bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy and Safety of High Loading Dose of Colistin in Multidrug-Resistant Acinetobacter baumannii: A Prospective Cohort Study
Authors: Katip Wasan , Meechoui Methisa , Thawornwittayakom Phatchawan , Chinwong Dujrudee , Oberdorfer Peninnah
Published: August 2017

Objectives:

We aimed to assess the efficacy and safety of a high loading dose of colistin and no loading dose of colistin to treat multidrug-resistant (MDR) Acinetobacter baumannii infections.

Methods:

We conducted a prospective cohort study of patients with MDR A baumannii infections at a university-affiliated hospital from December 2014 to January 2016. In the high loading dose group, the patients received a high loading dose of 300 mg colistin base activity (CBA) followed by a maintenance dose of 150 mg CBA twice daily, and patients in the no loading dose group received only the maintenance dose. The primary outcome was clinical response. The secondary outcomes were 28-day mortality and microbiological response.

Results:

A total of 255 cases were identified. The high loading dose of colistin strategy provided no significant difference in good clinical response when compared to the no loading dose group (65.5% vs 70.4%; P = .442), without a significant difference in the development of renal dysfunction (52.3% vs 49.4%; P = .664). However, microbiological eradication was significantly higher among patients who received the high loading dose of colistin when compared to those who received the no loading dose (87.9% vs 70.4%; P = .0006).

Conclusions:

The high loading dose of colistin strategy was effective and safe for treating patients with MDR A baumannii.
Effect of Interhospital ICU Relocation on Patient Physiology and Clinical Outcomes
Authors: Janz David R. , Khan Yasin A. , Mooney Jennifer L. , Semler Matthew W. , Rice Todd W. , Johnson Jessica L. , deBoisblanc Bennett P. ,   for the ICU MOVE Investigators and the Pragmatic Critical Care Research Group
Published: August 2017

Relocation of large numbers of critically ill patients between hospitals is sometimes necessary and the risks associated with relocation may be high. In the setting of adherence to an interhospital intensive care unit (ICU) relocation protocol, we aimed to determine whether the interhospital relocation of all ICU patients in a single day is associated with changes in vital signs, device removal, and worse clinical outcomes. We conducted a prospective, observational, cohort study of all critically ill adults admitted to a tertiary medical center’s ICUs on the day of a planned hospital relocation and exposed to interhospital ICU relocation compared with unexposed critically ill adults. Changes in vital signs were evaluated by the before-and-after interhospital relocation measurement of vital signs, and clinical outcomes were collected for all patients. A total of 699 patients were admitted to the ICU during the observation period, 24 of whom were exposed to interhospital ICU relocation on a single day. The median interhospital transport duration was 28 minutes (interquartile range: 24-35) and 29% of patients were receiving invasive mechanical ventilation. Patients exposed to interhospital ICU relocation had no significant change in any vital sign measurement and no devices were unintentionally removed. Inhospital mortality was similar (8.3%) to patients not exposed to interhospital ICU relocation (9.2%, P > .99). In the setting of adherence to an ICU relocation protocol, the interhospital ICU relocation of all critically ill adults during a single day is not associated with changes in vital signs, device removal, or worse clinical outcomes.
A Job Club for Older Job Seekers
Authors: Nakai Yoshie , Hill Stephen C. , Snell Andrea F. , Ferrell Jared Z.
Published: August 2017

The purpose of the current study is to explore the changes in participants’ attitude toward job search and perceived utility of training during job search interventions, called job clubs, designed for older adults. Latent growth modeling was used to examine the trajectories of these outcomes during 3-week-long job clubs. In addition, the study examined the relationship between participants’ self-regulatory skills (emotion control and motivation control) and the training outcomes. In Study 1 (20 job clubs, N = 200) and Study 2 (36 job clubs, N = 385), participants showed continuous positive change in the attitude and perceived utility of training. Although self-regulatory skills in the beginning of job club were not related to the improvement in the outcomes, dynamic measures of emotion control predicted change in attitude and motivation control predicted both attitude and perceived utility of training.
Study on warm forming effects of the axial-pushed incremental rolling process of spline shaft with 42CrMo steel
Authors: Cui Minchao , Zhao Shengdun , Chen Chao , Zhang Da-Wei , Li Jingxiang , Li Yongyi
Published: August 2017

The effects of the warm forming temperature on the axial-pushed incremental rolling process were investigated through finite element analysis and experimental studies. Firstly, the principle of warm axial-pushed incremental rolling process of spline shaft was introduced. Next, the material properties of 42CrMo steel at different forming temperatures were studied to discuss the effects of the warm forming temperature. Through finite element analysis, the simulations of the axial-pushed incremental rolling process were carried out to investigate the effects of the warm forming temperature on rolling forces. The results indicated that the axial and radial forces on the rolling dies were both reduced at the warm forming temperature. Finally, the experiment studies were carried out on a warm axial-pushed incremental rolling equipment. The dimensional precision, microstructure, and hardness of the formed spline shafts at warm temperature were compared with those of the formed spline shafts at room temperature. The results indicated that the spline shafts, which were formed at the warm temperature, possesses of a good dimensional precision and excellent performance. The results in this paper demonstrated that the warm forming temperature has the positive effects on the performance improvement of the axial-pushed incremental rolling process of spline shaft.
Attitudes and potential barriers towards hepatitis C treatment in patients with and without HIV coinfection
Authors: Allyn PR , O’Malley SM , Ferguson J , Tseng CH , Chew KW , Bhattacharya D
Published: August 2017

This study aimed to assess attitudes and potential barriers towards treatment in patients with hepatitis C virus (HCV) infection, comparing those with and without HIV coinfection. A cross-sectional survey of 82 HCV-infected adults with and without HIV was conducted in greater Los Angeles between November 2013 and July 2015. Overall, there were 53 (64.6%) with HIV coinfection, 20 (25.0%) with self-reported cirrhosis, and 22 (26.8%) with a history of prior HCV treatment. Of all, 93.2% wanted HCV treatment, but 45.9% were unwilling/unable to spend anything out of pocket, 29.4% were waiting for new therapies, and 23.5% were recommended to defer HCV treatment. HIV/HCV-coinfected patients were more likely to want treatment within one year (90.2% versus 68.2%, p = 0.02), more willing to join a clinical trial (74.5% versus 8.0%, p < 0.01), more willing to take medications twice daily (86.3% versus 61.5%, p = 0.01), and more likely to prefer hepatitis C treatment by an infectious diseases/HIV physician (36.7% versus 4.0%, p < 0.01). Of all, 77.1% of coinfected patients were willing to change antiretroviral therapy if necessary to treat HCV, but only 48.0% of patients were willing to take a medication if it had not been studied in HIV-positive patients. Treatment preferences differ between HIV/HCV-coinfected and HCV-monoinfected patients. Despite a strong willingness among the study cohort to start HCV treatment, other factors such as cost, access to medications, and provider reluctance may be delaying treatment initiation.
Preliminary study on the changes of ovarian reserve, menstruation, and lymphocyte subpopulation in systemic lupus erythematosus (SLE) patients of childbearing age
Authors: Gao H , Ma J , Wang X , Lv T , Liu J , Ren Y , Li Y , Zhang Y
Published: August 2017

Objective

The main aim of this study was to investigate the ovarian reserve, menstruation, and lymphocyte subpopulation in systemic lupus erythematosus (SLE) patients of childbearing age.

Methods

We enrolled 40 SLE patients of childbearing age and 40 age-matched healthy controls. Anti-Müllerian hormone (AMH) was tested by electrochemiluminescence, and lymphocyte subsets were tested by flow cytometry. Menstruation situation was obtained by interview.

Results

The AMH level of the SLE group was significantly lower than that of the control group ( p < 0.001), which was negatively correlated with erythrocyte sedimentation rate (ESR ( r = −0.316, p = 0.047)) and disease activity (SLEDAI ( r = −0.338, p = 0.033)). The AMH concentration of SLE patients with normal menstruation was higher than those with abnormal menstruation ( p < 0.001). The percentages of CD4+ T lymphocytes and NK (natural killer) cells in the SLE group were significantly lower than those in the control group ( p < 0.001). However, the percentages of B cells and CD8+ T lymphocytes in the SLE group were higher than those in the control group ( p < 0.05).

Conclusion

Decreased AMH and high incidence of abnormal menstruation indicated that autoimmunity activities of SLE can impair the ovarian reserve of female patients. Lymphocytes in SLE patients were in a state of disorder.
Preserving Self: Theorizing the Social and Psychological Processes of Living With Parkinson Disease
Authors: Vann-Ward Terrie , Morse Janice M. , Charmaz Kathy
Published: August 2017

The purpose of this constructivist grounded theory article is to identify, explore, and theorize the social and psychological processes used by people with Parkinson disease. Analytic procedures generated the five-stage theory of Preserving self of people with Parkinson disease: (a) making sense of symptoms, (b) defining turning points, (c) experiencing identity dilemmas, (d) reconnecting the self, and (e) envisioning a future. Reminders of former selves and capabilities were painful; participants desperately sought normalcy. Participants developed creative methods for maintaining independence but frequently overestimated their abilities and took risks. Participants were 15 men and 10 women (ages 40–95), most of whom lived with their families. Disease status was ascertained through medication logs and two scales: Hoehn and Yahr staging and Activities of Daily Living. Data included 62 in-depth interviews, nonparticipant observation, and participant photos, videos, and related documents. Recommendations were derived from the theory to support processes of Preserving Self as interventions designed to reduce the loss of self and to enhance Preserving self. These recommendations included developing relationships, teaching expected and unexpected feelings and behaviors, and involvement with sensory integrating activities.
Optimization of spiral-shaped piezoelectric energy harvester using Taguchi method
Authors: Tikani R , Torfenezhad L , Mousavi M , Ziaei-Rad S
Published: August 2017

Nowadays, environmental energy resources, especially mechanical vibrations, have attracted the attention of researchers to provide energy for low-power electronic circuits. A common method for environmental mechanical energy harvesting involves using piezoelectric materials. In this study, a spiral multimode piezoelectric energy harvester was designed and fabricated. To achieve wide bandwidth in low frequencies (below 15 Hz), the first three resonance frequencies of the beam were designed to be close to each other. To do this, the five lengths of the substrate layer were optimized by the Taguchi method, using an L27 orthogonal array. Each experiment of the Taguchi method was then simulated in ANSYS software. Next, the optimum level of each design variable was obtained. A test rig was then constructed based on the optimum design values and some experimental investigations were conducted. A good correlation was observed between measured and the finite element results.
Green Care as Psychosocial Intervention for Depressive Symptoms: What Might Be the Key Ingredients?
Authors: Salomon Rebecca E. , Salomon Alison D. , Beeber Linda S.
Published: August 2017

BACKGROUND: Green care is an umbrella term for psychosocial interventions that integrate biotic and abiotic elements of nature to promote an individual’s health and well-being. Green care decreases depressive symptoms but the parts of the interventions that lead to this effect are unknown. OBJECTIVES: Review of literature to evaluate perceived social support, behavioral activation, and self-efficacy as key ingredients to decrease depressive symptoms in psychosocial interventions and extrapolate those mediators, or key ingredients, to green care. DESIGN: A literature search of three databases was conducted to find relevant studies examining a psychosocial intervention for adults, the mediator of interest, and depressive symptoms. RESULTS: Evidence supports behavioral activation, social support, and self-efficacy as mediators of psychosocial interventions to improve depressive symptoms. CONCLUSIONS: Green care offers a portal for individuals with different depressive symptoms and severities to be treated alongside each other while receiving targeted interventions to meet the needs of each individual participant. Additionally, it offers the opportunity for psychiatric nurses to concurrently target all three active key ingredients.
Trajectories of Change in Body Weight During Inpatient Treatment for Anorexia Nervosa
Authors: Jennings Karen M. , Gregas Matthew , Wolfe Barbara
Published: August 2017

BACKGROUND: Identifying distinct trajectories of change in body weight during inpatient treatment for anorexia nervosa (AN) may provide knowledge about the process of weight restoration and may help detect optimal body weight response patterns among individuals who are at risk for not achieving weight restoration or leaving treatment prematurely. OBJECTIVE: This study explored the extent to which distinct trajectories of change in body weight existed among individuals during inpatient treatment for AN. DESIGN: Group-based trajectory modeling was used to identify distinct trajectories of change in body weight among 500 individuals receiving inpatient treatment for AN. RESULTS: Four distinct trajectories were identified: weight gain ( n = 197), treatment resistant ( n = 177), weight plateau ( n = 82), and weight fluctuate ( n = 44). CONCLUSION: Clinically, it is important to consider the heterogeneity of changes in body weight during inpatient treatment to help guide interventions and outcomes.
Inhibition of Endocannabinoid-Metabolizing Enzymes in Peripheral Tissues Following Developmental Chlorpyrifos Exposure in Rats
Authors: Buntyn Robert W. , Alugubelly Navatha , Hybart Rachel L. , Mohammed Afzaal N. , Nail Carole A. , Parker Greta C. , Ross Matthew K. , Carr Russell L.
Published: August 2017

Repeated developmental exposure to the organophosphate (OP) insecticide chlorpyrifos (CPF) inhibits brain fatty acid amide hydrolase (FAAH) activity at low levels, whereas at higher levels, it inhibits brain monoacylglycerol lipase (MAGL) activity. FAAH and MAGL hydrolyze the endocannabinoids anandamide (AEA) and 2-arachidonylglycerol (2-AG), respectively. Peripherally, AEA and 2-AG have physiological roles in the regulation of lipid metabolism and immune function, and altering the normal levels of these lipid mediators can negatively affect these processes. Exposure to CPF alters brain endocannabinoid hydrolysis activity, but it is unclear whether low-level exposure alters this activity in peripheral tissues important in metabolic and immune function. Therefore, rat pups were exposed orally from day 10 to 16 to 0.5, 0.75, or 1.0 mg/kg CPF or 0.02 mg/kg PF-04457845 (a specific FAAH inhibitor). At 12 hours postexposure, FAAH, MAGL, and cholinesterase (ChE) activities were determined. All treatments inhibited FAAH activity in brain, spleen, and liver. CPF inhibited ChE activity in spleen and liver (all dosages) and in brain (highest dosage only). CPF inhibited total 2-AG hydrolysis and MAGL-specific activity in brain and spleen (high dosage only). In liver, total 2-AG hydrolysis was inhibited by all treatments and could be attributed to inhibition of non–MAGL-mediated 2-AG hydrolysis, indicating involvement of other enzymes. MAGL-specific activity in liver was inhibited only by the high CPF dosage, whereas PF-04457845 slightly increased this activity. Overall, exposure to low levels of CPF and to PF-04457845 can alter endocannabinoid metabolism in peripheral tissues, thus potentially affecting physiological processes.
Ideologies of time: How elite corporate actors engage the future
Authors: Berg Johansen Christina , De Cock Christian
Published: August 2017

Our article deals with how elite corporate actors in a Western capitalist-democratic society conceive of and prepare for the future. Paying attention to how senior officers of 10 important Danish companies make sense of the future will help us to identify how particular temporal narratives are ideologically marked. This ideological dimension offers a common sense frame that is structured around a perceived inevitability of capitalism, a market economy as the basic organizational structure of the social and economic order, and an assumption of confident access to the future. Managers envisage their organization’s future and make plans for organizational action in a space where ‘business as usual’ reigns, and there is little engagement with the future as fundamentally open – as a time-yet-to-come. In using a conceptual lens inspired by the work of Fredric Jameson, we first explore the details of this presentism and a particular colonization of the future and then linger over small disruptions in the narratives of our interviewees which point to what escapes or jars their common sense frame, explore the implicit meanings they assign to their agency and also find clues and traces of temporal actions and strategies in their narratives that point to a subtly different engagement with time.
Correlations between third body evolution and tribological performance of copper-matrix friction material under abrasive paper interference conditions
Authors: Su Linlin , Gao Fei , Tao Hualong , Han Xiaoming , Fu Rong
Published: August 2017

The influence of the degree of morphological variances of third body on the friction coefficient is a foundational question for understanding the friction mechanism. The correlations between the composition and morphology of third body as well as the surface roughness and the friction coefficient of copper-matrix friction material were investigated using a pin-on-disc tribometer by a method of interface interference caused by various grit size abrasive papers by grinding the friction surface during friction. Friction tests were conducted under friction speeds of 200–800 r/min at a normal load of 0.5 MPa. The results indicate that the friction coefficients increase under dry abrasive paper interference condition. It is generally 0.07–0.09 higher than the noninterference case. Large particle sizes of abrasive paper interference causes the change in the morphology of third body. More specifically, high surface roughness caused by plowing of coarse abrasive paper interference is the main cause for high friction coefficient. This phenomenon is weakened with the increase in speed. And small particle size of abrasive paper interference induces the change in the composition and distribution of third body due to fine SiC particles grinding and embedding into the friction interface. These changes increase the hard spots contact area, exacerbate the abrasive wear at all speeds, leading to a higher friction coefficient.
Validity of screening for psychiatric disorders in unaccompanied minor asylum seekers: Use of computer-based assessment
Authors: Jakobsen Marianne , Meyer DeMott Melinda A. , Heir Trond
Published: August 2017

Self-report screening is an important element of transcultural research. Problems concerning illiteracy, cultural sensitivity, and possible misunderstandings have been handled differently in different settings. The aim of this study was to evaluate the validity of two well-known instruments: the Hopkins Symptoms Check List (HSCL-25), and the Harvard Trauma Questionnaire (HTQ, Part IV), with a sample of 160 unaccompanied asylum-seeking adolescents from Afghanistan and Somalia. Assessments were performed 4 months after arrival in Norway, and the screening instruments were presented to the informants on computers with touch-screen function, using the program MultiCASI. Sound-files in the native languages of the informants appeared simultaneously with the written items and could be repeated by touch. We found that the screening procedures were well received and understood by the informants regardless of reading and writing abilities. Agreement between diagnoses (CIDI) and screening results were similar to other studies. Computer-based assessment in this setting was practical, cost effective, and can be recommended.
Exploitation in all-male pornography set in the Czech Republic
Authors: Brennan Joseph
Published: August 2017

All-male pornography websites Czech Hunter, Debt Dandy and Dirty Scout rely on a fantasy of gay-for-pay sex in the Czech Republic. This article explores how these examples construct the ‘Eastern European’ gay-for-pay male and how such constructions are understood by viewers, drawing on discourse about Czech men and Czech pornography on online discussion forums. I argue that these examples of all-male pornography can be understood as expressing ‘exploitation themes’. The argument is made that such themes are the result of a residual attraction associated with the opening up of Eastern Europe to the West in the 1990s and that the promise of these sites is access to the (not-so-)newly available, particularly vulnerable, young men supposedly easily exploited by the money of Westerners.
Diagnosing asthma and chronic obstructive pulmonary disease with machine learning
Authors: Spathis Dimitris , Vlamos Panayiotis
Published: August 2017

This study examines the clinical decision support systems in healthcare, in particular about the prevention, diagnosis and treatment of respiratory diseases, such as Asthma and chronic obstructive pulmonary disease. The empirical pulmonology study of a representative sample (n = 132) attempts to identify the major factors that contribute to the diagnosis of these diseases. Machine learning results show that in chronic obstructive pulmonary disease’s case, Random Forest classifier outperforms other techniques with 97.7 per cent precision, while the most prominent attributes for diagnosis are smoking, forced expiratory volume 1, age and forced vital capacity. In asthma’s case, the best precision, 80.3 per cent, is achieved again with the Random Forest classifier, while the most prominent attribute is MEF2575.
e-Roster policy: Insights and implications of codifying nurse scheduling
Authors: Drake Robert G
Published: August 2017

Following a decade of dissemination, particularly within the British National Health Service, electronic rostering systems were recently endorsed within the Carter Review. However, electronic rostering necessitates the formal codification of the roster process. This research investigates that codification through the lens of the ‘Roster Policy’, a formal document specifying the rules and procedures used to prepare staff rosters. This study is based upon analysis of 27 publicly available policies, each approved within a 4-year period from January 2010 to July 2014. This research finds that, at an executive level, codified knowledge is used as a proxy for the common language and experience otherwise acquired on a ward through everyday interaction, while at ward level, the nurse rostering problem continues to resist all efforts at simplification. Ultimately, it is imperative that executives recognise that electronic rostering is not a silver bullet and that information from such systems requires careful interpretation and circumspection.
Online opportunities and risks for children and adolescents: The role of digital skills, age, gender and parental mediation in Brazil
Authors: Cabello-Hutt Tania , Cabello Patricio , Claro Magdalena
Published: August 2017

This article presents a study that applies integrated and multi-factor path analysis to report the direct and indirect effects of young Brazilian individual and home factors on their online opportunities and risks. The results show that engaging in more online opportunities, being older and having a lower level of parental mediation are associated with a higher number of online risks. At the same time, being older, having Internet access at home, having parents with a higher educational level, possessing more digital skills and receiving a higher level of co-use and active parental mediation are positively associated with online opportunities. Although restrictive parental mediation is negatively associated with online risks, it also reduces opportunities. In addition, co-use and active mediation are positively associated with parental educational level. These findings offer a starting point to understand children’s online behaviour and digital inclusion in Latin America and analyse its differences with other regions.
Detached disseminator, populist watchdog and facilitative change agent: The professional role perception of foreign correspondents in China
Authors: Zeng Yuan
Published: August 2017

Amidst the debate over a ‘global journalistic culture’, this study, drawing on Hallin and Mancini’s typology of media systems and Hanitzsch’s deconstruction of journalistic role perception, looks into how foreign correspondents in China perceive their professional roles, and how their role perceptions differ across different media systems. Based on a survey analysis of 101 journalists, the study identifies three role types among China correspondents: detached disseminator, populist watchdog, and facilitative change agent. A majority of respondents perceive their professional role as non-facilitative and non-advocate, disputing the ‘hostile foreign forces’ allegation China usually employs to discredit foreign correspondents. No significant national variance is detected in the relative size of the three role types, and journalists from different media systems all value objectivity, neutrality, detachment, as well as a strong audience orientation, echoing the global homogenizing tendency in certain components of journalistic culture. Yet, strong national variance prevails in key dimensions, including a watchdog role for the host country, advocacy orientation and power distance with home government, largely consistent with the respective journalistic culture in each media system, suggesting that national journalistic culture still holds a strong grip on foreign correspondence.
A survey of Haitian attitudes towards informed consent
Authors: Sutton Caitlin D , Lynde Grant C
Published: August 2017

Background

Universal standards for bioethics, including the tenet of informed consent, should be upheld in the setting of humanitarian medical missions. The obstacles to obtaining informed consent in the global health setting have been thoroughly discussed in the literature, but no studies have investigated these issues from the patient’s perspective. We sought to understand the patient’s experience of the consent process during a four-week surgical mission to Haiti.

Methods

All patients selected for surgery during a mission to Hinche, Haiti, were invited to participate in a survey assessing communication between them and their physicians, their understanding of the surgical procedure, and their desire for information during the consent process. Complete data were collected from 55 patients.

Results

Understanding a basic explanation of surgery and the associated risks was important to 98% of Haitian surgical patients, and 96% reported the desire for extensive risk communication. All patients felt that they should demonstrate their understanding of the surgery by signing a consent form before undergoing surgery. No demographic factors correlated with patient desire for additional information regarding surgical risk.

Conclusions

Our results highlight several areas needing improvement in the consent process during surgical missions, including deliberate and consistent use of a consent process as well as more extensive risk communication. Our survey demonstrates that the process of obtaining informed consent for surgery is important to Haitian patients in the setting of short-term surgical missions and suggests that continued efforts to improve our methods are necessary.
Introducing Interpretive Approach of Phenomenological Research Methodology in Environmental Philosophy
Authors: Paul Kalpita Bhar
Published: August 2017

Environmental philosophy, needless to say, is going through a transition in the zenith of the Anthropocene. It is high time to carry out engaged philosophy to bring in philosophical understandings in approaching real-world environmental issues for obtaining some novel insights into the human–environment relationship. For the same, I argue, we need to explore some new methodologies that would be capable of offering the opportunity to do engaged philosophy instead of borrowing methodologies from the social sciences. Here, I examine Phenomenological Research Methodology (PRM) for the same. I elaborate on the process of conducting a field study with this methodology. For analyzing narratives, I choose the interpretive stream over the descriptive one. By drawing extensively from the philosophy of phenomenology, I propose a four-step narrative analysis process that can unveil a narrator’s transcendent mode of being. Finally, I share my research experiences while employing PRM in the field and demonstrate how PRM has the potential to sidestep some of the widely held concerns associated with field studies. Along with, I highlight critical reflection of my experiences while employing this methodology, particularly, in the context of India.
Screening of extravascular findings in pulmonary embolism computer tomography: 397 patients with 1950 non-pulmonary artery findings
Authors: Sohns Jan M , Menke Jan , Bergau Leonard , Weiss Bernhard G , Kröhn Hannah , Weiberg Desiree , Derlin Thorsten , Schmuck Sebastian
Published: August 2017

Objectives

The aim of this study was to investigate the possible benefits from computed tomography scans of patients with a suspected pulmonary artery embolism with a focus on relevant extravascular findings.

Methods

A total of 400 consecutive computed tomography pulmonary angiographies were evaluated. Computed tomography scans were analyzed in detail for the presence of pulmonary artery embolisms, as well as any other findings. Extra-artery discoveries were classified into none-relevant (Group A), intermediate (Group B), or relevant (Group C) findings.

Results

Aggregated computed tomography pulmonary angiographies detected other diagnosis than pulmonary artery embolism in 236 patients (59%). There were 1950 non-pulmonary artery embolism findings (4.9 per patient; n = 397). In the pulmonary artery embolism group, there were 447 extra-pulmonary artery embolism findings (5.2 per patient; n = 86) and in the non-pulmonary artery embolism group, 1503 findings (4.8 per patient; n = 311). Patients with pulmonary artery embolism had a significantly higher rate of pro-coagulate risk factors ( p < 0.001).

Conclusions

Computed tomography pulmonary angiographies may help to identify further diagnoses. This study represents a retrospective review of a single center experience for incidental computed tomography findings during pulmonary artery embolism work-up and emphasizes the importance of analyzing the whole field-of-view.
A phantom study for the comparison of different brands of computed tomography scanners and software packages for endovascular aneurysm repair sizing and planning
Authors: Velu Juliëtte F , Groot Jebbink Erik , de Vries Jean-Paul PM , van der Palen Job AM , Slump Cornelis H , Geelkerken Robert H
Published: August 2017

Objectives

Correct sizing of endoprostheses used for the treatment of abdominal aortic aneurysms is important to prevent endoleaks and migration. Sizing requires several steps and each step introduces a possible sizing error. The goal of this study was to investigate the magnitude of these errors compared to the golden standard: a vessel phantom. This study focuses on the errors in sizing with three different brands of computed tomography angiography scanners in combination with three reconstruction software packages.

Methods

Three phantoms with a different diameter, altitude and azimuth were scanned with three computed tomography scanners: Toshiba Aquilion 64-slice, Philips Brilliance iCT 256-slice and Siemens Somatom Sensation 64-slice. The phantom diameters were determined in the stretched view after central lumen line reconstruction by three observers using Simbionix PROcedure Rehearsal Studio, 3mensio and TeraRecon planning software. The observers, all novices in sizing endoprostheses using planning software, measured 108 slices each. Two senior vascular surgeons set the tolerated error margin of sizing on ±1.0 mm.

Results

In total, 11.3% of the measurements (73/648) were outside the set margins of ±1.0 mm from the phantom diameter, with significant differences between the scanner types (14.8%, 12.1%, 6.9% for the Siemens scanner, Philips scanner and Toshiba scanner, respectively, p-value = 0.032), but not between the software packages (8.3%, 11.1%, 14.4%, p-value = 0.141) or the observers (10.6%, 9.7%, 13.4%, p-value = 0.448).

Conclusions

It can be concluded that the errors in sizing were independent of the used software packages, but the phantoms scanned with Siemens scanner were significantly more measured incorrectly than the phantoms scanned with the Toshiba scanner. Consequently, awareness on the type of computed tomography scanner and computed tomography scanner setting is necessary, especially in complex abdominal aortic aneurysms sizing for fenestrated or branched endovascular aneurysm repair if appropriate the sizing is of upmost importance.
School leadership and Black and minority ethnic career prospects in England: The choice between being a group prototype or deviant head teacher
Authors: Elonga Mboyo Jean Pierre
Published: August 2017

The body of research on the career prospects of Black and minority ethnic (BME) teachers cites racism as one of the reasons for BME underrepresentation in positions of school leadership in England. Understanding the nature of such discriminatory practices is needed in order to find solutions. It has also been reported that pioneer BME leaders are perceived as role models. Such a claim is mainly based on their appointment rather than their action or inaction in facilitating the career progression of other members of BME staff. To address these gaps, this study draws on electronic survey data of eight respondents out of ten, two of whom provided rich written and interview narratives. The data were analysed under the group-based identity formation framework to suggest that the underrepresentation of BME staff due to racism can be explained by head teachers’ prototypicality of group/team values and their failure to deviate from these. That a BME senior leader acted in the same way highlights the following: the dominance of the role of head as a group prototype; the need to challenge deep-seated discrimination; and the view that increased representation needs to be matched with modified school-wide attitude.
Adult Intelligence: The Construct and the Criterion Problem
Authors: Ackerman Phillip L.
Published: August 2017

Over 100 years have passed since Binet and Simon proposed scales for assessment of intelligence of children to predict academic success and failure. The extension of these assessments to adults largely resulted from efforts of psychologists to provide insights for military selection in World War I. At the time, relatively little thought was given to how adult intelligence might differ from child and adolescent intelligence. Traditional approaches for assessing adult intelligence have largely survived. However, there is little reference to adult intellectual functioning outside of laboratory-based tasks and clinical assessments of pathology. The result is that there are insufficient criterion measures for adult intelligence. Moreover, researchers have shifted from treating intelligence tests as predictors to treating them as criterion measures. The result is a disconnection between basic research on one hand and understanding adult intelligence on the other hand. This lack of connection is a serious impediment for predicting individual differences in performance on tasks which adults perform in their day-to-day work and nonwork lives. This article explores how the field has come to the current situation, and what remedies might be explored. Ultimately, a fundamental reexamination of how adult intelligence is studied and applied is suggested.
Building Research Capacity in a Mobile Psychiatric Rehabilitation Program: Service Learning in a University-Agency Collaboration
Authors: Holbrook Amber , Chen Wan-Yi
Published: August 2017

Social service agencies face increasing demands for accountability, emphasizing the necessity of preparing professionals to effectively evaluate practice. University-agency collaborations incorporating service learning can build community research capacity while providing opportunities for application of student research skills. We describe a partnership model between a Master of Social Work program evaluation course and a mobile psychiatric rehabilitation program to design a formative evaluation. Course structure and tasks central to the management of the partnership are described. Agency staff benefited from access to peer-reviewed literature, introduction to standardized assessment instruments, and stimulation of staff discussion and critical thinking around service provision. Students valued the applied research experience including exposure to the agency context and a real-world impact of their work. Lessons learned and implications for university-agency collaborations are discussed.
Early palliative home care: Evaluation of an interprofessional educational intervention for district nurses and general practitioners about nutritional care
Authors: Berggren Erika , Ödlund Olin Ann , Orrevall Ylva , Strang Peter , Johansson Sven-Erik , Törnkvist Lena
Published: August 2017

Background:

Teamwork is important in early palliative home care, and interprofessional education is required to achieve teamwork. It is thus crucial to ensure that interprofessional education works well for the members of all participating professions because levels of knowledge and educational needs may vary.

Aim:

To evaluate, by profession, the effectiveness of an interprofessional educational intervention for district nurses and general practitioners on three areas of nutritional care for patients in a palliative phase.

Design:

A quasi-experimental study that used a computer-based, study-specific questionnaire to evaluate the effectiveness of the intervention. The continuing education in primary health care (ConPrim®) model was used to create the intervention. ConPrim includes a web-based program, a practical exercise and a case seminar, all with interprofessional training.

Setting:

Primary health care centers in Stockholm County, Sweden. Intervention group (n = 87; 48 district nurses, 39 general practitioners); control group (n = 53; 36 district nurses, 17 general practitioners).

Results:

The total intervention effect was significant in all three areas, p = 0.000–0.004. The intervention effects were similar and significant for both professions in areas 1 and 2. In area 3, the intervention effects were significant for general practitioners but not for district nurses.

Conclusions:

The intervention seems promising, as it may create better prerequisites for teamwork and caring for patients living at home. However, it needs to be optimized to better increase district nurses’ level of knowledge (area 3).
Unusual Complication of the Nuss Procedure: Fistulization of the Internal Thoracic Artery to the Pulmonary Artery
Authors: Mongé Michael C. , Wax David , Barsness Katherine
Published: August 2017

Although minimally invasive repair of pectus excavatum has been shown to have a low complication rate in large series, several case reports have documented life-threatening complications, including bleeding and cardiac perforation. We present a rare case of an arteriovenous malformation from the internal thoracic artery to the pulmonary artery caused by occlusion of the internal thoracic artery by the Nuss bar followed by an unidentified angiogenic process. The patient became symptomatic and required transcatheter coil embolization.
Viewing presidential televised debates and civic engagement in Korea
Authors: Lee Hansoo , Lee Jae-Mook
Published: August 2017

This study examines the effects of viewing televised debates on political engagement. Voters consume information while viewing television debates, which can affect political engagement in a positive manner. Examining the effects of debates on political engagement, we analyze panel survey data from the 2012 Korean presidential election. According to the results, voters who view more televised debates are more likely to search for information and discuss political issues with others. The results provide evidence that viewing televised debates tends to enhance civic engagement.
Epidemiology of Navicular Injury at the NFL Combine and Their Impact on an Athlete’s Prospective NFL Career
Authors: Vopat Bryan , Beaulieu-Jones Brendin R. , Waryasz Gregory , McHale Kevin J. , Sanchez George , Logan Catherine A. , Whalen James M. , DiGiovanni Christopher W. , Provencher Matthew T.
Published: August 2017

Background:

Navicular injuries can result in persistent pain, posttraumatic osteoarthritis, and diminished performance and function.

Purpose:

To determine the epidemiology of navicular fracture in players participating in the National Football League (NFL) Scouting Combine and evaluate the impact of a navicular injury on the NFL draft position and NFL game play compared with matched controls.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Data were collected on players who previously sustained a navicular injury and participated in the NFL Combine between 2009 and 2015. The epidemiology of navicular injury was determined through an evaluation of the number of injuries, surgeries, and collegiate games missed as well as the position played, a physical examination, the surgical technique, and imaging findings. Players with a previous navicular injury (2009-2013) were compared with a set of matched controls. NFL performance outcomes included the draft position, career length ≥2 years, and number of games played and started within the first 2 years.

Results:

Between 2009 and 2015, 14 of 2285 (0.6%) players were identified as having sustained a navicular injury. A total of 11 of 14 (79%) athletes had sustained an overt navicular fracture, while 3 of 14 (21%) were diagnosed with stress reactions on magnetic resonance imaging. Eight patients who sustained a navicular fracture underwent surgery. There was evidence of ipsilateral talonavicular arthritis in 75% of players with a navicular fracture versus only 60% in the uninjured foot (odds ratio, 1.3; P = .04). Fifty-seven percent of players with navicular injury (72.7% of fractures) were undrafted versus 30.9% in the control group ( P = .001). Overall, 28.6% of players with navicular fracture played ≥2 years in the NFL compared with 69.6% in the control group ( P = .02).

Conclusion:

A previous navicular fracture results in a greater risk of developing posttraumatic osteoarthritis. Although only a low prevalence of navicular injury in prospective NFL players was noted, players with these injuries had a greater probability of not being drafted and not competing in at least 2 NFL seasons when compared with matched controls without an injury history to the NFL Combine.
Modified Hamilton’s Controlled Encircling Procedure for Retinal Detachment
Authors: Alves da Costa Pertuiset Paulo A. , Fanjul Dominguez Rodrigo A. , Gianello Garrido Pedro R.
Published: August 2017

Purpose:

To describe a novel, simple, and reproducible encircling scleral buckle technique based on Hamilton’s controlled encircling procedure in order to standardize buckle height achievement in cases of retinal detachment.

Methods:

We describe a case series in which a novel modification of Hamilton’s surgical technique was used, consisting of a typical encircling buckling procedure anchored in the center of each quadrant, with the ends of the band passed through a Watzke sleeve. Reference marks were placed to allow measurable shortening of the band when its ends were pulled to create an encircling indent. Postoperative ultrawide field retinal images were analyzed.

Results:

Our simple technique yielded predictable and reproducible postoperative scleral buckle heights. Shortening of the silicon band by 3, 4, 5, and 6.25 mm produced shallow indents, while additional shortening was considered excessive.

Conclusion:

Published studies about scleral buckle as a primary procedure or a combined technique with vitrectomy lack a uniform surgical technique. Our modification of Hamilton’s technique uses objective measurements to generate a consistent and predictable postoperative buckle height.
TP53 mutations identify younger mantle cell lymphoma patients who do not benefit from intensive chemoimmunotherapy
Authors: Eskelund Christian W. , Dahl Christina , Hansen Jakob W. , Westman Maj , Kolstad Arne , Pedersen Lone B. , Montano-Almendras Carmen P. , Husby Simon , Freiburghaus Catja , Ek Sara , Pedersen Anja , Niemann Carsten , Räty Riikka , Brown Peter , Geisler Christian H. , Andersen Mette K. , Guldberg Per , Jerkeman Mats , Grønbæk Kirsten
Published: August 2017

Key Points

The intensified standard-of-care regimens for younger patients with MCL do not overcome the deleterious effects of TP53 mutations. MCLs with TP53 mutations should be considered for alternative frontline treatment.
Distinct intestinal adaptation for vitamin B12 and bile acid absorption revealed in a new mouse model of massive ileocecal resection
Authors: Matsumoto Yuka , Mochizuki Wakana , Akiyama Shintaro , Matsumoto Taichi , Nozaki Kengo , Watanabe Mamoru , Nakamura Tetsuya
Published: August 2017

Ileocecal resection (ICR), one of several types of intestinal resection that results in short bowel syndrome (SBS), causes severe clinical disease in humans. We here describe a mouse model of massive ICR in which 75% of the distal small intestine is removed. We demonstrate that mice underwent 75% ICR show severe clinical signs and high mortality, which may recapitulate severe forms of human SBS, despite an adaptive response throughout the remnant intestine. By using this model, we also investigated whether the epithelium of the remnant intestine shows enhanced expression of factors involved in region-specific functions of the ileum. Cubn mRNA and its protein product, which play an essential role in vitamin B12 absorption in the ileum, are not compensatory up-regulated in any part of the remnant intestine, demonstrating a clear contrast with post-operative up-regulation of genes involved in bile acid absorption. Our study suggests that functional adaptation by phenotypical changes in the intestinal epithelium is not a general feature for nutrient absorption systems that are confined to the ileum. We also propose that the mouse model developed in this study will become a unique system to facilitate studies on SBS with ICR in humans.