bluuebunny/crossref_metadata_2025 huggingface dataset:
The persistence of sexual assault within the US military
Authors: Wood Elisabeth Jean , Toppelberg Nathaniel
Published: September 2017

What accounts for the puzzling persistence of sexual assault of both women and men within the ranks of the US military? Despite increasing efforts to end this intraforce violence, sexual assault of women persists at levels comparable to those in the civilian population and significantly higher than that of other crimes (data challenges prevent comparing rates for men). Drawing on recent analysis of rape as a practice rather than a strategy of war, we suggest the answer lies in the socialization not only of recruits but also of officers. We draw on an original typology of socialization processes and analysis of four well-documented cases to suggest the following account of why sexual assault persists. First, informal socialization processes (including sexualized hazing) trivialize sexual harassment and assault, establish assault as an appropriate form of punishment (including of those transgressing military gender norms), and license retaliation against victims who report. Second, officers sometimes sexually harass and assault subordinates, thereby endorsing similar acts by servicemembers under their command. Third, formal socialization processes of enlisted men and women, despite recent reforms, continue to reproduce a masculinity that undermines policies that seek to prevent sexual assault, in part because it fails to override these unauthorized and illegal socialization processes. Finally, the socialization of officers, combined with problematic incentive structures, undercuts efforts to end the de facto tolerance of sexual abuse by many officers. In our emphasis on horizontal as well as top-down socialization processes, and on those that subvert official policies as well as those that seek to inculcate them, we also contribute to scholarly understanding of socialization within organizations more generally.
Evaluation of an np control chart under truncated life test using quick switching sampling system
Authors: Jeyadurga P , Balamurali S
Published: September 2017

In this paper, we propose a new attribute np control chart for monitoring Weibull distributed mean life of a product using a quick switching sampling system. The proposed control chart consists of two pairs of control limits, namely normal and tightened control limits. The optimal parameters of the proposed control chart, such as coefficients of control limits and experiment termination ratio, are determined so that the average run length (ARL) is close to the target in-control ARL. The ARL is calculated for various shift constants for the corresponding determined parameters. The performance of the proposed control chart is evaluated and compared with other existing charts in terms of ARL.
Is Hospitalization Necessary after Ear Surgery? A National Survey and Retrospective Review of Postoperative Events
Authors: Jelicic Tanja , Savage Julian Richard , Aron Margaret
Published: September 2017

Objective

First, to survey our national otolaryngology colleagues on their postoperative care habits (hospitalization vs day surgery) after elective middle ear surgery. Second, to evaluate the necessity of hospitalization and safety of day surgery after these procedures.

Methods

A national survey regarding postoperative habits after elective middle ear surgery was launched. Then, the cases of all patients having undergone these surgical procedures at our center between 2010 and 2016 were reviewed. They were divided into 2 groups: hospitalization and day surgery. Postoperative events during hospitalization and rate of consultation/readmission for day surgery were recorded.

Results

Heterogeneity in postoperative habits for most elective otologic surgery exists among otolaryngologists. For tympanoplasty, however, day surgery was uniformly favored. At our institution, 88.6% of hospitalization patients had no complications during their stay. Complications noted for others were nausea (7.2%), bleeding (3.1%), hematoma (0.5%), and sensorineural hearing loss (0.5%). In the day surgery group, 3.0% consulted within 48 hours following their procedure, and the readmission rate was 1.3%. Nausea was the only cause for readmission, and stapes surgery accounted for 100% of readmissions.

Discussion

Most elective middle ear surgery can be safely performed as day care. Hospitalization does not provide care that could not have been provided at home in the majority of cases. Overnight hospital stay may be considered for stapes surgery.

Implications for Practice

Day surgery for elective middle ear surgery is sufficient for most cases. Transferring these cases to day care should lower costs to our health care system and increase bed availability.
Landfarming: A contested space for the management of waste from oil and gas extraction
Authors: Bloomfield Brian P , Doolin Bill
Published: September 2017

The extraction of unconventional hydrocarbons, particularly through hydraulic fracturing (‘fracking’), has generated both support and opposition in many countries around the globe. Along with arguments about economic benefits, decarbonisation, transition fuels and groundwater contamination, etc., the rapid expansion of this industry presents a pressing problem as regards the disposal of the resultant waste – including drilling and cutting material, oil and gas residues, various chemicals used in the process, salts and produced water. One putative solution – ‘landfarming’ – is a disposal process that involves spreading oil and gas waste on to land and mixing it with topsoil to allow bioremediation of the hydrocarbons. This paper examines the case of landfarming in New Zealand where the practice has proved controversial due to its association with fracking, fears about the contamination of agricultural land and potential danger to milk supplies. Drawing upon Gieryn’s notion of cultural cartography and boundary work as well as the literature on the politics of scale it analyses the struggles for epistemic authority regarding the safety of landfarming. The paper concludes that scalar practices were central to the production of knowledge (and ignorance) in these credibility struggles, and that the prevailing cultural cartography of knowledge remained the arbiter and basis for policy. The case has wider implications in terms of the management of waste from unconventional hydrocarbons as well as other environmental issues in which the politics of scale figure in contested knowledge claims.
Nonprofit Pay in a Competitive Market: Wage Penalty or Premium?
Authors: King Christian , Lewis Gregory B.
Published: September 2017

Two competing theories argue that the nonprofit sector pays differently: Nonprofit employees may accept lower pay to be able to do meaningful work for a good cause, or they may earn higher pay due to nonprofit organizations’ tax exemptions and weaker incentives to hold down wages. To test these opposing expectations, we use the 2005-2013 American Community Surveys to examine pay differences among registered nurses working for nonprofit, for-profit, and public hospitals. We also test hypotheses that public and nonprofit hospitals have smaller pay disparities by gender, race, and relationship status. We find that pay is highest in nonprofit hospitals, partly because they attract better-educated and more experienced nurses, but partly because they pay comparable nurses more than for-profit hospitals do. Furthermore, contrary to expectations, pay disparities appear to be largest in nonprofit hospitals.
Cavitation intensity monitoring in an axial flow pump based on vibration signals using multi-class support vector machine
Authors: Shervani-Tabar Mohammad Taghi , Ettefagh Mir Mohammad , Lotfan Saeed , Safarzadeh Hamed
Published: September 2017

The cavitation phenomenon, which is rampant in axial flow pumps, should be avoided due to its undesirable effects on the pump’s performance. Therefore, in this study the cavitation performance of an axial flow pump is monitored based on vibration signals. For this purpose, experimental vibration data is collected for five different levels of cavitation. Time-domain features are extracted based on statistical behavior of the measured signals. Considering the nonlinear and high-frequency nature of the cavitation noise in the signal, the second set of features including both time- and frequency-domain parameters are obtained based on statistical behavior of the first intrinsic mode function, via empirical mode decomposition combined with Hilbert Huang transform. Compensation distance evaluation technique is applied to pick the appropriate features. Multi-class support vector machine is trained for classification of the various levels of cavitation intensity. The results of testing the support vector machine algorithm show that the developed methodology can monitor the pump’s cavitation intensity in onsite operation with high accuracy.
The effect of the rotor adjustment on the vibration behaviour of the drive-train system for a 5 MW direct-drive wind turbine
Authors: Ye Kan , Ji Jinchen
Published: September 2017

Direct-drive wind turbines, different from the standard geared wind turbines, widely use a direct-drive permanent-magnet generator to avoid the gearbox failures. In the absence of a gearbox in the drive-train system, the direct-drive generator operates at low rotating speeds. Thus direct-drive wind turbines require a larger sized generator (higher weight) to transfer the kinetic energy into electrical energy. The inherent unbalanced magnetic pull force of the generator can have impact on the vibration behaviour of the drive-train system. This paper studies the effect of rotor position and weight adjustment on the vibration behaviour of the drive-train system within a 5 MW direct-drive wind turbine by considering the unbalanced magnetic pull force. The adjustment of rotor position and weight changes the location of the centre of gravity of the drive-train system. The drive-train system which consists of the main shaft, rotor, hub and blades is modelled as a four degree-of-freedom nonlinear system. Both rotor displacement and bearing forces are obtained for a wide range of rotor position and weight under different rotating speeds. The obtained results would provide useful information on the optimized rotor position and mass ratio to improve the performance of the drive-train system.
“Manifold Creatures”: A Response to the Posthumanist Challenge
Authors: Badley Graham Francis
Published: September 2017

“Manifold creatures” is a description used by Philip Roth to characterize who we are as human beings. The essay that follows first examines our manifoldness and our creatureliness as well as our attempts to become more humane and humanistic in our lives and views. However, the recent surge in interest in notions of transhumanism and posthumanism may be seen as direct challenges or even threats to humanism as a viable political and social stance. The essay concludes with the claim that a humanized humanism or an actively self-critical humanism is sufficiently strong to resist any of the challenges thrown down by militant posthumanists.
Basal Plate Myometrial Fibers and Hypertensive Disorders of Pregnancy: A Case–Control Study
Authors: Wang Ann A , Ernst Linda M , Miller Emily S
Published: September 2017

Introduction

Basal plate myometrium (BPMYO), the pathological presence of myometrial fibers in the basal plate, is a common finding on pathological examination of the placenta, yet its clinical correlates are not well studied. As myometrial fibers are frequently located in proximity to poorly converted maternal spiral arteries, our objective was to determine whether BPMYO is associated with hypertensive disorders of pregnancy (HDP), a well-known clinical sequela of abnormal maternal artery remodeling.

Methods

This case–control study included women who delivered a live-born singleton gestation whose placentas were sent for pathological examination. Cases were women with HDP (gestational hypertension, preeclampsia, or HELLP syndrome) as defined by American College of Obstetricians and Gynecologists. Controls were women without HDP. Women with chronic hypertension were excluded. The primary outcome was the presence of BPMYO. Secondary outcomes included the pathologic stage of BPMYO and the incidence of pathologically defined accreta. Each outcome was compared between cases and controls in bivariable and multivariable analyses.

Results

Of the 306 women who met inclusion criteria, 230 (75%) had HDP. BPMYO was present in 99 (32%) of placentas. Compared to controls, cases were younger, had higher body mass index, and were more likely to have diabetes, be nulliparous, deliver preterm, and have had a prior cesarean. There were no differences in the incidence of BPMYO, stage of BPMYO, or incidence of pathologically defined accreta between cases and controls. These findings persisted after controlling for potential confounders.

Conclusions

Although BPMYO may be more common in the setting of abnormal placental vasculature, there is no significant association between BPMYO and HDP.
Changes in Alternative Splicing as Pharmacodynamic Markers for Sudemycin D6
Authors: Thurman Morgan , van Doorn Jacob , Danzer Barbara , Webb Thomas R , Stamm Stefan
Published: September 2017

Objective:

The aim of the study was to define pharmacodynamic markers for sudemycin D6, an experimental cancer drug that changes alternative splicing in human blood.

Methods:

Blood samples from 12 donors were incubated with sudemycin D6 for up to 24 hours, and at several time points total RNA from lymphocytes was prepared and the pre-messenger RNA (mRNA) splicing patterns were analyzed with reverse transcription-polymerase chain reaction.

Results:

Similar to immortalized cells, blood lymphocytes change alternative splicing due to sudemycin D6 treatment. However, lymphocytes in blood respond slower than immortalized cultured cells.

Conclusions:

Exon skipping in the DUSP11 and SRRM1 pre-mRNAs are pharmacodynamic markers for sudemycin D6 treatment and show effects beginning at 9 hours after treatment.
Staying in or moving out? Justice and the abolition of the dark ghetto
Authors: Poama Andrei
Published: September 2017

Tommie Shelby articulates a nonideal theory of black US ghettos that casts them as consequences of an intolerably unjust institutional structure. I argue that, despite some of its significant merits, Shelby’s theory is weakened by his rejection of integration as a principle for reforming disadvantaged ghettos and correcting structural injustices in the US. In particular, I argue that Shelby unwarrantedly downplays the socio-economic efficiency of integrationist policies and fails to consider some of the ways in which integration might count as a duty of (corrective) justice.
Wolfgang Klafki’s concept of ‘Didaktik’ and its reception in Russia
Authors: Meyer Meinert A , Rakhkochkine Anatoli
Published: September 2017

We take the reception of Wolfgang Klafki’s didactics in Russia as our example for the difficult relations between knowledge transfer and knowledge transformation. We start with a description, analysis and evaluation of Klafki’s two didactical models, categorical didactics and critical-constructive didactics, and then describe and evaluate their reception in Russia. The paper demonstrates that while in Germany the concept of Bildung as transformation has pushed back interest in categorical and critical-constructive Bildung, interest in Klafki’s work is increasing in the Russian Federation and in other countries. Therefore we see an urgent need for didactical theory construction from an international and intercultural perspective.
Exploring the Process of Digital Storytelling in Mental Health Research
Authors: De Vecchi Nadia , Kenny Amanda , Dickson-Swift Virginia , Kidd Susan
Published: September 2017

Digital storytelling is an art-based research method that has potential to engage mental health consumers and clinicians in dialogue about their lived experiences. However, few studies have examined the process of digital storytelling and people’s perspectives about making digital stories. In this article, a process evaluation framework is used to explore two digital storytelling workshops conducted with mental health consumers and clinicians. Project planning and implementation documents were collated, and interviews conducted with workshop participants thematically analyzed. Data were combined with facilitator reflections and are reported using a process evaluation framework. Findings indicate that the digital storytelling process is a useful research method that can be used to create a space where power differentials between consumers and clinicians are made visible and shared dialogue can develop. Recommendations from the study include the importance of employing skilled consumer and clinician support personnel to guide the process of participation and negotiate ethical tensions to ensure participant safety.
Diagnosis and management of hook of hamate fractures
Authors: Kadar Assaf , Bishop Allen T. , Suchyta Marissa A. , Moran Steven L.
Published: September 2017

The purpose of this study was to evaluate the time to diagnosis and management of hook of hamate fractures in an era of advanced imaging. We performed a retrospective study of 51 patients treated for hook of hamate fractures. Patients were sent a quickDASH questionnaire regarding the outcomes of their treatment. Hook of hamate fractures were diagnosed with advanced imaging at a median of 27 days. Clinical findings of hook of hamate tenderness had better sensitivity than carpal tunnel-view radiographs. Nonunion occurred in 24% of patients with non-operative treatment and did not occur in the operative group. Both treatment groups achieved good clinical results, with a grip strength of 80% compared with the non-injured hand and a median quickDASH score of 2. Advanced imaging improved the time to diagnosis and treatment compared to historical case series. Nonunion is common in patients treated non-operatively.

Level of evidence: IV
An Alternate Technique of Applying Lag Screw for Fixation of Distal Fibula Fracture: Posterior to Anterior Interfragmentary Compression Screw
Authors: Vijimohan Suganth Jayaraman , Haque Syed , Ellis David
Published: September 2017

Ankle fractures are one of the most common lower limb fractures, representing a significant portion of the trauma workload. Marked proportion of these is isolated intraarticular lateral malleolus fractures. Anatomical reduction and rigid internal fixation using lag screw (interfragmentary screw) to provide interfragmentary compression has remained the choice of treatment in selected lateral malleolus fractures. Applying interfragmentary compression screw from anterior to the posterior surface of the fibula has been the traditional method of performing this. In this article, we describe an alternate method of applying posterior-anterior interfragmentary compression screw to the fibula fractures. We will also discuss the benefits it provides such as minimizing the chances of hardware-related peroneal tendon irritation. Further argument will focus on the mechanical benefit this will render while providing equal clinical outcome of the time tested anterior-posterior interfragmentary compression screw.

Levels of Evidence: Level V: Therapeutic comparison
Equality Revisited: A Cultural Meta-Analysis of Intergroup Contact and Prejudice
Authors: Kende Judit , Phalet Karen , Van den Noortgate Wim , Kara Aycan , Fischer Ronald
Published: September 2017

Across cultures, intergroup contact—interpersonal interaction with out-group members—is associated with less prejudice. Contact research was criticized, however, for bypassing intergroup inequality in the wider society. We propose a cultural psychology approach grounding people’s contact experiences in culturally afforded ways of relating to out-groups. Extending Allport’s equal-status hypothesis to the culture level, we hypothesized that the contact–prejudice association would be stronger in egalitarian cultures and weaker in more hierarchical cultures. To test this hypothesis, we revisited Pettigrew and Tropp’s influential meta-analysis and augmented it with culture-level measures of equality and hierarchy values. Our meta-analysis of intergroup contact and prejudice in 660 samples across 36 cultures suggested that egalitarianism was related to stronger contact–prejudice associations. Cultural hierarchy values and social dominance orientation corresponded with weaker contact–prejudice associations. Cultures of equality made a difference over and above equal status in the contact situation.
Risk factors and outcomes for multidrug-resistant Gram-negative bacilli bacteremia
Authors: Patolia Swati , Abate Getahun , Patel Nirav , Patolia Setu , Frey Sharon
Published: September 2017

Background:

The incidence of multidrug-resistant (MDR) organisms is increasing along with mortality. Identifying risk factors for the development of MDR Gram-negative bacilli (GNB) bacteremia could greatly impact patient care and management.

Methods:

Data from the electronic health record of patients with GNB over 13-month period were collected at a single university medical center. Baseline demographic data, risk factor, microbiological data, recurrence of bacteremia, and mortality were recorded.

Results:

A total of 177 patients were included in the analysis. MDR GNB occurred in 46 patients (26%). The mortality rate in the MDR group was 34.8% compared to 13.7% in non-MDR group ( p = 0.002). In multivariate analysis, diabetes mellitus [DM; odds ratio (OR): 2.8, 95% confidence interval (CI): 1–4.88], previous antibiotic use (OR: 2.93, 95% CI: 1.25–6.87), and urinary catheter as a source of infection (OR 5.96, 95% CI: 1.78–19.94) were significant risk factors for the development of MDR GNB. In addition, end-stage liver disease (OR: 3.64, 95% CI: 1.07–12.3), solid organ malignancy (OR: 3.64, 95% CI: 1.25–10.56), intra-abdominal source of infection (OR: 3.66, 95% CI: 1.14–11.73), inappropriate empiric antibiotics (OR 7.59, 95% CI: 1.68–34.34) and urinary catheter as a source of infection (OR 5.68, 95% CI: 1.37–23.5) were significant factors for mortality in patients with MDR GNB.

Conclusion:

Our study provides important information about the risk factors for the development of MDR GNB bacteremia and helps prognosticate patient with MDR GNB.
Iatrogenic Adrenal Insufficiency Secondary to Combination Therapy with Elvitegravir/Cobicistat/Tenofovir Disoproxil Fumarate/Emtricitabine and Interlaminar Triamcinolone Injection in an AIDS Patient
Authors: Wassner Chanie , Maiti Sutapa , Kodroff Kurt , Cohen Henry
Published: September 2017

We report the first identified case of suspected iatrogenic adrenal insufficiency after an interlaminar injection of triamcinolone acetonide while on concomitant Stribild (elvitegravir 150 mg/cobicistat 150 mg/tenofovir disoproxil fumarate 300 mg/emtricitabine 200 mg [EVG/c/TDF/FTC]). A 49-year-old female with HIV on EVG/c/TDF/FTC therapy presented to our endocrinology clinic to be evaluated for suspected Cushing syndrome. Prior to presentation, the patient had been given 2 interlaminar spinal injections of triamcinolone. Thereafter, she developed a swollen face, had unexplained weight gain, and fatigue. Cosyntropin stimulation test was positive for adrenal insufficiency. By applying the Naranjo Nomogram for Causality and the Drug Interaction Probability Scale to this drug–drug interaction, we calculated a score of 6 ( probable) and 5 ( probable), respectively. Symptoms resolved without further intervention. The EVG/c/TDF/FTC contains cobicistat, a strong cytochrome P450 3A4 (CYP3A4) inhibitor, which can potentiate drug interactions involving metabolizing of medications via this pathway. Clinicians are reminded to be vigilant while assessing the potential pharmacokinetic drug interactions not mentioned by the manufacturer.
Exploring the imprint of social media networks on neighborhood community through the lens of gentrification
Authors: Gibbons Joseph , Nara Atsushi , Appleyard Bruce
Published: September 2017

Gentrification, the rise of affluent socioeconomic populations in economically depressed urban neighborhoods, has been accused of disrupting community in these neighborhoods. Social media networks meanwhile have been recognized not only to create new communities in neighborhoods, but are also associated with gentrification. What relation then does gentrification and social media networks have to urban communities? To explore this question, this study uses social media networks found on Twitter to identify communities in Washington, DC. With space-time analysis of 821,095 geo-tagged tweets generated by 77,528 users captured from 15 October 2015 to 18 July 2016, we create a location-based interaction measure of tweets which overlays the social networks of the comprising users based on their followers and followees. We identify gentrifying neighborhoods with the 2000 Census and the 2010–2014 American Community Survey at the block group level. We then compare the density of location-based interactions between gentrifying and nongentrifying neighborhoods. We find that gentrification is significantly related to these location-based interactions. This suggests that gentrification indeed is associated with some communities in neighborhoods, though questions remain as to who has access. Making novel use of big data, these results demonstrate the important role built environment has on social connections forged “online.”
TheMUC5Bpromoter polymorphism is associated with specific interstitial lung abnormality subtypes
Authors: Putman Rachel K. , Gudmundsson Gunnar , Araki Tetsuro , Nishino Mizuki , Sigurdsson Sigurdur , Gudmundsson Elías F. , Eiríksdottír Gudny , Aspelund Thor , Ross James C. , San José Estépar Raúl , Miller Ezra R. , Yamada Yoshitake , Yanagawa Masahiro , Tomiyama Noriyuki , Launer Lenore J. , Harris Tamara B. , El-Chemaly Souheil , Raby Benjamin A. , Cho Michael H. , Rosas Ivan O. , Washko George R. , Schwartz David A. , Silverman Edwin K. , Gudnason Vilmundur , Hatabu Hiroto , Hunninghake Gary M.
Published: September 2017

TheMUC5Bpromoter polymorphism (rs35705950) has been associated with interstitial lung abnormalities (ILA) in white participants from the general population; whether these findings are replicated and influenced by the ILA subtype is not known. We evaluated the associations between theMUC5Bgenotype and ILA in cohorts with extensive imaging characterisation.

We performed ILA phenotyping andMUC5Bpromoter genotyping in 5308 and 9292 participants from the AGES-Reykjavik and COPDGene cohorts, respectively.

We found that ILA was present in 7% of participants from the AGES-Reykjavik, 8% of non-Hispanic white participants from COPDGene and 7% of African-American participants from COPDGene. Although theMUC5Bgenotype was strongly associated (after correction for multiple testing) with ILA (OR 2.1, 95% CI 1.8–2.4, p=1×10−26), there was evidence of significant heterogeneity between cohorts (I2=81%). When narrowed to specific radiologic subtypes, (e.g.subpleural ILA), theMUC5Bgenotype remained strongly associated (OR 2.6, 95% CI 2.2–3.1, p=1×10−30) with minimal heterogeneity (I2=0%). Although there was no evidence that theMUC5Bgenotype influenced survival, there was evidence thatMUC5Bgenotype improved risk prediction for possible usual interstitial pneumonia (UIP) or a UIP pattern in non-Hispanic white populations.

TheMUC5Bpromoter polymorphism is strongly associated with ILA and specific radiologic subtypes of ILA, with varying degrees of heterogeneity in the underlying populations.
Randomised placebo-controlled safety and tolerability trial of FK506 (tacrolimus) for pulmonary arterial hypertension
Authors: Spiekerkoetter Edda , Sung Yon K. , Sudheendra Deepti , Scott Valerie , Del Rosario Patricia , Bill Matthew , Haddad Francois , Long-Boyle Janel , Hedlin Haley , Zamanian Roham T.
Published: September 2017

Pulmonary arterial hypertension (PAH) is a devastating disease characterised by occlusive pulmonary vasculopathy. Activation of bone morphogenetic protein receptor 2 (BMPR2) signalling by FK506 (tacrolimus) reverses occlusive vasculopathy in rodent PAH models. Here, we determined the safety and tolerability of low-level FK506 therapy in stable PAH patients.

We performed a randomised, double-blind, placebo-controlled, 16-week, single-centre, phase IIa trial in PAH patients with New York Heart Association functional class II/III symptoms using three FK506 target levels (<2, 2–3 and 3–5 ng·mL−1). 23 patients were randomised and 20 patients completed the trial.

FK506 was generally well tolerated, with nausea/diarrhoea being the most commonly reported adverse event and no observation of line infections in patients on intravenous prostacyclin therapy. PAH patients had significantly lower BMPR2 expression in peripheral blood mononuclear cellsversushealthy controls (n=13; p=0.005), which improved after FK506 treatment. While we observed that some patients responded with a pronounced increase in BMPR2 expression as well as improvement in 6-min walk distance, and serological and echocardiographic parameters of heart failure, these changes were not significant.

Low-level FK506 is well tolerated and increases BMPR2 in subsets of PAH patients. These results support the study of FK506 in a phase IIb efficacy trial.
Image recognition performance enhancements using image normalization
Authors: Koo Kyung-Mo , Cha Eui-Young
Published: September 2017

When recognizing a specific object in an image captured by a camera, we extract local descriptors to compare it with or try direct comparison of images through learning methods using convolutional neural networks. The more the number of objects with many features, the greater the number of images used in learning, the easier it is to compare features. It also makes it easier to detect if the image contains the feature, thus helping generate accurate recognition results. However, there are limitations in improving the recognition performance when the feature of the object to be recognized in the image is significantly smaller than the background area or when the area of the image to be learned is insufficient. In this paper, we propose a method to enhance the image recognition performance through feature extraction and image normalization called the preprocessing process, especially useful for electronic objects with few distinct recognition characteristics due to functional/material specificity.
Prognostic Model to Predict Post-Autologous Stem-Cell Transplantation Outcomes in Classical Hodgkin Lymphoma
Authors: Chan Fong Chun , Mottok Anja , Gerrie Alina S. , Power Maryse , Nijland Marcel , Diepstra Arjan , van den Berg Anke , Kamper Peter , d’Amore Francesco , d’Amore Alexander Lindholm , Hamilton-Dutoit Stephen , Savage Kerry J. , Shah Sohrab P. , Connors Joseph M. , Gascoyne Randy D. , Scott David W. , Steidl Christian
Published: September 2017

Purpose

Our aim was to capture the biology of classical Hodgkin lymphoma (cHL) at the time of relapse and discover novel and robust biomarkers that predict outcomes after autologous stem-cell transplantation (ASCT).

Materials and Methods

We performed digital gene expression profiling on a cohort of 245 formalin-fixed, paraffin-embedded tumor specimens from 174 patients with cHL, including 71 with biopsies taken at both primary diagnosis and relapse, to investigate temporal gene expression differences and associations with post-ASCT outcomes. Relapse biopsies from a training cohort of 65 patients were used to build a gene expression–based prognostic model of post-ASCT outcomes (RHL30), and two independent cohorts were used for validation.

Results

Gene expression profiling revealed that 24% of patients exhibited poorly correlated expression patterns between their biopsies taken at initial diagnosis and relapse, indicating biologic divergence. Comparative analysis of the prognostic power of gene expression measurements in primary versus relapse specimens demonstrated that the biology captured at the time of relapse contained superior properties for post-ASCT outcome prediction. We developed RHL30, using relapse specimens, which identified a subset of high-risk patients with inferior post-ASCT outcomes in two independent external validation cohorts. The prognostic power of RHL30 was independent of reported clinical prognostic markers (both at initial diagnosis and at relapse) and microenvironmental components as assessed by immunohistochemistry.

Conclusion

We have developed and validated a novel clinically applicable prognostic assay that at the time of first relapse identifies patients with unfavorable post-ASCT outcomes. Moving forward, it will be critical to evaluate the clinical use of RHL30 in the context of positron emission tomography–guided response assessment and the evolving cHL treatment landscape.
Effects of Education and Income on Treatment and Outcome in Patients With Acute Myeloid Leukemia in a Tax-Supported Health Care System: A National Population-Based Cohort Study
Authors: Østgård Lene Sofie Granfeldt , Nørgaard Mette , Medeiros Bruno C. , Friis Lone Smidstrup , Schoellkopf Claudia , Severinsen Marianne Tang , Marcher Claus Werenberg , Nørgaard Jan Maxwell
Published: September 2017

Purpose

Previous US studies have shown that socioeconomic status (SES) affects survival in acute myeloid leukemia (AML). However, no large study has investigated the association between education or income and clinical characteristics, treatment, and outcome in AML.

Methods

To investigate the effects of education and income in a tax-supported health care system, we conducted a population-based study using individual-level SES and clinical data on all Danish patients with AML (2000 to 2014). We compared treatment intensity, allogeneic transplantation, and response rates by education and income level using logistic regression (odds ratios). We used Cox regression (hazard ratios [HRs]) to compare survival, adjusting for age, sex, SES, and clinical prognostic markers.

Results

Of 2,992 patients, 1,588 (53.1%) received intensive chemotherapy. Compared with low-education patients, highly educated patients more often received allogeneic transplantation (16.3% v 8.7%). In intensively treated patients younger than 60 years of age, increased mortality was observed in those with lower and medium education (1-year survival, 66.7%; adjusted HR, 1.47; 95% CI, 1.11 to 1.93; and 1-year survival, 67.6%; adjusted HR, 1.55; CI, 1.21 to 1.98, respectively) compared with higher education (1-year survival, 76.9%). Over the study period, 5-year survival improvements were limited to high-education patients (from 39% to 58%), increasing the survival gap between groups. In older patients, low-education patients received less intensive therapy (30% v 48%; adjusted odds ratio, 0.65; CI, 0.44 to 0.98) compared with high-education patients; however, remission rates and survival were not affected in those intensively treated. Income was not associated with therapy intensity, likelihood of complete remission, or survival (high income: adjusted HR, 1.0; medium income: adjusted HR, 0.96; 95% CI, 0.82 to 1.12; low income: adjusted HR, 1.06; CI, .88 to 1.27).

Conclusion

In a universal health care system, education level, but not income, affects transplantation rates and survival in younger patients with AML. Importantly, recent survival improvement has exclusively benefitted highly educated patients.
Biosimilars: Implications for Clinical Practice
Authors: Rifkin Robert M. , Peck Susan R.
Published: September 2017

In 2015, the United States Food and Drug Administration (FDA) approved the first biosimilar, filgrastim-sndz, a biosimilar of the granulocyte colony-stimulating factor filgrastim. Since that time, the FDA has approved four additional biosimilar tumor necrosis factor α inhibitors, and, in May 2017, the Oncology Drug Advisory Committee voted in favor of approval of an epoetin alfa biosimilar. The patents of several widely used biologic cancer therapies (including trastuzumab, rituximab, bevacizumab, cetuximab, and pegfilgrastim) are recently expired or due to expire in the near future, so the introduction of biosimilars into the oncology treatment armamentarium is imminent. However, their arrival also will introduce challenges, including pharmacy and supply chain management and the need for education of clinicians and patients about the efficacy and safety of these agents. These considerations, along with an overview of biosimilars in the oncology pipeline, will be discussed in this review.
Tranexamic acid
Authors: Winter George F
Published: September 2017

A new study has reported on the benefits of tranexamic acid in elective surgery. George Winter explores how it could also be a solution to the inequalities in global health
Supporting new starters with EAL
Authors: Walton Beth
Published: September 2017

As another new school year gets underway, how can you more effectively support new arrivals who might not speak English at home? Beth Walton looks at five key steps to giving good all-round support
A values-led philosophy
Authors: Aubrey-Smith Fiona
Published: September 2017

At the heart of the schools within the Inspire Learning Federation is a values-led philosophy for lifelong learning. Fiona Aubrey-Smith visited to find out more about their approaches to learning
Lessons from a school launch
Authors: Donnison Liam
Published: September 2017

The lessons Karen Edwards applied to launching a brand new school will ring true for primary heads whatever their situation, says Liam Donnison
Reflective account of when adverse events occur following dermal filler treatments
Authors: Warren Lynn
Published: September 2017

The quest for beauty has seen a dramatic rise in the popularity of dermal filler treatments. As this demand grows and the experience and qualifications of those injecting seems to be more questionable and unpredictable, it is not beyond reason to suggest that rates of complications are also increasing. The law of averages would naturally predict that regardless of expertise, the more patients aesthetic practitioners see, the more likely it is that complications will occur. Fortunately, adverse events are still relatively rare and as such, the literature on and diagnosis and management of complications lacks some consensus. This article is not designed to be a go-to resource for the management of complications following inflammatory reactions post dermal fillers; however, it is published to prompt the reader to look for gaps in their own knowledge regarding diagnosis and subsequent management pathways. The author demonstrates the importance of paying prompt attention and having up-to-date knowledge, while taking a sensitive and empathetic approach to care, in order to reduce distress for both patients and practitioners, and to avoid further subsequent sequelae.
Nuffield Council on Bioethics has raised a range of ethical issues in its recent report
Authors: Taber Sally
Published: September 2017

Sally Taber has been passionately and persistently calling for better patient safety in the non-surgical cosmetic interventions sector since working with Sir Liam Donaldson in 2005. Here, she comments on the key recommendations of the Nuffield Council on Bioethics' recent report, which uncovered questionable practice and recommended key changes for a rapidly developing, self-regulated industry
Six-month review of claims trends: laser and cosmetic injectables top the list
Authors: Di-Scala Naomi
Published: September 2017

As the summer begins to draw to a close and everyone gets back into the routine of school and work following their holidays, Naomi Di-Scala looks back at the non-surgical cosmetic procedure claims trends over the past 6 months. She also covers the differences between reportable and non-reportable claims, and then discusses how each one would typically be managed by insurers
Why has prescribing become such a taboo topic in medical aesthetics?
Authors: Senior Amy
Published: September 2017

At a time where an increasing number of non-prescribing nurses and beauty therapists are providing non-surgical cosmetic procedures, such as botulinum toxin and dermal fillers, questions continue to be raised around the ethics of prescribing for others. Amy Senior discusses why this has remained a topic of interest and urges nurses to raise concerns with their regulatory body about the lack of guidance in this area
NICE: Advanced paramedics to ease pressures on A&E?
Authors: Quaile Alistair
Published: September 2017

New draft guidance from the National Institute for Health and Care Excellence suggests that the NHS provide more advanced paramedics with enhanced training in order to alleviate pressures on emergency department services. Alistair Quaile takes a closer look at these recommendations and provides some insight into the bigger picture
Konsepsi Disabilitas dan Pendidikan Inklusif
Authors: Yulianto M. Joni
Published: September 2017

In the past decade, inclusive education has been a global rethoric and enjoyed  significant scholarly attention. Drawing from Indonesian experience, this paper seeks to establish a clear link between disability and inclusive education. The author argues that the concept ofinclusive education in Indonesia is not yet well understood by the educational practioners and policy maker and consequently,has hampered the implementation of this policy in the field.  It is only through  appropriate understanding of disability that the concept of inclusive education would be better comprehended and implemented.Based on the examination of inclusive education policies and various aspect of its implementation, this paper also offers series of recommendation aimed for better impelementation of this policy in Indonesia. Among the recommendations are adequate resources, better political willingness, multi stake holder participation as well as wider support system.
Studi Komparasi Modul Kimia Berbasis Media Screen Reader Jaws dan Braille Terhadap Prestasi, Motivasi, dan Kemandirian Belajar Peserta Didik Difabel Netra
Authors: Suprihatiningrum Jamil , Fitriyani Sholihah Nur
Published: September 2017

This study aimed to compare the achievement, motivation, and independent learning of blind students who use screen reader JAWS and braille module.This research was conducted at MAN Maguwoharjo Yogyakarta involving 5 blind students in the chemistry subject of academic year 2013/2014. One student is as an instrument validation test subject, two students as subjects in the experimental class and two students as subjects in the control class. The instruments used in this study are the observation sheet,multiple choice test, questionnaire responses, motivation scale, and independent learning scale. Data of student achievement, motivation and independence scale were analyzed using nonparametric statistical test of independent samples. The result shows that no significant difference between the achievement, motivation, and independence of blind students who use screen reader JAWS module and braille module.
Pemenuhan Aksesibilitas Bagi Penyandang Disabilitas
Authors: Syafi'ie M
Published: September 2017

Accessibility is a very pivotal discourse for people with dissabilities as it encourages their equal participation and independence in the society. Accessibility, in this paper, is divided into 2 (two) kinds, which are physical and nonphysical one. The physical accessibility refers to accesibilty in the relations with buildings and environment whereas the nonphysical one corresponds to communication, information and technology. This paper also reveals testimony from various activists of DPOs (disabled people organizations). The data presented here was collected in 2012 through qualitative study in DIY (Yogyakarta Special Province). The paper concludes that eventhough Indonesia has been enacted regulations on accessibilty to people with disabilities, its implementation is ineffectice and discrimination still occurs to the population.
Identifikasi Kemudahan Penyandang Difabilitas dalam Melakukan Pergerakan dengan Menggunakan Moda Transportasi
Authors: Suminar Ratna Eka
Published: September 2017

The accessibility of transportation for people with disabilities in Yogyakarta remains a serious challenge. The city’s public transportation has not yet met the accessibility standard, which in turn prevents persons with disability from social and economic participation. Based on the experience of people with disabilities in Yogyakarta, this paper shows the various barriers they experience in using public transportation. It is hoped that the findings will help the government to develop a policy on public transportation that ensures accessibility for persons with disabilities.[Penyandang difabilitas di Kota Yogyakarta belum sepenuhnya mendapatkan kemudahan dalam mengakses dan memanfaatkan moda transportasi. Salah satunya adalah belum adanya kemudahan dalam mengakses angkutan umum. Hal itu disebabkan oleh fasilitas pada angkutan umum yang masih belum memenuhi standar kemudahan bagi para penumpang penyandang difabilitas. Berbagai permasalahan terkait pemenuhan hak para difabel khususnya dalam bidang transportasi yang ditemukan di dalam penelitian ini dapat dijadikan masukan bagi pemerintah di dalam merumuskan suatu kebijakan yang dapat mengakomodasi kebutuhan para penyandang difabilitas khususnya dalam bidang transportasi.]
IDENTIFIKASI MEDIA PEMBELAJARAN KIMIA BAGI PESERTA DIDIK DIFABEL NETRA DAN RUNGU PADA SMA/MA INKLUSI DI YOGYAKARTA
Authors: Kamaludin Agus
Published: September 2017

Identification of learning media is the first step of series activities in inclusive setting research. The availability of chemistry learning media, obstacles encountered by teachers in modifying the media, and solutions that can be done to meet the needs of chemistry learning media for blind and deaf students ininclusive school in Yogyakarta need to be investigated. A descriptive qualitative research using data collecting techniques of observation, interview, attitude scale filling and document analysis has done. This research finds the fact that chemistry learning media for blind and deaf students are very limited, it is caused by the fact that the teachers had never follow any training for developing chemistry learning media for disabled student. As a recommendation, the solution to fulfill the needs of chemistry learning media is by providing training for teacher and developing media through undergraduate students’ final thesis.
METODE GURU BK DALAM MENGATASI PROBLEM PENYESUAIAN DIRI PADA ANAK BERKEBUTUHAN KHUSUS
Authors: Lestari Fitri
Published: September 2017

Penelitian ini bertujuan untuk mengetahui serta menjelaskan metode yang dilakukan guru BK dalam mengatasi problem penyesuaian diri pada sisiwa tunarungu SD LB di SLB Purwokerto. Penelitian ini merupakan penelitian lapangan dengan jenis penelitian kualitatif (studi kasus). Subjek penelitiannya kepala sekolah, guru BK, dan siswa tunarungu, sedangkan objek penelitiannya adalah problem penyesuaian diri pada siswa tunarungu SD LB dab metode guru BK dalam mengatasinya di SLB Purwokerto. Hasil penelitian ini menunjukkan bahwa problem penyesuainan diri pada siswa tunarungu meliputi kurang percaya diri, kurang mandiri, cenderung kaku, dan egoisentris. Metode yang digunakan oleh guru BK dalam mengatasi problem penyesuaian diri tersebut yaitu dengan metode bimbingan khusus. Metode bimbingan khusus dibagi menjadi 2 kelompok besar yaitu metode kelompok (metode ceramah, metode demonstrasi/praktik, metode drill, dan karyawisata) dan metode individu (metode tanya jawab dan metode penugasan).