bluuebunny/crossref_metadata_2025 huggingface dataset:
Design and Evaluation of an External Control Arm Using Prior Clinical Trials and Real-World Data
Authors: Ventz Steffen , Lai Albert , Cloughesy Timothy F. , Wen Patrick Y. , Trippa Lorenzo , Alexander Brian M.
Published: June 2019

Purpose:

We discuss designs and interpretable metrics of bias and statistical efficiency of “externally controlled” trials (ECT) and compare ECT performance to randomized and single-arm designs.

Experimental Design:

We specify an ECT design that leverages information from real-world data (RWD) and prior clinical trials to reduce bias associated with interstudy variations of the enrolled populations. We then used a collection of clinical studies in glioblastoma (GBM) and RWD from patients treated with the current standard of care to evaluate ECTs. Validation is based on a “leave one out” scheme, with iterative selection of a single-arm from one of the studies, for which we estimate treatment effects using the remaining studies as external control. This produces interpretable and robust estimates on ECT bias and type I errors.

Results:

We developed a model-free approach to evaluate ECTs based on collections of clinical trials and RWD. For GBM, we verified that inflated false positive error rates of standard single-arm trials can be considerably reduced (up to 30%) by using external control data.

Conclusions:

The use of ECT designs in GBM, with adjustments for the clinical profiles of the enrolled patients, should be preferred to single-arm studies with fixed efficacy thresholds extracted from published results on the current standard of care.
Hämoptysen: Wann ist die Bronchoskopie besonders wertvoll?
Authors: Wagner Manfred
Published: June 2019

Background: Bronchoscopy plays a key role to diagnose the etiology, to localize the site, and to identify the sources of the bleeding in patients with hemoptysis, but the ideal timing of an endoscopic examination is still unclear. Methods: We performed a secondary analysis of an observational and multicenter study, aimed at evaluating the epidemiology of hemoptysis in Italy and the diagnostic yield of the most frequently prescribed examinations. The aim of the study was to evaluate whether an early bronchoscopy (i.e., performed during active bleeding/≤48 h after hemoptysis stopped) helps localize bleeding (i.e., site, lobe, lung) and increase diagnostic yield in comparison with a delayed examination. Results: Four hundred eighty-six consecutive adult patients (69.2% males; median [IQR] age: 67 [53-76] years) with hemoptysis requiring an etiological diagnosis and undergoing bronchoscopy were recruited. Bleeding focus could be located more frequently in case of moderate-severe bleedings than in cases of mild hemoptysis (site: 70/154, 45.4%, VS. 73/330, 22.1%; p-value < 0.0001; lobe: 95/155, 61.3%, VS. 95/331, 28.7%; p-value < 0.0001; lung: 101/155, 65.1%, VS. 111/331, 33.5%; p-value < 0.0001). Early bronchoscopy showed a higher detection rate of bleeding source in comparison with delayed examination (site: 76/214, 35.5%, VS. 67/272, 24.6%; p-value = 0.01; lobe: 98/214, 45.8%, VS. 92/272, 33.8%; p-value = 0.007; lung: 110/214, 51.4%, VS. 102/272, 37.5%; p-value = 0.002). Early bronchoscopy did not provide any advantages in terms of increased diagnostic yield, in the total cohort (113/214, 52.8%, VS. 123/272, 45.2%; p-value = 0.10) and in the severity subtypes (mild: 56/128, 43.8%, VS. 88/203, 43.4%; p-value = 0.94; moderate-severe: 57/86, 66.2%, VS. 35/69, 50.7%; p-value = 0.051). Conclusions: Early bronchoscopy helps detect bleeding sources, particularly in cases of moderate-severe hemoptysis, without increasing diagnostic accuracy. Trial registration: ClinicalTrials.gov (identifier: NCT02045394).
Ist die Gabe von Surfactant bei erwachsenen Patienten mit akutem Atemnotsyndrom berechtigt?
Authors: Sofianos Georgios
Published: June 2019

Introduction: Surfactant is usually deficiency in adult acute respiratory distress syndrome (ARDS) patients and surfactant administration may be a useful therapy. The aim of this study was to perform a meta-analysis of the effect of surfactant administration on outcomes of adult patients with acute respiratory distress syndrome. Methods: PubMed, EMBASE, Medline, Cochrane database, Elsevier, Web of Science and http://clinicaltrials.gov were searched and investigated until December 2017. Randomized controlled trials (RCTs) comparing surfactant administration with general therapy in adult patients with ARDS were enrolled. The primary outcome was mortality (7-10-day, 28-30-day and 90-180-day). Secondary outcome included oxygenation (PaO2/FiO2 ratio). Demographic variables, surfactant administration, and outcomes were retrieved. Sensitivity analyses were used to evaluate the impact of study quality issues on the overall effect. Funnel plot inspection, Egger's and Begger's test were applied to investigate the publication bias. Internal validity was assessed with the risk of bias tool. Random errors were evaluated with trial sequential analysis (TSA). Quality levels were assessed by Grading of Recommendations Assessment, Development, and Evaluation methodology (GRADE). Results: Eleven RCTs with 3038 patients were identified. Surfactant administration could not improve mortality of adult patients [Risk ratio (RR) (95%CI)) = 1.02(0.93-1.12), p = 0.65]. Subgroup analysis revealed no difference of 7-10-day mortality [RR(95%CI)) = 0.89(0.54-1.49), p = 0.66], 28-30-day mortality[RR(95%CI) = 1.00(0.89-1.12), p = 0.98] and 90-180-day mortality [RR(95%CI) = 1.11(0.94-1.32), p = 0.22] between surfactant group and control group. The change of the PaO2/FiO2 ratio in adult ARDS patients had no difference [MD(95%CI) = 0.06(− 0.12-0.24), p = 0.5] after surfactant administration. Finally, TSA and GRADE indicated lack of firm evidence for a beneficial effect. Conclusions: Surfactant administration has not been shown to improve mortality and improve oxygenation for adult ARDS patients. Large rigorous randomized trials are needed to explore the effect of surfactant to adult ARDS patients.
Alles eine Frage des Trainings - Lungenultraschall bei Neugeborenen
Authors: Brandt David
Published: June 2019

Background: Respiratory distress (RD) is the most common neonatal illness. Lung ultrasound (LUS) is a technique previously tested in neonatal studies on RD, but literature regarding its routine clinical applicability is still lacking. Objective: To assess the concordance between LUS performed by neonatologists with different training levels and chest X-ray (CXR) for the diagnosis of RD in newborns during the first 24 h of life. Methods: We enrolled newborns with RD during the first 24 h of life. Patients under went LUS and CXR. LUS and CXR diagnosis were compared to evaluate concordance. Twenty percent of patients received two LUS (one from an experienced and one from a novice sonographer) to calculate the interobserver agreement. The difference in time needed to reach a diagnosis with LUS and CXR, and from novice and expert operators, was measured. Results: We studied 124 patients; 134 diagnoses were reported. The concordance between LUS and CXR diagnosis was 91% (95% CI 86-96%) with a κ statistic of 0.88 (95% CI 0.81-0.94). The median time to diagnosis was shorter for LUS (9.5 min, IQR 5-15) than for CXR (50 min, IQR 33-64) (p < 0.0001). In 25/124 patients, LUS was performed by both novice and experienced sonographers with complete concordance. The median time to diagnosis was shorter for expert (9 min, IQR 5-15) than novice operators (15 min, IQR 10-20) (p < 0.0002). Conclusion: LUS and CXR have a high concordance in the differential diagnosis of neonatal RD in the first 24 h of life. LUS has a shorter operation time than CXR.
Hospitalisation und Mortalität bei älteren Rauchern mit COPD oder chronischer Herzinsuffizienz
Authors: Frohnhofen Helmut
Published: June 2019

Background: In elderly smokers, chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) usually present with dyspnoea. COPD and CHF are associated almost invariably with concomitant chronic diseases, which contribute to severity and prognosis. Objectives: We investigated similarities and differences in the clinical presentation, concomitant chronic diseases and risk factors for mortality and hospitalization at 3-year follow-up in elderly smokers/ex-smokers with a primary diagnosis of COPD or CHF recruited and followed in specialized centers. Methods: We examined 144 patients with COPD and 96 with CHF, ≥65 years, ≥20 pack/years, and measured COPD Assessment Test (CAT) score, modified Medical Research Council, NYHA, and Charlson Index, routine blood test, estimated glomerular filtration rate, HRCT scan, 6-min walk test. In addition, in each patient we actively searched for CHF, COPD, peripheral vascular disease, and metabolic syndrome. Results: COPD and CHF patients had mild to moderate disease, but the majority was symptomatic. Comorbidities were highly prevalent and often unrecognized in both groups. COPD and CHF patients had a similar risk of hospitalization and death at 3 years. Lower glomerular filtration rate, shorter 6MWT, and ascending aorta calcification score ≥2 were independent predictors of mortality in COPD, whereas previous 12 months hospitalizations, renal disease, and heart diameter were in CHF patients. Lower glomerular filtration rate value, higher CAT score, and lower FEV1/FVC ratio were associated with hospitalization in COPD, while age, lower FEV1% predicted, and peripheral vascular disease were in CHF. Conclusions: There are relevant similarities and differences between patients with COPD and CHF even when admitted to specialized outpatient centers, suggesting that these patients should be manage in multidisciplinary units.
ОСОБЛИВОСТІ МЕДСЕСТРИНСЬКОГО ДОГЛЯДУ ЗА ПАЛІАТИВНИМИ ПАЦІЄНТАМИ ОДЕСЬКОГО ОБЛАСНОГО ЦЕНТРУ СОЦІАЛЬНО ЗНАЧУЩИХ ХВОРОБ
Authors: Slobodenyuk K. M. , Bob A. O. , Ermakova N. O. , Hutsol A. V.
Published: June 2019

Сестринський персонал відіграє ключову роль в організації паліативної допомоги хворим на ВІЛ/СНІД та туберкульоз. Паліативна допомога є цілісним підходом, що складається з медичного, соціального, психологічного та духовного компонентів. Медсестра – ключова особа в оточенні пацієнта, яка забезпечує належну медичну допомогу, кваліфікований догляд та психологічну підтримку паліативним пацієнтам.
ПРОБЛЕМА БУЛІНГУ В МЕДИЧНИХ ЗАКЛАДАХ УКРАЇНИ
Authors: Slipchenko O. S. , Haliyash N. B.
Published: June 2019

У статті порушено проблему необхідності дослідження та висвітлення проблеми булінгу в медичних закладах України, адже створення позитивної психологічної атмосфери у колективах може сприяти підвищенню рівня надання медичної допомоги пацієнтам.
European survey on preanalytical sample handling – Part 1: How do European laboratories monitor the preanalytical phase? On behalf of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Working Group for the Preanalytical Pha
Authors: Cadamuro Janne , Cornes Michael , Simundic Ana-Maria , de la Salle Barbara , Kristensen Gunn B.B. , Guimaraes Joao Tiago , Grankvist Kjell , Vermeersch Pieter , Nybo Mads , van Dongen – Lases Edmee , Ibarz Mercedes , von Meyer Alexander , Lippi Giuseppe
Published: June 2019

Introduction: Compared to other activities of the testing process, the preanalytical phase is plagued by a lower degree of standardization, which makes it more vulnerable to errors. With the aim of providing guidelines and recommendations, the EFLM WG-PRE issued a survey across European medical laboratories, to gather information on local preanalytical practices. This is part one of two coherent articles, which covers all practices on monitoring preanalytical quality except haemolysis, icterus and lipemia (HIL). Materials and methods: An online survey, containing 39 questions dealing with a broad spectrum of preanalytical issues, was disseminated to EFLM member countries. The survey included questions on willingness of laboratories to engage in preanalytical issues. Results: Overall, 1405 valid responses were received from 37 countries. 1265 (94%) responders declared to monitor preanalytical errors. Assessment, documentation and further use of this information varied widely among respondents and partially among countries. Many responders were interested in a preanalytical online platform, holding information on various aspects of the preanalytical phase (N = 1177; 87%), in a guideline for measurement and evaluation of preanalytical variables (N = 1235; 92%), and in preanalytical e-learning programs or webinars (N = 1125; 84%). Fewer responders were interested in, or already participating in, preanalytical EQA programs (N = 951; 71%). Conclusion: Although substantial heterogeneity was found across European laboratories on preanalytical phase monitoring, the interest in preanalytical issues was high. A large majority of participants indicated an interest in new guidelines regarding preanalytical variables and learning activities. This important data will be used by the WG-PRE for providing recommendations on the most critical issues.
Interference Control in Working Memory Is Associated with Ventrolateral Prefrontal Cortex Volume
Authors: Samrani George , Bäckman Lars , Persson Jonas
Published: June 2019

Goal-irrelevant information may interfere with ongoing task activities if not controlled properly. Evidence suggests that the ability to control interference is connected mainly to the prefrontal cortex (pFC). However, it remains unclear whether gray matter (GM) volume in prefrontal regions influences individual differences in interference control (IC) and if these relationships are affected by aging. Using cross-sectional and longitudinal estimates over a 4- to 5-year period, we examined the relationship between relative IC scores, obtained from a 2-back working memory task, GM volumes, and performance in different cognitive domains. By identifying individuals with either no or high levels of interference, we demonstrated that participants with superior IC had larger volume of the ventrolateral pFC, regardless of participant demographics. The same pattern was observed both at baseline and follow-up. Cross-sectional estimates further showed that interference increased as a function of age, but interference did not change between baseline and follow-up. Similarly, across-sample associations between IC and pFC volume were found in the cross-sectional data, along with no longitudinal change–change relationships. Moreover, relative IC scores could be linked to composite scores of fluid intelligence, indicating that control of interference may relate to performance in expected cognitive domains. These results provide new evidence that a relative IC score can be related to volume of specific and relevant regions within pFC and that this relationship is not modulated by age. This supports a view that the GM volume in these regions plays a role in resisting interference during a working memory task.
Rhythmic Temporal Structure at Encoding Enhances Recognition Memory
Authors: Jones Alexander , Ward Emma V.
Published: June 2019

Presenting events in a rhythm has been shown to enhance perception and facilitate responses for stimuli that appear in synchrony with the rhythm, but little is known about how rhythm during encoding influences later recognition. In this study, participants were presented with images of everyday objects in an encoding phase before a recognition task in which they judged whether or not objects were previously presented. Blockwise, object presentation during encoding followed either a rhythmic (constant, predictable) or arrhythmic (random, unpredictable) temporal structure, of which participants were unaware. Recognition was greater for items presented in a rhythmic relative to an arrhythmic manner. During encoding, there was a differential neural activity based on memory effect with larger positivity for rhythmic over arrhythmic stimuli. At recognition, memory-specific ERP components were differentially affected by temporal structure: The FN400 old/new effect was unaffected by rhythmic structure, whereas the late positive component old/new effect was observed only for rhythmically encoded items. Taken together, this study provides new evidence that memory-specific processing at recognition is affected by temporal structure at encoding.
Needle, Pen, and the Social Geography of Taste in Early National Providence
Authors: Silbert Kate
Published: June 2019

This essay examines needlework samplers from Mary Balch's school and diaries produced by elite young women in Providence, Rhode Island in the late eighteenth century. Drawing on scholarship on material culture, social geography, and gender, it traces the physical mobility that characterized daily life, reading and writing practices, and social boundaries in the early republic.
The Resistance Petitions of 1664–1665: Confronting the Restoration in Massachusetts Bay
Authors: Weimer Adrian Chastain
Published: June 2019

Concerned about losing their civil and church liberties under the newly restored Charles II's regime, colonial Puritans organized town-wide petition campaigns. Signed by both freemen and non-freemen, the 1664-1665 petitions drew on biblical, constitutional, and Civil War-era language to urge the Massachusetts General Court to resist the king's demands.
Archetypes of Knowledge
Authors: Zwart H.A.E. (Hub)
Published: June 2019

This paper substantiates why Jung’s psychology is still highly relevant for understanding science today. I explore how his methods and insights allow us to come to terms with the phenomenon of scientific discovery. After outlining core Jungian concepts and insights concerning science, I will focus on the relationship between alchemy and modern science. Also, I will highlight Jung’s understanding of scientific research as a practice of the self, directed at individuation (the integration of various aspects of the self into a coherent whole). Finally, I discuss the role of archetypes in the context of discovery of modern science. Whereas archetypal ideas may function as sources of insight and inspiration, the task for researchers is to come to terms with them, instead of being overwhelmed by them. Besides case studies discussed by Jung himself, I also present more recent examples, taken from molecular life sciences research and climate change research.
Blockchain-Based Money as the Ultimate Challenge to Sovereignty
Authors: de Caria Riccardo
Published: June 2019

The article considers the radical challenge that blockchain, and in particular the blockchain-based cryptocurrency Bitcoin, poses to state sovereignty. If blockchain ever succeeds to be adopted on a large scale, Bitcoin, or any other permissionless blockchain-based cryptocurrency for that matter, is a direct threat to one of the key tenets of sovereignty: the monopoly over money. Without this traditional monopoly, states will not be able to exist as they have so far. Building on this premise, the article argues that blockchain-based money is currently posing a serious challenge to state sovereignty and could therefore reshape public law.

This article also contends that Bitcoin in particular might collapse for technical reasons. However, if Bitcoin proves to be resilient enough to resist ongoing legal challenges, then the very “basic norm” of our legal systems will arguably change.
Rapid Method for the Detection of Porphyromonas gingivalis in Chronic Periodontitis
Authors: Yuan Jia , Chen Qiongyu , Xu Xiongjun
Published: June 2019

Porphyromonas gingivalis is the major cause of chronic periodontitis, a disease leading to the loss of teeth and other health complications. Therefore, an urgent need exists for a specific and rapid method for the detection of this pathogen in affected patients. The objective
of this study was to test the applicability of conventional and real-time PCR protocols to detect the presence of P. gingivalis using DNA isolated by magnetic microbeads. The samples were collected from 50 patients with periodontal disease and 50 healthy subjects. Following successful
isolation of DNA, the presence of P. gingivalis gene coding for its 16S rRNA was established by conventional PCR or quantitative realtime PCR. The bacteria were identified in 94% of the patients when samples of gingival crevicular fluid obtained from the active disease zone were used.
The corresponding value for the quiescent zone was 44%, and for the samples collected from the plaque was 12%. P. gingivaliswas not found in samples obtained from healthy subjects. Thus, the methodology developed here, based on isolation of DNA from affected periodontium by magnetic
microbeads and detection of P. gingivalis DNA by conventional or quantitative real-time PCR, has been proven to be specific, sensitive, and accurate. It provides a valuable tool for a rapid and reliable diagnosis of an imminent or ongoing disease.
IQ Motif-Containing GTPase-Activating Protein 3 Overexpression Correlates with Poor Prognosis and Radiation Therapy Resistance in Breast Cancer
Authors: Hua Xin , Yan Qihang , Long Zhiqing , Huang Xin , Deng Jiapeng , Lin Chao , Sun Xiaoqing , Wen Wen , Lu Zijian , Guo Na , He Zhenyu , Song Libing , Guo Ling , Zhang Wenwen , Lin Huanxin
Published: June 2019

IQ motif-containing GTPase-activating protein 3 (IQGAP3), the latest found IQGAP family protein, may act as a crucial factor in the process of cancer development and progression; however, its clinical value in breast cancer remains unestablished so far. Our team explored the correlation
between the IQGAP3 expression profile and clinicopathological features in breast cancer. IQGAP3 levels in breast cancer cell lines and tumor tissues were detected through real-time PCR and western blotting. We evaluated IQGAP3 expression in archived paraffin-embedded tissue specimens of 257
breast cancer patients, and determined the relationship between IQGAP3 expression and sensitivity to radiation therapy (RT), using subgroup analysis. We also analyzed the association between IQGAP3 expression and the clinical characters and prognosis of breast cancer. There was a significant
upregulation of IQGAP3 in breast cancer cell lines and human tumor tissues at both mRNA and protein levels. In addition, 42.8% of the breast cancer specimens had high expression of IQGAP3, which was significantly related to clinical stage (P = 0.001), T category (P = 0.002),
N category (P = 0.001), locoregional recurrence (P = 0.002), distant metastasis (P = 0.001), and vital status (P = 0.001). Univariate and multivariate statistical analyses showed that IQGAP3 is an independent prognostic factor for all the breast cancer patients
(P = 0.003, P = 0.001). Subgroup analysis revealed that IQGAP3 expression is correlated with radiation therapy resistance and is an independent predictor for radiation therapy outcome. Our findings suggest that IQGAP3 may be a reliable novel biomarker to provide personalized
prognosis and identify patients who can profit from a more aggressive RT regimen for improving breast cancer patient survival.
Transition to Employment and Community Life for Youths with Visual Impairments: Current Status and Future Directions
Authors: Nagle Katherine M.
Published: June 2019

Outcome data from the 21st Annual Report to Congress and the National Longitudinal Transition Study related to youths with visual impairments indicate that postsecondary education does not translate into increased employment opportunities for these youths. The literature on the best transition practices for students with visual impairments is reviewed, and specific recommendations are made in each area.
Effects of Adherence to Traditional Female Sex Roles on Compliance with Diabetic Regimens: A Case History
Authors: Van Boemel Gretchen B. , Lee Paul P.
Published: June 2019

This article investigates the possible association between adherence to traditional feminine sex roles, poor compliance with treatment for diabetes, and the onset of diabetic retinopathy. The authors present a case study and suggestions for health care professionals and future research in this area.
Connections: Facilitating Social Supports for Students with Deaf-Blindness in General Education Classrooms
Authors: Goetz Lori , O'Farrell Nora
Published: June 2019

This article describes a three-component package to facilitate social supports for students who were deaf-blind in general education classes and discusses the rationale for and importance of its use. It also presents case examples of the application of social support strategies to four students with deaf-blindness who were served in general education or deaf education classes.
Hepatic Myoepithelial Carcinoma in a Dog: Immunohistochemical Comparison With Other Canine Hepatic Carcinomas
Authors: Tsuji Yuka , Kuramochi Mizuki , Izawa Takeshi , Akiyoshi Hideo , Yamate Jyoji , Kuwamura Mitsuru
Published: June 2019

An 11-year-old female miniature Dachshund dog presented with a solid, soft, gray mass on the hepatic lateral left lobe. Histologically, the mass consisted of neoplastic proliferation of cells with round nuclei and eosinophilic and vacuolated cytoplasm arranged in alveolar, trabecular, and solid patterns. Immunohistochemically, the neoplastic cells were positive for pancytokeratin (CK AE1/AE3), CK5, CK14, vimentin, Sox9, and myoepithelial markers (α–smooth muscle actin, p63, and calponin). The morphological and immunohistochemical findings indicated a diagnosis of myoepithelial carcinoma. We conducted immunohistochemical studies on other representative canine hepatic tumors. Although the myoepithelial phenotype was not observed in the hepatocellular carcinoma, some tumor cells in cholangiocarcinoma showed immunohistochemical features of myoepithelium, suggesting that some neoplastic cells in cholangiocarcinoma may have the potential to differentiate into myoepithelial cells. To our knowledge, this is the first report in veterinary medicine of a hepatic carcinoma with a myoepithelial phenotype.
Traffic State Estimation in Heterogeneous Networks with Stochastic Demand and Supply: Mixed Lagrangian–Eulerian Approach
Authors: Kavianipour Mohammadreza , Saedi Ramin , Zockaie Ali , Saberi Meead
Published: June 2019

A network fundamental diagram (NFD) represents the relationship between network-wide average flow and average density. Network traffic state estimation to observe NFD when congestion is heterogeneously distributed, as a result of a time-varying and asymmetric demand matrix, is a challenging problem. Recent studies have formulated the NFD estimation problem using both fixed measurements and probe trajectories. They are often based on a given ground-truth NFD for a single day demand. Stochastic variations in network demand and supply may significantly affect the approximation of an NFD. This study proposes a modified framework to estimate network traffic states to observe NFD while capturing the stochasticity in transportation networks. A mixed integer problem with non-linear constraints is formulated to address stochasticity in the NFD estimation problem. To solve this Nondeterministic Polynomial-hard (NP-hard) problem, a solution algorithm based on the simulated annealing method is applied. The problem is formulated and the solution algorithm is implemented to find an optimal configuration of loop detectors and probe vehicles to estimate the NFD of the Chicago downtown network and capture its day-to-day variations, considering a given available budget. Ground-truth NFDs and estimated NFDs based on a subset of loop detectors and probe vehicles are calculated using a simulation-based dynamic traffic assignment model, which is the best surrogate available to replicate real-world conditions. The main contribution of this study is to capture stochasticity in the demand and supply sides to find a more robust subset of links and trajectories to be acquired for the NFD estimation.
What, if anything, is a caesura? The ontology of the ‘pause’ in English heroic verse
Authors: Groves Peter
Published: June 2019

The term ‘caesura’ (or ‘pause’) has featured in discussion of English iambic pentameter for four centuries, and yet it still lacks what the Latin hexameter or the French alexandrine have: a definition of the term that might be usefully applied in stylistic description. Despite the temptation to dismiss it as a prosodic chimera or a mere epiphenomenon of syntax, this article will investigate a rough consensus that emerged amongst 18th-century theorists and practitioners about the bisecting caesura as both a normative element of versification and an aesthetic instrument, and attempt to formalize that consensus into a taxonomy based on linguistic features that will allow the caesura to function as a feature of stylistic description and analysis, not just for the heroic couplet but for the pentameter more generally, in terms of three independent and objectively definable properties that I term ‘balance’, ‘juncture’ and ‘integration’.
Challenges and Opportunities Brought to the Chinese Economy by Brexit and the New US Administration
Authors: Morales Lucía , Andreosso-O’Callaghan Bernadette
Published: June 2019

The impact of Brexit and the election of Donald Trump as the 45th US president in the context of stock market reactions and economic policy uncertainty (EPU) within three key zones in ‘the Greater China Region’ (Hong Kong, Taiwan and China Mainland) are examined in this article. The chosen research period is from January 2014 to June 2017, and the EPU Index in the USA and the UK is used as a proxy to measure political uncertainty in two of the world major economies and how they impact on the Chinese stock market. The main contribution of the article can be found in the analysis of how stock market performance can be driven by policy-related uncertainty shocks in the international context. The results show that the stock markets in the ‘Greater China Region’ did not seem to react either to the uncertainty generated by Brexit or to the election of Donald Trump, implying that the Chinese stock markets appear to be quite resilient to the recent political events that have been disrupting the global economy.

JEL codes: G58, G15, G18
A phenomenographic approach to understanding some Taiwanese music teachers’ experiences of creativity in the classroom
Authors: Wiles Michael Ashley , Kokotsaki Dimitra
Published: June 2019

This study examines what creativity means to a group of Taiwanese music teachers and how it relates to their classroom experiences and teaching practices. The research followed a qualitative, interpretative approach. Interviews were used to gather data and were analysed according to phenomenographic principles. Analysis of the interviews indicated that two main approaches were taken by teachers regarding their experiences of creativity: a product-focused and a process-focused approach. In the product-focused approach, creativity was defined from the outside according to externally imposed factors, frames of reference and motivating forces. In the process-focused approach, creativity was defined from the inside, from the point of view of the individual involved, and in which personal agency, inclusion and collaboration were valued. The approach taken by teachers towards creativity also showed a relationship to how music education was perceived. Teachers who had a product-focused approach to creativity saw music education in terms of content, whereas those who were process focused had a meaning-oriented view of music education that valued the experience of students over the content that was taught. Similarly, a correspondence was found between how creativity was perceived and the nature of classroom interactions that varied between teacher centred and learner centred.
Strength and Function Across Maturational Levels in Young Athletes at the Time of Return to Sport After ACL Reconstruction
Authors: Ithurburn Matthew P. , Paljieg Adam , Thomas Staci , Hewett Timothy E. , Paterno Mark V. , Schmitt Laura C.
Published: June 2019

Background:

The impact of maturation on lower extremity strength and function after anterior cruciate ligament reconstruction (ACLR) may help guide future studies of age-specific rehabilitation.

Hypothesis

Pediatric ACLR patients would demonstrate higher thigh strength symmetry and knee-related function at return to sport (RTS) compared with adolescent and young adult participants who underwent traditional ACLR.

Study Design:

Prospective cohort study.

Level of Evidence:

Level 2.

Methods:

A total of 144 young athletes at the time of RTS clearance post-ACLR were classified into 3 maturational groups (pediatric, n = 16 with physeal-sparing ACLR [mean age = 12.3 years; range = 9.2-14.6 years]; adolescent, n = 113 [mean age = 16.5 years; range = 14.1-19.8 years]; young adult, n = 15 [mean age = 22.0 years; range = 20.5-24.9 years]). Quadriceps and hamstring strength were measured using an electromechanical dynamometer. Knee-related function was measured using the International Knee Documentation Committee (IKDC) subjective form and single-leg hop tests. The Limb symmetry Index (LSI) was used in calculations for hop and strength tests. Group differences were compared with Kruskal-Wallis tests and Mann-Whitney U post hoc tests. Proportions of participants meeting literature-recommended RTS criterion cutoffs were compared among the groups using chi-square tests.

Results:

The pediatric group demonstrated higher quadriceps LSI ( P = 0.01), IKDC scores ( P < 0.01), single-hop LSI ( P < 0.01), and crossover-hop LSI ( P = 0.02) compared with the young adult group. In addition, the pediatric group demonstrated higher IKDC scores ( P < 0.01) and single-hop LSI ( P = 0.02) compared with the adolescent group. The adolescent group demonstrated higher IKDC scores ( P < 0.01), single-hop LSI ( P = 0.02), and crossover-hop LSI ( P = 0.03) compared with the young adult group. The proportions of participants meeting all RTS criterion cutoffs were highest in the pediatric group and lowest in the young adult group ( P = 0.03).

Conclusion:

Young athletes at RTS clearance after pediatric ACLR demonstrated higher quadriceps strength symmetry and knee-related function than adolescents and young adults after traditional ACLR.

Clinical Relevance:

These findings demonstrate the need for further study regarding the impact of these group differences on longitudinal outcomes after ACLR, including successful RTS and risk of second ACL injury.
Total Quality Management, Concurrent Engineering and Manufacturing Performance: An Empirical Investigation
Authors: Deshpande Anant
Published: June 2019

The purpose of the research is to empirically investigate the relationships among the dimensions of total quality management, concurrent engineering, and manufacturing performance for a sample of 204 Indian manufacturing managers. Using the resource-based view, a theoretical framework is proposed. Structural equation modelling was used to test the relationships between the dependent and the independent variables.

Our research empirically indicates, that the dimensions of total quality management and concurrent engineering have a positive impact on each other and on the manufacturing performance the firm. However, customer focus was not found to have a significant impact on cost performance. The results of the study may not be generalizable as the study was conducted only in India. As future research, the relationships may be explored in other countries and cross-country differences may be investigated. To the best of our knowledge, no study has previously investigated the linkages between the dimensions of total quality management, concurrent engineering, and manufacturing performance in a unified context. Such investigations are crucial as the results of the research may provide a concrete support for the simultaneous implementation of total quality management and concurrent engineering and motivate more organizations to engage in such practices. Understanding the interlinkages between dimensions of these practices and the performance outcomes will also provide a theoretical as well as a practical platform for organizations to gain sustainable competitive advantage.
Quantification of Cardiorespiratory Fitness in Children with Obesity
Authors: BHAMMAR DHARINI M. , ADAMS-HUET BEVERLEY , BABB TONY G.
Published: June 2019

Purpose

Without consideration for the effects of fat mass, there could be an underestimation of cardiorespiratory fitness in children with obesity leading to a clinical diagnosis of deconditioning and resulting in unrealistic training goals and limitation of physical activities. The purpose of this study was to identify methods of quantifying cardiorespiratory fitness that were less influenced by fat mass.

Methods

Fifty-three children, 27 with obesity (10.9 ± 1.0 yr) and 26 without obesity (11.0 ± 1.0 yr), volunteered for this study. Maximal oxygen uptake, an indicator of cardiorespiratory fitness, was referenced to lean body mass, body mass, and predicted body mass at the 50th and 85th body mass index percentiles.

Results

Children with obesity carried 18 kg more fat mass and 7 kg more lean body mass compared with children without obesity. Cardiorespiratory fitness based on lean body mass, body mass, and predicted body mass at the 85th percentile was lower in children with obesity compared with children without obesity (P < 0.001). Differences in cardiorespiratory fitness based on predicted body mass at the 50th percentile between children with and without obesity did not reach statistical significance (P = 0.84). Fat mass influenced cardiorespiratory fitness least when referenced to lean body mass or predicted body mass at the 50th percentile (R
2 < 0.26) in contrast to when it was referenced to body mass or predicted body mass at the 85th percentile (R
2 > 0.37).

Conclusion

Quantifying cardiorespiratory fitness based on lean body mass or predicted body mass at the 50th percentile could be useful for estimating fitness levels in children with obesity.
MERLIM DE ROBERT DE BORON E O TEXTO RELIGIOSO
Authors: Nabarrete Mariany Camilo , Pierini Fábio Lucas
Published: June 2019

Este artigo tem por objetivo identificar o processo de cristianização do personagem protagonista da obra medieval Merlim, além de averiguar como e porque o autor, Robert de Boron, utiliza a intertextualidade, mais especificamente a estilização, para criar sua narrativa. As obras medievais, segundo estudiosos, possuem um caráter formador, criadas com o intuito de adequarem uma população a um determinado regime político e religioso, logo, um estudo sobre o personagem Merlim, em especial o descrito por Robert de Boron que recebe o nome da obra, é importante para que se possa compreender a necessidade da literatura Idade Média, bem como para desvendar-se uma razão que justifique a presença da personagem em obras posteriores. Para tanto, a análise do livro Merlim, de Robert de Boron, pauta-se nas teorias de intertextualidade e hipertextualidade de Gérard Genette (2010), assim como na teoria de paródia, paráfrase e intertextualidade defendida por Affonso Sant’Anna (2003). Com isso, nota-se que a modificação do personagem medieval realizada por Boron, por meio da intertextualidade, é regida pela intencionalidade do autor de catequizar povos pagãos, afinal, ao criar um personagem da cultura Celta, com características cristãs, próximas às de Jesus Cristo, conduz os povos para longe do pecado, como exortado pela Igreja na época.
Os indicadores de intersubjetividade e sua potência na clínica de crianças
Authors: Giaretta Vanessa , Silva Milena Da Rosa
Published: June 2019

Os indicadores de intersubjetividade são uma espécie de guia, reunindo fenômenos que vêm sendo destacados pela literatura psicanalítica e indicam que a constituição psíquica da criança está se desenvolvendo no encontro com seu ambiente subjetivante. Tais fenômenos foram reunidos pelo psicanalista uruguaio Victor Guerra. Neste artigo, as autoras sustentam que esses indicadores podem se consolidar como uma ferramenta teórica e técnica na clínica de crianças que apresentam entraves em seu processo de subjetivação. É apresentado um resumo desses indicadores e cenas clínicas, visando compreender de que modo eles podem amparar o trabalho analítico, iluminando um caminho rumo à subjetivação.
Relato de experiência: Uma narrativa científica na pós-modernidade
Authors: Daltro Mônica Ramos , Faria Anna Amélia de
Published: June 2019

A construção do conhecimento científico organiza-se numa multiplicidade, permanentemente desafiada a elaborar modos de leituras da realidade. Esse estudo apresenta o Relato de Experiência (RE) como produto científico próprio às ciências humanas e à pós-modernidade. Análise documental realizada entre 12/2017-01/2018, pesquisou periódicos da área da psicologia, classificados no quadriênio 2013-2016, na Plataforma Sucupira. Analisados 170 periódicos, identificou-se que apenas cinco aceitam o RE como um documento científico, esses de origem brasileira e vinculadas aos mais importantes programas de pós-graduação na psicologia brasileira e situados nas regiões Sudeste e Centro-Oeste. O Resultado reafirma a limitada força política do RE e a potência da perspectiva empirista cartesiana nos domínios da pesquisa em psicologia. Neste artigo, discute-se a importância do RE como narrativa que legitima a experiência enquanto fenômeno científico, e propõe-se seis passos de referência para sua construção.
‘Welcome to the World’: parents' experiences of an antenatal nurturing programme
Authors: Wadephul Franziska , Jones Catriona , Jomeen Julie
Published: June 2019

Background

The transition to parenthood lays the foundations for the parent-infant relationship, but can also be a time of increased vulnerability. It can therefore be a suitable time for interventions to increase parents' emotional wellbeing and support couple relationships as well as the relationship with the baby.

Aims

This study aimed to explore the experiences of attendees at an antenatal nurturing programme and its effect on their experiences of the early postnatal period.

Methods

A total of 36 attendees took part in six focus groups across the UK.

Findings

Participants' experiences of the programme were very positive; it provided knowledge and skills and gave participants a safe space in which to explore feelings and concerns. The programme encouraged participants to nurture themselves, as well as their babies and their relationships. Some groups formed strong support networks, while others did not.

Conclusion

Participants felt they had benefitted from the programme, particularly in terms of their emotional wellbeing and couple relationships.
Women's experiences of outpatient induction of labour
Authors: Kandola Dalvir
Published: June 2019

Background

Outpatient induction of labour is offered to relieve the pressure on inpatient stay and to improve women's experiences.

Aim

To contribute to the knowledge of outpatient induction of labour with the focus on women's experiences to inform practice. The question was: ‘What are women's experiences of outpatient induction of labour?’

Method

A comprehensive literature review using a pluralistic approach and thematic analysis.

Findings

The review found three themes: the home as a positive setting for outpatient induction of labour, the value of outpatient induction of labour in promoting normality and the importance of receiving reassurance during outpatient induction of labour.

Conclusion

Although the results were mostly positive and in favour of outpatient induction of labour, there were variations in service provision. There was a lack of understanding as to how best to offer reassurance to women once discharged home, which was found to have a direct effect on their experiences.
Mental health and the midwife
Authors: Axcell Claire
Published: June 2019

Ensuring maternal mental wellbeing is now a priority in midwifery. But, as Claire Axcell writes, part of ensuring holistic care for the woman is protecting the mental health of her care-givers
An a/r/tographic métissage: Storying the self as pedagogic practice
Authors: Osler Trish , Guillard Isabelle , Garcia-Fialdini Arianna , Côté Sandrine
Published: June 2019

This article traces the experience of four arts educators as they consider ‘self as subject-matter’ through living inquiry. Anchored in arts-based approaches, storying the self four ways offers both an individual perspective and an a/r/tographic métissage ofbecomingthrough the weaving of narratives that derive from sociocultural and historical contexts. The practice of narrative as research considers the following questions: how does the presentation/communication component of life writing colour a narrative? What common and potentially universal experiences occur within life writing research? Through the collaborative exchange of four narratives, a fifth emerges: in response to the creative journey of others, and in documenting our entanglements with them, we open spaces. Illustrating how the introspective and extrospective interact with the visual or performative as a vehicle for revealing the self, this article posits that the self-in-relation to theory and practice becomes a way of knowing that broadens educational discourse among artists/researchers/teachers.
Whose life is it anyway? Practice-based research into performed fictional-autobiography and the paradox of fiction
Authors: Lovat Simon
Published: June 2019

This article explores the notion of ‘self’ as it pertains to autobiographical writing, and its repercussions for the fact/fiction dichotomy inherent in autobiographical praxis. The mode of articulation is a discussion of the reception of two one-man plays: Memoires of a Confused Man (2016) and Are Strings Attached? (2017). Both plays are written and performed by this writer. Drawing on philosophical, cognitive and spiritual discourses, I show that ‘selfhood’ is not a transparent and unproblematic proposition. I then re-examine the so-called paradox of fiction. I argue that it is common experience to care about notional entities and suggest that this comes about by way of ‘transfictional disavowal’ and ‘affective metalepsis’. Finally, I offer an exemplary text, read first as ‘fiction’, and then as ‘autobiography’. I then propose a new modality of the ‘paradox of fiction’, which offers a satisfactory reading position of autobiographical writings based on a re-evaluation of ‘selfhood’.
Amazonas: mulheres e formação docente no Parfor
Authors: Castro Amanda Motta
Published: June 2019

Os escritos aqui apresentados têm como objetivo principal fazer uma reflexão sobre relações de gênero e a formação docente realizada no estado do Amazonas, na Universidade do Estado do Amazonas (UEA), dentro do Plano Nacional de Formação de Professores (PARFOR). O PARFOR é um programa do Governo Federal oferecido na modalidade presencial, este é um Programa emergencial instituído para atender o disposto no artigo 11, inciso III do Decreto nº 6.755, de 29 de Janeiro de 2009 e implantado em regime de colaboração entre a Capes, os estados, municípios e as Instituições de Educação Superior (IES). O objetivo deste programa é realizar a formação superior de docentes que já atuam na Educação Básica e não possuem curso de ensino superior. Aqui será debatida a experiência de orientação de 21 estudantes docentes do PARFOR entre os meses de Junho a Outubro de 2015 no município de Tefé, localizado no Médio Solimões, no Estado do Amazonas. Articulando gênero e Educação popular este texto faz uma discussão sobre a questão de gênero neste contexto.