bluuebunny/crossref_metadata_2025 huggingface dataset:
„Mnie po rusku było ciężko gadać”. Rozmowy z mieszkanką wsi Biełostok na Syberii
Authors: Skorwid Sergiej
Published: January 2020

“It was hard for me to speak Russian”: Interviews with a resident of the village of Belostok in SiberiaThe fieldwork in the formerly Polish village of Belostok in the Tomsk Region (Western Siberia) undertaken in 2017 is a continuation of the previous study of the idiolect of its sole Polish-speaking resident initiated by Natal’ia Anan’eva fourteen years ago. This article presents a record and commentary of two interviews with this speaker, Ms Maria Markish (Markisz) (born in 1928). The first of them was conducted in April 2017 by Agnieszka Kaniewska from the University of Wrocław (Rev. Krzysztof Korolczuk SJ also took part), and the second one – by the author of this paper in May the same year, with the assistance of A. Kaniewska. It remains to be hoped that the two collectively conducted interviews come as a sign of wider international cooperation in future studies on Polish dialects in Russia. „Mnie po rusku było ciężko gadać”. Rozmowy z mieszkanką wsi Biełostok na SyberiiBadania terenowe w ongiś polskiej wsi Biełostok w obwodzie tomskim na Syberii Zachodniej, przeprowadzone w 2017 roku, kontynuują wcześniejsze badania idiolektu jedynej użytkowniczki miejscowej gwary polskiej, pani Marii Markisz (ur. w 1928), zapoczątkowane 14 lat temu przez Natalię Ananjewą. W powyższych tekstach przedstawione są nagrania dwóch rozmów z tą mieszkanką Biełostoku wraz z  odnośnym komentarzem. Pierwsza rozmowa została nagrana przez Agnieszkę Kaniewską z Uniwersytetu Wrocławskiego (w rozmowie uczestniczył także o. Krzysztof Korolczuk SJ) w kwietniu, druga zaś przez autora niniejszego tekstu w maju 2017 roku, również z udziałem A. Kaniewskiej. Chciałoby się wierzyć, że te wspólnie przeprowadzone wywiady są zapowiedzią przyszłej, szerokiej współpracy międzynarodowej w zakresie badania gwar polskich na terenie Rosji.
Recenzja: Iryda Grek-Pabisowa, "Polskie wyspy gwarowe z przełomu XIX i XX wieku na Białorusi. Gwary późnego osadnictwa na Polesiu, Witebszczyźnie i Mohylewszczyźnie. Z wykazem słownictwa przedstawionym leksykograficznie", Warszawa: Instytut Slawistyki Polskiej Akademii Nauk, 2017
Authors: Jankowiak Mirosław
Published: January 2020

Review: Iryda Grek-Pabisowa, Polskie wyspy gwarowe z przełomu XIX i XX wieku na Białorusi. Gwary późnego osadnictwa na Polesiu, Witebszczyźnie i Mohylewszczyźnie. Z wykazem słownictwa przedstawionym leksykograficznie (Polish dialect islands in Belarus at the turn of the 20th century: Dialects of late settlement in Polesie, and the Vitebsk and Mogilev regions. With a lexicographic listing of vocabulary), Warszawa: Instytut Slawistyki Polskiej Akademii Nauk.This article is a review of the work entitled Polskie wyspy gwarowe z przełomu XIX i XX wieku na Białorusi. Gwary późnego osadnictwa na Polesiu, Witebszczyźnie i Mohylewszczyźnie. Z wykazem słownictwa przedstawionym leksykograficznie (Polish dialect islands in Belarus at the turn of the 20th century: Dialects of late settlement in Polesie, and the Vitebsk and Mogilev regions. With a lexicographic listing of vocabulary), published in electronic version in Warsaw in 2017. The volume is a result of long studies by renowned Polish linguist Professor Iryda Grek-Pabisowa. In her publication, the author characterised late Polish settlement on the territory of contemporary Belarus, available language sources as well as features of the subdialects (including East Slavic influences and comparisons with North Borderland Polish, polszczyzna północnokresowa). The second part of the volume consists of three dictionaries presenting Polish speech in Polesie and the Vitebsk and Mogilev regions. Recenzja: Iryda Grek-Pabisowa, Polskie wyspy gwarowe z przełomu XIX i XX wieku na Białorusi. Gwary późnego osadnictwa na Polesiu, Witebszczyźnie i Mohylewszczyźnie. Z wykazem słownictwa przedstawionym leksykograficznie, Warszawa: Instytut Slawistyki Polskiej Akademii Nauk.Tekst stanowi recenzję pracy pt. Polskie wyspy gwarowe z przełomu XIX i XX wieku na Białorusi. Gwary późnego osadnictwa na Polesiu, Witebszczyźnie i Mohylewszczyźnie. Z wykazem słownictwa przedstawionym leksykograficznie, która ukazała się w wersji elektronicznej w Warszawie w 2017 roku. Jest ona efektem wieloletniej pracy znanej polskiej lingwistki – prof. dr hab. Irydy Grek-Pabisowej. W publikacji autorka scharakteryzowała późne osadnictwo polskie na ziemiach współczesnej Białorusi, dostępne źródła językowe, a także cechy tychże gwar (z uwzględnieniem wpływów wschodniosłowiańskich i porównaniem z polszczyzną północnokresową). Drugą część publikacji stanowią trzy słowniki prezentujące mowę Polaków na Polesiu, Witebszczyźnie i Mohylewszczyźnie.
Recenzja: Anastasija Kostiučenko, "Sprachen und ihre Sprecher in Litauen. Eine soziolinguistische Untersuchung zum sozialen Status des Litauischen, Polnischen und Russischen" (Języki i mówcy na Litwie. Badania socjolingwistyczne nad społecznym statusem języków litewskiego, polskiego i rosyjskiego), Berlin: Logos Verlag, 2016
Authors: Zielińska Anna
Published: January 2020

Review: Anastasija Kostiučenko, Sprachen und ihre Sprecher in Litauen. Eine soziolinguistische Untersuchung zum sozialen Status des Litauischen, Polnischen und Russischen (Languages and their speakers in Lithuania: A sociolinguistic study on the social status of Lithuanian, Polish and Russian), Berlin: Logos Verlag, 2016.This article offers a review of the monograph Sprachen und ihre Sprecher in Litauen. Eine soziolinguistische Untersuchung zum sozialen Status des Litauischen, Polnischen und Russischen (Languages and their speakers in Lithuania: A sociolinguistic study on the social status of Lithuanian, Polish and Russian) by Anastasija Kostiučenko. Her volume presents a study on attitudes to Lithuanian, Polish and Russian in Lithuania, applying the matched guise technique developed by Canadian psychologist Wallace E. Lambert in the 1960s. The monograph is an important voice in the discussion on the methods of sociolinguistic study. This review includes some polemical observations. Recenzja: Anastasija Kostiučenko, Sprachen und ihre Sprecher in Litauen. Eine soziolinguistische Untersuchung zum sozialen Status des Litauischen, Polnischen und Russischen (Języki i mówcy na Litwie. Badania socjolingwistyczne nad społecznym statusem języków litewskiego, polskiego i rosyjskiego), Berlin: Logos Verlag, 2016.Artykuł przedstawia recenzję książki Sprachen und ihre Sprecher in Litauen. Eine soziolinguistische Untersuchung zum sozialen Status des Litauischen, Polnischen und Russischen Anastasiji Kostiučenko. Monografia prezentuje badania nad nastawieniem do języków (language attitude) litewskiego, polskiego i rosyjskiego na Litwie. Autorka zastosowała metodę kanadyjskiego psychologa Wallace’a E. Lamberta matched guise z lat 60. XX wieku. Książka stanowi ważny głos w dyskusji na temat metod badań socjolingwistycznych. Recenzja zawiera elementy polemiczne.
Structural, Morphological and Electrical Properties of CdO Thin Film Produced by Sol–Gel Spin Coating Procedure
Authors: Kumari Renu , Kumar Vipin
Published: January 2020

A sol–gel spin coating procedure was used to produce cadmium oxide (CdO) thin film on the precleaned glass substrate. The structural, morphological and electrical properties of the produced film were specified by XRD, SEM and two-probe method. The polycrystalline nature with cubical
structure of the cadmium oxide (CdO) thin film was confirmed by X-ray diffraction (XRD). Scanning electron microscope (SEM) confirms the uniform formation of film. The semiconducting character of the film was confirmed by electrical conductivity (direct current) measurement in dark. The Hall
effect measurement of cadmium oxide film confirms the n-type conductivity.
Potential Ganciclovir Liposomal Thermoreversible Gel for Ophthalmic Delivery Using Box-Behnken Statistical Design and Efficacy Assessment Study in Rabbit Model
Authors: Sheng Yanjuan , Zhu Yanni
Published: January 2020

The present study focuses on development of novel thermoreversible ophthalmic drug delivery system using Ganciclovir as potential candidate for treatment of various ocular infections. The formulation was prepared for thermoreversible gel which incorporates liposomes of Ganciclovir as
core system. Thermoreversible gel prolongs delivery of drug with use of combination of polymers like Poloxamer, Hydroxypropyl methyl cellulose. The Poloxamer used here serves as temperature sensitive polymer. Thus prepared system was evaluated for various parameters. Liposomes found to be
complies with basic requirement like non-leak ability, high in-vitro drug release with optimum encapsulation efficiency. The results obtained showed that the in situ gel is clear and transparent (prime requirement for ophthalmic product) with high gelling capacity and moderately
viscous liquid (1454 cp), highest bioadhesive strength (Dyne/cm2). The ex-vivo study was also done and compared with marketed eye drop formulation. The results showed superiority of in situ gel formulation over eye in sustaining the drug release over prolong period
of time. The haemolytic study performed proved the non-haemolytic nature of formulation.
Educational Accountability, Value-Added Modeling, and the Origin of the Achievement Gap
Authors: Yeh Stuart S.
Published: January 2020

Empirical results are consistent with the hypothesis that socioeconomic factors contribute to initial disparities in performance that are perpetuated by demoralizing grading, testing, and grouping practices throughout the K-12 years. The hypothesis may explain why the achievement gap increases after children enter the school system, why Black students lose ground within schools and within classrooms, why value-added modeling (VAM) estimates of teacher performance are unstable from year to year, why Rothstein found that VAM estimates of teacher performance predict prior student performance, why VAM estimates of teacher performance predict gains in student achievement, and why persistent sorting may account for the Gates Foundation’s Measures of Effective Teaching (MET) results despite random assignment of class rosters to teachers.
Culturally Responsive Pedagogy and Mathematics Through Creative and Body-Based Learning: Urban Aboriginal Schooling
Authors: Rigney Lester , Garrett Robyne , Curry Megan , MacGill Belinda
Published: January 2020

Global neoliberal imperatives that numerically measure student success through standardized testing undermine the educational outcomes of students, in particular Indigenous students, and construct a seemingly fixed reality that avoids State responsibility to address structural inequality in Australia. Achievement gaps between Indigenous and non-Indigenous school students in mathematics have become an urgent international problem. Although evidence suggests that culturally responsive pedagogies (CRPs) improve student academic success for First Nations peoples in settler colonial countries such as the United States, Canada, New Zealand, and Australia, less prominent is a focus on how CRP is enacted and mobilized in Australian classrooms. Although some initiatives exist, this article explores how creative and body-based learning (CBL) strategies might be utilized to enact CRP. Using an ethnographic case study approach, we examined how two early career teachers serving Indigenous and ethnically diverse students implemented CBL to reengage students with mathematics. Findings suggest that the teachers were able to mobilize a number of CRP principles using CBL strategies to facilitate engagement in mathematics for urban Aboriginal students. Specifically, when teachers repositioned students as “competent” and designed embodied learning experiences that connected to their cultural backgrounds, students let go of their cautious learner histories and remade themselves as clever and competent.
Republication of The Technology-Related Assistance to Individuals with Disabilities Act: Relevance to Individuals with Learning Disabilities and Their Advocates
Authors: Bryant Brian R. , Seay Penny Crews
Published: January 2020

Assistive technology (AT) was recognized by Congress as a viable need for people with disabilities when it passed the Tech Act in 1988. The legislation, which was reauthorized in 1994, has resulted in numerous programs and services that have helped people with disabilities access and use AT devices. The Tech Act’s implications for people with learning disabilities is discussed in this article.
Political party strength and electoral violence
Authors: Fjelde Hanne
Published: January 2020

Existing research on the causes of electoral violence has focused on structural determinants and election-specific characteristics but has paid less attention to the role of political agents that contest elections. This study addresses this gap by examining the relationship between the organizational strength of political parties and the risk of electoral violence. The study argues that strong political parties enhance the prospect for peaceful electoral dynamics for two reasons. First, having strong party organizations reduce incentives for violent electoral manipulation because these organizations enable more cost-efficient ways to mobilize voters. Second, strong party organizations constrain political actors from deploying electoral violence, both at the leadership and grassroot levels. The relationship between political party strength and electoral violence is studied by combining global data on the overall strength of political parties in the polity with data on violence across all national elections from 1946 to 2010. The statistical analysis accounts for a number of potentially confounding variables related to formal political institutions and election-specific characteristics. The results point to a statistically significant and substantively important association between strong political parties and a reduced risk of violent electoral conflict.
Coupling analysis of a 5-degree-of-freedom hybrid manipulator based on a global index
Authors: Zhao Yanqin , Mei Jiangping , Niu Wentie , Wu Mingkun , Zhang Fan
Published: January 2020

Parallel kinematic machines have been applied in aerospace and automotive manufacturing due to their potentials in high speed and high accuracy. However, there exists coupling in parallel kinematic machines, which makes dynamic analysis, rigidity enhancement, and control very complicated. In this article, coupling characteristics of a 5-degree-of-freedom (5-dof) hybrid manipulator are analyzed based on a local index and a global index. First, velocity analysis as well as acceleration analysis of the robot is conducted to provide essential information for dynamic modeling. Then the dynamic model is built based on the principle of virtual work. Whereas the mass matrix is off-diagonal, a local coupling index as well as a global index is defined, based on which coupling characteristics of the robot are analyzed. Results show that distributions of coupling indices are symmetric due to its structural features. And dimensional parameters, structural parameters, as well as mass parameters have a large influence on the system’s coupling characteristics. Research conducted in the article is of great help in optimal design and control. Meanwhile, the method proposed in the article can be applied to other types of parallel kinematic machines or hybrid manipulators.
The Influence of Network Positions on Exploratory Innovation: An Empirical Evidence from China’s Patent Analysis
Authors: Ma Ding , Zhang Ya-Rui , Zhang Fan
Published: January 2020

Existing studies find that exploratory innovation requires both access to heterogeneous resources for the establishment of novel knowledge combinations and high-quality cooperation to strengthen the absorption of heterogeneous knowledge. Therefore, structural holes and prominent positions exert critical effects on exploratory innovation. Few existing studies have investigated the influences of the two positions on exploratory innovation simultaneously. This study aims to identify the influence of network positions on exploratory innovation and the contingency mechanism. Basing on joint patent filing relationships identification belong to IPC Green Inventory, R&D collaboration networks in China consisted of 215 firms in the technological field of low-carbon energy were constructed. Negative binomial regression was used to analyse the influences of networks positions on exploratory innovation and the moderating effect of network density. Results reveal that network prominence and structural holes have inverted U-shaped effects on exploratory innovation. The simultaneous occupation of prominent positions and structural holes hinders exploratory innovation. Network density exerts positive and negative effects on the relationships between network prominence and exploratory innovation and between structural holes and exploratory innovation, respectively. The conclusions drawn in this study provide a reference for R&D network structural optimization toward exploratory innovation.
Mid-term outcomes of a partial 2-stage approach in late chronic periprosthetic hip infections
Authors: Castagnini Francesco , Tella Giuseppe , Montalti Maurizio , Biondi Federico , Bordini Barbara , Busanelli Luca , Toni Aldo
Published: January 2020

Introduction:

Late chronic periprosthetic infections (LCPIs) are worrisome complications of primary hip arthroplasties. The gold standard procedure is the 2-stage revision. 1-stage exchange is gaining popularity in order to reduce the invasivity of the former technique. A partial 2-stage exchange technique, retaining fixed components, may overcome some of the drawbacks of the previous techniques, allowing a much easier reconstruction step.

Methods:

28 patients with a LCPI after a primary total hip arthroplasty underwent a first removal stage: the loosened component was removed (23 cups and 5 stems) and the fixed component, with no local signs of infection, was retained. An antibiotic hand molded spacer was positioned in 16 cases. After a mean time of 8 months and a tailored antimicrobial therapy, the spacer was removed and the implant was revised.

Results:

The mean follow-up was 5 years. The HHS score was 82.7. 4 cases failed (2 patients presenting a septic relapse after revision and 2 patients undergoing Girdlestone arthroplasty), achieving a survival rate of 83.4% at 5 years. 2 patients were unwilling to perform a further procedure and did not proceed to the second stage. All the other patients had no clinical, radiological, laboratory signs of septic relapse.

Conclusions:

The partial 2-stage approach seems a promising technique for LCPI in selected cases, with good infection control. It allows an easier revision by sparing the fixed components. Larger case series and longer follow-ups are needed to confirm the results and identify the limits of this approach.
Predictive validity for the clinical diagnosis of a new parent questionnaire, the CABI, compared with CBCL
Authors: Cianchetti Carlo , Faedda Noemi , Pasculli Marcello , Ledda Maria Giuseppina , Diaz Giacomo , Peschechera Antonia , Craig Francesco , Morelli Federica , Balottin Umberto , Guidetti Vincenzo , Zuddas Alessandro , Margari Lucia
Published: January 2020

Background:

The questionnaires completed by the parents give a first general information on the behavioral problems of the child–adolescent, as a useful orientation to the clinical evaluation. The Child and Adolescent Behavior Inventory (CABI) is a 75-item parent questionnaire, which explores a large number of problem areas. The study of its predictive validity for the clinical diagnosis, in comparison with the Diagnostic and Statistical Manual of Mental Disorders ( DSM)-oriented scales of the Child Behavior Checklist (CBCL), can assess whether its use may be advantageous.

Material and Methods:

Parents/caregivers of 462 children and adolescents responded to both CABI and CBCL as a preliminary routine investigation. The results were compared with those of diagnoses obtained after the completion of the usual clinical procedure.

Results:

Accuracy values (probability of correct classification) resulted high for both instruments and significantly better for CABI anxiety and attention-deficit hyperactivity disorder (ADHD) scales, and for CBCL oppositional defiant disorder (ODD) and conduct disorder (CD) scales; no significant difference was found for depression scales. All the areas under the curve (AUC) of the receiver operating characteristic analysis reached excellent values, suggesting a very good predictive ability of the five scales of the two instruments. The comparison of AUC showed the CABI’s anxiety and ADHD scales to give significantly higher values than those of CBCL, indicating that these two scales have a better predictive ability.

Conclusion:

The study indicates a very good comparative (vs CBCL) and predictive validity of the CABI, suggesting an advantage in the use of this shorter questionnaire, available for free use both for clinical practice and supposedly for screening and epidemiological evaluations.
Flexible model predictive control based on multivariable online adjustment mechanism for robust gait generation
Authors: Dong Sheng , Yuan Zhaohui , Yu Xiaojun , Sadiq Muhammad Tariq , Zhang Jianrui , Zhang Fuli , Wang Cheng
Published: January 2020

The gait generation algorithm considering both step distance adjustment and step duration adjustment could improve the anti-disturbance ability of the humanoid robot, which is very important to the dynamic balance, but the step duration adjustment often brings non-convex optimization problems. In order to avoid this situation and improve the robustness of the gait generator, a gait generation mechanism based on flexible model predictive control is proposed in this article. Specifically, the step distance adjustment and step duration adjustment are set to be optimization objectives, while the change of pressure center is treated as the optimal input to minimize those objectives. With the current system state being used for online re-optimization, a feedback gait generator is formed to realize the strong stability of variable speed and variable step distance walking of the robot. The main contributions of this work are twofold. First, a gait generation mechanism based on flexible model predictive control is proposed, which avoids the problem of nonlinear optimization. Second, a variety of feasible optimization constraints were considered, they can be used on platforms with different computing resources. Simulations are conducted to verify the effectiveness of the proposed mechanism. Results show that as compared with those considering step adjustment only, the proposed method largely improves the compensation ability of disturbance and shortens the adjustment time.
The challenges of using physical restraint in intensive care units in Iran: A qualitative study
Authors: Salehi Zahra , Joolaee Soodabeh , Hajibabaee Fatemeh , Ghezeljeh Tahereh Najafi
Published: January 2020

Background

Physical restraint is widely used in intensive care units to ensure patient safety, manage agitated patients, and prevent the removal of medical equipment connected to them. However, physical restraint use is a major healthcare challenge worldwide.

Aim

This study aimed to explore nurses' experiences of the challenges of physical restraint use in intensive care units.

Methods

This qualitative study was conducted in 2018–2019. Twenty critical care nurses were purposively recruited from the intensive care units of four hospitals in Tehran, Iran. Data were collected via in-depth semi-structured interviews, concurrently analyzed via Graneheim and Lundman's conventional content analysis approach, and managed via MAXQDA software (v. 10.0).

Findings

Three main themes were identified (i) organizational barriers to effective physical restraint use (lack of quality educations for nurses about physical restraint use, lack of standard guidelines for physical restraint use, lack of standard physical restraint equipment), (ii) ignoring patients' wholeness (their health and rights), and (iii) distress over physical restraint use (emotional and mental distress, moral conflict, and inability to find an appropriate alternative for physical restraint).

Conclusion

Critical care nurses face different organizational, ethical, and emotional challenges in using physical restraint. Healthcare managers and authorities can reduce these challenges by developing standard evidence-based guidelines, equipping hospital wards with standard equipment, implementing in-service educational programs, supervising nurses' practice, and empowering them for finding and using alternatives to physical restraint. Nurses can also reduce these challenges through careful patient assessment, using appropriate alternatives to physical restraint, and consulting with their expert colleagues.
Company Response to Negative Online Reviews: The Effects of Procedural Justice, Interactional Justice, and Social Presence
Authors: Olson Eric D. , Ro Heejung
Published: January 2020

This research investigates how potential customers evaluate a company response to negative online reviews. Integrating the literature on perceived justice in service recovery, social presence in online communications, and signaling in trust formation process, this research examines the effects of procedural justice, interactional justice, and social presence in the company’s response to negative online reviews on potential customers’ trust and purchase intentions toward a company. A 2 × 2 × 2 between-subject experimental design is utilized, and 410 participants are recruited through a consumer panels firm. Main results include the three-way interaction effect of procedural justice, interactional justice, and social presence on trust and the mediating effect of trust. Social presence exacerbates the negative effects on trust when both interactional justice and procedural justice are low in the company response. However, the social presence effect becomes small in increasing trust when both interactional justice and procedural justice are high in the company response. Trust mediates the relationship between customer perceptions of company response and purchase intentions. This research provides practical implications for hospitality companies on how to effectively respond to negative online reviews.
Matrix-Associated Autologous Chondrocyte Implantation with Spheroid Technology Is Superior to Arthroscopic Microfracture at 36 Months Regarding Activities of Daily Living and Sporting Activities after Treatment
Authors: Hoburg Arnd , Niemeyer Philipp , Laute Volker , Zinser Wolfgang , Becher Christoph , Kolombe Thomas , Fay Jakob , Pietsch Stefan , Kuźma Tomasz , Widuchowski Wojciech , Fickert Stefan
Published: January 2020

Objective

Matrix-associated autologous chondrocyte implantation (ACI) and microfracture (MF) are well-established treatments for cartilage defects of the knee. However, high-level evidence comparing microfracture and spheroid technology ACI is limited.

Design

Prospective, phase III clinical trial with patients randomized to ACI ( N = 52) or MF ( N = 50). Level of evidence: 1, randomized controlled trial. Both procedures followed standard protocols. For ACI 10 to 70 spheroids/cm2 were administered. Primary outcome measure was the Knee Injury and Osteoarthritis Outcome Score (KOOS). This report presents results for 36 months after treatment.

Results

Both ACI and MF showed significant improvement over the entire 3-year observation period. For the overall KOOS, noninferiority of ACI (the intended primary goal of the study) was formally confirmed; additionally, for the subscores “Activities of Daily Living” and “Sport and Recreation,” superiority of ACI over MF was shown at descriptive level. Occurrence of adverse events were not different between both treatments (ACI 77%; MF 74%). Four patients in the MF group required reoperation which was defined as treatment failure. No treatment failure was reported for the ACI group.

Conclusions

Patients treated with matrix-associated ACI with spheroid technology showed substantial improvement in various clinical outcomes after 36 months. The advantages of ACI compared with microfracture was underlined by demonstrating noninferiority, in overall KOOS and superiority in the KOOS subscores “Activities of Daily Living” and “Sport and Recreation.” In the present study, subgroups comparing different age groups and defect sizes showed comparable clinical outcomes.
From Policy Statement to Practice: Integrating Social Needs Screening and Referral Assistance With Community Health Workers in an Urban Academic Health Center
Authors: Fiori Kevin , Patel Milani , Sanderson Dana , Parsons Amanda , Hodgson Sybil , Scholnick Jenna , Bathory Eleanor , White-Davis Tanya , Wigod Neal , Chodon Tashi , Rich Andrea , Braganza Sandra
Published: January 2020

Purpose: Social and economic factors have been shown to affect health outcomes. In particular, social determinants of health (SDH) are linked to poor health outcomes in children. Research and some professional academies support routine social needs screening during primary care visits. Translating this recommendation into practice remains challenging due to the resources required and dearth of evidence-based research to guide health center level implementation. We describe our experience implementing a novel social needs screening program at an academic pediatric clinic. Methods: The Community Linkage to Care (CLC) pilot program integrates social needs screening and referral support using community health workers (CHWs) as part of routine primary care visits. Our multidisciplinary team performed process mapping, developed workflows, and led ongoing performance improvement activities. We established key elements of the CLC program through an iterative process We conducted social needs screens at 65% of eligible well-child visits from May 2017 to April 2018; 19.7% of screens had one or more positive responses. Childcare (48.8%), housing quality and/or availability (39.9%), and food insecurity (22.8%) were the most frequently reported needs. On average, 76% of providers had their patients screened on more than half of eligible well-child visits. Discussion: Our experience suggests that screening for social needs at well-child visits is feasible as part of routine primary care. We attribute progress to leveraging resources, obtaining provider buy-in, and defining program components to sustain activities.
N. R. Madhava Menon: A Global Justice Educator’s Approach to Training Clinical Law Teachers
Authors: Bloch Frank S.
Published: January 2020

This article describes one aspect of Dr N. R. Madhava Menon’s lifelong commitment to bringing ‘socially relevant legal education’ to India and around the world, whereby lawyers would be trained not just in the rules of law but also in the social and ethical responsibilities of lawyers to the society at large. Over the course of more than 25 years, the author collaborated with Dr Menon in training of law teachers in clinical methods and, in particular, in the incorporation of social justice into law school clinical and legal aid programs. A key element of their collaboration was the development of the concept of a clinical method for training clinical law teachers that could be used in training-of-trainers (TOT) workshops throughout the world, including those run by national, regional, and international clinical organizations. The result was a model for the training of clinical law teachers based on what the author and Dr Menon described elsewhere as three defining qualities of the global clinical movement: Its professional educational mission, its methodology, and its commitment to reforming legal education by reorienting it toward educating lawyers for social justice. The article concludes with a description of their model that emphasizes the setting for the training, preparing the trainee teachers for the training, the use of training by doing, and the importance of reflection and critique in the successful generalization of students’ clinical learning.
White matter changes in chronic and episodic migraine: a diffusion tensor imaging study
Authors: Planchuelo-Gómez Álvaro , García-Azorín David , Guerrero Ángel L. , Aja-Fernández Santiago , Rodríguez Margarita , de Luis-García Rodrigo
Published: January 2020

Background

White matter alterations have been observed in patients with migraine. However, no microstructural white matter alterations have been found particularly in episodic or chronic migraine patients, and there is limited research focused on the comparison between these two groups of migraine patients.

Methods

Fifty-one healthy controls, 55 episodic migraine patients and 57 chronic migraine patients were recruited and underwent brain T1-weighted and diffusion-weighted MRI acquisition. Using Tract-Based Spatial Statistics (TBSS), fractional anisotropy, mean diffusivity, radial diffusivity and axial diffusivity were compared between the different groups. On the one hand, all migraine patients were compared against healthy controls. On the other hand, patients from each migraine group were compared between them and also against healthy controls. Correlation analysis between clinical features (duration of migraine in years, time from onset of chronic migraine in months, where applicable, and headache and migraine frequency, where applicable) and Diffusion Tensor Imaging measures was performed.

Results

Fifty healthy controls, 54 episodic migraine and 56 chronic migraine patients were finally included in the analysis. Significant decreased axial diffusivity (p < .05 false discovery rate and by number of contrasts corrected) was found in chronic migraine compared to episodic migraine in 38 white matter regions from the Johns Hopkins University ICBM-DTI-81 White-Matter Atlas. Significant positive correlation was found between time from onset of chronic migraine and mean fractional anisotropy in the bilateral external capsule, and negative correlation between time from onset of chronic migraine and mean radial diffusivity in the bilateral external capsule.

Conclusions

These findings suggest global white matter structural differences between episodic migraine and chronic migraine. Patients with chronic migraine could present axonal integrity impairment in the first months of chronic migraine with respect to episodic migraine patients. White matter changes after the onset of chronic migraine might reflect a set of maladaptive plastic changes.
Simultaneous occurrence of invasive pulmonary aspergillosis and diffuse large B-cell lymphoma: case report and literature review
Authors: Shao Lianyou , Jiang Longxiang , Wu Siyao , Yu Lihua , Wang Liangxing , Huang Xiaoying
Published: January 2020

Background

Patients with lymphoma are at risk for developing pulmonary opportunistic infections due to immunocompromise. However, clinical reports of concurrent lymphoma and opportunistic infection at presentation are rare and often confined to single cases. A delayed diagnosis of either opportunistic infection or lymphoma usually occurs in this complex situation. Here, we report such a case and analyse 18 similar cases searched in the PubMed database to deepen clinicians’ understanding.

Case presentation

A 48-year-old man presented with a 3-month history of fever, cough and emaciation. High-resolution computed tomography revealed bilateral cavitating lesions of different sizes. Aspergillus fumigatus complex was identified from a bronchoalveolar lavage fluid culture. However, antifungal treatment combined with multiple rounds of antibacterial therapy was unsuccessful, and the patient’s lung lesions continued to deteriorate. Multiple puncture biopsies finally confirmed the coexistence of diffuse large B-cell lymphoma. Despite the initiation of combination chemotherapy, the patient died of progressive respiratory failure.

Conclusions

Synchronous pulmonary lymphoma and simultaneous opportunistic infection is rare and usually lacks specific clinical and imaging manifestations. Lymphoma should be considered as part of the differential diagnosis of patients with an opportunistic infection when treatment fails or other symptoms are present that could be considered “atypical” for the condition. Tissue biopsy is the gold standard, and multiple biopsies are essential for making the final diagnosis and should be performed upon early suspicion.
Early-life exposure to the Chinese famine of 1959–61 and risk of Hyperuricemia: results from the China health and retirement longitudinal study
Authors: Zhang Wenqiang , Luan Rongsheng
Published: January 2020

Background

Short-term starvation has been related to hyperuricemia. However, little is known about the long-term effect of early-life exposure to famine on hyperuricemia risk in adulthood.

Methods

The analysis included 2383 participants from the China Health and Retirement Longitudinal Study in 2015. Hyperuricemia was diagnosed as serum uric acid ≥7 mg/dL in men and serum uric acid ≥6 mg/dL in women. Famine exposure subgroups were defined as unexposed (born between October 1, 1962, and September 30, 1964), fetal-exposed (born between October 1, 1959, and September 30, 1961), and early-childhood exposed (born between October 1, 1956, and September 1, 1958). The association between early-life famine exposure and hyperuricemia risk was assessed using multivariate logistic regression.

Results

The prevalence of hyperuricemia in the unexposed, fetal-exposed, and early-childhood exposed participants was 10.7, 14.1, 11.1%, respectively. Compared with unexposed and early-childhood exposed participants combined as an age-balanced control, fetal-exposed participants showed an increased risk of hyperuricemia in adulthood (OR = 1.41; 95%CI: 1.06–1.88), after adjusting for gender, marital status, famine severity, residence, smoking, drinking, BMI, hypertension, and diabetes. The famine effect on hyperuricemia was accentuated by overweight or obesity (Pfor interaction = 0.042). Compared with unexposed and BMI < 24 kg/m2participants, theOR(95%CI) of hyperuricemia was 3.66 (2.13–6.30) for fetal-exposed and overweight/obesity participants. However, combined unexposed and early-childhood exposed participants as an age-balanced control, the interaction of famine exposure and BMI was not statistically significant (Pfor interaction = 0.054).

Conclusion

Famine exposure in the fetal stage was associated with an increased risk of hyperuricemia in adulthood.
The potential effects of an extended alcohol withdrawal treatment programme on morbidity and mortality among inpatients in the German city of Bremen: a simulation study
Authors: Manthey Jakob , Lindemann Christina , Kraus Ludwig , Reimer Jens , Verthein Uwe , Schulte Bernd , Rehm Jürgen
Published: January 2020

Background

According to the German guidelines, people with severe alcohol use disorders (AUDs) should receive withdrawal treatment. Compared to somatic withdrawal treatment (SWT), extended duration and psychosocial elements of so-called “qualified withdrawal treatment” (QWT) aim to reduce relapse rates. Despite promising results of prospective studies on QWT, only few German inpatients seeking withdrawal treatment receive QWT. We estimated the potential effects on mortality and morbidity for higher proportions of treatment-seeking patients receiving QWT rather than SWT in the German city of Bremen.

Methods

In 2016 and 2017, 2051 inpatients were admitted to two specialised hospitals for withdrawal treatment. The potential beneficial effects of QWT over SWT were estimated by simulating treatment outcomes taken from two prospective studies. Outcomes comprised number and length of all-cause hospitalisations within 5 years, as well as abstinence and all-cause mortality rates within 28 months. Outcomes were estimated for actual and increased rates of QWT (25, 50%) among inpatients seeking alcohol treatment.

Results

In the selected hospitals, 170 patients (8%) received QWT. If 25% of AUD inpatients were to receive QWT, benefits in abstinence rates (+ 18%), the total number of hospitalisations (− 9%) and hospital days (− 10%) could be expected. If 50% of AUD inpatients were to receive QWT, benefits in abstinence rates (+ 45%), the total number of hospitalisations (− 23%) and hospital days (− 26%) were more pronounced, in addition to reductions in mortality (− 20%).

Conclusion

Increasing the proportion of people with severe AUD enrolled in extended withdrawal treatment programs (such as QWT) may contribute to reduce overall alcohol-attributable burden of disease. Randomised controlled trials or other prospective studies controlling for confounding factors are needed to determine the potential at the population level.
Forecasting tumor and vasculature response dynamics to radiation therapy via image based mathematical modeling
Authors: Hormuth David A. , Jarrett Angela M. , Yankeelov Thomas E.
Published: January 2020

Background

Intra-and inter-tumoral heterogeneity in growth dynamics and vascularity influence tumor response to radiation therapy. Quantitative imaging techniques capture these dynamics non-invasively, and these data can initialize and constrain predictive models of response on an individual basis.

Methods

We have developed a family of 10 biologically-based mathematical models describing the spatiotemporal dynamics of tumor volume fraction, blood volume fraction, and response to radiation therapy. To evaluate this family of models, rats (n = 13) with C6 gliomas were imaged with magnetic resonance imaging (MRI) three times before, and four times following a single fraction of 20 Gy or 40 Gy whole brain irradiation. The first five 3D time series data of tumor volume fraction, estimated from diffusion-weighted (DW-) MRI, and blood volume fraction, estimated from dynamic contrast-enhanced (DCE-) MRI, were used to calibrate tumor-specific model parameters. The most parsimonious and well calibrated of the 10 models, selected using the Akaike information criterion, was then utilized to predict future growth and response at the final two imaging time points. Model predictions were compared at the global level (percent error in tumor volume, and Dice coefficient) as well as at the local or voxel level (concordance correlation coefficient).

Result

The selected model resulted in < 12% error in tumor volume predictions, strong spatial agreement between predicted and observed tumor volumes (Dice coefficient > 0.74), and high level of agreement at the voxel level between the predicted and observed tumor volume fraction and blood volume fraction (concordance correlation coefficient > 0.77 and > 0.65, respectively).

Conclusions

This study demonstrates that serial quantitative MRI data collected before and following radiation therapy can be used to accurately predict tumor and vasculature response with a biologically-based mathematical model that is calibrated on an individual basis. To the best of our knowledge, this is the first effort to characterize the tumor and vasculature response to radiation therapy temporally and spatially using imaging-driven mathematical models.
MiR-199a-modified exosomes from adipose tissue-derived mesenchymal stem cells improve hepatocellular carcinoma chemosensitivity through mTOR pathway
Authors: Lou Guohua , Chen Liang , Xia Caixia , Wang Weina , Qi Jinjin , Li Aichun , Zhao Liying , Chen Zhi , Zheng Min , Liu Yanning
Published: January 2020

Background

MiR-199a-3p (miR-199a) can enhance the chemosensitivity of hepatocellular carcinoma (HCC). Because of the easy degradation of miRNA by direct infusion, effective vehicle-mediated delivery of miR-199a may represent a new strategy for improving HCC chemotherapy. Considering mesenchymal stem cell (MSC)-derived exosomes as promising natural nanovectors for drug and molecule delivery, we aimed to determine whether exosomes from adipose tissue-derived MSCs (AMSCs) could be used to deliver miR-199a and improve HCC chemosensitivity.

Methods

MiR-199a-modified AMSCs (AMSC-199a) were constructed by miR-199a lentivirus infection and puromycin selection. MiR-199-modified exosomes (AMSC-Exo-199a) were isolated from the supernatant of AMSC-199a and were assessed by transmission electron microscopy, nanoparticle tracking analysis, and flow cytometry analysis. The expression levels of miR-199a in HCC samples, AMSCs, exosomes, and HCC cells were quantified by real-time PCR. The effects of AMSC-Exo-199a on HCC chemosensitivity were determined by cell proliferation and apoptosis assays and by i.v. injection into orthotopic HCC mouse models with doxorubicin treatment. MTOR, p-4EBP1 and p-70S6K levels in HCC cells and tissues were quantified by Western blot.

Results

AMSC-Exo-199a had the classic characteristics of exosomes and could effectively mediate miR-199a delivery to HCC cells. Additionally, AMSC-Exo-199a significantly sensitized HCC cells to doxorubicin by targeting mTOR and subsequently inhibiting the mTOR pathway. Moreover, i.v.-injected AMSC-Exo-199a could distribute to tumor tissue and markedly increased the effect of Dox against HCC in vivo.

Conclusions

AMSC-Exo-199a can be an effective vehicle for miR-199a delivery, and they effectively sensitized HCC to chemotherapeutic agents by targeting mTOR pathway. AMSC-Exo-199a administration may provide a new strategy for improving HCC chemosensitivity.
Ketogenic diet and fasting diet as Nutritional Approaches in Multiple Sclerosis (NAMS): protocol of a randomized controlled study
Authors: Bahr Lina Samira , Bock Markus , Liebscher Daniela , Bellmann-Strobl Judith , Franz Liane , Prüß Alexandra , Schumann Dania , Piper Sophie K. , Kessler Christian S. , Steckhan Nico , Michalsen Andreas , Paul Friedemann , Mähler Anja
Published: January 2020

Background

Multiple sclerosis (MS) is the most common inflammatory disease of the central nervous system in young adults that may lead to progressive disability. Since pharmacological treatments may have substantial side effects, there is a need for complementary treatment options such as specific dietary approaches. Ketone bodies that are produced during fasting diets (FDs) and ketogenic diets (KDs) are an alternative and presumably more efficient energy source for the brain. Studies on mice with experimental autoimmune encephalomyelitis showed beneficial effects of KDs and FDs on disease progression, disability, cognition and inflammatory markers. However, clinical evidence on these diets is scarce. In the clinical study protocol presented here, we investigate whether a KD and a FD are superior to a standard diet (SD) in terms of therapeutic effects and disease progression.

Methods

This study is a single-center, randomized, controlled, parallel-group study. One hundred and eleven patients with relapsing–remitting MS with current disease activity and stable immunomodulatory therapy or no disease-modifying therapy will be randomized to one of three 18-month dietary interventions: a KD with a restricted carbohydrate intake of 20–40 g/day; a FD with a 7-day fast every 6 months and 14-h daily intermittent fasting in between; and a fat-modified SD as recommended by the German Nutrition Society. The primary outcome measure is the number of new T2-weighted MRI lesions after 18 months. Secondary endpoints are safety, changes in relapse rate, disability progression, fatigue, depression, cognition, quality of life, changes of gut microbiome as well as markers of inflammation, oxidative stress and autophagy. Safety and feasibility will also be assessed.

Discussion

Preclinical data suggest that a KD and a FD may modulate immunity, reduce disease severity and promote remyelination in the mouse model of MS. However, clinical evidence is lacking. This study is the first clinical study investigating the effects of a KD and a FD on disease progression of MS.

Trial registration

ClinicalTrials.gov, NCT03508414. Retrospectively registered on 25 April 2018.