bluuebunny/crossref_metadata_2025 huggingface dataset:
Endoscopic Lung Volume Reduction Using Endobronchial Valves in Patients with Severe Emphysema and Very Low FEV1
Authors: Trudzinski Franziska C. , Höink Anna J. , Leppert Daniela , Fähndrich Sebastian , Wilkens Heinrike , Graeter Thomas P. , Langer Frank , Bals Robert , Minko Peter , Lepper Philipp M.
Published: September 2016

Background: Patients with a forced expiratory volume in 1 s (FEV1) below 20% of the predicted normal values (pred.) and either homogeneous emphysema or low diffusing capacity for carbon monoxide (DLCO) have a high risk for adverse events including death when undergoing surgical lung volume reduction. Objectives: We hypothesized that selected patients can benefit from endoscopic lung volume reduction (eLVR) despite a very low FEV1. Methods: This study is a retrospective analysis of consecutive patients with severe airflow obstruction, an FEV1 ≤20% of pred., and low DLCO who were treated by eLVR with endobronchial valves (EBV) between June 2012 and January 2015. Pre- and postinterventional lung function parameters, the 6-min walking test (6-MWT) distance, adverse events, and follow-up were recorded. Results: In 20 patients, there was an overall improvement in lung function with an increase in FEV1 (16.97-21.03% of pred.) and a decrease in residual volume (322-270% of pred.) and total lung capacity (144-129.06% of pred.). The 6-MWT distance improved (from 239 ± 77 to 267± 97 m overall, and from 184 ± 50 to 237 ± 101 m if patients developed an atelectasis of the target lobe). Pneumothorax occurred in 5 of the 20 patients (25%). 30-day mortality was 0%, and all patients survived to discharge. Conclusions: The patients benefitted moderately from EBV treatment despite an initially low FEV1. Some patients improved remarkably. EBV treatment in patients with an FEV1 ≤20% of pred. is generally feasible and safe. The greatest risk is pneumothorax with prolonged chest tube duration.
Early Blood Pressure Lowering Does Not Reduce Growth of Intraventricular Hemorrhage following Acute Intracerebral Hemorrhage: Results of the INTERACT Studies
Authors: Chan Edward , Anderson Craig S. , Wang Xia , Arima Hisatomi , Saxena Anubhav , Moullaali Tom J. , Delcourt Candice , Wu Guojun , Wang Jinchao , Chen Guofang , Lavados Pablo M. , Stapf Christian , Robinson Thompson , Chalmers John ,   The INTERACT Investigators
Published: September 2016

Background: Intraventricular hemorrhage (IVH) extension is common following acute intracerebral hemorrhage (ICH) and is associated with poor prognosis. Aim: To determine whether intensive blood pressure (BP)-lowering therapy reduces IVH growth. Methods: Pooled analyses of the Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trials (INTERACT1 and INTERACT2) computed tomography (CT) substudies; multicenter, open, controlled, randomized trials of patients with acute spontaneous ICH and elevated systolic BP, randomly assigned to intensive (<140 mm Hg) or guideline-based (<180 mm Hg) BP management. Participants had blinded central analyses of baseline and 24-hour CT. Association of BP lowering to IVH growth was assessed in analysis of covariance. Results: There was no significant difference in adjusted mean IVH growth following intensive (n = 228) compared to guideline-recommended (n = 228) BP treatment (1.6 versus 2.2 ml, respectively; p = 0.56). Adjusted mean IVH growth was nonsignificantly greater in patients with a mean achieved systolic BP ≥160 mm Hg over 24 h (3.94 ml; p trend = 0.26). Conclusions: Early intensive BP-lowering treatment had no clear effect on IVH in acute ICH.
Early Changes in Monocyte Adhesion Molecule Expression and Tumor Necrosis Factor-α Levels in Chronic Kidney Disease - A 5-Year Prospective Study
Authors: Wallquist Carin , Mansouri Ladan , Norrbäck Mattias , Hylander Britta , Jacobson Stefan H. , Lundahl Joachim
Published: September 2016

Background: Despite the absence of clinical symptoms, patients with chronic kidney disease (CKD) exhibit elevated levels of pro-inflammatory markers. To investigate whether it is possible to detect inflammatory activity and altered monocyte function at an early stage of renal disease, we studied patients with CKD stages 2-3 over 5 years. Methods: The expression of adhesion molecules on monocytes at resting state and after stimulation with formyl-methionyl-leucyl-phenylalanine (fMLP), as well as oxidative metabolism capacity was measured with flow cytometry in 108 CKD patients and healthy controls. Soluble markers of inflammation, such as cytokines, were analyzed using the Milliplex technique. Results: Patients showed significantly lower CD11b expression after stimulation during the 3rd (p = 0.002) and the 5th year (p < 0.001), together with a lower oxidative burst in response to fMLP over time (p = 0.02). The expression of CD62L on resting monocytes was lower during the 3rd (p = 0.001) and the 5th (p = 0.001) year in patients. Levels of tumor necrosis factor-α and RANTES were significantly increased (p = 0.001, p = 0.006) and interleukin-12 levels were also higher in CKD patients during the 5th year (p = 0.007). Conclusion: Monocytes in CKD stages 2-3 show emerging functional abrasions, with altered adhesion molecule expression and impaired fMLP response. These findings suggest that a transformation of monocyte function occurs at an early phase of renal impairment and may together with increased plasma levels of pro-inflammatory cytokines contribute to the higher vulnerability of CKD patients to comorbidities, such as infections and cardiovascular disease.
Factors Affecting Adherence to Statins in Hypercholesterolemic Kuwaiti Patients: A Cross-Sectional Study
Authors: Al-Foraih Meisa , Somerset Shawn
Published: September 2016

Objective: This study examined statin adherence amongst Kuwaiti hypercholesterolemic patients in order to identify factors associated with poor adherence and to determine whether or not an association exists between statin adherence and the risk profile of coronary heart disease (CHD). Subjects and Methods: Two hundred hypercholesterolemic patients (30-69 years of age) were recruited from Kuwaiti primary healthcare clinics and interviewed about demographic characteristics, pre-existing self-reported medical conditions and prescribed medications. The Morisky Medication Adherence Scale was used to assess statin adherence (a self-reported, medication-adherence questionnaire divided into 3 levels, with a score of 8 denoting high adherence, 6 to <8 denoting medium adherence and <6 denoting low adherence). Data regarding anthropometric, psychological and serum risk factors were collected using 2 additional questionnaires, laboratory tests and bioelectrical impedance scales. Binary logistic regression was used to determine predictors of adherence and general linear modelling was used to test relationships between continuous outcomes and statin adherence. Results: Of the 200 participants, 117 (58.5%) reported low adherence, 83 (41.5%) reported medium adherence and no patients (0%) scored high adherence. Younger patients (aged 30-50 years) had lower adherence than older patients (>50 years) [odds ratio (OR) 1.05; 95% confidence interval (CI) 1.01-1.09] for every extra year; p < 0.01). Those without diabetes, i.e. 113 (56.5%), were less likely to report medium adherence than those with diabetes (OR 0.42; 95% CI 0.23-0.75; p < 0.01). Low statin adherence was associated with higher levels of plasma cholesterol (p < 0.001) and low-density lipoprotein (p < 0.01). Conclusion: In this study, there was a high prevalence of low statin adherence, especially among younger patients with fewer concomitant diseases. The results indicated an inverse relationship between statin adherence and CHD risk profile.
Economic Evaluation of Complementary and Alternative Medicine in Oncology: Is There a Difference Compared to Conventional Medicine?
Authors: Huebner Jutta , Prott Franz J. , Muecke Ralph , Stoll Christoph , Buentzel Jens , Muenstedt Karsten , Micke Oliver ,   on behalf of the Prevention and Integrative Oncology of the German Cancer Society Working Group
Published: September 2016

Objective: To analyze the financial burden of complementary and alternative medicine (CAM) in cancer treatment. Materials and Methods: Based on a systematic search of the literature (Medline and the Cochrane Library, combining the MeSH terms ‘complementary therapies', ‘neoplasms', ‘costs', ‘cost analysis', and ‘cost-benefit analysis'), an expert panel discussed different types of analyses and their significance for CAM in oncology. Results: Of 755 publications, 43 met our criteria. The types of economic analyses and their parameters discussed for CAM in oncology were cost, cost-benefit, cost-effectiveness, and cost-utility analyses. Only a few articles included arguments in favor of or against these different methods, and only a few arguments were specific for CAM because most CAM methods address a broad range of treatment aim parameters to assess effectiveness and are hard to define. Additionally, the choice of comparative treatments is difficult. To evaluate utility, healthy subjects may not be adequate as patients with a life-threatening disease and may be judged differently, especially with respect to a holistic treatment approach. We did not find any arguments in the literature that were directed at the economic analysis of CAM in oncology. Therefore, a comprehensive approach assessment based on criteria from evidence-based medicine evaluating direct and indirect costs is recommended. Conclusion: The usual approaches to conventional medicine to assess costs, benefits, and effectiveness seem adequate in the field of CAM in oncology. Additionally, a thorough deliberation on the comparator, endpoints, and instruments is mandatory for designing studies.
Cardiac Fibroblast GRK2 Deletion Enhances Contractility and Remodeling Following Ischemia/Reperfusion Injury
Authors: Woodall Meryl C. , Woodall Benjamin P. , Gao Erhe , Yuan Ancai , Koch Walter J.
Published: September 2016

Rationale:

G protein–coupled receptor kinase 2 (GRK2) is an important molecule upregulated after myocardial injury and during heart failure. Myocyte-specific GRK2 loss before and after myocardial ischemic injury improves cardiac function and remodeling. The cardiac fibroblast plays an important role in the repair and remodeling events after cardiac ischemia; the importance of GRK2 in these events has not been investigated.

Objective:

The aim of this study is to elucidate the in vivo implications of deleting GRK2 in the cardiac fibroblast after ischemia/reperfusion injury.

Methods and Results:

We demonstrate, using Tamoxifen inducible, fibroblast-specific GRK2 knockout mice, that GRK2 loss confers a protective advantage over control mice after myocardial ischemia/reperfusion injury. Fibroblast GRK2 knockout mice presented with decreased infarct size and preserved cardiac function 24 hours post ischemia/reperfusion as demonstrated by increased ejection fraction (59.1±1.8% versus 48.7±1.2% in controls;
P
<0.01). GRK2 fibroblast knockout mice also had decreased fibrosis and fibrotic gene expression. Importantly, these protective effects correlated with decreased infiltration of neutrophils to the ischemia site and decreased levels of tumor necrosis factor-α expression and secretion in GRK2 fibroblast knockout mice.

Conclusions:

These novel data showing the benefits of inhibiting GRK2 in the cardiac fibroblast adds to previously published data showing the advantage of GRK2 ablation and reinforces the therapeutic potential of GRK2 inhibition in the heart after myocardial ischemia.
Loss of Endothelial Nitric Oxide Synthase Promotes p25 Generation and Tau Phosphorylation in a Murine Model of Alzheimer’s Disease
Authors: Austin Susan A. , Katusic Zvonimir S.
Published: September 2016

Rationale:

Alzheimer’s disease has an unknown pathogenesis; however, cardiovascular risk factors are associated with a higher incidence of Alzheimer’s disease. A defining feature of endothelial dysfunction induced by cardiovascular risk factors is reduced bioavailable endothelial nitric oxide (NO). We previously demonstrated that endothelial NO acts as an important signaling molecule in neuronal tissue.

Objective:

We sought to determine the relationship between the loss of endothelial NO synthase (eNOS) and tau phosphorylation in neuronal tissue.

Methods and Results:

We used eNOS knockout (
−/−
) mice as well as an Alzheimer’s disease mouse model, amyloid precursor protein (APP)/PSEN1dE9
+/−
(PS1) that lacked eNOS (APP/PS1/eNOS
−/−
) to examine expression of tau kinases and tau phosphorylation. Brain tissue from eNOS
−/−
mice had statistically higher ratios of p25/p35, indicative of increased cyclin-dependent kinase 5 activity as compared with wild-type (n=8,
P
<0.05). However, tau phosphorylation was unchanged in eNOS
−/−
mice (
P
>0.05). Next, we determined the role of NO in tau pathology in APP/PS1/eNOS
−/−
. These mice had significantly higher levels of p25, a higher p25/p35 ratio (n=12–14;
P
<0.05), and significantly higher cyclin-dependent kinase 5 activity (n=4;
P
<0.001). Importantly, APP/PS1/eNOS
−/−
mice also had significantly increased tau phosphorylation (n=4–6;
P
<0.05). No other changes in amyloid pathology, antioxidant pathways, or neuroinflammation were observed in APP/PS1/eNOS
−/−
mice as compared with APP/PS1 mice.

Conclusions:

Our data suggests that loss of endothelial NO plays an important role in the generation of p25 and resulting tau phosphorylation in neuronal tissue. These findings provide important new insights into the molecular mechanisms linking endothelial dysfunction with the pathogenesis of Alzheimer’s disease.
Sexual size dimorphism in the viviparous caecilian amphibian Geotrypetes seraphini seraphini (Gymnophiona: Dermophiidae) including an updated overview of sexual dimorphism in caecilian amphibians
Authors: Maerker Markus , Reinhard Sandy , Pogoda Peter , Kupfer Alexander
Published: September 2016

Sexual size dimorphism (SSD) describing intersexual size differences of a given taxon is a widespread phenomenon in the animal kingdom. SSD plays a significant role in understanding life history and mating system evolution. The snakelike morphology of limbless caecilian amphibians lacking obvious secondary sexual characters (in contrast to frogs and salamanders) impedes an accurate comparison between sexes.

Here, the phylogenetically derived teresomatan and viviparous caecilianGeotrypetes seraphini seraphiniwas analysed for patterns of sexual dimorphism. In terms of body size females were the larger sex, but when body length was adjusted male-biased intersexual differences in cloacal shape appeared. The larger female size is likely explained by fecundity selection as clutch size was positively correlated to female body length. Unexpectedly a cryptic, ontogeny related variation of the nuchal collars was found. An overview of SSD in caecilians including data for 27 species of nine out of ten existing families revealed a quite high number of taxa showing sexually dimorphic head size dimensions exclusively present among phylogenetically derived teresomatan caecilians. Still further research including insights into the behavioural ecology and molecular ecology of mating systems is warranted to better understand the evolution of sexual size dimorphism of caecilian amphibians.
Assortative mating and divergent male courtship behaviours between two cryptic species of nine-spined sticklebacks (genus Pungitius)
Authors: Meguro Yu-ichiro , Takahashi Hiroshi , Machida Yoshiyasu , Shirakawa Hokuto , Gaither Michelle R. , Goto Akira
Published: September 2016

Assortative mating based on ecologically divergent traits is a major driver of speciation among three-spined sticklebacks, however, little is known about reproductive isolation and variations in courtship behaviour among nine-spined sticklebacks. Here we demonstrate assortative mating and divergent courtship behaviours between two cryptic species of nine-spined sticklebacks using no-choice mate trials and kinematic analyses. Strong assortative mating was demonstrated in our tank experiments, highlighting the importance of prezygotic reproductive isolation in these species. Kinematic analyses showed that the freshwater type exhibited aggressive courtship behaviour with frequent ‘Attacking’ and spent more time exhibiting displacement activities. In contrast, the brackish-water type demonstrated a higher frequency of the ‘Zigzag-dance’ and ‘Nest-showing’. Our study highlights the value of nine-spined sticklebacks as a comparative system for the study of speciation and paves the way for future studies on the role of courtship behaviours and assortative mating in the evolution of sticklebacks.
Human Rights? No Thanks We’re English!
Authors: Husa Jaakko
Published: September 2016

Twenty years ago a still ongoing scholarly debate started over the future direction of law in Europe. The lines of battle were drawn between the convergence and non-convergence theories. This paper re-examines and discusses the non-convergence theory and its take on English common law’s legal cultural key elements in the light of the human rights debate. The aim is to highlight human rights tensions within uk public law by applying a culturally oriented comparative law approach. The focus of the analysis is on the Human Rights Act and the way in which it has been adapted to the legal system. It is argued that the legal cultural perspective provides beneficial aspects for understanding the Human Rights Act centred debate without reducing it exclusively to politics. At least partially this debate is catalysed by continental civil law type features that the Human Rights Act transferred into common law.
A new species of Bertolonia (Melastomataceae) from the Southeastern Brazilian Atlantic Forest
Authors: SILVA-GONÇALVES KELLY CRISTINA DA , BAUMGRATZ JOSÉ FERNANDO A. , NUNES-FREITAS ANDRÉ FELIPPE
Published: September 2016

A new species of Bertolonia (Melastomataceae; Bertolonieae) endemic to the Brazilian Atlantic Forest is described and illustrated. Bertolonia organensis is known from only one locality in the Serra dos Órgãos National Park, state of Rio de Janeiro. The main diagnostic characteristics that distinguish B. organensis are the leaves with bullate adaxial surface and foveolate abaxial surface, cordate base and seven acrodromous veins, petiole and hypanthium glandulose-punctate, setulose and setulose-glandulose, the external calyx lobes erect, thick, narrow-triangular, apex acuminate-glandulose, margin entire, not ciliate, and the anthers connective dorsally appendaged, trilobed or with an acute calcar. Comparisons with similar species, geographic distribution and habitat are presented for the new species, as well as a key to identify all Bertolonia taxa known from the state of Rio de Janeiro. Bertolonia organensis is classified as Critically Endangered (CR).
A new species of Lepidaploa (Asteraceae: Vernonieae) from Minas Gerais State, Brazil
Authors: MARQUES DANILO , DEMATTEIS MASSIMILIANO
Published: September 2016

Lepidaploa scintillans is described as a new species from the Minas Gerais State in southeastern Brazil. This new species can be easily distinguished from other Lepidaploa species by the sericeous, nacreous-argent indumentum of both leaf surfaces and by the subpaleaceous outer pappus, which are unusual features in this genus.
Neotypification of the Linnaean name Iris aphylla (Iridaceae)
Authors: BOLTENKOV EUGENY V.
Published: September 2016

Iris aphylla Linnaeus (1753: 38) (Iridaceae) is a highly variable species from the morphological point of view, especially in the height of stem, stem branching, size of leaves, and color of flowers. Moreover, it can be found in different habitats. In the Middle-Russian Upland, this plant is mostly associated with meadow steppes on slopes and, rarely, with edges of shrub thickets; also occurs along forest edges and in open forests, where blooming plants are rare (Kazakova et al. 2015). It is native to Central, Eastern, and some parts of Western Europe. The species is widespread in the Ukraine and mainly in the south of middle European Russia, while in the European countries its populations are sparser. Iris aphylla is of autotetraploid origin (Mitra 1956); plants with the chromosome number 2n = 48 are found more frequently in Europe (Wróblewska et al. 2010). Its numerous synonyms, including four subspecies, indicate the variability of this species. The genetic data confirm the conclusion that the subspecies of I. aphylla should be regarded as a single species (Wróblewska et al. 2010). According to my best knowledge (see also Jarvis 2007) the name I. aphylla is still lacking typification.
Impatiens nicolsoniana, a new name for Impatiens mannii C.B. Clarke ex Hook.f. (Balsaminaceae)
Authors: GOGOI RAJIB , ARISDASON WILSON
Published: September 2016

The genus Impatiens Linnaeus (1753: 937), represented by over 1000 species in the world, is considered to be one of the most species-rich genera of angiosperms (Yu et al. 2015). The genus is distributed chiefly in the tropical and subtropical regions of the Old World, and extending into temperate Asia, Europe and North America (Grey-Wilson 1980, Fischer 2004).
Two new species of Mexican Rhinotragini and transference of Odontocera josemartii Zayas, 1956 to Stenopseustes (Coleoptera, Cerambycidae)
Authors: SANTOS-SILVA ANTONIO , BEZARK LARRY G.
Published: September 2016

Two new species of Rhinotragini are described from Mexico: Odontocera argenteolineata; and Stenopseustes transversus. Odontocera josemartii Zayas, 1956 is transferred to Stenopseustes Bates, 1873.
Global Precipitation Measurement Mission Products and Services at the NASA GES DISC
Authors: Liu Z. , Ostrenga D. , Vollmer B. , Deshong B. , Macritchie K. , Greene M. , Kempler S.
Published: September 2016

This article describes NASA/JAXA Global Precipitation Measurement (GPM) mission products and services at the NASA Goddard Earth Sciences (GES) Data and Information Services Center (DISC). Built on the success of the Tropical Rainfall Measuring Mission (TRMM), the next-generation GPM mission consists of new precipitation measurement instruments and a constellation of international research and operational satellites to provide improved measurements of precipitation globally. To facilitate data access, research, applications, and scientific discovery, the GES DISC has developed a variety of data services for GPM. This article is intended to guide users in choosing GPM datasets and services at the GES DISC.
Sampling Issues in Estimating Radar Variables from Disdrometer Data
Authors: Smith Paul L.
Published: September 2016

Simulation of sampling from gamma-distributed raindrop populations demonstrates that significant biases and substantial errors can occur in estimates of polarimetric radar variables based on samples of raindrop populations obtained with disdrometers. Biases and RMS errors of 0.5 dB or more in estimates of differential reflectivity Zdr can occur with samples of even a few hundred drops; significant biases and errors also occur in estimates of reflectivity ZH or specific differential phase Kdp. The results indicate that very large samples would be required to obtain adequate representation of the population characteristics for many radar applications. They also suggest that greater attention is needed to the sample sizes in the disdrometer data used in developing polarimetric rainfall-rate estimators or hydrometeor classification algorithms.
Chronic Periodontitis Genome-wide Association Study in the Hispanic Community Health Study / Study of Latinos
Authors: Sanders A.E. , Sofer T. , Wong Q. , Kerr K.F. , Agler C. , Shaffer J.R. , Beck J.D. , Offenbacher S. , Salazar C.R. , North K.E. , Marazita M.L. , Laurie C.C. , Singer R.H. , Cai J. , Finlayson T.L. , Divaris K.
Published: September 2016

Chronic periodontitis (CP) has a genetic component, particularly its severe forms. Evidence from genome-wide association studies (GWASs) has highlighted several potential novel loci. Here, the authors report the first GWAS of CP among a large community-based sample of Hispanics/Latinos. The authors interrogated a quantitative trait of CP (mean interproximal clinical attachment level determined by full-mouth periodontal examinations) among 10,935 adult participants (mean age: 45 y, range: 18 to 76 y) from the Hispanic Community Health Study / Study of Latinos. Genotyping was done with a custom Illumina Omni2.5M array, and imputation to approximately 20 million single-nucleotide polymorphisms was based on the 1000 Genomes Project phase 1 reference panel. Analyses were based on linear mixed models adjusting for sex, age, study design features, ancestry, and kinship and employed a conventional P < 5 × 10−8 statistical significance threshold. The authors identified a genome-wide significant association signal in the 1q42.2 locus ( TSNAX-DISC1 noncoding RNA, lead single-nucleotide polymorphism: rs149133391, minor allele [C] frequency = 0.01, P = 7.9 × 10−9) and 4 more loci with suggestive evidence of association ( P < 5 × 10−6): 1q22 (rs13373934), 5p15.33 (rs186066047), 6p22.3 (rs10456847), and 11p15.1 (rs75715012). We tested these loci for replication in independent samples of European-American ( n = 4,402) and African-American ( n = 908) participants of the Atherosclerosis Risk in Communities study. There was no replication among the European Americans; however, the TSNAX-DISC1 locus replicated in the African-American sample (rs149133391, minor allele frequency = 0.02, P = 9.1 × 10−3), while the 1q22 locus was directionally concordant and nominally significant (rs13373934, P = 4.0 × 10−2). This discovery GWAS of interproximal clinical attachment level—a measure of lifetime periodontal tissue destruction—was conducted in a large, community-based sample of Hispanic/Latinos. It identified a genome-wide significant locus that was independently replicated in an African-American population. Identifying this genetic marker offers direction for interrogation in subsequent genomic and experimental studies of CP.
“Present Through It All”: A Qualitative Exploration of Psychotherapy and Psychosis
Authors: Adame Alexandra L.
Published: September 2016

This article provides an overview of a qualitative study that focused on psychotherapists’ experiences of working with people struggling with psychosis. I interviewed four therapists in private practice about their experiences working with this population and describe many aspects of their work including how they understood the nature of psychosis, how they envision process of psychotherapy, and challenges they have faced. I used interpretive phenomenological analysis to analyze the therapists’ interviews. The findings of this project highlight the necessity of a supportive therapy relationship and the therapists’ genuine interest and respect for their clients.
Place attachment as a motivation for community preservation: The demise of an old, bustling, Dubai community
Authors: Alawadi Khaled
Published: September 2016

This paper describes how Dubai’s top-down redevelopment strategy affected residents of Sha’biyat Al Defaa’ and Sha’biyat Al Shorta, or Army and Police Colony, a densely aging Dubai neighbourhood. The article draws on an original ethnographic case study, including field observation, interviews with residents and local press reports. Findings show that redevelopment demolished this old neighbourhood to appeal to economic elites without making any effort to preserve any of its social, economic or emotional value to residents or the larger community. In doing so, Dubai sacrificed the wellbeing of a vulnerable population. I draw on the concept of place attachment to interpret this case’s significance for planning and preservation theory and practice. Place attachment conceptualises affective ties to both physical settings and the relationships and memories that such settings support. This study gives planners, policy makers and preservationists new evidence that attachment to land and community are important motivations for expanding historic preservation into concerns for community preservation. Conventionally, historic preservation concerns itself primarily with built landscapes; this paper argues that individuals’ feelings and bonds to social settings can be used as engines for preservation. The paper concludes that Dubai’s top-down planning model does not sensitively capture the needs of low-income communities. It argues that in advocating preservation and mitigating displacement impacts, city planners must pressure the state and developers for more affordable housing policies and projects, and must establish service programmes that provide technical and economic assistance to city residents who face eviction.
Mentoring Relationship Quality Profiles and Their Association With Urban, Low-Income Youth’s Academic Outcomes
Authors: Liao C. Lynn , Sánchez Bernadette
Published: September 2016

This study aimed to (a) identify mentoring quality profiles based on characteristics of informal mentoring relationships, (b) examine how mentor and youth demographic characteristics were related to the profiles, and (c) investigate whether the profiles were related to youth’s academic outcomes. Participants were 411 ninth-grade urban, low-income students. Mentors were comprised of older siblings, extended family members, and non-familial adults. Using cluster analysis, we identified two mentoring quality relationship profiles: (a) less close and growth oriented and (b) closer and more growth oriented. Boys were more likely to have less close and growth-oriented relationship profiles or to be in the non-mentored group compared with girls. Univariate tests showed differences among relationship profile groups and non-mentored groups on intrinsic motivation, educational aspirations and expectations, perceived economic benefits, and limitations of education and grade point average (GPA). The study reveals the importance of taking a within-group, person-centered approach when examining mentoring relationships.
Decreases in the proportion of bullying victims in the classroom
Authors: Garandeau Claire F. , Lee Ihno A. , Salmivalli Christina
Published: September 2016

Sharing a classroom environment with other victimized peers has been shown to mitigate the adverse effects of peer victimization on children’s social and psychological adjustment. By extension, this study hypothesized that classroom reductions in the proportion of victims would be harmful for children who remain victimized. Data were collected at the end of 2 subsequent school years from 4,466 fourth- to sixth-graders (mean age = 11 years), as part of the implementation of the Finnish anti-bullying program KiVa (an acronym for Kiusaamista Vastaan, “against bullying”). Multiple regression analyses were conducted on a subsample of 170 stable victims (children reporting being victimized at least 2–3 times a month at both time points) to test whether a decrease in the proportion of victims in their classrooms had an effect on their adjustment at Time 2. Stable victims felt more depressed, more socially anxious and were less liked at Time 2 in classrooms where the proportion of victims had decreased in 1 year compared to stable victims in classrooms where it had increased or remained the same. These effects were not moderated by the intervention status of the classroom. Paradoxically, an improved social environment can be detrimental for some children. These findings point to the necessity to maintain anti-bullying intervention efforts especially when successful.
Primary Caregiver Perception of Pain Control following Pediatric Adenotonsillectomy
Authors: Sowder Justin C. , Gale Craig M. , Henrichsen Jacob L. , Veale Kristy , Liljestrand Katie B. , Ostlund Barbara C. , Sherwood Aaron , Smith Austin , Olsen Griffin H. , Ott Mark , Meier Jeremy D.
Published: September 2016

Objectives

To (1) review pain medications prescribed following pediatric adenotonsillectomy (T&A), (2) identify pain medications reported to be helpful, and (3) compare parent‐reported outcomes among various combinations of pain medications.

Study Design

Case series with planned data collection.

Setting

Multihospital network.

Subjects and Methods

The primary caregivers of children aged 1 to 18 years who underwent isolated T&A from June to December 2014 were contacted 14 to 21 days after surgery. Data collected included pain medications prescribed, medications most helpful in controlling pain, and duration that pain medication was required. Parents rated their children’s pain on postoperative days 2, 3, 7, and 14 and reported the time to resumption of normal diet/activity, as well as any hospital return visits.

Results

The study cohort included 672 subjects of 1444 potential participants (46% response rate). The mean age of the patients was 7.9 ± 3.6 years. Narcotics were prescribed in 71.9%, and 70.4% were told to use ibuprofen. Children who took ibuprofen alone were significantly younger (P <. 001). Pain was significantly less on postoperative days 2 and 3 in the ibuprofen‐only group as compared with the groups taking narcotics only (P <. 001) and ibuprofen with narcotics (P =. 002). Those taking ibuprofen alone returned to normal activity (P <. 001) and diet (P =. 026) sooner than those taking ibuprofen with narcotics. No difference was seen in pain control on subgroup analysis comparing oxycodone and hydrocodone.

Conclusions

For pediatric T&A, significant variation exists in the management of postoperative pain. Parents of children given ibuprofen reported less pain than those given narcotics with and without ibuprofen. Further studies are needed to identify the optimal pain regimen for children after T&A.
Perioperative Deep Vein Thrombosis Risk Stratification: A Comparative Analysis of Free and Pedicled Flap Patients
Authors: Sinha Sumi , Puram Sidharth V. , Sethi Rosh K. V. , Goyal Neerav , Emerick Kevin S. , Lin Derrick , Durand Marlene L. , Deschler Daniel G.
Published: September 2016

Patients with head and neck cancer who undergo reconstructive surgery are at risk for deep venous thrombosis (DVT), but the risk profile for patients undergoing major flap reconstruction is highly variable. Herein, we report our findings from a retrospective analysis of head and neck cancer patients (n = 517) who underwent free (n = 384) or pedicled (n = 133) flap reconstructive operations at a major tertiary care center from 2011 to 2014. DVTs developed perioperatively in 9 (1.7%) patients. Compared with pedicled flap patients, free flap patients had a longer mean operative time (421.4 ± 4.4 vs 332.7 ± 10.7 min, P <. 0001), but the DVT incidence did not differ significantly between free and pedicled flap patients (1.6% vs 2.2%, respectively, P =. 28). These data suggest that perioperative DVT risk in head and neck oncology patients may be largely similar regardless of the reconstructive strategy pursued.
A new method to measure oxygenator oxygen transfer performance during cardiopulmonary bypass: clinical testing using the Medtronic Fusion oxygenator
Authors: Hamilton Carole , Marin Denise , Weinbrenner Frank , Engelhardt Branka , Rosenzweig Dow , Beck Ulrich , Borisov Pavel , Hohe Stephen
Published: September 2016

Background:

There is no acceptable method of testing oxygen transfer performance in membrane oxygenators quickly and easily during cardiopulmonary bypass. Pre-clinical testing of oxygenators is performed under controlled situations in the laboratory, correlating oxygen transfer to blood flow using 100% oxygen. This laboratory method cannot be used clinically as oxygen transfer values vary significantly at each blood flow and the FiO2 is not kept at 1. Therefore, a formula was developed which corrects the existing FiO2 to attain a PaO2 of 150 mmHg: the corrected FiO2 at 150 mmHg. In graph form, this corrected FiO2 (x-axis) is correlated to the patient’s oxygen consumption levels (y-axis), which determines the membrane oxygenator oxygen transfer performance.

Methods:

Blood gas and hemodynamic parameters taken during cardiopulmonary bypass using the Medtronic Fusion were used to calculate the oxygen consumption (inlet conditions to the oxygenator) and the corrected FiO2 for a PaO2 of 150 mmHg. Validation of the formula “FiO2-PaO2/(Pb−pH2O)+0.21” was carried out by plotting the calculated values on a graph using PaO2 values between 145 to 155 mmHg and then, using the corrected FiO2 for PaO2s outside of this range.

Results:

All trend-lines correlated significantly to confirm that the Medtronic Fusion had an extrapolated oxygen transfer of 419 milliliters O2/min at an FiO2 of 1 to achieve a PaO2 of 150 mmHg.

Conclusions:

Use of the corrected FiO2 correlated to the oxygen transfer conditions of the membrane oxygenator can easily be used on a routine basis, providing valuable information clinically. When used by the manufacturer under laboratory conditions, further clinically relevant data is provided in terms of FiO2 and resultant PaO2s instead of the present limitations using blood flow. In this way, a clinically justifiable method has been developed to finally establish a standard in testing membrane oxygenator performance.
Computational fluid dynamics simulation and full-scale experimental model inter-comparison of the wind flow around a university campus
Authors: Dhunny AZ , Toja-Silva F , Peralta C , Lollchund MR , Rughooputh SDDV
Published: September 2016

In this article, results obtained from two computational fluid dynamics solvers, WindSim and OpenFOAM, have been compared for the wind flow around the University of Mauritius’ campus for different wind directions, and a reference incident wind speed at diverse height above ground level. A grid resolution study is performed for both software and the mean differences of the two solvers with multiple turbulence models (standard k-ε, k-ε with Yap correction, and renormalization group k-ε) are analyzed with onsite measured data. The article concludes that the best results for the computational fluid dynamics simulation of the wind flow around buildings are obtained using OpenFOAM with k-ε turbulence model including Yap correction.
Relationship Between Handgrip Strength and Length of Stay for Left Ventricular Assist Device Implantation
Authors: Yost Gardner , Bhat Geetha
Published: September 2016

Background: Advanced heart failure is associated with a wide range of physiological derangements, including muscular deterioration, weight loss, and cardiac cachexia. These conditions, as well as poor nutrition status, have been shown to affect the quality of outcomes in patients who undergo left ventricular assist device (LVAD) implantation. Noting that handgrip strength has been shown to be an effective indicator of poor functional status, muscular strength, and nutrition, we investigated its use as a tool for prediction of length of stay (LOS) in patients undergoing LVAD implantation. Materials and Methods: Handgrip strength was measured in 90 patients undergoing evaluation for LVAD implantation using the Jamar Hand Dynamometer. Handgrip strength was normalized to body weight (HGS:BW), and patients were divided into 2 groups: those with HGS:BW <28.5% and those with HGS:BW ≥28.5%. Clinical data and length of stay were compared between groups. Results: Patients with lower HGS:BW tended to have worsened clinical indicators of heart failure severity, including reduced ejection fraction, serum albumin, and hemoglobin and increased B‐type natriuretic peptide and white blood cell count. Lower HGS:BW was an independent predictor for increased LOS. Conclusion: Handgrip strength measurement at the bedside is a simple and effective means of assessing functional status and risk for increased LOS following LVAD implantation, which may aid in preoperative evaluation of LVAD candidacy.
Clot Extraction With the FlowTriever Device in Acute Massive Pulmonary Embolism
Authors: Weinberg Aaron Samuel , Dohad Suhail , Ramzy Danny , Madyoon Hooman , Tapson Victor F.
Published: September 2016

Clinical guidelines support the use of systemic thrombolytic therapy for acute massive pulmonary embolism (PE). When anticoagulation and thrombolysis fail or are contraindicated, options become limited. We report an acute PE case in which treatment options were limited, and a novel device, the FlowTriever (Inari Medical, Irvine, California), was successfully used. This is the first case report of the use of this device that we are aware of.
Navigating Return to Work and Breastfeeding in a Hospital with a Comprehensive Employee Lactation Program
Authors: Froh Elizabeth B. , Spatz Diane L.
Published: September 2016

Background:

The Surgeon General’s Call to Action to Support Breastfeeding details the need for comprehensive employer lactation support programs. Our institution has an extensive employee lactation program, and our breastfeeding initiation and continuation rates are statistically significantly higher than state and national data, with more than 20% of our employees breastfeeding for more than 1 year.

Objective:

The objective of this research was complete secondary data analysis of qualitative data collected as part of a larger study on breastfeeding outcomes. In the larger study, 545 women who returned to work full or part time completed an online survey with the ability to provide free text qualitative data and feedback regarding their experiences with breastfeeding after return to work.

Methods:

Qualitative data were pulled from the online survey platform. The responses to these questions were analyzed using conventional content analysis by the research team (2 PhD-prepared nurse researchers trained and experienced in qualitative methodologies and 1 research assistant) in order to complete a thematic analysis of the survey data.

Results:

Analysis of the data yielded 5 major themes: (1) positive reflections, (2) nonsupportive environment/work culture, (3) supportive environment/work culture, (4) accessibility of resources, and (5) internal barriers. The themes that emerged from this research clearly indicate that even in a hospital with an extensive employee lactation program, women have varied experiences—some more positive than others.

Conclusion:

Returning to work while breastfeeding requires time and commitment of the mother, and a supportive employee lactation program may ease that transition of return to work.
Simulating Peace Negotiations
Authors: Kempin Reuter Tina
Published: September 2016

Background. This article reflects on the use of a simulation of peace talks between Israeli and Palestinians in an upper-level undergraduate course at a liberal arts university in the United States. The university was commissioned to test an externally developed proposal and implementation plan for peace negotiations between Israeli and Palestinians (the “IMPLEMENTATION PLAN”).

Aim. (1) To contribute to student’s academic learning and understanding of the conflict; (2) to find strengths and weaknesses of the model.

Method. Analysis of data collected using a convergent parallel mixed method approach involving surveys, exit interviews, and guided reflection papers.

Results.

Student Learning Outcomes. The data supports a deeper understanding of the nature of the conflict as well as the complexity of peace negotiations. Students reported a higher level of engagement with the subject matter as a result of the simulation. The model encouraged innovative thinking and new solutions, which might be of interest in real life application. Challenges to student learning were mainly related to (1) student identification with their roles and (2) a need to compromise and finding quick answers.

Model. The simulation demonstrated the strengths of the IMPLEMENTATION PLAN, namely to the focused, structured negotiation process with narrowly defined “tracks.” Challenges include the structure of the simulation, the question of applicability of the model to a real life situation, as well as the long-term implementation strategy of negotiation outcomes.

Conclusion. The simulation of the IMPLEMENTATION PLAN greatly benefited student learning and led to thought-provoking outcomes concerning negotiations. However, the findings suggest the need for flexibility and modification of the model.
Advance Care Planning: Understanding Clinical Routines and Experiences of Interprofessional Team Members in Diverse Health Care Settings
Authors: Arnett Kelly , Sudore Rebecca L. , Nowels David , Feng Cindy X. , Levy Cari R. , Lum Hillary D.
Published: September 2016

Background:

Interprofessional health care team members consider advance care planning (ACP) to be important, yet gaps remain in systematic clinical routines to support ACP. A clearer understanding of the interprofessional team members’ perspectives on ACP clinical routines in diverse settings is needed.

Methods:

One hundred eighteen health care team members from community-based clinics, long-term care facilities, academic clinics, federally qualified health centers, and hospitals participated in a 35-question, cross-sectional online survey to assess clinical routines, workflow processes, and policies relating to ACP.

Results:

Respondents were 53% physicians, 18% advanced practice nurses, 11% nurses, and 18% other interprofessional team members including administrators, chaplains, social workers, and others. Regarding clinical routines, respondents reported that several interprofessional team members play a role in facilitating ACP (ie, physician, social worker, nurse, others). Most (62%) settings did not have, or did not know of, policies related to ACP documentation. Only 14% of settings had a patient education program. Two-thirds of the respondents said that addressing ACP is a high priority and 85% felt that nonphysicians could have ACP conversations with appropriate training. The clinical resources needed to improve clinical routines included training for providers and staff, dedicated staff to facilitate ACP, and availability of patient/family educational materials.

Conclusion:

Although interprofessional health care team members consider ACP a priority and several team members may be involved, clinical settings lack systematic clinical routines to support ACP. Patient educational materials, interprofessional team training, and policies to support ACP clinical workflows that do not rely solely on physicians could improve ACP across diverse clinical settings.
A Comparison of Psychiatric and Nonpsychiatric Nurse Practitioner Knowledge and Management Recommendations Regarding Adolescent Mild Traumatic Brain Injury
Authors: Klein Tracy A. , Graves Janessa M.
Published: September 2016

BACKGROUND: Nurse practitioners (NPs) are statutorily authorized to provide assessment and cognitive recommendations for concussion in most states. Their scope of practice includes assessment and management of concussion sequalae including anxiety, insomnia, and depression, as well as return to school and activity guidance. OBJECTIVES: Analysis of symptom-based diagnosis of mild traumatic brain injury (TBI) in adolescents, including return to school and school workload recommendations comparing psychiatric and nonpsychiatric NPs. DESIGN: Cross-sectional Web-based survey with embedded videos using standardized actors and scripts randomized for patient sex and sport. A total of 4,849 NPs licensed in Oregon or Washington were invited by e-mail to view and respond to this study, with a response rate of 23%. RESULTS: Psychiatric mental health nurse practitioners (PMHNPs) were 44% less likely than family NPs to report using standardized concussion tools. 17% had completed continuing education on mild TBI compared to 54.5% of family NPs. Seven PMHNPs provided additional feedback related to discomfort in completing the survey due to lack of comfort or experience. Return to school recommendations and reduced workload advice did not significantly differ by NP type. CONCLUSION: PMHNPs may support individualized assessment through concussion evaluation, use of standardized tools, and differential consideration of TBI for mental health symptoms. More research is required related to the role and contribution of cognitive rest to full recovery.