bluuebunny/crossref_metadata_2025 huggingface dataset:
Age at First Childbirth and Hypertension in Postmenopausal Women
Authors: Park Sangshin
Published: March 2017

Whether age at first childbirth has an effect on hypertension incidence is unclear. The objectives of this study were to examine the relationship between age at first childbirth and hypertension and to examine whether degree of obesity, measured as body mass index, mediates age at first childbirth-related hypertension in postmenopausal women. This study analyzed 4779 postmenopausal women data from the Korea National Health and Nutrition Examination Survey 2010 to 2012. Logistic regression analyses were used to investigate relationship between age at first childbirth and hypertension. Mediation analysis was performed to examine the contribution of body mass index to age at first childbirth-related hypertension. Mean of participants’ age at first childbirth and current age were 23.8 and 63.4 years, respectively. The prevalence of hypertension was 51.1%. Age at first childbirth was significantly associated with the prevalence of hypertension (odds ratio, 0.963; 95% confidence interval, 0.930–0.998;
P
=0.036). Women with age at first childbirth ≤19 years had significantly higher risk of hypertension (odds ratio, 1.61; 95% confidence interval, 1.17–2.23;
P
=0.004) compared with those >19 years. Multivariable-adjusted prevalence of hypertension was significantly lower in women who delivered the first infant at 20 to 24 (45.5%), 25 to 29 (46.1%), and ≥30 (39.9%) years compared with those at ≤19 years (58.4%). Body mass index completely mediated age at first childbirth–hypertension relationship (indirect effect: odds ratio, 0.992; 95% confidence interval, 0.987–0.998;
P
=0.008). Age at first childbirth was significantly associated with hypertension in postmenopausal women. Body mass index mediated the effects of age at first childbirth on hypertension.
Transfer to High-Volume Centers Associated With Reduced Mortality After Endovascular Treatment of Acute Stroke
Authors: Rinaldo Lorenzo , Brinjikji Waleed , Rabinstein Alejandro A.
Published: March 2017

Background and Purpose—

Some have argued that it may be beneficial to expand the availability of endovascular revascularization services to lower-volume hospitals to minimize the morbidity associated with transfer to larger endovascular centers. We compared the outcomes after revascularization of patients directly admitted to a low-volume center and those transferred to a high-volume center.

Methods—

We searched a national database of hospital-reported outcomes for patients who underwent endovascular revascularization for acute ischemic stroke. Hospitals were categorized as low, medium, or high procedural volume hospitals. Outcomes of inpatient admissions were collected and compared on the basis of admission source and hospital procedural volume.

Results—

A total of 118 institutions with 8533 patients were included. Mortality rate (14.9% versus 18.6%;
P
=0.049) and mortality index (1.1 versus 1.6;
P
=0.048) were significantly lower among directly admitted relative to transferred patients. For all patients, there were significant differences in institutional mortality rate (low: 19.7%, medium: 14.9%, high: 9.8%;
P
=0.003) and mortality index (low: 1.5, medium: 1.1, high: 0.8;
P
=0.004) between low-, medium-, and high-volume hospitals. For transferred patients to high-volume centers, both mortality rate (high: 10.0% versus low: 20.4%;
P
=0.005) and mortality index (high: 0.8 versus low: 1.5;
P
=0.034) were significantly lower than that observed for directly admitted patients to low-volume hospitals.

Conclusions—

We report a beneficial effect of treatment at high-volume hospitals in spite of the detrimental effects of transfer. These findings argue for the centralization of care.
Seasonal Poetics: The Dry Season and Autumn Rains among Pre-Islamic Naǧdī and Ḥiǧāzī Tribes
Authors: Miller Nathaniel A.
Published: March 2017

This article maps out the depiction among pre-Islamic tribes of two seasons, the August ḫarīf rains and the qayẓ dry season. References to the ḫarīf rain are found almost exclusively in southwestern Arabia, Yemen and the Ḥiǧāz. Tribes in these regions evidently began their seasonal migration in August, that is, earlier than tribes of central and northeastern Arabia (Naǧd), where migration began in October and November. The most conspicuous result of this difference is the development of two regional methods of depicting the ẓaʿn, or departure of the beloved’s caravan, in the classical qaṣīda (polythematic ode). Naǧdī tribes set this scene at the beginning of the summer dry season, while the Ḥiǧāzī Huḏayl set it in a rainy season. A sequence of poets within Tamīm developed an idiosyncratic set of vocabulary for developing the early-summer ẓaʿn, just as certain Huḏalī poets developed certain techniques to describe their rainy season ẓaʿn.

Cet article analyse la représentation dans les tribus préislamiques de deux saisons, les pluies d’août (ḫarīf) et la saison sèche (al-qayẓ). Les références à la pluie ḫarīf se trouvent presque exclusivement au sud-ouest de l’Arabie, au Yémen et dans le Ḥiǧāz. Les tribus de ces régions commençaient apparemment leur migration saisonnière en août, plus tôt que les tribus du centre et du nord-est de l’Arabie (Naǧd), où la migration commençait en octobre ou novembre. Le résultat le plus remarquable de cette différence est l’évolution de deux méthodes régionales de la représentation du ẓaʿn, le départ de la caravane de la bien-aimée, dans la qaṣīda classique (ode polythématique). Les tribus du Naǧd plantent le décor de cette scène au début de la saison sèche, tandis que la tribu ḥiǧāzienne Huḏayl la situe à la saison des pluies.

This article is in English.
A Moravian Mission and the Origins of Evangelical Protestantism among Slaves in the Carolina Lowcountry
Authors: Fogleman Aaron Spencer
Published: March 2017

This article investigates the German Moravian slave mission in South Carolina (1738-1740), including its role in beginning evangelical Protestantism among Lowcountry slaves. It documents responses of planters, townspeople, and especially slaves and shows how the mission was connected to the transatlantic evangelical Protestant awakening. Following Wesley’s brief encounter in 1737 and preceding Whitefield’s visit in 1740 and the subsequent slave revival in Port Royal, the Moravians offered sustained contact with the new religious style. Several slaves responded enthusiastically, including a woman named Diana of Port Royal, who played a leadership role, while others defiantly rejected their message as the religion of barbaric masters. Disease, white resistance after the Stono Rebellion, internal problems, et al. forced the mission to close, but its brief history reveals the interests, struggles, hopes, and fears of slaves, planters, and missionaries in the mid-eighteenth century and how they were connected to other Atlantic and global missions.
Introduction: Missionary Encounters in the Atlantic World
Authors: Gerbner Katharine , Vélez Karin
Published: March 2017

Missionaries were often the most prolific writers on non-European peoples and cultures in the early modern Atlantic world. As a result, their sources have proven to be indispensable for early modernists. For decades, historians have explored missionary encounters and the sources they inspired to gain insight into a wide variety of topics including native history, the history of religion, labor history, environmental history, the history of the African diaspora, and the history of capitalism. While missionary sources are used widely, most scholarship on the encounters themselves focuses on either a particular denomination or a particular region. Rarely is the surprisingly cohesive barrier between Protestant and Catholic missions breached within single volumes or monographs. This special issue seeks to break down these divides. By making inter-denominational and inter-imperial connections, this volume asks new questions about the meaning of missionary encounters in the early modern world.
«Пoлeзныe Идиoты» Глaзaми Пoлякa
Authors: Cheremushkin (Пётp Чepёмушкин ) Petr
Published: March 2017

This is a review essay of Dariusz Tołczyk’s book Gułag w oczach Zachodu (The Gulag in the Eyes of the West), which was published in Polish in 2009. This controversial work examines the question of why, for at least the first half of the twentieth century, the West has turned a blind eye to the Stalinist repression. Tołczyk notes that the West paid little attention to the complaints of the Baltic countries and Poland about Stalin’s Great Terror. The reviewer states that the formation of an improved Western image of first Soviet Russia and then the Soviet Union from 1917 to the Gorbachev years by a West that is currently worried about the Putin regime, is Tołczyk’s, a Polish author residing in the United States, main theme.
Restoring the imagination: the contribution of Conrad Pepler, OP, and Gerald Vann, OP
Authors: Stepnowski Thomas More
Published: March 2017

Various definitions have been employed to describe or interpret the Catholic Imagination. The contributions of English Dominican Fathers Conrad Pepler (1908–1993) and Gerald Vann (1906–1963) may assist in furthering this discussion by using a Thomistic framework to define the imagination, identify threats to its formation and promote its restoration and the renewal of culture.
Liability for providing a prognosis in surgical practice
Authors: de Costa Alex , Tam Amy
Published: March 2017

The common law's development of the doctrine of informed consent has progressively imposed broader obligations on surgeons to provide patients with information about the surgical and alternative treatment choices available. Prognosis is critical because the patient cannot provide informed consent without information about the likely evolution of the physiological or pathological processes involved in the surgery under consideration. But does the duty of care that a surgeon owes a patient require a precise prognosis to be given in every case? A recent decision of the Court of Appeal considers that question.
Hospital-level variation in inpatient cost among children receiving extracorporeal membrane oxygenation
Authors: Barbaro Ryan P. , Boonstra Philip S. , Moler Frank W. , Davis Matthew M. , Prosser Lisa A
Published: March 2017

Objective:

Pediatric extracorporeal membrane oxygenation (ECMO) varies in the way care is provided from hospital to hospital. This variability in hospital ECMO care can be represented by the variation in ECMO costs. We hypothesized that hospitals will demonstrate large variations in case-mix-adjusted ECMO inpatient costs for children requiring ECMO and higher volume hospitals will have lower associated costs.

Methods:

We retrospectively analyzed the inpatient cost of children receiving ECMO in 2006, 2009 and 2012, using the Healthcare Cost and Utilization Project Kids’ Inpatient Database. We used a hierarchical linear regression model and the intraclass correlation coefficient to quantify how much of the difference in ECMO inpatient costs was associated with the hospital where a child received care. To do this, we adjusted for patient factors, hospital factors and potentially modifiable factors such as complications, procedures and length of stay.

Results:

The median inflation-adjusted inpatient costs for children requiring ECMO were $183,000, $240,000 and $241,000 in years 2006, 2009 and 2012, respectively. The largest median cost for ECMO cases in a given hospital in a given year ($690,000) was more than 11 times that of the smallest median cost ($60,000). After case-mix adjustment, 27% of the variation in inpatient costs was associated with the hospital where ECMO care was provided. Average hospital costs were not associated with hospital ECMO volume.

Conclusions:

The large variation in ECMO inpatient costs between hospitals suggests great variation in care between hospitals, which is important because hospitals have a co-existing variation in ECMO survival rates.
Accuracy of the Spectrum Medical M4 and Terumo CDI 500 compared to the Radiometer ABL90 FLEX benchtop blood analyzer
Authors: Reagor James A. , Gao Zhiqian , Lombardi John P. , Millin Barbara B. , Tweddell James S. , Cooper David S.
Published: March 2017

The benchtop blood analyzer is the gold standard for blood oxygen saturation (SO2) and hemoglobin (Hb) analysis. However, the benchtop analyzer only provides values at a given point in time. In the field of cardiovascular perfusion and the practice of cardiopulmonary bypass (CPB), continuous measurement of SvO2 and hemoglobin values have become commonplace. Two devices currently available which monitor these values are the Terumo CDI 500 and Spectrum Medical M4. A retrospective study was conducted to examine the accuracy of the M4 technology and the CDI 500 as they compare to each other and the ABL90 FLEX, a benchtop blood gas analyzer. The data revealed the magnitude of mean differences were small, even when significant. However, the 95% Limits of Agreement were too large for either device to allow substitution of the CDI 500 and M4 hemoglobin or SvO2 values for ABL90 values. As recommended by the manufacturers, the CDI 500 and M4 should only be used as a trending device.
Dexamethasone suppresses JMJD3 gene activation via a putative negative glucocorticoid response element and maintains integrity of tight junctions in brain microvascular endothelial cells
Authors: Na Wonho , Shin Jee Y , Lee Jee Y , Jeong Sangyun , Kim Won-Sun , Yune Tae Y , Ju Bong-Gun
Published: March 2017

The blood–brain barrier (BBB) exhibits a highly selective permeability to support the homeostasis of the central nervous system (CNS). The tight junctions in the BBB microvascular endothelial cells seal the paracellular space to prevent diffusion. Thus, disruption of tight junctions results in harmful effects in CNS diseases and injuries. It has recently been demonstrated that glucocorticoids have beneficial effects on maintaining tight junctions in both in vitro cell and in vivo animal models. In the present study, we found that dexamethasone suppresses the expression of JMJD3, a histone H3K27 demethylase, via the recruitment of glucocorticoid receptor α (GRα) and nuclear receptor co-repressor (N-CoR) to the negative glucocorticoid response element (nGRE) in the upstream region of JMJD3 gene in brain microvascular endothelial cells subjected to TNFα treatment. The decreased JMJD3 gene expression resulted in the suppression of MMP-2, MMP-3, and MMP-9 gene activation. Dexamethasone also activated the expression of the claudin 5 and occludin genes. Collectively, dexamethasone attenuated the disruption of the tight junctions in the brain microvascular endothelial cells subjected to TNFα treatment. Therefore, glucocorticoids may help to preserve the integrity of the tight junctions in the BBB via transcriptional and post-translational regulation following CNS diseases and injuries.
Processing Time and Cognitive Effort of Longhand Note Taking When Reading and Summarizing a Structured or Linear Text
Authors: Olive Thierry , Barbier Marie-Laure
Published: March 2017

We examined longhand note taking strategies when reading and summarizing a source text that was formatted with bullets or that was presented in a single paragraph. We analyzed cognitive effort when reading the source text, when jotting notes, when reading the notes, and when composing the summary, as well as time spent in these activities and the content of the notes and the summaries. With a formatted text, students’ perceived comprehension difficulty was lower and they expended less cognitive effort, spent less time reading the text, and noted more ideas. While composing the summary, only those students who read the formatted source text continued selecting ideas in their notes. Finally, the summaries were unaffected by the formatting of the source text. The study shows that formatting a source text with bullets facilitates note taking by helping students to grasp its structure and by reducing the cognitive effort of reading.
First Semester College Students’ Definitions of and Expectations for Engaging in Hookups
Authors: Olmstead Spencer B. , Conrad Kathryn A. , Anders Kristin M.
Published: March 2017

Our study was guided by a developmental lens (emerging adulthood) and the theory of symbolic interaction as we attended to the meanings and definitions that contextualize expectations for engaging in hookups while attending college. Using a directed approach to qualitative content analysis, we examined first semester college men’s and women’s ( N = 253) responses to a series of open-ended questions focused on definitions of and expectations for hooking up. Six definitional variations of hooking up emerged from these responses: (a) “sex” left undefined, (b) making out, (c) a range of sexual activities, (d) “sex” defined as intercourse, (e) the “all but sex” continuum, and (f) hanging out or going on a date. Chi-square analyses indicated no proportional differences in these definitions based on participant gender. Characteristics of hookup partners were also identified in participant responses. Whereas a greater proportion of men identified physical appearance as a necessary attribute of a potential hookup partner, a greater proportion of women discussed (a) familiarity with a hookup partner and (b) hookups as occurring between noncommitted individuals. Also, a greater proportion of men than women indicated expectations to hookup while attending college. Implications for research, relationship and sexual health education, and policy are discussed.
Modifiable Risk Factors for Delirium in Critically Ill Trauma Patients: A Multicenter Prospective Study
Authors: Duceppe Marc-Alexandre , Williamson David R. , Elliott Audrée , Para Mélissa , Poirier Marie-Christine , Delisle Marie-Soleil , Deckelbaum Dan , Razek Tarek , Desjardins Monique , Bertrand Jean-Claude , Bernard Francis , Rico Philippe , Burry Lisa , Frenette Anne Julie , Perreault Marc
Published: March 2017

Objective:

Intensive care unit (ICU)–acquired delirium has been associated with increased morbidity and mortality. Prevention strategies including modification of delirium risk factors are emphasized by practice guidelines. No study has specifically evaluated modifiable delirium risk factors in trauma ICU patients. Our goal was to evaluate modifiable risk factors for delirium among trauma patients admitted to the ICU.

Design:

Prospective observational study.

Setting:

Two level 1 trauma ICU centers.

Patients:

Patients 18 years of age or older admitted for trauma including mild to moderate traumatic brain injury were eligible for the study.

Interventions and Measurements:

Delirium was assessed daily using the confusion assessment method for the ICU (CAM-ICU). The effect of modifiable risk factors was assessed using multivariate Cox regression analysis adjusting for severity of illness and significant nonmodifiable risk factors.

Main Results:

A total of 58 of 150 recruited patients (38.7%; 95% confidence interval [CI] 30.9-46.5) screened positive for delirium during ICU stay. When adjusting for significant nonmodifiable risk factors, physical restraints (hazard ratio [HR]: 2.13; 95% CI: 1.07-4.24) and active infection or sepsis (HR: 2.12; 95% CI: 1.18-3.81) significantly increased the risk of delirium, whereas opioids (HR: 0.35; 95% CI: 0.13-0.98), episodes of hypoxia (HR: 0.55; 95% CI: 0.31-0.95), access to a television/radio in the room (HR: 0.26; 95% CI: 0.11-0.62), and number of hours mobilized per day (HR: 0.77; 95% CI: 0.68-0.88) were associated with significantly less risk of delirium.

Conclusion:

We have identified modifiable risk factors for delirium. Future studies should aim at implementing strategies to modify these risk factors and evaluate their impact on the risk of delirium.
Evaluation of Healthy Living Wellness Program With Minority Underserved Economically Disadvantaged Older Adults
Authors: Tallier Peggy C. , Reineke Patricia R. , Frederickson Keville
Published: March 2017

The purpose of this Roy adaptation model-guided study was to test the effectiveness of a student registered nurse intern-led nursing intervention entitled the Healthy Living Wellness Program. A one-group pretest/posttest preexperimental design was used. The intervention was imparted to minority, underserved, economically disadvantaged older adults ( N = 30). Significant findings pre- and postintervention were reported for body mass index, waist circumference, self-reported blood glucose, and weight. The findings supported the effectiveness of the nursing intervention, the Healthy Living Wellness Program, guided by the Roy adaptation model.
Transforming Nursing Education and the Formation of Students
Authors: Donohue-Porter Patricia , Forbes Maryann O. , White Jane H. , Baumann Steven L.
Published: March 2017

Transforming nursing education is a current focus across the country, the result of recent national reports that have made significant contributions for evaluating and changing curricula and ways students are taught. However, the need to ground these strategies for change within our discipline’s ontological foundation through nursing theory must be addressed. The purpose of this article is to use Parse’s Humanbecoming Paradigm to provide educators with exemplars of discipline-specific theory-based changes across educational levels. The exemplars are situated within the important tensions that educators face today in undergraduate, advanced practice, and doctoral programs. Conclusions are drawn regarding continuing efforts to ensure that nurse educators incorporate discipline-relevant theories when transforming nursing education.
Understanding by Looking Through Prisms
Authors: Ortuno Lila , Florczak Kristine L.
Published: March 2017

The authors of this column explore the transformational journey of a nursing student pursuing a graduate degree through the prisms of ethics, aesthetics, and nursing theory. The wisdom and insights gained contribute to an ever-changing worldview of humans and living experiences.
An analytical study of the scattering of ultrasonic guided waves at a delamination-like discontinuity in a plate
Authors: Schaal Christoph , Zhang Suzhou , Samajder Himadri , Mal Ajit
Published: March 2017

Interface delaminations between individual plies in a composite, or disbonds of face sheets in honeycomb structures often remain undetected. Using guided ultrasonic waves (Rayleigh and Lamb waves) such hidden defects can be detected. In this work, an analytical framework that considers propagating, nonpropagating and evanescent waves to analyze the scattering of an incident ultrasonic wave at a delamination-like discontinuity is presented. Wave conversion at the interface of the damage is quantified in terms of the power flows of the individual waves. The analytical solutions are compared with results from numerical simulations. For an incident Lamb wave, excellent agreement is found. However, it is shown that the analytical solution for an incident Rayleigh wave has significant differences from the numerical results, due to the incomplete nature of the Rayleigh wave-field in the half-space. Even though this study is performed for isotropic waveguides, the method can be extended to transversely isotropic laminates by substituting the corresponding expressions for the dispersion equations, as well as displacement and stress fields.
Formal Modeling of the Resistance to Peer Influence Questionnaire: A Comparison of Adolescent Boys and Girls With and Without Mild-to-Borderline Intellectual Disability
Authors: Dekkers Laura M. S. , Bexkens Anika , Hofman Abe D. , Boeck Paul De , Collot d’Escury Annematt L. , Huizenga Hilde M.
Published: March 2017

Items of the Resistance to Peer Influence Questionnaire (RPIQ) have a tree-based structure. On each item, individuals first choose whether a less versus more peer-resistant group best describes them; they then indicate whether it is “Really true” versus “Sort of true” that they belong to the chosen group. Using tree-based item response theory, we show that RPIQ items tap three dimensions: A Resistance to Peer Influence (RPI) dimension and two Response Polarization dimensions. We then reveal subgroup differences on these dimensions. That is, adolescents with mild-to-borderline intellectual disability, compared with typically developing adolescents, are less RPI and more polarized in their responses. Also, girls, compared with boys, are more RPI, and, when high RPI, more polarized in their responses. Together, these results indicate that a tree-based modeling approach yields a more sensitive measure of individuals’ RPI as well as their tendency to respond more or less extremely.
Flexural behavior of sandwich panels with cellular wood, plywood stiffener/foam and thermoplastic composite core
Authors: Labans Edgars , Kalnins Kaspars , Bisagni Chiara
Published: March 2017

A series of experimental tests have been carried out on three types of novel sandwich panels mainly designed for application in lightweight mobile housing. Two types of the panels are manufactured entirely from wood-based materials while the third one presents a combination of plywood for surfaces and corrugated thermoplastic composite as a core part. All sandwich panels are designed to allow rapid one-shot manufacturing. Mechanical performance has been evaluated in four-point bending comparing the data to the reference plywood board. Additionally, finite element simulations were performed to evaluate global behavior, stress distribution and provide the basis for a reliable design tool. Obtained results show sufficient mechanical characteristics suitable for floor and wall units. Compared to a solid plywood board, sandwich alternative can reach up to 42% higher specific stiffness, at the same time maintaining sufficient strength characteristics.
Phantom/liminal fat and feminist theories of the body
Authors: Kyrölä Katariina , Harjunen Hannele
Published: March 2017

This article brings together two concepts, ‘phantom fat’ and ‘liminal fat’, which both aim to grasp how fat in contemporary culture becomes a kind of material immateriality, corporeality in suspension. Comparing the spheres of representation and experience, we examine the challenges and usefulness of these concepts, and feminist fat studies perspectives more broadly, to feminist scholarship on the body. We ask what connects and disconnects fat corporeality and fat studies from ways of theorising other embodied differences, like gender, ‘race’, disability, class and sexuality, especially when thinking through their perceived mutability or removability, and assumptions about their relevance for subjectivity. While it is important to consider corporeality and selfhood as malleable and open to change in order to mobilise oppressive normativities around gendered bodies and selves, we argue that more attention should also be paid to the persistence of corporeality and a feeling of a relatively stable self, and the potential for empowerment in not engaging with or idealising continuous transformation and becoming. Furthermore, we suggest that the concepts of phantom fat and liminal fat can help shed light on some problematic ways in which feminist studies have approached – or not approached – questions of fat corporeality in relation to the politics of health and bodily appearance. Questions of weight, when critically interrogated together with other axes of difference, highlight how experiential and subjugated knowledges, as well as critical inquiry of internal prejudices, must remain of continued key importance to feminist projects.
Exploring Knowledge, Attitudes, and Practice Associated With Meditation Among Patients With Melanoma
Authors: Russell Lahiru , Orellana Liliana , Ugalde Anna , Milne Donna , Krishnasamy Meinir , Chambers Richard , Livingston Patricia M.
Published: March 2017

Aim: To explore the knowledge, attitudes, and practices associated with meditation among people with melanoma and investigate the relationship between perceived stress, trait mindfulness, and meditation. Factors associated with interest to participate in an online meditation program were also explored. Methods: A survey-based cross-sectional study of 291 patients attending a melanoma outpatient clinic assessed knowledge of meditation, attitudes toward meditation using Determinants of Meditation Practice Inventory (DMPI), and meditation experience. Perceived stress and trait mindfulness were measured using the Perceived Stressed Scale and Cognitive and Affective Mindfulness Scale, respectively. Results: Participants who had tried meditation (43%) were likely to be younger, female, and have completed higher education or be employed. Perceived stress score was higher among women, younger participants, and those treated in the past year but did not differ by melanoma stage. Participants reported a good understanding of the potential benefits of meditation, but even among people with meditation experience, common misconceptions prevailed. The main barrier to meditation was a perceived lack of knowledge about meditation . Higher DMPI scores were associated with lower education, moderate to low access to service centers, or living in disadvantaged neighborhoods . Participants practicing meditation that involved self-reflection reported less stress and higher trait mindfulness compared with participants practicing another type of meditation. People interested in participating in an online meditation-based program reported higher perceived stress than those not interested. Conclusion: A meditation-based intervention teaching self-reflective practices, targeted at people with melanoma, may have the potential to assist them with managing their stress.
Nutcracker Syndrome: Case Report on the Management of Recurrent Stenosis After Stenting
Authors: Hansraj Natasha , Hamdi Abdul , Khalifeh Ali , Wise Eric , Sarkar Rajabrata , Toursavadkohi Shahab
Published: March 2017

Nutcracker syndrome is a clinical entity leading to renal venous hypertension due to extrinsic compression of the left renal vein by the superior mesenteric artery. Current surgical therapy involves placement of an oversized renal vein stent with partial protrusion into the inferior vena cava (IVC) to relieve stenosis and prevent stent migration. Here, we present a patient with intractable pain and hematuria secondary to nutcracker syndrome who underwent left renal vein stent placement and developed recurrent symptoms due to flow-limiting kinking at the left renal hilum, with partial obstruction of the IVC from pseudointimal hyperplasia. This was treated with stent excision and construction of a left neorenal vein bypass. Thus, given these complications, we should perhaps revisit the recommendations for oversizing of the stent.
“Back on Track”: A Longitudinal Mixed Methods Study on the Rehabilitation of Young Adult Cancer Survivors
Authors: Hauken May Aasebø , Larsen Torill Marie Bogsnes , Holsen Ingrid
Published: March 2017

To address the multidimensional challenges faced by young adult cancer survivors, 20 young adult cancer survivors participated in a rehabilitation program. Mixed methods, including a longitudinal convergent parallel design, were employed to evaluate both process and outcome issues. Data were collected simultaneously via questionnaires, physical testing, and interviews at four separate time points. The results portrayed rehabilitation as a process involving the gradual improvement in quality of life, participation, and physical capacity, whereby finding a balance between the different aspects of life, novel insights, and multidimensional follow-ups were important factors. This study contributes to mixed methods literature as an example of how a longitudinal mixed methods approach may yield an enriched understanding of both the rehabilitation process and outcomes in cancer rehabilitation.
The Art and Science of Group Visits in Lifestyle Medicine
Authors: Frates Elizabeth Pegg , Morris Elizabeth C. , Sannidhi Deepa , Dysinger Wayne S.
Published: March 2017

Lifestyle medicine group sessions present a promising approach to clinical care. Based on decades of work in shared medical appointments and group visits for diabetes and other chronic conditions, a lifestyle medicine group session has the potential to provide a fresh and rewarding way of interacting with patients that fuels the practitioner and feeds patients’ needs to spend time with the lifestyle medicine practitioner, connect with him or her, connect with others, learn the latest recommendations regarding healthy habits, practice these behaviors, and discuss their obstacles, motivations, and strategies for healthy living. The lifestyle medicine group session discussed in this article is a combination of group coaching, education, and group support.
Racially-Mixed Personal Identity Equality
Authors: Hernández Tanya Katerí
Published: March 2017

A growing number of commentators view discrimination against multiracial (racially-mixed) people as a distinctive challenge to racial equality. This perspective is based on the belief that multiracial-identified persons experience racial discrimination in a manner that makes it necessary to reconsider civil rights law. This article disputes that premise and deconstructs its Personal Identity Equality approach to anti-discrimination law and demonstrates its ill effects reflected in Supreme Court affirmative action litigation.
Statistical analysis plan for the Head Position in Stroke Trial (HeadPoST): An international cluster cross-over randomized trial
Authors: Billot Laurent , Woodward Mark , Arima Hisatomi , Hackett Maree L , Muñoz Venturelli Paula , Lavados Pablo M , Brunser Alejandro , Peng Bin , Cui Liying , Song Lily , Heritier Stephane , Jan Stephen , Middleton Sandy , Olavarría Verónica V , Lim Joyce , Robinson Thompson , Pontes-Neto Octavio , Watkins Caroline , Anderson Craig S
Published: March 2017

Background

There is evidence to indicate that the lying flat head position increases cerebral blood flow and oxygenation in patients with acute ischemic stroke, but how these physiological effects translate into clinical outcomes is uncertain. The Head Position in Stroke Trial aims to determine the comparative effectiveness of lying flat (0°) compared to sitting up (≥30°) head positioning, initiated within 24 h of hospital admission for patients with acute stroke.

Design

An international, pragmatic, cluster-randomized, crossover, open, blinded outcome assessed clinical trial. Each hospital with an established acute stroke unit (cluster) site was required to recruit up to 140 consecutive cases of acute stroke (one phase of head positioning before immediately crossing over to the other phase of head positioning), including both acute ischemic stroke and intracerebral hemorrhage, in each randomized head position as a ‘business as usual’ policy.

Objective

To outline in detail the predetermined statistical analysis plan for the study.

Methods

All accumulated data will be reviewed and formally assessed. Information regarding baseline characteristics of patients, their process of care and management will be outlined, and for each item, statistically relevant descriptive elements will be described. For the trial outcomes, the most appropriate statistical comparisons are described.

Results

A statistical analysis plan was developed that is transparent, verifiable, and predetermined before completion of data collection.

Conclusions

We developed a predetermined statistical analysis plan for Head Position in Stroke Trial to avoid analysis bias arising from prior knowledge of the findings, in order to reliably quantify the benefits and harms of lying flat versus sitting up early after the onset of acute stroke.

Trial registration

ClinicalTrials.gov identifier NCT02162017; ANZCTR identifier ACTRN12614000483651
Umeclidinium in chronic obstructive pulmonary disease: latest evidence and place in therapy
Authors: Babu Kesavan Suresh , Morjaria Jaymin Bhagwanji
Published: March 2017

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity, mortality and health care expenditure throughout the world. COPD guidelines recommend the use of long-acting muscarinic antagonist (LAMA) either alone or in combination with a long-acting β2 agonist (LABA). For over 10 years, tiotropium was the only LAMA that was used in the management of COPD. Over the past few years, various new drugs have been identified that act on the muscarinic receptors and β2 receptors. Umeclidinium (Umec) is a new LAMA currently approved for use in patients with COPD either as monotherapy or in combination with vilanterol (Vil). Both Umec alone and in combination with Vil delivered through a multi-dose dry powder Ellipta™ device have shown improvement in lung function, health-related quality of life and exacerbation frequency in patients with COPD. This review provides an overview of the pharmacology, pharmacodynamics and pharmacokinetics of Umec, and evaluates the clinical efficacy and safety studies in patients with COPD.
The Feasibility of a Japanese Crowdsourcing Service for Experimental Research in Psychology
Authors: Majima Yoshimasa
Published: March 2017

Recent studies have empirically validated the data obtained from Amazon’s Mechanical Turk. Amazon’s Mechanical Turk workers behaved similarly not only in simple surveys but also in tasks used in cognitive behavioral experiments that employ multiple trials and require continuous attention to the task. The present study aimed to extend these findings to data from Japanese crowdsourcing pool in which participants have different ethnic backgrounds from Amazon’s Mechanical Turk workers. In five cognitive experiments, such as the Stroop and Flanker experiments, the reaction times and error rates of Japanese crowdsourcing workers and those of university students were compared and contrasted. The results were consistent with those of previous studies, although the students responded more quickly and poorly than the workers. These findings suggested that the Japanese crowdsourcing sample is another eligible participant pool in behavioral research; however, further investigations are needed to address issues of qualitative differences between student and worker samples.
Exceeding Pitch Count Recommendations in Little League Baseball Increases the Chance of Requiring Tommy John Surgery as a Professional Baseball Pitcher
Authors: Erickson Brandon J. , Chalmers Peter N. , Axe Michael J. , Romeo Anthony A.
Published: March 2017

Background:

Empirical evidence has suggested a connection between youth pitch counts and subsequent elbow injury. For players within the Little League World Series (LLWS), detailed historical player data are available. Some of these players progress to both professional play and require an ulnar collateral ligament reconstruction (UCLR).

Purpose:

To determine the percentage of LLWS pitchers who proceed to play professional (major or minor league) baseball, the rate of UCLR in former LLWS pitchers who played professional baseball, and the risk to those who exceeded current pitch count recommendations while playing in the LLWS.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

All LLWS pitchers from 2001 through 2009 from all teams and countries were identified, and all performance data were extracted. A professional (major and minor league) baseball database was then searched to determine whether each former LLWS pitcher played professional baseball. These professional players were then searched for using publicly available databases to determine whether they underwent UCLR.

Results:

Overall, 638 adolescents pitched in the LLWS between 2001 and 2009; 62 (10%) progressed to professional play. Of the 56 minor league players, 25 (45%) pitched. Of the 6 Major League Baseball players, 3 (50%) pitched. Three former LLWS pitchers (5%) who played professionally underwent UCLR. In former LLWS pitchers who exceeded pitch counts and played professionally, 50% (2/4) required UCLR, while only 1.7% (1/58) of those who did not exceed pitch count recommendations required UCLR ( P = .009). Similarly, among former LLWS pitchers who subsequently played professionally, 23.1% of those who played as a pitcher required UCLR while 0% of those who also played other positions required UCLR ( P = .008).

Conclusion:

Progression from LLWS pitching to professional baseball is uncommon. Among youth players, both diversification (playing other positions besides pitcher) as well as following current pitch limit regulations may protect against UCLR.
A collaborative approach for semantic time-based video annotation using gamification
Authors: Viana Paula , Pinto José Pedro
Published: March 2017

Efficient access to large scale video assets, may it be our life memories in our hard drive or a broadcaster archive which the company is eager to sell, requires content to be conveniently annotated. Manually annotating video content is, however, an intellectually expensive and time-consuming process. In this paper we argue that crowdsourcing, an approach that relies on a remote task force to perform activities that are costly or time-consuming using traditional methods, is a suitable alternative and we describe a solution based on gamification mechanisms for collaboratively collecting timed metadata. Tags introduced by registered players are validated based on a collaborative scoring mechanism that excludes erratic annotations. Voting mechanisms, enabling users to approve or refuse existing tags, provide an extra guarantee on the quality of the annotations. The sense of community is also created as users may watch the crowd’s favourite moments of the video provided by a summarization functionality. The system was tested with a pool of volunteers in order to evaluate the quality of the contributions. The results suggest that crowdsourced annotation can describe objects, persons, places, etc. correctly, as well as be very accurate in time.
A practical person authentication system using second minor finger knuckles for door security
Authors: Kusanagi Daichi , Aoyama Shoichiro , Ito Koichi , Aoki Takafumi
Published: March 2017

This paper proposes a person authentication system using second minor finger knuckles, i.e., metacarpophalangeal (MCP) joints, for door security. This system acquires finger knuckle patterns on MCP joints when a user takes hold of a door handle and recognizes a person using MCP joint patterns. The proposed system can be constructed by attaching a camera onto a door handle to capture MCP joints. Region of interest (ROI) images around each MCP joint can be extracted from only one still image, since all the MCP joints are located on the front face of the camera. Phase-based correspondence matching is used to calculate matching scores between ROIs to take into consideration deformation of ROIs caused by hand pose changes. Through a set of experiments, we demonstrate that the proposed system exhibits the efficient performance of MCP recognition and also show the potential possibilities of second minor finger knuckles for biometric recognition.
3D assessment of an underground mine pillar by combination of photogrammetric and geoelectric methods
Authors: Fargier Yannick , Antoine Raphaël , Dore Ludovic , Lopes Sérgio Palma , Fauchard Cyrille
Published: March 2017

The monitoring of underground cavities plays a key role in risk management policies. Mine and underground quarry stakeholders require relevant methodologies and practices to define and assess hazards associated with these structures. To monitor these structures, geophysical methods may offer an interesting compromise among operating cost, invasiveness, and risk assessment reliability. The use of conventional 3D-electric resistivity imaging (ERI) software validated on relatively flat media is not sufficient to efficiently assess complex 3D geometries such as underground mine pillars. We have developed a new approach to evaluate pillar condition by means of a sequential use of two techniques. First, the photogrammetric method yields a detailed 3D model of the pillar geometry from a set of pictures. Second, 3D-ERI is performed based on this suitable geometry. The methodology is tested on a synthetic model to evaluate the effect of various geometry resolutions on the inversion. We also evaluated the combination of the effect of measurement and geometry error. We performed a quasi 3D-ERI survey (three parallel electrode lines) on a real limestone mine pillar to determine the benefits and limitations of the combined procedure. First results revealed the capacity of the photogrammetric methods to obtain a high-precision geometry and its key role during the inversion process. Second results of the real case study revealed that a highly accurate geometry is required to detect accurately conductive anomalies in a complex 3D context.
Mercaptopurine Ingestion Habits, Red Cell Thioguanine Nucleotide Levels, and Relapse Risk in Children With Acute Lymphoblastic Leukemia: A Report From the Children’s Oncology Group Study AALL03N1
Authors: Landier Wendy , Hageman Lindsey , Chen Yanjun , Kornegay Nancy , Evans William E. , Bostrom Bruce C. , Casillas Jacqueline , Dickens David S. , Angiolillo Anne L. , Lew Glen , Maloney Kelly W. , Mascarenhas Leo , Ritchey A. Kim , Termuhlen Amanda M. , Carroll William L. , Relling Mary V. , Wong F. Lennie , Bhatia Smita
Published: March 2017

Purpose

Children with acute lymphoblastic leukemia (ALL) are generally instructed to take mercaptopurine (6-MP) in the evening and without food or dairy products. This study examines the association between 6-MP ingestion habits and 6-MP adherence, red cell thioguanine nucleotide (TGN) levels, and risk of relapse in children with TMPT wild-type genotype.

Methods

Participants included 441 children with ALL receiving oral 6-MP for maintenance. Adherence was monitored over 48,086 patient-days using the Medication Event Monitoring System; nonadherence was defined as adherence rate < 95%. 6-MP ingestion habits examined included: takes 6-MP with versus never with food, takes 6-MP with versus never with dairy, and takes 6-MP in the evening versus morning versus varying times.

Results

Median age at study was 6 years (range, 2 to 20 years); 43.8% were nonadherent. Certain 6-MP ingestion habits were associated with nonadherence (taking 6-MP with dairy [odds ratio (OR), 1.9; 95% CI, 1.3 to 2.9; P = .003] and at varying times [OR, 3.4; 95% CI, 1.8 to 6.3; P = .0001]). After adjusting for adherence and other prognosticators, there was no association between 6-MP ingestion habits and relapse risk (6-MP with food: hazard ratio [HR], 0.7; 95% CI, 0.3 to 1.9; P = .5; with dairy: HR, 0.3; 95% CI, 0.07 to 1.5; P = .2; taken in evening/night: HR, 1.1; 95% CI, 0.2 to 7.8; P = .9; at varying times: HR, 0.3; 95% CI, 0.04 to 2.7; P = .3). Among adherent patients, there was no association between red cell TGN levels and taking 6-MP with food versus without (206.1 ± 107.1 v 220.6 ± 121.6; P = .5), with dairy versus without (220.1 ± 87.8 v 216.3 ± 121.3; P =.7), or in the evening/night versus morning/midday versus varying times (218.8 ± 119.7 v 195.5 ± 82.3 v 174.8 ± 93.4; P = .6).

Conclusion

Commonly practiced restrictions surrounding 6-MP ingestion might not influence outcome but may hinder adherence. Future recommendations regarding 6-MP intake during maintenance therapy for childhood ALL should aim to simplify administration.