bluuebunny/crossref_metadata_2025 huggingface dataset:
Microemboli After Successful Thrombectomy Do Not Affect Outcome but Predict New Embolic Events
Authors: Sheriff Faheem , Diz-Lopes Mariana , Khawaja Ayaz , Sorond Farzaneh , Tan Can Ozan , Azevedo Elsa , Franceschini Maria Angela , Vaitkevicius Henri , Li Karen , Monk Andrew Donald , Michaud Sarah LaRose , Feske Steven K. , Castro Pedro
Published: December 2019

Background and Purpose—

We aimed to determine if microemboli after endovascular thrombectomy correlate with unfavorable outcomes despite successful recanalization.

Methods—

This is a prospective multicenter study of consecutive patients with ischemic stroke and occlusion of anterior circulation vessels (terminal internal carotid or main trunk of the middle cerebral artery/first-order branch of the main trunk of the middle cerebral artery segments of middle cerebral artery) after successful thrombectomy (modified Treatment In Cerebral Ischemia grades 2b-3). Microembolic signals (MES) were assessed by 30 minutes of transcranial Doppler monitoring within 72 hours of the last-seen-well time. Major outcomes included modified Rankin Scale at 90 days and infarct volume on head computed tomography at 24 hours. We also assessed early outcomes based on National Institutes of Health Stroke Scale variation and recurrence of stroke, transient ischemic attack, or systemic embolism within 90 days.

Results—

Among 111 patients, MES were detected in 43 (39%), with a median rate of 4 counts/h (interquartile range 2–12). The occurrence of MES was not associated with a significant difference in modified Rankin Scale (ordinal shift analysis, adjusted odds ratio, 1.06 [95% CI, 0.48–2.34]
P
=0.85) nor in functional independence (modified Rankin Scale, 0–2: adjusted odds ratio, 0.52 [95% CI, 0.19–1.39]
P
=0.19). Patients with and without MES had similar infarct volumes (adjusted beta, 11.2 [95% CI, −46.6 to +22.9]
P
=0.51) on 24-hour computed tomography. MES did predict new embolic events (adjusted Cox hazard ratio, 6.78 [95% CI, 1.63–27.8]
P
=0.01).

Conclusions—

MES detected by transcranial Doppler following endovascular treatment of anterior circulation occlusions do not predict clinical or radiological outcome. However, such emboli are an independent marker of recurrent embolic events within 90 days.
The Universal Declaration of Human Rights in Twenty Years of icc Practice: An International Law Perspective
Authors: Riccardi Alice
Published: December 2019

On the occasion of the 20th anniversary of the entry into force of the Rome Statute and the 70th anniversary of the proclamation of the Universal Declaration of Human Rights (udhr), this article ponders on the two instruments intimate and symbiotic relationship. Following the systematisation and analysis of all International Criminal Court (icc) rulings mentioning the udhr, the article argues that the Court has aligned itself with the practice of other international jurisdictions regarding the udhr. Notably, the icc has adhered to the tendency of considering the human rights expressed in the udhr binding irrespective of their formal source, as inherently equipped with authority and persuasiveness. This would originate from the udhr capacity to convey general principles innate in the international order and of such an essential nature that their status under international law does not need to be assessed.
The Role of Hand Movement in Spatial Serial Order Memory
Authors: Zhao Yangke , Chen Chuansheng , Qian Xiuying
Published: December 2019

Research on serial order memory has traditionally used tasks where participants passively view the items. A few studies that included hand movement showed that such movement interfered with serial order memory. In the present study of three experiments, we investigated whether and how hand movements improved spatial serial order memory. Experiment 1 showed that manual tracing (i.e., hand movements that traced the presentation of stimuli on the modified eCorsi block tapping task) improved the performance of backward recall as compared to no manual tracing (the control condition). Experiment 2 showed that the facilitation effect resulted from voluntary hand movements and could not be achieved via passive viewing of another person’s manual tracing. Experiment 3 showed that it was the temporal, not the spatial, signal within manual tracing that facilitated spatial serial memory.
Enjoying Art: The Experience of Beauty from Understanding Regularities
Authors: Serrao Fabrizio
Published: December 2019

Art production and enjoyment is a universal human behavior, yet the reasons why it evolved remain elusive. Works of art can convey strong emotions, and various authors attempted to explain the enjoyment of such emotions from an evolutionary perspective. Other authors focused instead on emergent properties of works of art: patterns and coherence, symmetry and proportions, harmony and consonance. Here, I argue that all these emergent properties fall into the definition of regularity, as well as other features that have been overlooked and yet create beauty in all arts (including literature). More precisely, I define a regular composition as having its elements arranged according to a rule that is understandable ‘a priori.’ Furthermore, I propose two novel evolutionary insights into the enjoyment of complex regularities. First, the enjoyment may stem from the drive to gain information on the environment, which would result in a preference for those arrangements that can be understood ‘a priori’ but provide information on a variety of elements. Second, because regularity is mostly a product of life, the attraction to regular stimuli might have evolved to promote the detection of living beings. This would encourage the interaction with other organisms in accordance with Wilson’s ‘biophilia’ hypothesis.
A new species of Bulbophyllum (Orchidaceae; Epidendroideae) from Papua New Guinea

Authors: THOERLE LISA , PHILLIPS WILLIAM A.
Published: December 2019

Bulbophyllum rinkei, a new species in Bulbophyllum sect. Monanthaparva from Papua New Guinea, is described and illustrated. Bulbophyllum rinkei is distinguished from the similar B. pterostele by its flowers with a trilobed lip with large, rounded, erect basal lateral lobes (vs. oblong with erect lateral margins) and a column with deltoid stelidia with an obtuse triangular tooth on the upper margin (vs.  spatulate, truncate).
A new Portholefish of the genus Diplophos (Stomiiformes: Gonostomatidae) from the western Pacific Ocean
Authors: KOEDA KEITA , HO HSUAN-CHING
Published: December 2019

A new Portholefish, Diplophos vicinia sp. nov., is described on the basis of nine specimens collected from the western Pacific Ocean by commercial midwater trawl. The new species, currently known only from the South China Sea and north of Papua New Guinea, can be easily distinguished from six nominal congeners by the combination of the following characters: dorsal-fin origin closer to snout than caudal-fin base, distance between last two AC photophores half that between preceding photophores, gill rakers 4 + 10–11=14–15, abdominal vertebrae 30–32, caudal vertebrae 44–45, total vertebrae 74–76, and the following photophore counts: IP 13–14, PV 18–19, IV 31–32, VAV 12–13, AC 37–39 + 2, and IC 83–86.
A Case Study of the Physical Processes Associated with the Atmospheric River Initial-Condition Sensitivity from an Adjoint Model
Authors: Demirdjian Reuben , Doyle James D. , Reynolds Carolyn A. , Norris Joel R. , Michaelis Allison C. , Ralph F. Martin
Published: December 2019

Analysis of a strong landfalling atmospheric river is presented that compares the evolution of a control simulation with that of an adjoint-derived perturbed simulation using the Coupled Ocean–Atmosphere Mesoscale Prediction System. The initial-condition sensitivities are optimized for all state variables to maximize the accumulated precipitation within the majority of California. The water vapor transport is found to be substantially enhanced at the California coast in the perturbed simulation during the time of peak precipitation, demonstrating a strengthened role of the orographic precipitation forcing. Similarly, moisture convergence and vertical velocities derived from the transverse circulation are found to be substantially enhanced during the time of peak precipitation, also demonstrating a strengthened role of the dynamic component of the precipitation.

Importantly, both components of precipitation are associated with enhanced latent heating by which (i) a stronger diabatically driven low-level potential vorticity anomaly strengthens the low-level wind (and thereby the orographic precipitation forcing), and (ii) greater moist diabatic forcing enhances the Sawyer–Eliassen transverse circulation and thereby increases ascent and dynamic precipitation. A Lagrangian parcel trajectory analysis demonstrates that a positive moisture perturbation within the atmospheric river increases the moisture transport into the warm conveyor belt offshore, which enhances latent heating in the perturbed simulation. These results suggest that the precipitation forecast in this case is particularly sensitive to the initial moisture content within the atmospheric river due to its role in enhancing both the orographic precipitation forcing and the dynamic component of precipitation.
Estimating the Effective Radiative Forcing of Contrail Cirrus
Authors: Bickel Marius , Ponater Michael , Bock Lisa , Burkhardt Ulrike , Reineke Svenja
Published: December 2019

Evidence from previous climate model simulations has suggested a potentially low efficacy of contrails to force global mean surface temperature changes. In this paper, a climate model with a state-of-the-art contrail cirrus representation is used for fixed sea surface temperature simulations in order to determine the effective radiative forcing (ERF) from contrail cirrus. ERF is expected to be a good metric for intercomparing the quantitative importance of different contributions to surface temperature and climate impact. Substantial upscaling of aviation density is necessary to ensure statistically significant results from our simulations. The contrail cirrus ERF is found to be less than 50% of the respective instantaneous or stratosphere adjusted radiative forcings, with a best estimate of roughly 35%. The reduction of ERF is much more substantial for contrail cirrus than it is for a CO2increase when both stratosphere adjusted forcings are of similar magnitude. Analysis of all rapid radiative adjustments contributing to the ERF indicates that the reduction is mainly induced by a compensating effect of natural clouds that provide a negative feedback. Compared to the CO2reference case, a less positive combined water vapor and lapse rate adjustment also contributes to a more distinct reduction of contrail cirrus ERF, but not as much as the natural cloud adjustment. Based on the experience gained in this paper, respective contrail cirrus simulations with interactive ocean will be performed as the next step toward establishing contrail cirrus efficacy. ERF results of contrail cirrus from other climate models equipped with suitable parameterizations are regarded as highly desirable.
Estimation of Aerosol-Corrected Surface Solar Irradiance at Local Incidence Angle over Different Physiographic Subdivisions of India and Adjoining Areas Using MODIS and SRTM Data
Authors: Lukose Libeesh , Dutta Dibyendu
Published: December 2019

Surface solar irradiance is considered as an important component of the surface radiation budget and constitutes one of the essential climate variables. In the present study, clear-sky instantaneous solar irradiance was estimated over 15 physiographic regions of India during January. Dewpoint temperature profiles were extracted from Moderate Resolution Imaging Spectroradiometer (MODIS) instrument onboard the Aqua satellite to calculate actual vapor pressure following Clausius–Clapeyron equation, which was further used in the Zillman parameterization for solar irradiance. The effect of terrain slope and aspect on direct radiation was taken into account by modifying the parameterized incoming shortwave flux by introducing the local incidence angle. A significant positive correlation was found between terrain-corrected MODIS irradiance and measured radiation data but the RMSE was very high (187 W m−2). Further, the effect of aerosol extinction was introduced by multiplying the terrain-corrected flux by a transmission factor obtained from satellite-derived aerosol optical depth and Ångström exponent. Due to the inclusion of the aerosol transmittance, the correlation was significantly improved (R2 = 0.84) and RMSE was reduced (31 W m−2). Further the effect of surface orientation on surface irradiance was evaluated on six hilly subdivisions. A large variation in the flux (135 to 161 W m−2) was noticed among different aspect classes. The variability was highest in the Eastern Himalayas subdivision (>250 W m−2) and was a minimum in the Eastern Hills subdivision (<28 W m−2). In absence of ground radiation data in hills, Modern-Era Retrospective Analysis for Research and Applications, version 2 (MERRA-2), was used for validation of model output but it performed poorly and got saturated at higher surface irradiance values.
Influence of carbon nanotubes on the properties of friction composite materials
Authors: EL-kashif Emad F , Esmail Shaimaa A , Elkady Omayma AM , Azzam BS , Khattab Ali A
Published: December 2019

Carbon nanotubes have a lot of applications in mechanical fields. This is because nanomaterials have many superior mechanical properties such as very high strength-to-weight ratio, high modulus-to-weight ratio, high corrosion resistance, and super intelligence properties, which make them as smart materials. One of these attractive applications is the use of carbon nanotubes in vehicle brake friction material. Therefore, the fabrication and testing processes of these nanomaterials should be performed carefully to evaluate their mechanical, tribological, and noise properties. In this paper, friction material mixed with carbon nanotubes have been fabricated with different carbon nanotube contents and the same fabrication parameters. The carbon nanotubes have been produced using the conventional submerged arc discharge technique. The produced friction materials have been cut into pieces with standard sizes and then tested mechanically and tribologically. The results of tests have illustrated that the addition of carbon nanotubes into the friction materials could improve their mechanical properties (hardness, strength, and modulus) and also could enhance their tribological properties (wear rate and friction coefficient). Moreover, the tests showed that the presence of carbon nanotubes in friction materials could reduce the noise, vibration of the friction materials, and reduce the temperature rise due to the effect of friction, which means that the carbon nanotubes could raise the thermal conductivity of friction material, while the friction coefficient has stayed within the allowable standard limits (0.35–0.45). Surface morphology shows that the presence of carbon nanotubes in the friction materials could help to avoid surface friction cracks or fins within the normal operating conditions. The good combination of mechanical and tribological properties was obtained at 0.5% carbon nanotubes.
Design and study of the action of the yarn-pulling mechanism of a carbon-fiber one-sided stitching device based on improved technology
Authors: Dong Jiuzhi , Ji Lingchao , La Xin , Yang Jingzhao , Chen Yunjun
Published: December 2019

To realize a one-sided stitching action and stable stitch formation, a poor match between the lead and the hook yarn needles in the stitching process must be avoided as it can lead to hook dropping and hook errors, causing loop loss, thread breaking, and even thread relaxing. Based on an analysis of the principle of one-sided stitching and matching the hook and lead yarn needles, the original stitching technology is improved and a method of trajectory superposition is proposed. A yarn-pulling mechanism is designed for a one-sided stitching device for three-dimensional preformed carbon/carbon composites. By analyzing the principle of the yarn-pulling mechanism, a mathematical model of that mechanism is established, and a trajectory simulation analysis is carried out with MATLAB, which verifies the rationality of the yarn-pulling principle. Results for the two crank angles of the yarn-pulling mechanism and the crank angle of the hook yarn needle at two particular moments reflect the matching relationship of the three, which provides a theoretical reference for the stitching device to adjust to and work well, forming the desired stitch. Finally, stitching tests are carried out, and the test results show the designed yarn-pulling mechanism can cooperate with the hook and the lead yarn needles to complete the stitch lock. This realizes a stable stitching action and avoids hook dropping and hook errors, thereby increasing stitching efficiency.
Study on modification of rabbit hair fibers with L-cysteine
Authors: Yongfu Xu , Zhang Yi
Published: December 2019

Rabbit hair fibers were modified by L-cystine under the action of ultrasound and a kind of modified rabbit hair fiber was obtained. An orthogonal test of four factors and three levels was designed. The range analysis was analyzed using a comprehensive score method of friction factor and fiber strength, and the variance analysis was carried out by Statistical Package for Social Science statistical software. The optimal modification conditions were obtained: a concentration of L-cystine (A) of 0.05 mol/L, ultrasonic power (B) of 90 W, a water bath temperature (C) of 75℃, and ultrasonic treatment time (D) of 1 hour. Univariate analysis showed the L-cystine concentration had the most significant effect on the modification of rabbit hair fibers, and the regression equation is y = 74.423 + 1300.267 A−1.818 C−9092A2 + 0.019C2. The surface brightness of the modified rabbit hair fibers was enhanced and the scale angle was increased 20° by setting up the angle of the scale model and the electron microscope. The internal structure of rabbit hair fibers was characterized by Fourier transform infrared spectroscopy, peak separation, and differential scanning calorimetry. The results showed that L-cystine reduced the disulfide bond in the macromolecular chain by 3%, resulting in a change in the secondary structure of the rabbit hair, a decrease in the α-helix structure content, and an increase in β-folding structure content. Ellman’s reagent was used to determine that the content of the sulfhydryl group consumed in the modification was 0.211 mol/L. Testing the dye adsorption capacity and spinnability (adding 20%) of modified rabbit hair fibers showed an obvious improvement.
Multiple Paths to Firm Innovation in Sub-Saharan Africa: How informal institutions matter
Authors: Saka-Helmhout Ayse , Chappin Maryse , Vermeulen Patrick
Published: December 2019

Although innovation studies in developing countries acknowledge the importance of resources for firm innovation, their emphasis tends to be on bottlenecks created by resource constraints and institutional weaknesses. We address this shortcoming by exploring the relationship among firm resources and formal and informal institutions leading to innovation in these settings. By adopting a crisp-set qualitative comparative analysis of firms in sub-Saharan Africa, we confirm the thesis that informal institutions substitute underdeveloped formal institutions and in combination with firm-level resources afford firm innovation. More importantly, we find that informal institutions also complement more developed formal institutions in the presence or absence of high levels of firm resources or accommodate them in the presence of high levels of firm resources to support firm innovation. Our findings point to multiple paths that firms can take to be innovative that best fit their existing institutional context.
‘The Dispositive’: Foucault’s Concept for Organizational Analysis?
Authors: Villadsen Kaspar
Published: December 2019

Foucault’s notion ‘the dispositive’ has been introduced in organization studies as a highly promising concept. However, its analytical and empirical potentials remain to be fully explored. This article develops dispositional analytics which conceives of organizations as pervaded by multiple dispositives that interact, reinforce or contradict one another. In this reconstruction, particular emphasis is given to the visibility produced by dispositives, through which subjects and object emerge in a particular prescriptive light. Furthermore, analytical privilege is given to relations over substance. This means foregrounding the interrelations between dispositives as well as the dispositive’s ‘internal relationality’, that is, the relations established by each dispositive out of which organizational problems arise and transform. The framework’s potentials are explored in a study of care workers’ responses to a management reform that disciplined and depersonalized care-giving. The difficulties that care workers faced in straddling legal demands, service standardization and care ethics are understood as a situation of heterogeneous dispositions. In this context, care workers and their managers tactically reconstructed their subjectivities, relating to the dispositives in diverse and unexpected ways.
Pulmonary aspergilloma: from classification to management
Authors: Harmouchi Hicham , Sani Rabiou , Issoufou Ibrahim , Lakranbi Marouane , Ouadnouni Yassine , Smahi Mohamed
Published: December 2019

Pulmonary aspergilloma is a form of aspergillosis characterized by the colonization of a preexisting pulmonary cavity, most often of tuberculosis origin. Clinical symptoms are predominately hemoptysis that can be life-threatening, and thoracic computed tomography can distinguish simple from complex pulmonary aspergilloma. The best therapeutic option remains surgery which allows surgical resection of the mycetoma and the underlying cavity. Nonsurgical treatment is performed in inoperable patients because of severe respiratory failure or a poor general condition.
Effect of Adductor Canal Block Versus Femoral Nerve Block on Quadriceps Strength, Function, and Postoperative Pain After Anterior Cruciate Ligament Reconstruction: A Systematic Review of Level 1 Studies
Authors: Edwards Matthew Dean , Bethea Joseph Preston , Hunnicutt Jennifer Lee , Slone Harris Scott , Woolf Shane Kelby
Published: December 2019

Background:

Femoral nerve block (FNB) is a popular technique for reducing postoperative pain in patients with anterior cruciate ligament reconstruction (ACLR), but it is also linked to a number of adverse effects, such as quadriceps weakness, antalgic ambulation, and increased fall risk. Adductor canal block (ACB) has been offered as a motor nerve–sparing alternative to FNB.

Purpose:

To evaluate available literature that compares the effects of ACB and FNB on functional outcomes after arthroscopic ACLR.

Study Design:

Systematic review.

Methods:

Following the 2009 PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a search of PubMed (Ovid), CINAHL, Scopus, Cochrane, and Google Scholar databases was conducted. Search terms were designed to capture studies comparing the effects of ACB and FNB in patients undergoing arthroscopic ACLR. Data were evaluated regarding study and patient characteristics, functional measures, opioid consumption, pain scores, and complications.

Results:

Eight randomized controlled trials (N = 655 patients) comparing the efficacy of ACB versus FNB in arthroscopic ACLR were included. The heterogeneity of outcome measures precluded meta-analysis. Seven studies reported functional measures, which included isokinetic strength, straight-leg raise, and other various measures. Follow-up periods varied between 1 hour and 6 months. In 3 trials, ACB was found to preserve quadriceps strength as measured using straight-leg raise for the first 12 to 24 hours after surgery, while 3 other trials found no difference between the groups. No differences were reported in isokinetic strength at 6 months. In other functional measures, ACB either outperformed or was equivalent to FNB. The majority of studies reporting opioid consumption, pain scores, and complications found no differences between the blocks.

Conclusion:

This systematic review suggests that when compared with FNB, ACB preserves quadriceps function in the early postoperative period after ACLR while providing a similar level of analgesia. Limitations of this study include the use of various functional measures and limited long-term follow-up. More research evaluating long-term functional outcomes with standardized measures is needed to draw adequate conclusions regarding the effects of ACB and FNB on function after ACLR.
Psychometric Properties of the Hip–Return to Sport After Injury Scale (Short Form) for Evaluating Psychological Readiness to Return to Sports After Arthroscopic Hip Surgery
Authors: Jones Denise M. , Webster Kate E. , Crossley Kay M. , Ackerman Ilana N. , Hart Harvi F. , Singh Parminder J. , Pritchard Michael G. , Gamboa Gauguin , Kemp Joanne L.
Published: December 2019

Background:

Successful return to sports activity after surgery requires both physical and psychological readiness. The Hip–Return to Sport After Injury (Short Form) has been developed to assess psychological readiness to return to sports after hip injury and hip surgery, including hip arthroscopy.

Purpose:

To evaluate the reliability, validity, responsiveness, and interpretability of the scale for a cohort of patients after hip arthroscopy with a range of sports participation levels.

Study Design:

Cohort study (diagnosis); Level of evidence, 2.

Methods:

Invitations to participate were sent to 145 patients from 3 specialist surgeons. The study included 77 participants 1 to 24 months after hip arthroscopy (mean ± SD age, 35 ± 9 years; 62% women) and 33 healthy age-matched controls (age, 37 ± 7 years; 52% women). The scale was administered electronically on 3 occasions to patients: baseline (≥1 month postarthroscopy), 1 week later, and 6 months later. In addition to the scale, participants were asked about sports participation status and their global rating of postsurgical change. The scale was administered to healthy controls on 1 occasion. The minimal detectable difference, discriminant validity, floor and ceiling effects, responsiveness, and interpretability (minimally important change) were determined for the scale.

Results:

Among the postarthroscopy group, excellent test-retest reliability was found (intraclass correlation coefficient = 0.869; 95% CI, 0.756-0.932) with a minimal detectable difference of 26 points out of 100 at the individual level and 4 points out of 100 at the group level. At baseline discriminant validity was evident between those who had returned to sports (median = 69, n = 35) and those who had not returned to sports (median = 30, n = 42; Mann-Whitney U score = 232.5, z = −5.141, P < .001) and between the returned-to-sports postarthroscopy group and healthy controls (median = 96, n = 33; Mann-Whitney U score = 165.500, z = 5.666, P < .001). No floor or ceiling effects were evident. Responsiveness was demonstrated for the scale in relation to sports status. With sports status as an anchor, a minimally important change of 26 points was identified.

Conclusion:

Assessment of the Hip–Return to Sport After Injury (Short Form) supports its use as a reliable and valid measure of psychological readiness to return to sports in patients after hip arthroscopy.
Progressive Elbow Magnetic Resonance Imaging Abnormalities in Little League Baseball Players Are Common: A 3-Year Longitudinal Evaluation
Authors: Holt Joshua B. , Pedowitz Jason M. , Stearns Philip H. , Bastrom Tracey P. , Dennis M. Morgan , Dwek Jerry R. , Pennock Andrew T.
Published: December 2019

Background:

Prior studies have revealed magnetic resonance imaging (MRI) evidence of elbow pathology in single-season evaluation of competitive youth baseball players. The natural history of these findings and risk factors for progression have not been reported.

Purpose:

To characterize the natural history of bilateral elbow MRI findings in a 3-year longitudinal study and to correlate abnormalities with prior MRI findings, throwing history, playing status, and physical examination.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

A prospective study of Little League players aged 12 to 15 years was performed. All players had preseason and postseason bilateral elbow MRI performed 3 years before this study. Players underwent repeat bilateral elbow MRI, physical examination, and detailed assessment of throwing history, playing status, and arm pain. Imaging was read by a blinded musculoskeletal radiologist and compared with prior MR images to assess for progression or resolution of previously identified pathology.

Results:

All 26 players who participated in the previous single-season study returned for a 3-year assessment. At the completion of the study, 15 players (58%) had dominant arm MRI pathology. Eighty percent (12/15 players) of MRI findings were new or progressive lesions. Players with postseason MRI pathology at the beginning of the study were more likely to have MRI pathology at the 3-year follow-up than players with previously normal postseason MRI ( P < .05), although 6 of the 14 players (43%) with previously normal MRI developed new pathology. Year-round play was a significant predictor of tenderness to elbow palpation ( P = .027) and positive MRI findings at 3 years ( P = .047). At the 3-year follow-up, 7 players (27%) reported having throwing elbow pain and 3 had required casting. Additionally, differences were noted in the dominant arm’s internal and external rotation in those that continued to play baseball ( P < .05).

Conclusion:

Dominant elbow MRI abnormalities are common in competitive Little League Baseball players. Year-round play imparts significant risk for progression of MRI pathology and physical examination abnormalities.
The Women’s Project: Educating Women in Rural Nicaragua About Gender and Violence
Authors: Sudderth Lori K.
Published: December 2019

Programs and policies addressing gendered violence in impoverished rural areas in developing countries face a number of challenges: high rates of intimate partner violence, low reporting rates, cultural restrictions on women’s employment, lack of education and adequate health care, limited access to legal options and social services, and corruption in the criminal justice system. In these social contexts, anonymity is low and patriarchal notions of gender are especially persistent. In some areas, there are no services specifically for victims of gendered violence and shelters are in urban centers, far away from family and friends. Even where legal interventions are available, the outcomes often favor the perpetrators, making this option less attractive and in some cases dangerous. Because of these barriers, victims of intimate partner violence in rural settings rely more often on informal or community networks of support rather than formal authorities and legal sanctions to stop the violence. Consequently, addressing intimate partner violence in rural areas in developing countries requires more than a criminal justice response; it requires empowering rural women economically and socially. This conceptual article describes one program that attempts to empower rural women and the implications for creating safe space for victims of violence in challenging contexts.
Bidirectional Intimate Partner Violence Among Chinese Women: Patterns and Risk Factors
Authors: Hu Ran , Xue Jia , Lin Kai , Sun Ivan Y. , Wang Xiying
Published: December 2019

Bidirectional intimate partner violence (BIPV) refers to the co-occurrence of violence perpetration by both partners. BIPV has been analyzed using samples from different sociodemographic contexts but has yet to be fully explored in China. The present study employed a latent class approach to identify BIPV patterns, rates of prevalence, and associated risk factors among a sample of 1,301 heterosexual adult women in mainland China. Five distinct patterns of BIPV were identified, including (a) bidirectional psychological aggression, (b) bidirectional violence of all types, (c) multi-type victimization with psychological aggression, (d) minimal violence, and (e) bidirectional multi-types without physical violence. Marital status, education, employment status, acceptance of male dominance, and justification of intimate partner violence (IPV) were found to be predictive of different types of BIPV. Our findings suggest a need for a conceptual recognition of the heterogeneity and bidirectionality of IPV among Chinese women. Future research should extend to other diverse populations and sociocultural or clinical contexts in China. IPV assessments, research, and social programs ought to recognize the complexity of IPV and consider various IPV patterns specific to heterosexual women.
Two Stories about Diet and Diabetes in Europe
Authors: Foley Peter J. T. , Gunson John T. S. , Baumann Steven L.
Published: December 2019

Unhealthy weight gain and diabetes are global challenges that threaten not only the well-beings of hundreds of millions of persons but also the global economy. The authors in this article describe two overlapping stories, one is about a 150-year-old diet, known as the Banting Diet, which is similar to the Atkins or Keto Diet, and the other is about a provider-patient relationship story that helped the patient make lifestyle modifications that were effective in significant weight loss, improved quality of life, and reduced need for exogenous insulin for Type 2 diabetes. Both of the stories are from England but might be useful worldwide.
Ethical Truths in the Discipline of Nursing
Authors: Milton Constance L.
Published: December 2019

There are different paradigms in the discipline of nursing that contain theories that guide the practice, research, and education for members of the discipline. Each paradigm and nursing theory espouses ethical truths differently. The author in this article introduces the notion of teaching the ethos of humanbecoming dignity through uncovering the abiding truths of presence, existence, trust, and worth. A suggested situational teaching-learning tool is introduced to illustrate the potential uncovering of ethical truths for students of the discipline.
Thoughts About Nursing Science and Nursing Sciencing Revisited
Authors: Fawcett Jacqueline
Published: December 2019

This essay includes an update of the first essay for this column, published in the first issue of 2012. The current essay includes various definitions of nursing as a discipline, and definitions of science, nursing science, and Parsesciencing, as well as a discussion of the work of nurse scientists. The Nursing Now initiative is identified as a way in which the contributions of the work of nurse scientists can be highlighted on a global scale.
Modelling of material removal rate in the magnetic field and air-assisted electrical discharge machining
Authors: Beravala Hardik , Pandey Pulak M
Published: December 2019

In the present research work, an attempt has been made to develop the mathematical model to predict the material removal rate in the electrical discharge machining process when the assistance of air and magnetic field is provided together. The proposed model incorporates the physical phenomenon occurred during electrical discharge machining such as the plasma column expansion and reduction in the mean free path of electron in the plasma column due to magnetic field. In addition, the model incorporates the effect of air on the material removal rate. The developed model correlates the material removal rate with the process parameters such as the peak current, pulse duration, duty cycle, air pressure and magnetic flux density. The experimental data were used to evaluate the constants for district processing conditions. The relation between air pressure and breakdown voltage in the liquid-air mixed dielectric has been established experimentally. The obtained expression of material removal rate has been validated for the experimental conditions other than that used for obtaining constants. The results show less than 10% error in the prediction by the model over the respective experimental values.
Conservation for digitisation: A collaboration between the Palestinian Museum and the British library
Authors: Baldwin Amy
Published: December 2019

Since 2018, the Palestinian Museum in Ramallah has been digitising items from small institutions and private individuals in Palestine as part of their Digital Archive project. In 2019, a partnership was established with the British Library in London with a view to setting up the first paper conservation studio in the West Bank at the Museum. Library conservators provided training for a conservator and conservation manager from the Museum in paper conservation skills specific to the demands of digitisation projects. Initial training in London was followed up by ongoing distance mentoring as well as a visit by British Library conservators to Ramallah, in which conservation volunteers were also trained. This article details the aims of the collaboration, the challenges of putting together appropriate training programmes to be delivered in very limited time frames and the outcomes of the project thus far.
Clinical experience in management of bloodstream infection in emergency medical ward: A preliminary report
Authors: Cheung Ying , Ko Shing , Wong Oi Fung , Lam Hoi Shiu Bosco , Ma Hing Man , Lit Chau Hung Albert
Published: December 2019

Background:

Bloodstream infection is a life‐threatening clinical condition posing significant morbidities and mortalities. An “Emergency Critical Care Management Program” has been implemented in the Emergency Medicine Ward at North Lantau Hospital as a pilot critical care service model in the local emergency medicine wards. Patients with blood stream infection are recruited in the program and managed under pre‐defined guideline.

Objectives:

We report our experience in managing patients with blood stream infection in the Emergency Medicine Ward and analyzed their clinical outcomes.

Methods:

This was a retrospective cohort study including a total of 64 patients with blood stream infection admitted to the Emergency Medicine Ward from 1 March 2015 and 31 March 2018. Patients’ characteristics, microbiology, and risk factors associated with adverse outcomes including in‐hospital mortality were analyzed.

Results:

The most common organism isolated from blood cultures was Escherichia coli (56%). Eight patients were transferred to the tertiary hospital. The overall in‐hospital mortality was 7.8% (5/64). From the univariate analysis, advanced age (p < 0.001), higher Sequential Organ Failure Assessment score and quick Sequential Organ Failure Assessment score (p < 0.001), higher Charlson Comorbidity Index (p = 0.003), more organ dysfunction (p < 0.001), pre‐existing medical history of chronic liver disease (p = 0.001), dysfunction in respiratory system (p = 0.032), cardiovascular system (p = 0.044) and the central nervous system (p < 0.001), presence of septic shock (p = 0.004), and need for higher level of organ support from the use of inotropes (p < 0.001) and mechanical ventilation (p = 0.024) were associated with in‐hospital mortality. In the subgroup analysis, the in‐hospital mortality rate for the patients with Sequential Organ Failure Assessment score less than 6 was 1.56% (1/64). Among the five in‐hospital mortality cases, four of them were managed in the Emergency Medicine Ward under the End‐of‐Life Care Program. Decision for withholding and withdrawing life‐sustaining therapy was made with the patients’ families.

Conclusion:

This preliminary report demonstrated that with careful patient selection, adoption of guidelines, and availability of expertise, critical care service can be safely implemented in the emergency medicine ward.
Family violence and the workplace: Recent developments in Australian law
Authors: Roff Emma
Published: December 2019

This article examines the workplace rights and anti-discrimination protections available for Australian workers who experience family violence. Despite the significance of family violence as a workplace issue, federal anti-discrimination law and, until recently, the Fair Work Act 2009 (Cth) have failed to provide adequate protection to such employees. The author considers two recent developments in Australian law which may provide more comprehensive rights and protections for family violence victims. Namely, the introduction of domestic violence leave by the Fair Work Amendment (Family and Domestic Violence Leave) Act 2018 (Cth) and the family violence attribute under the ACT Discrimination Act 1991.
Preventing Readmissions Through Effective Partnerships—Communication and Palliative Care (PREP-CPC): A Multisite Intervention for Encouraging Goals of Care Conversations for Hospitalized Patients Facing Serious Illness
Authors: Gradwohl Kelsey , Wood Gordon J. , Clepp Rebecca K. , Rivnay Liza , Szmuilowicz Eytan
Published: December 2019

Background:

Despite evidence showing that goals of care (GOC) conversations increase the likelihood that patients facing a serious illness receive care that is concordant with their wishes, only a minority of at-risk patients receive the opportunity to engage in such conversations.

Objective:

The Preventing Readmissions through Effective Partnerships—Communication and Palliative Care (PREP-CPC) intervention was designed to increase the frequency of GOC conversations for hospitalized patients facing serious illness.

Methods:

The PREP-CPC employed a sequential, multicohort design using a yearlong mentored implementation approach to support nonpalliative care health-care professionals at participating hospitals to implement quality improvement projects focused on GOC conversations.

Results:

Over the 3-year study period, 134 clinicians from 29 hospital teams were trained to facilitate GOC conversations. After the kickoff conference, participants reported improvements in their confidence in facilitating GOC conversations. The hospital teams then instituted site-specific pilot interventions to promote GOC conversations, identifying essential elements required for ongoing improvement. Since projects varied by hospital, results did as well, but reported positive outcomes included increased GOC conversations, increased Practitioner Orders for Life-Sustaining Treatment form completion rates, new screening and documentation methods, and increased support from leadership.

Conclusions:

The PREP-CPC pilot successfully engaged a diverse set of hospitals to participate in quality improvement collaborative promoting primary palliative care and more frequent GOC conversations. This initiative revealed several lessons that should guide future interventions.
A Public Health Approach to Palliative Care in the Canadian Context
Authors: Sirianni Giovanna
Published: December 2019

Palliative care helps improve the quality of life of individuals facing life-limiting illness throughout the course of their disease. In Canada, delivery and access to palliative care has been fraught with challenges including differential availability of services based on geography, funding, language, and socioeconomic status. Many groups, including the World Health Organization, have advocated for a public health approach to palliative care as an antidote to fragmented service delivery. Multiple scholars, academics, and public health advocates have suggested that a public health approach to palliative care can help with issues of access, equity, and cost. Through the lens of Kingdon’s Multiple Streams Framework, this commentary will explore potential reasons why a public health approach to palliative care has not been adopted in the Canadian context and why this is an opportune time to consider this policy innovation. The Compassionate Communities concept is discussed as a potential solution to a public health approach to palliative care delivery.
Abusive Supervisory Behavior Aimed at Raising Work Group Performance
Authors: Farmanara Parviz
Published: December 2019

Perceived abusive supervision implies detrimental human consequences and negative performance effects. However, paradoxically, there are numerous anecdotal reports on managers who appear to deliberately mistreat most of their subordinates in an effort to enhance work group performance, preferring abusive methods of influence over more constructive motivational approaches. Because destructive leadership theory does not provide a compelling explanation for this perplexing phenomenon, I conducted an inductive, longitudinal case study at the executive level of a large corporation to explore antecedents of performance-oriented abusive supervisory behavior. The analysis of rich, contextualized data reveals that empathic incompetence of superiors to consider the emotions, goals, and limitations of inferiors can imply a belief in the efficacy of harsh management tactics, resulting in abrasive supervisory conduct and an abusive supervision climate collectively perceived by subalterns. The findings suggest social dominance orientation (SDO) of upper-level managers to moderate these relationships through cognitive activation of abusive supervisory values.
Nonlinear vibration and stability analysis of double-walled piezoelectric nanoresonator with nonlinear van der Waals and electrostatic excitation
Authors: Hashemi Kachapi Sayyid H , Mohammadi Daniali Hamidreza , Dardel Morteza , Fathi Alireza
Published: December 2019

In this work, nonlinear vibration and frequency response analysis of a double-walled piezoelectric nanoresonator based on a cylindrical nanoshell is performed using the Gurtin–Murdoch surface/interface theory. The piezoelectric nanoresonator is simultaneously subjected to the visco-Pasternak medium and nonlinear van der Waals and electrostatic forces. It is found that the electrostatic and piezoelectric voltages, length to radius ratio, nanoresonator gap width, linear and nonlinear van der Waals coefficients and other parameters can effectively change the flexural rigidity of the system, which in turn affects the nonlinear frequency response. Also, increasing or decreasing of some parameters leads to increase or decrease in the resonance amplitude, resonant frequency, instability of the system, nonlinear behavior and bandwidth.
Experiences of Hospitalization of Patients With Psychotic Disorders on Medical–Surgical Units: A Thematic Analysis
Authors: Weissinger Guy M. , Brooks Carthon J. Margo , Ahmed Charisse , Brawner Bridgette M.
Published: December 2019

BACKGROUND:Individuals with psychotic disorders are more likely to have nonpsychiatric hospitalizations than the general population. Moreover, they experience worse outcomes in terms of rehospitalization, adverse events, in-hospital mortality, and longer length of stay. AIM: A patient-centered understanding of inpatient medical–surgical hospitalization experiences could shed light on disparities in hospital outcomes among individuals with psychotic disorders. METHOD: This article reports findings from Phase 1 (Qualitative) of a mixed methods, exploratory sequential study of nonpsychiatric hospitalizations of patients with psychotic disorders. Patients on medical–surgical units with diagnosed psychotic disorders ( n = 20) were interviewed about their experiences of hospitalization, and a thematic analysis was conducted of transcripts, case notes, and setting notes. RESULTS: Five themes emerged from analysis: (1) managing through hard times (subthemes: intense emotions, medically complex with many symptoms, strategies for self-management), (2) ignored and treated unfairly, (3) actively involved in health (subthemes: seeking health education, suggesting changes), (4) appreciation of caring providers, and (5) violence: expected and enacted. Participants connected the difficult nature of their hospitalization experiences with a variety of sources and outcomes, including strong emotions, variable relationships with providers and a struggle to receive health education. CONCLUSIONS: Nurses who care for patients with psychotic disorders in medical–surgical settings can better meet patients’ needs by concentrating on relationship building, especially during initial interactions, and helping patients better manage their medical and psychiatric symptoms through both pharmaceutical and nursing interventions.