bluuebunny/crossref_metadata_2025 huggingface dataset:
Hashtag Health: College Health on Social Media and Students’ Motivations to Follow, Interact, and Share Their Social Media Content
Authors: Perrault Evan K. , Hildenbrand Grace M. , McCullock Seth P. , Schmitz Katie J. , Dolick Kirstin N.
Published: June 2019

Social media are advocated as a prime channel through which to reach college students with health-related information. However, how well are colleges and universities utilizing social media as it was intended—a means to be truly social and not just promotional? Social media can only be effective if students actually follow, interact, and share the content being produced. The following study completed a census of student health center Facebook accounts in the United States as well as investigated students’ motivations to follow, interact with, and share health-related content. Facebook pages were found for about 20% of student health centers, and about two thirds posted content within the past 14 days. However, their median number of “likes” was between 191 and 496 despite being in existence for an average of 6 years. Additionally, the majority of these centers’ most recent posts were promotional, instead of trying to socially engage with their followers. Students indicated that they would be likely to follow, interact, or share social media content from college health accounts if they were incentivized to do so, if they thought the content could be relevant to them, or if they simply knew that the account existed. Unless more attention is given to growing their followings, resources used by student health organizations to consistently post content might be better placed elsewhere. Recommendations for increasing engagement with students are discussed.
Modifiable Risk Factors for Delayed Graft Function After Deceased Donor Kidney Transplantation
Authors: Kaufmann Kai B. , Baar Wolfgang , Silbach Kai , Knörlein Julian , Jänigen Bernd , Kalbhenn Johannes , Heinrich Sebastian , Pisarski Przemyslaw , Buerkle Hartmut , Göbel Ulrich
Published: June 2019

Purpose:

Delayed graft function is a major complication after kidney transplantation affecting patients’ long-term outcome. The aim of this study was to identify modifiable risk factors for delayed graft function after deceased donor kidney transplantation.

Methods:

This is a single-center retrospective cohort study of a university transplantation center. Univariate and multivariate step-wise logistic regression analysis of patient-specific and procedural risk factors were conducted.

Results:

We analyzed 380 deceased donor kidney transplantation patients between October 30, 2008 and December 30, 2017. The incidence of delayed graft function was 15% (58/380). Among the patient-specific risk factors recipient diabetes (2.8 [1.4-5.9] odds ratio [OR] [95% confidence interval [CI]]), American Society of Anesthesiologist score of 4 (2.7 [1.2-6.5] OR [95% CI]), cold ischemic time >13 hours (2.8 [1.5-5.3] OR [95% CI]) and donor age >55 years (1.9 [1.01-3.6] OR [95% CI]) revealed significance. The significant intraoperative, procedural risk factors included the use of colloids (3.9 [1.4-11.3] OR [95% CI]), albumin (3.0 [1.2-7.5] OR [95% CI]), crystalloids >3000 mL (3.1 [1.2-7.5] OR [95% CI]) and mean arterial pressure <80 mm Hg at the time of reperfusion (2.4 [1.2-4.8] OR [95% CI]).

Conclusion:

Patients undergoing deceased donor kidney transplantation with a mean arterial pressure >80 mm Hg at the time of transplant reperfusion without requiring excessive fluid therapy in terms of colloids, albumin or crystalloids >3000 mL are less likely to develop delayed graft function.
The Unsayable in Arts-Based Research: On the Praxis of Life Itself
Authors: Visse Merel , Hansen Finn , Leget Carlo
Published: June 2019

Arts-based research (ABR) provokes different ways of thinking about how art relates to knowledge in research. There are few authors, however, who explicate their view on aesthetics in the context of ABR and the type of knowledge that it generates. Accordingly, this article clarifies an aesthetic view in the context of a phenomenological approach to ABR. Ample arts-based researchers explore questions that touch upon the liminal nature and complexities of our lived experiences. Phenomenology is about that exactly: It leans into the unsayable dimensions of our reality and is interested in poetic and apophatic knowing. Apophatic knowing is a negating approach to understanding the unsayable, that is, a way of “nonknowing.” It can be practiced as a silent receptiveness. Consequently, we propose a Gadamerian approach to aesthetics that perceives ABR as an event. We argue for a poetics of research that is about being open and responsive to the movements of the artwork that ABR generates. Thus, by being receptive to movement, the enigma of phenomenality or life itself becomes the heart of ABR.
Bilateral iliac vein stenting reduces great and small saphenous venous reflux
Authors: Chait Jesse , Kibrik Pavel , Kenney Kevin , Alsheekh Ahmad , Ostrozhynskyy Yuriy , Marks Natalie , Hingorani Anil , Rajaee Sareh , Ascher Enrico
Published: June 2019

Objective

Iliac vein stenting has been an evolving treatment option in the management of CVI secondary to iliac vein obstruction. Historically, treatment of CVI has been focused on the elimination of saphenous vein disease; however, the effect of reduction of iliac vein obstruction on superficial venous reflux remains largely unknown. This study aimed to identify the effect of iliac vein stenting on saphenous vein reflux.

Methods

In this retrospective study spanning course of five years, we performed 2681 venograms with venoplasties and stenting of the iliac veins. Pre-operative and post-operative venous mapping was performed via duplex ultrasonography. Patients who received any lower extremity vascular intervention between “pre-” and “post-stenting” duplex ultrasonography examination, other than iliac vein stenting, were excluded from analysis.

Results

One thousand six hundred forty-five patients, of which 63.2% were female, underwent iliac vein stenting; 1033 patients received bilateral intervention, whereas 356 and 259 patients received unilateral left and right stenting, respectively. The average age of the patient cohort was 66 (range 22–100; SD ± 13.9). The distribution CEAP scores of each limb at the time of intervention were: C2 (1%), C3 (25%), C4 (51%), C5 (5%), and C6 (18%). Bilateral iliac vein stenting significantly reduced reflux in the bilateral great saphenous and small saphenous veins by 363.8 ms ( p < 0.0001) and 345.4 ms ( p < 0.0002), respectively, but had no effect on ASV reflux. Unilateral stenting did not produce significant reductions in reflux, besides an average reduction of 573.2 ms ( p = 0.004) in the left great saphenous vein.

Conclusion

Bilateral iliac vein stenting decreased great saphenous vein and small saphenous vein reflux. Unilateral stenting did not demonstrate a significant reduction in saphenous reflux. Bilateral reduction in stenosis of the iliac veins may influence superficial venous reflux.
A dual-stage low-power converter driving for piezoelectric actuator applied in flapping-wing micro aerial vehicles
Authors: Kong Guoli , Su Yu
Published: June 2019

It is essential for flapping-wing micro aerial vehicles to have a driver with compact size, low mass, and high conversion efficiency in low-power application. In this article, a dual-stage low-power converter driving for piezoelectric actuator was designed and implemented, which can be applied in flapping-wing micro aerial vehicles. Using the “simultaneous drive” method, an Residual Current Devices (RCD) passive snubber flyback DC/DC step-up converter cascaded with a bidirectional active half-bridge drive stage is designed. The flyback converter is controlled by pulse width modulation in discontinuous conduction mode to ensure the stability of the output high voltage. The half-bridge drive stage takes the approach of comparing the output voltage signal with an ideal waveform lookup table to generate arbitrary unipolar signals. The proposed converter has a weight of 345 mg, a size of 285 mm2 (19 × 15 mm2), a maximum output power of 500 mW, and a maximum conversion efficiency of 64.5%. An experiment driving for piezoelectric actuator was performed to observe the displacement generated by the converter. According to the experimental results, this converter can be applied in flapping-wing micro aerial vehicles.
Outcomes of patients with single-bone-forearm surgery: a clinical assessment and three-dimensional motion analysis
Authors: Schachinger Florian , Pobatschnig Barbara , Kranzl Andreas , Stauffer Alexandra , Farr Sebastian
Published: June 2019

The creation of a single-bone-forearm is a salvage procedure to stabilize the forearm. The purpose of this study was to investigate clinical outcomes and how these patients compensate for the lack of forearm rotation. We evaluated four patients (three children, one adult) who had undergone single-bone-forearm surgery. Patients were examined clinically and with three-dimensional motion analysis. We found these patients are generally capable to perform important activities of daily living (e.g. glass jug pouring), which would normally need forearm rotation. Motion analysis revealed remarkable compensatory motion at other joints during these activities. We conclude that patients with a single-bone-forearm can maintain a certain level of daily activities by using compensatory motions at other joints, although the time needed to complete the tasks may be longer.

Level of evidence: IV
Relationship between shoulder forces, shoulder joint shear stress, and throwing velocity during baseball pitching
Authors: Naito Kozo , Takagi Tokio , Kubota Hideaki , Maruyama Takeo
Published: June 2019

It is well accepted that the anterior shoulder joint force generated in baseball pitching is a risk factor for throwing-related injuries. However, the exact mechanism that causes shoulder joint force is still unclear. This study aimed to clarify the mechanism underlying generation of shoulder shear stress, and gain knowledge about proper throwing mechanics that can minimise joint stress and maximise performance. To this end, the throwing motions of 16 male collegiate baseball pitchers were measured using a three-dimensional motion capture system. Subsequently, induced-joint force analysis and induced-segmental velocity analysis, developed in this study, were used to decompose the shoulder joint force and fingertip velocity of the throwing upper extremity into causal muscular and interactive torque components. Induced-joint force analysis showed that the muscular torque–induced component to the maximum anterior shoulder joint force accounts for more than 100%, and the shoulder horizontal adduction torque is the greatest contributor among all joints. Induced-segmental velocity analysis found that the centrifugal force effect was the largest contributor, at 42.3% of the maximum fingertip velocity. The current findings imply that effectively exploiting centrifugal force for throwing arm acceleration is the key factor for achieving proper throwing that maximises ball speed and minimises shoulder joint load.
Hyperemesis gravidarum
Authors: Khan Yusra
Published: June 2019

Nausea and vomiting in pregnancy (NVP), or morning sickness, is the most common symptom experienced by pregnant women and affects 80% of pregnancies. NVP occurs across a spectrum, ranging from mild to severe, with hyperemesis gravidarum (HG) representing the most extreme form. HG is a complication of pregnancy affecting 1% of pregnancies, and if left untreated can cause maternal and fetal morbidity and mortality. Early treatment of NVP in primary care can prevent progression to HG. This article aims to help GP trainees understand the natural history of HG and provides a framework for its assessment and management.
Lifetime assessment of high-density polyethylene–silica nanocomposites
Authors: Dorigato A , Govaert LE , Pegoretti A
Published: June 2019

In this work, the effect of fumed silica on the long-term resistance of high-density polyethylene was investigated. Different amounts of functionalized fumed silica nanoparticles were dispersed in a high-density polyethylene matrix by melt compounding, and compression molded specimens were tested under tensile mode in the quasi-static ramp and creep conditions. In particular, tensile tests at different speeds and temperatures and the subsequent application of the modified Ree–Eyring model allowed the determination of an analytical expression correlating the strain rate with the yield stress and the testing temperature. It was demonstrated that the introduction of fumed silica led to a significant drop in the deformation rate, especially at elevated filler amounts. Creep tests showed that the nanofiller addition led to a progressive reduction of the critical deformation values. The application of this engineering approach evidenced how nanosilica introduction led to a systematic increase of the time-to-failure values, and good accordance between theoretical prediction and experimental measurements was found.
Curcumin Inhibits Proliferation and Migration of A549 Lung Cancer Cells Through Activation of ERK1/2 Pathway-induced Autophagy
Authors: Chen Quangang , Men Yanjuan , Wang Hui , Chen Renjin , Han Xufeng , Liu Jing
Published: June 2019

Curcumin is a major component of turmeric with promising tumor-suppressive activity; however, its underlying molecular mechanisms need to be investigated further. We aimed to investigate the mechanisms of curcumin on the proliferation and migration of lung cancer cells. To confirm that, A549 lung cancer cells were cultured in vitro with or without curcumin; the effect of curcumin on cell proliferation was evaluated using the cell counting kit-8 assay, and its effect on cell migration was evaluated using a wound-healing assay. The results suggested that curcumin treatment inhibited the proliferation and migration of A549 cells, but these effects were alleviated when autophagy was inhibited by small interfering RNA that targets ATG5 or autophagy inhibitor 3-methyladenine. Similarly, inactivation of extracellular signal-regulated kinase 1/2 (ERK1/2) also attenuated the effects of curcumin on A549 cells. Collectively, our data suggested that curcumin induces autophagy via activating the ERK1/2 pathway and the autophagy is important for the inhibiting effect of curcumin in lung adenocarcinoma cells.
Leaves of Duroia longiflora: Isolation of a Biflavanoid and Histochemical Analysis
Authors: Cruz Fabiele Souza da , Pacheco de Araújo Maria Gracimar , Nunez Cecilia Veronica
Published: June 2019

Duroia longiflora (Rubiaceae) is an Amazonian plant species with no previous chemical study. The aim of this work was to study the chemical composition of D. longiflora leaves and study their histochemistry. In vivo tissues of the leaves were histolocalized. Extracts were made from dried leaves with hexane, methanol, and water, and the methanolic extract was fractionated. Fractionation of the dichloromethane phase of the methanolic leaf extract allowed the isolation of a biflavanoid. Via nuclear magnetic resonance (mono and bidimensional), mass spectrometer analysis, and comparison with existing literature, its chemical structure was identified as 2α,3α-epoxy-5,7,3′,4′-tetrahydroxyflavan-(4β→8)-epicatechin. This is the first report describing the histochemical and phytochemical studies of D. longiflora leaves. As far as we know, this is the first report of this substance in any Rubiaceae species.
Megastigmane Glycosides From Phoebe tavoyana
Authors: Viet Thanh Nguyen Thi , Minh Tran Thi , Linh Nguyen Thuy , Phuong Ly Giang Thi , Trang Do Thi , Tai Bui Huu , Yen Pham Hai , Nhiem Nguyen Xuan , Kiem Phan Van
Published: June 2019

Two new megastigmane glycosides, phoebenoside A (1) and phoebenoside B (2) and 4 known compounds, dendranthemoside A (3), lyoniresinol (4), (+)-3- O-L-rhamnopyranoside-5-methoxyisolariciresinol (5), and (+)-lyoniresinol 3α- O-β-D-glucopyranoside (6) were isolated from the leaves of Phoebe tavoyana (Meisn.) Hook. Their chemical structures were elucidated by analyses of their spectroscopic data, and comparison with those reported in the literature.
Concrete slab fragmentation after bullet impact: An experimental study
Authors: Sielicki Piotr W , Ślosarczyk Agnieszka , Szulc Dominik
Published: June 2019

The response of nonreinforced concrete to high-speed flying fragments depends on many factors such as composition, geometry and boundary conditions of the obstacle. In this study, the authors verified experimentally a series of concrete slabs with various aggregate types and amounts of steel reinforcement. The material properties were previously developed and verified during the laboratory experiments with standard cubic specimens. Moreover, the main goal of this research was the verification of high-strength concrete plates using different kinds of aggregate, that is, traditional gravel, granite, basalt and amphibolite subjected to the military bullet impact. It is known that the aggregate filled about 70% of total concrete volume, and therefore, the properties of aggregate, like density, strength and surface will be the main factors influencing the concrete strength and further concrete resistance to projectiles. The research presented shows that the type and shape of aggregate determined the conditions of concrete failure. The outcomes show that the obtained compressive strength varied between 60 and 80 MPa. In the second stage of the test, randomly distributed reinforcement was added to selected concrete mixtures. Hooked steel fibres with an aspect ratio of 50 in the amounts of 50 and 100 kg per cubic metre were applied. The influence of steel fibres on the concrete properties was verified in compressive and splitting strength tests. On the basis of preliminary laboratory tests, the final slab specimens, with the dimensions of 0.5 × 0.5 m and 0.05 m thickness, were produced. The final verification was performed in the real field conditions using the most popular military bullet, whose kinetic energy was more than 2000 J. The measurements of the initial and final velocities of the bullets and concrete fragments were obtained using high-speed camera measurement equipment. The final failure of the slabs was presented as the primary outcome.
Expanding Universe Illusion
Authors: Phillips David , Heard Priscilla , Tyler Christopher W.
Published: June 2019

We present a new induced movement illusion from global expansion or contraction in a triangular region filled with rising or falling textures. Objective global expansion or contraction induces lateral movement in the oblique edges of the triangle. The effects may be due to common and relative movements operating within a single texture.
Guidance Counselors or School Counselors: How the Name of the Profession Influences Perceptions of Competence
Authors: Zyromski Brett , Hudson Tyler D. , Baker Emily , Granello Darcy Haag
Published: June 2019

School counselors ( n = 276) were given a measure of school counseling competencies and standards. About half the participants completed a version of the survey that used the term “Guidance Counselor” ( n = 131) and half completed a version of the survey that used the term “School Counselor.” Participants who completed the surveys that used the term “Guidance Counselor” were statistically significantly less likely to believe that school counselors were able to perform the 25 tasks on the survey.
Reviewing the Domain of Technology and Innovation Management: A Visualizing Bibliometric Analysis
Authors: Huang Yanyi , Ding Xiu-Hao , Liu Ruihong , He Yuanqiong , Wu Suming
Published: June 2019

Technology and innovation management (TIM) plays an increasingly important role in the survival and prosperity of firms and economic growth of countries, which makes it increasingly important to trace the trajectory of this research field. However, to date, few studies have analyzed the evolution of the field of TIM quantitatively. Aiming to achieve an overall understanding of the research in the field of TIM, this study extracts all publications in the top 13 journals on TIM and their references that could be located in the Web of Science. Next, through cocategory analysis, cocitation analysis, cokeyword analysis, and coauthor analysis, the crucial intellectual structure of the TIM field is identified, and the distribution and evolution of the hot spots of this field are presented. An overall picture, emerging trends, and key points of the field of TIM are provided, which might contribute to our understanding and future studies of TIM.
Medical Comfort at the Intersection of Sexual Orientation and Gender Identity
Authors: Oyarvide Tuthill Zelma , Gorman Bridget
Published: June 2019

Effective and comfortable provider-patient communication is associated with engagement in health-promoting behavior. Although research on medical experiences among sexual minorities has increased, work has not examined how gender intersects with sexual identity to shape medical experiences. Using an intercategorical intersectional approach, we examine whether sexual minorities perceive their medical provider as knowledgeable and comfortable with their sexual identity, and how these relationships differ for cisgender men, cisgender women, and multigendered transgender adults. Drawing on data from 3,050 adults included in the 2010 Social Justice Sexuality Project, logistic regression models show three main findings. First, compared with heterosexual cisgender women, bisexual cisgender women are less likely to perceive that their provider knew their sexual identity—and if they did perceive knowledge, they were less likely to perceive that their provider was comfortable with their sexual identity. Second, gay transgender adults have significantly lower odds of perceiving provider comfort with their sexual identity relative to heterosexual transgender adults. Finally, for each gender group, our models demonstrated the importance of medical and social relationships for perceiving both knowledge and comfort with sexual identity from medical care providers.
The biopolitics of carbon accounting in Indonesia’s forests
Authors: Boer Henry J
Published: June 2019

Across developing countries substantial effort and resources have been dedicated to setting up systems for the measurement, recording and verification of greenhouse gas emissions in the forestry and land-use sectors – a key initiative of the global climate programme Reducing Emissions from Deforestation and Forest Degradation. This paper approaches these systems through the lens of conservation biopolitics, identifying the calculative processes and spatial logics that attempt to regulate the life and death of the forest. It uses an example of the Indonesian National Carbon Accounting System to explore how a biopolitical apparatus of constant data accumulation and presentation integrates an infinitely complex set of ecological processes across highly differentiated spatial landscapes, and organises these into governable carbon domains. The Indonesian National Carbon Accounting System provides a visual and numeric representation of the various policy and socio-economic processes that drive and limit carbon emissions, and identifies where this occurs in the landscape. By understanding these forest–carbon–human dynamics, programmes can be designed that change how populations access, use and potentially restore the life of the forest. For state and non-state interests alike, the System was viewed as a critical tool for both developing and evaluating the performance of multiple forest carbon initiatives. It also offers a surveillance apparatus to regulate the carbon market and to discipline the actions of various agents that utilise forests and land. Critically, the biopolitical utility of these systems have been undermined by waning commitment within Indonesia to overhaul forest governance towards carbon outcomes.
Rates of Comorbid Anxiety and Depression in Patients With Age-Related Macular Degeneration
Authors: Olson Daniel , Zhang Xinxin , Ward Michael F. , Le Patrick , Ismail Omar M. , Poole Zachary B. , Donaldson Jared C. , Van Buren Eric , Lin Feng-Chang , Ulrich Jan N. , Davis Richard M.
Published: June 2019

Purpose:

The purpose of this article is to investigate how age-related macular degeneration (AMD) is associated with anxiety and depression.

Methods:

An online repository of deidentified patient data was queried to identify and retrospectively analyze patients with AMD, depression, or anxiety via ICD-9 and ICD-10 codes. Odds ratios were calculated between AMD and anxiety and depression, respectively.

Results:

Of the 51 019 patients analyzed in this study, 11 681 (22.9%) had depression, 8727 (17.1%) had anxiety, and 2752 (5.4%) had AMD. The prevalence of anxiety among AMD patients was 18.2%, and the prevalence of depression among AMD patients was 25.0%. The odds of a patient with AMD carrying a diagnosis of anxiety are 1.3 (95% CI 1.2, 1.5) times higher than a patient without AMD, and the odds of carrying a diagnosis of depression are also 1.3 (95% CI 1.1, 1.4) times more likely.

Conclusions:

Patients with AMD have increased odds of suffering from comorbid anxiety and depression. Ophthalmologists should consider mental health screens and appropriate referrals as new diagnoses of AMD are made or as the disease progresses.
A study on the origin of the oracle bone inscription “qin” (禽)
Authors: Park Seok-hong
Published: June 2019

The oracle bone graphic qin “禽” is known as a character related to the hunting culture of ancient China. Qin is generally considered to be a hunting tool for birds, but there is still room for discussion as to what kind of hunting implements this graph depicted. This paper proposes a different hypothesis concerning the origin of the shape of qin based on various studies on Chinese ancient characters and ancient hunting cultures to help draw logical conclusions about the origin of the shape of qin.
Combined inhibition of Bcl-2 and NFκB synergistically induces cell death in cutaneous T-cell lymphoma
Authors: Froehlich Tabea C. , Müller-Decker Karin , Braun Jana D. , Albrecht Thomas , Schroeder Anne , Gülow Karsten , Goerdt Sergij , Krammer Peter H. , Nicolay Jan P.
Published: June 2019

Therapeutic options for cutaneous T-cell lymphoma (CTCL) are limited and curative treatment regimens are not available. Thus, new targeted and well-tolerated therapeutic approaches are urgently needed. In this respect, we have recently shown that dimethyl fumerate (DMF) inhibits NF-κB acting as a survival factor in CTCL. Similarly, inhibition of the antiapoptotic protein B-cell lymphoma 2 (Bcl-2) has been shown to induce cell death in CTCL especially when combined with histone deacetylase inhibitors. Therefore, we hypothesized that inhibition of Bcl-2 should potentiate NF-κB inhibition in a novel combination treatment of CTCL. We show that, in vitro, the Bcl-2 inhibitors ABT-199 and ABT-263 induced specific cell death in primary CD4+ cells from CTCL patients as well as in the CTCL cell line SeAx, but not in T cells of healthy donors nor in the CTCL cell line HH, which lacks Bcl-2. Combined treatment with ABT-199 and DMF caused synergistic cell death specifically in CTCL cells engaging 2 independent signaling pathways. To verify these findings in vivo, we performed combined ABT-199 and DMF treatment in a xenograft mouse model for CTCL. The combined treatment effectively reduced tumor growth and increased overall survival via synergistic induction of CTCL cell death and suppression of tumor cell proliferation. Essentially, the combination treatment was superior to ABT-199 monotherapy with respect to both efficacy and tolerability. To sum up, our data provide proof of principle for the therapeutic potential of combining Bcl-2 and NF-κB inhibitors in treating CTCL. Next, this potential should be explored further in a clinical study.
Process evaluation of the Healthy Primary School of the Future: the key learning points
Authors: Bartelink N. H. M. , van Assema P. , Jansen M. W. J. , Savelberg H. H. C. M. , Moore G. F. , Hawkins J. , Kremers S. P. J.
Published: June 2019

Background

While schools have potential to contribute to children’s health and healthy behaviour, embedding health promotion within complex school systems is challenging. The ‘Healthy Primary School of the Future’ (HPSF) is an initiative that aims to integrate health and well-being into school systems. Central to HPSF are two top-down changes that are hypothesized as being positively disruptive to the Dutch school system: daily free healthy lunches and structured physical activity sessions. These changes are expected to create momentum for bottom-up processes leading to additional health-promoting changes. Using a programme theory, this paper explores the processes through which HPSF and the school context adapt to one another. The aim is to generate and share knowledge and experiences on how to implement changes in the complex school system to integrate school health promotion.

Methods

The current study involved a mixed methods process evaluation with a contextual action-oriented research approach. The processes of change were investigated in four Dutch primary schools during the development year (2014–2015) and the first two years of implementation (2015–2017) of HPSF. The schools (each with 15–26 teachers and 233–389 children) were in low socio-economic status areas. Measurements included interviews, questionnaires, observations, and analysis of minutes of meetings.

Results

Top-down advice, combined with bottom-up involvement and external practical support were key facilitators in embedding HPSF within the schools’ contexts. Sufficient coordination and communication at the school level, team cohesion, and feedback loops enhanced implementation of the changes. Implementation of the healthy lunch appeared to be disruptive and create momentum for additional health-promoting changes.

Conclusions

Initiating highly visible positive disruptions to improve school health can act as a catalyst for wider school health promotion efforts. Conditions to create a positive disruption are enough time, and sufficient bottom-up involvement, external support, team cohesion and coordination. The focus should be on each specific school, as each school has their own starting point and process of change.

Trial registration

The study was retrospectively registered in the ClinicalTrials.gov database on 14 June 2016 (NCT02800616).
Prediction of Low and Very Low Bone Mineral Density Among Adult Survivors of Childhood Cancer
Authors: van Atteveld Jenneke E. , Pluijm Saskia M.F. , Ness Kirsten K. , Hudson Melissa M. , Chemaitilly Wassim , Kaste Sue C. , Robison Leslie L. , Neggers Sebastian J.C.M.M. , Yasui Yutaka , van den Heuvel-Eibrink Marry M. , Wilson Carmen L.
Published: June 2019

PURPOSE

To develop and validate prediction models for low and very low bone mineral density (BMD) on the basis of clinical and treatment characteristics that identify adult survivors of childhood cancer who require screening by dual-energy x-ray absorptiometry.

PATIENTS AND METHODS

White survivors of childhood cancer (n = 2,032; median attained age, 29.3 years [range, 18.1 to 40.9 years]) enrolled in the St Jude Lifetime Cohort (SJLIFE; development) and survivors treated at the Erasmus Medical Center (validation) in the Netherlands (n = 403; median age, 24.2 years [range, 18.0 to 40.9 years]) were evaluated with dual-energy x-ray absorptiometry to determine lumbar spine BMD and total-body BMD. Low and very low BMD were defined as lumbar spine BMD and/or total-body BMD z scores of −1 or lower or −2 or lower, respectively. Multivariable logistic regression was used to build prediction models; performance was assessed using receiver operating characteristic curves. Diagnostic values were calculated at different probabilities.

RESULTS

Low BMD was present in 51% and 45% of SJLIFE and Dutch participants, respectively, and very low BMD was present in 20% and 10%, respectively. The model for low BMD included male sex (odds ratio [OR], 3.07), height (OR, 0.95), weight (OR, 0.98), attained age (OR, 0.97), current smoking status (OR, 1.48), and cranial irradiation (OR, 2.11). Areas under the curve were 0.72 (95% CI, 0.70 to 0.75) in the SJLIFE cohort and 0.69 (95% CI, 0.64 to 0.75) in the Dutch cohort. The sum of the sensitivity (69.0%) and specificity (64.0%) was maximal at the predicted probability of 50%. The model for very low BMD included male sex (OR, 3.28), height (OR, 0.95), weight (OR, 0.97), attained age (OR, 0.98), cranial irradiation (OR, 2.07), and abdominal irradiation (OR, 1.61), yielding areas under the curve of 0.76 (95% CI, 0.73 to 0.78; SJLIFE cohort) and 0.75 (95% CI, 0.67 to 0.83; Dutch cohort).

CONCLUSION

Validated prediction models for low and very low BMD, using easily measured patient and treatment characteristics, correctly identified BMD status in most white adult survivors through age 40 years.
Late Relapses in Patients With Diffuse Large B-Cell Lymphoma Treated With Immunochemotherapy
Authors: Wang Yucai , Farooq Umar , Link Brian K. , Larson Melissa C. , King Rebecca L. , Maurer Matthew J. , Allmer Cristine , Hefazi Mehrdad , Thompson Carrie A. , Micallef Ivana N. , Johnston Patrick B. , Habermann Thomas M. , Witzig Thomas E. , Ansell Stephen M. , Cerhan James R. , Nowakowski Grzegorz S.
Published: June 2019

PURPOSE

In patients with diffuse large B-cell lymphoma (DLBCL), most relapses occur within the first 2 years of diagnosis. We sought to define the rate and outcome of late relapses that occurred after achieving event-free survival at 24 months (EFS24).

METHODS

We prospectively followed 1,324 patients with newly diagnosed DLBCL from 2002 to 2015 and treated with immunochemotherapy. Cumulative incidences of late DLBCL and indolent lymphoma relapses were analyzed as competing events. Postrelapse survival was defined as time from first relapse to death from any cause.

RESULTS

In 847 patients who achieved EFS24, the cumulative incidence of late relapse was 6.9% at 3 years, 9.3% at 5 years, and 10.3% at 8 years after EFS24. The incidence of DLBCL relapse was similar in patients with DLBCL alone at diagnosis (6.3% at 5 years), compared with patients with concurrent indolent lymphoma at diagnosis (5.2%; P = .46). However, the rate of indolent lymphoma relapse was higher in patients with concurrent indolent lymphoma (7.4% v 2.1% at 5 years; P < .01). In patients with DLBCL alone, the rate of DLBCL relapse was similar in the germinal center B-cell–like (GCB) (4.1% at 5 years) and non-GCB (4.0%; P = .71) subtypes, whereas the rate of indolent lymphoma relapse was higher in patients with the GCB subtype (3.9% v 0.0% at 5 years; P = .02). Postrelapse survival was inferior for patients who relapsed with DLBCL than for those who relapsed with indolent lymphoma (median 29.9 months v unreached; P < .01).

CONCLUSION

Patients with DLBCL with a concurrent indolent lymphoma and those with the GCB subtype had a higher rate of late relapse, owing to increased relapses with indolent lymphoma. Patients who relapsed with DLBCL had a worse prognosis than those who relapsed with indolent lymphoma.
Interdisciplinary Chemistry Based on Integration of Liquid Crystals and Conjugated Polymers: Development and Progress
Authors: Akagi Kazuo
Published: June 2019

The helical structures and optoelectronic functions of conjugated polymers were dynamically controlled using an external force-responsive liquid crystal field, leading to cultivation and development of a novel research field named “Interdisciplinary Chemistry Based on Integration of Liquid Crystals and Conjugated Polymers”. First the external stimuli-responsive liquid crystal field was prepared to construct super-hierarchical helical structures of the conjugated polymers. Subsequently, the chiroptical properties including circularly polarized luminescence were enhanced and controlled. Furthermore, the helical carbons and graphites films were prepared via morphology-retaining carbonization using chemically or electrochemically doped conjugated polymers as precursors.
Ischemic Preconditioning Maintains Performance on Two 5-km Time Trials in Hypoxia
Authors: DA MOTA GUSTAVO R. , WILLIS SARAH J. , SOBRAL NELSON DOS SANTOS , BORRANI FABIO , BILLAUT FRANÇOIS , MILLET GRÉGOIRE P.
Published: June 2019

Purpose

The ergogenic effect of ischemic preconditioning (IPC) on endurance exercise performed in hypoxia remains debated and has never been investigated with successive exercise bouts. Therefore, we evaluated if IPC would provide immediate or delayed effects during two 5-km cycling time trials (TT) separated by ~1 h in hypoxia.

Methods

In a counterbalanced randomized crossover design, 13 healthy males (27.5 ± 3.6 yr) performed two maximal cycling 5-km TT separated by ~1 h of recovery (TT1 25 min and TT2 2 h post-IPC/SHAM), preceded by IPC (3 × 5 min occlusion 220 mm Hg/reperfusion 0 mm Hg, bilaterally on thighs) or SHAM (20 mm Hg) at normobaric hypoxia (fraction of inspired oxygen [FiO2] of 16%). Performance and physiological (i.e., oxyhemoglobin saturation, heart rate, blood lactate, and vastus lateralis oxygenation) parameters were recorded.

Results

Time to complete (P = 0.011) 5-km TT and mean power output (P = 0.005) from TT1 to TT2 were worse in SHAM, but not in IPC (P = 0.381/P = 0.360, respectively). There were no differences in time, power output, or physiological variables during the two TT between IPC and SHAM. All muscle oxygenation indices differed (P < 0.001) during the IPC/SHAM with a greater deoxygenation in IPC. During the TT, there was a greater concentration of total hemoglobin in IPC than SHAM (P = 0.047) and greater total hemoglobin in TT1 than TT2. Further, the concentration of oxyhemoglobin was lower during TT2 than TT1 (P = 0.005).

Conclusion

In moderate hypoxia, IPC allowed maintaining a higher blood volume during a subsequent maximal exercise, mitigating the performance decrement between two consecutive cycling TT.
Ultrasound Does Not Detect Acute Changes in Glycogen in Vastus Lateralis of Man
Authors: ROUTLEDGE HARRY E. , BRADLEY WARREN J. , SHEPHERD SAM O. , COCKS MATTHEW , ERSKINE ROBERT M. , CLOSE GRAEME L. , MORTON JAMES P.
Published: June 2019

Purpose

To examine the validity of ultrasound (via cloud-based software that measures pixilation intensity according to a scale of 0–100) to noninvasively assess muscle glycogen in human skeletal muscle.

Methods

In study 1, 14 professional male rugby league players competed in an 80-min competitive rugby league game. In study 2 (in a randomized repeated measures design), 16 recreationally active males completed an exhaustive cycling protocol to deplete muscle glycogen followed by 36 h of HIGH or LOW carbohydrate intake (8 g·kg−1 vs 3 g·kg−1 body mass). In both studies, muscle biopsies and ultrasound scans were obtained from the vastus lateralis (at 50% of the muscle length) before and after match play in study 1 and at 36 h after glycogen depletion in study 2.

Results

Despite match play reducing (P < 0.01) muscle glycogen concentration (pregame: 443 ± 65; postgame: 271 ± 94 mmol·kg−1 dw, respectively) in study 1, there were no significant changes (P = 0.4) in ultrasound scores (pregame: 47 ± 6, postgame: 49 ± 7). In study 2, muscle glycogen concentration was significantly different (P < 0.01) between HIGH (531 ±129 mmol·kg−1 dw) and LOW (252 ± 64 mmol·kg−1 dw) yet there was no difference (P = 0.9) in corresponding ultrasound scores (HIGH: 56 ± 7, LOW: 54 ± 6). In both studies, no significant correlations (P > 0.05) were present between changes in muscle glycogen concentration and changes in ultrasound scores.

Conclusions

Data demonstrate that ultrasound (as based on measures of pixilation intensity) is not valid to measure muscle glycogen status within the physiological range (i.e., 200–500 mmol·kg−1 dw) that is applicable to exercise-induced muscle glycogen utilization and postexercise muscle glycogen resynthesis.
Two Birds, One Stone: Joint Timing of Returns and Capital Gains Taxes
Authors: Lei Yaoting , Li Ya , Xu Jing
Published: June 2019

In asset return predictability, realized returns and future expected returns tend to move in opposite directions. This generates a tension between tax- and market-timing incentives. In this study, a portfolio choice problem in the presence of both return predictability and capital gains tax is examined. We characterize various features of the optimal trading strategy, and demonstrate that the optimal strategy helps mitigate the tension between market- and tax-timing. The calibrated model suggests that return predictability can significantly increase both the utility loss due to capital gains tax and the value of deferring capital gains realization. Overall, our results suggest that the nature of the asset return process can have important implications for the welfare effects of capital gains tax.

This paper was accepted by Karl Diether, finance.
Participation in leisure-time activities and the role of individual factors in children and adolescents with cerebral palsy
Authors: Amiri Alireza , Kalantari Minoo , Rezaee Mehdi , Baghban Alireza Akbarzadeh
Published: June 2019

Background/Aims

This study evaluated the role of individual factors of children and adolescents with cerebral palsy in the prediction of leisure participation.

Methods

A cross-sectional study design was used. A group of children and adolescents with cerebral palsy were selected to complete the Children's Assessment of Participation and Enjoyment. Participants' cognitive levels were assessed based on the Study of Participation of Children with Cerebral Palsy Living in Europe estimated cognitive levels.

Findings

The models could best predict up to 31.8% of the variance in the participation rates, 28.4% of the variance in the frequency scores and 33.5% of the variance in the enjoyment scores of leisure domains. The type of cerebral palsy was one of the most significant predictive factors of leisure participation (β ranged from −0.177 to −0.525 for quadriplegia).

Conclusions

Therapists and rehabilitation specialists may consider individual factors to predict a proportion of leisure participation subscales before planning for interventions aimed at promoting the leisure participation of children and adolescents with cerebral palsy.
Cross-cultural adaptation and clinical evaluation of a Korean version of the Work, Osteoarthritis or joint-Replacement Questionnaire
Authors: Lee Gyu-wan , Yi Chung-hwi , Kim Gyoung-mo , Lee Young-jung , Yoon Jang-whon
Published: June 2019

Background and aim

The Work Osteoarthritis or joint-Replacement Questionnaire (WORQ) is a new assessment tool developed in the Netherlands. It needs translation and cross-cultural adaptation for use in each country. The aim of this study was to translate the Work Osteoarthritis or joint-Replacement Questionnaire into Korean and to verify its reliability and validity.

Methods

To evaluate the clinimetric quality of the Korean-WORQ, we performed tests for internal consistency (Cronbach's alpha), reliability (intra-class correlation coefficients) and concurrent validity (Spearman's correlation coefficient). Factor analysis was carried out to identify the principal components of the questionnaire.

Findings

Both the internal consistency and intra-class correlation coefficients showed the reliability of the Korean-WORQ to be excellent. The Korean-WORQ had a strong positive correlation with the Western Ontario and McMaster Universities Osteoarthritis Index and three components were extracted in factor analysis.

Conclusions

Based on these results, the Korean-WORQ seems to be a suitable questionnaire for assessing the disability levels of patients with knee injuries.
Stigmatisation and societal pressure in patients with skin conditions
Authors: LONGHURST PHAEDRA
Published: June 2019

Skin conditions, such as psoriasis, rosacea and eczema, are associated with psychological comorbidities, including body dysmorphic disorder, depression, anxiety and suicidality. Those affected by these conditions report stigmatisation and social pressure. One way in which they are affected is in their diet. The inter-reationship between diet and skin conditions has a pathological basis. However, this is made more complex by the increasing influence of the media, including social media. The information that patients receive online is often not evidence-based and may lead to individuals manipulating their diets to treat and manage their skin conditions. Support from healthcare professionals is vital for treating or managing skin conditions, while also providing additional psychosocial intervention and support, where necessary. This article seeks to raise awareness of the perceived stigmatisation of those with a skin condition and the associated resulting behaviours. It will further reflect and discuss on the source and impact of pressures on diet, specifically disordered eating, and associated psychosocial concerns.
Pigmentation disorders: types, aetiology and treatment options
Authors: Tailor Rekha
Published: June 2019

Hyperpigmentation is a chronic skin disorder that can be very difficult to treat. Skin pigmentation disorders are commonly seen in women than in men, due to hormonal factors, and in those with darker skin types. Pigmentation disorders can cause significant stress for patients and can have a detrimental effect on their quality of life; it is therefore important that aesthetic practitioners have a sound understanding of the different types of hyperpigmentation and appropriate treatments. This article will explore pigmentation disorders and how they can be treated in aesthetic practice.
Seeing Like a European Border: Limits of the European Borders and Space
Authors: Grzymski Jan
Published: June 2019

The paper investigates the limits of EUrope - the leading theme of this special edition – in relation to EUropean space and borders. Drawing on Critical Border Studies, it attempts to overcome the academic accounts of the migration and border crisis, which are anchored in the
politicised opposition between opening and closing borders in EUrope and in its current central focus on 'effective protection' of EUrope's external borders. By looking at European Neighbourhood Policy and Schengen area, this article addresses the questions of what and where is EUrope's border
is now. In such context, the article concludes with exposing some of the crucial limits of EUropean space and borders that are located in contradictory nature of EU's power of attraction to non-EUrope, which is fuelling current practices of walling against non-EUrope.
A INSUFICIÊNCIA DO USO DO CONCEITO DE TRADIÇÃO PELA CRÍTICA HERMENÊUTICA DO DIREITO
Authors: Filho Paulo Ferrareze
Published: June 2019

O presente diagnóstico busca demonstrar que o uso do conceitode tradição oriundo da hermenêutica filosófica não é capaz de subsidiar apossibilidade de respostas corretas em Direito, tal qual propugna, via Dworkin e Gadamer, a Crítica Hermenêutica do Direito (CHD). Para tanto, o diagnóstico analisa características mitológicas da figura de Hermes Trismegistos, bem como operacionaliza os conceitos nietzschianos de perspectivismo e de morte de deus (história).