bluuebunny/crossref_metadata_2025 huggingface dataset:
Sustained responses to lasmiditan: Results from post-hoc analyses of two Phase 3 randomized clinical trials for acute treatment of migraine
Authors: Doty Erin Gautier , Krege John H , Jin Leah , Raskin Joel , Halker Singh Rashmi B , Kalidas Kavita
Published: July 2019

Background

Sustained pain freedom is an important attribute of acute migraine therapies for patients and physicians. Here we report efficacy of the centrally penetrant, highly selective, 5-HT1F agonist lasmiditan on sustained pain freedom and other outcomes at 24 and 48 hours post-dose.

Study design and methods

Data from the similarly designed, Phase 3, double-blind studies SAMURAI (NCT02439320) and SPARTAN (NCT02605174) were pooled to more precisely estimate efficacy effects in these post-hoc analyses. In both studies, inclusion criteria were 3–8 migraine attacks per month and Migraine Disability Assessment Score of ≥ 11 (at least moderate disability). Patients were randomized equally to lasmiditan 200 mg, 100 mg, 50 mg (50 mg only in SPARTAN), or to placebo. The study drug was to be taken within 4 hours of onset of pain for non-improving headache of at least moderate severity. Sustained pain freedom was defined as being pain free at 2 hours and at the given time point (24 or 48 hours) post-dose without use of additional study drug or migraine medications. Sustained responses were assessed similarly for most bothersome symptom-free, total migraine-free, and disability-free outcomes. For comparisons with previously published data on other acute medications, an additional endpoint of modified sustained pain freedom at 24 hours was defined as being pain free at 2 hours and no moderate-to-severe headache at 24 hours post-dose without use of additional study drug or migraine medications.

Results

Significantly higher proportions of patients treated with lasmiditan versus placebo achieved headache pain freedom at 2 hours post-dose: 200 mg: 35.6%; 100 mg: 29.9%; 50 mg: 28.6%; placebo: 18.3% (all p < 0.001). Sustained pain freedom was significantly higher in patients treated with lasmiditan versus placebo at 24 hours: 200 mg: 21.2%; 100 mg: 16.9%; 50 mg: 17.4%; placebo: 10.3% (all p < 0.01); and at 48 hours: 200 mg: 18.4%; 100 mg: 15.2%; 50 mg: 14.9%; placebo: 9.6% (all p < 0.05). Similar sustained benefits of lasmiditan versus placebo at 24 and 48 hours were noted for most bothersome symptom-free, total migraine-free and disability-free responses. Modified sustained pain freedom at 24 hours was also observed in significantly higher proportions of lasmiditan-treated patients versus placebo: 200 mg: 27.0%; 100 mg: 21.7%; 50 mg: 21.7%; placebo: 12.9% (all p < 0.01).

Conclusion

Sustained responses at 24 and 48 hours were noted in significantly more patients treated with lasmiditan versus placebo for several efficacy outcomes including pain freedom, most bothersome symptom-free, total migraine-free and disability-free responses.

Clinicaltrials.gov identifier numbers

SAMURAI: NCT02439320; SPARTAN: NCT02605174.
Multiple Platelet-Rich Plasma Injections Versus Single Platelet-Rich Plasma Injection in Early Osteoarthritis of the Knee: An Experimental Study in a Guinea Pig Model of Early Knee Osteoarthritis
Authors: Chouhan Devendra K. , Dhillon Mandeep S. , Patel Sandeep , Bansal Tungish , Bhatia Alka , Kanwat Himanshu
Published: July 2019

Background:

Platelet-rich plasma (PRP) has emerged as the forerunner among disease-modifying treatment options for early osteoarthritis (OA) of the knee. However, no consensus is available regarding optimum dosing schedules.

Purpose:

To determine whether multiple injections of PRP (3 injections) provide better short-term and long-term results than a single injection of PRP in a guinea pig model of knee OA.

Study Design:

Controlled laboratory study.

Methods:

36 Dunkin-Hartley guinea pigs (weighing ~600-800 g) were chosen for this study. The animals were assigned to group DC (disease control group), group G1 (single-PRP group), and group G2 (multiple-PRP group) containing 10, 10, and 12 animals, respectively. Another 4 animals were used for preparation of allogenic PRP. Groups G1 and G2 received 1 and 3 injections of PRP, respectively, at weekly intervals in the intervention knee while the contralateral knee was injected with normal saline. Group DC received no intervention in either knee. Half of the animals from each group (subgroups DC.3, G1.3, and G2.3) were sacrificed at 3 months, and the remaining half (subgroups DC.6, G1.6, and G2.6) were sacrificed at 6 months after intervention. Both knee joints were harvested for histological assessment of articular cartilage and synovium.

Results:

The mean synovial scores for groups G1 and G2 were significantly better than those for group DC at 3 months. No difference was found between groups G1 and G2 at 3 months. At 6 months, group G2 had significantly better mean synovial scores than group G1 and group DC. The mean articular cartilage scores in group G2 were significantly better than those in group DC at 3 months. However, at 6 months, no significant difference was found among any of the groups in terms of mean articular scores.

Conclusion:

Both single and multiple injections of PRP exert similar anti-inflammatory effects on the synovium in the short term. However, this effect is sustained in the long term only for multiple injections. Multiple injections of PRP exert a chondroprotective effect, but only in the short term. This effect is not seen with a single injection of PRP.

Clinical Relevance:

This study provides insight into the histological basis for the superiority of multiple injections of PRP.
Medical management of urolithiasis in the Middle Ages: Thesaurus Pauperum of Pope John XXI
Authors: Castellani Daniele , Pucci Michele , Cicconetti Cristian , Pavia Maria Pia , Dellabella Marco
Published: July 2019

Background/Objective:

This paper will present a brief description of medicine in the Middle Ages, and more comprehensive analysis of the medical management of urolithiasis in Thesaurus Pauperum, the main text of Pedro Hispano.

Method:

An in-depth reading of the Italian translation of Thesaurus Pauperum, and a review of the literature of the life of Pedro Rebuli Guiliani, known as Pedro Hispano, was performed.

Result:

Pedro Hispano was born in Portugal around 1205. He studied philosophy, theology and medicine in Paris. He was named professor of medicine at the University of Siena in 1247 and was elected Pope, as John XXI, in 1276. His primary medical book was Thesaurus Pauperum (‘Treasure of the Poor’), a prescription handbook for common diseases, directed not only to physicians but also to ordinary people. We focused on the description of medical management of urolithiasis in Thesaurus Pauperum.

Conclusion:

This text is interesting not so much on account of the pharmacopoeia used, but instead, because it is, probably, one of the first medical text reporting therapeutics close to the modern evidence-based medicine.
Percutaneous nephrolithotomy of staghorn renal stones in pediatric patients using adult-sized instrument
Authors: Nouralizadeh Akbar , Pakmanesh Hamid , Basiri Abbas , Radfar Mohammad Hadi , Narouie Behzad , Shakiba Behnam , Vali Abbas , Valipour Reza , Honarkar Ramezani Mehdi
Published: July 2019

Introduction:

In this study, we aimed to evaluate the safety and efficacy of the percutaneous nephrolithotomy procedure performed with adult-sized instruments in pediatric cases with staghorn kidney stone.

Methods:

We retrospectively evaluated the efficacy and safety of 94 percutaneous nephrolithotomy procedures performed during 15 years in a single center for 82 pediatric patients with staghorn calculi using adult-sized instruments (24-Fr nephroscope). Stone free status was defined as complete clearance of the stones or the presence of insignificant residual stones of <3 mm in diameter.

Results:

The mean age was 108 ± 53 months (range, 14–180 months). There were 39 patients (48%) with complete staghorn stones and 43 cases (52%) with partial staghorn. We fulfilled 91.4% of operations through a single access. The stone free rate was 86.6% after one percutaneous nephrolithotomy session. In total, seven patients referred for shock wave lithotripsy and four cases were scheduled for the second percutaneous nephrolithotomy session. Fever occurred in 18 patients (21%) and bleeding requiring transfusion in four children (5%). Prolonged leakage from nephrostomy site requiring anesthesia for double J stent placement occurred in one patient. No grade IV or V Clavien complication occurred.

Conclusion:

The success rate and complications of percutaneous nephrolithotomy with adult-size instruments in pediatric patients are acceptable.
Client-Initiated Violence Against Zambian Female Sex Workers: Prevalence and Associations With Behavior, Environment, and Sexual History
Authors: Malama Kalonde , Sagaon-Teyssier Luis , Parker Rachel , Tichacek Amanda , Sharkey Tyronza , Kilembe William , Inambao Mubiana , Price Matt A. , Spire Bruno , Allen Susan
Published: July 2019

Violence against women is a known risk factor for HIV and affects female sex workers (FSW) in sub-Saharan Africa. Little is known about the magnitude and determinants of violence against FSW in Zambia, where HIV and gender-based violence prevalence are high. We conducted a cross-sectional study, using multivariable logistic regression, to determine the prevalence and correlates of client-initiated physical violence among 419 FSW in Lusaka and Ndola. The prevalence of client-initiated physical violence was 39%. The odds of violence were higher for FSW who: lived in Lusaka, recruited clients from the street, serviced clients in the clients’ homes, had a physically forced sexual debut, and had a higher client volume. Our results call for safer working spaces for FSW and violence prevention interventions for their male clients.
Broken Promises of Capitalism’s Wonderland: Representing Uneven Development in Contemporary China and Japan
Authors: Ortiz-Moya Fernando , Moreno Nieves
Published: July 2019

China and Japan are currently in opposing stages of the expansion process of capitalism. While China is at the centre of the global accumulation of surplus capital through urbanisation and industrial expansion—i.e. the creation stage—Japan has been stagnant in recent decades and its periphery is de-urbanising—i.e. the destruction stage. Consequences of the global spatialisation of capital, however, are similar in both cases, resulting in growing social inequalities. This article uses films to explore the influence of this process on popular culture, specifically focusing on a Chinese film—Jia Zhangke’s A Touch of Sin (2013)—and a Japanese one—Kazuyoshi Kumakiri’s Sketches of Kaitan City (2010). The two films are composed of interconnected segments that portray the social by-products of the spatialisation of capitalism. We argue that, despite the apparent dissimilarities, this process creates parallel realities consequential to the broken promises of advancement made by the economic system. Ultimately, this generates a distorted social space that normalises the new, worsened living conditions resulting from capitalism’s continual expansion.
Socioeconomic Status, Ecologically Assessed Social Activities, and Daily Cortisol Among Older Urban African Americans
Authors: Zilioli Samuele , Fritz Heather , Tarraf Wassim , Lawrence Susan A. , Cutchin Malcolm P.
Published: July 2019

Objectives: Higher socioeconomic status (SES) individuals report more social activities than their lower SES counterparts. Yet, SES and racial health disparities are often confounded. Here, we tested whether the frequency of engagement in social activities contributed to the association between SES and daily cortisol secretion among urban African American older adults. Methods: Ninety-two community-dwelling African Americans aged 55 years and older reported what they were doing at regular intervals across the day on an Android smartphone for seven consecutive days. They also provided four saliva samples at four time points a day during the same period. Results: Higher SES older adults engaged in proportionally more social activities than their lower SES counterparts. A greater relative frequency of weekly social activities was associated with a steeper diurnal cortisol decline. Higher SES was indirectly linked to a steeper cortisol decline via increased relative frequency of weekly social activities. Discussion: Our findings suggest that engagement in weekly social activities represents a behavioral intermediary for SES health disparities in endocrine function among older urban African American adults.
A fast and accurate hybrid simulation model for the large-scale testing of automated driving functions
Authors: Fraikin Nicolas , Funk Kilian , Frey Michael , Gauterin Frank
Published: July 2019

The upcoming market introduction of highly automated driving functions and associated requirements on reliability and safety require new tools for the virtual test coverage to lower development expenses. In this contribution, a computationally efficient and accurate simulation environment for the vehicle’s lateral dynamics is introduced. Therefore, an analytic single track model is coupled with a long-short-term-memory neural network to compensate modelling inaccuracies of the single track model. This ‘Hybrid Vehicle Model’ is parameterized with selected training batches obtained from a complex simulation model serving as a reference to simplify the data acquisition. The single track model is parameterized using given catalogue data. Thereafter, the long-short-term-memory network is trained to cover for the single track model’s shortcomings compared to the ground truth in a closed-loop setup. The evaluation with measurements from the real vehicle shows that the hybrid model can provide accurate long-term predictions with low computational effort that outperform results achieved when using the models isolated.
Happiness and Social Behavior
Authors: Quoidbach Jordi , Taquet Maxime , Desseilles Martin , de Montjoye Yves-Alexandre , Gross James J.
Published: July 2019

It is often assumed that there is a robust positive symmetrical relationship between happiness and social behavior: Social relationships are viewed as essential to happiness, and happiness is thought to foster social relationships. However, empirical support for this widely held view is surprisingly mixed, and this view does little to clarify which social partner a person will be motivated to interact with when happy. To address these issues, we monitored the happiness and social interactions of more than 30,000 people for a month. We found that patterns of social interaction followed the hedonic-flexibility principle, whereby people tend to engage in happiness-enhancing social relationships when they feel bad and sustain happiness-decreasing periods of solitude and less pleasant types of social relationships that might promise long-term payoff when they feel good. These findings demonstrate that links between happiness and social behavior are more complex than often assumed in the positive-emotion literature.
Career medical officers in psychiatry and addiction in NSW: description, role and educational needs
Authors: Nash Louise , Meltzer Michele , Karageorge Aspasia
Published: July 2019

Objective:

To describe the workforce of career medical officers (CMOs) working in psychiatry and addiction medicine across New South Wales (NSW) and to explore their training and education needs, and experience of their role.

Method:

A cross-sectional survey of CMOs in NSW working in psychiatry or addiction medicine. The survey consisted of quantitative data and free-text responses, and was conducted online in late 2017.

Results:

Of the 41 CMOs identified and sent the survey link, 25 CMOs completed the survey (61% RR). Almost half had worked as a CMO for 11 years or longer. Only six respondents held a recognised senior CMO position. Common areas of expertise were clozapine, metabolic health, and electroconvulsive therapy (ECT). One-quarter of respondents did not receive supervision. Suggested education and training improvements included an annual 1-day training symposium and monthly peer review group for CMOs.

Conclusion:

CMOs are an often senior group of clinicians working in important areas of service provision. Ongoing educational support for this group of medical practitioners is prudent to ensure the delivery of best practice mental health and drug health care.
Integrating Effective Practices Into Co-Teaching: Increasing Outcomes for Students With Disabilities
Authors: Cook Sara Cothren , McDuffie-Landrum Kimberly
Published: July 2019

Co-teaching is the most popular model for supporting students with disabilities in the general education setting. However, the limited research that supports this framework as effective for increasing outcomes for students with disabilities may indicate co-teachers have difficulty providing students with specialized instruction to meet individual learning needs. In this article, co-teachers are provided a model for integrating effective practices strategically within various co-teaching models to increase educational outcomes for students with disabilities.
From motor to visually guided bimanual affordance learning
Authors: Sánchez-Fibla Martí , Forestier Sébastien , Moulin-Frier Clément , Puigbò Jordi-Ysard , Verschure Paul FMJ
Published: July 2019

The mechanisms of how the brain orchestrates multi-limb joint action have yet to be elucidated and few computational sensorimotor (SM) learning approaches have dealt with the problem of acquiring bimanual affordances. We propose a series of bidirectional (forward/inverse) SM maps and its associated learning processes that generalize from uni- to bimanual interaction (and affordances) naturally, reinforcing the motor equivalence property. The SM maps range from a SM nature to a solely sensory one: full body control, delta SM control (through small action changes), delta sensory co-variation (how body-related perceptual cues covariate with object-related ones). We make several contributions on how these SM maps are learned: (1) Context and Behavior-Based Babbling: generalizing goal babbling to the interleaving of absolute and local goals including guidance of reflexive behaviors; (2) Event-Based Learning: learning steps are driven by visual, haptic events; and (3) Affordance Gradients: the vectorial field gradients in which an object can be manipulated. Our modeling of bimanual affordances is in line with current robotic research in forward visuomotor mappings and visual servoing, enforces the motor equivalence property, and is also consistent with neurophysiological findings like the multiplicative encoding scheme.
Legislating at the Intersections: Race, Gender, and Representation
Authors: Reingold Beth , Widner Kirsten , Harmon Rachel
Published: July 2019

Record numbers of women, and in particular women of color, are gaining elective office across the country. This article explores how their presence in legislative bodies might make a difference in policy agendas and legislative advocacy, especially at the intersections of race and gender. Leveraging original datasets of Democratic lawmakers and the bills they sponsor in fifteen U.S. state houses in 1997 and 2005, we examine multiple forms of race–gender policy leadership and how it is tied to legislators’ race–gender identity. Testing theories of intersectional representation, we find that women of color often are the most likely race–gender policy leaders. Indeed, our measures of race–gender policy leadership reveal the distinctive representational work of women of color, which traditional, single-axis measures of legislative activity on behalf of women or racial/ethnic minorities cannot.
The Narcissistic Grandiosity Scale: A Measure to Distinguish Narcissistic Grandiosity From High Self-Esteem
Authors: Rosenthal Seth A. , Hooley Jill M. , Montoya R. Matthew , van der Linden Sander L. , Steshenko Yulia
Published: July 2019

Measures of self-esteem frequently conflate two independent constructs: high self-esteem (a normative positive sense of self) and narcissistic grandiosity (a nonnormative sense of superiority). Confusion stems from the inability of self-report self-esteem scales to adequately distinguish between high self-esteem and narcissistic grandiosity. The Narcissistic Grandiosity Scale (NGS) was developed to clarify this distinction by providing a measure of narcissistic grandiosity. In this research, we refined the NGS and demonstrated that NGS scores exhibit good convergent, discriminant, and concurrent validity relative to scores on theoretically relevant measures. NGS scores, when used as simultaneous predictors with scores on a self-esteem measure, related more strongly to phenomena linked to narcissistic grandiosity (e.g., competitiveness, overestimating one’s attractiveness, lack of shame), whereas self-esteem scores related more strongly to phenomena crucial to individuals’ well-being (e.g., higher levels of optimism and satisfaction with life, and lower levels of depression, worthlessness, and hostility). The NGS provides researchers with a measure to help clarify the distinctions between narcissistic grandiosity and high self-esteem, as well as other facets of narcissism, both in theory and as predictors of important real-life characteristics.
Analysis of sandwich Timoshenko porous beam with temperature-dependent material properties: Magneto-electro-elastic vibration and buckling solution
Authors: Bamdad M. , Mohammadimehr M. , Alambeigi K.
Published: July 2019

Vibration and buckling analysis of a magneto-electro-elastic sandwich Timoshenko beam with a porous core and poly-vinylidene fluoride (PVDF) matrix reinforced by carbon nanotubes (CNTs) is considered as face layers and material properties of CNTs and PVDF are assumed to be temperature-dependent. Different CNT distribution patterns including uniform distribution, AV (which top and bottom face sheets have functionally graded-A (FG-A) and functionally graded-V (FG-V) CNT distribution patterns, respectively) and VA patterns are employed. The governing equations of motion are derived based on Timoshenko beam theory, and Navier's solution is used to solve these equations. The sandwich beam resting on a Pasternak foundation and face layers are subjected to electric and magnetic potentials. The effect of different parameters such as porosity coefficient, electric and magnetic potential, parameters of foundation, and geometrical parameters are investigated on vibration and buckling behavior of the sandwich beam. Numerical results of this paper show that porosity distribution has a significant effect on the stiffness of the sandwich beam. The results can be used for future analysis of magneto-electro-mechanical sandwich systems as actuators and sensors.
Improving Student Behavior in Middle Schools: Results of a Classroom Management Intervention
Authors: Wills Howard P. , Caldarella Paul , Mason Benjamin A. , Lappin Amanda , Anderson Darlene H.
Published: July 2019

Transitioning from elementary to middle school is a time of particular vulnerability for students with behavior problems. This study examined the effects of class-wide function-related intervention teams (CW-FIT) in three middle school classrooms to determine whether this multitiered intervention could help teachers proactively manage student behavior. With a focus on teaching classroom expectations, delivering behavior-specific praise, and providing differential reinforcement within an interdependent group contingency, CW-FIT is designed to teach functional replacement behaviors that support students’ academic engagement. Intervention effects were assessed with seventh- and eighth-grade students from diverse backgrounds. Results, evaluated using a single-subject withdrawal (ABAB) design, indicated improved rates of on-task behavior at both class-wide and individual student levels, with corresponding increases in teacher praise and decreases in teacher reprimands. The positive way in which participants viewed CW-FIT implementation and its accompanying effects on student behaviors was consistent with earlier findings in elementary schools. Study limitations and areas for future research are discussed.
The Effects of Targeted Professional Development on Teachers’ Use of Empirically Supported Classroom Management Practices
Authors: Simonsen Brandi , Freeman Jennifer , Myers Diane , Dooley Kathryn , Maddock Eleanor , Kern Laura , Byun Sang
Published: July 2019

Teachers receive limited training and support in classroom management, making it incumbent on school leaders to provide efficient and effective professional development supports. We explored the effects of a brief targeted professional development (TPD) approach (brief training, email prompts, and self-management of trained skills) on teachers’ use of three empirically supported classroom management skills (prompts, opportunities to respond [OTR], and specific praise). Using an experimental crossover design, we documented that teachers increased their prompt and specific praise rates while they actively engaged in TPD. However, training effects did not maintain when TPD shifted to a new skill and teachers’ increased use of OTRs during TPD was neither statistically significant nor maintained. Teachers found TPD to be acceptable, usable, and feasible.
Spacer fabric/flexible polyurethane foam composite sandwiches: Structural design and quasi-static compressive, bursting and dynamic impact performances
Authors: Wang Hongyang , Li Ting-Ting , Wu Liwei , Lou Ching-Wen , Lin Jia-Horng
Published: July 2019

Nylon fabrics are used as the reinforcing upper layer. A warp-knitted spacer fabric that is saturated with flexible polyurethane foam is used as the lower layer. They are combined in order to form innovative impact energy absorbent composite sandwiches employing a two-step foam process. The quasi-static compressive strength, bursting strength, and dynamic shock cushioning characteristic of the composite sandwiches are evaluated, the latter of which is tested using a drop weight impact tester in order to simulate the impact resistance corresponding to complex environments. The experimental results suggest that a combination of warp-knitted spacer fabric increases the compressive strength and bursting strength of composite sandwiches by 107% and 60%, respectively. The shapes of impactors determine the contact force and dynamic impact time. The greater contact area results in the smaller contact force, indicating that the composite sandwiches have greater cushioning efficacy. Designed with a gradient combination, the flexible polyurethane foam strongly bonds the upper polyamide nonwoven fabric and the lower warp-knitted spacer fabric. The optimal compression resistance, a bursting strength of 1677 N, and a maximum energy absorption of 90% at a 15 J impact energy are presented. The innovative composite sandwiches have a promising perspective in packaging and individual impact protection in the future.
In Silico Analysis of Hepatitis B Virus Genotype D Subgenotype D1 Circulating in Pakistan, China, and India
Authors: Bahar Muneeb , Pervez Muhammad Tariq , Ali Akhtar , Babar Masroor Ellahi
Published: July 2019

The focus of this study was the computational analysis of hepatitis B virus (HBV) genotype D subgenotype D1 in Pakistan, China, and India. In total, 54 complete genome sequences of HBV genotype D subgenotype D1 were downloaded from National Center for Biotechnology Information (NCBI). Of these, 6 complete genome sequences were from Pakistan, 14 were from China, and 34 were from India. Sequence alignment showed less than 4% divergence in these sequences. C and X genes showed divergence of less than 3%. Comparison over the S gene showed more than 97% similarity among the nucleotide sequences of genotype D subgenotype D1. The identity and similarity matrix of 54 nucleotide sequences of HBV genotype D subgenotype D1 from Pakistan, China, and India revealed more than 93% identity and 93% similarity. Phylogenetic analysis highlighted that complete genome isolates of HBV circulating in Pakistan had the closest evolutionary relationship with its neighboring countries China and India. China’s (HQ833466) and Pakistan’s (AB583680.1) isolates shared the same ancestor. Gene structure analysis showed that “P” gene exons were the longest, about three-fourth of the genome size, whereas gene “S” had the second longest coding regions with 2 exons and 1 intron. However, “C” and “X” genes had 1 smallest exon. X proteins had proven role in spreading of the HBV infection diseases. For HBx analysis, 1 X protein sequence of HBV genotype D subgenotype D1 belonging to each country was obtained. Homology models of the 3 X proteins generated using SWISS-MODEL revealed GMQE (Global Model Quality Estimation) = 0.1. Global and local quality estimate scores including Z-scores for Qualitative Model Energy Analysis (QMEAN) C-beta, all-atom, solvation, and torsion energy scores were similar indicating good quality, accuracy, and reliability of the predicted models. Three-dimensional (3D) visualization showed similar structures and Ramachandran plots showed a high percentage of protein residues into the favorable region for X protein models.
Impact of the Time to Initiation of Parenteral Nutrition on Patient Outcomes in Critically Ill Adults
Authors: Shah Sunish , Hollands James M , Pontiggia Laura , Bingham Angela L
Published: July 2019

Background:

The optimal time to initiate parenteral nutrition (PN) in critically ill adults in whom enteral nutrition is not feasible is controversial.

Objective:

The objectives were to compare in-hospital mortality and hospital length of stay in patients initiated on PN within 7 days or after 7 days of poor nutrient intake.

Methods:

This single-center, retrospective study included critically ill adult patients who received at least 2 consecutive days of PN during hospitalization from May 2014 to July 2016.

Results:

The median duration of PN (interquartile range) was 8 (5-13) days. In total, 110 patients received PN within 7 days of poor nutrient intake while 49 patients received PN after 7 days of poor nutrient intake. There was no statistically significant difference in in-hospital mortality between groups (29.09% vs 18.37%, P = .1535). Patients initiated within 7 days had a significantly shorter median hospital length of stay than patients initiated after 7 days (20 days vs 27 days, P = .0013). There were 69 patients who were classified as obese. Obese patients initiated within 7 days had a significantly shorter median hospital length of stay than obese patients initiated after 7 days (17 days vs 33 days, P = .0007).

Conclusions:

Time to initiation of PN did not impact in-hospital mortality. However, there was an association between early initiation of PN and a shorter hospital length of stay that was most pronounced among obese patients.
Nicotinamide and Demographic and Disease transitions: Moderation is Best
Authors: Williams Adrian C , Hill Lisa J
Published: July 2019

Good health and rapid progress depend on an optimal dose of nicotinamide. Too little meat triggers the neurodegenerative condition pellagra and tolerance of symbionts such as tuberculosis (TB), risking dysbioses and impaired resistance to acute infections. Nicotinamide deficiency is an overlooked diagnosis in poor cereal-dependant economies masquerading as ‘environmental enteropathy’ or physical and cognitive stunting. Too much meat (and supplements) may precipitate immune intolerance and autoimmune and allergic disease, with relative infertility and longevity, via the tryptophan-nicotinamide pathway. This switch favours a dearth of regulatory T (Treg) and an excess of T helper cells. High nicotinamide intake is implicated in cancer and Parkinson’s disease. Pro-fertility genes, evolved to counteract high-nicotinamide-induced infertility, may now be risk factors for degenerative disease. Moderation of the dose of nicotinamide could prevent some common diseases and personalised doses at times of stress or, depending on genetic background or age, may treat some other conditions.
Fulminant Herpes Simplex Hepatitis Secondary to Adalimumab in Crohn’s Disease: A Case Report
Authors: Goel Kanika , Bunker Mark , Balog Anna , Silverman Jan F
Published: July 2019

Herpes simplex virus (HSV) hepatitis is an uncommon cause of fulminant hepatic failure, seen mostly in immunocompromised patients. Conventional treatment modalities for inflammatory bowel disease (IBD), such as steroids and azathioprine, have been known to cause HSV hepatitis. However, the reported incidence of HSV hepatitis in IBD patients undergoing tumor necrosis factor (TNF)-α inhibitor therapy is very rare. In this case report, we describe a rare case of fulminant HSV hepatitis that developed in a patient with Crohn’s disease after treatment with the TNF-α inhibitor, adalimumab.
A New Perspective on Burnout: Snapshots of the Medical Resident Experience
Authors: Harsh Jennifer S , Lawrence Tyler J , Koran-Scholl Jessica B , Bonnema Rachel
Published: July 2019

Background:

Burnout is harmful and frequently experienced by medical residents. Causes of burnout are numerous. To date, there have been no qualitative studies incorporating semistructured interviews and resident-taken photographs on their perspectives of burnout. This method is advantageous for its ability to explore the lived experience of burnout, in depth.

Objective:

The purpose of this study is to discover, through photographs and semistructured interviews, medical residents’ perspectives on what burnout means in their lives and how they manage burnout experiences.

Methods:

In 2017, 8 residents from Internal Medicine and Family Medicine Residency Programs at a large, Midwestern academic medical center participated in this study. The Transcendental Phenomenological Method was used to analyze the data collected through semistructured interviews, which used resident photographs as a guide.

Results:

Residency training was often described as a challenging experience, particularly because it took away residents’ ability to focus on their personal lives due to long work hours. This often resulted in exhaustion, self-doubt, and damaged or neglected relationships. Despite this, residents took active steps to mitigate burnout through a variety of coping strategies. In addition, residents found camaraderie, joy, and personal growth during their residency experience.

Conclusion:

Burnout continues to be an important topic in medical education and specifically for medical residents. Learning more about how burnout is perceived and the effects of burnout on residents day-to-day lives can guide the future development of strategies to promote wellness and minimize the impact of burnout.
How Will the New Global Polycystic Ovary Syndrome Guideline Change Our Clinical Practice?
Authors: Jacob Susie , Balen Adam H
Published: July 2019

Polycystic ovary syndrome (PCOS) is a far reaching condition that has a number of reproductive and general health implications. There has been much debate in recent years about the diagnosis and definition of PCOS and a plethora of studies assessing its management, ranging from the psychosocial aspects of the conditions, to the treatment of hyperandrogenism, anovulatory infertility, and the long-term metabolic and reproductive consequences. There has been a need to synthesise the evidence and produce an international consensus guideline for all aspects of the management of PCOS and this was achieved with the publication of the International evidence-based guideline for the assessment and management of polycystic ovary syndrome. The guideline is broadly categorised into 5 sections, which focus on diagnosis, holistic management and safe, effective fertility treatment. This article summarises the key points of the guidance and brings the management of PCOS up to date for the 21st century.
Linear and nonlinear analysis of mount angle effects on the dynamic stability of micropolar lubricated hydrodynamic lobed journal bearings
Authors: Zare Mehrjardi M , Rahmatabadi AD , Rashidi Meybodi R
Published: July 2019

Journal bearings are one of the most widely used types of supporting devices for industrial machinery, especially for high-speed rotary systems. Considering the importance of mechanical systems ability to control vibrations and motion disturbances, the design of noncircular journal bearings has been one of the appropriate techniques used in recent years. In the present work, the effects of mount angle as a noncircularity unique feature on the dynamic stability of lobed journal bearings with micropolar lubricant are studied. For this purpose, modified Reynolds equation based on the linear and nonlinear methods is solved by generalized differential quadrature (GDQ) method. Then the static and dynamic characteristics of two-, three- and four-lobe bearings including load carrying capacity, whirl frequency ratio, critical mass parameter and rotor perturbation in terms of bifurcation diagram and Poincare map are presented for different values of mount angle. Nonlinear analysis results indicate that variation of mount angle can change the rotor response from limit cycle oscillations to convergent perturbation to static equilibrium point. Further, against plain circular journal bearings, choosing an appropriate orientation or mounting angle provides the optimal stability of noncircular lobed journal bearings. Also, the linear analysis results for the range of dynamic stability are more cautious than the nonlinear method in most of investigated cases.
Grief after suicide: A study of taboo and metaphor
Authors: Overvad Anna Therese , Wagoner Brady
Published: July 2019

This article analyzes the negotiation of taboo surrounding grief after the suicide of a loved one. It draws on ethnographic fieldwork with a support group and individual interviews with its members. While the topic of taboo was prominent at group meetings, the same group members tended to claim in the interviews that they had not experienced it. To explore the issue of taboo, beyond affirmation or denial of its existence, we analyzed how the bereaved navigated the topic of suicide in language using Werner’s psychological theory of metaphor, which argues that metaphors arise to circumvent explicit reference to tabooed subjects. Members of the grief group clearly developed different strategies of metaphorical and other linguistic rephrasing to deal with the topics of death and suicide. Additionally, their language use differed depending on the person’s attitude toward the suicide, whether he or she was alone or with other group members, as well as whether the general public was being framed as an out-group.
Effect of social media sharing on destination brand awareness and destination quality
Authors: Dedeoğlu Bekir Bora , van Niekerk Mathilda , Küçükergin Kemal Gürkan , De Martino Marcella , Okumuş Fevzi
Published: July 2019

This study examines the effect of social media sharing on tourism destination brand awareness and destination natural and service quality and also examines the moderating roles of country of origin (COI; macro and micro) image on destination natural and service quality. Data were collected from 568 domestic and international tourists who have visited Alanya, Turkey. Relationships in the study were examined through structural equation modeling. As one of the components of social media sharing, participant sharing positively affects destination brand awareness, whereas any significant effect of nonparticipant sharing on destination brand awareness was not found. Destination brand awareness positively influences tourist perceptions of both destination service quality and destination natural quality. COI image moderates most of the relationships.
Assessment and treatment of depression in children and young people in the United Kingdom: Comparison of access to services and provision at two time points
Authors: Pile Victoria , Shammas Diana , Smith Patrick
Published: July 2019

Depression in young people is common and impairing. There have been significant service changes in the United Kingdom in the last decade, aiming to improve access to evidence-based interventions for depression. However, it is unclear whether youth with depression, first, access services and, second, receive appropriate interventions. In the current study, anonymised data from child and adolescent mental health services were extracted from a 1-year period at two time points (time 1: n = 770; time 2: n = 733). First, these were compared with prevalence and population data. Second, a subsample ( n = 45 at each time point) was evaluated against National Institute for Clinical Excellence (NICE) guidelines. Approximately, one-quarter of the expected number of cases (according to population and prevalence data) were seen in the 12 to 18-years age group, and only 2% of expected cases were seen in the 0 to 11-years age group. This was consistent across time points. Adherence to NICE guidance was mostly good at both time points, but there were concerns raised by this evaluation, in particular the use of medication in this population. From time 1 to 2, there was an increase in use of questionnaire measures, but a decrease in the correct completion of risk assessments.
The relative effect of recasts on L2 Korean learners’ accuracy development of two different forms and its relationship with language analytic ability
Authors: Kim Ji Hyun
Published: July 2019

This study explored the relative effect of recasts on second language (L2) Korean learners’ accuracy development of the object relative clauses (RCs) and the honorific subject–verb (S-V) agreement in Korean and its relationship with language analytic ability (LAA). Forty-five L2 Korean learners participated in the study and five Korean native speakers participated as their dyadic partners. The learners were assigned into the recast group ( n = 27) and the control group ( n = 18). The recast group received recasts to their errors of the target forms from an interlocutor, a native Korean speaker, during their engagement in four communicative activities, but no recasts were provided to the control group. Three language tests (i.e. a pretest, an immediate posttest, and a delayed posttest) to measure accuracy development and a LAA test were applied to both groups. The study found that recasts benefited L2 Korean learners’ accuracy development of both forms, but their effects were not equal: recasts were more effective for the object RCs than the honorific S-V agreement. In addition, the results showed that LAA had a positive effect on the extent to which the learners benefited from recasts.
How trust in EU institutions is linked to trust in national institutions: Explaining confidence in EU governance among national-level public officials
Authors: Persson Thomas , Parker Charles F , Widmalm Sten
Published: July 2019

This article analyzes the link between trust in national institutions and trust in European Union-level institutions among national public officials. Previous research has mainly looked at citizens; in contrast, little is known about the views national officials actually hold towards European Union-level institutions or how much confidence they place in them. Our study draws on a unique survey of 670 officials in 17 European Union member states who are involved in civil protection, a policy area which has recently emerged as one of the most important in the Union. Three mechanisms are explored: a ‘transference’ mechanism; a ‘trust syndrome’ mechanism and a ‘rational evaluation’ mechanism. Our findings confirm the existence of all three mechanisms and show that if European Union institutions are to be trusted to manage European Union-wide crises, then national institutions must be trusted too. This has far-reaching implications for the prospects of enhanced cooperation among civil-protection institutions in the European Union.
The performance of citizen’s and organisational authority
Authors: Mik-Meyer Nanna , Haugaard Mark
Published: July 2019

This article explores the interaction of two forms of authority: organisational authority and citizen’s authority. The concept of citizen’s authority derives from Pettit, and organisational authority has theoretical roots in Weber. Citizen’s authority entails the right to be the author of your own life decisions, while organisational authority is the right of an actor to speak on behalf of an organisation. With inspiration from Goffman and Austin, we take a performative ethnographic approach to the analysis of 23 video-recorded consultations with homeless individuals (23), their family members (3) and service providers (43) in three Danish shelters. While those with organisational authority (staff) can prevail over those with only citizen’s authority (clients), they typically refrain from doing so in an overt manner. We demonstrate that social actors are skilled at performing different kinds of authority simultaneously; they draw upon conflicting identities as clients, professionals and citizens in a changing front-stage and back-stage environment. The homeless and staff deploy rules and procedures as well as emotion and laughter in their encounters with each other.
Perceptions of violence against women in Europe: Assessing individual- and country-level factors
Authors: Vázquez David , Aizpurua Eva , Copp Jennifer , Ricarte Jorge J.
Published: July 2019

This study analyses individual- and country-level factors influencing women’s perceptions of the prevalence of violence against women in their countries. Multilevel modelling was used to study 39,377 women residing in 28 member states of the European Union (EU). Individual-level predictor variables included direct victimisation, vicarious victimisation, avoidant and defensive behaviours, awareness, and sociodemographic characteristics. At the country level, we accounted for an index of gender equality and the prevalence of intimate partner violence against women. The results showed that approximately 80 percent of women indicated that violence against women was common in their country. Most of the individual-level covariates were statistically significant, whereas the country-level indicators were not significantly associated with perceptions of violence against women.
Devised to punish: Policing, detaining and deporting Romanians from France
Authors: Vrăbiescu Ioana
Published: July 2019

The criminalization and de-criminalization of foreign nationals is performed by the French state through legal and institutional means in order to increase the deportability of unwanted EU citizens. By policing petty criminals and then instrumenting administrative coercion as a form of punishment, France opts to detain, deport and ban the entry of undesirable EU citizens, mostly Romanian citizens. Moreover, under a bilateral state agreement, France also engages Romanian police agents to help identify ‘their own’ nationals. This article uncovers, problematizes and explains the relationship between state (de-)criminalization practices and the forced removal of EU citizens. In doing so, it aims to respond to the following questions: What is the role of the Franco-Romanian police alliance in the criminalization of migration? What are the legal mechanisms advancing the de-criminalization of migration and how do they influence deportation processes? What is the meaning of punishment for EU deportable/deported citizens?