bluuebunny/crossref_metadata_2025 huggingface dataset:
Experimental evaluation of a capillary heating bed driven by an air source heat pump and solar energy
Authors: Su Junwei , Li Juan , Luo Xilian , Yu Chuck Wah , Gu Zhaolin
Published: October 2019

The traditional Chinese kang is a widely used domestic heating system in rural areas in northern China. However, such system could cause serious air pollution due to burning of biomass materials or coal. An improved bed heating system is introduced in this study to reform the traditional kang, using a capillary mat as a heating terminal, an air source heat pump (ASHP) and a solar energy as the heat source. An experimental prototype was built in a residential house in Xi’an, China, and tests were conducted to evaluate the system’s feasibility and performance under different operational modes. Results showed that the system could effectively provide an acceptable thermal environment for a separately heated room and with a reduced consumption of carbon-based fuel. When the system was completely driven by the ASHP, the daily electricity consumption of the ASHP is only 5.5 kWh with a supply water temperature of 40°C. When coupling the ASHP with the solar energy, the daily hours of solar energy utilization ranged from 3.5 to 4.5 h per day when the ratio of the solar thermal collector area to the floor area was approximately 1.0. The available ratio (days of utilized solar energy to the days comprising the full heating season) exceeded 66.0% over three heating seasons. The system was shown to be a feasible and energy-efficient heating strategy for rural buildings.
What to bring when you are told not to bring a thing: The need for protocols in acknowledging Indigenous knowledges and participants in Australian research
Authors: Bennett Bindi
Published: October 2019

This article provides a content analysis of articles published in Australian Social Work, the British Journal of Social Work, the International Journal of Social Welfare and International Social Work from 2007 to 2017 regarding the practice of acknowledging Indigenous participants and knowledges in articles that contain Indigenous content. This article argues that acknowledgement is an important way of recognising and showing respect for Indigenous people, as active agents in the research process. Indigenous cultural ideas, values and principles are now contributing to and informing a significant amount of research. Ways are suggested by which authors and journals can develop good practice when acknowledging Indigenous peoples respectfully within their research. This research found a need for the development of specific journal editorial policies and guidelines for authors who wish to publish content pertaining to Indigenous peoples that adequately reflects their contribution while protecting and acknowledging Indigenous knowledge, ideas and ownership of information.
Digital health and patient safety: Technology is not a magic wand
Authors: Sujan Mark , Scott Philip , Cresswell Kathrin
Published: October 2019

The use of novel health information technology provides avenues for potentially significant patient benefit. However, it is also timely to take a step back and to consider whether the use of these technologies is safe – or more precisely what the current evidence for their safety is, and what kinds of evidence we should be looking for in order to create a convincing argument for patient safety. This special issue on patient safety includes eight papers that demonstrate an increasing focus on qualitative approaches and a growing recognition that the sociotechnical lens of examining health information technology–associated change is important. We encourage a balanced approach to technology adoption that embraces innovation, but nonetheless insists upon suitable concerns for safety and evaluation of outcomes.
Healthcare data warehouse system supporting cross-border interoperability
Authors: Gavrilov Goce , Vlahu-Gjorgievska Elena , Trajkovik Vladimir
Published: October 2019

The free movement of European citizens across member states of the European Union adds an important level of complexity to strategic efforts of health interoperability. The use of electronic health data has been marked as an important strategic activity and policy to improve healthcare in European countries. Cross-border healthcare depends on the ability to set up shared practices with respect to patient data exchange across the countries. Data flow must comply with demanding security, legal and interoperability requirements, as defined by the European Patients Smart Open Services project specifications. The aim of this article is to propose a novel design of healthcare data warehouse based on the restructured Extract–Transform–Load process. We describe a portal framework that offers a comprehensive set of interoperability services to enable national e-Health platforms to set up cross-border health information networks compliant with European Patients Smart Open Services. The presented approach incorporates the technical and organizational interoperability by interconnecting Health Level Seven standard and Open National Contact Points framework in order to provide a modular, scalable and inter-operating architecture.
The challenges of using one’s body as a reference: “Is it higher than my sitting height?”
Authors: Lee Joohi , Lee Joo Ok
Published: October 2019

This article presents ways to promote children’s measurement reasoning in a preschool classroom setting using a non-standard unit. Providing children with a personalized ruler allows them to practice measurement as part of their daily routine.
Being ‘alone’ striving for belonging and adaption in a new reality – The experiences of spouse carers of persons with dementia
Authors: Hammar Lena Marmstål , Williams Christine L. , Meranius Martina Summer , McKee Kevin
Published: October 2019

Background and aim

Spouse carers of a person with dementia report feeling lonely and trapped in their role, lacking support and having no time to take care of their own health. In Sweden, the support available for family carers is not specialised to meet the needs of spouse carers of people with dementia. The aim of the study described in this paper was to explore spouse carers’ experiences of caring for a partner with dementia, their everyday life as a couple and their support needs.

Methods

Nine spouse carers of a partner with dementia living at home were recruited through a memory clinic and a dementia organisation. Semi-structured interviews were conducted with the participants, focusing on their experiences of providing care, their support needs in relation to their caring situation, their personal well-being and their marital relationship. The interviews were transcribed and underwent qualitative content analysis.

Results

The analysis resulted in one overall theme Being ‘alone’ striving for belonging and adaption in a new reality, synthesized from four sub-themes: (1) Being in an unknown country; (2) Longing for a place for me and us; (3) Being a carer first and a person second; and (4) Being alone in a relationship.

Conclusions

The training of care professionals regarding the unique needs of spouse carers of people with dementia needs improvement, with education, in particular, focusing on their need to be considered as a person separate from being a carer and on the significance of the couple’s relationship for their mutual well-being.
A review of design recommendations for P-class road lighting in European and CIE documents – Part 1: Parameters for choosing a lighting class
Authors: Fotios S
Published: October 2019

This paper is a discussion of the factors that might be used to establish a suitable light level for subsidiary roads where the target users are pedestrians. The weighting parameters used in the Commission Internationale de l'Eclairage document CIE115:2010 to discriminate between the six levels of the P-series of lighting classes are questioned. Limitations of the weighting parameters include (1) while some of the weighting parameters are associated with pedestrian road traffic collisions, they do not lead to optimal lighting conditions or to predicable relationships, (2) there is no evidence to support the one-class change prompted by a change in level of a weighting parameter nor for the assumed cumulative effect of different weighting parameters, and (3) they do not match the stated purposes of lighting in subsidiary roads. Giving consideration to the situations where evidence indicates a change in light level is warranted, and not assuming that different parameters are cumulative in effect, leads to a three-class system similar to those in the British Standard BS5489-3:1992 and the Illuminating Engineering Society of North America IESNA Design Guide 5:1994.
Comparisons between off-axis detection and on-axis recognition to implement mesopic photometry in roadway lighting standards
Authors: Ohashi R , Akashi Y , Uchida T
Published: October 2019

Mesopic photometry can be applied to road lighting practice to enhance peripheral visual performance and to reduce light levels. However, mesopic photometry characterizes peripheral vision, whereas photopic photometry characterizes foveal vision at all light levels. Higher scotopic / photopic ( S/ P) ratio light sources which enhance peripheral visual performance may have a negative influence on foveal vision. In addition, light level reductions, as realized in British Standard 5489-1: 2013, may impair foveal visual performance. To investigate the above-described concern, we conducted two experiments. First, we investigated whether Landolt ring targets detected by peripheral vision can be recognized correctly after moving the line of sight to fixate on the targets in foveal vision. Then, we found that subjects could recognize in foveal vision almost all targets that peripheral vision detected. The S/ P ratio of the background lighting did not influence this tendency. Second, we investigated luminance contrast thresholds for foveal vision to compare them with those for peripheral vision, obtained from the first experiment. We found that threshold contrasts of targets recognized by foveal vision were lower than those detected by peripheral vision. These results lead to the conclusion that the use of higher S/ P ratio light sources has no negative influence for foveal vision when implementing mesopic photometry.
An Intellectual History of the Concepts of Premier-Presidentialism and President-Parliamentarism
Authors: Elgie Robert
Published: October 2019

Shugart and Carey introduced the twin concepts of premier-presidentialism and president-parliamentarism in their 1992 volume, Presidents and Assemblies. Based on a meta-analysis of journal articles and book publications, this article distinguishes between an early and a contemporary history of the two concepts. The period of early history runs from 1992 to around 2009. This was the time when the two concepts were entering the academic consciousness and when there was also some typological and classificatory ambiguity. The period of contemporary history begins in 2010. This era is marked by conceptual and classificatory clarity and by an increasing reference to the two concepts in academic work. In the article, we show how the concepts have been applied over time, noting a number of changes across the two periods under consideration. We conclude by pointing out some challenges to the future application of the two concepts.
Health Promotion in Socially Vulnerable Youth: Sports as a Powerful Vehicle?
Authors: Van der Veken Karen , Willems Sara , Lauwerier Emelien
Published: October 2019

Community sport has emerged in the past decades and uses sports as a lever to improve health and well-being among socially disadvantaged youth. Despite this premise, we do not know whether and to what extent health promotion aims are achieved within community sports practice. Measurable actions are needed, but it can be hard for researchers or practitioners to know how to approach this. This study aimed at developing a health-promoting intervention targeting youth attending community sports. To this aim, we used a planned approach for intervention design within a community-based participatory research design. The result is a group-based program promoting health-supportive behavior among community sport coaches, as we found coaches to be quintessential in fostering motivation toward health behavior change in vulnerable youth attending community sports. The design of such a complex intervention is difficult, yet tractable, when using a planned approach. Of importance, community engagement was the core of our work and we provide the reader with detailed examples on the combined use of participatory research and planned intervention design. This article provides an exemplar of how to approach the development of a health-promoting intervention in hard-to-reach populations.
An experimental evaluation of convective heat transfer in multi-layered fibrous materials composed by different middle layer structures
Authors: Xiong Xiaoman , Venkataraman Mohanapriya , Jašíková Darina , Yang Tao , Mishra Rajesh , Militký Jiří , Petrů Michal
Published: October 2019

In this work, three types of multi-layered fibrous materials with different middle layer structures, including Struto nonwoven, Struto nonwoven with air pockets and Struto nonwoven with air pockets filled by aerogel particles, were prepared based on laser engraving technique and laminating method. A custom-built new device was fabricated to evaluate convective thermal behaviour of the multi-layered materials in cross flow. It was found that in cross flow the heat transfer coefficient of the multi-layered material with encapsulated aerogels is directly proportional to Reynolds number. There are considerable variances in heat transfer rates of the three structures at low airflow velocity (less than 10 m/s), but the values are very close at high airflow velocity. It is concluded that the air pockets and aerogels present in the multi-layered fibrous material have significant effect on convective thermal behaviour of the overall structure in cross flow. The finding is a new contribution to the field of aerogel-based fibrous materials as thermal insulators in building and industrial facilities.
Brief, Intensive, and Concentrated Treatment of Specific Phobia in a Child With Minimally Verbal Autism Spectrum Disorder
Authors: Muskett Ashley , Radtke Sarah , Ollendick Thomas H.
Published: October 2019

This case study illustrates a brief, intensive, cognitive behavioral therapy (CBT) for a young male client with a specific phobia of dogs and comorbid autism spectrum disorder (ASD). CBT has been shown to be an effective treatment for anxiety in children with ASD; however, this work has not often been extended to children with language impairment. This case study presents significant modifications to one-session treatment (OST) for specific phobia to make it applicable to a child with minimally verbal ASD. The intervention included four 3-hr treatment sessions conducted over the course of four consecutive days. Assessment sessions were conducted before treatment, and 1 week and 3 months following treatment. The client’s phobia symptoms decreased following the intervention at both the posttreatment and follow-up sessions. The Reliable Change Index (RCI) was calculated to evaluate changes from pretreatment to posttreatment and follow-up and demonstrated a clinically significant decrease in phobia symptomology following intervention. The results suggest the potential efficacy for a brief, intensive, and concentrated CBT treatment for a child with minimally verbal ASD and a severe phobia.
Making “The Garden City of the South”: Beautification, Preservation, and Downtown Planning in Augusta, Georgia
Authors: Souther J. Mark
Published: October 2019

This article illuminates how a smaller southern city engaged broader planning approaches. Civic leaders, especially women, pushed and partnered with municipal administrations to beautify Augusta, Georgia, a city with extraordinarily wide streets and a long tradition of urban horticulture. Their efforts in the 1900s to 1950s, often in concert with close by planners, led to a confluence of urban beautification, historic preservation, and downtown revitalization in the 1960s. This coordinated activity reshaped Augusta’s cityscape, exacerbated racial tensions, and enshrined principles of the City Beautiful, Garden City, and parks movements long after they receded in large cities, influencing the work of nationally prominent planners commissioned in the 1970s and 1980s.
Understanding Peacebuilding Coordination and Impact Using a Complex Adaptive Systems Method
Authors: Gregorian Hrach , Olson Lara , Woodward Brian
Published: October 2019

The application of complex adaptive systems (CAS) analysis can enhance the effectiveness of coordination in international peacebuilding interventions. This study demonstrates the utility of an inductive CAS analysis approach using rich field data from Kosovo in 2010. It reveals unintended patterns of interaction across key sectors that blocked many intervenors’ peacebuilding policies. Most notably, it shows that international actors pragmatically using informal coordination practices to advance peacebuilding goals also fuelled negative dynamics that, paradoxically, undermined those same goals. The methodology employed illuminates the complex, non-linear dynamics of interactions between international and local actors that led to many hybrid outcomes in Kosovo. Although the resulting insights on Kosovo’s challenges are specific to the 2010 period, many continue to resonate today. More broadly, it shows how a CAS approach can be used to support evidence-based coordination and adaptive management processes in international peacebuilding interventions to improve outcomes.
Use of EEG for Predicting Treatment Response to Transcranial Magnetic Stimulation in Obsessive Compulsive Disorder
Authors: Metin Sinem Zeynep , Balli Altuglu Tugçe , Metin Baris , Erguzel Turker Tekin , Yigit Selin , Arıkan Mehmet Kemal , Tarhan Kasif Nevzat
Published: October 2019

Aim. In this study we assessed the predictive power of quantitative EEG (qEEG) for the treatment response to right frontal transcranial magnetic stimulation (TMS) in obsessive compulsive disorder (OCD) using a machine learning approach. Method. The study included 50 OCD patients (35 responsive to TMS, 15 nonresponsive) who were treated with right frontal low frequency stimulation and identified retrospectively from Uskudar Unversity, NPIstanbul Brain Hospital outpatient clinic. All patients were diagnosed with OCD according to the DSM-IV-TR and DSM-5 criteria. We first extracted pretreatment band powers for patients. To explore the prediction accuracy of pretreatment EEG, we employed machine learning methods using an artificial neural network model. Results. Among 4 EEG bands, theta power successfully discriminated responsive from nonresponsive patients. Responsive patients had more theta powers for all electrodes as compared to nonresponsive patients. Discussion. qEEG could be helpful before deciding about treatment strategy in OCD. The limitations of our study are moderate sample size and limited number of nonresponsive patients and that treatment response was defined by clinicians and not by using a formal symptom measurement scale. Future studies with larger samples and prospective design would show the role of qEEG in predicting TMS response better.
Measurement of transcutaneous oxygen pressure in patients with post-thrombotic syndrome: Findings and possible clinical applications
Authors: Cuen-Ojeda Cesar , Anaya-Ayala Javier E , Laparra-Escareno Hugo , García-Alva Ramón , Lizola Rene , Arzola Luis H , Luna Lizeth , Hinojosa Carlos A
Published: October 2019

Objectives

Post-thrombotic syndrome is the commonest long-term sequela of deep venous thrombosis. Severe post-thrombotic syndrome reduces importantly the quality of life of patients and tissue hypoxia is associated with ulceration. Transcutaneous oxygen pressure (tcPO2) provides information on the delivery of oxygen through the microvascular circulation and measuring tcPO2 might detect values at which patients with post-thrombotic syndrome might ulcerate. The aim of our study is to determine tcPO2 in post-thrombotic syndrome patients and compare the values with a control group.

Methods

A cross-sectional study was performed. Periflux 5000 monitor (Perimed) was used to measure tcPO2 in patients with mild-moderate, severe post-thrombotic syndrome and control groups. In patients with ulceration, two measurements were obtained, the first around the ulcer and the second 10 cm away from the lesion. Categorical data were analyzed with Fisher’s exact test and a p value <0.05 was considered statistically significant.

Results

Twelve patients with post-thrombotic syndrome and 13 patients (control group) were enrolled. Post-thrombotic syndrome patients’ mean age was 58 years (47–72 years) and eight (67%) patients were males. The overall mean tcPO2 measurement in post-thrombotic syndrome group was 35.5 mm Hg (SD ± 11), while in the severe post-thrombotic syndrome was 23.2 mm Hg (SD ± 9). All severe post-thrombotic syndrome patients had measurements <40 mm Hg, tcPO2 value in control group was >50 mm Hg (SD ± 4) in all patients, with a mean value of 58.2 mm Hg. During comparison of severe post-thrombotic syndrome subgroup versus control group, we found that patients with venous ulcers had <40 mm Hg in tcPO2 measurement and all control group patients had >50 mm Hg ( p < 0.0001).

Conclusions

Our results demonstrate that severe post-thrombotic syndrome patients have significantly lower TcPO2 values compared to a healthy control group and non-severe post-thrombotic syndrome ( p = 0.0001). Further research is necessary to establish cut-off point values of tcPO2 in this debilitating disease for possible clinical applications and determination of ulcer healing predictors.
A high-volume, low-cost approach to participant screening and enrolment: Experiences from the T4DM diabetes prevention trial
Authors: Bracken Karen , Keech Anthony , Hague Wendy , Allan Carolyn , Conway Ann , Daniel Mark , Gebski Val , Grossmann Mathis , Handelsman David J , Inder Warrick J , Jenkins Alicia , McLachlan Robert , Robledo Kristy P , Stuckey Bronwyn , Yeap Bu B , Wittert Gary
Published: October 2019

Background/aims:

Participant recruitment to diabetes prevention randomised controlled trials is challenging and expensive. The T4DM study, a multicentre, Australia-based, Phase IIIb randomised controlled trial of testosterone to prevent Type 2 diabetes in men aged 50–74 years, faced the challenge of screening a large number of prospective participants at a small number of sites, with few staff, and a limited budget for screening activities. This article evaluates a high-volume, low-cost, semi-automated approach to screen and enrol T4DM study participants.

Methods:

We developed a sequential multi-step screening process: (1) web-based pre-screening, (2) laboratory screening through a network of third-party pathology centres, and (3) final on-site screening, using online data collection, computer-driven eligibility checking, and automated, email-based communication with prospective participants. Phone- and mail-based data collection and communication options were available to participants at their request. The screening process was administered by the central coordinating centre through a central data management system.

Results:

Screening activities required staffing of approximately 1.6 full-time equivalents over 4 years. Of 19,022 participants pre-screened, 13,108 attended a third-party pathology collection centre for laboratory screening, 1217 received final, on-site screening, and 1007 were randomised. In total, 95% of the participants opted for online pre-screening over phone-based pre-screening. Screening costs, including both direct and staffing costs, totalled AUD1,420,909 (AUD75 per subject screened and AUD1411 per randomised participant).

Conclusion:

A multi-step, semi-automated screening process with web-based pre-screening facilitated low-cost, high-volume participant enrolment to this large, multicentre randomised controlled trial. Centralisation and automation of screening activities resulted in substantial savings compared to previous, similar studies. Our screening approach could be adapted to other randomised controlled trial settings to minimise the cost of screening large numbers of participants.
Bias in retrospective analyses of biomarker effect using data from an outcome-adaptive randomized trial
Authors: Ji Lingyun , McShane Lisa M , Krailo Mark , Sposto Richard
Published: October 2019

Background/Aims

Biomarker-stratified outcome-adaptive randomization trials, in which randomization probabilities depend on both biomarker value and outcomes of previously treated patients, are receiving increased attention in oncology research. Data from these trials can also form the basis of investigation of additional biomarkers that may not have been incorporated into the original trial design. In this article, we investigate the validity of a standard analytical method that utilizes data from a biomarker-stratified outcome-adaptive randomization trial to assess the effect of a newly identified biomarker on patient outcomes.

Methods

In the context of an ancillary biomarker study for a two-arm phase II trial with a response endpoint, we conduct analytic and simulation studies to investigate bias in estimated biomarker effects under outcome-adaptive randomization. Conditions under which bias arises and magnitude of the bias are examined in several settings. We then propose unbiased estimators of biomarker effects with appropriate variance estimators.

Results

We demonstrate that use of biomarker-stratified outcome-adaptive randomization perturbs the patient population and treatment assignments. Consequently, application of standard analysis methods to data from an outcome-adaptive randomization trial either to estimate prognostic effect of a new biomarker in uniformly treated patients or to estimate effect of treatment in relation to the new biomarker can lead to substantially biased estimates. The proposed adjusted estimators are asymptotically unbiased, and the proposed variance estimators correctly reflect the sample variability in the estimators.

Conclusion

This article demonstrates existence of bias when standard, naïve statistical methods are utilized to assess biomarker effects using data from a biomarker-stratified outcome-adaptive randomization trial, and hence that results from naïve analyses must be interpreted with great caution. These findings highlight that, in an era where data and specimens are increasingly being shared for biomarker studies, care must be taken to document and understand implications of the study design under which specimens or data have been obtained.
Splenogonadal fusion: A rare paratesticular lesion and how to recognise it on ultrasound
Authors: Seager Matthew John , Alexander Sarah , Muneer Asif , Walkden Miles
Published: October 2019

Introduction

Splenogonadal fusion is a rare developmental disorder that results in a gonadal or paragonadal mass due to the close proximity of the developing spleen and gonad.

Case report

We describe a case of splenogonadal fusion presenting as a paratesticular mass in a 25-year-old male. This was ultimately diagnosed on surgical biopsy.

Discussion

Splenogonadal fusion is a rare abnormality but can be managed conservatively. The sonographic features and the differential diagnosis are highlighted.

Conclusion

Through this case, we highlight the clinical and sonographic features of splenogonadal fusion. Awareness amongst ultrasound practitioners is important, given that it can be managed conservatively, and means of a non-invasive diagnosis are highlighted.
The Return of the Repressed: The Persistent and Problematic Claims of Long-Forgotten Trauma
Authors: Otgaar Henry , Howe Mark L. , Patihis Lawrence , Merckelbach Harald , Lynn Steven Jay , Lilienfeld Scott O. , Loftus Elizabeth F.
Published: October 2019

Can purely psychological trauma lead to a complete blockage of autobiographical memories? This long-standing question about the existence of repressed memories has been at the heart of one of the most heated debates in modern psychology. These so-called memory wars originated in the 1990s, and many scholars have assumed that they are over. We demonstrate that this assumption is incorrect and that the controversial issue of repressed memories is alive and well and may even be on the rise. We review converging research and data from legal cases indicating that the topic of repressed memories remains active in clinical, legal, and academic settings. We show that the belief in repressed memories occurs on a nontrivial scale (58%) and appears to have increased among clinical psychologists since the 1990s. We also demonstrate that the scientifically controversial concept of dissociative amnesia, which we argue is a substitute term for memory repression, has gained in popularity. Finally, we review work on the adverse side effects of certain psychotherapeutic techniques, some of which may be linked to the recovery of repressed memories. The memory wars have not vanished. They have continued to endure and contribute to potentially damaging consequences in clinical, legal, and academic contexts.
Popular nationalism: Global Times and the US–China trade war
Authors: Zeng Wenna , Sparks Colin
Published: October 2019

This article analyses the coverage of the current US–China trade war in the Global Times. Some scholars argue that official nationalism, which stress the unity of the Chinese people, is challenged by popular nationalism, which privileges the dominant Han ethnicity, and that official nationalism is forced to make concessions to popular nationalism. If this is true, then one would expect to find evidence in the coverage of international issues in a ‘popular’ official newspaper like Global Times. The newspaper’s coverage stresses negative features of the USA, but devotes considerable space to the damage that Trump's policies are doing to ordinary Americans. It does not present China as the unique victim of US economic aggression. The coverage stresses broad international agreement for free trade, leaving the USA isolated in adopting protectionist policies. At least in this instance, state-led nationalism remains central and no concessions are made to popular sentiments.
Management of irritable bowel syndrome with diarrhea: a review of nonpharmacological and pharmacological interventions
Authors: Cangemi David J. , Lacy Brian E.
Published: October 2019

Irritable bowel syndrome (IBS) is a common gastrointestinal (GI) condition involving numerous potential causative factors (e.g. alterations in gut microbiota, motility, brain–gut axis). Several interventions are available for the management of patients with IBS, but no universal management algorithm currently exists. The aim of this article is to review interventions that may be considered in the management of patients with IBS with diarrhea (IBS-D). Nonpharmacological interventions include dietary and lifestyle modification, which are generally used as first-line therapy. Probiotics have demonstrated efficacy and safety in patients with IBS, but studies are inconsistent in strains examined, dosing, and treatment duration. Psychological therapies (e.g. cognitive behavioral therapy, hypnotherapy) also may improve IBS symptoms. Pharmacological interventions for the management of IBS-D include the US Food and Drug Administration–approved agents eluxadoline, rifaximin, and alosetron, as well as loperamide, smooth muscle antispasmodics, bile acid sequestrants, and antidepressants (i.e. tricyclic antidepressants, selective serotonin reuptake inhibitors). Eluxadoline and rifaximin have been shown to improve abdominal pain and stool consistency in patients with IBS-D. In addition, data indicate that alosetron improves IBS symptoms; however, it is approved only for women with severe IBS-D. Of the three approved agents, rifaximin has the most favorable safety profile. The risk–benefit ratio is an important consideration with every medication, but is especially important in the treatment of functional GI disorders such as IBS-D. Thus, the most troublesome symptoms, quality of life, symptom intensity, and individual patient preferences should be considered when formulating a management plan for patients with IBS-D.
The functional assessment and rehabilitation programme of the UK hand and upper limb transplant service
Authors: Burdon Joanna , Taplin Sarah , Kay Simon P , Wilks Daniel J
Published: October 2019

Introduction

Hand and upper limb transplants are becoming internationally recognised as an effective treatment to improve function and quality of life in carefully selected patients. A comprehensive functional assessment and rehabilitation programme are an essential component of the multi-disciplinary assessment and treatment approach. Although there is an increasing body of published data on the surgical techniques and outcomes following hand transplant, little exists in the literature to guide the hand therapist.

Method

The pre-transplant functional assessments and rehabilitation programme provided for patients undergoing hand transplantation in the UK are described and critically analysed. The UK programme is based on that provided in Lyon, France, but adapted to suit the resources and structure of the UK National Health Service.

Results

Twelve patients have received a functional assessment as part of the multi-disciplinary hand transplant assessment process, with the loss of autonomy a key reason for patients seeking hand transplant. Six of these patients have received hand transplants, with patients more than one year post-transplant having achieved good and fair outcomes according to the Hand Transplantation Score System.

Conclusions

Although hand and upper limb transplant surgery is innovative, the therapy provided is based on the fundamental principles of good communication, accurate assessment and delivery of a bespoke rehabilitation programme; values which are common to all areas of hand therapy practice. A future study reporting the long-term outcomes of patients following hand transplant in the UK is needed to allow the effectiveness of the programme to be evaluated.
Assessment of the “Second Day” Exercise Effect on Glycemic Control, Insulin Requirements, and CHO Intake in Type 1 Diabetes Adults
Authors: Müller-Korbsch Michael , Frühwald Lisa , Heer Michael , Fangmeyer-Binder Maria , Reinhart-Mikocki David , Fasching Peter
Published: October 2019

Background:

Glucose control during consecutive days of aerobic exercise has not been well studied. We assessed glycemia, insulin requirements, and carbohydrate (CHO) needs during two consecutive days of prolonged cycling in type 1 diabetes (T1D) adults using sensor-augmented insulin pump therapy.

Methods:

Twenty adults with well-controlled T1D and six healthy adults (for comparison) were enrolled. Assessments were made during two consecutive days of cycling activities (30 miles per day). On day 1 (D1), basal rates were reduced 50% and CHO intake was guided by real-time continuous glucose monitoring (rtCGM) data to maintain a target range (70-180 mg/dL). On day 2 (D2), basal insulin infusion was stopped for the first hour of biking and resumed at a minimal rate during biking. Carbohydrate intake one hour before, during, and ten minutes after biking was recorded. Times within/below target range, glycemic variability, and mean glucose were calculated from rtCGM data.

Results:

Among 17 T1D participants who completed the study, mean glucose levels at the start of cycling were slightly lower on D2 vs D1: 138 ± 16 mg/dL and 122 ± 16, respectively, P = NS. Type 1 diabetes participants achieved near-normal glucose levels at the end of both cycling events; however, the reduction in glucose was most notable at one hour into the event on D2 vs D1. Carbohydrate intake was notably lower during D2 vs D1 with no difference in time <54 mg/dL (both P = NS).

Conclusions:

Type 1 diabetes individuals using rtCGM-augmented insulin pump therapy can safely engage in consecutive days of prolonged aerobic exercise by significantly reducing insulin dosages with no increase in CHO intake.
Synthesis of Oligosaccharide Libraries Through Glycosylations on Unprotected Acceptors
Authors: Ding Yili , Vara Prasad Chamakura V. N. S. , Wang Bingyun
Published: October 2019

Starting from an unprotected GlcNAc acceptor, after first random glycosylation and deprotection, and second random glycosylation, deprotection, and purification, we were able to obtain a trisaccharide library containing 36 α-linked trisaccharide library. These compounds were characterized by 1D, 2D NMR and mass spectra. The library was used as the starting material for enzymatic reaction to obtain a tetrasaccharide in support of the results. Based on this method, a trisaccharide library containing 15 α-linked trisaccharides was synthesized.
Spatiotemporal Relationship Between Ecological Environment and Economic Development in Tropical and Subtropical Regions of Asia
Authors: Shi Tao , Weiteng Tian , Zhang Wei , Zhou Qian
Published: October 2019

This article is devoted to study the coordination coupling relationship between economic development and ecological environment in tropical and subtropical regions of Asia to reflect the spatiotemporal heterogeneity of the coordination in different regions. Using the entropy method and Geographically and Temporally Weighted Regression model, we empirically analyze 14 tropical and subtropical countries in Asia from 2003 to 2016. The empirical results show that most of the tropical and subtropical sample countries in Asia are at an intermediate coordination coupling level between economic development and ecological environment; the economic development lag type is the main one, and the ecological development lag type is less. At the same time, the positive effects between economic development and ecological environment in most sample countries are more obvious. Spatially, the ecological environment in the north of the Asian tropical and subtropical countries has a positive effect on economic development rather than that in the south and tends to be positive. The positive effect of economic development on ecological environment in the faster economic development areas is better than that in the slower economic development areas, and more areas tend to play negative effects. The research in this article provides a basis for strengthening ecological environment protection in tropical and subtropical regions of Asia, promoting the coordinated development of economic and ecological environment. Further, we put forward some corresponding policy recommendations.
The ocean in excess: Connecting with the cosmos in European geography and encountering Polynesian ontological perspectives
Authors: Winder Gordon M
Published: October 2019

In welcoming this addition to Peters and Steinberg’s insights on water, seas and oceans and their ontological implications this paper asks about connections with cosmos thinking in geography, and with learning with those with non-Western perspectives, for instance from Polynesia. It asks whether the ‘frames’ of understanding Peters and Steinberg seek can come from Geography, and what new forms of representation are needed?
Comparison of BRFSS Data Between Home-Based Care Providers and Health Care Support Workers in Clinical Environments in Washington State
Authors: Howard Ninica , Marcum Jennifer
Published: October 2019

Background: The demand for home-based health care support providers (HB providers) is growing as the locus of care shifts to private homes. However, industry representative data of these workers are limited. Methods: Washington Behavioral Risk Factor Surveillance System (WA BRFSS) data from 2011 to 2016 were analyzed to compare HB providers ( n = 385) with health care support occupations not based in the home, non-HB providers ( n = 229), and all other occupations ( n = 32,011). Findings: More HB providers were overweight (4.2%, 95% confidence interval [CI] = [3.3%, 5.2%]) than non-HB providers and all other occupations. Significantly more HB providers had arthritis (33.2%, 95% CI = [27.0%, 39.4%]) and diabetes (9.4%, 95% CI = [5.7%, 13.2%]) than non-HB providers. Nearly twice as many HB providers currently smoked (31.3%, 95% CI = [24.2%, 38.4%]) than non-HB providers. Significantly more HB providers reported serious mental illness (6.8%, 95% CI = [2.8%, 10.7%]) than all other occupations (2.2%). Conclusion/Application to Practice: It is imperative to maintain good health in this home-based health care population as these workers are aging and their professional time becomes limited.
Coaches’ Self-Initiated Complaints About Referees in Ice Hockey Postgame Press Conferences
Authors: Pehkonen Samu
Published: October 2019

The formulation and management of coaches’ dissent with referees in a setting where complaints may be sanctioned presents an empirical test for the “dilemma of stake.” This article analyzes how ice hockey coaches raise complaints against referees in postgame press conferences (PGPCs). Based on the conversation analytic study of video recordings from Finnish and Swedish men’s (semi)professional ice hockey leagues, this article posits that complaints are formulated within assessment sequences and are made hearable as complaints through implicit and explicit verbal and bodily cues. This article also suggests that while referees are the non-present third party in the PGPC, the design of the complaints provides opportunities and places obligations on the participants present in the PGPC (media representatives, game officials, and the opposing coach) to (dis)align with the complainer. Finally, this article reveals a tension between the normative expectations of the coaches to stand by their team, which may include criticizing referees, while respecting referees as guardians of sporting ethics and acknowledging the increased demands for media attention.
Changes in Expectations to Marry and to Divorce Across the Transition to Adulthood
Authors: Arocho Rachel
Published: October 2019

Marriage and divorce expectations predict family life and personal outcomes. Understanding how expectations are associated with varying characteristics over emerging adulthood (ages 18–28 years) will inform understanding of emerging adult development. Panel Study of Income Dynamics Transition into Adulthood 2005–2015 data were used in hybrid-effects ordinal logistic regression to parse interindividual and intraindividual variation associated with relationship experiences, socioeconomic and contextual characteristics, and mental and emotional well-being. Partnerships were associated with optimistic expectations: Both dating and cohabiting predicted greater marriage expectations and lower divorce expectations within individuals. Between individuals, greater time in full-time employment predicted more positive marital expectations, greater responsibility was associated with lower marital expectations, stronger religious identity predicted higher marital expectations and lower divorce expectations, having been arrested predicted greater divorce expectations, greater well-being predicted greater marriage expectations, and older age predicted lower marriage expectations. Both between and within individuals, greater worry predicted lower marriage expectations.
Teen Mothers’ Family Support and Adult Identity in the Emerging Adulthood: Implications for Socioeconomic Attainment Later in Life
Authors: Assini-Meytin Luciana C. , Garza Mary A. , Green Kerry M.
Published: October 2019

We examined the prospective role of parental support and adult identity profiles in the transition to adulthood on teen mothers’ socioeconomic outcomes in adulthood. Analyses were based on the National Longitudinal Study of Adolescent to Adult Health, a nationally representative sample of youth followed over a decade. We used data from Waves 1, 3, and 4 (mean age = 28.6, Wave 4). Analytical sample consisted of 981 females who gave birth before age 20. Analysis included design-based regression models. Findings from adjusted regression models showed no statistically significant associations between teen mothers’ parental support and socioeconomic outcomes. While teen mothers have already achieved an important marker of adulthood, variability in adult identity profiles was observed. Teen mothers with older subjective age, regardless of their levels of psychosocial maturation, had higher socioeconomic attainment on some indicators. Findings suggest that teen mothers’ adult identity profiles differentiate their socioeconomic trajectories later in life.
In Vitro Skin Permeation Methodology for Over-The-Counter Topical Dermatologic Products
Authors: Oh Luke , Yi Sojeong , Zhang Da , Shin Soo Hyeon , Bashaw Edward
Published: October 2019

For topically applied over-the-counter (OTC) products, the association of unwanted systemic exposure and adverse events may be difficult to ascertain without a recognition or determination of in vivo absorption. Evaluation of skin permeability using a validated in vitro permeation methodology can provide important information for both initial formulation selection and reformulation during the product life cycle. Additionally, a comparison of permeation rates between formulations using a validated methodology could reduce the number of nonclinical studies needed as part of reformulation. However, many in vitro permeation tests (IVPTs) have produced results with high variability and low reproducibility between study sites. It is unclear if this is due to a lack of a standardized protocol, or lack of control of multiple key experimental factors including skin source, preparation, receptor fluid, and study design. This review presents the authors perspective on the potential regulatory utility of IVPT and proposes steps to improve the accuracy and reproducibility of IVPT. The focus of this review is on topical dermatologic drugs with an initial emphasis on the OTC marketplace where reformulations are more common.
The Impact of Team Association on Attendees’ Product Knowledge and Purchase Intentions: A Case of Indian Premier League
Authors: Rai Jaskirat Singh , Singh Apar
Published: October 2019

Many research studies conducted in the recent past have found that the success of sports sponsorship depends much on consumers’ affiliation with the sport or a team. In order to understand the mechanics of the same, this study explores team–sponsor congruence, team identification and team involvement as exogenous variables to measure the attendees’ association with the team and its impact on their knowledge of the sponsor brand in order to ascertain the impact of their brand knowledge on the brand image of the sponsor and their purchase intentions. Using structural equation modelling technique, the study found that the attendees’ team association positively affects their knowledge of the sponsor brand, which in turn affects the sponsor image and purchase intention of the attendees. The study also found a weak direct association between the attendees’ product knowledge and their purchase intentions, implying the mediation of sponsor image. The study’s strength is in its sample of the respondents who were filtered for their high interest in the sport and the team (cricket and KXIP, respectively) under study. After selecting a team from the Indian Premier League (IPL) and analysing the responses of on-ground sport fans, the study provides valuable insights for the organizations which do or intend to sponsor a team in professional sport.