bluuebunny/crossref_metadata_2025 huggingface dataset:
The effectiveness of clinical pathway‐directed care on hospitalisation‐related outcomes in patients with severe traumatic brain injury: A quasi‐experimental study
Authors: Mohamed Warda Ramadan Abouzeid , Leach Matthew J. , Reda Nagwa Ahmad , Abd‐Ellatif Mohammad Mohamed , Mohammed Mona Aly , Abd‐Elaziz Mervat Anwar
Published: November 2017

Aims and objectives

To compare the effectiveness of clinical pathway‐directed care to usual care on hospitalisation‐related outcomes in patients with severe traumatic brain injury (STBI).

Background

Severe traumatic brain injury is a major cause of disability and mortality in young adults. Clinical pathways endeavour to bring evidence and clinical practice closer together to foster the delivery of best practice and to improve patient outcomes.

Design

Quasi‐experimental study.

Methods

The study was conducted in a trauma intensive care unit of a large teaching hospital in Egypt. Patients aged 18–60 years with a diagnosis ofSTBI, a Glasgow Coma Scale score between 3–8 and a nonpenetrating head injury were consecutively assigned to 15 days of care. The outcomes assessed were complications related to hospitalisation, clinical variances, length of intensive care unit (ICU) stay,ICUreadmission rate and patient/family satisfaction.

Results

Sixty participants completed the study (30 in each arm). Apart from age, there were no significant differences between groups in baseline characteristics. The clinical pathway group demonstrated statistically significantly fewer cases of hospitalisation‐related complications on day 15, and a significantly shorter length ofICUstay, lowerICUreadmission rate and a high level of patient/family satisfaction when compared with the usual care group. The effect of the intervention on fever, pressure ulceration, hyperglycaemia and readmission to theICUwas no longer statistically significant after controlling for age.

Conclusions

The findings of the current study suggest that the implementation of a clinical pathway for patients with severeTBImay be helpful in improving the patient experience as well as some hospitalisation‐related outcomes.

Relevance to clinical practice

The provision of clinical pathway‐directed care in a traumaICUmay offer benefits to the patient, family and institution beyond that provided by usual care.
Nurses’ preparedness for infectious disease outbreaks: A literature review and narrative synthesis of qualitative evidence
Authors: Lam Stanley K. K. , Kwong Enid W. Y. , Hung Maria S. Y. , Pang Samantha M. C. , Chiang Vico C. L.
Published: November 2017

Aims and objectives

To explore the core components that constitute nurses’ preparedness in an epidemic event.

Background

Healthcare service providers have worked to augment efforts to protect the public from the impact of epidemic events. While constituting the major healthcare taskforce, nurses are frequently tasked with fronting the response to an infectious disease outbreak. Given the crucial role of nurses in the management of prevailing epidemics, the constituents of their preparedness in epidemic events should be identified.

Design

A systematic search was undertaken to identify eligible studies from the literature. A narrative synthesis approach was employed to extract and synthesise findings of the reviewed qualitative studies.

Methods

Seven qualitative studies on nurses’ experience and perceptions of epidemic events were examined for scientific quality using the Critical Appraisal Skills Programme Qualitative Checklist. Findings of these studies were synthesised adopting a narrative synthesis approach.

Results

Three interplaying themes were identified as follows: (i) personal resources, (ii) workplace resources and (iii) situational influences. The findings suggest that an effective epidemic outbreak response would require further effort to reinforce the interplay between individual nurses, healthcare institutions and the governments.

Conclusions

The practical interplay among individual nurses, healthcare institutions and the governments is crucial in establishing an effective epidemic response. Further research on the understanding of the dynamic process of preparedness development is recommended to set future directions in research.

Relevance to clinical practice

This study offers important insights for devising future strategies in enhancing nurses’ preparedness and response to an epidemic event. These include recommendations on providing education and training to nurses regarding infectious diseases, fostering institutional assistance and support in an outbreak and revising government policies and planning.
Oral cancer databases: A comprehensive review
Authors: Sarode Gargi S. , Sarode Sachin C. , Maniyar Nikunj , Anand Rahul , Patil Shankargouda
Published: November 2017

Cancer database is a systematic collection and analysis of information on various human cancers at genomic and molecular level that can be utilized to understand various steps in carcinogenesis and for therapeutic advancement in cancer field. Oral cancer is one of the leading causes of morbidity and mortality all over the world. The current research efforts in this field are aimed at cancer etiology and therapy. Advanced genomic technologies including microarrays, proteomics, transcrpitomics, and gene sequencing development have culminated in generation of extensive data and subjection of several genes and microRNAs that are distinctively expressed and this information is stored in the form of various databases. Extensive data from various resources have brought the need for collaboration and data sharing to make effective use of this new knowledge. The current review provides comprehensive information of various publicly accessible databases that contain information pertinent to oral squamous cell carcinoma (OSCC) and databases designed exclusively for OSCC. The databases discussed in this paper are Protein‐Coding Gene Databases and microRNA Databases. This paper also describes gene overlap in various databases, which will help researchers to reduce redundancy and focus on only those genes, which are common to more than one databases. We hope such introduction will promote awareness and facilitate the usage of these resources in the cancer research community, and researchers can explore the molecular mechanisms involved in the development of cancer, which can help in subsequent crafting of therapeutic strategies.
Impact of untreated dental caries on the daily activities of children
Authors: Souza João Gabriel Silva , Souza Samilly Evangelista , Noronha Mayara dos Santos , Ferreira Efigênia Ferreira e , Martins Andrea Maria Eleutério de Barros Lima
Published: November 2017

Objectives

Untreated dental caries can compromise oral health‐related quality of life (OHRQoL). However, it is not clear which specific daily activities related to OHRQoL are compromised by the presence of this problem. Therefore, the purpose of this study was to identify which specific daily activities are affected by the presence of untreated dental caries using a representative sample of Brazilian children.

Methods

A cross‐sectional study using a representative sample of Brazilian children (12 years of age) was conducted. The presence of untreated dental caries was assessed using the “decayed – D” component of the DMFT (decayed, missing, and filled teeth) index. Clinical exams were conducted by trained and calibrated dentists. The daily activities were evaluated using the survey Oral Impacts on Daily Performance (OIDP), considering items and domains. Descriptive, bivariate, and multiple analyses were conducted (α = 0.05).

Results

A total of 7,247 children were included, and 39.9 percent had at least one tooth with untreated dental caries, with 33.5 percent experiencing an impact on at least one of the OIDP activities. This study identified a greater chance of the presence of untreated dental caries in children having an impact on the psychological domain (P = 0.006), as well as on the “difficulty eating” (P = 0.007), and “difficulty sleeping” (P = 0.023) items.

Conclusion

The presence of untreated dental caries among Brazilian children was associated with an impact on specific daily activities (difficulty eating and sleeping) and the psychological domain of OHRQoL.
A review of sleep disturbance in children and adolescents with anxiety
Authors: Brown Wilson J. , Wilkerson Allison K. , Boyd Stephen J. , Dewey Daniel , Mesa Franklin , Bunnell Brian E.
Published: November 2017

The present review examines the relations between sleep disturbance and anxiety in children and adolescents. The review begins with a detailed discussion of normative developmental trends in sleep, and the relation between sleep quality and emotion dysregulation in children. The extant literature on sleep disturbance in clinically anxious children with a focus on subjective versus objective measures of sleep is then summarized in detail. Finally, a review of the reciprocal relationship between sleep and emotion regulation is provided. The available research suggests that sleep disturbance is quite prevalent in children with anxiety disorders, although the directionality of the association between sleep disturbance and anxiety in children remains unclear. Despite this limitation, a reciprocal relationship between sleep quality and anxiety appears to be well established. Research using objective measures of sleep quality (e.g. polysomnography, sleep actigraphy, sleep bruxism) is warranted to better understand this relation. Further, complicating factors such as the environment in which sleep quality is measured, the developmental stage of participants, varying severity of anxiety and the timeframe during which assessment takes place should all be considered when examining sleep disturbance in this population.
Effect of Dietary Carbohydrate‐to‐Lipid Ratio on Growth and Carcass Composition of Juvenile Abalone, Haliotis discus, Reeve 1846
Authors: Lee Ki W. , Kim Hee S. , Jeong Hae S. , Kim June , Yun Ah‐Yeong , Cho Sung H.
Published: November 2017

The optimal dietary carbohydrate (C) : lipid (L) ratio on growth and carcass composition of juvenile abalone, Haliotis discus, was determined. A total of 1260 juveniles were randomly distributed into 18 containers. Six experimental diets containing different ratios of C to L (49:1, 48:2, 47:3, 45:5, 43:7, and 41:9) were prepared and referred to as the C49:L1, C48:L2, C47:L3, C45:L5, C43:L7, and C41:L9 diets, respectively. Water stability of the experimental diets was measured 12, 24, and 48 h after seawater immersion. Crude protein, L and ash content of the experimental diets decreased with time. Survival of abalone fed the C48:L2 diet was higher than that of abalone fed the C49:L1 and C41:L9 diets. Weight gain and specific growth rate (SGR) of abalone fed the C49:L1, C48:L2, and C47:L3 diets were higher than that of abalone fed the C45:L5, C43:L7, and C41:L9 diets. Crude L content of the soft body of abalone was directly reflected from dietary crude L content. In conclusion, the optimal dietary C : L ratio was estimated to be 48:2 and 47:3 based on survival, weight gain, and SGR of juvenile abalone, respectively. Greater than 3% L content in the diet deteriorated performance of this species of abalone.
Ancient chromosomal rearrangement associated with local adaptation of a postglacially colonized population of Atlantic Cod in the northwest Atlantic
Authors: Sinclair‐Waters Marion , Bradbury Ian R. , Morris Corey J. , Lien Sigbjørn , Kent Matthew P. , Bentzen Paul
Published: November 2017

Intraspecific diversity is central to the management and conservation of exploited species, yet knowledge of how this diversity is distributed and maintained in the genome of many marine species is lacking. Recent advances in genomic analyses allow for genome‐wide surveys of intraspecific diversity and offer new opportunities for exploring genomic patterns of divergence. Here, we analysed genome‐wide polymorphisms to measure genetic differentiation between an offshore migratory and a nonmigratory population and to define conservation units of Atlantic Cod (Gadus morhua) in coastal Labrador. A total of 141 individuals, collected from offshore sites and from a coastal site within Gilbert Bay, Labrador, were genotyped using an ~11k single nucleotide polymorphism array. Analyses of population structure revealed strong genetic differentiation between migratory offshore cod and nonmigratory Gilbert Bay cod. Genetic differentiation was elevated for loci within a chromosomal rearrangement found on linkage group 1 (LG1) that coincides with a previously found double inversion associated with migratory and nonmigratory ecotype divergence of cod in the northeast Atlantic. This inverted region includes several genes potentially associated with adaptation to differences in salinity and temperature, as well as influencing migratory behaviour. Our work provides evidence that a chromosomal rearrangement on LG1 is associated with parallel patterns of divergence between migratory and nonmigratory ecotypes on both sides of the Atlantic Ocean.
Preliminary study on the effects of heavy metals on the growth and some antioxidant enzymes in Arthrospira platensis‐M2 strain
Authors: Önem Burçin , Doğru Ali , Ongun Sevindik Tuğba , Tunca Hatice
Published: November 2017

In this study, we have analyzed superoxide dismutase (SOD), ascorbate peroxidase (APX) and glutathione reductase (GR) activities, biomass accumulation and chlorophyll‐a content in the Arthrospira platensis‐M2 strain grown at different concentrations of zinc (Zn), tin (Sn) and mercury (Hg). We found that there is a close relationship between chlorophyll‐a content and biomass accumulation in A. platensis‐M2 strain as a result of Zn, Sn and Hg exposures. Sn was found to be the most toxic heavy metal among others because of the continious inhibition of both biomass and chlorophyll‐a accumulation at 500 and 1000 μg mL−1 concentrations after the third day of the study, while they represented continuous increases at each Zn and Hg concentration over 7 days. Lower concentrations of Zn and Sn stimulate SOD and GR activities remarkably, probably due to oxidative stress caused by heavy metal toxicity. APX activity was significantly lowered by higher concentrations of the three metals used in this study. Our results suggest that higher heavy metal concentrations inhibited SOD, APX and GR activities but biomass and chlorophyll‐a accumulation endured in a time‐dependent manner, possibly due to some different defence mechanisms, which remain to be investigated.
Citizen Participation, Process, and Transparency in Local Government: An Exploratory Study
Authors: Kim Soonhee , Lee Jooho
Published: November 2017

This study had two purposes. First, it empirically examined the relationship between citizens' participation in administrative policymaking phases and their perception of government transparency. Second, it investigated how citizens' use of both offline and online participation channels and their involvement in different phases of policymaking (i.e., agenda setting, implementation, and evaluation) were related to their assessment of transparency in government. A 2009 survey of residents of Seoul, South Korea, was used to test the study hypotheses. Using two‐stage least squares estimate techniques, the study found that citizens involved in any citizen participation programs are more likely than those not involved to positively assess transparency in government. With regard to the relationship between participation channels and transparency, citizens who used offline participation channels were more likely than nonusers to perceive enhanced transparency in local government. However, their use of online participation channels had limited effect on perceptions of transparency. Finally, participation in two phases of the policy process, agenda setting and evaluation, positively affected citizens' assessment of transparency in government.
Early signs of cardiovascular dysregulation in young adult binge drinkers
Authors: Vaschillo Evgeny G. , Vaschillo Bronya , Buckman Jennifer F. , Heiss Sydney , Singh Gurpreet , Bates Marsha E.
Published: November 2017

Binge drinking is widespread on American college campuses, but its effects on the cardiovascular system are poorly understood. This study sought evidence of preclinical cardiovascular changes in binge drinking young adults (n = 24) compared to nondrinking (n = 24) and social drinking (n = 23) peers during baseline, paced sighing (0.033 Hz), and paced breathing (0.1 Hz) tasks. Binge drinkers showed consistent but often statistically nonsignificant evidence of greater sympathetic activation and reduced baroreflex sensitivity. Interestingly, the structure of group‐averaged baseline heart rate spectra was considerably different between groups in the low frequency range (0.05–0.15 Hz). In particular, the binge drinking group–averaged spectra showed several spectral peaks not evident in the other groups, possibly indicating two functionally distinct subranges (0.05–0.08 and 0.08–0.15 Hz) that reflect vascular tone baroreflex activity and heart rate baroreflex activity, respectively. Vascular tone baroreflex gain and power in two peaks in the 0.05–0.08 Hz range were associated with years of drinking in the binge drinking group. Vascular dysfunction may be an early indicator of drinking‐related change in the cardiovascular system.
Does informal caregiving affect self‐esteem? Results from a population‐based study of individuals aged 40 and over in Germany from 2002 to 2014
Authors: Hajek André , König Hans‐Helmut
Published: November 2017

Background

While it is known that informal caregiving is associated with care‐derived self‐esteem cross‐sectionally, little is known about the impact of informal caregiving on general self‐esteem longitudinally. Thus, we aimed at examining whether informal caregiving affects general self‐esteem using a longitudinal approach.

Methods

Data were gathered from a population‐based sample of community‐dwelling individuals aged 40 and over in Germany from 2002 to 2014 (n = 21 271). General self‐esteem was quantified using the Rosenberg scale. Individuals were asked whether they provide informal care regularly.

Results

Fixed effects regressions showed no significant effect of informal caregiving on general self‐esteem longitudinally. General self‐esteem decreased with increasing morbidity, increasing age, decreasing social ties, whereas it was not associated with changes in employment status, marital status and body mass index. Additional models showed that decreases in self‐esteem were associated with decreases in functional health and increases in depressive symptoms.

Conclusion

Our longitudinal study emphasises that the occurrence of informal caregiving did not affect general self‐esteem longitudinally. Further research is needed in other cultural settings using panel data methods.
The development of D antibodies after D‐mismatched kidney transplantation in a setting of reduced immunosuppression
Authors: Habets Thomas H.P.M. , Vanderlocht Joris , Straat Ron J.M.H.E. , van Smaalen Tim C. , Bos Gerard M.J. , Beckers Erik A. , Christiaans Maarten H.L. , Henskens Yvonne M.C.
Published: November 2017

BACKGROUND

D antigens are not taken into account in the allocation of solid organs. Female transplant recipients with D antibodies as a consequence of D‐mismatched kidney transplantation may develop hemolytic disease of the fetus and newborn in future pregnancies. We examined D antibody development in transplant recipients who received D‐mismatched kidney transplantation in absence of D prophylaxis and in a setting of reduced immunosuppression.

STUDY DESIGN AND METHODS

From 1993 until 2015, a total of 1355 kidney patients received transplantations in our center of whom 156 received a D‐mismatched graft. A retrospective analysis was conducted; frozen stored sera obtained from transplant recipients 3 months after transplantation were tested for irregular red blood cell (RBC) antibodies using a three‐cell screening and an identification panel. In the case of D antibody positivity, additional testing was performed 1 month before transplantation.

RESULTS

In seven of 156 (4.5%) transplant recipients we found irregular RBC antibodies after transplantation, of which five (3.2%) were determined to be D antibodies. We observed only one (0.6%) recipient without D antibodies before transplantation.

CONCLUSION

Although the risk of D antibody development is considerably lower after D‐mismatched kidney transplantation than D‐mismatched pregnancy, anti‐D prophylaxis may still be advisable for female transplant recipients of childbearing age.
Validating and implementing the use of an infusion pump for the administration of thawed hematopoietic progenitor cells—a single‐institution experience
Authors: Reich‐Slotky Ronit , Cushing Melissa M. , Hsu Yen‐Michael S. , Ancharski Michael , Rojas Johanna M. , Scrimenti Lara M. , Robilio Shawna , Assalone Dianna , Roselli Therese , Guarneri Danielle , Vasovic Ljiljana V. , Goel Ruchika , Shore Tsiporah , van Besien Koen
Published: November 2017

BACKGROUND

Direct thaw and administration of previously cryopreserved peripheral blood stem cell products is a commonly used practice and should be performed rapidly to reduce cellular damage caused by dimethyl sulfoxide exposure. Cells are typically thawed at the bedside and infused by gravity through a high‐flow‐rate central venous catheter. An existing nontunneled catheter is occasionally used instead and often results in a slower infusion rate. To ensure expedient and consistent infusions, we validated and implemented the use of an infusion pump for thawed peripheral blood stem cells.

STUDY DESIGN AND METHODS

Validation was performed in two phases: in vitro simulation and in vivo clinical assessment. Total nucleated cell recovery and viability plus progenitor cell viability and potency were compared in vitro between two cryopreserved peripheral blood stem cell units that were either passed through a preset infusion pump or drained by gravity. The infusion rate, adverse events, and engraftment times were retrospectively compared between patients who received infusions by infusion pump (n = 35) and by gravity (n = 38).

RESULTS

No significant differences were observed in vitro between the infusion methods for all measured variables. Overall infusion rates were similar in vivo for both groups but were significantly lower for patients who had nontunneled catheters that delivered the infusion by gravity. The time to neutrophil and platelet engraftment was similar for both groups.

CONCLUSION

This is the first study to assess the use of an infusion pump for stem cell transplant. The use of an infusion pump for peripheral blood stem cell infusion is safe, provides a reliable and consistent infusion method, and can mitigate the effect of the type of venous access line used.
Intravenous immunoglobulin–induced acute thrombocytopenia
Authors: Gurevich‐Shapiro Anna , Bonstein Lilach , Spectre Galia , Atweh Nardeen , Gruenewal Tsipora , Shapiro Michael , Tadmor Boaz , Raanani Pia
Published: November 2017

BACKGROUND

Intravenous immunoglobulin (IVIG) has known efficacy in various hematologic conditions, including immune thrombocytopenic purpura.

STUDY DESIGN AND METHODS

We present the clinical course of a patient with splenic marginal zone lymphoma, who developed acute thrombocytopenia on three consecutive episodes, with nadir counts of 27 × 109, 50 × 109, and 9 × 109/L, upon administration of Intratect IVIG for hypogammaglobulinemia. An immunofluorescence test applying flow cytometry and monoclonal antibody immobilization of platelet antigens (MAIPA) assay were used to evaluate the reaction between IgG present in the IVIG preparations and the patient's or healthy donors' platelets (PLTs).

RESULTS

A strong direct binding reaction was observed between the patient's PLTs and Intratect IgG using both methods. A similar reaction failed to materialize with controls. Binding was not antigen specific according to MAIPA.

CONCLUSIONS

This is the first reported case of thrombocytopenia as a possible adverse effect of IVIG.
KK graviton resonance and cascade decays in warped gravity
Authors: Dillon Barry M. , Han Chengcheng , Lee Hyun Min , Park Myeonghun
Published: November 2017

We consider the Kaluza–Klein (KK) graviton and its decays in the presence of the light radion, the modulus of extra dimension, appearing naturally light due to classical scale invariance in warped gravity. Due to the presence of a sizable wave function overlap in the extra dimension between the KK graviton and the radion, the KK graviton can decay largely into a pair of radions, each of which decays into a pair of collimated photons or photon-jets. Focusing on the setup where the KK graviton has suppressed couplings to the Higgs boson and fermions, we discuss the bounds on the light radion in the parameter space where the photon-jets are relevant. Moreover, we pursue the possibility of distinguishing the scenario from the case with direct photon contributions by the angular distributions of photons in the LHC Run 2. Roles of KK graviton and radion as mediators of dark matter interactions, extensions with brane kinetic terms and the model with a holographic composite Higgs are also addressed.
Estimating properties of the fast and slow adaptive processes during sensorimotor adaptation
Authors: Albert Scott T. , Shadmehr Reza
Published: November 2017

Experience of a prediction error recruits multiple motor learning processes, some that learn strongly from error but have weak retention and some that learn weakly from error but exhibit strong retention. These processes are not generally observable but are inferred from their collective influence on behavior. Is there a robust way to uncover the hidden processes? A standard approach is to consider a state space model where the hidden states change following experience of error and then fit the model to the measured data by minimizing the squared error between measurement and model prediction. We found that this least-squares algorithm (LMSE) often yielded unrealistic predictions about the hidden states, possibly because of its neglect of the stochastic nature of error-based learning. We found that behavioral data during adaptation was better explained by a system in which both error-based learning and movement production were stochastic processes. To uncover the hidden states of learning, we developed a generalized expectation maximization (EM) algorithm. In simulation, we found that although LMSE tracked the measured data marginally better than EM, EM was far more accurate in unmasking the time courses and properties of the hidden states of learning. In a power analysis designed to measure the effect of an intervention on sensorimotor learning, EM significantly reduced the number of subjects that were required for effective hypothesis testing. In summary, we developed a new approach for analysis of data in sensorimotor experiments. The new algorithm improved the ability to uncover the multiple processes that contribute to learning from error.

NEW & NOTEWORTHY Motor learning is supported by multiple adaptive processes, each with distinct error sensitivity and forgetting rates. We developed a generalized expectation maximization algorithm that uncovers these hidden processes in the context of modern sensorimotor learning experiments that include error-clamp trials and set breaks. The resulting toolbox may improve the ability to identify the properties of these hidden processes and reduce the number of subjects needed to test the effectiveness of interventions on sensorimotor learning.
Quantitative input-output relationships between human soleus muscle spindle afferents and motoneurons
Authors: McComas Alan , deBruin Hubert , Fu Winnie
Published: November 2017

A method is described that, for the first time, allows instantaneous estimation of the Ia fiber input to human soleus motoneurons following electrical stimulation of the tibial nerve. The basis of the method is to determine the thresholds of the most and least excitable 1a fibers to electrical stimulation, and to treat the intervening thresholds as having a normal distribution about the mean; the validity of this approach is discussed. It was found that, for the same Ia fiber input, the percentage of soleus motoneurons contributing to the H (Hoffmann)-reflex differed considerably among subjects; when the results were pooled, however, there was an approximately linear relationship between Ia input and motoneuron output. Weak extension of the great toe diminished the soleus motoneuron reflex discharge in all but 2 of 16 subjects; the results for weak ankle plantarflexion were less consistent, but overall, there was a reduction in soleus motoneuron output also. The methodology should provide new insights into disorders of movement and tone, especially as it permits estimates of motoneuron depolarization to be made.

NEW & NOTEWORTHY Assuming a normal distribution of Ia fiber thresholds to electrical stimulation and using the H-reflex, we determined for the first time an Ia input-α-motoneuron output relationship for the human soleus muscle. The relationship varies greatly among subjects but, overall, is approximately linear. Minimal contraction of a toe muscle alters the relationship dramatically, probably due to presynaptic inhibition of Ia fibers. Drawing on the literature, we can calculate changes in α-motoneuron membrane potential.
Implantable computer-controlled adaptive multielectrode positioning system
Authors: Ferrea E. , Suriya-Arunroj L. , Hoehl D. , Thomas U. , Gail A.
Published: November 2017

Acute neuronal recordings performed with metal microelectrodes in nonhuman primates allow investigating the neural substrate of complex cognitive behaviors. Yet the daily reinsertion and positioning of the electrodes prevents recording from many neurons simultaneously, limiting the suitability of these types of recordings for brain-computer interface applications or for large-scale population statistical methods on a trial-by-trial basis. In contrast, chronically implanted multielectrode arrays offer the opportunity to record from many neurons simultaneously, but immovable electrodes prevent optimization of the signal during and after implantation and cause the tissue response to progressively impair the transduced signal quality, thereby limiting the number of different neurons that can be recorded over the lifetime of the implant. Semichronically implanted matrices of electrodes, instead, allow individually movable electrodes in depth and achieve higher channel count compared with acute methods, hence partially overcoming these limitations. Existing semichronic systems with higher channel count lack computerized control of electrode movements, leading to limited user-friendliness and uncertainty in depth positioning. Here we demonstrate a chronically implantable adaptive multielectrode positioning system with detachable drive for computerized depth adjustment of individual electrodes over several millimeters. This semichronic 16-channel system is designed to optimize the simultaneous yield of units in an extended period following implantation since the electrodes can be independently depth adjusted with minimal effort and their signal quality continuously assessed. Importantly, the electrode array is designed to remain within a chronic recording chamber for a prolonged time or can be used for acute recordings with high signal-to-noise ratio in the cerebral cortex of nonhuman primates.

NEW & NOTEWORTHY We present a 16-channel motorized, semichronic multielectrode array with individually depth-adjustable electrodes to record in the cerebral cortex of nonhuman primates. Compared with fixed-geometry arrays, this system allows repeated reestablishing of single neuron isolation. Compared with manually adjustable arrays it benefits from computer-controlled positioning. Compared with motorized semichronic systems it allows higher channel counts due to a robotic single actuator approach. Overall the system is designed to optimize the simultaneous yield of units over the course of implantation.
Nrf2 at the heart of oxidative stress and cardiac protection
Authors: Chen Qin M. , Maltagliati Anthony J.
Published: November 2017

The NFE2L2 gene encodes the transcription factor Nrf2 best known for regulating the expression of antioxidant and detoxification genes. Gene knockout approaches have demonstrated its universal cytoprotective features. While Nrf2 has been the topic of intensive research in cancer biology since its discovery in 1994, understanding the role of Nrf2 in cardiovascular disease has just begun. The literature concerning Nrf2 in experimental models of atherosclerosis, ischemia, reperfusion, cardiac hypertrophy, heart failure, and diabetes supports its cardiac protective character. In addition to antioxidant and detoxification genes, Nrf2 has been found to regulate genes participating in cell signaling, transcription, anabolic metabolism, autophagy, cell proliferation, extracellular matrix remodeling, and organ development, suggesting that Nrf2 governs damage resistance as well as wound repair and tissue remodeling. A long list of small molecules, most derived from natural products, have been characterized as Nrf2 inducers. These compounds disrupt Keap1-mediated Nrf2 ubquitination, thereby prohibiting proteasomal degradation and allowing Nrf2 protein to accumulate and translocate to the nucleus, where Nrf2 interacts with sMaf to bind to ARE in the promoter of genes. Recently alternative mechanisms driving Nrf2 protein increase have been revealed, including removal of Keap1 by autophagy due to p62/SQSTM1 binding, inhibition of βTrCP or Synoviolin/Hrd1-mediated ubiquitination of Nrf2, and de novo Nrf2 protein translation. We review here a large volume of literature reporting historical and recent discoveries about the function and regulation of Nrf2 gene. Multiple lines of evidence presented here support the potential of dialing up the Nrf2 pathway for cardiac protection in the clinic.
Meta-evaluation of a participatory process in the strengthening of municipal management
Authors: Almeida Cristiane Andrea Locatelli de , Tanaka Oswaldo Yoshimi
Published: November 2017

OBJECTIVE: To evaluate, with a focus on participation, an evaluation process developed by municipal managers and administrators of a health region in the state of São Paulo, considering the need for theoretical reflection on participatory health practices in the Brazilian context. METHODS: Qualitative research that used the framework developed by Daigneault and Jacob (2009) to analyze the empirical material, encompassing three dimensions of participation: control of the evaluation process, diversity of participants, and extent of their involvement. We highlighted decisions or contextual aspects that deepened or limited the participatory option in the process under study. RESULTS: We identified the presence and important performance of stakeholders who are “not specialists in evaluation”, through participation both in the direction of the evaluation process and in its distinct stages. The formed group started from their own annoyances added to the need for information and reflection to define the subject and scope of the evaluation; the use of the process planned by them guided the definition of the data to be collected and the format of result dissemination; the empirical material analysis was undertaken jointly by the participants. Regarding the third dimension, a limitation was identified regarding the diversity of actors involved due to the prioritization of the possibility of in-depth work with a fixed group of managers. CONCLUSIONS: It is stated that there is no “ideal participation model” for evaluations. In certain contexts and structures, real opportunities for participation – even if they seem fragile at first sight – should be leveraged, and that requires flexibility and critical reflection on the part of those responsible for the evaluation processes to undertake the necessary adjustments.
Caesarean birth rates in public and privately funded hospitals: a cross-sectional study
Authors: Alonso Bruna Dias , Silva Flora Maria Barbosa da , Latorre Maria do Rosário Dias de Oliveira , Diniz Carmen Simone Grilo , Bick Debra
Published: November 2017

OBJECTIVE: To examine maternal and obstetric factors influencing births by cesarean section according to health care funding. METHODS: A cross-sectional study with data from Southeastern Brazil. Caesarean section births from February 2011 to July 2012 were included. Data were obtained from interviews with women whose care was publicly or privately funded, and from their obstetric and neonatal records. Univariate and multivariate analyses were conducted to generate crude and adjusted odds ratios (OR) with 95% confidence intervals (95%CI) for caesarean section births. RESULTS: The overall caesarean section rate was 53% among 9,828 women for whom data were available, with the highest rates among women whose maternity care was privately funded. Reasons for performing a c-section were infrequently documented in women’s maternity records. The variables that increased the likelihood of c-section regardless of health care funding were the following: paid employment, previous c-section, primiparity, antenatal and labor complications. Older maternal age, university education, and higher socioeconomic status were only associated with c-section in the public system. CONCLUSIONS: Higher maternal socioeconomic status was associated with greater likelihood of a caesarean section birth in publicly funded settings, but not in the private sector, where funding source alone determined the mode of birth rather than maternal or obstetric characteristics. Maternal socioeconomic status and private healthcare funding continue to drive high rates of caesarean section births in Brazil, with women who have a higher socioeconomic status more likely to have a caesarean section birth in all birth settings.
Reality and Fiction in Contemporary Television: The Case of Skam
Authors: Pearce Connor
Published: November 2017

Skam, a Norwegian television series, uses social media accounts that purport to represent the world of the characters to integrate the drama of the series with the lived reality of the audience. This makes for a unique aesthetic experience that enquires into the role that social media plays in the lives of young people in the Western world, and how the dominance of this mode of interaction forces a reevaluation of our understanding of reality and fiction.
Here We Are Again: Performing the Temporality of the Brazilian Transition
Authors: Steuernagel Marcos
Published: November 2017

In 2011, Brazilian theatre group Ói Nóis Aqui Traveiz staged an environmental production of Ariel Dorfman’s play Widows on an island that held political prisoners during the country’s military regime. In Viúvas-Performance sobre a ausência, Ói Nóis Aqui Traveiz, one of the most politically engaged theatre groups in the country, discloses relationships between disappearance, memory, and resistance in both politics and performance.
The Dogma of History
Authors: Beardslee Michael D.
Published: November 2017

This essay considers the role of historiography in doctrinal criticism from a hermeneutical perspective and in light of postcolonial and postmodern criticisms. First, historiography is defined using a Gadamerian typology, providing the basis for an analysis of Kenneth Scott Latourette’s well-respected essay on Christian historiography. This reading of Latourette illuminates the dogmatic nature of the prejudices informing Christian historical scholarship. Finally, these insights are applied to doctrinal criticism, arguing that the relationship between doctrine and historiography is dialectical, rather than one element having dominance over the other. It concludes by suggesting a chastened, “two-tiered” approach to doctrinal criticism capable of responding to the charges mentioned and to current trends in global Christianity.
Implementing r2p: Towards a Regional Solution?
Authors: Adediran Bolarinwa
Published: November 2017

Since the adoption of the principles of the Responsibility to Protect (r2p) in 2005, proponents and critics alike have accepted that it has not brought about a consistent and effective response to mass atrocity crimes. The incapacity that the Security Council exhibits in addressing the Syrian conflict provides a compelling justification for the need to examine alternative mechanisms through which the principles of the doctrine can be implemented. This paper argues that regional organisations should be considered legitimate authorising mechanisms in place of the Security Council in implementing r2p. The use of regional institutions as authorising mechanisms has not been properly considered or rigorously defended. In the paper, I make a case for regional organisations in authorising international action during mass atrocity situations by first establishing the legitimacy of regional organisations to act in response to local disputes. I propose and defend four arguments that provide justification and establish the utility of regional arrangements as alternative authorising mechanisms. I also examine and respond to three key objections that can be made against regional organisations. Finally, I outline a set of criteria that should determine which regional organisations are considered legitimate actors during mass atrocity situations.
Impact of Volcanic Eruptions on Decadal to Centennial Fluctuations of Arctic Sea Ice Extent during the Last Millennium and on Initiation of the Little Ice Age
Authors: Slawinska Joanna , Robock Alan
Published: November 2017

This study evaluates different hypotheses of the origin of the Little Ice Age, focusing on the long-term response of Arctic sea ice and oceanic circulation to solar and volcanic perturbations. The authors analyze the Last Millennium Ensemble of climate model simulations carried out with the Community Earth System Model at the National Center for Atmospheric Research. The authors examine the duration and strength of volcanic perturbations, and the effects of initial and boundary conditions, such as the phase of the Atlantic multidecadal oscillation. They evaluate the impacts of these factors on decadal-to-multicentennial perturbations of the cryospheric, oceanic, and atmospheric components of the climate system. The authors show that, at least in the Last Millennium Ensemble, volcanic eruptions are followed by a decadal-scale positive response of the Atlantic multidecadal overturning circulation, followed by a centennial-scale enhancement of the Northern Hemispheric sea ice extent. It is hypothesized that a few mechanisms, not just one, may have to play a role in consistently explaining such a simulated climate response at both decadal and centennial time scales. The authors argue that large volcanic forcing is necessary to explain the origin and duration of Little Ice Age–like perturbations in the Last Millennium Ensemble. Other forcings might play a role as well. In particular, prolonged fluctuations in solar irradiance associated with solar minima potentially amplify the enhancement of the magnitude of volcanically triggered anomalies of Arctic sea ice extent.
The Value of Remotely Sensed Information: The Case of a GRACE-Enhanced Drought Severity Index
Authors: Bernknopf Richard , Brookshire David , Kuwayama Yusuke , Macauley Molly , Rodell Matthew , Thompson Alexandra , Vail Peter , Zaitchik Benjamin
Published: November 2017

A decision framework is developed for quantifying the economic value of information (VOI) from the Gravity Recovery and Climate Experiment (GRACE) satellite mission for drought monitoring, with a focus on the potential contributions of groundwater storage and soil moisture measurements from the GRACE data assimilation (GRACE-DA) system. The study consists of (i) the development of a conceptual framework to evaluate the socioeconomic value of GRACE-DA as a contributing source of information to drought monitoring; (ii) structured listening sessions to understand the needs of stakeholders who are affected by drought monitoring; (iii) econometric analysis based on the conceptual framework that characterizes the contribution of GRACE-DA to the U.S. Drought Monitor (USDM) in capturing the effects of drought on the agricultural sector; and (iv) a demonstration of how the improved characterization of drought conditions may influence decisions made in a real-world drought disaster assistance program. Results show that GRACE-DA has the potential to lower the uncertainty associated with the understanding of drought and that this improved understanding has the potential to change policy decisions that lead to tangible societal benefits.
A meta-analysis of empirical e-government research and its future research implications
Authors: Wirtz Bernd W. , Daiser Peter
Published: November 2017

The desired e-government potentials and its shortcomings in reality are key reasons why e-government has become a major topic of interest to academics and practitioners, leading to an extensive body of knowledge. However, the literature still demands further quantitative empirical research to substantiate theory development. This situation calls for a specific review of the literature that arranges relevant knowledge and provides a solid foundation for future research. However, available meta-analyses do not deliver the particular insights to appropriately address the shortage of quantitative empirical e-government research. Therefore, this study explicitly focuses on this specific field to systematically uncover areas requiring further exploration, and defines promising research directions for a solid foundation for future investigations. Key findings of the meta-analysis are: the existence of a systematic divide of existing quantitative empirical e-government studies into 12 research subtopics, which are assessed according to different classification criteria for scientific research gap-spotting; the identification of emerging subtopics that carry innovative research potential; and that e-government is expected to be an ongoing, open-ended research environment that still provides manifold investigative opportunities. Based on these findings, straightforward suggestions for future research are provided.

Points for practitioners

Beyond providing insights into the current state of quantitative empirical research for scientific researchers, this article also delivers value for professionals working in public management and administration. First, the study provides a comprehensive overview of e-government-related meta-analyses, which allows us to quickly identify the literature in order to tackle particular e-government management issues. Second, the article classifies existing quantitative empirical studies, defines specific subject areas and arranges relevant knowledge, which eases the processes of confining and labelling e-government activities. Last, since these deliverables are based on empirical studies that draw their conclusions from perceptions of reality, the summaries and classifications are thus regarded to be of special importance for public managers.
Public Opinion and Public Policy: Heroin and Other Opioids
Authors: Cook Amy Kyle , Brownstein Henry H.
Published: November 2017

Virginia, much like other states, has experienced unprecedented rates of heroin and prescription opioid abuse, overdoses, and deaths. Given the wide range of competing voices concerning drug policy and the complicated situation of the contemporary opioid epidemic, this study examines whether public opinion is reflected in public policy toward illicit involvement with opioids. The 2016 Commonwealth Public Policy Survey, a statewide representative sample of 1,000 Virginia residents, found that Virginians are supportive of treatment over arrest for heroin and prescription pill abusers and factors such as race, education, and political affiliation are predictive of support for treatment over arrest. More importantly, the results of this poll converge with legislative policies of the 2017 General Assembly, supporting the notion that public support can have an influence on the policymaking process. Policy implications are discussed.