bluuebunny/crossref_metadata_2025 huggingface dataset:
New species of Achirus (Pleuronectiformes: Achiridae) from Northeastern Brazil
Authors: RAMOS ROBSON T. C. , RAMOS TELTON P. A. , LOPES PAULO R. D.
Published: July 2019

Eight species are considered valid in the genus Achirus (Lacépède), distributed on both sides of the Americas, mainly in marine and estuarine waters with A. novoae being the only species of this genus restricted to freshwaters of the Orinoco basin and its delta. A new species, A. mucuri, is described from the estuary of the Mucuri River, a small system in Bahia state, northeastern Brazil. A. mucuri differs from congeners, except A. novoae, in having a connection between the branchiostegal membrane and the isthmus. A. mucuri differs from A. novoae in its labial fimbriae and latero-sensory cephalic canal pattern.
Speechmaking and the Selectorate: Persuasion in Nonpreferential Electoral Systems
Authors: Fernandes Jorge M. , Won Miguel , Martins Bruno
Published: July 2019

This article examines the extent to which legislators use legislative debates to engage in localism activities to cater to the interests of their selectorate in nonpreferential electoral systems. We define localism activities as the delivery of tangible and intangible benefits to a geographically confined constituency that is instrumental to legislators’ re-selection. Our primary argument is that legislators whose selectorate operates at the local level make more speeches with parochial references. Results show strong support for this assertion. Furthermore, we find that high district magnitude leads to higher levels of localism. We use a mixed-methods research design, combining an original data set of 60,000 debates in Portugal with qualitative evidence from elite interviews. We make a methodological innovation in the field of representation and legislative studies by using a Named Entity Recognition tool to analyze the debates.
Effects of School Backpacks on Spine Biomechanics During Daily Activities: A Narrative Review of Literature
Authors: Suri Cazmon , Shojaei Iman , Bazrgari Babak
Published: July 2019

Objective

The purpose of this narrative review is to summarize the effects of carrying school backpacks on spine and low-back biomechanics as a risk factor for low back pain in young individuals.

Background

Backpacks constitute a considerable daily load for schoolchildren. Consistently, a large number of children attribute their low back pain experience to backpack use.

Method

A literature search was conducted using a combination of keywords related to the impact of carrying backpacks on lower back biomechanics. The references of each identified study were further investigated to identify additional studies.

Results

Twenty-two studies met inclusion criteria. A total of 1,159 people aged 7 to 27 years were included in the studies. The added load of a backpack and the changes in spinal posture when carrying a backpack impose considerable demand on internal tissues and likely result in considerable spinal loads. The findings included results related to the effects of backpack weight and position on trunk kinematics and spine posture as well as trunk muscle activity during upright standing, walking, and ascending and descending stairs.

Conclusion

Backpack-induced changes in trunk kinematics for a given activity reflect alterations in mechanical demand of the activity on the lower back that should be balanced internally by the active and passive responses of lower back tissues. Although the reported alterations in trunk muscle activities and lumbar posture are indications of changes in the active and passive response of the lower back tissues, the resultant effects on spinal load, that is, an important causal factor for low back pain, remains to be investigated in the future. A knowledge of backpack-induced changes in spinal loads can inform design of interventions aimed at reduction of spinal load via improved backpack design or limitation on carrying duration.

Application

This narrative review is intended to serve as an educational article for students and trainees in ergonomics and occupational biomechanics.
Measuring Job Creation, Growth, and Survival among the Universe of Start-ups in the United States Using a Combined Start-up Panel Data Set
Authors: Fairlie Robert W. , Miranda Javier , Zolas Nikolas
Published: July 2019

The field of entrepreneurship is growing rapidly and expanding into new areas. This article presents a new compilation of administrative panel data on the universe of business start-ups in the United States, which will be useful for future research in entrepreneurship. To create the US start-up panel data set, the authors link the universe of non-employer firms to the universe of employer firms in the Longitudinal Business Database (LBD). Start-up cohorts of more than five million new businesses per year, which create roughly three million jobs, can be tracked over time. To illustrate the potential of the new start-up panel data set for future research, the authors provide descriptive statistics for a few examples of research topics using a representative start-up cohort.
A Classification of Deafness Based on the Effect of Deafness on Efficiency in Life
Authors: Love J. Kerr
Published: July 2019

The deaf classified from the point of view of incapacity as a result of deafness: ( a) The true deaf-mute; developmental.—( b) The muted or semi-muted, totally deaf because of disease occurring shortly after birth.—( c) The speaking deaf, totally deaf from disease occurring after two years of age.—( d) Partially deaf, hard of hearing.

Hearing tests useless except in ( d).—Treatment useless except in ( d).

Syphilis: its association with congenital deafness; percentage due to this cause, in children.

Incapacity due to deafness.—Aids to hearing.—Prevention of deafness.
Qu’est-ce qu’un parti fondé sur une base religieuse ? Interprétations concurrentes d’une catégorie juridique dans le contexte politique égyptien
Authors: Steuer Clément
Published: July 2019

In Egypt, the ‘political parties with a religious basis’ are explicitly prohibited by law since 1977. However, this ban has had a negligible impact on political life, because administrative jurisprudence has since long diminished its scope, by reducing the question of the religious basis of a party to that of the confession of its members. Nevertheless, the secular opponents of the Islamists have repeatedly claimed, since the constitutionalization of this ban in January 2014, that it should be interpreted more strictly. This article first recalls how the Islamist and secular camps emerged during the political and constitutional struggles of the 2011–2013 era, before examining the competing interpretations of the notion of ‘religious party’, such as made by the administrative jurisprudence, by supporters of the ban on Islamist parties, and by the Islamists themselves.
Waste, dirt and desire: Fashioning narratives of material regeneration
Authors: Norris Lucy
Published: July 2019

The consumption of clothing fashioned from recycled textile fibre waste poses a challenge for buyers not simply due to fears of a loss of quality, but also to fears of ‘dirt’ and contagion. These concerns appear to reside in cast-off clothing’s intimate links with unknown bodies, and cultural perceptions of the recycling system’s ability to properly ‘clean’ these materials and transform them back again into textile fibres that can be worn again on the body. The fashion industry currently recycles less than 1% of its own cast-offs back into clothing, despite mainstream economists’ claims that keeping fibres in circulation for longer is not only environmentally sustainable but also economically advantageous: closed-loop business models secure resources in an increasingly competitive market still focused upon growth. Here it is argued that the drive towards a more circular fashion system in Europe brings competing frameworks of purity into the same field, where cultural values ascribed to clothing hygiene and cleanliness are confronted with the goals of sustainability and resource effectiveness. In their attempts to re-make post-consumer clothing fibres back into desirable fashion, manufacturers and retailers are trying to negotiate these complex value systems, with variable results. This article explores three, very different, contexts where manufacturers and retailers experiment with adding value to fashion made from mechanically-recycled wool: an ethical fashion trade fair in Berlin, textile specialists working with a British high street retailer, and a yarn wholesaler in Prato, Italy. The examples reveal the current precarity of the symbolic re-ordering of recycled textile materials as ‘clean and green’ rather than ‘old and dirty’, and how corporate actors struggle to re-shape their narratives of material sustainability at this increasingly visible frontier.
Join the queue: Including women’s toilet needs in public space
Authors: Greed Clara
Published: July 2019

The trend towards desegregated women’s and men’s toilets, including installing Gender Neutral Toilets (GNTs), and the implications of revisions to the Gender Recognition Act for women-only spaces, have brought into focus the pre-existing lack of female toilet provision in the UK. Looking at the problem from a town planning perspective, I argue that austerity-driven cuts are coming together with GNT provision to reshape the public toilet landscape in ways that continue to be detrimental to women. Typically women are only provided with half as many facilities as men, resulting in queues for the Ladies, and GNT provision based on relabelling rather than redesigned or additional provision can, in fact, increase competition for the cubicles in the Ladies. The historical, legislative and cultural reasons for this inequality are explored, along with the different types of public toilet and the different requirements of male and female users. The article draws on previous research project findings, many of which foreshadow the problems currently coming to the fore as a result of toilet desegregation. In conclusion, recommendations are made as to how to deal with the conundrum of providing adequate facilities for all women and men, whilst providing all sorts of individuals with choice and privacy to create inclusive, accessible cities for all.
Exploring the Influence of Racial-Ethnic and Gender Identity on the Prosocial Behaviors of African American Adolescent Males
Authors: Harris Johari , Kruger Ann C.
Published: July 2019

African American male students face a multitude of challenges that may lead to poor academic and social outcomes at school. There is extensive research on the predictors of their problems, but far less on the factors that can lead to positive outcomes. To address this gap, this exploratory study asked two main questions. Does racial-ethnic identity and gender identity predict adolescent African American males’ prosocial behaviors, and if so, is this done jointly or independently? Using regression analysis, this study found racial public regard, gender public regard, and gender private regard positively predicted participants’ prosocial behaviors. In addition, racial public regard moderated the positive relationship between racial centrality and prosocial behaviors as well as the positive relationship between racial private regard and prosocial behaviors. Findings suggest critical conversations concerning race should be included in social-emotional learning initiatives for these students.
When states and individuals meet: The UN Ombudsperson as a ‘contact point’ between international and world society
Authors: Giumelli Francesco , Costa Buranelli Filippo
Published: July 2019

Interaction between individuals and states is considered a distinctive character of domestic politics, while international politics is the ‘realm of states’. However, it is becoming more common to encounter loci where both states and individuals interact at the international level, such as in the cases of the Special Tribunals for Rwanda, Sierra Leone, Liberia and the Former Yugoslavia as well as the International Criminal Court (ICC). Within the International Relations (IR) theory panorama, one would expect the English School of International Relations (ES) to have the theoretical and analytical tools to conceptualize synergies between states and individuals, but this is not evident. This article asks, how does the interaction between individuals and states take place in the ES? We argue that this interaction takes place via ‘contact points’, defined as those international bodies that bring together states and non-state actors, be they individuals or groups, interacting on equal grounds in terms of rights and responsibilities towards each other. The notion of ‘contact point’ is developed inductively by focusing on the Office of the Ombudsperson to the Islamic State of Iraq and the Levant (ISIL; Da’esh) and Al-Qaida Sanctions Committee. This research has theoretical implications. We aim to refine, sharpen and advance both the ES’s theoretical and analytical architecture. The contribution we seek to make is one that will better equip ES scholars to conceptualize and analyse those secondary institutions that allow states and individuals to enjoy rights and duties equally. By so doing, we will make possible for the ES to provide a more fine-grained account for these synergies than other IR theories. The notion of ‘contact point’ does set a new agenda for the ES, since interactions between individuals and states are likely to become a constitutive essence of world politics.
Criminogenic Factors Associated with Noncompliance and Rearrest of Mental Health Court Participants
Authors: Honegger Laura N. , Honegger Kyle S.
Published: July 2019

There is a considerable overrepresentation of individuals with mental health issues within the U.S. criminal justice system as compared with the general population. Mental health courts (MHCs) arose in response to this concern, with a primary aim of reducing recidivism. Thus far, MHC research has largely neglected the potential utility of criminogenic factors. A retrospective analysis of 163 MHC participants was conducted to examine the association between clinical and criminogenic factors and noncompliance, as well as for recidivism, using a series of Bayesian negative binomial regression models to compare predictors. Criminogenic factors, namely first offending prior to the age of 18, having a substance-related diagnosis, commission of a variety of crimes, historical probation or parole violation, and having less than a high school education were associated with an increased rate of engaging in noncompliant behavior and rearrest. None of the clinical factors were directly associated with noncompliance or rearrest outcomes.
Balance in Family Triads: How Intergenerational Relationships Affect the Adult Sibling Relationship
Authors: de Bel Vera , Kalmijn Matthijs , van Duijn Marijtje A. J.
Published: July 2019

In order to understand the interdependency between intergenerational and adult sibling relationships, a family systems perspective is applied to identify a smaller—empirically analyzable—relational unit of analysis, that is, the sibling–parent–sibling triad. Using balance theory, triadic configurations are derived that represent enhancement, compensation, and loyalty conflicts. The hypotheses are tested for three relational dimensions: support exchange, contact, and conflict. Multilevel analyses of 549 sibling–parent–sibling triads from the Netherlands Kinship Panel data show strong evidence for enhancement, whereas some indication was obtained for sibling relationships being affected by loyalty conflicts. The results underscore and substantiate interdependency between intergenerational and adult sibling relationships.
Patterns of comorbidities in hospitalised cancer survivors for palliative care and associated in-hospital mortality risk: A latent class analysis of a statewide all-inclusive inpatient data
Authors: Luo Lan , Du Wei , Chong Shanley , Ji Huibo , Glasgow Nicholas
Published: July 2019

Background:

At the end of life, cancer survivors often experience exacerbations of complex comorbidities requiring acute hospital care. Few studies consider comorbidity patterns in cancer survivors receiving palliative care.

Aim:

To identify patterns of comorbidities in cancer patients receiving palliative care and factors associated with in-hospital mortality risk.

Design, Setting/Participants:

New South Wales Admitted Patient Data Collection data were used for this retrospective cohort study with 47,265 cancer patients receiving palliative care during the period financial year 2001–2013. A latent class analysis was used to identify complex comorbidity patterns. A regression mixture model was used to identify risk factors in relation to in-hospital mortality in different latent classes.

Results:

Five comorbidity patterns were identified: ‘multiple comorbidities and symptoms’ (comprising 9.1% of the study population), ‘more symptoms’ (27.1%), ‘few comorbidities’ (39.4%), ‘genitourinary and infection’ (8.7%), and ‘circulatory and endocrine’ (15.6%). In-hospital mortality was the highest for ‘few comorbidities’ group and the lowest for ‘more symptoms’ group. Severe comorbidities were associated with elevated mortality in patients from ‘multiple comorbidities and symptoms’, ‘more symptoms’, and ‘genitourinary and infection’ groups. Intensive care was associated with a 37% increased risk of in-hospital deaths in those presenting with more ‘multiple comorbidities and symptoms’, but with a 22% risk reduction in those presenting with ‘more symptoms’.

Conclusion:

Identification of comorbidity patterns and risk factors for in-hospital deaths in cancer patients provides an avenue to further develop appropriate palliative care strategies aimed at improving outcomes in cancer survivors.
Long-term impairment of neurovascular coupling following experimental subarachnoid hemorrhage
Authors: Balbi Matilde , Vega Max Jativa , Lourbopoulos Athanasios , Terpolilli Nicole A , Plesnila Nikolaus
Published: July 2019

CO2-reactivity and neurovascular coupling are sequentially lost within the first 24 h after subarachnoid hemorrhage (SAH). Whether and when these impairments recover is not known. Therefore, we investigated the reactivity of pial and intraparenchymal vessels by in vivo two-photon microscopy one month after experimental SAH.

C57BL/6 mice were subjected to either sham surgery or SAH by filament perforation. One month later, cerebral blood flow following CO2-challenge and forepaw stimulation was assessed by laser Doppler fluxmetry. Diameters of pial and intraparenchymal arterioles were quantified by in vivo two-photon microscopy.

One month after SAH, pial and parenchymal vessels dilated in response to CO2. Neurovascular coupling was almost completely absent after SAH: vessel diameter did not change upon forepaw stimulation compared to a 20% increase in sham-operated mice.

The current results demonstrate that neurovascular function differentially recovers after SAH: while CO2-reactivity normalizes within one month after SAH, neurovascular coupling is still absent. These findings show an acute and persistent loss of neurovascular coupling after SAH that may serve as a link between early brain injury and delayed cerebral ischemia, two distinct pathophysiological phenomena after SAH that were so far believed not to be directly related.
Introduction to the Special Issue—A Necessary Step in Pursuit of Equity: Developing a Racially/Ethnically Diverse Special Education Teaching Force
Authors: Trainor Audrey A. , Bettini Elizabeth , Scott LaRon A.
Published: July 2019

This special issue of Remedial and Special Education is a collection of theoretical and empirical research addressing equity in the preparation of a diverse special education teaching force, with a focus on racial/ethnic diversity. The purpose of this special issue is to open a conversation about equity as it pertains to special education teachers, including both students’ equitable access to special education teachers who share their racial/ethnic and/or cultural background and prospective special educators’ equitable access to the profession.
Roll-to-roll stack and lamination of gas diffusion layer in multilayer structured membrane electrode assembly
Authors: Chen Jiankui , Jiang Xi , Tang Wei , Ma Liang , Li Yiqun , Huang YongAn , Yin Zhouping
Published: July 2019

A membrane electrode assembly is the core component of a proton-exchange membrane fuel cell stack. It consists of multilayer structured membranes which are flexible, heterogeneous and have variable cross section. To improve the efficiency of membrane electrode assembly processing and manufacturing, a roll-to-roll system with gas diffusion layer is designed. By peeling the protective membrane and the upper and lower gas diffusion layers’ hot-pressing, proton-exchange membrane is manufactured into a five-layer catalyst-coated membrane. Then, the catalyst-coated membrane is manufactured into membrane electrode assembly by multilayer membrane breakpoint die-cutting and laying-off. The system integrates multiple key technologies, including roll-to-roll precise feeding, gas diffusion layer multi-degree accurate operation and multichannel temperature control, to realize the precise positioning of flexible multilayer membrane and brittle gas diffusion layer. The tension inhomogeneity and critical wrinkling tension are modeled for web traveling in the continuous roll-to-roll manufacturing equipment. The proposed roll-to-roll stack and lamination system effectively combines discontinuous hot-pressing, die-cutting, laying-off technics to realize the high-efficiency manufacturing of membrane electrode assembly.
Ethical challenges of obtaining informed consent from surgical patients
Authors: Moeini Sanaz , Shahriari Mohsen , Shamali Mahdi
Published: July 2019

Background:

Informed consent can be obtained by various methods, by various people, and with use of various types of consent forms. Persistent effort is necessary to reveal the practical realities of informed consent to improve ethical and legal standards.

Objective:

To determine the ethical challenges of obtaining informed consent from surgical patients.

Methods:

The present study was a descriptive cross-sectional study using two researcher-made questionnaires and a checklist for data collection. Data were collected from nursing personnel ( n = 95) and surgical patients ( n = 203) on the surgical wards of three university hospitals in Isfahan, Iran. Data were analyzed using descriptive statistics, Spearman’s rank correlation, Pearson’s correlation coefficient, and the t-test.

Ethical considerations:

The study was approved by the Ethics Committee of Isfahan University of Medical Sciences (No: 396478).

Results:

The mean scores (maximum 100) of awareness, competency, and authority were 36.3, 67.7, and 57.6, respectively. The overall quality of the informed consent was poor (score 53.9 of 100). The higher educational level in patients was correlated with lower awareness of and less authority to give informed consent. Only 12.6% of the nurses stated that patients were given sufficient information to assure informed consent. In 89.2% of the consent forms, the risks of the treatment were mentioned. However, alternative methods and risks and advantages of rejecting the treatment were not mentioned in any of the forms.

Conclusion:

Ethical challenges to obtaining informed consent include patients’ poor awareness of their rights, a failure to provide adequate information to patients, absence of consideration of patients’ educational level, an unclear definition of who is responsible for obtaining informed consent from the patients, time constraints, and use of unclear language and medical jargon. Constructing an ethical framework may guide nursing staff in dealing with the ethical challenges involved in obtaining informed consent.
‘Representing’ the voices of Fijian women rugby players: Working with power differentials in transformative research
Authors: Kanemasu Yoko , Molnar Gyozo
Published: July 2019

The politics of research practice has been discussed extensively in ethnographic and methodological literature, and increasingly in sport research literature. In this article we intend to contribute to the growing body of transformative research in the sociology of sport with reflections on our experience as dominant group researchers in a post-colonial, sub-cultural sporting environment; women’s rugby union in Fiji. We first examine the dilemmas and uncertainties engendered by our gendered/sexual positionalities and how we have sought to negotiate them. We also place our research in the context of Pacific islanders’ continuous effort for knowledge decolonisation and examine the ways in which our research replicates colonial silencing of local voices, however inadvertently. Finally, we explore the broader transformative potentials researchers may contribute to by situating their work as a collective and dialogic project within and beyond academic exercises, between researchers, athletes and others.
Retrospective evaluation of emergency department admissions in patients with ventricular assist device
Authors: Uz Ilhan , Özçete Enver , Öztürk Pelin
Published: July 2019

Background:

Ventricular assist devices, improve morbidity and survival in patients with end‐stage heart failure.

Objectives:

To evaluate the major causes of emergency department admissions in patients with ventricular assist device support.

Methods:

The charts of 200,000 adult patients who presented to our emergency department between January 2016 and January 2018 were reviewed retrospectively. A total of 444 emergency department visits made by 99 patients with ventricular assist device were included in the study.

Results:

The annual incidence of emergency department admissions of patients with ventricular assist device was 0.1%. The mean age was 55.5 ± 11.1 years and 85.9% of the study population were men. The most commonly encountered diagnoses were abnormal international normalized ratio or international normalized ratio follow‐up (18.2%); heart failure, non‐specific chest pain, and chronic obstructive pulmonary disease (15.3%); minor/major bleeding (12.1%); neurological disorders such as ischemic stroke, transient ischemic attack, vertigo, migraine, and syncope (11.2%); non‐device related infections (10.8%); ventricular tachycardia/fibrillation episode (8.5%); musculoskeletal disorders (7.2%); and device‐related complications such as driveline infection and pump thrombosis (6.3%). Of the patients with bleeding, 31.1% had intracranial bleeding, 31.1% had epistaxis, 24% had gastrointestinal bleeding, 11.1% had hematuria, and 1.8% had gingival hemorrhage. Of the 15 patients who died, 73.3% were diagnosed with intracranial hemorrhage.

Conclusion:

Even though the mortality rates of patients with ventricular assist device tends to decrease, these patients still have significant morbidity due to the increase in the prevalence of ventricular assist device use. Except for device‐related problems, emergency department management of this patient group does not differ much from other patient groups. As early diagnosis of any device‐related problems is mandatory for decreasing mortality, emergency department physicians should be familiar with mechanical support systems.
Design of a stiffness variable flexible coupling using magnetorheological elastomer for torsional vibration reduction
Authors: Lee Kang-Hyun , Park Jae-Eun , Kim Young-Keun
Published: July 2019

In this study, the design of an magnetorheological elastomer flexible coupling whose torsional stiffness can be controlled by an embedded magnetic field generator is proposed. It is designed to minimize the torsional vibration transmission between shafts adaptively to the dynamic disturbance. The coupling insert is composed of magnetorheological elastomer which is a smart material whose stiffness can be controlled by an external magnetic field. This article also proposes a compact magnetic field generator which can be fitted inside the coupling hubs, to control the torsional stiffness of the magnetorheological elastomer. The finite element method was used to design and estimate the dynamic stiffness variation of the magnetorheological elastomer coupling due to the applied magnetic field and disturbance frequency. Also, torsional vibration experiments were conducted to validate the performance of the proposed magnetorheological elastomer coupling. Results showed that it can adaptively tune in a range of frequencies between 16.8 and 23.5 Hz and has 95.7% stiffness variation under magnetic field of 150mT. The proposed system is expected to achieve a higher MRE effect with a softer base matrix.
The Effect of Patient-Specific Drug-Drug Interaction Alerting on the Frequency of Alerts: A Pilot Study
Authors: Horn John , Ueng Stephen
Published: July 2019

Background: False-positive drug-drug interaction alerts are frequent and result in alert fatigue that can result in prescribers bypassing important alerts. Development of a method to present patient-appropriate alerts is needed to help restore alert relevance. Objective: The purpose of this study was to assess the potential for patient-specific drug-drug interaction (DDI) alerts to reduce alert burden. Methods: This project was conducted at a tertiary care medical center. Seven of the most frequently encountered DDI alerts were chosen for developing patient-specific, algorithm-based DDI alerts. For each of the DDI pairs, 2 algorithms featuring different values for modifying factors were made. DDI alerts from the 7 drug pairs were collected over 30 days. Outcome measures included the number of DDI alerts generated before and after patient-specific algorithm application to the same patients over the same time period. Results: A total of 14 algorithms were generated, and each was evaluated by comparing the number of alerts generated by our existing, customized clinical decision support (CDS) software and the patient-specific algorithms. The CDS DDI alerting software generated an average of 185.3 alerts per drug pair over the 30-day study period. Patient-specific algorithms reduced the number of alerts resulting from the algorithms by 11.3% to 93.5%. Conclusion and Relevance: Patient-specific DDI alerting is an innovative and effective approach to reduce the number of DDI alerts, may potentially increase the appropriateness of alerts, and may decrease the potential for alert fatigue.
Public Health Data Collection and Implementation of the Revised Common Rule
Authors: Lee Lisa M.
Published: July 2019

For the first time, the revised Common Rule specifies that public health surveillance activities are not research. This article reviews the historical development of the public health surveillance exclusion and implications for other foundational public health practices.
Local All-Age Bicycle Helmet Ordinances in the United States: A Review and Analysis
Authors: Merrill-Francis Molly , Vernick Jon S. , Porter Keshia M. Pollack
Published: July 2019

Bicycle helmets protect against head injury. Mandatory helmet laws likely increase their use. Although 21 states and Washington, DC have mandatory helmet laws for youth (variously defined) bicyclists, no U.S. state has a mandatory helmet law that applies to all ages; however, some localities have all-age helmet laws for bicyclists. This study abstracted local helmet laws applicable to all-ages to examine their elements.
Joint Bleeding Tendencies in Adult Patients With Hemophilia: It’s Not All Pharmacokinetics
Authors: Zhou Jenny Y. , Barnes Richard F. W. , Foster Gary , Iorio Alfonso , Cramer Thomas J. , von Drygalski Annette
Published: July 2019

Hemophilic arthropathy from joint bleeding remains a complication with major morbidity in the increasingly aging patients with hemophilia. Prophylactic clotting factor infusions, based on pharmacokinetic dosing to reduce bleeding rates, are being explored more and more. However, there is little evidence on the benefits of pharmacokinetic dosing in direct association with bleeding events. Here, we prospectively followed a cohort of adult patients with hemophilia A and B (n = 26) and arthropathic joints on various clotting factor products over a period of 2 years with clinical and radiographic joint health assessments, frequent joint ultrasound, and pharmacokinetic studies. Joint bleeds and synovitis with synovial vascularity changes were objectively diagnosed by musculoskeletal ultrasound and power Doppler and analyzed in relation to pharmacokinetic, joint- and patient-specific parameters. Results revealed that, contrary to common beliefs, bleeding episodes were not readily explained by pharmacokinetic features, as they were not associated with more time spent below certain clotting factor thresholds. Joint bleeding was found to be associated with prominent vascularity changes, suggesting that vascular remodeling and leakiness may contribute to joint bleeding that cannot be prevented by clotting factor replacement alone.
Fostering Trauma Literacy: From the Classroom to the Newsroom
Authors: Seely Natalee
Published: July 2019

Covering traumatic story assignments is often central to a journalist’s job. Violent crimes, natural disasters, and tragic personal struggles—these are newsworthy events. Studies have associated trauma coverage with higher rates of posttraumatic stress disorder, burnout, and other traumatic stress symptoms in reporters. This study uses a survey of print journalists ( N = 254) and qualitative interview data to examine the extent that higher education journalism programs helped prepare reporters for covering trauma. Respondents who reported receiving some type of education about trauma journalism reported higher levels of trauma literacy, defined as an awareness of the potential effects of trauma and adaptive coping mechanisms. Results indicate the power of education to produce more prepared journalists. More than half (53%) of respondents reported never having received any type of education related to crisis reporting or covering trauma. A subset of respondents ( n = 24) from the sample were interviewed about the extent of their journalism education, their experiences covering traumatic assignments, and their feelings of preparedness on the job.
A New Game Plan for Concussion Education
Authors: Kroshus Emily , Chrisman Sara P. D.
Published: July 2019

Despite state laws requiring concussion education for youth sport stakeholders and a proliferation of educational programs, there has been little demonstrated impact on concussion reporting behaviors. We propose that this is because of four key limitations to existing approaches to concussion education: (1) deliberative decision making by the injured athlete is assumed, (2) interventions are often targeted at individuals rather than social systems, (3) education occurs once during preseason and is forgotten, and (4) dissemination challenges exacerbate health inequalities. Addressing these limitations, we propose a novel theoretic framework that situates individual behavior within a sport system’s culture and their broader structural context. Concussion education programs should seek to facilitate safety-supportive interpersonal communication within and between stakeholder groups and influence attributes of groups that drive behavior, including shared values. Addressing the limitations outlined and drawing on the proposed conceptual framework, we describe a novel approach to concussion education: pregame safety huddles.
Effects of Integrated Resort Experience on Customers’ Hedonic and Eudaimonic Well-Being
Authors: Ahn Jiseon , Back Ki-Joon , Boger Carl
Published: July 2019

This study examines the impact of integrated resort brand experiences (IRBEs) on customer well-being through the satisfaction of psychological needs. Partial least squares path modeling tests the hypotheses using a sample of 535 integrated resort customers. The results reveal that four dimensions of IRBE (i.e., sensory, affective, behavioral, and intellectual) have differing effects on needs satisfaction dimensions (i.e., autonomy, competence, and relatedness). Furthermore, the results show that autonomy and relatedness needs positively influence both hedonic and eudaimonic well-being. Thus, this study strongly demonstrates that specific brand experiences play an important role in the transformation of needs satisfaction into well-being. The current article appears to have a significant application of the concept of needs satisfaction on tourism brand marketing but it has not been tested empirically. Also, this article describes the significance of multidimensional IRBE to marketing strategy.
A Randomized, Double-Blind, Controlled Trial Evaluating the Efficacy of Nd:YAG 1064 nm Short-Pulse Laser Compared With Placebo in the Treatment of Toenail Onychomycosis
Authors: Sabbah Laura , Gagnon Carolanne , Bernier Fanny-Emmanuelle , Maari Catherine
Published: July 2019

Introduction:

Laser and light-based therapies have emerged as interesting treatment options with minimal side effects or contraindications to treat onychomycosis. Although increasing reports of successful treatment exist, few randomized, controlled, prospective studies have evaluated their true efficacy. We conducted a prospective, randomized, double-blind, controlled trial to evaluate the cure rate of onychomycosis treated by laser.

Methods:

Fifty-one patients were randomized to receive 3 treatments (0, 12, 24 weeks) of 1064 Nd:YAG short-pulse (Cutera GenesisPlus) laser or placebo sham laser. The primary efficacy end point is the proportion of patients with a complete cure rate of the target great toenail at week 52. The secondary efficacy end points, at week 52, were treatment success defined as almost clear nail (≤ 10%) and negative mycology, completely or almost clear nail of the great toenail, negative mycology, improvement from one OSI severity class to another of the target toenail, and the difference in proximal nail plate clearance between baseline and week 52.

Results:

No patient (0%) in the laser group and 2 patients (7.7%) in the placebo group reached the primary outcome. One patient (4.8%) in the laser group reached treatment success vs 2 (7.7%) in the placebo group. Only 6 patients (33%) had negative cultures in the laser group vs 11 (50%) in the placebo group. None of the secondary end points were met.

Conclusions:

This study demonstrated that 3 treatments of Nd:YAG 1064 nm laser at 3-month intervals were not effective to treat onychomycosis.
Stress management interventions for multiple sclerosis: A meta-analysis of randomized controlled trials
Authors: Taylor Paul , Dorstyn Diana S , Prior Elise
Published: July 2019

Stress management interventions can help to improve mental health for adults living with multiple sclerosis. However, uncontrolled study designs may overestimate intervention effects. A systematic search of the Embase, PsycINFO, PubMed, and Scopus databases identified eight randomized controlled trials evaluating cognitive behavioral approaches for a pooled sample of 568 adults with multiple sclerosis. Both group and individual-based stress management interventions appear to be effective in promoting self-management of stress. Further research is needed to confirm the optimal timing of stress management interventions across the MS spectrum and strategies to maintain intervention effects.
One-day workshops, a platform for continuous professional development of nursing staff in a neonatal intensive care unit
Authors: van Heerden Carlien , Maree Carin , Yazbek Mariatha , Janse van Rensburg Elsie S , Leech Ronell
Published: July 2019

The neonatal field is constantly changing with the development of new evidence-based practice and technology. The purpose of this paper is to report on a research project that aimed to create a platform for continuous professional development to improve evidence-based neonatal practice using action research. Using Problem Resolving Action Research, a process consisting of plan, act, observe and reflect was applied by a steering committee. A nominal group discussion technique determined training priorities of nursing staff in a neonatal intensive care unit and questionnaires obtained demographic data of participants and information pertaining to workshops and professional development over a period of two years. The findings indicate that one-day workshops serve as a valuable platform to contribute to professional development to improve quality care in neonatal practice.
In situ nanoindentation method for characterizing tensile properties of AISI 1045 steel based on mesomechanical analysis
Authors: Li Cong , Zhao Hongwei , Sun Linlin , Yu Xiujuan
Published: July 2019

A novel method for characterizing the tensile properties of AISI 1045 steel is proposed by combining the method of in situ nanoindentation test and the theory of mesomechanical analysis. First, the load–depth curves of exact location of ferrite, pearlite and grain boundary on the surface of AISI 1045 steel are obtained by 30 groups of in situ nanoindentation tests. The constitutive equation (stress–strain function) of the real-time metallographic structure is obtained by nanoindentation analysis of the above curves. Then, based on the principle of mesomechanical analysis, the computational representative volume element models are reconstructed according to the three metallographic images of AISI 1045 steel surface collected by the test equipment. Finally, taking the constitutive equation of the real-time metallographic structure as the input condition, the finite element analysis of the above representative volume element models are carried out. The data resulted from finite element analysis are taken as the tensile mechanical properties of AISI 1045 steel. The elastic modulus of AISI 1045 steel calculated is as the same as that by the traditional nanoindentation method. And, the error is less than 6% compared with the tensile test, which is within the range of the elastic modulus of the material. The error between the yield strength calculated and tensile test results is 3.4%. Due to the influence of surface cracks on the plastic deformation ability of AISI 1045 steel during tension, the error between the strain hardening index calculated and tensile test results is 7.4%. The results show that it is a more accurate nondestructive testing method in the point of material damage mechanism. On the premise of using more accurate representative volume element modelling way, this method is suitable for testing more materials.
Endovascular equipoise shift in a phase III randomized clinical trial of sonothrombolysis for acute ischemic stroke
Authors: Alexandrov Andrei V. , Tsivgoulis Georgios , Köhrmann Martin , Katsanos Aristeidis H. , Soinne Lauri , Barreto Andrew D. , Rothlisberger Travis , Sharma Vijay K. , Mikulik Robert , Muir Keith W. , Levi Christopher R. , Molina Carlos A. , Saqqur Maher , Mavridis Dimitris , Psaltopoulou Theodora , Vosko Milan R. , Fiebach Jochen B. , Mandava Pitchaiah , Kent Thomas A. , Alexandrov Anne W. , Schellinger Peter D. ,   for the CLOTBUST-ER Trial Investigators
Published: July 2019

Background:

Results of our recently published phase III randomized clinical trial of ultrasound-enhanced thrombolysis (sonothrombolysis) using an operator-independent, high frequency ultrasound device revealed heterogeneity of patient recruitment among centers.

Methods:

We performed a post hoc analysis after excluding subjects that were recruited at centers reporting a decline in the balance of randomization between sonothrombolysis and concurrent endovascular trials.

Results:

From a total of 676 participants randomized in the CLOTBUST-ER trial we identified 52 patients from 7 centers with perceived equipoise shift in favor of endovascular treatment. Post hoc sensitivity analysis in the intention-to-treat population adjusted for age, National Institutes of Health Scale score at baseline, time from stroke onset to tPA bolus and baseline serum glucose showed a significant (p < 0.01) interaction of perceived endovascular equipoise shift on the association between sonothrombolysis and 3 month functional outcome [adjusted common odds ratio (cOR) in centers with perceived endovascular equipoise shift: 0.22, 95% CI 0.06–0.75; p = 0.02; adjusted cOR for centers without endovascular equipoise shift: 1.20, 95% CI 0.89–1.62; p = 0.24)]. After excluding centers with perceived endovascular equipoise shift, patients randomized to sonothrombolysis had higher odds of 3 month functional independence (mRS scores 0–2) compared with patients treated with tPA only (adjusted OR: 1.53; 95% CI 1.01–2.31; p = 0.04).

Conclusion:

Our experience in CLOTBUST-ER indicates that increasing implementation of endovascular therapies across major academic stroke centers raises significant challenges for clinical trials aiming to test noninterventional or adjuvant reperfusion strategies.
The risk of liver cancer in autoimmune liver diseases
Authors: Lleo Ana , de Boer Ynto S. , Liberal Rodrigo , Colombo Massimo
Published: July 2019

Hepatocellular carcinoma (HCC), the dominant primary malignancy of the liver, has almost invariably a fatal outcome that can be averted only by early diagnosis and treatment. While the close association of HCC with chronic viral hepatitis and alcohol abuse has impacted favourably on screening and treatment of this deadly tumour, at the same time it has long obscured the etiologic role of autoimmune liver diseases. Recently, a systematic analysis of 25 published cohorts disclosed a 3.1 × 1000 patients/year incidence of HCC in autoimmune hepatitis patients that tripled in those with cirrhosis. HCC is also a sequela of primary biliary cholangitis, where the incidence is more relevant in males, those with advanced liver disease and nonresponders to ursodeoxycholic acid therapy. Cholangiocarcinoma (CCA), the second ranking primary cancer of the liver, is also on the rise with its intrahepatic pattern, in part reflecting an association with chronic liver diseases of diverse aetiology. In the USA and northern Europe, perihilar CCA is a frequent complication of primary sclerosing cholangitis, a cholestatic disorder thought to be immune mediated. International Guidelines clearly recommend HCC screening with abdominal ultrasonography every 6 months in autoimmune cirrhotic patients. While surveillance of patients with autoimmune liver disorders who are at risk of HCC affects both early diagnosis and radical therapy of this tumour, this is not the case for CCA, where early diagnosis is challenged by the lack of sensitive and accurate tests for screening.
Fidelity of Implementation for an Evidence-Based Enrichment Practice
Authors: Brigandi Carla B.
Published: July 2019

Children with gifts and talents benefit from participation in programs grounded in research-based models. Implementation fidelity, however, is a potential moderator of intended benefits. The purpose of this study was to examine one teacher’s fidelity of implementation for Type III Enrichment, an evidence-based gifted education practice and component of Renzulli’s Enrichment Triad Model and Renzulli and Reis’s Schoolwide Enrichment Model. Findings indicated the gifted education teacher implemented Type III Enrichment with fidelity; she adhered to recommended structures and processes, which she skillfully implemented, and student participants were responsive and engaged in the learning process. Audience impact was adversely affected by duration of the one-semester program. In addition, findings indicated the teacher supplemented recommended processes and these supplemental activities influenced student engagement in positive ways.