroke rate from 1.5%/year to 0.7%/year.

Conclusion

This review emphasizes the need to standardize the definition and diagnostic criteria of SBI on MRI. Current evidence suggests an increased risk and a small potential benefit of offering carotid endarterectomy to patient with silent brain infarct. Prospective studies are warranted to elucidate these issues further.
Effectiveness of the method of loci is only minimally related to factors that should influence imagined navigation
Authors: Caplan Jeremy B , Legge Eric LG , Cheng Bevin , Madan Christopher R
Published: July 2019

The method of loci is arguably the most famous mnemonic strategy and is highly effective for memorising lists of non-spatial information in order. As described and instructed, this strategy apparently relies on a spatial/navigational metaphor. The user imagines moving through an environment, placing (study) and reporting (recall) list items along the way. However, whether the method relies critically on this spatial/navigation metaphor is unknown. An alternative hypothesis is that the navigation component is superfluous to memory success, and the method of loci is better viewed as a special case of a larger class of imagery-based peg strategies. Training participants on three virtual environments varying in their characteristics (an apartment, an open field, and a radial-arm maze), we asked participants to use each trained environment as the basis of the method of loci to learn five 11-word lists. Performance varied significantly across environment. However, the effects were small in magnitude. Further tests suggested that navigation-relevant knowledge and ability were not major determinants of success in verbal memory, even for participants who were confirmed to have been compliant with the strategy. These findings echo neuroimaging findings that navigation-based cognition does occur during application of the method of loci, but imagined navigation is unlikely to be directly responsible for its effectiveness. Instead, the method of loci may be best viewed as a variant of peg methods.
Influence of psychological factors on patient-reported upper extremity disability
Authors: Cheng Homan , Novak Christine B. , Veillette Christian , von Schroeder Herbert P.
Published: July 2019

Disability reflects physical impairment and the influence of psychosocial factors. We investigated the relationship between disability and psychosocial factors in patients with upper extremity pathology. Ninety-two patients at a hand clinic were evaluated to assess disability, pain intensity, health status and psychosocial factors (pain catastrophizing, depression). Statistical analyses evaluated the relationships among disability and patient and psychosocial factors. Moderate levels of disability from all types of pathology were reported and associated with pain catastrophizing, pain and depression. Health status Short Form 36 domains were not correlated with disability as determined by Disabilities of the Arm, Shoulder and Hand (DASH) scores. A strong correlation was found between DASH and QuickDASH scores, but the QuickDASH scored significantly higher by 4 points. Pain catastrophizing was the strongest predictor of disability and explained 59% and 63% of variation in disability scores. Independent of pathology, those patients experiencing psychosocial issues, as well as demographic factors (i.e. employment status and age), were more likely to have disability with hand conditions and surgical procedures. We conclude from this study that psychological factors affect patient-reported outcomes.

Level of evidence: IV
Max Weber’s ethics
Authors: Lebow Richard Ned
Published: July 2019

I offer a critique of Weber’s two ethics. The first layer is internal and concerned with their logics. The second layer considers the external knowledge necessary to apply them appropriately and argues that it is extremely difficult to come by. The third layer connects Weber’s ethics to his politics because the choice of either ethic in almost any context is a value choice. This is apparent in Weber’s application of these ethics to Germany foreign policy. He used his ethics in a rhetorical way to justify his values rather than using these values as a guide to policy assessment. This reversal is endemic to politics. One response might be to stipulate beforehand the kinds of policies that are unacceptable in democracies regardless of their expected outcomes.
Improved Real-World Glycemic Control With Continuous Glucose Monitoring System Predictive Alerts
Authors: Abraham Sinu Bessy , Arunachalam Siddharth , Zhong Alex , Agrawal Pratik , Cohen Ohad , McMahon Chantal M.
Published: July 2019

Background:

Most standalone real-time continuous glucose monitoring (RT-CGM) systems provide predictive low and high sensor glucose (SG) threshold alerts. The durations and risk of low and high SG excursions following Guardian™ Connect CGM system predictive threshold alerts were evaluated.

Methods:

Continuous glucose monitoring system data uploaded between January 2, 2017 and May 22, 2018 by 3133 individuals using multiple daily injections (MDIs) or continuous subcutaneous insulin infusion (CSII) therapy were deidentified and retrospectively analyzed. Glucose excursions were defined as SG values that went beyond a preset low or high SG threshold for ≥15 minutes. For a control group, thresholds were based on the median of the low SG threshold limit (70 mg/dL) and the high SG threshold limit (210 mg/dL) preset by all system users. During periods when alerts were not enabled, timestamps were identified when a predictive alert would have been triggered. The time before low horizon was 17.5 minutes and the time before high horizon was 15 minutes, of all users who enabled alerts. Excursions occurring after a low SG or high SG predictive alert were segmented into prevented, ≤20, 20-60, and >60 minutes.

Results:

Excursions were prevented after 59% and 39% of low and high SG predictive alerts, respectively. The risk of a low or high excursion occurring was 1.9 ( P < 0.001, 95% CI, 1.88-1.93) and 3.3 ( P < 0.001, 95% CI, 3.20-3.30) times greater, respectively, when alerts were not enabled.

Conclusions:

The predictive alerts of the RT-CGM system under study can help individuals living with diabetes prevent some real-world low and high SG excursions. This can be especially important for those unable to reach or maintain glycemic control with basic RT-CGM or CSII therapy.
Secondary Metabolite Mapping Identifies Peony Episperm Inhibitors of Human Hepatoma Cells
Authors: Yang Xiao , Deng Ruixue , Liu Pu , Hu Jiangxia , Niu Wentian , Gao Jiayu
Published: July 2019

As the main by-product during the oil production of peony seeds, the episperm is traditionally used as a lead component in folk herbal formulas for the cancer treatment in China. However, the investigation of its phytochemical foundation underlying anticancer effects remains an ongoing challenge. The work therefore determined growth inhibition activities of 8 solvent extracts of peony episperms in the human liver cancer cell line. This activity was then mapped onto the secondary metabolite profile of extracts by principal components analysis (PCA). The top 3 principal components of High Performance Liquid Chromatograph (HPLC)-PCA map discriminated extract activities mainly based on the differential content of 5 stilbene compounds, which were then tested individually. The trans-ε-viniferin, gnetin-H, suffruticosol A, suffruticosol B, and suffruticosol C were thus determined as growth inhibitors and apoptosis inducers of human liver cancer cells with activities comparable to that of the antineoplastic cisplatin. A partial least squares regression-HPLC model was also constructed for the prediction of inhibitory effects of peony episperm extracts. These results expand the fundamental understanding of the peony episperms and support its current medicinal uses in China. Moreover, PCA-mediated secondary metabolite mapping was proved to be an efficient approach to qualify biomedical products required for pharmaceutical and medicinal uses.
The Creative Healthcare Architect
Authors: Zilm Frank , Atchley Ruth Ann , Gregersen Sabrina , Conrad Maisie Alice
Published: July 2019

The objectives of the research described in this article focus on an understanding of factors that influence creativity in healthcare design. Two areas of emphasis include the personality strengths of successful healthcare architects and elements of the current project delivery process. As part of the research, 48 healthcare architects participated in a battery of personality and creativity tests including Myers/Briggs, The Big Five, the Remote Associates Test (RAT), and an architectural creativity test. Results of the test point to strong “openness” for new ideas, particularly with the designers sampled. As a group, respondents scored low in “narcistic” bias (indicating emotional stability) and did not score high in verbal creativity. Compared to earlier studies of creative architects, the sample group included significantly fewer “perceiver” (Myers/Briggs), associated with a high level of curiosity. A second interesting finding was a significant difference between younger and older architects in the architectural creativity test. One possible hypothesis is the experience of the older architects. A second, and potentially more alarming, hypothesis is that technological disruptions are interfering with the ability to stimulate divergent thinking, particularly in the younger generation raised with smart phones and other network tools. Creativity in healthcare architecture demonstrates the case for domain-specific experience and skills along with creative input from other knowledge domains. The ability to establish group creativity may be inhibited by pressures to condense project time lines and not fully implement lean and other process strategies for exploring alternative solutions. Effective participation in group creativity tasks is particularly important for the complex world of healthcare design.
Complications Are Rare From Middle Turbinate Resection: A Prospective Case Series
Authors: Pinther Steven , Deeb Robert , Peterson Edward L. , Standring Robert T. , Craig John R.
Published: July 2019

Background

When chronic rhinosinusitis with nasal polyps (CRSwNP) fails to respond to medical therapy, endoscopic sinus surgery (ESS) plays an integral role in management. Some studies have shown that middle turbinate resection (MTR) during ESS leads to decreased polyp recurrence and revision ESS rates. Other studies suggest MTR can lead to complications.

Objective

The purpose of this study was to assess the safety of MTR during ESS for CRSwNP by determining the incidences of intraoperative cerebrospinal fluid (CSF) leak, postoperative epistaxis requiring operative intervention, and postoperative complete frontal stenosis.

Methods

A multiinstitutional, prospective case series of 91 adult CRSwNP patients was conducted. Patients with medically refractory CRSwNP underwent primary or revision ESS plus MTR by 3 surgeons. Two of the surgeons performed partial MTRs, and one of the surgeons performed complete MTRs. Patients were evaluated for the following complications: intraoperative CSF leak during MTR, postoperative epistaxis requiring operative intervention, and postoperative complete frontal ostial stenosis. Secondary outcomes included changes from preoperative to postoperative 22-item Sinonasal Outcome Test (SNOT-22) scores and revision ESS rates.

Results

Unilateral or bilateral complete ESSs with MTRs were performed on 91 CRSwNP patients. In total, 173 MTRs were performed. Two surgeons performed 97 partial MTRs on 49 patients, and the third surgeon performed 76 complete MTRs on 42 patients. One CSF leak occurred during partial MTR (1/173, 0.57%). No patients suffered postoperative epistaxis requiring operative intervention, and no patients developed complete frontal stenosis. From preoperatively to postoperatively, mean SNOT-22 scores decreased from 53.7 to 13.1 ( P = .001). No revision ESS was needed during the follow-up period. Mean follow-up time was 7.5 ± 5.4 months.

Conclusions

Partial and complete MTR during ESS for CRSwNP in this cohort resulted in very low, acceptable intraoperative and short-term postoperative complication rates and no detriment to SNOT-22 scores.
Performance of EuroSCORE II and logistic EuroSCORE in Bangladeshi population undergoing off-pump coronary artery bypass surgery: A prospective cohort study
Authors: Ranjan Redoy , Adhikary Dipannita , Mandal Sabita , Saha Sanjoy Kumar , Hasan Kamrul , Adhikary Asit Baran
Published: July 2019

Introduction

European System for Cardiac Operative Risk Evaluation (EuroSCORE) was developed to identify patients who may have a greater postoperative risk for adverse effects following adult cardiac surgery. This study evaluated the discriminatory potential of using the EuroSCORE system in predicting the early, as well as late, postoperative outcomes following coronary artery bypass graft surgery in Bangladesh.

Methods

A total of 865 patients who underwent isolated coronary artery bypass graft surgery were evaluated with the EuroSCORE risk scoring system. Moreover, we also compared the discriminatory potentials between the EuroSCORE II and the original logistic EuroSCORE.

Results

Operative mortality was best predicted by EuroSCORE II (area under the curve (AUC) 0.863, Brier score 0.030) compared to the original logistic EuroSCORE (AUC 0.849, Brier score 0.033). However, the overall expected-to-observed mortality ratio for EuroSCORE II was 1.1, whereas the observed ratio for the original logistic EuroSCORE was 1.7. EuroSCORE II was predictive of an intensive care unit stay of five days or more (AUC 0.786), prolonged inotropes use (AUC 0.746), stroke (AUC 0.646), de novo dialysis (AUC 0.810), and low output syndrome (AUC 0.715). Moreover, a high EuroSCORE II quintile significantly predicted the risk for late mortality (p < 0.0001).

Conclusions

EuroSCORE has an important role in predicting the early, as well as late, postoperative outcomes following coronary artery bypass surgery. However, the performance of EuroSCORE II is significantly better than the original logistic EuroSCORE in predicting postoperative morbidity and mortality after isolated coronary artery bypass graft surgery among Bangladeshi patients.
A current appraisal of evidence for the approach to sepsis and septic shock
Authors: Varon Jack , Baron Rebecca M.
Published: July 2019

Sepsis is a life-threatening syndrome of a dysregulated host response to infection. Despite advances in diagnosis and treatment, sepsis remains a significant cause of morbidity and mortality. Many aspects of the diagnosis and clinical management of sepsis require further study and remain controversial. This review aims to summarize relevant literature and controversies regarding the evaluation and management of sepsis and septic shock.
Postmortem Investigation of Immunohistochemical Staining and Gross Description of Sarcomatoid Carcinoma of the Lung in a Patient With Extreme Leukemoid Reaction
Authors: Ammar Ali , Ellis Austin , Hegert Julia , Jones Timothy W. , Khan Rumi
Published: July 2019

A 72-year-old male smoker was brought into the emergency department complaining of 4 months of progressive dyspnea and fatigue. Computed tomography angiogram of the lungs was negative for pulmonary embolism; however, a 10 cm right upper lobe mass and multiple bilateral pulmonary nodules were identified. While computed tomography scan of the head showed no lesions in the brain, there was osseous destruction of the right mandible. Records obtained from an outside hospital indicated that he had 2 prior biopsies of this lung mass that failed to show malignant cells. In addition, an outpatient positron emission tomography scan had shown increased tracer uptake in this mass as well as multiple nodules in the contralateral lung and in the left adrenal gland. This gentleman was admitted for sepsis and was started on broad-spectrum antibiotics. He continued to have respiratory compromise and required transfer to the intensive care unit for intubation and mechanical ventilation. Over the next 4 days, the patient progressed into septic shock requiring vasopressors and developed worsening respiratory failure. His white blood cell count continued to rise and peaked at 157 × 103 cells/µL. The patient’s wife decided to proceed with comfort measures and the patient subsequently expired. Autopsy was consistent with sarcomatoid carcinoma, also known as giant cell carcinoma of the lung. Immunohistochemical staining was also performed, which identified several tumor markers as well as distant metastasis, hemorrhage, and multi-organ necrosis.
Entrepreneurial Affect and Emotions in Entrepreneurship Education Impact Research: A Systematic Review and Research Agenda
Authors: Keller Pierre G. , Kozlinska Inna
Published: July 2019

In this research article, we systematically review literature on entrepreneurial affect and emotions in entrepreneurship education (EE) impact studies. In view of the increasing usage of entrepreneurial affect in the EE literature and the multiplicity of its facets, the main aim of this article is to create a definitional framework of affect. Based on the criteria of scientific standard and relevance for EE, we critically select 46 literature sources published from 1984 to 2017 and conduct a citation analysis of their impact. We then systemize and classify these sources using co-citation analyses as well as conduct a critical review of content similarities. As a result, we identify five main groups of the literature sources: (a) Affect in entrepreneurship research, (b) Affect in EE impact research, (c) Affect-cognition relationship, (d) Affect-conation relationship, and (e) Conceptual contributions. Our critical review of the literature sources further leads to the creation of the definitional framework of affect. The framework facilitates deeper understanding of affect and advocates terminological precision. It may, therefore, serve other EE researchers in conducting impact studies. In this vein, we formulate propositions for further research by combining the affect infusion model with the theory of planned behavior.
Real-time PCR detection of Toxoplasma gondii in tissue samples of wild boars (Sus scrofa) from southern Italy reveals high prevalence and parasite load
Authors: Santoro Mario , Viscardi Maurizio , Sgroi Giovanni , DʼAlessio Nicola , Veneziano Vincenzo , Pellicano Roberta , Brunetti Roberta , Fusco Giovanna
Published: July 2019

Background

Toxoplasmosis is a zoonotic parasitic disease caused by Toxoplasma gondii, a widespread protozoan in the phylum Apicomplexa. In Europe, several studies have demonstrated the presence of the parasite in tissues of wild boars (Sus scrofa), but no data exists on the T. gondii load in tissues which in turn may be an useful way to assess the infection risk for the consumer of wild boar meat.

Methods

We sampled and tested a total of 472 tissue samples of brain, heart and masseter muscle from 177 wild boars from the Campania region of southern Italy by real-time PCR analyses for detection and quantification of T. gondii. The sensitivity and specificity of the method were calculated by ROC analysis curves.

Results

PCR analysis revealed the presence of T. gondii in tissue samples of 78 out of 177 (44%) wild boars. In general, the brain presented the highest PCR prevalence (31%), followed by the heart (28.3%) and the masseter muscle (24.2%), with the highest estimated parasite numbers observed in the brain followed by the heart and masseter muscle. The PCR method showed an excellent discriminating ability for each of the examined tissues. According to the ROC analysis curves, the respective sensitivity and specificity were 99 and 100% for masseter muscle, 98 and 98% for brain and 96 and 98% for heart samples.

Conclusions

The high prevalence of infection here detected suggests a widespread distribution of the parasite in the wildlife of the Campania region of southern Italy. The T. gondii burdens detected may potentially represent a source of infection for humans.
Investigating Intestinal Glucagon After Roux-en-Y Gastric Bypass Surgery
Authors: Jorsal Tina , Wewer Albrechtsen Nicolai J , Christensen Marie M , Mortensen Brynjulf , Wandall Erik , Langholz Ebbe , Friis Steffen , Worm Dorte , Ørskov Cathrine , Støving René K , Andries Alin , Juhl Claus B , Sørensen Frederik , Forman Julie L , Falkenhahn Mechthilde , Musholt Petra B , Theis Stefan , Larsen Philip J , Holst Jens J , Vrang Niels , Jelsing Jacob , Vilsbøll Tina , Knop Filip K
Published: July 2019

Context

After Roux-en-Y gastric bypass (RYGB) surgery, postprandial plasma glucagon concentrations have been reported to increase. This occurs despite concomitant improved glucose tolerance and increased circulating plasma concentrations of insulin and the glucagon-inhibiting hormone glucagon-like peptide 1 (GLP-1).

Objective

To investigate whether RYGB-induced hyperglucagonemia may be derived from the gut.

Design and Setting

Substudy of a prospective cross-sectional study at a university hospital in Copenhagen, Denmark.

Participants

Morbidly obese individuals undergoing RYGB (n = 8) with or without type 2 diabetes.

Interventions

Three months before and after RYGB, participants underwent upper enteroscopy with retrieval of gastrointestinal mucosal biopsy specimens. Mixed-meal tests were performed 1 week and 3 months before and after RYGB.

Main Outcome Measures

The 29–amino acid glucagon concentrations in plasma and in mucosal gastrointestinal biopsy specimens were assessed using mass spectrometry–validated immunoassays, and a new monoclonal antibody reacting with immunoreactive glucagon was used for immunohistochemistry.

Results

Postprandial plasma concentrations of glucagon after RYGB were increased. Expression of the glucagon gene in the small intestine increased after surgery. Glucagon was identified in the small-intestine biopsy specimens obtained after, but not before, RYGB. Immunohistochemically, mucosal biopsy specimens from the small intestine harbored cells costained for GLP-1 and immunoreactive glucagon.

Conclusion

Increased concentrations of glucagon were observed in small-intestine biopsy specimens and postprandially in plasma after RYGB. The small intestine harbored cells immunohistochemically costaining for GLP-1 and glucagon-like immunoreactivity after RYGB. Glucagon derived from small-intestine enteroendocrine l cells may contribute to postprandial plasma concentrations of glucagon after RYGB.
Cell competition: the winners and losers of fitness selection
Authors: Bowling Sarah , Lawlor Katerina , Rodríguez Tristan A.
Published: July 2019

The process of cell competition results in the elimination of cells that are viable but ‘less fit’ than surrounding cells. Given the highly heterogeneous nature of our tissues, it seems increasingly likely that cells are engaged in a ‘survival of the fittest’ battle throughout life. The process has a myriad of positive roles in the organism: it selects against mutant cells in developing tissues, prevents the propagation of oncogenic cells and eliminates damaged cells during ageing. However, ‘super-fit’ cancer cells can exploit cell competition mechanisms to expand and spread. Here, we review the regulation, roles and risks of cell competition in organism development, ageing and disease.
The marketing in crisis situations on the example of the volleyball club AZS Częstochowa SSA
Authors: Kowalski Sławomir
Published: July 2019

The basic objective of the article is to define the main directions of development of sports marketing in crisis situations. The article is also aimed at showing marketing activities and using the method of influencing current and potential fans. The basic research subject is the volleyball men's club AZS Częstochowa SSA. The article analyzes the effects of marketing activities after the fall from PlusLiga and their analysis in terms of effectiveness based on data from the surveyed Club. The basic results contained in the article are specific corrective actions and their model presentation. In practice, that analyze can be used to build a new identity and marketing policy in crisis situations, such as a degradation to a lower class or a lower level of sport. The presented information and their analysis are an original attempt of a model approach to sports club management and its values in difficult situations from a marketing point of view.
Surrogate Optimization of Computationally Expensive Black-Box Problems with Hidden Constraints
Authors: Müller Juliane , Day Marcus
Published: July 2019

We introduce the algorithm SHEBO (surrogate optimization of problems with hidden constraints and expensive black-box objectives), an efficient optimization algorithm that employs surrogate models to solve computationally expensive black-box simulation optimization problems that have hidden constraints. Hidden constraints are encountered when the objective function evaluation does not return a value for a parameter vector. These constraints are often encountered in optimization problems in which the objective function is computed by a black-box simulation code. SHEBO uses a combination of local and global search strategies together with an evaluability prediction function and a dynamically adjusted evaluability threshold to iteratively select new sample points. We compare the performance of our algorithm with that of the mesh-based algorithms mesh adaptive direct search (MADS, NOMAD [nonlinear optimization by mesh adaptive direct search] implementation) and implicit filtering and SNOBFIT (stable noisy optimization by branch and fit), which assigns artificial function values to points that violate the hidden constraints. Our numerical experiments for a large set of test problems with 2–30 dimensions and a 31-dimensional real-world application problem arising in combustion simulation show that SHEBO is an efficient solver that outperforms the other methods for many test problems.
Examination of Primary School and Middle School Teachers’ Lifelong Learning Tendencies Based on Various Variables
Authors: Demir-Basaran Semra , Sesli Cigdem
Published: July 2019

The purpose of this study is to determine whether or not teachers’ lifelong learning tendencies vary by gender, professional field, educational level of service, professional seniority, and frequency of reading a book, magazine, and newspaper. The study employs a descriptive research model. Its population consists of primary teachers and field teachers working in the central district of Kayseri province, located in the middle part of Turkey, in the 2015-2016 academic year. The study group consists of 380 teachers chosen from this population through stratified sampling. The data were collected through Personal Information Form and Lifelong Learning Tendency Scale developed by Diker-Coskun. The obtained data were analyzed via SPSS 20.00 at 0.05 significance level. The study revealed that the teachers working in the middle part of Turkey have low lifelong learning tendencies. Also, the study determined that the teachers’ lifelong learning tendencies significantly vary by gender, professional field, educational level of service, and frequency of reading a book, magazine, and newspaper, but professional seniority is not a factor that leads to a significant difference in lifelong learning tendency.