bluuebunny/crossref_metadata_2025 huggingface dataset:
Redescription and circumscription of the Acuminate Crayfish, Cambarus acuminatus Faxon, 1884 (Decapoda: Cambaridae)
Authors: WILLIAMS BRONWYN W. , DELEKTA EMMY M. , LOUGHMAN ZACHARY J.
Published: February 2019

Cambarus acuminatus was described by Walter Faxon in 1884 from three specimens collected from the Saluda River in northwestern South Carolina, USA. Cambarus acuminatus sensu lato has since been acknowledged to comprise a species complex. This complex, also known as Cambarus sp. C, spans a range across much of the Piedmont Plateau and Coastal Plain from central South Carolina north to Maryland and southeastern Pennsylvania. A primary impediment to a much-needed thorough taxonomic assessment and revision of C. sp. C is the absence of taxonomically useful type material of C. acuminatus coupled with the lack of a detailed description of the species. Here we provide a redescription of C. acuminatus based on modern standards for astacoidean crayfishes in the genus Cambarus and emend the circumscription of the species, thereby laying the groundwork necessary for future taxonomic and phylogenetic work within, and involving, the C. sp. C complex.
Climate Change, Migration and Women: Analysing Construction Workers in Odisha
Authors: Patel Amrita , Giri Jasmine
Published: February 2019

The research article seeks to focus on the status of women from the coastal districts of Odisha who have become migrants essentially because of repeated floods and extreme climatic events. Fluctuating weather conditions, the consequent depletion of agricultural work and availability of other forms of employment in their place of origin are some reasons behind the migration of these women. The study particularly looks at Bhubaneswar where women, largely illiterate and landless, mostly belonging to Scheduled Caste groups, have been able to find work on construction sites. Despite evident hardship, they have been able to meet the challenges of living in new urban destinations and in the process better their living conditions. This can be seen in the improvement of their financial status, a new-found focus of educating their daughters, the development of levels of self-confidence and the overcoming of some deeply entrenched social barriers. However, in other areas, the marginalisation of such groups continues, and vulnerabilities prevail in many forms, evident, for instance, in the lack of land ownership by women, the absence of opportunities to upgrade skills to access better work opportunities and issues of safety and security of young girls.
Evolving Relationships: Nicaragua, Israel, and the Palestinians
Authors: Yurow Marshall
Published: February 2019

Nicaragua occupies a special place in the Israeli-Palestinian impact on Latin America. Israeli–Somoza Dynasty ties and Palestinian-Sandinista ties have been well documented over the past 35 years. Yet while the facts are available, the interpretations are still fiercely debated. Both relationships have been portrayed largely in polemical terms. The Israeli-Somoza relationship was viewed as a pariah-state alliance or a “debt of honor.” The Sandinista-Palestinian relationship was viewed as a terrorist connection or brotherhood against a common enemy. Both relationships were seen as static when in fact, having begun as realpolitik, they evolved over time.

Nicaragua ocupa un lugar especial en cuanto al impacto israelí-palestino en América Latina. Los lazos israelí-dinastía Somoza y los vínculos palestino-Sandinistas han sido bien documentados en los últimos 35 años. Sin embargo, aunque los hechos están conocidos, las interpretaciones siguen intensamente debatidas. Ambas relaciones han sido presentadas en gran medida en términos polémicos. La relación israelí-Somoza fue vista como una alianza de estados parias o una “deuda de honor.” La relación Sandinista-palestina fue vista como una conexión terrorista o hermandad contra un enemigo común. Ambas relaciones se consideraron estáticas cuando, de hecho, comenzando como realpolitik, evolucionaron con el tiempo.
Joint Modeling of Compensatory Multidimensional Item Responses and Response Times
Authors: Man Kaiwen , Harring Jeffrey R. , Jiao Hong , Zhan Peida
Published: February 2019

Computer-based testing (CBT) is becoming increasingly popular in assessing test-takers’ latent abilities and making inferences regarding their cognitive processes. In addition to collecting item responses, an important benefit of using CBT is that response times (RTs) can also be recorded and used in subsequent analyses. To better understand the structural relations between multidimensional cognitive attributes and the working speed of test-takers, this research proposes a joint-modeling approach that integrates compensatory multidimensional latent traits and response speediness using item responses and RTs. The joint model is cast as a multilevel model in which the structural relation between working speed and accuracy are connected through their variance-covariance structures. The feasibility of this modeling approach is investigated via a Monte Carlo simulation study using a Bayesian estimation scheme. The results indicate that integrating RTs increased model parameter recovery and precision. In addition, Program of International Student Assessment (PISA) 2015 mathematics standard unit items are analyzed to further evaluate the feasibility of the approach to recover model parameters.
Theorizing policy-industry processes: A media policy field approach
Authors: Steen-Johnsen Kari , Sundet Vilde Schanke , Enjolras Bernard
Published: February 2019

This article develops a theoretical perspective to study the conditions for media policy formation under the condition of digitalization – the Media Policy Field approach – building on an organizational field approach in combination with theories of policy development. The theory of strategic action fields offers a meso-level view of how actors in media fields interact and how their respective opportunities for influencing policy are structured by the state of the field and their respective positions. This theory is linked with the Multiple Streams Approach, which maintains that change occurs when policy entrepreneurs connect problem, policy and politics streams, and create policy windows. The Media Policy Field approach proposes three analytical foci for the study of current media policy processes: collective frames, incumbent and challenger roles and policy windows. Empirical strategies for pursuing this theoretical programme are discussed.
The influence of cognitions, emotions and behavioral factors on treatment outcomes in musculoskeletal shoulder pain: a systematic review
Authors: De Baets Liesbet , Matheve Thomas , Meeus Mira , Struyf Filip , Timmermans Annick
Published: February 2019

Objective:

To examine the predictive, moderating and mediating role of cognitive, emotional and behavioral factors on pain and disability following shoulder treatment.

Data sources:

Electronic databases (PubMed, Web of Science, Embase and PsycINFO) were searched until 14 January 2019.

Study selection:

Studies including persons with musculoskeletal shoulder pain that describe the predictive, moderating or mediating role of baseline cognitive, emotional or behavioral factors on pain or disability following treatment were selected.

Results:

A total of 23 articles, describing 21 studies and involving 3769 participants, were included. Three studies had a high risk of bias. There was no predictive role of baseline depression, anxiety, coping, somatization or distress on pain or disability across types of shoulder treatment. No predictive role of fear-avoidance beliefs was identified in patients receiving physiotherapy, which contrasted to the results found when surgical treatment was applied. Baseline catastrophizing was also not predictive for pain or disability in patients receiving physiotherapy. After conservative medical treatments, results on the predictive role of catastrophizing were inconclusive. Treatment expectations and baseline self-efficacy predicted pain and disability in patients receiving physiotherapy, which was not the case in patients receiving conservative medical treatment. Finally, there was a moderating role for optimism in the relationship between pain catastrophizing and disability in patients receiving physiotherapy.

Conclusion:

There is evidence that expectations of recovery and self-efficacy have a predictive role and optimism a moderating role on pain and/or disability following physiotherapy for musculoskeletal shoulder pain. After surgical treatment, fear-avoidance is a predictor of pain and disability.
A review of parathyroid mass and patients with nonspecific complaints
Authors: Demir Aslıhan Dilara
Published: February 2019

In this review, parathyroid mass and its nonspecific symptoms are discussed. In daily clinical practice, patients present with varying symptoms, including depression, chest pain, pancreatitis, or nonspecific fatigue. If the patient is not tested for a parathyroid mass along with performing routine electrolyte tests, diagnosing such a patient with a parathyroid mass may take several years. This issue and situation are discussed in this review.
The American Library Association and the post-World War II rebuilding of Eastern European libraries
Authors: Sroka Marek
Published: February 2019

The topic of the destruction of libraries during World War II has been well publicized. However, the American Library Association’s assistance with postwar cultural rehabilitation of Eastern European libraries remains relatively unknown. The paper examines the “Aid to Libraries in War Areas” program, funded by the Rockefeller Foundation and administered by the ALA, with respect to Eastern European countries, including Bulgaria, Czechoslovakia, Hungary, Poland, Romania, Russia (Soviet Union), and Yugoslavia. The program consisted of two parts: the first, which ran from 1941 to 1947, dealt with periodicals; the other, in operation from 1944 to 1947, focused on books. Its goal was to replenish, though on a limited scale, devastated collections with American publications unavailable to most European and Asian libraries during Axis occupation.
Women’s Experiences of Sexual Violence in Intimate Relationships: Applying a New Taxonomy
Authors: Bagwell-Gray Meredith E.
Published: February 2019

How do women describe their experiences of sexual violence in their intimate relationships? In answering this question, the present article builds upon a newly developed taxonomy of intimate partner sexual violence (IPSV). Women with past or present intimate partner violence experience ( N = 28) were recruited from a domestic violence program and the community at large. Data were collected with semistructured, in-person interviews, audio recorded, and transcribed. As defined by the taxonomy, 27 women (96%) experienced intimate partner sexual abuse; 19 (68%) experienced intimate partner sexual coercion; 14 (50%) experienced intimate partner sexual assault; and two (7%) experienced intimate partner–forced sexual activity. Intimate partner sexual abuse was central to women’s experiences of IPSV. Common categories of sexual abuse were having sex outside of the relationship, controlling reproductive decisions, degrading with sexual criticism and insults, refusing communication, denying pleasure, and withholding sex. The types of IPSV did not typically occur in isolation; the taxonomy revealed a grouping pattern, with intimate partner sexual assault and intimate partner sexual coercion co-occurring with sexual abuse. Understanding the different types of IPSV as a comprehensive mechanism of sexual control is a meaningful way to conceptualize sexual violence in intimate relationships. The expanded taxonomy provides a useful therapeutic tool in helping women share and heal from these experiences.
ALAS: An Intervention to Promote Career Development Among Latina/o Immigrant High School Students
Authors: McWhirter Ellen Hawley , Rojas-Araúz Bryan O. , Ortega Robert , Combs Darien , Cendejas Christina , McWhirter Benedict T.
Published: February 2019

This article describes the rationale, development, delivery, and evaluation strategy of a pilot career intervention program for immigrant Latina/o high school students: Advocating for Latina/o Achievement in School. This innovative intervention aims to prevent dropout and to promote academic success and college and career readiness through a combination of academic support and enhancing critical consciousness. Shorter term goals include increasing school-related self-efficacy expectations, school connectedness, school engagement, and critical consciousness. We describe the theoretical and empirical basis for the intervention components, and how they attend to dimensions of immigrant Latina/o students’ career development. We describe program logistics, outcomes, strengths, challenges, and lessons learned from delivering the intervention. We highlight unique features of the program and suggest its relevance to career education efforts in other school and national contexts in which immigrant students face racism and inequities.
Implementation of a Pilot Pharmacist Testosterone Therapy Management Service
Authors: Nagy Michael W. , Gruber Stephanie , McConnell Macy
Published: February 2019

Background:

Recent literature findings suggest that opportunities exist to optimize testosterone replacement therapy management.

Objective:

To evaluate the impact of a pilot clinical pharmacist testosterone therapy management service in a Veterans Affairs primary care setting.

Methods:

A 6-month, single-clinic, prospective cohort quality improvement project included male patients with an active prescription for testosterone. Patients were excluded if they switched primary care providers or were managed by a specialty clinic. After diagnosis, primary care providers had the option of referring patients for clinical pharmacist testosterone replacement therapy management. The project investigated the impact of pharmacist management on adherence to guideline-defined baseline and therapeutic monitoring, prior authorization workload, time saved by primary care providers, and clinical pharmacist interventions.

Results:

Sixty patients split between pharmacist management (N = 35) and nonpharmacist management (N = 25) cohorts. Monitoring of baseline parameters was significantly improved with clinical pharmacist management (54% vs 20%, P = 0.0006). Improved baseline monitoring decreased prior authorization team workload as requests were approved on the first submission at a higher rate (100% vs 75.4%, P = 0.06). Pharmacist management increased therapeutic monitoring for assessing symptom improvement (96% vs 26%, P < 0.001), monitoring of testosterone levels (96% vs 61%, P = 0.003), and safety monitoring with complete blood counts (100% vs 83%, P = 0.04). A total of 42 pharmacist–patient encounters saved over 600 minutes of primary care provider time.

Conclusion:

Clinical pharmacist involvement enhances therapeutic monitoring for male hypogonadism leaving room for expansion of clinical pharmacy services within testosterone replacement therapy management.
Incorporation of Clinical Pharmacy Into a Geriatric Transitional Care Management Program
Authors: Berquist Karly , Linnebur Sunny A. , Fixen Danielle R.
Published: February 2019

Transitional care management (TCM) programs have been shown to decrease hospital readmission rates, health-care costs, and medication-related errors and adverse drug events. Pharmacists have been utilized during the medication reconciliation process, during admission, and after hospital discharge to prevent readmission and identify medication discrepancies. There is a lack of data utilizing clinical pharmacists in the geriatric patient population transitional care process after hospital discharge. Less is known about the depth of professional services a pharmacist can perform in the geriatric setting. We analyzed the scope of pharmacist-assisted implementation of transitional care. A total of 365 patients received the clinical pharmacist comprehensive medication review during a 14-month time period. During these reviews, clinical pharmacists identified more than 600 medication discrepancies and offered more than 1000 recommendations to the primary care physician. Additionally, specific medication classes that have been identified to increase the risk of adverse drug events, specifically in older adults, were identified and used to screen for adverse drug events. Using this list, clinical pharmacists were able to identify 39 adverse drug events. The implementation of clinical pharmacists into the TCM program was successful; however, full salary compensation is unlikely with TCM reimbursement alone.
Influence of motor harmonic torque on wheel wear in high-speed trains
Authors: Qi Yayun , Dai Huanyun
Published: February 2019

With the increase of train speed, the harmonic torque of the traction motor of a high-speed train is not a negligible source of excitation. In order to explore the influence of the harmonic torque of the motor on wheel wear, a high-speed EMU vehicle model was established based on the multibody dynamics theory. FASTSIM was used to calculate the wear parameters, and the Zobory wear model was used to calculate the depth of the wheel wear. The influence of the harmonic torque of the motor on the wear parameters and wear depth of high-speed trains under straight and curve conditions is calculated, respectively. The simulation results show that the harmonic torque has a large influence on the wheel rail vertical force and the longitudinal creep force and has little influence on the lateral creep force. With the 30% harmonic torque, the wheel rail vertical force increases by 7.6%, the longitudinal creep force increases by 15%, and the lateral creep force increases by 4%. The amplitude of the longitudinal creepage increases by 14.2% when the harmonic torque is 10%, and increases by 34.4% when the harmonic torque is 30%. When the harmonic torque increases, the wheel wear depth increases, the 10% harmonic torque increases by 3% and the 30% harmonic torque increases by 8%, and the increase of the motor harmonic component accelerates the wheel wear. At the same time, small longitudinal positioning stiffness can help to reduce the influence of the harmonic torque, and the selection of the longitudinal positioning stiffness needs to consider the dynamic performance of the vehicle.
Recessionary changes at work and employee well-being: The protective roles of national and workplace institutions
Authors: Ogbonnaya Chidiebere , Gahan Peter , Eib Constanze
Published: February 2019

The recession following the 2008 financial crisis brought major changes to employees’ experiences at work. We investigate the adverse effects of two of such changes: perceived organizational distress and job deterioration. We also examine the extent to which institutions at national level (employment protection legislation and collective bargaining coverage) and at workplace level (employment contract and union membership) may act as buffers against these effects. Using data from 21 European countries, we show that recessionary changes were associated with reduced psychological well-being and greater levels of work–nonwork interference.
Dynamic response and control of middle rock sidewall under impact of blast loading
Authors: Hu Yingguo , Lu Wenbo , Zhang Le , Yan Peng
Published: February 2019

This study focuses on the dynamic response and control of middle rock sidewall (MRS) during blasting. First, the spatial distribution characteristic of blasting vibration in MRS was investigated thoroughly based on the blasting of temporary ship lock and ship lift of the Three Gorges project. Results demonstrated that the distribution of peak particle velocity (PPV) in MRS is parabolic, and the vibration amplification could be found obviously at the free surface. Site experiments were designed to determine the damage threshold of PPV used in the vibration control of blasting excavation of MRS. Results indicated that the PPV threshold of MRS is stricter than that of the conventional condition due to its unique geometric shape. Then numerical simulation was implemented to reproduce the dynamic response in MRS under blasting by using the LS-DYNA commercial software. Results revealed that the PPV distribution obtained by numerical simulation match well with that of site experiments. The reflection and superposition processes of blasting stress wave were investigated and verified against the comparison between different kinds of stress waves. Finally, the most optimal width of MRS was determined to make the peaks and troughs of different stress wave occur at the same position according to the interference theory of stress wave. The results of numerical simulation and theoretical calculations were compared to verify the rationality of the optimal width determination.
Knowledge, Attitudes, Self-Efficacy, and Healthy Eating Behavior Among Children: Results From the Building Healthy Communities Trial
Authors: Kulik Noel L. , Moore E. Whitney , Centeio Erin E. , Garn Alex C. , Martin Jeffrey J. , Shen Bo , Somers Cheryl L. , McCaughtry Nathan
Published: February 2019

Background/Aim. Increased knowledge, attitudes, and beliefs about a topic and behavioral capability and self-efficacy for healthy eating are often a precursor to behavior change. The purpose of this study is to determine the effectiveness of the multicomponent school-based program on children’s healthy eating knowledge, attitudes, and self-efficacy for healthy eating, and on their eating habits over time. Method. Quasi-experimental (4 treatment, 2 comparison) in a metropolitan area using a pretest–posttest method. Participants were 628 fifth-grade youth (377 treatment, 251 comparison) with a mean age of 9.9 years. The Building Healthy Communities (BHC) program is an 8-month school-wide healthy school transformation program and includes six main components. Outcome measures include children’s healthy eating knowledge, attitudes, self-efficacy, and behavior. Missing data were imputed, confirmatory factor analysis tested scale factor structure, and path analysis determined a parsimonious path explaining behavior change. Results. The Student Attitudes and Self-Efficacy (SASE) scale had good measurement model fit. BHC group’s healthy eating knowledge and behaviors increased significantly, while SASE remained moderate. For both groups, the students’ knowledge and SASE significantly predicted their healthy eating behaviors; however, the intervention group accounted for a greater amount of variance (35% vs. 26%). Discussion. The BHC program was effective in improving healthy eating knowledge and behavior among youth, and the relationship between variables did not vary by group. Healthy eating knowledge is a significant predictor of both future knowledge and behavior.
Ecology, Wicked Problems, and the Context of Community Interventions
Authors: Trickett Edison J.
Published: February 2019

The concept of ecology has, over time, become increasingly important as a frame for conducting community interventions. While multiple ecological frameworks have been proposed both within and outside public health, most have drawn on Bronfenbrenner’s work and the concern with multiple levels of the ecological context. The present article presents an ecological metaphor for community intervention developed in community psychology over the past 50 years. This perspective was specifically developed to conduct community research and intervention in the spirit of community development. The article begins with a brief discussion of social problems as “wicked problems” defying preordained and prescribed solutions. It then organizes the presentation of the ecological metaphor around five Cs that, together, provide an overview of the main points of the perspective: contextualist philosophy of science, community as a multilevel concept, culture and diversity as critical community-defining concepts, collaboration as a fundamental part of the ecology of intervention, and commitment (to community over time). Each of these five Cs adds to an appreciation of the differing aspects of the community intervention process as an ecological enterprise. Embedded in the five Cs are four ecological processes drawn from field biology that are metaphorically useful in providing a cognitive map for understanding community and assessing community impact: interdependence, cycling of resources, adaptation, and succession. Together, this ecological perspective both reflects and differs from extant perspectives in public health and, as such, is intended to contribute to furthering ecological thinking and acting more generally in community interventions.
Bone Metastasis Prognostic Factors in Breast Cancer
Authors: Yazdani Akram , Dorri Sara , Atashi Alireza , Shirafkan Hoda , Zabolinezhad Hedieh
Published: February 2019

Objective:

Bone is the most common site of metastasis in breast cancer. Prognostic factors for predicting bone metastases in breast cancer are controversial yet. In this study, we investigated clinical factors associated with secondary bone metastasis of breast cancer.

Methods:

In total, 1690 patients with breast cancer recorded between 2002 and 2012 in Motamed Cancer Institute, Tehran, Iran entered in the retrospective study. We studied age, menopausal status, histologic type, tumor size, number of cancerous axillary lymph nodes, serum concentrations of alkaline phosphatase (ALP), carcinogenicity antigen (CEA), cancer antigen (CA)-153, and hemoglobin (HB) in 2 groups with bone metastases (n = 123) and without it, respectively. We applied logistic regression to identify bone metastasis prognostic factors in breast cancer patients and calculated the cut-off value, sensitivity, and characteristics of independent prognostic factors using receiver operating characteristic (ROC) curve analysis.

Results:

Menopause, larger tumor size, and the greater number of cancerous axillary lymph nodes increased the chance of bone metastases significantly ( P < .05). There was no significant difference between mean groups with and without bone metastases regarding serum concentration of CEA, CA-153, HB, and histopathologic type ( P > .05). Logistic regression showed that age (odds ratio (OR) = 1.021), menopausal status (OR = 1.854), number of cancerous axillary lymph nodes (OR = 1.065), a tumor size between 2 and 5 cm diameter (OR = 2.002) and more than 5 cm diameter (OR = 4.009), and ALP (OR = 1.005) are independent prognostic factors associated with bone metastases. The ROC curve showed that the abovementioned factors have comparable predictive accuracy for bone metastases.

Conclusions:

Age, menopausal status, number of axillary lymph node metastases, tumor size, and ALP were identified as prognostic factors for bone metastasis in patients with breast cancer. So patients with these characteristics should be monitored more precisely with regular follow-ups.
Beliefs about L1 use in teaching English: A comparative study of Polish and Spanish teacher-trainees
Authors: Wach Aleksandra , Monroy Fuensanta
Published: February 2019

The study investigated the beliefs expressed by a sample of 206 Polish and Spanish teacher-trainees about the use of learners’ native language (L1) in teaching English as a foreign language (EFL). Quantitative and qualitative data from a questionnaire revealed considerable differences between the two nationality groups in their beliefs about both medium-oriented and framework-oriented functions of the L1 in an L2 classroom. Moreover, significant differences were found in the participants’ accounts of their prior EFL learning experience in terms of the L1–L2 proportion in teachers’ classroom language use. A possible interpretation of these findings relates trainees’ beliefs to the L2 educational cultures prevalent in different countries, pointing to a contextually-mediated complexity of teacher-trainees’ belief systems. The study adds to the existing research on the issues underlying L1 use in L2 teaching that are currently under debate by offering a cross-national comparison of teacher-trainees’ beliefs about the place of the L1 in L2 instruction.
Shear strength of fiber-reinforced high-strength steel ultra-high-performance concrete beams based on refined calculation of compression zone depth considering concrete tension
Authors: Qi Jianan , Ding Xiaomeng , Wang Zhen , Hu Yuqing
Published: February 2019

This article presents an experimental and theoretical investigation on the shear behavior of fiber-reinforced ultra-high-performance concrete beams reinforced with high-strength steel. The test parameters included the fiber volume fraction, fiber type, and stirrup ratio. The test results indicate that the shear failure in ultra-high-performance concrete beams is not brittle and catastrophic but has ductility characteristics. A moderate quantity of stirrups can significantly improve the shear behavior of ultra-high-performance concrete beams, as reflected in the thorough propagation of cracks in both shear span and pure bending zone. The depth of the compression zone considering concrete tension was derived based on the deformation compatibility and force equilibrium equations for both serviceability limit state and ultimate limit state. The comparison of the proposed method and classical beam theory shows that the concrete tension should not be neglected in the serviceability limit state analysis. After cracking, the concrete tension can be neglected for simplicity when the beam is heavily reinforced and should be considered when the beam is lightly reinforced. Then, a shear strength model was established based on Rankine’s failure criteria, the truss model, and Association Francaise de Génie Civil-Sétra. Finally, the proposed shear strength equation was verified by the test results and compared with other shear strength equations.
Conservative Management of Gallstone Disease in the Elderly Population: Outcomes and Recurrence
Authors: Mora-Guzmán I , Di Martino M , Bonito AC , Jodra VV , Hernández SG , Martin-Perez E
Published: February 2019

Background & Aims:

The prevalence of gallstone disease increases with age, being early cholecystectomy the most accepted treatment in the vast majority of patients in order to prevent complications and recurrence. The aim of this study is to determine the recurrence rate and its possible predictors after initial non-operative management.

Materials and Methods:

We reviewed a consecutive series of patients, older than 65 years, admitted for a gallstone-related disease and treated with a non-operative management between January 2010 and December 2013. We analyzed comorbidities, clinical data, diagnosis, management, recurrence, and its treatment. Median follow-up after the discharge was 2 years. Recurrence was analyzed by a Kaplan–Meier survival curve. Possible recurrence’s predictors were analyzed.

Results:

The study included 226 patients. Mean age was 80.4 ± 7.2 years, 127 (56%) were female. The main causes of index hospitalization were acute cholecystitis (58%) and biliary pancreatitis (18.1%). After 2 years of follow-up, the recurrence rate was 39.8%; mean time to recurrence was 255.2 ± 42.1 days, 81% of patients recurred within 1 year. Bile duct disease implied a higher recurrence rate than the gallbladder disease group (52% vs 33%, p < 0.001). Subjects with two or more diagnoses during index admission presented higher recurrence rate (32% vs 49%, p < 0.001).

Conclusion:

More than a third of elderly patients could present a recurrence within 2 years after initial non-operative management. Early cholecystectomy should be considered at index admission in order to prevent recurrence.
Has something changed? Leaders’, practitioners’ and parents’ interpretations after renewed early childhood education and care legislation in Finnish private centres
Authors: Mäntyjärvi Marjo , Puroila Anna-Maija
Published: February 2019

This study addresses leadership enactment in the context of early childhood education and care centres in Finland. The study was implemented at a time when the early childhood education and care legislation had changed. The research draws from relational leadership theory to address the following questions: How do leaders, practitioners and parents evaluate and interpret the impacts of changing early childhood education and care legislation in private Finnish centres? And how do these evaluations and interpretations reflect leadership enactment? This study conceptualises leadership as a context-dependent phenomenon constituted by shared meanings and relationships among leaders and other human actors in private centres. In order to achieve a multilevel picture of leadership enactment in private early childhood education and care centres, this study employed a mixed-methods approach. The data was collected through three online surveys and analysed both quantitatively and qualitatively. The findings revealed that private centres form a heterogeneous context for leadership enactment in Finnish early childhood education and care. Compared with practitioners and parents, the leaders were the most positive in their interpretations of the legislative changes. Specifically, the study found a gap between the leaders’ and parents’ evaluations of how the legislative changes had impacted daily praxis. The study calls for further research and tools for developing leadership enactment in private early childhood education and care.
Tidal Wave: A University’s Response to Transformational Learning Objectives
Authors: Barakat Maysaa , Mountford Meredith , Poole Deandre , Pappas Dustin
Published: February 2019

A textbook activity on symbols was intended as thought provoking but instead elicited a confrontational reaction by one student which left Dr. Jackson and the university searching for a response. When the topic spread through the channels within the university, matters got worse. This disguised case examines the lesson, conflict, and aftermath following a sensitive classroom activity intended to promote transformational learning around the concept of the strength of organizational symbols. Authors suggest organizational theory, power and politics, transformational learning, and cultural competence as possible lenses in which educational leaders can examine this case.
Exposure to Low-Dose Radiation Enhanced the Antitumor Effect of a Dendritic Cell Vaccine
Authors: Wang Sinian , Yu Huijie , He Rui , Song Xiujun , Chen Shu , Yu Nan , Li Wei , Li Fengsheng , Jiang Qisheng
Published: February 2019

The unsatisfactory clinical efficacy of dendritic cell (DC)-based cancer vaccines prepared by conventional methods is partly due to their insufficient capacity for migration. Our previous study showed that exposure to low-dose radiation (LDR) at a dose of 0.2 Gy promoted DC migration in vitro. The present study further investigates whether exposure to LDR at a dose of 0.2 Gy during the DC vaccine preparation could increase the antitumor effect of DC vaccines derived from mouse bone marrow. Our results showed that the migratory capacities of DCs were significantly increased after exposure to LDR. Furthermore, exposure to LDR resulted in an increased ability of DCs to induce T-cell proliferation, and the cytotoxic effect of cytotoxic T lymphocytes (CTLs) primed by the DCs exposed to LDR was significantly enhanced. An in vivo study using a mouse transplanted tumor model showed that subcutaneous injections of a DC vaccine exposed to LDR led to an increased mouse survival rate, infiltration of CTLs into tumor tissue, and apoptosis of tumor cells, which were accompanied by significant upregulation of serum interferon γ and interleukin 12. These results indicate that exposing DCs to LDR during the DC vaccine preparation is an effective approach to enhance its antitumor effect.
The Evolution of Breast Implant Infections: Serratia marcescens Is an Emerging Pathogen in Implant-Based Breast Reconstruction
Authors: Gui Jane L. , Lin Kant Y.
Published: February 2019

The flora of implant-based breast infections has changed over the last decade, including at our institution. A 10-year retrospective chart review was performed on 561 implant-based breast reconstructions in 378 patients performed by a single surgeon in an academic university hospital setting. Thirty-two breast infections requiring explantation of the implants occurred during those 10 years. During that time frame, a new pre- and peri-operative protocol was implemented in an effort to diminish infections. We believe that this protocol played a major role in the evolution of changing breast periprosthetic infection flora, from nearly one-third being gram-negative infections to 100% being gram-negative infections. Gram-negative antibiotic coverage should be considered in light of these evolving trends to prevent infections particularly with Serratia marcescens. This may be especially important in patients with BRCA1/2 or ATM mutations. Diabetic patients are more likely to develop Methicillin-resistant Staphylococcus aureus (MRSA) infections and preoperative MRSA decolonization is essential in these patients. Many patients have late-onset breast periprosthetic infection, the majority of which occurred after 30 days. Regular follow-up and patient education is important to provide timely treatment.
Current Trends Among US Surgeons in the Identification, Treatment, and Time of Repair for Medial Meniscal Ramp Lesions at the Time of ACL Surgery
Authors: DePhillipo Nicholas N. , Engebretsen Lars , LaPrade Robert F.
Published: February 2019

Background:

Given the potential hidden nature of medial meniscal ramp lesions and the controversy regarding treatment, it is important to understand the current trends regarding the identification and treatment strategies of meniscal ramp lesions by the leading surgeons and educators in the field of sports medicine.

Purpose:

To better understand the current trends in orthopaedic surgery regarding arthroscopic identification and treatment of medial meniscal ramp lesions at the time of anterior cruciate ligament (ACL) surgery.

Study Design:

Cross-sectional study.

Methods:

An electronic questionnaire was sent in a blinded fashion to 91 directors of orthopaedic sports medicine fellowship training programs in the United States. Participants’ email addresses were obtained through the American Orthopaedic Society for Sports Medicine directory of current fellowship program directors. Inclusion criteria were only those surgeons who currently performed ACL reconstruction surgery. Exclusion criteria were those surgeons who did not perform ACL reconstruction or who chose to opt out of the survey.

Results:

Overall, 19 surgeons opted out of the survey; 36 responded from the remaining 72 surveys (50%). The majority (n = 31, 86%) reported routinely checking for a medial meniscal ramp lesion via inspection of the posteromedial meniscocapsular junction during an ACL reconstruction. The most common repair technique cited was all-inside (n = 24, 66.7%), followed by inside-out (n = 8, 22.2%). Three (8%) surgeons indicated that they did not repair meniscal ramp lesions. Regarding surgical treatment (repair vs no treatment), the majority reported using the extent of the tear (89%; partial vs full thickness) and the stability of the tear upon probing (81%) as the main criteria for intraoperative decision making. Nineteen (52.8%) surgeons required a mean time of <15 minutes for meniscal ramp repair; 16 surgeons (44.4%), 15 to 30 minutes; and 1 surgeon (2.8%), 30 to 45 minutes.

Conclusion:

This study provides insight regarding meniscal ramp tear identification, treatment, and repair strategies from the fellowship directors of sports medicine orthopaedic surgery in the United States. Such information may be useful for current orthopaedic surgeons to advance their practice according to the current trends surrounding ACL reconstruction and medial meniscal ramp repair.
AIMP1 Mutation Long-Term Follow-Up, With Decreased Brain N-Acetylaspartic Acid and Secondary Mitochondrial Abnormalities
Authors: Khan Aneal , Bennett Jennifer , Scantlebury Morris H. , Wei Xing-Chang , Kerr Marina
Published: February 2019

Aminoacyl transfer RNA (tRNA) synthetase complex-interacting multifunctional protein I is a noncatalytic component of tRNA multi-synthetase complexes. Although important in joining tRNAs to their cognate amino acids, AIMP1 has several other functions including axonal growth, cytokine activity, and interactions with N-acetylaspartic acid in ribosomal tRNA synthetase complexes. Further, N-acetylaspartic acid donates an aspartate during myelination and is therefore important to axonal integrity. Mutations in AIMP1 can disrupt these functions, as demonstrated in this clinical case study of 2 monozygotic twins, who display congenital opisthotonus, microcephaly, severe developmental delay, and seizures. Whole exome sequencing was used to identify a premature stop codon in the AIMP1 gene (g. 107248613_c.115C>T; p.(Gln39). In the absence of whole exome sequencing, we propose that decreased N-acetylaspartic acid peaks on magnetic resonance spectroscopy could act as a biomarker for AIMP1 mutations.
Prospective study of Burkitt lymphoma treatment in adolescents and adults in Malawi
Authors: Painschab Matthew S. , Westmoreland Kate D. , Kasonkanji Edwards , Zuze Takondwa , Kaimila Bongani , Waswa Peter , El-Mallawany Nader Kim , Tomoka Tamiwe , Mulenga Maurice , Montgomery Nathan D. , Fedoriw Yuri , Gopal Satish
Published: February 2019

Burkitt lymphoma (BL) is common in sub-Saharan Africa (SSA). In high-income countries, BL is highly curable with chemotherapy. However, there are few prospective studies from SSA describing nonpediatric BL and no regional standard of care. Thirty-five participants age 15 years or older with newly diagnosed BL were enrolled in Malawi from 2013 to 2018. Chemotherapy was administered according to institutional guidelines, with concurrent antiretroviral therapy if HIV infected. Median age was 21 years (range, 15-61) and 15 participants (43%) were HIV infected. Twenty-seven participants (77%) had stage III to IV disease, and 19 (54%) had Eastern Cooperative Oncology Group performance status >1. Among HIV-infected participants, median CD4 count was 130 (range, 29-605) and 10 (67%) had suppressed HIV viral load. Four participants (11%) died before receiving chemotherapy. First-line chemotherapy consisted of: cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) (n = 22 [71%]); infusional etoposide, prednisolone, vincristine, cyclophosphamide, and doxorubicin (n = 4 [13%]); high-dose methotrexate-based chemotherapy (n = 4 [13%]); and rituximab plus CHOP (n = 1 [3%]). Among 28 evaluable participants, 14 (50%) achieved a complete response. Median overall survival (OS) was 7 months; 1-year OS was 40% (95% confidence interval [CI], 24%-56%). Sixteen (73%) of 22 deaths were a result of disease progression. Compared with CHOP, more intensive chemotherapy was associated with decreased mortality (hazard ratio, 0.24; 95% CI, 0.05-1.02; P = .05). This is among the best characterized prospective cohorts of nonpediatric BL in SSA. Most deaths resulted from progressive BL. Patients who received more intensive therapy seemed to have better outcomes. Defining optimal approaches is an urgent priority in SSA.
Ionic silver functionalized ovine forestomach matrix – a non-cytotoxic antimicrobial biomaterial for tissue regeneration applications
Authors: Karnik Tanvi , Dempsey Sandi G. , Jerram Micheal J. , Nagarajan Arun , Rajam Ravindra , May Barnaby C. H. , Miller Christopher H.
Published: February 2019

Background

Antimicrobial technologies, including silver-containing medical devices, are increasingly utilized in clinical regimens to mitigate risks of microbial colonization. Silver-functionalized resorbable biomaterials for use in wound management and tissue regeneration applications have a narrow therapeutic index where antimicrobial effectiveness may be outweighed by adverse cytotoxicity. We examined the effects of ionic silver functionalization of an extracellular matrix (ECM) biomaterial derived from ovine forestomach (OFM-Ag) in terms of material properties, antimicrobial effectiveness and cytotoxicity profile.

Methods

Material properties of OFM-Ag were assessed by via biochemical analysis, microscopy, atomic absorption spectroscopy (AAS) and differential scanning calorimetry. The silver release profile of OFM-Ag was profiled by AAS and antimicrobial effectiveness testing utilized to determine the minimum effective concentration of silver in OFM-Ag in addition to the antimicrobial spectrum and wear time. Biofilm prevention properties of OFM-Ag in comparison to silver containing collagen dressing materials was quantified via in vitro crystal violet assay using a polymicrobial model. Toxicity of ionic silver, OFM-Ag and silver containing collagen dressing materials was assessed toward mammalian fibroblasts using elution cytoxicity testing.

Results

OFM-Ag retained the native ECM compositional and structural characteristic of non-silver functionalized ECM material while imparting broad spectrum antimicrobial effectiveness toward 11 clinically relevant microbial species including fungi and drug resistant strains, maintaining effectiveness over a wear time duration of 7-days. OFM-Ag demonstrated significant prevention of polymicrobial biofilm formation compared to non-antimicrobial and silver-containing collagen dressing materials. Where silver-containing collagen dressing materials exhibited cytotoxic effects toward mammalian fibroblasts, OFM-Ag was determined to be non-cytotoxic, silver elution studies indicated sustained retention of silver in OFM-Ag as a possible mechanism for the attenuated cytotoxicity.

Conclusions

This work demonstrates ECM biomaterials may be functionalized with silver to favourably shift the balance between detrimental cytotoxic potential and beneficial antimicrobial effects, while preserving the ECM structure and function of utility in tissue regeneration applications.
The whole-aperture pore-structure characteristics of marine-continental transitional shale facies of the Taiyuan and Shanxi Formations in the Qinshui Basin, North China
Authors: Wang Jiyuan , Guo Shaobin
Published: February 2019

To systematically study the whole-aperture pore-structure characteristics of the marine-continental transitional shale facies in the Upper Palaeozoic Taiyuan and Shanxi Formations of the Qinshui Basin, we have collected a total of 11 samples for high-pressure mercury intrusion, low-pressure gas adsorption ([Formula: see text] and [Formula: see text]), nuclear magnetic resonance (NMR), and field-emission scanning electron microscopy with argon-ion polishing experiments to determine the pore morphology and distribution characteristics of shale samples in detail and to perform quantitative analyses. Then compared the pore-development characteristics of the Taiyuan Formation samples with those of the Shanxi Formation to determine which is preferable. The experimental results indicate that the shale samples of the Qinshui Basin mainly develop three types of pores: organic pores, intergranular pores, and microfractures. High-pressure mercury intrusion and gas-adsorption experiments indicate that the pore-size distributions exhibit multiple peaks. The samples contained varying proportions of macropores, mesopores, and micropores, among which the former two are dominant, accounting for approximately 85% of the total pore volume, whereas micropores account for only 15%. However, mesopores and micropores dominate the specific surface area; between them, the micropores are much more prevalent, accounting for more than 99% of the total specific surface area. Macropores contribute less than 1% of the specific surface area and therefore can be neglected. The pore morphology resembles the slit type parallel platy pores with a ballpoint pen structure. The NMR [Formula: see text] spectra have multiple-peak values. In addition, the large difference between the curved areas before and after centrifugation indicates that the samples contain a large proportion of mesopores and macropores, which is consistent with the results presented above. The results demonstrate that the development of pores in the Taiyuan Formation is better than that in the Shanxi Formation.