bluuebunny/crossref_metadata_2025 huggingface dataset:
Urban Transformation of Muslim Spanish Cites after 1492: The Case Study of Baza, Granada (Spain); from a “Petrified” City to Its Great Expansions
Authors: Santiago Zaragoza Juan Manuel , Lafuente-Bolívar Francisco Javier , Salas-Martínez Francisco Javier
Published: June 2020

Spanish Islamic cities stagnated or declined after 1492. Because of the expulsion of Jews and Moors, despite the repopulation policies, they seemed to “petrify” their size. The uninhabited houses and the suburbs disappeared. The extension and population of the main Muslim cities, Almeria, Seville, Toledo, Valencia, Zaragoza, tended to decrease. Murcia and Granada are two paradigmatic cases of evolution. In the kingdom of Granada, Baza was an important settlement at the end of Middle Ages. Urban transformations adapted it to Castilian policies: mosques were transformed into churches, squares and gates were opened, some streets widened, and so on. However, its size remained “petrified.” In the nineteenth century, there was a strong population growth cushioned by the phenomenon of “cave-house.” From mid-twentieth century, it had a strong expansion and growth regardless urban plans. Currently, the city, declared as Historic Site, has slowed down its growth, although its planning foresees it will keep growing.
Active fault tolerant control for high-precision positioning of a non-contact mode uncertain atomic force microscopy
Authors: Cetin Meric , Beyhan Selami
Published: June 2020

A non-contact mode atomic force microscope with chaotic dynamics may exposed to unknown faults, disturbances or uncertain parameters that are not always be compensated using classical control methods. Therefore, a fault tolerant controller must be designed for accurate tracking of the tip-position of the end-effector. In this paper, first, an unscented Kalman filter is designed for joint estimation of the states and parameters for an atomic force microscopy under process noise. The velocity of the end-effector, sample height and unknown fault are simultaneously estimated by measuring the tip position of randomly excited microscopy. Second, unscented Kalman filtering based model predictive controller is proposed for the accurate tracking of the tip-position. To prevent the disadvantage of the model-based controller design, an uncertainty or unknown fault function of the system is estimated by unscented Kalman filter such that the unmodeled dynamics of the system are compensated while the control signal is produced. Note that the controller voltage being applied to the microscopy is produced based on the estimated states and parameters of the atomic force microscopy. The numerical applications present that satisfactory tracking performance for tip position is obtained by the proposed fault tolerant controller such that extended Kalman filtering-based tracking results are also compared and discussed.
Use of Endoscopic Cartilage Graft Myringoplasty Without Tympanomeatal Flap Elevation to Repair Posterior Marginal Perforations
Authors: Lou Zhengcai
Published: June 2020

Objective:

We evaluated the graft success rate and hearing outcomes of endoscopic cartilage graft myringoplasty without tympanomeatal flap elevation used to repair posterior marginal perforations.

Study Design:

A prospective case series.

Materials and Methods:

A total of 31 patients with posterior marginal perforations who underwent endoscopic cartilage graft myringoplasty were included. The outcomes were the hearing gain and graft success rate at 6 and 24 months.

Results:

The graft success rate was 96.7% (30/31) at 6 months and 90.3% (28/31) at 24 months; 1 patient exhibited composite graft extrusion and lateralization in the region of the anterior annulus; a residual perforation was apparent. Reperforation occurred in 2 patients. The mean preoperative air-bone gap (ABG; 28.61 ± 3.14 dB) was significantly greater than the mean postoperative ABG (12.15 ± 3.98 dB; P < .05) at 6 months; however, there was no statistically significant difference between the post-6 months and post-24 months with regard to ABG values ( P = .871), ABG gain ( P = 0.648), or functional success rate ( P = .472). No significant graft blunting or atelectasis was noted during follow-up. The free perichondrium became fully integrated with the skin of the external auditory canal; the perichondrium could not be clearly distinguished endoscopically 4 to 8 weeks postoperatively. Computed tomography revealed well-pneumatized middle ear and mastoid cavity at postoperative 24 months.

Conclusion:

Endoscopic cartilage graft myringoplasty without tympanomeatal flap elevation reliably repairs posterior marginal perforations. The short- and long-term graft success rate is high, and the hearing results are satisfactory; the technique is minimally invasive.
XBRL Mandate and Timeliness of Financial Reporting: The Effect of Internal Control Problems
Authors: Hwang Seokyoun , No Won Gyun , Kim Jongkyum
Published: June 2020

Extensible Business Reporting Language (XBRL) is intended to make analysis easier and faster by enhancing the exchange of financial information. Such benefits from this global reporting standard would stem from more timely, accurate, and transparent financial reporting. This article investigates whether internal control weaknesses (ICWs) in firms have an impact on the timeliness of financial reporting in XBRL format. The results of our analyses show that the filing lags of firms with ICWs are longer than those of firms without ICWs for their first detail tagged XBRL disclosure. The results also reveal that firms with ICWs are more likely to use the grace period in their initial XBRL disclosures. The length of the grace period used by firms with ICWs is longer than that of firms without ICWs. Furthermore, our additional analyses reveal that the XBRL mandate has affected firms’ filing behaviors differently depending on firm characteristics such as firm size. Overall, our findings indicate that the impact of ICWs on the timeliness of financial reporting is greater under the mandated XBRL disclosure.
The turn to regulation in digital communication: the ACCC’s digital platforms inquiry and Australian media policy
Authors: Flew Terry , Wilding Derek
Published: June 2020

This article provides an overview of the Australian Competition and Consumer Commission (ACCC) Digital Platforms Inquiry, as a case study in the new thinking about digital platform regulation taking place in many nations. With its focus upon the impact of digital platforms on news and journalism, the ACCC Inquiry parallels other reviews, such as the Cairncross Review on the Future of Journalism in the United Kingdom. While the Inquiry had a somewhat ‘accidental’ history, the core issues that it raised have acquired considerable political resonance in Australia. The concept of harms provides a useful lens through which to understand the ACCC’s focus, as it identified harms caused by the market dominance of Google and Facebook for traditional news media businesses, and for consumers and citizens. Responding to the ACCC Final Report will present challenges in identifying the public good dimension of journalism and who should pay for it, the scope and reach of digital platform regulation and its relationship to media policy and regulation, and the scope for small nations to effectively manage the power of global digital platform giants.
Supporting information use and task accomplishment: What system features do users like and expect?
Authors: Liu Jingjing , Li Yuan
Published: June 2020

Information systems have been improving in helping users find information. However, they have been less attended to regarding helping searchers in using located information. This research attempts to address the issue of information use by investigating what information systems and features searchers think are helpful in using located information to accomplish information tasks. In all, 32 college students were invited to an information interaction lab, first being interviewed on a recently completed task and then working on a to-be-finished task, both being their real-life tasks of their own choices. Through questionnaires, the study discovered the most favoured existing and expected features helpful for users’ task completion. Users expected convenient citations, note taking in search result pages and being kept on task. Findings in this study have implications on designing search systems that can better support task accomplishment, in addition to returning search results.
Immunohistochemical Characteristics of Thymomas and Hyperplastic Lesions in Wistar Hannover Rats
Authors: Tomonari Yuki , Sato Junko , Yamada Naoaki , Kurotaki Tetsuro , Doi Takuya , Kanno Takeshi , Tsuchitani Minoru
Published: June 2020

Previously, we investigated the higher incidence of hyperplastic lesions and thymomas and histopathological resemblance of cortex–medullary structures between thymomas and normal thymuses in Wistar Hannover (WH) rats. Thymomas had pale-staining cell foci (PA) similar to medulla but without lymphocytes. Here, we focused on the differences in cytokeratin (CK) expression in the thymic epithelia of the cortex and medulla and compared the structures of thymomas and normal thymuses. Thymomas, hyperplastic lesions, and normal thymuses obtained from background studies of WH rats were stained with antibodies against CK14, CK18, and CD20. In normal thymuses, the epithelial cells were positive for CK14 in the medulla and subcapsular area and for CK18 in the cortex, B-cells were positive for CD20 in the medulla. In thymomas, the epithelial cells were positive for CK14 in the medullary differentiation (MD) areas and for CK18 in the cortex-like lymphocyte rich and PA, and B-cells were positive for CD20 in the MD areas.
Riding Waves on the Mexico–United States Border: Beaches, Local Surfers and Cross-Border Processes
Authors: Estrada Milán Jesús , Escala Rabadán Luis
Published: June 2020

This article examines the social and cultural relations that take place in surfing communities on the Mexican side of the border with the United States. Through ethnographic work with surfers from Northern Baja California, we identified different cross-border processes encouraged by this lifestyle sport: the formation of binational surfing communities, commodity circulation, localism, territorial disputes, and shared environmental problems. We point out that surfing on the border creates a system of affinities and rivalries based on the identity and nationalism, marked by the inequality and asymmetry between these two countries. This article also addresses the transnational cooperation and political actions undertaken to protect the oceans and beaches enjoyed by surfers in this border region.
Proactive environmental strategy and firm performance: The moderating role of corporate venturing
Authors: Shu Chengli , Liu Jinxin , Zhao Mengli , Davidsson Per
Published: June 2020

This article investigates how two types of proactive environmental strategies (PESs) – proactive green management and green political influence – affect firm performance directly and under varying conditions characterising corporate venturing activities (domestic versus international). The results obtained by analysing a multi-informant dataset reveal that proactive green management has a stronger positive impact on firm performance than green political influence does. Moreover, international venturing has a greater positive moderating effect than domestic venturing on the link between proactive green management and firm performance, whereas, domestic venturing has a stronger positive moderating effect than international venturing on the relationship between green political influence and firm performance. This article contributes by differentiating between two important forms of corporate venturing, by distinguishing two important types of PESs and by offering a more granular framework for aligning corporate venturing activities with PESs.
Activation of L1 orthography in L2 word reading: Constraints from language and writing system
Authors: Chen Lin , Perfetti Charles A , Fang Xiaoping , Chang Li-Yun
Published: June 2020

When reading in a second language, a reader’s first language may be involved. For word reading, the question is how and at what level: lexical, pre-lexical, or both. In three experiments, we employed an implicit reading task (color judgment) and an explicit reading task (word naming) to test whether a Chinese meaning equivalent character and its sub-character orthography are activated when first language (L1) Chinese speakers read second language (L2) English words. Because Chinese and English have different spoken and written forms, any cross language effects cannot arise from shared written and spoken forms. Importantly, the experiments provide a comparison with single language experiments within Chinese, which show cross-writing system activation when words are presented in alphabetic Pinyin, leading to activation of the corresponding character and also its sub-character (radical) components. In the present experiments, Chinese–English bilinguals first silently read or made a meaning judgment on an English word. Immediately following, they judged the color of a character (Experiments 1A and 1B) or named it (Experiment 2). Four conditions varied the relation between the character that is the meaning equivalent of the English word and the following character presented for naming or color judgment. The experiments provide evidence that the Chinese meaning equivalent character is activated during the reading of the L2 English. In contrast to the within-Chinese results, the activation of Chinese characters did not extend to the sub-character level. This pattern held for both implicit reading (color judgment) and explicit reading (naming) tasks, indicating that for unrelated languages with writing systems, L1 activation during L2 reading occurs for the specific orthographic L1 form (a single character), mediated by meaning. We conclude that differences in writing systems do not block cross-language co-activation, but that differences in languages limit co-activation to the lexical level.
Factors influencing the amount of therapy received during inpatient stroke care: an analysis of data from the UK Sentinel Stroke National Audit Programme
Authors: Gittins Matthew , Vail Andy , Bowen Audrey , Lugo-Palacios David , Paley Lizz , Bray Benjamin , Gannon Brenda , Tyson Sarah
Published: June 2020

Objectives:

To understand why most stroke patients receive little therapy. We investigated the factors associated with the amount of stroke therapy delivered.

Methods:

Data regarding adults admitted to hospital with stroke for at least 72 hours (July 2013–July 2015) were extracted from the UK’s Sentinel Stroke National Audit Programme. Descriptive statistics and multilevel mixed effects regression models explored the factors that influenced the amount of therapy received while adjusting for confounding.

Results:

Of the 94,905 patients in the study cohort (mean age: 76 (SD: 13.2) years, 78% had a mild or moderate severity stroke. In all, 92% required physiotherapy, 87% required occupational therapy, 57% required speech therapy but only 5% were considered to need psychology. The average amount of therapy ranged from 2 minutes (psychology) to 14 minutes (physiotherapy) per day of inpatient stay. Unmodifiable characteristics (such as stroke severity) dominated the variation in the amount of therapy. However important, modifiable organizational factors were the day and time of admission, type of stroke team, timely therapy assessments, therapy and nursing staffing levels (qualified and support staff), and presence of weekend or early supported discharge services.

Conclusion:

The amount of stroke therapy is associated with unmodifiable patient-related characteristics and modifiable organizational factors in that more therapy was associated with higher therapy and nurse staffing levels, specialist stroke rehabilitation services, timely therapy assessments, and the presence of weekend and early discharge services.
The Uniform Entrepreneur: Making Gender Visible in Social Enterprise
Authors: Kravets Olga , Preece Chloe , Maclaran Pauline
Published: June 2020

This paper extends the macromarketing debates on gender by considering how gender ideology acts as a macro-level constraint to developing sustainable initiatives. While the macromarketing literature has long considered the significance of social enterprise and nonprofits, gender has not been theorized within these studies. In redressing this gap we examine the case of the Uniform Project, spearheaded by disaffected advertising executive and enthusiastic social entrepreneur, Sheena Matheiken. Our critical interrogation of the project shows that Matheiken’s path to becoming entrepreneurial “woman of the year” reinforces a gendered model of social entrepreneurship. We also expose the role of media and the forums designed to encourage social innovations in gendering, thus stifling, a social enterprise. We reaffirm the importance of theorizing gender ideology in macromarketing and submit that any such theorization must recognize and account for the ways that gender intersects with neoliberal ideology to permeate markets, marketing and social enterprise.
Rational Choice Theory Applied to an Explanation of Juvenile Offender Decision Making in the Chinese Setting
Authors: Zhao Jihong , Wang Xinting , Zhang Hongwei , Zhao Ruohui
Published: June 2020

Rational choice theory (RCT) is a classical theory in criminology, with deep roots in the Enlightenment. It has secured a privileged place as a mainstream criminological theory in the United States. Ironically, RCT has not been applied to research on juvenile delinquency and related decision making in China. This study attempts to test the relative utility of RCT among adjudicated juvenile offenders incarcerated in an institution located in a southwestern province of China based on their responses to two hypothetical scenarios of offending. The results of the Tobit model analyses emerged from the two-wave longitudinal data lent strong support to the view that RCT can indeed serve as an important theory for explaining delinquent behaviors in China. More specifically, juvenile offenders used cost-benefit analysis to decide if they want to be involved either in the stealing scenario or in the fighting scenario. A discussion of findings and public policy implications are highlighted at the end of the paper
Environmental Circadian Disruption Increases Stroke Severity and Dysregulates Immune Response
Authors: Ramsey Anne M. , Stowie Adam , Castanon-Cervantes Oscar , Davidson Alec J.
Published: June 2020

Understanding the health consequences of chronic disruption of circadian rhythms can contribute to improving prevention strategies for shift workers. Chronic circadian disruption in shift work has been linked to a higher risk of stroke. Dysregulated immune responses are also linked to circadian disruption and may be a factor in stroke outcomes in shift workers. In this study, we test the hypotheses that specific schedules of circadian disruption exacerbate inflammatory responses in the brain, causing an increase in infarct size after experimentally induced ischemic stroke. Mice were exposed to 1 of 5 different lighting schedules followed by a 30-min middle cerebral artery occlusion, then reperfusion and 3-day recovery. A history of weekly phase advances resulted in an increased infarct volume versus the control lighting schedule. These effects were shift-direction specific, nonpermanent, and required multiple shifts to occur. In a separate cohort, stereotaxic injections of lipopolysaccharide were given bilaterally after exposure to 1 of 3 different lighting schedules. Ratios of pro- to anti-inflammatory cytokine expression show dysregulated responses after a history of phase advances. We conclude that chronic circadian disruption leads to worsened stroke outcome in a direction- and schedule-specific manner likely because of priming of the inflammatory response in the brain. These pieces of evidence suggest that the health impacts of shift work may be improved by targeting shift work scheduling, inflammatory mediators, or both.
A Single-Center Experience With Percutaneous Interventional Management of Refractory Chylous Ascites
Authors: Tai Elizabeth , Min Adam , Rajan Dheeraj K.
Published: June 2020

Purpose:

Management of chylous ascites is poorly understood with no management guidelines. We retrospectively reviewed patients treated for chylous ascites at our institution to evaluate efficacy and safety of lipiodol lymphangiography and embolization.

Materials and Methods:

Seven patients underwent percutaneous interventional management of chylous ascites (average age 52.5 years, 3 female, 6 post-surgical, 1 pancreatitis) from 2012. All patients underwent lipiodol inguinal lymph node injection. Adjunctive glue embolization was performed if a leak was identified. Data were collected on the cause of chylous ascites, conservative management strategies, procedural details, and success.

Results:

All patients had chylous ascites refractory to conservative management. Preprocedure lymphoscintigraphy identified a retroperitoneal leak in 6 patients. Seven patients underwent 12 lymphangiogram procedures; 8 were performed at our institution. Lymphangiography identified a leak in 5 patients (71%). Success was achieved in 2 patients (28%) treated at our institution after glue embolization following cannulation of the leaking lymphatic channels and 1 patient (14%) after lymphangiography alone for an overall success rate of 43% (3/7). Two patients (29%) were successfully treated after one procedure. Two patients (29%) unsuccessfully treated at our institution were referred to a specialized center in the United States. No 30 day post procedural complications.

Conclusions:

In our experience, lymphangiography and embolization was a safe, relatively effective and minimally invasive method for treating medically refractory chylous ascites. Complex cases required referral to a specialized institution with resources unavailable at our tertiary care center.
An Exploratory Study of Possible Correlates of Individual Whistleblowing Propensity Among Sworn Staff in a City Jail
Authors: Wells James B. , Minor Kevin I. , Lambert Eric G. , Reeves Anna
Published: June 2020

Staff are essential to running safe and humane correctional institutions. To this end, staff sometimes need to report coworker misconduct. Doing so requires a propensity to engage in whistleblowing, a topic that has received very little attention in the criminal justice literature. Using results from the Work Experiences Questionnaire (WEQ), an instrument designed to measure various features of correctional work environments, we found several exploratory variables to be significantly associated with individual whistleblowing propensity. Specifically, male staff, White staff, and staff with college degrees had higher propensity scores. Increases in job satisfaction and organizational whistleblowing propensity were also related to greater willingness to report wrongdoing, whereas affective organizational commitment had a negative effect. To the extent replicated, such findings can guide policy and practice concerning the reporting of correctional staff wrongdoing.
Introduction: Socialism to Be Embodied
Authors: Lehmann Maike , Oberländer Alexandra
Published: June 2020

This article belongs to the special cluster, “Family, Gender and (dis)Abled Bodies after 1953”, guest-edited by Maike Lehmann and Alexandra Oberländer.

While the ideal of the New Socialist Wo/Man was never fully realized and seems to have been abandoned across the Eastern Bloc after 1953, the question still arises what role individuals were to play within the socialist system. As dichotomous conceptualizations of state and society have been repeatedly criticized in recent years, we propose to look at how the role of the individual was imagined by different actors in Eastern European countries and how the ideals inherent in these imaginations were (to be) embodied. One possible avenue would be to explore the role of official language for subjectivization processes as they have been discussed during the last twenty years in Soviet studies. We, however, want to turn the attention towards the body and its role in shaping the individual in a cluster dealing with the impact family, gender, and dis/ability (were meant to) have on the formation of an individual body and its place within broader society. This is to explore some of the ways in which anybody could become somebody in socialist Eastern Europe and might help to shift the attention from dichotomous conceptualizations of political dogma and social practice towards an exploration of socialism as a diverse, yet specific cultural system.
Influences on Body Size Perceptions Among Black Women in the Mississippi Delta
Authors: Coleman Lois , Bass Martha , Cafer Annie , Ford-Wade Allison , Loftin Mark
Published: June 2020

Purpose:

To identify factors that influence Black women’s body size perceptions

Design:

Interviews (cognitive mapping exercise) with 25 women; focus group with 7 additional women

Setting:

Mississippi Delta

Participants:

Thirty-two black women

Measures:

Influences on body size perceptions, body mass index, and body satisfaction

Analysis:

Interviewee maps were combined and condensed, using matrix addition and qualitative aggregation, to create a social map. The social map was presented to a focus group. A paired sample t test and descriptive statistics were run to assess weight perception accuracy and body satisfaction.

Results:

The initial social map contained 27 variables. Male preferences (87.5%) and appearance (64%) were believed by most participants to influence perceptions of body size. The focus group identified lack of encouragement, stress, and substance use as factors worth adding to the map. A statistically significant proportion of interviewees possessed an inaccurate weight perception, t(24) = 2.741, P < .05. Furthermore, 76% were dissatisfied with their current weight status and 80% desired a healthy body size.

Conclusion:

These findings provide practitioners with leverage points, beyond diet and physical activity, that may improve the efficacy of weight reduction interventions among black women. Considering the paucity of research regarding influences on body size perceptions, this study also provides researchers with participant-defined variables worthy of further examination.
Estimating the Impacts of EDA Public Works Program Investments on County Employment
Authors: Han Kwideok , Whitacre Brian , Ji Inbae
Published: June 2020

Evaluating the effectiveness of government programs is an important topic for economic developers. One popular example is the U.S. Economic Development Administration’s (EDA) Public Works Program, initially established in 1965. Haughwout (1999) found a significant positive impact of EDA public works projects completed in 1990 on county-level employment over the period 1990 to 1994. The authors reexamine whether this effect continues to hold 20 years later by replicating Haughwout’s specification using data from 2010 to 2014. The results are consistent with those originally reported by Haughwout. The authors then extend the analysis by incorporating a spatial econometric approach to examine the existence of potential spillover effects. The results indicate that EDA investments have a significant positive effect on both targeted and neighboring counties’ employment. The findings suggest that public infrastructure investments can be important tools for economic development by positively influencing employment in both the recipient county and neighboring counties.
Assessment of the Use of Pharmacologic Venous Thromboembolism Prophylaxis in Post-Traumatic Brain Injury Patients
Authors: Saadi Raghad , Brandt Kimberly , Madlinger Robert , Nerenberg Steven F.
Published: June 2020

Background:

Traumatic brain injury (TBI) is an independent risk factor for venous thromboembolism (VTE). Prophylaxis (PPX) beyond 48 hours increases VTE risk 3- to 4-fold. Pharmacologic VTE PPX initiation is controversial due to potential bleeding complications.

Objective:

To evaluate VTE PPX in patients with TBI for practice variation, efficacy, and safety.

Methods:

Retrospective review from January 2013 to September 2016 in adults admitted to the intensive care unit with moderate to severe TBI. Demographics, time to stable computerized tomography scan, time to PPX initiation, PPX regimen, and incidences of VTE and adverse effects were collected. Data were analyzed via descriptive statistics, analysis of variance, and linear regression models.

Results:

Of 96 patients included, 14.6% did not receive VTE PPX (G1), 7.3% initiated therapy within 0 to 24 hours (G2), 14.6% after 24 to 48 hours (G3), and 63.5% after 48 hours (G4). VTE occurred in 0% of G1 and G2, 28.6% of G3, and 8.2% of G4 patients ( P = .038). Of 9 VTE cases, 8 received medical and 1 received trauma PPX dosing ( P = .44). There were 3 major bleeds ( P = .79) and 19 minor bleeds ( P = .042). Of 14 fatalities, 42.9% were in G1, 0% in G2, 14.2% in G3, and 42.9% in G4 ( P = .009).

Conclusion:

The majority of patients received delayed PPX, with no correlation between VTE incidence and PPX regimen. There was a significant difference in VTE incidence stratified by time to PPX. Further studies are required to determine optimal timing of PPX. Higher mortality rate was correlated with the lack of PPX. Increased minor bleeds occurred with earlier PPX initiation.
Controlling Nutritional Status score: A novel prognostic marker for patients with community‐acquired pneumonia
Authors: Yıldırım Birdal , Biteker Funda Sungur , Acar Ethem , Demir Ahmet
Published: June 2020

Objective:

We aimed to investigate the prevalence and prognostic value of malnutrition assessed by Controlling Nutritional Status score in community‐acquired pneumonia patients.

Methods:

All adult patients admitted to our emergency department and hospitalized for community‐acquired pneumonia were prospectively followed‐up until hospital discharge or death. Nutritional status was assessed with the Controlling Nutritional Status score, which is based on serum albumin levels, total cholesterol levels, and lymphocyte counts. The primary study endpoint was complicated hospital course defined as need for mechanical ventilation, mortality, or intensive care unit admission.

Results:

Three hundred and five patients (mean age 68.6 ± 11.2 years and 51.8% female) were enrolled, and 40 patients (13.1%) had complicated hospitalizations. Older patients, patients with more comorbidities, and patients with higher Controlling Nutritional Status scores on admission were tended to have a higher rate of complications during their hospitalization. Multivariate analysis showed that older age (odds ratio 2.55, 95% confidence interval 1.41–4.64, p < 0.001), presence of diabetes (odds ratio 1.54; 95% confidence interval 1.09–3.65; p = 0.004), pneumonia severity index ⩾ 3 (odds ratio 1.27, 95% confidence interval 0.524–3.725, p = 0.035), and Controlling Nutritional Status score > 4 (odds ratio 2.23, 95% confidence interval 1.129–3.657, p = 0.001) were independent predictors of complicated hospitalizations.

Conclusion:

Malnutrition determined by Controlling Nutritional Status score predicts complications in hospitalized patients with community‐acquired pneumonia.
Using Cognitive Interviewing Methodology to Define Acculturation Among Asian American Women
Authors: Kim BoRam , Aronowitz Teri
Published: June 2020

Introduction: Berry acculturation model (BAM) includes five measurement components. Current instruments do not examine all five components. This study’s aim was to complete cognitive interviews with Asian American college-aged women using two frequently used measures and investigate whether all five BAM’s components of acculturation are included. Methodology: This is a qualitative study using in-depth semistructured cognitive interviewing. Data were collected until saturation was reached ( n = 20). Content analysis was completed. Results: Two themes emerged: Components of acculturation and survey structure. All components of BAM were evident in the data. The women agreed that physical, biological, cultural, and social relationships are important aspects of acculturation. The psychological component emerged as women discussed intergenerational conflicts related to acculturation. Discussion: Future research includes psychometric testing of a new acculturation instrument that incorporates all five components of BAM. A valid, comprehensive measure is needed to understand how AA women adapt to mainstream culture.
The Role of Palliative Care in Caring for the Families of Patients With COVID-19
Authors: Bakar Melissa , Capano Elizabeth , Patterson Melissa , McIntyre Brooke , Walsh Chaplain Jean
Published: June 2020

In palliative care, we strive to provide care to the whole patient. When we think about the whole patient, we include the people who are important in our patients' lives. Our New York City-based palliative care team has found that caring for patients' loved ones has proven to be an even more important aspect of the care we have provided during the COVID epidemic. In this article, we describe the multicomponenet interdisciplinary interventions we have implemented to enhance our ability to create a therapeutic alliance with family members and facilitate the provision of goal concordant care to patients with COVID during this extremely difficult time.
U.S. School Nursing Job Analysis
Authors: Morse Brenna L. , Anderson Lori , Combe Laurie G. , Delack Sandi , Ondeck Lynnette , Homme Carissa
Published: June 2020

The complexity and demands of the school nurse role have changed greatly over time. Our aims included determining tasks and knowledge relevant to modern school nursing in the United States, identifying continuing education needs of school nurses, and describing anticipated changes to the professional role. A secondary analysis of a cross-sectional web-based survey of 750 school nurses was performed. The study team evaluated calculations of mean importance and frequency for school nursing task and knowledge statements. Conventional content analysis was used to analyze open-ended responses. School nurses rated most tasks and knowledge as relevant to practice, underscoring the great depth and breadth of education and training school nurses need to meet the demands of students today. The results of this secondary analysis may be leveraged to accurately describe the school nurse role, advocate for nursing services, and support school nurses as they strive to better the health of school communities.
Integrated sliding mode and direct torque controls for improving transient traction in high-speed trains
Authors: Ferestade Iman , Ahmadian Mehdi , Molatefi Habibollah , Moaveni Bijan , Bokaeian Vahid
Published: June 2020

Wheel slip control in high-speed trains is used to reduce the acceleration time and produce the maximum traction motor power. For controlling slip in a complete model of a train consisting of the traction motors, it is needed to keep the adhesion coefficient as much as possible by controlling the input voltage. In this article, integrated sliding mode and direct torque controls are used to control the transient traction in a full model of a high-speed railcar consisting of a wagon, two bogies, four wheelsets, and four traction motors. Cosimulations in SIMPACK with MATLAB/Simulink are carried out to evaluate the performance of the designed control structure. By comparing the results of the open-loop and closed-loop simulations, it is shown the acceleration time of the high-speed railcar is decreased 26% and the production of the traction motor power is increased 32% for both dry and wet surface conditions. It is also shown that the designed control structure is stable and robust in the presence of uncertainties.
The Effect of Computer-Assisted Instruction on Challenging Behavior and Academic Engagement
Authors: LeJeune Lauren M. , Lemons Christopher J.
Published: June 2020

Students with intellectual and developmental disabilities (IDD) require intensive supports, including those that target behavior, to make progress on literacy goals. In this study, we investigated whether computer-assisted instruction (CAI) may be one effective method to decrease challenging behavior and increase academic engagement. Participants were three students with IDD (7 to 9 years old) who engaged in challenging behaviors during instruction. We used a single-case alternating treatments design to compare levels of challenging behavior and academic engagement during paper-based and CAI (i.e., tablet computer-based) literacy instruction. Results indicated that CAI was associated with decreased challenging behavior and increased academic engagement for two of three participants. In addition, the CAI condition corresponded with higher scores on academic performance assessments for one participant. Although teacher and student measures of social validity were positive, there was limited evidence that results maintained. These findings are described in relation to their limitations, future directions for research, and impact on practitioners.
A Systematic Review of Tier 1 PBIS Implementation in High Schools
Authors: Estrapala Sara , Rila Ashley , Bruhn Allison Leigh
Published: June 2020

An emerging body of research shows Tier 1 Positive Behavioral Interventions and Supports (PBIS) can be successfully implemented in high schools to improve school climate and graduation rates and reduce problem behaviors. However, high schools are often hesitant to adopt PBIS because of contextual barriers such as school size, organizational culture, and student developmental level. Resistance to high school implementation is also related to teachers perceiving PBIS as less socially valid for high school students. Although previous systematic reviews of Tier 1 have examined implementation and effects, none have exclusively focused on the unique contextual needs related to high school implementation. In this review, we synthesized 16 published research studies conducted at the high school level, described how authors addressed the unique challenges of implementing PBIS in high schools, reported findings related to academic and behavioral outcomes, and made recommendations for future research and practice based on our findings.
Comparison of microscopic illumination between a three-dimensional heads-up system and eyepiece in cataract surgery
Authors: Nariai Yui , Horiguchi Masayuki , Mizuguchi Tadashi , Sakurai Ryota , Tanikawa Atsuhiro
Published: June 2020

Introduction

The ability to reduce illumination levels is generally accepted as one of the main benefits of a three-dimensional heads-up system (3D system: Ngenuity®; Alcon, CA, USA). Some studies have focused on illumination reduction in vitreoretinal procedures; however, information regarding illumination reduction in cataract surgery has not been published.

Purpose

This study aimed to compare the illumination of the operational field with a 3D system and a standard microscope eyepiece during cataract surgery.

Subject and methods

We retrospectively evaluated 91 eyes of 84 consecutive patients who were undergoing cataract surgery at our hospital. We used the 3D system and the eyepiece on alternative days. We determined the minimum light intensity required for safe surgery using the foot switch of the microscope (OMS800; Topcon, Tokyo, Japan). Illuminance on the ocular surface and the minimum illuminance required for the operation were calculated from the minimum light intensity.

Results

The 3D system was used in 45 eyes (3D group), and the eyepiece was used in 46 eyes (eyepiece group). The values of minimum illuminance in the 3D group were significantly lower than those in the eyepiece group (3D: 5500 ± 2000 lux, eyepiece: 11,900 ± 1800 lux; p < 0.001*). In addition, the illuminance of the operational field was reduced by 60.4% on average using the 3D system.

Conclusion

With real-time digital processing and automated brightness control, the 3D system reduced ocular surface illumination by 50% or more. Hence, the 3D system may contribute to reducing the risk of retinal phototoxicity and patient photophobia.
The new Myopic Traction Maculopathy Staging System
Authors: Parolini Barbara , Palmieri Michele , Finzi Alessandro , Besozzi Gianluca , Lucente Angela , Nava Ugo , Pinackatt Sajish , Adelman Ron , Frisina Rino
Published: June 2020

Purpose:

To describe a comprehensive OCT-based classification of myopic traction maculopathy (MTM).

Methods:

Two hundred eighty-one eyes with MTM (visited from 2006 to 2018), were retrospectively reviewed for age, best-corrected-visual-acuity (BCVA), axial length (AL), optical coherence tomography (OCT), and wide-field color fundus-photographs. The study was divided in two Phases. Phase 1: MTM types were categorized with OCT and correlated with age and BCVA. The type of staphyloma was described. Phase 2: the evolution of MTM was studied evaluating at least three OCT exams of each eye taken at different timings (interval between each exam: 1–10 years).

Results:

Phase 1: We identified, four MTM retinal stages (1. Inner/Outer Maculoschisis; 2. Predominantly outer Maculoschisis; 3. Maculoschisis-Macular Detachment; 4. Macular Detachment) and three foveal stages (a. Normal fovea; b. Inner Lamellar-Macular-Hole; c. Full-Thickness-Macular-Hole). Outer-Lamellar-Macular-Holes and epiretinal abnormalities were associated findings. Stages 1 to 2 were younger than stages 3 to 4 ( p < 0.05). BCVA in stages 1, 2 was similar, and higher than stages 3, 4 ( p < 0.02). About 14% of eyes had no staphyloma, 73% of eyes had staphyloma type 1 or 2. MTM stages were not correlated with AL. Phase 2: The retina could change in time from stage 1 to 4, or the fovea could change from stage a to c. Mean evolution time from stage 1 to 2, stage 2 to 3, and 3 to 4 were 20, 12, 3 months, respectively. BCVA decreased over time as stages increased ( p = 0.47).

Conclusion:

The MSS Table displays a new classification, the natural evolution, and practical insights for the management of MTM.
Baseline visual acuity and interdigitation zone as predictors in idiopathic epiretinal membranes: A retrospective cohort study
Authors: Fernandes Tiago Filipe , Sousa Keissy , Azevedo Inês , Gouveia Petra , Calvão-Santos Gil , Gomes Nuno , Falcão Manuel
Published: June 2020

Objective:

Determine which functional and anatomical characteristics may be predictors of final visual acuity in patients with idiopathic ERM (iERM) submitted to pars plana vitrectomy (PPV) with ERM and internal and internal limiting membrane (ILM) peeling.

Design:

Retrospective cohort study.

Subjects:

Patients with iERM submitted to PPV between 2016 and 2017.

Methods:

Data regarding the best-corrected visual acuity (BCVA) and the characteristics of the retinal layers observed in SD-OCT were collected preoperatively and until 12 months postoperatively. Central macular thickness (CMT), disorganization of the retinal inner layers (DRIL), outer nuclear layer (ONL) thickness, integrity of subfoveal external limiting membrane (ELM), ellipsoid zone (EZ), and interdigitation zone (IZ) were evaluated.

Results:

A total of 128 eyes with iERM from 121 patients were included. BCVA improved significantly ( p < 0.001). Significant improvement of BCVA, CMT, DRIL, ONL, ELM, and EZ were obtained. The final IZ was not different from baseline until the end of the study. A significant correlation was observed between the baseline BCVA, EZ, IZ, and the postoperative BCVA ( p < 0.001). However, only the baseline BCVA and the integrity of the subfoveal baseline IZ were predictive factors for final BCVA ( p < 0.005 and p < 0.001, respectively).

Conclusion:

PPV provides a significant improvement of BCVA and retinal anatomy recovery in iERM eyes. Baseline IZ didn’t change during the 12 months following surgery. Baseline BCVA and subfoveal IZ at baseline were prognostic factors for the final BCVA.
Cladribine transfer into human milk: A case report
Authors: Datta Palika , Ciplea Andrea I , Rewers-Felkins Kathleen , Baker Teresa , Gold Ralf , Hale Thomas W , Hellwig Kerstin
Published: June 2020

Background:

Cladribine is an antimetabolite used for the treatment of relapsing–remitting multiple sclerosis. At present, there are no data available on its use in breastfeeding mothers and its transfer in human milk.

Objective:

We present a case of a lactating mother who donated her milk samples to study the transfer of cladribine following a 20-mg oral dose.

Methods:

Analysis was done using liquid chromatography–mass spectrometry.

Results:

The relative infant dose calculated in this study was 3.06%.

Conclusion:

This is the first case report suggesting the transfer of cladribine in human milk in measurable quantities. However, caution should be advised during lactation.
Gut commensals, dysbiosis, and immune response imbalance in the pathogenesis of multiple sclerosis
Authors: Brown Jordan , Quattrochi Blair , Everett Colleen , Hong Bo-Young , Cervantes Jorge
Published: June 2020

Intestinal microbiota alterations have been found to be directly related to a wide range of disease states in humans, including multiple sclerosis (MS). The etiology of MS is highly debated and subsequently, there is no cure. Research dedicated to MS and its murine model, experimental autoimmune encephalomyelitis (EAE), have found that dysbiosis of the gut microbiota may play a role in the disease state and severity. In this review, we discuss the characteristic dysbiosis in MS, the role commensal-derived ligands may have in the pathogenesis of the disease, and the possibility of targeting the microbiota as a future therapy.
Returning to the roots of ontological security: insights from the existentialist anxiety literature
Authors: Gustafsson Karl , Krickel-Choi Nina C.
Published: June 2020

Research on ontological security in International Relations (IR) has grown significantly in recent years. However, this scholarship is marked by conceptual ambiguity concerning the meaning of and relationship between the key concepts of ontological insecurity and anxiety. In addition, ontological security scholarship has been criticized for applying a concept that was originally developed for understanding individuals to states, and for being excessively concerned with continuity while largely ignoring change or seeing it as a negative force to be avoided. Despite such issues, however, reflection on the theoretical origins of ontological security remains limited. Based on such reflection, the present article argues that these issues can be circumvented if we return to one of the theoretical precursors of ontological security studies, the existentialist literature on anxiety. R.D. Laing, who coined the term ontological security, was strongly influenced by the existentialist anxiety theorists. Anthony Giddens, however, who drew on Laing and whose understanding of ontological security permeates IR scholarship, explicitly rejected the distinction between normal and neurotic anxiety, which was central to the work of existentialists like Rollo May. This article reintroduces this distinction. Doing so is useful, the article argues, both for providing conceptual clarity and for moving beyond the criticisms of ontological security mentioned above. More generally, the article suggests that ontological security studies has much to gain from drawing on the insights of the existentialist literature on anxiety to a greater extent than has hitherto been the case.