bluuebunny/crossref_metadata_2025 huggingface dataset:
Asymptotically Normally Distributed Person Fit Indices for Detecting Spuriously High Scores on Difficult Items
Authors: Xia Yan , Zheng Yi
Published: September 2017

Snijders developed a family of person fit indices that asymptotically follow the standard normal distribution, when the ability parameter is estimated. So far, [Formula: see text], U*, W*, [Formula: see text], and [Formula: see text] from this family have been proposed in previous literature. One common property shared by [Formula: see text], U*, and W* (also [Formula: see text] and [Formula: see text] in some specific conditions) is that they employ symmetric weight functions and thus identify spurious scores on both easy and difficult items in the same manner. However, when the purpose is to detect only the spuriously high scores on difficult items, such as cheating, guessing, and having item preknowledge, using symmetric weight functions may jeopardize the detection rates of the target aberrant response patterns. By specifying two types of asymmetric weight functions, this study proposes SHa(λ)* (λ = 1/2 or 1) and SHb(β)* (β = 2 or 3) based on Snijders’s framework to specifically detect spuriously high scores on difficult items. Two simulation studies were carried out to investigate the Type I error rates and empirical power of SHa(λ)* and SHb(β)*, compared with [Formula: see text], U*, W*, [Formula: see text], and [Formula: see text]. The empirical results demonstrated satisfactory performance of the proposed indices. Recommendations were also made on the choice of different person fit indices based on specific purposes.
Nursing Home Referral Within the Veterans Health Administration: Practice Variation by Payment Source and Facility Type
Authors: Miller Edward Alan , Gidmark Stefanie , Gadbois Emily , Rudolph James L. , Intrator Orna
Published: September 2017

Veterans enrolled within the Veterans Health Administration (VHA) of the U.S. Department of Veterans Affairs (VA) may receive nursing home (NH) care in VHA-operated Community Living Centers (CLCs), State Veterans Homes (SVHs), or community NHs, which may or may not be under contract with the VHA. This study examined VHA staff perceptions of how Veterans’ eligibility for VA and other payment impacts NH referrals within VA Medical Centers (VAMCs). Thirty-five semistructured interviews were performed with discharge planning and contracting staff from 12 VAMCs from around the country. VA staff highlights the preeminent role that VA priority status played in determining placement in VA-paid NH care. VHA staff reported that Veterans’ placement in a CLC, community NH, or SVH was contingent, in part, on potential payment source (VA, Medicare, Medicaid, and other) and anticipated length of stay. They also reported that variation in Veteran referral to VA-paid NH care across VAMCs derived, in part, from differences in local and regional policies and markets. Implications for NH referral within the VHA are drawn.
Working with female offenders in restorative justice frameworks
Authors: Masson Isla , Österman Linnéa
Published: September 2017

Despite a recent increase in restorative justice practice in the criminal justice system, to date there has been no in-depth consideration of the impact of gender in these settings. This paper presents findings from a unique qualitative study on female offenders’ experiences of restorative conferencing in England and Wales, drawing on interviews with practitioners who have worked with female cases, as well as with women who have gone through a restorative justice conference in a perpetrator capacity. Gender-specific factors, suggested to be especially valuable for practitioners to consider when delivering effective and ethical restorative conferences with female offenders, are outlined.
Impact of region of interest (ROI) size on the diagnostic performance of shear wave elastography in differentiating solid breast lesions
Authors: Moon Jin Hee , Hwang Ji-Young , Park Jeong Seon , Koh Sung Hye , Park Sun-Young
Published: September 2017

Background

Shear wave elastography (SWE) using a region of interest (ROI) can demonstrate the quantitative elasticity of breast lesions.

Purpose

To prospectively evaluate the impact of two different ROI sizes on the diagnostic performance of SWE for differentiating benign and malignant breast lesions.

Material and Methods

A total of 154 breast lesions were included. Two types of ROIs were investigated: one involving an approximately 2-mm diameter, small round ROIs placed over the stiffest area of the lesion, as determined by SWE (ROI-S); and another ROI drawn along the margin of the lesion using a touch pen or track ball to encompass the entire lesion (ROI-M). Maximum elasticity (Emax), mean elasticity (Emean), minimum elasticity (Emin), and standard deviation (SD) were measured for the two ROIs. The area under the receiver operating characteristic curve (AUC) as well as the sensitivity and specificity of each elasticity value were determined.

Results

The AUCs for ROI-S were higher than those for ROI-M when differentiating benign and malignant breast solid lesions. The Emax, Emean, Emin, and SD of the elasticity values for ROI-S were 0.865, 0.857, 0.816, and 0.849, respectively, and for ROI-M were 0.820, 0.780, 0.724, and 0.837, respectively. However, only Emax ( P = 0.0024) and Emean ( P = 0.0015) showed statistically significant differences. For ROI-S, the sensitivity and specificity of Emax were 78.8% and 84.3%, respectively, and those for Emean were 80.8% and 81.4%, respectively.

Conclusion

Using ROI-S with Emax and Emean has better diagnostic performance than ROI-M for differentiating between benign and malignant breast lesions.
Non-invasive vagus nerve stimulation for the management of refractory primary chronic headaches: A real-world experience
Authors: Trimboli Michele , Al-Kaisy Adnan , Andreou Anna P , Murphy Madeleine , Lambru Giorgio
Published: September 2017

Background

Non-invasive vagus nerve stimulation has initial evidence of efficacy in migraine and cluster headache. However, little is known about its role in the management of refractory chronic headaches.

Methods

We evaluated the preventive and abortive effects of non-invasive vagus nerve stimulation in 41 consecutive patients with refractory primary chronic headaches in an open-label prospective clinical audit. Headache diaries were used to collect clinical information. Those who obtained at least 30% reduction in headache days/episodes after three months of treatment were considered responders and were offered treatment continuation.

Results

Twenty-three patients with chronic migraine, 12 with chronic cluster headache, four with hemicrania continua and two with short-lasting unilateral neuralgiform headache attacks with autonomic symptoms (SUNA) were treated. Two of 23 chronic migraine patients, one of 12 chronic cluster headache patients, and two of four hemicrania continua patients were considered responders. None of the patients with SUNA benefited from the therapy. Two chronic migraine patients were able to reduce the pain severity of moderate migraines with non-invasive vagus nerve stimulation.

Conclusion

Non-invasive vagus nerve stimulation may not constitute an effective acute nor preventive treatment in refractory chronic primary headaches. The encouraging effect in hemicrania continua warrants further evaluation in larger studies.
Characterizing Citizens’ Preferences for Engagement in Patient Care and Research in Adult and Pediatric Intensive Care Units
Authors: Burns Karen E. A. , Rizvi Leena , Charteris Anna , Laskey Samuel , Bhatti Saima B. , Chokar Kamalprit , Choong Karen L. M.
Published: September 2017

Rationale:

Engagement promotes and supports the active participation of patients and families in health care and research to strengthen their influence on decision-making. We sought to characterize how citizens wish to be engaged in care and research in the intensive care unit (ICU).

Methods:

Interviewers administered questionnaires to visitors in 3 adult ICUs and 1 pediatric ICU.

Results:

We surveyed 202 (adult [n = 130] and pediatric [n = 72]) visitors. Adults and pediatric visitors prioritized 3 patient care topics (family involvement in rounds, improving communication between family members and health-care providers, and information transmission between health-care practitioners during patient transfers) and 2 research topics (evaluating prevention and recovery from critical illness). Preferred engagement activities included sharing personal experiences, identifying important topics and outcomes, and finding ways to make changes that respected their needs. Both respondent groups preferred to participate by completing electronic surveys or comment cards and answering questions on a website. Few respondents (<5%) wanted to participate in committees that met regularly. Although adult and pediatric respondents identified common facilitators and barriers to participation, they ranked them differently. Although both groups perceived engagement to be highly important, adult respondents were significantly less confident that their participation would impact care (7.6 ± 2.2 vs 8.3 ± 1.8; P = .01) and research (7.3 ± 2.4 vs 8.2 ± 2.0; P = .01) and were significantly less willing to participate in care (5.6 ± 2.9 vs 6.7 ± 3.0; P = .007) and research (4.7 ± 3.0 vs ± 5.8 ± 3.0; P = .02).

Conclusions:

Adult and pediatric visitors expressed comparable engagement preferences, identified similar facilitators and barriers, and rated engagement highly. Adult visitors were significantly less confident that their participation would be impactful and were significantly less willing to engage in care and research.
Bifurcated Conversations in Sociological Studies of Religion and Gender
Authors: Avishai Orit , Irby Courtney Ann
Published: September 2017

Feminist sociologists claim that while feminist insights have been incorporated in sociological paradigms and women sociologists have been well-integrated into academia, sociological frameworks have not been transformed, a process known as the missing feminist revolution. Yet, few have examined how the missing feminist revolution operates in specific subdisciplines and the mechanisms that sustain it. This article undertakes these tasks by analyzing religion and gender scholarship published in six sociology journals over the past 32 years. We find evidence of partial integration and continued marginalization. However, we also document disparate networks of interlocutors that operate in two distinct intellectual fields—religion and gender. We argue that this bifurcation partially explains the missing feminist revolution and that insularity of feminist conversations likely contributes to this process. Our findings shed light on obstacles to transforming mainstream disciplines.
Numerical study of the effect of operating parameter on rapid heat cycle molding process
Authors: Hammami Moez , Kria Fatma , Baccar Mounir
Published: September 2017

Recently, rapid heat cycle molding technology has been developed based on the mold heating before each polymer injection stage. For this process, successful heating and cooling phases are of great importance to ensure the cycle productivity and product quality. In this study, a three-dimensional model was developed to investigate the thermal response during the rapid heat cycle molding process. The procedure uses the finite volume method and the fractional area volume obstacle representation to obtain the thermal behavior of both polymer and mold until reaching the regular cyclic regime. The authors’ objective was to determine the operating parameter effect on rapid heat cycle molding process. Thus, four parameters were studied: the heating and cooling temperatures, the heat transfer coefficient of the cooling phase, and the fouling resistance at the channels. To investigate the influence of these parameters on the product quality and the process productivity and profitability, four criteria were selected: cycle time, consumed energy, temperature gap at the surface cavity, and temperature homogeneity in the polymer part. It was found that the operating conditions had a significant effect on the rapid heat cycle molding cycle performance. It was demonstrated that the heating medium temperature affects only the heating time; however, the cooling water temperature affects both heating and cooling times. In particular, the cooling temperature range of 50–60 ℃ reduces the consumed energy compared with the lowest temperatures, without a significant increase in the cycle time.
HIV prevalence and correlated factors of female sex workers and male clients in a border region of Yunnan Province, China
Authors: Zhu Jing , Yuan Rui , Hu Dan , Zhu Zhibin , Wang Ning , Wang Bei
Published: September 2017

Female sex workers (FSWs) and their male clients are vulnerable to HIV infection and serve as a bridge in HIV transmission from the high-risk population to the general, low-risk population. To examine the factors of FSWs and male clients that correlate with the prevalence of HIV infection in the Chinese–Vietnamese border region, a cross-sectional survey was conducted in 2014 in the Hekou county of the Yunnan province of China. We performed a questionnaire survey to collect data on demographics, sexual behavior, and drug use. Blood and urine samples were collected for testing of HIV/sexually transmitted infections and drug use. We found that the prevalence of HIV infection among FSWs was 2.74%, and 15 male clients (2.62%) were HIV-positive. Multivariate logistic regression analysis revealed that herpes simplex virus type 2 infection was a risk factor for HIV infection in FSWs and male clients, suggesting the increased role of sexual transmission in the HIV epidemic in the Chinese–Vietnamese border region. Positive urinalysis result for amphetamine-type stimulants was observed in FSWs with HIV infection. History of drug use was correlated with HIV infection, which increased the HIV infection risk of male clients, confirming that drug use is an important target in future interventions for HIV prevention.
A retrospective clinical audit of general practices in Australia to determine the motivation for switch to dolutegravir/abacavir/lamivudine and clinical outcomes
Authors: Ferrer Pedro E , Bloch Mark , Roth Norman , Finlayson Robert , Baker David , Koh Ken , Orth David , Urbaityte Rimgaile , Brown Dannae , Drummond Fraser
Published: September 2017

The most common reasons for switching HIV-1 therapy in patients with virologic suppression are treatment regimen simplification and resolving tolerability issues. Single-pill regimens that include an integrase inhibitor are recommended options. A retrospective clinical audit was performed to determine the motivations for switching to dolutegravir (DTG)/abacavir (ABC)/lamivudine (3TC) at high HIV-caseload general practice clinics in Australia. The most common reasons for switching from a prior suppressive therapy to DTG/ABC/3TC were simplification of regimen, resolving toxicity/intolerance and patient preference (73%, 13% and 12%, respectively). Kaplan–Meier analysis showed that the probability of patients remaining on DTG/ABC/3TC therapy at 12 months was 95.1%. Switching to DTG/ABC/3TC from a range of other regimens was associated with a discontinuation rate of 3.2%, with 2.5% of patients discontinuing due to adverse events and no patients discontinuing due to virologic failure. Switching to DTG/ABC/3TC was a viable treatment strategy in this cohort of Australian patients.
Features of liquid phase movement in the inter-blade channel of nozzle blade cascade
Authors: Gribin Vladimir , Gavrilov Ilya , Tishchenko Aleksandr , Tishchenko Victor , Popov Vitaliy , Khomyakov Sergey , Alexeev Roman
Published: September 2017

The experimental results of wet steam flow in the blade channel of flat nozzle blade cascade have been considered in the paper. The aim of this work is to study the motion of liquid droplets inside the inter-blade channel. Experimental studies were performed on installation circuit of wet steam. In order to obtain velocity fields of droplets in investigated channel, the laser diagnostics system was used. It carries out the cross-correlation method—particle tracking velocimetry. Numerical simulation of wet steam flow in studied channel was performed. According to the obtained data, the main features of the droplets motion in the blade channel have been revealed. Basic droplets streams and the sources of their appearance have been determined. The process of deposition and breakdown of the droplets on the surface of the blades have been studied. It is shown that reflected region of droplets (“fountain”) is formed around the leading edge. The experimental data were compared with the results of numerical simulation of the droplets motion in the flat nozzle blade cascade.
Energy-saving behavior of Turkish women: A consumer survey on the use of home appliances
Authors: Ucal Meltem
Published: September 2017

This paper focuses on energy-related attitudes and behaviors of Turkish women, who are the main users of electrical home appliances responsible for most household energy consumption. Answers from 1323 female respondents surveyed through a unique questionnaire formed the dataset. The results from analysis of variance show that education has a significant effect on the relationship between energy saving and awareness and attitudes about climate change. Significant differences also exist between education level groups in terms of knowledge of the classification of energy-saving electrical home appliances. Responses to questions related to energy-saving purchasing behaviors are consistently higher for knowledgeable respondents. The paper then uses factor analysis and ordinal logit models to reveal interactions between energy-saving behavior regarding electrical home appliances and several factors, namely awareness, sensitivity, essentials, and receptiveness. The identification of these factors can provide useful insights for policy makers that enable them to construct energy-saving policies specifically tailored toward women.
Hypoxic Culture Promotes Dopaminergic-Neuronal Differentiation of Nasal Olfactory Mucosa Mesenchymal Stem Cells via Upregulation of Hypoxia-Inducible Factor-1α
Authors: Zhuo Yi , Wang Lei , Ge Lite , Li Xuan , Duan Da , Teng Xiaohua , Jiang Miao , Liu Kai , Yuan Ting , Wu Pei , Wang Hao , Deng Yujia , Xie Huali , Chen Ping , Xia Ying , Lu Ming
Published: September 2017

Olfactory mucosa mesenchymal stem cells (OM-MSCs) display significant clonogenic activity and may be easily propagated for Parkinson’s disease therapies. Methods of inducing OM-MSCs to differentiate into dopaminergic (DAergic) neurons using olfactory ensheathing cells (OECs) are thus an attractive topic of research. We designed a hypoxic induction protocol to generate DAergic neurons from OM-MSCs using a physiological oxygen (O2) level of 3% and OEC-conditioned medium (OCM; HI group). The normal induction (NI) group was cultured in O2 at ambient air level (21%). The role of hypoxia-inducible factor-1α (HIF-1α) in the differentiation of OM-MSCs under hypoxia was investigated by treating cells with an HIF-1α inhibitor before induction (HIR group). The proportions of β-tubulin- and tyrosine hydroxylase (TH)-positive cells were significantly increased in the HI group compared with the NI and HIR groups, as shown by immunocytochemistry and Western blotting. Furthermore, the level of dopamine was significantly increased in the HI group. A slow outward potassium current was recorded in differentiated cells after 21 d of induction using whole-cell voltage-clamp tests. A hypoxic environment thus promotes OM-MSCs to differentiate into DAergic neurons by increasing the expression of HIF-1α and by activating downstream target gene TH. This study indicated that OCM under hypoxic conditions could significantly upregulate key transcriptional factors involved in the development of DAergic neurons from OM-MSCs, mediated by HIF-1α. Hypoxia promotes DAergic neuronal differentiation of OM-MSCs, and HIF-1α may play an important role in hypoxia-inducible pathways during DAergic lineage specification and differentiation in vitro.
Feedforward Coordinate Control of a Robotic Cell Injection Catheter
Authors: Cheng Weyland , Law Peter K.
Published: September 2017

Remote and robotically actuated catheters are the stepping-stones toward autonomous catheters, where complex intravascular procedures may be performed with minimal intervention from a physician. This article proposes a concept for the positional, feedforward control of a robotically actuated cell injection catheter used for the injection of myogenic or undifferentiated stem cells into the myocardial infarct boundary zones of the left ventricle. The prototype for the catheter system was built upon a needle-based catheter with a single degree of deflection, a 3-D printed handle combined with actuators, and the Arduino microcontroller platform. A bench setup was used to mimic a left ventricle catheter procedure starting from the femoral artery. Using Matlab and the open-source video modeling tool Tracker, the planar coordinates ( y, z) of the catheter position were analyzed, and a feedforward control system was developed based on empirical models. Using the Student’s t test with a sample size of 26, it was determined that for both the y- and z-axes, the mean discrepancy between the calibrated and theoretical coordinate values had no significant difference compared to the hypothetical value of µ = 0. The root mean square error of the calibrated coordinates also showed an 88% improvement in the z-axis and 31% improvement in the y-axis compared to the unmodified trial run. This proof of concept investigation leads to the possibility of further developing a feedfoward control system in vivo using catheters with omnidirectional deflection. Feedforward positional control allows for more flexibility in the design of an automated catheter system where problems such as systemic time delay may be a hindrance in instances requiring an immediate reaction.
Evaluation of Parametric Response Mapping to Assess Therapeutic Response to Human Mesenchymal Stem Cells after Experimental Stroke
Authors: He Rui , Moisan Anaïck , Detante Olivier , Rémy Chantal , Krainik Alexandre , Barbier Emmanuel Luc , Lemasson Benjamin
Published: September 2017

Stroke is the leading cause of disability in adults. After the very narrow time frame during which treatment by thrombolysis and mechanical thrombectomy is possible, cell therapy has huge potential for enhancing stroke recovery. Accurate analysis of the response to new therapy using imaging biomarkers is needed to assess therapeutic efficacy. The aim of this study was to compare 2 analysis techniques: the parametric response map (PRM), a voxel-based technique, and the standard whole-lesion approach. These 2 analyses were performed on data collected at 4 time points in a transient middle cerebral artery occlusion (MCAo) model, which was treated with human mesenchymal stem cells (hMSCs). The apparent diffusion coefficient (ADC), cerebral blood volume (CBV), and vessel size index (VSI) were mapped using magnetic resonance imaging (MRI). Two groups of rats received an intravenous injection of either 1 mL phosphate-buffered saline (PBS)-glutamine (MCAo-PBS, n = 10) or 3 million hMSCs (MCAo-hMSC, n = 10). One sham group was given PBS-glutamine (sham, n = 12). Each MRI parameter was analyzed by both the PRM and the whole-lesion approach. At day 9, 1 d after grafting, PRM revealed that hMSCs had reduced the fraction of decreased ADC (PRMADC−: MCAo-PBS 6.7% ± 1.7% vs. MCAo-hMSC 3.3% ± 2.4%), abolished the fraction of increased CBV (PRMCBV+: MCAo-PBS 16.1% ± 3.7% vs. MCAo-hMSC 6.4% ± 2.6%), and delayed the fraction of increased VSI (PRMVSI+: MCAo-PBS 17.5% ± 6.3% vs. MCAo-hMSC 5.4% ± 2.6%). The whole-lesion approach was, however, insensitive to these early modifications. PRM thus appears to be a promising technique for the detection of early brain changes following treatments such as cell therapy.
“Why Am I the Way I Am?” Narrative Work in the Context of Stigmatized Identities
Authors: Rance Jake , Gray Rebecca , Hopwood Max
Published: September 2017

There are particular complexities faced by people attempting to tell their stories in the context of social stigma, such as the hostility which often surrounds injecting drug use. In this article, we identify some of the distinct advantages of taking a narrative approach to understanding these complexities by exploring a single case study, across two life-history interviews, with “Jimmy,” a young man with a history of social disadvantage, incarceration, and heroin dependence. Drawing on Miranda Fricker’s notion of “hermeneutical injustice,” we consider the effects of stigmatization on the sociocultural practice of storytelling. We note the way Jimmy appears both constrained and released by his story—how he conforms to but also resists the master narrative of the “drug user.” Narrative analysis, we conclude, honors the complex challenges of the accounting work evident in interviews such as Jimmy’s, providing a valuable counterpoint to other forms of qualitative inquiry in the addictions field.
Asymptotic stabilization of a class of uncertain nonlinear time-delay fractional-order systems via a robust delay-independent controller
Authors: Binazadeh T. , Yousefi M.
Published: September 2017

This paper studies the robust stabilization for a class of nonlinear time-delay fractional order (FO) systems in the presence of some practical aspects. The considered aspects in the FO system include: nonlinear Lipschitz functions; time-varying norm-bounded uncertain terms; and time-delays in the state variables. A major challenge in the control of time-delay systems is that the value of delay is usually not perfectly known or it may be even time-varying. In this paper, a novel asymptotic stabilizing control law is proposed which is delay independent and also has a robust manner in the presence of uncertain terms in the model which may be due to model uncertainties (parameter uncertainties or model simplification) and/or external disturbances. The proposed controller is a FO sliding mode controller that is designed such that the closed-loop system is asymptotically delay-independent stable. For this purpose, a FO sliding manifold is introduced and the occurrence of the reaching phase in a finite time is proved. Finally, in order to validate the theoretical results, an example is given and simulation results confirm the appropriate performance of the proposed controller.
Core crushing and dynamic response of sandwich steel beams with sinusoidal and trapezoidal corrugated cores: A parametric study
Authors: Zhang Linhui , Kim Jeongho
Published: September 2017

This paper presents a finite element based parametric study of the dynamic response and strength of sandwich steel beams with either sinusoidal or trapezoidal corrugated core subjected to impulsive blast loads. The sandwich steel beams consists of flat top and bottom substrates made of Steel 1018 and four core layers of Steel 1008. The core layers are arranged with uniform and non-uniform thicknesses. The finite element model is validated with a set of shock tube experiments and thus makes it feasible for a present parametric design study of core configurations. Sinusoidal and trapezoidal core shapes as well as various core thickness arrangements are taken into consideration for comparing core crushing and buckling behavior and their performances in mitigating blast load effects onto the main structure. A unit-cell beam and a fully clamped sandwich beam are studied to elucidate the effect of core shapes and arrangement onto its dynamic response.
Understanding the present, re-visioning the future: An initial mapping of music therapists in the United Kingdom
Authors: Carr Catherine E , Tsiris Giorgos , Swijghuisen Reigersberg Muriel
Published: September 2017

Music therapy is a small, but evolving profession. Numbers of music therapists are increasing, yet little is known regarding the workforce and its employment characteristics. To understand the current profile of the music therapy workforce in the United Kingdom (UK), the British Association for Music Therapy (BAMT) commissioned a national survey of its membership. This survey explores the profile of the UK music therapy workforce in terms of demographics, training and employment characteristics. An online survey was circulated to all BAMT members. Data were analysed using descriptive statistics and thematic analysis of open-ended responses. A total of 374 therapists responded (44% response rate). Following demographic information (including age, nationality and training background), we focus on employment characteristics such as income, types of work, settings, clients and age groups. Supervision and clinical fees are considered as well as commissioning and funding of self-employed and employed music therapy work. As an initial mapping of the current UK workforce, this study offers a pragmatic platform to consider development and strategic priorities and thus to re-vision the future of music therapy in the country. Potential implications for the international music therapy community are also discussed.
Exploring innovative learning culture in the newsroom
Authors: Porcu Ornella
Published: September 2017

Culture has been viewed as the biggest obstacle to change in the legacy media newsroom. Older as well as recent literature points out that professional culture typically hinders newsroom innovation processes, and newsrooms in transformation often seem to find culture clashes on their path. These transformational problems, however, appear to be viewed predominantly from a management point of view. By looking at journalism culture from the broader perspective of a learning culture which fosters innovation, including both management and newsroom workers, a more nuanced picture can be presented. In this article, the concept of innovative learning culture is introduced to provide a different lens through which drivers and obstacles of innovation in the newsroom can be observed. Furthermore, innovative learning culture can be used in empirical research to gain insights in the learning and innovation processes of professional journalists, a strikingly under-researched area. As such, innovative learning culture as a concept fills gaps in the empirical as well as in the more theoretical literature, which may enhance future newsroom research.
Medication management strategies used by older adults with heart failure: A systems-based analysis
Authors: Mickelson Robin S , Holden Richard J
Published: September 2017

Background:

Older adults with heart failure use strategies to cope with the constraining barriers impeding medication management. Strategies are behavioral adaptations that allow goal achievement despite these constraining conditions. When strategies do not exist, are ineffective or maladaptive, medication performance and health outcomes are at risk. While constraints to medication adherence are described in literature, strategies used by patients to manage medications are less well-described or understood.

Aim:

Guided by cognitive engineering concepts, the aim of this study was to describe and analyze the strategies used by older adults with heart failure to achieve their medication management goals.

Methods:

This mixed methods study employed an empirical strategies analysis method to elicit medication management strategies used by older adults with heart failure. Observation and interview data collected from 61 older adults with heart failure and 31 caregivers were analyzed using qualitative content analysis to derive categories, patterns and themes within and across cases.

Results:

Data derived thematic sub-categories described planned and ad hoc methods of strategic adaptations. Stable strategies proactively adjusted the medication management process, environment, or the patients themselves. Patients applied situational strategies (planned or ad hoc) to irregular or unexpected situations. Medication non-adherence was a strategy employed when life goals conflicted with medication adherence. The health system was a source of constraints without providing commensurate strategies.

Conclusions:

Patients strived to control their medication system and achieve goals using adaptive strategies. Future patient self-mangement research can benefit from methods and theories used to study professional work, such as strategies analysis.
Beyond the Ontological Turn: Affirming the Relative Autonomy of Politics
Authors: Khan Gulshan
Published: September 2017

In this article, I critically evaluate a characteristic tendency that is found across the various traditions of poststructuralism, both narrowly and more broadly defined. This is an increasing propensity to be preoccupied with ontological questions and seemingly at the expense of either a refinement of political concepts or a concrete analysis of forms of power and domination. I consider the reasons for this development and stress how this characteristic feature of poststructuralism appears to follow from the very fact of ontological pluralism. What we see in contemporary continental thought is a proliferation of different traditions, and each side seeks to defend their position in ontological terms. Following this, I advance the idea of a relative autonomy between ontology and politics, where the former does not determine the latter in any direct or straightforward fashion. I argue that we need to stress this relative autonomy to open a little space between ontology and politics, space where we can return poststructuralism to a more concrete engagement with ‘the political’.
Tetramethylpyrazine can ameliorate hepatocellular mitochondrial dysfunction by decreasing the inflammatory response and increasing AQP8 protein expression in septic rats
Authors: Tao Xiaogen , Li Kun , Wang Jinquan , Zhang Lin , Li Wei , Kan Baotian , Yu Guangcai , Jian Xiangdong
Published: September 2017

Sepsis, which could lead to mitochondrial dysfunction and cellular energy loss, always induces acute liver injury and has a high mortality rate. Tetramethylpyrazine (TMP) is an active extract from the Chinese herb Ligusticum chuanxiong and exhibits anti-sepsis activity. In this study, a rat sepsis model was first established via cecal ligation and puncture (CLP). Then, 48 Sprague Dawley male rats were randomly divided into four groups (12 rats in each group): control group (C), sepsis group (S), TMP treatment group (T), and TMP prevention group (P). Serum aspartate aminotransferase (AST), serum alanine aminotransferase (ALT), mitochondrial aspartate aminotransferase (mAST), and adenosine triphosphate (ATP) levels and mitochondrial membrane potential (MMP) were measured and used as indicators of hepatic dysfunction severity and mitochondrial function. In addition, the activities of Na+-K+-ATPase, Mg2+-ATPase, Ca2+-ATPase, and Ca2+-Mg2+-ATPase in the mitochondrial membrane, the expression level of AQP8 and some inflammatory factors, and the level of oxidative stress were measured to explore potential mechanisms. We found that AQP8 accepts signals from inflammatory factors upon stimulation and during various infections, and low AQP8 expression levels could result in further downstream mitochondrial dysfunction. In conclusion, our data demonstrated that TMP could ameliorate hepatocellular mitochondrial dysfunction by decreasing the inflammatory response and increasing AQP8 protein expression.
Pregnancy in women with Klippel-Trenaunay syndrome: Report of three pregnancies in a single patient and review of literature
Authors: Keepanasseril Anish , Keerthana K , Keepanasseril Arun , Maurya Dilip K , Kadambari D , Sistla Sharath
Published: September 2017

Klippel-Trenaunay syndrome is characterised by vascular abnormality which increases the risk of thromboembolism and haemorrhage. Physiological changes in pregnancy pose an increased risk to these complications. Being an uncommon disorder, there is limited literature about the management of women with pregnancy and Klippel-Trenaunay syndrome. We report in detail two of three pregnancies in a woman with Klippel-Trenaunay syndrome who had repeated episodes of haematochezia leading to anaemia, managed with Argon laser Photo-Coagulation in pregnancy and also reviewed the complications and the management of pregnant women with Klippel-Trenaunay syndrome.
Optimal early active mobilisation protocol after extensor tendon repairs in zones V and VI: A systematic review of literature
Authors: Collocott Shirley JF , Kelly Edel , Ellis Richard F
Published: September 2017

Introduction

Early mobilisation protocols after repair of extensor tendons in zone V and VI provide better outcomes than immobilisation protocols. This systematic review investigated different early active mobilisation protocols used after extensor tendon repair in zone V and VI. The purpose was to determine whether any one early active mobilisation protocol provides superior results.

Methods

An extensive literature search was conducted to identify articles investigating the outcomes of early active mobilisation protocols after extensor tendon repair in zone V and VI. Databases searched were AMED, Embase, Medline, Cochrane and CINAHL. Studies were included if they involved participants with extensor tendon repairs in zone V and VI in digits 2–5 and described a post-operative rehabilitation protocol which allowed early active metacarpophalangeal joint extension. Study designs included were randomised controlled trials, observational studies, cohort studies and case series. The Structured Effectiveness Quality Evaluation Scale was used to evaluate the methodological quality of the included studies.

Results

Twelve articles met the inclusion criteria. Two types of early active mobilisation protocols were identified: controlled active motion protocols and relative motion extension splinting protocols. Articles describing relative motion extension splinting protocols were more recent but of lower methodological quality than those describing controlled active motion protocols. Participants treated with controlled active motion and relative motion extension splinting protocols had similar range of motion outcomes, but those in relative motion extension splinting groups returned to work earlier.

Discussion

The evidence reviewed suggested that relative motion extension splinting protocols may allow an earlier return to function than controlled active motion protocols without a greater risk of complication.
A threshold trajectory was revealed by isolating the effects of hemoglobin rate of rise in anemia of chronic kidney disease
Authors: Fusco Gregory , Hariri Ali , Vallarino Carlos , Singh Ajay , Yu Peter , Wise Lesley
Published: September 2017

Background:

To assess cardiovascular risk among various hemoglobin (Hb) rates of rise (RoR) in chronic kidney disease (CKD) patients with anemia who have initiated therapy with erythropoiesis stimulating agents (ESAs).

Methods:

Observational cohort of CKD patients initiating ESA therapy from the Centricity® database, 1990–2011. Proportional hazards models tested the hypothesis that a slower Hb RoR (0 < g/dl/month ⩽ 0.125) is associated with a lower cardiovascular (CV) incidence [composite of fatal/nonfatal myocardial infarction (MI) and stroke] compared with faster RoR (0.125 < g/dl/month ⩽ 2.0, and >2.0 g/dl/month).

Results:

A total of 9220 patients receiving ESAs were followed for an average of 3.1 years. Slow (group B) RoR versus medium (group C′) and fast (group D′) RoR in Hb, throughout all Hb milestones, was associated with lower risk of the composite endpoint [B (slow) versus D′ (fast) [hazard ratio (HR) = 0.20 (0.11, 0.39), p < 0.0001]; B versus C′ (medium) [HR = 0.34 (0.19, 0.62), p = 0.0004], and C′ versus D′ [HR = 0.60 (0.42, 0.85), p = 0.005]]. Within achieved Hb milestones, HRs were: B versus D′ at milestone ⩾ 14.1 g/dl [HR = 0.17 (0.05, 0.56); p = 0.004] and at milestone 12.6−14.0 [HR = 0.18 (0.07, 0.46), p = 0.0004].

Conclusion:

Rapid Hb rise is associated with adverse CV outcomes, with markedly lower risk for rates below a threshold trajectory of 0.125 g/dl/month, even with complete correction.
New horizons in the management of castrate-resistant prostate cancer
Authors: Kamel Mohamed H , Raheem Omer A , Davis Rodney
Published: September 2017

Castrate-resistant prostate cancer is an incurable disease. It continues to be an area of intense research to save prostate cancer patients’ lives. We aim from this review to explore the new lines of treatment that aim at extending disease-specific survival. We conducted a PubMed research on available literature pertaining to key words alone and in combination: prostate cancer, castrate-resistant, immunotherapy, hormonal therapy, chemotherapy, radiation therapy, metastasis, survival and quality of life. We also reviewed the following guidelines on castrate-resistant prostate cancer: National Comprehensive Cancer Network (NCCN), American Urological Association (AUA), the National Institute for Health and Care Excellence (NICE) and the European Association of Urology (EAU). There are four new lines of treatment in castrate-resistant prostate cancer. An immunotherapy, sipuleucel T (Provenge); new hormonal therapies – in the form of a new androgen receptor blocker, enzalutamide (Xtandi) and new adrenal androgen synthesis inhibitor, abiraterone acetate (Zytiga); a new chemotherapy, cabazitaxel (Jevtana) and new radioactive agent, radium 223 (Xofigo). There is an agreement between guidelines that patients with M0 castrate-resistant prostate cancer should not be offered any of these treatments. Similarly, patients with castrate-resistant prostate cancer and poor performance status should be offered only palliative care. There are several new lines of treatment that can be used in castrate-resistant prostate cancer, and hopefully in the near future castrate-resistant prostate cancer will be changing from a lethal disease to more of a chronic disease.
Healthcare expenditure of multiple sclerosis patients in 2013: A nationwide study based on French health administrative databases
Authors: Lefeuvre Delphine , Rudant Jérémie , Foulon Stéphanie , Alla François , Weill Alain
Published: September 2017

Background

Little is known about expenditure items of multiple sclerosis (MS) patients over recent years in France.

Objective

To describe healthcare expenditure among MS patients and identify the main expenditure drivers.

Methods

All healthcare expenditure reimbursed by French National Health Insurance to MS patients in 2013 was described on the basis of nationwide health administrative databases (SNIIRAM/PMSI). Expenditure was described globally and according to age and sex.

Results

The average expenditure among the 90,288 MS patients included was €11,900 per patient. Pharmacy and hospitalisation accounted for 47% and 23% of healthcare expenditure, respectively (38% and 22% of MS patients were treated with disease-modifying therapies and hospitalised overnight or longer, respectively). Average expenditure did not differ according to age. However, pharmacy expenditure decreased with age (from 71% between the ages of 20 and 29 years to 18% between the ages of 70 and 79 years), whereas hospitalisation expenditure increased with age (from 15% to 35%). Paramedical fees accounted for 2% of expenditure between the ages of 20 and 29 years and 24% between the ages of 70 and 79 years.

Conclusion

Overall, pharmacy expenditure was the main expenditure item, which decreased with increasing age, while hospitalisation and paramedical expenditure increased with increasing age.
The World Database for Pediatric and Congenital Heart Surgery: The Dawn of a New Era of Global Communication and Quality Improvement in Congenital Heart Disease
Authors: St. Louis James D. , Kurosawa Hiromi , Jonas Richard A. , Sandoval Nestor , Cervantes Jorge , Tchervenkov Christo I. , Jacobs Jeffery P. , Sakamoto Kisaburo , Stellin Giovanni , Kirklin James K.
Published: September 2017

The World Society for Pediatric and Congenital Heart Surgery was founded with the mission to “promote the highest quality comprehensive cardiac care to all patients with congenital heart disease, from the fetus to the adult, regardless of the patient’s economic means, with an emphasis on excellence in teaching, research, and community service.” Early on, the Society’s members realized that a crucial step in meeting this goal was to establish a global database that would collect vital information, allowing cardiac surgical centers worldwide to benchmark their outcomes and improve the quality of congenital heart disease care. With tireless efforts from all corners of the globe and utilizing the vast experience and invaluable input of multiple international experts, such a platform of global information exchange was created: The World Database for Pediatric and Congenital Heart Disease went live on January 1, 2017. This database has been thoughtfully designed to produce meaningful performance and quality analyses of surgical outcomes extending beyond immediate hospital survival, allowing capture of important morbidities and mortalities for up to 1 year postoperatively. In order to advance the societal mission, this quality improvement program is available free of charge to WSPCHS members. In establishing the World Database, the Society has taken an essential step to further the process of global improvement in care for children with congenital heart disease.
Clinical Progress in the Management of Tetralogy of Fallot in the Dominican Republic: A Case Series
Authors: Perez María T. , Vázquez Marietta , Canarie Michael F. , Toribio Janet , León-Wyss Juan
Published: September 2017

Background:

Definitive surgical interventions for Dominican children with congenital heart disease, like those of other low- and middle-income countries, have been historically limited.

Methods:

We undertook review of a case series focusing on the surgical correction of complex forms of tetralogy of Fallot at a single center, CEDIMAT Centro Cardiovascular, in the Dominican Republic, over a 30-month period.

Results:

According to our criteria, 43 cases were determined to be complex tetralogy of Fallot repairs from the two-year period. Besides tetralogy of Fallot, the cohort had an additional 55 anatomic anomalies that had to be addressed at the time of surgery. Median age at the time of surgery was notably 30 months, and an average of 42 months elapsed from the time of diagnosis to the time of surgery for this group. Only 33% of the cases reviewed had no hypercyanotic crises before repair. Median time to extubation for this group of patients was one day, with a three-day median length of stay in the intensive care setting.

Conclusions:

Our study importantly captures the present experience of a surgical congenital heart program that has recently transitioned from a traditional “mission model” to a now self-sustaining local practice. Both the number and the complexity of the lesions corrected in this caseload represent an advance from the level of care previously provided to children in the Dominican Republic.