bluuebunny/crossref_metadata_2025 huggingface dataset:
Diagnostic Validation of a Whole-Slide Imaging Scanner in Cytological Samples: Diagnostic Accuracy and Comparison With Light Microscopy
Authors: Bonsembiante Federico , Bonfanti Ugo , Cian Francesco , Cavicchioli Laura , Zattoni Beatrice , Gelain Maria Elena
Published: January 2019

Digital slides created by whole-slide imaging scanners can be evaluated by pathologists located in remote sites, but the process must be validated before this technology can be applied to routine cytological diagnosis. The aim of this study was to validate a whole-slide imaging scanner for cytological samples. Sixty cytological samples, whose diagnoses were confirmed by gold-standard examinations (histology or flow cytometry), were digitalized using a whole-slide imaging scanner. Digital slides and glass slides were examined by 3 observers with different levels of cytopathological expertise. No significant differences were noted between digital and glass slides in regard to the number of cases correctly diagnosed, or the sensitivity, specificity, or diagnostic accuracy, irrespective of the observers’ expertise. The agreements between the digital slides and the gold-standard examinations were moderate to substantial, while the agreements between the glass slides and the gold-standard examinations were substantial for all 3 observers. The intraobserver agreements between digital and glass slides were substantial to almost perfect. The interobserver agreements when evaluating digital slides were moderate between observers 1 and 2 and between observers 1 and 3 while they were substantial between observers 2 and 3. In conclusion, our study demonstrated that the digital slides produced by the whole-slide imaging scanner are adequate to diagnose cytological samples and are similar among clinical pathologists with differing levels of expertise.
Pregabalin as Adjunctive Treatment for Focal Onset Seizures in Pediatric Patients: A Randomized Controlled Trial
Authors: Antinew Jeremias , Pitrosky Bruno , Knapp Lloyd , Almas Mary , Pitman Verne , Liu Jing , Craiu Dana , Modequillo Margaret , Nordli Douglas , Farkas Viktor , Farkas Mark Kristof
Published: January 2019

Efficacy and safety of pregabalin as adjunctive treatment for children (aged 4-16 years) with partial-onset seizures, hereafter termed focal onset seizures for this study, was evaluated. This double-blind, randomized, placebo-controlled, international study had 3 phases: 8-week baseline, 12-week double-blind treatment (2-week dose escalation; 10-week fixed dose), and 1-week taper. Selection criteria included experiencing focal onset seizures and receiving a stable regimen of 1 to 3 antiepileptic drugs. Study treatments were pregabalin 2.5 mg/kg/d, 10 mg/kg/d, or placebo; doses were increased to 3.5 or 14 mg/kg/d for subjects weighing <30 kg. The key endpoints were change in loge(28-day seizure rate), achieving a ≥50% seizure responder rate, safety, and tolerability during double-blind treatment. Subjects (n = 295; mean age 10.2 years, 55% male, 69% white) were randomized to pregabalin 2.5 mg/kg/d (n = 104), 10 mg/kg/d (n = 97), or placebo (n = 94). A statistically significant reduction in loge(28-day seizure rate) was demonstrated with pregabalin 10 mg/kg/d (a 19.9% improvement over placebo; P = .0185). Seizure frequency was numerically improved (statistically nonsignificant) with pregabalin 2.5 mg/kg/d ( P = .2577). Responder rate significantly favored pregabalin 10 mg/kg/d (40.6%, P = .0068) compared with placebo (22.6%) and was numerically improved with pregabalin 2.5 mg/kg/d (29.1%, P = .2600). Common adverse events (≥10% of any group) in 10 mg/kg/d, 2.5 mg/kg/d, and placebo groups, respectively, included somnolence (25.8%, 17.3%, 13.8%), increased weight (13.4%, 3.8%, 4.3%), and increased appetite (10.3%, 6.7%, 4.3%). Pregabalin 10 mg/kg/d demonstrated efficacy in seizure frequency reduction in children with focal onset seizures compared with placebo, and both pregabalin doses were generally safe and well tolerated.

www.clinicialtrials.gov identifier NCT01389596; EudraCT #2010-020852-79
Notes on a Southern urban practice
Authors: Bhan Gautam
Published: January 2019

Writing alongside Southern urban theorists, this essay argues that the emerging body of “theory from the South” must be simultaneously tied to the production of forms and theories of practice. It must ask: How can a new body of thought give us ways of moving and modes of practice? Drawing from the experience of Indian cities, three such modes of Southern practice are offered: squat as a practice not just of subaltern urbanization but of the state; repair in contradistinction to construct, build and even upgrade; and consolidate rather than focus on the building of a singular, universal network within services and infrastructure. The essay then offers a first set of shared characteristics that may enable us to think of a practice as “Southern”, and urges the expansion of a vocabulary of Southern urban practice.
Vulnerability of informal settlements in the context of rapid urbanization and climate change
Authors: Williams David Samuel , Máñez Costa María , Sutherland Catherine , Celliers Louis , Scheffran Jürgen
Published: January 2019

Rapid urbanization and climate change together increase the vulnerability of poor urban communities to natural hazards, undermining urban resilience. It is therefore critical to identify and deepen our understanding of the main variables, and the complex interactions between them, producing and shaping the vulnerability of poor urban communities to natural hazards. Identifying factors that challenge or support the efforts of these communities in responding to hazards is also helpful in policymaking for urban resilience. To develop this understanding, it is necessary to conduct detailed research at the local scale. This paper aims to contribute to this knowledge by applying participatory modelling techniques to a particular case study of an informal settlement in Durban, South Africa. The aim is to elucidate how this detailed empirical research can contribute to broader theoretical knowledge on urban vulnerability and resilience in the face of climate change and rapid urbanization.
Involving relatives in consultations for patients with long-term illnesses: Nurses and physicians’ experiences
Authors: Dreyer Anne , Strom Anita
Published: January 2019

Background:

Due to the major changes occurring in the demographic composition of the world’s population, the number of older individuals is increasing, which puts pressure on the healthcare systems in many different countries. The involvement of volunteers and family members may become necessary to fulfil a patient’s needs for follow-up treatments and long-term care in their homes.

Aim:

This study aimed to explore how nurses and physicians experienced and addressed ethical challenges when they dealt with relatives in what have traditionally been one-on-one consultations at two Norwegian hospital outpatient clinics.

Research Design and Methods:

A total of eight nurses and two physicians from two different hospitals participated in individual in-depth interviews. The transcribed interviews were analysed using an eclectic approach called ‘bricolage’ inspired by Kvale and Brinkmann. We combined cross-case thematic and theoretical normative analyses.

Ethical considerations:

The principles of voluntariness, confidentiality, withdrawal and anonymity were respected throughout the research process. In addition, the Norwegian Social Science Data Services approved this study.

Findings:

The findings showed that respect for a patient’s autonomy was used as an argument for delimiting the relatives’ access to the patient’s consultations. We found that there were insufficient routines in place for inviting and involving relatives in the patient consultations in the outpatient clinics.

Discussion:

The traditional Western attitudes towards the principles of patient autonomy will likely be challenged due to the growing need for family involvement in the care of a patient in the future.

Conclusion:

This study’s description of the nurses and physicians’ interpretations of ‘patient autonomy’ as a phenomenon uncover the need for systematic ethical deliberation in the clinical setting. On an organisational level, there is a strong indication of the need to discuss the routines that are in place to invite the next of kin to participate in such patient’s healthcare consultations.
Korean Physicians’ Perspectives on Prognostication in Palliative Care: A Qualitative Study
Authors: Lee Eon Sook , Suh Sang-Yeon , LeBlanc Thomas W. , Himchack Sang Hwa , Lee Sanghee Shiny , Kim Yoonjoo , Ahn Hong-Yup
Published: January 2019

Background:

Prognostication is an essential component of palliative care for patients with advanced cancer but also poses challenges. Little is known about physicians’ perspectives on prognostication and prognostic tools used in palliative care practice in Eastern countries.

Objectives:

To explore Korean physicians’ perspectives and experiences with prognostication in their palliative care practices.

Methods:

Semi-structured interviews were conducted in Korea in 11 palliative care physicians. A constant comparative and grounded theory approach was used to derive themes from interview transcripts.

Results:

Participants on average had 6.4 (SD = 4.5, range 0.5-15) years of hospice and palliative care experience. We identified 4 main themes about prognostication: (1) the importance of prognostication (to help patients and their families prepare for death, to determine the appropriate time of transition to hospice care, to facilitate appropriate decision making, and to facilitate communication with patients and their families); (2) difficulties of prognostication (discomfort estimating the exact date of death); (3) basis of prognostication (clinical prediction of survival as well as prognostic scores); and (4) areas for further research (need for a simpler scoring system or parameters to predict survival with greater certainty).

Conclusion:

Palliative care physicians in Korea reported similar perceptions about the role and challenges inherent in prognostication compared to clinicians in Western cultures. However, they emphasize the need to predict final days to keep families with dying patients, reflecting family-centered aspects of Asian culture. They reported frustrations with inaccurate prognostication schemas and called for the development of simpler, more accurate predictors as a focus of future research.
The Menace of Misinformation: Faculty Misstatements in Management Education and Their Consequences
Authors: Giacalone Robert A. , Promislo Mark D.
Published: January 2019

In this essay, we explore the misinformation that management professors give to students in the classroom. Although faculty do not intend to deceive students with this misinformation, nevertheless, it can have damaging consequences, including undermining students’ well-being and limiting their aspirations. We discuss two general types of misleading statements: misinformation about the economic model (e.g., that money and material possessions lead to happiness) and misinformation about what matters in life (e.g., that career success is the most important component in the fabric of life). Most of this misinformation is deeply rooted in our materialistic culture and economic system, and a belief in profit maximization as a predominant goal. Last, we discuss ways in which faculty can escape from providing this misinformation and help students find fulfilling paths in life.
Advancing Racial/Ethnic and Cultural Sensitivity Among PMHNP Students Through Education, Practice, and Experience
Authors: Boyer Chase J. , Rice Michael J. , Sorrell Tanya R. , Spurling Alyssa M.
Published: January 2019

BACKGROUND: There is an increased need for mental health providers to be more attuned to behavioral health needs of racial/ethnic/cultural minorities and the role of social milieus. AIMS: We prioritized training and assessing racial/ethnic and cultural sensitivity among psychiatric mental health nurse practitioner students throughout coursework, clinical practice, and experiences in underserved settings. METHOD: Prior to beginning clinical coursework, students completed a course on culturally competent care where we measured their ( n = 26) perception of their ability to be racially/ethnically sensitive providers at the beginning and end of the semester, demonstrating significant improvement. During clinical coursework, preceptors measured students’ racially/ethnically and culturally sensitive clinical behaviors with patients. RESULTS: Sensitivity of students in clinical training significantly improved over a semester of clinical supervision. Our results indicated that placements in underserved settings improved students’ racial/ethnic/cultural sensitivity but only among advanced students. At final evaluation, advanced students in underserved settings self-reported significantly higher racial/ethnic and cultural sensitivity than students not in an underserved setting. CONCLUSIONS: Our data suggest that we can produce more racially/ethnically and culturally sensitivity providers through coursework, supervised clinical practice, and experiences in underserved settings. These data are preliminary, and we plan to follow up these results and replicate this work with other cohorts in future semesters.
From primitive accumulation to entangled accumulation: Decentring Marxist Theory of capitalist expansion
Authors: Gonçalves Guilherme Leite , Costa Sérgio
Published: January 2019

During the last few decades, the concept of primitive accumulation ( ursprüngliche Akkumulation) introduced by Karl Marx and expanded by Rosa Luxemburg has been revived and improved. Accordingly, scholars have used this framework not to characterize a past moment in the history of capitalism, but to grasp the continuous process of coupling and uncoupling geographical and social spheres in the capital accumulation in different fields: financialization, the care economy, green grabbing, the sharing economy, real estate bubbles, data mining, etc. Despite the quality and productivity of these debates, they are still focused on authors and phenomena observed in the Global North, ignoring a long tradition of similar discussions developed especially in Latin America. The article seeks to decentre these debates by taking seriously into account approaches which address primitive accumulation from the perspective of (post)colonial and (post)slave societies. It coins the concept entangled accumulation to emphasize the interdependencies between practices of exploitation and expropriation, wage and slave labour, state power and illegal violence, and capitalist and non-capitalist economies, which have shaped capital accumulation throughout history.
Standards for opioid use disorder care: An assessment of Nordic approaches
Authors: Gedeon Charlotte , Sandell Mikael , Birkemose Inge , Kakko Johan , Rúnarsdóttir Valgerður , Simojoki Kaarlo , Clausen Thomas , Nyberg Fred , Littlewood Richard , Alho Hannu
Published: January 2019

Aims:

Outcomes in opioid use disorder (OUD) in Nordic countries have improved with integrated treatment and harm-reduction programmes. Approaches and the standard of care are different across the region. Evidence of treatment needs and current approaches are defined from evidence to inform development of a common standard.

Method:

Evidence of population sizes and treatment approach collected. Common standards for care (harm reduction, pharmacotherapy, psychology/social therapy) defined for each country.

Results:

Evidence defines number in treatment; potential population needing treatment not defined for all countries. Populations sizes, treatment access (ratio in treatment programme compared to total country population) defined: Sweden 4,000 in OUD care (access ratio 40); Finland 3,000 (55); Norway 8,000 (154); Denmark 7,500 (132). Approach to treatment similar: integrated treatment programmes standard. Care provided by specialists in outpatient clinics/primary care; secondary care/inpatient services are available. Harm reduction is limited in Sweden but available and more accessible elsewhere. Treatment entry criteria: access relatively unlimited in Norway and Denmark, more limited in Finland and Sweden. Standards of care defined: easy access to high-quality services, individual planning, care not limited by time, management of relapse, education for patients, continuous engagement, holistic approach including management of comorbidities, needle equipment programmes without limit, treatment in prisons as community.

Conclusion:

There are opportunities to improve OUD care in the Nordics. Policy makers and clinicians can advance OUD care and share common success factors. Collaborative work across the Nordic countries is valuable. Further research in clinical practice development can yield important results for the benefit of patients with OUD.
Investigation of liner cavitation considering coupling effect between engine vibration and acoustic field of water coolant passage
Authors: Wang Xiaoyu , Zhang Zheng , Chen Yu , Li Yinglong
Published: January 2019

The engine vibration gives rise to pressure fluctuation of water coolant; therefore, the coupled system between engine structure and acoustic field of water coolant passage needs to be established to calculate the response of engine vibration and water coolant pressure fluctuation. A rectangular tank is used to evaluate water pressure induced by structural impact vibration. The dynamic characteristics of structural-acoustic coupled system are discussed by changing water depth. Considering the resonance effect, the relationship between natural frequencies of structure and acoustic field is examined by variation of sound speed. The equation of motion of engine structure coupled with acoustic field of water coolant passage is established to calculate coolant pressure fluctuation during engine working condition. The effect of piston slap forces on pressure fluctuation is evaluated. The influence of acoustic characteristics of water coolant passage on pressure fluctuation is discussed by varying sound speed.
Critical viewpoints on the Bologna Process in Europe: Can we do otherwise?
Authors: Wihlborg Monne
Published: January 2019

The starting point for this inductive study is to determine, through a search of studies, what critical viewpoints in terms of research are delivered, based on experiences, observations and evaluation, concerning the Bologna Process over time? The aim is to present a description using a thematic analysis based on data from 38 papers (2004–2016) that reveal the critical reasoning behind the research. The reasoning is critical in the sense that various authors have elaborated on and problematized aspects of the Bologna Process in terms of what to avoid and/or have characterized aspects related to the Bologna Process that are not desirable. Based on the outcome of the thematic analysis, theorists were selected in order to deepen the reasoning and meaning highlighted in three themes. The findings are further discussed in terms of knowledge and curriculum development for the future and the advancement of European higher education policy and beyond on equal terms. The article suggests that there are causes for concern regarding unwanted consequences in the aftermath of the Bologna Process.
Assessing the Effects of Instructional Set Size on Learning
Authors: Miller Sarah J. , Noell George H. , Harris Meredith T. , McIver Elise B. , Alvarez Jessica P.
Published: January 2019

Research evaluating the variables that influence learning has devoted inadequate attention to the influence of the amount of new material presented at one time. The current study evaluated the impact of varying instructional set size (ISS) on the rate at which elementary school students mastered multiplication facts while receiving constant time delay (CTD) instruction. Instructional time was equated across conditions. Instruction was provided for an ISS of five and 20 using CTD instruction for multiplication facts. ISS 20 was more efficient for two out of the three participants. This suggests a much larger efficient ISS than previous research. The implications of this finding for the importance of the instructional method in attempting to identify an efficient ISS, as well as the study’s connection to prior research, in this area are discussed.
A data-driven approach for online aggregated load modeling through intelligent terminals
Authors: Tang Yi , Zhu Liangliang , Ning Jia , Wang Qi
Published: January 2019

Load model has significant impact on power system simulation. Current load modeling approaches are inadequate on revealing the accuracy and time-variation of load compositions. The application of wireless sensors dispersed in power distribution networks provides further opportunities for load modeling. In this article, a data-driven online aggregated load modeling approach is proposed systematically. First, all the electricity consumers are clustered according to big data of power consumption behaviors. In each cluster, typical users are designated to stand for the characteristics of the cluster, and intrusive measurement is adapted to capture these typical users’ time-varying information by employing wireless intelligent terminals, which can identify the composition of static load and induction motor load online. Second, the load models of other users in each cluster are assumed identical to typical users, including static impedance–current–power models and induction motor models. Finally, the composite load model is achieved by hierarchical aggregation and bottom-to-up stepwise equivalence. Simulations demonstrate that the load model built by proposed approach reflects higher accuracy and adaptability in power system.
Targeted Subcutaneous Vibration With Single-Neuron Electrophysiology As a Novel Method for Understanding the Central Effects of Peripheral Vibrational Therapy in a Rodent Model
Authors: Bills Kyle B. , Clarke Travis , Major George H. , Jacobson Cecil B. , Blotter Jonathan D. , Feland Jeffrey Brent , Steffensen Scott C.
Published: January 2019

Very little is known about the effects of whole body vibration on the supraspinal central nervous system. Though much clinical outcome data and mechanistic data about peripheral neural and musculoskeletal mechanisms have been explored, the lack of central understanding is a barrier to evidence-based, best practice guidelines in the use of vibrational therapy. Disparate methods of administration render study to study comparisons difficult. To address this lack of uniformity, we present the use of targeted subcutaneous vibration combined with simultaneous in vivo electrophysiological recordings as a method of exploring the central effects of peripheral vibration therapy. We used implanted motors driven by both Grass stimulators and programmed microcontrollers to vary frequency and location of stimulation in an anesthetized in vivo rat model while simultaneously recording firing rate from gamma-aminobutyric acid (GABA) neurons in the ventral tegmental area. We show that peripheral vibration can alter GABA neuron firing rate in a location- and frequency-dependent manner. We include detailed schematics and code to aid others in the replication of this technique. This method allows for control of previous weaknesses in the literature including variability in body position, vibrational intensity, node and anti-node interactions with areas of differing mechanoreceptor densities, and prefrontal cortex influence.
A smart performance measurement approach for collaborative design in Industry 4.0
Authors: Yin Yuanyuan , Qin Sheng-feng
Published: January 2019

Industry 4.0, the fourth industrial revolution, focuses on intelligent and smart manufacturing. This article investigates a smart design performance measurement approach, which can be utilized to support performance measurement implementation during a collaborative design process. First, we develop a smart product design framework with Industry 4.0 enabling technologies to support key design stages in an iterative fashion. Second, based on this framework, we propose a smart design performance measurement approach to potentially support a smart product design project management via its performance management. Third, we adapt our existing design performance measurement, for a traditional design environment into a smart design environment at its early stage to test its feasibility. This approach features integration of a flexible performance measurement setup, a multi-feedback design performance measurement mechanism and a multiple design performance measurement results presentation which allows the design performance measurement approach to produce flexible and customized operations by connecting design performance measurement with the stage-based design objectives, balancing design performance measurement feedbacks through interoperability between collaborative design team members and providing real-time design performance measurement results to guide design activities. An empirical industrial evaluation case study indicates that the proposed design performance measurement approach can support design team members in improving their collaborative design performance.
Microstructure and microwave absorbing properties of reduced graphene oxide/Ni/multi-walled carbon nanotubes/Fe3O4 filled monolayer cement–based absorber
Authors: Sun Yafei , Chen Min , Gao Peiwei , Zhou Tianshu , Liu Hongwei , Xun Yong
Published: January 2019

In this article, reduced graphene oxide/Ni/multi-walled carbon nanotubes/Fe3O4 filled paste is synthesized with the aim of developing a novel shielding material. To do so, nano-dispersion presenting homogeneous distribution is made by ultrasonic dispersing technology. Next, the effects of nano-absorbent content on the fluidity, mechanical strength, pore structure, resistivity, and absorbing reflectivity of paste are studied. At the end, the microstructure of composite is uncovered by scanning electron microscopy, Fourier transformer infrared, X-ray diffraction images as well as the pore size distribution and absorbing reflectivity are revealed. The results indicate that a small load of reduced graphene oxide and other nano-absorbents can significantly reduce the fluidity and resistivity of paste, but its pore structure is improved so that its mechanical properties are increased. Scanning electron microscopy images indicate that reduced graphene oxide promotes the increasing and thickening of the cement hydration products as well as the growth of a large number of flower-like and compact bulk crystals. Furthermore, the minimum reflectivity of −10.6 dB is obtained in the range of 2–18 GHz while the effective bandwidth of 16 GHz is obtained when reflectivity is less than −5 dB. This research provides a new pathway for the preparation of monolayer cement–based absorber.
Unsteady squeezing flow of magnetohydrodynamic carbon nanotube nanofluid in rotating channels with entropy generation and viscous dissipation
Authors: Dawar Abdullah , Shah Zahir , Khan Waris , Idrees Muhammad , Islam Saeed
Published: January 2019

The most favorable gift of modern science is nanofluid. The nanofluid can able to move freely through micro channels with the spreading of nanoparticles. Due to improved convection between the base liquid surfaces and nanoparticles, the nano suspensions express high thermal conductivity. Also, the benefits of suspending nanoparticles in base fluids are increased heat capacity, surface area, effective thermal conductivity, collision, and interaction among particles. This research aim to study squeezing flow of carbon nanotubes based on water (H2O) in rotating channels. Entropy generation is evaluated and for this purpose, second law of thermodynamics is employed. The influences of thermal radiation, viscous dissipation, and applied magnetic field on nanofluid are taken into account. The flow of the nanofluid is considered in unsteady three dimensions. The transformed ordinary differential equations (ODEs) are solved by homotopy analysis method with the help of similarity variables. Results obtained for single and multi-wall carbon nanotubes are compared. Plots have been presented in order to examine how the velocities, temperature, and entropy profiles become affected by numerous physical parameters. Generally, the velocity profiles escalate when the upper plate of the channel moves toward the lower stretching one and reduces when the upper plate is moving away from the lower one. The velocity profile in y-direction escalates with the escalation in nanoparticle volume fraction and suction parameter while the rotation parameter bids dual behavior with the escalating values. The velocity profile in x-direction bids the oscillatory behavior with the enhancement in nanoparticle volume fraction, rotation parameter, and magnetic parameter. The physical properties of carbon nanotubes, thermo physical properties of carbon nanotubes and nanofluid of some base fluids, and thermal conductivity of carbon nanotubes with different volume fractions are shown through tables.
Train collision dynamic model considering longitudinal and vertical coupling
Authors: Zhu Tao , Liu Sijing , Xiao Shou-ne , Che Quanwei
Published: January 2019

The train collision dynamic theory is an acceptable method for new vehicle design, which can save a great deal of simulation and experimentation. A train collision dynamic model that considers the longitudinal and vertical coupling is established. The vehicle subsystem and the track subsystem are also considered in the model through the function of the link between the wheel/rail subsystems and the coupler buffer/anti-climber subsystems. The entire train model is analyzed with a coupled feedback system. The dynamic simulation program of the coupled system is developed, the calculation flow of the coupled model is given, and the explicit time domain solution of the model is realized. Two numerical examples with the same kind of vehicle were completed, and the numerical results are compared with the finite element simulation results. The results show that the coupled model is not only close to the finite element model but also greatly shortens the solution time of the collision response. The accuracy and theory of the collision dynamics model in this article are verified. The results of the paper provide new theoretical evidence and a simulation method for further research on the design of the crashworthiness of rail vehicle structures and the collision dynamic evolution during a train collision.
Austerity Measures in Greece and Social Rights Protection under the European Social Charter: Comment on GSEE v. Greece case, Complaint No. 111/2014, European Committee of Social Rights, 5 July 2017
Authors: Papadopoulos Nikolaos A.
Published: January 2019

On the 5th of July 2017, the European Committee of Social Rights published another decision adopted under the collective complaints procedure, condemning Greece for violating plenty of the European Social Charter provisions concerning labour rights by implementing austerity measures between 2010 and 2014. The Committee adopted a dynamic and analytical interpretation of the Charter setting new criteria, such as the need to take into account the social needs of the most vulnerable when legislating and went even further than in its previous decisions in terms of social rights protection by producing a precedent that can be used as a tool against the application of austerity policies. This paper analyses GSEE v. Greece, Complaint No. 111/2014 before the Committee and attempts to review it under a multi-level context.
Daouidi v Bootes Plus SL and the Concept of ‘Disability’ in EU Anti-Discrimination Law
Authors: Ferri Delia
Published: January 2019

Daouidi v Bootes Plus SL is one the latest decisions in which the CJEU has been directly confronted with the concept of disability in the realm of EU anti-discrimination legislation. In particular, in this judgment, the Court attempted to identify when the dismissal of a worker due to temporary incapacity of an unknown duration may constitute direct discrimination on the grounds of disability. This decision appears to be significant in that, for the first time, the CJEU discusses the meaning of ‘long-term limitation’ for the purpose of Directive 2000/78. Although the Court treads carefully, it attempts to further elucidate and bring new elements to the definition of disability in EU anti-discrimination law. In spite of the fact that the Court is potentially widening the notion of disability, it appears, once again, quite reticent in its approach to the role of social, environmental and attitudinal barriers in disabling an individual, and remains somewhat ‘trapped’ in the medical model of disability. All in all, this analysis endeavors to highlight that the CJEU is struggling to move beyond a rhetorical recognition of the social model of disability and to apply this in practice.
An Analysis of Sports Specialization in NCAA Division I Collegiate Athletics
Authors: Swindell Hasani W. , Marcille Melanie L. , Trofa David P. , Paulino Franklin E. , Desai Natasha N. , Lynch Thomas Sean , Ahmad Christopher S. , Popkin Charles A.
Published: January 2019

Background:

Youth sports specialization has become more prevalent despite consequences such as increased injury rates and burnout. Young athletes, coaches, and parents continue to have misconceptions about the necessity of sports specialization, giving athletes the encouragement to focus on a single sport at a younger age.

Purpose:

To characterize the motivations for specialization and determine when elite athletes in various individual and team sports made the decision to specialize.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

A Likert-style survey was developed and distributed to athletes from two National Collegiate Athletic Association (NCAA) Division I institutions. The survey’s Flesch-Kincaid grade level was 6.3. Statistical analysis was performed via the Student t test, where a P value less than .05 was considered significant.

Results:

A total of 303 athletes with a mean ± SD age of 19.9 ± 1.52 years across 19 sports were surveyed; 94.7% of specialized athletes had previously played another organized sport prior to college, and 45% of athletes had played multiple sports up to age 16 years. The mean age of specialization was 14.9 years, with a significant difference between athletes competing in team (15.5 years) and individual (14.0 years) sports ( P = .008). Males in individual sports specialized earlier than those in team sports ( P ≤ .001). Nearly one-fifth (17.4%) of athletes reported specializing at age 12 years or earlier. Personal interest, skill level, time constraints, and potential scholarships were the most important reasons for specialization overall. For individual sports, the motivations for specialization were similar, but collegiate ( P < .001) or professional ( P < .001) ambitions were significantly larger contributing factors.

Conclusion:

Early sports specialization is uncommon among NCAA Division I athletes for most team sports, whereas individual sports tend to have athletes who specialize earlier and are more motivated by professional and collegiate goals. This study characterized the timing of specialization among elite athletes, providing a basis for understanding the motivations behind youth sports specialization. Physicians should be prepared to discuss the misconception that early sports specialization is necessary or common among most team-focused collegiate-level athletes. Knowing the motivations for sports specialization will guide clinicians in their discussions with youth athletes.
Oral Contraceptive Pills Are Not a Risk Factor for Deep Vein Thrombosis or Pulmonary Embolism After Arthroscopic Shoulder Surgery
Authors: Stone Austin V. , Agarwalla Avinesh , Gowd Anirudh K. , Jacobs Cale A. , Macalena Jeffrey A. , Lesniak Bryson P. , Verma Nikhil N. , Romeo Anthony A. , Forsythe Brian
Published: January 2019

Background:

Worldwide, more than 100 million women between the ages of 15 and 49 years take oral contraceptive pills (OCPs). OCP use increases the risk of venous thromboembolism (VTE) through its primary drug, ethinylestradiol, which slows liver metabolism, promotes tissue retention, and ultimately favors fibrinolysis inhibition and thrombosis.

Purpose:

To evaluate the effects of OCP use on VTE after arthroscopic shoulder surgery.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

A large national payer database (PearlDiver) was queried for patients undergoing arthroscopic shoulder surgery. The incidence of VTE was evaluated in female patients taking OCPs and those not taking OCPs. A matched group was subsequently created to evaluate the incidence of VTE in similar patients with and without OCP use.

Results:

A total of 57,727 patients underwent arthroscopic shoulder surgery from 2007 to 2016, and 26,365 patients (45.7%) were female. At the time of surgery, 924 female patients (3.5%) were taking OCPs. The incidence of vascular thrombosis was 0.57% (n = 328) after arthroscopic shoulder surgery, and there was no significant difference in the rate of vascular thrombosis in male or female patients (0.57% vs 0.57%, respectively; P > .99). The incidence of VTE in female patients taking and not taking OCPs was 0.22% and 0.57%, respectively ( P = .2). In a matched-group analysis, no significant difference existed in VTE incidence between patients with versus without OCP use (0.22% vs 0.56%, respectively; P = .2). On multivariate analysis, hypertension (odds ratio [OR], 2.00; P < .001) and obesity (OR, 1.43; P = .002) were risk factors for VTE.

Conclusion:

OCP use at the time of arthroscopic shoulder surgery is not associated with an increased risk of VTE. Obesity and hypertension are associated with a greater risk for thrombolic events, although the risk remains very low. Our findings suggest that patients taking OCPs should be managed according to the surgeon’s standard prophylaxis protocol for arthroscopic shoulder surgery.
Exploring the “minimal” structure of a functional ADAMTS13 by mutagenesis and small-angle X-ray scattering
Authors: Zhu Jian , Muia Joshua , Gupta Garima , Westfield Lisa A. , Vanhoorelbeke Karen , Tolia Niraj H. , Sadler J. Evan
Published: January 2019

Human ADAMTS13 is a multidomain protein with metalloprotease (M), disintegrin-like (D), thrombospondin-1 (T), Cys-rich (C), and spacer (S) domains, followed by 7 additional T domains and 2 CUB (complement components C1r and C1s, sea urchin protein Uegf, and bone morphogenetic protein-1) domains. ADAMTS13 inhibits the growth of von Willebrand factor (VWF)–platelet aggregates by cleaving the cryptic Tyr1605-Met1606 bond in the VWF A2 domain. ADAMTS13 is regulated by substrate-induced allosteric activation; without shear stress, the distal T8-CUB domains markedly inhibit VWF cleavage, and binding of VWF domain D4 or selected monoclonal antibodies (MAbs) to distal ADAMTS13 domains relieves this autoinhibition. By small angle X-ray scattering (SAXS), ADAMTS13 adopts a hairpin-like conformation with distal T7-CUB domains close to the proximal MDTCS domains and a hinge point between T4 and T5. The hairpin projects like a handle away from the core MDTCS and T7-CUB complex and contains distal T domains that are dispensable for allosteric regulation. Truncated constructs that lack the T8-CUB domains are not autoinhibited and cannot be activated by VWF D4 but retain the hairpin fold. Allosteric activation by VWF D4 requires T7, T8, and the 58–amino acid residue linker between T8 and CUB1. Deletion of T3 to T6 produced the smallest construct (delT3-6) examined that could be activated by MAbs and VWF D4. Columba livia (pigeon) ADAMTS13 (pADAMTS13) resembles human delT3-6, retains normal activation by VWF D4, and has a SAXS envelope consistent with amputation of the hairpin containing the dispensable T domains of human ADAMTS13. Our findings suggest that human delT3-6 and pADAMTS13 approach a “minimal” structure for allosterically regulated ADAMTS13.
Bark beetles use a spring-loaded mechanism to produce variable song patterns
Authors: Lindeman Amanda A. , Yack Jayne E.
Published: January 2019

Many insects vary their song patterns to communicate different messages, but the underlying biomechanisms are often poorly understood. Here we report on the mechanics of sound production and variation in an elytro-tergal stridulator, male Dendroctonus valens bark beetles. Using ablation experiments coupled with high-speed video and audio recordings, we show that: 1. chirps are produced using a stridulatory file on the left elytron (forewing) and a protrusion (plectrum) on the seventh abdominal segment; 2. chirps are produced by ‘spring stridulation’, a catch-and-release mechanism whereby the plectrum catches on a file tooth, and upon release, springs forward along the file; and 3. variability in chirp types is caused by introducing multiple catch-and-release events along the file to create regular interruptions. These results provide experimental evidence for the mechanics of elytro-tergal stridulation, and provide insight into how an insect can incorporate variability into its acoustic repertoire using a spring-loaded mechanism.
Patterns of alternative splicing in response to cold acclimation in fish
Authors: Healy Timothy M. , Schulte Patricia M.
Published: January 2019

Phenotypic plasticity is an important aspect of an organism's response to environmental change that often requires the modulation of gene expression. These changes in gene expression can be quantitative as a result of increases or decreases in the amounts of specific transcripts, or qualitative as a result of the expression of alternative transcripts from the same gene (e.g., via alternative splicing of pre-mRNAs). Although the role of quantitative changes in gene expression in phenotypic plasticity is well known, relatively few studies have examined the role of qualitative changes. Here, we use skeletal muscle RNA-seq data from Atlantic killifish (Fundulus heteroclitus), threespine stickleback (Gasterosteus aculeatus) and zebrafish (Danio rerio) to investigate the extent of qualitative changes in gene expression in response to cold. Fewer genes demonstrated alternative splicing than differential expression as a result of cold acclimation; however, differences in splicing were detected for between 426 and 866 genes depending on species, indicating that large numbers of qualitative changes in gene expression are associated with cold acclimation. Many of these alternatively spliced genes were also differentially expressed, and there was functional enrichment for involvement in muscle contraction among the genes demonstrating qualitative changes in response to cold acclimation. Additionally, there was a common group of 29 genes with cold-acclimation-mediated changes in splicing in all three species, suggesting that there may be a set of genes with expression patterns that respond qualitatively to prolonged cold temperatures across fishes.
Segment Coordination Variability Differs by Years of Running Experience
Authors: HAFER JOCELYN F. , PEACOCK JILLIAN , ZERNICKE RONALD F. , AGRESTA CRISTINE E.
Published: January 2019

Running is a popular activity that results in high rates of overuse injury, with less-experienced runners becoming injured at higher rates than their more-experienced peers. Although measures of joint kinematics and kinetics and ground reaction forces have been associated with overuse running injuries, similar differences across levels of running experience have not been found. Because running is a motor skill that may develop with experience, an analysis of segment coordination and its variability could provide additional insight into why injury incidence decreases with increasing experience.

Purpose

The purpose of this study was to determine if less-experienced runners have different segment coordination and lower segment coordination variability compared with their more-experienced peers.

Methods

This retrospective analysis included 20 more-experienced (≥10 yr running) and 21 less-experienced (≤2 yr running) runners. Sagittal thigh versus shank and shank versus foot segment coordination and coordination variability were calculated using a modified vector coding approach as individuals ran on a treadmill at preferred pace. Coordination and its variability were compared between groups during terminal swing and early, mid, and late stance for both segment couples.

Results

Segment coordination was similar between less- and more-experienced runners. Less-experienced runners had lower segment coordination variability compared with more-experienced runners for both the thigh versus shank and shank versus foot couples. This lower variability occurred during early and mid stance.

Conclusions

Runners appeared to attain stable segment coordination patterns within 2 yr of consistent running, but had lower coordination variability compared with individuals who had been running for 10 or more years. These results suggest that assessment of movement patterns and their flexibility may help inform injury prevention or treatment strategies for less-experienced runners.
Impressionable Voters
Authors: Andonie Costel , Diermeier Daniel
Published: January 2019

We propose a model of impressionable voters. Impressionable voters vote based on impressions rather than maximizing expected utility. We apply our model to elections with multiple candidates and solve for the stationary distributions of the implied stochastic process. In elections with two candidates, we find that impressionable voters select the candidate that maximizes utilitarian welfare. In multi-candidate elections, Condorcet winners are elected provided that a majority of voters is able to sufficiently distinguish competing candidates. In such cases, models with impressionable voters may have better normative properties than models with rational voters. (JEL D71, D72, D91)
The value of sonoelastography in the diagnosis of supraspinatus tendinopathy—a comparison study
Authors: Vasishta Aishvarya , Kelkar Abhimanyu , Joshi Priscilla , Hapse Renuka
Published: January 2019

Objective:

This study assessed the association between tendon stiffness on sonoelastography and grades of tendinopathy on MRI in patients with supraspinatus tendinopathy.

Methods:

25 consecutive adult patients with clinically suspected supraspinatus tendinopathy and no prior history of trauma referred for MRI of the shoulder were selected for this study. The supraspinatus tendinopathy was graded in consonance with MRI findings (Grade I, normal; Grade II, mild tendinopathy; Grade III, moderate tendinopathy; and Grade IV, marked tendinopathy). Strain ratios were evaluated. Spearman rank correlation test was used, to analyze the association of the MRI grade with strain ratios.

Results:

Out of 25 patients, Grade I changes on MRI were found in 5 patients (20.0%), Grade II tendinopathy in 13 patients (52.0%), Grade III in 6 patients (24.0%), and Grade IV in 1 patient (4.0%). The mean sonoelastography strain ratio of supraspinatus tendons were 0.76 ± 0.32 in patients with Grade I, 0.59 ± 0.40 in Grade II, 0.31 ± 0.10 in Grade III and 0.15 ± 0.02 in Grade IV patients respectively. The strain ratios showed good correlation with the MRI grade p < 0.05.

Conclusion:

We compared the MRI findings of supraspinatus tendinopathy with sonoelastography strain ratios. Sonoelastography showed good correlation with MRI.

Advances in knowledge:

Sonoelastography in supraspinatus tendinopathy may help in predicting improvement or worsening of the tendon health at the tissue level. Therefore, there is a possibility that it has use in the rehabilitation of professionals suffering from supraspinatus tendinopathy.