bluuebunny/crossref_metadata_2025 huggingface dataset:
Making Play Work
Authors: O’Shea Janet
Published: November 2018

This chapter examines the divergent functions of the live martial arts practice of sparring, as combative activity, as competition, as play, and as intersubjective exchange. In this process, the chapter examines the multiple connotations of competition within the overlapping spheres of game and sport. Central to this inquiry are the differences between competitive pleasure and competitive spectacle. In line with sports sociologists and historians, this chapter maintains that sport emphasizes competitive spectacle and hinges on outcome—winning or losing—rather than highlighting the pleasure of competition, suggesting that attention to physical, contestatory, and exploratory interactions between people may offset a societal overemphasis on winning. An intentional reclaiming of amateurism, with its attention to experimentation, can also play a role, as can a reconsideration of the significance of failure.
Freedom to Compete
Authors: Quinlan Meghan
Published: November 2018

Gaga, the movement language developed by Israeli choreographer Ohad Naharin, is advertised as “an experience of freedom and pleasure” in which students are encouraged to move at their own pace and not compare themselves to others, yet there are several aspects of the intensives that fall in line with contemporary neoliberal ideals of individualism and competition, such as the rehearsal of choreography and the presence of the creator of Gaga. This chapter explores the contradictions at Gaga dance intensives between the practice’s philosophical imperative to focus on the self and pleasure, and the desire of many dancers to impress the teachers and gain professional contacts or jobs. The chapter argues that the idyllic philosophies of Gaga are unable to neatly exist in the competitive socioeconomic climate of the contemporary concert dance world, urging a rethinking of how dancers participate in both corporeal and corporate economies.
Above and Beyond the Battle
Authors: Robinson Laura
Published: November 2018

This chapter explores competitive street dance crew choreography in relation to interdisciplinary theoretical frameworks regarding virtuosity and excess. Through a close analysis of five performances featured on the British television talent shows of Britain’s Got Talent and Got to Dance, this chapter examines the concept of virtuosity as transcendence in relation to the continued emphasis on technology and the street dance body. Through the choreographic application of animation techniques, synchronicity, the construction of “meta-bodies,” and the narrative of ordinary versus extraordinary, this chapter reveals that crews create the illusion of transgression through their affinity with technology, while also competing with their cinematic counterparts. Through this analysis, this chapter further reveals the negotiation between the individualistic nature of the virtuoso and the crew collective within the neoliberal capitalist framework of the competition.
Austin on Asserting and Knowing
Authors: Fiengo Robert
Published: November 2018

Austin argued that asserting is a family of four systematically related illocutionary acts: that, when we assert, we are always either Calling an item something, or Describing an item as something, or Exemplifying an item as something, or Classing an item as one thing rather than another. In this chapter, the author argues that each of these four assertive illocutionary acts implies a characteristic knowing of an item; that there are four ways to know an item, each way providing justification for one kind of asserting. If we assert something about an item and are challenged—if we are asked How do you know?—we justify our asserting in terms of the knowledge of the item that our asserting implied. By focusing on the question of how we know, this chapter attempts to clarify the relationship between our common assertive practices and the knowledge we bring to it.
Proxy Assertion
Authors: Ludwig Kirk
Published: November 2018

In proxy assertion an individual or group asserts something through a spokesperson. The chapter explains proxy assertion as resting the assignment of a status role to a person (that of spokesperson) whose utterances acts in virtue of that role have the status function of signaling that the principal is committed in a way analogous to an individual asserting that in his own voice. The chapter briefly explains how status functions and status roles are grounded and then treats, in turn, the case of a spokesperson for an individual and a group and the differences in the significance of what the spokesperson does in each case. Finally, it reviews complications introduced by spokesperson autonomy, where the spokesperson is given leave to represent her principal’s views or positions in her own words and to respond to questions on his behalf.
Assertion and Fiction
Authors: García-Carpintero Manuel
Published: November 2018

This article discusses three issues about the relations between fiction and assertion that have figured prominently in recent debates. In the first section, it addresses questions about assertions in connection with fiction raised by the standard occurrence of prima facie empty referential expressions in fictions. In the second, it considers whether fictions can make assertions, or related assertoric acts. The third and final section explores the possible effects that this would pose for the distinction between fiction and non-fiction.
Assertion and Convention
Authors: Green Mitchell S.
Published: November 2018

In light of a view of assertion as a product of cultural evolution, we disentangle a number of distinct questions that might be raised concerning the relation of assertion to convention and lay down eight benchmarks that any viable theory of assertion should respect. We next consider two well-known forms of conventionalism about speech acts, that of Millikan and that associated with Austin and Searle, showing why neither approach is viable. We go on to develop two positive accounts of assertion, one in terms of belief expression, the other in terms of commitment, neither of which requires what we shall term “extra-semantic conventions.” From there we consider two recent defenses of a form of conventionalism offered by Stainton (2016) and Jary (this volume), showing that neither succeeds in its aim. The lesson that we may draw from the failure of these arguments is that assertion is facilitated by, but does not crucially rely on, extra-semantic conventions.
Israel and the Arab World
Authors: Rabinovich Itamar
Published: November 2018

This chapter traces and analyzes the course of the Arab-Israeli conflict from its early days to the present. What began as a Jewish-Arab conflict in and over Palestine developed in 1948 into a larger conflict between Israel and the Arab world. The conflict festered in the 1950s and culminated in the war of June 1967. That war had two major contradictory results. First, it provided Israel with bargaining chips for negotiating peace with Arab countries that lost territory in the Six-Day War. Most significantly, this led to the signing of the Israeli-Egyptian peace treaty in 1979. But second, it also encumbered Israel with the West Bank, the Gaza Strip, and the lingering control of a large Palestinian population. To a great extent the larger Arab-Israeli conflict was telescoped into the Israeli-Palestinian conflict in its present form. In recent years two other contradictory developments have been shaping the Israeli-Arab landscape. The return of Iran and Turkey into the Middle Eastern arena has added an important Islamic dimension to the conflict. But Iran’s quest for regional hegemony and the exacerbation of Sunni-Shiite tensions in the Middle East have had a moderating effect on the attitude of the Sunni Arab states toward Israel.
The Chicano Movement in the New America
Authors: García Mario T.
Published: November 2018

The Chicano movement was the largest and most widespread civil rights and empowerment movement by people of Mexican descent in the United States. As part of the 1960s and 1970s social movements, the movement made Chicanos and other Latinos national political actors and laid the foundation for contemporary Latino political power in the 21st century. It assured that the old America would no longer survive. Chicanos and other minorities were the future and still are the future.
Atlantic Continuities in Tomás Rivera and Rudolfo Anaya
Authors: Quesada Sarah M.
Published: November 2018

This chapter draws from Tomás Rivera’s poetry and Rudolfo Anaya’s short story “The Man Who Could Fly” (2006) to read continuities of an Atlantic world formation within the Southwest. Specifically, this essay compares paradigms of a remembered “Congo” informed by dialectics of empire concerning both Central African exploration—in the case of Rivera—and plantational Latin American and American slavery—in the case of Anaya. While this article argues that in the case of Rivera, Henry Stanley’s exploration haunts the spatialization of Rivera’s poetry, in Anaya, by contrast, Atlantic continuities are chiefly embedded in a transnational comparison with Latin American Caribbean writers such as Gabriel García Márquez and Alejo Carpentier. Applying Caribbean thinker Edouard Glissant’s theorization of “Relation” to these Chicano narratives, this chapter decodes the racial geographies of the Southwest to theorize how landscape and fiction work together to memorialize subaltern Atlantic memory.
Democratic Socialist Planning
Authors: Devine Pat
Published: November 2018

This chapter summarizes Marx’s vision of a socialist/Communist society, sets out the defining characteristics of democracy and planning, and assesses the historical experience of the Soviet Union’s model of centralized command planning, the Yugoslav model of self-managed market socialism, and the Latin American attempts at twenty-first century socialism. This is followed by an evaluation of the three principal contemporary theoretical models of a possible future socialist/Communist economy: market socialism; Parecon, a version of electronic socialism; and the author’s own model of democratic planning through social ownership and negotiated coordination. The chapter ends with an exposition of the model of democratic planning, responses to criticisms, and a summarizing conclusion.
Energy and International Conflict
Authors: Colgan Jeff D. , Stockbruegger Jan B.
Published: November 2018

How does energy shape international conflict? This chapter reviews the ways in which energy has contributed to modern international wars and conflicts, then identifies a research agenda centered around two key future strategic challenges: the continued military presence of the United States in the Persian Gulf and strategic competition between the United States and China over China’s maritime oil supply routes in the South China Sea. The chapter focuses primarily on oil, the most important source of energy in the modern age, but also considers other sources of energy. It identifies and describes eight mechanisms linking oil to international conflict, then draws on these mechanisms to show how oil has contributed to international wars and how it has shaped the strategies of states during these wars. The chapter begins with World War I, the first war in which oil played a crucial role, and ends with twenty-first-century conflicts. This includes the impact of the 1973 oil crisis on international relations, wars caused by revolutionary petro-states such as Iraq and Iran, how oil contributed to the rise of terrorist groups such as al-Qaeda and the Islamic State, and the role of energy in Russia’s assertive behavior in Europe and Syria.
Energy Interdependence
Authors: Wilson Jeffrey D.
Published: November 2018

Interdependence is a defining feature of contemporary global energy systems. By connecting producers and consumers, international trade and investment links potentially benefit the energy security of all parties. However, the international “coordination game” over energy is characterized by two distinct behavioral logics: a geopolitical approach that views interdependence as a competitive zero-sum game and a global energy governance approach that favors cooperation through markets and institutions. This chapter explores how these behavioral logics structure the politics of energy interdependence. It reviews scholarly theories of competitive and cooperative energy behavior, connecting these to governments’ preferences for liberal or nationalist policy frameworks. It then explores how the tensions between these logics have conditioned recent attempts to build governance regimes for global energy markets. It concludes by mapping an agenda for future research, which suggests attention should be focused on the political factors determining the energy policy choices made by governments.
the Bible in the Korean Resistance against the Japanese Empire (1910–1945)
Authors: Kang Jina
Published: November 2018

There was a multifaceted relationship between Christianity and Korean nationalism during the decades of the Japanese occupation in Korea (1910–1945). This study surveys the influence of the Christian Bible during this tumultuous period. Nationalist sentiments were heightened during the occupation, and interpretations of the Bible inspired and motivated movements for the restoration of Korea’s sovereignty. Rather than the Bible simply serving as a source of inspiration for Korean nationalist movements, the reawakened sense of Korean nationalism during the Japanese occupation inspired a unique Korean hermeneutic for critical interpretation of the Bible.
The Oxford Movement
Authors: Nockles Peter B.
Published: November 2018

Although the extent of his role has been contested, Newman has been generally regarded as the leader of the so-called Oxford or Tractarian Movement. Some of his former followers and disciples who did not follow him to Rome in 1845, sensitive to what they regarded as the damage his conversion did to the Movement’s cause, retrospectively downplayed his central contribution. Newman’s Apologia (1864) has been criticized for both enshrining and encouraging a tendency among some of his followers to view its history through his eyes. Newman, however, never meant his Apologia to be a standard account of the history of the Movement but only of his personal religious biography. This chapter examines and analyses Newman’s unique place within the history of the Oxford Movement, through the Tracts for the Times and his other ‘Tractarian’ publications. It shows his abandonment of his theory of the ‘Via Media’, the reaction to Tract 90, and his articulation of a doctrine of development all paved the way for the denouement of 1845. Newman’s secession, however, did not mark the final end of the Oxford Movement but only the culmination of a phase in its longer history.
Catholic Theological Receptions
Authors: McInroy Mark
Published: November 2018

This chapter examines the Roman Catholic theological receptions of John Henry Newman, whose highly original writings frequently endured sharp criticism and misunderstanding in the nineteenth and early twentieth centuries. However, during the decades leading up to the Second Vatican Council (1962–5), Newman became a crucial resource for Catholic theologians associated with ‘la nouvelle théologie’ and ‘Transcendental Thomism’. These figures drew heavily on Newman’s works in their search for more satisfying treatments of urgent issues for modern Catholic theology, such as the development of doctrine, the relationship between faith and reason, and justification. In the contemporary setting, Newman’s subtle treatments of these important topics have enormous ongoing significance for Catholic theology.
Pathways to Growth Following Trauma and Loss
Authors: Davis Christopher G. , Porter Janessa E.
Published: November 2018

This chapter reviews theory and research on the psychological processes that transform adversity and loss events into personal growth and adjustment. Research tends to support a model of growth that features a significant threat to one’s worldview, followed by a process of searching for and finding meaning. However, there may be other pathways to growth and positive change following adversity. We propose a goal-based model of posttraumatic growth based on the notion that loss events often represent significant threats to meaningful personal projects and goals. Personal growth and adjustment may emerge from a process of disengaging from previous goals blocked by the loss, and the initiation of new, intrinsically meaningful goals. The renegotiation of goals that promise to satisfy one’s fundamental needs for autonomy, competence, and relatedness may promote positive identity change and growth.
Explaining Organic Growth Performance
Authors: Day George S.
Published: November 2018

Why are some firms consistently able to grow faster than their rivals in the same industry? We employ dynamic capabilities theory to show that organic growth leaders excel because they have innovation prowess. Their prowess is gained by combining discipline in their growth-seeking activities with an organizational ability to innovate. Empirical indicators of these constructs were assessed by a sample of senior leaders in 168 companies. We found that innovation ability (comprising the interconnected elements of innovation culture, innovation capabilities, and how the firm is organized to enable innovation) explained most of the performance differences between growth leaders, average performers, and growth laggards. However, it is the interaction of innovation ability and discipline in pursuing the growth strategy that explains why growth leaders outperform the average organic growth rate of their industry.
Gay Country, TransAmericana, and Queer Sincerity
Authors: Goldin-Perschbacher Shana
Published: November 2018

Most people do not expect gay or transgender people to create country music, and certainly not in earnest. This essay explores the music and approach of two North American innovators of gay and transgender country music, Patrick Haggerty of the band Lavender Country and Rae Spoon, spanning the early 1970s to the present. Both musicians cultivate an aesthetic of sincerity, which is discussed in relation to possibilities for queer and transgender expression and ideological critique, as well as for camp performance. One longstanding challenge for “othered” folk musicians is that they are expected to be both exotic and yet also relatable. Their aesthetic of “queer sincerity” aids their navigation of this “outsider populism.”
The Gospel According to the Gays
Authors: Johnson E. Patrick
Published: November 2018

This chapter traces the historical roots of gospel music and emphasizes myriad contributions made by Black queer individuals throughout the genre’s history, including popular gospel music performers such as Rosetta Tharpe, James Cleveland, Clara Ward, and Sylvester. It also includes the voices of queer church members drawn from oral histories. In doing so, it sheds light on a willfully neglected aspect of the history of gospel music. Further, exposing gospel’s connection to blues and jazz, the discussion illustrates the connection between sacred and secular music. Closely reading how these singers use performance, it demonstrates how these individuals negotiated their sexuality and gender identity within the Black church—a space known for its disavowal of sin, especially homosexuality—in covert or tacit ways that enabled them to maintain their credibility and influence while also authentically engaging both their sexuality and spirituality.
Postwar Japanese Political Philosophy
Authors: Kersten Rikki
Published: November 2018

When examining political thought in post-1945 Japan, we must acknowledge that the postwar philosophical landscape was fundamentally a trans-war one. Narratives that sought to rationalize the past war laid the foundations for a divided consciousness after the war that entrenched antagonistic opposites as the parameters for postwar discourse. State versus self, politics versus ethics, theory versus value, ideas versus action and intellectuals versus “ordinary” people were all manifestations of the desire in the postwar era to establish ethical legitimacy through the dynamic of normative distancing. Paramount in this endeavor was an insistence by Japan’s postwar thinkers on creating and maintaining a hostile separation between civil society and the state as the proof of a rehabilitated ethos for postwar democracy. This conceptual framing had consequences for postwar thought and how it was articulated. In effect, the retrospective fragmentation of subjective responsibility led to the alienation of politics and value in the postwar era, preventing the coherence of subjectivity and responsibility upon which the integrity of the trans-war narrative depended.
MEASUREMENT OF EMF EXPOSURE AROUND SMALL CELL BASE STATION SITES
Authors: van Wyk Marthinus Jacobus , Visser Jacobus Christiaan , le Roux Christiaan Wynand
Published: November 2018

As mobile network technologies and usage change, mobile network cells have become smaller to meet the increased demand for data throughput. Small cell base stations are frequently used as a mobile network deployment method and are predominantly installed to service areas with a high density of people and to cover a small geographical area. Various measurement programs of the electromagnetic field (EMF) exposure have been conducted around base stations in general and these results have been published. There is, however, little data available on the EMF exposure levels around small cells. A measurement program was conducted to perform EMF exposure measurements around small cell base station sites. Results are compared to the relevant safety guidelines and to available data for EMF exposure around base stations in general.
In a relationship: sister species in mixed colonies, with a description of new Chikunia species (Theridiidae)
Authors: Smith Cassandra , Cotter Addie , Grinsted Lena , Bowolaksono Anom , Watiniasih Ni Luh , Agnarsson Ingi
Published: November 2018

Group-living behaviour is rare in spiders but has evolved repeatedly, yielding several species, some showing cooperation among close kin, and others living in colonies where each female builds its own web and is territorial. The most frequent origins of group living are seen in the cobweb spiders (Theridiidae) that commonly build three-dimensional webs and show extensive maternal care, both putatively pre-adaptive traits to spider sociality. A very unusual behaviour was recently discovered in the theridiid genus Chikunia, where two distinct but related species occur in mixed-species colonies with potentially indiscriminate brood care. These mixed colonies consist of Chikunia nigra and a newly discovered species. Here, we describe the new species, Chikunia bilde sp. nov., and summarize the unique biology of this species pair. We also place the origin of mixed-species group living in a phylogenetic context, firmly confirming the placement of Chikunia within the clade (lost colulus clade) previously characterized as containing a concentration of independent origins of group living. The two Chikunia studied here are sister species, representing a rare case of close genetic and behavioural interspecific relationship. We conclude that the loss of aggression that accompanies group living and social behaviour in cobweb spiders might help to explain the origin of mixed-species colonies.
Resistance of Prairie Junegrass and Tufted Hairgrass Germplasm to Diseases Common in Temperate Low-Input Turfgrass Systems
Authors: Koch Paul L. , Hugie Kari , Watkins Eric
Published: November 2018

Prairie junegrass and tufted hairgrass are two turfgrass species that are native to the United States and require less water, fertilizer, and pesticide compared with more commonly used turfgrass species such as Kentucky bluegrass. However, little is known about the resistance of these low-input turfgrasses to common turfgrass diseases. The primary objective of this research was to identify disease-resistant germplasm of both prairie junegrass and tufted hairgrass that can be used in future low-input turfgrass breeding efforts. A total of 41 populations of tufted hairgrass and 23 populations of prairie junegrass were evaluated for resistance to Microdochium patch, dollar spot, and rust development in a controlled environment. Genetic variation in disease resistance was clearly present in the unimproved germplasm of both prairie junegrass and tufted hairgrass, providing important direction for future breeding efforts that will allow wider implementation of low-input turfgrass species.
A Review of Corynespora cassiicola and Its Increasing Relevance to Tomato in Florida
Authors: MacKenzie Keevan J. , Sumabat Leilani G. , Xavier Katia V. , Vallad Gary E.
Published: November 2018

Corynespora cassiicola is a highly diverse fungal pathogen that can infect more than 500 species of plants, including many economically important crops such as cotton, soybean, tomato, and cucumber. In Florida, the number one vegetable crop by market value are fresh-market tomatoes, which generate nearly half a billion dollars annually. Florida’s subtropical to tropical climate is conducive to infection and development of the target spot pathogen on tomato caused by C. cassiicola. There is no varietal resistance available for target spot of tomato, and preventative fungicide treatments are the primary method for control. In the last decade, C. cassiicola has been more frequently reported by Florida tomato growers, appearing not only more aggressive but also increasingly insensitive to various fungicides. This review brings together the most recent C. cassiicola literature, providing a history and understanding of the immense pathogen diversity and its relevance to tomato. It also provides insight into fungicide resistance development and pathogen survivability, which are important factors in providing effective control recommendations and in understanding the epidemiology of this disease, respectively.
Reliability and Validity of NCLEX-RN© State Pass Rate Standards
Authors: Foreman Stephen
Published: November 2018

AIM

The aim of the study was to determine whether state NCLEX-RN© pass rate standards for nursing education programs are valid and reliable.

BACKGROUND

Nursing education programs must meet minimum NCLEX-RN pass rate standards imposed on them by state regulatory bodies. The standards suggest validity and reliability issues.

METHOD

To compute descriptive statistics and reliability coefficients to evaluate state pass rate standards, the study used a database of statutes and regulations that establish pass rate standards and a database of NCLEX-RN pass rates for 2,157 nursing programs in 45 states for 2010 to 2016.

RESULTS

There is substantial variation in state pass rate standards. Nursing education program pass rates are not stable over time, suggesting there may be problems with reliability and validity.

CONCLUSION

State nursing boards should consider revising pass rate standards to make them more consistent and improve the reliability of pass rate violation determinations.
Planning and Implementing Disaster Drills for Undergraduate Nursing Students
Authors: Smithers Bonnie , Tenhunen Monica L.
Published: November 2018

As a component of disaster response, nurses need to understand their roles in preparing for and responding to a disaster. Limited evidence regarding educating undergraduate nursing students for disasters exists. An interdisciplinary disaster drill was developed and implemented at a university nursing program. Challenges in preparing the students without giving specific details and ways of providing a more realistic experience continue to be addressed. Continued evaluation of the simulation and making identified changes to the interdisciplinary disaster drills will improve student learning and help to prepare future nurses for disasters.
Long-Term Effects of Phased Implementation of Antimicrobial Stewardship in Academic ICUs: 2007–2015*
Authors: Morris Andrew M. , Bai Anthony , Burry Lisa , Dresser Linda D. , Ferguson Niall D. , Lapinsky Stephen E. , Lazar Neil M. , McIntyre Mark , Matelski John , Minnema Brian , Mok Katie , Nelson Sandra , Poutanen Susan M. , Singh Jeffrey M. , So Miranda , Steinberg Marilyn , Bell Chaim M.
Published: November 2018

Objectives:

Antimicrobial stewardship is advocated to reduce antimicrobial resistance in ICUs by reducing unnecessary antimicrobial consumption. Evidence has been limited to short, single-center studies. We evaluated whether antimicrobial stewardship in ICUs could reduce antimicrobial consumption and costs.

Design:

We conducted a phased, multisite cohort study of a quality improvement initiative.

Setting:

Antimicrobial stewardship was implemented in four academic ICUs in Toronto, Canada beginning in February 2009 and ending in July 2012.

Patients:

All patients admitted to each ICU from January 1, 2007, to December 31, 2015, were included.

Interventions:

Antimicrobial stewardship was delivered using in-person coaching by pharmacists and physicians three to five times weekly, and supplemented with unit-based performance reports. Total monthly antimicrobial consumption (measured by defined daily doses/100 patient-days) and costs (Canadian dollars/100 patient-days) before and after antimicrobial stewardship implementation were measured.

Measurements and Main Results:

A total of 239,123 patient-days (57,195 patients) were analyzed, with 148,832 patient-days following introduction of antimicrobial stewardship. Antibacterial use decreased from 120.90 to 110.50 defined daily dose/100 patient-days following introduction of antimicrobial stewardship (adjusted intervention effect –12.12 defined daily dose/100 patient-days; 95% CI, –16.75 to –7.49; p < 0.001) and total antifungal use decreased from 30.53 to 27.37 defined daily doses/100 patient-days (adjusted intervention effect –3.16 defined daily dose/100 patient-days; 95% CI, –8.33 to 0.04; p = 0.05). Monthly antimicrobial costs decreased from $3195.56 to $1998.59 (adjusted intervention effect –$642.35; 95% CI, –$905.85 to –$378.84; p < 0.001) and total antifungal costs were unchanged from $1771.86 to $2027.54 (adjusted intervention effect –$355.27; 95% CI, –$837.88 to $127.33; p = 0.15). Mortality remained unchanged, with no consistent effects on antimicrobial resistance and candidemia.

Conclusions:

Antimicrobial stewardship in ICUs with coaching plus audit and feedback is associated with sustained improvements in antimicrobial consumption and cost. ICUs with high antimicrobial consumption or expenditure should consider implementing antimicrobial stewardship programs.
A Phase Ib Study of the FGFR/VEGFR Inhibitor Dovitinib With Gemcitabine and Capecitabine in Advanced Solid Tumor and Pancreatic Cancer Patients
Authors: Ma Wen Wee , Xie Hao , Fetterly Gerald , Pitzonka Laura , Whitworth Amy , LeVea Charles , Wilton John , Mantione Krystin , Schihl Sarah , Dy Grace K. , Boland Patrick , Iyer Renuka , Tan Wei , Brady William , Straubinger Robert M. , Adjei Alex A.
Published: November 2018

Objectives:

Preclinical studies demonstrated antitumor activity of dovitinib in pancreatic cancer models. This phase Ib study aimed to determine the maximum tolerated dose (MTD) of dovitinib in combination with gemcitabine and capecitabine and to characterize the safety and pharmacokinetic profile in patients with advanced pancreatic and biliary tract cancers and solid malignancies.

Materials and Methods:

Patients received gemcitabine 1000 mg/m² intravenously on days 1 and 8, capecitabine 1300 mg/m² oral daily from day 1 to 14, and dovitinib oral daily 5 days on and 2 days off, every 21-day cycle. The standard 3+3 dose escalation design was utilized and the study expanded to treat an additional 20 advanced pancreatic and biliary tract cancers patients at MTD.

Results:

A total of 29 patients were enrolled. One patient experienced dose-limiting grade 3 colitis. Two patients developed clinically significant neuropathy after the first cycle requiring dose reduction. The MTD was not reached and dovitinib 300 mg was declared the recommended dose for expansion. The most frequent grade 2 or worse adverse events were fatigue (45%), neutropenia (41%), thrombocytopenia (34%), anemia (24%), nausea (24%), and palmer-plantar erythrodysaesthesia syndrome (21%). Partial responses were observed in 5 patients. Pharmacokinetic studies showed no drug-drug interaction between dovitinib, capecitabine and gemcitabine. Fibroblast growth factor 23 plasma level increased in 4 of 5 patients during the first cycle of treatment.

Conclusions:

Dovitinib 300 mg daily is the recommended dose when combined with gemcitabine and capecitabine, achieving clinically relevant plasma concentrations. The study combination demonstrated encouraging efficacy signals in advanced pancreatic cancer.
Effect of Medicaid Expansion on Colorectal Cancer Screening Rates
Authors: Zerhouni Yasmin A. , Trinh Quoc-Dien , Lipsitz Stuart , Goldberg Joel , Irani Jennifer , Bleday Ronald , Haider Adil H. , Melnitchouk Nelya
Published: November 2018

BACKGROUND:

Colorectal cancer screening decreases incidence and improves survival. Minorities and low-income patients have lower screening rates. The Affordable Care Act increased insurance coverage for low-income Americans by funding Medicaid expansion. Not all states expanded Medicaid. The effect of Medicaid expansion on colorectal cancer screening is unknown.

OBJECTIVE:

This study aimed to evaluate if Medicaid expansion improved colorectal cancer screening for minorities and low-income patients.

DESIGN:

We used the Behavior Risk Factor Surveillance System, a nationally representative health-related telephone survey, to compare colorectal cancer screening rates from 2012 to 2016 based on Medicaid expansion status. A difference-in-difference analysis was used to compare the trends.

SETTINGS:

All states were included in this survey.

PATIENTS:

Respondents aged 50 to 64 from the early expansion, 2014 expansion, and nonexpansion states were selected.

INTERVENTIONS:

Medicaid expansion was funded by the Affordable Care Act.

MAIN OUTCOME MEASURES:

The primary outcome measured was the screening rate based on US Preventive Services Task Force guidelines.

RESULTS:

Overall screening in expansion states increased (early, +4.5%, p < 0.001; 2014, +1.3%, p = 0.17) compared with nonexpansion states. Screening among low-income respondents increased in early expansion states (+5.7%; p = 0.003), whereas there was no change in 2014 expansion states compared with nonexpansion states (2014, –0.3%, p = 0.89). For blacks, there was a significant increase in early expansion states, but no change in 2014 expansion states (early, +8.1%, p = 0.045; 2014, –1.5%, p = 0.64). There was no significant change for Hispanic respondents in early or 2014 expansion states compared with nonexpansion states (early, +6.5%, p = 0.11; 2014, +1.2%, p = 0.77).

LIMITATIONS:

Survey data are subject to response and recall bias. Factors other than Medicaid expansion may have influenced the screening rate.

CONCLUSIONS:

The colorectal cancer screening rate has increased in all settings, but expansion accelerated the increases in early expansion states and among low-income and black respondents; however, there was no similar increase for Hispanic respondents. It will be important to continue to monitor the effects of Medicaid expansion on colorectal cancer care, especially the incidence by stage and mortality. See Video Abstract at http://links.lww.com/DCR/A792.
Implementing Universal Varicella Vaccination in Europe
Authors: Spoulou Vana , Alain Sophie , Gabutti Giovanni , Giaquinto Carlo , Liese Johannes , Martinon-Torres Federico , Vesikari Timo
Published: November 2018

Varicella is a common vaccine-preventable disease that usually presents as a mild disorder but can lead to severe complications. Before the implementation of universal varicella vaccination (UVV) in some European countries, the burden of varicella disease was broadly similar across the region. Despite this, countries adopted heterogeneous varicella vaccination strategies. UVV is currently recommended in 12 European countries. Known barriers to UVV implementation in Europe include (1) a perceived low disease burden and low public health priority; (2) cost-effectiveness and funding availability; (3) concerns related to a shift in varicella disease and incidence of herpes zoster and (4) safety concerns related to measles, mumps, rubella and varicella–associated febrile seizures after the first dose. Countries that implemented UVV experienced decreases in varicella incidence, hospitalizations and complications, showing overall beneficial impact. Alternative strategies targeting susceptible individuals at higher risk of complications have been less effective. This article discusses ways to overcome the barriers to move varicella forward as a truly vaccine preventable disease.
Epidemiology of Serious Bacterial Infections in Infants Less Than 90 Days of Age, Presenting to a Tertiary Care Emergency Department, 2010 to 2016
Authors: Mah Vicky , Vanderkooi Otto G. , Johnson David W.
Published: November 2018

Serious infections in infants require urgent treatment. Microbiology of bacterial isolates obtained from children younger than 90 days of was reviewed. Nine-hundred thirty-two infants were identified (mean age of 39 days). Seventy-four percent of organisms obtained were relevent. Common pathogens identified were Escherichia coli, Streptococcus agalactiae and Staphylococcus aureus. Emergence of S. aureus (18% methicillin resistant S.
aureus (MRSA)) and ampC producing enterobacteriaceae requires prompt attention.
Phakomatous Choristoma of the Orbit With Involvement of the Inferior Oblique Muscle
Authors: Harris Brandon F. , Harris Justin P. , Ducey Timothy J. , Boden John H. , Yakopson Vladimir S.
Published: November 2018

The authors report a case of phakomatous choristoma presenting as an orbital tumor with involvement of the inferior oblique muscle. This is the only known case of this rare tumor directly invading and incorporating the inferior oblique. This tumor should be included in the differential of eyelid tumors and orbital tumors in infants. Finally, the authors review the histopathological and embryological characteristics of this lenticular tumor.
The Impact of Head-of-Bed Positioning and Transducer Location on Cerebral Perfusion Pressure Measurement
Authors: McNett Molly , Livesay Sarah , Yeager Susan , Moran Cristina , Supan Erin , Ortega Stefany , Olson DaiWai M.
Published: November 2018

Introduction: Head-of-bed (HOB) elevation is the standard of care for patients with intracranial pressure monitoring at risk for intracranial hypertension. Measurement of cerebral perfusion pressure (CPP) based on HOB elevation and arterial transducer position has not been adequately studied. Methods: This is a planned secondary analysis of prospectively collected data in which paired, serial arterial blood pressure (ABP), intracranial pressure, and CPP measures were obtained once per day for 3 days, with measures leveled at the tragus (Tg) and the phlebostatic axis (PA). The HOB position was recorded for all paired readings. Results: From 136 subjects, ABP and CPP values were lower when the transducer was leveled at the Tg, compared with the PA (P < .001); these differences persisted regardless of HOB position. Conclusion: The difference in CPP when ABP is referenced at the Tg versus PA is not consistently attributed to HOB elevation.
Effect of Auditory Stimulation on the Level of Consciousness in Comatose Patients Admitted to the Intensive Care Unit: A Randomized Controlled Trial
Authors: Çevik Kivan , Namik Emre
Published: November 2018

Background:Comatose patients are exposed to sensory deprivation in the intensive care units. Auditory stimulation of patients who are unconscious is a nonmedical procedure. This study examines the effect of organized voice, performed by a nurse, on the state of consciousness of comatose patients in intensive care units.Method:This randomized controlled trial study of 60 patients was conducted fitting between August 2017 and February 2018. For 10 days, patients received the voice of a male nurse twice a day in the morning and night shifts, recorded on MP3 and repeated at least 3 to 4 times. Glasgow Coma Scale (GCS) scores were recorded by the researcher before and after auditory stimulation.Results:Patient mean age was 69.2 years; 56.7% of the experimental group and 53.3% of the control group were male. On the first day in the morning and evening after auditory stimulation, the mean GCS was 4.8 in the experimental group and 4.7 in the control group. Before and after the intervention on the 10th day after auditory stimulation, the mean GCS of patients was 9.5 in the experimental group and 7.1 in the control group in the morning and 9.6 and 7.2, respectively, in the evening. No significant differences in mean GCS by group were observed for the first 3 days (P> .05). However, the difference in mean GCS scores of the 2 groups was statistically significant after the third day (P< .05).Conclusions:Auditory stimulation is associated with higher GCS in comatose patients.
Timing of Muscle Activation Is Altered During Single-Leg Landing Tasks After Anterior Cruciate Ligament Reconstruction at the Time of Return to Sport
Authors: Rocchi Jacopo Emanuele , Labanca Luciana , Laudani Luca , Minganti Carlo , Mariani Pier Paolo , Macaluso Andrea
Published: November 2018

Objectives:

It is well known that alterations in landing mechanics persist for years after anterior cruciate ligament reconstruction (ACL-R). Nevertheless, existing literature is controversial in reporting successful or unsuccessful recovery of prelanding muscle activation timing after ACL-R. The study aimed at comparing myoelectric and kinematic patterns during landing tasks between ACL-R and healthy subjects.

Design:

Cross-sectional study.

Setting:

Institutional research laboratory.

Patients and Intervention:

Fifteen male athletes after ACL-R using patellar tendon and 11 using hamstrings autograft at the time of return to sport were recruited. Fifteen healthy athletes served as control group. Participants performed 4 different single-leg landing tasks arriving onto a force plate.

Main Outcome Measures:

Electromyographic (EMG) activity of knee extensors and flexors, normalized vertical ground reaction force (vGRF), and knee angular displacement were recorded.

Results:

In all the tasks, preimpact EMG duration was longer in ACL-R (112 ± 28 ms in the knee extensors; 200 ± 34 ms in the knee flexors) compared with healthy participants (74 ± 19 ms in the knee extensors; 153 ± 29 ms in the knee flexors;P< 0.05). Initial contact (IC) and maximum postimpact knee angle were lower in ACL-R (9 ± 7 degrees at IC; 39 ± 12 degrees at maximum flexion) compared with healthy participants (17 ± 9 degrees at IC; 52 ± 15 degrees at maximum flexion;P< 0.05). Normalized vGRF was higher in ACL-R compared with healthy participants (3.4 ± 0.5 and 2.7 ± 0.6;P< 0.05).

Conclusions:

At the time of return to sport, ACL-R subjects showed altered motor control strategies of single-leg landings. These alterations may lead to uncoordinated movement, hence increasing the risk of reinjury.
Derivation of a Focused, Brief Concussion Physical Examination for Adolescents With Sport-Related Concussion
Authors: Leddy John , Lesh Kevin , Haider Mohammad N. , Czuczman Natalie , Baker John G. , Miecznikowski Jeffrey , Willer Barry
Published: November 2018

Objective:

To describe the derivation of a brief but pertinent physical examination (PE) for adolescents who have sustained sport-related concussion (SRC).

Design:

Prospective cohort.

Setting:

University concussion management clinic.

Participants:

Acutely concussed (AC, n = 52, 15.5 ± 1.4 years, 4.4 ± 2 days since injury, 26.2 ± 38 days to recovery, 71% males) and healthy control (HC) adolescents (n = 30, 15.8 ± 1.4 years, 73% males).

Intervention:

Acutely concussed had a PE on visit 1 and were retested at visit 2 (13.6 ± 1 day after visit 1). Acutely concussed were further characterized as normal recovery (NR, n = 41, 15.5 ± 1.5 years, recovery time 13.0 ± 7 days) and delayed recovery (DR, n = 11, 15.5 ± 1.2 years, recovery time 75.4 ± 63 days).

Main Outcome Measure:

Physical examination findings, including cervical, vestibular, and oculomotor systems.

Results:

Visit 1 abnormal PE signs were significantly greater in AC versus HC (2.79 ± 2.13 vs 0.07 ± 0.37, P < 0.0001) but not in NR versus DR (2.61 ± 2.2 vs 3.45 ± 1.8, P = 0.246). Visit 2 abnormal PE signs differentiated NR versus DR (0.17 ± 0.7 vs 2.45 ± 2.1, P < 0.0001).

Conclusions:

A brief focused PE can help to diagnose SRC, establish recovery, and may have prognostic value.
Effect of WeChat and short message service on bowel preparation: an endoscopist-blinded, randomized controlled trial
Authors: Wang Shu-Ling , Wang Qian , Yao Jun , Zhao Sheng-Bing , Wang Li-Sheng , Li Zhao-Shen , Bai Yu
Published: November 2018

Objective

Adequate bowel preparation is essential for a successful colonoscopy; clinical studies suggest reinforced education can improve the preparation process. However, there have been no trials to compare WeChat directions (the most widely used social media app in China) with those of the short message service (SMS). This study was aimed to assess the effect of WeChat and SMS on the bowel preparation quality.

Participants and methods

This was a single-center, prospective, endoscopically blinded, randomized, controlled study. Patients in reinforced education groups received additional reminder messages by WeChat and SMS 2 days before colonoscopy. The primary outcome was bowel preparation quality evaluated by the Boston bowel preparation scale (BBPS) score and the rate of adequacy (BBPS score ≥6). Secondary outcomes included polyp detection rate, adenoma detection rate, and mean total adenomas detected. Patient tolerance level and subjective feelings were also evaluated.

Results

The total BBPS score and the percentage of adequacy were significantly higher in the reinforced education groups compared with the control (WeChat vs. control, P<0.001; SMS vs. control, P<0.001). Moreover, statistically significant differences between the two interventions were found in the total BBPS score but not in the rate of adequacy (P=0.007 and 0.561, respectively). The detection of adenomas, using multiplicity detection rate, advanced adenoma detection rate, and mean total adenomas detected, was much higher in the intervention groups (P=0.039, 0.037, and 0.019, respectively).

Conclusion

WeChat was superior to SMS for bowel preparation, although both of them may help improving the detection of adenomas.