bluuebunny/crossref_metadata_2025 huggingface dataset:
The Application of Humane Endpoints and Humane Killing Methods in Animal Research Proposals: A Retrospective Review
Authors: Herrmann Kathrin , Flecknell Paul
Published: April 2019

Refinement refers to the use of methods that help to minimise animal suffering in the laboratory. Research in this area has increased significantly over the past two decades. However, the extent to which refinements are applied in practice is uncertain. To provide an indication of the implementation and awareness of refinements, we reviewed the experimental techniques for 684 surgical interventions described in 506 animal research applications sent to the German competent authorities for approval in 2010. In this paper, we describe and discuss the appropriateness of the proposed humane endpoints and killing methods. We found that, when the investigators included humane endpoints in their application, these were often lacking in detail and/or were to be implemented at a late stage of suffering. In addition, the choice of method to kill the animals could be improved in the majority of the applications. We provide recommendations for future improvements, based on the recent literature. To ensure scientific rigour, avoid needless animal suffering and enable an accurate harm–benefit analysis, animal researchers have to be knowledgeable about refinement methods and apply them effectively. To assess compliance and ensure that only those studies in which potential benefits outweigh the harms are carried out, reviews such as ours — as well as retrospective assessments of actual harms and benefits — should be conducted widely and regularly, and the findings should be published.
Repairing one’s mood for the benefit of others: Agreeableness helps motivate low self-esteem people to feel better
Authors: Cortes Kassandra , Wood Joanne V. , Prince Jill
Published: April 2019

The chronic experience and expression of negativity is associated with poorer personal and relationship outcomes. Unfortunately, compared to people with high self-esteem, those with low self-esteem (LSEs) are less motivated to repair their negative moods. The current research examined mood repair in a novel way: in a close relationship context, when mood repair centers on benefitting others. We hypothesized that LSEs are more motivated than usual to repair negative moods when doing so benefits close others and when high in agreeableness (a trait involving prosocial motivation). We found support for our hypothesis with self-report (Studies 1 and 2) and behavioral measures (Study 2) of mood repair motivation, through an experimental manipulation of relationship context (Study 1), when participants expected to communicate with their romantic partners (Study 2), and for both sad (Study 1) and angry (Study 2) moods. Agreeable LSEs were more motivated to repair their negative moods than were disagreeable LSEs.
Calibration of Vissim Models for Rural Freeway Lane Closures: Novel Approach to the Modification of Key Parameters
Authors: Jehn Nicholas L. , Turochy Rod E.
Published: April 2019

The definition of freeway work zone capacity has been a topic of debate for several decades, leaving agencies with limited guidance on predicting the behavior of traffic flow at given volumes for various work zone configurations. The methodology presented in the recently published 6th edition of the Highway Capacity Manual (HCM) is a substantial improvement over historical guidance and provides estimates of the mean queue discharge rate under a variety of prevailing site conditions. However, it is limited by the fact that its outputs are deterministic, while traffic flow and breakdown are stochastic phenomena. Recently, well-calibrated microsimulation models have shown promise as a freeway work zone traffic analysis tool, but most guidance is focused on site-specific modeling. This research aimed to address these shortcomings by presenting a novel approach to developing and calibrating generalizable microsimulation models for rural freeway lane closures in Vissim, a traffic simulation software package developed by the PTV Group. Specifically, it was determined that such models may best replicate field conditions at rural freeway work zones when time headway is described by a field-measured distribution and truck characteristics are representative of the United States (U.S.) fleet. The results suggested that the default desired acceleration for heavy trucks should be set between 2 and 3 ft/s2 and that separate time headway distributions should be constructed for passenger cars and trucks. The methodology presented herein may be extended to obtain stochastic estimates of capacity for sites exhibiting a variety of geometric, traffic, and environmental characteristics.
Authoritarian regimes and civil–military relations: Explaining counterbalancing in autocracies
Authors: Escribà-Folch Abel , Böhmelt Tobias , Pilster Ulrich
Published: April 2019

How do autocracies structure their civil–military relations? We contend that personalist dictators are more strongly associated with counterbalancing than other authoritarian regime types. Personalists are characterized by weak institutions and narrow support bases, a lack of unifying ideologies and informal links to the ruler. They thus have strong incentives to coup-proof and, as we contend, counterbalancing seems particularly attractive. Quantitative analyses of autocratic regimes’ counterbalancing efforts since the 1960s provide support for this expectation. By showing that institutional coup-proofing significantly varies across autocratic forms of government, we contribute to the literature on comparative authoritarianism and civil–military relations.
Bispectral Index Monitoring in Unconscious Palliative Care Patients
Authors: Barbato Michael
Published: April 2019

This pilot study looks at the clinical application of bispectral index (BIS) monitoring within the palliative care situation. Using this instrument, the level of awareness in 12 patients was tracked from the onset of unconsciousness until death, and the levels were then related to the patients’ clinical state and treatment. The results give a surprising insight into the nature of unconsciousness in dying patients and the effects of treatment. The monitor proved to be a simple, effective, and acceptable method of assessing awareness in palliative care patients. A few minor problems were encountered in adapting it to the palliative care situation, but most of these were overcome as we became more familiar with the instrument. The study suggests that BIS could contribute significantly to patient care and lead to a better understanding of the dying process.
Future Echoes in Pediatric Palliative Care: Becoming Sensitive to Language
Authors: Rallison Lillian , Limacher Lori Houger , Clinton Michael
Published: April 2019

As the specialty of pediatric palliative care emerges and develops, finding language to describe the complexity of “living while dying” is a challenge. Terms such as “life-limiting” and “life-threatening” are commonly used, but may not be sensitive enough to capture the experience of children and their families due to the restrictions and power at play in the history of the words “limit” and “threat”. The search for the right words to use when speaking of children who are living while dying takes us to the language of metaphor and poetry that speaks to us in a different way, a way that encompasses not only the suffering, but also the dreams, hopes, and joys of children and families. Our preferred use of language also provides more than factual statements ever can, by speaking to the hearts and souls of health care providers who share precious moments with these families.
Developing a Living with Hope Program for Caregivers of Family Members with Advanced Cancer
Authors: Duggleby Wendy , Wright Karen , Williams Allison , Degner Lesley , Cammer Allison , Holtslander Lorraine
Published: April 2019

A theory-based intervention, the Living with Hope Program (LWHP), was designed to foster hope in caregivers of family members with advanced cancer. The LWHP was developed from qualitative data and using Harding and Higginson's recommendations for family caregiver interventions as a guide. The LHWP is: a) focused specifically on the caregivers themselves, b) theory based, c) feasible, d) acceptable, and e) pilot tested. The program consists of a hope video and a hope activity titled Stories of the Present. A mixed-method, concurrent triangulation, pre- and post-test design was used to pilot test the LWHP. The results of the pilot test suggest the LWHP is easy to use, flexible, and feasible, and shows promise in increasing hope and quality of life scores in family caregivers.
Meta-analysis of Survival Prediction with Palliative Performance Scale
Authors: Downing Michael , Lau Francis , Lesperance Mary , Karlson Nicholas , Shaw Jack , Kuziemsky Craig , Bernard Steve , Hanson Laura , Olajide Lola , Head Barbara , Ritchie Christine , Harrold Joan , Casareti David
Published: April 2019

This paper aims to reconcile the use of Palliative Performance Scale (PPSv2) for survival prediction in palliative care through an international collaborative study by five research groups. The study involves an individual patient data meta-analysis on 1,808 patients from four original datasets to reanalyze their survival patterns by age, gender, cancer status, and initial PPS score. Our findings reveal a strong association between PPS and survival across the four datasets. The Kaplan-Meier survival curves show each PPS level as distinct, with a strong ordering effect in which higher PPS levels are associated with increased length of survival. Using a stratified Cox proportional hazard model to adjust for study differences, we found females lived significantly longer than males, with a further decrease in hazard for females not diagnosed with cancer. Further work is needed to refine the reporting of survival times/probabilities and to improve prediction accuracy with the inclusion of other variables in the models.
High–Tech, Aggressive Palliative Care: In the Service of Quality of Life
Authors: Dush David M.
Published: April 2019

The hospice movement grew in part as a reaction to the perception that modern medical care had become too technological at the expense of being impersonal and insensitive to human psychological and spiritual concerns. In the United States, the institutionalization of hospice care under Medicare and other reimbursement systems has further established hospice as an alternative to high-technology, high-cost care. The present paper examines the question: What if hospice care becomes itself high-technology, aggressive, costly health care in order to remain true to its goal of maximizing quality of life? Implications for the goals and philosophical underpinnings of palliative care are discussed.
The Chinese Palliative Patient and Family in North America: A Cultural Perspective
Authors: Tong Kevin L. , Spicer Betsy Jo
Published: April 2019

Professionals may become frustrated when caring for the Chinese palliative patient and family, as we may expect them to behave or act like us. This paper discusses two distinctive characteristics which may be unfamiliar to Western caregivers. The first pertains to the concept of family-based popular health care, where the family assumes the major role of decision-maker on behalf of the patient. The second relates to the Eastern belief of silence surrounding the discussion of dying and the impending death, versus our Western orientation, which advocates openness and honesty. By gaining a greater understanding of these cultural traditions and practices, we can deliver more culturally sensitive health care to the Chinese patient and family.
Providing Palliative Care to Older Adults: Context and Challenges
Authors: Ross Margaret M. , Mcdonald Beth
Published: April 2019

This paper presents the findings of a study aimed at understanding more fully the work of nurses who provide care to older adults who are dying at home. The method employed was qualitative in nature and involved the use of focus groups for data collection. Data were gathered from a total of 40 community-based nurses during four sessions lasting approximately two hours each. Analysis revealed that the provision of care occurred within a context of aging and dying characterized by clients’ awareness of impending death, the presence of multiple pathologies, diminishing social support, and a lack of control. Challenges to providing care stemmed from an ethic of high expectation and a health care system experienced as fragmented, bureaucratic, and driven by cost efficiency. Challenges included working in isolation, achieving closure, securing personal support, working collaboratively with others, and keeping up to date. Findings from this study have implications for both education and practice.

Résumé / Cet article rapporte les résultats d'une étude visant à obtenir une meilleure compréhension du travail des infirmières qui soignent les personnes ägées mourantes à domicile. La méthode utilisée était de type qualitative et elle faisait appel aux discussions de groupes-cibles pour la collecte des données. L'information a ainsi été recueillie auprès de 40 infirmières communautaires lors de 4 sessions d'environ 2 heures chacune. L'analyse des discussions révèlent d'abord que ces soins sont dispensés dans un contexte particulier où les personnes ägées sont conscientes de leur mort imminente. De plus elles souffrent de multiples pathologies, de perte d'autonomie et n'ont peu ou pas de personnes sur qui elles peuvent compter dans leur entourage. Les défis reliés aux soins de ces malades à domicile sont doubles. D'une part l'attente des patients est grande et, d'autre part, en raison de la bureaucratisation et de la fragmentation du système de santé, les infirmières se sentent impuissantes à y répondre. L'infirmière communautaire qui soigne ces personnes se sent souvent isolée et éprouve de la difficulté à rompre les liens avec la famille après le décès du malade. Le défi pour elle consiste donc à collaborer avec d'autres, à recourir au support moral de ses pairs et de son entourage tout en maintenant ses connaissances à jour. Les résultats de cette recherche ont des implications tant sur la formation que sur la pratique.
What do Palliative Staff think about Audit?
Authors: Higginson Irene , Webb David
Published: April 2019

Forty-one of 68 palliative care clinicians responded to an anonymous questionnaire assessing the attitudinal, training, management, and support needs for introducing audit. Most respondents (88%) felt it was a good idea; reservations concerned the increase in work load. Although 66% of respondents had received audit training, only 39% were currently involved in audit. Respondents identified a need for more information and feedback, experienced assistance, and support. These concerns have to be addressed by health care managers if audit is to be successfully maintained. Current training sessions do not adequately meet staff needs; palliative care staff require an advanced audit training that includes staff motivation, analysis of results, and the provision of feedback.
A Report of an Investigation of End-of-Life Care Practices in Health Care Facilities and the Influences on those Practices
Authors: Wilson Donna
Published: April 2019

In 1992, 82.2% of deaths in Alberta occurred in acute care hospitals or continuing care facilities. This paper outlines the end-of-life care of adult in patients who died that year in four such facilities (n=137). CPR was an infrequent end-of-life treatment modality (2.9%), in stark contrast to the extensive use of other medical technologies. Almost every inpatient (94.2%) died with one or more technologies in continuous operation. Although reasons were infrequently given, the desire to promote patient comfort was the most frequent influence on end-of-life technology use. The findings of this study raise issues for debate and further investigation. Chief among these issues is whether or not medical technologies promote comfort during the dying process.
Striving for Balance: Palliative Care Patients’ Experiences of Making Everyday Choices
Authors: Bottorff Joan L. , Steele Rose , Davies Betty , Garossino Candy , Porterfield Pat , Shaw Mary
Published: April 2019

A fundamental principle of palliative care is the provision of patient-centred care, an approach explicitly based on the patient's perspective. Although much attention has been given to determining patients’ preferences for involvement in medical decisions, choices related to personal and nursing care routines have been largely ignored in the literature. Data from participant observations of nurse-patient interactions involving 16 palliative care patients and their nurses as well as 10 in-depth open-ended interviews with patients were analyzed using grounded theory methods. Although the choices made by patients appeared uncomplicated on the surface, the context of unfamiliarity, uncertainty, and unpredictability in palliative care increased the underlying complexity of decision making. Through a process of deliberation and trade-offs, patients attempted to regain or maintain some balance in their lives. This process of striving for balance consisted of three overlapping phases: weighing things up, communicating choice, and living with one's choices.
Effect of surface-modified silica on the thermal and mechanical behaviors of poly(lactic acid) and chemically crosslinked poly(lactic acid) composites
Authors: Prapruddivongs Chana , Rukrabiab Jatsada , Kulwongwit Nuth , Wongpreedee Thapanee
Published: April 2019

This work studied the properties of poly(lactic acid) (PLA) and chemically crosslinked poly(lactic acid) (CrPLA) in the presence of different types of silica (SiO2): SiO2 from rice husk ash (RhSiO2) and commercially available SiO2 (CoSiO2). A mixture of triallyl isocyanate and dicumyl peroxide was used as a chemical crosslinking agent. The rice husk was burnt in a furnace to extract RhSiO2. The thermal and mechanical properties of the PLA and CrPLA composites were investigated as a function of the SiO2 content. The presence of C–H functional groups supports the compatibility of stearic acid and RhSiO2, thereby facilitating the esterification reaction observed in the Fourier transform infrared-attenuated total reflectance spectra. This played an important role in changing the properties of the PLA-based composites. The concave fracture surfaces were consistent with the tensile results, the thermal properties, and the degree of swelling, which suggested that there was a better reaction between stearic acid and RhSiO2. However, the heat deflection temperatures of both the PLA and the CrPLA composites were not significantly affected by blending with either CoSiO2 or RhSiO2.
Perspective on Underpricing of IPOs in Emerging Economies
Authors: Ramana L V
Published: April 2019

Pricing of initial public offerings (IPOs) has received considerable attention from the perspective of asymmetric information theories, among others. Specific aspects of emerging markets have been incorporated into models to explain the varying degrees of underpricing. Using three features that are deemed to be important for such economies, that is, principal–principal conflicts, disclosure norms and legitimacy of the top management, and two different classes of investors, institutional and retail, two frameworks have been designed to explain the expected levels of underpricing under various pair-wise combinations of these parameters. The state of the secondary market, which is an important determinant of the decision to go public, is incorporated into the framework.

JEL Classifications: G3, G14, G15, G18
The Effects of Cohesion and Structural Position on the Top Management Team Boundary Spanning–Firm Performance Relationship
Authors: Ferguson Amanda J. , Ormiston Margaret E. , Wong Elaine M.
Published: April 2019

Top management teams (TMTs) interact with key external stakeholders through boundary spanning, often by holding outside directorships. Yet research suggests these activities have an equivocal relationship with firm financial performance. Although outside directorships promise informational benefits (i.e., the social network perspective), they also present challenges in the form of managerial opportunism (i.e., the agency perspective). Here, we adopt a contingency perspective to reconcile these perspectives, investigating the moderating role of cohesion, or the degree to which team members mutually support and get along with one another. We argue that boundary spanning will yield performance benefits for TMTs with high cohesion, because their increased commitment to the team will enable members to use their external relationships for the benefit of their firms. However, we also identify a boundary condition for this effect based on structural position in the TMT: that cohesion is especially relevant when proportionally more non-chief executive officer (CEO) TMT members span boundaries than CEOs span boundaries. Results from an archival study of TMTs using q-sort methodology provide support for these predictions.
Gambling involvement, type of gambling and grade point average among 18–29-year-old Finnish men and women
Authors: Latvala Tiina , Alho Hannu , Raisamo Susanna , Salonen Anne H
Published: April 2019

Aims:

This study explores the associations between gambling involvement, type of gambling, at-risk and problem gambling (ARPG) and register-based grade point average (GPA), among Finnish people aged 18–29 years ( N = 676). It is assumed that high gambling involvement and engaging in certain types of gambling are linked to ARPG, and that low school achievement is positively associated with these measures.

Methods:

A nationwide cross-sectional random sample was collected in 2015. The data were weighted based on gender, age and region. Analyses were carried out using logistic regression models.

Results:

Frequent gambling, playing several game types, online gambling and ARPG were more common among men than women. Those with low GPA played fast and low-paced daily lottery games and used online casinos significantly more often than men and women with average/high GPA. Men with a low GPA were also more likely to gamble on a weekly basis and played casino games and online poker more often. For women with a low GPA online gambling and playing slot machines were more common than for women with an average/high GPA. When controlling for sociodemographic variables and gambling involvement, men’s participation in daily lottery games and online poker was significantly associated with a low GPA, but among women none of the game types remained statistically significant. Among women, playing several different game types was linked with a low GPA.

Conclusions:

It seems that poorer school achievement is associated not only with frequent gambling, a large number of game types played and online gambling, but also, to some extent at least, with game type preferences.
Pre mathematics skills in infants: Numerosity as a game
Authors: Evans Lesley Anne , Gold Lindsay A
Published: April 2019

Pre literacy skills in young children have been well established. Explorations of the parallel concept of pre mathematic skills in young children are minimal. Recommendations for how to engage young children, specifically infants, in math have been limited to caregiver counting games. This colloquium presents an example of how an 11-month-old is able to demonstrate pre mathematics skills. This raises the question of beyond caregivers counting, what are early numerosity activities for preverbal infants?
Reforming Women’s Health Care: A Call to Action for Lifestyle Medicine Practitioners to Save Lives of Mothers and Infants
Authors: Krishnaswami Janani , del C. Colon-Gonzalez Maria
Published: April 2019

Maternal and infant mortality are fundamental indicators of a society’s health and wellness. These measures depict a health crisis in the United States. Compared with other rich countries, women in the United States more frequently die from pregnancy or childbirth, and infants are less likely to survive to their first birthday. Most of these deaths are preventable; disproportionately affect diverse, low-income groups; and are perpetuated by social and health care inequities and subpar preventive care. Lifestyle medicine (LM) is uniquely positioned to ameliorate this growing crisis. The article presents key prescriptions for LM practitioners to build health and health equity for women. These prescriptions, summarized by the acronym PURER, include action in the areas of (1) practice, (2) understanding/empathy, (3) reform, (4) empowerment, and (5) relationship health. The PURER approach focuses on partnering with diverse female patients to promote resilience, promoting social connection and engagement, facilitating optimal family planning and advocating for culturally responsive, equitable health care systems. Through PURER, LM practitioners can help women and partners resiliently overcome the harmful challenges of discrimination and stress characterizing present-day American life. Over time, the equitable and collective practice of LM can help ameliorate the health care barriers undermining the health of women, families, and society.
Effects of urban road variable message signs on driving behavior
Authors: Shen Jiajun , Wang Haoyu
Published: April 2019

To investigate the effects of variable message signs on driving behaviors in urban areas, a logistic model of driving behaviors influenced by variable message signs has been established based on a questionnaire survey. Simultaneously, real-world traffic data were collected by video cameras. Then, T-test was employed to analyze the influence of variable message signs on driving behaviors in urban roads. Results show that age, driving age, familiarity of road network, and the degree of attention to variable message signs were the main factors that affected driving behaviors. Specifically, drivers at the age ranging from 36 to 55 years, and drivers with a driving age ranging from 6 to 10 years prefer to reduce speed to read the information on variable message signs. Those drivers who are not familiar with the road network usually reduced speed to read the information displayed on variable message signs. Drivers who occasionally pay attention to variable message signs prefer to reduce speed to read the information on variable message signs. Both the logistic model and the T-test results indicate that variable message signs have a significant effect on driving behaviors in urban areas. Therefore, variable message signs need to be designed concise and easy to recognize so that they can improve the efficiency of road network.
Numerical investigation of the low-frequency flow oscillation over a NACA-0012 aerofoil at the inception of stall
Authors: ElAwad Yasir A , ElJack Eltayeb M
Published: April 2019

High-fidelity large eddy simulation is carried out for the flow field around a NACA-0012 aerofoil at Reynolds number of [Formula: see text], Mach number of 0.4, and various angles of attack around the onset of stall. The laminar separation bubble is formed on the suction surface of the aerofoil and is constituted by the reattached shear layer. At these conditions, the laminar separation bubble is unstable and switches between a short bubble and an open bubble. The instability of the laminar separation bubble triggers a low-frequency flow oscillation. The aerodynamic coefficients oscillate accordingly at a low frequency. The lift and the drag coefficients compare very well to recent high-accuracy experimental data, and the lift leads the drag by a phase shift of [Formula: see text]. The mean lift coefficient peaks at the angle of attack of [Formula: see text], in total agreement with the experimental data. The spectra of the lift coefficient does not show a significant low-frequency peak at angles of attack lower than or equal the stall angle of attack ([Formula: see text]). At higher angles of attack, the spectra show two low-frequency peaks and the low-frequency flow oscillation is fully developed at the angle of attack of [Formula: see text]. The behaviour of the flow-field and changes in the turbulent kinetic energy over one low-frequency flow oscillation cycle are described qualitatively.
Promoting global health and well-being of Indigenous youth through the connection of land and culture-based activism
Authors: Freeman Bonnie M.
Published: April 2019

This research explores and supports the importance of Indigenous cultural knowledge and practices as guiding factors in understanding the agency and actions of Indigenous youth in seeking justice while journeying across the land. The article examines the work of Indigenous scholars and the significance of Indigenous knowledge in connecting to the land and natural environment, thus contributing to ‘being alive well’. An example from Indigenous youth-focused research is highlighted to hear from the youth about the importance of being on ancestral land, journeying with peers and more importantly (re)gaining a sense of well-being and health through culture-based activism.
What are neural networks not good at? On artificial creativity
Authors: Oleinik Anton
Published: April 2019

This article discusses three dimensions of creativity: metaphorical thinking; social interaction; and going beyond extrapolation in predictions. An overview of applications of neural networks in these three areas is offered. It is argued that the current reliance on the apparatus of statistical regression limits the scope of possibilities for neural networks in general, and in moving towards artificial creativity in particular. Artificial creativity may require revising some foundational principles on which neural networks are currently built.
A model of longitudinal hemodynamic alterations after mild traumatic brain injury in adolescents
Authors: Thibeault Corey M , Thorpe Samuel , Canac Nicolas , O’Brien Michael J , Ranjbaran Mina , Wilk Seth J , Hamilton Robert B
Published: April 2019

There is an unquestionable need for quantitative biomarkers of mild traumatic brain injuries. Something that is particularly true for adolescents – where the recovery from these injuries is still poorly understood. However, within this population, it is clear that the vasculature is distinctly affected by a mild traumatic brain injury. In addition, our group recently demonstrated how that effect appears to show a progression of alterations similar but in contrast to that found in severe traumatic injuries. Through measuring an adolescent population with transcranial Doppler ultrasound during a hypercapnia challenge, multiple phases of hemodynamic dysfunction were suggested. Here, we create a generalized model of the hemodynamic responses by fitting a set of inverse models to the dominant features from that work. The resulting model helps define the multiple phases of hemodynamic recovery after a mild traumatic brain injury. This can eventually be generalized, potentially providing a diagnostic tool for clinicians tracking patient’s recovery, and ultimately, resulting in more informed decisions and better outcomes.
Late-Term Abortion and Medical Necessity: A Failure of Science
Authors: Studnicki James
Published: April 2019

Roe V. Wade (1973) placed the concept of medical necessity at the center of the public discourse on abortion. Nearly a half century later, 2 laws dealing with late-term abortion, 1 passed in New York and 1 set aside in Virginia, are an indication that the medical necessity argument regarding abortion has been rendered irrelevant. More importantly for this discussion, these laws are an indication of the failure of the US scientific and medical communities to inform this consequential topic with transparency, logical coherence, and evidence-based objectivity.
Managing Infants Exposed to Maternal Chorioamnionitis by the Use of Early-Onset Sepsis Calculator
Authors: Sharma Vinay , Adkisson Constance , Gupta Kunal
Published: April 2019

Objective. To reduce neonatal intensive care unit admission rate (NAR) and antibiotic utilization rate (AUR) in ≥36 weeks gestational age infants exposed to maternal chorioamnionitis (MC) through the application of early-onset sepsis calculator (EOSCAL). Study Design. This is a single-center cohort study. All infants born ≥36 weeks gestational age and exposed to MC were compared for NAR, AUR, and laboratory evaluation rate (LER) 2 years after and 1 year before the implementation of EOSCAL. Results. There is a significant decrease in NAR ( P < .001), AUR ( P < .04), and LER for blood culture, complete blood count, and C-reactive protein ( P < .001) after implementation of EOSCAL. If infants received antibiotics, it was for significantly less number of doses ( P < .01). There was no increase in the readmission rate. Conclusion. Use of EOSCAL significantly decreases the rate of NAR, AUR, and LER in infants exposed to MC, without affecting readmission rates and late antibiotic use.
Enhancing Graduate Practicum Project Development and Selection at Schools of Public Health: A Case Study
Authors: Cribbs Kristen , Lynch Susanna , LaMonica Marita , Amadi Chioma , Joshi Ashish
Published: April 2019

Experiential learning is a core competency of curricula across accredited U.S. schools of public health, helping students to hone diverse skill sets that will enable them to readily join the workforce and contribute to solving complex public health problems. At the City University of New York (CUNY) Graduate School of Public Health and Health Policy (SPH), all master’s and doctoral students are required to complete a practicum during their degree programs; yet practicum development and selection processes are often overlooked. To enhance the experiential learning program and Human Research Protection Program processes surrounding student practica at the CUNY SPH, researchers mined an administrative database and analyzed characteristics of practicum projects undertaken by graduate students. Findings from this novel study will facilitate policy and procedural changes within the SPH Office of Experiential Learning, which oversees the practicum program, and across SPH offices, including the Human Research Protection Program, to promote an optimal, student-centered practicum experience. Additionally, these analyses will serve as a model for other schools of public health seeking to develop, refine, and strengthen their practicum programs.
Women in the European Stroke Organisation: One, two, many… – A Top Down and Bottom Up approach
Authors: Sandset Else Charlotte , de Sousa Diana Aguiar , Christensen Hanne , Cordonnier Charlotte , Fischer Urs , Katan Mira , Kremer Christine , Pavlovic Aleksandra , Sprigg Nikola , Bart van der Worp H , Zedde Marialuisa , Caso Valeria
Published: April 2019

Background

An increasing proportion of physicians are women, yet they still face challenges with career advancement. In 2014, the European Stroke Organisation established the goal of increasing the number and participation of women within the society using a Top Down and Bottom Up approach. The ‘Women’s Initiative for Stroke in Europe’ was created the same year by a group of women active within the organisation. We aimed to assess the current status of women in European Stroke Organisation, and to explore the change in sex differences after the introduction of focused approaches to address disparities in 2014.

Methods

Using organisational records, we collected data on sex differences in core activities from 2008 up to 2017 including membership, participation in conferences, courses and in the official journal of the society, and positions of seniority and leadership. We estimated sex distribution differences in each of the activities from 2014 to date.

Results

In 2017, the proportion of female members was 40%, while 24% of fellows, 22% of the executive board and 19% of the editorial board in the official journal of the society were women. From 2014 to 2017, there was a significant increase in the proportion of female members (p = 0.0002) and in women participating in the annual conference as faculty (p = 0.001). There was no significant change in the sex distribution among the faculty members in junior educational activities (≤27%) or fellows.

Interpretation

In 2017, the proportion of women holding positions of seniority and leadership is still significantly lower to the proportion of women attending educational activities. Transparent data on sex distribution will assist implementing tailored programmes to achieve progress against sex-based barriers.
Diacylglycerol kinase ζ is a negative regulator of GPVI-mediated platelet activation
Authors: Moroi Alyssa J. , Zwifelhofer Nicole M. , Riese Matthew J. , Newman Debra K. , Newman Peter J.
Published: April 2019

Diacylglycerol kinases (DGKs) are a family of enzymes that convert diacylglycerol (DAG) into phosphatidic acid (PA). The ζ isoform of DGK (DGKζ) has been reported to inhibit T-cell responsiveness by downregulating intracellular levels of DAG. However, its role in platelet function remains undefined. In this study, we show that DGKζ was expressed at significant levels in both platelets and megakaryocytes and that DGKζ-knockout (DGKζ-KO) mouse platelets were hyperreactive to glycoprotein VI (GPVI) agonists, as assessed by aggregation, spreading, granule secretion, and activation of relevant signal transduction molecules. In contrast, they were less responsive to thrombin. Platelets from DGKζ-KO mice accumulated faster on collagen-coated microfluidic surfaces under conditions of arterial shear and stopped blood flow faster after ferric chloride–induced carotid artery injury. Other measures of hemostasis, as measured by tail bleeding time and rotational thromboelastometry analysis, were normal. Interestingly, DGKζ deficiency led to increased GPVI expression on the platelet and megakaryocyte surfaces without affecting the expression of other platelet surface receptors. These results implicate DGKζ as a novel negative regulator of GPVI-mediated platelet activation that plays an important role in regulating thrombus formation in vivo.
Optimal principal component analysis of STEM XEDS spectrum images
Authors: Potapov Pavel , Lubk Axel
Published: April 2019

STEM XEDS spectrum images can be drastically denoised by application of the principal component analysis (PCA). This paper looks inside the PCA workflow step by step on an example of a complex semiconductor structure consisting of a number of different phases. Typical problems distorting the principal components decomposition are highlighted and solutions for the successful PCA are described. Particular attention is paid to the optimal truncation of principal components in the course of reconstructing denoised data. A novel accurate and robust method, which overperforms the existing truncation methods is suggested for the first time and described in details.
National Comprehensive Cancer Network Infusion Efficiency Workgroup Study: Optimizing Patient Flow in Infusion Centers
Authors: Sugalski Jessica M. , Kubal Timothy , Mulkerin Daniel L. , Caires Rebecca L. , Moore Penny J. , Fiorarancio Fahy Rosanna , Gordon Jeanine N. , Augustyniak Connie Z. , Szymanski Gina M. , Olsen MiKaela , Frantz Diedra K. , Quinn Marisa A. , Kidd Sharol K. , Krause Diana M. , Carlson Robert W. , Stewart F. Marc
Published: April 2019

PURPOSE:

The National Comprehensive Cancer Network (NCCN) formed an Infusion Efficiency Workgroup to determine best practices for operating efficient and effective infusion centers.

METHODS:

The Workgroup conducted three surveys that were distributed to NCCN member institutions regarding average patient wait time, chemotherapy premixing practices, infusion chair use, and premedication protocols. To assess chair use, the Workgroup identified and defined five components of chair time.

RESULTS:

The average patient wait time in infusion centers ranged from 25 to 102 minutes (n = 23; mean, 58 minutes). Five of 26 cancer centers (19%) routinely mix chemotherapy drugs before patient arrival for patients meeting specified criteria. Total planned chair time for subsequent doses of the same drug regimens for the same diseases varied greatly among centers, as follows: Administration of doxorubicin and cyclophosphamide ranged from 85 to 240 minutes (n = 22); of FOLFIRINOX (folinic acid, fluorouracil, irinotecan hydrochloride, and oxaliplation) ranged from 270 to 420 minutes (n = 22); of rituximab ranged from 120 to 350 minutes (n = 21); of paclitaxel plus carboplatin ranged from 255 to 380 minutes (n = 21); and of zoledronic acid ranged from 30 to 150 minutes (n = 22) for planned total chair time. Cancer centers were found to use different premedication regimens with varying administration routes that ranged in administration times from zero to 60 minutes.

CONCLUSION:

There is a high degree of variation among cancer centers in regard to planned chair time for the same chemotherapy regimens, providing opportunities for improved efficiency, increased revenue, and more standardization across centers. The NCCN Workgroup demonstrates potential revenue impact and provides recommendations for cancer centers to move toward more efficient and more standard practices.
Intercellular transfer of P-glycoprotein mediates the formation of stable multidrug resistance in human bladder cancer BIU-87 cells
Authors: Cheng Xiao-zhi , Zhou Hui-liang , Tang Song-xi , Jiang Tao , Chen Qin , Gao Rui , Ding Yi-lang
Published: April 2019

Background: To investigate the biological characteristics of acquired drug-resistant cells (AqMDRs) formed by intercellular P-glycoprotein (P-gp) transfer and whether AqMDRs can form stable drug-resistant strains.

Methods: Drug-sensitive BIU-87 cells were cocultured with doxorubicin(DOX)-resistant derivative BIU-87/DOX cells in Transwell chambers for up to 96 h. The presence of P-gp in recipient cell membranes (AqMDRs) was detected by confocal microscopy, CCK-8, Western blot, and RT-PCR were used to detect resistance index (RI), P-gp expression andMDR1 mRNA expression in AqMDRs after 0, 4, 8, 16, and 20passages and frozen/resuscitated 20th generation AqMDRs.

Results: There was an increase in P-gp transfer with longer coculture times of drug-resistant and sensitive strains. Without DOX, although the AqMDR numbers increased with each passage, the RI and P-gp expression decreased gradually, and the expression level of MDR1 mRNA did not change significantly. With DOX, the RI and P-gp expression increased slightly, and the MDR1 mRNA expression level gradually increased to the BIU-87/DOX level. AqMDRs can grow stably at drug concentrations slightly higher than the IC50 of sensitive strains, which sensitive strains cannot survive.

Conclusions: P-gp transfer between cells gradually increases with longer coculturing of drug-resistant and sensitive strains. The drug resistance of AqMDRs decreases without drug intervention, but with drug intervention, cells can maintain resistance and gradually develop into stable drug-resistant cells.
Psychological factors contributing to parenting styles: A systematic review
Authors: Vafaeenejad Zahra , Elyasi Fourozan , Moosazadeh Mahmood , Shahhosseini Zohreh
Published: April 2019

Background: The set of strategies used by parents to put their children’s behaviors under control are called parenting styles, which can be influenced by numerous factors including socio-economic variables, cultural differences, personal characteristics, and psychological factors. These factors can differently contribute to parenting style. The purpose of this systematic review was to examine psychological factors affecting parenting style.

Methods: This study was a comprehensive literature review using the keywords of parenting styles, psychological factors, and parenting to search the databases of Google Scholar, PubMed, Scopus, Web of , and Scientific Information Database. In this respect, 416 articles were extracted. 368 articles were removed after reviewing their abstracts and full text and eventually 48 articles were selected to elicit the required data.

Results: Our findings were classified under two categories: factors related to parents (mental status, self-efficacy, parenting stress, perfectionism, personality traits, childhood trauma, marital satisfaction, parents’ attachment style, perceived parenting style, and substance abuse); and those related to children (child developmental and mental disability, child temperament, and anxiety).

Conclusions: Considering the multiple psychological factors that affect parenting style, it is recommended to include an assessment of parent-child psychological status in family programs in order to identify the needs for -oriented care and take steps towards the development of parenting skills.
Voting Rules in Sequential Search by Committees: Theory and Experiments
Authors: Mak Vincent , Seale Darryl A. , Rapoport Amnon , Gisches Eyran J.
Published: April 2019

We propose a committee extension of the individual sequential search model called the “secretary problem,” where collective decisions on when to stop the search are reached via a prespecified voting rule. We offer a game-theoretic analysis of our model and then report two experiments on three-person committees with either uncorrelated or perfectly correlated preferences under three different voting rules followed by a third experiment on single decision makers. Relative to equilibrium predictions, committees with uncorrelated preferences oversearched under minority and majority voting rules but, otherwise, undersearched or approximated equilibrium play. Individually, committee members were often less strategic when their preferences were uncorrelated than when they were perfectly correlated. Collectively, committees’ decisions were more strategic than single decision makers’ only under the unanimity rule, although still not significantly better in terms of the decision makers’ welfare. Finally, across our experiments that involved committee search, the unanimity rule always optimized committee welfare.

This paper was accepted by Yan Chen, behavioral economics.
Great expectations: ambitions for family carers in UK parliamentary debates on the Care Bill
Authors: Manthorpe Jill , Fernandez Jose Luis , Brimblecombe Nicola , Knapp Martin , Snell Tom , Moriarty Jo
Published: April 2019

The Care Act 2014 amended legislation relating to government responsibilities for adults with care needs. It set out new statutory responsibilities for the support of family or informal carers. As part of a study investigating the impact of the Care Act 2014 on family carers in England, we undertook a contextual literature review, focusing on parliamentary debates available online from Hansard. We describe the content of debates seeking to amend the law relating to carers and aspirations for the proposed reforms. We highlight the role of parliamentary carer champions, as well as carer-related themes and the lack of controversy over this subject.
Border-crossing: These deaths are not inevitable
Authors: Hampson Robert
Published: April 2019

This article is situated in my own work in poetry. It falls into two parts: the first takes off from my own work to explore different practices of bordering; the second part continues that exploration by reference to recent work by Caroline Bergvall and Jeff Hilson. The first section explores my sequence, ‘the war against tourism’. These poems were written between December 2003 and July 2006 in the environment created by the US Patriot Act 2001 and the Homeland Security Act 2002. The Homeland Security Act both foregrounded the protection of borders and introduced ‘homeland’ into US political discourse. The first section will focus on my sequence of site-specific poems (written on flights), which explore ‘homeland security’, refugees, terrorism, profiling, border interrogations and identity. It will consider border-crossings and how identity figures in these poems in the context of mobility. The second section, ‘these deaths are not inevitable’, focuses on Caroline Bergvall’s volume Drift and its engagement with the ‘left-to-die’ boat within a longer history of migration by sea, going back to the Anglo-Saxons bringing their culture to Britain in the fifth century. The article concludes with a brief examination of Jeff Hilson’s conceptual poem, ‘A Final Poem with Full Stops’, and how deaths in the Mediterranean relate to recent treatment of borders, refugees and migrants.