bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of Hearing Impairment in NICU Graduates by Otoacoustic Emission and Brainstem Evoked Response Audiometry Tests
Authors: Aradhana Aparna , Sarangi Gadadhar , Saboth Prasant , Tripathy Radha
Published: November 2020

Objectives:

To find out the incidence of hearing impairment in Neonatal Intensive Care Unit (NICU)-admitted newborns and to correlate between several risk factors.

Design:

Prospective observational study.

Setting:

In a tertiary teaching hospital of Odisha between October 2014 and October 2016.

Study population:

100 newborns delivered in the institution and admitted in NICU with usual indications and risk factors that underwent otoacoustic emission 1 and 2 (OAE1, OAE2) and Brainstem Evoked Response Audiometry (BERA).

Results:

84 babies in OAE1 and 86 babies in OAE2 got “pass” results. In BERA test, 92 babies got normal waveform. 7 (13.7%) of 51 premature babies, 5 (38.5%) of 13 very low birth weight babies, 7 (17.5%) of 40 babies receiving ototoxic medication for >5 days, 7 (31.8%) of 22 babies with hyperbilirubinemia, 6 (42.9%) of 14 babies with sepsis, 5 (20%) of 20 babies with birth asphyxia, 3 (60%) of 5 babies under mechanical ventilation for >5 days, 1 baby with ear abnormality, and 1 (50%) out of 2 babies with congenital infections had hearing impairment and statistically significant association with abnormal OAE and BERA test.

Conclusion:

There is high incidence of hearing loss in NICU-admitted newborns. OAE and BERA both should be performed for complete evaluation of hearing. Important risk factors are elaborated. Predischarge hearing assessment in NICU is most important.
Infrastructure Equity and Firm Performance in India
Authors: Hasnat Tanzeem
Published: November 2020

The growing financing requirements coupled with tightening of fiscal purse strings point to the pertinence of market-based finance for infrastructure provision and enhancement. For this, the question of the sectoral performance of infrastructure takes centre stage and this becomes the basis for the present study. The study assesses the risk-return and volatility profile of Nifty Infra, the National Stock Exchange (NSE) sectoral index for the 30 biggest infrastructure firms in India vis-à-vis the broader Nifty 50 for the time period 2010–2018. The study employs the standard financial economic analysis methods of capital asset pricing model (CAPM) and generalized autoregressive conditional heteroskedasticity in mean (M-GARCH) model and finds the sectoral equity performance of infrastructure to be marginally below that of a broadly diversified index. Further, the study analyses the cash flow and leverage characteristics which are imperative factors in medium-term risk-return profile of infrastructure stocks. The disaggregated firm level analysis of 10 select firms reveals that rent-like return does exist for the biggest players in the sector due to past installed capacities, while the subcontracting mechanism percolates to meagre cash flows for smaller players, partly bearing the greenfield risks. This suggests the need for state-induced measures to prop up liquidity in equity trade for infrastructure firms. This would not only enhance the risk-return profile but also mitigate excessive volatility for these heavily leveraged firms.
Sexual minority prevalence and attitudes within the British horseracing industry
Authors: Letts David
Published: November 2020

This article utilises the theories of Inclusive Masculinity and Organisational Cultural Lag to provide the first comprehensive exploration of sexual minority inclusion in the British horseracing industry. The study employs a quantitative approach, involving a survey distributed to two mixed-gender populations within the sport: jockeys ( n = 149) and non-athlete stakeholders ( n = 308). Results indicate that approximately one fifth of jockeys selected a response other than ‘straight’, while less than 4% of the population of jockeys and stakeholders would view a sexual minority colleague ‘very negatively’. However, despite the relatively high proportion of sexual minority individuals working within the industry, and the positive attitudinal responses towards having a sexual minority colleague, only one of the 149 jockeys surveyed identified as a sexual minority and were publicly ‘out’.
The extension of collective agreements in France, Portugal and Spain
Authors: García Calavia Miguel Ángel , Rigby Michael
Published: November 2020

This article examines the role of extension provisions for collective agreements in France, Portugal and Spain, three countries that have faced pressure to introduce more flexibility in their employment regimes during recent economic crises. The article establishes the continuing importance of extension provisions for maintaining high bargaining coverage in all three countries and traces the origin of national differences in their evolution to the strategies of the various actors, governments, employers and trade unions, and the context in which they are operating. It also looks at the characteristics of the extension regulations themselves.

Cet article examine le rôle des mécanismes d’extension des accords collectifs en France, au Portugal et en Espagne, trois pays qui ont été contraints d’introduire plus de flexibilité dans leurs régimes d’emploi durant les récentes crises économiques. L’article établit l’importance constante des dispositifs d’extension pour maintenir une couverture de négociation élevée dans ces trois pays et retrace l’origine des différences nationales dans leur évolution par rapport aux stratégies des différents acteurs, gouvernements, employeurs et syndicats, et au contexte dans lequel ils fonctionnent. Il examine également les caractéristiques des règles d’extension proprement dites.

Der vorliegende Artikel untersucht die Regelungen für die Ausweitung von Tarifverträgen in Frankreich, Portugal und Spanien. In diesen drei Ländern gibt es Forderungen nach mehr Flexibilität in der Gestaltung von Arbeitsverträgen vor dem Hintergrund der Wirtschaftskrisen der letzten Jahre. Der Artikel beschreibt die unverminderte Bedeutung dieser Ausweitungsregelungen für den Erhalt eines hohen Deckungsgrades von Tarifverträgen in allen drei Ländern und geht den Ursachen für unterschiedliche nationale Entwicklungen entsprechend den Strategien der einzelnen Akteure, Regierungen, Arbeitgeber und Gewerkschaften in ihrem jeweiligen Handlungskontext nach. Der Artikel befasst sich ebenfalls mit den Merkmalen der verschiedenen Ausweitungsregelungen.
Same same, but different: Varieties of capital markets, Chinese state capitalism and the global financial order
Authors: Petry Johannes
Published: November 2020

Since 2009, China’s capital markets have developed and internationalized to an unprecedented degree, which has contributed to a lot of debates on China’s rise and its implications for the global financial order. Contributing to these debates, this article analyses the development of capital markets in China and their integration into global finance between 2009 and 2019, focusing on three aspects: how Chinese capital markets are developing domestically; how they are integrating with global markets; and how Chinese capital markets are internationalizing, i.e. expanding abroad. Thereby, the article analyses the crucial role of securities exchanges who as organizers of capital markets are powerful actors that exercise considerable influence over these markets and their development. This empirical investigation reveals that while they share some characteristics with ‘global’ capital markets, Chinese capital markets function quite differently. The article argues that China’s state-owned exchanges facilitate the development of state-capitalist capital markets – capital markets that follow an institutional logic derived from China’s state-capitalist economic system. Rather than giving in to a neoliberal rulebook, China’s capital markets represent an alternative to, resist and challenge the norms, principles and procedures of the contemporary global financial order. While different capital markets share some characteristics, they are institutionally embedded, and these institutional settings facilitate different institutional logics that underpin and inform the functioning of markets. Instead of viewing capital markets as homogeneous entities, the article therefore proposes to investigate a ‘varieties of capital markets’ that are shaped by different institutional logics.
‘Banks 1 – Portugal 0’? Financial player entanglements in the Eurozone crisis
Authors: Stadheim Victoria B-G
Published: November 2020

The euro has been at the heart of the debate about the crisis in the Eurozone. For some, it represents a fixed exchange rate regime, which hampered peripheral countries’ competitiveness, and for others, the European Monetary Union has a ‘flawed institutional design’ and an insufficient degree of integration that engendered the crisis. The present article analyses monetary integration from a materialist perspective. It draws attention to political agency, power and crisis management. The article focuses on the case of Portugal and poses the question of how the country's authorities were compelled to request a rescue package from the International Monetary Fund, the European Central Bank and the European Commission in 2011. It shows that this decision was triggered by the political agency of a series of players within the world of finance, most notably Portugal’s domestic banks, the independent Bank of Portugal and the European Central Bank. Reflecting their material interconnection through the European monetary system, their agency was highly coordinated. The strategies for crisis management that came to deepen the recession were not the result of insufficient European integration – they rather reflected Portugal’s form of integration within the European Monetary Union at the specific moment of crisis.
Differences in Family-Owned SMEs’ Ethical Behavior: A Mixed Gamble Perspective of Family Firm Tax Evasion
Authors: Eddleston Kimberly A. , Mulki Jay P.
Published: November 2020

We develop a mixed gamble perspective of tax evasion that explains why family firms vary in how they weigh the costs and benefits of tax evasion. Testing our framework on family firms from India, we find that family firm identity is negatively related to tax evasion when firm performance is high. However, when firm performance is low, family firm identity is positively related to tax evasion. Our study therefore reveals why some family firms refrain from tax evasion, some rationalize it for the sake of the family firm, and others see tax evasion as a financial gain worth the risks.
Coping with the residency program during COVID-19: Hematology oncology pharmacy residents’ perspective
Authors: AlAzmi Aeshah A , AlNajjar Fouad , AlShomrani Majed
Published: November 2020

Introduction

The COVID-19 pandemic has led to significant changes in all governmental activities in Saudi Arabia including training and teaching, with the majority of such activities suspended in response to the COVID-19 pandemic. We aim to share the challenges that Hematology Oncology Pharmacy (HOP) residents faced during the quarantine period and provide recommendations on how to cope with the residency journey.

Method

We followed a qualitative methodological approach in March 2020 using a structured virtual group discussion for data generation.

Results

All six PGY2 hematology oncology pharmacy (HOP) residents were included in the group discussion. The group agreed that the need for HOP services during this pandemic is beyond the scope of oncology pharmacists’ normal daily practice. The group recognized two fundamental points. First, the goal of the current training should be customized to the most pressing need and recognized at the national level. Second, the current training system should be improved to ensure efficient use of current resources. On this basis, the group developed six main recommendations for action.

Conclusion

The current situation is a challenge for all healthcare providers, and the majority of the nation’s current generation never dealt with such a situation in days gone by. This paper presents the challenges that should be addressed at the national level and provide a fundamental consensus recommendation for practical approaches to maximize learning and minimize disruption to trainees’ progression while maintaining patient-pharmacy quality of care.
Asymptomatic Severe Aortic Stenosis and Noncardiac Surgery
Authors: Whitener Stephanie K. , Francis Loren R. , McMurray Jeffrey D. , Whitener George B.
Published: November 2020

The patient with severe asymptomatic aortic stenosis presenting for elective noncardiac surgery poses a unique challenge. These patients are not traditionally offered surgical aortic valve replacement or transcatheter aortic valve replacement given their lack of symptoms; however, they are at increased risk for postsurgical complications given the severity of their aortic stenosis. The decision to proceed with elective noncardiac surgery should be based on individual and surgical risk factors. However, severity of aortic stenosis is not accounted for in current surgical risk factor assessment scoring; therefore, extensive communication with patients and surgical teams is necessary to minimize a patient’s risk. A clear intraoperative plan should be designed to manage the unique hemodynamics of these patients, and a discussion should address postoperative placement.
Safety Assessment of AAV2-hGDNF Administered Via Intracerebral Injection in Rats for Treatment of Parkinson's Disease
Authors: Terse Pramod S. , Kells Adrian P. , Noker Patricia , Wright J. Fraser , Bankiewicz Krystof S.
Published: November 2020

Glial cell line-derived neurotrophic factor (GDNF) is a potent neuroprotective biologic in Parkinson's disease models. Adeno-associated viral vector serotype 2 (AAV2)-human GDNF safety was assessed in rats treated with a single intracerebral dose of vehicle, 6.8 × 108, 6.8 × 109, or 5.2 × 1010 vector genomes (vg)/dose followed by interim sacrifices on day 7, 31, 90, and 376. There were no treatment-related effects observed on food consumption, body weight, hematology, clinical chemistry, coagulation parameters, neurobehavioral parameters, organ weights, or serum GDNF and anti-GDNF antibody levels. Increased serum anti-AAV2 neutralizing antibody titers were observed in the 5.2 × 1010 vg/dose group. Histopathological lesions were observed at the injection site in the 6.8 × 109 vg/dose (day 7) and 5.2 × 1010 vg/dose groups (days 7 and 31) and consisted of gliosis, mononuclear perivascular cuffing, intranuclear inclusion bodies, and/or apoptosis on day 7 and mononuclear perivascular cuffing on day 31. GDNF immunostaining was observed in the injection site in all dose groups through day 376 indicating no detectable impacts of anti-AAV2 neutralizing antibody. There was no evidence of increased expression of calcitonin gene-related peptide or Swann cell hyperplasia in the cervical and lumbar spinal cord or medulla oblongata at the 5.2 × 1010 vg/dose level indicating lack of hyperplastic effects. In conclusion, no systemic toxicity was observed, and the local toxicity observed at the injection site appeared to be reversible demonstrating a promising safety profile of intracerebral AAV2-GDNF delivery. Furthermore, an intracerebral dose of 6.8 × 108 AAV2-GDNF vg/dose was considered to be a no observed adverse effect level in rats.
Enacting objects and subjects in a children’s rehabilitation clinic: Default and shifting ontological politics of muscular dystrophy care
Authors: Thille Patricia , Abrams Thomas , Gibson Barbara E
Published: November 2020

In health care clinics, problems are constructed through interactions, a choreography of human and non-human actors together enacting matters of concern. Studying the ways in which a body, person, family, or environment is objectified for clinical purposes opens discussion about advantages and disadvantages of different objectification practices, and exploration of creative ways to handle the diversity and tensions that exist. In this analysis, we explored objectifications in a Canadian neuromuscular clinic with young people with muscular dystrophy. This involved a close examination of clinical objectification practices across a series of 27 observed appointments. We identified the routinised clinical assessments, and argue these embed a default orientation to how to intervene in people’s lives. In this setting, the routine focused on meeting demands of daily activities while protecting the at-risk-body, and working toward an abstract sense of an independent future for the person/body with muscular dystrophy. But the default could be disrupted; through our analysis of the routine and disruptions, we highlight how contesting visions for the present and future were consequential in ways that might be more than what is anticipated within rehabilitation practice.
Electoral regimes and the politicisation of foreign trade in national elections
Authors: Taylor Timothy W
Published: November 2020

Under what conditions will political parties emphasise trade policy during national elections? While research shows the importance of domestic politics in driving trade policy, little attention has been directed towards its electoral salience. This study posits that electoral rules affect politicians’ incentives to politicise foreign trade. In single-member district systems, where the seats-votes elasticity is high, political parties have strong incentives to cater to voters. In contrast, proportional representation systems generate stronger incentives for parties to accommodate to industry interests. The winner-take-all nature of plurality rules thus generates stronger pressures for parties to politicise trade policy. The argument is empirically supported through an analysis of party election platforms in 32 countries from 1961 to 2016. These results indicate that electoral regimes affect not only trade policy, but also its elite-driven attention in national elections.
The value of ‘between-election’ political participation: Do parliamentary e-petitions matter to political elites?
Authors: Matthews Felicity
Published: November 2020

Responding to the crisis of democracy, legislatures worldwide are developing new participatory mechanisms to promote parliamentary engagement and provide additional opportunities for citizens to influence policymaking. Yet despite the prevalence of such initiatives, little is known about whether political elites are receptive to public input. This article addresses this important gap, presenting original research that examines the e-petition system in the United Kingdom’s national legislature. It demonstrates significant apathy – on occasion, antipathy – on the part of Westminster’s elected MPs. In particular, it reveals concerns that parliamentary e-petitions risk undermining the relationship between MPs and their constituents; inundating the parliamentary agenda with immediate, but not necessarily important, issues; and exacerbating misunderstandings of the parliamentary process. More broadly, political elites remain sceptical about the capacity of parliamentary e-petitions to address the democratic divide, with a widespread sense that e-petitions often amplify the voices of those who already shout the loudest.
Multiaxial fatigue prediction on crack initiation for rubber antivibration design – Location and orientation with stress ranges
Authors: Luo Robert K
Published: November 2020

In antivibration applications, it is essential that the given rubber product has a suitable service period; therefore, an accurate fatigue assessment during design is key. In this study, the effective stress approach was applied to two industrial products: a drum mount for road engineering and a Metacone spring for rail vehicles. This method employed a three-dimensional tensor that took all principal stress ranges into consideration, without underestimating fatigue damage, in a multi-axial stress state. As both the magnitude and direction of the effective stress were obtained based on analytical functions, there was no need to use the expensive critical plane search method to detect the plane of failure. The calculated angles (67.5° and −63.2° from the horizontal plane, respectively) were validated against the observed fatigue cracks. Engineers would be able to accelerate their design processes by using the approach presented in the current study, due mainly to three aspects: visualising all of the whole product's hot spots, circumventing an expensive critical plane search, and presenting the effective stress ranges. As the proposed effective stress approach was validated in only two specific industrial cases, an investigation into further engineering applications is still needed to lend this concept greater support.
Itineraries, iconoclasm, and the pragmatics of heritage
Authors: Bauer Alexander A
Published: November 2020

Recent calls across the world for removing monuments to White supremacy have brought widespread attention to the power of images and the role of heritage in society. A more careful examination of heritage’s itineraries and pragmatics—its practical effects—is thus warranted. This paper interrogates the pragmatics of heritage in two ways. First, what are the discourses and rhetorics of heritage—how is heritage invoked and talked about, like a sign of history, in making statements about the world? Second, what does heritage do, as a sign in history, when it is invoked, encountered, and circulated? What does heritage activate, and what are the practical effects of its itineraries? Drawing on the examples of the return of the Euphronios krater to Italy and the removal of Confederate and racist monuments in the US and elsewhere, I argue that while operating in these two modes—as signs of and in history—heritage’s greatest potential for transformational change is when it ceases acting as a rhetorical device and instead becomes itself the center of experiential social action.
An editorial perspective on judging the quality of inductive research when the methodological straightjacket is loosened
Authors: Corley Kevin , Bansal Pratima (Tima) , Yu Haitao
Published: November 2020

As inductive research has moved from the fringe to the mainstream, it not only has come to look more like deductive research, but has started to look more formulaic as well (i.e. standards, templates, checklists). The very thing that makes inductive research unique is its ability to challenge what is known and to do so creatively. The question, thus, needs to be asked: why does inductive research continue to become more formulaic when many inductive editors, reviewers, and authors celebrate novelty and creativity? We believe it is because reviewers and editors find it difficult to judge “quality” when there is no guidebook. The quality of science-based research is easier to judge than creative inductive research, which is often assumed to be in the “eye of the beholder.” From our SO!apbox, we tackle this challenge head-on by asking: what is “quality inductive research” when we loosen the science-based methodological straightjacket so as to deliver the novelty and creativity promised by inductive methods? In this editorial, we explore how editors can judge quality inductive research and offer innovative editorial practices that can help to foster creative inductive research.
The political decision on Portugal’s entry into PISA: A research note
Authors: Lopo Teresa Teixeira
Published: November 2020

In this article we carry out a preliminary reconstitution of the genealogy of the political decision to integrate Portugal in PISA (Programme for International Student Assessment), promoted by the Organisation for Economic Co-operation and Development, made in 1999 and implemented in 2000. For this we used a comprehensive analysis of newspaper articles, legal texts and documents on education policy as well as of interviews with relevant political actors. The first results of this analysis suggest that the decision, which was not unanimous among the government members with responsibilities in the education field, was taken by normative emulation, and aimed to consolidate a particular direction of the national education policy.
Effects of COVID-19 Pandemic on the Professional Roles and Responsibilities of Health Educators
Authors: Hancher-Rauch Heidi L. , Bishop Charity , Campbell Alli , Cecil Kara , Yazel Lisa
Published: November 2020

Public health professionals are at the forefront of the COVID-19 pandemic response. However, the roles and responsibilities of health educators in pandemic response are unknown. Researchers examined multiple factors that described how health educators’ work priorities and lives have been affected by COVID-19. An electronic questionnaire was administered nationally to health educators to assess the effect of the pandemic on their professional responsibilities, the challenges they are facing, and their fears about the future. Of the 913 respondents, 487 (43%) reported changing work priorities, with 80% of that group (389) sharing that their work priorities shifted focus to COVID-19. Most felt qualified to take on the new job responsibilities, but many feared the inability to get back to previous work roles or for their organizations to financially withstand the pandemic. Regardless of workplace setting or job priorities, health educators are prepared in the skills outlined in the Responsibilities and Competencies for Health Education Specialists, which may have led to their abilities in shifting roles so quickly and effectively. Findings from this study may prepare public health agencies to better use and train health educators for their roles in rapidly shifting public health priorities.
Development and auxetic characterization of 3D composites produced with newly-designed multi-cell flat-knitted spacer fabrics
Authors: Moshtaghian Zahra , Hasani Hossein , Zarrebini Mohammad , Pourheidar Shirazi Mohammad
Published: November 2020

The paper deals with development and characterization of 3D sandwich composite structures reinforced with newly-designed multi-cell flat-knitted spacer fabrics in terms of compressive behaviour and Poisson’s ratio. Multi-cell spacer knitted preforms was produced on a computerized flat knitting machine. 3D composite samples with three different cross-sectional geometries were prepared via vacuum assisted resin transfer moulding method. Quasi-static compressive experiments were carried out on the prepared 3D composite samples. The Poisson’s ratio of re-entrant 3D knitted composite varied between -6 and -1, which clearly points to existence of auxetic behaviour of the samples. The re-entrant 3D composites also demonstrated the highest initial slope and area under the compression force-displacement curve than spear-head or hexagonal composite structures which refer to higher energy absorbing capacity. The Poisson’s ratio of 3D regular hexagonal knitted composites at small strain was usually 4 which gradually decreased to 1.6 as the exerted compressive strain increased. Additionally, 3D spear-head knitted composite having zero Poisson’s ratio was also developed.
Characterizing Current Attitudes and Practices for Human Subject Safety in Studies Involving Pupil Dilation
Authors: Szpernal Jacob , Carroll Joseph , Spellecy Ryan , Bachman Groth Jane A.
Published: November 2020

Standards in pupil dilation practices regarding the safety of human subjects are not present in vision research despite the potential for significant adverse effects. We developed two surveys to examine current practices around pupil dilation among vision researchers and individuals associated with oversight of human subjects research. While both groups note an absence of adverse events associated with pupil dilation, vision researcher practices differed with informed consent use and measures taken to minimize complications. For Institutional Review Boards, general risk assumption associated with dilation was not unanimous and there was a lack of specific guidance available to researchers for minimizing risk. These results uncover the need for standardized practices regarding pupil dilation in human subjects research.
Researcher Knowledge, Attitudes, and Communication Practices for Genomic Data Sharing
Authors: Nick Heather P. , Kehoe Kelsey , Gammon Amanda , Contreras Jorge L. , Kaphingst Kimberly A.
Published: November 2020

This study examines knowledge, attitudes, and communication practices toward genomic data sharing among principal investigators and research coordinators engaged in cancer and non-cancer studies. We conducted 25 individual semi-structured interviews and conducted a qualitative thematic analysis. Most interviewees had basic knowledge of data sharing requirements, but lacked specific details of recent changes to NIH policy. Principal investigators perceived more risks to participants for data sharing than the research coordinators who generally obtained consent. Interviewees perceived a trend toward providing fewer data sharing options to participants in the consent process, and had observed that parents of pediatric patients asked more questions than adult patients. Our findings highlight potential areas for improvement related to data sharing during consent processes.
Outcomes of thoracic endovascular aortic repair in thoracic aortic aneurysm and penetrating aortic ulcer using the Conformable Gore TAG within and outside the instructions for use
Authors: Meisenbacher Katrin , Hagedorn Matthias , Grond-Ginsbach Caspar , Weber Dorothea , Böckler Dittmar , Bischoff Moritz S
Published: November 2020

Objective

To describe the outcome of thoracic endovascular aortic repair (TEVAR) in thoracic aortic aneurysm and penetrating aortic ulcer with respect to instructions for use status.

Methods

Between October 2009 and September 2017, a total of 532 patients underwent TEVAR; of which 195 have been treated using the Conformable GORE® TAG® thoracic endoprosthesis (CTAG). Fifty-six patients of this cohort underwent TEVAR for thoracic aortic aneurysm/penetrating aortic ulcer using the CTAG. Depending on the preoperative computed tomography angiography findings, patients were classified as inside or outside the device’s instructions for use. All inside instruction for use patients underwent postoperative reclassification regarding the instructions for use status. Study endpoints included TEVAR-related reintervention, exclusion of the pathology (endoleak type I/III), TEVAR-related mortality, and graft-related serious adverse events. The median duration of follow-up was 29.7 months (range: 0–109.4 months).

Results

Of the 56 patients, 17 were primarily classified as outside instruction for use, and in additional 13 patients, TEVAR was performed outside instruction for use, leading to 30 outside instruction for use patients (53.6%). Twenty-six patients (46.4%) were treated inside instruction for use. Reintervention-free survival was lower in outside instruction for use patients ( P = 0.016) with a hazard ratio of 9.74 (confidence interval 1.2–80.2; P = 0.034) for TEVAR-related reintervention. With respect to endoleak type I/III, relevant difference was detected between inside/outside instruction for use status ( P = 0.012). The serious adverse event rate was 30.4%, mainly in outside instruction for use patients ( P = 0.004). Logistic regression analysis indicated an association between graft-related serious adverse event/instructions for use status (odds ratio 6.11; confidence interval 1.6–30.06; P = 0.012). In-hospital death was seen more frequently in outside instruction for use patients ( P = 0.12) as was procedure-related death (log-rank test: P = 0.21).

Conclusion

TEVAR for thoracic aortic aneurysm/penetrating aortic ulcer is frequently performed outside instruction for use despite preoperative inside instruction for use eligibility, leading to important consequences for technical/clinical outcome. Instructions for use adherence in TEVAR should be of interest for further large-scale studies.
Development and validation of the Moral Sensitivity Inventory for people with intellectual disabilities
Authors: Otrębski Wojciech , Sudoł Agnieszka
Published: November 2020

This article presents the Moral Sensitivity Inventory, a unique reading-free tool for evaluating the moral sensitivity of people with intellectual disability. Moral sensitivity, one of the four components of Rest’s Four Component Model of Morality (1994), is thought to influence moral behavior. The Moral Sensitivity Inventory is intended for people aged 16–30 years with mild or moderate intellectual disabilities. The Moral Sensitivity Inventory is comprised of 10 stories with pictures illustrating the aspects of morality, which are grouped into six categories: responsibility; respect for the common good and the property of other people; harming other people; seeking and seeing the good in others; conformance to principles and norms; understanding. The Moral Sensitivity Inventory identifies competences and gaps in moral sensitivity, which makes it a helpful tool for educating and social rehabilitation of people with intellectual disabilities. The overall reliability of the tool was .89 and the reliability of individual stories ranged from .87 to .90.
Revised intracerebral hemorrhage expansion definitions: Relationship with care limitations
Authors: Lun Ronda , Yogendrakumar Vignan , Walker Greg , Shamy Michel , Fahed Robert , Qureshi Adnan , Dowlatshahi Dar
Published: November 2020

Background

Hematoma expansion is an important therapeutic target in intracerebral hemorrhage. Recently proposed hematoma expansion definitions have not been validated, and no previous definition has accounted for withdrawal of care.

Aims

To externally validate revised definitions of hematoma expansion that incorporate intraventricular hemorrhage, and to test their validity in the context of withdrawal of care.

Methods

We analyzed data from the Antihypertensive Treatment of Acute Cerebral Hemorrhage II trial, comparing revised definitions of hematoma expansion incorporating intraventricular hemorrhage expansion to the conventional definition of “≥6 mL or ≥33%.” Primary outcome was modified Rankin Scale of 4–6 at 90 days. We calculated the incidence, sensitivity, specificity, positive and negative predictive values, and c-statistic for all definitions of hematoma expansion. Definitions were compared using nonparametric methods. Secondary analyses were performed after removing patients with withdrawal of care.

Results

Primary analysis included 948 patients. Using the conventional definition, the sensitivity was 37.1% and specificity was 83.2% for the primary outcome. Sensitivity improved with all three revised definitions (53.3%, 48.7%, and 45.3%, respectively), with minimal change to specificity (78.4%, 80.5%, and 81.0%, respectively). The greatest improvement was seen with the definition “≥6 mL or ≥33% or any intraventricular hemorrhage,” with increased c-statistic from 60.2% to 65.9% ( p < 0.001). Secondary analysis excluded 46 participants who experienced withdrawal of care. The revised definitions similarly outperformed the conventional definition in this population, with the greatest improvement in c-statistic using “≥6 mL or ≥33% or any intraventricular hemorrhage” (58.1% vs. 64.1%, p < 0.001).

Conclusions

Revised hematoma expansion definitions incorporating intraventricular hemorrhage expansion outperformed conventional definitions for predicting poor outcome, even after accounting for care limitations.
Dynamical analysis of a fractional-order avian-human influenza epidemic model with logistic growth for avian population
Authors: Ye Xingyang , Lin Shimin , Xu Chuanju
Published: November 2020

In this paper, a fractional order avian-human influenza epidemic model with logistic growth for avian population is investigated. The dynamical behavior of this model is discussed. We first establish the existence, uniqueness, non-negativity and positive invariance of the solution. Then we analyze the existence of various equilibrium points, and some sufficient conditions are derived to ensure the global asymptotic stability of the disease free equilibrium point and endemic equilibrium point. Finally, we take some numerical simulations to validate the analytical results.
Revisiting the dogma of the Edinburgh position for safe immobilization
Authors: J. Jordan Daniel , Leow Jun M. , Stirling Paul H. C. , Lam Wee L.
Published: November 2020

Since the concept was first described 50 years ago in Edinburgh by J. I. P. James, the term ‘Edinburgh position’ has been synonymous with the position of safe immobilization for the hand. Widely employed for the management of injured hands, the position is associated with splinting the metacarpophalangeal joints at 90° and the proximal interphalangeal joints completely straight, namely, ‘the intrinsic-plus position’, to help reduce the long-term consequences of a stiff hand. Over the decades, the strict joint angles of the Edinburgh position have been debated due to changes in patterns of injury, treatment and rehabilitation. This article challenges the dogma that surrounds the use of the Edinburgh position in clinical practice. The history of the position was explored, and the results of a survey about current practice of hand immobilization from two study centres in Edinburgh is presented.

Level of evidence: IV
The Epistemic Significance of Emotional Experience
Authors: Ballard Brian Scott
Published: November 2020

Some philosophers claim that emotions are, at best, hindrances to the discovery of evaluative truths, while others omit them entirely from their epistemology of value. I argue, however, that this is a mistake. Drawing an evaluative parallel with Frank Jackson’s Mary case, I show there is a distinctive way in which emotions epistemically enhance evaluative judgment. This is, in fact, a conclusion philosophers of emotion have been eager to endorse. However, after considering several influential proposals—such as the view that emotions generate evaluative concepts, or the view that emotions justify evaluative beliefs on the model of perception—I conclude that the most promising contender is the notion that emotional experience acquaints us with evaluative properties.
What is palliative care?
Authors: Odukwe Francis , Ezeh Francis
Published: November 2020

In 1990, the World Health Organisation (WHO) recognised palliative care as a distinct specialty dedicated to relieving suffering and improving quality of life for patients with life-limiting illnesses or serious injuries. Fourteen years later, the WHO in its publication ‘ Global Atlas of Palliative Care at the End of Life’, projected that, ‘each year in the world, around 377 per 100,000 of the adult (over 15 years of age) population and 63 per 100,000 of the child population (under 15 years of age) will require “palliative care at the end of life’. This article will discuss what constitutes palliative care, the different elements of palliative care, the approaches to palliative care, specialist palliative care services, end of life care and where GPs fit into this area. We will also be sharing tips on providing palliative care as a GP and for GP trainees.
May antidepressant drugs worsen the conditions they are supposed to treat? The clinical foundations of the oppositional model of tolerance
Authors: Fava Giovanni A.
Published: November 2020

In recent years there has been a considerable debate on antidepressant drugs. Continued drug treatment with antidepressant medications may stimulate processes that run counter to the initial acute effects of a drug. The oppositional model of tolerance may explain loss of treatment efficacy during maintenance treatment and the fact that some side effects tend to occur only after a certain time. These processes may also direct the illness into a treatment-unresponsive course, including manifestations of bipolar disorder or paradoxical reactions. When drug treatment ends, oppositional processes no longer encounter resistance, resulting in potential onset of new withdrawal symptoms, persistent post-withdrawal disorders, hypomania, and resistance to treatment if it is reinstituted. In all these cases, antidepressant medications may constitute a form of iatrogenic comorbidity, which increases chronicity and vulnerability to depressive episodes. Antidepressant medications are essential drugs for the treatment of major depressive episodes. They are less likely, however, to provide protection for relapse prevention. Current prescription practices need to be reformulated in light of consideration of vulnerabilities and adverse effects of treatment. The oppositional model of tolerance provides a conceptual framework for weighing all these elements in the individual case. The model does not appear to apply to all patients who undergo treatment with AD, but only to a part of them. Studying the variables that are associated with such occurrence in certain patients and not in others would be one of the most important tasks of current therapeutic research. Current diagnostic systems in psychiatry do not consider the iatrogenic components of psychopathology, and can be applied to only patients who are drug free. They are suited for a patient who no longer exists: most of the cases that are seen in psychiatric clinical practice receive psychotropic drugs and such treatment is likely to affect prognosis and treatment choices.
Optimizing treatment duration with ramucirumab and paclitaxel by managing chemotherapy-associated toxicity: Review of four cases
Authors: Merl Man Yee , Moye Renee , Chatterjee Anindya , Ogburn Kenyon D
Published: November 2020

Gastric and gastroesophageal junction adenocarcinomas have poor prognoses. Ramucirumab is considered a second-line standard of care for patients with these cancers. Patients may develop chemotherapy-induced adverse events, and physicians may benefit from greater familiarity with treatment management in the setting of common adverse events. We report four cases of metastatic gastric or gastric and gastroesophageal junction adenocarcinoma treated with second-line ramucirumab plus paclitaxel. All patients developed chemotherapy-associated grade ⩾2 neutropenia and/or neuropathy, and one experienced recurrence of neurotoxicity, during second-line therapy. These adverse events were successfully managed by withholding or reducing the paclitaxel dose, without modifying the ramucirumab dosage schedule, and allowed administration of additional therapy cycles. In all patients, second-line therapy was associated with a best overall response of complete or partial response ranging from 2.2 to 12.4 months. These four cases demonstrate that paclitaxel-associated adverse events can be managed with dose modifications, thereby allowing continued therapy and potential survival benefits.
Detecting astroturf lobbying movements
Authors: Lits Brieuc
Published: November 2020

Astroturf lobbying refers to the simulation of grassroots support for or against a public policy. The objective of this tactic is for private interests to pretend they have public support for their cause. However, omitting to disclose the real sponsor of a message renders the communication unauthentic and undermines democratic and pluralist values. This article seeks to develop a method to detect astroturf movements based on emphasis framing analysis. The hypothesis is that astroturf groups employ different frames than genuine grassroots movements to comply with the private interests they truly represent. The results of the case study on the shale gas exploration debate in the United States show that astroturf groups used frames that differed significantly from authentic non-governmental organizations, which allowed their detection.
Relational interaction and embodiment: Conceptualizing meanings of LGBTQ+ activism in digital China
Authors: Chen Sally Xiaojin
Published: November 2020

This article theoretically and empirically explores meanings of recent activism practised by lesbian, gay, bisexual, transgender, queer and other non-heterosexual groups (LGBTQ+) in China. Chinese LGBTQ+ individuals, like the majority of Chinese citizens, are generally self-restrained in popular contention because of the political risks involved. They also face widespread discrimination from the public when revealing their LGBTQ+ identities. This article is concerned with the perceived meanings of Chinese LGBTQ+ individuals suppressing engrained self-constraint to promote LGBTQ+ contention and certain level of collective action. Theoretically, I conceptualize Chinese LGBTQ+ protests as relational interactions undertaken by LGBTQ+ individuals with other people of queer identities (ingroup members), authorities and the public based on the logic of connective action. I also explore the concepts of embodiment and online embodiment to understand individuals’ sensual experiences during LGBTQ+ contention. Empirically, I examine university student Qiu Bai’s lawsuits with the Education Ministry and her social media campaign against homophobic textbooks. Drawing on in-depth interviews and textual analysis, the case study provides a dialectical account of individuals’ experience of embodiment and self-constraint.
Teaching Kitchens in the Learning and Work Environments: The Future Is Now
Authors: Eisenberg David M. , Imamura, BEnvD Anthony
Published: November 2020

The learning and working environments of today’s hospitals and health systems are designed to predict, diagnose, treat, and manage disease. However, the food environments in these settings are often extraordinarily unappealing, unhealthy, and can adversely impact the well-being of health professionals. What if future health-care sites were designed as showrooms of the most appealing and nutritious foods? What if future cafeterias included ventilated “Teaching Kitchens” as extensions to the everyday “grab and go” check-out lines? What if health-care providers, trainees, staff, and community members had access to foods that were healthy, delicious, affordable, sustainable, and easy to prepare? Most importantly, what if health professionals learned to make these healthy, delicious recipes as part of their required training? “See one, do one, teach one” could become, “See one, taste one, make one, teach one”. Teaching Kitchens could serve as both learning laboratories and clinical research centers, whereby teaching kitchen curricula could be tested, through sponsored research, for their impact on behaviors, clinical outcomes, and costs. What if spaces adjacent to Teaching Kitchens were designated “Mindful Eating Spaces,” where self-selected patrons could enjoy a “Culinary Feast alongside a Technological Fast” in an effort to carve out a brief oasis of mindful, resilience-building reflection during any given day? This article describes the rationale for and necessary components of such a futurist “Teaching Kitchen” within future working and learning environments. Importantly, if and when Teaching Kitchens are built within health-care settings, they may serve as catalysts of personal and societal health enhancement for all.
The Effect of Affect: Friendship, Education and Prejudice in India
Authors: Venugopalan Asha
Published: November 2020

Intergroup relations are fundamentally based on the idea of ‘us’ and ‘them’, and this categorization has driven political loyalties and social ties in India, particularly the relations between Hindus and Muslims. Contemporary nationalist politics have often combined patriotic love for the country along with suspicion of minorities, particularly the Muslims. Given the history of tense relations between the Hindus and Muslims, the role of positive intergroup relations becomes paramount in sustaining peace among the groups. Based on Allport’s intergroup contact hypothesis, this article tests whether having a Muslim friend reduces prejudicial attitude among Hindus. Additionally, the article also tests the notion of education being a harbinger of liberal values and its role in reducing prejudice. The results indicate that having a Muslim friend is significantly correlated with a more positive outlook towards the Muslim community, but education does not reduce prejudice.