bluuebunny/crossref_metadata_2025 huggingface dataset:
From Isolation to Connection: The Practices and Promise of Open Domestic Violence Shelters
Authors: Goodman Lisa A. , Epstein Deborah , Hailes Helen P. , Slocum Allison , Wolff Jonathan , Coyne Kelly , McCraney Amy
Published: October 2020

Antidomestic violence advocates have begun to question two essential policies that have long defined domestic violence shelters—strict secrecy regarding shelter location and prohibitions on shelter access to all except staff and residents—both of which serve to increase survivors’ social isolation and entail coercive rules that resonate painfully with broader oppressive dynamics. In response a growing number of communities have begun experimenting with open shelters, which break from tradition by making their locations public, and allowing visitors. Although this innovation is a sharp departure from tradition, virtually no research exists to explore its philosophical underpinnings, benefits, and challenges. This study addresses this gap. Study Questions: We used a qualitative descriptive approach to explore the experiences and perspectives of open shelter directors. Participants included 14 open shelter directors from 11 states. We conducted semistructured phone interviews with each participant, focusing on their shelter’s (a) nature and history; (b) rationale; (c) policies and programs related to secrecy and openness; (d) benefits and challenges; (e) effects on specific survivor subgroups; and (f) practices used to build or strengthen survivors’ relationships. Open shelters: (a) promote physical safety using a broad array of measures; (b) adopt a range of policies that promote varying degrees of location disclosure and visitor accessibility; (c) face challenges, such as the need to gain buy-in from multiple constituents; and (d) Improve survivor outcomes, including decreased shame; improved advocacy relationships; increased access to services and community involvement in shelter life; and deepened relationships with network members; in turn increasing prospects for physical and psychological well-being long after survivors’ shelter stays are over. Findings suggest a new path for shelters interested in promoting survivor safety and healing in the context of a web of meaningful relationships.
Ethical Resistance: Modernity, Revisionism, and the Warsaw School of the History of Ideas
Authors: Błesznowski Bartłomiej
Published: October 2020

In this article, I reflect on the Warsaw school of the history of ideas (WSHI), a loose collective of people that formed after the birth of the communist system in Poland. First, I analyse the biographical factors that determined the political and intellectual choices of the WSHI members. Next, I attempt to show the nature of their public attitudes, which can be seen as part of the habitus of post-war Marxist intellectuals in Poland. My aim is to investigate how it happened that the WSHI, which was an element of Polish state at the beginning, became, in the 1960s, one of the primary points of contestation in Poland and an indicator of the collapse of the project of institutionalising Marxism-Leninism in Polish universities. I assume that the transformation did not entail a simple transmission from the nineteenth century to post-war revisionism but instead implied a series of breaks with, and migrations of, ideological models. Therefore, this analysis does not trace the line that separated the Polish leftist tradition from post-war communism, but rather describes their relationship, showing how the ethos of the socially engaged intelligentsia in Poland fitted into scholarly post-war biographies. My hypothesis is the following: in the case of the WSHI, the element of connection was a feature that Andrzej Mencwel refers to as “culturalism”—an ethical attitude inherited from earlier generations of leftist humanists.
Preparing for a future career through entrepreneurship education: Towards a research agenda
Authors: Killingberg Nils Magne , Kubberød Elin , Blenker Per
Published: October 2020

Although most students of entrepreneurship education find employment in established organizations after graduation, the employability of entrepreneurship education graduates remains largely overlooked in the education research literature. In this conceptual paper, the authors address this gap to motivate a future research agenda. The paper describes how entrepreneurship education may enable or impede the graduates’ entrance, development and transition in the labour market. To develop the theoretical arguments, the authors build on a processual conceptualization of employability. Seven propositions are presented to conceptually explore how competencies that are obtained through entrepreneurship education may influence the employability of graduates in a dynamic labour market. The propositions lay the groundwork for future studies on entrepreneurship education graduates’ employability and set a research agenda for how the employability of these graduates could be studied.
Efficient synthesis of cucurbiturils and their derivatives using mechanochemical high-speed ball milling (HSBM)
Authors: Xu Wenhao , Li Chengyu
Published: October 2020

Under solid-phase conditions, mechanical ball milling can be used to selectively prepare cucurbit[6]uril (CB[6]) and its derivatives without the use of catalysts and solvents. Using response surface method to determine the optimal conditions for the synthesis of CB[6]. The yield of CB[6] and its derivatives is 75–95%, with a high selectivity of more than 95%. In the synthesis of CB[6] using this method, the amount of acid required is significantly less, no organic solvent is needed, and the preparation of the fully aryl-substituted CB[6] is possible, which is otherwise difficult to be synthesized directly using traditional methods. Mechanical ball milling, thus, is of great significance in the synthesis and research of new cucurbituril supramolecules. Process scale-up experiments show that the yield and selectivity of the various types of cucurbiturils is higher than 95%, because of which they find good industrial applications.
Active disturbance rejection control for bearingless permanent-magnet slice motor based on nonlinear phase-locked loop observer
Authors: Zhang Yifan , Ruan Xiaodong , Hu Liang , Li Lingling , Li Bo , Chen Xin
Published: October 2020

In this paper, an active disturbance rejection control (ADRC) controller based on a novel nonlinear phase-locked loop observer (NPLLO) is proposed to improve the disturbance rejection property and suspension performance of bearingless permanent-magnet slice motor (BPMSM) for bearingless pumps. First, based on the mathematical model of BPMSM for bearingless pumps, the novel NPLLO, a structure derived from the nonlinear phase-locked loop (PLL) and combining a special nonlinear function, is designed to estimate the uncertainties and load/radial disturbance in real time. Second, NPLLO-based ADRC (NP-ADRC) controllers are designed for rotation and suspension, respectively. Third, the parameter tuning of NP-ADRC is analyzed. Finally, NP-ADRC is analyzed with simulation in MATLAB/Simulink and verified on a BPMSM test bench. Both simulation and experimental results verified the effectiveness of the proposed method.
Experimental investigation on resistance spot welding of dissimilar weld joints
Authors: Verma Rohit , Arora Kanwer Singh , Sharma Lochan , Chhibber Rahul
Published: October 2020

In the present study, galvanized High Strength Interstitial Free (HIF) steel sheets, and Dual Phase (DP780) steel sheets were used for the investigations. Resistance spot weld joints were fabricated between dissimilar steel sheets. The variation in dynamic resistance (DR) with the change in welding process parameters such as weld current, weld time and electrode force were used for establishing the range of adequate weld nugget formation parameters. Effect of these parameters over tensile strength, nugget diameter and the observed failure mode was studied using one factor at a time (OFAT) approach. Microstructure and hardness of parent metal, fusion & HAZ region has also been studied.
Une mise à jour du féminisme de Chloé Delaume : des Mouflettes d’Atropos à Mes bien chères sœurs
Authors: Cornelio Dawn
Published: October 2020

Chloé Delaume est souvent décrite comme féministe, mais peu de chercheur.euse.s font l’analyse directe de cet aspect de son œuvre, du moins, jusqu’à la publication de Les Sorcières de la République (2016) et Mes bien chères sœurs (2019), deux textes – un roman et un manifeste – où le féminisme passe au premier plan. En juxtaposant ces deux ouvrages au tout premier, Les Mouflettes d’Atropos (2002 [2000]), cet essai examinera le féminisme – et son évolution – aux deux extrêmes chronologiques des écrits de Delaume. Il démontrera comment le féminisme chez Delaume progresse d’un point de vue qui se concentre sur une seule femme et sa vie à un point de vue qui favorise le féminisme « sororal », de masse, et des conseils précis de l’autrice pour progresser et changer la société.
Impact of autoimmune cytopenias on severity of childhood-onset systemic lupus erythematosus: A single-center retrospective cohort study
Authors: Ogbu Ekemini A , Chandrakasan Shanmuganathan , Rouster-Stevens Kelly , Greenbaum Larry A , Sanz Ignacio , Gillespie Scott E , Marion Chelsea , Okeson Karli , Prahalad Sampath
Published: October 2020

Objective

To assess whether children with autoimmune cytopenias prior to or at diagnosis of systemic lupus erythematosus (cSLE), differ phenotypically from other cSLE patients; and have a lower risk and severity of lupus nephritis (LN) as observed in prior adult studies. To assess the effect of prior immune therapy for autoimmune cytopenias on 2-year risk of LN.

Methods

This was a retrospective cohort study of incident cSLE cases. We included patients aged less than 17 years at diagnosis. We excluded patients with LN at cSLE diagnosis. Our follow-up period was 2 years. We defined autoimmune cytopenias as either autoimmune hemolytic anemia, immune thrombocytopenia or Evan’s syndrome.

Results

Forty-three (33%) of the 130 patients had autoimmune cytopenias before or at cSLE diagnosis. Those with autoimmune cytopenias had significantly more neuropsychiatric symptoms and higher mean ESR but less arthritis, malar rash and myositis versus those without autoimmune cytopenias. They had lower 2-year incidence proportion of LN compared to other cSLE patients (7% vs 15%). Of the 16 patients who developed LN, those with autoimmune cytopenias had mostly class V (2 of 3 patients) versus mostly class III and IV in those without autoimmune cytopenias (6 of 12 patients). None of the 13 patients pre-treated for autoimmune cytopenias developed LN.

Conclusion

Patients with autoimmune cytopenias before or at cSLE diagnosis have intriguing differences from other cSLE patients. They may represent a unique sub-type of cSLE patients and should be further explored.
Development of a mixture model allowing for smoothing functions of longitudinal trajectories
Authors: Ding Ming , Chavarro Jorge E. , Fitzmaurice Garrett M.
Published: October 2020

In the health and social sciences, two types of mixture models have been widely used by researchers to identify participants within a population with heterogeneous longitudinal trajectories: latent class growth analysis and the growth mixture model. Both methods parametrically model trajectories of individuals, and capture latent trajectory classes, using an expectation–maximization algorithm. However, parametric modeling of trajectories using polynomial functions or monotonic spline functions results in limited flexibility for modeling trajectories; as a result, group membership may not be classified accurately due to model misspecification. In this paper, we propose a smoothing mixture model allowing for smoothing functions of trajectories using a modified algorithm in the M step. Specifically, participants are reassigned to only one group for which the estimated trajectory is the most similar to the observed one; trajectories are fitted using generalized additive mixed models with smoothing functions of time within each of the resulting subsamples. The smoothing mixture model is straightforward to implement using the recently released “ gamm4” package (version 0.2–6) in R 3.5.0. It can incorporate time-varying covariates and be applied to longitudinal data with any exponential family distribution, e.g., normal, Bernoulli, and Poisson. Simulation results show favorable performance of the smoothing mixture model, when compared to latent class growth analysis and growth mixture model, in recovering highly flexible trajectories. The proposed method is illustrated by its application to body mass index data on individuals followed from adolescence to young adulthood and its relationship with incidence of cardiometabolic disease.
BMP Antagonists Secreted by Mesenchymal Stromal Cells Improve Colonic Organoid Formation: Application for the Treatment of Radiation-induced Injury
Authors: Moussa Lara , Lapière Alexia , Squiban Claire , Demarquay Christelle , Milliat Fabien , Mathieu Noëlle
Published: October 2020

Radiation therapy is crucial in the therapeutic arsenal to cure cancers; however, non-neoplastic tissues around an abdominopelvic tumor can be damaged by ionizing radiation. In particular, the radio-induced death of highly proliferative stem/progenitor cells of the colonic mucosa could induce severe ulcers. The importance of sequelae for patients with gastrointestinal complications after radiotherapy and the absence of satisfactory management has opened the field to the testing of innovative treatments. The aim of this study was to use adult epithelial cells from the colon, to reduce colonic injuries in an animal model reproducing radiation damage observed in patients. We demonstrated that transplanted in vitro-amplified epithelial cells from colonic organoids (ECO) of C57/Bl6 mice expressing green fluorescent protein implant, proliferate, and differentiate in irradiated mucosa and reduce ulcer size. To improve the therapeutic benefit of ECO-based treatment with clinical translatability, we performed co-injection of ECO with mesenchymal stromal cells (MSCs), cells involved in niche function and widely used in clinical trials. We observed in vivo an improvement of the therapeutic benefit and in vitro analysis highlighted that co-culture of MSCs with ECO increases the number, proliferation, and size of colonic organoids. We also demonstrated, using gene expression analysis and siRNA inhibition, the involvement of bone morphogenetic protein antagonists in MSC-induced organoid formation. This study provides evidence of the potential of ECO to limit late radiation effects on the colon and opens perspectives on combined strategies to improve their amplification abilities and therapeutic effects.
Withdrawal of life-prolonging treatment in the face of severely limited resources: Ethical and legal analysis of the law in Israel
Authors: Gilbar Roy , Karako-Eyal Nili
Published: October 2020

The provision of lifesaving treatment subject to severely limited resources can lead to serious moral dilemmas and legal challenges on many levels. The issue becomes particularly acute in a crisis such as the current Covid-19 pandemic. In this context, legal questions arise regarding withdrawal of treatment, particularly withdrawal of ventilation. Israeli law prohibits withdrawal of ventilation, a situation that affects the prioritization criteria for patients who can benefit from ventilation. This issue is discussed in the context of the Covid-19 pandemic where the legal prohibition may lead to a situation in which patients will not have access to ventilators. In addition, a theoretical framework is proposed that includes not only beneficence, nonmaleficence, and distributive justice but also a relational approach to autonomy and justice. We also propose potential solutions under the current legal framework. Based on the legal analysis, it is proposed that Israeli law be amended so that more patients will have access to ventilation during a pandemic. It is argued that clinicians cannot act beneficently to prolong life if they ignore patients’ fundamental rights or the distributional effects of ethical policies. Autonomy and justice and their accompanying liberal and relational perspectives should remain relevant even during a pandemic, a time when resources are scarce.
Namibia’s Foreign Policy and Its Impact on Peace and Security in the Southern Africa Region: A Framework of Liberalism as a Theory of International Relations Studies
Authors: Mushelenga Peya
Published: October 2020

This article discusses aspects of Namibia’s foreign policy principles and how they impact on the values of democracy, and issue of peace and security in the region. The article will focus on the attainment of peace in Angola, democratisation of South Africa, and security situations in the Democratic Republic of Congo (DRC), Madagascar and Lesotho. The main question of this article is: To what extent has Namibia realised the objectives encapsulated in her foreign policy principles of striving for international peace and security and promote the values of democracy in the Southern African Development Community (SADC) region? The assumption is that though relatively a newly established state, Namibia has made her contribution towards democracy, peace and security in the Southern Africa region and the world at large.
Fatal Chlamydia psittaci infection in a domestic kitten
Authors: Sanderson Hailey , Vasquez Marce , Killion Hally , Vance Madison , Sondgeroth Kerry , Fox Jonathan
Published: October 2020

Chlamydia psittaci has not been reported to cause disease in domestic cats, to our knowledge. In contrast, C. felis infection is common in domestic cats and typically results in conjunctivitis, upper respiratory tract infection, and less frequently pneumonia. Herein, we report the pathologic findings and diagnostic features of a fatal case of psittacosis in a 7-wk-old domestic kitten. The animal was 1 of a litter of 5 that, together with the queen, were yielded to a pet rescue center in Wyoming. Over a period of ~3 wk, the kittens and queen became sick, thin, and icteric prior to death, despite antimicrobial treatments. Postmortem evaluation of a kitten revealed necrosuppurative hepatitis with Gimenez stain–positive intracellular bacteria, nonsuppurative pneumonia, and mild leptomeningitis. The diagnosis of psittacosis was made by 16S rRNA PCR using multiple primer sets and sequencing from liver. Psittacosis should be considered a differential diagnosis in domestic cats with intracellular bacterial hepatitis and interstitial pneumonia.
Networking, Social Skills and Launching a New Business: A 3-Year Study of Nascent Entrepreneurs
Authors: Klyver Kim , Arenius Pia
Published: October 2020

We combine insights from behavioral and skill perspectives on network agency to address how entrepreneurs’ networking with close social ties and weak ties influences business launch, and the extent to which social skills strengthened or weakened these influences. Combining network perspectives previously developed in parallel, we fill in the gap of how well entrepreneurs are networking. We find frequent networking with close social ties increases entrepreneurs’ chances of business launch when they have high social skills, but decreases their chances when they have low social skills, while networking with weak ties increases chances of business launch regardless of social skills.
“I’m Dealing With That”: Illness Concerns of African American and White Cancer Patients While Undergoing Active Cancer Treatments
Authors: Meghani Salimah H. , Levoy Kristin , Magan Kristin Corey , Starr Lauren T. , Yocavitch Liana , Barg Frances K.
Published: October 2020

Background:

National oncology guidelines recommend early integration of palliative care for patients with cancer. However, drivers for this integration remain understudied. Understanding illness concerns at the time of cancer treatment may help facilitate integration earlier in the cancer illness trajectory.

Objective:

To describe cancer patients’ concerns while undergoing cancer treatment, and determine if concerns differ among African Americans and Whites.

Methods:

A 1-time, semi-structured qualitative interview was conducted with a purposive subsample of cancer patients participating in a larger study of illness concerns. Eligible patients were undergoing cancer treatments and had self-reported moderate-to-severe pain in the last week. Analysis encompassed a qualitative descriptive approach with inductive thematic analysis.

Results:

Participants (16 African American, 16 White) had a median age of 53 and were predominantly females (72%) with stage III/IV cancer (53%). Illness concerns were largely consistent across participants and converged on 3 themes: symptom experience (pain, options to manage pain), cancer care delivery (communication, care coordination and care transitions), and practical concerns (access to community and health system resources, financial toxicity).

Conclusions:

The findings extend the scope of factors that could be utilized to integrate palliative care earlier in the cancer illness trajectory, moving beyond the symptoms- and prognosis-based triggers that typify current referrals to also consider diverse logistical concerns. Using this larger set of concerns aids anticipatory risk mitigation and planning (e.g. care transitions, financial toxicity), helps patients receive a larger complement of support services, and builds cancer patients’ capacity toward a more patient-centered treatment and care experience.
Understanding Asian Indian Americans’ Knowledge and Attitudes Toward Hospice Care
Authors: Shirsat Nikita , Hoe Deborah , Enguidanos Susan
Published: October 2020

Background:

Previous research has found racial differences in hospice knowledge and misconceptions about hospice care, which may hinder access to hospice care. Asian Indians are a rapidly growing population in the United States, yet limited research has focused on their beliefs toward end-of-life care. This project investigates Indian Americans’ knowledge of and attitudes toward hospice care and advance care planning.

Procedures:

A cross-sectional design was employed using surveys about participants’ knowledge of and attitudes toward hospice care and advance care planning. Surveys were conducted among Indian Americans, age 60 and over, recruited from Indian cultural centers in Northern California. The participants were first asked questions about hospice care. They were then given a summary explanation of hospice care and later asked about their attitudes toward hospice care. Data were analyzed using descriptive and bivariate analyses.

Results:

Surveys were completed by 82 participants. Findings revealed that 42.5% of respondents had an advance directive and 57.1% had named a health care proxy. Only 10% of respondents had known someone on hospice care and 10.4% correctly answered 4-5 of the knowledge questions. After being informed about hospice care, 69.6% of participants agreed that if a family member was extremely ill, they would consider enrolling him/her in hospice.

Conclusions:

This study’s results present a need for greater education about hospice services among older Asian Indians. Health practitioners should remain cognizant of potential misconceptions of hospice and cultural barriers that Asian Indians may have toward hospice care, so they can tailor conversations accordingly.
Evolving Goals of Care Discussions as Described in Interviews With Individuals With Advanced Cancer and Oncology and Palliative Care Teams
Authors: Dillon Ellis C. , Meehan Amy , Nasrallah Catherine , Lai Steve , Colocci Natalia , Luft Hal
Published: October 2020

Background:

Individuals with advanced cancer and their families have negative end-of-life experiences when the care they receive is not aligned with their values and preferences.

Objective:

To obtain in-depth information on how patients with advanced cancer and the oncology and palliative care (PC) clinicians who care for them discuss goals of care (GoC).

Design:

The research team conducted in-depth interviews and qualitative data analysis using open coding to identify how perspectives on GoC discussions vary by stage of illness, and experience with PC teams.

Setting/Subjects:

Twenty-five patients and 25 oncology and PC team members in a large multi-specialty group in Northern California.

Results:

At the time of diagnosis participants described having establishing GoC conversations about understanding the goal of treatment (e.g. to extend life), and prognosis (“How much time do I have?”). Patients whose disease progressed or pain/symptoms increased reported changing GoC conversations about stopping treatment, introducing hospice care, prognostic awareness, quality of life, advance care planning, and end-of-life planning. Participants believed in the fluidity of prognosis and preferences for prognostic communication varied. Patients appreciated how PC teams facilitated changing GoC conversations. Timing was challenging; some patients desired earlier conversations and PC involvement, others wanted to wait until things were “going downhill.”

Conclusion:

Patients and clinical teams acknowledged the complexity and importance of GoC conversations, and that PC teams enhanced conversations. The frequency, quality, and content of GoC conversations were shaped by patient receptivity, stage of illness, clinician attitudes and predispositions toward PC, and early integration of PC.
The Role of Regional and State Initiatives in Nursing Home Advance Care Planning Policies
Authors: Fu Caroline J. , Agarwal Mansi , Estrada Leah V. , Murali Komal P. , Quigley Denise D. , Dick Andrew W. , Stone Patricia W.
Published: October 2020

Objective:

Antibiotic use at the end of life (EoL) may introduce physiological as well as psychological stress and be incongruent with patients’ goals of care. Advance care planning (ACP) related to antibiotic use at the EoL helps improve goal-concordant care. Many nursing home (NH) residents are seriously ill. Therefore, we aimed to examine whether state and regional ACP initiatives play a role in the presence of “do not administer antibiotics” orders for NH residents at the EoL.

Methods:

We surveyed a random, representative national sample of 810 U.S. NHs (weighted n = 13,983). The NH survey included items on “do not administer antibiotics” orders in place and participation in infection prevention collaboratives. The survey was linked to state Physician Orders for Life-Sustaining Treatment (POLST) adoption status and resident, facility, and county characteristics data. We conducted multivariable regression models with state fixed effects, stratified by state POLST designation.

Results:

NHs in mature POLST states reported higher rates of “do not administer antibiotics” orders compared to developing POLST states (10.1% vs. 4.6%, respectively, p = 0.004). In mature POLST states, participation in regional collaboratives and smaller NH facilities (<100 beds) were associated with having “do not administer antibiotics” orders for seriously ill residents (β = 0.11, p = 0.006 and β = 0.12, p = 0.003, respectively).

Discussion:

NHs in states with mature POLST adoption that participated in infection control collaboratives were more likely to have “do not administer antibiotics” orders. State ACP initiatives combined with regional antibiotic stewardship initiatives may improve inappropriate antibiotic use at the EoL for NH residents.
Can Assistant Principals’ Years of Experience Make a Difference in School Suspensions? A State-wide Analysis of North Carolina Assistant Principals
Authors: Williams John A. , Davis Alicia , Richardson Sonyia C. , Lewis Chance W.
Published: October 2020

School discipline disparities within the U.S. P-12 public schooling system have been a staple issue for over four decades. The enforcement of out-of-school suspensions, in particular by inexperienced teachers, have traditionally impacted Black and Latinx students more than White students. Yet teachers are not the final decision-makers regarding student discipline which rests primarily on the shoulders of assistant principals and principals. While researchers have clearly linked teacher experience to discipline disparities, more research is needed to fully explicate the tenure of assistant principals; who often are the final decision-makers when it pertains to suspending a student. Utilizing human capital theory, this study examines school discipline data and North Carolina personnel data from the 2015–2016 school year to determine if assistant principals’ years of experience in the current role, and their years of experience as teachers could predict out-of-school suspensions by gender and race. The findings suggest that Black males’ suspension could be predicted by assistant principals’ years of experience as a teacher; and Latinx females’ suspensions could be predicted by assistant principals’ longevity in their current position and in their roles as classroom teachers. Interestingly, the findings illuminate that assistant principals are relatively inexperienced within the state, with most having less than one-year worth of experience in these positions.
Parents of Children With Nonsyndromic Orofacial Clefting Show Altered Palate Shape
Authors: El Sergani Ahmed M. , Brandebura Stephanie , Padilla Carmencita , Butali Azeez , Adeyemo Wasiu L. , Valencia-Ramírez Consuelo , Muñeton Claudia P. Restrepo , Moreno Lina M. , Buxó Carmen J. , Long Ross E. , Neiswanger Katherine , Shaffer John R. , Marazita Mary L. , Weinberg Seth M.
Published: October 2020

Objective:

The unaffected relatives of individuals with nonsyndromic orofacial clefts have been shown to exhibit subtle craniofacial differences compared with the general population. Here, we investigate whether these morphological differences extend to the shape of the palate.

Design:

We conducted a geometric morphometric analysis to compare palate shape in the clinically unaffected parents of children with nonsyndromic cleft lip with or without cleft palate and adult controls of European, Asian, and African ancestry. We conducted pairwise group comparisons using canonical variates analysis, and then confirmed and characterized findings of shape differences using Euclidean distance matrix analysis.

Results:

Significant differences in palate shape were detected in unaffected mothers (but not fathers) compared to demographically matched controls. The differences in shape were ancestry-specific; mothers of Asian-derived and African-derived ancestry showed wider and shorter palates with higher posterior palatal vaults, while mothers of European-derived ancestry showed narrower palates with higher anterior palatal vaults.

Conclusions:

Our findings suggest that altered palate shape is a subclinical phenotypic feature, which may be indicative of elevated orofacial cleft risk. The risk phenotype varied by sex and ancestry, suggesting possible etiologic heterogeneity among demographic groups. Understanding the genetic basis of these informative palate shape traits may reveal new genes and pathways relevant to nonsyndromic orofacial clefting.
Maintaining coherence in the situated cognition debate: what computationalism cannot offer to a future post-cognitivist science
Authors: Casper Mark-Oliver , Artese Giuseppe Flavio
Published: October 2020

It has been claimed that post-cognitivist approaches to cognition might be compatible with computationalism. A growing number of authors argue that if computations are theorized as non-representational and mechanistic, then many concepts typical of the enactive approach can also be used in computational contexts and vice versa. In this article, we evaluate the solidity and coherence of this potential combination and shed light on some of the most important problems that have been neglected by its defenders. We conclude by arguing that this potential integration between enactivism and computationalism might not be a priori impossible but, at the moment, it is still seen as problematic at best.
Ins and Outs: Perspectives of Inpatient Prescribing for Sacubitril/Valsartan
Authors: Gillette Michael , Bozkurt Biykem
Published: October 2020

Heart failure is a major public health concern with a rising prevalence and significant financial detriment. Although sacubitril/valsartan was shown to reduce the risk of death and hospitalization from heart failure in a contemporary cohort, it continues to remain substantially underutilized. A recent article in the Annals highlights the evidence behind inpatient initiation of sacubitril/valsartan. We provide further considerations and summarize the evidence for inpatient initiation of other guideline directed medical therapies. Overall, there is a need to improve methods to identify ideal populations and increase utilization in those who may benefit from sacubitril/valsartan. Further research is also needed to identify the risks versus benefits among underrepresented populations (i.e., advanced heart failure, heart failure with preserved ejection fraction, in conjunction with other contemporary evidence-based therapies that can lower blood pressure, etc.).
Development and Validation of a Short Form of the College-Going Self-Efficacy Scale
Authors: Hardin Erin E. , Gibbons Melinda M. , Cook Katherine D. , Sexton Kody , Bagwell Leigh
Published: October 2020

Social Cognitive Career Theory is a useful framework for understanding educational attainment and reducing educational inequities. A key construct for middle and high school students is college-going self-efficacy. The College-Going Self-Efficacy Scale (CGSES) has been used to measure secondary students’ confidence in their abilities to attend and persist in post-secondary education, but with 30-items, it may be too lengthy for use with other measures in SCCT-grounded research in school settings. Using two independent samples of rural Appalachian high school students, we develop and validate the College-Going Self-Efficacy Scale-Short Form (CGSES-SF). This 14-item measure retains the full breadth of content from the original CGSES, demonstrates measurement equivalence across gender and prospective college generation status, and demonstrates good reliability and validity in these samples. Suggestions for future use of the CGSES-SF are provided.
Correlating Arthroscopic and Radiographic Findings of Deep Deltoid Ligament Injuries in Rotational Ankle Fractures
Authors: Arthur D’Ann , Pyle Casey , Shymon Stephen J. , Lee David , Harris Thomas
Published: October 2020

Background:

The deep deltoid ligament (DDL) is a key stabilizer to the medial ankle and ankle mortise and can be disrupted in ligamentous supination external rotation type IV (LSER4) ankle fractures. The purpose of this study was to define the medial clear space (MCS) measurement on injury mortise radiographs that corresponds with complete DDL injury.

Methods:

A retrospective record review at a level 1 hospital was performed identifying patients with LSER4 ankle fractures who underwent arthroscopy and open reduction internal fixation. Chart reviews provided arthroscopic images and operative reports. Complete DDL injury was defined as arthroscopic visualization of the posterior tibial tendon (PTT). Inability to completely visualize the PTT was defined as a partial DDL injury. MCS was measured on injury mortise radiographs. Eighteen subjects met inclusion criteria.

Results:

Twelve subjects had complete and 6 subjects had partial DDL injury based on arthroscopic findings. Patients with complete DDL injury and those with partial DDL injury had injury radiograph MCS ranging from 5.5 to 29.9 mm and 4.0 to 5.0 mm, respectively. All patients with MCS ≥5.5 mm on injury radiographs had complete DDL injury and all patients with MCS ≤5.0 mm on injury radiographs had partial DDL injury.

Conclusion:

Complete DDL injury was found on injury ankle mortise radiographs as MCS widening of ≥5.5 mm, which correlated with arthroscopic visualization of the PTT. Using this cutoff, surgeons can surmise the presence of a complete deltoid ligament injury, allowing for improved preoperative planning.

Level of Evidence:

Level III, retrospective comparative study.
Comparison of Light Transmission Aggregometry With Impedance Aggregometry in Patients on Potent P2Y12 Inhibitors
Authors: Wadowski Patricia P. , Pultar Joseph , Weikert Constantin , Eichelberger Beate , Lang Irene M. , Koppensteiner Renate , Panzer Simon , Gremmel Thomas
Published: October 2020

Since data on the agreement between light transmission aggregometry (LTA) and multiple electrode aggregometry (MEA) in patients on the more potent P2Y12 inhibitors are missing so far, we investigated if the evaluation of the responsiveness to therapy by LTA can be replaced by MEA in 160 acute coronary syndrome (ACS) patients on dual antiplatelet therapy with aspirin and prasugrel or ticagrelor (n = 80 each). Cut-off values for high on-treatment residual platelet reactivity (HRPR) in response to adenosine diphosphate (ADP) or arachidonic acid (AA) were defined according to previous studies showing an association of HRPR with the occurrence of adverse ischemic outcomes. ADP- inducible platelet aggregation was 33% and 37% ( P = 0.07) by LTA and 19 AU and 20 AU ( P = 0.38) by MEA in prasugrel- and ticagrelor-treated patients, respectively. AA- inducible platelet aggregation was 2% and 3% by LTA and 15 AU and 16 AU by MEA, (all P ≥ 0.3) in patients on prasugrel and ticagrelor, respectively. By LTA, HRPR ADP and HRPR AA were seen in 5%/5% and in 4%/ 13% of patients receiving prasugrel- and ticagrelor, respectively. By MEA, HRPR ADP and HRPR AA were seen in 3%/ 25% and 0%/24% of prasugrel- and ticagrelor-treated patients, respectively. ADP-inducible platelet reactivity by MEA correlated significantly with LTA ADP in prasugrel-treated patients (r = 0.4, P < 0.001), but not in those receiving ticagrelor (r = 0.09, P = 0.45). AA-inducible platelet aggregation by LTA and MEA did not correlate in prasugrel- and ticagrelor-treated patients. Sensitivity/specificity of HRPR by MEA to detect HRPR by LTA were 25%/99% for MEA ADP and 100%/79% for MEA AA in prasugrel-treated patients, and 0%/100% for MEA ADP and 70%/83% for MEA AA in ticagrelor-treated patients. In conclusion, on-treatment residual ADP-inducible platelet reactivity by LTA and MEA shows a significant correlation in prasugrel- but not ticagrelor-treated patients. However, in both groups LTA and MEA revealed heterogeneous results regarding the classification of patients as responders or non-responders to P2Y12 inhibition.
Diagnosis and Treatment of Deep Vein Thrombosis in the Emergency Department: Results of an Italian Nominal Group Technique Study
Authors: Salvi Aldo , Nitti Cinzia , Fabbri Andrea , Groff Paolo , Ruggiero Enrico Giuseppe , Agnelli Giancarlo
Published: October 2020

Early diagnosis and treatment of deep vein thrombosis (DVT) is a main issue in the Emergency setting. With the aim of assisting clinicians in the diagnosis and the subsequent management of DVT in the Emergency Departments, a Nominal Group Technique (NGT) study was conducted. A panel of 5 Italian experts developed 21 consensus statements based on available evidence and their clinical experience. The agreed consensus statements may assist clinicians in applying the results of clinical studies and clinical experience to routine care settings, providing guidance on all aspects of the risk assessment, prophylaxis, early diagnosis and appropriate treatment of DVT in the EDs.
Pediatric blinatumomab preparation: Risk assessment on SmPC for software compliance
Authors: Cirino Mario , Provasi Riccardo , Cebulec Irina , Palmieri Clara , Schincariol Paolo , Zanon Davide
Published: October 2020

Introduction

Blinatumomab is an anticancer drug used in the treatment of Acute Lymphoblastic Leukaemia (ALL) in both adults and children. ALL is the most common form of cancer in children and patients who are refractory to standard treatments have poor prognosis. The preparation of blinatumomab is unique and extremely complex. It’s important to carry out any information to identify all the critical issues related to the preparation of blinatumomab: sharing procedure between prescribers, staff of the Centralized Chemotherapy Preparation Unit [Unità Farmaci Antiblastici (UFA)] and administering nurses aimed at reducing the clinical risk related to the management of the drug blinatumomab and to obtain correct prescriptions on the real dose to be prepared, safe worksheets with computer processing of all variables (volumes to be added and corresponding dose of drug) and complete labels containing all the information necessary for the control of the preparation and its correct infusion.

Methods

A computerized process involves the use of specific software to which precise instructions must be given. This study is divided into two phases, the first one focused on the analysis of Summary of Product Characteristics (SmPC) and the extrapolation of any unclear part of SmPC. The second phase involved the manufacturer to answer a questionnaire.

Results

This comparison with the company allowed to perfect the blinatumomab preparation process leading to: 1. allow the patient to be discharged and return a few times for infusions and consequently reduce the number of medical prescriptions; 2. set up the drug for each patient every 4 days; 3. reduce costs related to devices, staff employed.

Conclusion

Computerizing the preparation of anti-blastic drugs is a necessary path for the safety of the patient and all the operators involved, however it may be necessary to make changes in the preparation process to allow the software to work correctly. The comparison between pharmacist, clinician and, where necessary, the manufacturer of the drug, was effective in the preparation of this drug.
Organization of chemotherapeutic preparations in advance: Do we save or waste money?
Authors: Desmaris Romain-Pacôme , Bermudez Elisabeth , Annereau Maxime , Lemare François , Slimano Florian
Published: October 2020

Objective

The development of oncology day-hospital activities contributes to increase quality of life of patients and consequently have changed their perception about waiting. The extemporaneous preparation of antineoplastic has become difficult to achieve given the increasing activity, and hospital pharmacists have taken up the challenge by the implementation of the antineoplastic preparation in anticipation. Because anticipation can lead to an important number of preparations to be discarded, we also develop a recycled process for other patients to limit these waste extra costs. We aim to demonstrate the positive balance of anticipated preparation in this 4-year study report. Data sources: This prospective study was conducted in a major European oncology day-hospital from January, 2012 to December, 2015. The data were extracted from our software WinSimbad™ and updated as needed. The number and cost-associated of preparation ungiven chemotherapy doses (recycled or discarded) were compared to the global drug budget of our hospital in order to not exceed 2%. Data summary: 303,100 antineoplastic have been prepared. Approximately 35% of them were anticipated with an average of 5,431±984 that were finally ungiven. Two-third was recycled and the cost of the ungiven preparations finally discarded represents 1.7±0.15% of the global drug budget.

Conclusions

This study assesses the drug wastage and its associated cost of this concept through a prospective study and discusses the cost of ungiven antineoplastic preparations. With prior consideration of the need to define the acceptable rate of discarded ungiven preparation, the hospitals with an high oncology day-hospital activity should implement this approach.
Exploring Black Girls’ Subversive Literacies as Acts of Freedom
Authors: Kelly Lauren Leigh
Published: October 2020

Research on Black girls’ and women’s literacies reveals how they utilize literacy practices to resist oppression and define their identities. Yet, these practices are frequently absent from or marginalized in formalized schooling spaces. In addition, Black girlhood is rarely placed at the center of equity interventions in schools. As the history of activism in the United States is tied to Black women’s struggles for freedom, research and practice involving racial equity must be attentive to the literacies and activism of Black girls. Grounded in Black feminist theory, this article describes a longitudinal study of the critical consciousness development of two young Black women as they engaged in distinct literacy practices to navigate and resist racial oppression in high school. The author analyzes interviews as well as literacy artifacts to explore how these girls enacted critical, digital, and subversive literacies to challenge intersecting oppressions of race and gender in a predominantly White, suburban school.
Teaching Early Learners With Autism to Follow Written Directions: Making Text Mediate Action to Promote Independence
Authors: Mariage Troy V. , Englert Carol Sue , Plavnick Joshua B.
Published: October 2020

Many individuals with autism spectrum disorder (ASD) can effectively decode and read words fluently, but have significantly below-average understanding of text. Following written directions may hold unique potential as it requires a reader to convert a written text into a goal-directed and observable performance. The present data-based case study investigated whether two elementary students with ASD could learn to follow six-step written directions when they were given access to high-preference items as they completed the final step in the directions. It was anticipated that as the number of directions increased, there would need to be adjustments to the intervention, especially as working memory was taxed and students were reliant on understanding the written text to successfully follow the written directions. At baseline, neither student could follow the six-step directions. After participating in the multiple phases of the intervention, both students learned to read and follow six-step directions without a high preference reward following the last step in the directions. Teaching students to follow written directions by creating opportunities to access preferred items through reading text may provide the origins of making text mediate independent and self-regulated behavior, but it is not sufficient for all students when they lack executive skills. This study discusses implications for research and classroom practice.
Adipocyte-rich CTNNB1-mutated Intramuscular Gardner Fibroma Progressing to Desmoid Fibromatosis
Authors: Bakker Andrea , Slack Jonathan C , Caragea Mara , Kurek Kyle C , Bründler Marie-Anne
Published: October 2020

Gardner fibroma (GF) is a benign soft-tissue tumor that is associated with Gardner syndrome and can progress to, or co-occur with, desmoid fibromatosis (DF). Herein, we report a unique case of an 11-year-old boy who presented with a rapidly growing soft-tissue mass after biopsy of a stable fat-rich lesion present in the calf muscles since infancy, with Magnetic resonance imaging findings suggesting an intramuscular adipocytic tumor. The resection showed GF and DF. DF arising from a preexisting GF (the so-called “GF-DF sequence”) is a well-documented phenomenon. Although immunohistochemistry was negative for nuclear β-catenin expression, a CTTNB1 S45F mutation, which has been associated with aggressive behavior in DF, was identified in both components using a next-generation sequencing-based molecular assay. This is the first time a mutation in CTNNB1 has been identified in GF and the GF–DF sequence, thus expanding our knowledge of the molecular pathogenesis of the GF–DF sequence and highlighting the role of molecular testing in pediatric soft-tissue tumors. The histologic findings of an adipocyte-rich intramuscular GF also are unique, expanding the morphological spectrum of GF and adding GF to the differential diagnosis of intramuscular lesions with an adipocytic component.