bluuebunny/crossref_metadata_2025 huggingface dataset:
Surge or submerge? Predicting nurse staffing, medical hold capacity, and maximal patient care capabilities in the combat environment
Authors: Cassidy Jessica , Munari Dana , Forbes Damon , Remick Kyle , Martin Matthew J.
Published: April 2019

BACKGROUND

Capabilities for daily operations at medical facilities are determined by routine staffing levels and bed availability. Although all health care facilities must be prepared for mass casualty events, there are few tools or metrics to estimate nursing requirements, medical hold surge capacity, and critical failure points for high-volume events. We sought to create a modifiable and customizable toolkit for producing reliable capability estimates across a range of scenarios.

METHODS

The inputs for key variables (patient volume, acuity, staffing, beds available, and medical evacuation) were extrapolated from the literature and interviews with subject-matter experts. Models were developed for a small austere facility, one large facility, and one expanded large facility. Inputs were serially increased to identify the “failure point” for each and the variables most contributing to failure.

RESULTS

Two scenarios were created, one moderate volume and one for mass casualty events. Variables most affecting capacity were identified as: average daily volume, mass casualty volume and frequency, acuity, and medical evacuation frequency. The large facility reached failure in 13 (43%) of 30 days and was attributed to bed capacity. The small facility did not reach failure point for bed capability or staffing under low volumes; however, it reached failure immediately under moderate volumes. The most significant factor was medical evacuation frequency. An automated dashboard was created to provide immediate estimates based on varying inputs.

CONCLUSION

We developed an automated and customizable toolkit to analyze mass casualty/disaster capabilities in relation to nurse staffing and hold capacity, assess the impact of key variables, and predict resource needs. Total bed capacity and hospital throughput via discharge/medical evacuation are the most critical factors in surge capacity and sustained mass casualty operations. Decreasing medical evacuation frequency is the greatest contributor to reaching “failure point.”

LEVEL OF EVIDENCE

Not Applicable.
Multiple sclerosis: clinical trial design 2019
Authors: Pardini Matteo , Cutter Gary , Sormani Maria Pia
Published: April 2019

Purpose of review

Recent years have seen the approval of more than 15 disease-modifying drugs for multiple sclerosis (MS), mainly for its relapsing-remitting form (RRMS). The focus of the MS clinical trials is moving toward clinical trials aimed at progressive patients or based on putatively neuroprotective compounds. Here we reviewed the challenges of this paradigm shift.

Recent findings

Progressive MS and neuroprotective drugs trials will both need a change in patients’ enrollment criteria, outcome selection, and clinical trials design. Published ocrelizumab Primary Progressive MS data, as well as translational neuroimaging and clinical research suggest that MRI markers of inflammation could be used to enrich progressive MS trials population, albeit with the risk of overestimating the relevance of antiinflammatory therapeutic effects in this population and that conventional MRI-based metrics need to be complemented with volumetric and multiparametric approaches to disease severity quantification. Lastly, regarding statistical design, Bayesian approaches are at last making their way from oncology to neurology improving our ability to evaluate multiple treatments in the same trials’ population.

Adequate clinical trials design was one of the key factors in the RRMS treatment success story. Multidisciplinary collaborations are needed to adequately plan the progressive MS and restorative therapies trials that lay ahead in the near future.
Management of Peripapillary Choroidal Neovascular Membrane in Patients With Idiopathic Intracranial Hypertension
Authors: Ozgonul Cem , Moinuddin Omar , Munie Metasebia , Lee Michael S. , Bhatti M. Tariq , Landau Klara , Van Stavern Gregory P. , Mackay Devin D. , Lebas Maud , DeLott Lindsey B. , Cornblath Wayne T. , Besirli Cagri G.
Published: April 2019

Objective:

To report the clinical features and treatment outcomes of patients with peripapillary choroidal neovascular membrane (CNVM) secondary to idiopathic intracranial hypertension (IIH).

Methods:

Retrospective, multicenter chart review of patients diagnosed with peripapillary CNVM in the course of the treatment and follow-up of IIH.

Results:

Records were reviewed from 7 different institutions between 2006 and 2016. Ten patients (13 eyes) with a diagnosis of IIH and at least 3 months of follow-up developed CNVM. Three of the total 10 patients developed bilateral CNVM. The mean time from the diagnosis of IIH to CNVM diagnosis was 41 months. Mean follow-up period was 8 months after diagnosis of CNVM. All patients were treated with acetazolamide for IIH. Seven eyes were observed, and 6 eyes were given anti–vascular endothelial growth factor (anti-VEGF) injections, including bevacizumab, ranibizumab, and aflibercept. All CNVMs regressed with subretinal fibrosis, and visual acuity improved in most patients. Papilledema resolved in only 1 eye, while the other 12 eyes had persistent papilledema at last follow-up.

Conclusions:

Peripapillary CNVM, a rare complication of IIH, often resolves spontaneously with treatment of IIH. In vision-threatening and/or persistent cases, intravitreal anti-VEGF treatment may be a safe and effective therapeutic option.
Isolated Abducens Nerve Palsy as Manifestation of Diffuse Intracranial Dolichoectasia
Authors: Benavides Jose I. , Corona Adalgisa , Aguilera Johanna I. , Paliza Jose M.
Published: April 2019

An 83-year-old man presented with a 1-year history of abducens palsy. Brain MRA revealed arterial dolichoectasia of most cerebral vessels, including the basilar, internal carotid, and middle cerebral arteries. Abducens nerve palsy as a sole manifestation of diffuse intracranial dolichoectasia is unusual but may occur in diffuse intracranial dolichoectasia.
Characterizing key features in the formation of ice and gas hydrate systems
Authors: Liang Shuai , Hall Kyle Wm. , Laaksonen Aatto , Zhang Zhengcai , Kusalik Peter G.
Published: April 2019

Crystallization in liquids is critical to a range of important processes occurring in physics, chemistry and life sciences. In this article, we review our efforts towards understanding the crystallization mechanisms, where we focus on theoretical modelling and molecular simulations applied to ice and gas hydrate systems. We discuss the order parameters used to characterize molecular ordering processes and how different order parameters offer different perspectives of the underlying mechanisms of crystallization. With extensive simulations of water and gas hydrate systems, we have revealed unexpected defective structures and demonstrated their important roles in crystallization processes. Nucleation of gas hydrates can in most cases be characterized to take place in a two-step mechanism where the nucleation occursviaintermediate metastable precursors, which gradually reorganizes to a stable crystalline phase. We have examined the potential energy landscapes explored by systems during nucleation, and have shown that these landscapes are rugged and funnel-shaped. These insights provide a new framework for understanding nucleation phenomena that has not been addressed in classical nucleation theory.

This article is part of the theme issue ‘The physics and chemistry of ice: scaffolding across scales, from the viability of life to the formation of planets’.
Salt- and gas-filled ices under planetary conditions
Authors: Bove Livia E. , Ranieri Umbertoluca
Published: April 2019

In recent years, evidence has emerged that solid water can contain substantial amounts of guest species, such as small gas molecules—in gas hydrate structures—or ions—in salty ice structures—and that these ‘filled’ ice structures can be stable under pressures of tens of Gigapascals and temperatures of hundreds of Kelvins. The inclusion of guest species can strongly modify the density, vibrational, diffusive and conductivity properties of ice under high pressure, and promote novel exotic properties. In this review, we discuss our experimental findings and molecular dynamics simulation results on the structures formed by salt- and gas-filled ices, their unusual properties, and the unexpected dynamical phenomena observed under pressure and temperature conditions relevant for planetary interiors modelling.

This article is part of the theme issue ‘The physics and chemistry of ice: scaffolding across scales, from the viability of life to the formation of planets’.
Crystal-plane-dependent effects of antifreeze glycoprotein impurity for ice growth dynamics
Authors: Furukawa Yoshinori , Nagashima Ken , Nakatsubo Shunichi , Zepeda Salvador , Murata Ken-ichiro , Sazaki Gen
Published: April 2019

An impurity effect on ice crystal growth in supercooled water is an important subject in relation to ice crystal formation in various conditions in the Earth's cryosphere regions. In this review, we consider antifreeze glycoprotein molecules as an impurity. These molecules are well known as functional molecules for controlling ice crystal growth by their adsorption on growing ice/water interfaces. Experiments on free growth of ice crystals in supercooled water containing an antifreeze protein were conducted on the ground and in the International Space Station, and the normal growth rates for the main crystallographic faces of ice, namely, basal and prismatic faces, were precisely measured as functions of growth conditions and time. The crystal-plane-dependent functions of AFGP molecules for ice crystal growth were clearly shown. Based on the magnitude relationship for normal growth rates among basal, prismatic and pyramidal faces, we explain the formation of a dodecahedral external shape of an ice crystal in relation to the key principle governing the growth of polyhedral crystals. Finally, we emphasize that the crystal-plane dependence of the function of antifreeze proteins on ice crystal growth relates to the freezing prevention of living organisms in sub-zero temperature conditions.

This article is part of the theme issue ‘The physics and chemistry of ice: scaffolding across scales, from the viability of life to the formation of planets’.
(E)-1-(Benzo[d][1,3]dioxol-5-yl)-3-([2,2′-bithiophen]-5-yl)prop-2-en-1-one: crystal structure, UV–Vis analysis and theoretical studies of a new π-conjugated chalcone
Authors: Anizaim Ainizatul Husna , Zaini Muhamad Fikri , Laruna Muhammad Adlan , Razak Ibrahim Abdul , Arshad Suhana
Published: April 2019

In the title compound, C18H12O3S2, synthesized by the Claisen–Schmidt condensation method, the essentially planar chalcone unit adopts an s-cis configuration with respect to the carbonyl group within the ethylenic bridge. In the crystal, weak C—H...π interactions connect the molecules into zigzag chains along the b-axis direction. The molecular structure was optimized geometrically using Density Functional Theory (DFT) calculations at the B3LYP/6–311 G++(d,p) basis set level and compared with the experimental values. Molecular orbital calculations providing electron-density plots of HOMO and LUMO molecular orbitals and molecular electrostatic potentials (MEP) were also computed both with the DFT/B3LYP/6–311 G++(d,p) basis set. The experimental energy gap is 3.18 eV, whereas the theoretical HOMO–LUMO energy gap value is 2.73 eV. Hirshfeld surface analysis was used to further investigate the weak interactions present.
Pension plans assumptions: the case of discount rate
Authors: Morais Ana Isabel , Pinto Inês
Published: April 2019

Purpose

In 2009, the International Accounting Standards Board started revising International Accounting Standard (IAS) 19 to improve the requirements for managing the annual expense of a pension plan. The revised standard became effective in 2013. The purpose of this paper is to investigate what effect this revision had on managerial discretion. The paper also examines the implications of the revision on the value relevance of accounting information.

Design/methodology/approach

The authors use a sample of 72 firms listed on the FTSE 100 that have defined benefit plans for the period between 2009 and 2015. The authors use a regression discontinuity design to analyse the effect from the revision of IAS 19 on the choice of managers regarding the expected rate of return-on-plan assets. The paper also investigates whether firms with higher pension sensitivity are more likely to manage earnings upward before the revision of IAS 19. Further, the paper studies the value relevance of earnings after the revision of the accounting standard.

Findings

Consistent with predictions, the results show that the adoption of the revised IAS 19 limits the use of the expected rate of return on assets to manage the annual expense of defined benefit plans. This finding shows a sharp increase in the value relevance of earnings.

Practical implications

This finding is useful for users and preparers of financial statements and regulatory bodies as it identifies not only the influence of a change in the accounting standard for earnings management but also provides evidence on the consequences of managers’ discretion.

Originality/value

This paper provides direct evidence on the relationship between regulation and financial reporting discretion. It also provides evidence to accounting standard setters that the revision of IAS 19 improves the value relevance of financial information, which gives additional justification to the changes introduced by regulators.
The impacts of sector growth and monetary policy on income inequality in developing countries
Authors: Siami-Namini Sima , Hudson Darren
Published: April 2019

Purpose

The purpose of this paper is to explore the effect of growth in different sectors of the economy of developing countries on income inequality and analyze how inflation, as a proxy for monetary policy, makes a proportionate contribution for setting a binding national target for reducing income inequality. The paper examines the existence of a linear or nonlinear effect of inflation and sectoral economic growth on income inequality using a balanced panel data of 92 developing countries for the period of 1990–2014.

Design/methodology/approach

Methods section includes several steps as below: first, the functional form of the model using panel data for investigating the contribution of economic sectors in income inequality; second, to estimate the relationship between income inequality and sector growth: testing the Kuznets hypothesis; third, to estimate the relationship between inflation and income inequality base on general functional form of the model proposed by Amornthum (2004); fourth, a panel Granger causality analysis based on a VECM approach.

Findings

The statistically significant finding shows that first agricultural growth and then industrial growth have a dominate impact in reducing income inequality in our sample. But, the service sector growth has positive effects. The results confirm the existence of Kuznets inverted “U” hypothesis for industry growth and Kuznets “U” hypothesis for service sector growth. The findings show that sector growth and inflation affect income inequality in the long-run.

Originality/value

This research is an original paper which analyzes the effect of growth in different sectors of the economy of developing countries (agriculture, manufacturing and services sectors) on income inequality and test the Kuznets hypothesis in terms of sector growth and at the same time, examine the existence of a linear/nonlinear effect of inflation and sectoral economic growth on income inequality and test Granger causality relationship between income inequality and sector growth and inflation.
The relationship between hospital adoption and use of high technology medical imaging and in-patient mortality and length of stay
Authors: Sandoval Guillermo A. , Brown Adalsteinn D. , Wodchis Walter P. , Anderson Geoffrey M.
Published: April 2019

Purpose

The purpose of this paper is to investigate the relationship between hospital adoption and use of computed tomography (CT) scanners, and magnetic resonance imaging (MRI) machines and in-patient mortality and length of stay.

Design/methodology/approach

This study used panel data (2007–2010) from 124 hospital corporations operating in Ontario, Canada. Imaging use focused on medical patients accounting for 25 percent of hospital discharges. Main outcomes were in-hospital mortality rates and average length of stay. A model for each outcome-technology combination was built, and controlled for hospital structural characteristics, market factors and patient characteristics.

Findings

In 2010, 36 and 59 percent of hospitals had adopted MRI machines and CT scanners, respectively. Approximately 23.5 percent of patients received CT scans and 3.5 percent received MRI scans during the study period. Adoption of these technologies was associated with reductions of up to 1.1 percent in mortality rates and up to 4.5 percent in length of stay. The imaging use–mortality relationship was non-linear and varied by technology penetration within hospitals. For CT, imaging use reduced mortality until use reached 19 percent in hospitals with one scanner and 28 percent in hospitals with 2+ scanners. For MRI, imaging use was largely associated with decreased mortality. The use of CT scanners also increased length of stay linearly regardless of technology penetration (4.6 percent for every 10 percent increase in use). Adoption and use of MRI was not associated with length of stay.

Research limitations/implications

These results suggest that there may be some unnecessary use of imaging, particularly in small hospitals where imaging is contracted out. In larger hospitals, the results highlight the need to further investigate the use of imaging beyond certain thresholds. Independent of the rate of imaging use, the results also indicate that the presence of CT and MRI devices within a hospital benefits quality and efficiency.

Originality/value

To the authors’ knowledge, this study is the first to investigate the combined effect of adoption and use of medical imaging on outcomes specific to CT scanners and MRI machines in the context of hospital in-patient care.
How well can investors diversify with commodities? Evidence from a flexible copula approach
Authors: Fousekis Panos , Grigoriadis Vasilis
Published: April 2019

Purpose

This paper aims to investigate empirically the linkages between stock and commodity futures markets.

Design/methodology/approach

It involves the application of a flexible copula approach to weekly total returns from the S&P 500 index and from three commodity sub-indices (agriculture, metals and energy) from 1995 to 2017.

Findings

Co-movement is by no means frequent and symmetric. It was predominantly zero before the last financial crisis, and since then, it is positive and asymmetric. The pattern of asymmetry is consistent with transmission of shocks under extreme negative shocks only. Recently, total returns of commodity futures are very poor. At the same time, commodity futures markets move in step (out of step) with stock markets when the latter plunge (rise), pointing to limited diversification benefits. These appear to justify the concerns of investors and researchers whether including commodities in a portfolio of assets is still a prudent investment strategy.

Originality/value

It is the only manuscript that combines a flexible copula approach and co-movement measurement along both the positive and negative diagonals. The findings are in sharp contrast with those reported by Delatte and Lopez (2013) and are very important for portfolio management.
Improved imaging of a karst aquifer using focused source electromagnetic and differentially normalized method: a qualitative analysis
Authors: Souza de Araújo Oziel , Chemas Hindi Eduardo , Rigoti Augustinho , Rigoti Fábio Henrique
Published: April 2019

Geophysical investigations using conventional techniques applied to groundwater exploration can often present strong limitations involving high financial costs, complex acquisition logistics and high ambiguity in results. Dispersion of the electric current flow, induced polarization) effects, cultural noises and shallow lateral heterogeneities represent the main problems faced by geoelectric methods in these types of surveys. Moreover, elements such as intrusions and mineralization at different depths may be responsible for signal attenuation as well as high resistivity in unsaturated zones and complex three‐dimensional formations or clayey zones cause variations in the electric current. The focused source electromagnetic and differentially normalized method approaches can help to solve some these issues. Aiming at a higher signal‐to‐noise ratio, the focused source electromagnetic method and approaches of the differentially normalized method, first applied to petroleum exploration, are tested on a groundwater target, in a karst environment sectioned by a diabase dyke. We performed the processing and analysis on real IP resistivity profiling data acquired with two‐way dipole‐dipole array, guided by magnetic data acquired on the same profile, mapping a diabase dyke. The inversion of focused source electromagnetic method/differentially normalized method was not performed, instead that we converted the induced polarization–resistivity data to a differential signal to qualitatively prove the presence of aquifer. Joint interpretation of focused source electromagnetic method curves and inverted two‐dimensional induced polarization–resistivity sections allowed for precise delineation of a conductive zone associated with the karst aquifer, le magnetics allowed for the definition of a neighbour dyke. The techniques have great potential in the aid of groundwater exploration, contributing substantially to the reduction of interpretation ambiguity. Focused source electromagnetic method/differentially normalized method/ approaches show that a simple linear combination of the conventional geoelectric data is able to remove the geological noise and provide the vertical focusing of the electric current.
Predicting the ecological impacts of an alien invader: Experimental approaches reveal the trophic consequences of competition
Authors: Britton J. Robert , Gutmann Roberts Catherine , Amat Trigo Fatima , Nolan Emma T. , De Santis Vanessa
Published: April 2019

Ecological theory on the trophic impacts of invasive fauna on native competitors is equivocal. Whilst increased interspecific competition can result in coexisting species having constricted and diverged trophic niches, the competing species might instead increase their niche sizes to maintain energy intakes. Empirical experiments can test invasion theory on competitive interactions and niche sizes across different spatial scales and complexity.

The consequences of increased interspecific competition from a model alien fish Leuciscus idus were tested on two taxonomically and trophically similar native fishes, Squalius cephalus and Barbus barbus. Competitive interactions were tested in tank aquaria using comparative functional responses (CFRs) and cohabitation trials. The consequences of these competitive interactions for the trophic niche sizes and positions of the fishes were tested in pond mesocosms.

Comparative functional responses revealed that compared to B. barbus, L. idus had significantly higher attack and consumption rates; cohabitation trials revealed B. barbus growth rates were depressed in sympatry with L. idus. For L. idus and S. cephalus, differences in their functional response parameters and growth rates were not significant.

Pond mesocosms used stable isotope metrics to quantify shifts in the trophic niche sizes of the fishes between allopatry and sympatry using a substitutive experimental design. Isotopic niches were smaller and more divergent in sympatric paired species than predicted by their allopatric treatments, suggesting trophic impacts from interspecific competition. However, an all‐species sympatric treatment revealed similar niche sizes with allopatry. This maintenance of niche sizes in the presence of all species potentially resulted from the buffering of direct competitive effects of the species pairs by indirect effects.

Experimental predictions from tank aquaria assisted the interpretation of the constricted and diverged trophic niches detected in the paired‐species sympatric treatments of the pond mesocosms. However, the all‐species sympatric treatment of this experiment revealed greater complexity in the outcomes of the competitive interactions within and between the species. These results have important implications for understanding how alien species integrate into food webs and influence the trophic relationships between native species.
Verb‐mediated anticipatory eye movements in people with Down syndrome
Authors: Arias‐Trejo Natalia , Angulo‐Chavira Armando Q. , Barrón‐Martínez Julia B.
Published: April 2019

Background

Children and adults with neurotypical development employ linguistic information to predict and anticipate information. Individuals with Down syndrome (DS) have weaknesses in language production and the domain of grammar but relative strengths in language comprehension and the domain of semantics. What is not clear is the extent to which they can use linguistic information, as it unfolds in real time, to anticipate upcoming information correctly.

Aims

To investigate whether children and young people with DS employ verb information to predict and anticipate upcoming linguistic information.

Methods & Procedures

A preferential looking task was performed, using an eye‐tracker, with children and teenagers with DS and a typically developing (TD) control group matched by sex and mental age (average = 5.48 years). In each of 10 trials, two images were presented, a target and a distractor, while participants heard a phrase that contained a semantically informative verb (e.g., ‘eat’) or an uninformative verb (e.g., ‘see’).

Outcomes & Results

Both DS and TD control participants could anticipate the target upon hearing an informative verb, and prediction skills were positively correlated with mental age in those with DS.

Conclusions & Implications

This work demonstrates for the first time that children and teenagers with DS can predict linguistic information based on semantic cues from verbs, and that sentence processing is driven by predictive relationships between verbs and arguments, as in children with typical development. Clinicians can take advantage of these prediction skills, using them in therapy to support weaker areas.
What Do We Know About Chain Actors’ Evaluation of New Food Technologies? A Systematic Review of Consumer and Farmer Studies
Authors: Kamrath Carolin , Wesana Joshua , Bröring Stefanie , De Steur Hans
Published: April 2019

New food technologies, such as genetic modification, food fortification, and processing technologies, are of growing interest for future food security and safety. For ensuring successful implementation of such technologies, consumers and other food supply chain actors should embrace them. We present a systematic review to identify and compare key factors of supply chain actors’ evaluation of new food technologies. Evaluation encompasses indicators such as likelihood or intention to perform a behavior, perceived benefits/risks, willingness to pay, acceptance/adoption, and attitudes. Results from 183 studies showed several imbalances in research. Although studies mainly focused on (1) genetically modified foods, (2) by consumers, (3) in developed countries, only very few studies have targeted other food technologies, other supply chain actors such as farmers (13 studies) or processors (two studies), or developing countries (43 studies). With respect to consumers’ evaluation, key determinants were trust in institutions, information assessment, perceived risks and benefits, attitudes toward the product or technology, perceived behavioral control, quality perception of the product, and impact on health. Farmers’ evaluation of new food technologies was explained by the factors of perceived risk and benefits and of actual source of information. For the few processor evaluation studies, no convergence of factors could be reached. This systematic review contributes to a better understanding of consumers’ and farmers’ evaluation behavior and opens up avenues for future research on supply chain actors’ food technology evaluations. The differences in the conceptualization and measurement of extracted factors demonstrate the need for standardized approaches in future studies.
The impact of expanded Medicaid eligibility on access to naloxone
Authors: Frank Richard G. , Fry Carrie E.
Published: April 2019

Background and Aims

Federal, state and local US governments have sought interventions to reduce deaths due to opioid overdoses by increasing the availability of naloxone. The Affordable Care Act (ACA) expanded Medicaid coverage to low‐income, childless adults, potentially giving this group financial access to naloxone. The aims of this paper are: (1) to describe the changes in the amount of Medicaid‐covered naloxone used between 2009 and 2016 and (2) to quantify the differential change in the amount of dispensed naloxone between states that expanded their Medicaid programs and states that did not.

Design

A quasi‐experimental approach based on states’ ongoing choice to expand their Medicaid program to all adults with incomes between 100 and 138% of the federal poverty line (FPL), starting in 2014. As of 2018, 37 states had expanded and 14 states had not. Estimation of the policy impact relies on a difference‐in‐difference method.

Setting

US state Medicaid programs.

Participants and measurements

Data are from the Medicaid Drug Rebate Program and include all dispensed prescriptions of naloxone through the Medicaid program. State/quarters with fewer than 10 prescriptions are suppressed; n = 1632.

Findings

Prior to Medicaid expansion, the number of Medicaid‐covered naloxone prescriptions was very similar in expansion and non‐expansion states. On average, states that expanded Medicaid had 78.2 (95% confidence interval = 16.0–140.3, P = 0.02) more prescriptions per year for naloxone compared with states that did not expand Medicaid coverage, a nearly 10 increase over the pre‐expansion years. Medicaid expansion contributed to this growth in Medicaid‐covered naloxone more than other state‐level naloxone policies.

Conclusions

Medicaid accounts for approximately a quarter of naloxone sales. Medicaid expansion generated 8.3% of the growth in naloxone units from 2009 to 2016, holding other factors constant.
Stereotactic body radiation therapy for early hepatocellular carcinoma: a retrospective analysis of the South Australian experience
Authors: Wigg Alan J. , Narayana Sumudu K. , Le Hien , Iankov Ivan , Chinnaratha Mohamed A. , Tse Edmund , Chen John W. , Gowda Raghu
Published: April 2019

Background

Stereotactic body radiation therapy (SBRT) is an emerging treatment option for liver tumours unsuitable for established curative treatment such as ablation or surgery. The aim of the study is to evaluate the efficacy and safety of SBRT in the treatment of small hepatocellular carcinoma (HCC) in South Australia.

Methods

From 2014 to 2018, 13 HCC patients were treated with SBRT. Eligibility criteria for SBRT included: unsuitable for standard curative therapies (resection or percutaneous ablation), lack of complete response to prior transarterial chemoembolization, Child–Pugh classification ≤B7, tumours ≤5 cm and minimum of up to 6 months follow‐up post‐SBRT. The prescribed radiation dose was determined by liver function with doses ranging from 40 to 45 Gy in three or five fractions. Records for all patients were reviewed, and treatment response was scored according to the modified response evaluation criteria in solid tumours. Toxicity was graded according to the Common Terminology Criteria for Adverse Events version 4.0.

Results

The median follow‐up time was 22.7 months, and the median tumour size was 40 mm. The 1 year local control was 92.3%, recurrence‐free survival was 67.7% and overall survival was 86.4% at end of study. Three patients underwent liver transplant. No grade ≥3 non‐haematological toxicities were observed. One patient experienced acute grade ≥3 haematological toxicity.

Conclusion

SBRT is a safe, effective and non‐invasive alternative treatment option for patients with small HCCs, unsuitable for standard, evidence‐based therapies and lacking complete response to transarterial chemoembolization. Randomized controlled trials are required to further investigate the role of SBRT in HCC.
Unsettling Indian Water Settlements: The Little Colorado River, the San Juan River, and Colonial Enclosures
Authors: Curley Andrew
Published: April 2019

In the United States, indigenous nations are settling water claims for access to the continent's surface waters. This legal‐political process transforms the nature of indigenous water use to conform with logics of quantification that are foundational to western water laws. This article critiques Indian water settlements by highlighting the inherent limitations and marginalisation of indigenous water rights in two recent examples of water settlements, the Little Colorado River Water Settlement in 2012 and the San Juan River Water Settlement in 2005. This article argues that Indian water settlements are forms of colonial enclosures, built on a lineages of law that replicates and perpetuates settler‐colonial dispossession. These settlements enclose upon unquantified Indigenous rights in the interest of colonial‐capitalist expansion in the western states.
The effects of the supplementation of multi‐strain probiotics on intestinal microbiota, metabolites and inflammation of young SPF chickens challenged with Salmonella enterica subsp. enterica
Authors: Chang Chi Huan , Teng Po Yun , Lee Tzu Tai , Yu Bi
Published: April 2019

This study assessed the effect of probiotics on cecal microbiota, cecal short‐chain fatty acids (SCFAs), and the gene expression of cytokines in young specific‐pathogen‐free (SPF) chickens infected with S. enterica subsp. enterica. One‐day‐old SPF chickens (n = 105) were randomly assigned to one of the three treatment groups: control (Cont) group, Salmonella‐infected (Sal) group, and a Salmonella‐infected group treated with multi‐strain probiotics (ProSal group). All chickens except those in the Cont group were challenged orally with 1 × 108 cfu/ml of Salmonella 4 days after hatching. Chickens in the Sal group exhibited more abundance of Proteobacteria than those in the Cont and ProSal groups. At the genus level, chickens in ProSal group exhibited increased numbers of Lactobacillus and Oscillospira compared with those in the other groups. Chickens in the ProSal group exhibited a significant increase of cecal SCFAs compared with chickens in the Sal group. Chickens in the ProSal group exhibited increased gene expression of anti‐inflammatory cytokines, IL‐10 and TGF‐β4, and decreased expression of the proinflammatory cytokine, IFN‐γ, in the cecal tonsil compared with those in the Sal group. The results of this study indicated that the administration of probiotics can modulate microbiota, SCFAs, and immunomodulatory activity in SPF chickens.
Mothers' challenges with the parental control of 3‐year‐old children in Japan: A qualitative study
Authors: Onishi Ryuta , Saeki Kazuko , Hirano Michiyo
Published: April 2019

Background

Parents often struggle against the negativism of 3‐year‐old children in exerting parental control. Although most research on parental control is from western cultures, Japanese mothers may face unique challenges because of their sociocultural background. We therefore explored mothers' challenges in exerting parental control over 3‐year‐old children in Japan.

Methods

A descriptive qualitative approach was adopted. The participants were 10 Japanese mothers with children aged 3–4 years. We conducted individual semistructured interviews and analysed the data via qualitative content analysis.

Results

We found four categories and a structure of the challenges mothers faced in exerting parental control. Mothers' control attempts had four main intentions, each with a different subject (i.e., the children, themselves, the family, and society). Most challenges with parental control stemmed from mothers' “consciousness of parental responsibility.” In confronting the child in their attempts to exert parental control, mothers perceived a “struggle with the child's negativism,” which led them to recognize that they could not find a correct method of discipline. Furthermore, in the face of conflicting roles, mothers experienced “confusion in seeking the righteous answer as a parent.” Some mothers began to feel that they were discovering their maternal role in their own way rather than finding a correct answer, which formed a “conviction that my own parenting is not incorrect.”

Conclusions

The challenges mothers faced in exerting parental control over their 3‐year‐old children served as a turning point for them to reflect on themselves as parents. However, due to societal monitoring of parents and mothers' multiple roles in the family, it can be difficult for mothers to fully overcome the challenges of parental control. It is necessary to foster social capital in the community to which the mother belongs and to create an atmosphere in which community members can watch over parents warmly.
Circular RNA DOCK1 promotes bladder carcinoma progression via modulating circDOCK1/hsa‐miR‐132‐3p/Sox5 signalling pathway
Authors: Liu Peihua , Li Xiaozhou , Guo Xi , Chen Jinbo , Li Chao , Chen Minfeng , Liu Longfei , Zhang Xiangyang , Zu Xiongbing
Published: April 2019

Objectives

To reveal the role of circular RNA (circRNA) DOCK1 (circDOCK1) as a potential biomarker and therapeutic target and its competing endogenous RNA mechanism in bladder carcinoma (BC).

Methods

The next‐generation sequencing (NGS) technology was introduced to screen the circRNA expression profiles of BC using microarray. qPCR and Western blots assay were employed to measure the gene expression in different groups. Cell counting kit‐8, EdU and transwell assays were applied to detect the cell viability, proliferation and migration potential, respectively. Luciferase reporter assay was used to test the binds between hsa‐miR‐132‐3p/Sox5. Xenografted tumour growth of nude mice was performed to test the role of circDOCK1 in vivo.

Results

CircDOCK1 was upregulated in BC tissues and cell lines. Repression of circDOCK1 reduced cell viability, inhibited cell proliferation and curbed the cell migration potential of BC cell. CircDOCK1 played its role via regulation of circDOCK1/hsa‐miR‐132‐3p/Sox5 pathway in BC cells. Suppression circDOCK1 inhibited the tumour growth in vivo.

Conclusion

In this study, we revealed that circDOCK1 affected the progression of BC via modulation of circDOCK1/hsa‐miR‐132‐3p/Sox5 pathway both in vitro and in vivo and providing a potential biomarker and therapeutic targets for BC.
Ecological and social consequences of bison reintroduction in Colorado
Authors: Wilkins Kate , Pejchar Liba , Garvoille Rebecca
Published: April 2019

Bison were instrumental in shaping North America's Great Plains. Interest in restoring this iconic species and their ecological role in grassland ecosystems is rapidly gaining momentum. To evaluate the potential for bison to enhance habitat quality for wildlife and catalyze public engagement in grassland conservation, we assessed both the ecological and social effects of a recent bison reintroduction (2015) to northern Colorado. Specifically, we explored the effect of bison reintroduction on: (a) bird density and habitat use, (b) mammal habitat use, (c) vegetation composition and structure, and (d) visitor connectedness, known as place attachment, to a shortgrass prairie. We predicted that bison reintroduction would reduce cover and height of some grasses and shrubs, which would increase density and habitat use for obligate shortgrass prairie birds, and increase habitat use for coyote and lagomorphs. In addition, we predicted that visitors would express stronger place attachment to this grassland once bison were reintroduced. To measure ecological and social responses, we surveyed birds, mammals, and plants; and conducted structured visitor surveys before and after bison reintroduction. We found few short‐term effects of bison on grassland bird density and habitat use, mammal habitat use, and vegetation composition and structure. However, we measured a significant increase in visitor place attachment to the grassland site 1 year after bison reintroduction. Our results suggest that a new bison reintroduction may have immediate positive benefits for connecting people to conservation, and that the ecological and social effects may unfold over different time scales. We recommend that future bison reintroduction efforts monitor ecological and social outcomes to advance reintroduction biology.
Outcomes in adults with cerebral palsy: systematic review using the International Classification of Functioning, Disability and Health
Authors: Benner Joyce L , Noten Suzie , Limsakul Chonnanid , Van Der Slot Wilma M A , Stam Henk J , Selb Melissa , Van Den Berg‐Emons Rita J G , Roebroeck Marij E
Published: April 2019

Aim

In the context of the development of an International Classification of Functioning, Disability and Health (ICF) Core Set for adults with cerebral palsy (CP), this systematic review sought to identify the outcome measures used in studies on adults with CP, to examine their content using the ICF as a reference, and to demonstrate the most studied areas in this population.

Method

Embase, MEDLINE, Web of Science, PsycINFO, CINAHL, Cochrane, and Google Scholar were searched for studies on adults with CP published between 2000 and 2017. Meaningful concepts of commonly used outcome measures were linked to the ICF, and frequencies of resultant ICF categories were explored.

Results

In 274 included articles, 332 outcome measures were identified of which 155 were commonly used. In total, 4409 meaningful concepts were linked to the ICF. The component ‘Activities and participation’ included the most frequent categories, followed by ‘Body functions’. The most frequent categories were b280 ‘Sensation of pain’ (37.6%), d450 ‘Walking’ (33.3%), and d850 ‘Remunerative employment’ (27.5%).

Interpretation

The broad range of ICF categories identified in this systematic review emphasizes the heterogeneity of functioning and disability in adults with CP. The current results specifically reflect the researchers’ perspective and will serve as candidate categories to consider in the development of an ICF Core Set for adults with CP.

What this paper adds

Outcomes studied in adults with cerebral palsy are captured in varying International Classification of Functioning, Disability and Health (ICF) categories.

Activities and participation were studied more frequently than body functions and structures.

Mobility, employment, and self‐care were most frequent within ICF's ‘Activities and participation’ component.

Pain and neuromusculoskeletal and movement‐related functions were most frequent within ‘Body functions’.
Comparing postural instability and gait disorder and akinetic‐rigid subtyping of Parkinson disease and their stability over time
Authors: Erro R. , Picillo M. , Amboni M. , Savastano R. , Scannapieco S. , Cuoco S. , Santangelo G. , Vitale C. , Pellecchia M. T. , Barone P.
Published: April 2019

Background and purpose

Parkinson disease (PD) patients are classically classified according to two alternative motor subtyping methods: (i) tremor‐dominant versus postural instability and gait disorder; (ii) tremor‐dominant versus akinetic‐rigid. The degree of overlap between the two classification systems at diagnosis of PD and their temporal stability, as well as the correspondence between the two systems, were examined over a follow‐up period of 4 years.

Methods

Newly diagnosed, untreated PD patients were classified as tremor‐dominant versus postural instability and gait disorder and tremor‐dominant versus akinetic‐rigid at baseline and after 2 and 4 years.

Results

There was a poor overlap between the two classification systems at any time point and baseline subtype status could not predict 4‐year subtype membership. In fact, about half of our cohort shifted category during the first 2 years, regardless of the classification scheme adopted. A lower rate of shift was observed from 2‐ to 4‐year follow‐up.

Conclusions

The two classical motor subtyping methods of PD poorly overlap, which implies that a patient can be categorized as tremor‐dominant in one classification system but not in the other. Moreover, their temporal instability undermines their prognostic value in the early stage of PD.
Parental Involvement and Adolescents’ Academic Achievement: Latent Profiles of Mother and Father Warmth as a Moderating Influence
Authors: Chung Gerard , Phillips Jonathan , Jensen Todd M. , Lanier Paul
Published: April 2019

Parental involvement in their adolescents’ education plays an important role in promoting their children's academic outcomes. Yet, more research is needed to examine the relationship between parenting practices and parental warmth as well as to consider the potential joint contribution of warmth from both fathers and mothers. Thus, the primary purpose of the current study is to examine the extent to which patterns of parental warmth across fathers and mothers moderate the association between parental involvement and adolescents’ grade point average (GPA) and school engagement behaviors. Latent profile analysis was conducted to identify disparate profiles of fathers’ and mothers’ warmth within a nationally representative sample of 2,306 youths (51% male; mean age = 15.31 years, SD = 1.50; 77% non‐Hispanic White) residing in opposite‐sex, two‐parent families from Wave I and II of the National Longitudinal Study of Adolescent to Adult Health. Latent‐class enumeration processes support a five‐profile solution characterized by differences in levels of parental warmth and congruency across parents: (a) Congruent High Warmth, (b) Congruent Moderate Warmth, (c) Congruent Low Warmth, (d) Incongruent High Mother/Low Father Warmth, and (e) Incongruent Low Father/Lower Mother Warmth. Subsequent multiple linear regression analyses reveal a moderating effect for Congruent Low Warmth on the relationship between parental involvement and adolescents’ GPA. Ultimately, the results show that variation in parental warmth exists across fathers and mothers with differing impact on adolescents’ outcomes. Excluding one parent without considering the joint effects of both parents will not produce an accurate and precise understanding of parenting in research or practice.