bluuebunny/crossref_metadata_2025 huggingface dataset:
How preschool children think about libraries: Evidence from six children’s libraries in China
Authors: Xu Jianhua , Wang Pianran , Sturm Brian W. , Wu Yingying
Published: December 2018

Listening to young children’s voices is crucial to improving children’s library services. The first step is unveiling how young children think about the library. Thus, researchers recruited the Mosaic approach including photography, interview, and drawing to explore the features of children’s libraries in children’s perspectives in six libraries in China. The results indicate that first, the children’s library is a “primary third place”. Second, the children’s library is an overlapping of home and society. Third, children can read books in the children’s library, but not just read. Fourth, the children’s library improves children’s awareness as patrons. It is suggested that young patrons already form initial understandings of the library, begin to complain about any problems, and put forward requirements for the library. Additionally, their interpersonal needs should be paid attention to. Therefore, librarians and researchers should respect the rights of children and listen to their voice when designing and providing library services associated with children.
Covariate-adjusted survival analyses in propensity-score matched samples: Imputing potential time-to-event outcomes
Authors: Austin Peter C , Thomas Neal , Rubin Donald B
Published: December 2018

Matching on an estimated propensity score is frequently used to estimate the effects of treatments from observational data. Since the 1970s, different authors have proposed methods to combine matching at the design stage with regression adjustment at the analysis stage when estimating treatment effects for continuous outcomes. Previous work has consistently shown that the combination has generally superior statistical properties than either method by itself. In biomedical and epidemiological research, survival or time-to-event outcomes are common. We propose a method to combine regression adjustment and propensity score matching to estimate survival curves and hazard ratios based on estimating an imputed potential outcome under control for each successfully matched treated subject, which is accomplished using either an accelerated failure time parametric survival model or a Cox proportional hazard model that is fit to the matched control subjects. That is, a fitted model is then applied to the matched treated subjects to allow simulation of the missing potential outcome under control for each treated subject. Conventional survival analyses (e.g., estimation of survival curves and hazard ratios) can then be conducted using the observed outcome under treatment and the imputed outcome under control. We evaluated the repeated-sampling bias of the proposed methods using simulations. When using nearest neighbor matching, the proposed method resulted in decreased bias compared to crude analyses in the matched sample. We illustrate the method in an example prescribing beta-blockers at hospital discharge to patients hospitalized with heart failure.
Ancient human bones studied and compared by near infrared spectroscopy, thermogravimetry and chemometrics
Authors: Biancolillo Alessandra , Tomassetti Mauro , Bucci Remo , Izzo Simona , Candilio Francesca , Marini Federico
Published: December 2018

Near infrared spectroscopy and thermogravimetry have been coupled with chemometric exploratory methods in order to investigate ancient (pre-Roman/Roman) human bones from two different necropolises in Central-South Italy (Cavo degli Zucchi and Elea Velia). These findings have been investigated by principal component analysis and they have also been compared with ancient human bones from two Sudanese necropolises (Saggai and Geili). Samples coming from African and European necropolises, mainly differ in two aspects: the burial procedures and their historical period. The ritual applied in the European region involved cremation, while the one applied in the African necropolises did not. Bones from Italian sites (Cavo degli Zucchi and Elea Velia) are Pre-Roman/Roman while the others (from middle Nile) come from the Prehistoric, Meroitic, and Christian Sudanese age. Near infrared spectroscopy and thermogravimetric measures have been analysed either individually or by a mid-level data-fusion approach. Principal component analysis of the near infrared spectroscopy data allowed differentiation between burnt and unburnt samples, while from the scores plots extracted from the principal component analysis model based on the entire derived thermograms, it was possible to recognize the different clusters related to the various dating of samples. The data-fusion analysis led to considerations similar to those obtained from the model based on thermogravimetry data. Finally, instead of inspecting the entire thermogravimetry curves, principal component analysis was carried out on carbonates, total collagen and water losses only. In this case, the data-fusion approach has led to extremely interesting results; in fact, this model clearly shows that samples group in separate clusters in agreement with their age and the different burial rituals.
Entrepreneurial Orientations and Performance: A Problematic Explanatory Approach in the Iranian Knowledge-Based Industry
Authors: Cannavale Chiara , Nadali Iman Zohoorian
Published: December 2018

This study aims to thoroughly investigate how the different dimensions of entrepreneurial orientation (EO) influence firm performance in the Iranian knowledge-based industry. An empirical analysis of data from 155 Iranian knowledge-based firms was performed by employing the PLS method of structural equation modelling. Findings show that there is semantic redundancy among the different dimensions of EO. Specifically, just two of the five dimensions, proactiveness and risk-taking, could account for all the effects of EO on firm performance in the context of the Iranian knowledge-based industry. In addition, moderation, spuriousness, suppression of industrial contingencies and control variables were not at play. From a theoretical point of view, our work confirms that scholars should avoid considering EO as a holistic gestalt in different contexts. It also highlights that proactiveness and risk-taking are the orientations with the strongest effects on performance in Iranian knowledge-based firms. From an empirical point of view, our study sheds light on the importance of these two specific EO dimensions in the selection of human resources and in the development of policies aimed at fostering sustainability of knowledge-based firms. In addition, it represents a contribution to understanding how EO dimensions work in emerging countries, characterised by social and economic systems different from those of the Western world.
Incorporating Continuity in a 7-On 7-Off Hospitalist Model and the Correlation With Patient Handoffs and Length of Stay
Authors: O’Donnell Christopher M. , Stern Marsha , Leong Traci , Molitch-Hou Ethan , Mitchell Bruce
Published: December 2018

Little research in hospital medicine examines the effects of hospitalist continuity on patient outcomes. This study implemented a novel staffing model with approximately half of rounding teams starting their 7-day workweek on Monday and the others on Friday. Teams admitted their own patients on their first 4 days with additional nighttime admissions handed off to those teams. No admissions were given to teams on their last 3 days. Length of stay was significantly reduced from 6.34 days in 2015 to 5.7 days in 2016 ( P < .002) with a significant decrease in handoffs. There was an increase in odds ratio of death (1.37, SE = .128) with each additional hospitalist involved in a patient’s care while adjusting for year and number of patient diagnoses ( P < .001). There was no statistical difference in charges, 30-day readmissions, or mortality between years.
Disruption in PR Education: Online Master’s Degree Programs in Public Relations and Strategic Communication
Authors: Weissman Paula L. , Puglisi Gemma , Bernardini Dario , Graf Joseph
Published: December 2018

This study describes the characteristics of fully online public relations and strategic communication master’s programs offered by regionally accredited nonprofit and public universities in the United States. A website analysis of 53 programs reveals the types of institutions and academic units offering these programs, degrees offered, program names, and basic program requirements. In-depth interviews with 27 program directors provides further insight into the types of students served, overall focus of program curricula, distinguishing program features, and successes and challenges. Despite growth in online education, this appears to be the first study of online master’s programs in public relations and strategic communication.
The Effectiveness of a Packaged Intervention Including Point-of-View Video Modeling in Teaching Social Initiation Skills to Children With Autism Spectrum Disorders
Authors: Kouo Jennifer Lee
Published: December 2018

Deficits in social communication and interaction have been identified as distinguishing impairments for individuals with an autism spectrum disorder (ASD). As a pivotal skill, the successful development of social communication and interaction in individuals with ASD is a lifelong objective. Point-of-view video modeling (VM) has the potential to address these deficits. By presenting only what a person might see from his or her viewpoint, it may be more effective than other forms of VM, in limiting irrelevant stimuli and providing a clear frame of reference to facilitate imitation. The current study investigated the use of point-of-view VM in teaching social initiations (e.g., greetings). Using a multiple baseline across participants design, five kindergarten participants were taught greetings using a packaged intervention, which included point-of-view VM, video priming, verbal praise, reinforcement, and prompting. Immediately before and after viewing the entire point-of-view video model, the participants were evaluated on their greetings with a trained, typically developing peer serving as a communication partner. Specifically, the greetings involved participants’ abilities to shift their attention toward the peer who entered the room, maintain attention toward the peer, and engage in an appropriate greeting (e.g., hi, hello). Both generalization and maintenance were tested. Overall, the data suggest point-of-view VM is a promising intervention for increasing greetings. However, both generalization and maintenance were limited. Despite the limitations of the study and variable results, there are a number of implications moving forward for both practitioners and future researchers examining point-of-view modeling.
Biodegradable Stents in Resistant Peptic Oesophageal Stricture: Is It the Right Way to Go?
Authors: Richardson Tom , Naidoo Gerlin , Rupasinghe Namal , Smart Howard , Bhattacharya Sayantan
Published: December 2018

Peptic oesophageal stricture can be considered as the end result of prolonged gastro-oesophageal reflux. The ‘gold standard’ treatment for peptic stricture is endoscopic dilatation with balloon or bougie. It is predicted that up to 40% of patients remain symptomatic with dysphagia due to refractory (resistant to treatment) or recurrent strictures, needing frequent interventions at short intervals. Such patients have poor nutritional status due to the primary disease and are susceptible to complications related to repeated endoscopic dilatation such as bleeding and perforation. This general review aims to analyse existing published evidence and address the role of biodegradable stents in resistant peptic strictures as an alternative treatment to provide long-term dysphagia-free intervals.
Viscosity behaviour and thermal conductivity prediction of CuO-blend oil based nano-blended lubricant
Authors: Katpatal Dhananjay C , Andhare Atul B , Padole Pramod M
Published: December 2018

Lubricants play a major role in mechanical machines and studies on various nanolubricants are reported in the literature. This work deals with nanolubricants using blend of oils as base for nanolubricants. Nano-blended lubricants were prepared with a blend of ISO VG46 oil (mineral oil) and Jatropha oil (non-edible vegetable oil) and using them in proportions of 90:10 and 80:20 by dispersing 0.5–3 wt.% of surface-modified CuO nanoparticles by a two-step method. Various properties of these oils such as dispersion stability, viscosity and thermal conductivity were determined. Experimental values of viscosity were compared with the values predicted by using different viscosity models. Nano-blended lubricant 9010 was found more sensitive at lower concentration of nanoparticles compared to nano-blended lubricant 8020. It is observed that nano-blended lubricant 9010 with 1.5 wt.% CuO is more suitable for use in place of ISO VG46 oil compared to nano-blended lubricant 8020. Thermal conductivity values of all types of nano-blended lubricants have been found by thermal conductivity model to be approximately matching with the measured values.
From state-centric to transversal borders: Resisting the ‘structurally embedded border’ in Australia
Authors: Weber Leanne
Published: December 2018

In this article, I present new research that extends our understanding of the ‘structurally embedded border’ by identifying acts of resistance to restrictive federal policies perpetrated by providers of health and education services for asylum seekers in Australia. Situating the analysis within the theorization of borders, rather than the politics of resistance, reveals that opportunities for resistance are inherent within borders themselves, and arise from their performative and contested nature. Efforts to ‘fill gaps’ in service provision undermine federal policies aimed at attrition; while avoiding incorporation into networks of information exchange thwarts the expansion of the federal surveillance apparatus. While the transformative impact of these efforts appears to be dwarfed by the massive in/exclusionary powers of the federal state, these multiple acts of resistance create transversal borders of their own that in small, often temporary, and yet significant, ways begin to redraw the boundaries of inclusion from within.
Prediction of spray collapse in multi-hole gasoline direct-injection fuel injectors
Authors: Rachakonda Sampath K , Paydarfar Arman , Schmidt David P
Published: December 2018

A parametric study was conducted to predict the conditions leading to spray collapse in multi-hole gasoline direct-injection fuel injectors using computational fluid dynamics simulations. The computational fluid dynamics simulations were performed using an in-house multi-dimensional code that accounts for thermal non-equilibrium and entrainment of the non-condensable gas and coupled with primary atomization. The simulations were performed for a fixed injection pressure and fuel temperature on nine different six-hole injectors. The parameters were varied to include the effects of the ratio of the ambient pressure to the saturation pressure (Pa/Ps), the drill angle, and the diameters of the nozzle and the counter bore, respectively, on the spray. The findings indicate that spray collapse results from a combination of the nozzle geometry, the thermodynamic conditions of the fuel, and the ambient pressure. Spray collapse was observed in injectors with a narrow arrangement of the nozzle holes under extreme flash-boiling conditions with very low ambient pressures and in the case of non-flash-boiling conditions with very high ambient pressures.
Air Embolism During TEVAR: Liquid Perfluorocarbon Absorbs Carbon Dioxide in a Combined Flushing Technique and Decreases the Amount of Gas Released From Thoracic Stent-Grafts During Deployment in an Experimental Setting
Authors: Rohlffs Fiona , Trepte Constantin , Ivancev Krassi , Tsilimparis Nikolaos , Makaloski Vladimir , Debus E. Sebastian , Kölbel Tilo
Published: December 2018

Purpose:To investigate the influence of flushing thoracic stent-grafts with carbon dioxide and perfluorocarbon on the amount of gas released during stent-graft deployment in thoracic endovascular aortic repair (TEVAR). Materials and Methods: Ten TX2 ProForm thoracic stent-grafts were deployed into a water-filled container with a curved plastic pipe and flushed sequentially with carbon dioxide, 20 mL of liquid perfluorocarbon (PFC), and 60 mL of saline. Released gas was measured using a calibrated setup. The volume of released gas was compared with the results of an earlier published reference group, in which identical stent-grafts were flushed with 60 mL saline alone as recommended in the instructions for use. Results: The average amount of gas released in the test group was 0.076 mL, significantly lower (p<0.001) than the mean 0.79 mL of gas released in the reference group. Big bubbles appearing at the tip of the sheath when deployment was started were seen in all grafts of the reference group but in only 2 of the test group stent-grafts. Small bubbles were less frequent in the test group. Conclusion: The amount of gas released from thoracic stent-grafts during deployment can be influenced by different flushing techniques. The use of PFC in addition to the carbon dioxide flushing technique reduces the volume of gas released during deployment of tubular thoracic stent-grafts to a few microliters. This significant effect is presumably based on the high solubility of carbon dioxide in perfluorocarbon and could be a potential future approach to lower the risk of cerebral injury and stroke from air embolism during TEVAR.
Assessment of Technology Use and Technology Preferences for HIV Prevention Among Hispanic Women
Authors: Villegas Natalia , Cianelli Rosina , de Tantillo Lila , Warheit Melanie , Montano Nilda Peragallo , Ferrer Lilian , Patel Shefali
Published: December 2018

Introduction:

HIV transmission presents an ongoing risk to Hispanic women, and prevention efforts remain a priority. The use of technology to prevent HIV transmission among Hispanic women and those of lower socioeconomic status underscore the need for effective implementation of technology. The purpose of this study is to describe technology preferences and predictors of the use of the internet for HIV prevention among low-income Hispanic women.

Method:

A secondary analysis was conducted using baseline data from an intervention to prevent HIV among 320 Hispanic women. The parent study was SEPA, Salud (health), Educación (education), Promoción (promotion), y [and] Autocuidado (self-care).

Results:

Most participants reported using personal technology, such as smartphones (90.6%), the internet (78.1%), and personal email (67.5%), every day. Most (71.3%) participants were open to learning about HIV education via the internet. In the logistic regression analysis, education and time since the last visit to the health care provider were significant predictors of the use of the internet to learn about HIV prevention, after controlling for age, living with the partner, and years living in the United States.

Conclusion:

Hispanic women demonstrated high levels of comfort with different forms of technology. These results indicated the potential to expand future HIV intervention efforts by implementing electronic dissemination of bilingual and culturally appropriate information for Hispanic women of diverse ages.
Increasing Awareness of the All of Us Research Program in Latino Communities
Authors: Cuellar Norma G. , Aquino Elizabeth , Barreto Sara Cruet , Grau Grace , Gularte-Rinaldo Jeneva , Martinez Gail , Vital Veronica
Published: December 2018

Introduction:

The All of Us Research Program is funded by the National Institutes of Health. The aim of the program is to gather data from at least 1 million people of diverse backgrounds living in the United States to accelerate research and improve health. The purpose of this article is to discuss the collaboration of the All of Us Research Program and the National Association of Hispanic Nurses (NAHN) to increase awareness of the All of Us Research Program in Latino communities.

Method:

A community-based education approach by NAHN chapters across the country was used. The Sprint 1 grant was funded to increase awareness in health care providers of Latino communities. The Sprint 2 grant was funded to increase awareness in Latino communities.

Results:

A total of 8 NAHN chapters were selected to disseminate the All of Us Research Program information. These initiatives reached more than 156,000 health care providers and the chapters participated in 31 community-based activities across the country reaching thousands of Latinos.

Discussion:

The collaboration between the All of Us Research Program and NAHN was instrumental in disseminating information to the Latino population. Developing trust in Latino communities is an essential component of program success.
C2H2-Type Zinc Finger Proteins: Evolutionarily Old and New Partners of the Nuclear Hormone Receptors
Authors: Mackeh Rafah , Marr Alexandra K. , Fadda Abeer , Kino Tomoshige
Published: December 2018

Nuclear hormone receptors (NRs) are evolutionarily conserved ligand-dependent transcription factors. They are essential for human life, mediating the actions of lipophilic molecules, such as steroid hormones and metabolites of fatty acid, cholesterol, and external toxic compounds. The C2H2-type zinc finger proteins (ZNFs) form the largest family of the transcription factors in humans and are characterized by multiple, tandemly arranged zinc fingers. Many of the C2H2-type ZNFs are conserved throughout evolution, suggesting their involvement in preserved biological activities, such as general transcriptional regulation and development/differentiation of organs/tissues observed in the early embryonic phase. However, some C2H2-type ZNFs, such as those with the Krüppel-associated box (KRAB) domain, appeared relatively late in evolution and have significantly increased family members in mammals including humans, possibly modulating their complicated transcriptional network and/or supporting the morphological development/functions specific to them. Such evolutional characteristics of the C2H2-type ZNFs indicate that these molecules influence the NR functions conserved through evolution, whereas some also adjust them to meet with specific needs of higher organisms. We review the interaction between NRs and C2H2-type ZNFs by focusing on some of the latter molecules.
Public interest in the neo-liberal order: The role of the EU austerity model in the morphing of the Portuguese media landscape
Authors: Figueiras Rita
Published: December 2018

In this article, I examine the role of the EU austerity model in the morphing of the Portuguese media landscape by analyzing it in relation to the growing dependency of the Portuguese democracy on external resources and to the associated issues concerning public interest and capital interests. Portugal’s case illustrates well the conflict between capitalism and democracy in the neo-liberal era. It demonstrates how governments no longer have the degree of control they once had over their own state due not only to the presence of supranational institutions, but also to their dependence on investors – which has led to the increasing political power of large corporations over national governments and over national public interest. In this process, the state plays an active role in promoting the free play of market forces through public policy. Against this backdrop, one may also suggest that the news media might no longer be an adequate agent of public interest under the neo-liberal order.
The Net Promoter Scores with Friends and Family Test after four hand surgery procedures
Authors: Stirling Paul , Jenkins Paul J. , Clement Nicholas D. , Duckworth Andrew D. , McEachan Jane E.
Published: December 2018

The Friends and Family Test, a variant of the Net Promoter Score, was adapted for the National Health Service to evaluate overall patient satisfaction and how likely patients are to recommend an intervention. It ranges from −100 to 100. Positive scores indicate good performance. This study quantifies the scores in 810 patients at a mean of 14 months following four common procedures. The score was 83 for trigger finger release ( n = 103), 68 for carpal tunnel decompression ( n = 467), 62 for surgery for Dupuytren’s disease ( n = 224) and 44 for ganglia excision ( n = 16). Our study indicates that these procedures are highly valued and are recommended by patients according to the Friends and Family Test. The results of the Friends and Family Test correlated well with postoperative functional improvement and satisfaction. We conclude from this study that a compound score based on the Friends and Family Test is a useful addition to traditional measures of patient satisfaction.

Level of evidence: II
Quality of Cartilage Repair from Marrow Stimulation Correlates with Cell Number, Clonogenic, Chondrogenic, and Matrix Production Potential of Underlying Bone Marrow Stromal Cells in a Rabbit Model
Authors: Dwivedi Garima , Chevrier Anik , Alameh Mohamad-Gabriel , Hoemann Caroline D. , Buschmann Michael D.
Published: December 2018

Objective

Previous studies have shown that intrinsic behavior of subchondral bone marrow stem cells (BMSCs) is influenced by donors and locations. To understand the variability in cartilage repair outcomes following bone marrow stimulation, we tested the hypothesis that in vivo cartilage repair correlates with in vitro biological properties of BMSCs using a rabbit model.

Methods

Full-thickness cartilage defects were created in the trochlea and condyle in one knee of skeletally mature New Zealand White rabbits ( n = 8) followed by microdrilling. Three-week repair tissues were analyzed by macroscopic International Cartilage Repair Society (ICRS) scores, O’Driscoll histological scores, and Safranin-O (Saf-O) and type-II collagen (Coll-II) % stain. BMSCs isolated from contralateral knees were assessed for cell yield, surface marker expression, CFU-f, %Saf-O, and %Coll-II in pellet culture followed by correlation analyses with the above cartilage repair responses.

Results

In vivo cartilage repair scores showed strong, positive correlation with cell number, clonogenic, chondrogenic, and matrix production (Coll-II, GAG) potential of in vitro TGF-βIII stimulated BMSC cultures. Trochlear repair showed clear evidence of donor dependency and strong correlation was observed for interdonor variation in repair and the above in vitro properties of trochlear BMSCs. Correlation analyses indicated that donor- and location-dependent variability observed in cartilage repair can be attributed to variation in the properties of BMSCs in underlying subchondral bone.

Conclusion

Variation in cell number, clonogenic, chondrogenic, and matrix production potential of BMSCs correlated with repair response observed in vivo and appear to be responsible for interanimal variability as well as location-dependent repair.
Targeting elevated left ventricular end-diastolic pressure following primary percutaneous coronary intervention for ST-segment elevation myocardial infarction – a phase one safety and feasibility study
Authors: Khan Arshad A , Davies Allan J , Whitehead Nicholas J , McGee Michael , Al-Omary Mohammed S , Baker David , Bhagwandeen Rohan , Renner Ian , Majeed Tazeen , Hatton Rachael , Collins Nicholas J , Attia John , Boyle Andrew J
Published: December 2018

Introduction:

Elevated left ventricular end diastolic pressure (LVEDP) is an independent predictor of mortality and heart failure in patients with ST-segment elevation myocardial infarction (STEMI). Whether lowering elevated LVEDP improves outcomes remains unknown.

Methods:

This non-randomized, single blinded study with prospective enrolment and sequential group allocation recruited patients undergoing primary percutaneous coronary intervention for STEMI with LVEDP ⩾ 20 mmHg measured immediately after primary percutaneous coronary intervention. The intervention arm (n=10) received furosemide 40 mg intravenous bolus plus escalating doses of glyceryl trinitrate (100 µg per min to a maximum of 1000 µg) during simultaneous measurement of LVEDP. The control group (n=10) received corresponding normal saline boluses with simultaneous measurement of LVEDP (10 readings over 10 min). Efficacy endpoints were final LVEDP achieved, and the dose of glyceryl trinitrate needed to reduce LVEDP by ⩾ 20%. Safety endpoint was symptomatic hypotension (systolic blood pressure < 90 mmHg).

Results:

From 1 April 2017 to 23 August 2017 we enrolled 20 patients (age: 64±9 years, males: 60%, n=12, anterior STEMI: 65%, n=13). The mean LVEDP for the whole cohort (n=20) was 29±4 mmHg (intervention group: 28±3 mmHg vs. control group: 31±5 mmHg; p=0.1). The LVEDP dropped from 28±3 to 16±2 mmHg in the glyceryl trinitrate + furosemide group (p <0.01) but remained unchanged in the control group. The median dose of glyceryl trinitrate required to produce ⩾ 20% reduction in LVEDP in the intervention group was 200 µg (range: 100–800). One patient experienced asymptomatic decline in systolic blood pressure to below 90 mmHg. There was no correlation between LVEDP and left ventricular ejection fraction.

Conclusion:

The administration of glyceryl trinitrate plus furosemide in patients with elevated LVEDP following primary percutaneous coronary intervention for STEMI safely reduces LVEDP.
Health Savings Accounts: Consumer Contribution Strategies and Policy Implications
Authors: Lowsky David J. , Lee Donald K. K. , Zenios Stefanos A.
Published: December 2018

Background. Health savings accounts (HSAs) are tax-advantaged savings accounts available only to households with high-deductible health insurance. This article provides initial answers to two questions: 1) How should a household budget for its annual HSA contributions? 2) Do current contribution limits provide households with the flexibility to use HSAs efficiently? To answer these questions, we formulate the household’s problem as one of determining a contribution strategy for minimizing total expected discounted medical costs. Methods. We use the 2002–2014 Medical Expenditure Panel Survey to develop a novel data-driven model for forecasting a household’s health care costs based on its current cost percentile and other characteristics. A dynamic policy, in which the contribution each year brings the HSA balance up to a household-specific threshold, is derived. This is compared to a simpler static policy in which the target HSA balance is simply the plan’s out-of-pocket maximum, with contributions in any year capped by a limit. Results. We find that: 1) the dynamic policy can save a household up to 19% in costs compared to the static one that is a proxy for typical contribution behavior; and 2) the recommended contribution amounts for 9% to 11% of households in a given year materially exceed what is currently allowed by the federal government. Conclusions. The dynamic policy derived from our data-analytic framework is able to unlock significant tax savings for health care consumers. To allow all households to use HSAs in a tax-efficient manner, a two-tiered contribution policy is needed: Allow unlimited contributions up to some balance, and then impose restrictions thereafter. The resulting impact on overall tax receipts is estimated to be well below what is currently allowed by legislation.
Promoting Protective Factors in Environments of Risk for Young Children: An Organizing Framework for Practice, Policy, and Research
Authors: Fallon Barbara , Filippelli Joanne , Joh-Carnella Nicolette , Milne Elizabeth , Carradine Jessica
Published: December 2018

Early childhood is an important developmental period, which lays the foundation for future learning, behaviour, physical and mental health and gene expression. The most vulnerable children in society are often referred to and receive services from the child welfare system because of a concern of abuse and neglect and/or a poor developmental trajectory. This paper presents an organizing framework for how the child welfare system, in concert with allied partners, can support interventions for young children and families by acknowledging its crucial role in improving their development and well-being. The framework is informed by research amassed from numerous disciplines, including child welfare, development, neuroscience, neurobiology and epigenetics. Although the notions of protection and well-being are central considerations in child welfare legislation in Ontario, Canada, the operationalization of wellbeing has proven challenging in child welfare practice, policy and research. The framework proposes ten key indicators and priorities for identifying and promoting optimal child development. Findings from the 2013 cycle of the Ontario Incidence Study of Reported Child Abuse and Neglect (OIS-2013), the only provincial source of aggregated child welfare investigation data, are presented to articulate the divide between the environmental context of a population of at-risk children and the conditions that both protect children and increase the likelihood that they will thrive in adulthood. This paper argues there are different points of entry and intervention across sectors and provides a foundation for further discussion on how to promote well-being for society's most vulnerable children.
Gender Differences in Associations Between Stress and Cardiovascular Risk Factors and Outcomes
Authors: L. Taylor Jasmine , Makarem Nour , Shimbo Daichi , Aggarwal Brooke
Published: December 2018

Psychological stress, a subjective perception of an adverse environmental change, is a hallmark of modern society. Although psychological stress has previously been established as a risk factor for cardiovascular disease (CVD), it is unclear whether stress influences cardiovascular risk differently in men versus women. Gender disparities exist in the prevalence of stress as well as in the prevalence and prognosis of CVD; therefore, associations between stress and CVD risk and mortality may vary by sex. The purpose of this review was to summarize the evidence from recent and landmark studies on gender differences in the associations of stress with CVD risk factors and end points and to highlight clinical and public health implications as well as future research directions in this field. Taken together, research to date indicates that while stress is associated with poorer cardiovascular health metrics in both men and women, the influence of stress on measures of glucose regulation and dyslipidemia and on overall CVD risk may be stronger among women. However, men may be more susceptible to the influence of stress on body adiposity, blood pressure, and CVD mortality. In terms of behavioral risk factors for CVD, associations between stress and diet quantity and quality appear to be stronger among women, but the influence of stress on sedentary behaviors and sleep may be stronger among men. Given that gender disparities exist in the prevalence of overall and different types of stress (eg, financial stress, caregiving stress, and occupational stress), future studies should decipher the potential differential associations between types of stress and cardiovascular risk among men and women to identify vulnerable populations and develop targeted interventions.
The failure of radical treatments to cure cancer: can less deliver more?
Authors: Dalgleish Angus G. , Stern Peter L.
Published: December 2018

All too often attempts to deliver improved cancer cure rates by increasing the dose of a particular treatment are not successful enough to justify the accompanying increase in toxicity and reduction in quality of life suffered by a significant number of patients. In part, this drive for using higher levels of treatment derives from the nature of the process for testing and incorporation of new protocols. Indeed, new treatment regimens must now consider the key role of immunity in cancer control, a component that has been largely ignored until very recently. The recognition that some drugs developed for cytotoxicity at higher doses can display alternative anticancer activities at lower doses including through modulation of immune responses is prompting a significant re-evaluation of treatment protocol development. Given that tumours are remarkably heterogeneous and with inherent genetic instability it is probably only the adaptive immune response with its flexibility and extensive repertoire that can rise to the challenge of effecting significant control and ultimately elimination of a patient’s cancer. This article discusses some of the elements that have limited higher levels of treatment outcomes and where too much proved less effective. We explore observations that less can often be as effective, if not more effective especially with some chemotherapy regimens, and discuss how this can be exploited in combination with immunotherapies to deliver nontoxic improved tumour responses.
The Effect of Pharmacy-Led, Small-Group Academic Detailing on Prescribing Patterns in an Ambulatory Care Clinic
Authors: Awad Magdi H. , Ulbrich Timothy R. , Furdich Kenneth M. , Schneider Stacy R. , Gothard M. David
Published: December 2018

Background: While academic detailing seems to be the most promising intervention to improve prescribing patterns, implementation could be challenging for small community practices. Objective: A pharmacy-led, interactive, and tailored small-group academic detailing in a federally qualified health center is described. The primary objective of the study was to determine if the small-group academic detailing improved the prescribing patterns of the medical providers for select disease states: type 2 diabetes mellitus (T2DM), hyperlipidemia (HLD), and essential hypertension (HTN). Methods: Prescribing patterns in a federally qualified health center were examined in relation to small-group academic detailing sessions from April 2010 to March 2015. The markers for improvement were the increase in utilizing metformin and statins in patients diagnosed with T2DM and HLD, respectively, and the reduction of β-blocker use in patients diagnosed with essential HTN. Changes in prescribing patterns were evaluated using Pearson’s χ2 and Fisher’s exact tests. Results: The average number of active, adult patients with T2DM, HLD, and essential HTN was 839, 1768, and 2547, respectively. Utilization of metformin in T2DM increased from 5.5% at baseline to 37.7%, statin utilization in HLD increased from 77.1% to 86.9%, and β-blocker use in HTN decreased from 17.9% to 13.8% ( P < .005). Conclusions: A pharmacy-led, small-group academic detailing program improved and maintained appropriate prescribing patterns in an underserved community practice. This study serves as a successful pilot emphasizing the pharmacist’s role as an educator and a resource to medical providers regarding appropriate medication use.
Safety and efficacy of an oncolytic viral strategy using bortezomib with ICE/R in relapsed/refractory HIV-positive lymphomas
Authors: Reid Erin G. , Looney David , Maldarelli Frank , Noy Ariela , Henry David , Aboulafia David , Ramos Juan Carlos , Sparano Joseph , Ambinder Richard F. , Lee Jeannette , Cesarman Ethel , Yahyaei Sara , Mitsuyasu Ronald , Wachsman William
Published: December 2018

HIV-associated lymphomas (HALs) have high rates of latent infection by gammaherpesviruses (GHVs). We hypothesized that proteasome inhibition would induce lytic activation of GHVs and inhibit HIV infectivity via preservation of cytidine deaminase APOBEC3G, improving lymphoma control. We tested this oncolytic and antiviral strategy by using bortezomib combined with ifosfamide, carboplatin, and etoposide (ICE) alone or with rituximab (ICE/R) in relapsed/refractory HAL. A 3+3 dose-escalation design was used with a 7-day lead-in period of single-agent bortezomib. Bortezomib was administered intravenously on days 1 and 8 of each cycle at 1 of 4 dose levels: 0.7, 1.0, 1.3, or 1.5 mg/m2. ICE began day 8 of cycle 1 and day 1 of subsequent cycles. Rituximab was included on day 1 of cycles 2 to 6 for CD20+ lymphomas. Twenty-three patients were enrolled. The maximum tolerated dose of bortezomib was not reached. Grade 4 toxicities attributable to bortezomib were limited to myelosuppression. Responses occurred in 17 (77%) of 22 patients receiving any protocol therapy. The 1-year overall survival was 57%. After bortezomib alone, both patients with Kaposi sarcoma herpesvirus (KSHV)–positive lymphoma had more than a 1-log increase in KSHV viral load. In 12 patients with Epstein-Barr virus (EBV)–positive lymphoma, median values of EBV viral load increased. Undetectable HIV viremia at baseline in the majority of patients limited evaluation of HIV inhibition. APOBEC3G levels increased in 75% of evaluable patients. Bortezomib combined with ICE/R in patients with relapsed/refractory HAL is feasible with response and survival comparing favorably against previously reported second-line therapies. Changes in GHV viral loads and APOBEC3G levels trended as hypothesized. This trial was registered at www.clinicaltrials.gov as #NCT00598169.
RETRACTED ARTICLE: Novel role of miR-133a-3p in repressing gastric cancer growth and metastasis via blocking autophagy-mediated glutaminolysis
Authors: Zhang Xing , Li Zheng , Xuan Zhe , Xu Penghui , Wang Weizhi , Chen Zheng , Wang Sen , Sun Guangli , Xu Jianghao , Xu Zekuan
Published: December 2018

Background

Autophagy plays a crucial role in sustaining the homeostasis in various malignant diseases. It has also been reported to promote tumor development in multiple cancers. Glutaminolysis instead of Warburg Effect produce adequate ATP and provide nitrogen and carbon to replenish the TCA cycle which has been discovered to be a new energy source for tumor cells recently. By means of degrading intracellular particles including amino acids, nucleotides, fatty acids, sugars and aged organisms, autophagy can recycle the aforementioned particles into bioenergetics and biosynthesis pathways, finally favoring tumor cells. MicroRNA is a kind of noncoding RNA that regulates the targeting gene expression mostly at post-transcription level. Among these miRNAs, microRNA-133a-3p is reported to be a tumor suppressor in numerous cancers.

Methods

We characterized the down-regulated expression level of microRNA-133a-3p in gastric cancer via TCGA database. Subsequently, we verified the tumor suppressor role of microRNA-133a-3p in gastric cancer cells through a series biological function assay. We used immunofluorescence and transmission electron microscope to observe the negative effect of microRNA-133a-3p on autophagy and used dual-luciferase report assay to identify the candidate gene GABARAPL1 of microRNA-133A-3p.Then we used high performance liquid phase mass spectrometry and seahorse analysis to detect whether miR-133a-3p could block the glutaminolysis metabolism through autophagy. At last, we confirmed the tumor suppressor role of microRNA-133a-3p in vivo on PDX mice model.

Results

We demonstrated that microRNA-133a-3p overexpression could block the activation of autophagy to ruin the abnormal glutaminolysis and further inhibit the growth and metastasis of gastric cancer cells. We successfully proved gastric cancer cells can replenish glutaminolysis via autophagy and microRNA-133a-3p could block aforementioned pathway by targeting core autophagy participants GABARAPL1 and ATG13.We then verified the negative function of microRNA-133a-3p on autophagy-mediated glutaminolysis both in PDX model and human gastric cancer organoid model.

Conclusions

MicroRNA-133a-3p targets GABARAPL1 to block autophagy-mediated glutaminolysis, further repressing gastric cancer growth and metastasis.
Ink marks, bronze crossbows and their implications for the Qin Terracotta Army
Authors: Bevan Andrew , Li Xiuzhen , Zhao Zhen , Huang Jianhua , Laidlaw Stuart , Xi Na , Xia Yin , Ma Shengtao , Martinon-Torres Marcos
Published: December 2018

At the heart of bureaucratic practice during Warring States and early Imperial China were regular, small acts of accountancy in which objects and people were marked so that their movements could be kept track of, their quality checked and their numbers marshalled. In the mausoleum complex of the Qin Shihuang (259-210 bc, the First Emperor of the Qin Dynasty), the longer texts and shorter inscribed marks found on the bronze weapons of the Terracotta Army are reasonably well known, and such information helps us to understand aspects of Qin craft organisation and logistics at this crucial period of Chinese state formation. This paper’s modest starting point is a study of two further, less well-known ink inscriptions found on crossbow triggers from Terracotta Army Pit 1. Using multispectral photography, digital microscopy and Raman analysis, we uncover evidence of further marks on the same two triggers that suggest a similar pattern of ‘matching’ marks as suggested by the incised evidence. We also identify the black substance used to make the marks as a soot-based ink. Spatial analysis of both the inked and incised trigger marks then provides wider context for how such marking practices amongst Qin bronze-workers may have operated.
Metabolic fuel use after feeding in the zebrafish (Danio rerio): a respirometric analysis
Authors: Ferreira Marcio S. , Wood Chris M. , Harter Till S. , Dal Pont Giorgi , Val Adalberto L. , Matthews Philip G. D.
Published: December 2018

We used respirometric theory and a new respirometry apparatus to assess for the first time the sequential oxidation of the major metabolic fuels during the post-prandial period (10 h) in adult zebrafish fed with commercial pellets (51% protein, 2.12% ration). Compared to a fasted group, fed fish presented peak increases of oxygen consumption (78%), carbon dioxide (80%) and nitrogen excretion rates (338%) at 7-8 h, and rates remained elevated at 10h. Respiratory quotient increased slightly (0.89 to 0.97) whereas nitrogen quotient increased greatly (0.072 to 0.140), representing peak amino acid/protein usage (52%) at this time. After 48-h fasting, endogenous carbohydrate and lipid were the major fuels, but in the first few hours after feeding, carbohydrate oxidation increased greatly, fueling the first part of the post-prandial specific dynamic action (SDA), whereas increased protein/amino acid usage predominated from 6 h onwards. Excess dietary protein/amino acids were preferentially metabolized for energy production.
The effect of Hydrodistension in combination with Pentosan Polysulfate on treatment outcomes and compliance in the treatment of bladder pain syndrome
Authors: Şimşir Adnan , Kızılay Fuat , Özyurt Ceyhun
Published: December 2018

Objective: In the present study, we investigated the efficacy of bladder hydrodistension combined with pentosan polysulfate (PPS) treatment in interstitial cystitis (IC)/bladder pain syndrome (BPS).

Methods: In this study, 339 patients diagnosed with IC/BPS were categorized into two groups. The first group only received 300 mg/day PPS, while the second group received 300 mg/day PPS following bladder hydrodistension. The results were evaluated at the 3rd, 6th, and 12th months after the first dose using the interstitial cystitis symptom index (ICSI), international cystitis problem index (ICPI), visual analog scale (VAS), and female sexual function index (FSFI).

Results: PPS treatment started just after hydrodistension was significantly more effective than PPS treatment alone and combined treatment significantly reduced the rate of non-compliance such that, at the end of the 3rd month, 12.1% patients in Group-1 did not continue their treatment whereas only 1.9% of patients in Group-2 did not continue.

Conclusions: The study results indicate that PPS treatment started just after hydrodistension yields significantly better results in terms of both symptom improvement and treatment compliance in patients with IC/BPS.

How to cite this:Simsir A, Kizilay F, Ozyurt C. The effect of Hydrodistension in combination with Pentosan Polysulfate on treatment outcomes and compliance in the treatment of bladder pain syndrome. Pak J Med Sci. 2019;35(1):189-194. doi: https://doi.org/10.12669/pjms.35.1.172

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