bluuebunny/crossref_metadata_2025 huggingface dataset:
Short‐Term Safety of Nicotine Replacement in Smokers Hospitalized With Coronary Heart Disease
Authors: Pack Quinn R. , Priya Aruna , Lagu Tara C. , Pekow Penelope S. , Atreya Auras , Rigotti Nancy A. , Lindenauer Peter K.
Published: September 2018

Background

Little is known about the safety of nicotine replacement therapy (
NRT
) in smokers hospitalized with coronary heart disease.

Methods and Results

We examined the short‐term safety of
NRT
use among smokers hospitalized for coronary heart disease in a geographically and structurally diverse sample of
US
hospitals in the year 2014. We compared smokers who started
NRT
in the first 2 days of hospitalization with smokers without any exposure to
NRT
and adjusted for baseline differences through propensity score matching. Outcomes included inpatient mortality, hospital length of stay, and 1‐month readmission. From 270 hospitals, we included 27 459 smokers (mean age, 58 years; 69% men; 56.9% in intensive care unit), of whom 4885 (17.8%) received
NRT
(97.2% used the nicotine patch, at a median dose of 21 mg/d for 3 days). After propensity matching, covariates were well balanced within each patient group. Among patients with myocardial infarction, compared with patients who did not receive
NRT
, those who received
NRT
showed no difference in mortality (2.1% versus 2.3%;
P
=0.98), mean length of stay (4.4±3.5 versus 4.3±3.3 days;
P
=0.60), or 1‐month readmission (15.8% versus 14.6%;
P
=0.31). Results were similar for patients undergoing percutaneous coronary intervention or coronary artery bypass surgery.

Conclusions

Among smokers hospitalized for treatment of coronary heart disease, use of
NRT
was not associated with any differences in short‐term outcomes. Given the known beneficial effects of
NRT
in treating nicotine withdrawal, reducing cravings, and promoting smoking cessation after discharge, our findings suggest that
NRT
is a safe and reasonable treatment option.
Novel Noninvasive Assessment of Pulmonary Arterial Stiffness Using Velocity Transfer Function
Authors: Gupta Ankur , Sharifov Oleg F. , Lloyd Steven G. , Tallaj Jose A. , Aban Inmaculada , Dell'italia Louis J. , Denney Thomas S. , Gupta Himanshu
Published: September 2018

Background

Pulmonary artery (
PA
) stiffness is associated with increased pulmonary vascular resistance (
PVR
).
PA
stiffness is accurately described by invasive
PA
impedance because it considers pulsatile blood flow through elastic
PA
s. We hypothesized that
PA
stiffness and impedance could be evaluated noninvasively by
PA
velocity transfer function (
VTF
), calculated as a ratio of the frequency spectra of output/input mean velocity profiles in
PA
s.

Methods and Results

In 20 participants (55±19 years, 14 women) undergoing clinically indicated right‐sided heart catheterization, comprehensive phase‐contrast and cine‐cardiac magnetic resonance imaging was performed to calculate
PA VTF
, along with right ventricular mass and function.
PA
impedance was measured as a ratio of frequency spectra of invasive
PA
pressure and echocardiographically derived
PA
flow waveforms. Mean
PA
pressure was 29.5±13.6 mm Hg, and
PVR
was 3.5±2.8 Wood units. A mixed‐effects model showed
VTF
was significantly associated with
PA
impedance independent of elevation in pulmonary capillary wedge pressure (
P
=0.005). The mean of higher frequency moduli of
VTF
correlated with
PVR
(ρ=0.63;
P
=0.003) and discriminated subjects with low (n=10) versus elevated
PVR
(≥2.5 Wood units, n=10), with an area under the curve of 0.95, similar to discrimination by impedance (area under the curve=0.93).
VTF
had a strong inverse association with right ventricular ejection fraction (ρ=−0.73;
P
<0.001) and a significant positive correlation with right ventricular mass index (ρ=0.51;
P
=0.02).

Conclusions

VTF
, a novel right ventricular–
PA
axis coupling parameter, is a surrogate for
PA
impedance with the potential to assess
PA
stiffness and elevation in
PVR
noninvasively and reliably using cardiac magnetic resonance imaging.
Mitochondrial and Contractile Function of Human Right Atrial Tissue in Response to Remote Ischemic Conditioning
Authors: Kleinbongard Petra , Gedik Nilguen , Kirca Mücella , Stoian Leanda , Frey Ulrich , Zandi Afsaneh , Thielmann Matthias , Jakob Heinz , Peters Jürgen , Kamler Markus , Heusch Gerd
Published: September 2018

Background

Remote ischemic preconditioning (
RIPC
) by repeated brief cycles of limb ischemia/reperfusion attenuates myocardial ischemia/reperfusion injury. We aimed to identify a functional parameter reflecting the
RIPC
‐induced protection in human. Therefore, we measured mitochondrial function in right atrial tissue and contractile function of isolated right atrial trabeculae before and during hypoxia/reoxygenation from patients undergoing coronary artery bypass grafting with
RIPC
or placebo, respectively.

Methods and Results

One hundred thirty‐seven patients under isoflurane anesthesia underwent
RIPC
(3×5 minutes blood pressure cuff inflation on the left upper arm/5 minutes deflation, n=67) or placebo (cuff uninflated, n=70), and right atrial appendages were harvested before ischemic cardioplegic arrest. Myocardial protection by
RIPC
was assessed from serum troponin I/T concentrations over 72 hours after surgery. Atrial tissue was obtained for isolation of mitochondria (
RIPC
/placebo: n=10/10). Trabeculae were dissected for contractile function measurements at baseline and after hypoxia/reoxygenation (60 min/30 min) and for western blot analysis after hypoxia/reoxygenation (
RIPC
/placebo, n=57/60). Associated with cardioprotection by
RIPC
(26% decrease in the area under the curve of troponin I/T), mitochondrial adenosine diphosphate–stimulated complex I respiration (+10%), adenosine triphosphate production (+46%), and calcium retention capacity (+37%) were greater, whereas reactive oxygen species production (−24%) was less with
RIPC
than placebo. Contractile function was improved by
RIPC
(baseline, +7%; reoxygenation, +24%). Expression and phosphorylation of proteins, which have previously been associated with cardioprotection, were not different between
RIPC
and placebo.

Conclusions

Cardioprotection by
RIPC
goes along with improved mitochondrial and contractile function of human right atrial tissue.

Clinical Trial Registration

URL:
https://www.clinicaltrials.gov
. Unique identifier:
NCT
01406678.
Renal Soluble Guanylate Cyclase Is Downregulated in Sunitinib‐Induced Hypertension
Authors: Witte Jeannine , Mühlbauer Melanie , Braun Diana , Steinbach Antje , Golchert Janine , Rettig Rainer , Grisk Olaf
Published: September 2018

Background

The tyrosine kinase inhibitor sunitinib causes hypertension associated with reduced nitric oxide (NO) availability, elevated renal vascular resistance, and decreased fractional sodium excretion. We tested whether (1) nitrate supplementation mitigates sunitinib‐induced hypertension and NO contributes less to renal vascular resistance as well as fractional sodium excretion regulation in sunitinib‐treated rats than in controls; and (2) renal soluble guanylate cyclase (sGC) is downregulated and sGC activation lowers arterial pressure in rats with sunitinib‐induced hypertension.

Methods and Results

Arterial pressure responses to nitrate supplementation and the effects of systemic and intrarenal NO synthase (NOS) inhibition on renal hemodynamics and fractional sodium excretion were assessed in sunitinib‐treated rats and controls. Renal NOS and sGC mRNA as well as protein abundances were determined by quantitative polymerase chain reaction and Western blot. The effect of the sGC activator cinaciguat on arterial pressure was investigated in sunitinib‐treated rats. Nitrate supplementation did not mitigate sunitinib‐induced hypertension. Endothelium‐dependent reductions in renal vascular resistance were similar in control and sunitinib‐treated animals without and with systemic NOS inhibition. Selective intrarenal NOS inhibition lowered renal medullary blood flow in control but not in sunitinib‐treated rats without significant effects on fractional sodium excretion. Renal cortical sGC mRNA and sGC α
1
‐subunit protein abundance were less in sunitinib‐treated rats than in controls, and cinaciguat effectively lowered arterial pressure by 15‐20 mm Hg in sunitinib‐treated rats.

Conclusions

Renal cortical sGC is downregulated in the presence of intact endothelium‐dependent renal vascular resistance regulation in developing sunitinib‐induced hypertension. This suggests that sGC downregulation occurs outside the renal vasculature, increases renal sodium retention, and contributes to nitrate resistance of sunitinib‐induced hypertension.
Predicting Bleeding Events in Anticoagulated Patients With Atrial Fibrillation: A Comparison Between the HAS‐BLED and GARFIELD‐AF Bleeding Scores
Authors: Proietti Marco , Rivera‐Caravaca José Miguel , Esteve‐Pastor María Asunción , Romiti Giulio Francesco , Marin Francísco , Lip Gregory Y. H.
Published: September 2018

Background

Patients with atrial fibrillation (AF) treated with oral anticoagulants may be exposed to an increased risk of bleeding events. The HAS‐BLED (Hypertension, Abnormal renal and liver function, Stroke, Bleeding, Labile INRs, Elderly, Drugs or alcohol) score is a simple, well‐established, clinical bleeding‐risk prediction score. Recently, a new algorithm‐based score was proposed, the GARFIELD‐AF (Global Anticoagulant in the Field–AF) bleeding score. We compared HAS‐BLED and GARFIELD‐AF scores in predicting adjudicated bleeding events in a clinical trial cohort of patients with AF taking anticoagulants, in the first external comparative validation of both scores.

Methods and Results

We analyzed patients from the SPORTIF (Stroke Prevention Using an Oral Thrombin Inhibitor in Patients With AF) III and V trials. All patients assigned to the warfarin arm with information to calculate the scores were considered. Outcomes were major, major/clinically relevant nonmajor, and any bleeding. A total of 3550 warfarin‐treated patients were available for analysis. Of these patients, 2519 (71.0%) had a HAS‐BLED score ≥3, whereas based on GARFIELD‐AF median value, 2056 (57.9%) were categorized as “high score.” Both HAS‐BLED and GARFIELD‐AF C‐indexes showed modest predictive value (C‐index [95% confidence interval] for major bleeding, 0.58 [0.56–0.60] and 0.56 [0.54–0.57], respectively); however, GARFIELD‐AF was not predictive of any bleeding. The GARFIELD‐AF bleeding score had a significantly lower sensitivity and a negative reclassification for any bleeding compared with HAS‐BLED, assessed by integrated discrimination improvement and net reclassification improvement (both
P
<0.001). HAS‐BLED showed a 5% net benefit for any bleeding occurrence.

Conclusions

The algorithm‐based GARFIELD‐AF bleeding score did not show any significant improvement in major and major/clinically relevant nonmajor prediction compared with the simple HAS‐BLED score. For clinical usefulness in prediction of any bleeding, the HAS‐BLED score showed a significant net benefit compared with the GARFIELD‐AF.
Incidence, Predictors, and Outcomes of Implantable Cardioverter‐Defibrillator Discharge Among People Living With HIV
Authors: Alvi Raza M. , Neilan Anne M. , Tariq Noor , Awadalla Magid , Rokicki Adam , Hassan Malek , Afshar Maryam , Mulligan Connor P. , Triant Virginia A. , Zanni Markella V. , Neilan Tomas G.
Published: September 2018

Background

People living with
HIV
(
PHIV
) are at an increased risk for sudden cardiac death, and implantable cardioverter‐defibrillators (
ICDs
) prevent
SCD
. There are no data on the incidence, predictors, and effects of
ICD
therapies among
PHIV
.

Methods and Results

We compared
ICD
discharge rates between 59
PHIV
and 267 uninfected controls. For
PHIV
, we tested the association of traditional cardiovascular risk factors and
HIV
‐specific parameters with an
ICD
discharge and then tested whether an
ICD
discharge among
PHIV
was associated with cardiovascular mortality or an admission for heart failure. The indication for
ICD
insertion was similar among groups. Compared with controls,
PHIV
with an
ICD
were more likely to have coronary artery disease and to use cocaine. In follow‐up,
PHIV
had a higher
ICD
discharge rate (39% versus 20%;
P
=0.001; median follow‐up period, 19 months). Among
PHIV
, cocaine use, coronary artery disease,
QRS
duration, and higher New York Heart Association class were associated with an
ICD
discharge. An
ICD
discharge had a prognostic effect, with a subsequent 1.7‐fold increase in heart failure admission and a 2‐fold increase in cardiovascular mortality, an effect consistent across racial/ethnic and sex categories.

Conclusions

ICD
discharge rates are higher among
PHIV
compared with uninfected controls. Among
PHIV
, cocaine use and New York Heart Association class are associated with increased
ICD
discharge, and an
ICD
discharge is associated with a subsequent increase in admission for heart failure and cardiovascular mortality.
Guideline‐Recommended Therapies and Clinical Outcomes According to the Risk for Recurrent Cardiovascular Events After an Acute Coronary Syndrome
Authors: Hammer Yoav , Iakobishvili Zaza , Hasdai David , Goldenberg Ilan , Shlomo Nir , Einhorn Michal , Bental Tamir , Witberg Guy , Kornowski Ran , Eisen Alon
Published: September 2018

Background

Patients who have had an acute coronary syndrome (
ACS
) are at increased risk of recurrent cardiovascular events; however, paradoxically, high‐risk patients who may derive the greatest benefit from guideline‐recommended therapies are often undertreated. The aim of our study was to examine the management, clinical outcomes, and temporal trends of patients after
ACS
stratified by the Thrombolysis in Myocardial Infarction (TIMI) risk score for secondary prevention, a recently validated clinical tool that incorporates 9 clinical risk factors.

Methods and Results

Included were patients with
ACS
enrolled in the biennial Acute Coronary Syndrome Israeli Surveys (
ACSIS
) between 2008 and 2016. Patients were stratified by the TIMI risk score for secondary prevention to
low
(score 0–1),
intermediate
(2), or
high
(≥3) risk. Clinical outcomes included 30‐day major adverse cardiac events (death, myocardial infarction, stroke, unstable angina, stent thrombosis, urgent revascularization) and 1‐year mortality. Of 6827
ACS
patients enrolled, 35% were low risk, 27% were intermediate risk, and 38% were high risk. Compared with the other risk groups, high‐risk patients were older, were more commonly female, and had more renal dysfunction and heart failure (
P
<0.001 for each). High‐risk patients were treated less commonly with guideline‐recommended therapies during hospitalization (percutaneous coronary intervention) and at discharge (statins, dual‐antiplatelet therapy, cardiac rehabilitation). Overall, high‐risk patients had higher rates of 30‐day major adverse cardiac events (7.2% low, 8.2% intermediate, and 15.1% high risk;
P
<0.001) and 1‐year mortality (1.9%, 4.6%, and 15.8%, respectively;
P
<0.001). Over the past decade, utilization of guideline‐recommended therapies has increased among all risk groups; however, the rate of 30‐day major adverse cardiac events has significantly decreased among patients at high risk but not among patients at low and intermediate risk. Similarly, the 1‐year mortality rate has decreased numerically only among high‐risk patients.

Conclusions

Despite an improvement in the management of high‐risk
ACS
patients, they are still undertreated with guideline‐recommended therapies. Nevertheless, the outcome of high‐risk patients after
ACS
has significantly improved in the past decade, thus they should not be denied these therapies.
Mitochondrial DNA Sequence Variants Associated With Blood Pressure Among 2 Cohorts of Older Adults
Authors: Buford Thomas W. , Manini Todd M. , Kairalla John A. , McDermott Mary M. , Vaz Fragoso Carlos A. , Chen Haiying , Fielding Roger A. , King Abby C. , Newman Anne B. , Tranah Gregory J.
Published: September 2018

Background

Age‐related changes in blood pressure are associated with a variety of poor health outcomes. Genetic factors are proposed contributors to age‐related increases in blood pressure, but few genetic loci have been identified. We examined the role of mitochondrial genomic variation in blood pressure by sequencing the mitochondrial genome.

Methods and Results

Mitochondrial
DNA
(mt
DNA
) data from 1755 participants from the LIFE (Lifestyle Interventions and Independence for Elders) studies and 788 participants from the Health ABC (Health, Aging, and Body Composition) study were evaluated using replication analysis followed by meta‐analysis. Participants were aged ≥69 years, of diverse racial backgrounds, and assessed for systolic blood pressure (
SBP
), diastolic blood pressure, and mean arterial pressure. After meta‐analysis across the
LIFE
and Health
ABC
studies, statistically significant associations of mt
DNA
variants with higher
SBP
(m.3197T>C, 16S
rRNA
;
P
=0.0005) and mean arterial pressure (m.15924A>G, t‐RNA‐thr;
P
=0.004) were identified in white participants. Among black participants, statistically significant associations with higher
SBP
(m.93A>G,
HVII
; m.16183A>C,
HVI
; both
P
=0.0001) and mean arterial pressure (m.16172T>C,
HVI
; m.16183A>C,
HVI
; m.16189T>C,
HVI
; m.12705C>T; all
P
's<0.0004) were observed. Significant pooled effects on
SBP
were observed across all transfer
RNA
regions (
P
=0.0056) in white participants. The individual and aggregate variant results are statistically significant after multiple comparisons adjustment for the number of mt
DNA
variants and mitochondrial regions examined.

Conclusions

These results suggest that mt
DNA
‐encoded variants are associated with variation in
SBP
and mean arterial pressure among older adults. These results may help identify mitochondrial activities to explain differences in blood pressure in older adults and generate new hypotheses surrounding mt
DNA
variation and the regulation of blood pressure.

Clinical Trial Registration

URL
:
http://www.ClinicalTrials.gov
. Unique identifiers:
NCT
01072500 and
NCT
00116194.
The Problem of the Authority of the International Criminal Court
Authors: Moran Clare Frances
Published: September 2018

This research examines the problem of the authority of the International Criminal Court (ICC), focusing on its claim to jurisdiction as its primary exercise of authority. The research questions the basis of the Court’s authority, beginning with an analysis of current theories of authority and exploring their relevance to the Court. It then explores the ‘permission’ that it has to act, based on the consent of States and the UN Security Council mandate, and questions whether the Court has the authority to act, based on current legal theories. The problems associated with using current theory and methods of thinking about authority to explain the authority that the ICC are then explored.
Recharacterisation of Crimes and the Principle of Fair Labelling in International Criminal Law
Authors: de Souza Dias Talita
Published: September 2018

The principle of fair labelling has informed the creation of international crimes and other concepts of international criminal law since the modern inception of this discipline. In particular, it was the symbolic and condemnatory import of international labels such as genocide and crimes against humanity that partly motivated their introduction as offences separate from domestic ordinary crimes. Paradoxically, fair labelling has received marginal attention in legal scholarship and practice. Moreover, frequent instances of relabelling known as ‘recharacterisation of crimes’ may not be entirely consistent with that principle, inviting further analysis thereof. In this context, the purpose of this article is to provide a more systematic and comprehensive analysis of the principle of fair labelling in international criminal law, particularly in light of the phenomenon of recharacterisation of crimes. Its central claim is that fair labelling is as a fair trial right which precludes recourse to recharacterisation in certain circumstances.
Overlooked Ethical Problems Associated With the Research and Practice of Evidence-Based Treatments
Authors: Gnaulati Enrico
Published: September 2018

Proponents of evidence-based treatments (EBTs) have directed complaints of potential unethical practice against psychotherapists who refrain from using EBTs as first-line interventions for a range of psychiatric disorders on the grounds that these treatments should be given priority because of their exceptional scientific backing. This article counters these claims and highlights core ethical concerns associated with the research and practice of EBT itself; namely, the appropriateness of saturating the field with short-term models of psychotherapy and the questionable assumption that these can yield meaningful and lasting change; the uncertain relevance of the results of EBT investigations for psychotherapists working with real-world clients; the foreclosure of opportunities to address clients’ unmet developmental needs and self-fragility posed by the directive/didactic therapeutic stance inherent in EBTs; and, the reduced quality of psychotherapy offered to the public at large and threats to the clinical competence of early-career mental health professionals caused by overemphasizing training in EBTs over the acquisition of relational skills in graduate schools and postgraduate training sites.
Making Justice Peripheral by Constructing Practice as “Core”: How the Increasing Prominence of Core Practices Challenges Teacher Education
Authors: Philip Thomas M. , Souto-Manning Mariana , Anderson Lauren , Horn Ilana , J. Carter Andrews Dorinda , Stillman Jamy , Varghese Manka
Published: September 2018

Reformers are increasingly calling for and adopting practice-based approaches to teacher preparation, with particular emphasis on identifying and centering core practices. In this article, we argue that organizing teacher education around core practices brings its own risks, including the risk of peripheralizing equity and justice. Situating our argument within the broad economic trends affecting labor and higher education in the 21st century, we begin by examining the linkages between the core practices movement and organizations that advocate market-based solutions to education. We then explore how constructs of practice and improvisation and commitments to equity and justice are taken up, and with what implications and consequences, in core practices scholarship and its applications. In conclusion, we consider how work being done around core practices might contribute to a collective struggle for greater equity and justice in schools and in society.
Covert Attention, Temperament, and Looking: A Novel Approach to Studying Attention in the Social World
Authors: Collings Raymond D. , Eaton Leslie G.
Published: September 2018

The current study examines relations between individual differences in attention measured in laboratory and real-world settings. In-laboratory computer-based assessments of orienting, phasic alertness, and executive attention as well as self-report measures of temperament and attention-related problems were administered to 111 undergraduate participants. Participants later completed a walking tour of a multistory building while wearing video recording glasses. The recordings were subsequently coded for orientation and capture of overt attention. Overt attention was correlated with attention-related traits only in high-demand walking conditions (stairways). Our findings suggest that individual differences should be a more important consideration in attention research. The novel methodology piloted here may be especially practical for studying overt attention in social settings.
Meaning Through Attachment: An Integrative Framework
Authors: Dewitte Laura , Granqvist Pehr , Dezutter Jessie
Published: September 2018

We propose an integrative framework, advancing attachment as a vital factor in the development and maintenance of meaning throughout life. First, early attachment experiences provide a foundation for recognizing patterns and acquiring a sense of order and coherence. Furthermore, interactions with sensitive attachment figures stimulate mentalization capacities and exploration of the inner and outer environment, enabling the formation of complex representations of self, others, and the world, ultimately also molding how individuals appraise meaning in their lives. Second, attachment security can serve as an enduring and powerful resource for handling threats to meaning. When confronted with disruptions to meaning, secure attachment provides a coherent set of representations to fall back on and maintain or regain a firm sense of order and meaning under challenging circumstances. Moreover, by promoting cognitive openness and tolerance of ambiguity, secure attachment facilitates flexible and realistic adjustment of meaning representations when encountering discrepant information.
Learning from Excellence: the ‘Yaytix’ programme
Authors: Chain Gabriel , Marshall Emma , Geddie Cathy , Joseph Sonia , Chain Benjamin , Clark Claire
Published: September 2018

Background and aims

Learning from error can have a negative impact on the staff involved in the error (‘second victim phenomenon’1). We created a project, based on the principles of the Learning from Excellence project,2 to learn from excellence and correct the imbalance of negative to positive feedback in the context of hospital practice.

Methods and results

Using a questionnaire, we surveyed staff on existing feedback mechanisms and morale. We then introduced a system where staff recorded and commented on examples of excellence in practice. Recipients and their supervisors received copies of these reports and the feedback was analysed and discussed with senior staff (consultant, senior charge nurse, managers). We re-audited the staff two months after starting this project and noted improvements in staff morale and in positive reporting.

Conclusions

This project has improved the process of giving and learning from positive feedback and had a significant impact on staff morale. We can also demonstrate an example of improved clinical practice (from feedback received) and will now attempt to measure clinical outcomes with a new prospective study. Finally, we hope to set up a regional programme of reporting excellence in South-East Scotland.
Assessing the Quality of Nursing Homes in Managed Care Organizations: Integrating LTSS for Dually Eligible Beneficiaries
Authors: Graham Carrie , Ross Leslie , Bueno Edward Bozell , Harrington Charlene
Published: September 2018

Little is known about the quality of nursing homes in managed care organizations (MCOs) networks. This study (1) described decision-making criteria for selecting nursing home networks and (2) compared selected quality indicators of network and nonnetwork nursing homes. The sample was 17 MCOs participating in a California demonstration that provided integrated long-term services and supports to dually eligible enrollees in 2017. The findings showed that the MCOs established a broad network of nursing homes, with only limited attention to using quality criteria. Network nursing homes (602) scored significantly lower on 6 selected quality measures than nonnetwork (117) nursing homes. Low registered nurse and total nurse staffing were strong predictors of network nursing homes controlling for facility characteristics. Managed care organizations should consider greater transparency about the quality of their nursing homes and use specific quality criteria to improve the quality of their networks.
Pap smear accuracy for the diagnosis of cervical precancerous lesions
Authors: Nkwabong Elie , Laure Bessi Badjan Ingrid , Sando Zacharie
Published: September 2018

This cross-sectional descriptive study, aimed at accessing the accuracy of Pap smear in diagnosing cervical precancerous lesions, was carried out between 3 January and 30 April 2017. All women screened for cervical dysplasia by means of Pap smear with biopsy done for confirmation were subsequently recruited. Data were analysed using SPSS 20.0. A total of 231 women were screened for cervical dysplasia using Pap smear with 75 biopsies performed. Cervical dysplasia was noticed in 54 cases. The sensitivity, specificity, positive predictive and negative predictive values of Pap smear were 55.5%, 75%, 88.2% and 33.3%, respectively. The sensitivity of Pap smear remains low. Therefore, biopsy should be done in cases of macroscopic cervical architectural changes irrespective of the result of the Pap smear. Moreover, to reduce the number of women with cervical precancerous lesions, the government should make available financial resources to set up HPV vaccination programmes rather than screening programmes.
Assessing Intervention Needs of Juvenile Probationers: An Application of Latent Profile Analysis to a Risk–Need–Responsivity Assessment Model
Authors: Campbell Christina A. , Miller William , Papp Jordan , Barnes Ashlee R. , Onifade Eyitayo , Anderson Valerie R.
Published: September 2018

The assessment of criminogenic risk is critical in the prediction of future delinquency and the ability to provide appropriate services and interventions for youth offenders. The goal of this study was to determine whether using latent profile analysis (LPA) produced better risk classification profiles than traditional linear methods. Archival data were used to examine 1,263 male and female youth probationers. Criminogenic profiles were developed using the Youth Level of Service/Case Management Inventory, a widely used juvenile risk assessment. LPA determined that there were three distinct profiles: Minimal Intervention Needs, Social Behavior and Social Bonding Needs, and Maximum Intervention Needs. The profiles that youth fit into differed across demographic variables such as gender, age, recidivism, and history of child maltreatment, but not minority status and offense type. This research may aid in addressing specific intervention needs of offenders.
Enhancing Motivation and Job Satisfaction of Police Officers: A Test of High Performance Cycle Theory
Authors: Demirkol Ismail C. , Nalla Mahesh k.
Published: September 2018

Although goal-setting theory is one of the most examined motivation theories, few studies examine a theoretical framework of the high performance cycle (HPC) offered by Locke and Latham. Thus, the aim of this article is to examine the causes of job motivation and satisfaction within the framework of HPC. The data were gathered from 1,970 police officers working in various police departments in Turkey. Overall, the results of the study were consistent with the tenets of HPC. Results suggest that specific goals, self-efficacy, and feedback increase police officers’ job motivation, which leads to rewards and subsequently, job satisfaction among police officers. The results also suggest that job motivation has direct and indirect effects on job satisfaction. The practical implications of this study are to show that HPC is an effective and applicable framework to increase police officers’ job motivation and satisfaction.
A Locally Adaptive Phase Aberration Correction (LAPAC) Method for Synthetic Aperture Sequences
Authors: Chau Gustavo , Jakovljevic Marko , Lavarello Roberto , Dahl Jeremy
Published: September 2018

Phase aberration is a phenomenon caused by heterogeneity of the speed of sound in tissue, in which the actual speed of sound of the tissue is different than the assumed speed of sound used for beamforming. It reduces the quality and resolution of ultrasonic images and impairs clinical diagnostic capabilities. Although phase aberration correction (PAC) methods can reduce these detrimental effects, most practical implementations of PAC methods are based on the near field phase screen model, which have limited ability to represent the true aberration induced by inhomogeneous tissue. Accordingly, we propose a locally adaptive phase aberration correction (LAPAC) method that is applied through the use of synthetic aperture. The method is tested using full-wave simulations of models of human abdominal wall, experiments with tissue aberrators, and in vivo carotid images. LAPAC is compared with conventional phase aberration correction (cPAC) where aberration profiles are computed at a preselected depth and applied to the beamformer’s time delays. For all experiments, LAPAC shows an average of 1 to 2 dB higher contrast than cPAC, and enhancements of 3 to 7 dB with respect to the uncorrected cases. We conclude that LAPAC may be a viable option to enhance ultrasound image quality images even in the presence of clinically relevant aberrating conditions.
Pulmonary vein thrombosis after lobectomy with vein stump closure by ligation
Authors: Miyoshi Ryo , Nishikawa Shigeto , Tamari Shigeyuki , Noguchi Misa , Hijiya Kyoko , Chihara Koji
Published: September 2018

Objectives

Thrombosis in the pulmonary vein stump after a left upper lobectomy is a rare but potentially life-threatening complication, and the pulmonary vein stump length plays an important role here. We assessed the frequency and risk factors for thrombosis in patients undergoing lobectomy with division of the superior pulmonary vein using ligation.

Methods

We retrospectively reviewed 425 patients with primary lung cancer who underwent lobectomy or bilobectomy in our institution from 2008 to 2016, with contrast-enhanced chest computed tomography within a year after lobectomy. The superior pulmonary vein was divided by thread ligation, while the inferior pulmonary vein was divided using a linear stapler. The pulmonary vein stump length was measured using contrast-enhanced chest computed tomography.

Results

Four (0.9%) of the 425 patients experienced thrombosis in the pulmonary vein stump within 6 months after lobectomy. All 4 patients had undergone a left upper lobectomy, and 4.1% of this subset developed thrombus. One patient with a thrombus in the pulmonary vein stump experienced renal and cerebral infarction after a left upper lobectomy. The left superior pulmonary vein stump was significantly longer than the other pulmonary vein stumps.

Conclusions

Thrombosis in the pulmonary vein stump occurred in 4.1% of patients undergoing a left upper lobectomy with pulmonary vein stump closure by thread ligation, which is a relatively low frequency. Superior pulmonary vein stump closure using thread ligation might help prevent pulmonary vein stump thrombus after a left upper lobectomy.
Teaching Fraction Concepts Using the Concrete-Representational-Abstract Sequence
Authors: Flores Margaret M. , Hinton Vanessa M. , Meyer Jill M.
Published: September 2018

Understanding related to fraction concepts is a critical prerequisite for advanced study in mathematics such as algebra. Therefore, it is important that elementary students form conceptual and procedural understanding of fractional numbers, allowing for advancement in mathematics. The concrete-representational-abstract (CRA) instructional sequence of instruction has been shown to be an effective means of teaching conceptual understanding of fractional numbers. The purpose of this study was to compare the effects of CRA with remedial multitiered systems of support (MTSS) Tier 2 instruction for teaching fraction concepts. Thirty-one fifth-grade students participated in two different Tier 2 interventions; one group received typical Tier 2 instruction with their general education teachers and the other received CRA instruction with the researchers. The researchers measured student performance using a pretest and posttest and found significant differences in progress favoring the CRA group. Results and implications are discussed.
Childhood Conditions Predict Chronic Diseases and Functional Limitations Among Older Adults: The Case of Indonesia
Authors: Peele Morgan E.
Published: September 2018

Objective: Limited knowledge exists about whether childhood health and socioeconomic status (SES) conditions influence health among older adults in Indonesia. Method: Data from Wave 5 (2014/2015) of the Indonesian Family Life Survey ( N = 6,530) was used to examine associations between childhood health and SES and hypertension, lung conditions, diabetes, lower body functional limitations (LBFL), and instrumental activities of daily living limitations (IADL). Results: Poor childhood health was associated with 34% higher odds of hypertension (odds ratio [OR] = 1.34, p < .05), 37% higher odds of diabetes (OR = 1.37, p < .05), and 32% higher odds of lung conditions (OR = 1.32, p < .05). Household overcrowding was associated with 22% higher odds of a LBFL (OR = 1.22, p < .05) and 24% higher odds of an IADL (OR = 1.24, p < .01). Lacking a household toilet was associated with 18% higher odds of a LBFL (OR = 1.18, p < .05). Adjusting for adult SES and current health did not account for these relationships. Discussion: Childhood conditions appear to shape older adult health in Indonesia.
Active fault-tolerant control for vertical tail damaged aircraft with dissimilar redundant actuation system using integral sliding mode control
Authors: Ijaz Salman , Hamayun Mirza T , Yan Lin , Shi Cun
Published: September 2018

The research about the dissimilar redundant actuation system has indicated the potential fault-tolerant capability in modern aircraft. This paper proposed a new design methodology to achieve fault-tolerant control of an aircraft equipped with dissimilar actuators and is suffered from vertical tail damage. The proposed design is based on the concept of online control allocation to redistribute the control signals among healthy actuators and integral sliding mode controller is designed to achieve the closed-loop stability in the presence of both component and actuator faults. To cope with severe damage condition, the aircraft is equipped with dissimilar actuators (hydraulic and electrohydraulic actuators). In this paper, the performance degradation due to slower dynamics of electrohydraulic actuator is taken in account. Therefore, the feed-forward compensator is designed for electrohydraulic actuator based on fractional-order control strategy. In case of failure of hydraulic actuator subject to severe damage of vertical tail, an active switching mechanism is developed based on the information of fault estimation unit. Additionally, a severe type of actuator failure so-called actuator saturation or actuator lock in place is also taken into account in this work. The proposed strategy is compared with the existing control strategies in the literature. Simulation results indicate the dominant performance of the proposed scheme. Moreover, the proposed controller is found robust with a certain level of mismatch between the actuator effectiveness level and its estimate.
Dynamics analysis of a slender ball-screw feed system considering the changes of the worktable position
Authors: Zhang Huijie , Liu Hui , Du Chao , lv Dun , Zhang Jun , Zhao Wanhua
Published: September 2018

For a slender ball-screw feed system, the position of the screw–nut joints will change greatly when the moving worktable moves along its whole stroke. Therefore, the compression/tension and torsion stiffness of the screw-shaft on both sides of the screw–nut joints will change. Thus, the system transmission stiffness will also vary and affect its dynamics. In this article, considering the changes of the worktable position and using hybrid element method, a dynamic model was established for the slender ball-screw feed system, and a calculation method of the system stiffness and mass matrix was provided. The experiments on the slender ball-screw feed system with different positions were also performed to verify the proposed dynamic model. Finally, the influences of length, screw-tension force, pitch, nominal diameter of screw and rated dynamic load of screw-nut joints on the slender ball-screw feed system’s natural frequency along its whole stroke were studied. The results showed that the slender ball-screw feed system possesses obvious position-dependent variable dynamics along its whole stroke; the ratio of length to diameter of the screw ( Lf/ d0) would be better designed smaller than 50 in order to obtain the relative uniformity of the system dynamics when manufacturing large machine tools.
Longitudinal vibration of a resilient wheel under the adhesion limit
Authors: Yang Yang , Jun-jun Ding , Fu Li , Jin-cheng Li
Published: September 2018

In order to study the longitudinal vibration law of a resilient wheel under the adhesion limit of different working conditions, two longitudinal vibration models of the resilient wheel of a motor vehicle are established, and the vibration laws and influencing factors of the resilient wheel under different operating conditions are studied by simulation. The model of the resilient wheel under low-speed driving and low adhesive operating conditions is established based on the Fastsim wheel/rail contact theory, and the other high-speed model of the resilient wheel is established by considering adhesion curve negative slope characteristics based on the Polach wheel/rail contact theory. The results show that at low-speed driving conditions, the longitudinal vibration of the resilient wheel is more violent than that of the solid wheel, and the sliding vibration of the resilient wheel at the adhesion limit is far greater than the nonadhesion limit at low-speed driving conditions. When the rail surface is polluted and the adhesion coefficient is low, with the speed increasing to 80 km/h, stick-slip vibration occurs on the resilient wheel due to the increased vibration between the wheel rim and the wheel hub. Under high-speed conditions, owing to the negative slope characteristic of the adhesion curve, the wheel adhesion recovery time decreases with the reduction of driving torque. The amplitude of vibration for the above two conditions increases with the increase in the stiffness of the motor boom and the longitudinal stiffness of the primary suspension. With the increase in the value of the radial stiffness and torsional stiffness of the resilient wheel, the vibration amplitude of the resilient wheel becomes smaller or suppressed. The vibration of the resilient wheel is transmitted to the frame through the primary suspension, which has little effect on the vibration of the vehicle body.
Sexual Orientation and Depressive Symptoms Among High School Students in Jiangxi Province
Authors: Li Yue , Yuan Zhaokong , Clements-Nolle Kristen , Yang Wei
Published: September 2018

Research in western countries has shown that adolescents who self-identify as lesbian, gay, or bisexual (LGB) are at increased risk for depression, but little is known about this relationship among adolescents in China. A school-based cross-sectional survey was conducted among 1816 high school students in Jiangxi province. Logistic regression was used to explore the relationship between sexual orientation and depressive symptoms. Approximately 4% of participants self-identified as LGB, and 14% reported being unsure of their sexual identity. After controlling for potential confounding factors, students who self-identified as LGB had significantly higher odds of depressive symptoms compared with heterosexual students: adjusted odds ratio = 6.16 (2.13-17.83) and adjusted odds ratio = 2.29 (1.13-4.63) for males and females, respectively. Culturally appropriate programs and policies that support LGB students and address discrimination and victimization are needed to improve the mental health of Chinese LGB youth.
The Public Health Challenge of Ending Malnutrition: The Relevance of the World Health Organization’s GINA Database
Authors: Buckinx Fanny
Published: September 2018

In order to address malnutrition, implementation of nutrition actions is needed. While academic institutions will certainly play a part, strong coordination and leadership from major United Nations agencies are needed. To this effect, the World Health Organization has launched a Global Database on the Implementation of Nutrition Action (GINA). It contains information collected from various sources, including direct submissions by users. Users can share information on how programs are implemented, including country adaptations and lessons learnt. GINA allows users to share implementation experience in order to identify overlaps and gaps, to foster discussion toward improved planning and to promote good practices. The aim of this article is to highlight the relevance of the GINA database in meeting the public health challenge of ending malnutrition and, therefore, to encourage users from different countries to enter programs and policies in the database.
Formaldehyde Exposure in Indoor Air From Public Places and Its Associated Health Risks in Kunshan City, China
Authors: Liang Xiaojun , Zhang Jianxin , Song Wenlei , Wang Kewei , Zhang Baoying
Published: September 2018

This study assessed the noncarcinogenic and carcinogenic health risks associated with formaldehyde exposure for employees working in 4 categories of public places in Kunshan City in China. A total of 564 different public places, which can be divided into 4 categories (hotel and social interaction places, bathing and beauty places, cultural and entertainment places, and shopping places), and 2716 indoor air samples in those places were measured from January 1, 2010, to December 31, 2015. The average concentration of formaldehyde was 0.57 mg/m3, which is 5.7 times the acceptable concentration level (0.1 mg/m3). The noncarcinogenic risk assessment index for the 4 categories of places tested was above 1. The carcinogenic risk of formaldehyde for employees of the 4 categories of public places was 4.70 × 10−5 to 1.57 × 10−4, which was greater than the acceptable carcinogenic risk probability (1 × 10−6) from the US Environmental Protection Agency. The highest carcinogenic risk occurred in bathing and beauty places, and male employee carcinogenic risk was greater than that of females. Occupational formaldehyde exposure has serious noncarcinogenic and carcinogenic health risks for employees, and further research is needed to improve indoor air quality in the workplace environment.
Social Resilience and Mental Health Among Eritrean Asylum-Seekers in Switzerland
Authors: Melamed Sabra , Chernet Afona , Labhardt Niklaus D. , Probst-Hensch Nicole , Pfeiffer Constanze
Published: September 2018

Eritreans comprise the largest group of asylum-seekers in Switzerland. Gaining recognized refugee status can take up to 36 months, during which time asylum-seekers live in a state of legal limbo, intensifying threats to their well-being. Resilience and mental health among this population is poorly understood. We interviewed 10 asylum-seekers residing in Switzerland using qualitative, in-depth interviews. Data were analyzed using the Framework Method. Results indicated that mental health was understood as a binary state rather than a continuum and that trusted friends and family were responsible for recognizing and attempting to treat mental health problems. Pathways to care were potentially interrupted for asylum-seekers. Capital building, considered through the lens of social resilience, consisted of language learning, establishing of new individual- and community-level social networks, and proactive symbolic capital building through volunteering. We contextualize the asylum-seekers’ experience into a resilience framework and offer practical recommendations for improving mental health care access.