bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of oxidative stress on blood pressure and electrocardiogram findings in workers with occupational exposure to lead
Authors: Qu Wei , Du Guo-Li , Feng Bin , Shao Hua
Published: April 2019

Objective

To observe the correlation between the oxidative stress index and cardiovascular system damage in a population with lead exposure.

Methods

Two populations (144 manufacturing workers and 94 administrators) from a lead–acid battery manufacturer in Shandong Province in China were recruited. The blood lead level, oxidative stress index, blood pressure, electrocardiogram findings, and their correlations were analyzed in both groups.

Results

The blood lead level was significantly higher in manufacturing workers than administrators (254.34 vs. 65.32 µg/L, respectively). The differences in the oxidative stress index, serum total superoxide dismutase (T-SOD) concentration, and malondialdehyde (MDA) concentration between the two populations were statistically significant. The rates of abnormal blood pressure and electrocardiogram findings were significantly higher in manufacturing workers than administrators. Workers with middle- and high-dose lead exposure had lower T-SOD and higher MDA concentrations than those with low-dose lead exposure. Significant correlations were found between the blood lead level and the MDA concentration, systolic pressure, diastolic pressure, and electrocardiogram findings. Linear multiple regression analysis showed that T-SOD was negatively associated with blood lead, electrocardiogram findings, and MDA.

Conclusion

Lead exposure can lead to oxidative stress, increased blood pressure, and abnormal electrocardiogram findings and may impact cardiovascular diseases through oxidative stress.
Obesity and bariatric intervention in patients with chronic renal disease
Authors: Bellini Maria Irene , Paoletti Filippo , Herbert Paul Elliot
Published: April 2019

Obesity is associated with chronic metabolic conditions that directly and indirectly cause kidney parenchymal damage. A review of the literature was conducted to explore existing evidence of the relationship between obesity and chronic kidney disease as well as the role of bariatric surgery in improving access to kidney transplantation for patients with a high body mass index. The review showed no definitive evidence to support the use of a transplant eligibility cut-off parameter based solely on the body mass index. Moreover, in the pre-transplant scenario, the obesity paradox is associated with better patient survival among obese than non-obese patients, although promising results of bariatric surgery are emerging. However, until more information regarding improvement in outcomes for obese kidney transplant candidates is available, clinicians should focus on screening of the overall frailty condition of transplant candidates to ensure their eligibility and addition to the wait list.
Comparison of beliefs about teaching and learning of emotional expression in music performance between Spanish and English HE students of music
Authors: Bonastre Carolina , Timmers Renee
Published: April 2019

Despite an increase in research on emotional expression in music and its teaching and learning, little is known about the beliefs and conceptualizations that students hold regarding musical expression, and how they differ depending on educational context. To address this gap, a comparison was made between a sample of 79 UK and 117 Spanish higher education students of music, who were asked to indicate their beliefs about expressivity, most useful instructional methods to develop expressive performance, and factors that influence expressiveness and its teaching and learning. Results indicated agreement, but also several significant differences across cohorts. UK students endorsed the idea more strongly that musical context (i.e., piece and instrument) influences expressivity and the choice of teaching strategy, while Spanish students linked expressivity more strongly to particular music-emotional characteristics. Both groups considered using technical explanation as the better method for teaching expressivity, whilst modelling was considered the worst. On the other hand, they agreed that the choice of the teaching approach should depend on the age of the student with modelling being preferred for younger age groups, and technique for adults only. These results highlight differences in the understanding of musical expressivity that parallel academic debates on emotional vs. stylistic expressiveness.
Optimal Design of Bus Routes for Different Vehicle Types Considering Various Driving Regimes and Environmental Factors
Authors: Su Yue , Liu Xiaobo , Lu Guo , Fan Wenbo
Published: April 2019

As a major part of public transportation systems, bus transit has been regarded as an effective mode to alleviate traffic congestion and solve vehicle emission problems. The performance of a bus transit system depends largely on the design of bus stop locations. This research proposes a multi-period continuum model (peak and off-peak hours) to optimize the design of a bus route for four different vehicle types (i.e., supercharge bus, compressed natural gas (CNG) bus, lithium-ion battery bus, and diesel bus) considering driving regimes and pollutant cost. Inter-stop driving regimes—acceleration, cruising, coasting, and deceleration—are explicitly introduced into the optimization to determine whether and how the coasting regime should be undertaken in the tradeoff between commercial speed of vehicles and operating costs. The cost effectiveness of each alternative has been investigated in a life cycle and compared with respect to different vehicle types. The method has been applied to the real-world bus route no. 7 in Yaan City (China). The results of numerical experiments show that through optimization the total system cost can be reduced by more than 50%. The results of the continuum model are validated by comparison with the discretized results, and the outcomes are similar (with error less than 3%). Finally the life-cycle cost of the four vehicle types is analyzed, and the results indicate that, because of high purchase prices, it is difficult for clean-energy buses to outperform conventional buses in a life cycle (normally eight years), unless subsidies are provided.
Pattern Identification from Older Bicyclist Fatal Crashes
Authors: Das Subasish , Jha Kartikeya , Fitzpatrick Kay , Brewer Marcus , Shimu Tahmida Hossain
Published: April 2019

Estimates from the U.S. Census Bureau indicate that the elderly (age 65 and older) people represented 12% of the total population in 2005. Bicycling is becoming popular among people of all groups. In 2016, 130 elderly bicyclists were killed (20% higher than 2014) on the U.S. roadways. The sharp rise of elderly bicyclist fatal crashes calls for a rigorous study to determine the key associated factors in elderly bicyclist crashes. Graphical methods, such as joint correspondence analysis (JCA), are useful in identifying the association patterns from a complex data set with multiple variables by producing a proximity map of the variable categories in a low dimensional plane. This study used 3 years (2014 to 2016) of data on elderly bicyclist fatal crashes from the Fatality Analysis Reporting System (FARS) in the U.S. to determine the key associations between the contributing factors by using JCA. Some of the key findings include bicyclist fatal crashes on roadways with high posted speed being very random; higher crash occurrences on roadways with bicycle lane/shoulder/parking lane under dark conditions with no lighting, on two-way undivided roadways with bicyclists on the travel lane, and at signalized intersections (pedestrian/bicycle signal presence is unknown) with “motorists fail to yield” related crashes. The findings from the current study can help in refining the policies and safe design practices that explicitly recognize this issue and will better serve a growing segment of the nation’s population.
An Examination of the American Far Right’s Anti-Tax Financial Crimes
Authors: Sullivan Brandon A. , Freilich Joshua D. , Chermak Steven M.
Published: April 2019

Little attention has been paid to ideologically motivated tax protesters who use frivolous legal arguments as moral or legal justification for committing tax fraud and related financial crimes. These crimes have defrauded private citizens and governments and are associated with violent far-right extremism, negatively impacting public safety and stability. Using data from the U.S. Extremist Financial Crime Database, we provide an exploratory, descriptive analysis of the composition and motivation of financial crime schemes associated with the American far-right extremist anti-tax movement. Our innovative open-source database permits systematic empirical research into connections among tax avoidance, anti-tax, and anti-government belief and related criminal behavior, which is necessary for the advancement of scholarship on the causes and consequences of these frauds and the development of sound intervention and prevention policies and practices.
Time-dependent effect of ground water fluoride on motility, abnormality and antioxidant status of spermatozoa: An in vitro study
Authors: Chaithra B , Sarjan HN , Shivabasavaiah
Published: April 2019

The present study was undertaken to investigate the toxic effect of ground water fluoride (F) on motility, abnormality, and antioxidant status of spermatozoa. Treatment of ground water F with epididymal sperm suspension caused complete loss of sperm motility and decrease in the activities of superoxide dismutase (SOD) and catalase (CAT) and increase in the concentration of malondialdehyde (MDA) and abnormality of spermatozoa at 15 and 30 min time intervals. Further, incubation of spermatozoa with ground water F for 5, 10, and 15 min time intervals significantly reduced the sperm motility and activities of SOD and CAT and increased the concentration of MDA and abnormality of spermatozoa. The study revealed that F-induced effect on sperm motility and antioxidant status is time dependent. Increase in oxidative stress and concomitant decrease in motility of spermatozoa in ground water F clearly indicates that F-induced oxidative stress affected the sperm motility. The present study for the first time demonstrated the toxic effect of ground water F on spermatozoa at shorter duration of exposure, which affects the capability of spermatozoa in fertilization.
Results of the Workplace Health in America Survey
Authors: Linnan Laura A. , Cluff Laurie , Lang Jason E. , Penne Michael , Leff Maija S.
Published: April 2019

Purpose:

To provide a nationally representative snapshot of workplace health promotion (WHP) and protection practices among United States worksites.

Design:

Cross-sectional, self-report Workplace Health in America (WHA) Survey between November 2016 and September 2017.

Setting:

National.

Participants:

Random sample of US worksites with ≥10 employees, stratified by region, size, and North American Industrial Classification System sector.

Measures:

Workplace health promotion programs, program administration, evidence-based strategies, health screenings, disease management, incentives, work–life policies, implementation barriers, and occupational safety and health (OSH).

Analysis:

Descriptive statistics, t tests, and logistic regression.

Results:

Among eligible worksites, 10.1% (n = 3109) responded, 2843 retained in final sample, and 46.1% offered some type of WHP program. The proportion of comparable worksites with comprehensive programs (as defined in Healthy People 2010) rose from 6.9% in 2004 to 17.1% in 2017 ( P < .001). Occupational safety and health programs were more prevalent than WHP programs, and 83.5% of all worksites had an individual responsible for employee safety, while only 72.2% of those with a WHP program had an individual responsible for it. Smaller worksites were less likely than larger to offer most programs.

Conclusion:

The prevalence of WHP programs has increased but remains low across most health programs; few worksites have comprehensive programs. Smaller worksites have persistent deficits and require targeted approaches; integrated OSH and WHP efforts may help. Ongoing monitoring using the WHA Survey benchmarks OSH and WHP in US worksites, updates estimates from previous surveys, and identifies gaps in research and practice.
Teacher-Level Value-Added Models on Trial: Empirical and Pragmatic Issues of Concern Across Five Court Cases
Authors: Amrein-Beardsley Audrey , Close Kevin
Published: April 2019

Ongoing or recently completed across the United States are a series of lawsuits via which teacher plaintiffs are contesting how they are being evaluated using value-added models (VAMs) as part of states’/districts’ teacher accountability systems. To investigate the empirical and pragmatic matters addressed in court, researchers conducted a case study analysis of the documents submitted for five such cases. Researchers framed analyses using measurement concepts resident within the Standards for Educational and Psychological Testing, given issues with (a) reliability, (b) validity, (c) bias, (d) transparency, and (e) fairness, with emphases also on (f) whether VAMs are being used to make consequential decisions using concrete (e.g., not arbitrary) evidence, and (g) whether VAMs’ unintended consequences are also of legal pertinence and concern.
Thermal stability and flame retardancy of an epoxy resin modified with phosphoric triamide and glycidyl POSS
Authors: Li Jialiang , Wang Hongyu , Li Shichao
Published: April 2019

Phosphoric triamide (PTA) and glycidyl polyhedral oligomeric silsesquioxane (POSS) were simultaneously incorporated into the cured network of a bisphenol F epoxy resin and 4,4′-diaminodiphenyl methane (DDM) to improve the thermal stability and flame retardancy. PTA was synthesized by triethyl phosphate and DDM, and its chemical structure was confirmed by 1H nuclear magnetic resonance (NMR) and Fourier transform infrared (FTIR). The differential scanning calorimetric (DSC) results showed that the introduction of PTA and POSS slightly increased the glass transition temperature of the epoxy resin. The thermogravimetric analysis results indicated that compared with the pure, phosphoric, and silicic epoxy resins, the modified epoxy resin possessed the lowest weight loss rate and highest char residue. Its limiting oxygen index value was as high as 30.5, and the UL-94 grade reached V-1. A decomposition test was carried out to obtain sufficient char residue and investigate the condensed mechanism. The scanning electron microscopic images demonstrated that the char residue of the modified epoxy resin had a compact structure. The energy dispersive X-ray and FTIR analyses verified the synergistic effect of the phosphorus and silicon in the PTA and POSS, respectively, on the epoxy resin.
Measuring Thought-Control Failure: Sensory Mechanisms and Individual Differences
Authors: Kwok Eugene L. , Leys Gaelle , Koenig-Robert Roger , Pearson Joel
Published: April 2019

The ability to control one’s thoughts is crucial for attention, focus, ideation, and mental well-being. Although there is a long history of research into thought control, the inherent subjectivity of thoughts has made objective examination, and thus mechanistic understanding, difficult. Here, we report a novel method to objectively investigate thought-control success and failure by measuring the sensory strength of visual thoughts using binocular rivalry, a perceptual illusion. Across five experiments ( N = 67), we found that thought-control failure may occur because of the involuntary and antithetical formation of nonreportable sensory representations during attempts at thought suppression but not during thought substitution. Notably, thought control was worse in individuals with high levels of anxiety and schizotypy but more successful in mindful individuals. Overall, our study offers insight into the underlying mechanisms of thought control and suggests that individual differences play an important role in the ability to control thoughts.
The introduction of leucotomy in Germany: National Socialism, émigrés, a divided Germany and the development of neurosurgery
Authors: Rzesnitzek Lara
Published: April 2019

Thinking about the chronology of the introduction of leucotomy in Germany sheds new light on the hypothesis of a special ‘radical’ approach of German psychiatry to the treatment of the mentally ill during the period of National Socialism. Moreover, it offers new insights into the transnational and interdisciplinary conditions of the introduction of leucotomy in early divided post-war Germany.
Multi-fault diagnosis method for wind power generation system based on recurrent neural network
Authors: Wang Junnian , Dou Yao , Wang Zhenheng , Jiang Dan
Published: April 2019

With the continuous expansion of the scale of wind turbine system, wind power production, operation and equipment control of wind turbine have become more and more significant. To improve the reliability of wind turbine systems fault diagnosis, combining with data-driven technology, this paper proposes a multi-fault diagnosis method for wind power system based on recurrent neural network. According to the actual wind speed data, the normal operation and fault data of the wind turbine system are obtained by system modeling, and the classification and prediction model based on the recurrent neural network algorithm is established, which takes 30 characteristic parameters such as wind speed, rotor speed, generator speed and power generation as input, and 10 different types faults labels of the wind turbine as output. Specific rules formed inside the sample data of the wind turbine system are learned intelligently by the model which is continuously trained, optimized and tested to verify the feasibility of the algorithm. The results of evaluation standards such as accuracy rate, missed detection rate and F1-measure that compared with other related algorithms such as deep belief network show that the proposed algorithm can solve the problem of multi-classification fault diagnosis for wind power generation system efficiently.
Finite-time nonsingular terminal sliding mode control: A time setting approach
Authors: Shiri Reza , Rafee Nekoo Saeed , Habibnejad Korayem Moharam , Kazemi Shahab
Published: April 2019

This article proposes a combination of linear and nonlinear sliding surfaces to design a new structure for terminal sliding mode control, capable of accepting a definite final time as an input data. The structures of both single-input-single-output and multi-input-multi-output systems are expressed. The controller operates in two modes: first, reaching the states to linear sliding surface, defining control parameters and rise time; second, switching to nonlinear sliding surface and defining a convergence time. Sum of rise time and convergence time, both of which as inputs, sets the final time. The control gains are adaptively tuned and parameter uncertainty in dynamics is considered in the design. The proposed method is implemented theoretically and experimentally on Scout robot in point-to-point motion and trajectory tracking. The results are compared to conventional terminal sliding mode control and finite-time state-dependent Riccati equation to assess the improvement.
India Stimulating Growth in Bay of Bengal Region: Integrating Key Interests and Strengthening Innovation Capacity
Authors: Kaul Vijay Kumar , Chowdhury Tuhina Roy
Published: April 2019

The Bay of Bengal and Andaman Sea (BoBAS) rim countries comprising of India, Indonesia, Bangladesh, Thailand, Myanmar, Sri Lanka, Malaysia and Singapore is a group that has the potential to emerge as one of the fastest growing regions in Asia and the world. These countries are tied together with a multitude of factors such as history, culture, demographics and technological development. This article seeks to evaluate if these countries can complement each other’s growth strategy and the role that India can play to stimulate growth in this region. The article can broadly be divided into two parts: the first part discusses the evolution of development strategy and regional economic integration while the second part analyses the role that India can play in guiding the growth across these countries and the various key initiatives taken up by India in recent past to foster high and sustainable growth.
Does Economic Growth Spillover More from the Eastern than the Western Countries? Evidence from Bangladesh’s Four Decades of Growth Experience
Authors: Goswami Gour Gobinda , Alamgir Farzana
Published: April 2019

Bangladesh is an important member of the Bay of Bengal and the Andaman Sea (BoBAS) rim countries. The partners of growth in this region include traditional partners like eth USA, the UK and some newly emerging partners such as the European Union (EU), Germany, India and China. This article examines the pattern of growth dependence of Bangladesh vis-à-vis its 11 major trade, remittance, foreign aid and FDI partner countries by using vector autoregressive process (VAR) and annual data ranging from 1972 till 2015. Out of 11 partners selected in this study only three of them named the USA, India and Japan have significant growth spillover effect on the economy of Bangladesh. Most of the newly added countries in the list of partnership with Bangladesh are yet to offer any significant growth spillover effect. Only four and a half decade of exploration in economic interaction is not enough to yield sustained relationship be it trade, aid, remittance, foreign aid or FDI. A robustness check by using high frequency monthly data keeps the result intact. In all the three tests, we find that only Japan has two-way growth relationship with Bangladesh, which is trade and concessional loan-driven channel. Variance decomposition analysis identifies the USA, India (a member of BoBAS) and Japan as the prime driver of our growth counting around 32 per cent of the contribution whereas remaining 68 per cent originates from Bangladesh’s own soil.
ECB independence and accountability today: Towards a (necessary) redefinition?
Authors: Fromage Diane , Dermine Paul , Nicolaides Phedon , Tuori Klaus
Published: April 2019

This introductory article sets the ground for the analysis performed in the articles included in this Special Issue. It shows why a new analysis of the European Central Bank (ECB)’s accountability is required by referring to recent developments, and by underlining how much the ECB’s role and standing have changed since its creation 20 years ago. Indeed, its resorting to unconventional monetary policies in response to the recent economic and financial crisis, as well as the creation of the Banking Union, have significantly affected the ECB. This introduction also recalls the main elements of the debate on the balance between accountability and independence, and shows how this balance has evolved. On the basis of the findings of the articles included in this Special Issue, some conclusions and hypotheses as to the way forward are formulated.
Efficacy of MALDI-TOF mass spectrometry as well as genotypic and phenotypic methods in identification of staphylococci other than Staphylococcus aureus isolated from intramammary infections in dairy cows in Poland
Authors: Wanecka Anna , Król Jarosław , Twardoń Jan , Mrowiec Jacek , Korzeniowska-Kowal Agnieszka , Wzorek Anna
Published: April 2019

We compared the effectiveness of various methods for the identification of Staphylococcus spp. other than S. aureus isolated from intramammary infections of cows on 3 dairy farms in Lower Silesia, Poland. A total of 131 isolates belonging to 18 Staphylococcus species were identified by sequence analysis of the 16S rRNA and dnaJ genes, as well using a commercial identification system (ID 32 STAPH; bioMérieux) and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS; Bruker Daltonics). Sequencing of the 16S rRNA gene was found to have low discriminatory value because only 43% of isolates were recognized unequivocally. Much better results were obtained with the dnaJ gene (all isolates were correctly identified at the species level). However, some of these isolates achieved a low similarity level (<97%) and required a confirmatory test (sequencing of the rpoB gene). The performance of ID 32 STAPH was poor. Regardless of the probability level used (80% or 90%), the commercial system obtained identification rates <40%. Using MALDI-TOF MS and the commercial Bruker database, 67% of isolates were identified correctly with scores ≥2.0 (acceptable species-level identification) but this number increased to 97% after the database was expanded. The definitive identification of Staphylococcus spp. other than S. aureus causing intramammary infections in cattle often requires a combination of different procedures, and the existing databases should be updated.
Unusual histopathologic features in thymic corpuscles associated with porcine periweaning failure-to-thrive syndrome
Authors: Pallarés Francisco J. , Gómez Serafín
Published: April 2019

Six, 5–6-wk-old pigs, from 3 farms of the same company, with significant loss of body condition were submitted for postmortem evaluation. Macroscopically, the main lesion observed in all of the pigs was thymic atrophy. Microscopically, all of the pigs had thymic atrophy, superficial lymphocytic fundic gastritis, atrophic enteritis, superficial colitis, and neutrophilic and lymphocytic rhinitis, leading to a diagnosis of porcine periweaning failure-to-thrive syndrome. In the pigs from 2 of the farms, many of the thymic corpuscles had infiltrates of neutrophils and degenerate cells, in some cases infiltrating the surrounding parenchyma.
Nonlinear vibration analysis of multiscale doubly curved piezoelectric composite shell in hygrothermal environment
Authors: Karimiasl Mahsa , Ebrahimi Farzad , Vinyas Mahesh
Published: April 2019

This research studied large amplitude vibration behaviors of multiscale composites doubly curved shells with piezoelectric layer. By using Reddy’s third-order shear deformation theory, the strains and stresses are obtained. According to the Halpin–Tsai model three-phase composites layers are considered. The governing equations of the multiscale doubly curved shell are derived by implementing the Hamilton’s principle and are solved via homotopy perturbation method. For investigating correctness and accuracy, this article is validated by other previous studies. Finally, the influence of different parameters such as temperature rise, various distributions pattern, applied voltage, magnetic potential, and aspect and curvature ratio are observed in this article. It is found that these parameters have significant influence on nonlinear frequencies.
Numerical and experimental studies on a new variable stiffness and damping magnetorheological fluid damper
Authors: Huang Hui , Sun Shuaishuai , Chen Shumei , Li Weihua
Published: April 2019

This article describes a new magnetorheological fluid damper; its damping and stiffness are variable and controllable through the compact structure of two damping units and a spring. The ability of variable stiffness and damping enables it to be used for more effective vibration control in wide-band excitation wave occasions. First, the effective stiffness and output damping force are calculated in theory. Then, the magnetic field is simulated by finite element analysis. After the prototype of the new magnetorheological fluid damper is developed and machined, the damper’s performances are tested in a hydraulic actuated MTS machine, including stiffness variability and damping variability in different current. The successful development, numerical calculation, and experimental testing shows that the new damper not only outputs a controllable damping force but also occurs as the great variable stiffness in a certain range, which makes the true design and implementation of the concept of variable stiffness and damping.
“They Don’t Trust Us”: The Influence of Perceptions of Inadequate Nursing Home Care on Emergency Department Transfers and the Potential Role for Telehealth
Authors: Stephens Caroline E. , Halifax Elizabeth , David Daniel , Bui Nhat , Lee Sei J. , Shim Janet , Ritchie Christine S.
Published: April 2019

In this descriptive, qualitative study, we conducted eight focus groups with diverse informal and formal caregivers to explore their experiences/challenges with nursing home (NH) to emergency department (ED) transfers and whether telehealth might be able to mitigate some of those concerns. Interviews were transcribed and analyzed using a grounded theory approach. Transfers were commonly viewed as being influenced by a perceived lack of trust in NH care/capabilities and driven by four main factors: questioning the quality of NH nurses’ assessments, perceptions that physicians were absent from the NH, misunderstandings of the capabilities of NHs and EDs, and perceptions that responses to medical needs were inadequate. Participants believed technology could provide “the power of the visual” permitting virtual assessment for the off-site physician, validation of nursing assessment, “real time” assurance to residents and families, better goals of care discussions with multiple parties in different locations, and family ability to say goodbye.
The Bullet in the Glass: War, Death, and the Meaning of Penitentiary Experience in Colombia
Authors: Ariza Libardo José , Iturralde Manuel
Published: April 2019

In this article, we discuss the incidence of narratives on war and death in molding penitentiary experience in Colombia. Based upon the case of la Modelo National Prison in Bogotá, we illustrate the way in which penitentiary discourses are transmitted and reproduced through two rites that initiate newcomers into the local world of confinement. The first, the tale of terror, told by veteran guards, of the cemetery filled with the bodies left by the war between rebel fighters and paramilitary soldiers. The other, the dense description of the bullet holes in the glass shield at the Main Guard Post, which leads to the main cellblocks, which give proof to the guards’ endurance when faced by the violent power struggle that rages inside the penitentiary. At the same time, we show how these discourses on the horror of the war inside the penitentiary make their way from within the confines of prison out into the free world through ex-convicts’ memoirs, press accounts, and judicial documents written by court officials who visit the prison. Drawing on this case study, we argue that to achieve a contextual interpretation of carceral violence, it is indispensable to trace, reconstruct, and comprehend the trajectory of its foundational discourses, thus allowing for the assembly of the pieces that give meaning to penitentiary experience at the local level.
Epidemiology, Risk Factors, and Outcomes After Early Posttransplant Clostridiodes difficile Infection in Renal Transplant Recipients
Authors: Jorgenson Margaret R. , Descourouez Jillian L. , Yang Dou-Yan , Leverson Glen E. , Saddler Christopher M. , Smith Jeannina A. , Safdar Nasia , Mandlebrot Didier A. , Redfield Robert R.
Published: April 2019

Background:

Modifiable risk-factors associated with Clostridioides difficile infection (CDI) in renal-transplant (RTX) have not been clearly established and peri-transplant risk has not been described.

Objective:

Evaluate epidemiology, risk-factors and outcomes after CDI occurring in the first 90 days after RTX (CDI-90).Methods: Observational cohort study/survival analysis of adult RTX recipients from 1/1/2012-12/31/2015. Primary outcome was CDI-90 incidence/risk-factors. Secondary outcome was evaluation of post-90 day transplant outcomes.

Results:

982 patients met inclusion criteria; 46 with CDI-90 and 936 without (comparator). CDI incidence in the total population was 4.7% at 90 days, 6.3% at 1 year, and 6.4% at 3 years. Incidence of CDI-90 was 5%; time to diagnosis was 19.4±25 days (median 7). Risk-factors for CDI-90 were alemtuzumab induction (Hazard ratio [HR] 1.5, 95% CI(1.1-2.0), p = 0.005) and age at transplant (HR 1.007/year, 95% CI (1.002-1.012), p= 0.007). However, risk-factors for CDI at any time were different; donation-after-circulatory-death (DCD) donor (HR 2.5 95% CI (1.3-4.9), p = 0.008) and female gender (HR 1.6 95% CI (1.0-2.7), p = 0.049). On Kaplan-Meier, CDI-90 appeared to have an impact on patient/graft survival, however when analyzed in a multivariable stepwise Cox proportional hazards model, only age was significantly associated with survival ( p = 0.002).

Conclusion and Relevance:

Incidence of CDI-90 is low, mostly occurring in the first post-operative month. Risk-factors vary temporally based on time from transplant. In the early post-op period induction agent and age at transplant are significant, but not after. Associations between CDI and negative graft outcomes appear to be largely driven by age. Future studies validating these risk-factors as well as targeted prophylaxis strategies and their effect on long term graft outcomes and the host microbiome are needed.
Cecal Mucosal Myxoma: The First Report of a New Type of Mesenchymal Colon Polyp
Authors: Bsirini Caroline , Findeis-Hosey Jennifer J. , Huber Aaron R.
Published: April 2019

Myxomas are benign mesenchymal neoplasms of unknown etiology that most commonly occur in the cardiac atrium; however, other reported sites include the skin, joints, skeletal muscles, maxillofacial bones, and sinonasal tract. Myxomas involving the gastrointestinal (GI) tract are rare and are limited to a few published case reports. We are presenting, to our knowledge, the first case report of a mucosal myxoma in the colon presenting as a colonic polyp. A 49-year-old woman underwent a screening colonoscopy and was found to have a 0.2-cm sessile polyp in the cecum. Histologically, the polyp was composed of bland spindled cells in the lamina propria set in a hypocellular, myxoid stroma. The lesion was relatively well-demarcated from the surrounding mucosa. The overlying colonic epithelium showed no dysplasia. S-100 immunohistochemical stain showed only focal nonspecific positivity, while CD34, CD117, SMA, EMA, and desmin were all negative. Alcian blue special stain showed positive staining, supporting the diagnosis of myxoma. Myxomas in the GI tract are very rare, with this being the first reported case of a polypoid colonic mucosal myxoma. Previous reports of GI myxomas are limited to examples in the stomach, small bowel, and one recently reported case in the colon, all of which were submucosal lesions and not limited to the mucosa. In some of the prior reports, the patients had synchronous cardiac atrial myxomas. Mucosal colonic myxoma represents a newly identified mesenchymal polyp of the colon and pathologists should be aware of this diagnostic entity.
Correlation of Preoperative Radiographic Severity With Disability and Symptom Severity in Hallux Valgus
Authors: Matthews Michael , Klein Erin , Acciani Alyse , Sorensen Matthew , Weil Lowell , Weil Lowell S. , Fleischer Adam
Published: April 2019

Background:

Some US insurance companies have recently started to require minimum angular measurements, for coverage decisions, in patients seeking operative correction for symptomatic hallux valgus. This logic naturally assumes that the magnitude of radiographic bunion deformity is related to the magnitude of patient’s presenting symptoms and/or disability.

Methods:

We conducted an analysis of existing data in our practice to determine whether patient-reported symptoms and disability prior to bunion surgery correlated with preoperative radiographic measurements commonly used to quantify hallux valgus severity. Symptoms and disability level were determined using patient-reported preoperative Foot and Ankle Outcome Score (FAOS), a validated instrument commonly used in hallux valgus assessment. Spearman correlation coefficient was then used to quantify the strength of any correlations. Preoperative data from 107 patients (107 feet) with mean age of 49.3 ± 13.8 years who underwent isolated osseous hallux valgus surgery within our practice between June 1, 2016, and July 30, 2018, were available.

Results:

No radiographic variable achieved even a moderate correlation with any of the FAOS subscales with the exception of tibial sesamoid position with FAOS Pain (rho=0.402, P = .01) in patients aged 56 years and older. The direction of this correlation was positive, indicating that greater preoperative sesamoid abnormalities were paradoxically associated with less presenting pain (ie, higher FAOS Pain scores).

Conclusion:

It would appear that radiographic severity of bunion deformity is not well correlated with symptom level and/or disability and, we would argue, should not play a role in coverage decisions for patients presenting for hallux valgus surgery.

Level of Evidence:

Level IV, retrospective case series.
On the Validity of Forced Choice Scores Derived From the Thurstonian Item Response Theory Model
Authors: Walton Kate E. , Cherkasova Lina , Roberts Richard D.
Published: April 2019

Forced choice (FC) measures may be a desirable alternative to single stimulus (SS) Likert items, which are easier to fake and can have associated response biases. However, classical methods of scoring FC measures lead to ipsative data, which have a number of psychometric problems. A Thurstonian item response theory (TIRT) model has been introduced as a way to overcome these issues, but few empirical validity studies have been conducted to ensure its effectiveness. This was the goal of the current three studies, which used FC measures of domains from popular personality frameworks including the Big Five and HEXACO, and both statement and adjective item stems. We computed TIRT and ipsative scores and compared their validity estimates. Convergent and discriminant validity of the scores were evaluated by correlating them with SS scores, and test-criterion validity evidence was evaluated by examining their relationships with meaningful outcomes. In all three studies, there was evidence for the convergent and test-criterion validity of the TIRT scores, though at times this was on par with the validity of the ipsative scores. The discriminant validity of the TIRT scores was problematic and was often worse than the ipsative scores.
Experimental Evidence for Differences in the Prosocial Effects of Binge-Watched Versus Appointment-Viewed Television Programs
Authors: Billard Thomas J
Published: April 2019

This study investigated the influence of television consumption patterns on changes in attitudes toward depicted social out-groups. Participants were randomly assigned to view six episodes of Amazon’s Transparent, a comedy-drama program about a family whose father comes out as a transgender woman, in either one 3-hr (“binge-watching”) session or six weekly half-hour (“appointment-viewing”) sessions. Across both groups, we found exposure to the narrative reduced anti-transgender prejudice. Counter to the predictions of the extended elaboration likelihood model and the entertainment overcoming resistance model, however, improvement in prejudice toward transgender people was not predicted by narrative or character involvement. Rather, reduction in prejudice was an outcome of viewing condition, such that those who viewed the program on a schedule of one episode per week exhibited lower levels of postexposure prejudice than those who binge-watched, and their attitudinal changes were more persistent 3 weeks later. Results are discussed in the context of the original elaboration likelihood model, proposing mechanisms for further testing.
The Frequency, Nature, and Effects of Coerced Debt Among a National Sample of Women Seeking Help for Intimate Partner Violence
Authors: Adams Adrienne E. , Littwin Angela K. , Javorka McKenzie
Published: April 2019

This study examines the frequency, nature, and effects of coerced debt, defined as non-consensual, credit-related transactions that occur in intimate relationships where one partner uses coercive control to dominate the other. The sample includes 1,823 women who called the National Domestic Violence Hotline. Results suggest that coerced debt, from both coercive and fraudulent transactions, is a common problem and is significantly related to control over financial information, credit damage, and financial dependence on the abuser. This study supports the need for policy reform and victim services aimed at addressing coerced debt, thereby mitigating a potentially significant economic barrier to safety.
Bringing the R Back to SBAR: A Focused Heart Failure SBAR Tool
Authors: Leonard Christina , Zomorodi Meg
Published: April 2019

This article describes a quality improvement (QI) project implemented in a home health setting among a population of patients with heart failure (HF). It was discovered there was a lack of nurse-led recommendations and ineffective use of the situation, background, assessment, and recommendations (SBAR) tool among home health nurse when communicating with providers about HF patients. Therefore, the QI project focused on creating and implementing a focused HF SBAR tool and a self-care patient checklist to be utilized by all home health nurses for all visits with HF patients. The focused HF tool was created and laminated and became part of home health nurse’s identification badges. The implementation phase took place over a 60-day time period. Following implementation, outcomes were measured and demonstrated an increased use of SBAR, and an increase in nurse-led recommendations documented. In addition, there was a decrease in acute hospitalizations for HF among home health patients. Furthermore, there was an increase in nurse-led interventions implemented in the home along with an increase of referrals to physical therapy (PT) and occupational therapy (OT). The educational session was well-received and prompted a practice change in the delivery of future continuing education content. Finally, organizational leadership reported increased confidence and improved interprofessional communication among home health nurses and providers.
No effect of femoral canal jet-lavage on the stability of cementless stems in primary hip arthroplasty: a randomised RSA study with 6 years follow-up
Authors: Zampelis Vasileios , Flivik Gunnar , Kesteris Uldis
Published: April 2019

Introduction:

In contrast to cemented hip prostheses, the effect of washing the bone bed with jet-lavage prior to insertion of cementless stem components in primary hip arthroplasty (THA) is unclear. Jet-lavage potentially decreases the risk of fat embolisation during rasping and stem insertion and might help in avoiding bacterial contamination. An earlier animal study has shown less debris and better-organised trabecular structure of new bone when jet-lavage was used. We hypothesised that the primary stability of cementless femoral stems implanted after jet-lavage of the femoral canal prior to stem insertion would improve with earlier stabilisation, as measured with Radiostereometry (RSA), compared with insertion without prior jet-lavage.

Methods:

40 patients with primary osteoarthritis operated on with a cementless titanium grit blasted stem are included in the study. The patients were randomised to either jet-lavage or control without any lavage of the femoral canal prior to insertion of the prosthesis. The stem migration pattern was measured with RSA at 0, 3, 12, 24 and 72 months.

Results:

At 6 years, 19 patients remained for analysis in the jet-lavage and 18 in the control group. We found no difference in extent or pattern of migration as measured with RSA. Both groups seemed to have stabilised within 3 months after a slight subsidence and retroversion. No stem was revised or considered loose as measured with RSA.

Conclusions:

Washing the bone bed with jet-lavage prior to insertion of cementless stems does not affect the stability of cementless femoral components. No adverse effects were observed.
A new access, Dermatorrhea, 10 samples of the great saphenous vein
Authors: Wakabayashi Masanori
Published: April 2019

We devised a method that enables blood removal/return by creating a fistula between the skin and the great saphenous vein to insert the dialysis needle sheath in the femoral vein under ultrasonography guidance with respect to each dialysis. We report the principles, methods, and cases. A skin-great saphenous vein fistula is created under local anesthesia. It is used for blood removal/return during maintenance hemodialysis performed immediately after creating the fistula. Ten limbs of 10 patients (three men and seven women; mean age, 77.6 ± 4.8 years; dialysis history, 9.9 ± 13.0 years), where skin-great saphenous vein fistulas were created in our hospital between May 2017 and June 2018, were included. In all the cases, an arteriovenous fistula or arteriovenous graft was difficult to create because of the general condition and/or vascular fitness of the patients. During or after the fistula-creating surgery, no serious complications were found. No complications such as blood removal failure, infection, or hemorrhage were found during the follow-up period. The primary patency rates by the Kaplan–Meier method were 100% at 3 months and 67.5% at 6 months. This method is considered a valuable substitute method for cases with difficulty in creating a vascular access.
Reliability of Medical History Reporting in Older Adults With and Without Cognitive Impairment
Authors: Curcio Nicholas , Wilmoth Kristin , LoBue Christian , Cullum C Munro
Published: April 2019

Background:

Clinical diagnosis of cognitive disorders depends on accurate reporting of medical history, yet little is known about the reliability and the validity of such reports, particularly in older patients with and without cognitive impairment.

Methods:

In 2 studies, we examined the reliability and the validity of reported histories of select medical events in adults with and without cognitive impairment from a large national cohort.

Results:

Information from subjects (N1 = 3664), obtained from 2 time points, 6 to 12  months apart, was consistent across most medical events, regardless of the diagnostic group (range = 97.6%-100% agreement; Cohen κ range = 0.712-0.945), with few exceptions. Validity analyses (N2 = 382) revealed that 3 of 5 medical events assessed showed substantial agreement between self-report information and clinician diagnosis.

Conclusions:

These data represent some of the first to demonstrate the reliability and the validity of reported select medical events in older adults with and without cognitive impairment.
The interaction of repetition and difficulty for working memory in melodic dictation tasks
Authors: Cornelius Nathan , Brown Jenine L
Published: April 2019

This research examines the effect of repetition on melodic dictation tasks in an undergraduate ear-training class. A pilot group of freshman music majors ( n = 17) were asked to notate four melodies, of which two were slightly more difficult since they contained more melodic leaps. Participants heard two melodies repeated three times and two other melodies six times. An analysis of variance (ANOVA) suggests that the number of repetitions had a significant effect on participants’ dictation accuracy, both for scores on pitch and on rhythm. In addition, dictation accuracy was significantly lower when the melodies contained more leaps (controlling for other factors). Overall, we found a statistical interaction between the number of repetitions and the number of leaps in the melody, both of which factors affect the working memory load in these dictation tasks. Given the similarity of the notated melodies, these findings suggest that ear-training pedagogues must carefully select melodic dictations appropriate for student ability and control the number of melodic leaps. Furthermore, we found evidence that the variance in working memory for music among this population is wider than Karpinski (2000) hypothesizes. These findings provide pedagogues with melodic characteristics well-suited for the average incoming freshman music major. Finally, this first empirical evidence of the dictation ability of incoming undergraduate music majors invites a long-term study on the extent to which working memory and/or chunking ability may increase during the multi-semester ear-training curriculum.