bluuebunny/crossref_metadata_2025 huggingface dataset:
Baloxavir Marboxil: The First Cap-Dependent Endonuclease Inhibitor for the Treatment of Influenza
Authors: Yang Tianrui
Published: January 2019

Objective: To review the pharmacology, pharmacokinetics, clinical trials, and clinical implications of baloxavir marboxil. Data Sources: A MEDLINE search was conducted using the terms baloxavir, baloxavir marboxil, cap-dependent endonuclease inhibitor, and polymerase acidic endonuclease inhibitor. Additional data were obtained from the prescribing information and relevant guidelines. Study Selection and Data Extraction: All clinical trials were included. Data Synthesis: Baloxavir marboxil exploits a new mechanism of action of inhibiting cap-dependent endonuclease. Baloxavir was shown to be superior compared with placebo and noninferior compared with oseltamivir with regard to the primary end point. Baloxavir was well tolerated in the trials. A second phase III study investigating high-risk patients was completed with positive results. However, the full article is not yet published. Relevance to Patient Care and Clinical Practice: The small amount of literature limits baloxavir’s use in certain patient populations. Baloxavir offers advantages such as single-dose regimen, eliminating adherence concerns and lack of cross-resistance, making it an alternative for resistant viruses. Several uncertainties remain. Baloxavir has not been studied in hospitalized patients, patients with symptoms for >48 hours, or in combination with other antiviral agents. Furthermore, resistance to baloxavir can develop after 1 dose. Clinical studies are ongoing to evaluate baloxavir in young pediatric patients, hospitalized patients, and in combination therapy with neuraminidase inhibitors to further elucidate baloxavir’s place in therapy. Conclusion: Baloxavir is a new antiviral medication for the treatment of influenza. Given the new mechanism of action, baloxavir may be useful in treating patients with resistant viruses.
Quality Improvement Toolkits: Recommendations for Development
Authors: Hempel Susanne , Miake-Lye Isomi , Brega Angela G. , Buckhold Fred , Hassell Susan , Nowalk Mary Patricia , Rubenstein Lisa , Schreiber Kathryn , Spector William D. , Kilbourne Amy M. , Ganz David A.
Published: January 2019

A burgeoning number of toolkits dedicated to improving health care exist but development guidance is lacking. The authors convened a panel of health care stakeholders, including developers, purchasers, users, funders, and disseminators of toolkits. The panel was informed by a literature review that analyzed 44 publications and 27 toolkits. A modified Delphi process established recommendations and suggestions to guide toolkit development. The panel established 12 recommendations for content and 1 recommendation for toolkit development methods. The recommendations are accompanied by 11 suggestions for toolkit content, 9 suggestions for development methods, and 6 suggestions for toolkit evaluation methods. The authors established a set of key recommendations and suggestions addressing the content, development, and evaluation methods of quality improvement toolkits, together with a ready-to use checklist. The guidance aims to advance the value of toolkits as an emerging method to effectively disseminate interventions to improve the quality of care.
Numerical modeling of wave propagation in a cracked solid
Authors: Gomez Quriaky , Ciobanu Oana , Ionescu Ioan R
Published: January 2019

In this study, we investigate the dynamics of (damaged) materials with a nonlinear microstructure (microcracks in frictional contact) using a discontinuous Galerkin method. Although the propagation of a plane wave is associated with a complex phenomenon and the stress field loses its homogeneity, the loading pulse has an overall front wave at each moment. Thus, a macroscopic behavior can be extracted and compared with reference solutions based on analytical formulas deduced from the effective (static) elasticity models of a cracked solid. The influences of the mesh and of the microcrack pattern have been tested to choose an optimal numerical setting. We analyzed the sensitivity of the damaged pulse with respect to microcrack density, wavelength, and microcrack orientation. For small values of crack density parameter, the theoretical formula and the computed speed of the damaged pulse are very close, but for larger values there is an important gap between them. For large ratios of wavelength over crack length, the wave speed depends only on the crack density parameter. However, if this ratio is of the order of unity, the wave speed, pulse duration, and pulse amplitude are very sensitive to the wavelength. For more complex phenomena, namely blast propagation in a cracked material, we discuss how the microcrack orientation affects wave propagation and scattering.
Stochastic Actor-Oriented Models for the Co-Evolution of Networks and Behavior: An Introduction and Tutorial
Authors: Kalish Yuval
Published: January 2019

Stochastic actor-oriented (SAO) models are a family of models for network dynamics that enable researchers to test multiple, often competing explanations for network change and estimate the extent and relative power of various influences on network evolution. SAO models for the co-evolution of network ties and actor behavior, the most comprehensive category of SAO models, examine how networks and actor attributes—their behavior, performance, or attitudes—influence each other over time. While these models have been widely used in the social sciences, and particularly in educational settings, their use in organizational scholarship has been extremely limited. This paper provides a layperson introduction to SAO models for the co-evolution of networks and behavior and the types of research questions they can address. The models and their underpinnings are explained in nonmathematical terms, and theoretical explanations are supported by a concrete, detailed example that includes step-by-step model building and hypothesis testing, alongside an R script.
Hedging Risk with Derivatives in the Rain-Sensitive Hospitality Industry
Authors: Franzoni Simona , Pelizzari Cristian
Published: January 2019

Weather is a fundamental resource for tourism, but adverse meteorological events (such as persistent rain) need to be considered by hospitality firms because of the increasing economic damages they cause. The study adds to the weather derivative and tourism literature by advancing a model for the rainfall risk management of hospitality firms. It aims to show, in two steps, how hospitality firms could share the risks caused by rain with counterparties by adopting a rainfall derivative to mitigate the negative impacts of rain on profitability. In particular, the first step of the proposed model is based on scenario correlation between business performances and rain. The second step introduces rainfall derivatives and analyzes their impact on the earnings before interest and taxes of hospitality firms. The model is supported by a numerical application covering the decade 2005 to 2014 and based on the business performances of 25 hotels located on Lake Garda, Italy and on the amount of rainfall on that lake.
Structural model robustness checks in PLS-SEM
Authors: Sarstedt Marko , Ringle Christian M , Cheah Jun-Hwa , Ting Hiram , Moisescu Ovidiu I , Radomir Lacramioara
Published: January 2019

Partial least squares structural equation modeling (PLS-SEM) has become a standard tool for analyzing complex inter-relationships between observed and latent variables in tourism and numerous other fields of scientific inquiry. Along with the recent surge in the method’s use, research has contributed several complementary methods for assessing the robustness of PLS-SEM results. Although these improvements are documented in extant literature, research on tourism has been slow to adopt the relevant complementary methods. This article illustrates the use of recent advances in PLS-SEM, designed to ensure structural model results’ robustness in terms of nonlinear effects, endogeneity, and unobserved heterogeneity in a PLS-SEM framework. Our overarching aim is to encourage the routine use of these complementary methods to increase methodological rigor in the field.
Using interpretative phenomenological analysis in autism research
Authors: Howard Katie , Katsos Napoleon , Gibson Jenny
Published: January 2019

Qualitative studies within autism research are gaining prominence, yet there is little evidence about the usefulness of particular qualitative approaches in reflecting the perspectives and experiences of autistic participants. This short report serves to introduce interpretative phenomenological analysis as one among a range of qualitative approaches to autism research. We argue that certain features of interpretative phenomenological analysis, including its commitment to an equality of voice and researcher reflexivity, may help to illuminate the experiences of autistic individuals. The procedures of interpretative phenomenological analysis are presented through the lens of 10 studies into autistic people’s experiences, and a case is made for the suitability of this approach within qualitative autism research.
Input and literacy effects in simultaneous and sequential bilinguals: The performance of Albanian–Greek-speaking children in sentence repetition
Authors: Kaltsa Maria , Prentza Alexandra , Tsimpli Ianthi Maria
Published: January 2019

Aim:

The present study examines input and literacy effects in simultaneous and sequential bilinguals with the aim of (a) investigating the differences between bilingual and monolingual populations and (b) disentangling the individual contribution of different factors in bilingual syntactic abilities.

Methodology:

A sentence repetition task (SRT) in Greek with eight structures (Subject Verb Object [SVO], negative clauses, clitic structures, complement clauses, coordinated sentences, adverbial clauses, wh-questions and relative clauses) was employed. All bilinguals additionally participated in a standardized expressive vocabulary task in Greek to measure their lexical ability.

Data:

Sixty 8–10-year-old children (20 monolingual, 20 simultaneous and 20 late sequential bilinguals) were tested.

Findings:

The analysis showed that (a) monolinguals outperform sequential bilinguals in sentence repetition, (b) clitic structures are highly problematic for all participants, (c) vocabulary and syntactic skills are closely related for simultaneous but not for sequential bilinguals, (d) home language practices in the early years affect SRT performance and (e) sequential bilinguals benefit from literacy practices that support syntactic skills in the language tested. Overall, we found that the effect of input overrides the effect of a traditionally categorical factor in bilingualism: age of onset (AoO) of exposure to L2.

Originality:

The contribution of this study includes (a) the examination of syntactic abilities in bilinguals in connection with language input early in life and at the time of testing, (b) the non-pervasive role of age of exposure to the L2 in SRT performance and (c) the role of literacy measures as key factors affecting syntactic skills in bilinguals.

Implications:

Quality of input and literacy in particular have been shown to affect bilingual syntactic skills, suggesting that enhancing literacy exposure as a language policy for bilinguals has a significantly positive impact on language development.
Bayesian model updating of a 20-story office building utilizing operational modal analysis results
Authors: Lam Heung Fai , Hu Jun , Adeagbo Mujib Olamide
Published: January 2019

Most existing buildings are not equipped with long-term monitoring system. For the structural model updating and damage detection of this type of structures, ambient vibration test is popular as artificial excitation is not required. This article presents in detail the full-scale ambient vibration test, operational modal analysis, and model updating of a tall building. To capture the dynamic properties of the target 20-story building with limited number of sensors, a 15-setup ambient vibration test was designed to cover at least three measurement points (each consists of a vertical and two orthogonal horizontal measured degrees of freedom) for each selected floor. The modal parameters of each setup were extracted from the measured acceleration signals using a frequency domain decomposition method and were combined to form the global mode shape through the least-squares method. Due to the regularity of the building, a simple class of shear building models was employed to capture the dynamic characteristics of the building under lateral vibration. The identified modal parameters of the building were employed for the model updating of the shear building model to identify the distribution of inter-story stiffness. Since the “amount” of the measured information is small when compared to the “amount” of required information for identifying the uncertain parameters, the model updating problem is unidentifiable. To handle this problem, the Markov chain Monte Carlo–based Bayesian model updating method is employed in this study. The identified modal parameters revealed interesting features about the dynamic properties of the building. The well-matched results between model-predicted and identified modal parameters show the validity of the shear building model in this case study. This study provides valuable experience in the area of structural model updating and structural health monitoring.
Cyberbullying and traditional bullying among Nordic adolescents and their impact on life satisfaction
Authors: Arnarsson Arsaell , Nygren Jens , Nyholm Maria , Torsheim Torbjorn , Augustine Lilly , Bjereld Ylva , Markkanen Ilona , Schnohr Christina w. , Rasmussen Mette , Nielsen Line , Bendtsen Pernille
Published: January 2019

Aims: The aim of this study was to investigate the prevalence of cybervictimization in the six Nordic countries and to assess its overlap with traditional bullying. A further aim was to examine potential associations between life satisfaction, on the one hand, and traditional bullying and cyberbullying on the other. Methods: Analyses were based on data from the 2013⁄2014 Health Behaviour in School-aged Children study. It included 32,210 boys and girls, aged 11, 13, and 15, living in the six Nordic countries. Results: The prevalence of cyberbullying by both pictures and by messages was around 2% in all the Nordic countries except Greenland. There it was considerably higher. The prevalence of being bullied in a traditional manner varied widely by country. For boys, this type of bullying was most frequent in the youngest age group and then decreased steadily in the older age groups. Girls were on average more likely to be cyberbullied. Cyberbullying was more common among 13- and 15-year-olds than 11-year-olds. Higher family affluence was unrelated to the risk of cyberbullying. However, it was related to traditional bullying and combined forms of bullying. Compared with intact families, cybervictimization was commoner among single-parent families and stepfamilies. Adjusting for age, gender, family affluence, and family structure, those subjected to cyberbullying had lower life satisfaction than those who were not bullied. Conclusions: We found relatively little overlap between cyberbullying and traditional bullying, indicating that the two may be separate phenomena stemming from different mechanisms, at least in the Nordic context.
What’s newsworthy about ‘social news’? Characteristics and potential of an emerging genre
Authors: Hurcombe Edward , Burgess Jean , Harrington Stephen
Published: January 2019

This article describes the emerging genre of ‘social news’ – characterised by a ‘born-digital’ form of journalism which is both symptomatic of and a pragmatic response to the logics of social media. The article outlines the genre’s key formal characteristics, illustrating them through discussions of three key Australia-based publications – BuzzFeed Oz News, Junkee, and Pedestrian.tv. The analysis of these examples indicates that social news departs from traditional journalistic norms around objectivity, instead exhibiting a strong and explicit positionality, and actively critiquing ideas like ‘balance’. The article argues that social news demonstrates the progressive potential of new forms of journalism that have emerged from the same technological and economic developments that have caused the crisis in the news business. It concludes with a more elaborated description of the social news genre, with suggestions for further research.
Intersecting violence: Representations of Somali youth in the Canadian press
Authors: Jiwani Yasmin , Al-Rawi Ahmed
Published: January 2019

This article examines the press coverage accorded to Canadian youth of Somali origin in the Canadian press using two methodological procedures. Charting the representational clusters that cohere around Canadian Black male youth of Somali heritage reveals the circulation of stereotypical tropes that are mostly circumscribed within the framework of crime, terrorism, and violence, reflecting the intersection of stereotypes commonly ascribed to Muslims and to Black males. In the case of the Canadian Somali youth, this representation encompasses major narratives such as ‘radicalization and terror’, ‘immigration and belonging’, ‘surveillance and safety’, and ‘gang violence’ and, to a lesser extent, positive stories. To corroborate the first level of analysis, the computational analyses reveal four main topics and associations that are similar to the above findings, providing insight into the way Canadian Somali youth, especially men, are facing different challenges in their lived experiences in Canada.
An integrative typology of relational benefits and costs in social media brand pages
Authors: Tsimonis Georgios , Dimitriadis Sergios , Omar Suha
Published: January 2019

This article focuses on consumer–brand relationships in the social media environment and suggests a typology of the benefits and costs consumers perceive when interacting with social media brand pages. Employing an online questionnaire, quantitative data were collected from 881 followers of popular brand pages on both Facebook and Twitter. Study results indicate that followers of brand pages on Facebook and Twitter perceive “social,” “functional,” “enjoyment,” “special treatment,” “self-enhancement,” “advice,” and “status” benefits. “Privacy concern,” “information overload,” and “ad irritation” are consumers’ perceived costs. As the same seven factors of relational benefits and three factors of relational costs have been confirmed across all Facebook and Twitter brand pages, it is argued that the structure and dimensions of relational benefits and costs are medium and brand invariant, and are perceived in the same way by Facebook and Twitter followers. Considering the rapid development of social media and their penetration in business marketing actions, this research contributes to the digital marketing literature by providing a better understanding of relational benefits, relational costs, and consumer–brand relationships in a social media context. Finally, the article offers recommendations to brand managers, when designing appropriate social media content, that can enhance and strengthen a brand’s relationship with its customers.
Building automated survey coders via interactive machine learning
Authors: Moreo Alejandro , Esuli Andrea , Sebastiani Fabrizio
Published: January 2019

Software systems trained via machine learning to automatically classify open-ended answers (a.k.a. verbatims) are by now a reality. Still, their adoption in the survey coding industry has been less widespread than it might have been. Among the factors that have hindered a more massive takeup of this technology are the effort involved in manually coding a sufficient amount of training data, the fact that small studies do not seem to justify this effort, and the fact that the process needs to be repeated anew when brand new coding tasks arise. In this article, we will argue for an approach to building verbatim classifiers that we will call “Interactive Learning,” and that addresses all the above problems. We will show that, for the same amount of training effort, interactive learning delivers much better coding accuracy than standard “non-interactive” learning. This is especially true when the amount of data we are willing to manually code is small, which makes this approach attractive also for small-scale studies. Interactive learning also lends itself to reusing previously trained classifiers for dealing with new (albeit related) coding tasks. Interactive learning also integrates better in the daily workflow of the survey specialist and delivers a better user experience overall.
Ranking soccer teams on the basis of their current strength: A comparison of maximum likelihood approaches
Authors: Ley Christophe , Wiele Tom Van de , Eetvelde Hans Van
Published: January 2019

We present 10 different strength-based statistical models that we use to model soccer match outcomes with the aim of producing a new ranking. The models are of four main types: Thurstone–Mosteller, Bradley–Terry, independent Poisson and bivariate Poisson, and their common aspect is that the parameters are estimated via weighted maximum likelihood, the weights being a match importance factor and a time depreciation factor giving less weight to matches that are played a long time ago. Since our goal is to build a ranking reflecting the teams’ current strengths, we compare the 10 models on the basis of their predictive performance via the Rank Probability Score at the level of both domestic leagues and national teams. We find that the best models are the bivariate and independent Poisson models. We then illustrate the versatility and usefulness of our new rankings by means of three examples where the existing rankings fail to provide enough information or lead to peculiar results.
Flowbca: A Flow-Based Cluster Algorithm in Stata
Authors: Meekes Jordy , Hassink Wolter H. J.
Published: January 2019

In this article, we introduce the Stata implementation of a flow-based cluster algorithm, flowbca, written in Mata. The main purpose of flowbca is to identify clusters based on relational data of flows. We illustrate the command by providing multiple examples of applications from the research fields of economic geography, industrial input–output analysis, and social network analysis.
Speaking Stata: Seven Steps for Vexatious String Variables
Authors: Cox Nicholas J. , Schechter Clyde B.
Published: January 2019

String variables that seemingly should be numeric require some care. The column provides a step-by-step guide explaining how to convert them or—as the case may merit—to leave them as they are. Dates in string form, identifiers and categorical variables, and pure numeric content trapped in string form need different actions. Practical advice on good and not so good technique is sprinkled throughout.
Conceptual design and finite element method validation of a new type of self-locking hinge for deployable CubeSat solar panels
Authors: Solís-Santomé Arturo , Urriolagoitia-Sosa Guillermo , Romero-Ángeles Beatriz , Torres-San Miguel Christopher Rene , Hernández-Gómez Jorge J , Medina-Sánchez Isaac , Couder-Castañeda Carlos , Grageda-Arellano Jesús Irán , Urriolagoitia-Calderón Guillermo
Published: January 2019

Deployable mechanisms in CubeSat satellites have many problems with the system that provides the anchor position. The main defect of the traditional deployment mechanisms for solar panels in CubeSats is the lack of position system to block the back-driving of the panel when it reaches the final phase of the deployment. This generates spurious oscillations in the panel, affecting the photovoltaic process as well as generating fatigue in the mechanical elements of the mechanism (hinge or pin). In this work, the design, analysis and manufacture of a deployment mechanism for CubeSat solar panels is shown. A finite element method analysis was carried out in a hinge with an integrated blocking system as well as a double torsion spring, which can be used on CubeSats. The outcome shows the layout of the described anchor hinge and the used double-torsion spring, which provides a positive direction torque transfer. Likewise, the performed numerical analyses on the designed system, reduce the weight and optimise the geometry of the mechanism, showing its feasibility as well as the potential applications and further research in the area.
Computerized tomographic prediction of flexor tendon injuries complicating hamate hook fractures
Authors: Takeda Shinsuke , Tatebe Masahiro , Ishii Hisao , Morita Akimasa , Wakai Kenji , Hirata Hitoshi
Published: January 2019

We reviewed computerized axial tomography of 28 patients with hamate hook fractures who had surgical resection of the hook. We analysed the relationship between the fragment height ratio, fragment gap, and intraoperative findings of the tendons. We determined whether parameters in the images can predict complication of tear or disruption of the flexor tendons to the ring or little fingers. Of 28 patients, 16 had fragment height ratios between 50–74; ten among them had worn (eight patients) or ruptured (two patients) flexor tendons. Nine of the ten patients had fragment gaps greater than 2 mm. The remaining 12 patients had fragment height ratios between 75–100 and had intact tendons. We conclude that a fragment height ratio greater than 75 and fragment gap less than 2 mm in computer tomography may rule out tear or disruption of the flexor tendons of the ring and little fingers after hamate hook fractures, and a fragment height ratio between 50–74 with fragment gap greater than 2 mm indicates a high risk of flexor tendon tear or disruption.

Level of evidence: IV
Quantitative evaluation of impact attenuation by football helmets using a modal impulse hammer
Authors: Cummiskey Brian , Sankaran Goutham N , McIver Kevin G , Shyu Daniel , Markel Justin , Talavage Thomas M , Leverenz Larry , Meyer Janette J , Adams Douglas , Nauman Eric A
Published: January 2019

Concussions and changes in neurophysiology due to sub-concussive blows are common in contact sports, motivating a need for improved safety systems. While there have been attempts to determine whether or not new helmet designs influence the incidence of concussion, the results to date have been inconclusive. Consequently, the goal of this study was to evaluate the ability of modern football helmets to mitigate linear impacts directed normal, as well as oblique, to the surface of the helmeted head using a system that quantifies both the input load and the resulting accelerations of a Hybrid III headform. The transfer function connecting the inputs and outputs of the system was developed using dimensional analysis to provide a means of comparing helmets across brands and sports. For translational accelerations, increased helmet mass and a secondary layer of padding helped mitigate the impacts. The attenuation of angular accelerations depended substantially on helmet model and impact location.
Effect of mechanically aged minimalist and traditional footwear on female running biomechanics
Authors: Lippa Nadine , Bonacci Jason , Collins Paul K , Rawlins James W , Gould Trenton E
Published: January 2019

The purpose of this study was to improve the understanding of human–material interactions by combining polymer engineering and biomechanical approaches. The forefoot and heel of traditional shoes and minimalist running shoes were degraded using a mechanical aging protocol to quantify (1) the effect of subject-specific degradation and (2) human biomechanical effects due to decreased material properties. Four recreational-level female participants ran in the shoes pre-mechanical aging to determine the aging protocol input parameters and post-mechanical aging to evaluate the effect of degradation on kinematics and kinetics. Initial biomechanics translated into different mechanical aging input parameters among conditions: 500 greater number of impact cycles for minimalist shoe, 430 N higher peak force for forefoot, 75 kPa greater peak stress for the heel, 3.1 and 13.7 kN/s greater loading rates for minimalist shoe and the heel, and recovery time 220 ms greater for the heel. From mechanical aging, the shoe types and regions lost 1.2–1.8 mm thickness and 38%–54% energy absorption overall, while drop decreased 0.6 mm for traditional shoe only. Samples degraded at different rates depending on runner-specific input parameters. Human kinematics and kinetics were affected by both shoe type and aging. Aging of the shoes decreased knee flexion velocity (1°/s; p = 0.01), decreased ankle dorsiflexion during stance (3°, p = 0.01), and increased the vertical loading rate (4 BW/s, p = 0.01). The results support previous findings that different footwear influence running biomechanics and concurrently advance footwear science to show running biomechanics are also influenced by shoe degradation rates, such that unique and intuitive human–material interactions are apparent.
Health informal payments and their main determinants: The case of Iran
Authors: Meskarpour Amiri Mohammad , Teymourzadeh Ehsan , Ravangard Ramin , Bahadori Mohammadkarim
Published: January 2019

Introduction:

Informal payments are a serious obstacle to equitable access and universal health coverage in developing countries. This study aimed to identify the most important factors affecting health informal payments in Iran.

Methodology:

The cross-sectional and descriptive-analytical study was carried out on a study population of all Iranians who, at least once over the past year (i.e. 2017), had received healthcare services and were exposed to paying health informal payments. A sample of 1477 households was selected using a multi-stage stratified-cluster sampling method. The required data were collected using a researcher-made questionnaire and completed by face-to-face interviews with the heads of households. The main factors affecting the odds of making informal payments were identified using the Ordered Logistic Regression model.

Results:

Having basic health insurance coverage, awareness of health insurance entitlements, education, perceived behavioral control, and the pattern of health service utilization had, respectively, the highest effects on the odds of making informal payments for healthcare. The odds of making informal payments for patients with no awareness of the health insurance entitlements were 3.5, 3.6, and 6.7 times more than those with low, medium, and high awareness, respectively (Odds Ratio = 3.58, 3.69, 6.74; P < 0.001).

Conclusion:

The health policymakers, in addition to improving service financing, should plan to increase patients’ awareness, correct their false beliefs, change their attitudes, and improve social participation regarding health informal payments in order to reduce such transactions.
Frontal sinus mucocele in association with polyostotic fibrous dysplasia: A case report
Authors: Koh Leslie Timothy , Pollaers Katherine , Dhepnorrarat Chris Rataphol
Published: January 2019

Fibrous dysplasia is an uncommon developmental anomaly of bone wherein normal bone marrow is substituted and subsequently expanded by fibro-osseous tissue. Its association with mucocele formation in the paranasal sinuses is extremely rare. We present a case report of a patient with polyostotic fibrous dysplasia with frontal sinus mucocele formation, who underwent endoscopic drainage and marsupialisation via a transnasal approach.
Exercise stress test in apparently healthy individuals − where to place the finish line? The Ferrari corporate wellness programme experience
Authors: Sirico Felice , Fernando Fredrick , Di Paolo Fernando , Adami Paolo Emilio , Signorello Maria Grazia , Sannino Giuseppe , Bianco Antonio , Cerrone Annunziata , Baioccato Veronica , Filippi Nicola , Ferrari Umberto , Tuzi Manuel , Nurzynska Daria , Di Meglio Franca , Castaldo Clotilde , D’Ascenzi Flavio , Montagnani Stefania , Biffi Alessandro
Published: January 2019

Aims

The aim of our study was to assess the clinical significance of the exercise stress testing endpoints, namely 85% of maximal theoretical heart rate (MTHR), metabolic equivalent of task, and rating of perceived exertion (RPE), and their relation to electrocardiographic (ECG) changes in a healthy adult population.

Methods

A cross-sectional study was conducted on 408 males and 52 females (mean age 39.4 ± 8.6 years) who performed the maximal cycle ergometer exercise stress test until volitional exhaustion, reporting the RPE score at 85% of MTHR and at peak exercise. Metabolic equivalents of task were indirectly calculated from the maximum workload and compared with the predicted values. Sitting torso-lead ECG and blood pressure were recorded at rest, during exercise and during recovery.

Results

Of 460 participants, 73% exceeded 85% of MTHR. The RPE score represented the overall most significant endpoint of exercise stress testing, with the median value of 17 at peak exercise. ECG events were detected in 23/124 (18.5%) who reached ≤ 85% of MTHR and in 61/336 (18.2%) who achieved >85% of MTHR ( p = 0.92). In the latter group, 54% of ECG changes occurred at < 85% of MTHR and 46% at > 85% of MTHR ( p = 0.51). If the exercise stress testing had been interrupted at ≤ 85% of MTHR, almost half of the ECG events would have remained undetected and 35% of the cardiovascular abnormalities observed at the diagnostic follow-up would have remained undiagnosed.

Conclusion

Terminating exercise stress testing before volitional exhaustion and an RPE score of 17 limits the test accuracy and reduces the possibility to detect cardiovascular abnormalities in apparently healthy adult populations.
Use of Multislice CT for Investigation of Occult Geriatric Hip Fractures and Impact on Timing of Surgery
Authors: Williams John , Allen Felix , Kedrzycki Marta , Shenava Yathish , Gupta Renu
Published: January 2019

Introduction:

The National Institute of Health and Clinical Excellence guidelines in the United Kingdom recommend magnetic resonance imaging (MRI) as the first-line investigation for radiographically occult hip fractures, if available within 24 hours. In our department, however, multislice computerized tomography (MSCT) is instead used as a first-line investigation due to significant delays associated with obtaining MRI. Our aim was to determine the validity and practicality of MSCT for diagnosis of occult hip fractures and its impact on timing of surgery.

Materials and Methods:

We retrospectively analyzed medical records and imaging for consecutive patients who underwent MSCT to investigate occult hip fractures between January 2014 and October 2016. We reviewed subsequent imaging and reattendances for patients with negative MSCT to exclude initially missed fractures.

Results:

Two hundred six patients underwent MSCT to investigate occult hip fracture during the study period. Hip fractures were identified in 59 patients, comprising 35 (59.3%) subcapital, 12 (20.0%) intertrochanteric, 8 (13.6%) transcervical, and 4 (6.8%) basicervical fractures. One missed hip fracture was identified: a patient with a negative MSCT was further investigated with MRI that demonstrated acute subcapital hip fracture. Multislice computerized tomography was obtained within 24 hours of initial radiograph in 145 (70.4%) patients. A total of 44.5% of occult hip fractures had surgery within the nationally recommended 36 hours of admission (hospital average for all hip fractures was 76.4% over the same period).

Discussion and Conclusions:

Multislice computerized tomography is a pragmatic approach to investigate the majority of occult hip fractures in a timely manner and minimize associated delay to surgery. However it cannot completely exclude the diagnosis, especially in abnormal anatomy. The lack of a true gold standard comparison (ie, MRI) means a true sensitivity and specificity cannot be calculated, although can be cautiously estimated by lack of subsequent reattendance or investigation. Further prospective randomized CT versus MRI trials are required.
The HIV SEERs Project: A Qualitative Analysis of Program Facilitators’ Experience
Authors: Chenneville Tiffany , Gabbidon Kemesha , Drake Hunter
Published: January 2019

HIV-related stigma creates barriers to HIV testing, medication adherence, and retention in care. Guided by the principles of community-based participatory research (CBPR) and in collaboration with community health workers (CHWs), the Stigma-reduction through Education, Empowerment, and Research (SEERs) project was developed with and for youth living in Nakuru, Kenya to reduce HIV-related stigma. The purpose of this qualitative study was to examine the experiences of the CHWs serving as SEERs facilitators. To evaluate SEERs, 37 facilitators completed open-ended survey questions to gather their experiences and recommendations for future program implementation and sustainability. Participants’ mean age was 30.58 (standard deviation = 9.62), ranging from ages 18 to 53. Thematic content analysis was used to categorize (a) facilitators’ experiences and the community impact of the SEERs project, (b) lessons learned, and (c) challenges to sustainability. Recommendations will be used to modify the SEERs project, improve implementation and sustainability strategies, and may provide guidance for similar CBPR projects.
A long-term prospective observational study in 31 patients with hemicrania continua
Authors: Prakash Sanjay , Rathore Chaturbhuj , Rana Kaushik , Joshi Hemant , Patel Jay , Rawat Kalu Singh
Published: January 2019

Introduction:

Till date, there is no prospective study in patients with hemicrania continua (HC).

Methods:

Patients fulfilling the international classification of headache disorders criteria for HC were evaluated prospectively. All patients were subjected to a detailed clinical interview, based on a structured questionnaire. Before starting indomethacin, all patients were instructed to fill a headache diary for at least 5 days. Gradual tapering of indomethacin was done at regular intervals.

Results:

We enrolled 41 patients over 4.5 years, 31 of whom met the criteria after confirming the indomethacin response. The mean age was 41 years, and 55% were female. The mean duration of headache was 43.6 months. All patients had continuous strictly unilateral pain with episodic exacerbations. At least one cranial autonomic feature was noted in 81% of patients. Twenty-five patients (81%) felt a sense of restlessness during exacerbations. The mean follow-up was 2.5 years. Three-fourths of patients noted a reduction in indomethacin dose after an average 2.5 of years follow-up. The mean reduction of the dose in the follow-up was statistically significant (172 mg vs. 110 mg, p < 0.001). All patients missed the drug for various reasons over the observation period. The headache reappeared within 48 h in 97% of patients.

Conclusion:

Misdiagnosis of HC is still very common. Patients may not volunteer about the background pain and will focus only on the exacerbations. HC rarely remits, but indomethacin requirements may decrease over time. Skipping of the effective drug leads to the immediate reappearance of pain.
Acid solution decreases the compressional wave velocity of sandstone from the Yungang Grottoes, Datong, China
Authors: Geng Hong , Zhang Shijie , Zhi Jianhui , Zhang Runping , Ren Jianguang , Ro Chul-Un
Published: January 2019

To understand the effects of an acidic environment on the internal structure of sandstone from the Yungang Grottoes, Datong, China, the physicochemical properties of fresh and weathered sandstone samples and their compressional wave (P-wave) velocities in response to different concentrations of H2SO4 and HNO3 solution were investigated. X-ray diffraction (XRD) and a scanning electron microscope equipped with energy dispersive X-ray spectrometer (SEM–EDX) were used to determine grain morphology and chemical composition. The results show that the sandstone, which mainly consists of silicon dioxide and calcium carbonate, became more complicated in composition after weathering. A nonmetallic ultrasonic detector was used to measure the P-wave velocities of sandstones in a natural state and soaked with ultrapure water and with H2SO4 and HNO3 at concentrations of 0.2 mol L−1, 0.4 mol L−1, and 0.8 mol L−1, respectively. For the acid-treated groups, with increasing acidity, P-wave velocity decreased significantly, compressive strength decreased and effective porosity increased; these behaviours are different from those of the water-treat group, implying that the acid solutions damaged the microstructure of the sandstone. The results suggest that the deterioration risk of H2SO4 and HNO3, or sulfates and nitrates converted from ambient SO2, NO
x
and PM2.5, on the stone relics in the Yungang Grottoes should be a cause for concern.
Determining the optimal coefficients of the explicit finite-difference scheme using the Remez exchange algorithm
Authors: He Zheng , Zhang Jinhai , Yao Zhenxing
Published: January 2019

Explicit finite-difference (FD) schemes are widely used in the seismic exploration field due to their simplicity in implementation and low computational cost. However, they suffer from strong artifacts caused by using coarse grids for high-frequency applications. The optimization of constant coefficients is popular in reducing spatial dispersions, but current methods could not guarantee that the bandwidth of the tolerable dispersion error is the widest. We have applied the Remez exchange algorithm to optimize the constant coefficients of the explicit FD schemes, for conventional and staggered grids. The resulting dispersion errors are distributed alternately between the maxima and minima in the passband of the filter, which is consistent with the most important equal-ripple property of the error magnitude for the optimal solution according to the Chebyshev criterion. The Remez exchange algorithm can determine the optimal coefficients of the FD method with only a few iterations, and the resulting operator has a wider bandwidth compared with previous solutions. It can handle arbitrary orders without the influence of local minima. Its computational cost for solving the objective function is comparable to that of the least-squares method, but its bandwidth is wider. Its accuracy is also higher than that of the maximum norm solved by the simulated annealing algorithm, but its computational cost is much lower. Theoretically, the equal-ripple error can offer the widest bandwidth for suppressing numerical dispersions among all solutions obtained by the constant-coefficient optimization. In other words, we can obtain a smaller error limitation than traditional methods under the same bandwidth. This superiority over traditional methods is essential for reducing the total error accumulation, which is helpful to avoid rapid error accumulations especially for large-scale models and long-term problems.
Tamoxifen Pharmacogenetics and Metabolism: Results From the Prospective CYPTAM Study
Authors: Sanchez-Spitman Anabel , Dezentjé Vincent , Swen Jesse , Moes Dirk Jan A.R. , Böhringer Stefan , Batman Erdogan , van Druten Edith , Smorenburg Carolien , van Bochove Aart , Zeillemaker Anneke , Jongen Lynn , Los Maartje , Neven Patrick , Gelderblom Hans , Guchelaar Henk-Jan
Published: January 2019

PURPOSE

Tamoxifen is widely prescribed as adjuvant therapy in patients with early-stage breast cancer. It has been postulated that concentrations of endoxifen, the active metabolite of tamoxifen, are a better predictor of tamoxifen efficacy than CYP2D6 genotypes. Although in a retrospective study, an endoxifen threshold of 5.9 ng/mL for efficacy was described, confirmation based on prospective studies is lacking. The objective of the prospective CYPTAM (The Netherlands National Trial Register: NTR1509) study was to associate endoxifen concentrations and CYP2D6 genotypes with clinical outcome in patients with early-stage breast cancer receiving tamoxifen.

PATIENTS AND METHODS

From February 2008 to December 2010, patients with breast cancer treated with adjuvant tamoxifen were included. Patients could be enrolled up to a maximum of 12 months after tamoxifen initiation. Blood samples were retrieved for CYP2D6 genotyping and endoxifen measurements by Amplichip (Roche Diagnostics, Indianapolis, IN) and high-performance liquid chromatography–tandem mass spectrometry, respectively. Endoxifen concentrations were analyzed as a continuous variable, classifying patients into quartiles and using an endoxifen threshold of 5.9 ng/mL. Endoxifen concentrations and CYP2D6 genotypes were associated with relapse-free survival (censored at the time of tamoxifen discontinuation; RFSt) by Cox regression analysis.

RESULTS

A total of 667 pre- and postmenopausal patients were enrolled and had received tamoxifen for a median time of 0.37 years (range, 0.23 to 0.6 years) before study entry. No association was found between endoxifen concentrations and RFSt (adjusted hazard ratio, 0.991; 95% CI, 0.946 to 1.038; P = .691). Also, neither categorizing endoxifen concentrations into quartiles nor using 5.9 ng/mL as threshold altered these results. In addition, no association was found between CYP2D6 genotype and RFSt (adjusted hazard ratio, 0.929; 95% CI, 0.525 to 1.642; P = .799).

CONCLUSION

This prospective clinical study shows no association between endoxifen concentrations or CYP2D6 genotypes and clinical outcome in patients with early-stage breast cancer receiving adjuvant tamoxifen.
Clinical prognostic models for severe dengue: a systematic review protocol
Authors: Dao Phuoc Thang , Khuong Quynh Long , Vien Dang Khanh Linh , Ong Phuc Thinh , Le Sy Hieu , Le Ngoc Tu , Phung Khanh Lam
Published: January 2019

Background: Dengue is a common mosquito-borne, with high morbidity rates recorded in the annually. Dengue contributes a major disease burden in many tropical countries. This demonstrates the urgent need in developing effective approaches to identify severe cases early. For this purpose, many multivariable prognostic models using multiple prognostic variables were developed to predict the risk of progression to severe outcomes. The aim of the planned systematic review is to identify and describe the existing clinical multivariable prognostic models for severe dengue as well as examine the possibility of combining them. These findings will suggest directions for further research of this field.

Methods: This protocol has followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta – Analyses Protocol (PRISMA-P). We will conduct a comprehensive search of Pubmed, Embase and Web of Science. Eligiblity criteria include being published in peer-review journals, focusing on human subjects and developing the multivariable prognostic model for severe dengue, without any restriction on language, location and period of publication, and study design. The reference list will be captured and removed from duplications. We will use the Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies (CHARMS) checklist to extract data and Prediction study risk of bias assessment tool (PROBAST) to assess the study quality.

Discussion: This systematic review will describe the existing prediction models, summarize the current status of prognostic research on dengue, and report the possibility to combine the models to optimize the power of each paradigm.

PROSPERO registration: CRD42018102907
Poverty Propaganda
Authors: Shildrick Tracy
Published: January 2019

Does ‘real’ poverty still exist in Britain? How do people differentiate between the supposed ‘deserving’ and ‘undeserving’ poor? Is there a culture of worklessness passed down from generation to generation? Bringing together historical and contemporary material, this book sheds new light on how poverty is understood in contemporary Britain. The book debunks many popular myths and misconceptions about poverty and its prevalence, causes and consequences. In particular, it highlights the role of ‘poverty propaganda’ in sustaining class divides in perpetuating poverty and disadvantage in contemporary Britain.