bluuebunny/crossref_metadata_2025 huggingface dataset:
Far-field noise prediction for jets using large-eddy simulation and Ffowcs Williams–Hawkings method
Authors: Naqavi Iftekhar Z , Wang Zhong-Nan , Tucker Paul G , Mahak M , Strange Paul
Published: October 2016

Large-eddy simulations are performed for hot and cold jets with and without a flight stream. The acoustic and flight stream Mach numbers are 0.875 and 0.3, respectively. The temperature ratios for the hot and cold jets are 2.7 and 1.0, respectively. The mean flow field results are in good agreement with the measurements. The Ffowcs Williams–Hawkings equation is used to predict far-field noise. Several axisymmetric Ffowcs Williams–Hawkings surfaces at increasing radial distances are used. They show that the surfaces closer to the jet can be affected by the hydrodynamic pressure. It is important to close the Ffowcs Williams–Hawkings surfaces at the ends to account for all the acoustic signals emanating from the jet. In this work, 11 end discs are used at the downstream end of the Ffowcs Williams–Hawkings surface. It is found that the simple averaging processes to cancel hydrodynamic sound at the end discs are insufficient for slowly decaying jets. In such cases, a partially closed disc can be a better choice. To remove hydrodynamic signals, a filtering scheme for the end discs is suggested. For slowly decaying jets, this gives better results.
Restorying the present by revisiting the past: Unexpected moments of discovery and illumination through museum learning
Authors: Kawalilak Colleen , Groen Janet
Published: October 2016

Two adult educators, guided by autoethnography as methodology, share the restorying of their own lifelong learning narratives and unexpected insights gained from having experienced the powerful potential of museum learning and culture. Having previously regarded museum visits as an experience that primarily tapped the intellectual, cognitive domain, the authors, drawing from experiencing the Pier 21 Museum in Halifax and the War Brides installation exhibit at the Glenbow Museum, Calgary, were thrust into multiple ways and dimensions of how we learn, how we view the world, and how we locate ourselves in the world. Shared stories illuminate the potential for museum education to animate, breathe life into and offer a deepened understanding of our own personal, lifelong learning narratives.
What makes a city ‘smart’?
Authors: Thompson Emine Mine
Published: October 2016

Taking advantage of information and communications technology tools and techniques for city administration, whether it is for urban planning activities, for transport solutions or many other purposes, is not a new concept. However, in order for a city to be classified as ‘smart’, a synthesis of intelligence that transcends mere utilisation is essential. This article analyses the increasing use of information and communications technology and sensing technologies in cities by examining this new way of city governing from a critical perspective. Existing projects and initiatives were investigated to find out how, and to what extent, these tools are being employed by cities. The advantages and the current shortcomings of smart city are also discussed in order to understand the viability of using these tools.
From Classroom to Capitol
Authors: Rivera Lydia , Starry Bethany , Gangi Catherine , Lube Lauren M. , Cedergren Anders , Whitney Emily , Rees Keely
Published: October 2016

This commentary provides insight from Community Health Education and Master of Public Health students on the benefits of participating in a state-level Advocacy Experience and provides a theoretical framework for increased advocacy intention among students as a result of participating in a state-level Advocacy Experience. Providing students the opportunity to translate what they learn about advocacy in the classroom into advocacy in action with policy makers is vital to the career development of our future health education professionals and is key to increasing advocacy capacity within our profession. This article builds on previous work from emerging public health professionals highlighting the role of policy advocacy in professional development and provides additional perspectives from the next generation of health education specialists.
The EDIC Method: An Engaging and Comprehensive Approach for Creating Health Department Workforce Development Plans
Authors: Grimm Brandon L. , Brandert Kathleen , Palm David , Svoboda Colleen
Published: October 2016

In 2013, the Nebraska Department of Health & Human Services, Division of Public Health (Nebraska’s State Health Department); and the University of Nebraska Medical Center, College of Public Health developed a comprehensive approach to assess workforce training needs. This article outlines the method used to assess the education and training needs of Division staff, and develop comprehensive workforce development plans to address those needs. The EDIC method (Engage, Develop, Identify, and Create) includes the following four phases: (1) Engage Stakeholders, (2) Develop Assessment, (3) Identify Training Needs, and (4) Create Development Plans. The EDIC method provided a process grounded in science and practice, allowed input, and produced buy-in from staff at all levels throughout the Division of Public Health. This type of process provides greater assurance that the most important gaps in skills and competencies will be identified. Although it is a comprehensive approach, it can be replicated at the state or local level across the country.
Social Mobility: Charting the Economic Topography of Urban Space
Authors: Zwicker Heather , Supernant Kisha , Luckert Erika
Published: October 2016

This project on economic topographies is one of eight thematic ways in which the research group Edmonton Pipelines is remapping the neighborhood of Rossdale. The essay brings together poetry, data visualization, and technologies of mapping to analyze how the twin vectors of capitalism and colonialism have created Western Canadian cityspace. Rather than taking for granted the ups and downs of the built environment, the article muses on the possibilities of using haunting as an urban interface. Working through this metaphorical possibility concretely, this essay traces the contours of haunting in the case of Rossdale, a Canadian neighborhood that has undergone an emblematic form of gentrification. We develop literal topographical maps as a way of conceptualizing metaphorical hurdles to belonging to settler colonial cities. These socioeconomic topographical maps serve as a new form of urban cartography.
The Alt-social Network of Natalie Bookchin’s Testament
Authors: Laiola Sarah Whitcomb
Published: October 2016

This article addresses issues of user precarity and vulnerability in online social networks. As social media criticism by Jose van Dijck, Felix Stalder, and Geert Lovink describes, the social web is a predatory system that exploits users’ desires for connection. Although accurate, this critical description casts the social web as a zone where users are always already disempowered, so fails to imagine possibilities for users beyond this paradigm. This article examines Natalie Bookchin’s composite video series, Testament, as it mobilizes an alt-(ernative) social network of vernacular video on YouTube. In the first place, the alt-social network works as an iteration of “tactical media” to critically reimagine empowered user-to-user interactions on the social web. In the second place, it obfuscates YouTube’s data-mining functionality, so allows users to socialize online in a way that evades their direct translation into data and the exploitation of their social labor.
Modified Exposure and Response Prevention for the Treatment of Comorbid OCD-Like Repetitive Behavior and Developmental Disability
Authors: Benson Rodney , Stickney Laurie , Smetter Joseph , Steglitz Jeremy
Published: October 2016

Adults with developmental disabilities are particularly vulnerable to experiencing obsessive-compulsive disorder (OCD). However, the application of evidence-based treatments such as Exposure and Response Prevention (ERP) to individuals with comorbid OCD and developmental disabilities is a relatively new and emerging field of study. The present article presents a case study of modified ERP for the treatment of an adult woman with comorbid OCD-like repetitive behavior and developmental disabilities. Target behaviors, including OCD-like repetitive behavior, verbal agitation, and physical aggression, decreased over the course of the 7-month active treatment phase, and reductions in physical aggression and verbal agitation were maintained during follow-up. This case study provides important lessons about the individual-level and systems-level assessment and treatment of comorbid OCD-like repetitive behavior and developmental disabilities.
Combination of Open Subtotal Calcanectomy and Stabilization With External Fixation as Limb Salvage Procedure in Hindfoot-Infected Diabetic Foot Ulcers
Authors: Dalla Paola Luca , Carone Anna , Boscarino Giulio , Scavone Giuseppe , Vasilache Lucian
Published: October 2016

Diabetic hindfoot ulcers, complicated by osteomyelitis, are associated with a high risk of major amputation. Partial calcanectomy, preceded by an effective management of the infection and of the eventual peripheral artery disease, can be considered as valid therapeutic option. We have evaluated a therapeutic protocol for diabetic hindfoot ulcers complicated by osteomyelitis, which, besides an adequate surgical debridement, considers a reconstructive pathway assisted by the positioning of a circular external fixator. We made a prospective study of a cohort of diabetic patients affected by heel ulcer complicated by osteomyelitis. All patients underwent open partial calcanectomy associated with the positioning of a circular external frame specifically designed for hindfoot stabilization and offloading. A reconstructive procedure was implemented starting with the application of negative pressure wound therapy and coverage with dermal substitute and split thickness skin grafting. From November 2014 to November 2015, 18 consecutive patients were enrolled. Mean follow-up period was 212.3 ± 64.0 days. Healing was achieved in 18 (100%) patients. The mean healing time was 69.0 ± 64.0 days. No major amputation had to be performed during the follow-up. Open partial calcanectomy associated with external fixation and skin reconstruction was as efficient as limb salvage in patients with infected lesions of the hindfoot complicated by calcaneal osteomyelitis.
Preoperative Angiographic Criteria for Predicting Free-Flap Transfer Outcomes in Patients With Lower-Extremity Peripheral Arterial Disease
Authors: Park Sang Woo , Kim Junhyung , Choi Jaehoon , Kim Jun Sik , Lee Jeong Hwan , Park Young Sook
Published: October 2016

Patients scheduled for microsurgical reconstruction of the lower leg often receive preoperative assessment of recipient vessels using angiography. However, no clear standard is available for evaluating angiographic results to predict free-flap survival outcomes. We developed angiographic criteria for predicting surgical outcome in patients with lower-extremity peripheral arterial disease based on abnormality of the anterior tibial and posterior tibial arteries. We applied the criteria to a small number of patients scheduled for microsurgical reconstruction of the lower leg. Angiographies with arterial abnormalities were classified into 3 groups: favorable free-flap survival, compromised free-flap survival, and postsurgical pedal ischemia. The study enrolled 50 patients between 2005 and 2013. In 42% of patients, arterial abnormalities were observed by angiography. Age >65 years was the strongest risk factor for development of lower-leg arterial abnormality ( P < .001). The anterior tibial and peroneal arteries were significantly more stenotic than other vessels. In the favorable free-flap survival and compromised free-flap survival groups, free-flap transfers were attempted in 7 patients but intraoperatively abandoned in 2 patients, with postoperative failure in 1 patient. In the postsurgical pedal ischemia group, free-flap transfers were attempted in 10 patients but intraoperatively abandoned in 6 patients, with postoperative failure in 3.
APSA Awardee Submission: Tumor/cancer stem cell marker doublecortin-like kinase 1 in liver diseases
Authors: Nguyen Charles B , Houchen Courtney W , Ali Naushad
Published: October 2016

Liver diseases are the fourth leading cause of mortality among adults in the United States. Patients with chronic liver diseases such as viral hepatitis, fibrosis, and cirrhosis have significantly higher risks of developing hepatocellular carcinoma (HCC). With a dismal five-year survival rate of 11%, HCC is the third most common cause of cancer-related deaths worldwide. Regardless of the underlying cause, late presentation and a lack of effective therapy are the major impediments for successful treatment of HCC. Therefore, there is a considerable interest in developing new strategies for the prevention and treatment of chronic liver diseases at the early stages. Cancer stem cells (CSCs), a small cell subpopulation in a tumor, exhibit unlimited self-renewal and differentiation capacity. These cells are believed to play pivotal roles in the initiation, growth, metastasis, and drug-resistance of tumors. In this review, we will briefly discuss pivotal roles of the CSC marker doublecortin-like kinase 1 (DCLK1) in hepatic tumorigenesis. Recent evidence suggests that anti-DCLK1 strategies hold promising clinical potential for the treatment of cancers of the liver, pancreas, and colon.
More than Collectors
Authors: Heljakka Katriina Irja
Published: October 2016

The article aims to present, analyze, and discuss the attitudes of the three groups of adults—theorists, hobbyists and “everyday players”—toward play(ful) behavior and activities in relation to character toys. The rhetoric of play theorists is mirrored against the rhetoric of organized players (hobbyists) and (nonorganized) everyday players through in-depth interviews and participatory observation. Questions guiding the exploratory path this article takes include the following: First, what has led to the dominant ideas of the toy as a collectable item and of adult toy consumers as toy collectors? Second, why is the manipulation of toys that happens at adult age considered hobbying and not playing? The results of the analysis indicate that the uses of toys at adult age represent more complex and multifaceted actions and relationships to play than the terms “collecting” and “hobbying” imply.
Impact of Marital Status on Tumor Stage at Diagnosis and on Survival in Male Breast Cancer
Authors: Adekolujo Orimisan Samuel , Tadisina Shourya , Koduru Ujwala , Gernand Jill , Smith Susan Jane , Kakarala Radhika Ramani
Published: October 2016

The effect of marital status (MS) on survival varies according to cancer type and gender. There has been no report on the impact of MS on survival in male breast cancer (MBC). This study aims to determine the influence of MS on tumor stage at diagnosis and survival in MBC. Men with MBC ≥18 years of age in the SEER database from 1990 to 2011 were included in the study. MS was classified as married and unmarried (including single, divorced, separated, widowed). Kaplan–Meier method was used to estimate the 5-year cancer-specific survival. Multivariate regression analyses were done to determine the effect of MS on presence of Stage IV disease at diagnosis and on cancer-specific mortality. The study included 3,761 men; 2,647 (70.4%) were married. Unmarried men were more often diagnosed with Stage IV MBC compared with married (10.7% vs. 5.5%, p < .001). Unmarried men (compared with married) were significantly less likely to undergo surgery (92.4% vs. 96.7%, p < .001). Overall unmarried males with Stages II, III, and IV MBC have significantly worse 5-year cancer-specific survival compared with married. On multivariate analysis, being unmarried was associated with increased hazard of death (HR = 1.43, p < .001) and increased likelihood of Stage IV disease at diagnosis ( OR = 1.96, p < .001). Unmarried males with breast cancer are at greater risk for Stage IV disease at diagnosis and poorer outcomes compared with married males.
Subgrouping High School Students for Substance Abuse–Related Behaviors: A Latent Class Analysis
Authors: Khayyati Fariba , Mohammadpoorasl Asghar , Allahverdipour Hamid , AsghariJafarabadi Mohammad , Kouzekanani Kamiar
Published: October 2016

The aim of the current study was to characterize the prevalence of latent groups in terms of smoking, hookah, and alcohol in a sample of Iranian high school students. In this cross-sectional study, 4,422 high school students were assessed in East Azerbaijan Province, Iran. Latent class analysis was applied to determine the subgroups and prevalence of each class using the procLCA in SAS 9.2 software. The prevalence of hookah smoking was the highest among the other substances and had the greatest abuse among males than females. Nearly 86%, 9.5%, and 4.6% of the participants were low risk, tobacco experimenter, and high risk, respectively. The odds ratio indices of membership in each class, compared with the first class, associated with the independent variables. A fair number of students, males in particular, were identified as high risk-takers. Considering the simultaneous incidence of multiple high-risk behaviors, interventions must cover multiple aspects of the issue at the same time.
New Fathers’ Perinatal Depression and Anxiety—Treatment Options: An Integrative Review
Authors: O’Brien Anthony P. , McNeil Karen A. , Fletcher Richard , Conrad Agatha , Wilson Amanda J. , Jones Donovan , Chan Sally W.
Published: October 2016

More than 10% of fathers experience depression and anxiety during the perinatal period, but paternal perinatal depression (PPND) and anxiety have received less attention than maternal perinatal mental health problems. Few mainstream treatment options are available for men with PPND and anxiety. The aim of this literature review was to summarize the current understanding of PPND and the treatment programs specifically designed for fathers with perinatal depression. Eight electronic databases were searched using a predefined strategy, and reference lists were also hand searched. PPND and anxiety were identified to have a negative impact on family relationships, as well as the health of mothers and children. Evidence suggests a lack of support and tailored treatment options for men having trouble adjusting to the transition to fatherhood. Of the limited options available, cognitive behavioral therapy, group work, and blended delivery programs, including e-support approaches appear to be most effective in helping fathers with perinatal depression and anxiety. The review findings have important implications for the understanding of PPND and anxiety. Future research is needed to address the adoption of father-inclusive and father-specific models of care to encourage fathers’ help-seeking behavior. Inclusion of male-specific requirements into support and treatment options can improve the ability of services to engage new fathers. Psychotherapeutic intervention could assist to address the cognitive differences and dissonance for men adjusting to the role of father, including male identity and role expectations.
Thoracic outlet syndrome affecting high-performance musicians playing bowed string instruments
Authors: Demaree Christopher J , Wang Kevin , Lin Peter H
Published: October 2016

Thoracic outlet syndrome, a condition due to neurovascular compression in the upper shoulder region, can be caused by chronic repetitive activity of the upper extremities. Studies have linked upper extremity musculoskeletal disorders to high-performance musicians who play bowed string instruments such as the violin or viola. We report herein a case series of five elite musicians, including three violinists and two violaists, who developed neurogenic thoracic outlet syndrome following years of intense practice. Successful surgical treatment including first rib resection, scalenectomy, and brachial plexus neurolysis was performed in all patients. All patients were able to resume their musical career following surgical treatment. Our report represents the first description of thoracic outlet syndrome in high-performance bowed string instrumentalists. Clinicians should be aware of thoracic outlet syndrome as a differential diagnosis when treating string instrumentalists with upper extremity musculoskeletal ailments.
Strategies to prevent TEVAR-related spinal cord ischemia
Authors: Dias-Neto Marina , Reis Pedro Videira , Rolim Dalila , Ramos José Fernando , Teixeira José Fernando , Sampaio Sérgio
Published: October 2016

Spinal cord ischemia remains the Achilles’ heel of thoracic and thoracoabdominal diseases management. Great improvements in morbidity and mortality have been obtained with the endovascular approach TEVAR (Thoracic Endovascular Aortic Repair) but this devastating complication continues to severely affect the quality of life, even if the primary success of the procedure – dissection/aneurysm exclusion – has been achieved.

Several strategies to deal with this complication have been published in the literature over the time. Knowledge and technology have been evolving from identification of the risk factors associated with spinal cord ischemia, including lessons learned from open surgery, and from developments in the collateral network concept for spinal cord perfusion.

In this comprehensive review, the authors cover several topics from the traditional measures comprising haemodynamic control, cerebrospinal drainage and neuroprotective drugs, to the staged-procedures approach, the emerging MISACE (minimally invasive selective segmental artery coil-embolization) and innovative neurologic monitoring such as NIRS (near-infrared spectroscopy) of the collateral network.
Executive incentives as an instrument of leadership – Says who?
Authors: Spector Bert A
Published: October 2016

There is currently wide consensus concerning the notion that corporations can and should call on executive incentives, particularly cash bonuses and stock options, to shape executive behaviors and enhance company performance. To be sure, much controversy surrounds the implementation of such incentives, but the lightning rod is typically the matter of how much, not the use of incentives themselves. Contemporary research, by and large, seeks to fine-tune an existing paradigm rather than probe its underlying assumptions. This article calls on the methodology of history to probe the underlying assumptions and construction of executive incentives in order to ask those fundamental questions. By exploring the work of General Motors president Alfred Sloan and McKinsey & Company consultant Arch Patton, both prime movers of the widespread use of such incentives, the article notes that their beliefs were an outgrowth of a particular historical context. The assumptions that emerged as a result of that context have since become embedded into our collective institutional consciousness and have impacted society far beyond the borders of corporations; helping to support an ever-widening gulf between the top 1% of society and the remainder. A reconsideration of the underlying assumptions is encouraged. The impact on organizational performance would be either negligible or positive; and the effect on economic distribution in the company and the host society would be profound. Abandoning the outmoded notion of executive inventive, in other words, would be an act of true leadership.
Thrombolysis and thrombectomy in patients treated with dabigatran with acute ischemic stroke: Expert opinion
Authors: Diener HC , Bernstein R , Butcher K , Campbell B , Cloud G , Davalos A , Davis S , Ferro JM , Grond M , Krieger D , Ntaios G , Slowik A , Touzé E
Published: October 2016

Systemic thrombolysis with rt-PA is contraindicated in patients with acute ischemic stroke anticoagulated with dabigatran. This expert opinion provides guidance on the use of the specific reversal agent idarucizumab followed by rt-PA and/or thrombectomy in patients with ischemic stroke pre-treated with dabigatran. The use of idarucizumab followed by rt-PA is covered by the label of both drugs.
Stroke Epidemiology in an Australian Rural Cohort (SEARCH)
Authors: Newbury Jonathan , Kleinig Tim , Leyden James , Arima Hisatomi , Castle Sally , Cranefield Jennifer , Paterson Tracey , Jannes Jim , Crotty Maria , Anderson Craig S
Published: October 2016

Background

Stroke rates in Australia and New Zealand have been declining since 1990 but all studies have been completed in large urban centers.

Aim

We report the first Australasian stroke incidence study in a rural population.

Methods

The authors applied the principle of complete ascertainment, used the WHO standard definition of stroke and classified ischemic stroke by the TOAST criteria. Data were collected from five rural centers defined by postcode of residence, over a 2-year period with 12 months of follow up of all cases.

Results

There were 217 strokes in 215 individuals in a population of 96,036 people, over 2 years, giving a crude attack rate of 113 per 100,000 per year. The 181 first-ever strokes (83% of total), standardized to the WHO world population, occurred at a rate of 50/100,000 (95% CI: 43–58). The 28-day fatality for first-ever strokes was 24% (95% CI: 18–31) and 77% (95% CI: 71–83) were classified as ischemic (140/181), 15% (95% CI: 10–21) intracerebral hemorrhage, 3% (95% CI: 1–6) due to subarachnoid hemorrhage and 5% (95% CI: 2–9) were unknown. A high proportion of first-ever ischemic strokes (44%) were cardioembolic, mostly (77%) due to atrial arrhythmias. Of the 38 with known atrial arrhythmias prior to stroke, only six (16%) were therapeutically anticoagulated.

Conclusions

This rural companion study of a recent Australian urban stroke incidence study confirms the downward trend of stroke incidence in Australia, and reiterates that inadequate anticoagulation of atrial arrhythmia remains a preventable cause of ischemic stroke.
A methodology for model-based verification of safety contracts and performance requirements
Authors: Gómez-Martínez Elena , Rodríguez Ricardo J , Benac-Earle Clara , Etxeberria Leire , Illarramendi Miren
Published: October 2016

The verification of safety requirements becomes crucial in critical systems where human lives depend on their correct functioning. Formal methods have often been advocated as necessary to ensure the reliability of software systems, albeit with a considerable effort. In any case, such an effort is cost-effective when verifying safety-critical systems. Often, safety requirements are expressed using safety contracts, in terms of assumptions and guarantees.

To facilitate the adoption of formal methods in the safety-critical software industry, we propose a methodology based on well-known modelling languages such as the unified modelling language and object constraint language. The unified modelling language is used to model the software system while object constraint language is used to express the system safety contracts within the unified modelling language. In the proposed methodology a unified modelling language model enriched with object constraint language constraints is transformed to a Petri net model that enables us to formally verify such safety contracts. The methodology is evaluated on an industrial case study. The proposed approach allows an early safety verification to be performed, which increases the confidence of software engineers while designing the system.
Muramyl peptides activate innate immunity conjointly via YB1 and NOD2
Authors: Laman Alexander G , Lathe Richard , Shepelyakovskaya Anna O , Gartseva Alexandra , Brovko Feodor A , Guryanova Svetlana , Alekseeva Ludmila , Meshcheryakova Elena A , Ivanov Vadim T
Published: October 2016

Bacterial cell wall muramyl dipeptide (MDP) and glucosaminyl-MDP (GMDP) are potent activators of innate immunity. Two receptor targets, NOD2 and YB1, have been reported; we investigated potential overlap of NOD2 and YB1 pathways. Separate knockdown of NOD2 and YB1 demonstrates that both contribute to GMDP induction of NF-κB expression, a marker of innate immunity, although excess YB1 led to induction in the absence of NOD2. YB1 and NOD2 co-migrated on sucrose gradient centrifugation, and GMDP addition led to the formation of higher molecular mass complexes containing both YB1 and NOD2. Co-immunoprecipitation demonstrated a direct interaction between YB1 and NOD2, a major recombinant fragment of NOD2 (NACHT–LRR) bound to YB1, and complex formation was stimulated by GMDP. We also report subcellular colocalization of NOD2 and YB1. Although YB1 may have other binding partners in addition to NOD2, maximal innate immunity activation by muramyl peptides is mediated via an interaction between YB1 and NOD2.
The Influence of Nature Stimulus in Enhancing the Birth Experience
Authors: Aburas Rehab , Pati Debajyoti , Casanova Robert , Adams Nicole Gilinsky
Published: October 2016

The physical environment is one of the factors that affect women’s experience of labor. The basics of the childbirth process have not changed since the beginning of human existence; however, the environment in which women today give birth has changed significantly. Incorporating design elements and strategies that calm and reduce negative emotions may create positive experiences for women in labor. The purpose of this study was to examine the impact of one such strategy, namely, the presentation of images of nature, on the labor and delivery experience. The study findings showed that the experimental condition has a higher score on the Quality of Care From the Patient’s Perspective (QPP) subscale. In addition, there was an increase in the QPP scores associated with the increase in Nature TV watching time, QPP mean of watching time (less than 1 hr) group, m = 4.5 and QPP mean of watching time (more than 3 hs), m = 4.8. The mean score for the heart rate was lower in the experimental condition, m = 84.60, than in the control one, m = 90.49. For Apgar, the mean score was higher for Group A, m = 8.65, and Group B, m = 8.92. These findings support the study hypothesis which states that the nature images would influence the labor experience positively. In addition, the findings emphasize the importance of incorporating nonpharmacological techniques in the labor and delivery room (LDR) units to sooth the pain. Adding nature imagery to the LDR environment can be one of these techniques.
Polypharmacy and inappropriate medication use in patients with dementia: an underresearched problem
Authors: Parsons Carole
Published: October 2016

Multimorbidity and polypharmacy are increasingly prevalent across healthcare systems and settings as global demographic trends shift towards increased proportions of older people in populations. Numerous studies have demonstrated an association between polypharmacy and potentially inappropriate prescribing (PIP), and have reported high prevalence of PIP across settings of care in Europe and North America and, as a consequence, increased risk of adverse drug reactions, healthcare utilization, morbidity and mortality. These studies have not focused specifically on people with dementia, despite the high risk of adverse drug reactions and PIP in this patient cohort. This narrative review considers the evidence currently available in the area, including studies examining prevalence of PIP in older people with dementia, how appropriateness of prescribing is assessed, the medications most commonly implicated, the clinical consequences, and research priorities to optimize prescribing for this vulnerable patient group. Although there has been a considerable research effort to develop criteria to assess medication appropriateness in older people in recent years, the majority of tools do not focus on people with dementia. Of the limited number of tools available, most focus on the advanced stages of dementia in which life expectancy is limited. The development of tools to assess medication appropriateness in people with mild to moderate dementia or across the full spectrum of disease severity represents an important gap in the research literature and is beginning to attract research interest, with recent studies considering the medication regimen as a whole, or misprescribing, overprescribing or underprescribing of certain medications/medication classes, including anticholinergics, psychotropics, antibiotics and analgesics. Further work is required in development and validation of criteria to assess prescribing appropriateness in this vulnerable patient population, to determine prevalence of PIP in large cohorts of people with the full spectrum of dementia variants and severities, and to examine the impact of PIP on health outcomes.
Heart rate at admission is a predictor of in-hospital mortality in patients with acute coronary syndromes: Results from 58 European hospitals: The European Hospital Benchmarking by Outcomes in acute coronary syndrome Processes study
Authors: Jensen Magnus T , Pereira Marta , Araujo Carla , Malmivaara Anti , Ferrieres Jean , Degano Irene R , Kirchberger Inge , Farmakis Dimitrios , Garel Pascal , Torre Marina , Marrugat Jaume , Azevedo Ana
Published: October 2016

Aims:

The purpose of this study was to investigate the relationship between heart rate at admission and in-hospital mortality in patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation acute coronary syndrome (NSTE-ACS).

Methods:

Consecutive ACS patients admitted in 2008–2010 across 58 hospitals in six participant countries of the European Hospital Benchmarking by Outcomes in ACS Processes (EURHOBOP) project (Finland, France, Germany, Greece, Portugal and Spain). Cardiogenic shock patients were excluded. Associations between heart rate at admission in categories of 10 beats per min (bpm) and in-hospital mortality were estimated by logistic regression in crude models and adjusting for age, sex, obesity, smoking, hypertension, diabetes, known heart failure, renal failure, previous stroke and ischaemic heart disease. In total 10,374 patients were included.

Results:

In both STEMI and NSTE-ACS patients, a U-shaped relationship between admission heart rate and in-hospital mortality was found. The lowest risk was observed for heart rates between 70–79 bpm in STEMI and 60–69 bpm in NSTE-ACS; risk of mortality progressively increased with lower or higher heart rates. In multivariable models, the relationship persisted but was significant only for heart rates >80 bpm. A similar relationship was present in both patients with or without diabetes, above or below age 75 years, and irrespective of the presence of atrial fibrillation or use of beta-blockers.

Conclusion:

Heart rate at admission is significantly associated with in-hospital mortality in patients with both STEMI and NSTE-ACS. ACS patients with admission heart rate above 80 bpm are at highest risk of in-hospital mortality.
Using breastfeeding images to promote breastfeeding among young adults
Authors: Austen Erin L , Dignam Joey , Hauf Petra
Published: October 2016

Young adults’ reactions to breastfeeding images were assessed using varied approaches. In Study 1, participants viewed posters from a breastfeeding campaign; many anticipated negative reaction to the campaign. In Study 2, participants viewed novel infant-feeding posters; breastfeeding posters were viewed for less time than bottle-feeding posters, regardless of the task assigned. In Study 3, participants were asked to rate their comfort level viewing infant-feeding images; greater discomfort was reported for breastfeeding images. Taken together, we argue that many young adults expect, and experience, discomfort viewing breastfeeding, but it is important to continue using breastfeeding images in promotion efforts.
Life-threatening haematological complication occurring in a cat after chronic carbimazole administration
Authors: Mosca Andrea , Bresciani Luca
Published: October 2016

Case summary

An 11-year-old spayed female domestic shorthair cat with a history of hyperthyroidism treated with carbimazole for 7 months was presented for a check-up after a few episodes of vomiting. The cat had been receiving prednisolone at 0.5 mg/kg PO q12h for recent pancreatitis and concurrent inflammation of liver and small intestines confirmed by biopsies. Clinical examination revealed pale mucous membranes with a capillary refill time of <2 s. Haematology showed severely decreased packed cell volume (16%), and increased prothrombin time (42 s), partial thromboplastin time (>120 s) and fibrinogen serum concentration (3.5 g/l). Morphological changes of thrombocytes in the absence of thrombocytopenia were also noted. In-saline agglutination test was positive. Abdominal radiographic and ultrasonographic examinations excluded the presence of organ abnormalities and peritoneal effusion. Blood biochemistry was unremarkable. Feline leukaemia virus and feline immunodeficiency virus tests were negative. On the basis of these findings, immune-mediated anaemia secondary to chronic carbimazole administration was suspected. Prednisolone was increased to 2 mg/kg PO q24h and carbimazole tablets were stopped. Despite close monitoring and intensive care, the cat died the same evening of admission to the hospital.

Relevance and novel information

This report suggests that severe haemotoxicity may occur as a sequel of chronic carbimazole administration in cats. Routine bloodwork and accurate follow-up of cats under treatment with thyrotoxic therapy may be advisable, in order to detect haematological changes before lethal complications occur.
Scapular osteomyelitis in an immature domestic shorthair cat
Authors: Viskjer Sivert , Rapp Martin
Published: October 2016

Case summary

A 12-week-old, male, domestic shorthair cat was presented with severe left thoracic limb lameness. Investigation included physical examination, diagnostic imaging with radiography and CT, histopathology and microbiological culture. Physical examination revealed a large, firm mass on the left scapula. Radiography and CT showed a monostotic spherical expansile bone lesion in the infraspinatus fossa of the left scapula. The histopathological description was a central acute suppurative osteomyelitis with reactive fibrosis and new bone formation at the periphery. Aerobic and anaerobic cultures were negative and the underlying cause of the osteomyelitis could not be identified. The use of broad-spectrum antibiotics for 8 weeks proved effective with full clinical recovery and no signs of relapse during the follow-up time of 8 months.

Relevance and novel information

This report describes the management and outcome of a rare case of osteomyelitis with severe deformation of scapular bone morphology in an immature cat that was treated successfully with full recovery of limb function and restored integrity of the scapula.
Long-term treatment with low dose naltrexone maintains stable health in patients with multiple sclerosis
Authors: Ludwig Michael D , Turel Anthony P , Zagon Ian S , McLaughlin Patricia J
Published: October 2016

Introduction

A retrospective study was conducted on patients at Penn State Hershey Medical Center diagnosed with relapsing–remitting multiple sclerosis between 2006 and 2015.

Methodology

Laboratory and clinical data collected over this 10-year period were reviewed. Two cohorts of patients were established based on their relapsing–remitting multiple sclerosis therapy at the time of their first visit to Penn State. One group of patients ( n = 23) was initially prescribed low dose naltrexone at the time first seen at Hershey. This group was offered low dose naltrexone because of symptoms of fatigue or refusal to take an available disease-modifying therapy. The second group of patients ( n = 31) was treated with the glatiramer acetate (Copaxone) and offered low dose naltrexone as an adjunct therapy to their disease-modifying therapy.

Results

Patient data from visits after 1–50 months post-diagnosis were evaluated in a retrospective manner. Data obtained from patient charts included clinical laboratory values from standard blood tests, timed 25-foot walking trials, and changes in magnetic resonance imaging reports. Statistical analyses between the groups and for each patient over time indicated no significant differences in clinical laboratory values, timed walking, or changes in magnetic resonance imaging.

Conclusion

These data suggest that the apparently non-toxic, inexpensive, biotherapeutic is safe and if taken alone did not result in an exacerbation of disease symptoms.
Effects of Singing Bowl Sound Meditation on Mood, Tension, and Well-being: An Observational Study
Authors: Goldsby Tamara L. , Goldsby Michael E. , McWalters Mary , Mills Paul J.
Published: October 2016

Poor mood and elevated anxiety are linked to increased incidence of disease. This study examined the effects of sound meditation, specifically Tibetan singing bowl meditation, on mood, anxiety, pain, and spiritual well-being. Sixty-two women and men (mean age 49.7 years) participated. As compared with pre-meditation, following the sound meditation participants reported significantly less tension, anger, fatigue, and depressed mood (all Ps <.001). Additionally, participants who were previously naïve to this type of meditation experienced a significantly greater reduction in tension compared with participants experienced in this meditation ( P < .001). Feeling of spiritual well-being significantly increased across all participants ( P < .001). Tibetan singing bowl meditation may be a feasible low-cost low technology intervention for reducing feelings of tension, anxiety, and depression, and increasing spiritual well-being. This meditation type may be especially useful in decreasing tension in individuals who have not previously practiced this form of meditation.
Tribulus terrestris Extract Improves Human Sperm Parameters In Vitro
Authors: Khaleghi Sara , Bakhtiari Mitra , Asadmobini Atefeh , Esmaeili Farzane
Published: October 2016

Objective.

The object of present study was to investigate the effects of direct addition of Tribulus terrestris extract on human sperm parameters.

Design.

Semen specimens from 40 healthy men volunteers were divided into 4 groups: one group received no treatment (control group) while the others were incubated with 20, 40, and 50 µg/mL of T terrestris extract (experimental groups). Motility, viability, and DNA fragmentation were assessed in all groups.

Results.

The incubation of human semen with 40 and 50 μg/mL of T terrestris extract significantly enhanced total sperm motility, number of progressive motile spermatozoa, and curvilinear velocity over 60 to 120 minutes’ holding time ( P < .05 or P < < .01). Furthermore, viability was significantly enhanced by using T terrestris extract ( P < .01).

Conclusions.

In vitro addition of the T terrestris extract to human sperm could affect male fertility capacity.
Clinical Effects of Krachaidum (Kaempferia parviflora): A Systematic Review
Authors: Saokaew Surasak , Wilairat Preyanate , Raktanyakan Paranya , Dilokthornsakul Piyameth , Dhippayom Teerapon , Kongkaew Chuenjid , Sruamsiri Rosarin , Chuthaputti Anchalee , Chaiyakunapruk Nathorn
Published: October 2016

Kaempferia parviflora (Krachaidum) is a medicinal plant in the family Zingiberaceae. Its rhizome has been used as folk medicine for many centuries. A number of pharmacological studies of Krachaidum had claimed benefits for various ailments. Therefore, this study aimed to systematically search and summarize the clinical evidences of Krachaidum in all identified indications. Of 683 records identified, 7 studies were included. From current clinical trials, Krachaidum showed positive benefits but remained inconclusive since small studies were included. Even though results found that Krachaidum significantly increased hand grip strength and enhanced sexual erotic stimuli, these were based on only 2 studies and 1 study, respectively. With regard to harmful effects, we found no adverse events reported even when Krachaidum 1.35 g/day was used. Therefore, future studies of Krachaidum are needed with regards to both safety and efficacy outcomes.
Metacognitive and Metamemory Beliefs in the Development and Maintenance of Posttraumatic Stress Disorder
Authors: Takarangi Melanie K. T. , Smith Rashelle A. , Strange Deryn , Flowe Heather D.
Published: October 2016

Can metacognition increase trauma sufferers’ risk for developing and maintaining posttraumatic stress disorder (PTSD)? We assessed the role of a range of cognitive and metacognitive belief domains—including metamemory—on PTSD symptoms. Adult participants reported their existing meta/cognitions and lifetime exposure to trauma, then 12 weeks later, they reported meta/cognitions and PTSD symptoms in relation to new trauma exposure since the initial assessment. Participants with more PTSD symptoms held more problematic metacognitions than participants with fewer distress symptoms. Moreover, people who endorsed maladaptive metacognitions before trauma exposure were more likely to experience symptoms of PTSD after exposure. Metacognition predicted the maintenance of elevated PTSD symptoms over the 12-week delay. Our findings support the metacognitive model of PTSD and highlight the importance of metamemory, an understudied factor in PTSD research.
Strong Homotypic Continuity in Common Psychopathology-, Internalizing-, and Externalizing-Specific Factors Over Time in Adolescents
Authors: Snyder Hannah R. , Young Jami F. , Hankin Benjamin L.
Published: October 2016

Dimensional models of psychopathology that posit a general psychopathology factor (i.e., p factor), in addition to specific internalizing and externalizing factors, have recently gained prominence. However, the stability of these factors and the specificity with which they are related to one another over time (e.g., homotypic or heterotypic continuity) have not been investigated. The current study addressed these questions. We estimated bifactor models, with p, internalizing-specific, and externalizing-specific factors, with youth and caretaker reports of symptoms at two time points (18 months apart), in a large community sample of adolescents. Results showed strong stability over time with highly specific links (i.e., p factor at Time 1 to Time 2; internalizing-specific at Time 1 to Time 2 and externalizing-specific at Time 1 to Time 2), suggesting strong homotypic continuity between higher order latent psychopathology factors.
Polyphosphate colocalizes with factor XII on platelet-bound fibrin and augments its plasminogen activator activity
Authors: Mitchell Joanne L. , Lionikiene Ausra S. , Georgiev Georgi , Klemmer Anja , Brain Chelsea , Kim Paul Y. , Mutch Nicola J.
Published: October 2016

Key Points

PolyP significantly augments the plasminogen activator capacity of FXIIa. Platelet-bound fibrin acts as a reservoir for plasminogen, FXII(a), and polyP.
Oviposition preferences for ethanol depend on spatial arrangement and differ dramatically among closely related Drosophila species
Authors: Sumethasorn Matt , Turner Thomas L.
Published: October 2016

Recent work on the model fly Drosophila melanogaster has reported inconsistencies in their preference for laying eggs on intermediate concentrations of ethanol. In this study, we resolve this discrepancy by showing that this species strongly prefers ovipositing on ethanol when it is close to a non-ethanol substrate, but strongly avoids ethanol when options are farther apart. We also show fluidity of these behaviors among other Drosophila species: D. melanogaster is more responsive to ethanol than close relatives in that it prefers ethanol more than other species in the close-proximity case, but avoids ethanol more than other species in the distant case. In the close-proximity scenario, the more ethanol-tolerant species generally prefer ethanol more, with the exception of the island endemic D. santomea. This species has the lowest tolerance in the clade, but behaves like D. melanogaster. We speculate that this could be an adaptation to protect eggs from parasites or predators such as parasitoid wasps, as larvae migrate to non-toxic substrates after hatching. These natural differences among species are an excellent opportunity to study how genes and brains evolve to alter ethanol preferences, and provide an interesting model for genetic variation in preferences in other organisms, including humans.