bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors Associated with Unsuccessful Recanalization in Mechanical Thrombectomy for Acute Ischemic Stroke
Authors: Goda Toshiaki , Oyama Naoki , Kitano Takaya , Iwamoto Takanori , Yamashita Shinji , Takai Hiroki , Matsubara Shunji , Uno Masaaki , Yagita Yoshiki
Published: September 2019

Introduction: Mechanical thrombectomy (MT) for acute ischemic stroke has become a standard therapy, and the recanalization rate has significantly improved. However, some cases of unsuccessful recanalization still occur. We aimed to clarify patient factors associated with unsuccessful recanalization after MT for acute ischemic stroke. Methods: This was a single-center, retrospective study of 119 consecutive patients with anterior circulation acute ischemic stroke who underwent MT at our hospital between April 2015 and March 2019. Successful recanalization after MT was defined as modified Treatment in Cerebral Ischemia (mTICI) grade 2b or 3, and unsuccessful recanalization was defined as mTICI grades 0–2a. Several factors were analyzed to assess their effect on recanalization rates. Results: Successful recanalization was achieved in 88 patients (73.9%). The univariate analysis showed that female sex (38.6 vs. 67.7%, p = 0.007), a history of hypertension (53.4 vs. 83.9%, p = 0.003), and a longer time from groin puncture to recanalization (median 75 vs. 124 min, p < 0.001) were significantly associated with unsuccessful recanalization. The multivariate analysis confirmed that female sex (OR 3.18; 95% CI 1.12–9.02, p = 0.030), a history of hypertension (OR 4.84; 95% CI 1.32–17.8, p = 0.018), M2–3 occlusion (OR 4.26; 95% CI 1.36–13.3, p = 0.013), and the time from groin puncture to recanalization (per 10-min increase, OR 1.22; 95% CI 1.09–1.37, p < 0.001) were independently associated with unsuccessful recanalization. Conclusion: Female sex and a history of hypertension might be predictors of unsuccessful recanalization after MT for anterior circulation acute ischemic stroke. Further studies are needed to fully evaluate predictors of recanalization.
Psychological Aspects of Breast Reconstruction after Breast Cancer
Authors: Pittermann Anna , Radtke Christine
Published: September 2019

Even though breast cancer mortality is declining, the diagnosis still poses a huge threat for the affected woman and her close family. Breast cancer surgery, which often includes reconstructive procedures, can help restoring a satisfactory body image. The decision on the type of surgery should always be made together with the patient and should focus on her psychosocial needs. This review describes the psychological aspects of breast cancer for the patient and her social environment and offers ideas for a patient-oriented treatment plan.
Dialysis Catheter Insertion with Extended Ultrasound Monitoring
Authors: Letachowicz Krzysztof , Goździk Anna , Gołębiowski Tomasz , Letachowicz Waldemar , Kusztal Mariusz , Szymczak Anna , Zmonarski Sławomir , Kanafa Maciej , Janczak Dariusz , Krajewska Magdalena
Published: September 2019

Introduction: Dialysis catheter insertion is a routine procedure performed when there is necessity of urgent renal replacement therapy initiation. Due to limited access, higher costs, and long waiting times for fluoroscopy, alternative visualization methods are introduced into clinical practice. One of the most promising is transthoracic echocardiographic monitoring of guide-wire introduction. Objective: The feasibility of the technique was verified by nephrologists inserting dialysis catheters. Methods: A single center prospective trial was performed (NCT03727581). Introduction of guide-wire was monitored with ultrasound to confirm correct position of the wire in the inferior vena cava (IVC) or right atrium (RA). The study group included 30 patients, 19 males and 11 females, 25–83 years old. Results: It was possible to obtain a good picture of IVC in the majority of patients. In 20 (66.7%) cases, IVC view was excellent; in 9 (30%) cases, was fair; and in 1 (3.3%) patient, we failed to visualize IVC. The guide-wire was identified in IVC in 12 (42.8%) patients, in another 9 (32.1%) patients guide-wire was visible in IVC after withdrawing and advancing it, and in RA in 6 (21.4%) patients. Catheters were successfully placed in 29 (96.7%) patients. Conclusions: Detection of the guide-wire confirms correct course of the procedure and increases the safety of catheter insertion without fluoroscopy.
Unsuccessful Treatment of Cheilitis Granulomatosa with Oral Methotrexate
Authors: Sutharaphan Thanapon , Chanprapaph Kumutnart , Vachiramon Vasanop
Published: September 2019

Cheilitis granulomatosa (CG) is a rare idiopathic condition with painless lip swelling, characterized by non-necrotizing granulomatous inﬂammation in the absence of other identifiable causes such as Crohn’s disease, sarcoidosis, foreign body reaction, or infection. CG may precede the presentation of Crohn’s disease after long-term follow-up. Spontaneous remission of CG rarely occurs. To date, given the rarity of CG, there is no gold standard treatment. Recommended treatments are supported by small studies, case reports/series, and expert opinions. Glucocorticoids are the first-line therapy in the acute stages of the disease; however, recurrence commonly occurs. Previously, methotrexate (MTX) showed a beneﬁcial effect on orofacial swelling in a case of CG accompanied by Crohn’s disease. We present a patient with CG without Crohn’s disease. He was treated with oral MTX in combination with intralesional corticosteroid injection on one side of the lip. The injected side showed improvement, while lip swelling on the noninjected area remained unchanged after 3 months of treatment. Therefore, CG is refractory to treatment with MTX from our experience. Further studies regarding the optimum dosage of MTX is needed.
Combined Intestinal Adenomas/Microcarcinoids
Authors: Tamura Hiromi , Ando Hiroka , Doi Reiko , Adachi Shiro
Published: September 2019

The combined colonic adenoma/microcarcinoid tumor is a rare intestinal neoplasm featuring intermingled adenomatous and carcinoid components. A few case reports and small case series have suggested that this entity exhibits an indolent clinical course. Here, we report two cases with these tumors, and describe the morphological features and clinical follow-up. A 61-year-old male and 78-year-old male presented with heme-positive stools at their medical checkups. Colonoscopy revealed masses in the colons; we performed endoscopic mucosal resection. Both lesions featured low-grade adenomas and low-grade neuroendocrine tumors. We diagnosed combined colonic adenomas/microcarcinoids. The clinical courses of both patients were benign at follow-up at 2.5 and 6 years. Awareness of this rare colonic tumor should prevent potential diagnostic pitfalls and may help clarify the natural history of these tumors and their possible relationships with composite glandular/carcinoid tumors.
Evolution of the American College of Cardiology and American Heart Association Cardiology Clinical Practice Guidelines: A 10‐Year Assessment
Authors: DuBose‐Briski Victoria , Yao Xiaoxi , Dunlay Shannon M. , Dhruva Sanket S. , Ross Joseph S. , Shah Nilay D. , Noseworthy Peter A.
Published: September 2019

Background

The American College of Cardiology and American Heart Association periodically revise clinical practice guidelines. We evaluated changes in the evidence underlying guidelines published over a 10‐year period.

Methods and Results

Thirty‐five American College of Cardiology/American Heart Association guidelines were divided into 2 time periods: 2008 to 2012 and 2013 to 2017. Guidelines were categorized into the following topic areas: arrhythmias, prevention, acute and stable ischemia, heart failure, valvular heart disease, and vascular medicine. Changes in recommendations were assessed for each topic area. American College of Cardiology/American Heart Association designated class of recommendation as level I,
II
, or
III
(I represented “strongly recommended”) and levels of evidence (
LOE
) as A, C, or C (A represented “highest quality”). The median number of recommendations per each topic area was 281 (198–536, interquartile range) in 2008 to 2012 versus 247 (190–451.3, interquartile range) in 2013 to 2017. The median proportion of class of recommendation I was 49.3% and 44.4% in the 2 time periods, 38.0% and 44.5% for class of recommendation
II
, and 12.5% and 11.2% for class of recommendation
III
. Median proportions for
LOE
A were 15.7% and 14.1%, 41.0% and 52.8% for
LOE
B, and 46.9% and 32.5% for
LOE
C. The decrease in the proportion of
LOE
C was highest in heart failure (24.8%), valvular heart disease (22.3%), and arrhythmia (19.2%). An increase in the proportion of
LOE
B was observed for these same areas: 31.8%, 23.8%, and 19.2%, respectively.

Conclusions

There has been a decrease in American College of Cardiology/American Heart Association guidelines recommendations, driven by removal of recommendations based on lower quality of evidence, although there was no corresponding increase in the highest quality of evidence.
Nocturnal Mean Arterial Pressure Rising Is Associated With Mortality in the Intensive Care Unit: A Retrospective Cohort Study
Authors: Li Jiamei , Li Ruohan , Gao Ya , Zhang Jingjing , Zhao Yujie , Zhang Xiaoling , Wang Gang
Published: September 2019

Background

Disrupted circadian rhythm of blood pressure is commonly observed in patients in the intensive care unit (
ICU
). This study assessed the association of nocturnal mean arterial pressure rising (
NMAPR
) with short‐ and long‐term mortality in critically ill adult patients.

Methods and Results

Adult patients with a complete record of mean arterial pressure monitoring during the first 24 hours of
ICU
stay in the Multiparameter Intelligent Monitoring in Intensive Care
II
(MIMIC‐II) database were included in this retrospective cohort study. All patients were divided into the non‐
NMAPR
group (≤1) or the
NMAPR
group (>1), according to the value of mean nighttime divided by daytime mean arterial pressure. The associations of
NMAPR
with
ICU
, hospital, 28‐day, and 1‐year mortality were assessed using multivariable logistic regression or a Cox proportional hazards model. Interaction and subgroup analyses were performed for those patients who had a first Sequential Organ Failure Assessment (
SOFA
) score of ≥8 or <8. The overall cohort comprised 5185 patients. The patients with
NMAPR
(n=1865) had higher
ICU
, hospital, 28‐day, and 1‐year mortality than the non‐
NMAPR
group (n=3320). After adjusting for covariates, the analysis showed that
NMAPR
was significantly associated with mortality in the
ICU
(odds ratio: 1.34; 95% CI, 1.10–1.65), in the hospital (odds ratio: 1.35; 95%
CI
, 1.12–1.63), at 28 days (hazard ratio: 1.27; 95%
CI
, 1.10–1.48), and at 1 year (hazard ratio: 1.24; 95%
CI
, 1.10–1.40). All results of the interaction analysis had no statistical significance, and similar results persisted in the patients with different
SOFA
scores.

Conclusions

NMAPR
may aid in the early identification of critically ill patients at high risk of
ICU
, hospital, 28‐day, or 1‐year mortality.
Prevalence, Awareness, and Treatment of Isolated Diastolic Hypertension: Insights From the China PEACE Million Persons Project
Authors: Mahajan Shiwani , Zhang Danwei , He Siyun , Lu Yuan , Gupta Aakriti , Spatz Erica S. , Lu Jiapeng , Huang Chenxi , Herrin Jeph , Liu Shuling , Yang Jingwei , Wu Chaoqun , Cui Jianlan , Zhang Qiuli , Li Xi , Nasir Khurram , Zheng Xin , Krumholz Harlan M. , Li Jing , Dong Zhong , Jiang Bo , Zhang YingYi , Liu Yuhuan , Meng Yaqing , Xi Yunfeng , Tian Yuanmeng , Fu Yao , Liu Ting , Yan Shichun , Jin Lin , Wang Jing , Xu Xiaoling , Xing Xiuya , Zhang Luan , Fang Xin , Xu Yan , Xu Chunxiao , Fan Lei , Qi Minjie , Qi Junfeng , Li Junlin , Liu Qiong , Feng Yingqing , Wang Jiabin , Wen Hong , Xu Jie , He Jun , Jiang Chenxi , Yang Cangjiang , Yu Yue , Tashi Zongji , Hu Zhiping , Zhang Jing , Li Xiaoping , Ma Shaoning , Ma Yitong , Huang Ying , Zhang Yuchen , Shen Jiacong
Published: September 2019

Background

Characterizing and assessing the prevalence, awareness, and treatment patterns of patients with isolated diastolic hypertension (
IDH
) can generate new knowledge and highlight opportunities to improve their care.

Methods and Results

We used data from the China PEACE (Patient‐centered Evaluative Assessment of Cardiac Events) Million Persons Project, which screened 2 351 035 participants aged 35 to 75 years between 2014 and 2018.
IDH
was defined as systolic and diastolic blood pressure of <140 and ≥90 mm Hg; awareness as self‐reported diagnosis of hypertension; and treatment as current use of antihypertensive medications. Of the 2 310 184 participants included (mean age 55.7 years; 59.5% women); 73 279 (3.2%) had
IDH
, of whom 63 112 (86.1%) were untreated, and only 6512 (10.3%) of the untreated were aware of having hypertension. When compared with normotensives, participants who were <60 years, men, at least college educated, had body mass index of >28 kg/m
2
, consumed alcohol, had diabetes mellitus, and prior cardiovascular events were more likely to have
IDH
(all
P
<0.01). Among those with
IDH
, higher likelihood of awareness was associated with increased age, women, college education, body mass index of >28 kg/m
2
, higher income, diabetes mellitus, prior cardiovascular events, and Central or Eastern region (all
P
<0.05). Most treated participants with
IDH
reported taking only 1 class of antihypertensive medication.

Conclusions

IDH
affects a substantial number of people in China, however, few are aware of having hypertension and most treated participants are poorly managed, which suggests the need to improve the diagnosis and treatment of people with
IDH
.
(Post)human Temporalities: Science Fiction in the Anthropocene
Authors: Hay Jonathan
Published: September 2019

Although many SF texts proceed from the speculative premise that our species will continue to develop technologically, and hence become increasingly posthuman, our species’ continuance into even the next century is by no means assured. Rather, the Anthropocene exerts a new temporal logic; it is an age defined by an intensification of geological timescales. It is therefore noteworthy that many contemporary SF texts are ecologically interventionist and figure apocalyptic future temporalities which curtail the posthuman predilection common to the genre. This article analyses a tetrad of literary texts, written at various points during the last three decades, which summatively reveal the mutations of the (post)human temporalities figured by cli-fi texts. These four texts are: Kim Stanley Robinson’s Mars Trilogy (1992-1996); Jeanette Winterson’s The Stone Gods (2007); Michel Faber’s The Book of Strange New Things (2014); and Paolo Bacigalupi’s The Water Knife (2015).
Present-Tense Narration and Representing Trauma in Anne Enright’s The Gathering
Authors: McCarthy Karen Anne
Published: September 2019

In this article, I engage with the present-tense narration in Anne Enright’s novel, The Gathering. The narrator, Veronica Hegarty, is tasked with assembling her family for a wake after the suicide of her closest brother Liam. What his death unleashes in her is a compulsion to write down an “uncertain event,” which may or “may not have happened,” in which Liam was sexually assaulted as a child. The narrative suggests that Veronica witnessed this “event” and, in line with the aporetic nature of traumatic experience, did not register it as such. The narrative temporal strategy, as this article will demonstrate, is key to the author’s representation of the “event” which, due to its traumatic nature, is always of the present, and never successfully relegated to the past. I also explore the ways in which the novel suggests a healing which can be neither contained nor enacted within the confines of this overtly present-tense narrative.
Faculty and Student Perceptions of the Presence of Emotional Support Animals on a College Campus
Authors: Goodman-Wilson Miranda , Highfill Lauren
Published: September 2019

Colleges are experiencing an increase in requests for Emotional Support Animals (ESAs) to live on campus. However, misconceptions about policies pertaining to ESAs are pervasive. No formal, published study has yet examined the opinions of those who are most impacted—faculty and students. In the present study, 45 faculty and 228 students (49 living with an ESA) were surveyed about their understanding of ESAs and ESA-related policies. Participants were asked about the perceived benefits and disadvantages of having an ESA at college. Results indicate that the majority of faculty and students are supportive of ESAs on campus generally. However, opinions about permitting ESAs into academic spaces are considerably more mixed. Among both faculty and students, there is much confusion about the rules which govern their presence on campus. The survey also revealed support for increased accountability measures for ESAs in the form of training qualifications and welfare considerations.
Two new brackish-water species of Pogaina (Rhabdocoela: Provorticidae) from China
Authors: ZHONG LIN-HONG , XIE YAO-HANG , HU XIAO-ZHOU , CHEN YU-SI , FENG WEI-TAO , ZHANG YU , WANG AN-TAI
Published: October 2019

Two new species of the genus Pogaina Marcus, 1954 (Provorticidae), namely Pogaina sinensis n. sp. and Pogaina shenzhenensis n. sp. are described from brackish water in the intertidal zone of Shenzhen Bay. For P. sinensis n. sp., the tubular stylet is slightly curved at the distal end and a fusiform structure with a flange is present at 66% of the stylet. The flange encircles the stylet, with its ends attached to the midpoint and the distal end of the stylet. For P. shenzhenensis n. sp., the stylet has a N-shaped overall morphology. A band provided with dense needle-like structures is present at the distal end of the stylet. Both the morphological (stylet) and phylogenetic (18S rDNA and 28S rDNA) analyses support the establishment of these two new species.
Citizens and mobile government: an empirical analysis of the antecedents and consequences of mobile government usage
Authors: Wirtz Bernd W. , Birkmeyer Steven , Langer Paul F.
Published: September 2019

Mobile government services have significantly gained importance for practitioners and researchers. However, there is a lack of empirical investigation into the diffusion of mobile government among users. Based on the technology acceptance model and related literature, we derived a structural model providing the central antecedents of citizens’ usage intention of mobile government services and its effect on word-of-mouth intention. Findings from a sample of 161 German public administration students largely supported the model. Only the anticipated effect of perceived interactivity on intention to use was not supported.

Points for practitioners

The study provides a comprehensive model of mobile government applications’ success. Professionals who develop mobile government services should focus on usefulness, usability and a high level of service coverage, as well as privacy and security aspects, to increase citizens’ intention to use the respective service. Interactivity has not been found to be a significant factor for citizens’ intention to use mobile government services. The study also suggests that citizens will recommend the services to others if they intend to use it in the first place.
Introduction to the Special Issue on Radical Humanism, Critical Consciousness, and Social Change
Authors: Saleem Rakhshanda , Morrill Zenobia , Karter Justin M.
Published: September 2019

This special issue engages in exploring challenges faced by those involved in research, teaching, and practice within psychology, particularly humanistic psychology, with a commitment to social justice and transformation. It invited work by positing the critical urgency for incorporating decolonized transdisciplinary and transnational perspectives, analysis, and activism to alleviate human suffering and address the historical and ongoing realities of structural inequalities and injustice.
A Review of the Evidence for Real-Time Performance Feedback to Improve Instructional Practice
Authors: Sinclair Anne C. , Gesel Samantha A. , LeJeune Lauren M. , Lemons Christopher J.
Published: September 2019

In this comprehensive review, 32 studies were identified in which researchers investigated the effect of real-time performance feedback delivered via technology on interventionist implementation of instructional practices. Studies were evaluated for methodological rigor with quality indicators from the Council for Exceptional Children. Twenty-two single case designs and one group design met all quality indicators. The single case designs were analyzed using visual analysis and given success estimates calculated as a ratio of the number of demonstrated effects to potential demonstrations of effect. Methodologically sound evidence indicates that real-time performance feedback is an evidence-based practice for changing interventionist behavior during intervention sessions. Implications for research and practice are discussed.
The Perception of Cantonese Vowel Length Contrast by Mandarin Speakers
Authors: Luo Jingxin , Li Vivian Guo , Mok Peggy Pik Ki
Published: September 2019

The study investigates the perception of vowel length contrasts in Cantonese by native Mandarin speakers with varying degrees of experience in Cantonese: naïve listeners (no exposure), inexperienced learners (~1 year), and experienced learners (~5 years). While vowel length contrasts do not exist in Mandarin, they are, to some extent, exploited in English, the second language (L2) of all the participants. Using an AXB discrimination task, we investigate how native and L2 phonological knowledge affects the acquisition of vowel length contrasts in a third language (L3). The results revealed that all participant groups could discriminate three contrastive vowel pairs (/aː/–/ɐ/, /ɛː/–/e/, /ɔː/–/o/), but their performance was influenced by the degree of Cantonese exposure, particularly for learners in the early stage of acquisition. In addition to vowel quality differences, durational differences were proposed to explain the perceptual patterns. Furthermore, L2 English perception of the participants was found to modulate the perception of L3 Cantonese vowel length contrasts. Our findings demonstrate the bi-directional interaction between languages acquired at different stages, and provide concrete data to evaluate some speech acquisition models.
The forensic approach to plastic bag suffocation: Case reports and review of the literature
Authors: Santoro Paola , La Russa Raffaele , Besi Livia , Volonnino Gianpietro , dell’Aquila Massimiliano , De Matties Alessandra , Maiese Aniello
Published: September 2019

Death from plastic bag suffocation is unusual and rare in under-developed countries. Initially, deaths were accidental mostly of children but with time homicides, suicides and deaths in auto-erotic situations were noted. It is not always possible to discover the dynamics leading to the death especially when suicide is suspected. Often, the typical signs of asphyxia – petechial haemorrhages, facial congestion, oedema and cyanosis – are not there. The authors present two cases of plastic bag suffocation, where a multi-disciplinary approach was applied. This study reviews international literature on plastic bag suffocation, analysing the frequency of suicides, homicides and accidental deaths associated with plastic suffocation.
The Effect of Narrow Reading on L2 Learners’ Vocabulary Acquisition
Authors: Chang Anna C-S , Renandya Willy A.
Published: September 2019

Narrow reading has not received much attention from researchers regarding its contributions on L2 learners’ background knowledge, vocabulary knowledge, and writing styles. This study therefore investigated the effect of narrow reading on English as a foreign language (EFL) learners’ vocabulary learning. Twelve graded readers were selected and categorized into four sets: same author (Tim Vicary), same genre (crime and mystery), same title ( The Railway Children) and random readers. Each set contains three graded readers: one Level 1, one Level 2, and one Level 3. Fifty-six students were divided into four subgroups and each group took turns reading each set of the graded readers. Twenty-five unknown target words were selected to be tested in each category. After students had read a set of three graded readers, their vocabulary knowledge was assessed on three dimensions: form-meaning recall, sources, and use. The data were analysed using linear mixed-effects models (LMM), with the participants as the random effect, and text organization, vocabulary dimensions, time order, and reading text sequence as fixed effect variables. The results show that more vocabulary words were acquired from texts by the same author or random texts than from texts of the same title; the L2 learners recalled 61% of the source and 50% of the meaning, and 41% of the target words were used correctly. Students scored the lowest at Time 1 and the highest at Time 4, indicating that learning rates increased as they read more. Pedagogical implications are discussed, and future research directions are suggested.
Health-Related Quality of Life and Cumulative Psychosocial Risks in Adolescents
Authors: González-Cabrera Joaquín , Machimbarrena Juan M. , Fernández-González Liria , Prieto-Fidalgo Ángel , Vergara-Moragues Esperanza , Calvete Esther
Published: September 2019

Psychosocial risks can negatively affect adolescents’ physical, psychological, and social health. Grounded on the cumulative risk theory, the objective of this study was to analyze the differences in health-related quality of life (HRQoL) depending on the accumulation of several psychosocial risks (bullying, cyberbullying, cyberdating abuse, sexting, online grooming, and problematic Internet use). The participants were 3,212 Spanish adolescents (53.7% females) with a mean age of 13.92 ± 1.44, who completed self-report online questionnaires that assessed each of the aforementioned risks and HRQoL. Overall, 41.4% of the female participants and 36.8% of the males presented at least one risk, with significant differences between sexes. The percentage of participants who presented an accumulation of three or more risks was 8.2%. Risk accumulation was related to a lower HRQoL score than those who presented no risks. The scores in HRQoL decrease at up to four risks, point at which the differences ceased to be significant.
Religious fundamentalism in Iran: Religious and psychological adjustment within a Muslim cultural context
Authors: Ghorbani Nima , Chen Zhuo Job , Rabiee Fatemeh , Watson PJ
Published: September 2019

This first analysis of the Religious Fundamentalism Scale in Iran further examined findings that conservative religious commitments have positive adjustment implications outside the West. Religious Fundamentalism in a sample of 385 Iranian university students displayed direct relationships with Muslim religiosity and spirituality and correlated positively with the Transcendence and negatively with the Symbolism Post-Critical Beliefs (PCB) factors. Religious Fundamentalism, and conservative religiosity more generally, predicted better mental health in relationship with variables related to self-regulation, narcissism, and splitting. PCB factors defined a fundamentalist attitude of Literal Affirmation that also displayed some linkages with more adaptive psychological functioning. Iranians who self-identified as “both religious and spiritual” were more conservative religiously and more adjusted psychologically than three other religious-spiritual types. Conservative religiosity did predict the maladjustment of Exploitable Dependency. These data further suggested that conservative religiosity can have largely, though not wholly, positive mental health implications outside the West.
Equality, Efficiency, and Developmental Education Reform: The Impact of SB 1720 on the Mission of the Florida College System
Authors: Nix Amanda N. , Jones Tamara Bertrand , Brower Rebecca L. , Hu Shouping
Published: September 2019

Objective: Community colleges have long made higher education more accessible to students from diverse academic backgrounds, particularly those who are academically underprepared and require remediation. In light of developmental education (DE) reform, our article answers the following questions: How do campus personnel articulate the unique mission of Florida’s state colleges, formerly known as community colleges? Furthermore, how do they perceive the mandates of reform to have shaped their ability to carry out this mission? Method: This work is based on an embedded case study of 10 Florida College System institutions. Qualitative data were gathered between 2014 and 2018 from 544 college presidents, administrators, faculty, staff through 92 focus groups and 8 interviews. Results: Campus personnel strongly affirmed the mission of the Florida Colleges System as one of democratic equality. However, many were concerned that DE reform, namely Senate Bill 1720, prioritized efficiency over equality in the pursuit of cost savings. Specifically, participants expressed frustration that reforms accelerated DE coursework to an unmanageable pace and ignored the presence of a digital divide. Opinions of DE reform improved in the 4 years following implementation, but some concern persisted. Contributions: Our findings highlight the centrality of democratic equality to the community college mission for campus personnel. They also suggest that equality and efficiency need not always be opposing goals in education reform. Finally, they call into question social policy that universally promotes accelerated and computer-based courses without considering that some students may require accommodations.
Predicting survival in patients with advanced cancer in the last weeks of life: How accurate are prognostic models compared to clinicians’ estimates?
Authors: Hui David , Ross Jeremy , Park Minjeong , Dev Rony , Vidal Marieberta , Liu Diane , Paiva Carlos Eduardo , Bruera Eduardo
Published: September 2019

Background:

It is unclear if validated prognostic scores such as the Palliative Performance Scale, Palliative Prognostic Index, and Palliative Prognostic Score are more accurate than clinician prediction of survival in patients admitted to an acute palliative care unit with only days of survival.

Aim:

We compared the prognostic accuracy of Palliative Performance Scale, Palliative Prognostic Index, Palliative Prognostic Score, and clinician prediction of survival in this setting.

Design:

This is a pre-planned secondary analysis of a prospective study.

Setting/participants:

We assessed Palliative Performance Scale, Palliative Prognostic Index, Palliative Prognostic Score, and clinician prediction of survival at baseline. We computed their prognostic accuracy using the Concordance index and area under the receiver operating characteristics curve for 7-, 14-, and 30-day survival.

Results:

A total of 204 patients were included with a median overall survival of 10 days (95% confidence interval: 8–11 days). The Concordance index for Palliative Performance Scale, Palliative Prognostic Index, Palliative Prognostic Score, and clinician prediction of survival were 0.74, 0.71, 0.70, and 0.75, respectively. The areas under the curve for these approaches were 0.82–0.87 for 30-day survival, 0.75–0.80 for 14-day survival, and 0.74–0.81 for 7-day survival. The four prognostic approaches had similar accuracies, with the exception of 7-day survival in which clinician prediction of survival was significantly more accurate than Palliative Prognostic Score (difference: 7%) and Palliative Prognostic Index (difference: 8%).

Conclusion:

In patients with advanced cancer with days of survival, clinician prediction of survival and Palliative Performance Scale alone were as accurate as Palliative Prognostic Score and Palliative Prognostic Index. These four approaches may be useful for prognostication in acute palliative care units. Our findings highlight how patient population may impact the accuracy of prognostic scores.
Specialist palliative care services for older people in primary care: A systematic review using narrative synthesis
Authors: de Nooijer Kim , Penders Yolanda WH , Pivodic Lara , Van Den Noortgate Nele J , Pype Peter , Van den Block Lieve
Published: September 2019

Background:

There is recognition that older people with incurable conditions should have access to specialist palliative care services. However, it remains unclear which activities and outcomes these services entail for older people in primary care and to which patients they are provided.

Aim:

The aim of this review was to identify the criteria for referral to specialist services; who provides specialist palliative care; through which activities and with which frequency; which outcomes are reported; and which suggestions are made to improve services.

Design:

Systematic review of the literature and narrative synthesis. Quality appraisal and selection of studies were performed independently by two researchers. Participant characteristics, intervention features, outcome data and suggestions for improvement were retrieved.

Data sources:

Embase, Medline, Web of Science, Cochrane, Google Scholar, PsycINFO and CINAHL EBSCO databases (until June 2019).

Results:

Ten eligible articles, three qualitative, three quantitative, three mixed-method and one narrative review, were identified. Referral criteria were mainly based on patient characteristics such as diagnosis. The specialist services involved a variety of activities and outcomes and descriptions were often lacking. Services could be improved regarding the information flow between healthcare professionals, greater in-depth palliative care knowledge for case managers and social workers, identification of a key worker and support for family carers.

Conclusion:

The limited evidence available shows areas for improvement of the quality of and access to specialist services for older people, such as support for family carers. In addition, this review underscores the need for comprehensive reporting of interventions and the use of consensus-based outcome measures.
Exosomes Isolated From Adipose-Derived Stem Cells: A New Cell-Free Approach to Prevent the Muscle Degeneration Associated With Torn Rotator Cuffs
Authors: Wang Chongyang , Song Wei , Chen Bi , Liu Xudong , He Yaohua
Published: September 2019

Background:

Fatty infiltration, inflammation, and apoptosis are common degenerative changes in patients with chronic rotator cuff tears that can lead to muscle atrophy and can even result in massive irreparable rotator cuff tears. Some data have demonstrated the proregenerative, anti-inflammatory, and anti-apoptotic properties of stem cell–derived exosomes in some orthopaedic disorders, but their effect on torn rotator cuff muscles has never been investigated.

Purpose:

To study the effect of exosomes isolated from human adipose-derived stem cells (ASCs-Exos) on muscle degeneration, regeneration, and biomechanical properties in a rat model of a massive rotator cuff tear (MRCT).

Study Design:

Controlled laboratory study.

Methods:

A bilateral supraspinatus and infraspinatus tenotomy was performed on rats to create an MRCT model. Forty-two rats were randomly assigned to 3 groups: the sham surgery group, the saline group (lesions treated with a saline injection), and the ASCs-Exos group (lesions treated with an ASCs-Exos injection). Wet muscle weight, fatty infiltration, inflammation, vascularization, regeneration, and biomechanical properties were evaluated at 8 and 16 weeks after surgery.

Results:

The results revealed that the ASCs-Exos treatment could prevent the atrophy, fatty infiltration, inflammation, and vascularization of muscles in the MRCT model ( P < .001). Additionally, the myofiber regeneration and biomechanical properties of ASCs-Exos-treated rotator cuffs were significantly elevated compared with those in the saline-treated group ( P < .001).

Conclusion:

This study demonstrates that ASCs-Exos can effectively decrease atrophy and degeneration and improve muscle regeneration and biomechanical properties in torn rotator cuff muscles.

Clinical Relevance:

ASCs-Exos can be used as a new cell-free approach to prevent the muscle degeneration associated with torn rotator cuffs and may be helpful to repair torn rotator cuffs. Nevertheless, further work needs to be done in a large animal model owing to the inherent regenerative potential possessed by rodents.
Tangible user interface vocabulary to physically enhance space systems engineering tools
Authors: Cerqueira Christopher Shneider , Ambrosio Ana Maria , Kirner Claudio
Published: September 2019

Tangible user interface brings back physical cognitive artifacts empowered with Internet of Things, and it will be a key instrument in Industry 4.0 to control software. Such artifacts are tangible mental representation of the context of a system being built with software tools. One of the challenges on applying tangible user interface to define an appropriated interaction is the lack of a vocabulary to prepare physical artifacts for being manipulated in digital representation. We present a tangible interaction vocabulary to physically enhance software tools, particularly used in space system concept studies. It is a practical application which indicates opportunities for research and challenges for the development of new products.
Is Cancer Solvable? Towards Efficient and Ethical Biomedical Science
Authors: Shrager Jeff , Shapiro Mark , Hoos William
Published: September 2019

Global Cumulative Treatment Analysis (GCTA) is a novel clinical research model combining expert knowledge, and treatment coordination based upon global information-gain, to treat every patient optimally while efficiently searching the vast space that is the realm of cancer research.
Surrogate Endpoints and Drug Regulation: What Is Needed to Clarify the Evidence
Authors: Hey Spencer Phillips , Feldman William B. , Jung Emily H. , D'Andrea Elvira , Kesselheim Aaron S.
Published: September 2019

The FDA's new table of surrogate endpoints used for drug approvals is an important step forward for overseeing the use of biomarkers in clinical trials. Nevertheless, we present several ways in which the table can be improved.
Biomarkers as Surrogate Endpoints: Ongoing Opportunities for Validation
Authors: Zhang Audrey D. , Ross Joseph S.
Published: September 2019

Surrogate endpoints are a common application of biomarkers to estimate clinical benefit in clinical trials, despite questions about reliability. This article discusses ongoing opportunities for their validation, in the context of a regulatory environment in which they are increasingly championed.
Maternal Functioning and Depression Scores Improve Significantly With Participation in Visiting Moms® Program
Authors: Barkin Jennifer L. , Beals Laura , Bridges Christy C. , Ezeamama Amara , Serati Marta , Buoli Massimiliano , Erickson Amber , Chapman Megan , Bloch Joan R.
Published: September 2019

BACKGROUND: Postpartum depression is the most common complication of childbearing can affect the entire family unit. Health professionals must strive to identify and develop effective, feasible solutions for women during this critical period. AIMS: To determine whether postpartum maternal functioning (as measured by the Barkin Index of Maternal Functioning) and depression symptoms (as measured by the Patient Health Questionnaire-9) were improved after participation in the Visiting Moms program. METHOD: Paired data were collected from women at program intake and after completion of the Visiting Moms program. Visiting Moms provides services through eastern and central Massachusetts and was designed to support new mothers throughout the infant’s first year of life. The study population was composed of adult women living in the Jewish Family and Children’s Services geographic catchment area, who enrolled in Visiting Moms between January 1, 2013, and December 31, 2015. Descriptive statistics were calculated for all 402 women enrolled in this timeframe. Utilizing a pretest/posttest design, paired t tests were performed for the Barkin Index of Maternal Functioning ( n = 149) and for the Patient Health Questionnaire-9 ( n = 156), where women had complete scores at both intake and completion, to determine the program’s potential impact on depressive symptoms and functional status. RESULTS: Functioning and depression scores were significantly improved after participation in the program. CONCLUSIONS: Visiting moms, and similar programs, aimed at delivery of enhanced social support, may be effective in promoting mental and emotional wellness among new mothers who are require additional support in the postpartum period.
Facilitating global citizenship development in lingua franca virtual exchanges
Authors: Lenkaitis Chesla Ann , Loranc Barbara
Published: September 2019

This article investigates how engaging students to discuss topics that reflect their ideologies in lingua franca (LF) virtual exchanges can help facilitate global citizenship development. A six-week virtual exchange is explored with students from universities in Mexico, Poland, Spain, and the USA. This study utilizes five key elements of CALL-related tasks and three categories of telecollaborative tasks in order to promote students’ global citizenship, defined as awareness, caring, and embracing cultural diversity while promoting social justice and sustainability, coupled with a sense of responsibility to act. During the exchange, 55 participants, registered for foreign language courses (English or Spanish) or for a content area course (such as business and pedagogy) taught in English, met weekly in groups via Zoom video conferencing. In addition to discussing weekly topics, via selected current event photos, and using either English or Spanish as a LF, participants completed individual weekly pre- and post-Zoom session activities. Qualitative analyses revealed that weekly topics offered opportunities to problem solve, negotiate ideologies, and make connections to participants’ belief systems. Also, results indicated that participants became more socially responsible as shown by their increased citizenship awareness and civic-mindfulness.
Rumination about discrimination mediates the unique association between anger and collective action intentions
Authors: Borders Ashley , Wiley Shaun
Published: September 2019

People are more willing to engage in collective action when they feel anger about collective disadvantage (van Zomeren, Postmes, & Spears, 2008). However, anger is often a fleeting emotion, whereas collective action is deliberate and sustained. Moreover, people cannot always engage in collective action on demand. We propose that rumination, or repetitive thoughts about negative emotions and experiences, may constitute a mechanism by which anger about collective disadvantage is sustained, and through it the motivation to engage in collective action. In three separate samples (128 students of color, 155 women, and 150 sexual minorities), we measured group-based anger about discrimination, group efficacy, group identification, rumination about discrimination, and collective action intentions. In all samples, rumination mediated the unique association between group-based anger and collective action intentions, controlling for group efficacy and group identification. Further, in an experimental study with 117 undergraduate women, we found that rumination, compared to distraction, sustained anger about collective disadvantage over a short period of time, and this sustained level of anger mediated the relationship between rumination and collective action intentions. These results lend support to conceptualizing collective action as a form of coping with collective disadvantage, and highlight the potential role of emotion regulation strategies like rumination in understanding intergroup relations.
Blended collaborative care in the secondary prevention of coronary heart disease improves risk factor control: Results of a randomised feasibility study
Authors: Bosselmann Lena , Fangauf Stella V , Herbeck Belnap Birgit , Chavanon Mira-Lynn , Nagel Jonas , Neitzel Claudia , Schertz Anna , Hummers Eva , Wachter Rolf , Herrmann-Lingen Christoph
Published: September 2019

Background:

Risk factor control is essential in limiting the progression of coronary heart disease, but the necessary active patient involvement is often difficult to realise, especially in patients suffering psychosocial risk factors (e.g. distress). Blended collaborative care has been shown as an effective treatment addition, in which a (non-physician) care manager supports patients in implementing and sustaining lifestyle changes, follows-up on patients, and integrates care across providers, targeting both, somatic and psychosocial risk factors.

Aims:

The aim of this study was to test the feasibility, acceptance and effect of a six-month blended collaborative care intervention in Germany.

Methods:

For our randomised controlled pilot study with a crossover design we recruited coronary heart disease patients with ⩾1 insufficiently controlled cardiac risk factors and randomised them to either immediate blended collaborative care intervention (immediate intervention group, n=20) or waiting control (waiting control group, n=20).

Results:

Participation rate in the intervention phase was 67% ( n=40), and participants reported high satisfaction ( M=1.63, standard deviation=0.69; scale 1 (very high) to 5 (very low)). The number of risk factors decreased significantly from baseline to six months in the immediate intervention group ( t(60)=3.07, p=0.003), but not in the waiting control group t(60)=−0.29, p=0.77). Similarly, at the end of their intervention following the six-month waiting period, the waiting control group also showed a significant reduction of risk factors ( t(60)=3.88, p<0.001).

Conclusion:

This study shows that blended collaborative care can be a feasible, accepted and effective addition to standard medical care in the secondary prevention of coronary heart disease in the German healthcare system.
Speech Rhythm Convergence as a Social Coalition Signal
Authors: Polyanskaya Leona , Samuel Arthur G. , Ordin Mikhail
Published: October 2019

Patterns of nonverbal and verbal behavior of interlocutors become more similar as communication progresses. Rhythm entrainment promotes prosocial behavior and signals social bonding and cooperation. Yet, it is unknown if the convergence of rhythm in human speech is perceived and is used to make pragmatic inferences regarding the cooperative urge of the interactors. We conducted two experiments to answer this question. For analytical purposes, we separate pulse (recurring acoustic events) and meter (hierarchical structuring of pulses based on their relative salience). We asked the listeners to make judgments on the hostile or collaborative attitude of interacting agents who exhibit different or similar pulse (Experiment 1) or meter (Experiment 2). The results suggest that rhythm convergence can be a marker of social cooperation at the level of pulse, but not at the level of meter. The mapping of rhythmic convergence onto social affiliation or opposition is important at the early stages of language acquisition. The evolutionary origin of this faculty is possibly the need to transmit and perceive coalition information in social groups of human ancestors. We suggest that this faculty could promote the emergence of the speech faculty in humans.