bluuebunny/crossref_metadata_2025 huggingface dataset:
Gagné’s 9 Events of Instruction With Active Learning: Teaching Student Pharmacists How to Measure Blood Pressure
Authors: Chen Jack J. , Johannesmeyer Herman Joseph
Published: September 2019

As the scope of practice for pharmacists expands to include rendering physical assessment procedures, colleges and schools of pharmacy are increasingly incorporating various assessment skills into the curriculum. Pharmacy practice faculty are increasingly tasked with teaching and assessing learners on professional competency in entrustable professional activities and skills such as manual blood pressure measurement. Manual measurement using a sphygmomanometer and a stethoscope is considered the gold standard with regard to evaluating blood pressure. As pharmacy faculty begin to develop courses on physical assessment, a step-by-step, evidence-based andragogic/pedagogic method for designing, planning, instructing, and assessing learner proficiency is essential. The principles and techniques of active learning are frequently discussed and increasingly incorporated into the curricular and teaching philosophies of colleges and schools of pharmacy. However, the practical application of andragogic/pedagogic principles toward lesson planning and curation of active learning is infrequently discussed. In this article, we aim to illustrate a deliberate approach to designing and operationalizing active learning for auscultatory manual blood pressure measurement within the framework of Gagné’s 9 events of instruction. For each design and instruction step, we propose user-friendly, high-impact operational practices derived empirically from education science, experience, and observations. Schematically, the approach described is intended to also facilitate instructor metacognition and knowledge building of applied andragogy/pedagogy through pre hoc, ad hoc, and post hoc reflection. Pragmatically, the approach accommodates active learning lesson planning, promotes transparency of teaching and learning, and is generalizable and applicable toward the instruction of various physical assessment procedures within the health professions.
Measurement of forces on multi-point forming tools using fibre Bragg grating sensors
Authors: Elghawail Ali Mohamed , Pham Duc Truong , Huang Jun , Su Shizhong , Kerin Mairi , Ji Chunqian , Abosaf Mohamed , Essa Khamis
Published: September 2019

Multi-point forming uses forces applied to a tool, comprising of multiple pins set at different heights, to form sheet metal for panelling in white goods, automotive bodywork, aircraft frames and so on. The use of multiple pins allows for rapid change over and flexibility in the tool making it suitable for small-batch and prototype component manufacture. To explore the relationship between ‘springback’ of the sheet metal on release from the tool, and the applied pin force, it is first necessary to understand and measure the forming forces. This article presents a novel method of measuring forming forces on individual pins in a multi-point forming tool using fibre Bragg grating sensors, monitoring the elastic strain on the selected pins during the forming process. The operating principles behind forming force measurements using fibre Bragg gratings are introduced and a relationship is developed between springback in the formed part after the final unloading and the forming force as measured on selected individual pins under different compression ratios (30%, 40%, 50% and 60%) of the elastic cushion between the tips of the pins and the workpiece. Experiments were performed to validate the proposed measuring method, and results indicate that forming forces detected by the proposed method correlated well with the results obtained by numerical simulation. This suggests the proposed method has good potential for real-time measurement and monitoring of forming force distribution in multi-point forming tools during the forming process.
Predicting Exercise With a Personality Facet: Planfulness and Goal Achievement
Authors: Ludwig Rita M. , Srivastava Sanjay , Berkman Elliot T.
Published: September 2019

Establishing reliable predictors of health behavior is a goal of health psychology. A relevant insight from personality psychology is that facets can predict specific behaviors better than broad traits do. We hypothesized that we could predict physical activity with a facet of conscientiousness related to goal pursuit—planfulness. We measured the relationship between Planfulness Scale scores and physical activity in 282 individuals over a total of 20 weeks, using a piecewise latent growth curve model. We additionally tested whether planfulness uniquely relates to activity when compared with related constructs. Finally, ratings of participants’ written goals were correlated with these personality traits and physical activity. We found that planfulness was positively associated with average visits to a recreational center, that planfulness explained unique variance in activity, and that planfulness correlated with the descriptiveness of written goals. We conclude that the Planfulness Scale is a valid measurement uniquely suited to predicting goal achievement.
Exploring secondary school students’ self-perception and actual understanding of plagiarism
Authors: Chu Samuel Kai Wah , Hu Xiao , Ng Jeremy
Published: September 2019

Plagiarism has been a growing concern among institutions and academics in recent years. To address the problem, and to alleviate the growing trend of this academic misconduct, students’ perceptions of plagiarism should be considered. This study explores students’ self-perception and actual understanding of plagiarism, and the relations between them. Survey responses were collected from 433 students in a Hong Kong junior secondary school. Results reveal that students show different understanding towards ‘obvious’ and ‘obscure’ plagiarism, with misunderstanding or misconception more likely arising over obscure plagiarism. This study also reports that students’ self-perception on their understanding of plagiarism differed across grade levels, and their academic performance of inquiry-based learning has a relation to their self-perceived and actual understanding of plagiarism. Implications for improving the teaching and learning of plagiarism are discussed.
Analysis of metallographic structure and hardness of magnesium alloy area using friction stir welding
Authors: Hongfeng Wang , Dunwen Zuo , Shengrong Liu , Weiwei Song
Published: September 2019

The present work envisages the friction stir welding of AZ40 M magnesium alloy to analyze the influence of different process parameters (rotation speeds: 600, 800, and 1000 r/min; feed speeds: 100, 120, and 150 mm/min) on the metallographic structure at different locations in the weld zone. The welded regularity, analysis of the distribution law of the weld surface, and section hardness value (HV) were obtained under different welding process parameters. Our results show that, when the current feed rate was constant, the grain size of the weld nugget increased with an increase in the rotation speed. When the rotation speed was constant, the grain size of the weld nugget area decreased initially, which subsequently increased with an increase in the advance speed. When the rotation speed was 600 r/min and the feed speed was 120 mm/min, the nugget region grain was uniform, fine, and exhibited a highest HV.
A Question of Sacrifice: The Deep Structure of Deaths in Police Custody
Authors: Loader Ian
Published: September 2019

Deaths in police custody present a set of enduring and troubling puzzles. Why do such deaths seldom result in prosecutions or adequate redress? Why are victims’ families so under-resourced and typically met with a conflicted mix of empathy and hostility? Why do acknowledged problems remain unresolved despite review after review making the same criticisms and seemingly consensual recommendations? Why is the state’s failure to fulfil its duty of care towards those it detains met with public indifference? In this article, I argue that we can shed new light on these questions if we theorize and investigate police power using the metaphor of sacrifice. Thinking about police power through this lens enables us to identify and illuminate a conflict between the liberal rationality that appears to govern responses to custodial deaths and the illiberal values and affects that constitute what I term the deep structure of deaths in police custody. By re-examining reports of recent enquiries into the issue, I outline four recurring elements of this deep structure and show how they clash with surface liberal rationalities. The systemic reduction of custodial death requires, I conclude, that we name and contest the quasi-sacred conception of police authority that holds the police vital to the production of order and control and its agents to require protection when things ‘go wrong’.
Survivorship Care Practices and Confidence of Oncology Nurses in Singapore: A Cross-Sectional Study
Authors: Siew An Ling , Tay Li Hui , Ang Wei How Darryl , Lopez Violeta
Published: September 2019

Introduction: Cancer survivorship care is challenging because little is known about delivering comprehensive and coordinated survivorship care practices (SCP) to patients. The purpose of this study is to examine oncology nurses’ perceptions of responsibilities of SCP, confidence levels of SCP, and factors that influence provisions of SCP. Method: A descriptive cross-sectional study was conducted using the Cancer Professional Questionnaire. Analysis was conducted using independent t-test and analysis of variance to examine the differences between variables. Results: Nurses ( n = 147) agreed that it was their responsibilities to provide SCP, but the majority lacked the confidence to do so. Significant differences were found in the confidence levels of nurses with different education attainments ( p = .004). A lack of time and educational resources were factors impeding SCP. Discussion: Organizational interventions and education programs are needed to ensure that oncology nurses are confident in providing culturally congruent survivorship care in a multicultural country such as Singapore.
A Multidisciplinary Team-Based Approach to Improve Communication With Surrogates of Patients With Chronic Critical Illness
Authors: Greenberg Jared A. , Gerhart James , Horst Jacqueline N. , Chen Elaine , Hunter Rebecca L. , O’Mahony Sean , Yeow Mei-Ean , Fosler Laura , LaGorio Lisa A. , Meksraityte Edita , Weiss Tyler T. , Nowak Kristen , Geddes Jacqueline , Lambe Stacy S. , Fenton Kara , Shah Raj C.
Published: September 2019

Background:

Clinicians need to deliver prognostic information to surrogates of nondecisional, critically ill patients so that surrogates can make informed medical decisions that reflect the patient’s values. Our objective was to implement a new approach for communicating with surrogates of patients with chronic critical illness.

Methods:

Surrogate decision makers of patients who were difficult to liberate from mechanical ventilation were prospectively enrolled. Surrogates met with different members of the intensive care unit treatment team for sequential 15-minute appointments to receive patient-specific assessments and education on chronic critical illness. The feasibility and acceptability of this approach were determined. A 24-question comprehension instrument was developed to assess a participant’s understanding that a family member was displaying features of chronic critical illness. Each question was scored from 1 to 5, with larger scores indicating greater comprehension.

Results:

Over a 15-week period, educational sessions for 9 mechanically ventilated patients were conducted. On average, 2 surrogates per patient (range: 1-4) and 6 members of the interdisciplinary team (range: 4-6) were at each meeting. Surrogates and clinicians had very positive impressions of the communication intervention. The average preintervention comprehension score was 85 of 120 (standard deviation [SD]: 8, range: 71-101). The postintervention comprehension score was greater by 5 points on average (SD: 9, range: −11 to +20 points, P = .04).

Conclusions:

Surrogates of critically ill patients approved of this novel communication approach and had a greater understanding of the patient’s medical condition after the intervention.
Diversifying or Reinforcing Science Communication? Examining the Flow of Frame Contagion Across Media Platforms
Authors: Jones-Jang S. Mo , Hart P. Sol , Feldman Lauren , Moon Won-Ki
Published: September 2019

This study investigated whether increased technological affordances, characterized by the rise of social media, diversified communication in climate change discourse. Extending the literature of intermedia agenda setting, this study examined agenda and frame contagion across Twitter and online news media. Using a large dataset of media content about climate change, time-series analysis showed that news media played a major role in setting agendas and frames, but Twitter has increased its dominance in climate change discussions. The findings address both opportunities for strategic science communication and challenges resulting from unverified scientific claims (e.g., hoax frames) spread on social media.
Cultural Challenges in Adapting SWPBIS to a Dutch Context
Authors: Nelen Monique J. M. , Willemse T. Martijn , van Oudheusden Margreet A. , Goei Sui Lin
Published: September 2019

The transfer and adoption of school-wide approaches, like School-Wide Positive Behavior Interventions and Supports (SWPBIS), from one country to another, is an underexamined process. SWPBIS was mainly developed in the US. Although research shows that implementation of SWPBIS contributes to a positive school climate and a decrease in problem behavior, little is known about the generalizability of the effects in other countries. Of special interest is the role of underlying cultural values and concepts as reflected in SWPBIS. This can influence the acceptance of teachers and principals when implementing SWPBIS in another country. SWPBIS procedures need to be adjusted to the educational context where it is implemented. As a consequence, fidelity of implementation can be at stake when adjustments affect not only SWPBIS procedures (e.g., the way expected behavior is taught) but also core features (e.g., teaching of behavior). In this study, we explored cultural adaptation efforts in the Netherlands. We have drawn on perceptions of Dutch SWPBIS experts. In two sessions, 12 and then 10 experts were questioned. Results suggested that core features of SWPBIS seemed to be quite consistent across cultures, but adaptations in procedures were necessary.
Fast-Track Approach for Breast Reconstructive Surgery in Patients With Breast Cancer
Authors: Motuziuk Igor , Sydorchuk Oleg , Kostiuchenko Yevhenii , Kovtun Natalia , Poniatovskyi Petro
Published: September 2019

Aim:

The aim of this study was to develop and implement the concept of fast-track surgery (FTS) for reconstructive breast surgery in patients with breast cancer (BC) to improve early and long-term results of treatment.

Materials and methods:

The study includes 749 patients with stage 1 to 3 BC. A total of 253 patients with BC got treatment according to FTS program and were included to the core group. Other 496 patients with BC (control group) were not included to the FTS program. Patients were treated from December 2010 to December 2014. All age groups were covered (18-70 years old).

Results:

There was a significant difference in the average length of hospital stay (LOS) which was 14.27 ± 7.00 days in the core group and 20.11 ± 7.70 days in the control group ( P < .001). In advanced BC cases in the core group, LOS was >8 days lower comparing with the control group on average. The LOS in patients who underwent adjuvant chemotherapy was 2.7 times lower in the FTS group comparing with the control group.

Conclusions:

The study results allow us to recommend the concept of FTS for implementation in broad medical practice for breast reconstructive surgery in patients with BC. The FTS program was shown to be effective in all types of breast surgery, including immediate oncoplastic and reconstructive surgeries. The gradual reduction of LOS increased the number of surgeries in our department by 75% from 2008 till 2018.
Identification and Monitoring of Microalgal Genera Potentially Capable of Forming Harmful Algal Blooms in Punta Galeta, Panama
Authors: González Alexander , Broce Kathia , Fábrega-Duque José , Tejedor-Flores Nathalia , Young Karen
Published: September 2019

Coastal areas are attractive for human settlements because they allow easy access to benefits like food, security, and fishing. These aquatic ecosystems are supported by photosynthetic organisms that constitute the base of the food web. The term “Harmful Algal Bloom” (HAB) refers to the excessive proliferation of some taxa of these microorganisms reaching harmful levels to humans and other organisms. Biotoxins produced by these HABs could be transferred to the food chain and are the best-documented impact that HABs have on humans. The location and abundance of the HAB species producing the toxin is a good indicator of a possible human health hazard. The aim of this study was to monitor potentially harmful benthic/epibenthic microalgae in Punta Galeta, Panama over a 15-month period. The 3 main microalgae found were 2 dinoflagellates from the genera Prorocentrum and Ostreopsis and 1 diatom from the genus Coscinodiscus. Sampling made with both natural and artificial substrates yielded similar overall abundance patterns; however, for the macroalgae samples, there appeared to be significant host preferences for Ostreopsis and Coscinodiscus. Physicochemical measures taken at the site were found to fall within previously reported growth parameters for the microalgae found in the study.
Future Directions in Examining Neurological Adaptation to Bilingual Experiences
Authors: DeLuca Vincent
Published: September 2019

In recent years, research examining the neurocognitive effects of bilingualism has undergone a shift in focus towards examining the neurocognitive effects of individual differences within specific aspects of language experience. The DeLuca et al study advances this direction in showing a specificity of neural adaptations to separate aspects of language experience. However, this approach is an early step of several in towards a more comprehensive understanding of the nature of neural adaptation to bilingual language use. This commentary discusses several future directions worth further consideration in research examining bilingualism-induced neuroplasticity.
Student health-related fitness testing in school-based physical education: Strategies for student self-testing using technology
Authors: Keating Xiaofen , Liu Xiaolu , Stephenson Rachyl , Guan Jianmin , Hodges Michael
Published: September 2019

If used appropriately in schools, youth fitness testing can play a significant role in promoting a physically active lifestyle among school-age children. Unfortunately, many issues exist when testing students’ health-related fitness (HRF) components, such as privacy concerns, misuse of testing results, and time-consuming test procedures. This paper provides an alternative approach to implementing youth fitness testing, attempting to solve some of these long-standing problems. Contextual information concerning global youth fitness testing practices is first introduced, followed by strategies for fitness self-testing using emerging technologies instead of more traditional testing methods conducted in a physical education (PE) setting. We also address how a self-testing approach could be used as part of a fitness education programme where students learn about HRF components, develop competence, and learn how to improve their HRF over time, absent of an expert evaluator to monitor their own HRF. The potential role of modern technology in solving some of the seemingly unsolvable problems with youth fitness testing in schools worldwide and facilitating the implementation of self-testing HRF in school-based PE programmes is also presented. More effort should be given to the development of technology-based HRF self-testing and empirical research.
Effects of the interface categories on the acquisition patterns of English reflexives among learners of English as a foreign language
Authors: Wu Mingjun , Zhang Lawrence Jun , Wu Di , Wang Tongshun
Published: September 2019

Objectives:

Binding properties are difficult for learners to fully acquire. This study explored English-as-a-foreign-language learners’ acquisition patterns of the three binding properties of English reflexives and the effectiveness of the Interface Hypothesis.

Methodology:

One hundred and twenty-two native speakers of Chinese, a language with different binding properties, participated in the study; they were categorized into low, intermediate and advanced groups according to an English proficiency test. They were read 32 stories of 2 to 5 sentences each and were required to provide a comment sentence instantiating the three binding properties; i.e. c-command, subject orientation and locality.

Data and analysis:

A mixed repeated measures ANOVA was conducted with group and individual results of the experimental task to ascertain whether there were significant differences across different binding properties and among the three proficiency groups.

Findings:

Results from a truth-value judgment task indicate that the within-groups difficulty order of the three distinct binding properties is that: (a) for the low-proficiency group, c-command was easier than locality and orientation; and (b) for the intermediate-proficiency and the high-proficiency groups, c-command was easier than locality which, in turn, was easier than orientation. Among the three proficiency-groups, four acquisition patterns were found, which standard Binding Theory and its extensions cannot adequately explain.

Originality:

This is the first study to provide a variable-dependent account. It is argued that success or failure in establishing interface relations in second language grammars is likely to depend on a number of variables, including the involvement of the syntax–lexicon interface, syntax–semantics interface and syntax–discourse interface.

Implications:

The research suggests that the acquisition of English reflexives is variable-dependent, but not domain-wide. Specifically, the relationship between the binder and anaphoric expression can be established between the anaphors and some of their potential antecedents in second language English grammars, but not others, lending support to the Interface Hypothesis.
Dual citizenship and the perceived loyalty of immigrants
Authors: Jasinskaja-Lahti Inga , Renvik Tuuli Anna , Van der Noll Jolanda , Eskelinen Viivi , Rohmann Anette , Verkuyten Maykel
Published: September 2019

This survey experiment examined national majority group members’ reactions to immigrants’ citizenship status with a focus on dual citizenship. A sample of 779 participants ( nFinland = 174; nNetherlands = 377; nGermany = 228) was used to examine whether immigrants’ citizenship status affects trust towards immigrants, willingness to accept immigrants in strategic positions, and support for immigrants’ social influence in society. Perceived group loyalties were expected to mediate these relationships. Compared to national citizens, dual citizens were perceived as having lower national loyalty and higher foreign loyalty. Compared to foreign citizens, dual citizens were perceived to have higher national loyalty but equally high foreign loyalty. Higher national loyalty was further associated with higher trust, acceptance, and support, whereas higher foreign loyalty was associated with lower trust, acceptance, and support. These findings are discussed in relation to societal debates on dual citizenship and the limited social psychological research on this topic.
Occupancy detection systems for indoor environments: A survey of approaches and methods
Authors: Trivedi Dipti , Badarla Venkataramana
Published: September 2019

Utilization of smart services for indoor environments has gained extensive interest in the past decade due to the resulting increases in energy savings, user comfort and degree of automation. Occupancy detection is a critical element in automation systems due to its potential use in controlling electrical systems and devices such as lighting, air-conditioning and ventilation. It also has a high potential for improving the performance of demand-driven applications which require fine-grained occupancy information to optimize the trade-off between energy consumption and user comfort. Occupancy detection has been researched using different estimation methods and communication technologies. However, it remains challenging to procure sensory data and to model the occupancy information accurately due to the limitations of hardware deployment and underlying cost. This paper reviews existing occupancy methods and applications, along with their underlying issues. It provides a comparative analysis of the strategies from the perspectives of cost, intrusiveness and accuracy. Additionally, a new taxonomy which classifies the occupancy sensing techniques as being conventional or as alternate sensing has been proposed.
Fatigue life evaluation of an ultrafine-grained pure aluminum
Authors: Babaei Alireza , Esmaeili-Goldarag Firooz , Jafarzadeh Hossein
Published: September 2019

The aim of this study is an experimental and numerical investigation of the fatigue behavior of a notched ultrafine-grained pure aluminum processed by strip cyclic extrusion-compression method. In this regard, the fatigue experiments were conducted for the unprocessed and strip cyclic extrusion-compression processed specimens under various cyclic loads. In the numerical analyses, a dislocation dynamic constitutive material model which tracks the microstructure evolution was implemented for numerical estimation of the values of fatigue strength reduction factor via the volumetric approach. Considering the three-dimensional effect near the plate hole, the variation of the fatigue notch factor through the thickness of the plate was investigated and the obtained results showed that maximum fatigue strength reduction factor was occurred in the middle of the plate due to the symmetry of specimen geometry and loading condition. The investigation reveals a good agreement between the numerical and experimental lives. The results showed although the smooth processed specimens have higher fatigue strength in comparison of the unprocessed ones, the notched processed specimens have lower fatigue strength in comparison of the unprocessed ones.
Interpreting strategic issues: Effects of differentiation strategies and resource configurations on corporate entrepreneurship
Authors: Olson Bradley J , Yuan Wenlong , Bao Yongjian , Wu Zhenyu
Published: September 2019

Differentiation strategy represents the shared belief about the market and provides the lens through which executives filter external information. Based on the relevant information peculiar to the strategy and resource configurations in the firm, executives develop opportunity or threat interpretations and take responsive actions. Using the two-wave survey data from 294 CEOs in China during the 2008 macro crisis, we find that the configuration of differentiation, financial slack, and technological capabilities affects corporate entrepreneurship through opportunity interpretations.
Re-thinking communities: Collective identity and social experience in Iron-Age western Anatolia
Authors: Steidl Catherine
Published: September 2019

Reference to identity is ubiquitous in archaeology. Even when identity is not part of the questions driving research, assumptions about it affect interpretations of data; the terms used to designate individuals or collective groups carry implicit ideas about their identities. Default categories used to describe people, however, are often rooted in binary oppositions instead of the interactions that made up their daily social lives. In an archaeology of the ancient Mediterranean, these oppositional categories are most frequently rooted in ethnicity. This article presents the community as an ideal framework to address the problems posed by an overreliance on ethnicity for understanding ancient identities, but also to compare collective social dynamics more broadly. Laying out a methodology for communities’ archaeological study, it uses two case studies from Emporion (Spain) and Ephesos (Turkey) to illustrate the new questions and conversations facilitated by an archaeology of communities that complement ongoing identity studies.
Complex private-common property rights in institutional and planning theories
Authors: Slaev Aleksandar D
Published: September 2019

This research focuses on a substantial gap between theories of institutions and property rights: institutions are accepted as complex social structures, but property rights are generally considered as simple, that is, either private or public. Although usually unacknowledged, this simplified understanding of property rights is actually based on Samuelson’s theory developed six decades ago. According to Samuelson, the inherent characteristics of goods determine whether they are privately or collectively consumed commodities. Although Samuelson does not propose a mandatory unambiguous link between types of consumption and types of ownership, his theory implies that in principle, private goods are consumed and owned privately and public goods are consumed and owned publicly. Thus, in Samuelson’s theory, institutions are redundant. This article maintains that people need institutions and organisations because resources are scarce, and most resources are too expensive for individual use/consumption. To access such resources, people form groups and create organisations and institutions, thereby reducing the individual costs of use and consumption. As complex systems, institutions generate complex property rights – common/collective to the members of an organisation, but private to that organisation (the union of members). Furthermore, institutions determine the patterns of interaction between planning and the market (as the two main mechanisms of exercising property rights) at all levels of the multilevel structure of organisations and society. The article argues that Buchanan’s theory of clubs offers a more accurate explanation of the nature of property rights as relevant to institutions.
Outcome measures in a combined exercise rehabilitation programme for adults with COPD and chronic heart failure: A preliminary stakeholder consensus event
Authors: Jones Amy V , Evans Rachael A , Man William D-C , Bolton Charlotte E , Breen Samantha , Doherty Patrick J , Gardiner Nikki , Houchen-Wolloff Linzy , Hurst John R , Jolly Kate , Maddocks Matthew , Quint Jennifer K , Revitt Olivia , Sherar Lauren B , Taylor Rod S , Watt Amye , Wingham Jennifer , Yorke Janelle , Singh Sally J
Published: September 2019

Combined exercise rehabilitation for chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) is potentially attractive. Uncertainty remains as to the baseline profiling assessments and outcome measures that should be collected within a programme. Current evidence surrounding outcome measures in cardiac and pulmonary rehabilitation were presented by experts at a stakeholder consensus event and all stakeholders ( n = 18) were asked to (1) rank in order of importance a list of categories, (2) prioritise outcome measures and (3) prioritise baseline patient evaluation measures that should be assessed in a combined COPD and CHF rehabilitation programme. The tasks were completed anonymously and related to clinical rehabilitation programmes and associated research. Health-related quality of life, exercise capacity and symptom evaluation were voted as the most important categories to assess for clinical purposes (median rank: 1, 2 and 3 accordingly) and research purposes (median rank; 1, 3 and 4.5 accordingly) within combined exercise rehabilitation. All stakeholders agreed that profiling symptoms at baseline were ‘moderately’, ‘very’ or ‘extremely’ important to assess for clinical and research purposes in combined rehabilitation. Profiling of frailty was ranked of the same importance for clinical purposes in combined rehabilitation. Stakeholders identified a suite of multidisciplinary measures that may be important to assess in a combined COPD and CHF exercise rehabilitation programme.
Interest Group and Political Party Influence on Growth in State Spending and Debt
Authors: Holyoke Thomas T. , Cummins Jeff
Published: September 2019

Does more lobbying by more interest groups, especially groups representing a state’s largest business sector, lead to greater spending and debt? Or does the blame really rest with state lawmakers and their political parties, which compete to attract and retain the allegiance of these powerful organized interests so they can win control of state government? We test this question with data on annual state budgets from 2006 to 2015, the number of interest groups in each state for those years, the size of the constituencies in different economic and social sectors these groups potentially represent, and the degree of competition between the political parties. Our results reveal that while there is a positive interest group effect on spending, the effect becomes negative as parties compete more for control of the state. As the gatekeepers, lawmakers and their parties, more than interest groups, are ultimately responsible for a state’s fiscal condition.
Analysis of Hepatitis B Virus Reactivation After Radiotherapy in Patients With Hepatocellular Carcinoma Using the Lyman NTCP Model
Authors: Li Zhenjiang , Dong Yinping , Fan Min , Yin Yong , Zhu Jian , Li Baosheng , Huang Wei
Published: September 2019

Purpose:

To analyze the correlation of hepatitis B virus reactivation with patient-related and treatment-related dose–volume factors and to describe the feasibility of hepatitis B virus reactivation analyzed by a normal tissue complication probability model for patients with hepatocellular carcinoma treated with radiotherapy.

Materials and Methods:

Ninety patients with hepatitis B virus-related hepatocellular carcinoma treated with radiotherapy were enrolled in this retrospective study and were followed from June 2009 to December 2015. Of the 90 patients, 78 had received conventional fractionation radiotherapy to a mean dose of 39.6 to 50.4 Gy and 12 patients were scheduled to receive hypofractionation. The physical doses were converted into 2 Gy equivalents for analysis. The parameters, TD50 (1), n, and m, of the Lyman-Kutcher-Burman normal tissue complication probability model were derived using maximum likelihood estimation. Bootstrap and leave-one-out were employed to against model overfitting and improve the model stability.

Results:

Radiation-induced liver diseases were 17.8%, hepatitis B virus reactivation was 22.2%, and hepatitis B virus reactivation-induced hepatitis was 21.1%, respectively. In multivariate analysis, the V 5Gy was associated with hepatitis B virus reactivation; TD50 (1), m, and n were 32.3, 0.55, and 0.71 Gy, respectively, for hepatitis B virus reactivation. Bootstrap and leave-one-out results showed that the hepatitis B virus parameter fits were extremely robust.

Conclusion:

A Lyman-Kutcher-Burman normal tissue complication probability model has been established to predict hepatitis B virus reactivation for patients with hepatocellular carcinoma who received radiotherapy.
How High Can Patients Get on CBD?
Authors: Birnbaum Angela
Published: September 2019

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Vulnerability Selection for Remediation: An Empirical Analysis
Authors: Shah Ankit , Farris Katheryn A. , Ganesan Rajesh , Jajodia Sushil
Published: September 2019

Vulnerabilities are security flaws in software and network systems that criminal hackers can exploit to gain an asymmetric advantage. Cyber-Security Operations Centers must routinely triage and patch vulnerabilities in their system(s) to minimize external exposure to attackers. The personnel resources required to address vulnerability remediation tasks are limited and constrained, thus motivating the need for optimization approaches to improve the efficiency of the vulnerability selection process. This paper investigates two different approaches to vulnerability selection for mitigation through (a) Individual Attribute Value Optimization and (b) Multiple Attribute Value Optimization. The former approach presents a methodology that optimizes the selection of vulnerabilities for mitigation with respect to an individual attribute, while the latter approach considers multiple attributes in the vulnerability selection decision-making. Real scan data from a Cyber-Security Operations Center are used to compare the results between the two mathematical approaches. Furthermore, comparisons are made with the results obtained from (a) the actual (baseline) Cyber-Security Operations Center performance, and (b) a vulnerability prioritization algorithm called VULCON that appeared in recent literature.
Missed Empathic Opportunities During Hand Surgery Office Visits
Authors: van Hoorn Bastiaan T. , Menendez Mariano E. , Mackert Michael , Donovan Erin E. , van Heijl Mark , Ring David
Published: September 2019

Background: Empathy (conveyance of an understanding of a patient’s situation, perspective, and feelings) deepens the therapeutic alliance and leads to better health outcomes. We studied the frequency and nature of empathic opportunities and physician responses in patients visiting a hand surgeon. We also sought patient characteristics associated with the number of patient-initiated-clues and missed opportunities by surgeons. Methods: For this prospective cohort study, we enrolled 83 new, adult patients visiting 1 of 3 hand surgeons during a period of 4 months. All visits were audio-recorded, and empathic opportunities (patient-initiated emotional or social clues) and physician responses were categorized using the model of Levenson et al. Before the visit, patients completed the Newest Vital Sign health literacy test; 3 Patient-Reported Outcomes Measurement Information System-based questionnaires: Upper-Extremity function, Pain Interference, and Depression questionnaires; and a sociodemographic survey. Results: Empathic opportunities were present in 70% of hand surgery office visits. Surgeons responded empathically to about half of the opportunities. Patients with limited health literacy and greater symptoms of depression (small correlation; r = −0.29) were less likely to receive a positive response. Response to an empathic opportunity did not affect visit duration. Conclusions: Hand surgeons often miss empathic opportunities. Future research might address the influence of training physicians to address empathic opportunities on trust, adherence, satisfaction, and outcomes.
Oral anticoagulation versus antiplatelet or placebo for stroke prevention in patients with heart failure and sinus rhythm: Systematic review and meta-analysis of randomized controlled trials
Authors: Ntaios George , Vemmos Konstantinos , Lip Gregory YH
Published: September 2019

Background

Previous meta-analyses of randomized controlled trials of oral anticoagulation in patients with heart failure and sinus rhythm reported reduced stroke risk and increased bleeding risk compared to antiplatelets or placebo. However, the effect estimates may be subject to imprecision, as all included trials were prematurely terminated; stroke was not the primary outcome and overall results were primarily driven by a single trial. Recently, new trial data became available.

Aim

To provide more accurate estimates of the effect of oral anticoagulation on stroke risk in heart failure patients with sinus rhythm by systematic review and meta-analysis of available randomized controlled trials including recently published evidence.

Methods

We searched PubMed and Scopus for full-text articles of randomized controlled trials of oral anticoagulation versus antiplatelet or placebo in heart failure patients with sinus rhythm published between inception and 28 August 2018. The outcomes assessed were any stroke, major bleeding, and death.

Results

In five trials (9490 patients; 21,067 patient-years), oral anticoagulation-treated patients had lower stroke risk (odds ratio (OR) 0.60, 95%CI: 0.46–0.78, absolute-risk-reduction: 1.3%, number-needed-to-treat: 77), higher major bleeding risk (OR: 1.92, 95%CI: 1.51–2.45, absolute-risk-increase: 2.0%, number-needed-to-harm: 50), and no significant difference in death rates (OR: 0.90, 95%CI: 0.73–1.11) compared to antiplatelets or placebo.

Conclusions

In the largest meta-analysis to date, oral anticoagulation is associated with a considerable reduction of stroke risk, which is offset by a significant increase in major bleeding risk. For every 1000 patients treated with oral anticoagulation rather than antiplatelet or no antithrombotic treatment for 2.21 years, 13 strokes are prevented but 20 additional major hemorrhages occur, without significant difference in death rates.
Development as a historical component of the United Nations’ crime policy agenda: From social defence to the Millennium Development Goals
Authors: Blaustein Jarrett , Chodor Tom , Pino Nathan W
Published: September 2019

This article presents a historical analysis of the intellectual and institutional origins of the international community’s interest in the link between crime and development leading up to the adoption of the Millennium Development Goals in 2000. Drawing on a combination of documentary sources and interviews with long-time international crime policy insiders, it traces this interest back to the United Nations’ social defence agenda which emerged in the aftermath of the Second World War. We situate this agenda in relation to the Western aspiration to advance the Modernization project and reflect on how its shortcomings together with ideological, economic and geopolitical shifts at the international level contributed to the diversification of the United Nations’ crime policy agenda during the 1970s. These conditions collectively influenced the international community’s growing concern with crime as an existential threat to economic development during the 1980s. Our analysis highlights how this framing was reinforced by the rise of transnational organized crime as a threat to global capitalism following the collapse of the Soviet Union. It was against this historical backdrop that the United Nations Office for Drug Control and Crime Prevention was established to lead the international community’s fight against ‘uncivil society’. We conclude by reflecting on United Nations Office for Drug Control and Crime Prevention’s tumultuous early years along with the omission of ‘crime’ from the Millennium Development Goals and suggest that these conditions, along with the adoption of the United Nations Conventions Against Transnational Organized Crime and Corruption, set the stage for the organization’s future advocacy for the inclusion of crime in the Sustainable Development Goals.
Non-hormonal treatments of menopausal symptoms
Authors: Taylor Abi
Published: September 2019

Many women with menopausal symptoms will consult their GP for help and advice. These symptoms can be varied and include vasomotor symptoms (hot flushes and night sweats), urogenital dryness or irritation, muscle aches, poor sleep and low mood. For some women, explanation and reassurance may be all that is required; others may request treatment with hormone-replacement therapy (HRT). However, some women requesting treatment will not be able to take HRT, due to co-existing medical problems such as breast cancer or may wish to avoid hormones for other reasons. This article will describe some of the non-HRT treatments that may be offered either instead of or alongside systemic HRT.
Advances in nanoparticle development for improved therapeutics delivery: nanoscale topographical aspect
Authors: Singh Rajendra K , Knowles Jonathan C , Kim Hae-Won
Published: September 2019

Nanoparticle-based therapeutics delivery holds great promise for the treatment of intractable diseases. The high loading of drug molecules and their precise delivery to target sites are needed to gain optimal therapeutic functions of the nanoparticle delivery system. In this communication, we highlight, among other properties of nanoparticles (e.g. size, shape, surface chemistry, and degradation), the nanoscale topography, which has recently been shown to be an important parameter, ultimately determining drug loading, cell penetration, and body clearance. This nanotopographical aspect is considered to offer a new effective strategy to the development of nanoparticles for drug and gene delivery with enhanced therapeutic outcome.
Elagolix reduced dyspareunia and improved health-related quality of life in premenopausal women with endometriosis-associated pain
Authors: Leyland Nicholas , Taylor Hugh S , Archer David F , Peloso Paul M , Soliman Ahmed M , Palac Hannah L , Martinez Marisol , Abrao Mauricio S
Published: September 2019

Objectives:

The objective was to evaluate the effects of elagolix on dyspareunia in women with endometriosis-associated pain.

Methods:

Data were pooled from two similar, randomized, double-blind, placebo-controlled, 6-month phase 3 studies (Elaris Endometriosis-I and Elaris Endometriosis-II) of elagolix at two doses (150 mg QD and 200 mg BID) in women with endometriosis-associated pain. In this post hoc analysis, dyspareunia responders were defined as having a clinically meaningful decrease from baseline in the dyspareunia score and decreased or stable use of rescue analgesic agents, as recorded in a daily electronic diary. Sexual relationship was assessed using the 30-item Endometriosis Health Profile questionnaire sexual relationship module.

Results:

A total of 1384 women reported ⩾1 day of sexual activity at baseline (35 days prior to and including day 1 of treatment). Of these 1384 women, 1297 (94%) reported ⩾1 day of any dyspareunia (mild, moderate, or severe), of which 51% reported ⩾1 day of severe dyspareunia. Among sexually active women who reported any dyspareunia at baseline, both elagolix doses led to improvements in dyspareunia. Women in the 200-mg BID group showed more months at which the dyspareunia response rates were statistically significantly greater than placebo, particularly in a subgroup of women with severe dyspareunia at baseline. Compared to placebo, both elagolix doses led to statistically significantly greater improvements in the mean 30-item Endometriosis Health Profile sexual relationship module score.

Conclusion:

Up to 6 months of elagolix treatment improved dyspareunia in women with endometriosis-associated pain in a dose-dependent manner, with 200-mg BID dose showing the most significant improvements in dyspareunia and quality of sexual relationships compared with placebo.