bluuebunny/crossref_metadata_2025 huggingface dataset:
The effects of IT infrastructure integration and flexibility on supply chain capabilities and organizational performance: An empirical study of the electronics industry in Taiwan
Authors: Hou Chung-Kuang
Published: November 2019

In recent years, rapid development of information technology (IT) has forced companies to integrate tightly with their supply chain partners, enabling efficient information sharing between supply chain members and improving supply chain efficiency, in order to make their supply chain more flexible and efficient. IT therefore plays a critical role in supply chains. How to achieve higher organizational performance through IT in a complex and uncertain supply chain environment has become an important issue. Even though many practitioners and scholars have taken multiple points of view to investigate the effects of IT infrastructure capability on firms’ performance, little research has explored cause-and-effect relationships from the perspective of supply chain capabilities. Based on a resource-based view of the firm, this study develops a research framework for investigating the mediating role of supply chain capabilities in the relationships between IT infrastructure flexibility, integration, and firms’ performance. Data for the study were collected from 270 companies in the Taiwanese electronics industry and the relationships proposed in the framework were tested using the Partial Least Squares method. The results indicate that IT infrastructure integration and flexibility indirectly and positively impact organizational performance through the mediating effect of supply chain capability, and the mediating effect is a full mediation. The findings provide empirical support to resourced-based IT studies, which propose mediating IT impacts on organizational performance. This study should be useful to practitioners who implement IT strategy.
Identification and Referral for Early Intervention Services in New Zealand: A Look at Teachers’ Perspectives – Past and Present
Authors: Aspden Karyn , Baxter Stacey M. , Clendon Sally , McLaughlin Tara W.
Published: November 2019

Inclusive experiences for all children are foundational to New Zealand early childhood education, yet teacher beliefs and practices related to identification and referral processes may be delaying access to important early intervention support for children with disabilities. To better understand teachers’ perspectives, past and present, this article details the findings from two studies conducted 14 years apart. Through comparison of findings from the work of Aspden and Baxter, this article explores teachers’ beliefs and experiences related to identification and referral practices. In the original 2003 study, 50 early childhood teachers completed a paper-based postal survey, whereas in the 2017 replication, 78 early childhood teachers completed an online survey. Persistent concerns about teacher engagement with identification and referral processes were evident both past and present, particularly in relation to perceived parental reaction and beliefs about the adequacy of service provisions. Furthermore, the data revealed tensions between embracing a strengths-based approach and the need to identify children’s disabilities. The findings provide insight into referral practices in the New Zealand early childhood context and suggest the need for ongoing teacher consultation in relation to policy and practice, the development of more formal referral policies and procedures, as well as enhanced professional support and development that targets teachers’ need for knowledge of and connection with specialist agencies.
Apparent diffusion coefficient (ADC) values of serous, endometrioid, and clear cell carcinoma of the ovary: pathological correlation
Authors: Ono Takafumi , Kishimoto Keiko , Tajima Shinya , Maeda Ichiro , Takagi Masayuki , Suzuki Nao , Mimura Hidefumi
Published: November 2019

Background

Primary epithelial ovarian cancer is divided into several subtypes. The relationships between apparent diffusion coefficient (ADC) values and their subtypes have not yet been established.

Purpose

To investigate whether ADC values of epithelial ovarian cancer vary according to histologic tumor cellularity and evaluate the difference of clear cell carcinoma (CCC), high-grade serous carcinoma (HGSC), and endometrioid carcinoma (EC).

Material and Methods

This retrospective study included 51 cases of epithelial ovarian cancer (17 CCC, 20 HGSC, and 14 EC) identified by magnetic resonance imaging with pathological confirmation. All patients underwent diffusion-weighted imaging and the ADC values of lesions were measured. We counted the tumor cells in three high-power fields and calculated the average for each case. The Spearman’s correlation coefficient test was used to analyze correlation between ADC values and tumor cellularity. The ADC values of HGSC, EC, and CCC were compared using the Steel–Dwass test.

Results

The ADC values of all cases were significantly inversely correlated with tumor cellularity ( rs = −0.761; P < 0.001). The mean ± SD ADC values (×10−3 mm2/s) of CCC, HGSC, and EC were 1.24 ± 0.17 (range 0.98--1.65), 0.84 ± 0.10 (range 0.67--1.06), and 0.84 ± 0.10 (range 0.67--1.07). The mean ± SD tumor cellularity of CCC, HGSC, and EC was 162.88 ± 63.28 (range 90.33--305.67), 440.60 ± 119.86 (range 204.67--655.67), and 461.02 ± 81.86 (range 333.33--602.33).

Conclusion

There is a significant inverse correlation between ADC values and tumor cellularity in epithelial ovarian cancer. The mean ADC value of CCC was higher than those of HGSC and EC, seemingly due to the low cellularity of CCC.
Image evaluation and breast density categories as a function of mammary positioning in full-field digital mammography
Authors: Nakano Irene Tomoko , Salvador Gabriel Lucca de Oliveira , Schelin Hugo Reuters , Denyak Valeriy , Khoury Helen Jamil , Tacara Silvio
Published: November 2019

Background

Appropriate mammary positioning is an important factor in optimizing image quality in mammography (MMG).

Purpose

To study the correlation of quality criteria and breast density classification proposed by the American College of Radiology (ACR) and European Guidelines and its influence to achieve a proper positioning, therefore an adequate MMG.

Material and methods

A total of 128 routine MMG examinations were reviewed for the definition of breast composition parenchyma and assessment of several quality criteria proposed by the ACR and European Guidelines to achieve an adequate MMG. Adequate MMG was defined as a difference between the posterior nipple line (PNL), difference of the mediolateral oblique (MLO) and craniocaudal (CC) incidences > 1 cm. The quality criteria were analyzed as a function of correlation coefficient in order to evaluate the individual impact of each factor and analysis of variance (ANOVA) for all criteria. Receiver operating characteristic (ROC) curves were plotted to evaluate the performance of the criteria on each type of parenchyma.

Results

Negative correlation of fatty breasts and visibility of the mammary angle, a greater number of skin folds and PNL > 1 cm (r < 0). Dense MMG presented less visibility of the lateral tissue compared with other categories. Area under the curve of ROC analysis revealed values of 53.1% and 54.7% for the right and left breasts, respectively.

Conclusion

Several factors influenced in the MMG process, but we find that breast parenchyma has a substantial role in affecting these criteria and therefore a correct position for diagnosis, which could compromise MMG diagnostic performance.
Imaging findings of Stenotrophomonas maltophilia pneumonia: emphasis on CT findings between immunocompromised and immunocompetent patients
Authors: Kang Yeo Ryang , Cha Yoon Ki , Kim Jeung Sook , Lee Eun Kyoung , Oh Jin Young , Bak So Hyeon , Yoon Hyun Jung
Published: November 2019

Background

Stenotrophomonas maltophilia ( S. maltophilia) is a globally emerging, rare, waterborne, aerobic, gram-negative, multiple-drug-resistant organism, most commonly associated with respiratory tract infection in humans. Computed tomography (CT) findings in patients with S. maltophilia pneumonia are rarely reported.

Purpose

To compare CT findings between immunocompromised and immunocompetent patients, and to determine characteristic imaging findings of S. maltophilia pneumonia.

Material and Methods

CT findings of eight immunocompromised and 29 immunocompetent patients with proven S. maltophilia pneumonia were reviewed retrospectively. Different patterns of CT abnormalities between immunocompromised and immunocompetent patients were compared by Fisher’s exact test.

Results

Patchy ground-glass opacities (GGOs) were the most common CT findings, present in 36 (97.3%) of the 37 patients. Among the patients with patchy GGOs, consolidation was seen in 29 (78.4%) patients, and centrilobular nodules were noted in 15 (40.5%) patients. The transaxial distribution of the parenchymal abnormalities was predominantly randomly distributed in 30 (81.1%) cases. Regarding longitudinal plane involvement, the predominant zonal distributions were the diffuse distribution (n=23, 62.2%) and the lower lung zone (n=14, 37.8%). None of the patients showed upper lung zone predominance. The proportion of patients with parenchymal CT findings or associated findings in the immunocompromised patients was not significantly different from that of the immunocompetent patients. However, lower lung zone predominance on the longitudinal plane was significantly more common in immunocompetent patients than in immunocompromised patients (14/29 vs. 0/8, P=0.015). And diffuse distribution of parenchymal abnormalities on a longitudinal plane was significantly more frequent in immunocompromised patients than in immunocompetent patients (8/8 vs. 15/29, P=0.015).

Conclusion

The most common CT patterns of S. maltophilia pneumonia in immunocompromised and immunocompetent patients were patchy GGOs and consolidation. However, in immunocompetent patients, parenchymal abnormalities were more predominately distributed in lower lung zone than in immunocompromised patients; and in immunocompromised patients, parenchymal abnormalities were more diffusely distributed than in immunocompetent patients.
Reliability and validity of three isometric back extensor strength assessments with different test postures
Authors: Yang Sen , Wu Wenjie , Zhang Chengmin , Wang Donggui , Chen Can , Tang Yong , Li Kai , Xu Jianzhong , Luo Fei
Published: November 2019

Objective

To compare the test-retest reliability and validity of three simple maximal isometric back extensor strength (BES) assessment protocols with different test postures, and to recommend an optimal clinical protocol to quantify BES.

Methods

Asymptomatic adults, aged over 45 years, were assessed for maximal isometric BES using external fixation of dynamometers, with the subject in standing, prone and sitting positions, respectively. Measurements were repeated at a one-week interval to examine test-retest reliability. Validation was performed by comparing with results obtained from isokinetic dynamometer assessments.

Results

Out of a total of 60 included participants, intra-class correlation coefficients (ICC) were 0.92, 0.93 and 0.90 in standing, prone and sitting positions, respectively. Correlation analyses revealed acceptable convergent validity in the standing and prone position (r = 0.50 and 0.54, respectively), whereas tests conducted in the sitting position showed a relatively low validity (r = 0.32). Among the three protocols, measurement error was lowest in the prone position.

Conclusions

Maximal isometric BES assessment in the prone position was shown to be the most reliable and valid protocol, and may be considered the preferred option for assessing BES in clinical practice.
Rethinking power, production, and social reproduction: Toward variegated social reproduction
Authors: Bakker Isabella , Gill Stephen
Published: November 2019

This special issue introduces new work, new perspectives, and engages in a dialogue to revisit, extend and go beyond the original central hypothesis of Power, Production and Social Reproduction (2003). That volume and its primary hypothesis focused upon the unfolding contradiction between the global accumulation of capital and the provision of stable and progressive conditions of social reproduction. It hypothesized a growing contradiction between the intensified power of capital and many life-making/sustaining processes, including the condition of bodies and the biosphere. Our original hypothesis conceptualized capital accumulation and social reproduction as interlinked although within different and contradictory moments in the same system or totality. We add to this here the concept of variegated social reproduction which refers to the historical and ontological variability of social reproduction - and its specific differentiations and varieties in contemporary globalized capitalism - stemming from concrete social, cultural, ecological and material practices and structures. Indeed, as the articles in the special issue reflect, the neoliberalization and commodification of social reproduction remains incomplete and not all-encompassing or determinant. As such, the introduction and the special issue also suggest new research agendas.
A prolonged and successful heparin-free extracorporeal membrane oxygenation run in isolated thoracic trauma: A case report
Authors: Lorini F Luca , Grazioli Lorenzo , Manfredi Roberto , Rausa Emanuele , Ghitti Davide , Poli Giancarla , Peck Marcus , Cattaneo Sergio
Published: November 2019

A 21-year-old patient has been treated in emergency with venovenous extracorporeal membrane oxygenation after severe thoracic trauma causing severe air leak and haemothorax. The extracorporeal assistance was managed without heparin for 10 days till the full recovery of the lung, and no side-effect was recorded.
Sentencing, Domestic Violence, and the Overrepresentation of Indigenous Australians: Does Court Location Matter?
Authors: Fitzgerald Robin , Douglas Heather , Heybroek Lachlan
Published: November 2019

The significant overrepresentation of Indigenous people in Australian prisons has been the subject of numerous studies. In this article, we build on recent research suggesting that sentencing in domestic violence cases might be an important contributor to this overrepresentation of Indigenous people. We broaden the existing research by examining differences for Indigenous and non-Indigenous defendants in domestic violence cases across a range of sentencing outcomes including imprisonment, probation, fines, and good behavior orders. We also consider whether the degree of geographic remoteness of the court influences these sentencing outcomes. To accomplish this, we use administrative court data from Queensland, Australia, and employ a multinomial hierarchical modeling strategy appropriate for nested court-level multilevel data. The findings further support recent Australian research suggesting that there are sentencing disparities for Indigenous and non-Indigenous people in relation to domestic violence, and in particular, that harsher sentences such as imprisonment are disproportionately reserved for Indigenous defendants. Our research demonstrates that these disparities in the likelihood of imprisonment occur irrespective of defendants’ domestic violence protection order (DVO) breach histories and the location of the sentencing court. Based on the findings, we conclude with a discussion of possible ways forward. Although there is no question that Indigenous women should be safe and free from violence, supporting a harsher sentencing regime for those who breach DVOs is not effective. Instead, we argue that flexible strategies that work within and for Indigenous communities in Australia are required.
Single and repeated low-velocity impact response of E-glass fiber-reinforced epoxy and polypropylene composites for different impactor shapes
Authors: Dogan Akar
Published: November 2019

This study focuses on the effects of low-velocity impact (LVI) response of thermoset (TS) and thermoplastic (TP) matrix-based composites. In this study, the effects of the impactor shapes on the low-velocity impact response of the composite panels that produced from different matrix was investigated. Unidirectional E-glass fiber fabrics with an areal density of 300 g/m2 as reinforcement and epoxy matrix were used to produce TS composite. The vacuum-assisted resin infusion molding (VARIM) method was used to manufacture composite panels. The thermoplastic composites were manufactured with E-glass fiber-reinforced polypropylene prepregs. The tensile strength of TS matrix-based composites is higher than TP matrix-based composites that have the same fiber volume fraction. Despite being under the same impact energy, the TP specimens possess higher perforation threshold than TS specimens. The shape of the impactor significantly affected the perforation threshold. Besides, the impact number that caused perforation reduced dramatically in conical impactor. The repeated impact number that caused perforation is 36 for hemispherical (HS) impactor, but it is only 3 for conical impactor for polypropylene matrix-based composite. Moreover, a significant effect of fiber volumetric ratio on impact resistance was observed. The perforation threshold of glass fiber-reinforced polypropylene composites for 40% and 50% fiber volume fraction are 61 and 98 J, respectively. The perforation threshold of TP and TS specimens for HS impactor that has the same stacking sequence is 61 and 55 J, respectively.
Trails of Data: Three Cases for Collecting Web Information for Social Science Research
Authors: Li Fumin , Zhou Yisu , Cai Tianji
Published: November 2019

As the availability of online data grows rapidly, researchers are confronted with a pressing question: How should social scientists collect Internet data for research? This study focuses on one of the most commonly used data collection techniques: web scraping. Going beyond canned approaches by leveraging a general framework of data communication, this study illustrates how online information can be systematically queried and fetched for reproducible research. To generalize our approaches, we additionally explore the variations in site security and architecture that analysts may encounter during the scraping process before they are given access to the desired data. The approaches we introduce do not rely on any proprietary software and can be easily implemented on any computing platform with programming languages such as Python or R. The methodological discussion in this study is meant to be applicable to current web-based research efforts. We include three examples with complete Python implementation. We also present an integrated workflow that enables researchers to produce analytical data sets that are traceable and thus verifiable for analysis or replication. Lastly, options related to the validity and efficiency of data are discussed, and we highlight the ongoing debate surrounding the ethics of online data collection, ultimately advocating for the fair use of online data.
Sacrificial Labour: Social Inequality, Identity Work, and the Damaging Pursuit of Elusive Futures
Authors: Monahan Torin , Fisher Jill A
Published: November 2019

This article explores the relationship between personal sacrifice and identity work within conditions of profound structural insecurity. We develop the concept of sacrificial labour to describe how individual self-sacrifice aligns workers’ identities to the needs of organizations while gradually foreclosing the actualization of individuals’ desired future selves. Drawing upon qualitative data from a longitudinal study of healthy individuals who enrol in paid clinical trials for the pharmaceutical industry, we make two contributions to the identity-work literature. First, we argue that the ongoing project of building stable and secure identities may become damaging when structural and cultural conditions defy even provisional, fragile attainment of this goal. Second, we reflect on how racialization and social marginalization erode identities and constrain possibilities for identity recuperation. Whereas the identity-work literature often focuses on the agential accomplishments of individuals, we provide a troubling account of how persistent social and economic inequalities confound identity realization efforts.
The Constant Caregiver: Work–family Spillover among Men and Women in Nursing
Authors: Cottingham Marci D , Chapman Jamie J , Erickson Rebecca J
Published: November 2019

Work–family spillover is a central concept in the work and occupations literature, with prior research detailing its negative outcomes and gendered dimensions. With increased demands for careworkers and more men entering occupations such as nursing, we examine experiences and perceptions of spillover using qualitative data from a diverse sample of 48 US nurses. We find similarities across men and women in terms of exhaustion and stress as well as in anticipating spillover in their careers. Yet, we also find some differences, with men (but not women) highlighting the transfer of emotional capital between work and family. We extend work–family research by broadening the concept of spillover to include its anticipation and the transfer of emotional capital – both aspects that have been previously under-examined. These findings have implications for the retention and support of careworkers and refine the concept of spillover in ways that could apply to various employment sectors.
Synthesis of a benzoxazine monomer contained hyperbranched polysiloxane and the characteristics of its polymer alloys blend with bismaleimides
Authors: Jia Yuan , Liu Zhen , Shi Rui-Feng , Song Rui-Juan
Published: November 2019

A novel benzoxazine monomer contained hyperbranched polysiloxane structure (HBPSi-BOZ) was synthesized via a solvent process based on the polyformaldehyde, aniline, and a new hyperbranched polysiloxane with terminal amino groups (HBPSi-NH2). The HBPSi-BOZ was then used as modified phase to blend with bismaleimides (BMIs) resin, and a polymer alloy HBPSi-BOZ/BMI was successfully prepared. The thermal resistant properties, mechanical properties, and tribological properties of HBPSi-BOZ/BMI resins with different contents of HBPSi-BOZ prepared were researched to get an optimal ratio. The thermogravimetric analysis was also carried out to study the polymerization process and stability of HBPSi-BOZ/BMI resins. The results showed that as the thermal resistance increased, the wear resistance and mechanical properties of HBPSi-BOZ/BMI resins were also enhanced.
An efficient method for the dynamic modeling and analysis of Stewart parallel manipulator based on the screw theory
Authors: Hou Yulei , Zhang Guoxing , Zeng Daxing
Published: November 2019

Dynamic modeling serves as the fundamental basis for dynamic performance analysis and is an essential aspect of the control scheme design of parallel manipulators. This report presents a concise and efficient solution to the dynamics of Stewart parallel manipulators based on the screw theory. The initial pose of these manipulators is described. Then the pose matrix of each link of the Stewart parallel mechanism is obtained using an inverse kinematics solution and an exponential product formula. Considering the constraint relationship between joints, the constraint matrix of the Stewart parallel manipulator is deduced. In addition, the Jacobian matrix and the twist of each link are obtained. Moreover, by deriving the differential form of the constraint matrix, the spatial acceleration of each link is obtained. Based on the force balance relationship of each link, the inverse dynamics and the general form of the dynamic model of the Stewart parallel manipulator is established and the process of inverse dynamics is summarized. The dynamic model is then verified via dynamic simulation using the ADAMS software. A numerical example is considered to demonstrate the feasibility and effectiveness of this model. The proposed dynamic modeling approach serves as a fundamental basis for structural optimization and control scheme design of the Stewart parallel manipulators.
Effect of propeller-induced flow on the performance of biplane micro air vehicle dynamics
Authors: Jana Shuvrangshu , Kandath Harikumar , Shewale Mayur , Bhat M Seetharama
Published: November 2019

This paper presents the analysis of propeller-induced flow effects on the dynamics of a fixed wing biplane micro air vehicle. The analysis is based on wind tunnel tests and mathematical modeling. This analysis plays a pivotal role because the propeller-induced flow has significant effects on the dynamics of fixed wing micro air vehicle due to submergence of a large portion of the wing in propeller slipstream. Although the effect of the propeller-induced flow on the various aerodynamic parameter is reported in the literature; however, its effects on overall forces, moments and vehicle dynamics are not quantified so far. In this paper, propeller-induced flow effects are modeled as a function of motor rotation speed and mathematical analysis is performed to quantify their effects. The wind tunnel test is conducted at different propeller speeds on a biplane micro air vehicle “Skylark”, having wingspan and chord length of 150 mm and 140 mm, respectively. Analysis of results shows that the propeller slipstream increases the overall lift, drag, side force, range, and endurance significantly. Propeller flow also contributes to the rolling moment and the pitching moment, while it has negligible effects on the yawing moment. It is shown that the trim angle of attack is lower when the propeller flow is considered in computing the trim conditions.
Energy consumption, CO2 emissions, and economic growth in the United States, China, and India: A wavelet coherence approach
Authors: Khochiani Ramin , Nademi Younes
Published: November 2019

Climate change is one of the most dangerous threats to human beings, and therefore, it is of great importance for the researchers to inform the policy makers of the threats of climate change and global warming. One of the main causes of climate change is the greenhouse gas emissions, particularly CO2 emissions. In this paper, we try to find a nexus between energy consumption, CO2 emissions, and economic growth in the United States, China, and India, known as three most polluting countries in the world. For this purpose, we applied the wavelet correlation and the partial wavelet coherence approaches during the period 1971–2013. The empirical results for the United States show that the GDP is positively correlated with the CO2 emissions and energy consumption in all frequencies. For China, there is a significant positive relationship between the GDP and CO2 emissions/energy consumption for the short-term horizon. However, for India, although there is a significant positive relationship between the GDP and CO2 emissions, the nexus between the GDP and the energy consumption is not clear. Furthermore, the pollution haven hypothesis was confirmed by the obtained empirical results. Based on our study, we suggest the policy makers in these three countries making supportive decisions for the producers to use modern environment-friendly technologies and renewable energies in their products.
Environmental polycyclic aromatic hydrocarbons mixture, in human blood levels, decreased oestradiol secretion by granulosa cells via ESR1 and GPER1 but not ESR2 receptor
Authors: Zajda K , Gregoraszczuk EL
Published: November 2019

Tissue-dependent oestrogenic and anti-oestrogenic activity of polycyclic aromatic hydrocarbons (PAHs) has been suggested. In this study, the effect of two PAH mixtures, M1 composed of all 16 priority pollutants and M2 composed of five (noted in the highest levels) compounds, on follicle-stimulating hormone receptor (FSHR) expression, basal or FSH-induced oestradiol (E2) secretion and aromatase cytochrome P450 (P450arom) protein expression, by non-luteinised human granulosa cell line (HGrC1) was determined. In addition, the consequences of gene silencing of oestrogen receptor alfa (siESR1), oestrogen receptor beta (siESR2) and a G protein-coupled receptor (siGPER1) on the above parameters were described. Neither PAH mixture had an effect on basal FSHR protein expression; however, both mixtures increased FSH-induced FSHR expression. Decreased E2 secretion and P450arom expression was also demonstrated. In both basal and FSH treated cells, siESR1 and siGPER1 reversed the inhibitory effect of the mixtures on E2 secretion; however, in siESR2 cells, the inhibitory effect was still observed. This study showed that both classic ESR1 and GPER1 were involved in the inhibitory effect of both PAH mixtures on E2 secretion and confirmed that expression of P450arom could be downregulated through the aryl hydrocarbon receptor and additionally through the ESR2.
A quantitative investigation of students’ attitudes towards electronic book technology
Authors: Bulur Hatice Gonca , Gönül Mustafa Sinan
Published: November 2019

The purpose of this study is to analyse the factors that have an impact on technology adoption for e-books utilizing the Analytic Hierarchy Process and Multiple Regression Analysis methods. Findings indicate that perceived usefulness and ease of use are the most significant determinants in using e-books. Of key significance is that Analytic Hierarchy Process results show that consumers make pairwise comparisons, adding environmental concerns to the selection process. Recognizing the importance of all these factors is valuable to e-book developers and marketers in presenting products that meet all consumer choice criteria. The Analytic Hierarchy Process provides researchers with a more thorough decision-making analysis.
Cardiac Magnetic Resonance Imaging used for Evaluation of Adipose-Derived Stromal Cell Therapy in Patients with Chronic Ischemic Heart Disease
Authors: Qayyum Abbas Ali , Mathiasen Anders Bruun , Mygind Naja Dam , Vejlstrup Niels Groove , Kastrup Jens
Published: November 2019

Adipose-derived stromal cell (ASC) therapy is currently investigated as a new treatment option for patients with ischemic heart disease (IHD). The aim of this study was to evaluate the effect of ASC therapy in patients with chronic IHD measuring myocardial perfusion and cardiac function using cardiac magnetic resonance imaging (CMRI). Patients were included in MyStromalCell trial, a phase II, randomized, double-blinded, placebo-controlled study investigated the effect of ASCs in patients with chronic IHD with preserved left ventricular ejection fraction (LVEF). In total, 41 of 60 patients underwent cine, late enhancement, rest and stress imaging with CMRI. There was a non-significant difference between stress and rest values in maximal signal intensity, a measure of myocardial perfusion, from baseline to follow-up comparing placebo with ASC group (–52.52 ± 88.61 and 3.05 ± 63.17, p = 0.061, respectively). LVEF, myocardial mass, stroke volume, left ventricle end-diastolic volume and end-systolic volume changed non-significantly (–0.5 ± 4.7%, –3.5 ± 13.1 g, –0.7 ± 8.6 mL, 1.9 ± 25.1 mL and 2.6 ± 16.5 mL, respectively) in the placebo group and in the ASC group (0.7 ± 8.6%, 0.9 ± 10.8 g, –0.3 ± 26.1 mL, –3.0 ± 31.5 mL and –2.7 ± 20.4 mL, respectively) from baseline to 6 months follow-up. The amount of scar tissue was unchanged in the placebo group by 0.0 ± 1.6 g, p = 1.0 and in the ASC group with –0.3 ± 2.3 g, p = 0.540. There was no difference between the groups. There was a non-significant trend toward increased myocardial perfusion but no significant changes in functional parameters or amount of scar tissue in patients treated with ASCs compared with patients allocated into the placebo group.
Buprenorphine for Cancer Pain in Patients With Nonmedical Opioid Use: A Retrospective Study at a Comprehensive Cancer Center
Authors: Hansen Eric , Nadagoundla Chitra , Wang Chong , Miller Austin , Case Amy Allen
Published: November 2019

Background:

Outpatients with cancer commonly have nonmedical opioid use (NMOU) behaviors and use opioids to dull emotional and existential suffering. Buprenorphine is often used for cancer pain due to less reported euphoria when compared to other opioids.

Methods:

A retrospective review was done in patients who were prescribed buprenorphine for cancer pain. Pain scores were reported on a Likert pain scale of 1 to 10. Nonmedical opioid use was defined as patients taking opioids for emotional pain at or above the maximum prescribed amount.

Results:

For 16 patients, the mean pain score prior to buprenorphine (pain pre) was 8.3 (Standard deviation (Std) 1.6), and the mean pain score on follow-up post-buprenorphine (pain post) was 6.1 (Std 2.3) with a reduction in mean pain score (pain change) of −2.0 (Std 2.9, P = .059). Those patients without NMOU had a pain prescore of 9.5 (Std 1.0) and pain post of 4.3 (Std 2.5) with a mean pain change of −5.0 (Std 1.7, P = .20). The mean pain change in those with chemical coping (−1.3/Std 2.7), illicit drug use (−2.8/Std 1.0), or psychiatric comorbidity (−2.4/Std 2.7) were reduced after buprenorphine, however, not statistically significant. Outpatient rotation to buprenorphine was well tolerated.

Conclusions:

The pain score in those patients without NMOU was significantly lower after rotation to buprenorphine than those with NMOU. We deduce that in those with NMOU, it is more challenging to achieve pain relief with buprenorphine. Overall, for all patients, rotation to buprenorphine resulted in a marginally significantly reduced pain score.
Natural Language Processing to Assess Palliative Care and End-of-Life Process Measures in Patients With Breast Cancer With Leptomeningeal Disease
Authors: Brizzi Kate , Zupanc Sophia N. , Udelsman Brooks V. , Tulsky James A. , Wright Alexi A. , Poort Hanneke , Lindvall Charlotta
Published: November 2019

Background:

Palliative care consultation during serious life-limiting illness can reduce symptom burden and improve quality of care. However, quantifying the impact of palliative care is hindered by the limitations of manual chart review and administrative coding.

Objectives:

Using novel natural language process (NLP) techniques, we examined associations between palliative care consultations and performance on nationally endorsed metrics for high-quality end-of-life (EOL) care in patients with leptomeningeal disease (LMD) secondary to metastatic breast cancer.

Methods:

Patients with breast cancer with LMD were identified using administrative billing codes and NLP review of magnetic resonance imaging reports at 2 tertiary care centers between 2010 and 2016. Next, NLP was used to review clinical notes to (1) determine the presence of palliative care consultations and (2) determine the performance of process measures associated with high-quality EOL care, including discussions of goals of care, code status limitations, and hospice. Associations between palliative care consultation and documentation of EOL process measures were assessed using logistic regression.

Results:

We identified 183 cases of LMD. Median age was 56 (interquartile range [IQR]: 46-64) years and median survival was 150 days (IQR: 67-350). Within 6 months of diagnosis, 88.5% of patients had documentation of ≥1 process measure, including discussions of goals of care (63.4%), code status limitations (62.8%), or hospice (72.1%). Palliative care consultation was a predictor of subsequent documentation of goals of care (odds ratio [OR], 3.15; 95% confidence interval [CI], 1.58-6.27) and hospice discussions (OR, 4.61; 95% CI, 2.12-10.03).

Conclusion:

Palliative care involvement is associated with increased performance of EOL process measures in patients with breast cancer with LMD.
Effect of Nonselective β-Blockers on Mortality in Patients With End-Stage Cirrhosis
Authors: Snoga Jenna L. , Lusk Kathleen A. , Attridge Russell T. , Attridge Rebecca L.
Published: November 2019

Background: Data regarding safety of nonselective β-blockers (NSBBs) in patients with end-stage cirrhosis are conflicting, making it difficult for practitioners to justify if benefits outweigh the risks. Objective: Evaluate the effect of NSBB use on mortality in patients with end-stage cirrhosis. Methods: We performed a dual-center retrospective study of patients who received octreotide for a variceal bleed. Patients were stratified into 2 groups based on whether or not a NSBB was prescribed at hospital discharge. The primary outcome was 24-month mortality. Multivariable logistic regression, with 24-month mortality as the dependent variable, was performed to identify independent risk factors for the primary outcome. Results: 255 patients met inclusion criteria; 24-month mortality was 32.8%. The NSBB and no-NSBB groups had similar mortality rates at 24 months (32.0% vs 38.5%, P = 0.51). Mortality at 3 months (11.6% vs 23.3%, P = 0.08) and 12 months (22.2% vs 30.0%, P = 0.36) were similar, and there were no differences in rate of variceal bleeding (22.7% vs 13.3%, P = 0.34) or cirrhosis-related cause of death (20.4% vs 23.3%, P = 0.81). In the multivariable model, age, model for end-stage liver disease with sodium and hepatocellular carcinoma were independent risk factors for 24-month mortality. NSBB therapy had no effect on 24-month mortality (adjusted odds ratio = 1.05; 95% CI = 0.32 to 3.40). Conclusion and Relevance: In patients with end-stage cirrhosis, use of NSBBs did not affect 24-month mortality. More research is needed to determine when, and if, NSBBs should be discontinued in end-stage cirrhosis.
Synchronous Oncocytic Papillary Cystadenoma and Warthin Tumor of the Parotid Gland
Authors: Kakkar Aanchal , Zubair Arshad , Sharma Nisha , Monga Rabia , Sharma Suresh C.
Published: November 2019

Warthin tumor (WT) is the second most common benign salivary gland neoplasm. It is also the most frequent salivary gland tumor to occur synchronously or metachronously with another salivary gland neoplasm, in the same gland or on the other side. Oncocytic papillary cystadenomas (OPCs) are rare neoplasms that are more common in minor salivary gland locations and in women. We describe in detail the case of a 73-year-old male smoker with synchronous OPC and WT of the parotid gland. On microscopy, both tumors resembled each other considerably, with the only difference being that the OPC lacked the tumor-associated lymphoid proliferation characteristic of WT. These findings highlight that OPC bears considerable similarity to WT. While this morphological similarity may lead to misdiagnosis on rare occasions, it does not affect patient management, as clinical behavior of both these tumors is similar.
The Privileged Few: How Exclusionary Zoning Amplifies the Advantaged and Blocks New Housing—and What We Can Do About It
Authors: Einstein Katherine Levine
Published: November 2019

“Rethinking Exclusionary Zoning” provocatively claims that the movement to eliminate exclusionary zoning is misguided, and will create a worse set of social, economic, and political conditions than those currently produced by contemporary land-use regulations. In this response, I present several challenges to this claim. First, I demonstrate that “Rethinking Exclusionary Zoning” misses the well-documented political harms wrought by exclusionary zoning. Second, I illustrate that “Rethinking Exclusionary Zoning” misidentifies the central problems and solutions proposed by scholars and policy makers comprising the so-called Anti-EZ Project. These advocates seek fair and equitable land use—not the elimination of all regulations—as part of a broader housing policy agenda to increase the supply of housing in places that need it. They do not view local land-use reform as a panacea to urban inequality.
Invisible Hand or Ecological Footprint? Comparing Social Versus Environmental Impacts of Recent Economic Growth
Authors: Mikkelson Gregory M.
Published: November 2019

This study examines changes in some key indicators among 66 countries on six continents over a 56-year period, to compare the power of economic growth to improve human health and income distribution with its tendency to degrade the natural environment. The results indicate that growth depletes and pollutes nature far more than it benefits society. This suggests that public policy should shift toward enhancement of individual and social well-being in ways more direct and effective, and less ecologically damaging, than reliance on overall growth in gross domestic product. I illustrate this implication with a degrowth scenario for the United States to 2050 that draws on the empirical results for the period 1961 to 2016. And I consider certain reforms in the management and governance of organizations to implement such a scenario.
Demographic and Clinical Features of Hidradenitis Suppurativa in Turkey
Authors: Yüksel Mavişe , Basım Pelin
Published: November 2019

Background

The literature contains conflicting reports on the epidemiology and frequency of hidradenitis suppurativa (HS), a chronic, recurrent inflammatory disease of the apocrine glands.

Objective

To evaluate the clinical and demographic characteristics of HS cases in Turkey and investigate the similarities with world epidemiology.

Method

The records of 208 patients that presented to our polyclinics and were diagnosed with HS between June 2012 and July 2017 were retrospectively evaluated.

Results

Of the cases, 68.3% were male and 31.7% were female. Of the patients, 75.5% had no family history of HS, 60.6% were smokers, 39.4% were aged 20-29 years, and 36.1% were aged 30-39 years. The most commonly involved regions were the axilla (62%), groin (50.5%), and gluteus (15.9%). According to univariate analyses, male patients had higher disease stages than females (odds ratio=1.67). The patients with groin involvement, high body mass index (BMI), and low education level (0-8 years) had higher risk of severe disease stage (odds ratio=1.63, 8.91, and 1.51, respectively). The most commonly used treatment was oral antibiotics in Hurley stages I and II, and surgical intervention in Hurley III. In all 3 Hurley stages, clavulanic acid–amoxicillin combination was the mostly used systemic antibiotic (41.8%, 43.2%, and 47.8%, respectively).

Conclusions

This is the first epidemiological study on HS in the Turkish population, where HS shows male predominance. Male gender, low education level, absence of acne, high BMI, and groin involvement were associated with severe disease stages. Determining associated comorbidities and possible risk factors is important in progression and prevention of the disease.
Silence Matters: A survey of the right to silence in the summary jurisdiction of New South Wales
Authors: Schofield-Georgeson Eugene
Published: November 2019

There is a scant existing literature on the relationship between the right to silence and its effect on convictions in Australia and comparable jurisdictions. Existing research has downplayed its significance in the face of various ‘law and order’ interventions seeking to limit its operation. This study is one of the largest of its kind, surveying over 1,000 charges to empirically assess the frequency of use and the effects of silence rights (the right to silence, privilege against self-incrimination and burden of proof) on conviction, in relation to a particular set of charges laid against a specific group of marginalised defendants in the Local Court summary jurisdiction of NSW. Adding to the existing literature, this study shows empirically how silence rights operate within an Australian summary jurisdiction for a specific group of criminal defendants who are significantly socially marginalised. In the process, it demonstrates that the use of silence rights is significant for this group, mostly in non-regulatory criminal matters. In this respect, silence rights can be understood to correlate with rates of conviction, mitigation of criminal sentencing and the practice of charge-bargaining.
Environmental parameters and analysis of crowd flow in an academic building of a university
Authors: Lei Wenjun , Tai Chuanmin , Rong Chuanliang , Qi Xinye , Zhang Linhua , Cong Junzi
Published: November 2019

Academic buildings are the main gathering places in universities and colleges. The crowd flow could cause a change in environmental parameters of buildings. In other words, the change in environmental parameters in buildings can be somewhat reflective of the crowd flow. Therefore, field measurements of the crowd flow and environmental parameters in an academic building at a university were conducted in this study. During the periods of 7:30–8:00 and 13:20–13:50, the average speed of the crowd was the highest, which was about 1.2 m/s; the CO2 concentration was low, which was about 750 ppm. In the periods of 9:20–9:50 and 15:10–15:40, the average speed of people walking in the opposite directions was the lowest, which is 0.42 m/s; however, the CO2 concentration could reach 1800 ppm. Test results showed that the variations of CO2 concentrations were inversely related to the average speed of the crowd in the evacuation passage, except for the periods of 7:30–8:00 and 13:20–13:50. Spatial separation and physical separation could be used in the management of personnel flow in the academic building. The results may provide reference for the management of the crowd flow in similar academic buildings of other universities.
‘Art is my language’: Afghan cultural production challenging Islamophobic stereotypes
Authors: Ghani Bilquis , Fiske Lucy
Published: November 2019

Afghans and Afghanistan have, since September 11, risen to prominence in Western popular imagination as a land of tradition, tribalism and violence. Afghan women are assumed to be silent, submissive, and terrorised by Afghan men, who are seen as violent patriarchs driven by an uncompromising mediaeval religion. These Islamophobic tropes also inform perceptions of Afghans seeking asylum. In transit, identities are further reduced; asylum seekers lose even a national identity and become a Muslim threat – criminals, terrorists or invaders. These narrative frames permeate political discourse, media, and reports of non-governmental organisations (seeking donor funds to ‘save’ Afghan women). Drawing on fieldwork in Afghanistan and Indonesia, this article looks at how Afghans in Kabul and Indonesia are using art and other forms of cultural production to challenge over-simplified hegemonic narratives in the West, to open spaces for dialogue and expression within their own communities, and to offer a more nuanced account of their own identities.
Is there an app for that? A cluster randomised controlled trial of a mobile app–based mental health intervention
Authors: Kenny Rachel , Fitzgerald Amanda , Segurado Ricardo , Dooley Barbara
Published: November 2019

Demand for the use of mobile apps in mental health interventions has grown in recent years, particularly among adolescents who experience elevated levels of distress. However, there is a scarcity of evidence for the effectiveness of these tools within this population. The aim of this study was to test the effectiveness of CopeSmart, a mental health mobile app, using a multicentre cluster randomised controlled trial design. Participants were 15–18-years-olds (N = 560) recruited from 10 schools randomly assigned to an intervention or control condition. Intervention participants used the app over a 4-week period. Multi-level modelling analyses revealed no significant changes in the intervention group from pre-test to post-test, when compared to the control group, in terms of emotional distress, well-being, emotional self-awareness or coping strategies. Findings suggest that a 4-week app-based intervention may not be enough to elicit intra-personal changes in mental health outcomes in a general adolescent population.