bluuebunny/crossref_metadata_2025 huggingface dataset:
Peripheral Microvascular Function Reflects Coronary Vascular Function
Authors: Al-Badri Ahmed , Kim Jeong Hwan , Liu Chang , Mehta Puja K. , Quyyumi Arshed A.
Published: April 2019

Objectives—

Coronary endothelial dysfunction is a precursor of atherosclerosis and adverse outcomes. Whether endothelial dysfunction is a localized or generalized phenomenon in humans remains uncertain. We simultaneously measured femoral and coronary vascular function with the hypothesis that peripheral vascular endothelial function will be reflective of coronary endothelial function.

Approach and Results—

Eighty-five subjects underwent coronary angiography for evaluation of chest pain or abnormal stress tests. Endothelium-dependent and -independent vascular function were measured using intracoronary and intrafemoral infusions of acetylcholine and sodium nitroprusside, respectively. Coronary flow reserve was assessed using intracoronary adenosine infusion. Flow velocity was measured in each circulation using a Doppler wire (FloWire, EndoSonics). Coronary vascular resistance and femoral vascular resistance were calculated as mean arterial pressure (mm Hg)/coronary blood flow (mL/min) and mean arterial pressure (mm Hg)/femoral average peak velocity (cm/s), respectively. Mean age was 53±11 years, 37% were female, 44% had hypertension, 12% had diabetes mellitus, and 38% had obstructive coronary artery disease. There was a correlation between the change in femoral vascular resistance with acetylcholine and acetylcholine-mediated changes in both the coronary vascular resistance (
r
=0.27;
P
=0.014) and in the epicardial coronary artery diameter (
r
=−0.25;
P
=0.021), indicating that subjects with normal endothelial function in the femoral circulation had normal endothelial function in the coronary epicardial and microcirculation and vice versa. The coronary vasodilator response to adenosine also correlated with the femoral vasodilatation with acetylcholine (
r
=0.4;
P
=0.0002). There was no correlation between the coronary and femoral responses to sodium nitroprusside.

Conclusions—

Endothelial functional changes in the peripheral and coronary circulations were modestly correlated. Thus, peripheral microvascular endothelial function reflects endothelium-dependent coronary epicardial and microvascular function and the coronary flow reserve.

Visual Overview—

An online visual overview is available for this article.
Role of TPBG (Trophoblast Glycoprotein) Antigen in Human Pericyte Migratory and Angiogenic Activity
Authors: Spencer Helen L. , Jover Eva , Cathery William , Avolio Elisa , Rodriguez-Arabaolaza Iker , Thomas Anita C. , Alvino Valeria V. , Sala-Newby Graciela , Dang Zexu , Fagnano Marco , Reni Carlotta , Rowlinson Jonathan , Vono Rosa , Spinetti Gaia , Beltrami Antonio P. , Gargioli Cesare , Caporali Andrea , Angelini Gianni , Madeddu Paolo
Published: April 2019

Objective—

To determine the role of the oncofetal protein TPBG (trophoblast glycoprotein) in normal vascular function and reparative vascularization.

Approach and Results—

Immunohistochemistry of human veins was used to show TPBG expression in vascular smooth muscle cells and adventitial pericyte-like cells (APCs). ELISA, Western blot, immunocytochemistry, and proximity ligation assays evidenced a hypoxia-dependent upregulation of TPBG in APCs not found in vascular smooth muscle cells or endothelial cells. This involves the transcriptional modulator CITED2 (Atypical chemokine receptor 3 CBP/p300-interacting transactivator with glutamic acid (E)/aspartic acid (D)-rich tail) and downstream activation of CXCL12 (chemokine [C-X-C motif] ligand-12) signaling through the CXCR7 (C-X-C chemokine receptor type 7) receptor and ERK1/2 (extracellular signal-regulated kinases 1/2). TPBG silencing by siRNA transfection downregulated CXCL12, CXCR7, and pERK (phospho Thr202/Tyr204 ERK1/2) and reduced the APC migratory and proangiogenic capacities. TPBG forced expression induced opposite effects, which were associated with the formation of CXCR7/CXCR4 (C-X-C chemokine receptor type 4) heterodimers and could be contrasted by CXCL12 and CXCR7 neutralization. In vivo Matrigel plug assays using APCs with or without TPBG silencing evidenced TPBG is essential for angiogenesis. Finally, in immunosuppressed mice with limb ischemia, intramuscular injection of TPBG-overexpressing APCs surpassed naïve APCs in enhancing perfusion recovery and reducing the rate of toe necrosis.

Conclusions—

TPBG orchestrates the migratory and angiogenic activities of pericytes through the activation of the CXCL12/CXCR7/pERK axis. This novel mechanism could be a relevant target for therapeutic improvement of reparative angiogenesis.
Thirty‐Day Readmission After Infective Endocarditis: Analysis From a Nationwide Readmission Database
Authors: Morita Yusuke , Haruna Tetsuya , Haruna Yoshisumi , Nakane Eisaku , Yamaji Yuhei , Hayashi Hideyuki , Hanyu Michiya , Inoko Moriaki
Published: April 2019

Background

The contemporary incidence of and reasons for early readmission after infective endocarditis (
IE
) are not well known. Therefore, we analyzed 30‐day readmission demographics after
IE
from the US Nationwide Readmission Database.

Methods and Results

We examined the 2010 to 2014 Nationwide Readmission Database to identify index admissions for a primary diagnosis of
IE
with survival at discharge. Incidence, reasons, and independent predictors of 30‐day unplanned readmissions were analyzed. In total, 11 217 patients (24.8%) were nonelectively readmitted within 30 days among the 45 214 index admissions discharged after
IE
. The most common causes of readmission were
IE
(20.5%), sepsis (8.7%), complications of device/graft (8.1%), and congestive heart failure (7.6%). In‐hospital mortality and the valvular surgery rates during the readmissions were 8.1% and 9.1%, respectively. Discharge to home or self‐care, undergoing valvular surgery, aged ≥60 years, and having private insurance were independently associated with lower rates of 30‐day readmission. Length of stay of ≥10 days, congestive heart failure, diabetes mellitus, renal failure, chronic pulmonary disease, peripheral artery disease, and depression were associated with higher risk. The total hospital costs of readmission were $48.7 million per year (median, $11 267; interquartile range, $6021–$25 073), which accounted for 38.6% of the total episodes of care (index+readmission).

Conclusions

Almost 1 in 4 patients was readmitted within 30 days of admission for
IE
. The most common reasons were
IE
, other infectious causes, and cardiac causes. A multidisciplinary approach to determine the surgical indications and close monitoring are necessary to improve outcomes and reduce complications in in‐hospital and postdischarge settings.
Quality and Value of Health Care in the Veterans Health Administration: A Qualitative Study
Authors: Segal Andrea G. , Rodriguez Keri L. , Shea Judy A. , Hruska Kristina L. , Walker Lorrie , Groeneveld Peter W.
Published: April 2019

Background

The attitudes of Department of Veterans Affairs (
VA
) cardiovascular clinicians toward the
VA
's quality‐of‐care processes, clinical outcomes measures, and healthcare value are not well understood.

Methods and Results

Semistructured telephone interviews were conducted with cardiovascular healthcare providers (n=31) at
VA
hospitals that were previously identified as high or low performers in terms of healthcare value. The interviews focused on
VA
providers’ experiences with measures of processes, outcomes, and value (ie, costs relative to outcomes) of cardiovascular care. Most providers were aware of process‐of‐care measurements, received regular feedback generated from those data, and used that feedback to change their practices. Fewer respondents reported clinical outcomes measures influencing their practice, and virtually no participants used value data to inform their practice, although several described administrative barriers limiting high‐cost care. Providers also expressed general enthusiasm for the
VA
's quality measurement/improvement efforts, with relatively few criticisms about the workload or opportunity costs inherent in clinical performance data collection. There were no material differences in the responses of employees of low‐performing versus high‐performing
VA
medical centers.

Conclusions

Regardless of their medical center's healthcare value performance, most
VA
cardiovascular providers used feedback from process‐of‐care data to inform their practice. However, clinical outcomes data were used more rarely, and value‐of‐care data were almost never used. The limited use of outcomes data to inform healthcare practice raises concern that healthcare outcomes may have insufficient influence, whereas the lack of value data influencing cardiovascular care practices may perpetuate inefficiencies in resource use.
Role of Perivascular Oligodendrocyte Precursor Cells in Angiogenesis After Brain Ischemia
Authors: Kishida Natsue , Maki Takakuni , Takagi Yasushi , Yasuda Ken , Kinoshita Hisanori , Ayaki Takashi , Noro Takayuki , Kinoshita Yusuke , Ono Yuichi , Kataoka Hiroharu , Yoshida Kazumichi , Lo Eng H. , Arai Ken , Miyamoto Susumu , Takahashi Ryosuke
Published: April 2019

Background

Oligodendrocyte precursor cells (
OPC
s) regulate neuronal, glial, and vascular systems in diverse ways and display phenotypic heterogeneity beyond their established role as a reservoir for mature oligodendrocytes. However, the detailed phenotypic changes of
OPC
s after cerebral ischemia remain largely unknown. Here, we aimed to investigate the roles of reactive
OPC
s in the ischemic brain.

Methods and Results

The behavior of
OPC
s was evaluated in a mouse model of ischemic stroke produced by transient middle cerebral artery occlusion in vivo. For in vitro experiments, the phenotypic change of
OPC
s after oxygen glucose derivation was examined using a primary rat
OPC
culture. Furthermore, the therapeutic potential of hypoxic
OPC
s was evaluated in a mouse model of middle cerebral artery occlusion in vivo. Perivascular
OPC
s in the cerebral cortex were increased alongside poststroke angiogenesis in a mouse model of middle cerebral artery occlusion. In vitro
RNA
‐seq analysis revealed that primary cultured
OPC
s increased the gene expression of numerous pro‐angiogenic factors after oxygen glucose derivation. Hypoxic
OPC
s secreted a greater amount of pro‐angiogenic factors, such as vascular endothelial growth factor and angiopoietin‐1, compared with normoxic
OPC
s. Hypoxic
OPC
‐derived conditioned media increased the viability and tube formation of endothelial cells. In vivo studies also demonstrated that 5 consecutive daily treatments with hypoxic
OPC
‐conditioned media, beginning 2 days after middle cerebral artery occlusion, facilitated poststroke angiogenesis, alleviated infarct volume, and improved functional disabilities.

Conclusions

Following cerebral ischemia, the phenotype of
OPC
s in the cerebral cortex shifts from the parenchymal subtype to the perivascular subtype, which can promote angiogenesis. The optimal use of hypoxic
OPC
s secretome would provide a novel therapeutic option for stroke.
The Commemoration of the War Dead in Modern Japan
Authors: Nishimura Akira
Published: April 2019

This article begins by providing an overview of research trends in the study of the commemoration of the war dead in modern Japan. Studies of the attitudes of the living towards the dead in Japan have mainly focused on ancestor worship performed by family members. The issue of the war dead and their treatment has been the subject of debate within Japanese society since the end of the Second World War. Those who were killed in action, unlike other war casualties in Japan, have been accorded privileged treatment and been enshrined in Yasukuni. Studies of the commemoration of war dead in Japan began with the Yasukuni shrine issue, but research has recently appeared that deals with various types of commemoration. The latter part of this article discusses the commemorative pilgrimages in the former battlefields in Southeast Asia by Buddhist priests during the 1950s and 1960s. By doing so it provides an alternative perspective to the overly Yasukuni-centered discussion of the commemoration of war dead and highlights the missing link between the religious sectors’ engagement with the governmental project to recover the remains of the fallen and the later pilgrimages organized by each religious group that began in earnest after the lifting of restrictions on overseas travel in 1964.
Shifting Preservice Teachers’ Views of Animal Welfare and Advocacy through a Human-Animal Relationships Course
Authors: Tardif-Williams Christine Yvette , Binfet John-Tyler , Rousseau Camille Xinmei
Published: April 2019

This mixed-methods study explored how participation in an intensive course on human-animal relationships impacted preservice teachers’ views about human-animal welfare and advocacy and animal-focused curriculum. Participants were 25 undergraduate students (24 female; 1 male) following a teacher education pathway. Participants completed the Animal Rights Scale, and their insights on assigned readings were captured through weekly journal entries and responses to summative prompts. Participants reported feeling increased responsibility to advocate on behalf of nonhuman animals and greater support of animal welfare during the post-course (versus pre-course) assessment, and participants’ weekly and summative responses revealed some of the nuances and internal tensions in their thinking about integrating animal-focused curriculum as part of their future professional practice. As teachers play key roles fostering humane literacy and engaging young people with actual nature and animals, these findings have implications for both education and higher education curriculum and initiatives.
Young Men’s Employment and Their Marriage: A Comparison among Japan, South Korea, Singapore, the UK, France, and Sweden
Authors: Matsuda Shigeki
Published: April 2019

In Europe, falling fertility rates are regarded as part of a second demographic transition precipitated by changing values. Low fertility rates in developed Asian countries, however, are thought to be due to decreasing marriage rates, as a result of worsening young men’s employment. This study proposes the hypothesis that men in non-regular employment – those with low incomes and those who are unemployed – have lower probabilities of getting married. Male employment was analyzed using a logistic regression of micro data for 20- to 49-year-old men in Japan, South Korea, Singapore, the UK, France, and Sweden. The study’s findings generally supported the hypothesis and clearly confirmed that there is a relationship between employment and marriage in Asian countries, and especially in Japan.
Individual Attitudes toward the Welfare State: A Test of the “Crowding Out Hypothesis” across European Countries
Authors: Yuksek Durmus A. , Solakoglu Ozgur
Published: April 2019

Although numerous studies have confirmed the relationship between welfare states and social capital, their arguments have been contradictory. Some argue that strong welfare states crowd out social capital, while others consider the welfare state as a stimulator of social capital. However, research focusing on both the arguments simultaneously and considering whether or not welfare states can both make and break social capital is almost unavailable. Also, individual attitudes toward the welfare state have mainly been the neglected part of this research tradition. Concordantly, findings of this study suggest that regardless of the strength of the civil society, a welfare state can both crowd out and crowd in social capital. While the comprehensiveness of the welfare state plays a part in stimulating or rather unlikely destroying social capital, it is actually the particular design, implementation of the welfare policies, and legitimacy of the state officials that make or break social capital.
Digital Diplomacy: Emotion and Identity in the Public Realm
Authors: Duncombe Constance
Published: April 2019

Public diplomacy is increasingly facilitated through social media. Government leaders and diplomats are using social media platforms such as Twitter, Facebook and Instagram to communicate with foreign publics, changing the dynamics of interaction between broadcaster and audience. The key to understanding the power of social media in public diplomacy is the role of emotion in digital diplomacy strategies: social media statements relating to state identity can incite strong emotions that have the potential to undermine heretofore positive diplomatic relations, or provide communicative openings that move towards ameliorating crises. Examining the interaction of social media, emotion and identity provides insight into the increasing importance of digital diplomacy and the future challenges relating to digital disinformation that lie ahead.
Wisdom that Delivers: Resurrection and Hope in the Book of Kings
Authors: Stulac Daniel J. D.
Published: April 2019

This essay examines the story of Solomon and the two prostitutes (1 Kgs 3:16-28) in relation to David’s judgment concerning Mephibosheth (2 Sam 19:25-31) and in relation to four “resurrection”-type stories in the book of Kings. Readers have traditionally interpreted Solomon’s judgment favorably, though recently some have argued that Solomon’s wisdom is ironic. This essay argues that the Solomon of Kings presents as an irreducible paradox, as both an ideal and an anti-ideal. Read in light of 2 Sam 19:25-31, 1 Kgs 3:16-28 suggests that ideal Solomon surpasses his father in judgment through his restoration of a conceptually “dead” child to its mother. When viewed in this way, Solomon’s wisdom can be understood to launch a life-preservation typology central to the book’s theological hope. Reconsideration of Solomon’s character from this vantage point helps to illumine New Testament references to Solomon in both Matthew and Luke.
Paul’s Theology of Weakness in 1 Cor 8:1-14:40
Authors: Hiramatsu Kei
Published: April 2019

While partition theorists question the integrity of 1 Corinthians based on the observation that Paul addresses a variety of subjects in distinctive ways through this missive, a consistent theme does unite letter. Paul encourages the strong and privileged to renounce their status, rights, and freedom for the sake of the weak. Thus, this article explores Paul’s ecclesiology of the strong and the weak particularly in 8:1-14:40 by examining his address in each section (8:1-11:1; 11:2-11:16; 11:17-34; 12:1-14:40). In so doing, it seeks to demonstrate Paul’s theology of weakness as the underpinning theme of the letter.
Der ‘Münchener Psalter’ aus dem 14. Jahrhundert
Authors: Jeep John M.
Published: April 2019

A fourteenth-century version of Notker’s translation of the psalms with commentary yields 58 alliterating Middle High German word-pairs. These are compared with Notker’s original Old High German text, whereby phonological, morphological, semantic and syntactic changes are noted. In studying the transmission of the Biblical text, both continuity and change become evident.
Digital Journalistic Uses of the Terms “Sacred” and “Trivial”: Online Press Releases on Portrayals of Hindu Deities in the usa
Authors: Zeiler Xenia
Published: April 2019

The understanding of what is “sacred” and needs protection from alleged “trivialising” or “profaning” is obviously diverse. Especially in cases of severe dissent this is negotiated in public, including increasingly in digital journalistic contexts.

This article discusses media oppositions to an alleged “trivializing” of Hindu deities in the usa. It contextualizes and analyzes with coding techniques press releases from the website of Rajan Zed, president of the Nevada based Universal Society of Hinduism and the Indo-American Leadership Confederation. The article highlights that and how these press releases, each addressing a specific case of a purported trivialization of Kali, are utilized to propagate specific objectives and interpretations of Hinduism. The article presents an analysis of the verbal content of the online press releases, contextualizes this by discussing the subtext of the verbal expressions, and thus exemplifies that and how digital journalistic contexts contribute to current negotiations of religious identity and authority.
The Papal Election in the Philippines: Negotiating Religious Authority in Newspapers
Authors: Radde-Antweiler Kerstin
Published: April 2019

The Roman Catholic Church has always been present in news media worldwide. In 2013 the papal election caused special attention from the media because of the resignation by Benedict xvi. Heated discussions not only on the possible successor, but also on the necessary obligations of the Pope took place in the press discourse. Is there a changing understanding of authority, as the press coverage as well as millions of websites, Twitter contributions etc. suggested? The influence of new media on religious authority structures is assessed quite differently so far. However, what exactly is understood as religious authority? The paper presents exemplarily the press coverage in the Philippines and discusses the construction of religious authority in the press discourse during the papal election. Applying an analysis model, it thereby analyzes the different construction processes within a specific media genre and asks how and what kind of authority was ascribed to.
Axisymmetric Potential Vorticity Evolution of Hurricane Patricia (2015)
Authors: Martinez Jonathan , Bell Michael M. , Rogers Robert F. , Doyle James D.
Published: April 2019

Operational numerical models failed to predict the record-setting rapid intensification and rapid overwater weakening of Hurricane Patricia (2015) in the eastern North Pacific basin, resulting in large intensity forecast errors. In an effort to better understand the mesoscale processes contributing to Patricia’s rapid intensity changes, we analyze high-resolution aircraft observations collected on 22–23 October. Spline-based variational analyses are created from observations collected via in situ measurements, Doppler radar, and full-tropospheric dropsonde profiles as part of the Office of Naval Research Tropical Cyclone Intensity (TCI) experiment and the National Oceanic and Atmospheric Administration Intensity Forecasting Experiment (IFEX). We present the first full-tropospheric calculation of the dry, axisymmetric Ertel’s potential vorticity (PV) in a tropical cyclone without relying on balance assumptions. Detailed analyses reveal the formation of a “hollow tower” PV structure as Patricia rapidly approached its maximum intensity, and a subsequent breakdown of this structure during Patricia’s rapid overwater weakening phase. Transforming the axisymmetric PV analyses from radius–height to potential radius–isentropic coordinates reveals that Patricia’s rapid intensification was closely related to the distribution of diabatic heating and eddy mixing. During Patricia’s rapid overwater weakening phase, eddy mixing processes are hypothesized to be the primary factor rearranging the PV distribution near the eye–eyewall region, diluting the PV previously confined to the hollow tower while approximately conserving the absolute circulation.
Use of Historical Data to Assess Regional Climate Change
Authors: Lai Yuchuan , Dzombak David A.
Published: April 2019

Time series of historical annual average temperature, total precipitation, and extreme weather indices were constructed and analyzed for 103 (for temperature indices) and 115 (for precipitation indices) U.S. cities with climate records starting earlier than 1900. Mean rate of change and related 95% confidence bounds were calculated for each city using linear regression for the full periods of record. Box–Cox transformations of some time series of climate records were performed to address issues of non-normal distribution. Thirteen cities among the nine U.S. climate regions were selected and further evaluated with adequacy diagnoses and analyses for each month. The results show that many U.S. cities exhibit long-term historical increases in annual average temperature and precipitation, although there are spatial and temporal variations in the observed trends among the cities. Some cities in the Ohio Valley and Southeast regions exhibit decreasing or statistically nonsignificant increasing trends in temperatures. Many of the cities exhibiting statistically significant increases in precipitation are in the Northeast and Upper Midwest regions. The records for the cities are individually unique in both annual and monthly change, and cities within the same climate region sometimes exhibit substantially different changes. Within the full periods of record, discernible decade-long subtrends were observed for some cities; consequently, analysis of selected shorter periods can lead to inconclusive and biased results. These statistical analyses of constructed time series of city-specific long-term historical climate records provide detailed historical climate change information for cities across the United States.
Global Patterns of Submesoscale Surface Salinity Variability
Authors: Drushka Kyla , Asher William E. , Sprintall Janet , Gille Sarah T. , Hoang Clifford
Published: April 2019

Surface salinity variability on O(1–10) km lateral scales (the submesoscale) generates density variability and thus has implications for submesoscale dynamics. Satellite salinity measurements represent a spatial average over horizontal scales of approximately 40–100 km but are compared to point measurements for validation, so submesoscale salinity variability also complicates validation of satellite salinities. Here, we combine several databases of historical thermosalinograph (TSG) measurements made from ships to globally characterize surface submesoscale salinity, temperature, and density variability. In river plumes; regions affected by ice melt or upwelling; and the Gulf Stream, South Atlantic, and Agulhas Currents, submesoscale surface salinity variability is large. In these regions, horizontal salinity variability appears to explain some of the differences between surface salinities from the Aquarius and SMOS satellites and salinities measured with Argo floats. In other words, apparent satellite errors in highly variable regions in fact arise because Argo point measurements do not represent spatially averaged satellite data. Salinity dominates over temperature in generating submesoscale surface density variability throughout the tropical rainbands, in river plumes, and in polar regions. Horizontal density fronts on 10-km scales tend to be compensated (salinity and temperature have opposing effects on density) throughout most of the global oceans, with the exception of the south Indian and southwest Pacific Oceans between 20° and 30°S, where fronts tend to be anticompensated.
The Interrelations Between Different Causes of Dizziness: A Conceptual Framework for Understanding Vestibular Disorders
Authors: Zhu Richard T. , Van Rompaey Vincent , Ward Bryan K. , Van de Berg Raymond , Van de Heyning Paul , Sharon Jeffrey D.
Published: April 2019

Background:

According to population-based studies that estimate disease prevalence, the majority of patients evaluated at dizziness clinics receive a single vestibular diagnosis. However, accumulating literature supports the notion that different vestibular disorders are interrelated and often underdiagnosed.

Objective:

Given the complexity and richness of these interrelations, we propose that a more inclusive conceptual framework to vestibular diagnostics that explicitly acknowledges this web of association will better inform vestibular differential diagnosis.

Methods:

A narrative review was performed using PubMed database. Articles were included if they defined a cohort of patients, who were given specific vestibular diagnosis. The interrelations among vestibular disorders were analyzed and placed within a conceptual framework.

Results:

The frequency of patients currently receiving multiple vestibular diagnoses in dizziness clinic is approximately 3.7% (1263/33 968 patients). The most common vestibular diagnoses encountered in the dizziness clinic include benign paroxysmal positional vertigo (BPPV), vestibular migraine, vestibular neuritis, and Ménière’s disease.

Conclusions:

A review of the literature demonstrates an intricate web of interconnections among different vestibular disorders such as BPPV, vestibular migraine, Ménière’s disease, vestibular neuritis, bilateral vestibulopathy, superior canal dehiscence syndrome, persistent postural perceptual dizziness, anxiety, head trauma, and aging, among others.
A randomized controlled trial protocol investigating effectiveness of an activity-pacing program for deconditioned older adults
Authors: Timmer Amanda J. , Unsworth Carolyn A. , Browne Matthew
Published: April 2019

Background.

Acute hospitalization of older adults can lead to deconditioning and the need for rehabilitation to facilitate a return to home and previous lifestyle. An occupational therapy intervention to combat deconditioning is activity pacing, an active self-management strategy where individuals learn to modify how and when activities are completed with the aim of improving participation in occupation.

Purpose.

This study will examine the effectiveness of occupational therapy with activity pacing during rehabilitation for deconditioned older adults.

Method.

A randomized controlled trial is proposed with inclusion criteria of older adults, 65+ years old, living independently in the community prior to admission, with adequate cognition and language to participate in the intervention. Participation, health status, self-efficacy in daily activities, self-efficacy in activity pacing techniques, and symptom management (pain and fatigue) will be measured at admission, discharge, and 3 months postdischarge.

Implications.

Determining if an activity-pacing program is effective will provide occupational therapists with evidence to support service delivery.
Sociocybernetics and action research: Analysis and intervention in complex social problems
Authors: Almaguer-Kalixto Patricia E , Maass Moreno Margarita , Amozurrutia José Antonio
Published: April 2019

Participatory action research (PAR) has been used as a methodology for social intervention that combines research enquiry and action in the analysis of and intervention in complex social problems. However, a better systematization of complex social research processes is required to enable reflexivity at a participatory level and second-order observation of the full research system constructed. This article proposes a PAR model using conceptual and methodological elements of sociocybernetics, which is the application of first- and second-order cybernetics and general systems theory to social sciences. The authors see this model as able to reinforce the systematization of PAR, enabling a second-order reflexivity and feedback process through information analysis and communication strategies. The first part of the article explains how sociocybernetics concepts can contribute to this sociological methodology and discusses points of similarity between the two approaches and the basis of the proposed model. The second part addresses an empirical case of PAR developed in the context of the High Atlas in Morocco using the proposed model. By reinforcing a systems perspective, internal and external elements of the research system can be defined better to understand its relevance to optimal fulfilment of the research purpose. The value that sociocybernetics adds may be the comprehension of processes of change through the assimilation, accommodation and adaptation of the components and limits of the system, the feedback process and other interactions within the system and its environment, in order to analyse how social changes occur in complex settings.
A Measurement Is a Choice and Stevens’ Scales of Measurement Do Not Help Make It: A Response to Chalmers
Authors: Zumbo Bruno D. , Kroc Edward
Published: April 2019

Chalmers recently published a critique of the use of ordinal [Formula: see text] proposed in Zumbo et al. as a measure of test reliability in certain research settings. In this response, we take up the task of refuting Chalmers’ critique. We identify three broad misconceptions that characterize Chalmers’ criticisms: (1) confusing assumptions with consequences of mathematical models, and confusing both with definitions, (2) confusion about the definitions and relevance of Stevens’ scales of measurement, and (3) a failure to recognize that a measurement for a true quantity is a choice, not an absolute. On dissection of these misconceptions, we argue that Chalmers’ critique of ordinal [Formula: see text] is unfounded.
Weighing on us all? Quantification and cultural responses to obesity in NHS Britain
Authors: Bivins Roberta
Published: April 2019

How do cultures of self-quantification intersect with the modern state, particularly in relation to medical provision and health promotion? Here I explore the ways in which British practices and representations of body weight and weight management ignored or interacted with the National Health Service between 1948 and 2004. Through the lens of overweight, I examine health citizenship in the context of universal health provision funded from general taxation, and track attitudes toward “overweight” once its health implications and medical costs affected a public service as well as individual bodies and households. Looking at professional and popular discourses of overweight and obesity, I map the persistence of a highly individual culture of dietary and weight self-management in postwar Britain, and assess the degree to which it was challenged by a new measure of “obesity” – the body mass index – and by visions of an NHS burdened and even threatened by the increasing overweight of the citizens it was created to serve.
Summer thermal comfort and overheating in the elderly
Authors: Hughes Caroline , Natarajan Sukumar
Published: April 2019

Atypically warm summers such as 2003 and 2018 are predicted to become normal by 2050. If current climate projections are accurate, this could cause heat-related mortality to rise by 257% by 2050, the majority of which will be in vulnerable groups such as the elderly. However, little is known about the temperatures achieved in the homes of the elderly even in typical summers, and even less on whether these are comfortable. This study examines, for the first time, the validity of current thermal comfort models in predicting summer comfort levels in the 65+ demographic over a typical and an atypically warm summer. This was achieved through the first longitudinal study of thermal conditions in homes of the elderly in the South West UK, utilising repeated standardised monthly thermal comfort and health surveys with continuous temperature monitoring in both living and bed rooms. Results show that neither the PMV/PPD model (ISO 7730) nor the adaptive model (ISO 15251) accurately predict true thermal comfort in our sample. Overheating analysis using CIBSE TM59 (based on ISO 15251) suggests significantly more homes (50% living room, 94% bed room = 94% overall) overheated during the atypically warm summer, compared to the typical summer (3% living room, 57% bed room = 57% overall). These are worrying results, especially for the elderly, given the projected increases in both the severity and the frequency of extreme summers in a future, changed, climate.

Practical application: This paper provides new data on the performance of the homes of the elderly in both a typical and atypically warm summer. Our results could be considered for building performance evaluation in homes with elderly occupants to mitigate overheating risk. Crucially, we not only examine the impact of CIBSE criteria on these homes but also look at thermal acceptance, which is important to understand the true impact of elevated temperatures in this demographic.
Attitudes and Parameters Affecting the Behavior Toward Precursor Symptoms of Head and Neck Cancer
Authors: Vlastarakos Petros V. , Gkouvali Angeliki , Katsochi Despoina
Published: April 2019

The present study aimed to identify the association between sociodemographic and lifestyle-related factors with the response time from the appearance of symptoms potentially related to head and neck cancer (HNC) and gain an insight regarding the main source of health information about this specific area. Specific perceptions about human papillomavirus (HPV) infection in the head and neck area were also explored. An Internet-based survey was conducted between June 30, 2016, and July 31, 2016, using a structured questionnaire. The study sample comprised 1058 adults. A direct association was found between the response time period from the potential appearance of a mouth ulcer/soreness ( P < .001), earache ( P = .014), hoarseness ( P < .001), or painless lump in the neck ( P = .003) and alcohol consumption, as well as between smoking ( P = .012) and soft-drink consumption ( P < .001) and the appearance of hoarseness. Inverse association was found between age and the appearance of a mouth ulcer/soreness ( P = .017) and between a person’s educational level ( P < .001) and yearly income ( P = .006) and the appearance of an earache. A total of 79.1% of study participants seemed aware that oral sex represents the main mode of HPV transmission; this understanding was directly associated with a person’s educational level ( P < .001) and yearly income ( P = .001) and inversely associated with alcohol consumption ( P = .037). Health policy makers and health professionals need to devise strategies to increase the awareness of HNC risk associated with sexual behavior especially in young adults. The repressing effect of alcohol on timely patient response should be demonstrated in targeted campaigns, and the understanding of the “iceberg phenomenon,” frequently associating even common head and neck symptoms with HNC, acknowledged in undergraduate and postgraduate physician training.
Evaluating Simulator-Based Teaching Methods for Endoscopic Sinus Surgery
Authors: Lindquist Nathan R. , Leach Matthew , Simpson Matthew C. , Antisdel Jastin L.
Published: April 2019

A multitude of simulator systems for endoscopic sinus surgery (ESS) are available as training tools for residents preparing to enter the operating room. These include human cadavers, virtual reality, realistic anatomic models, and low-fidelity gelatin molds. While these models have been validated and evaluated as independent tools for surgical trainees, no study has performed direct comparison of their outcomes. To address this deficiency, we aimed to evaluate the utility of high-fidelity and low-fidelity trainers as compared to a traditional control (no simulator exposure) for novice trainees acquiring basic ESS skills. Thirty-four first-year medical students were randomized to 3 groups and taught basic sinus anatomy and instrumentation. Two groups received training with either the high-fidelity or low-fidelity trainer, while 1 group served as control. These groups were then tested with cadaveric specimens. These sessions were recorded and graded by an expert. There was no statistical difference in performance between the 3 study groups with regard to identification of anatomy, endoscopic competency, or completion of basic tasks. When the high-fidelity and low-fidelity arms were grouped into a single “trained” cohort, they demonstrated significantly improved time to completion for basic anatomy ( P = .043) and total time ( P = .041). This is the first study to perform a direct comparison of performance between high-fidelity and low-fidelity ESS simulators and controls. Although we found no difference in performance of novice trainees with regard to basic anatomical identification or procedural tasks associated with ESS, the use of ESS simulators may improve time to completion.
Patient and Clinician Perceptions of Prediabetes: A Mixed-Methods Primary Care Study
Authors: Roper Karen L. , Thomas Alisha R. , Hieronymus Laura , Brock Audrey , Keck James
Published: April 2019

Purpose

The purpose of the study was to assess patient and clinician perceptions of prediabetes in an academic family medicine practice. Data were collected in preparation for an implementation study to increase utilization of the National Diabetes Prevention Program (N-DPP).

Methods

In this mixed-methods study, discussions from 3 focus groups composed of patients with prediabetes were evaluated using thematic analysis for their understanding of and beliefs about prediabetes, care experiences, and attitudes toward N-DPP. Clinicians completed a Likert-scaled survey assessing attitudes and perceived barriers to providing prediabetes care.

Results

Among the 15 focus group participants, more than half were not aware of their diagnosis. Attitudes toward prediabetes were mixed: while many believed it was serious and elicited more fear than being “at risk,” others thought there were varying degrees of risk within the same diagnosis, making the diagnosis less impactful. Patients repeatedly expressed the perception that clinicians were not forthcoming about necessary behavior changes. Patients agreed on barriers to N-DPP, including scheduling and transportation. Clinicians (N = 31) concurred that patients lack awareness of their prediabetes diagnosis. They reported that time is available to screen all patients and that a prediabetes diagnosis is effective for advising patients of the need for lifestyle modification. There was consensus from both patients and clinicians that prediabetes is curable.

Conclusions

Increased patient awareness and patient-centered education is needed to overcome barriers to prediabetes care. To facilitate implementation of N-DPP referral processes, clinicians should clearly communicate risk, treatment information, and linkage to N-DPP as the suggested treatment plan.
A multidisciplinary clinic approach to improve physician-related diagnostic delay for patients with axial spondyloarthritis: a retrospective study
Authors: Li Jiajie , Xu Yuan , Chen Yuling , Ye Chunhua , Huang Jiaxian , Qian Liping , Xin Weiwei , Li Ting , Ye Shuang
Published: April 2019

Objective

To assess the diagnostic delay (DD) and physician-related DD (pDD) in patients with axial spondyloarthritis (SpA) and the potential benefits of a multidisciplinary clinic (MDC) approach.

Methods

A retrospective study was undertaken among patients with axial SpA, which aimed to analyse DD, pDD and their risk factors. The influence of pDD on disease outcomes was examined. The pDDs among consecutive SpA patients in an MDC cohort were compared with propensity score matched historical controls (1:1).

Results

A total of 208 patients with axial SpA formed the historical control group and 49 patients with axial SpA formed the MDC cohort after introduction of the MDC. The median DD and pDD in the historical controls were 25.5 and 10.0 months, respectively. A cut-off of pDD > 4 months was associated with more active disease and functional impairment. An initial visit to a non-rheumatologist was the most significant risk factor for pDD. Following MDC introduction, the median pDD decreased from 13 months to 1 month after adjustments were made for confounders such as sex, education level, history of smoking, human leukocyte antigen-B27 status and SpA/ankylosing spondylitis classification criteria.

Conclusion

The MDC was a promising approach that resulted in a reduced pDD among patients with axial SpA.
Truck CACC Implementation and Test to Verify Control Performance
Authors: Lu Xiao-Yun , Shladover Steven , Bergquist Stefan
Published: April 2019

This paper presents quantitative driving performance results for a cooperative adaptive cruise control (CACC) system tested on Class-8 trucks. It focuses on the vehicle following control performance measured on a closed test track and in mixed traffic on public freeways. The speed and distance tracking errors are reported for the string of three trucks driven under CACC control.
Religiosity Dimensions and Disability-Free Life Expectancy in Taiwan
Authors: Zimmer Zachary , Chiu Chi-Tsun , Saito Yasuhiko , Jagger Carol , Ofstedal Mary-Beth , Lin Yu-Hsuan
Published: April 2019

Objectives: Eight years of panel data are used to investigate the association between three dimensions of religiosity and total and disability-free life expectancy (TLE/DFLE) in Taiwan. Method: Data come from the 1999 “Taiwan Longitudinal Study on Aging” (TLSA; N = 4,440; Age 55+). Dimensions of religiosity are public, private, belief, and coping. Mortality is linked to a national database. Disability is activities of daily living (ADLs). TLE/DFLE estimates use the Stochastic Population Analysis for Complex Events (SPACE) software. Results: Those who engage in public and private religiosity live longer and more years disability-free than others, but proportion of life disability-free does not differ across levels of religiosity. Coping is less associated with TLE and DFLE. Coping however associates with more years disabled among men. Findings are robust to model specifications. Discussion: The way in which religiosity associates with health depends upon the definition. When it does associate, religiosity increases TLE and DFLE proportionately.
One-pot hydrothermal synthesis of polyaniline nanofibers/reduced graphene oxide nanocomposites and their supercapacitive properties
Authors: Xiong Shanxin , Wang Yuancheng , Chu Jia , Wang Xiaoqin , Zhang Runlan , Gong Ming , Wu Bohua , Li Zhen
Published: April 2019

In this article, polyaniline nanofibers/reduced graphene oxide (PANI-NFs/rGO) nanocomposites were prepared by a one-pot hydrothermal method. Under the condition of high temperature and high pressure, graphene oxide (GO) was reduced to rGO and aniline was in-situ polymerized to form PANI-NFs using ammonium persulfate as oxidant. The morphologies and structures of PANI-NFs/rGO nanocomposites were characterized by scanning electron microscopy, Fourier transform infrared spectroscopy (FTIR), and Raman analysis. The results show that PANI-NFs uniformly grow on the surfaces of rGO sheets, which can act as spacers to prevent the aggregation of rGO. Combining with FTIR and Raman analysis, it can be concluded that PANI-NFs/rGO nanocomposites are successfully prepared. The electrochemical performances of PANI-NFs/rGO nanocomposites were tested by cyclic voltammetry and galvanostatic charge–discharge. The PANI-NFs/rGO nanocomposites exhibit superior electrochemical performances compared to the PANI-NFs. With 10 wt% of GO loaded, the PANI-NFs/rGO nanocomposite exhibits highest specific capacitance of 942 F g−1 at a current density of 1 A g−1. The PANI-NFs/rGO nanocomposites also demonstrate good rate capacity and high cycling stability under the high discharging current density (10 A g−1), the specific capacitance can still reach to 680 F g−1. After 1000 charge–discharge cycling at a current density of 5 A g−1, 78% of specific capacitance can be retained. The enhanced capacitive performances can be attributed to the facile electron conduction pathway brought by the even distribution of highly conductive rGO nanosheets.
When and How Implicit First Impressions Can Be Updated
Authors: Ferguson Melissa J. , Mann Thomas C. , Cone Jeremy , Shen Xi
Published: April 2019

Human perceivers continually react to the social world implicitly —that is, spontaneously and rapidly. Earlier research suggested that implicit impressions of other people are slower to change than self-reported impressions in the face of contradictory evidence, often leaving them miscalibrated from what one learns to be true. Recent work, however, has identified conditions under which implicit impressions can be rapidly updated. Here, we review three lines of work showing that implicit impressions are responsive to information that is highly diagnostic, believable, or reframes earlier experience. These findings complement ongoing research on mechanisms of changing implicit impressions in a wider variety of groups, from real people to robots, and provide support for theoretical frameworks that embrace greater unity in the factors that can impact implicit and explicit social cognition.