bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of oral oncolytic initiation on medication adherence for pre-existing comorbid chronic conditions
Authors: Dashputre Ankur A , S Gatwood Katie , Schmidt Jillian , Gatwood Justin
Published: October 2019

Purpose

Oral oncolytics have improved survival in hematological cancers like chronic myeloid leukemia, chronic lymphocytic leukemia/small lymphocytic lymphoma, and multiple myeloma; however, it is unclear of the extent to which initiating these treatments might impact adherence to oral therapies for pre-existing comorbid chronic conditions.

Methods

Adults diagnosed with and prescribed oral oncolytics for chronic myeloid leukemia, chronic lymphocytic leukemia/small lymphocytic lymphoma, or multiple myeloma between 2013 and 2016 and with continuous eligibility six months before and after oral oncolytic initiation were identified from the Truven Health MarketScan databases. Among those identified, patients with pre-existing diabetes, hypertension, and/or hyperlipidemia with ≥1 fill for oral comorbid therapies were selected. Adherence to oral oncolytics and comorbid therapies was measured using the proportion of days covered metric. Wilcoxon signed-rank tests assessed changes in adherence for comorbid therapies after initiation of an oral oncolytic. Unadjusted difference-in-difference models assessed the impact of adherence to oral oncolytics on changes in adherence to comorbid therapies.

Results

Significant reductions in adherence after oncolytic initiation were observed across the comorbid therapies and were highest for patients taking lipid-lower agents (10.7–15.6%). Unadjusted difference-in-difference models revealed consistent and significantly lower reductions in adherence for those taking antihypertensives (chronic myeloid leukemia: p = 0.03; chronic lymphocytic leukemia/small lymphocytic lymphoma: p = 0.007; multiple myeloma: p = 0.09) and adherent to oral oncolytics.

Conclusion

Initiation of oral oncolytics may negatively impact adherence to oral therapies for chronic comorbid conditions, necessitating the need for medication management strategies to help patients adhere to their entire medication regimen.
Behcet’s-like syndrome following pembrolizumab: An immune-related adverse event associated with programmed death receptor-1 inhibitor therapy
Authors: Thomas Steffi , Bae Chay , Joy-Ann Tabanor , Traverse William
Published: October 2019

Introduction

The landscape for the treatment of metastatic melanoma has been revolutionized with the introduction immune checkpoint inhibitors. Immune checkpoint inhibitors have now become the standard of care for the treatment of cancers. These immune agents including programmed death receptor-1 inhibitors, programmed death-ligand 1 inhibitors and cytotoxic T-lymphocyte antigen-4 inhibitors have shown promising results but have been associated with numerous immune-related complications. Pembrolizumab, a programmed death receptor-1 inhibitor, has been associated with a number of immune-related adverse events affecting multiple organ systems including integument, ocular, endocrine, cardiovascular, pulmonary, renal, gastrointestinal, and musculoskeletal system.

Case report

We present a case of an 88-year-old Caucasian male with metastatic melanoma of the face with metastasis to the right fifth cranial nerve and into the right cavernous sinus. He underwent resection of the melanoma and was placed on pembrolizumab at 2 mg/kg every three weeks. Interestingly, 24 months on pembrolizumab therapy, he developed corneal erosions, oral and genital ulcerations.

Management and outcome

Patient completed his 24 months of pembrolizumab and was started on prednisone and colchicine with improvement in his symptoms. At his follow-up eight months, he had recurrence of an oral ulcer.

Discussion

Here we present a rare case of an elderly male on pembrolizumab who suffered from corneal erosions, oral and genital ulcers, a syndrome similar to Behcet’s disease. Given that pembrolizumab and other immune checkpoint inhibitors are being utilized in the treatment of cancers, physicians should be aware of the wide range immune-related adverse events including the possible Behcet’s-like syndrome presentation.
Bone modifying agents for patients with bone metastases from breast cancer managed in routine practice setting: Treatment patterns and outcome
Authors: Zekri Jamal , Farag Kamel , Yousof Osama , Zabani Yazeed , Mohamed Wael , Ahmed Goma A
Published: October 2019

Introduction

Bone metastases are common in patients with breast cancer and can lead to pain and skeletal-related events. Bone modifying agents are licensed to be used for these patients. We report the treatment patterns and outcome of zoledronic acid and denosumab in routine practice.

Methodology

Women with bone metastases from breast cancer who have started denosumab or zoledronic acid between 2011 and 2016 were eligible. Those with history of bone modifying agent use prior to diagnosis of bone metastases or with switching treatment between zoledronic acid and denosumab were excluded. Details of patients, tumors, bone modifying agent treatment, selected bone modifying agent toxicity, time to skeletal-related event development, and overall survival were collected retrospectively.

Results

In total, 163 women were eligible and included in this analysis. Number of skeletal-related events prior to starting bone modifying agents was 0, 1, 2, and 3 in 91 (55.8%), 53 (32.5%), 13 (8%), and 6 (3.7%), respectively. Zoledronic acid was started for 107 (65.6%) and denosumab for 56 (34.4%) patients. The proportion of patients receiving denosumab increased from 23.1 to 54.3% in years 2011 and 2016, respectively. Dose delay, reduction, and discontinuation due to toxicity were reported more frequently in patients receiving zoledronic acid. Denosumab delayed time to first on-treatment skeletal-related event compared with zoledronic acid (hazard ratio, 0.64; 95% CI, 0.41–0.98; log rank P = 0.044). There was no significant difference in median survival (zoledronic acid: 62 and denosumab: 58 months; log rank P = 0.956).

Conclusion

Denosumab is superior to zoledronic acid in reducing risk of skeletal-related events and in tolerance profile. However, overall survival is similar with both treatments. Our findings mirror those reported in scrutinized environment of landmark clinical trials.
Ruxolitinib for the treatment of lymphoma-associated hemophagocytic lymphohistiocytosis: A cautionary tale
Authors: Trantham Tanner , Auten Jessica , Muluneh Benyam , Van Deventer Hendrik
Published: October 2019

Introduction

Hemophagocytic lymphohistiocytosis is a hyperinflammatory syndrome characterized by fever, hyperferritinemia, hypertriglyceridemia, hypofibrinogenemia, and pancytopenia. Three publications reported success with ruxolitinib, a Janus-associated kinase (JAK1/2) inhibitor. This therapy interrupts the production of cytokines associated with hemophagocytic lymphohistiocytosis, namely interferon-γ and interleukins 2, 6, and 10.

Case report

We administered ruxolitinib to two patients with lymphoma-associated hemophagocytic lymphohistiocytosis who had failed standard treatment with dexamethasone and etoposide.

Management and outcome

Patient #1 was started on ruxolitinib 10 mg BID, and titrated to 15 mg BID. All but two of the hemophagocytic lymphohistiocytosis criteria resolved within two weeks, and she was able to restart therapy for lymphoma. During her ruxolitinib taper, she again presented with relapsed hemophagocytic lymphohistiocytosis. She was taking 2.5 mg a day at the time. Despite salvage treatment, she died from the disease. Patient #2 was a diffuse large B-cell lymphoma patient who presented with hemophagocytic lymphohistiocytosis and was treated with chemoimmunotherapy and achieved a complete response (CR). Hemophagocytic lymphohistiocytosis symptoms relapsed, and he was treated with ruxolitinib. He developed relapsed lymphoma and unfortunately died.

Discussion

While treating the underlying lymphoma is a clear priority, the cytopenias and other symptoms of hemophagocytic lymphohistiocytosis complicate the delivery of this therapy. Hence, the use of ruxolitinib as a bridge to definitive therapy was appealing. However, we are concerned about the progression of lymphoma while these patients were taking ruxolitinib. Ruxolitinib may be controlling cytokine storm associated with hemophagocytic lymphohistiocytosis, while other aspects of the condition are progressing. Therefore, we would advise caution in its use in lymphoma-associated-hemophagocytic lymphohistiocytosis until more data are available.
A Refined Model of Stress–Diathesis Relationships in Mothers With Significant Depressive Symptom Severity
Authors: Matsuda Yui , Schwartz Todd A. , Chang YunKyung , Beeber Linda S.
Published: October 2019

BACKGROUND: Mothers’ depressive symptoms affect their children’s growth as well as physical and mental well-being. Moreover, mothers of young children with developmental delay or disability (DD) tend to have higher depressive symptoms. AIMS: The purpose of this study was to examine associations between maternal depressive symptoms and number of children with DD among mothers with significant levels of depressive symptoms, while accounting for maternal diathesis factors and family stress factors. METHODS: This study was a secondary analysis of pooled baseline data collected from 2004 to 2012 in the northeastern and southeastern United States from three intervention studies to reduce depressive symptoms of mothers with young children ( n = 364). Multiple regression analyses were conducted to examine associations between maternal depressive symptoms and number of children with DD, followed by the post hoc pairwise comparison. RESULTS: In the model including family stress factors, we found a significant test for linear trend in the mean for maternal depressive symptoms across the number of children with DD ( F[1] = 4.3, p = .0388). CONCLUSIONS: Mothers who have multiple children with DD tend to experience higher depressive symptoms; thus, interventions are needed to help prevent these mothers from experiencing higher depressive symptoms or to reduce their current depressive symptoms. Both theory-based and strength-based interventions can target conflict management at the family level, reducing maternal depressive symptoms while improving mothers’ self-efficacy, which would help mothers care for their own health, manage family conflict, and seek appropriate support to manage the children’s medical and developmental needs.
Phacoemulsification, visco-goniosynechialysis, and goniotomy in patients with primary angle-closure glaucoma: A comparative study
Authors: Shokoohi-Rad Saeed , Karimi Farshid , Zarei-Ghanavati Siamak , Tireh Hossein
Published: October 2019

Objective:

The aim of this study was to evaluate the effects of goniotomy on patients with primary angle-closure glaucoma who underwent “phacoemulsification and visco-goniosynechialysis.”

Materials and methods:

This prospective randomized clinical trial was carried out on 63 eyes of 61 patients (48–85 years) with primary angle-closure glaucoma who were enrolled. The subjects were randomly assigned into two groups. In the first group (32 eyes) and the second group (31 eyes), the patients underwent “phacoemulsification + visco-goniosynechialysis + goniotomy” and “phacoemulsification + visco-goniosynechialysis,” respectively. Intraocular pressure and antiglaucoma medication were evaluated (1 week, as well as 1, 3, and 6 months after the surgery). Anterior segment optical coherence tomography parameters (Casia, Tomey, USA) and goniotomy were evaluated preoperatively and 6 months after the surgery.

Results:

The mean intraocular pressure lowering the effects in the “phacoemulsification + visco-goniosynechialysis + goniotomy” group was higher than that in the “phacoemulsification + visco-goniosynechialysis” group (6.93 and 4.6, respectively). Furthermore, the difference in intraocular pressure between the two groups was significant at 3 months (P = 0.014) and 6 months (P = 0.021) after the surgery. There was no difference in anterior segment optical coherence tomography findings before the intervention; however, after the intervention, the anterior segment optical coherence tomography indices were significantly different between the two groups. Moreover, the difference in “phacoemulsification + visco-goniosynechialysis + goniotomy” indices was more than the changes in the “phacoemulsification + visco-goniosynechialysis” group.

Conclusion:

The results of this study showed that phacoemulsification + visco-goniosynechialysis + goniotomy is a more effective surgery than phacoemulsification + visco-goniosynechialysis alone in undercounted primary angle-closure glaucoma.
Totally percutaneous endoluminal ballooning of stuck hemodialysis catheters: One-year experience of a referral center
Authors: Perandini Simone , Lucarelli Antonio , Beleù Alessandro , Montemezzi Stefania
Published: October 2019

The stuck catheter is an uncommon but dreaded complication of dialysis line placement. It always finds the operator unaware and often requires procedure modification or reschedule. Hong pioneered the technique of endoballooning to expand a stuck central venous catheter, thus freeing it from wall adhesions. The purpose of the current study was to present a totally percutaneous variation of endoluminal stuck catheters ballooning, along with our experience in terms of safety and feasibility. A major difference presented in respect to previous techniques is that this modification does not require isolation of the distal line stump at the venous entry point by tissue dissection, thus reducing procedural time and difficulty. We presented a case series of five lines that were ballooned by navigating low-profile material directly from the cutaneous exit of the lines, with optimal results (100% success). The findings of this investigation provide additional evidence with respect to the safety and effectiveness of endoluminal ballooning of Tesio lines and offer a new variation of endoluminal ballooning which we found easy to perform, safe, and effective.
Evaluation model of competitive and innovative tourism practices based on information entropy and alternative criteria weight
Authors: Teixeira Sérgio J , Ferreira João J , Wanke Peter , Moreira Antunes Jorge Junio
Published: October 2019

An evaluation model of competitive and innovative tourism practices in Portugal based on information entropy is proposed. The relative evolution of each criterion/construct is explored in the light of its predictability/randomness in Portuguese companies by calculating and analysing the information entropy of different perceptions on competitive and innovative tourism practices. This article presents a novel approach by using information entropy to handle probabilistically different competitive and innovative practice weights computed by alternative models such as (a) the Fuzzy Rasch model that combines the item response theory and the fuzzy set theory, (b) the fuzzy analytic hierarchy process (AHP) model and (c) the crisp AHP model based on eight different judgment scales on the relative evolution of each criterion/construct. The results show that the total information entropy suggests a strong heterogeneity in Portuguese companies in terms of innovation for competitiveness. They also reveal a significant relationship between innovative tourism practices and tourism competitiveness models.
Stochastic P-bifurcation in a generalized Van der Pol oscillator with fractional delayed feedback excited by combined Gaussian white noise excitations
Authors: Li Yajie , Wu Zhiqiang , Wang Feng , Zhang Guoqi , Wang Yuancen
Published: October 2019

This paper investigates the stochastic P-bifurcation behavior of bistability in a generalized Van der Pol system with fractional time-delay feedback under additive and multiplicative Gaussian white noise excitations. First, using the minimal mean square error principle, the fractional derivative is found to be equivalent to a linear combination of damping and restoring forces, and the original system is transformed into an equivalent integer-order system. Second, the stationary probability density function of system amplitude is obtained by stochastic averaging, and according to singularity theory, the critical parameters for stochastic P-bifurcation of the system are found. Finally, the different types of stationary probability density function curves of the system amplitude are qualitatively analyzed by choosing the corresponding parameters in each region divided by the transition set curves. The consistency between the analytical solutions and the Monte Carlo simulation results verifies the theoretical analysis in this paper. The method used in this paper can directly guide the design of the fractional-order controller to adjust the response of the system.
Active oscillation control of electric vehicles with two-speed transmission considering nonlinear backlash
Authors: Zhang Jianwu , Chai Benben , Lu Xingyang
Published: October 2019

The nonlinear backlash can influence the driveability of the electric driveline due to the lack of the traditional clutches and torsional damper devices. During the stand-start, regenerative braking and gear shift process of the electric drive system equipped with two-speed transmission, the request of transient traction motor change will transverse the powertrain backlash, which will excite the driveline oscillations coupled to the first rigid mode of the entire powertrain, referred as shuffle or shunt. These vibrations are transmitted to the chassis, causing deterioration in passenger comfort. In this paper, the nonlinear driveline model including the traction motor, half shaft, driveline backlash, and car wheel are developed. Then, dual extended Kalman filter method is employed to estimate vehicle mass and half shaft torsional angle of the proposed driveline. Based on the estimated information, a hierarchical architecture of the active oscillation compensation is proposed to alleviate the vibration in both contact and backlash mode. The experimental results show that the estimation method is effective and the vehicle shuffle can be significantly decreased by the developed control algorithm.
The Hextol Foundation: Building a sustainable social enterprise business model
Authors: Pattinson Steven
Published: October 2019

This case focuses on how social entrepreneurs use business model thinking to create successful business models for sustainable social enterprise. It explores how the Hextol Foundation, an independent charitable company whose aim is to improve the quality of life of young people who are learning disabled, or who have mental ill health, uses business model thinking as part of a decision-making process to develop a sustainable social enterprise business model. The case provides a detailed account of the unique challenges presented to entrepreneurs who are driven by social purpose rather than solely by the need to generate a profit. The case is also useful in highlighting how business model thinking is used by entrepreneurs to identify, evaluate and pursue a range of strategic options. It advances our understanding of business model thinking and business model innovation in the context of a social enterprise.
Analysis of the energy balance during World harmonized Light vehicles Test Cycle in warmed and cold conditions using a Virtual Engine
Authors: Olmeda Pablo , Martín Jaime , Arnau Francisco J , Artham Sushma
Published: October 2019

In recent years, the interests on transient operation and real driving emissions have increased because of the global concern about environmental pollution that has led to new emissions regulation and new standard testing cycles. In this framework, it is mandatory to focus the engines research on the transient operation, where a Virtual Engine has been used to perform the global energy balance of a 1.6-L diesel engine during a World harmonized Light vehicles Test Cycle. Thus, the energy repartition of the chemical energy has been described with warmed engine and cold start conditions, analyzing in detail the mechanisms affecting the engine consumption. The first analysis focuses on the “delay” effect affecting the instantaneous energy balance due to the time lag between the in-cylinder processes and pipes: as a main conclusion, it is obtained that it leads to an apparent unbalance than can reach more than 10% of the cumulated fuel energy at the beginning of the cycle, becoming later negligible. Energy split analysis in cold starting World harmonized Light vehicles Test Cycle shows that in this condition the energy accumulation in the block is a key term at the beginning (about 50%) that diminishes its weight until about 10% at the end of the cycle. In warmed conditions, energy accumulation is negligible, but the heat transfer to coolant and oil are higher than in cold starting conditions (21% vs 28%). The lower values of the mean brake efficiency at the beginning of the World harmonized Light vehicles Test Cycle (only about 20%) is affected, especially in cold starting, by the higher mechanical losses due to the higher oil viscosity and the heat rejection from the gases. The friction plays an important role only during the first half of the cycle, with a percentage of about 65% of the total mechanical losses and 10% of the total fuel energy at the end of the World harmonized Light vehicles Test Cycle. However, at the end of the cycle, it does not affect dramatically the mean brake efficiency which is about 31% both in cold starting and warmed World harmonized Light vehicles Test Cycle.
Voice, views and the UNCRC Articles 12 and 13
Authors: Bradwell Marie
Published: October 2019

The voice of children aged 4 to 8 years is seldom heard in research circles, within the constraints of high-pressure academic model which is the current education system in England. Children are rarely listened to but expected to listen in the current normative societal cycle. This deficiency of active listening as an everyday occurrence impacts on children’s Mental Health. This article will give reference to an original empirical study, Hear Me and Listen. This study carried out in 2018 highlights the minimalistic practice of listening to children aged 4 to 8 years in the everyday. The research method used consisted of the Mosaic Approach. This approach provides various avenues for communication aside from the verbal. Data collected were analysed through a thematic approach. Themes which came from analysis included ‘This Is Me’, ‘Relationships’, ‘Environment’, ‘Curriculum’ and ‘Practitioners’. This article draws on this analysis and concludes that a change in the normative discourse of ‘hearing’ and not acting to one of ‘active listening’ and supporting is a path worth mapping.
Predictors of Groin Access Pseudoaneurysm Complication: A 10-Year Institutional Experience
Authors: Naddaf Abdallah , Williams Stephen , Hasanadka Ravishankar , Hood Douglas B. , Hodgson Kim J.
Published: October 2019

Objective:

In clinical practice, the incidence of femoral pseudoaneurysms requiring repair is small, but at a tertiary care center, the repair rate is higher due to referrals. We sought to specifically study patients who suffered postcatheterization pseudoaneurysms requiring thrombin injection or operative repair and compare them to our routine transfemoral endovascular patients to identify predictors of clinically significant pseudoaneurysms. The underlying goal would be to identify what makes these patients that develop pseudoaneurysms different.

Methods:

A search of our billing records for Current Procedural Technology (CPT) codes of these 2 procedures between January 2008 and April 2018 was combined with our institution’s Peripheral Vascular Intervention Vascular Quality Initiative database spanning from January 2013 to December 2017. A comparison was then performed between patients who had the outcome of operative intervention for a pseudoaneurysm complication and those who did not, with the goal of elucidating patient demographics and periprocedural factors that would predict pseudoaneurysm formation using univariate and multivariate analyses.

Results:

There were 77 patients who required thrombin injection or open repair for access-related pseudoaneurysms and 324 patients who did not. Complications occurred more often in patients who were older than 75 (40.2% vs 21.9%; P = .0009), female (57.1% vs 38.6%; P = .003), obese (59.7% vs 33.3%; P < .001), hypertensive (96.1% vs 79.3%; P = .0005), who received a sheath >6F (32.4% vs 13%; P < .0001), intraoperative and postoperative anticoagulation (77.3% vs 32.7% and 52.1% vs 24.2%, respectively; P < .0001), and periprocedural P2Y12 inhibitors (48.7% vs 28%; P = .0005). Less complications were observed in patients who had a closure device used (42.9% vs 8.45%; P < .0001) and protamine reversal (26.5% vs 13.3%; P = .0163).

Conclusions:

Our findings validate published reports that incriminate a larger sheath size, perioperative anticoagulation, and female gender as increasing the rate of access site complications, with the use of a closure device being protective.
Placenta accreta spectrum: Risk factors, diagnosis and management with special reference to the Triple P procedure
Authors: Piñas Carrillo Ana , Chandraharan Edwin
Published: October 2019

Abnormal invasion of placenta or placenta accreta spectrum disorders refer to the penetration of the trophoblastic tissue through the decidua basalis into the underlying uterine myometrium, the uterine serosa or even beyond, extending to pelvic organs. It is classified depending on the degree of invasion into placenta accreta (invasion <50% of the myometrium), increta (invasion >50% of the myometrium) and percreta (invading the serosa and adjacent pelvic organs). Clinical diagnosis is made intra-operatively; however, the confirmative diagnosis can only be made after a histopathological examination. The incidence of abnormal invasion of placenta has increased worldwide, mostly as a consequence of the rise in caesarean section rates, from 1 in 2500 pregnancies to 1 in 500 pregnancies. The importance of the disease is due to the increased maternal and foetal morbidity and mortality. Foetal implications are mainly due to iatrogenic prematurity, while maternal implications are mostly the increased risk of obstetric haemorrhage and surgical complications. The average blood loss is 3000–5000 mL, and up to 90% of the patients require a blood transfusion. An accurate and timely antenatal diagnosis is essential to improve outcomes. The traditional management of abnormal invasion of placenta has been a peripartum hysterectomy; however, the increased incidence and the short- and long-term consequences of a radical approach have led to the development of more conservative techniques, such as the intentional retention of the placenta, partial myometrial excision and the ‘Triple P procedure’. Irrespective of the surgical technique of choice, women with a high suspicion or confirmed abnormally invasive placenta should be managed in a specialist centre with surgical expertise with a multi-disciplinary team who is experienced in managing these complex cases with an immediate availability of blood products, interventional radiology service, an intensive care unit and a neonatal intensive care unit to optimize the outcomes.
Machine learning in men’s professional football: Current applications and future directions for improving attacking play
Authors: Herold Mat , Goes Floris , Nopp Stephan , Bauer Pascal , Thompson Chris , Meyer Tim
Published: October 2019

It is common practice amongst coaches and analysts to search for key performance indicators related to attacking play in football. Match analysis in professional football has predominately utilised notational analysis, a statistical summary of events based on video footage, to study the sport and prepare teams for competition. Recent increases in technology have facilitated the dynamic analysis of more complex process variables, giving practitioners the potential to quickly evaluate a match with consideration to contextual parameters. One field of research, known as machine learning, is a form of artificial intelligence that uses algorithms to detect meaningful patterns based on positional data. Machine learning is a relatively new concept in football, and little is known about its usefulness in identifying performance metrics that determine match outcome. Few studies and no reviews have focused on the use of machine learning to improve tactical knowledge and performance, instead focusing on the models used, or as a prediction method. Accordingly, this article provides a critical appraisal of the application of machine learning in football related to attacking play, discussing current challenges and future directions that may provide deeper insight to practitioners.
A pragmatic methodology for studying international practices
Authors: S Sundaram Sasikumar , Thakur Vineet
Published: October 2019

Practice turn marks an important advancement in International Relations theorizing. In challenging abstract meta-theoretical debates, practice theorizing in International Relations aims to get close to the lifeworld(s) of the actual practitioners of politics. Scholars from different positions such as constructivism, critical theory, and post-structuralism have critically interrogated the analytical framework of practices in international politics. Building upon these works, we are concerned with a question of how to examine the context of international practices that unfolds in multiple ways in practitioners’ performances. Our central thesis is that a distinct pragmatic methodology offers an opportunity to keep with the practice turn and avoid the problematic foundational moves of mainstream practice theorizing. This involves foregrounding three interrelated processes in examining practices: the role of exceptions in the normal stream of performances, normative uptake of the analysts, and the semantic field that actors navigate in political performances. We argue that this methodology is predicated on its usefulness to interpret practices through reflective social-science inquiry.
From Scutellaria barbata to BZL101 in Cancer Patients: Phytochemistry, Pharmacology, and Clinical Evidence
Authors: Gao Jiayu , Yin Weiping , Corcoran Olivia
Published: October 2019

Scutellaria barbata D.Don is a popular Chinese medicinal plant documented to treat cancer patients in traditional Chinese medicine (TCM). A botanical new investigational drug for breast cancer BZL101 (FDA IDN# 59521) was previously developed in the United States from the aqueous extract of the aerial parts from S. barbata. The early phase 1A and 1B clinical trials show its favorable toxicity profiles, good clinical tolerance, and promising efficacy for patients with metastatic breast cancer. To further evidence the phytopharmacology research, drug development, and anticancer use of this herb, a systematic literature review was performed herein on the phytochemistry, pharmacology, and specifically anticancer clinical evidence. A systematic review of the literature on phytochemical and pharmacological properties of the plant related to cancer treatment employed several web-based scientific databases including Wanfang (Chinese), Pubmed, Web of Science, and Elsevier. Key words included Scutellaria barbata, Ban Zhi Lian, cancer, and tumor. Based on critical quality criteria, only 8 out of 69 reports related to clinical studies of cancer patients in China. This review covered the available literature up to July 2019. The anticancer effects of S. barbata can be explained by the presence of various flavonoids and diterpenoids alkaloids. The underlying mechanisms are primarily summarized as cyclin/cyclin-dependent kinase (CDK)-modulated cell cycle arrest and mitochondria-mediated apoptotic death. The highly cancer-cell selective cytotoxicity and detoxifying effects of S. barbata contribute to a favorable clinical profile and enhanced quality of life for the cancer patient, thereby demanding further study as an adjuvant or alternative to conventional chemotherapy. The phytochemical and pharmacological studies reviewed strongly underpin a fundamental understanding of the anticancer activity of S. barbata and support ongoing clinical trials. The further safety verification and clinical trials are expected to progress S. barbata-based development to finally transform the traditional TCM herb S. barbata to the valuable anticancer drug.
Spatiotemporal Expression of 3-B-3(−) and 7-D-4 Chondroitin Sulfation, Tissue Remodeling, and Attempted Repair in an Ovine Model of Intervertebral Disc Degeneration
Authors: Farrugia Brooke , Smith Susan M. , Shu Cindy C. , Melrose James
Published: October 2019

Objective

Examination of intervertebral disc (IVD) regeneration in an ovine annular lesion model.

Hypothesis

Sulfation motifs are important functional determinants in glycosaminoglycans (GAGs). Previous studies have correlated 3-B-3(−) and 7-D-4 chondroitin sulfate (CS) motifs in tissues undergoing morphogenetic transition in development. We hypothesize that these motifs may also be expressed in degenerate IVDs and may represent a reparative response.

Design

Induction of disc degeneration by 5 mm or 6 × 20 mm lesions in the annulus fibrosus (AF) over 6 or 3 to 6 months postoperation (PO). Tissue sections were stained with toluidine blue–fast green, 3-B-3(−) and 7-D-4 CS-sulfation motifs were immunolocalized in 3-month PO 6 × 20 mm lesion IVDs. Sulfated glycosaminoglycan (GAG), 3-B-3(−), and 7-D-4 epitopes were quantitated by ELISIA (enzyme-linked immunosorbent inhibition assay) in extracts of AF (lesion site and contralateral half) and nucleus pulposus (NP) 0, 3, and 6 months PO.

Results

Collagenous overgrowth of lesions occurred in the outer AF. Chondroid metaplasia in ~20% of the 6 × 20 mm affected discs resulted in integration of an outgrowth of NP tissue with the inner AF lamellae preventing propagation of the lesion. 3-B-3(−) and 7-D-4 CS sulfation motifs were immunolocalized in this chondroid tissue. ELISIA quantified CS sulfation motifs demonstrating an increase 3 to 6 months PO in the AF lesion and a reduction in sulfated GAG not evident in the contralateral AF.

Conclusions

(1) Outer annular lesions underwent spontaneous repair. (2) Chondroid metaplasia of the inner 6 × 20 mm defect prevented its propagation suggesting an apparent reparative response.
Levetiracetam induced hypomania: a case report
Authors: Altınöz Ali Ercan , Tosun Altınöz Şengül , Güzel Biltekin Başak , Can Kaya Murat
Published: October 2019

Levetiracetam (LEV) is a newer second-generation antiepileptic drug that is found to be effective in tonic-clonic seizures, partial onset seizures, and myoclonic seizures. Among antiepileptic drugs, LEV is usually known for fewer adverse drug reactions. Psychiatric disorders after the administration of LEV have been reported in the literature. There are many case reports on LEV-induced psychosis, but there are only three case reports of mania induced by LEV use. In this report, we present a case with no history of psychiatric disorder who had a hypomania episode after receiving LEV for epilepsy treatment. The development of manic symptoms with LEV therapy is unusual. Clinicians should consider monitoring patients closely for treatment-related psychological symptoms and psychotic symptoms, including the possibility of mania.
Green Investing and Indian Investors: The Case of Suzlon Energy
Authors: Chatnani Niti Nandini
Published: October 2019

In the early 2000s, ‘green investing’ caught the fancy of investors worldwide as they realized that being environmentally conscious could also be financially rewarding. The Suzlon Energy Initial Public Offering (IPO) in India in September 2005 received much attention, and was oversubscribed nearly 25 times. Many investors regarded Suzlon as a green investment opportunity, and the stock touched record high levels over the next three years of its listing. However, some large and highly leveraged acquisitions made with the objective of achieving fast growth led to major financial distress for the company. The race to capture new markets with new products also led to compromises on product quality and customer service. A good business model was damaged by bad investment decisions, and stock prices declined steadily. Suzlon disappeared from the radar of green investors till an acquisition 23 per cent stake in Suzlon Energy by a strategic investor revived the market’s interest in this stock. This paper is a case study of how, despite being a green business with great potential, Suzlon took on risks that led to major losses for its investors, and lessons for green investors of India.
Bank Recapitalization in India: A Critique of Public Policy Concerns
Authors: Mohapatra Amiya Kumar , Jha Srirang
Published: October 2019

Public sector banks in India have always been viewed as vehicles of economic and social development. These institutions reach out to people of all sections across the country and offer banking services even if they have to compromise on profitability. Most of the social schemes for poverty alleviations, livelihood, skill development, financial inclusion, etc., are channelized through public sector banks. However, their capability is severely limited due to burgeoning non-performing assets. Considering the importance of public sector banks for the economy of the country, the government often recapitalizes them so that banks may survive the threat of closure. However, bank recapitalization serves as Band-Aid while the underlying sickness continues to spread. This article examines the policy concerns vis-à-vis bank recapitalization and suggests corrective pathways. Factors leading to unremitting capital erosion in banks have been diagnosed and efforts have been made to figure out why previous attempts at recapitalization have failed to strengthen and transform the banking system.
Kiddie Junction: The Challenges Ahead
Authors: Chowdhary Rupal , Jhala Seema , Walia Ankit , Badjatya Rashmi
Published: October 2019

Kiddie Junction is a unique set-up of day care, playschool and evening classes. * The organization was started in 2011 by women entrepreneur Chetna Satija who thought of providing the facility of day care, play group and evening classes. The aim of the organization was not only profit maximization but also to give something more to the society by women empowerment, education and make a difference in the society. With her efforts in the right direction, the organization started with 6 kids in the year 2011 which rose to 30 kids in the next year, and now after 7 years, the organization has almost 100 kids. Quite satisfied with the growth of her organization, Chetna was in dilemma whether to start her own branches catering to different areas of Indore or start giving franchisee and other option such as shifting to bigger premises and increase the number of kids admitted in the school.
Subsidiary Innovation in a Developing Economy: Towards a Comprehensive Model and Directions for Future Research
Authors: Betaraya Dixit Manjunatha , Nasim Saboohi , Mukhopadhyay Joy
Published: October 2019

With the internationalization of innovation, multinational enterprise (MNE) subsidiaries have been found to play a critical role in product and process innovation. Deriving from a rich and diverse subsidiary innovation (SI) literature, this article attempts to develop a comprehensive model to study the factors that impact SI in a developing economy by devising three macro constructs, namely, (a) local environment (LE), (b) subsidiary traits (ST) and (c) headquarters (HQ) strategy (HS). The 15 factors associated with these macro constructs identified through literature review are statistically validated through an ‘Idea Engineering’ exercise for their contextual relevance. Based on an expert survey carried out in the developing economy context of India, barring 2 HS factors, rest of them have been found to be statistically significant in the Indian context. Antecedents of SI, identified by this article, can be used by domain practitioners and experts in the field to improve their organization’s innovative capability. The proposed model in this study can be further empirically validated by researchers working in the area of SI.
A Comparison of Psychological and Socio-economic Factors Affecting Individual User’s Social Media Behaviour
Authors: Bhandari Ravneet Singh , Bansal Ajay
Published: October 2019

Companies and business managers know about social media as a phenomenon and its power as a business tool. In various earlier researches many viewpoints, theories and models on online behaviour of individual consumers have been put across and build upon from time to time. However, keeping in mind the exponential growth in digital transactions in India, the digital platform managers of various companies are still data hungry and want data analytics to be done to understand various parameters affecting consumer black box. The focus of this study is on comparison of the psychological and socio-economic factors which affect the behaviour of individual user on social media. A model is proposed here by integrating psychological factors, social media behaviour elements and economic factors, and efforts to predict the impact for the social media usage are made. This research contributes by broadening the paradigm of various learning theories and predicts the online social media usage attitude development factors. This study in particular presents a different point of view about online social media behaviour by examining the effect of psychological and socio-economic elements and the moderating role of individual characteristics. It is an attempt by authors to empirically integrate and understand empirically, and draw a comparison between the impact of psychological and socio-economic factors that influence the consumers’ social media behaviour elements depending on their ability to affect the consumer’s attitude.
Developing Learners’ Cognitive Strategies and the Motivation to Use Them: Rethinking Education Policy
Authors: Dinsmore Daniel L. , Fryer Luke K.
Published: October 2019

Strategies—and the motivation to use them—are critical to helping learners solve complex problems and complete complex tasks. These strategies and motivation are specific to certain domains—such as science—and even specific to certain tasks. Policies to improve learners’ strategies and motivations should consider the learners themselves, the teacher, and the learning environment. With regard to learners, teachers should explicitly foster an array of learner strategies and teach them when and how to use them; teachers should expect development across learners to vary depending on other cognitive aspects, such as knowledge, as well as other motivational aspects, such as their interest. Policies should enable and encourage teachers to individualize explicit strategy instruction for each student with teachers developing their own strategy instruction by reflecting on that instruction using action research (i.e., research that is done by teachers in their own areas of practice).
The Added Value of Latinx and Black Teachers for Latinx and Black Students: Implications for Policy
Authors: Bristol Travis J. , Martin-Fernandez Javier
Published: October 2019

A research synthesis points to the added value—benefits to social and emotional development, as well as learning outcomes—for students of color taught by teachers of color. Given ongoing education debates, policymakers can use this evidence base to craft legislation aimed at increasing the ethnoracial diversity of the U.S. educator workforce. To begin, historical research shows how Latinx and Black teachers have supported their Latinx and Black students’ social and emotional development during state-sanctioned school segregation. Contemporary qualitative and quantitative research highlights how teachers of color improve social and emotional development, as well as learning, for their students of color. Implications for Higher Education Act (HEA) are discussed.
School-Based Interventions for Reducing Youths’ Racial and Ethnic Prejudice
Authors: Grapin Sally L. , Griffin Charity B. , Naser Shereen C. , Brown Jeffrey M. , Proctor Sherrie L.
Published: October 2019

Minoritized youth encounter racial and ethnic prejudice and discrimination in a variety of settings, including schools. Prejudice refers to harboring negative attitudes and beliefs toward targeted social groups; discrimination reflects translating those attitudes into actions that marginalize targeted groups. Exposure to racial and ethnic discrimination has been associated with numerous detrimental outcomes for youth, including poorer mental health outcomes and lower levels of academic performance. This article describes the nature of racial and ethnic discrimination encountered by minoritized youth as well as its impact on these populations. It also reviews research on prejudice reduction interventions for youth, with a focus on those interventions designed for school settings. In light of existing research, several policy recommendations support high-quality, evidence-based programming in schools.
Strengthening STEM Instruction in Schools: Learning From Research
Authors: Lynch Kathleen , Hill Heather C. , Gonzalez Kathryn , Pollard Cynthia
Published: October 2019

More than half of U.S. children fail to meet proficiency standards in mathematics and science in fourth grade. Teacher professional development and curriculum improvement are two of the primary levers that school leaders and policymakers use to improve children’s science, technology, engineering and mathematics (STEM) learning, yet until recently, the evidence base for understanding their effectiveness was relatively thin. In recent years, a wealth of rigorous new studies using experimental designs have investigated whether and how STEM instructional improvement programs work. This article highlights contemporary research on how to improve classroom instruction and subsequent student learning in STEM. Instructional improvement programs that feature curriculum integration, teacher collaboration, content knowledge, pedagogical content knowledge, and how students learn all link to stronger student achievement outcomes. We discuss implications for policy and practice.
Livelihoods with multiple stressors: Gendered youth decision-making under global change in rural Northwest Mexico
Authors: Buechler Stephanie , Lutz-Ley América
Published: October 2019

Livelihoods in rural communities have become increasingly complex due to rapidly changing socio-economic and environmental forces, with differing impacts on and responses by female and male youth. This study contributes to feminist political ecology through an explicit focus on youth and an examination of the intersections of age and gender in educational choices, livelihood systems, and human–environment interactions. We undertake double exposures analysis to explore female and male youths’ livelihood-related decision-making in Rayón, a semi-arid rural community in Northwest Mexico, undergoing global environmental change and globalization-related shifts in agriculture, climate, water, and socio-economic conditions. Global environmental change exacerbates an already fragile, local ecological context. A focus on gender issues among youth in three age categories (14–15, 16–19, and youth in their 20s) with respect to their decision-making concerning the future is critical to gaining a better understanding of the roles women and men will play in linked agricultural and non-agricultural, rural to urban livelihood systems. Agricultural employment increasingly includes global agribusiness where local youth compete with people from other areas. Access to employment, education, as well as water and land resources varied by gender, age, and social class, and played significant roles in livelihood diversification and migration decisions and outcomes. Mothers’ access to government assistance for their natural resource-based livelihoods positively impacted daughters’ opportunities. Educational curricula failed to link environmental change with local livelihoods and to prepare students for urban careers. This study offers insights related to female and male youths’ needs associated with environmental education, technology access, job training, and child and sibling care in order for them to more successfully confront the future across village, town, and city spaces.