bluuebunny/crossref_metadata_2025 huggingface dataset:
Super-Clausius–Clapeyron Scaling of Extreme Hourly Convective Precipitation and Its Relation to Large-Scale Atmospheric Conditions
Authors: Lenderink G. , Barbero R. , Loriaux J. M. , Fowler H. J.
Published: May 2017

Present-day precipitation–temperature scaling relations indicate that hourly precipitation extremes may have a response to warming exceeding the Clausius–Clapeyron (CC) relation; for the Netherlands the dependency on surface dewpoint temperature follows 2 times the CC relation (2CC). The authors’ hypothesis—as supported by a simple physical argument presented here—is that this 2CC behavior arises from the physics of convective clouds. To further investigate this, the large-scale atmospheric conditions accompanying summertime afternoon precipitation events are analyzed using surface observations combined with a regional reanalysis. Events are precipitation measurements clustered in time and space. The hourly peak intensities of these events again reveal a 2CC scaling with the surface dewpoint temperature. The temperature excess of moist updrafts initialized at the surface and the maximum cloud depth are clear functions of surface dewpoint, confirming the key role of surface humidity on convective activity. Almost no differences in relative humidity and the dry temperature lapse rate were found across the dewpoint temperature range, supporting the theory that 2CC scaling is mainly due to the response of convection to increases in near-surface humidity, while other atmospheric conditions remain similar. Additionally, hourly precipitation extremes are on average accompanied by substantial large-scale upward motions and therefore large-scale moisture convergence, which appears to accelerate with surface dewpoint. Consequently, most hourly extremes occur in precipitation events with considerable spatial extent. Importantly, this event size appears to increase rapidly at the highest dewpoint temperature range, suggesting potentially strong impacts of climatic warming.
The Structure, Evolution, and Dynamics of a Nocturnal Convective System Simulated Using the WRF-ARW Model
Authors: Blake Benjamin T. , Parsons David B. , Haghi Kevin R. , Castleberry Stephen G.
Published: May 2017

Previous studies have documented a nocturnal maximum in thunderstorm frequency during the summer across the central United States. Forecast skill for these systems remains relatively low and the explanation for this nocturnal maximum is still an area of active debate. This study utilized the WRF-ARW Model to simulate a nocturnal mesoscale convective system that occurred over the southern Great Plains on 3–4 June 2013. A low-level jet transported a narrow corridor of air above the nocturnal boundary layer with convective instability that exceeded what was observed in the daytime boundary layer. The storm was elevated and associated with bores that assisted in the maintenance of the system. Three-dimensional variations in the system’s structure were found along the cold pool, which were examined using convective system dynamics and wave theory. Shallow lifting occurred on the southern flank of the storm. Conversely, the southeastern flank had deep lifting, with favorable integrated vertical shear over the layer of maximum CAPE. The bore assisted in transporting high-CAPE air toward its LFC, and the additional lifting by the density current allowed for deep convection to occur. The bore was not coupled to the convective system and it slowly pulled away, while the convection remained in phase with the density current. These results provide a possible explanation for how convection is maintained at night in the presence of a low-level jet and a stable boundary layer, and emphasize the importance of the three-dimensionality of these systems.
Transcending Ontological Schisms in Relationships with Earth, Water, Air, and Ice
Authors: Veland Siri
Published: May 2017

Ontological separations made between earth, water, air, and ice can surreptitiously produce high-risk outcomes in environmental policy processes. Where legislation, risk assessments, land rights, or governance is based on unacknowledged schisms between Earth elements, they produce epistemological blind spots that unwittingly prevent asking critical questions of policy processes and render important connections invisible. This paper investigates a series of cases in which ontological schisms within Earth materials and knowledge systems have or may produce surreptitious outcomes. The article considers a diverse array of examples including managing environmental change in Australia, negotiating mining leases in Papua New Guinea, governing the ice edge in Norway, and climate change in the United States. Each case is presented as an illustration that unsettling ontological boundaries between Earth materials, that is, making their identification and definition an explicit component of land and sea policy and governance, lowers the risk of policy failure. The paper finishes by asking how environmental management might be shaped by relational ontologies. Some possibilities offered through transdisciplinary and adaptive management approaches are promising for intercultural collaboration, but this paper suggests a transformation is needed in how we consider our relations with each other and with Earth systems under rapid change. A new method or framework may be insufficient, and new ways of relating may be required. Acknowledging uncertainties in fundamental categorizations and structures can open discussions to ask novel questions of our relationships with Earth systems and imagine solutions to environmental crises and injustices.
Postsecular History
Authors: Kennel Maxwell
Published: May 2017

This study provides a particular historical reading of the postsecular moment. In an effort to problematize and historicize the claims of both the secular and the postsecular, this study draws a connecting line between a contemporary postsecular thinker (Daniel Colucciello Barber), and a group of religious dissidents in the seventeenth century Dutch Republic (the Collegiants). In order to demonstrate that the concept of the secular is value-laden and historically situated, the following will explore the ways in which an historical group shares many epistemological characteristics with present postsecular discourse.
The Role of the Eleven-Plus Test Papers and Appeals in Producing Social Inequalities in Access to Grammar Schools
Authors: Allen Rebecca , Bartley Joanne
Published: May 2017

We use eleven-plus test and appeals data obtained from a large local authority to explore how the process of admission to grammar schools produces such a strong social gradient in entry rates. We look at disparities between eleven-plus and subsequent SATs scores by social background for each element of the test. We then turn to whether the headteacher assessment panel seems to help or hinder poor students on the cusp of passing. Our analysis has implications for how to improve access to grammar schools for those from disadvantaged families.
Diverse veterans’ pre- and post-intervention perceptions of home telemental health for posttraumatic stress disorder delivered via tablet
Authors: Whealin Julia M , King L , Shore P , Spira JL
Published: May 2017

Objectives

Home telemental health services have the potential to overcome many individual and systemic barriers to care facing military veterans with posttraumatic stress disorder. However, little is known about the home telemental health-related attitudes and experiences of highly underserved rural or ethnically, racially diverse veterans. This study evaluated whether ethnically/racially diverse U.S. veterans residing in the rural Pacific Islands would find the delivery of evidence-based treatment for posttraumatic stress disorder via home telemental health tablet devices useful and helpful.

Method

Clinicians located in a central urban location delivered Cognitive Processing Therapy for posttraumatic stress disorder directly into patients’ homes via a tablet device and secure WiFi connection. Pre- and post-treatment measures were collected from a clinical sample of 47 veterans (average age: 49.3 years). Most (74.4%) self-identified as being of ethnic/racial minority background. Attitudinal, satisfaction, and usability scales were collected from home telemental health engaging ( n = 29) and non-engaging ( n = 18) veterans.

Results

Ratings on measures of home telemental health comfort, satisfaction with care, and usability were uniformly positive. Veterans were equally open to receiving mental health services at home via home telemental health or in the clinic. In the case of services for a physical problem, however, veterans preferred in-clinic care. Following treatment, veterans’ attitudinal scores increased on items such as “There is enough therapist contact in home telemental health interventions.” However, a small portion of veterans (7%) reported having technical or privacy concerns.

Conclusion

The provision of evidence-based posttraumatic stress disorder treatment directly into the patients’ homes proved feasible and was well received by the large majority of rural ethnically/racially diverse veterans.
Antecedents of internal political efficacy incidental news exposure online and the mediating role of political discussion
Authors: Ardèvol-Abreu Alberto , Diehl Trevor , Gil de Zúñiga Homero
Published: May 2017

Internal political efficacy has long been associated with news use and political discussion. Yet, as more people are inadvertently exposed to news and political discussion online, it remains unclear whether incidental news exposure also has a discursive effect on political efficacy. In a two-wave panel study, we applied the O-S-R-O-R model of communication effects to test these relationships. We found that political discussion with weak ties, but not strong ties, is a mediator between incidental news exposure and internal political efficacy.
‘An instinct for freedom’: Political undercurrents in the short fiction of Marjorie Barnard
Authors: Darby Robert
Published: May 2017

It is generally held that the short stories of the Australian writer Marjorie Barnard (1897–1987) do not express political values or deal with social issues, but are confined to the exploration of personal concerns. The author herself referred to her short stories as subjective ‘indulgences’, and this evaluation has largely been accepted by commentators. In this paper I challenge this interpretation and argue that the political pressures of the later 1930s seeped or forced themselves into her short fiction and, further, that several of her most interesting stories were directly instigated by and concerned with contemporary political and social questions. I further suggest that as her own political commitment intensified under the pressures of fascism and war, her original devotion to practising art, untainted by propaganda, came under severe pressure.
The Predictive Value of Coefficient of PCT × BG for Anastomotic Leak in Esophageal Carcinoma Patients With ARDS After Esophagectomy
Authors: Li Huan , Wang Daofeng , Wei Wenxiao , Ouyang Lamei , Lou Ning
Published: May 2017

Anastomotic leak was a potentially severe life-threatening complication of esophagectomy, which drew attention in consequence of progressive dyspnea until acute respiratory distress syndrome (ARDS) due to the early asymptomatic presentation. Respiratory failure, caused by ARDS as the severe presentation of anastomotic leak, is the most common organ failure. CRP (C-reactive protein), procalcitonin (PCT), and Blood G (BG) test are the sensitivity markers for inflammatory, sepsis, and fungemia, respectively. Early recognition and intervention treatment of anastomotic leak may alleviate complication and improve outcome. We retrospectively analyzed 71 patients, accepting mechanical ventilation support because of ARDS as the complication after radical resection of esophagus cancer. Clinical data were collected from the patients’ electronic medical records, including their clinically hematological examination, drainage fluid cultures, and sputum culture. Accord to appearance of anastomotic leak or not, all patients were divided into 2 groups, leak group and no-leak group. Inflammatory markers, such as CRP, PCT, and the coefficient of BG and PCT, were significantly different between the 2 groups. Respiratory index, white blood cell, hemoglobin (HBG), platelet (PLT), and other clinical factors were not significantly different between the 2 groups. Receiver operating characteristic curves were constructed to calculate the sensitivity, specificity, positive predictive value, negative predictive value, and area under the curve for various cutoff levels of several factors. Blood G tests presented the better predicting value for anastomotic leak. Blood G tests and PCT should be tested after esophagectomy. The coefficient of PCT and BG (>260) is of great significance, and clinical value to predict anastomotic leak for patients with postesophagectomy ARDS, early PCT and BG test, and especially, dynamic variation may alleviate complication and improve outcome.
High Hemoglobin Is an Independent Risk Factor for the Development of Hemolysis During Pediatric Extracorporeal Life Support
Authors: Jenks Christopher L. , Zia Ayesha , Venkataraman Ramgopal , Raman Lakshmi
Published: May 2017

Objective:

To evaluate risk factors for hemolysis in pediatric extracorporeal life support.

Design:

Retrospective, single-center study.

Setting:

Pediatric intensive care unit.

Patients:

Two hundred thirty-six children who received extracorporeal membrane oxygenation.

Interventions:

None.

Measurements and Main Results:

Risk factors for hemolysis were retrospectively analyzed from a single center in a total of 236 neonatal and pediatric patients who received extracorporeal membrane oxygenation support (ECMO). There was no difference in the incidence of hemolysis between centrifugal (127 patients) and roller head (109 patients) pump type or between venoarterial and venovenous ECMO. High hemoglobin (Hb) was found to be an independent risk factor for hemolysis in both pump types. The Hb level >12 g/dL was significant in the roller group and the Hb level >13 g/dL was significant in the centrifugal group for the development of hemolysis for the cumulative ECMO run. The presence of high Hb levels on any given day increased the risk of hemolysis for that day of the ECMO run regardless of ECMO pump type. Higher revolutions per minute (RPMs) and higher inlet pressures on any given day increased the risk for the development of hemolysis in the centrifugal pump. Lower inlet venous pressures and RPMs were not associated with hemolysis in the roller group.

Conclusions:

An Hb level greater than 13 g/dL was associated with an increased risk of hemolysis, and a high Hb on a given day was associated with a significantly higher risk of hemolysis on the same day. Higher RPMs and lower inlet venous pressures were associated with an increased risk of hemolysis in the centrifugal pump only.
Addressing nodal constraints on the capacity of railways
Authors: Armstrong John , Preston John , Potts Chris , Bektas Tolga , Paraskevopoulos Dimitris
Published: May 2017

As the demand for passenger and freight transport on Britain’s railways increases, providing additional capacity and making the best use of the existing infrastructure are priorities for the industry. Since the stations and junctions forming the nodes of the railway network tend to form the constraints on route and network capacity, improved understanding of their operation and capacity characteristics is particularly important. This paper describes the research undertaken to improve the understanding of nodal capacity and capacity utilisation, and to route and schedule trains more efficiently through nodes, thus improving service quality and/or releasing capacity for additional train services.
Trajectory generation using reinforcement learning for autonomous helicopter with adaptive dynamic movement primitive
Authors: Guo Xiao
Published: May 2017

The present paper introduces a smart trajectories generation algorithm for unmanned aerial vehicles under various environments. Dynamic movement primitive is extended by adding jerk to mock the kinematics, particularly for unmanned aerial vehicles. Combining the improved dynamic movement primitive with policy learning by weighted exploration with the returns, we propose the new algorithm producing optimal trajectories under different scenarios. Furthermore, numerical simulations under several scenarios are performed, demonstrating the ability of the proposed algorithm.
Determinants Perception and Experiences of Beneficiaries of a Hospital-based Community Health Insurance in Coastal Karnataka in India
Authors: Reshmi Bhageerathy , Nair Sreekumaran , Unnikrishnan Bhaskaran
Published: May 2017

The objective of this study was to find out the perceptions of beneficiaries in comparison to non-beneficiaries of a community-based health insurance scheme.

Both quantitative and qualitative methods were used to carry out this study; a cross-sectional household survey on 1,639 households was carried out, where the respondents were required to rate the services and facilities of the scheme A focus group discussion (FGD) with both the beneficiaries and non-beneficiaries was also carried out.

Overall, the services were rated good except in the case of treatment and inpatient services where the responses were rated average. The study results provide evidence that Community Based Health Insurance (CBHI) schemes can be a viable risk sharing mechanism for the informal sector people who would have otherwise not been covered under any health insurance or health care financing mechanism. Maintaining an affordable premium and including outpatient facilities and preventive treatment would improve the satisfaction level of those who have acceptability towards CBHI schemes.
Cost Accounting in Public Hospitals in Poland
Authors: Rauliajtys-Grzybek M. , Baran W. , Macuda M.
Published: May 2017

The aim of this article is to assess the cost accounting solutions that are used currently in Polish hospitals. The evaluation covered three main areas that require cost data—management, external reporting and pricing of health services (performed by a regulatory body). The study concerned the costing model that was obligatory for Polish public hospitals in the years 1998–2011 (top-down micro-costing model) and has not yet been replaced by another solution. Different research methods have been used for each of the areas under research, inter alia surveys, direct interviews and case study methods.

Empirical results indicate a limited usefulness of the researched costing model in all of the evaluated areas: management, financial reporting and pricing. First, the costing model is used moderately only for the most important management areas, such as planning, control and operational decision making. Second, it does not include the specifics of diagnosis-related groups (DRGs) (basic pricing object) and therefore does not allow for accurate determination of their costs. Third, due to lack of the complex costing methodology the model is used in an unstructured and incoherent manner.
Future perspectives of circulating tumor DNA in colorectal cancer
Authors: Nadal C , Winder T , Gerger A , Tougeron David
Published: May 2017

Tumor biopsy is currently the gold standard for diagnosis and in determining cell signaling pathways involved in the development of treatment resistance. However, there are major challenges with this technique, including the need for serial sampling to monitor treatment resistance, which is invasive and also has the potential for selection bias due to intra-tumoral and inter-tumoral heterogeneity. These challenges highlight the need for more effective methods for obtaining Tumor samples. Liquid biopsy analyzes genetic material or tumor cells shed into the blood from the primary tumor and metastatic sites and consequently provides a comprehensive, real-time picture of the tumor burden in an individual patient. Indeed, liquid biopsy has the potential to revolutionize cancer management. Here, we review recent studies on the potential clinical applications of liquid biopsy using circulating tumor DNA in colorectal cancer, including screening, diagnosis, detection of minimal residual disease after surgery, detection of recurrence, prognosis, predicting treatment response, monitoring tumor burden or response during treatment, and tracking resistance. We also discuss recent data demonstrating the utility of detecting KRAS-mutated circulating tumor DNA, both at diagnosis to determine an appropriate treatment strategy and during anti-epidermal growth factor receptor therapy to predict treatment resistance. The future integration of liquid biopsy into clinical practice is discussed, together with alternative approaches and key questions that need to be answered in future clinical studies before this technology can be implemented and used routinely.
A long non-coding RNA lncRNA-PE promotes invasion and epithelial–mesenchymal transition in hepatocellular carcinoma through the miR-200a/b-ZEB1 pathway
Authors: Shen Yuan , Liu Shanshan , Yuan Hanyu , Ying Xiaomin , Fu Hanjiang , Zheng Xiaofei
Published: May 2017

Long non-coding RNAs have been revealed to play important roles in the progression of hepatocellular carcinoma. However, the detailed mechanisms underlying their activities are not fully understood. Using microarray technology, a number of long non-coding RNAs were previously identified to be aberrantly expressed in hepatocellular carcinoma. In this study, one of these long non-coding RNAs, designated lncRNA-PE (lncRNA promotes epithelial–mesenchymal transition), was further explored to study its expression profile and function. A cohort of human hepatocellular carcinoma tissue samples combined with benign controls and established human hepatocellular carcinoma cell lines were examined for the expression of lncRNA-PE. The biological functions of lncRNA-PE were examined by wound-healing and Transwell assays, which revealed that lncRNA-PE promotes cell invasion and migration. By detecting the level of epithelial–mesenchymal transition markers, lncRNA-PE was revealed to promote epithelial–mesenchymal transition in hepatocellular carcinoma cells. Further study suggested that lncRNA-PE downregulated miR-200a/b by repressing the primary transcript expression, enhanced ZEB1 expression, and promoted epithelial–mesenchymal transition of hepatocellular carcinoma cells. All these data imply that lncRNA-PE might play an important role in hepatocellular carcinoma development via the miR-200a/b-ZEB1 pathway.
The transcription factor FOXA1 induces epithelial ovarian cancer tumorigenesis and progression
Authors: Wang Li-Li , Xiu Yin-Ling , Chen Xi , Sun Kai-Xuan , Chen Shuo , Wu Dan-Dan , Liu Bo-Liang , Zhao Yang
Published: May 2017

FOXA1 (forkhead box A1), a member of the FOXA transcription factor superfamily, plays an important role in tumor occurrence and development. However, the relationship between FOXA1 and ovarian cancer has not been reported. We examined normal ovarian tissue and ovarian cancer tissue and found increased FOXA1 expression in the cancer tissue. 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide and flow cytometry assays demonstrated that transfection with small interfering RNA to silence FOXA1 (si-FOXA1) in ovarian cancer cell lines decreased cell proliferation and induced apoptosis and S-phase arrest. In addition, si-FOXA1 transfection inhibited cell migration and invasion. Western blotting showed that si-FOXA1 transfection decreased the levels of YY1-associated protein 1, cyclin-dependent kinase 1, cyclin D1, phosphatidylinositol-3 kinase, E2F transcription factor 1, B-cell lymphoma 2, and vascular endothelial growth factor A protein. Based on these results, we suggest that FOXA1 plays a catalytic role in ovarian cancer pathogenesis and development by affecting the expression of the above-mentioned proteins.
Evaluation of a novel risk assessment method for self-harm associated with Borderline Personality Disorder
Authors: Rao Sathya , Broadbear Jillian H , Thompson Katherine , Correia Anna , Preston Martin , Katz Paul , Trett Robert
Published: May 2017

Objectives:

Borderline personality disorder (BPD) is associated with frequent self-harm and suicidal behaviours. This study compared physician-assessed self-harm risk and intervention choice according to a (i) standard risk assessment and (ii) BPD-specific risk assessment methods.

Methods:

Forty-five junior and senior mental health physicians were assigned to standard or BPD-specific risk training groups. The assessment utilized a BPD case vignette containing four scenarios describing high/low lethality self-harm and chronic/new patterns of self-harm behaviour. Participants chose from among four interventions, each corresponding to a risk category.

Results:

Standard and BPD-specific groups were alike in their assessment of self-harm risk. Divergence occurred on intervention choice for assessments of low lethality, chronic risk ( p<.01) and high lethality, chronic risk ( p<.005). Overall, psychiatrists were more likely than their junior colleagues to correctly assess risk and management options.

Conclusions:

Although standard and BPD-specific methods are well aligned for assessing self harm-associated risk, BPD-specific training raised awareness of BPD-appropriate interventions, particularly in the context of chronic patterns of self-harm behaviour. Wider dissemination of BPD-specific risk training may enhance the confidence of mental health clinicians in identifying the nature of self-harm risk as well as the most clinically appropriate interventions for clients with BPD.
Oppositional Defiant Disorder: An Overview and Strategies for Educators
Authors: Jones Sara H.
Published: May 2017

Oppositional defiant disorder (ODD) is a behavioral disorder that affects approximately 3.3% of the population across cultures. In this article, the author discusses symptoms, methods of diagnosis, and treatments for the disorder. Although most empirically supported treatments of ODD are based on parent–child training and therapy, there are some principles and strategies that educators can adopt. The author focuses on the salient strategies from research-based programs treating ODD and suggestions for educators on how to incorporate them in the classroom.
Alphas, Betas, and Incels: Theorizing the Masculinities of the Manosphere
Authors: Ging Debbie
Published: May 2017

Since the emergence of Web 2.0 and social media, a particularly toxic brand of antifeminism has become evident across a range of online networks and platforms. Despite multiple internal conflicts and contradictions, these diverse assemblages are generally united in their adherence to Red Pill “philosophy,” which purports to liberate men from a life of feminist delusion. This loose confederacy of interest groups, broadly known as the manosphere, has become the dominant arena for the communication of men’s rights in Western culture. This article identifies the key categories and features of the manosphere and subsequently seeks to theorize the masculinities that characterize this discursive space. The analysis reveals that, while there are some continuities with older variants of antifeminism, many of these new toxic assemblages appear to complicate the orthodox alignment of power and dominance with hegemonic masculinity by operationalizing tropes of victimhood, “beta masculinity,” and involuntary celibacy (incels). These new hybrid masculinities provoke important questions about the different functioning of male hegemony off- and online and indicate that the technological affordances of social media are especially well suited to the amplification of new articulations of aggrieved manhood.
Maintenance of Certification: What’s to Know
Authors: Rich Pat
Published: May 2017

The Maintenance of Certification (MOC) Program administered by the Royal College of Physicians and Surgeons applies to all Fellows of the Royal College including dermatologists. It is mandatory for those who wish to maintain their fellowship in the Royal College and can be critical for maintaining licensure requirements. Residents can take advantage of the program before becoming Fellows of the Royal College. Fellows and MOC Program participants in the Royal College MOC Program must complete a minimum of 400 credits during a 5-year cycle and a minimum of 40 credits in each year of the cycle. Credits are available for a wide range of CPD activities which the Royal College divides into three sections in its MOC Framework: Section 1, group learning; Section 2, self-learning; and Section 3, assessment. Many activities associated with involvement in Canadian Dermatology Association activities or involvement with the Journal of Cutaneous Medicine and Surgery (JCMS) are eligible for MOC Program credits. Failure to satisfactorily meet the requirements of the MOC Program in a 5-year cycle can result in loss of Fellowship in the Royal College.
Structure, coercive control, and autonomy promotion: A comparison of fathers’ and mothers’ food parenting strategies
Authors: Pratt Mercedes , Hoffmann Debra , Taylor Maija , Musher-Eizenman Dara
Published: May 2017

This study explored differences in mothers’ and fathers’ food parenting strategies, specifically coercive control, structure, and autonomy promotion, and whether parenting style and parental responsibility for food parenting related to the use of these strategies. Parents of children aged 2.5–7.5 years ( N = 497) reported about their parenting practices and food parenting strategies. Parenting style accounted for the majority of the variance in food parenting. Fathers were more authoritarian than mothers. Authoritarian and permissive parenting practices were related to more coercive strategies. Mothers reported more food parenting responsibility. Responsibility was related to less coercive practices and more autonomy promotion and structure.
Children and young people’s rights in the digital age: An emerging agenda
Authors: Livingstone Sonia , Third Amanda
Published: May 2017

Rights-based approaches to children’s digital media practices are gaining attention offering a framework for research, policy and initiatives that can balance children’s need for protection online with their capacity to maximize the opportunities and benefits of connectivity. But what does it mean to bring the concepts of the digital, rights and the child into dialogue? Arguing that the child represents a limit case of adult normative discourses about both rights and digital media practices, this article harnesses the radical potential of the figure of the child to rethink (human and children’s) rights in relation to the digital. In doing so, we critique the implicitly adult, seemingly invulnerable subject of rights common in research and advocacy about digital environments. We thereby introduce the articles selected for this special issue and the thinking that links them, in order to draw out the wider tensions and dilemmas driving the emerging agenda for children’s rights in the digital age.
Emergent Endovascular Repair of Challenging Aortocaval Fistula With Hostile Anatomy
Authors: Wang Yuewei , Yu Wenjuan , Li Yongxin , Wang Haofu
Published: May 2017

Aortocaval fistula (ACF) is a rare complication. Endovascular repair is an option for this fatal condition. However, endoleak and persistent fistula may occur and lead to technical failure. We performed endovascular repair for 3 cases of challenging ACF with hostile anatomy. Patient 1 was an 80-year-old man who complained of abdominal distension and lower limb edema for 15 days. He had renal and cardiac dysfunction. Computed tomography angiography (CTA) showed an ACF and extreme tortuosity of right iliac artery. The super-stiff guidewire could not pass the right iliac artery. We performed endovascular repair and an occluder was used to block the right external iliac artery. Postoperative CTA showed migration of the occluder, and we ligated the right external iliac artery. The patient survived for 5 years. Patient 2 was a 78-year-old man who complained of an acute abdominal pain for 30 hours. Computed tomography angiography showed great neck angulation (63.3°) and a huge aneurysm (9.9 cm in diameter). A type 1A endoleak occurred and an aortic cuff was deployed at the proximal seal zone. Meanwhile, a type 3 endoleak occurred because of the migration and detachment of the left iliac limb. Another stent-graft was deployed to connect the iliac limb. The patient was followed up for 1 year and remained in a good condition. Patient 3 was a 74-year-old man who experienced severe abdominal pain for 1 day. Computed tomography angiography showed great neck angulation (66°) and a huge aneurysm (10.1 cm in diameter). A type 1A endoleak occurred, and an aortic cuff was deployed at the proximal seal zone. The patient was followed up for 6 months. In conclusion, ACF is a rare but a fatal condition. Acute cases and chronic cases with instable hemodynamics need urgent diagnosis and surgical intervention. Endovascular repair is an efficacious alternative to the traditional open repair.
Estimating the projected frontal surface area of cyclists from images using a variational framework and statistical shape and appearance models
Authors: Drory Ami , Li Hongdong , Hartley Richard
Published: May 2017

We present a computer vision-based approach to estimating the projected frontal surface area (pFSA) of cyclists from unconstrained images. Wind tunnel studies show a reduction in cyclists’ aerodynamic drag through manipulation of the cyclist’s pose. Whilst the mechanism by which reduction is achieved remains unknown, it is widely accepted in the literature that the drag is proportional to the cyclist’s pFSA. This paper describes a repeatable automatic method for pFSA estimation for the study of its relationship with aerodynamic drag in cyclists. The proposed approach is based on finding object boundaries in images. An initialised curve dynamically evolves in the image to minimise an energy function designed to force the curve to gravitate towards image features. To overcome occlusions and pose variation, we use a statistical cyclist shape and appearance models as priors to encourage the evolving curve to arrive at the desired solution. Contour initialisation is achieved using a discriminative object detection method based on offline supervised learning that yields a cyclist classifier. Once an instance of a cyclist is detected in an image and segmented, the pFSA is calculated from the area of the final curve. Applied to two challenging datasets of cyclist images, for cyclist detection our method achieves precision scores of 1.0 and 0.96 and recall scores of 0.68 and 0.83 on the wind tunnel and cyclists-in-natura datasets, respectively. For cyclist segmentation, it achieves 0.88 and 0.92 scores for the mean dice similarity coefficient metric on the two datasets, respectively. We discuss the performance of our method under occlusion, orientation, and pose conditions. Our method successfully estimates pFSA of cyclists and opens new vistas for exploration of the relationship between pFSA and aerodynamic drag.
Beyond Uber and Airbnb: The Social Economy of Collaborative Consumption
Authors: Rowe Pia C. M.
Published: May 2017

The growing collaborative consumption movement has evolved significantly in the age of Web 2.0. While much of the research has focused on its economic aspects, there are also practices that have gone largely unnoticed. This article illustrates the range of these practices by proposing a typology that accounts for the various currencies exchanged and digital technologies used to promote sharing of goods and services. This article focuses on the social aspects of the collaborative consumption movement to construct a full picture of the concept. It presents a case study of an Australian grassroots community group, MamaBake, which promotes the communal cooking and sharing of meals between mothers, and shows that even non-monetary currencies, such as the shared norms of reciprocity used by MamaBake, can be stigmatizing under certain circumstances. In doing so, it imagines alternative manifestations of the collaborative consumption movement that go beyond market orientation and instead focuses on promoting soft, non-economic values.
Invasive Listeria monocytogenes Gastroenteritis Leading to Stupor, Bacteremia, Fever, and Diarrhea: A Rare Life-Threatening Condition
Authors: Mehmood Hassan , Marwat Asghar Dil Jan Khan , Khan Noman Ahmed Jang
Published: May 2017

Listeria monocytogenes is a gram-positive, rod-shaped organism that can cause serious infections such as meningitis, invasive gastroenteritis, and endocarditis. Every year 1600 people in the United States are affected, with significant mortality of 260 people annually. Listeria gastroenteritis has the third highest mortality rate among all the food-borne infection. Invasive listeriosis most commonly affect pregnant women, those in extremes of ages, people with comorbid diseases, and people with weakened immune response. In this article, we present a rare case of invasive Listeria gastroenteritis in an 83-year-old female with multiple comorbid conditions and past medical history of type 2 diabetes mellitus and multiple risk factors who was brought to the hospital with altered mental status. She had history of fever, abdominal pain, and watery diarrhea up to 14 episodes in 24 hours for the last 7 days. Her stool culture grew Listeria monocytogenes sensitive to penicillin. She was started on penicillin for 2 weeks. She had subsequently complete resolution of fever, diarrhea, and abdominal pain. High index of suspicion is the key to ensure timely initiation of appropriate empirical treatment in the setting of invasive gastroenteritis, especially in people who have high risk factors for listeriosis. We recommend raising awareness in the health care profession about invasive listeriosis in the need of time. Intravenous ampicillin or penicillin G is the treatment of choice, with meropenem as an alternative.
The Science of Empathy
Authors: Riess Helen
Published: May 2017

Empathy plays a critical interpersonal and societal role, enabling sharing of experiences, needs, and desires between individuals and providing an emotional bridge that promotes pro-social behavior. This capacity requires an exquisite interplay of neural networks and enables us to perceive the emotions of others, resonate with them emotionally and cognitively, to take in the perspective of others, and to distinguish between our own and others’ emotions. Studies show empathy declines during medical training. Without targeted interventions, uncompassionate care and treatment devoid of empathy, results in patients who are dissatisfied. They are then much less likely to follow through with treatment recommendations, resulting in poorer health outcomes and damaged trust in health providers. Cognitive empathy must play a role when a lack of emotional empathy exists because of racial, ethnic, religious, or physical differences. Healthcare settings are no exception to conscious and unconscious biases, and there is no place for discrimination or unequal care afforded to patients who differ from the majority culture or the majority culture of healthcare providers. Much work lies ahead to make healthcare equitable for givers and receivers of healthcare from all cultures. Self- and other-empathy leads to replenishment and renewal of a vital human capacity. If we are to move in the direction of a more empathic society and a more compassionate world, it is clear that working to enhance our native capacities to empathize is critical to strengthening individual, community, national, and international bonds.
Development and Validation of the PREMM5 Model for Comprehensive Risk Assessment of Lynch Syndrome
Authors: Kastrinos Fay , Uno Hajime , Ukaegbu Chinedu , Alvero Carmelita , McFarland Ashley , Yurgelun Matthew B. , Kulke Matthew H. , Schrag Deborah , Meyerhardt Jeffrey A. , Fuchs Charles S. , Mayer Robert J. , Ng Kimmie , Steyerberg Ewout W. , Syngal Sapna
Published: May 2017

Purpose

Current Lynch syndrome (LS) prediction models quantify the risk to an individual of carrying a pathogenic germline mutation in three mismatch repair (MMR) genes: MLH1, MSH2, and MSH6. We developed a new prediction model, PREMM5, that incorporates the genes PMS2 and EPCAM to provide comprehensive LS risk assessment.

Patients and Methods

PREMM5 was developed to predict the likelihood of a mutation in any of the LS genes by using polytomous logistic regression analysis of clinical and germline data from 18,734 individuals who were tested for all five genes. Predictors of mutation status included sex, age at genetic testing, and proband and family cancer histories. Discrimination was evaluated by the area under the receiver operating characteristic curve (AUC), and clinical impact was determined by decision curve analysis; comparisons were made to the existing PREMM1,2,6 model. External validation of PREMM5 was performed in a clinic-based cohort of 1,058 patients with colorectal cancer.

Results

Pathogenic mutations were detected in 1,000 (5%) of 18,734 patients in the development cohort; mutations included MLH1 (n = 306), MSH2 (n = 354), MSH6 (n = 177), PMS2 (n = 141), and EPCAM (n = 22). PREMM5 distinguished carriers from noncarriers with an AUC of 0.81 (95% CI, 0.79 to 0.82), and performance was similar in the validation cohort (AUC, 0.83; 95% CI, 0.75 to 0.92). Prediction was more difficult for PMS2 mutations (AUC, 0.64; 95% CI, 0.60 to 0.68) than for other genes. Performance characteristics of PREMM5 exceeded those of PREMM1,2,6. Decision curve analysis supported germline LS testing for PREMM5 scores ≥ 2.5%.

Conclusion

PREMM5 provides comprehensive risk estimation of all five LS genes and supports LS genetic testing for individuals with scores ≥ 2.5%. At this threshold, PREMM5 provides performance that is superior to the existing PREMM1,2,6 model in the identification of carriers of LS, including those with weaker phenotypes and individuals unaffected by cancer.
Pupillary Reflex for Evaluation of Thoracic Paravertebral Block: A Prospective Observational Feasibility Study
Authors: Duceau Baptiste , Baubillier Mélanie , Bouroche Gaëlle , Albi-Feldzer Aline , Jayr Christian
Published: May 2017

BACKGROUND:

Although thoracic paravertebral block (TPVB) is recommended in major breast surgery, there is no gold standard to assess the success of TPVB. Pupillary dilation reflex (PDR) is the variation of the pupillary diameter after a noxious stimulus. The objective was to evaluate the feasibility of recording the PDR to assess analgesia in an anesthetized thoracic dermatome after TPVB.

METHODS:

This prospective, observational, single-center study included 32 patients requiring breast surgery under general anesthesia and TPVB. TPVB was performed before surgery under ultrasound guidance with 20 mL of 0.75% ropivacaine. At the end of the surgery, remifentanil was stopped and the PDR was recorded after a 5-second tetanic stimulation (60 mA, 100 Hz) applied to the anterior chest wall. The PDR was defined as the maximal increase in pupil diameter after a standardized noxious stimulus, expressed as a percentage of the initial pupil diameter. The PDR was recorded twice in the same eye for each patient after a stimulus on both the TPVB and the control sides. Postoperative pain scores were recorded in a postanesthesia care unit. The primary outcome was the difference between the PDR on the TPVB and the control sides.

RESULTS:

The median (interquartile range) PDR was 9% (4%–13%) on the TPVB side and 41% (27%–66%) on the control side. There was a significant difference in the PDR between the TPVB and the control sides with a Hodges-Lehmann estimate of absolute difference of 37% points (95% confidence interval, 25–52, P < .001). Median postoperative pain scores (interquartile range) in the postanesthesia care unit were 1 (0–3) at rest and 1 (0–3) during mobilization, respectively. There was a linear correlation between maximal postoperative pain scores and the PDR on the TPVB side with a Pearson’s correlation coefficient r = 0.40 (95% confidence interval, 0.06–0.66, P = .02). No correlation was found between the number of blocked dermatomes and maximal postoperative pain scores (P = .06) or between the number of blocked dermatomes and the PDR on the TPVB side (P = .15).

CONCLUSIONS:

This proof-of-concept trial suggests that the effect of TPVB could be monitored by measuring the PDR after anterior chest wall stimulation in the dermatome of interest.
Noise-induced hearing loss: a modern epidemic?
Authors: Imam Lema , Hannan S Alam
Published: May 2017

Hearing loss is an increasingly common problem in the UK, and noise-induced hearing loss is the second most common acquired cause. There is a greater burden on the younger population, as recreational noise exposure is an important contributor. New damaging hearing behaviours have emerged including loud music exposure at concerts, nightclubs and via personal music players. The mechanism of damage is thought to involve many diverse pathways, which include oxidative damage, mechanical shearing forces and glutamate excitotoxicity. Although no current treatment exists to reverse the damage caused, these pathways can be targeted by agents that are being trialled for use in post-exposure treatment and prevention, with conflicting results. Other preventative strategies are important in addressing damaging hearing behaviours, including ‘safe listening’ promotion with advocacy materials for young adults, and promoting safe listening devices.
A COMPARATIVE ASSESSMENT OF FOLIC ACID-INDUCED CELLULAR SENESCENCE
Authors: Chakraborty Abhishek
Published: May 2017

The biological functions of folic acid (FA) including the prevention of neural tube defects in developing embryos and synthesis of DNA and its repair, have been well reported in literature. As a result; the fortification of folic acid into many daily foods in Canada such as wheat and cereals is mandatory. We have shown that over-osage of FA causes blood haemolysis, leading to progressive anaemia. It is reported that 200 – 400 μg/ml of FA increases the size of blood cells within 2h of treatment, also leading to abnormal cell division and necrosis (in vitro concentrations). This observation suggests early cell senescence. We hypothesized that FA may play a vital role in cellular senescence. 5th generation Kidney fibroblast (COS-7) cells were treated with 200 μg of FA in combination with an anti-neoplastic agent, nocodazole- prior to FA treatment. FA increased the expression of fibronectin (protein marker for aging) of nocodazole treated cells. Furthermore, fibronectin expression was higher in FA-treated cells of the 14th generation compared to the 8th generation. 14th generation cells also showed a larger decrease in cell size when exposed to FA. This suggests FA over-dosage has an affect on the cell growth cycle.
The Impact of Attire and Occupation on the Accuracy of Blood Pressure Measurements
Authors: Pandey Arjun
Published: May 2017

White coat hypertension describes individuals with elevated blood pressure (BP) in medical facilities, such as clinics, and hospitals, but whose BP is normal when they are going about their daily activities. The purpose of this study was to assess whether certain types of healthcare providers are more accurately able to determine BP in comparison to the twenty four hour ambulatory blood pressure monitoring (ABPM), as well as to assess the effect of a healthcare provider’s attire on BP reading. The results show that BP readings were significantly higher when any of the healthcare providers wore a white lab coat. This suggests that attire of the healthcare provider has an impact on the BP readings. Cardiologists were most prone to causing white coat hypertension compared to nurses or cardiovascular technicians. It is therefore advised that alternate healthcare providers check BP to minimize the risk of erroneous BP readings and reduce the risk of white coat hypertension.
NEW FAT FUELS FROZEN FLIES
Authors: Marshall Katie E. , Sinclair Brent J.
Published: May 2017

Goldenrod gall flies are one of Canada’s toughest animals, and are able to survive freezing of their body fluids. Since the flies can’t eat all winter, we wanted to know what happens to their fat stores following these freezing events. We found a surprise—gall flies have an unusual kind of fat that stays liquid at low temperature and seems to help them survive the winter.