bluuebunny/crossref_metadata_2025 huggingface dataset:
Arteriovenous fistula and pre-surgery mapping: Potential role of physical exercise on endothelial function
Authors: Distefano Giulio , Zanoli Luca , Basile Antonio , Fatuzzo Pasquale , Granata Antonio
Published: March 2019

Background:

The success of the construction of an arteriovenous fistula for haemodialysis is related to the vascular function of the vessels involved in the anastomosis, with particular reference to radial artery distensibility after reactive hyperaemia test and to the fall of resistance index. Only few studies have evaluated the impact of exercise protocols on the endothelial and morphological characteristics of the vessels of the upper limb with inconclusive results. In this pilot longitudinal study, we aimed to evaluate the impact of a standardized exercise protocol on the haemodynamic and resistive index of the arteries of the upper limb of uraemic patients.

Methods:

A total of 17 uraemic patients planned to construct arteriovenous fistula at the distal third of the forearm were enrolled and followed up for 30 days. All patients performed repeated handgrips for 30 min/day. The arterial parameters were detected before and after an ischaemic stress of 5 min and radial and brachial artery flow-mediated dilation was evaluated as well as radial artery resistance index.

Results:

Pre-exercise measurements of radial artery diameter and resistance index and brachial artery diameter were not modified by 30 days hand physical exercise, whereas the post-exercise haemodynamic were improved. Consequently, flow-mediated dilation of the radial artery was improved (21% ± 14% vs 30% ± 19%; p = 0.03) and resistance index of the radial artery was reduced ( p = 0.02).

Conclusion:

Exercise has beneficial effects on endothelial function of the radial artery by resistive index and, potentially, on the outcome of the arteriovenous fistula. Further studies with larger sample size are needed to confirm our preliminary data.
Stitching tivaevae: a Cook Islands research method
Authors: Futter-Puati Debi , Maua-Hodges Teremoana
Published: March 2019

The use of a context-specific research model is critical when undertaking research that involved Pacific people. This article discusses the use of a Kuki Airani | Cook Islands research framework known as the Tivaevae Model in a PhD study. This model first introduced by Maua-Hodges borrows from the traditions of creating a traditional tivaevae | handmade quilt. The tivaevae represents Kuki Airani epistemological and ontological worldviews. Utilising the processes used to create a tivaevae as a metaphor and guiding process, the research was stitched together to develop a metaphorical tivaevae symbolising aronga mapu | youth views of sexuality. This article discusses the research process and how the tivaevae model was used through data collection, analysis, findings design and the educational “project.” In doing so, this article examines the research process that is contextually and culturally appropriate to better understand the nuances of what indigenous research methods can potentially offer, both conceptually and methodologically to critical researchers.
Bipolar patients and creative online practices: Sharing experiences of controversial treatments
Authors: Egher Claudia
Published: March 2019

Bipolar disorder is among the top 10 causes of disability worldwide. It is managed through a combination of medical and psychotherapeutic interventions, but finding an effective treatment is often a long process of trial-and-error, that medical professionals and people diagnosed with this condition engage upon. This article investigates how people diagnosed with bipolar disorder enact lay expertise about the treatment of this condition online. Using De Certeau’s (1988) theory of everyday practices, three tactics are identified—complexity, uncertainty, and individualization—through which people diagnosed creatively adapt medical knowledge on bipolar disorder, to render their personal experiences and views on treatment more authoritative. It is suggested that through their technological features, which allow for the accumulation and refinement of the insights contributors share, blogs may function as digital repositories of patient experiences and may thus help facilitate collective processes of knowledge production. Online data were collected from two blogs, which were selected using the Google index as relevance indicator, and were analyzed through computer-mediated discourse analysis.
A missing link in understanding Party policy change? Conservative Party international volunteering projects and UK development policy (2007–2017)
Authors: Beswick Danielle , Hjort Mattias
Published: March 2019

This article analyses the rationale for and impacts of Conservative Party overseas volunteering projects from 2007 to 2017. Using interview data and participant observation, we uncover aims of project founders and explore impacts of volunteering on Party members and policy. We make three substantial contributions. The first focuses on the survival of Conservative Party modernisation strategies launched under David Cameron. Support for development, particularly Party pledges to spend 0.7% of UK gross national income on aid, are poorly explained by existing research. We argue that a focus on volunteering helps explain the survival of this commitment. Second, we argue that volunteering experience may support sustained Party policy change by enhancing ‘issue ownership’. Our final contribution is providing the first analysis of political parties as development-volunteer sending communities. Through new data and distinctive contributions, we demonstrate that understanding Party-supported volunteering promotes improved explanations of Party modernisation persistence and policy change.
Testing of modified primary stiffness for heavy-haul locomotives operating on sharper-radius curves
Authors: Liu Pengfei , Wei Kai , Wang Kaiyun , Feng Quanbao
Published: March 2019

For the typical wheelset drive subsystem with axle-suspended motor, the coupled vibration differential equations of wheelset and axle hung motor are derived. The mechanical model of traction rod is established. The subsystems are integrated into a whole locomotive-track coupled dynamic model which is verified from the aspects of load transfer and curving negotiation performance. To reduce the wheel–rail dynamic interaction of six-axle heavy-haul locomotive passing through curves in old existing lines, the parametric optimization flow of primary rubber joint is presented. The stiffness of 12 new rubber joints equipped in drawbars is tested and the stiffness dispersions are investigated. The research results show that, for a single rubber joint, the maximum and minimum values of radial stiffness can, respectively, increase and reduce by 16.2% and 33% with respect to the test mean value. For the assembled axle-box with upper and lower drawbars, the test longitudinal and lateral stiffness increase by 18% and 46%, respectively, relative to the designed values. A distinct dispersion phenomenon in the stiffness distributions of rubber samples is found. By combining with the numerical simulation results, the primary longitudinal stiffness is optimized from 199 MN/m to 52 MN/m, as the lateral stiffness changes from 6.89 MN/m to 2.6 MN/m. The final running test indicates that the optimized parameters can reduce the wheel–rail lateral force by 12% in the 300 m radius curve. The ride comfort could still keep in the same level, and the running stability has not been deteriorated.
A diary study of expatriate adjustment: Collaborative mechanisms of social support
Authors: Bayraktar Secil
Published: March 2019

Understanding the antecedents of expatriate adjustment is vital for the success of international assignments. Social support is one of the most critical predictors of cross-cultural adjustment. Nevertheless, the nuances and interaction of diverse sources and types of support in the expatriates’ social networks need further scrutiny. This study examines the distinct and collaborative role of four different social groups in the expatriates’ social network, specifically host country nationals, home country nationals, compatriots, and foreign expatriates, on expatriate adjustment. For that purpose, an exploratory qualitative approach was adopted by using a diary study. The study was conducted with 42 single expatriates working in 21 different countries. The results showed that the nature of support provided by each social group was distinct, contributing to expatriate adjustment via different mechanisms. Moreover, it was found that these mechanisms worked collaboratively toward facilitating the expatriate adjustment.
A dynamic risk assessment method to address safety of navigation concerns around offshore renewable energy installations
Authors: Mehdi Raza Ali , Baldauf Michael , Deeb Hasan
Published: March 2019

This work focuses on the development of a deterministic dynamic risk method that can be used by operational end-users such as seafarers, when navigating in restricted waters where there is spatial conflict due to multi-use of marine areas by the shipping and offshore renewable energy industries. The developed method can also be used during the planning stages of offshore renewable energy installations. A case study of vessel operations near an offshore wind farm is also presented. The article also briefly discusses the potential application of manoeuvring-based dynamic risk methods to resolve spatial conflicts in the maritime, as well as other transport domains.
International Education Teachers’ Experiences as an Educational Precariat in China
Authors: Poole Adam
Published: March 2019

The purpose of this paper is to extend Bunnell’s (2016) thesis that international education teachers (IETs) are forming a ‘global educational precariat’. The paper draws upon interview data from a larger study of international teachers in two international schools in Shanghai, China. In order to substantiate and develop Bunnell’s thesis, narrative inquiry was employed as a guiding methodology, which ensured that data analysis remained rooted in the participants’ lived experience but also allowed for triangulation, thereby enhancing validity. Findings confirm Bunnell’s thesis by highlighting a lack of agency, financial insecurity, and the marginalisation of professional identities as common experiences of IET precarity. The findings also challenge the notion of a global educational precariat by arguing that it may be more appropriate to conceptualise IETs in terms of a localised educational precariat rather than a global class in and of itself. The paper ends by sketching a research agenda that would involve comparing teachers’ experiences in different types of international schools in China and other contexts.
Recruiting and Retaining Young Urban Black Men in a Study of Violence: Procedures Used and Lessons Learned
Authors: Leech Tamara G. J. , Irby-Shasanmi Amy , Sow Hadya
Published: March 2019

We conducted a study about three common recruitment and retention obstacles facing scholars interested in racial disparities research: potential mistrust from the black community, a stigmatized research topic, and high participation burden. Nonetheless, we successfully recruited and retained 28 young black men in a three-month study of violence. In this article, we describe and explore the recruitment, engagement, and retention strategies employed during the study. Using a concurrent triangulation mixed-method design, we analyzed data from our web-based administrative system, participant enrollment and exit surveys, and team members’ field notes. A large percentage (79%) of participants completed the study. We received 81% of 556 expected surveys, and 100% of the remaining participants wanted to continue participating at study’s end. We conclude that internal incentives, the combination of informal and formal community recruiters, the visibility of the principal investigator, and face-to-face meetings may have contributed to the success of the project.
Elicitation as a Mind-Set: Why Visual Data Matter?
Authors: Roger Kerstin Stieber , Blomgren Constance
Published: March 2019

This article explores how the use of participatory visual methods can enhance and promote a mind-set of elicitation for researchers throughout the research process. By exploring five case studies that used images at varying stages, the authors analyzed these cases exploring how the use of images demonstrates a valuable mind-set of elicitation at every stage of the research process. This article explores how the use of participatory visual methods and an elicitation mind-set can, by way of summary, promote recruitment, enhance deeper data collection, further engagement by community members in research, and support richer knowledge intermediation back to a community. This article explores how the nature of images used in research in smaller Prairie-based or rural and Northern communities did, through the use of visual and participatory methodologies, expand the success, impact, and reach of elicitation in research.
A novel fixable cylindrical ultrasonic motor
Authors: Sun Dong , Tang Yu-juan , Wang Jiong , Wang Xin-jie
Published: March 2019

A novel cylindrical ultrasonic motor easy to be fixed is proposed in this article. There are threaded holes on the bottom of stator used for fixing, distinguishing it from other cylindrical stators. The bottom is machined as a round lug boss. Its radius is smaller than the inner radius of the stator in order not to affect the excitation of vibration mode. The finite element analysis was accomplished to verify the working principle. Based on the analysis, a prototype was fabricated and measured. The mechanical output characteristics were obtained by experiments. The maximal velocity of the proposed motor is 170 r/min at the operating frequency of 31.6 kHz.
Dynamic modeling and adaptive fuzzy terminal sliding mode controller with nonlinear observer of a 2-(PUU)2R hybrid mechanism
Authors: Zhang Xing , Mu Dejun , Wang Hongrui
Published: March 2019

This article proposes a new spatial 2-(PUU)2R hybrid mechanism that can perform the three degrees of freedom translation and one degree of freedom rotation and presents an analysis of the dynamics of the mechanism. An adaptive fuzzy terminal sliding mode controller with nonlinear observer for the hybrid mechanism is proposed to achieve a precise trajectory tracking, which could be utilized in solving the problems of the hybrid mechanism caused by model uncertainties, varying payloads, and external disturbances. Firstly, through the interrelation between the constraints, the 6 × 6 Jacobian matrix and 6 × 6 × 6 Hessian matrix for the mechanism are derived. Furthermore, dynamic modeling is established based on the virtual work principle, through which the characteristics of dynamic modeling can be proved. To achieve high-precision position tracking, a nonlinear observer was introduced to feed into the terminal sliding mode control which had improved the mechanism’s ability to resist the external disturbances. In addition, the chattering caused by the terminal sliding mode control was eliminated by approximating the switching gain with the usage of adaptive fuzzy logic in a finite time. Finally, a series of numerical simulations are carried out to prove the validity of the proposed approach, and the results verify better robustness and higher precision for the trajectory tracking than proportional–integral–derivative and sliding mode control.
The security field: Forming and expanding a Bourdieusian criminology
Authors: Bowden Matt
Published: March 2019

Recent scholarly contributions have sought to integrate Bourdieusian sociology with criminology, centring for example, on the ‘street’ field as a symbolic and narrative space occupied by players within criminal justice. This article complements this broad objective by focusing on the changes in contemporary police and security governance that are pointing towards an emerging security field. Such a change can be read from the literature on plural policing and crime control, and involves the morphology of policing into nodes or assemblages of security producers. While there has been some attention to the formation of security networks, further empirical work is required to map the field dynamics using a Bourdieusian toolkit. This article explores the concept of the security field, presents some observations from current field research and identifies some remaining questions and challenges for further conceptualization and empirical research.
School Nurses on the Front Lines of Medicine: The Approach to a Student With Severe Traumatic Bleeding
Authors: Erdman Marcus O. , Chardavoyne Paige , Olympia Robert P.
Published: March 2019

With the continued threat of mass casualty incidents in schools and surrounding communities, it is essential for school nurses to be knowledgeable regarding the recognition of hemorrhagic shock due to massive bleeding and the acute management of these victims. In the past decade, increased interest and research in acute bleeding control have led to published evidence-based guidelines to reduce morbidity and mortality for victims of violent acts. It is essential that healthcare providers, including nurses who are the first responders in schools, are aware of methods to assess and control massive bleeding. This article summarizes the most up-to-date recommendations for the management of children with traumatic bleeding.
The decline in middle-skilled employment in 12 European countries: New evidence for job polarisation
Authors: Peugny Camille
Published: March 2019

Is the middle class shrinking? This article contributes to the debate on job polarisation in Europe. Based on data from the European Union Labour Force Survey (EU-LFS) and looking at 12 European countries, it shows that there is an evident trend towards job polarisation. While this polarisation takes various forms, it is clearly the highest- and lowest-skilled jobs that have increased most rapidly among the active population over the past 20 years, to the detriment of middle-skilled jobs. The article then goes on to demonstrate that polarisation also exists when it comes to working conditions insofar as the lowest-skilled jobs are also where the most precarious employment conditions are found. Conversely, the remaining middle-skilled jobs are relatively shielded from this decline in working conditions.
Computer-aided pancreas segmentation based on 3D GRE Dixon MRI: a feasibility study
Authors: Gong Xiaoliang , Ma Chao , Yang Panpan , Chen Yufei , Du Chaolin , Fu Caixia , Lu Jian-Ping
Published: March 2019

Background

Pancreas segmentation is of great significance for pancreatic cancer radiotherapy positioning, pancreatic structure, and function evaluation.

Purpose

To investigate the feasibility of computer-aided pancreas segmentation based on optimized three-dimensional (3D) Dixon magnetic resonance imaging (MRI).

Material and Methods

Seventeen healthy volunteers (13 men, 4 women; mean age = 53.4 ± 13.2 years; age range = 28–76 years) underwent routine and optimized 3D gradient echo (GRE) Dixon MRI at 3.0 T. The computer-aided segmentation of the pancreas was executed by the Medical Imaging Interaction ToolKit (MITK) with the traditional segmentation algorithm pipeline (a threshold method and a morphological method) on the opposed-phase and water images of Dixon. The performances of our proposed computer segmentation method were evaluated by Dice coefficients and two-dimensional (2D)/3D visualization figures, which were compared for the opposed-phase and water images of routine and optimized Dixon sequences.

Results

The dice coefficients of the computer-aided pancreas segmentation were 0.633 ± 0.080 and 0.716 ± 0.033 for opposed-phase and water images of routine Dixon MRI, respectively, while they were 0.415 ± 0.143 and 0.779 ± 0.048 for the optimized Dixon MRI, respectively. The Dice index was significantly higher based on the water images of optimized Dixon than those in the other three groups (all P values < 0.001), including water images of routine Dixon MRI and both of the opposed-phase images of routine and optimized Dixon sequences.

Conclusion

Computer-aided pancreas segmentation based on Dixon MRI is feasible. The water images of optimized Dixon obtained the best similarity with a good stability.
An Econometric Analysis of Relationship between Economic Growth and Petroleum Consumption in India
Authors: Habib Musavir Ul
Published: March 2019

The objective of this study is to examine empirically the relationship between the petroleum consumption which is a non-renewable and fast-depleting natural resource and economic growth for India for the period 1980–2014. The results obtained thereof act as the tools for the proper resource management and the environmental planning for sustainability. The study found that economic growth and petroleum consumption are cointegrated and hence there is a long-run relationship between the petroleum consumption and economic growth; conversely speaking, petroleum consumption has a significant impact on the economic growth of India in the long run. So the reduction of petroleum consumption if undertaken will have the serious repercussions on economic growth of India in the long run. The Granger causality test confirms that there is unidirectional causality running from petroleum consumption to economic growth in the short run but not vice versa. Hence, the study found that to achieve the dual goal of economic growth and environmental sustainability, the policymakers should focus on conserving the non-renewable petroleum resources. But at the same time, the investment in the renewable energy sector ought to be pursued so as to maintain the same level of energy consumption as well as achieve the sustainable development.
Comparing Outcomes Between the Over-the-Top and All-Epiphyseal Techniques for Physeal-Sparing ACL Reconstruction: A Narrative Review
Authors: Wong Stephanie E. , Feeley Brian T. , Pandya Nirav K.
Published: March 2019

A variety of techniques are used for physeal-sparing anterior cruciate ligament (ACL) reconstruction; however, there is no clear consensus on the ideal surgical technique, the frequency of complications, and how to best avoid growth disturbance. The purpose of this study was to compare outcomes and complications between over-the-top and all-epiphyseal ACL reconstruction techniques. The hypothesis was that both physeal-sparing reconstruction techniques are efficacious, with similar risk of growth disturbance and complications. The Embase and PubMed databases were queried for studies on ACL ruptures in the skeletally immature population from 1985 to 2018. Full-text English studies were included (N = 160). Studies reporting rerupture and/or complications after physeal-sparing ACL reconstruction, specifically growth disturbance, were included (n = 10). Studies were separated into 2 groups: an all-epiphyseal group with femoral and tibial fixation points within the epiphysis and a group that had over-the-top femoral and tibial physeal-sparing reconstruction. Complications not specific to the pediatric population were excluded. Demographics, evaluation of skeletal maturity, surgical technique, growth disturbance, rerupture, and patient-reported outcome scores were collected. Data were analyzed in aggregate. The 10 studies included 482 knees. The mean age was 12.0 years; 81% of patients were male; and mean follow-up was 47.7 months. A total of 178 patients underwent all-epiphyseal reconstruction, and 298 had the femoral graft placed over the top. The rerupture rate was 9.0% (16 of 178) in the all-epiphyseal group and 7.2% (14 of 195) in the over-the-top group, of which 82% required revision reconstruction. Six patients had overgrowth in the all-epiphyseal group (mean, 1.8 cm) and 1 patient in the over-the-top group (1.5 cm). Three angular deformities occurred, all of which were in the over-the-top group. Both physeal-sparing ACL reconstruction techniques are successful. Overgrowth was more common in the all-epiphyseal group and angular deformity in the over-the-top group. Rerupture rates were similar between the groups. The authors recommend standardization of skeletal age assessment and baseline lower extremity alignment films.
Phytochemical and Antioxidant Activities of Cucumis africanus L.f.:: A Wild Vegetable of South Africa
Authors: Abifarin Taiwo Oluwafunmilola , Afolayan Anthony Jide , Otunola Gloria Aderonke
Published: March 2019

Objective.

To evaluate the phytochemical content and antioxidant potential of the acetone, aqueous, and methanol extracts of the fruit, leaf, and root of Cucumis africanus L.f.

Methods.

Total phenolic, flavonoid, and proanthocyanidin contents were evaluated using spectrophotometric methods. The free radical scavenging activity of the acetone, methanol, and aqueous extracts of the fruit, leaf, and root were evaluated against DPPH+, ABTS+, and phosphomolybdenum. Alkaloid and saponin contents were also determined.

Results.

The acetone extract of the fruit revealed the highest polyphenol content when compared with the other solvent extracts analyzed. Total phenol content of the parts tested ranged from 3.66 ± 0.17 to 44.98 ± 3.41, flavonoid content ranged from 4.63 ± 3.33 to 401.33 ± 7.89, and proanthocyanidin content ranged from 8.84 ± 2.65 to 504 ± 36.6. Significant amount of alkaloids present was observed in the fruits, leaf, and root (10.68 ± 0.68, 14.12 ± 1.67, and 12.15 ± 4.74), respectively, while saponin content was 33.33 ± 11.55, 26.67 ± 11.55, and 20.00 ± 0.00 for the fruit, leaf, and root, respectively. Solvent extracts showed significant antioxidant activity, with acetone showing highest antioxidant ability in correlation with the polyphenol contents. Based on the IC50 values, acetone extract of the root revealed the best DPPH radical scavenging ability, the leaf aqueous extract had the highest IC50 value for ABTS, and the methanol extract of the leaf was best for phosphomolybdenum assays.

Conclusion.

This study suggests that fruit, leaf, and root of Cucumis africanus could be a potential source of natural antioxidant and justifies its use in ethnomedicine.
A scale for patient-reported symptom assessment for patients with Erdheim-Chester disease
Authors: Diamond Eli L. , Reiner Anne S. , Buthorn Justin J. , Shuk Elyse , Applebaum Allison J. , Hyman David M. , Abdel-Wahab Omar , Rampal Raajit , Janku Filip , Brewer Kathleen , Campbell Jean , Mao Jun J. , Atkinson Thomas M. , Panageas Katherine S.
Published: March 2019

Erdheim-Chester disease (ECD) is an ultra-rare hematologic neoplasm characterized by somatic mutations of the MAPK pathway and by accumulation of lesional histiocytes within tissues. Clinical phenotypes and sites of disease involvement are heterogenous in ECD, and no tool exists for systematic and comprehensive assessment of ECD symptomatology. We describe a collaborative effort among ECD specialists, patient-reported outcome (PRO) methodologists, and ECD patients to develop the Erdheim-Chester Disease Symptom Scale (ECD-SS): a symptom inventory for clinical ECD care and evaluation of ECD therapies. Methodologically rigorous focus groups led to the identification of 63 ECD symptoms in 6 categories, incorporated into the ECD-SS with respect to both severity and frequency. Among 50 ECD patients participating in a prospective registry study completing the ECD-SS, 46 (92%) reported neurological/psychological symptoms, 29 (58%) reported pain, and at least one-half reported mood symptoms, memory problems, or fatigue. Symptoms were highly frequent or almost constant regardless of their severity. The ECD-SS is a rigorously developed, patient-centered tool that demonstrates the wide and previously unappreciated burden of symptomatology experienced by ECD patients. Further studies will refine the symptom inventory and define its psychometric properties and role in clinical care and investigation in the context of ECD.
Epilepsy Emergencies: Status Epilepticus, Acute Repetitive Seizures, and Autoimmune Encephalitis
Authors: VanHaerents Stephen , Gerard Elizabeth E.
Published: March 2019

PURPOSE OF REVIEW

This article reviews epilepsy emergencies, including status epilepticus, acute repetitive seizures, autoimmune encephalitis, and the current perspective on their diagnosis and treatment.

RECENT FINDINGS

Recent guidelines on the treatment of status epilepticus from the Neurocritical Care Society in 2012 and the American Epilepsy Society in 2016 highlight areas of consensus in the treatment of status epilepticus as well as areas of uncertainty. The TRENdS (Treatment of Recurrent Electrographic Nonconvulsive Seizures) trial is the first prospective randomized clinical trial to evaluate the efficacy of IV antiseizure medications in controlling nonconvulsive seizures on continuous EEG. It demonstrated that IV lacosamide is noninferior to fosphenytoin in this setting. Autoimmune encephalitis is an increasingly recognized cause of new-onset seizures or status epilepticus. Recently described scoring systems, the Antibody Prevalence in Epilepsy score and the Response to Immunotherapy in Epilepsy score, can help in the assessment of autoimmune encephalitis.

Status epilepticus, acute repetitive seizures, and autoimmune encephalitis are neurologic emergencies. For all these conditions, rapid and appropriate treatment may influence patient prognosis and mitigate neuronal injury. For convulsive status epilepticus, there is reasonable consensus on the initial steps that need to be taken. There is less agreement about the management of acute repetitive seizures and nonconvulsive status epilepticus. An increasingly recognized etiology of status epilepticus is autoimmune encephalitis, which may not be as rare as previously thought.
Evaluation of Seizure Etiology From Routine Testing to Genetic Evaluation
Authors: Schuele Stephan U.
Published: March 2019

PURPOSE OF REVIEW

Recognizing the cause of a first seizure and identifying the etiology of epilepsy are essential for management. A systematic approach to patients who present with a first seizure helps distinguish between an acute symptomatic seizure, a provoked or unprovoked seizure, and potential mimickers. Routine testing with EEG and MRI may reveal a predisposition for further seizures and help to establish the underlying epilepsy syndrome. An acquired etiology can be identified in 30% of patients with established epilepsy. The remaining 70% of patients have a presumably genetic etiology. Particularly in patients with specific epilepsy syndromes or suspicion for an autosomal dominant inheritance, genetic testing and counseling should be considered.

RECENT FINDINGS

Neuroimaging, autoimmune antibodies, and genetic testing have revolutionized our ability to investigate the etiology of many epilepsies. The new epilepsy classification distinguishes structural, metabolic, genetic, infectious, and immune-mediated etiologies, which often help determine prognosis and treatment.

There is growing acceptance and demystification of the termepilepsyas the most common cause for recurrent seizures. The new classification of epilepsy does not stop with the recognition of particular epilepsy syndromes but aims to determine the underlying etiology. This can lead to earlier recognition of surgical candidates, a better understanding of many of the genetic epilepsies, and medical treatments aimed at the underlying mechanism causing the disease.
Anesthetic Considerations in Saul-Wilson Syndrome, a Rare Skeletal Dysplasia: A Case Report
Authors: Matar Marla M.
Published: March 2019

Saul-Wilson syndrome, also known as microcephalic osteodysplastic dysplasia, is a rare type of dwarfism with significant anesthetic considerations. The genetic defect is associated with nearly uniform micrognathia, odontoid hypoplasia, and possible cervical spine instability that contribute to potentially increased risk of airway complications. Herein, we describe the anesthetic management of a 2-year-old child with Saul-Wilson syndrome.
Dynamic Hh signaling can generate temporal information during tissue patterning
Authors: García-Morales Diana , Navarro Tomás , Iannini Antonella , Míguez David G. , Casares Fernando
Published: March 2019

The differentiation of tissues and organs requires that cells exchange information in space and time. Spatial information is often conveyed by morphogens, molecules that disperse across receiving cells generating signaling gradients. Cells translate such concentration gradients into space-dependent patterns of gene expression and cellular behavior. But could morphogen gradients also convey developmental time? Here, investigating the developmental role of Hh on a component of the Drosophila visual system, the ocellar retina, we discovered that ocellar cells use the non-linear gradient of Hh as a temporal cue, collectively performing the biological equivalent of a mathematical logarithmic transformation. In this way, a morphogen diffusing from a non-moving source is decoded as a wave of differentiating photoreceptors that travels at constant speed throughout the retinal epithelium.
Standardizing Analytic Methods and Reporting in Activity Monitor Validation Studies
Authors: WELK GREGORY J. , BAI YANG , LEE JUNG-MIN , GODINO JOB , SAINT-MAURICE PEDRO F. , CARR LUCAS
Published: March 2019

Introduction

A lack of standardization with accelerometry-based monitors has made it hard to advance applications for both research and practice. Resolving these challenges is essential for developing methods for consistent, agnostic reporting of physical activity outcomes from wearable monitors in clinical applications.

Methods

This article reviewed the literature on the methods used to evaluate the validity of contemporary consumer activity monitors. A rationale for focusing on energy expenditure as a key outcome measure in validation studies was provided followed by a summary of the strengths and limitations of different analytical methods. The primary review included 23 recent validation studies that collectively reported energy expenditure estimates from 58 monitors relative to values from appropriate criterion measures.

Results

The majority of studies reported weak indicators such as correlation coefficients (87%), but only half (52%) reported the recommended summary statistic of mean absolute percent error needed to evaluate actual individual error. Fewer used appropriate tests of agreement such as equivalence testing (22%).

Conclusions

The use of inappropriate analytic methods and incomplete reporting of outcomes is a major limitation for systematically advancing research with both research grade and consumer-grade activity monitors. Guidelines are provided to standardize analytic methods and reporting in these types of studies to enhance the utility of the devices for clinical mHealth applications.
Beep Test Performance Is Influenced by 30 Minutes of Cognitive Work
Authors: MACMAHON CLARE , HAWKINS ZACKARY , SCHÜCKER LINDA
Published: March 2019

Purpose

This study explored conflicting findings in the literature on the influence of perceived cognitive fatigue on physical performance by testing the effect of the Stroop task (high cognitive load) on an intermittent running test (beep test).

Methods

In a within-subjects repeated-measures experiment, 13 active athletes performed the beep test on two occasions, in a randomized, counterbalanced order. In each session, a preceding cognitive task was completed for 30 min, with the incongruent Stroop task in the high load condition, and the congruent Stroop task in the low load condition. Perceived cognitive fatigue was measured before testing (baseline) and at 10, 20, and 30 min of the cognitive load manipulation. Perceived effort on the cognitive task and general motivation for the physical task (beep test) were measured before the beep test, and motivation-related perception of the beep test and ratings of perceived exertion were measured after completion of the test. Heart rate and beep test performance (completion stage and time) were also recorded.

Results

The incongruent Stroop task was perceived as more fatiguing and effortful. Participants also withdrew from the beep test significantly earlier in the high load condition (M = 8:48 min, SD = 2:32 min) compared to the low load condition (M = 9:20 min, SD = 2:28 min), F (1,11) = 21.76, P < 0.01, ŋ
2 = 0.67. There were no differences in heart rate or general motivation between the two conditions.

Conclusions

Whereas previous research shows that active athletes can maintain performance on the beep test after 10 min of the incongruent Stroop task, this study shows that performance is impaired after 30 min. Variables in need of exploration in future investigations include experience with both the physical and cognitive task.
Public Debt and Low Interest Rates
Authors: Blanchard Olivier
Published: March 2019

This lecture focuses on the costs of public debt when safe interest rates are low. I develop four main arguments. First, I show that the current US situation, in which safe interest rates are expected to remain below growth rates for a long time, is more the historical norm than the exception. If the future is like the past, this implies that debt rollovers, that is the issuance of debt without a later increase in taxes, may well be feasible. Put bluntly, public debt may have no fiscal cost. Second, even in the absence of fiscal costs, public debt reduces capital accumulation, and may therefore have welfare costs. I show that welfare costs may be smaller than typically assumed. The reason is that the safe rate is the risk-adjusted rate of return to capital. If it is lower than the growth rate, it indicates that the risk-adjusted rate of return to capital is in fact low. The average risky rate however also plays a role. I show how both the average risky rate and the average safe rate determine welfare outcomes. Third, I look at the evidence on the average risky rate, i.e., the average marginal product of capital. While the measured rate of earnings has been and is still quite high, the evidence from asset markets suggests that the marginal product of capital may be lower, with the difference reflecting either mismeasurement of capital or rents. This matters for debt: the lower the marginal product, the lower the welfare cost of debt. Fourth, I discuss a number of arguments against high public debt, and in particular the existence of multiple equilibria where investors believe debt to be risky and, by requiring a risk premium, increase the fiscal burden and make debt effectively more risky. This is a very relevant argument, but it does not have straightforward implications for the appropriate level of debt. My purpose in the lecture is not to argue for more public debt, especially in the current political environment. It is to have a richer discussion of the costs of debt and of fiscal policy than is currently the case. (JEL E22, E23, E43, E62, H63)
Surviving and thriving in the Fourth Industrial Revolution: Digital skills for education and society
Authors: Tsekeris Charalambos
Published: March 2019

This concise article maintains that, in times of structural and persistent crisis, Europe needs to effectively tackle the multiple challenges and existential fears by cultivating a strong and dynamical digital skills ecosystem, based on collective values and the fundamental liberal principles of co-creation, co-evolution, and collective intelligence, over against the obsolete principles of optimisation and top-down administration and control. This will arguably result in upgrading humanism (humanism 2.0) and democracy (democracy 2.0), and in boosting responsible innovation and, therefore, adaptiveness, as well as in translating technological progress into inclusive and sustainable economic growth, and risks into creative opportunities for all citizens.
Pollen tube contents from failed fertilization contribute to seed coat initiation in Arabidopsis
Authors: Liu Xiaoyan , Adhikari Parakash Babu , Kasahara Ryushiro D.
Published: March 2019

Plant seeds are essential for human beings, constituting 70% of carbohydrate resources worldwide; examples include rice, wheat, and corn. In angiosperms, fertilization of the egg by a sperm cell is required for seed formation; therefore, fertilization failure results in no seed formation, except in the special case of apomixis. Initially, plants produce many pollen grains inside the anthers; once the pollen grain is deposited onto the top of the pistil, the pollen tube elongates until it reaches the ovule. Generally, only one pollen tube is inserted into the ovule; however, we previously found that if fertilization by the first pollen tube fails, a second pollen tube could rescue fertilization via the so-called fertilization recovery system (FRS). Our previous reports also demonstrated that failed fertilization results in pollen tube-dependent ovule enlargement morphology (POEM), enlarged seeds, and partial seed coat formation if the pollen tube releases the pollen tube contents into the ovule. However, we have not determined whether all the ovules enlarge or produce seed coats if an ovule accepts the pollen tube contents. Therefore, we conducted a partial seed coat formation experiment taking into account both the FRS and POEM phenomena. Notably, the ratios of failed fertilization and the ovules with partial seed coats matched, indicating that all ovules initiate seed coat formation if the fertilization fails but the pollen tube contents enter the ovule. In addition, we confirmed that the agl62 mutant , defective in early endosperm formation, showed seed coat initiation with and without fertilization, indicating that for a normal seed coat initiation, fertilization is not required; however, for the completion of normal seed coat formation, both normal fertilization and endosperm formation are required. Further molecular evidence is required to understand these phenomena because very few factors related to FRS and POEM have been identified.
Efeitos do uso de TI móvel em sala de aula
Authors: Carvalho Jackson Soares de , Oliveira Deyvison De Lima , Souza José Arilson de , Ramos Elder Gomes
Published: March 2019

Nas instituições de ensino superior, a Tecnologia da Informação (TI) móvel é utilizada para tarefas previstas no plano de ensino e para atividades sem relação alguma com a aula. Este artigo buscou identificar os efeitos negativos do uso de TI móvel pelos discentes em sala de aula. Para tanto, os procedimentos metodológicos de coleta de dados consistiram em observação direta e em entrevistas com docentes e com um grupo focal com discentes. Para a análise dos dados coletados, adotou-se a análise de conteúdo. Por meio de levantamento bibliográfico, foi possível identificar 14 efeitos negativos da TI sobre os usuários. Na percepção dos entrevistados, 13 desses efeitos têm impacto significativo sobre os usuários. Os docentes e discentes participantes da pesquisa acreditam que o futuro da educação passa por uma presença ainda maior da tecnologia e que os efeitos negativos disso devem ser conhecidos para que sejam minimizados, melhorando, a qualidade do ensino.
DESCRITORES DA QUALIDADE DO SERVIÇO DE RESTAURANTES UNIVERSITÁRIOS COM FOCO NA PERCEPÇÃO DOS CLIENTES
Authors: Barbosa Mariana Vieira , Rocha Tamira Guilherme , Da Silva Tânia Muzy , Tonini Karla Andrea Dulce , Costa da Silva Thadia Thuron , Magalhães Couto Garcia Silvia Regina
Published: March 2019

No que se refere ao restaurante, a comida é somente o fim para a concretização da vivência de uma refeição, pois existem outros fatores considerados tangíveis e intangíveis que contribuem para o sucesso dessa experiência de consumo. Segundo Parasuraman et al., o que ocorre muitas vezes é uma diferença entre a expectativa do cliente em relação ao serviço e a percepção da gerência sobre o serviço prestado. Para este artigo, realizou-se estudo qualitativo baseado no instrumento SERVQUAL com estudantes universitários, clientes do sistema de alimentação de uma universidade pública. Empregou-se a técnica investigativa de grupos focais, com o propósito de identificar os principais descritores que norteiam a qualidade do serviço oferecido pelo restaurante universitário, segundo a percepção dos clientes. De acordo com os resultados, o questionário SERVQUAL contempla de maneira geral o serviço ora estudado; algumas especificidades,no entanto, como velocidade no atendimento, atendimento individualizado e preço merecem atenção especial, assim como determinantes como higiene das instalações e da refeição e preço deveriam ser mais explorados no questionário.Palavras-chave: Alimentação coletiva. Comportamento do consumidor. Estudantes.DOI: 10.12957/demetra.2019.33193
Teorias de enfermagem na promoção do conforto em dermatologia
Authors: Brandão Euzeli Da Silva , Santos Iraci Dos
Published: March 2019

Objetivo: refletir sobre a aplicação dos conceitos de Henderson e Kolcaba durante o cuidado a pessoa com afecção cutânea, visando à promoção do conforto, além da autonomia do enfermeiro. Conteúdo: estudo de reflexão pautado nos conceitos de Henderson, Kolcaba e nos atributos para avaliação do conforto em dermatologia. A restauração do equilíbrio das dimensões física, mental e espiritual exige uma fundamentação filosófica, teórica e tecnológica. Esta encontra respaldo na filosofia de Henderson, que visualizava a função da enfermeira como específica, autônoma e independente. A existência de necessidades de conforto não atendidas pressupõe a necessidade de intervenção. Assim, utilizou-se a análise conceptual do termo conforto, proposto por Kolcaba, incluindo três sentidos técnicos e quatro contextos, além dos atributos como: dor, mobilidade, padrão de sono, entre outros, considerados essenciais na avaliação do conforto em dermatologia. Conclusão: conclui-se que essa reflexão poderá contribuir para utilização das teorias citadas na prática de cuidar em dermatologia.
Taurodontism part 2: biomechanics, differential diagnosis, clinical implications and management
Authors: Hasan Muhammad
Published: March 2019

The first article described history, aetiology, molecular signalling mechanism, epidemiology and classification of taurodontism. This final article of the two-part series focuses on the biomechanics and other clinical aspects of taurodontism.

In certain disorders, especially during initial stages, the teeth can appear taurodontic and may complicate diagnosis. These conditions, along with their key features, are highlighted in this article, as are several syndromes relevant to taurodontism. In addition, the sections on imaging and clinical considerations discuss diagnostic methods and management of taurodontic teeth, respectively. Taurodontism, especially in severe forms, can be a root canal challenge. Sometimes, multiple taurodontism is seen in association with various syndromes and perhaps may assist in early diagnosis.

CPD/Clinical Relevance: Taurodontism has clinical implications in various dental disciplines, such as endodontics, surgery, orthodontics and prosthodontics. However, it is most relevant to endodontists as this deviation exclusively affects the internal anatomy of teeth.
The right mix
Authors: Mathers Sandra
Published: March 2019

Practitioners are aware of the need for CPD, but not all training is created equal. Knowing how to identify effective, evidence-based professional development is key, says the University of Oxford's Sandra Mathers
Pay slip
Authors: Rawstrone Annette
Published: March 2019

Many settings are wondering how they are going to afford the upcoming 5 per cent increase to the National Living Wage, let alone keep pay differentials to reward senior staff. So what are the options? Annette Rawstrone reports