bluuebunny/crossref_metadata_2025 huggingface dataset:
Regional Patterns and Association Between Obesity and Hypertension in Africa
Authors: Akpa Onoja M. , Made Felix , Ojo Akinlolu , Ovbiagele Bruce , Adu Dwomoa , Motala Ayesha A. , Mayosi Bongani M. , Adebamowo Sally N. , Engel Mark E. , Tayo Bamidele , Rotimi Charles , Salako Babatunde , Akinyemi Rufus , Gebregziabher Mulugeta , Sarfo Fred , Wahab Kolawole , Agongo Godfred , Alberts Marianne , Ali Stuart A. , Asiki Gershim , Boua Romuald P. , Gómez-Olivé F. Xavier , Mashinya Felistas , Micklesfield Lisa , Mohamed Shukri F. , Nonterah Engelbert A. , Norris Shane A. , Sorgho Hermann , Tollman Stephen , Parekh Rulan S. , Chishala Chishala , Ekoru Kenneth , Waddy Salina P. , Peprah Emmanuel , Mensah George A. , Wiley Ken , Troyer Jennifer , Ramsay Michèle , Owolabi Mayowa O. ,   as members of the CVD Working Group of the H3Africa Consortium
Published: March 2020

Hypertension and obesity are the most important modifiable risk factors for cardiovascular diseases, but their association is not well characterized in Africa. We investigated regional patterns and association of obesity with hypertension among 30 044 continental Africans. We harmonized data on hypertension (defined as previous diagnosis/use of antihypertensive drugs or blood pressure [BP]≥140/90 mmHg/BP≥130/80 mmHg) and obesity from 30 044 individuals in the Cardiovascular H3Africa Innovation Resource across 13 African countries. We analyzed data from population-based controls and the Entire Harmonized Dataset. Age-adjusted and crude proportions of hypertension were compared regionally, across sex, and between hypertension definitions. Logit generalized estimating equation was used to determine the independent association of obesity with hypertension (
P
value <5%). Participants were 56% women; with mean age 48.5±12.0 years. Crude proportions of hypertension (at BP≥140/90 mmHg) were 47.9% (95% CI, 47.4–48.5) for Entire Harmonized Dataset and 42.0% (41.1–42.7) for population-based controls and were significantly higher for the 130/80 mm Hg threshold at 59.3% (58.7–59.9) in population-based controls. The age-adjusted proportion of hypertension at BP≥140/90 mmHg was the highest among men (33.8% [32.1–35.6]), in western Africa (34.7% [33.3–36.2]), and in obese individuals (43.6%; 40.3–47.2). Obesity was independently associated with hypertension in population-based controls (adjusted odds ratio, 2.5 [2.3–2.7]) and odds of hypertension in obesity increased with increasing age from 2.0 (1.7–2.3) in younger age to 8.8 (7.4–10.3) in older age. Hypertension is common across multiple countries in Africa with 11.9% to 51.7% having BP≥140/90 mmHg and 39.5% to 69.4% with BP≥130/80 mmHg. Obese Africans were more than twice as likely to be hypertensive and the odds increased with increasing age.
Self-Reported Fatigue Predicts Incident Stroke in a General Population
Authors: Barlas Genevieve , Luben Robert L. , Neal Samuel R. , Wareham Nicholas J. , Khaw Kay-Tee , Myint Phyo K.
Published: March 2020

Background and Purpose—

Fatigue is a common symptom among stroke survivors and in general practice. However, the clinical significance of fatigue and its relationship to incident stroke is unclear. The aim of this study was to examine the relationship between self-reported fatigue and the incidence of stroke in a general population.

Methods—

This was a prospective, population-based study. The study population was 15 654 men and women aged 39 to 79 years recruited in 1993 to 1997 and followed till March 2016. Fatigue was assessed at 18 months after baseline using the vitality domain of the Short Form 36 questionnaire. Cox proportional hazard models were constructed to describe the prospective relationship between baseline fatigue and incident stroke adjusting for age, sex, systolic blood pressure, cholesterol, physical activity, smoking status, alcohol consumption, fruit and vegetable consumption, diabetes mellitus, body mass index, vitamin supplement use, education level, Townsend deprivation index, and occupational social class. Incident stroke was ascertained using death certificates and hospital record linkage data.

Results—

Through 249 248 person-years of follow-up, 1509 incident strokes occurred. Participants who reported the highest level of fatigue (quartile 4) were more likely to be women, to be multimorbid, and to perceive their health as fair or poor. We observed ≈50% relative risk increase in stroke risk (hazard ratio, 1.49 [95% CI, 1.29–1.71]) in those who reported the highest level of fatigue compared with those who reported the lowest level of fatigue (Q4 versus Q1). This relationship remained unaltered regardless of anemia status, the presence or absence of chronic bronchitis, thyroid dysfunction, or depression.

Conclusions—

Self-report fatigue assessed by the vitality domain of the Short Form 36 questionnaire predicts the risk of future stroke at the general population level. Identifying and addressing stroke risk factors in those who report fatigue in general practice may have substantial benefit at the population level.
Whole-Exome Sequencing in 22 Young Ischemic Stroke Patients With Familial Clustering of Stroke
Authors: Ilinca Andreea , Martinez-Majander Nicolas , Samuelsson Sofie , Piccinelli Paul , Truvé Katarina , Cole John , Kittner Steven , Soller Maria , Kristoffersson Ulf , Tatlisumak Turgut , Puschmann Andreas , Putaala Jukka , Lindgren Arne
Published: March 2020

Backgrounds and Purpose—

Although new methods for genetic analyses are rapidly evolving, there are currently knowledge gaps in how to detect Mendelian forms of stroke.

Methods—

We performed whole-exome sequencing in 22 probands, under 56 years at their first ischemic stroke episode, from multi-incident stroke families. With the use of a comprehensive stroke-gene panel, we searched for variants in stroke-related genes. The probands’ clinical stroke subtype was related to clinical characteristics previously associated with pathogenic variants in these genes. Relatives were genotyped in 7 families to evaluate stroke-gene variants of unknown significance. In 2 larger families with embolic stroke of unknown source, whole-exome sequencing was performed in additional members to examine the possibility of identifying new stroke genes.

Results—

Six of 22 probands carried pathogenic or possibly pathogenic variants in genes reported to be associated with their stroke subtype. A known pathogenic variant in
NOTCH3
and a possibly pathogenic variant in
ACAD9
gene were identified. A novel
JAK2
:c.3188G>A (p.Arg1063His) mutation was seen in a proband with embolic stroke of undetermined source and prothrombotic status. However, penetrance in the family was incomplete.
COL4A2:
c.3368A>G (p.Glu1123Gly) was detected in 2 probands but did not cosegregate with the disease in their families. Whole-exome sequencing in multiple members of 2 pedigrees with embolic stroke of undetermined source revealed possibly pathogenic variants in genes not previously associated with stroke,
GPR142:
c.148C>G (p.Leu50Val), and
PTPRN2
:c.2416A>G (p.Ile806Val);
LRRC1
c.808A>G (p.Ile270Val),
SLC7A10
c.1294dupG (p.Val432fs),
IKBKB
: c.1070C>T (p.Ala357Val), and
OXGR1
c.392G>A (p.Arg131His), respectively.

Conclusions—

Screening with whole-exome sequencing using a comprehensive stroke-gene panel may identify rare monogenic forms of stroke, but careful evaluation of clinical characteristics and potential pathogenicity of novel variants remain important. In our study, the majority of individuals with familial aggregation of stroke lacked any identified genetic causes.
Trends of r-tPA (Recombinant Tissue-Type Plasminogen Activator) Treatment and Treatment-Influencing Factors in Acute Ischemic Stroke
Authors: Marko Martha , Posekany Alexandra , Szabo Simon , Scharer Sebastian , Kiechl Stefan , Knoflach Michael , Serles Wolfgang , Ferrari Julia , Lang Wilfried , Sommer Peter , Greisenegger Stefan ,   for the Austrian Stroke Unit Registry Collaborators
Published: March 2020

Background and Purpose—

Frequencies of treatment with r-tPA (recombinant tissue-type plasminogen activator) are increasing over the past 15 years. However, published data on the influence of various demographic and clinical factors on r-tPA treatment as well as estimates of future trajectories are limited. We evaluated time trends and future trajectories of r-tPA treatment in patients with acute stroke and the influence of various factors on r-tPA treatment by analyzing data of 103 970 patients enrolled in the Austrian Stroke Unit Registry from 2006 to 2018, of which 18 953 were treated with r-tPA.

Methods—

Time trends of r-tPA-treatment were investigated in predefined subgroups (minor/major stroke, age, anterior/posterior circulation stroke); limited exponential time series models were calculated to estimate future trends of r-tPA-treatment. Logistic regression models were calculated to estimate the influence of clinical variables on r-tPA-treatment.

Results—

Overall, r-tPA treatment frequencies increased from 9.9% in 2006 to 21.8% in 2018. We observed a particular increase in patients >80 years, patients presenting with a National Institutes of Health Stroke Scale Score of 2 to 3, patients with posterior circulation stroke, patients with wake-up stroke, and patients without atrial fibrillation. Forecast of overall r-tPA frequencies predicted a further but flattened increase up to 24% by 2025. Logistic regression of time-dependent associations of clinical variables with r-tPA-treatment revealed increasing odds of r-tPA-treatment in patients with a posterior circulation stroke and decreasing odds of r-tPA-treatment in patients with atrial fibrillation.

Conclusions—

We observed a positive development of r-tPA-treatment frequencies mirroring increasing confidence with intravenous thrombolysis in clinical practice; however, decreasing odds of r-tPA-treatment over time in patients with atrial fibrillation deserve particular attention.
Impact of Body Temperature Before and After Endovascular Thrombectomy for Large Vessel Occlusion Stroke
Authors: Diprose William K. , Liem Bernard , Wang Michael T.M. , Sutcliffe James A. , Brew Stefan , Caldwell James R. , McGuinness Ben , Campbell Doug , Barber P. Alan
Published: March 2020

Background and Purpose—

In ischemic stroke, body temperature is associated with functional outcome. However, the relationship between temperature and outcome may differ in the intraischemic and postischemic phases of stroke. We aimed to determine whether body temperature before or after endovascular thrombectomy (EVT) for large vessel occlusion stroke is associated with clinical outcomes.

Methods—

Consecutive EVT patients were identified from a prospective registry. Temperature measurements within 24 hours of admission were stratified into pre-EVT (preprocedural and intraprocedural) and post-EVT measurements, which served as surrogates for the intraischemic and postischemic phases of large vessel occlusion stroke, respectively. The primary outcome was functional independence, defined as a modified Rankin Scale score of 0, 1, or 2 at 3 months. Secondary outcomes included the ordinal shift of modified Rankin Scale scores at 3 months, symptomatic intracerebral hemorrhage, and mortality at 3 months.

Results—

Four hundred thirty-two participants were included (59% men, mean±SD age 65.6±15.7 years). Multivariable logistic regression demonstrated that higher median pre-EVT temperature (per 1°C increase) was an independent predictor of reduced functional independence (odds ratio [OR], 0.66 [95% CI, 0.46–0.94];
P
=0.02), poorer modified Rankin Scale scores (common OR, 1.42 [95% CI, 1.08–1.85];
P
=0.01), and increased mortality (OR, 1.65 [95% CI, 1.02–2.69];
P
=0.04). Peak post-EVT temperature (per 1°C increase) was a significant predictor of elevated modified Rankin Scale scores (common OR, 1.39 [95% CI, 1.03–1.90];
P
=0.03) and higher mortality (OR, 1.66 [95% CI, 1.04–2.67];
P
=0.03).

Conclusions—

In patients with large vessel occlusion stroke treated with EVT, higher body temperatures during both the intraischemic and postischemic phases were associated with poorer clinical outcomes. Future research investigating the maintenance of normothermia or therapeutic hypothermia in patients needing to be transferred from primary to EVT-capable stroke centers could be considered.
Reduced Cognitive Assessment Scores Among Individuals With Magnetic Resonance Imaging–Detected Vascular Brain Injury
Authors: Anand Sonia S. , Friedrich Matthias G. , Desai Dipika , Schulze Karleen M. , Awadalla Philip , Busseuil David , Dummer Trevor J.B. , Jacquemont Sébastien , Dick Alexander , Kelton David , Kirpalani Anish , Lear Scott A. , Leipsic Jonathan , Noseworthy Michael D. , Parker Louise , Parraga Grace , Poirier Paul , Robson Paula , Tardif Jean-Claude , Teo Koon , Vena Jennifer , Yusuf Salim , Moody Alan R. , Black Sandra E. , Smith Eric E. ,   on behalf of the Canadian Alliance for Healthy Hearts and Minds Cohort
Published: March 2020

Background and Purpose—

Little is known about the association between covert vascular brain injury and cognitive impairment in middle-aged populations. We investigated if scores on a cognitive screen were lower in individuals with higher cardiovascular risk, and those with covert vascular brain injury.

Methods—

Seven thousand five hundred forty-seven adults, aged 35 to 69 years, free of cardiovascular disease underwent a cognitive assessment using the Digital Symbol Substitution test and Montreal Cognitive Assessment, and magnetic resonance imaging (MRI) to detect covert vascular brain injury (high white matter hyperintensities, lacunar, and nonlacunar brain infarctions). Cardiovascular risk factors were quantified using the INTERHEART (A Global Study of Risk Factors for Acute Myocardial Infarction) risk score. Multivariable mixed models tested for independent determinants of reduced cognitive scores. The population attributable risk of risk factors and MRI vascular brain injury on low cognitive scores was calculated.

Results—

The mean age of participants was 58 (SD, 9) years; 55% were women. Montreal Cognitive Assessment and Digital Symbol Substitution test scores decreased significantly with increasing age (
P
<0.0001), INTERHEART risk score (
P
<0.0001), and among individuals with high white matter hyperintensities, nonlacunar brain infarction, and individuals with 3+ silent brain infarctions. Adjusted for age, sex, education, ethnicity covariates, Digital Symbol Substitution test was significantly lowered by 1.0 (95% CI, −1.3 to −0.7) point per 5-point cardiovascular risk score increase, 1.9 (95% CI, −3.2 to −0.6) per high white matter hyperintensities, 3.5 (95% CI, −6.4 to −0.7) per nonlacunar stroke, and 6.8 (95% CI, −11.5 to −2.2) when 3+ silent brain infarctions were present. No postsecondary education accounted for 15% (95% CI, 12–17), moderate and high levels of cardiovascular risk factors accounted for 19% (95% CI, 8–30), and MRI vascular brain injury accounted for 10% (95% CI, −3 to 22) of low test scores.

Conclusions—

Among a middle-aged community-dwelling population, scores on a cognitive screen were lower in individuals with higher cardiovascular risk factors or MRI vascular brain injury. Much of the population attributable risk of low cognitive scores can be attributed to lower educational attainment, higher cardiovascular risk factors, and MRI vascular brain injury.
Global Assessment of Mendelian Stroke Genetic Prevalence in 101 635 Individuals From 7 Ethnic Groups
Authors: Grami Nickrooz , Chong Michael , Lali Ricky , Mohammadi-Shemirani Pedrum , Henshall David E. , Rannikmäe Kristiina , Paré Guillaume
Published: March 2020

Background and Purpose—

Mendelian stroke confers a high lifetime risk for mutation carriers; however, ethnicity-specific prevalence estimates have been difficult to establish.

Methods—

Eighteen genes responsible for Mendelian stroke were investigated using the Genome Aggregation Database. Genome Aggregation Database participants belonged to 1 of 7 populations: African/African-American, Latino/Admixed American, Ashkenazi Jewish, East Asian, Finnish European, non-Finnish European, and South Asian. Rare nonsynonymous variants from 101 635 participants free of neurological disease were examined for each ethnicity. Mutations were categorized according to 3 nested classes: pathogenic clinical variants, likely damaging variants based on in silico prediction, and all nonsynonymous variants.

Results—

ABCC6
,
KRIT1
,
CECR1
,
COL3A1
,
COL4A1
,
COL4A2
,
COLGALT1
,
GLA
,
HTRA1
,
NOTCH3
,
RNF213
, and
TREX1
harbored pathogenic clinical variants in Genome Aggregation Database. Across all 18 genes, total nonsynonymous carrier frequency was found to be high in 5 ethnicities (African/African-American, Latino/Admixed American, East Asian, non-Finnish European, and South Asian; 28.5%–37.5%) while lower total frequencies were estimated for in silico–predicted likely damaging variants (14.9%–19.7%) and pathogenic clinical variants (0.7%–2.8%). Overall, East Asian exhibited the highest total pathogenic clinical mutation carrier frequency (2.8%).
ABCC6
pathogenic clinical variants were most prevalent among East Asian (0.8%). Pathogenic
NOTCH3
variants, causal for cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy, were most frequent among East Asian (1.1%) and South Asian (1.2%). East Asian also demonstrated the highest carrier rate for
RNF213
(0.8%). Finnish European exhibited the greatest
HTRA1
frequency (0.2%), while
COL4A1
pathogenic variants were most prevalent in African/African-American (0.3%).

Conclusions—

Especially, among pathogenic clinical variants, Mendelian stroke genetic prevalence differed significantly between populations. These prevalence estimates may serve as guides for screening and risk profiling in patients worldwide, particularly for understudied non-European populations.
Equivalence Projective Simulation as a Framework for Modeling Formation of Stimulus Equivalence Classes
Authors: Mofrad Asieh Abolpour , Yazidi Anis , Hammer Hugo L. , Arntzen Erik
Published: March 2020

Stimulus equivalence (SE) and projective simulation (PS) study complex behavior, the former in human subjects and the latter in artificial agents. We apply the PS learning framework for modeling the formation of equivalence classes. For this purpose, we first modify the PS model to accommodate imitating the emergence of equivalence relations. Later, we formulate the SE formation through the matching-to-sample (MTS) procedure. The proposed version of PS model, called the equivalence projective simulation (EPS) model, is able to act within a varying action set and derive new relations without receiving feedback from the environment. To the best of our knowledge, it is the first time that the field of equivalence theory in behavior analysis has been linked to an artificial agent in a machine learning context. This model has many advantages over existing neural network models. Briefly, our EPS model is not a black box model, but rather a model with the capability of easy interpretation and flexibility for further modifications. To validate the model, some experimental results performed by prominent behavior analysts are simulated. The results confirm that the EPS model is able to reliably simulate and replicate the same behavior as real experiments in various settings, including formation of equivalence relations in typical participants, nonformation of equivalence relations in language-disabled children, and nodal effect in a linear series with nodal distance five. Moreover, through a hypothetical experiment, we discuss the possibility of applying EPS in further equivalence theory research.
Waiting for Abkhazia: Secession and Borders as International Legal Instruments in Contested Sovereignty
Authors: Nikoleishvili Shorena
Published: March 2020

The article explores the contested claims for sovereignty of Abkhazia through the lens of secession. It maps the evolution of the law on secession from the early 20th century to the present, with an attempt to find a doctrinal fit to the claims of Abkhazian secession from Georgia. The article suggests that rather than reflecting any of the existing modalities for legal or legitimate secession, Abkhazia together with other cases stemming from the post-Soviet space constitute a sui generis modality for secession. The article argues that this modality has a particularly tragic outcome for all of its participants, sentencing the secessionist regions in the post-Soviet space to a permanent state of flux.
Contesting Self-determination in the Wake of Empire: Sovereignty, Human Rights and Economic Justice
Authors: McKenna Miriam Bak
Published: March 2020

This article considers the ways in which geo-political and legal concerns materialised in debates over self-determination in the years following decolonisation, and how they impacted on its’ possibilities, objectives and conception. During this period, self-determination was not, as some scholars have argued, a declining norm, but one central to the competing visions of reinventing international law after empire. These varying articulations were largely shaped by the experience of colonialism and its ongoing effects, along with the ideological confrontation between East-West and North-South. One articulation stressed the primacy of political and economic sovereignty, prominently seen in calls for the establishment of a New International Economic Order. The other sought to integrate self-determination into the elevation of democratic governance and individual human rights protection. Examining these alternative formulations of self-determination, underlines the incompleteness of mainstream historical accounts, and may throw light upon continuing anxieties over its current legal status.
Right of Indigenous Communities to Prior Informed Consent under Article 7 of the Nagoya Protocol and a Comparative Analysis of Its Implementation by India and Bhutan
Authors: Gupta Mohit
Published: March 2020

The Convention on Biological Diversity (cbd) was adopted in 1992. This Convention had three major objectives: conservation of biological diversity, sustainable use of its component, and access and benefit sharing of biological resources arising out of their utilisation. The Nagoya Protocol to the cbd was adopted in 2010 for the fulfilment of the third objective of the cbd, access and benefit sharing. Article 7 of the Nagoya Protocol imposes an obligation on states parties to ensure that “prior and informed consent or approval or involvement” of the indigenous and local communities is taken before their knowledge is accessed. The present study first analyses the contents of Article 7 of the Nagoya Protocol. It will throw light on the meaning of the phrase “prior and informed consent or approval and involvement” as used in Article 7. It then highlights the implementation of Article 7 by two states parties, namely, India and Bhutan.
Children and Young People’s Participation Rights: Looking Backwards and Moving Forwards
Authors: McMellon Christina , Tisdall E. Kay M.
Published: March 2020

Children and young people’s participation is an ever-growing demand. Thirty years on from the UN Convention on the Rights of the Child’s adoption, however, fundamental challenges continue for participation that are widely recognised cross-nationally but remain stubbornly consistent. As a way in to considering the children and young people’s participation literature more generally, all articles referring to participation in their titles were identified from The International Journal of Children’s Rights. These 56 articles were analysed to identify trends, challenges and opportunities. The analysis found: a remarkably consistent narrative on participation over the 30 years; limitations on domains considered, geography and conceptual clarity; and far more written about challenges than solutions. Drawing on these findings and considering the participation literature more generally, the article recommends that the field expands its geographic and intellectual boundaries, uses powerful concepts like agency, competency and autonomy with greater precision, and explores fresh ideas like child protoganism, activism and children as human rights defenders.
What is Left in the “Too Hard Basket”? Developments and Challenges for the Rights of Children in Conflict with the Law
Authors: Lynch Nessa , Liefaard Ton
Published: March 2020

The 30 years since the enactment of the United Nations Convention on the Rights of the Child has seen extensive developments in the theory and practice of children’s rights. Children’s rights are now an established academic discipline with the study of children in conflict with the law being a fundamental area of analysis. This paper takes the approach of highlighting three areas of development of children’s rights scholarship in relation to the criminal justice system: children’s rights, developmental science and notable themes emerging from cross-national scholarship, including age limits, diversion, effective participation and deprivation of liberty. In addition, it analyses three gaps or challenges which are “left in the too-hard basket” for the coming decades.
Thirty Years of Research on Children’s Rights in the Context of Migration
Authors: Brittle Ruth , Desmet Ellen
Published: March 2020

This article presents a tentative analysis of 30 years of academic research in the field of children’s rights and migration (1989–2019). Much research has addressed the plight of unaccompanied, refugee and asylum-seeking children, trying better to link children’s rights considerations with international refugee law. Many publications address the best interests of the child principle and the right to be heard. Most research focuses on (migration towards) Europe. This has led to an increased visibility and recognition of children’s rights in the context of migration.

However, there are still various blind spots in the research reviewed. Most research focuses on some children, but not all (e.g., accompanied children), on some rights, but not all (e.g., economic, social and cultural rights), and on some types of migration, but not all (e.g., economic migration). Moreover, refugee and migrant children tend to be studied as a group, which risks reducing attention for their internal diversity.
New Insights into Yona Wallach’s Poem ‘Tefillin’: Sefer Or Zaruʿa and Shabbtai Tzvi
Authors: Cooper Frumkin Shlomit
Published: March 2020

First published in Iton 77 in 1982, the poem ‘Tefillin’ by Yona Wallach sparked uproar and prompted various discussions by researchers (and journalists). This article discusses two aspects that have not been considered in previous research. First, ‘Tefillin’ was written as part of a play based on Jacob Horowitz’s book Sefer Or zaruʿa (Tel Aviv 1927). Second, the poem was inspired by a text about Shabbtai Tzvi. This view is complemented here by additional mystical sources. ‘Tefillin”s literary context alters prior perception of Wallach’s poetry and image as a writer: instead of being uninfluenced by literary traditions, I show how Wallach in fact participates in a tradition of texts. The insights and text analysis presented here put forward a crucial research agenda, claiming that Hebrew literary criticism can benefit from a thorough knowledge of Kabbalah research. The absence of this attitude from current research limits the commentarial potential.
Madden–Julian Oscillation–Induced Suppression of Northeast Pacific Convection Increases U.S. Tornadogenesis
Authors: Kim Dongmin , Lee Sang-Ki , Lopez Hosmay
Published: March 2020

This study investigates the impact of the Madden–Julian oscillation (MJO) on U.S. tornadogenesis using atmospheric reanalysis and model experiments. Our analysis shows that the impact of MJO on U.S. tornadogenesis is most significant in May–July and during MJO phases 3–4 and 5–6 (P3456). These MJO phases are characterized by anomalous ascending motion over the Maritime Continent (MC) and anomalous subsidence over the northeast Pacific (EP), generating anomalous diabatic heating and cooling, respectively. These in turn generate large-scale atmospheric conditions conducive to tornadogenesis in the United States, enhancing the North American low-level jet (NALLJ) and thus increasing the influx of warm and moist air from the Gulf of Mexico to the United States and increasing the low-level wind shear and convective available potential energy along its path. Conversely, during MJO phases 1–2 and 7–8, the opposite patterns of atmospheric anomalies appear over the United States producing unfavorable environments for U.S. tornadogenesis. We further investigate the underlying mechanism for MJO-induced atmospheric circulations conducive to U.S. tornadogenesis using a linear baroclinic model (LBM). The LBM is forced by diabatic heating over the MC and cooling over the EP, which characterizes the P3456 MJO phase. The model experiment reproduces an anomalous ridge over the southern United States and associated anomalous low-level anticyclone that enhances the NALLJ and increases tornadic environmental parameters. Additional sensitivity experiments prescribing the diabatic heating over the MC and diabatic cooling over the EP independently demonstrate that diabatic cooling over the EP is the main driver for producing regional atmospheric conditions favorable for U.S. tornadogenesis.
Reflections on Therapeutic Action and the Origins of Psychic Life
Authors: Levine Howard B.
Published: March 2020

Psychoanalysis has seen a shift in emphasis regarding therapeutic action and technique. A predominant focus on the uncovering or reintegrating of repressed, disguised, or split-off contents has moved to include the intersubjective creation, development, and strengthening of psychic processes and capabilities. The analyst’s role in this process has been analogized to that of the primary maternal object in the origins of psychic life. This metaphor illuminates the movement from unrepresented to represented psychic states in treatment, as seen in a clinical example from the analysis of a particularly withdrawn young adult.
Emerging From Deadness: A Microanalysis of the Analytic Relationship
Authors: Graver Ruth
Published: March 2020

Video microanalysis, a technique developed by infant researchers, is used to understand the withdrawal that developed between analyst and analysand when the latter resumed use of the couch after a period of sitting up. The case includes three excerpts of microprocess, accompanied by descriptions of content apart from explicit verbal material, content such as tone of voice, speech patterns, facial expression, and body movements, along with diagrams showing the second-by-second vocal rhythm coordination of analyst and analysand. Supervision using the video, as well as the analyst’s viewing the video with the analysand in a modified use of video feedback, widened the pair’s understanding of the determinants of their mutual participation in withdrawal and a feeling of deadness, thus freeing them from the repetition of an enactment. It is shown how (1) movement to the couch created an affectively heightened state that brought central psychodynamic aspects of the analysand’s experience to the fore; (2) video microanalysis allowed access to previously unavailable content; and (3) understanding of unconscious, dynamically determined conflicts and defenses embedded in body movement, facial expression, speech tone, and rhythm patterns illuminated facets of the co-created relatedness between analysand and analyst.
A Prospective Randomized Clinical Trial of Combination Therapy with Proton Pump Inhibitors and Mucolytics in Patients with Laryngopharyngeal Reflux
Authors: Chae Minsuk , Jang Dong Hyuk , Kim Ho Chan , Kwon Minsu
Published: March 2020

Objectives:

To identify whether combination therapy with mucolytics and proton pump inhibitors (PPIs) leads to faster and more effective symptomatic relief in patients with laryngopharyngeal reflux (LPR).

Methods:

Patients diagnosed as LPR with a reflux symptom index (RSI) ≥ 13 and a reflux finding score (RFS) ≥ 7 were enrolled in this prospective study. Patients were randomly allocated to control (PPI only) or experimental (PPI + mucolytics) groups and changes in RSI and RFS values were assessed at 1- and 3-month follow-up.

Results:

One hundred sixteen patients were randomly allocated into either the control group ( n = 59) or the experimental group ( n = 57). The RSI and RFS scores significantly decreased in both groups (all P < .001) after 1 month of treatment; however, there was no significant difference in RSI change between groups ( P = .223). After 3 months of treatment, there remained no significant difference in RSI change between groups ( P = .592).

Conclusions:

Combination therapy with mucolytics and PPI compared to PPI alone did not lead to faster or more effective symptomatic relief in LPR patients.
Who’s Multiculturally Competent? Everybody and Nobody: A Multimethod Examination
Authors: Wilcox Melanie M. , Franks Danielle N. , Taylor Terrill O. , Monceaux Christopher P. , Harris Keoshia
Published: March 2020

This study was a social dominance theory-driven multimethod investigation of multicultural competence. Given the concerns with self-report, we examined the relationship between study variables and both self-report and performance-based multicultural competence. We also tested competing hypotheses regarding the relationship between the multicultural competence measures. We examined two samples: one of counselor trainees ( N = 93), and one of practicing therapists ( N = 107). The overwhelming performance floor effect in the context of self-report ceiling effects was striking and unexpected in its severity. Awareness of privilege was the most consistent predictor, and the only variable related to most multicultural competence measures. Results related to social dominance orientation, just-world beliefs, and empathy differed by sample. A key finding was the failure by a substantial proportion of participants in both samples to even minimally address clients’ sociocultural context. Thus, we focus our discussion on the implications of this result.
The Relationship of Special Education Teacher Performance on Observation Instruments With Student Outcomes
Authors: Johnson Evelyn S. , Zheng Yuzhu , Crawford Angela R. , Moylan Laura A.
Published: March 2020

In this study, we examined the relationship of special education teachers’ performance on the Recognizing Effective Special Education Teachers (RESET) Explicit Instruction observation protocol with student growth on academic measures. Special education teachers provided video-recorded observations of three instructional lessons along with data from standardized, curriculum-based academic measures at the beginning, middle, and end of the school year for the students in the instructional group. Teachers’ lessons were evaluated by external, trained raters. Data were analyzed using many-faceted Rasch measurement (MFRM), correlation, and multiple regression. Teacher performance on the overall protocol did not account for statistically significant variance in student growth beyond that of students’ beginning of the year academic performance. Teacher performance on an abbreviated protocol comprised of items that had average or higher item difficulties on the MFRM analysis accounted for an additional 4.5% of variance beyond that of beginning of the year student performance. Implications for further research are discussed.
Full Disclosure: How Smartphones Enhance Consumer Self-Disclosure
Authors: Melumad Shiri , Meyer Robert
Published: March 2020

Results from three large-scale field studies and two controlled experiments show that consumers tend to be more self-disclosing when generating content on their smartphone versus personal computer. This tendency is found in a wide range of domains including social media posts, online restaurant reviews, open-ended survey responses, and compliance with requests for personal information in web advertisements. The authors show that this increased willingness to self-disclose on one’s smartphone arises from the psychological effects of two distinguishing properties of the device: (1) feelings of comfort that many associate with their smartphone and (2) a tendency to narrowly focus attention on the disclosure task at hand due to the relative difficulty of generating content on the smaller device. The enhancing effect of smartphones on self-disclosure yields several important marketing implications, including the creation of content that is perceived as more persuasive by outside readers. The authors explore implications for how these findings can be strategically leveraged by managers, including how they may generalize to other emerging technologies.
Measuring Nation States’ Deliberativeness: Systematic Challenges, Methodological Pitfalls, and Strategies for Upscaling the Measurement of Deliberation
Authors: Fleuß Dannica , Helbig Karoline
Published: March 2020

A theoretically reflected and empirically valid measurement of nation states’ democratic quality must include an assessment of polities’ deliberativeness. This article examines the assessment of deliberativeness suggested by two sophisticated contemporary measurements of democratic quality, that is, the Democracy Barometer and the Varieties of Democracy-project. We feature two sets of challenges, each measurement of deliberativeness must meet: First, it must address the methodological challenges arising in the course of conceptualizing, operationalizing, and aggregating complex concepts (see Munck and Verkuilen, 2002). Second, attempts to measure nation states’ deliberativeness are confronted with specific conceptual and systematic challenges which we derive from recent deliberative democracy scholarship. We argue that both Democracy Barometer and Varieties of Democracy-project provide highly sophisticated assessments of democratic quality, but ultimately fail to capture nation states “deliberativeness” in a theoretically reflected and methodologically sound manner. We examine the methodological, pragmatic, and systematic reasons for these shortcomings. The crucial task for measurements of nation states’ deliberativeness consists in providing a conceptual approach and methodological framework for “upscaling” existing meso-level measurements (such as the DQI). The concluding section presents conceptual and methodological strategies that can enable researchers to meet these challenges and to provide a theoretically grounded and empirically valid measurement of nation states’ deliberativeness.
EFL Learners’ Acquisition of Academic Collocation and Synonymy: Does their Academic Experience Matter?
Authors: Wongkhan Prueksa , Thienthong Atikhom
Published: March 2020

It is generally accepted that collocation is essential for establishing synonymy. They are related linguistic features which are important and useful for language learners. Given this importance, this present study considered the experience of 120 Thai English as a Foreign Language (EFL) students. The study explored the students’ knowledge of academic collocation and synonymy in relation to their academic experience at university and examined their justifications for their collocation selections. The results of a forced-choice collocation test revealed that while the majority of the students demonstrated their knowledge of academic collocations and synonyms, the more experienced (ME) students significantly outperformed their less experienced (LE) counterparts in most collocation questions. In terms of explanations for their collocation choices, the ME group referred to their encounters as the most frequent reason while the LE group made the largest number of guesses. The findings suggest that despite not being taught explicitly about academic collocations, EFL learners can develop their collocation repertoire incidentally as they are exposed to academic discourse over their university years.
A Closer Look at the Business Case for Diversity: The Tangled Web of Equity and Epistemic Benefits
Authors: Steel Daniel , Bolduc Naseeb
Published: March 2020

This article examines the business case for diversity (BCD), according to which diversity should be promoted because diverse groups outperform nondiverse groups. Philosophers who defend BCD usually propose that diversity’s positive effects are contingent on equitable background conditions that promote respectful and open discourse, suggesting that efforts to promote equity and to reap the benefits of diversity go hand-in-hand. Yet we explain how epistemic benefits of diversity can depend on inequities, including inequalities of intellectual authority along the lines of social identity. Consequently, we propose a more complete account of the complex relationship between equity and epistemic benefits of diversity.
Unionism in a Right-to-Work Environment: United Faculty of Florida from Stagnation to Crisis Mobilization to Power Building
Authors: Nissen Bruce , Churchill Candi
Published: March 2020

The Janus vs. AFSCME District 31 legal decision forced all U.S. public-sector unions to operate under “right-to-work” conditions: any union fees for those covered by a union contract are now optional. Past experiences of successful public-sector unions operating in right-to-work states should offer lessons to all public-sector unions on how to succeed. This article examines the history and recent success of the United Faculty of Florida, a statewide higher education public-sector union. Critical turning points, crises, and lessons from that history are included.
Disability and the implication of coaccessibility: a case study on accessibility to the media in Turkey
Authors: Okyayuz A Şirin , Kaya Mümtaz
Published: March 2020

Media accessibility has been an important issue on the international agenda since the early 21st century. Many countries have achieved major developments in media accessibility, while others like Turkey are currently embarking on the journey. The following article discusses developments in media accessibility in Turkey with emphasis on disability and the implication of coaccessibility which may be defined broadly as appealing to audiences with differing accessibility needs, through the translation(s) inputted on a single product. The research so far seems to indicate that coaccessibility has potential political, social, educational and other implications. Turkish end-users embrace the current coaccessibility model, but the ultimate goal in accessibility for Turkey is to have optional sign language interpreting, audio description and subtitling for the D/deaf and hard of hearing and the actors need to strive to achieve this. Currently, it also falls to academics to research this phenomenon of coaccessibility, learn from it, both in terms of the practice itself and its possible implications for universal design, and design for all, and to ensure that end-users and others benefit from it until the day it can be replaced with a better option.
Examining Athlete Ally Through Resource Mobilization Theory
Authors: Schmidt Samuel H. , Hancock Meg H. , Frederick Evan L. , Hums Mary A. , Alagaraja Meera
Published: March 2020

Social movement organizations have played an important role in athlete activism. Countless athlete activists have all benefited from having organizations supporting their social justice efforts. One such organization, Athlete Ally, partners with today’s athletes to create an inclusive athletic environment. Due to their relationship, both Athlete Ally and the athletes provide each other with resources to enact change through sport. The purpose of the following study was to examine the resources exchanged between the two entities through resource mobilization theory using qualitative interviews. Resources are divided into five categories: moral, cultural, social-organizational, human, and material. Results revealed moral, social-organizational, and material resources are shared between the two entities but not human and cultural resources. Practical and theoretical implications are expanded upon in the article.
Storing value: The infrastructural ecologies of commodity storage
Authors: Banoub Daniel , Martin Sarah J
Published: March 2020

As Marx pointed out in the second volume of Capital, storage is a critical moment in the circulation of capital. Yet, despite the resurgent interest in the political economy of circulation, logistics, and infrastructures, commodity storage remains under-examined in critical human geography. This paper examines the “hidden abode” of storage by tracing attempts to control moisture and realize value in two different commodity chains: Newfoundland saltfish and American grain in the late-19th- and 20th centuries. Storing preserved codfish and grain presented different biophysical obstacles for firms, but both required interventions to discipline moisture to preserve and realize the value embodied in the commodities. Through our empirical work, we frame storage sites as infrastructural ecologies: complex, more-than-human assemblages that both constrain and enable the realization of value embodied in lively commodities. This paper contributes to debates on circulation, logistics, and infrastructures by highlighting historical geographies of storage as a novel vantage point from which to analyze the frictions and flows of value under capitalist social relations. By grounding logistics in a value-theoretical framework, this paper also contributes to recent debates regarding the value (and valuation) of nature in political economy, by highlighting the role of storage and realization in the nature–value nexus.
Prevalence of multidrug-resistant organisms on palliative care patients in a university hospital–bound palliative care unit: A prospective cohort analysis
Authors: Strapatsas Tobias Georg , Simons Viola , Ghebremedhin Beniam , Ahmad-Nejad Parviz , Schmalz Oliver
Published: March 2020

Background:

Multidrug-resistant organisms are a growing challenge and burden to patient care. To date, there are only data concerning the prevalence of methicillin-resistant Staphylococcus aureus infections. Thus, numbers of other multidrug-resistant organisms can only be extrapolated and inferred from more or less comparable cohorts.

Aim:

To evaluate the prevalence of multidrug-resistant organisms on palliative care in-patients.

Design:

A prospective cohort analysis

Setting/participants:

A University Hospital–bound palliative care unit, in which all patients admitted to the unit were screened for inclusion.

Results:

In total, 304 patients were included in this study. The prevalence for methicillin-resistant Staphylococcus aureus of 5.2% (95% confidence interval: 2.9%–8.4%), for vancomycin-resistant Enterococcus faecium of 10.5% (95% confidence interval: 7.2%–14.8%), for Ciprofloxacin-resistant-extended spectrum beta-lactamases isolates of 5.8% (95% confidence interval: 3.4%–9.3%) and Ciprofloxacin-resistant Carbapenem-resistant Gram-negative bacteria of 0.3% (95% confidence interval: 0%–1.3%) was calculated. Except for methicillin-resistant Staphylococcus aureus, patients carrying a multidrug-resistant organism had a significant longer duration of hospitalization. Median length of stay was 12 days (interquartile range: 14.5, no multidrug-resistant organisms), 14.5 days (interquartile range: 15, methicillin-resistant Staphylococcus aureus), 21 days (interquartile range: 16.5, vancomycin-resistant enterococci), 22 days (interquartile range: 20.75, Ciprofloxacin-resistant-extended spectrum beta-lactamases) and 32 days (interquartile range: 22.00) for patients carrying two organisms.

Conclusion:

There is a high prevalence of all multidrug-resistant organisms within the hospitalized palliative care patients. However, the multidrug-resistant organisms do not seem to impact the survival within this cohort. Further studies should evaluate additional end-points, for example, quality of life, which are of special interest in this cohort.