bluuebunny/crossref_metadata_2025 huggingface dataset:
Black Bodies on the Ground: Policing Disparities in the African American Community—An Analysis of Newsprint From January 1, 2015, Through December 31, 2015
Authors: Robinson Michael A.
Published: April 2017

This article tests the thesis that policing today is a consequence of its history with the Black community. The author provides a brief historical account of policing in America as it pertains to Blacks from slavery to the 21st century. An account of the role of the slave patrols and the various codes and laws enacted to control Blacks are also discussed. This research will examine the historical relationship between police and the Black community by taking a closer look at the killing of unarmed Black men from January 1, 2015, to December 31, 2015, using and analyzing newsprint retrieved from two data sources. Specific cases are discussed, and the author provides possible solutions to address the social problem of the killing of unarmed Black males by police.
Student Perceptions of a New Campus Alcohol Policy: Linking Deterrence and Blame Attribution
Authors: Kelley Margaret S.
Published: April 2017

How do students make judgments about their future behaviors involving the use of alcohol? The present study advances deterrence theory by introducing elements of attribution theory while examining the perceived deterrent effects of a newly instituted dry policy on a college campus. A phone survey of 508 full-time undergraduate students between the ages of 18 and 26 was conducted 1 year following the ban on alcohol. Hypotheses are presented in two models and predict that deterrence (surveillance and enforcement) and blame explain intentions to violate the alcohol policy. These relationships are expected to be mediated by problem attribution and shame and are moderated by gender. Results show that perceived peer surveillance does reduce intentions to violate the policy in the future but formal enforcement does not. Findings further indicate that attributing blame acts to increase the likelihood of experiencing shame, therefore, reducing intentions to violate the alcohol policy. Gender conditioned the effects of surveillance and shame (stronger for females) on future policy violations. Problems that arise from drinking can be understood as another form of attribution that acts to mediate surveillance. Surveillance and blame contribute to the judgment process as students think about violating the alcohol policy, and shame emerges as the key link between deterrence and attribution.
Death Anxiety From Quality of Life and Emotional Impact of Event: A Case Study of Proximate Earwitnesses of Dana Air Crash in Nigeria
Authors: Ottu Iboro Friday Akpan , Essien Ekong Akpan , Lawal Abiodun Musbau
Published: April 2017

The study investigated the traumatic impact of the Dana 2012 plane crash in Lagos, Nigeria. Using a cross-sectional survey, the roles of quality of life (QoL) and impact of event were examined against death anxiety of the proximate inhabitants of the crash site. Result showed significant influence of QoL on death anxiety, with higher QoL participants manifesting higher levels of death anxiety. However, impact of the crash event and demographic indicators such as age, sex, pilot preference, and belief-in-life after death did not influence death anxiety of participants. It can be concluded from these results that the perception of higher QoL has a profound influence on death anxiety of people reminiscing mortality reminders no matter their age, sex, beliefs, and life preferences. It is recommended that anxious death-related experiences be prevented in all spheres of life in pursuit of safety and sound mental health of the people.
Preparation of poly-p-phenylenebenzobisoxazole (PBO) fibrillated pulp and dielectric properties of carbon fiber/PBO wet-laid nonwoven fabric
Authors: Bai Jingjing , Wang Hao , Wang Yi , Hu Jian
Published: April 2017

A method to prepare a kind of wet-laid nonwoven fabric that can be used in microwave absorbing honeycomb is proposed. It was prepared through a papermaking process with carbon fiber (CF) and poly-p-phenylenebenzobisoxazole (PBO) fibrillated pulp. Fibrillated PBO pulp has a large surface area and lots of micro-fibrils which is beneficial for the uniformity and mechanical strength of the wet-laid nonwoven fabric. The electromagnetic properties and absorbing performances of the wet-laid nonwoven fabric with different content of CF were compared. The results showed that the complex permittivity increased when the content of the CF increased, and then decreased when the content was higher than 10 wt%. The resistivity measured by four probe testers decreased with the increase of the content of CF. Calculated by the measured complex permittivity and permeability, the CF/PBO wet-laid nonwoven fabric had a lowest reflection loss of -27.60 dB at a content of 20 wt%, with an optimum thickness of 1.72 mm.
A Comparative Study of Undergraduates’ Attitudes Toward Aging in Taiwan and the United States Through Student Drawings
Authors: Liou Chih-ling
Published: April 2017

The purpose of this study is to compare similarities and differences in the attitudes toward aging among college students from Taiwan and the United States; 128 Taiwanese students and 124 U.S. students participated in this study. The findings indicate that the majority of students from both countries viewed aging as consisting primarily of physical changes. The differences are the U.S. students’ drawings showing physical decline along with hospitals, nursing homes, or death, whereas Taiwanese students presenting physical decline as getting wrinkles, wearing glasses, or needing aid devices. U.S. students associated aging with grandparents–grandchildren relationships, whereas more Taiwanese students thought aging related to spousal relationships. This study adds to the existing literature that demonstrates the strong influence of different cultures on students’ attitudes toward aging. Further, knowledge derived from this study can be used in gerontology courses for both students and professors to lessen or correct ageist stereotypes over time.
Assessing Public Expenditures in Small Towns
Authors: Helpap David J.
Published: April 2017

Large, urban governments often provide a tremendous variety of public goods, while the expenditures of small communities usually address basic needs such as fire protection and road maintenance. However, certain small local governments dedicate significant public resources to recreation, culture, and public health services, among others. This research examines the variation in services provided by these smaller, often overlooked governments. Differences are explained, at least partially, by various community characteristics, location, and capacity. For the millions of people who reside in these communities, the findings illustrate why variations exist and what, potentially, can be done to alter expenditure levels.
Surgery of a nocardia lung abscess presenting as a tension pyopneumothorax
Authors: Fujimoto Ryo , Omasa Mitsugu , Ishikawa Hiroyuki , Aoki Minoru
Published: April 2017

While some cases of nocardial pneumonia develop secondary empyema, tension pyopneumothorax is a very rare and lethal complication. A 74-year-old man who exhibited thrombocytopenia during steroid therapy for autoimmune hepatitis, presented to our department with a nocardial tension pyopneumothorax. He underwent a left lower lobectomy after chest drainage, and was discharged without any complication other than reoperation to remove a postoperative hematoma.
Intracortical electrophysiological correlates of blood flow after severe SAH: A multimodality monitoring study
Authors: Foreman Brandon , Albers David , Schmidt J Michael , Falo Cristina Maria , Velasquez Angela , Connolly E Sander , Claassen Jan
Published: April 2017

Subarachnoid hemorrhage (SAH) is a devastating form of stroke. Approximately one in four patients develop progressive neurological deterioration and silent infarction referred to as delayed cerebral ischemia (DCI). DCI is a complex, multifactorial secondary brain injury pattern and its pathogenesis is not fully understood. We aimed to study the relationship between cerebral blood flow (CBF) and neuronal activity at both the cortex and in scalp using electroencephalography (EEG) in poor-grade SAH patients undergoing multimodality intracranial neuromonitoring. Twenty patients were included, of whom half had DCI median 4.7 days (interquartile range (IQR): 4.0–5.6) from SAH bleed. The rate of decline in regional cerebral blood flow (rCBF) was significant in both those with and without DCI and occurred between days 4 and 7 post-SAH. The scalp EEG alpha-delta ratio declined early in those with DCI. In the group without DCI, CBF and cortical EEG alpha-delta ratio were correlated (r = 0.53; p <  0.01) and in the group without DCI, inverse neurovascular coupling was observed at CPP <  80 mmHg. We found preliminary evidence that as patients enter the period of highest risk for the development of DCI, the absence of neurovascular coupling may act as a possible pathomechanism in the development of ischemia following SAH.
Preece-Baines Model 1 to Estimate Height and Knee Height Growth in Boys and Girls From Merida, Mexico
Authors: Banik Sudip Datta , Salehabadi Sedigheh Mirzaei , Dickinson Federico
Published: April 2017

Background:

Height and body segments in children have differential pubertal growth characteristics. Lower leg length is a sensitive indicator of child’s nutritional status.

Objective:

The purpose of this study was to estimate differential timing and tempo of height and knee height (KH) growth in 9- to 17-year-old boys (n = 475) and girls (n = 500) from Merida, Mexico.

Methods:

In this cross-sectional study, the Preece-Baines growth curves—model 1 (PB 1) was fitted to the anthropometric data for height and KH.

Results:

Based on the PB 1 model, KH had earlier age at maximum increment than height in boys (height = 12.37 years, KH = 11.54 years) and girls (height = 11.01 years, KH = 10.93 years). Peak velocity of these 2 dimensions was different in both sexes (boys: height = 7.11 cm/yr, KH = 2.25 cm/yr; girls: height = 5.14 cm/yr, KH = 1.45 cm/yr). Differences ( P <.001) by sex were also observed for the estimated size at peak velocity and final size of height and KH.

Conclusions:

When compared to height, KH was shown to have earlier adolescent growth spurt and a smaller difference between final size and the size at maximum (peak) velocity indicating an earlier age for achieving adult size. Overall, the studied boys and girls had short estimated final size, an earlier age at maximum increment, and a lower peak velocity in height than urban Guatemalan peers, the only regional reference available.
Fatigue life prediction of composite structures based on online stiffness monitoring
Authors: Zong Junda , Yao Weixing
Published: April 2017

This article presents an online statistical life prediction method based on both historical and local residual-stiffness information to reduce the effect of dispersive mechanical properties of fiber-reinforced plastic structures. Normalized residual-stiffness curves obtained from the laboratory are used as a benchmark, and the model parameters are assumed to be independent random variables. According to Bayesian statistical theory, the prior distribution of fatigue life is updated by the residual-stiffness sample information of the in-service structure through online monitoring; then, a more accurate life estimation is obtained. This method precisely captures the essence of stiffness degradation of a composite structure. The individual dispersion effect is largely eliminated through using the local stiffness data. In general, a more accurate life estimation can be obtained if more sample information is available. The test results of glass-fiber-reinforced plastic and carbon-fiber-reinforced plastic laminates show that the fatigue life can be accurately predicted with only the first 20% residual-stiffness data known.
Partnering to develop a talent pipeline for emerging health leaders in operations research
Authors: Ng Alfred , Henshaw Carly , Carter Michael
Published: April 2017

In initiating its first central office for Quality Improvement (QI), The Scarborough Hospital (TSH) sought to accelerate momentum towards achieving its “Quality and Sustainability” strategic priority by building internal capacity in the emerging QI specialty of operations research. The Scarborough Hospital reviewed existing models of talent management in conjunction with Lean and improvement philosophies. Through simple guiding principles and in collaboration with the University of Toronto’s Centre for Healthcare Engineering, TSH developed a targeted approach to talent management for Operations Research (OR) in the Office of Innovation and Performance Improvement, reduced the time from staffing need to onboarding, accelerated the development of new staff in delivering QI and OR projects, and defined new structures and processes to retain and develop this group of new emerging health leaders.
ICU Admission Source as a Predictor of Mortality for Patients With Sepsis
Authors: Motzkus Christine A. , Chrysanthopoulou Stavroula A. , Luckmann Roger , Rincon Teresa A. , Lapane Kate L. , Lilly Craig M.
Published: April 2017

Purpose:

Sepsis is the leading noncardiac cause of intensive care unit (ICU) death. Pre-ICU admission site may be associated with mortality of ICU patients with sepsis. This study quantifies mortality differences among patients with sepsis admitted to an ICU from a hospital ward, emergency department (ED), or an operating room (OR).

Methods:

We conducted a retrospective cohort study of 1762 adults with sepsis using ICU record data obtained from a clinical database of an academic medical center. Survival analysis provided crude and adjusted hazard rate ratio (HRR) estimates comparing hospital mortality among patients from hospital wards, EDs, and ORs, adjusted for age, sex, and severity of illness.

Results:

Mortality of patients with sepsis differed based on the pre-ICU admission site. Compared to patients admitted from an ED, patients admitted from hospital wards had higher mortality (HRR: 1.35; 95% confidence interval [CI]: 1.09-1.68) and those admitted from an OR had lower mortality (HRR: 0.37; 95% CI: 0.23-0.58).

Conclusion:

Patients with sepsis admitted to an ICU from a hospital ward experienced greater mortality than patients with sepsis admitted to an ICU from an ED. These findings indicate that there may be systematic differences in the selection of patient care locations, recognition, and management of patients with sepsis that warrant further investigation.
Association of Household Income Level and In-Hospital Mortality in Patients With Sepsis: A Nationwide Retrospective Cohort Analysis
Authors: Rush Barret , Wiskar Katie , Celi Leo Anthony , Walley Keith R. , Russell James A. , McDermid Robert C. , Boyd John H.
Published: April 2017

Objective:

Associations between low socioeconomic status (SES) and poor health outcomes have been demonstrated in a variety of conditions. However, the relationship in patients with sepsis is not well described. We investigated the association of lower household income with in-hospital mortality in patients with sepsis across the United States.

Methods:

Retrospective nationwide cohort analysis utilizing the Nationwide Inpatient Sample (NIS) from 2011. Patients aged 18 years or older with sepsis were included. Socioeconomic status was approximated by the median household income of the zip code in which the patient resided. Multivariate logistic modeling incorporating a validated illness severity score for sepsis in administrative data was performed.

Results:

A total of 8 023 590 admissions from the 2011 NIS were examined. A total of 671 858 patients with sepsis were included in the analysis. The lowest income residents compared to the highest were younger (66.9 years, standard deviation [SD] = 16.5 vs 71.4 years, SD = 16.1, P < .01), more likely to be female (53.5% vs 51.9%, P < .01), less likely to be white (54.6% vs 76.6%, P < .01), as well as less likely to have health insurance coverage (92.8% vs 95.9%, P < .01). After controlling for severity of sepsis, residing in the lowest income quartile compared to the highest quartile was associated with a higher risk of mortality (odds ratio [OR]: 1.06, 95% confidence interval [CI]: 1.03-1.08, P < .01). There was no association seen between the second (OR: 1.02, 95% CI: 0.99-1.05, P = .14) and third (OR: 0.99, 95% CI: 0.97-1.01, P = .40) quartiles compared to the highest.

Conclusion:

After adjustment for severity of illness, patients with sepsis who live in the lowest median income quartile had a higher risk of mortality compared to residents of the highest income quartile. The association between SES and mortality in sepsis warrants further investigation with more comprehensive measures of SES.
The Sorrow of Parting: Ethnographic Depth and the Role of Emotions
Authors: Parvez Z. Fareen
Published: April 2017

Literature on emotions and the ethnographic method has focused more on ethnographers’ emotions than the importance of informants’ emotions. This essay aims to analytically clarify the undertheorized role of informants’ emotions in fieldwork and to reflect on the consequences of the ethnographer’s need to invite and elicit their informants’ emotional vulnerabilities. Drawing on the anthropology of/from the body, it argues that in “revelatory moments,” when informants express vulnerability, ethnographers perceive the “dual nature of emotions” as particular and biographical as well as universal. Revelatory moments sharpen the analysis of the field and produce emotional intimacy. They can be crucial to achieving ethnographic depth, or thick description, which remains the gold standard of the method. Yet revelatory moments also have unintended consequences such as romanticizing informants and presenting ethical dilemmas. Three examples of emotional intimacy from fieldwork conducted in France and India illustrate the argument.
A Geopolitical Economy of Heavy Industrialization and Second Tier City Growth in South Korea: Evidence from the ‘Four Core Plants Plan’
Authors: Choi Young-Jin , Glassman Jim
Published: April 2017

In this article, we examine heavy industrialization and second tier urbanization in South Korea during the 1970s from a geopolitical economic perspective. We highlight the crucial, spatially complex geopolitical process of forming transnational class alliances, embedded in Cold War geopolitics, which has been neglected within state-centric developmental state theories and approaches to urbanization. Specifically, we trace the changes in the state’s original developmental plan for promoting the machinery industry in the southeast region during the 1960s and 1970s. We show how Hyundai, one of the most dominant chaebols, grew to exercise decisive influence over the state’s developmental strategy and became a powerhouse in the Korean economy, particularly in the city of Ulsan. Based on a case study of the Four Core Plants Plan, we show that the success of Hyundai was not an outcome of the effectiveness of the state’s developmental policy but was, ironically, due to the failure of the government’s original plan. The successful substitution of Hyundai’s own strategy for the state’s plan, which contributed enormously to the growth of Ulsan, would have been impossible without Hyundai’s enrollment into the transnational geopolitical economic alliance spurred by US military projects in Asia.
Convergence or Divergence? Educational Discrepancies in Work-Care Arrangements of Mothers with Young Children in Germany
Authors: Stahl Juliane Frederike , Schober Pia Sophia
Published: April 2017

This study examines how educational differences in work-care patterns among mothers with young children in Germany changed between 1997 and 2013. Since the mid-2000s, Germany has undergone a paradigm shift in parental leave and childcare policies. Our comparative analysis of East and West Germany provides new evidence on whether the long-standing gender regime differences interact with recent developments of social class inequalities in the changing family policy context. The analyses include pooled binary and multinomial logistic regressions based on 17,764 observations of 8604 children below the age of three years from the German Socio-Economic Panel Study (SOEP). The findings point to growing educational divergence in work-care arrangements in East and West Germany: employment and day-care use increased more strongly among families with medium and highly educated mothers compared to those with low education. This has critical implications for the latter’s economic security. The decline in the use of informal childcare options was, however, fairly homogenous.
Collective action as narrativity and praxis: Theory and application to Hong Kong’s urban protest movements
Authors: Lejano Raul , Chui Ernest , Lam Timothy , Wong Jovial
Published: April 2017

Policy scholars need to better describe the diversity of actors and interests that forge collective political action through nonformal social networks. The authors find extant theories of collective action to only partially explain such heterogeneity, which is exemplified by the urban protest movements in Hong Kong. A new concept, that of the narrative-network, appears better able to describe movements chiefly characterized by heterogeneity. Instead of simple commonalities among members, a relevant property is the plurivocity of narratives told by members of the coalition. Analyzing ethnographic interviews of members of the movement, the authors illustrate the utility of narrative-network analysis in explaining the complex and multiple motivations behind participation. Narrativity and the shared act of narration, within an inclusive and democratic community, are part of what sustains the movement. The research further develops the theory of the narrative-network, which helps explain the rise of street protest in Hong Kong as an emergent, alternative form of civic engagement.
Poly (ether ether ketone) composites reinforced by graphene oxide and silicon dioxide nanoparticles
Authors: Hou Xiaochen , Hu Ying , Hu Xiyu , Jiang Dong
Published: April 2017

Wear-resistant composites with excellent tribological performances and good mechanical/thermal properties were developed by blending the modification of nano-silicon dioxide (m-SiO2) and the modification of graphene oxide (m-GO) with a poly (ether ether ketone) (PEEK) matrix by twin-screw extrusion compounding and subsequently injection molding. The tribological behaviors and the mechanical/thermal properties of the composites were carefully investigated. Compared with pure PEEK, PEEK/m-GO, and PEEK/m-SiO2 composites, the PEEK/m-GO/m-SiO2 composites exhibited considerable enhancements in those performances. These were attributed to m-GO and m-SiO2 that carried the majority of the load during a sliding process and prevented severe wear of the matrix.
Dynamic performance of continuous railway bridges: Numerical analyses and field tests
Authors: Gou Hongye , Shi Xiaoyu , Zhou Wen , Cui Kai , Pu Qianhui
Published: April 2017

In this study, a refined finite element model was built that represented the structural and mechanical properties of railway bridges. A coupled vehicle–bridge vibration model was established to simulate the dynamic behavior of the bridge under moving trains. Field tests were then conducted to determine the free vibration characteristics as well as the strain, displacement, and acceleration of the bridge structure under trains moving at different speeds and braking at a specified position from a set speed. The dynamic response of the bridge was found to increase with the train speed, but the main beam of the bridge was more affected by a train braking than the one passing over it. Both the bridge and vehicle were found to meet the relevant requirements for safe design and operation, with the train exhibiting good running safety and smoothness, and the bridge structure showing sufficient stiffness and dynamic performance. Based on the field measurements and analytical modeling, it can be concluded that the use of appropriate equipment and the selection of a suitable layout for the sensors permit the assessment of the dynamic behavior of the bridges from vibration measurements. This indicates the potential for the continuous health monitoring of the railway bridges that may be sensitive to the vehicle–bridge interaction.
Smart bioimpedance-controlled craniotomy: Concept and first experiments
Authors: Niesche Annegret , Müller Meiko , Ehreiser Fritz , Teichmann Daniel , Leonhardt Steffen , Radermacher Klaus
Published: April 2017

Craniotomy is part of many neurosurgical interventions to create surgical access to intracranial structures. The procedure conventionally bears a high risk of unintended dural tears or damage of the soft tissue underneath the bone. A new synergistically controlled instrument has recently been introduced to address this problem by combining a soft tissue preserving saw with an automatic cutting depth control. Many approaches are known to obtain the information required on the local bone thickness. However, they suffer from unsatisfactory robustness against disturbances occurring during surgery and many approaches require additional intra- or preoperative steps in the workflow. This article presents first concepts for real-time cutting depth control based on in-process bioimpedance measurements. Furthermore, sensor integration into a synergistic surgical device incorporating a bidirectional oscillating saw is demonstrated and evaluated in first feasibility tests on a fresh bovine bone specimen. Results of bipolar measurements show that the transition of different layers of bicortical bone and bone breakthrough lead to characteristic impedance patterns that can be used for process control.
The Detrimental Effects of Oxytocin-Induced Conformity on Dishonesty in Competition
Authors: Aydogan Gökhan , Jobst Andrea , D’Ardenne Kimberlee , Müller Norbert , Kocher Martin G.
Published: April 2017

Justifications may promote unethical behavior because they constitute a convenient loophole through which people can gain from immoral behavior and preserve a positive self-image at the same time. A justification that is widely used is rooted in conformity: Unethical choices become more permissible because one’s peers are expected to make the same unethical choices. In the current study, we tested whether an exogenous alteration of conformity led to a lower inclination to adhere to a widely accepted norm (i.e., honesty) under the pressure of competition. We took advantage of the well-known effects of intranasally applied oxytocin on affiliation, in-group conformity, and in-group favoritism in humans. We found that conformity was enhanced by oxytocin, and this enhancement had a detrimental effect on honesty in a competitive environment but not in a noncompetitive environment. Our findings contribute to recent evidence showing that competition may lead to unethical behavior and erode moral values.
Do classic blood biomarkers of JSLE identify active lupus nephritis? Evidence from the UK JSLE Cohort Study
Authors: Smith E M D , Jorgensen A L , Beresford M W
Published: April 2017

Background

Lupus nephritis (LN) affects up to 80% of juvenile-onset systemic lupus erythematosus (JSLE) patients. The value of commonly available biomarkers, such as anti-dsDNA antibodies, complement (C3/C4), ESR and full blood count parameters in the identification of active LN remains uncertain.

Methods

Participants from the UK JSLE Cohort Study, aged <16 years at diagnosis, were categorized as having active or inactive LN according to the renal domain of the British Isles Lupus Assessment Group score. Classic biomarkers: anti-dsDNA, C3, C4, ESR, CRP, haemoglobin, total white cells, neutrophils, lymphocytes, platelets and immunoglobulins were assessed for their ability to identify active LN using binary logistic regression modeling, with stepAIC function applied to select a final model. Receiver-operating curve analysis was used to assess diagnostic accuracy.

Results

A total of 370 patients were recruited; 191 (52%) had active LN and 179 (48%) had inactive LN. Binary logistic regression modeling demonstrated a combination of ESR, C3, white cell count, neutrophils, lymphocytes and IgG to be best for the identification of active LN (area under the curve 0.724).

Conclusions

At best, combining common classic blood biomarkers of lupus activity using multivariate analysis provides a ‘fair’ ability to identify active LN. Urine biomarkers were not included in these analyses. These results add to the concern that classic blood biomarkers are limited in monitoring discrete JSLE manifestations such as LN.
Independent validation of the adjusted GAPSS: Role of thrombotic risk assessment in the real-life setting
Authors: Fernandez Mosteirin N , Saez Comet L , Salvador Osuna C , Calvo Villas J M , Velilla Marco J
Published: April 2017

Objective

The objective of this report is to independently validate the adjusted Global Antiphospholipid Syndrome Score (aGAPSS) to predict thrombosis in a cohort of patients with APS and/or autoimmune disease.

Methods

This retrospective cohort study included 319 consecutive patients with APS and/or autoimmune disease. Data on clinical manifestations, conventional cardiovascular risk factors and aPL profile were collected. The aGAPSS was calculated for each patient by adding together the points corresponding to the risk factors.

Results

Among the 319 patients included (mean age: 48.0; SD 15.47), conducted over a mean period of 52 months (range: 19–394), 219 fulfilled the current APS classification criteria (PAPS diagnosed in 130 patients and APS associated autoimmune disease (aAPS) in 89 patients), and 100 patients with autoimmune disease without APS (AD). A total of 201 patients (63.0%) had a history of one or several thrombotic manifestations, 189 (86.3%) of them APS patients: 118 PAPS (mean age: 50.14; SD 15.47) and 71 aAPS (mean age: 48.13; SD 15.81). Higher aGAPSS baseline values were seen in patients with thrombosis 6.58 (SD 3.36) when compared with those without 4.90 (SD 4.33) ( p = 0.001).

Conclusions

This study has shown that even when anti-phosphatidylserine/prothrombin antibodies (aPS/PT) are not computed in an adjusted model of GAPSS (aGAPSS), this score represents an improvement in assessment of the risk prediction of thrombosis in APS patients and/or autoimmune disease. However, cut-off values may differ from other kinds of cohorts, which suggests that baseline characteristics in divergent groups of patients can account for differences in cut-off values of GAPSS.
Rival patterns of time, narration and identity
Authors: Hidas Zoltán
Published: April 2017

The quest for one's identity has become one of the most characteristic concerns of modern man. In what follows, several ‘rhythms of identity’ will be measured by referring to the much recited historical and mythical Biblical past – still influentally reaching into our own time. A threefold orientation in time can thereby be identified in an idealtypical way, each of them corresponding to a respective view of identity. Operating differences, narrated stories, existential decisions – these options seem to build the frame of our self-orientation in a highly disoriented world.
The Impact of IRS Tax Policy on Hospital Community Benefit Activities
Authors: Yeager Valerie A. , Ferdinand Alva O. , Menachemi Nir
Published: April 2017

The Internal Revenue Service (IRS) recently introduced tax code revisions requiring stricter oversight of community benefit activities (CBAs) conducted by tax-exempt, not-for-profit hospitals. We examine the impact of this tax requirement on CBAs among these hospitals relative to for-profit and government hospitals that were not subject to the new policy. We employed a quasi-experimental, difference-in-difference study design using a longitudinal observational approach and used secondary data collected by the American Hospital Association (years 2006-2010 including 20,538 hospital year observations). Findings show a significant increase in the reporting of 7 of the 13 CBAs among tax-exempt, not-for-profit hospitals compared with other hospitals after the policy change. Examples include partnering to conduct community health assessments ( b = 0.035, p = .002) and using capacity assessments to identify unmet community health needs ( b = 0.041, p = .001). Recent tax revisions are associated with increases in reported CBAs among tax-exempt, not-for-profit hospitals. As the debate continues regarding tax exemption status for not-for-profit hospitals, policy makers should expand efforts for enhanced accountability.
Assessing the need for improved strategies and medication-related education to increase adherence for oral anticancer medications in the young adult oncology population
Authors: Divakaruni Anupama , Saylor Elizabeth , Duffy Alison P
Published: April 2017

Rationale

Oral anticancer medication adherence is a critical factor in optimizing cancer treatment outcomes and minimizing toxicity. Although potential adherence barriers exist, it is not well understood how these factors impact adherence.

Methods

This is a prospective, single-center, patient survey-based study conducted at the University of Maryland Greenebaum Comprehensive Cancer Center including 18- to 39-year-old patients who have been actively taking an oral anticancer medication for at least one month from 1 April 2013 to 1 April 2016. The primary objective of this study is to describe institutional practices for medication education and adherence monitoring practices as perceived by young adult patients at the University of Maryland Greenebaum Comprehensive Cancer Center and to describe practice consistency with recommendations from the American Society of Clinical Oncology/Oncology Nursing Society Chemotherapy Administration Safety Standards. The secondary objectives include patient-reported facilitators and barriers to oral anticancer medication adherence.

Results

Seventeen patients completed the survey; 24% ( n = 4) of patients denied receiving information about what to do in case of a missed dose. The most common facilitators of adherence include understanding of disease and treatment (88%, n = 15), perceived severity of illness (82%, n = 14), and use of oral anticancer medications (82%, n = 14). The most common barriers to adherence are side effects (59% n = 10), forgetfulness (47%, n = 8), and depressive symptoms (35%, n = 6).

Conclusion

Based on patient-reported guideline adherence, improvement is needed in including family, caregivers, and others in the education process as well as providing education about plan for missed doses and drug–drug and drug–food interactions. The strengths of the current medication education and adherence monitoring practices as perceived by the young adult patient population include education about the purpose and goals of treatment, the planned duration and schedule, side effects, and when to seek medical attention. The data collected from this survey can aid in future development and implementation of interventions aimed at improving medication adherence, such as integrating clinical pharmacy services into oral chemotherapy monitoring and education process.
Psychometric Properties of a Scale to Assess Parental Self-Efficacy for Influencing Children’s Dietary, Physical Activity, Sedentary, and Screen Time Behaviors in Disadvantaged Areas
Authors: Norman Åsa , Bohman Benjamin , Nyberg Gisela , Schäfer Elinder Liselotte
Published: April 2017

Background. According to social cognitive theory, self-efficacy is central to behavior change. Consequently, parental self-efficacy (PSE) for influencing children’s dietary, physical activity (PA), sedentary, and screen time behaviors is important for child obesity prevention. The aim of this study was to evaluate the psychometric properties of an instrument to measure PSE regarding these behaviors in disadvantaged areas. Method. Parents ( n = 229) of whom 47% had completed secondary school or less, and who participated in the Healthy School Start trial, responded to a 15-item PSE instrument. Children’s diet and screen time were measured through parent reports. PA and sedentary behaviors were measured using accelerometers. Construct validity was assessed using exploratory factor analysis (EFA), criterion validity by correlations with child behaviors, and internal consistency by Cronbach’s alpha. Results. The EFA yielded three factors: (a) PSE for promoting PA; (b) PSE for limiting intake of unhealthy foods, unhealthy drinks, and screen time; and (c) PSE for promoting intake of fruits and vegetables, all with acceptable to good internal consistency (α = .77-.81). Significant correlations ( p < .01) were found between children’s dietary ( rs = −.19 to −.29) and screen time ( r = −.29) behaviors and Factor 2, and dietary behaviors and Factor 3 ( rs = .20-.39) but not regarding PA and sedentary behaviors and Factor 1. Conclusion. The instrument demonstrated good construct validity and acceptable to good internal consistency regarding all but PA behaviors. It may be useful for assessing PSE in child obesity prevention interventions in disadvantaged settings after some refinement.
Changes in Ideational Profiles of Women of Reproductive Age in Urban Nigeria: The Role of Health Communication
Authors: Babalola Stella
Published: April 2017

Reproductive health indicators in Nigeria remain among the poorest in the world. Modern contraceptive prevalence rate has remained practically at the same level since 2003. Whereas contraceptive use is higher in urban compared with rural areas, the majority of urban women are not using a modern contraceptive method. Low contraceptive use in the country results from unfavorable ideational variables, including knowledge, values, beliefs, and norms. Ideational segmentation allows program planners to identify groups that are homogenous with respect to ideational variables and which have similar informational and skills strengthening needs. In this study, we conducted latent class analyses with longitudinal data collected from a sample of women in 2010/2011 and 2014 to identify distinct ideational segments among women of reproductive age in six Nigerian cities at the two points in time. The analysis revealed three ideational segments at baseline: (a) Inefficacious, misinformed and unsupported, labeled “Disempowered,” 58.8%; (b) Efficacious, misinformed, and unsupported, labeled “Unsupported,” 31.8%; and (c) efficacious, supported but misinformed, labeled “Skeptics, 9.4%. These groups differ in terms of sociodemographic characteristics and contraceptive use and intention to use. At endline, four ideational segments were identified: (a) Inefficacious, misinformed and unsupported, labeled “Disempowered,” 28.9%; (b) Efficacious, supported but misinformed, labeled “Skeptics,” 28.5%; (c) Efficacious, informed but unsupported, labeled “Unsupported,” 27.0%; and (d) efficacious, informed and supported, labeled “Empowered,” 15.6%. Exposure to Nigerian Urban Reproductive Health Initiative communication interventions was one of the most significant predictors of improvements in ideational characteristics over time. Messages tailored to the informational needs of the various ideational segments and that address their worldview are needed to increase contraceptive use.
Time Course Expression Analysis of 1[2-cyano-3,12-dioxooleana-1,9(11)-dien-28-oyl]imidazole Induction of Cytoprotection in Human Endothelial Cells
Authors: Bynum James A , Wang Xinyu , Stavchansky Salomon A , Bowman Phillip D
Published: April 2017

1[2-cyano-3,12-dioxooleana-1,9(11)-dien-28-oyl]imidazole (CDDO-Im), a synthetic derivative of oleanolic acid that exhibits antioxidant and anti-inflammatory activity in several animal and in vitro models, has been shown to be beneficial if given after injury. Although induction of heme oxygenase 1 appears to be a major effector of cytoprotection, the mechanism by which the overall effect is mediated is largely unknown. This study evaluated temporal gene expression profiles to better characterize the early transcriptional events and their relationship to the dynamics of the cytoprotective response in human umbilical vein endothelial cells (HUVEC) to CDDO-Im. Time-course gene expression profiling was performed on HUVEC treated with CDDO-Im for 0.5, 1, 3, 6, and 24 hours. More than 10 000 genes were statistically altered in their expression in at least 1 time point across the time course. Large alterations in immediate-early gene expression were readily detectable within 0.5 hour after administration of CDDO-Im.
An Improved 2-Dimensional Gel Electrophoresis Method for Resolving Human Erythrocyte Membrane Proteins
Authors: Kumar Manoj , Singh Rajendra , Meena Anil , Patidar Bhagwan S , Prasad Rajendra , Chhabra Sunil K , Bansal Surendra K
Published: April 2017

The 2-dimensional gel electrophoresis (2-DE) technique is widely used for the analysis of complex protein mixtures extracted from biological samples. It is one of the most commonly used analytical techniques in proteomics to study qualitative and quantitative protein changes between different states of a cell or an organism (eg, healthy and diseased), conditionally expressed proteins, posttranslational modifications, and so on. The 2-DE technique is used for its unparalleled ability to separate thousands of proteins simultaneously. The resolution of the proteins by 2-DE largely depends on the quality of sample prepared during protein extraction which increases results in terms of reproducibility and minimizes protein modifications that may result in artifactual spots on 2-DE gels. The buffer used for the extraction and solubilization of proteins influences the quality and reproducibility of the resolution of proteins on 2-DE gel. The purification by cleanup kit is another powerful process to prevent horizontal streaking which occurs during isoelectric focusing due to the presence of contaminants such as salts, lipids, nucleic acids, and detergents. Erythrocyte membrane proteins serve as prototypes for multifunctional proteins in various erythroid and nonerythroid cells. In this study, we therefore optimized the selected major conditions of 2-DE for resolving various proteins of human erythrocyte membrane. The modification included the optimization of conditions for sample preparation, cleanup of protein sample, isoelectric focusing, equilibration, and storage of immobilized pH gradient strips, which were further carefully examined to achieve optimum conditions for improving the quality of protein spots on 2-DE gels. The present improved 2-DE analysis method enabled better detection of protein spots with higher quality and reproducibility. Therefore, the conditions established in this study may be used for the 2-DE analysis of erythrocyte membrane proteins for different diseases, which may help to identify the proteins that may serve as markers for diagnostics as well as targets for development of new therapeutic potential.
Spatiotemporal Changes in P-glycoprotein Levels in Brain and Peripheral Tissues Following Ischemic Stroke in Rats
Authors: DeMars Kelly M , Yang Changjun , Hawkins Kimberly E , McCrea Austin O , Siwarski David M , Candelario-Jalil Eduardo
Published: April 2017

P-glycoprotein (P-gp) is known to transport a diverse array of xenobiotics, including therapeutic drugs. A member of the ATP-binding cassette (ABC) transporter family, P-gp is a protein encoded by the gene Mdr1 in humans and Abcb1 in rodents (represented by 2 isoforms Abcb1a and Abcb1b). Lining the luminal and abluminal membrane of brain capillary endothelial cells, P-gp is a promiscuous efflux pump extruding a variety of exogenous toxins and drugs. In this study, we measured dynamic changes in Abcb1a and Abcb1b transcripts and P-gp protein in the brain, liver, and kidney after experimental stroke. P-glycoprotein has been shown to increase in brain endothelial cells following hypoxia in vitro or after exposure to proinflammatory cytokines. Using a rat model of ischemic stroke, we hypothesized that P-gp expression will be increased in the brain, liver, and kidney in response to neuroinflammation following ischemic stroke. Adult Sprague Dawley rats underwent middle cerebral artery occlusion (MCAO) for 90 minutes and were killed at 4, 14, 24, and 48 hours postreperfusion onset to determine the time course of P-gp expression. To mimic ischemia occurring at the blood-brain barrier, rat brain endothelial (RBE4) cells were subjected to hypoxia and low glucose (HLG) for 16 hours. Immunoblotting analyses showed P-gp increases in brain and liver following 90-minute MCAO, as well as in cultured RBE4 cells after 16-hour HLG treatment, but fluctuated in the kidney depending on the time point. The relative roles of each isoform in the protein expression were analyzed with quantitative reverse transcriptase polymerase chain reaction. Ischemic stroke leads to significant increases in P-gp levels not only in the brain but also in the liver. The increase in P-gp could dramatically reduce the bioavailability and efficacy of neuroprotective drugs. Therefore, P-gp represents a big hurdle to drug delivery to the ischemic brain.
Medical Versus Interventional Treatment of Intra-Abdominal Abscess in Patients With Crohn Disease
Authors: Graham Emily , Rao Krishna , Cinti Sandro
Published: April 2017

Background:

Few studies exist to guide the treatment approach to intra-abdominal abscesses in Crohn disease, which can include antimicrobials alone or in conjunction with percutaneous drainage or surgery. The primary aim of this study is to review outcomes from different treatment approaches to intra-abdominal abscess in Crohn disease.

Methods:

Medical records were reviewed for patients admitted to the University of Michigan health care system with Crohn disease and intra-abdominal abscess over a 4-year period. Outcomes were compared among medical and interventional approaches. The χ2 test was used to test for statistical significance.

Results:

Of the 33 patients included, 13 were in the medical group and 20 were in the interventional group. Abscess recurrence/nonresolution occurred in 31% of patients in the medical group and 25% of patients in the interventional group ( P = .7).

Conclusions:

In this study, there was no significant difference in outcome between medical and interventional therapy for intra-abdominal abscess in Crohn disease.
Retrograde trans-synaptic visual pathway degeneration in multiple sclerosis: A case series
Authors: Al-Louzi Omar , Button Julia , Newsome Scott D , Calabresi Peter A , Saidha Shiv
Published: April 2017

Background:

Trans-synaptic degeneration (TSD) describes the propagation of neuronal injury through synaptic pathways in the human nervous system and may be linked to the accelerated retinal atrophy seen in multiple sclerosis (MS).

Results:

We report six cases where homonymous, hemi-macular ganglion cell + inner plexiform (GCIP) thickness reduction was seen in conjunction with posterior visual pathway lesions. Macular microcystoid changes of the inner nuclear layer (INL) were seen in a subset of three subjects.

Conclusion:

Our findings highlight the utility of assessing regional GCIP changes to identify potential retrograde TSD in MS and demonstrate that INL changes may be an accompaniment in such instances.