bluuebunny/crossref_metadata_2025 huggingface dataset:
Altered resting-state dorsal anterior cingulate cortex functional connectivity in patients with post-traumatic stress disorder
Authors: Chen Hui Juan , Zhang Li , Ke Jun , Qi Rongfeng , Xu Qiang , Zhong Yuan , Pan Mengjie , Li Jianjun , Lu Guang Ming , Chen Feng
Published: November 2018

Objective:

The brain functional alterations at regional and network levels in post-traumatic stress disorder patients are still unclear. This study explored brain functional alterations at regional and network levels in post-traumatic stress disorder patients with resting-state functional magnetic resonance imaging and evaluated the relationship between brain function and clinical indices in post-traumatic stress disorder.

Methods:

Amplitude of low-frequency fluctuation and seed-based functional connectivity analyses were conducted among typhoon survivors with ( n = 27) and without post-traumatic stress disorder ( n = 33) and healthy controls ( n = 30) to assess the spontaneous brain activity and network-level brain function. Pearson correlation analyses were performed to examine the association of brain function with clinical symptom and social support.

Results:

Both the post-traumatic stress disorder group and the trauma-exposed control group showed decreased amplitude of low-frequency fluctuation in the dorsal anterior cingulate cortex relative to the healthy control group. The post-traumatic stress disorder group showed increased dorsal anterior cingulate cortex functional connectivity with the right paracentral lobule and bilateral precentral gyrus/postcentral gyrus relative to both control groups. Both traumatized groups exhibited decreased dorsal anterior cingulate cortex functional connectivity with the right hippocampus and left cerebellum relative to the healthy control group. More decreased dorsal anterior cingulate cortex functional connectivity with the right hippocampus was found in the post-traumatic stress disorder group. The Checklist-Civilian Version score positively correlated with functional connectivity between the dorsal anterior cingulate cortex and the right paracentral lobule as well as between the dorsal anterior cingulate cortex and the right precentral gyrus/postcentral gyrus. The social support was associated with functional connectivity between the dorsal anterior cingulate cortex and the bilateral precentral gyrus/postcentral gyrus as well as the dorsal anterior cingulate cortex and the left middle frontal gyrus.

Conclusion:

Trauma exposure may result in aberrant local and network-level functional connectivity in individuals with or without post-traumatic stress disorder. Altered amplitude of low-frequency fluctuation in the dorsal anterior cingulate cortex may be a predisposing risk factor for post-traumatic stress disorder development following trauma exposure. More prominent decreased dorsal anterior cingulate cortex functional connectivity with the right hippocampus might be specific in the post-traumatic stress disorder group. Improvement of social support might possibly be significant for post-traumatic stress disorder patients.
The “No Wrong Door” Approach to HIV Testing: Results From a Statewide Retail Pharmacy–Based HIV Testing Program in Virginia, 2014-2016
Authors: Collins Bryan , Bronson Heather , Elamin Fatima , Yerkes Lauren , Martin Elaine
Published: November 2018

Objective:

As part of the Care and Prevention in the United States Demonstration Project (2012-2016), which aimed to reduce HIV-related morbidity and mortality among racial/ethnic minority groups in 8 states, the Virginia Department of Health (VDH) funded Walgreens to provide HIV testing in retail pharmacies in areas with large racial/ethnic minority communities and high rates of poverty. We describe this program and summarize its outcomes. We hypothesized that (1) offering walk-in HIV testing outside of traditional business hours and alongside other point-of-care tests in retail pharmacies would increase rates of first-time testers and (2) using data on social determinants of health associated with higher rates of HIV infection to locate test sites would increase the identification of people who were previously undiagnosed.

Methods:

Using 2010 US Census data and 2007-2011 five-year population estimates from the American Community Survey, VDH selected 32 Walgreens stores located in census tracts where at least 30% of the population was black and/or Hispanic/Latino and/or where at least 20% of the population was living at or below the federal poverty level. Pharmacists administered the INSTI HIV-1/HIV-2 Rapid Antibody Test. Clients with a reactive test result were linked to confirmatory testing and medical care.

Results:

Between June 1, 2014, and September 29, 2016, Walgreens pharmacists performed HIV tests on 3630 clients, of whom 1668 (46.0%) had either never been tested or were unsure if they had been tested. Of all clients tested, 30 (0.8%) had a reactive test result. Of 26 clients who also had positive confirmatory testing, 22 (84.6%) were linked to care. The mean cost per person tested was $41.79, and the mean cost per reactive result was $5057.

Conclusions:

Retail pharmacies may be an effective venue for those who have never been tested for HIV to access HIV testing, particularly if the pharmacies are located in priority areas or where community-based organizations are unable to operate.
Margaret C. Simms: Economist, Educator, Administrator, Organizer, and Mentor
Authors: Jones Barbara A. P.
Published: November 2018

In the history of African American women economists, no name stands above that of Dr. Margaret C. Simms. When she earned the PhD in economics in 1974, she joined a very small cadre of African American women who had the credential that would be the cornerstone of her career as a scholar, an educator, and a leader. Simms began her professional career in the academy and went on to serve in highly respected intellectual think tanks. Throughout her career, she was an active member of professional economic associations, produced ground breaking scholarly works, and provided service and leadership to the people and organizations around her.
Recurrent Henoch Schönlein purpura without renal involvement successfully treated with methotrexate
Authors: Miray Kisla Ekinci Rabia , Balci Sibel , Serbes Mahir , Duyuler Ayçin Gulsah , Dogruel Dilek , Ufuk Altintas Derya , Yilmaz Mustafa
Published: November 2018

Introduction

Henoch Schönlein purpura is characterised by palpable purpura, abdominal pain, arthritis/arthralgia, often with a self-limiting course. Herein, we report a patient with recurrent Henoch Schönlein purpura and severe gastrointestinal involvement, successfully treated with methotrexate.

Case presentation

A 12-year-old boy was admitted to our department with palpable purpura, abdominal pain and arthralgia. Since gastrointestinal complaints were severe, systemic steroids were administered, with tapering of dosage. Henoch Schönlein purpura recurred several times with severe abdominal pain, maelena and purpura during next two months. Colchicine and hydroxychloroquine were initiated. After four months, we also introduced methotrexate, which enabled discontinuation of previous medications including corticosteroids. Methotrexate was ceased four months later, and remission was sustained without any medications for 24 months.

Conclusion

Besides the conflicting data regarding the use of methotrexate in recurrent Henoch Schönlein purpura, our case introduces successful methotrexate experience in a child with Henoch Schönlein purpura and recurrent severe gastrointestinal involvement.
Human Rights and Status Functions, before and after the Enlightenment
Authors: Lobo Gregory J.
Published: November 2018

This article discusses John Searle’s status function account of human rights and Åsa Burman’s “A Critique of the Status Function Account of Human Rights.” While recognizing the validity of part of the critique, based on the distinction between types and tokens, the author argues that, nonetheless, one is not compelled to accept Burman’s conclusion, that “one must give up the status function account of human rights to explain how a human right (as a kind) can exist without collective recognition” (472). Specifically, the author accepts Burman’s critique of Searle’s attempt to preserve the intuition that human rights have existed without collective recognition, but concludes offering three ways to understand human rights even in the absence of collective recognition, all of which preserve the status function account.
Paediatric visceral leishmaniasis: a retrospective study on clinical manifestations, demographic features and laboratory findings of hospitalised cases in Iran between 2006 and 2016
Authors: Nourian Manijeh , Heidari Aliehsan , Tajali Saleheh , Ghasemi Erfan , Mohebali Mehdi , Heidari Amir
Published: November 2018

Visceral leishmaniasis (VL) is a neglected disease. Our retrospective study describes 38 clinical and epidemiological characteristics of VL in patients admitted to a paediatric hospital in Tehran, Iran, who came from different geographical regions, indicating that the disease has spread to most parts of the country. Some 76.3% of the children documented suffered with symptoms of the disease for two months before admission.
Design and experimental analysis of a solar thermoelectric heating, ventilation, and air conditioning system as an integral element of a building envelope
Authors: Ahmad Gondal Irfan
Published: November 2018

This study presents an innovative concept of a compact integrated solar-thermoelectric module that can form part of the building envelope. The heating/cooling modes use the photovoltaic electrical current to power the heat pump. The experimental analysis was carried out and the results of coefficient of performance were in the range 0.5–1 and 2.6–5 for cooling and heating functions, respectively. The study demonstrates that thermoelectric cooler can effectively be used for heating, ventilation, and air conditioning applications by integrating with solar panels especially in cooling applications. The system is environmentally friendly and can contribute in the implementation of zero energy buildings concept.

Practical application: In order to help address the challenge of climate change and associated environmental effects, there is continuous demand for new technologies and applications that can be readily integrated into day-to-day life as a means of reducing anthropogenic impact. Heating, ventilation, and air conditioning, as one of the largest energy consumers in buildings, is the focus of many researchers seeking to reduce building energy use and environmental impact. This article proposes using facades and windows that have an integrated modules of solar photovoltaic cells and thermoelectric devices that are able to work together to achieve heating and cooling effects as required by the building without requiring any external operational power.
The creative economy as a versatile policy script: exploring the role of competing intergovernmental organizations
Authors: Vlassis Antonios , De Beukelaer Christiaan
Published: November 2018

Since the early 2000s, several intergovernmental organizations (IGOs) have advanced the idea that the creative economy could be a ‘feasible development option’. The United Nations Conference on Trade and Development (UNCTAD) and the United Nations Development Programme (UNDP) took the lead by preparing the 2008 and 2010 Creative Economy Reports, whereas the United Nations Educational, Scientific and Cultural Organization (UNESCO) and UNDP executed the 2013 report. The article – based on an actor-centred institutionalism – explores the role IGOs have played in the promulgation of the ‘creative economy’ policy agenda. Through a socio-political analysis, we reveal how IGOs act and interact with each other vis-à-vis ‘creative economy’ policy agenda making. On one hand, the article seeks to highlight why and how IGOs include the creative economy within their priorities and use the concept, influence or challenge its orientations. On the other hand, it aims to examine their ability to act in common in order to globalize the ‘creative economy’ policy agenda and create new forms of cultural industries governance.
Intensive Patients’ Education and Lifestyle Improving Program in CAD Patients
Authors: Nie Chunyan , Li Tianzhu , Guo Xiaoxia
Published: November 2018

The objective of this article is to investigate the effects of intensive patients’ education and lifestyle improving program (IPEL) on anxiety, depression, and overall survival (OS) in coronary artery disease (CAD) patients with anxiety and depression. In all, 224 CAD patients with anxiety and depression were randomly assigned to IPEL or control group. In Stage I, the IPEL group received IPEL and usual care, while the control group only received usual care. In Stage II, patients were further followed up and OS analysis was performed. Hospital Anxiety and Depression Scale–anxiety (HADS-A) and HADS–depression (HADS-D) were used to assess anxiety and depression. IPEL reduced HADS-A score at Month 9 (M9)/M12, and the percentage of anxiety at M12 and HADS-A score changed. IPEL reduced HADS-D score at M12, and the percentage of depression at M12 and HADS-D score changed compared with control. Patients with nonanxiety/nondepression at M12 in the IPEL group showed better OS. IPEL reduces anxiety and depression and improves OS in CAD patients.
Novel subcutaneous low-molecular-weight heparin injection technique to reduce post-injection bruising
Authors: Jueakaew Sommapun , Piancharoensin Rattana , Pinkesorn Natchayakorn , Thippayarom Sarunya , Sermsathanasawadi Nuttawut
Published: November 2018

Objective

To investigate the efficacy of a novel low-molecular-weight heparin injection technique compared to the standard technique relative to bruising incidence, bruise size, and pain.

Methods

A randomized controlled trial was conducted in 44 patients with acute deep vein thrombosis. Patients who were randomized into the control group received a 10-s duration injection with immediate needle withdrawal, whereas study group patients received a 30-s duration injection with a 10-s pause before needle withdrawal. Two injection sites were assessed for pain and bruising between 48 and 60 h after injection.

Results

Bruises occurred in 50.0% and 18.2% of control and study group patients, respectively ( p = 0.03). Mean bruise size between 48 and 60 h after injection was 172.73 ± 372.60 mm2 and 28.18 ± 70.01 mm2 in the control group and study group, respectively ( p = 0.026). Pain scores were comparable between groups.

Conclusion

A 30-s duration injection with a 10-s pause before needle withdrawal resulted in significantly fewer and smaller bruises.
Effectiveness of high-dose glucocorticoids on hemolysis, elevating liver enzymes, and reducing platelets syndrome
Authors: Kang Suya , Zhou Liping , Wang Xiaoyan , Li Yongmei , Wang Yun
Published: November 2018

Objective

To investigate the effectiveness of high-dose glucocorticoids on hemolysis, elevating liver enzymes, and reducing platelets (HELLP) syndrome.

Methods

A total of 151 patients with HELLP syndrome were analyzed and divided into two groups. Six subgroups of treatment and control groups were divided into three grades in accordance with the American Mississippi Diagnostic Criteria.

Results

There were no differences in general characteristics of the patients, primipara rate, minimum platelet recovery time, postpartum hemorrhage volume, postpartum hemorrhage rate, cumulative average of maternal damage, intensive care unit admission rate, perinatal mortality rate, and overall incidence rate of adverse outcomes in fetuses among the groups. The primipara rate in the control group of the third grade was significantly higher than that in the treatment group of the third grade. The treatment group of the second grade (88.7%) had a significantly higher preterm delivery rate than that in the control group of the second grade (66.7%). There were no differences in minimum hemoglobin, and maximum lactate dehydrogenase, alanine aminotransferase, and aspartate aminotransferase levels among the groups and subgroups.

Conclusion

High-dose glucocorticoids cannot significantly improve maternal and fetal prognoses and laboratory indices. However, our results might offer some clinical evidence for HELLP syndrome therapy.
Challenges Faced by Family Caregivers: Multiple Perspectives on Eldercare
Authors: Strommen Jane , Fuller Heather , Sanders Gregory F. , Elliott Dustin M.
Published: November 2018

The focus of this study was to identify challenges to family eldercare provision from the perspectives of both caregivers and community stakeholders. This qualitative study used data from 306 family caregivers and 116 stakeholders (aging, social, and health service professionals who work with older adults and their families) in North Dakota. Data sources included an American Association of Retired Persons-ND survey of 110 caregivers, a survey by the ND Family Caregiver Support Program (196 participants), and a Statewide Caregiving Stakeholder Survey (116 participants). Thematic analysis identified five themes: (a) financial burden of providing eldercare, (b) insufficient access to respite care, (c) difficulty finding and navigating available services and programs, (d) lack of knowledge and training on care provision, and (e) challenges related to environmental context of caregiving. Implications for working with family caregivers and developing policies for eldercare are discussed.
Assessing High School Students’ Cost Concerns About Pursuing STEM: “Is It Worth It?”
Authors: Ko Sei Jin , Marx David M.
Published: November 2018

Women and ethnic minorities (e.g., Latinos) continue to be underrepresented in science, technology, engineering, and mathematics (STEM). In an attempt to understand why these STEM minorities are underrepresented, we explored high school students’ cost perceptions about pursuing STEM in college. Past research has grouped cost into three dimensions: effort, loss of valued alternatives (LoVA), and emotional. Focus group interviews with Latino high school students confirmed the three cost dimensions, but there were some cultural sources of cost unique to our sample. Consequently, we modified and refined existing cost items to create a STEM-specific and culturally contextualized cost scale. We utilized our scale to examine how high school students at the intersection of gender, ethnicity, and math identification differ in cost perceptions. Results showed that high, compared with low, math-identified students had lower effort and LoVA costs. Among high math-identified students, we also found that STEM ethnic minorities had lower emotional cost than STEM ethnic majorities.
Application of ZnO-Ag-Nd nanocomposite as a new synthesized nanophotocatalyst for the degradation of organic compounds: kinetic, thermodynamic and economic study
Authors: Azadi Mahak , Hasani Amir Hessam , Olya Mohammad Ebrahim , Borghei Seyed Mehdi
Published: November 2018

In the present research, a zinc oxide (ZnO)–silver (Ag)–neodymium (Nd) nanocomposite was synthesized via the combustion method for the degradation of dyes as organic pollutants. The synthesized nanophotocatalyst was characterized using X-ray diffraction, Fourier transform infrared spectroscopy, and scanning electron microscopy techniques. The process of organic pollutant (Acid Red 18) removal was carried out in a semi-batch photoreactor equipped with an ultraviolet lamp. Also, the influence of key operational parameters such as pH, temperature, initial concentration of solution, and nanophotocatalyst dosage was investigated to evaluate kinetic and thermodynamic properties. Under optimum process conditions (pH = 6.21, dosage of nanophotocatalyst = 0.08 g/l, and low initial concentration of the solution), degradation of pollutant was monitored by measuring the total organic carbon of the solution. Finally, an economic study showed that the photocatalytic advanced oxidation process is an viable treatment method for low concentrations of organic pollutants.
Short-term toxicity of dibutyl phthalate to mice intestinal tissue
Authors: Yu Jimian , Wang Wei , Wang Jianfeng , Wang Chun , Li Caiyan
Published: November 2018

The objective of this study was to investigate changes in intestinal histopathology and expression of heat-shock proteins (HSPs) in the small intestinal tissue of mouse after acute exposure to dibutyl phthalate (DBP). Forty-eight 60-day-old Institute of Cancer Research (ICR) mice were administered DBP by gavage once a day for 10 days. The mice were divided into three groups of 16 mice each: the high-dose group was administered 500 mg/kg body weight (BW) DBP; the low-dose group was administered 50 mg/kg BW; and the control group was not administered DBP. Significant increases in the uterine index, ovary index, and testicular index were observed in the DBP-exposed groups compared to those in the control group. Villus height and V/ C ratio significantly increased ( p < 0.05) in the duodenum and decreased ( p < 0.05) in the jejunum after the administration of DBP. The goblet cell number decreased in both the duodenum and the jejunum of mice exposed to DBP ( p < 0.05) compared to the number in the control group mice. Damage to the structure of the small intestine was accompanied by a marked increase in HSP27 expression and a decrease in the expression of HSP70 and HSP90 in both high-dose and low-dose groups. These results indicate that elevated HSP27 levels in the duodenum and jejunum may be important markers for acute DBP exposure and that HSP27 may act as a protective protein involved in intestinal mucosa repair.
Experiences of Intimate Partner Violence Among Lesbian, Gay, Bisexual, and Transgender College Students: The Intersection of Gender, Race, and Sexual Orientation
Authors: Whitfield Darren L. , Coulter Robert W. S. , Langenderfer-Magruder Lisa , Jacobson Daniel
Published: November 2018

Lesbian, gay, bisexual, and transgender (LGBT) college students experience disproportionate rates of intimate partner violence (IPV) compared with their heterosexual and cisgender counterparts. Some studies report rates of IPV among lesbian, gay, and bisexual college students as high as 50%, and 9 times greater among transgender students compared with their cisgender peers. Few studies have investigated the impact of intersectional identity on experiencing different types of IPV, such as emotional, physical, and sexual IPV. The present study utilized the National College Health Assessment–II from 2011 to 2013 ( n = 88,975) to examine the differences in types of IPV among college students based on sexual orientation, gender identity, and the intersection of these two identities. Bivariate Rao–Scott chi-square and multilevel logistic regression was used to test the associations between sexual orientation, gender identity, and the intersection of these identities on multiple types of IPV. Adjusting for covariates and school clustering, LGBT college students had higher odds of reporting emotional IPV (adjusted odds ratios [AORs] = 1.34-1.99), physical IPV (AOR = 1.58-2.93), and sexual IPV (AOR = 1.41-6.18). Bisexual and transgender college students demonstrated the highest odds of reporting IPV based on sexual orientation and gender identity, respectively. Intersectional identities were not significantly associated with IPV. These findings demonstrate a need for clinicians working with college students to be aware of the disproportionate prevalence of IPV among LGBT individuals, particularly for those clients those who identify as bisexual and/or transgender and participate in continuing education related to these populations. Furthermore, these findings illustrate the need for additional intersectional research with LGBT college students.
Pay Communications and Fairness: An Employee Perspective
Authors: Scott Dow
Published: November 2018

A variety of tools are used to create perceptions of fairness including job evaluation, pay surveys and merit pay guide charts, but without effective pay communications the benefits of fair pay programs can be lost. Increased access to information about pay (e.g., salary.com , O’net and Monster.com), along with increased use of social media where personal information is routinely shared, has changed employee attitudes about pay transparency and information employers should communicate about pay. This study examines the relationships of pay communications, pay transparency and pay understanding with employee perceptions of pay fairness. Data collected from 300 full-time employees across as many organizations found that pay understanding mediated the relationship between pay communications and pay fairness, while controlling for gender, education level, age and income level of respondents. When pay communications was controlled for in mediation analysis, variance attributed to pay transparency disappeared.
Structure and electrophysical properties of polyvinylidene fluoride (PVDF)/magnetite nanocomposites
Authors: Ramazanov MA , Maharramov AM , Shirinova HA , Palma Luca Di
Published: November 2018

In the present study, the effect of magnetite (Fe3O4) nanoparticles on the structural and dielectric properties of poly(vinylidene fluoride) (PVDF) matrix was investigated. Distribution of Fe3O4 nanoparticles in the polymer matrix has been studied by scanning electron microscopy (JEOL JSM-7600 F). The structure of the nanocomposite samples was investigated by the X-ray diffraction and Fourier-transform infrared spectroscopy. It was shown that the dielectric permittivity of PVDF + Fe3O4 nanocomposite samples was gradually increased up to 7 wt% of Fe3O4 content. Further increase in the concentration of the filler leads to decrease in the dielectric permittivity. The subsequent decrease in dielectric permittivity at higher Fe3O4 content can be explained by the increase in defects in the structure of the nanocomposite. The comparison of experimental data and the results of theoretical calculations show that the reduction in the empirical value of dielectric permittivity of the nanocomposite is obviously linked with the threshold value of filler. While calculating the theoretical value of the dielectric permittivity for the higher content of the filler, defects in the nanocomposite structure should be considered.
Influenza and Intentions to Vaccinate in an Underserved Hispanic Population: The Role of Theoretically Derived Constructs
Authors: Padilla Margie E. , Frietze Gabriel , Shenberger-Trujillo Jessica M. , Carrillo Melissa , Loya Amanda M.
Published: November 2018

Background:

Past research has focused on understanding influenza vaccine acceptance in non-Hispanic white populations; however, research on the social causes of influenza vaccine acceptance rates in Hispanic populations is slowly developing.

Objective:

The purpose of this study was to assess theoretically driven predictors (i.e. attitudes, perceptions, behaviors, etc.) on influenza and the intention to vaccinate.

Methods:

A survey was administered to assess predictors of intentions to receive the influenza vaccine. The survey included items adapted from the National Flu Survey.

Results:

Key constructs common in models of health behaviors emerged as predictors of behavioral intentions to receive the flu vaccine. Recent vaccination within the past year ( P < 0.001), perceived effectiveness of the flu vaccine ( P < 0.004), and perceived safety of the flu vaccine ( P = 0.009) were predictors of intentions to vaccinate. Exploratory analyses revealed that government distrust was a statistically significant predictor of intentions to vaccinate ( P = 0.044).

Conclusion:

The above results have important implications for health-care providers and public health educators. The better we understand the relationship between theoretically driven predictors and vaccine behaviors, the more educators and health-care providers can focus on meaningful, culturally sensitive, targeted-vaccine education.
Sequential coupling of electromagnetic–structural simulation for compression welding of tubular jobs
Authors: Khan Mohammed Rajik , Hossain Md. Mosarraf , Sharma Archana , Kumar Satendra
Published: November 2018

This work adopts a simplified analytical approach to design an axi-symmetric bitter circular coil and presents a sequential-coupled simulation of electromagnetic welding for tubular jobs using finite element analysis. A three-dimensional axi-symmetric transient electromagnetic model is proposed to predict the developed magnetic field and pressure, which is sequentially coupled to the mechanical model to obtain the deformations occurring on the mating members. Results in the form of changes in impact velocity, shear stress, and effective plastic strain induced on the outer wall of the flyer tube with varying process parameters, via input voltage and initial angle of taper of inner solid plug during welding simulation are graphically shown. Based on the results of the coupled finite element simulation, a weldability window for effective welding of tubular jobs is proposed.
Machinability of AA7075-T6/carbon nanotube surface composite fabricated by friction stir processing
Authors: Tekiyeh Ramin Mehdizad , Najafi Mohsen , Shahraki Saeid
Published: November 2018

Chip adhesion on rake face of cutting tool and subsequent formation of built-up-edge are critical problems in machining of aluminum alloys. In the current work, carbon nanotube as a solid lubricant has been integrated with aluminum 7075-T6 alloy through friction stir processing and the machinability of fabricated surface composite has been evaluated. Here, firstly, a series of friction stir processing experiment has been carried out to find optimum pass number regarding uniform dispersion of carbon nanotube in aluminum matrix. Then, a total number of 27 drilling experiments under different values of spindle speed and travel speed have been carried out on raw material, friction stir processed material without addition of carbon nanotube, and friction stir processed with addition of carbon nanotube. The obtained results showed that addition of carbon nanotube as reinforcement causes reduction of machining thrust force and surface roughness due to excellent lubrication property. Tribological observations through scanning electron microscopy and wear test revealed that the main mechanism for enhancing the machinability is reduction of friction coefficient as a result of carbon nanotube addition.
A finite element study on intra-operative corrective forces and evaluation of screw density in scoliosis surgeries
Authors: Musapoor Ameneh , Nikkhoo Mohammad , Haghpanahi Mohammad
Published: November 2018

Scoliosis is an abnormal sideways curvature of the spine and rib cage, which may need surgical treatments. Most of the corrective maneuvers in scoliosis surgeries are based on surgeon’s experience; hence, there is great interest of understanding how the correction ratio can be influenced by the magnitude of forces and moments. Therefore, the objective of this study was to develop and validate a detailed finite element model of the thoracolumbar which can be used to simulate the scoliosis surgeries based on patient-specific clinical images. The validated models of five patients were carefully developed, and the surgery procedures were simulated and the corrective forces were estimated using inverse finite element analysis during the surgery. Furthermore, parametric studies including the influences of the corrective force magnitude and screw density were evaluated. The results showed that the maximum estimated correction force and moment were 173 (±55.43) N and 10.67 (±2.02) N m, respectively, which were aligned with measured clinical observations. The sensitivity analysis on the magnitude of applied force to the screws showed that correction ratio was slightly increased in level 1 (i.e. FB = 1.3 ×  F) but decreased in level 2 (i.e. FB = 1.6 ×  F). In addition, the parametric study on increasing the number of pedicle screws showed that there was no significant difference between lower and higher screw density. However, the stress distribution was significantly greater using higher screw density during correction maneuvers. In conclusion, this study shows a direct relationship between the applied force/moment and screw density and the correction ratio up to a border line which should be defined accurately. This detailed computational modeling can be used in clinic in hope of achieving the optimum outcome of scoliosis surgery using individual patient-specific characterization.
Health providers as bricoleurs: An examination of the adaption of health ecosystems to superdiversity in Europe
Authors: Phillimore Jenny , Bradby Hannah , Doos Lucy , Padilla Beatriz , Samerski Silja
Published: November 2018

This article examines the ways in which healthcare providers from a mixed economy of welfare operating in superdiverse neighbourhoods connect and innovate across the healthcare ecosystem to meet diverse and complex needs. Moving beyond a health systems approach which siloes different types of provision, we use the concept of bricolage to make visible the work undertaken by providers across the ecosystem. While we show that public, private and civil society provision all adapt to meet complex and diverse needs to some degree, we highlight the importance of inter-connectedness between providers and note the role of civil society in addressing gaps and cracks in provision. The importance of adopting a whole ecosystem approach and focusing on the actions and interactions which enable the ecosystem to function in complex demographic environments is highlighted before we stress the dangers of over-reliance on civil society.
Leadership and innovation within a complex adaptive system: Public libraries
Authors: Freeburg Darin
Published: November 2018

Viewing public libraries as Complex Adaptive Systems, the current study analyzed leadership within these systems in terms of complexity and innovation. This included a leader’s capacity for ambiguity and emergence, features of leadership in different contexts, and perceptions of success and innovation. From a list of current public library directors and managers, 15 participants completed a 30-minute phone interview that followed a semi-structured guide. By analyzing the intersection of complexity of approach with complexity of context, eight leadership approaches were uncovered through coding. Results suggest that most participants engaged with most of the leadership approaches at some point. In addition, most of these approaches were seen as successful and innovative—though in different ways. Findings suggest that traditional hardline distinctions between leadership and management—or innovative and non-innovative—are no longer useful. This study is an important contribution to the study of public library leadership, as it applies theories of complexity to both approach and context.
Weighted volume under the three-way receiver operating characteristic surface
Authors: Huang Lei , Li Jialiang
Published: November 2018

It is often necessary to differentiate subjects from multiple categories using medical tests. We may then adopt statistical measures to characterize the performance of these tests. The three-way ROC analysis has been proposed to evaluate the diagnostic accuracy of medical tests with three categories, reflecting the correct classification probabilities across all possible decision thresholds. The geometry of the ROC surface is carefully studied, leading to numerical summary measures such as the volume under the surface. This paper generalizes the global volume under the surface of three-way ROC analysis to the weighted volume under the surface (WVUS) by introducing a weight function emphasizing particular regions of correct classification probabilities. This generalization practically allows researchers to calculate the diagnostic accuracy for a medical or clinical biomarker while satisfactorily high probabilities of correct classification for one or two classes are conditionally ensured. We provide the asymptotic properties of the proposed nonparametric and parametric estimators of WVUS, which could easily lend support to statistical inferences. Some simulations have been conducted to assess the proposed estimators and also to demonstrate the necessity of WVUS. A real data analysis about liver cancer illustrates our methodology.
‘To die, to sleep’ – assisted dying legislation in Victoria: A case study
Authors: Gilbert Julia , Boag Jane
Published: November 2018

Background:

Assisted dying remains an emotive topic globally with a number of countries initiating legislation to allow individuals access to assisted dying measures. Victoria will become the first Australian state in over 13 years to pass Assisted Dying Legislation, set to come into effect in 2019.

Objectives:

This article sought to evaluate the impact of Victorian Assisted Dying Legislation via narrative view and case study presentation.

Research design:

Narrative review and case study.

Participants and research context:

case study.

Ethical considerations:

This legislation will provide eligible Victorian residents with the option to request access to assisted dying measures as a viable alternative to a potentially painful, protracted death.

Findings:

This legislation, while conservative and inclusive of many safeguards at present, will form the basis for further discussion and debate on assisted dying across Australia in time to come.

Discussion:

The passing of this legislation by the Victorian parliament was prolonged, emotive and divided not only the parliament but Australian society.

Conclusion:

Many advocates for this legislation proclaimed it was well overdue and will finally meet the needs of contemporary society. Protagonists claim that medical treatment should not provide a means of ending life, despite palliative care reportedly often failing to relieve the pain and suffering of individuals living with a terminal illness.
Partnering With Parents: Reviewing the Evidence for Motivational Interviewing in Child Welfare
Authors: Shah Avani , Jeffries Shawn , Cheatham Leah P. , Hasenbein Will , Creel Misty , Nelson-Gardell Debra , White-Chapman Nyshetia
Published: November 2018

Child welfare workers (CWWs) face challenges to engaging families, including initial parental resistance, service plan noncompliance and other barriers. Adopting a motivational interviewing (MI) framework may improve engagement and collaboration between CWWs and parents, thereby leading to better child welfare (CW) outcomes. This comprehensive narrative review identifies the use of MI in CW, the outcomes of MI use and the gaps in the literature. Of the 16 articles that met inclusion criteria for our search, 12 suggested MI’s value in parenting skills, parent/child mental health, retention in services, substance use, and CW recidivism. Four of these studies specifically focused on CWW. Future studies should examine specific CW outcomes such as reunification, parent/child relationships, recidivism and parent/child mental health.
(En)gauging Self: Toward a Practical Framework for Race Talk
Authors: Murray-Johnson Kayon
Published: November 2018

Adult educators in higher education settings often facilitate topics that stir difficult dialogues on race and racism. In the United States, an increased population of racially diverse individuals set against the backdrop of our current sociopolitical climate, suggests the need for authentic conversations surrounding race remain critical. By extension, the need for skillful facilitators can only be expected to increase. At the same time, however, many instructors avoid or fear race talk because of its potential to become emotionally charged. This article proposes a practical, reflective framework that might be used by instructors to build emotive capacity—an important complement to instructional strategies when talking about race and racism.
Pharmacy Technicians Are People, Too! Let’s Consider Their Personal Outcomes Along With Other Pharmacy Outcomes
Authors: Adams Alex J. , Desselle Shane , Austin Zubin , Fenn Tess
Published: November 2018

Studies have found that expanded pharmacy technician roles can help “free up” pharmacist time, leading to role optimization. However, these studies and the positions taken by many are quite pharmacist-centric. We seem to have underestimated the importance of support staff in pharmacy operations. If research demonstrates that technicians can perform a function safely and effectively, that alone should compel the function’s allowance in practice. Freeing up pharmacist time for higher-order care is a positive corollary to technician advancement, but it need not be a precondition for it.
Therapist Values: Assessing and Treating Traditional and Nontraditional Relationships
Authors: McCarthy Barry , Wald Ross Lana
Published: November 2018

A common mental health assumption exists that all clinicians should be able to treat all problems and all clients. An unspoken belief among many clinicians is that nontraditional sexual preferences and feelings are driven by psychopathology. In contrast, in order to provide high-quality clinical treatment, a positive sexual health model advocates that the clinician exhibits interest in the client’s sexual issue, be trained and competent with the presenting problem, and provide therapy congruent with the clinician’s personal and professional values. Nontraditional clients and couples deserve that sexuality plays a positive role in their lives and relationship. Although the clinician needs to assess for psychopathology, it is crucial that the therapist not assume that nontraditional sexuality is motivated by psychopathology. All clients/couples deserve to be treated empathically and respectfully and receive high-quality mental health and sex therapy services.
How Right-Wing Extremists Use and Perceive News Media
Authors: Baugut Philip , Neumann Katharina
Published: November 2018

We investigate how right-wing extremists use, perceive, and try to provoke news media coverage. Findings from qualitative interviews with former leaders of right-wing extremist groups in Germany, who served as key informants, show that reports on right-wing extremism are used and trigger feelings of being personally affected. Consequently, right-wing extremists show hostile-media and third-person perceptions. These perceptions influence both emotions and behaviors among right-wing extremists, for example, they cause right-wing leaders to strategically monitor news media to exploit them for political goals. Our findings are presented along with a model and are accompanied by a discussion of the implications for responsible journalism.
Honoring Lived Experience: Life Histories as a Realist Evaluation Method
Authors: Richardson Emma Z. L. , Phillips Mary , Colom Alejandra , Nichols Jennica
Published: November 2018

Program participants have been largely excluded as an evidence source in realist evaluations. We test whether and how lived experience as described through life history interviews with pilot program participants can be used as a valid and unique source of data for elucidating context (C)–mechanism (M)–outcome (O) configurations and informing program theory. We use data about “Opening Opportunities,” a program for indigenous adolescent girls in rural Guatemala, to build a theory of change relating to educational attainment. Life histories yield a rich data set that allows probing of quintessential realist questions; capture subtle, hard-to-measure, and longer term contextual factors and mechanisms; elucidate co-occurring CM and MO dyads; help decipher individual- and structural-level contexts; and provide unique additions and refinements to the program theory. Importantly, this work expands potential evidence sources to inform program theory by including the unique insights from those with lived experience.
Avascular necrosis post unstable slipped capital femoral epiphysis: a treatment algorithm with staged hinged hip distraction: mid-term results
Authors: Balakumar Balasubramanian , Madan Sanjeev
Published: November 2018

Background:

Management of avascular necrosis (AVN) of the femoral head in slipped capital femoral epiphysis (SCFE) is difficult. We proposed to ascertain if staged hip distraction could prevent collapse and recover the femoral head.

Methods:

A retrospective review of the hip database retrieved 16 children with unstable SCFE and AVN. All underwent capital realignment by surgical dislocation followed by 2nd-stage hinged hip distraction. Patient demographics and radiographic parameters of deformity, AVN and arthritis were collected. The patients scored their hip function both before and after intervention and at follow-up using the modified Harris Hip Score and Nonarthritic Hip score.

Results:

7 boys and 9 girls formed the study group ( n = 16). The average age at surgery was 12.7 years (9–16 years). 8 rights hips and 8 left hips were involved. The average follow-up was 45 months (33–66 months). Group A ( n = 7) had hip distraction only if the follow-up radiographs showed AVN changes and collapse. Based on the observations in Group A, the protocol was changed for Group B. Group B ( n = 9) underwent hip distraction at 6 weeks of capital realignment for avascularity of the femoral head. In Group A, all patients had further collapse and advanced arthritis at follow-up. In Group B all patients had hip joint space restored and good hip function without pain at follow-up.

Conclusions:

Pre-emptive application of hip distractor for those children with proven lack of blood flow to the femoral head is a potential option to stall the progression of AVN and to help recover useful hip function.
Context-Sensitive Computational Mechanisms of Decision Making
Authors: Chawla Manisha , Miyapuram Krishna P
Published: November 2018

Real-world information is primarily sensory in nature, and understandably people attach value to the sensory information to prepare for appropriate behavioral responses. This review presents research from value-based, perceptual, and social decision-making domains, so far studied using isolated paradigms and their corresponding computational models. For example, in perceptual decision making, the sensory evidence accumulation rather than value computation becomes central to choice behavior. Furthermore, we identify cross-linkages between the perceptual and value-based domains to help us better understand generic processes pertaining to individual decision making. The purpose of this review is 2-fold. First, we identify the need for integrated study of different domains of decision making. Second, given that both our perception and valuation are influenced by the surrounding context, we suggest the integration of different types of information in decision making could be done by studying contextual influences in decision making. Future research needs to attempt toward a system-level understanding of various subprocesses involved in decision making.