bluuebunny/crossref_metadata_2025 huggingface dataset:
The Presence and Degree of Bone Marrow Edema Influence Midterm Clinical Outcomes After Microfracture for Osteochondral Lesions of the Talus
Authors: Shimozono Yoshiharu , Hurley Eoghan T. , Yasui Youichi , Deyer Timothy W. , Kennedy John G.
Published: July 2018

Background:

Subchondral bone marrow edema (BME) has been associated with articular cartilage loss, with the potential to be a negative prognostic indicator for clinical outcomes after microfracture. However, no single study has investigated the association between BME and clinical outcomes after microfracture for osteochondral lesions of the talus (OLTs) at midterm follow-up.

Purpose:

To clarify the association between postoperative subchondral BME and clinical outcomes in patients treated with microfracture for OLTs at both short-term and midterm follow-up using a grading system that classified the extent of BME of the talus.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Patients who underwent microfracture between 2008 and 2013 were assessed at 2- and 4-year postoperative follow-up. BME was evaluated using magnetic resonance imaging, and the presence of subchondral BME was determined with fat-suppressed T2-weighted sequences. Clinical outcomes were evaluated using the Foot and Ankle Outcome Score (FAOS). P < .05 was considered to be statistically significant.

Results:

Forty-three (83%) of 52 eligible patients were included. No significant differences were found in the FAOS between the BME and no BME groups at 2-year follow-up (83.1 ± 6.5 vs 88.6 ± 8.0, respectively; P = .109), but there was a significant difference at 4-year follow-up (77.5 ± 11.1 vs 84.7 ± 8.4, respectively; P = .041). A significant difference was found among BME grades at 4-year follow-up (grade 0: 84.7 ± 7.4, grade 1: 80.1 ± 10.5, grade 2: 74.0 ± 10.3, and grade 3: 67.5 ± 7.1; P = .035). A post hoc analysis showed significant differences between grades 0 and 2, 0 and 3, and 1 and 3 ( P = .041, .037, and .048, respectively). In addition, at 4-year follow-up, a significant correlation was noted between the FAOS and BME grade ( r = −0.453, P = .003) but not at 2-year follow-up ( r = −0.212, P = .178). Seventy-four percent of patients still had subchondral BME at 4-year follow-up after microfracture for OLTs.

Conclusion:

Patients with subchondral BME at midterm follow-up after microfracture for OLTs had worse clinical outcomes than those without subchondral BME. In addition, the degree of subchondral BME at midterm follow-up was correlated with clinical outcomes. However, at short-term follow-up, there were no significant differences in clinical outcomes based on both the presence and degree of BME, and no correlation was found between clinical outcomes and the degree of BME. The current study suggests that BME at short-term follow-up is a normal physiological reaction. However, BME at midterm follow-up after microfracture for OLTs may be pathological and is associated with poorer clinical outcomes.
A Prospective Analysis of the Contralateral Hip Among Patients With Femoroacetabular Impingement: What Are the Risk Factors for Disease Progression?
Authors: Louer Craig R. , Pashos Gail , Clohisy John C. , Nepple Jeffrey J.
Published: July 2018

Background:

The pathophysiology of femoroacetabular impingement (FAI) remains to be better understood, including factors affecting symptom development and disease progression.

Purpose:

(1) To determine rates of initial and subsequent symptom development in the contralateral hip of patients with symptomatic FAI and (2) to identify predictors of the development of symptomatic contralateral FAI.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

This prospective study cohort included the contralateral hip of 179 consecutive patients undergoing primary surgical treatment of FAI. At presentation and follow-up time points, patients recorded the presence of symptoms in the contralateral hip. Patients with a minimum 1-year follow-up were included in the final cohort. Univariate analysis compared the patient characteristics and FAI imaging characteristics (cam and pincer) of initially asymptomatic patients who developed symptoms and those who remained asymptomatic. Kaplan-Meier survival curves were calculated to demonstrate symptom development over time.

Results:

A total of 148 patients (83%) were followed for at least 1 year (mean, 2.9 years). Thirty-four (23%) patients had symptoms in the contralateral hip at the time of the initial presentation. An additional 27 hips (24% of the initially asymptomatic) developed symptoms during the follow-up period at a mean 2.0 years from presentation. Head-neck offset ratio on the anteroposterior pelvis radiograph was significantly lower among hips that developed symptoms (0.153 vs 0.163 asymptomatic group, P = .027). Maximum alpha angle ( P = .503), lateral center edge angle ( P = .975), and crossover sign ( P = .865) were not predictive of the development of symptoms. Patients developing contralateral hip symptoms were less likely to have a UCLA (University of California, Los Angeles) activity score of 9 or 10 at presentation (18.2% vs 43.8%, P = .032). The total arc of rotation in flexion (internal rotation in 90° of flexion + external rotation in flexion) was significantly decreased in hips developing symptoms (39.4º vs 50.4º, P = .012). Kaplan-Meier survival analysis demonstrated that 72%, 67%, 56%, and 48% of all patients remained asymptomatic at 1, 2, 3, and 4 years, respectively.

Conclusion:

Approximately 1 in 4 patients with FAI presents with symptoms in the contralateral hip, and an additional 1 in 4 patients develops significant symptoms in the following 4 years. Several factors, including low activity level, less hip rotational motion, and decreased head-neck offset ratio, were significantly associated with the development of symptoms, while the alpha angle and crossover sign were not.
New Technologies as a Neglected Social Movement Outcome: The Case of Activism against Animal Experimentation
Authors: Weisskircher Manès
Published: July 2018

Recently, scholars have focused on a growing number of social movement consequences. However, one important type of intended outcome has been neglected: the development of new technologies. Connecting to key insights from Science and Technology Studies, the aim of this article is to contribute to the literature on the effects of activism in two specific ways. First, I present and discuss four causal mechanisms that show how activists trigger the development of new technologies. Second, I demonstrate how the development of new technologies is a highly contested goal among activists, leading to divisions within social movements. Based on novel empirical research, this paper analyzes a crucial and understudied case of a movement pushing for new technologies: the animal rights movement and its efforts to push for alternatives to animal experimentation. Methodologically, I rely on semistructured interviews with activists from different social movement organizations, publications of social movement organizations, and secondary literature.
Stocks and environmental release of mercury in backlight cold cathode fluorescence lamps
Authors: Zhuang Xuning , Wang Yu , Yuan Wenyi , Bai Jianfeng , Wang Jingwei
Published: July 2018

Cold cathode fluorescent lamps (CCFLs), with mercury as their essential component, were widely used as backlight in liquid crystal display (LCD) appliances before 2008. Since 2008, the mercury-free light emitting diode started to be used as a substitute for CCFLs and the replacement finished in about 2014. Nowadays, CCFLs are obsolete products from the viewpoint of manufacture but they are important as waste. In recent years, large amounts of CCFLs are flowing to waste phase for treatment and this has become a major issue in most countries. To better understand and control the risk of CCFLs, the stock of mercury in CCFLs, its flow to waste phase and mercury emission with the life cycle of CCFLs in mainland China were estimated in this study. Results showed that there was 15.2 tons of mercury stocked in CCFLs in main LCD appliances (i.e., LCD televisions, LCD monitors, and laptop monitors) from 2003–2015. CCFLs and mercury started to flow to waste phase around the year 2007 and will likely peak in 2018 with an annual flow of 324.8 million units and 1.5 tons respectively, then will likely decline dramatically till 2030. Dismantling and production were the two main life stages of CCFLs with mercury vapor release, during which approximately 2.1 tons and 1.2 tons of mercury were released to the atmosphere respectively. The research also indicates that mercury recycling in specialized facilities was another life stage with high mercury emission risk in which the processes of shredding, separation, and residue disposal are inevitably accompanied by mercury release.
Hospital-Acquired Infections in Critically Ill Patients With Cancer
Authors: Battaglia Christopher C. , Hale Kaye
Published: July 2018

Hospital-acquired infections are a common and costly problem facing critically ill patients in the intensive care unit (ICU). Critically ill patients with cancer are a particularly vulnerable subpopulation who possesses additional, nonmodifiable risk factors for developing these infections and, in many cases, are at increased risk of death as a result. This review will describe the most common nosocomial infections patients with cancer acquire while in the ICU: ventilator-associated events, central line-associated bloodstream infection, catheter-associated urinary tract infections, and Clostridium difficile infection.
Back to the Origins: The Tragic History of the Szekler Sabbatarians
Authors: Győrffy Gábor , Tibori-Szabó Zoltán , Vallasek Júlia-Réka
Published: July 2018

Sabbatarians were the only proselyte religious community that had an official institutional form in nineteenth-century Europe. This study aims to present the history and gradual disintegration of the Sabbatarian community and their acceptance of a common fate with Transylvanian Jewry during the Second World War. This is realized by, first, outlining the historical context of the formation of Sabbatarianism; second, by describing the social and political circumstances of Transylvanian Jews in the first half of the twentieth century; and third, by giving a detailed presentation of the 1944 deportations and other related events.
Characteristic of a multistage reheating radial inflow in supercritical compressed air energy storage with variable operating parameters
Authors: Li Hui , Li Wen , Zhang Xuehui , Zhu Yangli , Zuo Zhitao , Qin Wei , Chen Haisheng
Published: July 2018

In the present study, aerodynamic performance of a four-stage reheating radial inflow turbine, which is adopted in the 1.5 MW supercritical compressed air energy storage system, is analyzed by using the method of integral numerical calculation. Results illustrate that when the inlet total pressure of the first stage is decreased, the expansion ratio of the fourth stage decreases the most. System isentropic efficiency decreases about 1% when the inlet total pressure of the first stage is changed from 7 MPa to 3 MPa, and the fourth stage’s isentropic efficiency decreases about 7%. When the rotational speed is decreased, isentropic efficiency and total power decrease gradually and isentropic efficiency changes from 90.5% at 110% speed ratio to 71.1% at 60% speed ratio. Increasing reheating temperature results to the decrease of mass flow rate and isentropic efficiency and the increase of total power. Total power increases by about 105% when the reheating temperature is changed from 60 ℃ to 520 ℃. When the guide vane opening of the first stage is increased, the expansion ratio of the first stage shows different trends compared to other stages and mass flow rates, and total power are proportional to the guide vane opening. System isentropic efficiency decreases by about 4% when the guide vane opening is adjusted from 80% to 30%.
Challenges of Delivering HIV/AIDS Services to Migrant Patients in the Perspective of Hospital Management
Authors: Chungsivapornpong Warawan , Sooksriwong Chaoncin
Published: July 2018

Background:

There has been a big challenge facing hospital management in dealing with migrant patients with HIV/AIDS as a result of insufficient health care workers and increased hospital budget. This study aims to analyse the current situation and to propose a management model on service delivery among HIV/AIDS migrant patients in a hospital setting.

Methods:

A qualitative research method was conducted at Samut Sakhon province using in-depth interviews and focus group discussions (FGDs) with 32 key informants from hospitals, provincial health offices, non-government organizations (NGOs) and health policymakers. The context, input, process and product (CIPP) framework was applied to analyse the current situation and the findings from the strengths, weaknesses, opportunities and threats (SWOT) analysis helped design a management model of HIV/AIDS care.

Results:

A HIV/AIDS management model was developed, consisting of key components in three levels: national enforcement of migrant registration, provincial migrant data centre and HIV/AIDS service integrated in community. This model would help administrators reduce financial burden and improve clinical outcomes.

Conclusions:

To enhance HIV/AIDS service delivery for migrant workers, data management and follow-up system on treatment continuation along with participation of multiple stakeholders including government, provincial health offices, public and private health care setting and international institutions are required.
No Demand for Skill: The Bane of India’s Vocational Training
Authors: Chadha Nishant , Gangopadhyay Shubhashis , Yadav Bhupesh
Published: July 2018

In this article, we document some empirical facts about vocational training in India. First, we show that the education levels and vocational training of the Indian labour force are low and have not changed between 2004–2005 and 2011–2012. Then, we show that in wage employment, regular wage and salary earners and casual labour, the returns to skilling are low while the returns to general education are significant, even within the same occupation and industry category. Using the enterprise surveys from the NSS, we also document that self-employment, which is the outside option for most unskilled, semi-skilled and even skilled people, is very unproductive. We, thus, argue that the Indian labour market is stuck in an equilibrium where both the number of persons getting skilled and the returns to skilling are low.

JEL: J240, O150
Huntington’s disease: Neuropsychiatric manifestations of Huntington’s disease
Authors: Goh Anita MY , Wibawa Pierre , Loi Samantha M , Walterfang Mark , Velakoulis Dennis , Looi Jeffrey CL
Published: July 2018

Objectives:

Huntington’s disease (HD) is a profoundly incapacitating, and ultimately fatal, neurodegenerative disease. HD is presently incurable, so the current goal is to allow affected individuals to live as well as possible with the illness, to maximise functional independence and quality of life for the person with HD, their carers and family members. This clinical update review focuses on the common neuropsychiatric manifestations in HD, and outlines and evaluates the various neuropsychiatric facets of HD, including the aetiology, symptoms and diagnosis.

Conclusions:

Neuropsychiatric symptoms can precede the classic motor clinical symptoms of HD (prodromal HD) by decades, and cause significant functional impairment. HD provides key insights and understanding into the organic psychiatric disorders, including contemporary clinical insights into the process of neurodegeneration and manifestation of neuropsychiatric symptoms.
Joyful Digressions: Going Gonzo
Authors: Kumm Brian E. , Pate Joseph A.
Published: July 2018

Within this article, we attempt to counter the seriousness that sometimes tends to weigh down academic pursuits. Although we acknowledge the necessary anchors that tether us to various obligations in our work, we enact a form of play that emerged over the course of our dissertations and extended into our budding careers. We call this form “going Gonzo.” By recounting the emergence of trickster figure within our work—who we simply call “Phillip”—we demonstrate how this form of play enabled us to strategically pull back and stretch forward in moments and spaces of intense tension. Ultimately, we describe this trickster in relation to a ludic logic of embracing the profane, foolish, and tenuously important as a way to garner levity and buoyancy amid the necessary anchors of seriousness of research.
Ibrutinib-related atrial fibrillation: Therapeutic challenges
Authors: Kapelios Chris J , Bonou Maria S , Diamantopoulos Panagiotis , Angelopoulou Maria K , Masoura Constantina , Barbetseas John , Viniou Nora-Athina
Published: July 2018

Ibrutinib is a drug used in several lymphohyperplastic diseases. Its use is associated with an increased risk of atrial fibrillation. New-onset atrial fibrillation in this setting is a true challenge as several antiarrhythmic drugs are not indicated and long-term anticoagulation has several limitations. Herein, we describe our experience in treating a 55-year-old patient receiving ibrutinib who presented with new-onset atrial fibrillation and borderline arterial pressure. Since first-line therapies, electrical cardioversion and ablation, could not be performed, rhythm control with intravenous administration of amiodarone was attempted and led to prompt sinus rhythm restoration. We discuss the therapeutic challenges related to sinus rhythm restoration and anticoagulation in this group of atrial fibrillation patients.
Associations Between Hand Hygiene Education and Self-Reported Hand-Washing Behaviors Among Korean Adults During MERS-CoV Outbreak
Authors: Yang Jieun , Park Eun-Cheol , Lee Sang Ah , Lee Sang Gyu
Published: July 2018

Background. Hand washing is an effective way to prevent transmission of infectious diseases. Education and promotional materials about hand washing may change individuals’ awareness toward hand washing. Infectious disease outbreak may also affect individuals’ awareness. Aims. Our study aimed to examine associations between hand-washing education and self-reported hand-washing behaviors among Korean adults during the year of the Middle East respiratory syndrome (MERS) outbreak. Methods. Data from the 2015 Community Health Survey were used for this study. The total study population comprised 222,599 individuals who were older than 20 years of age. A multiple linear regression model was used to investigate associations between hand hygiene education and self-reported hand-washing behaviors. Subgroup analyses stratified by age, sex, income, and MERS outbreak regions were also performed. Results. Individuals who received hand-washing education or saw promotional materials related to hand washing had significantly higher scores for self-reported use of soap or sanitizer (β = 0.177, P < .0001) and self-reported frequency of hand washing (β = 0.481, P < .0001) than those who did not have such experiences. The effect of hand-washing education on self-reported behavior change was greater among older adults, women, and lower income earners. The effect of hand hygiene education on self-reported use of soap or sanitizer was similar regardless of whether the participants lived in MERS regions. Conclusion. Our findings emphasize the importance of education or promotions encouraging hand washing, especially for older adults, women, and lower income earners. In addition, MERS outbreak itself affected individuals’ awareness of hand-washing behaviors. Well-organized campaigns that consider these factors are needed to prevent infectious diseases.
Associations Between the Features of Gross Placental Morphology and Birthweight
Authors: Freedman Alexa A , Hogue Carol J , Marsit Carmen J , Rajakumar Augustine , Smith Alicia K , Goldenberg Robert L , Dudley Donald J , Saade George R , Silver Robert M , Gibbins Karen J , Stoll Barbara J , Bukowski Radek , Drews-Botsch Carolyn
Published: July 2018

The placenta plays a critical role in regulating fetal growth. Recent studies suggest that there may be sex-specific differences in placental development. The purpose of our study was to evaluate the associations between birthweight and placental morphology in models adjusted for covariates and to assess sex-specific differences in these associations. We analyzed data from the Stillbirth Collaborative Research Network's population-based case–control study conducted between 2006 and 2008, which recruited cases of stillbirth and population-based controls in 5 states. Our analysis was restricted to singleton live births with a placental examination (n = 1229). Characteristics of placental morphology evaluated include thickness, surface area, difference in diameters, shape, and umbilical cord insertion site. We used linear regression to model birthweight as a function of placental morphology and covariates. Surface area had the greatest association with birthweight; a reduction in surface area of 83 cm2, which reflects the interquartile range, is associated with a 260.2-g reduction in birthweight (95% confidence interval, −299.9 to −220.6), after adjustment for other features of placental morphology and covariates. Reduced placental thickness was also associated with lower birthweight. These associations did not differ between males and females. Our results suggest that reduced placental thickness and surface area are independently associated with lower birthweight and that these relationships are not related to sex.
Is Adversary Evaluation Worth a Second Look?
Authors: Picciotto Robert
Published: July 2018

The adversary evaluation model emerged in a context that favored democratic debate. It was successfully used in a variety of sectors following its inception, but it was abandoned once neo-liberal thinking and goal achievement approaches became dominant. It is time to give it a second chance. The judicial evaluation model (JEM) relies on human testimony, rules of evidence, cross examination and principled deliberation. These features contribute to evaluation independence, a characteristic that is sorely needed in today’s fractured social environment. JEM promotes civil interaction among groups committed to different ideologies. It encourages tolerance and respects pluralism by combining professional authority with direct citizen participation and neutral facilitation. Competently designed and managed, it resists capture by vested interests and it holds promise as an instrument of progressive evaluation focused on the public interest. Since it is demanding and time consuming, it is especially relevant for large, controversial and complex interventions.
Theorising sharing practice in relation to digital culture
Authors: Kennedy Jenny
Published: July 2018

Sharing is a distinct form of interaction championed in digital contexts. Yet the term ‘sharing’ is a site of contestation. There are multiple overlapping imaginaries of sharing, such as sharing as an inherent social norm; sharing as a frictionless form of communication through social technologies; sharing as a fraught practice that, when over-performed, undermines and breaks down relationships and reputations; and sharing as an economic model. Furthermore, the term ‘sharing’ has been appropriated by specific cultural intermediaries at the cost of understanding the material and affective significance of sharing in everyday life. Yet still, there is no sufficient theory or formalisation of sharing, only reappropriations of existing theories – such as gift, reciprocity, knowledge and commodity exchange, and boundary work – that partially explain certain practices of sharing to the exclusion of others. Based on this observation, I argue that we are in need of a framework for theorising sharing as it is experienced in the contexts of digital device use. In response to this need, I set out a theory of sharing as a coherent and consistent set of elements, comprising competencies, materiality and symbolic values.
Organizing in the Anthropocene
Authors: Wright Christopher , Nyberg Daniel , Rickards Lauren , Freund James
Published: July 2018

The functioning of the biosphere and the Earth as a whole is being radically disrupted due to human activities, evident in climate change, toxic pollution and mass species extinction. Financialization and exponential growth in production, consumption and population now threaten our planet’s life-support systems. These profound changes have led Earth System scientists to argue we have now entered a new geological epoch – the Anthropocene. In this introductory article to the Special Issue, we first set out the origins of the Anthropocene and some of the key debates around this concept within the physical and social sciences. We then explore five key organizing narratives that inform current economic, technological, political and cultural understandings of the Anthropocene and link these to the contributions in this Special Issue. We argue that the Anthropocene is the crucial issue for organizational scholars to engage with in order to not only understand on-going anthropogenic problems but also help create alternative forms of organizing based on realistic Earth–human relations.
Comparative effectiveness of telemonitoring versus usual care for type 2 diabetes: A systematic review and meta-analysis
Authors: Kim Yunjung , Park Jeong-Eun , Lee Byung-Wan , Jung Chang-Hee , Park Dong-Ah
Published: July 2018

Aims

This study evaluated clinical effectiveness of telemonitoring on the management of patients with type 2 diabetes.

Methods

We searched Ovid-Medline, Ovid-EMBASE, and the Cochrane Library to identify randomized controlled trials that compared telemonitoring and usual care in patients with type 2 diabetes.

Results

Thirty-eight studies (6855 patients) were included. Telemonitoring was associated with a significant decrease in glycated haemoglobin levels compared to usual care (weighted mean difference –0.42%, 95% confidence interval –0.56 to –0.27) but there was evidence of heterogeneity ( I2 = 96.9%). Telemonitoring was associated with a significant glycated haemoglobin reduction when biological data were transmitted through a web-based device weekly, when voice feedback was performed daily or immediately and when patients were provided with counselling. Telemonitoring also reduced glycated haemoglobin level in studies that monitored patients’ medication adherence, provided counselling, education and alarm message. The rate of achieving glycated haemoglobin levels of < 7% was 1.8 times higher in the telemonitoring group compared to the usual care group (risk ratio 1.83, 95% confidence interval 1.35 to 2.47, I2 = 0%). There was also significant reduction in systolic blood pressure (weighted mean difference –1.33 mm Hg) and body mass index (weighted mean difference –0.25 kg/m2), but the clinical relevance of these results can be questioned. The data available on patient satisfaction, quality of life, medication adherence, prescription changes, stress and depression were limited.

Conclusions

Telemonitoring interventions may be a better option than usual care in improving glycated haemoglobin control of patients with type 2 diabetes. Further studies should assess clinical benefit according to specific delivery modes of the intervention and patient-reported outcomes.
Stability verification of hydraulic steel structures
Authors: Braun Benjamin , Deutscher Martin , Kuhlmann Ulrike
Published: July 2018

An overview and assessment for buckling verification of plate- and shell-like elements in hydraulic steel structures is given with regard to current standards DIN 19704-1, EN 1993-1-5, EN 1993-1-6, and EN 1993-1-7. Background information is included for verification procedures that require some explanations either due to gaps or fragmentation in several EN parts. A general way forward for the future framework with regard to buckling verification of hydraulic steel structures is proposed based on the findings herein.
Biaxial hysteretic model for the characterization of quasi-static testing of shear-critical reinforced concrete columns
Authors: Ning Chao-Lie , Du Wenqi , Li Bing
Published: July 2018

Given that the biaxial hysteretic model of shear-critical reinforced concrete columns is usually developed by incorporating with the single-degree-of-freedom system to write its expression in differential equation of motion control, it is unfeasible to match with the experimental data of the biaxial quasi-static testing in terms of force-displacement relationship. Therefore, a simple and effective biaxial hysteretic model is proposed in this study based on the Bouc–Wen–Baber–Noori model for characterizing the biaxial quasi-static testing of shear-critical reinforced concrete columns. An incremental numerical algorithm is then proposed to solve the pair of coupled differential equations based on the backward Euler discretization method and Newton–Raphson iteration scheme. Moreover, the influence of critical model parameters affecting the typical hysteretic characteristics of shear-critical reinforced concrete columns, such as strength deterioration, stiffness degradation, pinching phenomena, and biaxial coupling effect, is investigated, respectively, to demonstrate the capability of the biaxial hysteretic model developed. Finally, a parameter calibration procedure using the differential evolution algorithm is introduced to calibrate the magnitude of involved model parameters by comparing with the experimental data of the biaxial quasi-static testing. According to the investigation, it is found that the developed biaxial hysteretic model can reasonably describe the typical hysteretic characteristics of shear-critical reinforced concrete columns under biaxial quasi-static excitation. Following the proposed parameter calibration procedure, the biaxial hysteretic model developed produces the biaxial hysteretic loops of shear-critical reinforced concrete columns, which is in good agreement with the experimental data once the magnitude of involved model parameters is calibrated.
Fostering tourism and entrepreneurship in fringe communities: Unpacking stakeholder perceptions towards entrepreneurial climate
Authors: Kline Carol , Duffy Lauren , Clark Dana
Published: July 2018

The success of entrepreneurial ventures in tourism is tied to the community ecosystem that supports it. As such, communities are continuing to assess their entrepreneurial climate to identify areas where new programs might enhance entrepreneurial success. Based on previous measures of entrepreneurial climate, the current study furthers the entrepreneurial ecosystem literature within the context of fringe communities as it relates to tourism development. Fringe communities, which are found in the peri-urban outskirts of major cities, have increasingly grown as the urban–rural divide continues to blur. Amenity migrants flock to these communities with access to “best of both worlds” with regard to having access to the resources available in both areas. Given the complexity of community demographics emerging in these communities, this study explored whether stakeholder demographics and relationship with the community affects perception of the entrepreneurial climate. Specifically, this research examined residents’ perceptions in a location demonstrative of fringe communities: Moore County, North Carolina, US. The study found that the most differing views were held on Basic Community Needs, Community spaces/green spaces, Innovative, supportive & celebratory environment, and Community spirit.
Managing collective effervescence: ‘Zomsumption’ and postemotional fandom
Authors: Cronin James , Cocker Hayley L.
Published: July 2018

Based on an analysis of the YouTuber–fan community, we theorize the ‘living dead’ nature of collective effervescence under postemotional conditions. We introduce the concept of zomsumption, whereby ‘dead’ emotions are carefully synthesized, governed and presented as ‘living’ throughout the communal consumption of a totem. Here, we explore fans’ efforts to ensure the stability and longevity of their community through the lifelessness of their emotional behaviour. By forfeiting genuine and unfiltered emotions in favour of their rationalization and governance, fans access the illusory potential for more manageable forms of sociability and totemic worship. This outlook prompts us to reconsider the nature of the relationship between consumption communities and dominant structures of feeling. We suggest that consumption communities should not be presumed liberatory retreats from such structures as, contrarily, some may function as microcosms for reflecting and even incubating the wider postemotional order.
Fatigue performance investigation for hangers of suspension bridges based on site-specific vehicle loads
Authors: Deng Yang , Li Aiqun , Feng Dongming
Published: July 2018

Hangers or suspenders of a suspension bridge are the primary load-carrying members and are vital to the structural integrity and service life of the bridge. Site-specific vehicle loads monitored by the weigh-in-motion system can assist to obtain the operational cyclic stresses of hangers. Differing from most existing studies, herein, a framework for fatigue performance investigation for hangers of suspension bridges is proposed utilizing the full information of the weigh-in-motion data. This framework includes four steps: (1) generate influence surfaces for hangers, (2) reconstruct vehicular loading flows based on the weigh-in-motion data, (3) calculate time histories of hanger tension forces, and (4) evaluate fatigue damages and predict fatigue lives. Critical issues, such as the loading configuration of trucks, the threshold of the gross vehicle weight, and the time step for stress calculation, have been studied and discussed in detail. Based on 8-month weigh-in-motion data of a prototype suspension bridge, it is shown that the fatigue damage of hangers can be evaluated day by day, and subsequently the fatigue lives can be predicted. The correlation between the fatigue damages and vehicular loads is also investigated in this study.
Redesigning Transplant Organ Labeling to Prevent Patient Harm and Organ Loss
Authors: Khorzad Rebeca , Montague Enid , Nannicelli Anna P. , Woods Donna M. , Ladner Daniela P. , Brown Alexandra , Holl Jane Louise
Published: July 2018

Background:

In 2012, the Health Resources and Services Administration and the United Network for Organ Sharing launched the “Electronic Tracking and Transportation” (ETT) project, in response to “labeling and packaging issues” being a frequently reported safety incident. This article describes an improvement project conducted as part of this United Network for Organ Sharing project.

Methods:

An interdisciplinary team conducted a Process Failure Modes and Effects Analysis, laboratory simulations of organ labeling during procurement, and a heuristic evaluation of a label software application to inform the design of TransNet, a system that uses barcode technology at the point of organ recovery. A total of 42 clinicians and staff from 10 organ procurement organizations and 2 transplant centers in the United States participated.

Processes Addressed:

Key features of the redesigned labeling system include independent, double entry of label information into the software application, a machine-readable barcode on each organ’s label, and a handheld printer for at “point of use” label printing.

Outcomes:

The new labeling system, TransNet, has become mandatory since June 2017. A survey conducted on early adopters (N = 11), after 1 year of use, indicates the process is safer and more efficient.

Implications for Practice:

The findings from this study suggest that the application of quality planning methods, common in other industries, when redesigning a health-care process, are valuable and revelatory and should be adopted more extensively. Future evaluation of TransNet effectiveness to reduce safety incidents is critical.
High-Resolution Spectral Analysis Accurately Identifies the Bacterial Signature in Infected Chronic Foot Ulcers in People With Diabetes
Authors: Poosapadi Arjunan Sridhar , Tint Aye Nyein , Aliahmad Behzad , Kumar Dinesh Kant , Shukla Ravi , Miller Julie , Zajac Jeffrey D. , Wang Gayathiri , Viswanathan Rekha , Ekinci Elif Ilhan
Published: July 2018

Diabetic foot infections are a major cause of hospitalization, and delayed treatment can lead to numerous complications. The aim of this research was to investigate high-resolution spectroscopy of the wound center and periwound area for real-time estimation of multispectral signature of bacteria at the base of diabetic foot ulcers. We investigated the spectrum of the reflected visual light from diabetic foot ulcers and developed a method that identifies the presence of bacteria in the wound infections. We undertook a prospective pilot study on 18 patients with type 1 and type 2 diabetes and chronic diabetic foot ulcers. The spectral coefficients were directly compared with the results from the wound swab. The results of the multispectral analysis demonstrated 100% sensitivity, with 100% negative predictive values of identifying the presence of the bacteria, which was the cause of the infection in the wound. The results of our study suggest that the changes in the multispectral properties of the wound can be used to identify the presence of bacteria in the infected area using a noninvasive device without any contact with the wound. This technique holds great promise for real-time objective evaluation of the wound infection status beyond the standard visual assessment of diabetic foot ulcers.
Ethical, Practical, and Methodological Considerations for Unobtrusive Qualitative Research About Personal Narratives Shared on the Internet
Authors: Burles Meridith C. , Bally Jill M. G.
Published: July 2018

As Internet research grows in popularity, attention to the ethics of studying online content is crucial to ensuring ethical diligence and appropriateness. Over recent years, ethical guidelines and recommendations have emerged to advise researchers and institutional review boards on best practices. However, these guidelines are sometimes irrelevant, overly rigid, or lack recognition of the contingent nature of ethical decision-making in qualitative research. Furthermore, varied ethical stances and practices are evident in existing literature. This article explores key ethical issues for qualitative research involving online content, with a focus on the unobtrusive study of personal narratives shared via the Internet. Principles of informed consent and confidentiality are examined in depth alongside practical and methodological considerations for unobtrusive qualitative research. This critical exploration contributes to ongoing discussion of ethical conduct of Internet research and promotes ethically aware yet flexible approaches to online qualitative research and creative methodological efforts to overcoming ethical challenges.
High school coaches’ perceptions of their efficacy to work with lesbian, gay, and bisexual athletes
Authors: Halbrook Meghan , Watson Jack C
Published: July 2018

Historically, sport, at all levels, has created an environment of silence, negativity, and even fear for lesbian, gay, and bisexual (LGB) athletes. The purpose of this study was to identify coach characteristics and perceptions of their efficacy related to working with LGB youth athletes in the USA. An online survey was completed by n = 631 male and female head and assistant coaches from 25 different sports. Respondents filled out coaching demographics, team demographics, and the Efficacy Scale to Coach Gay, Lesbian, and Bisexual Athletes.5 Results revealed statistically significant differences in perceptions of LGB athletes between younger and older coaches, coaches who had previously coached openly LGB athletes and those who have not, and coaches with no religious affiliation and those who are Baptist, Catholic, or Protestant Christian. Although there does not appear to be a clear cut demographic of coaches who perceive themselves to be more effective when coaching LGB athletes, experiences coaching LGB athletes seem to contribute to higher perceptions of coaching ability and comfort. Future studies could include interviews with coaches and athletes to more thoroughly assess the current sport team environment with regard to LGB athletes, as well as the creation of high school coach education training and resources.
How do integrated care programmes work for patients with cardiovascular disease, chronic obstructive pulmonary disease, depression, diabetes and multi-morbidity? A rapid realist review
Authors: Mewes JC , Ahmed SA , Vrijhoef HJM
Published: July 2018

Background

In previous years, many multi-faceted initiatives have been set up to improve outcomes for people with chronic diseases. Evaluation studies about the (cost-)effectiveness of these integrated care programs showed heterogeneity in outcomes. Hence, it has been suggested to use realist evaluation for the evaluation of integrated care programmes. Thus, our aim was to gain insight into whether and how existing integrated care programmes work for people with cardiovascular disease, chronic obstructive pulmonary disease, depression, diabetes and multi-morbidity, and under what conditions within the Dutch healthcare setting.

Methods

A rapid realist review was conducted to identify the context and mechanisms that are associated with the outcomes of integrated care programmes. From a selection of systematic reviews and meta-analyses and Dutch literature, data on the context, mechanisms and outcomes of integrated care programmes were extracted. The data were analysed by placing the extracted variables in context-mechanism-outcome configurations which showed their interrelatedness. A panel of executives from Dutch care groups assessed the face validity of the context-mechanism-outcome configurations.

Results

Based on the existing literature, context-mechanism-outcome configurations were compiled for all five diseases. Some configurations could be filled with more detail than others, with the configuration of integrated care for people with diabetes being the most complete. Context-mechanism-outcome configurations were completed and confirmed by executives from Dutch care groups.

Conclusion

The configurations together with the identified factors in them reveal the underlying preliminary program theories of integrated care programmes. These theories need to be tested in further research.
miR-149-5p inhibits cell growth by regulating TWEAK/Fn14/PI3K/AKT pathway and predicts favorable survival in human osteosarcoma
Authors: Xu Rui-Da , Feng Fan , Yu Xiao-Sheng , Liu Zu-De , Lao Li-Feng
Published: July 2018

MicroRNAs (miRNAs) as small non-coding RNAs act as either tumor suppressors or oncogenes in human cancers, of which miR-149-5p (miR-149) is involved in tumor growth and metastasis, but its role and molecular mechanisms underlying osteosarcoma growth are poorly understood. The correlation of miR-149 expression with clinicopathological characteristics and prognosis in patients with sarcoma was analyzed by The Cancer Genome Atlas (TCGA) RNA-sequencing data. Osteosarcoma cell growth affected by miR-149 was evaluated by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and colony formation assays. As a result, we found that the expression level of miR-149 was markedly downregulated in human sarcoma samples and were negatively associated with tumor size, acting as an independent prognostic factor for overall survival of the sarcoma patients. Restoration of miR-149 expression suppressed osteosarcoma cell growth, while its knockdown reversed these effects. Furthermore, we identified TNFRSF12A (TNF receptor superfamily member 12A), also called fibroblast growth factor–inducible 14 (Fn14) as a direct target of miR-149, and TNFRSF12A and its ligand TNFSF12 (TNF superfamily member 12), also called tumor necrosis factor–related weak inducer of apoptosis (TWEAK), were both negatively correlated with miR-149 expression in sarcoma samples. Knockdown of TNFRSF12A suppressed cell growth, but its overexpression weakened the antiproliferative effects of miR-149 via the PI3K/AKT (AKT serine/threonine kinase) signaling pathway. Altogether, our findings show that miR-149 functions as a tumor suppressor in osteosarcoma via inhibition of the TWEAK–Fn14 axis and represents a potential therapeutic target in patients with osteosarcoma.
Culturally Motivated Remembering: The Moderating Role of Culture for the Relation of Episodic Memory to Well-Being
Authors: Wang Qi , Hou Yubo , Koh Jessie Bee Kim , Song Qingfang , Yang Yang
Published: July 2018

Episodic memory for specific personal events is a fundamental human cognitive faculty. Yet it is variably valued across cultures and may thus have different implications for psychological well-being. In a series of studies, we investigated the consequences of cultural fit in detailed episodic recall for psychological well-being among healthy adults and children from European American and East Asian cultural backgrounds. Participants recalled recent and distant personal events (Studies 1, 2, and 3) or recent positive and negative events (Study 4). The findings showed that culture moderated the relation of episodic memory to various aspects of mental health and well-being. Whereas detailed recall was linked to decreased use of avoidant coping among European Americans, it was associated with elevated depressive symptoms, decreased adaptive skills, and increased negative affect among East Asians. The findings support the person-culture-fit framework and suggest that the functional significance of episodic memory depends on cultural contexts.
A Novel Treatment With Obinutuzumab-Chlorambucil in a Patient With B-Cell Prolymphocytic Leukemia: A Case Report and Review of the Literature
Authors: Hew Jason , Pham Dat , Matthews Hew Trevanne , Minocha Vinay
Published: July 2018

We report the case of a patient with B-cell prolymphocytic leukemia who was successfully treated with the novel humanized monoclonal antibody obinutuzumab. This patient was previously treated with the combination of rituximab and bendamustine and had recurrent infusion reactions. Her treatment with rituximab and bendamustine was discontinued when she developed disease progression after 3 cycles of therapy. She was then treated with obinutuzumab 1000 mg on day 1 of every cycle and chlorambucil 0.5 mg/kg on days 1 and 15 every 28 days to which she had greater tolerability. After 4 cycles of treatment, she had resolution of her clinical symptoms, massive splenomegaly, and normalization of her white blood cell count.