bluuebunny/crossref_metadata_2025 huggingface dataset:
Real Help for the Gifted Physically Handicapped: Barrier-Free Education
Authors: Ford Barbara Gay
Published: May 2020

This article is an editorial concerning the needs of the gifted handicapped for accessibility to our institutions of higher education and public institutions such as libraries. The needs of the gifted handicapped in the classroom have been considered by many educators, but their needs in the community have often been overlooked. Therefore this editorial was written based on the experience of the author with the problems of some very capable but physically handicapped students. The article covers some of the unique experiences of the physically handicapped students on a university campus, and urges the reader to consider some of the changes that must be made before education is truly accessible to students who are gifted but also handicapped.
Creative Music Strategies Based upon Poetry and the Language
Authors: Cleveland Michael E.
Published: May 2020

Formal composition should not be a beginning creative musical activity, but should be preceded by freer, more divergent experiences with sound. Also, the concept of “composition” should be put aside in favor of that “organization of sounds.” Free exploration of sounds, using poetry or other means, may ultimately lead to the convergent skills required for formal composition.

Five ways of using poetry and the language for creative experiences in music are discussed: 1. Inventing words for familiar songs 2. Writing song lyrics to a familiar melodic pattern 3. Adding sounds to an existing poem 4. Creating an original sound-piece from a poem 5. Improvising upon verbal stimuli
Leadership Giftedness: Developing a Profile
Authors: Lindsay Bryan
Published: May 2020

A profile of the commonalities in characteristics and capabilities of gifted leaders in various fields is presented. The success of educating gifted students in leadership will be greatly enhanced as educators become aware of this primary criteria necessary for effective leadership.
Teacher Identification of the Gifted: A New Look
Authors: Borland James
Published: May 2020

Teacher recommendation as a means of identifying gifted children traditionally has been regarded as ineffective and inefficient, although such conclusions are based upon studies in which teachers were required to make global assessments of students' ability. The present study sought to re-examine the issue through the use of checklists on which the teachers were asked to indicate the presence or absence of certain behaviors. Significant, moderate, positive correlations between teacher rating and IQ were obtained, and the ratings were found to possess both high efficiency and stability. Teacher rating was found to be a better predictor of giftedness for girls than for boys. With IQ as the dependent variable, a main effect for achievement was found, but there was none for rating nor was there an interaction effect. Teacher rating was a better identifier of gifted underachievers than of gifted achievers.
An Indication of the Status of Education for Gifted Elementary Children: State of Iowa
Authors: Breiter Joan
Published: May 2020

This study attempted to determine which of the 449 public school districts in the State of Iowa have programs for gifted elementary children, or are planning programs, and what factors in planning/implementing such programs seem of most importance at this time. Conducted in the Fall of 1977, 351 districts responded, of which 36 had an operative program and 60 were planning programs.

The major conclusions to be drawn from the study are: (1) there is interest in the area, but most districts feel the need for assistance, (2) major problem areas in program building include the identification of gifted children, the definition of giftedness, and evaluation procedures, (3) there is a need to better prepare teachers to work with gifted children, and (4) the present program formats vary widely to fit local needs.

Recommendations include: (1) careful needs assessment by districts planning programs, (2) more specific aid to be offered by DPI, AEA and University personnel, and (3) more adequate financial support for such programs.
A Summer Institute for Teachers and Administrators of Young Gifted Children
Authors: Vukelich Carol , Kliman Deborah S. , Meyers Judith
Published: May 2020

A two-week Summer Institute for teachers and administrators of kindergarten and grade one gifted children is described. The purpose of the Institute was to plan strategies for meeting the needs of the young gifted and talented children in their classrooms, schools, or districts. Specific follow-up activities were designed to assist participants in implementing: (1) plans for identifying young gifted children; (2) strategies for meeting these children's needs; and (3) efforts to focus the local community on the needs of young gifted children.
LRP = IN (5PS/3ST) = SD/GTP a Formula for Staff Development for Programming for Gifted and Talented Students
Authors: Downing Gloria , Todd Anita
Published: May 2020

Excellence in the education of the gifted student demands an equally excellent education of the teachers of the gifted and of the supporting educational community. A long-range program of staff development must be an integral part of any process of program development and maintenance. In this change-agentry model, staff development activities are viewed within a framework of three program stages: awareness, implementation, and maintenance. Selection of inservice activities appropriate to each stage are based on the developmental theories of Bloom (cognitive) and Krathwohl (affective) and on Renzulli's Enrichment Triad Model for gifted students.
Deceit among the Gifted
Authors: Schab Fred
Published: May 2020

A survey of the moral behavior of Georgia gifted high school students, first made in 1969, was replicated in 1979. Significant changes were revealed in their beliefs, attitudes and admissions regarding cheating in school and morality in our society in general. The present day gifted youngsters were much more pessimistic regarding the moral behavior of others, were more likely to admit their own transgressions in various aspects of school performance, and questioned the honesty of people engaged in professional as well as semiprofessional occupations.
Thirteen Ways of Looking at a Gifted Teacher
Authors: Dubner Frances S.
Published: May 2020

The role of the teacher of gifted students engaged in independent study is a difficult one to define. Researchers have identified many, including counselor, instructor, guide, facilitator. However, the role that is chosen is often determined by the nature of the specific educational program in which the teacher and pupils are involved. The author examined Impact—a seven year old secondary school gifted program in DeKalb County, Georgia. Through analysis of responses of 351 students to a questionnaire, thirteen role categories emerged. This paper describes those roles and their relative importance to the students who participated in the program.
Parental Involvement in Gifted Programs
Authors: Cassidy Jack
Published: May 2020

Parental involvement is becoming increasingly important in all aspects of education, but particularly in gifted education. Basically, there are five roles which parents of gifted youngsters can perform: advisor/advocate; parental guide; mentor; classroom aide; and materials developer. Examples of exactly how parents can fulfill each role are provided. While it is unrealistic to expect every parent to enact all five roles, all parents can assume at least some of these roles.
Comparison of the PPVT, PPVT-R and the WISC-R with Gifted Students
Authors: Mccallum R. Steve , Karnes Frances A. , Bracken Bruce A.
Published: May 2020

WISC-R, PPVT-R, and PPVT scores were compared for 36 gifted students. WISC-R VIQ and FSIQ scores were nonsignificantly different from the PPVT and to PPVT-R Form M scores. PPVT-R Form L scores were significantly lower than those obtained from the WISC-R Verbal and Full Scales. Correlation coefficients for the WISC-R VIQs, FSIQs, and the various PPVT and PPVT-R scores were all statistically significant. Because of the technical limitations of the PPVT, the PPVT-R was recommended over the PPVT as one instrument for screening gifted children.
A New View of the Relationship between Creativity and Intelligence
Authors: Harvey Steven
Published: May 2020

One hundred and fourteen youths involved in a juvenile justice system, half of whom were included because of potential giftedness, were administered the age appropriate Weschler Intelligence Scales and the Torrance Test of Creative Thinking to assess their cognitive abilities. The resulting multivariate data were analyzed using maximum likehood factor analysis and structural equation model to develop a factor model of intellectual and creative abilities and the relationships among them. Two high order factor and five lower level characteristics were isolated. These were defined as general intelligence and general fluency at the higher level, and crystallized and fluid intelligence, verbal and figural divergent production, along with creative energy, at the lower level. While no relationship was found between general intelligence and general fluency, the creative energy factor was found to be influenced by both of these higher order factors. This result was used in discussion related to the theory of creativity.
Reading Instruction for the Gifted: A Survey of Programs
Authors: McCormick Sandra , Swassing Raymond H.
Published: May 2020

This article presents the results of a nationwide survey undertaken to determine how school systems are providing for the reading instruction of gifted students. Most districts make special provision for the reading instruction of the gifted within regular classroom settings, but a large number make no special provision at all. A smaller number of systems have special extraclassroom programs and some combine these with programs in the regular classroom. Additional data obtained from the survey and presented in this article include information on grade levels in which the special reading needs of the gifted are being served, how teachers are selected for the special programs, the curricula of reading programs for the gifted, the use of required reading lists, programs for gifted students who are poor readers, and teacher viewpoints on desirable features of reading programs for the gifted.
An Experimental Program for Gifted Four Year Olds
Authors: Vantassel-Baska Joyce , Schuler Anne , Lipschutz Judy
Published: May 2020

For years, the field of gifted education has supported the contention that gifted children should be identified and served at the beginning of their formal school experience in order to keep them interested and challenged by learning. Frequently, the large problem of underachievement among the gifted population has been laid at the doorstep of a lack of such early program opportunities. Yet few extant programs have emerged that provide services to children at preschool age or even early primary.

Of course, there have been notable exceptions. The longitudinal research on young gifted children being carried on at the University of Washington has found that preschool gifted children can be identified through multiple measures examined in a case study context; and that they have the ability to learn concepts and skills at earlier stages than their age peers even though the diversity of ability and level of mastery at a particular age may vary widely within the gifted group (Roedell, Jackson, Robinson, 1980). These recent findings corroborate the work at the Roeper School for the Gifted for over 40 years in the area of providing self-paced academic experiences for the young gifted child (Roeper, 1980). The Astor program in New York City found that four and five year olds could function well in a full-day gifted program that addressed both cognitive and affective areas of development (Ehrlich, in press). A program that compared the effectiveness of classroom approaches for use with preschool gifted children found that both an SOI-based classroom and an open classroom were effective, depending on the nature of the individual gifted learner (Karnes, 1978). And even in rural settings, the young gifted child could be served through a consultative model that linked limited program contact time with follow-up parental intervention (Hanninen, 1979).

All of these programs have demonstrated the appropriateness of identifying young gifted children using a test battery with reliance on a case study approach for final selection, providing experiences in academic learning for the preschool gifted child who is ready to move ahead and can profit from additional enrichment learning, and nurturing the social and emotional growth of the child through interactive strategies.
Comparing model-based control methods for simultaneous stiffness and position control of inflatable soft robots
Authors: Best Charles M. , Rupert Levi , Killpack Marc D.
Published: May 2020

Inflatable robots are naturally lightweight and compliant, which may make them well suited for operating in unstructured environments or in close proximity to people. The inflatable joints used in this article consist of a strong fabric exterior that constrains two opposing compliant air bladders that generate torque (unlike McKibben actuators where pressure changes cause translation). This antagonistic structure allows the simultaneous control of position and stiffness. However, dynamic models of soft robots that allow variable stiffness control have not been well developed. In this work, a model that includes stiffness as a state variable is developed and validated. Using the stiffness model, a sliding mode controller and model predictive controller are developed to control stiffness and position simultaneously. For sliding mode control (SMC), the joint stiffness was controlled to within 0.07 Nm/rad of a 45 Nm/rad command. For model predictive control (MPC) the joint stiffness was controlled to within 0.045 Nm/rad of the same stiffness command. Both SMC and MPC were able to control to within 0.5° of a desired position at steady state. Stiffness control was extended to a multiple-degree-of-freedom soft robot using MPC. Controlling stiffness of a 4-DOF arm reduced the end-effector deflection by approximately 50% (from 17.9 to 12.2cm) with a 4 lb (1.8 kg) step input applied at the end effector when higher joint stiffness (40 Nm/rad) was used compared with low stiffness (30 Nm/rad). This work shows that the derived stiffness model can enable effective position and stiffness control.
Incidence of and sociological risk factors for suicide death in patients with leukemia: A population-based study
Authors: Yang Jin , Liu Qingqing , Zhao Fanfan , Feng Xiaojie , Kaaya Rahel Elishilia , Lyu Jun
Published: May 2020

Objectives

Suicide is closely related to sociological factors, but sociological analyses of suicide risk in leukemia are lacking. This study is the first to use the Surveillance, Epidemiology, and End Results Program (SEER) database to analyze sociological risk factors for suicide death in leukemia patients.

Methods

A retrospective search of the SEER database was conducted. Logistic regression was used to identify independent risk factors for suicide death. Variables significant in the univariate logistic regression models were subsequently analyzed using multivariate regression.

Results

The death rate was highest in California (1.73%). Suicide mortality was more common during the 1970s and 1980s, after which it trended downward. Young age at diagnosis (18–34 vs. >64 years: odds ratio [OR] = 1.537, 95% confidence interval [CI] = 1.007–2.347; 35–64 vs. >64 years: OR = 1.610, 95% CI = 1.309–1.979), being male (OR = 1.518, 95% CI = 1.230–1.873), and living where a high proportion of people have at least a bachelor’s degree (>50% vs. <20%: OR = 8.115, 95% CI = 5.053–13.034) significantly increased suicide death risk.

Conclusion

Our findings could increase clinician awareness of and appropriate support for leukemia patients at risk of death by suicide.
Development and Performance Evaluation of a Connected Vehicle Application Development Platform
Authors: Islam Mhafuzul , Rahman Mizanur , Khan Sakib Mahmud , Chowdhury Mashrur , Deka Lipika
Published: May 2020

Connected vehicle (CV) application developers need a development platform to build, test, and debug real-world CV applications, such as safety, mobility, and environmental applications, in edge-centric cyber-physical system (CPS). The objective of this paper is to develop and evaluate a scalable and secure CV application development platform (CVDeP) that enables application developers to build, test, and debug CV applications in real-time while meeting the functional requirements of any CV applications. The efficacy of the CVDeP was evaluated using two types of CV applications (one safety and one mobility application) and they were validated through field experiments at the South Carolina Connected Vehicle Testbed (SC-CVT). The analyses show that the CVDeP satisfies the functional requirements in relation to latency and throughput of the selected CV applications while maintaining the scalability and security of the platform and applications.
Solid circular plate unilaterally supported along two antipodal edge arcs and deflected by a central transverse concentrated force
Authors: Strozzi Antonio
Published: May 2020

A solid circular plate unilaterally supported along two antipodal edge arcs and deflected by a static central transverse concentrated force is considered. It is clarified that two distinct mechanical responses are possible, depending on the angular extent of the supports; in the first kind of response, valid for small support angular widths, the plate rotates about the support lateral sides, lifting from the supports along their central zone. The second response is valid for high support angular extents, and according to this response the plate additionally beds over the central portion of the support upper faces. Only the first kind of response is examined in this paper. This plate contact problem is classifiable as receding, and the plate deflection is described in terms of a plate Kirchhoff model. The plate deflection is analytically expressed together with the transitional value of the support angular width that describes the passage from the first to the second mechanical response.
B or 13? Unconscious Top-Down Contextual Effects at the Categorical but Not the Lexical Level
Authors: Biderman Dan , Shir Yarden , Mudrik Liad
Published: May 2020

Contextual effects require integration of top-down predictions and bottom-up visual information. Given the widely assumed link between integration and consciousness, we asked whether contextual effects require consciousness. In two experiments (total N = 60), an ambiguous stimulus (which could be read as either B or 13) was presented alongside masked numbers (12 and 14) or letters (A and C). Context biased stimulus classification when it was consciously and unconsciously perceived. However, unconsciously perceived contexts evoked smaller effects. This finding was replicated and generalized into another language in a further experiment ( N = 46) using a different set of stimuli, strengthening the claim that symbolic contextual effects can occur without awareness. Moreover, four experiments (total N = 160) suggested that these unconscious effects might be limited to the categorical level (numbers context vs. letters context) and do not extend to the lexical level (words context vs. nonwords context). Taken together, our results suggest that although consciousness may not be necessary for effects that require simple integration or none at all, it is nevertheless required for integration over larger semantic windows.
Anaerobic degradation of palm oil mill effluent with aluminum bauxite residue for methane production
Authors: Ahmad Anwar , AlDawey Salam S , Reddy SS
Published: May 2020

Experimental study of the anaerobic digestion of palm oil mill effluent (POME) was carried out in an anaerobic upflow sludge blanket reactor (UASBR) with bauxite residue. The production rate of methane 114 L/gCOD/d and CH4 concentration was 205 L gCOD/d at 8.5 g/L of bauxite residue in UASBR. The results showed that the highest methane yield was 37.5 L gCODadded/h; CO2 reduction 1.5 L gCODadded and chemical oxygen demand (COD) removal reached 98.3% at 8.5 g/L of bauxite residue, respectively. The results the best by the modified kinetic model and Umax was 100 mg/L. The kinetic of methane production was also studied. The methane yield coefficient, YM, was 0.69 L CH4/gCODremoved. Anaerobic digestion of acetate was the dominant soluble metabolites in development and specific methanogenic activity results showed that high observed between stoichiometric and experimental higher methane production.
Ancient parasites from a peat bog: New insights into animal presence and husbandry in Crete over the past 2000 years
Authors: Roche Kévin , Jouffroy-Bapicot Isabelle , Vannière Boris , Le Bailly Matthieu
Published: May 2020

This paper presents an original palaeoparasitological study performed on samples from a sedimentary core in a peat bog (Asi Gonia, White Mountains, Crete, Greece). The aim of the study is to test the preservation and concentration of parasitic remains in peat sediments, to discuss animal presence around the site throughout the record, and to compare the results with other biomarkers of environmental history. In this aim, 22 sediment samples distributed between the Roman period and the present were processed and the residues were observed under light microscopy in search of parasitic markers (microscopic eggs or oocysts). The majority of the samples (86.4%) tested positive for the presence of helminth eggs. Several taxa were observed throughout the studied period, including Trichuris sp., Ascaris sp., Capillaria sp., Fasciola sp., Paramphistomum sp. and Macracanthorhynchus sp. The assemblage of parasite markers changes throughout the record and the variations show close correlations with previously published grazing indicators (fungal spores) and vegetation changes (pollen grains). This study sheds lights on animal associations and changing environments in the watershed over the past 2000 years. Indeed, we detected three main phases consisting of: Roman animal herding with pigs in an evergreen oak forest, then a more irregular but almost constant presence of ruminants during a second Byzantine and modern phase in a heather maquis landscape and, finally, present-day grazing in a phrygana/steppe landscape. These results highlight how palaeoparasitology can contribute to multi-proxy approaches in peat bog sedimentary sequences.
Effect of early eradication therapy on systemic lupus erythematosus risk in patients with Helicobacter pylori infection: a nationwide population-based cohort study
Authors: Wu Meng-Che , Huang Jing-Yang , Chen Huang-Hsi , Wei James Cheng-Chung
Published: May 2020

Background

This study aimed to investigate whether early eradication therapy influences systemic lupus erythematosus (SLE) risk in patients with Helicobacter pylori (HP) infection.

Methods

We identified 41,653 patients with HP infection in Taiwan from 2000 to 2013. The patient population was divided into early (within three months) and late (after three months) eradication cohorts. age, sex, co-morbidities and medical visits were matched at a 1:1 ratio. Multiple Cox regression, sensitivity analysis and stratified analysis were used to estimate SLE adjusted hazard ratios (aHR).

Results

The relative risk of SLE was 0.75 (95% confidence interval 0.43–1.31) in the early eradication cohort. After multivariate adjustment, the SLE risk was non-significantly lower in the early eradication cohort than in the late eradication cohort (aHR = 0.74, 95% CI 0.42–1.29). Stratified analysis revealed that early eradication could significantly reduce SLE risk during the three-year follow-up period (aHR = 0.16, 95% CI 0.05–0.53, p for interaction = 0.0013). Compared to eradication within three months of diagnosis, eradication within 3–36 months and >36 months corresponded with SLE aHRs of 4.78 (95% CI 1.19–19.20) and 7.66 (95% CI 2.17–27.05), respectively, when the follow-up period was less than three years.

Conclusion

Early HP eradication could significantly reduce SLE risk, especially in the first three-year follow-up.
Times of power, knowledge and critique in the work of Foucault
Authors: Portschy Jürgen
Published: May 2020

While Michel Foucault is commonly considered as a thinker with a primary interest in space and spatiality, his use of temporal categories, tropes and metaphors has until recently been only partially reconstructed. Working through different phases of his writings and lectures, this paper argues that Foucault opened a complex and interesting – yet to be acknowledged – analytical perspective on historically dominant, but fundamentally contested forms of social time-regimes, which accounts especially for contingent ruptures, silent continuities and the power-structured contexts of their emergence. Elucidating conceptual tools designed towards the analysis of rationalities and practises of temporal government and approaching social time regimes along the axes of power, knowledge and subjectivity, the aim of this paper is twofold: on the one side, it tries to further contribute to a ‘temporal turn’ in Foucault studies; on the other, it attempts to develop a Foucauldian vocabulary of temporal analysis as an alternative or supplement to established approaches in the field of critical social time studies.
Optimal individualized decision rules from a multi-arm trial: A comparison of methods and an application to tailoring inter-donation intervals among blood donors in the UK
Authors: Xu Yuejia , Wood Angela M , Sweeting Michael J , Roberts David J , Tom Brian DM
Published: May 2020

There is a growing interest in precision medicine where individual heterogeneity is incorporated into decision-making and treatments are tailored to individuals to provide better healthcare. One important aspect of precision medicine is the estimation of the optimal individualized treatment rule (ITR) that optimizes the expected outcome. Most methods developed for this purpose are restricted to the setting with two treatments, while clinical studies with more than two treatments are common in practice. In this work, we summarize methods to estimate the optimal ITR in the multi-arm setting and compare their performance in large-scale clinical trials via simulation studies. We then illustrate their utilities with a case study using the data from the INTERVAL trial, which randomly assigned over 20,000 male blood donors from England to one of the three inter-donation intervals (12-week, 10-week, and eight-week) over two years. We estimate the optimal individualized donation strategies under three different objectives. Our findings are fairly consistent across five different approaches that are applied: when we target the maximization of the total units of blood collected, almost all donors are assigned to the eight-week inter-donation interval, whereas if we aim at minimizing the low hemoglobin deferral rates, almost all donors are assigned to donate every 12 weeks. However, when the goal is to maximize the utility score that “discounts” the total units of blood collected by the incidences of low hemoglobin deferrals, we observe some heterogeneity in the optimal inter-donation interval across donors and the optimal donor assignment strategy is highly dependent on the trade-off parameter in the utility function.
Impact of an organised population screening programme for colorectal cancer: Measurement after first and second rounds
Authors: Mar Javier , Arrospide Arantzazu , Larrañaga Igor , Iruretagoiena Maria Luisa , Imaz Liher , Gorostiza Ania , Ibarrondo Oliver
Published: May 2020

Objective

The first and second rounds of the Basque programme for organised colorectal cancer screening were implemented between 2009 and 2014. Our objective was to measure the changes in incidence, tumour, node, metastasis staging distribution and tumour, node, metastasis-adjusted survival of patients with colorectal cancer from 2003 to 2014.

Method

Colorectal cancer cases with screening (patients <70 years old) and without screening (patients ≥70 years old) were compared during three four-year periods: 2003–2006, 2007–2010 and 2011–2014 (fully implemented phase). Cox regression, five-year relative survival and cancer probability of death were calculated for each four-year period, age group and tumour, node, metastasis stage. Adjusted incidence rates were analysed by joinpoint regression.

Results

In an analysis of 23,301 cases of colorectal cancer, the incidence in patients younger than 70 years in 2013 showed a 17% annual decrease. The survival hazard ratios for stages I, II and III for 2003–2006 and 2007–2010 were compared to those for 2011–2014. From the first to the third period, diagnosis in the early stages (I and II) rose from 45.1% to 50.9% in the younger patient group and remained stable in the older group (49.6% and 49.4%). Additionally, the five-year relative survival rate increased significantly from 0.67 to 0.82 in those patients younger than 70 years, whereas in patients 70 years or older the rate did not change significantly (0.61 and 0.65).

Conclusion

The screening reduced incidence and improved survival by anticipating the diagnosis and by reducing mortality for each tumour, node, metastasis stage in the target population. The effect on survival could also be due to lead-time bias.
Technical Efficiency in Small Tea Gardens of Assam
Authors: Das Karabi , Das Debarshi
Published: May 2020

Although Assam has been the leading producer of tea in India, the small tea growers are a new phenomenon in the state. In the last four decades this sector has experienced tremendous growth. Owners of small plots in the hinterland of eastern Assam have taken to small tea cultivation. The sector has a potential to mitigate underdevelopment; but one needs to understand if there is technical inefficiency in its production. This paper affirms the presence of technical inefficiency and investigates its sources. Our research is based on primary data collected across five districts of eastern and central Assam. Stochastic frontier model has been used to ascertain technical inefficiency. Policy implications are spelled out in the end.
Hyperglycemia as a positive predictor of mortality in major trauma
Authors: Chang Chia‐Peng , Hsiao Cheng‐Ting , Wang Cheng‐Hsien , Chen Kai‐Hua , Chen I‐Chuan , Lin Chun‐Nan , Hsiao Kuang‐Yu
Published: May 2020

Background:

Hyperglycemia in the acute phase after trauma is a stress response and a metabolic reflection in humans with injury, which could adversely affect outcome in trauma patients. In this study, we attempted to identify if hyperglycemia a reliable predictor for mortality in major trauma patients.

Objectives:

In order to identify if hyperglycemia a reliable predictor for mortality in major trauma, we designed and proformed a prospective observational study in a tertiary hospital.

Method:

We performed a prospective observational study to review the records of 601 patients with major trauma (injury severity scores >15) who visited our hospital's emergency department from August 2012 to July 2015. Logistic regression was performed to assess the effect of hyperglycemia on mortality.

Result:

Major trauma patients in the hyperglycemia group had low systolic/diastolic blood pressure at triage, low initial Glasgow Coma Scale score, high incidence of hypotension episodes, coagulopathy, acidosis, and anemia. Hyperglycemia was significantly correlated with mortality in major trauma patients in this study (odds ratio: 1.97, 95% confidence interval: 1.04–3.74).

Conclusion:

In major trauma patients with injury severity scores >15, hyperglycemia has a positive correlation with mortality, which could be a predictor of mortality in clinical practice.
Team Achievement Goals and Sports Team Performance
Authors: Van Mierlo Heleen , Van Hooft Edwin A. J.
Published: May 2020

This study focuses on team achievement goals and performance outcomes in interdependent sports teams. Team achievement goals reflect shared motivational states that exist exclusively at the team level. In a survey among 310 members of 29 premier-league field-hockey teams, team-level performance-approach, performance-avoidance, mastery-approach, and mastery-avoidance achievement goals explained 69% of the overall variance in team performance and 16% after controlling for previous performance. Teams performed better to the extent they were more approach- and less avoidance oriented in terms of both mastery and performance, although mastery-approach goals related to early-season team performance rather than predicting later changes in team performance.
The Psychosocial Adjustment of Children Born With a Cleft Lip and/or Palate: Cross-Sectional and Longitudinal Analyses
Authors: Pinckston Molly , Dalton Louise , Farrar Stephanie , Hotton Matthew T.
Published: May 2020

Objective:

To determine the psychosocial adjustment of children born with a cleft lip and/or palate (CL/P).

Design:

Longitudinal analyses of psychosocial outcomes and cross-sectional comparison with published norms.

Setting:

Retrospective clinical audit at a UK cleft center.

Participants:

Data available for 1174 participants born with a CL/P at ages 5 (n = 658), 10 (n = 415), and 15 (n = 171), with longitudinal data for a subset of the sample at 5 and 10 (n = 168) and 10 and 15 (n = 49).

Main Outcome Measure:

Parental-report Strengths and Difficulties Questionnaire (SDQ).

Results:

The majority of children scored in the average range for overall adjustment. Children born with CL/P had significantly higher mean overall SDQ scores relative to normative data at ages 5 and 10. Longitudinal analysis highlighted that adjustment at age 5 was a significant predictor of adjustment at age 10. Gender was another significant predictor of adjustment at age 5 and 10, with boys reporting more problems than girls. However, effect sizes for the impact of age and gender were small. Cleft type was not a significant predictor of SDQ score at any age.

Conclusions:

Children aged 5 and 10 years of age born with a cleft may experience greater overall psychosocial difficulties than the general population. The domains on the SDQ on which children experience difficulty may be influenced by age and gender. Future research should focus on the specific impact of cleft-related issues, including speech, language, and hearing difficulties, on psychosocial adjustment.
Hospitalist Perceptions of Fall Prevention
Authors: Runkel Katherine M. , Rdesinski Rebecca E. , Miura Lisa N.
Published: May 2020

Inpatient falls are common, but little is known about hospitalist perceptions regarding their exact role in fall prevention. The authors conducted a cross-sectional analysis of hospitalists’ attitudes and perceived barriers to fall prevention practices in 2 different hospital systems in Portland, Oregon. A total of 42 responses were collected. Although hospitalists in both groups agreed that all patients admitted should undergo fall risk assessments (FRAs), both groups disagreed that hospitalists should be responsible for performing them. Neither group felt that they had the time to complete FRAs and were either neutral or felt the lack of expertise to conduct them. These findings suggest that the hospitalist role in inpatient fall prevention multidisciplinary teams may be unclear to physician providers and that health care systems may benefit from examining this further.
Adaptive sliding mode observer–based decentralized control design for linear systems with unknown interconnections
Authors: Ranjbar Babak , Ranjbar Noiey Abolfazl , Rezaie Behrooz
Published: May 2020

In this study, a class of linear interconnected systems with unknown interconnections between subsystems is considered. Primarily, an observer is designed to reconstruct an equivalent of unknown interconnections that are considered uncertain. A decentralized controller will be thereafter designed to keep the stability of the original system when the estimated system is at risk of instability due to the lack of information on interconnections. To design a decentralized observer and to estimate states of each subsystem, without knowing the relations between subsystems, a combination of Luenberger observer along with the adaptive sliding mode technique is used. Because the interconnected system might generally be unstable, a state feedback controller is used to stabilize each subsystem using estimated states together with the output of other subsystems. The stability of the system and the convergence of the discrepancy between real states and that of estimated are guaranteed, gaining the Lyapunov theory. Simulation results signify that the proposed decentralized controller based on a new adaptive sliding mode observer is highly efficient for linear interconnected systems with unknown interconnections.
Metastatic penile squamous cell carcinoma with dramatic response to combined checkpoint blockade with ipilimumab and nivolumab
Authors: Baweja Abinav , Mar Nataliya
Published: May 2020

Introduction

Prognosis for patients with lymph node positive or metastatic penile squamous cell carcinoma remains poor. Chemotherapy with paclitaxel, ifosfamide, and cisplatin (TIP regimen) is recommended as a first-line option in this cohort of patients. No standard preferred subsequent-line therapy exists for patients with relapsed or refractory penile carcinoma following TIP chemotherapy. Molecular pathogenesis of penile cancer can be subdivided into human papilloma virus-dependent and human papilloma virus-independent pathways. Recent studies have demonstrated increased expression of programmed death ligand-1 in some penile tumors, commonly those that are human papilloma virus-negative. Given the rarity of penile carcinoma in industrialized countries and lack of effective therapies, checkpoint inhibitors may be an attractive treatment option for this subset of patients.

Case report

We report a case of metastatic penile cancer refractory to TIP chemotherapy, with a dramatic treatment response to ipilimumab and nivolumab. Molecular profiling of this tumor showed a high programmed death ligand-1 expression, high tumor mutational burden, high microsatellite instability, and alterations in DNA mismatch repair genes.

Discussion

This case highlights another dimension of information that may be gained with molecular genomic profiling of penile tumors, providing insight into the biologic behavior of this neoplasm and assessing for predictive biomarkers of response to immune checkpoint inhibitors.
Use of micropulse trans-scleral cyclophotocoagulation for acute rise in intraocular pressure due to anterior segment inflammation
Authors: Asano Shotaro , Chang Victor Koh Teck , Aquino Maria Cecilia Domingo , Kuan Paul Chew Tec
Published: May 2020

Purpose

The aim of this study was to report the use of micropulse trans-scleral cyclophotocoagulation as an adjunct therapy for two cases of medically uncontrolled intraocular pressure spikes due to anterior segment inflammation. Case description: Case 1 had previous cataract surgery and exhibited an intraocular pressure spike due to phacoantigenic uveitis (right eye intraocular pressure = 52 mmHg). Despite medical treatment, the right eye intraocular pressure remained high (43 mmHg), thus micropulse trans-scleral cyclophotocoagulation was carried out as a rescue therapy. After micropulse trans-scleral cyclophotocoagulation, the intraocular pressure at 1 day and 3 weeks was 9 and 16 mmHg, respectively. Case 2 had a history of previous blunt ocular trauma and 180° of angle recession. Both eyes were pseudophakia and underwent right eye Nd:YAG laser capsulotomy for posterior capsular opacification. Immediately after the procedure, the right eye intraocular pressure increased to 64 mmHg. Due to poor response to medical therapy, rescue micropulse trans-scleral cyclophotocoagulation was performed. After micropulse trans-scleral cyclophotocoagulation, the intraocular pressure at 1 day and 2 months was 12 and 21 mmHg, respectively.

Conclusion

Micropulse trans-scleral cyclophotocoagulation successfully decreased intraocular pressure in both cases of acute rise in intraocular pressure. Micropulse trans-scleral cyclophotocoagulation can potentially be useful as a rescue procedure to safely reduce medically uncontrollable intraocular pressure spike due to anterior segment inflammation.
Rituximab in the treatment of Susac’s syndrome: Report of a case
Authors: Monferrer-Adsuara Clara , Remolí-Sargues Lidia , Hernández-Bel Laura , Gracia-García Alicia , Hernández-Garfella María Luisa , Cervera-Taulet Enrique
Published: May 2020

Significance

Susac’s syndrome is a rare retinocochleocerebral immune-mediated endotheliopathy and clinically manifests as a pathognomonic triad of encephalopathy, hearing loss, and branch retinal artery occlusion. This triad is rarely present at symptom onset, thus, it is often initially misdiagnosed. To date, Susac’s syndrome has persisted as an elusive entity and there are numerous treatment regimens proposed with varying effectiveness mainly based on case series.

Purpose

To report our 12-month follow-up experience in the treatment of Susac’s syndrome with rituximab.

Case report

A 25-year-old female presenting with headache, paresthesias, tinnitus, peripheral vertigo, and a branch retinal artery occlusion. The patient had a personal history of anxiety-depressive disorder. After discarding other infectious/autoimmune conditions and magnetic resonance imaging suggestive findings of Susac’s syndrome, we observed a prompt response to the combination of intravenous immunoglobulin, corticosteroids, and rituximab.

Conclusion

A standard treatment paradigm is lacking in Susac’s syndrome as randomized controlled trials do not exist. There are no definitive scores to predict its outcome, and early diagnosis is important as the organs involved can easily become irreversibly damaged. Thus, patients with Susac’s syndrome must be treated promptly and aggressively. Our report highlights the possibility of positive long-term prognosis with an early use of rituximab. However, a systematic therapeutic approach on the basis of controlled trials is mandatory to develop a consensus.
Protesting Parties in Europe: A comparative analysis
Authors: Borbáth Endre , Hutter Swen
Published: May 2020

The article provides the first large-scale study of protest activities by political parties. The empirical analysis draws on original protest event data for 30 European countries based on semi-automated coding of news agencies. The article innovates by (a) proposing a standardized indicator for the extent to which protest and electoral politics relate to each other, (b) showing that parties’ involvement in protests differs across political contexts, and (c) mapping the profile of a typical party-sponsored event and a typical protesting party. Despite long-term trends toward differentiated modes of interest intermediation, the results indicate that a wide range of parties does protest. However, in highly differentiated contexts, the typical protesting party mirrors the outsider image of movement parties: it does not belong to a mainstream party family and has no government experience. By contrast, more strategic factors, such as opposition status, drive parties to the streets in less differentiated contexts.
Understanding decisions to scale up: a qualitative case study of three health service intervention evaluations
Authors: Rotteau Leahora , Albert Mathieu , Bhattacharyya Onil , Berta Whitney , Webster Fiona
Published: May 2020

Objective

Efforts to scale up evidence-based health care interventions are seen as a key strategy to address complex health system challenges. However, scale-up efforts have shown significant variability. We address the gap between scale-up theory and practice by exploring the socio-cultural factors at play in the evaluation and scale-up of three interventions within the clinical field.

Methods

A qualitative multiple case study was conducted to characterize the evaluation and scale-up efforts of three interventions. We interviewed 18 participants, including clinicians and researchers across the three cases. Using Pierre Bourdieu’s concepts of field and capital as a theoretical lens, we conducted a thematic analysis of the data.

Results

Despite the espoused goals of ensuring that health service interventions are always based on high-quality evidence within the clinical field, this study demonstrates that the outcomes of the evaluations are not the only factor in the decision to engage in scale-up efforts. Important socio-cultural factors also come into play. Bourdieu uses the term capital to refer to the resources that agents compete for and with their acquisition, accumulate power and/or social standing. The type of evidence valued in the clinical field and the ability to leverage capital in demonstrating that value are also important factors.

Conclusions

Determining if an intervention is effective and should be scaled up is more complex in practice than described in the literature. Efforts are needed to explicitly include the role of social processes in the current frameworks guiding scaling-up efforts.
Parental accommodation of symptoms in adolescents with chronic pain
Authors: La Buissonnière-Ariza Valérie , Schneider Sophie C , McBride Nicole M , Cepeda Sandra L , Hart Dennis , Haney Brandon , Storch Eric A
Published: May 2020

Chronic pain in adolescents can be highly impairing. Parental reactions to their child’s pain are important factors influencing pain perception and pain-related impairment in children and adolescents. The present study aimed to examine parental accommodation of pain symptoms using the Inventory of Parent Accommodations of Children’s Symptoms (IPACS) to provide empirical support for the utility of this measure in parents of adolescents with chronic pain. We examined the prevalence, nature, and correlates of accommodation behaviors in 66 adolescents with chronic pain and their parents using the IPACS. All parents reported some level of accommodation of their child’s pain symptoms. After controlling for pain severity, parental accommodation was associated with functional impairment. In addition, parental accommodation mediated the link between parental catastrophizing reactions to pain and child impairment and between child anxiety and depressive symptoms and child impairment. The IPACS appears to be a useful measure of parental accommodation of pain. Parental accommodation should be included as an intervention target when necessary. It is important to educate families about the negative consequences that can be related to excessive accommodation of pain symptoms and to provide effective resources to manage the impact of chronic pain and replace accommodation with more adaptive pain coping strategies.