bluuebunny/crossref_metadata_2025 huggingface dataset:
Vascular Inflammation, Calf Muscle Oxygen Saturation, and Blood Glucose are Associated With Exercise Pressor Response in Symptomatic Peripheral Artery Disease
Authors: Gardner Andrew W. , Montgomery Polly S. , Wang Ming , Chen Chixiang , Kuroki Marcos , Kim Danielle Jin-Kwang
Published: March 2019

We determined whether calf muscle oxygen saturation (StO2) and vascular biomarkers of inflammation and oxidative stress were associated with an exercise pressor response during treadmill walking in 179 patients with symptomatic peripheral artery disease (PAD). The exercise pressor response was measured as the change in blood pressure from rest to the end of the first 2-minute treadmill stage (2 mph, 0% grade). There was a wide range in the change in systolic blood pressure (−46 to 50 mm Hg) and in diastolic blood pressure (−23 to 38 mm Hg), with mean increases of 4.3 and 1.4 mm Hg, respectively. In multiple regression analyses, significant predictors of systolic pressure included glucose ( P < .001) and insulin ( P = .039). Significant predictors of diastolic pressure included cultured endothelial cell apoptosis ( P = .019), the percentage drop in exercise calf muscle (StO2; P = .023), high-sensitivity C-reactive protein ( P = .032), and glucose ( P = .033). Higher levels in pro-inflammatory vascular biomarkers, impaired calf muscle StO2 during exercise, and elevated blood glucose were independently associated with greater exercise pressor response in patients with symptomatic PAD. The clinical implication is that exercise and nutritional interventions designed to improve inflammation, microcirculation, and glucose metabolism may also lower blood pressure during exercise in patients with symptomatic PAD.
Sensorineural Hearing Loss in Leukemia: A Case Report Showing Intravascular Coagulation in the Cochlea and Vestibular Labyrinth
Authors: Okayasu Tadao , Faquin William C. , Nadol Joseph B.
Published: March 2019

Introduction:

Sensorineural hearing loss frequently has been described in patients with leukemia, and in fact, hearing loss may be the presenting symptom of this disease. However, the pathogenesis of sensorineural hearing loss in leukemia is not well understood.

Objective:

To describe the temporal bone histopathology in 1 patient with leukemia and sensorineural hearing loss.

Methods:

The histopathology of the temporal bones of 1 patient with chronic myelomonocytic leukemia who suffered well-documented bilateral sequential profound sensorineural hearing loss 4 months before death was investigated using light microscopy.

Result:

There was evidence of ischemic necrosis of the neuroepithelium and intravascular fibrin micro-thrombi suggestive of intravascular coagulation in the cochlea and vestibular labyrinth.

Conclusion:

Intravascular coagulation may be a contributing factor in the commonly reported finding of hemorrhage in the cochlea in leukemia and may play a role in the pathogenesis of sensorineural loss in some cases of leukemia.
Sub-Micron Spatial Resolution in Far-Field Raman Imaging Using Positivity-Constrained Super-Resolution
Authors: Winterauer Dominik J. , Funes-Hernando Daniel , Duvail Jean-Luc , Moussaoui Saïd , Batten Tim , Humbert Bernard
Published: March 2019

Raman microscopy is a valuable tool for detecting physical and chemical properties of a sample material. When probing nanomaterials or nanocomposites the spatial resolution of Raman microscopy is not always adequate as it is limited by the optical diffraction limit. Numerical post-processing with super-resolution algorithms provides a means to enhance resolution and can be straightforwardly applied. The aim of this work is to present interior point least squares (IPLS) as a powerful tool for super-resolution in Raman imaging through constrained optimization. IPLS’s potential for super-resolution is illustrated on numerically generated test images. Its resolving power is demonstrated on Raman spectroscopic data of a polymer nanowire sample. Comparison to atomic force microscopy data of the same sample substantiates that the presented method is a promising technique for analyzing nanomaterial samples.
Exploring Student Achievement Gaps in School Districts Across the United States
Authors: Hung Man , Smith William A. , Voss Maren W. , Franklin Jeremy D. , Gu Yushan , Bounsanga Jerry
Published: March 2019

This study examined factors contributing to achievement gaps between White and African American students in 2,868 diverse school districts across the United States. Using pooled data across five school years (2008-2013), six grade levels (grades third to eighth, which typically include students aged 8 years-14 years) and two different subjects (math and English language), descriptive, correlational, and multiple linear regressions were used to identify relevant factors in predicting an achievement gap. Achievement gaps were largest in the south and southwest United States. In addition, results indicate that economic inequality, racial inequality, and household adult education attainment are strongly associated with Black/White student achievement gaps. School-based factors such as per pupil expenditures and teacher/student ratios were not significant predictors. Household adult education attainment was the most significant contributor to achievement gaps, with higher levels of adult education associated with larger achievement gaps, implying that high resource communities may create additional barriers for minority students.
The role of trauma and partner support in perinatal depression and parenting stress: An Australian pregnancy cohort study
Authors: Galbally Megan , Watson Stuart J , Boyce Philip , Lewis Andrew J
Published: March 2019

Background:

Improving our understanding of the relationship between maternal depression and parenting stress is likely to lie in the range of additional factors that are associated with vulnerability to depression and also to parenting stress.

Objectives:

To examine the role of trauma and partner support, in understanding the relationship between perinatal depression and parenting stress.

Methods:

This study utilises data from 246 women in a pregnancy cohort study that followed women from early pregnancy until their infant was 12 months. Included were both women with a diagnosis of depression and those without depression. The measures included Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Edinburgh Postnatal Depression Scale, Childhood Trauma Questionnaire, Social Support Effectiveness Questionnaire and the Parenting Stress Index.

Results:

We found women with depression were more likely to report a history of childhood trauma. Depressive symptoms were positively associated with parenting stress while partner support was negatively associated with parenting stress. The protective role of partner support for parenting distress was observed in those with no history of childhood abuse and low depressive symptoms, but not in those with a trauma history and high depressive symptoms.

Conclusions:

These findings highlight the importance of early trauma in understanding the protective role of support on the relationship between parenting and depression. These findings can inform future studies and the refinement of future interventions aimed at both perinatal depression and parenting.
Disclosing the diagnosis of schizophrenia: A pilot study of the ‘Coming Out Proud’ intervention
Authors: Setti Viviane Piagentini Candal , Loch Alexandre Andrade , Modelli Arlete , de Almeida Rocca Cristiana Castanho , Hungerbuehler Ines , van de Bilt Martinus Theodorus , Gattaz Wagner Farid , Rössler Wulf
Published: March 2019

Background:

Schizophrenia is one of the most stigmatized psychiatric disorders, and disclosing it is often a source of stress to individuals with the disorder. The Coming Out Proud (COP) group intervention is designed to reduce the stigma’s negative impact and help participants decide if they want to disclose their disorder.

Aims:

To assess the effect of the COP intervention in individuals with the diagnosis of schizophrenia.

Methods:

A pilot study of 3 2-hour group lessons (6–12 participants) per week. Individuals were selected from three specialized outpatient services in São Paulo, Brazil; 46 people were willing to participate, 11 dropped out during the intervention and 4 were excluded due to low intelligence quotient (IQ), resulting in a final sample of 31 participants. Outcomes were assessed before ( T0/baseline) and after ( T1/directly) after the COP intervention, and at 3-week follow-up ( T2/3 weeks after T1). We applied eight scales, of which four scales are analyzed in this article (Coming Out with Mental Illness Scale (COMIS), Cognitive Appraisal of Stigma as a Stressor (CogApp), Self-Stigma of Mental Illness Scale-Short Form (SSMIS) and Perceived Devaluation-Discrimination Questionnaire (PDDQ)).

Results:

People who completed the COP intervention showed a significant increase in the decision to disclose their diagnosis (22.5% in T0 vs 67.7% in T2). As to the perception of stigma as a stressor, mean values significantly increased after the intervention ( T0 = 3.83, standard deviation ( SD) = .92 vs T2 = 4.44, SD = 1.05; p = .006). Two results had marginal significance: self-stigma was reduced ( T0 = 3.10, SD = 1.70 vs T2 = 2.73, SD = 1.87; p = .063), while perceived discrimination increased ( T0 = 2.68, SD = .55 vs T2 = 2.93, SD = .75; p = .063).

Conclusion:

This study suggests that the COP group intervention facilitated participants’ disclosure decisions, and the increasing awareness of stigma as a stressor in life may have facilitated their decision to eventually disclose their disorder. The results raise questions that require further analysis, taking sociocultural factors into account, as stigma is experienced differently across cultures.
Who Let the Dogs in? Antiblackness, Social Exclusion, and the Question of Who Is Human
Authors: Parker Lynette
Published: March 2019

This article illuminates how the lived experiences of Black men in comparison to experiences of dogs in society highlight antiblackness as the prevailing sentiment in America. This juxtaposition illuminates the psychological project embedded within antiblackness—to dehumanize Black people by elevating dogs alongside other racial groups that have been deemed as human. The article demonstrates how dogs have not only been embraced by Whites, but have been given access into spaces and granted civil liberties for which Blacks continue to struggle. The article looks at the role of dogs in a country that once categorized them as nuisances and marked them with distain by identifying them along with Blacks, Mexicans, Jews, Irish, Chinese, and Japanese as the “undesirable” elements of society. Today’s acceptance of and advocacy for dogs as a social phenomenon demonstrates the possibility of an ideology shift by Whites, while simultaneously demonstrating their dogged determination to hold to an ideology that cast Black people as less than human.
Les quatre saisons du Renouveau charismatique, 1967–2017
Authors: Aubourg Valérie
Published: March 2019

This article focuses on the Catholic Charismatic Renewal. I study its development since 1967 to the current day, in the prism of its relationship with Pentecostalism. I identify four ‘seasons’, in other words four historical periods: the flourishing years (1972–1982 ) during which the Pentecostal experience penetrates into Catholicism; an identity retreat (1982–1997), a period of rapprochement with neo-Pentecostalists in order to resuscitate the Renewal (since 1997); and a final, ‘post-charismatic’ stage corresponding to the broader introduction of characteristic elements of Pentecostalism in Catholicism.
‘Entering a gigantic maze:’ The ambivalent presence of previous-life memories in Druze discourse
Authors: Nigst Lorenz
Published: March 2019

According to the Druze notion of transmigration ( taqammuṣ), whenever someone dies, his or her soul moves into the body of a newborn Druze of the same sex. While this makes the Druze feel that they belong together in a more fundamental way because they are ‘born in each other’s houses’ (Oppenheimer), it is more ambivalent the moment children start to ‘speak’ about previous lives in another family. Allowing the ‘return’ of someone lost to death and potentially bringing two such houses in closer relation, ‘speaking’ also requires coming to terms with conflicting belonging.
Book review: Madhu Nagla, Sociology of Health and Medicine
Authors: Kahlon Neena Rosy
Published: March 2019

Madhu Nagla, Sociology of Health and Medicine. Jaipur: Rawat Publications, 2018, xv + 514 pp., ₹450 (paperback). ISBN: 978-81-316-0934-7.
Silk fabric protection obtained via chemical conjugation of transglutaminase and silk fibroin reinforcement
Authors: Zhao Suhua , Pan Hongliang , Liu Yali , Zeng Yirong , Liu Hongling , Yu Weidong
Published: March 2019

Historic silk fabric is an important part of Chinese precious cultural heritage and its protection has always been a major challenge. This paper proposes a bio-safety method by the chemical conjugation of transglutaminase (TGase or TG) and sodium caseinate (SC), which produced a macromolecular polymer between protein molecules and enhanced silk fabrics. The changes of the mechanical properties of the reinforced silk fabric after washing by 10 cycles were not obvious, indicating good washing durability. After TGase and SC reinforcement, the silk fibroin (SF) solution was sprayed on the surface of silk fabric to improve the mechanical properties, where the secondary structure were formed by the self-assembly of SF to improve the mechanical properties. Therefore, the breaking stress attained the maximum value when the SF solution concentration was 1.0%. Meanwhile, the breaking stress increased by about 20.89% compared with untreated silk fabric. When the artificially alkali aged silk fabric is reinforced, the breaking stress and strain of the reinforced sample increased by 37.77% relative to the alkali aged fabric. The surface morphology and secondary structure transformation of the samples were also analyzed by scanning electron microscopy and Fourier transform infrared spectroscopy, respectively. The results indicated that a significant SF layer was introduced on the surface of the silk fabric and the β-sheet structure increased due to the synergetic role of the macromolecular polymer and SF. Moreover, it is concluded that an increase in temperature and humidity will result in a decrease in the preservation index, which caused the degradation of silk fabric and proved that the preservation time of the reinforced silk fabric in the same environment was longer than that of the unreinforced sample. The biological enzyme chemical conjugation with silk fabric and physical combination of the pure SF solution is expected to be applied to the protection and enhancement of silk cultural relics.
Involuntary staying and self-rated health: A multilevel study on housing, health and neighbourhood effects
Authors: Kemppainen Teemu , Elovainio Marko , Kortteinen Matti , Vaattovaara Mari
Published: March 2019

Involuntary staying, or a desire to move without the possibility to do so, is an under-studied topic. In this study, we examine involuntary staying among the residents of post-Second World War Finnish housing estates; we study its frequency, association with self-rated health and role in the relationship between neighbourhood disadvantage and self-rated health. Involuntary staying and poor health are expected to be associated through long-term stress related to housing and health-based selection in inconvenient housing outcomes. Furthermore, we address the self-perceived reasons for involuntary staying and the interaction between involuntary staying and household income. Two types of involuntary staying are distinguished, depending on whether a resident wants to move within or away from the current neighbourhood. The survey data ( n = 7369) from a stratified cluster sample of the residents of 70 Finnish housing estate neighbourhoods are combined with the corresponding geo-referenced register data on these neighbourhoods’ sociodemographic characteristics. Of the residents, 35% are found to be involuntary stayers, and over half of the involuntary stayers want to move away from their current neighbourhoods. Financial concern is the most common self-perceived reason for involuntary staying. Both types of involuntary staying are associated with low self-rated health after adjusting for potential confounders. Being trapped in the current neighbourhood partially mediates the adjusted association between neighbourhood disadvantage and self-rated health. The association between self-rated health and involuntary staying is not modified by household income. In conclusion, involuntary staying is common in the study population and furthers the understanding about neighbourhood inequalities in health.
The contribution of intergroup neighbouring to community participation: Evidence from Shanghai
Authors: Wang Zheng , Zhang Fangzhu , Wu Fulong
Published: March 2019

What kind of neighbouring might enhance participation in community activities? Using a 1420-sized household survey collected in Shanghai, this paper examines the relationship between different types of neighbouring and community participation. Our results show that in-group neighbouring between residents belonging to the same social group does not have a direct effect on community participation. Instead intergroup neighbouring between migrant and local neighbours can lead to more willingness to take part in community activities. Owing to the unequal power configuration between minority and majority groups living in the same locality, intergroup neighbouring can help break down existing barriers between migrant residents and local residents who are mostly in charge of organising community activities. Our findings contribute to a better conceptualisation of neighbouring and community participation, which so far has focused on the quantity of neighbouring but largely ignored the types of neighbouring.
Experimental study on influence of dominant fatty acid esters in engine characteristics of waste beef tallow biodiesel
Authors: Srinivasan Gokul R , Shankar Vijayalakshmi , Jambulingam Ranjitha
Published: March 2019

Biodiesel is regarded as the most promising renewable biofuel which can satisfy the worldwide energy demand through its robust net energy output with less impact on environment and also an effective alternative or supplement for existing diesel fuel for powering Compression Ignition engines. This present study aims to compare the performance, combustion and emission characteristics of beef tallow biodiesel with its dominant fatty acid esters and their influence on these characteristics. Ethyl stearate, ethyl palmitate and ethyl oleate were identified as dominant fatty acid esters available in a composition of 14.78, 37.36 and 25.17%, respectively. Two set of samples were prepared for testing purpose and were classified as (i) blend samples and (ii) ester samples, with plain diesel as base fuel. The maximum cylinder pressure was found to be in the range between 67 and 71 bar for all the samples and heat release rate was found to be highest for B20 blend. Slight decrease in efficiency along with marginal increase in fuel consumption was a result of long chained fatty acid esters (stearate and oleate esters) whereas increase in CO2 emission and decrease in NOX emission were because of higher oxygen content, cetane number and degree of unsaturation in the ester molecule.
Predictors of Employment for Youths with Visual Impairments: Findings from the Second National Longitudinal Transition Study
Authors: McDonnall Michele Capella
Published: March 2019

The study reported here identified factors that predict employment for transition-age youths with visual impairments. Logistic regression was used to predict employment at two levels. Significant variables were early and recent work experiences, completion of a postsecondary program, difficulty with transportation, independent travel skills, and social skills.
Bridging the Gap between Physical Therapy and Orientation and Mobility in Schools: Using a Collaborative Team Approach for Students with Visual Impairments
Authors: Szabo Joanne , Panikkar Rajiv K.
Published: March 2019

This article explores transdisciplinary collaboration and role-release strategies that would allow physical therapists and orientation and mobility (O&M) specialists to more effectively support students with visual impairments (that is, those who are blind or have low vision) and additional disabilities with their expanded core curriculum (ECC) goals. Through examining public and specialized school special education documentation for 20 school-aged students, the authors seek to better understand current practice patterns of both O&M and physical therapy professionals who are working with students who are visually impaired with additional disabilities, and suggest ways in which educational team members from both disciplines can work together toward common goals for their students.
The Significance of Specialist Teachers of Learners with Visual Impairments as Agents of Change: Examining Personnel Preparation in the United Kingdom through a Bioecological Systems Theory
Authors: McLinden Mike , Ravenscroft John , Douglas Graeme , Hewett Rachel , Cobb Rory
Published: March 2019

Introduction

The unique challenges to learning and participation in education associated with visual impairment are well documented in the literature, as is the importance of addressing these challenges through ensuring practitioners who support them are equipped with appropriate knowledge, understanding, and skills. We use a bioecological systems theory as a lens through which to examine the personnel preparation of vision specialist teachers to act as agents of change. We draw on the different teacher preparation programs for specialist teachers of learners with visual impairments in the United Kingdom to demonstrate how this theory can be applied.

Methods

We use a bounded case study to bring together the respective teacher preparation programs in the UK in order to demonstrate complementary characteristics of the theoretical model proposed.

Results and discussion

We argue that a bioecological systems theory offers a holistic framework for educators involved in personnel preparation to explicitly engage with vision specialist teachers in their role as potential agents of change. This preparation includes developing distinctive knowledge, understanding, and skills to facilitate learner participation in education through promoting “progressive” and “mutual” accommodation between the active learner and the changing learning environments in order to achieve successful outcomes.

Implications for practitioners

The article is original in applying a bioecological systems theory to the preparation of these specialist teachers, with a focus on their role as agents of change. We argue that it has significance, therefore, for practitioners and researchers concerned with the personnel preparation of other practitioners for learners with distinctive educational needs across national contexts and settings.
Testing Hypersensitive Responses: Ethnic Minorities Are Not More Sensitive to Microaggressions, They Just Experience Them More Frequently
Authors: West Keon
Published: March 2019

Racial microaggressions have attracted significant empirical attention and have been associated with profound negative effects. However, some argue against the importance of microaggressions arguing that (some) responses to microaggressions merely reflect “hypersensitivity” to trivial events among certain ethnic minority individuals. Three studies tested this hypersensitivity hypothesis. In two cross-sectional studies with dissimilar samples ( N1 = 130, N2 = 264), ethnic minorities reported experiencing more microaggressions than ethnic majorities did, and microaggressions predicted less life satisfaction. However, contrary to the hypersensitivity hypothesis, minority identity did not moderate this relationship. In a randomized, controlled experiment ( N3 = 114), White and ethnic minority participants reported their positive and negative affect before and after recalling either a microaggression or a control event. Recalling microaggressions reduced positive affect and increased negative affect, but this was also not moderated by minority identity. Implications for the hypersensitivity hypothesis, and microaggressions research, are discussed.
A semantic web methodological framework to evaluate the support of integrity in thesaurus tools
Authors: Martínez-González M Mercedes , Alvite-Díez María-Luisa
Published: March 2019

With the Semantic Web, thesauri regain a relevant role supporting semantic searches and other added-value services. Thesaurus standards define the constructs a thesaurus can have and the integrity rules it must comply with. Thesaurus editors can be helped in their work if thesaurus tools offer them support for integrity, warning when integrity rules are violated and/or helping them to correct these mistakes. The most recent thesaurus standard is ISO 25964, which supersedes ISO 2788, evolving towards concept-based thesauri and better aligned with the Semantic Web approach than the term-based thesauri of ISO 2788. However, the W3C recommendation for Knowledge Organisation System (KOS) representation in the semantic web context is Simple Knowledge Organisation Systems (SKOS), which is in fact prior to ISO 25964. This article focuses on thesaurus integrity and the evolution from ISO 2788 to ISO 25964. Its effect on integrity issues is analysed. A methodological proposal for evaluating integrity support in thesaurus tools, arising from the results of this work, is presented. Its target audience is professionals in charge of thesaurus editing. Besides being adapted to the most recent thesaurus standard, ISO 25964, it also includes the comparison of ISO standards with SKOS. The article concludes with the presentation of the results obtained by applying the framework to three thesaurus tools.
Human Papillomavirus Vaccine Predictors Among U.S. Adults Aged 18 to 45 by Sexual Orientation
Authors: Kang JaHyun , Kim Kyounghae
Published: March 2019

Despite increased incidence rates of human papillomavirus (HPV)-associated cancers among sexual minorities, their HPV vaccine uptake remains suboptimal. This cross-sectional, correlational study aimed to investigate factors associated with HPV vaccination among a nationally representative sample of U.S. young adults by sexual orientation. We used the 2014 to 2017 Behavioral Risk Factor Surveillance System data for adults aged 18 to 45 years. HPV vaccination initiation was associated with being female and Hispanic, having higher educational attainment, and having ever been tested for HIV, whereas completion was associated with being female and non-Hispanic White and having higher educational attainment. Compared with those who reported identifying as straight, the lesbian or gay respondents were found to have been less likely not to complete the series. Providers should play a crucial part in addressing missed opportunities for HPV vaccination by implementing culturally competent communication strategies to empower sexual minorities to make informed HPV vaccine decisions.
Cross-Sectional Study on Patient Safety Culture, Patient Safety Competency, and Adverse Events
Authors: Han Yonghee , Kim Ji-Su , Seo YeJi
Published: March 2019

This study aims to examine the associations between nurses’ perceptions of patient safety culture, patient safety competency, and adverse events. Using convenience sampling, we conducted a cross-sectional study from February to May 2018 in two university hospitals. Furthermore, we performed multiple logistic regression to examine associations between patient safety culture, patient safety competency, and adverse events. Higher mean scores for “communication openness” in patient safety culture were significantly correlated with lower rates for pressure ulcers and falls; furthermore, higher mean scores for “working in teams with other health professionals” in patient safety competency were significantly correlated with reductions in ventilator-associated pneumonia. We recommend that a well-structured hospital culture emphasizing patient safety and continuation of in-service education programs for nurses to provide high-quality, clinically safe care is required. Moreover, further research is required to identify interventions to improve patient safety culture and competency and reduce the occurrence of adverse events.
Health-related quality of life and related factors among older adults with visual impairments
Authors: Siira Heidi J , Falck Aura AK , Kyngäs Helvi A
Published: March 2019

Aim was to explore the health-related quality of life (HRQoL) and related factors among older adults with visual impairment (VI). A total of 39 independently living subjects aged ⩾65 years (83 ± 6.5), referred to the Low Vision Center of the Oulu University Hospital, Finland during one year participated in the study. The participants had low vision or blindness as defined by the World Health Organization (WHO). The 15D, a generic HRQoL instrument, was used to assess the HRQoL, and an ophthalmic examination was performed to assess vision. A population-based control group ( n = 1074) was available for comparison. The mean 15D index scores for the participants and the control group were 0.768 ( SD = 0.089) and 0.827 ( SD = 0.044), respectively, ( p < .002). In the dimensions of move ( p < .05), see ( p < .001), breath ( p < .05), usual activities ( p < .001), depression ( p < .05), and distress ( p < .05), the study participants scored statistically significantly lower than the control group. However, the participants had better mental function scores (0.856 vs 0.773, p < .05). Among the participants, there was no difference in the 15D by gender (men 0.755, women 0.774, p > .05), habitation (alone 0.768, with someone 0.770, p > .05), or age ( r = –.084), nor did the extent of low vision appear to affect the 15D index in this material. The older adults with VI had poorer 15D index score than Finnish population of equal age, but they scored better in the dimension of mental function. Mental skills may indeed be crucial for independent living despite VI.
Air removal capacity of two different minimal invasive ECC systems: an in vitro comparison
Authors: Stehouwer Marco C , de Vroege Roel
Published: March 2019

Minimally invasive extracorporeal circulation systems are developed to decrease the deleterious effects of cardiopulmonary bypass. For instance, prime volume and foreign surface area are decreased in these systems. However, because of the lack of a venous reservoir in minimized systems, air handling properties of these minimally invasive extracorporeal circulation systems may be decreased as compared to conventional cardiopulmonary bypass systems. The aim of this in vitro study is to compare the air handling properties of two complete minimized cardiopulmonary bypass systems of two manufacturers, of which one system is provided with the air purge control. In an in vitro study, two minimally invasive extracorporeal circulation systems, Inspire Min.I manufactured by Sorin Group Italia, Mirandola, Italy (LivaNova, London, United Kingdom) and minimized extracorporeal circulation manufactured by Maquet, Rastatt, Germany (Getinge, Germany), were challenged with two types of air challenges; a bolus air challenge and a gaseous microemboli challenge. The air removal characteristics of the venous bubble traps and of the complete minimally invasive extracorporeal circulation systems were assessed by measuring the gaseous microemboli volume and number downstream of the venous bubble traps in the arterial line with a bubble counter. No significant differences were observed in air reduction between the venous bubble traps of Getinge (venous bubble traps) and LivaNova (Inspire venous bubble traps 8 in conjunction with the air purge control). Similarly, no significant differences were observed in volume and number of gaseous microemboli in the arterial line of both complete minimally invasive extracorporeal circulation systems. However, the gaseous microemboli load of the Inspire Min.I system was marginally lower after both the bolus air and the gaseous microemboli challenges. Both minimally invasive extracorporeal circulation systems assessed in this study, the LivaNova Inspire Min.I and the Getinge minimized extracorporeal circulation, showed comparable air removal properties, after both bolus and gaseous microemboli air challenges. Besides, air purge control automatic air removal system provided with the LivaNova Inspire Min.I. system may enhance patient’s safety with the use of a minimally invasive extracorporeal circulation system. We consider both systems equally safe for clinical use.
The experience of family caregivers of patients with cancer in an Asian country: A grounded theory approach
Authors: Kristanti Martina Sinta , Effendy Christantie , Utarini Adi , Vernooij-Dassen Myrra , Engels Yvonne
Published: March 2019

Background:

Strong family bonds are part of the Indonesian culture. Family members of patients with cancer are intensively involved in caring, also in hospitals. This is considered “normal”: a societal and religious obligation. The values underpinning this might influence families’ perception of it.

Aim:

To explore and model experiences of family caregivers of patients with cancer in Indonesia in performing caregiving tasks.

Design:

A grounded theory approach was applied. The constant comparative method was used for data analysis and a paradigm scheme was employed for developing a theoretical model.

Setting/participants:

The study was conducted in three hospitals in Indonesia. The participants were family caregivers of patients with cancer.

Results:

A total of 24 family caregivers participated. “Belief in caregiving” appeared to be the core phenomenon. This reflects the caregivers’ conviction that providing care is an important value, which becomes the will power and source of their strength. It is a combination of spiritual and religious, value and motivation to care, and is influenced by contextual factors. It influences actions: coping mechanisms, sharing tasks, and making sacrifices. Social support influences the process of the core phenomenon and the actions of the caregivers. Both positive and negative experiences were identified.

Conclusion:

We developed a model of family caregivers’ experiences from a country where caregiving is deeply rooted in religion and culture. The model might also be useful in other cultural contexts. Our model shows that the spiritual domain, not only for the patient but also for the family caregivers, should be structurally addressed by professional caregivers.
The trajectory of functional decline over the last 4 months of life in a palliative care population: A prospective, consecutive cohort study
Authors: Morgan Deidre D , Tieman Jennifer J , Allingham Samuel F , Ekström Magnus P , Connolly Alanna , Currow David C
Published: March 2019

Background:

Understanding current patterns of functional decline will inform patient care and has health service and resource implications.

Aim:

This prospective consecutive cohort study aims to map the shape of functional decline trajectories at the end of life by diagnosis.

Design:

Changes in functional status were measured using the Australia-modified Karnofsky Performance Status Scale. Segmented regression was used to identify time points prior to death associated with significant changes in the slope of functional decline for each diagnostic cohort. Sensitivity analyses explored the impact of severe symptoms and late referrals, age and sex.

Setting/participants:

In all, 115 specialist palliative care services submit prospectively collected patient data to the national Palliative Care Outcomes Collaboration across Australia. Data on 55,954 patients who died in the care of these services between 1 January 2013 and 31 December 2015 were included.

Results:

Two simplified functional decline trajectories were identified in the last 4 months of life. Trajectory 1 has an almost uniform slow decline until the last 14 days of life when function declines more rapidly. Trajectory 2 has a flatter more stable trajectory with greater functional impairment at 120 days before death, followed by a more rapid decline in the last 2 weeks of life. The most rapid rate of decline occurs in the last 2 weeks of life for all cohorts.

Conclusions:

Two simplified trajectories of functional decline in the last 4 months of life were identified for five patient cohorts. Both trajectories present opportunities to plan for responsive healthcare that will support patients and families.
Appropriate frameworks for economic evaluation of end of life care: A qualitative investigation with stakeholders
Authors: Kinghorn Philip , Coast Joanna
Published: March 2019

Background:

The use of quality-adjusted life years rests on the assertion that the objective of the health care system is to improve health.

Aim:

To elicit the views of expert stakeholders on the purpose and evaluation of supportive end of life care, and explore how different purposes of end of life care imply the need for different evaluative frameworks.

Design:

Semi-structured qualitative interviews, analysed through an economic lens using a constant comparative approach.

Participants:

Twenty professionals working in or visiting the United Kingdom or Republic of Ireland, with clinical experience and/or working as academics in health-related disciplines.

Results:

Four purposes of end of life care were identified from and are critiqued with the aid of the qualitative data: to improve health, to enable patients to die in their preferred place, to enable the patient to experience a good death, and to enable the patient to experience a good death, and those who are close to the patient to have an experience which is as free as possible from fear, stress and distress.

Conclusion:

Managing symptoms and reducing anxiety were considered to be core objectives of end of life care and fit with the wider health service objective of improving/maximising health. A single objective across the entire health system ensures consistency in the way that resource allocation is informed across that entire system. However, the purpose of care at the end of life is more complex, encompassing diverse and patient-centred objectives which we have interpreted as enabling the patient to experience a good death.
Migraine classification using somatosensory evoked potentials
Authors: Zhu Bingzhao , Coppola Gianluca , Shoaran Mahsa
Published: March 2019

Objective

The automatic detection of migraine states using electrophysiological recordings may play a key role in migraine diagnosis and early treatment. Migraineurs are characterized by a deficit of habituation in cortical information processing, causing abnormal changes of somatosensory evoked potentials. Here, we propose a machine learning approach to utilize somatosensory evoked potential-based biomarkers for migraine classification in a noninvasive setting.

Methods

Forty-two migraine patients, including 29 interictal and 13 ictal, were recruited and compared with 15 healthy volunteers of similar age and gender distribution. The right median nerve somatosensory evoked potentials were collected from all subjects. State-of-the-art machine learning algorithms including random forest, extreme gradient-boosting trees, support vector machines, K-nearest neighbors, multilayer perceptron, linear discriminant analysis, and logistic regression were used for classification and were built upon somatosensory evoked potential features in time and frequency domains. A feature selection method was employed to assess the contribution of features and compare it with previous clinical findings, and to build an optimal feature set by removing redundant features.

Results

Using a set of relevant features and different machine learning models, accuracies ranging from 51.2% to 72.4% were achieved for the healthy volunteers-ictal-interictal classification task. Following model and feature selection, we successfully separated the three groups of subjects with an accuracy of 89.7% for the healthy volunteers-ictal, 88.7% for healthy volunteers-interictal, 80.2% for ictal-interictal, and 73.3% for healthy volunteers-ictal-interictal classification tasks, respectively.

Conclusion

Our proposed model suggests the potential use of somatosensory evoked potentials as a prominent and reliable signal in migraine classification. This non-invasive somatosensory evoked potential-based classification system offers the potential to reliably separate migraine patients in ictal and interictal states from healthy controls.
A Data-Driven Fault Diagnosis Method for Railway Turnouts
Authors: Ou Dongxiu , Xue Rui , Cui Ke
Published: March 2019

Turnout systems on railways are crucial for safety protection and improvements in efficiency. The statistics show that the most common faults in railway system are turnout system faults. Therefore, many railway systems have adopted the microcomputer monitoring system (MMS) to monitor their health and performance in real time. However, in practice, existing turnout fault diagnosis methods depend largely on human experience. In this paper, we propose a data-driven fault diagnosis method that monitors data from point machines collected using MMS. First, based on a derivative method, data features are extracted by segmenting the original sample. Then, we apply two methods for feature reduction: principal component analysis (PCA) and linear discriminant analysis (LDA). The results show that LDA gave a better performance in the cases studied. A problem that cannot be overlooked is that the imbalanced quantity of rare fault samples and abundant normal samples will reduce the accuracy of classic fault diagnosis models. To deal with this problem of imbalanced data, we propose a modified support vector machine (SVM) method. Finally, an experiment using real data collected from the Guangzhou Railway Line is presented, which demonstrates that our method is reliable and feasible in fault diagnosis. It can further assist engineers to perform timely repairs and maintenance work in the future.
Children’s Independent Trips on Weekdays and Weekends: Case Study of Québec City
Authors: Cervesato Adrien , Waygood E. Owen D.
Published: March 2019

Children’s independent mobility (CIM) on school days (weekdays) and on the weekend are examined in this study. Previous studies have focused primarily on weekday trips, with a vast majority only examining trips to school. However, the types of trips and the available time differ between weekdays and weekends. Weekday trips are more regular and possibly more local, whereas on the weekend the children may have more free time (i.e., no school) to engage in activities. Parents (as a group) are also less likely to have work obligations, and thus potentially more time, on the weekend. Theoretically, each context for the weekend could facilitate more independent or active mode trips. Nonetheless, this may be linked to whether destinations are local, which is linked to the built environment. Using origin–destination data (2011) for the City of Québec, this paper will expand knowledge in the field of children’s travel by examining all trips during a weekday ( n = 979) and weekend ( n = 315) for children aged 9 to 11 across five built environment types. The findings show that weekend trips are rarely independent, and that the key explanatory factors for greater CIM are shorter distances, having an older sibling, and more urban environments. Other sociodemographic variables were not significant or were inconsistent between the two types of weekday.
Emergence of university-centred entrepreneurial ecosystems in the Caribbean
Authors: Allahar Haven , Sookram Ron
Published: March 2019

This study examines the progress of the two major universities in the Caribbean country of Trinidad and Tobago towards the transition to entrepreneurial universities through incorporating the core components of designing and delivering entrepreneurship education programmes, establishing effective university-led business incubators and the building of university–industry–government collaboration. The theoretical construct of the Triple Helix interrelationships and the development stages framework provide the basis for analysing the progress of the universities towards achieving their development mission. The general conclusion is that progress towards building an effective university-centred entrepreneurial ecosystem has been relatively slow and needs to be accelerated through more proactive leadership and greater involvement of internal and external stakeholders.
Lugones’s Metaphor of “World Travelling” in Narrative Inquiry
Authors: Dewart Georgia , Kubota Hiroko , Berendonk Charlotte , Clandinin Jean , Caine Vera
Published: March 2019

The metaphor of “world traveling” has been taken up by researchers engaged in narrative inquiry. This metaphor provides a reference point throughout the research process for navigating relational processes. In this article, we unpack how the metaphor of “world travelling” shapes the writing of research texts in narrative inquiry and the meaning making inherent in shared texts. We draw on a narrative inquiry focused on the experiences of men who are homeless in Japan, as well as a narrative inquiry focused on precariously housed women who are pregnant or engaged with early parenting and who use illicit substances. As we work with Lugones’s ideas, we see it is critical to engage in a collaborative process that is marked by a playful exchange of ideas and that pushes us to identify connections with others. At the same time, we work to create meaning; we need to challenge racial, social, political, and economic boundaries and social differences in ways that allow researchers and participants to locate themselves in relation to others. Engaging in this manner shows openness to multiple ways of sense making and to creating texts where expectations are broken. Representation requires the development of texts where we can “exercise double vision” and “create and cement relational identities.” These spaces of openness and multiplicity are always in motion and are marked by a sense of “dwelling,” “world travelling,” and “playfulness.”
Infra-anastomotic Innervation of Residual Aganglionic Distal Rectum After Pull-through Surgery for Hirschsprung Disease
Authors: Kapur Raj P , Arnold Michael A , Conces Miriam R
Published: March 2019

Background

Descending neurons are important for intestinal reflex activities, including the recto-anal inhibitory reflex involved in normal defecation. Pull-through surgery for Hirschsprung disease results in the anastomosis of ganglionic bowel to native aganglionic rectum just superior to the internal anal sphincter, which potentially could allow for physiologically significant infra-anastomotic innervation.

Methods

The density and distribution of intramuscular neuronal nitric oxide synthase (nNOS)- and mucosal calretinin-immunoreactive nerves were evaluated proximal and distal to the anastomosis in redo resection specimens after pull-through surgery for Hirschsprung disease. The findings were compared with data collected from cadaveric controls with no history of dysmotility and the distal aganglionic segments of primary rectal resections from patients with Hirschsprung disease.

Results

Native aganglionic rectum of Hirschsprung patients lacks the normal lush intramuscular nNOS- and mucosal calretinin-immunoreactive nerves present in normal bowel. In post-pull-through resection specimens obtained more than 7 months after pull-through surgery, nNOS- and calretinin-positive innervation is at least partially restored for variable distances up to 10 to 12 mm inferior to the anastomosis, respectively.

Conclusions

Innervation of infra-anastomotic muscularis propria and mucosa in the aganglionic distal rectum occurs to a variable degree after pull-through surgery for Hirschsprung disease and may contribute to individual differences in postoperative obstructive symptoms. Strategies to enhance infra-anastomotic innervation may improve clinical outcome.