bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of catheter-directed thrombolysis with and without percutaneous mechanical thrombectomy for subacute iliofemoral deep vein thrombosis
Authors: Xu Yi-Ding , Zhong Bin-Yan , Yang Chao , Cai Xu-Sheng , Hu Bo , Wang Xiao-Yun , Fan Bao-Rui , Jin Yong-Hai , Ni Cai-Fang , Duan Peng-Fei
Published: April 2020

Objective

To evaluate and compare the treatment efficacy and safety between catheter-directed thrombolysis monotherapy and catheter-directed thrombolysis combined with percutaneous mechanical thrombectomy for patients with subacute iliofemoral deep vein thrombosis.

Methods

We conducted a retrospective analysis of a total of 74 subacute iliofemoral deep vein thrombosis patients who underwent catheter-directed thrombolysis with and without percutaneous mechanical thrombectomy. Patients treated with catheter-directed thrombolysis combined with percutaneous mechanical thrombectomy (percutaneous mechanical thrombectomy group, n = 30) or catheter-directed thrombolysis monotherapy (catheter-directed thrombolysis group, n = 44) were included. The primary endpoints were the clinical efficacy rate of thrombolysis, primary patency, and the incidence of post-thrombotic syndrome (at 12 months diagnosed according to the original Villalta score criteria. Secondary endpoints were the total urokinase dose, the thrombolysis time, the detumescence rate and complications.

Results

The percentage of successful thrombolysis for percutaneous mechanical thrombectomy group was higher than that for catheter-directed thrombolysis group ( P = 0.045). At the 12-month follow-up, there was no difference in the primary patency ( P > 0.05) or the incidence of post-thrombotic syndrome ( P = 0.36). Percutaneous mechanical thrombectomy group had significant advantages in reducing urokinase doses and thrombolysis times compared with catheter-directed thrombolysis group for patients with thrombus clearance levels II and III ( P < 0.05).

Conclusion

Catheter-directed thrombolysis combined with percutaneous mechanical thrombectomy performs better in removing vein thrombi, reducing urokinase doses, and shortening thrombolysis times.
Beyond formal policies: Informal functions of mayor’s offices to promote entrepreneurship
Authors: Motoyama Yasuyuki
Published: April 2020

Scholars of economic development have generally concluded that local governments have limited capacities, due to their limited resources and orientation toward short-term growth output. In addition, past studies have predominantly examined explicit and formal policies or programs. However, there are other informal yet important dimensions of local governments that can promote economic development. By bringing in examples of mayor’s offices in the context of entrepreneurship in the U.S., this article explores and highlights four major informal functions those municipal offices can perform: (1) setting the priorities, (2) offering a clearinghouse, (3) connecting and coordinating people, and (4) appointing key personnel. Each function does have consequences, and a combination of the functions can significantly contribute to entrepreneurial activities in the local area. While evaluation of effectiveness will be difficult, scholars ought to conduct more exploratory research to understand those potentially significant functions of government for economic development, which includes qualitative dimensions that broadly affect individuals, firms, communities, and regions.
How Do Discrimination and Self-Esteem Control Beliefs Affect Prosociality? An Examination Among Black and Latinx Youth
Authors: Tyler Corine P. , Geldhof G. John , Settersten Richard A. , Flay Brian R.
Published: April 2020

Black and Latinx youth are situated in a maladaptive discriminatory context in the United States; however, prosociality may be one way that youth can promote their own positive development in the face of these experiences. We examined the longitudinal associations between discrimination and prosociality among 380 Black and Latinx early adolescents (MW6age = 12.38 years, 52% female) and considered race/ethnicity and self-esteem control beliefs as potential moderators to this association. Discrimination predicted higher levels of prosociality among Black youth 6 months later, but not among Latinx youth. Discrimination also predicted higher prosociality among youth with very high self-esteem control beliefs 6 months later, but not among youth with lower levels of self-esteem control beliefs. None of these associations were significant when looking across a 1-year time frame. Our findings support the predictions of self-esteem enhancement theory and highlight the importance of considering how youth’s unique racialized experiences can inform how they respond to discrimination.
Plaque enhancement in multi-cerebrovascular beds associates with acute cerebral infarction
Authors: Cui Bin , Yang Dandan , Zheng Weimin , Wu Ye , Yang Qi , Wang Zhiqun , Zhao Xihai
Published: April 2020

Background

It is valuable to explore the relationship between plaque characteristics and stroke by using three-dimensional (3D) magnetic resonance imaging (MRI) of the vessel wall.

Purpose

To investigate the association between plaque enhancement score (PES) of co-existing intracranial and extracranial carotid plaques and ischemic stroke using 3D MRI.

Material and Methods

Symptomatic patients were recruited and underwent cerebrovascular 3D MRI of the vessel wall. The number, enhancement degree, and stenosis of plaques in intracranial and extracranial carotid arteries were evaluated. The PES calculated by summing enhancement degree of all detected plaques was compared between patients with and without acute cerebral infarction (ACI) and its association with ACI was determined.

Results

Of 157 recruited patients, 118 (75.2%) had co-existing plaques. Patients with ACI had significantly greater PES of co-existing plaques compared with those without ACI (9, interquartile range [IQR] 5–11 vs. 5, IQR 2–7, P<0.001). The odds ratio for PES of co-existing plaques in discriminating ACI was 1.410 (95% confidence interval [CI] 1.146–1.735, P = 0.001) after adjustment for stenosis, intraplaque hemorrhage, and traditional risk factors. Receiver operating characteristic curve analysis showed that, in discriminating ACI, PES had higher area under the curve (AUC 0.693–0.764) than plaque number (AUC 0.625–0.683) and enhancement degree (AUC 0.570–0.706) alone in any vascular bed. The AUC of PES of co-existing plaques combined with stenosis, NIHSS scores, intraplaque hemorrhage, hyperlipidemia, and blood pressure reached 0.847.

Conclusion

Cerebrovascular plaque enhancement score combining plaque number and enhancement degree is independently associated with ACI. The enhancement score of co-existing plaques has higher strength in discriminating ACI compared with plaques in a single vascular bed.
Exploring potential biomarkers for lung adenocarcinoma using LC-MS/MS metabolomics
Authors: Mo Liang , Wei Bing , Liang Renji , Yang Zhi , Xie Shouzhi , Wu Shengrong , You Yong
Published: April 2020

Background

The average 5-year survival rate of lung adenocarcinoma patients is only 15% to 17%, which is primarily due to late-stage diagnosis and a lack of specific prognostic evaluations that can recommend effective therapies. Additionally, there is no clinically recognized biomarker that is effective for early-stage diagnosis.

Methods

Tissue samples from 10 lung adenocarcinoma patients (both tumor and non-tumor tissues) and 10 benign lung tumor samples were collected. The significantly differentially represented metabolites from the three groups were analyzed by liquid chromatography and tandem mass spectrometry.

Results

Pathway analysis indicated that central carbon metabolism was the top altered pathway in lung adenocarcinoma, while protein digestion and absorption, and central carbon metabolism were the top altered pathways in benign lung tumors. Receiver operating characteristic curve analysis revealed that adenosine 3′-monophosphate, creatine, glycerol, and 14 other differential metabolites were potential sensitive and specific biomarkers for the diagnosis and prognosis of lung adenocarcinoma.

Conclusion

Our findings suggest that the metabolomics approach may be a useful method to detect potential biomarkers in lung adenocarcinoma patients.
Value of ultrasound-guided transforaminal nerve block in the treatment of lumbar disc herniation
Authors: Guang-hui Liu , Guang-yu Zhu , Yu-zhang Liu , Yong-Tao Zhu , Shi-min Zhang , Jiao Jin
Published: April 2020

Objective

This study was performed to investigate the effectiveness and safety of ultrasound-guided transforaminal nerve block in the treatment of lumbar disc herniation.

Methods

Sixty patients who underwent treatment for protrusion of a lumbar intervertebral disc in Wangjing Hospital from January 2016 to December 2017 were divided into the study group and the control group. The visual analog scale (VAS) pain scores, the Japanese Orthopaedic Association (JOA) scores of the lumbar vertebra, PRI (pain rating index), and PPI (present pain intensity) were recorded at 30 minutes, 1 week, and 3 months after the operation.

Results

There were significant differences in the VAS, JOA, PRI, and PPI scores between the study group and control group.

Conclusion

Ultrasound guidance can improve the efficacy and safety of transforaminal nerve block in the treatment of lumbar disc herniation and shorten the operative duration.
Association between systolic blood pressure and first ischemic stroke in the Chinese older hypertensive population
Authors: Yu Yuling , Liu Lin , Huang Jiayi , Shen Geng , Chen Chaolei , Huang Yuqing , Zhang Bin , Tang Songtao , Feng Yingqing
Published: April 2020

Objective

This study aimed to evaluate the association between systolic blood pressure (SBP) and first ischemic stroke in older people with hypertension in the community.

Methods

This retrospective cohort study included 3315 residents who were hypertensive and older than 60 years in Guangdong, China.

Results

A total of 1475 men and 1840 women aged 71.41±7.20 years were included. All subjects had a median follow-up duration for 5.5 years and 206 subjects reached the endpoint. The prevalence of first ischemic stroke increased with a higher SBP. SBP expressed as a continuous variable (hazard ratio [HR], 1.01; 95% confidence interval [CI], 1.00–1.02) and categorical variable (HRs, 1.00, 1.06, 1.17, 1.39, and 1.60 for increasing blood pressure from  < 120–≥150 mmHg), was significantly associated with a higher risk of first ischemic stroke. Moreover, a fully adjusted model indicated an obvious increased risk in the SBP ≥150 mmHg group (HR, 1.60; 95% CI, 1.15–2.71) and the SBP 140–149 mmHg group (HR, 1.39; 95% CI, 1.01–2.39).

Conclusions

High SBP was independently associated with the risk of first ischemic stroke in hypertensive residents in the community aged older than 60 years. SBP ≥140 mmHg increases the risk of first ischemic stroke.
Climbing the Protest Pyramid: A Situational Analysis of the Resistance of Rickshaw Drivers in Guangzhou, China
Authors: Xu Jianhua
Published: April 2020

Guangzhou police confiscated more than 1,000 “illegal” rickshaws every day since they were banned from use in the city. However, rickshaws were omnipresent in all corners of the city, representing a massive army of unemployed or underemployed workers struggling to eke out a living. Various strategies were used by these rickshaw operators to protest and resist the mass confiscation by the police. Using data collected through systematic social observation of police law enforcement and rickshaw drivers’ routine activities, focus group interviews with the police, in-depth semistructured interviews with rickshaw drivers, official police detention statistics of rickshaw drivers, and media content data mining, this article provides a typology and an analysis of resistance. Based on the severity and intensity of resistance, these typologies are ranked in what I shall call a “pyramid of resistance.” This article further examines how situational factors such as degree of frustration, procedural justice, mobilization capacity, and campaign-style policing affect the escalation of resistance.
Improving Risk Communication: Developing Risk Ratios for the VRAG-R
Authors: Davies Simon T. , Helmus L. Maaike , Quinsey Vernon L.
Published: April 2020

We developed a set of risk ratios for the Violence Risk Appraisal Guide—Revised (VRAG-R) to broaden the range of risk communication options available when using this tool and to provide information needed for future efforts to apply The Council of State Governments Justice Center’s standardized five-level risk framework to the scale. A slightly reduced version of the VRAG-R normative data set was used for the analyses ( N = 1,238). Contrary to previous research developing risk ratios, logistic regression provided a more accurate estimate of observed violent recidivism rates than Cox regression for both total VRAG-R scores and VRAG-R decile bins. Further analyses indicated the relationship between the VRAG-R and violent recidivism was consistent over a 15-year follow-up period. Due to the difficulties with interpreting odds ratios, the final risk ratios were computed using rate ratios derived from a logistic regression model using a 5-year fixed follow-up period. These risk ratios, and templates for how the ratios might be used in an assessment report, are presented in the appendices.
Associations between diabetes and sex with peritoneal dialysis technique and patient survival: Results from the Australia and New Zealand Dialysis and Transplant Registry cohort study
Authors: Chen Jenny HC , Johnson David W , Wong Germaine , Boudville Neil , Borlace Monique , Walker Rachael , Hawley Carmel , McDonald Stephen , Lim Wai H
Published: April 2020

Background:

A differential association between mortality and cause of end-stage kidney disease in patients with type 2 diabetes mellitus (T2DM) has been shown. Sex-specific differences in diabetes-related complications have been described. It is unclear whether sex affects the associations between diabetes and peritoneal dialysis (PD) technique and patient survival.

Methods:

Using the Australia and New Zealand Dialysis and Transplant Registry, we examined a two-way interaction between sex and diabetes status (no diabetes, T2DM and non-diabetic nephropathy [T2DM + non-DN] and T2DM and diabetic nephropathy [T2DM + DN]) for PD technique failure (including death), all-cause mortality and cause-specific mortality in incident adult PD patients between 1996 and 2016 using adjusted Cox regression. Mediation analysis was conducted to determine whether peritonitis was a mediator in these associations.

Results:

In 8279 PD patients, those with T2DM + DN had the greatest risks in technique failure, all-cause mortality and cause-specific mortality followed by patients with T2DM + non-DN, then patients without diabetes. Sex modified the association with diabetes status in technique failure ( p interaction = 0.001) and cardiac mortality ( p interaction = 0.008). In women with T2DM + DN, the adjusted hazard ratio (HR) for technique failure was 1.45 (1.30–1.62) and was higher than men with T2DM + DN (1.17 [1.08–1.28]; referent: no diabetes). In women with T2DM + DN, the adjusted HR for cardiac mortality was 2.12 (1.73–2.61) and was also higher than men with T2DM + DN (1.66 [1.43–1.95]). Less than 10 % of the effect between diabetes and PD technique failure or mortality was mediated by peritonitis.

Conclusions:

PD patients with diabetic nephropathy had increased risk of PD technique failure and mortality, with the magnitude of these risks greater in women.
Urgent-start peritoneal dialysis in chronic kidney disease patients: A systematic review and meta-analysis compared with planned peritoneal dialysis and with urgent-start hemodialysis
Authors: Xieyi Guo , Xiaohong Tang , Xiaofang Wu , Zi Li
Published: April 2020

An increasing number of studies have focused on whether peritoneal dialysis (PD) can be used for the urgent initiation of dialysis in patients with chronic kidney disease (CKD). We performed this systematic review and meta-analysis to evaluate the feasibility and safety of urgent-start PD compared with those of planned PD and urgent-start hemodialysis (HD) in this population. PubMed, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), clinicaltrials.gov , and China National Knowledge Infrastructure (CNKI) were searched for relevant studies. Conference abstracts were also searched in relevant websites. The meta-analysis was performed using RevMan 5.3 software. A total of 15 trials involving 2426 participants were identified. The quality of the included studies was fair, but the quality of evidence was very low. Unadjusted meta-analysis showed that urgent-start PD had significantly higher mortality than planned PD, while adjusted meta-analysis did not show a significant difference. Higher incident of leakage and catheter mechanical dysfunction were observed in urgent-start PD. However, peritonitis, exit-site infection, or PD technique survival were comparable between urgent-start and planned PD. The all-cause mortality was comparable in urgent-start PD and urgent-start HD. Bacteremia was significantly lower in the urgent-start PD group than with urgent-start HD. Based on limited evidences, PD may be a viable alternative to HD for CKD patients requiring urgent-start dialysis. Because of the inconsistent results and the low quality of evidence, a definitive conclusion could not be drawn for whether urgent-start PD was comparable with planned PD. Therefore, high-quality and large-scale studies are needed in the future.
Endodontic Disinfection for Orthograde Root Canal Treatment in Veterinary Dentistry
Authors: Sasser Laura
Published: April 2020

Pulp debridement and disinfection in the pulp cavity is a critical step in achieving a successful root canal therapy. Microorganisms remaining in the root canal system after endodontic treatment are a main cause of root canal failure. The challenges faced in endodontic disinfection include the complex anatomy of the root canal system, the existence of a biofilm within the root canal, and the creation of a problematic smear layer during instrumentation of the canal. Historically, sodium hypochlorite and ethylenediaminetetraacetic acid have been utilized as irrigants and still remain as the most effective disinfectants due to their synergistic abilities to eradicate microorganisms, dissolve necrotic debris, and remove the smear layer and biofilm. This article addresses challenges in endodontic disinfection, objectives of endodontic irrigants, properties of an ideal irrigant, currently used irrigants, and irrigant delivery systems utilized in veterinary dentistry.
The distinct value of humanities students to employers in student consultancy projects
Authors: Koendjbiharie Sarita R.
Published: April 2020

This case study analyzes the use by high-profile employers of the brainpower of nearly 1400 humanities undergraduates through “live” projects. At the Faculty of Humanities of Leiden University, a cohort of hundreds advises a set of public, private, and third sector organizations each year in a capstone course within the multidisciplinary Bachelor of Arts in International Studies program. In this course, aptly named PRactising International Studies (PRINS), students have, in teams, successfully consulted for employers including Google, the World Food Programme, and Organisation for Economic Co-operation and Development (OECD). Drawing on experience of designing, recruiting for, and running the PRINS course, the author offers evidence of the distinct value of humanities to practice, which is demonstrable even at the undergraduate level. The analysis entails the ex ante knowledge needs employers sought to have fulfilled by humanities students, and the ex post recommendations in their consultancies that employers have acknowledged as practically relevant. The findings indicate the potential of large-scale consultancy courses in the preparation of students for the labor market and the need for humanities graduates in future workplaces worldwide.
Simulation and semi-physical verification of fuel metering unit model for turboshaft aeroengine
Authors: Wang Bin , Ji Hengyu , Ye Zhifeng
Published: April 2020

When modeling an aeroengine control system, effects of fuel metering unit are neglected or oversimplified, which most probably leads to unreliable simulation or experimental results. In order to well understand influences of fuel metering unit on performance of an aeroengine and to enrich the component-level model of a turboshaft aeroengine, a stepping motor controlled fuel metering unit is examined by combining process-based modeling and object-oriented modeling and is employed in the component-level engine model. Performances of the engine with and without the fuel metering unit are compared by simulation. The component-level engine model with the fuel metering unit characteristics considered meets the simulation requirements on the steady precision and can describe dynamics of the engine more precisely. A semi-physical experimental verification is implemented to confirm the influence of the fuel metering unit. The results show that simulation using the component-level engine model with the fuel metering unit sub-model is in accordance with the experiment, and that comparing to the engine model without fuel metering unit, the model with a fuel metering unit can extend the performance parameter response dozens of milliseconds.
Instability analysis for a centrifugal pump with straight inlet pipe using partially averaged Navier–Stokes model
Authors: Ye Weixiang , Qian Zhongdong , Huang Renfang , Li Xiaojun , Zhu Zuchao , Luo Xianwu
Published: April 2020

The current study numerically investigates the flow instability under several part-load conditions in a centrifugal pump with a straight inlet pipe to explore the underlying relationship between a positive slope phenomenon and internal flow using a partially averaged Navier–Stokes model. The model was validated by comparing the hydraulic performance and averaged flow in the impeller between the numerical results and experimental data of a tested pump. The internal flows in pumps have been intensively investigated based on Batchelor vortex family, Rayleigh–Taylor criterion, entropy generation rate, and energy equation to analyze the flow instability from different aspects. The simulation results using partially averaged Navier–Stokes model are acceptable due to the good agreement with the experimental data for the tested pump. No matter the geometry of the inlet pipe, the pre-swirling flows in the inlet pipe are in the convective instability region. Under the part-load condition of φ = 0.5 φbep, the axial vorticity coefficient is affected by the geometry of the inlet pipe. However, under the part-load condition with rotating stall, e.g. φ = 0.78 φbep, the flow in the inlet pipe is affected by the unstable flow in the pump impeller. For the pump with a straight inlet pipe, the vortex inside the blade-to-blade passage is in a stable state according to Rayleigh–Taylor criterion under the condition of φ = 0.5 φbep. However, the vortex in the blade-to-blade passage is in an unstable state due to centrifugal instability under those operation conditions with rotating stall cells in the impeller, and the dominant oscillations are dependent on the propagation of rotating stall cells. Finally, head loss analysis based on energy equations elucidates that turbulent kinetic energy production term is predominant in the head loss in pump impeller. The present results are helpful for better understanding of the unstable flows and positive slope phenomenon for centrifugal pumps.
“You may quite well say that we are all ill”: Freud on the continuity between normality and pathology
Authors: Petrolini Valentina
Published: April 2020

The relation between normality and pathology has intrigued philosophers for centuries, but it has been recently revived by a number of researchers who have articulated and defended various versions of the continuity thesis (or CT, namely the idea that normal and pathological states are not categorically different). Despite a growing interest in the notion of continuity, CT is far from being the received view within philosophy of psychiatry, with many researchers still seeing normal and pathological states as being different in kind. In this article, I show that the core ideas underlying CT were already present in a sophisticated form in Freud’s work. Indeed, Freud defends two interrelated theses that allow us to see him as an early defender of continuity. On the one hand, he is committed to the idea that healthy and mentally disordered subjects exhibit deep similarities in terms of mental functioning. On the other hand, he defends the possibility of describing with sufficient precision and generality what goes awry in pathological cases. The article is structured as follows: I first appeal to Freud’s work to show that his account of psychopathology supports continuity; I then focus on two theoretical aspects of Freud’s proposal that should be taken as desiderata for any refined account of mental disorders; and finally, I illustrate how the approach works in practice by analyzing one of Freud’s clinical cases.
Rapidly progressive glomerulonephritis due to systemic lupus erythematosus and ANCA-associated vasculitis overlap
Authors: Farah Randa I , Shahin Nisreen Abu , Alawneh Mohannad , Adwan Marwan
Published: April 2020

Systemic lupus erythematosus (SLE) and ANCA-associated vasculitis (AAV) are different autoimmune diseases. While vasculitis can be seen in the SLE clinical course as a secondary phenomenon, and may indicate a severe disease, primary vasculitis such as AAV rarely occurs in association with SLE. We present a 44-year-old woman who presented with rapidly progressive glomerulonephritis which was histologically identified as a combination of crescentic and lupus nephritis in the presence of myeloperoxidase ANCA antibody. The frequency of this association is very rare. The clinical, histological and immunological features are different in SLE/AAV overlap syndrome and need different treatment options, which may include rituximab, to achieve complete recovery. Since SLE/AAV overlap can be serious at presentation, the physician must be aware of this syndrome.
A Value-Based Framework for Understanding Cooperation
Authors: Pärnamets Philip , Shuster Anastasia , Reinero Diego A. , Van Bavel Jay J.
Published: April 2020

Understanding the roots of human cooperation, a social phenomenon embedded in pressing issues including climate change and social conflict, requires an interdisciplinary perspective. We propose a unifying value-based framework for understanding cooperation that integrates neuroeconomic models of decision-making with psychological variables involved in cooperation. We propose that the ventromedial prefrontal cortex serves as a neural integration hub for value computation during cooperative decisions, receiving inputs from various neurocognitive processes such as attention, memory, and learning. Next, we describe findings from social and personality psychology highlighting factors that shape the value of cooperation, including research on contexts and norms, personal and social identity, and intergroup relations. Our approach advances theoretical debates about cooperation by highlighting how previous findings are accommodated within a general value-based framework and offers novel predictions.
Palliative Care Consultations in Trauma Patients and Role of Do-Not-Resuscitate Orders: Propensity-Matched Study
Authors: Fokin Alexander A. , Wycech Joanna , Katz Jeffrey K. , Tymchak Alexander , Teitzman Richard L. , Koff Susan , Puente Ivan
Published: April 2020

Objective:

To delineate characteristics of trauma patients associated with a palliative care consultation (PCC) and to analyze the role of do-not-resuscitate (DNR) orders and related outcomes.

Methods:

Retrospective study included 864 patients from 2 level one trauma centers admitted between 2012 and 2019.  Level 1 trauma centers are designated for admission of the most severe injured patients. Palliative care consultation group of 432 patients who received PCC and were compared to matched control (MC) group of 432 patients without PCC. Propensity matching covariates included Injury Severity Score, mechanism of injury, gender, and hospital length of stay (HLOS). Analysis included patient demographics, injury parameters, intensive care unit (ICU) admissions, ICU length of stay (ICULOS), duration of mechanical ventilation, timing of PCC and DNR, and mortality. Palliative care consultation patients were further analyzed based on DNR status: prehospital DNR, in-hospital DNR, and no DNR (NODNR).

Results:

Palliative care consultation compared to MC patients were older, predominantly Caucasian, with more frequent traumatic brain injury (TBI), ICU admissions, and mechanical ventilation. The average time to PCC was 5.3 days. Do-not-resuscitate orders were significantly more common in PCC compared to MC group (71.5% vs 11.1%, P < .001). Overall mortality was 90.7% in PCC and 6.0% in MC ( P < .001). In patients with DNR, mortality was 94.2% in PCC and 18.8% in MC. In-hospital DNR-PCC compared to NODNR-PCC patients had shorter ICULOS (5.0 vs 7.3 days, P = .04), HLOS (6.2 vs 13.2 days, P = .006), and time to discharge (1.0 vs 6.3 days, P = .04).

Conclusions:

Advanced age, DNR order, and TBI were associated with a PCC in trauma patients and resulted in significantly higher mortality in PCC than in MC patients. Combination of DNR and PCC was associated with shorter ICULOS, HLOS, and time from PCC to discharge.
Remixing Approaches to Experiential Learning, Design, and Assessment
Authors: Heinrich William F. , Green Patrick M.
Published: April 2020

Background:

Experiential learning approaches applied in classrooms are often disconnected from theory and loosely connected in classroom practice. Given critiques of experiential learning, there is a significant need for process learning theory with a practice-driven model. Scholars have only begun to explore the enhanced learning that often emerges from educative experiences designed with the fullness of experiential learning theory—designing with context, meaning-making, and assessment equal to the learning.

Purpose:

Through the lens of scholar-practitioner reflective inquiry, we propose a remixed approach to designing experiential learning. By shifting approaches to experiential education (EE), experiential educators benefit from planning with intentional design, instruction, learning, and assessment.

Methodology/Approach:

We chose to interrogate our practice and conduct a methodological investigation to explore our questions through a blend of qualitative approaches, including collaborative and narrative inquiry, scholarly personal narrative, and transpersonal research. We explore approaches to process theory of learning and other influences on experiential learning.

Findings/Conclusions:

A shift in approaches in experiential education will benefit educators and students, specifically by attending to holistic design, instruction, assessment, and learning with context in mind. We remix familiar components of known theories to highlight a unique experiential teaching and learning mind-set.

Implications:

We commence with a discussion of the remixed framework of the Design–Instruction–Assessment–Learning (DIAL) model that promotes high-quality experiences for learners and instructors.
Mokken Scale Analysis of Lifetime Responses on the Columbia Suicide Severity Rating Scale’s Severity of Ideation Subscale
Authors: Tabares Jeffrey V. , Butner Jonathan E. , Bryan Craig J. , A. Harris Julia
Published: April 2020

Suicide risk screening assumes that suicidal thoughts and behaviors exist on a continuous, hierarchical spectrum with some suicidal thoughts implicated with greater risk for suicidal behaviors. However, screening measures based on the hierarchical model may not capture the suicide risk construct. This study assessed psychometric properties of the Columbia Suicide Severity Rating Scale (CSSRS) for (a) between- and within-person measurement dimensions, (b) item utility in capturing the suicide risk construct, and (c) tenability of a hierarchical risk model. We found that the CSSRS functions differentially between and within individuals, CSSRS items capture more suicide risk construct, and that CSSRS items in current practice likely appear in the correct order. The current CSSRS reasonably represents within-person suicide risk, but not between-person risk. Scale norms or alternate scoring could facilitate functional equivalence and utility for between- and within-person CSSRS dimensions.
Prostate Cancer in Latin America: Challenges and Recommendations
Authors: Reis Rodolfo Borges dos , Alías-Melgar Alejandro , Martínez-Cornelio Andrés , Neciosup Silvia P , Sade Juan Pablo , Santos Marcos , Villoldo Gustavo Martin
Published: April 2020

Prostate cancer (PCa) is the most frequent tumor among Latin American (LATAM) men. The incidence of de novo metastatic PCa is higher in LATAM than other parts of the world, and demographic changes in the region have increased disease burden. However, region-specific information regarding prevalence, progression, and treatment effectiveness is not currently available for nonmetastatic, castration-resistant PCa (nmCRPC). Nonmetastatic, castration-resistant PCa is a heterogeneous disease with varying potential to develop metastasis with limited treatments available, until recently. New clinical trials with promising results have allowed second-generation antiandrogen drugs to be used as first-line treatments, rendering guidelines outdated. As a result, this panel of experts reviewed the current status and challenges and developed recommendations for nmCRPC diagnosis and management in LATAM. The Americas Health Foundation (AHF) conducted a literature review and identified LATAM scientists and clinicians who have published in the field of PCa since 2012. The AHF convened a panel of 7 chosen experts urologists and medical oncologists from the region. The AHF developed specific questions relating to nmCRPC, which were answered by the experts prior to the multiday meeting. Each narrative was discussed and edited by the panel, through numerous rounds of discussion until a consensus was reached in a final manuscript. The panel proposes specific and realistic recommendations for improving access to diagnosis and management of PCa in LATAM. No treatment has yet shown improvement in overall survival; however, when including metastasis-free survival as an end point, second-generation antiandrogen drugs have emerged as effective treatment options and are currently included as first-line treatment. Although nmCRPC is a specific disease that represents a small percentage of patients with PCa, effective diagnostic and treatment strategies can contribute toward increasing quality of life and survival rates of patients with PCa in LATAM.
A Queer Cyborg Ethnographer in the Performative Friction of Dissenting Ontologies
Authors: Jokinen Päivi , Nordstrom Susan
Published: April 2020

The reader of this article is invited to join an encounter of methodological experimenting, productive tensions and a way of writing that seeks to challenge conventional human- and language-centered scholarly discourses. This article speculates with the possibility of two dissenting ontologies co-existing simultaneously and making each other visible. Troubling moments of the ontologies rubbing together are elaborated as friction and demonstrated in “queer reiterations” presented throughout the article. The moments of friction orient and reorient the research process. The article draws on Barad’s agential realist onto-epistemology in an interdisciplinary ethnographic research project embedded in psychometric capturing of data. The first part of the article scrutinizes theoretical frictions. The second part, “empirical frictions” takes the reader through encounters with so-called fieldwork and data. The final layer of research writing, “productive frictions” has been inspired by Haraway’s cyborg manifesto to foreground the emergence of the Queer Cyborg Ethnographer.
Impact of a cefepime shortage on dosing regimens and outcomes in hospitalized adults with febrile neutropenia
Authors: Haiduc Manuela , Patel Monank , Walsh Thomas L , Moffa Matthew A , Bremmer Derek N
Published: April 2020

Background

Drug shortages may negatively impact outcomes in hospitalized patients. A cefepime dosing regimen of 1 gram every 6 hours (1 g q6h) has shown to provide similar exposures above target minimum inhibitory concentrations compared to the regimen of 2 g q8h approved by the United States Food and Drug Administration (FDA) for febrile neutropenia. Our objective was to determine if the dosing regimen of 1 g q6h amidst a cefepime shortage is an appropriate alternative for the treatment of febrile neutropenia.

Methods

A retrospective chart review of hospitalized patients who received cefepime for febrile neutropenia over a two-year period was performed. Patients were grouped based on cefepime dosing strategy: 2 g q8h vs. 1 g q6h. The primary objective was to compare time to defervescence after cefepime initiation. Secondary objectives included all-cause 30-day mortality, duration of antibiotic therapy, and inpatient length of stay.

Results

Seventy-five patients in each arm were included. There were no differences in baseline age or severity of illness between groups. There was no difference in the primary objective as median time to defervescence was similar between the 2 g q8h and 1 g q6h groups (69.0 vs. 65.3 h: p= 0.67). Additionally, no differences were found in the secondary objectives of all-cause 30-day mortality (10.7% vs. 9.3%: p = 0.79), duration of therapy (80.8 vs. 88.0 h: p = 0.34), or length of stay (9 vs. 7 days: p = 0.50).

Conclusions

Our study identified no differences in clinical outcomes with cefepime 1 g q6h compared to the traditional FDA-approved 2 g q8h regimen for the treatment of febrile neutropenia.
PPP in Health Care—Trending Toward a Light Model: Evidence From Italy
Authors: Vecchi Veronica , Casalini Francesca , Cusumano Niccolò , Leone Velia Maria
Published: April 2020

Italy, as many other countries, adopted the design–build–finance–maintain (DBFMO) Anglo-Saxon model to build new hospitals. This model proved to be rigid, nontransparent, nonvalue for money, and unaffordable. The aim of this article is to analyze the main drawbacks of the traditional DBFMO public–private partnerships (PPP) contract applied to the health care sector, by referring to the Italian experience, and to discuss the evolutions, conceived through an inductive/deductive approach, conducted in a context of deep collaboration between academia, health care authorities, and market players to make PPP contracts more value for money, flexible, and affordable. The article provides also an example of the role of academia in closing the rigor–practice gap by supporting and facilitating an institutional change.
A parallel hierarchical blocked adaptive cross approximation algorithm
Authors: Liu Yang , Sid-Lakhdar Wissam , Rebrova Elizaveta , Ghysels Pieter , Li Xiaoye Sherry
Published: April 2020

This article presents a low-rank decomposition algorithm based on subsampling of matrix entries. The proposed algorithm first computes rank-revealing decompositions of submatrices with a blocked adaptive cross approximation (BACA) algorithm, and then applies a hierarchical merge operation via truncated singular value decompositions (H-BACA). The proposed algorithm significantly improves the convergence of the baseline ACA algorithm and achieves reduced computational complexity compared to the traditional decompositions such as rank-revealing QR. Numerical results demonstrate the efficiency, accuracy, and parallel scalability of the proposed algorithm.
What Novice Art Directors Need to Know Beyond Their Portfolio
Authors: Blakeman Robyn , Haley Eric , Taylor Maureen
Published: April 2020

To land a job as an art director, the presentation of a strong conceptualized portfolio is only part of the equation. What additional knowledge helps the novice creative not only during the initial interview but to succeed once they land the job? This study looked to identify what additional skills and traits working art and creative directors felt young creatives needed beyond their portfolio in order to land their first job in advertising. The results suggest ways forward in how to prepare students to incorporate design, business, and personal skills into a well-rounded creative and personal brand.
Innovations in Teaching Advertising: Teaching Digital on a Shoestring Budget
Authors: Mishra Karen E. , Mishra Aneil K.
Published: April 2020

The field of advertising is becoming increasingly integrated with public relations and social media ( Kim, 2012 ). As a result, many employers expect new graduates to understand how to navigate this from both an integrated and digital perspective in their new careers. The challenge is that some advertising courses may be taught from a theoretical perspective and without the digital tools that new graduates will need to know how to use. The Tool Kit Friday innovation is designed to help students learn how to use new digital tools, and to create client projects with those tools while also learning advertising strategy.
Advancing Evaluation Practice With Serious Games
Authors: Olejniczak Karol , Newcomer Kathryn E. , Meijer Sebastiaan A.
Published: April 2020

Evaluation professionals need to be nimble and innovative in their approaches in order to be relevant and provide useful evidence to decision-makers, stakeholders, and society in the crowded public policy landscape. In this article, we offer serious games as a method that can be employed by evaluators to address three persisting challenges in current evaluation practice: inclusion of stakeholders, understanding of causal mechanisms, and utilization of evaluation findings. We provide a framework that distinguishes among games along two crucial aspects of evaluation inquiry - its function and the nature of the evaluand. We offer examples of successfully implemented games in each set of the four arenas we delineate: teaching knowables, testing retention, crash-testing mechanisms, and exploring systems. We explain how games can be employed to promote learning about and among stakeholders, and to collect valuable intelligence about the operations of programs and policies.
Utility of Preinjection Aspiration for Hyaluronic Fillers: A Novel In Vivo Human Evaluation
Authors: Wang Jordan V. , Hazan Ezra , Hattier Georgette , Torbeck Richard L. , Khorasani Hooman , Saedi Nazanin
Published: April 2020

Background

Hyaluronic acid (HA) fillers have increased in popularity. While complications are rare, practitioners should focus on their prevention. Preinjection aspiration remains controversial as an effective safety checkpoint.

Objectives

Our study investigated the utility of preinjection aspiration as a safety checkpoint for HA fillers through comparison of physiochemical and rheological properties in a novel in vivo human model.

Methods

An in vivo human model consisted of a cannula inserted into a peripheral vein. Preinjection aspiration was evaluated using syringes of 10 commonly used HA fillers. The time required to visualize a flash was recorded.

Results

Using a multivariable regression model, needle gauge, HA concentration, elastic modulus ( G′), viscous modulus ( G″), and complex modulus ( G*) had significant relationships with time to flash, whereas pullback volume did not. However, when comparing pullback volume using a more appropriate paired analysis, 0.5 cc pullback volume had a significantly decreased time to flash than 0.2 cc.

Conclusions

Preinjection aspiration for HA fillers has utility as a safety checkpoint. The times to visualize flashback decreased when using a human peripheral vein model compared to a previous in vitro model, suggesting that there may be real-time clinical utility of preinjection aspiration. Waiting times to visualize flashback may be affected by physiochemical and rheological properties. Additional studies would help to validate our results.
Neoliberal Aesthetics and the Struggle against Redevelopment in an Italian Postindustrial Periphery
Authors: Guano Emanuela
Published: April 2020

Much has been written about the neoliberal aestheticization of cities and its role in fostering consumption not just in, but also of, urban space. However, at a time when the pursuit of aesthetic experiences has become increasingly common, its exclusive association with privileged urban groups needs to be revisited. Drawing on ethnographic research conducted in the Bisagno Valley, a postindustrial periphery of Genoa, Italy, this paper explores how forms of resistance to redevelopment may challenge a dominant distribution of the sensible condemning postindustrial peripheries to the ruinations of redevelopment. Valley activists, it suggests, seek to subvert the categorization of peripheries as non-places by promoting ways of sensing and making sense of urban space that, while deeply intimate, are also consistent with neoliberal aesthetics. By recasting their neighborhood as meaningful and worth protecting, activists reclaim a role as heritage consumers that may allow them to participate in conversations about its future.
Everything to everyone and the conditioning effect of intraparty cohesion: A replication in a cross-national context
Authors: Lin Nick , Lehrer Roni
Published: April 2020

Taking the intraparty politics perspective, Lehrer and Lin recently revisit Somer-Topcu’s work that demonstrates how being ambiguous can help parties expand support in elections. Using survey data from the German Internet Panel, Lehrer and Lin find that intraparty cohesion is a critical moderator of Somer-Topcu’s argument. While Lehrer and Lin’s results are of relevance to a wide literature on party competition, intraparty politics, and political representation, their empirical strategy of relying on only one country prohibits other researchers from drawing meaningful and generalizable conclusions. In this note, we join this literature and reevaluate Lehrer and Lin’s conjecture by using an innovative cross-national survey data that covers 12 European countries. With this comparative data set, we almost perfectly replicate what Somer-Topcu and Lehrer and Lin reveal in their works. Our empirical endeavor not only provides a solid empirical ground to Lehrer and Lin in a cross-national context but also has important implications for future research, particularly on electoral politics, party competition, and democratic representation.
Hotels benefit from stricter regulations on short-term rentals in European cities
Authors: Falk Martin Thomas , Yang Yang
Published: April 2020

The aim of this study is to examine whether the introduction of stricter rules on short-term rentals (STRs) in some European cities will have an impact on hotel overnight stays. The treatment group consists of cities with the strictest regulations in Europe (Amsterdam, Barcelona, Berlin, Paris and London). The coarsened exact matching method is used to select an appropriate control group consisting of cities where there are no similar regulations but which are of a similar size in relation to population and relevant tourist space. Weighted fixed-effect models are used to estimate the average treatment effect on the treated. The specification also includes variables controlling for accommodation prices, value-added tax (VAT) rate on accommodation, terrorist attacks, real income of the destination country and time. Results show that stricter regulations for STRs in the five cities lead to an average increase in overnight stays of around 9%. This suggests that STRs such as Airbnb are substitutes for hotel accommodations and thus strong competitors. In addition, terrorist attacks lead to a decline in overnight stays, while an increase in VAT on accommodation reduces hotel overnight stays.