bluuebunny/crossref_metadata_2025 huggingface dataset:
Differences in Prognostic Factors and Recurrence Patterns After Curative-Intent Resection of Perihilar and Distal Cholangiocarcinomas
Authors: Sallinen V. , Sirén J. , Mäkisalo H. , Lehtimäki T. E. , Lantto E. , Kokkola A. , Nordin A.
Published: February 2019

Background:

Perihilar cholangiocarcinoma and distal cholangiocarcinoma arise from the same tissue but require different surgical treatment methods. It remains unclear whether these cholangiocarcinoma types have different outcomes, prognostic factors, and/or recurrence patterns.

Methods:

This retrospective study evaluated patients who underwent curative-intent resection for perihilar cholangiocarcinoma or distal cholangiocarcinoma at a tertiary academic hospital during 2000–2015. Survival and prognostic factors were identified using Kaplan–Meier and Cox regression analyses.

Results:

The 90-day mortality rates were 0% for perihilar cholangiocarcinoma (36 patients) and 4% for distal cholangiocarcinoma (47 patients). There were no significant differences between perihilar cholangiocarcinoma or distal cholangiocarcinoma in median overall survival (30.9 vs 40.4 months) or median disease-free survival (14.2 vs 21.4 months). Among perihilar cholangiocarcinoma patients, age > 65 years was an independent predictor of poorer overall survival (hazard ratio: 2.45, 95% confidence interval: 1.07–5.64), while requiring bile duct re-resection was an independent predictor of disease-free survival (hazard ratio: 2.76, 95% confidence interval: 1.01–7.51). Among distal cholangiocarcinoma patients, a pN1 category independently predicted poorer overall survival (hazard ratio: 3.40, 95% confidence interval: 1.14–10.11), while preoperative CA19-9 levels >30 U/mL (hazard ratio: 2.51, 95% confidence interval: 1.09–5.79) and pN1 category (hazard ratio: 2.51, 95% confidence interval: 1.09–5.79) predicted a shorter disease-free survival. Local recurrence was more common with perihilar cholangiocarcinoma (50% of recurrences), while multiple synchronous sites were more common for distal cholangiocarcinoma (41% of recurrences).

Conclusion:

Perihilar cholangiocarcinoma and distal cholangiocarcinoma patients have similar survival outcomes. However, local control appears to be more prognostic for perihilar cholangiocarcinoma patients, while positive lymph nodes are critical prognostic factor for distal cholangiocarcinoma patients.
The ties that bind: How the dominance of WeChat combines with guanxi to inhibit and constrain China’s contentious politics
Authors: Wu Yan , Wall Matthew
Published: February 2019

Despite the market dominance of WeChat in contemporary China, we currently know little about its significance for Chinese politics. WeChat enables strong-tie communicative networks, which prior research indicates is consequential for contentious political engagement. Drawing on evidence from focus groups conducted with Chinese citizens in the United Kingdom, we reveal that although WeChat users are often connected through offline social and professional networks, contentious politics manifests on the app only under a narrow range of circumstances. Furthermore, political contention on WeChat is reported by our respondents to be largely confined to matters of ‘interest-oriented’ and/or ‘safe’ topics that do not challenge the wider political system. This trend is driven by a combination of political and cultural dynamics which we elaborate in a theoretically informed thematic analysis, arguing that engaging with the concept of guanxi provides more insight into the political repercussions of WeChat in China than a focus on tie strength.
A great leap of faith: The cashless agenda in Digital India
Authors: Athique Adrian
Published: February 2019

This article assesses the rationale for India’s November 2016 demonetization, in terms of its origins and impact over the following year. I argue that this intervention was conceived and understood as part of a larger international monetary experiment. The article draws upon international media commentary, impact assessments by Indian scholars and the professed goals of the Government of India. Having established a direct link between demonetization and an advancing ‘cashless agenda’ around the world, I situate Narendra Modi’s Digital India programme as the putative foundation for a transactional economy. Drawing upon ethnographic studies exploring the everyday experience of India’s year of living digitally, this article raises the critical question of who must, or indeed can, bear the transaction costs of this digital utopia. In conclusion, I argue that the rapid expansion of digital money situates these concerns at the heart of social and cultural, as much as economic, analysis.
Probation practice in a velvet cage? Specialist court work after probation privatisation in England and Wales
Authors: Robinson Gwen
Published: February 2019

This article presents findings of a study of pre-sentence probation work in Magistrates’ courts in England and Wales in the wake of a process of partial privatisation of probation services in that jurisdiction. Specifically it addresses the subjective experiences of probation workers in two court teams and seeks to make sense of the finding that, despite clear evidence of a process of McDonaldization in the court setting, probation practitioners in this study experienced their work in terms that were largely positive. Using a Weberian analytical framework, it is argued that this finding can only be fully understood with reference to the recent history of unprecedented rupture in the probation arena, and to a generalised perception of the court team as a ‘place of safety’ in an otherwise hostile and turbulent field. Thus, whilst confined in Weber’s metaphorical cage, practitioners experienced this less as a cage of iron than of rubber and velvet.
Pleasure as genre: popular fiction, South African chick-lit and Nthikeng Mohlele's Pleasure
Authors: Frenkel Ronit
Published: February 2019

The success of popular women's fiction requires a mode of analysis that is able to reveal the patterns across this category in order to better understand the appeal of these books. Popular fiction, like chick-lit, can be contradictorily framed as simultaneously constituting one, as well as many genres, if a genre is the codification of discursive properties. It may consist of romances, thrillers, romantic suspense and so forth in terms of its discursive properties, but popular women's fiction will also have a pattern of similarity that cuts across these forms – that similarity, I will suggest, lies in the idea of pleasure as a genre of affect that ties various popular fictions together, thereby acting as a type of imperial genre. Pleasure is so ubiquitous and so diverse across the multiple forms that constitute popular women's fiction that I argue it has become a genre in itself. This is, however, not a genre that limits itself to one particular stylistic form, but rather, as a dynamic social construct, it has become a genre of affect that invokes feelings of pleasure. Nthikeng Mohlele's most recent novel, Pleasure, exemplifies the applicability and plasticity of the concept of pleasure, allowing me to examine this work as a type of fictionalised theory which I then apply to South African chick-lit texts: the Trinity series by Fiona Snyckers and Happiness Is a Four-Letter Word by Cynthia Jele. Mohiele's expansive theorisation of pleasure is inherently local in that it is depicted at the level of experience and imagination; yet it is simultaneously macro and global in the connections made to deeply political circuits of identity-based oppressions and structural inequalities. Mohlele reveals the mobility of pleasure as a genre that offers an opportunity to think through the circuits that connect popular fiction through the lens of African literature.
A cross-case analysis of barriers to sustainability in small tourism accommodation enterprises in Dare County, North Carolina
Authors: Midgett Chelsea , Deale Cynthia S , Crawford Alleah , Weber Melvin , Bendickson Joshua
Published: February 2019

Sustainability, focusing on economic, environmental, and social dimensions, is important to many organizations, especially hospitality and tourism organizations. Yet, for several reasons these organizations may not incorporate sustainable practices. This study expands sustainability knowledge, advertising, education, and barriers. To address these topics, 20 small tourism accommodation enterprise owner/operators were interviewed. A cross-case analysis, using quantitative and qualitative data, comprised the unique methodology of the study. Findings indicated that the majority of small tourism accommodation enterprises had low levels/degrees of understanding about sustainable practices. It is also reasonable to conclude that there was a lack of incorporating sustainability in small tourism accommodation enterprises due to four barriers which included owner/operator’s knowledge, costs, a lack of awareness regarding outside forces, and availability due to location. Implications for the hospitality and tourism industry are discussed.
The interview as an opportunity for participant reflexivity
Authors: Perera Kaushalya
Published: February 2019

This article illustrates participant reflexivity in an interview. Even though scholars have called for ‘a consideration of real-time reflexivity as a means of reconfiguring the participant within epistemological research debates’ (Riach, 2009: 366) illustrations of real-time reflexivity are hard to locate in literature. Most accounts of reflexivity focus on the researcher, and are generally post-research reflections on the research process. This article presents a closely-analysed segment of a semi-structured interview, where the participant changes her position on militarisation in Sri Lankan universities during the interview. This is presented as an instance of realtime participant reflexivity. Using this interview, factors contributing towards reflexivity in interviews are examined and a case made for closer examination of the participant’s reflexivity in qualitative research.
Interpreting retained EU private law post-Brexit: Can commonwealth comparisons help us determine the future relevance of CJEU case law?
Authors: Giliker Paula
Published: February 2019

In June 2016, the United Kingdom voted in a referendum to leave the European Union (EU). The consequences of Brexit are wide-ranging, but, from a legal perspective, it will entail the repeal of the European Communities Act 1972. The UK government does not intend to repeal EU law which is in existence on exit day, but, in terms of the interpretation of retained law, decisions of the Court of Justice of the European Union (CJEU) will no longer be binding after Brexit. Nevertheless, s. 6(2) of the EU (Withdrawal) Act 2018 does allow the UK courts to continue to pay regard to EU law and decisions of the CJEU ‘so far as it is relevant to any matter before the court’. This article will consider the meaning of the phrase ‘ may have regard to anything…so far as it is relevant’. In empowering the courts to consider post-Brexit CJEU authority subject to the undefined criterion of relevancy, how is this power likely to be exercised? A comparison will be drawn with the treatment of Privy Council and the UK case law in Commonwealth courts following the abolition of the right of appeal to the Privy Council, with particular reference to the example of Australia. It will be argued that guidance may be obtained from the common law legal family which can help us predict the future relevance and persuasiveness of CJEU case law in the interpretation of retained EU private law.
To mix or not to mix? Exploring the dispositions to otherness in schools
Authors: Mendoza Manuela
Published: February 2019

This paper discusses literature around school mix (the school’s social diversity) and school mixing (the interactions between students/parents from different backgrounds), and their possible relationship with the development of democratic dispositions. I draw on the current global context, which is moulded by a tension between national ideologies driven by democratic values and the challenges posed by increasing levels of social diversity. Studies addressing the possible effects of school mix argue that both democratic and exclusionary dispositions may emerge depending on the form heterogeneity takes, particularly depending on whether school mix is translated or not into school mixing. Based on Bourdieu’s concept of habitus or dispositions, the paper outlines an analytical framework to conceptualize the possibilities for democratic dispositions to emerge through the experience of social difference.
Terrorist recruitment and prison radicalization: Assessing the UK experiment of ‘separation centres’
Authors: Rushchenko Julia
Published: February 2019

Although correctional institutions are supposed to be strong partners in de-radicalization and disengagement from violence, prisons have historically played an instrumental role in many radical organizations, enabling recruitment of new followers. Recent examples from Europe and the Middle East demonstrate that prisons frequently facilitate the spread of Islamist ideology by providing inmates a platform to forge alliances, exchange experience and recruit potential attackers. Because policies regarding management of terrorism-related offenders can either mitigate or exacerbate the risks of prison radicalization, it is important to evaluate their strengths and weaknesses. This article examines strategies for dealing with Islamism in prisons worldwide (dispersal, containment and mixed approach), focusing on best practices, and assesses the United Kingdom’s experiment of ‘separation centres’ from the point of view of its potential to tackle the spread of Islamism in prisons.
Social Movement Learning and Human Resource Development: An Agenda for a Radical Future
Authors: Sisco Stephanie , Valesano Michael , Collins Joshua C.
Published: February 2019

The Problem

Research concerning how social movements change power relations, policies, and structures in organizations remains unexplored within human resource development (HRD) literature.

The Solution

The purpose of this article is to explore the intersections of HRD and social movement learning (SML) by acknowledging how social movements invite organizations to recognize and learn about social interests and social injustice. A review of concepts concerning collective learning, power and politics, and spatial theory guided the assumptions and claims outlined throughout the article. Three leading suggestions emerged for future consideration: (a) social movements are self-directed and require support, and not direction; (b) HRD is equipped to provide a more holistic understanding of learning and development within and outside the workplace; and (c) organizations that support social movements should demonstrate a genuine interest in their social cause, and not use it merely as an opportunity to build social capital for the organization.

The Stakeholders

The value of social movement learning (SML) is discussed to draw attention to HRD scholars and practitioners, social activists, and employers who aspire to uplift individuals who are excluded and marginalized in society. Prospects to expand the application and scope of HRD are also discussed to reach a broader audience and appreciate the development and learning within social justice initiatives.
Health Literacy Among Canadian Men Experiencing Prostate Cancer
Authors: Seaton Cherisse L. , Oliffe John L. , Rice Simon M. , Bottorff Joan L. , Johnson Steven T. , Gordon Susan J. , Chambers Suzanne K.
Published: February 2019

The objective was to describe the health literacy of a sample of Canadian men with prostate cancer and explore whether sociodemographic and health factors were related to men’s health literacy scores. A sample of 213 Canadian men ( M age = 68.71 years, SD = 7.44) diagnosed with prostate cancer were recruited from an online prostate cancer support website. The men completed the Health Literacy Questionnaire along with demographic, comorbidity, and prostate cancer treatment–related questions online. Of the 5-point scales, men’s health literacy scores were highest for “Understanding health information enough to know what to do” ( M = 4.04, SD = 0.48) and lowest for “Navigating the health care system” ( M = 3.80, SD = 0.58). Of the 4-point scales, men’s scores were highest for “Feeling understood and supported by health care professionals” ( M = 3.20, SD = 0.52) and lowest for “Having sufficient information to manage my health” ( M = 2.97, SD = 0.46). Regression analyses indicated that level of education was positively associated with health literacy scores, and men without comorbidities had higher health literacy scores. Age and years since diagnosis were unrelated to health literacy. Support in health system navigation and self-management of health may be important targets for intervention.
#NiUnaMenos: Data Activism From the Global South
Authors: Chenou Jean-Marie , Cepeda-Másmela Carolina
Published: February 2019

This article explores the creation of a national index of sexist violence in Argentina in 2016 as an example of data activism in the Global South. Drawing upon a qualitative content analysis of press coverage and activist posts on social media, as well as interviews with activists, it describes the context of the #NiUnaMenos feminist mobilization and the collection “from below” of data on gender violence. This study illustrates how activists in the Global South can appropriate technology and promote new uses that not only respond to their local and immediate needs but also contribute to the production of alternative imaginaries on big data in the longer term. Moreover, the article positions women’s movements as an essential component of current social movements in Latin America.
The Possibilities for “Humanizing” Posthumanist Inquiries: An Intra-Active Conversation
Authors: Dernikos Bessie P. , Ferguson Daniel E. , Siegel Marjorie
Published: February 2019

What are the ethical responsibilities of doing and teaching qualitative inquiry at a time when Black and Brown bodies are under assault, an expression of White supremacy that has become ever more visible in the wake of the election of Donald Trump? And how might scholars who “think with” posthumanist theories respond to the call for more “humanizing” methodologies being made by African American and Latinx researchers? This article responds to this moment by presenting a conversation among three literacy scholars about the ethical challenges they have encountered in their own engagements with posthumanist theories, and the implications this has for doing/teaching qualitative inquiry. We call for more openness about the limits as well as the possibilities of posthumanisms, and more attention to ethics for justice. The entanglements of human/nonhuman assemblages in these dangerous times call on us to act, not only think, with theory.
The Efficacy of Cognitive Behavioral Therapy to Treat Depression and Anxiety and Improve Quality of Life Among Early-Stage Breast Cancer Patients
Authors: Sun Haoyao , Huang Hualei , Ji Shengjun , Chen Xiaochen , Xu Yongqing , Zhu Fenglan , Wu Jinchang
Published: February 2019

Purpose: Positive results have appeared among nonmetastatic breast cancer patients with the use of cognitive behavioral therapy (CBT). However, earlier stage patient results have been mixed. This novelty of this study was the focus on stage I and II breast cancer patients. The objective of the current study was to conduct a meta-analysis of psychosocial functions in early-stage breast cancer survivors to determine its efficacy. Methods: A search of Cochrane Library, EMBASE, MEDLINE, PsycInfo, and PubMed yielded 3237 abstracts, which were independently evaluated by research pairs. Meta-analysis was conducted on 8 studies that included a total of 1053 patients. Psychosocial functions were categorized according to 3 domains: (1) anxiety, (2) depression, and (3) quality of life. Results: Improvement in anxiety was observed in patients treated with CBT relative to controls without CBT ( P = .04). Depression and quality of life improvement was not observed in the CBT group within or after 4 months of treatment ( P > .05). Conclusions: The results indicated that observed improvements in anxiety in patients with early-stage breast cancer were moderate. The effectiveness of CBT for the improvement of patient outcomes could not be determined, given the methodological and clinical shortcomings of the included trials.
Lower Extremity Amputation among Diabetic Patients in San Antonio, Texas
Authors: Sunil Thankam , Limon Amanda , Ochoa Lyssa
Published: February 2019

Background:

In the United States, ethnic minorities are disproportionately affected by diabetes-related lower extremity amputations (LEA) and have higher associated mortality rates than non-Hispanic Whites. Bexar County, a county in south Texas, had higher diabetes rates than both Texas and the national average. Bexar County also had one of the highest LEA hospital admission rates in the State.

Aim:

Elucidate diabetes-related LEA factors to assist policy makers and health professionals develop more effective interventions.

Results:

For participants who had more than one amputation, the time between amputations was approximately 1 year. Hispanics endorsed more diabetic health beliefs than non-Hispanic Whites. Participants 64 and younger reported greater social support and greater depression symptomatology than participants 65 and older. Participants with an amputation reported greater ability to engage in activities that would manage their diabetes than participants without an amputation. Participants without an amputation reported greater concern of their general health than participants with an amputation.

Conclusion:

The present study demonstrated the necessity for more research on diabetic amputation and related depression among Hispanics. The study also highlighted the need to create culturally appropriate interventions to reduce the rate and frequency of additional amputations.
Using Modified Schema-Based Instruction with Technology-Based Supports to Teach Data Analysis
Authors: Root Jenny R. , Cox Sarah K. , Gonzalez Stephanie
Published: February 2019

Data analysis inherently requires problem solving, yet it is the most understudied mathematical skill for individuals with extensive support needs. The current study taught elementary students with extensive support needs (i.e., autism and intellectual disability) to solve math word problems requiring analysis of scaled pictographs through modified schema-based instruction on an iPad. Results of the single-case multiple probe across participants design found a functional relation between the iPad-based math intervention and math problem solving, with a large effect size (Tau-U = .96) confirming visual analysis. In addition, participants were able to generalize problem-solving skills when they were presented with data analysis problems from grade-level social studies textbooks and visual supports were faded. Implications for practice and future research in teaching mathematics to learners with extensive support needs are discussed.
Proposal for Treatment of Severe Dupuytren Disease in 2 Steps: Progressive Distraction With External Fixator and Collagenase - A Preliminary Case Series
Authors: Corain Massimo , Zanotti Filippo , Sartore Roberta , Pozza Paolo
Published: February 2019

Background: We want to describe a treatment for advanced Dupuytren disease using a spanning external fixator (EF) applied dorsally to produce progressive extension, followed by collagenase injection. Methods: Between October 2014 and September 2016, a total of 22 fingers from 18 patients were treated with an EF. The devices were implanted under local anesthesia, and the patients were instructed to gradually extend the hinge to gain a progressive extension. The EF was removed in an outpatient clinic setting after obtaining a complete extension of the treated joint in a mean of 19 days (range 15-22 days), and a collagenase injection was performed in the residual cord after a mean of 20 days (18-24 days), followed by splinting. Results: All patients were evaluated at an average follow-up of 14 months (range 3-23 months): the total average residual flexion deformity was 9.7° (range 0°-19°) with a correction of 107.2° (range 94°-138°), the average flexion deformity of the proximal interphalangeal joint was 7.4° (range 0°-15°) with a correction of 64.4° (range 46°-92°), and the average flexion deformity of the metatarsophalangeal joint was 2.4° (range 0°-9°) with a correction of 42.8° (range 15°-59°). No complications were reported in relation to EF treatment. Two cases of cutaneous laceration after collagenase injection were observed, neither of which required any additional treatment. Conclusions: All patients obtained a regression from 2 to 3 stages in disease severity only with EF. We had no report of complications due to the device. After collagenase injection and splinting, we obtained further finger extension with a mean total residual flexion deformity of 9.7° at 14-month follow-up.
Spatial navigation ability and gaze switching in older drivers: A driving simulator study
Authors: Kunishige Masafumi , Fukuda Hiroshi , Iida Tadayuki , Kawabata Nami , Ishizuki Chinami , MIyaguchi Hideki
Published: February 2019

Objective

Driving ability in older people is affected by declining motor, cognitive and visual functions. We compared perceptual and cognitive skills and driving behaviour in a Japanese population.

Methods

We used a driving simulator to measure the effects of spatial navigation skills and eye movements on driving ability. Participants were 34 older and 20 young adults who completed a simulated driving task involving a lane change and a right turn at an intersection. We used an eye tracker to measure gaze. We measured visual recognition (Benton Judgment of Line Orientation Test (BJLO)), spatial navigation (Card-Placing Test (CPT A & B)), visual perception (Raven’s Colored Progressive Matrices (RCPM)) and driving ability (Stroke Drivers’ Screening Assessment).

Results

Older participants scored significantly lower on the BJLO, CPT-A & B and RCPM, showed a significant correlation between gaze time and CPT-A & B scores (both p < .01) and had a longer gaze time. There were significant between-group differences in saccade switching (p < .01 right turn), distance per saccade (p < .05 for right turn and lane change) and saccade total distance (p < .05 right turn; p < .01 lane change). There was an association between age and rate of gaze at the right door mirror (p = 0.04).

Conclusion

The findings indicate that older drivers have poorer eye movement control and spatial navigation. This is likely to result in delayed responses and difficulties in predicting the on-coming driving environment. Driving simulation could help older drivers in their driving abilities.
Unveiling the Unspeakable: Integrating Video Elicitation Focus Group Interviews and Participatory Video in an Action Research Project on Dementia Care Development
Authors: Li Bing Yu , Ho Rainbow Tin Hung
Published: February 2019

With the intention to comprehensively reflect the reality, foster interactions between researchers and participants, and empower the marginalized groups to be heard, videos are increasingly used in health studies. The findings of an action research project that integrates video-based methods into the development of dementia care in an aged care home in Hong Kong are reported. A working alliance consisted of practitioners, community-dwelling volunteers, service managers, university educators, and researchers was formed to develop a sustainable, need-based play program for the institutionalized elderly with dementia (EWD). Two innovative methods, namely, video elicitation focus group interview (VEFI) and participatory video (PV), were applied. Data analyses were collaboratively conducted by all practitioner-researchers during eight reflexive sessions. Several short films were made through PV for institutional training and community education. VEFI effectively enhanced the practitioners’ understanding of the embodied expressions of the EWD and provided a reflexive, democratic environment to generate knowledge among practitioner-researchers. Counter-narratives of the EWD and educational materials on dementia care were generated through PV. The study demonstrates how innovative video-based methods may enable participatory health research to be more inclusive, engaging, and empowering, and how these methods may provide new perspectives on the ethics of researching vulnerable populations.
Improvements of direct current motor control and motion trajectory algorithm development for automated guided vehicle
Authors: Zhang Panlong , Wang Zhongcheng
Published: February 2019

The precise control of the two-wheel independent drive motor speed of automated guided vehicle is the prerequisite for high-precision operation of its actuator. The optimization of motor control performance has been a topic of concern to researchers. First, the model identification of direct current motor is done. Second, there are two control strategies, including parallel proportional–integral–differential control strategy and the coupling proportional–integral–differential control strategy, which are researched and compared for the direct current motor control system of automated guided vehicle in dispatching the goods from one location to another with greater ease. Finally, the motion trajectory algorithm of automated guided vehicle is also proposed on the basis of kinematics theory. Besides, the above control strategies and algorithm improved for automated guided vehicle are simulated by the MATLAB tool and the experimental simulations by Kinect sensor, and the simulation results show that the coupling proportional–integral–differential control strategy is slightly better in controlling performance because of some smaller cumulative errors and the better start performance. Meanwhile, the motion trajectory algorithm of automated guided vehicle under both the control strategies can achieve different effects in different control cases.
The spectacle of Discipline and Punish: The tableau, the diagram and the calligram
Authors: Fuggle Sophie
Published: February 2019

This article returns to Michel Foucault’s Discipline and Punish in order to consider its continued relevance for thinking about the representation of incarceration today beyond categories of ‘spectacle’ and ‘surveillance’. In order to rethink the text in relation to contemporary scholarship on visual criminology, it will explore the visual elements of Discipline and Punish in more detail via the concepts of the ‘tableau’ and the ‘diagram’ found in Gilles Deleuze’s Foucault. These concepts will be supplemented by the notion of the ‘calligram’, drawing on Foucault’s 1968 essay ‘Ceci n’est pas une pipe’ in order to explore what is at stake in current representations of incarceration via a specific engagement with offender art. Evoking Jacques Rancière’s notion of curiosity as a critique of the ‘intolerable image’, the article will suggest ways in which the relationship between the academic scholar qua ‘penal spectator’ and the ‘represented’ incarcerated subject can be reconfigured to produce a more critical, empathetic and socially responsible engagement with such representations.
Validation and iteration of CT perfusion defined malignant profile thresholds for acute ischemic stroke
Authors: Keenan Kevin J , Christensen Soren , Inoue Manabu , Mlynash Michael , Albers Gregory W , Smith Wade S
Published: February 2019

Background

Malignant profile computed tomography perfusion (CTP) lesions are associated with poor outcomes after administration of intravenous tissue-plasminogen activator (IV-tPA) for ischemic stroke.

Aims

To determine whether published CTP-based lesion thresholds predictive of poor outcomes in a predominantly 8 cm of CTP anatomic coverage cohort would predict poor outcomes in an independent 4 cm of CTP anatomic coverage cohort and to generate optimized 4 cm CTP thresholds.

Methods

Ischemic stroke patients with baseline CTP imaging with 4 cm of anatomic coverage before receiving IV-tPA at a single institution were retrospectively studied. Perfusion lesion time to maximum of tissue residue function (Tmax) and cerebral blood flow (CBF) volumes were determined using RAPID automated software. Fisher's exact tests assessed associations between lesion thresholds and outcomes. Receiver operating characteristic (ROC) curves generated optimized thresholds for 4 cm of CTP coverage.

Results

Sixty-three patients were included. Poor outcomes were associated with published thresholds of Tmax >6 s > 103 mL, Tmax > 8 s > 86 mL, and Tmax > 10 s > 78 mL but not CBF core >53 mL. Thresholds optimized for 4 cm of CTP coverage and associated with poor outcomes were Tmax > 6 s > 100 mL, Tmax > 8 s > 65 mL, Tmax >10 s > 46 mL, and CBF core >39 mL.

Conclusions

We validated the ability of published CTP Tmax lesion volume thresholds to predict poor outcomes despite IV-tPA in an independent cohort using only 4 cm of CTP anatomical coverage. A CBF > 39 mL threshold, rather than the predominantly 8 cm CTP coverage derived CBF threshold of >53 mL, was associated with poor outcomes in this 4 cm CTP coverage cohort.
Anthology of stroke epidemiology in the 20th and 21st centuries: Assessing the past, the present, and envisioning the future
Authors: Feigin Valery L
Published: February 2019

This narrative overview of stroke epidemiology shows dramatic changes in stroke incidence, prevalence, mortality, disability, and the understanding of risk factors and primary stroke prevention strategies over the last few decades. Likely future directions of stroke epidemiology and prevention are outlined.
Recrudescence of Old Stroke Deficits Among Transient Neurological Attacks
Authors: Jun-O’connell Adalia H. , Henninger Nils , Moonis Majaz , Silver Brian , Ionete Carolina , Goddeau Richard P.
Published: February 2019

Background:

Recrudescence of old stroke deficits (ROSD) is a reported cause of transient neurological symptoms, but it is not well characterized.

Objective:

We sought to determine the prevalence, potential triggers, and clinical outcome of ROSD in a cohort of patients presenting with acute transient neurological attack (TNA) and absent acute pathology on brain imaging.

Methods:

We retrospectively analyzed 340 consecutive patients who presented with TNA and no acute pathology on brain imaging that were included in an institutional stroke registry between February 2013 and April 2015. The presumed TNA cause was categorized as transient ischemic attack (TIA), ROSD, and other cause. Baseline characteristics, triggers, cardiovascular complications within 90 days, and death were recorded.

Results:

The prevalence of ROSD in the studied cohort was 10% (34/340). Infectious stressors and acute metabolite derangements were more common in ROSD compared to TIA ( P < .05, each). Compared to TIA and the other TNA, ROSD was more likely to have more than 1 acute stressor ( P < .001). Patients with ROSD had similar vascular risk factors compared to TIA ( P > .05), including hypertension, diabetes mellitus, peripheral vascular disease, hyperlipidemia, and similarly used HMG-CoA reductase inhibitor, antihypertensive, and antiplatelet medications. Among the patients with an available 90-day follow-up (n = 233), cardiovascular events were more frequent in the TIA group as compared to other TNA ( P < .05).

Conclusion:

ROSD is common and distinct from TIA and is associated with a triggering physiologic reaction leading to transient reemergence of prior neurologic deficits. Further study of the mechanism of this phenomenon is needed to help better identify these patients.
Rates and Trends of Endotracheal Intubation in Patients With Status Epilepticus
Authors: Alkhachroum Ayham M. , Rubinos Clio , Chatterjee Abhinaba , Chen Monica L. , Martin Andrew , Claassen Jan , Murthy Santosh B. , Merkler Alexander E.
Published: February 2019

Objective:

Among patients with status epilepticus, we sought to determine the rate of endotracheal intubation, identify the physician specialties responsible for endotracheal intubation, and characterize the trend in use of endotracheal intubation over the last 20 years.

Methods:

We performed a cross-sectional study using data from 2 sources. First, we used inpatient claims between 2009 and 2015 from a nationally representative 5% sample of Medicare beneficiaries. Patients with status epilepticus were identified using International Classification of Diseases, 9th Revision, Clinical Modification ( ICD-9-CM) codes, and those who underwent endotracheal intubation were identified based on Current Procedural Terminology codes. Medical specialties of providers performing intubation were identified based on Healthcare Provider Taxonomy Codes. Second, we used claims data from the National Inpatient Sample (NIS) to estimate the annual rates and trends of endotracheal intubation and tracheostomy among patients with status epilepticus from 1995 to 2014.

Results:

Among 1971 Medicare beneficiaries with status epilepticus, 566 (29%) patients underwent endotracheal intubation. 375 (66%) patients were intubated on admission. The most common medical providers performing intubation in patients with status epilepticus were emergency medicine physicians (50.4%), anesthesiologists (16.4%), and pulmonary medicine physicians (10.1%). Neurologists accounted for 1.7% of all intubations. Among individuals with status epilepticus identified in the NIS, 248 681 (41.7%) were intubated. The proportion of patients intubated increased from 29.5% (95% confidence interval [CI]: 27.8%-31.3%, P = .018) in 1995 to 50.8% (95% CI: 49.6%-52%, P = .012) in 2014. The proportion of patients with status epilepticus who underwent tracheostomy increased from 2.2% (95% CI: 1.7%-2.7%, P = .005) in 1995 to 3.4% (95% CI: 3%-3.9%, P = .004) in 2014.

Significance:

Approximately 1 in 3 patients with status epilepticus undergo endotracheal intubation. Over the last 20 years, the proportion of patients with status epilepticus undergoing endotracheal intubation has almost doubled. Neurologists perform a small percentage of these intubations.
Posterior quadrantic dysplasia with localized hemimegalencephaly in a patient with giant congenital melanocytic nevus: First case report
Authors: Kumar Ishan , Aggarwal Priyanka , Rai Tulika , Gupta Vineeta
Published: February 2019

Giant congenital melanocytic nevus (GCMN) is associated with neurocutaneous melanocytosis and various other neurological complications. Its association with migrational anomalies of the brain is extremely rare. Herein, we document the first case of GCMN in a one-day-old baby associated with localized hemimegalencephaly (HME) of the brain with extensive malformation of cortical development including polymicrogyria, pachygyria and sublobar dysplasia, limited to an enlarged quadrant of the brain. HME and GCMN are considered embryological anomalies of cell migration and proliferation. We discuss the unusual magnetic resonance imaging findings along with a brief review of the literature. To the best of our knowledge, our case is the first to report the association of GCMN with localized HME.
Body fat estimates from bioelectrical impedance equations in cardiovascular risk assessment: The PREVEND cohort study
Authors: Byambasukh Oyuntugs , Eisenga Michele F , Gansevoort Ron T , Bakker Stephan JL , Corpeleijn Eva
Published: February 2019

Aims

To investigate prospectively the association of body fat percentage (BF%) estimates using various equations from bioelectrical impedance analysis (BIA) with cardiovascular events, compared with body mass index (BMI) and waist circumference.

Methods and results

We used data of 34 BIA-BF%-equations that were used for estimation of BF% in 6486 (men = 3194, women = 3294) subjects. During a median follow-up of 8.3 years, 510 (7.9%) cardiovascular events (363 in men; 147 in women) occurred. In men, the crude hazard ratio (95% confidence interval) for BF% from the best predicting BIA-BF%-equation was 3.97 (3.30–4.78) against 2.13 (1.85–2.45) for BF% from the BIA device's BIA-BF%-equation, 1.34 (1.20–1.49) for BMI and 1.49 (1.40–1.73) for waist circumference per log-1-SD increase of all. In women, the hazard ratios for best predicting BIA-BF%-equation, BIA device estimation, BMI and waist circumference were 3.80 (2.85–4.99), 1.89 (1.57–2.28), 1.35 (1.21–1.51) and 1.52 (1.31–1.75), respectively. After adjustments for age, Framingham cardiovascular disease risk score and creatinine excretion – a marker of muscle mass – BF%s and BMI remained independently associated with cardiovascular events in both men and women, while waist circumference was independently associated with cardiovascular events in men, but not in women. According to discrimination ability (C-index) and additive predictive value (net reclassification index and integrated discrimination index) on obesity measures to the Framingham cardiovascular disease risk score, BF% was superior to BMI and waist circumference in both men and women.

Conclusions

BF% was independently associated with future cardiovascular events. Body fat estimates from the best-predicting BIA-BF%-equations can be a more predictive measurement in cardiovascular risk assessment than BMI or waist circumference.
Fait accompli, or live to fight another day? Deterring and surviving coups in authoritarian regimes
Authors: Olar Roman-Gabriel
Published: February 2019

Current explanations of coup activity focus on the regime factors that makes them more likely to be successful rather than what them more likely to occur. While 60% of all coups succeed in autocracies, there has been less attention to the 40% that do not. Current empirical approaches testing the effect of legislatures on coup success implicitly treat the decision to attempt a coup as random and relegates it into the model’s residuals. This article discusses why this empirical approach is theoretically unrealistic and shows that the selection effect of coup attempt and success should be empirically accounted for. The analysis replicates and extends Bove and Rivera’s (2015) study on autocrats’ strategies to prevent coups, and it demonstrates that (a) institutionalisation reduces the risk of coup onset by 50%, (b) after accounting for the factors influencing coup attempt, an elected legislature does not by itself, help autocrats survive coups, and (c) purges increase the likelihood of coup attempts, but reduce their likelihood of success.
Five-Strand Hamstring Autografts for Anterior Cruciate Ligament Reconstruction: A Systematic Review
Authors: Smith John-Rudolph H. , Houck Darby A. , Hart Jessica A. , Vidal Armando F. , Frank Rachel M. , Bravman Jonathan T. , McCarty Eric C.
Published: February 2019

Background:

Recent studies have described surgical techniques to increase the hamstring graft diameter for anterior cruciate ligament reconstruction (ACLR), particularly for 5-strand hamstring (5HS) autografts.

Purpose:

To review the literature examining the biomechanical and clinical outcomes of 5HS autografts for ACLR.

Study Design:

Systematic review; Level of evidence, 3.

Methods:

A systematic review using PRISMA (Preferred Reporting Items for Systematic Meta-Analyses) guidelines was performed by searching PubMed, Embase, and the Cochrane Library for studies reporting the biomechanical and clinical outcomes of 5HS autografts. All English-language literature published from 2012 to 2018 that reported the biomechanical properties of 5HS grafts and/or clinical outcomes after ACLR with 5HS autografts with a minimum 1-year follow-up was reviewed by 2 independent reviewers. Graft diameter, stiffness, displacement, strength, failure rates, anteroposterior knee laxity, and patient-reported outcome scores were collected. The study methodology was evaluated using the modified Coleman Methodology Score.

Results:

Two biomechanical and 3 clinical studies (1 with level 2 evidence, 2 with level 3 evidence) were included. The biomechanical studies compared the results of fourteen 4-strand hamstring (4HS) and fourteen 5HS graft specimens for ACLR (ovine grafts, n = 12; cadaveric grafts, n = 16) and found no significant differences in ultimate load, stiffness, displacement, and stress relaxation ( P > .05), likely attributed to insufficient incorporation of the fifth strand. The mean 5HS cadaveric graft diameter (8.2 mm) was significantly greater than that of 4HS grafts (6.8 mm) ( P = .002), whereas the mean ovine graft diameters were not significantly different (4HS, 5.2 mm; 5HS, 5.3 mm) ( P > .05). Two clinical studies compared the outcomes after ACLR of 53 patients with a 4HS autograft versus 62 patients with a 5HS autograft, while 1 clinical study reported the outcomes of 25 patients after ACLR with a 5HS autograft (mean age, 28.7 years; mean follow-up, 24.8 months). The overall mean diameter for 4HS and 5HS autografts was 8.4 and 9.1 mm, respectively. There was no significant difference in failure rates between 4HS and 5HS autografts ( P = .82). None of the comparative studies reported significant differences in any clinical outcomes ( P > .05 for all).

Conclusion:

The available literature on traditional 4HS and 5HS autografts for ACLR is limited. Of the available data, clinical and biomechanical studies suggest no difference in outcomes after ACLR with either graft construct. Additional research is needed to determine whether creating a 5HS graft is beneficial.
“The Leopard Does Not Change Its Spots”: Structuration Theory and the Process of Managerial Decision-Making Regarding Popular Management Theories
Authors: Pagel Sonya , Westerfelhaus Robert
Published: February 2019

Popular management theories (PMTs) significantly influence how organizations are run. To date, scholarship investigating the PMT phenomenon has focused on their perceived popularity, relative merits, and dissemination patterns, while ignoring the decision-making processes of the managers who constitute PMTs’ prime audience. This study departs from that research tradition by drawing upon data collected from 22 interviews with upper- and mid-level managers. The authors employ structuration theory to chart the structural features influencing managerial decisions regarding PMTs at three sites of structuration: conception, implementation, and reception. And, they point out how tensions between and among the sites prompt and constrain organizational change. The authors contend that the play between these contradictory impulses ultimately determine the extent to which, if at all, managers pursue full or partial implementation of a particular PMT or reject it and explore other options.
Improving Localization and Speech Reception in Noise for Bilateral Cochlear Implant Recipients
Authors: Potts Wendy B. , Ramanna Lakshmish , Perry Trevor , Long Christopher J.
Published: February 2019

This study looked at different methods to preserve interaural level difference (ILD) cues for bilateral cochlear implant (BiCI) recipients. One possible distortion to ILD is from automatic gain control (AGC). Localization accuracy of BiCI recipients using default versus increased AGC threshold and linked AGCs versus independent AGCs was examined. In addition, speech reception in noise was assessed using linked versus independent AGCs and enabling and disabling Autosensitivity™ Control. Subjective information via a diary and questionnaire was also collected about maps with linked and independent AGCs during a take-home experience. Localization accuracy improved in the increased AGC threshold and the linked AGCs conditions. Increasing the AGC threshold resulted in a 4° improvement in root mean square error averaged across all speaker locations. Using linked AGCs, BiCI participants experienced an 8° improvement for all speaker locations and a 19° improvement at the speaker location most affected by the AGC. Speech reception threshold in noise improved by an average of 2.5 dB when using linked AGCs versus independent AGCs. In addition, the effect of linked AGCs on speech in noise was compared with that of Autosensitivity™ Control. The Speech, Spatial, and Qualities of Hearing Scale-12 question comparative survey showed an improvement when using maps with linked AGCs. These findings support the hypothesis that ILD cues may be preserved by increasing the AGC threshold or linking AGCs.