bluuebunny/crossref_metadata_2025 huggingface dataset:
Computer‐assisted pedicle screw trajectory planning using CT‐inferred bone density: A demonstration against surgical outcomes
Authors: Knez Dejan , Nahle Imad S. , Vrtovec Tomaž , Parent Stefan , Kadoury Samuel
Published: May 2019

Purpose

Image‐guided spine surgery and preoperative computer‐assisted planning provide spine surgeons with tools to improve the safety, accuracy, and reliability of pedicle screw placement. The purpose of this study is to demonstrate a computer‐assisted pedicle screw placement planning tool in comparison to screws as delivered by a spine surgeon.

Methods

We describe a novel computer‐assisted tool for preoperative pedicle screw placement planning in computed tomography (CT) images, designed with respect to the vertebral shape and structure, and augmented with respect to the considerations of surgical practice. The approach is based on three‐dimensional (3D) modeling of the vertebral body and pedicles, and planning of the pedicle screw size and insertion trajectory by maximizing the screw fastening strength, evaluated through CT‐inferred bone density maps. The approach is augmented by yielding screw plans consistent with the straight‐forward surgical technique of aligning screws parallel to vertebral endplates, and the screw entry points following the spinal curvature to facilitate rod attachment. For a cohort of 25 patients, placement plans were retrospectively obtained for 204 pedicle screws with the computer‐assisted tool from preoperative CT images, while reference trajectories of inserted pedicle screws were reconstructed in 3D from postoperative biplanar radiographs.

Results

The best performing version of the computer‐assisted tool achieved clinically acceptable preoperative pedicle screw placement plans in 96.6% of the cases, while the comparison to the postoperative reconstructions resulted in 3.4 ± 2.5 mm for the screw entry point location, 2.7 ± 1.6 mm for the screw crossing point location, and 7.4 ± 5.3∘ for the screw sagittal inclination (mean absolute difference ± standard deviation).

Conclusion

Quantitative comparison revealed that the preoperative placement plans are consistent with the postoperative results, and that the computer‐assisted tool integrating bone density and surgical constraints can successfully incorporate important aspects of pedicle screw placement. The results therefore confirm the accuracy of the tool prior to being integrated in an image‐guidance system.
Results from the experimental evaluation of CeBr scintillators for He prompt gamma spectroscopy
Authors: Dal Bello Riccardo , Magalhaes Martins Paulo , Graça João , Hermann German , Kihm Thomas , Seco Joao
Published: May 2019

Purpose

The presence of range uncertainties hinders the exploitation of the full potential of charged particle therapy. Several range verification techniques have been proposed to mitigate this limitation. Prompt gamma spectroscopy (PGS) is among the most promising solutions for online and in vivo range verification. In this work, we present the experimental results of the detection of prompt gamma radiation, induced by He beams at the Heidelberg Ion‐Beam Therapy Center (HIT). The results were obtained, using a spectroscopic unit of which the design has been optimized using Monte Carlo simulations.

Methods

The spectroscopic unit is composed by a primary cerium bromide (CeBr) crystal surrounded by a secondary bismuth germanate (BGO) crystal for anticoincidence detection (AC). The digitalization of the signals is performed with an advanced FADC/FPGA system. The He beams at clinical energies and intensities are delivered to multiple targets in the experimental cave at the HIT. We analyze the production of prompt gamma on oxygen and carbon targets, as well as high Z materials such as titanium and aluminum. The quantitative analysis includes a systematic comparison of the signal‐to‐noise ratio (SNR) improvement for the spectral lines when introducing the AC detection. Moreover, the SNR improvement could provide a reduction of the number of events required to draw robust conclusions. We perform a statistic analysis to determine the magnitude of such an effect.

Results

We present the energy spectra detected by the primary CeBr and the secondary BGO. The combination of these two detectors leads to an average increase of the signal‐to‐noise ratio by a factor 2.1, which confirms the Monte Carlo predictions. The spectroscopic unit is capable of detecting efficiently the discrete gamma emission over the full energy spectrum. We identify and analyze 19 independent spectral lines in an energy range spacing from  MeV to  MeV. Moreover, when introducing the AC detection, the number of events required to determine robustly the intensity of the discrete lines decreases. Finally, the analysis of the low‐energy reaction lines determines whether a thin metal insert is introduced in the beam direction.

Conclusions

This work provides the experimental characterization of the spectroscopy unit in development for range verification through PGS at the HIT. Excellent performances have been demonstrated over the full prompt gamma energy spectrum with He beams at clinical energies and intensities.
Organizational influences on the intimate partner violence and sexual violence screening practices of college health care providers
Authors: Sutherland Melissa A. , Hutchinson M. Katherine
Published: May 2019

Experts and professional organizations in the U.S. have issued recommendations that health care providers (HCPs) should screen women for intimate partner violence (IPV) and sexual violence (SV). Despite the high rates of IPV and SV experienced by female college students, investigators have found that providers are not screening for IPV and SV in college health centers. In this study, a cross‐sectional survey design was utilized to: (a) examine college HCPs’ reports of IPV/SV screening behaviors and (b) identify the individual‐level and organization‐level structure and process characteristics that promote or inhibit IPV/SV screening. A total of 773 college HCPs (physicians, nurse practitioners, and registered nurses) were invited to participate in the study using two separate sampling frames. The final sample included 210 college HCPs. Providers reported low rates of IPV/SV screening (median = 20%). Screening rates varied by provider type with nurse practitioners reporting the highest screening rates. Urban location was associated with a three and one‐half times greater likelihood of IPV/SV screening. Use of an electronic health record that included a prompt to screen was associated with a three‐fold increase in the likelihood that HCPs would screen for IPV/SV. Further study is needed to better understand how organizational factors influence providers’ screening behaviors in college health centers and how these influences are mediated. Future studies should include larger and more diverse samples of colleges and examine geographical variations in screening practices.
Synthesis and Evaluation of Graphene Aerogel‐Supported MnxFe3−xO4 for Oxygen Reduction in Urea/O2 Fuel Cells
Authors: Bejigo Keyru Serbara , Park Bang Ju , Kim Ji Hyeon , Yoon Hyon Hee
Published: May 2019

Graphene aerogel‐supported manganese ferrite (MnxFe3−xO4/GAs) and reduced‐graphene oxide/manganese ferrite composite (MnFe2O4/rGO) were synthesized and studied as cathode catalysts for oxygen reduction reactions in urea/O2 fuel cells. MnFe2O4/GAs exhibited a 3D framework with a continuous macroporous structure. Among the investigated Fe/Mn ratios, the more positive oxygen reduction onset potential was observed with Fe/Mn=2/1. The half‐wave potential of MnFe2O4/GAs was considerably more positive than that of MnFe2O4/rGO and comparable with that of Pt/C, while the stability of MnFe2O4/GAs significantly higher than that of Pt/C. The best urea/O2 fuel cell performance was also observed with the MnFe2O4/GAs. The MnFe2O4/GAs exhibited an OCV of 0.713 V and a maximum power density of 1.7 mW cm−2 at 60 °C. Thus, this work shows that 3D structured graphene aerogel‐supported MnFe2O4 catalysts can be used as an efficient cathode material for alkaline fuel cells.
The relation between classroom management and mathematics achievement: A multilevel structural equation model
Authors: van Dijk Wilhelmina , Gage Nicholas A. , Grasley‐Boy Nicolette
Published: May 2019

The impact of teachers on their students’ academic achievement continues to be an area of inquiry. One area not fully explored is the relation between teachers’ behavior and classroom management (CM) skills, student motivation, and student achievement. We examined these relations using a multi‐level structural equation model. Data included Behavior Management subscale scores of the Classroom Assessment Scoring System for 247 fourth and fifth grade teachers, indicators of academic motivation, and end‐of‐year state standardized mathematics assessment results for 4,847 students from the National Center of Teacher Effectiveness Main Study. The results indicate teachers’ CM skills have a significant direct effect on student motivation and a significant indirect effect on students’ math achievement, suggesting that students in classrooms of teachers with better CM are more motivated to learn math and have higher math achievement scores. This underscores the importance of helping teachers increase their use of evidence‐based classroom management techniques.
Qualitatively Different Non‐Quartic Low‐Temperature Heat Capacity Behaviors due to Various Non‐Metallic Solids
Authors: Pässler Roland
Published: May 2019

Different non‐quartic cryogenic heat capacity dependences can be unambiguously associated with the qualitatively different types of either sub‐quartic or super‐quartic regimes. The simplest way for a prompt association with one of these two alternative regimes is based on a couple of parameters controlling the straight‐line tangents to the material‐specific C(T)/T3 curves in consideration. A representative non‐Debye heat capacity formula is used for performing high‐accuracy fittings of cryogenic heat capacity data sets, including reliable determinations of the material‐specific temperature dependences of effective power function exponents. The cryogenic heat capacity dependences of the exemplary wide bandgap materials AgCl and LiI are found to show pronounced sub‐quartic behaviors, whereas germanium and silicon are seen to pertain to the regime of super‐quartic behavior. These results are in clear contrast to a hypothetical field‐theoretical model published recently by Gusev [R. Soc. Open Sci. 2019, 6, 171285], which suggested an allegedly universal low‐temperature behavior of quartic type. An unprecedented graphical distinction tool is introduced here, consisting in alternative C(T)/T4 data representations, by means of which the qualitative differences between opposite non‐quartic heat capacity behaviors for the materials under study have been visualized in rather pronounced form. A brief discussion is given of preliminary assessments of non‐quartic cryogenic heat capacity behaviors for a larger variety of III–V, II–VI, and I–VII materials.
Converting Commercial Sewing Threads into High‐Performance and Flexible/Wearable Fiber‐Shaped Supercapacitors via Facile Vapor Deposition Polymerization
Authors: Gao Xue , Xiao Xinyu , Dong Bin , Hu Jing , Tang Sheng , Qi Wen , Zou Dechun
Published: May 2019

Fiber‐shaped supercapacitors (FSSCs) are expected to motivate the development of wearable electronics. However, their high cost and complex operations limit their industrial production. Herein, commercial sewing threads are utilized as fiber substrates to prepare FSSCs via facile methods. The sewing threads become conductive after poly(3,4‐ethylenedioxythiophene) (PEDOT) uniformly grew on the porous surface by in situ polymerization of vacuum‐deposited 2,5‐dibromo‐3,4‐ethylenedioxythiophene. Then, MnO2 nanoflakes electrochemically grow on the conductive threads and the PEDOT layer uniformly wraps the flake surface, thereby improving the electrochemical performance. The FSSCs based on PEDOT/MnO2/PEDOT sandwich structure exhibit a high specific capacitance of 53.89 mF cm–1 (132.02 mF cm–2), an energy density of 3.07 μWh cm–1 (7.51 μWh cm–2), and a power density of 21.3 μW cm−1 (52.3 μW cm–2). Mild polymerization plays a vital role in converting the sewing threads into fiber electrodes with excellent properties. It confers electrodes with a robust adhesion ability, which results in excellent stability. The intrinsic knittability of sewing threads endows the FSSCs with outstanding flexibility. The low cost of the materials and facile preparation methods promote the large‐scale production and wide application of FSSCs. Moreover, these FSSCs based on sewing threads provide insight into the opportunity to develop smart and wearable electronics.
Enhancement of Mechanical and Structural Traits of Aluminum Using Low Energy Plasma Focus Device
Authors: Raza Hafiz Ahmad , Shafiq Muhammad , Naeem Muhammad , Naz Muhammad Yasin
Published: May 2019

Owing to good machinability, low weight and high specific strength, aluminum is widely used in aerospace and automotive industries. However, low mechanical strength limits its wide spread use in mainstream industries. In this study, nitriding of aluminum was performed with a stream of low energy ions in 1.8 kJ Mather type dense plasma focus (DPF) device. The axial distance from the anode tip was varied in steps to study the effect of the stream length on structural and mechanical properties of the nitrided samples. XRD and Raman analysis confirmed the formation of aluminum nitride (AlN) on the plasma exposed surface. Williamson‐Hall (W−H) study revealed significant improvement in crystallinity and strain of the nitride samples. The most favorable results on mechanical and structural properties of the nitrided samples were obtained at an axial distance of 10 cm. The improved texture and maximum dislocation density for typical AlN (311) is obtained at the optimum distance. The micro‐hardness of the nitrided samples was measured ∼4.5 times higher than the base material.
Room‐Temperature Photocatalytic Decomposition of N2O over Nanobelt‐Like Bi2MoO6
Authors: Tan Junbin , Cheng Huifang , Liu Jixing , Sun Jinru , Li Yan , Wang Hong , Liu Jian , Zhao Zhen
Published: May 2019

A series of nanobelt‐like Bi2MoO6 photocatalysts were design and controllably constructed via a simple hydrothermal approach, and their catalytic performances were investigated for photocatalytic decomposition of N2O for the first time. It was found that Bi2MoO6 synthesized at 170 °C (BM‐170) exhibits the highest photocatalytic activity with 21.7% N2O conversion at 25 °C under UVA irradiation (λ=365 nm) for 12 h, and that the excellent activity should be attributed to its highest content of Oads, strongest absorption capacity for visible light, lowest recombination rate of photo‐generated electron‐hole pairs, and highest separation efficiency for photogenerated charge carriers. Therefore, this study shed new light on the understanding and application of Bi2MoO6 catalysts for photocatalytic decomposition of N2O.
Schottky Barrier‐Controlled Black Phosphorus/Perovskite Phototransistors with Ultrahigh Sensitivity and Fast Response
Authors: Zou Xuming , Li Yuanzhe , Tang Guanqi , You Peng , Yan Feng
Published: May 2019

Phototransistors are recognized as highly sensitive photodetectors owing to their high gain induced by a photogating effect. However, the response speed of a typical phototransistor is rather slow due to the long lifetime of trapped carriers in the channel. Here, a novel Schottky barrier‐controlled phototransistor that shows ultrahigh sensitivity as well as a fast response speed is reported. The device is based on a channel of few‐layer black phosphorous modified with a MAPbI3−xClx perovskite layer, whose channel current is limited by the Schottky barrier at the source electrode. The photoresponse speed of the device can be tuned by changing the drain voltage, which is attributed to a field‐assisted detrapping process of electrons in the perovskite layer close to the Schottky barrier. Under optimal conditions, the device exhibits a high responsivity of 106–108 A W−1, an ultrahigh specific detectivity up to 9 × 1013 Jones, and a response time of ≈10 ms.
Aryl hydrocarbon receptor signaling, toxicity, and gene expression responses to mono‐methylchrysenes
Authors: Alqassim Ahmad Y. , Wilson Mark J. , Wickliffe Jeffrey K. , Pangeni Deepa , Overton Edward B. , Miller Charles A.
Published: May 2019

Polycyclic aromatic hydrocarbons (PAHs) comprise a large family of toxic compounds that come from natural and anthropogenic sources. Chrysene is a PAH with multiple effects, but the toxic potentials of mono‐methylchrysenes are less characterized. A comparison of chrysene and six mono‐methylchrysenes was performed using assays for cytotoxicity, human aryl hydrocarbon receptor (AhR) reporter gene signaling, and AhR‐regulated target gene and protein expression. Sulforhodamine B and trypan blue dye binding assays revealed these chrysenes to be similar in their cytotoxic effects on HepG2 cells. A yeast‐based reporter assay detecting human AhR‐mediated gene expression identified 4‐methylchrysene as being six times more potent and 5‐methylchrysene about one‐third as potent as chrysene. Other methylchrysenes were more similar to chrysene in the ability to act as AhR ligands. The mono‐methylchrysenes all strongly induced CYP1A1 mRNA and protein and moderately induced CYP1B1 expression in HepG2 cells. Levels of CYP1A2 mRNA were induced at higher concentrations of the chrysenes, but protein expression was not significantly altered. The PCR‐based gene expression and immunoblotting analyses indicated induced expression differences across the chrysene members were similar to each other. Overall, the effects of methylated chrysenes were comparable to unsubstituted chrysene, suggesting members of this group may be considered approximately equivalent in their effects. © 2019 Wiley Periodicals, Inc.
From Heptazines to Triazines – On the Formation of Poly(triazine imide)
Authors: Kessler Fabian K. , Schnick Wolfgang
Published: May 2019

Poly(triazine imide), a 2D extended carbon nitride network compound that is obtained from ionothermal synthesis in LiCl/KCl or LiBr/KBr salt melt has been known for over a decade. We now have investigated the formation process of this material starting from various triazine‐ and heptazine‐based precursors as well as the differences between ionothermal and conventional synthesis via thermal condensation. Independent of chosen starting material, melem (triamino‐s‐heptazine) is initially formed from the starting material as the imminent precursor to poly(triazine imide). We elucidate the impact of various different carbon nitride precursor compounds on the formation process, propose a mechanism for the back reaction of heptazines to triazines, and rationalize the occurring processes.
Indian Food Systems towards 2050: Challenges and Opportunities
Authors: Pingali Prabhu , Aiyar Anaka , Abraham Mathew , Rahman Andaleeb
Published: May 2019

Despite India’s economic progress over the past two decades, regional inequality, food insecurity and malnutrition problems persist. Simultaneously, trends in overweight and obesity, along with micronutrient deficiency, portend a future public health crisis. In this book, we examine the interactions between India’s economic development, agricultural production and nutrition through the lens of a “food systems approach (FSA)”. We explore various challenges and opportunities to achieve a nutrition secure future. We bring together the latest data available on development processes in India to (1) highlight the nature of food system challenges, (2) identify trends and threats to progress, (3) emphasize policy and institutional interventions needed to address challenges and (4) set an agenda interlinking agricultural development, health and nutrition and economic development.
Managing Climate Change Risks in Food Systems
Authors: Pingali Prabhu , Aiyar Anaka , Abraham Mathew , Rahman Andaleeb
Published: May 2019

Understanding the pathways through which climate change will impact food security is essential to creating robust food systems. First, we present scientific evidence to show that climate change will decrease crop and livestock productivity in India. Second, we show that climate change will impact health and labor productivity by increasing susceptibility to communicable and non-communicable diseases. Finally, we show that climate change will affect agricultural production and increase the vulnerability of poor regions and poor households, worsening inequities. We propose measures to actively cut down emissions, strengthen safety nets, increase policy commitment to tackle climate change and improve investments and access to technology to both mitigate its effects and increase scope for adaptation.
Economic Growth, Agriculture and Food Systems: Explaining Regional Diversity
Authors: Pingali Prabhu , Aiyar Anaka , Abraham Mathew , Rahman Andaleeb
Published: May 2019

Despite India’s per capita GDP doubling over the last decade, states like Goa compare to countries in Latin America, while states like Uttar Pradesh compare to low-income countries in sub-Saharan Africa in terms of their development outcomes. In this chapter, we identify that comparative advantages that arise due to resource availability, agro-climatic conditions, investments in human capital and the differential growth of the non-agricultural sector explain this subnational divergence. We show that states that continue to develop economic sectors in which they have no comparative advantages will remain locked into a low growth equilibrium. Reorienting agriculture based on comparative advantages in agricultural production, reducing entry barriers into the urban labor market and upskilling the rural and urban workforce are keys to develop equitable food systems for the future.
Reimagining Safety Net Programs
Authors: Pingali Prabhu , Aiyar Anaka , Abraham Mathew , Rahman Andaleeb
Published: May 2019

Existing safety net programs in India provide income and nutritional assistance during different stages of an individual’s life. Critics have pointed out to inefficiencies in the design and delivery mechanisms which reduce the effectiveness of these programs in benefiting the targeted population. In this chapter, we argue that safety nets should account for the changing economic structure, demographic transitions and shifting livelihood patterns. As India urbanizes, focusing on urban poor, diversifying away from staple grain-focused policy is essential. Use of tools such as ICTs to curb corruption and leakages from the safety nets is essential. Finally, we highlight the complementary role of essential public goods provision together with the expansion of safety nets for reducing vulnerability and structural poverty.
Agricultural Technology for Increasing Competitiveness of Small Holders
Authors: Pingali Prabhu , Aiyar Anaka , Abraham Mathew , Rahman Andaleeb
Published: May 2019

Agricultural technology plays a vital role in building viable and sustainable food systems. The green revolution (GR) is a landmark example of how scale-neutral technology transformed agricultural production. However, one of the limitations of GR technologies was that it was concentrated to a few crops and to high potential regions where irrigation was readily available. Newer approaches to technological interventions need to help increase yields while limiting environmental externalities. In this chapter, we identify that biotechnology will be critical in productivity increase, improving resilience to climate change and reducing environmental impact. For this, there is a need for India to have more forward-looking biotechnology policy to bolster innovation towards climate change mitigation and adaptation.
Scientific modelling with diagrams
Authors: Stegmann Ulrich E.
Published: May 2019

Diagrams can serve as representational models in scientific research, yet important questions remain about how they do so. I address some of these questions with a historical case study, in which diagrams were modified extensively in order to elaborate an early hypothesis of protein synthesis. The diagrams’ modelling role relied mainly on two features: diagrams were modified according to syntactic rules, which temporarily replaced physico-chemical reasoning, and diagram-to-target inferences were based on semantic interpretations. I then explore the lessons for the relative roles of syntax, semantics, external marks, and mental images, for justifying diagram-to-target inferences, and for the “artefactual approach” to scientific models.
Reassessing truth-evaluability in the Minimalism-Contextualism debate
Authors: Fisher Sarah A.
Published: May 2019

The debate between Semantic Minimalism and Radical Contextualism is standardly characterized as concerningtruth-evaluability—specifically, whether or not sentences require rich contextualization in order to express complete, truth-evaluable contents. In this paper, I examine the notion of truth-evaluability, considering which kinds of mappings it might require from worldly states of affairs to truth-values. At one end of the spectrum, an exhaustive notion would require truth-evaluable contents to mapallpossible states of affairs to truth-values. At the other end, a liberal notion would require only that truth-evaluable contents mapat least onepossible state of affairs toat least onetruth-value. I show that both Minimalists and Radical Contextualists rely on some intermediate, moderately strict notion of truth-evaluability, falling between these two poles. I consider four ways in which such a notion could be defined. However, I argue that each of these is ultimately implausible, giving us no reason to favour a moderately strict notion of truth-evaluability over the liberal alternative. This suggests that the debate must shift to more moderate ground; rather than concerning thein principle possibilityof truth-evaluable contents, it fundamentally hinges on theirexplanatory value. More generally, paying close attention to the notion of truth-evaluability allows us to tease apart distinct strands in the Minimalism-Contextualism debate, and gain a better appreciation of what is at stake.
The effects of transcranial direct current stimulation compared to standard bupropion for the treatment of tobacco dependence: A randomized sham-controlled trial
Authors: Ghorbani Behnam Shahram , Mousavi Seyed Abbas , Emamian Mohammad Hassan
Published: May 2019

Background:

Current treatments for smoking cessation are not effective for most smokers. This study aims to examine the effectiveness of transcranial Direct Current Stimulation (tDCS) on smoking cessation.

Methods:

In this randomized, sham-controlled trial study, tobacco-dependent (by DSM-5) male participants were recruited from the general public invitation. Participants were randomly allocated to 5 groups; (A), treatment with 300mg bupropion for 8 weeks; (B), active tDCS (20 sessions for 4 weeks); (C), sham for group B ; (D), active tDCS (20 sessions for 12 weeks), and (E), sham for group D. The electrode montage was anode F3 and cathode F4. Study outcomes include salivary cotinine, Fagerstrom test for nicotine dependence, and smoked cigarette per day, were examined on three time points. Repeated-measures analysis of variances and the generalized estimation equation (GEE) model were employed for data analysis.

Results:

Among 210 volunteers, 170 participants completed the study. Mean age of participants was 42.9 years, ranging from 21 to 64 years. The 6-month point abstinence rates in groups A, B and D were 20%, 7% and 25.7%, and in C, D sham groups were 3.1% and 3% respectively. Results of the GEE model showed that although group D was not different from group A in abstinence rate, i.e., salivary cotinine >4 (p = 0.266), nicotine dependency by Fagerstrom test was lower in this group compared to group A (p = 0.019).

Conclusions:

The 12-week tDCS had a clinically good therapeutic effect on smoking cessation and its dependency. It may be a substitute for bupropion treatment.
Child consultation and the law in the Northern Territory of Australia
Authors: Kendall-Hall Danielle
Published: May 2019

Consultation with children is a delicate art, and consultation with vulnerable children, even more so. Experienced clinicians believe best practice in undertaking such work requires tertiary studies in social work or psychology combined with extensive supervised clinical experience. The current pathways to becoming a children’s lawyer in the Northern Territory do not involve mandatory training in child well-being, and yet lawyers are asked to consult with highly traumatised children and bring the voices of children into the courtroom. Lawyers for young children are additionally required to provide an opinion as to what they believe to be in the best interests of the child, without a social work or psychology-based qualification, training or in-depth guidelines to support their position. This article looks at what the law says about child consultation, what child development research says about child consultation and child consultation in practice in a Northern Territory child protection setting. At its conclusion, the author discusses potential pathways forward for lawyers and clinicians to work together in safe practices of child consultation.
Returning aggregate results of clinical trials: Empirical data of patient preferences
Authors: Aldinger Carmen E. , Ligibel Jennifer , Shin Im Hee , Denninger John W. , Bierer Barbara E.
Published: May 2019

Introduction:

The purpose of this research was to understand the preferences of patients receiving integrative medicine services for return of aggregate study results.

Methods:

A brief online survey (survey 1) was sent to 341 cancer patients receiving integrative medicine interventions; subsequently, a minimally revised survey (survey 2) was sent to 812 individuals with various medical conditions who had been either research participants in integrative medicine studies (n = 446) or patients (n = 346) of mind–body medicine.

Results:

Feedback to a model plain language summary was elicited from survey 1 and survey 2 respondents. Seventy-seven survey recipients (23%) responded to survey 1, and 134 survey recipients (17%) responded to survey 2. The majority of respondents to the surveys were female and 51–70 years of age. Ninety percent of responders to survey 1 and 89% of responders to survey 2 indicated that researchers should share overall results of a study with participants. In terms of the means of result distribution, 37%–47% preferred email, while 22%–27% indicated that, as long as the results are shared, it did not matter how this occurred. Of 38 survey 1 respondents who had previously participated in a clinical trial, 37% had received the results of their study. In survey 2, 63 individuals indicated that they previously participated in clinical trials, but only 16% recalled receiving results.

Conclusions:

These results confirm that the majority (89%–90%) of integrative medicine patients are interested in receiving the results of clinical trials. The majority (82%–94%) of respondents felt the model plain language summary of results provided was helpful.
Community engagement in patient-centered outcomes research: Benefits, barriers, and measurement
Authors: Sprague Martinez Linda , Carolan Kelsi , O’Donnell Arden , Diaz Yareliz , Freeman Elmer R.
Published: May 2019

Introduction:

This study employed the Delphi method, an exploratory method used for group consensus building, to determine the benefits and challenges associated with community engagement in patient-centered outcomes research.

Methods:

A series of email surveys were sent to the Patient-Centered Outcomes Research Institute (PCORI)-funded researchers (n = 103) in New England. Consensus was achieved through gathering themes and engaging participants in ranking their level of agreement over three rounds. In round one, participant responses were coded thematically and then tallied. In round two participants were asked to state their level of agreement with each of the themes using a Likert scale. Finally, in round three, the group was asked to rank the round two themes based on potential impact.

Results:

Results suggested the greatest benefit of community engagement is that it brings multiple perspectives to the table, with 92% ranking it as the first or second most important contribution. Time was ranked as the most significant barrier to engaging community. Strategies to overcome barriers to community engagement include engaging key stakeholders early in the research, being kind and respectful and spending time with stakeholders. The most significant finding was that no researchers reported having specific measures to evaluate community engagement.

Conclusion:

Community engagement can enhance both research relevance and methodology when researchers are engaged in meaningful collaborations. Advancing the science of community engagement will require the development of evaluation metrics to examine the multiple domains of partnership.
An example of medical device-based projection of clinical trial enrollment: Use of electrocardiographic data to identify candidates for a trial in acute coronary syndromes
Authors: Selker Harry P. , Kwong Manlik , Ruthazer Robin , Gorman Sheeona , Green Giuliana , Patchen Elizabeth , Udelson James E. , Smithline Howard A. , Baumann Michael R. , Harris Paul A. , Shah Rashmee U. , Nelson Sarah J. , Cohen Theodora , Jones Elizabeth B. , Barnewolt Brien A. , Williams Andrew E.
Published: May 2019

Background:

To identify potential participants for clinical trials, electronic health records (EHRs) are searched at potential sites. As an alternative, we investigated using medical devices used for real-time diagnostic decisions for trial enrollment.

Methods:

To project cohorts for a trial in acute coronary syndromes (ACS), we used electrocardiograph-based algorithms that identify ACS or ST elevation myocardial infarction (STEMI) that prompt clinicians to offer patients trial enrollment. We searched six hospitals’ electrocardiograph systems for electrocardiograms (ECGs) meeting the planned trial’s enrollment criterion: ECGs with STEMI or > 75% probability of ACS by the acute cardiac ischemia time-insensitive predictive instrument (ACI-TIPI). We revised the ACI-TIPI regression to require only data directly from the electrocardiograph, the e-ACI-TIPI using the same data used for the original ACI-TIPI (development set n = 3,453; test set n = 2,315). We also tested both on data from emergency department electrocardiographs from across the US (n = 8,556). We then used ACI-TIPI and e-ACI-TIPI to identify potential cohorts for the ACS trial and compared performance to cohorts from EHR data at the hospitals.

Results:

Receiver-operating characteristic (ROC) curve areas on the test set were excellent, 0.89 for ACI-TIPI and 0.84 for the e-ACI-TIPI, as was calibration. On the national electrocardiographic database, ROC areas were 0.78 and 0.69, respectively, and with very good calibration. When tested for detection of patients with > 75% ACS probability, both electrocardiograph-based methods identified eligible patients well, and better than did EHRs.

Conclusion:

Using data from medical devices such as electrocardiographs may provide accurate projections of available cohorts for clinical trials.
Age determination of glacially-transported boulders in Ireland and Scotland using Schmidt-hammer exposure-age dating (SHD) and terrestrial cosmogenic nuclide (TCN) exposure-age dating
Authors: Wilson Peter , Dunlop Paul , Millar Chris , Wilson Frances A.
Published: May 2019

Schmidt-hammer exposure-age dating (SHD) was applied at 15 sites with glacially-transported granite boulders in parts of northern and western Ireland and southwest Scotland that had been exposed by retreat of the last British-Irish Ice Sheet (BIIS) or Younger Dryas (YD) ice masses. Seven of these surfaces had previously been dated using terrestrial cosmogenic nuclide (TCN) exposure-age dating. Application of the granite calibration equation of Tomkins et al. (2018c) indicated a close correspondence between the SHD ages and the TCN ages (within 1σ or 2σ uncertainties). These findings demonstrate that SHD ages can be of comparable accuracy, precision, and reliability to TCN ages and are a strong argument for the more extensive use of SHD in some Quaternary dating projects. However, surface ages obtained by both SHD and TCN dating should not be accepted uncritically; they must be assessed in relation to the wider geological, geomorphological, and geochronological evidence. Evaluation of eight SHD ages, for which corresponding TCN ages are not available, indicate that most are consistent with current theory and field evidence, but some anomalous age estimates occur.
Afterword Uncertain trajectories and refigured social worlds: the image entourage and other practices of digital and social media photography
Authors: Kratz Corinne A.
Published: May 2019

Drawn from East, West, Central and Southern Africa, the case studies in this special issue build on several decades of important work on photography in Africa. That work has examined colonial photography and postcards, studio work from colonial times to the present, activist photography, photojournalism, and artists who work with photographic images. It has addressed issues of representation, portraiture, aesthetics, self-fashioning, identities, power and status, modernities and materiality, the roles of photographs in governance and everyday politics, and the many histories and modes of social practice around making, showing, viewing, exchanging, manipulating, reproducing, circulating and archiving photographic images. Yet these articles push such issues and topics in exciting directions by addressing new photographic circumstances emerging throughout the world, initiated through new media's technological shifts and possibilities. In Africa, this has fuelled a range of transformations over the last fifteen years or so, transformations that are still unfolding. As the articles show, digital images, mobile phone cameras and social media (also accessed via phone) constitute the potent triad that has set off these transformations.
Hostile visual encounters: fighting to control photographic meaning in the DRC's digital age
Authors: Graham Aubrey P.
Published: May 2019

On 16 July 2013, Simone Schlindwein, a German journalist, used her mobile phone to photograph a conflict-related image in the Democratic Republic of the Congo that later contributed to local riots and to her hasty exit across the border. From the ‘front’, she uploaded the photograph to her Twitter account and caused a melee of virtual and on-the-ground controversy that at record speed came to involve the United Nations, members of the Congolese diaspora, the Congolese army, the M23 rebel army propaganda office, and the residents of the region. This article starts from her image to ethnographically examine the resulting events and responses, both online and in the city of Goma. In so doing, it engages the heated regional debate as to whether the image was objectively captured or if the violence depicted was simply ‘playing for the camera’. Addressing the simultaneous online movement of the image through social media and news sites, the article argues that the combination of the socio-political climate, conflict and the uncontrollable narrative of the image created a perfect storm in which the entangled regional politics suddenly became visible.
‘Greenwich near London’: the Royal Observatory and its London networks in the seventeenth and eighteenth centuries
Authors: HIGGITT REBEKAH
Published: May 2019

Built in Greenwich in 1675–1676, the Royal Observatory was situated outside the capital but was deeply enmeshed within its knowledge networks and communities of practice. Scholars have tended to focus on the links cultivated by the Astronomers Royal within scholarly communities in England and Europe but the observatory was also deeply reliant on and engaged with London's institutions and practical mathematical community. It was a royal foundation, situated within one government board, taking a leading role on another, and overseen by Visitors selected by the Royal Society of London. These links helped develop institutional continuity, while instrument-makers, assistants and other collaborators, who were often active in the city as mathematical authors and teachers, formed an extended community with interest in the observatory's continued existence. After outlining the often highly contingent institutional and personal connections that shaped and supported the observatory, this article considers the role of two early assistants, James Hodgson and Thomas Weston. By championing John Flamsteed's legacy and sharing observatory knowledge and practice beyond its walls, they ensured awareness of and potential users for its outputs. They and their successors helped to develop a particular, and ultimately influential, approach to astronomical and mathematical practice and teaching.
Understanding and Overcoming Roadblocks to Environmental Sustainability: Past Roads and Future Prospects
Authors: Bergquist Ann-Kristin , Cole Shawn A. , Ehrenfeld John , King Andrew A. , Schendler Auden
Published: May 2019

This article examines key barriers to business sustainability discussed at a multidisciplinary conference held at the Harvard Business School in 2018. Drawing on perspectives from both the historical and business literatures, speakers debated the historical success of and future opportunities for voluntary business actions to advance sustainability. Roadblocks include misaligned incentives, missing institutions, inertia of economic systems, and the concept of sustainability itself. Overcoming these roadblocks will require systematic interventions and alternative normative concepts.
The Status and Legitimacy of Popular Uprisings in the AU Norms on Democracy and Constitutional Governance
Authors: Dersso Solomon A
Published: May 2019

During the first decade of the African Charter on Democracy, Elections and Governance, one significant political development in Africa has been the resort to popular protests or uprisings against tyrannical rule. These uprisings have been remarkable for their scale and extraordinary political ramifications, and succeeded in unseating longstanding authoritarian rulers. They presented serious challenges to the African Union's democratic and constitutional governance norms, in particular regarding the status of uprisings in relation to the ban on unconstitutional changes of government and the determination of whether and when resultant changes of government are constitutional. In addressing these issues, this article contends that, although popular uprisings (also called “democratic revolutions”) are not a priori deemed constitutional, the AU's application of its norm banning unconstitutional changes of government to the popular uprisings in North Africa and Burkina Faso has opened a legal avenue that offers constitutional legitimacy for popular uprisings overthrowing authoritarian regimes.
Toddy, Race, and Urban Space in Colonial Singapore, 1900–59
Authors: ALAGIRISAMY DARINEE
Published: May 2019

British Malaya's toddy industry features in history as a problem that plagued the plantation economy, when the city toddy shop was no less important in contributing to a racialized discourse of modernity in Singapore. Although colonial policy served to engender the racialization of toddy drinking as a peculiarly Tamil vice, toddy's social life in Singapore demonstrates that it became the poor man's beer regardless of race. The alcoholic drink gave rise to new adaptations, enterprises, and innovations in colonial Singapore, thus carving out a unique place for itself in the city's cultural landscape. Yet, Singapore's toddy industry dominated the public spotlight for less palatable reasons, which rendered it the subject of numerous demands for increased government regulation. The colonial government responded with a slew of measures that often differed from the federation's toddy policy. Singapore's toddy industry yielded divergent imaginaries of modernity, particularly in the aftermath of the Second World War. Some reformers sought its abolition or relocation away from city spaces, whilst others demanded its modernization on the grounds that this meagre establishment was the labourer's sole source of recreation. In light of recent developments that have prompted the government's intervention in limiting migrant labourers’ access to alcohol, this article will examine the considerations that informed the colonial establishment's urban toddy policy and its corresponding impact on Singapore society as it sped towards decolonization. Through an exploration of toddy's treatment in the English-language press, oral histories, and colonial office records, this article seeks to contribute perspectives on an aspect of Singapore's social history that remains largely unexplored.
Interactive impact of childhood maltreatment, depression, and age on cortical brain structure: mega-analytic findings from a large multi-site cohort
Authors: Tozzi Leonardo , Garczarek Lisa , Janowitz Deborah , Stein Dan J. , Wittfeld Katharina , Dobrowolny Henrik , Lagopoulos Jim , Hatton Sean N. , Hickie Ian B. , Carballedo Angela , Brooks Samantha J. , Vuletic Daniella , Uhlmann Anne , Veer Ilya M. , Walter Henrik , Bülow Robin , Völzke Henry , Klinger-König Johanna , Schnell Knut , Schoepf Dieter , Grotegerd Dominik , Opel Nils , Dannlowski Udo , Kugel Harald , Schramm Elisabeth , Konrad Carsten , Kircher Tilo , Jüksel Dilara , Nenadić Igor , Krug Axel , Hahn Tim , Steinsträter Olaf , Redlich Ronny , Zaremba Dario , Zurowski Bartosz , Fu Cynthia H.Y. , Dima Danai , Cole James , Grabe Hans J. , Connolly Colm G. , Yang Tony T. , Ho Tiffany C. , LeWinn Kaja Z. , Li Meng , Groenewold Nynke A. , Salminen Lauren E. , Walter Martin , Simmons Alan N , van Erp Theo G.M. , Jahanshad Neda , Baune Bernhard T. , van der Wee Nic J.A. , van Tol Marie-Jose , Penninx Brenda W.J.H. , Hibar Derrek P. , Thompson Paul M. , Veltman Dick J. , Schmaal Lianne , Frodl Thomas ,   ‘for the ENIGMA-MDD Consortium’
Published: May 2019

Background

Childhood maltreatment (CM) plays an important role in the development of major depressive disorder (MDD). The aim of this study was to examine whether CM severity and type are associated with MDD-related brain alterations, and how they interact with sex and age.

Methods

Within the ENIGMA-MDD network, severity and subtypes of CM using the Childhood Trauma Questionnaire were assessed and structural magnetic resonance imaging data from patients with MDD and healthy controls were analyzed in a mega-analysis comprising a total of 3872 participants aged between 13 and 89 years. Cortical thickness and surface area were extracted at each site using FreeSurfer.

Results

CM severity was associated with reduced cortical thickness in the banks of the superior temporal sulcus and supramarginal gyrus as well as with reduced surface area of the middle temporal lobe. Participants reporting both childhood neglect and abuse had a lower cortical thickness in the inferior parietal lobe, middle temporal lobe, and precuneus compared to participants not exposed to CM. In males only, regardless of diagnosis, CM severity was associated with higher cortical thickness of the rostral anterior cingulate cortex. Finally, a significant interaction between CM and age in predicting thickness was seen across several prefrontal, temporal, and temporo-parietal regions.

Conclusions

Severity and type of CM may impact cortical thickness and surface area. Importantly, CM may influence age-dependent brain maturation, particularly in regions related to the default mode network, perception, and theory of mind.