bluuebunny/crossref_metadata_2025 huggingface dataset:
Early Adolescents’ Adjustment at School: A Fresh Look at Grade and Gender Differences
Authors: Brass Nicole , McKellar Sarah E. , North Elizabeth A. , Ryan Allison M.
Published: August 2018

This study examined group differences by grade (fifth graders in elementary school and sixth graders in middle school) and gender in academic (behavioral and emotional engagement, academic self-concept, and worry) and socio-emotional adjustment (self-esteem, social satisfaction, social self-concept, and worry). Self-report data were collected from 1,003 students in the fall and spring of the school year (51.2% female, 36.7% Black, 47.2% White, 7.5% Hispanic, 5.7% Asian, 3% Other). Grade differences were null or favored fifth graders for academic adjustment. Grade differences were null or favored sixth graders for socio-emotional adjustment. Gender differences were null or favored girls for academic and socio-emotional adjustment; however, girls reported more worry in both domains. Change over time generally disfavored girls leading to the emergence of, or increases in, gender gaps by spring. The discussion considers early adolescent development and the need for continued attention to middle school reform regarding academic adjustment and gender differences.
Examining the Relationship Between Self-Perceptions of Person, Role, and Social Identity Change and Self-Concept Clarity
Authors: Carter Michael J. , Bruene Sara
Published: August 2018

Past research in the literature on the self has addressed how self-concept clarity changes over time. In this study, we use a cross-sectional research design to examine the relationship between self-perceptions of identity change and self-concept clarity, showing how fluctuations in self-concept clarity relate to two discrete dimensions of perceived identity change: the magnitude and direction of change. A survey was administered to 854 study participants that measured perceived changes in 12 discrete identities (four person, four role, and four social identities) over a 6-month period. The results reveal that generally the more severe one's perceived experience of identity change, the lower their degree of self-concept clarity. However, when the direction of one's perceived identity change is progressive (i.e., developing into an identity) rather than regressive (i.e., exiting out of an identity), one's degree of self-concept clarity increases.
A Stated Preference Survey Approach to Understanding Mobility Choices in Light of Shared Mobility Services and Automated Vehicle Technologies in the U.S.
Authors: Asgari Hamidreza , Jin Xia , Corkery Terrence
Published: August 2018

This paper presents the preliminary results of a recent nationwide survey that focuses on mode choice behavior in view of emerging mobility options such as ride-sourcing and automated vehicles (AV). The survey provides a comprehensive scan of current mode choice patterns and the influencing factors. Then it presents stated preference (SP) choices to understand how travelers measure the trade-offs among different mode alternatives. The choice experiments focused on four potential user markets: drivers who usually drive for daily activities, passengers who depend on other household members or friends, transit users or users who do not have access to a private vehicle on a regular basis, and visitors or who do not have access to a private vehicle occasionally. The results suggest that on-demand services incorporating AV technologies (with lower operating costs) may become a viable option for many travelers. Most drivers and passengers preferred single ride than shared ride regardless of whether it is on a daily or occasional basis. However, for transit users, shared rides showed higher potential than exclusive services, which may indicate that cost is a primary consideration in the mode choice decisions for these users.
Volume changes of biochar-amended landfill cover soil under a thermal cycle
Authors: Qing Cheng , Haowen Guo , Tugen Feng , Yang Lu
Published: August 2018

Biochar has been identified as a favourable amendment for landfill cover soils. So far, the effects of biochar on soil response to temperature variations are still unclear. Waste heat generates when municipal solid waste decomposes, and the temperature of landfill can increase up to 90°C. The present study aims to investigate the thermally induced volumetric behaviour of biochar-amended sand with different biochar application ratios of 0%, 5% and 10%. Experimental results show that, during heating from 23–83°C, pure sand expands. However, during the heating process biochar-amended sand samples contract first and then expand. This is because biochar treatment not only decreases soil density, but also promotes the formation of big size macro-aggregations with more macro-pores, which may be destroyed when particle rearrangements induced by thermal expansion occur. During the cooling process from 83–23°C, all the specimens with three biochar application ratios show contraction. Moreover, with an increasing biochar application ratio, the thermal expansion coefficient of the soil specimen decreases. This is because biochar is insensitive to temperature variation as it is produced in very high temperature. Therefore, biochar-amended soil is a promising alternative landfill cover material for municipal solid waste landfill, and the effect of temperature effect on its volume change in landfill cover design is also essential to be considered.
Unmasking the Hypovolemic Shock Continuum: The Compensatory Reserve
Authors: Suresh Mithun R. , Chung Kevin K. , Schiller Alicia M. , Holley Aaron B. , Howard Jeffrey T. , Convertino Victor A.
Published: August 2018

Hypovolemic shock exists as a spectrum, with its early stages characterized by subtle pathophysiologic tissue insults and its late stages defined by multi-system organ dysfunction. The importance of timely detection of shock is well known, as early interventions improve mortality, while delays render these same interventions ineffective. However, detection is limited by the monitors, parameters, and vital signs that are traditionally used in the intensive care unit (ICU). Many parameters change minimally during the early stages, and when they finally become abnormal, hypovolemic shock has already occurred. The compensatory reserve (CR) is a parameter that represents a new paradigm for assessing physiologic status, as it comprises the sum total of compensatory mechanisms that maintain adequate perfusion to vital organs during hypovolemia. When these mechanisms are overwhelmed, hemodynamic instability and circulatory collapse will follow. Previous studies involving CR measurements demonstrated their utility in detecting central blood volume loss before hemodynamic parameters and vital signs changed. Measurements of the CR have also been used in clinical studies involving patients with traumatic injuries or bleeding, and the results from these studies have been promising. Moreover, these measurements can be made at the bedside, and they provide a real-time assessment of hemodynamic stability. Given the need for rapid diagnostics when treating critically ill patients, CR measurements would complement parameters that are currently being used. Consequently, the purpose of this article is to introduce a conceptual framework where the CR represents a new approach to monitoring critically ill patients. Within this framework, we present evidence to support the notion that the use of the CR could potentially improve the outcomes of ICU patients by alerting intensivists to impending hypovolemic shock before its onset.
Discursive strategies in Nigeria’s 2015 Facebook campaign discourse
Authors: Felicia Oamen
Published: August 2018

This article examined the discursive strategies employed in Facebook feedback comments which were circulated during Nigeria’s 2015 general elections’ campaigns. This was done with a view to revealing citizens’ calculated struggle for access to state resources. Data for the study comprise 2000 selected comments posted on the Facebook walls of Jimi Agbaje of the People’s Democratic Party (PDP) and Akinwunmi Ambode of the All Progressives Congress (APC) from January to April 2015. The data were analyzed using Critical Discourse Analysis (CDA) approach, with emphasis on Fairclough’s discourse as social practice and notions from sociolinguistics and Computer-Mediated Discourse (CMD). The study reveals that commenters employed discursive strategies in the form of categorization of social groups, code switching for inclusive/exclusive discourse and representation of political groups through party symbols to characterize the in-group and others positively/negatively, respectively. Viewed against Nigeria’s challenging socio-cultural background, it could be argued that the comments though deployed to persuade reflect unequal power relations among the country’s citizenry.
Oxidative Stress and Preterm Birth: An Integrative Review
Authors: Moore Tiffany A. , Ahmad Iman M. , Zimmerman Matthew C.
Published: August 2018

Background:

A variety of methods and measures have been used to quantify oxidative stress in clinical studies related to preterm birth (PTB), and studies have reported conflicting findings. No integrative reviews have been conducted.

Objective:

To describe specific molecules used as markers of oxidative stress and methods to measure these molecules and to review the literature for associations between oxidative stress and PTB specific to these molecules.

Method:

Systematic literature searches were conducted in June 2015 and updated in 2017 in databases from the Biomedical Reference Collection: Basic Edition, including MEDLINE and clinicaltrials.gov . Articles were included if they described original research published after 2009 and compared PTB or preterm premature rupture of membranes with term birth (TB).

Results:

Abstracts ( n = 3,107) were reviewed for inclusion/exclusion criteria. Of these, 308 were full-text reviewed, and 30 articles were included in this review. All were identified as nonexperimental. The most common measurements of oxidative stress were quantification of total oxidant or antioxidant status or lipid peroxidation. Studies measuring reactive oxygen species or by-products of oxidative stress reported higher levels of these molecules for preterm specimens compared to TB specimens. Studies measuring antioxidants reported lower levels for these molecules in PTB specimens. Few of the studies had inconclusive findings.

Discussion:

Findings suggest that an imbalance between oxidants and antioxidants may be associated with PTB. The measurements and findings to date limit interpretation and understanding. Research using multidimensional methods and multidisciplinary teams are necessary to advance research and practice.
Smoking is associated with increased disease activity during natalizumab treatment in multiple sclerosis
Authors: Petersen Eva Rosa , Søndergaard Helle Bach , Laursen Julie Hejgaard , Olsson Anna Gabriella , Börnsen Lars , Soelberg Sørensen Per , Sellebjerg Finn , Bang Oturai Annette
Published: August 2018

Background:

Smoking has been associated with increased multiple sclerosis (MS) risk, disease worsening, and progression in MS patients. Furthermore, interactions between smoking and human leukocyte antigen (HLA) genes have been shown for MS risk. Recently, we found that smoking was associated with an increased relapse rate in interferon-beta-treated relapsing-remitting multiple sclerosis (RRMS) patients.

Objectives:

We examined the association between smoking and relapses in natalizumab-treated RRMS patients. Second, we investigated if an interaction between smoking and HLA-DRB1*15:01 or HLA-A*02:01 affected the number of relapses during treatment.

Methods:

In this observational cohort study, 355 natalizumab-treated RRMS patients were assessed. Prespecified criteria excluded 62 patients. Clinical data from the starting of treatment to the two-year follow-up visit were collected. Smoking status was obtained by a questionnaire survey. TaqMan allelic discrimination was used for genotyping of tag single-nucleotide polymorphisms (SNPs) for HLA-DRB1*15:01 and HLA-A*02:01. Negative binomial regression analysis was used to analyze the association between relapse rate and smoking intensity and HLA.

Results:

One pack of cigarettes (20 cigarettes) per day during natalizumab treatment increased the relapse rate during treatment with 38% (incidence rate ratio (IRR) = 1.38, 95% confidence interval (CI): 1.08–1.77, p = 0.01). No association or interaction was found between smoking and HLA-DRB1*15:01 or HLA-A*02:01, respectively.

Conclusion:

Smoking intensity was significantly associated with the number of relapses during natalizumab treatment.
A smartphone-based solution to monitor daily physical activity in a care home
Authors: Joosen Pieter , Piette Deborah , Buekers Joren , Taelman Joachim , Berckmans Daniel , De Boever Patrick
Published: August 2018

Introduction

In an ageing population, increasing chronic disease prevalence puts a high economic burden on society. Physical activity plays an important role in disease prevention and should therefore be promoted in the elderly.

Methods

In this study, a mobile health (mHealth) system was implemented in a care home setting to monitor and promote elderly peoples’ daily activity. The physical activity of 20 elderly people (8 female and 12 male, aged 81 ± 9 years old) was monitored over 10 weeks using the mHealth system, consisting of a smartphone and heart rate belt. Feedback on physical activity was provided weekly. A reference performance test battery derived from the Senior Fitness Test determined the participants’ physical fitness.

Results

Activity levels increased from week 1 onwards, peaking at week 5, and decreasing slightly until week 10. This illustrates that the use of mHealth and feedback on physical activity can motivate the elderly to become more active, but that the effect is transient without other incentives. Bio-data from the mHealth system were translated into a fitness score explaining 65% of the test battery’s variance. After separating the elderly into three groups depending on physical fitness determined from the test battery, classification based on the fitness score resulted in a correct classification rate of 67.3%.

Discussion

This study demonstrates that an mHealth system can be implemented in a care home setting to motivate activity of the elderly, and that the bio-data can be translated in a fitness score predicting the outcome of labour-intensive tests.
Imagining Englishness through contested English landscapes
Authors: Bennett Julia
Published: August 2018

This article adds to current debates on the nature of English identity through examining some of what Kathleen Stewart calls the ‘incommensurate qualities that … link complexly’ to create a certain feel of a place. Based on the premise that landscape and the story of the landscape, its history, are key elements of a national identity, the article explores the shaping of an imagined community of England through memory, forgetting and ‘official’ stories by using the examples of three specific but mundane places in north west England. One is urban ex-industrial, one a formerly industrial but rural site and one rural agricultural. These stories are unravelled to show how the landscapes are integrated ‘taskscapes’ where both national and local identities are performed. Class and race are hidden behind essentialised notions of Englishness. These exemplify a particular moral vision of English landscapes as natural and timeless countryside that serves to sideline urban and working landscapes and their populations. The article proposes treating a ‘taskscape’ as a gift to future generations, thus enabling all those who are a part of the present taskscape to belong.
Achievement and participation in schools for young adolescents with self-reported neuropsychiatric disabilities: A cross-sectional study from the southern part of Sweden
Authors: Carlberg Louise , Granlund Mats
Published: August 2018

Background: Schools are expected to be an environment where children can reach their fullest potential and develop their talents, personality, as well as their mental and physical abilities. Children with disabilities often have restricted participation and lower achievement in school. The aim is to investigate if there are any differences in participation and achievement in school between adolescents, with and without self-reported neuropsychiatric disabilities, and to explore the relations between achievement and participation. Methods: A cross-sectional study was carried out based on data collected from 1520 adolescents in the sixth and seventh grade, from the south of Sweden. Multiple logistic regression was conducted to explore the relationship between having a neuropsychiatric disability, with participation and achievement, and how different factors affected this relationship. Results: Having a self-reported neuropsychiatric disability increases the likelihood of having restricted participation (adjusted odds ratio (AOR): 2.89; 95% confidence interval (CI): 1.99–4.23) and lower achievement in school (AOR: 2.94; 95% CI: 2.06–4.24). These adolescents were also more likely to have negative relationships to their teachers, be bullied, have poorer connectedness to their parents, come from families with less money, be trying drugs and be male, in comparison to the adolescents without a neuropsychiatric disability. The odds of having lower achievement increased with lower engagement and absenteeism from class. Conclusions: Adolescents with self-reported neuropsychiatric disabilities have a disadvantaged situation in school, and are exposed to factors that could have long-term negative effects. More longitudinal research is required to conclude what factors are causing restricted participation and low achievement.
Mild Cognitive Impairment in Clinical Practice: A Review Article
Authors: Jongsiriyanyong Sukanya , Limpawattana Panita
Published: August 2018

The spectrum of cognitive decline in the elderly ranges from what can be classified as normal cognitive decline with aging to subjective cognitive impairment to mild cognitive impairment (MCI) to dementia. This article reviewed the up-to-date evidence of MCI including the diagnostic criteria of MCI due to Alzheimer’s disease, vascular cognitive impairment and MCI due to Parkinson disease, management and preventive intervention of MCI. There are various etiologies of MCI, and a large number of studies have been conducted to ascertain the practical modalities of preserving cognition in predementia stages. Lifestyle modification, such as aerobic exercise, is an approved modality to preserve cognitive ability and decrease the rate of progression to dementia, as well as being recommended for frailty prevention.
Casual Games Before Casual Games: Historicizing Paper Puzzle Games in an Era of Digital Play
Authors: Johnson Mark R.
Published: August 2018

This article examines “paper puzzle games”—crosswords, Sudoku, Kakuro, word searches, and so forth—in order to historicize and contextualize “casual games,” complicate our notions of “casual” play, and open up paper puzzle games to game studies consideration for the first time. The article begins by identifying the dearth of literature on paper puzzle games and offers an initial examination of these games through the lens of casual games, play, and players. It focuses on six traits in casual game design: appealing themes, ease of access, ease of learning, minimal required expertise, fast rewards, and temporal flexibility. It demonstrates that—from a perspective of mechanics, demographics, and contexts of play—paper puzzle games are excellent examples of casual games and therefore important to fully study. It also shows the complexity of paper puzzles as a topic in their own right, opening them up for future examination.
Thinking Outside the Box: The National Context for Educational Preparation and Adaptation among Chinese and Korean International Students
Authors: Chung Angie Y. , Chen Kenneth , Jung Gowoon , Li Muyang
Published: August 2018

Despite growing scholarly interest in international education, few studies have examined how the broader historic, structural, and cultural contexts of sending nations inform the global perspectives and pedagogical strategies of international students before and after migration. Based on surveys and focus groups with Korean and Chinese international students at one public university, the study provides an in-depth look at national differences in learning contexts as they may affect the educational and social adjustment of international students through the lens of gender, family, and nation. We argue that international students view and experience their overseas education through different historical and national understandings of family, economy, and culture within mainland China and South Korea—the former emphasizing geopolitical concepts of family and nation centered on China’s position within the global hierarchy and the latter invoking “compressed” neoliberal frameworks representing a time-space compression of traditional hierarchies and neoliberal free-market ideals in Korea. The study reconciles and synthesizes micro- and macro-levels of analyses by comparing the ways Korean and mainland Chinese international students navigate their educational experiences in the United States based on their respective nationalistic frameworks and shifting gender/family relations in the homeland.
Reliability and concurrent validity of the Velowin optoelectronic system to measure movement velocity during the free-weight back squat
Authors: García-Ramos Amador , Pérez-Castilla Alejandro , Martín Fernando
Published: August 2018

The objective of this study was to explore the reliability and concurrent validity of the Velowin optoelectronic system to measure movement velocity during the free-weight back squat exercise. Thirty-one men (age = 27.5 ± 3.2 years; body height = 1.76 ± 0.15 m; body mass: 78.3 ± 7.6 kg) were evaluated in a single session against five different loads (20, 40, 50, 60 and 70 kg) and three velocity variables (mean velocity, mean propulsive velocity and maximum velocity) were recorded simultaneously by a linear velocity transducer (T-Force; gold-standard) and a camera-based optoelectronic system (Velowin). The main findings revealed that (1) the three velocity variables were determined with a high and comparable reliability by both the T-Force and Velowin systems (median coefficient of variation of the five loads: T-Force: mean velocity = 4.25%, mean propulsive velocity = 4.49% and maximum velocity = 3.45%; Velowin: mean velocity = 4.29%, mean propulsive velocity = 4.60% and maximum velocity = 4.44%), (2) the maximum velocity was the most reliable variable when obtained by the T-force ( p < 0.05), but no significant differences in the reliability of the variables were observed for the Velowin ( p > 0.05) and (3) high correlations were observed for the values of mean velocity ( r = 0.976), mean propulsive velocity ( r = 0.965) and maximum velocity ( r = 0.977) between the T-Force and Velowin systems. Collectively, these results support the Velowin as a reliable and valid system for the measurement of movement velocity during the free-weight back squat exercise.
A joint manifold leaning-based framework for heterogeneous upstream data fusion
Authors: Shen Dan , Blasch Erik , Zulch Peter , Distasio Marcello , Niu Ruixin , Lu Jingyang , Wang Zhonghai , Chen Genshe
Published: August 2018

A joint manifold learning fusion (JMLF) approach is proposed for nonlinear or mixed sensor modalities with large streams of data. The multimodal sensor data are stacked to form joint manifolds, from which the embedded low intrinsic dimensionalities are discovered for moving targets. The intrinsic low dimensionalities are mapped to resolve the target locations. The JMLF framework is tested on digital imaging and remote sensing image generation scenes with mid-wave infrared (WMIR) data augmented with distributed radio-frequency (RF) Doppler data. Eight manifold learning methods are explored to train the system with the neighborhood preserving embedding showing promise for robust target tracking using video–radio-frequency fusion. The JMLF method shows a 93% improved accuracy as compared to a standard target tracking (e.g., Kalman-filter based) approach.
A Populist Zeitgeist? The Communication Strategies of Western and Latin American Political Leaders on Facebook
Authors: Zulianello Mattia , Albertini Alessandro , Ceccobelli Diego
Published: August 2018

By focusing on the Facebook activities of eighty-three political leaders from twenty-six Western and Latin American countries, we analyze their reliance on elements of populist communication for their competitive strategies. By integrating both a communication-centered and an actor-centered approach to the study of populism, we tackle four major research questions: Do populist and non-populist leaders adopt similar communication strategies on Facebook? Is there any evidence of the so-called populist zeitgeist in such arena? What different combinations between the so-called three “elements of populist communication” characterize the communication strategies of political leaders on Facebook? Are there major differences between Western and Latin American leaders? The results of our analysis provide an important contribution to the existing literature on populism and political communication in different respects. First, the populist zeitgeist “thesis” does not apply to the communication strategies of political leaders on Facebook. Second, the spread of elements of populist communication in Latin America is considerably lower in comparison with Western countries, irrespective of party ideological background. Finally, this paper identifies all the logical combinations that can occur between the interplay of the different elements of populist communication, thus enabling the classification of the communication strategies employed by political leaders on Facebook.
Beyond Futures: Designing Futures by Educating Future Designers
Authors: Ollenburg Stefanie
Published: August 2018

The goal in design is to plan and create artifacts, including objects, communication, and services. These are meant to be used or applied in an unknown future. Therefore, design is part of a process shaping the future, yet implications are rarely considered and become blind spots. The essay is a pledge to integrate the concept of futures and foresight methododology into the education of designers to give them a better understanding of how to deal with change and uncertainty. It may increase designers’ sensitivity of the impact their work may have in the future and push their creativity by broadening their view looking at different future scenarios. The essay starts by presenting the facets that design encompasses, putting it into a historical context, and explaining some educational concepts. Ultimately, the author suggests a didactic approach that she has applied in a futures studies introductory course for graduate students of architecture at the Münster School of Architecture (MSA) in Germany. It is based mainly on practice-oriented exercises and assignments. This includes an approach based on the author’s approach to combine the generic design process used in research through design – involving the phases of analysis, projection and synthesis (APS) – with the concept of futures and tools used in foresight methodology.
Free Speech, Free Markets & the Death of Trademark Law
Authors: Ghosh Shubha
Published: August 2018

Building on a public address given at NLU-Delhi in May, 2016, this Article examines the question of the relationship between economic liberalism and democracy. Is it a contradiction, or even a matter of concern, for a society to have free speech but not free markets, as Ronald Coase suggested? The Article resolves the tension through a consideration of the two different meanings of freedom and the differing, even if overlapping, goals of markets and politics. The ongoing debate over free expression and trademarks serves to anchor the argument with the main conclusion that commercial speech offers a unique example for economic liberalism and democracy, one that is distinct from the need for a multiplicity of viewpoints in the marketplace for ideas. The Article examines these ideas both in current United States Supreme Court jurisprudence and in global debates.
The ‘Other IP Right’: Is It Time to Codify the Indian Law on Protection of Confidential Information?
Authors: Reddy T. Prashant
Published: August 2018

Countries across the world are increasingly turning their attention to trade secret law, either enacting new laws or amending existing laws. As India faces similar calls to enact new laws to protect trade secrets, it is necessary to take stock of existing Indian law on protection of confidential information. As of now India protects confidential information either through contracts or under the equitable duty of confidence. Any codification exercise will however have to keep in mind several factors like the impact of a new law on employee mobility, competition, protecting free speech, ensuring procedural safeguards for defendants and insulating employees from any possible abuse of the criminal justice system. This article attempts to look at all these issues from an Indian perspective.
Innovation, Growth and Intellectual Property: A Study of the Indian Telecom Sector and the Way Forward
Authors: Chopra Sheetal , Chawla Punkhuri
Published: August 2018

The article is an evaluation of the growth of the Indian telecom sector in light of its innovative capabilities and production of intellectual property. The low patent footprint and investment in research and development of the Indian telecom sector shows a lack of focus on innovation and intellectual property creation by the domestic telecom industry, and it is argued that this prevents the sector to tap into its full potential. The economic growth of the telecom sector must be seen holistically, meaning that domestic Indian telecom companies must be internationally competitive and occupy a higher place in the telecommunications value chain. This article argues that regulatory focus needs to shift towards encouraging and protecting intellectual property in India, so as to incentivize investment in expansion of technological capabilities through R&D.
Racial Disparities in Student Debt and the Reproduction of the Fragile Black Middle Class
Authors: Houle Jason N. , Addo Fenaba R.
Published: August 2018

A nascent literature recognizes that student loan debt is racialized and disproportionately affects youth of color, especially black youth. In this study, the authors expand on this research and ask whether black-white disparities in student debt persist, decline, or increase across the early adult life course, examine possible mechanisms for changes in racial disparities in student debt across early adulthood, and ask whether racial disparities in student debt contribute to black-white wealth inequality among a recent cohort of college-going young adults. The authors address these questions using nationally representative data from the National Longitudinal Study of Youth 1997, multilevel growth curve models, and linear decomposition methods. There are three findings. First, black-white disparities in debt increase across the early adult life course, and previous research underestimated racial disparities in debt. Second, growth in this racial disparity is partially explained by differences in the social background, postsecondary experiences, and disparities in attained social and economic status of black and white young adults. As a result, the authors find that, compositionally, racial inequalities in student debt account for a substantial minority of the black-white wealth gap in early adulthood and that this contribution increases across the early adult life course. The authors conclude that debt trajectories are more informative than point-in-time estimates and that student debt may be a new mechanism of wealth inequality that creates fragility in the next generation of the black middle class.
Online Patient Resources for Ankle Instability
Authors: Abousayed Mostafa M. , Tartaglion Jason P. , Zonshayn Samuel , Rai Navdeep , Johnson Christopher K. , Rosenbaum Andrew J.
Published: August 2018

Background:

The Internet has drastically changed how patients access health-related information. There are several ways the public can access online health-related information such as search engines, blogs, support groups, and webinars. A recent study found that 45% of orthopedic patients searched for information online regarding their injury. Also, 78% believed they had better understanding of their condition after visiting these websites; furthermore, 41% felt the Internet supplied them with questions and concerns to discuss with their physicians. The aim of our study is to evaluate the accuracy, quality, and readability of online available information using the search terms “ankle sprain” and “ankle instability.”

Methods:

Three search engines (Google, Bing, and Yahoo) were used to search for the terms “ankle sprain” and “ankle instability.” The first 25 websites from each search were collected. Each website was assessed for quality, accuracy, and readability by 3 orthopedic residents blinded to the search term used. Websites were also evaluated for commercial bias and whether written by physicians or not.

Results:

Twenty sites were identified using Google, 14 using Bing, and 3 using Yahoo while the remaining 19 appeared in multiple search engines. Sixty-nine percent of the websites (39/56) were written by physicians whereas only 21% (12/56) were associated with commercial bias. The mean quality and accuracy of the websites written above a seventh-grade level was statistically significantly higher than those at or below a seventh-grade level ( P = .01). The mean accuracy of websites written by physicians was not statistically different from those not written by physicians ( P = .055).

Conclusion:

The current study highlights the poor quality and accuracy of online information related to ankle sprains, especially those with commercial bias. Furthermore, although websites written by or under supervision of physicians were found to be of superior quality, a majority of sites were found to have an unacceptably high reading level.

Level of Evidence:

Level IV, case series.
Pneumatic Vitreolysis for the Treatment of Symptomatic Vitreomacular Traction: A Prospective Pilot Study
Authors: Anderson Matthew F. , Magal Itay , Ells Anna , Fielden Michael , Williams R. Geoff , Kherani Amin
Published: August 2018

Purpose:

The purpose of this study was to determine the efficacy of pneumatic vitreolysis in the treatment of symptomatic focal vitreomacular traction (VMT).

Methods:

Patients choosing intravitreal gas injection as their preferred treatment for symptomatic VMT were invited to participate in this prospective study; 0.3 mL of perfluoropropane gas was injected. Optical coherence tomography was performed pre-and postprocedure to determine the proportion of eyes showing release of VMT.

Results:

Nine eyes of nine participants were included in the study, with a mean follow-up of 5.0±1.8 months. Gas injection resulted in the release of VMT in 7 of 9 eyes (78%) during the course of the study. Both eyes in which the VMT failed to release also showed an improvement in central macular anatomy. Mean visual acuity improved from logarithm of the minimum angle of resolution (logMAR) 0.33±0.14 (Snellen equivalent, ∼20/42) to logMAR 0.24±0.21 (Snellen, ∼20/35) at final follow-up ( P = .03); 8 of 9 patients (89%) reported a subjective improvement in their presenting symptoms and/or vision during the study period. The mean maximum foveal thickness of 480 ± 22 μm at baseline reduced to 282 ± 94 μm by the time of the final visit ( P = .002). Two patients had retinopexy for retinal breaks/suspect breaks.

Conclusions:

Pneumatic vitreolysis is an effective treatment for symptomatic VMT and may offer cost savings for patients and/or health services.
Changes in the use of the Mental Health Act 1983 in England 1984/85 to 2015/16
Authors: Keown Patrick , Murphy Hannah , McKenna Dannielle , McKinnon Iain
Published: August 2018

Background

Concerns have been raised about the increase in the use of involuntary detentions under the Mental Health Act in England over a number of years, and whether this merits consideration of legislative change.

Aims

To investigate changes in the rate of detentions under Part II (civil) and Part III (forensic) sections of the Mental Health Act in England between 1984 and 2016.

Method

Retrospective analysis of data on involuntary detentions from the National Archives and NHS Digital. Rates per 100 000 population were calculated with percentage changes. The odds of being formally admitted to a National Health Service hospital compared with a private hospital were calculated for each year.

Results

Rates of detention have at least trebled since the 1980s and doubled since the 1990s. This has been because of a rise in Part II (civil) sections. Although the overall rate of detentions under Part III (forensic) sections did not rise, transfers from prison increased and detentions by the courts reduced. The odds of being detained in a private hospital increased fivefold.

Conclusions

The move to community-based mental health services in England has paradoxically led to an increase in the number of people being detained in hospital each year, and in particular an inexorable rise in involuntary admissions. This is likely to be partly because of improved case finding with an increased focus on treatment and risk management, and partly because of changes in legislation. An increasing proportion of this government-funded care is being provided by private hospitals.

Declaration of interest

None.
Assessment and Stratification of High-Impact Data Elements in Electronic Clinical Quality Measures: A Joint Data Quality Initiative Between CancerLinQ® and Cancer Treatment Centers of America
Authors: Lettvin Rory J. , Wayal Alpna , McNutt Amy , Miller Robert S. , Hauser Robert
Published: August 2018

Purpose

A joint data quality initiative between the Cancer Treatment Centers of America and the ASCO big data health technology platform CancerLinQ® was initiated to document and codify the steps taken to evaluate, stratify, and determine the potential effect of data elements used for electronic clinical quality measures as captured within structured fields in electronic health records.

Methods

The processes involved the identification of clinical concepts required in measure population criteria and then to map these to the corresponding components of the CancerLinQ data model. A quantitative assessment of mappings between electronic clinical quality measure clinical concepts and attributes from the CancerLinQ clinical database was performed. In parallel, a qualitative analysis of high-impact data elements from the Cancer Treatment Centers of America clinical measures was made using local, expert consensus.

Results

An impact assessment was derived using a count of the data elements across measures and the specific population criteria affected.

Conclusion

A list of putative high-impact data elements can provide guidance for clinicians to facilitate specific data element capture related to quality metrics in an electronic environment.
Age-Standardized Mortality Rates in the Caribbean: One Source, Three Different Interpretations
Authors: Wolf Nicholas G. , Morgan Camille , Flanigan John S.
Published: August 2018

Purpose

A recent publication in Morbidity and Mortality Weekly Report ( MMWR) provided the opportunity to calculate differences in published cancer mortality estimates for Caribbean jurisdictions from three organizations: MMWR, the International Agency for Research on Cancer, and the Institute for Health Metrics and Evaluation. This comparison study serves to educate end users of these data.

Methods

We downloaded the publicly available cancer mortality estimates for 15 jurisdictions and the United States from the three organizations. We compared reported age-standardized mortality rates for each jurisdiction and calculated the range among estimates for each jurisdiction. We repeated this analysis after applying the same world population standard to all estimates.

Results

For males, the ranges of the Caribbean estimates were between 49% (Grenada and Trinidad) and 201% (US Virgin Islands) of the MMWR value, with an average of 88%. For females, the ranges were between 15% (Trinidad) and 171% (US Virgin Islands) of the MMWR value, with an average of 64%. After all estimates were compared using the same population standard, the ranges of the Caribbean estimates for males were between 6% (Grenada) and 111% (US Virgin Islands) of the MMWR value, with an average of 34%. For females, the ranges were between 7% (Grenada) and 97% (US Virgin Islands), with an average of 28%.

Conclusion

The use of different standard populations complicates comparisons across organizations. Data modeling does not completely compensate for quality of source data, as our analysis demonstrated by the differences in mortality rates despite the good quality of the vital registration in the Caribbean.
Sorting nexin-21 is a scaffold for the endosomal recruitment of huntingtin
Authors: Danson Chris M. , Pearson Neil , Heesom Kate J. , Cullen Peter J.
Published: August 2018

The endo-lysosomal network serves an essential role in determining the fate of endocytosed transmembrane proteins and their associated proteins and lipids. Sorting nexins (SNXs) play a central role in the functional organisation of this network. Comprising over 30 proteins in humans, SNXs are classified into sub-groups based on the presence of additional functional domains. Sorting nexin-20 (SNX20) and sorting nexin-21 (SNX21) comprise the SNX-PXB proteins. The presence of a predicted protein-protein interaction domain, termed the PX-associated B (PXB) domain, has led to the proposal that they function as endosome-associated scaffolds. Here, we used unbiased quantitative proteomics to define the SNX21 interactome. We reveal that the N-terminal extension of SNX21 interacts with huntingtin (Htt) whereas the PXB domain appears to associate with septins, a family of cytoskeletal- and membrane-associated proteins. In establishing that these interactions are sufficient for SNX21 to recruit Htt and septins on to an endosomal population, we reveal a scaffolding function for this sorting nexin. Our work paves the way for a more-detailed mechanistic analysis of the role(s) of the SNX-PXB proteins in endosomal biology.
Limping following limb loss increases locomotor stability
Authors: Wilshin Simon , Shamble Paul S. , Hovey Kyle J. , Harris Ryan , Spence Andrew J. , Hsieh S. Tonia
Published: August 2018

Although many arthropods have the ability to voluntarily lose limbs, how these animals rapidly adapt to such an extreme perturbation remains poorly understood. It is thought that moving with certain gaits can enable efficient, stable locomotion; however, switching gaits requires complex information flow between and coordination of an animal's limbs. We show here that upon losing two legs, spiders can switch to a novel, more statically stable gait, or use temporal adjustments without a gait change. The resulting gaits have higher overall static stability than the gaits that would be imposed by limb loss. By decreasing the time spent in a low-stability configuration—effectively “limping” over less stable phases of the stride—spiders increased the overall stability of the less statically-stable gait with no observable reduction in speed, as compared to the intact condition. Our results shed light on how voluntary limb loss could have persisted evolutionarily among many animals, and provide bioinspired solutions for robots when they break or lose limbs.
Vector Space Decomposition for Solving Large-Scale Linear Programs
Authors: Gauthier Jean Bertrand , Desrosiers Jacques , Lübbecke Marco E.
Published: August 2018

We develop an algorithmic framework for linear programming guided by dual optimality considerations. The solution process moves from one feasible solution to the next according to an exchange mechanism that is defined by a direction and a resulting step size. Part of the direction is obtained via a pricing problem devised in primal and dual forms. From the dual perspective, one maximizes the minimum reduced cost that can be achieved from splitting the set of dual variables in two subsets: one being fixed while the other is optimized. From the primal perspective, this amounts to selecting a nonnegative combination of variables entering the basis. The direction is uniquely complemented by identifying the affected basic variables, if any.

The framework is presented in a generic format motivated by and alluding to concepts from network flow problems. It specializes to a variety of algorithms, several of which are well known. The most prominent is the primal simplex algorithm where all dual variables are fixed: this results in the choice of a single entering variable commonly leading to degenerate pivots. At the other extreme, we find an algorithm for which all dual variables are optimized at every iteration. Somewhere in between these two extremes lies the improved primal simplex algorithm for which one fixes the dual variables associated with the nondegenerate basic variables and optimizes the remaining ones. The two last variants both bestow a pricing problem providing necessary and sufficient optimality conditions. As a result, directions yielding strictly positive step sizes at every iteration are also issued from these pricing steps. These directions move on the edges of the polyhedron for the latter while the former can also identify interior directions.
Screening, assessment and treatment for depression in patients with chronic heart failure
Authors: Baird Donita , Jackson Alun C , Higgins Rosemary O , Murphy Barbara M , Tully Phillip J
Published: August 2018

Patients with chronic heart failure (CHF) have clinically significant depression at a rate two to three times higher than the general population. Depression is associated with poorer survival, limitations in daily functioning, and more frequent adverse cardiac outcomes. Guidelines on the management of CHF have highlighted a need for screening and assessment of depression in patients with CHF using validated instruments such as the Beck Depression Inventory and the Patient Health Questionnaire, which should be administered routinely post-hospitalisation, while recognising that not all symptoms are related to CHF alone. Following referral to a mental health specialist, collaborative care, cognitive behavioural therapy, and positive psychology interventions are most likely to deliver benefits for depression in people with CHF. They may also benefit from assistance with any limitations in terms of physical activity and fatigue, health behaviours, social isolation, and adherence to their medical treatment.