bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychometric assessment of the Italian version of the melanoma module (SCNS-M12-Ita) of the Supportive Care Needs Survey (SCNS-SF34)
Authors: Miniotti Marco , Zeneli Anita , Bassino Stefania , Pavan Sara , Ribero Simone , Leombruni Paolo
Published: August 2019

Introduction:

This study examines the validity and the reliability of the translated-into-Italian version of the SCNS-SF34 melanoma module (SCNS-M12-Ita) for a sample of patients with melanoma ( n = 268).

Methods:

Content validity was analyzed by examining the redundancy of items. Floor/ceiling effects were investigated via frequency tables. Factor structure was studied through principal component analysis. Internal consistency was evaluated with Cronbach α. Test–retest reliability was analyzed using intraclass correlation coefficients (ICCs). Convergent–discriminant validity was studied by calculating Pearson correlations. Construct validity was investigated by comparing subgroups of patients through multivariate analysis of variance.

Results:

Content validity of the SCNS-M12-Ita was satisfactory. The floor effect ranged from 24.3% to 82.5%. The 2-factor solution explained 61.4% of the total variance. Internal consistency was excellent for component 1 (α = 0.92) and questionable (α = 0.58) for component 2. Test–retest reliability was excellent for component 1 (ICC = 0.92) and poor for component 2 (ICC = 0.58). Except for component 2, item-total correlations were greater than 0.60. Construct validity was confirmed, as the expected correlations ( r < 0.40) were observed and 60% of the postulated hypotheses about between-group differences were confirmed.

Conclusions:

The study demonstrated that the SCNS-M12-Ita is a valid and reliable instrument for assessing the supportive care needs of patients with melanoma.
The Effect of Student Loan Debt on Spending: The Role of Repayment Format
Authors: Zhang Yi , Wilcox Ronald T. , Cheema Amar
Published: August 2019

Across three studies, the authors investigate the effect of student loan debt on spending. Evidence from consumer finance data and experimental scenarios reveals that borrowers with moderate student loan debt are less likely to spend than people with low (or no) debt. However, borrowers with high debt are more likely to spend relative to those with moderate debt. The latter effect is consistent with goal disengagement, as paying off high student loan debt seems difficult. Importantly, the spending propensity associated with high student loan debt is attenuated by presenting the debt in a monthly payment (vs. lump-sum) format, which reduces perceived payoff difficulty. From a public policy perspective, the authors recommend that estimated monthly payments be included in all student loan disclosures.
Implementation science as a leadership capability to improve patient outcomes and value in healthcare
Authors: Votova Kristine , Laberge Anne-Marie , Grimshaw Jeremy M. , Wilson Brenda
Published: August 2019

When evidence thresholds are met, adopting healthcare innovations should add value, and this is forgone when evidence is not translated into practice. Activities that are not supported by evidence lead to ineffective or unnecessary care, or harm, poor outcomes, and low-value healthcare. This article provides an overview of implementation science, which is the scientific study of why implementation succeeds or fails. We draw parallels between the LEADS in a Caring Environment leadership framework and implementation science process models and frameworks. Taken together, the principles and practices in LEADS and the aims of implementation science are effectively quite similar and can be useful for healthcare management looking to optimize resources when implementing evidence-based practice and innovation into routine clinical care.
Equipoise in Appropriate Initial Volume Resuscitation for Patients in Septic Shock With Heart Failure: Results of a Multicenter Clinician Survey
Authors: Wardi Gabriel , Joel Ian , Villar Julian , Lava Michael , Gross Eric , Tolia Vaishal , Seethala Raghu R. , Owens Robert L. , Sell Rebecca E. , Montesi Sydney B. , Rahaghi Farbod N. , Bose Somnath , Rai Ashish , Stevenson Elizabeth K. , McSparron Jakob , Tolia Vaishal , Beitler Jeremy R.
Published: August 2019

Purpose:

International clinical practice guidelines call for initial volume resuscitation of at least 30 mL/kg body weight for patients with sepsis-induced hypotension or shock. Although not considered in the guidelines, preexisting cardiac dysfunction may be an important factor clinicians weigh in deciding the quantity of volume resuscitation for patients with septic shock.

Methods:

We conducted a multicenter survey of clinicians who routinely treat patients with sepsis to evaluate their beliefs, behaviors, knowledge, and perceived structural barriers regarding initial volume resuscitation for patients with sepsis and concomitant heart failure with reduced ejection fraction (HFrEF) <40%. Initial volume resuscitation preferences were captured as ordinal values, and additional testing for volume resuscitation preferences was performed using McNemar and Wilcoxon signed rank tests as indicated. Univariable logistic regression models were used to identify significant predictors of ≥30 mL/kg fluid administration.

Results:

A total of 317 clinicians at 9 US hospitals completed the survey (response rate 47.3%). Most respondents were specialists in either internal medicine or emergency medicine. Substantial heterogeneity was found regarding sepsis resuscitation preferences for patients with concomitant HFrEF. The belief that patients with septic shock and HFrEF should be exempt from current sepsis bundle initiatives was shared by 39.4% of respondents. A minimum fluid challenge of ∼30 mL/kg or more was deemed appropriate in septic shock by only 56.4% of respondents for patients with concomitant HFrEF, compared to 89.1% of respondents for patients without HFrEF ( P < .01). Emergency medicine physicians were most likely to feel that <30 mL/kg was most appropriate in patients with septic shock and HFrEF.

Conclusions:

Clinical equipoise exists regarding initial volume resuscitation for patients with sepsis-induced hypotension or shock and concomitant HFrEF. Future studies and clinical practice guidelines should explicitly address resuscitation in this subpopulation.
Effects of Pharmacist-Conducted Medication Reconciliation at Discharge on 30-Day Readmission Rates of Patients With Chronic Obstructive Pulmonary Disease
Authors: Singh Divita , Fahim Germin , Ghin Hoytin Lee , Mathis Scott
Published: August 2019

Purpose:

To analyze effect of pharmacist-conducted medication reconciliation on 30-day readmission rates in chronic obstructive pulmonary disease (COPD) and identify common medication errors among patient with readmissions.

Methods:

Pharmacists were educated on discharge medication reconciliation for patients with COPD. A retrospective chart review was conducted on patients who underwent pharmacist-conducted discharge medication reconciliation to determine 30-day readmissions. Medication errors analyzed included medication omissions and dose or frequency errors. Previously collected internal research without pharmacist-conducted medication reconciliation served as the control.

Results:

There were 65 patients in the control group and 50 in the intervention group. About 25% of patients in the control group and 26% of patients in the intervention group had any cause readmissions within 30 days of discharge ( P = .87). Both the control and the intervention group had similar COPD-related readmissions of 12.3% and 12.6%, respectively. Medication dose or frequency errors consisted of 68.9% and 46.7% of total errors in the control and the intervention groups, respectively. Long-acting muscarinic antagonist (LAMA) or long-acting beta 2-agonist (LABA) were the most common drug classes to be incorrectly dosed or omitted at discharge. In the intervention group, 30 errors were identified. Due to inability to coordinate discharges, pharmacists intervened on 13 errors, 7 of which were accepted by the prescriber.

Conclusion:

Pharmacist-conducted medication reconciliation at discharge did not affect 30-day readmission rates of patients with COPD. Confounding factors included a small sample size, passive pharmacist education, and discharge issues. The most common medication errors at discharge were dosing or frequency errors of LABAs or LAMAs.
Mitochondrial and lysosomal protective agents ameliorate cytotoxicity and oxidative stress induced by cyclophosphamide and methotrexate in human blood lymphocytes
Authors: Salimi A , Pirhadi R , Jamali Z , Ramazani M , Yousefsani BS , Pourahmad J
Published: August 2019

Cyclophosphamide (CYP) and methotrexate (MTX) have been evaluated for their ability to induce toxicity in human peripheral blood lymphocytes (PBLs) and the protective role of mitochondrial and lysosomal stabilizing agents. The potential toxicity effects of CYP and MTX were measured in vitro by cellular parameters assays such as cellular viability, reactive oxygen species (ROS) formation, mitochondrial membrane permeability transition (mitochondrial membrane potential (MMP)) collapse, lysosomal membrane damage, intracellular reduced glutathione (GSH), extracellular oxidized glutathione (GSSG), and lipid peroxidation. Separately, human lymphocytes were treated with concentrations of 0.1, 0.2, 0.4, 0.8, and 1.6 ng/mL for CYP and 1, 2, 5, and 10 µg/mL for MTX for 6 h. Statistical evaluations showed that CYP and MTX significantly decreased the cell viability at the three highest concentrations when compared with both the negative and solvent controls. In addition, CYP and MTX were significantly induced ROS formation, MMP collapse, lysosomal membrane damage, lipid peroxidation, and GSH depletion compared with the controls. Mitochondrial and lysosomal protective agents like cyclosporine A and chloroquine, respectively, decreased cytotoxicity and oxidative stress induced by CYP and MTX. The present results indicate that CYP and MTX are toxic to human PBLs and their toxicity could be ameliorated by mitochondrial and lysosomal protective agents.
‘I Too Am a Human’: The Political Psychology of Pakistan’s Former President General Pervez Musharraf
Authors: Conley Ross F.
Published: August 2019

This study explores the political psychology of General Pervez Musharraf, Pakistan’s most recent military dictator. It categorises his ‘operational code’—a collection of general political beliefs assessed from spoken and/or written statements—over four periods of his nine years of power.

By analysing word choices in 55 interviews and press conferences, the findings suggest that Musharraf maintained stable beliefs of a friendly political universe and a preference for cooperative strategies to achieve his goals. The largest changes in his beliefs came immediately after 9/11. Before, Musharraf expressed his strongest beliefs of a friendly political universe and favour for cooperation. After 9/11, these beliefs decreased, but they remained overall friendly and cooperative.

Additionally, 9/11 appears to have had the largest influence on Musharraf’s beliefs on how he should operate to meet his goals (instrumental beliefs), not on his beliefs of others in the political environment (philosophical beliefs).

Applied today, this can be useful when engaging Pakistan’s leaders. With Musharraf as an example, the long-held, philosophical beliefs of Pakistan’s leaders may not easily change. Foreign officials may find more success accepting these beliefs and focusing on shared goals that align with Pakistan’s political worldview.
Hawks Engineering Works: At the Crossroads of Growth
Authors: Shahid Muhammad Shehryar , Ahsan Saad Raafay
Published: August 2019

This case revolves around Hawks Engineering Works (HEW), an automotive parts supplier based in Lahore, Pakistan. Registered as a private partnership between the founding partners, Shahid and Akram, in 1987. HEW specializes in the supply of door hinges and door lock strikers for different automobiles. HEW has monopolized the production of these specialized parts and counts the ‘big three’ OEMs, i.e., Honda, Toyota and Suzuki, amongst its customers. While HEW has been an exemplary company over the years, winning many ‘best vendor’ awards for quality and delivery, recently, the company has been plagued with complaints from their biggest customers. These complaints center on miscommunication from HEW’s side on different matters, as well as late deliveries and falling quality standards. HEW’s management must thus evaluate what has gone wrong while the company has grown from a small entrepreneurial concern to a mid-sized organization. For this purpose, students must first understand the founders’ entrepreneurial journey. This will lead them to analyze HEW’s growth trajectory over the years, to identify its current positioning on this growth spectrum, and seek out and attempt to correct any misalignments in the company’s key management factors, which will help determine its future growth prospects.
Black Women: Perceptions and Enactments of Leadership
Authors: Aaron Tiffany S.
Published: August 2019

This critical in-depth interview study examined four Black women principals’ perceptions, descriptions, and enactments of school leadership as it relates to their intersectional identities as being both Black and women. The tenets of Black feminist epistemology and the theory of intersectionality form the conceptual framework of this study. Research demonstrates that Black women leaders’ multiplicative identity as Black and women influences their experiences and perceptions of leadership. The principals’ perceptions of school leadership developed into several categories and two themes: student-centered leadership and perceptions of racial stereotypes and deconstructing perceptions about Black women.
Differences in the Tensor Veli Palatini Muscle and Hearing Status in Children With and Without 22q11.2 Deletion Syndrome
Authors: Perry Jamie L. , Kotlarek Katelyn J. , Spoloric Kelly , Baylis Adriane , Kollara Lakshmi , Grischkan Jonathan M. , Kirschner Richard , Bates David Gregory , Smith Mark , Findlen Ursula
Published: August 2019

Purpose:

To investigate the dimensions of the tensor veli palatini (TVP) muscle using high image resolution 3-dimensional magnetic resonance imaging (MRI) of the soft palate among children with normal velopharyngeal and craniofacial anatomy and to compare values to individuals with a diagnosis of 22q11.2 deletion syndrome (22q11DS). We also sought to determine whether there is a relationship between hypoplasia of the TVP and severity of middle ear dysfunction and hearing loss.

Methods:

Three-dimensional MRI were used to collect and analyze data obtained across 53 children between 4 and 12 years of age, including 40 children with normal velopharyngeal and craniofacial anatomy and 13 children with a diagnosis of 22q11.2 DS. Tensor veli palatini muscle length, thickness, and volume as well as bihamular distance were compared among participant groups.

Results:

A Welch’s t-test revealed that the TVP in participants with 22q11DS is significantly shorter ( P = .005, 17.3 vs 19.0 mm), thinner ( P < .001, 1.1 vs 1.8 mm), and less voluminous ( P < .001, 457.5 vs 667.3 mm3) than participants without 22q11DS. Participants with 22q11DS also had a greater ( P = .006, 27.7 vs 24.7 mm) bihamular distance than participants without 22q11DS. There was an inverse relationship between TVP abnormalities noted above and the severity of audiologic and otologic histories.

Conclusion:

The TVP muscle is substantially reduced in volume, length, and thickness in children with 22q11DS. These findings serve as preliminary support for the association of patient hearing and otologic severity and TVP dysmorphology.
‘It’s Called Being Her Dog’: Young Men Talk About Being Boyfriends, Homosociality and the Expelling of Femininity in Aotearoa/New Zealand
Authors: Vogels Christina
Published: August 2019

This article showcases how young men, from a high school in Aotearoa/New Zealand, made sense of the rules of homosociality, with specific reference to how boyfriends and girlfriends should act in their relationships with one another. Young men talked about the importance of being a ‘good’ homosocial mate, which led them to also talk about the importance of expelling femininity as a way for them to manage their masculine identities and avoid being shamed, and therefore feminized. This article will argue that these reactions to femininity were embedded in a homosocial habitus, influencing how young men made sense of the various overlapping fields of action. Young men’s talk, however, also presented a range of ambivalences that contradicted these endorsements of homosociality. These contradictions are meaningful because of the opportunities they present in disrupting the hegemonic sense-makings of homosociality and gendered roles in (hetero) romantic interactions.
The production of space through transmediated identity practices: Spatial self in Instagram at Mavibahçe Shopping Centre in İzmir
Authors: Yılmaz Ahenk , Kocabalkanlı Ezgi
Published: August 2019

Widespread use of locative media and its integration with social media applications has provided individuals with the new ways of identity practices. Through checking in at locations, uploading still and moving images of/with certain spaces, and adding hashtags to proliferate meanings, space has turned into a stage where self-identities are digitally practiced. Within this context, this article explores the production of space through these practices on Instagram in the case study of Mavibahçe Shopping Center in Izmir, Turkey. The analysis based on questionnaires and digital media surveys targets the converged space of the same digital and physical location of Mavibahçe with the aim of providing insights into the use of space for identity constructions. The study concludes that visitors reproduce space through transmediated identity practices in Instagram in order to demonstrate their affiliations to certain lifestyles as part of their digital habitus. While they perform these acts, they prefer to use the spatial attributes that they favor as the background setting of their spatial self and tag only affirmative hashtags for their spatial experiences along with these representations, which reproduce the space of the chosen architectural settings in the digital media.
Overview of recent cases before the court of justice of the European Union (February 2019-June 2019)
Authors: van der Mei Anne Pieter , Melin Pauline
Published: August 2019

In the reporting period (February 2019-June 2019), the Court of Justice of the European Union did not deliver any ground breaking rulings that really altered existing coordination rules on social security. Nonetheless, the Court did rule in various interesting cases. These include the material scope of Regulation 883/2004 ( Dreyer), the rules determining the applicable legislation ( SF), invalidity benefits ( Vester), and family benefits ( Bogatu). In addition, the Court brought about clarification of the possibility of retaining worker status (and thus claiming social benefits as a worker) under Directive 2004/38 ( Tarola) and the right of Turkish nationals to export benefits under Decision 3/80 when returning to Turkey ( Coban).
Mandatory Reporting of Intimate Partner Violence: A Mixed Methods Systematic Review
Authors: Vatnar Solveig Karin Bø , Leer-Salvesen Kjartan , Bjørkly Stål
Published: August 2019

As one of the efforts to prevent intimate partner violence (IPV) and intimate partner homicide, countries have adopted legislation requiring professionals to report cases of IPV, or suspected IPV injuries, to the police or the criminal justice system. The term for this is mandatory reporting. In spite of its good intention, mandatory reporting of IPV is a controversial issue. The objective of this review was to systematically search for, appraise the quality of, and synthetize the evidence from quantitative and qualitative studies on mandatory reporting of IPV. A systematic review of the scientific literature was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. A comprehensive search was conducted through Ovid MEDLINE, PsycINFO, Scopus, Criminal Justice Abstracts, and SveMed+. Articles were included if they (a) were peer-reviewed empirical studies rather than theories or discussions, (b) described mandatory reporting of IPV, and (c) were written in English or Scandinavian languages. No time limit was applied. Twenty-five research studies met the criteria for review. Victims were generally supportive of a law requiring professionals to report IPV, although subsamples’ attitudes opposing mandatory reporting were presented as main findings in a substantial number of studies. Group differences between abused or nonabused women and knowledge about mandatory reporting of IPV among professionals was mixed and inconclusive. Few professionals had actually reported IPV under mandatory reporting. Empirical research appears to be scarce, with moderate to high degree of bias and with only limited recent development.
Mom Controls the Thermostat: Mitochondria Influence the Neuronal Firing Set Point
Authors: Gallagher Martin J.
Published: August 2019

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Bible Study as Luminous Converting Encounter: Swiss Pietist Initiatives in 19th-Century French Canada
Authors: Scorgie Glen G.
Published: August 2019

This article examines the understanding and use of Scripture in the evangelistic endeavors of “awakened” pietistic francophone Swiss Protestant missionaries in 19th-century French Canada (after 1867, Quebec). It begins by sketching the roots of this transatlantic initiative in Le Réveil, the Continental francophone expression of the Second Evangelical Awakening. It then shows how within this movement historic Protestant Bible-centeredness converged with an intensified pietistic expectation that receptive contemplation of Scripture (especially in conversational settings) could evoke profoundly experiential and transforming encounters with the divine. The records of the Swiss missionaries also display a mystic-like apprehension of Scripture’s luminosity, and of conversion as a comprehensively illuminating and radiant experience. This account challenges the assumption that mystical tendencies necessarily lead to privatized spirituality, while illustrating how a distinct form of evangelical spirituality stimulated missionary endeavor and shaped missionary practice.
Prenatal Yoga for Back Pain, Balance, and Maternal Wellness: A Randomized, Controlled Pilot Study
Authors: Holden Selma C , Manor Brad , Zhou Junhong , Zera Chloe , Davis Roger B , Yeh Gloria Y
Published: August 2019

Background

The objective was to assess the feasibility of a prenatal yoga randomized controlled trial (RCT) for gestational low back pain (LBP), mobility, and maternal well-being.

Methods

In this pilot, women aged 18 to 39 years with uncomplicated pregnancies at 12 to 26 weeks were randomized, stratified by presence of LBP, to attend a weekly yoga class or a time-matched educational support group for 12 weeks. Sample size was based on anticipated enrollment of 2 subjects per month. Primary outcomes were measures of feasibility and acceptability. Secondary outcomes included LBP disability, pregnancy symptom burden, childbirth self-efficacy, instrumented gait, balance, and falls at baseline, every 4 weeks, and 6 weeks postpartum.

Results

From April 2015 to December 2015, 168 women were contacted and 115 (68%) were eligible. Twenty women enrolled (N = 11 yoga; N = 9 control; mean gestational age 20.2 weeks). Retention at 12 weeks was 81% in yoga and 77% in control. There were no yoga-related adverse events. Exploratory analyses show no differences in back pain disability between groups. Significant groups effects were found on biomechanical assessments, including percentage change in gait speed ( F = 4.4, P =  .04), double support time ( F = 23.6, P < .01), instrumented timed-up-and-go ( F = 8.6, P < .01), and turn time ( F = 5.7, P = .02) suggesting clinically relevant improvements with yoga. Pregnancy Symptom Inventory (PSI) scores improved (13.1 point difference, 95% confidence interval, 5.1–21.1) at 12 weeks in yoga compared to control, adjusted for baseline gestational age.

Conclusion

Conducting an RCT of prenatal yoga to improve gestational LBP and maternal well-being is feasible and safe. While no differences in back pain were observed, biomechanical measures were sensitive assessments for evaluating gestational LBP-related mobility impairment and showed group differences. Additionally, the PSI showed significant differences in symptom burden over 12 weeks, supporting the ongoing claims that yoga improves a pregnant woman’s overall well-being.
Economic Populism and Bandwagon Bigotry: Obama-to-Trump Voters and the Cross Pressures of the 2016 Election
Authors: Morgan Stephen L. , Lee Jiwon
Published: August 2019

Through an analysis of validated voters in the 2016 American National Election Study, this article considers the voters who supported Obama in 2012 and Trump in 2016. More than 5.7 million in total, Obama-to-Trump voters were crucial to Trump’s victory in the Electoral College. They were more likely to be white, working class, and resident in the Midwest. They had lower levels of political interest, were centrist in both party affiliation and ideology, and were late deciders for the 2016 election. On economic interests, they were centrists, except for trade policy, which they viewed, on average, as a greater threat than other voters. They claimed to have more experience with economic vulnerability than Democratic loyalists of comparable social standing. On racial attitudes, including the racialized economic topic of immigration, they had a profile similar to Republican loyalists. While their support of Trump may be attributable to surging white nativism, this article argues for an alternative explanation. Voters who were attracted by Trump’s economic populism only joined his coalition if they could accept his racialized rhetoric. As a result, the Trump bandwagon predominantly attracted generically bigoted voters with racial attitudes similar to Republican loyalists.
Geographic disparity in systemic sclerosis mortality in the United States: 1999–2017
Authors: Rodriguez-Pla Alicia , Simms Robert W
Published: August 2019

Introduction:

Previous studies reported a progressive decrease in the systemic sclerosis mortality rates in the United States from 1959 to 2002. Identification of areas with clusters of higher mortality rates is important to implement targeted interventions. In this study, we aimed to estimate the mortality rates of scleroderma and to analyze its geographic variability at the state level in the United States.

Methods:

Mortality rates of scleroderma from 1999 to 2017 were obtained from the CDC Wonder Underlying Cause of Death database and its query system, using International Classification of Diseases, Tenth Revision codes. Age-adjusted rates were calculated by state and demographics. A linear regression model was applied to evaluate trends over time.

Results:

Over the period studied, a total of 24,525 deaths had scleroderma as the underlying cause of death. The age-adjusted mortality rate was 3.962 per million (95% CI: 3.912–4.012), decreasing progressively from 4.679 (95%CI: 4.423–4.934) in 1999 to 2.993 (95% CI: 2.817–3.170) per million in 2017. The age-adjusted mortality rate was 5.885 (95% CI: 5.802–5.967) and 1.651 (95% CI: 1.604–1.698) per million in females and males, respectively. Per races, the highest age-adjusted mortality rate was in Blacks or African Americans, at 5.703 per million (95% CI: 5.521–5.885), followed by American Indians or Alaska Native at 5.047 per million (95% CI: 4.428–5.667). Clusters of states with higher and lower mortality rates were identified. South Dakota had the highest whereas Hawaii had the lowest mortality rate.

Conclusion:

We found a trend to a progressive decrease in mortality rates of scleroderma during the years of our study. In addition, we found relevant state-by-state variation in mortality with several geographical clusters with higher mortality rates. Further analyses are warranted in order to better understand the factors associated with the observed geographic disparities.
Retinal Vascular Changes on Optical Coherence Tomography Angiography and Ultra-widefield Fluorescein Angiography in Patients With Chronic Leukemia
Authors: Liu T. Y. Alvin , Smith B. Douglas , Mackey Karen , Linz Marguerite O. , Scott Adrienne W.
Published: August 2019

Purpose:

This article describes pathological retinal vascular changes on multimodal imaging in patients with chronic leukemia.

Methods:

A prospective, observational study was conducted. Patients with chronic leukemia and concurrent leukocytosis were recruited from a tertiary-referral, academic medical center. Eligible patients received complete ophthalmic examinations and multimodal retinal imaging: spectral-domain optical coherence tomography (SD-OCT), optical coherence tomography angiography (OCTA), and ultra-widefield fluorescein angiography (UWF FA).

Results:

Six patients (11 eyes) were consecutively enrolled. At presentation, mean age was 56.9 years, median visual acuity was Snellen 20/20, and median leukocyte count was 114.5 K/mm3 (upper limit of normal: 11.00). Three of 11 eyes had SD-OCT abnormalities, including focal retinal thinning and hyperreflective material at the level of the retinal pigment epithelium. Five of 11 eyes showed OCTA abnormalities, including focal vascular flow loss and a diffuse decrease in vascular density. Four of 11 eyes had peripheral retinal abnormalities on UWF FA, including microaneurysms and nonperfusion. Five of 11 eyes showed pathological vascular changes on retinal imaging, and of these 5 eyes, 3 had unremarkable retinal examinations.

Conclusions:

Retinal vascular pathologies are frequently seen in patients with chronic leukemia and concurrent leukocytosis, though these patients are rarely symptomatic. Multimodal imaging allows for more sensitive detection of these pathologies compared with clinical examination alone. On OCTA, pathological vascular flow loss is more evident in the superficial capillary plexus. There may be a correlation between pathologies seen in the central and peripheral retina, but this observation will need to be confirmed by a future study with a larger cohort.
3D diffraction imaging with Kirchhoff time migration using vertical traveltime difference gathers
Authors: Li Zhengwei , Zhang Jianfeng
Published: August 2019

We have built a vertical traveltime difference (VTD) gather to image diffractions in the 3D time domain. This significantly improves detection of small-scale faults and heterogeneities in 3D seismic data. The VTD gather is obtained using 3D Kirchhoff prestack time migration based on the traveltime-related inline and crossline dip angles, which is closely related to the 2D dip-angle gather. In VTD gathers, diffraction events exhibit flattening, whereas reflection events have convex upward-sloping shapes. Different from the 2D dip-angle gather, Fresnel zone-related specular reflections are precisely focused on the given regions over all offsets and azimuths, thus leaving more diffraction energy after muting. To image linear diffractors, such as faults in three dimensions, the VTD gather can be extended into two dimensions by adding a dip-azimuth dimension. This makes it possible to correct phases of edge diffractions and detect the orientations of the linear diffractors. The memory requirement of the VTD or VTD plus azimuth gathers is much less than that of the 2D dip-angle gathers. We can store the gathers at each lateral position and then correct the phase and enhance the weak diffractions in 3D cases. Synthetic and field data tests demonstrate the effectiveness of our 3D diffraction imaging method.
Pathogenesis of Anti–PIT-1 Antibody Syndrome: PIT-1 Presentation by HLA Class I on Anterior Pituitary Cells
Authors: Kanie Keitaro , Bando Hironori , Iguchi Genzo , Muguruma Keiko , Matsumoto Ryusaku , Hidaka-Takeno Ryoko , Okimura Yasuhiko , Yamamoto Masaaki , Fujita Yasunori , Fukuoka Hidenori , Yoshida Kenichi , Suda Kentaro , Nishizawa Hitoshi , Ogawa Wataru , Takahashi Yutaka
Published: August 2019

Context

Anti–pituitary-specific transcriptional factor-1 (anti–PIT-1) antibody syndrome is characterized by acquired and specific deficiencies in growth hormone, prolactin, and thyroid-stimulating hormone. Although PIT-1–reactive cytotoxic T lymphocytes (CTLs) have been speculated to recognize anterior pituitary cells and to cause the injury in the pathogenesis of the syndrome, it remains unclear whether endogenous PIT-1 protein is processed through the proteolytic pathway and presented as an antigen on anterior pituitary cells.

Objective

To examine how PIT-1 protein is processed and whether its epitope is presented by major histocompatibility complex (MHC)/HLA class I on anterior pituitary cells.

Materials and Methods

Immunofluorescence staining and proximity ligation assay (PLA) were performed using anti–PIT-1 antibody and patients’ sera on PIT-1–expressing cell line GH3 cells and human induced pluripotent stem cell (iPSC)-derived pituitary tissues.

Results

PIT-1 was colocalized with MHC class I molecules, calnexin, and GM130 in the cytosol. PLA results showed that PIT-1 epitope was presented by MHC/HLA class I molecules on the cell surface of GH3 cells and iPSC-derived pituitary cells. The number of PIT-1/HLA complexes on the cell surface of pituitary cells in the patient was comparable with that in the control subject.

Conclusions

Our data indicate that PIT-1 protein is processed in the antigen presentation pathway and that its epitopes are presented by in MHC/HLA class I on anterior pituitary cells, supporting the hypothesis that PIT-1–reactive CTLs caused the cell-specific damage. It is also suggested that number of epitope presentation was not associated with the pathogenesis of anti–PIT-1 antibody syndrome.
Multifocus Fluorescence Correlation Spectroscopy with Spatially Separated Excitation Beams
Authors: Otosu Takuhiro , Ishii Kunihiko , Tahara Tahei
Published: August 2019

We report on a new multifocus optical system developed for fluorescence correlation spectroscopy (FCS). This system utilizes a beamsplitter array to spatially separate excitation beams. Fluorescence from each spot is individually detected with a single-photon avalanche photodiode (SPAD) through a fiber bundle. The combined use of beamsplitters and multiple SPADs is beneficial to give a higher detection uniformity among focal spots than the existing multifocus FCS systems. Applications of this setup show that the variation of the optical parameters among seven focal spots are as small as ∼5% and prove its high performance in FCS measurements. High efficiency of this system is also demonstrated in application to an advanced FCS method, two-dimensional fluorescence lifetime correlation spectroscopy. Along with the results of these applications, we describe a method for proper correction of the crosstalk effect in the multifocus setup.
Role Play As a Method for the Development of Creative communicative Activity of a Primary School Child
Authors: Виноградова Наталья , Vinogradova Natalya
Published: August 2019

The article discusses the problem of the formation of creative communicative activity in elementary school students, describes the conditions for the development of students’ ability to enter into a role dialogue. Examples of dialogical role plays that provide the formation of dialogue skills among junior schoolchildren, as well as brief monological statements as part of dialogic speech, are given.
Stimulating the Search Activity of Primary Schoolchildren in the Process of Solving Educational Problems
Authors: Аксючиц Светлана , Aksyuchic Svetlana
Published: August 2019

The article raises the problem of the formation of the search activity of younger schoolchildren and the formation of their subjective position in learning. The essence of the concept of “educational task” is revealed as a component of educational activity. The structure of the lesson is described, in the process of which the skills of younger schoolchildren to solve educational problems that are aimed at mastering generalized methods of objective actions are formed. This provides the opportunity for students to master the system of scientific concepts that allows selfdevelopment and self-learning. A concrete example of solving the educational problem in the lesson of the Russian language in the second grade

is given.
Ways to Improve the Financial Literacy of Primary and Secondary School Children
Authors: Кочурова Елена , Kochurova Elena , Романова М. , Romanova M.
Published: August 2019

The article discusses approaches to the formation of financial literacy and the introduction to the financial culture of children and adolescents attending primary and basic school. The questionnaire data are analyzed, the general questions of including the content of financial literacy training in the process of teaching different subjects are considered. The program of the training course “Financial literacy of primary and secondary school students” is offered.
Improving Resident Feedback on Diagnostic Reasoning after Handovers: The LOOP Project
Authors: Lane Kathleen P , Chia Catherine , Lessing Juan N , Limes Julia , Mathews Benji , Schaefer Julie , Seltz L Barry , Turner Grant , Wheeler Brittany , Wooldridge David , Olson Andrew PJ
Published: August 2019

Appropriate calibration of clinical reasoning is critical to becoming a competent physician. Lack of follow‐up after transitions of care can present a barrier to calibration. This study aimed to implement structured feedback about clinical reasoning for residents performing overnight admissions, measure the frequency of diagnostic changes, and determine how feedback impacts learners' self‐efficacy. Trainees shared feedback via a structured form within their electronic health record's secure messaging system. Forms were analyzed for diagnostic changes. Surveys evaluated comfort with sharing feedback, self‐efficacy in identifying and mitigating cognitive biases' negative effects, and perceived educational value of night admissions—all of which improved after implementation. Analysis of 544 forms revealed a 43.7% diagnostic change rate spanning the transition from night‐shift to day‐shift providers; of the changes made, 29% (12.7% of cases overall) were major changes. This study suggests that structured feedback on clinical reasoning for overnight admissions is a promising approach to improve residents' diagnostic calibration, particularly given how often diagnostic changes occur.
Community Pediatric Hospitalist Workload: Results from a National Survey
Authors: Alvarez Francisco , McDaniel Corrie E , Birnie Krista , Gosdin Craig , Mariani Allison , MD Natalia Paciorkowski , Mendez Suzanne Swanson , Weng Yingjie , Fromme H Barrett
Published: August 2019

As a newly recognized subspecialty, understanding programmatic models for pediatric hospital medicine (PHM) programs is vital to lay the groundwork for a sustainable field. Although variability has been described within university‐based PHM programs, there remains no national benchmark for community‐based PHM programs. In this report, we describe the workload, clinical services, employment, and perception of sustainability of 70 community‐based PHM programs in 29 states through a survey of community site leaders. The median hours for a full‐time hospitalist was 1,882 hours/year with those employed by community hospitals working 8% more hours/year and viewing appropriate morning pediatric census as 20% higher than those employed by university institutions. Forty‐three out of 70 (63%) site leaders perceived their programs as sustainable, with no significant difference by employer structure. Future studies should further explore root causes for workload discrepancies between community and academic employed programs along with establishing potential standards for PHM program development.
Things We Do for No Reason™: Discontinuing Buprenorphine When Treating Acute Pain
Authors: Haber Lawrence A , DeFries Triveni , Martin Marlene
Published: August 2019

Inspired by the ABIM Foundation's Choosing Wisely® campaign, the “Things We Do for No Reason™” (TWDFNR™) series reviews practices that have become common parts of hospital care but may provide little value to our patients. Practices reviewed in the TWDFNR™ series do not represent “black and white” conclusions or clinical practice standards but are meant as a starting place for research and active discussions among hospitalists and patients. We invite you to be part of that discussion.
Maintenance Location Routing for Rolling Stock Under Line and Fleet Planning Uncertainty
Authors: Tönissen Denise D. , Arts Joachim J. , Shen Zuo-Jun (Max)
Published: August 2019

Rolling stock needs regular maintenance in a maintenance facility. Rolling stock from different fleets are routed to maintenance facilities by interchanging the destinations of trains at common stations and by using empty drives. We consider the problem of locating maintenance facilities in a railway network under uncertain or changing line planning, fleet planning, and other uncertain factors. These uncertainties and changes are modeled by a discrete set of scenarios. We show that this new problem is NP-hard and provide a two-stage stochastic programming and a two-stage robust optimization formulation. The second-stage decision is a maintenance routing problem with similarity to a minimum cost-flow problem. We prove that the facility location decisions remain unchanged under a simplified routing problem, and this gives rise to an efficient mixed-integer programming (MIP) formulation. This result also allows us to find an efficient decomposition algorithm for the robust formulation based on scenario addition (SA). Computational work shows that our improved MIP formulation can efficiently solve instances of industrial size. SA improves the computational time for the robust formulation even further and can handle larger instances due to more efficient memory usage. Finally, we apply our algorithms on practical instances of the Netherlands Railways and give managerial insights.
Health problems of individuals with autism spectrum disorder
Authors: Yılmaz Medine , Sari Hatice Yildirim , Coşansu Gülhan Kuzu , Nahcivan Nursen , Aktaş Betül , Tiraki Zeliha , Dogruyol Devrim
Published: August 2019

Aim:

The purpose of this study is to determine the health needs of individuals with autism spectrum disorder (ASD) using the Problem Classification Scheme (PCS), one of the main components of the Omaha System. The data obtained are expected to guide health programmes focusing on the needs of individuals with ASD.

Method:

This descriptive study was conducted at a special education implementation centre providing daytime education for individuals with ASD. Data obtained by the institutional nurse during the daily diagnosis and examination procedures of the ambulatory treatment unit in the centre were defined by another researcher according to the PCS forms. Routine health care was provided for all the individuals whose condition was diagnosed.

Results:

The 10 most frequently documented problems were personal care (83.78%), mental health (62.84%), speech and language (61.49%), social contact (50%), interpersonal relationship (42.57%), cognition (32.43%), income (28.38%), medication regimen (24.32 %), nutrition (22.30%) and neglect (18.92%).

Conclusion:

The results indicate that it is useful to use the Omaha System in determining the health needs of an individual with autism holistically, and in assessing and evaluating the individual's care, as it provides a standardised language.

Impact statements:

The Omaha PCS System can be used by nurses in the holistic diagnosis of the health status of individuals with ASD.
Quality assessment of the physicochemical properties of vermiwash produced from different sources during successive storage periods
Authors: JAIKISHUN SIRPAUL , ADONIS SHAMIKA , ANSARI ABDULLAH ADIL
Published: August 2019

Abstract. Jaikishun S, Adonis S, Ansari AA. 2018. Quality assessment of the physicochemical properties of vermiwash produced from different sources during successive storage periods. Asian J Agric 2: 52-57. Organic farming is crucial for maintaining our health together with improving quality and quantity of crop production in environmentally friendly farming practices. Vermiwash is poised to be one of the key components in organic farming and reducing the enormous amounts of pollutants from the environment. This study aims to determine the physicochemical characteristics related to vermiwash from different sources (Jamun, Neem and Grass with combination and mixed with cattle dung) during a three-month storage period with monthly assessments and compared to fresh sample. While an increase in Electrical Conductivity (EC) was seen at the first month, successive decreases were noted thereafter with a significant difference (p=0.05) being observed among the treatments (p=0.05) after three months. Total dissolved salts decreased over the storage period with significant difference being observed among the treatments and storage period revealed that at p=0.05, F (7, 21) = 3.9>2.49 Fcrit. and F (3, 21) = 3.8>2.49 respectively. Phosphorous decreased while potassium increased with T7 having the highest. Calcium showed a significant difference (p=0.05) among the treatments while magnesium fluctuated during the period but deceased at the end of the storage period. Analysis of ferrous content revealed a significant difference (p=0.05, F (7, 21) = 3.8>2.48 Fcrit.) with the time period being significantly different (p=0.05, F (3, 21) = 6.8>3.0) with an increase at the end of the storage period. Fresh form of vermiwash is best to use to obtain maximum nutrients as the general nutrient composition deteriorates over with time
Color modification and homogenization of sugi wood by steaming
Authors: TOLVAJ LASZLO , BANADICS ENDRE A , TSUCHIKAWA SATORU , MITSUI KATSUYA , PREKLET EDINA
Published: August 2019

Abstract. Tolvaj L, Banadics EA, Tsuchikawa S, Mitsui K, Preklet E. 2019. Color modification and homogenization of sugi wood by steaming. Asian J For 3: 20-24. Sugi (Cryptomeria japonica D. Don) wood samples were steamed applying broad range of steaming time (0-20 days) at 90 and 110°C steaming temperatures. The color change was monitored objectively using the CIE Lab color system. A wide range of colors was created by steaming between the initial color and light brown color depending on the steaming time and temperature. The initial color of earlywood and latewood within sapwood and heartwood covered a wide range of hue. The initial redness and yellowness values ranged from 4.3 to 17.3 and 21.4 to 31.6 units, respectively. Steaming produced excellent color homogenization and increased saturation. After 9 days of steaming at 110°C, redness values converged, falling between 11.6 and 12.7 units. The yellowness values increased and also converged. After 9 days of steaming at 110°C the yellowness values were between 31.6 and 33.5 units. The color saturation of the examined tissues increased considerably and was also showed homogenized. After 9 days of steaming at 110°C, the saturation values were between 34.1 and 35.6 units (the initial values were between 22.6 and 32.1). It was difficult to differentiate the sapwood and heartwood at the end of the steaming process at 110°C.