bluuebunny/crossref_metadata_2025 huggingface dataset:
Di(2-ethylhexyl)phthalate induces reproductive toxicity via JAZF1/TR4 pathway and oxidative stress in pubertal male rats
Authors: Shi Yu-Qin , Fu Guo-Qing , Zhao Jing , Cheng Shen-Zhou , Li You , Yi Ling-Na , Li Zhen , Zhang Ling , Zhang Zhi-Bing , Dai Juan , Zhang Da-Yi
Published: February 2019

Di(2-ethylhexyl)phthalate (DEHP) is a typical endocrine-disrupting chemical and reproductive toxicant. Although previous studies have attempted to describe the mechanism by which DEHP exposure results in reproductive dysfunction, few studies focused on puberty, a critical period of reproductive development, and the increased susceptibility to injury in adolescents. To elucidate the mechanism underpinning the testicular effects of DEHP in puberty, we sought to investigate the JAZF1/TR4 pathway in the testes of pubertal rats. Specifically, we focused on the role of the JAZF1/TR4 pathway in male reproduction, including the genes JAZF1, TR4, Sperm 1, and Cyclin A1. In the present study, rats were exposed to increasing concentrations of DEHP (0, 250, 500, and 1000 mg/kg/day) by oral gavages for 30 days. Then we assayed testicular zinc and oxidative stress levels. Our results indicated that DEHP exposure could lead to oxidative stress and decrease the contents of testicular zinc. Additionally, significant morphological changes and cell apoptosis were observed in testes exposed to DEHP, as identified by hematoxylin and eosin staining and the terminal deoxynucleotidyl transferase-mediated nick and labeling assay. By measuring the expression levels of the above relevant genes by qPCR, we found the DEHP-induced increased expression of JAZF1 and decreased expression of TR4, Sperm 1, and Cyclin A1. Therefore, we have demonstrated that in vivo exposure to DEHP might induce reproductive toxicity in pubertal male rats through the JAZF1/TR4 pathway and oxidative stress.
CikA Modulates the Effect of KaiA on the Period of the Circadian Oscillation in KaiC Phosphorylation
Authors: Kaur Manpreet , Ng Amy , Kim Pyonghwa , Diekman Casey , Kim Yong-Ick
Published: February 2019

Cyanobacteria contain a circadian oscillator that can be reconstituted in vitro. In the reconstituted circadian oscillator, the phosphorylation state of KaiC oscillates with a circadian period, spending about 12 h in the phosphorylation phase and another 12 h in the dephosphorylation phase. Although some entrainment studies have been performed using the reconstituted oscillator, they were insufficient to fully explain entrainment mechanisms of the cyanobacterial circadian clock due to the lack of input pathway components in the in vitro oscillator reaction mixture. Here, we investigate how an input pathway component, CikA, affects the phosphorylation state of KaiC in vitro. In general, CikA affects the amplitude and period of the circadian oscillation of KaiC phosphorylation by competing with KaiA for the same binding site on KaiB. In the presence of CikA, KaiC switches from its dephosphorylation phase to its phosphorylation phase prematurely, due to an early release of KaiA from KaiB as a result of competitive binding between CikA and KaiA. This causes hyperphosphorylation of KaiC and lowers the amplitude of the circadian oscillation. The period of the KaiC phosphorylation oscillation is shortened by adding increased amounts of CikA. A constant period can be maintained as CikA is increased by proportionally decreasing the amount of KaiA. Our findings give insight into how to reconstitute the cyanobacterial circadian clock in vitro by the addition of an input pathway component, and explain how this affects circadian oscillations by directly interacting with the oscillator components.
The Use of Palliative Sedation to Treat Existential Suffering: A Scoping Review on Practices, Ethical Considerations, and Guidelines
Authors: Ciancio Allysa L. , Mirza Raza M. , Ciancio Amy A. , Klinger Christopher A.
Published: February 2019

Context:

Though palliative sedation has been recognized as an acceptable practice in Canada for many years now, there is a lack of clinical research and guidelines pertaining to its use as a treatment of existential refractory symptoms in the terminally ill.

Objectives:

This scoping review aimed to survey the literature surrounding palliative sedation and existential suffering and to inform research, policy, and practice.

Methods:

To address the main research question: Is palliative sedation an acceptable intervention to treat existential refractory symptoms in adults aged 65 and older? a scoping review following Arksey and O’Malley’s framework was performed, spanning electronic databases of the peer reviewed and grey literature. Articles were screened for inclusion, and a thematic content analysis allowed for a summary of key findings.

Results:

Out of 427 search results, 71 full text articles were obtained, 20 of which were included. Out of these articles, four themes were identified as key findings. These included: (1) Ethical considerations; (2) The role of the health care provider; looking specifically at the impact on nurses; (3) The need for multidisciplinary care teams; and (4) Existential suffering’s connection to religiosity and spirituality.

Conclusion:

Palliative sedation to treat existential refractory symptoms was labelled a controversial practice. A shortage of evidence-based resources limits the current literature’s ability to inform policy and clinical practice. There is a need for both qualitative and quantitative multi-center research so health care professionals and regional-level institutions have firm roots to establish proper policy and practice.
Comparing Single-Photon Emission Computed Tomography (SPECT), Electroencephalography (EEG), and Magneto-encephalography (MEG) Seizure Localizations in Pediatric Cases of Laser Ablation
Authors: Sachdev Harikrishan S. , Patel Bhairav , McManis Mark , Lee Mark , Clarke Dave F.
Published: February 2019

Intractable epilepsy may have a more severe effect on children in comparison to adults because the motor, sensorial, and cognitive functions of children are still undergoing development. For this same reason, however, children maintain a greater potential for recovery from intractable epilepsy because of the remaining cerebral plasticity. Thus, after 2 unsuccessful antiepileptic medications, surgical intervention is recommended. Pre-surgical localization of the epileptogenic zone increases seizure-freedom post-surgery by 200% to 300%. Single-photon emission computed tomography (SPECT) is commonly used, with magneto-encephalography (MEG) and electroencephalography (EEG), to localize the epileptogenic zone, because it localizes cerebral blood flow. There is limited research in the efficacy of SPECT localization in pediatric pharmacoresistant epilepsy. Therefore, the objective of this study was to determine the efficacy of SPECT in it’s ability to localize the epileptogenic zone in laser ablation cases of pediatric pharmacoresistant epilepsy. Out of 122 SPECTs conducted at Dell Children’s Medical Center from July 2010 to January 2015, 12 underwent laser ablation. In the 12 cases of laser ablation, SPECT displayed more sensitivity and specificity than EEG and more specificity than MEG when held against the laser ablation outcomes. This study further proves that SPECT is efficacious in epileptogenic zone localization of pediatric pharmacoresistant epilepsy.
Degradation and interaction with bone of magnesium alloy WE43 implants: A long-term follow-up in vivo rat tibia study
Authors: Oshibe Narumi , Marukawa Eriko , Yoda Tetsuya , Harada Hiroyuki
Published: February 2019

The aim of this in vivo study was to examine the degradation and biocompatibility of the WE43 magnesium alloy containing magnesium yttrium, rare earth elements, and zirconium over a one-year long-term follow-up period. Additionally, we compared anodized WE43 implants with monolithic ones and clarified the effect of the anodization. WE43 cylindrical implants with and without anodization (length, 10 mm; diameter, 0.3 mm) were transplanted into the rat tibia. In both groups, the development of corrosion and the change in implant volume were evaluated by in vivo micro-computed tomography until 12 months, and the bone tissue reaction was observed histologically. In the monolithic WE43 implants, hydrogen gas was evident until 14 days and the volume loss was 36.3% after 12 months. In the anodized WE43 implants, the development of hydrogen gas was inhibited and the volume loss was 27.7% after 12 months. The anodized WE43 implants showed a significantly slower corrosion process in the early phase. Therefore, these implants may require a prolonged period to degrade completely and may even resist complete degradation. At one year post surgery, bone maturation progressed and lamellar bone structure developed around the implant in both groups. In conclusion, the WE43 implants showed good long-term stability and biocompatibility in bone tissue.
The Effects of Dissociation on Analogue Trauma Symptoms After Trauma Processing Among Women With Varying Histories of Lifespan Victimization
Authors: Valdez Christine E. , Lilly Michelle M.
Published: February 2019

Research has identified two subtypes of posttraumatic stress disorder (PTSD); the traditional form that includes hyperarousal reactions, and the other involving ongoing dissociation. Dissociation has been reflected in the new diagnostic criteria for PTSD with the dissociative specification focused on the experience of high levels of depersonalization and/or derealization. PTSD that presents with ongoing dissociation appears to characterize complex cases of PTSD for individuals exposed to protracted trauma. Yet, our understanding of the role of dissociation in relation to PTSD symptoms is limited with inconsistent empirical findings. This study aims to elucidate the complex associations between trauma, dissociation, and trauma-relevant symptomatology. In total, 60 female interpersonal trauma survivors completed baseline measures of trauma and dissociation, and at least a week later, they completed self-report measures of state trauma intrusions, guilt, and anxiety before and after participating in a trauma recall task to examine dissociative tendencies on analogue trauma-related symptoms. After data collection, participants were categorized into two groups; individuals with multiple forms of lifetime interpersonal trauma versus individuals with trauma isolated to single-type trauma in childhood and/or adulthood. Results revealed trauma intrusions, guilt, and anxiety increased after trauma recall overall, though trauma groups differed in the manifestation of these outcomes. In addition, less depersonalization and greater derealization predicted increases in anxiety overall, though this only remained true for those exposed to multiple-type lifespan traumas. Results reveal dissociative tendencies may be most relevant in the processing of trauma-related material for those exposed to multiple types of trauma throughout the lifespan. Implications for treatment of trauma survivors with different clinical presentations are discussed.
Falling for the Ones That Were Abusive: Cycles of Violence in Low-Income Women’s Intimate Relationships
Authors: Cervantes Marisa V. , Sherman Jennifer
Published: February 2019

This study examines low-income women’s cycles of lifelong violence victimization. A qualitative analysis of in-depth interviews with 24 low-income women living in Eastern Washington State illustrates the complexity of abusive interpersonal relationships, and the decision-making processes that abused women utilize to escape violence. The data illustrate patterns of a discursive process of normalization, wherein early experiences of violence socialized women to treat abuse as a normal and expected component of adult intimate unions. The normalization of abuse also set the stage for later abuse within intimate relationships to be downplayed. The participants’ narratives demonstrate victims’ efforts to interrupt cycles of violence by identifying protection of children and partners’ other problematic behaviors as motivators in terminating their relationships. Abuse itself, however, is rarely stated as a main reason for victims to leave their abusers. The study’s findings also highlight the importance of utilizing alternative sampling strategies, as the sample of domestic violence victims was not recruited via victim support services, but rather for a study of economic strain. The patterns elucidate the multiple ways in which abuse goes unrecognized and unreported within marginalized communities. These findings also provide insight for those within the victim advocacy network and researchers of domestic violence by showcasing the experiences of victims who are often excluded from studies of domestic violence. To those who work actively in the field, this study serves as a call to action to widen sampling strategies and examine abuse in ways that better fit victims’ understandings and experiences of intimate partner and domestic violence.
Progress of novel techniques for lightweight automobile applications through innovative eco-friendly composite materials: A review
Authors: Agarwal Jyoti , Sahoo Swarnalata , Mohanty Smita , Nayak Sanjay K
Published: February 2019

The uncertain climatic changes-related issues in the recent times has led an apprehension for all automotive makers to develop innovative composite materials to reduce vehicle’s fuel consumption. Hence, this review article has given special attention toward the factors that motivated several automakers to undergo research on biocomposites as it plays an important role for biodegradability and sustainability across the globe. In particular, cellulose nanofibers-reinforced composites are the main research focus in the current scenario which can be applied for different automotive applications with numerous advantages and abundant accessibility. Polypropylene (PP) is the emerging polymer in the automotive industry, and many researchers are now mainly focusing their research on PP-based composites which can serve as a boon for different environmental problems faced by the current scenario as depicted by Figure 1. It also reported the recent advancement on the development of innovative composite materials by different automakers with regard to finding suitable actions for reduction of fuel consumption to the recommended confines.
Development of fiber-reinforced polypropylene with NaOH pretreated rice and coffee husks as fillers: Mechanical and thermal properties
Authors: Yiga Vianney Andrew , Pagel Sinja , Lubwama Michael , Epple Stefan , Olupot Peter Wilberforce , Bonten Christian
Published: February 2019

Incorporation of agricultural wastes as fillers in fiber-reinforced plastics is gaining momentum in plastics engineering research. In this study, fiber-reinforced polypropylene (PP) with rice and coffee husks as filler material were developed. The effect of alkali (sodium hydroxide) pretreatment of the husks on mechanical and thermal properties of developed PP biocomposites was observed. Filler material loading was varied from 0% to 20% for rice husks and 0% to 10% for coffee husks. A twin-screw extruder was used for compounding the PP matrix with rice and coffee husk filler materials. Tensile strengths and percentage elongation results varied from 27.4 to 37.4 MPa and 2.4% to 70.3% (unmodified coffee husks), 31.1 to 37.4 MPa and 5% to 70.3% (unmodified rice husks), 30.7 to 37.4 MPa and 5.3% to 70.3% (modified coffee husks), and 30.7 to 37.4 MPa and 4.8% to 70.3% (modified rice husks). Young’s modulus ranged between 1656 and 2247.8 MPa for biocomposite PP samples with unmodified filler material. Young’s modulus ranged between 1740 and 2160 MPa after alkali treatment of the filler material. Charpy impact strengths ranged from 1.2 to 4 kJ/m2 and 3.1 to 19.6 kJ/m2 for samples containing unmodified and modified filler material, respectively. Thermogravimetric analysis showed that an increase in filler content resulted into delayed weight loss at high degradation temperatures. The results suggest that these developed fiber-reinforced plastics can be used in applications requiring high thermal stability and good mechanical properties.
Facets of Career Development in a New Immigrant Destination: Exploring the Associations Among School Climate, Belief in Self, School Engagement, and Academic Achievement
Authors: Storlie Cassandra A. , Toomey Russell B.
Published: February 2019

With contemporary career challenges facing Latino/a youth, particularly those from immigrant communities, counselors and career development professionals may find it challenging to provide effective career services for this unique population. Students from one middle school and one high school located in a new immigrant destination were surveyed to test the hypothesis that belief in self and school engagement (i.e., behavioral, emotional, and cognitive engagement) played a serial mediating role in the association between school safety and academic achievement (i.e., grade point average). Moderation of the mediation model by ethnicity was also examined. Results from the sample ( N = 877) indicated that school safety was associated with higher levels of belief in self, which in turn was associated with higher levels of school engagement. Only behavioral engagement, however, was associated with greater academic achievement. Associations did not differ by ethnicity. Career implications on the importance of behavioral engagement among teachers, counselors, career development professionals, and administrators to support the academic achievement of marginalized youth are provided.
‘Between a Rock and a Hard Place’: The Implications of Lost Autonomy and Trust for Professionals at Sea
Authors: Sampson Helen , Turgo Nelson , Acejo Iris , Ellis Neil , Tang Lijun
Published: February 2019

This article describes changes associated with increased bureaucratisation and surveillance in the regulation and management of the 21st century shipping industry. Drawing upon 303 ‘real-life’ vignette-based interviews, it describes how these transformations are experienced by contemporary navigating officers, and engineers, working on commercial cargo vessels. The article draws attention to the dysfunctional effects of distrust in organisations, describing how lost trust and associated fears impact on the decision-making process of officers thereby inducing a degree of organisational paralysis. This finding may be of particular significance to employers who have introduced punishment-centred bureaucratisation in order to improve organisational efficiency and who are concurrently undermining it.
Extended state observer-based finite-time guidance laws on account of thruster dynamics
Authors: Duan Meijun , Zhou Di , Cheng Dalin
Published: February 2019

Guidance laws are designed for a near space interceptor with line-of-sight angle as input and on–off type thrust as output. The dynamics of thruster is viewed as a first-order lag with on–off working style and is integrated with the target–interceptor engagement dynamics to design bang-bang type sliding mode guidance laws. An extended state observer is designed to estimate the line-of-sight angular rate and the acceleration of target with the line-of-sight angle as a measurement. It is rigorously proved that the states of guidance system converge to a neighborhood of sliding mode in finite time and the line-of-sight angular rate converges to a neighborhood of the origin along the sliding mode in finite time under the designed guidance laws. Furthermore, in order to reduce the switching frequency of thruster, a sliding mode guidance law with hysteresis-band according to the sufficient condition for finite time convergence is proposed. Then, it is integrated with the bang-bang type sliding mode guidance law to yield a composite guidance law. Simulation results show that the extended state observer can effectively estimate the line-of-sight angular rate and the target acceleration, and the proposed sliding mode guidance laws have better performance than typical proportional guidance law.
Tyrrhenian central Italy: Holocene population and landscape ecology
Authors: Stoddart Simon , Woodbridge Jessie , Palmisano Alessio , Mercuri Anna Maria , Mensing Scott Andrew , Colombaroli Daniele , Sadori Laura , Magri Donatella , Di Rita Federico , Giardini Marco , Mariotti Lippi Marta , Montanari Carlo , Bellini Cristina , Florenzano Assunta , Torri Paola , Bevan Andrew , Shennan Stephen , Fyfe Ralph , Roberts C Neil
Published: February 2019

This paper compares changes in vegetation structure and composition (using synthetic fossil pollen data) with proxy data for population levels (including settlements and radiocarbon dates) over the course of the last 10 millennia in Tyrrhenian central Italy. These data show generalised patterns of clearance of woodland in response both to early agriculturalists and urbanism, as well as the specific adoption of tree crops and variations in stock grazing. The results provide a comprehensive understanding of the development of the anthropogenised landscape of one of the most important early centres of European civilisation, showing regional trends as well as local variations.
Choroid thickness profile in patients with lupus nephritis
Authors: Braga J , Rothwell R , Oliveira M , Rodrigues D , Fonseca S , Varandas R , Ribeiro L
Published: February 2019

Background

Choroidopathy is a rare manifestation of systemic lupus erythematosus (SLE). This entity is associated with active phases of severe SLE and it is frequently accompanied by acute kidney failure, central nervous system involvement and coagulopathy.

Purpose

To evaluate the choroid thickness of patients with lupus nephritis (LN) without choroidopathy, and to compare this with that of age-matched SLE patients without LN and healthy control subjects.

Study design

Cross-sectional case control study.

Material and methods

Fifteen women with LN in remission phase (study group), 15 women with SLE in remission without LN (SLE control group), and 15 healthy women (healthy control group), without ocular diseases or significant refractive error, were recruited. Full ophthalmological examination and a macular optical coherence tomography in enhanced depth imaging mode were performed. The choroid thickness was measured at nine macular points and six lines of mean choroidal thickness were determined. A comparative analysis between the three groups was performed using the one-way ANOVA test and the paired t-test. The choroid thickness of patients under corticotherapy was also compared to that of patients without corticotherapy. Additionally, the correlation between choroid thickness and disease duration was evaluated using the Pearson analysis.

Results

The mean macular choroidal thickness was 295.73 ± 67.62 μm in the study group, 233.34 ± 41.01 µm in the SLE control group, and 240.98 ± 37.93 μm in the control group ( p = 0.00006 and p = 0.0003, respectively). Additionally, the choroid thickness was significantly thicker than in the SLE and healthy control groups at the foveal ( p = 0.004 and p < 0.000), nasal ( p < 0.000 and p = 0.001), superior ( p = 0.002 and p < 0.000) and inferior ( p < 0.000 and p = 0.001) mean lines. The choroidal thickness in this group was not associated with the duration of the disease. The subgroup of patients with LN under corticotherapy did not reveal a significantly different choroidal thickness.

Conclusion

This study suggests a relationship between LN and choroidal changes, which may represent an increased risk for choroidopathy in these patients. Choroid thickening was not related with the duration of the disease. This thickening may be correlated with histopathological changes similar to those occurring in kidney glomeruli.
Transcranial Doppler findings in antiphospholipid syndrome
Authors: Ricarte I F , Dutra L A , Barsottini O G P , Souza A W S de , Andrade D C O de , Mangueira CLP , Silva G S
Published: February 2019

Introduction

Transcranial Doppler is a method that enables the assessment of different cerebral hemodynamic parameters. It also allows for the evaluation of the presence of right-to-left circulation shunts (RLS) and for the detection of microembolic signals (MESs), which might be associated with an increased risk of cerebrovascular events. For instance, the presence of MESs on transcranial Doppler in patients with systemic lupus erythematous (SLE) and antiphospholipid syndrome (APS) is associated with an increased risk of stroke. Therefore, transcranial Doppler could be a useful tool for stroke risk stratification in these patients.

Objective

Our objective was to evaluate transcranial Doppler cerebral mean blood flow velocities as well as the presence of MESs and RLS in patients with antiphospholipid syndrome and SLE.

Patients and methods

Twenty-two patients with primary APS (PAPS), 24 patients with secondary APS (SAPS), 27 patients with SLE without APS and 21 healthy controls were evaluated. Clinical and epidemiological data were compiled from medical charts, and all subjects underwent transcranial Doppler examination with breath-holding index calculation. Both middle cerebral arteries were monitored for 60 min for the detection of MESs. RLS was investigated with agitated saline injected as a bolus.

Results

There were no significant differences in mean blood flow velocities among the groups. MESs were more frequently found in patients with SLE when compared with controls and patients with APS (SLE: 17.4%, SAPS: 4.3%, PAPS: 0%, controls: 0%, p = 0.03). Anticoagulant therapy was more frequently used in the APS group (PAPS: 81.8%, SAPS: 75.2%, SLE: 1.7%, p < 0.001). Patients with APS had a higher frequency of RLS when compared with volunteers (63.6% versus 38.1%, p = 0.05). Breath-holding index values tended to be lower in patients with SAPS than in control subjects and patients with PAPS and SLE ( p = 0.06).

Conclusions

Patients with APS had a higher frequency of RLS than healthy controls. This finding alerts to the importance of cardiac investigation in patients with stroke and APS, because further therapies such as RLS occlusion might eventually add protection. The higher frequency of MES in patients with SLE could suggest an effect of anticoagulant therapy on MES prevention, more frequently used in patients with APS.
Complete renal response at 12 months after induction therapy is associated with renal relapse-free rate in lupus nephritis: a single-center, retrospective cohort study
Authors: Ichinose K , Kitamura M , Sato S , Eguchi M , Okamoto M , Endo Y , Tsuji S , Takatani A , Shimizu T , Umeda M , Fukui S , Sumiyoshi R , Koga T , Kawashiri S , Iwamoto N , Igawa T , Tamai M , Nakamura H , Origuchi T , Nishino T , Kawakami A
Published: February 2019

Background

Lupus nephritis (LN) is a major risk factor for overall morbidity and mortality in systemic lupus erythematosus (SLE).

Methods

We retrospectively analyzed cases of proliferative and membranous LN patients who underwent a renal biopsy at our hospital in 1993–2016. We analyzed the association between complete renal response (CR) rates at 12 months after induction therapy and predictive factors for CR and their association with renal flares.

Results

Of the 95 cases analyzed, we were able to track the therapeutic responses of 81 patients at 12 months after their induction therapy. The median follow-up duration after renal biopsy was 51 months (interquartile range: 16.5–154.5 months). The Cox proportional hazards model showed that, compared to not attaining CR at 12 months, the attainment of CR at 12 months was correlated with being free from renal flares. The multivariate logistic analysis revealed that the predictive factors for CR at 12 months were the anti-La/SSB antibodies (U/ml) (odds ratio (OR) 1.22, 95% confidence interval (CI) 1.01–1.63, p = 0.0220), blood urea nitrogen (BUN) (OR 0.68, 95% CI 0.44–0.90, p = 0.00048) and serum β2 microglobulin (MG) (OR 0.26, 95% CI 0.06–0.74, p = 0.00098) levels.

Conclusions

Among LN patients, being free from renal flares was associated with attaining CR at 12 months after induction therapy. Anti-La/SSB antibodies were a positive predictive factor, and BUN and serum β2MG levels were negative predictive factors of CR at 12 months.
Interprofessional Collaboration Between a Multidisciplinary Palliative Care Team and the Team Pharmacist on Pain Management
Authors: Geum Min Jung , Ahn Ji Hyune , Kim Jae Song , Kim Soo Hyun , Son Eun Sun , Hu Youn Jung , Choi Hye Jin , Rhie Sandy Jeong
Published: February 2019

Purpose:

The purpose of the study was to evaluate the impact on pain management by multidisciplinary palliative care team (mPCT) and the team pharmacist.

Methods:

Patients who were admitted to palliative care unit (PCU) for at least 7 days between April 2014 and December 2015 were included. The mPCT consisted of a physician, a pharmacist, nurses, and non-clinical support staff. The team was on charge of pain management of patients who were admitted to PCU. Pain intensity was assessed at 3 time points in each patient; 1 week before PCU admission (day −7), on the day of admission (day 0), and 1 week after admission (day 7) using 0 to 10 numerical rating scale (NRS). Analgesic use was evaluated with 6 categories based on National Comprehensive Cancer Network and Korean pain management guidelines. Pain intensity and analgesic use appropriateness were compared at day −7, day 0, and day 7 for the patients who were admitted to the PCU.

Results:

Pain intensity decreased significantly on day 7 of PCU admission compared to it on day 0 (NRS: 4.05 vs 2.66, P < .001). A significant negative correlation was found between pain intensity and the proper use of analgesics ( r = –0.407; P < .001, r = –0.309; P = .001, r = –0.241; P = .009, on day −7, day 0, day 7, respectively).

Conclusion:

The mPCT contributed to the reduction of inappropriate use of analgesics and improved pain control. Pharmacist intervention appeared to have improved pain control in patients under palliative care. Each team member’s role should be individualized and developed further.
Cleft Palate Outcomes and Prognostic Impact of Palatal Fistula on Subsequent Velopharyngeal Function—A Retrospective Cohort Study
Authors: Smyth Alistair G. , Wu Jianhua
Published: February 2019

Objective:

To assess outcomes from cleft palate repair and define the level of impact of palatal fistula on subsequent velopharyngeal function.

Design:

A retrospective cohort study.

Setting:

A regional specialist cleft lip and palate center within United Kingdom.

Patients, Participants:

Nonsyndromic infants born between 2002 and 2009 undergoing cleft palate primary surgery by a single surgeon with audited outcomes at 5 years of age. Four hundred ten infants underwent cleft palate surgery within this period and 271 infants met the inclusion criteria.

Interventions:

Cleft palate repair including levator palati muscle repositioning with or without lateral palatal release.

Main Outcome Measures:

Postoperative fistula development and velopharyngeal function at 5 years of age.

Results:

Lateral palatal incisions were required in 57% (156/271) of all cases. The fistula rate was 10.3% (28/271). Adequate palatal function with no significant velopharyngeal insufficiency (VPI) was achieved in 79% of patients (213/271) after primary surgery only. Palatal fistula was significantly associated with subsequent VPI (risk ratio = 3.03, 95% confidence interval: 1.95-4.69; P < .001). The rate of VPI increased from 18% to 54% when healing was complicated by fistula. Bilateral cleft lip and palate (BCLP) repair complicated by fistula had the highest incidence of VPI (71%).

Conclusions:

Cleft palate repair with levator muscle repositioning is an effective procedure with good outcomes. The prognostic impact of palatal fistula on subsequent velopharyngeal function is defined with a highly significant 3-fold increase in VPI. Early repair of palatal fistula should be considered, particularly for large fistula and in BCLP cases.
Family Involvement in Adult Chronic Disease Care: Reviewing the Systematic Reviews
Authors: Gilliss Catherine L. , Pan Wei , Davis Linda Lindsey
Published: February 2019

Health care providers, policy makers, and investigators are dependent upon the quality and accuracy of published research findings to inform and guide future practice and research in their field. Systematic reviews, the synthesis of outcomes across studies are increasingly more common in the family literature; however, published review reports often lack information on strategies reviewers used to insure dependability of findings, and minimize methodological bias in the review. In this article, we summarize findings from systematic reviews of interventions and outcomes from family involvement in adult chronic disease care published between 2007 and 2016. In addition, we explore procedures reviewers used to insure the quality and methodologic rigor of the review. Our discussion provides guidance and direction for future studies of family involvement in chronic disease care.
Matrix Metalloproteinases and Their Inhibitors and Proteoglycan 4 in Patients Undergoing Total Joint Arthroplasty
Authors: Thorson Chase , Galicia Kevin , Burleson Andrew , Bouchard Olivia , Hoppensteadt Debra , Fareed Jawed , Hopkinson William
Published: February 2019

Osteoarthritis, a degenerative disease of the joints, is the most common form of arthritis in the knee. Total joint arthoplasty is a commonly used treatment for joint degeneration and osteoarthritis, and due to these factors, TJA for hip and knee joints is projected to grow by 137% and 601% between 2005 and 2030. Matrix metalloproteases are enzymes found in the extracellular matrix that cleave matrix components. Normally MMPs are downregulated in tissues by Tissue Inhibitors of Metalloproteases, or TIMPs. The relative concentration of TIMPs also may denote some of the activity of the MMPs found in serum. Lubricin (proteoglycan 4) is a molecule found in the synovial fluid that protects joints by dissipating strain energy during locomotion. Lubricin synovial fluid concentration is also diminished in many patients with osteoarthritis, but not all. Given the importance of these three sets of molecules, our lab investigated the correlation between circulating lubricin, MMP levels and TIMPs levels. Blood plasma samples were obtained from de-identified subjects undergoing total joint arthroplasty at Loyola University Medical Center and the University of Utah. Normal blood plasma from pooled healthy individuals served as a control. We analyzed biomarker levels in plasma using ELISA. Our data show that MMP-1 and 9 were increased in TJA patients compared to normal controls, while MMP-2 and 13 were decreased. We also found decreased lubricin and tissue factor in surgical patients relative to controls. These data support the idea that lubricin is vital in protecting the synovial joint and that MMPs play a complex role in the destruction of the joint.
Adaptive impulsive synchronization for a class of fractional order complex chaotic systems
Authors: Zhang Xingpeng , Li Dong , Zhang Xiaohong
Published: February 2019

In this paper, a new lemma is proposed to study the stability of a fractional order complex chaotic system without dividing the complex number into real and imaginary parts. The proving process of the new lemma combines the fundamental properties of the complex field and the fractional order extension of the Lyapunov direct method. It extends the fractional order extension of the Lyapunov direct method from the real number field to the complex number field. Based on the new lemma, we propose a new impulsive synchronization scheme for fractional order complex chaotic systems. The numerical simulation results also show the validity of our conclusion.
Influence of spring-mass systems on frequency behavior and critical voltage of a high-speed rotating cantilever cylindrical three-dimensional shell coupled with piezoelectric actuator
Authors: Safarpour Hamed , Pourghader Johar , Habibi Mostafa
Published: February 2019

In this article, vibrational behavior and critical voltage of a spinning cylindrical thick shell covered with piezoelectric actuator (PIAC) carrying spring-mass systems are investigated. It should be noted that, the installed sensors on the proposed systems are considered as a tip mass. This structure rotates about axial direction and the formulations include the Coriolis and centrifugal effects. In addition, various cases of thermal (uniform, linear, and nonlinear) distributions are studied. The modeled cylindrical thick shell covered with PIAC, its equations of motion, and boundary conditions are derived by the principle of minimum total potential energy and based on a new three-dimensional refined higher-order theory (RHOST). For the first time in the present study, attached spring-mass systems have been considered in the rotating cylindrical thick shells covered with PIAC. The accuracy of the presented model is verified compared with previous studies. The novelty of the current study is consideration of the applied voltage, rotation, various temperature distributions and spring-mass systems implemented on the proposed model using the RHOST. The generalized differential quadrature method is presented to discretize the model and to approximate the governing equations. In this study the simply supported conditions have been applied to edges [Formula: see text] and cantilever (clamped-free) boundary conditions have been studied in x = 0, L, respectively. The results show that, applied voltage, angular velocity, temperature changes and spring-mass systems play an important role on the critical voltage, critical angular speed, critical temperature, and natural frequency of the structure. Another significant result is that, by increasing the lumped mass and coefficient of the spring in the first frequency of the cantilever cylindrical shell, increase or decrease of the natural frequency depends on the nonlinear temperature change parameter. The results of the current study are useful suggestions for designing electromechanical systems such as hydraulic pipes with the installation of the sensors to them.
Risk Factors in IT Public–Private Partnership Projects
Authors: Ghribi Souhir , Hudon Pierre-André , Mazouz Bachir
Published: February 2019

Project managers from both the public and private sectors have always known that better project management is often synonymous with better risk management. As such, all projects are subject to risk factors that make their management more or less complicated. In this article, we contend that successful project managers need tools to better identify and assess project risks and we try to provide such a tool in the form of grid of specific risk factors. This article analyzes risk factors in IT projects conducted using public–private partnership (PPP) procurement from the public partner’s perspective. Our research uses, as empirical case studies, three projects undertaken by the Tunisian government in partnership with IT and engineering companies. The results reveal 13 specific risk factors, which are classified into three generic risk factor categories: strategic, operational, and key resources. The adverse effects of risks materializing are also identified and analyzed.
Ultrasound aided repositioning of misplaced guidewire during subclavian vein catheterisation
Authors: Longo Ferdinando , Piliego Chiara , Agrò Felice E
Published: February 2019

Catheter misplacement is a common complication during central vein catheterisation, and during subclavian vein catheterisation, one of the most common misplacements of the catheter is the ipsilateral internal jugular vein. Facing this type of misplacement, we tried to find an ultrasound-guided method to reposition the guidewire during subclavian vein catheterisation in adults.
A Case of Critical Calcified Innominate Artery Stenosis Successfully Treated With the Shockwave Lithoplasty
Authors: Tripolino Cesare , Grillo Placido , Tassone Eliezer Joseph , Morabito Gaetano , Maselli Daniele , Missiroli Bindo
Published: February 2019

Purpose:

The Shockwave Lithoplasty System represents a novel technology combining a balloon angioplasty catheter with the use of sound waves. Evidences suggest that it is a reliable tool to overcome calcified stenosis in both peripheral and coronary arteries. Here, we describe the case of a patient with calcified innominate artery stenosis successfully treated with the Shockwave Lithoplasty System.

Case Report:

A 78-year-old woman with hypertension, and dyslipidemia, came to our observation for dizziness. Instrumental examinations showed critical calcified stenosis of the innominate artery. The lesion was successfully treated with the Shockwave Lithoplasty System and subsequent stent apposition. Final angiography demonstrated excellent position of the stent, good wall apposition, and confirmed patency of the right common and right vertebral artery origins.

Conclusion:

Our clinical experience demonstrates that Lithoplasty is safe and effective also for the treatment of supra-aortic vessels.
Party membership and social movement activism: A macro–micro analysis
Authors: Giugni Marco , Grasso Maria
Published: February 2019

This article examines the macro–micro dynamics linking party membership with protest participation. We theorise that institutional and extra-institutional engagement are mutually reinforcing and that party membership has a positive effect on party activism. We examine key ideational and structural factors identified in the literature to analyse the relative importance of various factors for party members’ involvement. We look at micro-macro-level linkages by examining macro-level contextual variables as well as the extent to which these features mediate the individual-level effects. Our results suggest that party members support social movements for a variety of ideational and structural reasons but that strategic reasons are also important. Moreover, we find that contexts marked by more open political opportunities close the gap in social movement activism between party members and non-members suggesting that contexts with higher public spending as well as crises could be capitalised on to engage the wider public into political activism.
Functions of oral monologic tasks: Effects of topic familiarity on L2 speaking performance
Authors: Qiu Xuyan
Published: February 2019

Tasks with different design factors may dissimilarly affect oral production, and thus can be adopted for different pedagogical purposes. However, the functions of task types are not fully explored. To address this gap, this study investigates the influence of content familiarity and task repetition on sixty English as a foreign language learners’ speaking performance, in terms of complexity, accuracy, and fluency (CAF). Participants twice performed four monologic tasks, and received stimulated recall interviews. The findings indicate that participants produced structurally more complex speech under familiar conditions, and increased their CAF in task repetition. Furthermore, content familiarity and task repetition may facilitate conceptualization. Task repetition may also direct participants’ attention towards lexical choices and grammatical encoding. Moreover, repeating unfamiliar topics effectively increased CAF. The findings suggest content familiarity and task repetition are two dimensions of topic familiarity, and that teachers might consider implementing task repetition when presenting unfamiliar topics to learners.
Nuclear disaster as chronic crisis: Accounts of radiation embodiment by survivors of the Chernobyl nuclear disaster from Belarus born before, in and after 1986
Authors: Zhukova Ekatherina
Published: February 2019

This article looks at chronic crisis on an empirical example of radiation embodiment by survivors of a nuclear disaster. Developing further the work of Henrik Vigh, this article argues that chronic crisis is conflictual in nature, where some individuals fully embrace it, while others reject it. A total of 16 in-depth interviews were conducted with survivors of the Chernobyl nuclear disaster from Belarus who were below 18 years in 1986 and born in or after 1986. It is shown that survivors do not consider themselves affected, when they argue against social stigma imposed by others and when development discourse in relation to post-communist health care is used as a background against which nuclear victimhood can be argued. It is also demonstrated that survivors do consider themselves affected, when they embrace disaster temporality and victimhood and argue against narrow scientific definitions of victimhood which downplay a variety of health conditions attributed to the disaster. This article concludes that chronic crisis may not always be transformative, but reproduce the existing inequalities. It contributes to the anthropology of disaster and the anthropology of suffering by bringing together scholarship in feminist theory of disability and critical perspectives on development.
Individualising difference, negotiating culture: Intersections of culture and care
Authors: Broom Alex , Kirby Emma , Kokanović Renata , Woodland Lisa , Wyld David , de Souza Paul , Koh Eng-Siew , Lwin Zarnie
Published: February 2019

In this article, we focus on developing a critical sociology of ‘cultural and linguistic diversity’ as evident in cancer care praxis, drawing on the perspectives of cancer care health professionals. Set within the context of increasing efforts on the part of healthcare providers to ‘accommodate difference’ and ‘incorporate diversity’, we aimed to utilise participants’ accounts of practice to ask: how do we and how should we think about and operationalise ‘culture’ (if at all) in cancer care settings. Drawing on eight focus groups with doctors, nurses, allied health staff and multicultural community workers, here we explore their accounts of: othering and over-simplification; the role of absences in biographical reciprocity; intimacy, care and carelessness; and entanglements of culture with other aspects of the person. Based on their accounts, we argue for a broadening of the examination of the nexus of culture and care, to focus on the problematics of othering, intimacy, reciprocity and complexity.
Black people’s racial identity and their acceptance of Black-White Multiracial people
Authors: Franco Marisa , Holmes Olivia L. , Swafford Felicia , Krueger Nolan , Rice Kenneth
Published: February 2019

The current study examined whether Black people’s racial ideology, experiences of racism, and their interaction predict their acceptance of Black-White Multiracial people. Black racial ideologies represent an aspect of Black people’s racial identity that addresses their perspectives on how people within the Black community should behave. Participants ( N = 325) were administered a series of measures. Latent class analysis revealed three classes of Black racial identity: undifferentiated (average ideologies), integrationist (high assimilationist, humanist, and oppressed minority), and nationalist (high nationalist). The nationalist group was most likely to endorse rejecting Multiracial people as members of the Black community and also to endorse forcing a Black identity onto Multiracial people, whereas the integrationist group was least likely to make such endorsements. For participants in the nationalist (but not integrationist or undifferentiated) cluster, personal experiences of racism were related to endorsement of forcing a Black identity onto a Multiracial person. Findings suggest that Multiracial people might achieve the most identity affirmation and sense of community among Black people holding integrationist views.