bluuebunny/crossref_metadata_2025 huggingface dataset:
Effets du Lifestyle Redesign chez les aînés : une recension systématique
Authors: Lévesque Marie-Hélène , Trépanier Jordane , Sirois Marie-Josée , Levasseur Mélanie
Published: March 2019

Description.

Le Lifestyle Redesign® (LR) a pour objectif de soutenir, à travers des routines occupationnelles saines et signifiantes, la santé, le fonctionnement et la qualité de vie d’aînés. Les données probantes concernant son efficacité et sa rentabilité sont toutefois dispersées.

But.

Cette étude visait à synthétiser les effets cliniques et le coût-efficacité du LR et à vérifier l’applicabilité des résultats en milieu communautaire québécois.

Méthodologie.

Une recension systématique des écrits a été réalisée, suivie d’un groupe de discussion auprès de quatre ergothérapeutes.

Résultats.

Considéré rentable (sous les 50 000 $ d’année de vie ajustée par la qualité), le LR présente des bénéfices tant pour la santé mentale que physique. Selon les ergothérapeutes consultés, la pertinence d’intégrer le LR à leur pratique est sans équivoque, mais comporte des défis.

Conséquences.

Le LR est une intervention ergothérapique dont les effets cliniques et le coût-efficacité sont prometteurs pour les aînés vivant dans la communauté.
Antibiotic Prescribing in Outpatient Children: A Cohort From a Clinical Data Warehouse
Authors: Grammatico-Guillon Leslie , Shea Kimberly , Jafarzadeh S. Reza , Camelo Ingrid , Maakaroun-Vermesse Zoha , Figueira Marisol , Adams William G. , Pelton Steve
Published: March 2019

Aim. To characterize antibiotic (ab) prescriptions in children. Methods. Evaluation of outpatient ab prescriptions in a 3-year cohort of children in primary care using a data warehouse (Massachusetts Health Disparities Repository) by comorbid conditions, demographics, and clinical indication. Results. A total of 15 208 children with nearly 120 000 outpatient visits were included. About one third had a comorbid condition (most commonly asthma). Among the 30 000 ab prescriptions, first-line penicillins and macrolides represented the most frequent ab (70%), followed by cephalosporins (16%). Comorbid children had 54.3 ab prescriptions/100 child-years versus 38.8 in children without comorbidity; ab prescription was higher in urinary tract infections (>60% of episodes), otitis, lower respiratory tract infections (>50%), especially in comorbid children and children under 2 year old. Ab prescriptions were significantly associated with younger age, emergency room visit, comorbid children, and acute infections. Discussion. A clinical data warehouse could help in designing appropriate antimicrobial stewardship programs and represent a potential assessment tool.
Pierre Trudeau and Canada’s Pacific tilt, 1945–1984
Authors: Donaghy Greg
Published: March 2019

Canadian international history is currently enjoying an Asian moment. A handful of younger scholars have cast their attention eastward, generating exciting new work on Canadian relations with specific countries and regions across the Pacific region. This article draws on some of their work, as well as the author’s own long-standing research on Canada’s Department of External Affairs, to weigh the Pacific’s changing importance to Canada. The article argues that the domestic and foreign policies of Prime Minister Pierre Trudeau, elected in 1968, were truly transformational. Trudeau swept away the traditional hesitations and confining North Atlanticism that characterized the diplomacy of his postwar predecessors. Instead, he pursued a full-throttled policy of strategic engagement that repositioned Asia front and centre of contemporary Canadian foreign policy.
Effects of Causal Attribution and Implicit Mind-Set on Wisdom Development
Authors: Alhosseini Fatemeh , Ferrari Michel
Published: March 2019

This study investigates the relationship between motivation and the development of wisdom. Eighty Canadian participants were interviewed and completed Ardelt’s Three-Dimensional Wisdom Scale (3D-WS). Using a mixed method design, we assessed wisdom definitions, interpersonal causal attributions, and mind-set about developing wisdom. A chi-square analysis revealed a significant relationship between attribution and mind-set about wisdom development. Two multivariate analyses of variance showed that both factors significantly influenced wisdom scores on the 3D-WS. These results suggest that people who consider wisdom development to be controllable and believe that their personal wisdom can be developed (i.e., growth mind-set) tend to be wiser, regardless of their definition of wisdom. By introducing the importance of mind-set and attribution, this study will open new avenues for research on teaching for wisdom and allow educators to develop programs to cultivate wisdom that focus on altering attribution and mind-set.
Dalit Feminism in Tokyo: Analogy and Affiliation in Transnational Dalit Activism
Authors: Mehta Purvi
Published: March 2019

This article discusses different conceptions and translations of the devadasi system in transnational Dalit feminist activism. I focus specifically on activist participation at the 1994 Asia Tribunal on Women’s Human Rights in Tokyo, Japan and the construction of an analogy between the experiences and struggles of devadasis and that of ‘military comfort women’, i.e. women from Japan’s former colonies who were abducted and raped by the Japanese military during World War II. I argue that strategic claims of commonality are part of the process of making specific, local practices legible to a global audience and that these sorts of claims also enable transnational feminist activism and solidarity.
Postcolonial Patriarchal Nativism, Domestic Violence and Transnational Feminist Research in Contemporary Uganda
Authors: Hundle Anneeth Kaur
Published: March 2019

This article examines the development of a multidimensional, transnational feminist research approach from and within Uganda in relation to a high-profile case of domestic violence and femicide of a middle-class, upper-caste Indian migrant woman in Kampala in 1998. It explores indigenous Ugandan public and Ugandan Asian/Indian community interpretations and the dynamics of cross-racial feminist mobilisation and protest that emerged in response to the Joshi-Sharma domestic violence case. In doing so, it advocates for a transnational feminist research approach from and within Uganda and the Global South that works against the grain of nationalist and nativist biases in existing feminist scholarly trends. This approach lays bare power inequalities and internal tensions within and across racialised African and Asian communities, and thus avoids the romanticisation of cross-racial feminist African-Asian solidarities.
A Psychometric Model for Discrete-Option Multiple-Choice Items
Authors: Bolt Daniel M. , Kim Nana , Wollack James , Pan Yiqin , Eckerly Carol , Sowles John
Published: March 2019

Discrete-option multiple-choice (DOMC) items differ from traditional multiple-choice (MC) items in the sequential administration of response options (up to display of the correct option). DOMC can be appealing in computer-based test administrations due to its protection of item security and its potential to reduce testwiseness effects. A psychometric model for DOMC items that attends to the random positioning of key location across different administrations of the same item is proposed, a feature that has been shown to affect DOMC item difficulty. Using two empirical data sets having items administered in both DOMC and MC formats, the variability in key location effects across both items and persons is considered. The proposed model exploits the capacity of the DOMC format to isolate both (a) distinct sources of item difficulty (i.e., related to the identification of keyed responses versus the ruling out of distractor options) and (b) distinct person proficiencies related to the same two components. Practical implications in terms of the randomized process applied to schedule item key location in DOMC test administrations are considered.
Limited Attention Diminishes Spatial Suppression From Large Field Glass Patterns
Authors: Pavan Andrea , Contillo Adriano , Ghin Filippo , Foxwell Matthew J. , Mather George
Published: March 2019

Glass patterns (GPs) consist of randomly distributed dot pairs (dipoles) whose orientations are determined by specific geometric transforms. We investigated the role of visuospatial attention in the processing of global form from GPs by measuring the effect of distraction on adaptation to GPs. In the nondistracted condition, observers were adapted to coherent GPs. After the adaptation period, they were presented with a test GP divided in two halves along the vertical and were required to judge which side of the test GP was more coherent. In the attention-distracted condition, a high-load rapid serial visual presentation task was performed during the adapting period. The magnitude of the form after-effect was measured using a technique that measures the coherence level at which the test GP appears random. The rationale was that if attention has a modulatory effect on the spatial summation of dipoles, in the attention-distracted condition, we should expect a weaker form after-effect. However, the results showed stronger form after-effect in the attention-distracted condition than in the nondistracted condition, suggesting that distraction during adaptation increases the strength of form adaptation. Additional experiments suggested that distraction may reduce the spatial suppression from large-scale textures, strengthening the spatial summation of local-oriented signals.
Pamidronate-encapsulated electrospun polycaprolactone as a potential bone regenerative scaffold
Authors: Remya KR , Chandran Sunitha , John Annie , Ramesh P
Published: March 2019

This study explores the potential of electrospun polycaprolactone scaffolds for the controlled delivery of pamidronate disodium pentahydrate, an amino-bisphosphonate drug used for the treatment of osteoporosis. Major drawbacks associated with oral bisphosphonate therapy are its poor bioavailability and gastrointestinal side-effects. Herein, we used polycaprolactone, a well-known Food and Drug Administration–approved biomaterial, as the delivering vehicle for pamidronate disodium pentahydrate. Scaffolds based on polycaprolactone with three different formulations (1, 3, and 5 wt%) of pamidronate disodium pentahydrate were fabricated by electrospinning, and a comparative study was carried out to evaluate the effect of pamidronate disodium pentahydrate on physico-mechanical and biological properties of polycaprolactone. The observations from Fourier-transform infrared spectra and thermogravimetric analysis confirmed the successful incorporation of pamidronate disodium pentahydrate into polycaprolactone scaffolds. The study also revealed that pamidronate disodium pentahydrate–loaded scaffolds exhibited improved hydrophilicity as well as superior mechanical properties as depicted by the contact angle measurements and mechanical property evaluation. In vitro drug release studies of pamidronate disodium pentahydrate–loaded scaffolds in phosphate buffer saline at 37°C showed that all the scaffolds exhibited controlled release of pamidronate disodium pentahydrate. In vitro degradation studies further revealed that pamidronate disodium pentahydrate incorporated polycaprolactone scaffolds degraded faster as depicted by the fiber rupture and drop in mechanical properties. In vitro cell culture studies using human osteosarcoma cell lines demonstrated that pamidronate disodium pentahydrate–loaded polycaprolactone scaffolds were cytocompatible. The human osteosarcoma cells had favorable interaction with the scaffolds, and the viability of adhered cells was depicted by the fluorescein diacetate/propidium iodide staining. MTT assay further revealed enhanced cell viability on PCL/PDS3 scaffolds. Our findings bespeak that the pamidronate disodium pentahydrate–encapsulated electrospun polycaprolactone scaffolds have the potential to serve as a promising drug delivery vehicle for osteoporotic bone defect repair.
Biocompatibility and biodegradation properties of polycaprolactone/polydioxanone composite scaffolds prepared by blend or co-electrospinning
Authors: Zhou Xin , Pan Yiwa , Liu Ruihua , Luo Xin , Zeng Xianyan , Zhi Dengke , Li Jing , Cheng Quhan , Huang Ziqi , Zhang Hui , Wang Kai
Published: March 2019

Electrospun polymer scaffolds are regarded as an ideal tissue engineering scaffold due to similar morphological properties with the native extracellular matrix. Among these, polycaprolactone is widely used to fabricate electrospun fibrous scaffolds due to its excellent biocompatibility, good mechanical properties, and ease of manufacture. However, its low biodegradation rate has a negative influence on its application in tissue engineering scaffold. To address this issue, this study prepared hybrid scaffolds composed of polycaprolactone and polydioxanone (a fast-degrading polyether-ester) via either the blend or co-electrospinning. Subsequently, the structural characteristics, mechanical strength, in vitro/vivo degradation, cellularization, and vascularization of two kinds of hybrid scaffolds were evaluated to decide which method is more suitable for producing tissue engineering scaffolds. The incorporation of polydioxanone increased the mechanical strength of both composite scaffolds. Moreover, co-electrospun scaffolds exhibited improved hydrophilicity compared to blend scaffolds. The results of in vitro and in vivo degradation studies showed that the degradation rate of both composite scaffolds was faster than that of neat polycaprolactone scaffolds due to the incorporated polydioxanone component. Especially in co-electrospun scaffolds, the fast degradation of polydioxanone fiber gave rise to larger pore size, thus leading to faster cellularization and better vascularization compared to blend scaffolds. Therefore, co-electrospinning was demonstrated to be superior to blend electrospinning for the preparation of composite scaffolds. Co-electrospun polycaprolactone–polydioxanone scaffolds may be promising candidates for tissue engineering.
Feminist Praxis: The Michigan Meeting on Ending Gender-Based Violence
Authors: Larance Lisa Young , Armstrong Elizabeth A. , Munro-Kramer Michelle , Sheridan-Fulton Emily , Kusunoki Yasamin , Ngo Quyen , Fincher Sharron , Denson Nicole
Published: March 2019

Feminist praxis in conference planning and implementation may be a promising approach to addressing the complex issue of gender-based violence in an academic setting. This “In Brief” provides an overview of how the Michigan Meeting on Ending Gender-Based Violence planning committee at the University of Michigan embraced feminist praxis by foregrounding diversity in conference presenters and topics presented; structuring the conference’s formal and free spaces; creating an inclusive, trauma-informed space where participants and presenters felt welcome; and highlighting participant feedback. By design, this focus in conference planning and implementation enabled tensions to surface between community-based practitioners and university-based researchers, while encouraging the formation of trust. The interdisciplinary conference structure also promoted and made possible greater connections and opportunities for networking and brainstorming on potential future programs and projects. Overall, the outcomes of this conference were positive and show that engagement and participation of community-based practitioners in traditionally academic settings leads to more nuanced discussions necessary for effectively addressing and, hopefully, ending gender-based violence.
The Effect of Political Parties on Nationwide Referendums in Poland after 1989
Authors: Hartliński Maciej
Published: March 2019

This article is part of the special cluster titled Political Parties and Direct Democracy in Eastern Europe, guest-edited by Sergiu Gherghina.

The article is the first attempt to describe and compare five nationwide referendums in Poland after 1989 as tools of direct democracy exploited by political parties. The article makes two primary contributions to the literature. The explanation focuses on the circumstances as well as the two main motives of the referendum initiators, that is, to cause trouble for political opponents and strengthen one’s own position by legitimising one’s own proposals concerning the political system and foreign policy directions. Moreover, the article discusses six methods employed by political parties to use the institution of nationwide referendum for their own political purposes. Interestingly, the Polish example shows that nationwide referendums have twofold effects for their initiators. On the one hand, they allow political parties to effectively realise the aims behind the initiated referendum. On the other hand, both political parties (1996, 1997, 2003) and presidents (1996 and 2015) sustained defeats in the next parliamentary or presidential elections.
Hijacked Direct Democracy: The Instrumental Use of Referendums in Romania
Authors: Gherghina Sergiu
Published: March 2019

This article is part of the special cluster titled Political Parties and Direct Democracy in Eastern Europe, guest-edited by Sergiu Gherghina.

The relationship between political parties and referendums has been receiving increased attention in the literature. While most research has focused on the challenges faced by political parties, little attention is dedicated to the ways in which they can use referendums to serve their purposes. This article analyzes the seven national-level referendums organized in post-communist Romania between 1991 and 2012 and shows how referendums were not used primarily as a means to reflect citizens’ opinions on policy issues. Instead, they were primarily used as electoral strategies for legitimacy purposes or to augment the popularity of the initiators or main supporters. In isolated instances, they were oriented against other competitors.
Privacy: Potential Violations of Human Dignity
Authors: Milton Constance L.
Published: March 2019

Privacy has been understood as a bioethical concept whose focus is on personal choosing or the right to control access to self. In nursing, privacy concerns abound where there is potential for the violation of human dignity as scientific advancements in genetic biotechnology potentially disclose personal information and genetic structures are made known to others without the consent of persons whose genetic material is being utilized for biological experimentation. In this article, the author offers new insights into the concept of privacy and human dignity as gene editing and its possible consequences unfurl within the scientific and healthcare arenas. A humanbecoming ethos perspective for nursing is illuminated.
Three-dimensional echocardiographic evaluation of the right ventricle in patients with uncomplicated systemic lupus erythematosus
Authors: Buonauro A , Sorrentino R , Esposito R , Nappi L , Lobasso A , Santoro C , Rivellese F , Sellitto V , Rossi F W , Liccardo B , Tufano A , Galderisi M , Paulis A de
Published: March 2019

Our aim was to identify subclinical right ventricular (RV) alterations in systemic lupus erythematosus (SLE) by combining standard and three-dimensional echocardiography (3DE). Fifty SLE patients without concomitant cardiac disease and 50 healthy controls, matched for age and gender, were enrolled. Disease damage was evaluated by inflammatory markers and SLE damage index. All patients underwent an echo-Doppler examination with 3DE assessment of RV function, RV septal and lateral longitudinal strain. The two groups had comparable body mass index and blood pressure. RV transversal middle diameter and pulmonary arterial pressure were significantly higher in SLE compared to controls. By 3DE, RV end-systolic volume ( p = 0.037) was greater, whereas stroke volume ( p = 0.023), ejection fraction ( p < 0.0001) and septal and lateral longitudinal strain (both p < 0.0001) were lower in SLE. SLE damage index ≥ 1 was negatively associated with tricuspid annular plane systolic excursion (TAPSE) ( p < 0.002), tricuspid E/A ratio ( p = 0.003), RV ejection fraction ( p < 0.05), lateral longitudinal strain ( p < 0.0001) and septal longitudinal strain ( p = 0.04). By separate multivariate models, after adjusting for age, C reactive protein and proBNP, SLE damage index was independently associated with TAPSE ( p = 0.009) and RV lateral longitudinal strain ( p = 0.007). In conclusion, a subclinical RV systolic dysfunction is detectable in SLE by 3DE, RV lateral wall strain being a key parameter. RV dysfunction is associated with cumulative disease damage.
Quest for Egalitarian Socio- spiritual Order: Lingayats and Their Practices
Authors: Desai Prakash
Published: March 2019

The Lingayat movement led by Basava, Allama, Mahadevi and many others in Karnataka in the twelfth century stands as one of the important movements that challenged, protested and, to a major extent, succeeded in unseating the social supremacy of the upper strata of the society. However, this tradition of egalitarian ideals is waning away from the followers of the Lingayat movement. It is observed that the superficial practices among the many followers of this movement do not have philosophical sanctity. These practices make the followers of the Lingayat movement almost a prototype of Hindu orthodoxy and question their claims of being different. Contradictions and confusion, in the understanding of the community’s ideals by the followers, may put the community in a sort of cultural crisis. The state of practice of ideals among the followers could be understood in terms of their assertions of caste and sub-caste identity; the demand for a separate religious identity on the basis of unique cultural beliefs; and confusing and contradictory political orientations.
Efficiency of Microfinance Institutions in India: A Two-Stage DEA Approach
Authors: Sinha Ram Pratap , Pandey Pallavi
Published: March 2019

The present study uses robust data envelopment analysis to estimate the performance of 30 Indian microfinance institutions (MFIs) from 2008–2009 to 2015–2016. Due to the non-availability of information in some instances, the present study uses an unbalanced panel of observations. In the matter of evaluation of performance, the study makes a major departure from the extant studies undertaken in the Indian context and adopts a double bootstrap approach originally suggested by Simar and Wilson. The current approach thus evaluates conditional performance of the in-sample MFIs in the presence of capital-to-asset ratio as an environmental variable. The two-stage estimation also involved the estimation of the influence of capital-to-asset ratio on the reciprocal of efficiency scores, and contrary to the expectations, the relationship was found to be positive.
A Policy Study on the Implementation Challenges of Phytosanitary Standards: The Case of ISPM 15 in Botswana, Cameroon, Kenya, and Mozambique
Authors: Papyrakis Elissaios , Tasciotti Luca
Published: March 2019

The rise in international trade in recent decades has been accompanied by an increase in the movement of wood packaging materials (WPMs). Recognizing the associated threat of cross-border pest movement, the Commission on Phytosanitary Measures, the governing body of the International Plant Protection Convention, adopted the International Standards for Phytosanitary Measures No. 15 (ISPM 15; guidelines for regulating WPM in international trade) for the treatment of WPMs. The objective of this article is to raise awareness on the challenges four sub-Saharan countries—Botswana, Cameroon, Kenya, and Mozambique—are facing when it comes to implementation. During extensive fieldwork, we conducted interviews with key stakeholders to understand their role in the setup and implementation of the standard as well as their perceptions on relevant challenges. Addressing these challenges is vital for achieving compliance and removing associated institutional and economic barriers. The article can assist policy-makers and academics to design future policies that tackle implementation problems, especially in the context of developing countries.
Robust adaptive vibration control of an underactuated flexible spacecraft
Authors: MoradiMaryamnegari H. , Khoshnood A.M.
Published: March 2019

Designing a controller for multi-body systems including flexible and rigid bodies has always been one of the major engineering challenges. Equations of motion of these systems comprise extremely nonlinear and coupled terms. Vibrations of flexible bodies affect sensors of rigid bodies and might make the system unstable. Introducing a new control strategy for designing control systems which do not require the rigid–flexible coupling model and can dwindle vibrations without sensors or actuators on flexible bodies is the purpose of this paper. In this study, a spacecraft comprising a rigid body and a flexible panel is used as the case study, and its equations of motion are extracted using Lagrange equations in terms of quasi-coordinates. For oscillations on a rigid body to be eliminated, a frequency estimation algorithm and an adaptive filtering are used. A controller is designed based on the rigid model of the system, and then robust stability conditions for the rigid–flexible system are obtained. The conditions are also developed for the spacecraft with more than one active frequency. Finally, the robust adaptive vibration control system is simulated in the presence of resonance. Simulations’ results indicate the advantage of the control method even when several active frequencies simultaneously resonate the dynamics system.
Factors associated with longer endocrine therapy use by South Carolina Medicaid-insured breast cancer survivors
Authors: Bedi Julie S , Mayo Rachel M , Chen Liwei , Dickes Lori , Sherrill Windsor W , Jones Karyn
Published: March 2019

Purpose

The objective of this study is to determine demographic, clinical, and pharmaceutical factors that are associated with longer endocrine therapy usage duration.

Methods

South Carolina Central Cancer Registry incidence data linked with South Carolina Medicaid prescription claims and administrative data were used. The study included a sample ( N = 1399) of female South Carolina Medicaid recipients with hormone receptor-positive breast cancer diagnosed between 2000 and 2012 who filled at least one ET prescription. A series of multiple regression models were built to explore the association of demographic, clinical, and pharmaceutical factors with the endocrine therapy usage duration.

Results

Multiple linear regression analysis showed that none of the demographic or clinical factors tested were significantly associated with the endocrine therapy usage duration. However, the type of endocrine therapy taken as well as receipt of the prescriptions that could have been used to alleviate side-effects (adrenals, nonsteroidal anti-inflammatory agents, anti-inflammatory agents, and vitamins) were significantly associated.

Conclusion

Our study highlights the potential value of concurrent prescriptions for improving the endocrine therapy usage duration, with an optimal intervention point before 14 months post ET initiation. This work informs further research needed to test pharmacologic interventions that may significantly increase the endocrine therapy duration as well as other nonpharmacologic strategies for side-effect management.
Etoposide phosphate for pediatric orthopedic malignancies after intravenous etoposide hypersensitivity
Authors: Brooks Joel P , Azmy Veronica , Thompson Alison , Luon Darren , Prozora Stephanie D , Price Christina , Hsu F Ida
Published: March 2019

Background

Hypersensitivity reactions to etoposide have been reported and patients have been safely transitioned to etoposide phosphate for continued therapy. However, the safety and efficacy of substituting etoposide phosphate for etoposide has not been well established in pediatric orthopedic malignancies. The aim of this study is to determine whether etoposide phosphate can be substituted for etoposide in pediatric orthopedic malignancies.

Methods

A chart review of pediatric patients who developed hypersensitivity reactions to etoposide while being treated for orthopedic malignancies was performed at a large academic medical center. Three patients were identified, two with Ewing sarcoma and one with an osteosarcoma. All three patients experienced hypersensitivity reactions to their first doses of etoposide and were switched to etoposide phosphate for further therapy.

Results

After premedication, all three patients tolerated full doses of etoposide phosphate without a graded dose challenge or desensitization. Two of the patients were premedicated with diphenhydramine alone, while the third received diphenhydramine and dexamethasone.

Conclusions

Etoposide phosphate is a potentially safe alternative for pediatric patients with orthopedic malignancies who experience etoposide hypersensitivity. However, caution is needed as there are cases of etoposide phosphate hypersensitivity.
Three-year results from the Retro-IDEAL study: Real-world data from diabetic macular edema (DME) patients treated with ILUVIEN® (0.19 mg fluocinolone acetonide implant)
Authors: Augustin Albert J , Bopp Silvia , Fechner Martin , Holz Frank , Sandner Dirk , Winkgen Andrea-M , Khoramnia Ramin , Neuhann Thomas , Warscher Marcus , Spitzer Martin , Sekundo Walter , Seitz Berthold , Duncker Tobias , Ksinsik Christian , Höh Helmuth , Gentsch Daniela
Published: March 2019

Introduction:

The Retro-IDEAL (ILUVIEN Implant for chronic DiabEtic MAcuLar edema) study is a retrospective study designed to assess real-world outcomes achieved with the ILUVIEN® (0.19 mg fluocinolone acetonide (FAc)) in patients with chronic diabetic macular edema (DME) in clinical practices in Germany.

Methods:

This study was conducted across 16 sites in Germany and involved 81 eyes (63 patients) with persistent or recurrent DME and a prior suboptimal response to a first-line intravitreal therapy (primarily anti-VEGF intravitreal therapies).

Results:

Patients were followed-up for 30.8 ± 11.3 months (mean ± standard deviation) and had a mean age of 68.0 ± 10.4 years. Best-recorded visual acuity (BRVA) improved by +5.5 letters at month 9 (P ⩽ 0.005, n=56; from a baseline of 49 letters) and this was maintained through to month 30 (P ⩽ 0.05, n = 42). There was a concurrent improvement in central macular thickness with a reduction from 502 µm at baseline to 338 µm at year 1 (P ⩽ 0.0001, n = 43). This effect was sustained to year 3 (i.e. 318 µm; P ⩽ 0.0001, n = 29). Mean intraocular pressure (IOP) remained constant between baseline and year 3 with a peak change of 1.9 mm Hg occurring at year 1. Elevated IOP was observed in a similar percentage of patients prior to (22.2% of cases) and following (27.2%) treatment with the FAc implant. In the majority of cases, these elevations were managed effectively with IOP medications.

Conclusions:

Despite substantial amounts of prior intravitreal treatments – primarily with anti–vascular endothelial growth factor (VEGF) drugs – this real-world study showed that sustained structural and functional improvements can last for up to 3 years with a single FAc implant.
Applying Supervised Machine Learning to Identify Which Patient Characteristics Identify the Highest Rates of Mortality Post-Interhospital Transfer
Authors: Reimer Andrew P , Schiltz Nicholas K , Ho Vanessa P , Madigan Elizabeth A , Koroukian Siran M
Published: March 2019

Objective:

To demonstrate the usefulness of applying supervised machine-learning analyses to identify specific groups of patients that experience high levels of mortality post-interhospital transfer.

Methods:

This was a cross-sectional analysis of data from the Health Care Utilization Project 2013 National Inpatient Sample, that applied supervised machine-learning approaches that included (1) classification and regression tree to identify mutually exclusive groups of patients and their associated characteristics of those experiencing the highest levels of mortality and (2) random forest to identify the relative importance of each characteristic’s contribution to post-transfer mortality.

Results:

A total of 21 independent groups of patients were identified, with 13 of those groups exhibiting at least double the national average rate of mortality post-transfer. Patient characteristics identified as influencing post-transfer mortality the most included: diagnosis of a circulatory disorder, comorbidity of coagulopathy, diagnosis of cancer, and age.

Conclusions:

Employing supervised machine-learning analyses enabled the computational feasibility to assess all potential combinations of available patient characteristics to identify groups of patients experiencing the highest rates of mortality post-interhospital transfer, providing potentially useful data to support developing clinical decision support systems in future work.
Autonomic dysfunction in people with neuromyelitis optica spectrum disorders
Authors: Crnošija Luka , Krbot Skorić Magdalena , Andabaka Marko , Junaković Anamari , Martinović Vanja , Ivanović Jovana , Mesaroš Šarlota , Pekmezović Tatjana , Drulović Jelena , Habek Mario
Published: March 2019

Aims:

To determine the difference in autonomic symptom burden measured with the Composite Autonomic System Score-31 (COMPASS-31) and presence of objective dysautonomia in people with neuromyelitis optica spectrum disorders (pwNMOSD) compared to people with multiple sclerosis (pwMS).

Design/Methods:

Twenty pwNMOSD and 20 pwMS, matched for age, sex, and disease duration, were enrolled. All patients completed the COMPASS-31. The quantification of cardiovascular autonomic dysfunction (CAD) was made using the two indices of the Composite Autonomic Scoring Scale (CASS): adrenergic index (AI) and cardiovagal index (CI).

Results:

In all pwNMOSD, COMPASS-31 was >0. Sympathetic dysfunction was present in 8 (40%), parasympathetic dysfunction in 10 (50%), and orthostatic hypotension in 6 (30%) pwNMOSD. This group of patients had higher frequency and level on the pupillomotor domain of the COMPASS-31 compared to pwMS ( p = 0.048 and p = 0.006, respectively). A binary logistic regression model showed that drop in diastolic blood pressure (dBP) during tilt-table test and normal function of autonomic nervous system, defined as AI = 0 and CI = 0, were independent predictors of pwNMOSD ( p = 0.042 and p = 0.029, respectively). If CAD was present, it was significantly worse in pwNMOSD compared to pwMS ( p = 0.003).

Conclusion:

Significant proportion of pwNMOSD experience dysautonomia, which seems to be different from dysautonomia observed in pwMS.
Two-year dynamic functional network connectivity in clinically isolated syndrome
Authors: Rocca Maria A , Hidalgo de La Cruz Milagros , Valsasina Paola , Mesaros Sarlota , Martinovic Vanja , Ivanovic Jovana , Drulovic Jelena , Filippi Massimo
Published: March 2019

Background:

The features of functional network connectivity reorganization at the earliest stages of MS have not been investigated yet.

Objective:

To combine static and dynamic analysis of resting state (RS) functional connectivity (FC) to identify mechanisms of clinical dysfunction and recovery occurring in clinically isolated syndrome (CIS) patients.

Methods:

RS functional magnetic resonance imaging (fMRI) and clinical data were prospectively acquired from 50 CIS patients and 13 healthy controls (HC) at baseline, month 12 and month 24. Between-group differences and longitudinal evolution of network FC were analysed across 41 functionally relevant networks.

Results:

At follow-up, 47 patients developed MS. Disability remained stable (and relatively low). CIS and HC exhibited two recurring RS FC states (states 1 and 2, showing low and high internetwork connectivity, respectively). At baseline, patients showed reduced state 2 connectivity strength in the default-mode and cerebellar networks, and no differences in global dynamism versus HC. A selective FC reduction in networks affected by the clinical attack was also detected. At follow-up, increased state 2 connectivity strength and global connectivity dynamism was observed in patients versus HC.

Conclusion:

Longitudinal FC modifications occurring relatively early in the course of multiple sclerosis may represent a protective mechanism contributing to preserve clinical function over time.
On the evidence consistency of pharmacovigilance outcomes between Food and Drug Administration Adverse Event Reporting System and electronic medical record data for acute mania patients
Authors: Duan Rui , Zhang Xinyuan , Du Jingcheng , Huang Jing , Tao Cui , Chen Yong
Published: March 2019

Evaluation of premarketing drug safety in clinical trials is often limited, due to the relatively small sample size and short follow-up time. The data collected in the postmarketing spontaneous reporting systems such as Food and Drug Administration Adverse Event Reporting System as well as electronic medical record systems provide crucial information to evaluate postmarketing drug safety. In this article, we assess the strengths and limitations of Food and Drug Administration Adverse Event Reporting System and electronic medical record data in studying the postmarketing pharmacovigilance outcomes for 12 selected antidepressant drugs. In addition, we evaluate the consistency of the results obtained from these two data sources, and provide potential directions for evidence integration.
Flipped healthcare for better or worse
Authors: Vallo Hult Helena , Hansson Anders , Svensson Lars , Gellerstedt Martin
Published: March 2019

The medical profession is highly specialized, demanding continuous learning, while also undergoing rapid development in the rise of data-driven healthcare. Based on clinical scenarios, this study explores how resident physicians view their roles and practices in relation to informed patients and patient-centric digital technologies. The paper illustrates how the new role of patients alters physicians’ work and use of data to learn and update their professional practice. It suggests new possibilities for developing collegial competence and using patient experiences more systematically. Drawing on the notion of flipped healthcare, we argue that there is a need for new professional competencies in everyday data work, along with a change in attitudes, newly defined roles, and better ways to identify and develop reliable online sources. Finally, the role of patients, not only as consumers but also producers of healthcare, is a rather formidable and complex cultural change to be addressed.
Communal data work: Data sharing and re-use in clinical genetics
Authors: Vassilakopoulou Polyxeni , Aanestad Margunn
Published: March 2019

In this article, we examine work with communal data in the context of clinical genetic testing. Drawing from prior research on digital research infrastructures and from the analysis of our empirical data on genetic testing, we describe how data generated in laboratories distributed all over the world are shared and re-used. Our research findings point to six different human-driven activities related to expanding, disambiguating, sanitizing and assessing the relevance, validity and combinability of data. We contribute to research within Health Informatics with a framework that foregrounds human-driven activities for data interoperability.
Defrosting concepts, destabilizing doxa: Critical phenomenology and the perplexing particular
Authors: Mattingly Cheryl
Published: March 2019

A key problem for critical theory is how to problematize the very concepts that undergird its own frameworks once they have become canonical. The more that certain constructs come to dominate an intellectual landscape and train our critical gaze, the more important this task becomes. To address this challenge, I offer a phenomenological approach to concept critique. I propose to consider critical phenomenology, at least in its most radical form, as an experience-near process of concept destabilization. I build upon Arendt’s intriguing formulation: thinking is a form of experience that disquiets concepts. She calls this ‘defrosting.’ I further suggest that perplexing particulars hold this kind of disruptive defrosting potential, helping us awaken our own critical gaze.
Categorization and ethnicization of Algerians within Lyon’s housing and urban policies (1950–1970)
Authors: Belmessous Fatiha
Published: March 2019

According to the ‘French Republican integration pattern’ – based on the principle of colour-blind universality – naming people using ethnic or racial references is illegal in the administration’s documentation as well as in the census. Yet, aspects of the colonial rights system were adopted into the French Republican ideology, thereby constituting a very specific relationship between nationality and citizenship in the administrative management of colonial natives on French mainland soil. This paper reveals the ambiguities of the Republican ideas when they were implemented by street-level administrators within Lyon’s metropolitan area (1950–1970). Examining the administration’s documentation in the Archives of the Rhône Department (ARD), this paper demonstrates how the Ministry of the Interior took leadership in the welfare sector, especially in housing and urban policies. Its role and work built upon the roots of institutionalized racism which accompanied the settlement of Algerian populations in France, even after Algeria’s independence (1962). By institutionalizing racial treatment, the successive administrations in charge of housing and urban policies within the Lyon metropolitan area have contributed to the legitimization of an ideology of segregation based on opposing aims: on the one hand, the mixing and coexistence of different cultural and ethnic groups, and on the other hand, the adherence to a supposed ‘tolerability threshold’ using arbitrarily developed quotas for the settlement of Algerians.
Vibration-based breathing crack identification using non-linear intermodulation components under noisy environment
Authors: Prawin J , Rama Mohan Rao A
Published: March 2019

Structural damages can result in non-linear dynamical signatures such as lower and higher order harmonics and signal modulation that can significantly enhance their detection. The conventional spectral analysis is used in most existing vibration-based damage diagnostic techniques to extract these damage-sensitive non-linear features. However, the major limitation of using spectral analysis is that the amplitudes of non-linear harmonics are highly sensitive to measurement noise and may mislead the damage diagnostic process. Keeping this in view, we present a new reference-free damage diagnostic technique for fatigue-breathing crack detection, localization and characterization using the cyclic spectral analysis-based technique. A new damage index based on spectral correlation exploiting the non-linear intermodulation in the response is proposed. The proposed cyclic spectral analysis-based diagnostics are highly immune to the measurement noise. Numerical and experimental simulation studies have been carried out by considering a beam with single and multiple breathing cracks, to test and verify the robustness and effectiveness of the proposed technique.
Dating Violence Perspectives of Latino College Students: Considerations for Violence Prevention Programming
Authors: Terrazas-Carrillo Elizabeth , Garcia Ediza , Briseño Jonathan , de la Cruz Itzamara
Published: March 2019

This study sought to explore dating violence perceptions from Latino students in a college setting with the goal of enhancing knowledge for developing successful culturally tailored preventive interventions that decrease Latino college student dropout and enhance persistence. Focus groups including 35 college students attending a Hispanic Serving Institution were conducted. Conventional qualitative analysis showed Latino college students prefer dating violence prevention programming that places a focus on interdependent self-construals emphasizing relationships, which is consistent with their collectivistic values. Moreover, participants addressed unique cultural characteristics of Latinos that should be considered in any dating violence prevention program targeting this population.
Canadian Men’s Health Literacy: A Nationally Representative Study
Authors: Oliffe John L. , McCreary Donald R. , Black Nick , Flannigan Ryan , Goldenberg S. Larry
Published: March 2019

Though men’s health promotion has attracted increased research attention, conspicuously absent have been empirical insights to health literacy levels within and across male subgroups. Recent advancements in the measurement of health literacy have made available avenues for evaluating individual and social determinants of health literacy. Important insights can be drawn to detail patterns and diversity among men as a means to informing the design, implementation, and evaluation of tailored health promotion programs. Drawing on 2000 Canada-based men’s responses to the Health Literacy Questionnaire, correlations between demographic variables and six health literacy scales are described. Low income, low education, and living alone were associated with men’s low health literacy, with the strongest effect sizes for the “Social support for health” and “Actively engaged with health care professionals” scales. Multiple linear regressions confirmed low income as the strongest predictor of men’s low health literacy in all the scales except “Appraisal of health information.” Low income, self-identifying as gay, bisexual, or other, and living alone were strongly predictive of low scores on the “Social support for health” scale. The findings affirm the importance of considering men’s health literacy and inequities to advance effective men’s health promotion programs.
Evaluation on Short-Term Therapeutic Effect of 2 Porphyrin Photosensitizer-Mediated Photodynamic Therapy for Esophageal Cancer
Authors: Liu Huilong , Liu Yanfang , Wang Li , Ruan Xinjian , Wang Fei , Xu Dandan , Zhang Jing , Jia Xiaoyan , Liu Duanqi
Published: March 2019

Purpose:

To analyze and study the short-term therapeutic effects and main adverse effects of 2 Porphyrin photosensitizer-mediated photodynamic therapy for esophageal cancer.

Methods:

We apply the hematoporphyrin derivative and hematoporphyrin injection produced by different manufacturers at different periods as photosensitizers in therapy of 79 esophageal cancer cases, with the administration dosage of 5 mg/kg and intravenous drip 24 hours before irradiation. We apply the gold vapor laser and semiconductor laser, respectively, as treatment light source, with the power density of 100 to 300 mW/cm2 and energy density of 100 to 300 J/cm2. After treatment for 1 to 4 sessions, we evaluate the short-term therapeutic effects as complete response, partial response, minor response, or no change, and then make comparative study on therapeutic effects and adverse effects.

Results:

There were 47 patients in hematoporphyrin derivative group, including 3 (6.4%) patients with complete response, 31 (66.0%) patients with partial response, 10 (21.3%) patients with minor response, and 3 (6.4%) patients with no change. The dysphagia score was reduced from 2.53 (1.16) before treatment to 1.32 (1.20; P < .01) after treatment. There were 32 patients in the hematoporphyrin injection group, including 3 (9.4%) patients with complete response, 19 (59.4%) patients with partial response, 6 (18.8%) patients with minor response, and 4 (12.5%) patients with no change. The dysphagia score was reduced from 2.41 (1.13) before treatment to 1.18 (0.99; P < .01) after treatment. The dysphagia scores of 2 groups after treatment were significantly reduced compared to those before treatment. Both groups did not display serious adverse effect.

Conclusions:

Two porphyrin photosensitizers in treatment of esophageal cancer at different clinical stages all had good effect with similar therapeutic effect, mild adverse effect, and good tolerance, which implies it is a preferable palliative therapy means.