bluuebunny/crossref_metadata_2025 huggingface dataset:
Hepatitis B Virus and HIV Coinfection: Fibrosis, Fat, and Future Directions
Authors: Kim Arthur Y.
Published: April 2019

HIV and hepatitis B virus (HBV) share routes of transmission, and coinfection is associated with higher levels of HBV DNA, accelerated fibrosis progression, and increased liver-related events compared with those with HBV alone. The full spectrum of hepatic histology has not been recently addressed, in part because of the decreasing use of liver biopsy in clinical practice. The current study provides a modern “snapshot” of biopsy data from 114 HIV/HBV coinfected individuals, elucidating the degree of liver fibrosis years into the effective antiretroviral era and also revealing that hepatic steatosis was a frequent finding.
Poetic Justice: A Case of Resolved Intractable Hiccups Following POEM for Achalasia
Authors: Christian Kaci , Wellington Jennifer , Kim Raymond , Quezada Sandra , Xie Guofeng
Published: April 2019

Achalasia is an esophageal motility disorder of impaired lower esophageal sphincter relaxation and absent peristalsis. The presenting symptoms are commonly dysphagia, chest pain, regurgitation, and weight loss. Hiccups have been associated with gastrointestinal diseases but uncommonly associated with achalasia. We present a 62-year-old man with a history of dysphagia, weight loss, and intractable hiccups. High-resolution impedance manometry revealed Type I achalasia, which was treated with per oral endoscopic myotomy. Postoperatively, his dysphagia, weight loss, and intractable hiccups resolved.
Hemobilia Leading to a Diagnosis of Hepatocellular Carcinoma
Authors: Gollol-Raju Narasimha Swamy , Jayananda Sriraksha , Mudireddy Prashant
Published: April 2019

Hemobilia from hepatocellular carcinoma (HCC) is rare and is usually noted in established cases of HCC after invasive procedures. Hemobilia can present with serious complications including acute pancreatitis and cholangitis. We describe an unusual case of hemobilia causing obstructive jaundice with suspected cholangitis and acute pancreatitis with subsequent workup revealing HCC.
Severe Pernicious Anemia Predisposing to Hypoxic Hepatitis
Authors: Mbachi Chimezie , Palacios Argueta Pedro , Wang Yuchen , Mba Benjamín
Published: April 2019

Hypoxic hepatitis or ischemic hepatitis is most commonly encountered in critical care patients, most of whom have shock states secondary to cardiac or respiratory failure. We report a case of severe pernicious anemia predisposing to hypoxic hepatitis that had a good prognosis with simple treatment. Care should be taken in management of severe anemia, interpretation of serum vitamin B12 levels after blood transfusion, and the use of intravenous fluids.
New Diagnosis of Acquired Immunodeficiency Syndrome in a Patient With Crohn's Disease
Authors: Aharoni Golan Maya , Weisshof Roni , Wang Yunwei , Rubin David T.
Published: April 2019

There are limited data on the natural history of Crohn's disease (CD) in the presence of human immunodeficiency virus infection and the safety of available treatments. We report a patient with CD who presented with pneumocystis pneumonia secondary to newly diagnosed acquired immunodeficiency syndrome. One month before his admission, his gastrointestinal symptoms were well controlled without treatment but gradually reappeared after antiretroviral therapy was initiated. Clinical remission was achieved with vedolizumab treatment. We review the management challenges of CD in a patient with human immunodeficiency virus and describe the unique mechanism of anti-α4β7 integrin therapy in this setting.
Breast Metastasis From a Combined Hepatocellular–Cholangiocarcinoma
Authors: Silva Marco , Coelho Rosa , Rios Elisabete , Gomes Sara , Carneiro Fátima , Macedo Guilherme
Published: April 2019

Combined hepatocellular-cholangiocarcinoma (cHCC-CC) is a unique entity that contains mixed elements of both hepatocellular carcinoma and cholangiocarcinoma. We report a 62-year-old woman with alcoholic cirrhosis with elevated α-fetoprotein of 25.3 ng/mL. Abdominal computed tomography showed a poorly defined subcapsular nodular lesion in the VIII segment, showing enhancement during the arterial phase and washout in the delayed phase. Histological examination of hepatic segmentectomy revealed a malignant epithelial neoplasia constituted by 2 distinct components, consistent with the diagnosis of cHCC-CC, classical type. One year after surgical resection, the patient noticed a nodule in the right breast. Histological examination of core needle biopsy was compatible with a metastasis in the breast of the previously diagnosed liver cancer. To our knowledge, this is the first report of breast metastases from a cHCC-CC, denoting disseminated metastatic disease and poor prognosis.
An Obstructing Fecal Bezoar in a Patient with Scleroderma with Successful Colonoscopic Disimpaction
Authors: Sarnoff Rachel , Girmay Blen , Bhakta Dimpal , Mocharla Robert , Williams Renee
Published: April 2019

Scleroderma (SSc) is a disease caused by collagen deposition resulting in fibrosis within multiple organs, including the gastrointestinal tract, skin, joints, kidneys, lungs, and heart. We report a rare case of a patient with diffuse SSc who presented with a large bowel obstruction from a fecal bezoar impaction. The bezoar was successfully removed using colonoscopy after lavage, cold forceps, balloon dilator, and cap-assisted disimpaction. We demonstrate that patients with SSc are at risk for bezoar formation and true mechanical obstruction in the lower gastrointestinal tract, which may require more aggressive endoscopic treatment if conservative measures fail.
Elbasvir/Grazoprevir in People With Hepatitis C Genotype 1 Infection and Child-Pugh Class B Cirrhosis: The C-SALT Study
Authors: Jacobson Ira M. , Poordad Fred , Firpi-Morell Roberto , Everson Gregory T. , Verna Elizabeth C. , Bhanja Sanhita , Hwang Peggy , Caro Luzelena , Robertson Michael , Charles Edgar D. , Platt Heather ,   on behalf of the C-SALT Investigators
Published: April 2019

INTRODUCTION:

Treatment options are limited for people infected with hepatitis C virus (HCV) with decompensated liver disease. The C-SALT study assessed elbasvir (EBR) plus grazoprevir (GZR) in individuals with HCV genotype 1 infection and Child-Pugh class B (CP-B) cirrhosis.

METHODS:

In this 12-week, phase 2, nonrandomized, open-label study (NCT02115321; Protocol MK-5172-059), participants with CP-B cirrhosis received EBR 50 mg plus GZR 50 mg once daily, and a control group of noncirrhotic participants received EBR 50 mg plus GZR 100 mg once daily. The primary endpoint was sustained virologic response 12 weeks after the end of therapy.

RESULTS:

Sustained virologic response at 12 weeks after the end of therapy was achieved by 27/30 (90.0%) CP-B participants and 10/10 (100.0%) noncirrhotic participants. Two participants relapsed, and one died during follow-up after having undetectable HCV RNA at the end of treatment. Most CP-B participants had stable or improved model for end-stage liver disease and Child-Pugh scores at follow-up week 12 compared with baseline. There was no significant difference in drug exposure between groups, despite the differing GZR dose. Adverse events occurring in >10% of participants were fatigue (CP-B: 30.0%; noncirrhotic: 30.0%), arthralgia (16.7%; 20.0%), nausea (10.0%; 20.0%), and headache (10.0%; 50.0%). No serious treatment-related adverse events or hepatic events of clinical interest occurred.

CONCLUSIONS:

EBR 50 mg plus GZR 50 mg once daily for 12 weeks was highly effective and well tolerated in a traditionally hard-to-treat population.

TRANSLATIONAL IMPACT:

Although EBR plus reduced-dose GZR is not available for people with CP-B cirrhosis, these results complement phase 2/3 trial data and real-world experience with EBR/GZR.
Development and Validation of Confocal Endomicroscopy Diagnostic Criteria for Low-Grade Dysplasia in Barrett's Esophagus
Authors: di Pietro Massimiliano , Bertani Helga , O'Donovan Maria , Santos Patricia , Alastal Hani , Phillips Richard , Ortiz-Fernández-Sordo Jacobo , Iacucci Marietta , Modolell Ines , Reggiani Bonetti Luca , Ragunath Krish , Wernisch Lorenz
Published: April 2019

OBJECTIVES:

Low-grade dysplasia (LGD) in Barrett's esophagus (BE) is generally inconspicuous on conventional and magnified endoscopy. Probe-based confocal laser endomicroscopy (pCLE) provides insight into gastro-intestinal mucosa at cellular resolution. We aimed to identify endomicroscopic features and develop pCLE diagnostic criteria for BE-related LGD.

METHODS:

This was a retrospective study on pCLE videos generated in 2 prospective studies. In phase I, 2 investigators assessed 30 videos to identify LGD endomicroscopic features, which were then validated in an independent video set (n = 25). Criteria with average accuracy >80% and interobserver agreement κ > 0.4 were taken forward. In phase II, 6 endoscopists evaluated the criteria in an independent video set (n = 57). The area under receiver operating characteristic curve was constructed to find the best cutoff. Sensitivity, specificity, interobserver, and intraobserver agreements were calculated.

RESULTS:

In phase I, 6 out of 8 criteria achieved the agreement and accuracy thresholds (i) dark nonround glands, (ii) irregular gland shape, (iii) lack of goblet cells, (iv) sharp cutoff of darkness, (v) variable cell size, and (vi) cellular stratification. The best cutoff for LGD diagnosis was 3 out of 6 positive criteria. In phase II, the diagnostic criteria had a sensitivity and specificity for LGD of 81.9% and 74.6%, respectively, with an area under receiver operating characteristic of 0.888. The interobserver agreement was substantial (κ = 0.654), and the mean intraobserver agreement was moderate (κ = 0.590).

CONCLUSIONS:

We have generated and validated pCLE criteria for LGD in BE. Using these criteria, pCLE diagnosis of LGD is reproducible and has a substantial interobserver agreement.
A Novel, Duodenal-Release Formulation of a Combination of Caraway Oil and L-Menthol for the Treatment of Functional Dyspepsia: A Randomized Controlled Trial
Authors: Chey William D. , Lacy Brian E. , Cash Brooks D. , Epstein Michael , Corsino Patrick E. , Shah Syed M.
Published: April 2019

OBJECTIVES:

We conducted a randomized, placebo-controlled trial, which evaluated a novel formulation of caraway oil and L-menthol using microsphere-based site-specific targeting (COLM-SST) vs placebo in patients with functional dyspepsia (FD).

METHODS:

Adult men and women with FD defined by Rome III criteria were recruited. Patients were randomized to COLM-SST (25 mg of caraway oil and 20.75 mg of L-menthol per capsule, at 2 capsules per dose, twice per day) or placebo. Efficacy was measured at 24 hours, 2 weeks, and 4 weeks. Patients were allowed to take concomitant medications for their FD throughout the trial, and rescue medicines were allowed, 48 hours after start of dosing.

RESULTS:

Ninety-five patients were enrolled (mean age = 43.4 years; 75.8% women). At 24 hours, the active arm reported a statistically significant reduction in postprandial distress syndrome symptoms (P = 0.039), and a nonsignificant trend toward benefit of epigastric pain syndrome symptoms (P = 0.074). In patients with more severe symptoms, approximately 3 quarters of patients showed substantial global improvement (i.e., clinical global impressions), after 4 weeks of treatment, vs half in the control arm. These differences were statistically significant for patients with epigastric pain syndrome (P = 0.046), and trending toward significance for patients with postprandial distress syndrome (P = 0.091). There was no statistically significant difference between groups for Global Overall Symptom scores for the overall population at 2 and 4 weeks. Treatment emergent adverse events were mild to moderate, and no serious adverse events were reported.

DISCUSSION:

In patients taking their usual medications for FD, COLM-SST provided rapid relief (within 24 hours) and relief of severe FD symptoms. It was safe and well tolerated.
Malignant Mucoepidermoid Tumor Arising in the Accessory Parotid Gland: A Case Report
Authors: Tamiolakis Demetrio , Thomaidis Vasilios , Tsamis Ioannis , Jivannakis Theodoros , Cheva Ageliki , Papadopoulos Nikolas
Published: April 2019

Purpose: The head and neck surgeon’s fascination with parotid surgery arises from the gland’s spectrum of histopathological presentations, as well as the diversity of its morphological features. A mass arising in the mid-cheek region may often be overlooked as a rare accessory lobe parotid neoplasm. This report serves to revisit the topic of accessory parotid gland neoplasms to emphasize proper management, particularly the surgical aspects, so that consequences of salivary fistula, facial nerve paralysis, and recurrence are avoided. Case report: We report a case of mucoepidermoid carcinoma which was assessed pre-operatively as arising from the accessory parotid gland of a 11-year-old female. She had complained of a painless and round mass of the left cheek for a duration of 12 months. Sialography, ultrasonography, CT scan and MRI were performed preoperatively. Sialography revealed a small duct separating from the Stensen’s duct. CT and MRI showed that the tumor with smooth outline was lying on the masseter muscle and detached from the main parotid gland. The preoperative diagnosis was an accessory parotid gland tumor. The tumor was removed without facial nerve injury via standard parotidectomy incision. The tumor was composed of mucous, intermediate and epidermoid cells. The pathological diagnosis was low-grade mucoepidermoid carcinoma. Conclusions: Accessory parotid gland neoplasms are rare and may present as innocuous extraparotid mid-cheek masses. A high index of suspicion, prudent diagnostic skills (including fine-needle aspiration [FNA] biopsy followed by computed tomography [CT] imaging), and scrupulous surgical approach (extended parotidectomy-style incision and limited peripheral nerve dissection when possible) are the keys to successful management of these lesions.
Inorganic Lead Toxicology
Authors: Patočka Jiří , Černý Karel
Published: April 2019

Lead is a health hazard for all humans. Especially children under the age of six are most at risk for lead poisoning. Lead toxicity causes hematological, gastrointestinal, and neurological dysfunction. Symptoms are usually noted with blood lead greater than 2 micromoles/L. Severe or prolonged exposure may also cause chronic nephropathy, hypertension, and reproductive impairment. Lead inhibits some enzymes, alters cellular calcium metabolism, stimulates synthesis of binding proteins in kidney, brain, and bone, and slows down nerve conduction. Acute lead poisoning is relatively infrequent and results from ingestion of acid soluble lead compounds or inhalation of lead vapors but chronic exposure to low levels of the metal is still a public health issue, especially among some minorities and socioeconomically disadvantaged groups. Lead has been used since prehistoric times, and has become widely distributed and mobilized in the environment. Exposure to and uptake of this non-essential element have consequently increased. Both occupational and environmental exposures to lead remain a serious problem in many developing and industrializing countries and a public health problem of global dimensions.
Prevalence and Treatment of Pediculus Humanus Capitis with 1% Permethrin and 0.4% d-Phenothrin in Turkey
Authors: Tanyuksel Mehmet , Araz R. Engin , Albay Ali , Aycicek Hasan
Published: April 2019

Pediculosis humanus capitis (head lice) is an important public health problem among school children. In our study, 20,612 schoolchildren (10,367 boys, 10,245 girls) were examined for Pediculus humanus capitis in 36 elementary schools between December 1996 and February 1998 in Ankara, Turkey. The prevalence of pediculosis capitis infestation was found to be 3.4% (701 / 20, 612). Of these, 382 students were treated with application of 1% permethrin cream rinse, and 184 students with 0.4% d-phenothrin shampoo. On day 14 of the controlled trial, the success rates were 93.7 % in the 1% permethrin cream rinse group and 75.5 % in the 0.4% d-phenothrin shampoo group. The 1% permethrin cream rinse was also significantly more active in pediculicidal efficacy when compared to the 0.4% d-phenothrin shampoo (p<0.001). As a result, these findings demonstrate that pediculosis capitis still remains a widespread health problem.
Linguistic and cognitive representation of time and viewpoint in narrative discourse
Authors: van Krieken Kobie , Sanders José , Sweetser Eve
Published: April 2019

In this introduction to the special issue on time and viewpoint in narrative discourse, we highlight the central contributions of the issue concerning the relation between the linguistic construal and cognitive representation of time and viewpoint. We explain how linguistic and gestural cues guide the representation of narrative time progression and argue that this representation involves various cognitive operations regulating the alignment between the viewpoints of narrator, addressee, and narrative characters. These operations are steered by a variety of linguistic phenomena, including verb tense, adverbs, demonstratives, reduplication and negation, as well as body partitioning. We discuss how genre characteristics influence the relation between the linguistic and cognitive representation of time and viewpoint. Finally, we explain how the analyses presented in the various papers both demonstrate and clarify how the cognitive representation of time in narrative discourse relies on the human capacity to simultaneously manage multiple viewpoints, leading to the conclusion that time and viewpoint are closely related in the representation of narrative discourse.
The analytical solution of Van der Pol and Lienard differential equations within conformable fractional operator by retarded integral inequalities
Authors: Usta Fuat , Sarıkaya Mehmet Zeki
Published: April 2019

In this study we introduced and tested retarded conformable fractional integral inequalities utilizing non-integer order derivatives and integrals. In line with this purpose, we used the Katugampola type conformable fractional calculus which has several practical properties. These inequalities generalize some famous integral inequalities which provide explicit bounds on unknown functions. The results provided here had been implemented to the global existence of solutions to the conformable fractional differential equations with time delay.
The use of ultrasound velocity and damping for the detection of internal structural defects in standing trees of European beech and Norway spruce
Authors: Krajnc Luka , Kadunc Aleš , Straže Aleš
Published: April 2019

Field measurements were carried out to assess the feasibility of ultrasound velocity and damping for the non-invasive testing of standing trees. A total of 87 trees of European beech (Fagus sylvaticaL.) and 68 trees of Norway spruce (Picea abiesKarst.) were measured in the field, felled and assessed individually for the presence of red heartwood or butt rot. The field assessment of these internal structural defects at the stump level (SL) of the trees was compared with the ultrasound measurements recorded at two tree heights [(i.e. at the SL and 0.5 m above the stump level (ASL)] and in several directions, all perpendicular (PP) to the tree stem. Lower ultrasound velocity and higher damping were found in both species with the presence of internal defects in both the radial and tangential directions of the tree stem. The diameter at breast height (DBH) had a varying effect on both ultrasound velocity and damping. A binary logistic regression was used to test the potential of ultrasound velocity and damping to predict the presence of internal defects. Both the approaches offer similar levels of prediction accuracy (0.72 and 0.76 in beech, and 0.83 and 0.82 in spruce). Due to the significant reduction in measuring time when using ultrasound damping only, this principle is recommended for the detection of red heartwood in beech trees and butt rot in spruce trees.
A Comprehensive Induction Machine Model for Multi-Phase Power Flow Studies – Application to Industrial Power Systems and Wind Farms
Authors: Bathini Veerabrahmam , Nagaraja R. , Parthasarathy K. , Thukaram D.
Published: April 2019

This paper presents the development of three comprehensive static models of a 3-phase induction machine in phase frame of reference for interfacing with multi-phase power flow programs. The models developed are based on specified slip or specified power, either at the rotor shaft or at the terminals of the induction machine. The development of these models also takes into consideration load torque characteristics. The mathematical formulation of these models is based on branch constraint approach instead of the traditional node constraint approach. This facilitates the arbitrary connections of the induction machine, namely wye, wye-grounded, wye-grounded through impedance, and delta. The models are ideally suited for application in the present trend of operating power and distribution networks with high penetration of renewable energy sources (RES). These models assist in evaluating the performance of wind generators operating under unbalanced system conditions and also in selection of proper phase wise compensation. These static models compute the correct initial operating conditions of induction machines for 3-phase transient stability studies and EMTP-type simulation studies, to evaluate the precise dynamic behaviour of the power system. The procedure for integrating these models in the multi-phase power flow program is also described. The performance of the developed multi-phase power flow program, including static induction machine models, has been evaluated for various power network sizes. The results obtained are verified against the existing literature to clearly demonstrate the efficacy of the proposed methodology.
Nonlinear Effects with Semiconductor Optical Amplifiers
Authors: Amiri IS , Rashed Ahmed Nabih Zaki , Mohamed Abd El-naser A. , Aboelazm Mohamed B. , Yupapin P
Published: April 2019

This study has presented the nonlinear medium such as passive nonlinear medium like highly nonlinear fiber (HNLF) and active nonlinear medium like SOA. The FWM effects have ended up plainly huge at high optical power levels and have become even more meaningful when the capacity of the optical transmission line is increased, which has been reached through decreasing the channel separations. Also, anatomy has been done to analyze the performance of FWM when unequal channel spacing is considered. The outcomes indicate that when unequal channel spacing is used, the power levels of the beat frequency generated due to FWM effect in WDM system was increased to large values, so the performance of the wavelength division multiplexing (WDM) system is not enhanced, on the other hand when equal channel separations are used, and at the same bandwidth required to transmit 4 input channels the quality of receiving signal is greater than the system used unequal channel separation. This means that in the WDM system equal channels separation is more efficient than unequal channels separation-based SOA. The simulation is done using 4 channel wave division multiplexing signals at a rate of 10 Gb/s.
Preparation of Transparent N-Zno:Al / P-Cualcro2 Heterojunction Diodeby Sol-Gel Technology
Authors: Shirshneva-Vaschenko E.V. , Sokura L.A. , Shirshnev P.S. , Kirilenko D.A. , Snezhnaia Zh.G. , Bauman D.A. , Bougrov V.E. , Romanov A.E.
Published: April 2019

This paper presents the study of oxide film heterojunction made of CuAlCrO2 and ZnO:Al (AZO) deposited on fused quartz by sol-gel spin coating. Transmission electronmicroscopy (TEM) analysis has showed that the solvent, which was used to prepare the AZO sol, affects the thickness and planarity of the applied layers and the grain size of the polycrystalline film. The formation of a fine-grained structure of AZO films (grain size is up to 12 nm) leads to the formation of a smoother p-CuAlCrO2 / n-AZO heterojunction. X-ray diffraction (XRD) analysis and TEM have revealed that the heterojunction was formed by AZO polycrystals, which orient axes [101] and [100] against the [101] and [006] directions in CuAlCrO2 polycrystals. The optical transmission of the heterojunction in the visible range reached 70 %. The current -voltage (I-V) characteristics of p-CuAlCrO2 / n-AZO corresponds to a diode one in the range from 4 up to 4 V. For the large values of the reverse bias, an increase in the leakage current is observed, which is associated with tunneling breakdown of heterojunction. The ideality factor of fabricated p-CuAlCrO2 / n-AZO heterojunction is more than 2, which indicates the mechanisms of conductivity by defect-levels. In additional, it has been observed the response of the current-voltage characteristics to the green illumination (532 nm) of the diode that is associated with indirect band-gap absorption in CuAlCrO2. The impact of the white LED illumination had no effect on the current-voltage characteristics of the diode.
Structural Organization of Themagnetic Part of Smart Material Based on Nanoparticles of Iron or Magnetite in Pores of Mcm-41 Mesoporous Silica for Target Drug Delivery
Authors: Zemtsova E.G. , Ponomareva A.N. , Arbenin A.Y. , Smirnov V.M.
Published: April 2019

The important stage of the development of smart material for the target drug delivery is the construction of the magnetic part of this material, including mesoporous silica and magnetic nanoparticles (Fe3O4or Fe0). Such a systemwill allow carry outmagnetic decapsulation (excretion) of drug from smart material using the magnetic field of a given value in the right place of the body. The paper considers the features of synthesis mesoporous silica MCM-41 with various pore diameter (33-51 Å) and synthesis of superparamagnetic nanoparticles of magnetite or metallic iron in the pores of mesoporous silica. The dependence of magnetic properties of nanocomposites MCM-41/Fe0 and MCM-41/Fe3O4 from the pore diameters of MCM-41 templates is studied. It was found that the matrix has a decisive influence on the content of iron or magnetite nanoparticles. The saturation magnetization of the material increases with increasing pore size of the mesoporous matrix. Nanocomposites MCM-41/Fe0 and MCM-41/Fe3O4 exhibit superparamagnetism, that allows them to be used as a magnetic material for targeted drug delivery.
The Electron Spin Resonance (Esr) Spectra of Potassium-Alumina-Borate Glass Doped with Copper Ions
Authors: Shirshnev P.S. , Eremina R.M. , Yatsyk I.V. , Snezhnaia Zh.G. , Panov D.I. , Shirshneva-Vaschenko E.V. , Romanov A.E. , Bougrov V.E.
Published: April 2019

We investigate electron spin resonance (ESR), absorption, and photoluminescence spectra of potassium-boron copper-containing glasses. In previous works it was found, that the considered glasses demonstrate a red shift of photoluminescence. In present work, we provide an evidence on the formation in glasses specific copper-containing structures that can be responsible for the red shift of photoluminescence “copper” band.
Monolayers of Surfactants Containing Nanoparticles of Hexacyanoferrates of Various Metals
Authors: Stepashkin N.A. , Chernenko M.K. , Khripun V.D. , Ivanov N.S , Sukhodolov N.G.
Published: April 2019

In this article the possibility of obtaining Langmuir-Blodgett films on the basis of octadecylamine monolayers containing nanoparticles of hexacyanoferrates of various metals was shown. A comparison was made between different methods for obtaining these particles. Nanoparticles were produced using sodium hexametaphosphate as a stabilizer, their average size were determined by laser diffraction. The isotherms of compression were studied for monolayers on a subphase containing nanoparticles. Optimal conditions for the transfer of monolayers to a solid substrate were chosen according to the data obtained and their morphology was studied by scanning electron microscopy. The cyclic voltammetry method also confirmed the successful transfer of a monolayer to a solid substrate and showed the manifestation of the electrochemical properties of the obtained substrates.
Hardening by Annealing and Implementation of High Ductility of Ultra-Fine Grained Aluminum: Experiment and Theory
Authors: Orlova T. S. , Skiba N. V. , Mavlyutov A. M. , Murashkin M. Yu. , Valiev R. Z. , Gutkin M. Yu.
Published: April 2019

The influence of low temperature annealing and subsequent deformation on microstructure, strength and ductility was investigated for the first time for high pressure torsion (HPT) processed commercially pure Al. Extremely high increases in the conventional yield stress (up to 50%) and ultimate tensile strength (up to 30%) were obtained by annealing of the ultrafine grained (UFG) samples in the range 90-200 °C for 1 h. Such increases were accompanied by a sharp drop in ductility up to 1%. Implementation of high ductility at the level of coarse-grained Al, while maintaining high strength of the HPT-processed sample was demonstrated for the first time and achieved by repeating the low temperature annealing followed by subsequent additional HPT deformation. The key role of relaxation of non-equilibrium high-angle grain boundaries (GBs) in the strengthening effect of UFG-Al by annealing is shown. Two theoretical models are suggested to explain the hardening by annealing and the implementation of high ductility in UFG structures. Within the models, plastic deformation occurs through emission of lattice dislocations from triple junctions of GBs containing pile-ups of grain-boundary dislocations, glide of the lattice dislocations across neighboring grains, their accumulation at and climb along the opposite GBs. The energy characteristics and the critical stresses of dislocation emission are determined in two different cases, for UFG Al subjected to annealing only and to annealing with subsequent additional HPT deformation. The calculated theoretical dependences of the flow stress on the plastic deformation value well fit qualitatively and quantitatively to our experimental data.
Zinc oxide nanoparticles: potential novel applications in cellular physiology, pathology, neurosciences and cancer research
Authors: Pantic Senka , Skodric Sanja Radojevic , Loncar Zlatibor , Pantic Igor
Published: April 2019

With the rapid development of nanotechnology during the past several years, attention has been focused on metallic nanomaterials, due to their specific physical and chemical characteristics. Zinc oxide nanoparticles (ZnO NPs) have numerous potential applications in industry, as a part of various consumer products, but also in medical research. Anticancer properties of ZnO NPs have been suggested in cell cultures, however, the precise mechanism responsible for their activity in these conditions remains elusive. Cytotoxicity and genotoxicity of ZnO NPs are also unclear. Apart from cancer research, ZnO NPs are today widely researched in almost all areas of fundamental medicine. In this short review, we discuss recently published articles on ZnO NPs applications in cellular physiology, pathology, neurosciences and oncology.
Chinas schleichende Annexion im Südchinesischen Meer – die strategischen Hintergründe
Authors: Kirchberger Sarah , O’Keeffe Patrick
Published: April 2019

Im Juli 2016 wies China einen Schiedsspruch des Internationalen Schiedshofs in Den Haag zurück, der den chinesischen „historischen“ Anspruch auf Riffe und Felsen im Südchinesischen Meer als nicht mit dem Völkerrecht vereinbar erklärte. Umfangreiche chinesische Landgewinnungsprojekte, die seit 2013 in den Spratly- und Paracel-Inselgruppen begannen, und die anschließende Militarisierung dieser künstlichen Inseln hatten zuvor bereits internationale Kritik auf den Plan gerufen und die gleichfalls Anspruch erhebenden Nachbarstaaten alarmiert. Viele Analysen haben seither versucht, Chinas kompromissloses Verhalten unter Rückgriff auf die historische, symbolische oder wirtschaftliche Bedeutung des Südchinesischen Meeres für die chinesische Gesamtstrategie zu erklären. In diesem Aufsatz werden hingegen einige häufig übersehene militärstrategische Faktoren beleuchtet. Diese deuten darauf hin, dass China einen kohärenten Ansatz verfolgt, um jederzeit ein umfassendes Echtzeit-Lagebild in einem Seegebiet zu schaffen, das aufgrund mehrerer kritischer Militäreinrichtungen auf der Insel Hainan einen Schlüsselfaktor für die militärische Modernisierung und die nukleare Abschreckungsstrategie Chinas darstellt.
Neue Perspektiven in Nahost – Wie Chinas Initiativen politische Verhältnisse in der Region grundlegend verändern
Authors: Lukas Stefan
Published: April 2019

Kurzfassung

Wenn bisher die Erkenntnis galt, dass China auch außenpolitisch erwacht ist und bereits in Südostasien neue Stärke zeigt, so greift sein Einfluss nunmehr auch gen Westen um sich. Neue Ziele zweier Großinitiativen sind dabei die Vernetzung der eigenen Wirtschaft mit dem Nahen und Mittleren Osten sowie der Ausbau der militärischen Kapazitäten in der Region. Im Zentrum der Betrachtung stehen hier die neue Seidenstraßeninitiative und das Engagement innerhalb der Shanghaier Organisation für Zusammenarbeit. Dass sich die Volksrepublik dabei nicht mehr nur auf die Mittel der Soft-Power stützt, sondern sich neuerdings als Akteur auf dem Gebiet der Hard-Power etabliert, wird in diesem Aufsatz ebenso dargestellt wie die neuen Herausforderungen für die deutsche und europäische Außenpolitik, die diese Initiativen mit sich bringen. Zuletzt werden fünf Problemfelder aufgezeigt, die im Zuge des neuen Engagements auf internationaler Bühne nicht nur auf China selbst zukommen werden.
Der Islamische Staat und die Strategie des führerlosen Widerstands
Authors: Brüggemann Ulff
Published: April 2019

Kurzfassung

Der Islamische Staat (IS) hatte mit seinem Versuch, in Teilen von Syrien und des Iraks ein Kalifat zu errichten, die Gegenwehr anderer Staaten herausgefordert. Diese bildeten eine Anti-IS-Koalition. Auf deren Luftschläge reagierte der IS mit Terroranschlägen in einigen Staaten, die an der Koalition beteiligten waren. Ziel war es diese von der Fortsetzung der Luftschläge abzubringen. Dabei griff der IS vor allem auf die Strategie des führerlosen Widerstandes zurück, die in der einschlägigen Literatur bereits zuvor als Mittel der Wahl gegen einen übermächtigen Gegner beschrieben worden war. Der IS ist mit dieser Strategie gescheitert, weil es ihm nicht gelang die Botschaft zu kommunizieren und weil die Strategie des führerlosen Widerstands auch an inhärenten Widersprüchen scheiterte. Mit dem physischen Zusammenbruch des „Kalifats“ sind mittlerweile auch die technischen Möglichkeiten der Kommunikation entfallen. Offen ist welche Schlussfolgerungen der Rest des IS aus dieser Erfahrung ziehen wird.
Domänenübergreifende Abschreckung – eine neue Herausforderung westlicher Sicherheitspolitik
Authors: Mallory Charles King
Published: April 2019

Kurzfassung

Der Beitrag untersucht neue Herausforderungen, die sich für eine Abschreckungspolitik ergeben, die unterschiedliche militärische Domänen umfasst und stellt Überlegungen darüber an, wie diesen Herausforderungen begegnet werden kann. Domänenübergreifende Abschreckung wird in drei Bereichen angesprochen: Weltraum, hybride Landkriegsführung und cybergestützte Kriegführung. Der Artikel rekapituliert die hauptsächlichen Bedingungen und Wirkfaktoren, die eine Abschreckungspolitik erfolgreich werden lassen unter Hinweis auf Ergebnisse der klassischen Abschreckungstheorie. Er setzt sich daraufhin für jede Domäne mit Abschreckungsstrategien auseinander, die entweder innerhalb einer Domäne bleiben oder die über diese hinausgehen. Dabei wird zwischen Abschreckung unterschieden, die auf Erfolgsvereitelung (deterrence by denial) oder auf Bestrafung (deterrence by punishment) basiert. Der Verfasser identifiziert dabei Bereiche, die besondere Priorität erfordern und schlägt Kriterien vor anhand derer zwischen unterschiedlichen Abschreckungsstrategien Prioritäten gesetzt werden können. Als nächster Schritt untersucht der Artikel, wie die Voraussetzungen für eine erfolgreiche Abschreckungspolitik unter Anwendung dieser Kriterien gegeben sind und wo Anpassungsbedarf besteht.
Hasskriminalität und geschlechtsbezogene Gewalt gegen Frauen: Eine Einführung aus strafrechtlicher Perspektive
Authors: Steinl Leonie
Published: April 2019

Der Beitrag geht der Frage nach, ob geschlechtsbezogene Gewalt gegen Frauen als Form von Hasskriminalität verstanden werden sollte. Zunächst analysiert er unterschiedliche Begriffsdefinitionen von Hasskriminalität auf völkerrechtlicher, (supranational-)europäischer und nationaler Ebene und kristallisiert aus diesen charakteristische Elemente von Hasskriminalität. Anschließend wendet er sich dem deutschen Recht zu und befasst sich mit den normativen Anknüpfungspunkten für Hasskriminalität im deutschen Strafgesetzbuch. Im Fokus stehen dabei die Ergänzung der Grundsätze der Strafzumessung durch das Gesetz zur Umsetzung von Empfehlungen des NSU-Untersuchungsausschusses sowie der Straftatbestand der Volksverhetzung. In einem nächsten Schritt wird dann der Frage nachgegangen, inwiefern geschlechtsbezogene Gewalt gegen Frauen als Hasskriminalität eingeordnet werden sollte. Dazu wird unter anderem die amerikanische Diskussion befragt. Um den Tatbestand der Hasskriminalität stärker zu konturieren und Scheinargumente zu entlarven, wird anschließend das Erfordernis eines geschlechtsbezogenen Vorurteilsmotivs beleuchtet. Der Beitrag schließt mit einer Betrachtung der Effekte der Einordnung bestimmter Erscheinungsformen von geschlechtsbezogener Gewalt gegen Frauen als Hasskriminalität.
Zum Zusammenhang von Recht, Moral, Moralpolitik und Moralpanik am Beispiel der Reform des Sexualstrafrechts
Authors: Schmidt Anja
Published: April 2019

Dem 50. StÄG, das im Jahr 2016 den Grundsatz „Nein heißt Nein“ im deutschen Sexualstrafrecht verankerte, war eine erregte Debatte vorausgegangen. Befürworter/innen der Reform skandalisierten Lücken im strafrechtlichen Schutz des Rechts auf sexuelle Selbstbestimmung. Gegner/innen der Reform markierten dies als moralpanische Empörung bzw. moralisierende Skandalisierung und gingen davon aus, dass eine Reform das Strafrecht moralisierend in den Bereich intimer Lebensgestaltung hinein verlängern würde. Tatsächlich dürfte die immense öffentliche Empörung, die auf die Ereignisse in der Silvesternacht von Köln 2015/2016 folgte, zum Zustandekommen der Reform beigetragen haben. Im Beitrag wird das Verhältnis von Recht und Moralpolitik, Recht und Moralpanik sowie Recht und Moral am Beispiel der Reform des Sexualstrafrechts untersucht. Es wird verdeutlicht, dass diese Analyseebenen voneinander getrennt werden müssen, dass insbesondere ein Einordnen des Rechtssetzungsprozesses als moralpolitisch und der Debatten um eine Reform des Sexualstrafrechts als moralpanisch wenig zur inhaltlichen Bewertung des 50. StÄG beitragen. Ob dieses inhaltlich als unzulässig moralisierendes Recht bewertet werden muss, wird abschließend untersucht und verneint. Es wird zudem herausgearbeitet, dass dem erbitterten Streit um die Verankerung des Grundsatzes „Nein heißt Nein“ im Sexualstrafrecht ein grundlegender Dissens tief verankerter Überzeugungen zum Vorliegen und zum Herstellen von Einverständlichkeit in unserer sexuellen Kultur zugrunde liegen dürfte.
Wirkungen von Bildungsregulierung im Vergleich: Rahmenbedingungen und Finanzierung von Privatschulen in Deutschland, Österreich und der Schweiz
Authors: Nikolai Rita , Wrase Michael , Kann Caroline , Criblez Lucien
Published: April 2019

Der Beitrag analysiert die rechtliche und finanzielle Regulierung von Privatschulen in Deutschland, Österreich und der Schweiz. Auf Basis schulrechtlicher Regelungen werden Gemeinsamkeiten und Unterschiede herausgearbeitet, die die Gründung und den Betrieb von Privatschulen beeinflussen. Der Ländervergleich zeigt, dass Deutschland bezogen auf Finanzierung und Gleichbehandlung der subventionierten Privatschulen unabhängig von deren Trägerschaft im Vergleich zu Österreich und der Schweiz das privatschulfreundlichste Umfeld in der Schulpolitik aufweist.
Die Vergesellschaftung rechtlicher Grundbegriffe
Authors: Wielsch Dan
Published: April 2019

Die Wirklichkeit subjektiver Rechte, ihre Funktion für soziale Institutionen, wird im Recht selbst nur unzureichend reflektiert. In dem Maße, wie die privatrechtlichen Grundbegriffe zu solchen des positiven Rechts werden, wandert auch die Reflexion über die gesellschaftlichen Wirkungen subjektiver Rechte in den politischen Prozess aus. Die Kopplung von unparteilicher Normreflexion an das Demokratieprinzip gerät jedoch unter Druck, wenn sich Gesellschaft nicht mehr territorial, sondern global konstituiert und epistemisch ausdifferenziert. Will das Recht unter diesen Bedingungen unparteilich über Rechtskonflikte entscheiden, muss es die Verknüpfung privater Rechte mit unterschiedlichen gesellschaftlichen Teilrationalitäten rekonstruieren. Das wird anhand der sozialen Multilateralität von Eigentumsrechten und hier wiederum mit besonderem Blick auf die Rechte des Urhebers gezeigt. Angesichts von Regelbildungsprozessen jenseits des politischen Systems ist auch der Begriff der öffentlichen Autonomie umzudenken und entsprechend zu multiplizieren. Er ist darauf gerichtet, jedwede gegebene Praxis in Frage stellen zu können durch effektive Möglichkeiten zur Etablierung einer Gegenpraxis. Die Zeit, in der das Recht meinte, die Wirklichkeit der Rechte ausblenden und sich politisch entlasten zu können, ist vorbei.
The Importance of Leadership and Organizational Capacity in Shaping Health Workers’ Motivational Reactions to Performance-Based Financing: A Multiple Case Study in Burkina Faso
Authors: Fillol Amandine , Lohmann Julia , Turcotte-Tremblay Anne-Marie , Somé Paul-André , Ridde Valéry
Published: April 2019

Background: Performance-based financing (PBF) is currently tested in many low- and middle-income countries as a health system strengthening strategy. One of the main mechanisms through which PBF is assumed to effect change is by motivating health workers to improve their service delivery performance. This article aims at a better understanding of such motivational effects of PBF. In particular, the study focused on organizational context factors and health workers’ perceptions thereof as moderators of the motivational effects of PBF, which to date has been little explored. Methods: We conducted a multiple case study in 2 district hospitals and 16 primary health facilities across three districts. Health facilities were purposely sampled according to pre-PBF performance levels. Within sampled facilities, 82 clinical skilled healthcare workers were in-depth interviewed one year after the start of the PBF intervention. Data were analyzed using a blended deductive and inductive process, using self-determination theory (SDT) as an analytical framework. Results: Results show that the extent to which PBF contributed to positive, sustainable forms of motivation depended on the "ground upon which PBF fell," beyond health workers’ individual personalities and disposition. In particular, health workers described three aspects of the organizational context in which PBF was implemented: the extent to which existing hierarchies fostered as opposed to hindered participation and transparency; managers’ handling of the increased performance feedback inherent in PBF; and facility’s pre-PBF levels in regards to infrastructure, equipment, and human resources. Conclusion: Our results underline the importance of leadership styles and pre-implementation performance levels in shaping health workers’ motivational reactions to PBF. Ancillary interventions aimed at fostering participatory as opposed to directional leadership or start-up support to low-performing health facilities will likely boost PBF effects in regards to the development of valuable motivational capacities.
Social Accountability in Maternal Health Services in the Far-Western Development Region in Nepal: An Exploratory Study
Authors: Hamal Mukesh , Heiter Kalina , Schoenmakers Lian , Smid Myonne , de Cock Buning Tjard , De Brouwere Vincent , Bardají Azucena , Nepal Chiranjibi , Dieleman Marjolein
Published: April 2019

Background: Social accountability or citizen-led accountability has been promoted in many low- and middle-income countries to improve the quality, access to and use of maternal health services. Experiences with social accountability in maternal health services in Nepal have not yet been documented. This study identifies existing social accountability structures and activities in maternal health services in two districts of Far-Western Nepal and explores their functions, implementation and gaps/challenges. Methods: An exploratory study was conducted that included in-depth interviews with purposively selected policy advisors (8), healthcare officials (11), healthcare providers (12) and non-governmental staff (3); and focus group discussions (FGDs) with 54 women. Data analysis was conducted using thematic content analysis based on George’s information, dialogue and negotiation framework. Results: Social accountability in maternal health existed in terms of structures such as mothers’ groups (MGs), female community health volunteers (FCHVs) and Health Facility Operation and Management Committees (HFOMCs); and activities such as social audits and community health score board (CHSB). MGs and FCHVs were perceived as trusted intermediaries, but their functioning was limited to information. HFOMCs were not fully functional. Social audits and CHSBs were implemented in limited sites and with poor participation by women. Health-sector responses were mainly found at the local level. Factors contributing to these challenges were the absence of a mandate and limited capacity, including resources. Conclusion: Formal structures and activities existed for social accountability in maternal health services in the Far-Western Development Region of Nepal, but there were limitations pertaining to their implementation. The main recommendations are: for clear policy mandates on the social accountability roles of MGs and FCHVs; wider implementation of social audits and CHSBs, with emphasis on the participation of women from disadvantaged groups; improved capacity of HFOMCs; and improved engagement of the health sector at all levels to listen and respond to women’s concerns.
Framing Bias in the Interpretation of Quality Improvement Data: Evidence From an Experiment
Authors: Ballard Andrew
Published: April 2019

Background: A growing body of public management literature sheds light on potential shortcomings to quality improvement (QI) and performance management efforts. These challenges stem from heuristics individuals use when interpreting data. Evidence from studies of citizens suggests that individuals’ evaluation of data is influenced by the linguistic framing or context of that information and may bias the way they use such information for decision-making. This study extends prospect theory into the field of public health QI by utilizing an experimental design to test for equivalency framing effects on how public health professionals interpret common QI indicators. Methods: An experimental design utilizing randomly assigned survey vignettes is used to test for the influence of framing effects in the interpretation of QI data. The web-based survey assigned a national sample of 286 city and county health officers to a "positive frame" group or a "negative frame" group and measured perceptions of organizational performance. The majority of respondents self-report as organizational leadership. Results: Public health managers are indeed susceptible to these framing effects and to a similar degree as citizens. Specifically, they tend to interpret QI information presented in a "positive frame" as indicating a higher level of performance as the same underlying data presenting in a "negative frame." These results are statistically significant and pass robustness checks when regressed against control variables and alternative sources of information. Conclusion: This study helps identify potential areas of reform within the reporting aspects of QI systems. Specifically, there is a need to fully contextualize data when presenting even to subject matter experts to reduce the existence of bias when making decisions and introduce training in data presentation and basic numeracy prior to fully engaging in QI initiatives.