bluuebunny/crossref_metadata_2025 huggingface dataset:
A biomimetic vibration sensor using a symmetric electrodes metal core piezoelectric fiber
Authors: Bian Yixiang , Zhang Yi , Sun Kaixuan , Jin Hong , Dai Longchao , Shen Hui
Published: September 2017

A biomimetic vibration sensor to sense external vibrations was designed based on the hair receptor of insects similar to the water strider. Platinum core piezoelectric ceramic fiber body was prepared by squeeze and press method. This was followed by high-temperature sintering, surface electrode coating, and polarizing to fabricate the symmetric coated metal core piezoelectric fiber vibration sensor. A cantilever beam structure with two surface electrodes was designed as the theoretical sensor model. The fiber was fixed on a matrix structure. Experiments were performed to verify sensing characteristics under impact vibration and simple harmonic excitation. Results showed that the symmetric coated metal core piezoelectric fiber was able to sense amplitude and direction of impact vibration along with frequency, amplitude, and direction under simple harmonic excitation. Such a biomimetic vibration sensor can be effectively used to sense vibration amplitude and direction for a wide range of applications.
Effects of atomic oxygen on epoxy-based shape memory polymer in low earth orbit
Authors: Tan Qiao , Li Fengfeng , Liu Liwu , Chu Hetao , Liu Yanju , Leng Jinsong
Published: September 2017

Atomic oxygen is a dominant component of the low earth orbit and can erode most spacecraft polymeric material. In this article, the atomic oxygen erosion resistance tests of an epoxy-based shape memory polymer are carried out in a ground-based atomic oxygen simulator with a vacuum space chamber. The samples, before and after the atomic oxygen exposure, are compared in appearance, surface morphology, mass, main component, dynamical and static mechanical properties, and shape memory properties. The atomic oxygen exposure causes oxidization reaction of the material, which leads to surface roughen and mass loss, while the shape memory polymer main components remain same. The results of dynamical and static mechanical tests indicate that the atomic oxygen exposure has little effect on the storage modulus and glassy transition temperature (Tg), whereas the elongation, elastic modulus, tensile strength, and yield strength decrease since the atomic oxygen exposure gives rise to tiny cracks. The shape memory property has rarely changed since the atomic oxygen erosion is mainly located near the surface of the sample.
Between the Patient and Politics – A Ready-to-Use Simulation for Human Service Practitioners
Authors: Mallinson Daniel J. , O’Hanlon Erin
Published: September 2017

Background. Caregivers in human services fields operate within a space between their clients and the larger social forces that shape clients’ lives. Empathetic practitioners should learn to identify both personal circumstances and larger systemic forces (e.g., economic inequality) beyond their control that influence patients’ circumstances.

Aim. This article presents a novel two-phase simulation that can be beneficial for increasing empathy and policy knowledge among pre-practitioners in a variety of human service fields.

Method. We use a mixed-method design to evaluate the impact of a pilot study (n=9) of the simulation. First, pre-, mid-, and post-event surveys are used in conjunction with t-tests to determine changes in overall empathy and knowledge. Second, we use feedback from the first-phase debriefing and end-of-program focus groups to identify emergent themes. Learners role play a state legislator or interest group and must develop legislation to address shortages in physicians and nurses.

Result. We found evidence of increased knowledge of the policymaking process and understanding of how politics relates to individual healthcare access challenges. Evidence of gains in empathy were not apparent from the quantitative measures, but were expressed in participant debriefing.

Conclusion. The framework presented is flexible enough to adapt and be implemented for a variety of policy problems across a diverse array of human service fields. It shows promise in raising knowledge and potentially empathy.
Dexmedetomidine Use in a Pediatric Intensive Care Unit: A Retrospective Cohort Study
Authors: Banasch Heidi L. , Dersch-Mills Deonne A. , Boulter Leah L. , Gilfoyle Elaine
Published: September 2017

Background: Use of dexmedetomidine in critically ill pediatric patients is increasing despite limited data on effects on mechanical ventilation times, use of other sedatives, adverse effects, and withdrawal. Objectives: To describe the use and tolerability of dexmedetomidine in a large cohort of critically ill children. Methods: This was a retrospective cohort study of patients receiving dexmedetomidine in a pediatric intensive care unit. Ethical approval was granted by the local review board. Data on dexmedetomidine administration, ventilatory support, other sedatives, adverse effects, and withdrawal were collected. Results: There were 219 patients included. Dexmedetomidine was a first-line sedative in 47.9% of patients; the median infusion duration was 27 hours. Of patients on other sedatives at dexmedetomidine initiation, 39.5% had a dose reduction in those sedatives by 24 hours. Use of dexmedetomidine in noninvasively ventilated patients was common (19.6%), as was use in patients on no ventilatory support (35.6%). Patients receiving no ventilatory support used dexmedetomidine for shorter durations ( P = 0.001) and were less likely to have received prior sedatives ( P < 0.001). Adverse effects occurred in 42% of patients and were associated with younger age ( P = 0.001) and longer dexmedetomidine duration ( P < 0.001). The majority of patients (65%) were weaned off dexmedetomidine, and 80% of patients had at least one sign of withdrawal. Conclusions: Our data suggest substantial use in noninvasively ventilated patients. Adverse effects appeared more common in younger patients and those with prolonged infusions. A high rate of withdrawal effects was seen; no associations with age, dose, or duration were found.
Dedifferentiated Liposarcoma Mimicking a Primary Colon Mass
Authors: Hollowoa Blake , Lamps Laura W. , Mizell Jason S. , English George W. , Bridge Julia A. , Ram Roopa , Gardner Jerad M.
Published: September 2017

Dedifferentiated liposarcoma is typically a nonlipogenic high-grade sarcoma that arises from well-differentiated liposarcoma. It most commonly presents as a large mass in the retroperitoneum. Significant involvement of the gastrointestinal tract by dedifferentiated liposarcoma is uncommon. We present a unique case of dedifferentiated liposarcoma radiographically mimicking a primary colon mass with resulting intussusception; stranding of the adjacent adipose tissue was presumed to be a secondary reactive change. On histopathologic analysis of the hemicolectomy specimen, a high-grade sarcoma was seen growing through the colonic wall, and the majority of the surrounding pericolonic adipose tissue was actually composed of well-differentiated liposarcoma with characteristic fibrous bands rather than benign fat with reactive fibrosis. This case raises awareness that well-differentiated liposarcoma and dedifferentiated liposarcoma can rarely present as a primary intestinal mass mimicking colon cancer or other more common entities. When radiographic examination shows a perigastrointestinal or retroperitoneal fatty mass and/or stranding of the fat adjacent to a solid gastrointestinal mass, this unusual scenario should be considered in the radiologic differential diagnosis. Pathologists should keep dedifferentiated liposarcoma in the initial histologic differential diagnosis for any high-grade spindle cell tumor of the retroperitoneum or intra-abdominal visceral organs.
Evaluation of Thromboelastometry in Sepsis in Correlation With Bleeding During Invasive Procedures
Authors: Lukas Pavel , Durila Miroslav , Jonas Jakub , Vymazal Tomas
Published: September 2017

Prolongation of prothrombin time (PT) is often encountered in patients with sepsis. On the other hand, thromboelastometry as a global coagulation test might yield normal results. The aim of our study was to evaluate whether prolonged PT in the presence of normal thromboelastometry parameters is associated with severe bleeding in patients with sepsis undergoing invasive procedures. In patients with sepsis undergoing low-risk bleeding invasive procedures (central venous catheter placement, dialysis catheter insertion, drain insertion, and so on) or high-risk bleeding invasive procedures (surgical tracheostomy, surgical laparotomy, thoracotomy, and so on), coagulation was assessed by thromboelastometry using EXTEM test (test for evaluation of the extrinsic pathway of coagulation, contains activator of extrinsic pathway) and with PT. For period of years 2013 to 2016, we assessed occurrence of severe bleeding during those procedures and 24 hours later in patients with prolonged PT and normal thromboelastometry results. This retrospective study was performed at Department of Anaesthesiology and Intensive Care Medicine of Motol University Hospital in Prague. Data from 76 patients with sepsis were analyzed. Median value of international normalized ratio (INR) was 1.59 (min—1.3 and max—2.56), and median value of prothrombin ratio (PR) was 1.5 (min—1.23 and max—2.55) with normal thromboelastometry finding. Despite prolonged INR/PR, no severe bleeding was observed during invasive procedures. Our data show that sepsis may be accompanied by normal thromboelastometry results, despite prolonged values of PT, and invasive procedures were performed without severe bleeding. This approach to coagulation assessment in sepsis may reduce administration of fresh frozen plasma to the patients. The study was registered at Clinical Trials.gov with assigned number NCT02971111.
The in-use stability of the rituximab biosimilar Rixathon®/Riximyo® upon preparation for intravenous infusion
Authors: Lamanna William C , Heller Katharina , Schneider Daniel , Guerrasio Raffaele , Hampl Veronika , Fritsch Cornelius , Schiestl Martin
Published: September 2017

Purpose

The purpose of this study was to evaluate the in-use physicochemical and biological stability of the Sandoz rituximab biosimilar, marketed under the trade names Rixathon® and Riximyo® in the European Union, upon preparation for intravenous infusion.

Methods

Three batches of Rixathon®/Riximyo® in the final month of their 36 month shelf life were exposed to room temperature and light for 14 days to recapitulate a major temperature excursion. Samples were diluted to the lowest allowable concentration of 1 mg/mL in 0.9% NaCl solution in either polypropylene or polyethylene infusion bags and stored for 14 or 30 days at 5 ± 3℃ followed by an additional 24 h at room temperature to simulate product handling. Samples stored in infusion bags were analyzed using SEC, CEX, non-reducing CE-SDS, peptide mapping and CDC to assess physicochemical and biological stability.

Results

Analysis of Rixathon®/Riximyo® diluted to the lowest allowable concentration in 0.9% sodium chloride in either polypropylene or polyethylene infusion bags revealed no change in molecular weight variants, charge variants, deamidation, oxidation, overall composition or potency over a 31-day period.

Conclusion

Physicochemical and biological analyses demonstrate that Rixathon®/Riximyo® stability is not impacted by dilution and formulation conditions required for intravenous infusion, even under worst case conditions with regard to product shelf life, temperature excursion, light exposure, dilution factor and infusion bag storage time over a 31-day period.
Chasing TIGER: Federal Funding Opportunities and Regional Transportation Planning
Authors: Lowe Kate , Sciara Gian-Claudia
Published: September 2017

Many challenges make it difficult to achieve the collaborative metropolitan transportation planning ideals articulated in federal policy. A central challenge is that metropolitan planning organizations (MPOs) are responsible for identifying and prioritizing region-serving investments, but numerous transportation agencies and local governments typically implement projects and hold the purse strings. New, less restricted sources of funding could exacerbate these challenges, and so we examine the role of MPOs and their plans in local decisions to pursue project funding from the federal Transportation Investment Generating Economic Recovery (TIGER) program. Based on a national survey of MPOs, we find that the local selection of TIGER projects aligns with the federal emphasis on shovel-readiness, but that this criterion still allowed significant latitude for additional factors to shape local project selection. Despite competing factors and limits to regional planning, MPO planning and documents still played a substantial role in the local selection of TIGER projects.
A Metagenomic Analysis of Bacterial Microbiota in the Digestive Tract of Triatomines
Authors: Carels Nicolas , Gumiel Marcial , da Mota Fabio Faria , de Carvalho Moreira Carlos José , Azambuja Patricia
Published: September 2017

The digestive tract of triatomines (DTT) is an ecological niche favored by microbiota whose enzymatic profile is adapted to the specific substrate availability in this medium. This report describes the molecular enzymatic properties that promote bacterial prominence in the DTT. The microbiota composition was assessed previously based on 16S ribosomal DNA, and whole sequenced genomes of bacteria from the same genera were used to calculate the GC level of rare and prominent bacterial species in the DTT. The enzymatic reactions encoded by coding sequences of both rare and common bacterial species were then compared and revealed key functions explaining why some genera outcompete others in the DTT. Representativeness of DTT microbiota was investigated by shotgun sequencing of DNA extracted from bacteria grown in liquid Luria-Bertani broth (LB) medium. Results showed that GC-rich bacteria outcompete GC-poor bacteria and are the dominant components of the DTT microbiota. In addition, oxidoreductases are the main enzymatic components of these bacteria. In particular, nitrate reductases (anaerobic respiration), oxygenases (catabolism of complex substrates), acetate-CoA ligase (tricarboxylic acid cycle and energy metabolism), and kinase (signaling pathway) were the major enzymatic determinants present together with a large group of minor enzymes including hydrogenases involved in energy and amino acid metabolism. In conclusion, despite their slower growth in liquid LB medium, bacteria from GC-rich genera outcompete the GC-poor bacteria because their specific enzymatic abilities impart a selective advantage in the DTT.
An Exploration Into Short-Interval Maintenance of Adult Hemispheric Cortical Thickness at an Individual Brain Level
Authors: Wall John , Xie Hong , Wang Xin
Published: September 2017

Adult cerebral cortical structure is thought to be statically maintained over short intervals. This view is based on group average findings but has never been studied at the individual level. This issue was examined with an unconventional longitudinal magnetic resonance imaging design which measured hemispheric mean cortical thickness of an adult man repeatedly at week intervals over 6 months. These measures were compared with measurement error estimates to test the current prediction that thickness measures would be statically maintained within measurement error variation. The results did not support this prediction. Thickness underwent incremental and decremental fluctuations which ranged up to 0.12 mm and 5.83% over week and multiweek intervals and which differed from measurement error variation. These exploratory analyses suggest a working hypothesis that short-interval cortical structural maintenance in an individual can involve fluctuations in thickness. If confirmed, this hypothesis has potential implications for cortical maintenance mechanisms and precision medicine approaches.
Feasibility of the Atlas Unicompartmental Knee System Load Absorber in Improving Pain Relief and Function in Patients Needing Unloading of the Medial Compartment of the Knee: 1-Year Follow-Up of a Prospective, Multicenter, Single-Arm Pilot Study (PHANTOM High Flex Trial)
Authors: Slynarski Konrad , Walawski Jacek , Smigielski Robert , van der Merwe Willem
Published: September 2017

In young patients with medial knee osteoarthritis (OA), surgical intervention may not be desirable due to preferences to avoid bone cutting procedures, return to high activity levels, and prolong implant survival. The Atlas Knee System was designed to fill the gap between ineffective conservative treatments and invasive surgery. This single-arm study included 26 patients, aged 25 to 65 years, who completed 12 months of follow-up. All dimensions of the Knee injury and Osteoarthritis Outcome Score (KOOS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Knee Society Score significantly improved from baseline to 12 months. About 96.2% and 92.3% of patients experienced a ⩾20% improvement in their KOOS pain and WOMAC pain scores, respectively, at 12 months. This study highlights the potential benefit of a joint unloading device in the management of young patients with medial knee OA. The trial is still ongoing and another analysis is planned at 24 months.
Acitretin Use in Dermatology
Authors: Guenther Lyn C. , Kunynetz Rod , Lynde Charles W. , Sibbald R. Gary , Toole John , Vender Ronald , Zip Catherine
Published: September 2017

Background:

Acitretin has been used for the treatment of severe psoriasis for over 20 years.

Objective:

The current project was conceived to optimise patient care by recognising the role acitretin can play in the treatment of patients with psoriasis and those with other disorders of keratinisation.

Methods:

A literature review was conducted to explore the role of acitretin and to assess its value for dermatologic disorders other than severe psoriasis. A panel of Canadian dermatologists developed a clinical pathway using a case-based approach, focusing on specific patient features.

Results:

The clinical pathway covers plaque psoriasis with hyperkeratotic plantar disease, palmoplantar pustulosis, hyperkeratotic hand dermatitis, lichen planus, lamellar ichthyosis, and hidradenitis suppurativa.

Conclusion:

The recommendations in our clinical pathway reflect the current use of acitretin in Canada for severe psoriasis and other disorders of keratinisation.
Somatic learning: Bringing the body into critical reflection
Authors: Rigg Clare
Published: September 2017

Critical reflection is a process of bringing unquestioned assumptions to the fore for critique, through paying attention to dissatisfactions, discrepancies, tensions and contradictions in experience. It is important because it helps reveal the complexities for and against learning that are embedded in a particular context. Aesthetics and a focus on emotional and political dynamics are two approaches already being used to encourage learning through critical reflection. However, this article argues there is still more benefit to be gained from understanding how and why a focus on the body can support critically reflective perspectives on learning. My contribution is to illustrate how Buddhist practices of mindfulness meditation and associated philosophy can inform a somatic learning process that connects bodily sensation to cognition.
Pilot study comparing telephone to in-person delivery of cognitive-behavioural therapy for trauma-related insomnia for rural veterans
Authors: Laurel Franklin C , Walton Jessica L , Raines Amanda M , Chambliss Jessica L , Corrigan Sheila A , Cuccurullo Lisa-Ann J , Petersen Nancy J , Thompson Karin E
Published: September 2017

Introduction

It is estimated that 70% of patients with posttraumatic stress disorder (PTSD) have chronic insomnia. A recent meta-analysis examined cognitive-behavioural therapy for insomnia (CBT-I) in veterans with and without PTSD, and suggested that most studies had questionable methodology, but generally supported its effectiveness in this population. Further, while CBT-I via telehealth (i.e. using telecommunication and information technology to deliver health services) has shown effectiveness for primary insomnia, it has not been applied to PTSD-related insomnia.

Methods

Veterans with insomnia who were diagnosed with PTSD ( n = 12) or having significant subthreshold PTSD symptoms ( n = 6) on the Clinician Administered PTSD Scale were randomly assigned to receive CBT-I in-person ( n = 7) or by telephone ( n = 11), to pilot test the potential effectiveness, acceptability, and feasibility of administering CBT-I in rural veterans. A six-week CBT-I protocol was delivered, and the veteran’s insomnia was assessed at post-treatment and follow-up.

Results

Given the small sample size, Cohen’s d was used to detect group differences, finding large effect sizes favouring the in-person delivery, until three-months post-treatment when this difference diminished. Most veterans found the treatment acceptable, regardless of mode of delivery. Based on the results, a larger project is feasible. Feasibility for a larger project is favourable.

Discussion

In summary, our findings uphold and extend previous research. Specifically, current pilot data suggest that telephone-delivered CBT-I may be able to reduce trauma-related insomnia symptoms. Future trials are needed to assess the effectiveness of CBT-I delivered to rural veterans with posttraumatic insomnia.
Tele-orthopaedics: A snapshot of services in Australia
Authors: Caffery Liam J , Taylor Monica , North John B , Smith Anthony C
Published: September 2017

Health services in the United States and Europe have reported that tele-orthopaedics saves significant patient travel time, reduces time off work, increases satisfaction with care and in some scenarios reduces the cost of care. Less is known about the role of tele-orthopaedics in Australia. The aim of this study was to explore Australian-based tele-orthopaedic services, and to identify the barriers and enablers associated with these services. We used a qualitative case study methodology where specific services were identified from multiple sources and invited to participate in a structured interview. Nine tele-orthopaedic services contributed to the study. Telehealth activity in each service ranged from one to 75 patients per week, and service maturity ranged from three months to 10 years. Services were used predominantly for fracture clinics and peri-operative consultations. The majority (78%) of services used videoconferencing. Two services used asynchronous methods to review radiographs without direct patient involvement. Tele-orthopaedics was found to be disruptive as it required the redesign of many care processes. However, all services found the redesign feasible. Staff resistance was a commonly cited barrier. Further, imaging repositories from multiple imaging providers complicated access to information. Key enablers included clinical champions, picture archiving and communication systems, and the perceived benefit to patients who would avoid the need for travel. Whilst it appears that tele-orthopaedics is not widely utilised in Australia, recognition of the barriers and enablers is important for the development of similar services.
Treatment of Aneurysmal Bone Cysts with Bioactive Glass in Children
Authors: Syvänen J. , Nietosvaara Y. , Kohonen I. , Koskimies E. , Haara M. , Korhonen J. , Pajulo O. , Helenius I.
Published: September 2017

Background and Aims:

Aneurysmal bone cysts represent about 1% of primary bone tumors. The standard treatment is curettage, followed by local adjuvant treatments and bone grafting. The problem is the high recurrence rate. The purpose of this study was to evaluate retrospectively the use of bioactive glass as a filling material in the treatment of aneurysmatic bone cysts in children.

Material and Methods:

A total of 18 consecutive children (mean 11.3 years at surgery; 10 males; 11 lower, 6 upper limb, 1 pelvis; 15 with primary surgery) with histologically proven primary aneurysmal bone cysts operated with curettage and bioactive glass filling between 2008 and 2013 were evaluated after a mean follow-up of 2.0 years (range, 0.7–5.1 years).

Results:

Two (11%) patients showed evidence of aneurysmal bone cyst recurrence and both have been re-operated for recurrence. Bone remodeling was noted in all patients with remaining growth and no growth plate disturbances were recorded. Two patients needed allogeneic blood transfusion. No intraoperative or postoperative complications were recorded.

Conclusion:

We conclude that bioactive glass is a suitable filling material for children with primary aneurysmal bone cyst. Bioactive glass did not affect bone growth and no side effects were reported.
Computed Tomography Angiography is the Definitive Vascular Imaging Modality for Penetrating Neck Injury: A South African Experience
Authors: Madsen A. S. , Kong V. Y. , Oosthuizen G. V. , Bruce J. L. , Laing G. L. , Clarke D. L.
Published: September 2017

Background and Aims:

Computed tomography angiography has become central to the diagnostic algorithm for penetrating neck injury, but despite its widespread use the literature to support this adoption is limited. We reviewed our experience with computed tomography angiography for the identification of vascular trauma in hemodynamically stable patients with penetrating neck injury at a major trauma center in South Africa.

Materials and Methods:

A prospectively kept trauma registry capturing data in real time was retrospectively reviewed. All patients with penetrating neck injury investigated with computed tomography angiography as the initial vascular investigation during a 47-month period were included.

Results:

A total of 380 patients were included. Indications for computed tomography angiography were as follows: hard signs (13), soft signs (201), no signs but proximity/zone I or III wounds (141), and undefined signs of vascular injury (25). Of the 380 scans, 7 (1.8%) were indeterminate, 299 (78.7%) negative, and 74 (19.5%) positive for a vascular injury (54 arterial and 20 isolated venous injury). Eight were false positive and 4 false negative. The sensitivity, specificity, positive, and negative predictive values for detecting arterial injury were 93.9%, 97.5%, 85.2%, and 99.1%, respectively. Overall, the yield for demonstrating “true arterial injury” was 12.1% (46/380); hard signs: 76.9% (10/13), soft signs: 16.4% (33/201), and no signs: 2.1% (3/141) which all were secondary to gunshot wounds). Only 8.4% (32/380) required intervention for arterial injury and none for isolated venous injury (hard signs: 62.0%, soft signs: 11.4%, and no signs: 0.7%). No serious complications resulted from computed tomography angiography.

Conclusion:

Computed tomography angiography is a safe and effective imaging modality for the investigation of vascular trauma post penetrating neck injury. Asymptomatic patients with stab wounds do not need to be imaged regardless of proximity concerns. Symptomatic stable patients including a subgroup with hard signs should be imaged rather than explored. Computed tomography angiography provides an interventional road map and can identify injuries amenable to endovascular or conservative management.
Prediction of burn rate, knocking and cycle-to-cycle variations of binary compressed natural gas substitutes in consideration of reaction kinetics influences
Authors: Hann Sebastian , Urban Lukas , Grill Michael , Bargende Michael
Published: September 2017

Since zero-dimensional/one-dimensional simulations of natural gas spark-ignition engines use model theories similar to gasoline engines, the impact of changing fuel characteristics needs to be taken into consideration in order to obtain results of higher quality. For this goal, this article proposes some approaches that consider the influence of binary fuel mixtures such as methane with up to 40 mol% of ethane, propane, n-butane or hydrogen on laminar flame speed and knock behavior. To quantify these influences, reaction kinetics calculations are carried out in a wide range of the engine operation conditions. Obtained results are used to update and extend existing sub-models. The model quality is validated by comparing simulation results with measured heat release rates and knock limit. The benefit of the new sub-models is demonstrated by predicting the influence the fuel takes on engine operating limits in terms of knocking and lean misfire limits, the latter being determined using a cycle-to-cycle variation model.
Mediated research encounters: methodological considerations in cross-language qualitative interviews
Authors: Chiumento Anna , Rahman Atif , Machin Laura , Frith Lucy
Published: September 2017

Given increasing globalisation, the continuing prevalence of emergencies, and the importance of rigorous research to ensure the mental health needs of populations exposed to emergencies are effectively met, cross-language research will continue to arise. Drawing upon the lead author’s experience of conducting a cross-language qualitative study in three post-conflict settings in South Asia, this article discusses methodological considerations raised when interviewing with interpreters. These include considering interpreter positionality and matching; the approach to cross-language mediation during interviews; and assessing the quality of interpreter facilitated interviews. Drawing upon approaches taken in this study, the important choices researchers face about how these are managed are examined, considering the roles of researcher and interpreter positionality, the research context, and the epistemological underpinnings of the research. The discussion further illuminates the interrelated methodological, practical and ethical considerations for other researchers embarking upon similar research.
The infantilized researcher and research subject: ethics, consent and risk
Authors: Connor James , Copland Simon , Owen Jill
Published: September 2017

Current research ethics processes, based on the mantra of privacy and institutional protection, take a paternalistic approach to research participants that leaves them open to harm. Reflecting on our own research/consultancy as a case study to illustrate the current flaws, we explore our and our subjects’ experiences within the wider political context of institutional ethical rules and the Australian NHMRC guidelines. In doing so we argue for fundamental changes to the modern research ethics processes – a system that treats participants more as research collaborators rather than victims in waiting. A complete review of ethics processes is needed to empower participants and researchers to recognize the reality of the process as co-created and negotiated. This includes changes at the top level of research administration – a shift in ethics policies and procedures as well as greater education in ethics with commensurate trust for active researchers.
Dynamic intersemiosis as a humour-enacting trigger in a tourist video
Authors: Francesconi Sabrina
Published: September 2017

This article seeks to explore the use of multiple semiotic resources in a multimodal text, namely a YouTube video on the Hans Brinker Budget Hotel in Amsterdam. More specifically, it observes how dynamic intersemiosis is adopted for humorous meaning-making and with an ultimate promotional function. First, it is here claimed that dynamic intersemiosis acts as the humour-enacting trigger enabling script shift, i.e. the semantic process of frame reversal inherent in humour generation. Then, multimodally expressed humour is discussed as performing a parody of similar tourism and eco-tourism texts and of the specialized language they adopt. The questions raised are: How do dynamic images and the soundscape combine in terms of congruence and dissonance? How does intersemiosis act as a humour-enacting trigger in the multimodal artefact? How does multimodally expressed humour position the Hans Brinker Hotel within a tourism discourse? How and why is the parody of promotional (eco)-tourism videos realized?
Glocal riddim: cultural production and territorial identity in Caribbean music videos
Authors: Balaji Murali , Sigler Thomas
Published: September 2017

Over the past two decades, several musical genres have transcended their Caribbean origins to achieve global recognition and success. Among these are soca, dancehall and reggaeton, all forms that had been inextricably tied to native cultural expressions, but have become increasingly popular as global commodities, particularly as web-based streaming platforms (e.g. YouTube) enhance their global audiovisual mobility. Numerous artists within these genres have become internationally recognized superstars, and many of the most recent tracks reflect an increasing co-mingling with American ‘pop’ music, as record companies seek to invigorate mainstream sounds with these ‘exotic’, yet widely popular artists. This article explores representations of scalar territorial identity as articulated in music videos from within these genres so as to evaluate how identity intersects with profit-driven models applicable to the contemporary music industry. By evaluating imagery from a regionally representative sample of music videos, they identify the intimate relationship between identity, scale and cultural production. Ultimately, we interrogate how place-based identity is commodified in these representations and whether certain images are constructed more for transnational consumption than an articulation of a coherent local national, or regional identity.
Who’s devising your theatre experience? A director’s approach to inclusive theatre for blind and low vision theatregoers
Authors: Naraine Mala D , Whitfield Margot R , Fels Deborah I
Published: September 2017

In this article, the authors present the first documented implementation of a director-produced and delivered audio description (AD) for devising theatre. In a single live, audio-described performance of Highway 63: The Fort Mac Show at Theatre Passe Muraille in Toronto, Canada, the director/describer’s artistically informed approach focuses on entertainment value for blind and low vision (B/LV) theatregoers. In-depth, semi-structured interviews with the director/screenwriter/describer garnered insight into a director’s unique perspective on the development process for the integrated approach to AD, including her artistic choices, expectations and delivery style as a first-time amateur director/describer. The process of developing and delivering integrated AD had a transformative effect on her as a director.
A Social Marketing Intervention to Prevent Drowning Among Inner-City Youth
Authors: Glassman Tavis J. , Castor Tom , Karmakar Monita , Blavos Alexis , Dagenhard Paige , Domigan Julianne , Sweeney Erin , Diehr Aaron , Kucharewski Ruthie
Published: September 2017

Background. Water-related injuries and fatalities pose serious public health issues, especially to African American youth, a demographic group that drowns at disproportionately high rates. Aim. The purpose of this study was to determine if a social marketing intervention targeting the parents and guardians of inner-city youth (U.S. Midwest) could positively influence their perceptions concerning water safety. Method. Researchers employed a quasi-experimental design using matched pairs to evaluate the intervention. Participants consisted of parents who enrolled their children in a six-session survival-swimming course. Guided by the Health Belief Model, the researchers disseminated six prevention messages using six different channels (brochure, e-mail, SMS text message, postcard, Facebook, and window cling). Results. The findings from a two-way analysis of covariance revealed that treatment group participants’ knowledge and perceptions of water-related threat all changed favorably. Additionally, all participants planned to reenroll their children in swim lessons. Discussion. A social marketing campaign using the Health Belief Model improved inner-city parents’ knowledge regarding water safety and enhanced their self-efficacy. Conclusion. This study provides practitioners with feasible strategies (prevention messages) to supplement swim lessons, with the ultimate goal of preventing drowning among at-risk youth.
Cultural Rights and the Margin of Appreciation Doctrine: A Legal Tool for Balancing Individual Rights and Traditional Rules
Authors: Macioce Fabio
Published: September 2017

The aim of this article is to suggest a way forward for conflicts between individual rights and group rights, and between policies of equality and policies of difference. I propose a strategy to deal with problems of recognition, by establishing a legal mechanism in which powers and responsibilities are shared by the group and the state. This strategy does recognize the importance of the subsidiarity principle, and it is based on the European Court of Human Rights (ECtHR)’s margin of appreciation doctrine. This approach aims to combine respect for fundamental rights with the defense of a group’s identity, by allowing group representatives a wider margin of interpretation in constitutional rights enforcement. At the same time, I argue that this perspective may be a judicial mechanism to encourage groups to gradually develop their traditions, and to update them to constitutional standards.
Src-family kinases activation in spinal microglia contributes to central sensitization and chronic pain after lumbar disc herniation
Authors: Huang Yangliang , Li Yongyong , Zhong Xiongxiong , Hu Yuming , Liu Pan , Zhao Yuanshu , Deng Zhen , Liu Xianguo , Liu Shaoyu , Zhong Yi
Published: September 2017

Background

Lumbar disc herniation is a major cause of radicular pain, but the underlying mechanisms remain largely unknown. Spinal activation of src-family kinases are involved in the development of chronic pain from nerve injury, inflammation, and cancer. In the present study, the role of src-family kinases activation in lumbar disc herniation-induced radicular pain was investigated.

Results

Lumbar disc herniation was induced by implantation of autologous nucleus pulposus, harvest from tail, in lumbar 4/5 spinal nerve roots of rat. Behavior test and electrophysiologic data showed that nucleus pulposus implantation induced persistent mechanical allodynia and thermal hyperalgesia and increased efficiency of synaptic transmission in spinal dorsal horn which underlies central sensitization of pain sensation. Western blotting and immunohistochemistry staining revealed that the expression of phosphorylated src-family kinases was upregulated mainly in spinal microglia of rats with nucleus pulposus. Intrathecal delivery of src-family kinases inhibitor PP2 alleviated pain behaviors, decreased efficiency of spinal synaptic transmission, and reduced phosphorylated src-family kinases expression. Furthermore, we found that the expression of ionized calcium-binding adapter molecule 1 (marker of microglia), tumor necrosis factor-α, interleukin 1 -β in spinal dorsal horn was increased in rats with nucleus pulposus. Therapeutic effect of PP2 may be related to its capacity in reducing the expression of these factors.

Conclusions

These findings suggested that central sensitization was involved in radicular pain from lumbar disc herniation; src-family kinases-mediated inflammatory response may be responsible for central sensitization and chronic pain after lumbar disc herniation.
Cancer screening in women living with HIV infection
Authors: Aboulafia David M
Published: September 2017

The number of women living with HIV continues to increase. Thirty years into the AIDS epidemic, we now expect those with access to highly active antiretroviral to survive into their seventh decade of life or beyond. Increasingly, the focus of HIV care is evolving from preventing opportunistic infections and treating AIDS-defining malignancies to strategies that promote longevity. This holistic approach to care includes detection of malignancies that are associated with certain viral infections, with chronic inflammation, and with lifestyle choices. The decision to screen an HIV-infected women for cancer should include an appreciation of the individualized risk of cancer, her life expectancy, and an attempt to balance these concerns with the harms and benefits associated with specific cancer screening tests and their potential outcome. Here, we review cancer screening strategies for women living with HIV/AIDS with a focus on cancers of the lung, breast, cervix, anus, and liver.
One decade of oral anticoagulation in stroke patients: Results from a large country-wide hospital-based registry
Authors: Tanislav Christian , Allendörfer Jens , Pfeilschifter Waltraud , Fuest Sven , Stein Marco , Meyer Marco , Reuter Iris , Kaps Manfred , Misselwitz Björn
Published: September 2017

Background

New evidence regarding stroke prevention in atrial fibrillation has been published. Implementing knowledge into clinical practice remains challenging.

Aims

To investigate oral anticoagulants in stroke patients documented in a nationwide registry.

Methods

The database is an obligatory federal-state-wide hospital-based registry that covers more than 95% of all ischemic strokes, transient ischemic attacks and intracerebral hemorrhages in a community of more than six million inhabitants (Hesse/Germany). We analyzed oral anticoagulants prescribed on discharge in patients with stroke or transient ischemic attack during 2006–2015.

Results

From 2006 to 2015, we annually selected median 20,895 patients. From 2006 to 2015, the proportion of patients treated with oral anticoagulants increased (9.8% to 24%). The annual proportion of patients with atrial fibrillation remained constant (median: 23%). In atrial fibrillation patients treated with oral anticoagulants, the age increased (median 2008/2009: 76.9 years vs. 2014/2015 79.4 years). The percentage of treated individuals in atrial fibrillation increased dramatically (2006: 30.1% to 2015: 74.5%); in 2015, 30.8% of these patients received vitamin K antagonists and 70.2% new oral anticoagulants. Independent factors associated with new oral anticoagulants therapy were a previous medication with new oral anticoagulants and a treatment on stroke unit. Between new oral anticoagulants- and vitamin K antagonists-treated patients (2015), no differences in age were noted (both mean: 79.4 years).

Conclusions

The new oral anticoagulants availability enhanced a general trend treating more target patients with oral anticoagulants.
Effects of early nerve repair on experimental brachial plexus injury in neonatal rats
Authors: Bourke Gráinne , McGrath Aleksandra M. , Wiberg Mikael , Novikov Lev N.
Published: September 2017

Obstetrical brachial plexus injury refers to injury observed at the time of delivery, which may lead to major functional impairment in the upper limb. In this study, the neuroprotective effect of early nerve repair following complete brachial plexus injury in neonatal rats was examined. Brachial plexus injury induced 90% loss of spinal motoneurons and 70% decrease in biceps muscle weight at 28 days after injury. Retrograde degeneration in spinal cord was associated with decreased density of dendritic branches and presynaptic boutons and increased density of astrocytes and macrophages/microglial cells. Early repair of the injured brachial plexus significantly delayed retrograde degeneration of spinal motoneurons and reduced the degree of macrophage/microglial reaction but had no effect on muscle atrophy. The results demonstrate that early nerve repair of neonatal brachial plexus injury could promote survival of injured motoneurons and attenuate neuroinflammation in spinal cord.
A molecular mechanism for IL-4 suppression of loricrin transcription in epidermal keratinocytes: implication for atopic dermatitis pathogenesis
Authors: Bao Lei , Mohan Girish C , Alexander Jaime B , Doo Caroline , Shen Kui , Bao Jeremy , Chan Lawrence S
Published: September 2017

Skin barrier defects play an important role in atopic dermatitis (AD) pathogenesis. Loricrin, an important barrier protein suppressed in human AD, is down-regulated by IL-4 in keratinocytes. However, the molecular mechanism is unknown. Since loricrin transcription requires p300/CBP, and Stat6 also recruits this common coactivator for its stimulated factors, we hypothesize that IL-4-activated Stat6 competes for the available endogenous p300/CBP, leading to loricrin transcription inhibition. First, we showed that loricrin is suppressed in the skin of IL-4 transgenic mice, an AD mouse model. In human keratinocytes, IL-4 down-regulation of loricrin is abrogated by a pan-Jak inhibitor, suggesting that the Jak-Stat pathway is involved. To further investigate the downstream molecular mechanism, we transfected HaCat cells with a loricrin promoter and then treated them with either IL-4 or vehicle. Not surprisingly, IL-4 greatly suppressed the promoter activity. Interestingly, this suppression was prevented when we knocked down Stat6, indicating that Stat6 participates in IL-4 regulation of loricrin. A Stat6-specific inhibitor confirmed the knockdown study. Finally, IL-4 suppression of loricrin was reversed with transfection of a CBP expression vector in a dose-dependent manner. Taken together, for the first time, we delineate a molecular mechanism for IL-4 down-regulation of loricin expression in human keratinocytes, which may play an important role in AD pathogenesis.
Traumatic brain injury in adults
Authors: Mistry Jayran , Murray Nicola
Published: September 2017

Traumatic brain injury (TBI) is a leading cause of death and disability worldwide. Falls, assaults and road traffic accidents are the most common causes, with alcohol precipitating 65% of adult cases. The incidence of TBI is highest in men. As the UK population ages, however, the incidence of TBI in the elderly is rising. Approximately 1 million people affected in the UK have long-term sequelae, and GPs should be aware of the common causes and consequences of TBI. This article will focus primarily on mild TBI in adults.
Rethinking the Endpoints of mHealth Intervention Research in Diabetes Care
Authors: Modzelewski Katherine L. , Stockman Mary-Catherine , Steenkamp Devin W.
Published: September 2017

Mobile health (mHealth) is an emerging branch of medicine that utilizes technology to impact health care. With increasing access to smartphones and mobile devices, there has been an increase in both the availability and use of mHealth resources, including the use of text messages, apps, and web portals. In diabetes, there is particular interest as technology has long been a mainstay of management through glucometers, insulin pumps and continuous glucose monitors, which are increasingly interconnected. Although there is high demand for mHealth interventions in diabetes, there is no clear consensus on the best way to monitor these interventions. While randomized controlled trials are considered the gold standard for most medical research, we propose that alternative trial designs may be more applicable in the ever-changing mHealth landscape.