bluuebunny/crossref_metadata_2025 huggingface dataset:
Developing Music Education Policy Wonks: Preservice Music Education and Policy
Authors: Aguilar Carla E. , Dye Christopher K.
Published: November 2019

The typical undergraduate music education student is focused on developing their musicianship and leadership abilities, professional education competencies, and specific pedagogical expertise. While these are desirable outcomes of a music education degree, music teachers must learn how to effectively interact with a range of policies that will influence how they navigate their professional and private lives. The purpose of this article is to outline and explore mechanisms to engage preservice teachers with educational policies and policy-related practices. We discuss resources for learning about federal and state policies related to education and music education and strategies for interfacing with policymakers. We suggest models that integrate policy topics into existing coursework and new curricular structures that may facilitate the development of “scholar-musicians.” Implications of music teacher educators bringing their role as politically active citizens into the classroom and adding political knowledge to the expectations placed on new teachers are considered.
Be Aware of a Potential Pitfall in Oral and Dental Specimens: Alvogyl Fibers
Authors: AbdullGaffar Badr , Awadhi Farzad
Published: November 2019

Alvogyl dressing is used to help control hemostasis, foster healing, and prevent complications after certain oral procedures. It is a paste composed of different antiseptic and analgesic substances, and fern-derived Penghawar djambi fibers that have styptic properties. It is claimed to be a resorbable and self-eliminating paste with little complications. However, some studies have demonstrated detrimental effects. We report 3 cases of postextraction nonhealing sockets after Alvogyl dressing. Histologically, they demonstrated residual Alvogyl fibers with foreign body giant cell stromal reaction and complications that were clinically confused with abscess, cysts, infections, and neoplastic lesions. Being unaware of their histopathologic appearances, the foreign bodies in 2 cases were initially confused with fungal hyphae, parasitic ova, vegetable material, and other surgical and nonsurgical materials. To add to our confusion, they were periodic acid-Schiff (PAS) and Grocott methenamine silver (GMS) positive, septated, spiked, and calcified. A history of Alvogyl dressing was retrospectively found. Learning from our mistakes and being aware of the histologic manifestations of Alvogyl fibers, the third case was correctly spotted. Because Alvogyl fibers are undissolvable and are not spontaneously eliminated, they may, if left for a long period, elicit tumefactive foreign body giant cell stromal and epithelial reactions that can be confused with inflammatory, infectious, and neoplastic lesions. Histologically, they can mimic infectious agents and noninfectious materials. Because history of dressing is not always provided, pathologists should be familiar with their histomorphologic features to avoid pitfalls and guide clinicians to correct diagnosis and management. In absence of history, certain histologic features are helpful hints.
On the Use of Empirical Bayes Estimates as Measures of Individual Traits
Authors: Liu Siwei , Kuppens Peter , Bringmann Laura
Published: November 2019

Empirical Bayes (EB) estimates of the random effects in multilevel models represent how individuals deviate from the population averages and are often extracted to detect outliers or used as predictors in follow-up analysis. However, little research has examined whether EB estimates are indeed reliable and valid measures of individual traits. In this article, we use statistical theory and simulated data to show that EB estimates are biased toward zero, a phenomenon known as “shrinkage.” The degree of shrinkage and reliability of EB estimates depend on a number of factors, including Level-1 residual variance, Level-1 predictor variance, Level-2 random effects variance, and number of within-person observations. As a result, EB estimates may not be ideal for detecting outliers, and they produce biased regression coefficients when used as predictors. We illustrate these issues using an empirical data set on emotion regulation and neuroticism.
An Integrated Approach to Testing Dynamic, Multilevel Theory: Using Computational Models to Connect Theory, Model, and Data
Authors: Ballard Timothy , Palada Hector , Griffin Mark , Neal Andrew
Published: November 2019

Some of the most influential theories in organizational sciences explicitly describe a dynamic, multilevel process. Yet the inherent complexity of such theories makes them difficult to test. These theories often describe multiple subprocesses that interact reciprocally over time at different levels of analysis and over different time scales. Computational (i.e., mathematical) modeling is increasingly advocated as a method for developing and testing theories of this type. In organizational sciences, however, efforts that have been made to test models empirically are often indirect. We argue that the full potential of computational modeling as a tool for testing dynamic, multilevel theory is yet to be realized. In this article, we demonstrate an approach to testing dynamic, multilevel theory using computational modeling. The approach uses simulations to generate model predictions and Bayesian parameter estimation to fit models to empirical data and facilitate model comparisons. This approach enables a direct integration between theory, model, and data that we believe enables a more rigorous test of theory.
Total hip arthroplasty in patients with osteoporosis
Authors: Karachalios Theofilos S , Koutalos Antonios A , Komnos George A
Published: November 2019

There is a high prevalence of osteoporosis in patients undergoing total hip arthroplasty. There are several clinically relevant questions related to the management of such cases: the effect of ageing; the initial osseointegration of implants, especially when cementless THA is used; the effect of medical osteoporosis treatment on bone-implant interface; the incidence of intraoperative and late periprosthetic fractures, and the long-term survival of both cemented and cementless total hip arthroplasty performed for proximal femoral fractures and hip osteoarthritis. A critical review of the literature is presented in an attempt to draw practical conclusions.
Contrast-Induced Acute Kidney Injury: Review and Practical Update
Authors: Morcos Ramez , Kucharik Michael , Bansal Pirya , Al Taii Haider , Manam Rupesh , Casale Joel , Khalili Houman , Maini Brijeshwar
Published: November 2019

Contrast-induced acute kidney injury (CI-AKI) is an important consideration in patients undergoing cardiac catheterization. There has been a continuous strive to decrease morbidity and improve procedural safety. This review will address the pathophysiology, predictors, and clinical management of CI-AKI with a concise overview of the pathophysiology and a suggested association with left atrial appendage closure. Minimizing contrast administration and intravenous fluid hydration are the cornerstones of an effective preventive strategy. A few adjunctive pharmacotherapies hold promise, but there are no consensus recommendations on prophylactic therapies.
Characteristics and Outcomes of Severe ARDS Patients Receiving ECMO in Southern Thailand
Authors: Assanangkornchai Nawaporn , Vichitkunakorn Polathep , Bhurayanontachai Rungsun
Published: November 2019

Extracorporeal membrane oxygenation (ECMO) is a treatment option considered for acute respiratory distress syndrome (ARDS) patients who are refractory to conventional treatments. However, treatment with ECMO has not shown significant reduction of mortality which may be due to inappropriate selection criteria. Thus, we aim to evaluate the treatment outcomes of patients treated with ECMO in our center and determine an optimal cutoff level of the Respiratory ECMO Survival Prediction (RESP) score for case selection. This was a retrospective case-control study conducted at Songklanagarind Hospital, Thailand, from January 2014 to August 2018. ECMO patients were randomly matched to a control group of patients with severe ARDS within the same time period. There were 19 cases diagnosed with ARDS and treated with ECMO and 57 controls with ARDS. The patients in both groups had an average APACHE II score of 30.2 (SD = 4.7) and mainly had bacterial pneumonia. The in-hospital mortality was not significantly different between the cases and controls (68.4% vs 63.2%, respectively); however, the ECMO cases had a significantly longer length of intensive care unit stay and cost of hospitalization. Active malignancy, male gender, PaO2/FiO2 ratio, and hypotension needing vasopressors were the risk factors for mortality. The RESP score did not discriminate between the survivors and nonsurvivors. Thus, more patient is needed to construct a better selection criterion.
Disrupting climate change futures: Conceptual tools for lost histories
Authors: De Cock Christian , Nyberg Daniel , Wright Christopher
Published: November 2019

Considering the worsening climate crisis, we argue that our present conditions require a particular approach to the past in order to disrupt current intellectual trajectories. We enrol Walter Benjamin’s concept of history, via the writings of Svetlana Alexievich and Margaret Atwood, with the aim of bringing a criticality to the present to make us reconsider the ways we think about and act in our present world. Based on Alexievich and Atwood’s work, we develop research conceptualizations of forgotten and alternative histories to open up a space to consider a future climate-changed world beyond the dominant tropes of inevitable dystopian apocalypse and clever technological adaptation. We offer the concept of ‘hope without optimism’ in encouraging management and organization studies scholars to develop a discipline fit for the Anthropocene.
Bullying, physical activity, and body image among Brazilian students
Authors: Garcia Ana Claudia , Sousa Raquel , Varela Andrea , Monteiro Luciana
Published: November 2019

To determine the prevalence of bullying in Brazilian schools and analyze its association with physical activity and body image, data were collected from 51.192 students. Boys are more frequently bullied (7.2%) and they also bully more than girls ( p ⩽ 0.01). Regarding body image, 26 percent of the girls considered themselves thin or very thin ( p ⩽ 0.01). For boys, we observed associations between the variable of being treated well by classmates and race. Bullying was associated to mother’s education. The data show the need for cross-sector actions based on educational policies and practices that can reduce and prevent bullying in schools.
To cross or not to cross: Clinical boundary considerations with persons who are refugees
Authors: Shors Madhuri Kasat , Kroll Jerome
Published: November 2019

Recent studies suggest that culturally divergent explanatory models of illness and treatment practices, differing physician–patient goals and expectations, and mistrust and misunderstandings between refugee patients and health care professionals are associated with lower health care utilization and outcomes among refugees in Western host countries. In our experience working as psychiatrists with persons who are refugees, we have found that attention to the processes that define and redefine boundary relationships has important implications for therapeutic care, as well as for training residents and others in culturally-responsive care. This article examines the manner and micro-processes by which boundaries are established, maintained, or altered between medical provider and person who is a refugee as a key pathway in the development of working relationships that are culturally sensitive. We work from an expanded concept of boundaries in psychiatry, viewing boundaries as a way of describing interactions that play important and even critical roles in advancing, impeding, and redefining significant aspects of the therapeutic relationship between practitioner and patient. The quality of the interactions occurring minute by minute within treatment sessions provides the foundation from which relationships are defined, parameters of openness or closure of communication are conveyed, and the power structure is laid out. We offer Martin Buber’s formulation of the I–Thou relationship as the philosophical grounding of flexible, culturally sensitive boundary behaviors. At its best, boundaries of mutual engagement that are respectful and cognizant of a patient’s individuality and cultural history and values are conveyed to the refugee patient.
Caregivers’ causal attributions of their relatives’ mental illness and the association with stigma
Authors: Sagayadevan Vathsala , Lau Ying Wen , Zhang Yunjue , Jeyagurunathan Anitha , Shafie Saleha , Chang Sherilyn , Chong Siow Ann , Subramaniam Mythily
Published: November 2019

Causal attributions of mental illness have received substantial attention given their influence on help-seeking patterns of individuals and the level of engagement with health services. Few studies, however, have examined caregivers’ perspectives of their relatives’ illness. The current study aimed to examine caregivers’ causal attributions of their relatives’ mental illness and its association with perceived stigma in a multi-ethnic Asian sample. Primary caregivers ( N = 350) of psychiatric outpatients were recruited from a psychiatric hospital. The attribution and stigma sections of the Family Interview Schedule (FIS) were utilized to obtain caregivers’ causal report of their relatives’ illness and stigma perception. Logistic regressions were performed to examine the socio-demographic and diagnostic correlates of the four categories of causal attributions (psychosocial, biological, drug-/substance use-related, supernatural). The majority of caregivers identified psychosocial causes, followed by biological, supernatural, and lastly drug-/substance use-related causes for their relatives’ illness. Marital status, religion, employment status and the diagnosis of depressive disorders were significant correlates of biological attributions. Ethnicity and not knowing their relatives' diagnosis were significantly associated with psychosocial attributions. For drug-/substance use-related attributions, ethnicity was the only significant correlate. Supernatural attributions did not yield any significant associations. Caregivers who endorsed drug-/substance use-related reasons also reported significantly higher stigma than caregivers who did not endorse these attributions. A tendency to endorse biological and psychosocial causes for their relative’s illness was noted among caregivers. Further research on caregivers’ causal attributions is warranted to account for and replicate current study findings.
Influence of concrete mix proportions on axial performance of concrete-filled steel tubes made with self-compacting concrete
Authors: Ouyang Y , Zeng JJ , Li LG , Kwan AKH
Published: November 2019

Self-compacting concrete is quite commonly used in concrete-filled steel tube structures, but the compaction level of the self-compacting concrete, that is, the percentage of volume occupied by materials other than air void, within the steel tube is seldom investigated. The authors are of the view that the concrete mix proportions of the self-compacting concrete may have significant effects on the compaction level of the self-compacting concrete, which will be quantified by the ‘compaction index’ proposed in this study and thus the performance of the concrete-filled steel tube. Moreover, the mix proportions would also influence the performance of the concrete-filled steel tube by affecting the aggregate–aggregate and aggregate–paste interactions of the concrete, albeit this important issue is rarely addressed in previous studies either. Herein, a pilot study is conducted to investigate the influences of the self-compacting concrete mix proportions on the axial performance of concrete-filled steel tube. Four groups of concrete-filled steel tube specimens made with different self-compacting concrete were tested, and the investigated concrete mix parameters included the paste volume, fine to coarse aggregate ratio, and 9.5–19.0 mm aggregate ratio. It was found that the compaction index of the self-compacting concrete is a key factor enabling the successful use of self-compacting concrete in concrete-filled steel tube. Moreover, the paste volume and aggregate proportions of the concrete mix have certain effects on the post-peak behaviour and ductility of concrete-filled steel tube.
Preoperative cardiac function parameters as valuable predictors for nurses to recognise delirium after cardiac surgery: A prospective cohort study
Authors: Cai Shining , Latour Jos M , Lin Ying , Pan Wenyan , Zheng Jili , Xue Yan , Gao Jian , Lv Minzhi , Zhang Xiaomin , Luo Zhe , Wang Chunsheng , Zhang Yuxia
Published: November 2019

Background:

Delirium is a common postoperative complication after cardiac surgery. The relationship between delirium and cardiac function has not been fully elucidated.

Aims:

The aim of this study was to identify the association between preoperative cardiac function and delirium among patients after cardiac surgery.

Methods:

We prospectively recruited 635 cardiac surgery patients with a planned cardiac intensive care unit admission. Postoperative delirium was diagnosed using the confusion assessment method for the intensive care unit. Preoperative cardiac function was assessed using N-terminal prohormone of brain natriuretic peptide (NT-proBNP), New York Heart Association functional classification and left ventricular ejection fraction.

Results:

Delirium developed in 73 patients (11.5%) during intensive care unit stay. NT-proBNP level (odds ratio (OR) 1.24, 95% confidence interval (CI) 1.01–1.52) and New York Heart Association functional classification (OR 2.34, 95% CI 1.27–4.31) were both independently associated with the occurrence of delirium after adjusting for various confounders. The OR of delirium increased with increasing NT-proBNP levels after the turning point of 7.8 (log-transformed pg/ml). The adjusted regression coefficients were 1.19 (95% CI 0.95–1.49, P=0.134) for NT-proBNP less than 7.8 (log-transformed pg/ml) and 2.78 (95% CI 1.09–7.12, P=0.033) for NT-proBNP greater than 7.8 (log-transformed pg/ml). No association was found between left ventricular ejection fraction and postoperative delirium.

Conclusion:

Preoperative cardiac function parameters including NT-proBNP and New York Heart Association functional classification can predict the incidence of delirium following cardiac surgery. We suggest incorporating an early determination of preoperative cardiac function as a readily available risk assessment for delirium prior to cardiac surgery.
Diversity in Party Leadership in State Legislatures
Authors: Hansen Eric R. , Clark Christopher J.
Published: November 2019

Members of historically underrepresented groups—women, African Americans, Latinos, and workers—are serving in American legislatures in increasing numbers. However, legislators wield substantially greater power in the lawmaking process when they hold leadership positions. Incorporation of these groups into leadership positions could indicate fuller political representation, but scholars to date have not assessed how well these groups are represented in leadership. We analyze original data describing the backgrounds of approximately 2,200 leaders in 30 states between 2003 and 2014. The data show that, on average across states, members of these groups are as well represented in state legislative leadership positions as they are in rank-and-file membership, but there is substantial variation across states and across parties. We then ask what factors might explain this variation and explore institutional characteristics, like the number of leadership positions or leader selection methods. The results show that legislative chambers with a higher number of leadership posts tend to have more women in leadership, and that selection through elections is associated with decreased African American presence in leadership. The findings have implications for minority incorporation and influence in American politics.
Chemoselective aza-Michael addition of indoles to 2-aroyl-1,3-diarylenones
Authors: Li Zheng , Yang Aizhen , Ma Xiaolong , Liu Zhenrong
Published: November 2019

A total of 20 examples of 2-[(1 H-indol-1-yl)(aryl)methyl]-1,3-diphenylpropane-1,3-diones were efficiently synthesized by the aza-Michael addition at the N1 position of indoles with 2-aroyl-1,3-diarylenones at room temperature in the presence of potassium hydroxide. The salient features of this protocol are no transition-metal catalysts, mild conditions, high chemoselectivity, high atom economy, high yields, and a simple work-up procedure.
André Boivin: A pioneer in endotoxin research and an amazing visionary during the birth of molecular biology
Authors: Cavaillon Jean-Marc
Published: November 2019

André Boivin (1895–1949) started his career in Marseille as a biochemist. Soon after the discovery of insulin, he worked on its purification, allowing for the treatment of local patients. He later moved to Strasbourg and set-up a microtitration technique of small carbon molecules and a method for quantifying purine and pyrimidine bases. His main scientific contribution occurred in Bucharest, where he was recruited to organize the teaching of medicinal chemistry. Together with Ion and Lydia Mesrobeanu, at the Cantacuzene Institute, they were the first to characterize the biochemical nature of endotoxins, which he termed the “glucido-lipidic antigen.” After joining the Institut Pasteur annex near Paris, he worked with Gaston Ramon pursuing his research on smooth and rough LPS. Additionally, with Albert Delaunay, he researched the formation of exotoxins and antibodies (Abs). He was nominated assistant-director of the Institut Pasteur in 1940. He initiated research on bacterial DNA and RNA, and was the first to hypothesize on how RNA fits into gene function. In 1947 he moved for a second time to Strasbourg, accepting a position as a Professor of Biological Chemistry. After his premature death at the age of 54, the French academies mourned his loss and recognized him as one of their outstanding masters of biochemistry, microbiology, immunology, and molecular biology.
Reframing school bullying: The question of power and its analytical implications
Authors: Horton Paul
Published: November 2019

The past 30 years has seen a significant increase in research interest and public discussion about school bullying and an associated diversification in perspectives on the issue. In attempting to bridge divisions between different research paradigms, there have been calls for cross-paradigmatic dialogue. In this short think piece, I seek to facilitate such dialogue by addressing the question of power and considering its analytical implications for school bullying research, anti-bullying initiatives, and education more generally. In doing so, I relate the discussion to the various systems of the widely used social–ecological framework. I argue that a focus on power suggests a need for more consideration of the various levels of the social–ecological framework, more consideration of the importance of social difference, and more consideration of the importance of the school context and issues of power and resistance therein.
Controversial issues in the neoadjuvant treatment of triple-negative breast cancer
Authors: Fitzpatrick Amanda , Tutt Andrew
Published: November 2019

Triple-negative breast cancer (TNBC), as a collective group of heterogenous tumours, displays the highest rate of distant recurrence and lowest survival from metastatic disease across breast cancer subtypes. However, a subset of TNBC display impressive primary tumour response to neoadjuvant chemotherapy, translating to reduction in future relapse and increased overall survival. Maximizing early treatment response is crucial to improving the outlook in this subtype. Numerous systemic therapy strategies are being assessed in the neoadjuvant setting and the current paradigm of generic chemotherapy components in regimens for high-risk breast cancers, regardless of biological subtype, is changing. Therapeutic approaches with evidence of benefit include platinum drugs, polyadenosine diphosphate ribose polymerase (PARP) inhibitors, immunotherapy and second adjuvant therapy for those not achieving pathological complete response. Importantly, molecular testing can identify subgroups within TNBC, such as deoxyribonucleic acid (DNA) homologous recombination repair deficiency, lymphocyte-predominant tumours, and TNBC type 4 molecular subtypes. Clinical trials that address the interaction between these biomarkers and treatment approaches are a priority, to identify subgroups benefiting from additional therapy.
Occupancy and Conservation Prospects of Endemic Banded Wattle-Eye Platysteira laticincta in the Kilum–Ijim Community Forest, Northwestern Cameroon
Authors: A. Valery Binda , Mayaka Theodore B.
Published: November 2019

The banded wattle-eye bird species, BWE ( Platysteira laticincta) is rare, endangered, and endemic to the Bamenda Highlands, Western Cameroon. Kilum–Ijim Community Forest is its last stronghold. Little is known about BWE’s distribution and habitat requirements—the present baseline study aimed at reducing this knowledge gap. Bird occurrence—using call playback technique—and vegetation variables were recorded in 50-m radius sampling plots placed in the altitude range 2,100 to 2,800 m. The BWE occurred at 43 (35%) of 123 plots mostly within Kilum sector of the Community Forest, at altitude range 2,168 to 2,707 m. The log-odds of BWE occurrence significantly (a) increased with canopy height, herb relative abundance, bare soil relative abundance, and shrub relative abundance and (b) decreased with altitude and understory height. These results suggest that the BWE may prefer forest areas at lower altitude with more bare ground and denser undergrowth cover. The implications for BWE conservation are discussed.
School Nurses’ Roles in Preparing Special Needs Students for Active School Shootings
Authors: McIntosh Constance , Brelage Pamela , Pokorny Ryan , Duckham James , Boucher Naomi
Published: November 2019

The occurrence of mass shootings in U.S. public schools is increasing. For this reason, schools have begun expanding their awareness and preparation for these crises. However, in most preparation strategies, students with disabilities are not accounted for, which leaves an already vulnerable population at further risk. Due to their expertise in working with students with diverse needs and promoting health and safety in schools, school nurses are the ideal persons to lead the discussion about safety deficits when it comes to school shootings and students with special needs. This article provides a rationale for school nurses taking leadership roles in creating school shooting policies as well as provides guidelines for how nurses can work collaboratively to keep students with disabilities safe.
Follow-up of patients after revascularisation for peripheral arterial diseases: a consensus document from the European Society of Cardiology Working Group on Aorta and Peripheral Vascular Diseases and the European Society for Vascular Surgery
Authors: Venermo Maarit , Sprynger Muriel , Desormais Ileana , Björck Martin , Brodmann Marianne , Cohnert Tina , De Carlo Marco , Espinola-Klein Christine , Kownator Serge , Mazzolai Lucia , Naylor Ross , Vlachopoulos Charalambos , Ricco Jean-Baptiste , Aboyans Victor
Published: November 2019

Peripheral arterial diseases comprise different clinical presentations, from cerebrovascular disease down to lower extremity artery disease, from subclinical to disabling symptoms and events. According to clinical presentation, the patient's general condition, anatomical location and extension of lesions, revascularisation may be needed in addition to best medical treatment. The 2017 European Society of Cardiology guidelines in collaboration with the European Society for Vascular Surgery have addressed the indications for revascularisation. While most cases are amenable to either endovascular or surgical revascularisation, maintaining long-term patency is often challenging. Early and late procedural complications, but also local and remote recurrences frequently lead to revascularisation failure. The rationale for surveillance is to propose the accurate implementation of preventive strategies to avoid other cardiovascular events and disease progression and avoid recurrence of symptoms and the need for redo revascularisation. Combined with vascular history and physical examination, duplex ultrasound scanning is the pivotal imaging technique for identifying revascularisation failures. Other non-invasive examinations (ankle and toe brachial index, computed tomography scan, magnetic resonance imaging) at regular intervals can optimise surveillance in specific settings. Currently, optimal revascularisation surveillance programmes are not well defined and systematic reviews addressing long-term results after revascularisation are lacking. We have systematically reviewed the literature addressing follow-up after revascularisation and we propose this consensus document as a complement to the recent guidelines for optimal surveillance of revascularised patients beyond the perioperative period.
Does Parental Financial Socialization for Emerging Adults Matter? The Case of Austrian and Slovene First-Year University Students
Authors: Sirsch Ulrike , Zupančič Maja , Poredoš Mojca , Levec Katharina , Friedlmeier Mihaela
Published: November 2019

The study tested a model of first-year university students’ financial socialization focusing on parents as financial socialization agents and students’ present financial outcomes. Results from 395 Austrians (70% females) and 412 Slovenes (55% females) revealed significant pathways from recollected socialization experiences to students’ self-perceived financial learning outcomes (adopting parental role modeling and financial knowledge) and financial behavior control. Financial knowledge and behavioral control partly mediated the effect of prior socialization experiences on students’ financial behavior, financial relationship with parents, and financial satisfaction. Among country-specific pathways, adopting parental role modeling indirectly influenced financial outcomes in the Slovene students, whereas for the Austrian students, it was directly associated with better financial relationships with parents. Our findings on the pathways to healthy financial outcomes provide important suggestions to parents and emerging adult students.
Presentation and Treatment Outcomes of Liberian Children Age 5 Years and Under Diagnosed With Severe Malaria
Authors: Collins-Andrews Benetta , McQuilkin Patricia , Udhayashankar Kanagasabai , Adu Eric , Moormann Ann
Published: November 2019

Malaria is endemic in Liberia with a prevalence rate of up to 60% in some regions, and it has been a major cause of death in children under 5 years of age. Prior to the recent Ebola epidemic, we undertook a prospective, hospital-based pilot study at the National Referral Hospital in Monrovia, to characterize the presentation, accuracy of diagnosis, and treatment outcomes of children presenting for treatment of malaria. From June 2013 to May 2014, we recruited children 5 years and under who presented to the JFK Medical Center with suspected malaria. We collected both clinical and laboratory data on admission and on discharge. We enrolled 477 patients with an average age of 1.6 years. Demographic factors associated with testing negative for malaria included regular bed net use and prior treatment for malaria. The most common presenting symptoms of severe malaria in this population were headache and seizures. Of 246 patients admitted and treated for severe malaria, 33% tested negative by rapid diagnostic test and blood smear for malaria. The case fatality rate was higher for the patients who tested negative for malaria (4.9%) versus those who tested positive (0.6%). Three children who tested negative for malaria showed evidence of undiagnosed Salmonella typhi infection. These results suggest that malaria may be overdiagnosed and that the diagnoses of other infectious diseases, which present in a similar fashion, may be neglected. These findings underscore the need to develop rapid diagnostic tests to screen for alternative causes of febrile illness.
Considerations for Implementing Point-of-Care Ultrasound in a Community-Based Family Medicine Residency Program
Authors: Weemer Megan , Hutchins Matt , Beachy Eric , McGuire Nicole
Published: November 2019

Background:

Prior to implementing Point-of-Care Ultrasound (POCUS) training into our Family Medicine Residency Program, we sought to determine opinions on the most relevant applications according to current Family Medicine residents and recent graduates. As there are so many POCUS applications relevant to Family Medicine, it would be efficient to teach only the most relevant scans.

Objective:

Examine current POCUS use and the perception of future use among current residents and recent graduates of a Family Medicine Residency Program.

Methods:

In 2017, an electronic survey was used to examine differences in perceptions regarding the value of POCUS applications, benefits of use, and potential barriers to implementation.

Results:

Of the 88 surveys sent, 21 of 21 current residents (100%) and 28 of 67 recent graduates (41.8%) completed the survey with a total completion rate of 55.7%. The POCUS practices differed between groups. Current residents were significantly more likely than recent graduates to use POCUS for vascular procedural guidance and other procedural guidance. Recent graduates were significantly more likely to report POCUS use for abdominal aortic aneurysm screening and lower extremity Doppler screening for deep vein thrombosis. All P values were significant at the .05 level.

Conclusions:

Point-of-Care Ultrasound training is generally desired by current residents. Some applications are perceived to be of sufficient utility by current residents and recent graduates. Findings would justify investment of time and effort required to implement POCUS training in Family Medicine Residency curriculums. Curriculum should focus on applications viewed as high priority based on usage rates.
G-protein αq gene expression plays a role in alcohol tolerance in Drosophila melanogaster
Authors: Aleyakpo Benjamin , Umukoro Oghenetega , Kavlie Ryan , Ranson Daniel C. , Thompsett Andrew , Corcoran Olivia , Casalotti Stefano O.
Published: November 2019

Ethanol is a psychoactive substance causing both short- and long-term behavioural changes in humans and animal models. We have used the fruit fly Drosophila melanogaster to investigate the effect of ethanol exposure on the expression of the Gαq protein subunit. Repetitive exposure to ethanol causes a reduction in sensitivity (tolerance) to ethanol, which we have measured as the time for 50% of a set of flies to become sedated after exposure to ethanol (ST50). We demonstrate that the same treatment that induces an increase in ST50 over consecutive days (tolerance) also causes a decrease in Gαq protein subunit expression at both the messenger RNA and protein level. To identify whether there may be a causal relationship between these two outcomes, we have developed strains of flies in which Gαq messenger RNA expression is suppressed in a time- and tissue-specific manner. In these flies, the sensitivity to ethanol and the development of tolerance are altered. This work further supports the value of Drosophila as a model to dissect the molecular mechanisms of the behavioural response to alcohol and identifies G proteins as potentially important regulatory targets for alcohol use disorders.
Minimal change disease after hematopoietic stem cell transplant: Manifestation of chronic graft-versus-host disease
Authors: Padhi Parikshit , Muchayi Timothy , Teske Evan , Kuperman Michael , Barrantes Fidel
Published: November 2019

Chronic graft-versus-host disease is a potentially life-threatening immunological complication which can occur any time after hematopoietic stem cell transplant. Many organ systems can be affected; however, kidneys are normally not and development of nephrotic syndrome is particularly rare. In our report, a 64 year old who was diagnosed with acute myelogenous leukemia developed acute kidney injury and nephrotic syndrome secondary to minimal change disease. The patient responded well to treatment with steroids and rituximab therapy. Our goal is to communicate that nephrotic syndrome should be suspected in patients with significant hypoalbuminemia after graft-versus-host disease and withdrawing immunosuppression.
Poverty of Social Construction and Landlessness: Dignity for Dalits in Eastern Uttar Pradesh
Authors: Malik Bibhuti Bhushan
Published: November 2019

Drawing from empirical research, the article highlights the landlessness of the Dalits in eastern Uttar Pradesh vis-à-vis the social construction of poverty and the question of identity based on caste. It analyses the nature and extent of inequality in the ownership of land (both agricultural and homestead) among different social groups and presents a comparative perspective of Dalits at the national, state and local levels. Further, on the basis of block and village level analysis, the article reveals the size of landholding patterns among different caste groups of eastern Uttar Pradesh. The article seeks an answer to the question as to why the Dalits do not have land and for what reasons. It is observed that land for them is not only a source of livelihood but also a question of dignity. The article advocates that minimum size of land will provide them safety, security and dignity.
Ambedkar’s Journey of Conversion to Buddhism
Authors: Kumar Sanjeev
Published: November 2019

The history of religious conversions has highlighted two aspects. One is the transformation in one’s spiritual and transcendental realm and the other is the social and the political domain that encompasses a sense of rejection of existing religious and philosophical world views as well as assertion of one’s political outlook. In this context, this article explores the contours of one of the most important political thinkers of modern India, that is, B. R. Ambedkar who embraced Buddhism after 40 years of his experiment with the Hindu religion. This article is divided into two parts; the first deals with Ambedkar’s engagement with Hinduism with a hope of reforming the same but having failed in his attempt for 20 years, he declared to leave the religion in 1936. The second part deals with Ambedkar’s both explicit and implicit deliberations for selecting the right noble faith, that is, Buddhism whose foundation was egalitarianism, based on equality and compassion. He used Deweyian experimentalism and Buddhist rationalism, to reject Hinduism and seek refuge in the reformed Buddhism, that is, Navayana Buddhism.
The utility of fibrinogen level as a predictor of complications after laparoscopic gynecologic surgery: a prospective observational study
Authors: Macciò Antonio , Chiappe Giacomo , Kotsonis Paraskevas , Lavra Fabrizio , Nieddu Romualdo , Onnis Paolo , Sanna Elisabetta , Mais Valerio , Madeddu Clelia
Published: November 2019

Background

Complications after laparoscopic gynecological surgery may increase patients’ morbidity and mortality; therefore, their timely diagnosis and early treatment would help clinicians to avoid life-threatening situations. We aimed to evaluate the predictive role of fibrinogen for diagnosing complications after laparoscopic gynecologic surgery for benign and malignant conditions.

Patients and methods

All patients who underwent elective laparoscopic gynecologic surgery between June 2013 and December 2017 at the Department of Gynecologic Oncology, Azienda Ospedaliera Brotzu, Cagliari, were prospectively included. Post-operative complications were assessed and graded according to the Clavien-Dindo classification. Fibrinogen and white blood cell level were determined preoperatively, on the first post-operative day and at the appearance of symptoms indicative of an irregular post-operative course or at the time of re-hospitalization for persistent symptoms. The postoperative changes (calculated from the first postoperative day) were correlated with the occurrence and severity of complications and their predictive role was assessed.

Results

We enrolled 1016 patients: 36% underwent surgery for benign pathologies (mainly voluminous fibromatous uteri and severe deep endometriosis) and 64% for gynecologic malignancies. The overall complication rate was of 3.45%, the rate of major postoperative complications was 2.85%. A postoperative fibrinogen increase ≥ 20% had a high diagnostic accuracy to identify postoperative complications early (AUC 0.931, sensitivity 89%, and specificity 99%). The magnitude of postoperative fibrinogen change was associated with complication severity.

Conclusions

Our findings demonstrated that fibrinogen increase can enable the early detection of postoperative complications after laparoscopic gynecological surgery. Further prospective and multi-center studies are warranted to confirm these results.
Accuracy of genomic selection for grain yield and agronomic traits in soft red winter wheat
Authors: Lozada Dennis N. , Mason R. Esten , Sarinelli Jose Martin , Brown-Guedira Gina
Published: November 2019

Background

Genomic selection has the potential to increase genetic gains by using molecular markers as predictors of breeding values of individuals. This study evaluated the accuracy of predictions for grain yield, heading date, plant height, and yield components in soft red winter wheat under different prediction scenarios. Response to selection for grain yield was also compared across different selection strategies- phenotypic, marker-based, genomic, combination of phenotypic and genomic, and random selections.

Results

Genomic selection was implemented through a ridge regression best linear unbiased prediction model in two scenarios- cross-validations and independent predictions. Accuracy for cross-validations was assessed using a diverse panel under different marker number, training population size, relatedness between training and validation populations, and inclusion of fixed effect in the model. The population in the first scenario was then trained and used to predict grain yield of biparental populations for independent validations. Using subsets of significant markers from association mapping increased accuracy by 64–70% for grain yield but resulted in lower accuracy for traits with high heritability such as plant height. Increasing size of training population resulted in an increase in accuracy,with maximum values reached when ~ 60% of the lines were used as a training panel. Predictions using related subpopulations also resulted in higher accuracies. Inclusion of major growth habit genes as fixed effect in the model caused increase in grain yield accuracy under a cross-validation procedure. Independent predictions resulted in accuracy ranging between − 0.14 and 0.43, dependent on the grouping of site-year data for the training and validation populations. Genomic selection was “superior” to marker-based selection in terms of response to selection for yield. Supplementing phenotypic with genomic selection resulted in approximately 10% gain in response compared to using phenotypic selection alone.

Conclusions

Our results showed the effects of different factors on accuracy for yield and agronomic traits. Among the factors studied, training population size and relatedness between training and validation population had the greatest impact on accuracy. Ultimately, combining phenotypic with genomic selection would be relevant for accelerating genetic gains for yield in winter wheat.
Antimicrobial susceptibility testing of Enterobacteriaceae: determination of disk content and Kirby-Bauer breakpoint for ceftazidime/avibactam
Authors: Yang Xianggui , Wang Dan , Zhou Qin , Nie Fang , Du Hongfei , Pang Xueli , Fan Yingzi , Bai Tingting , Xu Ying
Published: November 2019

Background

Detection of ceftazidime/avibactam (CAZ/AVI) antibacterial activity is absolutely vital with the rapid growth of carbapenem resistantEnterobacteriaceae(CRE). But now, there is no available automated antimicrobial susceptibility testing card for CAZ/AVI, so Kirby-Bauer has become an economical and practical method for detecting CAZ/AVI antibacterial activity againstEnterobacteriaceae.

Result

In this study, antimicrobial susceptibility testing of CAZ/AVI against 386Enterobacteriaceae(188Klebsiella pneumoniae, 122Escherichia coli, 76Enterobacter cloacae) isolated from clinical patients was performed by broth microdilution. Of the 386 strains, 54 extended spectrum β lactamases negative (ESBL(−)), 104 extended spectrum β lactamases positive (ESBL(+)), 228 CRE. 287 isolates were susceptible to CAZ/AVI and 99 isolates were resistant to CAZ/AVI. At the same time, to obtain optimal content avibactam (AVI) disk containing ceftazidime (30 μg), inhibition zone diameter of four kinds of ceftazidime (30 μg) disk containing different AVI content (0 μg, 10 μg, 25 μg, 50 μg) were tested by Kirby-Bauer method. The microdilution broth method interpretation was used as the standard to estimate susceptible or resistance and then coherence analysis was carried out between Kirby-Bauer and broth microdilution. The result shows the inhibition zone diameter of 30 μg/50 μg disk, susceptible isolates: 20.5 mm–31.5 mm, resistance isolates: 8.25 mm–21.5 mm. The inhibition zone diameter of 30 μg/25 μg disk, susceptible isolates: 19.7 mm–31.3 mm, resistance isolates: 6.5 mm–19.2 mm. The inhibition zone diameter of 30 μg/10 μg disk, susceptible isolates: 19.5 mm–31 mm, resistance isolates: 6.5 mm–11 mm. The inhibition zone diameter of ceftazidime (30 μg), susceptible isolates: 6.5 mm–27.5 mm, resistance isolates 6.5 mm.

Conclusion

Our results show that 30 μg/50 μg, 30 μg/25 μg, 30 μg/10 μg CAZ/AVI disk have significant statistical differences to determinate CAZ/AVI antibacterial activity, but for 30 μg/50 μg disk, there has a cross section between susceptible isolates (minimum 20.5 mm) and resistance isolates (maximum 21.5 mm). For 30 μg/25 μg disk, it is hard to distinguish the difference between susceptible isolates (minimum 19.7 mm) and resistance isolates (maximum 19.2 mm), so 30 μg/10 μg CAZ/AVI disk is more conducive to determinate antibacterial activity.