bluuebunny/crossref_metadata_2025 huggingface dataset:
Visual impairment, low vision acuity, and the mediating effect of sleep indicators among older adults in India
Authors: Himanshu Himanshu , Arokiasamy Perianayagam , Talukdar Bedanga , Selvamani Y
Published: November 2019

Little is known about the prevalence and association between visual impairment, low vision acuity, and sleep indicators (sleep duration and sleep problem) in the Indian context. We investigate this association for Indian older adults (50+ ages). Using cross-sectional data from WHO-Study on global AGEing and adult health (WHO-SAGE) 2007–2008, a sample of 6560 ( Mage = 61.81, SD = 9.00) was selected for analysis. Self-reported visual impairment and performance-based low vision acuity were used as outcome variables, whereas sleep duration, problem in sleep, and medical condition with socio-demographic were used as covariates. Multivariate logistic regression analyses were conducted. In a fully adjusted model (including all covariates), vision impairment was associated with short sleep duration (<6 hr) and sleep problem, separately and together for both genders. Low vision was positively associated with short sleep duration and sleep problem, separately and together for males, whereas only long sleep (⩾9 hr) is associated with low vision acuity for females in fully adjusted model. Results suggest that sleep apnea including short sleep duration and sleep problem is the underestimated cause of visual impairment and vision acuity. Healthcare providers should consider sleep parameters (sleep duration and sleep problem) along with sleep apnea in the treatment of visual impaired older adults.
Miller Fisher syndrome with early intracranial hypertension and delayed bilateral simultaneous facial nerve palsy: a case report
Authors: Liu Yu-Ming , Chen Yan-Li , Deng Yan-Hua , Liang Yan-Ling , Li Wei , Chen Jia
Published: November 2019

Miller Fisher syndrome (MFS), a variant of Guillain–Barré syndrome, is characterized by ataxia, areflexia and ophthalmoplegia. This case report describes a 40-year old male that presented with a 3-day history of unsteady walking and numbness on both hands, and a 2-day history of seeing double images and unclear articulation. Lumbar puncture revealed an opening pressure of 260 mm H2O. Plasma serology was positive for anti-ganglioside M1-immunoglobulin M (anti-GM1-IgM) antibodies and negative for anti-ganglioside Q1b (anti-GQ1b) antibodies. The patient was diagnosed with MFS based on the clinical course and neurophysiological findings. On the 4th day of treatment with intravenous immunoglobulin (IVIG), his ataxia and unsteady walking improved, but his bilateral eyeballs were fixed, and over the next few days he developed bilateral peripheral facial paralysis. After 5 days of IVIG treatment, methylprednisolone treatment was offered and the patient's symptoms gradually improved. Early intracranial hypertension and delayed facial nerve palsy may be atypical presentations of MFS. Anti-GM1-IgM antibodies may be the causative antibodies for MFS. If the IVIG therapy does not stop the progression of the disease, the addition of corticosteroid therapy may be effective. However, the relationship between IgM type, anti-GM1 antibody and MFS remains unclear and requires further research.
Inhibition of PPARγ by bisphenol A diglycidyl ether ameliorates dexamethasone-induced osteoporosis in a mouse model
Authors: Wang Yaoqing , Pan Zhenyu , Chen Fan
Published: November 2019

Objectives

Bisphenol A diglycidyl ether (BADGE) is an antagonist for PPARγ that reduces bone marrow adiposity and increases bone formation in some animal models of osteoporosis and osteonecrosis. However, the effect of BADGE treatment on glucocorticoid-induced osteoporosis is unknown. This study investigated the preventive effects of BADGE on steroid-induced osteoporosis in mice.

Methods

Thirty-six female C57BL/6J mice were randomly divided into normal (phosphate-buffered saline), model (50 mg/kg dexamethasone sodium phosphate [Dex]), and BADGE (30 mg/kg of BADGE, combined with Dex) groups. All groups received intraperitoneal injections of their treatments, daily for 4 weeks. Protein and mRNA expression levels of gene markers were measured. Micro-computed tomography was used to measure physical parameters of femurs. Bone histomorphology was analyzed by hematoxylin and eosin staining. ELISA was used to measure serum osteocalcin and C-terminal telopeptide of type I collagen (CTX-1).

Results

Glucocorticoid treatment enlarged the marrow fat, concomitant with bone deterioration; BADGE treatment reversed steroid-induced marrow adiposity. Compared with the model group, BADGE treatment improved bone quality and increased bone volume, while increasing osteogenic markers and reducing adipogenic markers at both mRNA and protein levels; moreover, it reduced serum CTX-1 and increased serum osteocalcin.

Conclusion

BADGE treatment ameliorates glucocorticoid-induced osteoporosis by inhibiting PPARγ.
Expression of serum microRNA-155 and its clinical importance in patients with heart failure after myocardial infarction
Authors: Zhang Baojian , Li Biao , Qin Fen , Bai Fan , Sun Chao , Liu Qiming
Published: November 2019

Objective

This study was conducted to investigate the level of microRNA-155 (miRNA-155) in patients with heart failure (HF) after myocardial infarction (MI) and its clinical importance.

Methods

Serum miRNA-155 levels were measured using quantitative reverse transcription (qRT)-PCR. The left ventricular ejection fraction (LVEF), left ventricular posterior wall thickness, and left ventricular end-diastolic diameter were measured by echocardiography. Serum amino-terminal pro-B-type natriuretic peptide (NT-proBNP) and other parameters were also analyzed.

Results

miRNA-155 levels in patients with HF were significantly higher than in control and MI groups. The area under the receiver operating characteristic curve of serum miRNA-155 in the diagnosis of HF after MI was 0.941, the cutoff value was 1.77, sensitivity was 92.73%, and specificity was 92.14%. NT-proBNP levels were significantly higher and LVEF was lower in patients with high versus low miRNA-155 expression.

Conclusions

Patients with HF after MI had elevated miRNA-155 levels and poor cardiac function, suggesting that determining miRNA-155 expression could be used to assess the severity of the disease.
Video Analysis of Shoulder Dislocations in Rugby: Insights Into the Dislocating Mechanisms
Authors: Montgomery Connor , O’Briain David E. , Hurley Eoghan T. , Pauzenberger Leo , Mullett Hannan , Moran Cathal J.
Published: November 2019

Background:

Mechanisms previously described for traumatic shoulder injuries in rugby may not adequately describe all the mechanisms that result in shoulder dislocations.

Purpose:

To investigate the mechanism of shoulder dislocation events in professional rugby players through use of systematic video analysis.

Study Design:

Case series; Level of evidence, 4.

Methods:

In our series, 39 cases of shoulder dislocations from games played in top professional leagues and international matches across a 2-year period were available for video analysis. All cases were independently assessed by 2 analysts to identify the sequence of events occurring during shoulder dislocation. This included injury circumstance such as contact with another player or the ground, game scenario, injury timing, and the movements and force vectors involved in the dislocation mechanism.

Results:

We identified 4 distinct injury mechanisms. The previously described mechanisms “try scorer,”“tackler,” and “direct impact” were identified in 67% of cases. We describe a new injury mechanism occurring in the “poach position,” accounting for 18% of all shoulder dislocations studied. The remaining 15% could not be categorized. Shoulder dislocations occurred to a ball carrier in 15% of cases (n = 6) and a non–ball carrier in 85% of cases (n = 33). The injury most commonly occurred during a tackle (49%; n = 19) followed by ruck/maul (26%; n = 10). Time of injury showed that 36% (n = 14) of cases occurred in the last quarter of the game.

Conclusion:

Shoulder dislocations have now been shown to occur predominantly as a result of 1 of 4 distinct mechanisms, most frequently in the second half of the game. A new mechanism for shoulder dislocation has been described in this series, termed the poach position.
The Safety of Blood Flow Restriction Training as a Therapeutic Intervention for Patients With Musculoskeletal Disorders: A Systematic Review
Authors: Minniti Melissa C. , Statkevich Andrew P. , Kelly Ryan L. , Rigsby Victoria P. , Exline Meghan M. , Rhon Daniel I. , Clewley Derek
Published: November 2019

Background:

The effectiveness of blood flow restriction training (BFRT) as compared with other forms of training, such as resistance training, has been evaluated in the literature in clinical and nonclinical populations. However, the safety of this intervention has been summarized only in healthy populations and not in clinical populations with musculoskeletal disorders.

Purpose:

To evaluate the safety and adverse events associated with BFRT in patients with musculoskeletal disorders.

Study Design:

Systematic review.

Methods:

A literature search was conducted with 3 online databases (MEDLINE, CINAHL, and Embase). Eligibility criteria for selecting studies were as follows: (1) BFRT was used as a clinical intervention, (2) study participants had a disorder of the musculoskeletal system, (3) authors addressed adverse events, (4) studies were published in English, and (5) the intervention was performed with human participants.

Results:

Nineteen studies met eligibility criteria, with a pooled sample size of 322. Diagnoses included various knee-related disorders, inclusion body myositis, polymyositis or dermatomyositis, thoracic outlet syndrome, Achilles tendon rupture, and bony fractures. Nine studies reported no adverse events, while 3 reported rare adverse events, including an upper extremity deep vein thrombosis and rhabdomyolysis. Three case studies reported common adverse events, including acute muscle pain and acute muscle fatigue. In the randomized controlled trials, individuals exposed to BFRT were not more likely to have an adverse event than individuals exposed to exercise alone. Of the 19 studies, the adverse events were as follows: overall, 14 of 322; rare overall, 3 of 322; rare BFRT, 3 of 168; rare control, 0 of 154; any adverse BFRT, 10 of 168; any adverse control, 4 of 154. A majority of studies were excluded because they did not address safety.

Conclusion:

BFRT appears to be a safe strengthening approach for knee-related musculoskeletal disorders, but further research is needed to make definitive conclusions and to evaluate the safety in other musculoskeletal conditions. Improved definitions of adverse events related to BFRT are needed to include clear criteria for differentiating among common, uncommon, and rare adverse events. Finally, further research is needed to effectively screen who might be at risk for rare adverse events.
Platelet adhesion emulation: A novel method for estimating the device thrombosis potential of a ventricular assist device
Authors: Liu Guang-Mao , Chen Hai-bo , Hou Jian-feng , Zhang Yan , Hu Sheng-shou
Published: November 2019

Device thrombosis inside ventricular assist devices remains a limitation to their long-term clinical use. Thrombosis potential exists in almost all ventricular assist devices because the device-induced high shear stress and vortices can activate platelets, which then aggregate and adhere to the surfaces inside the ventricular assist device. To decrease the device thrombosis potential of long-term use of ventricular assist devices, a methodology entitled platelet adhesion emulation for predicting the thrombosis potential and thrombosis position inside the ventricular assist devices is developed. The platelet adhesion emulation methodology combines numerical simulations with in vitro experiments by correlating the structure of the flow passage components within the ventricular assist device with the platelet adhesion to estimate the thrombosis potential and location, with the goal of developing ventricular assist devices with optimized antithrombotic performance. Platelet adhesion emulation is aimed at decreasing the device thrombus potential of ventricular assist devices. The platelet adhesion emulation effectiveness is validated by simulating and testing an axial left ventricular assist device. The blood velocity relative to the surfaces of the flow passage components is calculated to estimate the platelet adhesion potential, indicating the probability of thrombus formation on the surfaces. Platelet adhesion emulation experiments conducted in a mock circulation loop with pump prototypes show the distribution of platelet adhesion on the surfaces. This methodology of emulating the device thrombosis distribution indicates the potential for improving the component structure and reducing the device thrombosis of ventricular assist devices.
Outstanding leadership in primary education: Perceptions of school leaders in English primary schools
Authors: Dhillon Jaswinder K , Howard Colin , Holt Jayne
Published: November 2019

The nature of leadership and management in a school are key to achieving high-quality education for all pupils. Leadership theories and empirical research have sought to identify characteristics of leaders, aspects of the context in which they work and their relationships with others to identify features of successful school leadership. This article reports on findings from a study into outstanding leadership in primary education using Q-methodology. The perceptions of head teachers, deputy head teachers, governors and academics with personal experience of leadership in English primary schools were gathered using Q-sort and analysed with PQ software. Overall, the analysis identified very strong agreement over six statements from a Q-set of 23 statements of outstanding leadership. There were subtle differences between urban and rural school settings.
An AUC Target Simulation for Vancomycin in Patients With Class III Obesity
Authors: Langton Meagan M. , Ahern John W. , MacDougall Julie
Published: November 2019

Objective:

The objective of this simulation is to compare 24-hour vancomycin (Vanc24) dosage requirements between a target area under the curve (AUC) versus a target trough approach in patients with class III obesity.

Methods:

Adult patients were included if they received vancomycin in accordance with the University of Vermont Medical Center’s class III obesity dosage protocol from June 2016 through December 2018. Patient-specific pharmacokinetic parameters were calculated for each patient using the Sawchuck-Zaske method. For this simulation, Vanc24 dosages were calculated to achieve an AUC of 400 mg/L h and a trough concentration of 15 mg/L.

Results:

Sixty-three patients had Vanc24 dosage requirements calculated. The median age was 59 years (interquartile range [IQR]: 51.5-68), body mass index (BMI): 45.7 kg/m2 (IQR: 42.4-51.5), and 50.7% were male. The mean Vanc24 dosage requirements were 3995 mg (standard deviation [SD] ±1673) in the target trough approach versus 2783 mg (SD ±1149) in the target AUC approach ( P < .0001).

Conclusion:

A target AUC approach required less vancomycin over a 24-hour time period relative to a target trough approach. Vancomycin therapeutic drug monitoring that explicitly targets AUC may reduce vancomycin exposure and potentially decrease the risk of nephrotoxicity in patients with class III obesity.
A hybrid optimization approach for unequal-sized dynamic facility layout problems under fuzzy random demands
Authors: Zha Shanshan , Guo Yu , Huang Shaohua , Wu Qi , Tang Pengzhou
Published: November 2019

Dynamic facility layout problems involve devising the optimal layout for each different production period. This article studies unequal-area dynamic facility layout problems under fuzzy random environment to minimize the sum of the material handling costs and rearrangement costs. For a more general situation, a novel model of unequal-area dynamic facility layout problems is proposed on the basis of fuzzy random theory, in which uncertain demands are characterized by fuzzy random variables. Unequal-area dynamic facility layout problems are one of the non-deterministic polynomial-time hard problems. Therefore, a hybrid particle swarm optimization and simulated annealing algorithm is innovated to solve the proposed unequal-area dynamic facility layout problems model under fuzzy random environment, in which the shapes and areas of facilities are changed dynamically. Two facility-swapping methods and two local search methods help hybrid algorithm escape from local optima, allowing a more reliable solution. Moreover, a new shifting method is developed to prevent the spatial overlapping between adjacent facilities and save material handling costs. The performance of the hybrid algorithm is confirmed by some test problems available. Finally, the proposed method is extended to a facility layout planning of a new aircraft assembly shop floor. Computational results show that the efficiency and effectiveness of the proposed method, in sharp comparison with other approaches.
Sulphur Emission Control in China: Domestic Policy and Regional Cooperative Strategy
Authors: Nakada Minoru , Ueta Kazuhiro
Published: November 2019

This paper investigates the economic costs of pollution due to sulphur dioxide emissions in China and their impacts on human health and ecosystems in Northeast Asia, specifically China and Japan. We compare actual emission charging as practiced in China with the estimated domestic and regional “optimal” charges. The analysis demonstrates that, while the actual SO2 emission charge in China has been increased, it may be still less than the estimated domestic “optimal” charge incorporating damage costs only on human health by dry deposition in a gaseous form, excluding damage costs caused by acid rain in China. Nevertheless, it would be still beneficial for Japan to financially assist China with its SO2 reduction because the percent contribution by northeast China to deposition in Japan is increasing.
The Impact of Market Power on the Functioning of Tradable Green Certificates Schemes
Authors: del Río Pablo
Published: November 2019

Quotas with Tradable Green Certificates (TGC) schemes have generally been regarded as an effective and cost-efficient way to promote electricity from renewable energy sources (RES-E). The theoretical analysis of the effectiveness and cost-effectiveness of TGC schemes has traditionally taken place assuming perfect competition in, both the electricity and TGC markets. However, these markets may not approach the conditions of a perfectly competitive market. This paper analyses the influence of market power in, both, the TGC and electricity markets on RES-E deployment, cost-effectiveness and cost distribution. The major conclusion is that market power should not be a concern. Market power does not affect the effectiveness of a quota with TGC system, i.e., it does not affect RES-E deployment, although market power on the supply side of markets may negatively affect the cost-effectiveness of the system and increase the cost burden for electricity consumers.
Chatham House Conference on Middle East Oil
Authors: Boehmer-Christiansen Sonja
Published: November 2019

Gas reserves are abundant worldwide, but mainly concentrated in Russia and the Middle East Region… world gas consumption therefore implies higher reliance on international trade, long distance transportation especially of LNG, and ‘critically underpinning these realisation of major investments. (Eurogas 18/9/2006 Report: The European Gas market - Views on the Way Forward, Brussels)
Study of the relaxation and resonance behaviors of ternary composites: Epoxy–strontium titanate–carbon black
Authors: Khouni Habib , Bouzit Nacerdine
Published: November 2019

The principal subject of the present article is the study of the phenomenon of dispersion as well as the effect of the concentration of strontium titanate (SrTiO3) and carbon black on the complex permittivity of ternary composites: epoxy resin–SrTiO3 –black carbon. The relative permittivity of the mixtures as a function of volume fraction of SrTiO3 was modeled by the modified Lichtenecker mixing law (MLL). A new dispersion model, based on the Lorentzian resonance model, has been proposed to describe the frequency behavior of complex permittivity. For these ternary composites, the frequency dispersion behavior of the complex permittivity that exhibits both relaxation and resonance spectra with increasing SrTiO3 concentration has been showed. The new empirical equation proposed in our work has been well describing the complex permittivity of resonance type for the SrTiO3 and carbon black composites. The effects of SrTiO3 content on the electromagnetic properties and absorption characteristics of electromagnetic waves of epoxy resin composites were studied. As the volume fraction of SrTiO3 increases, it was confirmed that the complex permittivity of the composites follows the MLL and the resonant frequency shifted toward the high frequency range. The resonance frequency of the composites was estimated in good agreement with the theoretical values calculated by the second new equation proposed in this article. Complex permittivity is measured using time domain spectroscopy in the frequency range direct current (DC) to 30 GHz.
Prisoners of the Chaco: The Bolivian Experience of Captivity
Authors: Niebuhr Robert
Published: November 2019

When Bolivian forces engaged the Paraguay Army in 1932 to control the desolate Chaco Boreal they began what would be a monumental transformative project. More than a quarter of a million men served on the Bolivian side, or almost 10 per cent of the total population. Of those, more than 50,000 perished and over 20,000 surrendered. Bolivian prisoners laboured in Paraguay as servants, construction workers, and farm hands; this article aims to detail aspects of who these prisoners were and what they did in captivity.
Multicenter Analysis of Dosing Protocols for Sotalol Initiation
Authors: Biswas Minakshi , Levy Andrew , Weber Rachel , Tarakji Khaldoun , Chung Mina , Noseworthy Peter A. , Newton-Cheh Christopher , Rosenberg Michael A.
Published: November 2019

Sotalol, a Vaughan-Williams Class III antiarrhythmic medication, is used to manage atrial arrhythmias. Due to its QT-prolonging effect and subsequent increased risk of torsade de pointes, many centers admit patients during the initial dosing period. Despite its widespread use, little information is available regarding dosing protocols during this period. In this multicenter investigation, dosing protocols in patients initiating sotalol therapy were examined to identify predictors of successful sotalol initiation. Over a 4-year period, patients admitted to 5 hospitals in the United States for inpatient telemetry monitoring during initiation for nonresearch purposes were enrolled. A 3-day course of 5 of 6 doses of sotalol was considered successful completion of the loading protocol. Of the 213 enrolled patients, over 90% were successfully discharged on sotalol. Significant bradycardia, ineffectiveness, and excessive QT prolongation were reasons for failed completion. Absence of a dose adjustment was a strong predictor of successful initiation (odds ratio: 6.6, 95% confidence interval: 1.3-32.7, P = .02). Hypertension, use of a calcium channel blocker, use of a separate β-blocker, and presence of a pacemaker were predictors of dose adjustments. Marginal structural models (ie, inverse probability weighting based on probability of a dose adjustment) verified that these factors also predicted successful initiation via preventing any dose adjustment and suggests that considering these factors may result in a higher likelihood of successful initiation in future investigations. In conclusion, we found that the majority of patients admitted for sotalol initiation are successfully discharged on the medication. The study findings suggest that factors predicting need for dose adjustment can be used to identify patients who could undergo outpatient initiation. Prospective studies are needed to verify this approach.
Theory of Lodging
Authors: Roberts Chris , Young Lisa , Johanson Misty
Published: November 2019

For the initial development of the theory of lodging, the focus was on guest behavior in a hotel room. The theory is expanded to encompass the guest behavior in the entire hotel facility, including entrance into the lobby, private usage of the room, and time spent in such areas as the restaurant, lounge, gift shop, gym, spa, function rooms, and so on. The theory began with the observed differences in human behavior while at home versus during an overnight stay at a commercial lodging establishment. Further consideration is given to the guest behavior inside the public spaces of a hotel, which is beyond the privacy of the guest room but still within the protective boundary of the hotel building itself, and which is all a part of the lodging experience.
Effect of tunneled and nontunneled peripherally inserted central catheter placement: A randomized controlled trial
Authors: Dai Can , Li Jia , Li Qiu-mei , Guo Xiuquan , Fan Yu-ying , Qin Hui-ying
Published: November 2019

Purpose:

To compare the effect of tunneled and nontunneled peripherally inserted central catheter placement under B-mode ultrasound.

Methods:

A single center, randomized, controlled, nonblinded, prospective trial was conducted in Guangzhou, China, between July 2018 and May 2019. A total of 174 participants were randomized to the experimental group (tunneled peripherally inserted central catheter) or the control group (nontunneled peripherally inserted central catheter) and were followed until extubation. Basic characteristics, peripherally inserted central catheter characteristics, the incidence of complications, and the costs of peripherally inserted central catheter placement and maintenance were collected. Data were analyzed by intention-to-treat.

Results:

A total of 168 of the participants had successful peripherally inserted central catheter placements (85/87, 97.7% in the experimental group and 83/87, 95.4% in the control group, P = 0.682). Compared to the control group, the experimental group had a lower incidence of complications during the placement (18.4% vs 32.2%, P = 0.036), a lower incidence of wound oozing (27.6% vs 57.5%, P < 0.001), a lower incidence of medical adhesive–related skin injury (9.2% vs 25.3%, P = 0.005), a lower incidence of venous thrombosis (1.1% vs 9.2%, P = 0.034), a lower incidence of catheter dislodgement (1.1% vs 9.2%, P = 0.034), and lower costs of peripherally inserted central catheter maintenance at 1, 2, and 3 months ( P < 0.05).

Conclusion:

Tunneled peripherally inserted central catheter may be recommended for good effectiveness.
How to challenge an international order: Russian diplomatic practices in multilateral security organisations
Authors: Schmitt Olivier
Published: November 2019

Many policy and academic debates focus on the extent to which Russia is a revisionist power challenging the ‘liberal world order’. However, there is little agreement on the primary motives explaining the behaviour of Russia, some pointing to her unsatisfied great power ambitions and neo-imperial ideologies, and others to genuine security concerns. Adjudicating those claims is important because of their policy implications for engagement and/or deterrence towards Russia. This article contributes to this debate through a theoretical contribution to practice-based approaches to International Relations. Using De Certeau’s understanding of practices, it analyses Russian diplomatic practices in multilateral security organisations and illustrates how this helps infer foreign policy motives, contrary to the field-specific relationalism of Bourdieu-inspired practice approaches. Empirically, it builds on 126 interviews and participant observation in three multilateral security organisations (the United Nations, the NATO–Russia Council and the Organisation for Security and Cooperation in Europe). The article shows that at least since 2014, Russian diplomats in the three organisations consistently defend policies and use narratives that reveal more interest in status recognition, sometimes at the expense of security concerns.
Low left ventricular outflow tract velocity time integral is associated with poor outcomes in acute pulmonary embolism
Authors: Yuriditsky Eugene , Mitchell Oscar JL , Sibley Rachel A , Xia Yuhe , Sista Akhilesh K , Zhong Judy , Moore William H , Amoroso Nancy E , Goldenberg Ronald M , Smith Deane E , Jamin Catherine , Brosnahan Shari B , Maldonado Thomas S , Horowitz James M
Published: November 2019

The left ventricular outflow tract (LVOT) velocity time integral (VTI) is an easily measured echocardiographic stroke volume index analog. Low values predict adverse outcomes in left ventricular failure. We postulate the left ventricular VTI may be a signal of right ventricular dysfunction in acute pulmonary embolism, and therefore a predictor of poor outcomes. We retrospectively reviewed echocardiograms on all Pulmonary Embolism Response Team activations at our institution at the time of pulmonary embolism diagnosis. Low LVOT VTI was defined as ⩽ 15 cm. We examined two composite outcomes: (1) in-hospital death or cardiac arrest; and (2) shock or need for primary reperfusion therapies. Sixty-one of 188 patients (32%) had a LVOT VTI of ⩽ 15 cm. Low VTI was associated with in-hospital death or cardiac arrest (odds ratio (OR) 6, 95% CI 2, 17.9; p = 0.0014) and shock or need for reperfusion (OR 23.3, 95% CI 6.6, 82.1; p < 0.0001). In a multivariable model, LVOT VTI ⩽ 15 remained significant for death or cardiac arrest (OR 3.48, 95% CI 1.02, 11.9; p = 0.047) and for shock or need for reperfusion (OR 8.12, 95% CI 1.62, 40.66; p = 0.011). Among intermediate–high-risk patients, low VTI was the only variable associated with the composite outcome of death, cardiac arrest, shock, or need for reperfusion (OR 14, 95% CI 1.7, 118.4; p = 0.015). LVOT VTI is associated with adverse short-term outcomes in acute pulmonary embolism. The VTI may help risk stratify patients with intermediate–high-risk pulmonary embolism.
Parents’ discourse on English for young learners
Authors: Carmel Rivi
Published: November 2019

English, the global lingua franca, enjoys a growing status worldwide. The high status of English is also linked to the increasing interest in teaching English to young learners (EYL), and is reciprocally linked to complex political, cultural and social forces. Research on the advantages of learning English at a young age is controversial and inconclusive, but despite uncertainties it seems that EYL will continue to be a growing trend. This study aimed to understand the forces that drive the EYL phenomenon and focuses on the analysis of parent’s discourse from a critical discursive sociocultural perspective. Findings illuminate the subtle, powerful ways in which parents’ discourse leads to the growing of EYL in Israel. Parents’ overenthusiasm to promote English in schools stems from their perceptions about the high value of English, global aspirations and their belief in the popular axiom ‘the younger the better’. Findings further suggest that decisions about EYL and its teaching are not necessarily based on professionals or academics but rather exist within the powers of the community, with parents being a dominant force.
Damage detection of structures using signal processing and artificial neural networks
Authors: Beheshti Aval Seyed Bahram , Ahmadian Vahid , Maldar Mohammad , Darvishan Ehsan
Published: November 2019

This article presents a signal-based seismic structural health monitoring technique for damage detection and evaluating damage severity of a multi-story frame subjected to an earthquake event. As a case study, this article is focused on IASC–ASCE benchmark problem to provide the possibility for side-by-side comparison. First, three signal processing techniques including empirical mode decomposition, Hilbert vibration decomposition, and local mean decomposition, categorized as instantaneous time–frequency methods, have been compared to find a method with the best resolution in extracting frequency responses. Time-varying single degree of freedom and multiple degree of freedom models are used since real vibration signals are nonstationary and nonlinear in nature. Based on the results, empirical mode decomposition has proved to outperform than the others. Second, empirical mode decomposition is used to extract the acceleration response of the sensors. Next, a two-stage artificial neural network is used to classify damage patterns. The first artificial neural network identifies location and severity of damage and the second one calculates the severity of damage for the entire structure. IASC–ASCE benchmark problem is used to validate the proposed procedure. By taking advantage of signal processing and artificial intelligence techniques, damage detection of structures was successfully carried out in three levels including damage occurrence, damage severity, and the location of damage.
Explaining interest group access to the European Commission’s expert groups
Authors: Vikberg Carl
Published: November 2019

Conventional wisdom holds that interest group access to the European Commission is biased in favor of specific interests and against diffuse interests. Yet, patterns of access vary between policy areas. In this article, I map and explain the relative access of specific and diffuse interests to the European Commission’s expert groups. I find that specific interests gain more access in general, but there are considerable variations across issues. I argue that variations in access across expert groups are explained by the relative ability of specific and diffuse interests to contest policies in different policy areas. This argument gains support by statistical analyses using a novel dataset comprising all expert groups with interest group participants. The findings suggest that a political logic helps explain variations in specific and diffuse interest access to the Commission.
How can the use of a mobile application change the course of a sightseeing tour? A question of pace, gaze and information processing
Authors: Calvignac Cédric , Smolinski Jan
Published: November 2019

When we use a smartphone as we move about, we see our surroundings in a different way, adopting new practices to combine physical exploration of place with digital navigation on the Web. This article seeks to identify how consulting digital information as we go along modifies our behaviour. Specifically, we will focus on the use of a mobile application dedicated to the presentation of a tourist site. Our exploratory study is based on a comparison of two groups of visitors: the first group was provided with a printed tourist guide, and the second had the same guide plus a smartphone with a tourist guide application. For the purposes of comparison, the visitors were followed step by step (their movements were tracked by GPS) and click by click (the application recorded the user’s browsing history). At the end of the tour, participants were also invited to comment on their experience, in semi-structured interviews. The results of the study suggest that the use of a smartphone while sightseeing modifies significantly our walking pace, the number of halts and slowdowns we make, and also the type of circuit we follow. Using the smartphone leads visitors to follow more carefully the itinerary proposed and, as a result, to explore the world with greater application
A Structured Cognitive Intervention Pathway as a decision-support tool for non-pharmacological interventions within a dementia care service (Innovative practice)
Authors: Carter Mark , Quail Zara , Bourke Allison , Young Charles
Published: November 2019

Individual cognitive interventions for Alzheimer’s disease have been shown to be beneficial and cost effective when evaluated as sole interventions. However, there is a need for a systematic, person-centric, structured approach to guide non-pharmacological intervention selection based on disease stage, symptoms, outcome assessment, and individual requirements. Our Structured Cognitive Intervention Pathway aims to facilitate the selection of first-line, or subsequent, non-pharmacological management for people with Alzheimer’s disease living at home and in elderly care facilities. We discuss the Pathway’s conceptual basis and evaluation of implementation as a decision-support tool within a dementia care service in China.
Pilot study of a psychotherapeutic intervention for reducing guilt feelings in highly distressed dementia family caregivers (Innovative practice)
Authors: Gallego-Alberto Laura , Márquez-González María , Romero-Moreno Rosa , Cabrera Isabel , Losada Andrés
Published: November 2019

Many caregivers of people with dementia experience guilt but few interventions have been designed to help them with these feelings. This study aimed to describe a psychological intervention specifically developed for decreasing caregivers´ guilt. The sample was composed of four caregivers, individually interviewed before and after the intervention. The intervention consisted of eight group-based sessions and was based on cognitive-behavioral, acceptance and self-compassion techniques. Three participants reported clinically reliable change in guilt. Clinically significant changes were also observed in their levels of anxiety and depression. The results suggest that carers might benefit from interventions designed to reduce their feelings of guilt.
Young, Accused and Detained; Awful, But Lawful? Pre-Trial Detention and Children’s Rights Protection in Contemporary Western Societies
Authors: van den Brink Yannick
Published: November 2019

This article explores the underlying explanations of the high reliance on pre-trial detention of children across contemporary Western societies, with a particular focus on the Netherlands. Empirical research findings are used to identify patterns and functions of pre-trial detention in the administration of youth justice. In addition, two driving forces behind pre-trial detention decision-making are explored after scrutinizing the penological underpinnings of youth justice and youth crime control in Western societies. Ultimately, the article addresses to what extent and how international children’s rights standards can effectively protect child suspects and accused from excessive, unlawful and arbitrary pre-trial detention.
Nonlinear optimal control for ship propulsion systems comprising an induction motor and a drivetrain
Authors: Rigatos Gerasimos , Siano Pierluigi , Abbaszadeh Masoud
Published: November 2019

The article proposes a nonlinear optimal [Formula: see text] control method for electric ships’ propulsion systems comprising an induction motor, a drivetrain and a propeller. The control method relies on approximate linearization of the propulsion system’s dynamic model using Taylor series expansion and on the computation of the state-space description’s Jacobian matrices. The linearization takes place around a temporary operating point which is recomputed at each time-step of the control method. For the approximately linearized model of the ship’s propulsion system, an H-infinity (optimal) feedback controller is developed. For the computation of the controller’s gains, an algebraic Riccati equation is solved at each iteration of the control algorithm. The stability properties of the control method are proven through Lyapunov analysis.
Two spatial association–considered mathematical models for diagnosing the long-term balanced relationship and short-term fluctuation of the deformation behaviour of high concrete arch dams
Authors: Wang Shaowei , Xu Yingli , Gu Chongshi , Xia Qun , Hu Kun
Published: November 2019

The safety of a high concrete arch dam should be rapidly diagnosed from different angles. Displacement is an actual comprehensive reflection of the arch dam, and it is very important to diagnose the overall deformation behaviour by displacement-based mathematical monitoring models. In this article, based on the spatial association validation of the measured displacement of two high arch dams by the empirical orthogonal function decomposition and the Pearson correlation analysis, two spatial association–considered mathematical models were proposed for the dam displacement of multimonitoring points: one model for the long-term balanced relationship and one model for the short-term fluctuation. To diagnose the abnormality of the dam long-term spatial association, each displacement time series of the multimonitoring points on the dam body with strong spatial associations was decomposed by wavelet multiresolution analysis, and the decomposed high-frequency components, which had the same periodicity as the causal factors of the reservoir water level or air temperature, were determined to establish the cointegration monitoring model. The second model was a combination prediction model, with two sub-models established from the modelling angles of the hydraulic, seasonal and time causal factors and the adjacent point displacement factors, and this second model was mainly used for identifying dam short-term local abnormal deformation behaviour. Engineering examples show that the deformation behaviour of an arch dam under normal conditions has strong spatial associations. The two proposed models have high accuracy and interpreting ability and can effectively reduce the number of needed monitoring models.
The influence of the ‘gay-propaganda’ law on violence against LGBTIQ people in Russia: Evidence from criminal court rulings
Authors: Kondakov Alexander
Published: November 2019

This article presents the results of a study of the victimization of queer people in Russia before and after the ‘gay-propaganda’ bill was signed into law in 2013. Despite the development of hate crime legislation, few violent incidents against LGBTIQ (lesbian, gay, bisexual, transgender, intersex, and questioning) individuals are recorded in the Russian legal system. An original method of court rulings analysis is put forward in order to move towards an actual number of criminal offences against these groups. All court decisions that mention non-heterosexual victims are reviewed to identify whether these cases could have been considered hate crimes. As a result, 267 first-instance criminal court rulings dealing with 297 LGBTIQ victims are identified in 2011–16. Descriptive statistical analysis demonstrates that the number of victims grew substantially after 2013.
Time-limited trials: A qualitative study exploring the role of time in decision-making on the Intensive Care Unit
Authors: Lonergan Bradley , Wright Alexandra , Markham Rachel , Machin Laura
Published: November 2019

Background

Withholding and withdrawing treatment are deemed ethically equivalent by most Bioethicists, but intensivists often find withdrawing more difficult in practice. This can lead to futile treatment being prolonged. Time-limited trials have been proposed as a way of promoting timely treatment withdrawal whilst giving the patient the greatest chance of recovery. Despite being in UK guidelines, time-limited trials have been infrequently implemented on Intensive Care Units. We will explore the role of time in Intensive Care Unit decision-making and provide a UK perspective on debates surrounding time-limited trials.

Methods

This qualitative study recruited 18 participants (nine doctors, nine nurses) from two Intensive Care Units in North West England for in-depth, one-to-one semi-structured interviews. A thematic analysis was performed of the data.

Results

Our findings show time is utilised by Intensive Care Unit staff in a variety of ways including managing uncertainty when making decisions about a patient’s prognosis or the reversibility of a disease, constructing relationships with patients’ relatives, communicating difficult messages to patients’ relatives, justifying resource allocation decisions to colleagues, and demonstrating compassion towards patients and their families.

Conclusions

Time shifts the balance towards greater certainty in Intensive Care Unit decision-making, by demonstrating futility, and can ease the difficult transition for staff and families from active treatment to palliation. However, this requires clear and open communication, both within the Intensive Care Unit team and with the family, being prioritised when time is used in decision-making.
Healing of Diabetic Neuroischemic Foot Wounds With vs Without Wound-Targeted Revascularization: Preliminary Observations From an 8-Year Prospective Dual-Center Registry
Authors: Alexandrescu Vlad-Adrian , Brochier Sophie , Limgba Augustin , Balthazar Severine , Khelifa Hafid , De Vreese Pierrick , Azdad Khalid , Nodit Mihaela , Pottier Morgane , Van Espen Didier , Sinatra Tommy
Published: November 2019

Purpose: To assess the clinical efficacy of endovascular angiosome-oriented wound-targeted revascularization (WTR) vs indirect (wound-indifferent) revascularization (IR) in diabetic patients with neuroischemic foot ulcers. Materials and Methods: Between April 2009 and July 2017, 167 diabetic patients (mean age 72.8 years; 137 men) with chronic limb-threatening ischemia (Rutherford category 5) and foot wounds (Wagner 2–4) in 194 limbs were prospectively registered and scheduled for primary infragenicular endovascular treatment. Specific angiosome source artery reperfusion sustained by patent foot arches or arterial-arterial connections was attempted initially. If this approach failed, topographic revascularization via available collaterals (WTRc) and IR were sequentially attempted. Results: Reperfusion was successful in 176 (91%) of 194 limbs (113 with WTR, 28 with WTRc, and 35 with IR); the global angiosome-oriented technical success (WTR and WTRc) was 73% (141/194). The mean follow-up was 10.9±0.7 months (range 3–12.5). Over 1 year, 102 (58%) of the 176 successfully treated limbs experienced wound healing [79/113 (70%) in the WTR group, 15/28 (54%) in the WTRc group, and 7/35 (20%) in the IR group; p=0.011]. The mean time to healing was 6.8±0.4 months in the WTR group, 7.9±0.6 months in the WTRc group, and 9.8±0.7 months in the IR group (p=0.001). Relapses were noted in 18 (16%) WTR limbs, 5 (18%) WTRc limbs, and 6 (17%) IR limbs. Comparison between WTR and IR and WTRc vs IR showed improved cicatrization in the angiosome-oriented groups (p<0.05). Major adverse limb events (MALE) and limb salvage were different between WTR and WTRc and between WTR and IR groups (p<0.05), while WTRc vs IR was not. Amputation-free survival was not influenced by the revascularization strategy (p=0.093). Conclusion: Wound healing in diabetic patients with chronic limb-threatening ischemia appeared to be improved by intentional wound-targeted revascularization, but no uniform benefit concerning MALE or limb preservation was observed. IR still represents an alternative for limb salvage in cases in which angiosome-guided revascularization fails.
Are Perceptions of Local Conditions Rooted in Reality? Evidence From Two Large-Scale Local Surveys
Authors: Holbrook Thomas M. , Weinschenk Aaron C.
Published: November 2019

In this research note, we test an assumption that is often made in the literature on local retrospective voting—that peoples’ perceptions of local conditions are well-grounded in reality. To do so, we examine the relationship between objective measures of local conditions and aggregated survey measures of perceptions of those conditions. We focus on three different conditions that have been shown to influence vote choice and approval at the local level—the state of the local economy, the quality of local public schools, and levels of local crime—and find strong evidence that perceptions of these conditions reflect actual local conditions. This important and previously unreported finding helps bolster the connections some scholars have found between objective indicators and election outcomes at the local level, as those indicators are tied to mass perceptions of related local conditions, which are connected to evaluations of incumbents. Overall, our results indicate that local electorates are well-positioned to hold local officials responsible. Given the general conception of the local electorate as disengaged, the strength and consistency of our findings are somewhat unexpected.