bluuebunny/crossref_metadata_2025 huggingface dataset:
The Game Between Game Theory and Gaming Simulations: Design Choices
Authors: Roungas Bill , Bekius Femke , Meijer Sebastiaan
Published: April 2019

Background. The abstraction of complex systems, which is required by default when modelling gaming simulations, is a convoluted and time-consuming process. For gaming simulations to be efficient and effective, the problem of the real system they imitate needs to be narrowed down and simplified as much as possible. Additionally, even after abstraction of the real system, multiple design decisions need to be made and these may differ depending on the gaming simulation.

Aim. This article proposes a framework for formalizing, and consequently standardizing, expediting and simplifying, the modelling of gaming simulations.

Method. The proposed framework applies game concepts pertaining to game theory in the abstraction of the real system and the game design decisions.

Results. Application of the framework in three case studies reveals several advantages of incorporating game theory into game design, such as formally defining the game design elements and identifying the worst-case scenarios in the real-systems, to name but two.

Conclusions. Given the framework’s advantages in general, and the game design recommendations it offers in particular, it is safe to conclude that, for the cases presented in this article, the framework make positive contributions towards the development of gaming simulations.
Nursing Students’ Perceptions Using an Interactive Digital Simulation Table: A Usability Study
Authors: Verkuyl Margaret , Betts Lorraine , Sivaramalingam Suba
Published: April 2019

Background. There is a need to enhance simulation activities in nursing education to prepare students for clinical practice. The purpose of this study was to assess ease of use and usefulness in a newly developed interactive digital simulation table to promote technology uptake before the table was embedded in nursing curriculum.

Methods. A usability study including survey and interviews was conducted to test the interactive digital simulation table with nursing students. The scenario used in this study provided students with practice in decision- making when caring for a client with asthma/chronic obstructive lung disease.

Results. Participants found the interactive digital simulation table easy to use and felt it would be useful for nursing education as it provided an experience similar to real clinical practice.

Conclusion. There is evidence to support including the interactive digital simulation table as part of a suite of simulations offered to nursing students.
Impact of Intermediate Cystic Fibrosis Classification on Parents’ Perceptions of Child Vulnerability and Protectiveness
Authors: Tluczek Audrey , Levy Hara , Rock Michael J. , Ondoma Cissy , Brown Roger L.
Published: April 2019

This cross-sectional, mixed-method study examined factors associated with parent perceptions of child vulnerability and protectiveness in three groups: cystic fibrosis (CF-group, n = 40), intermediate CF classification (I-group, n = 20), and healthy (H-group, n = 50). A composite indicator structural equation (CISE) using Bayesian estimation tested two mediational models: psychological and biological. Significant results ( p < .05) from the psychological model showed I-group and CF-group parents perceived their children to be more vulnerable than H-group parents but reported lower levels of protectiveness than H-group parents. Perceptions of vulnerability mediated protectiveness for CF- and I-groups. The biological model showed I-group children had significantly less severe genotype and phenotype, and lower sweat chloride levels than the CF-group; I-group parents had lower expectations about children developing CF symptoms. Both models showed negative associations between children’s ages and protectiveness. Psychological factors explained perceptions of child vulnerability and protectiveness; biological factors explained protectiveness. Parent perceptions of vulnerability and protectiveness are separate, independent constructs.
Interventions to Decrease Use in Prehospital and Emergency Care Settings Among Super-Utilizers in the United States: A Systematic Review
Authors: Iovan Samantha , Lantz Paula M. , Allan Katie , Abir Mahshid
Published: April 2019

Interest in high users of acute care continues to grow as health care organizations look to deliver cost-effective and high-quality care to patients. Since “super-utilizers” of acute care are responsible for disproportionately high health care spending, many programs and interventions have been implemented to reduce medical care use and costs in this population. This article presents a systematic review of the peer-reviewed and grey literature on evaluations of interventions to decrease prehospital and emergency care use among U.S. super-utilizers. Forty-six distinct evaluations were included in the review. The most commonly evaluated intervention was case management. Although a number of interventions reported reductions in prehospital and emergency care utilization and costs, methodological and study design weaknesses—especially regression to the mean—were widespread and call into question reported positive findings. More high-quality research is needed to accurately assess the impact of interventions to reduce prehospital and emergency care use in the super-utilizer population.
Sustainability as a Competitive Tool for the Brave? Or for the Best? A Behavioral Theory Perspective
Authors: Bettinazzi Emanuele L. M. , Massa Lorenzo , Neumann Kerstin
Published: April 2019

Who invests in sustainability as a strategic choice? We adopt a behavioral theory perspective to explain the heterogeneity of sustainability-driven investments. Building on problemistic search and organizational inertia arguments, and contrary to resource-based explanations, we argue that a firm’s competitiveness might actually reduce its likelihood to invest in sustainability. We also propose that less competitive firms invest in sustainability to improve their economic situation and, thus, that this choice results in positive performance effects. We further theorize that a firm’s level of commitment to its stakeholders will strengthen its likelihood to invest in sustainability. In a sample of 780 North American public companies in the period from 2007 to 2011, we find evidence to support our proposed model. Based on our findings, we draw implications for the further study of the behavioral roots of strategic change as well as for sustainability-oriented managerial practice and policy making.
Single-Dose Pharmacokinetics of Amphetamine Extended-Release Oral Suspension in Healthy Adults
Authors: Herman Barry K. , Bouhajib Mohammed , King Thomas R. , Kando Judith C. , Pardo Antonio
Published: April 2019

Purpose: This single-dose pivotal study evaluated the pharmacokinetics of amphetamine extended-release oral suspension (AMPH EROS) under fasted and fed conditions and the relative bioavailability of AMPH EROS and immediate-release mixed amphetamine salts (IR MAS) in adults. Methods: This open-label, randomized, three-period, three-treatment, six-sequence crossover study enrolled 30 healthy adult participants who were randomly assigned to receive either 1 dose of AMPH EROS 18.8 mg under fed or fasted conditions or 30 mg of IR MAS under fasted conditions. Participants crossed over with a 7-day washout period between each of the three periods. Plasma samples were measured for Cmax, AUC0- t, AUC0-5, AUC5- t, and AUC0-∞ for comparative bioavailability. Results: The geometric mean ratios for Cmax, AUC0- t, and AUC0-∞ were within the 90% confidence limits [80.0%, 125.0%] for comparable bioavailability. There was no food effect for AMPH EROS. Both the AMPH EROS and IR MAS formulations were generally well tolerated with no serious adverse events reported. Conclusions: The bioavailability of a single dose of AMPH EROS was comparable to two 15 mg doses of IR MAS, given 4 hr apart, with no food effect or safety concerns observed.
The environmental costs of the global digital economy in Asia and the urgent need for better policy
Authors: Notley Tanya
Published: April 2019

Digital services and products are often described as immaterial or virtual. However, they are responsible for a vast amount of environmental damage and destruction. The creation, processing, storage and movement of data relies on extensive natural and finite resources including electricity, water, metals, elements and chemicals as well as the production of human-made materials including plastics and glass; the disposal of these materials can produce toxic waste which is often illegally hidden and shipped around the world to bypass responsibility. Despite clear evidence of the materiality of digital flows, corporate rhetoric artfully acts to conceal the environmental risks and costs of digital flows, while state and international policy and regulation has thus far been unable to produce an effective response. This article seeks to examine the roots of this problem by reviewing the historical global policy discourse on the digital economy. The article is also grounded in Asia – which now accounts for almost half of the world’s Internet users – by looking close up at State policies in the second most economically advanced country in the region: Singapore. The article concludes with a discussion of what needs to happen if states are to reduce the environmental burden of the digital economy and ensure the costs are more justly distributed.
Efficacy and safety of memantine in children with autism spectrum disorder: Results from three phase 2 multicenter studies
Authors: Hardan Antonio Y , Hendren Robert L , Aman Michael G , Robb Adelaide , Melmed Raun D , Andersen Kristen A , Luchini Rachel , Rahman Rezwanur , Ali Sanjida , Jia X Daniel , Mallick Madhuja , Lateiner Jordan E , Palmer Robert H , Graham Stephen M
Published: April 2019

Three phase 2 trials were conducted to assess the efficacy and long-term safety of weight-based memantine extended release (ER) treatment in children with autism spectrum disorder. MEM-MD-91, a 50-week open-label trial, identified memantine extended-release treatment responders for enrollment into MEM-MD-68, a 12-week randomized, double-blind, placebo-controlled withdrawal trial. MEM-MD-69 was an open-label extension trial in which participants from MEM-MD-68, MEM-MD-91, and open-label trial MEM-MD-67 were treated ⩽48 weeks with memantine extended release. In MEM-MD-91, 517 (59.6%) participants were confirmed Social Responsiveness Scale responders at week 12; mean Social Responsiveness Scale total raw scores improved two to three times a minimal clinically important difference of 10 points. In MEM-MD-68, there was no difference between memantine and placebo on the primary efficacy parameter, the proportion of patients with a loss of therapeutic response (defined as ⩾10-point increase from baseline in Social Responsiveness Scale total raw score). MEM-MD-69 exploratory analyses revealed mean standard deviation improvement in Social Responsiveness Scale total raw score of 32.4 (26.4) from baseline of the first lead-in study. No new safety concerns were evident. While the a priori–defined efficacy results of the double-blind trial were not achieved, the considerable improvements in mean Social Responsiveness Scale scores from baseline in the open-label trials were presumed to be clinically important.
Cultural perspectives on positive responses to extreme adversity: A playing field for metaphors
Authors: Meili Iara , Maercker Andreas
Published: April 2019

In Euro-American societies, “resilience” and “post-traumatic growth” are commonly used metaphorical terms for positive responses to extreme adversity. However, research on illness narratives has demonstrated that other cultures may have different metaphorical concepts that act as vehicles for shared beliefs about how to overcome extreme adversity or traumatic experiences. The purpose of this article is to identify metaphors used in various cultures to describe positive responses to extreme adversity and to discuss the cultural ontologies and other socio-cultural factors that shape them. Metaphors of this nature were extracted from psychological, anthropological and ethnographic studies and were organized into categories: battle, path, container, balance, weight, object and network metaphors. Findings support the notion that metaphorical expressions related to positive responses to extreme adversity vary widely across cultures. We argue that an understanding of cultural differences in metaphors for mental health-related concepts is crucial to assisting trauma survivors from different cultural backgrounds.
Reconstructing the life-cycle of a mixed language: An exploration of Ecuadoran Media Lengua
Authors: Lipski John M
Published: April 2019

Aims and objectives:

This study explores the assertion that bilingual mixed languages are only diachronically stable if they are not spoken together with both of the contributing source languages. Ecuadoran Media Lengua, which combines all-Quichua morphosyntax with nearly all lexical roots replaced by Spanish-derived forms, coexists in three communities with both Spanish and Quichua, having arrived in each community in successive generations.

Methodology and design:

Trilingual speakers (Quichua, Media Lengua, Spanish) participated in four interactive tasks: speeded translation, speeded acceptability judgments, language classification, and lexical decision.

Data and analysis:

For each task, the calculated rate of separation of Quichua and Media Lengua was the response variable for a series of linear mixed-effects models, with community (and when appropriate, age group) as a fixed effect.

Findings/conclusions:

The results suggest that a mixed language spoken together with the languages that supplied both the lexical roots and the morphosyntax can maintain its integrity for a generation or two, but the perceptual boundaries circumscribing the mixed language eventually become more permeable. They point to a significant correlation between the chronology of language contacts and the perceptual stability of Media Lengua, which is greatest when the only competing language is Quichua, somewhat less when Spanish is acquired later as the second language, and lowest when Spanish is one of the early acquired or native languages alongside Quichua.

Originality:

This is the first attempt to test the putative diachronic stability of a mixed language by means of synchronic experimental data.
Applying a model of volunteerism to better understand the experiences of White ally activists
Authors: Fingerhut Adam W. , Hardy Emma R.
Published: April 2019

In the fight for equality, outgroup allies have played a critical role. Despite this, little is known about what motivates these individuals and keeps them committed long term. The current research applies Omoto and Snyder’s (1995) volunteerism model to better understand the experiences of White ally activists. White individuals ( N = 355) involved in racial justice work completed an online survey assessing antecedents (helping personality, motivations, social support), experiences (satisfaction, sense of community), and consequences (degree of involvement, well-being) of their antiracism work. Results showed a direct link between social support and degree of involvement, and an indirect link mediated by sense of community. Additionally, there was a direct link between social support and well-being, and an indirect link mediated by satisfaction. Helping personality and other-focused motives were not related to the outcomes. Implications for future research and for those working with White ally activists are discussed.
Ultrafine particle emissions from a smouldering cigarette in a residence and its associated lung cancer risk
Authors: Wu Chili , Zhang Hongli , Fu Sauchung , Chan Kachung , Qin Daoding , Chao Christopher Y. H.
Published: April 2019

After smoking bans were enforced in most public spaces, residences became the major places for exposure to second-hand smoke. Since cigarette smoke contains mainly submicron and ultrafine particles (UFPs), the harmful effects of the particles in cigarette smoke might be correlated more with number and surface area concentrations of UFPs instead of their mass concentration. To assess these harmful effects, we investigated the size distribution of particles (20 nm to 600 nm) released from sidestream smoke. An experiment was carried out in a two-zone house which was divided into smoking and non-smoking areas. Particle concentrations were measured in both zones and the exposure doses of people in both zones were calculated. The lung cancer risk of UFPs was then analysed by a modified surface area-based risk assessment scheme, which was found to be much closer to the incidence rate of lung cancer. In most of the studied scenarios, the excess lifetime cancer risks to non-smoker occupants exceeded an acceptable level. Although closing a door separating the two zones is a common isolation measure, adequate protection for the non-smokers cannot be achieved unless sufficient ventilation in the smoking zone is provided.
Archaeological places: Negotiations between local communities, archaeologists and the state in India
Authors: Menon Jaya , Varma Supriya
Published: April 2019

In South Asia, local communities most often live near or amidst archaeological places. Their lives are in many ways framed and structured by these places. At the same time, these places too are impacted by the communities that live nearby. Archaeological sites in India are being destroyed at a rapid pace, due to increasing population and development pressures. This story gets further complicated by legislative practices of preservation related to monuments and archaeological sites, which are solely in the hands of the state through its institutions. It is this very act of protection that sometimes leads to conflict between the institutions of the state and local communities. At the same time, several archaeological sites have also survived due to local interests because they have been transformed into ritual spaces or are considered as ancestral places. Additionally, monuments have been converted into heritage hotels and have become an important means of livelihood for the families that own them. Thus, for protection to succeed, the critical intervention and involvement of local communities living in close proximity to monuments and archaeological sites is fundamental. Is it then education that can enable the survival of archaeological places? School education has the scope of involving and alerting children to their environs, whether it is the natural environment or a built one, and this could be a long-term solution.
Psychometric evaluation of the Heart Failure Somatic Perception Scale in a European heart failure population
Authors: Pucciarelli Gianluca , Greco Andrea , Paturzo Marco , Jurgens Corrine Y , Durante Angela , Alvaro Rosaria , Vellone Ercole
Published: April 2019

Background:

The Heart Failure Somatic Perception Scale (HFSPS) is a four-factor instrument used to assess how bothersome are 18 physical signs and symptoms of heart failure. To date, construct validity and reliability of the HFSPS have been evaluated in only one American study and never in a European population.

Aim:

To evaluate psychometric properties (validity and reliability) of the HFSPS in a European heart failure population.

Methods:

This was an Italian multicentre study in which the HFSPS factorial structure was assessed using confirmatory factor analysis. Criterion related validity of the HFSPS was evaluated by correlating its factor scores with the Kansas City Cardiomyopathy Questionnaire (KCCQ) scores using Pearson’s r. The HFSPS internal consistency reliability was evaluated using the factor score determinacy coefficient, Cronbach’s α and model-based internal consistency index.

Results:

Most of the participants ( n=321) were male (56.6%), with a mean age of 71.48 years (SD, 12.75) and in New York Heart Association class II (61.8%). The confirmatory factor analysis, testing the original HFSPS four-factor structure (dyspnoea, chest discomfort, early and subtle, and oedema), resulted in the following supportive fit indices: χ2(126, N=321)=337.612, p<0.001, comparative fit index =0.920, Tucker–Lewis index =0.903, root mean square error of approximation =0.072 and standardized root mean square residual =0.045. With regard to the criterion related validity, all the correlations with the KCCQ were statistically significant. The HFSPS reliability resulted in factor score determinacy coefficients ⩾ 0.87 and Cronbach’s α ⩾ 0.75, with the exception of the two-item chest discomfort subscale; the model-based reliability coefficient was 0.914.

Conclusion:

The validity and reliability of the HFSPS were supportive in this European sample. The HFSPS can be used to assess how bothersome heart failure signs and symptoms are in order to improve their management.
Personal networks and desistance from crime in young offenders
Authors: Martí Joel , Albani Eugenia , Ibàñez Aina , Cid José
Published: April 2019

In this article we analyse the structure, composition and relational resources of young offenders’ personal networks in order to identify how they are related to desistance. We present a mixed-methods analysis of a sample of young offenders, either in juvenile custody or on probation in Catalonia’s juvenile justice system. We first construct a typology of personal networks according to their composition and structure. In each of the profiles we conduct a qualitative analysis in order to identify the role of relational resources in desistance processes and the meaning that desisters give to these resources. Results show the different relevance of strong and weak ties according to the characteristics of the network and explain how these ties may contribute to the process of desistance.
Non-therapeutic research in children
Authors: May Ng Sze
Published: April 2019

The future health of children depends on clinical research which is an important part of medical progress. The principles of the child’s best interests standards and how it is applied in the context of research are explored. This review will show that there is a need for research involving children but there are gaps in the current legal and ethical framework which are not readily applicable to non-therapeutic research involving children. There are significant challenges in trying to achieve a balance between what is socially good and the obligation to protect children who participate in research.
Effect of Irbesartan on AGEs-RAGE and MMPs systems in rat type 2 diabetes myocardial-fibrosis model
Authors: Hongwei Ye , Ruiping Cao , Yingyan Fang , Guanjun Zhang , Jie Hu , Xingyu Liu , Jie Tang , Zhenghong Li , Qin Gao , Junfeng Hu , Heng Zhang
Published: April 2019

To investigate the effect of Irbesartan on the changes of myocardial advanced glycation end products and their receptor (AGEs-RAGE), and matrix metalloproteinases (MMPs) systems in rat type 2 diabetes myocardial fibrosis model. All male Sprague-Dwaley rats were randomly divided into four groups: control (CON), high glucose and high-caloric diet (HC), type 2 diabetes (T2DM) and Irbesartan + T2DM (Ir+T2DM) groups. At 12th week, the fasting blood glucose (FBG) and fasting serum insulin (FINS) levels, insulin resistance index (IRI), insulin sensitivity index (ISI), body weight (BW), the ratio of heart weight/body weight (H/B), left ventricular weight index (LVWI), and cardiac col I, col III contents, plasma MMP-2, MMP-9 levels were evaluated. The protein expressions of col I, AGE, RAGE, MMP-2, MMP-14, and TIMP-2 were analyzed by Western blot. In the T2DM group, FBG, H/B, LVWI, IRI were increased ( P < 0.01), while FINS, BW, ISI were decreased in contrast to the CON and HC groups ( P < 0.05–0.01). In the Ir+ T2DM group, BW was higher, IRI, H/B, LVWI were lower than in the T2DM group. Compared with the CON and HC groups, the contents of col I and col III, the protein expressions of col I, AGE, RAGE, TIMP-2 and MMP-14 were increased, MMP-2 protein expression, the ratios of MMP-2/TIMP-2 and MMP-14/TIMP-2, MMP-2, and MMP-9 levels were decreased in the T2DM group ( P < 0.01). After Irbesartan treatment, all parameters were reversed. Irbesartan can ameliorate myocardial fibrosis in type 2 diabetes rat model, the likely mechanisms may be related to the down-regulation of AGEs-RAGE system and changes of MMPs pathway.

Impact statement

There are about 425 million diabetes patients (20–79 years) in the world according to the International Diabetes Federation Diabetes Atlas – 8th Edition. The cardiovascular complication is one of the major causes of death in diabetes patients. Myocardial fibrosis is one of the serious pathological changes, so investigating the pathogenesis of myocardial fibrosis has the significant value. Our study aims to investigate the effect of Irbesartan (the angiotensin II receptor antagonist) on the changes of AGE-RAGE system and MMP family components, and analyzes the potential mechanisms in type 2 diabetes-induced myocardial fibrosis. Our results provide the theoretical base for better understanding the pathogenesis in type 2 diabetes-induced myocardial complication. It is useful for clinicians to select the effective therapeutic measures for treatment of type 2 diabetes-induced organ fibrosis.
“What I Want to Do as a Father Is Be There”: Constructions of School Involvement for Fathers of Children with Complex Disabilities
Authors: Pancsofar Nadya , Petroff Jerry G. , Rao Shridevi , Mangel Alyssa
Published: April 2019

Fathers of children with complex disabilities can play an important role in the development and learning of their children; however, very little is known about their school involvement experiences. We conducted semi-structured interviews with 15 fathers of children with complex disabilities to learn how these fathers perceived their involvement in their children’s education and schooling. Fathers constructed their school involvement with a consideration of their work and co-parenting experiences. Their employment was perceived as a form of indirect involvement in their children’s education, but could also be associated with barriers to more direct school involvement. Fathers also discussed the role of the co-parenting relationship in their school experiences and identified several factors that contributed to a greater involvement of mothers in school settings. Among these were a perceived unique expertise of mothers and school environments that were more welcoming to mothers. They also discussed some potentially negative ramifications of being less involved in school settings, compared with mothers.
Effect of Low-Intensity Extracorporeal Shock Wave on the Treatment of Erectile Dysfunction: A Systematic Review and Meta-Analysis
Authors: Dong Liang , Chang Degui , Zhang Xiaojin , Li Junjun , yang Fang , Tan Kun , Yang Yali , Yong Shanshan , Yu Xujun
Published: April 2019

Low-intensity extracorporeal shockwave therapy (Li-ESWT) has been reported as a useful and noninvasive treatment for erectile dysfunction (ED). Systematic review and meta-analysis are utilized to evaluate the efficacy of Li-ESWT by comparing the changes in the International Index of Erectile Function erectile function domain (IIEF-EF) and the Erection Hardness Score (EHS) versus sham therapy in men with ED. A systematic search of the MEDLINE, EMBASE, ClinicalTrials.gov, CBM, CNKI, WANGFANG, and VIP was conducted to obtain randomized controlled trials (RCTs) published in peer-reviewed journals or presented in abstract forms of Li-ESWT for ED treatment from January 2010 to June 2018. If RCTs are published in peer-reviewed literature and IIEF-EF scores and EHS are used to assess erectile function outcomes, they are eligible for inclusion. A meta-analysis was used to summarize the estimates. The meta-analysis included seven RCTs involving 522 participants. The data revealed that men treated with Li-ESWT showed significant improvement in pooled mean IIEF-EF scores from baseline to follow-up compared with sham therapy (MD: 1.99 points; 95% CI [1.35, 2.63]; p < .00001). Changes in the IIEF-EF score increased significantly in the treatment group (MD: 3.62; 95% CI [2.99, 4.25]; p < .00001). The EHS increased significantly in the treatment group in four studies (OR: 16.02; 95% CI [7.93, 32.37]; p < .00001). Patients with moderate and/or severe ED reported better results in mean IIEF scores (MD: 3.95; 95% CI [2.44, 5.46]; p < .00001). In meta-analysis of seven RCTs with men who received Li-ESWT for ED, there was evidence that the IIEF-EF and EHS experienced improvements following Li-ESWT.
Optimization and simulation of a voice coil motor for fuel injectors of two-stroke aviation piston engine
Authors: Gao Hongli , Zhang Fujun , Wang Enhua , Liu Bolan , Zeng Wenwen , Wang Zhengkai
Published: April 2019

Two-stroke engines taking advantages of high power density and light weight as well as small size are widely used on aircrafts. Compared with conventional fuel injection system, gasoline direct injection technology can control the air-fuel ratio according to different working conditions and thus a more efficient combustion can be achieved. Normally, a solenoid valve is employed in the gasoline fuel injectors to control the injected fuel amount and timing. In this study, the performance of a novel voice coil motor for gasoline direct injection injectors of a two-stroke aviation engine is studied. The voice coil motor works as a linear actuator to pressurize the fuel, and thus the amount of injected fuel and the injection timing can be controlled by the driving current of the coil. As a result, the high-pressure pump of the conventional fuel injection system can be canceled. The working principle of the voice coil motor is described at first. Then, a finite element model of the voice coil motor is setup, and the influences of structure parameters including the coil turns, the magnetizer height, and the yoke thickness are analyzed. Subsequently, the magnetic equivalent circuit methodology is used to study the response characteristics of the voice coil motor. The results show that the coil turns, the magnetizer height, and the yoke thickness are three important parameters that will influence the electromagnetic force. The total mass and resistance of the coil and the coefficients k and ke are four important parameters that will influence the dynamic response time. A theoretical optimization of these parameters can improve the system performance of the voice coil motor significantly. The results of this study can provide a reference for the design of gasoline direct injection system for aviation piston engines.
Comparison of postoperative results between carotid endarterectomy and carotid artery stenting for patients with contralateral carotid artery occlusion: A meta-analysis
Authors: Xin Wen-Qiang , Zhao Yan , Ma Tie-Zhu , Gao Yi-Kuan , Wang Wei-Han , Wang Hong-Yu , Yang Xin-Yu
Published: April 2019

Objectives

The purpose of this study was to conduct a meta-analysis to systematically compare the safety and efficacy of carotid endarterectomy and carotid artery stenting in contralateral carotid occlusion patients who needed reperfusion.

Methods

This study retrieved potential academic articles comparing results between carotid endarterectomy and carotid artery stenting for patients with contralateral carotid occlusion from the MEDLINE database, the PubMed database the EMBASE database, and the Cochrane Library from January 1990 to May 2018. The reference articles for the identified studies were carefully reviewed to ensure that all available documents were represented in the study.

Results

Four retrospective cohort study involving 6252 patients with contralateral carotid occlusion were included in our meta-analysis. During 30-day follow-up, there is significant difference in post-procedure mortality (odds ratio (OR) = 0.476, 95% confidence interval (CI) (0.306–0.740), P = 0.001); no significant differences are not found in post-procedure stroke (risk difference (RD) = 0.002, 95%CI (–0.007 to 0.011); P = 0.631), myocardial infarction (RD = 0.003, 95%CI (–0.002 to 0.008); P = 0.301), and transient cerebral ischemia (RD = 1.059, 95%CI (–0.188 to 5.964); P = 0.948).

Conclusions

Carotid endarterectomy was associated with a lower incidence of mortality compared to carotid artery stenting for patients with contralateral carotid occlusion. Regarding stroke, myocardial infarction, and transient ischemic attack, there was no significant difference between the two groups. More randomized controlled trials and prospective cohorts are necessary to help further clarify the ideal approach for these patients.
The language of suffering: Media discourse and public attitudes towards the MH17 air tragedy in Malaysia and the UK
Authors: Theng Ong Theng , McKenzie Robert M.
Published: April 2019

‘If it bleeds, it leads’, events characterised by fatalities, are likely to attract high levels of media coverage. This study adopts a multidisciplinary approach to investigate public discourses on the MH17 tragedy in Malaysia and the United Kingdom. First, corpus-based discourse analysis was employed to explore the construction of the Malaysian Airlines tragedy MH17 in four selected Malaysian and British newspapers. In addition, an attitudinal study examining 50 Malaysian and 50 UK nationals’ perceptions of the tragedy was conducted. Keywords analysis revealed an overall tendency for the news media to construct the air tragedy through classifications between ‘us’ and ‘others’. Specifically, important ‘Us’ (Malaysian elites) and non-important ‘Other’ (non-Malaysian) in the Malaysian newspapers, versus good ‘Us’ (the West) and evil ‘Others’ (Russia) in the British newspapers. The attitudinal analysis shows, for both the Malaysian and the UK respondents, the most salient associations with the MH17 tragedy related to ‘ conflicts’.
The impact of maternal anemia and labor on the obstetric Shock Index in women in a developing country
Authors: Rojas-Suarez José , Paternina-Caicedo Ángel , Tolosa Jorge E , Guzmán-Polanía Leidy , Gonzalez Nataly , Pomares Fredy , Maza Augusto , Miranda Jezid
Published: April 2019

Background

The Shock Index is a clinical tool to evaluate the hemodynamic status during hemorrhage. The impact of labor and pre-existing anaemia is unknown. The objective was to describe and discuss its clinical utility in this context.

Methods

This was a prospective cross-sectional study. The Shock Index (ratio between heart rate and systolic blood pressure) was measured in pregnant women at term, before or during labor. They were stratified according to the presence of anemia.

Results

The median Shock Index was significantly lower in women in labor than in those not in labor (0.72 (IQR: 0.64–0.83) vs. 0.85 (IQR: 0.80–0.94); p < 0.001). In women in labor, the Shock Index was not significantly different if anemia was present (0.72 (0.63–0.83) vs. 0.73 (0.65–0.82); p = 0.67).

Conclusions

Values of the Shock Index are affected by labor, which may hinder its utility in identifying hemorrhage during this period. However, the values were not altered by maternal anaemia. Therefore, an abnormal postpartum Shock Index should not be attributed to an abnormal antepartum Shock Index due to mild/moderate anemia.
The problem of reductionism in educational theory: Complexity, causality, values
Authors: Wrigley Terry
Published: April 2019

This article seeks to examine some of the problems in current policy, pedagogy and practice through the concept of reductionism. It examines various forms which this may take involving inappropriate scientific methodologies, a diminished sense of structure (or, conversely, agency), temporal confusion and teleological/ethical reductionism, drawing on examples from natural and social sciences as well as education. It draws on Critical Realist understandings of causality, stratification and emergence to ground the discussion ontologically and epistemologically. The article then builds on this theoretical foundation for a critical discussion of teaching and learning, poverty-related underachievement, school development, and evidence-based teaching.
Content-Specific Leadership: Identifying Literature-Based Implications for Principal Preparation
Authors: Cunningham Kathleen M. W. , Lochmiller Chad R.
Published: April 2019

Principals are increasingly called upon to support effective instruction and student learning across content areas. Content and process standards emphasize the need for leadership that addresses teachers’ pedagogical and content understandings. The purpose of this article is to conceptualize content-specific leadership in mathematics and science for considerations for preparation programs through a systematic literature review. Prior research suggests both the importance of leadership development related to content-specific leadership practices and the possibilities associated with distributed leadership models aimed at the improvement of mathematics and science instruction. Specifically, leadership preparation programs must equip and support principals to make strategic school-based investments in mathematics and science instruction.
Recurrence of cutaneous Mycobacterium chelonae infection: A case report
Authors: DuBow Anaïs , Morand Meggie , Désy Delphine , Krasny Mark
Published: April 2019

Mycobacterium chelonae is a species of mycobacteria that can be found ubiquitously in the environment. It can be found in soil, water, and in aquatic animals. Infections with this pathogen usually involve the soft tissues, eyes, bones, and skin. We present the case of a recurrence of a sporotrichoid cutaneous infection by M. chelonae in an immunocompromised 31-year-old woman with systemic lupus erythematosus. The patient originally developed a swelling of her right foot followed by a sporotrichoid pattern of infection on her right lower leg. A susceptibility profile was established, and treatment with linezolid and clarithromycin was administered for 8 months, in accordance with guidelines from the American Thoracic Society. The patient was clear of new lesions for approximately 1 month before noting a re-emergence. Treatment with linezolid and clarithromycin was re-initiated with subsequent improvement. This case underlines the need for prolonged treatment of this infection in patients with an immunocompromised status.
Hemothorax induced by severe cough: An unusual presentation
Authors: Camarillo-Reyes Luis Arturo , Marquez-Córdova Roberto Ivan , Surani Salim , Varon Joseph
Published: April 2019

Massive hemothorax resulting from cough-induced rib fracture is a condition in which blood accumulates in the chest, compromising the lungs and mediastinal structures. The most common cause of massive hemothorax is acute pro-traumatic injury. We present a case of a 47-year-old gentleman with morbid obesity and psoriasis, who was admitted to the emergency department due to shortness of breath that has been increased progressively after coughing for a period of 2 weeks. Chest radiograph demonstrated a large density in the left hemithorax, collapsing the left lung. Chest computerized tomography showed a left seventh rib fracture and massive pleural effusion. A closed chest tube thoracostomy was performed draining 3 L of hemorrhagic effusion, likely due to bleeding from the intercostal artery tear due to severe and prolonged cough. Cough-induced hemothorax due to spontaneous rib fractures are rare and clinicians should be well aware of this entity to prevent hemorrhagic shock and organ damage.
Family Medicine Patients Have Shorter Length of Stay When Cared for on a Family Medicine Inpatient Service
Authors: Garrison Gregory M. , Keuseman Rachel L. , Boswell Christopher L. , Horn Jennifer L. , Nielsen Nathaniel T. , Nielsen Megan L.
Published: April 2019

Introduction: Hospitalists have been shown to have shorter lengths of stays than physicians with concurrent outpatient practices. However, hospitalists at academic medical centers may be less aware of local resources that can support the hospital to home transition for local primary care patients. We hypothesized that local family medicine patients admitted to a family medicine inpatient service have shorter length of stay than those admitted to general hospitalist services which also care for tertiary patients at an academic medical center. Methods: A retrospective cohort study was conducted at an academic medical center with a department of family medicine providing primary care to over 80 000 local patients. A total of 3100 consecutive family medicine patients admitted to either the family medicine inpatient service or a general medicine inpatient service over 3 years were studied. The primary outcome was length of stay, which was adjusted using multivariate linear regression for demographics, prior utilization, diagnosis, and disease severity. Results: Adjusted length of stay was 33% longer (95% CI 24%-44%) for local family medicine patients admitted to general medicine inpatient services as compared with the family medicine inpatient service. Readmission rates within 30 days were not different (19% vs 16%, P = .14). Conclusions: Local primary care patients were safely discharged from the hospital sooner on the family medicine inpatient service than on general medicine inpatient services. This is likely because the family physicians staffing their inpatient service are more familiar with outpatient resources that can be effectively marshaled to help local patients with the transition from hospital to home.
Parental Perspectives on Financial Incentives for Adolescents: Findings From Qualitative Interviews
Authors: Beskin Kera M. , Caskey Rachel
Published: April 2019

Background. Financial incentives are becoming more common to promote health behaviors; however, little is known about the acceptability of incentivizing adolescent health behaviors. Design. Qualitative semistructured phone interviews were conducted with 26 parents who had participated in a research study involving incentivizing a recommended, preventive adolescent health behavior (human papillomavirus vaccination). Data were coded and analyzed to identify themes. Interview domains included the following: preferred incentive distribution, ideal financial incentive amount, and general reactions to economic incentives for preventative services. Results. Parents held positive perceptions about incentives and most parents felt that the incentive could be provided directly to their adolescent child, rather than to the parent. Parents stated several benefits from incentivizing adolescent health behavior including creating an opportunity to teach their child about money, reimbursing families for time and effort, and motivating the adolescent to complete the health behavior. Topics for consideration when providing cash incentives to adolescents included the adolescent’s maturity level, parents’ desire to monitor adolescent’s spending, and parents’ want to remain involved in health care and financial decisions for their adolescent. Conclusions. This study demonstrates the potential for parental acceptance of financial incentives for adolescent health behaviors and explores areas of parental concern around financial incentives, which could help inform future health care–based incentive programs.
Teaching Risk and Probability: Building the Monopoly® Board Game Into a Probability Simulator
Authors: Gazdula Joe , Farr Richard
Published: April 2019

This article describes the adaptation and use of the Monopoly® board game as a simple simulator to help introduce the principles of probability and risk. It focusses on teaching experiences in an undergraduate business program and offers a new approach to teaching probability and risk with dice to produce a collaborative simulated gaming environment. It allows students to be actively involved in developing the probability of throwing dice numbers and the analysis of risk and decision making in a competitive environment. Concluding with a probability analysis technique, it allows students to reflect on formal and informal approaches to decision making in risk environments and helps build communication for discussion, collaborative learning, and self-analysis among students.
Key concepts in children's footwear research: a scoping review focusing on therapeutic footwear
Authors: Hill Matthew , Healy Aoife , Chockalingam Nachiappan
Published: April 2019

Background

Reports suggest that children with mobility impairment represent a significant proportion of the population living with a disability. Footwear is considered to be the key extrinsic factor affecting children's gait and footwear modifications have been historically postulated to assist with locomotory difficulty. Although therapeutic footwear has been considered within the literature, there is a lack of consistency on terminology and paucity on the overall understanding. A scoping review was performed to chart the key concepts in children's footwear and to establish the range of studies that considered therapeutic footwear.

Methods

A systematic search of MEDLINE, CINAHL, PubMed, SPORTdiscus, and Scopus electronic databases was performed using MeSH headings and free text terms in relation to children's footwear. All studies that used footwear as an intervention in children aged 9 months to 18 years with the outcome measures including design, fit, and the effects on development and health were included. Studies were charted by textual narrative synthesis into research groupings dependent on the topics discussed and the methods used in the studies.

Results

The search yielded a total of 5006 articles with 287 of these articles meeting the inclusion criteria. Two overarching areas of research were identified; articles that discussed footwear design and those that discussed the effects of footwear. Eight further general groupings were charted and apportioned between the overarching areas and therapeutic footwear was charted into three subgroupings (corrective, accommodative and functional).

Conclusion

Children's footwear has become an increasing area of research in the past decade with a shift towards more empirical research, with most of the included articles examining biomechanical and anthropometric aspects. However, children's therapeutic footwear has not shared the same recent impetus with no focused review and limited research exploring its effects. Empirical research in this area is limited and there is ambiguity in the terminology used to describe therapeutic footwear. Based on the findings of this review the authors suggest the term children's therapeutic footwear be used as the standard definition for footwear that is designed specifically with the purpose to support or alleviate mobility impairment in childhood; with subgroupings of corrective, accommodative and functional dependent on the intended therapeutic role.
Engaging leadership training – fostering social interaction skills through e-learning and blended solutions
Authors: Lonka Kirsti , Ketonen Elina , Marttinen Kitte , Talvio Markus
Published: April 2019

Töökohal õppimise soodustamiseks ja töötajate heaolu suurendamiseks katsetati ühes ettevõttes kaasava õpikeskkonna (ELE) mudelit. Uuringus osales 107 keskastmejuhti, kes jagati kolme rühma: e-õppe rühma (n = 42), võrdlusrühma (n = 42) ja ettevõtte moodustatud kaasava õpikeskkonna põimõppe rühma (n = 23), milles kasutati nii e-õpet kui ka kontaktõpet. Kõik rühmad osalesid eel- ja järeltestimises. Osalejate teadmisi hinnati 16 valikvastustega küsimuse põhjal ja teadmiste rakenda mise oskusi juhtumitel põhineva keeruliste suhtlusolukordadega toimetuleku meetodi abil. Kirjeldusi selle kohta, kuidas käituda juhtumina esitatud olukordades, analüüsiti sisuanalüüsi põhimõtetest lähtudes. Seda, kas osavõtjate teadmised ja oskused koolituse tulemusena muutusid ja kas kuulumine ühte või teise rühma avaldas muutustele mõju, hinnati kordusmõõtmiste üldistatud lineaarsete mudelitega. A nalüüsist ilmnes, et e-õppe rühma tulemused paranesid enam kui võrdlusrühma omad ning kaasava õpikeskkonna põimõppe rühma tulemused paranesid kõige rohkem. Seega on võimalik suhtlusoskusi veebi kaudu õppida.
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