bluuebunny/crossref_metadata_2025 huggingface dataset:
Net Interest Margins of Banks in India
Authors: Barik S. S. , Raje Nishita
Published: March 2019

Net interest margin (NIM) is the raison d’être of banking. It is an important measure of efficacy of the banking sector. At the system level, it is indicative of the cost of financial intermediation, health of the banking sector and its pricing power. In recent years, the Indian banking sector has experienced a major metamorphosis, with increasing competition and changing norms of liquidity, income recognition and capital. The end of regulatory forbearance and asset quality review (AQR) unearthed significant non-performing assets. This article traces the influence of various factors on the NIM, using bank-level data for 42 Indian banks over 25 quarters from March 2011 to March 2017. The study employs a dynamic panel generalised method of moments (GMM) framework to trace the impact of three distinct set of factors in setting banks’ NIMs: bank-level factors (like the share of low interest-bearing deposits held, the extent of gross non-performing assets [GNPAs], the capital-to-risk weighted assets ratio [CRAR], size of the loan book, operating costs and lending rates); system-level factors such as the monetary policy rate, credit growth and yields on government securities and macro-variables such as GDP growth and inflation. The results indicate that the main determinants of NIMs are banks’ CRAR levels, the proportion of current account and savings account deposits (CASA) to total deposits, operating costs and size of the loan book. Macro-factors like the growth of the economy and repo rate have a positive influence on the NIM.

JEL Classification: C23, E43, G21
Gender Responsive Budgeting for Indian Cities: The Case of Bhopal and Pune
Authors: Mahadevia Darshini , Bhatia Neha , Sebastian Ritika
Published: March 2019

Women contribute significantly to the prosperity of cities through their paid and unpaid labour. However, limited or lack of access to essential infrastructure services such as water and sanitation, restricted mobility, tenure security and so on increase their burden of unpaid care work, thereby aggravating gender-based disadvantage and resulting in ‘time poverty’, which is largely overlooked by policymakers. This article assesses whether metropolitan cities of India, Bhopal and Pune have integrated a gendered perspective in their development using the gender responsive budgeting (GRB) tool from the expenditure side. Using Maxine Molyneux’s conceptualization of ‘strategic gender needs’ and ‘practical gender needs’, the article develops gender-sensitive indicators to assess progress on four categories of urban infrastructure: water supply, sanitation, housing and public transport. It then uses the benefit incidence analysis (BIA) of public expenditure tool to arrive at expenditure benefits reaching women in both cities. This article is as much a methodological contribution as budget analysis.
“We Cannot Let Them Die”: Undocumented Immigrants and Media Framing of Health Deservingness in the United States
Authors: Viladrich Anahí
Published: March 2019

Based on a systematic qualitative analysis of articles published by The New York Times (2009–2017), this article presents the main media frames that support the access to government-sponsored health care by undocumented immigrants, just before and after passage of the U.S. Affordable Care Act in 2010. Under the umbrella of “selective inclusion,” this study highlights a “compassionate frame” that conveys sympathy toward severely ill, undocumented immigrants. This approach is reinforced by a “cost-control” frame that underlines the economic benefits of providing health care to the undocumented immigrant population in the United States. Supported by both humane and market-based approaches, these frames make a compelling case for the inclusion of particular groups into the U.S. health care safety net. Ultimately, these findings contribute to our understanding of the media framing of undocumented immigrants’ right to health care on the basis of deservingness.
A Strategy to Support the Communication of Students With Autism Spectrum Disorder
Authors: Douglas Sarah N. , Gerde Hope K.
Published: March 2019

Communication is an essential skill that develops in early childhood and links to later academic and social success. However, some children, such as those with autism spectrum disorder (ASD), struggle to develop sufficient social communication skills and may require speech language therapy and targeted support from educators to achieve functional communication. Unfortunately, educators, including teachers and paraeducators, may have limited knowledge and skills to best support the social communication needs of students with ASD. Therefore, this article introduces a research-based strategy, POWR: Prepare, Offer, Wait, and Respond, that can be used by educators and peers to effectively enhance the social communication development of students with ASD. Research support and detailed guidelines regarding how communication partners (e.g., teachers, paraeducators, peers) can implement the POWR strategy are included.
Risky Business? The Value of Employing Offenders and Ex-Offenders: An Interview With James Timpson, Chief Executive of Timpson
Authors: Pandeli Jenna , O’Regan Nicholas
Published: March 2019

This interview with James Timpson, Chief Executive of Timpson retailers, explores his innovative approach to recruitment and empowerment in the workplace. James Timpson is passionate about the employment of ex-offenders, working closely with the prison service in the United Kingdom and creating a workplace that invests in its employees. This interview offers some interesting insights into how organizations can contribute positively to society and engage seriously with improving our communities. Drawing on James’s insights, we provide a commentary on the impact that James’s work can have on ex-offenders in terms of reducing reoffending and improving the lives of a vulnerable group of people through creating a workplace culture that emphasizes empowerment. James shows how organizations can support ex-offenders and simultaneously ensure the success of the company. In fact, he shows how these two things can go hand in hand.
Baricitinib: The Second FDA-Approved JAK Inhibitor for the Treatment of Rheumatoid Arthritis
Authors: Mogul Amanda , Corsi Katherine , McAuliffe Laura
Published: March 2019

Objective: To review the pharmacology, pharmacokinetics, safety, and efficacy of baricitinib, a recently approved selective Janus Kinase (JAK) inhibitor for the treatment of rheumatoid arthritis (RA), and explore its potential role in therapy. Data Sources: Articles were identified using a PubMed search from inception through January 2019 using the terms rheumatoid arthritis, Olumiant, baricitinib, and LY3009104, its molecular name. Study Selection and Data Extraction: Articles relating to randomized clinical trials, pharmacology, pharmacokinetics, efficacy, and safety of baricitinib were evaluated. Data Synthesis: Baricitinib exerts its effects by inhibiting JAK1 and JAK2 enzymes, targeting cytokine and growth factor receptor stimulation, thus reducing downstream immune cell function. Four trials have demonstrated the efficacy of baricitinib with or without methotrexate in patients naïve to disease-modifying antirheumatic drugs (DMARDs) and those who had an inadequate response to or intolerance to both conventional and biological DMARDs. Furthermore, baricitinib was associated with delayed radiographic progression. Despite baricitinib 4 mg often demonstrating greater efficacy compared with the 2 mg dose, only the 2 mg dose is Food and Drug Administration approved because of safety concerns with the 4 mg dose, primarily thromboembolism. Relevance to Patient Care and Clinical Practice: Baricitinib provides an oral treatment option for patients failing tumor necrosis factor inhibitors (TNFis). Safety, cost, and comparative effectiveness to tofacitinib should be considered prior to prescribing baricitinib. Conclusion: Baricitinib is the second medication in its class and has been proven efficacious for the treatment of RA. Given concerns for adverse effects associated with baricitinib, it should be reserved for patients who have failed one or more TNFis.
Intratubular Teratoma: A Rare Form of Testicular Germ Cell Neoplasia
Authors: Genco Iskender Sinan , Ratzon Fanni , Glickman Leonard , Santagada Eugene , Unger Pamela
Published: March 2019

Germ cell neoplasia in situ is the initial manifestation for invasive germ cell tumor. Further progression will result in intratubular germ cell tumor with the majority being intratubular seminoma or intratubular embryonal carcinoma. Intratubular teratoma in the testis is exceptionally rare with no well-documented cases to our knowledge. In this article, we report a case of an intratubular teratoma adjacent to mixed germ cell tumor in the testis. The patient is a 34-year-old male who presented with a palpable right testicular mass and underwent right radical orchiectomy. Gross examination of the testis revealed 2.0-cm tan, well-circumscribed, firm, and nodular mass at the inferior pole. Microscopic examination revealed a mixed germ cell tumor, predominantly seminoma (95%) with embryonal carcinoma (4%) and teratoma (1%). There is also germ cell neoplasia in situ, intratubular seminoma, and intratubular teratoma at the periphery of the tumor. Tubules with intratubular teratoma were filled by neoplastic squamous cells with a single layer of germ cell neoplasia in situ at the periphery. Adjacent to the intratubular teratoma was seminoma, embryonal carcinoma, and invasive teratoma. Immunohistochemical stains showed the neoplastic squamous cells in the tubule to be positive for p40 and negative for OCT34 and D2-40. The single layer of germ cell neoplasia in situ at the periphery of the intratubular teratoma was negative for p40 and positive for OCT34 and D2-40. Although teratoma is a common component in an adult germ cell tumor, an intratubular manifestation is exceptional. The present case illustrates this rare finding.
Governing the New Geography of Poverty in Metropolitan America
Authors: Mattiuzzi Elizabeth , Weir Margaret
Published: March 2019

This article contributes to the research on the new geography of poverty by examining how low-income residents fit into the governmental patchwork that defines metropolitan America. Our analysis pays particular attention to two features of local governments: their size and their status as incorporated municipalities or unincorporated areas. Relying on Census data, we study these patterns for the five largest metropolitan areas in each of the five Census-designated regions of the country (25 metros total) from 1990 to 2012–2016. We show that the distribution of poor people across jurisdiction types, and their concentration in particular jurisdictions or places, has changed over time. In the older metros of the Northeast and Midwest, poverty grew in smaller secondary cities while it expanded in unincorporated areas in the South and in larger secondary cities in the West. We conclude with a discussion of the implications of these shifts for studying local governance and poverty.
The effects of surface elasticity on the thermal stress around a circular nano-hole in a thermoelectric material
Authors: Song Kun , Song Hao-Peng , Schiavone Peter , Gao Cun-Fa
Published: March 2019

We analyze the contribution of surface elasticity and electric current density on the thermal stress distribution around a circular nano-hole in a thermoelectric material. Using complex variable methods, we obtain closed-form solutions describing the corresponding thermoelastic fields in the vicinity of the nano-hole. Our results indicate that the effect of surface elasticity is to generate significant normal and shear stresses on the boundary of the hole, allowing for the ability to either suppress or enhance hoop stress depending on the sign of the corresponding surface material constant. In addition, we find that positive hoop stress generated on the boundary by the remote electric current density can be neutralized by the incorporation of positive surface elasticity. In the case of the remaining boundary stress components, both surface elasticity and electric current density are found to enhance normal stress, while the maximum shear stress depends largely on the contribution of surface elasticity.
Factors Associated With High Blood Lead Levels in a Sample of 100 Children in Tehran
Authors: Zamani Nasim , Gholami Narges , Hassanian-Moghaddam Hossein , Farnaghi Fariba , Gachkar Latif
Published: March 2019

Background:

Lead is considered a neurotoxic agent. We aimed to evaluate the blood lead level (BLL) in young population and determine probable risk factors of lead exposure in Iran.

Methods:

In a cross-sectional study, a total of 100 children were entered and their BLLs were checked.

Results:

In all, 25 and 8 patients had BLLs above 5 and 10 µg/dL, respectively. There was a significant univariate correlation between BLL and place of living, water pipe type, using dairy products, and stature in both cut-offs of 5 and 10 µg/dL. Binary regression analysis showed that pipe type was associated with high BLLs at cut-offs of 5 and 10 µg/dL, respectively. Also, there was an association between 50th percentile of stature for age and cut-off of 5 µg/dL.

Conclusions:

Higher BLLs may be seen in short stature pediatric population. Polyvinyl chloride (PVC) and polypropylene water pipes may even cause more release of lead and result in higher absorption of this metal in the pediatric population.
The entrapment of trap design: Materiality, political economy and the shifting worlds of fixed gear fishing equipment
Authors: Swanson Heather Anne
Published: March 2019

Anthropologists have often focused on what one can read about the worlds of hunters and prey from the forms of traps. This article demonstrates, however, that a trap’s design is not always tightly coupled to the worlds within which it is deployed. Using the case of Columbia River salmon traps, it shows how the social, economic and ecological roles of traps can dramatically change – even as their physical shape remains the same. In the late 19th century, these traps were lucrative for their owners, but unpopular with the region’s gillnet fishermen. The fishermen feared that traps entrapped the community in a problematic form of political economy – that they created the wrong kind of subjects and social order, concentrating wealth in the hands of a small, lazy owner class. The fishermen argued that such problems inhered in the materiality of the traps and that their physical design produced inequality that jeapordized the community. The gillnetters ultimately won over the government with their arguments, and fish traps were banned. But the banning of traps has subsequently proved entrapping. Today, some of the river’s salmon are listed as endangered species. Gillnets, which often kill fish before they are hauled in, do not allow fishermen to sort out endangered and unendangered fish; they are thus being phased out. Traps that keep fish alive in their holds would allow for sorting out and releasing endangered fish, and they are now heralded as an environmentally sustainable technology by conservationists. But after decades of arguments that traps embody and create unjust economic forms, it is logistically and socially difficult to bring back traps. Based on this example, this article proposes an approach to traps that gives special attention to how the material force of traps shifts as they are linked to different ecological contexts and practices of political economy.
Community leaders' attitudes towards and perceptions of suicide and suicide prevention in Ghana
Authors: Osafo Joseph , Akotia Charity S. , Quarshie Emmanuel Nii-Boye , Andoh-Arthur Johnny , Boakye Kofi E.
Published: March 2019

Community leaders can play an important role in suicide prevention because they are potential gatekeepers in resource-poor settings. To investigate their attitudes towards suicide and the role they play when people are in suicidal crisis, 10 community leaders were interviewed in a rural community in Ghana. Thematic Analysis of the interviews showed that leaders held two conflicting views about suicide: health crisis and moral taboo. They also viewed the reasons for suicide as psychosocial strains more than psychiatric factors. Though they viewed suicide as a moral taboo, they maintained a more neutral position in their gatekeeping role: providing support for persons in suicidal crisis more often than exerting a condemnatory attitude. Implications for gatekeeper training are discussed.
Evaluation of the acceptability and clinical utility of an Arabic-language mindfulness CD in an Australian community setting
Authors: Blignault Ilse , Saab Hend , Woodland Lisa , Comino Elizabeth
Published: March 2019

The cultural, linguistic, and religious diversity of Australia's population presents challenges for mental health service delivery. Arabic-speaking communities in Australia underutilise mental health services despite high levels of trauma and psychological distress. Clinicians who work with this population lack linguistically and culturally appropriate clinical resources. The aim of this study was to explore the acceptability and clinical utility of a Mindfulness Skills CD translated into formal Arabic. The 70 participants were Arabic-speaking adults, mostly Lebanese-born Muslim women, who enrolled in a 5-week mindfulness program using the CD and agreed to follow-up at 12 weeks. Both recruitment and data collection were undertaken by a female project officer who is a widely respected member of the Arabic community in south-east Sydney. Compliance with the program protocol was high and all but 4 participants continued to use the CD beyond the 5 weeks. Overall, participants reported that mindfulness techniques fitted well with their way of life and were compatible with their cultural and religious practices. Most found mindfulness complementary to their regular reflective prayer. Using the Mindfulness Skills CD was associated with statistically significant reductions in psychological distress as measured by the Kessler Scale (K10) and the Depression, Anxiety, and Stress Scale (DASS21) postprogram (K10; DASS21 Depression and Stress subscales) and at follow-up (all measures). The evaluation showed that the Arabic Mindfulness Skills CD is an effective and culturally appropriate mental health resource for this population group. This low-cost, easily distributed resource is suitable for use in individual self-management and as an adjunct to primary and specialist mental health care.
The whiteness of lighting and colour preference, Part 2: A meta-analysis of psychophysical data
Authors: Huang Z , Liu Q , Luo MR , Pointer MR , Wu B , Liu A
Published: March 2019

In this work, the correlation between the perceived whiteness of lighting and the corresponding colour preference of observers was comprehensively investigated based on the data of 19 groups of experiments collected from 14 studies. The dataset included 13 experiments with constant correlated colour temperature and 6 experiments with multiple correlated colour temperatures, with illuminance levels ranging from 200 lx to 500 lx. For the five studies implemented by the authors, the subjective ratings of colour preference and the whiteness of lighting were acquired. For other cases, only the preference ratings were collected while the whiteness of lighting was quantified by a measure named degree of neutrality ( Sneutral), which has been validated in our previous work. The meta-analysis results confirm our former statement that people prefer whiter illumination and further specify its prerequisite. That is, the whiteness of lighting generally correlates well with colour preference under the conditions where the candidate lights differed to a certain extent in white. In addition, it was further demonstrated that for the scenarios with multiple correlated colour temperatures ranging from 2500 K to 5500 K people indeed preferred perceptually whiter light chromaticities, while for correlated colour temperatures higher than 5500 K it seemed that they appeared too cold to be preferred.
Multi-attribute decision-making method based on Taylor expansion
Authors: Sun Peng , Yang Jiawei , Zhi Yongfeng
Published: March 2019

Determining attribute weights is an indispensable step in multi-attribute decision-making problems, and it is also a top priority in the study of multi-attribute decision-making problems. Existing methods for determining attribute weights do not completely and effectively reflect the decision-maker’s dependency preferences, which will result in unreasonable ranking results for decision-makers. To solve this problem, this article proposes a feature-weighted multi-attribute decision-making method based on Taylor expansion. The method uses the natural base and the eigenvalues of the matrix to construct the feature-weighted coefficients and weights; normalizes all the feature vectors of the matrix; and constructs a new weight vector. Combined with the example to analyze and verify, the method makes reasonable use of all decision information, which saves the decision time of decision-makers.
The impact of randomized trial results on abdominal aortic aneurysm repair rates from 2003 to 2016: A population-based time-series analysis
Authors: Salata Konrad , Hussain Mohamad A , Mestral Charles de , Greco Elisa , Mamdani Muhammad , Tu Jack V , Forbes Thomas L , Bhatt Deepak L , Verma Subodh , Al-Omran Mohammed
Published: March 2019

Objectives

The uptake of endovascular aortic repair for elective and ruptured abdominal aortic aneurysm repair is not well studied. We aimed to examine the trends in open surgical repair and endovascular aortic repair of eAAA and rAAA and to examine the effects of randomized trial publications on elective open surgical repair and endovascular aortic repair rates.

Methods

We conducted a population-based time-series analysis of eAAA and rAAA repairs in Ontario, Canada from 2003 to 2016. We examined changes in overall and approach-specific rates of eAAA and rAAA repair using exponential smoothing models. Interventional autoregressive integrated moving average models were fit to the eAAA rates to examine the impact of randomized trial results on these rates.

Results

We identified 19,489 eAAA (12,232 open (63%) and 7257 endovascular (37%)) and 2732 rAAA (2466 open (90%) and 266 endovascular (10%)) repairs from 2003 to 2016. The rate of eAAA repair declined from 6.39/100,000 in 2003 to 5.59/100,000 in 2016 (13% decrease, p = 0.17). The rate of elective open surgical repair decreased nearly three-fold from 6.07/100,000 to 2.12/100,000 ( p < 0.0001), while elective endovascular aortic repair increased approximately 10-fold (0.32/100,000 to 3.47/100,000, p < 0.0001). The rate of ruptured open surgical repair decreased from 1.62/100,000 to 0.37/100,000 ( p < 0.44), while ruptured endovascular aortic repair uptake increased (0.00/100,000 to 0.12/100,000, p < 0.25). The mid-term results of the DREAM and EVAR-1 trials were associated with a decrease in the rate of elective open surgical repair decline after 2010 ( p = 0.01).

Conclusions

While elective open surgical repair use has significantly decreased from 2003 to 2016, elective endovascular aortic repair use has significantly increased. The DREAM and EVAR-1 results significantly impacted the observed rates of elective open surgical repair only. The reasons for these trends require further characterization.
Global fast terminal sliding mode control based on radial basis function neural network for course keeping of unmanned surface vehicle
Authors: Wan Lili , Su Yixin , Zhang Huajun , Tang Yongchuan , Shi Binghua
Published: March 2019

A scheme to solve the course keeping problem of the unmanned surface vehicle with nonlinear and uncertain characteristics and unknown external disturbances is investigated in this article. The chattering existing in global fast terminal sliding mode controller in solving the course keeping problem of the unmanned surface vehicle with external disturbance is analyzed. To reduce the chattering and eliminate the influence of the unknown disturbance, an adaptive global fast terminal sliding mode controller based on radial basis function neural network is developed. The equivalent control that usually requires a precise model information of the system is computed using the radial basis function neural network. The weights of the neural network are online adjusted according to the adaptive law that is derived using Lyapunov method to ensure the stability of the closed-loop system. Using the online learning of the neural network, the nonlinear uncertainty of the system and the unknown disturbance of external environment are compensated, and the system chattering is reduced effectively as well. The simulation results demonstrate that the proposed controller can achieve a good performance regarding the fast response and smooth control.
Primary school principals in Ethiopia: Selection and preparation
Authors: Gurmu Tesfaye Gemechu
Published: March 2019

The study is an explanatory qualitative research that seeks to investigate the processes of Ethiopian primary school principals’ selection and training for professionalising principals. The participants are seven faculty members, 11 school principals and five education officials. Data are collected through semi-structured interview, focus group discussion and document analysis that are analysed thematically. Findings of the study show that the denial of principalship to professional graduates and political affiliation lens are scenarios that inform principals’ selection for leadership positions. Selection criteria that give emphasis to university degree Grade Point Average (GPA), teaching experience and performance are deciding who is selected for postgraduate diploma in school leadership (PGDSL) training. These indicate the gap the selection processes have in selecting competent leaders for the training. The study also shows that the duration of the primary school principals’ training is short. Its curriculum lacks depth and breadth. Albeit the training helps trainees to be familiarised with school leading, it is deficient in informing principalship professionalisation. The Ministry of Education, therefore, needs to revisit the selection and training processes so that proper criteria and procedures, inform the selection and training of competent professionals needed in the area.
Thickening of the axillary recess capsule on ultrasound correlates with magnetic resonance imaging signs of adhesive capsulitis
Authors: Sernik Renato A , Vidal Leão Renata , Luis Bizetto Eduardo , Sanford Damasceno Rodrigo , Horvat Natally , Guido Cerri Giovanni
Published: March 2019

Objective

To correlate the thickness of the axillary recess capsule measured by ultrasound with magnetic resonance imaging signs of adhesive capsulitis in patients with shoulder pain.

Materials and methods

We prospectively evaluated 193 consecutive patients (141 women and 52 men, aged 40–69 years) with shoulder pain lasting 1–9 months from January 2015 to December 2016 who underwent shoulder ultrasound. All participants had routine shoulder ultrasound with additional measurement of axillary recess capsule thickness. After examinations, two groups were formed: negative ultrasound group, composed of patients with a capsule thickness of 2.0 mm or less, and positive ultrasound group, composed of individuals with a capsule thickness greater than 2.0 mm. All patients from the positive ultrasound group and 27 randomly chosen patients from the negative ultrasound group underwent shoulder magnetic resonance imaging.

Results

In all, 169/193 patients (88%) had an axillary recess capsule thickness of 2.0 mm or less (negative ultrasound group) and 24/193 patients (12%) had a capsule thickness greater than 2.0 mm (positive ultrasound group). Twenty-seven patients from negative ultrasound group (27/169) were randomly selected to undergo shoulder magnetic resonance imaging. None of them had magnetic resonance imaging criteria for adhesive capsulitis. All patients from positive ultrasound group (24/24) underwent shoulder magnetic resonance imaging and 23 of them (23/24) had magnetic resonance imaging signs of adhesive capsulitis, with a sensitivity of 100% and a specificity of 96%.

Conclusion

In patients with shoulder pain, a thickness greater than 2.0 mm of the axillary recess capsule measured by ultrasound correlates to magnetic resonance imaging signs of adhesive capsulitis with good sensitivity and specificity.
A case of multi-organ failure due to hyperparathyroidism-related hypercalcaemia
Authors: Cummings Daniel , Vannahme Milena , Stanworth Helen
Published: March 2019

Albeit still rare, hypercalcaemia has been linked to pulmonary oedema in solid organ malignancy and chronic renal failure. However to date, there is only one case report linking pulmonary oedema to hypercalcaemia secondary to primary hyperparathyroidism.

Case presentation

A 60-year-old male presented to the emergency department with a history of confusion and collapse. Investigations revealed initial serum calcium of over 5 mmol/L. He subsequently developed widespread bilateral chest infiltrates with increasing oxygen requirements and an acute kidney injury. On day 9, continuous haemodiafiltration was commenced; however, hypercalcaemia proved resistant to maximal therapy. His initial parathyroid hormone (PTH) level measured 371 ng/L, and an ultrasound of his neck revealed a 2 × 2.5 cm parathyroid mass in the inferior neck. An acute parathyroidectomy was performed following which his chest infiltrates resolved and serum calcium levels returned to within normal range.

Conclusions

This case highlights primary hyperparathyroidism and the resulting hypercalcaemia as a sole cause for multi-organ failure in an otherwise well patient.
Pronator quadratus pedicled bone graft in the treatment of Kienböck disease: follow-up 2 to 12 years
Authors: Shin Young Ho , Yoon Jun O , Ryu Jae Jung , Lee Tae Kyoon , Choi Shin Woo , Kim Jae Kwang
Published: March 2019

We inserted a pronator quadratus pedicled bone graft into the avascular lunate with preservation of its corticocartilaginous portion for the treatment of Kienböck disease. Twenty-seven patients (14 men, 13 women; mean age, 42 years (range 17–66 years)) were treated between September 2005 and July 2014 and followed up from 2 to 12 years. Three patients had Lichtman stage II disease, 13 had stage IIIA, and 11 had stage IIIB. Among them, 18 patients showed radiological improvement in lunate morphology. The Lichtman stage was unchanged in 23 patients and aggravated in four patients. The Stahl index was significantly decreased, but grip strength was significantly improved and 18 patients did not have any wrist pain during daily activities. Although our technique did not restore the already changed carpal malalignment, it improved lunate morphology. Clinically, it provided satisfactory pain levels in two-thirds of the patients and grip strength was improved.

Level of evidence: IV
Eplerenone as a treatment for resistant hypertension in pregnancy
Authors: Gehlert Jessica , Morton Adam
Published: March 2019

Mineralocorticoid receptor antagonists are highly effective in the management of resistant hypertension and primary hyperaldosteronism. Recent studies demonstrate that mineralocorticoid receptor antagonists significantly reduce blood pressure, severity of obstructive sleep apnoea and arterial stiffness in patients with resistant hypertension and moderate–severe obstructive sleep apnoea. Eplerenone is a selective mineralocorticoid receptor antagonist that does not act as an androgen receptor blocker, thus reducing the risk of fetal anti-androgenic effects. Rat and rabbit studies demonstrated that when exposed to 30 times the equivalent therapeutic human dose, 100 mg/day, there were no teratogenic or demasculinisation effects. To date, the use of eplerenone has been reported in six human pregnancies in women with Gitelman syndrome, primary hyperaldosteronism and cardiac failure, in which no teratogenic effects were seen. Described here is a case of resistant hypertension associated with obstructive sleep apnoea in pregnancy, treated with eplerenone. The potential role of using eplerenone in pregnancy as treatment for resistant hypertension is discussed.

Trial registration: Not applicable.
Contemporary considerations for the use of cardiovascular magnetic resonance imaging during pregnancy
Authors: Ducas Robin , Nguyen Elsie T , Wald Rachel M
Published: March 2019

Cardiovascular imaging during pregnancy is frequently used to help direct diagnosis and management for women with known or suspected cardiac disease. Although echocardiography is the most commonly used imaging modality in pregnancy, cardiovascular magnetic resonance imaging is an important and increasingly used tool, which can provide complementary, and oftentimes incremental, information regarding cardiovascular anatomy, ventricular function, and vascular flows. Advantages of cardiovascular magnetic resonance imaging over echocardiography and other imaging techniques include superior reproducibility, excellent cross-sectional evaluation of cardiac structures, high spatial resolution, and lack of ionizing radiation (a limitation of computed tomography and conventional catheter-based angiography). Cardiovascular magnetic resonance imaging in the absence of gadolinium-based contrast agents poses no known risk to the mother or fetus and its applications in pregnancy are expanding. Clinicians should be familiar with the role of cardiovascular magnetic resonance imaging in pregnancy to optimize and enhance care for mothers with heart disease.
Head injuries
Authors: Getty Joshua , Atesli Zeki
Published: March 2019

Head injuries are a common presenting complaint in primary and secondary care and vary in severity. Head injuries can cause life-threatening intracranial bleeding, skull and cervical spine fractures, symptoms of concussion and minor abrasions. Appropriate assessment of head injuries, including indications for radiological imaging and admission, is important for GPs whether working in urgent care or community settings. This article aims to review evidence and guidance for healthcare professionals assessing and managing head injuries and their sequelae.
The Smartphone as the “Weapon of the Weak”: Assessing the Role of Communication Technologies in Malaysia's Regime Change
Authors: Tapsell Ross
Published: March 2019

This paper examines the role of new communication technologies in the regime change of Malaysia's 2018 elections. I argue that growing Internet penetration in semi-rural areas of Malaysia's Peninsula “heartlands” allow for new forms of campaign message to be spread in unique and compelling ways. Facebook and instant-messenger platform WhatsApp are playing a prominent role in shaping political discourse in contemporary Malaysia, and this was evident in the election campaign that brought an end to Malaysia's ruling coalition, the Barisan Nasional's, 60-year hold on power. In this article I use James Scott's (1987) Weapons of the Weak as the theoretical foundation for assessing the role of WhatsApp and other social media sites as tools of resistance, specifically in spreading information about the corruption and nepotism of Prime Minister Najib Razak and his wife, Rosmah Mansour. Given the prominence of the smartphone for news and information in Southeast Asia, this article explains how the digital era is changing the avenues via which the region receives and shares political information – as well as outlines the consequences that it brings for elections campaigns and democracy.
Triple Duel: The Impact of Coalition Fragmentation and Three-Corner Fights on the 2018 Malaysian Election
Authors: Ostwald Kai , Schuler Paul , Chong Jie Ming
Published: March 2019

Malaysia's previously hegemonic Barisan Nasional (BN) government was unexpectedly defeated in the 2018 general election despite a fragmented opposition and widespread three-corner fights that theory states should inhibit turnover. Why? We argue that the opposition-split hypothesis rests on three core assumptions: third parties split only the anti-incumbent vote; coalition/party support is relatively uniform across the country; and opposition parties are not “elite splits” in disguise. The Malaysian context challenges all three of these assumptions. Counterfactual election simulations ultimately suggest that the opposition split neither dramatically helped nor hurt the BN. While this does not upend conventional wisdom on opposition coordination, it does demonstrate that the theory manifests only when its assumptions accord with local realities. More substantively, our analysis also provides insights into why the new opposition will likely seek to increase the salience of ethno-religious issues in a bid to recapture electoral ground.
The 14th General Election, the Fall of Barisan Nasional, and Political Development in Malaysia, 1957-2018
Authors: Nadzri Muhamad M. N.
Published: March 2019

The results of the recent 2018 general election (GE14) in Malaysia were exceptional. The ruling party – Barisan Nasional (BN) – was ousted from power after over six decades of authoritarian rule, by a new opposition coalition – the Pakatan Harapan (PH). In this historic election, BN lost all the federal states in Peninsular Malaysia except for the two less developed ones of Perlis and Pahang. BN was also defeated in Sabah for the second time since its dramatic recapture in 1995. However, these results are not as surprising if one looks at the outcome from its historical and developmental perspectives. The indication of the breakdown of the one-party dominant state of Malaysia can (at least) be traced back to 10 years ago – since the 2008 general election (GE12). BN then lost several parliamentary seats in the urban centres, even with a less unified opposition. It had also lost four states on the west coast of Peninsular Malaysia, and had been fairly incompetent in reclaiming control over Selangor and Penang since that particular election. Five years later, in the 2013 general election (GE13), the results aggravated BN. It had lost its popular votes to the then opposition coalition – the Pakatan Rakyat (PR). The main objectives of this article, therefore, are twofold. First, it intends to shed light on the recent general elections through historical and developmental approaches by linking them to the electoral results, and political development in Malaysia, respective to GE12 and GE13. Second, it strives to make available for analysis the arguments on how the opposition pact managed to unseat BN in GE14. The analysis in this article is based on the data gathered by the author through a mixture of media studies, library research, and direct observation – as this author was one of the official observers appointed by the Election Commission of Malaysia for GE14. The main argument of this article on the breakthrough of PH to the federal government is that the opposition managed to reshape the multiparty electoral system to a “two-plus-one party system” from late 2016, which boosted the level of political competition between the two main parties in Malaysia – namely, BN and PH – in GE14. Four major factors have been identified as constituting the triumph of PH and the fall of BN in the election. These are: the existence of a credible representative and strong opposition, with the inclusion of Mahathir and two Malay/ Bumiputra (“the natives”) political parties; the rupture of the elites within the ruling regime; the presence of impactful issues surrounding Najib's administration; and, the advancement of information and communications technology as well as its impact on the emergence of a digital and much more participative society in Malaysia.
Alkamides from Piper nigrum L. and Their Inhibitory Activity against Human Liver Microsomal Cytochrome P450 2D6 (CYP2D6)
Authors: Subehan  , Usia Tepy , Kadota Shigetoshi , Tezuka Yasuhiro
Published: March 2019

Drug–herb interaction through inhibition of cytochrome P450 alters the pharmacological response and/or toxicities of drug used concomitantly. In our screening, Piper nigrum L. was observed to inhibit cytochrome P450 2D6 (CYP2D6) in human liver microsomes. Thus, the MeOH extract of this plant was investigated for their chemical constituents and 19 alkamides including a new pipercyclobutanamide were isolated. Their structures were elucidated on the basis of spectroscopic analyses. The isolated compounds were tested for their inhibition on human liver microsomal dextromethorphan O-demethylation activity, a selective marker for CYP2D6, and pipercyclobutanamide A (17) showed the most potent inhibition with an IC50 value of 0.34 μM. The result demonstrated the potential of drug–alkamides interaction on concomitant consume of white pepper with the drugs being metabolized by CYP2D6.
Anticoagulant effect and Constituents of Baccharis illinita
Authors: Pizzolatti Moacir Geraldo , Verdi Luiz Gonzaga , Brighente Inês Maria C. , Neiva Terezinha de Jesus C. , Schripsema Jan , Filho Raimundo Braz
Published: March 2019

Chemical investigation of ethanolic extracts of the leaves and stems of Baccharis illinita resulted in the isolation and identification of retusin, quercetin-3, 7, 4′-trimethyl ether, aromadendrin-7-methyl ether, 3-(4-hydroxyphenyl)-2-propenoic acid ( E and Z) hexacosyl ester, 3-(3, 4-dihydroxyphenyl)-2-propenoic acid ( E) hexacosyl ester and hexacosanoyl acid acetyl ester (all new for this genus), together with apigenin-7, 4′-dimethyl ether, kaempferol-3, 7, 4′-trimethyl ether, kaempferol-7,4′-dimethyl ether, p-coumaric acid, hexacosanol, and stigmasta-5, 22-dien-3-ol (3β, 22 E, 24 S) hexadecanoyl. Their structures were assigned by comparison of the obtained spectroscopic data with those in the literature. Extracts of the flowers, roots and stems demonstrated marked anticoagulant activity, but only the extract of the stems had any significant effect on platelet aggregation.
Two New Dibenzylbutyrolactone Type Lignans from the Stems of Kadsura heteroclita
Authors: Wang Wei , Ma Xiaochi , Liu Peng , Liu Rongxia , Guan Shuhong , Guo Dean
Published: March 2019

Two new lignans, named as 6-hydroxyhinokinin and 6-hydroxyhinokinin-6- O-β-D-glucopyranoside, together with five known compounds: elemol, oplodiol, catechin, β-sitosterol and daucosterol were isolated from Kadsura heteroclita. The structures of these compounds were characterized by extensive 1D and 2D NMR spectral experiments, chemical analysis and comparison with literature data. The absolute structures of the novel lignans were elucidated as 8 S, 8′ S, based on their optical rotations.
Novel Synthesis of Prenylated Phenols and Their Antioxidant Properties
Authors: Mula Soumyaditya , Patro Birija S. , Kalena Govind P. , Chattopadhyay Subrata
Published: March 2019

A novel method for the prenylation of phenols has been developed using 2-methyl-but-3-ene-2-ol as the prenylating agent in the presence of Amberlyst 15. The prenylated catechols and quinols showed better antioxidant activity than the corresponding non-prenylated compounds in the in vitro DPPH and lipid peroxidation assay. The resorcinol derivatives did not show significant antioxidant activity.
Analysis of the Leaf Essential Oil of Stauranthus perforatus from Monteverde, Costa Rica
Authors: Schmidt Jennifer M. , Setzer William N.
Published: March 2019

The leaf essential oil of Stauranthus perforatus Leibm. (Rutaceae) from Monteverde, Costa Rica, was isolated by hydrodistillation and the chemical composition determined by GC–MS. The most abundant essential oil components were α-pinene, germacrene D, and α-cadinol.
Camptothecins: Some Recent Chemical Studies
Authors: Das Biswanath , Krishnaiah Maddeboina , Venkateswarlu Katta , Das Ratna
Published: March 2019

Camptothecin, a novel, naturally-occurring pyrrolo(3,4-b)-quinoline alkaloid, and its analogues (collectively known as camptothecins) possess interesting chemistry and important anticancer and antiviral properties. The isolation of various known and unknown camptothecins from the Indian plant Nothapodytes foetida (Wight) Sleumer (Icacinaceae) and our studies on their chemical and biochemical modifications are briefly reviewed.
Three New C19-Diterpenoid Alkaloids from Delphinium Bonvalotii
Authors: He Yong , Chen Dong-Lin , Wang Feng-Peng
Published: March 2019

Three new lycoctonine-type C19-diterpenoid alkaloids, bonvalotidine A, bonvalotidine B, and bonvalotidine C, along with sixteen known alkaloids, were isolated from the roots of Delphinium bonvalotii Franch. Their structures were established by spectral analysis and chemical methods.
Isolation and Characterization of 2,4,5-Trimethoxy-benzaldehyde and 1-(2,4,5-trimethoxyphenyl)-Ethanone from Pachypodanthium Staudtii, and their General Toxicity towards Brine Shrimps
Authors: Nahar Lutfun , Sarker Satyajit D.
Published: March 2019

The 1D and 2D NMR analyses, notably, 1H, 13C PENDANT, HMQC, HMBC and NOESY, were carried out on two benzene derivatives, 2,4,5-trimethoxybenzaldehyde and 1-(2,4,5-trimethoxyphenyl)-ethanone, isolated from the dichloromethane extract of the stem bark of Pachypodanthium staudtii. The general toxicity of these compounds (LC50 = 32.6 and 80.5 μg/mL, respectively) was determined by the brine shrimp lethality bioassay.
The Potential Angiotensin-Converting Enzyme Inhibitory Activity of Oleanolic Acid in the Hydroethanolic Extract of Crataegus monogyna Jacq
Authors: Attard Everaldo , Attard Henrietta
Published: March 2019

The hydroethanolic extract of Crataegus monogyna was studied for its chemical constitution and angiotensin-converting enzyme (ACE) inhibitory activity. The extract contained triterpenic acids, flavonoids and coumarins. The ACE inhibitory activity was studied using captropril, as a control drug, and oleanolic acid, as a constituent of the hydroethanolic extract and a member of the triterpenic acid group. The hydroethanolic extract and oleanolic acid showed higher IC50 values (335.00 μg/mL and 3.61 μM, respectively) in comparison to captopril (46.9 nM). However, these results indicate the anti-ACE activity of oleanolic acid and the triterpenic acids, which has not been demonstrated earlier for hawthorn extracts. In previous studies, the ACE inhibitory activity of C. monogyna extracts was always attributed to flavonoids and proanthocyanidins.
Chemical Composition and Antibacterial Activity of the Essential Oils of Blainvillea Rhomboidea (Asteraceae)
Authors: Pires Andreza Maria L. , Albuquerque Maria Rose Jane R. , Nunes Edson P. , Melo Vânia M. M. , Silveira Edilberto R. , Pessoa Otília Deusdênia L.
Published: March 2019

The essential oils of Blainvellea rhomboidea (Asteraceae) were obtained by hydrodistillation and analyzed by GC/MS and GC/FID. Initially, the essential oil from the aerial parts was investigated. From the 18 identified components, 5-indanol (14.5%) followed by p-cymen-8-ol (10.1%), β-caryophyllene (9.6%), caryophyllene oxide (9.6%), limonene (8.6%), terpinolene (7.8%), and spathulenol (7.7%) were the major constituents. The oil was tested against seven bacterial strains and the results showed significant antimicrobial activity. As a consequence, the essential oils from leaves and from flowers were analyzed separately. The major constituents of the leaf oil were terpinolene (21.2%), β-caryophyllene (19.2%), spathulenol (9.1%), caryophyllene oxide (7.4%), and bicyclogermacrene (7.1%), while the oil of the flowers contained terpinolene (28.1%), 5-indanol (16.3%), p-cymen-8-ol (15.3%) and limonene (14.7%) as prevalent compounds. The oils were tested against the same bacterial strains and the flower oil was the more active. These results indicated that the components of the essential oil from flowers seem to be responsible for the activity.