bluuebunny/crossref_metadata_2025 huggingface dataset:
Gresham’s Law and News in a Post-Truth World
Authors: Kovacic Branislav
Published: April 2019

Economists and finance experts have studied how ‘bad money drives out good’ and formulated Gresham’s law (Mokyr, 2003). The law states that the more expensive money tends to disappear from circulation because it is counterfeited, hoarded, or exported. One can propose a similar principle in the news business – real, verified, and socially relevant news tends to be replaced by fake, unverified, and often socially irrelevant news. This tends to happen not only in the American version of news production models (purportedly neutral and objective) but also in other more ideologically and politically oriented news production models.
Terrorism and inbound tourism: Does immigration have a moderating effect?
Authors: Harb Georges , Bassil Charbel
Published: April 2019

This article investigates the impact of terrorism on bilateral tourism flows within the Organization for Economic Co-operation and Development countries. It also examines the moderation effect of immigration in the destination country on the terrorism–tourism relationship. The results obtained from the estimated gravity models show that after reaching a certain threshold, terrorism negatively impacts tourist arrivals. This relation seems to be moderated by the share of immigrants in the country of destination: when the share of immigrants in a country is relatively high, the positive impact of immigration on tourist arrivals would counterbalance the adverse impact of terrorism on tourist arrivals.
Load–response correlation–based equivalent static wind loads for large cooling towers
Authors: Cao SS , Ke ST , Zhang WM , Zhao L , Ge YJ , Cheng XX
Published: April 2019

The load–response correlation method has been recognized by the wind engineering community as a useful equivalent static wind load calculation method for structural design of quasi-static structures against strong winds. However, it has been found that the load–response correlation method is less effective to non-linear systems and in situations where load processes are non-Gaussian, such as large cooling towers subjected to strong winds. To validate the applicability of the load–response correlation method to large cooling towers, an aero-elastic model has been designed for a 215-m-high cooling tower in this article, which can simultaneously produce wind loads and wind-induced displacements of the structure according to wind tunnel model tests. Using data measured on the aero-elastic model, the exact results of correlation coefficients between wind loads and structural responses are obtained and validated by a non-linear finite element analysis. By comparing the correlation coefficients measured on the scaled model to the results based on the load–response correlation calculation, it is found that the correlations are much stronger for the load–response correlation calculation than those for the exact wind tunnel measurement. The explanation for this observation is that the non-linearity of the real structure and the non-Gaussian feature of the actual wind loads can weaken the correlations between the wind loads and the structural responses.
Embedded fiber Bragg grating sensor–based wing load monitoring system for composite aircraft
Authors: Kwon Hyunseok , Park Yurim , Kim Jin-Hyuk , Kim Chun-Gon
Published: April 2019

An embedded fiber Bragg grating sensor–based wing load monitoring system for composite aircraft was presented. The presented system was implemented to an actual composite aircraft, and the implemented system was verified through flight tests. During the manufacturing process of the aircraft, fiber Bragg grating sensors were embedded into the composite wing, and the interrogation and data processing system for in-flight measurement of strain distribution and flight parameters and estimation of wing load was installed on-board the aircraft fuselage. Through load calibration tests, wing loads were estimated using strain responses from the embedded fiber Bragg grating sensors, and in-flight wing load estimation was performed. Through flight tests, flight data were successfully acquired, and the acquired flight data were comprehensively analyzed to verify the performance and effectiveness of the implemented system. As a result, the total wing load of the test-bed aircraft was estimated with an average error of 4.19%, and the wing load history reasonably corresponded to the loading conditions for various flight states, such as take-off, climb and descent, and banked turn.
Formation of high-density polyethylene–poly(ethylene-octene) core–shell particles in recycled poly(ethylene terephthalate) by reactive blending
Authors: Liu Yongjun , Zhong Ming , Liu Gang , Pu Shouzhi
Published: April 2019

Recycled poly(ethylene terephthalate) (R-PET)/high-density polyethylene (HDPE)/glycidyl methacrylate grafted poly(ethylene-octene) (mPOE) blends, in which the binary (HDPE/mPOE) dispersed phase was of a HDPE core-mPOE shell structure, were prepared. For this purpose, HDPE-g-mPOE graft copolymers were prepared in HDPE/mPOE blends via reactive extrusion with the presence of the free radical initiator dicumyl peroxide (DCP). Then, R-PET was blended with the HDPE/mPOE blends by melt extrusion. The effect of the DCP and mPOE content in the HDPE/mPOE blends on the phase morphology and mechanical properties of the R-PET/HDPE/mPOE blends were studied systematically. It was found that the blends containing reactive compatibilizer exhibited the encapsulation of the HDPE by the mPOE, forming core–shell particles dispersed phase morphology. The graft chains of HDPE-g-mPOE-g-PET formed by the in situ reaction between R-PET and mPOE phases reduced the interfacial tension. Consequently, the dispersed phase morphology was observed to form smaller diameter core–shell particles. The resultant blends exhibited an effect on both the thermal and mechanical properties. Differential scanning calorimetric analysis showed the dispersed phase particles could act as a nucleating agent in the R-PET matrix to improve the crystallization temperature, while the graft copolymers formed in the compatibilized R-PET/HDPE/mPOE blend decreased the nucleation activity. Notched Charpy impact strength and elongation at break of the R-PET were improved by forming the core–shell particles dispersed phase morphology.
A Modified Syringe Plunger Device Significantly Reduces Guidewire Threading Time Regardless of Experience Level or the Presence of Presbyopia
Authors: Ysa August , Lobato Marta , Mikelarena Ederi , Arruabarrena Amaia , Gómez Roberto , de Blas Mariano , Metcalfe Matthew , Fonseca Juan L.
Published: April 2019

Purpose: To evaluate the efficacy of a new guidewire threading instrument (GTI) in reducing guidewire threading times compared with the traditional freehand method. Materials and Methods: This prospective, controlled, single-center study recruited 100 subjects (mean age 45.2±11.3 years; 43 men) and divided them into 2 groups depending on their professional background: 50 experienced medical personnel (performed or assisted in >50 catheter-based procedures) and 50 medical personnel with no experience in endovascular techniques (inexperienced group). The threading time of both groups was recorded using the conventional freehand method and with the GTI for both 0.035- and 0.014-inch platforms. Users of eyeglasses for presbyopia were tested with and without glasses. Median values are reported with the interquartile range (IQR; Q1, Q3) in parentheses. Results: The mean insertion times with both the 0.035-inch and 0.014-inch guidewires in the overall study group were significantly better with the use of the GTI compared with the traditional freehand method (p<0.001). Both the experienced and the inexperienced participants improved their insertion times using the GTI with both guidewire platforms (p<0.001). The threading time with the new device was also significantly reduced (p<0.001) for both participants with presbyopia and those without. When comparing the median absolute time improvement (difference between freehand/GTI insertion times) for the 0.014-inch platform, the inexperienced group showed a greater improvement in their performance [3.52 seconds (IQR 2.76, 5.12)] compared with the experienced group [1.87 seconds (IQR 1.37, 2.66), p<0.001]. The median “absolute time improvement” was also significantly greater for the presbyopic group [5.75 seconds (IQR 3.14, 8.20)] vs the group without age-related visual impairment [2.64 seconds (IQR 1.65, 3.36), p<0.001]. Conclusion: This simple and inexpensive homemade device facilitates wire threading of low-profile catheters and seems to be especially helpful for trainees with no experience and presbyopic operators.
Safety and Feasibility of Intravascular Lithotripsy for Treatment of Common Femoral Artery Stenoses
Authors: Brodmann Marianne , Schwindt Arne , Argyriou Angeliki , Gammon Roger
Published: April 2019

Purpose: To evaluate the safety and feasibility of treating calcified, stenotic common femoral arteries (CFAs) using the Peripheral Intravascular Lithotripsy (IVL) System. Methods: An analysis was performed of 21 patients (mean age 71.9±10.1 years; 16 men) across 3 sites with calcified CFA stenoses treated with the Peripheral IVL System. The outcomes of interest were the ability to deliver IVL to the target lesion, the increase in acute gain, the reduction in diameter stenosis, the rate of provisional stenting, and angiographically defined complications. Results: Access to the target lesion and delivery of treatment by the IVL catheter were successful in all 21 patients. Post treatment mean diameter stenosis was 21.3%, representing an acute mean lumen gain of 3.1±1.3 mm (range 0.7–5.2). Vascular complications were minimal, with only 5 type B (non-flowing-limiting) dissections reported. The profunda femoris artery was patent in all patients following IVL, and none of the subjects experienced a perforation, distal embolization, thrombus, no reflow, or abrupt closure. Conclusion: These early results demonstrate that calcified, stenotic CFA lesions can be safely and successfully treated using the Peripheral IVL System.
Illinois Department of Motor Vehicle Customers’ Reasons for (Not) Registering as an Organ Donor
Authors: Reynolds-Tylus Tobias , Quick Brian L. , King Andy J. , Moore Miriam
Published: April 2019

Context:

Organ donation campaigns are maximized when promotional messages address salient issues among the intended audience. A diverse sample (N = 1573) was recruited to identify the reasons for (not) registering as an organ donor.

Objective:

Relying on an established coding scheme, an updated explanation for why individuals register (or not) as organ donors is provided. Moreover, registration trends with respect to race, biological sex, and age is presented.

Method:

Participants exiting Department of Motor Vehicle offices (N = 12) were surveyed to understand their reasons for registering and not registering as organ donors.

Results:

Benefits of donation followed by prior registration, rational arguments, and personal experiences represented nearly 90% of the coded responses for registering. Conversely, negative beliefs, decisional uncertainty, perceived disqualification, no reason, general fear/disgust, and lack of opportunity constituted nearly 90% of the coded responses for not registering as an organ donor. Whites and Latinx individuals were more likely to register as organ donors compared to African Americans. Participants in the lower (18-24) and upper (65+) age brackets had the lowest donor registration rates.

Conclusion:

Promotional efforts should continue to target younger and older audience segments with information about organ donation as well as African Americans. Results from the current study suggest emphasizing the benefits of organ donation as well as overcoming negative beliefs, decisional uncertainty, and perceived disqualifications.
Cognitive Function of Elderly Persons in Japanese Neighborhoods: The Role of Street Layout
Authors: Koohsari Mohammad Javad , Nakaya Tomoki , McCormack Gavin R. , Shibata Ai , Ishii Kaori , Yasunaga Akitomo , Oka Koichiro
Published: April 2019

Objectives:

The aims of this study were to examine (a) associations of two metric and space syntax measures of street layout with the cognitive function of Japanese older adults and (b) the extent to which objectively assessed physical activity mediated such associations.

Methods:

Cross-sectional data from 277 older adults who lived in Japan were used. Street layout attributes were objectively calculated for each participant’s geocoded home location. The Mini-Mental State Examination was used to evaluate cognitive function. Physical activity was objectively assessed with accelerometers.

Results:

There was a statistically significant negative association between street integration and the odds of having cognitive impairment. Objectively assessed physical activity did not attenuate this relationship.

Conclusions:

Our findings provide unique evidence regarding the importance of the topological aspects of street layouts in (re)designing neighborhoods to support mental illness.
A Case Study of Parent–Child Interaction Therapy for the Treatment of High-Functioning Autism Spectrum Disorder
Authors: Cambric Mercedes , Agazzi Heather
Published: April 2019

Youth with autism spectrum disorder (ASD) may have difficulties with compliance, impulsivity, and attention, which can affect daily adaptive functioning leading to disruptions in family social interactions, communication skills, academic achievement, and engagement in the community. Although previous research has identified behavioral treatments such as applied behavior analysis (ABA) therapy for youth with ASD, it is important to explore more interventions that can be effective in decreasing problematic behaviors while also building positive social skill development. This case study illustrates the effectiveness of Parent–Child Interaction Therapy (PCIT) to address behavioral problems in a 7-year-old boy with high-functioning ASD (HF-ASD) and comorbid ADHD. Overall, the results demonstrated a decrease in child challenging behaviors and an increase in child compliance. In addition, the child’s mother increased her use of positive parenting skills and effective commands. This study provides additional support for PCIT for children with ASD, but was not without challenges. These challenges, characteristic of families affected by ASD, and treatment implications for clinicians working with this population are discussed.
Employing Mexican American Folklore as an Educational Tool to Teach Cultural Competence
Authors: Feize Leyla , Longoria Denise A. , Fernandez Alfredo
Published: April 2019

The goal of this research was to explore Mexican American cultural elements through folklore as a way of addressing cultural competence. Content analysis of 21 stories, which were collected from Mexican American older adults, indicated that strong family ties, gender roles, and religiosity are central cultural elements in Mexican American culture. Critically evaluating cultural factors and employing constructive cultural elements can assist social work professionals in providing effective social services to this population via culturally competent practice.
“I Guess I’ll Have to Bring It”: Examining the Construction and Outcomes of a Social Justice–Oriented Service-Learning Partnership
Authors: Bialka Christa S. , Havlik Stacey , Mancini Gina , Marano Helene
Published: April 2019

In a 2012 issue of The Journal of Transformative Education, Tharp stressed the need for more research regarding the praxis of diversity and critical service learning. In response, this qualitative case study investigated how a service-learning experience supported university and school students in their exploration of ableism, defined as the systematic discrimination and exclusion of individuals who have disabilities. Additionally, this research used transformative learning as a lens to examine whether the partnership described in this case could be categorized as critical. Findings revealed that the praxis of coursework and the partnership played a pivotal role in illuminating ableism, the partnership provided insight into intersectional issues of social justice, and all participants engaged with the concept of ableism. This article explores how the partnership achieved the aims of critical service learning, addresses where it fell short, and considers the implications for service-learning experiences designed to address ableism. Finally, this article offers a novel way to consider how critical service learning, ableism awareness, and transformative learning can be used in tandem to address social justice.
A Qualitative Interview With Young Children: What Encourages or Inhibits Young Children’s Participation?
Authors: Ponizovsky-Bergelson Yael , Dayan Yael , Wahle Nira , Roer-Strier Dorit
Published: April 2019

The goal of every qualitative interview is to produce rich data. Inducing storytelling is a challenge in every interview. Interviews with young children (ages 3–6) present an additional challenge because of perceived power differences between children and adults. This research examines how interviewers’ questions and expressions encourage or inhibit children from telling their stories. We extracted 1,339 child interviewee–adult interviewer turn exchanges from a national study on children’s perspectives on risk and protection ( N = 420) and analyzed them in two steps. First, we categorized the interviewers’ questions and expressions and children’s responses. Seven categories were found for interviewer expressions and five for children’s responses. We then examined the relationship between interviewer categories and children’s responses. The categories that produced the richest data were encouragement, open-ended questions, and question request. Sequence of utterances and closed-ended questions produced the least storytelling. We did not find significant differences based on a child’s gender with regard to the interviewer categories. The results and implications for researching young children are addressed.
Trajectory planning method for improving alignment accuracy of probes for dual-robot air-coupled ultrasonic testing system
Authors: Guo Canzhi , Xu Chunguang , Xiao Dingguo , Hao Juan , Zhang Hanming
Published: April 2019

Composite workpieces, especially the complex-curved surfaces composite workpieces, have been increasingly used in different industries. Non-destructive testing of these parts has become an urgent problem to be addressed. To solve the problem, this article presents a dual-robot air-coupled ultrasonic non-destructive testing scheme and introduces the structure of the system and a general calibration method for the workpiece frame of a dual-robot system in detail. Importantly, this article proposes a tangential constraint method, which makes the probes completely aligned during the inspection process. Verification experiments and ultrasonic testing experiments for a glued multilayered composite workpiece were performed using the dual-robot air-coupled ultrasonic non-destructive testing system. A comparative experiment was also performed using a dual-robot water jet-coupling ultrasonic testing system. Experimental results show that the dual-robot non-destructive testing scheme and the tangential constraint method function well, and all the artificial defects on the sample can be detected by both kinds of testing methods. Vivid 3-D C-scan image based on the test result is provided for convenience of observation. In other words, a kind of flexible versatile testing platform with multiple degrees of freedom is established.
Establishing an electronic health record–supported approach for outreach to and recruitment of persons at high risk of type 2 diabetes in clinical trials: The vitamin D and type 2 diabetes (D2d) study experience
Authors: Aroda Vanita R , Sheehan Patricia R , Vickery Ellen M , Staten Myrlene A , LeBlanc Erin S , Phillips Lawrence S , Brodsky Irwin G , Chadha Chhavi , Chatterjee Ranee , Ouellette Miranda G , Desouza Cyrus , Pittas Anastassios G ,   for the D2d Research Group
Published: April 2019

Aims

To establish recruitment approaches that leverage electronic health records in multicenter prediabetes/diabetes clinical trials and compare recruitment outcomes between electronic health record–supported and conventional recruitment methods.

Methods

Observational analysis of recruitment approaches in the vitamin D and type 2 diabetes (D2d) study, a multicenter trial in participants with prediabetes. Outcomes were adoption of electronic health record–supported recruitment approaches by sites, number of participants screened, recruitment performance (proportion screened who were randomized), and characteristics of participants from electronic health record–supported versus non–electronic health record methods.

Results

In total, 2423 participants were randomized: 1920 from electronic health record (mean age of 60 years, 41% women, 68% White) and 503 from non–electronic health record sources (mean age of 56.9 years, 58% women, 61% White). Electronic health record–supported recruitment was adopted by 21 of 22 sites. Electronic health record–supported recruitment was associated with more participants screened versus non–electronic health record methods (4969 vs 2166 participants screened), higher performance (38.6% vs 22.7%), and more randomizations (1918 vs 505). Participants recruited via electronic health record were older, included fewer women and minorities, and reported higher use of dietary supplements. Electronic health record–supported recruitment was incorporated in diverse clinical environments, engaging clinicians either at the individual or the healthcare system level.

Conclusion

Establishing electronic health record–supported recruitment approaches across a multicenter prediabetes/diabetes trial is feasible and can be adopted by diverse clinical environments.
‘An Amazing Gift’? Memory entrepreneurship, settler colonialism and the Canadian Museum for Human Rights
Authors: Dean Amber , Failler Angela
Published: April 2019

Drawing on research undertaken at the Canadian Museum for Human Rights, this article considers the role of memory entrepreneurship in the museum’s historic launch and in a sampling of its content, social media posts, points of sale and marketing campaigns. These examples are read in tension with Roger I. Simon’s conceptualization of ‘the terrible gift’ of what we come to know belatedly about events of mass violence, which calls into question the consolatory promises of learning from ‘those who came before us’ and the ‘lessons of their lives’. The museum’s involvement in the City of Winnipeg’s tourism initiatives and the revitalization of Winnipeg’s downtown are also considered, and we suggest that the museum’s participation in the creative economy might affect its tendency to situate human rights violations primarily in the past. Critiques of the Canadian Museum for Human Rights’ present occupation of Indigenous land and the museum (and City of Winnipeg)’s ongoing reliance on natural resources extracted at the expense of Indigenous communities remain as difficult or inassimilable knowledge. Juxtaposing Indigenous, cultural and economic critiques with the Canadian Museum for Human Rights’ advancement of memory entrepreneurship, our article explores the inter-implication of consumer culture, capitalism, settler colonialism and the museum’s ability to contribute to societal change. We conclude by turning to the activism of members of Shoal Lake 40 First Nation, arguing that their calls for access to safe water and an all-season road in and out of their community pose both an economic and a political challenge to the Canadian Museum for Human Rights and its brand of memory entrepreneurship by insisting that gestures to include and proffer representational forms of recognition to Indigenous peoples must simultaneously attend to sovereigntist calls for redistribution of land and resources in order to meaningfully address the historical and ongoing injustices of settler colonialism.
Ankle Arthrodesis With Structural Grafts Can Work for the Salvage of Failed Total Ankle Arthroplasty
Authors: Halverson Adam L. , Goss David A. , Berlet Gregory C.
Published: April 2019

Background. Treatment options after failed total ankle arthroplasty (TAA) are limited. This study reports midterm outcomes and radiographic results in a single-surgeon group of patients who have undergone ankle arthrodesis with intramedullary nail fixation and structural allograft augmentation following failed TAA. Methods. A retrospective review on patients who underwent failed TAA revision with structural femoral head allograft and intramedullary tibiotalocalcaneal (TTC) nail fixation was completed. Foot Function Index (FFI), American Orthopaedic Foot & Ankle Society (AOFAS) outcome scores, and radiographs were obtained at each visit with 5-year follow-up. Results. Five patients were followed to an average of 5.2 years (range 4.7-5.6). Enrollment FFI was 34.82 (range 8.82-75.88); at midterm follow-up it was 20.42 (range 0-35.38). Enrollment AOFAS scores averaged 66.6 (range 61-77); at midterm follow-up it was 70.33 (range 54-88). Radiographs showed union in 4 of 5 patients at enrollment and 2 of 3 patients at midterm. Conclusions. Utilization of TTC fusion with femoral head allograft is a salvage technique that can produce a functional limb salvage. Our results show continued improvement in patient-reported outcomes, with preservation of limb length and reasonable union rate.

Levels of Evidence: Therapeutic, Level II: Prospective, comparative trial.
The Role of Relaxin-2 in Tissue Remodeling of Chronic Rhinosinusitis With Nasal Polyps
Authors: Li Yimin , Tan Guojing , Liu Jie , Ke Xia , Shen Yang , Huang Jiangju , Hu Guohua , Xiang Tingxiu , Yang Yucheng
Published: April 2019

Background

Relaxin is a small peptide hormone that regulates extracellular matrix remodeling and reduces fibrosis in a number of organs. Little is known about its impact on chronic rhinosinusitis with nasal polyps (CRSwNP); thus, we aimed to determine the expression of human H2 relaxin (relaxin-2) and its role in tissue remodeling in CRSwNP.

Methods

Patients were enrolled and divided into the following groups: CRS with NP (CRSwNP; n = 20), CRS without NP (CRSsNP; n = 20), and controls (n = 15). Tissue samples were analyzed by Masson trichrome staining for collagen, while the location and expression of relaxin-2, transforming growth factor beta 1 (TGF-β1), and phosphorylated (p) Smad2/Smad3 were analyzed by immunohistochemistry and Western blot. The expression of relaxin-2, Smad2, Smad3, and TGF-β1 mRNA was tested by quantitative polymerase chain reaction (qPCR). Ex vivo NP were treated with relaxin-2 (n = 15) or TGF-β1 (n = 15). Collagen type I (collagen I), relaxin-2, and TGF-β1 levels in the culture supernatants were examined by enzyme-linked immunosorbent assay, while pSmad2/Smad3 in culture pellets was analyzed by Western blot, and the expression of Smad2 and Smad3 mRNA was tested by qPCR.

Results

The collagen, relaxin-2, TGF-β1, and pSmad2/Smad3 protein expression levels were significantly decreased in the CRSwNP group compared with the CRSsNP group ( P < .05). The expression of relaxin-2, Smad2, Smad3, and TGF-β1 mRNA in the CRSsNP group was significantly higher than in the CRSwNP and control groups ( P < .05). Compared with the ex vivo controls, in CRSwNP, the levels of TGF-β1, collagen I, pSmad2/Smad3, Smad2, and Smad3 were markedly decreased after relaxin-2 treatment. However, relaxin-2, collagen I, pSmad2/Smad3, Smad2, and Smad3 were remarkably increased after TGF-β1 treatment.

Conclusions

The antifibrotic effects of relaxin-2 may play a role in tissue remodeling in CRSwNP, but the detailed mechanism deserves further study.
Riociguat for the treatment of transthyretin cardiac amyloidosis: data from a named patient use program in Austria
Authors: Duca Franz , Aschauer Stefan , Zotter‐Tufaro Caroline , Binder Christina , Kammerlander Andreas A. , Börries Benedikt , Agis Hermine , Kain Renate , Hengstenberg Christian , Mascherbauer Julia , Bonderman Diana
Published: April 2019

Patients with transthyretin cardiac amyloidosis (TTR CA) suffer from impaired exercise capacity, have a poor quality of life (QoL), and approved treatments are lacking. Stimulators of the soluble guanylate cyclase are promising new pharmaceuticals in the treatment armamentarium of heart failure patients. The aim of the present study was to report on the safety and efficacy of riociguat administration in patients with TTR CA. TTR CA patients received riociguat for 4–6 months within the frames of a national named patient use (NPU) program. Parameters of interest included changes in submaximal exercise capacity, invasive hemodynamic parameters, and QoL. Between March 2012 and June 2017, 86 CA patients were screened for the NPU program, of whom 13 TTR CA patients were eligible for participation. In our study cohort, riociguat had an acceptable tolerability profile. At follow‐up, we could detect slight improvements in median 6‐min walk distance (396 m [interquartile range (IQR) = 340–518] vs. 400 m [IQR = 350–570], P = 0.045), New York Heart Association class ≥ III (n = 7 [53.9%] vs. n = 0 [0.0%], P = 0.031), cardiac output (4.3 L/min [IQR = 3.9–5.1] vs. 4.5 L/min [IQR = 4.2–5.1], P = 0.022), diastolic pressure gradient (1.0 mmHg [IQR = −1.5–3.0) vs. −1.0 mmHg [IQR = −3.0–1.0], P = 0.049), and QoL (50.0% [IQR = 40.0–58.0] vs. 60.0% [IQR = 50.0–75.0], P = 0.021). Pulmonary arterial pressures were not altered. The present case series of TTR CA patients indicates that riociguat administration was safe and associated with minor clinical as well as hemodynamic improvements.
Seeing the quality improvement forest through the quality improvement trees: A meta-synthesis of case studies in Florida and Georgia
Authors: Livingood William C , Bilello Lori , Lukens-Bull Katryne
Published: April 2019

Objectives:

To identify important characteristics of quality improvement applications for population health and healthcare settings and to explore the use of quality improvement as a model for implementing and disseminating evidence-based or best practices.

Methods:

A meta-synthesis was used to examine published quality improvement case studies. A total of 10 published studies that were conducted in Florida and Georgia were examined and synthesized using meta-synthesis (a qualitative research methodology) for meaningful insights and lessons learned using defined meta-synthesis inclusion criteria. The primary focus of the analysis and synthesis were the reported processes and findings that included responses to structured questioning in addition to emergent results from direct observation and semi-structured open-ended interviewing.

Results:

The key insights for the use of quality improvement in public health and healthcare settings included (1) the essential importance of data monitoring, analysis, and data-based decision making; (2) the need to focus on internal mutable factors within organizations; (3) the critical role of quality improvement team group dynamics; (4) the value of using a quality improvement collaborative or multi-clinic quality council/committee for sharing and comparing performance on key metrics; and (5) the need to identify a quality improvement approach and methods for clarification as a structured quality improvement intervention.

Conclusion:

In addition to the advantages of using quality improvement to enhance or improve healthcare and public health services, there is also potential for quality improvement to serve as a model for enhancing the adoption of evidence-based practices within the context of dissemination and implementation research.
Implications of inflammation and insulin resistance in obese pregnant women with gestational diabetes: A case study
Authors: Al-ofi Ebtisam Aziz
Published: April 2019

Background:

Obesity is one of the leading pregnancy risks for both the mother and the neonate. The prevalence of gestational diabetes mellitus has been increasing, especially with the increase in obesity in reproductive-aged women. A high body mass index, a sedentary lifestyle, a previous macrosomic infant, polycystic ovary syndrome and hypothyroidism are the main risk factors for gestational diabetes mellitus. Early gestational diabetes mellitus detection in high-risk individuals is a useful method for preventing further complications and/or preventing this disease by improving the patient’s lifestyle.

Case presentation:

A morbidly obese woman with a high body mass index (>36) at 24 weeks gestational age presented with several gestational diabetes mellitus risk factors. Her glucose tolerance test verified gestational diabetes mellitus, and, incidentally, her C-reactive protein level was elevated without obvious reason. Her plasma levels of inflammatory cytokines had also been assessed and were exaggerated. After lifestyle intervention, including weight management, the patient’s inflammatory mediators, including her C-reactive protein level, dropped. Therefore, this study aimed to identify the relationship between the patient’s inflammation and obesity.

Conclusion:

Antenatal C-reactive protein screening could be used throughout pregnancy to predict inflammation from high-risk pregnant women. This case scenario describes the interrelationships between inflammation, insulin resistance and adipokines, as well as the contributions of hypothyroidism and polycystic ovary syndrome. Further research should emphasise the relationships between inflammation and obesity in pregnancy.
Depressive symptomatology in a female patient with Tarlov cyst
Authors: Kontoangelos Konstantinos , Economou Marina , Katsi Vasiliki , Papageorgiou Charalambos
Published: April 2019

Introduction:

The spinal perineurial cyst is a rare anomaly of the nervous system. It is also known as Tarlov cyst, since it was described for the first time by Isadore M. Tarlov. The pathology is defined as a cystic dilatation between the perineurium and endoneurium of spinal nerve roots, located at the level of the spinal ganglion and filled with cerebrospinal fluid but without communication with the perineurial subarachnoid space.

Case report:

We present the case of a 56-year-old female who reported sudden onset of symptoms of a depressive symptomatology accompanied with acute pain in the lumbar area. Lumbosacral magnetic resonance imaging scan revealed Tarlov cysts.

Discussion:

Radiological investigations in patients with depressive symptomatology may be substantial.
Digital flexion contracture caused by tophaceous gout in flexor tendon
Authors: Tajika Tsuyoshi , Kuboi Takuro , Mieda Tokue , Oya Noboru , Endo Fumitaka , Nakazawa Takuro , Chikuda Hirotaka
Published: April 2019

Gouty tophus is an unusual cause of digital flexion contracture. Awareness of this pathophysiology will lead to more confidence in proper treatment and surgical management of this rare condition. This report describes a case of digital flexion contracture by tophaceous gout distinguished between trigger finger and locking of the metacarpophalangeal joint. We found the flexor tendon with a deposited chalky white substance suggestive of gouty tophus intraoperatively. We performed tenosynovectomy and removed the chalky white substance to the greatest degree possible. Histological findings confirmed the diagnosis of gout. Postoperatively, the patient recovered nearly to a full range of motion of the affected digits. When meeting with the patient who has had hyperuricemia and who is unable to extend the affected digits suddenly, one must keep in mind digital flexion contracture caused by tophaceous gout.
The Nurse Professional Competence (NPC) Scale: A tool that can be used in national and international assessments of nursing education programmes
Authors: Gardulf Ann , Florin Jan , Carlsson Marianne , Leksell Janeth , Lepp Margret , Lindholm Christina , Nordström Gun , Theander Kersti , Wilde-Larsson Bodil , Nilsson Jan
Published: April 2019

The quality of basic nursing bachelor programmes nationally and internationally must regularly be assessed to ensure that they fulfil requirements and are appropriate in relation to developments and changes in societies and healthcare systems. There is a need for instruments in helping to assess this. The aim of this study was to investigate whether the Nurse Professional Competence (NPC) Scale could serve as a tool to measure and detect possible differences between universities/university colleges regarding nursing students’ self-reported competence. Totally, 543 nursing students who had just completed their academic three-year nursing bachelor programmes at 10 universities/university colleges in Sweden participated in the study (response rate 71%). The students answered the NPC Scale with its 88 items constituting eight competence areas (CAs) and two overarching themes. The results from using the NPC Scale by the students were then compared between the 10 universities/university colleges. Significant mean score differences were found between the universities/university colleges on all CAs and on both themes. The highest mean score differences were found for the CAs ‘Medical and technical care’ and ‘Documentation and information technology’. The lowest mean score differences were found for the CAs ‘Value-based nursing care’ and ‘Leadership in and development of nursing’. It is concluded that the NPC Scale can serve as a useful tool in national and international assessments of nursing bachelor programmes.
Participatory social network map making with family carers of people living with dementia
Authors: Campbell Sarah , Clark Andrew , Keady John , Kullberg Agneta , Manji Kainde , Rummery Kirstein , Ward Richard
Published: April 2019

This article focuses on the use of a participatory social network mapping method with family carers. This is one of a suite of methods developed in a 5-year qualitative multi-centre project exploring how neighbourhoods support, enable or disable people with dementia and their families to live well in their communities. The article considers how mapping provides insights into family support networks, revealing the fluidity of support and care within relationships as well as providing opportunity for individuals to represent the complexities of their relationships with more and less significant others. However, the potential offered by the approach goes beyond those of visual representations of networks and contacts. Paying attention to the co-production process, as well as the reflexive dialogue that emerges in the exchange between researcher, participants, and the maps themselves, we consider how the maps emerge as affective artifacts, weighted with emotion.
A Needs Assessment of Family Physicians to Inform Development of Educational Resources on Antipsychotic Use in Dementia
Authors: Carnahan Ryan M. , Daly Jeanette M. , Minion Sarah , Gryzlak Brian , Weckmann Michelle T. , Levy Barcey T. , Bay Camden P.
Published: April 2019

Objectives: Objectives of this study were to (1) assess the needs and preferred resources of Iowa physicians to inform the development of educational resources for best practice dementia care and (2) compare the responses of nursing home medical directors with nonmedical directors. Methods: Of 498 physicians, 101 (20%) completed and returned the survey. Family physicians were obtained from a list of family physicians from the Iowa Board of Medical Examiners. Respondent answers were summarized and presented as total numbers and percentages in tables. Significant differences between medical directors and nonmedical directors were evaluated using chi-square tests, Fisher exact tests, and Wilcoxon rank-sum tests. Results: Medical directors and nonmedical directors had similar preferences for resources used and information needs. Online resources, pocket guides, a handbook, consulting pharmacists, and facility in-services were the most commonly preferred sources of new information. Medical directors were significantly more aware of the Food and Drug Administration warning on antipsychotic use in dementia and treated more nursing home patients. No differences were observed between groups related to confidence in and use of nondrug strategies instead of antipsychotics to manage behavioral symptoms of dementia. Conclusion: The results of this survey illustrate physician preferences for information and resources on the management of behavioral and psychological symptoms in dementia. Information was used to inform the development of resources to aid physicians and other health care providers in making decisions about managing these symptoms.
Impact of the HealthMatters Train-the-Trainer Program on the Health and Health Behaviors of Staff Supporting Adults With Intellectual and Developmental Disabilities
Authors: Marks Beth , Sisirak Jasmina , Chang Yen-Ching , Murphy Ryan
Published: April 2019

The health status and health behaviors among support staff providing daily support for people with intellectual and developmental disabilities (IDD-SS) in community-based organizations (CBOs) have not been systematically studied. This study examined the health impact of IDD-SS workers who participated in a HealthMatters Program: Train-the-Trainer Certified Instructor Workshop followed by implementing a 12-week HealthMatters Program for people with intellectual and developmental disabilities (IDD) that they care for as part of their employment. A total of 48 IDD-SS were enrolled into either an intervention ( n = 28) or control group ( n = 20). IDD-SS in the intervention group received an 8-hour HealthMatters Program: Train-the-Trainer Workshop immediately prior to teaching a 12-week HealthMatters Program for people with IDD. Assessments were conducted with IDD-SS before and after completing the 12-week HealthMatters Program to evaluate whether IDD-SS experienced any benefit of the training and teaching the program on their own health and health behaviors. Relative to the control group, the IDD-SS in the intervention group showed significant improvements in social/environmental supports for nutrition ( F = 4.92, p = .032), exercise outcome expectations ( F = 6.58, p = .014), nutrition outcome expectations ( F = 8.87, p = .005), fruit and vegetable intake ( F = 13.62, p = .001), knowledge of fruit and vegetable intake recommendations ( F = 11.25, p = .002), and stages of change for eating fruits and vegetables ( F = 6.86, p = .012). Results demonstrated that IDD-SS benefited from the health education programming. Findings support the need to develop programs and organizational policies for health promotion activities for direct care staff.
The Emergence of Principal–Agent– Principal Model in India: The Case of Infosys Ltd
Authors: Subramanian S.
Published: April 2019

The existing corporate governance literature focuses on a principal–agent model or a principal–principal model which demonstrate two-way conflicts. This study seeks to understand the emergence of a three-way principal–agent–principal conflict between the controlling/promoter shareholder, the professional manager and the minority shareholders in emerging market family-controlled firms which are professionalizing their management. Using the case study method, this article proves that in the listed emerging market firms, the professional manager gets empowered under a specific internal governance structure as the institutions of external governance become effective. This leads to a three-way principal–agent–principal conflict between the controlling/promoter shareholder, the professional manager and the minority shareholders. A principal–agent–principal model in the emerging markets changes the very basics of corporate governance framework and opens up new research avenues in the field of corporate governance. The evolvement of the three-way conflict might call for unique regulations to deal with corporate governance problems in the emerging markets.
Muslim Politics in Assam: The Case of AIUDF
Authors: Nath Monoj Kumar
Published: April 2019

All India United Democratic Front (AIUDF) was formed in 2005 as Assam United Democratic Front (AUDF). It represents Muslim politics in contemporary Assam. In the 2006 and 2011 Assam Assembly elections (AAE), AIUDF showed continuous success, though it could not gain substantially in the communally polarized 2016 Assembly elections. With this backdrop, the present article is an attempt to understand contemporary Muslim politics in Assam through AIUDF. It argues that AIUDF was an attempt by a group of Muslim leaders in Assam, mainly from Jamiat Ulema-e-Hind (Jamiat), to share power in the name of Muslims and the party was made relevant in Assam politics by Congress through its soft Hindutva politics. It also argues that increasing dominance of AIUDF in Assam elections created ground for the Bharatiya Janata Party (BJP) to grow and to form government in 2016.
Globalization and Its Impact on Business Education in Emerging Economies: A Case of India
Authors: Bhatia Shweta Malhotra , Panneer Sigamani
Published: April 2019

The article reviews the impact of globalization on the quality of contemporary business education in India. When the Indian government liberalized the business education market in the 1990s, it was assumed that creation of business schools would automatically lead to employment-ready individuals, especially in managerial roles. On the contrary, certain trends suggest that business schools have been producing suboptimally skilled individuals for the industry, leading to an incessantly widening skill–employability gap. The article discusses the plausible reasons for this gap. The article also argues for integrating emotional intelligence (EI) as a key behavioural skill in management education framework.
Australian Football League Injury Characteristics Differ Between Matches and Training: A Longitudinal Analysis of Changes in the Setting, Site, and Time Span From 1997 to 2016
Authors: Hoffman Daniel T. , Dwyer Dan B. , Tran Jacqueline , Clifton Patrick , Gastin Paul B.
Published: April 2019

Background:

Injury surveillance has been used to quantify the scope of the injury burden in Australian football. However, deeper statistical analyses are required to identify major factors that contribute to the injury risk and to understand how these injury patterns change over time.

Purpose:

To compare Australian Football League (AFL) injury incidence, severity, prevalence, and recurrence by setting, site, and time span from 1997 to 2016.

Study Design:

Descriptive epidemiology study.

Methods:

A total of 15,911 injuries and medical illnesses recorded by team medical staff at each club were obtained from the AFL’s injury surveillance system and analyzed using linear mixed models with 3 fixed effects (setting, time span, site) and 1 random effect (club). All types of injuries and medical illnesses were included for analysis, provided that they caused the player to miss at least 1 match during the regular season or finals. Five-season time spans (1997-2001, 2002-2006, 2007-2011, and 2012-2016) were used for comparisons. Incidence rates were expressed at the player level. Recurrences were recoded to quantify recurrent injuries across multiple seasons.

Results:

Compared with training injuries, match injuries had a 2.8 times higher incidence per season per club per player (matches: 0.070 ± 0.093; training: 0.025 ± 0.043; P < .001). Match injuries resulted in 1.9 times more missed matches per club per season (matches: 17.2 ± 17.0; training: 9.1 ± 10.5; P < .001). and were more likely to be recurrences (matches: 11.6% ± 20.0%; training: 8.6% ± 21.8%; P < .001). From the 1997-2001 to 2007-2011 time spans, overall injury severity increased from a mean of 3.2 to 3.7 missed matches ( P ≤ .01). For the most recent 2012-2016 time span, injuries resulted in 3.6 missed matches, on average. Hip/groin/thigh injuries had the highest incidence (0.125 ± 0.120) and prevalence (19.2 ± 16.4) rates, and recurrences (29.3% ± 27.9%) were 15% more likely at this site than any other injury site.

Conclusion:

The risks of match injuries are significantly higher than those of training injuries in the AFL. Compared with the 1997-2001 time span, injuries became more severe during the 2007-2011 time span.