bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of Implicit Type Nonlinear Dynamical Problem of Impulsive Fractional Differential Equations
Authors: Ahmad Naveed , Ali Zeeshan , Shah Kamal , Zada Akbar , ur Rahman Ghaus
Published: February 2018

We study the existence, uniqueness, and various kinds of Ulam–Hyers stability of the solutions to a nonlinear implicit type dynamical problem of impulsive fractional differential equations with nonlocal boundary conditions involving Caputo derivative. We develop conditions for uniqueness and existence by using the classical fixed point theorems such as Banach fixed point theorem and Krasnoselskii’s fixed point theorem. For stability, we utilized classical functional analysis. Also, an example is given to demonstrate our main theoretical results.
Understanding Unlicensed Drug Vendor Practices Related to Childhood Malaria in One Rural District of Uganda: An Exploratory Study
Authors: Liow Eric , Kassam Rosemin , Sekiwunga Richard
Published: February 2018

This study investigated unlicensed drug outlets’ practices for the management of malaria in the rural district of Butaleja, Uganda. A qualitative design using semistructured interviews was used. Interviews were recorded, translated, transcribed, and analyzed using thematic analysis. A total of 75 vendors, representing 85% of the outlets in the study area, were interviewed. Most of the vendors were associated with a drug shop type of outfit. About three-quarters reported having completed some level of postsecondary education, but just one-tenth of the vendors had qualifications that made them eligible to apply for a license to operate a drug shop. While most outlets stocked at least one type of antimalarial, only about one-quarter stocked an artemisinin-based combination therapy (ACT), one-quarter expressed a preference for ACTs, and less than one-tenth attested to firmly adhering to the national malaria treatment guidelines on dispensing ACTs as the first-line option. In contrast, nine out of 10 vendors stocked quinine and well over a third stocked antimalarials no longer recommended, such as chloroquine and sulphadoxine-pyrimethamine. Given the ongoing gap between the national malaria policy and unlicensed drug outlet practices, this study calls for greater engagement of unlicensed vendors to improve the management of childhood malaria.
Susceptibility of Diabetic Mice to Noise Trauma
Authors: Han Wook Kyoung , Kim Eung Hyub , Shin Sun-Ae , Shin Dong-Sik , Kim Bong Jik , Lyu Ah-Ra , Park Yong-Ho
Published: February 2018

Diabetes can lead to many end-organ complications. However, the association between diabetes and hearing loss is not well understood. Here, we investigated the effect of noise exposure on diabetic mice compared with wild-type mice. Hearing threshold shifts, histopathologic changes in the cochlea, and inflammatory responses were evaluated over time. After noise exposure, more severe hearing threshold shifts, auditory hair cell loss, and synaptopathies were notable in diabetic mice compared with wild-type mice. Moreover, increased inflammatory responses and reactive oxygen species production were observed in the ears of diabetic mice. The results demonstrated that diabetic mice are more susceptible to noise trauma.
EBG Based Microstrip Patch Antenna for Brain Tumor Detection via Scattering Parameters in Microwave Imaging System
Authors: Inum Reefat , Rana Md. Masud , Shushama Kamrun Nahar , Quader Md. Anwarul
Published: February 2018

A microwave brain imaging system model is envisaged to detect and visualize tumor inside the human brain. A compact and efficient microstrip patch antenna is used in the imaging technique to transmit equivalent signal and receive backscattering signal from the stratified human head model. Electromagnetic band gap (EBG) structure is incorporated on the antenna ground plane to enhance the performance. Rectangular and circular EBG structures are proposed to investigate the antenna performance. Incorporation of circular EBG on the antenna ground plane provides an improvement of 22.77% in return loss, 5.84% in impedance bandwidth, and 16.53% in antenna gain with respect to the patch antenna with rectangular EBG. The simulation results obtained from CST are compared to those obtained from HFSS to validate the design. Specific absorption rate (SAR) of the modeled head tissue for the proposed antenna is determined. Different SAR values are compared with the established standard SAR limit to provide a safety regulation of the imaging system. A monostatic radar-based confocal microwave imaging algorithm is applied to generate the image of tumor inside a six-layer human head phantom model. S-parameter signals obtained from circular EBG loaded patch antenna in different scanning modes are utilized in the imaging algorithm to effectively produce a high-resolution image which reliably indicates the presence of tumor inside human brain.
Noninvasive Real‐Time Characterization of Renal Clearance Kinetics in Diabetic Mice after Receiving Danshensu Treatment
Authors: Gao Lei , Kwan Yiu-Wa , Bulmer Andrew C. , Lai Christopher W. K.
Published: February 2018

Danshensu (DSS) is an active ingredient extracted from the root of the Danshen that could ameliorate oxidative stress via upregulation of heme oxygenase‐ (HO‐) 1. Little is known about the treatment effects of DSS on kidney function in diabetic mice. Therefore, the primary aim of the present study was to characterize the renal clearance kinetics of IRdye800CW in db/db mice after DSS treatment. The secondary aim was to measure several biomarkers of renal function and oxidative stress (urinary F2‐isoprostane, HO‐1 in kidney and serum bilirubin). Fourteen db/db diabetic mice were randomly assigned into two groups and received either DSS treatment (DM + DSS) or vehicle treatment (DM). A third group that comprised of db/+ nondiabetic mice (non‐DM control) received no DSS treatment and served as the nondiabetic control. At the end of a 3‐week intervention period, serum and urinary biomarkers of renal function and oxidative stress were assessed and the renal clearance of IRdye800CW dye in all mice was determined noninvasively using Multispectral Optoacoustic Tomography. The major finding from this study suggested that DSS treatment in db/db mice improved renal clearance. Increased expression of HO‐1 after DSS treatment also suggested that DSS might represent a potential therapeutic avenue for clinical intervention in diabetic nephropathy.
Left Circumflex Artery Rupture with Left Atrial Tamponade and Functional Mitral Stenosis
Authors: Huang Weiting , Hammad Khaled Mohamed Emadeldin Moheb , Chao Victor Tar Toong , Yeo Khung Keong
Published: February 2018

The growth in percutaneous transluminal devices has enabled operators to tackle more complex, native, and post-bypass surgery anatomy. However, complications such as coronary artery dissection, coronary perforation, retrograde aortic dissection, arrhythmias, and acute coronary syndrome still occur with resulting mortality rates of up to 4.2% in complex interventions. Perforation of the circumflex artery is of particular interest in view of its position and relation to the surrounding cardiac structures. This is a site of potential fluid collection, and as the left atrium is fixed to the parietal pericardium at the entry of the pulmonary veins, fluid in the oblique sinus can accumulate enough pressure to compress the left atrium and the coronary sinus. We present a case of left circumflex artery perforation which demonstrates the physiologic complications of coronary sinus and left atrial compression and the resultant functional mitral stenosis.
The Early Clinical Outcomes of a Percutaneous Full-Endoscopic Interlaminar Approach via a Surrounding Nerve Root Discectomy Operative Route for the Treatment of Ventral-Type Lumbar Disc Herniation
Authors: Shi Chao , Kong Weijun , Liao Wenbo , Lu Yanxiao , Fu Yao , Wen Hongquan , Du Qian , Wu Fujun
Published: February 2018

The objective of this study is to introduce a method using a percutaneous full-endoscopic interlaminar approach via a surrounding nerve root discectomy (SNRD) operative route that involves removing the protrusive disc via both the shoulder and the axilla of the corresponding nerve root for the treatment of ventral-type lumbar disc herniation (VLDH) and its early clinical symptoms. Twenty-two patients with VLDH satisfied the inclusion criteria and underwent the full-endoscopic interlaminar approach operation via a SNRD successfully during the period from November 2014 to June 2016. All operations were completed without conversion to other surgical techniques. The average operation time was 78.64 ± 25.97 min (50–145 min). The average removed disc tissue volume was 2.87 ± 0.48 ml (2–3.6 ml). No nerve root injury, infection, or other complications occurred. The postoperative ODI and VAS values of low back and sciatic pain were significantly decreased at each time point compared to preoperative measurements P<0.05. The MacNab scores at the 12-month follow-up included 15 excellent and 7 good scores. In summary, a percutaneous full-endoscopic interlaminar approach through SNRD is a safe and effective treatment option for patients with VLDH.
Thalamic Deep Brain Stimulation Salvages Failed Focused Ultrasound Thalamotomy for Essential Tremor: A Case Report
Authors: Wang Tony R. , Dallapiazza Robert F. , Moosa Shayan , Huss Diane , Shah Binit B. , Elias W. Jeffrey
Published: February 2018

Background: A recent randomized controlled trial investigating unilateral MRI-guided focused ultrasound (FUS) for essential tremor demonstrated efficacy. The long-term durability of this thalamotomy, however, is unknown. Furthermore, the feasibility of stimulating a previously lesioned target such as the thalamic nucleus ventralis intermedius (Vim) is poorly understood. We report a case of tremor recurrence, following an initially successful FUS thalamotomy, in which Vim-DBS was subsequently utilized to regain tremor control. Methods: An 81-year-old right-handed female with medically refractory essential tremor (a Clinical Rating Scale for Tremor [CRST] value of 73) underwent left-sided FUS thalamotomy with initial abolition of right-upper extremity tremor. By the 6-month follow-up, there was complete recurrence of tremor (a CRST value of 76). The patient subsequently underwent left-sided Vim-DBS. Results: Vim-DBS provided clinical improvement with a CRST value of 42 at the 3-month follow-up; the patient continues to do clinically well at the 6-month follow-up. This result mirrors previous reported cases of stimulation following radiofrequency and gamma-knife lesioning. Our literature review highlights several reasons for the waning of clinical benefit seen with lesional procedures. Conclusion: This case demonstrates that thalamic DBS can salvage a failed FUS thalamotomy and also the feasibility of stimulating a previously lesioned target.
A Comparison of the Effects of Grayanotoxin-Containing Honey (Mad Honey), Normal Honey, and Propolis on Fracture Healing
Authors: Sahin Aynur , Turkmen Suha , Guzel Nizamettin , Mentese Ahmet , Turedi Suleyman , Karahan Suleyman Caner , Yulug Esin , Demir Selim , Aynaci Osman , Deger Orhan , Gunduz Abdulkadir
Published: February 2018

Objectives: Delayed healing and non-union of fractures have a significant effect upon patient morbidity. Studies have therefore largely concentrated on accelerating fracture healing. This study was intended to compare the effect of “mad honey” and propolis on fracture healing using radiological and histopathological analysis. Subjects and Methods: Femur fracture was surgically performed on 48 rats, followed by fixation. Animals were then divided into 8 groups: 2 control groups (15- and 30-day) and 6 treatment groups (15- and 30-day normal honey, 15- and 30-day “mad honey,” and 15- and 30-day propolis). Rats were sacrificed at the end of these periods, and radiological and histological examinations were performed. Results: Radiological healing in the propolis group after 15-day therapy was statistically better than in the control (p = 0.004) and normal honey (p = 0.006) groups. After 30-day therapy, healing in the propolis group (p = 0.005) and grayanotoxin-containing “mad honey” group (p = 0.007) were significantly better than in the control group. Histologically, there was a statistically significant difference between the 15-day propolis group and the other groups (control, honey, mad honey: p = 0.003, p = 0.003, and p = 0.002, respectively). We also found a statistically significant difference when the 30-day propolis group (p = 0.005) and “mad honey” group (p = 0.007) were compared to the control group. Conclusions: This study shows that grayanotoxin-containing “mad honey” and propolis can accelerate fracture healing.
Dysregulated Pseudogene
HK2P1
May Contribute to Preeclampsia as a Competing Endogenous RNA for Hexokinase 2 by Impairing Decidualization
Authors: Lv Hong , Tong Jing , Yang Jieqiong , Lv Shijian , Li Wei-Ping , Zhang Cong , Chen Zi-Jiang
Published: February 2018

Preeclampsia is a pregnancy-specific hypertensive disorder, which seriously undermines the health of maternity and fetus. However, its cause and pathogenesis remain elusive. Flawed decidualization is considered to be related to preeclampsia. Increasing evidence indicates that long noncoding RNAs are correlated with a variety of diseases, including preeclampsia. In this study, we verified the expression of long noncoding RNA
HK2P1
(hexokinase 2 pseudogene 1) and its cognate gene
HK2
(hexokinase 2), which were found by our previous RNA-sequencing analysis in the decidua of severe preeclampsia patients and matched control subjects. Besides that, we also investigated the function and the mechanism of
HK2P1
and
HK2
during decidualization. HK2 is the crucial enzyme involved in glycolysis. The
HK2P1
and
HK2
genes are homologous to each other. The results demonstrated that
HK2P1
, like
HK2
, stimulated the glucose uptake and lactate production of human endometrial stromal cells. In addition,
HK2P1
and
HK2
are indispensable for endometrial decidualization. Downregulated
HK2P1
or
HK2
inhibited human endometrial stromal cells proliferation and differentiation. Furthermore, there was a significant positive correlation between the expression of
HK2P1
and
HK2
, and
HK2P1
regulated the
HK2
expression via competition for the shared miR-6887-3p. Taken together, our results indicated that the reduced expression of
HK2P1
and
HK2
may have contributed to the occurrence and development of preeclampsia by suppressing glycolysis and impairing decidualization. Our study would be helpful to understand the pathogenesis and the regulatory network of preeclampsia.
Interaction Between the Sodium‐Glucose–Linked Transporter 2 Inhibitor Dapagliflozin and the Loop Diuretic Bumetanide in Normal Human Subjects
Authors: Wilcox Christopher S. , Shen Wen , Boulton David W. , Leslie Bruce R. , Griffen Steven C.
Published: February 2018

Background

Dapagliflozin inhibits the sodium‐glucose–linked transporter 2 in the renal proximal tubule, thereby promoting glycosuria to reduce hyperglycemia in type 2 diabetes mellitus. Because these patients may require loop diuretics, and sodium‐glucose–linked transporter 2 inhibition causes an osmotic diuresis, we evaluated the diuretic interaction between dapagliflozin and bumetanide.

Methods and Results

Healthy subjects (n=42) receiving a fixed diet with ≈110 mmol·d
−1
of Na
+
were randomized to bumetanide (1 mg·d
−1
), dapagliflozin (10 mg·d
−1
), or both for 7 days, followed by 7 days of both. There were no meaningful pharmacokinetic interactions. Na
+
excretion increased modestly with the first dose of dapagliflozin (22±6 mmol·d
−1
;
P
<0.005) but by more (
P
<0.005) with the first dose of bumetanide (74±7 mmol·d
−1
;
P
<0.005), which was not significantly different from both diuretics together (80±5 mmol·d
−1
;
P
<0.005). However, Na
+
excretion with dapagliflozin was 190% greater (
P
<0.005) when added after 1 week of bumetanide (64±6 mmol·d
−1
), and Na
+
excretion with bumetanide was 36% greater (
P
<0.005) when added after 1 week of dapagliflozin (101±8 mmol·d
−1
). Serum urate was increased 4% by bumetanide but reduced 40% by dapagliflozin or 20% by combined therapy (
P
<0.05).

Conclusions

First‐dose Na
+
excretion with bumetanide and dapagliflozin is not additive, but the weekly administration of one diuretic enhances the initial Na
+
excretion with the other, thereby demonstrating mutual adaptive natriuretic synergy. Combined therapy reverses bumetanide‐induced hyperuricemia. This requires further study in diabetic patients with hyperglycemia who have enhanced glycosuria and natriuresis with dapagliflozin.

Clinical Trial Registration

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00930865.
Adult Congenital Heart Disease in a Nationwide Population 2000–2014: Epidemiological Trends, Arrhythmia, and Standardized Mortality Ratio
Authors: Wu Mei‐Hwan , Lu Chun‐Wei , Chen Hui‐Chi , Kao Feng‐Yu , Huang San‐Kuei
Published: February 2018

Background

The adult congenital heart disease (
ACHD
) population will grow with medical advances, but data are limited. We investigated the epidemiological profile of
ACHD
in Taiwan, a country with a congenital heart disease program since 1955, population of 23 million, and easily accessible high‐standard medical care.

Methods and Results

ACHD
patients, born after 1954, were identified from the nationwide database 2000–2014. The
ACHD
prevalence in the population aged 18 to 59 was 140.53, 157.08, 182.45, and 217.00 per 100 000 in 2000, 2005, 2010, and 2014, respectively (increasing time trend,
P
<0.0001). Percentage of severe
ACHD
also increased over time (
P
<0.0001) and was 11.70% in 2014. The 5 leading
ACHD
diagnoses were ventricular septal defect, secundum atrial septal defect, patent ductus arteriosus, pulmonary stenosis, and tetralogy of Fallot. Freedom from tachyarrhythmia at age 50 years was 0.574 and 0.710 for severe and simple
ACHD
, respectively. Cardiac causes accounted for the majority of deaths, followed by malignancy in simple
ACHD
and external causes/sudden death/out‐of‐hospital death in severe
ACHD
patients. The proportion of unexpected death was 10%. Compared with the general population, the standardized mortality ratio was higher not only in severe
ACHD
(3.164; 95% confidence interval, 2.664–3.664), but also in women with simple
ACHD
(1.704; 95% confidence interval, 1.499–1.909), with a higher proportion of cardiac, labor, and sudden death as causes of death.

Conclusions

We demonstrated an increasing trend in
ACHD
prevalence and medical complexity. They are at risk of tachyarrhythmia, higher mortality, and unexpected deaths, suggesting a gap in their medical care.
Long-Term Survival After Intravenous Thrombolysis for Ischemic Stroke
Authors: Muruet Walter , Rudd Anthony , Wolfe Charles D.A. , Douiri Abdel
Published: February 2018

Background and Purpose—

Intravenous thrombolysis with alteplase is one of the few approved treatments for acute ischemic stroke; nevertheless, little is known about its long-term effects on survival and recovery because clinical trials follow-up times are limited.

Methods—

Patients registered between January 2005 and December 2015, to the population-based South London Stroke Register of first-ever strokes. Propensity score was used to match thrombolyzed and control cases to a 1:2 ratio by demographical and clinical covariates. The primary outcome was survival up to 10 years using Kaplan–Meier estimates, Cox proportional hazards, and restricted mean survival time. Secondary outcomes included stroke recurrence and functional status (Barthel Index and Frenchay Activities Index scores) at 5 years.

Results—

From 2052 ischemic strokes, 246 treated patients were matched to 492 controls. Median follow-up time 5.45 years (interquartile range, 4.56). Survival was higher in the treatment group (median, 5.72 years) compared with control group (4.98 years, stratified log-rank test <0.001). The number needed to treat to prevent 1 death at 5 years was 12 and 20 at 10 years. After Cox regression analysis, thrombolysis reduced risk of mortality by 37% (hazard ratio, 0.63; 95% confidence interval [CI], 0.48–0.82) at 10 years; however, after introducing a multiplicative interaction term into the model, mortality risk reduction was 42% (hazard ratio, 0.58; 95% CI, 0.40–0.82) at 10 years for those arriving within 3 hours to the hospital. On average, in a 10-year period, treated patients lived 1 year longer than controls. At 5 years, thrombolysis was associated with independence (Barthel Index≥90; odds ratio, 3.76; 95% CI, 1.22–13.34) and increased odds of a higher Frenchay Activities Index (proportional odds ratio, 2.37; 95% CI, 1.16–4.91). There was no difference in stroke recurrence.

Conclusions—

Thrombolysis with intravenous alteplase is associated with improved long-term survival and functional status after ischemic stroke.
New York City Impacts on a Regional Heat Wave
Authors: Ortiz Luis E. , Gonzalez Jorge E. , Wu Wei , Schoonen Martin , Tongue Jeffrey , Bornstein Robert
Published: February 2018

Heat waves are projected to increase in magnitude and frequency throughout this century because of increasing global temperatures, making it critically important to acquire improved understanding of their genesis and interactions with large cities. This study presents an application of the method of factor separation to assess combined impacts of a synoptic-scale heat wave, urban land cover, and urban energy and momentum fluxes on temperatures and winds over New York City, New York, via use of high-resolution simulations (1-km grid spacing) with an urbanized version of the Weather Research and Forecasting (WRF) Model. Results showed that factors behaved different throughout the day, with synoptic conditions dominating afternoon temperature contributions (>7°C). At night, combined urban surface factors contributed over 5°C during the heat wave and up to 1.5°C on non-heat-wave days. Positive interactions among all factors during morning and nighttime indicate an amplification of the urban heat island of up to 4°C during the heat wave. Midtown Manhattan vertical cross sections, where urban canopies are most dense, showed a change in the sign (from positive to negative) of the contribution of the urban fluxes between night and day below 500 m, possibly as a result of decreased radiative cooling from trapping by buildings and increased thermal storage by buildings as well as frictional effects that oppose the incoming warm air.
Direct Numerical Simulations to Investigate Energy Transfer between Meso- and Synoptic Scales
Authors: Eghdami Masih , Bhushan Shanti , Barros Ana P.
Published: February 2018

Understanding the development of the atmospheric energy spectrum across scales is necessary to elucidate atmospheric predictability. In this manuscript, the authors investigate energy transfer between the synoptic scale and the mesoscale using direct numerical simulations (DNSs) of two-dimensional (2D) turbulence transfer under forcing applied at different scales. First, DNS results forced by a single kinetic energy source at large scales show that the energy spectra slopes of the direct enstrophy cascade are steeper than the theoretically predicted −3 slope. Second, the presence of two inertial ranges in 2D turbulence at intermediate scales is investigated by introducing a second energy source in the meso-α-scale range. The energy spectra for the DNS with two kinetic energy sources exhibit flatter slopes that are closer to −3, consistent with the observed kinetic energy spectra of horizontal winds in the atmosphere at synoptic scales. Further, the results are independent of model resolution and scale separation between the two energy sources, with a robust transition region between the lower synoptic and the upper meso-α scales in agreement with classical observations in the upper troposphere. These results suggest the existence of a mesoscale feedback on synoptic-scale predictability that emerges from the concurrence of the direct (downscale) enstrophy transfer in the synoptic scales and the inverse (upscale) kinetic energy transfer from the mesoscale to the synoptic scale in the troposphere.
The U.S. Horizontal Merger Guidelines After One Half Century
Authors: Becker Gilbert B.
Published: February 2018

The U.S. antitrust agencies’ Horizontal Merger Guidelines are approaching their half century mark, having progressed through three earlier versions to their current 2010 form. Recent reports promote the contention that the enhanced sophistication and transparency of the newer versions have led to improved policy results. This study questions this conclusion by examining recent retrospective merger case evidence as well as agency policy and practices, in light of long-held Supreme Court dicta.
Pain Exposure Physical Therapy versus conventional treatment in complex regional pain syndrome type 1—a cost-effectiveness analysis alongside a randomized controlled trial
Authors: Barnhoorn Karlijn , Staal J Bart , van Dongen Robert TM , Frölke Jan Paul M , Klomp Frank P , van de Meent Henk , Adang Eddy , Nijhuis-van der Sanden Maria WG
Published: February 2018

Objective:

To analyze cost-effectiveness of Pain Exposure Physical Therapy compared to conventional treatment alongside a randomized controlled trial (NCT00817128) in patients with complex regional pain syndrome type 1, where no clinical difference was shown between the two groups in an intention-to-treat analysis.

Design:

Randomized controlled trial with 9 months follow-up.

Setting:

Patients were recruited from hospitals and general practitioners in the region around a university hospital.

Subjects:

A total of 56 patients, 45 (80.4%) female, were randomized. About 4 patients in the intervention and 11 patients in the conventional group switched groups. The mean (SD) age was 44.3 (16.6) years, and in 37 (66.1%) patients, the upper extremity was affected.

Interventions:

Patients received either Pain Exposure Physical Therapy (maximum of five sessions), or conventional treatment conforming with the Dutch multidisciplinary guideline.

Main measures:

For the economic evaluation difference between the groups in health-related quality of life (quality-adjusted life years (QALYs)), and the clinical outcomes Impairment level Sum Score—Restricted Version and Pain Disability was determined based on the intention-to-treat analysis as well as differences in both healthcare-related costs and travel expenses. Cost-effectiveness planes were constructed using bootstrapping to compare effects and costs.

Results:

No significant effects were found for QALYs (mean difference = −0.02; 95% confidence interval (CI) −0.10 to 0.04) and clinical outcomes. A cost minimization analysis showed a significant difference in costs between groups. The conventional treatment was 64% more expensive than the Pain Exposure Physical Therapy.

Conclusion:

This economic analysis shows that Pain Exposure Physical Therapy compared to conventional treatment is cost-effective.
Assessment and management of constipation for patients receiving palliative care in specialist palliative care settings: A systematic review of the literature
Authors: Muldrew Deborah HL , Hasson Felicity , Carduff Emma , Clarke Mike , Coast Jo , Finucane Anne , Graham Lisa , Larkin Philip , McCorry Noleen K. , Slater Paul , Watson Max , Wright Eileen , McIlfatrick Sonja
Published: February 2018

Background:

Constipation is an important issue for patients receiving palliative care within specialist palliative care settings. Questions and ambiguity, however, persist about international best practice and management.

Aim:

To synthesise the current evidence base on the assessment and management of constipation for palliative care patients within a specialist palliative care setting.

Design:

This is a systematic review.

Data sources:

MEDLINE, Embase, CINAHL, Scopus and Cochrane databases were systematically searched in April 2017 for empirical studies, written in English, on the assessment and management of constipation in specialist palliative care settings, published between 2007 and 2017. Two researchers independently reviewed and critically appraised all studies, conducted data extraction, and undertook a thematic analysis.

Results:

In total, 13 studies were included in the review comprising randomised trials ( n = 3), observational ( n = 4) and descriptive studies ( n = 6). Most research was conducted in specialist palliative care units, targeting either healthcare professionals or patients. The analysis highlighted a lack of standard definition of constipation, raising questions on the existence and comparability of baseline prevalence figures, the physical and psychological impact on patients, resource impact on staff and service, the subjective and objective methods of assessing constipation, and key aspects of constipation management, including a lack of focus on non-pharmacological management in this setting.

Conclusion:

The results of this review are being used to inform the development of an educational intervention targeting healthcare professionals. Gaps in the evidence base include lack of consistent definition of constipation, constipation prevention, non-pharmacological management, and the consideration of the management of constipation for the dying patient.
Relationship between diverticulosis and nonalcoholic fatty liver disease in elderly patients
Authors: Sahin Abdurrahman , Tunc Nurettin , Demirel Ulvi , Kursat Poyrazoglu Orhan , Yalniz Mehmet , Halil Bahcecioglu Ibrahim
Published: February 2018

Objective

To compare clinical and laboratory features of elderly patients with and without diverticulosis and assess factors related to hepatosteatosis.

Method

This retrospective case–control study analysed the clinical and laboratory data, colonoscopy and abdominal ultrasonography records of patients >65 years who underwent colonoscopies. Subjects were categorized according to the presence and absence of colonic diverticulosis. Univariate/multivariate logistic regression analyses were performed to evaluate the independent predictive factors of hepatosteatosis.

Results

A total of 355 patients were enrolled in the study: 169 had colonic diverticulosis; and 186 without colonic diverticulosis formed the control group. Age, sex and chronic disorders associated with the metabolic syndrome did not differ between the diverticulosis and control groups. The rate of hepatosteatosis was lower in patients with diverticulosis compared with the control group (27% versus 42%, respectively). Diabetes mellitus, hyperlipidaemia and hepatosteatosis were more common among patients aged <75 years. In the multivariate logistic regression analysis, diverticulosis remained an independent predictor of hepatosteatosis (odds ratio 0.529; 95% confidence interval 0.323, 0.866). Other independent predictive factors in the multivariate analysis were triglyceride and albumin.

Conclusion

Diverticulosis in the elderly was found to be a negative predictor of hepatosteatosis. Higher values of albumin and triglyceride in conjunction with the absence of diverticulosis may be suggestive of nonalcoholic fatty liver disease in the elderly.
The relationship between flow and music performance anxiety amongst professional classical orchestral musicians
Authors: Cohen Susanna , Bodner Ehud
Published: February 2018

Research investigating methods of facilitating classical music performance has tended to focus on treating the debilitating effects of Music Performance Anxiety (MPA). It has been suggested that flow and MPA may be antithetical experiences and that fostering techniques for facilitating flow may provide a powerful tool for helping to alleviate MPA. However, there is a scarcity of data exploring professional classical musicians’ experiences of flow, and little empirical evidence supporting a relationship between flow and MPA. The current study examined the flow experiences and the relationship between flow and MPA amongst 202 professional classical orchestral musicians in Israel. Results showed that the majority of participants regularly experience flow. Hierarchical regression analysis provided evidence of a strong, negative relationship between flow and MPA, supporting the suggestion that facilitating flow may provide a helpful approach for alleviating MPA. An additional exploratory investigation was made into performers’ experiences of Musical Emotional Contagion (MEC), the influence of the emotional contents of the music on the performer. Results showed that the majority of participants reported experiences of MEC and there was evidence of significant associations between MEC, flow and MPA. The clinical implications of the findings are discussed.
Utopianism and social change: Materialism, conflict and pluralism
Authors: Martell Luke
Published: February 2018

This article discusses criticisms that utopia and utopianism undermine social change. It outlines two types of utopia, future and current. It argues against claims that utopianism is idealist and steps aside from material and conflictual dimensions of society and so undermines change, proposing that utopias are material and conflictual and contribute to change. Against liberal and pluralist criticisms that utopianism is end-ist and totalitarian and terminates diversity and change, it argues that utopianism can encompass liberal and pluralist dimensions and be dynamic rather than static. It is proposed that criticisms create false conflations and dichotomies. Critical perspectives, rather than being rejected, are answered on their own terms. Utopianism, it is argued, is part of change, materially, now and in the future.
Lay Patient Navigators’ Perspectives of Barriers, Facilitators and Training Needs in Initiating Advance Care Planning Conversations With Older Patients With Cancer
Authors: Niranjan Soumya J. , Huang Chao-Hui S. , Dionne-Odom J. Nicholas , Halilova Karina I. , Pisu Maria , Drentea Patricia , Kvale Elizabeth A. , Bevis Kerri S. , Butler Thomas W. , Partridge Edward E. , Rocque Gabrielle B.
Published: February 2018

Context:

Respecting Choices is an evidence-based model of facilitating advance care planning (ACP) conversations between health-care professionals and patients. However, the effectiveness of whether lay patient navigators can successfully initiate Respecting Choices ACP conversations is unknown. As part of a large demonstration project (Patient Care Connect [PCC]), a cohort of lay patient navigators underwent Respecting Choices training and were tasked to initiate ACP conversations with Medicare beneficiaries diagnosed with cancer.

Objectives:

This article explores PCC lay navigators’ perceived barriers and facilitators in initiating Respecting Choices ACP conversations with older patients with cancer in order to inform implementation enhancements to lay navigator-facilitated ACP.

Methods:

Twenty-six lay navigators from 11 PCC cancer centers in 4 states (Alabama, George, Tennessee, and Florida) completed in-depth, one-on-one semistructured interviews between June 2015 and August 2015. Data were analyzed using a thematic analysis approach.

Results:

This evaluation identifies 3 levels—patient, lay navigator, and organizational factors in addition to training needs that influence ACP implementation. Key facilitators included physician buy-in, patient readiness, and navigators’ prior experience with end-of-life decision-making. Lay navigators’ perceived challenges to initiating ACP conversations included timing of the conversation and social and personal taboos about discussing dying.

Conclusion:

Our results suggest that further training and health system support are needed for lay navigators playing a vital role in improving the implementation of ACP among older patients with cancer. The lived expertise of lay navigators along with flexible longitudinal relationships with patients and caregivers may uniquely position this workforce to promote ACP.
Sized Out: Women, Clothing Size, and Inequality
Authors: Bishop Katelynn , Gruys Kjerstin , Evans Maddie
Published: February 2018

Feminist scholars have long critiqued the fashion industry’s ultra-thin beauty standards as harmful to women. Combining data from three qualitative studies of women’s clothing retailers—of bras, plus-size clothing, and bridal wear—we shift the analytical focus away from glamorized media images toward the seemingly mundane realm of clothing size standards, examining how women encounter, understand, and navigate these standards in their daily lives. We conceptualize clothing size standards as “floating signifiers,” given their lack of consistency within and across brands and the extent to which women engage in identity work and body work in relation to them. Our findings indicate that the instability of these unregulated standards allows some women—particularly those with bodies located closest to the boundaries between size categories—to claim conformity to body ideals and to access some of the associated psychological, social, and material privileges. However, even as individual women may benefit by distancing themselves from stigmatized size categories, this pattern renders women’s body acceptance tenuous while simultaneously reinforcing hierarchies among women based on body size and shape.
Illustrating war-time: Cartoons and the British and Dominion soldier experience during the Great War, 1914–1918
Authors: Chapman Jane , Wilson Ross
Published: February 2018

This article assesses how time was depicted within illustrated narratives published in trench newspapers and regimental journals by British and Dominion soldiers as a means of adapting to and enduring the experience of the First World War. Through an extensive archival study of these sources, soldiers’ ‘comic strips’ have been used to demonstrate that time is illustrated as a personal and social experience that enables individuals to comprehend their role within the army. Previous assessments of the experience of time on the battlefields have been dominated by the perception that mechanized warfare induced a fractured and disorientating sense of time. This has traditionally been heralded by scholars as indicating the arrival of a new ‘modern era’. However, research findings demonstrate the way in which soldiers illustrated time, the passing of time, the use of order, experience and progress are evident. Far from reflecting the alienating effect of modern warfare, soldiers illustrate ‘war-time’ as a means by which they inculcate themselves into a military culture and continue their role in the war.
Social Entrepreneurial Intentions of Students from Hong Kong
Authors: Ip Ching Yin , Wu Shih-Chia , Liu Huei-Ching , Liang Chaoyun
Published: February 2018

This study examined whether personality traits, creativity and social capital affect social entrepreneurial intentions. Using both online and offline surveys, a sample of 331 Hong Kong students was recruited for analyses. Factor analyses supported that personality traits could be divided into dimensions of extraversion, openness to experience, neuroticism, conscientiousness and agreeableness; creativity could be divided into dimensions of originality and usefulness; and social capital could be divided into dimensions of bridging and bonding. The results from multiple regression analysis revealed that openness negatively predicted social entrepreneurial intentions, whereas originality positively predicted social entrepreneurial intentions. However, no direct association was found between social capital and social entrepreneurial intentions. The reason for the negative relationship between openness and social entrepreneurial intentions, which contradicted our initial claim, is discussed.
An Empirical Investigation into Institutions Unlocking Entrepreneurial Activity
Authors: Urban Boris , Muzamhindo Angeline
Published: February 2018

Entrepreneurship scholars tend to agree that institutional factors influence entrepreneurship; however, empirical studies have led to different conclusions with regard to the relative importance of each driver. This study empirically investigates the influence that the regulatory, cognitive, normative and conducive institutional factors have on different types of entrepreneurial activity (EA) in South Africa. Following a survey of 163 ventures, regression results reveal that it is the cognitive and conducive institutional environments, which have a significant impact on EA. These results highlight the importance of institutional environmental factors in relation to opportunity-based EA. Additionally, the findings provide key insights to scholars and policymakers where institutional factors in an emerging market context serve as a catalyst for EA.
Book Review: Susana C Santos, Antonio Caetano, Craig Mitchell, Hans Landstrom and Alain Fayolle (Eds), The Emergence of Entrepreneurial Behaviour: Intention, Education and Orientation
Authors: Shankar Raj K.
Published: February 2018

Susana C Santos, Antonio Caetano, Craig Mitchell, Hans Landstrom and Alain Fayolle (Eds), The Emergence of Entrepreneurial Behaviour: Intention, Education and Orientation, Cheltenham, UK: Edward Elgar Publishing, 2017, 320 pp.
Parapoxviral vulvovaginitis in Holstein cows
Authors: Moeller Robert B. , Crossley Beate , Adaska John M. , Hsia Gary , Kahn Richard , Blanchard Patricia C.
Published: February 2018

A group of Holstein first-calved heifers developed small pustules and ulcers on the vulva and in the vagina during the first 1–4 wk postpartum. The lesions varied from small red pinpoint foci to pustules and ulcers, 3–5 mm diameter. Some ulcers coalesced to form large ulcerated areas up to 15 mm diameter. In some animals, these ulcers progressed to become deep ulceration of the vaginal and vulvar mucosa with >50% of the mucosa involved. Vaginal biopsies from 4 heifers and vaginal individual swabs from 8 heifers for a combined sampling of 9 heifers were taken for clinical assessment. Six of the 9 heifers had parapoxvirus based on histopathology and/or PCR. Histologic examination of the biopsies of the pustules identified ballooning degeneration of the epithelium with degenerate epithelium containing eosinophilic intracytoplasmic inclusions consistent with a parapoxvirus in 3 of 4 biopsies. Testing for bovine herpesvirus 1, 2, and 4, bovine viral diarrhea virus, bovine papular stomatitis virus, and orf virus remained negative.
Commentary: Who Are Your Friends? The Influence of Identification and Family In-Group and Out-Group Friendships on Nonfamily Employee OCB and Deviance
Authors: Marler Laura E. , Stanley Laura J.
Published: February 2018

We refine the findings of Vardaman, Allen, and Rogers that indicate the structural position of nonfamily employees in friendship networks can enhance organizational identification and reduce turnover in family firms. We extend their work by offering a more nuanced perspective that not all friendships are created equal. We propose that a family friend’s membership in the family in-group or out-group influences nonfamily employees’ organizational identification, and in turn, their behavior (i.e., organizational citizenship behavior and deviance). Our theorizing expands the nascent literature on nonfamily employees, offering a theoretical rationale for their complex and often poorly understood behavior.
Social partner gaze direction and conversational phase; factors affecting social attention during face-to-face conversations in autistic adults?
Authors: Freeth Megan , Bugembe Patricia
Published: February 2018

Social attention is atypical in autism. However, the majority of evidence for this claim comes from studies where the social partner is not physically present and the participants are children. Consequently, to ensure acquisition of a comprehensive overview of social attention in autism, systematic analysis of factors known to influence face-to-face social attention in neurotypicals is necessary and evidence from adulthood is required. This study assessed the influence of experimenter gaze direction (direct or averted) and conversational phase (speaking or listening) on social attention during a face-to-face conversation. Eye-tracking analyses indicated that when the experimenter looked directly at the participant, autistic adults looked at the experimenter’s face less than did neurotypical adults. However, this between-group difference was significantly reduced when the experimenter’s gaze was averted. Therefore, opportunities for reciprocal social gaze are missed by autistic adults when the social partner makes direct eye contact. A greater proportion of time was spent fixating the experimenter’s eye region when participants were speaking compared to listening in both neurotypical and autistic adults. Overall, this study provides a rich picture of the nature of social attention in face-to-face conversations adopted by autistic adults and demonstrates individual variation in social attention styles.
Is the environment in kindergarten associated with the vegetables served and eaten? The BRA Study
Authors: Himberg-Sundet Anne , Kristiansen Anne Lene , Bjelland Mona , Moser Thomas , Holthe Asle , Andersen Lene F. , Lien Nanna
Published: February 2018

Aim: The aim of the present study was to explore the associations between the economic, political, sociocultural and physical environments in kindergartens, along with the frequency and variety of vegetables served, and the amount of vegetables eaten. Method: The BRA Study collected data through two paper-based questionnaires answered by the kindergarten leader and pedagogical leader of each selected kindergarten, and a five-day vegetable diary from kindergartens ( n = 73) in Vestfold and Buskerud Counties, Norway. The questionnaires assessed environmental factors, and the frequency and variety of vegetables served. The non-parametric Mann–Whitney U and Kruskal–Wallis tests were used to explore the associations between factors in the kindergarten environments and vegetables served and eaten. Results: Kindergartens that included expenditures for food and beverages in the parental fees served a larger variety of vegetables ( p = 0.046). A higher frequency of served vegetables ( p = 0.014) and a larger amount ( p = 0.027) of vegetables eaten were found in kindergartens where parents paid a monthly fee of 251 NOK or more. Similarly, the amount of vegetables eaten was higher ( p = 0.017) in kindergartens where the employees paid a monthly fee to eat at work. Furthermore, a larger amount ( p = 0.046) of vegetables was eaten in kindergartens that had written guidelines for food and beverages that were offered. Conclusions: This study indicates that the economic environment in a kindergarten seems to be positively associated with the vegetables served and eaten there. This is of high relevance for public health policy as vegetable consumption is an important factor in reducing the risk of non-communicable diseases.
Maximal Strength Training as a Therapeutic Approach in Long-Standing Anorexia Nervosa: A Case Study of a Woman With Osteopenia, Menstrual Dysfunction, and Compulsive Exercise
Authors: Bratland-Sanda Solfrid , Øverby Nina Cecilie , Bottegaard Anette , Heia Morten , Støren Øyvind , Sundgot-Borgen Jorunn , Torstveit Monica Klungland
Published: February 2018

In persons with anorexia nervosa (AN), compulsive exercise and osteopenia are common symptoms. Although treatment of osteopenia besides weight regain is lacking, maximal strength training (MST) has been found to be effective in other populations. Such training has not been prescribed to those with AN due to uncertainty of tolerance. We therefore examined use of MST in a woman with long-standing AN, osteopenia, menstrual dysfunction, and compulsive exercise. The MST intervention consisted of four exercises: three sets of five repetitions maximum (RM), 3 times per week for 16 weeks. We examined muscle strength, bone mineral density (BMD), AN psychopathology, and compulsive exercise at baseline, posttest, and 6-month follow-up. Attendance rate was 100%. The subject improved muscle strength by 20% to 40%. BMD in lumbar spine improved by 4% to posttest, and by 8% from baseline to 6-month follow-up. The BMD T-scores shifted from values classified as osteopenic to normal values throughout the course of the intervention, despite continuance of menstrual dysfunction and lack of weight gain. No changes in AN psychopathology or levels of compulsive exercise were detected. Perceived psychological benefits including new bodily experiences were self-reported by the subject, emphasizing the importance of close follow-up by competent instructors.