bluuebunny/crossref_metadata_2025 huggingface dataset:
Intercomparison of Radiation Codes in Climate Models (ICRCCM): Longwave Clear-Sky Results—A Workshop Summary
Authors: Luther Frederick M. , Ellingson Robert G. , Fouquart Yves , Fels Stephen , Scott Noelle A. , Wiscombe Warren J.
Published: April 2018

An international program of intercomparison of radiation models has been initiated because of the central role of radiative processes in many proposed climate change mechanisms. Models ranging from the most detailed (line-by-line) to the most-highly parameterized have been compared with each other and with selected aircraft observations. Although line-by-line-model fluxes tend to agree with each other to within one percent (if the water-vapor–continuum absorption is ignored), the less-detailed models show a spread of 10–20 percent. The spread is even larger (30–40 percent) for the sensitivities of the models to changes in important radiation variables, such as carbon dioxide amounts and water-vapor amounts. These spreads are disturbingly large.

Lacking highly accurate flux observations from within the atmosphere, it has been customary to regard line-by-line–model results as “the truth.” However, uncertainties in the physics of line wings and in the proper treatment of the water-vapor continuum make it impossible for the line-by-line models to provide an absolute reference for evaluating less-detailed models. Therefore, a dedicated surface-based field measurement program is recommended in order to properly evaluate model performance; the goal would be to use sophisticated spectrometers to measure accurately spectral radiances rather than integrated fluxes.
The Land/Sea Breeze Experiment (LASBEX)
Authors: Intrieri J. M. , Little C. G. , Shaw W. J. , Banta R. M. , Durkee P. A. , Hardesty R. M.
Published: April 2018

The Land/Sea Breeze Experiment (LASBEX) was conducted at Moss Landing, California, 15–30 September 1987. The experiment was designed to study the vertical structure and mesoscale variation of the land/sea breeze. A Doppler lidar, a triangular array of three sodars, two sounding systems (one deployed from land and one from a ship), and six surface weather stations (one shipborne) were sited around the Moss Landing area. Measurements obtained included ten sea-breeze and four land-breeze events. This paper describes the objectives and design of the experiment, as well as the observing systems that were used. Some preliminary results and selected observations are presented, called from the data collected, as well as the ensuing analysis plans.
Playing it safe: toy safety and conformity assessment in Europe and the United States
Authors: Larson Derek B. , Jordan Sara R.
Published: April 2018

Do similar standards of product safety lead to similar levels of consumer safety? In 2007, more than 19 million toys worldwide were recalled for violations of applicable safety standards. Following these recalls, both the EU and the US instituted new policies governing children’s products: the US Consumer Product Safety Improvement Act of 2008 (CPSIA) and EU 2009 Toy Safety Directive. The relevant toy safety standards that emerged from this legislation, such as ISO (ISO 8124), US (ASTM F963), and EU (EN 71) standards are comparable in terms of their language but not their results. Using a data set profiling implementation of EU and US conformity assessment systems for determination of product safety for toys manufactured in China, we find that weighted recall totals for violative products are between 10 and 20 times higher in the EU than the US. This suggests that differences in the implementation of global standards result in more unsafe products initially reaching consumers in some locations.

Points for practitioners

Government officials should avoid assuming that safety begins and ends with international standards. The process for verifying that products meet established standards is as important as the standards themselves, and it can have significant economic and safety impacts The choice of conformity assessment system for a given product or market is driven by many considerations, including appetite for risk, political institutions and practice, and variations in national-level administrative capacity. Discussions on the merits of any conformity assessment system for a given market, or product, should incorporate all of these factors.
A Time for a Crime
Authors: van Sleeuwen Sabine E. M. , Ruiter Stijn , Menting Barbara
Published: April 2018

Objectives:

This article examines to what extent repeat offenders’ crime location choices are conditional on the timing of the offenses within the week and within the day. Extending crime pattern theory, we argue that offenders acquire time-specific rather than general knowledge of their environment. We hypothesize that offenders are more likely to offend in previously targeted areas at similar than at different days and times.

Methods:

Data on 12,639 offenses committed by 3,666 repeat offenders in the Netherlands are analyzed using discrete spatial choice models.

Results:

Offenders are most likely to offend in areas they already targeted before at similar parts of the week and similar times of the day, especially when the previous offense was committed on exactly the same weekend day or weekday and at the same hour of day. Offenders are less likely to return to previously targeted areas at different times of the week and day, and least likely to offend in areas they never targeted before. The effects were stronger for the same than for different types of crime.

Conclusions:

Assessing cyclic time patterns in crime location choice not only enhances our understanding of spatial criminal decision-making, but could also improve predictive policing methods.
Elections Have Consequences for Student Mental Health: An Accidental Daily Diary Study
Authors: Roche Michael J. , Jacobson Nicholas C.
Published: April 2018

Polling suggested that the 2016 United States presidential election affected citizens' mood and stress levels. Yet, polling often fails to employ repeated measurement designs that can capture pre- and post-levels of change within the same person. In this study, undergraduate students ( N = 85) completed a 14-day daily diary where mood, stress, and mental health outcomes were assessed before and after the election. Multilevel modeling revealed an immediate upsurge in anxiety, stress, and poor sleep quality the day after the election, followed by a recovery period indicating these effects were short-lived. Other reactions (anger, fear, marginalization, and experiencing discrimination) evidenced a significant upsurge without a significant recovery. We consider how daily diary research designs like this one could be integrated into college settings to inform counseling center resource allocation, and we also comment on the promise of the daily diary methodology for political research.
Analysis of the influence of the guided needle structure on the vortex spinning process and yarn properties
Authors: Han Chenchen , Cheng Longdi , Gao Weidong , Xue Yuan , Xue Wenliang , Yang Ruihua
Published: April 2018

Based on the nozzle structures of MVS870 and J26, this paper analyzed the influence of the guided needle existence and length on the vortex spinning process and yarn properties. In this research, we compared the airflow pressure and velocity distribution under different guided needle structures in the twisting cavity, combining with the numerical simulation of the fluid dynamics model. The influence of the negative pressure and the airflow velocity changing law on the yarn structure and properties was verified by experiments in this paper. The results show that the existence of the guided needle structure could help the head end of the single fiber get into the center of the yarn with less pulling-out by the high-speed rotating airflow, and then improve the yarn tightness and the yarn binding force on the fibers, which will result in a greater extent, as the length of the guided needle is larger. This study present a feasible theoretical analysis for the influence of the guided needle structure on the vortex spinning process and yarn properties, which has guiding significance in actual production practice.
An agenda for rethinking mid-career master programs in public administration
Authors: van der Meer Frans-Bauke , Marks Peter
Published: April 2018

The pace of societal change and the development of societal challenges have speeded up considerably during the last couple of decades, with substantial impact on different levels, i.e. ranging from global to local, or from business to government. When focusing on the public domain, these changes and challenges have had a major impact on public professionals, who face different and frequently changing questions. Mid-career programs in Public Administration (MPA) have the mission to support enrolled professionals in dealing with these changes and challenges. This article is about the development of such MPAs. Both substantive and didactic development is needed. To counter institutional inertia it seems vital to institutionalize a regular rethinking and adaptation of curricula and didactic strategies. This article identified some important points of attention and some options to deal with these in order to continuously improve the contribution of MPA programs to relevant and effective professional development and ongoing professional learning.
Introduction to the Special Issue: Interventions to Reduce Challenging Behavior Among Individuals With Autism Spectrum Disorder
Authors: Davis Tonya N. , Rispoli Mandy
Published: April 2018

The prevalence of autism spectrum disorder (ASD) is on the rise. In addition to the social communication skill deficits and restrictive repetitive behaviors and interests, many individuals with ASD engage in challenging behavior. Challenging behavior is associated with a multitude of negative outcomes. Challenging behavior may cause harm to the individual with ASD as well as limit opportunities for educational, vocational, and social participation and development. In addition, caregivers experience high stress and low quality of mental health. As a result, challenging behavior warrants intervention that is specifically tailored to the unique characteristics of individuals with ASD. The purpose of this Special Issue is to showcase recent research in the treatment of challenging behavior for individuals with ASD. This two-part Special Issue contains 12 studies that range from systematic and quality reviews of the intervention literature, to innovative treatment approaches, to studies that develop and evaluate treatments for restrictive and repetitive behaviors and interests.
Health-Related Quality of Life and Personal Life Goals of Adults With Sickle Cell Disease After Hematopoietic Stem Cell Transplantation
Authors: Gallo Agatha M. , Patil Crystal , Adeniyi Tokunbo , Hsu Lewis L. , Rondelli Damiano , Saraf Santosh
Published: April 2018

Allogeneic hematopoietic stem cell transplantation (HSCT) from a human leukocyte antigen (HLA)-matched sibling donor offers a unique therapy to reverse SCD. This mixed-methods study explores recipients’ perception of HSCT success, personal life goals, and associated health-related quality of life (HRQOL) more than 1 year after HSCT. Recipients completed the Short Form-36, version 1 (SF-36v1) HRQOL survey followed by a 60- to 90-min face-to-face or telephone audio-recorded interview. Eleven of 15 eligible recipients participated in the study. Although the eight HRQOL subscale scores varied, the three recipients with a successful HSCT and the highest scores were pursuing their personal life goals. The four with avascular necrosis (AVN) had lower scores related to AVN limitations, yet they were pursuing their personal goals. The two reporting a failed HSCT had reverted back to having SCD, and their subscale scores were among the lowest. Our results show that HSCT success, ability to pursue goals, and HRQOL align in predictable ways.
Exploring the “Liberal Paradox” from the Inside: Evidence from the Swedish Migration Courts
Authors: Johannesson Livia
Published: April 2018

Courts are influential actors during the implementation of immigration policies in liberal democracies. The “liberal paradox” thesis stipulates that courts are driven by logics that hamper restrictionist immigration policies. This study contributes to this theory by exploring the norm construction of impartiality among judicial workers in Swedish migration courts when deciding asylum appeals. Its findings contradict the liberal paradox assumption that courts act according to inner logics that benefit immigrants’ rights. At Sweden’s migration courts, judicial workers show impartiality by using a skeptical approach to asylum applicants and do so to distance themselves from the political discourse of generosity that has dominated Swedish political debate for decades. The broader implications of these findings are that immigration policy theories can benefit from qualitative research exploring informal norm constructions in courts, as such work can offer new insights about the role of courts in the implementation of immigration policies.
Different Patterns of Labor Market Integration by Migration Motivation in Europe: The Role of Host Country Human Capital
Authors: Zwysen Wouter
Published: April 2018

We study whether the acquisition of host country human capital, such as obtaining equivalent qualifications, good language skills, or naturalization, explains differences in labor market integration between migrants depending on their initial motivation. We use cross-national European data from the 2008 ad hoc module of the Labour Force Survey to analyze migrant gaps in labor market participation, employment, occupational status, and precarious employment. We find that different rates of and returns to host country human capital explain a substantial part of the improvements in labor market outcomes with years of residence, particularly for noneconomic migrants who experience faster growth on average.
Emotional Stress and the Integration of Muslim Minorities in France and Canada
Authors: Joly Marie-Pier , Reitz Jeffrey G.
Published: April 2018

This study examines theories of Muslim minority integration as these apply to republican France and multicultural Canada, using data on psychological distress as a key measure. Based on the 2001–2002 Canadian Community Health Survey and the 2008 French Enquête sur la Santé et la Protection Sociale, we find Muslim minorities experience higher levels of psychological distress than non-Muslims, not only in France but also in Canada. The Muslim difference is unrelated to religious attachment and rather is partly explained by high rates of unemployment or labor market inactivity.
EphrinB2 activation enhances angiogenesis, reduces amyloid-β deposits and secondary damage in thalamus at the early stage after cortical infarction in hypertensive rats
Authors: Xing Shihui , Pan Nannan , Xu Wei , Zhang Jian , Li Jingjing , Dang Chao , Liu Gang , Pei Zhong , Zeng Jinsheng
Published: April 2018

Cerebral infarction causes secondary neurodegeneration and angiogenesis in thalamus, which impacts functional recovery after stroke. Here, we hypothesize that activation of ephrinB2 could stimulate angiogenesis and restore the secondary neurodegeneration in thalamus after cerebral infarction. Focal cerebral infarction was induced by middle cerebral artery occlusion (MCAO). Secondary damage, angiogenesis, amyloid-β (Aβ) deposits, levels of ephrinB2 and receptor for advanced glycation end product (RAGE) in the ipsilateral thalamus were determined by immunofluorescence and immunoblot. The contribution of ephrinB2 to angiogenesis was determined by siRNA-mediated knockdown of ephrinB2 and pharmacological activation of ephrinB2. The results showed that formation of new vessels and ephrinB2 expression was markedly increased in the ipsilateral thalamus at seven days after MCAO. EphrinB2 knockdown markedly suppressed angiogenesis coinciding with increased Aβ accumulation, neuronal loss and gliosis in the ipsilateral thalamus. In contrast, clustered EphB2-Fc significantly enhanced angiogenesis, alleviated Aβ accumulation and the secondary thalamic damage, which was accompanied by accelerated function recovery. Additionally, activation of ephrinB2 significantly reduced RAGE levels in the ipsilateral thalamus. Our findings suggest that activation of ephrinB2 promotes angiogenesis, ameliorates Aβ accumulation and the secondary thalamic damage after cerebral infarction. Additionally, RAGE might be involved in Aβ clearance by activating ephrinB2 in the thalamus.
The added value of chemical shift MRI in the preoperative diagnosis of thymolipoma
Authors: Calandriello Lucio , Larici Anna Rita , Sica Giuliano , Ciliberto Mario , Manfredi Riccardo
Published: April 2018

Thymolipoma is a rare tumor of the thymus. Classic radiologic findings of thymolipoma include fatty masses of the anterior mediastinum in conjunction with the thymus. Differential diagnosis with other more aggressive entities like liposarcoma and teratoma can be challenging. We report a case where chemical shift magnetic resonance imaging helped in the differential diagnosis.
Prostate-specific antigen associates with extensive lymph node invasion in high-risk prostate cancer
Authors: Porcaro Antonio B , Corsi Paolo , Inverardi Davide , Sebben Marco , Tafuri Alessandro , Processali Tania , Mattevi Daniele , De Marchi Davide , Pirozzi Marco , Cerruto Maria A. , Amigoni Nelia , Rizzetto Riccardo , Brunelli Matteo , Siracusano Salvatore , Artibani Walter
Published: April 2018

Objective:

To evaluate clinical predictors of lymph node invasion (LNI) in patients with high-risk prostate cancer undergoing radical prostatectomy (RP) with extended pelvic lymph node dissection (ePLND).

Methods:

A contemporary cohort of 116 patients, who underwent ePLND during RP, was retrospectively evaluated. Patients were classified into 3 groups including cases without LNI (group 1), with 1 to 3 positive nodes (group 2; limited LNI), and with more than 3 positive nodes (group 3; extensive LNI). The multinomial logistic regression model (multivariate analysis) evaluated the risk of LNI.

Results:

Overall, 30 patients (25.9%) had LNI, which was limited in 17 cases (14.7%) and extensive in 13 subjects (11.2%). Median prostate-specific antigen (PSA) was higher in cases with limited (11.4 ng/mL) or extensive (23.5 ng/mL) LNI than cases without (7.3 ng/mL) and the difference was significant ( p <.0001). Median proportion of biopsy-positive cores was higher in limited (0.64) or extensive (0.54) LNI than cases without (0.34) and the difference was significant ( p < .0001). The distribution of other factors did not show any significant difference among the groups. On multivariate analysis, only higher values of PSA significantly affected the odds of extensive LNI when compared to cases without (odds ratio, 1.054; p = .005); PSA showed a fair discrimination power (area under the curve 0.792).

Conclusion:

PSA was the only independent predictor of extensive LNI and could be an important preoperative factor for stratifying high-risk patients.
The efficacy of a multifactorial falls-prevention programme, implemented in primary health care
Authors: Johansson Erika , Jonsson Hans , Dahlberg Raymond , Patomella Ann-Helen
Published: April 2018

Introduction

A major threat to healthy ageing is accidental falls causing individual suffering as well as increasing costs for society. The aim of this study was to compare and evaluate a multifactorial falls-prevention programme, with ordinary falls prevention in primary healthcare.

Method

Eligible patients were community-dwelling older adults (+65) who had fallen within the last 6 months or were concerned about falling. Participants ( n = 131) were randomized to an intervention or control group. The primary outcome was measure of falls and the secondary was fear of falling.

Results

There was a significant decrease in the risk of falls and fear of falling at 12 months in favour of the intervention group. When comparing groups over time, including baseline measures, only fear of falling remained significant.

Conclusion

Small-group learning environments in combination with learning by doing, could be an effective approach for the translation of knowledge into everyday life and valued activities leading to a decrease in falls and fear of falling. Multifactorial and multi-disciplinary approaches against falls in a small-group learning environment could be effective in preventing falls and reducing fear of falling among older adults at risk.
Into-Tunnel Repair Versus Onto-Surface Repair for Rotator Cuff Tears in a Rabbit Model
Authors: Li Xiaoxi , Shen Peng , Su Wei , Zhao Song , Zhao Jinzhong
Published: April 2018

Background:

Clinically, onto-surface repair is commonly used for rotator cuff tears. The retear rate after rotator cuff repair (RCR) is relatively high, with failure occurring mostly at the tendon-bone connection site. For anterior cruciate ligament (ACL) reconstruction, into-tunnel reconstruction is commonly employed. The retear rate after ACL reconstruction is relatively low, with retears seldom occurring at the tendon-bone interface. No study on into-tunnel RCR has been conducted.

Hypothesis:

Into-tunnel RCR could promote fibrocartilage regeneration at the tendon-bone interface and has biomechanical advantage over onto-surface repair in a rabbit rotator cuff tear model.

Study Design:

Controlled laboratory study.

Methods:

Thirty-six New Zealand White rabbits were used in this study. The supraspinatus tendons were cut from the footprint to create a rotator cuff tear on both shoulders. On one side, the supraspinatus was cut longitudinally into 2 halves, sutured, and pulled into 2 tunnels through the greater tuberosity (into-tunnel repair). On the other side, the tendon was reattached to the surface of the footprint with transosseous sutures (onto-surface repair). Twelve animals were sacrificed, of which 6 were used for a histological examination and the other 6 for biomechanical testing, at 4, 8, and 12 weeks, respectively.

Results:

The tendon-bone interface in the into-tunnel group showed a different healing pattern from that in the onto-surface group. In the former, most of the tendon tissue in the tunnel was replaced with newly generated fibrocartilage; the rest of the tendon fibers appeared in large bundles with direct connection to the bone. In the latter, fibrocartilage regeneration was seldom found at the tendon-bone interface; the tendon near the bone surface appeared as small fibrils. The biomechanical evaluation revealed a higher ultimate load ( P < .001) and stiffness ( P < .001) at the tendon-bone junction in the into-tunnel group than those in the onto-surface group at 12 weeks.

Conclusion:

In a rabbit rotator cuff tear model, into-tunnel RCR could result in a different tendon-bone healing pattern, with obvious fibrocartilage regeneration at the interface and higher tendon-bone healing strength than that in onto-surface repair.

Clinical Relevance:

New RCR patterns may be developed to improve the tendon-bone healing pattern and obtain better tendon-bone healing strength.
Women’s Attitude and Its Influence on Violence During Pregnancy in Northern State of Peninsular Malaysia: Cross-Sectional Study
Authors: Haron Khaironisak , Shaffie Zaridah , Ghazi Hasanain Faisal , Isa Zaleha Md
Published: April 2018

The objective of this study was to determine the prevalence of men’s violence against pregnant women and whether it is influenced by women’s attitude. A cross-sectional study was carried out in a hospital in northern state of Peninsular Malaysia. A total of 1,200 postnatal women aged 18 years and above who had been admitted to the hospital were recruited in the study. Universal sampling was performed, and participants were interviewed face-to-face by using a validated Malay version of WHO Women’s Health and Life Experiences Questionnaire. The main outcome measures in the study were emotional, physical or sexual violence. The study results showed that more than one third of women (35.9%; confidence interval [CI] = [0.33, 0.39]) had experienced any type of violence during pregnancy with the commonest was psychological violence (29.8%; CI = [0.27, 0.32]) followed by physical (12.9%; CI = [0.11, 0.15]) and sexual violence (9.8%; CI = [0.08, 0.12]). Women who were drug users, had an exposure to violence during childhood, had higher parity, and had inadequate antenatal care were at greater risk. Agree that husband is justified to hit his wife in certain conditions and agree that women has a right to refuse sex in certain conditions were among violence-supporting attitudes. It can be concluded that men’s violence against pregnant women is extremely prevalent. Sensitive assessment, attitude modification, and intervention (primary, secondary, and tertiary) are of great value in combating men’s violence against pregnant women.
Utility Manning: Young Filipino Men, Servitude and the Moral Economy of Becoming a Seafarer and Attaining Adulthood
Authors: Galam Roderick G
Published: April 2018

To get a job as a seafarer in the global maritime industry, thousands of male Filipino youths work for free as ‘utility men’ for manning agencies that supply seafarers to ship operators around the world. Based on ethnographic fieldwork and approached from a moral economy perspective, this article examines how manning agencies and utility men differentially rationalize this exploitative work (utility manning). Manning agencies use it as a technology of servitude that, through physical and verbal abuse and other techniques, enforces docility to prepare utility men for the harsher conditions on-board a ship. In contrast, utility men use it as a technology of imagination, gleaning from it a capacity to shape their future. Faced with few social possibilities in the Philippines, they deploy servitude as a strategy for attaining economic mobility and male adulthood.
Identification of spin maneuver aerodynamic nonlinear model by applying ensemble empirical mode decomposition and extended multipoint modeling
Authors: Mokhtari MA , Sabzehparvar M
Published: April 2018

Identification of the “aircraft aerodynamic model” in some unusual flight conditions such as spin maneuver provides critical information to the flight controller to retake the “dynamic stability” after it has been disturbed by the systematic, natural or environmental oscillations. Hence, a method for identifying the appropriate aerodynamic model in spin maneuvers is presented in this paper. We present an innovative systematic method for aerodynamic modeling of spin maneuvers, which combines the ensemble empirical mode decomposition technique and extended multipoint modeling approach, using flight data. In ensemble empirical mode decomposition, in addition to having all the empirical mode decomposition features, the original signal is collected with the white noise, and by using its statistical characteristics, the ensemble empirical mode decomposition solves the mode mixing problem. By applying the ensemble empirical mode decomposition to the flight parameter data, their intrinsic mode frequencies are extracted and are used as inputs to the extended multipoint modeling model. The extended multipoint modeling structure includes some parameters describing the distribution of aerodynamic forces and moments along each of the aircraft components. Moreover, this method allows coupling between the forces and moments. Unlike conventional methods, which consider the average forces obtained by plane surfaces relative to the center of mass, in the extended multipoint modeling technique, the force generated by each plane of the aircraft is allowed to appear independently in the motion equations. For identifying the aerodynamic model with extended multipoint modeling structure, the equation error method is used with a maximum likelihood optimizer inside. The obtained algorithm has been applied to two sets of spin maneuver flight data which were recorded in actual spin flight. The results demonstrate that the proposed method is able to reproduce the aerodynamic forces and moments for the second spin flight inputs with high accuracy by using a model which is derived from the first spin data identification.
Right time, right place, and right direction: First reported use of dual simultaneous external defibrillation in Hong Kong
Authors: Lau James Siu Ki , Chau Yau Ming , Wong Yau Tak , Kan Pui Gay
Published: April 2018

Introduction:

Refractory ventricular fibrillation is not uncommon and can be extremely difficult to abort. There is currently no standard guideline to effectively manage this electrical storm.

Case Presentation:

We hereby present the first successful reported use of dual simultaneous external defibrillation on a patient with refractory ventricular fibrillation in Hong Kong.

Conclusion:

Given the numerous successful cases with intact neurology in literature, dual simultaneous external defibrillation should be employed in indicated patients.
Analysis of prehospital care of patients with acute myocardial infarction in Bulgaria
Authors: Milanova Maria Hristova , Naydenov Stefan Naydenov , Runev Nikolay Margaritov , Manov Emil Ivanov , Krastev Plamen Krasimirov
Published: April 2018

Introduction:

Acute myocardial infarction is one of the most devastating cardiovascular diseases and about 50% of all deaths due to it occur prior to hospitalization. Our study aimed to evaluate the prehospital delay in patients with acute myocardial infarction.

Methods:

We enrolled 682 consecutive patients with acute myocardial infarction from May 2008 to December 2014, with a mean age of 66.6 ± 12.9 years. Detailed information was collected about the symptoms, first medical contact, concomitant clinical conditions, and the socioeconomic data. We analyzed the following prehospital times: (1) onset of symptoms to emergency call, (2) onset of symptoms to first medical contact, (3) first medical contact to hospital admission, and (4) onset of symptoms to hospital admission.

Results:

The first medical contact was with the National Emergency Medical Service in 266 (39.0%) patients, another emergency unit 106 (15.6%), cardiologist 41 (6%), general practitioner 36 (5.3%), and others 233 (34.1%). The median time from the onset of symptoms till emergency call was 190 min, from the first contact with a team of the National Emergency Medical Service till hospital admission 60 min, and from the onset of symptoms till hospital admission 4.8 h.

Conclusion:

The total prehospital delay in our study was unacceptably prolonged, with patient’s decision time as the major contributor. The delay could be substantially shortened by (1) increased awareness of the general population, particularly of individuals at high cardiovascular risk and (2) continuous medical education and regular practical training of the primary care providers about coping with medical emergencies.
Violence in Rural, Suburban, and Urban Schools in Pennsylvania
Authors: Flynn Kalen , McDonald Catherine C. , D’Alonzo Bernadette A. , Tam Vicky , Wiebe Douglas J.
Published: April 2018

School violence is a public health issue with direct and collateral consequences that has academic and social impacts for youth. School violence is often considered a uniquely urban problem, yet more research is needed to understand how violence in rural and suburban schools may be similar or different from urban counterparts. Using school violence data from a state with urban, suburban, and rural counties, we explored the landscape of school violence in Pennsylvania (PA) through mapping, descriptive statistics, and factor analysis. Results show school violence is not solely an urban problem. Schools in all county types and across grade levels deal with violence to varying degrees, and the majority of schools across county types experience low levels of violence. Types of violence experienced by PA schools loaded onto three factors, suggesting that targeted interventions may be better suited to addressing school violence.
Eosinophilic Myocarditis With Hypersegmented Granulocytes and Neutrophilia Without Eosinophilia: A Case Mimicking Neutrophilic Myocarditis
Authors: Hashimoto Hirotsugu , Hashikata Takehiro , Shindo Akito , Horiuchi Hajime
Published: April 2018

We report a case of a 78-year-old woman with neutrophilia without eosinophilia who was pathologically diagnosed with eosinophilic myocarditis by myocardial biopsy. The biopsy specimen showed infiltrating granulocytes with hypersegmentation, mimicking neutrophils; however, they were confirmed to be eosinophils by Giemsa staining.
Immunoexpression of BAP1, ROS1, and ALK in Spitzoid Melanocytic Tumors
Authors: Cardili Leonardo , Viana Cristiano Ribeiro , Germano Andressa , Fernandes Mariana , Barcellos Denise , Landman Gilles
Published: April 2018

Background. Spitzoid tumors are a heterogeneous group of melanocytic neoplasms that frequently imposes diagnostic difficulties. Lately, several advances in molecular biology afforded significant discoveries on the pathogenesis of these tumors. BAP1 (BRCA-1 associated protein-1) inactivation and anomalous expression of kinase translocation-related proteins are among the main criteria launched by new classification proposals. Our aim was to systematically assess the immunoexpression of BAP1, ROS1 (receptor tyrosine kinase c-Ros oncogene 1), and ALK (anaplastic lymphoma receptor tyrosine kinase) proteins in an unpublished series of spitzoid tumors. Methods. Retrospective study based on 47 formalin-fixed paraffin-embedded tissue samples from 3 different institutions. BAP1, ROS1, and ALK immunostains were performed in all cases. We included 27 Spitz tumors without significant abnormality, 15 atypical spitzoid tumors, and 5 spitzoid melanomas. Results. We observed loss of BAP1 nuclear immunolabeling in 4.3% of evaluable cases (2/46), both of them atypical spitzoid tumors. The proportional frequency of BAP1-inactivated cases among atypical spitzoid tumors was 14.2% (2/14). No immunoexpression of ROS1 or ALK was found. Conclusions. Our study revealed 2 additional BAP1-inactived cases and described its respective frequency. The absence of anomalous expression of translocation-related proteins ALK and ROS1 in this series, composed predominantly of low-grade/low-risk tumors, indicates that translocated spitzoid lesions may not be as prevalent as initially suggested, at least in some populations. Furthermore, our findings encourage additional investigation on unequal occurrence of such immunomarkers among different diagnostic categories of spitzoid neoplasms.
Validation and Generalizability of Preoperative PROMIS Scores to Predict Postoperative Success in Foot and Ankle Patients
Authors: Anderson Michael R. , Houck Jeff R. , Saltzman Charles L. , Hung Man , Nickisch Florian , Barg Alexej , Beals Timothy , Baumhauer Judith F.
Published: April 2018

Background:

A recent publication reported preoperative Patient-Reported Outcomes Measurement Instrumentation System (PROMIS) scores to be highly predictive in identifying patients who would and would not benefit from foot and ankle surgery. Their applicability to other patient populations is unknown. The aim of this study was to assess the validation and generalizability of previously published preoperative PROMIS physical function (PF) and pain interference (PI) threshold t scores as predictors of postoperative clinically meaningful improvement in foot and ankle patients from a geographically unique patient population.

Methods:

Prospective PROMIS PF and PI scores of consecutive patient visits to a tertiary foot and ankle clinic were obtained between January 2014 and November 2016. Patients undergoing elective foot and ankle surgery were identified and PROMIS values obtained at initial and follow-up visits (average, 7.9 months). Analysis of variance was used to assess differences in PROMIS scores before and after surgery. The distributive method was used to estimate a minimal clinically important difference (MCID). Receiver operating characteristic curve analysis was used to determine thresholds for achieving and failing to achieve MCID. To assess the validity and generalizability of these threshold values, they were compared with previously published threshold values for accuracy using likelihood ratios and pre- and posttest probabilities, and the percentages of patients identified as achieving and failing to achieve MCID were evaluated using χ2 analysis.

Results:

There were significant improvements in PF ( P < .001) and PI ( P < .001) after surgery. The area under the curve for PF (0.77) was significant ( P < .01), and the thresholds for achieving MCID and not achieving MCID were similar to those in the prior study. A significant proportion of patients (88.9%) identified as not likely to achieve MCID failed to achieve MCID ( P = .03). A significant proportion of patients (84.2%) identified as likely to achieve MCID did achieve MCID ( P < .01). The area under the curve for PROMIS PI was not significant.

Conclusions:

PROMIS PF threshold scores from published data were successful in classifying patients from a different patient and geographic population who would improve with surgery. If functional improvement is the goal, these thresholds could be used to help identify patients who will benefit from surgery and, most important, those who will not, adding value to foot and ankle health care.

Level of evidence:

Level II, Prospective Comparative Study
Intimate Partner Violence in Urban, Rural, and Remote Areas: An Investigation of Offense Severity and Risk Factors
Authors: Strand Susanne J. M. , Storey Jennifer E.
Published: April 2018

This study compared the severity of intimate partner violence (IPV) and the relationship between risk factors for IPV and overall risk judgments of future IPV in urban, rural, and remote areas. IPV risk assessments conducted by the Swedish police between 2010 and 2014 in urban ( n = 564), rural ( n = 456), and remote ( n = 196) areas were examined. Rurality was associated with the severity of IPV reported, as well as the presence of risk factors and their relationship to overall risk judgments. Cases in remote areas included more severe IPV as well as more risk factors.
Justification of Wife Beating in Adolescents: Associated Beliefs and Behaviors
Authors: Devenish Bethany , Hooley Merrilyn , Mellor David
Published: April 2018

Socioeconomically disadvantaged adolescents who are exposed to social norms related to violence against women are more likely to experience or be perpetrators of intimate partner violence. This study evaluated factors hypothesized to be associated with acceptance of wife beating among 240 male and female adolescents aged 10-16 years participating in a World Vision program in Armenia. Acceptance of wife beating was associated with relational victimization, perceived social support, and parent and community boundaries and expectations, but was not associated with overt victimization or aggression. These findings highlight several areas that may be important for violence prevention research.
Standardized care by redesign of an intravitreal injection pathway
Authors: Van Calster Joachim , Willekens Koen , Seys Deborah , Van Elderen Peter , Spileers Werner , Vanhaecht Kris
Published: April 2018

Purpose:

Intravitreal injection of medication is a rapid rising surgical intervention in modern ophthalmological care. With increasing numbers, the caseload of complications follows and the burden on daily clinical organization increases. This study focuses on developing a standardized treatment protocol to improve care and reduce hazard.

Methods:

A standardized treatment protocol was designed and educated to the involved medical doctor and registered nurse. An independent observer used this protocol to evaluate the actions performed during the intravitreal injection. Data on the included patients and products injected were collected.

Results:

In total, 180 injections of 134 patients were observed between 1 December 2011 and 18 October 2012, divided over 16 measurements. From the fifth measurement on, a 100% protocol adherence for the time out procedure was achieved and maintained over time, with a transient insignificant decrease. The performance of actions of the medical doctor and assisting registered nurse followed the same trend with a rapid increase and 100% protocol adherence. No microorganism caused development of endophthalmitis was recorded.

Conclusion:

The optimization of an intravitreal injection care pathway leads to a more standardized intervention process with no apparent reduction in clinical efficiency and safety.
Clinical outcome and higher order aberrations after bilateral implantation of an extended depth of focus intraocular lens
Authors: Pilger Daniel , Homburg David , Brockmann Tobias , Torun Necip , Bertelmann Eckart , von Sonnleithner Christoph
Published: April 2018

Purpose:

The purpose of this study was to assess the clinical outcome after a bilateral implantation of an extended depth of focus intraocular lens in comparison to a monofocal intraocular lens.

Setting:

Department of Ophthalmology, Charité—Medical University Berlin, Germany.

Patients and Methods:

A total of 60 eyes of 30 patients were enrolled in this prospective, single-center study. The cataract patients underwent phacoemulsification with bilateral implantation of a TECNIS® Symfony (Abbott Medical Optics, Santa Ana, CA, USA, 15 patients) or a TECNIS Monofocal ZCB00 (Abbott Medical Optics, Santa Ana, CA, USA, 15 patients). Postoperative evaluations were performed after 1 and 3 months, including visual acuities at far, intermediate, and near distance. Mesopic, scotopic vision, and contrast sensitivity were investigated. Aberrometry was performed using an iTrace aberrometer with a pupil scan size of 5.0 mm.

Results:

After 3 months, the TECNIS Symfony group reached an uncorrected visual acuity at far distance of −0.02 logMAR compared to −0.06 logMAR in the TECNIS Monofocal group ( p = 0.03). Regarding the uncorrected vision at intermediate and near distance the following values were obtained: intermediate visual acuity −0.13 versus 0.0 logMAR (TECNIS Symfony vs TECNIS Monofocal, p = 0.001) and near visual acuity 0.11 versus 0.26 logMAR (TECNIS Symfony vs TECNIS Monofocal, p = 0.001). Low-contrast visual acuities were 0.27 versus 0.20 logMar (TECNIS Symfony vs TECNIS Monofocal, p = 0.023).

Conclusion:

The TECNIS Symfony intraocular lens can be considered an appropriate alternative to multifocal intraocular lenses because of good visual results at far, intermediate, and near distance as well as in low-contrast vision.
Defying expectations: what leader insurgencies reveal about media and party incapacity in the time of ‘audience democracy’
Authors: Walter James , Ghazarian Zareh
Published: April 2018

Political communication and citizen engagement have been impacted by crises in both political parties and conventional media models. This article contends that the confluence of these crises has been insufficiently understood, and that this lack of understanding depends upon a third element: the dissolution of a ‘holding culture’, a sense of the ‘rules of the game’ that has constituted the ground on which parties and the media operated and generated the imaginative space for constituting community. This dissolution might be represented as resistance to a now discredited political class, once constituted by ‘old’ political and media elites, and promising a new culture – with the potential for parties to be more responsive to ‘the people’, and for a more diversified and representative media. By looking at case studies of leadership insurgency in parties and the impact of new media in creating the discursive conditions for their emergence, this article explores the realities in relation to political communication and democratic engagement.
The power of the personal: situating Aboriginal memoir in the Indigenous public sphere and as a mode of public intellectual intervention
Authors: Fordham Helen
Published: April 2018

Memoir is not routinely considered a part of media practice. However, as a literary form produced for reading publics that express cultural identities, it can be considered a part of the Indigenous public sphere, which has been theorised as a counter-public of resistance and a site of cultural renegotiation of ideas about Indigeneity. Through an analysis of a selection of Indigenous memoir published during the 1980s, it is argued that these texts operated as a version of Edward Said’s public intellectualism by exposing the oppression of the inherited and unexamined binaries and regimes of truth that produce and perpetuate the conditions of inequality and injustice. As the authors recalled lives of suffering, their memories provided alternative narratives that challenged the silences of Australia’s official history, which sustained racist attitudes and identities and cast the Indigenous Public Sphere as a site of contested historiography.
Culturally Sensitive Assessment of Anxious-Depressive Distress in Vietnam: Avoiding Category Truncation
Authors: Hinton Devon E. , Pollack Amie Alley , Weiss Bahr , Trung Lam T.
Published: April 2018

The present study investigated what complaints are prominent in psychologically distressed Vietnamese in Vietnam beyond standard symptoms assessed by Western diagnostic instruments for anxiety and depression. To form the initial Vietnamese Symptom and Cultural Syndrome Addendum (VN SSA), we reviewed the literature, consulted experts, and conducted focus groups. The preliminary VN SSA was then used in a general survey (N = 1004) of five provinces in Vietnam. We found that the VN SSA items were highly and significantly correlated with a measure of anxious-depressive psychopathology (a composite measure of the General Anxiety Disorder-7; Posttraumatic Diagnostic Scale; and Patient Health Questionnaire-9). The VN SSA item most highly correlated to anxious-depressive psychopathology was “thinking a lot” ( r = .54), reported by 15.8% of the sample. Many other symptoms in the addendum also were prominent, such as orthostatic dizziness (i.e., dizziness upon standing up; r = .41), reported by 22.9% of the sample. By way of comparison, somatic complaints more typically assessed to profile Western anxious-depressive distress, such as palpitations, were less prominent, as evidenced by being less strongly correlated to Western psychiatric symptoms and being less frequent (e.g., palpitations: r = .31, 7.1% of the sample). Study results suggest that to avoid category truncation when profiling anxious-depressive distress among Vietnamese that items other than those in standard psychopathology measures should also be assessed.
‘Risky business’: The future for female trekking guides in Nepal
Authors: Hillman Wendy
Published: April 2018

Over the years, much has been researched on male trekking guides, the trekking industry and male dominated and led tours. Research is lacking on female-only advancements made in this industry, and the risks that female guides experience daily. The research comes from face-to-face semi-structured interviews with 10 female trekking guides from Nepal. The interviews were undertaken with female guides employed by the ‘3 Sisters Adventure’ trekking agency to ascertain the risks and safety issues for female trekking guides in the Himalayas. Findings suggest that female guides do indeed face risks and safety issues when guiding treks. More recently, female trekking guides have begun to carve their own niche within current Nepali tourism enterprises and into the future.