bluuebunny/crossref_metadata_2025 huggingface dataset:
Biosorption of Cadmium by Filamentous Fungi Isolated from Coastal Water and Sediments
Authors: Manguilimotan Lebeth C. , Bitacura Jayzon G.
Published: October 2018

The use of microorganisms in decontaminating the environment encumbered with heavy metal pollutants through biosorption is considered as a good option for bioremediation. This study was conducted to isolate Cadmium (Cd) tolerant fungi from coastal waters and sediments, compare their biosorption capabilities, and identify the isolates with the highest Cd uptake. Water and sediment samples were collected near the effluent sites of industrial belt in Ibo, Lapu-lapu City, Cebu, Philippines. Potato dextrose agar (PDA) plates containing Cd (25, 50, 75, and 100 ppm) were used to isolate Cd tolerant fungi from the samples. The distinct colonies that grew on the highest Cd concentration (100 ppm) were then isolated into pure cultures. The pure cultures of Cd tolerant fungi served as a source of inocula for in vitro biosorption assay using Cd dissolved in potato dextrose broth (PDB) as the substrate. Cd tolerant fungal isolates with the highest Cd uptake were finally identified up to the lowest possible taxon based on their colonial and microscopic characteristics. Most filamentous fungal colonies have grown most at the lower Cd concentrations and least at the higher concentrations. From the characteristics of the fungal growth on the plate with the highest Cd concentration, eight distinct colonies from both sediment and water samples were isolated into pure cultures. Among the eight fungal isolates, only three had significant Cd biosorption efficiency, these were fungal isolate 3 (13.87 %), fungal isolate 6 (11.46 %), and fungal isolate 4 (10.71 %). Two of them (fungal isolates 3 and 4) belong to genus Aspergillus while the other (fungal isolate 6) is a species of Penicillium. The results of this study showed that Cd tolerant fungi with biosorption capacity could be isolated from coastal water and sediments in the vicinity of areas suspected of heavy metal contamination.
Pleiotropic Effects of Heparins: From Clinical Applications to Molecular Mechanisms in Hepatocellular Carcinoma
Authors: Korhan Peyda , Yılmaz Yeliz , Bağırsakçı Ezgi , Güneş Ayşim , Topel Hande , Carr Brian I. , Atabey Neşe
Published: October 2018

Hepatocellular carcinoma (HCC) is a major health problem worldwide and most cases are incurable because of late presentation. It is the most common primary neoplasm of the liver and often arises in the context of a chronic liver disease that impairs coagulation. Portal vein thrombosis (PVT) is a common complication of HCC that is associated with a poor prognosis. Heparin derivatives are widely used in the management of venous thromboembolism (VTE). Among them low molecular weight heparin (LMWH) favorably influences the survival in patients with advanced cancer, including HCC. Due to their pleiotropic function, heparins affect tumorigenesis in many ways and may promote or hamper tumorigenic transformation depending on the cancer type and cancer stage along with their structural properties and concentration. Thus, their application as an antithrombotic along with the conventional therapy regime should be carefully planned to develop the best management strategies. In this review, we first will briefly review clinical applications of heparin derivatives in the management of cancer with a particular focus on HCC. We then summarize the state of knowledge whereby heparin can crosstalk with molecules playing a role in hepatocarcinogenesis. Lastly, we highlight new experimental and clinical research conducted with the aim of moving towards personalized therapy in cancer patients at risk of thromboembolism.
Myokines as Possible Therapeutic Targets in Cancer Cachexia
Authors: Manole Emilia , Ceafalan Laura C. , Popescu Bogdan O. , Dumitru Carmen , Bastian Alexandra E.
Published: October 2018

Cachexia is an extremely serious syndrome which occurs in most patients with different cancers, and it is characterized by systemic inflammation, a negative protein and energy balance, and involuntary loss of body mass. This syndrome has a dramatic impact on the patient’s quality of life, and it is also associated with a low response to chemotherapy leading to a decrease in survival. Despite this, cachexia is still underestimated and often untreated. New research is needed in this area to understand this complex phenomenon and ultimately find treatment methods and therapeutic targets. The skeletal muscle can act as an endocrine organ. Signaling between muscles and other systems is done through myokines, cytokines, and proteins produced and released by myocytes. In this review, we would like to draw attention to some of the most important myokines that could have potential as biomarkers and therapeutic targets: myostatin, irisin, myonectin, decorin, fibroblast growth factor 21, interleukin-6, interleukin-8, and interleukin-15.
Uncertainty, Risk, and the Efficiencies of the Principal and the Agent: A Chance Constrained Data Envelopment Analysis Approach
Authors: Zhao Linlin , Zha Yong , Liang Liang
Published: October 2018

In a principal-agent relationship, although the principal (e.g., the investor) can control the inputs and decide the motivated payments to the agent (e.g., the top management team), she cannot have the ability to decide how many outputs she can be rewarded. Since the motivated payments the agent gains from the principal are closely related to the uncertain outputs, they also have the characteristic of uncertainty. Furthermore, the attitudes and behaviors of both parties, such as risk attitude of the principal/agent on the uncertainty of outputs/motivated payments, can have significant influence on the efficiencies of two parties and consequently affect the enthusiasm and effort of the agent. To address this issue, chance constrained data envelopment analysis (DEA) approach is proposed. Based on this stochastic approach, the measures of the principal’s efficiency, the agent’s efficiency, and the agent’s effort level are provided. A case study of 16 China listed real estate companies validates our models and shows that the uncertainties of outputs and payments have significant influences on the efficiencies of the principal and the agent and the effort of the agent as well.
Combinatorics of Second Derivative: Graphical Proof of Glaisher-Crofton Identity
Authors: Blasiak Pawel , Duchamp Gérard H. E. , Penson Karol A.
Published: October 2018

We give a purely combinatorial proof of the Glaisher-Crofton identity which is derived from the analysis of discrete structures generated by the iterated action of the second derivative. The argument illustrates the utility of symbolic and generating function methodology of modern enumerative combinatorics. The paper is meant for nonspecialists as a gentle introduction to the field of graphical calculus and its applications in computational problems.
The Impact of Aggressive Driving Behavior on Driver-Injury Severity at Highway-Rail Grade Crossings Accidents
Authors: Ma Changxi , Hao Wei , Xiang Wang , Yan Wei
Published: October 2018

The effect of aggressive driving behavior on driver’s injury severity is analyzed by considering a comprehensive set of variables at highway-rail grade crossings in the US. In doing so, we are able to use a mixed logit modelling approach; the study explores the determinants of driver-injury severity with and without aggressive driving behaviors at highway-rail grade crossings. Significant differences exist between drivers’ injury severity with and without aggressive driving behaviors at highway-rail grade crossings. The level of injury for younger male drivers increases a lot if they are with aggressive driving behavior. In addition, driving during peak-hour is found to be a statistically significant predictor of high level injury severity with aggressive driving behavior. Moreover, environmental factors are also found to be statistically significant. The increased level of injury severity accidents happened for drivers with aggressive driving behavior in the morning peak (6-9 am), and the probability of fatality increases in both snow and fog condition. Driving in open space area is also found to be a significant factor of high level injury severity with aggressive driving behaviors. Bad weather conditions are found to increase the probability of drivers’ high level injury severity for drivers with aggressive driving behaviors.
Cellular Origin, Tumor Progression, and Pathogenic Mechanisms of Cutaneous Neurofibromas Revealed by Mice withNf1Knockout in Boundary Cap Cells
Authors: Radomska Katarzyna J. , Coulpier Fanny , Gresset Aurelie , Schmitt Alain , Debbiche Amal , Lemoine Sophie , Wolkenstein Pierre , Vallat Jean-Michel , Charnay Patrick , Topilko Piotr
Published: October 2018

Patients carrying an inactive NF1 allele develop tumors of Schwann cell origin called neurofibromas (NF). Genetically engineered mouse models have significantly enriched our understanding of plexiform forms of NFs (pNF). However, this has not been the case for cutaneous neurofibromas (cNF), observed in all NF1 patients, as no previous model recapitulates their development. Here, we show that conditional Nf1 inactivation in Prss56-positive boundary cap cells leads to bona fide pNFs and cNFs. This work identifies subepidermal glia as a likely candidate for the cellular origin of cNFs and provides insights on disease mechanisms, revealing a long, multistep pathologic process in which inflammation-related signals play a pivotal role. This new mouse model is an important asset for future clinical and therapeutic investigations of NF1-associated neurofibromas.

Significance:

Patients affected by NF1 develop numerous cNFs. We present a mouse model that faithfully recapitulates cNFs, identify a candidate cell type at their origin, analyze the steps involved in their formation, and show that their development is dramatically accelerated by skin injury. These findings have important clinical/therapeutic implications.

This article is highlighted in the In This Issue feature, p. 1
Efficacy of Semiannual Single Fixed Low-Dose Rituximab Therapy in Steroid-Dependent Minimal Change Nephrotic Syndrome: A Case Series
Authors: Usui Ryosuke , Tsuchiya Yohei , Nitta Kosaku , Koike Minako
Published: October 2018

The frequency of using rituximab to treat refractory nephrotic syndrome has recently been increasing, and the conventional dose of rituximab used to treat it, 375 mg/m2 body surface area once weekly for 4 weeks, has been modelled on the chemotherapy regimen for B-cell non-Hodgkin’s lymphoma. The dose and intervals of rituximab in refractory nephrotic syndrome remain controversial. Clear lymphoma cell hyperplasia is seen in lymphoma patients, but not in nephrotic syndrome patients. Since we thought that it might be possible to reduce the dose of rituximab if only used for the purpose of depleting CD20-positive B cells in nephrotic patients’ peripheral blood, we tried semiannually with a single fixed rituximab dose of 100 mg/body, and a complete remission was attained in 3 cases without treatment with prednisolone or cyclosporine. Our report strongly suggests considering appropriate dose and interval of rituximab therapy in the treatment of steroid-dependent nephrotic syndrome.
Association between Atrial Fibrillation and Aortic Aneurysms: A Population-Based Cohort Study
Authors: Hsu Chia-Ching , Chien Wu-Chien , Wang Jen-Chun , Chung Chi-Hsiang , Liao Wen-I , Lin Wei-Shiang , Lin Chin-Sheng , Tsai Shih-Hung
Published: October 2018

Objective: Atrial fibrillation (AF) is the most common form of sustained arrhythmia. Several molecular pathways associated with the pathogenesis of AF also participate in the initiation and progression of aortic aneurysm (AA). In this study, we aimed to evaluate potential associations between AA and AF. Patients and Methods: The data for this nationwide population-based retrospective cohort study were obtained from Taiwan’s National Health Insurance Research Database (NHIRD). All medical conditions for each case and the controls were categorized using the 9th revision of the International Classification of Diseases (ICD-9). Odds ratios and 95% confidence intervals for associations between AF and AA were estimated using Cox regression and adjusted for comorbidities. Results: Our analyses included 116,225 AF cases and 116,225 propensity score-matched controls. Compared with the controls, the patients with AF exhibited a significantly increased risk of developing an AA (adjusted hazard ratio, HR 1.243, p < 0.001). Another cohort of 19,776 patients diagnosed with AA were identified, and 19,776 propensity score-matched patients were included as controls. Patients who had AA were also at an increased risk of developing AF (adjusted HR 1.187, p < 0.001). Heart failure (HF) was a common risk factor for both AA and AF. Conclusion: There are associations between AF and AA. HF is a mutual risk factor for the development of AF and AA.
Hyperprolactinemia/Prolactinomas in the Postmenopausal Period: Challenges in Diagnosis and Management
Authors: Pekić Sandra , Medic Stojanoska Milica , Popovic Vera
Published: October 2018

Hyperprolactinemia is not a common finding in postmenopausal women. Prolactinomas detected after menopause are usually macroadenomas. Due to atypical clinical features they may remain unrecognized for a long period of time. Interestingly the growth potential of prolactinomas remains after menopause. Most tumors are invasive and present with high prolactin levels. They respond to medical treatment with dopamine agonists in terms of prolactin normalization, tumor shrinkage, and improvement in pituitary function. Treatment with dopamine agonists is usually long term. Reducing doses of cabergoline to the lowest that keeps prolactin levels normal prior to withdrawal is proposed to patients with macroprolactinomas who normalize prolactin after > 5 years of treatment and who do not have cavernous sinus invasion. Cabergoline can achieve a high percentage of remission maintenance in the first years after withdrawal. However, the percentage of relapse-free patients 5 years after withdrawal is significantly lower. Besides recurrent hyper­prolactinemia in a subgroup of macroprolactinomas after a long-interval tumor regrowth may be detected. Menopause cannot ensure remission of the tumor so long-term surveillance is suggested. In patients with microadenomas data on long-term remission rates (normalization of prolactin and disappearance of the tumor) after suspension of treatment with dopamine agonists are highly variable. The current strategy for microprolactinomas is not to treat hyperprolactinemia in menopause if it recurrs after discontinuation of dopamine agonists. This is based on: (1) reports that elevated prolactin levels may normalize in some women after menopause, (2) the fact that the association between prolactin levels and breast cancer is inconsistent in postmenopausal women, (3) the lack of clinical evidence that normalization of prolactin levels in postmenopausal women improves bone mineral density or reduces the risk of fracture, and (4) the fact that, concerning the metabolic syndrome, no data are available on metabolic parameters after suspension of treatment with dopamine agonists. For a change in strategy, i.e., for the potential benefits from treatment of hyperprolactinemia in the postmenopausal period with dopamine agonists concerning weight loss, improved insulin sensitivity, decreased fracture risk, and improved sexuality, more evidence is needed.
Tying Hands, Sinking Costs, and Leader Attributes
Authors: Yarhi-Milo Keren , Kertzer Joshua D. , Renshon Jonathan
Published: October 2018

Do costly signals work? Despite their widespread popularity, both hands-tying and sunk-cost signaling have come under criticism, and there’s little direct evidence that leaders understand costly signals the way our models tell us they should. We present evidence from a survey experiment fielded on a unique sample of elite decision makers from the Israeli Knesset. We find that both types of costly signaling are effective in shaping assessments of resolve for both leaders and the public. However, although theories of signaling tend to assume homogenous audiences, we show that leaders vary significantly in how credible they perceive signals to be, depending on their foreign policy dispositions, rather than their levels of military or political experience. Our results thus encourage international relations scholars to more fully bring heterogeneous recipients into our theories of signaling and point to the important role of dispositional orientations for the study of leaders.
Defining teacher leadership
Authors: Cheung Rebecca , Reinhardt Thomas , Stone Elisa , Little Judith Warren
Published: October 2018

Teacher leadership is widely thought to be critical to the success of local school improvement efforts. But it’s often unclear what teacher leadership entails, precisely. Supported by district-level staff, and with assistance from a university-based research team (the authors of this article), a group of science teacher leaders created a conceptual framework to guide their work. Teacher leadership, they concluded, involves four main activities: collaborating with teachers, modeling effective instruction, providing resources, and advocating on teachers’ behalf.
Personal Recollections of James H. Cone
Authors: Moltmann Jürgen , Lösel Steffen
Published: October 2018

On the occasion of James H. Cone’s death in April 2018, his long-time colleague Jürgen Moltmann reflects on the many decades of their theological and personal friendship, from their initial meeting in 1970 to their last get-together in 2015. With deep personal gratitude, Moltmann speaks about the counseling role, which Cone assumed for him in the United States context for many years, and shares important moments in their common effort to develop a liberating theology for all humankind. After Moltmann’s “Personal Recollections of Wolfhart Pannenberg,” published in Theology Today 72:1 (2015): 11–14, this is another valuable testimony of twentieth-century theological history.
Children of migration: Hopes and tensions over border-crossing in Moldova
Authors: Douillet Catherine
Published: October 2018

Moldova is one of the smallest and poorest European countries, with one of the highest migration rates in the world. While actual migration figures are difficult to obtain, due to the fluctuating and often illegal nature of Moldovan migration, it is an ever-present fact of life in Moldova with about, according to some estimates, a third of the adult population working abroad, often ‘leaving behind’ children in the care of relatives, neighbours or in orphanages. This paper investigates how such high migration rates affect Moldovan family life and personal definitions of identity and success. It highlights the personal quests of the young Moldovan population, particularly college students, and pays particular attention to the young adults who are children of migration themselves, with many of them having grown up with one or both parents working abroad during part or all of their childhood and adolescence.
The rhetoric of leaving, or the mirage of the fetishized West in Cristian Mungiu’s Occident
Authors: Cordali Gradea Adriana
Published: October 2018

In one of his earlier films, Occident (2002), Cristian Mungiu showcases the East–West divide in post-communist Romania. First, the rhetoric of leaving and the rhetoric of staying are complex historical legacies of the communist period, when communist propaganda demonized capitalism and the West. In the communist totalitarian public rhetoric, East–West binaries emphasized the East and communism, which led to a fetishization of the West in the private sphere. I call the motility of predominant discourses between private and public spheres the dialectic of rhetoric, which is also always historical. Secondly, the fetish of the West is a kind of Occidentalism, or a reversed Orientalism, and it is made apparent in the film’s title. The film’s characters are trapped between binaries, given that all these factors have social, political and psychological consequences on people’s lives. Compositionally, the film’s multiple narrative planes compile a postmodern, fragmented structure, mirroring the breakdown of rhetorical master-narratives in post-communism.
What Would a Society Look Like Where Children’s Life Chances Were Really Fair?
Authors: Calder Gideon
Published: October 2018

An increasingly widely used term in recent decades, the central place of ‘life chances’ in UK policy has been confirmed by the retrospective renaming of the Life Chances Act 2010 (formerly the Child Poverty Act 2010). Alongside this, the notion that we should promote fairer life chances has gained purchase across the political spectrum. Yet this notion is loose and ill-defined. This article unpacks the term from the point of view of children. It highlights problems involved with defining and measuring fair life chances for children in suitably broad and non-partial ways, and argues for a plural measure. It outlines two separate dimensions where questions of fairness might apply, in terms of the life course, showing how a suitably supple conception of fair life chances would need to apply across both dimensions. And in light of this account, it suggests three policy approaches – to poverty, childcare, and the configuration of opportunities – which would help establish a society where life chances were really fair: not sufficient, but vital contributions. Overall, the article suggests that a commitment to making life chances fairer requires considerably more radical steps than the term’s recent handling in political discourse would imply.
The chronic effect of pulsed 1800 MHz electromagnetic radiation on amino acid neurotransmitters in three different areas of juvenile and young adult rat brain
Authors: Ahmed Nawal A , Radwan Nasr M , Aboul Ezz Heba S , Khadrawy Yasser A , Salama Noha A
Published: October 2018

The extensive use of mobile phones worldwide has raised increasing concerns about the effects of electromagnetic radiation (EMR) on the brain due to the proximity of the mobile phone to the head and the appearance of several adverse neurological effects after mobile phone use. It has been hypothesized that the EMR-induced neurological effects may be mediated by amino acid neurotransmitters. Thus, the present study investigated the effect of EMR (frequency 1800 MHz, specific absorption rate 0.843 W/kg, power density 0.02 mW/cm2, modulated at 217 Hz) on the concentrations of amino acid neurotransmitters (glutamic acid, aspartic acid, gamma aminobutyric acid, glycine, taurine, and the amide glutamine) in the hippocampus, striatum, and hypothalamus of juvenile and young adult rats. The juvenile and young adult animals were each divided into two groups: control rats and rats exposed to EMR 1 h daily for 1, 2, and 4 months. A subgroup of rats were exposed daily to EMR for 4 months and then left without exposure for 1 month to study the recovery from EMR exposure. Amino acid neurotransmitters were measured in the hippocampus, striatum, and hypothalamus using high-performance liquid chromatography. Exposure to EMR induced significant changes in amino acid neurotransmitters in the studied brain areas of juvenile and young adult rats, being more prominent in juvenile animals. It could be concluded that the alterations in amino acid neurotransmitters induced by EMR exposure of juvenile and young adult rats may underlie many of the neurological effects reported after EMR exposure including cognitive and memory impairment and sleep disorders. Some of these effects may persist for some time after stopping exposure.
The usefulness of the SOFA and APACHE II scoring systems for the early prediction of mortality in patients with dapsone poisoning
Authors: Lee Y , Kim SJ , Kim YS , Kim H , Lee DK , Lee J , Go TH , Cha YS
Published: October 2018

The rate of mortality from dapsone poisoning is high because of the long absorption half-life of dapsone. This study aimed to evaluate the usefulness of the sequential organ failure assessment (SOFA) and acute physiology and chronic health evaluation II (APACHE II) scoring systems for the early prediction of mortality in patients with dapsone poisoning. This is a retrospective and observational study of consecutive patients diagnosed with dapsone poisoning. The SOFA and APACHE II scores were obtained within the first 24 h of admission. Patients were divided into survivor and non-survivor groups. In total, 106 patients were included. The SOFA scores of the survivor and non-survivor groups were 1 (0–8) and 4 (1–10), respectively ( p < 0.001). The APACHE II scores of the survivor and non-survivor groups were 9 (1–25) and 14 (3–23), respectively ( p < 0.001). Based on these scores and in-hospital mortality cases, the standardized mortality ratios for the APACHE II and SOFA were 1.00 (95% confidence interval (CI): 0.64–1.48) and 1.00 (95% CI: 0.64–1.49), respectively. In the model adjusted for clinically important variables and variables with significant differences between the survivor and non-survivor groups, the area under the curve of the SOFA (0.907; 95% CI: 0.834–0.955) was significantly higher than that of the APACHE II (0.793; 95% CI: 0.703–0.867) ( p = 0.008). The SOFA and APACHE II score systems had good discrimination and satisfactory calibration performance in patients with dapsone poisoning. However, the SOFA score was a more useful method in predicting mortality than the APACHE II score.
Value conflicts in perioperative practice
Authors: Blomberg Ann-Catrin , Bisholt Birgitta , Lindwall Lillemor
Published: October 2018

Background:

The foundation of all nursing practice is respect for human rights, ethical value and human dignity. In perioperative practice, challenging situations appear quickly and operating theatre nurses must be able to make different ethical judgements. Sometimes they must choose against their own professional principles, and this creates ethical conflicts in themselves.

Objectives:

This study describes operating theatre nurses’ experiences of ethical value conflicts in perioperative practice.

Research design:

Qualitative design, narratives from 15 operating theatre nurses and hermeneutic text interpretation.

Ethical consideration:

The study followed ethical principles in accordance with the Helsinki Declaration and approval was granted by the local university ethics committee.

Findings:

The result showed that value conflicts arose in perioperative practice when operating theatre nurses were prevented from being present in the perioperative nursing process, because of current habits in perioperative practice. The patient’s care became uncaring when health professionals did not see and listen to each other and when collaboration in the surgical team was not available for the patient’s best. This occurred when operating theatre nurses’ competence was not taken seriously and was ignored in patient care.

Conclusion:

Value conflicts arose when operating theatre nurses experienced that continuity of patient care was lacking. They experienced compassion with the patient but still had the will and ability to be there and take responsibility for the patient. This led to feelings of despair, powerlessness and of having a bad conscience which could lead to dissatisfaction, and even resignations.
Neuroticism and emotion regulation through music listening: A meta-analysis
Authors: Miranda Dave , Blais-Rochette Camille
Published: October 2018

Recent research has found that neuroticism (i.e., trait emotional instability) may dispose people to use music listening as a strategy to regulate their emotions. To estimate the magnitude of this relationship, we performed a meta-analysis (random effects model) of the extant 13 correlational studies ( k = 13) for a total of 2641 participants. Results indicated a significant small-to-medium summary effect ( r =.22, 95% CI [0.17, 0.27]) for the positive correlation between neuroticism and emotion regulation through music listening. Furthermore, there was no evidence of significant heterogeneity in effect sizes across studies. Overall, we conclude that the putative effect of neuroticism on musical emotion regulation is relatively moderate. Findings may suggest that people higher in neuroticism are more prone to use music listening as an accessible resource to regulate their negative emotions or manage whatever affects their mood in everyday life.
A Discharge Time-Out: A Case Study on Physician–Nurse Discharge Communication and the Challenge of Sustainability in Resident-Led Quality Improvement
Authors: Raffel Katie E. , Gupta Neha , Vercammen-Grandjean Christopher , Hohman Jessica , Ranji Sumant , Pierluissi Edgar , Mourad Michelle
Published: October 2018

Resident-led quality improvement (QI) is an important component of resident education yet sustainability of improvement and impact on resident education have rarely been explored. This study describes a resident-led intervention to improve nursing (RN)–provider (MD) communication at discharge—the Discharge Time-Out (DTO)— and explores its uptake and sustainability. One year later, residents were surveyed regarding QI self-efficacy and planned QI involvement. Baseline verbal RN–MD communication at discharge was rare. During DTO implementation, rates of structured communication averaged 56% (341/608) with several months >70%. During the monitoring phase, this fell to 45% and did not recover (833/1852). Participating residents reported increased QI self-efficacy ( P < .05) and increased likelihood of participating in future QI ( P < .05). The DTO increased RN–MD communication but was not sustained. Resident-led QI should explicitly address sustainability to achieve improvement and educational objectives. To foster resident education and avoid short-lived, low-impact projects, increased attention should be given to sustainability of resident-led QI.
From Middle Childhood to Adulthood Attachment
Authors: Mohd Hasim Marshina Juliza , Mustafa Hasrina , Hashim Nor Hazlina
Published: October 2018

Attachment theory argues that attachment styles developed during infancy and childhood will be relatively enduring and continue during adulthood. While research on adult attachment has been mounting in the past, less is known on the enduring effect of attachment styles with mother, father, and their peer or peers during childhood on adult romantic attachment styles. Past research in fact have obtained mixed findings on the stability of attachment styles from childhood to adulthood, especially in the context of Malaysian setting. In order to explore the stability of attachment styles from childhood to adulthood, a survey among 400 married individuals was conducted and partial least squares was employed for data analysis. The application of attachment theory in this study was established via two dimensions of anxiety and avoidance. The result indicated that respondents who exhibited high levels of anxiety and high levels of avoidance with mother, father, and their peers would display the same attachment styles with their romantic partners or spouses during adulthood. The findings provide conclusive evidence on the continuity and stability of attachment styles with stronger and enduring bonds observed for peer-adult attachment.
Risk Factors for Failure of Total Ankle Arthroplasty With a Minimum Five Years of Follow-up
Authors: Cody Elizabeth A. , Bejarano-Pineda Lorena , Lachman James R. , Taylor Michel A. , Gausden Elizabeth B. , DeOrio James K. , Easley Mark E. , Nunley James A.
Published: October 2018

Background:

As the popularity of total ankle arthroplasty (TAA) increases and indications expand, surgeons require a better understanding of which patient factors are associated with implant failure. In this study, we aimed to use a large total ankle database to identify independent risk factors for implant failure at mid- to long-term follow-up.

Methods:

A prospectively collected database was used to identify all patients who underwent primary TAA with a minimum 5 years’ follow-up. The primary outcome was revision, defined as removal of one or both metal components; failures due to infection were excluded. Patient and clinical factors analyzed included age, sex, body mass index (BMI), smoking status, presence of diabetes, indication for TAA, implant, tourniquet time, and presence of ipsilateral hindfoot fusion. Preoperative coronal deformity and sagittal talar translation were assessed, as were postoperative coronal and sagittal tibial component alignment. Univariable and multivariable analyses were performed to identify predictors of implant failure. After excluding 5 ankles that failed because of deep infection, 533 ankles with a mean 7 (range, 5-11) years of follow-up met the inclusion criteria. Four implants were used: INBONE I, INBONE II, STAR, and Salto-Talaris.

Results:

Thirty-four ankles (6.4%) were revised or removed a mean 4 (range, 1-9) years postoperatively. The only independent predictors of failure were the INBONE I prosthesis and ipsilateral hindfoot fusion ( P = .006 and P = .023, respectively).

Conclusions:

This is among the largest studies to analyze the relationship between TAA failure rates and multiple different patient, operative, and radiographic factors. Of note, age, BMI, and amount of deformity were not associated with higher failure rates. Only patients with ipsilateral hindfoot fusion or who received the INBONE I prosthesis were at significantly higher risk of implant failure.

Level of Evidence:

Level III, retrospective cohort study.
Comparison of Radiographic and Clinical Results After Extended Distal Chevron Osteotomy With Distal Soft Tissue Release With Moderate Versus Severe Hallux Valgus
Authors: Song Jae Hwang , Kang Chan , Hwang Deuk Soo , Lee Gi Soo , Lee Sang Bum
Published: October 2018

Background:

We compared the radiographic and clinical outcomes of moderate and severe hallux valgus treated by extended distal chevron osteotomy (EDCO) and distal soft tissue release (DSTR).

Methods:

We performed a retrospective analysis comparing the utility of EDCO for the treatment of moderate (36 patients, 46 feet) and severe (36 patients, 42 feet) hallux valgus. The radiologic outcomes were evaluated based on the preoperative and 3-year follow-up x-rays. The clinical results were investigated based on the 3-year follow-up Manchester-Oxford Foot Questionnaire (MOXFQ), patient satisfaction, and postoperative complications.

Results:

The mean postoperative intermetatarsal angle, hallux valgus angle, tibial sesamoid position, and relative metatarsal bone length were significantly different compared with the preoperative values for both the moderate and severe groups ( P < .001). At 3-year follow-up, intergroup differences were observed in the mean postoperative intermetatarsal angle ( P = .001), hallux valgus angle ( P = .003), and tibial sesamoid position ( P = .013); however, mean radiographic results were within the normal range for both groups. There were no intergroup differences for either the first metatarsal bone length ( P = .172) or shortening ( P = .621). No significant difference in MOXFQ ( P = .525) was evident between the groups at 3-year follow-up. In satisfaction analysis, 82.6% of the moderate group reported good to excellent results, as did 81.0% of the severe group ( P = .815). A total of 7 complications were reported in each group ( P = 1.000).

Conclusion:

The present study showed that midterm mean radiographic results of both moderate and severe hallux valgus treated by EDCO with DSTR were favorable, and those values were within the normal range. Clinical outcomes were comparable between the 2 groups, including overall efficacy. Based on these results, we recommend EDCO with DSTR as an efficient and reliable operative option for both moderate and severe hallux valgus.

Level of Evidence:

Level III, retrospective comparative study.
Dynamics of a general jerky equation
Authors: Tang Diandian , Zhang Shirui , Ren Jingli
Published: October 2018

Some classic nonlinear dynamical systems, such as Rössler's toroidal model, the Genesio model, and 19 Sprott's models, can be classified into seven distinct basic classes of jerky dynamics, labeled by [Formula: see text]. This paper is devoted to the dynamics of a general jerky equation which contains [Formula: see text] as parameters vary. It is shown that the system undergoes fold, Hopf, zero-Hopf, and Bogdanov–Takens bifurcations based on the center manifold theorem and normal form theory. Numerical simulations are also given to make the theoretical results visible and to detect more complicated dynamical behaviors, including degenerate Hopf bifurcation, fold bifurcation of cycle, and limit cycles. Especially, an apple-like attractive portrait is discovered near the zero-Hopf bifurcation point for the first time. Finally, according to the conclusions of the general jerky equation, exact conditions are summarized by two tables on how bifurcations will occur for [Formula: see text], respectively.
Racism, Social Programming, and Evaluation
Authors: Thomas Veronica G. , Madison Anna , Rockcliffe Faun , DeLaine Kendra , Lowe Stacey McDonald
Published: October 2018

Recent public events have unnerved the country, touched the consciousness of the populace, and reveal the resurgence of the White supremacist movement, causing many citizens to reflect on race relations. Given the profound impact of racism deeply embedded in the fabric of this country and its complex and destructive influence on the lives of people of color in social programs and in the contexts being evaluated, evaluators and the evaluation profession must not be complicit in the status quo by ignoring issues of race and racism in our work. This article sounds a clarion call for evaluators to use their power and privilege to advance a more equitable society by “calling out” racists’ practices, unmasking inequities, and articulating participants’ experiences within their racialized environments. We unpack how racism is a complex and destructive force in evaluation contexts. In this article, we hope to stimulate evaluative thinking and action by urging evaluators to gain a deeper understanding of racism as a complex interplay of individual attitudes, social values, and institutional policies and practices and to bring these understandings to their work. While evaluators alone cannot solve the racism problem, they certainly can at least elevate this harsh reality in the discourse on the eradication of social problems that derive from a national legacy of exploitation and bigotry. As reflective practitioners and advocates for democratic ideals, evaluators have both an opportunity and responsibility to illuminate the potential impact of race and racism on the programs that we evaluate and the environments that we engage. The article concludes with specific actions that evaluators can take toward this end.
Contemplating remote presence technology for culturally safe health care for rural indigenous children
Authors: Holt Tanya , Hansen Gregory , McKinney Veronica , Mendez Ivar
Published: October 2018

Indigenous children living in rural and remote Canada have limited access to paediatric specialty services. As such, they experience a high rate of medical transport out of their home communities. The Truth and Reconciliation Commission’s calls to action has prioritized access to health care that is culturally safe and community directed. Remote presence robotic technology—a novel form of telemedicine—seeks to overcome the barriers of distance and time to improve health care access. The robot allows for direct patient visualization, examination, and communication with local health care providers and family members. This intervention may reduce unnecessary paediatric transfers, and enhance culturally safe care in the child’s home community through timely access to paediatric subspecialty care.
The use of telemedicine for delivering healthcare to bariatric surgery patients: A literature review
Authors: Coldebella Belinda , Armfield Nigel R , Bambling Matthew , Hansen Julie , Edirippulige Sisira
Published: October 2018

Introduction

Bariatric weight loss surgery is one of the most effective treatments for severe obesity. Research shows that the availability of healthcare services pre and post bariatric surgery improves behavioural change and weight loss outcomes. The aim of this systematic review is to assess the evidence relating to the use of telemedicine for providing health services to bariatric surgery patients.

Methods

A search was conducted using PubMed, EMBASE, CINAHL, PsycNET and SCOPUS. Original research relating to telemedicine for bariatric surgery patients published in peer-reviewed journals were included.

Results

Database search returned 258 references and a total of 10 studies were included in the review. Six studies assessed use, feasibility and acceptance of telemedicine by patients/practitioners. Studies also examined the use of telemedicine for weight loss, changes in physical activity, diet/eating or other behavioural changes. Two studies were randomised controlled trials; one showed a significant difference in outcomes between intervention and control group.

Discussion

This review suggests that telemedicine may be a potential method for providing healthcare services to bariatric surgery patients. However, the current evidence base does not allow for definitive conclusions.
Telementoring for hepatitis C treatment in correctional facilities
Authors: Neuhaus Maike , Langbecker Danette , Caffery Liam J , Taylor Monica , Garner Lisa , Williams Gayle , Smith Anthony C , Macdonald Graeme A
Published: October 2018

Introduction

Prevalence of hepatitis C virus (HCV) is substantially higher among prisoners than the general population. In Australia until recently, only a small proportion of prisoners with HCV received antiviral therapy. The direct-acting antivirals (DAAs) for HCV are highly effective, with a low burden of side effects. Since 2016, DAAs are available to all Australians with HCV. However, currently in Australia, they can only be prescribed by or in consultation with experienced prescribers. This study evaluated a telementoring service to upskill doctors and nurse practitioners working in correctional facilities.

Methods

The telementoring service was implemented in five correctional facilities. Qualitative interviews were used to examine the perceived clinical effectiveness and organisational impacts of the service. Content analysis of the interviews was used to identify key themes.

Results

In the first ten months of the service, there were 16 telementoring sessions with 173 patients discussed. Sixteen staff participated in qualitative interviews. From these, three key themes were identified: access to antiviral therapy; organisational impacts (cost, increased staff knowledge and confidence, staff time, and workload); and, adaptations of the care model and future opportunities.

Conclusion

Telementoring is an effective method to facilitate eligible prescriber status to medical doctors and upskill other clinicians in correctional facilities to increase capacity to treat HCV.
Music therapy and dementia care practice in the United Kingdom: A British Association for Music Therapy membership survey
Authors: Schneider Justine
Published: October 2018

The place of music therapy in the spectrum of musical interventions in dementia care needs to be better understood in light of the ‘supply’ and ‘demand’ of this provision. A semi-structured, online survey of British Association for Music Therapy members and affiliates was undertaken in summer 2017. It asked respondents to report on employment practice and settings, and experience in dementia-related music therapy. It asked about training received and given, and what barriers prevent wider availability of music therapy for people with dementia in the United Kingdom. Replies came from 188 people, 142 of whom were working with people with dementia. Most respondents reported working in the public or voluntary sector, but one in five was self-employed. Most (61%) were employed in residential care or hospital settings, for an average of 20 hours per week. The main factor that would increase music therapy provision in dementia care was seen as ‘greater awareness’ of music therapy amongst the general public and within the National Health Service. Nearly one-quarter (23%) thought that training and development could help increase provision. This was the largest survey undertaken to date of dementia practice by Music Therapists in the United Kingdom. It has implications for recruitment, professional development, promotion of the specialism and research.
Warm white versus neutral white LED street lighting: Pedestrians' impressions
Authors: Davidovic M , Djokic L , Cabarkapa A , Kostic M
Published: October 2018

The subjective impressions of pedestrians are necessary in order to decide on the appropriate colour of light to be used for street lighting. Therefore, a pilot project aimed to compare subjective evaluations of the sidewalk illumination under two street lighting installations, realised by LEDs of 3000 K (warm white) and 4000 K (neutral white), was recently conducted in Belgrade. Both installations had comparable sidewalk illuminances as well as other relevant photometric parameters. The evaluation was done through a questionnaire. A group of 139 (61 male and 78 female) respondents, all of them university students, was asked to grade both lighting installations for the sidewalk light intensity, the appearance of human faces, the colour of light and the colour rendering as well as the overall impression. According to the median values, the 3000 K LED installation was considered better than the 4000 K installation for all aspects assessed as well as the overall impression. Although the survey results convincingly showed a preference for 3000 K LEDs for this comparison, additional research is needed using a more representative sample of people and a wider range of locations before a definite conclusion can be reached.
Can “Indirect” Contact Laser Surgery be Used for Fluorescence-Image Guided Tumor Resections? Preliminary Results
Authors: Elagin Vadim V. , Shakhova Maria A. , Sirotkina Marina A. , Shakhov Andrey V. , Pavlova Nadezhda P. , Snopova Ludmila B. , Bredikhin Vladimir I. , Kamensky Vladislav A.
Published: October 2018

Ensuring the complete removal of tumor tissue is the main challenge during resection operations. Recently, a technique of “indirect” contact laser surgery has been developed. In this study we assess the possibility of using such surgery for fluorescence image-guided tumor resection. Mouse colon adenocarcinoma CT-26 cells stably expressing the fluorescent protein mKate-2 was used as the tumor model. Resections of the tumor nodes were performed with either a scalpel blade, a laser scalpel with a bare tip, or a laser scalpel with a strongly absorbing coating on the fiber tip. Tumor-positive resection margins were detected using an IVIS Spectrum fluorescence imaging system. After tumor resection with the scalpel blade over half of the animals needed one additional resection to remove residual tumor cells. Animals in this group showed tumor recurrence within 7 days. Fluorescence imaging of the tumor bed, performed after resection to assess the presence of tumor cell clusters, was sufficiently effective only with a bloodless resection. The laser scalpels both with the bare tip and with the strongly absorbing coating on the tip provided such bloodless tumor resection in contact mode. Fewer animals required additional resections when the bare tipped scalpel was used and this also resulted in a reduction in tumor recurrence. After resections were carried out with the laser scalpel with the strongly absorbing coating on the tip, fluorescence was detected in the operative field and this led to undertaking additional resections, although subsequent investigation suggested that this was “false” fluorescence, resulting from the effects of the scalpel rather than the presence of residual tumor cells. The method of laser resection with a strongly absorbing coating on the tip therefore did not appear to demonstrate definite advantages over laser resection with a bare tip when removing tumors.