bluuebunny/crossref_metadata_2025 huggingface dataset:
Perioperative Management of Total Laryngectomy Patients: A Survey of American Head and Neck Society Surgeons
Authors: Ahmed Omar H. , Roden Dylan F. , Ahmed Yasmina C. , Wang Binhuan , Nathan Cherie-Ann O. , Myssiorek David
Published: February 2019

Objectives:

Standards of care for total laryngectomy (TL) patients in the postoperative period have not been established. Perioperative care remains highly variable and perhaps primarily anecdotally based. The aim of this study was to survey members of the American Head and Neck Society to capture management practices in the perioperative care of TL patients.

Methods:

In this survey study, an electronic survey was distributed to the international attending physician body of the American Head and Neck Society. Forty-five-question electronic surveys were distributed. A total of 777 members were invited to respond, of whom 177 (22.8%) fully completed the survey. The survey elicited information on management preferences in the perioperative care of TL patients. Differences in management on the basis of irradiation status and pharyngeal repair (primary closure vs regional or free flap reconstruction) were ascertained. Main outcomes and measures were time to initiate oral feeding, perioperative antibiotic selection and duration, and estimated pharyngocutaneous fistula rates. These measures were stratified by patient type.

Results:

Most respondents completed head and neck fellowships (77.0%) and practice at academic tertiary centers (72.3%). Ampicillin/sulbactam was the most preferred perioperative antibiotic (43.2%-49.1% depending on patient type), followed by cefazolin and metronidazole in combination (32.0%-33.7%) and then clindamycin (10.8%-12.6%). Compared with nonirradiated patients, irradiated patients were significantly more likely to have longer durations of antibiotics ( P < .05), longer postoperative times to initiate oral feeding ( P < .05), and higher estimated fistula rates ( P < .05). Additionally, in nonirradiated patients, flap-repaired patients (vs primary repair) were significantly more likely to have longer durations of antibiotics (odds ratio, 1.29; 95% confidence interval, 1.13-1.48) and postoperative times to initiate oral feeding (odds ratio, 2.24; 95% confidence interval, 1.76-2.84).

Conclusions:

Perioperative management of TL patients is highly variable. Management of antibiotics and oral feeding are significantly affected by irradiation status and scope of pharyngeal repair. Further studies are needed to standardize perioperative care for this unique patient population.
When Victims Refuse and Prosecutors Decline: Examining Exceptional Clearance in Sexual Assault Cases
Authors: Richards Tara N. , Tillyer Marie Skubak , Wright Emily M.
Published: February 2019

This study examines the predictors of sexual assault case clearance, with a focus on arrest and two types of exceptional clearance: victim refusal to cooperate and prosecutorial declination to prosecute. Using National Incident Based Reporting System (NIBRS) data on crime incidents that contain a sexual offense ( N = 21,977), we estimated a multinomial regression model to examine the predictors of different clearance types for cases of sexual assault. Results indicated that the likelihood of victim refusal decreases in cases perpetrated by strangers, involving victim injury, occurring in public, and involving multiple offenses. A similar pattern of findings was observed for the decision to decline to prosecute a case. In addition, prosecutors are more likely to decline to prosecute cases with male victims and older victims. We discuss the implications of our findings and directions for future research.
When Nonresponse Mechanisms Change: Effects on Trends and Group Comparisons in International Large-Scale Assessments
Authors: Sachse Karoline A. , Mahler Nicole , Pohl Steffi
Published: February 2019

Mechanisms causing item nonresponses in large-scale assessments are often said to be nonignorable. Parameter estimates can be biased if nonignorable missing data mechanisms are not adequately modeled. In trend analyses, it is plausible for the missing data mechanism and the percentage of missing values to change over time. In this article, we investigated (a) the extent to which the missing data mechanism and the percentage of missing values changed over time in real large-scale assessment data, (b) how different approaches for dealing with missing data performed under such conditions, and (c) the practical implications for trend estimates. These issues are highly relevant because the conclusions hold for all kinds of group mean differences in large-scale assessments. In a reanalysis of PISA (Programme for International Student Assessment) data from 35 OECD countries, we found that missing data mechanisms and numbers of missing values varied considerably across time points, countries, and domains. In a simulation study, we generated data in which we allowed the missing data mechanism and the amount of missing data to change over time. We showed that the trend estimates were biased if differences in the missing-data mechanisms were not taken into account, in our case, when omissions were scored as wrong, when omissions were ignored, or when model-based approaches assuming a constant missing data mechanism over time were used. The results suggest that the most accurate estimates can be obtained from the application of multiple group models for nonignorable missing values when the amounts of missing data and the missing data mechanisms changed over time. In an empirical example, we furthermore showed that the large decline in PISA reading literacy in Ireland in 2009 was reduced when we estimated trends using missing data treatments that accounted for changes in missing data mechanisms.
ISMP Adverse Drug Reactions: Pheochromocytoma Crisis Induced by Metoclopramide Baclofen Dependence Following High-Dose Therapy Fatal Cardiotoxicity Following High-Dose Cyclophosphamide Acute Anterograde Amnestic Syndrome Induced by Fentanyl Ivermectin-Induced Toxic Epidermal Necrolysis Pembrolizumab-Induced Type 1 Diabetes
Authors: Mancano Michael A. , Lapin Jonathan , Paik Andrew
Published: February 2019

The purpose of this feature is to heighten awareness of specific adverse drug reactions (ADRs), discuss methods of prevention, and promote reporting of ADRs to the US Food and Drug Administration’s (FDA) MedWatch program (800-FDA-1088). If you have reported an interesting, preventable ADR to MedWatch, please consider sharing the account with our readers. E-mail Dr. Mancano at michael.mancano@temple.edu . Your report will be published anonymously unless otherwise requested. This feature is provided by the Institute for Safe Medication Practices (ISMP) in cooperation with the FDA’s MedWatch program and Temple University School of Pharmacy. ISMP is an FDA MedWatch partner.
Networks of Cooperation: Rebel Alliances in Fragmented Civil Wars
Authors: Gade Emily Kalah , Gabbay Michael , Hafez Mohammed M. , Kelly Zane
Published: February 2019

When rebels make alliances, what informs their choice of allies? Civil wars are rarely simple contests between rebels and incumbent regimes. Rather, rival militant networks provide the context in which these fragmented conflicts unfold. Alliances that emerge within this competitive landscape have the power to alter conflict trajectories and shape their outcomes. Yet patterns of interrebel cooperation are understudied. The existing scholarship on rebel alliances focuses on why rebels cooperate, but little attention is given to the composition of those alliances: with whom rebels cooperate. We explore how power, ideology, and state sponsorship can shape alliance choices in multiparty civil wars. Employing network analysis and an original data set of tactical cooperation among Syrian rebels, we find compelling evidence that ideological homophily is a primary driver of rebel collaboration. Our findings contribute to an emerging literature that reasserts the role of ideology in conflict processes.
Silica-Based Infiltrations for Enhanced Zirconia-Resin Interface Toughness
Authors: Ramos N.C. , Kaizer M.R. , Campos T.M.B. , Kim J. , Zhang Y. , Melo R.M.
Published: February 2019

Novel silica-based infiltrations on the surface of zirconia have the potential to improve their bondability, allowing for the etching/silane adhesive bonding technique. Nonetheless, adhesively bonded joints are subject to mixed tensile and shear stresses when the restoration is in occlusal service. Thus, we aimed to investigate the effect of 2 novel silica-based infiltrations on the interfacial toughness of adhesively bonded zirconia using the Brazil nut method, which allows for controlled types of stresses to be applied at the interfaces. In total, 150 3Y-TZP (In-Ceram YZ; Vita) Brazil nuts were machined and randomly assigned to 3 groups: C, control (air abraded); SG, sol-gel silica infiltration; and GI, glass infiltration. SG specimens were immersed twice in silicic acid for 20 min and dried (100°C, 1 h). GI specimens were presintered (1,400°C, 1 h) before a glass powder slurry was applied to the intaglio surface. All specimens were then sintered (1,530°C, 2 h). Following adhesive bonding (Panavia F 2.0, Kuraray) and water storage (37°C) for 10 d, the Brazil nuts were subdivided into groups baseline and aged (40,000 thermal cycles between 5°C and 55°C, with a dwell time of 30 s). The Brazil nuts were subjected to axial-loading tests using various inclinations (precrack angle with load direction): Θ = 0°, 5°, 10°, 15°, or 25°, which define the stress type at the interface, from pure tension (0°) to increasing levels of shear. Under pure tension (0°), GI yielded superior interfacial fracture energy, SG and C were similar, and aging had no effect. Under predominantly shear stresses (25°), aging significantly decreased interfacial fracture energy of C and SG, while GI remained stable and was superior. The glass infiltration of the zirconia intaglio surface increases its adhesive bonding interfacial toughness. The sol-gel silica infiltration method requires improvement to obtain a homogeneous surface infiltration and an enhanced bond strength.
The Influence of Tobacco Retailer Density and Poverty on Tobacco Use in a Densely Populated Urban Environment
Authors: Farley Shannon M. , Maroko Andrew R. , Suglia Shakira F. , Thorpe Lorna E.
Published: February 2019

Objectives:

Researchers have identified associations between neighborhood-level factors (eg, income level, tobacco retailer density) and smoking behavior, but few studies have assessed these factors in urban environments. We explored the effect of tobacco retailer density, neighborhood poverty, and housing type (multiunit and public) on smoking in a large urban environment (New York City).

Methods:

We used data on smoking prevalence and individual sociodemographic characteristics from the 2011-2013 New York City Community Health Survey, data on tobacco retailers from the 2012 New York City Department of Consumer Affairs, data on neighborhood sociodemographic characteristics and population density from the 2009-2013 American Community Survey, and data on multiunit and public housing from the 2012 New York City Primary Land Use Tax Lot Output data set. We used aggregate neighborhood-level variables and ordinary least squares regression, geographic weighted regression, and multilevel models to assess the effects of tobacco retailer density and neighborhood poverty on smoking prevalence, adjusting for sociodemographic characteristics (age, sex, race/ethnicity, and education) and neighborhood population density. We also assessed interactions between tobacco retailer density and poverty and each housing type on smoking.

Results:

Neighborhood poverty positively and significantly modified the association between tobacco retailer density and prevalence of neighborhood smoking ( β = 0.003, P = .01) when we controlled for population density, sociodemographic characteristics, and types of housing. Neighborhood poverty was positively associated with the prevalence of individual smoking ( β = 0.0099, P < .001) when we adjusted for population density, sociodemographic characteristics, and type of housing.

Conclusion:

More research is needed to determine all the environmental factors associated with smoking prevalence in a densely populated urban environment.
The face of affordable housing in a neoliberal paradigm
Authors: Friedman Rachel , Rosen Gillad
Published: February 2019

This article makes borrowed use of the ‘paradigm shift’ concept to explain the development and culmination of Israel’s neoliberal housing transformation. Using a mixed-method approach based chiefly on 60 interviews conducted with key players in Israel’s housing industry, we examine how a shift in authority over housing policy promoted two central ideas that reshaped the housing arena and urban space. We explore how these themes, specifically, construing housing in-affordability as a supply issue and defining its beneficiaries as the middle class, shaped key affordable housing mechanisms. These mechanisms include increasing the supply of general housing, small-size housing units and rentals. We also identify a parallel paradigm – a shadow paradigm – alongside the reigning neoliberal paradigm that is used as an intervention mechanism in times of crisis or during windows of opportunity. We demonstrate how the shadow paradigm addresses housing needs that cannot be met within the governing paradigm, for example, through the buyer’s price programme.
Funding, financing and governing urban infrastructures
Authors: O’Brien Peter , O’Neill Phil , Pike Andy
Published: February 2019

This Special Issue aims to further understanding and explanation of the funding, financing and governing of urban infrastructure amidst its engagements with contemporary financialisation. Drawing upon empirical material from international cases from Europe, North America, Africa and Asia, it identifies critical issues to advance work in this area. These themes concern: the impacts of financialisation upon shifting the definitions and conceptualisations of urban infrastructure; the worth of adopting more actor-oriented and grounded approaches to financialisation; the importance of affording greater recognition to national and local states as the objects and agents of financialising relations, processes and practices; the substance and ramifications of the emergent informalisation of infrastructure policy-making and governance; and, the implications of financialisation for the evolving and uneven landscapes of urban infrastructure provision. The arguments are, first, that how infrastructure is funded, financed and governed is integral to explaining socially and spatially uneven infrastructural provision and its urban development ramifications; and second, the engagements of urban infrastructure with contemporary financialisation have become central in such accounts. Future research avenues are identified. These comprise: identifying exactly how revenues are generated from infrastructure assets; specifying the relations of financialisation with other processes such as ‘assetisation’, ‘marketisation’ and privatisation; extending the geographical and comparative reach of current studies; elaborating the spaces of regulation in negotiating and accommodating infrastructure financialisation; and, scrutinising the roles of decentralised powers and resources in financialising urban infrastructure and exploring its alternatives.
LP-based observer design for switched positive linear time-delay systems
Authors: Liu Li-Juan , Zhao Xudong , Sun Xi-Ming , Zong Guangdeng
Published: February 2019

In this paper, we consider the problem of observer design for a class of switched positive time-delay systems. First, a switched positive time-delay observer is designed under average dwell time switching signals and numerical conditions are given in the form of linear programming. By providing a new design approach for the observation gain matrix of switched positive time-delay systems, the computational complexity of the numerical conditions is reduced. Moreover, the results can be extended to the switched positive systems with multiple delays. Then, a switched positive time-delay observer is presented under arbitrary switching signals. Finally, a numerical example and a practical example of a reservoir are given to show the effectiveness of our results.
Linking With External Covariates: Examining Accuracy by Anchor Type, Test Length, Ability Difference, and Sample Size
Authors: Albano Anthony D. , Wiberg Marie
Published: February 2019

Research has recently demonstrated the use of multiple anchor tests and external covariates to supplement or substitute for common anchor items when linking and equating with nonequivalent groups. This study examines the conditions under which external covariates improve linking and equating accuracy, with internal and external anchor tests of varying lengths and groups of differing abilities. Pseudo forms of a state science test were equated within a resampling study where sample size ranged from 1,000 to 10,000 examinees and anchor tests ranged in length from eight to 20 items, with reading and math scores included as covariates. Frequency estimation linking with an anchor test and external covariate was found to produce the most accurate results under the majority of conditions studied. Practical applications of linking with anchor tests and covariates are discussed.
Resources, competitiveness, and socioeconomic development: The case of a South American emerging economy
Authors: Alonso Abel D
Published: February 2019

This study contributes to the regional development and entrepreneurship literature, examining the significance of resources in the context of Uruguay’s main industries for the nation’s socioeconomic development through the lens of the resource-based theory of the firm. Face-to-face interviews were conducted with 47 key informants representing public and private entities. Alignments between the findings and the resource-based theory of the firm emerged, in that strategies implemented to improve the competitiveness of main Uruguayan industries were based on valuable, rare, imperfectly imitable, and non-substitutable resources. However, decisive external factors triggering demand, investments, and modernisation are equally significant in generating competitive advantage. A refinement of the resource-based theory of the firm based on the study’s results is proposed; implications are discussed; and future research opportunities suggested.
Superselective renal artery embolization for bleeding complications after percutaneous renal biopsy: a single-center experience
Authors: Haochen Wang , Jian Wang , Li Song , Tianshi Lv , Xiaoqiang Tong , Yinghua Zou
Published: February 2019

Objective

This study aimed to determine if superselective renal artery embolization is a safe and effective method of treating bleeding complications after percutaneous renal biopsy.

Methods

From January 2006 to December 2017, 43 patients (22 men and 21 women, mean age: 44.5 ± 14.0 years) underwent angiography for post-biopsy bleeding complications following percutaneous biopsy. Patients underwent angiography and superselective artery embolization. We recorded serum creatinine and hemoglobin values to assess the effect of embolization.

Results

Successful embolization was achieved in all patients. There was a pseudoaneurysm in 10 cases, arteriovenous fistula in eight, contrast media extravasation in 16, arteriovenous fistula combined with contrast media extravasation in five, and pseudoaneurysm combined with arteriovenous fistula in four. The embolic substance was a microcoil only or combined with a gelatin sponge. The mean creatinine value was not different at 1 day and 1 week after embolization compared with before embolization. Mean hemoglobin values were significantly higher at 1 day and 1 week after embolization than before embolization.

Conclusions

Superselective renal artery embolization is a safe and effective treatment for post-biopsy bleeding complications after percutaneous renal biopsy. Lumbar or iliolumbar artery angiography is necessary if renal arteriography shows no signs of hemorrhage.
A comparison of different modes of pneumatic compression on muscle tissue oxygenation: An intraparticipant, randomised, controlled volunteer study
Authors: Nandwana Sanat K , Ho Kwok M
Published: February 2019

Intermittent pneumatic compression (IPC) to the lower limbs is widely used as a mechanical means to prevent deep vein thrombosis in hospitalised patients. Due to a theoretical concern about impairing blood flow, thromboembolic-deterrent stockings and IPC are considered contraindicated for patients with peripheral vascular diseases by some clinicians. This study assessed whether IPC would alter peripheral limb muscle tissue oxygenation (StO2), and whether such changes were different during 10 minutes of sequential and single-compartment compressions. Twenty volunteers were randomised to have their left or right arm treated with a sequential or single-compartment IPC for 10 minutes, using the contralateral arm without compression as an intraparticipant control. After a five-minute wash-out period, the procedure was repeated on the same arm using the alternative mode of IPC. Both hands’ thenar muscles StO2 was monitored every two minutes for 10 minutes using the same near-infrared spectroscopy StO2 monitor. Both sequential (3.5%, 95% confidence intervals (CI) 2.7–4.2; p < 0.001) and single-compartment IPC (1.6%, 95% CI 0.4–2.8; p = 0.039) significantly increased muscle StO2 within 10 minutes compared to no compression; and the increments were higher during sequential compressions compared to during single-compartment compressions (2.1%, 95% CI 0.7–3.5; p = 0.023). This mechanistic study showed that both modes of IPC increased upper limb muscle StO2 compared to no compression, but the StO2 increments were higher with the multiple-chamber sequential compressions mode. Contrary to the theoretical concern that IPC may impair peripheral limb tissue oxygenation, our results showed that IPC actually increases oxygenation of the peripheral limb muscles, especially during the sequential compressions mode.
Correlation and agreement between the TEG® 5000 and the TEG® 6s during liver transplant surgery
Authors: Robson Jacqueline L , DJ Watts Andrew , McCulloch Timothy J , Paleologos Michael S , Mortimer Ross A , Kam Peter CA
Published: February 2019

The TEG® 5000 and novel TEG® 6s measure the viscoelasticity of whole blood during in vitro clot formation. The two devices measure similar coagulation variables but utilize distinctly different technologies. This study aimed to determine the correlation and agreement between the thrombelastographic parameters obtained by the two devices during liver transplant surgery. We obtained blood samples at six predefined intervals during the surgery of 10 consecutive patients. Two operators proficient in the use of the TEG® 6s and TEG® 5000 systems performed thrombelastographic measurements on each sample: non-citrated TEG® 5000, citrated TEG® 5000 and citrated TEG® 6s. Agreement and correlation were assessed using Bland Altman plots and Lin’s concordance correlation. There was considerable inter-device variability for the different parameters measured by the TEG® 5000 and TEG® 6s devices. Acceptable agreement was observed when results were within the normal reference ranges. However, with increasing coagulopathy, agreement was poor and results could not be considered interchangeable. Although each of the three tests appeared reliable for qualitative detection of abnormalities of clot formation during liver transplant surgery, we found their quantitative results were not interchangeable.
Utilization of Large-Scale Rolling-Wheel Tester to Investigate the Stress Reduction in Pavement Layers Due to the Use of Geosynthetic Materials
Authors: Wright Jason , Kim S. Sonny , Chorzepa Mi G. , Durham Stephan A.
Published: February 2019

In a geosynthetic-reinforced pavement system, the load-bearing capacity of subgrade soil is improved by the lateral distribution of vertical stresses at the reinforcing layer. Under small-scale triaxial testing, the tensile properties of the geosynthetic are difficult to measure. Therefore, it is desirable to conduct large-scale testing to accurately monitor the behavior of geosynthetic-reinforced pavement foundations when subjected to rolling-wheel loadings. This study investigates the behavior of geosynthetic-reinforced pavement foundation systems through large-scale rolling-wheel tests performed with problematic subgrade soils found in north Georgia. Sixteen large-scale specimens were constructed of which twelve were reinforced with geosynthetic. Subgrade soils were compacted either at their optimum moisture content or at a higher than optimum moisture content to produce different California Bearing Ratios during specimen preparation. Both an extruded biaxial geogrid and woven geotextile were placed at various locations to investigate the optimal placement locations for different subgrade conditions. Pressure sensors were installed near the bottom of the aggregate base layer and near the top of the subgrade layer to monitor the variations in vertical stress within the pavement system under rolling-wheel load. Further, light weight deflectometer measurements were collected post-test to determine the effect of the geosynthetic on pavement foundation stiffness. The vertical pressure at the bottom of the aggregate base and top of subgrade decreased on average approximately 15.3% and 18.8%, respectively. The results indicate which type of geosynthetic and placement location provides the greatest reduction of pressure for each of the given subgrade conditions.
Testing Unmanned Aircraft for Roadside Snow Avalanche Monitoring
Authors: McCormack Edward , Vaa Torgeir
Published: February 2019

An important part of the Norwegian Public Roads Administration’s (NPRA’s) mission is to monitor and react to snow avalanche hazards in steep areas above their roads. Small unmanned aircraft systems (UASs) are increasing capable and commercially available. The NPRA wanted to evaluate if this technology could support their avalanche program but had concerns about UASs’ ability to function and to provide usable information in typical field conditions. The NPRA hired vendors to fly nine different UAS aircraft on challenging avalanche surveillance missions in cold, windy weather in steep mountains. An evaluation team’s conclusions were that different aircraft could be effectively used for different aspects of avalanche monitoring and that cameras on UASs (both visible light and infrared) provided images useful for avalanche surveillance. A second test further evaluated if sensors and cameras carried on UASs could provide NPRA’s avalanche staff with usable snow depth, layering, and surface information. Data from UAS carrying visual cameras, used for both real-time viewing and photogrammetry (structure from motion), and ground penetrating radar (GPR) were compared with snow pack information collected using hand dug pits. The review team found the GPR output could identify the weak snow layers that cause avalanches but the raw data required time-consuming post-processing. Photogrammetry had considerable potential as it mapped snow surface conditions and, with a baseline survey, measured snow depth, both of which are valuable for avalanche assessment. Overall, the review team felt UAS technology held considerable promise to support transportation agencies’ roadside avalanche monitoring programs.
Long-term Outcomes of Meniscal Allograft Transplantation With and Without Extrusion: Mean 12.3-Year Follow-up Study
Authors: Lee Sang-Min , Bin Seong-Il , Kim Jong-Min , Lee Bum-Sik , Lee Chang-Rack , Son Dong-Wook , Park Jun-Gu
Published: February 2019

Background:

Meniscal allograft transplantation (MAT) is a widely performed surgical technique used to reconstruct meniscal deficiencies after meniscectomy. However, the long-term effects of extrusion on clinical and radiologic outcomes are unclear.

Hypothesis:

In long-term follow-up, extrusion after MAT would show poorer outcomes than nonextrusion and would lead to faster progression of arthritic changes.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Forty-five MAT cases (lateral, n = 36; medial meniscal, n = 9) with a minimum 8-year follow-up period were selected. The mean follow-up period was 12.3 years (range, 8.0-19.6 years). Data were collected on patients’ sex, age, surgical side, and mechanical axis deviation. Patients were categorized into 2 groups: extrusion (≥3 mm) and nonextrusion (<3 mm). Categories were based on extrusion length measured via magnetic resonance imaging taken 1 year after surgery. Joint space width (JSW) on the affected and contralateral sides was measured on bilateral weightbearing posterior-anterior radiographs at 45° of flexion at 3 time points (preoperative, 4-6 years postoperative, and >8 years postoperative). Differences of the measured and relative JSW values between the groups and differences at different time points were analyzed. The Lysholm score was used to evaluate clinical function.

Results:

Mean ± SD extrusion was 3.07 ± 0.82 mm. The extrusion and nonextrusion groups were composed of 19 (42.2%) and 26 (57.8%) patients, respectively. Analysis of JSW showed a difference in relative JSW between the groups at >8 years ( P = .017). At the point of transition from 4 to 6 years to >8 years, the differences in absolute JSW values were −1.25 ± 0.78 mm (extrusion group) and −0.58 ± 0.66 mm (nonextrusion group; P < .001). Relative JSW values also differed between groups (extrusion group, −0.22 ± 0.13; nonextrusion group, −0.04 ± 0.18; P < .001). No differences were observed in the Lysholm scores between the groups at each time point.

Conclusion:

Long-term follow-up after MAT revealed a greater decrease in JSW in the extrusion group than in the nonextrusion group. However, no significant differences in clinical outcomes were observed.
Problem Solving in Technology-Rich Environments and Self-Rated Health Among Adults in the U.S.: An Analysis of the Program for the International Assessment of Adult Competencies
Authors: Millar Roberto J. , Sahoo Shalini , Yamashita Takashi , Cummins Phyllis
Published: February 2019

Problem-solving skills in the context of technologically complex modern societies have become increasingly important to health management in later life. This study is designed to investigate the associations between problem-solving skills in technology-rich environments (PSTRE) and health, and to explore whether age differences exist. Using data from the 2012/2014 Program for the International Assessment of Adult Competencies (PIAAC), we used logistic regression to examine the relationship between PSTRE and self-reported health among a representative sample of American adults aged 35 years and older ( N = 3,260). Overall, greater PSTRE (odds ratio [OR] = 1.012, p < .001) was significantly associated with better self-rated health even after adjusting for the sociodemographic characteristics. Yet, PSTRE was only partially predictive of health in some age groups. Our findings highlight the potential of PSTRE to reduce health disparities among middle-aged and older adults living in modern technology and information-rich societies.
Levels of Melatonin in Continuous Spikes and Waves During Sleep
Authors: Ayça Senem , Aksoy Halil Ural , Taştan İsmail , Polat Muzaffer
Published: February 2019

Levels of melatonin have been reported before in children with epilepsy, but such has not been reported to date in those with continuous spikes and waves during sleep. The aim of the present study was to assess serum melatonin levels and melatonin circadian rhythm in patients with continuous spikes and waves during sleep and epilepsy. Serum melatonin was measured in 39 children stratified into 3 groups. Group 1 included 15 patients with continuous spikes and waves during sleep, group 2 included 12 epilepsy patients, and group 3 included 12 controls, respectively. Blood samples were taken from all participants at 1:00 am and 9:00 am and melatonin levels were measured using a quantitative enzyme-linked immunosorbent assay test. The 9:00 am melatonin levels of group 1 were significantly decreased and pair groups were compared. The Pa value (representing a comparison between groups 1 and 2) was .002, the Pb value (representing a comparison between groups 1 and 3) was .001, and the Pc value (representing a comparison between groups 2 and 3) was .86. These findings suggest that the 9:00 am melatonin levels were significantly decreased in the comparison of groups 2 and 3. Further detailed research is necessary to determine the factors leading to the rapid decline of morning melatonin levels of children with continuous spikes and waves during sleep.
Cerebral Autoregulation–Guided Optimal Blood Pressure in Sepsis-Associated Encephalopathy: A Case Series
Authors: Rosenblatt Kathryn , Walker Keenan A. , Goodson Carrie , Olson Elsa , Maher Dermot , Brown Charles H. , Nyquist Paul
Published: February 2019

Background:

Impaired cerebral autoregulation and cerebral hypoperfusion may play a critical role in the high morbidity and mortality in patients with sepsis-associated encephalopathy (SAE). Bedside assessment of cerebral autoregulation may help individualize hemodynamic targets that optimize brain perfusion. We hypothesize that near-infrared spectroscopy (NIRS)–derived cerebral oximetry can identify blood pressure ranges that enhance autoregulation in patients with SAE and that disturbances in autoregulation are associated with severity of encephalopathy.

Methods:

Adult patients with acute encephalopathy directly attributable to sepsis were followed using NIRS-based multimodal monitoring for 12 consecutive hours. We used the correlation in time between regional cerebral oxygen saturation and mean arterial pressure (MAP) to determine the cerebral oximetry index (COx) as a measure of cerebral autoregulation. Autoregulation curves were constructed for each patient with averaged COx values sorted by MAP in 3 sequential 4-hour periods; the optimal pressure (MAPOPT), defined as the MAP associated with most robust autoregulation (lowest COx), was identified in each period. Severity of encephalopathy was measured with Glasgow coma scale (GCS).

Results:

Six patients with extracranial sepsis met the stringent criteria specified, including no pharmacological sedation or neurologic premorbidity. Optimal MAP was identified in all patients and ranged from 55 to 115 mmHg. Additionally, MAPOPT varied within individual patients over time during monitoring. Disturbed autoregulation, based on COx, was associated with worse neurologic status (GCS < 13) both with and without controlling for age and severity of sepsis (adjusted odds ratio [OR]: 2.11; 95% confidence interval [CI]: 1.77-2.52; P < .001; OR: 2.97; 95% CI: 1.63-5.43; P < .001).

Conclusions:

In this high-fidelity group of patients with SAE, continuous, NIRS-based monitoring can identify blood pressure ranges that improve autoregulation. This is important given the association between cerebral autoregulatory function and severity of encephalopathy. Individualizing blood pressure goals using bedside autoregulation monitoring may better preserve cerebral perfusion in SAE than current practice.
Argentinean Validation of the Factorial Structure of the Learning Experiences Questionnaire (LEQ)
Authors: Morán Valeria E. , Cupani Marcos , Azpilicueta Ana E. , Garrido Sebastián J. , Martinatto Cintia A.
Published: February 2019

Studies of self-efficacy that is linked to realistic, investigative, artistic, social, enterprising, and conventional (RIASEC) typology constitute a growing field of research because of its relevance to vocational and occupational choices. Particularly in Argentina, this line of research is still ongoing and requires valid and reliable measurement tools. The present work adapted the Learning Experiences Questionnaire (LEQ) in a sample of 721 university students (473 women, 248 men), 18–53 years old, from Córdoba, Argentina. The authors translated the items of the LEQ and corroborated the cultural adequacy of their content. The multiple factorial structure that was reported in previous studies in North American contexts was replicated using the multitrait-multimethod matrix. The results provide convergent and discriminant evidence of the scale for use with Argentinean university students. Limitations are discussed, and further lines of investigation are suggested.
University–industry collaboration: A literature review and synthesis
Authors: Sjöö Karolin , Hellström Tomas
Published: February 2019

This study applies a systematic literature review and qualitative content analysis to identify and synthesize key factors that enable collaborative innovation between industry and universities. Using a keyword search in the Web of Science database, the review identified 40 papers that were frequently cited on the topic. Results were summarized into seven main themes or central factors stimulating collaborative innovation: resources, university organization, boundary-spanning functions, collaborative experience, culture, status centrality and environmental context. This article elaborates on these ‘enabling factors’ and uses them to summarize a number of results from the reviewed studies regarding facilitators of collaborative innovation. The discussion focuses on how these factors relate and the extent to which they are amenable to policy intervention.
Multimodal control parameter optimization for aircraft longitudinal automatic landing via the hybrid particle swarm-BFGS algorithm
Authors: Bian Qi , Nener Brett , Li Ting , Wang Xinmin
Published: February 2019

The airborne automatic landing system needs to provide both accurate trajectory tracking and constant sink rate. In this article, a hybrid optimizer combining a modified particle swarm algorithm with the damped Broyden–Fletcher–Goldfarb–Shanno (BFGS) method is presented to not only solve the parameter tuning problem for the automatic landing system design, but also explore the hidden properties of the multimodal optimization problem. In doing so, the quasi-random sequence-based particle initialization method is adopted to let the particles cover the problem domain more evenly. Then, the damped BFGS-based searching method is used to calculate the local minimum of each particle. A three-point searching method is adopted as a substitution method if the damped BFGS method fails. By using the modified niching method, each particle is updated and converges to an estimated local minimum point. Finally, a range of optimized solutions is analysed and presented to the engineer for the automatic landing system design. A series of simulations are carried out on a test bed based on a 6 degrees of freedom (DoF) non-linear model of the F/A-18. Comparative results verify the effectiveness of the proposed method.
Missile longitudinal autopilot design using a generalized extended state observer-based mixed H2/H∞ control method
Authors: Dong Yi , Li Jian , Li Tong , Wu Jie
Published: February 2019

This work presents a novel robust control design approach for missile longitudinal autopilot under multiple disturbances and uncertainties. The uncertainties and disturbances of the missile dynamics are treated as a lumped disturbance based on the concept of equivalent input disturbance. Then a generalized extended state observer is employed to estimate the system states and the equivalent input disturbance in an integrated manner. These estimates are used to construct the state-feedback controller as well as to attenuate the effect of the exogenous disturbances and endogenous uncertainties. The state-feedback controller is obtained by solving the linear matrix inequalities of mixed [Formula: see text]/[Formula: see text] control problem, which provides an impressive flexibility to tune the controller to compromise between [Formula: see text] performance and [Formula: see text] performance. Closed-loop stability of the system under the presented controller-observer structure is also established. The proposed design tactfully circumvents the engineering implementation problems encountered by mixed [Formula: see text]/[Formula: see text] control, achieves strong robustness against disturbances and uncertainties, and does not involve any complicated nonlinear control methodologies. Numerical simulation results of nominal and perturbed performance comparisons with classic methods sufficiently demonstrate the feasibility and robustness of the proposed method.
Preliminary evaluation of a predictive controller for a rotary blood pump based on pulmonary oxygen gas exchange
Authors: Huang Feng , Gou Zhe , Fu Yang
Published: February 2019

Physiological control of rotary blood pumps is becoming increasingly necessary for clinical use. In this study, the mean oxygen partial pressure in the upper airway was first quantitatively evaluated as a control objective for a rotary blood pump. A model-free predictive controller was designed based on this control objective. Then, the quantitative evaluation of the controller was implemented with a rotary blood pump model on a complete cardiovascular model incorporated with airway mechanics and gas exchange models. The results show that the controller maintained a mean oxygen partial pressure at a normal and constant level of 138 mmHg in the left heart failure condition and restored basic haemodynamics of blood circulation. A left ventricular contractility recovery condition was also replicated to assess the response of the controller, and a stable result was obtained. This study indicates the potential use of the oxygen partial pressure index during pulmonary gas exchange when developing a multi-objective physiological controller for rotary blood pumps.
Downregulation of miR-633 activated AKT/mTOR pathway by targeting AKT1 in lupus CD4+ T cells
Authors: Chen S , Wang Y , Qin H , Lin J , Xie L , Chen S , Liang J , Xu J
Published: February 2019

Background

Accumulating evidence suggests that the AKT/mTOR pathway plays an important role in the pathogenesis of systemic lupus erythematosus (SLE) through activating T cells, and there are few studies looking into the role of microRNA (miRNAs) in the mechanism. We first found that miR-633 expression in CD4+T cells of SLE patients was significantly reduced.

Objective

To investigate the role of miR-633 in the AKT/mTOR pathway in lupus CD4+T cells.

Methods

Samples of 17 SLE cases and 16 healthy controls were collected to detect the expression of miR-633, AKT1, mTOR mRNA and proteins by quantitative polymerase chain reaction (qPCR) and Western-blot, respectively. To determine whether AKT1 is a direct target of miR-633, a luciferase assay was performed. In vitro, AKT1 siRNA, miR-633 mimics/inhibitors or negative controls were transfected to Jurkat cells, human primary CD4+T cells and lupus CD4+T cells. RNA and proteins were extracted after 48 h, and levels of AKT/mTOR pathway markers and downstream multiple cytokines were detected by qPCR or Western-blot.

Results

In SLE patients, the miR-633 levels in CD4+T cells were significantly decreased and negatively correlated with SLEDAI. AKT1, mTOR mRNA and proteins were all up-regulated. The degree of downregulation of miR-633 was correlated negatively with AKT1 mRNA. The luciferase assay proved that AKT1 is a direct target of miR-633. In Jurkat and lupus CD4+T cells, overexpression of miR-633 could result in lower levels of AKT1 and mTOR. Inhibition of miR-633 expression in primary CD4+T cells caused reverse effects, and protein levels of p-AKT, p-mTOR, and p-S6RP increased. Moreover, among various cytokines, the expression of IL-4, IL-17, and IFN-γ mRNA was raised.

Conclusion

Our study suggests that miR-633 deletion can activate the AKT/mTOR pathway by targeting AKT1 to participate in the pathogenesis of SLE.
Moral distress in undergraduate nursing students
Authors: Bordignon Simoní Saraiva , Lunardi Valéria Lerch , Barlem Edison Luiz Devos , Dalmolin Graziele de Lima , da Silveira Rosemary Silva , Ramos Flávia Regina Souza , Barlem Jamila Geri Tomaschewski
Published: February 2019

Background:

Moral distress is considered to be the negative feelings that arise when one knows the morally correct response to a situation but cannot act because of institutional or hierarchal constraints.

Objectives:

To analyze moral distress and its relation with sociodemographic and academic variables in undergraduate students from different universities in Brazil.

Method:

Quantitative study with a cross-sectional design. Data were collected through the Moral Distress Scale for Nursing Students, with 499 nursing students from three universities in the extreme south of Brazil answering the scale. The data were analyzed in the statistical software SPSS version 22.0, through descriptive statistical analysis, association tests (t-test and analysis of variance), and linear regression models.

Ethical considerations:

Approval for the study was obtained from the Research Ethics Committee at Universidade Federal do Rio Grande.

Findings:

The mean intensity of moral distress in the constructs ranged from 1.60 to 2.55. As to the occurrence of situations leading to moral distress in the constructs, the frequencies ranged from 1.21 to 2.43. The intensity level of moral distress showed higher averages in the more advanced grades of the undergraduate nursing course, when compared to the early grades of this course (between 5 and 10 grade, average = 2.60–3.14, p = 0.000).

Conclusion:

The demographic and academic characteristics of the undergraduate nursing students who referred higher levels of moral distress were being enrolled in the final course semesters, were at a federal university, and had no prior degree as an auxiliary nurse/nursing technician.
Applying mindfulness training to enhance the mental toughness and emotional intelligence of amateur basketball players
Authors: Ajilchi Bita , Amini Hamid Reza , Ardakani Zahra Pouraghaei , Zadeh Majid Mozafari , Kisely Steve
Published: February 2019

Objectives:

Mindfulness is a proven treatment in clinical settings. Our objective was to examine the feasibility and effect of a mindfulness-training program on the mental resilience and emotional intelligence of amateur basketball players.

Methods:

This was a parallel-group, pre- and post- test, randomised controlled trial. Thirty male amateur male basketball players from Tehran, Iran, were assigned randomly into experimental and control groups ( n = 15 each). Outcomes were measured using the mindfulness sport inventory, mental toughness (MT) questionnaire and emotional intelligence questionnaire. Data were analysed using ANCOVA and MANCOVA.

Results:

Mindfulness scores were significantly greater in the intervention group than in the controls following training. The intervention also increased overall MT and all of the component sub scores. The same applied to emotional intelligence and all of its components.

Conclusions:

These findings may have implications on sport mindfulness training in increasing the MT and emotional intelligence of athletes.
Psychodynamic therapy for non-compliance: a case report
Authors: Saha Shanthi , McCarthy Claire , Dhillon Rohan
Published: February 2019

Objectives:

This paper outlines the use of psychodynamic psychotherapy as an adjunct to treatment as usual for addressing challenging behaviours in a patient with schizophrenia under the care of a community mental health team (CMHT) in South Australia.

Methods:

Ms P suffered from schizophrenia and demonstrated challenging behaviours in the context of being administered depot medication under a community treatment order (CTO). Multiple attempts at addressing non-compliance and consistently disruptive behaviour through conventional methods had failed. Consequently, the novel approach of fortnightly psychodynamic psychotherapy sessions was trialled for 5 months, augmenting treatment as usual.

Results:

Psychodynamic psychotherapy proved effective for this patient. With treatment, she showed an improved compliance and overall engagement. Additionally, consequent to regularly receiving medication, her mental state improved and hospitalisations decreased.

Conclusions:

Further research could lead to a better understanding of how and in what contexts, psychodynamic therapy and psychodynamic thinking can be utilised in the public health system.