bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of participation in multiple school-based health promotion programmes on students’ health
Authors: Kang EunKyo , Yun Young Ho
Published: December 2019

Objective:

The objective of this study was to investigate the impact of experiencing diverse, multi-dimensional health promotion programmes in school on students’ self-reported health status.

Design:

Cross-sectional design.

Methods:

We surveyed 2,568 students from 15 middle schools and 15 high schools in Korea between August 2014 and January 2015. Self-reported information related to health status, attendance at physical, social, mental or spiritual health promotion programmes, and socio-demographics was collected and analysed.

Results:

Male students, students aged 15 and below, and students living in rural areas were more satisfied with their health status. Regardless of programme type, the number of health promotion programmes attended correlated positively with better overall health status ( p < .001–.032). Attending physical health promotion programmes was significantly associated with physical, mental, spiritual and overall health (adjusted odds ratio [aOR] = 1.28–1.40). Attending mental health programmes was significantly related to all aspects of health status (aOR = 1.49–2.17), and participating in social health programmes was significantly related to all aspects of health status except physical and social health (aOR = 1.36–1.67). Participation in spiritual health programmes was related to spiritual and overall health (aOR = 1.33, 1.58). In hierarchical regression analyses, health promotion programme attendance was independently associated with subjective health status after controlling for differences between schools.

Conclusion:

Participation in health promotion programmes was found to be related not only to the targeted health status but also to other aspects of subjective health.
Distribution of Health Care Resources in Austria – Inequality Assessment of Different Health Care Resources at Different Points in Time
Authors: Sommersguter-Reichmann Margit , Reichmann Gerhard
Published: December 2019

A major objective of health policy in many countries is to avoid inequality in the distribution of health care resources. Our goal is to provide initial insight into the inequality in the regional distribution of different health care resources per capita and the variation of the inequality over time in Austria to provide starting points for policy recommendations and international comparisons. We also aim to examine whether the type of inequality measure and need-adjustment has an impact on the results. The findings reveal that inequality in the distribution of GPs with contracts with social health insurance is comparably small, but we observe an increase in inequality from 2002 to 2014. In general, there is a clear trend toward private physicians, of whom private specialists preferably open their practices in densely populated areas. Despite considerable reductions in public hospital beds between 2002 and 2014, the distribution across regions remains almost constant. The use of different inequality measures and need-adjustment provides additional insights so that custom-made policies to reduce inequalities can be developed.
Research on texture image inpainting of jacquard fabric based on non-single vision
Authors: Wang Wenzhen , Deng Na , Xin Binjie , Kan Chi-wai , Wang Yiliang , Lu Shuaigang
Published: December 2019

For the texture image inpainting of jacquard fabric with a large damaged region but complete data information around it, traditional exemplar-based image inpainting algorithms are not only have rapid falling traditional confidence value, but also the matching precision is greatly limited due to the lack of robustness, which results in a wrong guided direction and an unsatisfactory inpainting effect. To solve the above-mentioned problems, a novel digital image acquisition system for damaged fabric was designed and one set of texture image inpainting algorithms of jacquard fabric based on non-single vision was developed. In this image inpainting method, the images to be inpainted and target images were obtained through the non-single-vision imaging method. By using the image registration and Poisson image blending technology, the damaged region was filled by block matching first and then patches from the target image to the data missing region were copied. The experimental results clearly showed that the proposed method achieves better results in visual appearance and inpainting quality, compared with traditional approaches for inpainting. In addition, this method shows broad potential application prospects in the virtual restoration of ancient fabrics using image inpainting technology.
Availability, Price, and Affordability of Essential Medicines to Manage Noncommunicable Diseases: A National Survey From Nepal
Authors: Khanal Saval , Veerman Lennert , Ewen Margaret , Nissen Lisa , Hollingworth Samantha
Published: December 2019

The aim of this study was to evaluate the availability, price, and affordability of essential noncommunicable disease (NCD) medicines in Nepal. A cross-sectional survey was conducted in Nepal in 2015 using World Health Organization/Health Action International (WHO/HAI) methodology. We collected data on the availability and price of 60 essential NCD medicines from medicine distribution outlets in both the public and private health care sectors in 6 regions. Essential NCD medicines were more available in the private sector (78%) than the public sector (60%). Furosemide tablets were the cheapest (NPR 0.6/10 tablets) and streptokinase injections were the most expensive (NPR 2200/vial) drugs. There was no significant difference ( P > .05) in availability and affordability of essential NCD medicines across the 6 survey areas. Treating selected NCD conditions with medicines was generally affordable, with 1 month of treatment costing no more than a day’s wage of the lowest paid unskilled government worker. The lower availability of NCD medicines in the public sector limits the effectiveness of the government’s policy of providing free health services at public facilities. Although NCD medicines were generally affordable, future health policy should aim to ensure improved equitable access to NCD medicines, particularly in public facilities.
Medicaid Capitation Payments by State
Authors: Hsia David C.
Published: December 2019

Congress has repeatedly proposed changing Medicaid from an entitlement to a block grant. Each state would receive a fixed amount instead of a Federal payment influenced by state decisions on eligibility, coverage, and pricing. This paper uses existing data series to simulate redistributing the annual $353 billion Federal payment among Medicaid’s 56 state (and territorial) programs.

Capitation by general population would shift $52 billion, mainly from large Northeastern and West Coast states to large Southern and Mountain states. Capitation by population below the Federal Poverty Line (FPL) would shift $60 billion in a similar pattern. Policymakers should understand likely state-to-state effects when considering Medicaid legislation. States could then prepare for possible changes in their Federal payment for Medicaid.
The crude ostracism detection system: Pupils react to minimal cues of exclusion
Authors: Hwang Hyesung G. , Suh Jihyun , Balbona Jared , Sodhi Shreya , Markson Lori
Published: December 2019

When people are rejected by others, they typically feel an immediate sense of pain—referred to as social pain. Social pain is hypothesized to be the alarm response of a “quick and crude” ostracism detection system, a system that is highly sensitive to even minimal signs of exclusion. Physiological reactivity has been found to accompany this social pain, but it is unclear whether the physiological mechanism underlying the ostracism detection system is also “quick and crude.” To test whether physiological reactivity to exclusion is “quick and crude,” the present study investigated whether pupil dilation (an index of physiological reactivity) differs when detecting exclusion from human entities versus nonhuman entities and when experiencing versus witnessing exclusion using a Cyberball paradigm. Experiment 1 showed that pupil size decreased less when viewing players who were exclusive than those who were inclusive, regardless of whether the players were human (i.e., undergraduate students) or nonhuman (i.e., computerized) entities. The same pupil reactivity pattern was observed in Experiment 2 after participants watched interactions in which another person was included or excluded by human or nonhuman entities. In Experiment 3, participating in real-life interactions with human players did not cause pupil reactivity to be greater to human players compared to nonhuman players, but pupil size again decreased less when viewing exclusive players compared to inclusive players. Across all three experiments, pupil size decreased less when viewing players who were exclusive than inclusive regardless of the social identity of the players. These findings support the idea of a highly sensitive, “quick and crude” physiological mechanism that underlies the ostracism detection system.
Clinical features and their effect on outcomes of patients with triple negative breast cancer with or without lymph node involvement
Authors: Sobočan Monika , Turk Maja , Čater Pija , Sikošek Nina Čas , Crnobrnja Bojana , Takač Iztok , Arko Darja
Published: December 2019

Objective

Clinical and pathological characteristics of triple negative breast cancer (TNBC) treatment are required for escalation or de-escalation of treatment because of a lack of druggable targets. This study aimed to identify the factors affecting the risk of disease recurrence and disease-related death in patients with TNBC.

Methods

Patients with TNBC who were treated at the University Medical Centre Maribor between January 2010 and December 2017 were studied. Clinical and pathological data were analyzed using multivariate analysis and non-parametric tests. Subgroup analysis was performed to examine additional factors that affect 5-year overall survival (OS) and recurrence-free survival.

Results

Multivariate analysis showed that tumor size and the lymph node ratio (LNR) were significant risks in our population. Better discrimination of patients at risk of a shorter recurrence-free survival and OS was achieved by using the LNR. Only lymphovascular invasion was significant for predicting 5-year OS.

Conclusion

For risk-based decision-making systems, the LNR is useful for discriminating between high- and low-risk patients with TNBC.
Identification of differentially expressed genes between the colon and ileum of patients with inflammatory bowel disease by gene co-expression analysis
Authors: Zhang Yuting , Shen Bo , Zhuge Liya , Xie Yong
Published: December 2019

Objective

We aimed to identify differentially expressed genes (DEG) in patients with inflammatory bowel disease (IBD).

Methods

RNA-seq data were obtained from the Array Express database. DEG were identified using the edgeR package. A co-expression network was constructed and key modules with the highest correlation with IBD inflammatory sites were identified for analysis. The Cytoscape MCODE plugin was used to identify key sub-modules of the protein–protein interaction (PPI) network. The genes in the sub-modules were considered hub genes, and functional enrichment analysis was performed. Furthermore, we constructed a drug–gene interaction network. Finally, we visualized the hub gene expression pattern between the colon and ileum of IBD using the ggpubr package and analyzed it using the Wilcoxon test.

Results

DEG were identified between the colon and ileum of IBD patients. Based on the co-expression network, the green module had the highest correlation with IBD inflammatory sites. In total, 379 DEG in the green module were identified for the PPI network. Nineteen hub genes were differentially expressed between the colon and ileum. The drug–gene network identified these hub genes as potential drug targets.

Conclusion

Nineteen DEG were identified between the colon and ileum of IBD patients.
When carers end foster placements: exploring foster carers’ experience of adolescent foster placement breakdown
Authors: Valentine Daniella , MacCallum Fiona , Knibbs Jacky
Published: December 2019

While foster carers experience the rewards and challenges of parenting vulnerable and complex adolescents, some of these placements break down. Compared to research into the impact of placement breakdown on looked after children, there are relatively limited reports on how foster carers are affected. The aim of the present study was to provide an exploratory account of foster carers’ lived experience of ending adolescent foster placements. Nine participants from seven foster families in the UK were recruited. Semi-structured interviews were conducted and analysed within an Interpretative Phenomenological Analysis (IPA) framework. Exploration of the foster carers’ experience identified four superordinate themes, two of which are relevant here: ‘emotional aftermath’ and ‘we’re only human’. Following a placement ending, foster carers identified different emotions including joy, relief and sadness. A grieving process was also identified, which involved coming to terms with loss and accepting the termination of the relationship. It is further suggested that foster carers are likely to experience shame and guilt as a consequence of placement breakdown.
Is Nurturing Attachments training effective in improving self-efficacy in foster carers and reducing manifestations of Reactive Attachment Disorder in looked after children?
Authors: Gibbons Naomi , Bacon Alison M , Lloyd Lisa
Published: December 2019

Looked after children have frequently experienced complex developmental trauma manifesting as behavioural, cognitive and emotional challenges and difficulties in forming secure relational attachments to caregivers. Nurturing Attachments training was developed specifically to support carers who are parenting such children. The present study reports on a mixed-methods evaluation of this programme, focusing particularly on its impact on carer self-efficacy and behavioural manifestations of Reactive Attachment Disorder (RAD) which are common among looked after children, even if they are not formally diagnosed. Ten foster carers completed measures of self-efficacy and RAD before and after the training. A significant increase in carer self-efficacy was found but there was no overall change in levels of children's RAD-related behaviour. Semi-structured interviews were undertaken to explore the reasons for this. They revealed three key themes: reflection on then and now; knowledge and understanding; and contact with birth parents. These demonstrated how, after training, foster carers were able to reflect on changes in their own behaviours and draw on new knowledge and understanding. However, contact with biological parents remained challenging and some children seemed to show increased RAD-type behaviours associated with this. Results are discussed in terms of implications for training foster carers.
Exploring the Consequences of Major Lifetime Discrimination, Neighborhood Conditions, Chronic Work, and Everyday Discrimination on Health and Retirement
Authors: Gonzales Ernest , Lee Yeonjung Jane , Marchiondo Lisa A.
Published: December 2019

This study examines the associations of multiple forms of perceived discrimination and negative neighborhood conditions with mental health and retirement age. Respondents aged above 51 years from the Health and Retirement Study were selected in 2006 and surveyed through 2014. Ordinary least squares regression evaluated associations. Bias-corrected bootstrap resampling method tested whether mental health mediated the relationships between disadvantages and retirement age. Major lifetime and work discrimination, as well as neighborhood conditions, were directly associated with earlier retirement. Individuals who did not experience disadvantages retired at age 65, whereas respondents with the highest levels of disadvantage retired earlier (at age 62). Mental health partially mediated relationships between major lifetime discrimination, neighborhood conditions, and work discrimination with retirement age, whereas mental health fully mediated the relationship between everyday discrimination and retirement age. Efforts to promote civil rights, reduce discrimination, and enhance individual resilience may promote mental health and capacity to work longer.
“It’s Sexual Assault. It’s Barbaric”: Strip Searching in Women’s Prisons as State-Inflicted Sexual Assault
Authors: Hutchison Jessica
Published: December 2019

Rationale:

In the era of the #MeToo movement, sexual assault has emerged from the shadows to become a dominant topic of public and scholarly conversation. Yet women in prison have largely been left out of these conversations, particularly as it relates to their experiences of being strip searched.

Method:

Five cisgender women were interviewed about their experiences being strip searched while imprisoned in Canada.

Findings:

Findings demonstrate that strip searching is a form of sexual assault. Women were unable to say “no” to being strip searched due to power imbalances and fear of serious consequences. Experiences of prior sexual victimization made being strip searched particularly harmful.

Discussion:

This study shows that structural violence occurring behind prison walls is a replication of structural violence occurring in the community. That strip-searching policies and practices are developed and implemented by the state necessarily means it is state-inflicted sexual assault. I theorize that strip searching is not understood as sexual assault because imprisoned women are relegated to a class of subhumanness for which humane treatment is not required.

Implications:

Implications for reducing the harms of strip searching are discussed, aimed at moving toward the abolishment of strip searching as a practice in women’s prisons.
Remapping Pipelines and Pathways: Listening to Queer and Transgender Youth of Color’s Trajectories Through Girls’ Juvenile Justice Facilities
Authors: Mountz Sarah
Published: December 2019

Queer and trans youth of color are disproportionately imprisoned in U.S. juvenile detention facilities where they are especially vulnerable to experiencing violence, isolation, neglect, and discrimination. While the figures of their overrepresentation are just emerging, regulation of youth sexuality and gender norms has been embedded in the logics of the juvenile court since its inception. Pathways and pipelines to incarceration have become popular metaphors in research and advocacy to explain how failed safety nets and multiple sites of punishment produce gendered and racialized patterns of criminalization; however, the overrepresentation of queer and trans youth of color has been virtually ignored within these conceptualizations. This article builds on a queer antiprison framework in examining the experiences of formerly incarcerated queer and trans youth of color in New York. Life history interviews were conducted as part of a larger community based participatory research (CBPR) project with 10 participants, ages 18–25. Findings expose the overlapping role of families of origin, foster and adoptive families, schools, and child welfare and juvenile justice systems, in a constellation of exposures to interpersonal and state violence. An alternative metaphor of a revolving door is proposed, and implications for social work are addressed.
Transformative Praxis With Incarcerated Women: Collaboration, Leadership, and Voice
Authors: Pollack Shoshana
Published: December 2019

The ever-widening net of racialized and colonial carceral spaces and neoliberal strategies of control of poor and marginalized communities means that social workers are often in positions of complicity with or resistance to (or both) the norms and practices of the carceral state. Feminist praxis can both challenge and inadvertently sustain the prison industrial complex and its harms. Approaches that even tacitly accept some of the basic premises and discourses of correctional frameworks risk being co-opted and transmuted into racialized and colonial control practices. In this article, I use the example of Walls to Bridges Canada, a social justice iteration of the U.S.-based Inside-Out Prison Exchange Program, to illustrate the power and significance of feminist praxis that privileges the epistemic vantage point of those who are incarcerated. This article will examine how collaborative work with criminalized and incarcerated women (in classrooms, research studies, and community work) moves beyond “giving voice,” to promoting leadership by those with lived experience and shared collaborative knowledge production.
Development and Validation of the Romantic Love Myths Questionnaire
Authors: Lara Laura , Gómez-Urrutia Verónica
Published: December 2019

The purpose of this study was to develop and validate an instrument to measure love myths among Chilean youth. Items created based on review of available literature were refined through experts’ revisions and participant focus groups. The initial questionnaire was applied to 1,538 high school and university students, aged between 14 and 24 years old. Exploratory factor analysis performed with half of the sample led to a 10-item questionnaire, grouped in two factors: idealization and love–abuse. Confirmatory factor analyses conducted with the other half of the sample corroborated this factorial structure. Reliability analyses indicated an adequate internal consistency, and correlations with dating violence and quality of relationship provide evidence on its concurrent validity. Complementary, results showed that females endorse more idealization and males love–abuse, and adolescents scored higher in both dimensions than emerging adults.
Did Connecticut’s “Raise the Age” Increase Motor Vehicle Thefts?
Authors: Circo Giovanni , Scranton Alexander
Published: December 2019

In 2010, Connecticut followed the pattern of most other U.S. states by raising the age of juvenile jurisdiction from 15 to 16. This was further raised from 16 to 17 years, 2 years later in July 2012. This sweeping change meant youth were no longer automatically prosecuted as adults in the criminal justice system. Following the change, crimes in Connecticut steadily decreased in line with nationwide trends—However, a subsequent increase in motor vehicle thefts prompted concern among critics of the “raise the age” (RTA) legislation. This study examines the change in Uniform Crime Reports (UCR) county-level index crimes before and after Connecticut changed the maximum age of juvenile jurisdiction from 16 to 17 in 2012, focusing specifically on motor vehicle thefts. Using a weighted difference-in-differences design, we estimate that RTA played a minimal role on the increase in Connecticut auto thefts between 2012 and 2017.
Comparison of demand limiting and load leveling operating modes of ice cold energy storage (ICES) in an air-conditioning system
Authors: Sanaye Sepehr , Hekmatian Mohammad
Published: December 2019

Application of ice cold energy storage (ICES) is for reducing power consumption in air-conditioning systems. ICES systems have two full and partial operating modes. Partial operating mode of ICES system is modeled here at two demand limiting (POM-DL) and load leveling (POM-LL) conditions. After energy, exergy, and economic and environmental modeling/analysis of POM-DL and POM-LL, multi-objective (exergy and total cost) genetic algorithm (GA) optimization technique is applied to find the optimum values of objective functions and system design parameters. Then, the performance of POM-DL and POM-LL systems is compared. For our case study, the acquired results show 11.20% and 10.94% reduction in electricity consumption for POM-DL and POM-LL systems, respectively, in comparison with that for a traditional VCR (an electrical chiller). Furthermore, these systems reduce 13.58% and 12.36% electricity cost by shifting the electricity consumption of cooling system from on peak (ONP) hours to off peak (OFP) hours for POM-DL and POM-LL, respectively.
Guidance and control for own aircraft in the autonomous air combat: A historical review and future prospects
Authors: Dong Yiqun , Ai Jianliang , Liu Jiquan
Published: December 2019

The Autonomous Air Combat technique has been a lasting research topic for decades. However, no complete solutions seem to have appeared because of the highly dynamic and complex nature of the Autonomous Air Combat problem. In devising the Autonomous Air Combat solutions, we follow similar methodologies in the robotics community, and divide the overall scheme into two folds: the perception of other (enemy/friendly) aircraft, and the guidance/control for own aircraft. While the perception in the first fold serves as a foundation, this paper is mainly focused on the second one. Based on our survey, a review of own aircraft guidance/control in the (primarily one-to-one) Autonomous Air Combat solutions is presented. We divide different Autonomous Air Combat solutions into three groups, i.e. mathematics-based, knowledge-encoded, and learning-driven. In each group, we present the representative methods first; problem definition, solution, and a brief overview of the historical development are illustrated. We also comment on both weakness and strengths for each group/method. We point out certain technical paths/challenges that need to be addressed in the future Autonomous Air Combat development, i.e. to abstract and emulate the human pilot experiences, and to develop the online learning capabilites. Inspired by the state-of-art techniques in other similar fields (robotics, autonomous driving), we also propose potential solutions, i.e. traditional approaches enhanced by the novel data-driven technique. Via this paper, we hope to deliver an in-depth analysis of past experiences and potential challenges/solutions for the Autonomous Air Combat technique. We also advocate referring to the approaches/techniques that are utilized in other similar fields in devising the Autonomous Air Combat solutions.
Design and analysis of an integrated device for launch adapter and resettable orbital deployer for picosatellites
Authors: Wang Wenlong , Zhang Xiaotian , Hao Daqian , Gong Wenfei
Published: December 2019

The design, analysis, and test of the integrated device for the launch adapter and the resettable orbital deployer are presented in this paper. This integrated device contains both functions of the single-use launch adapter and the resettable orbital deployer. Two types of release mechanisms are combined. The four-bar linkage mechanism is applied in the single-use adapter function. This release mechanism provides sufficient strength of connection in the launch stage and is released when entering the orbit. The electromagnetic hook mechanism is applied in the resettable orbital deployer. The deployer can be reloaded by the manipulator on the mother satellite with picosatellites taken out from the cargo to deploy multiple times. Dynamics simulation, finite element simulation, as well as the prototype test verify the preliminary feasibility of this design.
Screening Hub Genes as Prognostic Biomarkers of Hepatocellular Carcinoma by Bioinformatics Analysis
Authors: Zhou Zengyuan , Li Yuzheng , Hao Haiyue , Wang Yuanyuan , Zhou Zihao , Wang Zhipeng , Chu Xia
Published: December 2019

Hepatocellular carcinoma (HCC) is a widespread, common type of cancer in Asian countries, and the need for biomarker-matched molecularly targeted therapy for HCC has been increasingly recognized. However, the effective treatment for HCC is unclear. Therefore, identifying additional hub genes and pathways as novel prognostic biomarkers for HCC is necessary. In this study, the expression profiles of GSE121248, GSE45267 and GSE84402 were obtained from the Gene Expression Omnibus (GEO), including 132 HCC and 90 noncancerous liver tissues. Differentially expressed genes (DEGs) between HCC and noncancerous samples were identified by GEO2 R and Venn diagrams. In total, 109 DEGs were identified in these datasets, including 24 upregulated genes and 85 downregulated genes. Subsequently, Gene Ontology (GO) enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) preliminary analyses of the DEGs were performed using DAVID. The protein–protein interaction (PPI) network of the DEGs was constructed with the Search Tool for the Retrieval of Interacting Genes (STRING) and visualized in Cytoscape. Module analysis of the PPI network was performed using MCODE to get hub genes. Moreover, the influence of the hub genes on overall survival was determined with Kaplan–Meier plotter. All hub genes were analyzed by Gene Expression Profiling Interactive Analysis (GEPIA) and KEGG. Overall, the hub genes DTL, CDK1, CCNB1, RACGAP1, ECT2, NEK2, BUB1B, PBK, TOP2A, ASPM, HMMR, RRM2, CDKN3, PRC1, and ANLN were upregulated in HCC, and the survival rate was lower for HCC with increased expression of these hub genes. CCNB1, CDK1, and RRM2 were enriched in the p53 signaling pathway, and CCNB1, CDK1, and BUB1B were enriched in the cell cycle. In brief, we screened 15 hub genes and pathways to identify potential prognostic markers for HCC treatment. However, the specific occurrence and development of HCC with expression of the hub genes should be verified in vivo and in vitro.
Has the Global Financial Crisis Changed the Market Response to Credit Ratings? Evidence from an Emerging Market
Authors: Krishnan Kaveri , Basu Sankarshan , Thampy Ashok
Published: December 2019

This article analyses the differential market response to credit rating revisions in the pre- and post-global financial crisis (GFC) period using data from India. By reviewing the stock price reaction to the announcement of long-term rating changes during the period 1996–2015, the study finds evidence that the stock price reacted less to rating announcements after the GFC of 2008. However, the difference in the cumulative abnormal returns before the GFC and after the GFC is not statistically significant.

JEL codes: G240, G010, G140
Equity fines for corporate crime: Why they should be back on the legislative agenda
Authors: Schofield-Georgeson Eugene
Published: December 2019

Corporate crime causes significant social and environmental harm and its sentencing is frequently ineffective due to the ability of corporations to pass-on monetary fines to stakeholders such as workers and consumers. This article investigates the notion of equity fines or share dilution as an alternative corporate punishment that avoids the pitfalls of conventional monetary fines while acting as a significant deterrent to corporate offending. It does so by responding to the last official Australian critique of this punishment, in light of a 2010 attempt by the Scottish legislature to implement equity fines in that jurisdiction.
Tubulopapillary Carcinoma: An Aggressive Variant of Invasive Breast Carcinoma With a Micropapillary DCIS-Like Morphology
Authors: Guerrieri Claudio , Hudacko Rachel
Published: December 2019

Tubulopapillary carcinoma is a recently described variant of breast carcinoma characterized by a proliferation of elongated and anastomosing tubular glands exhibiting intraluminal micropapillary and sometimes papillary epithelial projections. We have recently encountered a patient with invasive breast carcinoma displaying a prominent tubulopapillary component. The histomorphology in our case had an uncanny resemblance to micropapillary ductal carcinoma in situ, but the invasive nature of the glands was confirmed not only by the lack of myoepithelial cells but also by the presence of identical metastatic foci within ipsilateral axillary lymph nodes. This case was made all the more intricate by the simultaneous presence of invasive micropapillary carcinoma in the opposite breast and a carcinosarcoma of the uterus with a serous papillary carcinoma component. As noted in the only prior report on tubulopapillary carcinoma of the breast, our case confirms the aggressive nature of this form of invasive carcinoma, the histological features of which appear to be easily identifiable and reproducible.
Dynamics of Physicians’ Trust in Fellow Health Care Providers and the Role of Health Information Technology
Authors: Raj Minakshi , Wilk Adam S. , Platt Jodyn E.
Published: December 2019

Physicians are expected and incentivized to coordinate patient care with other providers, including nonphysician clinician (NPC) members of care teams, requiring trust. Trust in the context of care teams has not been well-studied; even less is known about how health information technologies (HIT) may modify trust in these relationships. We conducted semistructured interviews with 30 physicians at a Midwestern academic center to examine how physicians determine they can trust NPCs, and how technology modifies these relationships. A majority of physicians base trust in NPCs on cognitive factors such as competence and reliability. Technology enhances trust between physicians and NPCs by supporting evidence-based decision making; it can also erode trust by limiting opportunities for developing familiarity and comfort with fellow providers. Our work has implications for enhancing HIT to promote trust between providers, and for developing more robust measures of trust that can be used in evaluating and improving teamwork within practices.
Pomalidomide desensitization for hypersensitivity: A case report
Authors: Park Jiyeon J , Huang Esther , Monteleone Catherine A , Kane Michael P , Cooper Dennis L
Published: December 2019

Introduction

Pomalidomide is an immunomodulating agent that is used to treat relapsed and/or refractory multiple myeloma. Although the incidence of hypersensitivity with pomalidomide is not well documented, the most common type of hypersensitivity involves a cutaneous reaction. Previous reports have successfully utilized a desensitization protocol in patients who developed hypersensitivity to pomalidomide. Here we describe a case of a patient who developed urticaria on pomalidomide and successfully underwent a desensitization using the previously reported method in a case report.

Case report

A 68-year-old woman with relapsed multiple myeloma and no known drug allergies developed urticaria a day after taking the first dose of pomalidomide.

Management and Outcome

The patient underwent a 10-step desensitization process in the medical intensive care unit without any reported adverse events. The following day in the medical intensive care unit, the patient was able to tolerate a full dose of pomalidomide with no further reactions and was discharged with instructions to take a full dose of pomalidomide daily for 21 days out of a 28-day cycle. The patient was followed up in the outpatient clinic and noted no further reactions from pomalidomide at the three-month visit.

Discussion

The 10-step desensitization protocol with pomalidomide was well tolerated in the patient with hypersensitivity to pomalidomide. Whether this approach would work in patients with more severe reactions such as anaphylaxis and angioedema is still unknown.
Measurement of the leak rate of masks used for anticancer drug handling using a mask fitting tester
Authors: Sato Junya , Yamawaki Yuki , Ito Masako , Endo Megumi , Tanaka Rei , Shino Michihiro
Published: December 2019

Background

Exposure to inhalation of anticancer drugs is frequent in anticancer drug handling. Using an activated carbon mask with the ability to remove particulates and vapors of anticancer drugs may be effective. Mask fitting performance is important, because low fitting performance leads to inhalation via bypassing the mask filter (leak). This study evaluated the leak rate of multiple-shaped masks.

Methods

Activated carbon and nonactivated carbon masks of the pleated-type (like surgical mask) and cup-type were used. Four pharmacists wore the masks and a fitting tester was employed. The particle reduction rate of particles in ambient air was calculated using: particle count (outside - inside)/outside × 100 (%). Leak rate was calculated as the difference in the particle reduction rate due to the presence or the absence of a seal in the mask surroundings.

Results

Reduction rates of the pleated-type nonactivated carbon mask and the pleated-type activated carbon mask were 14.8% and 34.8% (mean). These values significantly increased to 85.6% and 83.3% upon sealing the mask surroundings. Particle reduction rates of the cup-type nonactivated carbon mask and activated carbon mask were 99.3% and 33.6%. When mask surroundings were sealed, these values were 99.6% and 39.2%. Leak rates of pleated-type nonactivated carbon mask, pleated-type activated carbon mask, cup-type nonactivated carbon mask, and cup-type activated carbon mask were 70.8%, 48.5%, 0.3%, and 5.6%, respectively.

Conclusion

A difference was found in the leak rate between masks used in anticancer drug handling. Based on the low leak rate, the cup-type activated carbon mask was thought to be effective.
Child Sexual Abuse by Catholic Priests, Deacons, and Male Members of Religious Orders in the Authority of the German Bishops’ Conference 1946–2014
Authors: Dressing Harald , Dölling Dieter , Hermann Dieter , Kruse Andreas , Schmitt Eric , Bannenberg Britta , Whittaker Konrad , Hoell Andreas , Voss Elke , Salize Hans Joachim
Published: December 2019

This study explores the extent of sexual abuse of minors by members of the Catholic Church in Germany. It is the first comprehensive study to examine this extent in a European country. The goals of this study are as follows: (a) to analyze whether the extent and characteristics of sexual abuse in a European country are comparable to those in the United States and Australia and (b) how discrepancies can be explained. The personnel files of 38,156 Catholic Priests, deacons, and male members of religious orders in the authority of the German Bishops’ Conference were analyzed. The study period lasted from 1946 to 2014. All 27 German dioceses took part in this study. A total of 4.4% of all clerics ( N = 1,670) from 1946 to 2014 were alleged to have committed sexual abuse, and 3,677 children or adolescents were identified as victims. These results are similar to those from comparable studies in the United States. Sexual abuse of minors within the authority of the Catholic Church seems to be a worldwide phenomenon.
Evaluation of aqueous humor and serum cortistatin levels in diabetic patients with and without diabetic retinopathy
Authors: Balbaba Mehmet , Ulaş Fatih , Erdağ Murat , Yıldırım Hakan , Çeliker Ülkü , Aydın Süleyman
Published: December 2019

Purpose:

To evaluate the aqueous humor and serum cortistatin levels in diabetic patients with and without diabetic retinopathy and its relationship with various metabolic markers that have been reported to be associated with diabetes mellitus.

Methods:

The current study included 20 diabetes mellitus patients with diabetic retinopathy, 20 diabetes mellitus patients without diabetic retinopathy, and 20 healthy control subjects with the same sex and age characteristics. Aqueous humor and serum cortistatin, fasting blood glucose, hemoglobinA1c, 25-hydroxyvitamin D levels, blood lipid profiles, and body mass index were measured in all subjects.

Results:

In diabetic patients with and without diabetic retinopathy and in healthy control subjects, the mean aqueous humor cortistatin levels were 25.55 ± 2.03, 27.71 ± 2.01, and 32.76 ± 3.43 ng/mL, respectively. Likewise, the mean serum cortistatin levels were 6.16 ± 1.08, 6.57 ± 1.00, and 7.56 ± 1.51 ng/mL, respectively. Aqueous humor cortistatin levels were decreased in diabetic patients with and without diabetic retinopathy when compared to healthy controls ( p < 0.001). Although aqueous humor cortistatin levels tended to be reduced in diabetic patients with diabetic retinopathy, the difference was not statistically significant between diabetic patients with and without diabetic retinopathy ( p = 0.147). Serum cortistatin levels were not statistically significant between diabetic patients with and without diabetic retinopathy and healthy control subjects ( p = 0.166). Body mass index, fasting blood glucose, and hemoglobinA1c levels were significantly different between the groups ( p < 0.05 for all parameters tested).

Conclusion:

Aqueous humor cortistatin levels were decreased in diabetic patients with and without diabetic retinopathy. The results suggest that a local decrease in the amount of cortistatin may play a role in the pathogenesis of diabetic retinopathy.
Relationship Between Aquifer Processes and Groundwater Quality: A Case of Olbanita Aquifer System, Lower Baringo Basin, Kenya Rift
Authors: Sosi Benjamin , Getabu Albert , Maobe Samson , Barongo Justus
Published: December 2019

A hydrogeochemical relation has been hypothesized through the analyses of physiochemical data of a fractured volcanic rock aquifer located in the Lower Baringo Basin, Kenyan Rift. Data sets included 15 individual metrics determined in 42 dry and wet season water samples obtained from 6 boreholes in the area. Aquifer evolutionary theory was postulated using sequential principal component analysis (PCA) and hierarchical cluster analysis. To eliminate the effects of scale dimensionality, PCA decomposed the variable data into 4 factors, namely, electrical conductivity, salinity, alkalinity, and carbonate equilibrium with external pH control for the dry season and salinity, carbonate equilibrium with external pH control, alkalinity, and electrical conductivity for the wet season. The main result depicted a major shift in the variability factor from electrolytic conductivity (34.8%) in the dry season to salinity (23.5%) in the wet season. Ward’s linkage cluster analysis partitioned the aquifer into 2 spatially discrete associations; the western and the eastern entities, respectively, in spite of their shared recharge area. These agglomerative scheduling validated in an integrative approach (with groundwater flow predictions using a calibrated petrophysical groundwater model for the area) linked the 4 factors to aquifer processes and 3 pathways: fault permeability, weathering processes, and water-rock interaction. Statistical approaches are, therefore, useful in the conceptualization of pollutant sources and their attenuation for effective groundwater quality management.
Cooking Online With a Chef: Health Professionals’ Evaluation of a Live Culinary Coaching Module
Authors: Polak Rani , Finkelstein Adi , Paganoni Sabrina , Welch Rob , Silver Julie K
Published: December 2019

Introduction:

Cooking Online With a Chef (COWC) is a live, telemedicine module delivered by a health coach chef to participants who log in from their home kitchen. Our purpose is to identify health professionals’ perceptions on its educational value and to determine feasibility for clinical practice.

Method:

Sixty-four health care professionals participated in a 75-minute COWC module as active participants during a live remote Continuing Medical Education (CME) program that includes five 75-minute telemedicine sessions. Post-program questionnaire elicited feedback on the module educational value and relevance to clinical practice through Likert-type scale and open-ended questions. This report presents descriptive analysis of the Likert-type scale questions and thematic qualitative analysis of the open-ended question.

Results:

Seventy percent of health care professional participants rated the quality of the COWC module as either very good or excellent, and 73% rated its relevance to clinical practice as very good or excellent. Open-ended question feedback showed appreciation of the learning experience with specific suggestions about how to improve participants’ preparation for the module.

Conclusions:

The COWC telemedicine module was well received by self-selected health care professionals. Future studies are being planned to determine the efficacy of the module on patients’ nutrition.
Moving past antioxidant supplementation for the dietary treatment of multiple sclerosis
Authors: Holton Kathleen F , Kirkland Anna E
Published: December 2019

Current research has demonstrated the definitive presence of oxidative stress in multiple sclerosis (MS). This finding has led to clinical trial research which has indicated that specific antioxidants have the ability to effectively reduce markers of oxidative stress. However, few interventions testing antioxidant supplements have shown efficacy for reducing the symptom burden in the disorder. This paper quickly reviews what is currently known about oxidative stress and antioxidants in MS, explains which nutrients are critical for the creation and maintenance of the myelin sheath, describes potential negative effectors in the diet which may be contributing to oxidative stress, and how these aspects of diet, combined with current knowledge on antioxidants, may be able to be combined into a whole food dietary intervention which can be tested for efficacy in MS.
Subjective memory impairment, instrumental activities of daily living and longitudinal effect on mortality among older adults in a population-based cohort study: The HUNT Study
Authors: Tangen Gro Gujord , Langballe Ellen Melbye , Strand Bjørn Heine
Published: December 2019

Background: Subjective impairment in memory and instrumental activities in daily living (IADL) are associated with future cognitive decline and poorer mental health in older adults, but their association with mortality is uncertain. Our aim was to examine the associations between subjective memory and IADL impairments and all-cause mortality, as well as the mortality risk for reporting both memory and IADL impairments. Methods: Data from the 70-year-old and older cohort in the third survey of a population-based study, the Nord-Trøndelag Health Study (HUNT3), were linked to the Norwegian Causes of Death Registry. A total of 5802 older adults had complete data from HUNT3 (70.8% of the 70+ cohort). The mean follow-up time was 8.0 years, and 1870 respondents had died. Associations between subjective memory and ADL impairments with mortality were analysed in Cox regression models adjusted for covariates with attained age as the timescale. Analyses were performed separately for two age groups – 70–79 and 80+ years – to fulfil the proportional hazards assumption. Results: Subjective impairments in short-term memory and IADL were significantly associated with mortality both separately and combined. These associations were strongest in the 70- to 79-year-old group, where reporting impairment on one short-term memory item increased the mortality risk by 51% (hazard ratio=1.51; 95% confidence interval 1.20–1.91). Long-term memory impairments were not associated with mortality in the adjusted models. Conclusions: Subjective short-term memory impairments and IADL impairments are associated with increased mortality risk. Neither of these symptoms should be regarded as benign aspects of ageing, and concerns should be properly addressed.