bluuebunny/crossref_metadata_2025 huggingface dataset:
Integrating recovery-oriented and realistic evaluation principles into an evaluation of a Partners in Recovery programme
Authors: Harris Paul , Barry Margarete , Sleep Lyndal , Griffiths Jessica , Briggs Lynne
Published: September 2020

Partners in Recovery (PIR) was an Australian government initiative designed to provide support and service linkage for individuals with complex needs living with severe and persistent mental illness. This article reports the external evaluation process and approach that was undertaken of the Gold Coast Partners in Recovery initiative between September and December 2015 regarding the achievement of PIR outcomes. The evaluation of this consortia-based initiative was framed using principles of realistic evaluation and recovery-oriented practice. Numerous evaluations of similar initiatives have recently been undertaken, each adopting different approaches and methods in accordance with local needs and expectations. The incorporation of realistic evaluation with recovery-oriented principles in this mixed methods research design, however, offers a unique perspective. This can be used to inform future developments in evaluative practice particularly in the area of recovery-oriented services and/or partnership-focused, capacity-building initiatives.
Merit, Luck, and Taxes: Societal Reward Rules, Self-Interest, and Ideology in a Real-Effort Voting Experiment
Authors: Tepe Markus , Vanhuysse Pieter , Lutz Maximilian
Published: September 2020

When are high earnings considered a legitimate target for redistribution, and when not? We design a real-effort laboratory experiment in which we manipulate the assignment of payrates (societal “reward rules”) that translate performance on a real-effort counting task into pre-tax earnings. We then ask subjects to vote on a flat tax rate in groups of three. We distinguish three treatment conditions: the same payrate for all group members (“equal” reward rule), differential (low, medium, and high) but random payrates (“luck” rule), and differential payrates based on subjects’ performance on a quiz with voluntary preparation opportunity (“merit” rule). Self-interest is the dominant tax voting motivation. Tax levels are lower under “merit” rule than under “luck” rule, and merit reasoning overrides political ideology. But information is needed to activate merit reasoning. Both these latter effects are present only when voters have “full merit knowledge” that signals precisely how others obtained their incomes.
Simulation Experience in Community Health Nursing: Postpartum Evaluation of the Mother and the Infant at Home Environment
Authors: Ates Elif , Ulus Bahire , Karahan Azize
Published: September 2020

Background:

This study aims to improve the skills of the undergraduate nursing students about data collection for postpartum evaluation of the mother and the infant at home environment by using simulation experience.

Method:

The study was conducted between February and May 2019. 63 third-year undergraduate students, who were enrolled to the department of nursing of a foundation university in Istanbul, constituted the sample of the study. First implementation stage of the study, which had one-group pretest-posttest quasi-experimental design, was conducted at the simulation center of the university by using a simulation-based scenario. Second implementation stage was conducted at the Family Health Centers, located in Ümraniye district of İstanbul province in Turkey. Data was collected by using “Family Diagnosis Performance Checklist for Home Visits (FDPC)” and “Students Satisfaction and Self-confidence in Learning Scale (SCLS)”.

Results:

We found a statistically significant difference between the self-confidence subscale of the SCLS after the simulation activity and the actual home visits ( p < 0.05). Comparison of the scores obtained from the satisfaction subscale of the SCLS after the simulation activity and the actual home visits reveals no statistically significant difference ( p > 0.05). Finally, we found a statistically significant difference between FDPC scores obtained from the simulation-based home visit scenario and the actual home visits ( p < 0.001).

Conclusions:

The results of this study suggest that simulation-based learning in community health nursing improves self-confidence of nursing students and contributes to their skills on data collection and diagnosis during home visits.
Quality of Life of Older People Receiving Home Health Care Services: An Example From Turkey
Authors: Rencber Emin , Terzi Ozlem
Published: September 2020

Advanced age, restrictions on daily life activities, increased disability, and chronic diseases negatively affect the quality of life of older individuals. The aim of the present study was to investigate the quality of life of older patients receiving home health care services (HHCS) in Samsun province, Turkey. The population of this cross-sectional study comprised 489 individuals aged 65 years and older. Patient selection was performed using the stratified randomized sampling method. A total of 183 patients were included in the study. Data were collected using a questionnaire and face-to-face interviews. The Mann-Whitney U and Kruskal–Wallis tests were used in the statistical evaluation of data, and significance was regarded as p < .05 for all tests. Some 75.4% of the patients were women, and the average age was 82 years. Eighty-three percent of the participants were semi-dependent or completely dependent in the activities of daily living (ADL); however, in the instrumental activities of daily living (IADL), 96.0% were semi-dependent or completely dependent. The quality of life of the older people receiving HHCS was identified as low both in the physical and mental health components. However, physical quality of life was statistically higher in men, in graduates of primary school or above, and in patients with no decubitus ulcers compared with the others. We found that the older individuals receiving HHCS had a lower quality of life due to their chronic diseases and high dependency compared with the general population and their contemporaries.
Endodiathermy assisted vitreous base and anterior hyaloid visualization during vitrectomy for rhegmatogenous retinal detachment
Authors: Abdullatif Abdussalam M , Nabih Mostafa H
Published: September 2020

Purpose:

To describe a novel technique to visualize vitreous base and the anterior hyaloid during vitrectomy for Rhegmatogenous Retinal Detachment (RRD).

Methods:

Retrospective, single-center study enrolling all patients who underwent vitrectomy for RRD between June 2015 and June 2018. After core vitrectomy and the necessary additional procedures, endodiathermy was activated near the edge of the peripheral vitreous. This created a heat-induced bubble stream and the bubbles were entangled in the vitreous base and anterior hyaloid. As a result, the vitreous base and anterior hyaloid were visualized and removed.

Results:

Between June 2015 and June 2018, a total of 210 cases of rhegmatogenous retinal detachment were treated with vitrectomy. Endodiathermy assisted vitreous base shaving and anterior hyaloid removal was used in those cases with a very low incidence of iatrogenic peripheral retinal breaks during vitreous base shaving (2%), and with no case of lens injury related to the technique. We achieved a final anatomical success of 95.2% in the study period after mean number of operations of 1.3 ± 0.2. Endodiathermy near the peripheral vitreous was not associated with any intraoperative or postoperative complications.

Conclusion:

Endodiathermy assisted vitreous base and anterior hyaloid visualization is a safe adjuvant method that could help in achieving complete and rapid vitreous base shaving and anterior hyaloid removal.
Intraoperative two-stage evaluation of muscle contractures in Crowe type IV hips in total hip arthroplasty (a new surgical technique)
Authors: Bilgen Ömer F , Yaray Osman , Mutlu Müren , Aksakal Ahmet M
Published: September 2020

Background:

It is important to maintain soft-tissue balance and prevent muscle contractures after hip reduction during total hip arthroplasty (THA) in patients with Crowe type IV developmental dysplasia of the hip (DDH). To make such hips functional and durable, the techniques to achieve soft-tissue balance were studied to create an algorithm for intraoperative 2-stage evaluation of muscle contractures, specifying the optimal order for contracture release.

Methods:

Between February 2011 and March 2015, we evaluated 64 patients (75 hips) with DDH for muscle contractures as they underwent THA. Following acetabular implantation, femoral osteotomy was applied of various lengths according to limb-length discrepancy. First, the distal part of the femur was prepared by broaching, and the hip was then reduced. The tensor fascia lata, rectus femoris, sartorius, hamstrings, and adductor muscles were evaluated, and any contractures were released. A trial conjoining of the distal and proximal parts of the femur was made, and the hip was reduced again. Finally, the iliopsoas and abductor muscles were evaluated, and contractures were released.

Results:

The mean follow-up duration was 4.6 years. Preoperative and postoperative Harris Hip Scores were 52 and 87, respectively. Limb-length discrepancy was mean 4.2 cm preoperatively, and <1 cm postoperatively. All contractures were released according to our newly developed algorithm.

Conclusions:

It is challenging to pinpoint the main muscle causing contractures, because other muscles acting on the hip joint have similar secondary functions. The method we describe here may provide better and more specific restoration of muscle function in a hypoplastic hemipelvis in DDH.
External validation study of hip peri-prosthetic joint infection with cemented custom-made articulating spacer (CUMARS)
Authors: Quayle Jonathan , Barakat Ahmed , Klasan Antonio , Mittal Aaina , Stott Philip
Published: September 2020

Introduction:

Peri-prosthetic joint infection (PJI) is a devastating complication after total hip arthroplasty (THA). The use of custom-made articulating spacers (CUMARS) has been described for use in the first of 2-stage treatment. We report our outcomes of managing PJI using CUMARS.

Methods:

Patients undergoing 1st-stage revision using the Exeter standard stem, all-polyethylene acetabulum and antibiotic-loaded cement were identified. Medical records were assessed for demographics, microbiological and operative treatment, complications, eradication of infection and reoperations. No postoperative restrictions were enforced. 2nd-stage revision was undertaken in the presence of pain or subsidence.

Results:

53 patients underwent 1st-stage revision using this technique. The average follow-up was 3.9 (range 0.5–7.2) years. Infection was eradicated in 47 (88.7%) patients. 2 patients had chronic infection managed with suppressive antibiotics, 2 patients died before eradication confirmed, 1 patient had raised inflammatory markers but no positive aspiration cultures, 1 patient was lost to follow-up. Complications occurred in 5 (9.4%) patients – 4 dislocations and 1 infected haematoma. 4 patients required a repeated 1st stage. 2nd-stage revision was performed in 19 patients (35%).

Conclusions:

The CUMARS technique is an effective way of eradicating PJI after THA. It maintains function by providing a stable construct that permits weight-bearing. It delays or negates the need for 2nd-stage revision. Furthermore, it allows surgeons to choose between managing patients prospectively as a single-stage revision with the option of reverting to a 2nd stage.
Arterial insertion method: A new method for systematic evaluation of ultrasound-guided radial arterial catheterization
Authors: Bardin-Spencer Amy J , Spencer Timothy R
Published: September 2020

Introduction:

Peripheral arterial catheter insertion is a common procedure for critically ill patients requiring frequent blood gas sampling and continuous blood pressure monitoring. There are clear advantages of ultrasound-guided arterial cannulation, which have shown to be more effective in reducing complications, time to successful cannulation, number of attempts, and overall first-time success rates. Evidence suggests that using palpation alone has a first-time success rate of less than 70% yet is still a widely performed technique. A systematic evaluation may be required to reduce variations in arterial catheterization practices.

Design:

The arterial insertion method is a systematic evaluation to aid in arterial catheter insertion with ultrasound guidance, intended to improve the procedural approach. The process of arterial insertion method ensures appropriate choice of zone selection to optimize catheter longevity and performance in patients requiring arterial access. Moving the insertion site proximally 4 cm from the red zone into the green zone may reduce mechanical complications and preserve catheter performance and dwell time.

Conclusion:

The standardization of ultrasound guidance in arterial catheterization promotes vessel health and patient safety through device and site optimization. The arterial insertion method systematic evaluation may be utilized to reduce variation in practice and promote the use of ultrasound as a standard for the insertion of radial arterial catheters.
Tribally specific cultural learning: the Remember the Removal program
Authors: Lewis Melissa , Myhra Laurelle , Smith Benny , Holcomb Sarah , Erb Joseph , Jimenez Tyler
Published: September 2020

Remember the Removal is a program for Cherokee youth and young adults which aims to increase Cherokee knowledge, culture, and language by retracing the Trail of Tears. This study evaluated the Cherokee values that were gained and how the participants learned and applied traditional Cherokee values through the program. This is significant because cultural knowledge and connection are important developmental aspects for Indigenous youth and can also protect them from health risks. To assess cultural growth, a total of 23 Remember the Removal participants took part in focus groups. Participants comprised two cohorts: the first cohort of the program was in 1984 ( n = 15) and the most current cohort occurred in 2015 ( n = 9). Data were analyzed using program evaluation and decolonization methods. Results indicated that there were five themes related to Cherokee values: treat everyone with kindness, help each other, work together, take care of one another, treat each other as family, and be confident. These values mapped onto traditional Cherokee Community Values that had been pre-established by Cherokee Nation and the Cherokee community. This analysis confirmed that this cultural training is feasible; results in improved connection to peers, family, and tribe; is representative of Cherokee values; that the values are applied outside of the program and into the community; and can last up to 32 years.
Quality of Life in Children With Diabetes Treated With Insulin Pump Compared With Multiple Daily Injections in Tertiary Care Center
Authors: Al Shaikh Adnan , Al Zahrani Abdullah M , Qari Yousef H , AbuAlnasr Abdulaziz A , Alhawsawi Waseem K , Alshehri Khalid A , AlShaikh Sahl A
Published: September 2020

Background:

Continuous Subcutaneous Insulin Infusion (CSII) and Multiple Daily Injections (MDI) have been widely used as options in treating diabetes in childhood. Glycemic control is important to reduce diabetes complications; however, more focus needs to be on patients’ Quality of Life (QoL). Diabetes and QoL have strong associations in terms of patients’ overall health including their psychology, physical well-being, compliance with medication. A previous systematic review stressed that strong evidence to deny or prove the benefits of insulin pump therapy on health-related quality of life is deficient. The aim of this study is to assess the health-related quality of life and the psychological impacts of children with diabetes who use CSII and MDI treatment.

Methods:

A cross-sectional study included 68 pediatric patients with type 1 Diabetes (T1DM) who were treated in a tertiary center in Jeddah, Saudi Arabia. We used the Pediatric Quality of Life Inventory 3.0 Diabetes Module and this module assesses the health-related quality of life of children with diabetes.

Results:

Thirty-four (50%) participants found to be on MDI, of which 21 (61.8%) are males, compared to 34 (50%) patients using CSII, of which 12 (35.2%) are females. Participants using CSII had statistically significant better symptom control, less treatment difficulties but were more worrisome than MDI participants.

Conclusion:

CSII group had better quality of life in almost all aspects even though they were more worrisome. Further studies with a larger sample size are needed to give comprehensive generalizations.
Violent International Relations
Authors: Van Milders Lucas , Toros Harmonie
Published: September 2020

Can International Relations (IR) be studied without reproducing its violence? This is the central question of this article. To investigate this, the first step is to expose the violence that we argue remains at the heart of our discipline. The article thus begins by exploring the disciplinary practices firmly grounded in relations of coloniality that plague disciplines more broadly and IR in particular. An analysis of IR’s epistemic violence is followed by an autoethnographic exploration of IR’s violent practices, specifically the violent practices in which one of the article’s authors knowingly and unknowingly engaged in as part of an impact-related trip to the international compound of Mogadishu International Airport in Somalia. Here the article lays bare how increasing demands on IR scholars to become ‘international experts’ having impact on the policy world is pushing them more and more into spaces governed by colonial violence they are unable to escape. The final section of this article puts forward a tentative path toward a less violent IR that advocates almost insignificant acts of subversion in our disciplinary approach and practices aimed at exposing and challenging this epistemic and structural violence. The article concludes that IR does not need to be abandoned, but rather, by taking on a position of discomfort, needs to acknowledge its violence and attempt to mitigate it – one almost insignificant step at a time.
Gendering the practice turn in diplomacy
Authors: Standfield Catriona
Published: September 2020

International Relations has developed an exciting new research agenda on diplomatic practice, drawing largely on the theories of Pierre Bourdieu. However, it largely ignores Bourdieu’s theory of patriarchy, as well as extensive feminist Bourdieusian analysis. These are analytical tools that can be used to understand how diplomacy reproduces itself as a masculinized field. They are ‘practice theory’ as well and should be incorporated into our research on diplomatic practice. My aims here are to recover feminist practice theory for a diplomatic studies audience and to indicate how we can develop an interdisciplinary research agenda on gender and diplomacy. The first part of the article provides an overview of practice theory in diplomatic studies and discusses Bourdieu’s overlooked contributions regarding gender. I then use Bourdieu’s ‘thinking tools’ of field, habitus and practice to examine diplomacy and gender using examples drawn from the literature, as well as from some primary sources. Throughout, I show how feminist sociologists have developed his ideas to create sophisticated approaches to studying the persistence of patriarchy. This does not capture all the ways in which diplomacy is gendered, but these tools reveal the limitations in our current understanding of diplomatic practices. I conclude with suggestions for future interdisciplinary research that takes gender seriously.
The centrality of disclosure decisions to the illness experience for youth with chronic conditions: A qualitative study
Authors: Woodgate Roberta Lynn , Tennent Pauline , Barriage Sarah , Legras Nicole
Published: September 2020

The aim of this paper is to illuminate findings of disclosure experiences for youth living with chronic illness using a non-categorical approach. The findings were derived from a larger qualitative study framed by social constructivist grounded theory that sought to understand youth’s involvement in healthcare decision-making in the context of chronic illness. Fifty-four youth participated in the study, ranging from 9 to 24 years. Three main themes representing the youth’s perspectives and experiences of disclosing chronic illness were identified: (1) disclosure is central to the illness experience; (2) spectrum of disclosure; and (3) navigating others’ reactions to disclosure. The findings reinforce that more emphasis on decisions related to disclosing illness in research and clinical care for youth with chronic conditions is warranted.
Spanish copula selection with adjectives in school-aged bilingual children
Authors: Requena Pablo E , Dracos Melisa
Published: September 2020

Aims and objectives/purpose/research questions:

This study examined whether school-aged second-generation heritage speakers exhibit knowledge of the semantic and pragmatic constraints on Spanish copula selection with adjectives, and whether experiential factors affect copula interpretation.

Design/methodology/approach:

Following a between-subjects design, we administered 2 Picture Selection Tasks to 50 second-generation bilingual children (ages 5;1–14;10) and 21 first-generation adults living in the same community in central Texas. Task 1 included real adjectives and Task 2 novel adjectives. We administered a morphosyntactic proficiency test in English and Spanish (BESA/BESA-ME) to the children and obtained language exposure and use data.

Data and analysis:

Using generalized linear mixed models, analyses compared bilingual children to first-generation adults in their selection of the temporary picture with each copula ( ser vs. estar), and also examined the role of age, language exposure/use, and morphosyntactic proficiency.

Findings/conclusions:

Only children with high Spanish morphosyntactic proficiency approached adult-like sensitivity to the semantic and pragmatic distinctions between ser and estar with adjectives. Age, Spanish exposure and use, and English proficiency did not significantly influence performance on the tasks.

Originality:

This study provides the first detailed examination of the acquisition of copula selection with adjectives in Spanish-English school-aged heritage speakers living in the US.

Significance/implications:

This study offers evidence of the vulnerability of aspect, as instantiated in Spanish copula selection, among school-aged bilingual children. It also suggests low-proficiency children might be a catalyzing locus of the accelerated changes in copula use.
Representation and emancipation: Cinema of the oppressed
Authors: Ben Labidi Imed
Published: September 2020

Palestinian cinematic productions have historically attempted to alter biased perceptions of their identity, experience of dispossession, and struggle for liberation, using films to communicate the harsh realities of Israeli occupation. While preserving a pluralistic and hybrid character, and blending different genres from Third and Second films (experimental, neorealist, and transnational), Palestinian cinema – as examined through a close reading of Tawfik Saleh’s 1972 film The Dupes, Hany Abu-Assad’s Rana’s Wedding from 2002, and Najwa Najjar’s 2014 Eyes of a Thief – contests monolithic tropes and representations of Palestinians as either victims or terrorists in Western media and films. Drawing on Edward Said’s analysis of representation and its ties to occupation, the goal of this article is to engage with the idea of film narratives as a form of intervention that demystifies racial bias against colonized people, transforms viewers’ political consciousness, and devises strategies to keep resistance legitimate and ongoing.
Orthodontics in patients with significant medical co-morbidities
Authors: Alawsi Fahad , Sawbridge David , Fitzgerald Rhian
Published: September 2020

A wide variety of patients with medical co-morbidities may present to general orthodontic practice. It is important for the treating clinician to have a general understanding of key medical conditions that may impact upon the treatment and management options. This clinical supplement provides a treatment-focused summative update for the orthodontist regarding significant medical co-morbidities, their general prevalence and an exploration of potential impacts upon orthodontic treatment. This review also discusses the significance of key medications and provides suggestions for the safe provision of orthodontic treatment.
Application of the diode laser for soft-tissue surgery in orthodontics: Case series
Authors: Ahn John Hyunbaek , Power Susan , Thickett Eleanor
Published: September 2020

Referral to an oral surgeon for soft-tissue surgery before, during or after orthodontic treatment is not uncommon. This process may delay treatment and could potentially increase the risk of complications. In addition, seeing multiple specialties in different environments may demotivate paediatric or anxious patients from pursuing orthodontic treatment and could also adversely affect patient compliance and satisfaction. The development of laser technology provides a safe and effective alternative, allowing the orthodontic clinician to perform soft-tissue surgery. To date, there are no laser exposure protocols or UK guidelines regarding the use of laser surgery in orthodontics. This case series reports four clinical cases that demonstrate potential advantages of using a diode laser for the management of soft tissue in the field of orthodontics.
Conspicuous souvenirs: Analysing touristic self-presentation through souvenir display
Authors: Kuhn Friedericke
Published: September 2020

Holiday travel offers the opportunity for self-definition and enhancement of social prestige. Due to the growing importance of self-expressive values within the ongoing course of individualisation, tourists increasingly make use of their travel experience to self-present in a positive way. Yet, tourism studies have not investigated what tourists actually want to communicate about themselves when representing their travel experience through the display of souvenirs. Using semi-structured qualitative interviews, this study examines touristic self-expression and exposes the self-concepts attached to and communicated through the display of souvenirs as material symbols of travel experience. Results show that tourists often have a clear intention to express positive self-messages when showing their souvenirs to others. Souvenirs are used to represent personal character traits, social affiliation to in-groups and neo-tribes, and to demonstrate individual travel history. This article adds to the discussion of individual ascription of meaning to the tourist experience and souvenirs, and gives an insight to the function of souvenirs for self-expression and social exchange.
Place matters: Thinking about spaces for humanities practices
Authors: Pawlicka-Deger Urszula
Published: September 2020

This essay reflects on the role of place for humanities practices and contributes to emerging discussions on infrastructure for the humanities and socio-material conditions of scholarly knowledge production. I provide a theoretical framework for studying venues for humanities work drawing on the phenomenological approach to the concepts of place and space, the pedagogical perspective on learning spaces in higher education, and epistemological studies of scientific places. Next, I analyse the landscape for the reconfiguration of humanities venues and present arguments for engaging with space by referring to the functioning of digital humanities. This essay shows that place is an extremely important resource, seeing as it is endowed with the power to drive new practices, institutionalize a community, and consolidate a discipline. Therefore, humanists should reflect critically on the ‘architecture of the humanities’ and engage in making their own spaces that determine practices, communication, and well-being.
Rethinking social capital in the desistance process: The ‘Artful Dodger’ complex
Authors: Kay Christopher
Published: September 2020

Social capital has become a core component of our understanding of desistance in recent years. Some of this work, however, seems to present social capital as inherently positive, suggesting that increasing stocks in social capital is fundamental to the desistance process. Knowledge surrounding exactly how social capital is utilized within the desistance process, with the exception of acquiring social capital as a social good, remains underexplored. Through an analysis of the desistance narratives of young adult men serving community orders under the supervision of the probation service in England and Wales, this article argues that, instead of being considered to be inherently good, social capital is perhaps better thought of as value neutral, consisting of both positive and negative aspects (some of which occur simultaneously). Desistance, then, is not simply about obtaining social capital (because many people with convictions possess stocks of social capital that supported their offending); rather it is about reorienting the type of capital available to them at any given time, from relationships that imbue ‘anti-social capital’ to those that imbue ‘pro-social capital’. This distinction has significant theoretical and policy interventions, arguing that it is pro-social capital that the literature makes reference to in terms of supporting desistance efforts. The article concludes by offering some tentative suggestions for future research, along with ways in which this distinction can further support how we operationalize desistance within criminal justice policy and practice.
Soft actuated material: Exploration of a programmable composite
Authors: Kieffer Lynn Hyun , Nicholas Paul
Published: September 2020

This paper describes the development of a programmable composite material and investigates its application in architecture as flexible and controllable surfaces. The composite leverages qualities found in the field of soft robots, that is, strength, precision, and the ability to change shape through vacuum actuation. It is an exploration of a range of applications for shape shifting composites within different phases of architecture. This research has deployed a controlled form-actuator of a designed surface as a reusable and flexible approach for concrete formwork and as a continuously changing spatial element, which aims to create a more engaging relationship between habitat and inhabitant. The design method linked to this composite aims to converge technology and material behavior and therethrough create a more linear process from design to construction. This paper elaborates on the design, simulation and fabrication methods, and their development through empirical research from individual actuatable cells to a controllable multi-cell surface and associated design tool.
Evaluation of a Health Care Performance Improvement Initiative to Facilitate Optimal Clinical Outcomes in Patients Receiving Ventricular Assist Device Support
Authors: Lockard Kathleen L. , Dunn Elizabeth , Kunz Nicole , Pearsol Amanda , Schaub Richard D. , Severyn Donald A. , Lohmann Douglas , McCall Michael , Morelli Brian , Teuteberg Jeffrey J. , Kormos Robert L. , Sciortino Christopher M. , Dew Mary Amanda
Published: September 2020

Background:

Ventricular assist device (VAD) patients are at high risk for morbidities and mortality. One potentially beneficial component of the Joint Commission VAD Certification process is the requirement that individual VAD programs select 4 performance measures to improve and optimize patients’ clinical outcomes.

Problem Statement:

Review of patient data after our program’s first certification visit in 2008 showed that, compared to national recommendations and published reports, our patients had suboptimal outcomes in 4 areas after device implantation: length of hospital stay, receipt of early (<48 hours) postsurgical physical therapy, driveline infection incidence, and adequacy of nutritional status (prealbumin ≥18 mg/dL).

Methods:

Plan-Do-Study-Act processes were implemented to shorten length of stay, increase patient receipt of early physical therapy, decrease driveline infection incidence, and improve nutritional status. With 2008 as our baseline, we deployed interventions for each outcome area across 2009 to 2017. Performance improvement activities included staff, patient, and family didactic, one-on-one, and hands-on education; procedural changes; and outcomes monitoring with feedback to staff on progress. Descriptive and inferential statistics were examined to document change in the outcomes.

Outcomes:

Across the performance improvement period, length of stay decreased from 40 to 23 days; physical therapy consults increased from 87% to 100% of patients; 1-year driveline infection incidence went from 38% to 23.5%; and the percentage of patients with prealbumin within the normal range increased from 84% to 90%.

Implications:

Performance improvement interventions may enhance ventricular assist device patient outcomes. Interventions’ sustainability should be evaluated to ensure that gains are not lost over time.
Situating Representation As a Form of Erasure: #OscarsSoWhite, Black Twitter, and Latinx Twitter
Authors: Gutiérrez Arcelia
Published: September 2020

This article explores how Latinxs have responded to the visibility of campaigns and movements such as #OscarsSoWhite. It outlines the discourses Latinxs have deployed on Twitter to justify their demands for inclusion in the media industries and how notions of competition, coalition building, and solidarity operate between various ethnoracial groups in digital media activism. The article theorizes “Latinx Twitter” and its anti-Blackness and explores the clashes this counterpublic has had with Black Twitter by analyzing the discourses surrounding the hashtags #OscarsSoWhite, #NotYourMule, and #OscarsSoWhiteAndBlack. It advances the notion of competing ethnoracialized counterpublics to explore how race and ethnicity operate relationally in the U.S. and how competition among marginalized groups impacts media activism.
Protein Kinase D1 Is Increased in Tumor Tissue, Correlates With Advanced Tumor Features and Worse Prognosis of Non-Small Cell Lung Cancer
Authors: Yao Jing , Jiang Yan , Geng Shuang , Sun Li
Published: September 2020

Objective:

This study aimed to assess protein kinase D1 expression and its association with tumor characteristics as well as prognosis in patients with non-small cell lung cancer.

Methods:

Protein kinase D1 expression in tumor tissues and adjacent tissues from 172 patients with non-small cell lung cancer who underwent surgical resection were analyzed by immunohistochemical staining. Based on the total immunohistochemical score, protein kinase D1 expression was classified as protein kinase D1 high expression (further divided into protein kinase D1 high+++, protein kinase D1 high++, and protein kinase D1 high+ expressions) and protein kinase D1 low expression. Clinical characteristics of patients with non-small cell lung cancer were acquired from the database. Accumulating disease-free survival and overall survival were calculated based on patients’ relapse/survival status.

Results:

Protein kinase D1 expression was increased in tumor tissues compared to adjacent tissues ( P < .001). Tumor protein kinase D1 high expression correlated with poorer pathological differentiation ( P = .041), increased tumor size ( P = .003), the presence of lymph node metastasis ( P = .001), and elevated tumor, nodes and metastases stage ( P < .001). Besides, both accumulating disease-free survival and overall survival were decreased in patients with tumor protein kinase D1 high expression compared to patients with tumor protein kinase D1 low expression ( P = .010 for disease-free survival and P = 0.005 for overall survival). Moreover, they were lowest in patients with tumor protein kinase D1 high+++ expression, followed by patients with tumor protein kinase D1 high++ expression, then patients with tumor protein kinase D1 high+ expression, and highest in patients with tumor protein kinase D1 low expression ( P < .001 for disease-free survival and P = .001 for overall survival). Notably, higher tumor protein kinase D1 expression was an independent predictive factor for decreased disease-free survival ( P = .001) and overall survival ( P = .004).

Conclusions:

Protein kinase D1 might be a potential marker to identify patients with non-small cell lung cancer with worse tumor features and prognosis.
An Integrated Analysis of mRNAs and miRNAs Microarray Profiles to Screen miRNA Signatures Involved in Nasopharyngeal Carcinoma
Authors: Liu Lei , Wang Hailing , Yan Chaohui , Tao Shudong
Published: September 2020

Objective:

We aim to identify several microRNAs (miRNAs/miRs)-messenger RNAs (mRNAs) biomarkers correlated to nasopharyngeal carcinoma (NPC) based on an integrated analysis of miRNA and mRNAs microarray expression profiles.

Methods:

The available mRNA and miRNA microarray datasets were retrieved from Gene Expression Omnibus (GEO) database according to pre-determined screening criteria. Differentially expressed miRNA and mRNAs (DEmiRNAs and DEmRNAs) were extracted between NPC and noncancerous nasopharyngeal tissues. The target genes of DEmiRNAs were predicted with miRTarBase followed by the construction of DEmiRNAs-target DEmRNAs network, and functional analyses were performed. The DEmiRNAs expressions were validated and the performance of these DEmiRNAs was assessed by the area under the curve (AUC) values. Finally, the correlations between DEmiRNAs and specific clinical factors were analyzed.

Results:

There were 1140 interaction pairs (including let-7d/f- MYC/ HMGA2 and miR-452- ITGA9) in DEmiRNAs-target DEmRNAs network. The GO annotation analysis showed that several genes such as MYC, HMGA2 and ITGA9 primarily participated in cellular process. KEGG analysis showed that these targets were associated with cell cycle and cancer-related pathways. Down-regulated let-7(-d and –f) and up-regulated miR-452 were verified in datasets. The AUC values of these 3 DEmiRNAs (let-7d, let-7-f and miR-452) was 0.803, 0.835 and 0.735, respectively. Besides, miR-452 was significantly related to survival rate of NPC patients.

Conclusion:

The findings implied let-7d/f- MYC/ HMGA2 and miR-452- ITGA9 might be promising targets for the detection and treatment of NPC.
Antiepileptic Drugs as Teratogens: The Mechanism Remains a Mystery
Authors: Mefford Heather C.
Published: September 2020

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Patterns of Engagement Among Puerto Rican University Completers: Do Major and Gender Matter?
Authors: Dika Sandra L. , Wang Yi , Findlater Nickcoy
Published: September 2020

Researchers conducted a correlational study utilizing data from a public 4-year institution in Puerto Rico to understand differences in the levels and types of student engagement reported by graduating students, based on gender and major. Findings indicated that graduates from physical sciences, engineering, mathematics, and computing majors perceived a distinct engagement culture, with significantly higher emphasis on higher order learning and report writing, and lower institutional emphasis on providing academic and non-academic support.
Ghost imaging enhancement for detections of the low-transmittance objects
Authors: Zhang Ying , Li Wendong , Yu Yonghe , Xiao Ya , Xu Dongyu , He Weikai , Gu Yongjian
Published: September 2020

The underwater environment is extremely complex and variable, which makes it difficult for underwater robots detecting or recognizing surroundings using images acquired with cameras. Ghost imaging as a new imaging technique has attracted much attention due to its special physical properties and potential for imaging of objects in optically harsh or noisy environments. In this work, we experimentally study three categories of image reconstruction methods of ghost imaging for objects of different transmittance. For high-transmittance objects, the differential ghost imaging is more efficient than traditional ghost imaging. However, for low-transmittance objects, the reconstructed images using traditional ghost imaging and differential ghost imaging algorithms are both exceedingly blurred and cannot be improved by increasing the number of measurements. A compressive sensing method named augmented Lagrangian and alternating direction algorithm (TVAL3) is proposed to reduce the background noise imposed by the low-transmittance. Experimental results show that compressive ghost imaging can dramatically subtract the background noise and enhance the contrast of the image. The relationship between the quality of the reconstructed image and the complexity of object itself is also discussed.
Beliefs about sensitive parenting among mothers of children with disabilities
Authors: Matoso Leonor , Baião Rita , Baptista Joana
Published: September 2020

The relevance of the quality of parent-child interactions for child development has long been established. Nevertheless, research on beliefs about maternal sensitivity is still scarce, to an even greater extent in the context of child disability. This inquiry aimed to describe beliefs about sensitive parenting among mothers of children with developmental disabilities and to examine how those beliefs relate to sociodemographic factors and perceived stress. Participants included 40 mothers with a child up to 7 years of age with a developmental disability. Mothers reported on sociodemographic factors and daily hassles and sorted an adapted version of the Maternal Behavior Q-Sort. Results revealed a strong convergence between maternal beliefs about the ideal mother and the attachment theory’s concept of sensitivity. Daily hassles predicted beliefs about the ideal mother. These results underline the importance of implementing interventions in the context of child disability aimed at reducing parental stress.
An improved first order reliability method based on modified Armijo rule and interpolation-based backtracking scheme
Authors: Zhou Sheng-Tong , Wang Di , Xiao Qian , Zhou Jian-min , Li Hong-Guang , Tu Wen-Bing
Published: September 2020

Hasofer-Lind and Rackwtiz-Fiessler (HLRF) method is an efficient iterative algorithm for locating the most probable failure point and calculating the first order reliability index in structural reliability analysis. However, this method may encounter numerical instability problems for high nonlinear limit state function (LSF). In this paper, an improved HLRF-based first order reliability method is developed based on a modified Armijo line search rule and an interpolation-based step size backtracking scheme to improve the robustness and efficiency of the original HLRF method. Compared with other improved HLRF-based methods, the proposed method can not only guarantee the global convergence but also adaptively estimate some sensitive algorithm parameters, such as initial step size, step-size reduction coefficient, using the current known iterative information. Ten selected examples with high nonlinear LSFs are used to compare the robustness and efficiency of the proposed method with the original HLRF method and the improved HLRF (iHLRF) method. Results indicate that the proposed method is not only more computationally efficient but also less sensitive to the remaining user-defined algorithm parameters than the iHLRF method.
Palliative balloon atrial septostomy in two pediatric patients with severe pulmonary arterial hypertension requiring extracorporeal membrane oxygenation support
Authors: Brackett Samantha L. , Deutsch Nina , Unegbu Chinwe
Published: September 2020

Pulmonary arterial hypertension is a pernicious disease with a diverse etiology in the pediatric population. Despite the increased availability of drug therapies, pulmonary arterial hypertension continues to cause significant morbidity and mortality. In pediatric patients with severe pulmonary arterial hypertension who have failed medical therapy, a few studies have demonstrated the role of balloon atrial septostomy as a bridge to lung transplantation or a means of improving symptomatology. However, no data exists on the utilization of balloon atrial septostomy as a palliative intervention to wean from extracorporeal membrane oxygenation (ECMO) when all other therapies are exhausted. Here we describe a case series of two pediatric patients with severe pulmonary arterial hypertension, requiring ECMO support, who were successfully weaned from ECMO following balloon atrial septostomy.
Patient-Reported Outcomes from a 1-Year, Real-World, Head-to-Head Comparison of OnabotulinumtoxinA and Topiramate for Headache Prevention in Adults With Chronic Migraine
Authors: Blumenfeld Andrew M. , Patel Atul T. , Turner Ira M. , Mullin Kathleen B. , Manack Adams Aubrey , Rothrock John F.
Published: September 2020

Introduction/Objective:

Chronic migraine (CM) is associated with impaired health-related quality of life and substantial socioeconomic burden, but many people with CM are underdiagnosed and do not receive appropriate preventive treatment. OnabotulinumtoxinA and topiramate have demonstrated efficacy (treatment benefit under ideal conditions) for the prevention of headaches in people with CM in clinical trials, but real-world studies suggest markedly different clinical effectiveness (treatment benefit based on a blend of efficacy and tolerability). This study sought to evaluate patient-reported outcomes (PROs) of onabotulinumtoxinA versus topiramate immediate release for people with CM.

Methods:

FORWARD was a prospective, multicenter, randomized, parallel-group, open-label, phase 4 study comparing onabotulinumtoxinA 155 U every 12 weeks with topiramate 50 to 100 mg/day for ≤36 weeks in people with CM. PROs measured included the Headache Impact Test (HIT-6), 9-item Patient Health Questionnaire Quick Depression Assessment (PHQ-9), Work Productivity and Activity Impairment Questionnaire: Specific Health Problem (WPAI:SHP), and Functional Impact of Migraine Questionnaire (FIMQ).

Results:

A total of 282 patients were randomized and treated with onabotulinumtoxinA (n = 140) or topiramate (n = 142). From baseline to week 30, mean HIT-6 test scores improved significantly in patients taking onabotulinumtoxinA compared with topiramate ( P < .001). Improvements in depression over time were observed via larger changes in PHQ-9 scores with onabotulinumtoxinA than topiramate ( P < .001). Work productivity assessed via WPAI:SHP scores revealed significant improvements with onabotulinumtoxinA versus topiramate in Work Productivity Loss ( P = .024) and Activity Impairment ( P < .001) domains. Results from the FIMQ also revealed a larger reduction from baseline with onabotulinumtoxinA vs topiramate ( P < .0001).

Conclusion:

OnabotulinumtoxinA treatment had more favorable real-world effectiveness than topiramate on depression, headache impact, functioning and daily living, activity, and work productivity. The overall study results suggest that the beneficial effects on a range of PROs are the result of improved effectiveness when onabotulinumtoxinA is used as preventive treatment for CM.

Trial Registration: ClinicalTrials.gov:

NCT02191579; https://clinicaltrials.gov/ct2/show/NCT02191579