bluuebunny/crossref_metadata_2025 huggingface dataset:
Asserting the Nation: The Dominance of National Narratives in Policy Influencers’ Constructions of Higher Education Students
Authors: Brooks Rachel
Published: September 2019

Drawing on interviews with 26 higher education ‘policy influencers’ from six European countries (Denmark, England, Germany, Ireland, Poland, and Spain), this article considers the ways in which students were commonly understood by this particular group of social actors. It argues that, although a number of the characteristics of contemporary students identified by the interviewees are evident across many nation-states within Europe, they were frequently discussed and explained in terms of very distinct ‘national narratives’, with policy influencers often making reference to their country’s specific history and culture. The implications of such narratives for European higher education and geopolitical relations more generally are explored.
Those who go underwater: Indignation, sentiment, and ethical immanence in northern Uganda
Authors: Victor Letha
Published: September 2019

Anthropologists have engaged in a sustained discussion on the parameters and temporality of ethical life. If one understands the ethical as intrinsic to ordinary acts and practice, rather than solely evident in moments of crisis or ‘discursive interaction’, then ethnographers have been tasked with better describing and locating practical judgment in the lived experiences of their interlocutors, who daily encounter existential ambiguity. In situations where chronic violence makes crisis itself quotidian, and the appearance of ‘moral breakdown’ is mundane, the waters of anthropological ethics become even more muddy. This article takes up that consideration by examining ongoing ethical projects amongst Acholi residents of socially disrupted northern Uganda, where ethnographers are also called to relate and deliberate. It describes the problem of purported spirit attacks and witchcraft at a secondary school for girls in the town of Gulu, which many of the pupils judge to be the work of lute ceto pii (‘those who go underwater’), a category of devil worshippers thought by many Ugandans to be the source of ill-gotten wealth, power and fame, to cause misfortune, and to signal an imminent end to life as they know it. Reminiscent of the slave revolt detailed by Nietzsche, wherein a new type of morality is founded upon a ressentiment of the powerful, in contemporary Uganda acts of acknowledgment, passion, irony and ritual nevertheless reflect ethical underdeterminacy. I argue that interpreting and responding to such rancour is a question not just of tracing the genealogy of moral sentiment or indignation, but of acknowledging and acting (despite) the underdeterminacy of affective forces that inflect the palimpsest of Acholi ontologies.
Ordinary realism: A difficulty for anthropology
Authors: Motta Marco
Published: September 2019

In this article, I address the editors’ (Sidnell and Lambek) arguments about the immanence of the ethical, in contrast to different questions concerning ‘ordinary ethics’ recently raised in anthropology. I will do so by asking what an ‘ordinary realism’ might entail for anthropology, and the way it could possibly help us to appreciate the difficulties inherent in our work of approaching the issues at stake in the reality we face, whether during fieldwork or back home. I will proceed and develop this questioning with the help of some contemporary philosophers who have sustained and enriched the debates on ethics in anthropology. I will illustrate the difficulty of ordinary realism for anthropology with an example taken from a particular moment during my field in Zanzibar where dreams and witchcraft entered the scene.
Study on the influences of oil supply pressure and maximum opening of electromagnetic valve on upstream pressure fluctuation
Authors: Han Zhiqiang , Hu Mingyan , Zhao Jiahui , Yu Wenbin
Published: September 2019

The pressure fluctuation in the hydraulic pipeline in the electro-hydraulic variable valve mechanism will cause the instability of the oil pressure in the hydraulic chamber, thereby making the valve movement characteristics unpredictable, which can affect the adjustment function of the valve mechanism to the air intake, and further affect the combustion, emission, and fuel consumption of the engine. In this article, a simulation model is established for the working process of a certain type of marine diesel engine’s electro-hydraulic variable valve system, and the simulation and experiment are combined to study the influence of the hydraulic oil supply pressure P0 (10–13 MPa) and the maximum opening d (2.5–4 mm) of the electromagnetic valve on the upstream instantaneous pressure variation of the hydraulic circuit of the electromagnetic valve. The fluctuation curve of instantaneous pressure variation is divided into three stages (I a–b, II b–c–d, and III d–e), and the characteristic values ( Pa, Pb, Pc, Pd, Pe) and characteristic phases ( βa, βb, βc, βd, βe) at the inflection point of the fluctuation curve are selected to describe the influence of the hydraulic oil supply pressure and the maximum opening of the inlet electromagnetic valve on the upstream instantaneous pressure variation of the hydraulic circuit of the electromagnetic valve. The result shows that the decrease in the characteristic parameters Pa and Pc values and the increase in the Pb and Pd values increase with the increase in the oil supply pressure and the maximum opening. When the maximum opening is constant, the decrease in the characteristic parameter Pe value increases with the increase in the oil supply pressure; when the oil supply pressure remains unchanged, the difference in the characteristic parameter Pe value is less than 0.04 MPa at different maximum openings, which is hardly affected by the maximum opening; and the influence of the oil supply pressure and the maximum opening on the characteristic phase βa-e is very different.
Ethologies of Education
Authors: Snaza Nathan
Published: September 2019

This essay offers a “version” of Vinciane Despret’s “ethology of ethology” through close engagement with the concepts Despret constructs in What Would Animals Say if We Asked the Right Questions? Reading Despret with other thinkers associated with feminist science studies, the essay sketches Despret’s critique of reductive animal science, and her corresponding work—often collaborative—to find more open, risky ways of researching animal behavior, including the behavior of the human animals we call “scientists.” The distinction between control-driven work in laboratories and the more anecdotal observations she finds in some ethology and anthropology leads Despret to propose a certain ethics of asking questions and listening to answers that Snaza proposes could guide a different, more risky approach to educational research.
Oral Antibiotic Management of Acute Osteomyelitis of the Hand: Outcomes and Cost Comparison to Standard Intravenous Regimen
Authors: Henry Mark , Lundy Forrest H.
Published: September 2019

Background: Acute, direct inoculation osteomyelitis of the hand has traditionally been managed by intravenous antibiotics. With proven high levels of bone and joint penetration, specific oral antimicrobials may deliver clinical efficacy but at substantially lower cost. Methods: Sixty-nine adult patients with surgically proven acute, direct inoculation osteomyelitis of the hand were evaluated for clinical response on a 6-week postdebridement regimen of susceptibility-matched oral antibiotics. Inclusion required gross purulence and bone loss demonstrated at the initial debridement and radiographic evidence of bone loss. Excluded were 2 patients with extreme medical comorbidities. There were 53 men and 16 women with a mean age of 46 years. Mean follow-up was 16 weeks (±10). The cost model for the outpatient oral antibiotic treatment was intentionally maximized using Walgreen’s undiscounted cash price. The cost model for the traditional intravenous treatment regimen was intentionally minimized using the fully discounted Medicare fee schedule. Results: All patients achieved resolution of osteomyelitis by clinical and radiographic criteria. In addition, 7 patients underwent successful subsequent osteosynthesis procedures at the previously affected site without reactivation. The mean postdebridement direct cost of care per patient in the study cohort was $482.85, the cost of the antibiotic alone. The postdebridement direct cost of care per patient on a regimen of vancomycin 1.5 g every 12 hours via peripherally inserted central catheter line was $21 646.90. Conclusions: Acute, direct inoculation osteomyelitis of the hand can be successfully managed on oral antibiotic agents with substantial direct and indirect cost savings.
Discontinuous Galerkin method for solving incompressible two-phase shallow granular flow model
Authors: Saleem Muhammad Rehan , Nisar Ubaid Ahmed , Qamar Shamsul
Published: September 2019

This article deals with the numerical study of two-phase shallow flow model describing the mixture of fluid and solid granular particles. The model under investigation consists of coupled mass and momentum equations for solid granular material and fluid particles through non-conservative momentum exchange terms. The non-conservativity of model equations poses major challenges for any numerical scheme, such as well balancing, positivity preservation, accurate approximation of non-conservative terms, and achievement of steady-state conditions. Thus, in order to approximate the present model an accurate, well-balanced, robust, and efficient numerical scheme is required. For this purpose, in this article, Runge–Kutta discontinuous Galerkin method is applied successfully for the first time to solve the model equations. Several test problems are also carried out to check the performance and accuracy of our proposed numerical method. To compare the results, the same model is solved by staggered central Nessyahu–Tadmor scheme. A good comparison is found between two schemes, but the results obtained by Runge–Kutta discontinuous Galerkin scheme are found superior over the central Nessyahu–Tadmor scheme.
The modality switching costs of Chinese–English bilinguals in the processing of L1 and L2
Authors: Zhao Tianyang , Huang Yanli , Chen Donggui , Jiao Lu , Marmolejo-Ramos Fernando , Wang Ruiming , Xie Jiushu
Published: September 2019

Modality switching cost indicates that people’s performance becomes worse when they judge sequential information that is related to different sensory modalities than judging information that is related to the same modality. In this study, we conducted three experiments on proficient and non-proficient bilingual individuals to investigate the modality switching costs in L1 and L2 processing separately. In Experiment 1, materials were L1 and L2 words that were either conceptually related to a visual modality (e.g., light) or related to an auditory modality (e.g., song). The modality switching costs were investigated in a lexical decision task in both L1 and L2. Experiment 2 further explored the modality switching costs while weakening the activation level of the perceptual modality by adding a set of fillers. Experiment 3 used a word-naming task to explore the modality switching effect in language production in L1 and L2. Results of these experiments showed that the modality switching costs appeared in both language comprehension and production in L1 and L2 conditions. The magnitude of the modality switching costs was conditionally modulated by the L2 proficiency level, such as in the L2 condition in Experiment 1 and in both L1 and L2 conditions in Experiment 3. These results suggest that sensorimotor simulation is involved in not only language comprehension but also language production. The sensorimotor simulation that is acquired in L1 can be transferred to L2.
On the limits of familiarity accounts in lexical decision: The case of repetition effects
Authors: Perea Manuel , Marcet Ana , Vergara-Martínez Marta , Gomez Pablo
Published: September 2019

Recent modelling accounts of the lexical decision task have suggested that the reading system performs evidence accumulation to carry out some functions. Evidence accumulation models have been very successful in accounting for effects in the lexical decision task, including the dissociation of repetition effects for words and nonwords (facilitative for words but inhibitory for nonwords). The familiarity of a repeated item triggers its recognition, which facilitates ‘word’ responses but hampers nonword rejection. However, reports of facilitative repetition effects for nonwords with several repetitions in short blocks challenge this hypothesis and favour models based on episodic retrieval. To shed light on the nature of the repetition effects for nonwords in lexical decision, we conducted four experiments to examine the impact of extra-lexical source of information—we induced the use of episodic retrieval traces via instructions and list composition. When the initial block was long, the repetition effect for nonwords was inhibitory, regardless of the instructions and list composition. However, the inhibitory effect was dramatically reduced when the initial block included two presentations of the stimuli and it was even facilitatory when the initial block was short. This composite pattern suggests that evidence accumulation models of lexical decision should take into account all sources of evidence—including episodic retrieval—during the process of lexical decision.
Substitute prescribing in heroin addiction
Authors: Doan Laura
Published: September 2019

Substitute prescribing involves the prescription in a controlled environment of a pharmaceutically manufactured medication to replace illicit or harmful drug use, as part of a broader package of psychosocial interventions to minimise withdrawal symptoms and assist an individual to gradually reduce drug misuse and/or the harms associated with high-risk using.
Tai Chi Movements for Wellbeing – evaluation of a British Lung Foundation pilot
Authors: Lewis A , Hopkinson NS
Published: September 2019

Aims:

In breathless individuals with respiratory disease, pulmonary rehabilitation (PR) can improve exercise capacity, symptoms and ability to cope with their condition. However, access is often limited, and adherence can be poor. Thus, there is interest in developing alternative and complementary forms of exercise intervention and tai chi may be effective in this context.

Method:

The British Lung Foundation worked in collaboration with ‘Tai Chi Movements for Wellbeing’ Training to train leaders to run community-based tai chi groups in the UK. Leaders received funding to run 3 months of once-a-week classes consisting of a 12 movement sequence of tai chi. Participants completed a questionnaire survey to evaluate the service at the start of their first session and again after 3 months.

Results:

Ten tai chi groups recruited 128 participants, 65% women, mean (standard deviation (SD)) age 70.1 (7.4) years at baseline. Seventy individuals completed the follow-up questionnaire at 3 months. Participants demonstrated an improvement in Medical Research Council (MRC) Dyspnoea Score pre 3 (interquartile range (IQR) = 1.8), post 2 (IQR = 1), p = .013 and disease burden; chronic obstructive pulmonary disease (COPD) assessment test score pre 19.4 (8.7), post 17.9 (9.4), mean change –1.5 (confidence interval (CI): –2.89 to –0.127), p = .033. Those who completed the programme had a worse baseline COPD assessment test (CAT) score and were more likely to have participated in maintenance exercise previously. Qualitative feedback suggested that participants felt the classes had helped with breathlessness and relaxation.

Conclusion:

Establishing a tai chi for wellbeing programme for people with respiratory disease is feasible, with a reasonable level of compliance, and is perceived to be helpful by participants.
Placental Abnormalities Associated With Childbirth
Authors: Wright Robert G. , Macindoe Christopher , Green Patricia
Published: September 2019

Pathologists are faced with a variety of problems when considering placental tissue in cases of stillbirth. It is recognized that there are changes which occur following fetal demise and which can complicate the assessment and may coexist with other morphological changes. It is recognized that up to 25% of stillbirths may have a recognizable abnormality causing fetal demise. A systematic review of placental tissue allows many of these disorders to be identified. This review considers macroscopic and microscopic features of placental pathology in stillbirth together with clinicopathological correlation. Stillbirth definitions, general aspects of macroscopic assessment of placentas, placental changes after fetal demise, and some recognizable causes of fetal demise are considered.
Impact of a Drug Overdose Decedent Toxicology Testing Legislative Mandate on Informing Coroner Death Investigation and Certification Practices
Authors: Quesinberry Dana , Bunn Terry L. , Hargrove Sarah , Slavova Svetla
Published: September 2019

Objective:

To (a) determine the impact of Kentucky’s (KY’s) mandate requiring postmortem toxicology testing of coroner cases; (b) identify the influence of coroner experience and training, jurisdiction size, budget, and location on postmortem testing requests; (c) identify facilitators/barriers for postmortem toxicology testing requests and listing the specific drugs involved in drug-poisoning deaths on death certificates.

Methods:

A modified Dillman approach was used to deliver the survey to KY’s elected coroners between April and May 2016. Responses stratified by identified influence factors were compared using χ2 tests and Fisher exact tests.

Results:

Fifty-eight percent of coroners reported that drug overdose investigations had changed since the mandate was enacted. Statistically significant differences in responses were found when stratified. Sixty-three percent of coroners reported always using testing results to complete death certificates.

Conclusions:

Uptake of the mandate for postmortem toxicology testing of all decedents is not yet complete.

Policy Implication:

Without uptake of the mandate, surveillance efforts may result in undercounting of drug overdose deaths and the involvement of specific drugs. Mandates for enhanced training and modification of funding structure for medico-legal death investigations could facilitate uptake.
Fatal Microscopic Pulmonary Tumor Thromboemboli: Unusual Presentation of Occult Cervical Carcinoma. Two Case Reports and Review of the Literature
Authors: Kirsch Daniel , Scordi-Bello Irini
Published: September 2019

Cor pulmonale (right heart failure) due to microscopic pulmonary tumor emboli (MPTE) can arise from a variety of malignancies including breast, lung, and liver and carries significant morbidity and mortality. Tumor cell aggregates spread hematogenously to the lungs and occlude small pulmonary vessels leading to pulmonary hypertension through either a mechanical process or inducing vascular remodeling as a downstream result of interactions between the embolus and the vessel wall. Its presentation includes unexplained dyspnea, hypoxemia, tachycardia, pulmonary hypertension, right heart failure, and in some cases sudden death. The symptoms may suggest the more common entity of pulmonary thromboembolism, particularly in the setting of previously known metastatic cancer; however, computed tomography scans may appear normal and ventilation-perfusion scans which are the preferable diagnostic modality are not always ordered. In most cases of MPTE, the presentation reflects metastasis of an already known and advanced tumor, but, in rare cases, it may be the primary manifestation of an occult malignancy. We present here 2 unique cases of MPTE in women with occult cervical cancer. In both cases, the malignancy was discovered and diagnosed at autopsy. Microscopic pulmonary tumor emboli can be easily overlooked, and therefore, forensic pathologists and other death investigators should be aware of it and trained to at least consider the possibility in appropriate situations. Thorough microscopic examination of apparently normal tissues may be necessary, particularly in cases of unexplained right heart failure and sudden death, even if the decedent has few or no identifiable risk factors for cancer.
Death in a Carbon Dioxide Therapy Bath: A Case Report and Review of the Literature
Authors: Samuel Julian , Georgievskaya Zhanna
Published: September 2019

Carbon dioxide (CO2) therapy is the subcutaneous or transcutaneous administration of CO2 for therapeutic purposes. Carbon dioxide therapy is used for localized lipolysis, to treat chronic skin conditions, and is a safe treatment. Full-body CO2 baths are offered in European spa centers, in which the clients are placed into full body bags infused with CO2 at an optimal concentration range between 1000 and 1400 mg/L (516 000-722 500 ppm). Commercially manufactured, air-tight bags and accompanying apparatus designed to provide CO2 baths can be purchased for home use. Few human CO2-related deaths have been reported. They have been mostly accidental, consisting of persons trapped in a closed environment in the presence of “dry ice” or solid CO2. There have been no reported deaths of a human undergoing a CO2 therapy at home. We present a case of a middle-aged male found at home completely inside an air-sealed bag wrapped tightly around his body. The bag was connected to a working pump and a CO2 gas tank. The pump was connected through an inflow and outflow circuit to the bag. The inflow tubing for CO2 gas delivery was partially disrupted, while the outflow tubing was intact. The autopsy and toxicology were unremarkable. The cause of death was determined to be asphyxia by vitiated atmosphere as evident by the displacement of oxygen by CO2 and low pressure created inside a “CO2 therapy bath.” The manner of death was accidental.
Diabetes Healthcare Professionals Use Multiple Continuous Glucose Monitoring Data Indicators to Assess Glucose Management
Authors: Sheng Tong , Offringa Reid , Kerr David , Clements Mark , Fischer Jerome , Parks Linda , Greenfield Michael
Published: September 2019

Background:

Continuous glucose monitoring (CGM) offers multiple data features that can be leveraged to assess glucose management. However, how diabetes healthcare professionals (HCPs) actually assess CGM data and the extent to which they agree in assessing glycemic management are not well understood.

Methods:

We asked HCPs to assess ten de-identified CGM datasets (each spanning seven days) and rank order each day by relative glycemic management (from “best” to “worst”). We also asked HCPs to endorse features of CGM data that were important in making such assessments.

Results:

In the study, 57 HCPs (29 endocrinologists; 28 diabetes educators) participated. Hypoglycemia and glycemic variance were endorsed by nearly all HCPs to be important (91% and 88%, respectively). Time in range and daily lows and highs were endorsed more frequently by educators (all Ps < .05). On average, HCPs endorsed 3.7 of eight data features. Overall, HCPs demonstrated agreement in ranking days by relative glycemic control (Kendall’s W = .52, P < .001). Rankings were similar between endocrinologists and educators ( R2 = .90, Cohen’s kappa = .95, mean absolute error = .4 [all Ps < .05]; Mann-Whitney U = 41, P = .53).

Conclusions:

Consensus in the endorsement of certain data features and agreement in assessing glycemic management were observed. While some practice-specific differences in feature endorsement were found, no differences between educators and endocrinologists were observed in assessing glycemic management. Overall, HCPs tended to consider CGM data holistically, in alignment with published recommendations, and made converging assessments regardless of practice.
Paradigm lost? A historical review of the application of systems theory to public relations since 1975
Authors: Hiscock Robert
Published: September 2019

This study traces the formative application of systems theory to public relations and its consideration as a promising paradigm framework for the field, through a rich array of critical perspectives, and more recent analyses that examine public relations as a social phenomenon. The principles of grounded theory are applied to the selection and assessment of a representative sample of academic literature published between 1975 and 2016. A categorization framework emerges from the thematic analysis of the data that re-evaluates the historical application of systems theory. Two main insights emerge from the study. First, even in cases where a specific systems theory is not directly invoked, systems concepts are evident throughout the data of this period. Second, although systems theory has been applied extensively in the analyses of the organization, and more lately in the analyses of the impacts of public relations on the social world as a whole, analysis of the individual as a system actor as a central unit of analysis was not apparent in the data. Accordingly, a reflection on the individual as a system actor is undertaken, along with an updated visual model of the public relations system. Concluding remarks summarize the case for the ongoing relevance of systems theory to public relations research, practice, and education.
Optimisation of cardiac resynchronisation therapy device selection guided by cardiac magnetic resonance imaging: Cost-effectiveness analysis
Authors: Crespo Carlos , Linhart Markus , Acosta Juan , Soto-Iglesias David , Martínez Mikel , Jáuregui Beatriz , Mira Áurea , Restovic Gabriela , Sagarra Joan , Auricchio Angelo , Fahn Bernhard , Boltyenkov Artem , Lasalvia Luis , Sampietro-Colom Laura , Berruezo Antonio
Published: September 2019

Background

A recent study showed that the presence and characteristics of myocardial scar could independently predict appropriate implantable cardioverter-defibrillator therapies and the risk of sudden cardiac death in patients receiving a de novo cardiac resynchronisation device.

Design

The aim was to evaluate the cost-effectiveness of cardiac magnetic resonance imaging-based algorithms versus clinical practice in the decision-making process for the implantation of a cardiac resynchronisation device pacemaker versus cardiac resynchronisation device implantable cardioverter-defibrillator device in heart failure patients with indication for cardiac resynchronisation therapy.

Methods

An incidental Markov model was developed to simulate the lifetime progression of a heart failure patient cohort. Key health variables included in the model were New York Heart Association functional class, hospitalisations, sudden cardiac death and total mortality. The analysis was done from the healthcare system perspective. Costs (€2017), survival and quality-adjusted life years were assessed.

Results

At 5-year follow-up, algorithm I reduced mortality by 39% in patients with a cardiac resynchronisation device pacemaker who were underprotected due to misclassification by clinical protocol. This approach had the highest quality-adjusted life years (algorithm I 3.257 quality-adjusted life years; algorithm II 3.196 quality-adjusted life years; clinical protocol 3.167 quality-adjusted life years) and the lowest lifetime costs per patient (€20,960, €22,319 and €28,447, respectively). Algorithm I would improve results for three subgroups: non-ischaemic, New York Heart Association class III–IV and ≥65 years old. Furthermore, implementing this approach could generate an estimated €702 million in health system savings annually in European Society of Cardiology countries.

Conclusion

The application of cardiac magnetic resonance imaging-based algorithms could improve survival and quality-adjusted life years at a lower cost than current clinical practice (dominant strategy) used for assigning cardiac resynchronisation device pacemakers and cardiac resynchronisation device implantable cardioverter-defibrillators to heart failure patients.
The future of agriculture and food: Evaluating the holistic costs and benefits
Authors: Sandhu Harpinder , Müller Alexander , Sukhdev Pavan , Merrigan Kathleen , Tenkouano Abdou , Kumar Pushpam , Hussain Salman , Zhang Wei , Pengue Walter , Gemmill-Herren Barbara , Hamm Michael W , Tirado von der Pahlen Maria Cristina , Obst Carl , Sharma Kavita , Gundimeda Haripriya , Markandya Anil , May Peter , Platais Gunars , Weigelt Jes
Published: September 2019

Inadequacies of the current agriculture and food systems are recognised globally in the form of damages to environment and human health. In addition, the prevailing economic and policy systems do not reflect these damages in its accounting systems and standards. These shortcomings lead to perverse and pervasive outcomes for society at large. Our proposal is to consider all social and environmental externalities – both negative and positive, in global agriculture and food systems and reflect them in an economic system by evaluating comprehensive costs and benefits. This can be done by adopting an innovative, universal, and inclusive framework (the ‘TEEBAgriFood’ framework) in order to stimulate appropriate policy responses.
Home Dialysis Among Elderly Patients: Outcomes and Future Directions
Authors: Auguste Bourne L. , Chan Christopher T.
Published: September 2019

Elderly patients who receive home dialysis (peritoneal dialysis or home hemodialysis) may have reduced survival compared to younger patients. Therefore, it is important to ascertain the goals of home dialysis in the elderly rather than simply fixate on standard metrics such as technique survival. As Canada’s population continues to age, the prevalence of end-stage kidney disease among the elderly population is increasing. Patients with multiple comorbidities are now surviving long enough to be started on dialysis. Although home dialysis has been associated with better survival and improved quality of life, its impact on the frail and elderly populations require further elucidation. Home dialysis patients can either independently perform tasks or have support in the home to safely conduct dialysis. Moreover, patients burdened with frailty and multiple comorbidities who lack support in the home may not be able to perform home dialysis safely. Innovative strategies to improve accessibility to home-based therapies need further exploration. In addition, the concept of goal-directed dialysis promotes more individualized treatment. Future continuous quality improvement initiatives must examine if goal-directed dialysis leads to better quality of life outcomes in the elderly.
Factors influencing adoption of eHealth technologies in Ghana
Authors: Kesse-Tachi Agyenna , Asmah Alexander Ekow , Agbozo Ebenezer
Published: September 2019

This study covers factors influencing the adoption of electronic health (eHealth) technologies in Ghana. The study was designed as a quantitative survey with questionnaire as the main method of data gathering. A total of 1640 questionnaires were administered to users and potential users of eHealth technologies in both public and private healthcare centres in Ghana. The study concludes that institutional characteristics and healthcare manager characteristics have a high influence on eHealth adoption. However, factors related to performance expectancy and effort expectancy only have low influence on the adoption of eHealth devices and systems. Accordingly, the study makes recommendations to policymakers for improving eHealth adoption in the health sector.
Is There a Difference Between the Readabilities of Informed Consent Forms Used for Elective and Emergency Procedures in Turkey?
Authors: Sönmez Mehmet Giray , Öztürk Sönmez Leyla , Kozanhan Betül , Dündar Zerrin Defne
Published: September 2019

Background:

Informed consent is an important aspect of ethical medical practice. In legal terms, making an intervention without informed consent may mean negligence or malpractice and may lead to legal action, maltreatment, and even attack against the doctor. This study aims to evaluate the readability of informed consent forms (ICFs) used for elective (urology and general surgery) and emergency procedures (emergency medicine and intensive care) by comparing through readability formulas.

Methods:

Elective and emergency ICFs were accessed through the web sites of national health care associations. A total of 387 consent forms were evaluated and the same forms were included only once. A total of 35 consent forms were evaluated for emergency procedures, while a total of 55 consent forms were evaluated for elective procedures. Ateşman and Bezirci-Yılmaz formulas defined for determining the readability level of Turkish texts and Gunning fog and Flesch Kincaid formulas measuring the general readability level were used for calculating the readability level of consent forms.

Results:

Even though elective ICFs are more readable compared to those of emergency procedures according to Bezirci-Yılmaz formulas, this was statistically insignificant ( P = .54). The readability of elective consent forms was found to be at a significantly more difficult level to read compared to Ateşman, Gunning fog, and Flesch Kincaid formulas ( P = .002, P < .001, P < .001, respectively).

Conclusion:

Even though the procedure is emergency or elective, a difficult readability level may cause problems for the doctor in legal phases. Readable and understandable consent forms should be available to be able to explain morbidity and mortality and improve prognosis. Education level of our country should also be considered while preparing these consent forms.
Hysteroscopy and the risk of gas embolism: A review
Authors: Ratner Roni T , Tsaltas Jim , Vollenhoven Beverley
Published: September 2019

Hysteroscopy is one of the most frequent procedures that a gynecologist will perform over their career. It is also one of the safest procedures. Operative hysteroscopy has an increased risk profile due to the nature of the surgery. The following review will address the issue of gas embolism in hysteroscopy. This review will look at the evidence regarding the likely causation, rates, and potential methods of minimizing risk to patients as well as treatment options available should this complication arise.
Assessment of Comorbidity and Use of Prescription and Nonprescription Drugs in Patients Above 65 Years Attending Family Medicine Outpatient Clinics
Authors: Kurt Münevver , Akdeniz Melahat , Kavukcu Ethem
Published: September 2019

Background and aim: Aging is often accompanied by chronic diseases, comorbidity, and polypharmacy. Use of prescription/nonprescription drugs, and over-the-counter (OTC) drugs seen frequently in the elderly. The aim of this study was to assess the comorbidity and multimorbidity status and to evaluate the use of prescription and nonprescription drugs in patients aged 65 years. Materials and Methods: In this cross-sectional and descriptive study, statistical analyses were performed using SPSS Version 22.0. Kolmogorov–Smirnov tests were applied based on meeting the assumption of a normal distribution of the data. Other statistical tests used were one-way analysis of variance tests, t tests, Pearson correlation analysis, Chi-square tests, Mann–Whitney U tests, and Spearman correlation analysis. Results: A total of 244 people participated in the study. The multimorbidity rate was 85%. Participants used an average of 4.26 drugs daily. The polypharmacy ratio was 42%. The nonprescription drug usage rate was 20%. Participants used nonprescription drugs most often with the pharmacist’s advice. Conclusion: Multimorbidity, comorbidity, prescription, and nonprescription drug use were very high among elderly patients. Because older people are more susceptible to adverse drug reactions and drug interactions, physicians who provide care to older people should take a comprehensive drug history.
Hopeful Discourse: Elementary Children’s Activist Responses to Modern-Day Slavery Grounded in Systems Thinking
Authors: Curwen Margaret Sauceda , Ardell Amy , MacGillivray Laurie
Published: September 2019

This qualitative case study examines how fifth graders and their teachers participated in critical literacy instruction grounded in systems thinking on the topic of slavery. Systems thinking seeks to discover relationships and patterns in diverse underlying systems; critical literacy examines everyday texts, focuses on social justice and change, and promotes transformative practices. Classroom observations, photographs, interviews, and student artifacts were collected and analyzed to provide insight into students’ understandings of patterns of slavery from American colonial times to modern-day trafficking. Through a range of texts and different modalities, students sought to understand different group perspectives and ultimately took action to disrupt an unjust system. Three aspects of students’ learning led them to an agentic role: (1) crossing boundaries across time and differences, (2) developing a holistic worldview, and (3) reimagining a different world and altering the existing discourse.
3D diffraction imaging method using low-rank matrix decomposition
Authors: Zhao Jingtao , Yu Caixia , Peng Suping , Li Chuangjian
Published: September 2019

Seismic weak responses from subsurface small-scale geologic discontinuities or inhomogeneities are encoded in 3D diffractions. Separating weak diffractions from a strong reflection background is a difficult problem for diffraction imaging, especially for the 3D case when they are tangent to or interfering with each other. Most conventional diffraction separation methods ignore the azimuth discrepancy between reflections and diffractions when suppressing reflections. In fact, the reflections associated with a specific pair of azimuth-dip angle possess sparse characteristics, and the diffractions adhering to Huygens’ principle behave as low-rank components. Therefore, we have developed a 3D low-rank diffraction imaging method that uses the Mahalanobis-based low-rank and sparse matrix decomposition method for separating and imaging 3D diffractions in the azimuth-dip angle image matrix. The advantages of our 3D diffraction imaging method not only includes the handling of interfering events but also includes ensuring a better protection of weak diffractions. The numerical experiment illustrates the good performance of our method in imaging small-scale discontinuities and inhomogeneities. The field data application of carbonate reservoirs further confirms its potential value in resolving the masked small-scale cavities that can provide storage spaces and a migration pathway for petroleum.
Basal-type lumenogenesis in extraembryonic endoderm stem cells models the early visceral endoderm
Authors: Kim Minjae , Zhong Yixiang , Jung Kyoung Hwa , Chai Young Gyu , Binas Bert
Published: September 2019

Cultured rat primitive extraembryonic endoderm (pXEN) cells easily form free-floating multicellular vesicles de novo, exemplifying a poorly studied type of morphogenesis. Here, we reveal the underlying mechanism and the identity of the vesicles. We resolve the morphogenesis into vacuolization, vesiculation and maturation, and define the molecular characteristics and requirements of each step. Vacuolization is fueled by macropinocytosis and occurs by default if not blocked by high cell density or matrix proteins. Fine-tuned cell–cell contact then forms nascent three-cell vesicles with vacuole-derived lumina. In maturation, the vesicles complete epithelialization, expand via mitosis and continued fluid uptake, and differentiate further. The mature vesicles consist of a simple squamous epithelium with an apical-outside/basal-inside polarity that we trace back to the single cell stage. The polarity and gene expression pattern of the vesicles are similar to those of the early visceral endoderm. pXEN cells provide a useful in vitro model for study of matrix-independent, basal-type lumenogenesis and the physiology of the visceral endoderm.

This article has an associated First Person interview with the first author of the paper.
The golgin PpImh1 mediates reversible cisternal stacking in the Golgi of the budding yeast Pichia pastoris
Authors: Jain Bhawik Kumar , Dahara Roma , Bhattacharyya Dibyendu
Published: September 2019

The adhesive force for cisternal stacking of Golgi needs to be reversible – to be initiated and undone in a continuous cycle to keep up with the cisternal maturation. Microscopic evidence in support of such a reversible nature of stacking, in the form of ‘TGN peeling,’ has been reported in various species, suggesting a potential evolutionarily conserved mechanism. However, knowledge of such mechanism has remained sketchy. Here, we have explored this issue in the budding yeast Pichia pastoris which harbors stacked Golgi. We observed that deletion of GRIP domain golgin P. pastoris (Pp)IMH1 increases the peeling of late cisterna, causing unstacking of the Golgi stack. Our results suggest that the PpImh1 dimer mediates reversible stacking through a continuous association–dissociation cycle of its GRIP domain to the middle and late Golgi cisterna under the GTP hydrolysis-based regulation of Arl3-Arl1 GTPase cascade switch. The reversible cisternal stacking function of PpImh1 is independent of its vesicle-capturing function. Since GRIP domain proteins are conserved in plants, animals and fungi, it is plausible that this reversible mechanism of Golgi stacking is evolutionarily conserved.

This article has an associated First Person interview with the first author of the paper.
Local inhibition of rRNA transcription without nucleolar segregation after targeted ion irradiation of the nucleolus
Authors: Siebenwirth Christian , Greubel Christoph , Drexler Guido A. , Reindl Judith , Walsh Dietrich W. M. , Schwarz Benjamin , Sammer Matthias , Baur Iris , Pospiech Helmut , Schmid Thomas E. , Dollinger Günther , Friedl Anna A.
Published: September 2019

Nucleoli have attracted interest for their role as cellular stress sensors and as potential targets for cancer treatment. The effect of DNA double-strand breaks (DSBs) in nucleoli on rRNA transcription and nucleolar organisation appears to depend on the agent used to introduce DSBs, DSB frequency and the presence (or not) of DSBs outside the nucleoli. To address the controversy, we targeted nucleoli with carbon ions at the ion microbeam SNAKE. Localized ion irradiation with 1–100 carbon ions per point (about 0.3–30 Gy per nucleus) did not lead to overall reduced ribonucleotide incorporation in the targeted nucleolus or other nucleoli of the same cell. However, both 5-ethynyluridine incorporation and Parp1 protein levels were locally decreased at the damaged nucleolar chromatin regions marked by γH2AX, suggesting localized inhibition of rRNA transcription. This locally restricted transcriptional inhibition was not accompanied by nucleolar segregation, a structural reorganisation observed after inhibition of rRNA transcription by treatment with actinomycin D or UV irradiation. The presented data indicate that even multiple complex DSBs do not lead to a pan-nucleolar response if they affect only a subnucleolar region.
Preliminary assessment of the utilization of durian peel liquid smoke as a natural preservative for mackerel
Authors: Faisal Muhammad , Gani Asri , Mulana Farid
Published: September 2019

Background: Durian peel is a type of biomass waste that contains cellulose, hemicelluloses, and lignin. The pyrolysis of these compounds results in production of liquid smoke which can be used as a natural preservative to replace current synthetic preservatives. This research assessed the ability of liquid smoke produced during pyrolysis of durian peel to preserve fish.

Methods: Dry durian peel waste underwent batch reactor pyrolysis at 340°C and 380°C, resulting in production of liquid smoke (grade 3), charcoal, and tar. This liquid smoke was then distilled at 190°C to produce grade 1 liquid smoke, which was used to preserve mackerel. The preservation process was conducted by soaking the mackerel samples in liquid smoke at 0.5, 1, 2, and 3% concentration levels followed by observations every 6 hours. Tests to determine the total volatile base nitrogen (TVB-N) content, antibacterial quality of the liquid smoke and organoleptic quality of the fish were conducted in order to assess the preservation properties of the liquid smoke.

Results: Tests on the antibacterial effects showed that the liquid smoke inhibited the growth of Escherichia coli and Staphylococcus aureus on fish even at low concentrations. At 54 hours, the TVB-N values remained below 30 mg nitrogen/g, indicating that the fish was still safe for human consumption. Results from the organoleptic tests showed that the concentration of liquid smoke influenced the preservation effects.

Conclusions: At a concentration of 2–3%, the fish samples possessed acceptable flavor, taste, color and texture for up to 48 hours of soaking. However, the best conditions were obtained with a 3% concentration of liquid smoke (produced with 340°C pyrolysis), as the fish was still considered acceptable for up to 42 hours.
A new statistical method to analyze Morris Water Maze data using Dirichlet distribution
Authors: Maugard Marianne , Doux Cyrille , Bonvento Gilles
Published: September 2019

The Morris Water Maze (MWM) is a behavioral test widely used in the field of neuroscience to evaluate spatial learning memory of rodents. However, the interpretation of results is often impaired by the common use of statistical tests based on independence and normal distributions that do not reflect basic properties of the test data, such as the constant-sum constraint. In this work, we propose to analyze MWM data with the Dirichlet distribution, which describes constant-sum data with minimal hypotheses, and we introduce a statistical test based on uniformity (equal amount of time spent in each quadrant of the maze) that evaluates memory impairments. We demonstrate that this test better represents MWM data and show its efficiency on simulated as well as in vivo data. Based on Dirichlet distribution, we also propose a new way to plot MWM data, showing mean values and inter-individual variability at the same time, on an easily interpretable chart. Finally, we conclude with a perspective on using Bayesian analysis for MWM data.