bluuebunny/crossref_metadata_2025 huggingface dataset:
Arthroscopic Treatment of Osteochondral Lesions of the Talus in a Pediatric Population: A Minimum 2-Year Follow-up
Authors: Carlson Michael J. , Antkowiak Tomasz T. , Larsen Nicholas J. , Applegate Gregory R. , Ferkel Richard D.
Published: June 2020

Background:

Treatment of osteochondral lesions of the talus (OLTs) in children presents a difficult clinical challenge, with few large series reported.

Purpose:

To evaluate functional and radiographic outcomes for children and adolescents undergoing arthroscopic treatment of symptomatic OLT with a minimum follow-up of 2 years.

Study Design:

Case series; Level of evidence, 4.

Methods:

Patients were identified who had symptomatic OLT treated arthroscopically with marrow stimulation techniques. Inclusion criteria were age ≤18 years, symptomatic chronic OLT as the surgical indication, failure of nonoperative treatment, and minimum follow-up of 24 months. Outcome measures included Foot Function Index, American Orthopaedic Foot and Ankle Society Hindfoot Score, Tegner Activity Scale, 36-Item Short Form Health Survey (Short Form-36, v 2), visual analog scale, ankle range of motion, and patient satisfaction survey. Weightbearing radiographs were compared with preoperative radiographs via an ankle arthritis classification system. Magnetic resonance imaging (MRI) was used to evaluate postoperative lesion characteristics per the MOCART scale (magnetic resonance observation of cartilage repair tissue). The size, location, lesion stability, traumatic etiology, skeletal maturity, and length of follow-up were recorded and analyzed through univariate logistic regression.

Results:

The study group consisted of 22 patients (11 male, 11 female) with a mean age of 14.4 years (range, 8-18 years) and a mean follow-up of 8.3 years (range, 2-27 years). Of 22 patients, 20 were satisfied with the results from surgery and would recommend it to others. Mean follow-up visual analog scale for pain was reported as 2.2 on a 10-point scale, and mean American Orthopaedic Foot and Ankle Society score at follow-up was 86.6. Mean postoperative Foot Function Index scores for the study group were as follows: pain, 17.1; disability, 16.5; activity, 4.7; and overall, 38.7. Mean Short Form-36 physical component score was 50.7. Postoperative radiographs indicated a van Dijk osteoarthritis grade of 0 in 56%, I in 38%, II in 6%, and III in 0%. Postoperative MRI MOCART scores showed complete filling of the cartilage in 27% of cases, complete graft integration in 22%, and intact repair surface in 22%, with a mean MOCART score of 48.0. No correlation was found between radiographic and MRI findings and clinical outcomes. None of the prognostic factors were significantly associated with patient satisfaction, progression of arthritis, or MOCART scores.

Conclusion:

Arthroscopic treatment of symptomatic OLT in adolescent patients (≤18 years) demonstrated high functional outcomes, high clinical satisfaction rates, and minimal radiographic osteoarthritic progression despite low MOCART scores.
The Role of the Medical School Training on Physician Opioid Prescribing Practices: Evidence from Ontario, Canada: Le rôle de la formation à la faculté de médecine à l’égard des pratiques de prescription d’opioïdes des médecins: données probantes d’Ontario, Canada
Authors: de Oliveira Claire , Iwajomo Tomisin , Gomes Tara , Kurdyak Paul
Published: June 2020

Background:

Recent research found that physicians who completed medical school training at top-ranked U.S. medical schools prescribed fewer opioids than those trained at lower ranked schools, suggesting that physician training may play a role in the opioid epidemic. We replicated this analysis to understand whether this finding holds for Ontario, Canada.

Methods:

We used data on all opioid prescriptions written by Ontario physicians between 2013 and 2017 from the Narcotics Monitoring System. Using the Corporate Provider Database and ICES Physician Database, which contain medical school of training, we linked patients who filled opioid prescriptions with their respective prescribing physician. Available data on Canadian medical school rankings were obtained from Maclean’s news magazine. We used regression analysis to assess the relationship between number of opioid prescriptions and medical school ranking.

Results:

Compared to the United States, average annual number of opioid prescriptions per physician was lower in Ontario (236 vs. 78). Unlike the United States, we found little evidence that physicians trained at lower ranked medical schools prescribed more than their top-ranked school counterparts after controlling for specialty and location of practice. However, primary care physicians trained at non-English-speaking foreign schools prescribed the most opioids even after excluding opioid maintenance therapy–related prescriptions.

Conclusion:

The role of medical school training on opioid prescribing patterns among Ontario physicians differs from that in the United States likely due to greater homogeneity of curricula among Canadian schools. Ensuring physicians trained abroad receive additional pain management/addiction training may help address part of the opioid epidemic in Ontario.
Bow Hunter’s Syndrome in Children: A Review of the Literature and Presentation of a New Case in a 12-Year-Old Girl
Authors: Golomb Meredith R. , Ducis Katrina A. , Martinez Mesha L.
Published: June 2020

Background:

Bow hunter's syndrome, or occlusion of the vertebral artery with head rotation leading to ischemia and sometimes stroke, is rarely described in children. The authors review the literature and present a new case.

Methods:

Both OVID dating back to 1946 and PubMed records were reviewed using the terms (“Bow hunter syndrome” OR “bow hunter’s”) OR “rotational vertebral artery occlusion” combined with “child,” and limited to English language. SCOPUS and the bibliographies of cases found in the search were used to identify additional articles.

Results:

Twelve articles were found describing 25 patients; there were 26 patients when combined with our case. Ages ranged from 1 to 18 years. Most (88.5%, 23/26) were male. Medical treatments included aspirin, clopidogrel, abciximab, enoxaparin, warfarin, and cervical collar. Stenting was tried in 2 cases but did not work long-term. Surgical treatments included decompression, cervical fusion, or a combination. We present a new case of a 12-year-old girl with recurrent stroke who had bilateral vascular compression only visible on provocative angiographic imaging with head turn. She was referred for cervical fusion, and abnormal ligamentous laxity was noted intraoperatively.

Conclusions:

Bow hunter's syndrome is a rare but important cause of stroke since many of the patients experience recurrent strokes before the diagnosis is made. Reasons for the male predominance are unclear. Provocative angiography plays a key role in diagnosis, and both medical treatment and neurosurgical intervention may prevent recurrence.
Clinical Features and Risk Factors for Mortality in Children With Acute Encephalitis Who Present to the Emergency Department
Authors: Hu Mei-Hua , Wu Chang-Teng , Hsia Shao-Hsuan , Hung Po-Cheng , Huang Go-Shine
Published: June 2020

Acute encephalitis is an important pediatric emergency that tends to be associated with neurological morbidity, critical illness, and mortality. Few data have specifically focused on evaluating various early clinical parameters in the pediatric emergency department as candidate predictors of mortality. The present retrospective study assessed the clinical, laboratory, and neuroimaging findings of children with acute encephalitis who presented to the emergency department. Of 158 patients diagnosed with encephalitis, 7 (4.4%) had mortality. Compared to the survivors, a multivariate analysis revealed that an initial Glasgow Coma Scale score ≤ 5 (odds ratio [OR]: 8.3, P = .022), acute necrotizing encephalitis (OR: 12.1, P = .01), white blood count level ≤ 5.2 × 109 cells/L (OR: 28.7, P < .001), aspartate aminotransferase level > 35 U/L (OR: 14.3, P = .022), and influenza A infection (OR: 7.7, P = .027) were significantly associated with mortality. These results indicate that the early recognition of preliminary clinical features and the development of more specific etiologies for encephalitis are important for early treatment strategies.
The Embodiment of Deviance: The Biopolitics of the “Difficult Child” in Socialist Czechoslovakia
Authors: Henschel Frank
Published: June 2020

This article belongs to the special cluster, “Family, Gender and (dis)Abled Bodies after 1953”, guest-edited by Maike Lehmann and Alexandra Oberländer.

In this article, I examine the academic discourses and socio-educational practices in post-war socialist Czechoslovakia concerning children who were considered “behaviorally difficult,” and I analyze those discourses and practices as elements of biopolitics and governmentality. I concentrate on the diagnostic conceptualizations introduced into the psycho-medical discourse of the 1950s and 1960s by what was called “defectology.” Czechoslovak defectologists, who composed their approaches from Soviet, Czech, and other academic sources, explained children’s difficult behavior in terms of “defectivity,” that is, a disturbed relationship between the individual and his or her social environment. The educational aims of defectology and the communist regime converged in the ideal of the “embodiment of socialism,” according to which the difficult child should be taught to be a conforming, able-minded, and productive citizen. The preferred treatment for reaching this goal was reeducation in the expanding network of residential institutions. However, defectology had no solution to the increasing number of children diagnosed as difficult or deviant. Moreover, other disciplines, like psychology, pediatrics, and pedagogy, criticized its conceptual inadequacy, which reoriented the discourse and governmentality toward prevention. I also show how gender and ethnicity abetted the diagnosis and affected the treatment of behavioral difficulties, for defectologists and other practitioners considered “sexually depraved” girls and “Gypsy children” as the “embodiment of deviance.”
Understanding the Correlates of Donor Intention: A Comparison of Local, National, and International Charity Destinations
Authors: Robson Andrew , Hart David John
Published: June 2020

The United Kingdom is generous toward charitable donations, and this commitment appears robust against a background of economic uncertainty. While prior work has identified a clear preference for domestic over international causes, research has yet to identify the range of variables that significantly correlate with this important element of charitable choice. A survey of 1,004 U.K. residents was designed to assess willingness to donate to local, national, and international causes. For each destination, stepwise multiple regression analysis identified the key variables that correlate to an individual’s willingness to donate. Findings suggest that donor willingness correlates with levels of trust, preferred types of charitable cause, and donation channels. In contrast, the role of donor demographics is relatively limited. The findings suggest some commonality in the variables that associate most significantly with willingness to donate locally and nationally, but those relating to international donation intention are relatively distinct.
A two-stage integrating optimization of production scheduling, maintenance and quality
Authors: Zheng Jiafei , Yang Hongbing , Wu Qingsong , Wang Ziyang
Published: June 2020

During the process of actual production, production scheduling, preventive maintenance and quality control have a close interaction with each other and thus need to be integrated for improving manufacturing system performance. The aim of this article is to jointly optimize the job sequence, the preventive maintenance locations, the preventive maintenance interval and decision variables of control chart such that the expected cost per unit time and penalty cost due to schedule delay are minimized. A two-stage integrating optimization model of production scheduling, maintenance and quality in a single machine system is developed. A control chart is adopted to monitor the whole process with Taguchi’s loss function estimating the quality cost of each condition and perfect preventive maintenance activity is conducted at the end of each interval. A genetic algorithm is designed to solve this model in order to obtain the optimal job sequence and the locations of preventive maintenance. Numerical examples and thorough sensitivity analyses are provided to illustrate the proposed integrated model. Finally, the efficiency of the proposed two-stage integration model is verified by the comparison of the stand-alone model under the same condition. Compared with the stand-alone model, the proposed integrated method can save the cost rate by 12%–42% under five different situations.
Conflict, fortification, and settlement patterns: A study of the vernacular villages in Guangdong, South China
Authors: Tao Jin , Zhuo Xiaolan , Qin Qiaohua , Xiao Dawei , Zhang Shawei , Chen Huashuai
Published: June 2020

This study explores the defensive characteristics of vernacular fortified villages preserved within Guangdong province in South China. Based on field investigations that cover 1,592 townships, the planning layout, architectural design, and relevant special structures of various fortified villages were analysed and illustrated. In this way, the distribution patterns of the villages were exhibited, and their natural and social mechanisms of formation were thus revealed. Results show that the full utilization of the natural environment and organic integration with artificial defence facilities, as well as the adaption to the local culture, were the main concerns surrounding the construction of fortified villages.
A ‘very fowle warre’: Scorched earth, violence, and Thomas Howard’s French and Scottish campaigns of 1522-1523
Authors: Murphy Neil
Published: June 2020

This article examines the scorched-earth campaigns Thomas Howard, earl of Surrey, launched in France and Scotland in 1522-1523. These campaigns saw exceptional levels of violence directed against civilian populations by Tudor armies. Howard destroyed tens of thousands of acres of the countryside in France and Scotland, as well as numerous towns, villages, and strongholds. He made methodical and systematic use of scorched earth to achieve the prolonged ruination of the enemy frontiers. Overall, this article shows that Howard’s campaigns of 1522-1523 represented a marked escalation in the level of violence English armies directed at civilians.
Survive to be critical: The Wartime Graphic as a ‘masquerading’ media in the Russo-Japanese War, 1904-1905
Authors: Sakai Yu
Published: June 2020

By focusing on unconventional war imagery of the Russo-Japanese War (1904-1905) in The Wartime Graphic, a widely popular pictorial war magazine in Japan, this article uncovers an art of publishing critical materials under the difficult circumstances of modern total war. The magazine’s contents suggest that it was a ‘masquerading’ media which provided critical cultural space while circumventing censorship. Examining the space and expressions in the middle ground, this article will shed light on considerable yet hitherto overlooked dimensions of wartime Japanese press and Japanese society, challenging dichotomous understandings of ‘pro-’ and ‘anti-’ war.
Chinese women skateboarders in Hong Kong: A skatefeminism approach
Authors: Fok Clara Yee Ling , O’Connor Paul
Published: June 2020

This paper conceptualises the experiences of Hong Kong Chinese women skateboarders through the emergent concept of skatefeminism. It responds to the recent global growth and transformation of women’s skateboarding as a visible and promoted part of the sportification and industry of skateboarding. Notably the rise in visibility and inclusion of women’s skateboarding has coincided with an active debate on issues of social justice and sexual identities in skateboarding. We ask, in what ways do Hong Kong women skateboarders express alternatives femininities and can these be explored through skatefeminism? Our cohort of 10 women skateboarders share many of the values and ambivalences of women skateboarders in North American research. But in contrast our participants expressed conservative views regarding gender roles, physical abilities and relationships. Skatefeminism provides a way to make sense of these diverse outlooks and understand the different perspectives of female skateboarders while continuing to recognise their shared experience and subjectivities through skateboarding.
Clinical availability of SNOOP4 in acute non‐traumatic headache patients admitted to the emergency department
Authors: Wongtanasarasin Wachira , Wittayachamnankul Borwon
Published: June 2020

Objectives:

Non‐traumatic headache accounts for up to 4.5% of all patients presenting to the emergency department. Non‐traumatic headache is generally classified into two categories: primary and secondary headache disorders. Differentiating secondary from primary headache disorders is essential. SNOOP4 is known as a mnemonic for suggesting clinicians send neuroimaging to rule out serious conditions. Yet, the benefit of using this mnemonic in the emergency department is not well established. This study aimed to assess the significance of SNOOP4 in detecting serious causes of non‐traumatic headache in adults presenting to the emergency department.

Methods:

We conducted a prospective observational study of adult patients presenting to the emergency department of the single tertiary hospital over a period of 12 months. Patients with acute non‐traumatic headache presented at the emergency department were included. A standard record form was used. Patients were investigated and treated following the pre‐existing protocols. Results were interpreted by attending radiologists. Each factor, according to SNOOP4, was then evaluated for the ability to predict serious causes of non‐traumatic headache.

Results:

A total of 90 patients were included in this study with complete details obtained on 83 (92.2%) patients. Of these, 63 (75.9%) were female. The mean age was 44.5 years (inter‐quartile range: 27–58.5). The duration of the headache ranged from 10 min to 7 days. Out of 83, 27 (32.5%) had at least one SNOOP4 criterion. In all, 25 patients (30.1%) underwent neuroimaging. The sensitivity, specificity, positive predictive value, and negative predictive value of SNOOP4 were 77.8%, 73.0%, 25.9%, and 96.4% respectively.

Conclusion:

SNOOP4 criteria show very high negative predictive value for excluding serious causes of acute non‐traumatic headache in adult patients presenting to the emergency department.
The development of patient suicide post-vention guidelines for psychiatry trainees and supervisors
Authors: Henry Jessica , Ramages Meagan , Cheung Gary
Published: June 2020

Objectives:

Patient suicide is one of the most stressful events for psychiatrists and psychiatry trainees. However, there is often a lack of consistent guidance and support available to clinicians, including post-vention. The aim of this paper is to describe the development of a resource that could support psychiatry trainees following patient suicide.

Methods:

Following a literature review, we adapted two US patient suicide post-vention guidelines to reflect local processes and support systems available by consulting a number of key stakeholders in the training programme and district health boards.

Results:

The first part of the post-vention guidelines included procedural processes such as the serious incident review process and reporting to coroner’s office. The second part included a checklist for trainee, supervisor, local training facilitator and director of training according to the following time frame: first 24 hours, first 1–2 weeks and following months.

Conclusions:

Post-vention guidelines and teaching about patient suicide and its effects could improve the training experience of psychiatry trainees and facilitate the development of resilience as they progress through training.
Parent Training and Communication Empowerment of Children With Cochlear Implant
Authors: Nicastri Maria , Giallini Ilaria , Ruoppolo Giovanni , Prosperini Luca , de Vincentiis Marco , Lauriello Maria , Rea Monica , Traisci Gabriella , Mancini Patrizia
Published: June 2020

Deaf children with cochlear implants (CIs) need a supportive family environment to facilitate language development. The present study was designed to assess the effects of parent training (PT) on enhancing children’s communication development. The PT was based on the “It Takes Two to Talk” model, with specific adaptations for families of deaf children. Before and after the PT, 14 participating families and matched no-treatment controls were assessed using the Parent Stress Index and Cole’s interaction checklist. The children’s language was assessed with the MacArthur–Bates Communicative Development Inventory and, after 3 years, with the Boston Naming, the Peabody, and the Test for Reception of Grammar–Version 2 (TROG-2). The families’ quality of interaction and the children’s language increased significantly more in the trained group than in controls and differences were still present after 3 years. The parents seemed to benefit from PT that focused on strategies to empower and promote communication skills in children with CIs.
Clinical and Socio-demographic Determinants of Self-care Maintenance, Monitoring and Management in US Adults with Type 2 Diabetes Mellitus
Authors: Luciani Michela , Rossi Emanuela , Rebora Paola , Stawnychy Michael , Ausili Davide , Riegel Barbara
Published: June 2020

The aims of this study were to describe self-care in US T2DM patients and to identify clinical and sociodemographic determinants of self-care maintenance, monitoring, and management in US T2DM patients. A secondary analysis was performed using data from a cross-sectional study done to test the psychometric performance of the Self-Care of Diabetes Inventory in US English speaking adults with diabetes. In our sample ( n = 207), self-care maintenance was adequately performed (median = 75), self-care monitoring was borderline (median = 67.6) and self-care management was poor (median = 55.6). Low income ( p = .0019) and low self-care confidence ( p < .0001) were associated with relatively lower self-care maintenance. Not taking insulin ( p = .0153) and low self-care confidence ( p < .0001) were associated with relatively low self-care monitoring. Low self-care confidence ( p < .0001) was associated with low self-care management. Self-care confidence is a strong determinant of self-care. Interventions designed to improve self-care confidence are urgently needed.
Feasibility of an Online, Interactive Body Mass Index Parental Notification Letter (e-BMI)
Authors: Hoke Alicia M. , Poger Jennifer M. , Lehman Erik B. , Kraschnewski Jennifer L.
Published: June 2020

School-based body mass index (BMI) screening is required in 50% of states with parent notification letters distributed among 11 of those states. Additional research is needed to effectively communicate screening results to parents. We conducted a pilot investigation of parent acceptability of an electronic, interactive BMI parental notification letter (e-BMI) along with the feasibility of implementing an e-BMI letter in the school setting. In addition, we assessed parental attitudes and practices regarding their child’s weight-related behaviors. Electronic letter distribution and parent receipt were consistent with traditional paper letter mailings; however, we did not observe any significant behavioral impacts with either letter format. Parents reported interest in wellness programming offered by the school, a potential opportunity for schools to engage families in healthful practices. Additional research is needed to understand the impact of e-BMI letters and accompanying web-based resources specifically for parents of students with overweight or obesity.
Exploratory Analysis of the Impact of an mHealth Medication Adherence Intervention on Tacrolimus Trough Concentration Variability: Post Hoc Results of a Randomized Controlled Trial
Authors: McGillicuddy John W. , Chandler Jessica L. , Sox Luke R. , Taber David J.
Published: June 2020

Background:

Medication nonadherence is a leading cause of late allograft loss in kidney transplantation (KT). Tacrolimus trough coefficient of variation (CV), measured using the coefficient of variation, is strongly correlated with acute rejection, graft function, and graft loss.

Objective:

The objective of this study was to determine if this mobile health (mHealth) intervention aimed at improving medication adherence in a nonadherent KT population would affect high intrapatient tacrolimus variability.

Methods:

A 6-month, prospective, parallel-arm, randomized controlled clinical trial was conducted to determine the effects of an mHealth intervention on tacrolimus CV. Intervention arm participants utilized an electronic medication tray and an mHealth app to monitor home-based adherence. Tailored motivational reinforcement messages were delivered to promote competence for adherence. Tacrolimus CV was measured using a 12-month rolling average, assessed at monthly intervals (6-month intervention period and 6 months after completion of the study); 80 were included, 40 in each arm.

Results:

At baseline, tacrolimus CV was similar between arms (37% ± 15% intervention, 37% ± 13% control, P = 0.894). Patients randomized to the intervention had a significant reduction in mean 12-month tacrolimus CVs ( P = 0.046) and a significant improvement in the proportion achieving low tacrolimus CV (tacrolimus CV < 40%; P = 0.001), as compared with the control arm.

Conclusion and Relevance:

High tacrolimus CV is a risk factor for acute rejection and graft loss; these results offer the potential promise of improved medication adherence and clinical outcomes through the use of innovative technology.
Does More Mean Less?: Interest Surplus and the Gender Gap in STEM Careers
Authors: Cardador M. Teresa , Damian Rodica Ioana , Wiegand Justin P.
Published: June 2020

The persistent gender gap in STEM (Science, Technology, Engineering, and Math) career choice represents a perplexing problem for researchers and policy makers alike. We contribute to the body of research on the gender gap in STEM careers by testing a “surplus model” of vocational interests as a predictor of STEM career choice. The model suggests that, controlling for ability, female adolescents with strong STEM-related interest should be less likely to pursue STEM careers when they also have strong interests in other areas, due to wider career options. We tested the surplus model in a large national longitudinal data set and translated the results into differences in annual wages. Our findings illuminate the predictive validity of a surplus model of interests on STEM career choice across gender, provide insight into the gender gap in STEM, and suggest opportunities for future research.
The Influence of Gender on Perceptions of Culpability and Victim Status in Statutory Rape Offenses Involving Teachers
Authors: Muniz Caitlyn N. , Powers Ráchael A. , Leili Jennifer A.
Published: June 2020

Perceptions of child sexual abuse and statutory rape vary based on the gender of the victim, the perpetrator, and the combination of both. We extend existing research to examine attributions of responsibility and punitive preferences for student victims in student–teacher sexual relationships contingent on the gender dyad of the student and teacher and the interaction between the gender dyad and respondent gender. Participants ( N = 648) were randomly assigned to vignettes wherein the gender of the student and teacher were manipulated (female teacher/male student; female teacher/female student; male teacher/female student; male teacher/male student). Overall, respondents were “pro-victim,” though results indicate significant differences in respondent gender and how the gender dyads were perceived. Students in the male same-sex dyads were attributed less responsibility than other students. Furthermore, men were less likely to perceive the student as a victim, and women were more likely to indicate the student should be punished.
High-Quality and High-Yield RNA Extraction Method From Whole Human Saliva
Authors: Gandhi Vaibhav , O’Brien Mara H. , Yadav Sumit
Published: June 2020

Background:

Human saliva has been identified as a novel, practical, and noninvasive source of biomarkers and genetic materials. However, it is equally challenging due to the availability of an abundance of impurities in the form of microbes and other proteinaceous compounds. The objective of this study was to develop a robust, reproducible, and economic method of extracting high-yield and high-quality RNA from whole human saliva.

Methods:

The modified TRIzol protocol was developed to extract RNA from saliva (n = 14), followed by complementary DNA synthesis and reverse transcription quantitative polymerase chain reaction analyses for the genes encoding IL1B, ALPL, RUNX2, and ACTB. To compare our protocol with the spin column–based method, we used Qiagen Salivary Protect Micro-RNA spin columns (n = 6). To evaluate and compare the yields and quality of extracted RNAs from both methods, we used (1) Experion Bioanalyzer, (2) QuantiFluor RNA dye, and (3) NanoDrop 2000 Spectrometer.

Results:

With the modified TRIzol lysis protocol, a high yield of total RNA, on average 12.34 μg, from saliva was extracted compared with on average 0.2 μg with a spin column–based method. The average RQI (RNA quality index) with the TRIzol method was 7.86, which is also comparable with that of the spin column–based method (RQI = 7.58). QuantiFluor dye used for RNA quantification showed a 16-fold higher yield of RNA concentration using our TRIzol protocol.

Conclusions:

Our modified TRIzol protocol is a reproducible method to extract RNA from whole human saliva which can be used for gene expression analysis. This method allows also ensures the quality of RNA required for specific applications such as RNA sequencing.
Situationally orchestrated pedagogy: Teacher reflections on positioning as expert, facilitator, and caregiver
Authors: Blasco Maribel , Kjærgaard Annemette , Thomsen Thyra Uth
Published: June 2020

Based on qualitative data generated during a faculty development program for teachers of first-year students at a Danish business school, we explore teachers’ reflections about tactically mobilizing different positions in teaching situations. We propose that positioning theory offers a promising tool for understanding teachers’ assumptions about their professional identities and, when used in faculty development programs, can strengthen teachers’ awareness that they can situationally orchestrate pedagogy by purposefully shifting between different positions. Over time, this awareness may help to develop teachers’ situational wisdom. We introduce the concept of “pedagogical positioner” to capture this meta-positioning skill. We further identify three positions that teachers can adopt when teaching first-year students: the content expert, the learning facilitator, and the supportive caregiver. Based on positioning theory, we conceptualize the discursive positions, storylines, and rights and duties that emerge in teachers’ accounts of these shifts. Finally, we discuss the advantages and limitations of reflexive and interactive positioning in teaching, and suggest how awareness about different positions might be fostered through faculty development programs.
Legitimating complementary therapies in the NHS: Campaigning, care and epistemic labour
Authors: Dodworth Kathy , Stewart Ellen
Published: June 2020

Questions of legitimacy loom large in debates about the funding and regulation of complementary and alternative medicine (CAM) in contemporary health systems. CAM’s growth in popularity is often portrayed as a potential clash between clinical, state and scientific legitimacies and legitimacy derived from the broader public. CAM’s ‘publics’, however, are often backgrounded in studies of the legitimacy of CAM and present only as a barometer of the legitimating efforts of others. This article foregrounds the epistemic work of one public’s effort to legitimate CAM within the UK’s National Health Service: the campaign to ‘save’ Glasgow’s Centre for Integrative Care (CIC). Campaigners skilfully intertwined ‘experiential’ knowledge of the value of CIC care with ‘credentialed’ knowledge regarding best clinical and managerial practice. They did so in ways that were pragmatic as well as purist, reformist as well as oppositional. We argue for legitimation as negotiated practice over legitimacy as a stable state, and as labour borne by various publics as they insert themselves into matrices of knowledge production and decision-making within wider health care governance.
‘Machiavellian Russia’ in the Crimean conflict: Clarification of strategic narratives analysis method
Authors: Gackowski Tomasz , Brylska Karolina
Published: June 2020

The article concerns the strategic narratives concept as a tool of soft power and proposes methods and techniques of analysing strategic narratives. We argue that the best approach should apply a methodological triangulation which combines different methods and techniques while simultaneously addressing gaps in the implementation of theoretical perspectives. We present a theoretical concept of analysis and validate it using the example of a case study of the Crimea conflict in 2014 and 2015. Relying on the following three sources of original data: content analysis of media coverage (press comments over 8 weeks of 2014 and 2015), a cross-sectional survey (Computer Assisted Telephone Interviewing), and survey and focus group interviewing on the reception of Internet memes; we show that a strategic narrative works both in the media and in the opinions of media recipients. Investigating the ‘Machiavellian Russia’ strategic narrative, we show that mass-media interpretation of present events seems to depend on historical context and comparisons, which create a specific bubble around recipients of media messages.
Bayesian variable selection and shrinkage strategies in a complicated modelling setting with missing data: A case study using multistate models
Authors: Beesley Lauren J , Taylor Jeremy MG
Published: June 2020

Multistate modelling is a strategy for jointly modelling related time-to-event outcomes that can handle complicated outcome relationships, has appealing interpretations, can provide insight into different aspects of disease development and can be useful for making individualized predictions. A challenge with using multistate modelling in practice is the large number of parameters, and variable selection and shrinkage strategies are needed in order for these models to gain wider adoption. Application of existing selection and shrinkage strategies in the multistate modelling setting can be challenging due to complicated patterns of data missingness, inclusion of highly correlated predictors and hierarchical parameter relationships.

In this article, we discuss how to modify and implement several existing Bayesian variable selection and shrinkage methods in a general multistate modelling setting. We compare the performance of these methods in terms of parameter estimation and model selection in a multistate cure model of recurrence and death in patients treated for head and neck cancer. We can view this work as a case study of variable selection and shrinkage in a complicated modelling setting with missing data.
Safety and Efficacy of Drug-Coated Balloon Angioplasty for the Treatment of Chronic Limb-Threatening Ischemia: A Systematic Review and Meta-Analysis
Authors: Giannopoulos Stefanos , Ghanian Sheila , Parikh Sahil A. , Secemsky Eric A. , Schneider Peter A. , Armstrong Ehrin J.
Published: June 2020

Purpose: To investigate the safety and efficacy of drug-coated balloons (DCB) for the treatment of femoropopliteal or infrapopliteal lesions in patients with chronic limb-threatening ischemia (CLTI). Materials and Methods: A systematic literature search was conducted in PubMed, Scopus, and Cochrane Central up to January 2020 to identify randomized trials and observational studies presenting data on the effectiveness and safety of DCBs in the treatment of femoropopliteal or infrapopliteal lesions. A meta-analysis utilizing random effects modeling was conducted to investigate primary patency and all-cause mortality at 12 months; the results are reported as the odds ratios (ORs) and 95% confidence intervals (CIs). Secondary outcomes were procedural success, bailout stenting, target lesion revascularization (TLR), reocclusion, major amputation, wound healing, and major adverse limb events. Results: Twenty-six studies, 12 retrospective and 14 prospective, comprising 2108 CLTI patients treated with DCBs for femoropopliteal (n=1315) or infrapopliteal (n=793) lesions were analyzed. The average lesion lengths were 121±44 and 135±53 mm, respectively. The overall 12-month all-cause mortality and major amputation rates were 9% (95% CI 6% to 13%) and 5% (95% CI 2% to 8%), respectively. Primary patency rates were 82% (95% CI 76% to 87%) and 64% (95% CI 58% to 70%), respectively. A sensitivity analysis of the infrapopliteal lesions demonstrated no difference between DCB and balloon angioplasty in terms of primary patency, TLR, major amputation, or mortality over 12 months. However, patients with infrapopliteal lesions undergoing DCB angioplasty did have a significantly lower risk for reocclusion (10% vs 25%; OR 0.38, 95% CI 0.21 to 0.70, p=0.002). Conclusion: DCB angioplasty of femoropopliteal and infrapopliteal lesions in patients with CLTI results in acceptable 12-month patency rates, although comparative data have not shown a patency benefit for infrapopliteal lesions. The 12-month mortality rate of DCB vs balloon angioplasty was not significantly different, but studies with longer-term outcomes are necessary to determine any association between DCB use and mortality in patients with CLTI.
Who Might Support a Tyrant? An Exploration of Links Between Adolescent Family Conflict and Endorsement of Tyrannical Implicit Leadership Theories
Authors: Walker Dayna O. H. , Reichard Rebecca J. , Riggio Ronald E. , Keller Hansbrough Tiffany
Published: June 2020

This research takes an exploratory approach to shed light on the paradox that negative leader characteristics, such as pushy, obnoxious, and manipulative, appeal to some individuals. We employ social learning theory to argue how parents can model conflict for their adolescents, which may shape implicit leadership theories later in life. Spanning 21 years, this longitudinal study examines adolescent family environment and parents’ gender attitudes as antecedents of adult tyrannical implicit leadership theories using a sample of 102 individuals and their parents. Findings from multiple regression analyses suggest that high family conflict during formative years may predispose individuals to endorse the implicit leadership theory dimension known as tyranny. Furthermore, fathers’ egalitarian gender attitudes, as well as mothers’ masculine sex-types, may amplify this effect. Results inform the literature on leadership perceptions by surfacing the early life antecedents of paradoxical leadership preferences.
Adaptive dynamic programming-based controller with admittance adaptation for robot–environment interaction
Authors: Zhan Hong , Huang Dianye , Chen Zhaopeng , Wang Min , Yang Chenguang
Published: June 2020

The problem of optimal tracking control for robot–environment interaction is studied in this article. The environment is regarded as a linear system and an admittance control with iterative linear quadratic regulator method is obtained to guarantee the compliant behaviour. Meanwhile, an adaptive dynamic programming-based controller is proposed. Under adaptive dynamic programming frame, the critic network is performed with radial basis function neural network to approximate the optimal cost, and the neural network weight updating law is incorporated with an additional stabilizing term to eliminate the requirement for the initial admissible control. The stability of the system is proved by Lyapunov theorem. The simulation results demonstrate the effectiveness of the proposed control scheme.
Liberal and Democratic Egalitarian Rights: A Critical Legal Conception
Authors: McManus Matthew
Published: June 2020

This paper defends the need for a comprehensive critique of liberalism and the liberal approach to rights from the political left, in the vein of classical critical legal theory. However, it argues that critical legal theory was limited by its frequent unwillingness to put forward a counter normative approach which could inspire interest and activism. The paper therefore concludes by sketching out a more leftist approach to rights centering on an expressivist account of human dignity.
Redundancy allocation of mixed warm and cold standby components in repairable K-out-of-N systems
Authors: Gong Min , Liu Hanlin , Peng Rui
Published: June 2020

In system design process, standby redundancy is a widely used technique to improve system reliability and availability. Typical standby techniques involve cold standby, hot standby, and warm standby. In this article, we investigate the repairable K-out-of- N system with mixed standby strategy containing both warm and cold standby. In the proposed system, each component can be in failure, cold, warm, and active states and the components are assumed to be repairable. The systems are modeled by continuous time Markov chain and the system long-run availability is derived. Furthermore, the optimal configuration of standby components in the system is studied considering both system availability and system running cost. Illustrative examples are presented to show the applications of the proposed model.
Overview of multimodal analgesia initiated in the perioperative setting
Authors: Tubog Tito D
Published: June 2020

Despite progress in pain management in the perioperative setting, the literature is full of evidence that managing postoperative pain is suboptimal. Since the mechanism of pain is complex, the use of multimodal technique allows clinicians to use a combination of two or more drugs targeting different areas of pain transmission because of surgery. As part of enhanced recovery initiatives after surgery, healthcare and professional organisations incorporate the use of multimodal analgesia in surgical guidelines to improve patient satisfaction. This review aims to understand and summarise the current body of evidence involving the most common pharmacological therapies to manage postoperative pain in the preoperative setting.
Bereavement in critical care: A narrative review and practice exploration of current provision of support services and future challenges
Authors: Pattison Natalie A , White Catherine , Lone Nazir I
Published: June 2020

This special article outlines the background to bereavement in critical care and scopes the current provision and evidence for bereavement support following death in critical care. Co-authored by a family member and former critical care patient, we aim to draw out the current challenges and think about how and where support can be implemented along the bereavement pathway. We draw on the literature to examine different trajectories of dying in critical care and explore how these might impact bereavement, highlighting important points and risk factors for complicated grief. We present graphic representation of the critical junctures for bereavement in critical care. Adjustment disorders around grief are explored and the consequences for families, including the existing evidence base. Finally, we propose new areas for research in this field.
Left ventricular assist devices
Authors: Gwyn Jennifer CV
Published: June 2020

Background

There is a growing population of patients in the UK with advanced heart failure who are receiving a left ventricular assist device (LVAD) as a bridge to transplant. This is due to the plateauing number of heart transplantations and the increasing evidence of the effectiveness of these devices. It is, therefore, important that all clinicians working in an intensive care setting have an understanding of how LVADs work, whether as a district general physician referring a patient for consideration of implantation or a tertiary centre healthcare professional managing the complications.

Presentation

This case study describes the journey of a patient presenting with decompensated heart failure who failed to improve despite maximal medical intervention. The patient was not eligible for a heart transplant at the time, so an LVAD was inserted as a bridge to recovery of organ dysfunction and then eventual cardiac transplantation.

Discussion

This article will focus on providing an overview of the indications and anatomy of LVADs as well as the evidence behind their use so that intensive care professionals are aware of the potential of these devices. There will also be further discussion around complications of these devices and practical points to consider when managing a patient who has an LVAD in situ.
Low-dose statin pretreatment improves function and prognosis of recurrent ischemic stroke patients
Authors: Cui Chaohua , Dong Shuju , Chen Ning , Bao Jiajia , He Li
Published: June 2020

Background:

Statins are effective in improving the prognosis of stroke patients. In clinical practice, low-dose statins are often administered to stroke patients in Asian countries but their effects on the prognosis of recurrent ischemic stroke patients are still unclear.

Methods:

Data of consecutive recurrent ischemic stroke patients were prospectively collected. The National Institutes of Health Stroke Scale (NIHSS) of admission and discharge and the modified Rankin scale (mRs) of 90 days after stroke onset were adopted to evaluate primary outcomes. Secondary outcomes included the subgroup analysis.

Results:

Among 219 patients (mean age 65.41 ± 11.58 years), 150 (68.5%) were male. The low-dose statin group had a higher percentage of milder stroke at admission ( p < 0.001) and discharge ( p < 0.001), and favorable functional outcome at 90 days ( p < 0.001). Univariable regression analysis showed that the use of low-dose statins was inversely associated with higher discharge NIHSS [odds ratio (OR) = 0.36, p = 0.009] and higher mRs at 90 days (OR = 0.230, p < 0.001). Multivariable logistic regression analysis revealed that low-dose statins also had a significantly inverse association with higher mRs at 90 days (OR = 0.098, p = 0.049). According to subgroup analysis, a significant effect was found in the good-persistency subgroup (NIHSS score at discharge: OR = 0.051, p = 0.004; mRs score at 3 months: OR = 0.053, p = 0.005), but not in the poor-persistency subgroup.

Conclusion:

Low-dose statin pretreatment alleviated stroke severity and improved functional outcomes of recurrent stroke patients.