bluuebunny/crossref_metadata_2025 huggingface dataset:
A quick and accurate method for the estimation of covariate effects based on empirical Bayes estimates in mixed-effects modeling: Correction of bias due to shrinkage
Authors: Yuan Min , Xu Xu Steven , Yang Yaning , Xu Jinfeng , Huang Xiaohui , Tao Fangbiao , Zhao Liang , Zhang Liping , Pinheiro Jose
Published: November 2018

Nonlinear mixed-effects modeling is a popular approach to describe the temporal trajectory of repeated measurements of clinical endpoints collected over time in clinical trials, to distinguish the within-subject and the between-subject variabilities, and to investigate clinically important risk factors (covariates) that may partly explain the between-subject variability. Due to the complex computing algorithms involved in nonlinear mixed-effects modeling, estimation of covariate effects is often time-consuming and error-prone owing to local convergence. We develop a fast and accurate estimation method based on empirical Bayes estimates from the base mixed-effects model without covariates, and simple regressions outside of the nonlinear mixed-effect modeling framework. Application of the method is illustrated using a pharmacokinetic dataset from an anticoagulation drug for the prevention of major cardiovascular events in patients with acute coronary syndrome. Both the application and extensive simulations demonstrated that the performance of this high-throughput method is comparable to the commonly used maximum likelihood estimation in nonlinear mixed-effects modeling.
Early and Late Protective Effect of Bone Marrow Mononuclear Cell Transplantation on Radiation-Induced Vascular Dysfunction and Skin Lesions
Authors: Holler Valérie , Buard Valerie , Roque Telma , Squiban Claire , Benderitter Marc , Flamant Stephane , Tamarat Radia
Published: November 2018

Skin lesions caused by accidental exposure to radiation or by radiotherapy are a major clinical challenge. We evaluated the effect of bone marrow mononuclear cells (BMMNC) on collagen remodeling and vascular function in radiation-induced skin lesions in the acute and late phases in mice. We studied the effect of BMMNC transplantation in a mouse model of cutaneous radiation injury combining local skin gamma-irradiation and biopsy punch wound. Mice were first irradiated, punched and then BMMNC were intramuscularly administered. Seven days after injury, BMMNC promoted wound healing by (i) increasing re-epithelialization, tissue collagen density and mRNA levels of collagens 1A1, 1A2, and 3A1, and (ii) inhibiting the radiation-induced vascular activation and limiting interactions between leukocytes and the vascular endothelium compared with control. Importantly, BMMNC did not amplify the inflammatory response despite the infiltration of neutrophils and macrophages associated with the expression of IL-6 and MCP-1 mRNAs in the tissue. Remarkably, the beneficial effects of BMMNC therapy on matrix remodeling were maintained for 2 months. Furthermore, BMMNC injection restored vascular function in skin tissue by increasing vascular density and vascular permeability. This therapeutic strategy based on BMMNC injection protects against radiation-induced skin lesions by preventing vascular dysfunction and unfavorable remodeling in the acute and late phases.
Theoretical foundations of narrative care: Turning towards relational ethics
Authors: Blix Bodil H , Berendonk Charlotte , Caine Vera
Published: November 2018

In the past decades, narrative practices have been developed, and care has been conceptualized as being narrative in nature. More recently, narrative care has been developing both as a practice and a field of study. It is necessary to make the theoretical foundations of narrative care visible to avoid the risk of narrowly defining narrative care as a matter of storytelling and listening. In this article, we develop an understanding of narrative care grounded in early feminist pragmatist philosophy, with a focus on social and political activism and experience. Pragmatism holds the possibilities to open spaces for realities that are constantly in flux and for emergent situations that must be considered across time, diverse places and social contexts. With the aid of Vera’s stories about her relationship with Tammy, we demonstrate the importance of recognizing that realities are multiple, complex and uncertain. Furthermore, we discuss how the stronghold of formula stories and issues of power, positioning and inequities, restrict people’s possibilities to be, become and co-author their stories. We also argue that the playfulness, imagination and world travelling of narrative care are in line with early feminist pragmatism, which draws on a wide and diverse range of experiences. Jane Addams linked democracy to dialogue, joint experiences and social equality. This calls for the development of ethical frameworks grounded in care that are more specifically focused on relational ethics and a commitment to dialogical and relational democracy and the prioritization of community.
The Impact of the Hai Yang Shi You 981 Event on Vietnam’s Stock Markets
Authors: Le Thai-Ha , Park Donghyun , Tran Cong-Phu-Khanh , Tran-Nam Binh
Published: November 2018

This study examines the extent to which the Hai Yang Shi You 981 (HD-981) event, the sudden deployment of a Chinese oil rig in disputed territorial waters near Paracel Islands in May 2014, affected the stock market performance of 20 sectors of the Vietnamese economy. The impact was measured in terms of stock returns, using daily data on stock market indices. The results strongly indicate that the HD-981 event significantly and negatively affected the overall performance of Vietnam’s stock markets. There is, however, considerable variation across sectors. While most sectors which are heavily dependent on the economy of China were adversely affected, the impact on some sectors was negligible. By conducting this study on Vietnam’s stock markets, we hope to generate implications and lessons for other emerging markets in the region.

JEL Classification: G1, G14, C58
‘Choking smokers, don’t you think the joker laughs at you’: European Union competence and regulation of tobacco products packaging under the new Tobacco Products Directive
Authors: Abaquesne de Parfouru Anatole
Published: November 2018

Directive 2014/40 updated and repealed Directive 2001/37. As with the previous Directive, the new Tobacco Products Directive’s legal basis, proportionality, and subsidiarity were at issue in three recently decided cases, an action for annulment and two preliminary rulings, upholding the Directive’s validity, as well as in another pending preliminary reference. The new TPD once again raises questions of EU competence and recourse to the Article 114 TFEU general internal market legal basis for health measures. This article examines the dual nature of internal market legislation and interaction between internal market and public health objectives, analysing means of justifying the legal basis and proportionality of health-related internal market measures: the high level of health protection envisaged by mainstreaming provisions and the ‘decisive factor’ formula; the EU legislature's discretion as to the most appropriate method of approximation; and its broad discretion in areas involving complex assessments. This article examines the legal basis, proportionality, extent and relevance of labelling and packaging provisions on health warnings, TNCO labelling, misleading features and packet standardization. It suggests further adaptation of the public health legal basis, to reflect the evolution of EU competences in practice and avoid contrived reliance on the internal market objective, which should not, however, entail excessive risk-regulation.
Coordinated Community-Based Hoarding Interventions: Evidence of Case Management Practices
Authors: Bratiotis Christiana , Woody Sheila , Lauster Nathan
Published: November 2018

Hoarding is a problem for which coordinated interprofessional interventions are suited to address associated health and safety concerns. Case management (CM) consists of a set of well-established strategies commonly used in community service settings to address serious mental illness and similar complex problems. The present study used qualitative methods to examine whether CM activities occurred in four North American community-based hoarding intervention models. Findings indicated interventions associated with hoarding cases mapped closely onto eight major functions of CM, though emphasis on specific CM activities depended on availability of resources. CM appears to be a useful rubric for approaching complex social and functional problems that arise among urban clients with hoarding disorder.
Effective design strategy for a high-viscosity magnetorheological fluid–based energy absorber with multi-stage radial flow mode
Authors: Fu Benyuan , Liao Changrong , Li Zhuqiang , Xie Lei , Jian Xiaochun , Liu Chunzhi
Published: November 2018

High-viscosity linear polysiloxane–based magnetorheological fluid features its excellent suspension stability. Few reports could be found for magnetorheological energy absorbers using such highly viscous but highly stable magnetorheological fluids as the controlled medium. This study presents a design strategy for the high-viscosity linear polysiloxane–based magnetorheological fluid–based magnetorheological energy absorber with multi-stage radial flow mode. The design strategy is based on the Herschel–Bulkley flow model incorporating minor losses proposed in our prior work. The optimal geometrical parameters were obtained by gradually reducing the number of unknown variables. By analyzing the effect of thicknesses of baffle and outer cylinder and number of coil turns on magnetic circuit, the distribution of magnetic flux in the effective region of magnetorheological valve was optimized. Furthermore, a magnetorheological energy absorber was fabricated and tested using a high-speed drop tower facility with a 600 kg mass. The maximum nominal impact velocity was 4.2 m/s, and the applied current varied discretely from 0, 1, 2, to 3 A. Comparison of our Herschel–Bulkley flow model with measured data was conducted via analysis of peak force, dynamic range, and maximum displacement that indicate the performance of magnetorheological energy absorber. The results validated the effectiveness of the design strategy for the high-viscosity linear polysiloxane–based magnetorheological fluid–based magnetorheological energy absorber.
Effects of added SiO2 nanoparticles on the thermal expansion behavior of shape memory polymer nanocomposites
Authors: Mahmoodi Mohammad Javad , Hassanzadeh-Aghdam Mohammad Kazem , Ansari Reza
Published: November 2018

In this study, a unit cell–based micromechanical approach is proposed to analyze the coefficient of thermal expansion of shape memory polymer nanocomposites containing SiO2 nanoparticles. The interphase region created due to the interaction between the SiO2 nanoparticles and shape memory polymer is modeled as the third phase in the nanocomposite representative volume element. The influences of the temperature, volume fraction, and diameter of the SiO2 nanoparticles on the thermal expansion behavior of shape memory polymer nanocomposite are explored. It is observed that the coefficient of thermal expansion of shape memory polymer nanocomposite decreases with the increase in the volume fraction up to 12%. Also, the results reveal that with the increase in temperature, the shape memory polymer nanocomposite coefficient of thermal expansion linearly increases. The role of interphase region on the thermal expansion response of the shape memory polymer nanocomposite is found to be very important. In the presence of interphase, the reduction in nanoparticle diameter leads to lower coefficient of thermal expansion for shape memory polymer nanocomposite, while the variation of nanoparticles diameter does not affect the coefficient of thermal expansion in the absence of interphase. Based on the simulation results, the shape memory polymer nanocomposite coefficient of thermal expansion decreases as the interphase thickness increases. In addition, the contribution of interphase coefficient of thermal expansion to the shape memory polymer nanocomposite coefficient of thermal expansion is more significant than that of interphase elastic modulus.
Performance of natural rubber and silicone-based magnetorheological elastomers under large-strain combined axial and shear loading
Authors: Yarra Siddaiah , Gordaninejad Faramarz , Behrooz Majid , Pekcan Gokhan
Published: November 2018

This study presents an experimental investigation on large-strain behavior of natural rubber– and silicone-based magnetorheological elastomers within a larger scope of structural vibration mitigation due to wind, traffic and seismic events. Magnetorheological elastomer samples with different weight percentages of iron particles, additives, and elastomer matrix were fabricated. The microstructures of specimens were examined, and their mechanical properties were investigated by a unique electromagnetic double-lap shear experimental setup capable of applying simultaneous compression and shear loads. The experimental results demonstrated that the isotropic natural rubber–based magnetorheological elastomers exhibit about 30% magnetorheological effect under large strains, while they achieve a higher magnetorheological effect under the combined axial and shear loading. The magnetorheological effect was 92% and 33% for 10% and 100% shear strains when 100 psi axial stress was applied. A natural rubber–based magnetorheological elastomer was further investigated applying dynamic cyclic load with and without compression load for different strains, frequencies, and magnetic field intensities. It was observed that for higher frequency, magnetorheological effect was reduced. Magnetorheological effects were 73% and 29% for 0.1 and 10 Hz frequencies, respectively, under 100 psi axial stress at 150% shear strain. The result of this study suggests that isotropic natural rubber–based magnetorheological elastomers may be suitable for high-demand-force applications, and in particular, in civil structures.
Impact of Health Plan Deductibles and Health Insurance Marketplace Enrollment on Health Care Experiences
Authors: Chen Weiwei , Page Timothy F.
Published: November 2018

High-deductible health plans (HDHPs) have become increasingly prevalent among employer-sponsored health plans and plans offered through the Health Insurance Marketplace in the United States. This study examined the impact of deductible levels on health care experiences in terms of care access, affordability, routine checkup, out-of-pocket cost, and satisfaction using data from the Health Reform Monitoring Survey. The study also tested whether the experiences of Marketplace enrollees differed from off-Marketplace individuals, controlling for deductible levels. Results from multivariable and propensity score weighted regression models showed that many of the outcomes were adversely affected by deductible levels and Marketplace enrollment. These results highlight the importance of efforts to help individuals choose the plan that fits both their medical needs and their budgets. The study also calls for more attention to improving provider acceptance of HDHPs and Marketplace plans as these plans become increasingly common over time.
What’s the Risk in Seeking Help for Depression? Assessing the Nature and Pleasantness of Outcome Perceptions Among Individuals With Depressive Symptomatology
Authors: Lueck Jennifer A.
Published: November 2018

Despite a growing mental health crisis in the United States, empirical indicators of what could make a depression help-seeking message effective and why are currently not available. Even worse, some depression help-seeking messages can activate negative beliefs among depressed individuals that may make help-seeking even less likely than before. The current study is based on the premise that normative theoretical frameworks used for health promotion purposes might not work in populations affected by depression. Addressing a primary driver for health behavior change in gain-and-loss framing, the present research examines the nature of risk perceptions regarding help-seeking among those with depressive symptomatology who have not yet sought help ( N = 738) to inform more effective suicide prevention efforts. Previously, quantitative analyses revealed that the effectiveness of gain-and-loss framing, particularly on attitudes toward help-seeking, depends on the severity of depressive symptomatology. Whereas a persuasive gain-frame advantage was found for those with mild and severe depression symptoms, both framing strategies appeared to backfire and worsen attitudes among those with moderately severe depression symptoms. The present study enriches those results by conducting an in-depth analysis of risk perceptions regarding help-seeking to inform more effective depression help-seeking messages. Risk perceptions were primarily indicative of stigma and the related resistance to seeking help. Judgment and mistreatment were expected not only from the general public but also from the mental health professionals from whom help should be sought. Theoretical and practical implications are discussed.
‘Women-protective’ language as a tool of exclusion: Debates on oocyte donation in Latvia
Authors: Mezinska Signe , Mileiko Ilze
Published: November 2018

‘Women-protective’ language is broadly used as a frame in political discussions on women’s reproductive healthcare and labour rights. This article addresses the use of ‘women-protective’ language in online news articles in the Latvian media about the proposed prohibition of oocyte donation for nulliparous women. The main focus of the recent Latvian debate has not been on the technology itself, but rather on the female body and women’s rationality and decision-making capacity. The results of the analysis show that use of the ‘women-protective’ frame positions women as victims, increases control over the female body and restricts women’s rights to make autonomous decisions. The application of this frame is especially dangerous when used by politicians as it may lead to the legal restriction of women’s rights.
Strategic alliances: Red, green, or “watermelon” candidates in Mexican legislative elections
Authors: Spoon Jae-Jae , Pulido-Gómez Amalia
Published: November 2018

What role do small parties play in new democracies? Although some research has posited that these parties developed to promote policies that the major parties were not addressing, we argue that they are as opportunistic as their larger party competitors. To test our argument, we examine the legislative electoral alliances between the Institutional Revolutionary Party (PRI) and the Ecological Green Party of Mexico (PVEM) in single member districts from 2006 to 2015. In alliance districts, the parties distribute the districts between them: those in which the candidate is from the PRI and those in which the candidate is from the PVEM. There is then a second dynamic in these electoral alliances: Many of the PVEM candidates are former PRI politicians, whom we refer to as “watermelon” candidates, as they are green on the outside and red on the inside. We argue that the parties will select the alliance strategy that will be most electorally beneficial—running a PRI, PVEM, or watermelon candidate. We find that running a PRI or watermelon candidate increases the alliance’s probability of winning. Our findings have important implications for understanding Mexican party politics as well as the role of small parties and party competition in developing democracies.
Philanthropic giving, sales growth, and tourism firm performance: An empirical test of a theoretical assumption
Authors: Wang Keling , Miao Yaqiong , Chen Ming-Hsiang , Hu Dengfeng
Published: November 2018

Aiming to test a theoretical assumption that corporate giving (CG) could increase sales of tourism firms and hence firm performance, this study empirically investigates whether CG could increase sales growth and enhance firm performance in the Chinese tourism industry. Empirical results can enhance theoretical innovation and development. Panel regression test results reveal three interesting findings and support the theoretical assumption. First, there is a variation in the impact of CG on tourism firm performance. While CG does not significantly affect Chinese travel firm performance, it has a significant effect on hotel firm performance in terms of sales growth, return on asset, and return on equity. Second, state ownership is not a critical factor in the financial impact of CG on travel and hotel firms. Third, the Chinese hotel industry might use CG a short-term image builder and sales and profitability generator rather than as a long-term competitiveness strategy. Lastly, there is an inverted U-shaped relationship between CG and hotel firm performance.
Protesting to protect “us” and/or “them”? Explaining why members of third groups are willing to engage in collective action
Authors: Klavina Liga , van Zomeren Martijn
Published: November 2018

In three studies we test whether three key predictors of collective action (i.e., group identification, anger, and efficacy) also predict whether and how members of third groups are willing to undertake collective action. Little is known about this, particularly about whether and how third-group members may engage in collective action to protect their own group and/or to protect an outgroup in need. In three studies that employed different three-group contexts, we found that the three predictors contributed to third-group members’ collective action intentions aimed at protecting the ingroup as well as those aimed at protecting the outgroup. Study 1 found this among Latvians ( N = 89) in response to the Russian annexation of Ukrainian territory; Study 2 found this among residents of a Dutch village ( N = 98) located nearby a gas-extraction-related earthquake region, in response to authorities’ inadequate protection of the residents of that region; and Study 3 found this among Latino Americans ( N = 278) in response to police brutality against Black Americans. Moving beyond replication and application of previous work, our set of studies show first evidence for ingroup and outgroup protection as motives of third-group members’ collective action. We discuss the implications of our findings for the broader social psychology of collective action literature.
Extreme and spectrum characteristics of wind loads on super-large cooling tower under different four-tower combinations
Authors: Wang Hao , Ke Shitang , Ge Yaojun , Tamura Yukio
Published: November 2018

The wind loads distribution on the super-large cooling tower under the interference effect of tower group is very complicated. Particularly, energy distribution of fluctuation wind loads and extreme model is difficult to be predicted. However, accurate calculations of these two factors are the most direct ways for analysis of wind resistance dynamics of super-large cooling tower. The wind tunnel tests of the highest super-large cooling tower under five typical tower combinations (serial, rectangular, rhombus, L-shaped, and inclined L-shaped) with 320 working conditions were performed. On this basis, non-Gaussian and non-stationary properties of local wind pressure and overall force coefficient of super-large cooling tower were analyzed. Distribution laws of local wind pressure extremes and overall force coefficient extremes were discussed based on Hermite method and peak factor method. Key attention was paid to the mapping relationships of characteristic angles with local and overall aerodynamic force extremes. The effects of four-tower combination modes on fluctuation wind loads energy of super-large cooling tower were studied based on the power spectral density function, intrinsic mode function, and evolution power spectral density function. Besides, the estimation formulas of local wind pressure spectrum and overall pressure coefficient spectrum of super-large cooling tower under four-tower combination were proposed. It can be found that the extremes of local wind pressure and overall aerodynamic force could be predicted based on the linear relationship between characteristic angles and fluctuation wind loads. In addition, it is suggested to choose serial combination first, followed by inclined L-shaped, L-shaped, rhombus, and rectangular modes successively.
Cardiovascular events in patients with type 2 diabetes
Authors: Erdmann Erland
Published: November 2018

Diabetes is a common risk factor for cardiovascular disease. Coronary heart disease and left ventricular dysfunction are more common in diabetic patients than in non-diabetic patients, and diabetic patients benefit less from revascularisation procedures. This increased risk can only partly be explained by the adverse effects of diabetes on established risk factors; hence, a substantial part of the excess risk must be attributable to direct effects of hyperglycaemia and diabetes. In type 2 diabetes, hyperinsulinaemia, insulin resistance and hyperglycaemia have a number of potential adverse effects, including effects on endothelial function and coagulation. Risk factor modification has been shown to reduce the occurrence of cardiovascular events in patients with diabetes; indeed, diabetic patients appear to benefit more in absolute terms than non-diabetic patients. There is thus a strong case for intensive treatment of risk factors, including insulin resistance and hyperglycaemia, in patients with type 2 diabetes.
Insulin resistance and cardiovascular disease
Authors: Laakso Markku
Published: November 2018

Insulin resistance is characterised by a decreased rate of insulin-mediated glucose uptake and is associated with adverse changes in cardiovascular risk factors, such as high triglyceride levels, low levels of high-density lipoprotein cholesterol, raised blood pressure, obesity and increased levels of plasminogen activator inhibitor 1. The term `insulin resistance syndrome' (IRS) is used to describe the complex of factors associated with insulin resistance that is found in patients both with and without type 2 diabetes. Although the presence of insulin resistance syndrome is generally considered to be a risk factor for cardiovascular disease, there is a lack of definitive evidence for a causal link. Recently, however, a statistical method known as factor analysis has been applied to the cluster of cardiovascular risk factors associated with IRS. This has been able to show that the `insulin resistance factor' (high plasma insulin and glucose levels, body mass index, waist-to-hip ratio and triglyceride levels) predicted coronary heart disease events in elderly non-diabetic men as well as in patients with type 2 diabetes. Therefore, treatment of insulin resistance whether by pharmacological (eg. thiazolidinediones) or nonpharmacological means has the potential to offer both improvements in glycaemic control and in cardiovascular events.
Changing goals and guidelines
Authors: Wood David
Published: November 2018

The Joint British Societies guidelines on the prevention of coronary heart disease (CHD) are being revised. Target populations will be patients with any symptomatic presentation of atherosclerotic disease, whatever the vascular territory. The first-degree relatives of patients with premature cardiovascular disease also need to be targeted. Third, individuals at high multifactorial risk of developing cardiovascular disease need to be targeted.

New risk prediction charts are being produced. Patients with a cardiovascular risk of ≥ 20% over 10 years (equivalent to a CHD risk of 15% over 10 years) will require investigation and treatment to blood pressure and lipid targets. Those with a cardiovascular disease risk below this threshold require lifestyle advice.
Targeting multiple pathways in cholesterol management
Authors: Wierzbicki Anthony
Published: November 2018

There is a wide variation in plasma total cholesterol levels in populations that are genetically similar: these variations are driven by the environment. We absorb 40—50% of our cholesterol from the diet, and synthesise 50—60% in the liver. Cholesterol absorption inhibitors target the exogenous pathway of cholesterol absorption.

Agents that act on different pathways in cholesterol metabolism, such as statins and cholesterol absorption inhibitors, can be co-administered in an attempt to achieve complementary or synergistic effects on lipid control.
The need for a new approach in cholesterol management
Authors: Hobbs Richard
Published: November 2018

By the year 2020, cardiovascular disease will be the world's biggest cause of premature death. As the plasma cholesterol is lowered, the incidence of coronary heart disease (CHD) events is reduced. European data on secondary prevention show that many patients have not had a plasma cholesterol recorded — even those with a diagnosis of CHD. English data show that only half of patients with a cholesterol measurement are being prescribed a statin, and only half of those are being treated to target. Poor public understanding of this subject area is one obstacle to progress.
The role of dyslipidaemia in coronary heart disease
Authors: Wierzbicki Anthony S
Published: November 2018

The role of cholesterol in cardiovascular disease (CVD) and especially coronary heart disease (CHD) is well established. Epidemiological studies show consistent relationships between total cholesterol, low-density lipoprotein cholesterol (LDL-C) and CHD risk. These same studies show a strong inverse relationship for levels of high-density lipoprotein cholesterol (HDL-C) and CHD risk and a possible relationship for triglycerides.

The metabolic syndrome is a common syndrome affecting 20—25% of the population whose features include abdominal obesity, low-HDL-C, elevated triglycerides, hypertension, hyperglycaemia, hyperinsulinaemia, elevated inflammatory markers, renal dysfunction and microalbuminuria. In the UKPDS study in type 2 diabetes that compared the effects of improved glycaemic and blood pressure control, though some benefit was seen on cardiovascular end points with tighter control, the critical factors predisposing to later macrovascular disease were LDL-C and HDL-C.

There is extensive trial evidence for the benefits of statins in secondary and primary prevention. All guidelines state these are first-line agents for the treatment of cardiovascular risk. Statins have undoubted benefits in the treatment of patients with type 2 diabetes. Statins are also effective in reducing CVD in patients with metabolic syndrome. However, the focus on the benefits of statin therapy has limited discussion of their limitations. In all statin trials to date they reduce CVD events by 25—30% with the largest reduction in the GREACE study being 50%. Only high-dose statin therapy prevents progression of atherosclerosis. Thus, a single minded concentration on LDL-C may underestimate the benefits of a more integrated approach to the management of hyperlipidaemia.
Understanding cardiovascular outcomes in type 2 diabetes
Authors: Wheatcroft Stephen B , Kearney Mark T
Published: November 2018

Although morbidity and mortality from cardiovascular disease are decreasing overall, individuals with type 2 diabetes remain at significantly increased risk. Diabetes-related coronary artery disease currently accounts for a substantial proportion of a cardiologist's workload, and this is likely to increase further with the increasing prevalence of obesity. Patients with type 2 diabetes or metabolic syndrome typically have visceral obesity, which, along with insulin resistance, is becoming an increasingly important risk factor for cardiovascular disease. Visceral adipose tissue is now established as a metabolically active organ, which is thought to contribute to vascular disease by secreting a range of cytokines and other pro-inflammatory mediators. Furthermore, evidence is accumulating that the long period of insulin resistance, which typically precedes the onset of diabetes , may be an important factor underlying the development of atherosclerosis. The continuing tendency toward adverse cardiovascular outcomes in those with type 2 diabetes, despite optimal management of conventional risk factors, argues for intensified efforts to prevent or delay the development of atherosclerotic disease. With the prevalence of obesity and type 2 diabetes continuing to increase, it is essential to focus treatment strategies on the pre-diabetes phase in order to significantly impact on cardiovascular event rates in the future.
The challenge of tackling cardiovascular outcomes
Authors: Barnett Anthony H
Published: November 2018

In recent years there has been a dramatic increase in the incidence of type 2 diabetes mellitus, mainly attributed to the escalating prevalence of obesity and overweight in many populations worldwide, highlighting the need to tackle dietary and physical activity factors. In people with type 2 diabetes, cardiovascular disease is the greatest cause of morbidity and premature mortality, imposing an ever-increasing burden on healthcare resources. Our improved understanding of the pathophysiology of type 2 diabetes has produced a wealth of studies in recent years, leading to substantial advances in the management of diabetes. This review will consider key landmark studies that have provided evidence to support the use of oral glucose-lowering agents, antihypertensives and lipid-lowering agents in this disease, highlighting the practical significance for clinicians.
“No-one would sleep if we didn’t have books!”: Understanding shared reading as family practice and family display
Authors: Hall Mel , Levy Rachael , Preece Jenny
Published: November 2018

Families are pivotal in terms of facilitating children’s language development, including their ability to read. However, to date, there is little research designed to understand how shared reading operates within the realm of everyday family practices. Drawing on data from a study which set out to explore shared reading practices in the home, this article considers reading within the context of the family and everyday family life. In-depth interviews were carried out with 29 parents of pre-school children to investigate shared reading practices within a socially and culturally mixed sample. This study revealed that the relationship between shared reading practices and family practices is recursive. In particular, building on the seminal work of Finch reading was seen to be a specific feature of family practice and routine, and acts as a form of family display. Furthermore, this article demonstrates how shared reading contributes toward the ways in which structure and agency may operate in a family setting. Constructing reading as a family practice and a form of display makes an important contribution to understandings of home literacy practices and behaviors. This article concludes that endeavors to engage families with shared reading therefore require a comprehensive understanding of family life and family practices and the role of shared reading within.
The Racial Implications of Voter Identification Laws in America
Authors: Barreto Matt A. , Nuño Stephen , Sanchez Gabriel R. , Walker Hannah L.
Published: November 2018

Over 40 states have considered voter identification laws in recent years, with several adopting laws requiring voters to show a valid ID before they cast a ballot. We argue that such laws have a disenfranchising affect on racial and ethnic minorities, who are less likely than Whites to possess a valid ID. Leveraging a unique national dataset, we offer a comprehensive portrait of who does and does not have access to a valid piece of voter identification. We find clear evidence that people of color are less likely to have an ID. Moreover, these disparities persist after controlling for a host of relevant covariates.
Different Error Size During Locomotor Adaptation Affects Transfer to Overground Walking Poststroke
Authors: Alcântara Carolina C. , Charalambous Charalambos C. , Morton Susanne M. , Russo Thiago L. , Reisman Darcy S.
Published: November 2018

Background. Studies in neurologically intact subjects suggest that the gradual presentation of small perturbations (errors) during learning results in better transfer of a newly learned walking pattern to overground walking. Whether the same result would be true after stroke is not known. Objective. To determine whether introducing gradual perturbations, during locomotor learning using a split-belt treadmill influences learning the novel walking pattern or transfer to overground walking poststroke. Methods. Twenty-six chronic stroke survivors participated and completed the following walking testing paradigm: baseline overground walking; baseline treadmill walking; split-belt treadmill/adaptation period (belts moving at different speeds); catch trial (belts at same speed); post overground walking. Subjects were randomly assigned to the Gradual group (gradual changes in treadmill belts speed during adaptation) or the Abrupt group (a single, large, abrupt change during adaptation). Step length asymmetry adaptation response on the treadmill and transfer of learning to overground walking was assessed. Results. Step length asymmetry during the catch trial was the same between groups ( P = .195) confirming that both groups learned a similar amount. The magnitude of transfer to overground walking was greater in the Gradual than in the Abrupt group ( P = .041). Conclusions. The introduction of gradual perturbations (small errors), compared with abrupt (larger errors), during a locomotor adaptation task seems to improve transfer of the newly learned walking pattern to overground walking poststroke. However, given the limited magnitude of transfer, future studies should examine other factors that could impact locomotor learning and transfer poststroke.
Finite element solution of the three-dimensional system of equations of heat dynamics of friction and wear during single braking
Authors: Grzes Piotr
Published: November 2018

A three-dimensional numerical model of a disk brake to study temperature on a discrete contact of rough surfaces has been developed. It includes the system of equations formulated based on thermotribological postulates of heat dynamics of friction and wear with mutual influence of contact pressure, velocity, properties of materials, and temperature. Two approaches of calculation of the flash temperature and its influence on the maximum temperature during a single braking application were studied. Changes in the contact temperature, sliding velocity, and the thermomechanical wear during braking were shown and discussed. It was found that two of the examined variants of calculation of the flash temperature agree well for the three considered materials of the brake pads combined with the cast iron disk, at each initial sliding velocity in the range from 5 to 20 m s−1.
The effects of a nonlinear pedagogy training program in the technical-tactical behaviour of youth futsal players
Authors: Pizarro David , Práxedes Alba , Travassos Bruno , del Villar Fernando , Moreno Alberto
Published: November 2018

The aim of this study was to analyse the effect of an intervention program, based on nonlinear pedagogy, on the decision-making and execution of different actions in futsal. The intervention program consisted of 12 training sessions. A quasi-experimental study was developed with eight male futsal players ( M = 15.375, SD = 0.517). The GPET instrument was used to analyse the decision-making and execution of 3442 actions measured during competitive matches (pass, dribbling and shooting). Both variables were analysed with regard to the three tactical principles of attack: keep the ball possession, progression towards the goal and shooting at goal with the lowest level of opposition. With respect to the pass, results showed significantly higher values in decision-making and execution in the first and second principles, but not in the third one. In the dribbling action, results showed significantly higher values in decision-making in the second and third principle, but not in the first one. However, no significant differences were found in the shooting actions. These findings suggest that coaches should take into account in the task design, the tactical principles of play to develop tactical behaviour of youth futsal players.
Pregnancy outcomes among women with type 1 diabetes mellitus using continuous subcutaneous insulin infusion versus multiple daily injections: A retrospective cohort study
Authors: Dixon Benjamin RS , Nankervis Alison , Hopkins Stephanie CN , Cade Thomas J
Published: November 2018

Background

Insulin delivery options for pregnant women with type 1 diabetes mellitus are either continuous subcutaneous insulin infusion or multiple daily injections. The aim of this paper is to compare pregnancy outcomes in women with type 1 diabetes mellitus using continuous subcutaneous insulin infusion or multiple daily injections in pregnancy.

Methods

Retrospective single-centre cohort study of 298 pregnancies booked between 2006 and 2016. Descriptive analysis was performed for HbA1c values. Logistic regression models were created to compare selected maternal and neonatal outcomes.

Results

Continuous subcutaneous insulin infusion was associated with increased risk of large-for-gestational age (aOR 2.00, 95% CI 1.20–3.34) and preterm neonates (aOR 1.80, 95% CI 1.04–3.03). Continuous subcutaneous insulin infusion had no association with increased risk of adverse pregnancy outcomes. No difference in HbA1c values existed between groups.

Conclusion

Using continuous subcutaneous insulin infusion for type 1 diabetes mellitus through pregnancy is associated with increased risk of large-for-gestational age and preterm neonates, without increased risk of associated adverse maternal or neonatal outcomes.
Validation of content of clinical cases in obstetric medicine for a shared web-based educational tool
Authors: Cumyn Annabelle , Gibson Paul
Published: November 2018

Subsequent to the validation of a Canadian Curriculum blueprint for Obstetric Medicine (OM), the Canadian Consensus for a Curriculum in Obstetric Medicine (CanCOM) research group was approached to develop 20 cases to address gaps in clinical exposure during clinical rotations in OM. Forty-nine Obstetric Internists were identified and 43 confirmed their affiliation to the group. Participants (N = 22) reviewed the content of the CanCOM blueprint and identified curriculum content that they considered essential for a rotation for senior General Internal Medicine residents. This survey led to the creation of the CanCOM II essential content blueprint for General Internal Medicine. Following this step, a second subgroup of participants (N = 21) participated in a Delphi survey to identify the content that should be addressed by a teaching case for senior General Internal Medicine residents. A high-level of consensus was obtained for 13 topics and a moderate level for the 7 subsequent topics resulting in the creation of the CanCOM II clinical cases available at http://gemoq.ca/cancom-ii-clinical-case-databank/
Antisynthetase syndrome in pregnancy: A case and review of the literature
Authors: Green Lauren J , O’Neill Lorraine , Frise Charlotte J
Published: November 2018

Antisynthetase syndrome is a rare autoimmune, multisystem, inflammatory condition, characterised by autoantibodies against aminoacyl tRNA synthetases. The predominant features are myositis and interstitial lung disease but other symptoms such as Raynaud’s phenomenon may also be present. Described here is a 36-year-old woman with antisynthetase syndrome who planned and underwent a successful pregnancy, during which a multidisciplinary team approach secured a good outcome for both mother and baby.
Design and development of a low-cost mask-type eye tracker to collect quality fixation measurements in the sport domain
Authors: Martín Jesús Morenas , Luis del Campo Vicente , Manso Fernández-Argüelles Luis Jesús
Published: November 2018

The aim of the study was to build a low-cost mask-type eye tracker with accuracy and precision levels similar to those reported for commercial eye tracking devices. To this end, head-mounted hardware was designed and developed, while open-source software was modified for digital image capture, manipulation, and fixation analysis. An image recognition application was also included with different lighting scenarios. Moreover, parallax and viewing perspective errors were controlled to ensure the quality of data collection. The device was wireless and lightweight (99 g) to allow for natural movement and avoid participant discomfort. After calibration of a 9-target monocular grid, spatial accuracy and precision of the eye tracker was evaluated by 30 participants, at four different lighting setups, both before and after a climbing task. Validity tests showed high levels of accuracy in all conditions as evidenced by a systematic error for a 13-target grid of <0.5°. The reliability tests also showed consistent measurements with no differences in accuracy recorded between participants, lighting conditions, and visual behaviors for the pre- versus post-climbing task. These results suggest that the present eye tracker reports spatial accuracy similar to other commercial systems with levels of high quality. Altogether, this innovative user interface is suitable for research purposes and/or performance analysis in physical activity and sport-related activities. Also, features of this mask-type eye tracking system make it a suitable perceptual user interface to investigate human–computer interactions in a large number of other research fields including psychology, education, marketing, transportation, and medicine.
Phase Ib/II single-arm trial evaluating the combination of everolimus, lapatinib and capecitabine for the treatment of HER2-positive breast cancer with brain metastases (TRIO-US B-09)
Authors: Hurvitz Sara , Singh Rashi , Adams Brad , Taguchi Julie A. , Chan David , Dichmann Robert A. , Castrellon Aurelio , Hu Eddie , Berkowitz Jonathan , Mani Aruna , DiCarlo Brian , Callahan Rena , Smalberg Ira , Wang Xiaoyan , Meglar Ivana , Martinez Diego , Hobbs Evthokia , Slamon Dennis J.
Published: November 2018

Background:

Improving outcomes for patients with human epidermal growth factor 2-positive (HER2+) central nervous system (CNS) metastases remains an unmet clinical need. This trial evaluated a novel combination of everolimus, lapatinib and capecitabine for this disease.

Methods:

Patients with trastuzumab-pretreated, HER2+ breast cancer brain metastasis without prior therapy with a mammalian target of rapamycin (mTOR) inhibitor were eligible. Patients received lapatinib and everolimus daily (continuously) and capecitabine twice daily (d1–14) in 21-d cycles. The primary endpoint was the 12-week CNS objective response rate (ORR). Secondary endpoints included safety, progression-free survival (PFS), overall survival (OS), best CNS ORR and extra-CNS ORR.

Results:

A total of 19 participants were enrolled and treated with ⩾1 dose of the study drug. The median age was 58.5 years, the median number of therapies for metastatic breast cancer was 2.5 (0–11). Pretrial, 74% of participants had received prior lapatinib, capecitabine or both. A total of 63% had received previous CNS radiation or surgical resection and CNS radiation. The maximum tolerated doses were lapatinib at 1000 mg, everolimus at 10 mg, and capecitabine at 1000 mg/m2. Phase II proceeded with capecitabine at 750 mg/m2 due to better tolerability. The most common grade 3/4 adverse events were mucositis (16%), diarrhea, fatigue, and hypokalemia (11% each). Of 11 participants evaluable for 12-week CNS ORR, 3 (27%) had partial response and 7 (64%) had stable disease. The best CNS ORR in eligible participants was 28% (5/18). The median PFS and OS were 6.2 and 24.2 months, respectively.

Conclusions:

This novel triplet combination of lapatinib, everolimus, and capecitabine is well tolerated and yielded a 27% response rate in the CNS at 12 weeks in heavily pretreated participants. Larger studies are warranted to further evaluate this regimen.

Trial registration:

ClinicalTrials.gov: NCT01783756. Registered 05 February 2013, https://clinicaltrials.gov/ct2/show/NCT01783756