bluuebunny/crossref_metadata_2025 huggingface dataset:
Physicochemical stability of pembrolizumab admixture solution in normal saline intravenous infusion bag
Authors: Sundaramurthi Prakash , Chadwick Sean , Narasimhan Chakravarthy
Published: August 2019

Introduction

Pembrolizumab is an anti-PD-1 monoclonal antibody, approved and under development for numerous indications in oncology. It is available as either lyophilized powder for reconstitution or ready-to-use solution. Both are required to be diluted in saline or dextrose solution prior to intravenous infusion. After dilution, the recommendation per summary of product characteristics is 24 h at 2–8℃ and 6 h at room temperature. The purpose of this study was to investigate the physicochemical stability of pembrolizumab diluted solution (1 mg/mL) at both refrigerated and room temperature conditions for an extended period.

Methods

Under aseptic conditions, pembrolizumab was diluted in 250 mL of saline injection in polyolefin bags to obtain the final protein concentration of 1 mg/mL. Thus, prepared bags were then stored at either 5℃ ± 3℃, refrigerator exposing the product to ambient light or room temperature (20℃ ± 3℃) on the benchtop.

Results

Using several analytical methods, it was demonstrated that pembrolizumab solution for infusion, diluted in normal saline can be stored in polyolefin infusion bags for at least 1 week at 5℃ or RT with no evidence of chemical or physical instability. No aggregation was observed.

Conclusion

Thus, the practical use of aseptically prepared diluted pembrolizumab in saline can be safely extended to optimize the workload of centralized preparation units and to minimize costs. However, it is the responsibility of the end-user to maintain overall quality of prepared admixture solution that is administered to patient, by following aseptic compounding process as recommended in the packaging insert.
External contamination of antineoplastic drug containers from a Canadian wholesaler
Authors: Hilliquin D , Bussières JF
Published: August 2019

Introduction

Contamination of hospitals’ surfaces with antineoplastic drugs is documented despite safe handling practices. The exterior of commercial containers is often contaminated during the manufacturing process and can cross-contaminate hospitals’ surfaces. The aim was to investigate the contamination of the exterior of antineoplastic drug vials available in Canada in 2018.

Methods

Cross-sectional study. All available antineoplastic drugs vials from a single wholesaler were targeted. Containers were sampled upon their receipt by the pharmacy staff, before they were cleaned. One wipe was used to sample the external surface of five vials from a single batch from the same manufacturer. Nine antineoplastic drugs were quantified by ultra-performance liquid chromatography–tandem mass spectrometer: cyclophosphamide, docetaxel, 5-fluorouracil, gemcitabine, ifosfamide, irinotecan, methotrexate, paclitaxel, vinorelbine.

Results

Twenty-one samplings were done (105 containers from nine different manufacturers): cyclophosphamide = 2, docetaxel = 1, gemcitabine = 2, 5-fluorouracil = 2, ifosfamide = 2, irinotecan = 3, methotrexate = 6, paclitaxel = 2, vinorelbine = 1. One of these samplings was done on blister packaging, the remainder were done on glass vials. A total of 15/21 samples (71%) were positive to at least one drug (docetaxel, 5-fluorouracil, ifosfamide, and vinorelbine). A maximum of 272 ng/vial was quantified (gemcitabine). Cross contamination with other antineoplastic drugs was detected on 16/21 (76%) samples.

Conclusion

The majority of samples were positive to at least one antineoplastic drug, confirming that the exterior of antineoplastic drugs containers is still an important source of contamination. Manufacturers should reduce this contamination. Vials should be washed upon receipt, before they are stored in pharmacy. Gloves must be worn at all times to avoid occupational exposure.
Current status of eye disorders caused by docetaxel administration every 3 weeks: A case-control study in Japanese patients
Authors: Noguchi Yusuke , Kawashima Yugo , Maruyama Megumi , Kawara Hiroko , Tokuyama Yoko , Uchiyama Kiyoshi , Shimizu Yoshihiro
Published: August 2019

Purpose

Docetaxel is known to cause eye disorders. In this study, current status of eye disorders caused by docetaxel administration every 3 weeks in Japanese patients was examined.

Methods

This case-control study targeted patients who were newly administered docetaxel at the Kyoto Okamoto Memorial Hospital between 1 July 2015 and 30 June 2018. Eye disorder occurrence was defined as an event in which the pharmacist confirmed the symptoms in a patient interview and the ophthalmologist diagnosed the disorder.

Results

Of the 89 subjects, 7 (7.9%) had eye disorders. The symptoms were watering eyes (7.9%), a stye and eye discharge (2.2% each), corneal and conjunctival disorder, visual acuity reduction, and blepharedema (1.1% each). Four patients who presented with watering eyes, eye discharge, or corneal and conjunctival disorder showed improvement with the use of eye drops such as artificial tears. Two patients who presented with a stye showed improvement with the use of oral cefcapene. One patient with mild symptoms showed spontaneous improvement. However, one patient had irreversible visual acuity reduction. The multivariate logistic regression analysis revealed that a cumulative docetaxel dose of ≥300 mg/m2 (odds ratio: 15.50, 95% confidence interval: 1.37–175.00, p = 0.027) and concomitant cyclophosphamide use (odds ratio: 13.20, 95% confidence interval: 1.13–153.00, p = 0.039) were significant risk factors associated with eye disorders.

Conclusion

In conclusion, it was determined that docetaxel-related eye disorders might be influenced by the cumulative dose of docetaxel and concomitant cyclophosphamide use. In addition, relatively mild symptoms improved with medication.
Paroxetine for the treatment of intractable and persistent cough in patients diagnosed with cancer
Authors: Thakerar Arti , Simadri Karishma , Alexander Marliese , Fullerton Sonia
Published: August 2019

Introduction

Intractable and persistent cough is experienced by more than a third of patients with advanced cancer, with a significant negative impact on quality of life. Pharmacological treatment has been of little help in some patients. Limited evidence suggests novel agents such as paroxetine may reduce cough severity. This retrospective study aimed to assess effectiveness and tolerability of paroxetine for the treatment of intractable cough in patients with cancer.

Methods

Single-centre medical record review of paroxetine use in patients with advanced malignancy and cough treated at an Australia tertiary referral cancer centre between 1 October 2012 and 1 October 2017. Data relating to cough type and severity, response and adverse events were extracted from medical records. Cough type was described as non-productive dry cough, productive chesty cough or cough exhibiting both non-productive and productive features (mixed cough).

Results

Overall, 24/34 patients (71%) experienced a major or moderate reduction in their cough severity after treatment with paroxetine. Nearly half (47%) described a major improvement and a quarter (24%) moderate improvement. Of the 34 patients, nearly half had a lung primary cancer (16/34, 47%) and nearly all (17/18) of those without lung cancer had lung metastases from another primary cancer. Patients with dry cough reported greater benefit from paroxetine. Of the 56% (19/34) of patients with non-productive dry cough, 80% (15/19) reported an improvement in symptoms post paroxetine. The remaining 15 patients, 44% of the group, presented with either a productive chesty cough (9/34, 27%) or mixed cough (6/34, 18%). Of these patients, 60% (9/15) reported an improvement in symptoms. Two thirds of patients were commenced on paroxetine 10 mg (22/34, 65%), with the remainder starting at 20 mg (14/34, 35%).

Conclusion

Paroxetine may be an effective, novel, off-label treatment for intractable and persistent cough in patients with advanced cancer.
An Insight Into the Involvement of Mothers of Low Socioeconomic Status in Scottish Primary School Health Education Activities
Authors: Donnelly Samantha , Buchan Duncan S. , Gibson Ann-Marie , Mclellan Gillian , Arthur Rosie
Published: August 2019

School-based health activities that involve parents are more likely to be effective for child health and well-being than activities without a parent component. However, such school-based interventions tend to recruit the most motivated parents, and limited evidence exists surrounding the involvement of hard-to-reach parents with low socioeconomic status (SES). Mothers remain responsible for the majority of family care; therefore, this study investigated mothers with low SES to establish the reasons and barriers to their involvement in school-based health activities and to propose strategies to increase their involvement in those activities. Interviews were conducted with mothers with low SES, who were typically not involved in school-based health activities ( n = 16). An inductive–deductive approach to hierarchical analysis revealed that there are several barriers resulting in mothers being less involved, particularly due to issues surrounding the schools’ Parent Councils and the exclusivity of school-based events. Efforts made by the school to promote health activities and involve parents in such activities were revealed, alongside recommendations to improve on these practices. The findings offer multiple ways in which future school-based health interventions can recruit and involve mothers with low SES.
Feline asthma and heartworm disease: Clinical features, diagnostics and therapeutics
Authors: Garrity Sarah , Lee-Fowler Tekla , Reinero Carol
Published: August 2019

Practical relevance:

For feline practitioners, the cat with a cough or respiratory distress and thoracic radiographs with a bronchial or bronchointerstitial pattern suggests lower airway disease. Two important differentials, allergic asthma and heartworm disease (HWD), have many overlapping clinicopathologic features, but also clear and important differences in terms of cause and disease progression, treatment and prognosis. Notably, asthma is readily treatable and HWD is preventable.

Clinical significance:

Feline HWD comprises two clinical syndromes: the comparatively recently described heartworm-associated respiratory disease (HARD) and adult HWD. The former is much more common; very few cats with HARD develop adult HWD. In HARD, following death of immature worms, pulmonary lesions may improve over time (‘self-cure’). Lesions of adult HWD also improve over time as long as reinfection does not occur; however, with death of adult heartworms, mortality is high, and the prognosis is guarded. In asthma, morbidity is relatively high, but mortality is low, with an overall good to excellent prognosis.

Disease recognition:

Feline asthma is encountered worldwide. In the authors’ impression, feline HWD is often under-recognized.

Aims:

The aim of this review is to assist clinicians in differentiating feline asthma from feline HWD; as such, the emphasis is on distinguishing clinical features, as well as on diagnostics, therapy and prognosis. In differentiating these conditions, clinicians can attempt the goal of properly managing these diseases and can best educate owners on prognosis.

Evidence base:

For both feline asthma and feline HWD, the authors have drawn on the available peer-reviewed literature studies involving experimental models as well as spontaneous disease.
Management of feline carpal injuries: What are the options and when is arthrodesis indicated?
Authors: Basa Rachel M , Johnson Kenneth A
Published: August 2019

Practical relevance:

Feline carpal injuries are usually caused by falls from a height that result in hyperextension injury or antebrachiocarpal luxation or subluxation. Isolated ligamentous damage or fracture of the carpus is unusual; it is more common to have a combination of both in the cat. These injuries can be debilitating since cats climb and jump from great heights, and have a greater range of antebrachial pronation and supination than dogs.

Anatomy:

There are differences in the anatomy of the feline and canine carpus. In particular, cats only have a single short radial collateral ligament, also known as the medial collateral ligament. This means that, in the cat, antebrachiocarpal subluxation is possible with rupture of the dorsal joint capsule and short radial collateral ligament alone.

Clinical challenges:

Many feline carpal injuries can be treated without performing pancarpal arthrodesis. However, determining which ligaments and joint levels are affected requires careful examination and often stress radiography. When pancarpal arthrodesis is performed in the cat, it has been reported to reduce the height of jumping and to increase reluctance to climb. This is speculated to be due to reduced pronation and supination movement of the carpus.

Evidence base:

The current evidence base for management of feline carpal injuries is grade III or IV, with most of the studies being retrospective case series involving cadaveric dissection or direct extrapolation from published information about the dog. There are few guidelines regarding the optimal treatment options for carpal injuries in the cat.
American Association of Kidney Patients survey of patient preferences for hemodialysis vascular access
Authors: Balamuthusamy Saravanan , Miller Larry E , Clynes Diana , Kahle Erin , Knight Richard A , Conway Paul T
Published: August 2019

Objectives:

To determine the vascular access modalities used for hemodialysis, the reasons for choosing them, and determinants of satisfaction with vascular access among patients with end-stage renal disease.

Methods:

The American Association of Kidney Patients Center for Patient Research and Education used the American Association of Kidney Patients patient engagement database to identify eligible adult hemodialysis patients. Participants completed an online survey consisting of 34 demographic, medical history, and hemodialysis history questions to determine which vascular access modalities were preferred and the reasons for these preferences.

Results:

Among 150 respondents (mean age 54 years, 53% females), hemodialysis was most frequently initiated with central venous catheter (64%) while the most common currently used vascular access was arteriovenous fistula (66%). Most (86%) patients previously received an arteriovenous fistula, among whom 77% currently used the arteriovenous fistula for vascular access. Older patients and males were more likely to initiate hemodialysis with an arteriovenous fistula. The factors most frequently reported as important in influencing the selection of vascular access modality included infection risk (87%), physician recommendation (84%), vascular access durability (78%), risk of complications involving surgery (76%), and impact on daily activities (73%); these factors were influenced by patient age, sex, and race. Satisfaction with current vascular access was 90% with arteriovenous fistula, 79% with arteriovenous graft, and 67% with central venous catheter.

Conclusion:

Most end-stage renal disease patients continue to initiate hemodialysis with central venous catheter despite being associated with the lowest satisfaction rates. While arteriovenous fistula was associated with the highest satisfaction rate, there are significant barriers to adoption that vary based on patient demographics and perception of procedure invasiveness.
Hemimethylation Patterns in Breast Cancer Cell Lines
Authors: Sun Shuying , Lee Yu Ri , Enfield Brittany
Published: August 2019

DNA methylation is an epigenetic event that involves adding a methyl group to the cytosine (C) site, especially the one that pairs with a guanine (G) site (ie, CG or CpG site), in a human genome. This event plays an important role in both cancerous and normal cell development. Previous studies often assume symmetric methylation on both DNA strands. However, asymmetric methylation, or hemimethylation (methylation that occurs only on 1 DNA strand), does exist and has been reported in several studies. Due to the limitation of previous DNA methylation sequencing technologies, researchers could only study hemimethylation on specific genes, but the overall genomic hemimethylation landscape remains relatively unexplored. With the development of advanced next-generation sequencing techniques, it is now possible to measure methylation levels on both forward and reverse strands at all CpG sites in an entire genome. Analyzing hemimethylation patterns may potentially reveal regions related to undergoing tumor growth. For our research, we first identify hemimethylated CpG sites in breast cancer cell lines using Wilcoxon signed rank tests. We then identify hemimethylation patterns by grouping consecutive hemimethylated CpG sites based on their methylation states, methylation “M” or unmethylation “U.” These patterns include regular (or consecutive) hemimethylation clusters (eg, “MMM” on one strand and “UUU” on another strand) and polarity (or reverse) clusters (eg, “MU” on one strand and “UM” on another strand). Our results reveal that most hemimethylation clusters are the polarity type, and hemimethylation does occur across the entire genome with notably higher numbers in the breast cancer cell lines. The lengths or sizes of most hemimethylation clusters are very short, often less than 50 base pairs. After mapping hemimethylation clusters and sites to corresponding genes, we study the functions of these genes and find that several of the highly hemimethylated genes may influence tumor growth or suppression. These genes may also indicate a progressing transition to a new tumor stage.
Inhibition of Indoleamine 2,3 Dioxygenase Does Not Improve Cancer-Related Symptoms in a Murine Model of Human Papilloma Virus–Related Head and Neck Cancer
Authors: Vichaya Elisabeth G , Vermeer Daniel W , Budac David , Lee Anna , Grossberg Aaron , Vermeer Paola D , Lee John H , Dantzer Robert
Published: August 2019

The expression of indoleamine 2,3 dioxygenase (IDO) by tumors can contribute to immunotolerance, and IDO induced by inflammation can also increase risk for the development of behavioral alterations. Thus, this study was initiated to determine whether IDO inhibition, intended to facilitate tumor clearance in response to treatment, attenuates behavioral alterations associated with tumor growth and treatment. We used a murine model of human papilloma virus–related head and neck cancer. We confirmed that tumor cells express IDO and expression was increased by radiotherapy. Interestingly, inhibition of IDO activation by the competitive inhibitor 1-methyl tryptophan mildly exacerbated treatment-associated burrowing deficits (burrowing is a sensitive index of sickness in tumor-bearing mice). Genetic deletion of IDO worsened tumor outcomes and had no effect on the behavioral response as by decreased burrowing or reduced voluntary wheel running. In contrast, oral administration of a specific inhibitor of IDO1 provided no apparent benefit on the tumor response to cancer therapy, yet decreased voluntary wheel-running activity independent of treatment. These results indicate that, independent of its potential effect on tumor clearance, inhibition of IDO does not improve cancer-related symptoms.
Measurement of the crankshaft seals friction losses in a modern passenger car diesel engine
Authors: Knauder Christoph , Allmaier Hannes , Sander David E , Sams Theodor
Published: August 2019

This paper presents results of experimental investigations on the friction losses of the crankshaft radial lip seals of a modern four-cylinder diesel engine for passenger car applications. A two stage strip-test has been conducted on a motored engine test bed to obtain the friction torque of the radial lip seals. For the experimental investigations with the crankshaft seals removed from the engine, a special sealing apparatus has been designed and built. A wide range of tests have been performed covering the full speed range of the engine at lubricant temperatures of 70 ℃, 90 ℃, and 110 ℃. The results show a dependency on crankshaft speed and engine media supply temperature but also revealed the presence of constant plateaus of friction torque over engine speed.
Effect of Cr2O3 on the microstructure and tribological performance of sprayed Fe-based coating on cylinder liner
Authors: Liu Eryong , Wang Furong , Du Shuangming , Zeng Zhixiang , Du Huiling , Bai Yaping
Published: August 2019

Improving the vehicle efficiency by weight reduction and friction loss has become the severe challenge to machinery manufacturers. Generally, replacing heavy cast iron engine component by aluminum alloys played a key role in reducing fuel consumption and pollutants emission, but the durability in poor mechanical properties of aluminum alloys restricted its application in severe conditions of engine cylinder. In order to improve the tribological properties of aluminum cylinder liner, Cr2O3-added Fe-based coating was prepared by plasma spraying technology, and the effect of Cr2O3 on the microstructure and tribological performance of sprayed coating was investigated in this study. All the Cr2O3-added coatings improved mechanical properties significantly, such as hardness and wear resistance compared to that of Fe-based alloy. However, appropriate content of Cr2O3 was beneficial to wear resistant but the excessive Cr2O3 deteriorated the wear resistance under dry sliding condition. The degradation was likely generated by the embrittlement of the Cr2O3 reinforcements, weaker interface of Cr2O3/matrix, and the inherent lamellar structure of sprayed coating. As a result, Fe-based coating with 30 wt.% Cr2O3 provided excellent mechanical properties and can be substitute for the application in aluminum alloy cylinder liner.
Majoritarian and consensual democracies: The seat product connection
Authors: Taagepera Rein , Nemčok Miroslav
Published: August 2019

This study connects two apparently disparate fields of inquiry in a specific quantitative way. In Lijphart’s Patterns of Democracy, the majoritarian–consensual “executives–parties” score ( L) combines five indices. Four of these largely or entirely derive from factors that Shugart and Taagepera, Votes from Seats, logically deduced from the product of two numbers: the number of seats in an average electoral district ( M) and in the first or only chamber of representative assembly ( S). Hence L connects to the purely institutional seat product MS (logged) along a simple logistic pattern. It can be predicted from [Formula: see text], with R2 = 0.59. Thus, surprisingly, the majoritarian–consensual typology largely stems from the number of seats available.
Beyond acute stroke: Rate of stroke transfers to a tertiary centre following the implementation of a dedicated inpatient teleneurology network
Authors: Al Kasab Sami , Almallouhi Eyad , Debenham Ellen , Turner Nancy , Simpson Kit N , Holmstedt Christine A
Published: August 2019

Introduction

This study evaluated the impact of establishing an inpatient teleneurology consultation service alongside an already established telestroke network on the stroke transfers to the hub. The study also aimed to assess the financial impact of establishing this network.

Methods

Prospectively collected data on all stroke patients evaluated through our telestroke and teleneurology networks between January 2008 and March 2018 were interrogated. For all spokes (eight sites) that had both teleneurology and telestroke services, we compared the rate of transfers to the hub before and after the establishment of the teleneurology network in August 2014. The cost reduction was estimated using the Medicare 5% standard analytic files.

Results

A total of 4296 stroke patients were evaluated during the study period. Of these, 2493 were seen before and 1803 were seen after the implementation of the teleneurology network at the included sites. Patients in the pre-teleneurology group were older (66.4 years ( SD = 14.7 years) vs. 67.8 years ( SD = 15.1 years); p = 0.002). Otherwise, there were no differences in baseline characteristics. Patients in the pre-teleneurology group were more likely to be transferred to the telestroke hub (29.4% vs. 20.2%; p < 0.001). The estimated mean cost reduction for each one minus the cost of transfer was estimated to be US$4997.

Discussion

The implementation of an inpatient teleneurology network was associated with a significant reduction in the transfer rate of stroke patients to hospitals with a higher level of care and could lead to a significant cost reduction.
CVD risk factors and surrogate markers - Urban-rural differences
Authors: Nuotio Joel , Vähämurto Lauri , Pahkala Katja , Magnussen Costan G. , Hutri-Kähönen Nina , Kähönen Mika , Laitinen Tomi , Taittonen Leena , Tossavainen Päivi , Lehtimäki Terho , Jokinen Eero , Viikari Jorma S.A. , Raitakari Olli , Juonala Markus
Published: August 2019

Aims: Disparity in cardiovascular disease (CVD) mortality and risk factor levels between urban and rural regions has been confirmed worldwide. The aim of this study was to examine how living in different community types (urban–rural) in childhood and adulthood are related to cardiovascular risk factors and surrogate markers of CVD such as carotid intima-media thickness (IMT) and left ventricular mass (LVM). Methods: The study population comprised 2903 participants (54.1% female, mean age 10.5 years in 1980) of the Cardiovascular Risk in Young Finns Study who had been clinically examined in 1980 (age 3–18 years) and had participated in at least one adult follow-up (2001–2011). Results: In adulthood, urban residents had lower systolic blood pressure (–1 mmHg), LDL-cholesterol (–0.05 mmol/l), lower body mass index (–1.0 kg/m2) and glycosylated haemoglobin levels (–0.05 mmol/mol), and lower prevalence of metabolic syndrome (19.9 v. 23.7%) than their rural counterparts. In addition, participants continuously living in urban areas had significantly lower IMT (–0.01 mm), LVM (1.59 g/m2.7) and pulse wave velocity (–0.22 m/s) and higher carotid artery compliance (0.07%/10 mmHg) compared to persistently rural residents. The differences in surrogate markers of CVD were only partially attenuated when adjusted for cardiovascular risk factors. Conclusions: Participants living in urban communities had a more favourable cardiovascular risk factor profile than rural residents. Furthermore, participants continuously living in urban areas had less subclinical markers related to CVD compared with participants living in rural areas. Urban–rural differences in cardiovascular health might provide important opportunities for optimizing prevention by targeting areas of highest need.
A novel air management system for a large bore two-stroke naturally aspirated gas engine to reduce emissions
Authors: Gubba Sreenivasa Rao , Tamma Bhaskar , Kazempoor Pejman , Hurley Thomas J , Patterson Mark A , Hartman Grant
Published: August 2019

The oil and gas industry operates by reciprocating natural gas engines which must comply with regulated emission standards for hazardous air pollutants, including NOx, CO, and volatile organic compounds (VOCs). These pollutants are regulated by Environmental Protection Agency, and each engine is regularly tested for compliance with national emission standards. A general emissions control strategy in combustion engines is to control the air-to-fuel ratio. However, stationary reciprocating engines, especially two-stroke engines, rarely have any mechanisms to control air and fuel parameters at various operating conditions. This article discusses a novel air management system that is invented to control the air-to-fuel ratio for a large bore two-stroke naturally aspirated gas engine, that is, AJAX™ brand model number 2802. The method can also be used for other engines with the same working principle. This novel air management system has been developed through comprehensive computational analyses of the gas exchange process inside the engine and is presented here. Pilot tests have also been conducted to validate the computational model results. The results show that this air management system can significantly reduce the engine emissions to the standard level at various operating conditions, including partial loads and speeds. In the case of VOCs emissions, up to a 75% reduction is observed.
Top management team diversity, individualism–collectivism, and MNE performance
Authors: Gil Adrian , Brouthers Lance Eliot , Keig Dawn L
Published: August 2019

Existing theories of diversity typically focus on a limited range of usually American research settings and on a relatively narrow range of types of diversity. Here, we examine a less commonly used measure of diversity, top management team (TMT) functional diversity, for a sample of non-US multinational enterprises (MNEs) from a cross-cultural perspective. We theorize and empirically test the notion that the individualism–collectivism dimension of national culture moderates the relationship between TMT diversity (measured by functional heterogeneity) and firm performance such that greater functional diversity among TMTs in collectivistic national cultures improves firm performance, while greater functional diversity among TMTs in individualistic national cultures weakens MNE performance. Our empirical results based on a sample of MNEs from 25 countries support our hypotheses. The relationship between TMT functional heterogeneity and firm performance is strongly negative in highly individualistic national cultures but positive in collectivistic national cultures. Managerial implications, limitations, and future research directions are discussed.
What Happens in the Beginning, Matters in the End: Achieving Best Evidence with Child Suspects in the Police Station
Authors: Gooch Kate , von Berg Piers
Published: August 2019

During the last 30 years, the way in which children give evidence in the criminal justice system in England and Wales has been radically transformed. These reforms have, however, neglected child suspects in the police station. Recent piecemeal reforms to the statutory regime for children in police detention have overlooked a critical stage of the criminal justice process: the police interview. This article critically analyses the policy, practice and law surrounding police questioning of child suspects. It demonstrates that the absence of child-specific guidance when interviewing child suspects is not only out of step with wider reforms, but carries real risks regarding the effective communication and participation of child suspects.
Exploring the multi-dimensionality of permanence and stability: Emotions, experiences and temporality in young people’s discourses about long-term foster care in Ireland
Authors: Moran Lisa , McGregor Caroline , Devaney Carmel
Published: August 2019

This paper focuses on qualitative findings on how young people in long-term foster care in Ireland interpret permanence and stability. We focus principally on subjective and relational permanence, emphasising the significance of these concepts for social work, while extending some conceptual approaches to permanence. Importantly, findings from this study highlight conceptual gaps in how permanence and stability are conceptualised in research and we outline an approach which more fully embraces the multi-dimensionality of young people’s life experiences and emotions. Recent studies underline that permanence encompasses several elements (e.g. ecological, legal). However, this paper extends current research in illustrating how Irish young people in foster care experience permanence and stability every day, and how these experiences embrace discursive, emotional and temporal dimensions.
Public Health and School Health Education: Aligning Forces for Change
Authors: Birch David A. , Auld M. Elaine
Published: August 2019

The interdependent relationship between health and education has long been documented by leading health and education scholars. Children who are not physically, mentally, socially, or emotionally healthy will not be ready to learn and thus hampered to achieve their full potential as productive members of society. Despite this evidence, the United States has yet to bridge the divide between the health and education systems. This perspective introduces three manuscripts in this Special School Health Education Collection on the future of school health education in the United States, and provides a context for the challenges and recommendations each article outlines to improve the quantity and quality of school health education for preK-12 youth. Although some of the challenges and recommendations are not novel, what is exciting is the opportunity to move the agenda forward given the Whole School, Whole Community, Whole Child model and the Every Student Succeeds Act of 2015. Aligning the forces of public health and school health educators is essential to make school health education a societal imperative.
Promoting Health Literacy Through Defining and Measuring Quality School Health Education
Authors: Videto Donna M. , Dake Joseph A.
Published: August 2019

Changes in national and state policies in the past two decades have had a negative impact on school health education. During this same time, significant gains have been made in our understanding of the relationship between health and academic outcomes. This article proposes three challenges that could help refocus our country’s efforts toward the positive impacts quality school health education can have on our population. Each of these challenges has corresponding recommendations to guide stakeholder efforts to help bring about these changes.
Theory Building and Testing in HRD: Current Advancements and Future Directions
Authors: Seo Jaekyo , Noh Ki Bum , Ardichvili Alexandre
Published: August 2019

This research studied changes in theory building and testing levels, reported in 668 articles published in three leading Human Resource Development (HRD) journals in years 2000 to 2017. Using a modified taxonomy of theory building research, we found evidence to suggest that the trajectory of theory building and testing efforts in HRD suggests that the field has reached a stage of a mature discipline. The study has found that some types of research have become less important as the discipline matured (e.g., Reporters, or articles reporting observation of phenomena) or remain stable (Modifiers of existing theories), whereas others steadily grow in importance (theory Builders and Expanders). Correlating the results of citation analysis with types of articles, we found that articles that propose and test new theoretical constructs at the same time, or those that expand new theories, enjoy significantly higher levels of citations, compared with articles that report observations of practice or duplicate earlier studies.
Likelihood of Normal ABI Increases With Physiologic Testing Referrals From Rural Primary Care Physicians
Authors: Scissons Robert P. , Ettaher Abraham , Afridi Sophia
Published: August 2019

Disparities in diagnostic capabilities have been noted between rural and urban health care facilities. We believe the clinical evaluation of peripheral arterial disease (PAD) by rural physicians may be similarly affected. Patients referred for arterial physiologic testing in an urban and rural regional health care network for a consecutive 7-month period were reviewed. Patients were classified into 3 groups based on referring physician specialty: (1) vascular surgeon or vascular medicine specialist (Vasc), (2) urban primary care physician (Urban), and (3) rural primary care physician (Rural). Normal patients were defined by a posterior tibial (PT) or dorsalis pedis (DP) ankle-brachial index (ABI) of ⩾0.90, bilaterally. Abnormal patients had both PT and DP ABI <0.90 in one or both extremities. Group comparisons were made for normal and abnormal patients, age (⩾65 years old), and gender. Patients with history of amputations, angioplasty, bypass graft, stent, calcification (PT or DP ABI ⩾1.30), and previous physiologic testing outside the designated period of analysis were considered a separate subclassification and analyzed separately. Emergency room referrals, inpatients, and patients with incomplete examination data were excluded from the analysis. A total of 430 patient exams were evaluated. Group-Rural had significantly greater numbers of normal ABI patients compared with Group-Urban ( P = .0028) and Group-Vasc ( P = .0000). No significant differences were noted between all groups for age and gender. Substantial disparities were noted in normal and abnormal ABI patients between rural health care physicians and their urban primary care and vascular specialist counterparts. Significantly greater numbers of normal ABI referrals by rural primary care physicians may warrant enhanced PAD diagnosis education or telemedicine alternatives.
The Relationship Between Electronic Gaming and Health, Social Relationships, and Physical Activity Among Males in Saudi Arabia
Authors: Alshehri Abdullah Ghurm , Mohamed Ahmed Mohamed Abdel Salam
Published: August 2019

Physical and psychological effects of playing computer games cannot be ignored. Electronic games are considered to be an influential factor in growth, personality development, and positive sociability of children, and game duration has been associated with increased aggression, reduced mental health, and higher BMI. The aim of the present study was to explore the relationship between electronic gaming and health, social relationships, and physical activity among males aged 16–18 years in Saudi Arabia. An online survey designed by the authors containing 60 items and divided into 5 sections was used during one school semester. The sample was selected randomly from 30 high schools; 90 students were selected from each school, with 30 chosen from each of grades 9, 10, and 11. Respondents were 194 male students, aged 17.23 ± 1.52 years. The questionnaire was presented to six experts to assess validity, with Cronbach’s α established at 0.87. Results showed that playing electronic games had a negative relation with health, social relationships, and physical activity among males. The most negative significant was the correlation between electronic games and physical activity ( r = −.49), followed by that with social relationships ( r = −.42) and BMI ( r = −.31) . The lowest result was for health ( r = .20). More empirical investigations are needed to explore deeper effects of electronic gaming on various groups in Saudi society, including the general population, employees, and different categories of school and university students.
Independent coordinate coupling method for vibration analysis of a functionally graded carbon nanotube–reinforced plate with central hole
Authors: Guo Yan , Jiang Yanan , Huang Bin
Published: August 2019

In this article, the free vibration of a functionally graded carbon nanotube–reinforced plate with central hole is investigated by means of the independent coordinates-based Rayleigh–Ritz method. For the proposed method, the kinematic and potential energies are substituted into Lagrange’s equation in order to obtain the equation of motion. However, the total energies are computed by the difference of energies between the hole domain and the plate domain. By applying the displacement matching condition at the hole domain, two coordinate systems are coupled. For the Rayleigh–Ritz method, the mode shape functions of uniform beams are assumed as admissible functions. By this method, convergent results can be obtained with certain number of terms of admissible functions. The present results clearly reflect the effects of the carbon nanotube distribution type, carbon nanotube volume fraction, hole size, and boundary condition on the nondimensional natural frequencies. The provided results show that the present method is efficient in studying the vibration problems of functionally graded carbon nanotube–reinforced plate with central hole.
A new biased estimation method based on Neumann series for solving ill-posed problems
Authors: Yang QW
Published: August 2019

The ill-posed least squares problems often arise in many engineering applications such as machine learning, intelligent navigation algorithms, surveying and mapping adjustment model, and linear regression model. A new biased estimation (BE) method based on Neumann series is proposed in this article to solve the ill-posed problems more effectively. Using Neumann series expansion, the unbiased estimate can be expressed as the sum of infinite items. When all the high-order items are omitted, the proposed method degenerates into the ridge estimation or generalized ridge estimation method, whereas a series of new biased estimates can be acquired by including some high-order items. Using the comparative analysis, the optimal biased estimate can be found out with less computation. The developed theory establishes the essential relationship between BE and unbiased estimation and can unify the existing unbiased and biased estimate formulas. Moreover, the proposed algorithm suits for not only ill-conditioned equations but also rank-defect equations. Numerical results show that the proposed BE method has improved accuracy over the existing robust estimation methods to a certain extent.
System-integrated technology-enabled model of care (SINEMA) to improve the health of stroke patients in rural China: Statistical analysis plan for a cluster-randomized controlled trial
Authors: Gong Enying , Yan Lijing L , McCormack Kara , Gallis John A , Bettger Janet Prvu , Turner Elizabeth L
Published: August 2019

Background

The system-integrated technology-enabled model of care (SINEMA) trial aimed to evaluate the effectiveness of a community-based multi-component intervention for secondary prevention of stroke in rural China.

Objective

To present the detailed statistical analysis plan for the trial prior to database locking and data analysis.

Methods

The detailed analysis plan outlines primary and secondary outcome measures, describes the over-arching data analysis principles to be adopted as well as more detailed descriptions of specific analytical approaches for effectiveness analyses, as well strategies to handle missing outcome data.

Discussion

Publication of the statistical analysis plan increases the transparency of the data analysis procedure and reduces potential bias in trial reporting.

Trial registration

The trial was registered with clinicaltrials.gov (NCT03185858).
TRIAGE-STROKE: Treatment strategy In Acute larGE vessel occlusion: Prioritize IV or endovascular treatment—A randomized trial
Authors: Behrndtz Anne , Johnsen Søren P , Valentin Jan B , Gude Martin F , Blauenfeldt Rolf A , Andersen Grethe , Majoie Charles BLM , Fisher Marc , Simonsen Claus Z
Published: August 2019

Rationale

For patients with acute ischemic stroke and large vessel occlusions, intravenous thrombolysis and endovascular therapy are standard of care, but the effect of endovascular therapy is superior to intravenous thrombolysis. If a severe stroke with symptoms indicating large vessel occlusions occurs in the catchment area of a primary stroke center, there is equipoise regarding optimal transport strategy.

Aim

For patients presenting with suspected large vessel occlusions (PASS ≥ 2) and a final diagnosis of acute ischemic stroke, we hypothesize that bypassing the primary stroke center will result in an improved 90-day functional outcome.

Sample size

We aim to randomize 600 patients, 1:1.

Design

A national investigator-driven, multi-center, randomized assessor-blinded clinical trial. The Prehospital Acute Stroke Severity Scale has been developed. It identifies most patients with large vessel occlusions in the pre-hospital setting. Patients without a contraindication for intravenous thrombolysis are randomized to either transport directly to a comprehensive stroke centers for intravenous thrombolysis and of endovascular therapy or to a primary stroke center for intravenous thrombolysis and subsequent transport to a comprehensive stroke centers for of endovascular therapy, if needed.

Outcomes

The primary outcome will be the 90-day modified Rankin Scale score (mRS) for all patients with acute ischemic stroke. Secondary outcomes include 90-day mRS for all randomized patients, all patients with ischemic stroke but without large vessel occlusions, and patients with hemorrhagic stroke. The safety outcomes include severe dependency or death and time to intravenous thrombolysis for ischemic stroke patients.

Discussion

Study results will influence decision making regarding transport strategy for patients with suspected large vessel occlusions.
‘Everyone gets a kick’: Coach characteristics and approaches to inclusion in an Australian Rules Football program for children
Authors: May Tamara , Sivaratnam Carmel , Williams Katrina , McGillivray Jane , Whitehouse Andrew , Rinehart Nicole J
Published: August 2019

This study aimed to understand coaches’ approaches to including children with disabilities in a community-based Australian rules football program for children. Football coaches for the program, called Auskick, completed an online survey providing qualitative and quantitative information about their experiences of inclusive coaching. Coaches (N = 130) completed the survey over 2016/2017. The average years of coaching experience was 3.3 (range 0–19 years). While 79% of coaches had experienced a child with a disability attending their football centre, only 31% of coaches (56% of paid coaches and 27% of volunteer coaches) had completed disability training. Autism, attention deficit hyperactivity disorder and intellectual disability were the most common types of developmental disabilities, and asthma, vision and hearing problems were the most common physical disabilities of children attending the coaches’ centres. Eighty-nine coaches provided examples of inclusive approaches. The most common was having an inclusive attitude, asking the parents for help, making adaptations to suit the child, giving extra time, getting additional help and staff training. Community football coaches frequently work with children who have a broad range of developmental and physical disabilities. Coach disability training is needed to support children with disabilities attending these types of sporting programs in the community.
Media use, fear of terrorism, and attitudes towards immigrants and refugees: Young people and adults compared
Authors: Debrael Marlies , d’Haenens Leen , De Cock Rozane , De Coninck David
Published: August 2019

In Flanders, citizens hold rather negative attitudes towards immigrants and refugees. This could be due to the news media, which depict newcomers in a rather negative way. The purpose of this study is to analyze whether there are separate media worlds at work in Flemish young people and adults and whether this results in different attitudes towards immigrants and refugees. To do so, we questioned 1,759 people aged 13 to 65 by means of an online questionnaire. Results indicate that overall news consumption increases with age, and that young people mainly use social media for their news consumption while adults still rely on traditional media. Interestingly, young adults are the most welcoming group towards immigrants and refugees. Although news media consumption seems to be related to fear of terrorism and attitudes towards newcomers to some extent, socio-demographic factors play an important role in the development of fear and negative attitudes towards newcomers.