bluuebunny/crossref_metadata_2025 huggingface dataset:
The Chinese Diaspora and the Reshaping of Pacific Economic Relations
Authors: Tracy Noel
Published: November 2017

Until quite recently most commentators assumed that the international relations and political economy of the Pacific region would be dominated by the US-Japan relationship for the forseeable future. Two new factors have emerged in recent years to upset that judgement. The first is undoubtedly the rapid rise to economic prominence of China as a result of the post 1985 ‘economic miracle’; the second is the arrival of Chinese diaspora business as major players in the Asia-Pacific. This is evidenced by their ablity to outinvest Japan in the region by a consistently large margin since 1992 but particularly by their important role in the re-industrialisation of China and the latter's emergence as a major exporter. The Chinese diaspora presents a particular problem for International Political Economy (IPE): a series of highly integrated manufacturing, trading and investing networks operating throughout the region and beyond but lacking the backing of a powerful state. This purpose of this article is to begin the task of trying to conceptualise this phenomenon within IPE.
Aliran in Malaysia: A Public Interest Group Assuming the Role of the Liberal Press
Authors: Blackburn Kevin
Published: November 2017

This article studies how the Malaysian public interest group, Aliran, has attempted to foster a civic culture and create a liberal press. Aliran believes these are necessary for the advancement of democracy in Malaysia. The organization's journal, Aliran Monthly, follows the liberal press method of scrutinizing what it sees as the four estates of government, the executive, the legislative, the judiciary, and the Malaysian press. The Aliran Monthly advances the group's goal of creating a civic culture by fostering the idea that the country's citizens should insist upon the accountability of the four estates. By providing a dissenting opinion, the Aliran Monthly sees itself as assisting the citizens of Malaysia in evaluating the individuals and institutions that govern them.
Motorcycle Subcultures in Australia: Sketching the Big Picture
Authors: Vale Colin
Published: November 2017

Most research concerning motorcycle subcultures derives from the United States, Britain and Japan and is not particularly applicable to Australia. Furthermore, previous research into motorcycle clubs has dealt with only one type of subculture. This paper highlights the existence of two types of motorcycle subcultures in Australia, patch and non-patch groups. Based on five years of participant observation, comparison of the two types of subcultures and general overview of motorcycle subcultures is presented.
How do we Manage our Cities? Problems and Prospects for Urban Policy in the 1990s
Authors: Caulfield Jan , Wanna John
Published: November 2017

How policy processes relate to the city is the subject of this paper. We argue that the way in which cities are perceived by policy makers does make a difference to the policy approach adopted in planning for cities. In conventional ‘relativist’ approaches the nature of the city itself is not a prime consideration in policy formation or implementation but merely a complex site where diverse policies intersect. In this model policy design is related to criteria other than location. By contrast, if the city is seen as having an essential character then the policy design is likely to be spatially sensitive. The paper explores urban policy during the Hawke-Keating years and, in particular, the ‘integrated’ approach to city planning advanced by Minister Brian Howe as an example of an essentialist understanding of the city. Despite some competition from the new managerialism within the public sector, we conclude that the integrated approach offered some important reforms in urban policy design.
The politics of educational planning and development in Vanuatu
Authors: Mather Glenda
Published: November 2017

The marketing of educational resources and the selling of Australian education packages to the population of Asia and the Pacific reinforces a pervasive neo-colonial impact. This is indicated by the role that Australian politicians often assume in regional organisations and the recent tone of statements regarding environmental and political concerns in the region. In real terms, this process extends the social, cultural and political influence of Australia in the region. As part of this process of educational aid, the Primary & Secondary Education Project (PASEP), investigates the problems of design, planning and project implementation in Vanuatu through a detailed examination of an educational project, co-funded by AIDAB, the World Bank and the respective Vanuatu Governments during the period 1990—1994. The major issues of curriculum reform provide an underlying focus for these changes. The outcome of the project suggests that the ongoing dynamics of political change should not be underestimated or ignored by any planning process.
Institutional Vandalism
Authors: Allen Rodney
Published: November 2017

Virtually all our social institutions, public and corporate, are suffering paroxysms of restructuring. Waves of institutional agitation are sweeping across our social structure. This article explores some of the causes and consequences of the present frenzy of institutional change, finding that much of it is not the inevitable result of social, economic and technological pressures beyond our control, but rather is largely prompted by a developing cultural addiction to change as a good in itself. A lot of so-called restructuring, it concludes, amounts to unnecessary institutional vandalism.
Regulating Advertising in New Zealand and Australia: Learning from Failure and Success
Authors: Harker Debra
Published: November 2017

Advertising is the most visible element of modern marketing and an important component of trading. It is also an activity often accused by its critics of being intrusive and pervasive. Such accusations are not easily refuted by an industry which spends billions of dollars each year attempting to persuade its target markets. When advertising does offend, mislead, or is untruthful, a structure is required to provide protection for parties. In Australia a system of self regulation was dismantled at the end of 1996 and is currently in a state of flux as the industry grapples with designing a new system. In contrast, the self reguatory system operating in New Zealand appears to be effective and expanding. This article develops a conceptual framework for determining ‘acceptable advertising’ and analyses the regulation of advertising in Australia and New Zealand. It is argued that the New Zealand experience offers the Australian advertising industry and government regulators some useful instruction.
The Decline of Japan in Asia—an Update
Authors: Lever-Tracy Constance
Published: November 2017

This paper focuses on relative levels of investment and trade between Japan and East Asia in the 1990s. Although Japan has been devoting a higher proportion of its world wide investments to this region, the value of this investment has been falling absolutely and even more so relative to the size of inflows from other sources. The region is more important for the trade of Japan than is Japan for the trade of the region. While trade between Japan and China has become more important recently for the latter. Japan's contribution to the trade of the rest of the region has largely stagnated. For both FDI and trade intra regional flows are now larger than are flows between the region and Japan. Evidence that Japan dominates the region through supply of machinery or through coordinating regional production networks is not convincing. The paper concludes that Japanese hegemony over the region is neither actual nor imminent.
The ‘Pipeline Fallacy’ and Gender Inequality in Higher Education Employment
Authors: Castleman Tanya , Allen Margaret
Published: November 2017

Some writers reflecting on the continued low representation of women in management and non-traditional professions have posited a process of slow, long term change which will produce gender equality in the future as a result of recent changes of practice. This view (explicitly or implicitly) entails the notion of a ‘pipeline’ through which changes work their way through the system. This model is misleading. While equal employment opportunity initiatives may have a delayed impact, the pipeline fallacy obscures the need for active intervention in dynamic employment processes which continue to favour men over women. The pipeline fallacy diverts attention from systemic gender inequities to individual categories of blameworthy individuals. One example of ‘the blamed’ is older male employees who are sometimes portrayed as blocking the career entry or advancement of younger women. Attacks on this group of employees are often disguised attacks on conditions of employment. An examination of higher education employment data provides no evidence that male tenure blocks the opportunities of women although women continue to gain lower rewards in terms of tenure and seniority. The data suggest that the appointment and promotion practices which have favoured men are continuing.
Pauline Hanson's One Nation Party: Xenophobic Populism Compared
Authors: DeAngelis Richard
Published: November 2017

Recent political experience in France, Austria, Italy, USA and New Zealand plus the theories of contemporary right-wing radical or populist parties of Herbert Kitschelt and Hans-Georg Betz, offer valuable insight into the rise of Pauline Hanson's One Nation Party. As in other ‘globalising’ and reform-imposing liberal democracies, the causes of Hansonism as generic protest populism are multiple, hard-to-avoid, and predictable. Yet general explanations need to be supplemented by recognizing specific features of her movement, which are highly contingent on particular contexts and personal characteristics. Hanson's own brand of xenophobic populism, however, also exhibits certain unique features when compared with other similar Western European parties. Such feature include—the gender of the party leader, the relative absence of conventional ‘racism’, and the emphasis on democratic values and advocacy for a form of protectionist welfare state. Ironically, while these specificities give Hansonism, for the moment, a more ‘humane’ and moderate tone they also may limit not only its anti-democratic, intolerant, and destablising potential, but also its long-term growth and influence. If Kitschelt is correct, new radical right or populist parties which fail to take full advantage of emerging global trends favoring small government, free markets and authoritarian values, will compromise their long-run chances of success. That prediction may already be at work in determining Hanson's fate.
Energy and the Environment: The Limits of Australian Public Policy
Authors: Parker Rachel
Published: November 2017

An analysis of recent policy developments that seek to address the ecological impact of energy reveals a major short-fall in Australian public policy. Notwithstanding some important recent initiatives Australia's general environmental policy performance continues to lag significantly behind that of the international community. This short-fall is explained, in large part due to the dominance of neo-liberalism over much of Australia's policy regime. This policy approach acts to constrain effective governance of private industry, promotes cost minimisation in the pursuit of international competitiveness often at the expense of prudent and responsible environmental conservation. The case of the energy sector is germane to understanding this failure to meet internationally respectable greenhouse gas emission targets at Kyoto. The power of this sector within the national economy acts to constrain government policy and to reinforce neo-liberal dogma which acts to the detriment of the nation's international standing on matters of environmental protection.
The Intrusion of Market Principles in Human Services Provision
Authors: Doyle Robert
Published: November 2017

In many countries, generally, the size and role of government is changing, moving away from a role of provider to one of regulation. Much of economic and political life is governed by a belief that market forces provide the best avenue for social good. However, while there is now a more limited government intervention in the economic market, there is an imposed government-regulated ‘social market’ in the social welfare services. The changing role of government in social welfare provision has implications for both consumers and social welfare providers within both economic and welfare systems. In the social market, there appears to be a re-emergence of cartel-like organisations—movements toward larger, centralised and/or differentiated market-driven and business-oriented organisational forms. The dilemma is that the imposition of market principles, along with reduced government spending, tends to create an increasingly oligopolistic market in social welfare.

The most political decisions about welfare lie in the future: the relationship between economic and social policy, between employment and income, between political decision-making and economic decision-making, between state and market, between this and subsequent generations.1
Regional community ‘empowerment’ and the competitive training market
Authors: Lawrence Kate
Published: November 2017

This paper sketches some connections and gaps between ‘community’ and Australian vocational education and training (VET) policy in regional contexts. While ‘community’ and ‘regional community’ feature in current VET policy statements, such policies demonstrate both a lack of clarity about what constitutes regional community/communities and an absence of strategies to address the collective interests suggested within a community discourse. The question is raised as to whether current policy based increasingly upon market relations can support or enable the expression of collective, community-based interests. An increase in VET purchasing power for individuals and enterprises in regional areas is not an adequate strategy for ‘empowering regional communities’: there need to be mechanisms by which the collective and long-term Interests of a region's community members are considered, whether or not they have financial power as VET ‘clients’. Some current initiatives which may facilitate the engagement by regional communities with the VET system are discussed.
The Regional Security Implications of the East Asian Crisis
Authors: O'Neil Andrew
Published: November 2017

The effects of the East Asian economic crisis will be felt for some time to come. In particular, the uneven economic impact of the crisis raises important questions about the capacity of states to undertake remedial measures to their individual economies while at the same time ensuring that regional security in East Asia is maintained. Like the causes and consequences of the economic crisis, its security implications are likely to be wide ranging. One of the few strategic certainties of the crisis is that regional security in East Asia will become more fluid in the short to medium term. The central argument of this article is that the regional crisis has cast further doubt over the capacity of East Asian states to successfully manage security affairs during the next decade or so. Even if the implications of the economic crisis do not alter the regional security balance in any fundamental sense, the effects of accentuated uneven economic development will pose an additional problem for states in their attempts to cooperatively manage adverse security challenges in the region. This will be especially evident in North East Asia, where the potential for inter-state conflict is greatest and where the foundations for multilateral security are weakest.
The Tax Debate, Pressure Groups and the 1998 Federal Election
Authors: Brown Jerome
Published: November 2017

In contrast to previous attempts at comprehensive taxation reform, the dynamics of the most recent debate were distinguished by two key elements: a relatively high degree of unity among business associations and the formation of an unprecedented reform alliance between the business and welfare sectors. All participants in the debate were influenced by the failure of consumption tax reform as part of the Coalition's Fightback! package in 1993 and as part of Treasurer Keating's ‘Option C’ in 1985. The Government were motivated by a conviction that welfare and church opposition proved fatal to Fightback!, while business felt that their opposition may have been decisive in 1985. From mid 1996 the peak business and welfare bodies met to promote comprehensive tax reform and to develop a consensus position for submission to the Government. The formation of the Business Coalition for Tax Reform supports the view that business associations are increasingly adopting more sophisticated roles in the public policy process and attempting to overcome the fragmentation which has plagued their efforts by a strategy of forming ad hoc, issue-based coalitions of associations. For their part, Labor did not wish to appear isolated on tax reform and sought desperately to detach the peak welfare body, the Australian Council of Social Service (ACOSS), from its alliance with business. The pressure to which ACOSS was exposed demonstrated how its support had become a valuable political commodity for both business and Labor in the pre-election tax debate.
Defining and Understanding Economic Globalisation
Authors: Conley Tom
Published: November 2017

This article challenges the idea that globalisation is a clearcut, inevitable and irreversible process that leads inextricably to particular policy choices, a diminished role for the state and declining political efficacy. Globalisation constitutes more than a material effect; it is also an ideological construction used to define new limitations on political possibilities—a political construction that has been used, paradoxically, to weaken the role of politics and the idea of political choice. Although globalisation is increasingly used to frame the present, it is more often used as an explanation, rather than as something that needs to be explained. When it is explained, globalisation is often defined by terms that themselves need explaining. Common descriptions such as integration, interdependence, global awareness, liberalisation and convergence Identify aspects of globalisation, but individually fail to capture the contradictions and differential effects of a multifarious and uncertain process. Such definitions need to be considered together and supplemented with an analysis of the concept's importance as a persuasive construction used with political intent.
Globalisation and the Welfare State: From the Local to the International
Authors: Mendes Philip
Published: November 2017

This article examines the impact of globalisation on welfare states, with some specific reference to the Australian situation. The argument advanced is broadly commensurate with that of Ramesh Mishra, who argues that globalisation is as much a political and ideological phenomenon as it is economic. Whilst Mishra acknowledges that economic globalisation suggests a consistent international downward trend in social expenditure, he also documents the considerable differences between the English speaking countries, and other OECD states. I argue that the influence of globalisation on individual nation states can best be understood by exploring those political and ideological forces locally and internationally which are respectively seeking either to retrench or retain the welfare state.
Australian Politics, Human Rights and Moral Authenticity
Authors: Langlois Anthony J
Published: November 2017

This paper examines the relationship between some particular political problems with human rights in Australia and philosophical problems with theorising human rights. John Howard's disdain for the United Nations Human Rights Treaty System and Meg Lees discussion of IVF as a basic human right are used to explore the way in which the language or discourse of human rights is used in relation to public policy issues. It is argued that a greater conceptual awareness of the politics of human rights may suggest a more satisfactory manner in which to theorise the human rights discourse.
Translational control of a human CDKN1A mRNA splice variant regulates the fate of UVB-irradiated human keratinocytes
Authors: Collier Ann E. , Spandau Dan F. , Wek Ronald C.
Published: November 2017

In response to sublethal ultraviolet B (UVB) irradiation, human keratinocytes transiently block progression of the cell cycle to allow ample time for DNA repair and cell fate determination. These cellular activities are important for avoiding the initiation of carcinogenesis in skin. Central to these processes is the repression of initiation of mRNA translation through GCN2 phosphorylation of eIF2α (eIF2α-P). Concurrent with reduced global protein synthesis, eIF2α-P and the accompanying integrated stress response (ISR) selectively enhance translation of mRNAs involved in stress adaptation. In this study, we elucidated a mechanism for eIF2α-P cytoprotection in response to UVB in human keratinocytes. Loss of eIF2α-P induced by UVB diminished G1 arrest, DNA repair, and cellular senescence coincident with enhanced cell death in human keratinocytes. Genome-wide analysis of translation revealed that the mechanism for these critical adaptive responses by eIF2α-P involved induced expression of CDKN1A encoding the p21 (CIP1/WAF1) protein. We further show that human CDKN1A mRNA splice variant 4 is preferentially translated following stress-induced eIF2α-P by a mechanism mediated in part by upstream ORFs situated in the 5′-leader of CDKN1A mRNA. We conclude that eIF2α-P is cytoprotective in response to UVB by a mechanism featuring translation of a specific splice variant of CDKN1A that facilitates G1 arrest and subsequent DNA repair.
Sequential search leads to faster, more efficient fragment-basedde novoprotein structure prediction
Authors: de Oliveira Saulo H P , Law Eleanor C , Shi Jiye , Deane Charlotte M
Published: November 2017

Motivation

Most current de novo structure prediction methods randomly sample protein conformations and thus require large amounts of computational resource. Here, we consider a sequential sampling strategy, building on ideas from recent experimental work which shows that many proteins fold cotranslationally.

Results

We have investigated whether a pseudo-greedy search approach, which begins sequentially from one of the termini, can improve the performance and accuracy of de novo protein structure prediction. We observed that our sequential approach converges when fewer than 20 000 decoys have been produced, fewer than commonly expected. Using our software, SAINT2, we also compared the run time and quality of models produced in a sequential fashion against a standard, non-sequential approach. Sequential prediction produces an individual decoy 1.5–2.5 times faster than non-sequential prediction. When considering the quality of the best model, sequential prediction led to a better model being produced for 31 out of 41 soluble protein validation cases and for 18 out of 24 transmembrane protein cases. Correct models (TM-Score > 0.5) were produced for 29 of these cases by the sequential mode and for only 22 by the non-sequential mode. Our comparison reveals that a sequential search strategy can be used to drastically reduce computational time of de novo protein structure prediction and improve accuracy.

Availability and implementation

Data are available for download from: http://opig.stats.ox.ac.uk/resources. SAINT2 is available for download from: https://github.com/sauloho/SAINT2.

Supplementary information

Supplementary data are available at Bioinformatics online.
Identification of topological features in renal tumor microenvironment associated with patient survival
Authors: Cheng Jun , Mo Xiaokui , Wang Xusheng , Parwani Anil , Feng Qianjin , Huang Kun
Published: November 2017

Motivation

As a highly heterogeneous disease, the progression of tumor is not only achieved by unlimited growth of the tumor cells, but also supported, stimulated, and nurtured by the microenvironment around it. However, traditional qualitative and/or semi-quantitative parameters obtained by pathologist’s visual examination have very limited capability to capture this interaction between tumor and its microenvironment. With the advent of digital pathology, computerized image analysis may provide a better tumor characterization and give new insights into this problem.

Results

We propose a novel bioimage informatics pipeline for automatically characterizing the topological organization of different cell patterns in the tumor microenvironment. We apply this pipeline to the only publicly available large histopathology image dataset for a cohort of 190 patients with papillary renal cell carcinoma obtained from The Cancer Genome Atlas project. Experimental results show that the proposed topological features can successfully stratify early- and middle-stage patients with distinct survival, and show superior performance to traditional clinical features and cellular morphological and intensity features. The proposed features not only provide new insights into the topological organizations of cancers, but also can be integrated with genomic data in future studies to develop new integrative biomarkers.

Availability and implementation

https://github.com/chengjun583/KIRP-topological-features

Supplementary information

Supplementary data are available at Bioinformatics online.
Finding Positive Results with a New Focus on End-of-Life Content in an Associate Degree Nursing Program
Authors: Gravis Esther
Published: November 2017

The end-of-life lecture has historically led to an emotionally difficult day for first-semester nursing students. The instructor implemented a few small changes to update the end-of-life lecture content, and as a result, positive outcomes were found. The purpose of this project was to provide a positive end-of-life experience for first-semester nursing students. A variety of small changes were implemented to achieve this goal.
We’re Not Just Horsing Around: Creating Innovative Community Clinical Experiences Utilizing Diverse Opportunities
Authors: Hamilton Mashawna R. , Delaney Elizabeth , Hall Kelly
Published: November 2017

Community nursing clinical experiences are essential to the education of BSN prelicensure students. Because of limited traditional community clinical sites, faculty must identify innovative, nontraditional community sites that provide quality experiences. Faculty at Ohio University identified a unique opportunity to provide a multidisciplinary collaborative community clinical rotation in conjunction with the Center for Therapeutic Riding Center located at the Ohio Horse Park. Nineteen senior BSN students participated in a six-week community clinical experience caring for a variety of vulnerable populations participating in the therapeutic riding program. Faculty and students responded positively to the experience.
A Paradigm Shift From Brick and Mortar: Full-Time Nursing Faculty Off Campus
Authors: Beck Marlene , Bradley Holly B. , Cook Linda L. , Leasca Joslin B. , Lampley Tammy , Gatti-Petito JoAnne
Published: November 2017

The organizational structure for the Master of Science in Nursing’s online program at Sacred Heart University offers a remarkably different innovative faculty model. Full-time, doctorally prepared faculty reside in several different states and teach online but are fully integrated and immersed in all aspects of the college of nursing. This untraditional model, which has proven to be successful over time using best practices for online education, is replicable and offers an innovative option for online learning.
Collaborative Testing Using Quizzes as a Method to Improve Undergraduate Nursing Student Engagement and Interaction
Authors: Burgess Adriane , Medina-Smuck Michelle
Published: November 2017

Alternative testing methods are gaining popularity as an innovative means of assessing learning and retention of knowledge. Collaborative testing, an alternative to traditional testing, fosters interaction and collaboration among students. This article describes the use of collaborative testing using quizzes in an accelerated second-degree baccalaureate nursing program in order to enhance learning and retention of course content. Feedback from students was overwhelmingly positive, and most believed this strategy provided a structured method to their studying and acquisition of course concepts, which was particularly beneficial within an accelerated course format.
Use of Service-Learning to Teach Health Literacy with Online Graduate Nursing Students
Authors: George Tracy P. , DeCristofaro Claire
Published: November 2017

To meet Healthy People 2020 goals, health literacy must be included in health care program curricula. In a fully online graduate nursing course, an innovative service-learning activity asked students to collaborate in the creation of low-literacy patient education pamphlets for practice partners at a community rehabilitation facility. Involvement with community stakeholders such as support groups and interprofessional team members enhanced interdisciplinary educational outcomes. Through this innovative project-based activity, students were able to meet the clinical education and decision support needs of rehabilitation patients while translating academic coursework to support actual community needs.
Challenges of Cerebral Perfusion Pressure Measurement
Authors: Livesay Sarah L. , McNett Molly M. , Keller Monica , Olson DaiWai M.
Published: November 2017

Monitoring cerebral perfusion pressure (CPP) is recommended by a number of clinical practice guidelines and is a routine function performed by critical care neuroscience nurses. However, several studies highlight theoretical and practice variations in the measurement of CPP regarding the location of the arterial pressure transducer during measurement. Agreement on the technique and process for obtaining valid measurements is lacking. This article identifies the challenges associated with CPP measurement and highlights opportunities for standardizing CPP measurement to improve consistency in care and findings reported in the research literature. The challenges associated with practice variations impact multiple nursing domains, including the environment, patient treatment, and team communication; all ultimately impacting nursing workflow. The practice variation and impact on nursing workflow have significant implications for further research, electronic health record development, and refining monitoring technology.
Risk Factors for Falls Among Hospitalized Acute Post–Ischemic Stroke Patients
Authors: Cox Robynn , Buckholz Beth , Bradas Cheryl , Bowden Victoria , Kerber Kathleen , McNett Molly M.
Published: November 2017

Background: Falls remain an important benchmarking indicator for hospitals. Research identifies factors associated with falls among hospitalized patients in general. Similarly, the stroke literature outlines fall risk factors in the inpatient rehabilitation and community setting. Purpose: The aim of this study was to identify prevalence and risk factors for falls among acute, hospitalized AIS patients within an urban public healthcare system. Secondary aims were to identify activities present at the time of the fall and outcomes associated with falling. Methods: This is a retrospective case-control study. Data were abstracted and merged from hospital stroke and fall registries and matched with medical records from 2013 to 2015 among all adult patients admitted for AIS. Results: The study included 856 patients with AIS, with 2.3% experiencing a fall during the acute care hospitalization period. Falls among patients with AIS accounted for 1.4% of all hospitalized adult falls. Bivariate analysis indicate that a higher proportion of falls occurred among male patients when compared with female patients (75% male; χ2 = 3.964, P < .05) and among patients with a history of previous myocardial infarction or renal insufficiency (χ2 = 5.260, P < .05; χ2 = 11.116, P < .001, respectively). Multivariate analyses identify previous myocardial infarction (OR, 2.5; 95% confidence interval, 1.0–6.3; P = .04) and renal insufficiency (odds ratio, 4.2; 95% confidence interval, 1.5-12.2; P = .008) as strongest predictors of falls. The occurrence of a fall resulted in increased hospital length of stay (7.1 vs 4.0 days, P < .000) and slightly decreased functional outcome at discharge. Most falls occurred during the day shift while toileting, despite implementation and adherence to fall prevention programs. Conclusions: Fall rates among hospitalized patients with AIS are low, which may be reflective of increased vigilance among providers and widespread integration of fall prevention strategies. Consistent with the fall literature among other populations, the occurrence of a fall in the inpatient setting can substantially increase length of stay.
A Feasibility Randomized Controlled Crossover Trial of Home-Based Warm Footbath to Improve Sleep in the Chronic Phase of Traumatic Brain Injury
Authors: Chiu Hsiao-Yean , Lin En-Yuan , Chiu Hsiao-Ting , Chen Pin-Yuan
Published: November 2017

Introduction: Sleep disturbance is a common complaint after traumatic brain injury (TBI). The aim of this study was to examine the effects of a home-based warm footbath intervention on sleep in patients with TBI. Methods: This was a randomized controlled crossover study, and 23 adults with TBI were recruited and randomized to receive first a 30-minute, 41°C warm footbath and then a usual care, or vice versa, with each lasting 3 days and separated by a 3-day washout. Sleep efficiency, sleep onset latency (SOL), total sleep time, and wake after sleep onset (WASO) were assessed by actigraphy. Results: We found that home-based warm footbath significantly had a reduced SOL (difference, −5.11 minutes) and a suppressed WASO (difference, −2.57 minutes) compared with those of usual care, but not in sleep efficiency and total sleep time. No adverse effect was reported. Conclusions: This study suggested that home-based warm footbath is practical and effective in relieving post-TBI sleep disturbances, particular in SOL and WASO. Nurses can use home-based warm footbath as an effective intervention for management of sleep disturbances after TBI.
The Importance of Educating Patients With Stroke About Vitamin D
Authors: Schneider Melissa A.
Published: November 2017

There is a growing body of evidence linking vitamin D to more than only bone health. Researchers are discovering connections between low vitamin D levels and increased stroke risk, higher mortality, and poorer outcomes after stroke. Nurses need to be aware of ongoing research regarding vitamin D and include information about this important vitamin with patient education, especially for older patients admitted with stroke symptoms or risks.
Certification Matters
Authors: Elwell Sean
Published: November 2017

As professionals, we have many opportunities to prove our expertise in our field. Professional Certification is one of those opportunities. Certified nurses have reported feeling more empowered, with better collaborative relationships, as well as believing that they provide better care. Nurses also have perceived intrinsic value to obtaining certification in a specialty practice area. The certification process attempts to demonstrate that the nurse has exceeded the minimal standards and exhibits a high level of competence over the subject area. Leaders should continue to encourage their team members to obtain professional certification in their specialty areas of practice.
Rivaroxaban-induced hepatotoxicity: review of the literature and report of new cases
Authors: Licata Anna , Puccia Fania , Lombardo Vania , Serruto Antonietta , Minissale Maria G. , Morreale Ilaria , Giannitrapani Lydia , Soresi Maurizio , Montalto Giuseppe , Almasio Piero L.
Published: November 2017

Aim/Objective/Background

Direct-acting oral anticoagulant drugs are marketed worldwide for the primary and secondary prevention and treatment of thromboembolic disorders. Rivaroxaban, an oral, direct factor Xa inhibitor, is one of the most used. Rivaroxaban-induced hepatotoxicity is unusual, although a number of adverse reports have recently been reported. Here, we report two new cases of rivaroxaban-induced hepatitis.

Methods

A systematic search of case reports on the MEDLINE database encompassing the years 2008–2016 was carried out.Additional references were obtained following a manual search of the retrieved papers. We report two new cases of adverse events occurred in patients treated with rivaroxaban (20 mg/die) to prevent systemic embolism, who presented with hepatocellular liver injury with onset at 8 weeks after initiation of the drug intake.

Results

Twenty-six cases were retrieved from MEDLINE (57.7% female, 42.3% male). Using the Roussel Uclaf Causality Assessment Method (RUCAM) scale, liver injury was classified as hepatocellular (42.3%), cholestatic (26.9%), or mixed (15.4%). Older age (≥65 years) was present as a risk factor in 57.7%. The time lapse between initiation of treatment and onset of hepatic injury ranged from 2 to 180 days (median: 15 days). Our two new patients were diagnosed with drug-induced liver injury (hepatocellular pattern) using the ‘consensus criteria’, for drug-induced liver injury. Their RUCAM scores were calculated and assessed as highly probable and probable, respectively. A clinical recovery after rivaroxaban withdrawal was observed.

Conclusion

Direct-acting oral anticoagulants have been commonly prescribed, even if safety issues regarding the use of these drugs are still an ongoing concern, especially in patients experiencing chronic liver disease. Dedicated postauthorization safety studies should be undertaken to better define rivaroxaban-induced drug-induced liver injury.
A Model of the Effect of Lens Development on Refraction in Schoolchildren
Authors: He Ji C.
Published: November 2017

SIGNIFICANCE

The study provides a new theory on the mechanism underlying myopia development, and it could be useful in clinical practice to control myopia development in schoolchildren.

PURPOSE

To model the effect of the crystalline lens on refractive development in schoolchildren.

METHODS

The Zemax 13 was used to calculate Zernike aberrations and refractions across 50° horizontal visual fields. Optical effects of the anterior chamber depth, lens thickness, and radii of curvature of the lens surfaces on refractions were modeled. Refractive changes induced by lens development in emmetropic and myopic eyes, based on a previous longitudinal study from literature, were calculated.

RESULTS

A lens thickness reduction with an anterior chamber depth deepening caused a hyperopic shift over the visual fields and even more at the periphery. Opposite effects were found when the lens was thinned without any change of the anterior chamber depth. While a flattening of the anterior lens surface produced hyperopic refractions overall, a posterior lens flattening caused a myopic shift at the periphery, but a hyperopic shift of the central refraction. In the myopic eye, lens development induced refractive change toward more hyperopic over the visual fields and more at the periphery.

CONCLUSIONS

Lens thinning and lens axial movement participate in peripheral refractive development in schoolchildren, and lens development with a deeper anterior chamber depth and a flatter lens surface in the myopic eye could generate extra hyperopia over visual fields. The myopic lens development could be due to a backward movement of the lens, driven by a backward growth of the ciliary process, which might be a causative factor of myopia development.
Spinal Cord Injury by Direct Damage During CT-Guided C7 Transforaminal Epidural Steroid Injection
Authors: Chang Min Cheol
Published: November 2017

Cervical transforaminal epidural steroid injection (TFESI) under the guidance of computed tomography (CT) can offer great anatomical resolution and precise needle placement in the axial plane. However, some complications, including blood pressure surge, allergic reactions, vasovagal syncope, and cerebral infarct, have been reported after CT-guided cervical TFESI. We report the first case of iatrogenic spinal cord injury during a CT-guided cervical TFESI. A 67-year-old woman, upon receiving TFESI on Lt. C7, experienced an electrical shock-like sensation throughout the body. The patient complained of weakness in the left upper and lower extremities (manual muscle testing grade: 2–4) and neuropathic pain (numeric rating scale: 9) in the left upper and lower extremities. Cervical magnetic resonance imaging (MRI) performed 9 days after TFESI showed a high T2 signal at the left side of the spinal cord from levels C5 to C7, and an electrophysiological study performed 14 days after TFESI revealed corresponding findings with cervical MRI. Three months after finishing treatment with a high dose of intravenous methylprednisolone, the patient’s motor weakness improved, but it did not recover fully.
Estimating Glomerular Filtration Rate in Kidney Transplant Recipients: Comparing a Novel Equation With Commonly Used Equations in this Population
Authors: Salvador Cathrin L. , Hartmann Anders , Åsberg Anders , Bergan Stein , Rowe Alexander D. , Mørkrid Lars
Published: November 2017

Background

Assessment of glomerular filtration rate (GFR) is important in kidney transplantation. The aim was to develop a kidney transplant specific equation for estimating GFR and evaluate against published equations commonly used for GFR estimation in these patients.

Methods

Adult kidney recipients (n = 594) were included, and blood samples were collected 10 weeks posttransplant. GFR was measured by 51Cr-ethylenediaminetetraacetic acid clearance. Patients were randomized into a reference group (n = 297) to generate a new equation and a test group (n = 297) for comparing it with 7 alternative equations.

Results

Two thirds of the test group were males. The median (2.5-97.5 percentile) age was 52 (23-75) years, cystatin C, 1.63 (1.00-3.04) mg/L; creatinine, 117 (63-220) μmol/L; and measured GFR, 51 (29-78) mL/min per 1.73 m2. We also performed external evaluation in 133 recipients without the use of trimethoprim, using iohexol clearance for measured GFR. The Modification of Diet in Renal Disease equation was the most accurate of the creatinine-equations. The new equation, estimated GFR (eGFR) = 991.15 × (1.120sex/([age0.097] × [cystatin C0.306] × [creatinine0.527]); where sex is denoted: 0, female; 1, male, demonstrating a better accuracy with a low bias as well as good precision compared with reference equations. Trimethoprim did not influence the performance of the new equation.

Conclusions

The new equation demonstrated superior accuracy, precision, and low bias. The Modification of Diet in Renal Disease equation was the most accurate of the creatinine-based equations.
Tissue is more important than time: insights into acute ischemic stroke from modern brain imaging
Authors: Bivard Andrew , Parsons Mark
Published: November 2017

Purpose of review

The clinical practice of acute ischemic stroke treatment has undergone a major change over the last 5 years, as multimodal imaging becomes more accessible, and evidence mounts that individualized treatment is possible. Multimodal imaging performed before treatment provides invaluable information to treating clinicians, which includes confirmation of the diagnosis, and provides guidance on the appropriateness and the likely outcome of intravenous or endovascular treatment for individual patients (and their families). However, often health systems struggle to keep pace with science; thus, a one-size fits all protocol-driven basic imaging approach is still the norm in many stroke centers.

Recent findings

Comprehensive multimodal computed tomography (CT) (incorporating noncontrast CT, CT angiography, and perfusion CT) provides rapid, reliable information about stroke pathophysiology that cannot be provided by more limited imaging prior to treatment. Multimodal CT identifies treatment responders for both intravenous thrombolysis and endovascular therapy. Now we are in the era of thrombectomy, the use of multimodal imaging routinely to guide treatment can no longer be avoided.

In light of the ground breaking thrombectomy trial results and previous studies validating the use of multimodal imaging, there is now a strong rationale for performing comprehensive multimodal CT assessments before treatment as a standard of care for all stroke patients.
Pregnancy and ischemic stroke: a practical guide to management
Authors: van Alebeek Mayte E. , de Heus Roel , Tuladhar Anil M. , de Leeuw Frank-Erik
Published: November 2017

Purpose of review

Ischemic stroke during pregnancy or the puerperium is a devastating disease during a crucial period in life and warrants a specific approach. To date, current practice is mainly based on expert opinion because of a lack of randomized controlled trials and high-quality observational studies. The present review is intended as a practical guide to (acute) management of ischemic stroke during pregnancy and puerperium.

Recent findings

Recent findings showed that the incidence of stroke during pregnancy is rising. In 2014, the first guideline for the prevention of stroke in women was released, however on many (pregnancy) related topics the evidence was too scarce to make clear evidence-based recommendations.

The risk of ischemic stroke is elevated especially from the third trimester until 6 weeks postpartum. MRI is the most accurate and well tolerated diagnostic option but low-dose CT-head is a valid alternative. Reperfusion therapies should not be withheld from a pregnant woman with moderate-to-severe stroke when benefits outweigh the risk. Aspirin up to 150 mg daily is considered well tolerated during pregnancy and lactation period. Multidisciplinary care is essential when counseling these women in the acute and later stages.
Beyond cancer genes: colorectal cancer as robust intrinsic states formed by molecular interactions
Authors: Yuan Ruoshi , Zhang Suzhan , Yu Jiekai , Huang Yanqin , Lu Demin , Cheng Runtan , Huang Sui , Ao Ping , Zheng Shu , Hood Leroy , Zhu Xiaomei
Published: November 2017

Colorectal cancer (CRC) has complex pathological features that defy the linear-additive reasoning prevailing in current biomedicine studies. In pursuing a mechanistic understanding behind such complexity, we constructed a core molecular–cellular interaction network underlying CRC and investigated its nonlinear dynamical properties. The hypothesis and modelling method has been developed previously and tested in various cancer studies. The network dynamics reveal a landscape of several attractive basins corresponding to both normal intestinal phenotype and robust tumour subtypes, identified by their different molecular signatures. Comparison between the modelling results and gene expression profiles from patients collected at the second affiliated hospital of Zhejiang University is presented as validation. The numerical ‘driving’ experiment suggests that CRC pathogenesis may depend on pathways involved in gastrointestinal track development and molecules associated with mesenchymal lineage differentiation, such as Stat5, BMP, retinoic acid signalling pathways, Runx and Hox transcription families. We show that the multi-faceted response to immune stimulation and therapies, as well as different carcinogenesis and metastasis routes, can be straightforwardly understood and analysed under such a framework.
Are dogs red–green colour blind?
Authors: Siniscalchi Marcello , d'Ingeo Serenella , Fornelli Serena , Quaranta Angelo
Published: November 2017

Neurobiological and molecular studies suggest a dichromatic colour vision in canine species, which appears to be similar to that of human red–green colour blindness. Here, we show that dogs exhibit a behavioural response similar to that of red–green blind human subjects when tested with a modified version of a test commonly used for the diagnosis of human deuteranopia (i.e. the Ishihara's test). Besides contributing to increasing the knowledge about the perceptual ability of dogs, the present work describes for the first time, to our knowledge, a method that can be used to assess colour vision in the animal kingdom.