bluuebunny/crossref_metadata_2025 huggingface dataset:
Driving Style Clustering using Naturalistic Driving Data
Authors: Chen Kuan-Ting , Chen Huei-Yen Winnie
Published: May 2019

Knowledge of driving styles may contribute to traffic safety, riding experience, and support the design of advanced driver-assistance systems or highly automated vehicles. This study explored the possibility of identifying driving styles directly from driving parameters using data from the Strategic Highway Research Program 2 database. Partitioning Around Medoids method was implemented to cluster driving styles based on 14 variables derived from time series records. Principal component analysis was then conducted to understand the underlying structure of the clusters and provide visualization to aid interpretation. Three clusters of driving styles were identified, for which the influential differentiating factors are speed maintained, lateral acceleration maneuver, braking, and longitudinal acceleration. Chi-square test of homogeneity was performed to compare the proportions of trips assigned to the three driving style clusters across levels of each driver attribute (age, gender, driving experience, and annual mileage). The results showed that all four attributes examined had an impact on how the trips were clustered, thus suggesting that the clusters capture individual differences in driving styles to some extent. While our results demonstrate the potential of naturalistic vehicle kinematics in capturing individuals’ driving styles, it was also possible that the identified clusters were classifying mostly drivers’ transient behaviors rather than habitual driving styles. More vehicle parameters and information about road conditions are necessary to obtain deeper insights into driving styles.
Dynamiques entre catégories de marchés : une étude de l’(in)visibilité du marché de la mode grande taille
Authors: Dion Delphine , Tachet Béatrice
Published: May 2019

Résumé

En étudiant le marché de la mode, cette recherche analyse le rapport de domination existant entre deux catégories de marché : un marché principal, celui de la mode conventionnelle et un marché secondaire, la mode grande taille. Elle observe les dynamiques à partir des pratiques et dispositifs matériels qui créent l’(in)visibilité symbolique et physique des catégories de marché. Ce travail ouvre de nouvelles perspectives sur la compréhension des dynamiques de marché. Premièrement, l’article montre que la catégorisation n’est pas seulement une question de représentations, de discours ou d’interactions sociales, mais implique aussi des dispositifs matériels. La matérialité apparait comme un dispositif de visibilité et d’invisibilité. Deuxièmement, l’article met en avant les enjeux de la visibilité sociale. Derrière l’invisibilité physique (ne pas être vu, être caché…) se cache l’invisibilité sociale (ne pas exister socialement). D’où le sentiment de stigmatisation et d’exclusion des femmes rondes.
“It Changed My Life”: Traumatic Loss, Behavioral Health, and Turning Points Among Gang-Involved and Justice-Involved Youth
Authors: Dierkhising Carly B. , Sanchez Jose A. , Gutierrez Luis
Published: May 2019

An especially vulnerable population to traumatic loss, violence exposure, and posttraumatic stress symptoms are those involved in the juvenile justice system. However, justice-involved youth are not a homogeneous group. Research looking at subpopulations within juvenile justice systems highlight the diverse backgrounds and treatment needs of justice-involved youth such as those who are also gang-involved. The current study seeks to address the interrelated issues of behavioral health, traumatic grief, loss, and self-reported turning points among a sample of formerly incarcerated youth who report extensive juvenile justice histories ( N = 62). All youth participated in an extensive survey interview. Just over half (56.5%) of the youth reported being gang-involved. Chi-square analyses revealed that gang- and justice-involved youth were significantly more likely to have experienced traumatic loss compared with their justice-only peers (χ2 = 4.265, p < .05). Gang involvement approximately doubled youth’s exposure to community violence, both direct and witnessed, and there were significant differences in the levels of posttraumatic stress symptoms and substance use, between the gang- and justice-involved youth compared with the justice-only youth. When asked to describe a turning point in their lives, 15% of the sample described significant loss and how it affected their lives, for better or worse. Findings lend support for a focus on supporting posttraumatic growth and increasing access to trauma-focused treatment, with an emphasis on grief and loss, for those who are both gang- and justice-involved.
Analytical study of tensegrity lattices for mass-efficient mechanical energy absorption
Authors: Goyal Raman , Peraza Hernandez Edwin A , Skelton Robert E
Published: May 2019

This article studies tensegrity structures known as “D-bar” systems for applications as lightweight components for mechanical energy absorption. Aerospace structures such as planetary landers, designed to absorb energy from large impact loads while requiring minimal mass, would benefit from such components. Previous studies showed that D-bar systems support compressive loads with minimal mass compared with continuum options such as single columns. In this work, analytical equations for the mechanical (elastic) energy stored in D-bar systems of any complexity (a quantity proportional to the number of strings/bars in the system) are derived for the first time. The energy stored in D-bar systems is compared with that of bent buckled beams used in “flexible-bar tensegrity” concepts, which were proposed in the literature as energy absorption components for planetary landers. Comparisons are made between D-bar systems and bent buckled beams as isolated components subjected to a compressive load and as components of planetary landers. In all comparisons, the results show that D-bar systems of low complexity allow for higher energy storage and lower mass than bent buckled beams. Thus, it is concluded that D-bar systems can enhance the design of planetary landers and other applications that need lightweight mechanical energy absorption components.
A new modern pollen dataset describing the Brazilian Atlantic Forest
Authors: Montade Vincent , Ledru Marie-Pierre , Giesecke Thomas , Flantua Suzette GA , Behling Hermann , Peyron Odile
Published: May 2019

To improve our understanding of the Atlantic Forest responses to climate changes in space and time, it is essential to explore how the Brazilian Atlantic rain forest is structured as observed in modern pollen assemblages and which climate parameters determine these patterns. In this context, we compiled 196 modern pollen samples including 125 from the Atlantic Forest biome and assigned each sample to one or more eco-physiognomies. We identified seven eco-physiognomies of which four clusters of one or two eco-physiognomies were clearly distinguished, namely (1) Araucaria forest with high elevation grassland, (2) lowland rain forest, (3) semi-deciduous with riverine forests and (4) northeastern Atlantic rain forest. Climatically distinct, these clusters reflect a general temperature increase and precipitation increase from the first to the fourth cluster. Furthermore, comparison of the modern pollen dataset with the Côlonia pollen record from southeastern Brazil revealed that vegetation attributed to Araucaria forest with high elevation grassland showed an important variability with several shifts towards the lowland rain forest. As illustrated by comparison with the long fossil pollen record of Côlonia, developing such a modern training set is crucial for the understanding of responses of Atlantic Forest to environmental changes. However, additional samples are still necessary to improve characterization of different eco-physiognomies at a local scale following a defined floristic and climatic gradient. This sampling effort is becoming increasing urgent as a result of strong biodiversity loss and habitat destruction in this region.
Cytoprotective effects of taxifolin against cadmium-induced apoptosis in human keratinocytes
Authors: Moon SH , Lee CM , Nam MJ
Published: May 2019

Cadmium (Cd) is a heavy metal widely used in industry, and the skin is an important target of this metal. Taxifolin (Tax), a natural source of bioflavonoids found in various conifers, exerts multiple biologic effects on skin cells. However, the mechanisms by which Tax protects keratinocytes against Cd are currently unclear. We investigated the cytoprotective effects of Tax against Cd-induced apoptosis in the human HaCaT keratinocyte. The water-soluble tetrazolium salt (WST-1) assay and Annexin V/propidium iodide double-staining assay results showed that Cd-induced cell death was lower in cells treated with Tax (0–100 μM) than in cells treated with Cd alone. Additionally, a reduction of Cd-induced DNA fragmentation by Tax was shown by terminal deoxynucleotidyl transferase (TdT)-mediated dUTP nick-end labeling assay. The levels of reactive oxygen species were also lower in Cd/Tax-treated cells than in Cd-treated cells. We employed a two-dimensional electrophoresis-based proteomic analysis to identify treatment-related alterations in protein expression. Tax downregulated cathepsin B and D and upregulated hsp27, cyclophilin A, and peroxiredowin-1. Western blotting confirmed the downregulation of cathepsin B and D and the upregulation of hsp27. The cytoprotective effects of Tax against Cd-induced apoptosis were also characterized by the changes in the activity of caspase 3, -7, poly ADP-ribose polymerase, the cellular proliferation-related ERK1/2, and AKT. Furthermore, the levels of cell cycle-related proteins, such as SP1 and p21, decreased, whereas p53 level increased. We concluded that Tax reduced Cd cytotoxicity and Cd-induced apoptosis by inhibiting the apoptotic pathway.
Antibacterial wood-plastic composite produced from treated and natural dyed wood fibers
Authors: Jamili Fatemeh , Mirjalili Mohammad , Zamani Hasan Ali
Published: May 2019

The main goal of the present study was the fabrication of wood/polyvinyl chloride (WPVC) composite with enhanced properties. In this regard, the wood fibers were primarily bleached with sodium chlorite and then dyeing of fibers was carried out with green walnut shells as a natural dye. Influences of natural dye on color, antibacterial, and mechanical properties of the composite were investigated. The WPVC composite showed excellent antibacterial activity measured against two common pathogenic bacteria including Escherichia coli and Staphylococcus aureus. Also, negligible toxicity of the composite was proven with cytotoxicity test. Furthermore, the color variation of the bleached sample after light irradiation was negligible, which demonstrated the proper colorfastness of the composite.
Inflation and Fiscal Deficit in India: An ARDL Approach
Authors: Kaur Gurleen
Published: May 2019

Global financial crisis of 2008 which marked its 10th anniversary recently has intensified the problem of fiscal deficit and inflation which happen to be the two foremost macroeconomic challenges confronting the Indian economy. In the light of unsettled debate pertaining to the inflationary tendencies of fiscal deficit, the present study attempts to empirically examine the important macroeconomic determinants of inflation in India and investigates whether the proposition of a positive effect of fiscal deficits on inflation can be verified in the particular case of the Indian economy using quarterly data from Q1: 1996–1997 to Q1: 2016-2017. The ARDL Bounds approach to cointegration reveals the existence of long-run relationship between inflation; gross fiscal deficit; money supply; exchange rate; crude oil prices; and output gap. The long-run and short-run dynamics indicate that gross fiscal deficit and money supply generate negative impact on inflation in India. From the supply side, crude oil prices and exchange rate are found to be playing an important role in determining domestic prices. From the demand side, in the absence of a stronger output-inflation relationship, the support for flexible inflation targeting framework does get encumbered as the case for the existence of Phillips curve in India further weakens through our analysis. This result bears significance especially in the context of a switch to a rule based anti-inflationary strategy in India.
A Mediation Effect of Job Satisfaction and Affective Commitment in Relationship Between Passion and Work Intentions after Retirement
Authors: Tarkar Preeti , Dhamija Somesh , Singh Pawan
Published: May 2019

The aim of this study is to identify an intention towards work after retirement. This article examines the multilevel sequential mediating role of job satisfaction and affective commitment in the relationship between passion for work and intention towards work. This study has used 310 respondents retired from government jobs and data are collected through a well-administered questionnaire. Smart partial least square-structural equation modelling (SmartPLS-SEM) was used to analyse data. Path analysis of the structural model revealed that passion for work has a significant relationship with job satisfaction, affective commitment and intention towards work. The findings of the analysis show that the multilevel mediator model is significant ( β = 0.08, p < 0.05) at the 5 per cent level of significance. This study supports the satisfaction-commitment model and creates intention towards work after retirement. This research is unique in the sense that it relates passion for work and satisfaction-commitment model with the work intentions of the retired persons.
Holistic Conceptualizations of Health by Incarcerated Aboriginal Women in New South Wales, Australia
Authors: Kendall Sacha , Lighton Stacey , Sherwood Juanita , Baldry Eileen , Sullivan Elizabeth
Published: May 2019

While there has been extensive research on the health and social and emotional well-being (SEWB) of Aboriginal women in prison, there are few qualitative studies where incarcerated Aboriginal women have been directly asked about their health, SEWB, and health care experiences. Using an Indigenous research methodology and SEWB framework, this article presents the findings of 43 interviews with incarcerated Aboriginal women in New South Wales, Australia. Drawing on the interviews, we found that Aboriginal women have holistic conceptualizations of their health and SEWB that intersect with the SEWB of family and community. Women experience clusters of health problems that intersect with intergenerational trauma, perpetuated and compounded by ongoing colonial trauma including removal of children. Women are pro-active about their health but encounter numerous challenges in accessing appropriate health care. These rarely explored perspectives can inform a reframing of health and social support needs of incarcerated Aboriginal women establishing pathways for healing.
The Role of the School Principal in Educational Reform
Authors: Mulcahy Donal E.
Published: May 2019

The quality of educational leadership, and that of the school principal in particular, is an important factor in school reform. This essay addresses concerns that the teaching profession and, as a result, the prospect of school reform is under threat from forces that seek to transform the role of school principal to that of corporate executive. It does so by identifying and examining persistent themes in the work of the Fordham Institute and confronting them with arguments and research that challenges this view.
Job Satisfaction and Teacher Turnover Intentions in Malawi: A Quantitative Assessment
Authors: Kafumbu Fatsani Thomas
Published: May 2019

This study aimed at uncovering the link between levels of job satisfaction with turnover intentions among teachers with the aim of broadening the knowledge base with regard to teachers’ welfare in public secondary schools in Malawi. In the empirical investigation, a correlational-analytic design was used. The stratified random sample consisted of 120 secondary school teachers and it was found that most teachers had a moderate level of satisfaction with their work. Furthermore, it was found that job satisfaction among teachers was related to their turnover intentions and that demographics had a significant influence on this relationship except for school type.
Accessibility to Talar Dome in Neutral Position, Dorsiflexion, or Noninvasive Distraction in Posterior Ankle Arthroscopy
Authors: Hirtler Lena , Schellander Katarina , Schuh Reinhard
Published: May 2019

Background:

Osteochondral lesions of the talus are frequent pathologies of the ankle joint. Especially through arthroscopy, the treatment is kept as minimally invasive as possible. However, there are some drawbacks as to the reachability because of the high congruency of the ankle joint. Here, either noninvasive distraction or maximal dorsiflexion may be an option for better access to the lesion. The purpose of this study was to evaluate maximal dorsiflexion compared to neutral position or noninvasive distraction of the ankle joint in the arthroscopic reachability of the talar dome. The hypothesis of this study was that maximal dorsiflexion would allow for greater accessibility of the talar dome compared to neutral position or noninvasive distraction of the joint.

Methods:

Twenty matched pairs (n=40) of anatomical ankle specimens were used. The effects of neutral position, maximal dorsiflexion, and noninvasive distraction of the ankle joint on arthroscopic accessibility of the ankle joint were tested. After disarticulation of the talus, reach was measured and compared between the 3 positions.

Results:

In neutral position, 13.7±1.2 mm of the talar dome was reached laterally and 14.0±1.0 mm medially. In maximal dorsiflexion, the distance was 19.0±1.1mm laterally and 19.8±1.4 mm medially, and in noninvasive distraction it was 16.1±1.5 mm laterally and 15.7±1.0 mm medially. The statistical comparison showed a significantly better reach in dorsiflexion laterally ( P = .003) and medially ( P = .026).

Conclusion:

Accessibility of the talar dome in maximal dorsiflexion was superior to that in neutral position or noninvasive distraction.

Clinical Relevance:

Results of this study may allow for better planning in arthroscopic treatment of osteochondral lesions of the talus.
“I’m Doing My Part, I Just Need Help From the Community”: Intervention Implications of Foster and Adoptive Parents’ Experiences Raising Children and Young Adults With FASD
Authors: Petrenko Christie L. M. , Alto Michelle E. , Hart Andrea R. , Freeze Sarah M. , Cole Lynn L.
Published: May 2019

Individuals with fetal alcohol spectrum disorders (FASD) have high rates of health care service utilization. It is vital that health care professionals understand FASD and associated family experiences to strengthen their ability to respond to family needs and tailor family-focused interventions. This study included 24 foster and adoptive parents of children and adults (aged 3-33 years) with FASD. Data were collected via individual interviews and focus groups and analyzed thematically. Consistent with a developmental psychopathology perspective, parents’ experiences interacted with the individual (with FASD), family, and broader systems ecological levels. Parents undertook protective actions in an attempt to prevent secondary conditions, support their child and family, and mitigate systems barriers. They also experienced stressors at each level, and stress was increased by protective actions. The overall parenting experience was fueled by a protective parenting attitude. Findings can strengthen family-focused care practices with individuals with FASD and their families and inform novel family interventions.
Retrospective analysis of the efficacy and safety of neoadjuvant gemcitabine and cisplatin in muscle-invasive bladder cancer
Authors: Meleis Laura , Moore Russell , Inman Brant A , Harrison Michael R
Published: May 2019

Background

Neoadjuvant cisplatin-based combination chemotherapy for muscle-invasive bladder cancer (MIBC) improves overall and disease-free survival. However, there is much debate over the optimal neoadjuvant regimen. Gemcitabine plus cisplatin (GC) has been the neoadjuvant regimen of choice for many institutions for patients with MIBC based on data extrapolated from the metastatic setting. Based on recent data, many institutions are transitioning to variations of methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC) as the neoadjuvant regimen of choice.

Objective

To assess the effectiveness and safety of neoadjuvant chemotherapy with gemcitabine plus cisplatin in patients with muscle-invasive bladder cancer prior to cystectomy.

Methods

This is a single-center, retrospective, cohort study at Duke University Hospital (DUH). Patients included had MIBC and received gemcitabine plus cisplatin chemotherapy prior to a cystectomy. The primary endpoint was to assess the pathologic complete response (pCR) rate in MIBC after treatment with gemcitabine and cisplatin. Patients were split into two groups, those who received their chemotherapy at DUH, and those who received their chemotherapy at an outside facility.

Results

Overall pCR rate for all patients (n = 36) was 14%. The pCR rates for patients in the Duke Chemotherapy Group (n = 17) and in the Community Chemotherapy Group (n = 19) were 24% and 5%, respectively. GC was overall well tolerated in most patients with few adverse events ≥ grade 3.

Conclusions

This retrospective study demonstrates a consistent pCR rate (24% in Duke Chemotherapy Group) for neoadjuvant GC in MIBC compared with other literature. The overall pCR rate for all patients was 14%.
Concomitant use of capecitabine and proton pump inhibitors – Is it safe?
Authors: Cheng Vian , Lemos Mario de , Hunter Nicole , Badry Nadine , Lemos Jane de
Published: May 2019

Background

Capecitabine is a commonly used oral chemotherapy agent. Recent data suggest that concurrent use of proton pump inhibitors may reduce the efficacy of capecitabine by decreasing its absorption through increased gastric pH. Since proton pump inhibitors are widely used, we evaluated the supportive evidence for the probability of occurrence and potential seriousness of this drug interaction.

Methods

The probability of occurrence was evaluated based on the clinical, pharmacokinetic and in vitro evidence using the Drug Interaction Probability Scale. The possibility of seriousness was assessed based on the potential impact on the therapeutic intent of capecitabine therapy.

Results

The probability of occurrence of the interaction is doubtful. Clinical findings from two retrospective post hoc analyses showed inconsistent trends towards reduced survival. Pharmacokinetics studies found no significant decrease in systemic capecitabine level with concurrent gastric acid suppression with antacid or food intake. In vitro data do not support the proposed mechanism of reduced capecitabine absorption due to increased gastric pH. The possibility of seriousness varies depending on the treatment intent of capecitabine therapy. The most and least serious possible outcome would be reduced possibility of cure or survival and symptom control, respectively.

Conclusion

Although the possible outcome may be serious, the probability of interaction between capecitabine and proton pump inhibitors is doubtful. Therefore, we suggest that intervention should be limited to minimal change to existing therapy plan. This may include routinely ascertaining the need for proton pump inhibitor use. Alternate acid suppressing agents may be considered based on the therapeutic intent of capecitabine therapy.
A Conceptual-Theoretical-Empirical Structure for the Study of Alzheimer Informal Caregivers and Home Health Care Nursing Services
Authors: Garvey Joanne M. , Dalton Joanne Marie , Magny-Normilus Cherlie
Published: May 2019

The purpose of this article is to describe the process used to create a conceptual-theoretical-empirical structure for a proposed study of policies for home health care nursing services for informal caregivers of persons with Alzheimer disease. The process consisted of linkage of the Conceptual Model of Nursing and Health Policy with Roy’s Adaptation Model to guide derivation of a middle-range theory of home health care nursing services for Alzheimer disease informal caregiving, and selection of appropriate empirical research methods.
Quality improvement in vascular access: The role of patient-reported outcome measures
Authors: Field Melanie , Tullett Karen , Khawaja Aurangzaib , Jones Robert , Inston Nicholas G
Published: May 2019

Quality improvement initiatives should be aimed to enhance clinical outcomes, service delivery and quality of life for patients. For patients reliant on haemodialysis, vascular access is a lifeline. Survival differences relating to the type of vascular access are evident and many initiatives have focussed on increasing absolute rates of arteriovenous fistulas and/or decreasing central venous catheter use. While these have achieved some success quantitatively, the qualitative effects are less obvious. The aims of this review article are to explore the concepts of quality of care in vascular access. There is a paucity of studies into the effects of vascular access on the quality of life of dialysis patients, and where studies have been performed, generalised patient-reported outcome measures have been used. To facilitate the implementation of quality improvement programmes specifically for vascular access requires suitable tools. While existing patient-reported outcome measures may be applicable to vascular access, it is likely that these will require further evaluation, and the development of vascular access–specific patient-reported outcome measures may be required.
The Odds of Stage IV Melanoma Diagnoses Based on Socioeconomic Factors
Authors: Dick Mary , Aurit Sarah , Silberstein Peter
Published: May 2019

Background:

When diagnosed at stage 0-I, melanoma has a 5-year survival rate of 92% to 100% in comparison with stage IV, which has a 5-year survival rate of 15% to 20%.

Objective:

The objective of this article is to identify what socioeconomic and demographic factors were associated with increased odds in receiving a delayed melanoma diagnosis.

Methods:

This study analyzed the odds of 108,628 patients from the National Cancer Database who were diagnosed between 2004 and 2012 with American Joint Committee on Cancer stage 0-I and stage IV based on race, sex, insurance type, income, facility type, and education.

Results:

We identified significantly ( P < .05) increased odds of stage IV primary melanoma diagnosis in those who had nonprivate insurance, including Medicare (odds ratio [OR] = 1.31, 95% confidence interval [CI]: 1.19-1.45), other government insurance (OR = 2.19, 95% CI: 1.61-2.98), Medicaid (OR = 6.97, 95% CI: 5.98-8.13), or no insurance (OR = 5.10, 95% CI: 4.41-5.91). Increased odds of late-stage melanoma were also associated with male sex (OR = 1.46, 95% CI: 1.36-1.57), race and ethnicity other than non-Hispanic white such as Hispanic whites (OR = 1.49, 95% CI: 1.15-1.92) or African Americans (OR=4.81, 95% CI: 3.75-6.18), and who had decreased education (OR = 1.19, 95% CI: 1.09-1.30). There was not a significant increase in odds of late-stage melanoma in patients from areas with the lowest levels of income compared with areas of highest income.

Conclusions:

Certain socioeconomic and demographic factors are associated with odds of a later-stage melanoma diagnosis.
Measures of general and abdominal obesity and disability severity in a large population of people with multiple sclerosis
Authors: Fitzgerald Kathryn C , Salter Amber , Tyry Tuula , Fox Robert J , Cutter Gary , Marrie Ruth Ann
Published: May 2019

Background:

Metabolic comorbidity is overrepresented in people with multiple sclerosis (MS) and is associated with adverse MS outcomes. Excess visceral adiposity, approximated using waist circumference (WC), is a risk factor for metabolic comorbidity and predicts poorer outcomes in other neurologic diseases.

Objective:

To evaluate the association between WC and clinical and disease characteristics in people with MS.

Methods:

North American Research Committee on MS (NARCOMS) registry participants reported height and weight (used to calculate body mass index (BMI)) and were mailed a tape measure with instructions to measure WC. We considered WC continuously and used cut-points derived from the abdominal obesity criteria for the metabolic syndrome (men: WC ⩾ 40 in; women: WC ⩾ 35 in). We assessed the association between WC and disability (Patient-Determined Disease Steps) and symptom severity (validated scales) using multivariable-adjusted multinomial models.

Results:

Of 6367 responders with MS, we included 5832 (92%). Of these, 3181 (55%) reported WC meeting criteria for the abdominal obesity component of metabolic syndrome. In multivariable models adjusting for overall obesity status, WC was associated with 47% increased odds of severe versus mild disability (odds ratio (OR): 1.47; 95% confidence interval (CI): 1.22–1.78).

Conclusions:

Increased WC is associated with more severe disability, even after adjusting for overall obesity in this large cross-sectional survey.
Predictors of treatment outcome in patients with paediatric onset multiple sclerosis
Authors: Kopp Tine Iskov , Blinkenberg Morten , Chalmer Thor Ameri , Petersen Thor , Ravnborg Mads Henrik , Soelberg Sørensen Per , Magyari Melinda
Published: May 2019

Background:

Disease-modifying therapies (DMT) are increasingly used for children with multiple sclerosis (MS) even though most double-blinded randomized controlled trials evaluating efficacy, safety and dosing strategy of a specific drug have included adults.

Objective:

To investigate predictors of treatment outcomes in patients with paediatric onset MS treated with DMTs.

Methods:

Prospective cohort study from the nationwide Danish Multiple Sclerosis Registry including all patients with a MS diagnosis who initiated treatment with an approved DMT before the age of 18 ( N = 137) and followed until their 25th birthday. Selected baseline predictors were tested in univariate and multivariate regression models.

Results:

Multivariate analyses showed that being female and having disease duration for 2 or more years prior to DMT initiation predicted a higher relapse rate. In addition, disease duration and baseline expanded disability status scale (EDSS) predicted both confirmed disability worsening and improvement. We found no difference in treatment outcome between children with MS onset before and after the age of 13 years.

Conclusions:

The efficacy of DMT in paediatric onset MS patients is comparable to that seen in adult onset MS patients. Earlier treatment start is associated with a beneficial prognosis in the paediatric cohort.
Illness perceptions of youths with functional disorders and their parents: An interpretative phenomenological analysis study
Authors: Hulgaard Ditte Roth , Rask Charlotte Ulrikka , Risor Mette Bech , Dehlholm Gitte
Published: May 2019

Background:

Functional disorders, defined as disorders with no clear medical explanation, are common and impose a significant burden on youths, their families, healthcare services and society as a whole. Currently, the literature describes resistance among patients and their families towards psychological symptom explanations and treatments. More knowledge about the thoughts and understandings of youths with functional disorders and their parents is needed. The aim of this study was to explore the illness perceptions of youths with severe functional disorders and their parents.

Methods:

A qualitative interview study using interpretative phenomenological analyses. The study included 11 youths aged 11–15 years with functional disorders and their parents, where interviews were performed at the point of referral from a somatic to a psychiatric treatment setting.

Results:

Analyses identified three main themes. Themes 1(Ascribing identity to the disorder) and 2 (Monocausal explanations) explore key elements of the participants’ illness perceptions, and theme 3 (Mutable illness perceptions) explores how illness perceptions are influenced by experiences from healthcare encounters.

Conclusions:

The label ‘functional disorder’ was poorly integrated in the illness perceptions of the youths and their parents. Participants used a monocausal and typically physical explanation rather than a multicausal biopsychosocial explanation for their symptoms.
Making expertise fit: On the use of certified versus experiential knowledge in becoming an informed patient
Authors: Versteeg Wytske , te Molder Hedwig
Published: May 2019

This article reports a discursive psychological study of online conversations among patients with ADHD, diabetes, or ALS on what constitutes an “informed patient.” Being informed means different things for different patient groups. Whether patients prioritize experiential or certified expert knowledge is not indicative of patients’ preferences per se but depends on how they give meaning to the responsibilities particular to their disease. ADHD patients hold each other accountable for demonstrating the seriousness of their disease. ALS patients use expert information to orient to a norm of thinking positive. Diabetes patients challenge experts to carve out independence from the diabetes regimen.
Trauma team leaders in Canada: A national survey
Authors: Belhumeur Vincent , Malo Christian , Nadeau Alexandra , Hegg-Deloye Sandrine , Gagné Anne-Julie , Émond Marcel
Published: May 2019

Introduction

The availability, composition and activation criteria for trauma teams vary across different health care systems, but little is known about these features in the Canadian health system. The aim of this study is to provide a description of the current trauma team available in Level 1 and 2 centres across Canada.

Methods

In 2017, using a modified Dillman technique, a survey was sent to 210 health professionals across all Canadian trauma care facilities, including questions that focused on (1) the presence and the composition of a trauma team, (2) the established criteria to activate this team and (3) the initial patient care.

Results

Overall, 107 (57%) completed surveys were received. Only 22 (11.7%) were from Level 1 or 2 centre and considered for compilation. Seventeen respondents have a trauma team in their centre, and they all shared their criteria for activating their team (1–27 different indications). The suspected injuries, the judgment of the emergency physician, the systolic blood pressure, the Glasgow Coma Score and the respiratory rate were the most frequently mentioned items. In the presence of a pre-hospital care warning, the initial assessment of a severely injured patient is exclusively completed by a member of the trauma team for only 35.1% of the respondents. For 11.8% of respondents, trauma team coordinates airway management. For 64.7% of participants, the trauma team leader is the dedicated care provider to accompany patients until the final destination.

Conclusions

The results suggest a great variability across Canada, regarding the roles assumed by the trauma team but also regarding the activation criteria leading them to take action.
Influence of light source on the sensitivity of a Polarization Maintaining Fiber Loop Mirror vibration sensor
Authors: Jiang Ying , Yu Mingjin , Zhang Mengqi , Lu Jiyun
Published: May 2019

Wavelength or light intensity demodulation method for a polarization maintaining fiber loop mirror (PM-FLM) sensor is not only expensive but also unsuitable for vibration monitoring. This paper studies the voltage demodulation principle and explores theoretically the influence of light source on the sensitivity. Then a PM-FLM sensor is applied to vibration monitoring. A low-power narrow-band light source reflected from FBG and a high-power laser light source are used respectively as input. The time domain voltage signals of vibration from a photo-detector are collected by a data acquisition card and converted via a fast Fourier transform algorithm. The experimental result shows that a PM-FLM sensor using a high-power narrow-band light source as input has a higher sensitivity to vibration than the one using a low-power narrow-band light source. In practical application, we can choose a high-power narrow-band light source as input to improve the sensitivity to vibration.
“Who are we without the war?”: The evolution of the Tamil ethnic identity in post-conflict Sri Lanka
Authors: Thurairajah Kalyani
Published: May 2019

Studies of post-conflict societies have often focused on inter-ethnic group dynamics following the end of conflict, specifically the process of reconciliation between groups, or resurgence of violence across groups. This paper focuses on intra-ethnic differences with respect to defining ethnic identity. This paper will examine how the end of the Sri Lankan ethnic conflict created cleavages amongst Sri Lankan Tamils with respect to how they define their ethnic identity and their ethnic group. Drawing upon 66 semi-structured interviews conducted in three regions of Sri Lanka, this paper presents three perspectives that were held among Tamils in post-conflict Sri Lanka. The first perspective was that the end of the ethnic conflict led to a loss in the fundamental tenets of the Tamil ethnic identity. The second perspective considered the promotion of a distinct Tamil ethnic identity to be a gateway to conflict. The third perspective articulated that the end of the ethnic conflict meant that the Tamil ethnic identity could move forward in a more cosmopolitan direction. The findings of this study demonstrate the importance of considering the social construction of ethnic identities, and their implications on post-conflict reconstruction.
Walking to Music and Metronome at Various Tempi in Persons With Multiple Sclerosis: A Basis for Rehabilitation
Authors: Moumdjian Lousin , Moens Bart , Maes Pieter-Jan , Van Nieuwenhoven Johan , Van Wijmeersch Bart , Leman Marc , Feys Peter
Published: May 2019

Background. Mobility dysfunctions are prevalent in persons with multiple sclerosis (PwMS), thus novel rehabilitation mechanisms are needed toward functional training. The effect of auditory cueing is well-known in Parkinson’s disease, yet the application of different types of auditory stimuli at different tempi has not been investigated yet. Objectives. Investigating if PwMS, compared with healthy controls (HC), can synchronize their gait to music and metronomes at different tempi during walking and the effects of the stimuli on perceived fatigue and gait. Additionally, exploring if cognitive impairment would be a factor on the results. Methods. The experimental session consisted of 2 blocks, music and metronomes. Per block, participants walked 3 minutes per tempi, with instructions to synchronize their steps to the beat. The tempi were 0%, +2%, +4% +6%, +8%, +10% of preferred walking cadence (PWC). Results. A total of 28 PwMS and 29 HC participated. On average, participants were able to synchronize at all tempi to music and metronome. Higher synchronization was obtained for metronomes compared with music. The highest synchronization for music was found between +2% and +8% of PWC yet pwMS perceived less physical and cognitive fatigue walking to music compared with metronomes. Cognitive impaired PwMS (n = 9) were not able to synchronize at tempi higher than +6%. Conclusion. Auditory-motor coupling and synchronization was feasible in HC and PwMS with motor and cognitive impairments. PwMS walked at higher tempi than their preferred walking cadence, and lower fatigue perception with music. Coupling walking to music could be a promising functional walking training strategy.
Why Still so Few? A Theoretical Model of the Role of Benevolent Sexism and Career Support in the Continued Underrepresentation of Women in Leadership Positions
Authors: Hideg Ivona , Shen Winny
Published: May 2019

We advance our understanding of women’s continued underrepresentation in leadership positions by highlighting the subtle, but damaging, role benevolent sexism, a covert and socially accepted form of sexism, plays in this process. Drawing on and integrating previously disparate literatures on benevolent sexism and social support, we develop a new theoretical model in which benevolent sexism of both women and those in their social networks (i.e., managers and intimate partners) affect women’s acquisition of career social support for advancement at two levels, interpersonal and intrapersonal, and across multiple domains, work and family. At the interpersonal level, we suggest that managers’ and intimate partners’ benevolent sexism may undermine their provision of the needed career support to advance in leadership positions for women. At the intrapersonal level, we suggest that women’s personal endorsement of benevolent sexism may undermine their ability to recognize and willingness to seek out career support from their family members (i.e., intimate partners) and managers for advancement to leadership positions. Implications for theory and future research are discussed.
Functional Balance and Gait Characteristics in Men With Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia
Authors: Al-Yahya Emad , Mohammad Maha T. , Muhaidat Jennifer , Demour Saddam Al , Qutishat Dania , Al-Khlaifat Lara , Okasheh Rasha , Lawrie Sophie , Esser Patrick , Dawes Helen
Published: May 2019

The purpose of this cross-sectional study was to compare gait characteristics and functional balance Babilities in men with LUTS secondary to benign prostatic hyperplasia (BPH) to those of community-dwelling older adults under different conditions of increasing difficulties, and to aid health-care providers to identify those patients with decreased level of activity and increased risk of falls. We recruited a group of 43 men diagnosed with symptomatic BPH and a control group of 38 older men. Participants performed the timed up and go and 10-m walking tests under different conditions—namely, single task, dual-task motor, and dual-task cognitive. Time to complete the tests and spatial and temporal gait parameters were compared between groups and conditions via mixed-design ANOVA. Under dual-task conditions, individuals in both groups performed significantly worse compared to the single functional balance and walking tasks. As the complexity of the walking task increased—from dual-task motor to dual-task cognitive—significant differences between groups emerged. In particular, men with BPH performed worse than older adults in tasks demanding increased attentional control. Results suggest that dual-task decrements in functional balance and gait might explain decreased level of physical activity and increased risk of falls reported in men with LUTS. Health-care providers for men with LUTS due to BPH should assess for abnormal gait and remain vigilant for balance problems that may lead to decreased mobility and falls. The dual-task approach seems a feasible method to distinguish gait and balance impairments in men with BPH.
Study on solid–liquid two-phase flow characteristics of centrifugal pump impeller with non-smooth surface
Authors: Gu Yunqing , Liu Nuojia , Mou Jiegang , Zhou Peijian , Qian Heng , Dai Dongshun
Published: May 2019

In order to improve the working performance of the solid–liquid two-phase flow in centrifugal pump, the current study attempted to probe into the influence of the solid-phase particle concentration on the characteristics of centrifugal pump and the drag reduction characteristics of impeller on non-smooth surface. Based on the principle of bionics and with MP80-160 single-stage single-suction centrifugal pump as a model, the current study adopted Eulerian model to carry out numerical simulation by building the pit-type non-smooth surface on the impeller blades. The results show that the higher concentration of solid-phase particles leads to the more centrifugal pump hydraulic head and decreasing efficiency. The pit type in the layout of the non-smooth surface area shows a better drag reduction effect. Shear stress of wall inside the pit is much less than that on the smooth surface, which can effectively improve the working performance of the solid–liquid two-phase flow in centrifugal pump.
Assessment of health-related quality of life in patients prior to carotid body tumor resection
Authors: García-Alva Ramón , Lozano-Corona Rodrigo , Anaya-Ayala Javier E , Lizola Rene , Lopez-Rocha Sabsil , Cuen-Ojeda Cesar , Laparra-Escareno Hugo , Hinojosa Carlos A
Published: May 2019

Background

Carotid body tumors represent approximately 0.5% of the total head and neck tumors, and the most common presentation form is an asymptomatic cervical mass. Despite of being most of them asymptomatic the quality of life could be impacted; however, the literature remains silent about this matter. The Short Form 36 (SF-36) is a health-related quality of life (HRQoL) instrument that includes eight domains to assess physical and emotional function in different diseases. The aim of this study was to compare HRQoL in preoperative patients with carotid body tumor and a control paired group. The secondary objective was to compare HRQoL between carotid body tumor patients according to the volume tumor and Shamblin classification.

Methods

A cross-sectional study that included 23 patients diagnosed with carotid body tumor prior to resection and 23 control patients paired by age and gender was conducted from January 2017 to December 2018. The SF-36 questionnaire was applied in 46 patients. Three-dimensional volume reconstruction and estimation (3DVR) was obtained from a preoperative computed tomography angiography (CTA). Descriptive statistical analysis was performed for demographics and categorical variables were reported by frequencies and percentages. Continuous variables were summarized using median with interquartile ranges (IQR) with 95% confidence interval (CI) and were compared. Differences between medians were analyzed with the Mann–Whitney U test and all statistical tests were two-sided.

Results

In the carotid body tumor group, the mean age was 55 years, females were more frequently affected 19 (83%). Shamblin I was identified in 9% of patients, Shamblin II in 52% and Shamblin III in 39%. Carotid body tumor laterality were 57% right, 34% left and 9% bilateral tumors. The eight domains that comprise the SF-36 questionnaire were statistically significant when compared to the control group.

Conclusion

Significant differences were found in all SF-36 domains in carotid body tumor patients in comparison to control subjects, confirming that this neoplasm has negative impact in the general HRQoL.
Perioperative nurses’ experiences of caring for donation after cardiac death organ donors and their family within the operating room
Authors: Smith Zaneta
Published: May 2019

Background

Worldwide, operating rooms have seen the re-emergence of donation after cardiac death organ donors to increase the number of available organs. There is limited information on the issues perioperative nurses encounter when caring for donor patients after cardiac death who proceed to organ procurement surgery.

Objectives

The purpose of this paper is to report a subset of findings derived from a larger study highlighting the difficulties experienced by perioperative nurses when encountering donation after cardiac death organ donors and their family within the operating room during organ procurement surgery from an Australian perspective.

Methods

A qualitative grounded theory method was used to explore perioperative nurses’ (n = 35) experiences of participating in multi-organ procurement surgery.

Results

This paper reports a subset of findings of the perioperative nurses’ experiences directly related to donation after cardiac death procedures drawn from a larger grounded theory study. Participants revealed four aspects conceptualised as: ‘witnessing the death of the donation after cardiac death donor’; ‘exposure to family’; ‘witnessing family grief’ and ‘stepping into the family’s role by default’.

Conclusion

Perioperative nurses’ experiences with donation after cardiac death procedures are complex, challenging and demanding. Targeted support, education and training will enhance the perioperative nurses’ capabilities and experiences of caring for the donation after cardiac death donor and their family with the operating room context.