bluuebunny/crossref_metadata_2025 huggingface dataset:
Preparation of Mesoporous Gamma Alumina Derived from Waste Can for Nutrient Recovery Process
Authors: Seo Seong Gyu , Hwang Kyung-Jun , Ahn Ho-Hyun , Shim Wang Geun , Hwang Min-Jin
Published: January 2020

Mesoporous gamma alumina (MGA) was synthesized using aluminum trash containers by a low temperature hydrothermal method for effectively removing phosphate from wastewater. The effects of precursor concentrations in gel precipitation process over the pore size and surface area of MGA
were investigated in detail. The phosphate removal by prepared MGAs were rigorously investigated through adsorption isotherms and kinetics of phosphate.
Efficacy of a First-Grade Mathematics Intervention on Measurement and Data Analysis
Authors: Doabler Christian T. , Clarke Ben , Kosty Derek , Turtura Jessica E. , Firestone Allison R. , Smolkowski Keith , Jungjohann Kathleen , Brafford Tasia L. , Nelson Nancy J. , Sutherland Marah , Fien Hank , Maddox Steven A.
Published: January 2020

Well-designed mathematics instruction focused on concepts and problem-solving skills associated with measurement and data analysis can build a foundational understanding for more advanced mathematics. This study investigated the efficacy of the Precision Mathematics Level 1 (PM-L1) intervention, a Tier 2 print- and technology-based mathematics intervention designed to increase first-grade students’ conceptual understanding and problem-solving skills around the areas of measurement and data analysis. Employing a randomized controlled trial, 96 first-grade students at risk for mathematics difficulties were randomly assigned within classrooms to either a treatment (PM-L1) or a control (business-as-usual) condition. A statistically significant positive effect was found on one of five outcome measures, with the other four showing positive but nonsignificant results. Results also suggested preliminary evidence of differential response based on students’ number sense and early literacy risk status. Implications for using mathematics interventions focused on measurement and data analysis to build comprehensive, multitiered service delivery models in mathematics are discussed.
Involvement of Students With Severe Disabilities in Specialized Health Care Procedures
Authors: Ballard Sarah L. , Dymond Stacy K.
Published: January 2020

A recommended practice in the field of severe disabilities is involving students in their specialized health care procedures; however, little is known about how this practice is occurring in schools. The purpose of this qualitative multiple-case study was to understand how secondary-age students with severe disabilities are involved in their specialized health care at school. Purposeful sampling resulted in nine cases and a total of 41 participants. A case comprised a secondary-age focus student and the student’s parent(s), special education teacher, school nurse, and classroom nurse or paraprofessional. Data sources were observations, interviews, and document reviews. The researchers analyzed the data using an iterative inductive coding approach for each individual case to identify patterns in the data followed by a cross-case synthesis using visual matrices to identify salient themes across cases. This process resulted in four themes depicting how students were involved in their specialized health care at school, which were (a) partially participating, (b) interacting with adults, (c) engaging in risky behaviors, and (d) passively participating. The findings from this study highlight a need for improved attention to the promotion of self-care in specialized health care for this population.
Exploring Associations Between Inner-Context Factors and Implementation Outcomes
Authors: Suhrheinrich Jessica , Rieth Sarah R. , Dickson Kelsey S. , Stahmer Aubyn C.
Published: January 2020

Classroom pivotal response teaching (CPRT) is an evidence-based practice (EBP) adapted for classroom use. A recent effectiveness trial of CPRT involved training 98 special education classrooms in Southern California. The Exploration, Planning, Implementation, and Sustainment (EPIS) conceptual framework illustrates the impact of inner- and outer-context factors on implementation outcomes. This article evaluates how teacher factors (including attitudes toward EBP) and organizational factors (implementation climate and district support) influence training outcomes (fidelity of intervention, report of use, sustainment, and satisfaction). Teachers’ ratings of training quality were related to higher fidelity during their follow-up year, β = .34, t(78) = 2.97, p < .004, and rating of intervention ease of use was related to higher daily CPRT use. Teacher ratings on the appeal scale of the attitudes measure were associated with individual sustainment, β = .35, t(55) = 2.76, p < .01. Leader involvement at recruitment meetings, β = .35, t(48) = 2.58, p = .01, and provision of CPRT training space, β = .44, t(48) = 2.73, p < .01, were significantly related to school sustainment. Teachers’ overall attitudes toward the intervention were significantly related to satisfaction with CPRT training, β = .41, t(80) = 3.96, p < .01. This study makes important preliminary contributions to understanding the impact of inner-context implementation determinants of a classroom-based EBP for students with autism spectrum disorder.
Between Two Rocks and in a Hard Place: Reflecting on the Biomechanical Basis of Shoulder Occupational Musculoskeletal Disorders
Authors: Dickerson Clark R. , McDonald Alison C. , Chopp-Hurley Jaclyn N.
Published: January 2020

Objective

The aim was to review the biomechanical origins of occupational shoulder damage, while considering the complexity of shoulder mechanics and musculoskeletal consequences of diverse task demands.

Background

Accessible measures of physical exposures are the primary focus of occupational shoulder assessments and analyses. This approach has led to guidelines and intervention strategies that are often inadequate for mitigating shoulder disorders amongst the complexity of modern workplace demands. Integration of complex shoulder mechanics into occupational assessments, analyses, and interventions is critical for reducing occupational shoulder injury risk.

Method

This narrative review describes shoulder biomechanics in the context of common injury mechanisms and consequent injuries, with a particular focus on subacromial impingement syndrome. Several modulators of shoulder injury risk are reviewed, including fatigue, overhead work, office ergonomics considerations, and pushing and pulling task configurations.

Results

Relationships between work requirements, muscular demands, fatigue, and biomechanical tissue loads exist. This review highlights that consideration of specific workplace factors should be integrated with our knowledge of the intricate arrangement and interpersonal variability of the shoulder complex to proactively evaluate occupational shoulder demands and exposures.

Conclusion

A standard method for evaluating shoulder muscle exposures during workplace tasks does not exist. An integrated approach is critical for improved work design and prevention of shoulder tissue damage and accompanying disability.

Application

This review is particularly relevant for researchers and practitioners, providing guidance for work design and evaluation for shoulder injury prevention by understanding the importance of the unique and complex mechanics of the shoulder.
My Journey as a Citizen Therapist
Authors: Doherty William J.
Published: January 2020

My story begins with the idealism of humanistic and family systems therapies of the 1970s, followed by disillusionment with making a difference in the larger world, and then the discovery of citizen therapist work. I describe my initial forays into direct community action and then two current projects on major social problems: police relationships with the African American community and political polarization in the Trump era. A key breakthrough along the way was coming to see my role as a citizen professional in a democracy—acting with community members rather than just for them.
L’angle mort de la « laïcité ouverte » : les processus de navigation et négociations dans le vécu religieux au Canada
Authors: Selby Jennifer A , Beaman Lori G , Barras Amélie
Published: January 2020

Building on our critiques of the reasonable accommodation of religious minorities in Canada (see Selby et al., 2018a ; Beaman, 2017 ; Barras, 2016), this paper argues for attention to processes as intrinsic to everyday interactions of religiosity (following Tully, 1995, 2000 ; Van Quaquebeke et al., 2007). We contend that frameworks like Maclure and Taylor’s (2010) on ‘open’ and ‘closed’ secularism are useful for nation state comparison, but ineffectively account for the power asymmetries lodged within everyday religiosity. Their model protects the status quo ; it does not call institutional values or procedures into question, erases the navigation that occurs before an ‘accommodation’ is requested, and entrenches conflict as reflective of the experiences of religious minorities. Based on interviews with 90 self-defined Muslims in two cities, we propose a model of navigation and negotiation to better capture how religious practices are contextual and embedded in power relations.
Explaining the rise of ‘nonreligion studies’: Subfield formation and institutionalization within the sociology of religion
Authors: Bullivant Stephen
Published: January 2020

As recently as 2008, a major reference work in the sociology of religion could (correctly) describe the study of atheism, secularity, and nonreligion as ‘meager, fragmentary, and unappreciated’. Only a decade later, this situation has been radically transformed. Not only is there a substantial, ever-growing, and constantly diversifying (methodologically, theoretically, geographically) research literature, but ‘nonreligion studies’ now possesses a full ‘academic architecture’ of conferences, journals, monograph series, professional communities, and grant successes. Over this period, the study of nonreligion has become increasingly institutionalized as an established subfield of the sociology of religion. This has not simply come about by magic. On the contrary, there are very good sociological reasons i) why, for over a century, nonreligion failed to take off (outside of certain, telling milieux) as an area of sustained sociological interest; and ii) why and how this has – seemingly so rapidly – changed.
Perceptions of Organizational Politics Research: Past, Present, and Future
Authors: Hochwarter Wayne A. , Rosen Christopher C. , Jordan Samantha L. , Ferris Gerald R. , Ejaz Aqsa , Maher Liam P.
Published: January 2020

Research examining the influence of perceptions of organizational politics (POPs) is currently at a nexus—capable of recognizing its previous contributions but also with an eye toward the future. Scholars credit much of the maturation over the past 30 years to Ferris, Russ, and Fandt’s seminal model. Despite the ever-increasing number of publications attributed to this topic, and model, opportunities to bridge and expand the current research base remain plentiful. We begin this review by differentiating POPs from political behavior and constructs considered overlapping conceptually. We then describe the evolution of two models responsible for guiding POPs research and conclude our review by summarizing meta-analytic studies investigating antecedents and outcomes of POPs. Doing so allows us to identify gaps currently impeding development and to recommend relevant approaches to extend research. Following this review, we introduce event systems theory as a guiding framework for integrating and expanding the knowledge base. This structure allows scholars to recast POPs as a discrete phenomenon capable of being evaluated in terms of its novelty, disruption, and criticality. Theoretically, this approach allows for greater precision in identifying causes and consequences of POPs, and it provides insight into how such perceptions emerge and evolve. Last, we discuss future research opportunities intended to improve understanding of this pervasive phenomenon, and we encourage much-needed future research examining the dynamics of POPs in contemporary work settings.
Microscopic vs Endoscopic Ear Surgery for Congenital Ossicular Anomaly
Authors: Chung Jaein , Kang Jae‐Yoon , Kim Min‐Su , Kim Bongjik , Choi Jin Woong
Published: January 2020

Objective

To compare surgical outcomes of transcanal endoscopic ear surgery (TEES) for congenital ossicular anomalies with those of conventional microscopic surgery.

Study Design

Retrospective case review.

Setting

Tertiary referral academic center.

Subjects and Methods

From March 2012 to November 2018, 42 consecutive ears in 40 patients with congenital ossicular anomaly who underwent ossiculoplasty or stapes surgery using either ear endoscopes (TEES group) or an operating microscope (microscopic group) were included. Postoperative audiometric results, operation time, switch of approach, and complications were compared between the 2 groups.

Results

Twenty‐four ears (66.1%) were in the microscopic group and 18 ears (33.9%) were in the TEES group. The mean (SD) preoperative air‐bone gap was 31.8 (10.0) dB in the microscopic group and 35.2 (11.1) dB in the TEES group. The mean (SD) postoperative air‐bone gap was 7.4 (6.5) dB in the microscopic group and 5.6 (5.0) dB in the TEES group. The differences in the preoperative and postoperative air‐bone gaps between the 2 groups were not statistically significant (P =. 316 and P =. 412, respectively). Average operation time in the TEES group was 24.6 minutes shorter than that in the microscopic group, which was statistically significant (P =. 019). None of patients in the TEES group did require a switch of approach. There was no significant difference in complication incidence between the 2 groups.

Conclusions

TEES for congenital ossicular anomaly has comparable audiometric results and complication rates to conventional microscopic surgery. TEES appears to have the advantages of shorter operation times.
Timing of Initial Posttracheostomy Surveillance Endoscopy in Pediatric Patients
Authors: Smith Matthew M. , de Alarcon Alessandro , Meinzen‐Derr Jareen , Cohen Aliza P. , Born Hayley , Wilcox Lyndy J. , Benscoter Dan T. , Hart Catherine K.
Published: January 2020

Objective

To determine the optimal timing of the first posttracheostomy microlaryngoscopy and bronchoscopy (MLB).

Study Design

Case series with chart review.

Setting

Tertiary pediatric medical center.

Subjects and Methods

Patients (<21 years of age) who underwent tracheostomy placement from January 1, 2011, to December 31, 2016. Patients were divided into early and late posttracheostomy surveillance groups (<6 weeks vs 6 to 14 weeks, respectively) based on the timing of their first posttracheostomy MLB. The primary outcome was to ascertain the clinical yield of the initial posttracheostomy MLB by documenting whether a medical or surgical treatment decision was made based on MLB findings.

Results

In total, 202 patients were included; of these patients, 162 met criteria for placement in the early group and 40 met criteria for the late group. There was no significant difference between the early and late groups regarding whether a medical or surgical decision was made at the time of the first MLB (21.5% vs 19%, respectively; P =. 49). Multiple logistic regression identified that the presence of tracheostomy‐related symptoms prior to MLB (odds ratio, 6.75; 95% confidence interval, 2.78‐16.39) was the sole predictor of a medical or surgical decision being made at the first posttracheostomy MLB.

Conclusion

The presence of tracheostomy‐related symptoms was predictive of a medical or surgical decision being made using information obtained at the time of the first posttracheostomy MLB. We thus recommend that surveillance endoscopy be initiated when tracheotomized children start to develop tracheostomy‐related symptoms.
Drug‐Induced Sleep Endoscopy Performed in the Endoscopy Suite: A Resource Utilization Analysis
Authors: Ghazizadeh Shabnam , Moore Kyasha , Kiai Kianusch , Mendelsohn Abie H.
Published: January 2020

Objectives

To analyze the resource utilization of performing drug‐induced sleep endoscopy (DISE) procedures in an endoscopy suite (ES) setting as compared with the operating room (OR).

Study Design

A retrospective review of DISE procedures performed by a single attending surgeon from 2016 to 2018.

Setting

Tertiary hospital.

Subjects and Methods

All patients undergoing sleep endoscopy without concurrent surgical procedures were included. No exclusion criteria were incorporated. Analysis assessed for differences in procedure‐related expenditures, patient characteristics, anesthesia and surgeon time, and access to care.

Results

A total of 87 sleep endoscopies were included: 65 (74.7%) performed in the ES and 22 (25.3%) in the OR. Patient groups were similar in age and apnea‐hypopnea index severity (P >. 05). Patient body mass index was significantly higher for the ES group (P =. 03). Total facility time, postoperative recovery time, anesthesia care time, and time in the surgical room were significantly decreased in the ES setting (P <. 01). Surgical time was similar between the groups (P >. 05). For ES procedures, total cost was reduced by 74% (P <. 01). DISE in the ES resulted in a mean $5080 less in health system charges versus the OR group (P <. 01). There were no treatment‐related complications in either setting.

Conclusion

The resource utilization profile of performing DISE can be significantly improved by transferring these procedures from the OR to the ES setting.
For better or for worse: Marital status transitions and sexual life in middle and later life
Authors: Stokes Jeffrey E. , Gallagher Elizabeth , Kanyat Remona , Bui Cindy , Beaulieu Celeste
Published: January 2020

Marital status and marital status transitions have known implications for adults’ mental and physical quality of life. Less attention has been paid, however, to the implications of marital status and transitions for sexual quality of life, particularly among the aging population. The present study analyzed three-wave longitudinal data from the National Survey of Midlife Development in the U.S. (1995–2014) in order to examine the effects of marital status/transitions on adults’ frequency of sexual activity, sexual satisfaction, effort put into sexual life, and control over sexual life. Further, this study assessed whether the implications of marital status/transitions for adults’ sexual quality of life varied according to (a) pre-transition reports of sexual quality of life, (b) gender, and/or (c) age. Multilevel lagged dependent variable models analyzed 2,869 observations drawn from 1,769 midlife and older adults over a two-decade span. Results indicated that the implications of marital status and marital status transitions for sexual life (a) were contingent upon baseline context across all four sexual quality of life outcomes, (b) varied by gender across three of the four sexual quality of life outcomes, and (c) varied only slightly by age concerning frequency of sexual activity. Overall, findings indicated that marital status transitions may be either beneficial or detrimental for adults’ sexual lives, depending on prior context; marital status transitions were most beneficial for sexual quality of life when baseline reports of sexual life were poor. Moreover, women were less likely to reap the potential rewards of marital status transitions such as divorce and widowhood, reflecting stronger social and normative constraints upon unmarried women’s sexuality, particularly for older women. We situate these findings within the growing literature concerning marital status transitions, the “graying of divorce,” and sexual life among the aging population.
Lights and shadows of schizophrenia therapy research: Lessons from oral risperidone and olanzapine
Authors: Nicotra Eraldo F , Lecca Daniele , Casu Gianluca , Palomba Mario , Sil Annesha , Marchese Giorgio
Published: January 2020

Background:

Recently, patents of several atypical antipsychotics have reached their expiration date.

Aims:

The purpose of the study was to highlight whether modifications of economic/scientific factors may be associated with possible changes in ongoing clinical research on antipsychotic drugs.

Methods:

A large systematic analysis was used to depict the time-dependent distribution of published research articles addressing the clinical properties of oral risperidone and olanzapine conventional tablets, two largely prescribed atypical antipsychotics for which the patents have already expired in most of the countries.

Results:

The systematic analysis indicated that the time-dependent distribution of the selected research articles followed a wave-shape pattern. A dramatic decline of primary and secondary analyses investigating the clinical effects of oral risperidone and olanzapine has occurred in the last decade, complemented by an expected strong reduction in the numbers of industrial-supported clinical studies and a smaller, but significant, decline in the amount of independent research articles.

Conclusions:

To date, greater involvement of independent research seems to be the only realistic chance to properly continue the investigation on the clinical properties of oral risperidone and olanzapine conventional tablets, as well as those of other off-patent antipsychotic drugs. However, the limits and potentialities of independent research in accomplishing such a demanding and enduring scientific effort should be addressed.
κ and λ urine free light chains: a new method for quantification
Authors: Giussani Marta , Ciniselli Chiara Maura , Macciotta Alessandra , Panella Rossella , Verderio Paolo , Bonini Chiara , Morelli Daniele
Published: January 2020

Background:

Immunofixation electrophoresis of urinary proteins, coupled with densitometric analysis, is the gold standard method for determining urinary monoclonal free light chains (FLCs), i.e. Bence Jones protein. Recently, immunochemical methods have been developed for Bence Jones protein quantification, but no such method has been widely adopted. This study evaluated a new antibody-based immunoturbidimetry method for urinary FLC quantification, using immunofixation electrophoresis as reference.

Methods:

κ and λ FLCs were measured in urine specimens from 95 (training cohort) and 103 (testing cohort) patients by both immunofixation electrophoresis and immunoturbidimetry.

Results:

There was almost perfect concordance in the training cohort between the new immunoturbidimetry assay and immunofixation electrophoresis and substantial agreement, with Cohen kappa of 0.85 and 0.75, for κ and λ FLC determination, respectively. Results were confirmed in the testing cohort, where Cohen kappa was 0.86 for κ and 0.94 for λ FLCs. The κ FLC assay had 88% sensitivity and 98%–100% specificity; the λ FLC assay had 94% and 96% sensitivity and 91% and 99% specificity in the training and testing cohorts, respectively.

Conclusions:

The new immunochemical method has a satisfactory performance and almost perfect agreement with immunofixation electrophoresis and gives the advantage of FLC quantification.
Differences in predicting glucose absorption from peritoneal dialysate compared to measured absorption in peritoneal dialysis patients treated by continuous ambulatory peritoneal dialysis and ambulatory peritoneal dialysis cyclers
Authors: Tangwonglert Theerasak , Davenport Andrew
Published: January 2020

Background and aims:

Glucose-containing peritoneal dialysates are used to generate an osmotic gradient for the convective removal of water and sodium. Predictive equations were developed to estimate glucose absorption without having to formally measure changes in dialysate glucose. In view of the changes in peritoneal dialysis prescriptions over time, we compared predicted and measured glucose absorption.

Subjects/methods:

We measured peritoneal glucose losses when peritoneal dialysis patients attended their first assessment of peritoneal membrane function, and compared this to glucose exposure and Kidney Disease Outcomes Quality Initiative, Grodstein and Bodnar predictive equations.

Results:

We studied 689 patients; 329 (56.9%) males, 53 (37.1%) diabetics, with mean age 57.1 ± 16.2 years, with 186 treated by automated peritoneal dialysis cyclers and 377 by automated peritoneal dialysis with a daytime icodextrin exchange and 126 by continuous ambulatory peritoneal dialysis. Using Bland -Altman analysis, all equations demonstrated systematic bias overestimating glucose absorption with increasing glucose absorption. For continuous ambulatory peritoneal dialysis patients, the Kidney Disease Outcomes Quality Initiative formula underestimated glucose absorption (bias 188 (−39 to 437) mmol/day, as did Grodstein (bias 37.9 (−105 to 29) mmol/day, whereas mean bias for Bodnar was −29 (−130 to 180)). There was systematic overestimation for all equations for both automated peritoneal dialysis with and without a daytime exchange, with increasing bias with greater glucose absorption.

Conclusion:

Although formally measuring peritoneal glucose absorption is time consuming and requires patient co-operation, current predictive equations overestimate glucose absorption and do not provide accurate estimations of glucose absorption particularly for automated peritoneal dialysis patients.
Precision medicine: Driving the evolution of biobanking quality
Authors: Barnes Rebecca O. , Watson Peter H.
Published: January 2020

The promise of precision medicine will only be realized if the healthcare system adapts to meet some key infrastructure needs. Among these needs are adequate biobanking practices, capable of producing the biological samples and data that precision medicine relies upon in both the research and clinical phases. Within the research domain, there have been significant improvements to biobanking processes over the past two decades, driven by increased understanding of the impact of pre-analytical variability and the critical role of biospecimen and data quality. In the era of precision medicine, biobanking to support clinical needs has similar quality requirements. The extensive knowledge and resources that have been developed by the research biobanking community are available for adoption by clinical biobanking. The challenge and opportunity now presented to the healthcare system is to adopt or adapt these resources, for example, external biobanking standards and verification programs.
Two Preregistered Direct Replications of “Objects Don’t Object: Evidence That Self-Objectification Disrupts Women’s Social Activism”
Authors: De Wilde Matthias , Casini Annalisa , Bernard Philippe , Wollast Robin , Klein Olivier , Demoulin Stéphanie
Published: January 2020

Self-objectification has been claimed to induce numerous detrimental consequences for women at the individual level (e.g., sexual dysfunction, depression, eating disorders). Additionally, at the collective level, it has been proposed that self-objectified women might themselves contribute to the maintenance of the patriarchal status quo, for instance, by participating less in collective action. In 2013, Calogero found a negative link between self-objectification and collective action, which was mediated by the adoption of gender-specific system justification. Here, we report two preregistered direct replications (PDRs) of Calogero’s original study. We conducted these PDRs after three failures to replicate the positive relation between self-objectification and gender-specific system-justification belief in correlational studies. Results of the two PDRs, in which we used a Bayesian approach, supported the null hypothesis. This work has important theoretical implications because it challenges the role attributed to self-objectified women in the maintenance of patriarchy.
Application of survival analysis techniques to determine the optimal number of acupuncture therapy sessions for stroke patients
Authors: Sangtin Siriluck , Supasiri Thanan , Tangsathitporn Rungroat , Pongpirul Krit
Published: January 2020

Background:

Acupuncture has shown clinical benefits in stroke patients but there is currently no clear recommendation on the number of acupuncture sessions that should be offered. The aim of this study was to determine the optimal number of acupuncture therapy sessions, following which significant clinical improvement could be anticipated.

Methods:

We performed a retrospective observational study in stroke patients who had received acupuncture therapy as an adjunct treatment at Trang Hospital—a non-academic provincial hospital in Southern Thailand—between 1 July 2016 and 30 June 2017. Significant clinical improvement in activities of daily living (ADLs) was defined as an increase in the Barthel Index of ⩾10 points from baseline. Survival analysis techniques were applied to determine the optimal number of acupuncture therapy sessions.

Results:

Of 89 patients, 78% had a significant clinical improvement. Kaplan–Meier analysis estimated that 50% of the patients exhibited significant improvements by the eighth acupuncture therapy session. By the 16th session, the proportion of patients increased to 81%. Subgroup analyses revealed that the clinical improvement did not depend on baseline Barthel index, whereas early treatment (within 3 months of stroke onset) was associated with a faster response than late treatment. The median numbers of sessions required to achieve a significant improvement in the early and late treatment groups were 8 and 11, respectively.

Conclusion:

Stroke patients who were going to improve saw a significant improvement in Barthel index by the 16th acupuncture session and the marginal improvement declined substantially afterward. Our approach required minimal data available from the medical records of a non-academic facility, yet practical implication could be achieved.

Trial Registration:

The study was retrospectively registered on 18 August 2017 with the Thai Clinical Trials Registry (ref. TCTR20170822002).
Clostridium perfringens type C necrotic enteritis in pigs: diagnosis, pathogenesis, and prevention
Authors: Posthaus Horst , Kittl Sonja , Tarek Basma , Bruggisser Julia
Published: January 2020

Clostridium perfringens type C causes severe and lethal necrotic enteritis (NE) in newborn piglets. NE is diagnosed through a combination of pathology and bacteriologic investigations. The hallmark lesion of NE is deep, segmental mucosal necrosis with marked hemorrhage of the small intestine. C. perfringens can be isolated from intestinal samples in acute cases but it is more challenging to identify pathogenic strains in subacute-to-chronic cases. Toxinotyping or genotyping is required to differentiate C. perfringens type C from commensal type A strains. Recent research has extended our knowledge about the pathogenesis of the disease, although important aspects remain to be determined. The pathogenesis involves rapid overgrowth of C. perfringens type C in the small intestine, inhibition of beta-toxin (CPB) degradation by trypsin inhibitors in the colostrum of sows, and most likely initial damage to the small intestinal epithelial barrier. CPB itself acts primarily on vascular endothelial cells in the mucosa and can also inhibit platelet function. Prevention of the disease is achieved by immunization of pregnant sows with C. perfringens type C toxoid vaccines, combined with proper sanitation on farms. For the implementation of prevention strategies, it is important to differentiate between disease-free and pathogen-free status of a herd. The latter is more challenging to maintain, given that C. perfringens type C can persist for a long time in the environment and in the intestinal tract of adult animals and thus can be distributed via clinically and bacteriologically inapparent carrier animals.
The Paradox of Consent for Capacity Assessments
Authors: Koch Peter
Published: January 2020

The use of decision-making capacity assessments (DMCA) in clinical medicine is an underdeveloped yet quickly growing practice. Despite the ethical and clinical importance of these assessments as a means of protecting patient autonomy, clinicians, philosophers, and ethicists have identified a number of practical and theoretical hurdles which remain unresolved. One ethically important yet largely unaddressed issue is whether, and to what extent physicians ought to inform and obtain consent from patients prior to initiating a capacity assessment. In what follows, I address the following question: Must, or should, physicians obtain consent for capacity assessments? I argue that physicians have an ethical obligation to obtain express patient consent for capacity assessments, and in doing so, I challenge the predominant view which requires physicians to merely inform patients without obtaining consent. I then identify an underlying philosophical paradox that complicates the clinician's duty to obtain consent: in short, consent is needed for an assessment of one's ability to consent. Finally, I recommend a practical solution to this paradox of consent for capacity assessments by proposing a model of double consent from both the patient and health care representative.
Positive, Negative, and Disorganized Schizotypy Predict Differential Patterns of Interview-Rated Schizophrenia-Spectrum Symptoms and Impairment
Authors: Kemp Kathryn C. , Bathery Alyssa J. , Barrantes-Vidal Neus , Kwapil Thomas R.
Published: January 2020

The present study assessed the construct validity of the Multidimensional Schizotypy Scale (MSS). Specifically, it assessed the associations of the MSS positive, negative, and disorganized schizotypy subscales with interview-rated symptoms and impairment in 177 young adults. As hypothesized, the MSS positive schizotypy subscale was associated with interview-rated positive symptoms, and schizotypal and paranoid personality traits. Negative schizotypy was associated with interview-rated negative symptoms, and schizotypal and schizoid traits, and elevated rates of schizophrenia-spectrum personality disorders. Disorganized schizotypy was associated with disorganized symptoms and attentional deficits. All three subscales were associated with impaired functioning. This was the first study to evaluate the validity of the MSS using interview measures. The findings indicate that the schizotypy dimensions are associated with unique patterns of symptoms and impairment, and support the validity of the MSS.
A passive energy-based method for footstep impact localization, using an underfloor accelerometer sensor network with Kalman filtering
Authors: Alajlouni Sa’ed , Tarazaga Pablo
Published: January 2020

An underfloor accelerometer sensor network can be used to track occupants in an indoor environment using measurements of floor vibration induced by occupant footsteps. To achieve occupant tracking, each footstep impact location must first be estimated. This paper proposes a new energy-based algorithm for footstep impact localization. Compared to existing energy-based algorithms, the new algorithm achieves higher localization accuracy and removes a previously required calibration step (removal of the need to estimate floor-dependent parameters). Furthermore, the algorithm uses a much smaller data sampling rate compared to time of flight/arrival localization methods, which greatly reduces data and data-processing time. The new algorithm is a two-step location estimator: the first step is a coarse location estimate, with the second step as a fine location search through a nonlinear minimization problem. The performance of the proposed algorithm is evaluated using a single occupant walking experiment on an instrumented floor inside an operational smart building. This paper also demonstrates that higher localization accuracy is obtained using an additional Kalman filtering scheme.
Guideline adherence for the management of emergency department patients with febrile neutropenia and no infection source: Is there room for improvement?
Authors: Jansma Brianna , Vakkalanka Priyanka , Talan David A , Negaard Briana , Faine Brett A
Published: January 2020

Introduction

Febrile neutropenia is an oncologic emergency associated with significant morbidity and mortality. The objective of our study was to assess guideline adherence and clinical outcomes associated with the management of high- and low-risk febrile neutropenia patients presenting to the emergency department.

Methods

A retrospective observational cohort study was conducted at a 60,000-visit emergency department at an academically-affiliated tertiary referral hospital. Patients were identified as low- or high-risk using the guideline-recommended Multinational Association for Supportive Care in Cancer score. The primary outcome was the proportion of cases in which the management was concordant with applicable febrile neutropenia guidelines. Guideline adherence was defined as hospital admission and intravenous antimicrobial therapy for high-risk patients and discharge home with oral antimicrobial therapy for low-risk patients. Secondary outcomes included appropriate vancomycin administration, hospital length of stay, rates of acute kidney injury, in-hospital Clostridium difficile infection rates, and 30-day mortality.

Results

Of the 237 patients included, 94 (39.7%) were low-risk patients and 143 (60.3%) were high-risk patients. Guideline adherence occurred in 96.8% of high-risk patients and 0.4% of low-risk patients. Mean hospital length of stay of the low-risk group was 5 ± 5.0 days compared to 7.2 ± 7.3 days in the high-risk group. Vancomycin was often inappropriately given in 69.5% of high-risk patients. Clostridium difficile occurred in 15 (10.3%) adherent and 4 (4.4%) non-adherent patients. By 30 days, 4 (4.3%) low-risk and 15 (10.7%) high-risk patients died.

Conclusion

Adherence to the febrile neutropenia guidelines was low resulting in unnecessary hospital admissions of low-risk patients and frequent over-prescription of empirical vancomycin.
Implementer learning in developmental evaluation: A cultural historical activity theory and expansive learning analysis
Authors: Baldwin Cheryl K.
Published: January 2020

Cultural historical activity and expansive learning theories were employed in a retrospective case study to investigate implementer learning and how knowledge is co-created in the early stage of an inter-agency partnership supported with developmental evaluation. Data collection methods were semi-structured qualitative interviews, evaluator field notes of implementer discursive interactions, evaluator log, and ethnographic program observations. Activity system analyses revealed a primary contraction between organizational independence and interdependence, which inhibited program implementation. Learning as negotiated work with conflicts manifesting from this contradiction evolved implementer perspectives and created a new model of interdependent implementer leadership practice. The mediating role of the developmental evaluator involved both reality testing and serving as a neutral mediating presence that supported implementers importing their resources for problem-solving as expansive learning.
Influence of specimen dimensions and reinforcement corrosion on bond performance of steel bars in concrete
Authors: Zhang Bai , Zhu Hong , Chen Jun , Yang Ou
Published: January 2020

To study the deterioration of bond performance between concrete and corroded steel bars with designed corrosion levels of 0%, 0.5%, 1.0%, 2.0%, 5.0%, 8.0%, and 10.0%, pull-out tests were performed on cube specimens with the dimensions of 10 D × 10 D × 10 D, where D is the diameter of longitudinal rebars ( D = 14, 20, and 25 mm, respectively). The experimental results indicated that with the specimen dimensions increased, the expansive cracks induced by corrosion products appeared earlier and the maximum expansive cracking width was larger at the same corrosion levels. The bond strength and the initial bond stiffness first increased and then dramatically decreased as the concrete deterioration and reinforcement corrosion levels increased for each specimen dimension, whereas the specimens with the larger diameter ( D = 25 mm) were more sensitive to the corrosion than those with the smaller diameter ( D = 14, 20 mm). The free-end slip and the energy dissipation for each specimen dimensions, which decreased slowly with increasing corrosion levels before the corrosion-induced cracks and then weakened rapidly when the corrosion-induced cracks appeared, was almost independent of the influence on corrosion levels after the corrosion-induced cracks appeared. Based on the experimental results, a simplified expression for the calculation of residual bond stress and an empirical model of the bond–slip constitutive equation that considers the influence of reinforcement corrosion were proposed, which can be used in finite element analysis of corroded reinforced concrete.
HoneyDetails: A prototype for ensuring patient’s information privacy and thwarting electronic health record threats based on decoys
Authors: Esther Omolara Abiodun , Jantan Aman , Abiodun Oludare Isaac , Arshad Humaira , Dada Kemi Victoria , Emmanuel Etuh
Published: January 2020

Advancements in electronic health record system allow patients to store and selectively share their medical records as needed with doctors. However, privacy concerns represent one of the major threats facing the electronic health record system. For instance, a cybercriminal may use a brute-force attack to authenticate into a patient’s account to steal the patient’s personal, medical or genetic details. This threat is amplified given that an individual’s genetic content is connected to their family, thus leading to security risks for their family members as well. Several cases of patient’s data theft have been reported where cybercriminals authenticated into the patient’s account, stole the patient’s medical data and assumed the identity of the patients. In some cases, the stolen data were used to access the patient’s accounts on other platforms and in other cases, to make fraudulent health insurance claims. Several measures have been suggested to address the security issues in electronic health record systems. Nevertheless, we emphasize that current measures proffer security in the short-term. This work studies the feasibility of using a decoy-based system named HoneyDetails in the security of the electronic health record system. HoneyDetails will serve fictitious medical data to the adversary during his hacking attempt to steal the patient’s data. However, the adversary will remain oblivious to the deceit due to the realistic structure of the data. Our findings indicate that the proposed system may serve as a potential measure for safeguarding against patient’s information theft.
Influence of sulfating method on La–Ni–S2O82–/ZrO2–Al2O3 solid superacid catalyst for n-pentane isomerization
Authors: Zhao Haiqiang , Song Hua , Zhao Lele , Li Feng
Published: January 2020

La–Ni–S2O82–/ZrO2–Al2O3 catalysts were successfully prepared by two different methods of sulfate impregnation, and the physico-chemical properties of the catalysts were characterized by X-ray diffraction, Brunauer–Emmett–Teller analysis, Fourier transform infrared spectroscopy, pyridine adsorption–infrared spectroscopy, and X-ray photoelectron spectroscopy techniques. Catalytic activities were evaluated in a fixed-bed flow reactor using n-pentane isomerization as the probe reaction. Compared with catalyst La–Ni–S2O82–/ZrO2–Al2O3-I, prepared by the traditional impregnation method, the catalyst La–Ni–S2O82–/ZrO2–Al2O3-W, prepared by the incipient-wetness impregnation method, possessed higher pore volume, pore size, sulfur content, and stronger Brønsted acid sites. The catalytic activity for La–Ni–S2O82–/ZrO2–Al2O3-W was maintained at around 56% within 3000 min with an isopentane selectivity of 88% which showed much greater stability than that of La–Ni–S2O82–/ZrO2–Al2O3-I. This can be attributed to the fact that (1) the large pore size and pore volume of La–Ni–S2O82–/ZrO2–Al2O3-W can largely suppress carbon deposition and (2) the more numerous and stronger Brønsted acid sites for La–Ni–S2O82–/ZrO2–Al2O3-W guaranteed to provide enough acid sites for isomerization during the reaction process.
Replies
Authors: Sangiovanni Andrea
Published: January 2020

In this article, I reply to Giacomo Floris, Adam Etinson, Daniel Corrigan, Luise Müller and Johannes Haaf.
An Approach to Adapting a Community-Based Cancer Control Intervention to Organizational Context
Authors: Knott Cheryl L. , Bowie Janice , Mullins C. Daniel , Santos Sherie Lou Zara , Slade Jimmie , Rosenberg Elizabeth , Woodard Nathaniel , Williams Ralph , Williams Randi M.
Published: January 2020

There has been increasing attention in implementation science to optimizing the fit of evidence-based interventions to the organizational settings where they are delivered. However, less is known about how to maximize intervention–context fit, particularly in community-based settings. We describe a new strategy to customize evidence-based health promotion interventions to community sites. Specifically, leaders in African American churches completed a memorandum of understanding where they were asked to identify two or more health promotion implementation strategies from a menu of 20 and select a planned implementation time frame for each. In a pilot phase with three churches, the menu-based strategy and protocols were successfully implemented and finalized in preparation for a subsequent randomized trial. The three pilot churches identified between two and nine strategies (e.g., form a health ministry, allocate space or budget for health activities, include health in church communications/sermons). The selected strategies varied widely, reinforcing the need for interventions that can be customized to fit the organizational context. Despite the challenges of integrating health promotion activities into non–health focused organizations, this approach has promise for fostering sustainable health activities in community settings.
Reliability design of relief groove for torque shaft of shearer
Authors: Gao Hongbin , Zhang Qianqian
Published: January 2020

On cutting coal, the cutting resistance of a shearer may change suddenly due to uneven coal quality. It can lead to sudden acceleration of the cutting motor, deceleration, overload shutdown, and even burnout of the motor. We studied the dynamic, static, and working characteristics of the torque shaft of a typical shearer to ensure that the torque shaft of the cutting unit can transfer the torque from the cutting motor to the gear reducer in the rocker under rated conditions and be turned off immediately to protect the motor in case of overload. A method of radial size design of the relief groove of torque shaft based on combining positive, reverse reliability with unloading coefficient has been presented, and the flow chart using this design method has been provided. The positive and reverse reliability torsional test of strength of the experimental torque shafts without relief grooves using three different materials and the measurement test of unloading coefficient of various types of relief grooves were performed. The experimental results obtained through our investigation achieve and even surpass the design purpose. More importantly, to serve the industry it is designed for, the torque shaft designed using this method has high reliability.