bluuebunny/crossref_metadata_2025 huggingface dataset:
Anaphylaxis to intravenous paracetamol containing povidone. A case report and narrative review of excipient allergy related to anaesthesia
Authors: Preuss James F , Goddard Catherine E , Clarke Russell C , Platt Peter R , Sadleir Paul HM
Published: October 2020

Investigation of intraoperative anaphylaxis includes the exclusion of potential trigger agents the individual was exposed to within a plausible interval preceding the reaction. Occasionally, none of these agents will test positive. In this situation it is important to consider that excipients may be responsible for anaphylaxis, that the dilutions prepared to test the medication may not contain an appropriate concentration of the excipient to induce a positive skin reaction, or if an alternative formulation of the medication is tested, it may not contain the culprit excipient. This case describes a patient, who previously experienced an anaphylactic reaction to Betadine® (Sanofi-Aventis Australia Pty Ltd, North Ryde BC, NSW) experiencing anaphylaxis in the recovery period after general anaesthesia where Betadine was avoided. The recently administered therapeutics were excluded by skin testing, however further investigation determined that a povidone-containing formulation of paracetamol had been administered. Skin testing with povidone-containing paracetamol resulted in a positive reaction in the patient, but not in a volunteer control. Pharmaceutical excipients are added to medications to increase absorption, shelf-life and efficacy. Different brands of the same drug may contain different excipients. When testing for anaphylaxis with such compounds one must be sure the dilution is appropriate for both the parent compound and the excipient to ensure the accuracy of skin-prick and intradermal testing. This case demonstrates the potential for excipients to cause severe allergy and the importance of detailed history pertaining to previous allergic episodes as even the most unlikely of medications can potentially result in anaphylaxis due to excipients.
Deriving Pavement Deflection Indices from Layered Elastic Theory
Authors: Nielsen Christoffer P.
Published: October 2020

Pavement deflection indices such as the surface curvature index or base damage index are widely used to characterize the condition of pavements. Often, the indices are constructed to provide an estimate of a particular strain component somewhere in the pavement structure. Since the pavement damage is a function of the strain, structural indices provide a simple way of estimating the damage rate in a pavement. Despite their widespread use, it has so far proven difficult to derive deflection indices from first principles; instead, new indices are found by evaluating a range of candidates using a trial-and-error approach. In this paper, a systematic method of deriving deflection indices is presented. The method is based on applying the convolution theorem for Hankel transforms to the solution of a layered elastic problem. Besides allowing for easy derivation of new deflection indices, the method can be used to account for the impact of varying layer thicknesses in the pavement.
Evidence-Based Clinical Anatomy of the Popliteofibular Ligament and Its Importance in Orthopaedic Surgery: Cadaveric Versus Magnetic Resonance Imaging Meta-analysis and Radiological Study
Authors: Pękala Przemysław A. , Mann Mitchell R. , Pękala Jakub R. , Tomaszewski Krzysztof A. , LaPrade Robert F.
Published: October 2020

Background:

The popliteofibular ligament (PFL) is a static stabilizer of the posterolateral corner of the knee, preventing varus angulation, tibial rotation, and posterior translation. The PFL is anatomically variable, and there is no current review that outlines its prevalence rate and morphological variations.

Purpose:

To investigate the anatomic prevalence and morphological qualities of the PFL in various global patient populations via a meta-analysis of relevant literature involving both cadaveric dissections and patient-based research using magnetic resonance imaging (MRI) scans.

Study Design:

Meta-analysis.

Methods:

We pooled literature data detailing PFL prevalence rates and performed a retrospective MRI study of 100 knees to determine the overall PFL prevalence. Data searches and analyses were performed according to Anatomical Quality Assurance and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines.

Results:

There were 30 cadaveric studies and 11 MRI studies (including our radiological investigation), representing a total of 1595 lower limbs. The meta-analysis of cadaveric studies showed a higher prevalence of the PFL than the meta-analysis of MRI studies, with 98.4% (95% CI, 97.5%-99.2%) and 89.0% (95% CI, 73.9%-98.6%), respectively. Our MRI investigation reported a PFL prevalence of 92.0%.

Conclusion:

The PFL was found to be a constant or rarely absent anatomic structure of the human knee according to the analysis of cadaveric dissection studies, and it was identified notably less on MRI, albeit not significantly. Increasing PFL anatomic knowledge, including awareness of its prevalence and morphological diversity, will improve injury diagnoses, treatment methods, and prognoses.
Impacts of age, diabetes, gender, and access type on costs associated with vascular access among Chinese patients on hemodialysis
Authors: Xiong Yuqin , Yu Yang , Yang Yuan , Wang Liya , Shi Ping , Deng Yuchen , Li Yi , Fu Ping
Published: October 2020

Objectives:

Examine the impacts of age, diabetes, gender, and access type on vascular access (VA) associated costs among Chinese hemodialysis (HD) patients.

Methods:

We retrospectively included patients whose first permanent VA was created at the West China Hospital. Clinical characteristics, maturation, intervention, utilization, and exchange of every VA, as well as VA-related infection were collected. The study period for each patient was from HD initiation to the last follow-up. VA-related costs, including those for placement and intervention procedures, were calculated according to the standards set in 2019 for Chinese tertiary hospitals. Mann-Whitney U and Chi-square tests were conducted for comparisons between groups.

Results:

A total of 358 Chinese HD patients experienced functionally 143 arteriovenous fistula (AVF), 22 arteriovenous graft (AVG), and 439 tunneled cuffed central venous catheter (tcCVC) during a median study period of 26 (IQR 13–44) months, of which 42.5% used more than one permanent VA. The median annual VA-related cost in the groups of age >75 years and ⩽75 years, diabetes and non-diabetes, male and female, was $525 and $397 ( p = 0.016), $459 and $462 ( p = 0.64), $476 and $445 ( p = 0.94), respectively. The median monthly costs for AVF ($18), AVG ($289), and tcCVC ($37) were significantly different.

Conclusion:

HD patients aged >75 years had significantly higher annual VA-related costs. However, the annual VA-related costs did not differ across the diabetes groups or the gender groups. AVF was the most cost-effective permanent VA type in China, partly due to the inexpensive materials used compared to AVG or tcCVC.
“Endourological closure of a malformative vascular source of bleeding using the VortX 0.018” coil®”
Authors: De Gobbi Alberto , Barbisan Davide , Ciaccia Matteo , Cova Giandavide , Farneti Fabrizio , Maccatrozzo Luigino , Mangano Mario Salvatore
Published: October 2020

Aims:

Renal vascular malformations, congenital or acquired, are sometimes challenging for urologists and interventional radiologists to resolve. Arterovenous fistulas and pseudoaneuryms are usually embolized by interventional radiologists, with a low rate of complications. We propose a new endourological/interventional radiology technique to treat a source of arterovenous bleeding coming from a renal calyx in a minimally invasive way.

Methods:

A combined endourological and interventional radiology procedure is described, using a Flexible Fiberoptic Ureteroscopes to undertake a retrograde intrarenal surgery (RIRS) to identify the source of bleeding; subsequently the VortX Coil® is inserted through a microcatheter to stop the bleeding and the correct position of the VortX coil is evaluated. Furthermore, we made a literature research on Pubmed and Medline to look for similar procedures.

Results:

In case of a renal bleeding that could not be treated by endovascular way, a combined urological and interventional radiology procedure can be undertaken. We did not find similar endourological and interventional radiology procedure on Pubmed and Medline, so this is the first tecnique of endourological closure of a bleeding point using a coil.

Conclusion:

From our experience this could be a mininvasive technique to solve renal bleedings coming from a calyx that are not found by endovascular approach. Indeed, in our knowledge, the technique here described is the first that provides the use of an endovascular coil by endourological way in renal vascular malformations.
Patterns of Primary Care Use Prior to a First Diagnosis of Nonaffective Psychotic Disorder in Ontario, Canada: Modèles d’utilisation des soins de première ligne avant un premier diagnostic de trouble psychotique non affectif en Ontario, Canada
Authors: Schoer Nicole , Rodrigues Rebecca , Reid Jennifer , Ryan Bridget L. , Lizotte Daniel J. , Booth Richard , MacDougall Arlene G. , Kurdyak Paul , Anderson Kelly K.
Published: October 2020

Background:

Many people experience early signs and symptoms before the onset of psychotic disorder, suggesting that there may be help-seeking prior to first diagnosis. The family physician has been found to play a key role in pathways to care. This study examined patterns of primary care use preceding a first diagnosis of psychotic disorder.

Methods:

We used health administrative data from Ontario (Canada) to construct a population-based retrospective cohort. We investigated patterns of primary care use, including frequency and timing of contacts, in the 6 years prior to a first diagnosis of psychosis, relative to a general population comparison group matched on age, sex, geographic area, and index date. We used latent class growth modeling to identify distinct trajectories of primary care service use, and associated factors, preceding the first diagnosis.

Results:

People with early psychosis contacted primary care over twice as frequently in the 6 years preceding first diagnosis (RR = 2.22; 95% CI, = 2.19 to 2.25), relative to the general population, with a sharp increase in contacts 10 months prior to diagnosis. They had higher contact frequency across nearly all diagnostic codes, including mental health, physical health, and preventative health. We identified 3 distinct service use trajectories: low-, medium-, and high-increasing usage.

Discussion:

We found elevated patterns of primary care service use prior to first diagnosis of psychotic disorder, suggesting that initiatives to support family physicians in their role on the pathway to care are warranted. Earlier intervention has implications for improved social, educational, and professional development in young people with first-episode psychosis.
Development and calibration of reduced-size plate thermometer for measuring incident heat flux
Authors: Yun Hong-Seok , Han Ho-Sik , Hwang Cheol-Hong
Published: October 2020

This study proposes a new reduced-size plate thermometer with a modified shape and improved insulation performance in order to resolve problems commonly found when using conventional plate thermometers to measure incident heat flux in fire environments, for example, a low spatial resolution caused by the large plate area and a non-uniform temperature distribution on the plate. The main results of this study showed that the new plate thermometer exhibits high spatial temperature uniformity, and that the plate thermometer can be reduced in size to 30 mm. Moreover, it was found that the relative error of the incident heat flux of the plate thermometer was substantially reduced compared to that of a heat flux meter using a conduction correction factor expressed as a third-order polynomial function of heat flux, rather than using an average empirical constant calculated from measurement over a wide range of heat fluxes. Finally, it was confirmed that the incident heat flux measured by the new reduced-size plate thermometer in a heptane pool fire was in good agreement with the heat flux meter measurements during the rapid-fire growth, fully developed and decay phases of a fire.
Explorative and Exploitative Learning Affected by Extraneous Cognitive Load and Gameplay Anxiety in a Gestalt Perception Game
Authors: Hong Jon-Chao , Hwang Ming-Yueh , Chen Mei-Syuan , Tai Kai-Hsin
Published: October 2020

In line with the attention-to-affect model, this study employed a game that encompasses Gestalt perception to explore how extraneous cognitive load (ECL) and gameplay anxiety correlate with attitude towards exploitative learning and attitude towards explorative learning as students play the Visual-Saliency game (VSG) with images of artworks. The data of 56 sixth-grade students were collected and subjected to Smart PLS analysis to verify the pathways. The results of this study show that ECL is negatively related to attitude towards exploitative learning and attitude towards explorative learning. However, gameplay anxiety is negatively related to attitude towards exploitative learning, but is not significantly related to explorative learning when playing the VSG. The implication of this study is that Gestalt perception in game playing can give students more opportunities to practice reasoning, and they can gain more knowledge about the artworks themselves.
Challenges and success strategies for dyad leadership model in healthcare
Authors: Saxena Anurag
Published: October 2020

The use of a dyad leadership model involving a physician co-leader and a co-leader with a different background, the dyad co-leader, is gradually increasing in Healthcare Organizations (HCOs). There is a paucity of empirical studies on various aspects of this model. This study’s aim was to identify challenges and strategies for success in the dyad leadership model in healthcare. Through a mixed-methods approach utilizing focus groups, surveys, and semi-structured interviews, perceptions of 37 leaders in one HCO at different hierarchical levels were analysed based on their lived experiences. The challenges and success strategies spanned personal, interpersonal, and organizational domains. The areas requiring attention included mindsets, competencies, interpersonal relationship, support, time, communication, and collaboration. In addition, the importance of organizational context addressing its structure, strategy, operations, and culture was highlighted. The findings from this study may be used for praxis, development, and implementation of dyad leadership.
Time to First Culture Positivity for Gram-Negative Rods Resistant to Ceftriaxone in Critically Ill Adults
Authors: Buell Kevin G. , Casey Jonathan D. , Noto Michael J. , Rice Todd W. , Semler Matthew W. , Stollings Joanna L.
Published: October 2020

Background:

The optimal timing for the de-escalation of broad-spectrum antibiotics with activity against Pseudomonas aeruginosa and resistant Gram-negative rods (GNRs) in critically ill adults remains unknown.

Research Question:

We tested the hypothesis that cultures will identify GNRs that ultimately demonstrate resistance to ceftriaxone within 48 hours, potentially allowing safe de-escalation at this time point.

Study Design and Methods:

We conducted a secondary analysis of data from the Isotonic Solutions and Major Adverse Renal Events Trial: a pragmatic, cluster-randomized, multiple-crossover trial comparing balanced crystalloids versus saline for intravenous fluid administration in 15,802 critically ill adults at 5 intensive care units (ICUs) at Vanderbilt University Medical Center in Nashville, TN, USA. The primary endpoint was the time-to-positivity of respiratory and blood cultures that ultimately demonstrated growth of GNRs resistant to ceftriaxone. Multivariable logistic regression modeling was used to examine risk factors for the growth of cultures after 48 hours.

Results:

A total of 524 respiratory cultures had growth of GNRs, of which 284 (54.2%) had resistance to ceftriaxone. A total of 376 blood cultures grew GNRs, of which 70 (18.6%) had resistance to ceftriaxone. At 48 hours, 87% of respiratory cultures and 85% of blood cultures that ultimately grew GNRs resistant to ceftriaxone had demonstrated growth. Age, gender, predicted risk of inpatient mortality and prior use of antibiotics did not predict the growth of cultures after 48 hours.

Interpretation:

Among a cohort of critically ill adults, 13% of respiratory cultures and 15% of blood cultures that ultimately grew GNRs resistant to ceftriaxone did not demonstrate growth until at least 48 hours after collection. Further work is needed to determine the ideal time for critically ill adults to de-escalate from broad-spectrum antibiotics targeting Pseudomonas aeruginosa and extended-spectrum β-lactamase-producing gram-negative pathogens.
Building bridges for teachers as researchers
Authors: Chudasama Meera
Published: October 2020

There has been little exploration of how Research Leads build bridges and manage networks to encourage teachers to be researchers. As a middle leader on a teaching timetable, in this article, I focus on some of the current issues and dilemmas I have personally faced when trying to thrive in this role. I address these issues and draw on my own experience as evidence to support possible solutions in being a middle leader. Some of the challenges faced in this role are encouraging teachers to become researchers, motivating teachers to engage in research, making research relatable to teachers and using reflective practice to develop researching practitioners. Further to this, I explore how using a bottom-up strategy can work with senior leaders through to classroom teachers; even though this can be a difficult process, this strategy is constantly evolving with the aim to create a research-informed community. In all, this article takes a personal perspective and reflects personal experiences in being a Research Lead and a teacher-researcher. It aims to provide some strategies in managing the challenges of being a middle leader, not in the traditional sense but as a networker, community builder and teacher-researcher.
“SEW” What Do We Know and Where Do We Go? A Review of Socioemotional Wealth and a Way Forward
Authors: Swab R. Gabrielle , Sherlock Chelsea , Markin Erik , Dibrell Clay
Published: October 2020

This analysis provides a review of family business literature concerning the application of socioemotional wealth (SEW) and its extension through the FIBER framework. Specifically, we answer Brigham and Payne’s call by assessing the multidimensionality of the SEW construct, the interrelatedness of the dimensions, and its specificity to family firms. We contribute to the literature by conducting a systematic review of the SEW literature and examining the applications of the FIBER dimensions, noting the evolution of specific research themes. Last, using necessary condition analysis, we provide four conceptual inferences regarding the assumptions of SEW to provide a way forward.
Computerized adaptive technology for the assessment of HRQOL of PD and CKD patients
Authors: Finkelstein Fredric O , Cimini Monica , Finkelstein Susan H , Kliger Alan S
Published: October 2020

This study was designed as a pilot study to see whether electronic patient-reported outcome measures using computer adaptive technology (CAT) could be successfully implemented in clinics caring for chronic kidney disease (CKD) and peritoneal dialysis (PD) patients. The results demonstrate the feasibility of using CAT on an iPad to assess the symptom burden and health-related quality of life of both PD and CKD patients.
Utilizing Pharmacists to Optimize Medication Management Strategies During the COVID-19 Pandemic
Authors: Burgess L. Hayley , Cooper Mandelin K. , Wiggins Elizabeth H. , Miller Karla M. , Murray Edward , Harris Scott , Kramer Joan S.
Published: October 2020

As the COVID-19 pandemic swept through the United States, our heath-system mobilized clinical pharmacy services to address critical clinical medication management needs. Reinforcing recommended medication management strategies for clinical pharmacists was key to successful implementation. Best practice strategies include converting patients from intravenous (IV) to oral medication, transitioning to IV push medication administration, evaluating standard medication administration timing, reviewing metered dose inhaler (MDI) and nebulizer utilization, using alternatives for medications in short supply, reviewing coronavirus disease COVID-19 treatment recommendations, reviewing COVID-19 patient care on interdisciplinary rounds, de-prescribing and de-escalating to eliminate unnecessary medications, and assessing for appropriate venous thromboembolism prophylaxis. These strategies served to help protect medication supply, reduce number of staff entries into patient rooms to conserve personal protective equipment, limit nursing time in patient rooms to reduce COVID-19 exposure risk, and to conserve compounding supplies. Here we present example medication management guidance as used by a large healthcare system during the COVID-19 pandemic.
Mid to late-Holocene sea-surface temperature variability off north-eastern Newfoundland and its linkage to the North Atlantic Oscillation
Authors: Orme Lisa C , Miettinen Arto , Seidenkrantz Marit-Solveig , Tuominen Kirsi , Pearce Christof , Divine Dmitry V , Oksman Mimmi , Kuijpers Antoon
Published: October 2020

In recent decades the surface water temperature and salinity in the Labrador Sea have been influenced by atmospheric circulation patterns, such as the North Atlantic Oscillation (NAO), as well as a trend to increasingly warm atmospheric temperatures in recent years. These changes are concerning, given the important role that temperature and salinity have on deep convection in the Labrador Sea. Yet, due to the shortness of available records, the long-term patterns of climate variability in the region are not clear. Here, a diatom-based reconstruction of summer sea-surface temperature (SST) developed from Trinity Bay, Newfoundland, provides insight into variations of SST since 7.2 cal ka BP in the southwestern Labrador Sea. The results show that the Holocene Thermal Maximum (HTM) lasted until c. 5.2 cal ka BP, which was followed by a gradual cooling trend overprinted by centennial temperature fluctuations of 1–2°C. Long-term cooling was likely the result of declining Northern Hemisphere orbital summer insolation, potentially amplified by long-term changes in surface and bottom water salinity, which led to a gradual reduction in the stratification of the water column. Centennial fluctuations in temperature vary in-phase with reconstructed variations in the NAO, supporting a consistent relationship between atmospheric circulation and SST over centennial-millennial timescales. Other factors influencing the SST variability may have been solar forcing during the mid-Holocene and variations in the strength of the subpolar gyre during the late-Holocene. The most prolonged cool period at 5.2–4.1 cal ka BP coincides with sharply reduced salinity in the Labrador Sea and a weakening of deep ventilation in the northeast Atlantic, highlighting a period with altered ocean surface conditions and circulation across the northern North Atlantic.
Leslie Wallace Lauste MBE (1908–2001): Brighton surgeon and prisoner of war in occupied Europe
Authors: Taylor Alexander William , Whiston Benjamin , Cooper Maxwell John
Published: October 2020

Leslie Wallace Lauste (1908–2001) was an English surgeon of French ancestry who practised in Brighton. This article used his memoirs and interviews to describe his life during the Second World War. In 1940, after declining evacuation by the Royal Navy, he was captured at Boulogne- Sur-Mer. Lauste went on to work in the following hospitals, of which most were attached to prisoner of war (POW) camps: Dannes-Camiers (France), Lille (France), Enghien (Belgium), Malines (Belgium), Dieberg (Germany), Klein-Zimmern (Germany), Stadtroda (Germany), Treysa (Germany), Kloster Haina (Germany), Lamsdorf (Poland), and Moosburg (Germany). Lauste’s memoirs indicate that most surgical work was routine rather than trauma-related. He gained considerable freedoms in camp and attended external hospitals to give a surgical opinion. Lauste witnessed the consequences of allied bombing raids on German cities and considered these a “genocide.” Lauste’s life offers insight into the Nazi mistreatment of Russian prisoners, management of a typhus outbreak, camp liberation, and extraordinary journeys within occupied Europe. His memoirs provide new insight into the life of a British POW surgeon and reveals personal courage, kindness to others, and passion for medicine. Lauste never married. He died in Brighton in 2001.
Working Capital Financing, Firm Performance and Financial Flexibility: Evidence from Indian Hospitality Firms
Authors: Altaf Nufazil
Published: October 2020

This article examines the relationship between working capital financing and firm performance for a sample of 185 Indian hospitality firms. In addition, this study examines the impact of financial flexibility on working capital financing performance relationship for a period of 10 years. This study employs two-step generalized method of moment (GMM) techniques to arrive at results. Results of the study confirm the inverted U-shaped relationship between working capital financing and firm performance with optimal break-even point, beyond which short-term debt financing has a negative effect on performance at 0.54. In addition, we found that firms likely to be more financially flexible can finance a greater proportion of working capital using short-term debt, since break-even point turns out to be high for firms likely to be more financially flexible. The study is expected to extend the existing debate on working capital management by using the sample of Indian Hospitality firms for analysing the above-mentioned relationships.
The Role of Faith-based Organizations (FBOs) in the Rehabilitation of Offenders
Authors: Khan Sultan
Published: October 2020

Since time immemorial, religion has been, and is, a part of society that provides a moral compass and stability in society. It regulates human behavior so that there is conformity to norms and values that are upheld by society. Deviation from these norms and values is subject to sanction, which results in incarceration. At the turn of the 20th century, a more proactive step has been taken for the rehabilitation of those who have come into conflict with the law. The many secular programs that were implemented in the rehabilitation of prisoners 1 provided little to the desired effect, which is highlighted by looking at the rate of recidivism. In this context, the role of religion became increasingly recognized as a way to rehabilitate prisoners. In some instances, faith-based programs have been integrated into secular programs, while in other instances, faith-based organizations (FBOs) volunteer to independently provide their service. Irrespective of the approach used, there is sufficient evidence to support the view that faith-based programs have a positive effect on the rehabilitation of prisoners and helps to reduce recidivism.
Palliative Care Consultation Affects How and Where Heart Failure Patients Die
Authors: Pham Richard , McQuade Casey , Somerfeld Alex , Blakowski Sandra , Hickey Gavin W.
Published: October 2020

Objective:

Determine the role of palliative care on terminal code status and setting of death for those with heart failure.

Background:

Although palliative care consultation (PCC) has increased for many conditions, PCC has not increased in those with cardiovascular disease. While it has been shown that the majority of those with heart failure die in medical facilities, the impact of PCC on terminal code status and setting of death requires further analysis.

Methods:

Patients admitted with heart failure between 2014-2015 at an academic VA Healthcare System were reviewed. Primary outcome was terminal code status. Secondary outcomes included setting of death, hospice utilization, and mortality scores. Student t-testing and Chi-square testing were performed where appropriate.

Results:

334 patients were admitted with heart failure and had a median follow up time of 4.3 years. 196 patients died, with 122 (62%) receiving PCC and 74 (38%) without PCC. Patients were more likely to have terminal code statuses of comfort measures with PCC (OR = 4.6, p = 0.002), and less likely to be full code (OR = 0.09, p < 0.001). 146 patients had documented settings of death and were more likely to receive hospice services with PCC (OR 6.76, p < 0.001). A patient’s chance of dying at home was not increased with PCC (OR 0.49, p = 0.07), but they were more likely to die with inpatient hospice (OR = 17.03; p < 0.001).

Conclusion:

Heart failure patients who received PCC are more likely to die with more defined care preferences and with hospice services. This does not translate to dying at home.
Designing Effective Sustainability Assignments: How and Why Definitions of Sustainability Impact Assignments and Learning Outcomes
Authors: Urdan Matthew S. , Luoma Patrice
Published: October 2020

The importance of, and interest in, sustainability in management education has increased significantly over the past three decades. However, the definition of sustainability remains complex and elusive, thus creating significant issues for sustainability instruction, assignment design, and student learning. We reviewed definitions and use of sustainability and corporate social responsibility (CSR) nomenclature from academics, corporations, and business and society course textbooks. The evidence is clear that sustainability and CSR are commonly and frequently used interchangeably not only in academic research and the classroom but also by textbook authors and business reports. Using a sustainability assignment gone wrong, we present data and analysis showing that this lack of definitional clarity and intermingling of the concepts of sustainability and CSR led to problems with student learning and outcomes from the assignment. Student work was heavily influenced by corporate terminology, which superseded textbook, nomenclature, and classroom instruction. We call for future research to delve into the issue of clarifying the definitional complexity and conflation.
Education and Transition for Students With Disabilities in American Juvenile Correctional Facilities
Authors: Ochoa Theresa A. , Datchi Corinne C. , Weller Nicole M. , Northcutt Bohmert Miriam , Grubbs Derek
Published: October 2020

National rates of juvenile incarceration show that about 33% of the population in correctional confinement has disabilities such as behavioral disorders or specific learning disabilities. All students identified under the Individuals with Disabilities Education Improvement Act (IDEIA) as having a disability are entitled to special education and transition services when they are incarcerated if they need specialized services. Despite the requirements for education and transition, research shows that rates of recidivism increase from about 55% for the general population of incarcerated youth to approximately 85% for youth with disabilities. This article addresses three related questions: (a) What educational and transitional services does IDEIA require schools to offer students in juvenile correctional facilities in the United States? (b) How are parents involved with the education and rehabilitation of their children with disabilities in correctional confinement? (c) What are the challenges associated with parental involvement and transition to and from incarceration for students with disabilities?
Costa Rican Education Supports for Youth With Disabilities Within Correctional Confinement
Authors: de Mezerville Claire M. , Meza Ana E. , Ovares Yanúa
Published: October 2020

Costa Rica has developed a modality for people in vulnerable conditions to remain in the education system called Educación Abierta, Spanish for “Open Education.” This modality is described, and a lack of specific research is identified regarding minors with a disability and deprived of liberty. This article acknowledges the current good practices on local educational programs for this population, as well as the challenges that are still to be faced regarding diagnosis and intervention strategies within Centro de Formación Juvenil Zurquí for students with attention deficit and hyperactivity disorder, dyslexia, and dyscalculia, among others.
Management of Velopharyngeal Insufficiency in Cleft Patients With and Without Multidisciplinary Team Care
Authors: Torrecillas Vanessa , Pollard Sarah Hatch , McCrary Hilary , Taylor Helene M. , Palmer Alexandra , Meier Jeremy , Muntz Harlan , Skirko Jonathan R.
Published: October 2020

Objective:

To evaluate the effect of an American Cleft Palate-Craniofacial Association (ACPA)–approved multidisciplinary team on velopharyngeal insufficiency (VPI) diagnosis and treatment.

Design:

Retrospective cohort setting; tertiary children’s hospital patients; children with cleft palate repair identified through procedure codes.

Main Outcome Measures:

Velopharyngeal insufficiency diagnosis was assigned based on surgeon or team assessment. Age at diagnosis and surgery was recorded. Difference in age and rate of VPI diagnosis and surgery was analyzed with t test. Multivariate linear and logistic regression adjusted for confounding variables.

Results:

Nine hundred forty patients were included with 71.5% cared for by an ACPA-approved multidisciplinary team. More (38.8% ) team care patients were found to have a diagnosis of VPI in comparison to 10% in independent care ( P < .001). Team care was associated with an almost 6-fold increase in VPI diagnosis ( P < .001). Team care was associated with a higher proportion of speech surgery (21% vs 10%, P < .001). Among children receiving team care, each visit was associated with 25% increased odds of being diagnosed with VPI ( P < .001) and 20% increased odds of receiving speech surgery ( P < .001). Age at VPI diagnosis and speech surgery were similar between groups ( P = .55 and .29).

Discussion:

Team care was associated with more accurate detection of VPI, resulting in more VPI speech therapy visits and surgical management. A higher number of team visits were similarly associated.

Conclusion:

Further studies of the clinical implication of timely and accurate VPI diagnosis, including quality of life assessments, are recommended to provide stronger guidance on team visit and evaluation planning.
Clustering Education Policy in Secondary Provision: Impact on Higher Education and Job Market
Authors: Alam Gazi Mahabubul
Published: October 2020

International commitment is to address all forms of imbalanced and discriminatory situations experienced within the education system. While students of secondary provision in many developed countries enjoy the liberty of choosing their desired subjects from different areas (i.e., science, business, and arts), students in some developing counterparts are restricted to consider one cluster. With a policy support, students of the science cluster can procure higher education (HE) in any area, while students from other clusters are restricted to study HE in their respective area only. By virtue of this policy, the limited scope of HE and jobs in the areas of business and arts is being occupied by science graduates because of one-way traffic that favors science cluster. This has a grave impact on the HE and job market, which is the central focus of this research. We failed to find such studies conducted in the context of a developing nation. Considering this, the article is the first of its kind. Given the differentiated nature of research questions, multiple techniques were used to collect the data. However, this research bears the norms of qualitative method. Findings confirm that having been denied access to HE, secondary graduates especially from the business cluster, dropped out without furthering their education. This has deteriorated the quality of HE and job performance—more precisely, it has deprived students of the business and arts clusters. This research suggests a revision of the prevailing policy to address these constraints.
Intravenous Zanamivir: A Viable Option for Critically Ill Patients With Influenza
Authors: Slain Douglas
Published: October 2020

Objective:

To review the pharmacology, clinical trial data, and clinical implications for the intravenous formulation of zanamivir.

Data Sources:

MEDLINE, PubMed, EMBASE, and Google Scholar were searched during November 2019 to July 2020. Search terms zanamivir and neuraminidase inhibitor were used.

Study Selection and Data Extraction:

All human trials and major reports from compassionate use programs with the intravenous zanamivir (IVZ) formulation were assessed and reviewed here.

Data Synthesis:

IVZ was found to be similar but not superior to oral oseltamivir in hospitalized patients when studied in populations with very low baseline oseltamivir resistance. IVZ provides an effective alternative for critically ill patients when oral antiviral therapy is not preferred or when oseltamivir resistance is increased.

Relevance to Patient Care and Clinical Practice:

IVZ was recently authorized for use by the European Medicines Agency, and it is eligible for consideration in emergency use protocols and US stockpile inclusion. It will be of particular interest in critically ill patients especially during influenza seasons with appreciable oseltamivir and peramivir resistance.

Conclusions:

The available information suggests that the intravenous formulation of zanamivir offers a viable alternative treatment for critically ill patients with influenza, especially when resistance to other agents is present.
Pitfalls in Morphologic Diagnosis of Pathogens: Lessons Learned From the Pseudo-Cystoisospora Epidemic
Authors: Gopinath Arun , Alkhasawneh Ahmad , Mubeen Aysha , Makary Raafat , Mohammed Ibraheem , Baskovich Brett
Published: October 2020

Multiple groups have recently reported involvement of the gallbladder mucosa of immunocompetent patients by cystoisospora organisms. However, this has recently been disproved with the support of molecular and ultrastructural studies. Here we present a summary of these events, recounting how this pseudo-Cystoisospora epidemic began and ended. This review also highlights the important role played by ancillary techniques in supplementing the morphologic diagnosis of pathogens.
Developing a Strong Home–School Connection to Better Identify and Serve Culturally, Linguistically, and Economically Diverse Gifted and Talented Students
Authors: Lockhart Kari , Mun Rachel U.
Published: October 2020

Scholars and practitioners of gifted education have made strides in recognizing the need for equitable identification practices, as well as acknowledging the importance of culturally relevant teaching practices, so that students from traditionally underrepresented student populations (i.e., culturally, linguistically, and economically diverse [CLED] students, rural students) have the opportunity to develop their unique gifts and talents. However, little attention has been paid to the vital roles that parent/family and community have in shaping a gifted and talented child’s future. The relationship between students’ families, communities, and their school is often an overlooked variable, but one that has the potential to make significant improvements in gifted education for traditionally underrepresented students in gifted education. This article identifies potential barriers to forming strong home–school connections and outlines specific strategies for overcoming these stumbling blocks. We discuss ways in which teachers and administrators can utilize specific engagement strategies, rethink structures within the school environment, and employ responsive attitudes and behaviors to cultivate strong, healthy home–school connections.
Pharmacists’ Perceptions, Barriers, and Potential Solutions to Implementing a Direct Pharmacy Access Policy in Indiana
Authors: Newlon Jenny L. , Ades Ryan , Vernon Veronica , Wilkinson Tracey A. , Meredith Ashley H.
Published: October 2020

This study assessed pharmacists’ perceptions, barriers, and potential solutions for implementing a policy allowing pharmacists to prescribe hormonal contraceptives in Indiana. A mixed-method survey ( n = 131, 22.3% response rate), using Likert-type scales, dichotomous responses (yes/no), and open-ended questions, was distributed to pharmacy preceptors in Indiana. Pharmacists felt prescribing contraceptives would be beneficial (79.1%) and were interested in providing this service (76.0%), but only 35.6% reported having the necessary resources. Participants with a PharmD were significantly more likely to feel the service would be beneficial (odds ratio [ OR] = 10.360, 95% confidence interval [CI: 1.679, 63.939]) and be interested in prescribing contraceptives ( OR = 9.069, 95% CI [1.456, 56.485]). Reimbursement (86.4%), training courses (84.7%), private counseling rooms (69.5%), and increasing technician responsibilities (52.5%) were identified as ways to ease implementation. Women had significantly greater odds of being more comfortable than men prescribing injections ( OR = 2.237, 95% CI [1.086, 4.605]), and intravaginal rings ( OR = 2.215, 95% CI [1.066, 4.604]), when controlling for age, degree, and setting. Qualitative findings reinforced quantitative findings.
Now as a Liminal Space, Writing as a Patchwork: Autoethnographic Reflections on the Self in the Middle of the Pandemic
Authors: Lee Sun Young
Published: October 2020

In the middle of the COVID-19 pandemic, I came to think about the role of my identity in my scholarship. Drawing on liminality as a conceptual apparatus, this autoethnography displays multiple layers of the self, that is, thresholding, passing, and daydreaming. Moving everyday encounters into parts of discourses, I consider how the self is always in full of uncertainty, wandering, rather than being fixed. I end with reflecting on the writing process: autoethnographic writing has been continual process to capture multiple liminal moments into a patchwork; it becomes possible by distancing the observing-self from the observed-self, however temporal those are.
Breast Microinvasive Carcinoma With Different Morphologies: Analysis of Clinicopathologic Features of 121 Cases
Authors: Feng ChangYin , Zheng QiaoLing , Yang YingHong
Published: October 2020

Purpose:

To investigate the clinicopathological features of patients with breast microinvasive carcinoma (MI).

Methods:

The clinical data of 121 cases with breast MI were retrospectively collected. The whole tumor in each case was stained with hematoxylin and eosin (H&E) for pathological evaluation. The relationships among size of tumor, histological grade, tumor-infiltrating lymphocytes (TILs), the number of MIs, type of MI, and lymph node metastasis were analyzed.

Results:

It was revealed that 86% of the cases had high-grade ductal carcinoma in situ (DCIS) and 63.6% had multiple MIs. The larger size of the tumors, the higher the grade of DCIS, the more the number of MIs; 3.3% of cases had rich TILs (lymphocyte/stroma > 30%) in the DCIS, and 26.5% had rich TILs in MIs. The type A of MIs is characterized by single cells and small clusters of solid cells. Tumor cells in type B of MIs can form glandular ducts. Formal grading of microinvasive is challenging/impossible due to its limited size precluding a representative mitotic count. But nuclear grade and tubule (differentiation) grades can be reported. In addition, 72.7% of cases had type A of MIs and 27.3% of cases had type B of MIs. Type B was found to be highly accompanied by moderate-grade DCIS. Only 6.6% of patients with MI had lymph node metastasis, which was mainly related to MIs with less TILs.

Conclusion:

Breast MI is easy to occur in high-grade DCIS, and multiple infiltration foci may be observed in case with tumor size of higher than 3.5 cm. Microinvasive carcinoma with poor TILs maybe a risk factor for lymph node metastasis in patient with DCIS-Mi.
Frictional dynamic model predictions of FZG-A10 spur gear pairs considering profile errors
Authors: Feki Nabih , Hammami Maroua , Ksentini Olfa , Abbes Mohamed Slim , Haddar Mohamed
Published: October 2020

In this work, a nonlinear dynamic model of an FZG-A10 spur gear was investigated by taking into account for the actual time-varying gear mesh stiffness and the frictional effects between meshing gear teeth to evaluate the influence of the dynamic effects on frictional gear power loss predictions. The equations of motion of the generalized translational-torsional coupled dynamic system derived from Lagrange principle was extended compared to authors’ previous work in order to account for time dependent coefficient of friction and profile errors. The dynamic response of spur gears, computed by an iterative implicit scheme of Newmark, is changed due to the presence of coefficient of friction and profile errors. A dynamic analysis was performed and the influence of frictional effect including tooth shape deviations, in particular, was scrutinized since a time-dependent coefficient of friction is deeply related to the gear surface roughness and all parameters dependent on gears error profiles are introduced in the proposed model. The predicted meshing gear power losses with constant and local friction coefficient were compared. The influence of constant and variable profile errors considered in the local coefficient of friction formulation was also studied and their corresponding root mean square (RMS) power loss was compared to the experimental results. The results using FZG A10 spur gear pairs running under several operating conditions (different loads and speeds) validate the superiority of the proposed model against previous similar models.
Persistence, seasonality, and fractional integration within a nonlinear framework: Evidence from US citizens’ overseas travel
Authors: Gil-Alana Luis A , Payne James E
Published: October 2020

This research note examines data on US citizens’ overseas air passenger travel with respect to the degree of persistence, seasonality, nonlinearities, and fractional integration. Based on seasonally differenced data with allowance for autocorrelated errors, we find evidence of nonlinearity with moderate persistence and mean reversion in US overseas air travel. The results suggest that shocks to US overseas air travel will dissipate over time, and as such, the observed persistence and nonlinearity can provide useful information in the modeling and forecasting of future behavior.